bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy analysis of pembrolizumab dosing patterns in patients with advanced melanoma and non-small cell lung cancer
Authors: Kartolo A , Holstead R , Hopman W , Young L , Baetz T 
Published: January 2021

Aim To evaluate the impact of discrepancy between prescribed and recommended fixed 200 mg dose (P-F discrepancy) on immune-related adverse events (irAEs) and treatment efficacy in patients with advanced melanoma and NSCLC. Methods This retrospective study included 177 patients with advanced melanoma or non-small cell lung cancer (NSCLC) who received at least one cycle of single-agent pembrolizumab. We defined P-F discrepancy as the differences between prescribed pembrolizumab dose and 200 mg recommended dose, expressed in percentages. Our primary outcome was immune-related adverse events (irAEs), and our secondary outcomes included overall survival (OS) and progression free survival (PFS). Results The median P-F discrepancy was –21.5%, with the 25th and 75th percentile at –32% and –5.0% respectively. ROC curve analyses did not show any optimal cutoffs to prognosticate irAEs (AUC = 0.558 for all patients) or cancer mortality (AUC = 0.583 for melanoma; AUC = 0.539 for NSCLC) in either cancer type. Separate multivariable Cox analyses suggested no statistically significant association between P-F discrepancy and overall survival in patients with melanoma (HR 1.012, 95%CI 0.987–1.038, P = 0.362) or NSCLC (HR 0.998, 95%CI 0.978–1.019, P = 0.876). Conclusion There was no optimal pembrolizumab cut-off point to predict irAEs or treatment efficacy. We supported the use of weight-based pembrolizumab dosing, given the potential cost-saving and no differences in terms of irAEs or treatment efficacy in patients with advanced melanoma or NSCLC. Future studies on province- or national-level would be important to validate our findings.
A simplified model of a multi-jointed mechanical finger calibrated with experimental data by vision system
Authors: Cosenza C , Niola V , Savino S 
Published: January 2021

The development of suitable models for mechanical fingers, whether they are part of prosthetic device or of a robotic hand, is a powerful tool to predict the behaviour of their components since the early stages of design, especially for underactuated mechanisms. Experimental data can improve the reliability of such models and promote their application to build proper control strategies especially for prosthetic hands. Here, we have developed a multi-jointed model of a mechanical finger. The finger is part of the Federica hand: an underactuated mechanical hand that was conceived for prosthetic purpose. The model accounts for friction phenomena in the finger and it is tuned with experimental data acquired through a digital image correlation device. The model allowed us to write kinematics relations of the phalanges and evaluate finger configurations in relation to the closure velocity. Moreover, it was possible to estimate the tendon force and the work analysis occurring during the closure tasks, both in free mode and in presence of objects.
Paradigm and Cultural Shifts on Employee Leave and Work-Life Initiatives
Authors: Latheef Zahir I. 
Published: January 2021

The Problem Policies on employee leave and flexible workplace arrangements have not met the needs of employees in achieving work-life balance. Even when such policies do exist, employers are largely unable to actualize the benefits of these policies. These challenges have been exacerbated by the global pandemic creating more demand for work-life flexibility practices. The Solution Organizations must engage in a paradigm and cultural shift to achieve the benefits of work-life policies and practices. An organizational culture that moves beyond a human resource management (HRM) lens of administration and compliance to a human resource development (HRD) lens of support and development is central to overcoming this challenge. The Stakeholders Stakeholders for this concluding article include executive leaders of organizations, HRD and HRM scholars and practitioners.
Circ_0003998 Regulates the Progression and Docetaxel Sensitivity of DTX-Resistant Non-Small Cell Lung Cancer Cells by the miR-136-5p/CORO1C Axis
Authors: Zhang Wei , Song Chao , Ren Xiaona 
Published: January 2021

Background: Drug resistance in cancer cells is a major challenge for anti-cancer therapy. Circular RNA (circRNA) circ_0003998 has been identified as an important regulator in the chemoresistance development of non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the molecular basis underlying the resistance control of circ_0003998 in NSCLC. Methods: The levels of circ_0003998, miR-136-5p and coronin 1C (CORO1C) were gauged by the quantitative real-time polymerase chain reaction (qRT-PCR) or western blot. Cell viability, colony formation and apoptosis were evaluated by the Cell Counting Kit-8 (CCK-8), colony formation and flow cytometry assays, respectively. Targeted relationships among circ_0003998, miR-136-5p and CORO1C were confirmed by the dual-luciferase reporter and RNA immunoprecipitation (RIP) assays. Animal studies were performed to evaluate the function of circ_0003998 in vivo. Results: Our data indicated that circ_0003998 expression was associated with NSCLC resistance to docetaxel (DTX). The knockdown of circ_0003998 promoted DTX sensitivity, suppressed cell colony formation, and enhanced cell apoptosis of A549/DTX and H1299/DTX cells in vitro. Moreover, circ_0003998 knockdown hampered tumor growth and enhanced DTX sensitivity in vivo. Mechanistically, circ_0003998 directly targeted miR-136-5p, and miR-136-5p was a molecular mediator of circ_0003998 function in vitro. Furthermore, CORO1C was a functionally important target of miR-136-5p in regulating DTX-resistant NSCLC cell colony formation, apoptosis and DTX sensitivity in vitro. Additionally, circ_0003998 modulated CORO1C expression by working as a miR-136-5p sponge. Conclusion: Our present work identified that circ_0003998 regulated DTX-resistant NSCLC cell colony formation, apoptosis and DTX sensitivity at least partially by controlling CORO1C expression by sponging miR-136-5p, illuminating a rationale for developing circ_0003998 as a therapeutic target of chemoresistant NSCLC.
Stent-assisted coiling of cerebral aneurysms: Head to head comparison between the Neuroform Atlas and EZ stents
Authors: Daou Badih J , Palmateer Gregory , Linzey Joseph R , Thompson B Gregory , Chaudhary Neeraj , Gemmete Joseph J , Pandey Aditya S 
Published: January 2021

Background The Neuroform Atlas stent is thought to have features allowing for an improved stent delivery system. We aimed to provide a comparison of the Atlas and Neuroform EZ stents in patients treated with stent-assisted coiling. Methods Seventy-seven aneurysms treated with the Atlas stent and 77 aneurysms with similar characteristics treated with the EZ stent were retrospectively compared. Outcomes included angiographic occlusion per the Raymond–Roy (RR) scale, recanalization, retreatment and procedural complications. Results With the Atlas stent, technical success was 100% and immediate RR1 occlusion was 81.8%. Follow-up RR1 was achieved in 83.7%. The recanalization rate was 7% and the retreatment rate was 4.6%. The complication rate was 6.5% (new neurological deficit in 1.3%). With the EZ stent, technical success was 96%, immediate RR1 occlusion was 67.6% and follow-up RR1 was 67.6%. The recanalization rate was 12.7% and the retreatment rate was 14.1%. The complication rate was 10.4% (new neurological deficit in 2.6%). The rate of immediate RR1 occlusion was significantly higher with the Atlas stent ( p = 0.03), and the rate of follow-up RR1 was nonsignificantly higher with the Atlas stent ( p = 0.08). The retreatment rate was significantly lower with the Atlas stent ( p = 0.009). There were no significant differences in the rates of recanalization ( p = 0.5) and complications ( p = 0.6). Conclusions Stent-assisted coiling with the Atlas stent is safe and effective and shows better immediate results as compared to the EZ stent, with improved overall follow-up outcomes.
Flow diverter stents in the treatment of recanalized intracranial aneurysms
Authors: Akgul Erol , Onan Hasan Bilen , Islek Irem , Tonge Mehmet , Durmus Yavuz , Barburoglu Mehmet , Azizova Aynur , Erol Cengiz , Hakyemez Bahattin , Sencer Serra , Aydin Kubilay , Arat Anil 
Published: January 2021

Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.
Preconsultation Questionnaires for Patients Attending Elective Foot and Ankle Clinics: Is This the Way Forward in Outpatient Clinics?
Authors: Anugraha Anoop , Dalal Rakesh , Raad Marjan , Patel Neelam , Sugathan Hari 
Published: January 2021

Orthopaedic clinics can often be overbooked’ busy and delayed appointments are a common sight in the National Health Service. We recognize this is becoming a growing problem that needs to be addressed; therefore, we have carried out a quality improvement project (QIP) that can save clinicians time. We have developed the “Stockport Foot and Ankle Questionnaire,” a novel preconsultation questionnaire to gather information about patient history and symptoms. We found that the average time required for consultation reduced from a mean of 22 minutes, without questionnaires, to a mean of 15 minutes with the questionnaire, effectively saving 7 minutes per consultation. The preconsultation questionnaire in foot and ankle clinics is a novel technique to improve efficiency, productivity, and standardization in outpatient clinics. It is a patient-centered approach that identifies where effective changes can be implemented in how outpatient services are run. We recommend routine use of these questionnaires to save valuable clinician time. Levels of Evidence: Level II
Effect of Facet Tropism on Postoperative Cervical Range of Motion After Single-Level Cervical Disc Arthroplasty
Authors: Liu Ziyang , Rong Xin , Liu Hao , Ding Chen , Hong Ying , Wang Beiyu 
Published: January 2021

Study Design: Retrospective analysis. Objectives: Cervical disc arthroplasty (CDA) was designed to replace the degenerated disc with the prosthesis to preserve cervical motion. The commonly used artificial discs are designed symmetric, whereas the facet joints were reported to be asymmetric in many people. This study aimed to evaluate the effect of facet tropism on the cervical range of motion (ROM) after single-level CDA using Prestige LP. Methods: A total of 90 patients who underwent single-level CDA using Prestige LP from 2012 to 2017 were retrospectively reviewed. Radiographs were taken at each time point to measure the C2-C7 ROM and the ROM at the surgical segment. The pre-operation CT scans were utilized to reconstruct and calculate the angular direction of facet joints with respect to transverse, coronal, and sagittal reference planes. Facet tropism above 7° was defined as facet joint asymmetry. Results: No significant difference was found in flexion-extension C2-C7 ROM or ROM at the surgical segment between patients with symmetric and asymmetric fact joints regarding the sagittal plane. Patients with coronal asymmetric facet joints had lower flexion-extension ROM at the surgical level. Patients with transverse asymmetric facet joints had both lower flexion-extension C2-C7 ROM and ROM at the surgical level. After CDA surgery, patients obtained good clinical outcomes including increased Japanese Orthopedic Association (JOA) and decreased Neck Disability Index (NDI) as well as Visual Analogue Scale (VAS). Conclusion: The coronal and transverse tropism seemed to be correlated with decreased flexion-extension ROM after CDA using Prestige LP.
Effect of synchronous irrigation on cyclic fatigue of nickel-titanium instrument in the dynamic and static models
Authors: Liu Haiyun , Li Yanfeng , Chai Guangquan , Lv Yuan , Li Changjian , Li Shumao , Yang Chunhao , Li Aishunag , Wang Yingdi , Li Weiwei 
Published: January 2021

Objective: To evaluate the effect of synchronous water irrigation on the fatigue resistance of nickel-titanium instrument. Methods: A standardized cyclic fatigue test models were established, and five types of nickel-titanium instruments (PTU F1, WO, WOG, RE, and M3) were applied. Each instrument was randomly divided into two groups ( N = 12). There was synchronous water irrigation in the experimental group, and no water irrigation in the control group. Besides, ProTaper Universal F1 was randomly divided into 10 groups ( N = 20). In the static group, nickel-titanium instruments were divided into one control group (no irrigation, N = 20) and six experimental group (irrigation, N = 20) based on different flow rate, angle and position; while in the dynamic group, instruments were divided into one control group (no irrigation, N = 20) and two experimental group (irrigation, N = 20) based on different flow rate. The rotation time (Time to Failure, TtF) of instruments was recorded and analyzed. Results: According to the static experiments, the TtF of instruments in all experimental groups was significantly higher than that in the static control group. Besides, the dynamic tests of PTU F1 showed that the TtF in the experimental group was significantly higher than that in the dynamic control group. Compared with control group, the TtF in the experimental groups increased by at least about 30% and up to 160%. The static and dynamic tests of PTU F1 showed that the TtF of nickel-titanium instrument in all experimental groups was significantly higher than that in the control group. However, there was no significant difference between any two experimental groups. Conclusion: Regardless of dynamic or static model, TtF with irrigation was longer than that with non-irrigation, indicating that synchronous irrigation can increase the fatigue resistance of nickel-titanium instrument. However, different irrigation conditions may have the same effect on the fatigue resistance.
Minimally invasive hysterectomy for endometriosis: Surgical outcomes based on surgeon specialty
Authors: Mutter Olga , Ackroyd Sarah A , Taylor George A , Diaz Juan 
Published: January 2021

Introduction: To evaluate differences in surgical outcomes of minimally invasive hysterectomy performed for endometriosis between general gynecologists and gynecologic oncologists. Methods: Utilizing the 2016–2018 American College of Surgeons National Surgical Quality Improvement Program (NSQIP) hysterectomy dataset, we evaluated baseline characteristics and surgical outcomes for patients who underwent a minimally invasive hysterectomy for endometriosis between general gynecology and gynecologic oncology groups. Results: From 2016 to 2018, a total of 3751 minimally invasive hysterectomies were performed for the primary diagnosis of endometriosis. Of these cases, 3129 (83.4%) were performed by general gynecologists and 622 (16.6%) by gynecologic oncologists. There were several differences in baseline characteristics between the groups. Notably, general gynecologists performed a higher proportion of vaginal hysterectomies (7.9% vs 0.6%, p < 0.01). There were no statistically significant differences in overall 30-day complications or mortality between general gynecology and oncology groups, with the exception of a higher rate of postoperative sepsis (0.8% vs 0.2%, p = 0.01) in hysterectomies performed by oncologists. Compared to general gynecologists, oncologists had a longer operative time (134.9 ± 65.4 min vs 129 ± 60.9 min, p = 0.05). Multivariate regression of multiple tracked and composite outcomes revealed no consistent confounding variables other than race. In fact, African American race was a statistically significant predictive factor of composite complications (OR 1.80, p < 0.01), morbidity (OR 1.84, p < 0.05), and unplanned readmission (OR 2.30, p < 0.01). Surgeon specialty was not associated with composite complications, hysterectomy-specific complications, or readmission. Conclusion: There are no significant differences in surgical outcomes for minimally invasive hysterectomy for endometriosis between these two surgical subspecialties.
A comparison of six outcome measures across the recovery period after distal radius fixation—Which to use and when?
Authors: Fang Christian , Fang Evan , Yee Dennis KH , Kwan Kenny , Leung Gladys , Leung Frankie 
Published: January 2021

Purpose: Many standardized outcome measures exist to measure recovery after surgical fixation of distal radius fractures, however, choosing the optimal instrument is difficult. We evaluated responsiveness, ceiling/floor effects, and criterion validity over multiple time intervals across a 2-year follow-up period for six commonly used instruments. Methods: A total of 259 patients who received open reduction and internal fixation for distal radius fractures between 2012 and 2015 were recruited. Patients were administered the Patient-Rated Wrist Evaluation ( PRWE), Shortened Disabilities of the Arm, Shoulder and Hand questionnaire ( QuickDASH), Green and O’Brien score (Cooney modification) ( CGNO), Gartland and Werley score (Sarmiento modification) ( SGNW), flexion-extension arc ( FEArc), and grip fraction test ( GripFrac) at 1.5, 3, 6, 12, and 24 months postoperatively. Responsiveness was evaluated by calculating standardized response means (SRM) and Cohen’s d effect sizes (ES), and by correlating each instrument’s change scores against those of QuickDASH and PRWE, which were also used as external comparators to assess criterion validity. Ceiling/floor effects were calculated for all measures at each time point. Results: SRM (1.5–24 months) were 1.81, 1.77, 1.43, 1.16, 2.23, 2.45 and ES (1.5–24 months) were 1.81, 1.82, 1.95, 1.31, 1.99 and 2.90 for QuickDASH, PRWE, CGNO, SGNW, FEArc, and GripFrac respectively. Spearman correlation coefficients against QuickDASH at 24 months were: 0.809, 0.248, 0.563, 0.285, and 0.318 for PRWE, CGNO, SGNW, FEArc, and GripFrac respectively. Significant (>15% of patients reaching maximum score) ceiling effects were observed before 6 months for PRWE and SGNW. Conclusions: Our evidence supports the use of QuickDASH, PRWE, FEArc and GripFrac up to 6 months postsurgery, and QuickDASH and PRWE after 6 months. Level of evidence: Level II.
Safe Femoral Fixation Depth and Orientation for Lateral Extra-Articular Tenodesis in Anterior Cruciate Ligament Reconstruction
Authors: Zhu Meng , Han Lee Dave Yee , Williams Andy 
Published: January 2021

Background: Patients who undergo anterior cruciate ligament (ACL) reconstruction (ACLR) can have a persistent postoperative pivot shift. Performing lateral extra-articular tenodesis (LET) concurrently has been proposed to address this; however, LET femoral fixation may interfere with the ACLR femoral tunnel, which could damage the ACL graft or its fixation. Purpose: To evaluate the safe maximum implant or tunnel depth for a modified Lemaire LET when combined with ACLR anteromedial portal femoral tunnel drilling and to validate the safe LET drilling angles to avoid conflict with the ACLR femoral tunnel. Study Design: Descriptive laboratory study. Methods: Twelve fresh-frozen cadaveric knees were used. With each knee at 120° of flexion, an ACLR femoral tunnel in the anteromedial bundle position was created arthroscopically via the anteromedial portal using a 5-mm offset guide, a guide wire, and an 8-mm reamer, which was left in situ. A modified Lemaire LET was performed using a 1 cm-wide iliotibial band strip harvested with the distal attachment intact, to be fixed in the femur. The desired LET fixation point was identified with an external aperture 10 mm proximal and 5 mm posterior to the fibular collateral ligament’s femoral attachment, and a 2.4-mm guide wire was drilled, aiming at 0°, 10°, 20°, or 30° anteriorly in the axial plane and at 0°, 10°, or 20° proximally in the coronal plane (12 different drilling angle combinations). The relationship between the LET drilling guide wire and the ACLR femoral tunnel reamer was recorded for each combination. When a collision with the femoral tunnel was recorded, the LET wire depth was measured. Results: Collision with the ACLR femoral tunnel occurred at a mean LET wire depth of 23.6 mm (range, 15-33 mm). No correlation existed between LET wire depth and LET drilling orientation ( r = 0.066; P = .67). Drilling angle in the axial plane was significantly associated with the occurrence of tunnel conflict ( P < .001). However, no such association was detected when comparing the drilling angle in the coronal plane ( P = .267). Conclusion: Conflict of LET femoral fixation with the ACLR femoral tunnel using anteromedial portal drilling occurred at a mean depth of 23.6 mm but also at a depth as little as 15 mm, which is shorter than most implants. When longer implants or tunnels are used, the orientation should be directed at least 30° anteriorly in the axial plane to minimize the risk of tunnel conflict, bearing in mind the risk of joint violation. Clinical Relevance: This study provides important information for surgeons performing LET in combination with ACLR anteromedial portal femoral tunnel drilling regarding safe femoral implant or tunnel length and orientation.