bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a Functional Brace in ACL-Deficient Subjects Measuring Ground Reaction Forces and Contact Pressure: A Pilot Study
Authors: Ghadikolaee Mehran Shirian , Sharifmoradi Keyvan , Karimi Mohammad Taghi , Tafti Nahid 
Published: February 2020

ABSTRACT

Introduction
An ideal functional brace for anterior cruciate ligament-deficient (ACLD) patients should control anterior movement of the tibia and simultaneously decrease the effects of ground reaction shearing force. The current study was aimed to compare the interface pressure between the anterior shell of a functional brace and proximal of tibia in both sound and ACLD limbs, and to assess the effect of using functional brace on the symmetry of vertical and anteroposterior components of ground reaction force and impulse of ground reaction force during level walking.

Methods
Seven unilateral ACLD men participated in this study. The interface pressure between the anterior shell and proximal of the tibia and ground reaction force was recorded by means of Novel Pliance X and Kistler force platform, respectively. Wilcoxon ranked-sign test and factor analysis repeated measure analysis of variance were used to analyze data.

Results
The use of functional brace had no significant effect on interface pressure and peak points of the ground reaction force. By use of a functional brace, the valley and the impulse of the vertical component of ground reaction force on ACLD limb increased significantly (P < 0.05) and also improved limb symmetry of all parameters. The interface pressure was greater at distal contact points of the shell, which are at the middle level of the tibia crest.

Conclusions
The results suggest that functional brace could not apply force on proximal tibia especially at ACLD limb and therefore could not normalize vertical component of ground reaction force during level walking.
Mobility Analysis of AmpuTees (MAAT 6): Mobility, Satisfaction, and Quality of Life among Long-Term Dysvascular/Diabetic Prosthesis Users—Results of a Cross-Sectional Analysis
Authors: Wurdeman Shane R. , Stevens Phillip M. , Campbell James H. 
Published: February 2020

ABSTRACT

Objective
The aim of this study was to establish the mobility, satisfaction, and quality of life (QoL) among prosthesis users with dysvascular/diabetic amputation at both acute and long-term phases of prosthetic rehabilitation.

Methods
This is a multisite, cross-sectional outcomes analysis. A total of 341 individuals met the inclusion/exclusion criteria. Individuals were grouped into acute phases (0–3 months [n = 24], 4–6 months [n = 72]) and chronic phases (24–36 months [n = 91], 37–48 months [n = 53], 49–60 months [n = 47], and 60–84 months [n = 54]) after amputation. Mobility was measured with the Prosthetic Limb Users Survey of Mobility (PLUS-M), whereas QoL and satisfaction (Sat) were reported using 10-point scales adapted from the Prosthesis Evaluation Questionnaire–Well-Being (PEQ-WB). Composite PEQ-WB scores were also compared.

Results
The average mobility, QoL, and Sat among prosthesis users was, respectively, 44.8 ± 10.6, 7.6 ± 2.2, and 7.6 ± 2.2. There were no observed differences in mobility (F
5,330 = 1.52, P = 0.18), QoL (F
5,333 = 0.78, P = 0.57), or PEQ-WB (F
5,335 = 1.618, P = 0.155) between any groups. For Sat, there was a group difference (F
5,334 = 2.44, P = 0.03) as individuals appear to experience an initial increase in Sat with receipt of a prosthesis (0–3 months) compared with 25 to 36 months (P = 0.005), 49 to 60 months (P = 0.008), and 61 to 84 months (P = 0.009).

Conclusions
Those individuals with amputation secondary to dysvascular disease and diabetes who continue to participate in prosthetic rehabilitation appear to experience levels of mobility, Sat, and QoL 7 years after amputation comparable to that reported in the first 6 months postamputation. There may be a modest increase in Sat with receipt of an initial prosthesis, potentially due to an increased optimism for one's situation. Notably, the mobility levels observed in the dysvascular population through a range of long-term postamputation periods remain within a single standard deviation of the population mean for individuals with a lower-limb amputation using a prosthesis for mobility.
Development of an algorithm to facilitate the clinical management of syphilis
Authors: Orser Lauren , O'Byrne Patrick , Bourgault Andrée , Scherling Nicole 
Published: February 2020

Abstract

Background:
Syphilis staging is important to determine treatment, post-treatment monitoring, and sexual partner follow-up. Many prescribers find syphilis staging to be challenging. Current guidelines for the management of patients diagnosed with syphilis provide little direction aside from an overview of some common symptoms and directing providers to stage cases in conjunction with experienced colleagues.

Local problem:
In Canada and the United States, the rate of infectious syphilis has increased noticeably since 2000. Given the increase in rates of syphilis, it is important for all clinicians to understand how to appropriately manage patient care to reduce rates of infection.

Methods and interventions:
A clinical algorithm was developed to stage infectious syphilis. This was tested among nurse practitioners and physicians in a sexually transmitted infection clinic. The algorithm was developed based on a review of the available United States, Canadian, and British practice guidelines.

Results:
Project results demonstrated that this resource could be a relevant practice tool for providers in multiple clinical settings to ensure that patients receive appropriate diagnosis, staging, and treatment of syphilis infection. A case study of a patient who presented to the clinic as a contact is used to review the algorithm and demonstrate the appropriate clinical management of patients.

Conclusions:
The algorithm appropriately guided practice and was useful to clinicians.
Endoscopic Management of Malleus Head Fixation in Revision Stapes Surgery
Authors: Fernandez Ignacio Javier , Botti Cecilia , Fermi Matteo , Presutti Livio 
Published: February 2020

Objective:
Malleus ankylosis is an uncommon finding during stapes surgery, which can result in functional failure if undetected during primary surgery. Its management can be difficult and different approaches and solutions have been described to date, most of which require interruption of the ossicular chain. We report the management of such condition through a transcanal endoscopic technique, with preservation of ossicular chain integrity.

Patients:
The procedure was carried out in a patient affected by otosclerosis with persistent hearing loss after primary stapes surgery.

Intervention:
Surgical treatment of malleus head fixation through a totally endoscopic transcanal approach during revision stapes surgery.

Main Outcome Measure:
Pure tone audiometry, speech audiometry.

Results:
The patient experienced a complete closure of the air-bone gap. No postoperative vertigo or sensorineural hearing loss were observed.

Conclusions:
The present report describes the transcanal endoscopic management of malleus ankylosis during revision stapes surgery, which has not been previously reported in the literature. Pearls related to this approach and advantages in comparison to previously described approaches of the literature are discussed as well.
Complications of stereotactic biopsy of lesions in the sellar region, pineal gland, and brainstem
Authors: Cheng Gang , Yu Xin , Zhao Hulin , Cao Weidong , Li Hailong , Li Qinggang , Li Zhicaho , Yin Feng , Liu Rui , Zhang Jianning 
Published: February 2020

Abstract
Stereotactic biopsy (STB) is commonly used in the pathological diagnosis of intracranial lesions. The associated complication and mortality rates are low, but few reports with large sample sizes have assessed the complications of STB for lesions in the brain midline.
To evaluate the complications of STB of lesions in the sellar region, pineal region, and brainstem.
This was a retrospective analysis of patients who underwent STB of lesions in the sellar region, pineal region, and brainstem at the Neurosurgery Department, Sixth Medical Center, PLA General Hospital, China, between January 2015 and December 2017. The rates of and possible reasons for surgical complications (including bleeding) and mortality were analyzed.
A total of 145 patients underwent STB of midline brain lesions, including 16 (11.0%) in the sellar region, 18 (12.4%) in the pineal region, and 111 (76.6%) in the brainstem. Successful biopsy of the sellar region, pineal region, and brainstem was achieved in 16/16 (100%), 18/18 (100%), and 107/111 (96.4%) patients, respectively. There were no complications following STB of lesion in the sellar or pineal regions. Complications occurred in 17/111 patients (15.3%) during/after brainstem biopsy, three of whom died (2.7%). The main clinical manifestations were facioplegia, facial pain, changes in blood pressure and heart rate, and difficulty breathing.
STB of lesions in the sellar region, pineal region, and brainstem had a high success rate, but mortality was 2.7%. The occurrence of complications (15.3%) was closely related to the anatomical and functional characteristics of the region biopsied.
A clinical pilot study to evaluate the efficacy of oral intake of phellinus linteus (sanghuang) extract on knee joint and articular cartilage
Authors: Ku Yong Ho , Lee Hyun , Ryu Hwa Yeon , Park Hae-Jin , Shin Mi-Rae , Kang Jae Hui 
Published: February 2020

Abstract

Background:
Knee osteoarthritis (KOA) is the most common form of degenerative arthritis. We used Phellinus linteus (PL), which has been well-known anti-inflammatory function. In this study, we will evaluate if PL extract improves symptoms with KOA.

Methods:
This study will be an 8-week single-center randomized controlled double-blind clinical trial. Total of 24 subjects with KOA will be enrolled and they will be divided into 3 groups, PL 1,000 mg, PL 1,500 mg and placebo. Subjects will be followed up every 4 weeks with efficacy and safety at the 2nd and 3rd visits. All subjects should maintain a dosage schedule for this protocol. The primary outcome will be assessed with the Korean version of the Western Ontario and McMasters Universities. And the secondary outcomes will be measured using the visual analog scale, quality of life scale (EQ-5D-3L), ESR, C-reactive protein, and C-telopeptide of type-II collagen. Statistical analysis will be performed on the principle of full analysis set.

Discussion:
This study has inclusion and exclusion criteria and a well-controlled intervention. This clinical trial is the first step to assess the efficacy and safety of PL in patients with KOA. This study will make an important contribution to the literature and aid follow-up research into the use of PL in KOA.
Placebo response rate in patients with chronic constipation
Authors: Chen Jie , Liu Xinghuang , Bai Tao , Hou Xiaohua 
Published: February 2020

Abstract

Objective:
The aim of this systematic review and meta-analysis is to calculate the pooled placebo response rate in patients with chronic constipation (CC) in randomized controlled trial (RCT) and its related factors.

Method:
This systematic review and meta-analysis will be conducted under the guidance of Cochrane Handbook. The inclusive and exclusive criteria and search strategies for PubMed, Cochrane Library, and Embase will be introduced in this protocol. Data collection, extraction, and assessment of risk of bias will be conducted independently by 2 reviewers. The pooled placebo response rate and its 95% confidence interval (95%CI) will be calculated and the heterogeneity assessment, publication bias assessment, and subgroup analysis will be performed using R 3.6.0. This study has been registered on the PROSPERO platform (CRD42019121287).

Result:
The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.
Network and pathway-based analyses of genes associated with osteoporosis
Authors: Gu Huijie , Huang Zhongyue , Chen Guangnan , Zhou Kaifeng , Zhang Yiming , Chen Jiong , Xu Jun , Yin Xiaofan 
Published: February 2020

Abstract
Osteoporosis (OP) is a disease characterized by bone mass loss, bone microstructure damage, increased bone fragility, and easy fracture. The molecular mechanism underlying OP remains unclear.
In this study, we identified 217 genes associated with OP, and formed a gene set [OP-related genes gene set (OPgset)].
The highly enriched GOs and pathways showed OPgset genes were significantly involved in multiple biological processes (skeletal system development, ossification, and osteoblast differentiation), and several OP-related pathways (Wnt signaling pathway, osteoclast differentiation, steroid hormone biosynthesis, and adipocytokine signaling pathway). Besides, pathway crosstalk analysis indicated three major modules, with first module consisted of pathways mainly involved in bone development-related signaling pathways, second module in Wnt-related signaling pathway and third module in metabolic pathways. Further, we calculated degree centrality of a node and selected ten key genes/proteins, including TGFB1, IL6, WNT3A, TNF, PTH, TP53, WNT1, IGF1, IL10, and SERPINE1. We analyze the K-core and construct three k-core sub-networks of OPgset genes.
In summary, we for the first time explored the molecular mechanism underlying OP via network- and pathway-based methods, results from our study will improve our understanding of the pathogenesis of OP. In addition, these methods performed in this study can be used to explore pathogenesis and genes related to a specific disease.
Retrospective imaging studies of gastric cancer
Authors: Huang Zixing , Liu Dan , Chen Xinzu , Yu Pengxin , Wu Jiangfen , Song Bin , Hu Jiankun , Wu Bing 
Published: February 2020

Abstract

Introduction:
Peritoneal metastasis (PM) is a frequent condition in patients presenting with gastric cancer, especially in younger patients with advanced tumor stages. Computer tomography (CT) is the most common noninvasive modality for preoperative staging in gastric cancer. However, the challenges of limited CT soft tissue contrast result in poor CT depiction of small peritoneal tumors. The sensitivity for detecting PM remains low. About 16% of PM are undetected. Deep learning belongs to the category of artificial intelligence and has demonstrated amazing results in medical image analyses. So far, there has been no deep learning study based on CT images for the diagnosis of PM in gastric cancer.

We proposed a hypothesis:
CT images in the primary tumor region of gastric cancer had valuable information that could predict occult PM of gastric cancer, which could be extracted effectively through deep learning.

Objective:
To develop a deep learning model for accurate preoperative diagnosis of PM in gastric cancer.

Method:
All patients with gastric cancer were retrospectively enrolled. All patients were initially diagnosed as PM negative by CT and later confirmed as positive through surgery or laparoscopy. The dataset was randomly split into training cohort (70% of all patients) and testing cohort (30% of all patients). To develop deep convolutional neural network (DCNN) models with high generalizability, 5-fold cross-validation and model ensemble were utilized. The area under the receiver operating characteristic curve, sensitivity and specificity were used to evaluate DCNN models on the testing cohort.

Discussion:
This study will help us know whether deep learning can improve the performance of CT in diagnosing PM in gastric cancer.
Pediatric primary diffuse leptomeningeal melanomatosis
Authors: Xu Xinke , Zheng Yaqi , Li Junliang , Wang Fenghua , Li Fangcheng 
Published: February 2020

Abstract

Rationale:
Primary melanocytic tumors of central nerve system (CNS) are rare, primary diffuse leptomeningeal melanomatosis (PDLM), a subtype of malignant melanomas of CNS, is extremely rare,especially in pediatrics. As the clinical manifestation of PDLM is not characteristic, It is often misdiagnosed as tubercular meningitis and hemorrhage.

Patient concerns:
A 13-year-old boy was admitted to our department with symptoms of recurrent headache and vomiting twice. As the brain imaging revealed a lesion located in the left temporal lobe mimicked hemorrhage, so there was a misdiagnosis of hemorrhage in first hospitalization. He was admitted again for the recurrence of the headache and vomiting. Detailed physical examination showed multiple melanin changes in the skin of the whole body which were ignored in last hospitalization. Brain imaging showed the significantly enlarged lesion in the left temporal lobe and several smaller lesions in the left parietal lobe and cerebellum which indicated metastasis.

Diagnosis:
According to the history,physical examination and the radiological finding, the patient was diagnosed with malignant melanoma of central never system possibly.

Interventions:
The patient underwent left temporal and parietal lesions total resection with a craniotomy.

Outcomes:
The diagnosis of PDLM was established according to pathological characteristics and the negative finding of positron emission tomography (PET)-computed tomography (CT) outside CNS. The patient got no further treatment for economic reasons and experienced the progression and died 5 months after operation.

Lessons:
PDLM is extremely rare in CNS, as the clinical manifestation, radiological changes are not special, early diagnosis is difficult. The confirmed diagnosis is established by leptomeningeal biospy or surgical tissue. PET-CT can help differential diagnosis with metastastic leptomeningeal melanomas. The prognosis is dismal due to the inefficiency of chemotherapy or radiotherapy.
Focus group interview regarding the accessibility of health information for people with disabilities and means of improving this accessibility in the future
Authors: Shon Changwoo , Jeon Boyoung , Lim Jae Hee , Park So Youn , Lee Ye-Rin , Kim Young-Eun , Park Saengryeol , Lee Na-Eun , Oh In-Hwan 
Published: February 2020

Abstract
This study concerns the accessibility of health information for people with disabilities. More specifically, by interviewing policy elites who have backgrounds in this area, we seek to obtain their opinions regarding the type of information people with disabilities require, and people with disabilities overall awareness of such information. Based on the information obtained, we also aim to identify methods of improving this accessibility.
A focus group interview was conducted involving policy elites who had previously participated in decision-making processes for health policy. These elites were sourced from the fields of academia, medicine, and government. Content analysis was performed using NVivo 10, which is a computer-assisted/aided qualitative data-analysis software.
The focus-group participants felt that relevant information for people with disabilities is provided in a fragmentary manner through several channels that have relatively low reliability, which creates difficulties for a significant portion of the target recipients. Discussions regarding the type of health information required by people with disabilities yielded the following topic clusters: information regarding health-care providers who specialize in specific disability types and regarding health behaviors for certain lifecycles, and information that helps people with disabilities return to society. Further, the focus group recommended 2 means of providing essential health information to PWDs in the future. As short-term strategies, the participants proposed simplifying the existing, fragmented information channels and the creation of a comprehensive web-based information portal with an associated call center. As a long-term strategy, they proposed the development of smart-device-based information services that are tailored to the needs of individuals.
Efforts to reduce the disparities in health information for people with disabilities are essential for addressing the existing inequality regarding the availability of health information.
Association between ABCB1 (3435C>T) polymorphism and susceptibility of colorectal cancer
Authors: Han Li-li , Zuo Bai-le , Cai Wei-liang , Guo Zhen-ni , Tong Bing-hua , Wei Hui-lian , Zhu Zheng , Li Guo-yin 
Published: February 2020

Abstract
Studies on the relationship between ABCB1 3435C>T polymorphism (rs1045642) and colorectal cancer (CRC)susceptibility have yielded inconclusive results. To clarify this issue, we undertook a meta-analysis to investigate the relationship between rs1045642 and CRC risk.
Three electronic scientific publication databases (Cochrane Library, Pubmed, Embase) were screened using specific search terms. Relevant literature was identified using literature traceability methods. Selected publications were evaluated according to the inclusion and exclusion criteria. Effect size information (odds ratio and the corresponding 95% confidence interval [CI]) was obtained following quality assessment and data extraction from the included publications, and a meta-analysis conducted. Statistical analysis was performed with the Stata sofz (Version 13.0) software.
Overall, 17 case-control studies involving 7129 CRC patients and 7710 healthy control subjects satisfied the criteria for inclusion in the meta-analysis. There was no significant association between ABCB1 3435C>T polymorphism and CRC risk in any of the genetic models. In the CC versus CT model (I

2
= 20.9%, P
heterogeneity = .276), CC versus CT + TT model (I

2
= 45.6%, P
heterogeneity = .102) and CT versus CC + TT model (I

2
= 17.8%, P
heterogeneity = .298) analyses, between-study heterogeneities were detected as significant in Asian populations. In the CT versus TT model (I

2
= 24%, P
heterogeneity = .254) and CC + CT versus TT model (I

2
= 0, P
heterogeneity = .55), between-study heterogeneities were found to be significant in groups of different populations.
The meta-analysis described here suggests that the ABCB1 3435C>T polymorphism is not related to CRC susceptibility.
The influence of blood pressure patterns on renal outcomes in patients with chronic kidney disease
Authors: Cha Ran-hui , Lee Hajeong , Lee Jung Pyo , Kim Yon Su , Kim Sung Gyun 
Published: February 2020

Abstract
Blood pressure (BP) control is the most established practice for preventing the progression and complications of chronic kidney disease (CKD). We examined the influence of BP patterns on target organ damage in hypertensive patients with CKD by using long-term follow-up data of the APrODiTe-2 study.
We collected 5 years of data of APrODiTe-2 study (1 year longitudinal study) participants after the enrollment on the progression of estimated glomerular filtration (eGFR), renal outcomes (doubling of serum creatinine, 50% decrease of eGFR, maintenance dialysis, and kidney transplantation), cerebro-cardiovascular (CCV) accidents, and all-cause mortality (n=378) to evaluate the long-term influence of BP patterns on target organ damages.
Initially, more than 2/3 of patients showed masked (50.0%) and sustained uncontrolled (30.6%) BP control states as well as non- (31.3%) and reverse-dipping (35.0%) states. Only 18.8% and 20.8% of participants showed a better change in BP control patterns and a dipping pattern change to dippers over 1 year, respectively. Composite of new CCV accidents occurred in 43 patients (11.4%), and no BP patterns were associated with the occurrence of new CCV accidents. A worse change in BP control categories over 1 year was associated with increased occurrence of composites of renal outcomes after adjustment for age, sex, and the cause of CKD (HR 5.997 [1.454–24.742], P = .013 and HR 4.331 [1.347–13.927], P = .014, respectively). Patients with a worse initial BP control category, a worse change in BP control categories over 1 year, and higher clinic systolic BP and pulse pressure (PP) (> median level) were more likely to have faster eGFR progression (absolute eGFR and eGFR ratio).
Higher BP burden (a worse change in BP control categories, higher initial clinic systolic BP and PP) was associated with faster eGFR progression and increased occurrence of renal outcomes.