bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-reported outcome after patient-specific unicondylar knee arthroplasty for unicompartmental knee osteoarthritis
Authors: Freigang Viola , Rupp Markus , Pfeifer Christian , Worlicek Michael , Radke Stefan , Deckelmann Stephan , Alt Volker , Baumann Florian 
Published: November 2020

AbstractBackgroundUnicondylar knee arthroplasty was introduced in the late 1960s and remains a topic of controversial discussion. Patient-specific instruments and patient-specific implants are not yet the standard of care. The question remains whether this time-consuming and costly technique can be beneficial for the patient. The aim of this study was to evaluate whether a custom-made unicondylar knee arthroplasty leads to improved patient-reported outcome.MethodsThis retrospective study evaluates the patient-reported outcome after custom-made unicondylar knee arthroplasty (CM-UKA, ConforMIS™ iUni® G2, ConforMIS Inc., Billerica, MA, USA). We evaluated 29 patients (31 knees) at an average of 2.4 years (range 1.2–3.6 years) after operation for unicondylar osteoarthritis of the knee. The target zone for the postoperative leg axis was a slight under-correction of 0–2° varus. Follow-up evaluation included the Forgotten Joint Score (FJS), the Knee Society Score (KSS), a Visual Analogue Scale (VAS) and a radiographic evaluation including a long-leg radiograph. Primary outcome measure was patient satisfaction based on the Forgotten Joint Score.ResultsWe found an excellent postoperative health-related quality of life with a mean FJS of 76.8 (SD 17.9) indicating a low level of joint awareness after CM-UKA. The mean preoperative KSS was 66.0 (SD 13.71) and 59.4 (17.9) for the KSS function score. The increase was 22.8 points for the KSS knee score (p < 0.0001) and 34.8 points for the KSS function score (p < 0.0001). The VAS for pain decreased from a mean of 5.4 (SD 1.8) to 1.1 (SD 1.2) (p < 0.0001). The malalignment rate with a postoperative deviation of more than 2° in the leg axis was 29%. There was no evidence of component loosening after a mean follow-up of 2.4 years.ConclusionsCustom-made unicondylar knee arthroplasty (CM-UKA) can provide improved clinical and functional outcomes for patients with isolated knee osteoarthritis of the medial compartment. We found excellent results regarding patient satisfaction and a low malalignment rate for CM-UKA. Further studies are needed to investigate long-term survivorship of the implant.Level of evidenceLevel IV.Trial registrationTrial Registration number:Z-2014-0389-10Regensburg Clinical Studies Center (REGCSC) 09/07/2014.
Quantitative DCE-MRI: an efficient diagnostic technique for evaluating early micro-environment permeability changes in ankylosing spondylitis
Authors: Yang Hui , Jiang Ling , Li Jiang , Zheng Xiuzhu , Yao Qianqian , Li Changqin , Zhu Jianzhong , Qin Jian 
Published: November 2020

Abstract
Background
In the management of early inflammatory joint of ankylosing spondylitis (AS), there is a need for reliable noninvasive quantitative monitoring biomarker to closely assess status of synovitis progression. Cognizant to this,studies geared on improving techniques for quantitative evaluation of micro-environment permeability of the joint space are necessary. Such improved techniques may provide tissue perfusion as important biological parameters and can further help in understanding the origin of early changes associated with AS. The purpose of this study was to prospectively evaluate the diagnostic performance and determine longitudinal relationships of early micro-environment active in the joint space of the sacroiliac joint (SIJ) with a rat model by using quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods
Thirty wistar male rats were randomly assigned to the model (n = 15) or control (n = 15) group. All rats underwent DCE-MRI of SIJ region at fixed time points (12, 17 and 22 weeks),between September 2018 and October 2019. Differences in permeability parameters between the two groups at the same time point were compared by using an independent samples t test. Spearman correlations of DCE-MRI parameters with different time points in model group were analyzed. All statistical analyses were performed with software.

Results
At 12 weeks,the Ktrans,Kep and Ve values in the model group were slightly lower than those in control group,but all the differences were not statistically significant (p > 0.05). Compared with control group,the transfer constant (Ktrans) values increased significantly at 17 weeks and 22 weeks in model group,while the rate constant (Kep) and volume of extravascular extracellular space (Ve) significantly increased only at 22 weeks(p < 0.05). The Ktrans,Kep and Ve were positively correlated with increasing time points (r = 0.946, P<0.01 for Ktrans; r = 0.945, P<0.01 for Kep; and r = 0.832, P<0.01 for Ve).

Conclusion
Quantitative DCE-MRI parameters are valuable for evaluating the early longitudinal relationship of micro-environment permeability changes in the joint space of SIJ.
Differences in growth-economics of fast vs. slow growing grass species in response to temperature and nitrogen limitation individually, and in combination
Authors: Colesie Claudia , Stangl Zsofia Reka , Hurry Vaughan 
Published: November 2020

Abstract
Background
Fast growing invasive alien species are highly efficient with little investment in their tissues. They often outcompete slower growing species with severe consequences for diversity and community composition. The plant economics trait-based approach provides a theoretical framework, allowing the classification of plants with different performance characteristics. However, in multifaceted background, this approach needs testing. The evaluation and prediction of plant performance outcomes in ecologically relevant settings is among the most pressing topics to understand and predict ecosystem functioning, especially in a quickly changing environment. Temperature and nutrient availability are major components of the global environmental change and this study examines the response of growth economic traits, photosynthesis and respiration to such changes for an invasive fast-growing (Bromus hordaceus) and a slow-growing perennial (Bromus erectus) grass species.

Results
The fully controlled growth chamber experiment simulated temperature—and changes in nitrogen availability individually and in combination. We therefore provide maximum control and monitoring of growth responses allowing general growth trait response patterns to be tested. Under optimal nitrogen availability the slow growing B. erectus was better able to handle the lower temperatures (7 °C) whilst both species had problems at higher temperatures (30 °C). Stresses produced by a combination of heat and nutrient availability were identified to be less limiting for the slow growing species but the combination of chilling with low nutrient availability was most detrimental to both species.

Conclusions
For the fast-growing invader B. hordeaceus a reduction of nitrogen availability in combination with a temperature increase, leads to limited growth performance in comparison to the slow-growing perennial species B.erectus and this may explain why nutrient-rich habitats often experience more invasion than resource-poor habitats.
Diversity of entomopathogenic fungi associated with Mediterranean fruit fly (Ceratitis capitata (Diptera: Tephritidae)) in Moroccan Argan forests and nearby area: impact of soil factors on their distribution
Authors: Hallouti Ayoub , Ait Hamza Mohamed , Zahidi Abdelaziz , Ait Hammou Rachid , Bouharroud Rachid , Ait Ben Aoumar Abdellah , Boubaker Hassan 
Published: November 2020

AbstractBackgroundStudying the ecology of biocontrol-agents is a prerequisite to effectively control medfly (Ceratitis capitata(Diptera: Tephritidae)) with entomopathogenic fungi. In this context, factors affecting the occurrence and distribution of medfly-associated entomopathogenic-fungi were studied. Soil samples (22) were collected from natural and cultivated areas of Souss-region Morocco.ResultsA total of 260 fungal isolates belonging to 22 species and 10 genera were obtained by using medfly pupae as bait. Medfly-associated fungi were detected in all studied soils and pupae infection percentages ranged from 3.33% to 48%. Two genera,FusariumandBeauveriawere the most frequent with 83 isolates (32%) and 50 isolates (19.23%) respectively. Pathogenicity test of isolated species against medfly pupae showed high mortality rates up to 91% for some strains. Principal component analysis (PCA) demonstrated a strong influence of origin, physical, and chemical properties of soil on the abundance of these fungi. In general, medfly-associated fungi were more abundant in soils with moderate pH (7.5 to 8) having high sand and organic content. High relative humidity negatively influenced the abundance of these fungi. Both factors directly affected the fungal infection percentages in pupae. The response of fungi to these parameters varied among species. According to principal component analysis (PCA), the soils of argan fields and forests were more suitable for the development of medfly-associated fungi than citrus orchards.ConclusionsThese results guide identifying suitable soils for the effective application of entomopathogenic fungi as biological control agents. In summary, isolated indigenous strains seem to be a promising option to controlC. capitata.
Physicians’ clinical prediction of survival in head and neck cancer patients in the palliative phase
Authors: Hoesseini Arta , Offerman Marinella P. J. , van de Wall-Neecke Bojou J. , Sewnaik Aniel , Wieringa Marjan H. , Baatenburg de Jong Robert J. 
Published: November 2020

AbstractBackgroundThe prognosis of patients with incurable head and neck cancer (HNC) is a relevant topic. The mean survival of these patients is 5 months but may vary from weeks to more than 3 years. Discussing the prognosis early in the disease trajectory enables patients to make well-considered end-of-life choices, and contributes to a better quality of life and death. However, physicians often are reluctant to discuss prognosis, partly because of the concern to be inaccurate. This study investigated the accuracy of physicians’ clinical prediction of survival of palliative HNC patients.MethodsThis study was part of a prospective cohort study in a tertiary cancer center. Patients with incurable HNC diagnosed between 2008 and 2011 (n = 191), and their treating physician were included. Analyses were conducted between July 2018 and February 2019. Patients’ survival was clinically predicted by their physician ≤3 weeks after disclosure of the palliative diagnosis. The clinical prediction of survival in weeks (CPS) was based on physicians’ clinical assessment of the patient during the outpatient visits. More than 25% difference between the actual survival (AS) and the CPS was regarded as a prediction error. In addition, when the difference between the AS and CPS was 2 weeks or less, this was always considered as correct.ResultsIn 59% (n = 112) of cases survival was overestimated. These patients lived shorter than predicted by their physician (median AS 6 weeks, median CPS 20 weeks). In 18% (n = 35) of the cases survival was correctly predicted. The remaining 23% was underestimated (median AS 35 weeks, median CPS 20 weeks). Besides the differences in AS and CPS, no other significant differences were found between the three groups. There was worse accuracy when predicting survival closer to death: out of the 66 patients who survived 6 weeks or shorter, survival was correctly predicted in only eight (12%).ConclusionPhysicians tend to overestimate the survival of palliative HNC patients. This optimism can result in suboptimal use of palliative and end-of-life care. The future development of a prognostic model that provides more accurate estimates, could help physicians with personalized prognostic counseling.
Validation and cultural adaptation of the Integrated Palliative care Outcome Scale (IPOS) for the Portuguese population
Authors: Antunes Bárbara , Ferreira Pedro Lopes 
Published: November 2020

Abstract
Background
To culturally adapt and validate the Integrated Palliative care Outcome Scale to European Portuguese.

Methods
Multi-centred observational study with 2 assessment points. Data were collected in nine centres using consecutive sampling. All patients were screened for eligibility. Inclusion criteria: ≥18 years, mentally fit to give consent, diagnosed with an incurable, potentially life-threatening illness, read, write and understand Portuguese. Translation and back translation with independent native speakers blind to the original measure created a Portuguese version, which was culturally adapted using cognitive interviews. For psychometric testing, the COSMIN checklist was followed. Reliability and content validity were assessed for patient and staff versions. Construct and criterion validity were tested for patient version.

Results
1703 individuals were screened between July 1st 2015 and February 2016, 135 (7.9%) were included. Mean age was 66.8 years (SD 12.7), 58 (43%) were female. Most patients (109; 80.7%) had a cancer diagnosis. Cronbach’s alpha showed good internal consistency, 0.657 for patient, 0.705 for staff versions. Intraclass correlation coefficient testing reproducibility revealed very good reliability, 0.794–0.950 for patient and 0.456–0.925 for staff versions. There was good content validity and significant results for construct validity. Physical symptoms were better detected by females. IPOS could discriminate: practical issues in different places of care, based on cancer diagnosis, physical and emotional symptoms based on life expectancy both for patient and professional dimensions, physical and emotional symptoms based on phase of illness, for professional dimensions, and physical symptoms from the patients’ viewpoint.

Conclusions
The Portuguese IPOS is a reliable and valid measure.
Deconvolution of cellular subsets in human tissue based on targeted DNA methylation analysis at individual CpG sites
Authors: Schmidt Marco , Maié Tiago , Dahl Edgar , Costa Ivan G. , Wagner Wolfgang 
Published: November 2020

AbstractBackgroundThe complex composition of different cell types within a tissue can be estimated by deconvolution of bulk gene expression profiles or with various single-cell sequencing approaches. Alternatively, DNA methylation (DNAm) profiles have been used to establish an atlas for multiple human tissues and cell types. DNAm is particularly suitable for deconvolution of cell types because each CG dinucleotide (CpG site) has only two states per DNA strand—methylated or non-methylated—and these epigenetic modifications are very consistent during cellular differentiation. So far, deconvolution of DNAm profiles implies complex signatures of many CpGs that are often measured by genome-wide analysis with Illumina BeadChip microarrays. In this study, we investigated if the characterization of cell types in tissue is also feasible with individual cell type-specific CpG sites, which can be addressed by targeted analysis, such as pyrosequencing.ResultsWe compiled and curated 579 Illumina 450k BeadChip DNAm profiles of 14 different non-malignant human cell types. A training and validation strategy was applied to identify and test for cell type-specific CpGs. We initially focused on estimating the relative amount of fibroblasts using two CpGs that were either hypermethylated or hypomethylated in fibroblasts. The combination of these two DNAm levels into a “FibroScore” correlated with the state of fibrosis and was associated with overall survival in various types of cancer. Furthermore, we identified hypomethylated CpGs for leukocytes, endothelial cells, epithelial cells, hepatocytes, glia, neurons, fibroblasts, and induced pluripotent stem cells. The accuracy of this eight CpG signature was tested in additional BeadChip datasets of defined cell mixtures and the results were comparable to previously published signatures based on several thousand CpGs. Finally, we established and validated pyrosequencing assays for the relevant CpGs that can be utilized for classification and deconvolution of cell types.ConclusionThis proof of concept study demonstrates that DNAm analysis at individual CpGs reflects the cellular composition of cellular mixtures and different tissues. Targeted analysis of these genomic regions facilitates robust methods for application in basic research and clinical settings.
Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study
Authors: Richardson Kathryn , Loke Yoon K. , Fox Chris , Maidment Ian , Howard Robert , Steel Nicholas , Arthur Antony , Boyd Penelope J. , Aldus Clare , Ballard Clive , Savva George M. 
Published: November 2020

AbstractBackgroundSleep disturbance is common in dementia and often treated with Z-drugs (zopiclone, zaleplon, and zolpidem). While some observational studies suggest that Z-drugs are associated with adverse events such as falls and fracture risks in older people, this has not been studied in dementia.MethodsWe used data from 27,090 patients diagnosed with dementia between January 2000 and March 2016 from the Clinical Practice Research Datalink linked to Hospital Episodes Statistics data in England. We compared adverse events for 3532 patients newly prescribed Z-drugs by time-varying dosage to (1) 1833 non-sedative-users with sleep disturbance; (2) 10,214 non-sedative-users with proximal GP consultation matched on age, sex, and antipsychotic use; and (3) 5172 patients newly prescribed benzodiazepines. We defined higher dose Z-drugs and benzodiazepines as prescriptions equivalent to ≥ 7.5 mg zopiclone or > 5 mg diazepam daily. Cox regression was used to estimate hazard ratios (HRs) for incident fracture, hip fracture, fall, mortality, acute bacterial infection, ischaemic stroke/transient ischaemic attack, and venous thromboembolism over a 2-year follow-up, adjusted for demographic- and health-related covariates.ResultsThe mean (SD) age of patients was 83 (7.7) years, and 16,802 (62%) were women. Of 3532 patients prescribed Z-drugs, 584 (17%) were initiated at higher doses. For patients prescribed higher dose Z-drugs relative to non-users with sleep disturbance, the HRs (95% confidence interval) for fractures, hip fractures, falls, and ischaemic stroke were 1.67 (1.13–2.46), 1.96 (1.16–3.31), 1.33 (1.06–1.66), and 1.88 (1.14–3.10), respectively. We observed similar associations when compared to non-sedative-users with proximal GP consultation. Minimal or inconsistent excess risks were observed at ≤ 3.75 mg zopiclone or equivalent daily, and for mortality, infection, and venous thromboembolism. We observed no differences in adverse events for Z-drugs compared to benzodiazepines, except lower mortality rates with Z-drugs (HR [95% confidence interval] of 0.73 [0.64–0.83]).ConclusionsHigher dose Z-drug use in dementia is associated with increased fracture and stroke risks, similar or greater to that for higher dose benzodiazepines. Higher dose Z-drugs should be avoided, if possible, in people living with dementia, and non-pharmacological alternatives preferentially considered. Prescriptions for higher dose Z-drugs in dementia should be regularly reviewed.Trial registrationENCePP e-register of studies,EUPAS18006
Effects of metformin on atrial and ventricular arrhythmias: evidence from cell to patient
Authors: Nantsupawat Teerapat , Wongcharoen Wanwarang , Chattipakorn Siriporn C. , Chattipakorn Nipon 
Published: November 2020

AbstractMetformin has been shown to have various cardiovascular benefits beyond its antihyperglycemic effects, including a reduction in stroke, heart failure, myocardial infarction, cardiovascular death, and all-cause mortality. However, the roles of metformin in cardiac arrhythmias are still unclear. It has been shown that metformin was associated with decreased incidence of atrial fibrillation in diabetic patients with and without myocardial infarction. This could be due to the effects of metformin on preventing the structural and electrical remodeling of left atrium via attenuating intracellular reactive oxygen species, activating 5′ adenosine monophosphate-activated protein kinase, improving calcium homeostasis, attenuating inflammation, increasing connexin-43 gap junction expression, and restoring small conductance calcium-activated potassium channels current. For ventricular arrhythmias, in vivo reports demonstrated that activation of 5′ adenosine monophosphate-activated protein kinase and phosphorylated connexin-43 by metformin played a key role in ischemic ventricular arrhythmias reduction. However, metformin failed to show anti-ventricular arrhythmia benefits in clinical trials. In this review, in vitro and in vivo reports regarding the effects of metformin on both atrial arrhythmias and ventricular arrhythmias are comprehensively summarized and presented. Consistent and controversial findings from clinical trials are also summarized and discussed. Due to limited numbers of reports, further studies are needed to elucidate the mechanisms and effects of metformin on cardiac arrhythmias. Furthermore, randomized controlled trials are needed to clarify effects of metformin on cardiac arrhythmias in human.
Recent advances in the management of anaplastic thyroid cancer
Authors: De Leo Simone , Trevisan Matteo , Fugazzola Laura 
Published: November 2020

AbstractAnaplastic thyroid cancer (ATC) is undoubtedly the thyroid cancer histotype with the poorest prognosis. The conventional treatment includes surgery, radiotherapy, and conventional chemotherapy. Surgery should be as complete as possible, securing the airway and ensuring access for nutritional support; the current standard of care of radiotherapy is the intensity-modulated radiation therapy; chemotherapy includes the use of doxorubicin or taxanes (paclitaxel or docetaxel) generally with platin (cisplatin or carboplatin). However, frequently, these treatments are not sufficient and a systemic treatment with kinase inhibitors is necessary. These include multitarget tyrosine kinase inhibitors (Lenvatinib, Sorafenib, Sunitinib, Vandetanib, Axitinib, Pazopanib, Pyrazolo-pyrimidine compounds), single target tyrosine kinase inhibitors (Dabrafenib plus Trametinib and Vemurafenib against BRAF, Gefitinib against EGFR, PPARγ ligands (e.g. Efatutazone), Everolimus against mTOR, vascular disruptors (e.g. Fosbretabulin), and immunotherapy (e.g. Spartalizumab and Pembrolizumab, which are anti PD-1/PD-L1 molecules). Therapy should be tailored to the patients and to the tumor genetic profile. A BRAF mutation analysis is mandatory, but a wider evaluation of tumor mutational status (e.g. by next-generation sequencing) is desirable. When a BRAFV600E mutation is detected, treatment with Dabrafenib and Trametinib should be preferred: this combination has been approved by the Food and Drug Administration for the treatment of patients with locally advanced or metastatic ATC with BRAFV600E mutation and with no satisfactory locoregional treatment options. Alternatively, Lenvatinib, regardless of mutational status, reported good results and was approved in Japan for treating unresectable tumors. Other single target mutation agents with fair results are Everolimus when a mutation involving the PI3K/mTOR pathway is detected, Imatinib in case of PDGF-receptors overexpression, and Spartalizumab in case of PD-L1 positive tumors. Several trials are currently evaluating the possible beneficial role of a combinatorial therapy in ATC. Since in this tumor several genetic alterations are usually found, the aim is to inhibit or disrupt several pathways: these combination strategies use therapy targeting angiogenesis, survival, proliferation, and may act against both MAPK and PI3K pathways. Investigating new treatment options is eagerly awaited since, to date, even the molecules with the best radiological results have not been able to provide a durable disease control.