bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of biologics on reducing the risks of total knee replacement and total hip replacement in rheumatoid arthritis
Authors: Chang Yu-Sheng , Chen Jin-Hua , Lin Tzu-Min , Hsu Hui-Ching , Chen Wei-Sheng , Lin Sheng-Hong , Kuo Pei-I , Lin Yi-Chun , Chang Chi-Ching 
Published: September 2021

Abstract

Objectives
RA damages the joints and increases the risks of total knee replacement (TKR) and total hip replacement (THR). However, the benefits of biologics in preventing TKR or THR remain unclear.

Methods
This retrospective nationwide study used the 2000–2013 claims-based National Health Insurance dataset. Biologics are reimbursed for refractory cases. The risks of TKR and THR in the biologic cohort were compared with those of an age- and sex-matched csDMARD cohort. A multivariate Cox regression model was used to investigate the benefits of bDMARDs for TKR and THR.

Results
TKR was performed in 5979 biologic cases and 11 958 matched controls, of which 249 (4.16%) and 871 (7.28%) cases received TKR, respectively. THR was performed in 6245 biologic cases and 12 490 matched controls, of which 159 (2.55%) and 516 (4.13%) cases had THR, respectively. The biologic cohort had significantly lower incidence rates of TKR (11.73 vs 16.33/1000 person-years, P &lt; 0.001) and THR (7.09 vs 9.16/1000 person-years, P &lt; 0.001). After adjustment for confounding factors, the regular bDMARD subgroup (average dose &gt;0.95 defined daily dose/day) had significantly lower risks of TKR (aHR: 0.55, 95% CI: 0.38, 0.81) and THR (aHR: 0.63, 95% CI: 0.40, 0.98). Those without MTX use, with steroid use, with biologic switch, and overlapping antiphospholipid syndrome had significantly higher risks of TKR and THR.

Conclusions
Compared with the csDMARD cohort, the risks of TKR and THR in the bDMARD cohort were the same as those in the low-to-moderate dose subgroups and significantly lower in those with regular bDMARD use.
Comparison of the immediate effects of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot: a prospective study
Authors: Razavi Khorasani Seyede Gelare , Bagherzadeh Cham Masumeh , Sharifnezhad Ali , Saeedi Hassan , Farahmand Behshid 
Published: September 2021

Background:
The aims of this quasi-experimental study were to compare the effect of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot.

Methods:
Eighteen amateur athletes with flexible flatfoot participated in this study. All participants received custom-molded rigid medical insoles and prefabricated soft medical insoles. Mean peak pressure (kPa), maximum force (N), and contact area (cm2) were calculated for the heel, medial and lateral midfoot, first metatarsal head, second and third metatarsal heads, fourth and fifth metatarsal heads, hallux, and other toe area using the Pedar-X system (Novel GmbH, Munich, Germany) immediately.

Results:
The use of both prefabricated and custom-molded insoles significantly reduced the mean pressure and force in the heel, second and third metatarsophalangeal joints (MTP2,3), the fourth and fifth metatarsophalangeal joints (MTP4,5), and increased the pressure in the medial midfoot compared to the shoe (P<0.001). No significant difference was observed between the two insoles (P>0.05). The contact area increased significantly in the medial midfoot (P<0.001) and MTP2,3 (P=0.02) and decreased in the hallux (P<0.001) and other toes (P=0.01) using both insoles compared to only shoes.

Conclusions:
The results showed that the use of a medical insole in athletes with flexible flatfoot could alter athletics’ plantar pressures immediately. Since both insoles had a similar effect on the distribution of plantar pressures, it seems that the prefabricated soft medical insole is a more suitable option for daily use in athletes to prevent injury because of its availability and cost-effectiveness.

Level of Evidence:
Level II.
Simplified Antibiotic-Coated Plating for Infected Nonunion, Fracture-Related Infection, and Single-Stage Prophylactic Fixation
Authors: Medda Suman , Hsu Joseph R. 
Published: September 2021

Summary:
Antibiotic-coated implants are increasing in prevalence in the treatment of fracture-related infections. Coated plates may be desirable in certain anatomic locations or to augment nail fixation. We describe a simple, reproducible technique for the fabrication of antibiotic-coated plates and our initial results of a small case series.
In-Hospital Morbidity and Mortality With Delays in Femoral Shaft Fracture Fixation
Authors: Obey Mitchel R. , Clever David C. , Bechtold Daniel A. , Stwalley Dustin , McAndrew Christopher M. , Berkes Marschall B. , Wolinsky Philip R. , Miller Anna N. 
Published: September 2021

Objectives:
To investigate trends in the timing of femur fracture fixation in trauma centers in the United States, identify predictors for delayed treatment, and analyze the association of timing of fixation with in-hospital morbidity and mortality using data from the National Trauma Data Bank.

Methods:
Patients with femoral shaft fractures treated from 2007 to 2015 were identified from the National Trauma Data Bank and grouped by timing of femur fixation: <24, 24–48 hours, and >48 hours after hospital presentation. The primary outcome measure was in-hospital postoperative mortality rate. Secondary outcomes included complication rates, hospital length of stay (LOS), days spent in the intensive care unit LOS (ICU LOS), and days on a ventilator.

Results:
Among the 108,825 unilateral femoral shaft fractures identified, 74.2% was fixed within 24 hours, 16.5% between 24 and 48 hours, and 9.4% >48 hours. The mortality rate was 1.6% overall for the group. When fixation was delayed >48 hours, patients were at risk of significantly higher mortality rate [odds ratio (OR) 3.60; 95% confidence interval (CI), 3.13–4.14], longer LOS (OR 2.14; CI 2.06–2.22), longer intensive care unit LOS (OR 3.92; CI 3.66–4.20), more days on a ventilator (OR 5.38; CI 4.89–5.91), and more postoperative complications (OR 2.05; CI 1.94–2.17; P < 0.0001).

Conclusions:
Our study confirms that delayed fixation of femoral shaft fractures is associated with increased patient morbidity and mortality. Patients who underwent fixation >48 hours after presentation were at the greatest risk of increased morbidity and mortality. Although some patients require optimization/resuscitation before fracture fixation, efforts should be made to expedite operative fixation.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Use of Thromboelastography in the Evaluation and Management of Patients With Traumatic Brain Injury: A Systematic Review and Meta-Analysis
Authors: Cannon Jeremy W. , Dias João D. , Kumar Monisha A. , Walsh Mark , Thomas Scott G. , Cotton Bryan A. , Schuster James M. , Evans Susan L. , Schreiber Martin A. , Adam Elisabeth H. , Zacharowski Kai , Hartmann Jan , Schöchl Herbert , Kaplan Lewis J. 
Published: September 2021

OBJECTIVES:
Traumatic brain injury is associated with coagulopathy that increases mortality risk. Viscoelastic hemostatic assays such as thromboelastography (Haemonetics SA, Signy, Switzerland) provide rapid coagulopathy assessment and may be particularly useful for goal-directed treatment of traumatic brain injury patients. We conducted a systematic review to assess thromboelastography in the evaluation and management of coagulopathy in traumatic brain injury patients.

DATA SOURCES:
MEDLINE, PubMed Central, Embase, and CENTRAL.

STUDY SELECTION:
Clinical studies of adult patients with traumatic brain injury (isolated or polytrauma) who were assessed by either standard thromboelastography or thromboelastography with platelet mapping plus either conventional coagulation assays or platelet function assays from January 1999 to June 2021.

DATA EXTRACTION:
Demographics, injury mechanism and severity, diagnostic, laboratory data, therapies, and outcome data were extracted for analysis and comparison.

DATA SYNTHESIS:
Database search revealed 1,169 sources; eight additional articles were identified by the authors. After review, 31 publications were used for qualitative analysis, and of these, 16 were used for quantitative analysis. Qualitative and quantitative analysis found unique patterns of thromboelastography and thromboelastography with platelet mapping parameters in traumatic brain injury patients. Patterns were distinct compared with healthy controls, nontraumatic brain injury trauma patients, and traumatic brain injury subpopulations including those with severe traumatic brain injury or penetrating traumatic brain injury. Abnormal thromboelastography K-time and adenosine diphosphate % inhibition on thromboelastography with platelet mapping are associated with decreased survival after traumatic brain injury. Subgroup meta-analysis of severe traumatic brain injury patients from two randomized controlled trials demonstrated improved survival when using a viscoelastic hemostatic assay-guided resuscitation strategy (odds ratio, 0.39; 95% CI, 0.17–0.91; p = 0.030).

CONCLUSIONS:
Thromboelastography and thromboelastography with platelet mapping characterize coagulopathy patterns in traumatic brain injury patients. Abnormal thromboelastography profiles are associated with poor outcomes. Conversely, treatment protocols designed to normalize abnormal parameters may be associated with improved traumatic brain injury patient outcomes. Current quality of evidence in this population is low; so future efforts should evaluate viscoelastic hemostatic assay-guided hemostatic resuscitation in larger numbers of traumatic brain injury patients with specific focus on those with traumatic brain injury-associated coagulopathy.
Integrated bioinformatics analysis reveals correlations of high TRIM59 expression with worse prognosis and immune infiltrates in lung adenocarcinoma
Authors: Yang Lingge , Wu Yuan , You Liangkun , Xie Binbin , Lou Jun , Han Weidong , Wang Kai 
Published: September 2021

Objective:
Most patients with advanced lung cancer have a poor prognosis. Recent studies have identified TRIM59 as a novel molecule that serves as a prognostic factor for the progression of non-small cell lung cancer. In the present study, we investigated the role of TRIM59 in predicting the prognosis of lung adenocarcinoma (LUAD) as well as the correlation between TRIM59 expression and immune infiltrates.

Methods:
We analyzed TRIM59 expression in normal and tumor tissues based on RNA-sequencing datasets from The Cancer Genome Atlas and Genotype-Tissue Expression databases. Forty-seven cases of LUAD tissues and their matching adjacent tissues were collected, and TRIM59 expression in tissue samples was demonstrated by immunohistochemistry. All tissue specimens were obtained under the approval of the Medical Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval No. IR2019001101; approved on April 3, 2019). The immune cell scores were calculated using the CIBERSORT database. The Tumor Immune Estimation Resource database was used to analyze the correlation between TRIM59 and immune cell activities.

Results:

TRIM59 was up-regulated in most cancer types. High TRIM59 expression predicted a worse prognosis in patients with LUAD (overall survival,
P
= 0.00096; disease-specific survival,
P
= 0.00056; disease-free interval,
P
= 0.0009; progression-free interval,
P
= 0.0012). Moreover, TRIM59 was highly expressed in patients with LUAD who had a poorer prognosis. TRIM59 also showed a significant correlation with the ESTIMATE score (
P
= 0.04) and stromal score (
P
= 0.005) in patients with LUAD. Notably, a significant correlation between TRIM59 and the tumor mutation burden was found in LUAD but in no other cancer types (
P
< 0.001). Further investigation showed that TRIM59 had a significant correlation with gene markers on neutrophils and dendritic cells.

Conclusion:
TRIM59 is a potential prognosticator in LUAD and may be correlated with immune cell identification, immune cell infiltration, and immunotherapy checkpoints in LUAD.
The bi-directional role of the gut–brain axis in inflammatory and other gastrointestinal diseases
Authors: Mogilevski Tamara 
Published: September 2021

Purpose of review
There is a growing body of evidence implicating the role of the gut–brain axis in a multitude of inflammatory and non-inflammatory gastrointestinal disorders. The interaction between the gut and the brain is bidirectional and its therapeutic manipulation is gaining traction as the new frontier in the management of gastrointestinal disorders. This review summarizes the recent literature on this subject and serves as a reference for future research directions.

Recent findings
Recent studies have shown that the gut–brain axis, through its main communicator – the vagal nerve – plays a multimodal role in manipulating gastrointestinal physiology. This is evident systemically via the cholinergic anti-inflammatory pathway, through its effect on intestinal barrier function and also locally on intestinal epithelial and immune cells. Vagal nerve stimulation and faecal microbiota transplantation are two ways by which therapeutic manipulation has been attempted with success.

Summary
There has been exceptional progress in our understanding of the gut–brain axis in recent literature. Its role in the modulation of a multitude of gastrointestinal disorders is becoming clear. Preclinical findings are sufficient for this research to proceed to clinical trials in order to harness its clinical therapeutic potential for the care of patients.
Nutrients and Bioactive Components of Human Milk After One Year of Lactation
Authors: Sinkiewicz‐Darol Elena , Martysiak‐Żurowska Dorota , Puta Małgorzata , Adamczyk Iwona , Barbarska Olga , Wesołowska Aleksandra , Bernatowicz‐Łojko Urszula 
Published: September 2021

ABSTRACTObjective:Specifying the nutrient content and bioactive compounds in milk from long‐term lactation for the purpose of finding additional sources of donors’ milk for human milk banks.Method:Human milk samples were collected from 43 mothers of term infants (term infant human milk, TIHM) (3–6 weeks of lactation) and 50 mothers who have breastfed for over a year (long‐nursing human milk, LNHM). The milk collection time was 24 hours. The analyses of fat, protein, carbohydrate and energy content were performed with human milk analyzer MIRIS (Miris HMA™ ); lactoferrin and vitamin C content using high performance liquid chromatography in reversed phase (RP‐HPLC); total antioxidant activity (TAC) and lysozyme by enzyme‐linked immunosorbent assay (ELISA); and the activity of glutathione peroxidase (GPx) and catalase (CAT) via spectrophotometric methods. Sociodemographic characteristics of both groups of mothers have been compiled.Results:Higher fat content and energy value was found in LNHM than in TIHM. Protein content in LNHM and TIHM did not differ. Carbohydrate content was lower in LNHM than in TIHM. TAC, CAT and GPx activity were higher in LNHM compared to TIHM. No significant differences in the content of lysozyme, lactoferrin and vitamin C between the studied groups were found.Conclusions:The findings suggest that after 12 months of lactation, human milk still has significant nutritional value, does not lose bioactive components and can be considered for use in human milk banks.
Machine Learning Algorithms Using Routinely Collected Data Do Not Adequately Predict Viremia to Inform Targeted Services in Postpartum Women Living With HIV
Authors: Murnane Pamela M. , Ayieko James , Vittinghoff Eric , Gandhi Monica , Katumbi Chaplain , Milala Beteniko , Nakaye Catherine , Kanda Peter , Moodley Dhayendre , Nyati Mandisa E. , Loftis Amy J. , Fowler Mary G. , Flynn Pat , Currier Judith S. , Cohen Craig R. 
Published: September 2021

Background:Adherence to antiretroviral treatment (ART) among postpartum women with HIV is essential for optimal health and prevention of perinatal transmission. However, suboptimal adherence with subsequent viremia is common, and adherence challenges are often underreported. We aimed to predict viremia to facilitate targeted adherence support in sub-Saharan Africa during this critical period.Methods:Data are from PROMISE 1077BF/FF, which enrolled perinatal women between 2011 and 2014. This analysis includes postpartum women receiving ART per study randomization or country-specific criteria to continue from pregnancy. We aimed to predict viremia (single and confirmed events) after 3 months on ART at >50, >400, and >1000 copies/mL within 6-month intervals through 24 months. We built models with routine clinical and demographic data using the least absolute shrinkage and selection operator and SuperLearner (which incorporates multiple algorithms).Results:Among 1321 women included, the median age was 26 years and 96% were in WHO stage 1. Between 0 and 24 months postpartum, 42%, 31%, and 28% of women experienced viremia >50, >400, and >1000 copies/mL, respectively, at least once. Across models, the cross-validated area under the receiver operating curve ranged from 0.74 [95% confidence interval (CI): 0.72 to 0.76] to 0.78 (95% CI: 0.76 to 0.80). To achieve 90% sensitivity predicting confirmed viremia >50 copies/mL, 64% of women would be classified as high risk.Conclusions:Using routinely collected data to predict viremia in >1300 postpartum women with HIV, we achieved moderate model discrimination, but insufficient to inform targeted adherence support. Psychosocial characteristics or objective adherence metrics may be required for improved prediction of viremia in this population.
Brief Report: HCV Universal Test-and-Treat With Direct Acting Antivirals for Prisoners With or Without HIV: A Prison Health Care Workers–Led Model for HCV Microelimination in Thailand
Authors: Supanan Ruamthip , Han Win Min , Harnpariphan Weerakit , Ueaphongsukkit Thornthun , Ubolyam Sasiwimol , Sophonphan Jiratchaya , Tangkijvanich Pisit , Thanprasertsuk Sombat , Avihingsanon Anchalee ,   on behalf of the HIV-NAT HCV Study Team
Published: September 2021

Background:
This study investigated the sustained virologic responses (SVRs) among prisoners with hepatitis C virus (HCV) using universal test-and-treat approach by prison health care workers in a central male prison in Thailand.

Methods:
A universal HCV screening was conducted in a maximum-security central prison (Klong Prem Central Prison) in Thailand. HCV RNA–confirmed prisoners were treated with generic sofosbuvir/velpatasvir by prison health care workers, regardless of their HCV genotypes and duration of prison sentences. We evaluated the SVR rates at 12 weeks after completing direct acting antivirals (DAA) treatment.

Results:
A total of 68 prisoners with detectable HCV RNA received DAA treatment. The median age and duration of prison sentences were 44 years (interquartile range, 41–53) and 25 (interquartile range, 19–33) years, respectively. Twenty-five percentage of the participants was coinfected with HIV, and 6% of the participants was coinfected with hepatitis B virus. Among all prisoners who received DAA treatment, 20 (29%) had genotype (GT)-1a, 3 (4%) had GT-1b, 22 (32%) had GT-3a, 3 (4%) had GT-3b, and 7 (10%) had GT-6. Overall, improvements in liver biomarkers were seen after HCV treatment, and SVR was achieved in 97% of the participants with per-protocol analysis and in 90% of the participants with intention-to-treat analysis.

Conclusions:
HCV treatment using DAA among prisoners through universal test-and-treat approach led by prison health care workers is highly effective and safe, and such model can potentially help to facilitate the goals of HCV microelimination among prisoners in Thailand.
Disparities in Craniosynostosis Outcomes by Race and Insurance Status
Authors: Hauc Sacha C. , Junn Alexandra , Dinis Jacob , Phillips Sarah , Alperovich Michael 
Published: September 2021

Abstract
Disparities in access to care for surgical intervention in craniosynostosis have been suggested as a cause in discrepancies between the surgical approach and consequently perioperative outcomes following surgery. This work aimed to investigate the influence of race, insurance status, and the presence of craniosynostosis-related conditions on the short-term outcomes after the surgical management of craniosynostosis. Using the National Inpatient Sample database for the years 2010 to 2012, sociodemographic predictors for 30-day postoperative complication rates and requirements for blood transfusion in craniosynostosis surgeries were identified. Medicaid patients were significantly more likely to experience complications (P = 0.013) and higher rates of blood transfusions (P = 0.011). Compared to those without any complications, patients who experienced postoperative complications and blood transfusions were older (191.5 versus 181.7 days old, P < 0.001), had a greater number of chronic diseases (P < 0.001), and had a longer average length of stay (P < 0.001). On multivariable regression, Medicaid patients were 1.7 times more likely to experience any postoperative complication compared to privately insured patients. White patients also experienced a 0.741 times lower likelihood of requiring a blood transfusion. At the hospital level, receiving surgery at government-operated hospitals was found to be a protective factor for postoperative complications compared to for-profit private (P = 0.016) and nonprofit private (P = 0.028). Healthcare providers and policy makers should be cognizant of these sociodemographic disparities and their potential causes to ensure equitable treatment for all patients regardless of insurance status and racial/ethnic background.
Mechanical Comparison of Four Different Types of Osteosynthesis in a 11-mm Advancement Le Fort I Osteotomy
Authors: de Lima Valthierre Nunes , Hadad Henrique , Suguimoto Roberto Macoto , Magro-Filho Osvaldo 
Published: September 2021

Objective:
This study aimed to evaluate 4 methods of osteosynthesis in the maxilla after a linear advance of 11 mm.

Methodology:
Le Fort I osteotomies were performed on 24 resin models and different osteosynthesis were applied in the anterior region. Group I received Lindorf plates; group II, modified Lindorf plates; group III, inverted “T” plates; and group IV, “L” plates. All groups received “L” plates in the posterior region. Analysis were performed through universal mechanical testing machine with an axial linear load until 5-mm displacement. The data obtained about the force and the amount of deformation were computed, thus the energy required for displacement and stiffness was calculated. Statistical analysis was performed using 2-way analysis (Shapiro-Wilk, followed by Holm-Sidak) (P
< 0.05).

Results:
Groups I and II showed greater resistance to displacement (P < 0.05) than the other groups. The largest amount of maximum force exerted for the 5-mm displacement was in group II (91.73 N), followed by group I (87.46 N), presenting the best values in comparison with the other groups (P < 0.001). Group III had less stiffness (P < 0.001) than the other groups.

Conclusions:
The use of preclinical methodologies to verify the mechanical stability of fixation models allows a prediction in the choice of greater resistance systems. The fixation type with greater resistance to deformation was achieved with modified Linford plates followed by Linford plates in the anterior region and plate “L” bilaterally in the posterior region.