bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the Helical Blade Lead to Higher Rates of Fixation Failure as Compared to Lag Screw in the Cephalomedullary Nailing Treatment of Hip Fractures? A Systematic Review and Meta-Analysis
Authors: Kim Chul-Ho , Kim Han Soul , Kim Yong-Chan , Moon Dou Hyun 
Published: January 2021

Objectives:
Recently, several studies have suggested that blade-type cephalomedullary nails (CMNs) have a higher risk of fixation failure than that of lag screws, but no clinical consensus exists. This study compared fixation failure between helical blade-type and lag screw-type CMNs with cut-out and cut-through rates as primary outcomes and degree of sliding length, time to union, and nonunion rate as secondary outcomes.

Data Sources:
MEDLINE, Embase, and Cochrane Library were systematically searched for studies published before March 4, 2020, using the PRISMA guidelines.

Study Selection:
Studies were included if they directly compared helical blade and lag screw for treating hip fractures. Data could be extracted for CMN alone to avoid mixing CMN and extramedullary plate devices, such as the dynamic hip screw.

Data Extraction:
Two board-certified orthopaedic surgeons specializing in hip surgery independently extracted data from the selected studies, and the data collected were compared to verify agreement.

Data Synthesis:
All data were pooled using a random-effects model. For all comparisons, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated as dichotomous data, whereas continuous data were analyzed using mean differences with 95% CIs.

Conclusions:
Fixation failure (OR = 1.88, 95% CI: 1.09–3.23, P = 0.02), especially cut-through (OR = 5.33; 95% CI, 2.09–13.56; P < 0.01), was more common with helical blades than with lag screws, although the cut-out rate was not significantly different between both the 2 groups (OR = 0.87, 95% CI: 0.38–1.96, P = 0.73). Surgeons should carefully select a blade-type CMN when treating hip fractures.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Defining the Mean Angle of Diaphyseal Long Bone Nonunions—Does Shear Prevail?
Authors: Houston James , Armitage Leanne , Sedgwick Philip M. , McGovern Madeline , Smith Raymond M. , Trompeter Alex J. 
Published: January 2021

Objectives:
To define the mean angle of a series of diaphyseal nonunions based on radiographic analysis.

Design:
A retrospective cohort study.

Setting:
Two level-1 trauma centers.

Patients:
One hundred twenty patients presenting with nonunion.

Intervention:
A mean nonunion angle was calculated from a series of AP and lateral X-rays using a standardized technique. The nonunion angle was then estimated in a single plane by considering the greater of the 2 measured angles. Additional data collected included patient age, sex, nonunion site, initial fracture angle, and original fracture pattern.

Main Outcome Measurement:
Single plane nonunion angle.

Results:
The mean angles of all nonunion in coronal plane was 42 degrees (SD 17 degrees) and 42 degrees in sagittal plane (SD 18 degrees) and 48 degrees (SD 15 degrees) in single plane. The single plane nonunion angle in fractures which were originally multiplanar was steeper to those occurring in originally single plane fractures (P 0.002) although both were close to 45 degrees. There was no significant difference in the nonunion angles on subgroup analysis of cohort location, sex, or anatomic location.

Conclusions:
This study demonstrates the mean angle of diaphyseal nonunions from long bones of the lower limb approaches 45 degrees. This is noted in all types of fractures and is irrespective of anatomic location or sex. This confirms the hypothesis that shear is likely to play a role in the development of a nonunion. This study provides further evidence that nonunions occur primarily because of mechanical instability.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Safety and Efficacy of Oral and/or Intravenous Tedizolid Phosphate From a Randomized Phase 3 Trial in Adolescents With Acute Bacterial Skin and Skin Structure Infections
Authors: Bradley John S. , Antadze Tinatin , Ninov Borislav , Tayob Mohammed S. , Broyde Natasha , Butterton Joan R. , Chou Margaret Z. , De Anda Carisa S. , Kim Jason Y. , Sears Pamela S. 
Published: January 2021

Background:
Tedizolid phosphate is an oxazolidinone prodrug approved in 2014 for treatment of adults with acute bacterial skin and skin structure infections (ABSSSIs); however, efficacy has not previously been evaluated in children. This study compared the safety and efficacy of tedizolid (administered as tedizolid phosphate) with active antibacterial comparators for the treatment of ABSSSIs in adolescents.

Methods:
This was a randomized, assessor-blind, global phase 3 study of tedizolid versus active comparators for the treatment of Gram-positive ABSSSIs in adolescents (12 to <18 years of age; NCT02276482). Enrolled participants were stratified by region and randomized 3:1 to receive tedizolid phosphate 200 mg (oral and/or intravenous) once daily for 6 days or active comparator, selected by investigator from an allowed list per local standard of care, for 10 days. The primary endpoint was safety; blinded investigator’s assessment of clinical success at the test-of-cure visit (18–25 days after the first dose) was a secondary efficacy endpoint. Statistical comparisons between treatment groups were not performed.

Results:
Of the 121 participants enrolled, 120 were treated (tedizolid, n = 91; comparator, n = 29). Treatment-emergent adverse events were balanced between treatment groups (tedizolid, 14.3%; comparator, 10.3%). Overall, 3 participants (3.3%) in the tedizolid group and 1 (3.4%) in the comparator group experienced a single drug-related TEAE. Clinical success rates were high in both treatment groups: 96.7% and 93.1% at the test-of-cure visit for the tedizolid and comparator groups, respectively.

Conclusions:
Tedizolid demonstrated safety and efficacy similar to comparators for the treatment of ABSSSIs in adolescents.
Effect of Prehospital Antibiotic Therapy on Clinical Outcome and Pathogen Detection in Children With Parapneumonic Pleural Effusion/Pleural Empyema
Authors: Forster Johannes , Piazza Giuseppina , Goettler David , Kemmling Daniel , Schoen Christoph , Rose Markus , Streng Andrea , Liese Johannes G. 
Published: January 2021

Background:
Parapneumonic pleural effusion and pleural empyema (PPE/PE) are complications of community-acquired pneumonia. The objective of this study was to analyze prehospital antibiotic therapy (PH-ABT) of children with PPE/PE and investigate its effects on clinical outcome and pathogen detection.

Methods:
Prospective nationwide active surveillance in Germany between October 2010 and June 2018. Children and adolescents <18 years of age with pneumonia-associated PE or PPE requiring drainage or with persistence of PPE/PE >7 days were included.

Results:
A total of 1724 children with PPE/PE were reported, of whom 556 children (32.3% of 1719 with available data) received PH-ABT. Children with PH-ABT had a shorter median hospital length of stay (15 vs. 18 days, P < 0.001), a longer time from onset of symptoms until hospital discharge (25 vs. 23 days, P = 0.002), a lower rate of intensive care unit admission (58.3% vs. 64.4%, P = 0.015) and fewer infectious complications (5.9% vs. 10.0%; P = 0.005). Bacterial pathogens in blood or pleural fluid culture were detected in 597 (34.5%) of 1513 children. Positive culture results were less frequent in children with than without PH-ABT (81/466 [17.4%] vs. 299/1005 [29.8%]; P < 0.001), whereas detection rates in pleural fluid samples by polymerase chain reaction were similar (91/181 [50.3%] vs. 220/398 [55.3%]; P = 0.263).

Conclusions:
In children with PPE/PE, PH-ABT significantly reduced the overall rate of bacterial pathogen detection by culture, but not by polymerase chain reaction. PH-ABT was associated with a lower rate of infectious complications but did not affect the overall duration of disease. We therefore speculate that the duration of PPE/PE is mainly a consequence of an infection-induced inflammatory process, which can only partially be influenced by antibiotic treatment.
Vitamin D Supplement for Prevention of Alzheimer's Disease: A Systematic Review and Meta-Analysis
Authors: Du Yage , Liang Fangfang , Zhang Liping , Liu Jie , Dou Haoying 
Published: January 2021

Background:
Prevention of Alzheimer's disease (AD) with Vitamin D (VD) supplementation has been studied widely, but the results in the literature are very conflicting.

The Study Question:
Can VD supplementation really prevent AD?

Study Design:
The literature was searched from PubMed, Cochrane library, Web of Science, and EMBASE to identify relevant randomized clinical trials (RCTs). The titles and abstracts were evaluated independently by 2 of the authors.

Results:
Nine RCTs with 2345 participants were included. In the meta-analysis, we found no significant difference in the Mini-Mental State Examination, verbal fluency, verbal memory, visual ability, and attention scores between the VD intervention group and comparison group [standardized mean difference (SMD) = −0.05, 95% confidence interval (CI) = −0.51 to 0.41; SMD = −0.01, 95% CI = −0.13 to 0.11; SMD = 0.12, 95% CI = −0.45 to 0.69; SMD = 0.42, 95% CI = −0.15 to 1.00; and SMD = 0.01, 95% CI = −0.24 to 0.27, respectively]. In subgroup analysis, we found that the intervention with only VD or plus calcium, follow-up duration, and baseline 25(OH)D levels did not explain the cause for high heterogeneity.

Conclusions:
Overall, the current evidence did not support the beneficial effect of VD supplement to prevent AD. High quality RCTs and further studies are needed to clarify the effects of VD supplementation on preventing AD.
A fixed-point approach for decaying solutions of difference equations
Authors: Došlá Zuzana , Marini Mauro , Matucci Serena 
Published: January 2021

A boundary value problem associated with the difference equation with advanced argument

*

Δ
(

a

n

Φ

(
Δ

x

n

)
)
+

b

n

Φ

(

x

n
+
p

)
=
0
,

n
≥
1

is presented, where
Φ
(
u
) = |
u
|

α

sgn
u
,
α
> 0,
p
is a positive integer and the sequences
a
,
b
, are positive. We deal with a particular type of decaying solution of (*), that is the so-called intermediate solution (see below for the definition). In particular, we prove the existence of this type of solution for (*) by reducing it to a suitable boundary value problem associated with a difference equation without deviating argument. Our approach is based on a fixed-point result for difference equations, which originates from existing ones stated in the continuous case. Some examples and suggestions for future research complete the paper.

This article is part of the theme issue ‘Topological degree and fixed point theories in differential and difference equations’.
Positive solutions of systems of perturbed Hammerstein integral equations with arbitrary order dependence
Authors: Infante Gennaro 
Published: January 2021

Motivated by the study of systems of higher-order boundary value problems with functional boundary conditions, we discuss, by topological methods, the solvability of a fairly general class of systems of perturbed Hammerstein integral equations, where the nonlinearities and the functionals involved depend on some derivatives. We improve and complement earlier results in the literature. We also provide some examples in order to illustrate the applicability of the theoretical results.
This article is part of the theme issue ‘Topological degree and fixed point theories in differential and difference equations’.
Fixed points for planar maps with multiple twists, with application to nonlinear equations with indefinite weight
Authors: Margheri Alessandro , Rebelo Carlota , Zanolin Fabio 
Published: January 2021

In this paper, we investigate the dynamical properties associated with planar maps which can be represented as a composition of twist maps together with expansive–contractive homeomorphisms. The class of maps we consider present some common features both with those arising in the context of the Poincaré–Birkhoff theorem and those studied in the theory of topological horseshoes. In our main theorems, we show that the multiplicity results of fixed points and periodic points typical of the Poincaré–Birkhoff theorem can be recovered and improved in our setting. In particular, we can avoid assuming area-preserving conditions and we also obtain higher multiplicity results in the case of multiple twists. Applications are given to periodic solutions for planar systems of non-autonomous ODEs with sign-indefinite weights, including the non-Hamiltonian case. The presence of complex dynamics is also discussed.This article is part of the theme issue ‘Topological degree and fixed point theories in differential and difference equations’.
Direct detection of SARS-CoV-2 RNA using high-contrast pH-sensitive dyes
Authors: Brown Timothy A. , Schaefer Katherine S. , Tsang Arthur , Yi Hyun Ah , Grimm Jonathan B. , Lemire Andrew L. , Jradi Fadi M. , Kim Charles , McGowan Kevin , Ritola Kimberly , Armstrong Derek T. , Mostafa Heba H. , Korff Wyatt , Vale Ronald D. , Lavis Luke D. 
Published: January 2021

AbstractThe worldwide COVID-19 pandemic has had devastating effects on health, healthcare infrastructure, social structure, and economics. One of the limiting factors in containing the spread of this virus has been the lack of widespread availability of fast, inexpensive, and reliable methods for testing of individuals. Frequent screening for infected and often asymptomatic people is a cornerstone of pandemic management plans. Here, we introduce two pH sensitive ‘LAMPshade’ dyes as novel readouts in an isothermal RT-LAMP amplification assay for SARS-CoV-2 RNA. The resulting JaneliaLAMP (jLAMP) assay is robust, simple, inexpensive, has low technical requirements and we describe its use and performance in direct testing of contrived and clinical samples without RNA extraction.
Severe bandemia is not associated with increased risk for adverse events in general pediatric emergency department patients
Authors: Najafali Daniel , Berman Emilie , Cao Tiffany T , Karwoski Allison , Kaur Norvir , Afridi Ikram , Abdalla Norhan , Afridi Leenah , Sahadzic Iana , Solomon Juliana , Yardi Isha , Tran Quincy K 
Published: January 2021

ABSTRACTBackgroundThe presence of band cells >10% of the total white blood cell (WBC) count (“bandemia”) is often used as an indicator of serious bacterial illness (SBI). Results from studies of bandemia as a predictor of SBI were conflicting and little is known about the relationship between severe bandemia (SB) and clinical outcomes from SBI in children.ObjectivesIn this retrospective patient-centered study, we hypothesized that SB (band level >20%) is not associated with adverse outcomes in an emergency department (ED) pediatric population.MethodsMedical records from children between the ages of 2 months and 18 years with SB who presented to a tertiary referral regional hospital were studied. Outcomes were categorized as severe adverse events (SAEs) or moderate adverse events (MAEs). Multivariate logistic regressions were used to assess the association between SB and outcomes.ResultsWe analyzed 102 patients. Mean age (standard deviation [SD]) was 5.25(0.5) years, 18 (18%) had MAE, 21 (21%) had SAE, and no patients died. Mean band levels were similar between groups: no adverse events [28 (10)] vs. SAE [31 (9)] vs. MAE [27(8)], p=0.64. Multivariate logistic regressions showed SB was not associated with any adverse events (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.9-1.1, p=0.27). Non-normal X-ray (XR) (OR 17, 95% CI 3.3-90, p<0.001) was associated with MAE, while non-normal computerized tomography (CT) scan (OR 15.4, 95% CI 2.2-100+, p=0.002) was associated with SAE.ConclusionSevere bandemia was not associated with higher odds of adverse events among the general ED pediatric population. Clinicians should base their clinical judgment on the overall context of history, physical examinations, and other laboratory and imaging data.
Continuous pain report demonstrates time delay of pain ratings in Fibromyalgia
Authors: Kharko Anna Y , Hall Stephen D , Furlong Paul L , Roser Matthew E 
Published: January 2021

ABSTRACTBackgroundEnhanced temporal summation (TS), measured through self-reported pain ratings, has been interpreted as indicative of central sensitisation in fibromyalgia. Greater TS in patients, however, has not been universally observed. It is also unclear whether increased pain report maintains beyond the TS period.MethodsIn this study, we measured TS through continuously reported pain ratings. Fibromyalgia-diagnosed patients (n = 17) and matched pain-free controls (n = 13) rated painful transcutaneous electrical stimulation of various intensity levels in 18 one-minute-long blocks. Pain was rated on a 101-point visual analogue scale. The resulting continuous response was divided into TS (< 15s) and adaptation (15 – 60s) periods. Average pain values were extracted for each period alongside the timing of key events such as maximal pain ratings. The difference in temporal summation and adaptation measures between fibromyalgia and control participants was analysed using mixed-effects modelling.ResultsThe average pain ratings for TS and adaptation periods were not significantly associated with fibromyalgia diagnosis but were with stimulation intensity. The same was true for the magnitude of the maximal rating during TS and the slope leading to that peak rating. The presence of fibromyalgia, however, did predict the time of the maximal TS rating, as well as the value and the time of the maximal adaptation rating.ConclusionsOur study did not find homogeneously increased TS pain ratings. Instead, by utilising continuous pain data we demonstrate for the first time that the time of TS peak rating, as well as the magnitude and time of adaptation peak rating are linked to fibromyalgia diagnosis.
SARS-CoV-2 Variant of Concern 202012/01 has about twofold replicative advantage and acquires concerning mutations
Authors: Grabowski Frederic , Preibisch Grzegorz , Giziński Stanisław , Kochańczyk Marek , Lipniacki Tomasz 
Published: January 2021

AbstractThe novel SARS-CoV-2 Variant of Concern (VOC)-202012/01 (also known as B.1.1.7), first collected in United Kingdom on September 20, 2020, is a rapidly growing lineage that in January 2021 constituted 86% of all SARS-CoV-2 genomes sequenced in England. The VOC has been detected in 40 out of 46 countries that reported at least 50 genomes in January 2021. We have estimated that the replicative advantage of the VOC is in the range 1.83–2.18 [95% CI: 1.71–2.40] with respect to the 20A.EU1 variant that dominated in England in November 2020, and in range 1.65–1.72 [95% CI: 1.46–2.04] in Wales, Scotland, Denmark, and USA. As the VOC strain will likely spread globally towards fixation, it is important to monitor its molecular evolution. We have estimated growth rates of expanding mutations acquired by the VOC lineage to find that the L18F substitution in spike has initiated a substrain of high replicative advantage in relation to the remaining VOC substrains. The L18F substitution is of significance because it has been found to compromise binding of neutralizing antibodies. Of concern are immune escape mutations acquired by the VOC: E484K, F490S, S494P (in the receptor binding motif of spike) and Q677H, Q675H (in the proximity of the polybasic cleavage site at the S1/S2 boundary). These mutants may hinder efficiency of existing vaccines and expand in response to the increasing after-infection or vaccine-induced seroprevalence.
The Experience of Care Partners of Patients with Parkinsonism and Psychosis
Authors: Mantri Sneha , Klawson Emily , Albert Steven , Rapoport Robyn , Precht Chelle , Glancey Sarah , Daeschler Margaret , Mamikonyan Eugenia , Kopil Catherine M. , Marras Connie , Chahine Lana M. 
Published: January 2021

ABSTRACTBackgroundParkinson’s disease psychosis (PDP) has a major impact on quality of life and care partner burden; however, little is known about the lived experiences of care partners in managing PDP.ObjectiveTo understand how care partners of individuals with PDP experience their role and articulate their needs related to psychosis.MethodsThis was a qualitative study of semi-structured telephone interviews. Recruitment was conducted online via the clinical study matching tool, Fox Trial Finder; study activities took place remotely via telephone interviews. Transcripts of the phone interviews were analyzed by grounded theory methods, and a codebook of key themes that emerged from the analysis was developed.ResultsNine care partners (all female) were interviewed. Discussion topics in the codebook included (1) care partner burden and guilt; (2) communication with medical professionals; (3) coping strategies; (4) emotional reactions of the care partner to psychosis; (5) sources of knowledge about PD psychosis; (6) attitudes towards medications for PDP; (7) strategies to care for loved ones with psychosis; (8) psychosis triggers.ConclusionsThis qualitative analysis uncovers important aspects of the care partner experience, including challenges in navigating the medical system and communicating with professionals. Providers treating patients with PDP should be aware of these constraints and provide added support for strained care partners.
OASIS+: leveraging machine learning to improve the prognostic accuracy of OASIS severity score for predicting in-hospital mortality
Authors: EL-Manzalawy Yasser , Abbas Mostafa , Hoaglund Ian , Cerna Alvaro Ulloa , Morland Thomas B. , Haggerty Christopher M. , Hall Eric S. , Fornwalt Brandon K. 
Published: January 2021

ABSTRACTSeverity scores assess the acuity of critical illness by penalizing for the deviation of physiologic measurements from normal and aggregating these penalties (also called “weights” or “subscores”) into a final score (or probability) for quantifying the severity of critical illness (or the likelihood of in-hospital mortality). Although these simple additive models are human readable and interpretable, their predictive performance needs to be further improved. To address this need, we argue for replacing these simple additive models with models based on state-of-the-art non-linear supervised learning algorithms (e.g., Random Forest (RF) and eXtreme Gradient Boosting (XGB)). Specifically, we present OASIS+, a variant of the Oxford Acute Severity of Illness Score (OASIS) in which an ensemble of 200 decision trees is used to predict in-hospital mortality based on the 10 same clinical variables in OASIS. Using a test set of 9566 admissions extracted from MIMIC-III database, we show that the performance of OASIS can be substantially improved from AUC score of 0.77 to 0.83 using OASIS+. Moreover, we show that OASIS+ has superior performance compared to eight other commonly used severity scoring methods. Our results underscore the potential of improving existing severity scores by using more sophisticated machine learning algorithms (e.g., ensemble of non-linear decision tress) not just via including additional physiologic measurements.