bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of non-single canals in mandibular premolars and correlations with other anatomical variants: an in vivo cone beam computed tomography study
Authors: Jang Young-Eun , Kim Yemi , Kim Bom Sahn , Kim Sin-Young , Kim Hyung-Jong 
Published: September 2019

Abstract
Background: A knowledge regarding anatomical variants is important to achieve success in endodontic treatment. Root canal treatment of mandibular first premolars (PM1s) is challenging due to the existence of numerous variations in canal configurations, including a C-shaped variant. We aim to determine the frequency and morphologic characteristics of non-single canals of mandibular first (PM1s) and second (PM2s) premolars in a Korean population using cone beam computed tomography (CBCT) and to evaluate correlations between non-single canals of PM1s and other anatomical variants, such as distolingual roots (DLRs) in mandibular first molars (M1s) and C-shaped canals in mandibular second molars (M2s). Methods: A total of 971 PM1s and 997 PM2s from 500 patients were examined in vivo by CBCT. Root canal configurations and C-shaped canals were determined in accordance with the Vertucci classification and Fan classification, respectively. The correlation between non-single canals in PM1s and DLRs in M1s was evaluated using logistic regression analysis. Results: PM2s typically had one root (99.89%) with one canal (98.4%). Among PM1s with non-single canals (21.2%), Vertucci type V (10.9%) and C-shaped (3.7%) canals were prevalent. Among C-shaped PM1 canals, the majority were Vertucci type V (77.8%); a C-shaped configuration (C2) was predominant mostly at the middle and/or apical third of the root. After adjusting for other variables (i.e., sex, age, and side), C-shaped canals in PM1s was significantly correlated with the presence of DLRs in M1s (odds ratio = 2.616; 95% confidence interval, 1.257–5.443; p = 0.010). Conclusions: The presence of C-shaped PM1 canals was positively related to the presence of DLRs in M1s. Although C-shaped canals in PM1s are difficult to distinguish, this finding could aid clinicians in predicting C-shaped canal configurations in PM1s of patients who exhibit DLRs in M1s.
Efficacy and safety of sodium zirconium cyclosilicate in patients with baseline serum potassium level ≥5.5 mmol/L: pooled analysis from two phase 3 trials
Authors: Amin Alpesh N. , Menoyo Jose , Singh Bhupinder , Kim Christopher S. 
Published: September 2019

Abstract
Background: Reliable, timely-onset, oral treatments with an acceptable safety profile for patients with hyperkalemia are needed. We examined the efficacy and safety of sodium zirconium cyclosilicate (SZC; formerly ZS-9) treatment for ≤48 hours in patients with baseline serum potassium level ≥5.5 mmol/L.
Methods: Data were pooled from two phase 3 studies (ZS-003 and HARMONIZE) among patients receiving SZC 10 g three times daily. Outcomes included mean and absolute change from baseline, median time to potassium level ≤5.5 and ≤5.0 mmol/L, and proportion achieving potassium level ≤5.5 and ≤5.0 mmol/L at 4, 24, and 48 hours. Outcomes were stratified by baseline potassium. Safety outcomes were evaluated.
Results: At baseline, 125 of 170 patients (73.5%) had potassium level 5.5–<6.0, 39 (22.9%) had potassium level 6.0–6.5, and 6 (3.5%) had potassium level >6.5 mmol/L. Regardless of baseline potassium, mean potassium decreased at 1-hour post-initial dose. By 4 and 48 hours, 37.5% and 85.0% of patients achieved potassium level ≤5.0 mmol/L, respectively. Median (95% confidence interval) times to potassium level ≤5.5 and ≤5.0 mmol/L were 2.0 (1.1–2.0) and 21.6 (4.1–22.4) hours, respectively. Fifteen patients (8.8%) experienced adverse events; none were serious.
Conclusions: SZC 10 g three times daily achieved serum potassium reduction and normokalemia, with a favorable safety profile.
ClinicalTrials.gov identifiers: NCT01737697 and NCT02088073
Evaluation of the secondary use of electronic health records to detect seasonal, holiday-related, and rare events related to traumatic injury and poisoning
Authors: Bergquist Timothy , Pejaver Vikas , Hammarlund Noah , Mooney Sean D. , Mooney Stephen J. 
Published: September 2019

Abstract
Background The increasing adoption of electronic health record (EHR) systems enables automated, large scale, and meaningful analysis of regional population health. We explored how EHR systems could inform surveillance of trauma-related emergency department visits arising from seasonal, holiday-related, and rare environmental events. Methods We analyzed temporal variation in diagnosis codes over 24 years of trauma visit data at the three hospitals in the University of Washington Medicine system in Seattle, Washington, USA. We identified seasons and days in which specific codes and categories of codes were statistically enriched, meaning that a significantly greater than average proportion of trauma visits included a given diagnosis code during that time period. Results We confirmed known seasonal patterns in emergency department visits for trauma. As expected, cold weather-related incidents (e.g. frostbite, snowboarding injury) were enriched in the winter, whereas fair weather-related incidents (e.g. bug bites, boating accidents, bicycle accidents) were enriched in the spring and summer. Our analysis of specific days of the year found that holidays were enriched for alcohol poisoning, assaults, and firework accidents. We also detected one time regional events such as the 2001 Nisqually earthquake and the 2006 Hanukkah Eve Windstorm. Conclusions Though EHR systems were developed to prioritize operational rather than analytic priorities and have consequent limitations for surveillance, our EHR enrichment analysis nonetheless re-identified expected temporal population health patterns. EHRs are potentially a valuable source of information to inform public health policy, both in retrospective analysis and in a surveillance capacity.
The value of GRASP on DCE-MRI for assessing response to neoadjuvant chemotherapy in patients with esophageal cancer
Authors: Lu Yanan , Ma Ling , QIN Jianjun , Wang Zhaoqi , Guo Jia , Zhao Yan , Zhang Hongkai , Yan Xu , Liu Hui , Li Hailiang , Kamel Ihab R , Qu Jinrong 
Published: September 2019

Abstract
Background To compare the value of two dynamic contrast-enhanced Magnetic Resonance Images (DCE-MRI) reconstruction approaches, namely golden-angle radial sparse parallel (GRASP) and view-sharing with golden-angle radial profile (VS-GR) reconstruction, and evaluate their values in assessing response to neoadjuvant chemotherapy (nCT) in patients with esophageal cancer (EC).

Methods

EC patients receiving nCT before surgery were enrolled prospectively. DCE-MRI scanning was performed after nCT and within 1 week before surgery. Tumor Regression Grade (TRG) was used for chemotherapy response evaluation, and patients were stratified into a responsive group (TRG1+2) and a non-responsive group (TRG3+4+5). Wilcoxon test was utilized for comparing GRASP and VS-GR reconstruction, Kruskal-Wallis and Mann-Whitney test was performed for each parameter to assess response, and Spearman test was performed for analyzing correlation between parameters and TRGs, as well as responder and non-responder. The receiver operating characteristic (ROC) was utilized for each significant parameter to assess its accuracy between responders and non-responders.

Results

Among the 64 patients included in this cohort (52 male, 12 female; average age of 59.1±7.9 years), 4 patients showed TRG1, 4 patients were TRG2, 7 patients were TRG3, 11 patients were TRG4, and 38 patients were TRG5. They were stratified into 8 responders and 56 non-responders.

A total of 15 parameters were calculated from each tumor. With VS-GR, 10/15 parameters significantly correlated with TRG and response groups. Of these, only AUCmax showed moderate correlation with TRG, 7 showed low correlation and 2 showed negligible correlation with TRG. 8 showed low correlation and 2 showed negligible correlation with response groups. With GRASP, 13/15 parameters significantly correlated with TRG and response groups. Of these, 10 showed low correlation and 3 showed negligible correlation with TRG. 11 showed low correlation and 2 showed negligible correlation with TRG. Seven parameters (AUC ＊ >0.70, P<0.05) showed good performance in response groups.

Conclusions

In patients with esophageal cancer on neoadjuvant chemotherapy, several parameters can differentiate responders from non-responders, using both GRASP and VS-GR techniques. GRASP may be able to better differentiate these two groups compared to VS-GR.
Lack of association between intraoperative handoff of care and postoperative complications: a retrospective observational study
Authors: O'Reilly-Shah Vikas N , Melanson Victoria G , Sullivan Cinnamon L , Jabaley Craig S , Lynde Grant C 
Published: September 2019

Abstract
Background:
The significance of intraoperative anesthesia handoffs on patient outcomes are unclear. One aspect differentiating the disparate results is the treatment of confounding factors, such as patient comorbidities and surgery time of day. We performed this study to quantify the significance of confounding variables on composite adverse events during intraoperative anesthesia handoffs.
Methods:
In this retrospective study, we analyzed data from the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP). We examined the effects of intraoperative handoffs between anesthesia personnel. A total of 12,111 cases performed examined at two hospitals operated by a single healthcare system that were that included in the ACS NSQIP database performed. The presence of attending and anesthetist or resident handoffs, patient age, sex, body mass index, American Society of Anesthesiologists Physical Status (ASA-PS) classification, case length, surgical case complexity, and evening/weekend start time were measured.
Results:
A total of 2,586 of all cases in the NSQIP dataset experienced a handoff during the case. When analyzed as a single variable, attending handoffs were associated with higher rates of adverse outcomes. However, once confounding variables were added into the analysis, attending handoffs and complete care transitions were no longer statistically significant.
Conclusions:
Inclusion of significant covariates is essential to fully understanding the impact provider handoffs have on patient outcomes. Case timing and lengthy case duration are more likely to result in both a handoff and an adverse event. The impact of handoffs on patient outcomes seen in the literature are likely due, in part, to how covariates were addressed.
Willingness to adopt wearable devices with behavioral and economic incentives by health insurance wellness programs: results of a US cross-sectional survey with multiple consumer health vignettes
Authors: Soliño-Fermández Diego , Ding Alexander , Bayro-Kaiser Esteban , Ding Eric L. 
Published: September 2019

Abstract
Background: The number of health-related wearable devices is growing but it is not clear if Americans are willing to adopt health insurance wellness programs based on wearables and the incentives with which they would be more willing to adopt.

Methods: In this cross-sectional study we used a survey methodology, usage vignettes and a dichotomous scale to examine U.S. residents’ willingness to adopt wearables (WTAW) in six use-cases where it was mandatory to use a wearable device and share the resulting data with a health insurance company. Each use-case was tested also for the influence of additional economic incentives on WTAW.

Results: A total of 997 Americans across 46 states participated in the study. Most of them were 25 to 34 years old (40.22%), 57.27% were female, and 74.52% were white. On average, 69.5% of the respondents were willing to adopt health-insurance use-cases based on wearable devices, though 77.8% of them were concerned about issues related to economic benefits, data privacy and to a lesser extent, technological accuracy. WTAW was 11-18% higher among consumers in use-cases involving health promotion and disease prevention. Furthermore, additional economic incentives combined with wearables increased WTAW overall. Notably, financial incentives involving providing healthcare credits, insurance premium discount, and/or wellness product discounts had particularly greater effectiveness for increasing WTAW in the consumer use-cases involving participation: for health promotion (RR=1.06 for financial incentive, 95% CI: 1.01-1.11; P=0.018); for personalized products and services (RR=1.11 for financial incentive, 95% CI: 1.01-1.21; P=0.018); and for automated underwriting discount at annual renewal (RR=1.28 for financial incentive, 95% CI: 1.20-1.37; P<0.001).

Conclusions:
Under the adequate economic, data privacy and technical conditions, 2 out of 3 Americans would be willing to adopt health insurance wellness programs based on wearable devices, particularly if they have benefits related to health promotion and disease prevention, and particularly with financial incentives.
Parenchymal central nervous system involvement in aggressive B-cell lymphoma: retrospective analysis of clinical and MRI features in a Chinese population
Authors: Wu Yuchen , Wang Yaming , Sun Xuefei , Bai Xueyan , Qian Jun , Zhu Hong , Cui Qu , Xing Ruixian , Chen Yuedan , Liu Qing , Guo Jiayuan , Ji Nan , Sun Shengjun , Liu Yuanbo 
Published: September 2019

Abstract
Introduction: Secondary central nervous system lymphoma (SCNSL) was defined as secondary central nervous system (CNS) involvement in patients with systemic lymphoma. Parenchymal involvement of the CNS in aggressive B-cell lymphoma was rare and remains a diagnostic dilemma. Materials and Methods: In our study, we retrospectively analyzed the clinical and magnetic resonance imaging (MRI) features of 26 parenchymal SCNSL patients. In addition, we compared MRI features between SCNSL and primary CNS lymphoma (PCNSL) patients after 1:1 propensity score matching. Results: Among SCNSL patients, the median CNS relapse time was 3 months, and multiple lesions were found in 76.9% of the cases. In PCNSL, this percentage was 34.8% (p=0.023). None of the SCNSL patients and 11.5% of the PCNSL patients had solitary infratentorial lesions (p=0.011). Conclusions: The majority of parenchymal involvement occurred within the first year of systemic lymphoma, in which mostly cases presenting with multiple and supratentorial locations, unlike what was found in PCNSL.
Knowledge of neonatal danger signs and associated factors among mothers who gave birth during the last four months while attending immunization services in Harar town public health facilities, Ethiopia.
Authors: Tekulu Fissaha welay , Kassa Nega Assefa , Hadera Gebrekiros Aregawi , Assefa Natnael Etsay , Mengesha Meresa Berwo , Weldemariam Mulu Gebretsadik , Gebremeskel Senait Gebreslasie 
Published: September 2019

Abstract
Objective:
The purpose of this study was to assess knowledge about neonatal danger signs and associated factors among mothers who gave birth in the last 4 months attending immunization services.
Result: The study recruited 432 mothers to participate. A knowledge score of neonatal danger signs was found [32.9% (95% CI: 28.9%, 37%)]. Mothers educated to secondary level were 4.9 times more likely to know about neonatal danger signs [(AOR=4.9, 95% CI: (1.15, 21). Similarly, mothers whose husband educated to college and above [AOR=4.95, 95% CI: (1.15, 21)], and being multipara mother [(AOR=2.59, 95% CI: (1.05, 6.6)], were factors significantly associated with good knowledge of mothers about neonatal danger signs.
Keywords: Neonatal danger sign, Mothers' knowledge, Immunization
Efficacy and safety of self-expanding metallic stent placement followed by neoadjuvant chemotherapy and scheduled surgery for treatment of obstructing left-sided colonic cancer
Authors: Han Jia Gang , Wang Zhen Jun , Zeng Wei Gen , Wang Yan Bin , Wei Guang Hui , Zhai Zhi Wei , Zhao Bao Cheng , Yi Bing Qiang 
Published: September 2019

Abstract
BACKGROUND: Stoma is reported to be frequent in self-expanding metallic stent (SEMS) treated patients with obstructing left-sided colon cancer than in those with non-obstructing surgery. This study aimed to evaluate the safety and feasibility of SEMS followed by neoadjuvant chemotherapy prior to elective surgery for obstructing left-sided colon cancer. METHODS: Eleven consecutive patients with obstructing left-sided colon cancer between May 2014 and November 2015 were included retrospectively. All patients received SEMS followed by neoadjuvant chemotherapy. The primary outcome measure was stoma and laparoscopic surgery. RESULTS: Chemotherapy was with two cycles of CAPOX (54.5%) or three cycles mFOLFOX6 (45.5%). Median serum albumin and hemoglobin levels before surgery were significantly higher than before neoadjuvant chemotherapy (p = 0.01 and p = 0.008 respectively) and before SEMS (p = 0.01 and p = 0.003 respectively). Median bowel wall thickness proximal to the upper edge of tumor was significantly more before neoadjuvant chemotherapy than before stent (p = 0.003), and significantly less before surgery than before neoadjuvant chemotherapy (p = 0.003). No patient underwent stoma creation. Laparoscopic surgery was performed in nine (81.8%) patients. No local recurrence or metastases developed over median cancer-specific follow-up of 44 months (range, 37-55 months). CONCLUSION: SEMS followed by neoadjuvant chemotherapy prior to elective surgery appears to be safe and well tolerated in patients with obstructing left-sided colon cancer.NCT02972541; retrospectively registered
The Influence of Marital Status on Survival in Patients with Nasopharyngeal Carcinoma: A Surveillance, Epidemiology, and End Results (SEER) Database Analysis
Authors: Yu Bin , Ning Hong , Xu Shan , Qin Li , Lin Bin-wei , Lin Fei 
Published: September 2019

Abstract
Purpose: To assess the influence of marital status on survival in patients with nasopharyngeal carcinoma (NPC). Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to analyze 5477 patients who were diagnosed with NPC from 2004 to 2016. Kaplan–Meier survival analysis and Cox proportional hazard regression were used to analyze the influences of marital status on cause-specific survival (CSS) and overall survival (OS). Subgroup analyses was used to assess the influences of marital status on CSS based on different factors. Results: The 5477 patients were divided into three groups, with 61.5%, 22.4%, and 16.1% of patients being married, single/unmarried, and separated/widowed/divorced, respectively. The separated/widowed/divorced group were more likely to be female ( P <0.001); had the highest proportion of elderly subjects ( P <0.001); were mostly Caucasian ( P <0.001); had pathological grading I/II ( P <0.001); were likely to receive surgery ( P =0.032); and were registered at the northeast, north central, and south ( P < 0.001) regions. The 5-year CSS was 92.6%, 92.4%, and 85.1% in the married, single/unmarried, and separated/widowed/divorced groups, respectively ( P <0.001); and respective 5-year OS was 60.7%, 54.6%, and 40.1% ( P <0.001). Marital status was the independent prognostic factor for NPC. Compared with married patients, separated/widowed/divorced patients had a significantly increased risk of NPC-related death (hazard ratio [HR]=2.180, 95% confidence interval [CI] 1.721–2.757, P <0.001). The single/unmarried ( P =0.355) group had a similar CSS as that of the group. Conclusion: Marital status is an independent prognostic factor for survival of NCP patients. Separated/widowed/divorced status increases the risk of NPC mortality; hence, more social and psychosocial support should be given to patients who are separated, widowed, or divorced.
Discussion on perioperative anesthesia rescue treatment for DIC parturients with severe placental abruption
Authors: Wang Author Shihong , Wang Hua 
Published: September 2019

Abstract
Background: To investigate perioperative anesthesia rescue treatment method and effect of DIC parturients with severe placental abruption. Methods: Designed as a retrospective inductive analysis, the present study included 6 parturients of DIC with severe placental abruption who were admitted to Dalingshan Hospital of Dongguan City from January 2013 to December 2018. The research further studied and analyzed the perioperative anesthesia treatment of 6 DIC parturients with severe placental abruption. Observation indicators included (1) Preoperative evaluation, (2) Intraoperative conditions, and (3) Follow-up after operation. Results: (1) Preoperative evaluation: 25 cases of severe placental abruption were grade III ASA, including 3 stillbirths. (2) Intraoperative conditions: 6 cases of DIC parturients were confirmed to have severe placental abruption, including 3 stillbirths. (3) Postoperative follow-up: All the 6 parturients were cured without any complications. Conclusion: Standardized rescue processing method with multidisciplinary cooperation, rapid and advanced intervention, and simultaneous multiple measures can improve the operative safety of parturients with placental abruption.
Assessment of food taboos and related misconceptions during pregnancy in Mekelle city, Tigray, Northern Ethiopia
Authors: Tela Freweini Gebrearegay , Gebremariam Lemlem Weldegerima , Beyene Selamawit Asfaw 
Published: September 2019

Abstract
Introduction Communities, rural or urban, have their own taboos and misconceptions regarding what type of foods to consume and avoid during pregnancy and why. In Ethiopia, as in many other developing countries, there are misconceptions on specific quality and quantity of food a pregnant woman should or should not eat during pregnancy, affecting their nutritional status. Despite this, information related to food taboos in Ethiopia is lacking. Therefore, this study assessed food taboos and related misconceptions during pregnancy in Mekelle city, Tigray, Northern Ethiopia.Method A cross-sectional study was conducted among 332 pregnant women who were in antenatal care follow-up in selected private clinics starting from January 1st up to June/30/2017. A semi-structured questionnaire consisting of closed and open ended questions was prepared in the way that it can assess the food taboo practices, types of foods avoided, and the perceived reasons for avoidance. Data were entered in to SPSS version 21 for analysis. The results were described using frequency and percentage, and presented using tables. Cross-tabulation (x 2 - test) was used to analyze the association between different socio-demographic variables and food taboo practice. Statistical significance was declared at P -value < 0.05 and 95% confidence interval (CI).Result The results of this study indicate that 11.5% of the pregnant women avoided at least one type of food during their current pregnancy because of different perceptions. The mothers were forbidden from taking food items such as yogurt, banana, legumes, honey, “kollo” (roasted barley and wheat), and spices (mustard). The most common perceptions for the avoidance of these foods were abortion, abdominal cramp to the mother and newborn, prolonged labor, and coating to the body of the fetus. Among the socio-demographic characteristics studied, educational status was found to significantly influence food taboo practices among the study participants (P<0.0001).Conclusion The misconception on the feeding practice during pregnancy should be discouraged, and health providers should promptly counsel pregnant women about appropriate feeding practices during their ANC visits.