bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cystitis treatment with phytotherapy within the Rif, Northern Morocco
Authors: Chaachouay Noureddine , Orch Hicham , Zidane Lahcen 
Published: April 2021

AbstractBackgroundCystitis is often caused by a bacterial infection, which is the most widespread type among other urinary infections. This investigation was aimed to document detailed ethnobotanical information of medicinal plants used to heal cystitis problems because of their effective therapeutic properties. The study was carried in the Rif, from March 1, 2015, to April 15, 2017. Semi-structured direct interviews were carried with 657 interviewees to collect the indigenous therapeutic knowledge. Surveys included interviewed demographic profile and ethnomedicinal information. UR and MUV were applied in data analysis.ResultsA total of 60 plant species distributed in 51 genera and 31 families were commonly used by our interviewees in the therapy of cystitis. Apiaceae was designed by the highest number of species (7 species);Capparis spinosaL. was the medicinal plant most frequently prescribed by regional people. Leaves were the most commonly used plant part (41.5%), and the majority of herbal remedies were prepared from decoction (55 %).ConclusionsThis research is the first contribution to the ethnobotanical study of this region. It is suggested that the ingredients of natural plant species documented are being investigated to discover the therapeutic effects and mechanisms of action. Primary consideration must be paid to the preservation of medicinal species, comprehensive documentation of popular medicinal data, and biological validation of listed species.Graphical abstract
Palbociclib for Residual High-Risk Invasive HR-Positive and HER2-Negative Early Breast Cancer—The Penelope-B Trial
Authors: Loibl Sibylle , Marmé Frederik , Martin Miguel , Untch Michael , Bonnefoi Hervé , Kim Sung-Bae , Bear Harry , McCarthy Nicole , Melé Olivé Mireia , Gelmon Karen , García-Sáenz José , Kelly Catherine M. , Reimer Toralf , Toi Masakazu , Rugo Hope S. , Denkert Carsten , Gnant Michael , Makris Andreas , Koehler Maria , Huang-Bartelett Cynthia , Lechuga Frean Maria Jose , Colleoni Marco , Werutsky Gustavo , Seiler Sabine , Burchardi Nicole , Nekljudova Valentina , von Minckwitz Gunter 
Published: April 2021

PURPOSE About one third of patients with hormone receptor–positive, human epidermal growth factor receptor 2–negative breast cancer who have residual invasive disease after neoadjuvant chemotherapy (NACT) will relapse. Thus, additional therapy is needed. Palbociclib is a cyclin-dependent kinase 4 and 6 inhibitor demonstrating efficacy in the metastatic setting. PATIENTS AND METHODS PENELOPE-B ( NCT01864746 ) is a double-blind, placebo‐controlled, phase III study in women with hormone receptor–positive, human epidermal growth factor receptor 2–negative primary breast cancer without a pathological complete response after taxane‐containing NACT and at high risk of relapse (clinical pathological staging-estrogen receptor grading score ≥ 3 or 2 and ypN+). Patients were randomly assigned (1:1) to receive 13 cycles of palbociclib 125 mg once daily or placebo on days 1-21 in a 28-day cycle in addition to endocrine therapy (ET). Primary end point is invasive disease-free survival (iDFS). Final analysis was planned after 290 iDFS events with a two-sided efficacy boundary P < .0463 because of two interim analyses. RESULTS One thousand two hundred fifty patients were randomly assigned. The median age was 49.0 years (range, 19-79), and the majority were ypN+ with Ki-67 ≤ 15%; 59.4% of patients had a clinical pathological staging-estrogen receptor grading score ≥ 3. 50.1% received aromatase inhibitor, and 33% of premenopausal women received a luteinizing hormone releasing hormone analog in addition to either tamoxifen or an aromatase inhibitor. After a median follow-up of 42.8 months (92% complete), 308 events were confirmed. Palbociclib did not improve iDFS versus placebo added to ET-stratified hazard ratio, 0.93 (95% repeated CI, 0.74 to 1.17) and two-sided weighted log-rank test (Cui, Hung, and Wang) P = .525. There was no difference among the subgroups. Most common related serious adverse events were infections and vascular disorders in 113 (9.1%) patients with no difference between the treatment arms. Eight fatal serious adverse events (two palbociclib and six placebo) were reported. CONCLUSION Palbociclib for 1 year in addition to ET did not improve iDFS in women with residual invasive disease after NACT.
Impact of Variant Reclassification in Cancer Predisposition Genes on Clinical Care
Authors: Chiang Jianbang , Chia Tze Hao , Yuen Jeanette , Shaw Tarryn , Li Shao-Tzu , Binte Ishak Nur Diana , Chew Ee Ling , Chong Siao Ting , Chan Sock Hoai , Ngeow Joanne 
Published: April 2021

PURPOSE Genetic testing has clinical utility in the management of patients with hereditary cancer syndromes. However, the increased likelihood of encountering a variant of uncertain significance in individuals of non-European descent such as Asians may be challenging to both clinicians and patients. This study aims to evaluate the impact of variant reclassification in an Asian country with variants of uncertain significance reported in cancer predisposition genes. METHODS A retrospective analysis of patients seen at the Cancer Genetics Service at the National Cancer Centre Singapore between February 2014 and March 2020 was conducted. The frequency, direction, and time to variant reclassification were evaluated by comparing the reclassified report against the original report. RESULTS A total of 1,412 variants of uncertain significance were reported in 49.9% (845 of 1,695) of patients. Over 6 years, 6.7% (94 of 1,412) of variants were reclassified. Most variants of uncertain significance (94.1%, 80 of 85) were downgraded to benign or likely benign variant, with a smaller proportion of variants of uncertain significance (5.9%, 5 of 85) upgraded to pathogenic or likely pathogenic variant. Actionable variants of uncertain significance upgrades and pathogenic or likely pathogenic variant downgrades, which resulted in management changes, happened in 31.0% (39 of 126) of patients. The median and mean time taken for reclassification were 1 and 1.62 year(s), respectively. CONCLUSION We propose a clinical guideline to standardize management of patients reported to have variants of uncertain significance. Management should be based on the patient’s personal history, family history, and variant interpretation. For clinically relevant or suspicious variants of uncertain significance, follow-up is recommended every 2 years, as actionable reclassifications may happen during this period.
Leftover Opioid Analgesics and Disposal Following Ambulatory Pediatric Surgeries in the Context of a Restrictive Opioid-Prescribing Policy
Authors: Stone Amanda L. , Qu’d Dima , Luckett Twila , Nelson Scott D. , Quinn Erin E. , Potts Amy L. , Patrick Stephen W. , Bruehl Stephen , Franklin Andrew D. 
Published: April 2021

BACKGROUND:
Opioid analgesics are commonly prescribed for postoperative analgesia following pediatric surgery and often result in leftover opioid analgesics in the home. To reduce the volume of leftover opioids and overall community opioid burden, the State of Tennessee enacted a policy to reduce initial opioid prescribing to a 3-day supply for most acute pain incidents. We aimed to evaluate the extent of leftover opioid analgesics following pediatric ambulatory surgeries in the context of a state-mandated restrictive opioid-prescribing policy. We also aimed to evaluate opioid disposal rates, methods of disposal, and reasons for nondisposal.

METHODS:
Study personnel contacted the parents of 300 pediatric patients discharged with an opioid prescription following pediatric ambulatory surgery. Parents completed a retrospective telephone survey regarding opioid use and disposal. Data from the survey were combined with data from the medical record to evaluate proportion of opioid doses prescribed that were left over.

RESULTS:
The final analyzable sample of 185 patients (62% response rate) were prescribed a median of 12 opioid doses (interquartile range [IQR], 12–18), consumed 2 opioid doses (IQR, 0–4), and had 10 opioid doses left over (IQR, 7–13). Over 90% (n = 170 of 185) of parents reported they had leftover opioid analgesics, with 83% of prescribed doses left over. A significant proportion (29%, n = 54 of 185) of parents administered no prescribed opioids after surgery. Less than half (42%, n = 71 of 170) of parents disposed of the leftover opioid medication, most commonly by flushing down the toilet, pouring down the sink, or throwing in the garbage. Parents retaining leftover opioids (53%, n = 90 of 170) were most likely to keep them in an unlocked location (68%, n = 61 of 90). Parents described forgetfulness and worry that their child will experience pain in the future as primary reasons for not disposing of the leftover opioid medication.

CONCLUSIONS:
Despite Tennessee’s policy aimed at reducing leftover opioids, a significant proportion of prescribed opioids were left over following pediatric ambulatory surgeries. A majority of parents did not engage in safe opioid disposal practices. Given the safety risks related to leftover opioids in the home, further interventions to improve disposal rates and tailor opioid prescribing are warranted after pediatric surgery.
Long-term monitoring for the surveillance of the conservation status of Tursiops truncatus in an EU Natura2000 site in the Mediterranean Sea. A pilot study in the Tuscan Archipelago
Authors: ARCANGELI ANTONELLA , CROSTI ROBERTO , CAMPANA ILARIA , CAROSSO LARA , GREGORIETTI MARTINA , MAINARDI GIULIA , MAZZUCATO VERONICA , CASTELLI ALBERTO 
Published: April 2021

A pilot study, using the dataset from the research network ‘FLT Med Net’, which regularly monitors transborder regions in the Mediterranean Sea using ferries as platform for systematic surveys, was undertaken to assess common bottlenose dolphin range and population trends within the Natura 2000 EU marine site “Tutela del Tursiops truncatus”. The site was recently designated by the Tuscany Region (Italy) within the requirement of the EU Habitats Directive. In order to evaluate the conservation status of bottlenose dolphin according to the surveillance scheme of the Directive, two six-year periods (2007-2012; 2013-2018) were compared to assess trends in distribution-occurrence (range); Sightings Per Unit of Effort and Density (population). In total, 18146 NM were surveyed along two fixed transects, recording 90 sightings of Tursiops truncatus and a total of 268 specimens. Between the two periods, slight but not statistically significant differences were assessed, with decreasing trend in range and population of the species; no variation was detected in mean group sizes. Travelling was the most common behaviour, and juveniles were present in 20% of the sightings, concentrated during spring and summer. The consistent FLT Med Net dataset was found to be appropriate to evaluate important parameters for the assessment of trends in the conservation status of Tursiops truncatus at the Natura2000 site scale.
Comparison of gender, age, and body mass index for spatiotemporal parameters of bilateral gait pattern
Authors: Abualait Turki , Ahsan Mohammad 
Published: April 2021

Background: Studies on the gaits parameters have been identified on the patient population. Most researchers confirm that the patients walk differently than normal people and they may have a greater risk of falls. Consistent finding and description of gender, age, and body mass index differences in gait studies is rare in healthy subjects. This research was performed to compare spatiotemporal parameters of gait between gender, as per their age and body mass index level. Methods: A cross-sectional study was conducted with forty-five young adults (F=20, M=25). Stadiometer and Physilog 4 inertial sensors were used for data collection. A gait analyzer 5.2 software (GaitUp, S.A. Lausanne, Switzerland) was used to determine spatiotemporal parameters. Results: No statistically significant differences were found in any bilateral foot gait parameters with respect to gender, age, and body mass index. Females were found with higher total double support and cadence than males. Cadence also increases with age. Obese people showed lower gait speed, cadence, and total double support. Conclusion: These findings may be beneficial to those who have abnormal gait pattern due to age, body mass index differences, decreased muscle strength, spasticity, and joint mobility. This important information should be considered to rehabilitate patients with abnormal gait patterns to controlling dynamic balance and risk of falling.
Case Report: Successful primary percutaneous coronary intervention in octogenarian with acute-on-chronic kidney disease and total atrioventricular block after acute myocardial infarction
Authors: Andrianto Andrianto , Laksmi Ni Putu Anggun , Herdyanto Rio 
Published: April 2021

Myocardial infarction (MI) is frequently complicated by the worsening of renal function. Undergoing primary percutaneous coronary intervention (PCI) becomes crucial to a patient with ST-segment elevation myocardial infarction (STEMI). With appropriate management of MI, acute-on-chronic kidney disease (ACKD) requiring dialysis post-MI remains an important clinical predictor of elevated in-hospital mortality among patients with MI. In this study, we reported an octogenarian patient suffering from STEMI with ACKD and total atrioventricular block (TAVB). She underwent insertion of a temporary pacemaker and primary PCI. Renal function was improved after dialysis by decreasing the amount of serum creatinine from 8.1 mg/dL at admission to 1.05 mg/dL after primary PCI and dialysis. Primary PCI should still be considered for patients with acute MI, even though these patients have kidney disease, to save the heart muscle and even indirectly improve the kidney function itself.
Evaluating participants' perceptions of a functional physical fitness assessment for those aged 60 years and over conducted in the community by student physiotherapists
Authors: Candy Elizabeth , Bunn Lisa , Virgo Pauline , Byrne Christopher , Bannigan Katrina 
Published: April 2021

Background/aims Physical fitness is crucial in preserving independence and quality of life for older adults. A functional physical fitness assessment has been designed specifically for those aged 60 years and over. This study explored older people's perceptions of this assessment, conducted by student physiotherapists, and the feasibility of a larger study to evaluate the long-term effects of its use. Methods A total of five scheduled drop-in sessions were arranged. Participants aged 60 years and over were recruited. Physiotherapy students conducted the assessment and participants completed follow-up physical activity status and quality of life questionnaires as well as an evaluation of the session. Focus groups were conducted to explore participant's perceptions and experiences. Data was analysed using descriptive statistics and thematic analysis. Results Overall, 91 adults (aged 60–93 years) participated, 75 (46 (61%) women and 10 (13%) men) completed questionnaires, and seven attended focus groups. In total, 100% of the 91 participants suggested that those aged 60 years and over would benefit from functional fitness assessment, and 79% perceived this would lead to increased physical activity. Focus group participants reported they enjoyed working with students and suggested that regular assessment would provide a yardstick for their level of fitness, that they would like to repeat their tests next year and that ‘they were mentally a positive thing’. Conclusions Functional fitness assessments were perceived as useful and encouraged older adults to increase their activity levels. Students successfully completed the tests in non-healthcare settings. This study suggests that a large trial designed to assess the benefit of regular functional fitness assessment for the over 60s in community settings is feasible.
The influence of expectation modification in knee arthroplasty on satisfaction of patients: a randomized controlled trial
Authors: Tolk Jaap J. , Janssen Rob P. A. , Haanstra Tsjitske M. , van der Steen M. C. , Bierma-Zeinstra Sita M. A. , Reijman Max 
Published: April 2021

Aims Meeting preoperative expectations is known to be of major influence on postoperative satisfaction after total knee arthroplasty (TKA). Improved management of expectation, resulting in more realistic expectations can potentially lead to higher postoperative satisfaction. The objective of this study was to assess the effect of an additional preoperative education module, addressing realistic expectations for long-term functional recovery, on postoperative satisfaction and expectation fulfilment. Methods In total, 204 primary TKA patients with osteoarthritis were enrolled in this randomized controlled trial (RCT). Patients were allocated to either usual preoperative education (control group) or usual education plus an additional module on realistic expectations (intervention group). Primary outcome was being very satisfied (numerical rating scale for satisfaction ≥ 8) with the treatment result at 12 months' follow-up. Other outcomes were change in preoperative expectations and postoperative expectation fulfilment. Results A total of 187 patients (91.7%) were available for analysis at follow-up. In the intention-to-treat analysis, 58.5% (55/94) of patients were very satisfied with the treatment result in the control group, and 69.9% (65/93) of patients in the intervention group (adjusted odds ratio (AOR) 1.72, 95% confidence interval (CI) 0.90 to 3.29). A per-protocol analysis for patients who attended the education session (92.0%, n = 172) showed that 56.9% (49/86) of patients were very satisfied in the control group and 74.4% (61/86) in the intervention group (AOR 2.44, 95% CI 1.21 to 4.91). After preoperative education, the expectation scores in the intervention group were significantly lower (mean difference -6.9 (95% CI -10.2 to -3.6)) and did not alter in the control group (mean difference 0.5 (95% CI -2.9 to 3.9)). Overall, fulfilment of expectations at 12 months was significantly higher in the intervention group (mean difference 11.4% (95% CI 2.3 to 20.5)). Conclusion Improved preoperative patient education can modify patient expectations, resulting in higher postoperative fulfilment of expectation and higher satisfaction in the group that attended the preoperative education. This is the first RCT to confirm the potential of improved expectation management on satisfaction after TKA. Cite this article: Bone Joint J 2021;103-B(4):619–626.
Management of low periprosthetic distal femoral fractures
Authors: Ross Lauren A. , Keenan Oisin J. F. , Magill Matthew , Brennan Caitlin M. , Clement Nick D. , Moran Matt , Patton James T. , Scott Chloe E. H. 
Published: April 2021

Aims Debate continues regarding the optimum management of periprosthetic distal femoral fractures (PDFFs). This study aims to determine which operative treatment is associated with the lowest perioperative morbidity and mortality when treating low (Su type II and III) PDFFs comparing lateral locking plate fixation (LLP-ORIF) or distal femoral arthroplasty (DFA). Methods This was a retrospective cohort study of 60 consecutive unilateral (PDFFs) of Su types II (40/60) and III (20/60) in patients aged ≥ 60 years: 33 underwent LLP-ORIF (mean age 81.3 years (SD 10.5), BMI 26.7 (SD 5.5); 29/33 female); and 27 underwent DFA (mean age 78.8 years (SD 8.3); BMI 26.7 (SD 6.6); 19/27 female). The primary outcome measure was reoperation. Secondary outcomes included perioperative complications, calculated blood loss, transfusion requirements, functional mobility status, length of acute hospital stay, discharge destination and mortality. Kaplan-Meier survival analysis was performed. Cox multivariate regression analysis was performed to identify risk factors for reoperation after LLP-ORIF. Results Follow-up was at mean 3.8 years (1.0 to 10.4). One-year mortality was 13% (8/60). Reoperation was more common following LLP-ORIF: 7/33 versus 0/27 (p = 0.008). Five-year survival for reoperation was significantly better following DFA; 100% compared to 70.8% (95% confidence interval (CI) 51.8% to 89.8%, p = 0.006). There was no difference for the endpoint mechanical failure (including radiological loosening); ORIF 74.5% (56.3 to 92.7), and DFA 78.2% (52.3 to 100, p = 0.182). Reoperation following LLP-ORIF was independently associated with medial comminution; hazard ratio (HR) 10.7 (1.45 to 79.5, p = 0.020). Anatomical reduction was protective against reoperation; HR 0.11 (0.013 to 0.96, p = 0.046). When inadequately fixed fractures were excluded, there was no difference in five-year survival for either reoperation (p = 0.156) or mechanical failure (p = 0.453). Conclusion Absolute reoperation rates are higher following LLP fixation of low PDFFs compared to DFA. Where LLP-ORIF was well performed with augmentation of medial comminution, there was no difference in survival compared to DFA. Though necessary in very low fractures, DFA should be used with caution in patients with greater life expectancies due to the risk of longer term aseptic loosening. Cite this article: Bone Joint J 2021;103-B(4):635–643.
The use of low intensity pulsed ultrasound in the foot and ankle
Authors: Rashid Mustafa S. , Tourné Yves , Teoh Kar H. 
Published: April 2021

Low intensity pulsed ultrasound (LIPUS) therapy has demonstrated clinical effectiveness in achieving union in a variety of fracture situations. Few studies have investigated the effectiveness of LIPUS therapy in foot and ankle surgery. The overall rate of union in all published studies relating to the use of LIPUS in a variety of foot and ankle fracture and fusion situations is 95%. Some studies suggest lower healing rates (~ 67%) when LIPUS therapy is used to treat hindfoot fusion nonunion. A well-powered, high-quality, randomized controlled trial is needed to demonstrate the clinical and cost effectiveness of LIPUS therapy in foot and ankle surgery. Cite this article: EFORT Open Rev 2021;6:217-224. DOI: 10.1302/2058-5241.6.200045
Next generation sequencing for pathogen detection in periprosthetic joint infections
Authors: Indelli Pier F. , Ghirardelli Stefano , Violante Bruno , Amanatullah Derek F. 
Published: April 2021

Periprosthetic joint infections (PJI) represent one of the most catastrophic complications following total joint arthroplasty (TJA). The lack of standardized diagnostic tests and protocols for PJI is a challenge for arthroplasty surgeons. Next generation sequencing (NGS) is an innovative diagnostic tool that can sequence microbial deoxyribonucleic acids (DNA) from a synovial fluid sample: all DNA present in a specimen is sequenced in parallel, generating millions of reads. It has been shown to be extremely useful in a culture-negative PJI setting. Metagenomic NGS (mNGS) allows for universal pathogen detection, regardless of microbe type, in a 24–48-hour timeframe: in its nanopore-base variation, mNGS also allows for antimicrobial resistance characterization. Cell-free DNA (cfDNA) NGS, characterized by lack of the cell lysis step, has a fast run-time (hours) and, together with a high sensitivity and specificity in microorganism isolation, may provide information on the presence of antimicrobial resistance genes. Metagenomics and cfDNA testing have reduced the time needed to detect infecting bacteria and represent very promising technologies for fast PJI diagnosis. NGS technologies are revolutionary methods that could disrupt the diagnostic paradigm of PJI, but a comprehensive collection of clinical evidence is still needed before they become widely used diagnostic tools. Cite this article: EFORT Open Rev 2021;6:236-244. DOI: 10.1302/2058-5241.6.200099