bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra-articular Transcalcaneal Fracture-Dislocation Associated With Ipsilateral Transtalar Fracture: A Report of a Rare Combination
Authors: Nishikawa Danilo Ryuko Cândido , de Miranda Bruno Rodrigues , Duarte Fernando Aires , Saito Guilherme Honda , Bitar Rogério Carneiro , Monteiro Augusto César , Prado Marcelo Pires , de Cesar Netto Cesar 
Published: May 2020

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report
External validation of an emergency department triage algorithm for chest pain patients
Authors: Miró Òscar , Lopez-Ayala Pedro , Martínez-Nadal Gemma , Troester Valentina , Strebel Ivo , Coll-Vinent Blanca , Gil Víctor , Jiménez Sònia , García-Martínez Ana , Ortega Mar , Boeddinghaus Jasper , Nestelberger Thomas , Gualandro Danielle M , Bragulat Ernest , Sánchez Miquel , Peacock W Frank , Mueller Christian , López-Barbeito Beatriz 
Published: May 2020

Background
We aimed to externally validate an emergency department triage algorithm including five hierarchical clinical variables developed to identify chest pain patients at low risk of having an acute coronary syndrome justifying delayed rather than immediate evaluation.

Methods
In a single-centre cohort enrolling 29,269 consecutive patients presenting with chest pain, the performance of the algorithm was compared against the emergency department discharge diagnosis. In an international multicentre study enrolling 4069 patients, central adjudication by two independent cardiologists using all data derived from cardiac work-up including follow-up served as the reference. Triage towards ‘low-risk’ required absence of all five clinical ‘high-risk’ variables: history of coronary artery disease, diabetes, pressure-like chest pain, retrosternal chest pain and age above 40 years. Safety (sensitivity and negative predictive value (NPV)) and efficacy (percentage of patients classified as low risk) was tested in this initial proposal (Model A) and in two additional models: omitting age criteria (Model B) and allowing up to one (any) of the five high-risk variables (Model C).

Results
The prevalence of acute coronary syndrome was 9.4% in the single-centre and 28.4% in the multicentre study. The triage algorithm had very high sensitivity/NPV in both cohorts (99.4%/99.1% and 99.9%/99.1%, respectively), but very low efficacy (6.2% and 2.7%, respectively). Model B resulted in sensitivity/NPV of 97.5%/98.3% and 96.1%/89.4%, while efficacy increased to 14.2% and 10.4%, respectively. Model C resulted in sensitivity/NPV of 96.7%/98.6% and 95.2%/91.3%, with a further increase in efficacy to 23.1% and 15.5%, respectively.

Conclusion
A triage algorithm for the identification of low-risk chest pain patients exclusively based on simple clinical variables provided reasonable performance characteristics possibly justifying delayed rather than immediate evaluation in the emergency department.
An innovative lipid-lowering approach to enhance attainment of low-density lipoprotein cholesterol goals
Authors: Buonvino Camille , Chopard Romain , Guillon Benoît , Puymirat Etienne , Farnier Michel , Ferrières Jean , Krempf Michel , Bruckert Eric , Meneveau Nicolas , Schiele François 
Published: May 2020

Aims
To improve attainment of LDL-cholesterol (LDL-c) targets, an expert group proposed an algorithm for lipid-lowering therapy during hospitalization for acute coronary syndrome and during follow-up. We aimed to assess adherence to this algorithm, and evaluate its impact on LDL-c levels and on attainment of therapeutic LDL-c targets in a population of post-acute coronary syndrome patients.

Methods and results
Prospective, observational study including patients admitted for acute coronary syndrome between February 2017 and September 2018. Patients admitted without statins or ezetimibe were considered ‘naïve’. Baseline LDL-c was admission LDL-c in naïve patients, and for those taking lipid-lowering therapy at admission, baseline LDL-c was back-calculated. In line with the most recent guidelines, the target was a &gt;50% reduction in naïve LDL-c and &lt;55 mg/dL. In total, 270 patients were analysed, mean age 67 ± 12 years, 78% men, 26% diabetic. At admission, 175 (65%) were naïve, 95 (35%) had previous lipid-lowering therapy, of which 13 (5%) statin+ezetimibe. Average LDL-c at admission was 120 ± 47 mg/dL (136 ± 44 mg/dL in naïve, 91 ± 39 mg/dL in pretreated patients). Discharge prescription was in compliance with the algorithm in 204 (76%) patients. Average LDL-c at two months was 57 ± 28 mg/dL; it was &lt;55 mg/dL in 135 (50%), and 178 (66%) achieved a &gt;50% reduction. Overall, 125/270 (46%) achieved the LDL-c goal. The reduction in LDL-c observed at two months persisted at five months.

Conclusion
Prescription of high-intensity statins, associated with ezetimibe where applicable, achieves LDL-c levels &lt;55 mg/dL in 50% of patients at two months, and attains therapeutic goals defined by the European Society of Cardiology in 46% of cases.
Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction Using Transosseous Sutures Versus Suture Anchors: A Prospective Nonrandomized Controlled Trial
Authors: Ye Mao , Zhang Hangzhou , Liang Qingwei 
Published: May 2020

Background: Patellar instability remains a challenging problem for orthopaedic surgeons. Recurrent patellar instability is traditionally treated with medial patellofemoral ligament (MPFL) reconstruction using a suture anchor or bone tunnel technique. Although the use of transosseous sutures was recently described for MPFL reconstruction, relevant clinical data have not been reported. Purpose/Hypothesis: The purpose of this study was to compare a new transosseous suture fixation technique with the suture anchor technique for MPFL reconstruction. The hypothesis was that reconstruction with transosseous sutures would show similar clinical results to reconstruction with suture anchors. Study Design: Cohort study; Level of evidence, 2. Methods: There were 65 patients with recurrent lateral patellar dislocations from January 2014 to December 2016 who were included in this prospective nonrandomized controlled trial. In total, 31 patients underwent MPFL reconstruction with suture anchors at the patella site (suture anchor group), while the other 34 patients underwent MPFL reconstruction with transosseous sutures (transosseous suture group). The main outcome variable (patellar redislocation) was recorded at follow-up (range, 25-60 months). The International Knee Documentation Committee (IKDC) score, Kujala score, range of motion, congruence angle, patellar tilt, redislocation rate, and complications were collected preoperatively and/or postoperatively. Results: No recurrent dislocations or other complications were observed in any of the patients. No significant differences were found at follow-up between the suture anchor and transosseous suture groups for subjective IKDC score, Kujala score, congruence angle, patellar tilt, redislocation rate, or range of motion. Conclusion: This short-term study showed that after MPFL reconstruction (suture anchors or transosseous sutures), patellar stability could be restored. With the numbers available, no significant differences in outcome scores were observed between patients in the transosseous suture and suture anchor groups.
Mineralogical and hydraulic characteristics of mudstone in the Tamusu candidate area in northwest China for high-level radioactive waste geological disposal
Authors: Xiang Long , Liu Xiaodong , Liu Pinghui , Jiang Xingfu , Dai Chaocheng 
Published: May 2020

AbstractThe Tamusu region in northwest China is a key candidate area for China's clay rock deep geological repositories (DGRs) for high-level radioactive waste (HLRW) as it is composed of a continuous layer of thick lacustrine mudstone. To evaluate this mudstone as a host rock, two special test boreholes were drilled to investigate its spatial distribution and mineralogical and hydraulic characteristics. The southwest boundary and depositional centre of the lake basin were well delineated by boreholes TZK-1 and TZK-2. The continuous single-layer thickness of the target mudstone formation was up to 300 m at a depth of 500–800 m. Three main mineral types were determined, namely carbonates (mainly dolomite and ankerite), analcime and albite, and their abundance was used to distinguish three different facies. Other mineral phases, such as clay minerals (mainly illite and kaolinite), pyrite, hematite, quartz and calcite, were present as admixtures. The presence of carbonates may increase the mechanical strength and analcime may enhance the radionuclide adsorption properties of the mudstone. The self-sealing properties, which may be affected by the small amount of clay minerals, remain to be investigated. The hydraulic conductivity of the mudstone determined via in situ pulse tests ranged from 10–13 to 10–10 m s–1, suggesting that the Tamusu mudstone has ultra-low permeability. The transmissivity of the Tamusu mudstone fluctuated in regions with varying lithologies, but remained relatively constant for consistent lithologies. In summary, these preliminarily results confirm the possible suitability of the target formation as a host rock for DGRs of China's HLRW.
Mobilising community networks for early identification of tuberculosis and treatment initiation in Cambodia: an evaluation of a seed-and-recruit model
Authors: Teo Alvin Kuo Jing , Prem Kiesha , Tuot Sovannary , Ork Chetra , Eng Sothearith , Pande Tripti , Chry Monyrath , Hsu Li Yang , Yi Siyan 
Published: May 2020

Background and objectivesThe effects of active case finding (ACF) models that mobilise community networks for early identification and treatment of tuberculosis (TB) remain unknown. We investigated and compared the effect of community-based ACF using a seed-and-recruit model with one-off roving ACF and passive case finding (PCF) on the time to treatment initiation and identification of bacteriologically confirmed TB.MethodsIn this retrospective cohort study conducted in 12 operational districts in Cambodia, we assessed relationships between ACF models and: 1) the time to treatment initiation using Cox proportional hazards regression; and 2) the identification of bacteriologically confirmed TB using modified Poisson regression with robust sandwich variance.ResultsWe included 728 adults with TB, of whom 36% were identifiedviathe community-based ACF using a seed-and-recruit model. We found community-based ACF using a seed-and-recruit model was associated with shorter delay to treatment initiation compared to one-off roving ACF (hazard ratio 0.81, 95% CI 0.68–0.96). Compared to one-off roving ACF and PCF, community-based ACF using a seed-and-recruit model was 45% (prevalence ratio (PR) 1.45, 95% CI 1.19–1.78) and 39% (PR 1.39, 95% CI 0.99–1.94) more likely to find and detect bacteriologically confirmed TB, respectively.ConclusionMobilising community networks to find TB cases was associated with early initiation of TB treatment in Cambodia. This approach was more likely to find bacteriologically confirmed TB cases, contributing to the reduction of risk of transmission within the community.
Development of a novel method for the quantification of tyrosine 39 phosphorylated α- and β-synuclein in human cerebrospinal fluid
Authors: Na Chan Hyun , Sathe Gajanan , Rosenthal Liana S. , Moghekar Abhay R. , Dawson Valina L. , Dawson Ted M. , Pandey Akhilesh 
Published: May 2020

Abstract
Background
Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder. Biomarkers that can help monitor the progression of PD or response to disease-modifying agents will be invaluable in making appropriate therapeutic decisions. Further, biomarkers that could be used to distinguish PD from other related disorders with PD-like symptoms will be useful for accurate diagnosis and treatment. C-Abl tyrosine kinase is activated in PD resulting in increased phosphorylation of the tyrosine residue at position 39 (Y39) of α-synuclein (α-syn) (pY39 α-syn), which contributes to the death of dopaminergic neurons. Because pY39 α-syn may be pathogenic, monitoring pY39 α-syn could allow us to diagnose presymptomatic PD and help monitor disease progression and response to treatment. We sought to investigate if increased phosphorylation of pY39 α-syn can be detected in the cerebrospinal fluid (CSF) of PD patients by targeted mass spectrometry.

Methods
Here, we report a two-step enrichment method in which phosphotyrosine peptides were first enriched with an anti-phosphotyrosine antibody followed by a second round of enrichment by titanium dioxide (TiO2) beads to detect EGVLpYVGSK sequence derived from tyrosine 39 region of α- and β-synuclein (αβ-syn). Accurate quantification was achieved by adding a synthetic heavy version of pY39 αβ-syn peptide before enzymatic digestion.

Results
Using the developed enrichment methods and optimized parallel reaction monitoring (PRM) assays, we detected pY39 αβ-syn peptide in human CSF and demonstrated that the ratio of pY39 αβ-syn to Y39 αβ-syn was significantly increased in the CSF of patients with PD.

Conclusions
We anticipate that this optimized two-step enrichment-based PRM detection method will help monitor c-Abl activation in PD patients and can also be used to quantify other phosphotyrosine peptides of low abundance in biological samples.
Individualized intervention for frail non-dialysis elderly patients with chronic kidney disease: protocol for a randomized controlled trial
Authors: Chang Jing , Gao Yun , Fang Xiang-Yang , Zhao Su-Mei , Hou Yuan-Ping , Sun Qian-Mei 
Published: May 2020

AbstractBackgroundFrailty describes an age-related clinical state and can be regarded as a predictive factor for fall, disability, hospitalization, and death in the elderly. Previous studies proved that frailty could be reversed or attenuated by multi-disciplinary intervention. However, only a few studies have been performed in non-dialysis patients with chronic kidney disease.MethodsA randomized parallel controlled trial will be conducted to compare an individualized intervention according to the consequence of the comprehensive geriatric assessment with routine treatment. A total of 242 individuals aged ≥65 years, who fulfill the Fried Phenotype of frailty and have chronic kidney disease stage 3–5 without dialysis will be recruited from the Department of Nephrology and Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University. The participants will be followed-up for 30 days and 12 months.DiscussionThis protocol would be established to examine the efficiency of targeted intervention for frailty. If a positive consequence could be obtained, a novel treatment for frail elderly patients with chronic kidney disease who have never undergone dialysis can be carried out in routine clinical practice.Trial registrationThe trial was prospectively registered at the Chinese Clinical Trials Registry with the registration numberChiCTR-IOR-17013429on November 17, 2017.
Continuous quality monitoring in the field: an evaluation of the performance of the Fio Deki Reader™ for rapid HIV testing in South Africa
Authors: Noble Lara , Scott Lesley , Stewart-Isherwood Lynsey , Molifi Seponono John , Sanne Ian , Da Silva Pedro , Stevens Wendy 
Published: May 2020

Abstract
Background
Rapid diagnostic tests (RDTs) are a cornerstone of HIV diagnosis and rely on good quality processing and interpretation, particularly in the era of test and treat. The Deki Reader (Fio Corporation®, Toronto, Ontario, Canada) is a portable device designed specifically for analysing RDTs and was selected for evaluation in South Africa in the context of HIV RDT analysis.

Methods
This study consisted of a laboratory evaluation and two-part field evaluation of the Deki Reader v100, covering two RDT testing algorithms, and an evaluation of the continuous quality monitoring through the Fionet™ web portal. Based on user feedback from the field evaluation, the device underwent hardware and software redesign, and the Deki Reader v200 was evaluated in the laboratory. Ethics approval for this evaluation was obtained from the University of the Witwatersrand Human Research Ethics Committee: M150160.

Results
The intra- and inter-device laboratory precision of the Deki Reader v100 were 98.3 and 99.2% respectively, and 99.3 and 100% for the Deki Reader v200. The laboratory concordances compared to standard-of-care reporting were 99.5 and 98.0% for the two respective models, while sensitivity and specificity were 99.5 and 99.4% for the Deki Reader V100 and 100 and 93.1% for the Deki Reader V200 respectively. Screening and confirmatory concordances in the field were 99.3 and 96.5% under algorithm 1 and 99.7 and 100% under algorithm 2. Sensitivity and specificity for the field evaluation were 99.8 and 97.7%. Overall robustness of the device was acceptable and continuous quality monitoring through Fionet™ was feasible.

Conclusions
The Deki Reader provides an option for improved and reliable quality assessment for rapid diagnosis of HIV using RDTs to enhance the quality of healthcare at the point-of-care. However, the introduction of new RDTs and modification of current algorithms necessitates ongoing and agile RDT reader adjustments, which will require cost modelling to ensure sustainability of devices implemented into national HIV programs.
Dehydration-associated chronic kidney disease: a novel case of kidney failure in China
Authors: Yang Xinglin , Wu Haiting , Li Hang 
Published: May 2020

Abstract
Background
Mesoamerican nephropathy (MeN) is a pattern of chronic kidney disease (CKD) prevalent among Central American men who work in agriculture, and its underlying cause has not been elucidated. Currently, experts hypothesize that MeN is related to repeated episodes of occupational heat stress leading to water loss and hence it is also called dehydration-associated CKD.

Case presentation
We report a case of a 40-year-old man, whose first admission to Peking Union Medical College Hospital was due to acute kidney injury (AKI). The clinical and pathological processes were consistent with acute tubular necrosis (ATN). However, after full recovery, CKD developed 1 year later. The second renal biopsy showed characteristics of ischemic renal disease but there was no evidence of vascular disease. It is worth noting that the patient had been taking part in long-distance running without drinking adequate water for years, which would have markedly decrease his renal blood flow. Thus, this patient may have developed chronic dehydration-associated kidney disease sharing the similar etiology of MeN.

Conclusions
We report here a case of dehydration-associated CKD in a Chinese patient which shared similar etiology to MeN. Even in non-agricultural areas, this etiology of CKD should be noted to obtain a relevant history and prompt diagnosis.
FAT4 silencing promotes epithelial-to-mesenchymal transition and invasion via regulation of YAP and β-catenin activity in ovarian cancer
Authors: Malgundkar Shika Hanif , Burney Ikram , Al Moundhri Mansour , Al Kalbani Moza , Lakhtakia Ritu , Okamoto Aikou , Tamimi Yahya 
Published: May 2020

Abstract
Background
The adhesion molecule, FAT4, has a tumor suppressor function with a critical role in the epithelial-to-mesenchymal-transition (EMT) and anti-malignant growth in several cancers. No study has investigated yet its role in epithelial ovarian cancer (EOC) progression. In the present study, we examined the role of FAT4 in proliferation and metastasis, and its mechanisms of interaction in these processes.

Methods
We have performed cell viability, colony formation, and invasion assays in ovarian cancer cells treated with siRNA to knockdown FAT4 gene expression. The regulatory effects of FAT4 on proteins involved in apoptotic, Wnt, Hippo, and retinoblastoma signaling pathways were evaluated by Western blotting following FAT4 repression. Also, 426 ovarian tumor samples and 88 non-tumor samples from the Gene Expression Profiling Interactive Analysis (GEPIA) database were analyzed for the expression of FAT4. Pearson’s correlation was performed to determine the correlation between FAT4 and the E2F5, cyclin D1, cdk4, and caspase 9 expressions.

Results
Lower expression of FAT4 was observed in ovarian cancer cell lines and human samples as compared to non-malignant tissues. This down-regulation seems to enhance cell viability, invasion, and colony formation. Silencing FAT4 resulted in the upregulation of E2F5, vimentin, YAP, β-catenin, cyclin D1, cdk4, and Bcl2, and in the downregulation of GSK-3-β, and caspase 9 when compared to control. Furthermore, regulatory effects of FAT4 on the EMT and aggressive phenotype seem to occur through Hippo, Wnt, and cell cycle pathways.

Conclusion
FAT4 downregulation promotes increased growth and invasion through the activation of Hippo and Wnt-β-catenin pathways.
Vaping induced pneumonitis: a small community hospital’s case series and analysis
Authors: Silverman Andrew L. , Siddique Haseeb , Kumar Vikas , Le Thuy-Hong , Ng Joseph 
Published: May 2020

Abstract
Background
Electronic cigarettes/e-cigarettes (ECs), or vaping, is currently the most popular form of smoking amongst youth in the United States. ECs are battery-powered devices that vaporize a liquid that comes in small cartridges, or pods, that contain various chemicals, nicotine, and an array of flavors that can be modified to include cannabinoids (THC). With increasing popularity, however, there is an epidemic of pulmonary and gastrointestinal illnesses associated with vaping in the continental U.S.A.

Methods
We analyzed medical charts of three patients who were active users of ECs and presented with pneumonitis to our community medical center between January and August 2019.

Results
We report three cases of vaping pneumonitis in young adults, ages 18 to 21, who presented with similar symptoms, profiles, imaging studies, and disease progression. The average length of stay was approximately one week, and all patients had an extensive work-up in addition to a relapsing and remitting course of their condition.

Conclusions
Early recognition and diagnosis of vaping pneumonitis are essential in the treatment of the ongoing epidemic. Extensive unnecessary work up may lead to increased healthcare costs. Our case series echoes the concerns of the CDC such that ECs should be avoided, and those with any pulmonary or gastrointestinal symptoms should seek medical attention promptly.