bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic debridement does not enhance surgical treatment of intra-articular distal radius fractures: a randomized controlled trial
Authors: Selles Caroline A. , Mulders Marjolein A. M. , Colaris Joost W. , van Heijl Mark , Cleffken Berry I. , Schep Niels W. L. 
Published: November 2019

The aim of this study was to determine the difference in functional outcomes after open reduction and internal fixation (ORIF) with and without arthroscopic debridement in adults with displaced intra-articular distal radius fractures. In this multicentre trial, 50 patients were randomized between ORIF with or without arthroscopic debridement. The primary outcome measure was the Patient-Rated Wrist Evaluation (PRWE) score. Secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, pain scores, range of wrist motion, grip strength, and complications. Median PRWE was worse for the intervention group at 3 months and was equal for both groups at 12 months. The secondary outcome measures did not show consistent patterns of differences at different time-points of follow-up. We conclude that patients treated with additional arthroscopy to remove intra-articular hematoma and debris did not have better outcomes than those treated with ORIF alone. We therefore do not recommend arthroscopy for removal of hematoma and debris when surgically fixing distal radius fractures. Level of evidence: I
Rigid infection prevention and control rules and religious discrimination: An uncomfortable juxtaposition?
Authors: Blenkharn J Ian 
Published: November 2019

Confusion and conflict arise when infection prevention and control (IPC) policies lead to allegations of religious discrimination. Many IPC standards are generic in construct, often failing to address wider issues and general policy applicable to all may have unequal impact on minority groups. Achieving uniformity by treating everyone the same is not necessarily the same as treating them equally. Some variation in approach might be acceptable, often desirable and sometimes inevitable but must not compromise staff safety or patient welfare. Concerns regarding clinical safety may overlook or override cultural and religious; without care, the outcome might change from cooperative to confrontational. Where, and how, to draw the line?
A cross-sectional investigation into the association between Porphyromonas gingivalis and autoantibodies to citrullinated proteins in a German population
Authors: Oluwagbemigun Kolade , Yucel-Lindberg Tülay , Dietrich Thomas , Tour Gregory , Sherina Natalia , Hansson Monika , Bergmann Manuela , Lundberg Karin , Boeing Heiner 
Published: November 2019

Background: Porphyromonas gingivalis (P.g) is unique among pathogens due to its ability to generate citrullinated proteins in an inflammatory milieu, potentially mediating the loss of immune tolerance, the production of anticitrullinated protein antibodies (ACPAs), and subsequently the development of rheumatoid arthritis (RA). Based on this hypothesis, we set out to investigate whether P.g is linked to ACPAs in a well-characterized German population. Participants and methods: A total of 600 participants (292 women and 308 men with a mean age of 67 years) of the European Prospective Investigation into Cancer and Nutrition-Potsdam study were selected in 2013, and paired saliva and serum samples were collected. Salivary P.g DNA and serum anticyclic citrullinated peptide (anti-CCP2) levels were quantified by real-time polymerase chain reaction and anti-CCP2 enzyme-linked immunosorbent assay, respectively. In selected participants, additional ACPA fine-specificities were also analysed on a custom-made multiplex peptide array. Results: Among participants with C-reactive protein greater than 3.0 mg/l, a one-unit increase in P.g DNA was associated with an almost twofold increase in anti-CCP2 levels. Moreover, participants with high P.g DNA had on average approximately 2.8-times higher anti-CCP2 levels when compared with participants with low P.g DNA, (Holm-adjusted p value = 0.01). Furthermore, citrullinated epitopes on α-enolase and vimentin were common ACPA reactivities among participants who also had high P.g DNA and elevated C-reactive protein. Conclusions: Our study suggests that in specific subgroups of individuals with systemic inflammation, higher salivary P.g DNA is associated with elevated serum ACPA. These data support a role for P.g in the development of anticitrulline immunity.
Mortality risk prediction in lupus patients complicated with invasive infection in the emergency department: LUPHAS score
Authors: Wu Wanlong , Ma Jun , Zhou Yuhong , Tang Chao , Zhao Feng , Sun Fangfang , Xu Wenwen , Chen Jie , Ye Shuang , Chen Yi 
Published: November 2019

Background: Infection remains a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). This study aimed to establish a clinical prediction model for the 3-month all-cause mortality of invasive infection events in patients with SLE in the emergency department. Methods: SLE patients complicated with invasive infection admitted into the emergency department were included in this study. Patient’s demographic, clinical, and laboratory characteristics on admission were retrospectively collected as baseline data and compared between the deceased and the survivors. Independent predictors were identified by multivariable logistic regression analysis. A prediction model for all-cause mortality was established and evaluated by receiver operating characteristic (ROC) curve analysis. Results: A total of 130 eligible patients were collected with a cumulative 38.5% 3-month mortality. Lymphocyte count <800/ul, urea >7.6mmol/l, maximum prednisone dose in the past ⩾60 mg/d, quick Sequential Organ Failure Assessment (qSOFA) score, and age at baseline were independent predictors for all-cause mortality (LUPHAS). In contrast, a history of hydroxychloroquine use was protective. In a combined, odds ratio-weighted LUPHAS scoring system (score 3–22), patients were categorized to three groups: low-risk (score 3–9), medium-risk (score 10–15), and high-risk (score 16–22), with mortalities of 4.9% (2/41), 45.9% (28/61), and 78.3% (18/23) respectively. ROC curve analysis indicated that a LUPHAS score could effectively predict all-cause mortality [area under the curve (AUC) = 0.86, CI 95% 0.79–0.92]. In addition, LUPHAS score performed better than the qSOFA score alone (AUC = 0.69, CI 95% 0.59–0.78), or CURB-65 score (AUC = 0.69, CI 95% 0.59–0.80) in the subgroup of lung infections ( n = 108). Conclusions: Based on a large emergency cohort of lupus patients complicated with invasive infection, the LUPHAS score was established to predict the short-term all-cause mortality, which could be a promising applicable tool for risk stratification in clinical practice.
Evolving therapeutic goals in Crohn's disease management
Authors: Chateau Thomas , Peyrin‐Biroulet Laurent 
Published: November 2019

SummaryThe main objectives in Crohn's disease are to avoid disease complications and preserve the patient's quality of life. Early disease control and close monitoring with specific targets to reach might be the only way to change the disease course. In two decades, we have moved from clinical response to full remission (clinical and endoscopic remission) requiring a tight monitoring of both symptoms and objective signs of inflammation. This review summarizes the concepts of tight control and treat‐to‐target and their potential for disease modification.
Serum neurofilament light chain concentration in a phase 1/2 trial of autologous mesenchymal stem cell transplantation
Authors: Baldassari Laura E , Planchon Sarah M , Bermel Robert A , Nakamura Kunio , Fisher Elizabeth , Feng Jenny , Sakaie Ken E , Ontaneda Daniel , Cohen Jeffrey A 
Published: November 2019

Background Serum neurofilament light chain concentration is a proposed biomarker of axonal injury in multiple sclerosis. Mesenchymal stem cells have anti-inflammatory and repair-promoting activities, making them of interest for potential multiple sclerosis treatment. Objectives The purpose of this study was to assess correlation of serum neurofilament light chain concentration and measures of multiple sclerosis disease activity/severity, longitudinal stability of serum neurofilament light chain concentration, and treatment effect of mesenchymal stem cell transplantation on serum neurofilament light chain concentration. Methods Twenty-four multiple sclerosis patients underwent intravenous infusion of autologous mesenchymal stem cells. Clinical assessments, serum collection, and brain magnetic resonance imaging were performed at months –1, 0 (transplant), 1, 3, and 6. Matched control serum was collected once ( n = 10). Serum neurofilament light chain concentration was measured by single-molecule array. Serum neurofilament light chain concentration correlations with disease measures were analyzed by Spearman correlations and linear mixed effect models. Pre-post transplant serum neurofilament light chain concentration was compared by Wilcoxon signed rank testing. Results There were significant ( p<0.01) correlations between serum neurofilament light chain concentration and gadolinium-enhancing lesion number (rho = 0.55) and volume (rho = 0.65), and new/enlarging T2 lesions (rho = 0.65). Patients without disease activity had lower fluctuation in serum neurofilament light chain concentration ( p = 0.01). Mean pre- versus post-treatment serum neurofilament light chain concentration values were not significantly different. Conclusions Serum neurofilament light chain concentration correlated with magnetic resonance imaging measures of disease activity cross sectionally and longitudinally, and was stable in patients without disease activity. There was no clear treatment effect of mesenchymal stem cell transplantation on serum neurofilament light chain concentration.
Human MYD88L265P is insufficient by itself to drive neoplastic transformation in mature mouse B cells
Authors: Sewastianik Tomasz , Guerrera Maria Luisa , Adler Keith , Dennis Peter S. , Wright Kyle , Shanmugam Vignesh , Huang Ying , Tanton Helen , Jiang Meng , Kofides Amanda , Demos Maria G. , Dalgarno Audrey , Patel Neil A. , Nag Anwesha , Pinkus Geraldine S. , Yang Guang , Hunter Zachary R. , Jarolim Petr , Munshi Nikhil C. , Treon Steven P. , Carrasco Ruben D. 
Published: November 2019

Abstract
MYD88 L265P is the most common mutation in lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) and one of the most frequent in poor-prognosis subtypes of diffuse large B-cell lymphoma (DLBCL). Although inhibition of the mutated MYD88 pathway has an adverse impact on LPL/WM and DLBCL cell survival, its role in lymphoma initiation remains to be clarified. We show that in mice, human MYD88L265P promotes development of a non-clonal, low-grade B-cell lymphoproliferative disorder with several clinicopathologic features that resemble human LPL/WM, including expansion of lymphoplasmacytoid cells, increased serum immunoglobulin M (IgM) concentration, rouleaux formation, increased number of mast cells in the bone marrow, and proinflammatory signaling that progresses sporadically to clonal, high-grade DLBCL. Murine findings regarding differences in the pattern of MYD88 staining and immune infiltrates in the bone marrows of MYD88 wild-type (MYD88WT) and MYD88L265P mice are recapitulated in the human setting, which provides insight into LPL/WM pathogenesis. Furthermore, histologic transformation to DLBCL is associated with acquisition of secondary genetic lesions frequently seen in de novo human DLBCL as well as LPL/WM-transformed cases. These findings indicate that, although the MYD88L265P mutation might be indispensable for the LPL/WM phenotype, it is insufficient by itself to drive malignant transformation in B cells and relies on other, potentially targetable cooperating genetic events for full development of lymphoma.
Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility
Authors: Giannouli Eleftheria , Fillekes Michelle Pasquale , Mellone Sabato , Weibel Robert , Bock Otmar , Zijlstra Wiebren 
Published: November 2019

AbstractBackgroundReduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults.MethodsData were obtained in two study waves with a total sample ofn = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days.ResultsMultiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5–30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models.ConclusionsIn older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.
Association between thigh muscle strength four years after partial meniscectomy and radiographic features of osteoarthritis 11 years later
Authors: Ericsson Ylva B. , Roos Ewa M. , Owman Henrik , Dahlberg Leif E. 
Published: November 2019

AbstractBackgroundMeniscus injury and meniscectomy both entail increased risk of knee osteoarthritis (OA). Thigh muscle weakness is a suggested mediator of OA but there is little evidence of its importance for knee OA development after meniscectomy. This study aimed to examine the association between thigh muscle strength after partial meniscectomy in middle-aged subjects with a non-traumatic meniscal tear and later radiographic knee OA changes.MethodsThirty-four out of 45 participants in an exercise-trial underwent testing for isokinetic thigh muscle strength 4 years after arthroscopic partial meniscectomy and had radiographic examination 11 years later (15 years post-surgery, mean age at follow-up of 57 years (range 50–61)). Outcomes were grade of joint space narrowing and osteophyte score in the medial tibiofemoral compartment of the operated knee and the contralateral knee. We tested the association between muscle strength at baseline and the radiographic outcomes at follow-up using logistic regression analyses adjusted for sex and overweight.ResultsAt follow-up, 33/34 subjects had joint space narrowing and 27/34 subjects had osteophytes in the operated knee, in the contralateral knee joint space narrowing was found in 23 subjects. In the operated knee baseline knee extensor and flexor strength were negatively associated with grade of joint space narrowing at follow-up (OR 0.972 and 0.956,p = 0.028 and 0.026, respectively) and also with osteophyte score (OR 0.968 and 0.931,p = 0.017 and 0.011, respectively). In the contralateral knee longitudinal associations between strength and radiographic OA features were similar, OR 0.949–0.972,p < 0.05.ConclusionThe finding that stronger thigh muscles 4 years after meniscectomy were associated with less severe osteoarthritic changes in the medial tibiofemoral compartment of both the operated and contralateral knee 11 years later, may suggest that strong thigh muscles can help to preserve joint integrity in middle-aged subjects at risk of knee OA.
Calculation method to predict postoperative limb length in patients undergoing THA following developmental dysplasia of hips
Authors: Guo Renwen , Chen Jerry Yongqiang , Zhang Guoqiang , Zhou Yonggang , Chen Jiying , Chai Wei 
Published: November 2019

AbstractBackgroundLimb length discrepancy (LLD) is one of the main cause of dissatisfaction after total hip arthroplasty (THA). The teardrop-lesser trochanter method can accurately predict and analyze LLD for healthy people. However, for patients with preoperative LLD, no method for predicting postoperative LLD is currently available, and these patients are highly susceptible to more severe LLD after THA. Accordingly, this study proposed a calculation method to predict postoperative limb length for these patients.MethodsEighty patients who underwent THA between May 2016 and October 2018 due to unilateral developmental dysplasia of the hip (DDH) were evaluated. Relevant parameters were measured from radiographs of full-length lower limbs, e.g. the distance between the rotation center of the hip and the midpoint of the tibial plafond and the distance between the point which was marked at the same height as the lesser trochanter on the anatomical long axis of the femur and the midpoint of the tibial plafond. Then, a mathematical model was established by simplifying the structure from the hip to the ankle. The relationship between the placement position of the prosthesis and the LLD value was calculated by Law of Sines and Iterative Calculation.ResultsThe preoperatively predicted LLD values and the postoperatively measured LLD values were compared, yielding a mean absolute difference of 3.7 (range, 0.1 to 8.6) mm. The intraclass correlation coefficient (ICC) of the two parameters exhibited strong reliability (ICC = 0.911, 95%CI, 0.795 to 0.955). The Bland-Altman plot also showed good conformity between the two parameters.ConclusionsThe proposed calculation method effectively predicted the postoperative LLD using preoperative parameters. Despite the complexity of the method, it can go a long way towards reducing the occurrence of severe postoperative LLD in DDH-THA.
Prolotherapy injections and physiotherapy used singly and in combination for lateral epicondylalgia: a single-blinded randomised clinical trial
Authors: Yelland Michael , Rabago David , Ryan Michael , Ng Shu-Kay , Vithanachchi Dinusha , Manickaraj Nagarajan , Bisset Leanne 
Published: November 2019

Abstract

Background
Lateral epicondylalgia (tennis elbow) is a common, debilitating and often treatment-resistant condition. Two treatments thought to address the pathology of lateral epicondylalgia are hypertonic glucose plus lignocaine injections (prolotherapy) and a physiotherapist guided manual therapy/exercise program (physiotherapy). This trial aimed to compare the short- and long-term clinical effectiveness, cost effectiveness, and safety of prolotherapy used singly and in combination with physiotherapy.

Methods
Using a single-blinded randomised clinical trial design, 120 participants with lateral epicondylalgia of at least 6 weeks’ duration were randomly assigned to prolotherapy (4 sessions, monthly intervals), physiotherapy (weekly for 4 sessions) or combined (prolotherapy+physiotherapy). The Patient-Rated Tennis Elbow Evaluation (PRTEE) and participant global impression of change scores were assessed by blinded evaluators at baseline, 6, 12, 26 and 52 weeks. Success rate was defined as the percentage of participants indicating elbow condition was either ‘much improved’ or ‘completely recovered.’ Analysis was by intention-to-treat.

Results
Eighty-eight percent completed the 12-month assessment. At 52 weeks, there were substantial, significant improvements compared with baseline status for all outcomes and groups, but no significant differences between groups. The physiotherapy group exhibited greater reductions in PRTEE at 12 weeks than the prolotherapy group (p = 0.014).

Conclusion
There were no significant differences amongst the Physiotherapy, Prolotherapy and Combined groups in PRTEE and global impression of change measures over the course of the 12-month trial.

Trial registration
ACTRN12612000993897.
Fibular strut allograft influences reduction and outcomes after locking plate fixation of comminuted proximal humeral fractures in elderly patients: a retrospective study
Authors: Cui Xueliang , Chen Hui , Ma Binbin , Fan Wenbin , Li He 
Published: November 2019

Abstract

Background
Proximal humeral fractures (PHFs) are the third most commonly occurring fractures in elderly patients. Most of these fractures can be treated with conservative methods, but the optimal surgical treatment strategy for unstable fractures in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes between locking compression plate (LCP) fixation and LCP fixation with fibular allograft implantation for the treatment of comminuted PHFs.

Methods
We retrospectively reviewed 60 patients (mean age, 72.75 years) with closed 3- or 4-part fractures, and a minimum of 2 years of follow-up. Fracture reduction was quantitatively determined by humeral head height (HHH) and neck-shaft angle (NSA). The clinical outcome was evaluated by Constant-Murley score (CMS) and American Shoulder and Elbow Surgeons (ASES) score.

Result
The average radiological changes were higher in the LCP group than in the locking plate with fibular allograft group (HHH of 4.16 mm vs 1.18 mm [p < 0.001] and NSA of 9.94° versus 3.12° [p < 0.001]) . The final average outcome scores were lower in the LCP group than in the FA group (CMS of 73.00 vs 78.96 [p = 0.024] and ASES score of 72.80 vs 78.64 [p = 0.022]). The FA group showed better forward elevation (p = 0.010) and abduction (p = 0.002); however, no significant differences were observed for shoulder external rotation or internal rotation. The number of complications was higher in the LCP group (28.57%) than in the FA group (1.2%) (p < 0.001).

Conclusion
For comminuted PHFs in elderly patients, LCP fixation combined with a fibular allograft is reasonable option to ensure satisfactory radiological and clinical outcomes.

Trial registration
ZDYJLY(2018)New-9. Name of registry: IEC for clinical Research of Zhongda Hospital, Affiliated to Southeast University. Date of registration: 2018-05-17.