bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical evaluation of a wrist sensorimotor rehabilitation program for triangular fibrocartilage complex injuries
Authors: Chen Zhiqing 
Published: July 2021

Introduction Triangular fibrocartilage complex (TFCC) injuries are associated with distal radioulnar joint (DRUJ) instability and impaired wrist proprioception. Sensorimotor training of extensor carpi ulnaris (ECU) and pronator quadratus (PQ) can enhance DRUJ stability. With limited evidence on effectiveness of TFCC sensorimotor rehabilitation, this study aimed to evaluate the effects and feasibility of a novel wrist sensorimotor rehabilitation program (WSRP) for TFCC injuries. Methods Patients diagnosed with TFCC injuries were recruited from May 2018 to January 2020 at an outpatient hand clinic in Singapore General Hospital. There are four stages in WSRP: (1) pain control, (2) muscle re-education and joint awareness, (3) neuromuscular rehabilitation, and (4) movement normalization and function. WSRP also incorporated dart throwing motion and proprioceptive neuromuscular facilitation. Outcome measures included grip strength measured with grip dynamometer, numerical pain rating scale, joint position sense (JPS) measurement, weight bearing measured with the ‘push-off’ test, and wrist function reported on the Patient Rated Wrist Hand Evaluation. Results Ten patients completed the WSRP. Mean changes were compared with minimal clinically important differences (MCID) for outcomes. All patients achieved MCID on pain, 70% of patients achieved MCID on grip strength, weight bearing and wrist function. Paired t-tests and Cohen’s D for outcome measures were calculated. There were large effect sizes of 2.47, 1.35, and 2.81 for function, grip strength and pain respectively, and moderate effect sizes of 0.72 and 0.39 for axial loading and JPS respectively. Discussion WSRP presents a potential treatment approach in TFCC rehabilitation. There is a need for future prospective clinical trials with control groups.
CT Osteoabsorptiometry Assessment of Subchondral Bone Density Predicts Intervertebral Implant Subsidence in a Human ACDF Cadaver Model
Authors: Orías Alejandro A. Espinoza , Sheha Evan , Zavras Athan , John Paul , Fitch Ashlyn A. , An Howard S. , Inoue Nozomu , Colman Matthew 
Published: July 2021

Study Design: Cadaveric biomechanics study. Objective: Subchondral bone mineral density (sBMD) reflects the long-term mineralization and distribution of stress on joints. The use of 3-dimensional (3-D) methods to evaluate sBMD, including computed tomography osteoabsorptiometry (CT-OAM), enables the assessment of density distribution with emphasis on subchondral bone. This study sought to measure the sBMD of cervical endplates using CT-OAM and correlate it to mechanical implant subsidence in a cadaveric model. Methods: Fourteen fresh human cadaveric cervical spines were subjected to dynamic testing after single level discectomy and instrumentation using a PEEK interbody spacer. Specimens were imaged with CT 3 times: 1st) whole intact cervical spine, 2nd) after implantation, and 3 rd) after testing. These images were used to assess sBMD distributions using CT-OAM directly underneath the spacer. Subsidence was defined as the displacement of the device into the endplates. Results: The observed “failure mode” was consistently recorded as subsidence, with a mean of 0.45 ± 0.36 mm and 0.40 ± 0.18 mm for the C4-5 and C6-7 levels, respectively. There were no differences by level. The experimental cyclic test showed that denser endplates experienced less deformation under the same load. Conclusions: This study achieved its stated aim of validating the use of CT-OAM as a method to analyze the sBMD of the cervical endplates. Studies such as this are providing new information on available technology such as CT-OAM, providing new tools for clinicians treating spinal conditions in need of augmentation and stabilization via interbody devices.
Medial Ulnar Collateral Ligament Repair With Internal Brace Augmentation: Results in 40 Consecutive Patients
Authors: O’Connell Robert , Hoof Marcus , Heffernan John , O’Brien Michael , Savoie Felix 
Published: July 2021

Background: Medial ulnar collateral ligament (MUCL) repair has been proven to be effective in nonprofessional overhead-throwing athletes, with faster and higher rates of return to play (RTP) than the more traditional Tommy John reconstruction. Biomechanical studies and clinical data suggest that MUCL repair augmented with a collagen-coated internal brace may be an effective treatment option in this patient population. Purpose: To evaluate the functional outcomes of young nonprofessional athletes who underwent MUCL repair with internal brace augmentation for medial elbow instability. The hypothesis was that these patients will have high rates of RTP and improved functional outcomes. Study Design: Case series; Level of evidence, 4. Methods: Nonprofessional overhead athletes treated with MUCL repair with internal brace augmentation between 2015 and 2017 were prospectively evaluated for a minimum of 1 year. Preoperatively, all patients had evidence of medial elbow pain caused by MUCL insufficiency, as confirmed by signal changes on magnetic resonance imaging and valgus instability on arthroscopic examination. These findings did not allow them to participate in their chosen sport or profession, and each patient had failed nonoperative treatment. Postoperative outcomes were evaluated using the Overhead Athlete Shoulder and Elbow Score of the Kerlan-Jobe Orthopaedic Clinic. Complications were recorded and detailed. Results: A total of 40 nonprofessional overhead athletes were included in this study (35 men and 5 women; mean age, 17.8 years [range, 14-28 years]). The mean follow-up time was 23.8 months (range, 12-44 months). The mean postoperative Kerlan-Jobe Orthopaedic Clinic score was 92.6 (range, 64-100). Overall, 37 athletes (92.5%) returned to play or profession at the same level or higher at a mean time of 6.9 months (range, 2-12 months). Three patients did not RTP: 1 was limited by a concomitant medical diagnosis, and the other 2 chose not to resume athletics after the procedure but remained symptom free. Conclusion: In the nonprofessional athlete, primary MUCL repair with internal brace augmentation is a viable alternative to traditional repair techniques or reconstruction, allowing for a rapid RTP and promising functional outcomes.
Only a Plate? Nine-Year Follow-Up After Partial Mandibulectomy and Reconstruction With Titanium Plate
Authors: Hashemi Helya , Thor Andreas 
Published: July 2021

Background: Oral squamous cell carcinoma is the main malignancy of the oral cavity; floor of the mouth and the lateral border of the tongue being the most affected sites. This kind of oral neoplasms may require mandibular resection and reconstruction. Treatment options for such mandibular defects include bone grafts, free flaps, and reconstruction plates. Today, the commonly used treatment method is vascularized fibula flaps due to its many advantages when compared to other methods. However, it is a complex procedure and demands much of both practitioners and the patient. Case Presentation: In this report, we present a case of oral squamous cell carcinoma of the gingiva of the mandible which was treated with a partial mandibulectomy and resection. Because of the patients age and fragility an immediate mandibular reconstruction with a pre-shaped reconstruction plate, without hard or soft tissue transfer, was performed. Yearly controls showed pleasing results both aesthetically and functionally and the patient showed no plate-related complications up until the patient’s death, 9 years later. Conclusion: With this case, we would like to illustrate that using reconstruction plates only may be a viable option in selected cases for continuity defects of the mandible, specifically in fragile patients less suitable for more demanding surgical interventions.
Asymmetric organelle inheritance predicts human blood stem cell fate
Authors: Loeffler Dirk , Schneiter Florin , Wang Weijia , Wehling Arne , Kull Tobias , Lengerke Claudia , Manz Markus G. , Schroeder Timm 
Published: July 2021

Abstract
Understanding human hematopoietic stem cell fate control is important for its improved therapeutic manipulation. Asymmetric cell division, the asymmetric inheritance of factors during division instructing future daughter cell fates, was recently described in mouse blood stem cells. In human blood stem cells, the possible existence of asymmetric cell division remained unclear because of technical challenges in its direct observation. Here, we use long-term quantitative single-cell imaging to show that lysosomes and active mitochondria are asymmetrically inherited in human blood stem cells and that their inheritance is a coordinated, nonrandom process. Furthermore, multiple additional organelles, including autophagosomes, mitophagosomes, autolysosomes, and recycling endosomes, show preferential asymmetric cosegregation with lysosomes. Importantly, asymmetric lysosomal inheritance predicts future asymmetric daughter cell-cycle length, differentiation, and stem cell marker expression, whereas asymmetric inheritance of active mitochondria correlates with daughter metabolic activity. Hence, human hematopoietic stem cell fates are regulated by asymmetric cell division, with both mechanistic evolutionary conservation and differences to the mouse system.
The impact of increasing karyotypic complexity and evolution on survival in patients with CLL treated with ibrutinib
Authors: Kittai Adam S. , Miller Cecelia , Goldstein Daniel , Huang Ying , Abruzzo Lynne V. , Beckwith Kyle , Bhat Seema A. , Bond David A. , Grever Michael R. , Heerema Nyla A. , Rogers Kerry A. , Ruppert Amy S. , Byrd John C. , Woyach Jennifer A. 
Published: July 2021

Abstract
Complex karyotype, defined as ≥3 cytogenetic abnormalities, is prognostic of survival in patients treated with ibrutinib or venetoclax in relapsed/refractory (RR) chronic lymphocytic leukemia (CLL). Recent studies re-evaluating this dichotomous variable have shown that higher numbers of cytogenetic abnormalities (ie, ≥5) have a worse overall survival in patients treated with chemoimmunotherapy. We sought to determine if increasing karyotypic complexity, treated as a continuous variable, was prognostic of survival for patients treated with ibrutinib for CLL. We conducted a retrospective analysis of all patients with CLL treated with single-agent ibrutinib or in combination with an anti–CD20 antibody at our institution. We included 456 patients with both treatment-naive and RR disease. Median number of prior therapies was 2 (range, 0-13), 30% of patients had presence of del(17p), and 75% expressed unmutated IGHV. Fifty percent had ≥3 cytogenetic abnormalities, including 30% with ≥5. In a multivariable analysis, increasing karyotypic complexity was an independent predictor of shorter progression-free survival (hazard ratio, 1.07; 95% confidence interval, 1.04-1.10; P &lt; .0001) and overall survival (hazard ratio, 1.09; 95% confidence interval, 1.05-1.12; P &lt; .0001). Furthermore, we found that presence of clonal evolution determined by cytogenetic analysis at progression was prognostic of subsequent survival (P = .02). This solidifies karyotypic complexity as an important prognostic factor for patients with CLL treated with ibrutinib. Further research should consider sequential karyotypic analysis as a determination of risk of progression and death in patients with CLL.
Aberrant glycosylation of anti-SARS-CoV-2 spike IgG is a prothrombotic stimulus for platelets
Authors: Bye Alexander P. , Hoepel Willianne , Mitchell Joanne L. , Jégouic Sophie , Loureiro Silvia , Sage Tanya , Vidarsson Gestur , Nouta Jan , Wuhrer Manfred , de Taeye Steven , van Gils Marit , Kriek Neline , Cooper Nichola , Jones Ian , den Dunnen Jeroen , Gibbins Jonathan M. 
Published: July 2021

Abstract
A subset of patients with coronavirus disease 2019 (COVID-19) become critically ill, suffering from severe respiratory problems and also increased rates of thrombosis. The causes of thrombosis in severely ill patients with COVID-19 are still emerging, but the coincidence of critical illness with the timing of the onset of adaptive immunity could implicate an excessive immune response. We hypothesized that platelets might be susceptible to activation by anti–severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies and might contribute to thrombosis. We found that immune complexes containing recombinant SARS-CoV-2 spike protein and anti-spike immunoglobulin G enhanced platelet-mediated thrombosis on von Willebrand factor in vitro, but only when the glycosylation state of the Fc domain was modified to correspond with the aberrant glycosylation previously identified in patients with severe COVID-19. Furthermore, we found that activation was dependent on FcγRIIA, and we provide in vitro evidence that this pathogenic platelet activation can be counteracted by the therapeutic small molecules R406 (fostamatinib) and ibrutinib, which inhibit tyrosine kinases Syk and Btk, respectively, or by the P2Y12 antagonist cangrelor.
Improved Sézary cell detection and novel insights into immunophenotypic and molecular heterogeneity in Sézary syndrome
Authors: Najidh Safa , Tensen Cornelis P. , van der Sluijs-Gelling Alita J. , Teodosio Cristina , Cats Davy , Mei Hailiang , Kuipers Thomas B. , Out-Luijting Jacoba J. , Zoutman Willem H. , van Hall Thorbald , Orfao Alberto , Almeida Julia , van Dongen Jacques J. M. , Vermeer Maarten H. 
Published: July 2021

Abstract
Sézary syndrome (SS) is an aggressive leukemic form of cutaneous T-cell lymphoma with neoplastic CD4+ T cells present in skin, lymph nodes, and blood. Despite advances in therapy, prognosis remains poor, with a 5-year overall survival of 30%. The immunophenotype of Sézary cells is diverse, which hampers efficient diagnosis, sensitive disease monitoring, and accurate assessment of treatment response. Comprehensive immunophenotypic profiling of Sézary cells with an in-depth analysis of maturation and functional subsets has not been performed thus far. We immunophenotypically profiled 24 patients with SS using standardized and sensitive EuroFlow-based multiparameter flow cytometry. We accurately identified and quantified Sézary cells in blood and performed an in-depth assessment of their phenotypic characteristics in comparison with their normal counterparts in the blood CD4+ T-cell compartment. We observed inter- and intrapatient heterogeneity and phenotypic changes over time. Sézary cells exhibited phenotypes corresponding with classical and nonclassical T helper subsets with different maturation phenotypes. We combined multiparameter flow cytometry analyses with fluorescence-activated cell sorting and performed RNA sequencing studies on purified subsets of malignant Sézary cells and normal CD4+ T cells of the same patients. We confirmed pure monoclonality in Sézary subsets, compared transcriptomes of phenotypically distinct Sézary subsets, and identified novel downregulated genes, most remarkably THEMIS and LAIR1, which discriminate Sézary cells from normal residual CD4+ T cells. Together, these findings further unravel the heterogeneity of Sézary cell subpopulations within and between patients. These new data will support improved blood staging and more accurate disease monitoring.
Adolescent and young adult stress and coping during COVID-19: the utility of a pediatric emergency department screener
Authors: Yau Ji-Ting Janet , Nager Alan L. 
Published: July 2021

Abstract
Background
COVID-19 altered lives, especially adolescents and young adults who lost their emotional and social support systems and may be suffering.

Objective
In response to the coronavirus pandemic, a questionnaire was created and administered to Pediatric Emergency Department (PED) patients in order to identify psychosocial stress and coping abilities.

Methods
A 12-question (yes/no) quality improvement (QI) paper-based questionnaire was administered by PED providers to assess psychosocial stress and coping among patients 12 years and greater who presented to the PED at a tertiary Children’s Hospital, March-September 2020. Questions were asked/recorded to determine rates of distress and provide social work intervention, if needed. Analysis-Chi-squared, Fisher’s exact, and Mann-Whitney U tests.

Results
Among 1261 PED patients who participated in the study, the mean age was 15.4 years (SD = 2.4), (58% female, 41.5% male, 0.6% missing data). We identified 611 patients (48.5%) who admitted to feeling scared about contracting the disease, 876 patients (69.5%) who were concerned about the health of their families, and 229 patients (18.2%) who screened positive for food insecurity. In addition, 596 patients (47.3%) felt anxiety, 333 patients (26.4%) felt depressed, and 13 patients (1%) admitted to having suicidal ideation because of COVID-19. The majority of patients, 1165 (92.4%), felt supported during the pandemic. Social work was consulted for 235 (18.6%) of patients participating.

Conclusions
While patients typically present to PEDs for a somatic complaint, screening their psychosocial and emotional states may reveal underlying mental health concerns that require intervention and at times, assistance from social workers.
Feasible and effective use of a simulation-based curriculum for post-graduate emergency medicine trainees in India to improve learner self-efficacy, knowledge, and skills
Authors: Ahluwalia T. , Toy S. , Gutierrez C. , Boggs K. , Douglass K. 
Published: July 2021

Abstract
Background
Pediatric emergency medicine training is in its infancy in India. Simulation provides an educational avenue to equip trainees with the skills to improve pediatric care. We hypothesized that a simulation-based curriculum can improve Indian post-graduate emergency medicine (EM) trainees’ self-efficacy, knowledge, and skills in pediatric care.

Methods
We designed a simulation-based curriculum for management of common pediatric emergencies including sepsis, trauma, and respiratory illness and pediatric-specific procedures including vascular access and airway skills. Training included didactics, procedural skill stations, and simulation. Measures included a self-efficacy survey, knowledge test, skills checklist, and follow-up survey. Results were analyzed using the Wilcoxon signed-rank test and paired-samples t test. A 6-month follow-up survey was done to evaluate lasting effects of the intervention.

Results
Seventy residents from four academic hospitals in India participated. Trainees reported feeling significantly more confident, after training, in performing procedures, and managing pediatric emergencies (p < 0.001). After the simulation-based curriculum, trainees demonstrated an increase in medical knowledge of 19% (p < 0.01) and improvement in procedural skills from baseline to mastery of 18%, 20%, 16%, and 19% for intubation, bag-valve mask ventilation, intravenous access, and intraosseous access respectively (p < 0.01). At 6-month follow-up, self-efficacy in procedural skills and management of pediatric emergencies improved from baseline.

Conclusions
A simulation-based curriculum is an effective and sustainable way to improve Indian post-graduate EM trainees’ self-efficacy, knowledge, and skills in pediatric emergency care.
Whole-genome sequencing of two Streptomyces strains isolated from the sand dunes of Sahara
Authors: Zerouki Chahira , Bensalah Farid , Kuittinen Suvi , Pappinen Ari , Turunen Ossi 
Published: July 2021

Abstract
Background
Sahara is one of the largest deserts in the world. The harsh climatic conditions, especially high temperature and aridity lead to unique adaptation of organisms, which could be a potential source of new metabolites. In this respect, two Saharan soils from El Oued Souf and Beni Abbes in Algeria were collected. The bacterial isolates were selected by screening for antibacterial, antifungal, and enzymatic activities. The whole genomes of the two native Saharan strains were sequenced to study desert Streptomyces microbiology and ecology from a genomic perspective.

Results
Strains Babs14 (from Beni Abbes, Algeria) and Osf17 (from El Oued Souf, Algeria) were initially identified by 16S rRNA sequencing as belonging to the Streptomyces genus. The whole genome sequencing of the two strains was performed using Pacific Biosciences Sequel II technology (PacBio), which showed that Babs14 and Osf17 have a linear chromosome of 8.00 Mb and 7.97 Mb, respectively. The number of identified protein coding genes was 6910 in Babs14 and 6894 in Osf17. No plasmids were found in Babs14, whereas three plasmids were detected in Osf17. Although the strains have different phenotypes and are from different regions, they showed very high similarities at the DNA level. The two strains are more similar to each other than either is to the closest database strain. The search for potential secondary metabolites was performed using antiSMASH and predicted 29 biosynthetic gene clusters (BGCs). Several BGCs and proteins were related to the biosynthesis of factors needed in response to environmental stress in temperature, UV light and osmolarity.

Conclusion
The genome sequencing of Saharan Streptomyces strains revealed factors that are related to their adaptation to an extreme environment and stress conditions. The genome information provides tools to study ecological adaptation in a desert environment and to explore the bioactive compounds of these microorganisms. The two whole genome sequences are among the first to be sequenced for the Streptomyces genus of Algerian Sahara. The present research was undertaken as a first step to more profoundly explore the desert microbiome.
LncGSEA: a versatile tool to infer lncRNA associated pathways from large-scale cancer transcriptome sequencing data
Authors: Ren Yanan , Wang Ting-You , Anderton Leah C. , Cao Qi , Yang Rendong 
Published: July 2021

Abstract
Background
Long non-coding RNAs (lncRNAs) are a growing focus in cancer research. Deciphering pathways influenced by lncRNAs is important to understand their role in cancer. Although knock-down or overexpression of lncRNAs followed by gene expression profiling in cancer cell lines are established approaches to address this problem, these experimental data are not available for a majority of the annotated lncRNAs.

Results
As a surrogate, we present lncGSEA, a convenient tool to predict the lncRNA associated pathways through Gene Set Enrichment Analysis of gene expression profiles from large-scale cancer patient samples. We demonstrate that lncGSEA is able to recapitulate lncRNA associated pathways supported by literature and experimental validations in multiple cancer types.

Conclusions
LncGSEA allows researchers to infer lncRNA regulatory pathways directly from clinical samples in oncology. LncGSEA is written in R, and is freely accessible at https://github.com/ylab-hi/lncGSEA.