bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pancreatic outflow tract reconstruction after pancreaticoduodenectomy: a meta-analysis of randomized controlled trials
Authors: Wang Xin Xin , Yan Yu Ke , Dong Bao Long , Li Yuan , Yang Xiao Jun 
Published: July 2021

Abstract
Background
To evaluate the outcomes of pancreaticogastrostomy and pancreaticojejunostomy after pancreatoduodenectomy with the help of a meta-analysis.

Methods
Randomized controlled trials comparing pancreaticogastrostomy and pancreaticojejunostomy were searched electronically using PubMed, The Cochrane Library, and EMBASE. Fixed and random-effects were used to measure pooled estimates. Research indicators included pancreatic fistula, delayed gastric emptying, postoperative hemorrhage, intraperitoneal fluid collection, wound infection, overall postoperative complications, reoperation, and mortality.

Results
Overall, 10 randomized controlled trials were included in this meta-analysis, with a total of 1629 patients. The overall incidences of pancreatic fistula and intra-abdominal collections were lower in the pancreaticogastrostomy group than in the pancreaticojejunostomy group (OR=0.73, 95% CI 0.55~0.96, p=0.02; OR=0.59, 95% CI 0.37~0.96, p=0.02, respectively). The incidence of B/C grade pancreatic fistula in the pancreaticogastrostomy group was lower than that in the pancreaticojejunostomy group, but no significant difference was observed (OR=0.61, 95%CI 0.34~1.09, p=0.09). Postoperative hemorrhage was more frequent in the pancreaticogastrostomy group than in the pancreaticojejunostomy group (OR=1.52; 95% CI 1.08~2.14, p=0.02). No significant differences in terms of delayed gastric emptying, wound infection, reoperation, overall postoperative complications, mortality, exocrine function, and hospital readmission were observed between groups.

Conclusion
This meta-analysis suggests that pancreaticogastrostomy reduces the incidence of postoperative pancreatic fistula and intraperitoneal fluid collection but increases the risk of postoperative hemorrhage compared with pancreaticojejunostomy.
Luteal phase support for in vitro fertilization/intracytoplasmic sperm injection fresh cycles: a systematic review and network meta-analysis
Authors: Wu Hanglin , Zhang Songying , Lin Xiaona , Wang Shasha , Zhou Ping 
Published: July 2021

AbstractBackgroundVarious luteal phase supports (LPSs) have been proven to increase the pregnancy rate in fresh cycles of in vitro fertilization or intracytoplasmic sperm injection; however, there is still significant debate regarding the optimal use of LPS.MethodsA systematic review with the use of a network meta-analysis was performed via electronic searching of Ovid MEDLINE, the Cochrane Library, Embase, Web of Science,ClinicalTrials.govand Google Scholar (up to January 2021) to compare the effectiveness and safety of various LPSs, as well as to evaluate the effects of different initiations of LPSs on pregnancy outcomes. The primary outcomes included live birth and ongoing pregnancy, with the results presented as odds ratios (ORs) with 95% confidence intervals (CIs).ResultsEighty-nine randomized controlled trials with 29,625 women comparing 14 interventions or placebo/no LPS treatments were included in the meta-analyses. No significant differences were found in terms of the pregnancy outcomes when LPS was started within 48 h after oocyte retrieval versus a delayed initiation between 48 h and 96 h after oocyte retrieval. The addition of gonadotropin-releasing hormone (GnRH) agonists to progesterone vaginal pessaries showed a significant benefit in terms of live birth (OR 1.39, 95% CI 1.08 to 1.78). Only human chorionic gonadotropin (HCG) was found to be more efficacious than the placebo/no LPS treatment in terms of live birth (OR 15.43, 95% CI 2.03 to 117.12, low evidence). Any active LPSs (except for rectal or subcutaneous progesterone) was significantly more efficacious than the placebo/no LPS treatment in terms of ongoing pregnancy, with ORs ranging between 1.77 (95% CI 1.08 to 2.90) for the vaginal progesterone pessary and 2.14 (1.23 to 3.70) for the intramuscular progesterone treatment. Among the comparisons of efficacy and tolerability between the active treatments, the differences were small and very uncertain.ConclusionDelays in progesterone supplementation until 96 h after oocyte retrieval does not affect pregnancy outcomes. The safety of GnRH agonists during the luteal phase needs to be evaluated in future studies before the applications of these agonists in clinical practice. With comparable efficacy and acceptability, there may be several viable clinical options for LPS.
Development and validation of the Sorting non-trauMatIc adoLescent knEe pain (SMILE) tool – a development and initial validation study
Authors: Guldhammer Clara , Holden Sinead , Sørensen Marina Elmelund , Olesen Jens Lykkegaard , Jensen Martin Bach , Rathleff Michael Skovdal 
Published: July 2021

Abstract
Background
Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain.

Method
A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10–17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a gold standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the gold standard, and Kappa statistic for interrater reliability were calculated.

Results
The final tool improved diagnostic agreement with the gold standard from 22.7% (95% CI 10.3–35.1) to 77.3% (95% CI 64.9–89.7). Inter-rater reliability increased from poor agreement k = − 0.04 (95% CI, − 0.12-0.04) to moderate agreement k = 0.56 (95% CI, 0.40–0.72).

Conclusion
This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.
Chronic colitis exacerbates NLRP3-dependent neuroinflammation and cognitive impairment in middle-aged brain
Authors: He Xiao-fei , Li Li-li , Xian Wen-biao , Li Ming-yue , Zhang Li-ying , Xu Jing-hui , Pei Zhong , Zheng Hai-qing , Hu Xi-quan 
Published: July 2021

Abstract
Background
Neuroinflammation is a major driver of age-related brain degeneration and concomitant functional impairment. In patients with Alzheimer’s disease, the most common form of age-related dementia, factors that enhance neuroinflammation may exacerbate disease progression, in part by impairing the glymphatic system responsible for clearance of pathogenic beta-amyloid. Inflammatory bowel diseases (IBDs) induce neuroinflammation and exacerbate cognitive impairment in the elderly. The NACHT-LRR and pyrin (PYD) domain-containing protein 3 (NLRP3) inflammasome has been implicated in neuroinflammation. Therefore, we examined if the NLRP3 inflammasome contributes to glymphatic dysfunction and cognitive impairment in an aging mouse model of IBD.

Methods
Sixteen-month-old C57BL/6J and NLRP3 knockout (KO) mice received 1% wt/vol dextran sodium sulfate (DSS) in drinking water to model IBD. Colitis induction was confirmed by histopathology. Exploratory behavior was examined in the open field, associative memory by the novel-object recognition and Morris water maze tests, glymphatic clearance by in vivo two-photon imaging, and neuroinflammation by immunofluorescence and western blotting detection of inflammatory markers.

Results
Administration of DSS induced colitis, impaired spatial and recognition memory, activated microglia, and increased A1-like astrocyte numbers. In addition, DSS treatment impaired glymphatic clearance, aggravated amyloid plaque accumulation, and induced neuronal loss in the cortex and hippocampus. These neurodegenerative responses were associated with increased NLRP3 inflammasome expression and accumulation of gut-derived T lymphocytes along meningeal lymphatic vessels. Conversely, NLRP3 depletion protected against cognitive dysfunction, neuroinflammation, and neurological damage induced by DSS.

Conclusions
Colitis can exacerbate age-related neuropathology, while suppression of NLRP3 inflammasome activity may protect against these deleterious effects of colitis.
Feasibility of task-sharing with community health workers for the identification, emergency management and referral of women with pre-eclampsia, in Mozambique
Authors: Sevene Esperança , Boene Helena , Vidler Marianne , Valá Anifa , Macuacua Salésio , Augusto Orvalho , Fernandes Quinhas , Bique Cassimo , Macete Eusébio , Sidat Mohsin , von Dadelszen Peter , Munguambe Khátia ,   CLIP Feasibility Working Group, Pires Rosa , Nhamirre Zefanias , Chiaú Rogério , Matavele Analisa , Tembe Adérito , Machai Lina , Payne Beth , Drebit Sharla , Kariya Chirag , Magee Laura 
Published: July 2021

Abstract
Background
Maternal mortality is an important public health problem in low-income countries. Delays in reaching health facilities and insufficient health care professionals call for innovative community-level solutions. There is limited evidence on the role of community health workers in the management of pregnancy complications. This study aimed to describe the feasibility of task-sharing the initial screening and initiation of obstetric emergency care for pre-eclampsia/eclampsia from the primary healthcare providers to community health workers in Mozambique and document healthcare facility preparedness to respond to referrals.

Method
The study took place in Maputo and Gaza Provinces in southern Mozambique and aimed to inform the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomized controlled trial. This was a mixed-methods study. The quantitative data was collected through self-administered questionnaires completed by community health workers and a health facility survey; this data was analysed using Stata v13. The qualitative data was collected through focus group discussions and in-depth interviews with various community groups, health care providers, and policymakers. All discussions were audio-recorded and transcribed verbatim prior to thematic analysis using QSR NVivo 10. Data collection was complemented by reviewing existing documents regarding maternal health and community health worker policies, guidelines, reports and manuals.

Results
Community health workers in Mozambique were trained to identify the basic danger signs of pregnancy; however, they have not been trained to manage obstetric emergencies. Furthermore, barriers at health facilities were identified, including lack of equipment, shortage of supervisors, and irregular drug availability. All primary and the majority of secondary-level facilities (57%) do not provide blood transfusions or have surgical capacity, and thus such cases must be referred to the tertiary-level. Although most healthcare facilities (96%) had access to an ambulance for referrals, no transport was available from the community to the healthcare facility.

Conclusions
This study showed that task-sharing for screening and pre-referral management of pre-eclampsia and eclampsia were deemed feasible and acceptable at the community-level, but an effort should be in place to address challenges at the health system level.
Fixed-bearing vs mobile-bearing prostheses for total knee arthroplasty after approximately 10 years of follow-up: a meta-analysis
Authors: Hao Dongsheng , Wang Junjie 
Published: July 2021

AbstractBackgroundThe benefits and risks of fixed-bearing and mobile-bearing designs for total knee arthroplasty (TKA) were compared, and long-term functional, clinical and radiological outcomes were analysed.MethodsA comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane Central databases was conducted to identify randomized controlled trials (RCTs) comparing fixed-bearing and mobile-bearing designs with no less than 9 years of follow-up. Primary outcome measures were Knee Society Scores (KSSs), range of motion (ROM) in knee joint values, complication rates and revision rates. The final search was performed on 23 April 2021.ResultsSix RCTs were included. A total of 451 patients with 612 knees met the inclusion criteria. The mobile-bearing design, in contrast to the fixed-bearing design, can clearly increase the KSFSs, especially with posterior cruciate retention. There was no significant difference in the KSKSs, ROM values, revision rates or complication rates between the two bearing design groups.ConclusionAfter approximately 10 years of follow-up, the mobile-bearing design has advantages in KSFSs over the fixed-bearing design. The mobile-bearing design may also have advantages in the revision rates over the fixed-bearing design when the posterior cruciate ligament is substituted. There may be no clear difference in KSKSs, ROM values or complication rates between these two designs.
Safety and efficacy studies of kyphoplasty, mesh-container-plasty, and pedicle screw fixation plus vertebroplasty for thoracolumbar osteoporotic vertebral burst fractures
Authors: Li Yimin , Qian Yunfan , Shen Guangjie , Tang Chengxuan , Zhong Xiqiang , He Shaoqi 
Published: July 2021

Abstract
Background
Percutaneous kyphoplasty (PKP), percutaneous mesh-container-plasty (PMCP), and pedicle screw fixation plus vertebroplasty (PSFV) were three methods for osteoporotic vertebral burst fractures (OVBF). The purpose of the current study was to evaluate the clinical safety and efficacy of PKP, PMCP, and PSFV for OVBFs.

Methods
This retrospective study included 338 consecutive patients with thoracolumbar OVBFs who underwent PKP (n = 111), PMCP (n = 109), or PSFV (n = 118) and compared their epidemiological data, surgical outcomes, and clinical and radiological features. Clinical evaluations of VAS and ODI and radiological evaluations of height restoration, deformity correction, cement leakage, and canal compromise were calculated preoperatively, postoperatively, and 2 years postoperatively.

Results
Cement leakage (31/111 vs. 13/109 and 16/118, P < 0.05) was significantly higher in group PKP than in groups PSFV and PMCP. VAS and ODI scores improved postoperatively from 7.04 ± 1.15 and 67.11 ± 13.49 to 2.27 ± 1.04 and 22.00 ± 11.20, respectively, in group PKP (P < 0.05); from 7.04 ± 1.29 and 67.26 ± 12.79 to 2.17 ± 0.98 and 21.01 ± 7.90, respectively, in group PMCP (P < 0.05); and from 7.10 ± 1.37 and 67.36 ± 13.11 to 3.19 ± 1.06 and 33.81 ± 8.81, respectively, in the PSFV group (P < 0.05). Moreover, postoperative VAS and ODI scores were significantly higher in group PSFV than in groups PKP and PMCP (P < 0.05). However, VAS scores were not significantly different in the three groups 2 years postoperatively (P > 0.05). Postoperative anterior (81.04 ± 10.18% and 87.51 ± 8.94% vs. 93.46 ± 6.42%, P < 0.05) and middle vertebral body height ratio (83.01 ± 10.16% and 87.79 ± 11.62% vs. 92.38 ± 6.00%, P < 0.05) were significantly higher in group PSFV than in groups PMCP and PKP. Postoperatively, Cobb angle (10.04 ± 4.26° and 8.16 ± 5.76° vs. 4.97 ± 4.60°, P < 0.05) and canal compromise (20.76 ± 6.32 and 19.85 ± 6.18 vs. 10.18 ± 6.99, P < 0.05) were significantly lower in group PSFV than in groups PMCP and PKP.

Conclusion
Despite relatively worse radiological results, PMCP is a safe and minimally invasive surgical method that can obtain better short-term clinical results than PKP and PSFV for OVBFs.
Epidemiology of mucopolysaccharidoses (MPS) in United States: challenges and opportunities
Authors: Puckett Yana , Mallorga-Hernández Alejandra , Montaño Adriana M. 
Published: July 2021

Abstract
Background
Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US), showing considerable variation by country. This study aimed to identify MPS incidence and prevalence in the US at a national and state level to guide clinicians and policy makers.

Methods
This retrospective study examined all diagnosed cases of MPS from 1995 to 2015 in the US using the National MPS Society database records. Data included year of birth, patient geographic location, and MPS variant type. US population information was obtained from the National Center for Health Statistics. The incidence and prevalence rates were calculated for each disease. Incidence rates were calculated for each state.

Results
We obtained information from 789 MPS patients during a 20-year period. Incidence of MPS in the US was found to be 0.98 per 100,000 live births. Prevalence was found to be 2.67 per 1 million. MPS I, II, and III had the highest incidence rate at birth (0.26/100,000) and prevalence rates of 0.70–0.71 per million. Birth incidences of MPS IV, VI, and VII were 0.14, 0.04 and 0.027 per 100,000 live births.

Conclusions
This is the most comprehensive review of MPS incidence and prevalence rates in the US. Due to the large US population and state fragmentation, US incidence and prevalence were found to be lower than other countries. Nonetheless, state-level studies in the US supported these figures. Efforts should be focused in the establishment of a national rare disease registry with mandated reporting from every state as well as newborn screening of MPS.
Novel folliculin gene mutations in Polish patients with Birt–Hogg–Dubé syndrome
Authors: Radzikowska Elżbieta , Lechowicz Urszula , Winek Jolanta , Opoka Lucyna 
Published: July 2021

AbstractBackgroundBirt–Hogg–Dubé syndrome (BHDS) is a rare, autosomal dominant, inherited disease caused by mutations in the folliculin gene(FLCN). The disease is characterised by skin lesions (fibrofolliculomas, trichodiscomas, acrochordons), pulmonary cysts with pneumothoraces and renal tumours. We present the features of Polish patients with BHDS.Materials and methodsThe first case of BHDS in Poland was diagnosed in 2016. Since then, 15 cases from 10 families have been identified. Thirteen patients were confirmed via directFLCNsequencing, and two according to their characteristic clinical and radiological presentations.ResultsBHDS was diagnosed in 15 cases (13 women and 2 men) from 10 families. The mean ages at the time of first pneumothorax and diagnosis were 38.4 ± 13.9 and 47.7 ± 13 years, respectively. Five patients (33%) were ex-smokers (2.1 ± 1.37 packyears), and 10 (67%) had never smoked cigarettes. Twelve patients (83%) had a history of recurrent symptomatic pneumothorax. Three patients had small, asymptomatic pneumothoraces, which were only detected upon computed tomography examination. All patients had multiple bilateral pulmonary cysts, distributed predominantly in the lower and middle, peripheral, and subpleural regions of the lungs. Generally, patients exhibited preserved lung function. Skin lesions were seen in four patients (27%), one patient had renal angiomyolipoma, and one had bilateral renal cancer. Different mutations of theFLCNgene were identified (mainly in exon 6), with two novel heterozygous variants: c.490delA p.(Arg164GlyTer13) and c.40delC p.(His14ThrsfTer41).ConclusionsAll analysed patients with BHDS presented with lung lesions and with less frequent skin and renal lesions than previously reported in other populations. In addition, more frequent mutations located in exon 6 were detected, and two novelFLCNgene mutations were identified.
A rare presentation of endogenous human chorionic gonadotrophin associated severe ovarian hyperstimulation in the second trimester: a case report
Authors: Fessehaye Abraham , Gudu Wondimu 
Published: July 2021

AbstractBackgroundOvarian hyperstimulation syndrome is usually an iatrogenic and potentially life-threatening disease. It develops following ovulation induction and use ofin vitrofertilization techniques.Case summaryA 32-year-old primigravida Ethiopian woman presented at 15 weeks gestation with a history of progressive bilateral leg swelling and abdominal pain of 2 weeks duration. She had triplet pregnancy and conceived throughin vitrofertilization. She was managed in intensive care unit.ConclusionPatients with multiple pregnancy followingin vitrofertilization conception can have ovarian hyperstimulation syndrome as late as 15 weeks gestation. Hence, frequent follow-up should be continued to detect early signs of OHSS to avoid further complications and need of intensive care unit care.
Understanding how to facilitate continence for people with dementia in acute hospital settings: a mixed methods systematic review and thematic synthesis
Authors: Edwards Deborah , Harden Jane , Jones Aled , Featherstone Katie 
Published: July 2021

Abstract
Background
People living with dementia (PLWD) are at significant risk of developing urinary and/or faecal incontinence and are also at risk of functional incontinence or being labelled as being incontinent. Despite the growing population of PLWD and importance of continence care, little is known about the appropriate management, organisation, and interactional strategies for PLWD admitted to acute hospitals. This mixed methods systematic review and thematic synthesis sought to identify successful strategies across all care settings that could then be used to inform innovations in continence care for PLWD in the acute hospital setting.

Methods
In phase 1, a scoping search of two electronic databases (MEDLINE and PsycINFO) and a consultation with stakeholders was undertaken. Findings were presented to the project steering group and two priority areas for phase 2 were identified which were communication and individualised care plans. In phase 2, eight databases and relevant UK government and other organisational websites were searched for English language citations from inception to August 2020. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT Version 11). Thematic synthesis was employed and the strength of synthesised findings for the intervention studies was assessed using the GRADE approach and the confidence in synthesised qualitative and survey findings was assessed using the CERQual approach.

Results
In phase 1, 1348 citations were found and 75 included. In phase 2, 6247 citations were found, 14 research studies and 14 policy and guidance documents were included. The quality of studies varied. Material was synthesised into three overarching syntheses which were: communication this is dignified, person-centred and respectful; communication during outpatients apointments and delivering individualised continence care.

Conclusions
Recognising that PLWD are not always able to communicate their continence needs verbally is important. Incorporating interpersonal and communication skills into the context of continence care within training for those working with this patient group is crucial for continence to be maintained during an acute admission. Continence care in the acute setting should be tailored to the individual and be developed in partnership with staff and caregivers.

Trial registration
PROSPERO: CRD42018119495.