bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-vitro 3D Analysis of Sacroiliac Joint Kinematics
Authors: Odeh Khalid , Wu Wei , Taylor Ben , Leasure Jeremi , Kondrashov Dimitriy 
Published: March 2021

Study Design.
An in-vitro biomechanical study of human cadaver sacroiliac joints.

Objective.
Our study aimed to develop a more comprehensive understanding of the native motion of the SIJ within the context of spinal kinematics and spinal implant evaluation.

Summary of Background Data.
Increasing attention has been given to the sacroiliac joint (SIJ) as a source of low back pain, despite its limited range of motion. We sought to characterize the rotational and translational motion in each axis utilizing standard pure moment flexion-extension (FE), lateral bending (LB), and axial rotation (AR) testing.

Methods.
Sixteen sacroiliac joints were evaluated from eight lumbosacral cadaver specimens (six females, two males) from subjects aged 28 to 57 years (mean age 46.8) with body mass index (BMI) 22 to 36 (mean BMI 30). Single leg stance was modeled by clamping the blocks on one ischium in a vise and letting the contralateral ischium hang freely. Pure moment loading was applied in FE, right/left AR, and right/left LB. Relative motions were collected with infrared markers.

Results.
The on-axis ratio was significantly lower in LB than in FE (P = 0.012) and in AR (P = 0.017). The rotation deviation angle measured 13.9 ± 9.1° in FE, 17.1 ± 8.7° in AR, and 35.7 ± 25.7° in LB. In LB the rotational deviation angle is significantly higher than both FE and AR (P = 0.003 and P = 0.011, respectively). In-plane translation was significantly higher (P = 0.005) in FE loading than in LB loading.

Conclusion.
A nontrivial amount of rotation and translation occurred out of the expected axis of motion. The largest amount of off-axis rotation was observed in lateral bending. Relative to resultant translation, in-plane translation was lowest in lateral bending. Our results indicate that rotation of the SIJ is not fully described with the in-plane metrics which are normally reported in evaluation of fusion devices. Future studies of the SIJ may need to consider including off-axis rotation measurements when describing SIJ kinematics.

Level of Evidence: 5
New Decade, Old Debate: Blocking the Cytokine Pathways in Infection-Induced Cytokine Cascade
Authors: Rizvi Mahrukh S. , Gallo De Moraes Alice 
Published: March 2021

Objectives:
Our understanding of the immunopathogenesis of coronavirus disease 2019 is evolving; however, a “cytokine storm” has been implicated. Ongoing clinical trials are evaluating the value of anticytokine therapies to treat patients with coronavirus disease 2019. This review summarizes the existing literature evaluating the efficacy and safety of anticytokine therapy to tackle the dysregulated immune response to infectious pathogens, discusses potential reasons for failure, applicability to coronavirus disease 2019, and future direction.

Data Sources:
Medline, PubMed, ClinicalTrials.gov, and media reports.

Study Selection:
The studies were included by author consensus.

Data Extraction:
Data were selected for inclusion after reviewing each study by author consensus.

Data Synthesis:
“Cytokine storm” is a nonspecific term, encompassing systemic inflammatory response to infectious pathogens, autoimmune conditions, cancers, trauma, and various chemotherapies. Like bacterial sepsis, viral pathogens may fuel immunopathogenesis by inducing a dysregulated autoamplifying cytokine cascade, ultimately leading to organ injury. This narrative review discusses what we know of the immune milieu of coronavirus disease 2019 versus noncoronavirus disease 2019 sepsis and/or acute respiratory distress syndrome, summarizes the existing literature on cytokine inhibitors in patients with sepsis and/or acute respiratory distress syndrome, and discusses possible reasons for recurrent failure. In doing so, it aims to assist decisions regarding the use of anticytokine therapy in patients with coronavirus disease 2019, as many regions of the world confront the second wave of the pandemic.

Conclusions:
As ongoing clinical trials determine the efficacy and safety of anticytokine therapy in patients with coronavirus disease 2019, clinicians should uphold caution when incorporating it into treatment protocols, while maintaining focus on established evidence-based practices and the mantra of “less is more.”
High-risk, recurrent and oligometastatic prostate cancer: recent developments on the role of radiation
Authors: Molitoris Jason K. , Alexander Gregory S. , Siddiqui Osman , Cohen Justin , Mishra Mark V. , Rana Zaker 
Published: March 2021

Purpose of review
Although a standard of care in the treatment of organ-confined prostate cancer, use of radiation for treatment in the high-risk, metastatic and salvage settings is evolving rapidly.

Recent findings
Recent clinical trials have explored the role of increased treatment for high-risk disease with the addition of adjuvant chemotherapy and expanded the role of radiation in settings previously reserved for systemic therapy. Addition of adjuvant chemotherapy for high-risk prostate cancer is controversial and recent evidence is discussed that continues to refine the patient population for further evaluation. Evidence recently published demonstrates that for patients with low burden metastatic disease and those with oligometastatic disease may have a survival benefit with radiation treatment to all sites of known disease. Finally, reirradiation after prior radiotherapy-based treatment offers a potential salvage option for patients with locally recurrent prostate cancer.

Summary
As treatment paradigms evolve for prostate cancer, recent evidence continues to demonstrate benefit for the use of local therapy, both in patients with organ-confined disease and, more increasingly, in those with limited metastatic or locally recurrent disease. Further work is needed to identify subgroups of patients who may benefit from available treatment escalation approaches.
The evolving treatment landscape of advanced urothelial carcinoma
Authors: Andreev-Drakhlin Alexander Y. , Egoryan Goar , Shah Amishi Y. , Msaouel Pavlos , Alhalabi Omar , Gao Jianjun 
Published: March 2021

Purpose of review
Bladder cancer is the 10th most common cancer in the world and the 6th most common cancer among men. In the past few years, several new agents have been approved for the treatment of urothelial tumors. In this paper, we review the evolving treatment landscape of advanced urothelial carcinoma (UC).

Recent findings
Since 2016, the Food and Drug Administration (FDA) has approved five immunotherapies targeting programmed cell death 1/programmed cell death 1 legend, an antinectin-4 antibody drug conjugate (ADC), and a fibroblast growth factor receptor (FGFR) inhibitor for the treatment of patients with advanced UC. Moreover, there are multiple targeted agents, immune checkpoint inhibitors (ICI), ADCs, and their combinations currently being tested in clinical studies with the goal of obtaining FDA approval.

Summary
Precision oncology efforts continue to advance our understanding of the UC biology and transform the existing treatment paradigms. An enlarging arsenal of treatment options promises further personalization of UC therapy.
Highlighting recent treatment advances in metastatic prostate cancer: expanding the treatment arsenal
Authors: Gourdin Theodore 
Published: March 2021

Purpose of review
Present highlights from recent research examining the treatment of advanced prostate cancer.

Recent findings
Although debate remains about the optimal sequencing of docetaxel and novel androgen directed therapies in addition to androgen deprivation therapy (ADT) in the treatment of men with new metastatic prostate cancer, the novel LHRH antagonist relugolix seems poised to become an appealing option in a choice of initial ADT. Novel radioisotopes, genomically selected therapies, and immune therapy combinations show progress in opening up new treatment options for men with castration-resistant prostate cancer.

Summary
Although no clear consensus has emerged, evolving data continue to refine the selection of systemic therapies in treatment naïve metastatic prostate cancer. With potentially less cardiotoxic androgen deprivation therapies, novel radioisotopes, targeted pharmaceuticals, and immune therapy combinations, progress appears to be on the horizon in improving outcomes for men with advanced prostate cancer.
Supportive care centers: definition of excellence
Authors: Carla Ida Ripamonti , Maurizio Lucchesi 
Published: March 2021

Purpose of review
The current review is relevant because despite significant progress in oncology, a large proportion of patients with cancer still experience morbidity and symptoms, resulting from the cancer and/or its treatment.

Recent findings
The main theme concerns the definition of excellence of Supportive Care centers based on the indications of the Multinational Association Supportive Care Cancer (MASCC) because there are no data in literature on this topic.

Summary
Supportive care centers provide assistance to cancer patients suffering for anticancer treatments-related adverse effects. This leads to patient management with immediate evaluation and treatment of symptoms and therefore with improvement of quality of life and survival. In addition, there is less use of emergency room and hospitalizations with consequent savings of resources. According to MASCC evaluation criteria, some types of centers could be excellent in supportive care in cancer. Size, number of treated patients, or academic presence are not mandatory for the certification of excellence. However, centrality of patient and assessment of patient's needs, dedicated organizational models to evaluate and treat the adverse effects of anticancer treatments, dedicated activity and multidisciplinary staff, teaching programs, and adherence to guidelines are milestones for good clinical practices and consequently the centers that practice them represent the excellence in supportive care in cancer.
Teaching supportive care: what is the core curriculum?
Authors: Herrstedt Jørn , Molassiotis Alex 
Published: March 2021

Purpose of review
Cancer treatment options have developed rapidly in the past years. Targeted- and immune therapy have resulted in additional supportive care needs. This review describes a teaching program in supportive care.

Recent findings
Supportive care begins at the time of cancer diagnosis and continues until the patient has died or is cured and late toxicities and other survivorship issues have been properly addressed. Supportive care is divided into four phases. In the curative phase, competences regarding prevention and management of acute treatment and subacute treatment side effects are important. In the survivorship phase, competences related to late toxicity and chronic toxicity are warranted. In the palliative phase, focus will be on competences concerning cancer complications, and specific end-of-life competences are needed as well. Obviously some competences are needed in all phases, for example, communication skills.

Summary
Competences concerning symptoms and complications are summarized for each phase in table format. General competences are listed in the text body of the manuscript. Regular update and implementation is crucial. The future cancer population will consist of a higher number of older cancer patients and survivors. This should reflect curriculum updates as should the increasing possibilities for multigene sequencing enabling personal medicine (including supportive care) to a larger extent than today.
Standardization and Selection of High-risk Patients for Surgical Wound Infections in Plastic Surgery
Authors: Starnoni Marta , Pinelli Massimo , Porzani Silvia , Baccarani Alessio , De Santis Giorgio 
Published: March 2021

Background:
The aim of the present study was to show that the Infection Risk Index (IRI), based on only 3 factors (wound classification, American Society of Anesthesiologists score, and duration of surgery), can be used to standardize selection of infection high-risk patients undergoing different surgical procedures in Plastic Surgery.

Methods:
In our Division of Plastic Surgery at Modena University Hospital, we studied 3 groups of patients: Group A (122 post-bariatric abdominoplasties), Group B (223 bilateral reduction mammoplasties), and Group C (201 tissue losses with first intention healing). For each group, we compared surgical site infection (SSI) rate and ratio between patients with 0 or 1 risk factors (IRI score 0 or 1) and patients with 2 or 3 risk factors (IRI score 2 or 3).

Results:
In group A, patients with IRI score 0–1 showed an SSI Ratio of 2.97%, whereas patients with IRI score 2–3 developed an SSI ratio of 27.27%. In group B, patients with IRI score 0–1 showed an SSI ratio of 2.99%, whereas patients with IRI score 2–3 developed an SSI ratio of 18.18%. In group C, patients with IRI score 0–1 showed an SSI ratio of 7.62%, whereas patients with IRI score 2–3 developed an SSI ratio of 30.77%.

Conclusions:
Existing infection risk calculators are procedure-specific and time-consuming. IRI score is simple, fast, and unspecific but is able to identify patients at high or low risk of postoperative infections. Our results suggest the utility of IRI score in refining the infection risk stratification profile in Plastic Surgery.
Barriers to Accessing Mental Health Care After a Sexual Assault Medical Forensic Examination
Authors: Gilmore Amanda K. , Leone Ruschelle M. , Hahn Christine K. , Oesterle Daniel W. , Davidson Tatiana M. 
Published: March 2021

ABSTRACT

Background
Research indicates low rates of accessing mental health care following sexual assault; however, barriers associated with accessing care are not well understood.

Design
Participants (N = 37) were recruited from a local hospital following a sexual assault medical forensic examination (SAMFE). Hierarchical linear regressions models examined the effects of age, racial identity, student status, insurance status, relationship to perpetrator, time since assault, problematic drinking, and posttraumatic stress symptoms on (a) barriers to accessing care and (b) the likelihood of seeking mental health treatment at no charge.

Results
Lack of insurance was associated with more barriers to accessing mental health care and a higher likelihood of seeking post-SAMFE care at no charge. Posttraumatic stress symptoms were associated with more barriers to accessing care (p = 0.038). Identifying as a student (p = 0.026) and engaging in problematic drinking (p = 0.047) were associated with a lower likelihood of seeking post-SAMFE care, whereas increased symptoms of posttraumatic stress were associated with a greater likelihood of seeking post-SAMFE care (p = 0.007).

Conclusions
Providing post-SAMFE care, irrespective of insurance, may be a needed first step in addressing the mental health needs of individuals with recent sexual assault. Secondary prevention programs targeted toward alcohol misuse may also be warranted.
Coexistence of Sjögren syndrome in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome
Authors: Wang Lun , Yu Yanying , Zhang Shuo , Zhang Wen , Li Chen 
Published: March 2021

Abstract
To identify the prevalence and clinical characteristics of Sjögren syndrome (SS) in a Chinese single-center cohort of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome.
Patients diagnosed with SS were screened out from a cohort of 164 cases of SAHPO syndrome. Information regarding the patients’ gender, age at onset, clinical features, laboratory tests, bone scintigraphy, and treatment was reviewed.
Five patients were screened out. The prevalence of SS in SAPHO patients was 3.05% The mean onset age of SS was 48.0 ± 12.0 years old and no apparent time order in the occurrence of SAPHO and SS was observed. Compared with the general SAPHO cohort, the 5 SS patients exhibited no significant difference in the SAPHO related clinical features or inflammatory markers, except for a higher prevalence of peripheral joints and bones involvement in bone scintigraphy. Objective evidence of dryness and positive salivary gland biopsy were found in all the patients. However, the positive rates of SSA and SSB antibody were only 20%. Anti-inflammatory treatment for SS was recorded in 3 patients (ESSDAI score: 3 in 2 patients; 12 in 1 patient) with extra-glandular manifestations, severe complications or poor response to the basic treatment.
The prevalence of SS is higher in the SAPHO cohort than in the general Chinese population. Objective tests or biopsy might be more indicative than the antibody detection for SS diagnosis. Anti-inflammatory treatment should be prescribed in consideration of both the severity of SS and the demand for disease activity control of SAPHO.
Osteotomy combined with lateral ligament reconstruction in treating osteochondral lesion in patients with talar injury and varus ankle
Authors: Hu Mu , Xu Xiang-Yang 
Published: March 2021

Abstract
This study aimed to investigate the therapeutic effects of osteotomy combined with lateral ligament reconstruction on the osteochondral lesion of patients with talar injuries and varus ankles.
Seventy five patients with talar injuries and varus ankles who received osteotomy combined with lateral ligament reconstruction for the osteochondral lesions from June 2008 to December 2014 were retrospectively reviewed. Patients were followed up for 32.4 ± 15.3 months after surgeries, and the AOFAS-AH score, VAS score and SF36 score were determined preoperatively and postoperatively. The iconographic data were compared preoperatively and postoperatively, including tibial anterior surface angle (TAS), TTS, TT, and tibial lateral surface angle (TLS) angles.
After surgeries, the AOFAS-AF score increased from 43.2 ± 8.1 to 82.1 ± 5.6, the VAS score decreased from 6.9 ± 2.3 to 1.8 ± 1.5, and the SF36 score increased from 48.7 ± 9.4 to 83.5 ± 6.2. TAS increased from 83.3 ± 5.1 to 90.3 ± 6.1, TTS increased from 70.3 ± 6.1 to 82.5 ± 5.4, TT decreased from 12.9 ± 6.1 to 6.9 ± 5.7, and TLS increased from 76.5 ± 4.1 to 81.2 ± 3.3 (P < .05).
Osteotomy combined with lateral ligament reconstruction is effective for the treatment of talar osteochondral lesion with varus ankle, which could relieve the arthritic symptoms induced by cartilage lesions. By correcting the force line on lower limbs and metapedes with osteotomy completely, the treatments on talar osteochondral lesion and lateral ligament reconstruction are the critical factors with better results.
Effects of STC on postoperative recovery of disturbance of consciousness in traumatic multiple intracranial hematoma patients
Authors: Wang Dan , Zhou Zhulin , Zhang Bingjie , Zhang Bo , Yang Hongfa 
Published: March 2021

Abstract

Objective:
The study explored the therapeutic value of standard trauma craniectomy (STC) for the treatment of traumatic multiple intracranial hematoma.

Methods:
Clinical data of traumatic multiple intracranial hematoma patients who underwent surgical treatment in 2014 and 2015 were collected. The STC group and a control group according to the surgical mode, 48 and 30 cases were randomly selected from each group, respectively. Statistical analysis was performed on the change in the Glasgow coma scale (GCS) score from before the operation to 1 day, 1 week and 1 month postoperatively through repeated analysis of variance and Wilcoxon rank-sum analysis.

Results:
Significant differences in the GCS were observed at different time points for the two operative modes (P < .01), and an interaction was observed between time and treatment groups (P < .05). The rates of change of the GCS score for the two surgical modes were most obviously different at 3 days and 1 week postoperatively (P ≤ .001, P < .01). No statistically significant differences were observed in the rates of change of the GCS at 1 month postoperatively (P > .05).

Conclusions:
Compared to conventional craniotomy, STC has obvious effects on the recovery after disturbance of consciousness at 1 week postoperatively but does not result in a significant improvement in recovery at 1 month postoperatively.
Clinical seizures and unfavorable brain MRI patterns in neonates with hypoxic ischemic encephalopathy
Authors: Lin Yen-Kuang , Hwang-Bo Seok , Seo Yu-Mi , Youn Young-Ah 
Published: March 2021

Abstract
The aim was to examine whether clinical seizures and amplitude-integrated electroencephalogram (aEEG) patterns in infants with hypoxic ischemic encephalopathy (HIE) can predict the extent of brain injury on magnetic resonance images (MRI) and the long-term neurodevelopmental outcomes at 18∼24 months of age.
HIE infants who underwent therapeutic hypothermia (TH) between June 2014 and March 2017 were included in this study. Infants with clinical seizure were analyzed for aEEG patterns and the extent of brain injury on MRI findings. Clinical seizure, aEEG, and brain MRI were assessed and compared with neurodevelopmental outcomes at 18∼24 months of age.
Among the 97 HIE infants enrolled in this study with brain MRI scans, 78 (73.1%) TH-treated HIE infants exhibited clinical seizures. More abnormalities on a EEGs and more significant use of first and second antiepileptic drugs (AEDs) were significantly higher in the clinical-seizure group with longer hospitalized days. At a corrected 18 to 24 months of age, HIE infants in the clinical-seizure group with more extension of injury lesions on diffusion-weighted MRI scans exhibited significantly more delayed neurodevelopment. A risk factor analysis indicated that male infants who stayed in the hospital for more than 11 days were at a higher risk of having clinical seizures. The lesion size in MRI greater than 37 pixels was a risk factor with an 81.8% accuracy.
Seizures in HIE infants may predict abnormal brain MRI scans and abnormal neurodevelopment at 18 to 24 months of age.