bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Calcar Collar Is Protective Against Early Torsional/Spiral Periprosthetic Femoral Fracture
Authors: Johnson Aaron J. , Desai Shivam , Zhang Chunyang , Koh Kyung , Zhang Li-Qun , Costales Timothy , O’Toole Robert V. , Manson Theodore T. 
Published: April 2020

Background:
Periprosthetic fracture is a leading reason for readmission following total hip arthroplasty. Most of these fractures occur during the early postoperative period before bone ingrowth. Before ingrowth occurs, the femoral component can rotate relative to the femoral canal, causing a spiral fracture pattern. We sought to evaluate, in a paired cadaver model, whether the torsional load to fracture was higher in collared stems. The hypothesis was that collared stems have greater load to fracture under axial and torsional loads compared with collarless stems.

Methods:
Twenty-two cadaveric femora (11 matched pairs) with a mean age of 77 ± 10.2 years (range, 54 to 90 years) were harvested. Following dissection, the femora were evaluated with use of a dual x-ray absorptiometry scanner and T scores were recorded. We utilized a common stem that is available with the same intraosseous geometry with and without a collar. For each pair, 1 femur was implanted with a collared stem and the contralateral femur was implanted with a collarless stem with use of a standard broaching technique. A compressive 68-kg load was applied to simulate body weight during ambulation. A rotational displacement was then applied until fracture occurred. Peak torque prior to fracture was measured with use of a torque meter load cell and data acquisition software.

Results:
The median torque to fracture was 65.4 Nm for collared stems and 43.1 Nm for uncollared stems (p = 0.0014, Wilcoxon signed-rank test). The median T score was –1.95 (range, –4.1 to –0.15). The median difference in torque to fracture was 29.18 Nm. As expected in each case, the mode of failure was a spiral fracture around the implant.

Conclusions:
Collared stems seemed to offer a protective effect in torsional loading in this biomechanical model comparing matched femora.

Clinical Relevance:
These results may translate into a protective effect against early periprosthetic Vancouver B2 femoral fractures that occur before osseous integration has occurred.
The Corporate Practice of Medicine
Authors: Moses Michael J. , Weiser Lori G. , Bosco Joseph A. 
Published: April 2020

Abstract:
There has been an upsurge in the number of practices owned by non-physicians. With orthopaedic surgery as the next frontier in this market, orthopaedists need to consider the ethical consequences of such acquisitions. The history and trends of practice ownership are reviewed alongside how laws shifted to reflect a changing health-care climate. The 4 tenets of bioethics (beneficence, nonmaleficence, autonomy, and justice) are explored with regard to practice acquisition by non-physician entities. Although non-physician-owned corporations and private equity firms provide liquidity to the health-care sector, there are ethical concerns that may ultimately impact patient care. Orthopaedic surgeons must be cautious when engaging in acquisitions with non-physician-owned entities, as the goals of each party may not align. This may yield situations that infringe on the basic principles of bioethics for both physician and patient.
Whether to Fused PET/CT or CECT in Post-Therapeutic Colorectal Cancer Assessments: A Study of the Efficacy of the Modality of Choice among Egyptian Patients.
Authors: Baz Ahmed , Hassan Talaat Ahmed 
Published: April 2020

Abstract
One of the most common cancers, colorectal cancer accounts for several tumor-related mortalities; its high recurrence rates either as a local recurrence of the disease or as a distant metastatic disease (up to 35-40%) have been reported in the treated patients within the first two years following surgery. There has been heated debate over the modality of choice for imaging of the primary colorectal cancer. This study investigates the diagnostic performance of fused Positron Emission Tomography/ Computed Tomography (PET/CT) in comparison to Contrast-enhanced Computed Tomography (CECT) as a follow-up and restaging imaging tool for post-therapeutic colorectal cancers. Data were collected from 84 Egyptian patients (26 females and 58 males, age ranges from 35 to 80 years) who were treated from colorectal cancers. They were referred to a private imaging center for evaluation of their disease recurrence by fused PET/CT.Disease recurrence was categorized as operative bed recurrence/residual (incomplete therapeutic response), nodal, and distal metastases. The site of the tumor recurrence was predominantly seen in the rectosigmoid region in 31 patients (36.9%), followed by the ascending colon where it was present in 13 patients (15.4%), then the transverse colon as depicted in 9 patients (10.7%); The descending colon recurrence was noted in 6 patients (7.1%), and the caecal recurrence existed in only one patient (1.3%). With reference to histopathology reports, the fused PET\CT had sensitivity, specificity, positive predictive value, negative predictive value, and an overall accuracy of 93.33%, 83.33%, 93.33%, 83.33% & 90.48% respectively as compared to CECT (73.33%, 58.33%, 81.48%, 46.67%, 69. 05% respectively).Our findings indicate that fused PET\CT may be more effective than the CECT regarding the detection of operative bed recurrent disease and incomplete therapeutic responses. PET\CT may also offer a cost-effective whole-body scan for restaging of the recurrent diseases through an accurate detection of the nodal and distant metastases.
The yield of routine histopathology in fistula-in-ano: a retrospective analysis
Authors: Samarasekera Dharmabandhu Nandadeva , Jayarajah Umesh , Almeida Isuru S 
Published: April 2020

Abstract

Objective

Fistulae-in-ano with a specific aetiology such as TB and Crohn’s are usually complex and challenging to treat. This study was aimed to determine the yield of routine histological analysis in fistula-in-ano, in detecting specific aetiology. Histopathology reports of all patients without a previous diagnosis, who underwent surgery for fistulae-in-ano were retrospectively analysed.
Results

A total of 215 patients [median age:40 years(range:14–73), males = 178(82.8%)] were analysed. The majority(75%,n = 161) were simple fistulae and recurrent(67%,n = 145). Histological evaluation revealed inflamed granulation tissue in 94.9%(n = 204) of patients. Five(2.3%) patients had conclusive evidence of Crohn’s disease and three(1.4%) had tuberculosis. One patient(0.5%) had evidence of adenocarcinoma with mucinous differentiation. Significant proportion of fistula with a specific aetiology were complex fistulae (82%vs.22%,p < 0.001) and associated with abscess/collections (45.5%vs.11.8%, p < 0.001). Age, type of fistula, level of internal opening, recurrence and presence of haemorrhoids were comparable in those with and without a specific aetiology. One patient with Crohn’s and those with TB did not have any associated symptoms to suggest the diagnosis. Routine histopathological analysis in patients presenting with fistula in-ano should be performed as clinical prediction based on the nature of fistula may not be always accurate.
Enhanced melanin pigment production from Dietzia schimae NM3 in cheese whey using Box-Behnken design
Authors: Eskandari Sahar , Etemadifar Zahra 
Published: April 2020

Abstract
Melanin is a natural, dark-brown complex molecular structure pigment formed by the oxidative polymerization of phenolic compounds. Microbial melanin pigment can be use in industrial fields, canned additives and preservatives. Optimization method is used to produce a quick and sufficient product with reliable and cost-effective processes. In this project, four factors (temperature, l-tyrosine, pH and CuSO4) affecting in melanin production by Dietzia schimae NM3 were optimized by response surface methodology with Box–Behnken design in inexpensive medium (whey powder). The anti-bacterial activity of D. schimae melanin was assayed by disk diffusion test. The optimal medium compositions were obtained in whey 5% (w/v), l-tyrosine 2.5 g/l, CuSO4 0.013 g/l, pH 10.5, and temperature 32 °C by maximum yield of 790 mg/l melanin pigment. The ANOVA results of RSM showed a significant P-value (0.0001), model F-value (78.84) and probability R² (0.98), with insignificant lack of fit (0.091). Melanin also showed antibacterial activity against gram-positive strains such as Bacillus cereus (20 mm), B. subtilis (18 mm), Streptococcus pyogenes (17 mm), Staphylococcus epidermidis (18 mm), and S. aureus (18 mm), which was comparable with amoxicillin (AMX) and cefotaxime (CTX) as control positives. We realized the ability of D. schimae melanin pigment as natural substances to be considered for industrial fields due to its biocompatibility and physicochemical properties.
Astragaloside IV prophylactic administration relieves recurrent allergic atopic dermatitis
Authors: Zheng Jie , Yu Xi , Wei Xiao , Fan Hongwei , Hong Min 
Published: April 2020

Abstract
BackgroundAtopic dermatitis (AD) is a common allergic inflammatory skin disease with high relapse rates and recurring severity. However, the underlying pathogenesis of AD recurrence is still unclear. Our previous study reported Astragaloside IV (AS-IV) administration in sensitization stage ameliorated the allergic inflammation of AD. In this study, we aimed to evaluate the efficacy of AS-IV which prophylactic applied in remission phase of AD and to investigate the underlying mechanisms.MethodsThe efficacy of AS-IV with prophylactic administration in remission phase of AD was evaluated in a fluorescein isothiocyanate (FITC)-induced AD relapse (AD-Re) model. Production of IL-4, IL-5 IL-13, IFN-γin mice ear tissues, IgE in serum were measured by ELISAs. Pharmacokinetic profile of AS-IV was assessed by HPLC-MS. Protein and gene expression levels of TLRs and NF-κB were detected by WB and qRT-PCR, respectively. Results: Prophylactic administration in remission phase of AD, AS-IV attenuated ear swelling, inflammatory cell infiltration, IgE production of ear homogenates in AD-Re mice. Levels of T helper (Th)2 cytokines including IL-4, IL-5, IL-13 but not Th1 cytokine IFN-γin AD-Re mice were inhibited remarkably with AS-IV preventively treatment. In addition, a different pharmacokinetic profile of AS-IV was observed as applied in remission phase. Moreover, AS-IV prophylactic administration decreased the gene expression of NF-κB and TLR8 in AD-Re mice. Consistently, the proteins expression of TLR8, TIRAP and MyD88 in ear homogenates also reduced obviously in AS-IV treated mice. Conclusions: Our finding indicated the disordered TLR8-mediated NF-κB pathway may play an important role in the pathogenesis of AD recurrence. AS-IV prophylactic administration in remission phase could regulate TLR8-mediated NF-κB pathway to against AD recurrence. These findings further improved our understanding of the pathogenesis of AD recurrence and the pharmacological effects of AS-IV.
Time-dependent management of Hirschsprung disease during Covid-19 pandemic
Authors: Prato Alessio Pini , Arnoldi Rossella , Faticato Maria Grazia , Felici Enrico , Nozza Paolo 
Published: April 2020

Abstract
INTRODUCTION – During Covid-19 pandemic, some elective non-deferrable surgical procedures has been maintained on a local basis to avoid complications of time-dependent issues. The aim of this paper is to suggest a possible strategy for the management of patients with Hirschsprung (HSCR) during this dramatic Covid-19 pandemic considering.MATERIALS AND METHODS - A systematic literature search on PubMed and Embase of all available literature addressing “Hirschsprung”, “preoperative enterocolitis”, “preoperative mortality”, “complications”, and “timing” in all possible combination has been performed limiting documents to the last 10 years and excluding non-English papers.RESULTS – Systematic review assessed 170 papers and focused on 10 full-text papers addressing the same issues as above. The incidence of preoperative HAEC proved to be as high as 34% with a mortality between 2.4% and 8%. Age at surgery varied in literature reports but recent evidences suggested that patients should be operated around 3 months of age after effective bowel decompression. Rectal irrigations should not be continued over 2 to 4 months to avoid nutritional issues and subsequent possible increase of surgical complications.CONCLUSIONS – Based on available literature, contingent shortage of health resources and necessity to avoid hospital overcrowding during this pandemic, we suggest as follows: 1) surgery should be delayed for healthy neonates up to 3 months of age, and a diverting enterostomy consider for those with ultralong HSCR, unwell or with ineffective nursing; 2) surgery can be delayed but rectal irrigations cannot be maintained indefinitely (ideally within 2 to 4 months at maximum); 3) Surgery could be postponed in older patients, provided previous bouts of HAEC are excluded. This chosen behaviour of our Center for Digestive Diseases aims at avoiding risk of complication and serve the best for our patients in this delicate setting of Covid-19 pandemic.
Clinical features of COVID-19 patients in one designated medical institutions in Chengdu, China
Authors: Zhou Gui , Tan Yun-Hui , Luo Jiang-Cuo , Lu Yi-Xiao , Feng Jing , Li Juan , Yang Yun-Mei , Chen Long , Zhang Jian-Ping 
Published: April 2020

Abstract
OBJECTIVE: To study the clinical characteristics of patients infected with the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) responsible for coronavirus disease (COVID-2019).METHODS: Data were collected from 20 patients admitted to the Pidu District People’s Hospital in Chengdu from January 26, 2020 to March 1, 2020 with laboratory-confirmed SARS-Cov-2 infection. Clinical data were collected using the World Health Organization (WHO) nCoV CASE RECORDFORM Version 1.2 28JAN2020, which includes parameters such as: temperature, epidemiological characteristics, social network, history of exposure, and incubation period. If information was unclear, the team reviewed the original data and contacted patients directly if necessary.RESULTS: The median age of the 20 COVID-19 infected patients studied was 42.5 years. In this cohort, four patients became severely ill and one deteriorated rapidly during treatment. This patient was transferred to another medical center with an intensive care unit (ICU) for treatment. This patient died after admission to the ICU. Two of the twenty patients remained positive SARS-Cov-2 more than three weeks, and they were quarantined in a medical facility without medication. According to our analysis, all of the studied cases were infected by human-to-human transmission due to the lack of protective measures; transmission through contact within families requires confirmation. The most common symptoms at onset of illness were fever in 13 (65%) patients, cough in 9 (45%), headache in 3 (15%), fatigue in 6 (30%), diarrhea in 3 (15%), and abdominal pain in 2 (10%). Six patients (30%) developed shortness of breath upon admission. The median time from exposure to onset of illness was 6.5 days (interquartile range 3.25–9 days), and from the onset of symptoms to first hospital admission was 3.5 (1.25–7) days.CONCLUSION: Compared with patients infected with SARS-Cov-2 in Wuhan (up to the end of February 2020), the symptoms of patients in one hospital in Chengdu, Sichuan Province, were relatively mild and patients were discharged from the hospital after only a short stay. However, the fasting blood glucose of the infected individuals was found to be slightly elevated because of the state of emergency. The dynamic changes in lymphocyte levels can predict disease status of COVID-19. They are also suggestive of changes in mean platelet volume during disease progression. This suggests that the patients had mild cases of COVID-19. However, because there is no effective drug treatment for COVID-19, it is important to detect and identify severe cases from mild cases early.
WITHDRAWN: Interplay between cancer cells and M2 macrophages is necessary for miR-550a-3-5p down-regulation-mediated HPV-positive OSCC progression
Authors: Cao Mingxin , Zhang Weilong , Yu Xianghua , Wu Jiashun , Qiao Xinwei , Huang Meichang , Wang Ke , Wu Jingbiao , Tang Yajie , Jiang Jian , Liang Xinhua , Tang Ya-ling 
Published: April 2020

Abstract

Background: Human papillomavirus (HPV)-positive oral squamous cell carcinoma (OSCC) is increasing worldwide with typically higher grade and stage. Studies suggested that microRNAs (miRNAs) play a critical role in cancer; However, their role in HPV-positive OSCC progression remains unclear.Methods: miRNA microarray was performed to identify differentially expressed miRNAs. qRT-PCR and FISH were performed to determine the relative expression of miR-550a-3-5p. CCK-8, Flow cytometry, Wound healing, Cell invasion assays and xenograft experiments were conducted to analyze the biological roles of miR-550a-3-5p. Tumor-associated macrophages (TAMs) generation, co-culturing of cancer cells with TAMs, Western blot, Dual-luciferase reporter gene assay, Immunohistochemistry and animal studies were performed to explore the mechanisms underlying the functions of miR-550a-3-5p. Results: In this study, we identified 19 miRNAs differentially expressed in HPV-positive OSCC specimens. One of these, miR-550a-3-5p, was down-regulated in HPV-positive OSCC. This down-regulation correlated with higher tumor size and nodal metastasis. Biofunctional investigations revealed that miR-550a-3-5p inhibited tumor growth and progression in nude mice models without altering the in vitro migration, invasion and EMT of HPV-positive OSCC cells. After co-culturing cancer cells with tumor-associated macrophages (TAMs), we found that the effects of miR-550a-3-5p on suppressing migration, invasion and EMT of HPV-positive OSCC cells were dependent on decreasing M2 macrophages polarization. Moreover, we identified that miR-550a-3-5p, down-regulated by E6 oncoprotein, inhibited M2 macrophages polarization by YAP/CCL2 signaling, which in turn abrogating EMT program in HPV-positive OSCC cells. Using YAP inhibitor, verteporfin (VP) in a HPV-positive OSCC model of transgenic mice also showed that tumors were less progressive when compared to those in Vehicle group. In both xenografts and clinical HPV-positive OSCC samples, miR-550a-3-5p levels were inversely associated with YAP, CCL2 expressions and the number of M2 macrophages.Conclusions: E6/miR-550a-3-5p/YAP/CCL2 signaling induces M2 macrophages polarization to enhance EMT and progression, revealing a novel crosstalk between cancer cells and immune cells in HPV-positive OSCC microenvironment.
Therapeutic targeting Netrin-1-positive invasive bladder cancer cells with oridonin
Authors: Yu Meng , Li Yuanyuan , Sun Dan , Xing Haotian , An Jun , Yang Jieping , Wei Baojun , Liu Shuangjie , Kong Chuize , Yu Fan , Okumura Kazuhiro , Wakabayashi Yoichi , Izumi Hideki , Yashinami Michio , Mae Takao , Nagase Hiroki , Nakagawara Akira , Zhu Yuyan 
Published: April 2020

Abstract
Background

Small compound oridonin acts as an effective anti-tumor agent used for a wide variety of human malignancies, while the antitumor efficacy and molecular mechanism of oridonin against bladder cancer remains unclear.
Methods

Four independent cohorts of bladder cancer were employed to assess the correlation between netrin-1 expression and progression and prognosis of bladder cancer. Clinical potential of netrin-1 as a biomarker and oridonin-mediated netrin-1-targeting anti-tumor mechanism were investigated by QRT-PCR, Western blot and ELISA. Regulatory mechanisms of Netrin-1 were investigated by luciferase reporter assay and Western blot. The EJ-inoculated nude mice xenograft model was used for the in vivo study.
Results

High expression of netrin-1 was significantly correlated with a poor overall survival in three independent bladder cancer cohorts. Urinary netrin-1 level was significantly elevated in bladder cancer patients correlating with tumor invasion and grade. Netrin-1 promoted cell proliferation, tumorsphere-forming, migration and invasion in bladder cancer cells. Oridonin treatment strikingly suppressed these malignant phenotypes and induced cell death in TCC cell lines and murine xenografts. Oridonin markedly decreased netrin-1 through inhibiting NF-κB transcriptional activity and shortening the half-life of NTN1 mRNA via inducing IRE1α, resulting in repression of its downstream signaling.
Conclusions

Together, these results strongly suggest that netrin-1 promotes the progression of bladder cancer, and acts as a potential urinary biomarker for the diagnosis as well as the prediction of the tumor progression. Oridonin exerts its strong anti-tumor activity against the invasive bladder cancer by suppressing netrin-1 mRNA production and stability.
The C-terminal fragment of LRRK2 with the G2019S substitution increases the neurotoxicity of mutant A53T α-synuclein in dopaminergic neurons in vivo
Authors: Cresto Noémie , Gardier Camille , Gaillard Marie-Claude , Gubinelli Francesco , Roost Pauline , Molina Daniela , Joséphine Charlène , Dufour Noëlle , Aurégan Gwenaelle , Guillermier Martine , Bernier Sueva , Jan Caroline , Gipstein Pauline , Hantraye Philippe , Chartier-harlin Marie-Christine , Bonvento Gilles , Camp Nadja Van , Taymans Jean-Marc , Cambon Karine , Liot Géraldine , Bemelmans Alexis-Pierre , BROUILLET Emmanuel 
Published: April 2020

Abstract
Background: Alpha-synuclein (α-syn) and leucine-rich repeat kinase 2 (LRRK2) likely play crucial roles both in sporadic and familial forms of Parkinson’s disease (PD). The most prevalent mutation in LRRK2 is the G2019S substitution, which induces neurotoxicity through increased kinase activity. There is likely an interplay between LRRK2 and α-syn involved in the neurodegeneration of dopaminergic (DA) neurons in the substantia nigra (SNc) in PD. However, the mechanisms underlying this interplay are ill-defined. Here, we investigated whether LRRK2G2019S can increase the neurotoxicity induced by a mutant form of α-syn (A53T mutation) in DA neuronsin vivo.Methods: We used a co-transduction approach with AAV2/6 vectors encoding human a-synA53T and the C-terminal portion of LRRK2 (ΔLRRK2), which contains the kinase domain, with either the G2019S mutation (ΔLRRK2G2019) alone or the D1994A mutation (ΔLRRK2G2019S/D1994A), which inactivates the kinase activity of LRRK2. The AAVs were co-injected into the rat SNc and histological evaluation was performed at 6- and 15-weeks post-injection (PI). Results: Most SNc neurons co-expressed ΔLRRK2 and human α-synA53T after transduction. ΔLRRK2G2019S alone produced no cell loss at 15-weeks PI, whereas as expected, transduction with AAV-a-synA53T mixed with a control AAV coding for GFP produced significant loss of DA neurons. Co-injection of AAV-ΔLRRK2G2019S and AAV-α-synA53T induced a loss of DA neurons slightly but significantly greater than that produced by co-injection of AAV-α-synA53T and AAV-GFP. We also studied the inactive form, ΔLRRK2G2019S/D1994A at 6 weeks PI. Results showed that ΔLRRK2G2019S/D1994A did not alter the early toxicity of α-synA53T, in contrast to the active form ΔLRRK2G2019S that produced a moderate but significant increase in α-synA53T toxicity.Conclusion. Thus, these results show that mutant LRRK2 may selectively facilitate α-syn toxicity in DA neurons through a cell-autonomous mechanism involving its kinase activity. However, considering that the effect of ΔLRRK2G2019S upon human α-synA53T is moderate in our paradigm where pathological proteins are overexpressed, the study supports the hypothesis that the interplay between LRRK2 and α-syn also implicates non-cell-autonomous mechanisms such as those involved in neuroinflammation.