bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cement augmentation for trochanteric femur fractures: A meta-analysis and systematic review of randomized clinical trials and observational studies
Authors: Rompen I F , Knobe M , Link B -C , Beeres F J P , Baumgärtner R , Diwersi N , Migliorini F , Nebelung S , Babst R , van de Wall B J M 
Published: May 2021

Abstract

Objective
To date, it is unclear what the clinical benefit of cement augmentation in fixation for trochanteric fractures is. The aim of this meta-analysis is to compare cement augmentation to no augmentation in fixation of trochanteric femur fractures in the elderly patients (&gt;65 years) following low energy trauma.

Methods
PubMed/Medline/Embase/CENTRAL/CINAHL were searched for both randomized clinical trials (RCT) and observational studies comparing both treatments. Effect estimates were pooled across studies using random effects models. Subgroup analysis was performed stratified by study design (RCTs and observational studies). The primary outcome is overall complication rate. Secondary outcomes include re-operation rate, mortality, operation duration, hospital stay, general quality of life, radiologic measures and functional hip scores.

Results
A total of four RCT's (437 patients) and three observational studies (293 patients) were included. The effect estimates of RCTs were equal to those obtained from observational studies. Cement augmentation has a significantly lower overall complication rate (28.3% versus 47.2%) with an odds ratio (OR) of 0.3 (95%CI 0.1-0.7). The occurrence of device/fracture related complications was the largest contributing factor to this higher overall complication rate in the non-augmented group (19.9% versus 6.0%, OR 0.2, 95%CI 0.1-0.6). Cement augmentation also carries a lower risk for re-interventions (OR 0.2, 95%CI 0.1- 0.7) and shortens the hospital stay with 2 days (95%CI -2.2 to -0.5 days). The mean operation time was 7 minutes longer in the augmented group (95%CI 1.3-12.9). Radiological scores (lag screw/blade sliding mean difference -3.1mm, 95%CI -4.6 to -1.7, varus deviation mean difference -6.15°, 95%CI; -7.4 to -4.9) and functional scores (standardized mean difference 0.31, 95%CI 0.0-0.6) were in favor of cement augmentation. Mortality was equal in both groups (OR 0.7, 95%CI 0.4-1.3) and cement related complications were rare.

Conclusion
Cement augmentation in fixation of trochanteric femoral fractures leads to fewer complications, re-operations and shorter hospital stay at the expense of a slightly longer operation duration. Cementation related complications occur rarely and mortality is equal between treatment groups. Based on these results, cement augmentation should be considered for trochanteric fractures in elderly patients.
Multicenter observational study of the gore excluder conformable endograft for endovascular abdominal aortic repair: Initial results
Authors: Roesti A , Isaak A , Gemayel G , Mujagic E , Briner L , Wolff T , Deslarzes-Dubuis C , Corpataux J -M , Déglise S 
Published: May 2021

Abstract

Objective
Endovascular repair (EVAR) has become the standard of care for treatment of abdominal aortic aneurysms. However, a significant number of EVAR remains outside the IFU, especially in cases of severe proximal angulation (&gt;60 degrees), resulting in failure. The new device GORE EXCLUDER Conformable AAA Endoprosthesis (W. L. Gore & Associates, Flagstaff, Ariz) has been designed to accommodate neck angulation, due to conformability and angulation control. The aim of this multicenter study is to report the initial results of this device.

Methods
From March 2019 to January 2021, the data of all consecutive patients with AAA treated with the Gore Excluder Conformable endograft at 4 vascular centers were reviewed. Patients were followed using a standardized protocol, with CT-scan at 1, 6 and 12 months, and then yearly. The primary endpoint was technical success and secondary outcomes were postoperative morbidity, rate of endoleak (EL) and any aneurysm-related re-interventions during follow-up.

Results
Among the 32 patients included, most were men with a mean age of 77 years old (range 60-92). Half of patients were smokers and 72% had hypertension. The mean diameter of AAA was 62 mm (47-90). The mean length of aortic neck was 26 mm (10-69), the mean diameter 23 mm (16-31) and the median neck angulation was 81 degrees (range 40-110). The mean procedural duration was 102 min (54-153) with a mean time of scopy of 24 min (8-47) and a total volume of contrast of 101 ml (40-165). Thirteen iliac branch device have been used in 7 patients. The technical success was 97% with 1 type Ia EL (3%). In the post-operative period, 4 medical and 3 surgical complications were observed. Two reinterventions were needed with an iliac stenting for a stenosis and a correction of a femoral false aneurysm. During the mean follow-up of 7 months, 2 type Ia ELs were observed. One spontaneously resolved and the other one was followed. One distal limb extension was succesfully implanted at 3 months for a type Ib EL for a total rate of reintervention of 9%. No migration was observed. No death occured.

Conclusion
The use of the Gore Excluder Conformable endograft seems to be safe and effective in difficult anatomies and especially high angulation. It allows for precise deployment without the need for additional contrast or operation time. Longer follow-up and more patients are required to confirm these excellent initials results.
Outcome after cervical debranching for proximal landing zone extension in thoracic endovascular aortic repair
Authors: Makaloski V , Lutz E , Bühlmann R , Weiss S , Schmidli J 
Published: May 2021

Abstract

Objective
Aim of this study was to assess perioperative and long-term outcome after cervical debranching for proximal landing zone extension in thoracic endovascular aortic repair (TEVAR).

Methods
Retrospective analysis of all patients undergoing left-sided carotid-subclavian bypass (CSB) and subclavian-carotid transposition (SCT) with simultaneous or staged TEVAR between 2010 and 2019. Endpoints were patency and re-intervention due to the debranching, postoperative stroke, cranial nerve injury and mortality at 30 days and during follow-up.

Results
Forty-eight patients (66 ± 12 years, 81 % male) had 25 (52%) CSB and 23 (48%) SCT. TEVAR was performed simultaneously in 39 (81%). Eleven (23%) patients had simultaneous emergency debranching and TEVAR. There were eight (17%) re-interventions within 30 days: four due to local hematoma, one for bypass occlusion, two for stenosis (of which one was not confirmed intraoperatively), and one after initially abandoned SCT with subsequent CSB on the next day. Thirty-day mortality was 2 %; one patient died on the first postoperative day after combined CABG surgery and multiorgan failure. Four (8%) patients suffered postoperative strokes; three occurred after simultaneous emergency procedures and none was fatal. Seven (15%) patients had postoperative ipsilateral cranial nerve lesions: two occurred after CSB and five after SCT. Two patients had recurrent laryngeal nerve palsy, two had phrenic nerve injury and three had Horner syndrome. All patients had mild symptoms and recovered mostly.
During a mean follow-up of 31±29 months with a Follow-up Index of 0.77, there were no reinterventions or occlusions, and no graft infections. Primary patency was 94%, primary assisted patency 96%, and secondary patency 100%. 9 patients died during follow-up after a mean of 30±29 months (range 0-82) all of them with patent cervical debranching.

Conclusion
Cervical debranching for proximal landing zone extension in TEVAR is a safe procedure with an acceptable rate of early re-interventions. There is a higher risk for postoperative stroke during simultaneous emergency debranching and TEVAR. Cranial nerve injuries and hematomas remain relevant periprocedural complications. During follow-up, excellent patency can be expected.
Management of malignant pleural effusion. A retrospective study comparing efficiency and outcomes of VATS talcum pleurodesis, insertion of tunneled pleural catheter (PleurX®), and a combination of both
Authors: Figueiredo L F Azenha , Deckarm S , Kocher G 
Published: May 2021

Abstract

Objective
The management of malignant pleural effusion is a common problem in thoracic surgery. Patients are often polymorbid and are usually referred at a terminal stage of their oncological disease. Our objective was to compare the efficiency and outcomes after different treatment strategies of malignant pleural effusion.

Methods
We retrospectively reviewed the charts of a total of 416 patients treated during the period of 2010 to 2020 who underwent thoracoscopic pleurodesis with or without implantation of tunneled pleural catheter (TPC) as well as patients who underwent the implantation of TPC alone. Primary outcome was postoperative survival and secondary outcome was length of stay (LOS). In addition, we documented the recurrence of ipsilateral pleural effusion and the need for reintervention as well as the pulmonary reexpansion of the lung on postoperative chest x-ray. Inclusion criteria were malignant pleural effusion and documented follow-up until time of death. Exclusion criteria were treatment for mesothelioma, pneumothorax and emphysema.

Results
A total of 199 patients were included for analysis. Median LOS of patients treated with implantation of TPC alone in analgosedation (n = 28) was 1 day (range:1-4 days). Median LOS of patients who received video-assisted talcum pleurodesis (n = 65) without implantation of a TPC was 6 days (range 1-38 days). Median LOS of patients who received VATS talcum pleurodesis and TPC (n = 106) was 3 days (range 1-34 day). The difference in LOS was statistically significant (p &lt; 0.05). Median overall survival was 108 days (range 3-3001 days). There was no statistically significant difference in survival between the different treatment groups (p = 0.47).

Conclusion
The primary goal when treating patients with malignant pleural effusion is relief of dyspnea and/or pain and to keep the duration of the inpatient treatment to a minimum. In patients with a considerable surgical risk due to comorbidities and their underlying oncological disease and who don’t require the sampling of histological material, a conservative treatment option with implantation of a TPC can be sufficient. The additional insertion of a TPC not only reduces the length of stay, but also has a positive effect on the efficacy of the pleurodesis in terms of less recurrence. We therefore recommend the routine use of TPC when performing VATS talcum pleurodesis in patients with malignant pleural effusion.
Ex vivo analysis of graft viability using 31P magnetic resonance imaging spectroscopy
Authors: Longchamp A , Klauser A , Agius T , Songeon J , Nastasi A , Ruttiman R , Meier R P H , Buhler L , Allagnat F , Corpataux J -M , Lazeyras F 
Published: May 2021

Abstract

Objective
Expansion in organ supply has been proposed through the use of organs after circulatory death (donation after circulatory death [DCD]) in order to face the chronic shortage of kidneys for transplantation. However, many DCD grafts are discarded because of long warm ischemia times, and the absence of reliable non-invasive means to determine kidney viability. P magnetic resonance imaging (pMRI) spectroscopy is a noninvasive method to detect high-energy phosphate metabolites, such as ATP. However, the reliability of pMRI to predict kidney energy state, and its viability before transplantation remain also unknown.

Methods
To mimic DCD, pig kidneys underwent 0, 30 min or 60 min of warm ischemia, before oxygenated hypothermic machine perfusion (HMP). During the ex vivo perfusion, we assessed energy metabolites and Gadolinium elimination using pMRI. Each sample underwent histopathological scoring.

Results
Using pMRI, we found that in pig kidney, ATP was rapidly generated in presence of oxygen (100 kPa), which remained stable up to 22 h. Warm ischemia (60 min) induced significant histological damages, delayed cortical and medullary Gadolinium elimination (perfusion), and reduced ATP levels, but not its precursors (AMP). Finally, ATP levels and kidney perfusion both inversely correlated with the severity of kidney histological injury.

Conclusion
ATP levels, and kidney perfusion measurements using pMRI, are biomarkers of kidney injury after warm ischemia. Future work will define the role of pMRI in predicting kidney graft viability and patient's survival.
Optimal liver metabolism and proliferation require the tight junction protein claudin-3
Authors: Baier F A , Sanchez-Taltavull D , Gómez Castellà C , Jebbawi F , Keogh A , Dias M , Deutsch U , Engelhardt B , Furuse M , Odriozola A , Zuber B , Odermatt2 A , Candinas D , Stroka D 
Published: May 2021

Abstract

Objective
The expression of hepatic tight junction proteins and their contribution to homeostasis and regeneration remained largely unexplored. Here, we determine the cell type specific expression of tight junction genes in murine livers. We further explore the regulation and functional importance of the transmembrane protein CLDN3 in normal and regenerating livers.

Methods
Murine livers were used for tissue- and single cell RNA-seq. CLDN3 localization was determined by immunofluorescence. CLDN3+/+ or CLDN3-/- livers were analysed by electron microscopy, fluorescence-activated cell sorting and liquid chromatography mass spectrometry. Lipid content was quantified with oil-red. Mice were subjected to 2/3 partial hepatectomy. Proliferation was quantified with Ki67 and pHH3 stainings. Cell cycle gene expression was determined by RT-qPCR. Barrier impairments were assessed with total bile acid measurements. Differential gene expression was analysed by tissue RNAseq with DESeq2.

Results
We determined the profile of tight junction gene expression the main liver cell types, showing that tight junction transcripts can be found in hepatocytes and cholangiocytes but also on non-parenchymal cell populations. CLDN3 was among the highly expressed- and regulated genes in native and regenerating livers. CLDN3 had a zonated expression pattern. CLDN3-/- mice had microscopically intact tight junctions, but showed significantly downregulated hepatic energy metabolism and suboptimal cell proliferation in the regeneration model.

Conclusion
Our data suggests a functional role of CLDN3 for maintenance of energy homeostasis and optimal regeneration, proving that the function of hepatic tight junction proteins extends beyond basic membrane sealing.
Intrapleural hyperthermic chemotherapy induces pro-immunogenic e-selectin expression in the vasculature of malignant pleural mesothelioma
Authors: Hao Y , Chriqui L -E , Gattlen C , Gonzalez M , Krueger T , Krueger T , Dyson P , Cavin S , Perentes J 
Published: May 2021

Abstract

Objective
Malignant pleural mesothelioma (MPM) is a deadly disease with dismal prognosis. Prior studies combining surgery with intrapleural hyperthermic chemotherapy (IPHC) have shown improved survivals in selected patients with MPM. However, the mechanisms by which IPHC acts on MPM and its microenvironment remains unknown. Here we focus on tumor endothelial adhesion molecule expression patterns.

Methods
First, we determined the impact of IPHC on MPM tumor and vascular compartments in vitro using a novel bioincubater for hyperthermic cell culture. The cytotoxicity of normo (37 °C) / hyperthermic (42 °C for 60 minutes) cisplatin/carboplatin therapies were evaluated on four MPM (MSTO211H, H-Meso, AE17 and AB12) and one endothelial (EC-RF24) cell lines at a minimum of 24 hours using a presto-blue assay. Second, we treated endothelial cells with IPHC (60 min, 42 °C at optimized cytotoxic concentrations) and determined its impact on pro-immunogenic adhesion molecule (E-selectin, VE-cadherin, VCAM and Connexin-43) expression at 24 hours by Western blot.

Results
Tumor and endothelial cell viability decreased with increasing doses of both chemotherapeutics but was not affected by hyperthermia (IC50 with or without hyperthermia of each cell line at 24 hours reported in Figure 1A). Interestingly, endothelial cell line IC50 was much higher than that of MPM tumor cells for both chemotherapeutics (Figure 1A). Pro-immunogenic adhesion molecule E-Selectin was increased at 24 hours by IPHC with both chemotherapeutics while VE-Cadherin, VCAM and Connexin-43 were not affected (Figure 1B).

Conclusion
Hyperthermia adds no cytotoxicity to intrapleural chemotherapy. However, IPHC favors pro-immunogenic endothelial E-selectin expression. The latter could help induce patient immunity against their MPM and improve survival. Confirmation of these findings in vivo is mandatory.
Outcome measurement in trauma surgery with a fracture database and clinical and patient-reported outcome measures (PROMs)
Authors: Bilici M , Morgenstern M , Frank C , Alispahic N , Müller A , Sauermann M , Eckardt H , Rikli D 
Published: May 2021

Abstract

Objective
Patient-Reported Outcome Measures (PROMs) gain growing attention. The Food and Drug Administration suggested in 2009 to have PROMs for every new treatment and technology. The use of PROMs was further promoted by the Patient Protection and Affordable Care Act of 2010 in the USA. Recommendations from other national and international organizations include the OECD's Project of Patient-Reported Indicator Surveys (PaRIS) and the International Consortium for Health Outcomes Measurement (ICHOM). Our development and initiation of a Fracture Database started early in 2018. We orientated our database on the role model of the Swedish Fracture Registry.

Methods
REDCap (Research Electronic Data Capture) is a web interface for a SQL (Structured Query Language)-Database. We used it to program the Fracture Registry. We collect data about demographics, diagnosis, treatment, adverse events, clinical outcomes, and PROMs. The PROMS are recorded with the Software 'Heartbeat ONE' vs. 6.15.4. Inclusion criteria are all patients with fractures of the upper and lower extremity, including the pelvis and multiple injuries, treated surgically. Excluded are all patients with fractures of the hand as monotrauma and non-surgical treatment. We established questionnaire sets for each anatomical region. Every hospitalized patient is screened for inclusion criteria to get the baseline PROMs. Follow-up PROMs are collected at 3-months and 12-months in our outpatient clinic.

Results
In five months of collecting PROMs, we have evaluated 599 patients, 521 fulfilling the inclusion criteria. 329 (63%) questionnaire sets were completed. The mean time for answering the questions was 11-20 minutes. The input rate of 63% for PROMs accounts for the start of the process, with 22 (4%) patients being dismissed before answering the questionnaires. 93 (18%) patients denied participation. 52 (10%) patients were not able to participate (dementia, delirium). Other causes for missing data were language barriers (n = 28; 5%), medical reasons like polytraumatized patients (n = 4; 0.8%), and deceased patients (n = 15; 2.9%).

Conclusion
Most Orthopaedic Trauma centers publish data about PROMs from surgically treated patients. Starting in the first quarter of 2021, we will include non-surgically treated patients. We have optimized the process of including patients. Our aim is a response rate of more than 80% within this year to get representing data.
Impact of autism genetic risk on brain connectivity: a mechanism for the female protective effect
Authors: Lawrence Katherine E , Hernandez Leanna M , Fuster Emily , Padgaonkar Namita T , Patterson Genevieve , Jung Jiwon , Okada Nana J , Lowe Jennifer K , Hoekstra Jackson N , Jack Allison , Aylward Elizabeth , Gaab Nadine , Van Horn John D , Bernier Raphael A , McPartland James C , Webb Sara J , Pelphrey Kevin A , Green Shulamite A , Bookheimer Susan Y , Geschwind Daniel H , Dapretto Mirella ,   GENDAAR Consortium, Aylward Elizabeth , Bernier Raphael A , Bookheimer Susan Y , Dapretto Mirella , Gaab Nadine , Geschwind Daniel H , Jack Allison , McPartland James C , Nelson Charles A , Pelphrey Kevin A , Van Horn John D , Webb Sara J , Ankenman Katy , Corrigan Sarah , Depedro-Mercier Dianna , Guilford Desiree , Gupta Abha R , Jacokes Zachary , Jeste Shafali , Keifer Cara M , Libsack Erin , Lowe Jennifer K , Kresse Anna , MacDonnell Erin , McDonald Nicole , Naples Adam , Neuhaus Emily , Sullivan Catherine A W , Tsapelas Heidi , Torgerson Carinna M , Ventola Pamela , Welker Olivia , Wolf Julie 
Published: May 2021

Abstract
The biological mechanisms underlying the greater prevalence of autism spectrum disorder in males than females remain poorly understood. One hypothesis posits that this female protective effect arises from genetic load for autism spectrum disorder differentially impacting male and female brains.
To test this hypothesis, we investigated the impact of cumulative genetic risk for autism spectrum disorder on functional brain connectivity in a balanced sample of boys and girls with autism spectrum disorder and typically developing boys and girls (127 youth, ages 8–17). Brain connectivity analyses focused on the salience network, a core intrinsic functional connectivity network which has previously been implicated in autism spectrum disorder.
The effects of polygenic risk on salience network functional connectivity were significantly modulated by participant sex, with genetic load for autism spectrum disorder influencing functional connectivity in boys with and without autism spectrum disorder but not girls.
These findings support the hypothesis that autism spectrum disorder risk genes interact with sex differential processes, thereby contributing to the male bias in autism prevalence and proposing an underlying neurobiological mechanism for the female protective effect.
Aberrant Claustrum Microstructure in Humans after Premature Birth
Authors: Hedderich Dennis M , Menegaux Aurore , Li Hongwei , Schmitz-Koep Benita , Stämpfli Philipp , Bäuml Josef G , Berndt Maria T , Bäuerlein Felix J B , Grothe Michel J , Dyrba Martin , Avram Mihai , Boecker Henning , Daamen Marcel , Zimmer Claus , Bartmann Peter , Wolke Dieter , Sorg Christian 
Published: May 2021

Abstract
Several observations suggest an impact of prematurity on the claustrum. First, the claustrum’s development appears to depend on transient subplate neurons of intra-uterine brain development, which are affected by prematurity. Second, the claustrum is the most densely connected region of the mammalian forebrain relative to its volume; due to its effect on pre-oligodendrocytes, prematurity impacts white matter connections and thereby the development of sources and targets of such connections, potentially including the claustrum. Third, due to its high connection degree, the claustrum contributes to general cognitive functioning (e.g., selective attention and task switching/maintaining); general cognitive functioning, however, is at risk in prematurity. Thus, we hypothesized altered claustrum structure after premature birth, with these alterations being associated with impaired general cognitive performance in premature born persons.
Using T1-weighted and diffusion-weighted magnetic resonance imaging in 70 very preterm/very low-birth-weight (VP/VLBW) born adults and 87 term-born adults, we found specifically increased mean diffusivity in the claustrum of VP/VLBW adults, associated both with low birth weight and at-trend with reduced IQ.
This result demonstrates altered claustrum microstructure after premature birth. Data suggest aberrant claustrum development, which is potentially related with aberrant subplate neuron and forebrain connection development of prematurity.