bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurofilament light chain level in plasma extracellular vesicles and Parkinson’s disease
Authors: Chung Chen-Chih , Chan Lung , Chen Jia-Hung , Bamodu Oluwaseun Adebayo , Hong Chien-Tai 
Published: December 2020

Background: Neurofilament light chain (NfL) is essential for axonal maintenance and reflects neuronal damage. Extracellular vesicles (EVs), especially exosomes, secreted by cells into the blood, are emerging as novel biomedical research platforms of physiological and pathological processes. The present study investigated the possible association between plasma EV NfL and Parkinson’s disease (PD). Methods: One hundred and sixteen patients with mild to moderate PD and 46 non-PD, neurological controls were recruited, and their clinical motor symptoms and cognitive function were evaluated. Plasma EVs were isolated using an exoEasy kit, and immunomagnetic reduction assay was used to assess EV NfL level. Statistical analysis was performed using SPSS 25.0, and p < 0.05 was considered significant. Results: The isolated plasma EVs were validated according to size and the presence of specific surface markers. Compared with the neurological control group, the levels of plasma EV NfL in patients with PD were not significantly different (PD: 9.42 ± 3.89, control: 9.53 ± 3.62 pg/mL plasma, p = 0.71). On the other hand, plasma EV NfL in patients with PD trendwise correlated with the severity of akinetic rigidity ( p = 0.05). PD patients with optimal EV NfL (lowest quartile) had 6.66 ± 2.08 lower Unified Parkinson’s Disease Rating Scale-III score after adjustment for age, sex, and disease duration. Conclusion: Plasma EV NfL levels did not distinguish patients with PD from the neurological control group. The possible correlation between plasma EV NfL with the severity of motor symptoms within the PD patients, especially with akinetic rigidity, was noted. Further clinical validation of the blood EV NfL by a longitudinal follow-up study of PD patients is warranted.
Antitumor activity and efficacy of shorter versus longer duration of anthracycline-taxane neoadjuvant chemotherapy in stage II–III HER2-negative breast cancer: a 10-year, retrospective analysis
Authors: Lobefaro Riccardo , Zattarin Emma , Nichetti Federico , Prisciandaro Michele , Ligorio Francesca , Brambilla Marta , Sepe Pierangela , Corti Francesca , Peverelli Giorgia , Ottini Arianna , Beninato Teresa , Mazzeo Laura , Rea Carmen G. , Mariani Gabriella , de Braud Filippo , Bianchi Giulia V. , Vernieri Claudio , Capri Giuseppe 
Published: December 2020

Background: Neoadjuvant anthracycline-taxane-based chemotherapy (ChT) is a standard of care treatment option for stage II–III breast cancer (BC) patients. However, the optimal duration of neoadjuvant ChT has been poorly investigated so far. Material and methods: We retrospectively retrieved clinical data of patients with stage II–III human epidermal growth factor receptor 2-negative (HER2–) BC who were treated between October 2007 and January 2018 with neoadjuvant AT (doxorubicin-paclitaxel) for three cycles followed by CMF (cyclophosphamide-methotrexate-5-fluorouracil) for three cycles (cohort A) or with four AT cycles followed by four CMF cycles (cohort B). The aim of our study was to investigate the impact of neoadjuvant ChT duration (cohort A versus cohort B) on pathological complete response (pCR) rates, disease-free survival (DFS) and overall survival (OS). Results: Of 209 HER2– BC patients included, 62 had triple-negative breast cancer (TNBC) and 147 had hormone receptor-positive (HR+) BC. Median age was 48 years (range 30–74 years). A total of 111 patients belonged to cohort A and 98 patients belonged to cohort B. pCR was detected in 29 (13.9%) patients, 25 (40.3%) of whom had TNBC and four (2.7%) had HR+ HER2– BC. Patients achieving pCR had significantly longer DFS and OS, with statistical significance reached only in patients with TNBC. We found no differences between cohort A and cohort B in terms of pCR rates (15.3% versus 12.2%; p = 0.55), DFS ( p = 0.49) or OS ( p = 0.94). The incidence of grade 3/4 adverse events was similar in cohort A versus cohort B as well (22.5% versus 19.4%; p = 0.54). Conclusion: Shorter duration of neoadjuvant anthracycline-taxane ChT was not associated with worse clinical outcomes in patients with stage II–III BC. Prospective studies are needed to evaluate whether the duration of neoadjuvant anthracycline-taxane-based ChT can be reduced in specific patient subgroups without negatively affecting clinical outcomes.
Anterior Cruciate Ligament Injuries in the Older Athlete
Authors: Best Matthew J. , Zikria Bashir A. , Wilckens John H. 
Published: December 2020

Context: Older adults are remaining active longer and continuing during later stages of life to participate in sports and activities that involve pivoting on 1 foot. The rate of anterior cruciate ligament (ACL) tears is increasing in people older than 40 years of age, which has caused a concomitant increase in the rate of surgical reconstruction. Evidence Acquisition: We searched the PubMed database for articles published in English between January 1980 and January 2018 using the terms anterior cruciate ligament injury, ACL injury, ACL tear, anterior cruciate ligament reconstruction, ACLR, older, older athlete, and elderly. Study Design: Clinical review. Level of Evidence: Level 4. Results: Nonoperative treatment with activity modification and physical therapy may be an appropriate option for nonathletes older than 40 years of age with physically low-demand lifestyles. For patients with injuries that are unresponsive to nonoperative treatment or athletes participating in physically demanding activities, ACL reconstruction can improve function and facilitate return to sports. When evaluating whether a patient is a candidate for surgery, numerous variables should be considered, such as timing, graft choice, and postoperative rehabilitation. Conclusion: Outcomes of ACL reconstruction in older athletes are similar to those of younger patients. To date, published evidence is inadequate to determine the long-term effects of nonoperative and operative treatment as well as the role of ACL reconstruction in the development of osteoarthritis in the older athlete.
Nasal Obstruction and Quality of Life Assessment After Septoplasty With Turbinoplasty: Correlation Between Subjective Scales
Authors: Corredor-Rojas Gloria , García-Chabur María A. , Castellanos Juliana , Moreno Sergio , Pinzón Martin , Peñaranda Augusto 
Published: December 2020

Background Assessment of nasal obstruction is imprecise due to a low correlation between findings on the physical examination and objective measures with the severity of symptoms reported by the patient even after septoplasty with turbinoplasty is performed. The aim of this study is to evaluate the use of subjective scales, and the correlation between them for the evaluation of nasal obstruction after surgery. Objective To assess the impact of undergoing septoplasty with turbinoplasty to relieve nasal obstructive symptoms and the quality of life in a mid-term period by using the Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), and Glasgow Benefit Inventory (GBI). Methods A retrospective study was conducted of patients who underwent a septoplasty with turbinoplasty due to nasal septodeviation and secondary nasal obstructive symptoms at the Hospital Universitario Fundación Santa Fe de Bogotá. Three scales were used to measure the outcomes one year after surgery: VAS (0–10), NOSE (0–100), and GBI (−100 to 100). Results Data from 56 patients (21 females, mean age 37.5 years of age, SD 12.13) was collected. The results showed that 75% of the patients had a post-surgical NOSE score below 50 and a VAS score below 6. Regarding the GBI scale, 75% of the patients improved in their quality of life. An inverse proportional correlation was found between the NOSE and GBI scales (rho = −0.3682) (95% CI −0.579 to –0.111), and there was a directly proportional correlation between the NOSE and VAS scales (rho = 0.7440) (95% CI 0.595 to 0.844). Conclusion Subjective measures suggest there was an improvement in nasal obstructive symptoms and quality of life after surgery. Non-anatomical causes such as rhinitis can be confounding factors to consider in subsequent studies. VAS stands out as a possible interchangeable scale with NOSE to measure nasal obstruction in these patients.
Acute heart failure – The ‘real’ Malaysian experience: An observational study from a single non-cardiac centre
Authors: Raja Shariff Raja Ezman , Kasim Sazzli , Borhan Marisa Khatijah , Yusoff Mohd Rahal 
Published: December 2020

Background: Cardiovascular care in Malaysia adopts a ‘spoke-and-hub’ model, leaving the majority of acute heart failure (AHF) care to non-cardiac centres. Granular data on AHF care are essential and yet remain scarce. Objectives: This study aimed to illustrate the baseline characteristics, management and outcome of AHF patients. Methods: A retrospective, cross-sectional study was conducted on 1307 AHF patients admitted between 1 January 2012 and 31 December 2016. Results: The younger and Malay-predominant population reflects the distribution of ischaemic heart disease in Malaysia, highlighting the need to tackle metabolic risks factors. The majority are precipitated by ischaemia (61.8%). Common co-morbidities include hypertension (70.9%), coronary artery disease (57.8%) and diabetes (62.2%). The majority were of New York Heart Association Class II (31.9%) and Class III (25.6%). A total of 14.5% required inotropes and vasopressors, 12.9% required intravenous nitrates and 8.6% required dialysis. A further 4.9% of patients required intubation and mechanical ventilation, and 25.9% required non-invasive ventilation. Readmission and mortality were extremely high in our population. Short inpatient stays, restricting optimisation of medication, and gaps in the provision of coronary intervention and stress testing are possible contributing factors. When compared to global and regional registries, disparities were noted specifically surrounding mortality rate and optimum use of guideline-directed medical therapy. Conclusion: Although smaller and single centred, our study provides a unique insight into a pure Malaysian-only cohort from a hospital with no cardiology services in-house, which is more reflective of the majority of hospitals in Malaysia, unlike previous studies and registries.
Impact of non-pharmaceutical interventions on the COVID-19 epidemic: A modelling study
Authors: Awaidy Salah Al , Mahomed Ozayr 
Published: December 2020

Objective: This study aimed to assess the impact of non-pharmaceutical interventions on the COVID-19 epidemic in Oman. Methods: Data were retrieved from published national surveillance data between 24 February and 30 June 2020. To show the impact of the Government introduced public health intervention early in the epidemic, we used a simple disease-transmission model equation of the 2019-n CoV epidemic. Results: From all confirmed cases, the rates of intensive care unit admission were 4.56% (1824). We estimated an R0 of 3.11 with no intervention would result in nearly the entire population of Oman being infected within 65 days. A reduction of the R0 to 1.51 provided an estimated 89,056 confirmed cases, with 167 deaths or 0.4% mortality by June 30 with a requirement of 4052 intensive care unit beds. The current scenario (24 February to 30 June 2020) indicates an R0 of 1.41, resulting in 40,070 confirmed COVID-19 cases, 176 deaths and 69% of confirmed cases recovered. Conclusion: In early implementation of non-pharmaceutical interventions, an intensive lockdown has had a profound impact on the mitigation of a large-scale COVID-19 outbreak in Oman.
Use of indocyanine green fluorescence imaging to determine the area of ileum with poor blood flow during robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion
Authors: Yajima Shugo , Nakanishi Yasukazu , Matsumoto Shunya , Tanabe Kenji , Masuda Hitoshi 
Published: December 2020

Introduction: The utility of Firefly mode, a technology using near-infrared imaging, used with the intravenous injection of indocyanine green, and which is available as an optional feature for the Da Vinci surgical platform has recently been explored. We herein describe a case in which we detected the ileum with inadequate blood flow using Firefly mode during the processing of the robot-assisted radical cystectomy with intracorporeal urinary diversion. Presentation of the case: A 75-year-old woman diagnosed as having invasive bladder cancer underwent robot-assisted laparoscopic radical cystectomy with complete intracorporeal urinary diversion using a Da Vinci Xi surgical system. We used Firefly mode after injection of indocyanine green during the processing of the intracorporeal digestive restoration, which resulted in providing intraoperative visual assessment of blood flow to the ileum, allowing us to detect intestine with inadequate blood flow which was not so obvious under the normal visible light mode. We resected the ileum with poor blood flow and reanastomosed the residual small bowel. The patient was released from the hospital only with minor complications. Conclusion: Firefly mode, used with indocyanine green has a potential to be a useful tool that may facilitate robotic surgery including robot-assisted radical cystectomy with intracorporeal urinary diversion. Level of evidence: 5 (case report)
Patient centricity: Alienating patients from their own decisions is subjugation
Authors: Gill Michael 
Published: December 2020

This paper aims to scope patient centricity as being more than patient-clinician interactions and to raise a number of challenges. Patient centricity 1 is about listening to and working with patients from the ill-informed to the well informed. The concept does not attempt to isolate or overturn clinical expertise but rather, add a useful dimension which promotes trust and self-care. There are many examples of patients and clinicians working together, making shared decisions and promoting self-care to varying degrees. These examples, however, are isolated like spring desert flowers with many disappearing. Patient centricity requires the sharing of patient data and the right to correct errors. This requires an approach where the clinician gives up some authority in favour of increased equity and trust. Patient centricity, patient centred approaches and patient pathways are all about involving the patient in decisions, collaborating with the patient as a partner and about addressing the inequality of power between clinician and patient. Where there is a lack of patient centricity unfortunate events can occur across the industry. Clinicians, patients and the health industry are working together better and there are a number of notable success. In many ways patient centricity has only just started to emerge as a permanent feature.
Beliefs About Medicine and Glycemic Control Among Type 2 Diabetes Patients: A Cross-Sectional Study in West Bank, Palestine
Authors: Khdour Maher R. , Awadallah Heba B. , Alnadi Mustafa A. , Al-Hamed Doaa H. 
Published: December 2020

Introduction: To examine the mean differences between patient beliefs about medicine with reference to adherence and glycemic control. Methods: This study utilized a cross-sectional questionnaire-based approach. Adherence to medication was measured with the Morisky Green Levine Medication Adherence Scale (MGLS); glycemic control as the last HbA1c test value; and beliefs about medicine with the Beliefs about Medicines Questionnaire (BMQ). Results: According to MGLS scale, 220 (57.9%) of the diabetic patients were classified as high adherent to their medications and 160 (42.1%) were classified as low adherent. Patients had strong believes in their medication, the mean necessity score was significantly outweighed the mean concerns score (17.7 vs 14.4; P < .001). Low adherent patients had significantly more concerns about long term effect of medications (14.4 vs 13.8; P < .008). No significant mean differences were found between glycemic controlled and uncontrolled group regarding necessity or concern domains. Conclusion: Assessing beliefs about medicine is crucial for recognizing patients at risk of low adherence, which offers a way to help patients with diabetes to achieve a better glycemic control.
The Current Status of Spinal Posttraumatic Deformity: A Systematic Review
Authors: De Gendt Erin E. A. , Vercoulen Timon F. G. , Joaquim Andrei F. , Guo Wei , Vialle Emiliano N. , Schroeder Gregory D. , Schnake Klaus S. , Vaccaro Alexander R. , Benneker Lorin Michael , Muijs Sander P. J. , Oner F. Cumhur 
Published: December 2020

Study Design: Systematic Review. Objective: To systematically analyze the definitions and descriptions in literature of “Spinal Posttraumatic Deformity” (SPTD) in order to support the development of a uniform and comprehensive definition of clinically relevant SPTD. Methods: A literature search in 11 international databases was performed using “deformity” AND “posttraumatic” and its synonyms. When an original definition or a description of SPTD (Patient factors, Radiological outcomes, Patient Reported Outcome Measurements and Surgical indication) was present the article was included. The retrieved articles were assessed for methodological quality and the presented data was extracted. Results: 46 articles met the inclusion criteria. “Symptomatic SPTD” was mentioned multiple times as an entity, however any description of “symptomatic SPTD” was not found. Pain was mentioned as a key factor in SPTD. Other patient related parameters were (progression of) neurological deficit, bone quality, age, comorbidities and functional disability. Various ways were used to determine the amount of deformity on radiographs. The amount of deformity ranged from not deviant for normal to >30°. Sagittal balance and spinopelvic parameters such as the Pelvic Incidence, Pelvic Tilt and Sacral Slope were taken into account and were used as surgical indicators and preoperative planning. The Visual Analog Scale for pain and the Oswestry Disability Index were used mostly to evaluate surgical intervention. Conclusion: A clear-cut definition or consensus is not available in the literature about clinically relevant SPTD. Our research acts as the basis for international efforts for the development of a definition of SPTD.
Dose and Recovery Response of Patellofemoral Cartilage Deformations to Running
Authors: Heckelman Lauren N. , Riofrio Alexie D. , Vinson Emily N. , Collins Amber T. , Gwynn Olivia R. , Utturkar Gangadhar M. , Goode Adam P. , Spritzer Charles E. , DeFrate Louis E. 
Published: December 2020

Background: Running is a common recreational activity that provides many health benefits. However, it remains unclear how patellofemoral cartilage is affected by varied running distances and how long it takes the cartilage to recover to its baseline state after exercise. Hypothesis: We hypothesized that patellofemoral cartilage thickness would decrease immediately after exercise and return to its baseline thickness by the following morning in asymptomatic male runners. We further hypothesized that we would observe a significant distance-related dose response, with larger compressive strains (defined here as the mean change in cartilage thickness measured immediately after exercise, divided by the pre-exercise cartilage thickness) observed immediately after 10-mile runs compared with 3-mile runs. Study Design: Descriptive laboratory study. Methods: Eight asymptomatic male participants underwent magnetic resonance imaging of their dominant knee before, immediately after, and 24 hours after running 3 and 10 miles at a self-selected pace (on separate visits). Results: Mean patellar cartilage thicknesses measured before exercise and after the 24-hour recovery period were significantly greater than the thicknesses measured immediately after both the 3- and 10-mile runs ( P < .001). This relationship was not observed in trochlear cartilage. Mean patellar cartilage compressive strains were significantly greater after 10-mile runs compared with 3-mile runs (8% vs 5%; P = .01). Conclusion: Patellar cartilage thickness decreased immediately after running and returned to its baseline thickness within 24 hours of running up to 10 miles. Furthermore, patellar cartilage compressive strains were dose-dependent immediately after exercise. Clinical Relevance: These findings provide critical baseline data for understanding patellofemoral cartilage biomechanics in asymptomatic male runners that may be used to optimize exercise protocols and investigations targeting those with running-induced patellofemoral pain.
Amalgam Phase-Down Part 2: UK-Based Knowledge, Opinions, and Confidence in the Alternatives
Authors: Bailey O. , Vernazza C.R. , Stone S. , Ternent L. , Roche A.-G. , Lynch C. 
Published: December 2020

Introduction: Amalgam use has recently been phased down, and the potential for a phase-out is being investigated. Objectives: The study aimed to identify knowledge of the phase-down and opinions of a potential phase-out of amalgam by UK primary care clinicians and assess their confidence in using different materials in different situations. Methods: An anonymized, prepiloted cross-sectional e-survey was used to assess primary care clinicians’ knowledge and opinions of the amalgam phase-down and potential phase-out and their confidence in using amalgam and the alternatives in different situations. In total, 11,902 invitations were distributed through British dentist and therapist associations. Prior hypotheses were tested alongside descriptive statistics. Results: Response rate was 13% ( n = 1,513). Knowledge of the amalgam phase-down was low, with just 3% clinicians correctly identifying all patient groups in whom amalgam use should be avoided in the United Kingdom. Postgraduate education on posterior composite placement was high (88%), but a large majority had personal and patient-centered concerns over the suitability of the alternatives and lacked confidence when placing composite in comparison to amalgam in difficult situations ( P < 0.0001). Logistic regressions revealed that the best predictors of high confidence in placing mesio-occluso-distal composites and composites in difficult situations were being a private general dentist or being primarily a composite user. Conclusion: Primary care clinicians have major personal and patient-centered concerns regarding the amalgam phase-down (of which they have limited knowledge) and potential phase-out. Many lack confidence in using the alternative, composite, to restore posterior teeth in difficult situations, whereas confidence in using amalgam in similar situations is high. Effective education of clinicians and understanding patients’ needs, alongside policy changes, are required to enable a successful amalgam phase-down and potential phase-out. Knowledge Transfer Statement: This study shows that UK primary care clinicians are worried about the phase-down of amalgam for themselves and their patients. Many lack confidence in the alternative, composite, when used in difficult situations, which is in stark contrast to amalgam. Knowledge of the phase-down is limited. There is a need for more effective education of clinicians, an understanding of patients’ values, and policy changes to ensure the success of the phase-down and potential phase-out of amalgam.