bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-Reported and Radiographic Outcomes of Joint-Preserving Surgery for Rheumatoid Forefoot Deformities
Authors: Yano Koichiro , Ikari Katsunori , Tobimatsu Haruki , Okazaki Ken 
Published: January 2021

Background:
Rheumatoid arthritis (RA) is an autoimmune disorder and a chronic inflammatory disease that can damage joints throughout the body. As dramatic improvements in medical treatment have contributed to reduced progression of joint destruction, surgical methods for the treatment of RA-related forefoot deformities have gradually changed from joint-sacrificing to joint-preserving. The aim of this study was to assess the long-term outcomes, including patient-reported outcomes, of joint-preserving surgery for forefoot deformities associated with RA.

Methods:
This retrospective study included 105 feet in 89 patients with RA who were treated during the period of January 2012 to May 2015 and had a minimum of 5 years of follow-up (mean, 6.0 ± 0.9 years). The patient-reported outcome measure used was the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), which was completed preoperatively and at the latest follow-up (n = 53 feet). The hallux valgus angle (HVA), the intermetatarsal angle (IMA), and the position of the medial sesamoid were measured preoperatively, at 3 months postoperatively, and at the latest follow-up. Cases of delayed wound-healing, hallux valgus recurrence, nonunion at the osteotomy sites, and reoperation were recorded. Kaplan-Meier survival curves were used to determine the estimated survivorship, with reoperation as the end point.

Results:
Scores of all 5 subscales of the SAFE-Q demonstrated significant improvement at the latest follow-up. The average HVA and IMA decreased significantly 3 months postoperatively, and these measurements remained significantly lower than the preoperative values (p < 0.01). The position of the medial sesamoid at the latest follow-up improved significantly (p < 0.01). Delayed wound-healing was found at the site of surgery in 21 (20.0%) of the 105 feet. Recurrence of hallux valgus was observed in 11 (10.5%) of the feet. There was no case of nonunion at any osteotomy site. Eleven (10.5%) of the feet required reoperation. The estimated survivorship of the studied joint-preserving surgery at 7 years, with reoperation as the end point, was 89.5%.

Conclusions:
Satisfactory long-term patient-reported and radiographic outcomes after joint-preserving surgery for forefoot deformities associated with RA can be achieved.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Comparison of Magnetically Controlled Growing Rods with Other Distraction-Based Surgical Technologies for Early-Onset Scoliosis
Authors: Bednar E. Dimitra , Bergin Brad , Kishta Waleed 
Published: January 2021

Background:
Severe and progressive early-onset scoliosis (EOS) has a serious prognosis including cardiopulmonary compromise. Growth-friendly technologies are the current surgical standard of care. Magnetically controlled growing rods (MCGRs) are newer implants with the potential for better quality of life and cost savings; however, they have not been well compared with the traditional distraction-based implants. The objective of this study was to compare the surgical outcomes, complications, metal ion levels, quality-of-life outcomes, and cost of MCGRs with other distraction-based surgical technologies for the treatment of EOS.

Methods:
The MEDLINE, Embase, and Web of Science databases were searched. Record screening and data abstraction were completed in duplicate. Summary outcomes were calculated in a meta-analysis, if heterogeneity was appropriate, using a fixed-effects model.

Results:
This systematic review and meta-analysis included 18 studies. MCGRs were as clinically effective as other distraction-based technologies, with no significant difference in the Cobb angle at the latest follow-up (mean difference [MD], 1.20°; 95% confidence interval [CI], −1.80° to 4.20°; p = 0.43) and a significantly lower complication rate (odds ratio, 0.42; 95% CI, 0.25 to 0.71; p = 0.001). Quality of life measured using the EOSQ-24 (24-Item Early-Onset Scoliosis Questionnaire) was better in the MCGR group compared with other technologies (MD, 2.18; 95% CI, 0.40 to 3.95; p = 0.02). Serum titanium levels were 2.98 ng/mL (95% CI, 1.41 to 4.55 ng/mL; p = 0.0002) greater in patients with MCGRs, but the clinical impact is unclear. MCGRs had greater cost for the device and insertion but became cost-neutral or cost-effective compared with other technologies by 4 years postoperatively.

Conclusions:
MCGRs are clinically equivalent and cost-effective in the long term compared with other distraction-based technologies for the treatment of EOS.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Correlation of Macular Sensitivity Measures and Visual Acuity to Vision-related Quality of Life in Patients with Age-related Macular Degeneration
Authors: Forshaw Thomas Richard Johansen , Parpounas Alexandra Kalia , Sørensen Torben Lykke 
Published: January 2021

Abstract
Background: Visual acuity is commonly used as a functional outcome measure in patients with age-related macular degeneration (AMD), despite having a weak correlation with self-perceived visual quality of life. Microperimetry is a useful method of detecting loss of macular function. We wanted to investigate the relationship between these two objective visual outcome measures and subjective vision-related quality of life, finding out which objective measure is more patient-relevant. Methods: Fifty-one consecutive patients with AMD were recruited to the study. Participants were required to complete the Visual Function Questionnaire 39, the Early Treatment Diabetic Retinopathy Study visual acuity examination and a microperimetry assessment using the Micro Perimeter 3. One patient withdrew consent and seven patients dropped out due to cooperation difficulties under microperimetry. Forty-three patients with AMD were included in the study: twenty-eight patients with late AMD (exudative AMD) and fifteen patients with early (non-exudative) AMD. The right eye was included as standard, as was the eye with the best-corrected visual acuity.Results: There was a higher correlation between vision-related quality of life and macular sensitivity (r=0.458; p=0.014) than between vision-related quality of life and visual acuity (r=0.446; p=0.018) in patients with late AMD. There was a positive correlation between vision-related quality of life and macular sensitivity in patients with early AMD (r=0.542; p=0.037) while the correlation between vision-related quality of life and visual acuity in these patients was not statistically significant. Composite score (r=0.469; p=0.012) correlated highest with the nasal outer macular sub-region and near-distance activities score (r=0.652; p<0.001) correlated highest with the nasal inner macular sub-region in patients with late AMD. Correlations between composite score and macular sub-regions in patients with early AMD were not significant, but near-distance activities score correlated with the nasal outer macular sub-region in these patients (r=0.469; p=0.012). Conclusions: Macular sensitivity as measured using microperimetry correlates significantly better with vision-related quality of life than visual acuity, showing it to be a more patient-relevant outcome measure in patients with late AMD. Furthermore, the nasal sub-regions of the macula appear to be preferred retinal loci in patients with AMD.
Factors Influencing Pre-Hospital and In-Hospital Delays at Time-To-Treatment and Complications in Stroke: A Prospective Cohort Study
Authors: Ghadimi Neda , Hanifi Nasrin , Dinmohammadi Mohammadreza 
Published: January 2021

Abstract
Background: The results of acute ischemic stroke (AIS) are highly affected by time-to-treatment. This study aimed at determining the factors influencing the in-hospital and pre-hospital delays in the complications and time-to-treatment in AIS. Methods: The present prospective study was carried out on 204 AIS patients referring to the stroke care unit in Zanjan, Iran (2019). To collected the required data, the patients and families were interviewed, as well as using the observations and records. The complication and mortality rates were recorded for 30 days after stroke via call follow-ups. Results: Based on the obtained results, the maximum delay was associated with the onset-to-arrival time (288.19 ±339.02 minutes). The logistic regression results indicated a statistically significant decline in the treatment via consultation after initiating the symptoms, transferring the patient to the hospital via emergency medical service, and the patients’ comprehension regarding the AIS symptoms. It was also found that an increase in the onset-to-treatment time (P <.001) and higher National Institutes of Health Stroke Scale (NIHSS) scores (P< .001) are the most critical factors related to the post-stroke complications. The higher age (P <.044) and NIHSS scores (P < .001) were considerably related to the mortality in AIS patients. Conclusion: It is essential to inform people regarding AIS indicators and referring to AIS treatment units to reduce the treatment time.
Local and Systemic Inflammation After Implantation of a Novel Iron Based Porous Degradable Bone Replacement Material in Sheep Model
Authors: Wegener Bernd , Behnke Maik , Milz Stefan , Jansson Volkmar , Redlich Christian , Hermanns Walter , Pieper Korbinian , Quadbeck Peter 
Published: January 2021

Abstract
Despite a high regenerative potential of healthy bone, replacement of large bone defects is an currently ongoing medical challenge. Due to a lack of mechanical stability of existing bone substitutes, recently developed degradable metallic alloys are an interesting alternative providing higher load bearing properties. Degradable iron-based alloys are an attractive innovation. Therefore, a degradable iron-based bone replacement material has been developed.To test the suitability of a newly designed iron-based alloy, an animal experiment was performed. Porous iron-based degradable implants with two different densities and a control group were tested. The implants were positioned in the proximal tibia. Over a period of 6 and 12 months, blood and histological parameters were monitored for signs of inflammation and degradation. Even if degradation at the desired rate was not achieved, in the histological evaluation of the implants` environment we found degraded particles, but no inflammatory reaction. Iron particles were also found within the popliteal lymph nodes on both sides. The serum blood levels of phosphorus, iron and ferritin in the long term groups were elevated. Other parameters did not show any changes.Iron-based degradable porous bone replacement implants showed a good biocompatibility in this experiment. For a clinical application, however, the rate of degradation would have to be significantly increased. Biocompatibility would then have to be re-evaluated.
Depletion of EREG Enhances the Osteo/Dentinogenic Differentiation Ability of Dental Pulp Stem Cells via P38 MAPK and Erk Pathway in Inflammatory Microenvironment
Authors: Ran Ran , Yang Haoqing , Cao Yangyang , Yan Wanhao , Zheng Ying , Jin Luyuan 
Published: January 2021

Abstract
Background Epiregulin (EREG) is an important component of EGF, which was demonstrated to promote the osteo/dentinogenic differentiation of stem cells from SCAPs. Whether it could stimulate the osteo/dentinogenic differentiation of DPSCs in inflammatory environment is not clear. The purpose of the present study was to investigate the role of EREG on the DPSCs’ osteo/dentinogenic differentiation ability in inflammatory environment. Methods DPSCs were isolated from human third molars. Short hairpin RNAs (shRNAs) was used to knock down the EREG expression in DPSCs. Recombinant human EREG protein (rhEREG) was adopted in the rescue experiment. TNF-α was employed to mimic the inflammatory environment in vitro. Alkaline phosphatase (ALP) staining, Alizarin red staining, quantitative calcium analysis, and real time RT-PCR was used to detect the osteo/dentinogenic differentiation markers and related signaling pathways under normal and inflammatory environment. Results EREG depletion promoted ALP activity and mineralization ability of DPSCs. Expression of BSP, DMP-1, and DSPP were also enhanced. Besides, 50ng/ml rhEREG treatment weakened the osteo/dentinogenic differentiation potential. 10 ng/mL TNF-α treatment for 4h increased the expression of EREG in DPSCs. However, knockdown of EREG rescued the impaired osteo/dentinogenic differentiation ability caused by TNF-α treatment. Further mechanism study showed that, EREG depletion activated p38 MAPK and Erk signaling pathways in DPSCs under normal and inflammatory environment. Conclusions Our results demonstrated that EREG could inhibited the osteo/dentinogenic differentiation potential of DPSCs via p38 MAPK and Erk signaling pathways in normal and inflammatory environment.
Genetic Architecture and Dynamics&nbsp;of PfKelch13’s Propeller Domain in Plasmodium Falciparum Clinical Isolates Collected in Senegal.
Authors: Pouye Mariama , Diop Gora , Derbois celine , Mbengue Babacar , Ka oumar , Thiam Fatou , Thiam Alassane , Thiam Laty , Cabannes Eric , Olaso Robert , Menard Didier , Deleuze Jean-François , Mbengue Alassane , Dieye Alioune 
Published: January 2021

Abstract
Plasmodium resistance to Artemisinin Combination-based Therapies (ACT) in Southeast Asia is a major public health concern that is sporadically appearing in Africa. Senegal has shifted from malaria control to elimination plans. Given notable progresses obtained through robust strategic plans, it is still crucial to assess genetic variability of the Plasmodium falciparum artemisinin resistance gene marker Kelch13 (PfKelch13) in circulating field isolates. We here report an analysis of PfKelch13-propeller polymorphism in clinical isolates collected nine years after ACT introduction in five Senegalese regions with different malaria transmission settings. Sequencing of PfKelch13-propeller domain from 280 clinical isolates reveals that 16% (45/280) of the parasite population harbored variants. Dynamics of PfKelch13 variants reveals emerging, persistent but also disappearing mutations over time. In addition to the malaria epidemiology, our survey also shows the dynamics of PfKelch13 variants in different malaria transmission settings in Senegal. Despite the absence of PfKelch13 associated artemisinin resistance mutations, a shift from 86% to 68% of PfKelch13WT was observed when comparing parasites collected prior vs. post ACT intensive usage in Dakar a low malaria transmission area. All together, our data confirms the need to closely monitor PfKelch13 polymorphism to anticipate and or prevent emergence of P. falciparum resistance in Senegal.
Long -Term Persistence of Antibodies Against Varicella in Fully Immunized Healthcare Workers: An Italian Retrospective Cohort Study
Authors: Bianchi Francesco , Tafuri Silvio , Larocca Angela , Germinario Cinzia , Stefanizzi Pasquale 
Published: January 2021

Abstract
Background. Chickenpox is a highly contagious disease caused by the varicella zoster virus (VZV), and in infants, adolescents, adults, pregnant women, and the immunocompromised it can be serious. The best way to prevent chickenpox is immunization with the varicella vaccine. Protective levels of antibodies induced by the varicella vaccine decline over time, but there is currently no formal recommendation for testing anti-varicella zoster virus (VZV) IgG levels in immunized healthcare workers (HCWs). Methods. The aims of this study were to evaluate the seroprevalence of circulating anti-VZV IgG in a sample a sample of students and residents of the medical school of the University of Bari, the long-term immunogenicity of the varicella vaccine, and the effectiveness of a strategy consisting of a third vaccine booster dose. The study population was screened as part of a biological risk assessment conducted between April 2014 and October 2020. A strategy for the management of non-responders was also examined. Results. The 182 students and residents included in the study had a documented history of immunization (two doses of varicella vaccine). The absence of anti-VZV IgG was determined in 34% (62/182; 95%CI=27.2–41.4%), with serosusceptibility more common among males than females (p<0.05). After a third varicella dose, seroconversion was achieved in 100% of this previously seronegative group. No serious adverse events were recorded. Conclusions. One-third of the study population immunized against VZV lacked a protective antibody titer, but a third dose of vaccine restored protection. Since it is highly unlikely that VZV will be eliminated in the immediate future, the loss of immunity in a substantial portion of the population implies a risk of varicella outbreaks in the coming years. Screening for varicella immunity in routine assessments of the biological risk of medical students and HCWs may help to prevent nosocomial VZV infections.
Stakeholder-engaged Research: Strategies for the Prevention and Control of Overweight and Obesity in Kenya
Authors: Wanjau Mary , Kivuti-Bitok Lucy , Aminde Leopold , Veerman Lennert 
Published: January 2021

Abstract
Background: This study was done as part of a larger study that aims to identify the most impactful and cost-effective strategies for the prevention and control of overweight and obesity in Kenya. Our objective was to involve stakeholders in the identification of the strategies that would be included in our larger study. The results from the stakeholders engagement are analyzed and reported in this paper. Design: This was a qualitative study. A one day stakeholder workshop that followed a deliberative dialogue process was conducted.Participants: A sample of stakeholders who participate in the national level policymaking process for health in Kenya. Outcome Measure: Strategies for the prevention and control of overweight and obesity in Kenya. Results: Out of the twenty-three stakeholders who confirmed attendance, fifteen participants attended the one-day workshop. The stakeholders identified a total of 24 strategies for the prevention and control of overweight and obesity in Kenya. From the ranking process carried out the top six strategies identified were: a research-based strategy for the identification of the nutritional value of indigenous foods, implementation of health promotion strategies that focus on the creation of healthy environments, physical activity behavior such as gym attendance, jogging, walking, and running at the individual level, implementation of school curricula on nutrition and health promotion, integration of physical education into the new Competency-Based Education policy, and policies that increase use of public transport.Conclusion The stakeholders identified and ranked strategies for the prevention and control of overweight and obesity in Kenya. This informs future overweight and obesity prevention research and policy in Kenya and similar settings.
Thermal Index for Early Non-invasive Assessment of Brain Injury in Newborns Treated With Therapeutic Hypothermia – Preliminary Report of Non-invasive Thermal Measurements
Authors: Walas Wojciech , Mączko Anna , Halaba Zenon , Bekiesińska-Figatowska Monika , Miechowicz Iza , Bandoła Dominka , Ostrowski Ziemowit , Rojczyk Marek , Nowak Andrzej 
Published: January 2021

Abstract
Perinatal asphyxia (PA) is the 3rd most common cause of neonatal death and one of the most common causes of severe neurological impairments in children. Current tools and measurements mainly based on the analysis of clinical evaluation and laboratory and electrophysiological tests do not give consistent data allowing to predict the severity of hypoxic-ischemic encephalopathy (HIE) until an magnetic resonance imaging (MRI) score is performed. The aim of this work is to evaluate the usefulness of the new index, called Thermal Index (TI) in the assessment of the degree of brain damage in newborns in the course of therapeutic hypothermia (TH) due to PA.This was a prospective, observational, pilot study which did not require any changes in the applicable procedures. Analysis has been applied to six newborn babies treated with TH in Neonatal/Paediatric ICU in University Hospital in Opole in 2018 due to PA. They all met criteria for TH according to the current recommendations. Brain MRI was performed after the end of TH when the children were brought back to normal temperature, with the use of 1.5 T scanner, using T1-, T2-weighted images, fluid-attenuated inversion recovery (FLAIR), inversion recovery (IR), susceptibility-weighted imaging (SWI), and diffusion-weighted imaging (DWI). The images were assessed using MRI score according to the scoring system proposed by Weeke et al. The Thermal Index assessing endogenous heat production was calculated according to the formula proposed in this paper. High, statistically significant positive correlation were found between MRI scores and TI values (0.98; p = 0.0003) in the 1st hour of therapy. High correlation with MRI assessment, the non-invasiveness of measurements and the availability of results within the first few hours of treatment, allow authors to propose the Thermal Index as a tool for early evaluating of the brain injury in newborns treated with TH. Further research is required to confirm the usefulness of the proposed method.
hiPSC-derived 3D Bioprinted Skeletal Muscle Tissue Implants Regenerate Skeletal Muscle Following Volumetric Muscle Loss
Authors: Jodat Yasamin A. , Zhang Ting , Tanoury Ziad Al , Kamperman Tom , Shi Kun , Huang Yike , Panayi Adriana , Endo Yori , Wang Xichi , Quint Jacob , Arnaout Adnan , Kiaee Kiavash , Hassan Shabir , Lee Junmin , Martinez Angel Flores Huidobro , Ochoa Sofia Lara , Lee KangJu , Calabrese Michelle , Carlucci Alessandro , Tamayol Ali , Sinha Indranil , Pourquié Olivier , Shin Su Ryon 
Published: January 2021

Abstract
Engineering of biomimetic tissue implants provides an opportunity for repairing volumetric muscle loss (VML), beyond a tissue’s innate repair capacity. Here, we present thick, suturable, and pre-vascularized 3D muscle implants containing human induced pluripotent stem cell-derived myogenic precursor cells (hiPSC-MPCs), which can differentiate into skeletal muscle cells while maintaining a self-renewing pool. The formation of contractile myotubes and millimeter-long fibers from hiPSC-MPCs is achieved in chemically, mechanically, and structurally tailored extracellular matrix-based hydrogels, which can serve as scaffolds to ultimately organize the linear fusion of myoblasts. Embedded multi-material bioprinting is used to deposit complex patterns of perfusable vasculatures and aligned hiPSC-MPC channels within an endomysium-like supporting gel to recapitulate muscle architectural integrity in a facile yet highly rapid manner. Moreover, we demonstrate successful graft-host integration and de novo muscle formation upon in vivo implantation of pre-vascularized constructs within a VML model. This work pioneers the engineering of large pre-vascularized hiPSC-derived muscle tissues toward next generation VML regenerative therapies.