bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dorsal fracture-dislocation of the radiocarpal joint: a new classification and implications in surgical treatment
Authors: Biondi Marco , Lauri Giulio 
Published: June 2020

Dorsal dislocations and fracture-dislocations of the radiocarpal joint are a spectrum of pathology involving both the bony and ligamentous structures that stabilize the radiocarpal joint. We retrospectively reviewed 63 dorsal radiocarpal dislocations treated in our Institute in order to propose a new classification and define surgical treatment. Preoperative CT-scan findings together with clinical and radiological outcomes were recorded. We identified four main types of lesions: Type I, pure dorsal radiocarpal dislocation; Type IIA, dorsal wall impaction and radial styloid avulsion; Type IIB, as IIA with additional intra-articular die punch; Type III, volar and dorsal marginal fragments; Type IV, larger volar and dorsal fragments. For each type of lesion, we propose specific options for treatment that are progressively more invasive. We believe that this classification adequately addresses the whole spectrum of bony and soft tissue injuries that occurs in dorsal radiocarpal fracture-dislocations giving a practical guide for surgical treatment. Level of evidence: IV
Chondral and Osteochondral Femoral Cartilage Lesions Treated with GelrinC: Significant Improvement of Radiological Outcome Over Time and Zonal Variation of the Repair Tissue Based on T2 Mapping at 24 Months
Authors: Schreiner Markus M. , Raudner Marcus , Szomolanyi Pavol , Ohel Kitty , Ben-Zur Livnat , Juras Vladimir , Mlynarik Vladimir , Windhager Reinhard , Trattnig Siegfried 
Published: June 2020

Objective To prospectively assess the efficacy of GelrinC in the treatment of chondral and osteochondral femoral cartilage lesions using morphological (Magnetic Resonance Observation of Cartilage Repair Tissue [MOCART]) and quantitative (T2-mapping) magnetic resonance imaging (MRI). Design This study was designed as a prospective single-arm, open label, multicenter study. Morphological magnetic resonance imaging (MRI) for MOCART assessment and T2 mapping was performed 1 week and 6, 12, 18, and 24 months after GelrinC implantation. Evaluation of T2 mapping was based on the assessment of global T2 indices (T2 of the repair tissue [RT] divided by T2 of healthy reference cartilage) and zonal variation. Results Fifty-six (20 female) patients were prospectively enrolled. The mean MOCART score significantly increased from baseline to the 24-month follow-up with 88.8 (95% CI, 85.8-91.9; P < 0.001) for all lesions combined as well as 86.8 (95% CI, 83.0-90.6) for chondral lesions and 94.1 (95% CI, 68.55-100) for osteochondral lesions. Furthermore, based on T2 mapping, significant zonal variation of the RT was observed at 24 months ( P = 0.039), which did not differ significantly from healthy reference cartilage ( P = 0.6). Conclusion Increasing MOCART scores were observed throughout the follow-up period, indicative of maturation of the cartilage repair. Significant zonal variation of the RT at 24 months might indicate the transformation into hyaline cartilage–like RT. Slightly differing morphological outcome between chondral and osteochondral lesions, but similar global and zonal T2 indices at 24 months, support the potential of GelrinC as a treatment option for both lesion types.
Mesenchymal Stromal Cell Transplantation Induces Regeneration of Large and Full-Thickness Cartilage Defect of the Temporomandibular Joint
Authors: Gomez Marcos , Wittig Olga , Diaz-Solano Dylana , Cardier José E. 
Published: June 2020

Objective Cartilage damage (CD) in the temporomandibular joint (TMJ) continues being a major problem in maxillofacial field. Evidence suggests that cellular therapy may be used for repairing CD in the TMJ. Design A murine model of condyle CD (CCD) was generated in the TMJ to evaluate the capacity of mesenchymal stromal cells (MSCs) to induce cartilage regeneration in CCD. A large CCD was surgically created in a condyle head of the TMJ of C57BL/6 mice. Human MSC embedded into preclotted platelet-rich plasma (PRP) were placed on the surface of CCD. As controls, untreated CCD and exposed TMJ condyle (sham) were used. After 6 weeks, animals were sacrificed, and each mandibular condyle was removed and CCD healing was assessed macroscopically and histologically. Results Macroscopic observation of CCD treated with MSC showed the presence of cartilage-like tissue in the CCD site. Histological analysis showed a complete repair of the articular surface with the presence of cartilage-like tissue and subchondral bone filling the CCD area. Chondrocytes were observed into collagen and glycosaminoglycans extracellular matrix filling the repaired tissue. There was no evidence of subchondral bone sclerosis. Untreated CCD showed denudated osteochondral lesions without signs of cartilage repair. Histological analysis showed the absence of tissue formation over the CCD. Conclusions Transplantation of MSC induces regeneration of TMJ-CCD. These results provide strong evidence to use MSC as potential treatment in patients with cartilage lesions in the TMJ.
Targeting translational read‐through of premature termination mutations in BMPR2 with PTC124 for pulmonary arterial hypertension
Authors: Long Lu , Yang Xudong , Southwood Mark , Moore Stephen , Crosby Alexi , Upton Paul D. , Dunmore Benjamin J. , Morrell Nicholas W. 
Published: June 2020

Pulmonary arterial hypertension is a fatal disorder of the lung circulation in which accumulation of vascular cells progressively obliterates the pulmonary arterioles. This results in sustained elevation in pulmonary artery pressure leading eventually to right heart failure. Approximately, 80% of familial and 20% of sporadic idiopathic pulmonary arterial hypertension cases are caused by mutations in the bone morphogenetic protein receptor type 2 (BMPR2). Nonsense mutations in BMPR2 are amongst the most common mutations found, where the insertion of a premature termination codon causes mRNA degradation via activation of the nonsense‐mediated decay pathway leading to a state of haploinsufficiency. Ataluren (PTC124), a compound that permits ribosomal read‐through of premature stop codons, has been previously reported to increase BMPR2 protein expression in cells derived from pulmonary arterial hypertension patients harbouring nonsense mutations. In this study, we characterised the effects of PTC124 on a range of nonsense BMPR2 mutations, focusing on the R584X mutation both in vitro and in vivo. Treatment with PTC124 partially restored BMPR2 protein expression in blood outgrowth endothelial cells isolated from a patient harbouring the R584X mutation. Furthermore, a downstream bone morphogenetic protein signalling target, Id1, was rescued by PTC124 treatment. Mutant cells also exhibited increased lipopolysaccharide‐induced permeability, which was reversed by PTC124 treatment. Increased proliferation and apoptosis in R584X blood outgrowth endothelial cells were also significantly reduced by PTC124. Moreover, oral PTC124 increased lung BMPR2 protein expression in mice harbouring the R584X mutation (Bmpr2+/R584X). Our findings provide support for future experimental medicine studies of PTC124 in pulmonary arterial hypertension patients with specific nonsense BMPR2 mutations.
Preliminary investigation of the associations between psychological flexibility, symptoms and daily functioning in people with chronic abdominal pain
Authors: Yu Lin , Inspector Yoram , McCracken Lance M 
Published: June 2020

Objective: Acceptance and commitment therapy (ACT), based in the psychological flexibility model, may benefit people with chronic abdominal pain. The current study preliminarily investigates associations between psychological flexibility processes and daily general, social and emotional functioning in chronic abdominal pain. Methods: An online survey comprising measures of psychological flexibility processes and daily functioning was distributed through social media. Subjects: In total, 89 participants with chronic abdominal pain were included in the analyses. Results: All investigated psychological flexibility processes significantly correlated with pain interference, work and social adjustment, and depression, in the expected directions (|r| = .35–.68). Only pain acceptance significantly correlated with gastrointestinal (GI) symptoms, r = -.25. After adjusting for pain in the analyses, pain acceptance remained significantly associated with all outcomes, |β| = .28–.56, but depression. After adjusting for pain and pain acceptance, only cognitive fusion remained significantly associated with anxiety, β = -.27, and depression, β = .43. When contrasting GI-specific anxiety with psychological flexibility processes, pain acceptance was uniquely associated with pain-related interference and work and social adjustment, and cognitive fusion and committed action were uniquely associated with depression. Conclusions: Psychological flexibility processes were positively associated with daily functioning in people with chronic abdominal pain. ACT may provide benefit for these people. Further studies with experimental designs are needed to examine the utility of ACT for people with abdominal pain.
The application of evidence-based bundle approach to reduce surgical site infection in geriatric hip fracture patients: A single centre experience
Authors: Lok Chow Chun , Alexander Chan Pak Hin , Wah Hung Yuk , Ho Fan Jason Chi 
Published: June 2020

Introduction: Surgical site infection (SSI) is associated with increased morbidity and mortality, prolongation on length of hospital stay and cost of community healthcare. In 2010 and 2012, our centre experienced an unexpectedly high rate of SSI in geriatric hip fracture patients with hemiarthroplasty done. A multifaceted intervention programme – ‘bundle approach’ – consisting of preoperative microbiological screening, perioperative measures and postoperative wound care was implemented. Method: Preoperative methicillin-resistant Staphylococcus aureus (MRSA) screening was implemented. Intravenous vancomycin was given as prophylactic antibiotic of choice in those patients with positive MRSA screening. All patients will be bathed with chlorhexidine lotion 1 day before operation or on the day of operation. Standardized protocol of surgical site disinfection was implemented: a stringent first stage povidone-iodine disinfection, second stage waterproof extremity draping and sterile plastic sheet wrapping of non-surgical region and third stage ChloraPrep, followed by circumferential iodophor-impregnated plastic adhesive drape (‘Ioban’) covering the hip and thigh region. The surgical wound was dressed with Aquacel adhesive tape after wound closure. Results: The total numbers of infected cases were 17 from 2008 to 2012 and 9 from 2013 to 2018 (first quarter). The rates of infection were 7.02% from 2008 to 2012 and 3.16% from 2013 to 2018 (first quarter). There was a statistically significant reduction in the number of infected cases of hemiarthroplasty after the implementation of bundle approach ( p = 0.0411). Discussion: The bundle approach showed to achieve an effective and sustained decrease in SSI for the geriatric hip fracture patients.
Human Acellular Dermal Matrix Augmentation Phalloplasty Surgery
Authors: Zhang Huimin , Jin Chengyue , Zhang Peiyang , Wu Yuanyi , Zhang Min , Bai Wenjun , Li Qing , Xu Tao , Zhang Xiaowei 
Published: June 2020

Introduction and Objective: Many men often have the need to enlarge their penises for psychological gain and to satisfy or to impress their partners. Many surgical techniques have been reported. However, none is the gold standard. Aim: To evaluate the efficacy and safety of human acellular dermal matrix allograft in augmentation phalloplasty technique. Methods: From March 2015 to September 2017, a total of 182 patients were prospectively recruited into our cohort after complete physical and psychological evaluation that deemed suitable for penile enhancement. Penis circumference was measured at the mid-length of the penis. Mean was 7.03 cm (6.93 ± 1.00 cm) and 12.1 cm (10.59 ± 1.15 cm) during flaccid and erection, respectively. All patients received human acellular dermal matrix graft under spinal or local anesthesia. The allograft was preconditioned in normal saline for 20 minutes, and mesh incisions were made to optimize blood flow. The width was equal to the circumference of both corpus cavernosa but without corpus spongiosum. The length of the graft was determined by measuring the length between the tip of the coronary sulcus and the root of penis. A complete incision below the coronary sulcus to the depth of the Buck’s fascia was made. Then separate the dartos fascia from the Buck’s fascia. The prepared graft was then placed on top of the Buck’s fascia, with the blood-remained side facing the Buck’s fascia. The graft was sutured using 4-0 absorbable polyglycolic acid suture to the Buck’s fascia. Extra caution needed to be taken when fixing ventrally to avoid injuring the urethra. Once completed, the dartos fascia was restored, the dartos fascia and subcutaneous tissue were sutured with 4-0 absorbable suture, and skin closure is achieved subsequently. Results: The post-operative course was without complications. At the follow-up after 1 year, the mean flaccid girth increased to 8.07 ± 1.06 cm ( P < .05), while the mean erect girth increased to 12.79 ± 1.23 cm ( P < .05). Sexual activity was allowed after 8 weeks of surgery. The majority reported that sexual self-esteem and functioning significantly improved. In addition, 59 patients reported alleviation of premature ejaculation. Conclusions: Compared to autologous dermis-fat graft and xenograft, augmentation phalloplasty using human acellular dermal matrix has several advantages: (1) it avoids harm harvesting site of the autograft; (2) the effects of dermis allograft can last at least 1 year; and (3) acellular dermal matrix is more likely to be accepted by people.
Women and Partners’ Information Need, Emotional Adjustment, and Breast Reconstruction Decision-Making Before Mastectomy
Authors: Lamore Kristopher , Flahault Cécile , Untas Aurélie 
Published: June 2020

Objective: Our aim was to explore the differences between women and their partners on information need, emotional adjustment, and breast reconstruction (BR) decision-making after breast cancer diagnosis. A second aim was to explore these differences regarding surgery type (mastectomy vs immediate BR). Methods: Women newly diagnosed with a first nonmetastatic breast cancer and having a mastectomy were invited to fill out online questionnaires, in conjunction with their partners, before mastectomy. Questionnaires assessed their information need (Patient Information Need Questionnaire), emotional adjustment (Profile of Mood States), motivations to have BR or not, shared decision-making (Shared Decision-Making Questionnaire), and partner influence in BR decision-making. Results: Thirty (15 women and their partners) people took part in the study. Women and partners had similar levels of information need, emotional adjustment, and shared decision-making. However, partners did not entirely perceive why BR is wished or not by the women. Furthermore, partners of women having a mastectomy alone had higher scores of mood disturbance and a greater need for information, compared to partners of women having an immediate BR ( P < .05). Likewise, men expressed a greater need for disease-oriented information than their loved ones ( P < .05). Conclusions: This is the first study to highlight differences in couples’ experiences of breast cancer diagnosis and BR decision-making before mastectomy. Partners express an important need for information and do not entirely perceive why BR is wished or not by their loved ones. An online tool providing information to both women and partners could help them in breast cancer care pathway and BR decision-making.
An Analysis of the Perception of Psoriasis Symptoms and the Impact on Willingness to Seek Medical Attention
Authors: Bray Jeremy K. , Feldman Steven R. 
Published: June 2020

Background: Most people with psoriasis do not have a medical visit for psoriasis within a given year. Objective: To assess individuals’ perceptions of the impact of psoriasis symptoms and how this impact affects willingness to seek medical attention. Methods: A total of 302 subjects with self-reported psoriasis were recruited through Amazon Mechanical Turk and surveyed via Qualtrics to assess the impact of psoriasis on their daily lives and willingness to seek medical care. Comparisons were made between subjects presented with either an image of mild psoriasis or severe psoriasis. Outcome measures were evaluated on a 10-point Likert scale and compared using 1-way analysis of variance and 2-group t tests. Results: In the mild and severe psoriasis groups, those who rated the impact on their daily life ≥8 (1-10 scale) reported a greater willingness to seek medical attention for their psoriasis ( M = 9.1, SD = 1.5) compared to those who rated the impact between 6 and 7 ( M = 7.5, SD = 1.9, P < .01) and between 1 and 5 ( M = 6.4, SD = 2.4, P < .01). Those who rated the impact between 6 and 7 ( M = 7.5, SD = 1.9) reported a greater willingness to seek medical attention compared to those who rated the impact between 1 and 5 ( M = 6.4, SD = 2.4, P < .01). Conclusion: Patients with psoriasis may not visit a dermatologist in part due to not viewing their symptoms as severe enough to seek medical attention.
Comparing low-molecular-weight heparin dosing for treatment of venous thromboembolism in patients with obesity (RIETE registry)
Authors: Mirza Reza , Nieuwlaat Robby , López-Núñez Juan J. , Barba Raquel , Agarwal Arnav , Font Carme , Ciammaichella Maurizio , Grandone Elvira , Ikesaka Rick , Crowther Mark , Monreal Manuel ,   the RIETE Investigators
Published: June 2020

Abstract
Because of the absence of comparative evidence, current guidelines and product monographs diverge in the dosing of low-molecular-weight heparin (LMWH) for obese patients with venous thromboembolism (VTE). We used the RIETE registry to compare the primary composite outcomes (VTE recurrence, major bleeding, or death) in patients with VTE who weighed &gt;100 kg during LMWH therapy with capped doses of LMWH (18 000 IU/d) vs uncapped doses (&gt;18 000 IU/d). Multivariable logistic regression analysis was used to account for possible confounders. A total of 2846 patients who weighed &gt;100 kg were included: 454 (16%) received capped doses of LMWH, and the remaining 2392 received uncapped doses. Mean (standard deviation) LMWH treatment duration was 14.8 (20.6) and 14.3 (32.3) days, respectively. Thirty-one patients (1.9%) had VTE recurrences, 38 (1.3%) had bleeding episodes, 65 (2.3%) died, and 122 (4.3%) had at least 1 of the composite outcomes. Unadjusted outcome rates revealed that capped dosing was associated with a decrease in the composite outcome (rate ratio, 0.22; 95% confidence interval [CI], 0.04-0.75). Multivariable analysis confirmed that patients who received capped doses had significantly lower rates of the composite outcome (odds ratio, 0.16; 95% CI, 0.04-0.68) while receiving LMWH. These retrospective observational data suggest that capped dosing of LMWH is an acceptable alternative to uncapped dosing based on body weight, given the significantly lower composite event rate of VTE recurrence, major bleeding, and all-cause death.
Sputum neutrophil elastase associates with microbiota andPseudomonas aeruginosain bronchiectasis
Authors: Oriano Martina , Gramegna Andrea , Terranova Leonardo , Sotgiu Giovanni , Sulaiman Imran , Ruggiero Luca , Saderi Laura , Wu Benjamin , Chalmers James D. , Segal Leopoldo N. , Marchisio Paola , Blasi Francesco , Aliberti Stefano 
Published: June 2020

IntroductionNeutrophilic inflammation is a major driver of bronchiectasis pathophysiology, and neutrophil elastase activity is the most promising biomarker evaluated in sputum to date. How active neutrophil elastase correlates with the lung microbiome in bronchiectasis is still unexplored. We aimed to understand whether active neutrophil elastase is associated with low microbial diversity and distinct microbiome characteristics.MethodsAn observational, cross-sectional study was conducted at the bronchiectasis programme of the Policlinico Hospital in Milan, Italy, where adults with bronchiectasis were enrolled between March 2017 and March 2019. Active neutrophil elastase was measured on sputum collected during stable state, microbiota analysed through 16S rRNA gene sequencing, molecular assessment of respiratory pathogens carried out through real-time PCR and clinical data collected.ResultsAmong 185 patients enrolled, decreasing α-diversity, evaluated through the Shannon entropy (ρ −0.37, p<0.00001) and Pielou's evenness (ρ −0.36, p<0.00001) and richness (ρ −0.33, p<0.00001), was significantly correlated with increasing elastase. A significant difference in median levels of Shannon entropy as detected between patients with neutrophil elastase ≥20 µg·mL−1(median 3.82, interquartile range 2.20–4.96)versusneutrophil elastase <20 µg·mL−1(4.88, 3.68–5.80; p<0.0001). A distinct microbiome was found in these two groups, mainly characterised by enrichment withPseudomonasin the high-elastase group and withStreptococcusin the low-elastase group. Further confirmation of the association ofPseudomonas aeruginosawith elevated active neutrophil elastase was found based on standard culture and targeted real-time PCR.ConclusionsHigh levels of active neutrophil elastase are associated to low microbiome diversity and specifically toP. aeruginosainfection.
The impact of time from injury to surgery in functional recovery of traumatic acute subdural hematoma
Authors: Chen Shih-Han , Sun Jui-Ming , Fang Wen-Kuei 
Published: June 2020

Abstract
Background
The time from injury to surgery (TIS) is critical in the functional recovery of individuals with traumatic acute subdural hematoma (TASDH). However, only few studies have confirmed such notion.

Methods
The data of TASDH patients who were surgically treated in Chia-Yi Christian Hospital between January 2008 and December 2015 were collected. The significance of variables, including age, sex, traumatic mechanism, coma scale, midline shift on brain computed tomography (CT) scan, and TIS, in functional recovery was assessed using the student’s t-test, Mann-Whitney U test, chi-square test, univariate and multivariate models, and receiver operating characteristic (ROC) curve.

Results
A total of 37 patients achieved functional recovery (outcome scale score of 4 or 5) and 33 patients had poor recovery (outcome scale score of 1–3) after at least 1 year of follow-up. No significant difference was observed in terms of age, sex, coma scale score, traumatic mechanism, or midline shift on brain CT scan between the functional and poor recovery groups. TIS was found to be significantly shorter in the functional recovery group than in the poor recovery group (145.5 ± 27.0 vs. 181.9 ± 54.5 min, P-value = 0.002). TIS was a significant factor for functional outcomes in the univariate and multivariate regression models. The analysis of TIS with the ROC curve between these two groups showed that the threshold time for functional recovery in comatose patients and those with TASDH who were surgically treated was 2 h and 57.5 min.

Conclusions
TIS is an important factor l for the functional recovery of comatose TASDH patients who underwent surgery.