bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training physicians in India to interpret pediatric chest radiographs according to World Health Organization research methodology
Authors: McCollum Eric D. , Higdon Melissa M. , Fancourt Nicholas S. S. , Sternal Jack , Checkley William , De Campo John , Shet Anita 
Published: March 2021

Abstract
Background
Chest radiography is the standard for diagnosing pediatric lower respiratory infections in low-income and middle-income countries. A method for interpreting pediatric chest radiographs for research endpoints was recently updated by the World Health Organization (WHO) Chest Radiography in Epidemiological Studies project. Research in India required training local physicians to interpret chest radiographs following the WHO method.

Objective
To describe the methodology for training Indian physicians and evaluate the training’s effectiveness.

Materials and methods
Twenty-nine physicians (15 radiologists and 14 pediatricians) from India were trained by two WHO Chest Radiography in Epidemiological Studies members over 3 days in May 2019. Training materials were adapted from WHO Chest Radiography in Epidemiological Studies resources. Participants followed WHO methodology to interpret 60 unique chest radiographs before and after the training. Participants needed to correctly classify ≥80% of radiographs for primary endpoint pneumonia on the post-training test to be certified to interpret research images. We analyzed participant performance on both examinations.

Results
Twenty-six of 29 participants (89.7%) completed both examinations. The average score increased by 9.6% (95% confidence interval [CI] 5.0–14.1%) between examinations (P<0.001). Participants correctly classifying ≥80% of images for primary endpoint pneumonia increased from 69.2% (18/26) on the pretraining to 92.3% (24/26) on the post-training examination (P=0.003). The mean scores of radiologists and pediatricians on the post-training examination were not statistically different (P=0.43).

Conclusion
Our results demonstrate this training approach using revised WHO definitions and tools was successful, and that non-radiologists can learn to apply these methods as effectively as radiologists. Such capacity strengthening is important for enabling research to support national policy decision-making in these settings. We recommend future research incorporating WHO chest radiograph methodology to consider modelling trainings after this approach.
Effects of lenalidomide on the bone marrow microenvironment in acute myeloid leukemia: Translational analysis of the HOVON103 AML/SAKK30/10 Swiss trial cohort
Authors:   on behalf of the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON) and Swiss Group for Clinical Cancer Research (SAKK), Brune Magdalena M. , Stüssi Georg , Lundberg Pontus , Vela Visar , Heim Dominik , Manz Markus G. , Haralambieva Eugenia , Pabst Thomas , Banz Yara , Bargetzi Mario , Grobholz Rainer , Fehr Martin , Cogliatti Sergio , Ossenkoppele Gert J. , Löwenberg Bob , Rudolf Christina Biaggi , Li Qiyu , Passweg Jakob , Mazzuchelli Luca , Medinger Michael , Tzankov Alexandar 
Published: March 2021

AbstractThis translational study aimed at gaining insight into the effects of lenalidomide in acute myeloid leukemia (AML). Forty-one AML patients aged 66 or older of the Swiss cohort of the HOVON-103 AML/SAKK30/10 study were included. After randomization, they received standard induction chemotherapy with or without lenalidomide. Bone marrow biopsies at diagnosis and before the 2nd induction cycle were obtained to assess the therapeutic impact on leukemic blasts and microenvironment. Increased bone marrow angiogenesis, as assessed by microvessel density (MVD), was found at AML diagnosis and differed significantly between the WHO categories. Morphological analysis revealed a higher initial MVD in AML with myelodysplasia-related changes (AML-MRC) and a more substantial decrease of microvascularization after lenalidomide exposure. A slight increase of T-bet-positive TH1-equivalents was identifiable under lenalidomide. In the subgroup of patients with AML-MRC, the progression-free survival differed between the two treatment regimens, showing a potential but not significant benefit of lenalidomide. We found no correlation between the cereblon genotype (the target of lenalidomide) and treatment response or prognosis. In conclusion, addition of lenalidomide may be beneficial to elderly patients suffering from AML-MRC, where it leads to a reduction of microvascularization and, probably, to an intensified specific T cell-driven anti-leukemic response.
Acute kidney injury adversely affects the clinical course of acute myeloid leukemia patients undergoing induction chemotherapy
Authors: Ballo Olivier , Eladly Fagr , Büttner Stefan , Stratmann Jan Alexander , Rudolf Sarah , Brunnberg Uta , Kreisel Eva-Maria , Steffen Björn , Wagner Sebastian , Finkelmeier Fabian , Serve Hubert , Brandts Christian H. 
Published: March 2021

AbstractAcute kidney injury (AKI) complicates the clinical course of hospitalized patients by increasing need for intensive care treatment and mortality. There is only little data about its impact on AML patients undergoing intensive induction chemotherapy. In this study, we analyzed the incidence as well as risk factors for AKI development and its impact on the clinical course of AML patients undergoing induction chemotherapy. We retrospectively analyzed data from 401 AML patients undergoing induction chemotherapy between 2007 and 2019. AKI was defined and stratified according to KIDGO criteria by referring to a defined baseline serum creatinine measured on day 1 of induction chemotherapy. Seventy-two of 401 (18%) AML patients suffered from AKI during induction chemotherapy. AML patients with AKI had more days with fever (7 vs. 5, p = 0.028) and were more often treated on intensive care unit (45.8% vs. 10.6%, p < 0.001). AML patients with AKI had a significantly lower complete remission rate after induction chemotherapy and, with 402 days, a significantly shorter median overall survival (OS) (median OS for AML patients without AKI not reached). In this study, we demonstrate that the KIDGO classification allows mortality risk stratification for AML patients undergoing induction chemotherapy. Relatively mild AKI episodes have impact on the clinical course of these patients and can lead to chronic impairment of kidney function. Therefore, we recommend incorporating risk factors for AKI in decision-making considering nutrition, fluid management, as well as the choice of potentially nephrotoxic medication in order to decrease the incidence of AKI.
Patientensicherheit in der Rheumatherapie
Authors: Sierocinski Elizabeth , Angelow Aniela , Mainz Armin , Walker Jochen , Chenot Jean-François 
Published: March 2021

Zusammenfassung
Hintergrund
Methotrexat (MTX) ist das das am häufigsten verordnete krankheitsmodifizierende Antirheumatikum. Ein regelmäßiges Labormonitoring wird empfohlen, um Nebenwirkungen wie Hepatotoxizität und Myelotoxizität sowie MTX-Toxizität-begünstigende Zustände wie eingeschränkte Nierenfunktion früh zu erkennen. Zudem wird eine prophylaktische Folsäuregabe empfohlen. Diese Arbeit untersucht, ob die empfohlene Kontrolluntersuchungen und Folsäureverordnungen während der MTX-Therapie durchgeführt werden.

Material und Methoden
Abrechnungsdaten der gesetzlichen Krankenkassen vom 01.01.2009 bis 31.12.2013 wurden analysiert. Aus der Forschungsdatenbank des InGef (Institut für angewandte Gesundheitsforschung Berlin, früher Health Risk Institute) wurden 40.087 Erwachsene mit einer kodierten rheumatischen Erkrankung (ICD-10-Codes M05–M18), ohne Karzinomdiagnose und ohne MTX-Verordnung ≥ 12 Monate vor Erstverordnung extrahiert. Es wurde analysiert, ob Laborkontrollen entsprechend den Handlungsempfehlungen, eine jährliche rheumatologische Betreuung sowie die Verordnung von Folsäure erfolgten.

Ergebnisse
Es begannen 12.451 Patienten eine neue MTX-Therapie im Beobachtungszeitraum. Das Blutbild, die Leberwerte und die Nierenfunktion wurden bei 42–46 % und der Urinstatus bei 14 % der Patienten wie empfohlen untersucht; 84 % befanden sich in regelmäßiger rheumatologischer Betreuung, und 74 % bekamen eine Folsäureprophylaxe. Möglicherweise MTX-assoziierte schwerwiegende Komplikationen wurden in 0,7 bis 3,5 Fällen/1000 Personenjahre beobachtet.

Diskussion
Kontrolluntersuchungen bei MTX-Therapie werden seltener als empfohlen durchgeführt. Möglicherweise MTX-assoziierte Komplikationen sind aus der Praxisperspektive sehr selten. Einerseits sind Maßnahmen für die bessere Koordination der Kontrolluntersuchungen erforderlich. Andererseits müssen der Nutzen des Monitorings und die Abstände der Monitoringintervalle durch empirische Untersuchungen besser belegt werden.
Implementing fast-track in total hip arthroplasty: rapid mobilization with low need for pain medication and low pain values
Authors: Götz Julia Sabrina , Leiss Franziska , Maderbacher Günther , Meyer Matthias , Reinhard Jan , Zeman Florian , Grifka Joachim , Greimel Felix 
Published: March 2021

Abstract
Introduction
Total hip arthroplasty (THA) is reported to be one of the most painful surgical procedures. Perioperative management and rehabilitation patterns are of great importance for the success of the procedure. The aim of this cohort study was the evaluation of function, mobilization and pain scores during the inpatient stay (6 days postoperatively) and 4 weeks after fast-track THA.

Materials and methods
A total of 102 consecutive patients were included in this retrospective cohort trial after minimally invasive cementless total hip arthroplasty under spinal anesthesia in a fast-track setup. The extent of mobilization under full-weight-bearing with crutches (walking distance in meters and necessity of nurse aid) and pain values using a numerical rating scale (NRS) were measured. Function was evaluated measuring the range of motion (ROM) and the ability of sitting on a chair, walking and personal hygiene. Furthermore, circumferences of thighs were measured to evaluate the extent of postoperative swelling. The widespread Harris Hip Score (HHS) was used to compare results pre- and 4 weeks postoperatively.

Results
Evaluation of pain scores in the postoperative course showed a constant decrease in the first postoperative week (days 1–6 postoperatively). The pain scores before surgery were significantly higher than surgery (day 6), during mobilization (p < 0.001), at rest (p < 0.001) and at night (p < 0.001). All patients were able to mobilize on the day of surgery. In addition, there was a significant improvement in independent activities within the first 6 days postoperatively: sitting on a chair (p < 0.001), walking (p < 0.001) and personal hygiene (p < 0.001). There was no significant difference between the measured preoperative and postoperative (day 6 after surgery) thigh circumferences above the knee joint. Compared to preoperatively, there was a significant (p < 0.001) improvement of the HHS 4 weeks after surgery. In 100% of the cases, the operation was reported to be successful and all of the treated patients would choose a fast-track setup again.

Conclusion
Application of a fast-track scheme is effective regarding function and mobilization of patients. Low pain values and rapid improvement of walking distance confirms the success of the fast-track concept in the immediate postoperative course. Future prospective studies have to confirm the results comparing a conventional and a fast-track pathway.
Eye movement alterations in presymptomatic C9orf72 expansion gene carriers
Authors: Behler Anna , Knehr Antje , Finsel Julia , Kunz Martin S. , Lang Christina , Müller Kathrin , Müller Hans-Peter , Pinkhardt Elmar H. , Ludolph Albert C. , Lulé Dorothée , Kassubek Jan 
Published: March 2021

AbstractObjectiveThe clinical manifestation of amyotrophic lateral sclerosis (ALS) is characterized by motor neuron degeneration, whereas frontotemporal dementia (FTD) patients show alterations of behavior and cognition. Both share repeat expansions inC9orf72as the most prevalent genetic cause. Before disease-defining symptoms onset, structural and functional changes at cortical level may emerge inC9orf72carriers. Here, we characterized oculomotor parameters and their association to neuropsychological domains in apparently asymptomatic individuals with mutations in ALS/FTD genes.Patients and methodsForty-eight carriers of ALS genes, without any clinical symptoms underwent video-oculographic examination, including 22 subjects withC9orf72mutation, 17 withSOD1, and 9 with other ALS associated gene mutations (n = 3KIF5A;n = 3FUS/FUS + TBK1;n = 1NEK1;n = 1SETX;n = 1TDP43). A total of 17 subjects underwent a follow-up measurement. Data were compared to 54 age- and gender-matched healthy controls. Additionally, mutation carriers performed a neuropsychological assessment.ResultsIn comparison to controls, the presymptomatic subjects performed significantly worse in executive oculomotor tasks such as the ability to perform correct anti-saccades. A gene mutation subgroup analysis showed that dysfunctions inC9orf72carriers were much more pronounced than inSOD1carriers. The anti-saccade error rate of ALS mutation carriers was associated with cognitive deficits: this correlation was increased in subjects withC9orf72mutation, whereasSOD1carriers showed no associations.ConclusionInC9orf72carriers, executive eye movement dysfunctions, especially the increased anti-saccade error rate, were associated with cognitive impairment and unrelated to time. These oculomotor impairments are in support of developmental deficits in these mutations, especially in prefrontal areas.
High-throughput STELA provides a rapid test for the diagnosis of telomere biology disorders
Authors: Norris Kevin , Walne Amanda J. , Ponsford Mark J. , Cleal Kez , Grimstead Julia W. , Ellison Alicia , Alnajar Jenna , Dokal Inderjeet , Vulliamy Tom , Baird Duncan M. 
Published: March 2021

AbstractTelomere biology disorders are complex clinical conditions that arise due to mutations in genes required for telomere maintenance. Telomere length has been utilised as part of the diagnostic work-up of patients with these diseases; here, we have tested the utility of high-throughput STELA (HT-STELA) for this purpose. HT-STELA was applied to a cohort of unaffected individuals (n = 171) and a retrospective cohort of mutation carriers (n = 172). HT-STELA displayed a low measurement error with inter- and intra-assay coefficient of variance of 2.3% and 1.8%, respectively. Whilst telomere length in unaffected individuals declined as a function of age, telomere length in mutation carriers appeared to increase due to a preponderance of shorter telomeres detected in younger individuals (< 20 years of age). These individuals were more severely affected, and age-adjusted telomere length differentials could be used to stratify the cohort for overall survival (Hazard Ratio = 5.6 (1.5–20.5); p < 0.0001). Telomere lengths of asymptomatic mutation carriers were shorter than controls (p < 0.0001), but longer than symptomatic mutation carriers (p < 0.0001) and telomere length heterogeneity was dependent on the diagnosis and mutational status. Our data show that the ability of HT-STELA to detect short telomere lengths, that are not readily detected with other methods, means it can provide powerful diagnostic discrimination and prognostic information. The rapid format, with a low measurement error, demonstrates that HT-STELA is a new high-quality laboratory test for the clinical diagnosis of an underlying telomeropathy.
Psychosocial impact of COVID-19 on cancer patients, survivors, and carers in Australia: a real-time assessment of cancer support services
Authors: Edge Rhiannon , Mazariego Carolyn , Li Zhicheng , Canfell Karen , Miller Annie , Koczwara Bogda , Shaw Joanne , Taylor Natalie 
Published: March 2021

Abstract
Purpose
This study aimed to explore the psychosocial impacts of the coronavirus disease (COVID-19) pandemic on cancer patients, survivors, and carers in Australia.

Methods
Using real-time insights from two Cancer Council NSW services—131120 Information and Support Line and Online Community (CCOC) forums—we assessed service demand trends, distress levels (using the distress thermometer), and content from 131120 calls and online posts between 01 December 2019 and 31 May 2020. Emergent themes were identified through an inductive conventional content analysis with 131120 call notes, followed by a deductive directed content analysis on CCOC posts.

Results
In total, 688 COVID-19-related 131120 calls (n = 496) and online posts (n = 192) were analysed. Service demand peaked in March 2020 and self-reported distress peaked in May 2020 at an average of 8/10 [Mean = 7.5; SD = 0.9]. Five themes emerged from the qualitative analysis: psychological distress and fear of virus susceptibility, practical issues, cancer service disruptions, information needs, and carer Issues.

Conclusions
The psychosocial impacts of COVID-19 on people affected by cancer are multifaceted and likely to have long-lasting consequences. Our findings drove the development of six recommendations across three domains of support, information, and access. Cancer patients, survivors, and carers already face stressful challenges dealing with a cancer diagnosis or survivorship. The added complexity of restrictions and uncertainty associated with the pandemic may compound this. It is important that healthcare providers are equipped to provide patient-centred care during and after this crisis. Our recommendations provide points of consideration to ensure care is tailored and patient oriented.
Sonic Hedgehog modulates the inflammatory response and improves functional recovery after spinal cord injury in a thoracic contusion–compression model
Authors: Zhang Hao , Younsi Alexander , Zheng Guoli , Tail Mohamed , Harms Anna-Kathrin , Roth Judith , Hatami Maryam , Skutella Thomas , Unterberg Andreas , Zweckberger Klaus 
Published: March 2021

Abstract
Purpose
The Sonic Hedgehog (Shh) pathway has been associated with a protective role after injury to the central nervous system (CNS). We, therefore, investigated the effects of intrathecal Shh-administration in the subacute phase after thoracic spinal cord injury (SCI) on secondary injury processes in rats.

Methods
Twenty-one Wistar rats were subjected to thoracic clip-contusion/compression SCI at T9. Animals were randomized into three treatment groups (Shh, Vehicle, Sham). Seven days after SCI, osmotic pumps were implanted for seven-day continuous intrathecal administration of Shh. Basso, Beattie and Bresnahan (BBB) score, Gridwalk test and bodyweight were weekly assessed. Animals were sacrificed six weeks after SCI and immunohistological analyses were conducted. The results were compared between groups and statistical analysis was performed (p < 0.05 was considered significant).

Results
The intrathecal administration of Shh led to significantly increased polarization of macrophages toward the anti-inflammatory M2-phenotype, significantly decreased T-lymphocytic invasion and significantly reduced resident microglia six weeks after the injury. Reactive astrogliosis was also significantly reduced while changes in size of the posttraumatic cyst as well as the overall macrophagic infiltration, although reduced, remained insignificant. Finally, with the administration of Shh, gain of bodyweight (216.6 ± 3.65 g vs. 230.4 ± 5.477 g; p = 0.0111) and BBB score (8.2 ± 0.2 vs. 5.9 ± 0.7 points; p = 0.0365) were significantly improved compared to untreated animals six weeks after SCI as well.

Conclusion
Intrathecal Shh-administration showed neuroprotective effects with attenuated neuroinflammation, reduced astrogliosis and improved functional recovery six weeks after severe contusion/compression SCI.
Lipschitz classification of self-similar sets with overlaps
Authors: Wang Lian , Xiong Dong-Hong 
Published: March 2021

AbstractIn Rao et al. (Comptes Rendus Acad Sci Paris Ser I(342):191–196, 2006), Rao–Ruan–Xi solved an open question posed by David and Semmes and gave a complete Lipschitz classification of self-similar sets on$$\mathbb R$$Rwith touching structure. In this short note, by applying a matrix rearrangeable condition introduced in Luo (J Lond Math Soc 99(2):428–446, 2019), we generalize their result onto the self-similar sets with overlapping structure.
High-level laser therapy versus scalpel surgery in the treatment of oral lichen planus: a randomized control trial
Authors: Tarasenko Svetlana , Stepanov Mikhail , Morozova Elena , Unkovskiy Alexey 
Published: March 2021

Abstract
Objective
To compare the clinical effectiveness of various types of high-level laser therapy (HLLT) toward scalpel excision for the surgical treatment of erosive oral lichen planus (OLP).

Materials and methods
The total number of 128 individuals were enrolled in the study. The 35 did not meet the inclusion criteria due to malignancy signs and presence of diabetes mellitus. In total, 8 were lost to follow-up, and 10 were excluded from the analysis, due to analgesics intake. This way 75 patients with the erosive form of OLP were analyzed in three intervention groups (Er:YAG, n = 19; Nd:YAG, n = 15; Er:YAG + Nd:YAG combination, n = 20) and one control group with scalpel excision (n = 21). The therapy effectiveness has been assessed based on the comparison of salivary interleukin (IL)-1β, IL-6 and interferon (IFN)-γ preoperative levels to 14, 30 days, and 2 years postoperation, as well as pain level and time of epithelization.

Results
All HLLT groups demonstrated a significantly (p > 0.05) higher IL-1β, IL-6, IFNγ and pain level reduction and quicker epithelization toward the control group on the 30th day, except Nd:YAG in case of IFNγ level. The highest IL-1β, IFNγ and pain level reduction and quicker epithelization on the 30th day was observed in Er:YAG group, followed by Er:YAG + Nd:YAG combination, Nd:YAG respectively. However no significant difference was observed between the HLLT groups with regard to IL-6 level reduction. After a 2-year follow-up, no significant difference was observed between all study groups with regard to all variables.

Conclusion
HLLT yields a superior clinical outcome compared to the scalpel excision for the surgical treatment of oral lichen planus, whereby the Er:YAG has been proposed as the most effective laser type at the end of the first postoperative month.

Clinical relevance
For the surgical treatment of erosive OLP the Er:YAG laser may be a preferable treatment option compared to Nd:YAG and scalpel surgery.

Trial registration
The present trial was registered retrospectively in the German Clinical Trials Register, as a member of WHO international clinical trials registry platform, on the 18.03.2020 with the following number: DRKS00020986