bluuebunny/crossref_metadata_2025_split huggingface dataset:
High-Grade Patellar Chondral Defects: Promising Results From Management With Osteochondral Autografts
Authors: Figueroa David , Calvo Rodriguez Rafael , Donoso Rodrigo , Espinoza Jaime , Vaisman Alex , Yañez Claudio 
Published: July 2020

Background: Patellar chondral defects represent up to 34.6% of defects found during routine arthroscopy. Surgical management has evolved during the past 20 years in an effort to develop techniques to replace hyaline cartilage. Currently, the only technique that achieves this is osteochondral autologous transfer (OAT). Although good and excellent results have often been reported at midterm and long-term follow-up for femoral lesions, little is known about isolated patellar defects. Purpose: To assess clinical and imaging results of patients treated with OAT for high-grade patellar defects. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective study on all patients who received OAT for high-grade symptomatic patellar chondral defects between 2010 and 2018 at our institution. The study included patients younger than 40 years of age with anterior knee pain and a grade 4 International Cartilage Repair Society patellar chondral defect between 1 and 2.5 cm2. Patients with surgery in other knee compartments, concomitant anterior cruciate ligament ruptures, infection, rheumatoid arthritis, and degenerative lesions were excluded. Six months postoperatively, all patients underwent magnetic resonance imaging (MRI) to allow assessment of graft integrity via the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score to evaluate morphologic features and integration. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Kujala scores were used to assess functional outcomes at final follow-up. Results: A total of 26 patients who received a patellar OAT were included. Most patients were male (88.4%), and the mean ± SD age was 28.5 ± 9.7 years. Patellar chondral defects had a median size of 180 mm2 (range, 64-250 mm2), and patients received a median of 1 autograft (range, 1-3). Functional outcomes assessed at a minimum of 1 year after surgery showed a mean Kujala score of 90.42 ± 6.7 and a mean WOMAC score of 95 ± 3.6. MRI revealed a median MOCART score of 75 points (range, 20-90 points). Conclusion: To our knowledge, this is the largest series to date regarding isolated patellar OAT. At midterm follow-up, most patients reported good and excellent results regarding symptoms and activity levels. Most autografts showed good osseous integration and excellent filling of the chondral surface, as evidenced on MRI. OAT is a good alternative to treat high-grade patellar chondral defects, especially among young patients.
Non-target screening of organic pollutants and target analysis of halogenated polycyclic aromatic hydrocarbons in the atmosphere around metallurgical plants by high-resolution GC/Q-TOF-MS
Authors: Yang Lili , Wu Jiajia , Zheng Minghui , Cao Zhe , Li Cui , Shi Miwei , Liu Guorui 
Published: July 2020

Abstract
Background
The 16 priority polycyclic aromatic hydrocarbons (PAHs) issued by US Environmental protection agency are a major focus in atmosphere in previous studies. Many more PAH congeners or their substitutes could be produced during combustion or thermal industrial processes and released into the atmosphere. However, a full screening of various organic pollutants in air surrounding important industrial sources has not been conducted. Identifying and characterizing organic pollutants in air is essential for accurate risk assessment. This study conducted non-target screening of organic pollutants and simultaneous target analysis of emerging contaminants including 8 polychlorinated naphthalenes and 30 higher cyclic halogenated PAHs by high-resolution gas chromatography quadrupole time-of-flight mass spectrometry (GC/Q-TOF-MS) and applied to the air samples collected surrounding metallurgical plants. Emerging organic chemicals of high toxicity in air were identified.

Results
We identified and characterized 187 organic chemicals categorized as PAHs, alkylated polycyclic aromatic compounds (PACs), heterocyclic PACs, and aliphatic hydrocarbons in atmosphere around industrial sources. Some of these identified chemicals, such as phthalic acid esters, dimethylbenz[a]anthracene, and hydroquinone with alkane substituents are of potential high toxicities and have not been the focus of previous studies of airborne contaminants. Moreover, hydroquinone with alkane substituents may be critical intermediates and precursors of an emerging contaminant—environmentally persistent free radicals. Thus, the presence of those identified highly toxic chemicals in the air merits attention. Moreover, 38 chlorinated and brominated PAHs as target compounds were accurately quantitated by using isotopic dilution method by application of GC/Q-TOF-MS, and the findings were similar to those of high-resolution magnetic mass spectrometry.

Conclusion
In this study, both non-target screening of organic pollutants and target analysis of halogenated PAHs in air were achieved by GC/Q-TOF-MS. The method could be of significance for simultaneous analysis of those trace pollutants containing multiple congeners. Specific pollutants of potential high toxicity in atmosphere around industrial sources were identified. Those knowledge could be helpful for comprehensively recognizing the organic contaminants in air surrounding metallurgical plants and better understanding their potential health risks.
Severe euglycemic diabetic ketoacidosis of multifactorial etiology in a type 2 diabetic patient treated with empagliflozin: case report and literature review
Authors: Sampani Erasmia , Sarafidis Pantelis , Dimitriadis Chrysostomos , Kasimatis Efstratios , Daikidou Dimitra , Bantis Konstantinos , Papanikolaou Alexios , Papagianni Aikaterini 
Published: July 2020

Abstract
Background
Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are a relatively novel class of oral medications for the treatment of Type 2 DM with a generally acceptable safety profile. However, these agents have been associated with rare events of a serious and potentially life-threatening complication named euglycemic diabetic ketoacidosis (euDKA). euDKA is not identical with the typical diabetic ketoacidosis, as it often presents with serious metabolic acidosis but only mild to moderate glucose and anion gap elevation.

Case presentation
We report a case of a 51-year old female with Type 2 DM treated with an SGLT-2 inhibitor, developing severe metabolic acidosis with only mild blood glucose elevation after a routine surgery. A careful evaluation of involved factors led to the diagnosis of euDKA, followed by cautious application of simple therapeutic measures that resulted in complete restoration of acidosis and glycemic control in less than 48-h.

Conclusions
Euglycemic ketoacidosis is a rare but rather serious complication of SGLT-2 inhibitors use, often with a multifactorial etiology. Its atypical presentation requires a high level of awareness by physicians as early recognition of this complication can quickly and safely restore acid-base balance.
“The right time is just after birth”: acceptability of point-of-care birth testing in Eswatini: qualitative results from infant caregivers, health care workers, and policymakers
Authors: Sacks Emma , Khumalo Philisiwe , Tsabedze Bhekisisa , Montgomery William , Mthethwa Nobuhle , Nhlabatsi Bonisile , Masuku Thembie , Cohn Jennifer , Chouraya Caspian 
Published: July 2020

Abstract
Background
Testing for HIV at birth has the potential to identify infants infected in utero, and allows for the possibility of beginning treatment immediately after birth; point of care (POC) testing allows rapid return of results and faster initiation on treatment for positive infants. Eswatini piloted birth testing in three public maternities for over 2 years.

Methods
In order to assess the acceptability of POC birth testing in the pilot sites in Eswatini, interviews were held with caregivers of HIV-exposed infants who were offered birth testing (N = 28), health care workers (N = 14), and policymakers (N = 10). Participants were purposively sampled. Interviews were held in English or SiSwati, and transcribed in English. Transcripts were coded by line, and content analysis and constant comparison were used to identify key themes for each respondent type.

Results
Responses were categorized into: knowledge, experience, opinions, barriers and challenges, facilitators, and suggestions to improve POC birth testing. Preliminary findings reveal that point of care birth testing has been very well received but challenges were raised. Most caregivers appreciated testing the newborns at birth and getting results quickly, since it reduced anxiety of waiting for several weeks. However, having a favorable experience with testing was linked to having supportive and informed family members and receiving a negative result. Caregivers did not fully understand the need for blood draws as opposed to tests with saliva, and expressed the fears of seeing their newborns in pain. They were specifically grateful for supportive nursing staff who respected their confidentiality. Health care workers expressed strong support for the program but commented on the high demand for testing, increased workload, difficulty with errors in the testing machine itself, and struggles to implement the program without sufficient staffing, especially on evenings and weekends when phlebotomists were not available. Policymakers noted that there have been challenges within the program of losing mothers to follow up after they leave hospital, and recommended stronger linkages to community groups.

Conclusions
There is strong support for scale-up of POC birth testing, but countries should consider ways to optimize staffing and manage demand.
Effectiveness of preemptive antifibrinolysis with tranexamic acid in rheumatoid arthritis patients undergoing total knee arthroplasty: a study protocol for a randomized controlled trial
Authors: Lei Yiting , Liu Jiacheng , Liang Xi , Hu Ning , Pei Fuxing , Huang Wei 
Published: July 2020

Abstract
Background
Patients with rheumatoid arthritis (RA) who have undergone total knee arthroplasty are at increased risk of requiring a blood transfusion. This study is designed to compare the effects of preemptive antifibrinolysis of single-dose and repeat-dose tranexamic acid (TXA) in in RA patients undergoing total knee arthroplasty (TKA).

Methods/design
The study will be a double-blind randomized controlled trial with two parallel groups of RA patients. Group A will be given 100 ml normal saline twice daily starting from 3 days before the operation, Group B will be given TXA 1.5 g twice daily starting from 3 days before the operation. All patients will be given TXA 1.5 g 30 min before the operation. The primary outcomes will be evaluated with total blood loss and hidden blood loss. Other outcome measurements such as, fibrinolysis parameters, inflammatory factors, visual analogue scale for post-operative pain, analgesia usage, coagulation parameters, transfusion, the length of stay (LOS), total hospitalization costs, the incidence of thromboembolic events and other complications will be recorded and compared. Recruitment is scheduled to begin on 1 August 2020, and the study will continue until 31 May 2021.

Discussion
In current literature there is a lack of evidence with regard to the efficacy of TXA in RA patients. The findings of this study, whether positive or negative, will contribute to the formulation of further recommendations on the use of TXA in RA patients undergoing TKA.

Trial registration
Chinese Clinical Trial Registry, ChiCTR2000029720. Registered 14 February 2020.
Recurrent granular cell tumor of the thyroid: a case report and literature review
Authors: He Yu-qin , Lu Hai-zhen , Li De-zhi , Chen Mo-qi , Wang Kai , Xu Zhen-gang , Liu Shao-yan 
Published: July 2020

Abstract
Background
Granular cell tumor (GCT) of the thyroid is a rare benign tumor of Schwann cell origin with a favorable prognosis and only 10 cases have been reported so far in scientific literature. The present case study describes the first case of recurrent thyroid GCT.

Case presentation
Our case describes a 20-year-old woman who had undergone lobectomy for GCT of the thyroid 4 years ago. Hematoxylin-eosin (HE) staining revealed that the lesion was composed of epithelioid cells with an abundance of eosinophilic granular cytoplasm. Immunohistochemical analysis showed that tumor cells tested positive for S-100 protein and negative for desmin. Both histological and immunohistochemical analyses supported the diagnosis of recurrent GCT of the thyroid.

Conclusions
Our case suggested that a tumor-free margin excision and post-operative follow-up are necessary for the treatment of GCT of the thyroid.
A novel pleural-bladder pump for the management of recurrent malignant pleural effusions: a feasibility animal study
Authors: Laroumagne S. , Guinde J. , Berdah S. , Dutau H. , Capel J. , Astoul P. 
Published: July 2020

Abstract
Background
Recurrent malignant pleural effusions (MPE) are common and associated with significant morbidity in cancer patients. A new pump connecting the pleural cavity and the bladder may have application for the management of recurrent MPE. In a pre-clinical study, we investigated the utility of this pump in healthy pigs.

Methods
A novel pump system (Pleurapump® system) was inserted into four pigs under general anaesthesia. A tunnelled-pleural catheter was connected to a subcutaneously implanted pump while the urinary bladder was connected by percutaneous technique. Animals were ventilated mechanically and pump functioning was tested using a range of ventilation parameters and spontaneous breathing. Fluid was added to the pleural space to mimic pleural effusion and to assess the effectiveness of the pump at removing fluid to the bladder.

Results
The ‘pleurapump’ system successfully transported fluid from the pleural cavity to the bladder. Pressure variations caused by respiration and variations in the amount of fluid in the pleural cavity had no impact on the pumping. Pumping stopped when the pleural cavity was drained.

Conclusion
This pump can be implanted into pigs and successfully removed fluid from the pleural cavity to the bladder and may represent a new treatment for management of recurrent MPE. Evaluation in humans is planned.
Plasmodium falciparum genetic factors rather than host factors are likely to drive resistance to ACT in Ghana
Authors: Hodoameda Peter , Duah-Quashie Nancy Odurowah , Hagan Charles Oheneba , Matrevi Sena , Abuaku Benjamin , Koram Kwadwo , Quashie Neils Ben 
Published: July 2020

Abstract
Background
Artemisinin-based combination therapy (ACT) partner drugs, currently used in Ghana are lumefantrine, amodiaquine and piperaquine. Plasmodium falciparum isolates with reduced susceptibility to these partner drugs may affect treatment outcome. Mutations in pfmdr1 gene is linked to reduced parasite susceptibility to amodiaquine and lumefantrine. In addition, the potency of the partner drugs in vivo depends on the metabolism by the cytochrome P450 (CYP) enzyme in the host. Mutations in the CYP2C8 and CYP3A4 genes are linked to reduced metabolism of amodiaquine and lumefantrine in vitro, respectively. This study investigated the host and parasite genetic factors affecting the susceptibility of the malaria parasite to ACT partner drugs.

Methods
Archived samples from 240 patients age ≤ 9 years participating in anti-malarial drug resistance survey in Ghana, and given artemether with lumefantrine (AL) or artesunate with amodiaquine (AA), were selected and analysed. Polymerase chain reaction (PCR) followed by Sanger sequencing was used to determine the polymorphisms in CYP2C8, CYP3A4 and pfmdr1 genes.

Results
For CYP3A4, all had wild type alleles, suggesting that the hosts are good metabolizers of lumefantrine. For CYP2C8 60% had wild type alleles, 35% heterozygous and 5% homozygous recessive alleles suggesting efficient metabolism of amodiaquine by the hosts. For pfmdr1 gene, at codon 86, 95% were wild type (N86) and 5% mutant (Y86). For codon 184, 36% were wild type (Y184) and 64% mutant (F184) while for codons 1034, 1042 and 1246, 100% (all) were wild type. The high prevalence of N86-F184-D1246 haplotype (NFD) suggest presence of parasites with reduced susceptibility to lumefantrine and not amodiaquine. Delayed clearance was observed in individuals with mutations in the pfmdr1 gene and not cytochrome 450 gene. Both synonymous and non-synonymous mutations were observed in the pfmdr1 at low prevalence.

Conclusion
The outcome of this study indicates that the parasite's genetic factors rather than the host’s are likely to drive resistance to ACT in Ghana.
Transurethral needle electrode resection and transurethral holmium laser resection of bladder cancer
Authors: Zhou Yu , Zhang Zheng-Long , Luo Mao-Hua , Yang Hua 
Published: July 2020

Abstract
Purpose
The aim of the present study was to explore the efficacy and safety of transurethral needle electrode resection and transurethral holmium laser resection of non-muscular invasive bladder cancer (NMIBC).

Patients and methods
In this prospective, case-control study, patients from the Urinary Surgery or Oncology Department who met the inclusion and exclusion criteria received transurethral needle electrode resection (n = 52) or transurethral holmium laser resection (n = 51).

Results
A total of 103 patients with NMIBC were included in the present study, with 68 males and 35 females. Their mean age was 57.3 years. Sixty-two patients had Ta, 15 patients had T1, and 26 patients had Tis. Operative time, intraoperative blood loss, postoperative gross hematuria time, bladder irrigation time, and postoperative hospitalization time were all significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. After resection, transurethral holmium laser resection significantly decreased the value of HGF, TSH, and TNF-α versus the transurethral needle electrode resection group. The incidence of obturator reflex was significantly lower in the transurethral holmium laser resection group than the transurethral needle electrode resection group. There was no significant difference in disease-free survival rate and progression-free survival rate between the two groups.

Conclusions
Transurethral holmium laser resection has clinical advantages in the treatment of NMIBC.
The extracellular vesicle of gut microbial Paenalcaligenes hominis is a risk factor for vagus nerve-mediated cognitive impairment
Authors: Lee Kyung-Eon , Kim Jeon-Kyung , Han Sang-Kap , Lee Dong Yun , Lee Hae-Ji , Yim Sung-Vin , Kim Dong-Hyun 
Published: July 2020

Abstract
Background
In a pilot study, we found that feces transplantation from elderly individuals to mice significantly caused cognitive impairment. Paenalcaligenes hominis and Escherichia coli are increasingly detected in the feces of elderly adults and aged mice. Therefore, we isolated Paenalcaligenes hominis and Escherichia coli from the feces of elderly individuals and aged mice and examined their effects on the occurrence of age-related degenerative cognitive impairment and colonic inflammation in mice.

Results
The transplantation of feces collected from elderly people and aged mice caused significantly more severe cognitive impairment in transplanted young mice than those from young adults and mice. Oral gavage of Paenalcaligenes hominis caused strong cognitive impairment and colitis in specific pathogen-free (SPF) and germ-free mice. Escherichia coli also induced cognitive impairment and colitis in SPF mice. Oral gavage of Paenalcaligenes hominis, its extracellular vesicles (EVs), and/or lipopolysaccharide caused cognitive impairment and colitis in mice. However, celiac vagotomy significantly inhibited the occurrence of cognitive impairment, but not colitis, in mice exposed to Paenalcaligenes hominis or its EVs, whereas its lipopolysaccharide or Escherichia coli had no such effects. Vagotomy also inhibited the infiltration of EVs into the hippocampus.

Conclusions
Paenalcaligenes hominis, particularly its EVs, can cause cognitive function-impaired disorders, such as Alzheimer’s disease, and its EVs may penetrate the brain through the blood as well as the vagus nerve.
The application of Kunnan’s test fairness framework (TFF) on a reading comprehension test
Authors: Moghadam M. , Nasirzadeh F. 
Published: July 2020

AbstractThe present study tries to investigate the fairness of an English reading comprehension test employing Kunnan’s (2004) test fairness framework (TFF) as the most comprehensive model available for test fairness. The participants of this study comprised 300 freshman students taking general English course chosen based on the availability sampling, three test developers, and seven university officials, administering the test. The main instrument is the teacher-made reading comprehension test to examine its validity, reliability, and differential item functioning (DIF). Furthermore, to examine the other modules of TFF, namely, access, administration, and social consequence, a questionnaire and semi-structured interviews with the test developers and test administrators were applied. In order to analyze the data, exploratory factor analysis is used to evaluate test validity employing Minitab software. Moreover, t test and ANOVA were used to examine the disparate impact of the test using SPSS package. Furthermore, the Mantel-Haenszel procedure is applied to determine the DIF, while coding the required formulas in R programming. The frequencies of different aspects of access and test administration are explained and consolidated by qualitative data gleaned from interview sessions. Examining the data with respect to TFF modules, it was concluded the test must be enhanced in terms of validity, while it is totally fair. The statistical procedure and the mixed research design implemented in the present study can be a sound model to be applied by test developers to enhance the test fairness of the exams.