bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Outcomes and Survivorship of Fresh-Frozen Meniscal Allograft Transplant With Soft Tissue Fixation: Minimum 10-Year Follow-up Study
Authors: Grassi Alberto , Macchiarola Luca , Lucidi Gian Andrea , Coco Vito , Romandini Iacopo , Filardo Giuseppe , Neri Maria Pia , Marcacci Maurilio , Zaffagnini Stefano 
Published: July 2020

Background: Meniscal allograft transplant (MAT) is considered an effective procedure for reducing pain and improving knee function. Nevertheless, the current knowledge regarding the results of MAT is limited to short- to mid-term follow-up studies, especially for arthroscopic techniques. Purpose: To evaluate the long-term clinical outcomes, reoperations, and failures with a minimum follow-up of 10 years after fresh-frozen MAT performed arthroscopically with soft tissue fixation. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 patients (age, 36.6 ± 10.6 years; 36 male, 10 female) who underwent medial MAT (n = 27) or lateral MAT (n = 19) with a minimum 10-year follow-up were evaluated with the Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain, and Tegner score. Surgical failure was defined as the need for partial or total graft removal (meniscectomy or knee replacement), and clinical failure was defined as the need for partial or total graft removal in addition to a poor Lysholm score (<65 points) at final follow-up. Survival analysis was performed with Kaplan-Meier curve, and clinical scores were analyzed based on the Patient Acceptable Symptom State (PASS) for MAT. Results: 10-year survival and clinical data were available for 38 patients. Because 6 meniscectomies were required, the rate of survival free from surgical failure was 91% at 5 years and 86% at 10 years. Lower survival was reported in lateral MAT (73%) compared with medial MAT (96%). Because a further 4 patients had poor Lysholm scores, the rate of survival free from surgical and clinical failure was 87% at 5 years and 70% at 10 years. The average Lysholm score at final follow-up was 82 ± 20, and 60% to 82% of patients achieved PASS of the various KOOS subscales. The Tegner score and the KOOS Sport score significantly decreased from mid-term to long-term evaluation ( P < .001 and P < .05, respectively). Other KOOS subscales and the Lysholm score remained stable at long-term evaluation. No significant differences were found between isolated MAT or combined MAT regarding subjective scores, surgical failures, or clinical failures. Conclusion: Up to 10 years after surgery, 86% of fresh-frozen MATs with soft tissue fixation were still in situ, and satisfactory clinical results were present for about 70% of patients. Decline of clinical outcomes from midterm to long term was noted only in sports-related scores. A higher number of overall reoperations was noted in female patients, whereas a higher risk of failure was present in the patients with lateral MAT.
Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial
Authors: Toth Michael J. , Tourville Timothy W. , Voigt Thomas B. , Choquette Rebecca H. , Anair Bradley M. , Falcone Michael J. , Failla Mathew J. , Stevens-Lapslaey Jennifer E. , Endres Nathan K. , Slauterbeck James R. , Beynnon Bruce D. 
Published: July 2020

Background: Anterior cruciate ligament (ACL) injuries and reconstruction (ACLR) promote quadriceps muscle atrophy and weakness that can persist for years, suggesting the need for more effective rehabilitation programs. Whether neuromuscular electrical stimulation (NMES) can be used to prevent maladaptations in skeletal muscle size and function is unclear. Purpose: To examine whether early NMES use, started soon after an injury and maintained through 3 weeks after surgery, can preserve quadriceps muscle size and contractile function at the cellular (ie, fiber) level in the injured versus noninjured leg of patients undergoing ACLR. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients (n = 25; 12 men/13 women) with an acute, first-time ACL rupture were randomized to NMES (5 d/wk) or sham (simulated microcurrent electrical nerve stimulation; 5 d/wk) treatment to the quadriceps muscles of their injured leg. Bilateral biopsies of the vastus lateralis were performed 3 weeks after surgery to measure skeletal muscle fiber size and contractility. Quadriceps muscle size and strength were assessed 6 months after surgery. Results: A total of 21 patients (9 men/12 women) completed the trial. ACLR reduced single muscle fiber size and contractility across all fiber types ( P < .01 to P < .001) in the injured compared with noninjured leg 3 weeks after surgery. NMES reduced muscle fiber atrophy ( P < .01) through effects on fast-twitch myosin heavy chain (MHC) II fibers ( P < .01 to P < .001). NMES preserved contractility in slow-twitch MHC I fibers ( P < .01 to P < .001), increasing maximal contractile velocity ( P < .01) and preserving power output ( P < .01), but not in MHC II fibers. Differences in whole muscle strength between groups were not discerned 6 months after surgery. Conclusion: Early NMES use reduced skeletal muscle fiber atrophy in MHC II fibers and preserved contractility in MHC I fibers. These results provide seminal, cellular-level data demonstrating the utility of the early use of NMES to beneficially modify skeletal muscle maladaptations to ACLR. Clinical Relevance: Our results provide the first comprehensive, cellular-level evidence to show that the early use of NMES mitigates early skeletal muscle maladaptations to ACLR. Registration: NCT02945553 (ClinicalTrials.gov identifier)
Preoperative Medial Meniscal Extrusion Is Associated With Patient-Reported Outcomes After Medial Opening Wedge High Tibial Osteotomy
Authors: Kim Man Soo , Koh In Jun , Kim Chul Kyu , Choi Keun Young , Kang Ki Ho , In Yong 
Published: July 2020

Background: Although the medial compartment continues to sustain some loading after medial opening wedge high tibial osteotomy (MOWHTO) in varus-deformed knees, no studies have examined the relationship between medial meniscal extrusion (MME) and patient-reported outcome measures after MOWHTO. Purpose: To examine whether compartmental baseline MME was associated with patient-reported outcome measures after MOWHTO. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study was composed of 149 MOWHTOs in 147 patients with clinical and radiological assessments. Patients were grouped according to severity of MME in the medial compartment at the time of surgery. MME was categorized into 4 groups according to MOAKS (MRI [magnetic resonance imaging] Osteoarthritis Knee Score) criteria and relative value of MME. We compared preoperative characteristics, including Kellgren-Lawrence (KL) grading scale, meniscal tear pattern, and postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscores. Associations between extent of MME and WOMAC subscores at postoperative 1 and 2 years were assessed with generalized linear models. Results: Pattern of meniscal tear ( P < .05) and KL grade ( P < .05) were associated with MME. Patients with KL grades 3 and 4 at the time of surgery had significantly greater MME than those with KL grade 2 ( P < .05). When patients were divided into 4 groups according to MOAKS criteria at the time of surgery, there were significant differences in WOMAC pain scores among groups at 1 and 2 years after the operation (all P < .05). The WOMAC function score also differed among groups at postoperative 1 year ( P < .05) but not postoperative 2 years ( P > .05). When patients were divided into 4 groups according to relative MME at the time surgery, the WOMAC pain score differed significantly among groups at postoperative 1 and 2 years (all P < .05). Analysis of WOMAC pain score as the dependent variable in multivariate analyses revealed that severity of absolute and relative MME and KL grade were independent predictors of worse WOMAC pain score at postoperative 1 and 2 years (all P < .05). Conclusion: Greater preoperative MME at the time of surgery was associated with inferior patient-reported outcomes, especially pain, in patients with MOWHTO at 1 and 2 years after surgery.
Bandwidth enhancement in damping control for piezoelectric nanopositioning stages with load uncertainty: Design and implementation
Authors: Ling Jie , Feng Zhao , Kang Xi , Xiao Xiaohui 
Published: July 2020

High bandwidth and fast tracking of desired trajectories are eagerly required in various applications that use piezoelectric nanopositioning stages, especially in atomic force microscopes where the vibration stemming from lightly damped modes of stages is a challenging control problem. In this study, a bandwidth-enhanced positive acceleration, velocity, and position feedback damping controller is presented to achieve the tracking bandwidth exceeding the first resonant frequency through using a novel pole-shift method. The stability of the positive feedback damped loop is examined by a mixed passivity, small-gain approach, and Nyquist theorem framework. Also, in conjunction with a proportional–integral tracking controller, robust stability is addressed for load uncertainties. Experimental application to a piezoelectric nanopositioning stage demonstrates that a closed-loop bandwidth of 282.5 Hz is achieved, which exceeds the dominating resonance of the stage at 210 Hz. The achieved bandwidth is 1.35 times larger than the dominating resonance, which is a competitive result among most existing damping control approaches. Comparative tracking results verify the effectiveness of the proposed control scheme on the suppression of low-frequency hysteresis and tracking performance of high-speed triangular waves under load variations.
Transradial access for flow diversion of intracranial aneurysms: Case series
Authors: Waqas Muhammad , Vakharia Kunal , Dossani Rimal H , Rajah Gary B , Tso Michael K , Gong Andrew D , Rho Kyungduk , Rai Hamid H , Snyder Kenneth V , Levy Elad I , Siddiqui Adnan H , Davies Jason M 
Published: July 2020

Background Transradial access for neurointerventions offers advantages of fewer access-site complications, reduced procedure time, and greater patient comfort over transfemoral access. Data about transradial access for flow diversion are limited. We share our early experience with transradial access for flow diversion in a relatively large case series. Methods Consecutive patients who underwent Pipeline embolization device (Medtronic) deployment via transradial access were included in the study, irrespective of location and laterality of the intracranial aneurysm. The cases were performed between July 2016 and October 2019. Demographics, aneurysm characteristics, and procedure-related details (including catheter systems used) were recorded and statistically evaluated. Results Thirty-five transradial flow diversion procedures were attempted in 32 patients, of which 33 procedures were successful. In two cases involving left common carotid artery and internal carotid artery access, guide catheter herniation into the aortic arch led to abandonment of transradial access in favor of transfemoral access. The most common aneurysm locations in the transradial access procedures were the posterior communicating artery ( n = 7), ophthalmic artery ( n = 7), and superior hypophyseal artery ( n = 7). Most transradial access procedures (66.7%) were performed using a biaxial catheter system. 6-French Benchmark (Penumbra) and Phenom 27 (Medtronic) were the most commonly utilized guide- and microcatheters, respectively. One patient had intraprocedural subarachnoid hemorrhage. No access-site complications occurred. Conclusion This study demonstrates safety and feasibility of transradial access for Pipeline embolization device deployment and shows the versatility of this approach for different catheter systems. Tortuosity and acute angulation of the left common carotid artery and internal carotid artery were associated with approach failure.
Determinants of gonorrhea and syphilis infections among pregnant women attending antenatal clinic at Dilla University Referral Hospital, Ethiopia: Unmatched case-control study
Authors: Hailu Kumneger , Gebretsadik Achamyelesh 
Published: July 2020

Objective: This study was designed to determine the risk factors associated with gonorrhea and syphilis infections among pregnant women attending antenatal care clinic at Dilla University Referral Hospital. Method: A hospital-based unmatched case-control study (64 cases and 128 controls) with 1:2 ratios was conducted from 29 January 2018 to 20 June 2018, at the antenatal care clinic of the Dilla University Referral Hospital. Venous blood and vaginal swab were collected to screen for gonorrhea and syphilis. A pretested interviewer-administered questionnaire was used to gather data on sociodemographic and predisposing factors. Logistic regression analysis used to identify risk factors for sexually transmitted infections among pregnant women at 95% confidence interval and p-value < 0.05. Result: A total of 64 cases of syphilis or gonorrhea were identified with a mean age of 26 years (±4.1 years.). Of those cases, 40 were syphilis seropositive and the remaining were gonorrhea cases. Lower educational status (adjusted odds ratio = 2.4, 95% confidence interval: 1.1–4.9), age of first sex <18 years (adjusted odds ratio = 2.8, 95% confidence interval: 1.3–5.9), history of abortion (adjusted odds ratio = 3.1, 95% confidence interval: 1.4–6.6), and having two or more sexual partners in the past year (adjusted odds ratio = 2.5, 95% confidence interval: 1.1–5.7) were significantly associated with gonorrhea and syphilis infection. Conclusion: Demographic, behavioral, and obstetric factors are associated with the occurrence of syphilis or gonorrhea among pregnant women. Strengthening the existing antenatal care services, providing health education on risk factors, and prioritizing women with the risk characteristics and initiation of gonorrhea and syphilis screening during antennal care are mandatory.
Efficacy and safety of PD-1/PD-L1 inhibitors plus nab-paclitaxel for patients with non-small cell lung cancer who have progressed after platinum-based chemotherapy
Authors: Zhang Fan , Huang Di , Zhao Lei , Li Tao , Zhang Sujie , Zhang Guoqing , Yuan Fang , Zhang Jie , Zhang Yuzi , Zhao Zhengyi , Cui Longgang , Zhao Jing , Wang Guoqiang , Cai Shangli , Bai Yuezong , Wang Jinliang , Hu Yi 
Published: July 2020

Background: Immunotherapy combined with platinum-based chemotherapy is now the standard first-line treatment for non-small cell lung cancer (NSCLC) patients. However, limited evidence exists to show the efficacy of immunotherapy plus taxanes for patients who have progressed after platinum-based chemotherapy. Methods: The immunotherapy naïve patients with metastatic NSCLC who received anti-PD-1/PD-L1 monotherapy or combined with nab-paclitaxel after prior platinum-based chemotherapy from 2015 to 2018 in PLA General Hospital were identified. The progression-free survival, overall survival (OS), objective response rate (ORR), disease control rate (DCR) and safety were assessed. Results: Of 57 patients, 40 were treated with anti-PD-1/PD-L1 monotherapy and 17 were treated with anti-PD-1/PD-L1 plus nab-paclitaxel. With a median OS follow-up of 16.3 months, the nab-paclitaxel group showed significantly longer OS compared with the immune monotherapy group (median, 28.6 months versus 15.9 months, log-rank p = 0.020). When adjusted by covariates in COX proportional regression model, both the treatment group [ p = 0.009, hazard ratio (HR) 0.361; 95% confidence interval (CI) 0.168–0.773] and performance status ( p = 0.003, HR 0.372; 95% CI 0.192–0.721) demonstrated independent association with the longer OS from combination therapy. In addition, ORR was 23.5% (4/17) in the immune checkpoints inhibitors (ICIs) plus nab-paclitaxel group versus 13.5% (5/37) in immune monotherapy group ( p = 0.439), with a DCR of 88.2% (15/17) and 59.5% (22/37) ( p = 0.034), respectively. The incidence of grade 3/4 adverse events was 23.5% (4/17) in the combination group and 2.5% (1/40) in the immune monotherapy group. Conclusion: PD-1/PD-L1 inhibitor plus nab-paclitaxel resulted in significantly longer OS and higher response versus ICI single agent in metastatic NSCLC patients who have progressed after platinum-based chemotherapy. These findings need to be further explored by prospective studies.
Observational cohort study of clinical outcome in Epstein–Barr virus associated gastric cancer patients
Authors: Qiu Miao-Zhen , He Cai-Yun , Yang Da-Jun , Zhou Da-Lei , Zhao Bai-Wei , Wang Xiao-Jian , Yang Li-Qiong , Lu Shi-Xun , Wang Feng-Hua , Xu Rui-Hua 
Published: July 2020

Background: Epstein–Barr virus-associated gastric cancer (EBVaGC) has unique clinicopathologic features and our present understanding of its treatment outcome is limited. Here, we investigated the clinical outcomes of resectable and metastatic EBVaGC cases with regards to their respective treatment. Methods: We retrieved the data of EBVaGC patients treated at our center from October 2014 to June 2019. The primary endpoint was overall survival (OS). Secondary endpoints were disease-free survival (DFS) for stage I–III patients, progression-free survival (PFS) and objective response rate (ORR) for stage IV patients. Results: Patients classified as stage I–III accounted for 83.7% of the total 197 cases analyzed. Two patients had mismatched repair-deficiency. The 5-year OS rate of the entire cohort was 63.51% [95% (confidence interval (CI): 52.31–72.76%]. Tumor-node-metastasis (TNM) stage and gastric stump cancer were identified as independent prognostic factors for OS. The 3- and 5-year DFS rate for stage I–III patients were 83.72% (95% CI: 75.86–89.19%) and 73.83% (95% CI: 60.39–83.32%), respectively. TNM stage III, neural invasion, lymphovascular invasion, and baseline plasma EBV-DNA positive were correlated with shorter DFS. The ORR and disease control rate (DCR) for metastatic EBVaGC patients to first-line therapy were 29.0% and 90.3% (median PFS: 9.8 months), respectively, and to second-line therapy were 25.0% and 75.0%, respectively. Seven patients received anti-PD1 therapy and had an ORR of 28.5% and a median PFS of 2.8 months. Conclusions: EBVaGC patients have few metastases, long DFS, and high DCR. TNM stage and gastric stump cancer were independent prognostic factors for OS.
Differentiating glioblastoma multiforme from cerebral lymphoma: application of advanced texture analysis of quantitative apparent diffusion coefficients
Authors: Mehrnahad Mehrsad , Rostami Sara , Kimia Farnaz , Kord Reza , Taheri Morteza Sanei , Rad Hamidreza Saligheh , Haghighatkhah Hamidreza , Moradi Afshin , Kord Ali 
Published: July 2020

Purpose The purpose of this study was to differentiate glioblastoma multiforme from primary central nervous system lymphoma using the customised first and second-order histogram features derived from apparent diffusion coefficients. Methods and materials: A total of 82 patients (57 with glioblastoma multiforme and 25 with primary central nervous system lymphoma) were included in this study. The axial T1 post-contrast and fluid-attenuated inversion recovery magnetic resonance images were used to delineate regions of interest for the tumour and peritumoral oedema. The regions of interest were then co-registered with the apparent diffusion coefficient maps, and the first and second-order histogram features were extracted and compared between glioblastoma multiforme and primary central nervous system lymphoma groups. Receiver operating characteristic curve analysis was performed to calculate a cut-off value and its sensitivity and specificity to differentiate glioblastoma multiforme from primary central nervous system lymphoma. Results Based on the tumour regions of interest, apparent diffusion coefficient mean, maximum, median, uniformity and entropy were higher in the glioblastoma multiforme group than the primary central nervous system lymphoma group ( P ≤ 0.001). The most sensitive first and second-order histogram feature to differentiate glioblastoma multiforme from primary central nervous system lymphoma was the maximum of 2.026 or less (95% confidence interval (CI) 75.1–99.9%), and the most specific first and second-order histogram feature was smoothness of 1.28 or greater (84.0% CI 70.9–92.8%). Based on the oedema regions of interest, most of the first and second-order histogram features were higher in the glioblastoma multiforme group compared to the primary central nervous system lymphoma group ( P ≤ 0.015). The most sensitive first and second-order histogram feature to differentiate glioblastoma multiforme from primary central nervous system lymphoma was the 25th percentile of 0.675 or less (100% CI 83.2–100%) and the most specific first and second-order histogram feature was the median of 1.28 or less (85.9% CI 66.3–95.8%). Conclusions Texture analysis using first and second-order histogram features derived from apparent diffusion coefficient maps may be helpful in differentiating glioblastoma multiforme from primary central nervous system lymphoma.
Survival time and prognostic factors after whole-brain radiotherapy of brain metastases from of breast cancer
Authors: Okada Yukinori , Kobayashi Mariko , Shinozaki Mio , Abe Tatsuyuki , Kanemaki Yoshihide , Nakamura Naoki , Kojima Yasuyuki 
Published: July 2020

Background Breast cancer has a poor prognosis due to the high risk of distant metastasis. Purpose To identify the prognosticators of brain metastasis from breast cancer treated by whole-brain radiotherapy. Material and Methods We evaluated patients diagnosed with primary brain metastasis without carcinomatous meningitis from breast cancer and had undergone whole-brain radiotherapy as initial treatment between 1 January 2010 and 30 September 2019. We investigated associations between overall survival time from diagnosis using cranial contrast-enhanced magnetic resonance imaging (MRI)/computed tomography (CT) and the following parameters: (i) age; (ii) sex; (iii) time to appearance of brain metastasis; (iv) other metastasis at appearance of brain metastasis; (v) blood test; (vi) symptoms at time of brain metastasis; (vii) whole-brain radiotherapy dose; (viii) whether whole-brain radiotherapy was completed; (ix) course of chemo- or radiotherapy; (x) subtype; (xi) additional irradiation after whole-brain radiotherapy; (xii) pathology; and (xiii) imaging findings. Results We evaluated 29 consecutive female patients (mean age 55.2 ± 12.1 years). Median overall survival time after diagnosis on cranial contrast-enhanced MRI/CT was 135 days (range 16–2112 days). Multivariate stepwise analysis of the three parameters of lactate dehydrogenase, dose, and subtype identified the following significant differences: Hazard Ratio (HR) for dose (discontinued, 30 Gy/10 fractions, 31.5 Gy/11 fractions, 32.5 Gy/11 fractions, 37.5 Gy/15 fractions) was 0.08 (95% confidence interval [CI] 0.02–0.30, P < 0.01), and HR for subtype (luminal, HER2, triple-negative) was 2.70 (95% CI 1.16–6.243, P < 0.01). Conclusion HER2-type and 37.5 Gy/15 fractions are good prognostic factor after whole-brain radiotherapy in breast cancer with brain metastases.