bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression, Immunosuppressant Levels, and Clinical Outcomes in Postlung Transplant Recipients
Authors: Chu Michael C , Smith Patrick J , Reynolds John M , Palmer Scott M , Snyder Laurie D , Gray Alice L , Blumenthal James A 
Published: February 2020

Objective Posttransplant depression has been linked to increased risk for adverse outcomes in lung transplant patients. Maintaining target serum immunosuppressant levels is also essential for optimal lung transplant clinical outcome and may be a crucial predictor of outcomes. Because depression could affect medication nonadherence, resulting in out-of-range immunosuppressant levels, we examined the relationship between posttransplant depression, immunosuppressant medication trough level variability, indexed by out-of-range values on clinical outcomes and coefficient of variability, and clinical outcomes. Method A consecutive series of 236 lung transplant recipients completed the Center for Epidemiological Studies-Depression two-month posttransplant. Immunosuppressant trough levels (i.e., tacrolimus or cyclosporine) within the range of individualized immunosuppressant targets were obtained at three-, six-, nine-month follow-up clinic visits. Clinical outcomes including hospitalizations and mortality were obtained from medical records. Results Fourteen percent of patients were classified as depressed (Center for Epidemiological Studies-Depression ≥16), 144 (61%) of patients had at least 25% out-of-range immunosuppressant values, and the average coefficient of variability was 36%. Over a median of 2.6 years (interquartile range = 1.2), 32 participants died (14%) and 144 (61%) had at least one unplanned, transplant-related hospitalization. Both depression (hazard ratio = 1.45 (1.19, 1.76), p < . 01) and immunosuppressant variation (immunosuppressant out-of-range: hazard ratio = 1.41 (1.10, 1.81), p < .01) independently predicted more frequent hospitalizations and higher mortality. Conclusions Early posttransplant depression was associated with significantly worse clinical outcomes. While immunosuppressant level variability is also related to adverse outcomes, such variability does not account for increased risk observed with depression.
Dynamic contrast-enhanced MRI histogram parameters predict progression-free survival in patients with advanced esophageal squamous carcinoma receiving concurrent chemoradiotherapy
Authors: Xu Lulu , Ge Xiaolin , Sun Nana , Liu Xisheng 
Published: February 2020

Background There is increased interest in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for predicting the outcomes of patients with advanced esophageal cancer. Purpose To explore whether DCE-MRI histogram parameters can predict 12-month progression-free survival (PFS) in patients with advanced esophageal squamous carcinoma receiving concurrent chemoradiation therapy (CRT). Material and Methods This retrospective study enrolled 134 patients with advanced esophageal squamous carcinoma who were receiving CRT. The pre-CRT DCE-MRI histogram parameters (median, mean, SD, skewness, kurtosis, and 10th and 90th percentiles) of Ktrans, Kep, and Ve were collected. PFS analyses were performed using the Kaplan–Meier method and log-rank tests to compute the survival curves. The significant prognostic predictors among the data characteristics and DCE-MRI parameters were determined using multivariate Cox proportional hazards regression analyses. Results There were 65 good responders (PFS ≥ 12 months) and 69 poor responders (PFS < 12 months). The median and mean values of Ktrans were higher, and the kurtosis value of Ktrans was lower in good responders. The median, mean, and 10th and 90th percentile values of Ktrans were higher, and the kurtosis values of Ktrans and Ve were lower in good responders. The PFS of patients aged ≥60 years, a CR effect, or a 10th percentile value of Ktrans ≥0.13 was increased ( P < 0.001, <0.001, and 0.014, respectively). Conclusion DCE-MRI histogram parameters can be used to evaluate the response to CRT in patients with advanced esophageal squamous carcinoma. The 10th percentile value of Ktrans has significant prognostic value for 12-month PFS.
Autologous Chondrocyte Implantation and Osteochondral Allograft Transplantation Render Comparable Outcomes in the Setting of Failed Marrow Stimulation
Authors: Riff Andrew J. , Huddleston Hailey P. , Cole Brian J. , Yanke Adam B. 
Published: February 2020

Background: Marrow stimulation techniques (MSTs) such as subchondral drilling and microfracture are often chosen as first-line treatment options for symptomatic cartilage defects of the knee. When an MST fails, many cartilage restoration techniques are employed, including autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA). However, a few series in the literature suggest that ACI after a failed MST results in inferior outcomes as compared with primary ACI. Purpose/Hypothesis: The purpose of this study was (1) to evaluate the clinical outcomes of ACI and OCA after a failed MST (secondary ACI and OCA) and compare them with the outcomes of primary ACI and OCA and (2) to compare clinical outcomes of secondary ACI and secondary OCA for refractory lesions involving the femoral condyle. The hypotheses were as follows: (1) secondary ACI will render inferior functional outcomes and an increased clinical failure rate as compared with primary ACI, (2) secondary OCA will render comparable results to primary OCA, and (3) secondary OCA will render superior outcomes to secondary ACI. Study Design: Cohort study; Level of evidence, 3. Methods: Patients were retrospectively identified who underwent ACI and OCA for symptomatic chondral lesions of the knee refractory to a previous MST. Age-, sex-, and body mass index–matched groups of patients undergoing primary ACI and OCA were used as controls. Postoperative data were prospectively collected using several subjective scoring systems (Tegner, Lysholm, International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, 12-Item Short Form Health Survey). Groups were compared with regard to patient-reported outcomes, subjective satisfaction, clinical failure rate, and reoperation. Student t tests were used for continuous data, and chi-square tests were performed for categorical data. Results: A total of 359 patients were examined: 92 patients undergoing secondary ACI, 100 primary ACI, 88 secondary OCA, and 79 primary OCA. The mean patient age was 30.3 years (range, 14.9-49.9 years) at the time of ACI and 35.4 (range, 15-54.5) at the time of OCA. There was no difference between the primary and secondary groups with regard to postoperative functional scores, subjective satisfaction, reoperation rate, and clinical failure rate. Conclusion: ACI and OCA are both viable treatment options for chondral defects of the knee, even in the setting of a failed MST. Secondary ACI renders functional outcomes, subjective satisfaction, and reoperation and failure rates comparable with primary ACI and secondary OCA.
Early Radiographic Healing and Functional Results After Autologous Osteochondral Grafting for Osteochondritis Dissecans of the Capitellum: Introduction of a New Magnetic Resonance Imaging–Based Scoring System
Authors: Wang Kemble K. , Williams Kathryn , Bae Donald S. 
Published: February 2020

Background:Autologous osteochondral grafting (OG) is an option in the treatment of capitellar osteochondritis dissecans (COCD). However, radiographic healing after this procedure has not been well documented.Purpose:To develop a magnetic resonance imaging (MRI)–based scoring system specific for evaluating healing after single-plug OG in COCD and to evaluate correlation between radiographic healing and early clinical outcomes.Study Design:Cohort study (diagnosis); Level of evidence, 3.Methods:Between 2014 and 2017, 183 elbows with COCD were enrolled in a prospective registry. A total of 61 elbows in 59 patients underwent single-plug OG. Of these, 52 elbows in 50 patients had pre- and postoperative MRI scans. Postoperative MRI and clinical outcome data from this group were used to develop the novel BOGIE score (Boston Osteochondral Graft Incorporation in the Elbow), with a possible range of 4 to 12.Results:Median age at surgery was 14.2 years (interquartile range, 13.1-15.0 years). Median clinical follow-up after OG was 12.4 months (interquartile range, 9.5-16.9 months; range, 6-53 months). Compared with before surgery, elbow function at 6 months after surgery and at latest follow-up was significantly improved as measured by the Timmerman and Andrews score (TAS; median: 145 before surgery, 185 at 6 months after surgery, 190 at latest follow-up; P < .001, before vs after surgery), as well as the short version of Disabilities of the Arm, Shoulder and Hand score; median: 21 before surgery, 7 at 6 months after surgery, and 0 at latest follow-up; P < .001 before surgery vs after surgery). Median BOGIE score at 6 months after surgery was 10 (range, 4-12). BOGIE score intraobserver reliability was 0.90 (95% CI, 0.82-0.94) for reader 1 and 0.91 (95% CI, 0.86-0.95) for reader 2. Interobserver reliability between the readers was 0.86 (95% CI, 0.78-0.92). Correlation was observed between the 6-month BOGIE score and the concurrent postoperative objective TAS ( P < .001) as well as total TAS ( P = .01) but not the subjective TAS ( P = .08). Patients who underwent subsequent secondary surgery for persistent symptoms had a significantly lower postoperative BOGIE score at 6 months than those who did not (median, 7.8 vs 10.3; P = .016)Conclusion:Quantitative evaluation for radiologic healing after single-plug OG in COCD is possible. The MRI-based BOGIE score appears to correlate with early clinical function and may be useful as an adjunct tool in decision making on activity progression. The use of a standardized MRI score may improve comparability of outcomes after OG in the literature.
A Retrospective Mixed Longitudinal Study of Tooth Formation in Children With Clefts
Authors: Kimbrough Sarah B. , Parris William G. , Williams Richard A. , Harris Edward F. 
Published: February 2020

Objective: To test for systematic age changes in cleft children based on dental age. Design: Retrospective case–control longitudinal study. Setting: One orthodontic solo practice. Patients: Nonsyndromic, complete cleft lip and palateCLP cases, either unilateral or bilateral (102 children; 370 radiographs), between 4 and 16 years of age. Interventions: Children were treated with a team approach, but only orthodontic radiographs were studied. Main Outcome Measure: The principal outcome measure was dental age of the cleft cases compared to a sex-specific sample of phenotypically normal children (1107 children), from the same geographical region. Multiple panoramic radiographs taken during the course of orthodontic treatment were examined to track patterns of dental age as children matured. Analysis used linear mixed models primarily testing for sex, cleft type (unilateral, bilateral), and hypodontia differences. Initial expectation was that cleft children would exhibit delayed dental ages from postnatal stressors and would become more deviant with maturity. Results: In childhood (4-6 years), both sexes were significantly delayed ( P < .001), but dental age normalized around 8 to 10 years. Boys experienced faster maturation thereafter than girls ( P < .001). Only trivial differences occurred between unilateral CLP and bilateral CLP samples.Hypodontia further depressed maturation rates ( P < .001). Dental age improved in a decidedly curvilinear fashion ( P < .001), with greater change at earlier ages. Conclusions: This report agrees with other contemporary studies, showing childhood catch-up. Older studies observed that clefting caused significant delays that worsened with growth. This potential “seachange” suggests better recovery and quicker normalization of children with clefts, perhaps due to improved management.
Kinematic and Dynamic Analysis of a 3-PRUS Spatial Parallel Manipulator
Authors: Thomas Mervin Joe , Joy M. L. , Sudheer A. P. 
Published: February 2020

AbstractParallel Kinematic Machines (PKMs) are being widely used for precise applications to achieve complex motions and variable poses for the end effector tool. PKMs are found in medical, assembly and manufacturing industries where accuracy is necessary. It is often desired to have a compact and simple architecture for the robotic mechanism. In this paper, the kinematic and dynamic analysis of a novel 3-PRUS (P: prismatic joint, R: revolute joint, U: universal joint, S: spherical joint) parallel manipulator with a mobile platform having 6 Degree of Freedom (DoF) is explained. The kinematic equations for the proposed spatial parallel mechanism are formulated using the Modified Denavit-Hartenberg (DH) technique considering both active and passive joints. The kinematic equations are used to derive the Jacobian matrix of the mechanism to identify the singular points within the workspace. A Jacobian based stiffness analysis is done to understand the variations in stiffness for different poses of the mobile platform and further, it is used to decide trajectories for the end effector within the singularity free region. The analytical model of the robot dynamics is presented using the Euler-Lagrangian approach with Lagrangian multipliers to include the system constraints. The gravity and inertial forces of all links are considered in the mathematical model. The analytical results of the dynamic model are compared with ADAMS simulation results for a pre-defined trajectory of the end effector.
Flow Resistance Modeling for Coolant Distribution within Canned Motor Cooling Loops
Authors: Wang Shengde , Yao Zhenqiang , Shen Hong 
Published: February 2020

AbstractTaylor–Couette–Poiseuille (TCP) flow dominates the inner water-cooling circulation of canned motor reactor coolant pumps. Current research on TCP flow focuses on torque behaviors and flow regime transitions through experiments and simulations. However, research on axial flow resistance in a large Reynolds number turbulent state is not sufficient, especially for the various flow patterns. This study is devoted to investigating the influence of annular flow on the axial flow resistance of liquid in the coaxial cylinders of the stator and rotor in canned motor reactor coolant pumps, and predicting the coolant flow distribution between the upper coil cooling loop and lower bearing lubricating loop for safe operation. The axial flow resistance, coupled with the annular rotation, is experimentally investigated at a flow rate with an axial Reynolds number,Rea, from 2.6 × 103to 6.0 × 103and rotational Reynolds number,Ret, from 1.6 × 104to 4.0 × 104. It is revealed that the axial flow frictional coefficient varies against the axial flow rate in linear relation sets with logarithmic coordinates, which shift up when the flow has a higherRet. Further examination of the axial flow resistance, with theReaextending to 3.5 × 105andRetup to 1.6 × 105, by simulation shows gentle variation rates in the axial flow frictional coefficients against theRea. The relation curves with different Retvalues converge when theReaexceeds 3.5 × 105. A prediction model for TCP flow consisting of a polygonal approximation with logarithmic coordinates is developed to estimate the axial flow resistance against different axial and rotational Reynolds numbers for the evaluation of heat and mass transfer during transition states and the engineering design of the canned motor chamber structure.
Advancing tools to promote health equity across European Union regions: the EURO-HEALTHY project
Authors:   on behalf of the EURO-HEALTHY investigators, Santana Paula , Freitas Ângela , Stefanik Iwa , Costa Cláudia , Oliveira Mónica , Rodrigues Teresa C. , Vieira Ana , Ferreira Pedro Lopes , Borrell Carme , Dimitroulopoulou Sani , Rican Stéphane , Mitsakou Christina , Marí-Dell’Olmo Marc , Schweikart Jürgen , Corman Diana , Bana e Costa Carlos A. 
Published: February 2020

Abstract
Background
Population health measurements are recognised as appropriate tools to support public health monitoring. Yet, there is still a lack of tools that offer a basis for policy appraisal and for foreseeing impacts on health equity. In the context of persistent regional inequalities, it is critical to ascertain which regions are performing best, which factors might shape future health outcomes and where there is room for improvement.

Methods
Under the EURO-HEALTHY project, tools combining the technical elements of multi-criteria value models and the social elements of participatory processes were developed to measure health in multiple dimensions and to inform policies. The flagship tool is the Population Health Index (PHI), a multidimensional measure that evaluates health from the lens of equity in health determinants and health outcomes, further divided into sub-indices. Foresight tools for policy analysis were also developed, namely: (1) scenarios of future patterns of population health in Europe in 2030, combining group elicitation with the Extreme-World method and (2) a multi-criteria evaluation framework informing policy appraisal (case study of Lisbon). Finally, a WebGIS was built to map and communicate the results to wider audiences.

Results
The Population Health Index was applied to all European Union (EU) regions, indicating which regions are lagging behind and where investments are most needed to close the health gap. Three scenarios for 2030 were produced – (1) the ‘Failing Europe’ scenario (worst case/increasing inequalities), (2) the ‘Sustainable Prosperity’ scenario (best case/decreasing inequalities) and (3) the ‘Being Stuck’ scenario (the EU and Member States maintain the status quo). Finally, the policy appraisal exercise conducted in Lisbon illustrates which policies have higher potential to improve health and how their feasibility can change according to different scenarios.

Conclusions
The article makes a theoretical and practical contribution to the field of population health. Theoretically, it contributes to the conceptualisation of health in a broader sense by advancing a model able to integrate multiple aspects of health, including health outcomes and multisectoral determinants. Empirically, the model and tools are closely tied to what is measurable when using the EU context but offering opportunities to be upscaled to other settings.
The efficacy and safety comparison of first-line chemotherapeutic agents (high-dose methotrexate, doxorubicin, cisplatin, and ifosfamide) for osteosarcoma: a network meta-analysis
Authors: Zhang Bin , Zhang Yan , Li Rongzhen , Li Jiazhen , Lu Xinchang , Zhang Yi 
Published: February 2020

AbstractBackgroundOsteosarcoma, a primary malignant bone tumor derived from mesenchymal tissue, is the most common type of pleomorphic tumor that occurs in children and adolescents. The aim of this study was to compare the efficacy and safety of high-dose methotrexate (M), doxorubicin (D), cisplatin (C), and ifosfamide (I) in the management of osteosarcoma.MethodsElectronic databases including PubMed, Cochrane Library, and Embase database were searched for studies published from when the databases were established to July 13, 2019. The network meta-analysis was performed using software R 3.3.2 and STATA version 41.0 after demographic and outcome data extraction. The ranks based on probabilities of interventions for each outcome were performed. In addition, the consistency of direct and indirect evidence was assessed by node splitting.ResultsThe network meta-analysis results revealed that MDCI had a significant lower hazard risk of overall survival [MDCI vs MDC: HR = 0.74, 95% CrI (0.23, 0.87); MDCI vs DC: HR = 0.60, 95% CrI (0.16, 0.92)]. In addition, MDCI had a clearly longer progression-free survival time than that of DC [MDCI: HR = 0.88, 95% CrI (0.46, 0.98)]. No significant difference was detected in MDC and DC in OS, PFS, and AEs. The probabilities of rank plot showed that MDCI ranked first in OS (73.12%) and PFS (52.43%). DC was the best treatment in safety, ranked first (75.43%).ConclusionsMDCI showed its superiority among all chemotherapeutic agents in relation to efficacy and safety, followed by MDC. In addition, MDCI was associated with an increased risk of AEs. According to our analysis, DC was less effective but safer for MDC and MDCI.
Outcomes of fertility preservation in women with endometriosis: comparison of progestin-primed ovarian stimulation versus antagonist protocols
Authors: Mathieu d’Argent Emmanuelle , Ferrier Clément , Zacharopoulou Chrysoula , Ahdad-Yata Naouel , Boudy Anne-Sophie , Cantalloube Adèle , Levy Rachel , Antoine Jean-Marie , Daraï Emile , Bendifallah Sofiane 
Published: February 2020

Abstract
Background
PPOS protocols, initially described for FP in women with cancer, have many advantages compared to antagonist protocols. PPOS protocols were not evaluated for women with endometriosis. The objective of the study was to describe fertility preservation outcomes in women with endometriosis and to compare an antagonist protocol with a Progestin-Primed Ovarian Stimulation (PPOS) protocol.

Method
We conducted a prospective cohort study associated with a cost-effectiveness analysis in a tertiary-care university hospital. The measured outcomes included the numbers of retrieved and vitrified oocytes, and direct medical costs. In the whole population, unique and multiple linear regressions analysis were performed to search for a correlation between individual characteristics and the number of retrieved oocyte.

Results
We included 108 women with endometriosis who had a single stimulation cycle performed with either an antagonist or a PPOS protocol. Overall, 8.1 ± 6.6 oocytes were retrieved and 6.4 ± 5.6 oocytes vitrified per patient. In the multiple regression model, age (p = 0.001), prior ovarian surgery (p = 0.035), and anti-Mullerian hormone level (p = 0.001) were associated with the number of retrieved oocytes. Fifty-four women were stimulated with an antagonist protocol, and 54 with a PPOS protocol. A mean of 7.9 ± 7.4 oocytes were retrieved in the antagonist group and 8.2 ± 5.6 in the PPOS group (p = 0.78). A mean of 6.4 ± 6.4 oocytes were vitrified in the antagonist group and 6.4 ± 4.7 in the PPOS group (p = 1). In the cost-effectiveness analysis, the PPOS protocol was strongly dominant over the antagonist protocol.

Conclusion
Fertility preservation procedures are feasible and effective for patients affected by endometriosis. Antagonist and PPOS protocols were associated with similar results but the medico-economic analysis was in favor of PPOS protocols.
Imaging of skull vault tumors in adults
Authors: Pons Escoda Albert , Naval Baudin Pablo , Mora Paloma , Cos Mònica , Hernandez Gañan Javier , Narváez José A. , Aguilera Carles , Majós Carles 
Published: February 2020

AbstractThe skull vault, formed by the flat bones of the skull, has a limited spectrum of disease that lies between the fields of neuro- and musculoskeletal radiology. Its unique abnormalities, as well as other ubiquitous ones, present particular features in this location. Moreover, some benign entities in this region may mimic malignancy if analyzed using classical bone-tumor criteria, and proper patient management requires being familiar with these presentations. This article is structured as a practical review offering a systematic diagnostic approach to focal calvarial lesions, broadly organized into four categories: (1) pseudolesions: arachnoid granulations, meningo-/encephaloceles, vascular canals, frontal hyperostosis, parietal thinning, parietal foramina, and sinus pericrani; (2) lytic: fibrous dysplasia, epidermal inclusion and dermoid cysts, eosinophilic granuloma, hemangioma, aneurysmal bone cyst, giant cell tumor, metastasis, and myeloma; (3) sclerotic: osteomas, osteosarcoma, and metastasis; (4) transdiploic: meningioma, hemangiopericytoma, lymphoma, and metastasis, along with other less common entities. Tips on the potential usefulness of functional imaging techniques such as MR dynamic susceptibility (T2*) perfusion, MR spectroscopy, diffusion-weighted imaging, and PET imaging are provided.