bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alternate In-Brace and Out-of-Brace Radiographs Are Recommended to Assess Brace Fitting and Curve Progression With Adolescent Idiopathic Scoliosis Follow-Up
Authors: Kawasaki Sachiko , Cheung Prudence Wing Hang , Shigematsu Hideki , Tanaka Masato , Suga Yuma , Yamamoto Yusuke , Tanaka Yasuhito , Cheung Jason Pui Yin 
Published: July 2021

Study Design: Retrospective cohort study. Objective: To determine the prevalence of missed curve progression in patients with adolescent idiopathic scoliosis (AIS) undergoing brace treatment with only in-brace follow-up radiographs, and to provide recommendations on when in-brace and out-of-brace should be obtained during follow-up. Methods: 133 patients who had documented clinically significant curve progression during brace treatment or only when an out-of-brace radiograph were studied. Of these, 95 patients (71.4%) had curve progression noted on in-brace radiographs while 38 patients (28.6%) showed curve progression only after brace removal. We analyzed differences in age, sex, curve types, Risser stage, months after menarche, standing out-of-brace Cobb angle, correction rate, and flexibility rate between the groups. Multivariate logistic regression was performed to determine factors contributing to curve progression missed during brace treatment. Results: There were no differences in initial Cobb angle between out-of-brace and in-brace deterioration groups. However, the correction rate was higher (32.7% vs 25.0%; P = .004) in the in-brace deterioration group as compared to the out-of-brace deterioration group. A lower correction rate was more likely to result in out-of-brace deterioration (OR 0.970; P = .019). For thoracic curves, higher flexibility in the curves was more likely to result in out-of-brace deterioration (OR 1.055; P = .045). For double/triple curves, patients with in-brace deterioration had higher correction rate (OR 0.944; P = .034). Conclusions: Patients may develop curve progression despite good correction on in-brace radiographs. Those with higher flexibility and suboptimal brace fitting are at-risk. In-brace and out-of-brace radiographs should be taken alternately for brace treatment follow-up.
Bone Staples Provide Favorable Primary Stability in Cortical Fixation of Tendon Grafts for Medial Collateral Ligament Reconstruction: A Biomechanical Study
Authors: Glasbrenner Johannes , Deichsel Adrian , Raschke Michael J. , Briese Thorben , Frank Andre , Herbort Mirco , Herbst Elmar , Kittl Christoph 
Published: July 2021

Background: The use of the interference screw (IFS) for the cortical fixation of tendon grafts in knee ligament reconstruction may lead to converging tunnels in the multiligament reconstruction setting. It is unknown whether alternative techniques using modern suture anchor (SA) or bone staple (BS) fixation provide sufficient primary stability. Purpose: To assess the primary stability of cortical fixation of tendon grafts for medial collateral ligament (MCL) reconstruction using modern SA and BS methods in comparison with IFS fixation. Study Design: Controlled laboratory study. Methods: Cortical tendon graft fixation was performed in a porcine knee model at the tibial insertion area of the MCL using 3 different techniques: IFS (n = 10), SA (n = 10), and BS (n = 10). Specimens were mounted in a materials testing machine, and cyclic loading for 1000 cycles at up to 100 N was applied to the tendon graft, followed by load-to-failure testing. Statistical analysis was performed using 1-way analysis of variance. Results: There were no statistical differences in elongation during cyclic loading or peak failure load during load-to-failure testing between BS (mean ± standard deviation: 3.4 ± 1.0 mm and 376 ± 120 N, respectively) and IFS fixation (3.9 ± 1.2 mm and 313 ± 99.5 N, respectively). SA fixation was found to have significantly more elongation during cyclic loading (6.4 ± 0.9 mm; P < .0001) compared with BS and IFS fixation and lower peak failure load during ultimate failure testing (228 ± 49.0 N; P < .01) compared with BS fixation. Conclusion: BS and IFS fixation provided comparable primary stability in the cortical fixation of tendon grafts in MCL reconstruction, whereas a single SA fixation led to increased elongation with physiologic loads. However, load to failure of all 3 fixation techniques exceeded the loads expected to occur in the native MCL. Clinical Relevance: The use of BS as a reliable alternative to IFS fixation for peripheral ligament reconstruction in knee surgery can help to avoid the conflict of converging tunnels.
Osteoarthritis-Related Knee Pain Treated With Genicular Artery Embolization: A Systematic Review and Meta-analysis
Authors: Torkian Pooya , Golzarian Jafar , Chalian Majid , Clayton Alexander , Rahimi-Dehgolan Shahram , Tabibian Elnaz , Talaie Reza 
Published: July 2021

Background: Genicular artery embolization (GAE) is an innovative technique that has been investigated as a supplementary treatment method for chronic pain secondary to knee osteoarthritis (OA). Purpose: To evaluate the current evidence on the effectiveness and safety of GAE for OA-related knee pain. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic literature search was conducted in the PubMed, Web of Science, EMBASE, and Scopus databases to identify studies related to knee OA treated with GAE. Treatment agents were categorized as Embozene, imipenem/cilastatin, resorbable microspheres, and polyvinyl alcohol. The main outcomes were the mean difference (MD) in pre- and postembolization pain based on the visual analog scale (VAS) or the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores as well as changes in the need for pain medication. Random- and fixed-effects models were applied for data analysis. Results: Of 379 initially inspected publications, 11 (N = 225 patients; 268 knees) were included in the final review. The quality of the studies was fair in 8 and poor in 3—categorized according to the National Institutes of Health quality assessment tool. Overall, 119, 72, 13, and 21 patients were treated with imipenem/cilastatin, Embozene, resorbable microspheres, and polyvinyl alcohol, respectively. Symptomatic improvement was reported in all studies. The pooled effect size, characterized by MD, showed a significant improvement in the VAS and WOMAC pain scores, with better functional status after GAE. Pre- versus postembolization MDs in VAS scores ranged from 32 within the first week to 58 after a 2-year follow-up (equivalent to 54% and 80% improvement, respectively). There was a similar trend in the overall WOMAC scores, with MDs ranging from 28.4 to 36.8 (about 58% and 85% improvement, respectively). GAE resulted in a decreased need for pain medication for knee OA, with a 27%, 65%, and 73% decline in the number of patients who used opioids, nonsteroidal anti-inflammatory drugs, and intra-articular hyaluronic acid injection, respectively ( P < .00001 for all). No significant difference between embolic agents was seen with regard to post-GAE pain reduction. No severe or life-threatening complications were reported. Conclusion: OA treated by GAE using different embolic particles can be considered generally safe, with good efficacy and no reported serious complications.
Exploring the applicability of the robotic seal PARO to support caring for older persons with dementia within the home context
Authors: Inoue Kaoru , Wada Kazuyoshi , Shibata Takanori 
Published: July 2021

Objective: To (1) examine the potentiality of using the robot PARO to mediate care provided by the family and (2) identify problems when utilizing PARO in the home context. Methods: Family members of 7 households were asked to use PARO for at least three times per week, over 1 to 3 months. Research data, including standardized assessments, interviews, and observations, were collected at initial and subsequent monthly visits. Collected data were analyzed through descriptive statistics and inductive thematic content analysis. Results: Out of the seven participants, five responded positively to PARO, thereby achieving their goals of improving activity engagement, relaxation, a respite from supervision, and improved mood. A positive initial interaction with PARO showed continued interest to it. Participants were observed to communicate with caregivers and relate to PARO. Discussion: The application of PARO at home is possibly influenced by the persons’ initial level of interest toward PARO. It is crucial to perform careful observation and assessment before deciding to use PARO within the home context to support the life of older persons with dementia.
Artificial intelligence in computed tomography for quantifying lung changes in the era of CFTR modulators
Authors: Dournes Gael , Hall Chase S. , Willmering Matthew M. , Brody Alan S. , Macey Julie , Bui Stephanie , Denis de Senneville Baudouin , Berger Patrick , Laurent François , Benlala Ilyes , Woods Jason C. 
Published: July 2021

BackgroundChest computed tomography (CT) remains the imaging standard for demonstrating cystic fibrosis (CF) airway structural diseasein vivo. However, visual scoring systems as an outcome measure are time consuming, require training and lack high reproducibility. Our objective was to validate a fully automated artificial intelligence (AI)-driven scoring system of CF lung disease severity.MethodsData were retrospectively collected in three CF reference centres, between 2008 and 2020, in 184 patients aged 4–54 years. An algorithm using three 2D convolutional neural networks was trained with 78 patients’ CT scans (23 530 CT slices) for the semantic labelling of bronchiectasis, peribronchial thickening, bronchial mucus, bronchiolar mucus and collapse/consolidation. 36 patients’ CT scans (11 435 CT slices) were used for testingversusground-truth labels. The method's clinical validity was assessed in an independent group of 70 patients with or without lumacaftor/ivacaftor treatment (n=10 and n=60, respectively) with repeat examinations. Similarity and reproducibility were assessed using the Dice coefficient, correlations using the Spearman test, and paired comparisons using the Wilcoxon rank test.ResultsThe overall pixelwise similarity of AI-drivenversusground-truth labels was good (Dice 0.71). All AI-driven volumetric quantifications had moderate to very good correlations to a visual imaging scoring (p<0.001) and fair to good correlations to forced expiratory volume in 1 s % predicted at pulmonary function tests (p<0.001). Significant decreases in peribronchial thickening (p=0.005), bronchial mucus (p=0.005) and bronchiolar mucus (p=0.007) volumes were measured in patients with lumacaftor/ivacaftor. Conversely, bronchiectasis (p=0.002) and peribronchial thickening (p=0.008) volumes increased in patients without lumacaftor/ivacaftor. The reproducibility was almost perfect (Dice >0.99).ConclusionAI allows fully automated volumetric quantification of CF-related modifications over an entire lung. The novel scoring system could provide a robust disease outcome in the era of effective CF transmembrane conductance regulator modulator therapy.
Predicting the risk of respiratory distress in newborns with congenital pulmonary malformations
Authors: Delacourt Christophe , Bertille Nathalie , Salomon Laurent J. , Rahshenas Makan , Benachi Alexandra , Bonnard Arnaud , Choupeaux Laure , Fouquet Virginie , Goua Valérie , Hameury Frédéric , Hervieux Erik , Jouannic Jean-Marie , Khen-Dunlop Naziha , Le Bouar Gwenaelle , Massardier Jérôme , Roditis Léa , Rosenblatt Jonathan , Sartor Agnès , Thong-Vanh Catherine , Lelong Nathalie , Khoshnood Babak 
Published: July 2021

ObjectivesMost children with prenatally diagnosed congenital pulmonary malformations (CPMs) are asymptomatic at birth. We aimed to develop a parsimonious prognostic model for predicting the risk of neonatal respiratory distress (NRD) in preterm and term infants with CPM, based on the prenatal attributes of the malformation.MethodsMALFPULM is a prospective population-based nationally representative cohort including 436 pregnant women. The main predictive variable was the CPM volume ratio (CVR) measured at diagnosis (CVR first) and the highest CVR measured (CVR max). Separate models were estimated for preterm and term infants and were validated by bootstrapping.ResultsIn total, 67 of the 383 neonates studied (17%) had NRD. For infants born at term (>37 weeks, n=351), the most parsimonious model included CVR max as the only predictive variable (receiver operating characteristic (ROC) curve area: 0.70±0.04, negative predictive value: 0.91). The probability of NRD increased linearly with increasing CVR max and remained below 10% for CVR max <0.4. In preterm infants (n=32), both CVR max and gestational age were important predictors of the risk of NRD (ROC: 0.85±0.07). Models based on CVR first had a similar predictive ability.ConclusionsPredictive models based exclusively on CVR measurements had a high negative predictive value in infants born at term. Our study results could contribute to the individualised general risk assessment to guide decisions about the need for newborns with prenatally diagnosed CPM to be delivered at specialised centres.
Effect of exacerbation history on clinical response to dupilumab in moderate-to-severe uncontrolled asthma
Authors: Corren Jonathan , Katelaris Constance H. , Castro Mario , Maspero Jorge F. , Ford Linda B. , Halpin David M.G. , Rice Megan S. , Radwan Amr , Deniz Yamo , Rowe Paul J. , Teper Ariel , Djandji Michel 
Published: July 2021

BackgroundThe phase 3 LIBERTY ASTHMA QUEST study (ClinicalTrials.gov:NCT02414854) in patients with uncontrolled, moderate-to-severe asthma has demonstrated the efficacy and safety of dupilumab 200 and 300 mg every 2 weeksversusplacebo. Thispost hocanalysis assessed the effect of dupilumab on efficacy outcomes and asthma control across a range of historical exacerbation rates in patients with type 2-high asthma.MethodsAnnualised severe exacerbation rates over the 52-week treatment period, pre-bronchodilator forced expiratory volume in 1 s (FEV1) at weeks 12 and 52, and the five-item Asthma Control Questionnaire (ACQ-5) score at weeks 24 and 52 were assessed in patients with ≥1, ≥2 or ≥3 exacerbations in the previous year. Subgroups were stratified by baseline blood eosinophils ≥150 or ≥300 cells·μL−1or baseline exhaled nitric oxide fraction ≥25 ppb and baseline inhaled corticosteroid (ICS) dose.ResultsAcross all type 2-high subgroups, dupilumabversusplacebo significantly reduced severe exacerbations by 54–90%, with greater improvements in patients with more exacerbations prior to study initiation. Similarly, improvements in FEV1(least squares (LS) mean differenceversusplacebo: ≥1 exacerbations, 0.15–0.25 L; ≥2 exacerbations, 0.12–0.32 L; ≥3 exacerbations, 0.09–0.38 L; majority p<0.05) and ACQ-5 score (LS mean difference range: ≥1 exacerbations, −0.30 to −0.57; ≥2 exacerbations, −0.29 to −0.56; ≥3 exacerbations, −0.43 to −0.61; all p<0.05) were observed, irrespective of prior exacerbation history, across all subgroups.ConclusionsDupilumab significantly reduced severe exacerbations and improved FEV1and asthma control in patients with elevated type 2 biomarkers irrespective of exacerbation history and baseline ICS dose.
Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET
Authors: Kahnert Kathrin , Lutter Johanna I. , Welte Tobias , Alter Peter , Behr Jürgen , Herth Felix , Kauczor Hans-Ulrich , Söhler Sandra , Pfeifer Michael , Watz Henrik , Vogelmeier Claus F. , Bals Robert , Jörres Rudolf A. , Trudzinski Franziska C. 
Published: July 2021

Background:Infection control measures for coronavirus disease 2019 (COVID-19) might have affected management and clinical state of patients with COPD. We analysed to which extent this common notion is fact-based.Methods:Patients of the COSYCONET cohort were contacted with three recurring surveys (COVID1, 2 and 3 at 0, 3 and 6 months, respectively). The questionnaires comprised behaviour, clinical and functional state, and medical treatment. The responses to the questionnaires were compared amongst themselves and with pre-COVID information from the last visit of COSYCONET.Results:Overall, 594 patients were contacted and 375 patients (58% males, forced expiratory volume in 1 s (FEV1) 61±22% predicted) provided valid data in COVID1 and COVID2. Five patients reported infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most patients – except for patients with higher education – reported compliance with recommended protective measures, whereby compliance to hygiene, contact and access to physicians slightly improved between COVID1 and COVID2. Also, patients obtained more information from physicians than from public media. In the majority of cases, the personal physician could not be substituted by remote consultation. Over time, symptoms slightly increased and self-assessed physical capacity decreased. Results of COVID3 were similar. Women and patients with more exacerbations and dyspnoea avoided medical consultations, whereas Global Initiative for Chronic Obstructive Lung Disease (GOLD) D patients were more amenable to tele-consultation.Conclusion:In well-characterised COPD patients, we observed on average slight deteriorations of clinical state during the period of COVID-19 restrictions, with high and partially increasing adherence to protective measures. The data suggest that in particular, women and GOLD D patients should be actively contacted by physicians to identify deteriorations.
Outcomes and characteristics of COVID-19 patients treated with continuous positive airway pressure/high-flow nasal oxygen outside the intensive care setting
Authors: Sykes Dominic L. , Crooks Michael G. , Thu Thu Khaing , Brown Oliver I. , Tyrer Theodore J.P. , Rennardson Jodie , Littlefield Catherine , Faruqi Shoaib 
Published: July 2021

BackgroundContinuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to coronavirus disease 2019 (COVID-19) pneumonia. Limited data are available for patients treated with noninvasive respiratory support outside of the intensive care setting.MethodsIn this single-centre observational study we observed the characteristics, physiological observations, laboratory tests and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with noninvasive respiratory support outside of the intensive care setting.ResultsWe report the outcomes of 140 patients (mean±sdage: 71.2±11.1, 65% male (n=91)) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1versus74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2versus4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.ConclusionsCPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.
A model for estimating the health economic impact of earlier diagnosis of chronic thromboembolic pulmonary hypertension
Authors: Boon Gudula J.A.M. , van den Hout Wilbert B. , Barco Stefano , Bogaard Harm Jan , Delcroix Marion , Huisman Menno V. , Konstantinides Stavros V. , Meijboom Lilian J. , Nossent Esther J. , Symersky Petr , Noordegraaf Anton Vonk , Klok Frederikus A. 
Published: July 2021

BackgroundDiagnostic delay of chronic thromboembolic pulmonary hypertension (CTEPH) exceeds 1 year, contributing to higher mortality. Health economic consequences of late CTEPH diagnosis are unknown. We aimed to develop a model for quantifying the impact of diagnosing CTEPH earlier on survival, quality-adjusted life-years (QALYs) and healthcare costs.Material and methodsA Markov model was developed to estimate lifelong outcomes, depending on the degree of delay. Data on survival and quality of life were obtained from published literature. Hospital costs were assessed from patient records (n=498) at the Amsterdam UMC – VUmc, which is a Dutch CTEPH referral center. Medication costs were based on a mix of standard medication regimens.ResultsFor 63-year-old CTEPH patients with a 14-month diagnostic delay of CTEPH (median age and delay of patients in the European CTEPH Registry), lifelong healthcare costs were estimated at EUR 117 100 for a mix of treatment options. In a hypothetical scenario of maximal reduction of current delay, improved survival was estimated at a gain of 3.01 life-years and 2.04 QALYs. The associated cost increase was EUR 44 654, of which 87% was due to prolonged medication use. This accounts for an incremental cost–utility ratio of EUR 21 900/QALY.ConclusionOur constructed model based on the Dutch healthcare setting demonstrates a substantial health gain when CTEPH is diagnosed earlier. According to Dutch health economic standards, additional costs remain below the deemed acceptable limit of EUR 50 000/QALY for the particular disease burden. This model can be used for evaluating cost-effectiveness of diagnostic strategies aimed at reducing the diagnostic delay.
Propofol attenuates lung ischemia/reperfusion injury though the involvement of the MALAT1/microRNA-144/GSK3β axis
Authors: Zhang Jian-Ping , Zhang Wei-Jing , Yang Miao , Fang Hua 
Published: July 2021

Abstract
Background
Propofol, an intravenous anesthetic, was proven to protect against lung ischemia/reperfusion (I/R) injury. However, the detailed mechanism of Propofol in lung I/R injury is still elusive. This study was designed to explore the therapeutic effects of Propofol, both in vivo and in vitro, on lung I/R injury and the underlying mechanisms related to metastasis-associated lung adenocarcinoma transcript 1 (MALAT1)/microRNA-144 (miR-144)/glycogen synthase kinase-3β (GSK3β).

Methods
C57BL/6 mice were used to establish a lung I/R injury model while pulmonary microvascular endothelial cells (PMVECs) were constructed as hypoxia/reperfusion (H/R) cellular model, both of which were performed with Propofol treatment. Gain- or loss-of-function approaches were subsequently employed, followed by observation of cell apoptosis in lung tissues and evaluation of proliferative and apoptotic capabilities in H/R cells. Meanwhile, the inflammatory factors, autophagosomes, and autophagy-related proteins were measured.

Results
Our experimental data revealed that Propofol treatment could decrease the elevated expression of MALAT1 following I/R injury or H/R induction, indicating its protection against lung I/R injury. Additionally, overexpressing MALAT1 or GSK3β promoted the activation of autophagosomes, proinflammatory factor release, and cell apoptosis, suggesting that overexpressing MALAT1 or GSK3β may reverse the protective effects of Propofol against lung I/R injury. MALAT1 was identified to negatively regulate miR-144 to upregulate the GSK3β expression.

Conclusion
Overall, our study demonstrated that Propofol played a protective role in lung I/R injury by suppressing autophagy and decreasing release of inflammatory factors, with the possible involvement of the MALAT1/miR-144/GSK3β axis.