bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conventional risk prediction models fail to accurately predict mortality risk among patients with coronavirus disease 2019 in intensive care units: a difficult time to assess clinical severity and quality of care
Authors: Endo Hideki , Ohbe Hiroyuki , Kumasawa Junji , Uchino Shigehiko , Hashimoto Satoru , Aoki Yoshitaka , Asaga Takehiko , Hashiba Eiji , Hatakeyama Junji , Hayakawa Katsura , Ichihara Nao , Irie Hiromasa , Kawasaki Tatsuya , Kurosawa Hiroshi , Nakamura Tomoyuki , Okamoto Hiroshi , Shigemitsu Hidenobu , Takaki Shunsuke , Takimoto Kohei , Uchida Masatoshi , Uchimido Ryo , Miyata Hiroaki 
Published: June 2021

AbstractSince the start of the coronavirus disease 2019 (COVID-19) pandemic, it has remained unknown whether conventional risk prediction tools used in intensive care units are applicable to patients with COVID-19. Therefore, we assessed the performance of established risk prediction models using the Japanese Intensive Care database. Discrimination and calibration of the models were poor. Revised risk prediction models are needed to assess the clinical severity of COVID-19 patients and monitor healthcare quality in ICUs overwhelmed by patients with COVID-19.
Analysis of hard tissue facial symmetry after unilateral mandibular reconstruction
Authors: Khaghaninejad Mohamad Saleh , Khojastepour Leila , Ahmadi Hanie , Tavanafar Saeid , Ebrahimi Alireza , Mahjoori-Ghasrodashti Mohammad 
Published: June 2021

AbstractBackgroundThis study aimed to determine how successful reconstruction of the mandible can recover the symmetry.Materials and methodsAll patients who underwent surgical treatment for unilateral mandibular reconstruction in 4 years were retrospectively examined. Bilateral differences of gonion (GO) positions were measured in 3 dimensions based on immediate postoperative computed tomography. The data collected was analyzed in 3 ways: First, the comparison of bilateral differences of GO in 3 dimensions. Second, the mean Asymmetry Index in control subjects was used to divide all cases into three groups: “Symmetry,” “Asymmetry,” and “Marked asymmetry.” Third, “maximum normal asymmetry” was calculated, and all cases were categorized as below and above maximum normal asymmetry. The difference between two gonial angles was used to determine the amount of asymmetry.ResultsForty-seven patients and 47 normal adults were enrolled. The mean bilateral GO difference in the control group was higher than in the study group patients, but it was not statistically significant. The mean Asymmetry Index for the control group was not also significantly higher than the study cases. The study group was “Symmetric” in 78.7% of the cases whereas the control group in 91.4%, 19.1% of the study group and 8.5% of controls were “Asymmetric,” and 2.1% of study cases and 0% of controls were “Markedly Asymmetric.” Maximum normal asymmetry was 82.9% in the study group and 97.8% in the control group. The mean differences between the right and left gonial angles were higher in the study group, but it was not significant (P= 0.1).ConclusionsOur study’s results showed that bilateral symmetry in mandibular reconstruction patients was satisfactory and similar to the normal individuals.
Evaluation of intra-tumoral (IT) SD-101 and pembrolizumab (Pb) in combination with paclitaxel (P) followed by AC in high-risk HER2-negative (HER2-) stage II/III breast cancer: Results from the I-SPY 2 trial.
Authors: Chien Amy Jo , Soliman Hatem Hussein , Ewing Cheryl Ann , Boughey Judy Caroline , Campbell Michael J. , Rugo Hope S. , Wallace Anne M. , Albain Kathy S. , Stringer-Reasor Erica Michelle , Church An L , Kalinsky Kevin , Elias Anthony D. , Mitri Zahi Ibrahim , Clark Amy Sanders , Nanda Rita , Thomas Alexandra , Yau Christina ,   I-SPY 2 Consortium, Berry Donald A , Esserman Laura 
Published: June 2021

508 Background: I-SPY 2 is a multicenter, phase 2 trial using response-adaptive randomization within molecular subtypes defined by receptor status and MammaPrint (MP) risk to evaluate novel agents as neoadjuvant therapy for women with high-risk breast cancer. SD-101 is an investigational Toll-like receptor 9 (TLR9) agonist CpG-C class oligodeoxynucleotide that stimulates the production of IFN-α and interleukin (IL)-12, functional maturation of plasmacytoid dendritic cells, and production of cytotoxic antibodies. IT SD-101 was combined with systemic anti-PD-1 antibody Pb to investigate the antitumor and immunologic activity of this novel immunotherapeutic strategy. Methods: Women with tumors ≥ 2.5cm were eligible for screening. Only pts (pts) with HER2- disease were eligible for this treatment. Treatment included weekly P x 12 in combination with IT SD-101 2 mg/ml (1 ml for T2 tumors, 2 ml for >T3 tumors) weekly x 4, then q3 weeks x 2, and IV Pb q3 weeks x 4, followed by doxorubicin/cyclophosphamide (AC) q2-3 weeks x 4 (SD-101+Pembro 4). Pts in the control arm received weekly P x 12 followed by AC q2-3 weeks x 4. The I-SPY 2 methods have been previously published. This investigational arm was eligible for graduation (>85% chance of success in a 300-person phase 3 neoadjuvant trial) in 3 of 10 pre-defined signatures: HER2-, hormone receptor (HR)+/HER2- and HR-/HER2-. Results: 75 pts were randomized and evaluable in SD-101+Pembro 4 treatment arm. The control arm included 329 historical controls enrolled since April 2010. The study arm was stopped due to maximal patient accrual. Pt characteristics were balanced; 56% HR+, 44% HR-. The probability that SD-101+Pembro4 was superior to control exceeded 97% for all eligible tumor signatures, but did not reach the threshold for graduation in any of the signatures. However, it is notable that the rate of pCR/Residual Cancer Burden 1 (RCB1) in the HR+/HER2- signature was 51%. Preliminary safety events for SD-101+Pembro 4 include increased rates of fever, neutropenia, febrile neutropenia, transaminitis, and immune-related events, including adrenal insufficiency. Conclusions: The SD-101+Pembro 4 regimen was active but did not meet the pre-specified threshold for graduation in I-SPY 2. pCR/RCB 1 analysis suggests improved response in the HR+/HER-negative signature compared to control. The clinical significance of these findings needs to be weighed against the potential risk of immune-related toxicities. Clinical trial information: NCT01042379. [Table: see text]
PCOS Features and Steroid Profiles Among Young Adult Women with a History of Premature Adrenarche
Authors: Tennilä Jussi , Jääskeläinen Jarmo , Utriainen Pauliina , Voutilainen Raimo , Häkkinen Merja , Auriola Seppo , Morin-Papunen Laure , Liimatta Jani 
Published: June 2021

Abstract

Context
Premature adrenarche (PA) may increase the risk for polycystic ovary syndrome (PCOS).

Objective
To study features of PCOS in young adult women with a history of PA.

Methods
Thirty PA and 42 control females were followed from prepuberty to young adulthood (median age 18.1 years). The main outcome measures were ovarian function, the use of contraceptives, and clinical and biochemical indicators of hyperandrogenism.

Results
We found no differences in the use of hormonal contraceptives (50 vs 50%, PA vs controls, respectively; P &gt; .999), indication for using contraceptives (P = .193), or in the history of oligo- (17 vs 26%, P = .392) and amenorrhea (0 vs 0%, P &gt; .999). Among women not using hormonal contraceptives, those with a history of PA had a higher prevalence of hirsutism (27 vs 0%, P = .023) but not acne (87 vs 67%, P = .252). Steroid profiles were broadly comparable between the groups, but PA women had lower sex hormone–binding globulin (SHBG) concentrations (30.1 vs 62.4 nmol/L, P &lt; .001) resulting in higher free androgen index (3.94 vs 2.14, P &lt; .001). The difference in SHBG levels persisted through body mass index adjustment. SHBG correlated negatively with the homeostasis model assessment for insulin resistance (r –0.498, P = .003). Anti-Müllerian hormone concentrations were comparable between the groups (39.3 vs 32.1 pmol/L, P = .619).

Conclusion
PA was not associated with evident ovarian dysfunction in young adult women. However, women with a history of PA had decreased SHBG levels and thus, increased bioavailability of circulating androgens.
Tall cell percentage alone in PTC without aggressive features should not guide patients’ clinical management
Authors: Poma Anello Marcello , Viola David , Macerola Elisabetta , Proietti Agnese , Molinaro Eleonora , De Vietro Dario , Elisei Rossella , Materazzi Gabriele , Miccoli Paolo , Basolo Fulvio , Ugolini Clara 
Published: June 2021

Abstract

Context
Recent diagnostic criteria updates of the tall cell variant of papillary thyroid carcinoma (TCPTC) by the World Health Organization (WHO) have determined the inclusion of tumors with 30% to 49% of tall cells. However, the impact of tall cell percentage on papillary thyroid carcinoma (PTC) patients’ prognosis is still debated.

Objective
We aimed to evaluate whether tall cell percentage affects patient outcome in the absence of aggressive features.

Methods
Rates of aggressive features, recurrence-free survival (RFS), and distant RFS (5-year median follow-up) were compared among tumors with less than 30%, 30% to 49% and at least 50% tall cells. We also evaluated the impact of the new tall cell cutoff on patient management.

Results
Overall, 3092 tumors (15.7% of all PTCs) were collected: A total of 792 PTCs had less than 30%, 503 had 30% to 49%, and 1797 had 50% or more tall cell areas. With the new WHO definition, the number of TCPTCs increased by 28%. There were no differences in recurrence rates according to tall cell percentage. The coexistence of BRAF and TERT promoter mutations predicted a worse RFS. Considering the new definition of TCPTC, the level of risk according to the American Thyroid Association increased from low to intermediate in 4.2% of cases. However, the recurrence rate within this subgroup was comparable to low risk.

Conclusion
TCPTC and PTC with tall cell areas can be considered as a unique group with similar recurrence risk. However, whenever aggressive features are absent, tumors have a low risk of recurrence independently of tall cell percentage.
SUMO proteases SENP3 and SENP5 spatiotemporally regulate the kinase activity of Aurora A
Authors: Yu Bin , Lin Qiaoyu , Huang Chao , Zhang Boyan , Wang Ying , Jiang Qing , Zhang Chuanmao , Yi Jing 
Published: June 2021

ABSTRACT
Precise chromosome segregation is mediated by a well-assembled mitotic spindle, which requires balance of the kinase activity of Aurora A (AurA, also known as AURKA). However, how this kinase activity is regulated remains largely unclear. Here, using in vivo and in vitro assays, we report that conjugation of SUMO2 with AurA at K258 in early mitosis promotes the kinase activity of AurA and facilitates the binding with its activator Bora. Knockdown of the SUMO proteases SENP3 and SENP5 disrupts the deSUMOylation of AurA, leading to increased kinase activity and abnormalities in spindle assembly and chromosome segregation, which could be rescued by suppressing the kinase activity of AurA. Collectively, these results demonstrate that SENP3 and SENP5 deSUMOylate AurA to render spatiotemporal control on its kinase activity in mitosis.
This article has an associated First Person interview with the first author of the paper.
Clinical and bacteriological outcomes in patients with urinary tract infections presenting to primary care in Harare, Zimbabwe: a cohort study
Authors: Olaru Ioana D. , Chisenga Mutsawashe , Yeung Shunmay , Chonzi Prosper , Masunda Kudzai P.E. , Ferrand Rashida A. , Kranzer Katharina 
Published: June 2021

Background: Treatment for urinary tract infections (UTIs) is usually empiric and is based on local antimicrobial resistance data. These data, however, are scarce in low-resource settings. The aim of this study is to determine the impact of antibiotic treatment on clinical and bacteriological outcomes in patients presenting with UTI symptoms to primary care in Harare. Methods: This cohort study enrolled participants presenting with UTI symptoms to 10 primary healthcare clinics in Harare between July 2019 and July 2020. A questionnaire was administered and a urine sample was collected for culture. If the urine culture showed growth of ≥105 colony forming units/mL of a uropathogen, a follow up visit at 7-21 days was conducted. Results: The analysis included 168 participants with a median age of 33.6 years (IQR 25.1-51.4) and of whom 131/168 (78.0%) were female. Effective treatment was taken by 54/168 (32.1%) participants. The urine culture was negative at follow up in 41/54 (75.9%) of participants who took appropriate treatment and in 33/114 (28.9%, p<0.001) of those who did not. Symptoms had improved or resolved in 52/54 (96.3%) of those on appropriate treatment and in 71/114 (62.3%, p<0.001) of those without. Conclusion: The findings of this study show that effective treatment leads to symptom resolution and bacterial clearance in people presenting with UTIs to primary care. Although UTIs are not life-threatening and can resolve without treatment, they do impact on quality of life, highlighting the need for optimised treatment recommendations.
An Irish Nationalist Perspective on Eastern Europe: William Smith O’Brien’s Travel Journals, 1861-1864
Authors: Healy Róisín 
Published: June 2021

An Irish Nationalist Perspective on Eastern Europe: William Smith O’Brien’s Travel Journals, 1861-1864
The travel journals of Irish nationalist politician William Smith O’Brien, challenge the claim by Lar-ry Wolff of a general western European condescension towards eastern Europe from the eighteenth century onwards. Hostility towards British rule in Ireland led Smith O’Brien to celebrate and identify with the Hungarians and Poles in their struggles against their imperial rulers during his travels in the 1860s. He concluded, however, that the Irish suffered more under Britain than these nations under either Austria or Russia.
La imparcialidad en la imposición de sanciones a los servidores públicos en Colombia en la ley 734 de 2002
Authors: Carmona Giraldo Natalia 
Published: June 2021

El régimen disciplinario como elemento básico de la organización estatal, para cumplir los fines del Estado Social de Derecho, respecto al principio de imparcialidad en los procesos que se adelantan en contra de los servidores públicos, principio que se ve vulnerado, por la misma norma, que otorga amplias facultades a la Procuraduría General de la Nación, en el presente artículo se abordará el origen del problema, se definirá la imparcialidad desde la visión de la Corte Constitucional y la Corte Interamericana de Derechos Humanos, y por último se hará un estudio de caso jurisprudencial del principio de imparcialidad; se tratará de explicar el ejercicio del principio de la imparcialidad en la imposición de sanciones a los servidores públicos en Colombia en la Ley 734 de 2002, mediante el análisis de fuentes y revisión de datos, a través del método descriptivo analítico y bibliográfico o documental, lo que sin duda dejara al lector un panorama acerca de la importancia sobre el tema.
Robotic arm-assisted versus manual total hip arthroplasty
Authors: Ng Nathan , Gaston Paul , Simpson Philip M. , Macpherson Gavin J. , Patton James T. , Clement Nicholas D. 
Published: June 2021

Aims The aims of this systematic review were to assess the learning curve of semi-active robotic arm-assisted total hip arthroplasty (rTHA), and to compare the accuracy, patient-reported functional outcomes, complications, and survivorship between rTHA and manual total hip arthroplasty (mTHA). Methods Searches of PubMed, Medline, and Google Scholar were performed in April 2020 in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Search terms included “robotic”, “hip”, and “arthroplasty”. The criteria for inclusion were published clinical research articles reporting the learning curve for rTHA (robotic arm-assisted only) and those comparing the implantation accuracy, functional outcomes, survivorship, or complications with mTHA. Results There were 501 articles initially identified from databases and references. Following full text screening, 17 articles that satisfied the inclusion criteria were included. Four studies reported the learning curve of rTHA, 13 studies reported on implant positioning, five on functional outcomes, ten on complications, and four on survivorship. The meta-analysis showed a significantly greater number of cases of acetabular component placement in the safe zone compared with the mTHA group (95% confidence interval (CI) 4.10 to 7.94; p < 0.001) and that rTHA resulted in a significantly better Harris Hip Score compared to mTHA in the short- to mid-term follow-up (95% CI 0.46 to 5.64; p = 0.020). However, there was no difference in infection rates, dislocation rates, overall complication rates, and survival rates at short-term follow-up. Conclusion The learning curve of rTHA was between 12 and 35 cases, which was dependent on the assessment goal, such as operating time, accuracy, and team working. Robotic arm-assisted total hip arthroplasty was associated with improved accuracy of component positioning and functional outcome, however no difference in complication rates or survival were observed at short- to mid-term follow-up. Overall, there remains an absence of high-quality level I evidence and cost analysis comparing rTHA and mTHA. Cite this article: Bone Joint J 2021;103-B(6):1009–1020.
Unexpected low-grade infections in revision hip arthroplasty for aseptic loosening
Authors: Hipfl Christian , Mooij Wiebke , Perka Carsten , Hardt Sebastian , Wassilew Georgi I. 
Published: June 2021

Aims The purpose of this study was to evaluate unexpected positive cultures in total hip arthroplasty (THA) revisions for presumed aseptic loosening, to assess the prevalence of low-grade infection using two definition criteria, and to analyze its impact on implant survival after revision. Methods A total of 274 THA revisions performed for presumed aseptic loosening from 2012 to 2016 were reviewed. In addition to obtaining intraoperative tissue cultures from all patients, synovial and sonication fluid samples of the removed implant were obtained in 215 cases (79%) and 101 cases (37%), respectively. Histopathological analysis was performed in 250 cases (91%). Patients were classified as having low-grade infections according to institutional criteria and Musculoskeletal Infection Society (MSIS) International Consensus Meeting (ICM) 2013 criteria. Low-grade infections according to institutional criteria were treated with targeted antibiotics for six weeks postoperatively. Implant failure was defined as the need for re-revision resulting from periprosthetic joint infection (PJI) and aseptic reasons. The mean follow-up was 68 months (26 to 95). Results Unexpected positive intraoperative samples were found in 77 revisions (28%). Low-grade infection was diagnosed in 36 cases (13%) using institutional criteria and in nine cases (3%) using MSIS ICM 2013 criteria. In all, 41 patients (15%) had single specimen growth of a low-virulent pathogen and were deemed contaminated. Coagulase-negative Staphylococcus and anaerobes were the most commonly isolated bacteria. Implant failure for PJI was higher in revisions with presumed contaminants (5/41, 12%) compared to those with low-grade infections (2/36, 6%) and those with negative samples (5/197, 3%) (p = 0.021). The rate of all-cause re-revision was similar in patients diagnosed with low-grade infections (5/36, 14%) and those with presumed contaminants (6/41, 15%) and negative samples (21/197, 11%) (p = 0.699). Conclusion Our findings suggest that the presumption of culture contamination in aseptic revision hip arthroplasty may increase the detection of PJI. In this cohort, the presence of low-grade infection did not increase the risk of re-revision. Further studies are needed to assess the relevance of single specimen growth and the benefits of specific postoperative antibiotic regimens. Cite this article: Bone Joint J 2021;103-B(6):1070–1077.
Early results from a single centre’s experience with the STRYDE nail
Authors: Iliadis Alexios Dimitrios , Wright Jonathan , Stoddart Michael Thomas , Goodier William David , Calder Peter 
Published: June 2021

AimsThe STRYDE nail is an evolution of the PRECICE Intramedullary Limb Lengthening System, with unique features regarding its composition. It is designed for load bearing throughout treatment in order to improve patient experience and outcomes and allow for simultaneous bilateral lower limb lengthening. The literature published to date is limited regarding outcomes and potential problems. We report on our early experience and raise awareness for the potential of adverse effects from this device.MethodsThis is a retrospective review of prospective data collected on all patients treated in our institution using this implant. We report the demographics, nail accuracy, reliability, consolidation index, and cases where concerning clinical and radiological findings were encountered. There were 14 STRYDE nails implanted in nine patients (three male and six female) between June 2019 and September 2020. Mean age at surgery was 33 years (14 to 65). Five patients underwent bilateral lengthening (two femoral and three tibial) and four patients unilateral femoral lengthening for multiple aetiologies.ResultsAt the time of reporting, eight patients (13 implants) had completed lengthening. Osteolysis and periosteal reaction at the junction of the telescopic nail was evident in nine implants. Five patients experienced localized pain and swelling. Macroscopic appearances following retrieval were consistent with corrosion at the telescopic junction. Tissue histology was consistent with effects of focal metallic wear debris.ConclusionFrom our early experience with this implant we have found the process of lengthening to be accurate and reliable with good regenerate formation and consolidation. Proposed advantages of early load bearing and the ability for bilateral lengthening are promising. We have, however, encountered concerning clinical and radiological findings in several patients. We have elected to discontinue its use to allow further investigation into the retrieved implants and patient outcomes from users internationally. Cite this article: Bone Joint J 2021;103-B(6):1168–1172.
Functional dystonia in the foot and ankle
Authors: Gray Julia , Welck Matthew , Cullen Nicholas P. , Singh Dishan 
Published: June 2021

Aims To assess the characteristic clinical features, management, and outcome of patients who present to orthopaedic surgeons with functional dystonia affecting the foot and ankle. Methods We carried out a retrospective search of our records from 2000 to 2019 of patients seen in our adult tertiary referral foot and ankle unit with a diagnosis of functional dystonia. Results A total of 29 patients were seen. A majority were female (n = 25) and the mean age of onset of symptoms was 35.3 years (13 to 71). The mean delay between onset and diagnosis was 7.1 years (0.5 to 25.0). Onset was acute in 25 patients and insidious in four. Of the 29 patients, 26 had a fixed dystonia and three had a spasmodic dystonia. Pain was a major symptom in all patients, with a coexisting diagnosis of chronic regional pain syndrome (CRPS) made in nine patients. Of 20 patients treated with Botox, only one had a good response. None of the 12 patients who underwent a surgical intervention at our unit or elsewhere reported a subjective overall improvement. After a mean follow-up of 3.2 years (1 to 12), four patients had improved, 17 had remained the same, and eight reported a deterioration in their condition. Conclusion Patients with functional dystonia typically presented with a rapid onset of fixed deformity after a minor injury/event and pain out of proportion to the deformity. Referral to a neurologist to rule out neurological pathology is advocated, and further management should be carried out in a movement disorder clinic. Response to treatment (including Botulinum toxin (Botox) injections) is generally poor. Surgery in this group of patients is not recommended and may worsen the condition. The overall prognosis remains poor. Cite this article: Bone Joint J 2021;103-B(6):1127–1132.