bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rheumatic immune-related adverse events associated with immune checkpoint inhibitors compared with placebo in oncologic patients: a systemic review and meta-analysis
Authors: Zhang Shuo , Zhou Ziyue , Wang Li , Li Mengtao , Zhang Fengchun , Zeng Xiaofeng 
Published: February 2021

Objective: We aim to characterize the incidence and relative risk of rheumatic and systemic immune-related adverse effects (irAEs) among immune checkpoint inhibitor (ICI) therapy compared with those after placebo treatment. Methods: Randomized clinical trial studies with placebo control with the following keywords were searched from Embase, PubMed, Cochrane databases: immune checkpoint inhibitors, neoplasms, randomized controlled trials, and adverse effects. Results: Among the 5444 published and 316 registration records, nine placebo-controlled randomized clinical trials met our selection criteria, and included data from 5560 patients. Compared with placebo use, using ICIs increases the risk of overall-rheumatic irAEs. The incidence and relative risk of all-grade rheumatic irAEs were 18.40% [95% confidence interval (CI) 12.16–25.59%, p < 0.01] and 2.30 (95% CI 1.32–4.02), respectively, while musculoskeletal irAEs were 11.30% (95% CI 9.76–12.85%) and 1.01 (95% CI 0.84–1.22). The incidence and relative risk of severe rheumatic irAEs were 5.72% (95% CI 3.92–7.82%), and 8.29 (95% CI 3.75–18.35), respectively. Arthralgia was the most common rheumatic irAE (incidence 11.00%, 95% CI 9.55–12.64%; relative risk 0.99, 95% CI 0.82–1.19), although usually not severe. Colitis (incidence 3.23%, 95% CI 1.27–7.98%; relative risk 6.53, 95% CI 2.66–16.04) and pneumonitis (incidence 3.11%, 95% CI 1.56–6.21; relative risk 4.04, 95% CI 1.65–9.89) were commonly observed and tended to be severe. Hepatitis, hypophysitis, thyroiditis, and myositis were rare and less recorded, yet can be severe and life threatening. Other extremely rare severe rheumatic irAEs included sarcoidosis ( n = 11), autoimmune arthritis ( n = 8), autoimmune uveitis ( n = 3), autoimmune pericarditis, bursitis, osteochondrosis, psoriasis, polymyalgia rheumatica, systemic inflammatory response syndrome, and Sjögren syndrome ( n = 1, each). Conclusion: ICI therapy increased the incidence and relative risk of all-grade and severe rheumatic irAEs. Arthralgia was the most commonly observed non-severe irAE, while colitis and pneumonitis were commonly observed severe irAEs. Rare rheumatic irAEs like hepatitis, hypophysitis, thyroiditis, and myositis warrant special attention.
Workforce challenges in digital health implementation: How are clinical psychology training programmes developing digital competences?
Authors: Pote Helen , Rees Annabel , Holloway-Biddle Charley , Griffith Emma 
Published: February 2021

Objectives Digital practice in psychological services is a rapidly expanding and innovative area which is supporting continuation of clinical provision during the COVID-19 pandemic. Training the workforce to deliver safe and effective online psychological provision is key to service success and relies on accurate mapping of competences and current training needs. This paper discusses the initial stage for developing the first digital mental health competence framework for applied psychology in the UK. It reports on the digital training currently provided nationally and barriers/facilitators to acquiring these competencies. Methods Eighteen of the thirty UK Clinical Psychology Doctoral training programmes completed a 16-item survey. This mapped current digital health teaching and skills acquisition for trainee Clinical Psychologists throughout their 3-year pre-registration training. Furthermore, potential barriers and facilitators to developing these digital skills for both trainee and qualified Clinical Psychologists were investigated. Results The quantitative analysis highlighted the majority of respondents viewed developing digital mental health competencies with importance, but were not integrating this into teaching or clinical placements activity. The qualitative, inductive content analysis revealed seven key themes influencing the development of digital mental health skills, with the majority of respondents identifying with two themes; the need for practice guidelines (50% of respondents) and opportunities for digital mental health experience. Conclusions The findings suggest the need for a greater focus on developing the digital health knowledge, skills, and confidence across trainee and qualified Clinical Psychologists. Strategic analysis indicated the need to develop a framework for digital mental health competences across the curriculum and placement experience. Easily accessible learning packages may support the implementation of training nationally.
Functional MRI evaluation of the effect of carotid artery stenting: a case study demonstrating cognitive improvement
Authors: Chinda Betty , Liang Simon , Siu William , Medvedev George , Song Xiaowei 
Published: February 2021

Background The narrowing of the carotid arteries with plaque formation represents a major risk factor for ischemic stroke and cognitive impairments. Carotid angioplasty and stenting is a standard clinical treatment to reduce stroke risk. The cognitive effect of carotid angioplasty and stenting remains largely unknown. Purpose This study aims to provide direct evidence of possible effects of carotid angioplasty and stenting on cognition, using task-phase functional magnetic resonance imaging. Material and Methods This study received harmonized institutional ethics board approval (Grant number REB ID =H18-02495/FHREB 2018-058). Two patients had MRI scans pre-carotid angioplasty and stenting and two-month post-carotid angioplasty and stenting. Case 1 had severe (>95%) flow-limiting stenosis in the right carotid artery. Case 2 had 70% non-flow limiting stenosis in the left carotid artery. At each scan, patients completed two functional magnetic resonance imaging sessions while performing a working memory task. Accuracy, reaction time, and brain activation were analyzed for each patient for possible pre-post carotid angioplasty and stenting changes. Results Case 1 showed increased activation in the right (treated-side) frontal and temporal lobes post-carotid angioplasty and stenting; associated with improvements in accuracy (from 58% to 74%) and task completion rate (from 17% to 72%). Case 2 completed the tasks pre- and post-carotid angioplasty and stenting with >90% accuracy, while decreased functional magnetic resonance imaging activation in the contralateral (untreated) hemisphere and mildly increased activation in the left (treated -side) anterior circulation territory were observed post-carotid angioplasty and stenting. Conclusion These cases provided the first task-phase functional magnetic resonance imaging data demonstrating that carotid angioplasty and stenting improved cognitive function in the re-perfused vascular territory. The finding supports the role of carotid angioplasty and stenting in improving cognitive performance beyond reducing stroke risk.
Minimally Invasive Scoliosis Surgery Is a Feasible Option for Management of Idiopathic Scoliosis and Has Equivalent Outcomes to Open Surgery: A Meta-Analysis
Authors: Alhammoud Abduljabbar , Alborno Yahya , Baco Abdul Moeen , Othman Yahya Azhar , Ogura Yoji , Steinhaus Michael , Sheha Evan D. , Qureshi Sheeraz A. 
Published: February 2021

Study Design: Meta-analysis. Objective: To compare outcomes between minimally invasive scoliosis surgery (MISS) and traditional posterior instrumentation and fusion in the correction of adolescent idiopathic scoliosis (AIS). Methods: A literature search was performed using MEDLINE, PubMed, EMBASE, Google scholar and Cochrane databases, including studies reporting outcomes for both MISS and open correction of AIS. Study details, demographics, and outcomes, including curve correction, estimated blood loss (EBL), operative time, postoperative pain, length of stay (LOS), and complications, were collected and analyzed. Results: A total of 4 studies met the selection criteria and were included in the analysis, totaling 107 patients (42 MIS and 65 open) with a mean age of 16 years. Overall there was no difference in curve correction between MISS (73.2%) and open (76.7%) cohorts. EBL was significantly lower in the MISS (271 ml) compared to the open (527 ml) group, but operative time was significantly longer (380 min for MISS versus 302 min for open). There were no significant differences between the approaches in pain, LOS, complications, or reoperations. Conclusion: MISS was associated with less blood loss but longer operative times compared to traditional open fusion for AIS. There was no difference in curve correction, postoperative pain, LOS, or complications/reoperations. While MISS has emerged as a feasible option for the surgical management of AIS, further research is warranted to compare these 2 approaches.
Vertebral Coplanar Alignment Technique Versus Bilateral Apical Vertebral Derotation Technique in Neuromuscular Scoliosis
Authors: Weissmann Karen A. , Barrios Carlos , Lafage Virginie , Lafage Renaud , Costa Marcelo A. , Álvarez Diego , Huaiquilaf Carlos M. , Ang Bryan , Schulz Ronald G. 
Published: February 2021

Study Design: Single-center retrospective analysis of prospectively collected data. Objective: Our aim was to compare the correction capacity in 3 planes of the VCA technique versus the AD technique in neuromuscular scoliosis patients. Methods: We analized patients with neuromuscular scoliosis that underwent posterior spinal fusion from 2013 to 2017 using 2 different techniques for correction: vertebral coplanar alignment (VCA) that takes into consideration the fact that the medial cortex is more resistant than the lateral cortex, with more anchor points for better distribution of forces and ligamentotaxis and the more widely spread apical derotation (AD) technique. Clinical, surgical, and radiographic information of patients operated on with the AD technique were compared to those operated on with the VCA technique in the coronal, sagittal and axial plane at pre-op, immediate post-op, and 2 year follow-up. Results: 64 patients met inclusion criteria, 34 patients underwent the VCA technique and 30 patients underwent the AD technique. The 2 cohorts did not differ in terms of demographics, clinical presentation or preoperative alignment. There were no significant differences in the correction ability between both techniques regarding curve magnitude, apical vertebral rotation, or pelvic obliquity. There was a significant decrease in thoracic kyphosis in the AD group compared to the VCA group in the immediate postop period (4.2 ± 26.6º for VCA and 13.2 ± 21.3º for AD (p = 0.048)). Conclusion: Both apical derotation technique and vertebral coplanar alignment allow for correction in the 3 planes for patients with neuromuscular scoliosis. VCA is a less hypokyphosing technique than AD.
Ossification of Posterior Longitudinal Ligament in Cervical Spine and Its Association With Ossified Lesions in the Whole Spine: A Cross-Sectional Study of 2500 CT Scans
Authors: Singh Neerav Anand , Shetty Ajoy Prasad , Jakkepally Sridhar , Kumarasamy Dinesh , Kanna Rishi Mukesh , Rajasekaran Shanmuganathan 
Published: February 2021

Study Design: A retrospective study. Objective: To identify the prevalence and characteristics of ossified posterior longitudinal ligament (OPLL) in the cervical spine and its association with other spinal ligament ossifications. Method: This study is a retrospective review of whole spine CT scans of polytrauma patients from 2009 to 2018. Patients were screened for cervical OPLL (C-OPLL), thoracolumbar OPLL, thoracic ossified ligamentum flavum (OLF), cervical and thoracolumbar ossified anterior longitudinal ligament (C-OALL AND T-L OALL), ossified nuchal ligament (ONL) and, diffuse idiopathic skeletal hyperostosis (DISH) using CT scans. Their prevalence and distributions were assessed using statistical tools. Chi-square tests were used to determine statistical association between the categorical parameters. Results: Out of 2500 patients, 128 had C-OPLL with a prevalence rate of 5.12% with mean age of 55.89 year. The most commonly affected level was C5, followed by C6, and C4. The segmental OPLL was highest in number (77.7%), followed by localized type (14.8%). While the prevalence rate of thoracic OPLL was 0.56%, OLF was 9.9%. Ossifications that coexisted along with C-OPLL were thoracic OPLL (7.81%), thoracic OLF (36.71%), cervical OALL (29.68%), thoracolumbar OALL (37.5%), DISH (27.34%) and, ONL (7.03%). Conclusion: Our study indicated a prevalence rate of 5.12% for C-OPLL with a predominance of segmental OPLL (77.7%). Among these patients, approximately 36% had coexisting thoracic OLF. In patients with symptomatic OPLL induced cervical myelopathy, MRI analysis of whole spine with relevant CT correlation may help in detecting additional ossification sites of compression.
Levels of evidence backing the AAOS clinical practice guidelines
Authors: Reddy Arjun K , Scott Jared , Checketts Jake X , Fishbeck Keith , Boose Marshall , Stallings Landon , Vassar Matt 
Published: February 2021

Purpose: The American Academy of Orthopaedic Surgeons produces clinical practice guidelines for the treatment of orthopedic injuries. We examined the strength of the evidence underlying these recommendations in order to answer the following questions: (1) Have AAOS work groups improved guideline creation practices to locate evidence to generate strong recommendations? (2) Is there variability in the available evidence based on anatomic site or stage of care? (3) Has the level of evidence supporting improved over time? Methods: Twenty-two current guidelines of the Academy were examined which yielded 408 individual recommendations. These recommendations were assigned one of five strength of evidence ratings (strong, moderate, limited, inconclusive, consensus) by the guideline panel, based on the availability and quality of the supporting evidence. From these guidelines, we extracted all of the recommendations and their corresponding evidence ratings. We then classified the recommendations by stage of care, year, and anatomical site. Results: The distribution of the levels of evidence was as follows: 77 (18.9%) were based on consensus; 53 (13.0%) were inconclusive; 93 (22.8%) were based on limited evidence; 112 (27.5%) were based on moderate evidence; and 73 were based on (17.9%) strong evidence. Strong strength of evidence was found in 45.2% of the recommendations for preventive/screening/diagnostic care, 41.1% of nonsurgical treatment, 45.1% of surgical treatment, 51.1% of rehabilitation/postoperative treatment, and 45.5% of the recommendations that had mixed stages of care. Inconclusive strength of evidence was found to be prevalent from 2009–2013, but was eliminated starting in 2014. Conclusions: Only 73 (17.9%) recommendations generated by the Academy in its 22 clinical practice guidelines are based on a “strong” strength of evidence. More robust research is needed in orthopedics to bolster confidence in the recommendations in future guideline updates.
Risk Factors for Rapid Chondrolysis After Partial Lateral Meniscectomy: A Scoping Review of the Literature
Authors: Pioger Charles , Saithna Adnan , Kandhari Vikram , Thaunat Mathieu , Vieira Thais D. , Freychet Benjamin , Franck Florent , Sonnery-Cottet Bertrand 
Published: February 2021

Background: The occurrence of rapid chondrolysis after partial lateral meniscectomy is rare. The pathophysiology, risk factors, and outcomes of treatment have not been established. Purpose: The primary aim of this study was to perform a scoping review of the literature to determine the potential risk factors and pathogenesis of rapid chondrolysis. The secondary objective was to report outcomes of treatment. Study Design: Systematic (scoping) review. Methods: A scoping review of the literature was conducted in accordance with the framework of Arksey and O’Malley. A search strategy based on the terms “chondrolysis” AND “knee,” “chondrolysis” AND “meniscus,” and “chondral damage” AND “lateral meniscus” was applied to the PubMed database on March 31, 2020. All relevant studies were included. Patient demographics and clinical data were extracted from these studies and analyzed in order to investigate the potential risk factors, pathogenesis, and outcomes of treatment for rapid chondrolysis. Results: Five articles (22 cases) featuring rapid chondrolysis in the lateral compartment after partial lateral meniscectomy were identified and included. The condition occurred most frequently in patients who were young (mean age, 25.6 years), male (20/22 cases; 91%), and participating in high-intensity sports (19/22 cases; 86.4%) within 1 year of the index procedure. Half of the included study population underwent surgery for a radial tear. All professional athletes (13/13) returned to the preinjury level of sport. All authors of included studies suggested that the main causal risk factor was mechanical focal cartilage overload in the lateral compartment of the knee. Conclusion: Rapid chondrolysis after partial lateral meniscectomy is a rare condition that typically occurs within 12 months of the index procedure. Younger age, male sex, high-intensity sports participation, and some meniscal tear patterns (eg, radial tear) are potentially important risk factors. Return-to-sport rates at short-term follow up are high, but no long-term studies were identified. The pathogenesis of rapid chondrolysis seems to relate to mechanical focal cartilage overload.
Reference states of forest ecosystem types and feasibility of biocenotic indication of ecological soil condition as part of ecosystem integrity and services assessment
Authors: Jenssen Martin , Nickel Stefan , Schütze Gudrun , Schröder Winfried 
Published: February 2021

Abstract
Background
Structures and functions of ecosystems and, subsequently, their services for human societies may be influenced by climate change and atmospheric deposition. Jenssen et al. (UBA Texte 87/2013: 1–381, 2013) developed a spatially explicit evaluation system enabling the evaluation of ecosystems’ integrity. This methodology is based on a spatially explicit ecosystem classification of forests. Based on the six ecological functions, the methodology enables to compare the ecosystem type-specific integrity at different levels of ecological hierarchy for a reference state (1961–1990) with the further development of the forest ecosystem types as measured for the years 1991–2010 and as modelled for the period 2011–2070. The present study aimed at deepening the methodology and developing it into a practical system for assessing and mapping forest ecosystem integrity and services. The objectives of this advanced investigation were: (1) to quantify the reference conditions for a total of 61 forest ecosystem types; (2) to test the possibility of supplementing the quantification of ecosystem integrity by information on soil biocenoses as yielded by soil monitoring; (3) to model chemical soil indicators and to compare the respective results with those derived by Ellenberg’s indicator values for nutrient state; and (4) to verify the indicator modelling.

Results
Reference states related to the time prior to 1991 have been quantified for a total of 61 forest ecosystem types covering 85% (81,577 km2) of the mapped forest area of Germany. The reference states comprise statistical indicators for the plant-species diversity (habitat function), for nutrient and water balances and further ecological information as net-primary production and carbon storage. The assignment of lumbricide communities as soil biocenosis indicators was attempted but not succeeded because of insufficient data availability. The nutrient cycle types of the elaborated reference states were characterized by humus form, C/N ratio in topsoil and N indicator values according to Ellenberg et al. (Scr Geobot 18:1–262, 2001). Applying the developed methodology, for 83 out of 105 study plots the reference states prior to 1991 could be determined.

Conclusions
For complementing forest ecosystem reference states by soil biocenosis indicators it is necessary to further evaluate the primary literature looking for missing observation data. The W.I.E. indicator value applied in this paper to determine topsoil C/N ratios in forests is well suited for area-covering mapping of both near-natural forest–soil states and deposition-induced disharmonic state changes, in which C/N value and base saturation are no longer correlated.
A graph-based algorithm for detecting rigid domains in protein structures
Authors: Dang Truong Khanh Linh , Nguyen Thach , Habeck Michael , Gültas Mehmet , Waack Stephan 
Published: February 2021

Abstract
Background
Conformational transitions are implicated in the biological function of many proteins. Structural changes in proteins can be described approximately as the relative movement of rigid domains against each other. Despite previous efforts, there is a need to develop new domain segmentation algorithms that are capable of analysing the entire structure database efficiently and do not require the choice of protein-dependent tuning parameters such as the number of rigid domains.

Results
We develop a graph-based method for detecting rigid domains in proteins. Structural information from multiple conformational states is represented by a graph whose nodes correspond to amino acids. Graph clustering algorithms allow us to reduce the graph and run the Viterbi algorithm on the associated line graph to obtain a segmentation of the input structures into rigid domains. In contrast to many alternative methods, our approach does not require knowledge about the number of rigid domains. Moreover, we identified default values for the algorithmic parameters that are suitable for a large number of conformational ensembles. We test our algorithm on examples from the DynDom database and illustrate our method on various challenging systems whose structural transitions have been studied extensively.

Conclusions
The results strongly suggest that our graph-based algorithm forms a novel framework to characterize structural transitions in proteins via detecting their rigid domains. The web server is available at http://azifi.tz.agrar.uni-goettingen.de/webservice/.