bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undifferentiated arthritis: a changing population who did not benefit from enhanced disease-modifying anti-rheumatic drug strategies—results from a 25 year longitudinal inception cohort
Authors: Verstappen Marloes , Matthijssen Xanthe M E , van der Helm-van Mil Annette H M 
Published: November 2021

Abstract

Objectives
International guidelines stress timely DMARD initiation in early arthritis as well as when classification criteria are not yet fulfilled. Consequently, undifferentiated arthritis (UA) patients may be increasingly treated with DMARDs. Since UA is a diagnosis of exclusion, the introduction of the 2010 classification criteria presumably decreased the UA population, as former UA patients became regarded as RA. Consequently, the contemporary definition of UA has changed into: no clinical diagnosis and not fulfilling the 1987 nor 2010 RA-criteria. Importantly, placebo-controlled trials on DMARD efficacy in contemporary UA are absent. We aimed to study whether enhanced treatment strategies across the last 25 years improved outcomes in contemporary UA, whereby inclusion period was used as instrumental variable for DMARD treatment.

Methods
UA was defined, retrospectively, as clinical arthritis (joint swelling at physical examination) neither fulfilling the 1987 nor 2010 RA-criteria or any other clinical diagnosis. In total, 1132 UA patients consecutively included in the Leiden Early Arthritis Clinic between 1993 and 2019 were divided into five inclusion periods: 1993–1997, 1998–2005, 2006–2010, 2011–2014 and 2015–2019. The frequency of DMARD initiation was compared across the inclusion periods, as were the following outcomes: 28-joint DAS with CRP (DAS28-CRP) and the HAQ Disability Index (HAQ-DI) during follow-up, prevalence of DMARD-free-status within 10 years (DFS; spontaneous remission or sustained remission after DMARD stop) and progression to RA (according 1987/2010 criteria).

Results
The contemporary UA population is mainly autoantibody negative, with a median swollen joint count of 2, tender joint count of 3 and HAQ score of 0.6. These characteristics were similar across the inclusion periods. DMARD treatment increased from 17% (1993–1997) to 52% (2015–2019) and methotrexate became more common. The DAS28-CRP during follow-up improved from 2011 onwards (−0.18 to −0.25 DAS units; P &lt; 0.05). Disability scores during follow-up did not significantly improve. DFS prevalence also remained similar: 58%, 57% and 61% for 1993–1997, 1998–2005 and 2006–2010, respectively (P = 0.77). Likewise, the percentages of RA development did not decrease (14%, 21%, 26%, 18% and 27%, respectively).

Conclusion
Although intensified DMARD treatment slightly improved disease activity scores, physical functioning and long-term outcomes did not improve. This suggests overtreatment in the contemporary UA population and underlines the importance of developing stratification methods suitable for this patient-population.
JC-10 probe as a novel method for analyzing the mitochondrial membrane potential and cell stress in whole zebrafish embryos
Authors: Younes Nadin , Alsahan Bana S , Al-Mesaifri Asmaa J , Da’as Sahar I , Pintus Gianfranco , Majdalawieh Amin F , Nasrallah Gheyath K 
Published: November 2021

Abstract

Background
A sensitive method to investigate cellular stress and cytotoxicity is based on measuring mitochondrial membrane potential. Recently, JC-10, was developed to measure mitochondrial membrane potential in vitro and used as an indicator for cytotoxicity. Yet, JC-10 has never been used in vivo (whole organism). In normal cells, JC-10 concentrates in the mitochondrial matrix, where it forms red fluorescent aggregates. However, in apoptotic/necrotic cells, JC-10 diffuses out of the mitochondria, changes to monomeric form, and stains cells in green. Here, we aimed to develop and optimize a JC-10 assay to measure cytotoxicity in zebrafish embryo. We also investigated the effectiveness of JC-10 assay by comparing it to common cytotoxicity assays.

Methods
Zebrafish embryos were exposed to a toxic surfactant AEO-7 at no observed effect concentration (6.4 μg/L), and then cytotoxicity was measured using (i) JC-10 mitochondrial assay, (ii) acridine orange (AO), (iii) TUNEL assay, and (iv) measuring the level of Hsp70 by western blotting.

Results
As compared to the negative control, embryos treated with NOEC of AEO-7 did not show significant cytotoxicity when assessed by AO, TUNEL or western blotting. However, when JC-10 was used under the same experimental conditions, a significant increase of green:red fluorescent ratio signal was detected in the AEO-7 treated embryos, indicating mitochondrial damage and cellular cytotoxicity. Noteworthy, the observed green: red ratio increase was dose dependent, suggesting specificity of the JC-10 assay.

Conclusion
JC-10 is a sensitive in vivo method, thus, can be used as surrogate assay to measure cytotoxicity in whole zebrafish embryos.
Obstetric Complications in Women With Congenital Uterine Anomalies According to the 2013 European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy Classification
Authors: Panagiotopoulos Michail , Tseke Paraskevi , Michala Lina 
Published: December 2021

OBJECTIVE:
To assess the risk for obstetric complications in women with congenital uterine anomalies and the risk in each main class of uterine anomaly (U2 [septate], U3 [bicorporeal], U4 [hemi-uterus]), based on the 2013 classification by the ESHRE (European Society of Human Reproduction and Embryology) and the ESGE (European Society for Gynaecological Endoscopy).

DATA SOURCES:
MEDLINE, Scopus, and ClinicalTrials.gov were searched from inception until January 2021. The reference list of all included articles and previous systematic reviews were also screened to identify potential additional articles.

METHODS OF STUDY SELECTION:
Comparative and noncomparative studies that investigated the obstetric outcomes of women with any type of known congenital uterine anomaly were considered eligible for inclusion. Screening and eligibility assessment was performed independently by two reviewers.

TABULATION, INTEGRATION, AND RESULTS:
Forty-seven studies were included. The quality of included comparative studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Odds ratios (ORs), pooled proportions of each obstetric outcome, and 95% CIs were calculated in RevMan and Stata accordingly, using random effects models. Congenital uterine anomalies were associated with increased risk of preterm birth (OR 3.89, 95% CI 3.11–4.88); cervical insufficiency (OR 15.13, 95% CI 11.74–19.50); prelabor rupture of membranes (OR 2.48, 95% CI 1.38–4.48); fetal malpresentation (OR 11.11, 95% CI 5.74–21.49); fetal growth restriction (OR 3.75, 95% CI 1.88–7.46); placental abruption (OR 5.21, 95% CI 3.34–8.13); placenta previa (OR 4.00, 95% CI 1.87–8.56); placental retention (OR 1.71, 95% CI 1.16–2.52); and cesarean birth (OR 4.52, 95% CI 2.19–9.31); when compared with those without anomalies. Pooled estimated risks were 25% for preterm birth, 40% for fetal malpresentation, 64% for cesarean birth, 12% for prelabor rupture of membranes, 15% for fetal growth restriction, 4% for placental abruption, 5% for preeclampsia, 13% for cervical insufficiency, and 2% for placenta previa. Classes U2 (septate), U3 (bicorporeal), and U4 (hemi-uterus) were also associated independently with preterm birth, fetal malpresentation, cesarean birth, and placental abruption.

CONCLUSION:
Congenital uterine anomalies are associated with obstetric complications across all examined ESHRE and ESGE classifications.

SYSTEMATIC REVIEW REGISTRATION:
PROSPERO, CRD42021244487.
Novel Minimally-Invasive Triple Pelvic Osteotomy: JiShuiTan Minimally-Invasive Approach
Authors: Lyu XueMin , Yang Zheng , Wang Yukun , Zhang Tao , Lu Ming , Bian Zhen 
Published: November 2021

Purpose:
Triple pelvic osteotomy (TPO) is often performed to improve femoral head coverage, correct deformity, and stabilize the hip joint in a variety of pediatric orthopaedic conditions. After the TPO was first reported, many modifications were developed to simplify or improve the procedure, however, because of the specific anatomy with several critical nerves and vessels passing through the approaches, extensive exposure and prolonged intraoperative fluoroscopy are often required for TPO. This report introduces a novel, minimally-invasive surgical approach that minimizes the time of intraoperative fluoroscopy and size of the surgical incision, and reviews our experience.

Methods:
A total of 48 hips in 43 patients with a mean age of 8.3±1.7 years (range: 6.0 to 12.2 y) were included in this study. Of these, 21 patients (22 hips) had Legg-Calvé-Perthes disease (LCPD) and 22 patients (26 hips) had developmental dysplasia of the hip (DDH). The TPOs were performed using the novel, minimally-invasive TPO approach, with a mean postoperative follow-up of 38 months (range: 24 to 54 mo) in the DDH group and 44 months (range: 23 to 58 mo) in the LCPD group. The acetabular index (AI), femoral head migration rate (MP), center edge angle (CEA) and the Severin and Stulberg classification systems were used to evaluate the preoperative and postoperative results. SPSS software was used to analyze the data.

Results:
The AI decreased from 33.8 degrees±9.2 to 2.9 degrees±10.1, the lateral CEA increased from −10.8 degrees±23.8 to 34.1 degrees±9.9, and the femoral head MP decreased from 64.0%±19.8% to 1.1%±2.6% in the DDH group at last follow-up, indicating significant improvement. The AI decreased from 20.8 degrees±4.7 to −1.3 degrees±7.3, the lateral CEA increased from 6.8 degrees±11.5 to 42.3 degrees±6.4, and the femoral head MP decreased from 42.2%±13.0% to 1.3%±3.3% in the LCPD group at last follow-up, also indicating significant improvement.

Conclusion:
This approach can simplify the TPO, making the complex operation safer, more effective, and capable of achieving satisfactory correction.
Propensity-Matched Comparison of 90-Day Complications in Robotic-Assisted Versus Non-Robotic Assisted Lumbar Fusion
Authors: Yu Charles C. , Carreon Leah Y. , Glassman Steven D. , Brown Morgan E. , Daniels Christy L. , Polly David W. , Gum Jeffrey L. 
Published: November 2021

Study Design.
Retrospective single center propensity-matched observational cohort study that included patients who underwent 1- to 3-level lumbar fusion surgery for degenerative conditions.

Objective.
To compare 90-day complication rates between robotic-assisted and non-robotic-assisted lumbar spinal fusions in propensity-matched cohorts.

Summary of Background Data.
A recent administrative database (PearlDiver) study reported increased 30-day complications with the utilization of robotic-assisted enabling technology.

Methods.
Of 146 robotic-assisted cases that met inclusion criteria, 114 were successfully propensity matched to 114 patients from 214 cases who had 1 to 3 level lumbar fusion without robotic assistance based on age, sex, body mass index, smoking status, American Society of Anesthesiologist grade, number of surgical levels, primary versus revision, and surgical approach (posterior-only or anterior-posterior). We excluded tumor, trauma, infection, or deformity cases. Outcomes included surgical and medical (major/minor) complications at intraoperative, immediately postoperative, 30- and 90-day postoperative intervals, including reoperations, and readmissions within 90 days.

Results.
All cause intraoperative complication rates were similar between non-robotic-assisted (5.3%) and robotic-assisted groups (10.5%, P = 0.366). Immediate postoperative medical complication rate was also similar between non-robotic-assisted (6.1%) and robotic-assisted groups (1.8%, P = 0.089). Thirty-day complication rates, 90-day complication rates, reoperation rates, and readmission rates showed no difference between non-robotic-assisted and robotic-assisted groups. There was no difference between return to OR for infection between the cohorts (non-robotic-assisted: 6 [5%] vs. robotic-assisted: 1 [0.8%], P = 0.119). There was however improved length of stay (LOS) in the robotic-assisted group compared with non-robotic-assisted group (2.5 vs. 3.17 days, P = 0.018).

Conclusion.
In propensity-matched cohorts, patients undergoing 1- to 3-level robotic-assisted posterior lumbar fusion for degenerative conditions did not have increased 90-day complication rate, and had a shorter length of stay compared with non-robotic-assisted patients. There findings differ from a prior administrative database study as the robotic-assisted group in the current study had 0% return to OR for malpositioned screws and 0.8% return to OR for infection.

Level of Evidence: 2
Digital Ocular Compressions Reduce Intraocular Pressure in Eyes With Tube Shunts
Authors: Welburn Kyle , Slagle Grant , Mancha Saoul , Sponsel William E. 
Published: November 2021

Précis:
Digital ocular compressions (DOCs) decrease intraocular pressure in eyes with tube shunts by significantly greater magnitude and duration when compared with fellow eyes without filtering surgery.

Purpose:
DOCs are commonly used by glaucoma surgeons to reduce intraocular pressure (IOP) in the early postoperative period. Little is known, however, about the effects of DOC in eyes with tube shunts. We therefore examined these effects in eyes with long-established, functional glaucoma tube shunts.

Methods:
In this masked prospective study, adult subjects with primary open angle glaucoma and an Ahmed tube shunt in only 1 eye were recruited. After obtaining baseline IOP with Goldmann applanation tonometry a single transpalpebral DOC was applied to each eye (in random order). Postcompression IOP was measured after 10, 20, 30, 60, 90, 120, 150, 180, 210, and 240 minutes or until the measured IOP returned to baseline. The fellow (nonsurgical) eye was a control. Magnitude and duration of IOP reduction were evaluated using Kaplan-Meier analysis. The pressure applied to eyes in each cohort was standardized through the use of a force sensitive resistor and impulse was analyzed for differences.

Results:
Twenty-two eyes of 11 patients underwent DOC. There was no significant difference in the impulse applied to eyes in each cohort (P=0.6). A mean initial IOP reduction of 5.36 mm Hg occurred in tube shunt eyes and 2.55 in control eyes (P=0.014). Log-rank analysis demonstrated longer survival in the tube shunt group (P=0.049).

Conclusions:
DOC is an effective method for transiently reducing IOP in eyes with long-established, patent tube shunts for about an hour. To maintain this decrease in pressure, compressions will have to be performed on a scheduled basis.
Impact of Depression and Nicotine Dependence on Executive Functioning in Rural Older Adult Smokers
Authors: Noonan Devon , Silva Nikolas J. , McClintock Shawn M. , Silva Susan G. 
Published: December 2021

Abstract

Introduction
Rural older adults are an underserved population with high rates of smoking and related morbidity and mortality. Age-related executive function deficits are common in older smokers; however, the association of depression and nicotine dependence on executive function has not been explored. This study addressed whether depression and nicotine dependence are related to executive dysfunction in rural older adult smokers.

Methods
The sample included 40 rural older adults recruited from two primary care clinics in North Carolina. Executive function was evaluated with the Behavioral Regulation Index (BRI), Metacognition Index, and Global Executive Composite (GEC) T scores from the Behavior Rating Inventory of Executive Function-Adult. Nicotine dependence and depression symptoms were assessed using the Fagerstrom Test and Center for Epidemiologic Depression Scale-10, respectively. Analysis of variance was used to explore whether depression and/or nicotine dependence influences executive function. Nondirectional tests were performed with significance set at .10.

Results
Smokers who screened positive for depression had significantly greater executive dysfunction than those who did not (BRI: p = .0003, Metacognition Index: p < .0001, GEC: p < .0001), and moderate/high dependence was associated with greater executive function deficits compared with those with mild dependence (BRI: p = .0942). Together, depression and nicotine dependence explained 50% of the variability of the GEC overall scores.

Conclusions
Executive dysfunction is common in rural older adult smokers and associated with depression and nicotine dependence severity. Futures studies should test the relationship of executive function and smoking cessation in the older adult population as it may have implications for cessation in this population.
Dental Implant Supported Thumb Prosthesis with Friction Fit Retention System
Authors: Gupta Mahimaa , Singh Saumyendra V. , Arya Deeksha , Mishra Brijesh , Keshri Rishabh , Chand Pooran 
Published: November 2021

ABSTRACT

Introduction
An amputated thumb causes aesthetic deficit and functional loss. Reconstruction can be surgical or prosthetic. A small residuum leaves little scope for rehabilitation with suction-retained prosthesis. Prosthetic management requires implant placement or distraction osteogenesis to be successful.
This report presents the use of bone-anchored dental implants to support a prosthesis for rehabilitation of an amputated thumb.

Case Description
Satisfactory osseointegration of a dental implant placed in the amputated right pollex of a 24-year-old woman was achieved, after a two-stage surgical procedure. A healing abutment, which is normally placed transitionally after second-stage surgery, was modified to create a permanent friction fit coping. This was used to retain the silicone thumb.

Discussion and Conclusions
The study to some extent established off-the-label use of dental implants in rehabilitating amputated digits. Also, the friction fit retention system proved to be a cost- and armamentarium-effective method of retaining thumb prosthesis for cases with small residuum.

Clinical Relevance
This report describes a procedure for two-stage surgical placement of an osseointegrated dental implant in an amputated thumb with fabrication of prosthesis, which was effectively retained by a modified healing abutment.
The current understanding and future directions for sputum microbiome profiling in chronic obstructive pulmonary disease
Authors: Tiew Pei Yee , Mac Aogáin Micheál , Chotirmall Sanjay H. 
Published: November 2021

Purpose of review
Next-generation sequencing (NGS) has deepened our understanding of the respiratory microbiome in health and disease. The number of microbiome studies employing sputum as an airway surrogate has continued to increase over the past decade to include multiple large multicentre and longitudinal studies of the microbiome in chronic obstructive pulmonary disease (COPD). In this review, we summarize the recent advances to our understanding of the bacteriome, virome and mycobiome in COPD.

Recent findings
Diverse microbiome profiles are reported in COPD. The neutrophilic Haemophilus-predominant bacteriome remains a prominent COPD phenotype, relatively stable over time and during exacerbations. Studies of the virome remain limited but reveal a potential involvement of viruses and bacteriophages particularly during COPD exacerbations and advancing disease severity. Mycobiome signatures, even in stable COPD are associated with poorer clinical outcomes including mortality.

Summary
The sputum microbiome in COPD is being increasingly recognized for its clinical relevance, even in the stable state. Future studies integrating microbial kingdoms holistically (i.e. bacterial, viral and fungal) will provide deeper insight into its functionality including the relevance of microbial interactions and effect of treatment on microbiome-associated clinical outcomes.
Body composition in sexual precocity
Authors: Gonc Elmas Nazli , Kandemir Nurgun 
Published: November 2021

Purpose of review
In this review, we have summarized the current data on the effect of sexual precocity and treatment with gonadotropin-releasing hormone analogues (GnRHa) on body composition.

Recent findings
Higher body weight and weight gain in infancy and childhood may increase the risk of early puberty in girls. The relation between BMI and pubertal onset in boys is controversial. Current studies draw attention to the fact that a similar relationship may exist in boys too. Obesity prevalence is high among girls with central precocious puberty (CPP) and treatment with GnRHa has a different effect on BMI according to baseline body composition. Although BMI values of normal weight girls tend to increase under treatment, they return to normal following treatment. The few studies that have followed up body composition longitudinally in girls show a gradual increase in adiposity, decrease in muscle mass and bone mineral density during GnRHa treatment, whereas bone mass was preserved after treatment. Adequate data are not available in boys to determine the effect of GnRHa therapy on body composition.

Summary
Body composition and fat distribution should be monitored longitudinally in patients with CPP treated with GnRHa to ascertain the long-term effects of therapy.
Applying implementation science to improve care for familial hypercholesterolemia
Authors: Jones Laney K. , Brownson Ross C. , Williams Marc S. 
Published: November 2021

Purpose of review
Improving care of individuals with familial hypercholesteremia (FH) is reliant on the synthesis of evidence-based guidelines and their subsequent implementation into clinical care. This review describes implementation strategies, defined as methods to improve translation of evidence into FH care, that have been mapped to strategies from the Expert Recommendations for Implementing Change (ERIC) compilation.

Recent findings
A search using the term ‘familial hypercholesterolemia’ returned 1350 articles from November 2018 to July 2021. Among these, there were 153 articles related to improving FH care; 1156 were excluded and the remaining 37 were mapped to the ERIC compilation of strategies: assess for readiness and identify barriers and facilitators [9], develop and organize quality monitoring systems [14], create new clinical teams [2], facilitate relay of clinical data to providers [4], and involve patients and family members [8]. There were only 8 of 37 studies that utilized an implementation science theory, model, or framework and two that explicitly addressed health disparities or equity.

Summary
The mapping of the studies to implementation strategies from the ERIC compilation provides a framework for organizing current strategies to improve FH care. This study identifies potential areas for the development of implementation strategies to target unaddressed aspects of FH care.