bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of nucleo-annuloplasty using radiofrequency ablation for discogenic back pain in a local Hong Kong population
Authors: Yam Joyce Oching , Cheung Philip , Chiang Lan Fong , Wan Shuk Ying Sambo , Mok Wing Yuk 
Published: January 2021

Purpose: Degenerative disk disease is a global and common debilitating condition with substantial healthcare and economic costs. Disc-Fx is a relatively new minimally invasive, percutaneous nucleo-annuloplasty procedure aimed to alleviate symptoms of discogenic back pain via manual discectomy with nuclear and annular modification via means of radiofrequency ablation. The aim of this retrospective study is to report the 1-year outcomes, efficacy and safety of the percutaneous nucleo-annuloplasty procedure for treatment of discogenic back pain in the local Hong Kong population. Methods: This retrospective study consists of 16 patients with a total of 24 levels from 2017 to –2019 with at least 6 months of chronic back pain failing conservative management, MRI-confirmed disc degeneration, and who have undergone percutaneous nucleo-annuloplasty via Disc-Fx procedure. All patients had plain radiography and magnetic resonance imaging prior to procedure. Percutaneous nucleo-annuloplasty was only performed in patients with confirmed discogenic back pain via a positive provocative test on discography. Results: The mean functional outcome of Oswestry Disability Index improved from 46.25 points preoperatively to 24.12 at the of 1-year follow-up (p-value = 0.00). The Numerical Pain Rating Scale improved from 6.25 points to 4.4 points (p-value: 0.01) and 14.56 points to 8.85 points (p-value = 0.01) at preoperative to 1-year post-procedure respectively. There were no reported procedural related complications in the study population. Conclusion: The procedure of percutaneous nucleo-annuloplasty shows to be a relatively safe procedure that can be considered in patients with discogenic back pain. Larger studies would be desired to draw further conclusions about its efficacy.
That one doctor. . . Qualitative thematic analysis of 49 women’s written accounts of their endometriosis diagnosis
Authors: Fernley Nicole 
Published: January 2021

Introduction: One in nine women experience endometriosis, a common gynaecological disease, yet time to diagnosis averages 7 years. People are sharing their endometriosis experiences online. This research’s aim was to expose and synthesise the collective themes of diagnostic experience. Method: A qualitative thematic analysis of publicly accessible online autobiographical accounts of women and their endometriosis diagnosis. Themes were coded within NVIVO and thematic maps and tables created. Eighty-nine original accounts were identified, 26 were excluded. Saturation point was 49. Results: Women communicated long, painful and emotional journeys to diagnosis. Forty women experienced endometriosis symptoms before the age of 20, 33 before 15 years. Despite repeated GP presentation, 36 women had never heard of endometriosis before diagnosis. Women highlighted the positive impact of ‘that one doctor’ who said the word ‘endometriosis’ who listened, believed, investigated and provided prompt referral to specialists. Diagnosis gave relief and answers to the long journey, provided women a sense of community, hope and personal visibility after feeling alone. While this common disease is undiagnosed women suffer. Conclusion: ‘That one doctor’ can transform a patient’s experience and create a positive diagnosis pathway towards endometriosis. The doctor patient alliance is vital for prompt diagnosis. Symptom dismissal with long diagnosis delays are having negative, physical and psychological consequences for women. Early detection, GP education and community awareness campaigns are imperative to reduce further delayed diagnosis and long-term negative impacts of undiagnosed endometriosis.
αβ T-cell graft depletion for allogeneic HSCT in adults with hematological malignancies
Authors: de Witte Moniek A. , Janssen Anke , Nijssen Klaartje , Karaiskaki Froso , Swanenberg Luuk , van Rhenen Anna , Admiraal Rick , van der Wagen Lotte , Minnema Monique C. , Petersen Eefke , Raymakers Reinier A. P. , Westinga Kasper , Straetemans Trudy , Halkes Constantijn J. M. , Boelens Jaap-Jan , Kuball Jürgen 
Published: January 2021

Abstract
We conducted a multicenter prospective single-arm phase 1/2 study that assesses the outcome of αβ T-cell depleted allogeneic hematopoietic stem cell transplantation (allo-HSCT) of peripheral blood derived stem cells from matched related, or unrelated donors (10/10 and 9/10) in adults, with the incidence of acute graft-versus-host disease (aGVHD) as the primary end point at day 100. Thirty-five adults (median age, 59; range, 19-69 years) were enrolled. Conditioning consisted of antithymocyte globulin, busulfan, and fludarabine, followed by 28 days of mycophenolic acid after allo-HSCT. The minimal follow-up time was 24 months. The median number of infused CD34+ cells and αβ T cells were 6.1 × 106 and 16.3 × 103 cells per kg, respectively. The cumulative incidence (CI) of aGVHD grades 2-4 and 3-4 at day 100 was 26% and 14%. One secondary graft failure was observed. A prophylactic donor lymphocyte infusion (DLI) (1 × 105 CD3+ T cells per kg) was administered to 54% of the subjects, resulting in a CI of aGVHD grades 2-4 and 3-4 to 37% and 17% at 2 years. Immune monitoring revealed an early reconstitution of natural killer (NK) and γδ T cells. Cytomegalovirus reactivation associated with expansion of memory-like NK cells. The CI of relapse was 29%, and the nonrelapse mortality 32% at 2 years. The 2-year CI of chronic GVHD (cGVHD) was 23%, of which 17% was moderate. We conclude that only 26% of patients developed aGVHD 2-4 after αβ T-cell–depleted allo-HSCT within 100 days and was associated with a low incidence of cGVHD after 2 years. This trial was registered at www.trialregister.nl as #NL4767.
Hematologic indices in individuals with pathogenic germline DICER1 variants
Authors: Vasta Lauren M. , Khan Nicholas E. , Higgs Cecilia P. , Harney Laura A. , Carr Ann G. , Harris Anne K. , Schultz Kris Ann P. , McMaster Mary L. , Stewart Douglas R. 
Published: January 2021

Abstract
Pathogenic germline variants in DICER1 underlie an autosomal dominant, pleiotropic tumor-predisposition disorder. Murine models with the loss of DICER1 in hematopoietic stem cell progenitors demonstrate hematologic aberrations that include reductions in red and white blood cell counts, hemoglobin volume, and impaired maturation resulting in dysplasia. We investigated whether hematologic abnormalities such as those observed in DICER1-deficient mice were observed in humans with a pathogenic germline variant in DICER1. A natural history study of individuals with germline pathogenic DICER1 variants and family controls conducted through the National Cancer Institute (NCI) evaluated enrollees at the National Institutes of Health Clinical Center during a comprehensive clinical outpatient visit that included collecting routine clinical laboratory studies. These were compared against normative laboratory values and compared between the DICER1 carriers and controls. There were no statistical differences in routine clinical hematology laboratory studies observed in DICER1 carriers and family controls. A review of the medical history of DICER1 carriers showed that none of the individuals in the NCI cohort developed myelodysplastic syndrome or leukemia. Query of the International Pleuropulmonary Blastoma/DICER1 Registry revealed 1 DICER1 carrier who developed a secondary leukemia after treatment of pleuropulmonary blastoma. We found limited evidence that the hematologic abnormalities observed in murine DICER1 models developed in our cohort of DICER1 carriers. In addition, no cases of myelodysplastic syndrome were observed in either the NCI cohort or the International Pleuropulmonary Blastoma/DICER1 Registry; 1 case of presumed secondary leukemia was reported. Abnormalities in hematologic indices should not be solely attributed to DICER1. This trial was registered at www.clinicaltrials.gov as #NCT01247597.
Clinical predictors of poor outcomes in patients with sickle cell disease and COVID-19 infection
Authors: Minniti Caterina P. , Zaidi Ahmar U. , Nouraie Mehdi , Manwani Deepa , Crouch Gary D. , Crouch Andrew S. , Callaghan Michael U. , Carpenter Sarah , Jacobs Charleen , Han Jin , Simon Jena , Glassberg Jeffrey , Gordeuk Victor R. , Klings Elizabeth S. 
Published: January 2021

Abstract
We aimed to identify predictors of outcomes and survival in patients living in 4 major metropolitan areas who had sickle cell disease (SCD) and COVID-19 to inform best approaches to prevention and care. Data were collected at baseline and during the clinical course in SCD patients diagnosed with COVID-19 in four COVID-19 epicenters. Patients were followed up posthospital discharge for up to 3 months. Of sixty-six SCD patients with COVID-19, fifty patients (75%) required hospitalization, and seven died (10.6%). Patients with preexisting kidney disease (chronic kidney disease) were more likely to be hospitalized. The most common presenting symptom was vaso-occlusive pain. Acute chest syndrome occurred in 30 (60%) of the 50 hospitalized patients and in all who died. Older age and histories of pulmonary hypertension, congestive heart failure, chronic kidney disease, and stroke were more prevalent in patients who died, as were higher creatinine, lactate dehydrogenase, and D-dimer levels. Anticoagulation use while inpatient was twice less common in patients who died. All deaths occurred in individuals not taking hydroxyurea or any other SCD-modifying therapy. Patients with SCD and COVID-19 exhibited a broad range of disease severity. We cannot definitively state that the overall mortality is higher in patients with SCD, although our case fatality rate was ∼10% compared with ∼3% in the general population, despite a median age of 34 years. Individuals with SCD aged &gt;50 years, with preexisting cardiopulmonary, renal disease, and/or stroke not receiving hydroxyurea, who present with high serum creatinine, lactate dehydrogenase, and D-dimer levels, are at higher risk of death, irrespective of genotype or sex.
The use of photogrammetric fossil models in palaeontology education
Authors: Cunningham John A. 
Published: January 2021

AbstractPhotogrammetry allows overlapping photographs of fossils to be taken and converted into photo-realistic three-dimensional (3-D) digital models. These models offer potential advantages in teaching palaeontology: they are cheap to produce, can be easily shared and allow the study of rare and delicate specimens. Here I describe approaches for using photogrammetric models in the teaching and learning of palaeontology. Little is known about how students perceive these models and whether they find them valuable in their learning. To address this, first-year university students taught using both fossil specimens and digital models were surveyed about their experience through an anonymous online survey. Most students found that the digital models were easy to use, helped them understand anatomy and were more useful than studying photographs. However, most did not see the models as a substitute for studying real fossils and felt they could learn more from physical models. Digital models are a useful addition to palaeontological education that can supplement real fossils and allow palaeontological education to take place in circumstances where handling of specimens is not possible.
Serum alanine aminotransferase activity and risk factors for cardiovascular disease in a Caucasian population: the Tromsø study
Authors: Bekkelund Svein Ivar 
Published: January 2021

Abstract
Background
High and low levels of serum alanine aminotransferase (ALT) are both associated with cardiovascular diseases (CVD) risks especially in elderly, but the mechanisms are less known. This study investigated associations between ALT and CVD risk factors including effects of sex and age in a Caucasian population.

Methods
Cross-sectional data were analysed sex-stratified in 2555 men (mean age 60.4 years) and 2858 women (mean age 60.0 years) from the population study Tromsø 6. Associations were assessed by variance analysis and multivariable logistic regression of odds to have abnormal ALT. Risk factors included body mass index (BMI), waist-to-hip-ratio, blood pressure, lipids, glucose, glycated haemoglobin and high-sensitive C-reactive protein (CRP).

Results
Abnormal elevated ALT was detected in 113 men (4.4%) and 188 women (6.6%). Most CVD risk factors associated positively with ALT in both sexes except systolic blood pressure and CRP (women only), while ALT was positively associated with age in men when adjusted for CVD risk factors, P < 0.001. BMI predicted ALT in men (OR 0.94; 95% CI 0.88–1.00, P = 0.047) and women (OR 0.90; 95% CI 0.86–0.95, P < 0.001). A linear inversed association between age and ALT in men and a non-linear inversed U-trend in women with maximum level between 60 and 64 years were found.

Conclusion
This study confirms a positive relationship between ALT and CVD risk factors, particularly BMI. Age is not a major confounder in the ALT-CVD relationship, but separate sex-analyses is recommended in such studies.
Increasing consultant-level staffing as a proportion of overall physician coverage improves emergency department length of stay targets
Authors: Jenkins Dominic , Thomas Sarah A. , Pathan Sameer A. , Thomas Stephen H. 
Published: January 2021

AbstractObjectivesOne goal of Emergency Department (ED) operations is achieving an overall length of stay (LOS) that is less than four hours. The goal of the current study was to assess for association between increasing number of on-duty EM Consultants and LOS, while adjusting for overall (all-grade) on-duty emergency doctors’ numbers and other operational factors.MethodsThis was a retrospective analysis of three years (2016–2019) of data, employing a unit of analysis of 3276 eight-hour ED shifts. The study was conducted using a prospectively populated ED database in a busy (annual census 420,000) Middle Eastern ED with staffing by Consultants and multiple non-Consultant grades (Specialists, fellows, and residents). Using logistic regression, the main predictor variable of “on-duty Consultantn” was assessed for association with the study’s primary (dichotomous) endpoint: whether a shift’s median LOS met the target of < 240 min. Linear regression was used to assess for association between on-duty Consultantnand the study’s secondary (continuous) endpoint: median LOS for the ED shift.ResultsMultivariate logistic regression adjusting for a number of operations factors (including total EP on-duty complement) identified an association between increasingnof on-duty Consultants and the likelihood of a shift’s meeting the 4-h ED LOS target (OR 1.27, 95% CI 1.20 to 1.34,p < .0001). Multiple linear regression, which also adjusted for total on-duty EPnand other operational factors, also indicated LOS benefit from more on-duty Consultants: each additional on-duty Consultant was associated with a shift’s median LOS improving by 5.4 min (95% CI 4.3 to 6.5,p < .0001).ConclusionsAt the study site, in models that adjusted for overall on-duty EP numbers as well as myriad other operational factors, increasing numbers of on-duty Consultants was associated with a statistically and operationally significant reduction in ED LOS.
Informing the research agenda for optimizing audit and feedback interventions: results of a prioritization exercise
Authors: Colquhoun Heather L. , Carroll Kelly , Eva Kevin W. , Grimshaw Jeremy M. , Ivers Noah , Michie Susan , Brehaut Jamie C. 
Published: January 2021

Abstract
Background
Audit and feedback (A&F) interventions are one of the most common approaches for implementing evidence-based practices. A key barrier to more effective A&F interventions is the lack of a theory-guided approach to the accumulation of evidence. Recent interviews with theory experts identified 313 theory-informed hypotheses, spread across 30 themes, about how to create more effective A&F interventions. In the current survey, we sought to elicit from stakeholders which hypotheses were most likely to advance the field if studied further.

Methods
From the list of 313, three members of the research team identified 216 that were clear and distinguishable enough for prioritization. A web-based survey was then sent to 211 A&F intervention stakeholders asking them to choose up to 50 ‘priority’ hypotheses following the header “A&F interventions will be more effective if…”. Analyses included frequencies of endorsement of the individual hypotheses and themes into which they were grouped.

Results
68 of the 211 invited participants responded to the survey. Seven hypotheses were chosen by > 50% of respondents, including A&F interventions will be more effective… “if feedback is provided by a trusted source”; “if recipients are involved in the design/development of the feedback intervention”; “if recommendations related to the feedback are based on good quality evidence”; “if the behaviour is under the control of the recipient”; “if it addresses barriers and facilitators (drivers) to behaviour change”; “if it suggests clear action plans”; and “if target/goal/optimal rates are clear and explicit”. The most endorsed theme was Recipient Priorities (four hypotheses were chosen 92 times as a ‘priority’ hypotheses).

Conclusions
This work determined a set of hypotheses thought by respondents to be to be most likely to advance the field through future A&F intervention research. This work can inform a coordinated research agenda that may more efficiently lead to more effective A&F interventions.
Acute effects of strength and endurance exercise on serum BDNF and IGF-1 levels in older men
Authors: Arazi Hamid , Babaei Parvin , Moghimi Makan , Asadi Abbas 
Published: January 2021

Abstract
Background
Regarding an important effects of physical exercise on brain function in elders, the aim of this study was to examine the effects of strength and endurance exercise on brain neurobiological factors in older men.

Methods
Thirty older men volunteered to participate in this study and were randomly assigned to strength, endurance and control groups. The subjects in strength group performed two circuits of resistance exercise (6 exercises with 10 repetition of 65–70% of one repetition maximum), while endurance group performed 30 min running with 65–70% of maximal heart rate. Blood was obtained pre and post-exercise to determine changes in serum BDNF, IGF-1 and platelets.

Results
After exercise, both the strength and endurance groups showed significant increases in serum BDNF and IGF-1 concentrations and platelets at post-exercise and in comparison to control group (p < 0.05). In addition, no statistically significant differences were detected between the strength and endurance groups at post-exercise.

Conclusion
Our findings indicate that both the strength and endurance interventions are effective in elevating BDNF, IGF-1, and platelets, without significant differences between them.
Translation and validation of the Korean version of the clinical frailty scale in older patients
Authors: Ko Ryoung-Eun , Moon Seong Mi , Kang Danbee , Cho Juhee , Chung Chi Ryang , Lee Yunhwan , Hong Yun Soo , Lee So Hee , Lee Jung Hee , Suh Gee Young 
Published: January 2021

Abstract
Background
Frailty is a multidimensional syndrome that leads to an increase in vulnerability. Previous studies have suggested that frailty is associated with poor health-related outcomes. For frailty screening, the Clinical Frailty Scale (CFS) is a simple tool that is widely used in various translated versions. We aimed to translate the CSF into Korean and evaluated its contents and concurrent validity.

Methods
Translations and back-translations of the CFS were conducted independently. A multidisciplinary team decided the final CFS-K. Between August 2019 and April 2020, a total of 100 outpatient and inpatient participants aged ≥65 years were enrolled prospectively. The clinical characteristics were evaluated using the CFS-K. The CFS-K scores were compared with those of other frailty screening tools using Pearson’s correlation coefficient and Spearman’s rank correlation. The area under curve (AUC) for identifying the Eastern Cooperative Oncology Group Performance Status (ECOG PS) grade 3 or more was calculated for the CFS-K and other screening tools.

Results
The mean age of the participants was 76.5 years (standard deviation [SD], 7.0), and 63 (63%) participants were male. The mean CFS-K was 4.8 (SD, 2.5). Low body mass index (p = 0.013) and low score on the Korean version of the Mini-Mental State Examination (p < 0.001) were significantly associated with high CFS-K scores, except for those assigned to scale 9 (terminally ill). The CFS-K showed a significant correlation with other frailty screening tools (R = 0.7742–0.9190; p < 0.01), except in the case of those assigned to scale 9 (terminally ill). In comparison with other scales, the CFS-K identified ECOG PS grade 3 or more with the best performance (AUC = 0.99). Patients assigned to scale 9 on the CFS-K (terminally ill) had similar frailty scores to those assigned to scale 4 (vulnerable) or 5 (mildly frail).

Conclusions
In conclusion, the CFS-K is a valid scale for measuring frailty in older Korean patients. The CFS-K scores were significantly correlated with the scores of other scales. To evaluate the predictive and prognostic value of this scale, further larger-scale studies in various clinical settings are warranted.
Evaluation of undetected cases during the COVID-19 epidemic in Austria
Authors: Rippinger C. , Bicher M. , Urach C. , Brunmeir D. , Weibrecht N. , Zauner G. , Sroczynski G. , Jahn B. , Mühlberger N. , Siebert U. , Popper N. 
Published: January 2021

Abstract
Background
Knowing the number of undetected cases of COVID-19 is important for a better understanding of the spread of the disease. This study analyses the temporal dynamic of detected vs. undetected cases to provide guidance for the interpretation of prevalence studies performed with PCR or antibody tests to estimate the detection rate.

Methods
We used an agent-based model to evaluate assumptions on the detection probability ranging from 0.1 to 0.9. For each general detection probability, we derived age-dependent detection probabilities and calibrated the model to reproduce the epidemic wave of COVID-19 in Austria from March 2020 to June 2020. We categorized infected individuals into presymptomatic, symptomatic unconfirmed, confirmed and never detected to observe the simulated dynamic of the detected and undetected cases.

Results
The calculation of the age-dependent detection probability ruled values lower than 0.4 as most likely. Furthermore, the proportion of undetected cases depends strongly on the dynamic of the epidemic wave: during the initial upswing, the undetected cases account for a major part of all infected individuals, whereas their share decreases around the peak of the confirmed cases.

Conclusions
The results of prevalence studies performed to determine the detection rate of COVID-19 patients should always be interpreted with regard to the current dynamic of the epidemic wave. Applying the method proposed in our analysis, the prevalence study performed in Austria in April 2020 could indicate a detection rate of 0.13, instead of the prevalent ratio of 0.29 between detected and estimated undetected cases at that time.