bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reduced Risk of Revision with Computer-Guided Versus Non-Computer-Guided THA
Authors: Davis Edward T. , McKinney Kerren D. , Kamali Amir , Kuljaca Selena , Pagkalos Joseph 
Published: July 2021

Background:
Computer-assisted total hip arthroplasty (THA) is known to improve implantation precision, but clinical data demonstrating an improvement in survivorship and patient-reported outcome measures (PROMs) are lacking. Our aim was to compare the risk of revision, PROMs, and patient satisfaction between cohorts who underwent THA with and without the use of computer guidance.

Methods:
We used the data set and linked PROM data of the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man. Our sample included THAs performed for osteoarthritis using cementless acetabular components from a single manufacturer (cementless and hybrid THAs). An additional analysis was performed limiting the sample size to cementless-only THAs. The primary end point was revision (any component) for any reason. Kaplan-Meier survivorship analysis and an adjusted Cox proportional-hazards model were used.

Results:
There were 41,683 non-computer-guided and 871 (2%) computer-guided cases included in our analysis of the cementless and hybrid group. There were 943 revisions in the non-computer-guided group and 7 in the computer-guided group. The cumulative revision rate at 10 years was 3.88% (95% confidence interval [CI]: 3.59% to 4.18%) for the non-computer-guided group and 1.06% (95% CI: 0.45% to 2.76%) for the computer-guided group. The Cox proportional-hazards model yielded a hazard ratio of 0.45 (95% CI: 0.21 to 0.96; p = 0.038). In the analysis of the cementless-only group, the cumulative revision rate at 10 years was 3.99% (95% CI: 3.62% to 4.38%) and 1.20% (95% CI: 0.52% to 3.12%) for the 2 groups, respectively. The Cox proportional-hazards model yielded a hazard ratio of 0.47 (95% CI: 0.22 to 1.01; p = 0.053). There was no significant difference in the 6-month Oxford Hip Score, the EuroQol-5 Dimension (EQ-5D) and EQ-VAS (Visual Analogue Scale) scores, and patient-reported success rates. Patient satisfaction (single-item satisfaction outcome measure) was higher in the computer-guided group, but this finding was limited by a reduced number of responses.

Conclusions:
In our analysis, the use of computer-guided surgery was associated with a lower rate of revision at mean follow-up of 5.6 years. This finding was upheld when the sample was restricted to cementless-only THAs. Causality cannot be inferred in view of the observational nature of the study, and additional studies are recommended to validate these findings.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Alternatives to Traditional Pedicle Screws for Posterior Fixation of the Degenerative Lumbar Spine
Authors: Rosinski Alexander A. , Mittal Ashish , Odeh Khalid , Ungurean Victor , Leasure Jeremi , Telles Connor , Kondrashov Dimitriy 
Published: July 2021

Background:
Traditional pedicle screws are currently the gold standard to achieve stable 3-column fixation of the degenerative lumbar spine. However, there are cases in which pedicle screw fixation may not be ideal. Due to their starting point lateral to the pars interarticularis, pedicle screws require a relatively wide dissection along with a medialized trajectory directed toward the centrally located neural elements and prevertebral vasculature. In addition, low bone mineral density remains a major risk factor for pedicle screw loosening, pullout, and pseudarthrosis. The purpose of this article is to review the indications, advantages, disadvantages, and complications associated with posterior fixation techniques of the degenerative lumbar spine beyond the traditional pedicle screws.

Methods:
Comprehensive literature searches of the PubMed, Scopus, and Web of Science databases were performed for 5 methods of posterior spinal fixation, including (1) cortical bone trajectory (CBT) screws, (2) transfacet screws, (3) translaminar screws, (4) spinous process plates, and (5) fusion mass screws and hooks. Articles that had been published between January 1, 1990, and January 1, 2020, were considered. Non-English-language articles and studies involving fixation of the cervical or thoracic spine were excluded from our review.

Results:
After reviewing over 1,700 articles pertaining to CBT and non-pedicular fixation techniques, a total of 284 articles met our inclusion criteria. CBT and transfacet screws require less-extensive exposure and paraspinal muscle dissection compared with traditional pedicle screws and may therefore reduce blood loss, postoperative pain, and length of hospital stay. In addition, several methods of non-pedicular fixation such as translaminar and fusion mass screws have trajectories that are directed away from or posterior to the spinal canal, potentially decreasing the risk of neurologic injury. CBT, transfacet, and fusion mass screws can also be used as salvage techniques when traditional pedicle screw constructs fail.

Conclusions:
CBT and non-pedicular fixation may be preferred in certain lumbar degenerative cases, particularly among patients with osteoporosis. Limitations of non-pedicular techniques include their reliance on intact posterior elements and the lack of 3-column fixation of the spine. As a result, transfacet and translaminar screws are infrequently used as the primary method of fixation. CBT, transfacet, and translaminar screws are effective in augmenting interbody fixation and have been shown to significantly improve fusion rates and clinical outcomes compared with stand-alone anterior lumbar interbody fusion.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Breast Cancer Survivor Experience Of Rehabilitation Services In South Africa: Towards A Cancer Survivorship Plan
Authors: Motsoeneng Portia , Beutel Anita , Burgess Theresa , Naidoo Niri , Stewart Annemie , Shamley Delva 
Published: July 2021

Abstract
Purpose

Integrated rehabilitation health care pathway are implemented to meet both physical and clinical needs of breast cancer survivors as they transition from treatment to survivorship. The aim of this study was to assess the current South African upper limb rehabilitation service, provision, and perspectives of these from the health professionals and the end users breast cancer survivor with upper limb disorder.
Methods

A sequential mixed-methods design informed this study. Service provision was evaluated via an online survey questionnaire completed by health practitioners working in public and private breast cancer units. Focus groups were conducted with both public health practitioners providing the services and breast cancer survivors accessing the services.
Results

This study has revealed a dearth of rehabilitation services for breast cancer survivors in the public health sector of South Africa. Data reveal an overstretched, understaffed and poorly trained public health sector, unable to deliver adequate upper limb services to breast cancer survivors. Focus group data suggests that this is due to financial austerity rather than poor recognition of the need. Poor patient education is driving poor upper limb outcomes and barriers to exercise behaviour.
Conclusion

The current South African upper limb rehabilitation services does not cater for the unmet needs of a breast cancer survivor leading to poor health outcomes.
Recovery of the Irreversible Crystallinity of Nanocellulose by　Crystallite Fusion: A Strategy for Achieving Efficient Energy Transfers in Sustainable Biopolymer Skeletons
Authors: Daicho Kazuho , Kobayashi Kayoko , Fujisawa Shuji , Saito Tsuguyuki 
Published: July 2021

Abstract
Crystallite refers to a single crystalline grain in crystal aggregates, and multiple crystallites form a grain boundary or the inter-crystallite interface. A grain boundary is a structural defect that hinders the efficient directional transfer of mechanical stress or thermal phonons in crystal aggregates. We observed that grain boundaries within an aggregate of a-few-nanometers-wide fibrillar crystallites of wood cellulose were crystallized by enhancing their inter-crystallite interactions; multiple crystallites were coupled into single fusion crystals without passing through a melting or dissolving state. Accordingly, the crystallinity of wood cellulose, which has been considered irreversible once decreased, was significantly enhanced, and the thermal energy transfer in the aggregate was improved. Other fibrillar crystallites of crab shell chitin also showed a similar fusion phenomenon by enhancing the inter-crystallite interactions. These findings imply that such crystallite fusion naturally occurs in biological structures with network skeletons of aggregated fibrillar crystallites.
Small Cell Carcinoma Esophagus: Experience of an Indian Tertiary Cancer Center
Authors: Panda Goutam Santosh , Noronha Vanita , Yadav Subhash , Joshi Amit , Patil Vijay , Menon Nandini , Kumar Rajiv , Janu Amit , Mahajan Abhishek , Purandare Nilendu , Agarwal Jai Prakash , Karimundackal George , Prabhash Kumar 
Published: July 2021

Abstract
Background: Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive tumor with no established standard treatment.Methods: This is a retrospective study of adult patients with histologically proven SCCE registered between February 2011 and March 2020 at Tata Memorial Hospital in Mumbai.Results: There were 56 patients with 29(51.8%) having limited-stage disease (LD) and 27(48.2%) having extensive-stage disease (ED). The median age was 58(IQR 51-65) years, 57.1% were men, 40% were smokers. Amongst LD-SCCE patients, 23 underwent local therapy i.e. radiation (19, 65.5%), surgery (4, 13.8%) and 27 received chemotherapy in neoadjuvant (23, 79.3%), concurrent (18, 62.1%) and adjuvant (4,13.8%) settings. Total 19 ED-SCCE patients (70.4%) received chemotherapy. Prophylactic cranial irradiation (PCI) was delivered to 11(37.9%) and 7(25.9%) patients with LD-SCCE and ED-SCCE, respectively. Signiﬁcant grade ≥3 chemo-toxicities in patients with LD-SCCE and ED-SCCE included febrile neutropenia in 33.3% and 23.5%, anemia in 9.5% and 17.6%, and dyselectrolytemia in 14.3% and 11.8%, respectively. The median overall survival (OS) in LD-SCCE and ED-SCCE were 22.9 (95% CI 1.8-44.1) months and 11.8 (95% CI 7.3-16.4) months, respectively. Age <60years (p=0.004) and tumor epicenter in lower third esophagus (p=0.002) were good prognostic factors for OS in LD-SCCE and ED-SCCE patients respectively. The incidence of brain metastasis was low, both at presentation (1/27, 3.7%) and at relapse (5/56, 8.9%).Conclusion: Although the median overall survival of LD-SCCE is better than ED-SCCE, it is still under 2 years. Brain metastases are uncommon and PCI can be avoided with close clinico-radiological follow up.
Mind Your Language: Factors Enhancing Students’ English Language Skills in an International Medical Programme (IMP)
Authors: Chan Sharon Min Hui , Mamat Norul Hidayah , Nadarajah Vishna Devi 
Published: July 2021

Abstract
Background

Language proficiency is crucial for doctors as they communicate with patients, peers and other healthcare professionals. Although proficiency in English is part of admission requirements, there is a gap of knowledge on medical students’ perception of factors enhancing English language (EL) skills during training in international medical programmes (IMP). The gap prevents educators and policy makers from helping students who struggle with communication skills during medical training. This study therefore explores factors that enable enhancement of English language skills from medical students’ perspectives
Methods

Six focus group interviews with 24 medical students of an IMP were conducted. Data were analysed using Braun and Clarke’s framework of thematic analysis.
Results

Results established three main factors enhancing EL skills namely use of EL in medical training and practice, influence of university culture in EL mastery and individual EL proficiency with eight themes demonstrating the factors as perceived by medical students
Conclusions

Findings of this study informs how students perceived enhancement of EL skills as a professional and social requirement during medical training and for future practice. It also informs that setting English language admission pre requisites needs to be complemented with opportunities to practice context specific communication skills. Thus, international medical programmes should embed diverse and inclusive strategies to support and develop medical students’ English language skills.
Associations Among Daily Fish Intake, Monocyte/HDL-C Ratio, and Lifestyle in Japanese Males Aged &gt;50: Risk Stratification of Atherosclerotic Cardiovascular Disease
Authors: Tani Shigemasa , Atsumi Wataru , Imatake Kazuhiro , Suzuki Yasuyuki , Yagi Tsukasa , Matsumoto Naoya , Okumura Yasuo 
Published: July 2021

Abstract
Background: The monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) may be a novel inflammatory marker of the developing atherosclerotic cardiovascular disease (ASCVD). We investigated the relationship between the average number of days of fish intake per week and the MHR and lifestyle behaviors and to explore the validity of stratifying the risk of ASCVD using the combination of MHR and the serum HDL-C level.Methods: This cross-sectional study was conducted in a population of 2485 males aged over 50 years at the Health Planning Center of Nihon University Hospital between April 2018 and March 2019.Results: The average frequency of fish intake was 2.32 ± 1.31 per week. Multiple stepwise regression analysis identified increased weekly fish frequency intake as an independent determinant of a decreased MHR (β = -0.072, p < 0.0001). Healthier lifestyle behaviors were also significantly associated with decreased MHR. As the fish intake frequency increased, the proportion of subjects with the cigarette smoking habit decreased (p = 0.014), that of subjects with aerobic exercise habit increased (p < 0.0001), and that of subjects with alcohol drinking habit increased (p < 0.0001). A risk stratification or ASCVD by combining the HDL-C level and fish intake frequency with the MHR could be developed, indicating that even with similar HDL-C levels, higher HMR and fish frequency are associated with higher risk ASCVD. Conclusion: A high fish intake frequency may be associated with healthier lifestyle behaviors as well as a lower MHR, and may thus represent a component of a healthy lifestyle associated with a lower risk of ASCVD in Japanese males aged over 50 years. These associations may be related to being the preventive effect of fish intake on ASCVD.Clinical Trial Registration: UMIN (http://www.umin.ac.jp/) Study ID: UMIN 000041368 registered 10/08/2020
Bank Transaction Analyze for Recognize of Money Laundering Using Decision Tree Algorithm (DTA)
Authors: DadashzadehFahim Somayeh , Karimi Ramin , Soleimani Ali 
Published: July 2021

Abstract
Bank Transaction Analyze for Recognize of Money Laundering Using DTA One of the important problems of the banking systems is illegal transactions based on fraud and money laundering that can destroy the economy and financial foundation of a country. Fraud and money laundering are used to escape from tax payment or inject dirty money to the economy cycle. The offenders use lots of transactions to show their illegal funds rightful. One important problem of fraud and money laundering recognize in banking system is high complexity of it. We need to use knowledge discover methods like learning machine and data mining. We can mostly recognize the hidden pattern of illegal transactions by using various learning machines or data mining like Bayesian Network, DT, Support Vector Machine or Artificial Neural Network. To recognize the pattern and classify the banking transactions, ML methods need to classify in two categories Normal and Abnormal to find suitable features for increase their accuracy. Actually, the feature selection is too important in bank fraud recognition and it is a kind of optimization too because the suitable feature selection causes recognize error go down by techniques like DT. In this research we use DTA to select important features related with bank fraud to decide and knowledge discovery which has a good speed in discover of bank fraud. When the features of bank fraud select in right way and with good accuracy then the accuracy of DT will be increased and we must select those features that are more important to get better accuracy in recognition of fraud and money laundering.
Empirical prediction of variant-associated cryptic-donors with 87% sensitivity and 95% specificity
Authors: Dawes Ruebena , Joshi Himanshu , Cooper Sandra 
Published: July 2021

Abstract
Predicting which cryptic-donors may be activated by a genetic variant is notoriously difficult. Through analysis of 5,145 cryptic-donors activated by 4,811 variants (versus 86,963 decoy-donors not used; any GT or GC), we define an empirical method predicting cryptic-donor activation with 87% sensitivity and 95% specificity. Strength (according to four algorithms) and proximity to the authentic-donor appear important determinants of cryptic-donor activation. However, other factors such as auxiliary splicing elements, which are difficult to identify, play an important role and are likely responsible for current prediction inaccuracies. We find that the most frequent mis-splicing events at each exon-intron junction, mined from 40,233 RNA-sequencing samples, predict with remarkable accuracy which cryptic-donor will be activated in rare disease. Aggregate RNA-Sequencing splice-junction data provides an accurate, evidence-based method to predict variant-activated cryptic-donors in genetic disorders, assisting pathology consideration of possible consequences of a variant for the encoded protein and RNA diagnostic testing strategies.
Comparison of Radiotherapy Combined with Nimotuzumab vs. Chemoradiotherapy for Locally Recurrent Nasopharyngeal Carcinoma
Authors: Zong Jing-Feng , Liang Qian-Dong , Lu Qiong-Jiao , Liu Yu-Hong , Xu Han-Chuan , Chen Bi-Juan , Guo Qiao-Juan , Xu Yun , Hu Cai-Rong , Pan Jian-Ji , Lin Shao-Jun 
Published: July 2021

Abstract
BackgroundThe present study compared the effectiveness and toxicity of two treatment modalities, namely radiotherapy combined with nimotuzumab (N) and chemoradiotherapy (CRT) in patients with locally recurrent nasopharyngeal carcinoma (LR-NPC).MethodsPatients with LR-NPC who were treated with radiotherapy were retrospectively enrolled from January 2015 to December 2018. The treatment included radiotherapy combined with N or platinum-based induction chemotherapy and/or concurrent chemotherapy. The comparison of survival and toxicity between the two treatment modalities was evaluated by the log-rank and chi-squared tests. Overall survival (OS) was the primary endpoint.ResultsA total of 87 patients were included, of whom 32 and 55 were divided into the N group and the CRT group, respectively. No significant differences were noted in the survival rate between the N and the CRT groups (4-year OS rates, 37.1% vs. 40.7%, respectively; P=0.735). Mild to moderate acute complications were common during the radiation period and mainly included mucositis and xerostomia. The majority of the acute toxic reactions were tolerated well. A total of 48 patients (55.2%) demonstrated late radiation injuries of grade ≥3, including 12 patients (37.5%) in the N group and 36 patients (66.5%) in the CRT group. The CRT group exhibited significantly higher incidence of severe late radiation injuries compared with that of the N group (P=0.011). ConclusionRadiotherapy combined with N did not appear to enhance treatment efficacy compared with CRT in patients with LR-NPC. However, radiotherapy combined with N may be superior to CRT due to its lower incidence of acute and late toxicities. Further studies are required to confirm the current findings.
Preventing Loss of Femoral Periprosthetic Bone Mineral Density in Cementless Total Hip Arthroplasty Using a Tapered Wedge Stem in Patients With Osteoporosis Treated With Denosumab: a Retrospective, Cohort Study
Authors: Kamo Keiji , Kijima Hiroaki , Okuyama Koichiro , Kawano Tetsuya , Seki Nobutoshi , Sato Chie , Kido Tadahito , Chiba Mitsuho , Miyakoshi Naohisa , Shimada Yoichi 
Published: July 2021

Abstract

Background: Bone mineral density (BMD) of the proximal femur around the stem decreases due to stress shielding after cementless total hip arthroplasty (THA). When severe stress shielding occurs, the risk of periprosthetic femoral fractures increases, and this bone loss can also increase the difficulty of future revision THA. Denosumab is known to improve the quality and strength of cortical bone in the proximal femurs of patients with osteoporosis. The purpose of this study was to investigate whether denosumab prevents loss of proximal femoral periprosthetic BMD in cementless THA using a tapered wedge stem in patients with osteoporosis.Methods: Sixty-three consecutive patients who had undergone unilateral primary THA using a tapered wedge stem were included in this retrospective study. Twenty-four patients who received denosumab for osteoporosis were the denosumab group, and the 39 without denosumab were the control group. At 2 weeks, 6 months, and 12 months after THA, bone turnover markers and femoral periprosthetic BMD were measured.Results: BMD in zone 1 was significantly increased from baseline at both 6 and 12 months after THA in the denosumab group and significantly decreased in the control group. BMD in zone 7 was significantly decreased compared to baseline at both 6 and 12 months after THA in the control group, but not in the denosumab group. The use of denosumab for THA patients with osteoporosis was independently related to preventing loss of periprosthetic BMD of the femur at 12 months after surgery in zones 1 and 7 on multivariate analysis.Conclusions: Denosumab significantly increased proximal femoral periprosthetic BMD in zone 1 and prevented loss of BMD in zone 7 in patients with osteoporosis after cementless THA using a tapered wedge stem at both 6 and 12 months after surgery.
Injectable non-immunogenic PEG-like conjugate that forms a subcutaneous depot and enables sustained delivery of a peptide drug
Authors: Ozer Imran , Slezak Anna , Everitt Jeffrey , Li Xinghai , Zakharov Nikita , Collier Joel , Campbell Jonathan , D'Alessio David , Chilkoti Ashutosh 
Published: July 2021

Abstract
Many biologics have a short plasma half-life, and their conjugation to polyethylene glycol (PEG) is commonly used to solve this problem. Unfortunately, PEG is immunogenic and forms vacuoles, and improvement in PEGylated drugs' half-life is at an asymptote. Here, we developed a PEG-like, non-immunogenic, and injectable conjugate technology for sustained delivery of biologics. An optimal poly[oligo(ethylene glycol) methyl ether methacrylate] (POEGMA) depot of exendin, a peptide drug used in the clinic in treating type 2 diabetes, outperformed PEG, non-depot-forming POEGMA, and a clinical sustained-release exendin-4 formulation in efficacy and pharmacokinetics. Notably, POEGMA was non-immunoreactive, while PEG induced a persistent anti-PEG immune response, leading to its subsequent doses' early clearance and loss of efficacy. POEGMA did not induce vacuolization. Solving these problems of PEG and improving upon its half-life benefits by creating injectable POEGMA conjugates that form a drug depot under the skin and provide sustained efficacy breathe new life into an established and valuable drug delivery technology that is facing an impasse.