bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do First-Trimester Subchorionic Hematomas Affect Pregnancy
Outcomes?
Authors: Elmas Burak , Özgü Burçin Salman , Zorlu Uğurcan , Koç Bergen Laleli , Ozdemir Eda Ureyen , Akkaya Selver Kübra , Akay Arife , Öztürk Neslihan , Erkaya Salim 
Published: September 2022

Abstract
Objective The aim of this study is to investigate the relationship between
first trimester subchorionic hematomas and pregnancy outcomes in women with
singleton pregnancies.
Material and methods Between January 2018 and January 2019, patients who
had a single pregnancy between the 6th and 14th weeks of their pregnancy and
were hospitalized with the diagnosis of abortus imminens in the early pregnancy
service were included in the study. According to the ultrasonographic
examination, those with subchorionic hematoma and those with no hematoma were
compared in terms of demographic data, pregnancy outcomes and pregnancy
complications.
Results 400 abortus immines cases with subchorionic hematoma and 400
abortus imminens cases without subchorionic hematoma were compared. Preterm
delivery percentages were similar in both groups, however abortus percentage was
significantly higher in the hematoma group (34.2 vs. 24.7%;
p=0.007). In addition, it was revealed that the presence of subchorionic
hematoma before the 20th gestational week increased the risk of miscarriage 1.58
times. However, no data could be found in the study that could correlate the
size of the hematoma with pregnancy loss.
Conclusion The presence of subchorionic hematoma increases abortion rates
in abortus imminens cases. And the presence of subchorionic hematoma in cases
with ongoing pregnancy does not increase the complications of delivery.
Neonatal Outcomes since the Implementation of No Routine Endotracheal Suctioning of Meconium-Stained Nonvigorous Neonates
Authors: Sheikh Mehwish , Nanda Vishakha , Kumar Rajeev , Khilfeh Manhal 
Published: September 2022

Objective This study aimed to evaluate the effect of the 2015 Neonatal Resuscitation Program recommendations of no routine endotracheal suctioning for nonvigorous neonates on the incidence of meconium aspiration syndrome (MAS) and death. We hypothesized that the revised guidelines have not changed the outcome of MAS/death.
Study Design This was a single-center retrospective cohort study. We recorded data on nonvigorous neonates born at gestational age > 37 weeks, who were divided into period 1, n = 95 (before the new guidelines, January 1, 2013–December 31, 2015) and prospective period 2, n = 91 (after the implementation of new guidelines, January 1, 2017–December 31, 2020). Primary outcomes included MAS and death. Secondary outcomes included respiratory neonatal intensive care unit (NICU) admission, length of NICU stay, and feeding difficulties.
Results No significant differences in the occurrence of MAS (11 vs. 17%) (odds ratio [OR] of 1.46 [95% confidence interval [CI]: 0.59–3.55]) or death (1 vs. 3%) (OR of 2.00 [95% CI: 0.18–21.57]) among the two periods were observed. In period 2, there was an increased NICU respiratory admission (37 vs. 61%), with an OR of 2.31 (95% CI: 1.10–4.84). More neonates in period 2 required subsequent intubation for respiratory failure in the delivery room (12 vs. 28%) with an OR of 2.03 (95% CI: 1.02–4.51); p-value of 0.05.
Conclusion Our study did not observe a significant difference in the incidence of MAS or death between the two periods since the 2015 guidelines. However, the incidence of NICU respiratory admission increased.
Key Points
Hyperhomocysteinemia in Cardiovascular Diseases: Revisiting Observational Studies and Clinical Trials
Authors: Guéant Jean-Louis , Guéant-Rodriguez Rosa-Maria , Oussalah Abderrahim , Zuily Stéphane , Rosenberg Irwin 
Published: September 2022

Thromboembolic manifestations are relatively frequent in patients with intermediate/severe hyperhomocysteinemia (>30 µmol/L) related to inherited disorders and deficiencies in vitamin B12 and folate. In contrast, moderate hyperhomocysteinemia (15–30 µmol/L) is a modest predictor of cardiovascular risk. The recognition of homocysteine as a cardiovascular risk factor has been challenged by some but not all randomized clinical trials. We reviewed the main data of this controversy and formulated conclusions to be translated in clinical practice.Homocysteine-lowering trials have been performed in cardiovascular subjects with moderate but not intermediate/severe hyperhomocysteinemia despite the dose–effect risk association. The first meta-analyses found no benefit and led cardiology societies not recommending homocysteine in the assessment of cardiovascular risk. This guideline challenged the need to diagnose and treat the nutritional and genetic causes of intermediate/major hyperhomocysteinemia and was not revised when larger meta-analyses concluded to a reduced risk of stroke. In a recent observational study, 84% of consecutive cardiovascular patients assessed for homocysteine had intermediate or major hyperhomocysteinemia, which was properly assessed in only half of the cases and related to B12 and/or folate deficiency and Addison/Biermer disease in 55% of these cases.In conclusion, revisiting observational studies and clinical trials suggests that cardiovascular patients should be screened for hyperhomocysteinemia, when no other risk factor is found. Patients with intermediate/major hyperhomocysteinemia should be properly assessed and treated for B vitamin deficiencies and inherited disorders according to current guidelines. Further trials are needed to assess the effect of lowering homocysteine according to hyperhomocysteinemia categories at baseline.
Biochemical Relapse in Low-risk Prostate Cancer Treated with Radical Prostatectomy and Bilateral Pelvic Lymphadenectomy
Authors: Dominguez-Bellini Cristina , Ramos José Gustavo , Becerra Luis Miguel , Varela Rodolfo 
Published: September 2022

Abstract
Introduction For low-risk prostate cancer (PCa), curative treatment with radical prostatectomy (RP) can be performed, reporting a biochemical relapse-free survival rate (bRFS) at 5 and 7 years of 90.1% and 88.3%, respectively. Prostatic specific antigen (PSA), pathological stage (pT), and positive margins (R1) are significant predictors of biochemical relapse (BR). Even though pelvic lymphadenectomy is not recommended during RP, in the literature, it is performed in 34% of these patients, finding 0.37% of positive lymph nodes (N1). In this study, we aim to evaluate the 10-year bRFS in patients with low-risk PCa who underwent RP and extended pelvic lymph node dissection (ePLND).
Methodology All low-risk patients who underwent RP plus bilateral ePLND at the National Cancer Institute of Colombia between 2006 and 2019 were reviewed. Biochemical relapse was defined as 2 consecutive increasing levels of PSA > 0.2 ng/mL. A descriptive analysis was performed using the STATA 15 software (Stata Corp., College Station, TX, USA), and the Kaplan-Meier curves and uni and multivariate Cox proportional hazard models were used for the survival outcome analysis. The related regression coefficients were used for the hazard ratio (HR), and, for all comparisons, a two-sided p-value ˂ 0.05 was used to define statistical significance.
Results Two hundred and two patients met the study criteria. The 10-year bRFS for the general population was 82.5%, statistically related to stage pT3 (p = 0.047), higher Gleason grade group (GG) (p ≤ 0.001), and R1 (p ≤ 0.001), but not with N1. A total of 3.9% of the patients had N1; of these, 75% had R1, 25% GG2, and 37% GG3. Among the N0 (non-lymph node metástasis in prostate cáncer) patients, 31% of the patients had R1, 41% GG2, and 13% GG3.
Conclusions Our bRFS was 82.5% in low-risk patients who underwent RP and ePLND. With higher pT, GG, and presence of R1, the probability of BR increased. Those with pN1 (pathologicaly confirmed positive lymph nodes) were not associated with bRFS, with a pN1 detection rate of 3.9%.
Details: In low-risk PCa, curative treatment with RP can be performed, reporting a bRFS rate at 5 and 7 years of 90.1% and 88.3%, respectively. Despite the fact that pelvic lymphadenectomy is not recommended during RP in clinical guidelines, in the literature, it is performed in 34% of these patients, finding 0.37% of N1. In this study, we report the 10-year bRFS in patients with low-risk PCa who underwent surgery.
Publication Trends in Pediatric Stone Disease: A Bibliometric Analysis
Authors: Fernández Nicolás , Herrera Daniela Alejandra Varela , Villanueva Juliana , Cheng Julie , Tasian Gregory 
Published: September 2022

Abstract
Introduction In the pediatric population, the prevalence of stone disease has increased in recent years. We aim to analyze the bibliometric characteristic of available literature on the management of stones in this population.
Methods We performed a search for articles published until December 2019 on the Scopus, Google Scholar, PubMed, Embase, and Web of Science databases using the keywords children, lithiasis, and stones. We excluded articles involving patients older than 18 years of age and those with non-urological lithiasis. Then, we performed a bibliometric analysis using the original language, year of publication, impact factor (yearly number of citations), and absolute citation count as variables to calculate the impact index (number of sources adjusted for the time since publication).
Results We included 291 articles published between 1940 and December 2019 for analysis. The average number of citations per manuscript was of 15.3 (± 21.9), and the average impact index was of 502 (± 976.4). A total of 4 articles were published before 1970. The evaluation of historical landmarks that could affect citation counts, such as the launch of a journal specialized in pediatric urology (Journal of Pediatric Urology), showed a mean citation count of 23.29 before the first edition, and of 14.96 after (p = 0.0006). The variation on the impact index with the same criteria was of 539.6 before the first edition of the Journal of Pediatric Urology, and of 316.32 after (p = 0.001). The average number of citations before internet access was of 17.9, and, after the internet, of 15.1 (p = 0.17). We also observed a difference in counts regarding languages of publication.
Conclusions The proportional academic productivity on pediatric stone disease demonstrates that citation counts do not reflect the true academic impact of subspecialized topics.
The Association of Maternal Satisfaction with Childbirth by Length of Second Stage
Authors: Pham Amelie , Sardana Aayushi , Sparks Andrew D. , Gimovsky Alexis C. 
Published: September 2022

Objective The aim of this study was to quantify patient satisfaction by hour of second stage of labor and subsequent delivery mode.
Study Design Pilot cross-sectional study of nulliparous women delivered at George Washington University Hospital between April 2018 and March 2019. Patients completed three survey questionnaires in the immediate postpartum period: Patient Perception Score (PPS), Consumer Satisfaction Questionnaire (CSQ), and Six Simple Questions (SSQ). Length of second stage was divided into 2 groups (≤3 hours and >3 hours). Data on maternal characteristics, maternal outcomes, and neonatal outcomes were collected in REDCap and statistical analysis was performed using SAS version 9.4.
Results Survey response rate was 100% (n = 100). Seventy-one patients had a normal second stage and 29 patients had a prolonged second stage. Prolonged second stage was significantly associated with a lower proportion of NSVD (65.5 vs. 90.1%; p <0.01) and a higher proportion of epidural (82.8 vs. 60.6%; p = 0.03) in comparison to a normal second stage. Length of second stage had a statistically significant negative correlation with overall PPS scores (ρ =  − 0.25, p ≤0.01). Length of second stage was not correlated with the SSQ (ρ = 0.05, p = 0.25) or CSQ (ρ =  − 0.18, p = 0.11) surveys. CSQ scores were statistically significantly lower in women who underwent second stage cesarean delivery.
Conclusion Maternal satisfaction with childbirth and health care experience was high regardless of length of second stage. Only the PSS survey showed that shorter length of second stage was correlated with higher satisfaction. Cesarean delivery in the second stage was significantly associated with decreased maternal satisfaction. Future studies with larger cohorts are needed to confirm our findings.
Key Points
A Contemporary Clinico-Anatomical Guide to Craniovertebral Junction Surgery
Authors: Spiessberger Alexander , Gruter Basil , Prashant Giyarpuram , Haegler Joshua , Eisenberg Mark , Cohen-Gadol Aaron A. , Dehdashti Amir R. 
Published: September 2022

Abstract
Background Surgical treatment of ventral and ventrolateral lesions of the craniocervical junction are among the most challenging neurosurgical pathologies to treat. Three surgical techniques, the far lateral approach (and its variations), the anterolateral approach, and the endoscopic far medial approach can be used to approach and resect lesions in this area.
Objective The aim of the study is to examine the surgical anatomy of three skull base approaches to the craniocervical junction and review surgical cases to better understand the indications and possible complications for each of these approaches.
Methods Cadaveric dissections with standard microsurgical and endoscopic instruments were performed for each of the three surgical approaches, and key steps and surgically relevant anatomy were documented. Six patients with appropriate pre-, post-, and intraoperative imaging and video documentation are presented and discussed accordingly.
Results Based on our institutional experience, all three approaches can be utilized to safely and effectively approach a wide variety of neoplastic and vascular pathology. Unique anatomical characteristics, lesion morphology and size, and tumor biology should all be considered when determining the optimal approach.
Conclusion Preoperative assessment of surgical corridors with 3D illustrations helps to define the best surgical corridor. 360 degree knowledge of the anatomy of craniovertebral junction allows safe surgical approach and treatment of ventral and ventrolateral located lesions using one of the three approaches.
Using the Electronic Health Record User Context in Clinical Decision Support Criteria
Authors: Salmasian Hojjat , Rubins David , Bates David W. 
Published: September 2022

Abstract
Background Computerized clinical decision support (CDS) used in electronic health record systems (EHRs) has led to positive outcomes as well as unintended consequences, such as alert fatigue. Characteristics of the EHR session can be used to restrict CDS tools and increase their relevance, but implications of this approach are not rigorously studied.
Objectives To assess the utility of using “login location” of EHR users—that is, the location they chose on the login screen—as a variable in the CDS logic.
Methods We measured concordance between user's login location and the location of the patients they placed orders for and conducted stratified analyses by user groups. We also estimated how often login location data may be stale or inaccurate.
Results One in five CDS alerts incorporated the EHR users' login location into their logic. Analysis of nearly 2 million orders placed by nearly 8,000 users showed that concordance between login location and patient location was high for nurses, nurse practitioners, and physician assistance (all >95%), but lower for fellows (77%) and residents (55%). When providers switched between patients in the EHR, they usually did not update their login location accordingly.
Conclusion CDS alerts commonly incorporate user's login location into their logic. User's login location is often the same as the location of the patient the user is providing care for, but substantial discordance can be observed for certain user groups. While this may provide additional information that could be useful to the CDS logic, a substantial amount of discordance happened in specific user groups or when users appeared not to change their login location across different sessions. Those who design CDS alerts should consider a data-driven approach to evaluate the appropriateness of login location for each use case.
Bedside Ultrasound for Early Diagnosis of Necrotizing Enterocolitis: A Pilot Study
Authors: Oulego-Erroz Ignacio , Rodríguez-Fanjul Javier , Terroba-Seara Sandra , Sorribes-Orti Clara , Fernandez-Fernández David , Fuentes-Martínez Silvia , Pou-Blázquez Álvaro 
Published: September 2022

Objective This study aimed to assess whether bedside ultrasound (BUS) as the first imaging modality allows an earlier diagnosis of necrotizing enterocolitis (NEC) compared with abdominal radiography.
Study Design A before–after controlled study in preterm infants with suspected NEC. The intervention group (October 2019–October 2021) received BUS as the first imaging modality and was managed accordingly to BUS findings. The control group (October 2015–September 2019) received radiography as the first imaging modality. The main outcome was NEC confirmation at the time of initial imaging. Secondary outcomes included time to diagnosis, laboratory data, and treatment requirements.
Results Thirty-five episodes of suspected NEC with 14 (40%) confirmed NEC cases and 49 episodes of suspected NEC with 22 (44.9%) confirmed NEC cases were included in the intervention and control groups, respectively. In the intervention group, 11 of 14 (78.6%) NEC cases were confirmed at initial evaluation compared with 5 of 22 (22.7%) in the control group (p = 0.001). Infants in the intervention group developed thrombocytopenia and coagulopathy less frequently, were exposed to less radiation, and required less days of parenteral nutrition compared with the control group (p < 0.05).
Conclusion The use of BUS as the first imaging modality allowed an earlier diagnosis and timely treatment of NEC compared with abdominal radiography.Key Points
Optical filter–fiber combination based infrared measurement device for surface temperature measurement
Authors: Shi Chao , Liu Zhimin , Liang Lizhen , Liu Wei , Li Chao , Wang Na , Song Zeyang 
Published: September 2022

Neutral Beam Injection (NBI) is one of the four efficient ways of assistant heating on the Experimental Advanced Superconducting Tokamak (EAST) device. Measures have been taken to ensure more reliable monitoring of NBI components’ thermal data. Infrared thermometers, unlike surface-mounted thermocouples, have the advantage of non-contact and thus will not cause interference and get far less chance of malfunctioning [Childs et al., Rev Sci. Instruments 71, 2959–2978 (2000)]. In this paper, the remote infrared temperature measurement with optical fiber is reported to meet the requirement of the EAST-NBI diagnostic system. Some tests have been conducted on the remote infrared temperature measurement under the working condition, and an atmospheric propagation simulation was performed to estimate the atmosphere absorption. The results indicate that the detector’s response is in line with the theory, and the atmosphere absorption within a certain wavelength should not be ignored. Temperature measurement error is within one percent at temperatures above 200 °C. So, for the temperature range of 200–600 °C, the remote infrared temperature measurement by the optical fiber can fully meet its expectation.
Basic principles and optical system design of 17.48 keV high-throughput modified Wolter x-ray microscope
Authors: Li Yaran , Li Wenjie , Chen Liang , Ma Huanzhen , Xu Xinye , Xu Jie , Wang Xin , Mu Baozhong 
Published: September 2022

High-precision x-ray imaging diagnostics of hotspot at the stagnation stage are essential for regulating implosion asymmetry and retrieving physical implosion parameters. With regard to 10–20 keV energy band imaging, existing diagnostic instruments such as Kirkpatrick–Baez microscopes and pinhole cameras are insufficient in terms of spatial resolution and collection efficiency. The situation is even worse when high-speed, time-resolved imaging diagnostics are performed by coupling framing cameras or line-of-sight imagers. This article presents the basic principles and optical system design of a 17.48 keV modified Wolter x-ray microscope, to resolve the problems encountered in high-energy imaging diagnostics. The proposed optical configuration offers a better spatial resolution, greater depth of field, and preliminary compliance with the requirements of high precision optical processing techniques. The spatial resolution is better than 1 µm in a field range ±150 µm, and is better than 3 µm in a total field of view ∼408 µm in diameter. The geometric solid angle is calculated as 3.0 × 10−5 sr and is estimated to be 1.2 × 10−6 sr, considering the reflectivity of the double mirrors. The proposed microscope is expected to effectively improve spatial resolution and signal-to-noise ratio for high-energy imaging diagnostics.
Laser compression via fast-extending plasma gratings
Authors: Wu Zhaohui , Zuo Yanlei , Zeng Xiaoming , Li Zhaoli , Zhang Zhimeng , Wang Xiaodong , Hu Bilong , Wang Xiao , Mu Jie , Su Jingqin , Zhu Qihua , Dai Yaping 
Published: September 2022

A method is proposed for compressing laser pulses by fast-extending plasma gratings (FEPGs), which are created by ionizing a hypersonic wave generated by stimulated Brillouin scattering in a background gas. Ionized by a short laser pulse, the phonon forms a light-velocity FEPG to fully reflect a resonant pump laser. As the reflecting surface moves with the velocity of light, the reflected pulse is temporally overlapped and compressed. One- and two-dimensional fully kinetic particle-in-cell simulations with a laser wavelength of 1 µm show that in this regime, a pump pulse is compressed from 10–40 ps to 7–10 fs (i.e., a few optical cycles), with a two-dimensional transfer efficiency up to 60%. This method is a promising way to produce critical laser powers while avoiding several significant problems that arise in plasma-based compressors, including an unwanted linear stage, major plasma instabilities, and the need for seed preparation.
Foliar application of ascorbic acid enhances growth and yield of lettuce (Lactuca sativa) under saline conditions by improving antioxidant defence mechanism
Authors: Naz Safina , Mushtaq Abubakar , Ali Sajid , Muhammad Hafiza Muniba Din , Saddiq Bushra , Ahmad Riaz , Zulfiqar Faisal , Hayat Faisal , Tiwari Rahul Kumar , Lal Milan Kumar , Altaf Muhammad Ahsan 
Published: September 2022

Lettuce (Lactuca sativa L.) production is low because of different environmental stresses. Salt stress significantly reduces lettuce growth and yield. Foliar application of ascorbic acid is considered as a possible way to mitigate the adverse salinity effects on plants. This current study investigated the effect of foliar spray of ascorbic acid (control, 100, 200, 300 and 400 mg/L) to mitigate negative effects of salinity (0, 50, 100 and 150 mM NaCl) in lettuce plants in 2019 and 2020. Salinity level of 200 mM NaCl significantly reduced growth and yield traits; i.e. leaf length and diameter, number of leaves, fresh plant weight, number of roots, root length and root dry weight and these traits increased under foliar application of ascorbic acid concentration of 400 mg/L. Two salinity levels (150 and 200 mM NaCl) × 400 mg/L ascorbic acid enhanced superoxide dismutase (SOD) content in lettuce plants. Peroxidase (POD) content increased in 200 mM NaCl and 400 mg/L ascorbic acid. Catalase (CAT) content increased in 100, 150 and 200 mM NaCl and 400 mg/L ascorbic acid. Ascorbic acid was significantly greater in 200 mM NaCl and 400 mg/L ascorbic acid. Phenolic content was the maximum in 200 mM NaCl and 300 mg/L and 400 mg/L ascorbic acid. Titratable acidity was higher in 0, 50, 100, 150 and 200 mM NaCl and control of ascorbic acid. We conclude that ascorbic acid had potential to mitigate the adverse effects of salinity by reducing oxidative injury in agricultural crops especially lettuce.