bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Clinical Outcomes of Intercalary Allograft Reconstruction for Lower-Extremity Bone Tumors
Authors: Sanders P.T.J. , Spierings J.F. , Albergo J.I. , Bus M.P.A. , Fiocco M. , Farfalli G.L. , van de Sande M.A.J. , Aponte-Tinao L.A. , Dijkstra P.D.S. 
Published: April 2020

Background:
Improved survival rates for patients with primary bone tumors of the extremities have increased the demand for reliable and durable reconstruction techniques. Some authors have stated that, after successful ingrowth, allografts are a durable long-term solution. This hypothesis is largely based on small studies with short-to-midterm follow-up. In order to determine the durability of intercalary allograft reconstructions in the lower extremities, we evaluated the long-term clinical outcomes at a minimum of 10 years.

Methods:
All patients who received an intercalary allograft reconstruction in a lower extremity between 1980 and 2006 were included in this retrospective multicenter cohort study. One hundred and thirty-one patients with a median age of 19 years were included. Eighty-nine (68%) had a femoral reconstruction, and 42 (32%) had a tibial reconstruction. The most prevalent diagnoses were osteosarcoma (55%), Ewing sarcoma (17%), and chondrosarcoma (12%). The median follow-up was 14 years. A competing risk model was employed to estimate the cumulative incidences of mechanical failure and infection. Patient mortality or progression of the disease was used as a competing event.

Results:
Nonunion occurred in 21 reconstructions (16%), after a median of 16 months, and was associated with intramedullary nail-only fixation (p < 0.01) and fixation with nonbridging plate(s) (p = 0.03). Allograft fracture occurred in 25 reconstructions (19%) after a median of 42 months (range, 4 days to 21.9 years). Thirteen (52%) of the allograft fractures occurred within 5 years; 8 (32%), between 5 and 10 years; and 4 (16%), at >10 years. With failure for mechanical reasons as the end point, the cumulative incidences of reconstruction failure at 5, 10, and 15 years were 9%, 14%, and 21%, respectively.

Conclusions:
Intercalary allograft reconstruction is an acceptable reconstructive option, mainly because of the absence of superior alternatives with a known track record. However, a considerable and continuing risk of mechanical complications should be taken into account.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Nonunion in Pediatric Femoral Neck Fractures
Authors: Sanghavi Sahil , Patwardhan Sandeep , Shyam Ashok , Nagda Taral , Naik Premal 
Published: April 2020

➢ Nonunion is the third most common complication of femoral neck fractures in children after osteonecrosis and premature physeal closure causing coxa vara.➢ The most common cause of nonunion of a femoral neck fracture in developed countries is failure of fixation or loss of reduction, whereas in developing countries, it is delayed presentation.➢ Most failures of fixation, if identified in time (<3 months), retain adequate bone contact. Hence, removal of the offending implant, refixation without bone-grafting, and valgus osteotomy to correct the biomechanical forces by converting the vertical fracture line into a horizontal fracture line provide adequate results with respect to osseous union.➢ In patients with a delayed presentation, the intervening fibrous tissue and resorption of the neck pose challenges. In these patients, in addition to performing a valgus osteotomy and fixation, in situ stabilization across the fibrous tissue and reconstruction of the inferomedial aspect of the neck using fibular strut-grafting, which adds stability, bone contact, and biological material, provide adequate union.
Clinical Observership Opportunities in North America for International Orthopaedic Surgeons
Authors: Carrillo Laura A. , Segarra Borja , Sabharwal Sanjeev 
Published: April 2020

Background:
Although efforts have been made to address the inequities of surgical care globally, to our knowledge, there has been no comprehensive analysis of orthopaedic clinical observerships in North America that are available for international surgeons.

Methods:
Two investigators performed a systematic online search to identify orthopaedic clinical observerships that are available in the United States and Canada for international surgeons. Variables such as host type, geographic location of host site, program type, eligibility criteria, subspecialty focus, application and participation fees, availability of funding, duration of observership, and the quality of online information that is available based on an online content (OC) score were collected.

Results:
Of the 113 available observership sponsors in North America, 36 (32%) were professional-society-based, 69 (61%) were academic/institution-based, and 8 (7%) were private-practice-based. Most observerships were located in the U.S. (n = 85) and, of these, the Northeast was the most common U.S. region (n = 29, p = 0.008). Of the observerships with a focus, pediatrics was the most frequent orthopaedic subspecialty (p < 0.0001), followed by spine and trauma. Professional-society-sponsored observerships offered funding to international surgeons more often than academic/institution-based and privately sponsored programs (p < 0.0001). The average OC score for the entire cohort was 2.35 and was similar among the 3 host types (p = 0.954). The program structure and requirements such as applicant eligibility, application and participation fees, and duration of observership varied widely.

Conclusions:
There are opportunities for international orthopaedic surgeons to participate in clinical observerships in North America. Given the greater funding support and lack of fees for professional-society-sponsored observerships, these observerships may pose fewer financial barriers for surgeons from low and middle-income countries (LMICs). The quality of online information was similar among the 3 different host types and can be improved.

Clinical Relevance:
The relevance and impact of a clinical observership experience in North America for a practicing orthopaedic surgeon from an LMIC need to be explored further.
Photosynthetic performance and photosynthesis-related gene expression coordinated in a shade-tolerant species Panax notoginseng under nitrogen regimes
Authors: Zhang Jin-Yan , Cun Zhu , Chen Jun-Wen 
Published: April 2020

Abstract

Background: Nitrogen (N) is an essential component of photosynthetic apparatus. However, the mechanism that photosynthetic capacity is suppressed by N is not completely understood. Photosynthetic capacity and photosynthesis-related genes were comparatively analyzed in a shade-tolerant species Panax notoginseng grown under the levels of low N (LN), moderate N (MN) and high N (HN). Results: Photosynthetic assimilation was significantly suppressed in the LN- and HN-grown plants. Compared with the MN-grown plants, the HN-grown plants showed thicker anatomic structure and larger chloroplast accompanied with decreased ratio of mesophyll conductance (gm ) to Rubisco content (gm /Rubisco) and lower Rubisco activity. Meanwhile, LN-grown plants displayed smaller chloroplast and accordingly lower internal conductance (gi ). LN- and HN-grown individuals allocated less N to light-harvesting system (NL ) and carboxylation system (NC ), respectively. N surplus negatively affected the expression of genes in Car biosynthesis ( GGPS , DXR , PSY , IPI and DXS ). The LN individuals outperformed others with respect to non-photochemical quenching. The expression of genes ( FBA, PGK, RAF2, GAPC, CAB, PsbA and PsbH ) encoding enzymes of Calvin cycle and structural protein of light reaction were obviously repressed in the LN individuals, accompanying with a reduction in Rubisco content and activity. Correspondingly, the expression of genes encoding RAF2 , RPI4 , CAB and PetE were repressed in the HN-grown plants. Conclusions: LN-induced depression of photosynthetic capacity might be caused by the deceleration on Calvin cycle and light reaction of photosynthesis, and HN-induced depression of ones might derive from an increase in the form of inactivated Rubisco.
Burden of Fatigue among Adults Living with HIV/AIDS Attending Antiretroviral Therapy in Ethiopia
Authors: Gebreyesus Tsiwaye , Belay Addisalem , Berhe Gebretsadik , Haile Gebremedhin 
Published: April 2020

Abstract
Background: Fatigue is one of the most common and devastating Human Immuno-deficiency Virus (HIV) - related symptoms, with a varying prevalence in different study areas. In Ethiopia, there is a paucity of information on the magnitude and factors associated with fatigue among HIV/Acquired Immune Deficiency Syndrome (AIDS) patients. This may lead to under-diagnosis and eventually under-management of the symptom. Methods: Institution based cross-sectional study design was conducted among 609 HIV/AIDS patients who were selected by using a systematic random sampling method. Data were collected by using interviewer administered structured questionnaire. Level of fatigue was measured by Fatigue Severity Scale. Results: The prevalence of fatigue was found to be 51.7%. The factors associated with fatigue were: Parity [AOR= 2.01; 95% CI: 1.09-3.71], CD4 count 200-499 cells/mm3 [AOR= 2.81; 95% CI: 1.58-4.99], anemia [AOR= 4.90 95% CI: 2.40-9.97], co-morbidities [AOR= 3.65; 95% CI: 1.71-7.78], depression [AOR= 3.68 95% CI: 1.99-6.79], not being physically active [AOR= 3.20 95% CI: 1.50-6.81], clinical stage II or IV HIV [AOR= 3.11; 95% CI: 1.51-6.40] and [AOR= 4.08; 95% CI: 1.37-12.14], respectively. Conclusion: The finding of this study revealed that fatigue is a common health problem among adult People Living with HIV (PLHIV). Factors associated with fatigue included: Parity, CD4 count 200-499 cells/mm3, Clinical Stage II or IV HIV, anemia, co-morbidities, depression, and not being physically active. The health care service needs to address the predisposing factors by provision integrated care including timely detection and treatment of comorbidities, mental health problems, and promote physical activity to slow down disease progression and then reduce exposure to fatigue.
Short-latency afferent inhibition and somato-sensory evoked potentials during the migraine cycle: surrogate markers of a cycling cholinergic thalamo-cortical drive?
Authors: Coppola Gianluca , Lenola Davide Di , Abagnale Chiara , Ferrandes Fabio , Sebastianelli Gabriele , Casillo Francesco , Lorenzo Cherubino Di , Serrao Mariano , Evangelista Maurizio , Schoenen Jean , Pierelli Francesco 
Published: April 2020

Abstract
Background: Short-latency afferent inhibition (SAI) consists of motor cortex inhibition induced by sensory afferents and depends on the excitatory effect of cholinergic thalamocortical projections on inhibitory GABAergic cortical networks. Given the electrophysiological evidence for thalamo-cortical dysrhythmia in migraine, we studied SAI in migraineurs during and between attacks and searched for correlations with somatosensory habituation, thalamocortical activation, and clinical features.
Methods: SAI was obtained by conditioning the transcranial magnetic stimulation-induced motor evoked potential (MEP) with an electric stimulus on the median nerve at the wrist with random stimulus intervals corresponding to the latency of individual somatosensory evoked potentials (SSEP) N20 plus 2, 4, 6, or 8 ms. We recruited 30 migraine without aura patients, 16 between (MO), 14 during an attack (MI), and 16 healthy volunteers (HV). We calculated the slope of the linear regression between the unconditioned MEP amplitude and the 4-conditioned MEPs as a measure of SAI. We also measured SSEP amplitude habituation, and high-frequency oscillations (HFO) as an index of thalamo-cortical activation.
Results: Compared to HV, SAI, SSEP habituation and early SSEP HFOs were significantly reduced in MO patients between attacks, but enhanced during an attack. There was a positive correlation between degree of SAI and amplitude of early HFOs in HV, but not in MO or MI.
Conclusions: The migraine cycle-dependent variations of SAI and SSEP HFOs are further evidence that facilitatory thalamocortical activation (of GABAergic networks in the motor cortex for SAI), likely to be cholinergic, is reduced in migraine between attacks, but increased ictally.
Laparoscopic versus open major liver resection for hepatocellular carcinoma: a case-matched analysis of short- and long-term outcomes
Authors: He Aoxiao , Li Yong , Wang Jiakun , Feng Qian , Liao Wenjun , Huang Zhihao , Xiao Zhouqing , Wu Junjun , Peng Long , wu linquan 
Published: April 2020

Abstract
Background: The feasibility and safety of laparoscopic major hepatectomy (LMH) is still uncertain. The purpose of the present study is to compare the short- and long-term outcomes of LMH with those of open major hepatectomy (OMH) for hepatocellular carcinoma (HCC).Method: Between January 2012 and December 2018, a total of 26 patients received laparoscopic major hepatectomy in our center. To minimize any confounding factors, a 1:3 case-matched analysis was conducted based on the demographics and extent of liver resection. Data of demographics, perioperative outcomes and long-term oncologic outcomes were reviewed.Results: Intraoperative blood loss (P=0.007) were significantly lower in LMH group. In addition, LMH group exhibited a lower overall complication rate (P=0.039) and shorter postoperative hospital stay (P=0.024). However, no statistically significant difference was found between LMH and OMH regarding operation time (P=0.215) and overall cost (P=0.024). Two laparoscopic cases were converted to open liver resection. In regard with long-term outcomes, there was no significant difference between LMH and OMH regarding disease-free survival (DFS) (P=0.079) and overall survival (OS) (P=0.172).Conclusion: LMH can be an effective and safe alternative to OMH for selected patients with liver cancer in short- and long-term outcomes.
Traditional Chinese medicine Da-Cheng-Qi-Tang ameliorates impaired gastrointestinal motility and intestinal inflammatory response in a mouse model of postoperative ileus
Authors: Chen Chunqiu , Li Min , Liu Xiaohong , Fan Jianwei , Zhang Hong , Lin Sisi , Yin Lu , Fichna Jakub , Li Yongyu 
Published: April 2020

Abstract
Background Chinese medicine decoction Da-Cheng-Qi-Tang (DCQT) is effective for treating gastrointestinal (GI) disorders, including postoperative ileus (POI); however, the mechanism by which DCQT improves intestinal motility of POI remains unknown. Purpose The aim of this study is to explore the therapeutic effect and mechanism of the decoction with the traditional formula DCQT (T-DCQT) and a modified DCQT (M-DCQT) in an experimental POI mouse model. Methods Mice were divided into 5 experimental groups with 16 mice per group as follows: (1) control group; (2) sham group; (3) POI group; (4) T-DCQT group and (5) M-DCQT group. Each group was subdivided into 2 groups in which the therapeutic effect was examined at 24h and 48h after operation. POI was induced by classic intestinal manipulation operation and the gastrointestinal(GI) motility was measured with a charcoal marking mixture gavage. The intestinal tissues were collected for evaluation of the histopathological alteration, and analysis of the expression of inflammatory signal pathways, as NF-κB, p38 MAPK, and TLR4 by qPCR, immunohistochemical staining and western-blotting, respectively. Plasma inflammatory cytokines were determined using a high-throughput liquid chip. All analyses were performed with samples collected 24 and/or 48h after operation. Results GI transit was significantly reduced in mice with POI and this dysfunction was alleviated after administration of either T-DCQT or M-DCQT enema. When compared to controls, the pathological changes in the ileum mucosal of POI mice were significantly improved, and the increased expression of NF-κB, p38 MAPK, and TLR4 in the intestinal tissues were reversed, following T- DCQT or M-DCQT treatment. Plasma inflammatory cytokines, such as IL-1α, IL-6, MCP-1, MIP-1β and IL-17 levels were significantly highly expressed in POI group, and most of them, as IL-1α, IL-6, MIP-1β and IL-17 were significantly reduced after T-DCQT or M-DCQT treatment. Conclusion The current study indicated that administration of T-DCQT or M-DCOT could ameliorate the POI-associated inflammatory response and improve GI motility, by controlling inflammatory cytokines release and modulating the expression of some inflammatory signal pathways in the POI mouse model.
Trypanosome infections in naturally infected horses and donkeys of three active sleeping sickness foci in the south of Chad
Authors: Vourchakbé Joël , Tiofack Arnol Auvaker , Mpoame Mbida , Simo Gustave 
Published: April 2020

Abstract
Background Equine trypanosomiases are complex infectious diseases with overlapping clinical signs defined by their mode of transmission. Despite their economic impacts, these diseases have been neglected by the scientific community, the veterinary authorities and regulatory organizations. To fill the observed knowledge gap, we undertook the identification of different trypanosome species and subspecies naturally infecting horses and donkeys within the Chadian sleeping sickness focus. The end objective, being to investigate the potential role of these domestic animals as reservoirs of the human infective Trypanosoma brucei gambiense Method Blood samples were collected from 155 donkeys and 131 horses in three human African trypanosomiasis (HAT) foci of Chad. Rapid diagnostic test (RDT) and capillary tube centrifugation (CTC) test were used to search for trypanosome infections. DNA was extracted from each blood sample and different trypanosome species and subspecies were identified with molecular tools. Results From 286 blood samples collected, 54 (18.9%) and 36 (12.6%) were respectively positive for RDT and CTC. PCR revealed 194 (67.8%) animals with trypanosome infections. The kappa Cohen coefficients used to evaluate the concordance between the diagnostic methods were low; ranging from 0.087±0.04730 to 0.48 ± 0.06951. Trypanosomes of the subgenus Trypanozoon were the most prevalent (29.4%), followed by T. congolense forest (11.5%), T. congolense savannah (4.9%) and T. vivax (4.5%). Two donkeys and one horse from the Maro HAT focus were found with T. b. gambiense infections. Between animal species and HAT foci, no significant differences were observed in the infection rates of different trypanosomes. Conclusion This study revealed several trypanosome species and sub species in donkeys and horses, highlighting the existence of AAT in HAT foci of Chad. The identification of T. b. gambiense in donkeys and horses suggests considering these animals as potential reservoir for HAT in Chad. The presence of both human-infective and human non infective trypanosomes species highlights the need for developing joined control strategies for HAT and AAT.
Inhibition of acute leukemia with attenuated Salmonella typhimurium strain VNP20009
Authors: Li Meirong , Lu Mengmeng , Lai Yunhao , Zhang Xindan , Li Yuyu , Mao Ping , Liang Zhicheng , Mu Yunping , Lin Ying , Zhao Allan Z. , Zhao Zhenggang , Zhou Sujing , Li Fanghong 
Published: April 2020

Abstract
Background Despite recent promising progress, the prognosis of acute leukemia (AL) patients remains to be improved. New therapies are therefore still needed. Spontaneous complete remission (SCR) of leukemia caused by severe bacterial infection in clinic suggests the possibility of bacterial treatment for AL. An engineered attenuated Salmonella typhimurium VNP20009 with good tolerance and safety has been shown to be highly effective as an anti-tumor agent in many solid cancer models, but it has not been applied in leukemia. Therefore, we selected VNP20009 as a candidate for the bacterial therapy of AL in this study. Methods Murine xenograft tumor models were used to verify the growth inhibition effect of VNP20009 on AL tumors. Histopathological features of the tumor were observed by H&E staining, Ki-67 immunohistochemical staining and TUNEL immunofluorescence staining. The apoptosis proteins Bax and cleaved caspase-3 in tumors were detected by Western blotting. The ratios of apoptosis, green fluorescent protein positive (GFP + ) cells and immune cells were detected by flow cytometry. Blood cell count were counted by IDEXX automatic five-classification blood cell analyzer. Detection of cytokines and chemokines in serum was completed on a Luminex Multi-factor Detection Platform. Results VNP20009 can induce apoptosis of AL cells by up-regulating the expression levels of Bax and cleaved caspase-3 . Furthermore, VNP20009 significantly inhibited the proliferation of MLL-AF9-induced AML cells and prolonged the survival of the AML-carrying mice. VNP20009 restored the counts of white blood cell and its five subsets in PB to near-physiological values, and elevated the levels of certain cytokines, such as tumor necrosis factor-α (TNF-α), leukemia inhibitory factor (LIF), interferon-γ (IFN-γ), chemokine C-X-C motif ligand-10 (CCXC-10) and C-C motif ligand-2 (CCL-2). Moreover, the ratio of immune cells, including natural killer cells (NKs), CD4 + Th1-type cells and CD8 + IFN-γ-producing effector T cells were highly upregulated in the AML mice treated with VNP20009. Conclusions VNP20009 induces the apoptosis of AL cells and activates the immune system, leading to the development of a strong and effective anti-tumor systemic response and tumor remission in acute leukemia. Keywords: acute leukemia, attenuated Salmonella typhimurium VNP20009, immunotherapy, bacterial cancer therapy, apoptosis
Does large (&gt;24mm) follicle yield a competent oocyte/embryo?
Authors: Orvieto Raoul , Mohr-Sasson Aya , Blumenfeld Shlomit , Nahum Ravit , Aizer Adva , Haas Jigal 
Published: April 2020

Abstract
Aim: To evaluate the effect of large follicular size ( > 24mm) at day of oocyte retrieval on oocyte/embryo quality. Patients and Methods: A cohort study conducted in a single tertiary medical center between July 2018 and May 2019. Before ultrasound-guided follicular aspiration, follicles were measured and divided into two groups according to their maximal dimensional size: large: ≥24 mm and normal: <24 mm. Microscopic examination of the follicular aspirates was performed by embryologist. Each follicle aspirated was evaluated for oocyte maturation, oocyte fertilization and embryo quality. Results: 428 follicles were measured, including 383 (62.81%) in the normal and 45 (14.06%) in the large follicle groups. Oocytes were achieved during aspiration from 297 (75.5%) and 29 (64.4%) of the normal and large follicle groups, respectively (p=0.05). No in-between group differences were observed in mature oocyte (MII), fertilization and top quality embryo (TQE) rates. Nevertheless, once a zygote (2PN) was achieved, a trend toward a higher TQE rate/2PN was found in the large follicle group [16 /19 (84.2%) vs. 115/171 (67.3%); p=0.062]. Conclusion: While a non-significant decrease in oocyte recovery rate was found in follicles ≥24 mm, the zygote and TQE per follicles were comparable.** Drs. Orvieto and Mohr-Sasson should be considered "similar in author order."