bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on the outcome of patients with aseptic femoral head necrosis treated with percutaneous multiple small-diameter drilling core decompression: a retrospective cohort study based on magnetic resonance imaging and equivalent sphere model analysis
Authors: Tan Yang , He Hangyuan , Wan Zihao , Qin Jun , Wen Yinxian , Pan Zhengqi , Wang Hua , Chen Liaobin 
Published: July 2020

AbstractBackgroundAseptic necrosis of the femoral head (ANFH) has a high incidence in the community and causes substantial problems with health as well as economic and social stress. Core decompression is the most commonly used treatment for early ANFH. Although many studies have reported on the efficacy of femoral head core decompression surgery for ANFH, there are still some shortcomings in assessing the severity of femoral head necrosis, the location distribution, and changes in necrotic lesions before and after surgery. Magnetic resonance imaging (MRI) and equivalent sphere model analysis were used to further clarify the clinical efficacy of percutaneous multiple small-diameter drilling core decompression in patients with ANFH.MethodsFrom July 2013 to November 2016, 24 patients (32 cases of the hip joint) with ANFH who underwent percutaneous multiple small-diameter drilling core decompression were selected, and a retrospective analysis was conducted. MRI as well as VAS, OHS-C, and HHS scores were used to evaluate joint function in all patients before and 6, 12, and 24 months after the operation.ResultsTwenty-four months after the operation, 10 hips were amputated. The survival rates of alcoholic femoral head necrosis (AFNH), idiopathic femoral head necrosis (IFHN), and steroid-induced femoral head necrosis (SIFHN) patients at 24 months were 100%, 85.7% (− 2 hips), and 0.0% (− 8 hips), respectively. The MRI and equivalent sphere analysis results revealed that the anterior superior medial quadrant was the area most prone to osteonecrosis, and the posterior superior medial quadrant was the area second most prone to necrosis. After the operation, the average percentage of the AFHN necrosis area in the total volume of the femoral head decreased from 14.5 to 10.3%, and the average percentage of the IFHN necrosis area decreased from 16.3 to 9.2%; however, the average percentage of the necrosis area for SIFHN increased from 30.4 to 33.1%.ConclusionPercutaneous multiple small-diameter drilling core decompression significantly reduced the lesion volume for AFHN and IFHN, but the effect on SIFHN was not good.
Adapting acute malnutrition treatment protocols in emergency contexts: a qualitative study of national decision-making
Authors: Kozuki Naoko , Seni Mamoudou , Sirat Amin , Abdullahi Omar , Adalbert Mena Fundi Eso , Biotteau Marie , Goldsmith Amelia , Dalglish Sarah L. 
Published: July 2020

Abstract
Background
Each year, an estimated 17 million children suffer from severe acute malnutrition (SAM) and 33 million from moderate acute malnutrition (MAM), with many of the most severe cases found in extremely food insecure contexts or conflict situations. Current global outpatient treatment protocols for uncomplicated SAM and MAM, adapted by most countries for use at national level, call for SAM and MAM to be managed separately, however global-level stakeholders have recently begun evaluating simplified and/or combined protocols managing acute malnutrition.

Methods
This study analyzes national policy discussions and decision-making around outpatient acute malnutrition treatment for uncomplicated cases in emergency situations in Niger, Nigeria, Somalia, and South Sudan. Data collection (March–July 2018) included semi-structured in-depth interviews with 50 respondents (N = 11–15 per country) from government, funding agencies, and implementing partners, as well as 11 global and regional stakeholders. We also conducted a document analysis (N = 10–15 per country and at global level) to situate debates and evaluate current policy. Data were analyzed iteratively using thematic content analysis.

Results
We find that while combined/simplified protocols for outpatient management of uncomplicated cases of acute malnutrition are being used in emergency situations in all four countries, there is widespread confusion about protocol terminology and content, stemming from a lack of coherence at the global level. As a result, national-level stakeholders express diverse, if overlapping, rationales for modifying current protocols, which vary given the intensity and scope of the emergency. Without specific global-level guidance, combined/simplified protocols are often used on an ad hoc basis, although the processes for triggering them were at least nominally controlled at the national level. Decisions about when and where to enact “exceptional” modifications to country protocols were often based on inconsistent determinations of what constitutes an “emergency.” Respondents said more evidence is needed on both clinical and operational aspects of these protocols, and they awaited clear guidance from global norm-setting agencies.

Conclusions
Based on these findings, global-level stakeholders should urgently improve coordination and communication around existing protocols. Standardized guidance based on the available evidence is required to clarify best practices for combined management of SAM and MAM, particularly in emergency contexts (which should be defined) and in situations of limited resources. Given the complexity of governance arrangements in conflict situations, both guidance and updates on research must be disseminated in a rational, systematic, and digestible way to the multiplicity of field actors.
Longitudinal changes in EEG power, sleep cycles and behaviour in a tau model of neurodegeneration
Authors: Holton C. M. , Hanley N. , Shanks E. , Oxley P. , McCarthy A. , Eastwood B. J. , Murray T. K. , Nickerson A. , Wafford K. A. 
Published: July 2020

Abstract
Background
Disturbed sleep is associated with cognitive decline in neurodegenerative diseases such as Alzheimer’s disease (AD) and frontotemporal dementia (FTD). The progressive sequence of how neurodegeneration affects aspects of sleep architecture in conjunction with behavioural changes is not well understood.

Methods
We investigated changes in sleep architecture, spectral power and circadian rhythmicity in the tet-off rTg4510 mouse overexpressing human P301L tau within the same subjects over time. Doxycycline-induced transgene-suppressed rTg4510 mice, tTa carriers and wild-type mice were used as comparators. Spectral power and sleep stages were measured from within the home cage environment using EEG electrodes. In addition, locomotor activity and performance during a T-maze task were measured.

Results
Spectral power in the delta and theta bands showed a time-dependent decrease in rTg4510 mice compared to all other groups. After the initial changes in spectral power, wake during the dark period increased whereas NREM and number of REM sleep bouts decreased in rTg4510 compared to wild-type mice. Home cage locomotor activity in the dark phase significantly increased in rTg4510 compared to wild-type mice by 40 weeks of age. Peak-to-peak circadian rhythm amplitude and performance in the T-maze was impaired throughout the experiment independent of time. At 46 weeks, rTG4510 mice had significant degeneration in the hippocampus and cortex whereas doxycycline-treated rTG4510 mice were protected. Pathology significantly correlated with sleep and EEG outcomes, in addition to locomotor and cognitive measures.

Conclusions
We show that reduced EEG spectral power precedes reductions in sleep and home cage locomotor activity in a mouse model of tauopathy. The data shows increasing mutant tau changes sleep architecture, EEG properties, behaviour and cognition, which suggest tau-related effects on sleep architecture in patients with neurodegenerative diseases.
Natural history, prognostic factors and patient perceived response to treatment in chronic spontaneous urticaria
Authors: Stepaniuk Peter , Kan Manstein , Kanani Amin 
Published: July 2020

AbstractBackgroundAlthough the diagnosis and management of chronic spontaneous urticaria (CSU) is well documented in the literature, some aspects of the disease remain unclear. We aimed to further describe the natural history, prognostic factors, humanistic burden and uptake of traditional and alternative therapies in patients with CSU.MethodsThis was a prospective, cross-sectional analysis at a single centre. We reviewed patient medical records and conducted a survey in patients with CSU.Results72 patients participated in the study with a median duration of CSU of 48 months. 30% of patients had symptoms that resolved in under 2 years with these patients trending towards an older age of onset of CSU (48 ± 17 years). 16% of patients had symptoms lasting 10 years or longer with these patients trending towards a younger age of onset (22 ± 16 years). Patients with a relapsing/remitting disease course (31%) and those with co-existing angioedema (57%) trended towards a longer median duration of CSU (96 and 50 months respectively) and were observed to have a higher proportion of patients reporting CSU duration of 10 years or longer (33% and 25%, p = 0.033 and p = 0.036 respectively). Patients with co-existing autoimmune/thyroid disease (19%) trended towards a shorter median duration of CSU (37 months). 54 patients (75%) reported sleep disturbance and 29 patients (43%) required emergency room visit(s) for symptomatic control. 84% of patients who trialed second generation antihistamines reported a response to treatment, while 73% of patients who trialed omalizumab reported a response to treatment. Patients using alternative medicine such as acupuncture, traditional Chinese medicine and naturopathic medicine had lower reported response rates (20–29%) to treatment.ConclusionsThe natural history of CSU may be longer than previously reported with our study finding a median duration of symptoms of nearly 4 years with one-third of patients reporting a relapsing/remitting disease course. Younger age of onset, a relapsing/remitting disease course and angioedema may predict a longer duration of CSU, whereas older age of onset and co-existing autoimmune/thyroid disease may predict a shorter duration of CSU. Reported symptomatic benefit was higher from guidelines based pharmacologic therapy versus various alternative medicines.
Schools overcoming the digital divide: in depth analyses towards organizational resilience in the computer and information literacy domain
Authors: Drossel Kerstin , Eickelmann Birgit , Vennemann Mario 
Published: July 2020

Abstract
Background
The ongoing digitalization poses new challenges for schools concerning students’ digital skills. In this context, the International Computer and Information Literacy Study (IEA-ICILS 2018) has identified substantial social disparities concerning computer and information literacy of grade 8 students. Furthermore, it has been observed that many schools, especially those located in socioeconomically challenged areas, are particularly engaged in supporting students’ digital literacy and innovatively designing learning processes with information and communications technology (ICT). Empirical studies have made it apparent that some schools have high average achievements concerning domains such as reading literacy and mathematics in spite of socioeconomically challenged student bodies. These schools are regarded as being organizationally resilient. This contribution focusses on these organizationally resilient schools with regard to the domain of computer and information literacy. It aims to investigate how these schools can be classified as a typology according to selected school and/or teacher characteristics.

Methods
As a first step, representative samples of IEA-ICILS 2018 are used to identify organizationally resilient schools by using students’ achievement measures (plausible values) and their background information regarding their families’ socio-economic status. In order to develop a typology, latent profile analyses (LPA) are conducted by using input and process indicators on the school level, which have been proven to be relevant for implementation through existing empirical research.

Results
About one twentieth of the schools examined in this contribution can be regarded as organizationally resilient and can be allocated onto a typology of three school types that are characterized by different school-level factors.

Conclusions
The international comparison permits the conclusion that the phenomenon of organizational resilience is also existent with regard to the content domain of computer and information literacy. However, the proportion of resilient schools is subject to considerable variation between countries.
Isolation, molecular characterization of indigenous Beauveria bassiana isolate, using ITS-5.8 s rDNA region and its efficacy against the greatest wax moth, Galleria mellonella L. (Lepidoptera: Pyralidae) as a model insect
Authors: Fergani Yasmin A. , Yehia Ramy S. 
Published: July 2020

AbstractThe entomopathogenic fungi (EPF), as a biological control agent, can provide an alternative option for high-risk insecticides. Beauveria bassiana is one of the most potential EPF of pest control all over the world. The EPF isolate Y-F_ITS1 was isolated from Egyptian fauna on Beauveria-specific selective medium (BS medium). Molecular screening of the B. bassiana isolate, using PCR amplification with B. bassiana-specific primers and nucleotide sequence analysis of the internal transcribed spacer (ITS) region, confirmed the isolate as B. bassiana (accession no. [MK773644.1]). Efficacy of the isolate Y-F_ITS1 was examined against fourth instar larvae of Galleria mellonella L. as a model insect using concentrations from 104 to 107 spores ml−1 in a contact toxicity assay under laboratory conditions. The pathogenicity experiment showed that all the tested concentrations caused mortalities ranged from 75 to 98.33%, within 5 days posttreatment with cumulative mortalities, reached 100%, before 7 days with typical symptoms of infection and sporulation. Further investigations are needed to prove its efficacy against different economic pests as a credible candidate of integrated pest management (IPM) program.
Diagnosis of peripheral neuropathy
Authors: Lehmann Helmar C. , Wunderlich Gilbert , Fink Gereon R. , Sommer Claudia 
Published: July 2020

Abstract
Introduction
Peripheral neuropathy represents a spectrum of diseases with different etiologies. The most common causes are diabetes, exposure to toxic substances including alcohol and chemotherapeutics, immune-mediated conditions, and gene mutations. A thorough workup including clinical history and examination, nerve conduction studies, and comprehensive laboratory tests is warranted to identify treatable causes.

First steps
The variability of symptoms allows distinguishing characteristic clinical phenotypes of peripheral neuropathy that should be recognized in order to stratify the diagnostic workup accordingly. Nerve conduction studies are essential to determine the phenotype (axonal versus demyelinating) and severity. Laboratory tests, including genetic testing, CSF examination, nerve imaging, and nerve biopsy, represent additional clinical tests that can be useful in specific clinical scenarios.

Comments
We propose a flow chart based on five common basic clinical patterns of peripheral neuropathy. Based on these five clinical phenotypes, we suggest differential diagnostic pathways in order to establish the underlying cause.

Conclusions
The recognition of characteristic clinical phenotypes combined with nerve conduction studies allows pursuing subsequent diagnostic pathways that incorporate nerve conduction studies and additional diagnostic tests. This two-tiered approach promises higher yield and better cost-effectiveness in the diagnostic workup in patients with peripheral neuropathy.
Electrophysiological study of posterior antebrachial cutaneous nerve in a sample of normal subjects
Authors: Saba Emmanuel Kamal Aziz 
Published: July 2020

AbstractBackgroundsPosterior antebrachial cutaneous nerve sensory conduction study is clinically essential for the assessment of its integrity and for the localization of radial nerve lesions. The aim of the study was to assess posterior antebrachial cutaneous nerve sensory antidromic conduction technique and to obtain normal reference values for different sensory nerve action potential parameters of this nerve among a sample of Egyptian population.ResultsThe current study included 120 upper limbs of 60 apparently healthy subjects [35 (58.3%) women]. Their mean age was 39.20 ± 11.95 years. The posterior antebrachial cutaneous nerve was recorded in all upper limbs (100%). The values (mean ± standard deviation) for the posterior antebrachial cutaneous nerve sensory nerve action potential onset latency were 2.05 ± 0.25 ms, peak latency was 2.63 ± 0.28 ms, conduction velocity was 60.50 ± 5.38 m/s, amplitude was 11.04 ± 4.26 μV, and inter-side sensory nerve action potential amplitude ratio was 0.69 ± 0.17. There were no statistically significant differences between men and women, as well as between right and left upper limbs regarding different posterior antebrachial cutaneous sensory nerve action potential parameters. There were no statistically significant correlations between participants’ age and anthropometric measures (i.e., height, weight, and body mass index) with different posterior antebrachial cutaneous nerve sensory nerve action potential parameters. There were no statistically significant adjusted effects of age, gender, and anthropometric measures on different posterior antebrachial cutaneous nerve sensory nerve action potential parameters in multiple linear regression analysis by controlling all other physiologic factors.ConclusionsThis research provides an applicable electrophysiological technique and normal reference values for the posterior antebrachial cutaneous nerve sensory conduction study.
Hypoglycemia and Islet Dysfunction Following Oral Glucose Tolerance Testing in Pancreatic-Insufficient Cystic Fibrosis
Authors: Kilberg Marissa J , Harris Clea , Sheikh Saba , Stefanovski Darko , Cuchel Marina , Kubrak Christina , Hadjiliadis Denis , Rubenstein Ronald C , Rickels Michael R , Kelly Andrea 
Published: July 2020

Abstract

Context
Oral glucose tolerance test (OGTT)-related hypoglycemia is common in pancreatic-insufficient cystic fibrosis (PI-CF), but its mechanistic underpinnings are yet to be established.

Objective
To delineate the mechanism(s) underlying OGTT-related hypoglycemia.

Design and Setting
We performed 180-minute OGTTs with frequent blood sampling in adolescents and young adults with PI-CF and compared results with those from a historical healthy control group. Hypoglycemia (Hypo[+]) was defined as plasma glucose &lt;65 mg/dL. We hypothesized that CF-Hypo[+] would demonstrate impaired early phase insulin secretion and persistent late insulin effect compared with control-Hypo[+], and explored the contextual counterregulatory response.

Main Outcome Measure
OGTT 1-hour and nadir glucose, insulin, C-peptide, and insulin secretory rate (ISR) incremental areas under the curve (AUC) between 0 and 30 minutes (early) and between 120 and 180 minutes (late), and Δglucagon120-180min and Δfree fatty acids (FFAs)120-180min were compared between individuals with CF and control participants with Hypo[+].

Results
Hypoglycemia occurred in 15/23 (65%) patients with CF (43% female, aged 24.8 [14.6-30.6] years) and 8/15 (55%) control participants (33% female, aged 26 [21-38] years). The CF-Hypo[+] group versus the control-Hypo[+] group had higher 1-hour glucose (197 ± 49 vs 139 ± 53 mg/dL; P = 0.05) and lower nadir glucose levels (48 ± 7 vs 59 ± 4 mg/dL; P &lt; 0.01), while insulin, C-peptide, and ISR-AUC0-30 min results were lower and insulin and C-peptide, and AUC120-180min results were higher (P &lt; 0.05). Individuals with CF-Hypo[+] had lower Δglucagon120-180min and ΔFFA120-180min compared with the control-Hypo[+] group (P &lt; 0.01).

Conclusions
OGTT-related hypoglycemia in PI-CF is associated with elevated 1-hour glucose, impaired early phase insulin secretion, higher late insulin exposure, and less increase in glucagon and FFAs. These data suggest that hypoglycemia in CF is a manifestation of islet dysfunction including an impaired counterregulatory response.
Immune Checkpoint Inhibitor-induced Thyroid Dysfunction Is Associated with Higher Body Mass Index
Authors: Pollack Rena , Ashash Amit , Cahn Avivit , Rottenberg Yakir , Stern Hagay , Dresner-Pollak Rivka 
Published: July 2020

Abstract

Context
Obesity is a proinflammatory metabolic state that may play a role in the development of immune-related adverse events (irAEs) associated with immune checkpoint inhibitor therapy.

Objective
To characterize the association between body mass index (BMI) and thyroid irAEs.

Methods
We performed a single-center, retrospective analysis of 185 cancer patients treated with anti-PD-1/L1 from January 2014 to December 2018. Patients with normal thyroid function at baseline and available BMI were included.

Main outcome measures
The primary endpoint was difference in BMI in patients who developed overt thyroid dysfunction versus those who remained euthyroid following anti-PD-1/L1 initiation. Additional endpoints included any (overt or subclinical) thyroid dysfunction, overt thyrotoxicosis or overt hypothyroidism, and time to development of dysfunction according to BMI.

Results
Any thyroid dysfunction developed in 72 (38.9%) patients and 41 (22.1%) developed overt thyroid dysfunction. Mean BMI was higher in those with overt thyroid dysfunction versus euthyroid (27.3 ± 6.0 vs 24.9 ± 4.5, P = .03). Development of overt thyrotoxicosis versus remaining euthyroid was associated with higher BMI (28.9 ± 5.9 vs 24.9 ± 4.5; P &lt; .01), whereas overt hypothyroidism was not (26.7 ± 5.5 vs 24.9 ± 4.5, P = .10). Overt thyrotoxicosis developed within 57.5 (interquartile range [IQR] 31.8-78.8) days of treatment in the low-normal BMI group, 38.0 (IQR 26.8-40.5) days in the overweight group, and 23.0 (IQR 21.0-28.0) days in the obese group (P = .02).

Conclusions
Patients treated with PD-1/L1 inhibitors were more likely to develop thyroid irAEs, specifically overt thyrotoxicosis, with increasing BMI. Overt thyrotoxicosis occurred earlier in obese versus leaner patients. These data highlight the complex interplay between obesity and immune response in immune checkpoint inhibitor-treated patients.