bluuebunny/crossref_metadata_2025_split huggingface dataset:
Falls as One of the Atypical Presentations of COVID-19 in Older Population
Authors: Gawronska Karolina , Lorkowski Jacek 
Published: February 2021

Introduction: Studies revealed COVID-19 atypical symptoms such as falls, delirium, confusion, dizziness, unusual fatigue in older patients. Falls in the older population and their consequences are one of the leading causes of disability; they significantly reduce the quality of life and lead to loss of independence and impaired social functioning. The aim of this study is to present the possible correlation between COVID-19 and diseases of the musculoskeletal system, in particular the occurrence of fall-related injuries. Significance: This article highlights the importance of falls as one of the atypical symptoms of COVID-19 infection in older adults, which is not directly associated with infection and could be misinterpreted. Methods: The conducted meta-analysis is based on a review of the scientific literature available in English, French, Dutch, Polish in the PubMed/MEDLINE, Cochrane Library, Embase, Scopus, PEDro, GBL databases from December 1, 2019 to July 30, 2020, covering Clinical Trial, Randomized Controlled Trial, Meta-Analysis, Systematic Reviews and Case Reports. The following keywords were taken into account: fall, (hip/pertrochanteric/proximal femur) fracture, aged and COVID-19. Twenty-seven references were accepted for final analysis. Results: It was found that symptoms such as falls observed in the older adults can be associated with COVID-19 infection. Falls and slips are also the most common mechanism for hip fracture during the pandemic outbreak. Conclusions: According to authors of this study, atypical presentations of COVID-19 should be considered when screening and testing the people at increased risk due to their age. However, further prospective studies are urgently needed to investigate the possible correlation between COVID-19 and falls in older adults.
The Biomechanical Properties of Cement-Augmented Pedicle Screws for Osteoporotic Spines
Authors: Wang Yuetian , Yang Lei , Li Chunde , Sun Haolin 
Published: February 2021

Study Design: This is a broad, narrative review of the literature. Objective: In this review, we describe recent biomechanics studies on cement-augmented pedicle screws for osteoporotic spines to determine which factors influence the effect of cement augmentation. Methods: A search of Medline was performed, combining the search terms “pedicle screw” and (“augmentation” OR “cement”). Articles published in the past 5 years dealing with biomechanical testing were included. Results: Several factors have been identified to impact the effect of cement augmentation in osteoporotic spines. These include the type of augmentation material, the volume of injected cement, the timing of augmentation, the severity of osteoporosis, the design of the pedicle screw, and the specific augmenting technique, among others. Conclusions: This review elaborates the biomechanics of cement-augmented pedicle screws, determines which factors influence the augmentation effect, and identifies the risk factors of cement leakage in osteoporotic bone, which might offer some guidance when using this technique in clinical practice. Further, we provide information about newly designed screws and recently developed augmentation materials that provide higher screw stability as well as fewer cement-related complications.
The Asymmetric Effects of Regional House Prices in the UK: New Evidence from Panel Quantile Regression Framework
Authors: Tzeremes Panayiotis 
Published: February 2021

This study unfurls the non-linear behaviour of regional house prices in the United Kingdom by employing quarterly observations spanning the period 1992Q1–2017Q4. Our enquiry aims at examining UK house prices within a multivariable framework and, more specifically, by employing panel quantile regression with fixed effect. In brief, the empirical findings obtained from these methodologies indicate that the UK house prices are influenced at lower and upper quantiles, and that precisely they are influenced by variables such as income, private sector housing starts and employment. We highly support that there is a strong heterogeneity among UK regions and that asymmetry may be one of the keys of the ripple effect. Particularly, the income shows a positively significant performance at lower and higher regional house prices. Moreover, the variables private sector housing starts and employment rate are statistically significant for house prices. Leveraging for first-time panel quantile regression for the case of regional house prices in the UK, policymakers will have a profound understanding of regional house prices. JEL Classifications: C22, R21, R31
Clinical Anatomy of the Anterior Meniscofemoral Ligament of Humphrey: An Original MRI Study, Meta-analysis, and Systematic Review
Authors: Pękala Przemysław A. , Rosa Mateusz A. , Łazarz Dominik P. , Pękala Jakub R. , Baginski Adam , Gobbi Alberto , Mann Mitchell R. , Tomaszewski Krzysztof A. , LaPrade Robert F. 
Published: February 2021

Background: The anterior meniscofemoral ligament (aMFL) of Humphrey is an anatomically variable fibrous band of connective tissue that attaches between the lateral aspect of the medial femoral condyle and posterior horn of the lateral meniscus, running posterior to the anterior cruciate ligament and anterior to the posterior cruciate ligament (PCL). The presence of an intact aMFL may contribute to stabilization of the lateral compartment of the knee joint. Purpose: The original magnetic resonance imaging (MRI) arm of this study aimed to assess the aMFL incidence among Polish patients. The goal of the systematic review and meta-analysis was to review the literature discussing the clinical anatomy of the aMFL and provide data on its prevalence. It was hypothesized that significant heterogeneity exists within the published literature. Study Design: Cross-sectional study and systematic review; Level of evidence, 3. Methods: A retrospective investigation was performed on the MRI scans of 100 knees (52 right, 48 left) of Polish patients. Scans were randomly selected from a database of MRI examinations performed in 2019. For the meta-analysis, major online databases were queried for data on the aMFL, and 2 authors independently assessed and extracted data from all included studies. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool. Results: In the MRI arm of this study, the aMFL was found in 62 of the 100 lower limbs. The meta-analysis included 41 studies with a total of 4220 limbs. The aMFL was present in 55.5% (95% CI, 45.5%-65.3%) of cases. Arthroscopic studies yielded the highest prevalence (82.3% [95% CI, 36.6%-100.0%]); of MRI studies, the highest prevalence was at 3.0-T strength (51.0% [95% CI, 13.3%-88.2%]). Conclusion: Significant variability in the prevalence of the aMFL was found in the literature. More emphasis should be placed on the clinical relevance of injuries to the aMFL because of its significant role in the function of the knee. It is important to be aware that, because of the anatomy of the aMFL, the ligament can also function to support a torn PCL.
Chronic and Recurrent Rectus Femoris Central Tendon Ruptures in Athletes: Clinical Picture, MRI Findings, and Results of Surgical Treatment
Authors: Lempainen Lasse , Kosola Jussi , Valle Xavier , Puigdellivol Jordi , Ranne Juha , Orava Sakari , Pruna Ricard 
Published: February 2021

Background: Severe rectus femoris central tendon rupture is an uncommon sports-related injury. Most rectus femoris central tendon injuries can be treated by nonoperative means, but some tend to reinjure, resulting in chronic symptoms. Physicians treating athletes with rectus femoris injuries should be aware of this clinical condition and know that surgical treatment could be beneficial to the athlete if the rectus femoris central tendon rupture becomes chronic. Purpose: To describe the clinical picture, magnetic resonance imaging (MRI) findings, and surgical treatment results of rectus femoris central tendon injuries. Study Design: Case series; Level of evidence, 4. Methods: This study included 12 patients who underwent successful repair of recurrent rectus femoris central tendon rupture. Presurgical MRI scans were obtained and compared with the surgical findings. The time of return to play was recorded, and the outcome of surgical treatment was evaluated with validated Subjective Patient Outcome for Return to Sports (SPORTS) criteria: good = full return to preinjury level of sports without any symptoms; moderate = return to preinjury level of sports with some residual symptoms (mild discomfort during sports); and poor = did not return to preinjury level of sports. Results: Overall, 10 patients had a good outcome (83%), and 2 had a moderate outcome (17%). All athletes included in the study were able to return to sport at their preinjury levels 2.5 to 4 months postoperatively. Presurgical MRI scans correlated well with the surgical findings. Conclusion: The surgical treatment of rectus femoris central tendon rupture seems to be a good option in chronic and recurrent cases. After surgery and successful rehabilitation, the athlete is expected to continue sports at the preinjury level.
Early Outcomes and Complications Following Initiation of a Total Ankle Arthroplasty Program
Authors: Lundeen Gregory , Neary Kaitlin C. , Kaiser Cody , Jackson Lyle 
Published: February 2021

Background: Surgeons who lack experience with total ankle arthroplasty (TAA) may remain hesitant to introduce this procedure owing to previously published results of high complication rates during initial cases. The purpose of the present study was to report the development of a TAA program through intermediate outcomes and complications for an initial consecutive series of TAA patients of a single community-based foot and ankle fellowship–trained orthopedic surgeon with little TAA experience using a co-surgeon with similar training and TAA exposure. Methods: The initial 20 patients following third-generation TAA with a single surgeon were reviewed. Clinical outcomes were measured and radiographs were evaluated to determine postoperative implant and ankle position. Complications were also measured including intraoperative, early (<3 months), and intermediate postoperative complications. Results: With a minimum follow-up of 2 years and average follow-up of 51 months (range 24-70 months), the mean American Orthopaedic Ankle & Foot Society Ankle-Hindfoot score was 87.7 (59-100) and VAS was 1.0 (0-5.5). All patients were improved following TAA. Radiographic evaluation demonstrated no evidence of component malalignment or ankle joint incongruity. There were no intraoperative complications nor any wound complications. Three patients returned to the operating room for placement of medial malleolar screw placement, and 1 had asymptomatic tibial component subsidence. Conclusions: Orthopedic surgeons with a proper background and updated training may be able to perform TAA with good outcomes. A TAA program was developed to define minimum training criteria to perform this procedure in our community. Our complication rate is consistent with those reported in the literature for experienced TAA centers, which contrasts previous literature suggesting increased complication rates and worse outcomes when surgeons perform initial TAAs. Utilization of an orthopedic co-surgeon was felt to be instrumental in the success of the program. Level of Evidence: Level IV, retrospective case series.
Tofacitinib for the Treatment of Refractory Palmoplantar Psoriasis: A Case Series
Authors: Muzumdar Sonal , Leonardi Craig , Strober Bruce 
Published: February 2021

Background: Palmoplantar psoriasis can severely impact patient quality of life. Despite the influx of many new medications, it remains one of the most challenging psoriasis phenotypes to treat. Case Description: Herein, we present a case series of 7 patients with hyperkeratotic palmoplantar psoriasis refractory to systemic therapy who were successfully treated with tofacitinib, a Janus kinase (JAK) 1/3 inhibitor. Conclusions: Tofacitinib may be an effective therapy for the management of recalcitrant palmoplantar psoriasis. The efficacy of tofacitinib for the treatment of palmoplantar psoriasis might clarify the dependence on this subtype of psoriasis on specific cytokines that signal through JAK 1/3.
Rational selection of a biomarker panel targeting unmet clinical needs in kidney injury
Authors: van Duijl T. T. , Soonawala D. , de Fijter J. W. , Ruhaak L. R. , Cobbaert C. M. 
Published: February 2021

AbstractThe pipeline of biomarker translation from bench to bedside is challenging and limited biomarkers have been adopted to routine clinical care. Ideally, biomarker research and development should be driven by unmet clinical needs in health care. To guide researchers, clinical chemists and clinicians in their biomarker research, the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has developed a structured questionnaire in which the clinical gaps in current clinical pathways are identified and desirable performance specifications are predefined. In kidney injury, the high prevalence of the syndrome acute kidney injury (AKI) in the hospital setting has a significant impact on morbidity, patient survival and health care costs, but the use of biomarkers indicating early kidney injury in daily patient care remains limited. Routinely, medical labs measure serum creatinine, which is a functional biomarker, insensitive for detecting early kidney damage and cannot distinguish between renal and prerenal AKI. The perceived unmet clinical needs in kidney injury were identified through the EFLM questionnaire. Nephrologists within our tertiary care hospital emphasized that biomarkers are needed for (1) early diagnosis of in-hospital AKI after a medical insult and in critically ill patients, (2) risk stratification for kidney injury prior to a scheduled (elective) intervention, (3) kidney injury monitoring in patients scheduled to receive nephrotoxic medication and after kidney transplantation and (4) differentiation between prerenal AKI and structural kidney damage. The biomarker search and selection strategy resulted in a rational selection of an eleven-protein urinary panel for kidney injury that target these clinical needs. To assess the clinical utility of the proposed biomarker panel in kidney injury, a multiplexed LC–MS test is now in development for the intended translational research.
A scoping review of studies using observational data to optimise dynamic treatment regimens
Authors: Mahar Robert K. , McGuinness Myra B. , Chakraborty Bibhas , Carlin John B. , IJzerman Maarten J. , Simpson Julie A. 
Published: February 2021

Abstract
Background
Dynamic treatment regimens (DTRs) formalise the multi-stage and dynamic decision problems that clinicians often face when treating chronic or progressive medical conditions. Compared to randomised controlled trials, using observational data to optimise DTRs may allow a wider range of treatments to be evaluated at a lower cost. This review aimed to provide an overview of how DTRs are optimised with observational data in practice.

Methods
Using the PubMed database, a scoping review of studies in which DTRs were optimised using observational data was performed in October 2020. Data extracted from eligible articles included target medical condition, source and type of data, statistical methods, and translational relevance of the included studies.

Results
From 209 PubMed abstracts, 37 full-text articles were identified, and a further 26 were screened from the reference lists, totalling 63 articles for inclusion in a narrative data synthesis. Observational DTR models are a recent development and their application has been concentrated in a few medical areas, primarily HIV/AIDS (27, 43%), followed by cancer (8, 13%), and diabetes (6, 10%). There was substantial variation in the scope, intent, complexity, and quality between the included studies. Statistical methods that were used included inverse-probability weighting (26, 41%), the parametric G-formula (16, 25%), Q-learning (10, 16%), G-estimation (4, 6%), targeted maximum likelihood/minimum loss-based estimation (4, 6%), regret regression (3, 5%), and other less common approaches (10, 16%). Notably, studies that were primarily intended to address real-world clinical questions (18, 29%) tended to use inverse-probability weighting and the parametric G-formula, relatively well-established methods, along with a large amount of data. Studies focused on methodological developments (45, 71%) tended to be more complicated and included a demonstrative real-world application only.

Conclusions
As chronic and progressive conditions become more common, the need will grow for personalised treatments and methods to estimate the effects of DTRs. Observational DTR studies will be necessary, but so far their use to inform clinical practice has been limited. Focusing on simple DTRs, collecting large and rich clinical datasets, and fostering tight partnerships between content experts and data analysts may result in more clinically relevant observational DTR studies.
Expression and prognostic impact of FZDs in pancreatic adenocarcinoma
Authors: Li Yang , Liu Zirong , Zhang Yamin 
Published: February 2021

Abstract
Background
Despite the high number of researches on pancreatic adenocarcinoma (PAAD) over past decades, little progress had been made due to lack of effective treatment regimens. We aimed to investigate the expression level, mutation, and clinical significance of the Frizzled (FZD) family in PAAD so as to establish a sufficient scientific evidence for clinical decisions and risk management.

Methods
PAAD samples were extracted from The Cancer Genome Atlas (TCGA). Oncomine, Gene expression profiling interactive analysis (GEPIA), human protein atlas (HPA), Kaplan–Meier Plotter, cBioPortal, LinkedOmics, DAVID database, and R software (× 64 3.6.2) were used to comprehensively analyze the roles of FZDs. p value below to 0.05 was considered as significant difference.

Results
In total, 179 PAAD tissues and 171 paracancerous tissues were included. The expression levels of FZD1, 2, 6, 7, and 8 were higher in PAAD tissues than those in normal pancreatic tissue. The higher the expression levels of FZD2 and FZD7, the higher the clinical stage. The overall survival (OS) time was significantly different between low FZD3, 4, 5, 6, and 9 expression group and high expression group. Multivariable analysis showed that FZD3 and FZD6 were independent prognostic factors. The recurrence free survival (RFS) time was significantly different between low FZD4 and FZD8 expression group and high expression group. The RFS difference between low FZD6 expression group and high expression group had not reached statistical significance (p = 0.067), which might be due to the small sample size. However, multivariable analysis showed that FZD6 was the only independent factor for RFS. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that FZDs played a critical role in the Wnt signaling pathway, which was further confirmation that FZDs were transmembrane receptors of Wnt signaling pathway.

Conclusions
Our results strongly indicated a crucial role of the FZD family in PAAD. FZD3 and FZD6 could be potential prognostic and predictive markers, and FZD6 might also function as a potential therapeutic target in PAAD by blocking Wnt/β-catenin pathway.
A PET imaging study of the brain changes of glucose metabolism in patients with temporal lobe epilepsy and depressive disorder
Authors: Wen Jin-Feng , Guo Xin-Wen , Cao Xiang-Yi , Liao Ji-Wu , Ma Ping , Hu Xiang-Shu , Pan Ji-Yang 
Published: February 2021

Abstract
Background
This study aims to compare the difference of the brain changes of glucose metabolism between temporal lobe epilepsy patients (TLE) with major depressive disorder and temporal TLE without major depressive disorder.

Methods
A total of 24 TLE patients, who met the inclusion criteria of our hospital, were enrolled in this study. They were divided into a TLE with depression group (n = 11) and a TLE without depression group (n = 13), according to the results of the HAMD-24 Scale. Two groups patients were examined using 18F-FDG PET brain imaging.

Results
The low metabolic regions of the TLE with depression group were mainly found in the left frontal lobe, temporal lobe and fusiform gyrus, while the high metabolic regions of the TLE with depression group were mainly located in the right frontal lobe, visual joint cortex and superior posterior cingulate cortex. Both of the TLE groups had high metabolic compensation in the non-epileptic area during the interictal period.

Conclusions
There is an uptake difference of 18F-FDG between TLE patients with depression and TLE patients without depression in multiple encephalic regions.
Tenofovir disoproxil fumarate in pregnancy for prevention of mother to child transmission of hepatitis B in a rural setting on the Thailand-Myanmar border: a cost-effectiveness analysis
Authors: Bierhoff Marieke , Angkurawaranon Chaisiri , Rijken Marcus J. , Sriprawa Kanlaya , Kobphan Pachinee , Nosten Francois N. , van Vugt Michèle , McGready Rose , Devine Angela 
Published: February 2021

AbstractBackgroundHepatitis B Virus (HBV) is transmitted from mother to child which can be prevented via birth dose vaccine combined with three follow up hepatitis B vaccines, hepatitis B immunoglobulins (HBIG), and maternal antiviral treatment with Tenofovir Disoproxil Fumarate (TDF). This study evaluates the cost effectiveness of six strategies to prevent perinatal HBV transmission in a resource limited setting (RLS) on the Thailand-Myanmar border.MethodsThe cost effectiveness of six strategies was tested by a decision tree model in R. All strategies included birth and follow up vaccinations and compared cost per infection averted against two willingness to pay thresholds: one-half and one gross domestic product (GDP) per capita. Strategies were: 1) Vaccine only, 2) HBIG after rapid diagnostic test (RDT): infants born to HBsAg+ are given HBIG, 3) TDF after RDT: HBsAg+ women are given TDF, 4) TDF after HBeAg test: HBeAg+ women are given TDF, 5) TDF after high HBV DNA: women with HBV DNA > 200,000 are given TDF, 6) HBIG & TDF after high HBV DNA: women with HBV DNA > 200,000 are given TDF and their infants are given HBIG. One-way and probabilistic sensitivity analyses were conducted on the cost-effective strategies.ResultsVaccine onlywas the least costly option withTDF after HBeAg teststrategy as the only cost-effective alternative.TDF after HBeAg testhad an incremental cost-effectiveness ratio of US$1062; which would not be considered cost-effective with the lower threshold of one-half GDP per capita. The one-way sensitivity analysis demonstrated that the results were reasonably robust to changes in single parameter values. The PSA showed thatTDF after HBeAg testhad an 84% likelihood of being cost effective at a willingness to pay threshold of one GDP per capita per infection averted.ConclusionsWe found thatTDF after HBeAg testhas the potential to be cost-effective if TDF proves effective locally to prevent perinatal HBV transmission. The cost of TDF treatment and reliability of the RDT could be barriers to implementing this strategy. WhileTDF after RDTmay be a more feasible strategy to implement in RLS,TDF after HBeAg testis a less costly option.