bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiparametric MRI-based radiomics for the prediction of microvascular invasion in hepatocellular carcinoma
Authors: Jiang Tao , He Shuai , Yang Huazhe , Dong Yue , Yu Tao , Luo Yahong , Jiang Xiran 
Published: March 2022

Background Preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is essential in obtaining a successful surgical treatment, in decreasing recurrence, and in improving survival. Purpose To investigate the value of multiparametric magnetic resonance imaging (MRI)-based radiomics in the prediction of peritumoral MVI in HCC. Material and Methods A total of 102 patient with pathologically proven HCC after surgical resection from June 2014 to March 2018 were enrolled in this retrospective study. Histological analysis of resected specimens confirmed positive MVI in 48 patients and negative MVI in 54 patients. Radiomics features were extracted from four MRI sequences and selected with the least absolute shrinkage and selection operator (LASSO) regression and used to analyze the tumoral and peritumoral regions for MVI. Univariate logistic regression was employed to identify the most important clinical factors, which were integrated with the radiomics signature to develop a nomogram. Results In total, 11 radiomics features were selected and used to build the radiomics signature. The serum level of alpha-fetoprotein was identified as the clinical factor with the highest predictive value. The developed nomogram achieved the highest AUC in predicting MVI status. The decision curve analysis confirmed the potential clinical utility of the proposed nomogram. Conclusion The multiparametric MRI-based radiomics nomogram is a promising tool for the preoperative diagnosis of peritumoral MVI in HCCs and helps determine the appropriate medical or surgical therapy.
Bony Apprehension Test for Identifying Bone Loss in Patients With Traumatic Anterior Shoulder Instability: A Validation Study
Authors: James Michael , Kwong Cory A. , More Kristie D. , LeBlanc Justin , Lo Ian K.Y. , Bois Aaron J. 
Published: March 2022

Background: The presence of bone loss has important implications for the surgical treatment of patients with recurrent shoulder instability. The bony apprehension test (BAT) is a physical examination maneuver that was designed to improve specificity from the anterior apprehension test (AAT) in detecting critical bone loss. Purpose: The purpose of this study was to compare the BAT with the AAT and relocation test based on their abilities to predict critical bone loss. Several well–described criteria were utilized to capture critical (≥25%) and subcritical (≥13.5%) glenoid defects, as well as Hill-Sachs defects (≥19%). The ability of the BAT to predict bipolar bone loss was also assessed, as indicated by engaging Hill-Sachs defects and off–track lesions. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: The study cohort included patients ≥18 years of age who were scheduled to undergo arthroscopic stabilization for traumatic anterior shoulder instability. Notable exclusion criteria included multidirectional shoulder instability, connective tissue disorders, and workers’ compensation or litigation cases. Patients underwent physical examination immediately before surgery by the treating surgeon (ie, before the induction of anesthesia). Critical glenoid and humeral bone defects were measured on preoperative computed tomography scans. Hill-Sachs engagement and on- or off–track determination of bone loss were assessed arthroscopically and via computed tomography, respectively. Results: A total of 52 patients were included in the study. In cases of subcritical glenoid bone loss (≥13.5%) and critical Hill-Sachs defects (≥19%), the BAT had good and fair specificity (82% and 72%, respectively) but poor sensitivity (40% and 39%). The BAT also had poor sensitivity (0%), specificity (67%), and positive predictive value (0%) for higher percentages of glenoid bone loss (≥25%). When engaging Hill-Sachs lesions were assessed, the BAT had excellent specificity (94%) and positive predictive value (94%) but poor sensitivity (43%) and negative predictive value (44%). Furthermore, the BAT performed poorly at predicting off–track humeral lesions. The AAT demonstrated 100% sensitivity and 0% specificity in detecting all measures of bone loss. Conclusion: The BAT performed poorly at identifying subcritical and critical bone loss and was not found to have any clinical value. Future work is needed to identify a physical examination test that could complement advanced imaging for preoperative assessment of critical bone loss.
Adolescent Peer Victimization and Deliberate Self-Harm: A Three-Wave Moderated Mediation Model
Authors: Wei Yi , Ren Ping , Qin Xingna , Zhang Yunyun , Luo Fang , Chen Chuansheng 
Published: March 2022

Background: Identifying deliberate self-harm (DSH) and peer victimization in adolescents is a public health issue. The present study evaluates a three-wave longitudinal model to examine the effect of peer victimization on DSH and the roles of internalizing problems (depression and anxiety) and perceived peer and teacher support climate in this relationship. Methods: The participants were 2381 adolescents (51.2% boys, Mage = 13.38, SD = .59) from Chinese middle schools. Self-report measures were used to collect data every 6 months in three waves. Results: (1) Peer victimization at T1 positively predicted DSH at T3. (2) Depression at T2, rather than anxiety, mediated the relationship between peer victimization at T1 and DSH at T3. (3) Perceived peer support climate at T1 played a moderating role between peer victimization at T1 and depression and anxiety at T2, but perceived teacher support climate did not. Peer victimization had a stronger predictive effect on depression and anxiety for students with high level of perceived peer support climate. Limitations: Study limitations include the short interval (6 months) of the longitudinal design, the reliance on self-report questionnaires, the inclusion of only one aspect of student-student and teacher–student relationships, and the age limitation. Conclusions: The results demonstrated the importance of prevention for improving social and emotional skills to reduce peer victimization and of interventions to promote a peer support climate in the classroom. The findings highlight the need to consider different types of internalizing problems and perceived support in studies of DSH in adolescents.
Immunosensing the rheumatoid arthritis biomarker through bifunctional aldehyde-amine linkers on an iron oxide nanoparticle seeded voltammetry sensor
Authors: Zhou Bowei , Yan Yonglong , Xie JingBo , Huang Hongbo , Wang Heyun , Gopinath Subash CB , Anbu Periasamy , He Sanshan , Zhang Lijun 
Published: March 2022

An immunosensor was developed on an interdigitated electrode (IDE) by voltammetry sensing for the early identification of the autoimmune disease ‘rheumatoid arthritis (RA)’ by detecting the biomarker anti-cyclic citrullinated peptide antibody (anti-CCP). Higher immobilization of cyclic citrullinated peptide (CCP) as a probe was achieved by using green synthesized iron oxide nanoparticles (IONPs). Field-emission scanning electron microscopy and field-emission transmission electron microscopy observations revealed that the polydispersed material displayed multifaceted features. X-ray photoelectron spectroscopy analysis confirms the occurrence of Fe, O, and C groups on the synthesized IONPs. IONPs were immobilized with a probe on IDE through bifunctional aldehyde-amine linkers. Due to the elevated occupancy of CCP and the highly efficient electric transfer from IONPs, higher changes in current are observed upon binding of anti-CCP with CCP. In the linear range from 8 to 250 pg/mL, the sensitivity and detection limit of anti-CCP were 8 and 15 pg/mL, respectively, with a regression coefficient of y = 1E−06x−3E−07; R2= 0.9637. Control experiments with nonimmune antibody and anti-carcinoembryonic antigen indicate the specific detection of anti-CCP. Furthermore, spiking of anti-CCP in human serum does not interfere, representing the specific detection of anti-CCP. This CCP-immobilized IDE through IONP helps to quantify anti-CCP levels in the biological fluid for diagnosing RA.
Comparison of angiographic results and clinical outcomes of no-reflow after stenting in left anterior descending (LAD) versus non-LAD culprit STEMI
Authors: Khan Kamran Ahmed , Kumar Rajesh , Shah Jehangir Ali , Farooq Fawad , Shaikh Quratulain , Kumar Dileep , Sial Jawaid Akbar , Saghir Tahir , Achakzai Abdul Samad , Karim Musa 
Published: March 2022

Objectives: No-reflow is a complication that frequently occurs after stenting during primary percutaneous coronary intervention. In this study, we focused on angiographic results and clinical outcomes after no-reflow in the left anterior descending (LAD) artery versus non–left anterior descending artery ST-elevation myocardial infarction (STEMI). Methods: In this prospective study, a total of 201 patients who had developed no-reflow during primary percutaneous coronary intervention were enrolled. The patients were divided into left anterior descending artery culprit and non-left anterior descending artery culprit groups. The primary endpoints were final thrombolysis in myocardial infarction flow, corrected thrombolysis in myocardial infarction frame count and final myocardial blush grade. Secondary endpoints were major adverse cardiovascular events in-hospital and at 1 month. Results: Out of the 201 patients, 60.19% had culprit left anterior descending artery. Pulse rate, baseline systolic and diastolic blood pressure, single-vessel disease, left ventricular ejection fraction <30%, baseline thrombolysis in myocardial infarction I flow and final thrombolysis in myocardial infarction II flow (24.8% vs 11.3%, p = .017), and thrombolysis in myocardial infarction frame count (28.17 ± 11.86 vs 24.38 ± 9.05, p = .016) were significantly higher in the left anterior descending artery group. In contrast, baseline Killip Class I, three-vessel disease, baseline thrombolysis in myocardial infarction II flow, final thrombolysis in myocardial infarction III flow (74.4% vs 87.5%, p = .024) and left ventricular ejection fraction >40% were significantly greater in the non–left anterior descending artery group. However, for both in-hospital and at 30 days, overall major adverse cardiovascular event was similar in the two groups. The demographics, clinical and medication profiles and the routes used to treat no-reflow were all comparable in both groups. Conclusions: No-reflow in left anterior descending artery ST-elevation myocardial infarction is associated with lower final thrombolysis in myocardial infarction III flow, higher thrombolysis in myocardial infarction frame count and relatively lower Grade III myocardial blush than non-left anterior descending artery ST-elevation myocardial infarction with subsequent lower left ventricular ejection fraction and a higher frequency of in-hospital heart failure and hospitalisation due to heart failure.
Caudal and middle segmental mandibulectomies for the treatment of unilateral temporomandibular joint ankylosis in cats
Authors: Villamizar-Martinez Lenin A , Ferro Daniel G , Carvalho Vanessa G , Ferreira Jonathan , Reiter Alexander M 
Published: March 2022

Case series summary Three cats affected by unilateral temporomandibular joint ankylosis underwent segmental mandibulectomy, while one cat with bilateral ankylosis underwent right temporomandibular joint gap arthroplasty and left segmental mandibulectomy. Minimal intraoperative complications were linked to the segmental mandibulectomies in the cases reported. All cats recovered their ability to open the mouth, and the vertical range of motion was unaltered during the postoperative period. Mandibular drift and dental malocclusion were the main postoperative complications related to the segmental mandibulectomies. Relevance and novel information Surgical excision of ankylotic tissue at the temporomandibular joint region may be technically challenging and associated with severe iatrogenic trauma of surrounding tissues. The results of this case series suggest that middle or caudal segmental mandibulectomy is a safe, feasible and effective surgical procedure to treat unilateral temporomandibular ankylosis in cats and could be considered as an alternative surgical technique to surgical excision of ankylotic tissue at the temporomandibular joint.
Bi-parametric MRI/TRUS fusion targeted repeat biopsy after systematic 10-12 core TRUS-guided biopsy reveals more significant prostate cancer especially in anteriorly located tumors
Authors: Häggman Michael , Dahlman Pär , Ahlberg Mats , Liss Per , Cantera Ahlman Rafaele , Dragomir Anca , Ladjevardi Sam 
Published: March 2022

Background MRI and fusion guided biopsy have an increased role in the diagnosis of prostate cancer. Purpose To demonstrate the possible advantages with Bi-parametric MRI fusion-guided repeat biopsy over systematic 10–12-core biopsy for the diagnosis of prostate cancer. Material and Methods Four hundred and twenty-three consecutive men, with previous systematic 10–12-core TRUS-guided biopsy, and with suspicion of, or diagnosis of, low-risk prostate cancer underwent fusion-guided prostate biopsy between February 2015 and February 2017. The material was retrospectively assessed. In 220 cases no previous cancer was diagnosed, and in 203 cases confirmatory fusion guided biopsy was performed prior to active monitoring. MRI was classified according to PI-RADS. Systematic biopsy was compared to fusion guided biopsy for the detection of cancer, and PI-RADS was compared to the Gleason score. Results Fusion guided biopsy detected significantly more cancers than systematic ( p < .001). Gleason scores were higher in the fusion biopsy group ( p < .001). Anterior tumors were present in 54% of patients. Fusion biopsy from these lesions showed cancer in 53% with previously negative biopsy in systematic biopsies and 66% of them were upgraded from low risk to intermediate or high-risk cancers. Conclusion These results show superior detection rate and grading of bi-parametric MRI/TRUS fusion targeted repeat biopsy over systematic 10–12 core biopsies. Fusion guided biopsy detects more significant cancers despite using fewer cores. The risk group was changed for many patients initially selected for active surveillance due to upgrading of tumors. Bi-parametric MRI shows promising results in detecting anterior tumors in patients with suspected prostate cancer.
A Situation Assessment of Community Health Workers’ Preparedness in Supporting Health System Response to COVID-19 in Kenya, Senegal, and Uganda
Authors: Chengo Rehema , Esho Tammary , Kuria Shiphrah , Kimani Samuel , Indalo Dorcas , Kamanzi Lilian , Mouhamed Bachir , Wabwire Andrew , Camara Khaltoume , Kapsandui Tonny , Kagurusi Patrick , Nankanja Maureen , Oele Gorge , Osur Joachim 
Published: March 2022

Background: Coronavirus disease (COVID-19) caused socio-economic disruptions across the globe. The pandemic disrupted the health system (HS) calling for reengineering in response to high infection rates, deaths, and resultant containment measures. To deal with COVID-19 and promote resilience, community health workers (CHWs) were engaged across countries. Objective: Assess the preparedness of CHWs in supporting health system response in prevention and management of COVID-19 in Kenya, Senegal, and Uganda. Methods: A mixed methods design study involving national and subnational jurisdictions in the 3 countries. Key informant interviews were conducted with policy actors (16) and health care workers (24) while in-depth interviews involved CHWs (14) and community members (312) subjected to survey interviews. Results: Most (>50%) households survived on <USD 100/month during COVID-19 announced in March 2020 through national TV (57%), FM (42%), and radio station (27%). Community members interactions with CHWs increased during the pandemic through home visits as health educators, basic counseling providers and distributors of pandemic information tools, personal protective equipments, and social support commodities. The CHWs faced challenges during pandemic prevention and management including lack of: protective gear, salary, refresher courses, and identification tools; limited supervision and training; hostile reception during home visits; misconception and politicking about the pandemic. To effectively support prevention and manage of COVID-19, priority needs for CHWs were identified namely: provision of resources, protective gear, transport reimbursement, stipends, identification cards, and tools for recording and reporting; empowerment with adequate skills, trainings on provision of psychosocial support, first aid, and sensitization on policies. Conclusion: COVID-19 linked disruptions to optimal functioning of HS necessitated engagement of CHWs in the pandemic prevention and management. Findings underscore the important role CHWs play in supporting HS during crisis like COVID-19 to mitigate disruptions and stabilize the system for effective response. The CHWs can improve resilience of social and HS during unplanned disruptions for optimal functioning and attainment of universal health care. Policy makers should develop structured mechanisms for engaging CHWs while committing resources to address challenges that affect seamless synergy between health and CHWs Systems.
Demographic Factors Associated With an Increased Incidence of Intra-articular Injuries After Delayed Anterior Cruciate Ligament Reconstruction
Authors: Riepen Dietrich , Kanski Gregory , Chavez Audrie Aliza , Tavakolian Paul , Gronbeck Christian , Khazzam Michael , Coyner Katherine J. 
Published: March 2022

Background: Delays from the time of an anterior cruciate ligament (ACL) tear to surgical reconstruction are associated with an increased incidence of meniscal and chondral injuries. Purpose: To evaluate the association between delays in ACL reconstruction (ACLR) and risk factors for intra-articular injuries across 8 patient demographic subsets. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We performed a retrospective chart review of all patients who underwent ACLR from January 2009 to May 2015 at a single institution. Variables collected were age, sex, body mass index, time from injury to surgery, and presence of meniscal tears and chondral injuries. Demographic subsets were created according to sex, age (<27 vs ≥27 years), body mass index (<25 vs ≥25 kg/m2), and injury setting (sports vs non–sports related). Subsets were divided by time from injury to ACLR: 0 to <6 months (control group), 6 to <12 months, and ≥12 months. Multivariate logistic regression–generated odds ratios (ORs) were calculated. Results: Overall, 410 patients were included. ORs were significant for an increased incidence of medial meniscal tears (MMTs) (OR, 1.12-3.72; P = .02), medial femoral condyle (MFC) injuries (OR, 1.18-4.81; P = .02), and medial tibial plateau (MTP) injuries (OR, 1.33-31.07; P = .02) with surgical delays of 6 to <12 months. With ≥12-month delays, significance was found for MMTs (OR, 2.92-8.64; P < .001), MFC injuries (OR, 1.86-5.88; P < .001), MTP injuries (OR, 1.37-21.22; P = .02), lateral femoral condyle injuries (OR, 2.41-14.94; P < .001), and lateral tibial plateau injuries (OR, 1.15-5.27; P = .02). In the subset analysis, differences in the timing, location, rate, and pattern of chondral and meniscal injuries became evident. Female patients and patients with non–sports-related ACL tears had less risk of associated injuries with delayed surgery, while other demographic groups showed an increased injury risk. Conclusion: When analyzing patients who were symptomatic enough to eventually require surgery, an increased incidence of MMTs and medial chondral injuries was associated with ≥6-month delays in ACLR, and an increased incidence of lateral chondral injuries was associated with ≥12-month delays. Female patients and patients with non–sports-related ACL tears had less risk of injuries with delayed ACLR.
The reliability of a simple novel radiographic finding in the diagnosis of subscapularis tendon tears: the “digitation sign”
Authors: Neyton Lionel , Nigues Ana 
Published: March 2022

Objectives: Subscapularis (SSP) tendon injuries are increasingly being diagnosed by arthroscopy. Preoperative diagnosis remains a challenge with clinical examination and magnetic resonance imaging (MRI) lacking sensitivity. The purpose of the study was to evaluate a new MRI finding in the coronal plane, the ‘Digitation Sign’. Methods: A consecutive series of 197 patients who underwent surgery for arthroscopic rotator cuff repair between January 2020 and December 2020 was reviewed. Inclusion criteria were: availability of a preoperative MRI less than 18 months old and age of more than 18 years. SSP injuries were described intraoperatively according to the Lafosse et al. and the French Arthroscopy Society classifications. Of the 197 patients, 44 had a preoperative arthroscan, 21 did not have an available DICOM file, and 1 patient had a history of repair on the side being examined. We included 132 shoulders for analysis. MRI scans were reviewed by 3 independent observers. The SSP was assessed on axial, sagittal, and coronal sections according to Adams’ criteria. The ‘Digitation Sign’ was assessed in the coronal plane on the T2 sequences. The statistical analysis determined the inter-observer agreement, and sensitivity and specificity calculations. Results: The inter-observer analysis detected substantial agreement (κ = 0.640). Of the 132 patients included, 74 (56%) had an arthroscopically confirmed SSP injury. 55 (74.3%) of the SSP injuries were correctly diagnosed by the ‘Digitation Sign’ alone, 62 (83.8%) with Adams’ criteria alone and 66 (89.2%) with a combination of both. 49 (84.5%) of the intact SSP were confirmed with the ‘Digitation Sign’ alone, 45 (77.6%) with Adams’ criteria alone and only 39 (67.2%) with a combination of both. The sensitivity of the ‘Digitation Sign’ combined with Adams’ criteria was statistically better than the sensitivity of Adams’ criteria alone (p = 0.046). The ‘Digitation Sign’ was more specific than Adams’ criteria (p = 0.014). The effectiveness of the ‘Digitation Sign’ combined with Adams’ criteria increased with the severity of the injury (grade III or IV). SSP injuries were significantly associated with biceps injuries (p <0.0001). Conclusion: Preoperative MRI analyzed according to a protocol that combines Adams’ criteria and the ‘Digitation Sign’ is simple, reproducible and sensitive in the diagnosis of SSP injuries. The specificity of the ‘Digitation Sign’ enables quick verification of the integrity of the subscapularis in the first reading of standard coronal sections of cuff tear analysis.