bluuebunny/crossref_metadata_2025_split huggingface dataset:
Деструктивний поліоніхомікоз із вторинною інкарнацією нігтів: аналіз клінічних спостережень, авторські погляди на комплексне лікування
Authors: Vergun A. R. , Krasnyi M. R. , Kit Z. M. , Vergun O. M. 
Published: March 2021

Мета роботи: оптимізувати комплексне лікування та хірургічні інтервенції при хронічній оніхопатології, асоційованій з оніхомікозом та інкарнацією нігтів, включно ускладнені, комбіновані та рецидивуючі ураження.
Матеріали і методи. Здійснено ретроспективний та проспективний аналіз клінічних особливостей і результатів лікування 919 пацієнтів за 10-річний період: 503 чоловіків та 416 жінок віком 5–92 роки. Також симультанно досліджено деякі біохімічні лабораторні девіації. Видалення уражених нігтів у хворих на поліоніхомікоз здійснювали послідовними етапами на фоні системної терапії. Застосовували системну ад’ювантну пульс-терапію 400 мг ітраконазолу впродовж двох днів до первинної хірургічної корекції вторинних інкарнацій та впродовж перших трьох днів післяопераційного періоду. Санацію інших уражених нігтів з метою запобігання реінфекції мікозом проводили антимікотичним 5 % аморолфінним лаком або 8 % циклопіроксовмісним лаком для нігтів. Використовували клінічні, параклінічні, мікробіологічні методи, функціональну діагностику, рентгенологічні, біохімічні, морфологічні та статистичні методи.
Результати досліджень та їх обговорення. Комплексне лікування гнійної оніхеальної патології включає хірургічну резекцію або видалення нігтя, некректомію, дренування гнійних вогнищ, санацію уражень м’яких тканин, консервативне лікування мікозу та супутніх уражень. Схему комплексного лікування, що включає пульс-терапію ітраконазолом, видалення уражених нігтів, обробку нігтьового ложа полівідонйодом, використання лініменту тербінафіну та санацію інших нігтьових пластин антимікотичними лаками – циклопіроксом або аморолфіном можна використовувати для лікування тяжких випадків поліоніхомікозу. Встановлено, що піднігтьовий гіперкератоз та дерматофітома внаслідок здавлення центральної частини нігтя детермінують вторинне вростання його країв, χ2=20,87, p<0,01. Вогнища оніхолізису (оніхомадезу) та деструкції гіперкератозу, що призводять до вторинного оніхолізису, відшарування нігтьової пластини, χ2=15,23, р<0,0211, визначають та обґрунтовують доцільність малотравматичної оніхоектомії. Видалення уражених нігтів у пацієнтів з деструктивним оніхомікозом, ускладненим піднігтьовим гіперкератозом або оніхогрифозом з інкарнацією нігтя, ми здійснювали з використанням менш травматичної мобілізації нігтьової пластини через локуси оніхолізису, оніхолізовані структури за допомогою послідовного застосування стерильного леза педикюрного інструменту PE-60/1, із застосуванням стерильних манікюрних лез PE-10/2 та стерильного інструменту PE-30 (заокругленого пушера із зігнутим сепараційним лезом), одночасним видаленням гіперкератозу, оніхоматрикоми (дерматофітоми), змінених тканин у ділянках вростання та гіпергрануляцій, що значно зменшує травматичність процедури та детермінує зменшення післяопераційного больового синдрому (χ2=48,32, p<0,01), прискорення загоєння ран, поліпшення якості життя пацієнтів.
Характеристика структурно-функціонального стану кісткової тканини у хворих похилого та старечого віку з переломами вертлюгової ділянки стегнової кістки
Authors: Valovina Y. D. , Vitvitsky Z. Y. , Valovina N. Y. 
Published: March 2021

Мета роботи: проаналізувати структурно-функціональний стан кісткової тканини (СФСКТ) у людей похилого та старечого віку та структуру переломів вертлюгової ділянки стегнової кістки (ВДСК) на ґрунті порушень мінеральної щільності кісткової тканини (МЩКТ).
Матеріали і методи. У роботі проаналізовано результати обстеження 98 хворих похилого та старечого віку, які перебували на лікуванні в КНП “Івано-Франківська обласна клінічна лікарня Івано-Франківської обласної ради” впродовж 2008–2018 рр. Середній вік хворих складав 75,4±10,8 (від 60 до 90 років). І групу склали 46 хворих із переломами ВДСК (основна група), які отримали низькоенергетичні пошкодження. До контрольної групи увійшли 52 особи, котрі обстежувались з приводу захворювань опорно-рухового апарату. Усім хворим виконано двохенергетичну рентгенівську абсорбціометрію (DEXA) поперекового відділу хребта. У хворих І групи визначали тип перелому за класифікацією AO/ASIF.
Результати досліджень та їх обговорення. Порушення показників МЩКТ виявлено у 72 (73,5 %) хворих обох груп. У хворих І групи максимальний показник зниження кісткової маси Т індекс становив -3,5, у хворих ІІ групи – Т= -2,8. У хворих похилого віку І групи середній показник Т індексу становив -1,32, а у хворих старечого віку І групи – -1,86. У хворих похилого віку ІІ групи середній показник Т становив -0,85, а у хворих старечого віку ІІ групи – -1,33. Серед хворих І групи, в яких при денситометрій виявлено порушення структури кісткової тканини, більшість переломів за класифікацією AO/ASIF були складними, тобто уламкові зі зміщенням, і становили 39(84,8 %) випадків. Порушення показників МЩКТ в обстежених хворих похилого та старечого віку та висока частота складних уламкових переломів вказують на необхідність подальшого вивчення СФСКТ та оптимізації лікування у хворих цієї вікової категорії.
Prospective Study on Plasma MicroRNA‐4286 and Incident Acute Coronary Syndrome
Authors: Shen Miaoyan , Xu Xuedan , Liu Xuezhen , Wang Qiuhong , Li Wending , You Xiaomin , Peng Rong , Yuan Yu , Long Pinpin , Niu Rundong , Yang Handong , Cheng Xiang , Pan An , Tanguay Robert M. , Zhang Xiaomin , He Meian , Wang Chaolong , Liang Liming , Wu Tangchun 
Published: March 2021

Background
Mounting evidence suggests that circulating microRNAs (miRNAs) are critical indicators of cardiovascular disease. However, prospective studies linking circulating miRNAs to incident acute coronary syndrome (ACS) are limited, and the underlying effect of associated miRNA on incident ACS remains unknown.

Methods and Results

Based on a 2‐stage prospective nested case–control design within the Dongfeng‐Tongji cohort, we profiled plasma miRNAs from 23 pairs of incident ACS cases and controls by microarray and validated the candidate miRNAs in 572 incident ACS case–control pairs using quantitative real‐time polymerase chain reaction. We observed that plasma miR‐4286 was associated with higher risk of ACS (adjusted odds ratio according to an interquartile range increase, 1.26 [95% CI, 1.07–1.48]). Further association analysis revealed that triglyceride was positively associated with plasma miR‐4286, and an interquartile range increase in triglyceride was associated with an 11.04% (95% CI, 3.77%–18.83%) increase in plasma miR‐4286. In addition, the Mendelian randomization analysis suggested a potential causal effect of triglyceride on plasma miR‐4286 (
β
coefficients: 0.27 [95% CI, 0.01–0.53] and 0.27 [95% CI, 0.07–0.47] separately by inverse variance‐weighted and Mendelian randomization‐pleiotropy residual sum and outlier tests). Moreover, the causal mediation analysis indicated that plasma miR‐4286 explained 5.5% (95% CI, 0.7%–17.0%) of the association of triglyceride with incident ACS.

Conclusions
Higher level of plasma miR‐4286 was associated with an increased risk of ACS. The upregulated miR‐4286 in plasma can be attributed to higher triglyceride level and may mediate the effect of triglyceride on incident ACS.
A risk prediction score to identify patients at low risk for COVID-19 infection
Authors: Chew Wui Mei , Loh Chee Hong , Jalali Aditi , Fong Grace Shi En , Kumar Loshini Senthil , Sim Rachel Hui Zhen , Tan Russell Pinxue , Gill Sunil Ravinder , Liang Trilene Ruiting , Koh Jansen Meng Kwang , Tay Tunn Ren 
Published: March 2021

Abstract

Introduction:
Singapore’s enhanced surveillance programme for COVID-19 identifies and isolates hospitalised patients with acute respiratory symptoms to prevent nosocomial spread. We developed risk prediction models to identify patients with low risk for COVID-19 from this cohort of hospitalised patients with acute respiratory symptoms.

Methods:
This was a single-centre retrospective observational study. Patients admitted to our institution’s respiratory surveillance wards from 10 February to 30 April 2020 contributed data for analysis. Prediction models for COVID-19 were derived from a training cohort using variables based on demographics, clinical symptoms, exposure risks and blood investigations fitted into logistic regression models. The derived prediction models were subsequently validated on a test cohort.

Results:
Of the 1,228 patients analysed, 52 (4.2%) were diagnosed with COVID-19. Two prediction models were derived, the first based on age, presence of sore throat, dormitory residence, blood haemoglobin level (Hb), and total white blood cell counts (TW), and the second based on presence of headache, contact with infective patients, Hb and TW. Both models had good diagnostic performance with areas under the receiver operating characteristic curve of 0.934 and 0.866, respectively. Risk score cut-offs of 0.6 for Model 1 and 0.2 for Model 2 had 100% sensitivity, allowing identification of patients with low risk for COVID-19. Limiting COVID-19 screening to only elevated-risk patients reduced the number of isolation days for surveillance patients by up to 41.7% and COVID-19 swab testing by up to 41.0%.

Conclusion:
Prediction models derived from our study were able to identify patients at low risk for COVID-19 and rationalise resource utilisation.
Assessing the Impact of an Online Climate Science Community: The Early Career Climate Forum
Authors: Guckian Meaghan L. , Markowitz Ezra M. , Tucker Clay S. , Kiekebusch Elsita , Klemm Toni , Middleton Lindsey , Wootten Adrienne , Staudinger Michelle D. 
Published: March 2021

AbstractOnline science communities can serve as powerful platforms for advancing scientific knowledge, capacity, and outreach by increasing collaboration and information sharing among geographically distant peers, practitioners, and the public. Here, we examine the value and role of the Early Career Climate Forum (ECCF), a climate-focused online science community that is based in the United States and is dedicated to training and providing support to the next generation of climate scientists. In a survey of community users and contributors, we find that the ECCF played a unique role in providing users access to career resources as well as climate-related research and insights. Respondents also indicated that the ECCF provides them with a strong sense of community and a sense of hope for the future of climate science research. These findings highlight the importance of online science communities in shaping and supporting the next generation of scientists and practitioners working at the science–management interface on climate change issues.
Comparison of high-sensitivity C-reactive protein vs. C-reactive protein for diagnostic accuracy and prediction of mortality in patients with acute myocardial infarction
Authors: Hofer Felix , Perkmann Thomas , Gager Gloria , Winter Max-Paul , Niessner Alexander , Hengstenberg Christian , Siller-Matula Jolanta M 
Published: March 2021

Background The role of chronic inflammation in the pathogenesis of atherosclerosis has been unequivocally proven. However, the prognostic impact of C-reactive protein, a marker of inflammatory response in patients with acute myocardial infarction has not been fully clarified. Furthermore, there is no direct comparison of the diagnostic accuracy of C-reactive protein and high sensitivity C-reactive protein in the acute myocardial infarction population. Methods In this prospective observational cohort study, 344 patients with acute myocardial infarction were enrolled. All-cause mortality was a primary endpoint. Patients were followed prospectively for a median of six years. Results The correlation between high sensitivity C-reactive protein and C-reactive protein ( r = 0.99; P < 0.001) and the diagnostic accuracy (98.6%) was high. The ROC analysis revealed that C-reactive protein and high sensitivity C-reactive protein had a low AUC for prediction of mortality (C-reactive protein: 0.565, 95% CI [0.462–0.669], vs. high sensitivity C-reactive protein: 0.572, 95% CI [0.470–0.675]) or major adverse cardiac events (C-reactive protein: AUC 0.607, 95% CI [0.405–0.660], vs. high sensitivity C-reactive protein: AUC 0.526, 95% CI [0.398–0.653]) when assessed at time point of acute myocardial infarction. In contrast, longitudinal inflammatory risk assessment with serial C-reactive protein measurements in the stable phase of the disease revealed a 100% specificity, 100% negative predictive value, 32% sensitivity and 12% positive predictive value of C-reactive protein to predict long-term mortality. The Kaplan Meier analysis showed a significant survival benefit for patients at low residual inflammatory risk ( P =  0.014). Conclusion C-reactive protein and high sensitivity C-reactive protein provide a similar diagnostic accuracy, highlighting that C-reactive protein might replace high sensitivity C-reactive protein in routine assessments. Furthermore, low inflammatory status during the stable phase after acute myocardial infarction predicts favourable six-year survival.
Influence of Preoperative Tunnel Widening On the Outcomes of a Single Stage–Only Approach to Every Revision Anterior Cruciate Ligament Reconstruction: An Analysis of 409 Consecutive Patients From the SANTI Study Group
Authors: Pioger Charles , Saithna Adnan , Rayes Johnny , Haidar Ibrahim M. , Fradin Thomas , Ngbilo Cedric , Vieira Thais Dutra , Cavaignac Etienne , Sonnery-Cottet Bertrand 
Published: March 2021

Background: Preoperative tunnel widening is a frequently reported indication for performing a 2-stage revision anterior cruciate ligament reconstruction (ACLR) instead of a single-stage procedure. However, the strength of the available evidence to support a 2-stage strategy is low. Purpose/Hypothesis: The purpose was to evaluate the clinical outcomes of a single stage–only approach to revision ACLR. It was hypothesized that this approach would be associated with significant improvements from baseline in patient-reported outcome measures (PROMs) and knee stability and that there would be no significant differences in any postoperative outcomes between patients with and without preoperative tunnel widening. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective analysis was conducted of a large series of consecutive patients undergoing revision ACLR with a minimum follow-up of 2 years. Preoperative tunnel widening was assessed using digital radiographs. All patients underwent single-stage surgery with an outside-in technique, regardless of the degree of tunnel widening. Clinical outcomes were compared according to whether tunnel widening was present (either tunnel ≥12 mm) or not (both tunnels <12 mm). Results: The study included 409 patients with a mean ± SD follow-up of 69.6 ± 29.0 months. After revision ACLR, there was a significant reduction in the side-to-side anteroposterior laxity difference, from 7.7 ± 2.2 mm preoperatively to 1.2 ± 1.1 mm at 2 years ( P < .001). The mean International Knee Documentation Committee (IKDC) and all subscales of the Knee injury and Osteoarthritis Outcome Score (KOOS) exceeded the thresholds for the Patient Acceptable Symptom State defined for primary ACLR. An overall 358 patients had retrievable preoperative radiographs. According to the tunnel diameter measurements, 111 patients were allocated to group A (both tunnels <12 mm) and 247 patients to group B (either/both tunnels ≥12 mm). There were no significant differences between groups with respect to anteroposterior side-to-side laxity difference, graft rupture rates, non–graft rupture related reoperations, or contralateral anterior cruciate ligament injury rates. There was also no significant difference between groups that exceeded minimal detectable change thresholds for any of the PROMs recorded (ACL-RSI [Anterior Cruciate Ligament–Return to Sports After Injury], Lysholm, Tegner, IKDC, KOOS). Conclusion: A single-stage approach to revision ACLR is associated with excellent clinical results when an outside-in drilling technique is utilized. The presence of preoperative tunnel widening does not significantly influence PROMs, knee stability, graft rupture rates, or non–graft rupture related reoperation rates.
Synthetic cathinone poisoning from ingestion of drug-laced “instant coffee packets” in Taiwan
Authors: Chou H-H , Hsieh C-H , Chaou C-H , Chen C-K , Yen T-H , Liao S-C , Seak C-J , Chen H-Y 
Published: March 2021

Background: Synthetic cathinone abuse is a global health issue. Synthetic cathinones emerged in Taiwan in 2009, and their prevalence rapidly rose. They are usually made into “instant coffee packets,” and these so-called “toxic coffee packets” may also contain psychoactive drugs other than synthetic cathinones. Due to the diversity of the ingredients, clinical presentations can be complex. Methods: Retrospective analysis of emergency department (ED) patients who reported ingesting toxic coffee packets at three Chang-Gung Memorial Hospitals located in northern Taiwan between January, 2015 and December, 2019. Results: Sixty patients were included. Their mean age was 28.85 ± 9.24 years and 47(78.33%) were male. The most common presentations were palpitation, agitation, hallucination, and altered consciousness. Tachycardia and hypertension were common, while hyperthermia was observed in only three patients. Three patients (5%) developed rhabdomyolysis, and one underwent transient hemodialysis. Most patients were discharged from the ED, but 15(25%) were admitted, of whom nine (15%) were admitted to the intensive care unit (ICU), and one eventually died. Confirmation tests (mass-spectrometry-based analysis) were available in 10 patients; all reported positive for at least one type of synthetic cathinone. Polysubstance exposure was common. In multivariate logistic regression analyses, Glasgow coma scale ≤13 and the presence of seizure were associated with ICU admission. Conclusion: Patients who report ingesting toxic coffee packets are very likely to have been exposed to synthetic cathinones. Polysubstance exposure is common following ingestion. Cardiovascular and neurological symptoms are the main presentations, and severe complications such as rhabdomyolysis and life-threatening dysrhythmia can occur.
Patterns of treatment and outcome of palbociclib plus endocrine therapy in hormone receptor-positive/HER2 receptor-negative metastatic breast cancer: a real-world multicentre Italian study
Authors: Palumbo Raffaella , Torrisi Rosalba , Sottotetti Federico , Presti Daniele , Rita Gambaro Anna , Collovà Elena , Ferzi Antonella , Agostinetto Elisa , Maria Teragni Cristina , Saltalamacchia Giuseppe , Tagliaferri Barbara , Balletti Emanuela , Bernardo Antonio , Quaquarini Erica 
Published: March 2021

Background: The CDK4/6 inhibitor palbociclib combined with endocrine therapy (ET) has proven to prolong progression-free survival (PFS) in women with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (MBC). Few data are available regarding the efficacy of such a regimen outside the clinical trials. Patients and methods: This is a multicentre prospective real-world experience aimed at verifying the outcome of palbociclib plus ET in an unselected population of MBC patients. The primary aim was the clinical benefit rate (CBR); secondary aims were the median PFS, overall survival (OS) and safety. Patients received palbociclib plus letrozole 2.5 mg (cohort A) or fulvestrant 500 mg (cohort B). Results: In total, 191 patients (92 in cohort A, 99 in cohort B) were enrolled and treated, and 182 were evaluable for the analysis. Median age was 62 years (range 47–79); 54% had visceral involvement; 28% of patients had previously performed one treatment line (including chemotherapy and ET), 22.6% two lines and 15.9% three. An overall response rate of 34.6% was observed with 11 (6.0%) complete responses and 52 (28.6%) partial responses. Stable disease was achieved by 78 patients (42.9%) with an overall CBR of 59.8%. At a median follow-up of 24 months (range 6–32), median PFS was 13 months without significant differences between the cohorts. When analysed according to treatment line, PFS values were significantly prolonged when palbociclib-based therapy was administered as first-line treatment (14.0 months), to decrease progressively in second and subsequent lines (11.7 and 6.7 months, respectively). Median OS was 25 months, ranging from 28.0 months in 1st line to 18.0 and 13.0 months in 2nd and subsequent lines, respectively. Conclusions: Our data indicate that palbociclib plus ET is active and safe in HR+/HER2− MBC, also suggesting a better performance of the combinations in earlier treatment lines.
Remnant Muscle Preservation on Hamstring Tendon Autograft During ACL Reconstruction Promotes Volumetric Increase With Biological and Regenerative Potential
Authors: Funchal Luis Fernando Z. , Ortiz Rafael , Jimenez Andrew , Funchal Gabriella Di Giunta , Cohen Moises , Astur Diego Costa 
Published: March 2021

Background: The removal of all adherent muscle tissue from the hamstring graft during anterior cruciate ligament reconstruction (ACLR) is common practice. However, there is a paucity of research to justify this removal or evaluate its biological implications. Purpose/Hypothesis: The purpose of this study was to (1) evaluate the histological characteristics of the myotendinous muscle tissue harvested from hamstring tendons, (2) compare the final diameter of the prepared graft before and after the removal of the remnant musculature, and (3) evaluate patients who were treated with and without preservation of the graft-adhered muscle. The hypothesis was that the adherent musculature of the graft would have cells that could contribute to graft incorporation and revascularization, assist in the proprioceptive capacity of the neoligament, and increase the graft’s diameter. Study Design: Cohort study; Level of evidence, 3. Methods: We divided 84 patients into 2 groups: group 1 underwent ACLR using hamstring tendon autograft with adherent musculature, and group 2 underwent ACLR using hamstring tendon autograft stripped of its remnant muscle. All patients had minimum 2-year follow-up. The muscle harvested from the graft in group 2 was submitted for histological examination, and the graft diameter before and after muscle removal was compared. The Tegner activity scale and Lysholm scores were determined preoperatively and at 12 and 24 months postoperatively. Results: There was a significant difference in graft diameter between groups. The evaluation of the graft diameter in group 2 showed a decrease of 11.52% after removal of muscle tissue from the tendon graft. Patients from group 1 had better Tegner and Lysholm scores (mean ± SD) after 12 months (Tegner, 8.03 vs 7 [ P = .004]; Lysholm, 95.48 ± 1.2 vs 87.54 ± 3.21 [ P = .002]) and better Lysholm scores after 24 months (95.76 ± 2.1 vs 89.32 ± 2.47; P = .002). The muscle tissue of the analyzed fragments presented a pattern with fibrous tissue beams, invaginating regularly and sequentially from the myotendinous junction into the muscles. Conclusion: Preserving the muscle tissue on tendon grafts promoted a volumetric increase in the final autograft diameter and demonstrated biological and regenerative potential. Patients who underwent ACLR using the tendon with the muscle attached had better functional scores at 2-year follow-up as compared with patients treated using the tendon with the muscle removed.