bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nodal Metastases in Pediatric and Adult Acinic Cell Carcinoma of the Major Salivary Glands
Authors: Dublin Jared C. , Oliver Jamie R. , Tam Moses M. , Persky Michael J. , Jacobson Adam S. , Liu Cheng , Hu Kenneth S. , Vaezi Alec E. , Morris Luc G.T. , Givi Babak 
Published: March 2022

ObjectiveAcinic cell carcinoma (AciCC) is a rare, usually low‐grade salivary malignancy. Evidence on rates of lymph node metastases (LNMs) is limited in pediatric patients and varies significantly (4%‐45%) in adults. We set out to determine and compare rates of LNMs in pediatric and adult AciCC and to analyze their impact on survival, using the National Cancer Database.Study DesignHistorical cohort study.SettingNational Cancer Database.MethodsAll AciCCs of the major salivary glands with complete clinical and pathologic nodal staging were selected between 2010 and 2016. Patient demographics, tumor characteristics, treatment, and survival were analyzed. Univariable and multivariable regression were performed to determine factors associated with LNMs and survival.ResultsWe identified 57 (4.6%) pediatric patients (<18 years) and 1192 (95.4%) adults with AciCC. Clinical LNMs were rare in pediatric patients (n < 10) and adults (n = 88, 7.4%). Occult LNMs were uncommon in pediatric patients (n < 5) and adults (n = 41, 4.6%). Three‐year overall survival for pediatric patients was 97.8%. Adults with LNM had worse 3‐year overall survival than those without (66.0% vs 96.3%, P <. 001). In multivariable regression, high‐grade disease (hazard ratio, 10.15 [95% CI, 5.60‐18.80]; P <. 001) and T3‐T4 tumors (hazard ratio, 2.80 [95% CI, 1.56‐4.97]; P <. 001) were associated with LNM in adult patients.ConclusionLNMs in AciCC of the major salivary glands are rare in children and adults. However, high‐grade and T3‐T4 tumors are associated with an increased risk of LNM. LNM is associated with worse survival.
Interval cancers in a population-based screening program for colorectal cancer with gender-specific cut-off levels for fecal immunochemical test
Authors: Ribbing Wilén Hanna , Saraste Deborah , Blom Johannes 
Published: March 2022

Objective To evaluate interval cancers (IC) in the population-based Swedish regional colorectal cancer (CRC) screening program of Stockholm-Gotland, which uses gender-specific cut-off levels for the fecal immunochemical test (FIT). Methods All individuals aged 60–69 in Stockholm-Gotland invited to the screening program in October 2015 to September 2017 were followed up 2 years after invitation. Cut-off level for a positive FIT was 40 µg/g in women and 80 µg/g in men. Those with a positive FIT were referred to colonoscopy. Screening-detected CRC (SD-CRC) and IC after negative FIT (FIT-IC) or negative screening colonoscopy (Colonoscopy-IC) were identified in the Swedish colorectal cancer register. The IC rate was calculated as IC/(FIT negatives + negative screening colonoscopies). The IC incidence rate (ICs among negatives per 100,000 person-years) in different sex and age groups was compared to the mean CRC incidence before regional screening implementation. Test sensitivity was defined as SD-CRC/(SD-CRC + FIT-IC). Results Approximately 214,400 individuals were invited, and in 3521 screening colonoscopies 257(6.3%) SD-CRCs were detected. During follow-up, 124 FIT-IC and 7 Colonoscopy-IC were diagnosed, yielding an IC rate of 12.6 and 6.0 per 10,000 negatives ( p = 0.00005) and a test sensitivity of 62% and 75% ( p = 0.01) in men and women respectively. The IC incidence rate compared to CRC incidence was non-significantly lower in women. Conclusion In the population-based screening program of Stockholm-Gotland with a cut-off of 40 µg/g in women and 80 µg/g in men, the test sensitivity was higher and the IC rate was lower in women, which might imply lowering the cut-off level in men. However, the IC incidence rate relative to the CRC incidence was similar in both genders.
Technological Efforts, Firm Ownership and Productivity: A Study of Information Technology Service Firms in India
Authors: Goswami Asmita , Narayanan K. 
Published: March 2022

The article presents differences in firm-level total factor productivity in the information technology (IT) service firms in India over the period 2000–2016. It is an attempt to study whether technological efforts contribute to productivity differences in the firms in conjunction with several other firm specific characteristics. Controlling for endogeneity in inputs, the estimation of productivity through semi-parametric techniques indicates considerable heterogeneity in productivity across firm types. Technological efforts of firms have a significant impact on the productivity of IT firms. Both embodied technology imports and in-house R&D contribute to higher productivity. While the Indian firms are observed to be more productive compared to their foreign counterparts, the technological efforts also differ due to ownership factors and that contributes to changes in productivity. JEL: D24, O14, O39
Development of scheme to evaluate the performance of parachute canopy fabrics under tensile impact
Authors: Behera Gyana R , Mukhopadhyay Arunangshu , Sikka Monica 
Published: March 2022

The present research is an extension of the earlier work wherein a wider scheme of small-scale tensile impact testing is proposed, to characterise the whole parachute canopy instead of full-scale wind tunnel testing. The drop height for equivalent tensile impact on the rectangular stitched specimens is chosen as 300 mm, and accordingly, the dimension (Length × Width) has been decided (300 mm × 100 mm). To evaluate the performance of stitched specimen (at 45° bias angle), ungripped width of 20 mm on both sides of the specimen has been worked out. In the work, the actual payload responsible for parachute inflation has been addressed for the calculation of the exact opening shock force. Subsequently, to apply impact load on the specimen, dead weights are predicted based on the different levels of opening shock forces of the C-9 parachute canopy under different aerodynamic conditions. Considering a specific case, the behaviour of the ripstop and plain-woven fabric sample in terms of load versus extension curve and work done at the time of impact have been analysed under different loads using a high-speed digital camera. This study revealed that the plain-woven fabric is to be preferred for human dropping because it has a higher extension and higher impact duration than ripstop fabric. As a result, the plain-woven fabric will produce a lower impact or shock force in the parachute canopy which is to be transferred to the skydiver. On the other hand, ripstop fabric possesses higher strength, therefore can be preferred for materials dropping.
Angiosarcoma of a Femoropopliteal Bypass Thrombosed Vein Graft
Authors: Veterano Carlos , Teixeira Sérgio , Silva Ivone , Coelho Andreia , Almeida Rui , Pinto Pedro Sá 
Published: March 2022

Background Angiosarcoma is a rare subtype of malignant vascular tumours which has been only anecdotally described in patients submitted to lower limb revascularization. Case presentation This paper reports a patient previously submitted to a femoropopliteal bypass using autologous great saphenous vein (GSV). Nine years after the initial surgery, a primary angiosarcoma of the thrombosed vein graft was diagnosed, requiring en bloc surgical resection. Rampant metastatic spread was documented despite primary tumour surgical resection with a dismal outcome within months. Conclusions Malignant transformation of autologous vein for lower limb revascularization is extremely rare and anecdotally described in the literature. It is a poorly studied complication with an aggressive behaviour. This report further reinforces the need for early recognition of this pathology.
Real-World Use of Continuous Glucose Monitoring Systems Among Adolescents and Young Adults With Type 1 Diabetes: Reduced Burden, but Little Interest in Data Analysis
Authors: Huhn Friederike , Lange Karin , Jördening Mia , Ernst Gundula 
Published: March 2022

Background:Since 2016, German health insurance companies reimburse continuous glucose monitoring (CGM) systems for persons with insulin-dependent diabetes, leading to a tremendous increase of CGM use. This study assessed the use of CGM, the satisfaction with, and the data analysis behavior among young people.Methods:During a diabetes camp for young people from all over Germany, participants anonymously answered a questionnaire on their method of glucose monitoring, satisfaction and quality of CGM use, HbA1c, and diabetes distress (Problem Areas in Diabetes Scale [PAID]-5).Results:A total of 308 participants (age 21.4 ± 3.5 years; 73% female; diabetes duration 10.1 ± 5.9 years) completed the questionnaire. Approximately, 25% used self-monitoring of blood glucose (SMBG), 46% intermittent-scanning continuous glucose monitoring (iscCGM), and 30% real-time continuous glucose monitoring (rtCGM). Mean HbA1c was slightly, but not significantly, higher among SMBG users compared with CGM users (8.0% ± 1.9% vs. 7.7% ± 1.4%; P = .791). Diabetes distress was not associated with the method of glucose monitoring (SMBG 5.6 vs. iscCGM 6.2 vs. rtCGM 6.5; P = .386). Overall, satisfaction with CGM use was very high; 98% of the CGM users reported better well-being with CGM compared with previous SMBG use. Only 19% of CGM users reported regular data analyses; their HbA1c was lower compared with other CGM users (7.2% ± 1.2% vs. 7.7% ± 1.4%; P = .039).Conclusions:In this large sample of young people, 75% were using a CGM system. Treatment satisfaction was very high, but CGM use was not associated with reduced diabetes distress or better glycemic control. However, young people who regularly analyzed their CGM data reported lower HbA1c levels.
Endoscopic Endonasal Repair of the Orbital Medial Wall Fracture Utilising Nasal Septal Cartilage as the Reconstructive Material
Authors: Takaishi Shinya 
Published: March 2022

Background To repair orbital medial wall fractures, otorhinolaryngologists often use the silicone sheet technique by inserting an inverted U-shaped silicone sheet into the middle meatus after the removal of fractured bones, and packing gauze inside the silicone sheet for several days to fix the shape of the medial wall. However, this method does not sufficiently reduce the orbital content. Objective To describe the surgical procedure to repair medial wall fractures using nasal septal cartilage as the reconstructive material. Methods First, endoscopic septoplasty is performed. Although the correction of the septal deviation is performed to secure the operative field, the nasal septal cartilage, except the L-strut is resected simultaneously. After septoplasty, the fractured bones of the lamina papyracea are removed from the herniated orbital contents, and then the orbital contents can be reduced without resistance by pushing laterally. Subsequently, the cartilage is inserted beneath the fracture edges of the orbital medial wall with great care to avoid entrapping the orbital soft tissue and extraocular muscles. Results The cartilage can be placed appropriately along the medial wall of the orbit. Conclusion This technique enables to repair most cases of orbital medial wall fractures using the endoscopic endonasal approach alone without alloplastic implants.
Folate Receptor Expression by Human Monocyte–Derived Macrophage Subtypes and Effects of Corticosteroids
Authors: Warmink Kelly , Siebelt Michiel , Low Philip S. , Riemers Frank M. , Wang Bingbing , Plomp Saskia G. M. , Tryfonidou Marianna A. , van Weeren P. René , Weinans Harrie , Korthagen Nicoline M. 
Published: March 2022

Objective Folate receptor beta (FR-β) has been used as a clinical marker and target in multiple inflammatory diseases, including osteoarthritis (OA) and rheumatoid arthritis (RA). However, the conditions under which FR-β+ macrophages arise remain unclear and could be affected by corticosteroids. Therefore, we studied FR-β expression in vitro in macrophage subtypes and determined their response to triamcinolone acetonide (TA), a clinically often-used corticosteroid. Design Human monocyte–derived macrophages were differentiated to the known M0, M1, or M2 macrophage phenotypes. The phenotype and FR-β expression and plasticity of the macrophage subtypes were determined using flow cytometry, reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and enzyme-linked immunosorbent assay (ELISA). Results FR-β expression was low in granulocyte-macrophage colony-stimulating factor (GM-CSF)-generated (M1-like) macrophages and high in macrophage colony-stimulating factor (M-CSF)-generated (M0 and M2-like) macrophages. FR-β expression remained high once the M0 or M2 macrophages were stimulated with pro-inflammatory stimuli (interferon-γ plus lipopolysaccharide) to induce M1-like macrophages. On the contrary, anti-inflammatory TA treatment skewed GM-CSF macrophage differentiation toward an M2 and FR-β+ phenotype. Conclusions As corticosteroids skewed monocytes toward an FR-β-expressing, anti-inflammatory phenotype, even in an M1 priming GM-CSF environment, FR-β has potential as a biomarker to monitor success of treatment with corticosteroids. Without corticosteroid treatment, M-CSF alone induces high FR-β expression which remains high under pro-inflammatory conditions. This explains why pro-inflammatory FR-β+ macrophages (exposed to M-CSF) are observed in arthritis patients and correlate with disease severity.
Five-Year Follow-up After Hip Arthroscopic Surgery in the Horsens-Aarhus Femoroacetabular Impingement (HAFAI) Cohort
Authors: Kierkegaard Signe , Mechlenburg Inger , Dalgas Ulrik , Lund Bent 
Published: March 2022

Background: Patients with femoroacetabular impingement syndrome (FAIS) are offered hip arthroscopic surgery to decrease hip pain, improve their function, and decrease development of hip osteoarthritis (OA). Nonetheless, long-term follow-up data are few. Purpose: To investigate patient-reported outcomes, clinical tests, reoperations, and radiographic status 5 years after primary hip arthroscopy in patients with FAIS. Study Design: Case series; Level of evidence, 4. Methods: A total of 60 patients (age, 36 ± 9 years; 63% female) diagnosed with FAIS were included in the study and followed for 5 years after hip arthroscopy. Follow-up included Copenhagen Hip and Groin Outcome Score (HAGOS); Hip Sports Activity Scale; and clinical tests (flexion, adduction, internal rotation [FADIR]; flexion, abduction, external rotation [FABER]; and psoas muscle/tendon major pain provocation). Radiographic evaluation included lateral joint-space width (LJSW) and Tönnis classification for hip OA. Reoperations and conversion to total hip replacement (THR) were recorded. We calculated the proportion of patients who exceeded the minimal important change (MIC), achieved the Patient Acceptable Symptom State (PASS), and were within the 95% reference interval of age- and sex-matched persons with no hip problems. Changes were investigated using paired t tests. Results: Compared with preoperatively, all HAGOS subscales were improved substantially 5 years after surgery (mean, ≥21 points; P < .001), and 67% to 89% of patients reported improvements exceeding MIC. Between 56% and 80% achieved PASS, but only 7% to 24% reached the 95% reference interval for the HAGOS subscales. A total of 36% had a positive FADIR test and 25% had a positive FABER test, which were improvements compared with preoperatively ( P < .001 for both). Patients with a positive FADIR test had significantly worse HAGOS subscales. Six patients (10%) had a THR since their primary hip arthroscopy. In the remaining patients, the mean LJSW was decreased (-0.4 mm; P = .043), and hip OA had worsened in 9 patients (23%; P = .003). Conclusion: Five years after surgery, the majority of patients experienced HAGOS improvements exceeding MIC while also showing an acceptable PASS. However, clinical tests, participation in physical activities, and quality of life indicated that many patients still experience hip problems. Registration: NCT04590924 ( ClinicalTrials.gov identifier).
Clinical and Radiographic Outcomes After Arthroscopic Inlay Bristow Surgery With Screw Versus Suture Button Fixation: A Comparative Study of 117 Patients With 3.3-Year Follow-up
Authors: Song Qingfa , Zhang Shuhan , Cheng Xu , Xiao Jian , Lin Lin , Liu Qiang , Shao Zhenxing , Cui Guoqing 
Published: March 2022

Background: Some studies have advocated the use of suture button fixation during Bristow-Latarjet surgery to reduce complications associated with screw fixation. However, data comparing these fixation methods are relatively incomplete. Purpose: To investigate the efficacy of modified arthroscopic Bristow-Latarjet surgery and compare the clinical and radiographic outcomes using screw versus suture button fixation. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 136 patients with traumatic anterior shoulder instability who underwent the modified arthroscopic Bristow-Latarjet surgery between June 2015 and February 2018. Of these patients, 117 who met the inclusion criteria were enrolled at a mean follow-up of 3.3 ± 0.7 years. Shoulders were separated into 2 groups based on fixation technique: screw fixation (group A; n = 63) or suture button fixation (group B; n = 54). Computed tomography imaging findings and clinical results were assessed preoperatively; immediately after operation; and postoperatively at 3 months, 6 months, 1 year, and final follow-up. Results: There were no significant differences between the groups in terms of postoperative clinical scores, the level of return to sports, range of motion, graft position, or reoperation rates. Bone healing was observed in 97.4% of the cases overall (114/117), with 98.4% bone union in group A and 96.3% in group B at final follow-up. Bone absorption was more common in group A (n = 30; 47.6%) compared with group B (n = 10; 18.5%) ( P = .003). There were no hardware-related complications in group B, compared with 7.9% of patients in group A ( P = .034). One patient in group B had a recurrent dislocation due to an unexpected event, and there were no recurrent dislocations in group A. Conclusion: After the modified arthroscopic Bristow-Latarjet procedure, both suture button and screw fixation methods demonstrated high bony healing rates and low risk of recurrence. Less coracoid graft resorption and no hardware-related complications were seen with suture button fixation.
Self-efficacy and Emotional Distress in a Cohort With Patellofemoral Pain
Authors: Hott Alexandra , Pripp Are Hugo , Juel Niels Gunnar , Liavaag Sigurd , Brox Jens Ivar 
Published: March 2022

Background: Patellofemoral pain (PFP) is commonly described and approached in biomechanical terms despite strong evidence that psychosocial factors such as kinesiophobia, emotional distress, and self-efficacy are important in long-standing musculoskeletal pain. Purpose: To describe levels of self-efficacy, emotional distress, kinesiophobia, and widespread pain in a cohort with long-standing PFP and determine their association with measures of pain, function, and health-related quality of life. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were 112 patients with PFP (age range, 16-40 years) who had been recruited to a randomized controlled trial. Seven baseline factors (patient sex, pain duration, number of pain sites throughout the body, kinesiophobia [Tampa Scale of Kinesiophobia], emotional distress [Hopkins Symptom Checklist], self-efficacy, and knee extension strength) were investigated for associations with the following outcomes: symptoms of PFP (Anterior Knee Pain Scale), pain (worst and usual), and health-related quality of life (5-level EuroQol-5 Dimensions [EQ-5D-5L]). We used bivariate models and multivariable linear regression models with a stepwise backward removal method to find associations with the outcomes. Internal validation was conducted, and adjusted coefficients after shrinkage are presented. Results: Of the study patients, 28% reported emotional distress (Hopkins Symptom Checklist ≥1.75), 69% reported multiple pain sites, and 33% had widespread pain. The kinesiophobia score was elevated, with a mean score of 35.4 ± 8.2. Self-efficacy was strongly associated with better function (Anterior Knee Pain Scale) and health-related quality of life (EQ-5D-5L) as well as lower pain scores in bivariate and multivariable models. Self-efficacy and emotional distress explained 50% of the variance in health-related quality of life (EQ-5D-5L). Conclusion: Our findings support other studies of PFP suggesting elevated levels of kinesiophobia and emotional distress and higher rates of widespread pain compared with the general population or pain-free controls. Higher self-efficacy was associated with better function and health-related quality of life. Together with emotional distress, it explained half the variance of health-related life quality. The results underline the importance of approaching these patients in a biopsychosocial model. Registration: NCT02114294 ( ClinicalTrials.gov identifier).
Predictors of Recurrence in Symptomatic Large Artery Atherosclerosis and Cryptogenic Strokes—A Comparative Study
Authors: Lotlikar Radhika Sanjay , Saikiran Karkala , George Jithin , Namboodiri Narayanan , Sylaja P. N. , Sreedharan Sapna Erat 
Published: March 2022

Background and Purpose: Ischemic stroke has highest recurrence risk in the first-year, ranging from 5.7% to 14%, depending on etiology, with highest reported following cardioembolism and large artery atherosclerosis (LAA), while it is not negligible in cryptogenic strokes. We evaluated the utility of clinical, imaging parameters along with electrographic and echocardiographic biomarkers of atrial dysfunction in 2 etiological groups, namely LAA and cryptogenic strokes and compared the predictors of recurrence risk at 1 year. Methodology: All acute ischemic strokes admitted to Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India for 1 year (July 2019 till June 2020) with 1 year completed follow-up were screened from electronic records. Strokes secondary to LAA and undetermined cause were compared for their clinical, imaging, and cardiac variables to predict risk of recurrence in the first year. Results: Of the 179 patients, 93 had strokes secondary to LAA and 86 had cryptogenic strokes (CS). Seventy-five patients had more than 1 event at presentation/follow-up. Recurrence risk did not differ between the 2 etiological subgroups at 1 year. Hypertension ( P = .016), multiple territory strokes ( P = .02), and dilated left ventricle (LA) chamber ( P = .047) were independently associated with recurrence risk in the entire cohort as well as within the undetermined group. Early hospitalization within 48 h reduced the overall recurrence risk ( P = .01), thus emphasizing the role of early etiological evaluation and initiation of secondary prevention in reducing future events, irrespective of etiology. Conclusion: In optimally managed LAA and cryptogenic strokes, presence of hypertension, multiterritorial infarcts, and dilated LA chambers increases the recurrence risk pointing to a likely cardiac substrate itself contributing to future stroke risk.