bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combination of hyperbaric oxygen and core decompression therapies improve outcomes in the treatment of hip osteonecrosis
Authors: Bozkurt Ibrahim , Yalcin Nadir , Uluyardimci Enes , Akgul Esra Artvinli 
Published: April 2021

Introduction: To investigate whether combined treatment of hyperbaric oxygen (HBO) and core decompression (CD) result with better outcomes and have an additional influence on health quality scores when compared with HBO alone. Methods: 63 consecutive patients’ 80 hips (43 male, 20 female, 17 bilateral), diagnosed with Stage II Osteonecrosis of the femoral head were included in our study. The mean age at presentation in the HBO and CD + HBO groups were 39.9 years and 39.2 years, respectively. The mean follow-up was 39.8 months (24–56 months) for HBO group and 43.1 months (24–58 months) for the CD + HBO group. Standard radiographs and MRI were performed initially and during controls. Clinical outcomes were assessed using the modified Harris Hip Score (HHS), the visual analogue score (VAS) and SF-36 life quality score. Results: 52 hips (65%) were Ficat Stage IIa and 28 hips (35%) were IIb. Totally, 46 hips (30 hips IIa, 16 hips IIb) were in HBO alone group and 34 hips (22 hips IIa, 12 hips IIb) were in CD + HBO group. Both VAS and HHSs were improved in each group after treatment ( p < 0.001). When both groups were compared, this improvement was more distinct and evident in CD + HBO combination group than HBO alone group ( p < 0.001). The physical function and pain components of SF-36 survey were found to be different in between two groups ( p < 0.005). Discussion: HBO treatment decreases pain, increases functional scores for Ficat Stage II patients. Addition of HBO treatment to decompression of the femoral head improves the results better than HBO alone. In particular, reduction of pain is more prevalent for Stage IIa patients than IIb with combination of HBO and CD therapies.
Inpatient Insulin Pen Implementation, Waste, and Potential Cost Savings: A Community Hospital Experience
Authors: Najmi Urooj , Haque Waqas Zia , Ansari Umair , Yemane Eyerusalem , Alexander Lee Ann , Lee Christina , Demidowich Andrew P. , Motevalli Mahsa , Mackay Periwinkle , Tucker Cynthia , Notobartolo Cindy , Sartippour Poroshat , Raynor Jennifer , Zilbermint Mihail 
Published: April 2021

Background: Insulin pen injectors (“pens”) are intended to facilitate a patient’s self-administration of insulin and can be used in hospitalized patients as a learning opportunity. Unnecessary or duplicate dispensation of insulin pens is associated with increased healthcare costs. Methods: Inpatient dispensation of insulin pens in a 240-bed community hospital between July 2018 and July 2019 was analyzed. We calculated the percentage of insulin pens unnecessarily dispensed for patients who had the same type of insulin pen assigned. The estimated cost of insulin pen waste was calculated. A pharmacist-led task force group implemented hospital-wide awareness and collaborated with hospital leadership to define goals and interventions. Results: 9516 insulin pens were dispensed to 3121 patients. Of the pens dispensed, 6451 (68%) were insulin aspart and 3065 (32%) were glargine. Among patients on insulin aspart, an average of 2.2 aspart pens was dispensed per patient, but only an estimated 1.2 pens/patient were deemed necessary. Similarly, for inpatients prescribed glargine, an average of 2.1 pens/patient was dispensed, but only 1.3 pens/patient were necessary. A number of gaps were identified and interventions were undertaken to reduce insulin pen waste, which resulted in a significant decrease in both aspart (p = 0.0002) and glargine (p = 0.0005) pens/patient over time. Reductions in pen waste resulted in an estimated cost savings of $66 261 per year. Conclusions: In a community hospital setting, identification of causes leading to unnecessary insulin dispensation and implementation of hospital-wide staff education led to change in insulin pen dispensation practice. These changes translated into considerable cost savings and facilitated diabetes self-management education.
Perceptions of Psychotherapy Waiting Rooms: Design Recommendations
Authors: Noble Lilly , Devlin Ann Sloan 
Published: April 2021

Objective: This study fills the gap in literature by examining the design elements preferred in psychotherapy waiting rooms. Background: Studies have examined waiting rooms in hospitals and doctors’ offices, but there is little published literature on waiting rooms in psychotherapy offices. Waiting rooms in psychotherapy offices may affect clients’ perceived quality of care and their comfort level. Method: Psychotherapists in Connecticut and Rhode Island were interviewed and agreed to have the waiting rooms (20 in total) of their practices photographed. Then, in a within-subjects design, 250 participants (225 retained for analyses) from MTurk answered questions about the quality of care and comfort in the environment expected in those 20 waiting rooms. Results: Factor analytic results showed that waiting rooms that were welcoming and comfortable as well as large and spacious rated higher for the quality of care and comfort in the environment anticipated by the participant; those that were cramped and crowded rated lower. Few therapists reported any design education about counseling environments and none about the waiting room. Conclusion: Information from this study can guide the design of psychotherapy waiting rooms and enhance healthcare experience.
A Phase II, Multicenter, Randomized, Placebo-Controlled Study of Benralizumab, a Humanized Anti-IL-5R Alpha Monoclonal Antibody, in Patients With Eosinophilic Chronic Rhinosinusitis
Authors: Takabayashi Tetsuji , Asaka Daiya , Okamoto Yoshitaka , Himi Tetsuo , Haruna Shinichi , Yoshida Naohiro , Kondo Kenji , Yoshikawa Mamoru , Sakuma Yasunori , Shibata Kunihiko , Suzuki Motohiko , Kobayashi Masayoshi , Kawata Ryo , Tsuzuki Kenzo , Okano Mitsuhiro , Higaki Takaya , Takeno Sachio , Kodama Satoru , Yonekura Syuji , Saito Hiromi , Nozaki Akiyo , Otori Nobuyoshi , Fujieda Shigeharu 
Published: April 2021

Background Strong eosinophil infiltration in chronic rhinosinusitis with nasal polyp (CRSwNP) is highly associated with recalcitrance and higher nasal polyp recurrence rate after surgery. The prevalence of eosinophilic CRSwNP (ECRS) is increasing in Asian countries including Japan. Benralizumab is a humanized anti-IL-5R alpha monoclonal antibody that depletes eosinophils by antibody-dependent cell-mediated cytotoxicity. Objective To assess the efficacy and safety of benralizumab in patients with ECRS. Methods This phase II, randomized, double-blind, placebo-controlled study was conducted in Japan. Patients were randomized 1:2:2 to placebo, a single administration of benralizumab 30 mg, or benralizumab 30 mg every 4 weeks (q4w) for a total of three doses. The primary endpoint was the change in nasal polyp score from baseline at Week 12. Results Overall, 56 patients were enrolled (placebo, n = 11; benralizumab single dose, n = 22; benralizumab q4w, n = 23). Although the mean total nasal polyp score began to decrease after the initiation of benralizumab treatment, there were no statistically significant differences in change in nasal polyp score from baseline at Week 12 between benralizumab and placebo (placebo, −0.5 ± 0.8; benralizumab single, −0.3 ± 0.8; benralizumab q4w, −0.5 ± 1.5). Post-hoc analysis showed that the administration of benralizumab decreased nasal polyp scores ≥2 points in 42.2% of ECRS patients and that patients with high blood eosinophil levels had a greater tendency to respond to benralizumab treatment. The safety profile was similar to that in previous studies and no unexpected adverse events were noted. Conclusion Although benralizumab did not meet the primary efficacy endpoint, reductions of nasal polyp scores were seen in the benralizumab group compared with the placebo group over the whole study period, especially in patients with high levels of blood eosinophils.
Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study
Authors: Wan Zhong-Yuan , Zhang Jun , Shan Hua , Liu Tang-Fen , Song Fang , Samartzis Dino , Wang Hai-Qiang 
Published: April 2021

Study Design: Cross-sectional study. Objective: Recently, there has been a rise in children and adolescents developing low back pain and/or sciatica. Degenerative lumbar spine MRI phenotypes can occur in this population but reports have been sporadic and the true incidence of such spine changes remains debatable. As such, the study aimed to address the epidemiology of MRI phenotypes of the lumbar spine in this young population. Methods: 597 children and adolescents with lumbar MRIs were included in the study. T1- and T2-weighted lumbar images from L1/2 to L5/S1 were analyzed in axial and sagittal planes. Global phenotype assessment was performed of each level and based on established nomenclature protocols. Results: The cohort consisted of 57.3% (342) boys and 42.7% (255) girls, with a mean age of 10.75 ± 5.25 years (range: 0 to 18 years). The prevalence of imaging findings of lumbar disc degeneration (LDD) and lumbar disc herniation (LDH) were 2.2% (95% CI: 0.93–3.43) and 5.8% (95%CI: 2.58-8.99), respectively. There was significant difference between each disc segment from L1/2 to L5/S1 for both LDD and LDH. Schmorl’s nodes were noted in 16 cases (2.7%, youngest case as 15 years), with 11 boys (68.8%) and most frequent segment as L3/4. Modic changes and high-intensity zones were absent in this cohort. Conclusions: LDD can emerge as early as the first decade of life with Schmorl’s nodes, without additional specific phenotypes, including Modic changes and high-intensity zones. The study provides valuable information of a unique age group that is often under-represented but equally important as adults.
Effect of Leg Dominance on Medium- to Long-Term Functional Outcomes, Quality of Life, and Revision Rates After Isolated ACL Reconstruction
Authors: Uzun Erdal , Misir Abdulhamit , Guney Ahmet 
Published: April 2021

Background: The effect of leg dominance on short-term functional outcomes and return to sports after arthroscopic anterior cruciate ligament reconstruction (ACLR) has been evaluated. However, postoperative medium- to long-term recovery and revision rates are not well known. Purpose: To investigate whether leg dominance affects medium- to long-term clinical and functional scores and revision rates after ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Included in this study were 235 patients (205 male and 30 female) who underwent isolated arthroscopic ACLR. Patients were divided according to the leg dominance status of their injured limb into 2 groups: dominant leg injured (120 patients) and nondominant leg injured (115 patients). Preoperative and postoperative functional outcomes and health-related quality of life (HRQoL) were evaluated using the visual analog scale for pain, Tegner activity scale, Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee evaluation form, 36-Item Short Form Health Survey (SF-36), and overall patient satisfaction. Moreover, the revision rates of the 2 groups were compared according to leg dominance, patient characteristics, and operative features. Results: The mean follow-up period was 8.0 ± 2.3 years (range, 5-13 years). A significant preoperative to postoperative improvement in range of motion and functional scores was noticed in both groups ( P < .001 for all). However, the improvement was significantly higher in the dominant leg group for the Tegner ( P = .001), Lysholm ( P = .006), and IKDC ( P < .001) scores as well as for the SF-36 domain scores for general health ( P = .009), social role ( P = .048), and emotional role ( P = .032). Also, patient satisfaction was significantly higher in the dominant leg group ( P = .007). The dominant leg group was associated with a lower revision rate compared with the nondominant leg group (5.8% vs 15.7%, respectively; P = .015). Conclusion: High recovery rates were seen after arthroscopic ACLR, regardless of leg dominance. However, leg dominance had a significant effect on postoperative medium- to long-term functional outcomes, HRQoL, and revision rates.
Heme activates platelets and exacerbates rhabdomyolysis-induced acute kidney injury via CLEC-2 and GPVI/FcRγ
Authors: Oishi Saori , Tsukiji Nagaharu , Otake Shimon , Oishi Naoki , Sasaki Tomoyuki , Shirai Toshiaki , Yoshikawa Yuri , Takano Katsuhiro , Shinmori Hideyuki , Inukai Takeshi , Kondo Tetsuo , Suzuki-Inoue Katsue 
Published: April 2021

Abstract
There is increasing evidence that platelets participate in multiple pathophysiological processes other than thrombosis and hemostasis, such as immunity, inflammation, embryonic development, and cancer progression. A recent study revealed that heme (hemin)-activated platelets induce macrophage extracellular traps (METs) and exacerbate rhabdomyolysis-induced acute kidney injury (RAKI); however, how hemin activates platelets remains unclear. Here, we report that both C-type lectin-like receptor-2 (CLEC-2) and glycoprotein VI (GPVI) are platelet hemin receptors and are involved in the exacerbation of RAKI. We investigated hemin-induced platelet aggregation in humans and mice, binding of hemin to CLEC-2 and GPVI, the RAKI-associated phenotype in a mouse model, and in vitro MET formation. Using western blotting and surface plasmon resonance, we showed that hemin activates human platelets by stimulating the phosphorylation of SYK and PLCγ2 and directly binding to both CLEC-2 and GPVI. Furthermore, hemin-induced murine platelet aggregation was partially reduced in CLEC-2–depleted and FcRγ-deficient (equivalent to GPVI-deficient) platelets and almost completely inhibited in CLEC-2–depleted FcRγ-deficient (double-knockout) platelets. In addition, hemin-induced murine platelet aggregation was inhibited by the CLEC-2 inhibitor cobalt hematoporphyrin or GPVI antibody (JAQ-1). Renal dysfunction, tubular injury, and MET formation were attenuated in double-knockout RAKI mice. Furthermore, in vitro MET formation assay showed that the downstream signaling pathway of CLEC-2 and GPVI is involved in MET formation. We propose that both CLEC-2 and GPVI in platelets play an important role in RAKI development.
Prospective KIR genotype evaluation of hematopoietic cell donors is feasible with potential to benefit patients with AML
Authors: Shaffer Brian C. , Le Luduec Jean-Benoit , Park Soo , Devlin Sean , Archer Anne , Davis Eric , Cooper Candice , Nhaissi Melissa , Suri Beth , Wells Deborah , Tamari Roni , Papadopoulos Esperanza , Jakubowski Ann A. , Giralt Sergio , Hsu Katharine C. 
Published: April 2021

Abstract
Donor KIR and recipient HLA combinations that minimize inhibition and favor activation of the NK repertoire are associated with improved outcomes after allogeneic hematopoietic cell transplantation (HCT) in patients with myeloid neoplasia. We prospectively evaluated a weighted donor ranking algorithm designed to prioritize HLA-compatible unrelated donors (URDs) with weak inhibitory KIR3DL1/HLA-Bw4 interaction, followed by donors with nontolerized activating KIR2DS1, and finally those with KIR centromeric B haplotype. During donor evaluation, we performed KIR genotyping and ranked 2079 URDs for 527 subjects with myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML). Among all patients, 394 (75%) had at least 1 KIR-advantageous donor, and 263 (50%) underwent HCT. In patients with AML, KIR3DL1 weak inhibition provided protection from relapse. Compared with KIR3DL1-Weak Inhibiting donors, KIR3DL1-Noninteracting donors were associated with increased risk of relapse (HR, 2.97; 95% CI, 1.33-6.64; P = .008) and inferior event-free survival (EFS; HR, 2.14; 95% CI, 1.16-3.95; P = .015). KIR3DL1-Strong Inhibiting donors were associated with HR, 1.65 (95% CI, 0.66-4.08; P = .25) for AML relapse and HR, 1.6 (95% CI, 0.81-3.17; P = .1) for EFS when compared with the use of KIR3DL1-weak inhibiting donors. Donor KIR2DS1/HLA-C1 status and centromeric KIR haplotype-B content were not associated with decreased risk of AML relapse. There was no benefit to KIR-based donor selection in patients with MDS. This study demonstrates that donor KIR typing is feasible, and prioritization of donors with certain KIR3DL1 genotypes may confer a protection from relapse after HCT in patients with AML.
The landscape of copy number variations in classical Hodgkin lymphoma: a joint KU Leuven and LYSA study on cell-free DNA
Authors: Buedts Lieselot , Wlodarska Iwona , Finalet-Ferreiro Julio , Gheysens Olivier , Dehaspe Luc , Tousseyn Thomas , Fornecker Luc-Matthieu , Lazarovici Julien , Casasnovas René-Olivier , Gac Anne-Claire , Bonnet Christophe , Bouabdallah Kamal , Copie-Bergman Christiane , Fabiani Bettina , Dierickx Daan , Marcelis Lukas , Vermeesch Joris , André Marc , Vandenberghe Peter 
Published: April 2021

Abstract
The low abundance of Hodgkin/Reed-Sternberg (HRS) cells in lymph node biopsies in classical Hodgkin lymphoma (cHL) complicates the analysis of somatic genetic alterations in HRS cells. As circulating cell-free DNA (cfDNA) contains circulating tumor DNA (ctDNA) from HRS cells, we prospectively collected cfDNA from 177 patients with newly diagnosed, mostly early-stage cHL in a monocentric study at Leuven, Belgium (n = 59) and the multicentric BREACH study by Lymphoma Study Association (n = 118). To catalog the patterns and frequencies of genomic copy number aberrations (CNAs), cfDNA was sequenced at low coverage (0.26×), and data were analyzed with ichorCNA to yield read depth-based copy number profiles and estimated clonal fractions in cfDNA. At diagnosis, the cfDNA concentration, estimated clonal fraction, and ctDNA concentration were significantly higher in cHL cases than controls. More than 90% of patients exhibited CNAs in cfDNA. The most frequent gains encompassed 2p16 (69%), 5p14 (50%), 12q13 (50%), 9p24 (50%), 5q (44%), 17q (43%), 2q (41%). Losses mostly affected 13q (57%), 6q25-q27 (55%), 4q35 (50%), 11q23 (44%), 8p21 (43%). In addition, we identified loss of 3p13-p26 and of 12q21-q24 and gain of 15q21-q26 as novel recurrent CNAs in cHL. At diagnosis, ctDNA concentration was associated with advanced disease, male sex, extensive nodal disease, elevated erythrocyte sedimentation rate, metabolic tumor volume, and HRS cell burden. CNAs and ctDNA rapidly diminished upon treatment initiation, and persistence of CNAs was associated with increased probability of relapse. This study endorses the development of ctDNA as gateway to the HRS genome and substrate for early disease response evaluation.
CDX2 regulates ACE expression in blood development and leukemia cells
Authors: El Omar Reine , Julien Emmanuelle , Biasch Katia , Guffroy Blandine , Lioure Bruno , Vallat Laurent , Gross Isabelle , Domon-Dell Claire , Lanza François , Gachet Christian , Negroni Matteo , Freund Jean-Noël , Tavian Manuela 
Published: April 2021

Key PointsExpression of caudal-related homeobox gene 2 (CDX2) and angiotensin-converting enzyme (ACE) correlates during hematopoietic emergence. This emergence occurs in human and mouse embryos and in human acute myeloid leukemia; CDX2 homeoprotein also binds to the ACE promoter.
Laser Additive Manufacturing on Metal Matrix Composites: A Review
Authors: Li Neng , Liu Wei , Wang Yan , Zhao Zijun , Yan Taiqi , Zhang Guohui , Xiong Huaping 
Published: April 2021

AbstractImportant progresses in the study of laser additive manufacturing on metal matrix composites (MMCs) have been made. Recent efforts and advances in additive manufacturing on 5 types of MMCs are presented and reviewed. The main focus is on the material design, the combination of reinforcement and the metal matrix, the synthesis principle during the manufacturing process, and the resulted microstructures as well as properties. Thereafter, the trend of development in future is forecasted, including: Formation mechanism and reinforcement principle of strengthening phase; Material and process design to actively achieve expected performance; Innovative structure design based on the special properties of laser AM MMCs; Simulation, monitoring and optimization in the process of laser AM MMCs.
Explaining demand patterns during COVID-19 using opportunistic data: a case study of the city of Munich
Authors: Mahajan Vishal , Cantelmo Guido , Antoniou Constantinos 
Published: April 2021

Abstract
Background
The COVID-19 pandemic is a new phenomenon and has affected the population’s lifestyle in many ways, such as panic buying (the so-called “hamster shopping”), adoption of home-office, and decline in retail shopping. For transportation planners and operators, it is interesting to analyze the spatial factors’ role in the demand patterns at a POI (Point of Interest) during the COVID-19 lockdown viz-a-viz before lockdown.

Data and Methods
This study illustrates a use-case of the POI visitation rate or popularity data and other publicly available data to analyze demand patterns and spatial factors during a highly dynamic and disruptive event like COVID-19. We develop regression models to analyze the correlation of the spatial and non-spatial attributes with the POI popularity before and during COVID-19 lockdown in Munich by using lockdown (treatment) as a dummy variable, with main and interaction effects.

Results
In our case-study for Munich, we find consistent behavior of features like stop distance and day-of-the-week in explaining the popularity. The parking area is found to be correlated only in the non-linear models. Interactions of lockdown with POI type, stop-distance, and day-of-the-week are found to be strongly significant. The results might not be transferable to other cities due to the presence of different city-specific factors.

Conclusion
The findings from our case-study provide evidence of the impact of the restrictions on POIs and show the significant correlation of POI-type and stop distance with POI popularity. These results suggest local and temporal variability in the impact due to the restrictions, which can impact how cities adapt their transport services to the distinct demand and resulting mobility patterns during future disruptive events.