bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term prediction of clinical and radiographic contralateral hip osteoarthritis after index total hip arthroplasty
Authors: Ocokoljic Ana , Krivec Lukas , Alimy Assil-Ramin , Simon Alexander , Strahl André , Beil Frank Timo , Rolvien Tim 
Published: December 2024

Abstract
Introduction
Patients with primary hip osteoarthritis undergoing unilateral total hip arthroplasty (THA) often face uncertainty about the future need for arthroplasty in the contralateral hip. We aimed to identify parameters that have predictive value with regard to the necessity for contralateral THA or the development of contralateral radiographic osteoarthritis (OA) phenotypes following index surgery.

Materials and methods
In this retrospective study, we analyzed 220 patients undergoing THA. Of these, 24.1% required contralateral THA at a mean follow-up of 18.3months. Our assessments included preoperative and follow-up pelvis radiographs as well as bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry prior to index THA. Comprehensive radiological measurements such as the Kellgren-Lawrence OA grade, osteophyte evaluation as well as joint shape and alignment (including alpha and CE angles) were performed.

Results
We identified three indicators at the initial assessment for predicting the need for contralateral THA: higher BMI (odds ratio (OR) 1.1 [95%-CI 1.0-1.2], p = 0.033), higher alpha angles (> 61.5°) (OR 2.5 [95%-CI 1.0-6.3], p = 0.045) and the presence of multiple osteophytes (OR 2.6 [95%-CI 1.4–4.9], p = 0.004). Moreover, higher alpha angles were linked to more severe radiographic OA, especially osteophytosis. Higher BMD T-scores were also associated with progressive formation of multiple and large osteophytes but not joint space narrowing.

Conclusion
Three factors - BMI, alpha angle, and osteophyte number - are key short-term predictors for contralateral THA after index THA. We also identified BMD as a surrogate for osteophyte formation. These findings provide novel and valuable insights for patients and surgeons regarding risks and counseling for contralateral OA and THA.
Anterior femoral offset is a flawed measurement of patellofemoral overstuffing
Authors: Klasan Antonio , Heyse Thomas Jan , Nedopil Alexander Johannes 
Published: December 2024

Abstract
Background
Patellofemoral joint (PFJ) issues after total knee arthroplasty (TKA) are becoming a topic of interest once again. Due to the complex three-dimensional shape of the trochlea, various two-dimensional proxy measurements on plain X-rays have been described. One of these measurements is the anterior femoral offset (AFO). It is the distance between the anterior femoral cortex and the trochlea’s most anterior point (MAP) on a true lateral X-ray after TKA. Because the relationship between the trochlea’s MAP and its groove, which is the primary joint surface articulating with the patella, is unknown, the purpose of this study was to measure the distance between the MAP and the trochlear groove.

Methods
After femoral component implantation, the surgeon identified the trochlea’s MAP and the trochlear groove in ten consecutive TKAs and measured their distance. Measurements were performed with a ruler on a true lateral photograph and with a radiographic marker on a lateral radiograph in four different knee flexion angles, according to a previously published protocol.

Results
The trochlear groove had a mean distance from the MAP between 2.09 ± 0.15 and 5.50 ± 0.17 mm, depending on the position. In no case is the trochlear groove visible on a true lateral view.

Conclusion
On a true lateral X-ray, the trochlea’s MAP omits the trochlear groove. Because the patella primarily articulates with the trochlear groove and because the relationship between the MAP and the trochlear groove is variable depending on the knee flexion angle, any conclusions regarding overstuffing based on a postoperative lateral knee X-ray are flawed.
Comparison of pain, functional and psychological trajectories between total and unicompartmental knee arthroplasties: secondary analysis of a 6-month prospective observational study
Authors: Terradas-Monllor Marc , Rierola-Fochs Sandra , Merchan-Baeza Jose Antonio , Parés-Martinez Carles , Font-Jutglà Cristina , Hernández-Hermoso José A. , Ochandorena-Acha Mirari 
Published: December 2024

Abstract
Introduction
Unicompartmental knee arthroplasty (UKA) treats osteoarthritis in one knee compartment, while total knee arthroplasty (TKA) addresses all compartments. The debate focuses on UKA's advantages of quicker recovery and fewer complications versus TKA's lower long-term revision rates, emphasizing the need for thorough outcome evaluations. The aim of the present study is to describe and compare the pain, functional and psychological trajectories during a 6-month postoperative rehabilitation period between total and unicompartmental knee arthroplasties.

Materials and Methods
115 participants who had undergone either TKA or UKA were recruited. Outcome measurements were performed at 1, 4, 12 and 24 weeks post-surgery. Measurements included pain intensity (Visual Analog Scale), range of motion, walking speed (4 m walking test), physical performance (30-s chair stand test), health functioning (Western Ontario and McMaster Universities Osteoarthritis Index), pain catastrophizing (pain catastrophizing scale), fear of movement (Tampa Scale of Kinesiophobia), anxiety and depression (Hospital Anxiety and Depression Scale). A mixed-effects model was used to estimate the influence of type of surgery (either unicompartmental or total knee arthroplasty) to pain, function, and psychological trajectories.

Results
Both TKA and UKA groups showed significant improvements across the six-month rehabilitation period except for anxiety symptoms in the TKA group, and fear of movement and depression in the UKA group. Between group analysis revealed that in the acute phase UKA patients showed improved range of motion and TKA patients displayed faster walking speed but higher fear of movement. Overall, the type of surgery does not significantly influence the overall rehabilitation pain, functional and psychological trajectories.

Conclusions
Despite differences in the acute phase, there are no differences in pain, functional and psychological trajectories throughout the six-month rehabilitation period. These results should be acknowledged to better inform patients and to improve patient education during the perioperative period.

Trial registration number
NCT03378440 (2017-12-18), retrospectively registered.

Level of evidence
Level II.
Determination of activities of 210Pb in Slovak tobacco and cigarettes: a study on radiological risks
Authors: Dulanská Silvia , Silliková Veronika Demovics , Goneková Zuzana , Ticháková Michaela , Gebeová Klára , Trnka Michal , Kosnáč Daniel , Pánik Ján 
Published: December 2024

AbstractThis study investigates the 210Pb activity concentrations in tobacco and cigarettes available in Slovakia, utilizing two specific extraction methods including the Sr Resin sorbent used in extraction chromatography, and the AnaLig Sr01 sorbent, which operates based on molecular recognition principles. The findings revealed significant variations in 210Pb activity concentrations, with concentrations ranging from 13.3 to 33.8 mBq/g in tobacco, and from 16.8 to 28.5 mBq/g in cigarettes. The average 210Pb activity per cigarette was 14.4 mBq ± 1.7 mBq. Annual effective doses for smokers were calculated, with values for tobacco ranging from 27.9 to 126.7 µSv and for cigarettes from 25.5 to 115.7 µSv. The study highlights the importance of comparing these two methods to ensure an accurate assessment of 210Pb exposure and evaluation of radiological risks associated with smoking in Slovakia.
The diagnostic journey of patients being investigated for myopathy in a tertiary centre in England
Authors: Qiang Zekai , Barnett Laura , Bingham Georgia , Han Oscar , Walsh Annabel , Conwill Martin , McDonough Harry E. , McDermott Christopher J. , Shaw Pamela J. , Alix James J. P. 
Published: December 2024

Abstract
Myopathies are heterogenous and can provide a diagnostic puzzle. Many patients investigated for myopathy will go on to other diagnoses. An overall understanding of how patients are investigated for suspected myopathy is lacking. Our aim was to understand how patients were investigated for myopathy in our tertiary centre and the timeline of their diagnostic journey. Through local database searches over a 5-year period (2015–2019), we identified a final total of 770 patients investigated for myopathy. Of these, 29.7% went on to a diagnosis of myopathy. The top non-myopathy diagnoses were neuropathy, spinal pathology and ataxia. Both the myopathy and non-myopathy groups had symptoms for an extended period before reaching specialist services (both groups 104 weeks). Following a first hospital visit, median time to diagnosis was not significantly different (myopathy 46.9 weeks, non-myopathy 40.7 weeks, p > 0.05). Data on the diagnostic journey for specific myopathies was also collected, with inflammatory myopathies diagnosed most quickly and muscular dystrophies most slowly. Muscle MRI and biopsy had the best positive predictive values (82.7% and 83.1%, respectively), while EMG had the best negative predictive value (89.3%). A combination of CK, EMG and neuroaxis MRI (brain and spinal cord) yielded at least one correct test result with respect to final diagnosis in 98.9% of cases. In conclusion, patients in whom a muscle disease is considered experience significant diagnostic delay. The first step in the diagnostic journey should be able to identify both myopathy and non-myopathy cases.
Myelin basic protein and TREM2 quantification in the CSF of patients with Multiple System Atrophy and other Parkinsonian conditions
Authors: Maass Fabian , Canaslan Sezgi , van Riesen Christoph , Hermann Peter , Schmitz Matthias , Schulte Claudia , Brockmann Kathrin , Synofzik Matthis , Bähr Mathias , Zerr Inga 
Published: December 2024

Abstract

Background
It is well known that myelin disruption and neuroinflammation are early and distinct pathological hallmarks in multiple system atrophy (MSA) as well as in idiopathic Parkinson’s disease and in other atypical Parkinsonian syndromes. The objective of this study was to assess the value of non-neuronal biomarker candidates that reflect myelin disruption and neuroinflammation.

Methods
Myelin basic protein (MBP) and the soluble form of TREM2 were quantified in a comprehensive movement disorder cohort from two different neurological centers, comprising a total of 171 CSF samples. Commercially available ELISA systems were employed for quantification.

Results
The results of the MBP analysis revealed a significant increase in cerebrospinal fluid (CSF) MBP levels in all atypical Parkinsonian conditions compared to PD. This differentiation was more pronounced in the MSA-c subtype compared to MSA-p. Receiver operating characteristic (ROC) analysis revealed a significant discrimination between PD and MSA (p = 0.032, AUC = 0.70), PD and DLB (p = 0.006, AUC = 0.79) and PD and tauopathies (p = 0.006, AUC = 0.74). The results of the TREM2 analysis demonstrated no significant differences between the PD and atypical Parkinsonian groups if not adjusted for confounders. After adjusting for age, sex, and disease duration, the PD group exhibited significantly higher TREM2 levels compared to the DLB group (p = 0.002).

Conclusions
In conclusion, MBP, but not TREM2, is elevated in the CSF of not only MSA but in all atypical Parkinsonian conditions compared to idiopathic Parkinson’s disease. This highlights the value of the evaluation of myelin/oligodendrocyte-associated markers in neurodegenerative movement disorders.
Medical costs of treating myasthenia gravis in patients who need intravenous immunoglobulin (IVIg) – a register-based study
Authors: Bugge Christoffer , Engebretsen Ingrid , Kristiansen Ivar Sønbø , Sæther Erik Magnus , Lindberg-Schager Ingrid , Arneberg Fredrik , Gilhus Nils Erik 
Published: December 2024

Abstract

Background
Several innovative treatments are expected for myasthenia gravis (MG) in the coming years. Healthcare payers usually require cost-effectiveness analyses before reimbursement. We aimed to investigate resource utilization and direct medical costs for patients with MG treated with intravenous immunoglobulin (IVIg) to inform such analyses.

Methods
We identified patients with MG in the Norwegian Patient Registry based on at least two hospital encounters with an MG diagnosis (ICD-10 G70.0) from 1 Jan 2010 to 31 Dec 2021. IVIg treatment was identified by medical procedure and Anatomical Therapeutic Chemical (ATC) codes (RPGM05 and J06BA02). Using Diagnosis-Related Group (DRG) cost weights, we estimated direct medical costs for each year following the first MG diagnosis.

Results
Over the study period, 1083 patients were diagnosed with MG in Norway, of whom 155 (14.3%) were treated with IVIg. No significant differences in age or sex were observed between IVIg and non-IVIg patients. Compared with non-IVIg patients, IVIg-patients had 2.3 times higher direct medical costs during the first year after MG diagnosis (EUR 35,714 vs. EUR 15,457) and 3.1 times higher costs during the second year (EUR 19,119 vs. EUR 6256). In the fifth year after diagnosis, IVIg-patients still had higher costs and resource utilization than non-IVIg patients (EUR 9953 vs. EUR 5634).

Conclusion
IVIg treatment represents an important marker for high direct medical costs among patients with MG. The costs continue to be high during the first five years after MG diagnosis.
Exploring clinical chemistry markers in amyotrophic lateral sclerosis: insights into survival and disease trajectories
Authors: Psychogios Ioannis , Hu Yihan , Seitz Christina , Joyce Emily E. , Lovik Anikó , Ingre Caroline , Fang Fang 
Published: December 2024

Abstract

Objective
Commonly measured clinical chemistry markers might be indicative of survival and disease progression in amyotrophic lateral sclerosis (ALS).

Methods
In a cohort study of 270 ALS patients diagnosed from April 2014 to May 2021 in Stockholm, Sweden, we examined the link between 29 clinical chemistry markers at diagnosis and mortality risk at 6 months, 1 year, and 3 years after diagnosis. Summary variables from exploratory factor analysis (EFA) assessed the markers’ collective impact on survival. We integrated ALS functional rating scale-revised (ALSFRS-R) scores with survival data using a joint latent class model to identify patterns of functional decline. Multinomial logistic regression determined how the EFA-derived factors predicted the decline trajectories post-diagnosis.

Results
Higher levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B, and albumin at diagnosis were linked to lower mortality in ALS patients, while increased neurofilament light chain (NfL), leukocyte count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and carbon dioxide (CO2) levels indicated higher mortality. The ‘Red blood cell profile’ factor, derived from EFA, emerged as a significant predictor of survival, independent of other prognostic indicators. The joint latent class model identified three distinct patient groups based on functional decline, with ‘Red blood cell profile’ suggesting a lower likelihood of being in the groups with slower progression.

Conclusion
Clinical chemistry markers, including NfL, lipids, albumin, leukocyte count, MCV, MCH, CO2, and the ‘Red blood cell profile,’ were associated with ALS survival. As these markers represent broader bodily functions, integrating them in ALS patient care could improve disease management.
Balance and gait disorders in de novo Parkinson’s disease: support for early rehabilitation
Authors: Lindholm Beata , Hagell Peter , Odin Per , Hansson Oskar , Siennicki-Lantz Arkadiusz , Elmståhl Sölve , Dahlin Lars B. , Franzén Erika 
Published: December 2024

Abstract

Background
Postural instability is considered a late complication of Parkinson’s disease (PD). However, growing evidence shows that balance and gait problems may occur early in the disease.

Objective
To describe balance, gait, and falls/near falls in persons with newly diagnosed, untreated PD (“de novo”), and to compare this with persons with mild-moderate PD (Later PD). In addition, we evaluated differences relative to PD subtypes in de novo PD.

Methods
De novo (n = 54) and Later (n = 58) PD were assessed regarding motor symptoms, balance, gait, and falls/near falls.

Results
At least 25% of de novo PD had impaired reactive balance and/or comfortable gait speed ≤ 1.0 m/s. At least 50% had abnormal dynamic balance. A third reported balance problems during dual-tasking. Five persons (9%) reported falls/near falls. The median (q1–q3) motor symptom score was 21 (14–28) in de novo PD and 13.5 (9–20) in Later PD (p < 0.001). Later PD performed worse on more balance-demanding tests and a higher percentage of individuals reported falls/near falls (p ≤ 0.048). De novo PIGD PD (n = 10) exhibited worse motor symptoms, reactive and dynamic balance, gait speed, mobility, and freezing of gait as compared to the non-PIGD de novo PD (n = 37) (p ≤ 0.049).

Conclusion
Balance and gait were impaired in de novo PD and most pronounced in PIGD subtype. In addition, balance difficulties during dual-tasking and falls/near falls were evident during this early stage. The lower scores of motor symptoms in Later PD did not result in better mobility, balance, or less falls/near falls indicating that medications have less effect on these symptoms.
Eptinezumab treatment was associated with longer interictal headache/migraine periods which corresponded to greater improvements in patient-reported quality of life measures
Authors: Tepper Stewart J. , Diamond Merle L. , Hirman Joe , Asher Divya , Fiore Damian , Cady Roger 
Published: December 2024

Abstract

Introduction
Longer periods between headache episodes (interictal periods) may provide greater time for the nervous system to reset from a previous episode, potentially improving disease status and health-related quality of life. This post hoc analysis evaluated this hypothesis by associating patients’ longest interictal periods with improvements in patient-reported outcomes.

Methods
PROMISE-2 (NCT02974153) was a double-blind, placebo-controlled study evaluating eptinezumab for preventive treatment of chronic migraine (N = 1072). Daily electronic diary data from Weeks 1–12 and Weeks 1–24 were used to identify interictal periods, defined as days between headache episodes. For each patient, the longest interictal period within these intervals was identified and categorized (1–4, 5–9, 10–14, > 14, and > 21 days). For each category, the following patient-reported outcomes were assessed: 6-item Headache Impact Test (HIT-6), Patient Global Impression of Change (PGIC), and patient-identified most bothersome symptom (PI-MBS).

Results
Excluding interictal periods with > 10% missing data (resulting in 1010 patients with sufficient data), the mean (SD) of longest interictal periods over Weeks 1–12 was 9.4 (11.0) days. A ≥6-point HIT-6 reduction was observed in 78% (56/72) vs 26% (91/351) of patients with a > 21-day vs 1–4-day longest interictal period, respectively; much or very much improvement per PGIC was reported in 90% (65/72) vs 25% (87/348), respectively, and per PI-MBS was reported in 88% (63/72) vs 26% (92/348), respectively. Similar results were observed for Weeks 1–24.

Conclusion
Longer interictal periods were associated with more patients indicating positive changes in headache-related life impact, disease status, and symptomology.

Trial registration: ClinicalTrials.gov (identifier: NCT02974153; registered: 2016-11-23)
Frequency and neuropathology of HTT repeat expansions in FTD/ALS: co-existence rather than causation
Authors: Zimmermann Milan , Mengel David , Raupach Katrin , Haack Tobias , Neumann Manuela , Synofzik Matthis 
Published: December 2024

Abstract

Introduction
While ≥ 40 CAG repeat expansions in HTT present a well-established cause of Huntington’s disease (HD), an enrichment of HTT repeat expansions was recently reported also in patients with amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), including FTD/ALS patients with additional HD neuropathology. This raises the question whether the phenotypic spectrum of HTT expansions can be extended to ALS and FTD, and whether HTT should be considered as a new causative gene of FTD/ALS. If HTT repeat expansions were indeed systematically related to FTD/ALS, one would expect an increased frequency of HTT carriers in FTD/ALS, who can clinically/neuropathologically not be explained better than by the presence of the HTT repeat expansions.

Methods
Screening of HTT repeat expansions in 249 consecutive patients with ALS or FTD by short-read genome sequencing took place. The post-mortem neuropathological examination was performed in the identified HTT repeat expansion carrier.

Results
One HTT repeat expansion [40/22 repeats (± 1)] was identified in an ALS patient, giving a frequency of 0.4% (1/249) (frequency in the general population: 0.03–0.18%). This patient showed a classic ALS phenotype, but no clinical or imaging signs of HD. Post-mortem brain examination revealed—in addition to ALS-typical degeneration of upper and lower motor neurons with TDP-43 inclusions—HD-typical polyQ-aggregates in gyrus cinguli, striatum and frontal lobe, yet without evidence of striatal degeneration.

Conclusions
Our study does not support the notion of an increased frequency of HTT repeat expansions in FTD/ALS. Moreover, the phenotype of the HTT carrier identified can be better explained by two co-existent, but independent diseases: (i) ALS and (ii) presymptomatic HD, which—given the low repeat number—is likely to become manifest only later in life. These findings corroborate the concept that HTT repeat expansions are likely co-existent/coincidental, but not causative in FTD/ALS.
Effects of a scoring aid on glasgow coma score assessment and physicians’ comprehension: a simulator-based randomized clinical trial
Authors: Kliem Paulina S. C. , Tisljar Kai , Grzonka Pascale , Berger Sebastian , Amacher Simon A. , De Marchis Gian Marco , Dittrich Tolga D. , Hunziker Sabina , Rüegg Stephan , Bassetti Stefano , Bingisser Roland , Marsch Stephan , Sutter Raoul 
Published: December 2024

Abstract

Purpose
Examining the impact of scoring aids on the accuracy of assessing the Glasgow Coma Score (GCS) in a standardized trauma scenario (primary outcome). Evaluating physicians’ understanding of the GCS assessment and clinical application (secondary outcome).

Materials and methods
This randomized trial was performed at the simulator center of a Swiss tertiary academic medical hospital. Participants included intensivists, emergency physicians, internists, and neurologists. The setting involved a trauma patient portraying a GCS of 8 (eyes 1, verbal 2, motor 5). Participants were randomized to receiving or not receiving a scoring aid. Video/audio recordings of the assessments and questionnaires were analyzed by two investigators.

Results
Among 109 participants, 55 received a scoring aid. Overall, 52% scored correctly (score interquartile range 7–8); 43% scored too low and 90% scored within a range of ± 1. A scoring aid increased accuracy (62% vs. 43%, p = 0.045) and participants’ confidence, whilst decreasing assessment duration. Clinical experience further improved reliability. 89% found assessing a GCS of 8 most challenging, particularly with motor response evaluation (64%). 26% indicated tracheal intubation to be mandatory with a score of GCS ≤ 8.

Conclusions
GCS assessment is improved by professional experience and a scoring aid, the use of which needs to be promoted in daily clinical practice. Frequent inaccuracy and misunderstanding regarding clinical applications may alter patient management and misguide treatment and prognosis.

Trial registration
ISRCTN registry (IDISRCTN12257237) https://www.isrctn.com/ISRCTN12257237 Retrospectively registered (last amendment 08/22/2023).