bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximal Femur Endoprosthesis Augmentation With Polymethylmethacrylate and Condylar Plate: Surgical Technique Description
Authors: Leal García Efraim , Gaitán Lee Hernando , Piñeros Rincón Mariana 
Published: March 2021

Introduction:
Aseptic loosening by mechanical failure is one of the main causes of proximal femur endoprosthesis failure with different clinical consequences such as pain, inflammation, progressive loosening of muscular volume, and strength with functional limitation.

Materials and Methods:
We present the surgical description of the case of a patient with aseptic loosening of proximal femur endoprosthesis that was treated with a novel technique that combines different methods to achieve primary stability.

Discussion:
Different surgical techniques have been described to treat aseptic loosening of femoral endoprosthesis, including bone allografts, and total femur prosthesis which provides good functional results but high rates of complications such as infection (13%), dislocation (6%), and material failure (3%).

Results:
Proximal femur endoprosthesis augmentation with polymethylmethacrylate and condylar plate is a novel surgical technique that allows primary stabilization of the construct, early rehabilitation, improvement of functionality, and no signs of new loosening in a follow-up period of 6 months.
A Series of RET Fusion Spitz Neoplasms With Plaque-Like Silhouette and Dyscohesive Nesting of Epithelioid Melanocytes
Authors: Kim Daniel , Compres Elsy V. , Zhang Bin , Khan Ayesha U. , Sunshine Joel C. , Quan Victor L. , Gerami Pedram 
Published: March 2021

Abstract:Two distinct studies have shown thatRETfusions are found in 3%–4% of Spitz neoplasms.RETfusions have been well described in papillary thyroid cancer, non–small-cell lung cancer, breast cancer, and soft-tissue mesenchymal tumors as well as some other neoplasms. However, there are no comprehensive descriptions to date of the characteristic morphologic, clinical, or genomic findings inRETfusion Spitz neoplasms. In this study, we identified 5 cases ofRETfusion Spitz neoplasms. These tumors showed characteristic morphologic features which included plaque-like silhouette and monotonous epithelioid cytology with expansile and dyscohesive nesting. Four of 5 patients including 1 diagnosed as Spitz melanoma had clinical follow-up all of which was uneventful. Furthermore, we describe the genomic sequences in 4 of these cases, 2 of which have previously describedKIF5B-RETfusion and 2 of which had a novelLMNA-RETfusion. We believe this report significantly contributes to our current knowledge regarding Spitz neoplasms and describes characteristics features which can help with recognition of theRETsubgroup of Spitz.
Synchronous Liver Resection, Cytoreductive Surgery, and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Liver and Peritoneal Metastases: A Systematic Review and Meta-analysis
Authors: Flood Michael P. , Das Atandrila A. , Soucisse Mikael L. , Kong Joseph , Ramsay Robert G. , Michael Michael , Loveday Benjamin P.T. , Warrier Satish K. , Heriot Alexander G. 
Published: March 2021

BACKGROUND:
Synchronous liver resection, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy for colorectal liver and peritoneal metastases have traditionally been contraindicated. More recent clinical practice has begun to promote this aggressive treatment in select patients.

OBJECTIVE:
This study aimed to investigate the perioperative and oncological outcomes of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, with and without liver resection, in the management of metastatic colorectal cancer.

DATA SOURCES:
Medline, Embase, and Cochrane Library databases were searched up to July 2020.

STUDY SELECTION:
Cohort studies comparing outcomes following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with and without liver resection for metastatic colorectal cancer were reviewed. No randomized controlled trials were available.

INTERVENTION:
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with or without synchronous liver resection were compared.

MAIN OUTCOME MEASURES:
The primary outcome measures were perioperative mortality and major morbidity. Secondary outcomes included 3- and 5-year overall survival and 1- and 3-year disease-free survival.

RESULTS:
Fourteen studies fitted the inclusion criteria, with 8 studies included in the meta-analysis. On pooled analysis, there was no significant difference in perioperative morbidity and mortality between the two groups. Patients that underwent concomitant liver resection had worse 1- and 3-year disease-free survival and 3- and 5-year overall survival.

LIMITATIONS:
Only a limited number of studies were available, with a moderate degree of heterogeneity.

CONCLUSIONS:
The addition of synchronous liver resection to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of resectable metastatic colorectal cancer was not associated with increased perioperative major morbidity and mortality in comparison with cytoreduction and hyperthermic intraperitoneal chemotherapy alone. However, the presence of liver metastases was associated with inferior disease-free and overall survival. These data support the continued practice of liver resection, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy in the management of select patients with such stage IV disease.
Incorporating Information on Control Diseases Across Space and Time to Improve Estimation of the Population-level Impact of Vaccines
Authors: Shioda Kayoko , Cai Jiachen , Warren Joshua L. , Weinberger Daniel M. 
Published: March 2021

Background:
The synthetic control method evaluates the impact of vaccines while adjusting for a set of control time series representing diseases that are unaffected by the vaccine. However, noise in control time series, particularly in areas with small counts, can obscure the association with the outcome, preventing proper adjustments. To overcome this issue, we investigated the use of temporal and spatial aggregation methods to smooth the controls and allow for adjustment of underlying trends.

Methods:
We evaluated the impact of pneumococcal conjugate vaccine on all-cause pneumonia hospitalizations among adults ≥80 years of age in 25 states in Brazil from 2005 to 2015. Pneumonia hospitalizations in this group indicated a strong increasing secular trend over time that may influence estimation of the vaccine impact. First, we aggregated control time series separately by time or space before incorporation into the synthetic control model. Next, we developed distributed lags models (DLMs) to automatically determine what level of aggregation was most appropriate for each control.

Results:
The aggregation of control time series enabled the synthetic control model to identify stronger associations between outcome and controls. As a result, the aggregation models and DLMs succeeded in adjusting for long-term trends even in smaller states with sparse data, leading to more reliable estimates of vaccine impact.

Conclusions:
When synthetic control struggles to identify important prevaccine associations due to noise in control time series, users can aggregate controls over time or space to generate more robust estimates of the vaccine impact. DLMs automate this process without requiring prespecification of the aggregation level.
Bleeding and antithrombotic therapy during pregnancy in women with poor aPL-related obstetric outcomes
Authors: Alijotas-Reig Jaume , Esteve-Valverde Enrique , Ferrer-Oliveras Raquel , Sáez-Comet Luis , Lefkou Elmina , Mekinian Arsène , Belizna Cristina , Ruffatti Amelia , Tincani Angela , Pardos-Gea Josep , Nalli Cecilia , Marozio Luca , Espinosa Gerard , De Carolis Sara , Latino Omar , Sebastian Udry , LLurba Elisa , Trespidi Laura , Chighizola Cecilia , Pengo Vittorio , Rovere-Querini Patrizia , Canti Valentina , Mayer-Pickel Karoline , Reshetnyak Tatiana , Tabacco Sara , Arnau Anna 
Published: March 2021

BACKGROUND
The combination of low-dose aspirin (LDA) and low-molecular-weight heparin (LMWH) until the end of gestation are the currently the accepted standard of care for the treatment of antiphospholipid-related obstetric disorders. In refractory cases, hydroxychloroquine (HCQ) can be added to this standard of care.

OBJECTIVE
To evaluate the haemostatic safety of LDA and LMWH (medium to high prophylactic doses) during pregnancy and the puerperium in women with both full-blown obstetric antiphospholipid syndrome (OAPS) (Sydney criteria) and noncriteria – incomplete – OAPS.

STUDY DESIGN
Retrospective/prospective multicentre observational study. Obstetric background, laboratory categories, delivery mode, antithrombotic regimens and bleeding complications were compared.

SETTING
A total of 30 tertiary European hospitals.

PATIENTS
Mainly, Caucasian/Arian pregnant women were included. Other ethnicities were minimally present. Women were controlled throughout pregnancy and puerperium.

MAIN OUTCOME MEASURES
The primary end-point was to evaluate the number of major and minor haemorrhagic complications in this cohort of women. Neuraxial anaesthetic bleeding complications were particularly assessed. Secondly, we aimed to compare local/general bleeding events between groups.

RESULTS
We studied 1650 women, of whom 1000 fulfilled the Sydney criteria of the OAPS and 650 did not (noncriteria OAPS). Data on antithrombotic-related complications were available in 1075 cases (65.15%). Overall, 53 (4.93%) women had bleeding complications, with 34 being considered minor (3.16%) and 19 major (1.76%). Neither obstetric complications nor laboratory categories were bleeding-related. Assisted vaginal delivery and caesarean section were related to local haemorrhage. Heparin doses and platelet count were not associated with major bleeding.

CONCLUSIONS
LDA and medium to high prophylactic LMWH during pregnancy in women with full-blown OAPS/noncriteria OAPS are safe. A slight increase in bleeding risk was noted in instrumental deliveries. No women who underwent spinal or epidural anaesthesia suffered bleeding complications. No haemorrhage was observed in cases where HCQ was added to standard therapy.
Technical factors to consider when developing an Expanded Carrier Screening platform
Authors: Fabiani Marco , Cogo Francesco , Poli Maurizio , Capalbo Antonio 
Published: March 2021

Purpose of review
Expanded Carrier Screening (ECS) is a genetic test able to detect carriers for a large number of autosomal recessive and X-linked diseases. Its clinical utilization is increasing but some technical aspects for its implementation are still controversial.

Recent findings
In the current literature, several aspects of ECS panel implementation have been addressed. One of the most relevant topics involves which genes/pathologies should be included in an optimized ECS panel and which variants should be reported.

Summary
Here, we review the best practice criteria to refine and improve clinical utility and validity of an ECS panel. The criteria for optimal ECS panel implementation include the severity of pathologies, the prevalence of diseases in general population and a definitive or strong gene/disease association. Moreover, we discuss the main complications associated with the reporting of Variant of Uncertain Significance and the need for periodic reassessment.
Geographic atrophy: where we are now and where we are going
Authors: Richard Alyse J. , Duker Jacob S. , Reichel Elias 
Published: March 2021

Purpose of review
Age-related macular degeneration (AMD) affects a significant percentage of the elderly population and end-stage disease classified by either geographic atrophy (GA) or neovascular AMD (nvAMD) is one of the leading causes of vision loss worldwide. Despite the fact that there are currently treatments for nvAMD, there are no treatments in practice to prevent disease onset or progression of GA. This topic is at the forefront of ophthalmic research demonstrated by the recent advances in disease characterization, genetic and environmental risk factor classification, biomarker discovery and mechanism of pathogenesis categorization. There are also numerous clinical treatment trials underway, targeting proposed pathways and biomarkers associated with GA that are promising.

Recent findings
With several clinical trials of potential treatments underway and numerous recent publications on disease diagnosis and classification, the understanding of GA pathogenesis has increased substantially. Although the exact mechanism of pathology is still elusive, recent literature has highlighted the utilization of current and new ophthalmic imaging modalities and discovery of objective and functional markers that can lead to earlier diagnosis and treatment.

Summary
Herein, we will provide an overview and discussion of the current status of GA including advances in mechanism of pathogenesis, diagnosis, classification and current treatment modalities.
Locked in Permanent Employment—Longitudinal Associations With Depressive and Functional Somatic Symptoms
Authors: Virtanen Pekka , Hammarström Anne , Janlert Urban 
Published: March 2021

Objective:
To study mental health as a precedent and an outcome of not being in the preferred job (“locked-in situation”).

Methods:
Longitudinal data from age 16 to 43 were derived from surveys of the Northern Swedish Cohort. Changes in mental health were studied with analyses of variance for repeated measures.

Results:
Getting out of locked-in situation was associated with improving and getting into locked-in with worsening mental health between age 30 and age 43. The worsening was more pronounced and the improvement less pronounced in white-collar than in blue-collar employees. Poor mental health at age 16 predicted locked-in situation in early middle age.

Conclusions:
The findings clarify the bidirectional nature of the associations between locked-in situation and poor mental health, as well as the importance of social class in assessing these associations.
Alterations in Metabolic and Cardiovascular Risk Factors During Critical Training in Wildland Firefighters
Authors: Gurney Shae C. , Christison Katherine S. , Williamson-Reisdorph Cassie M. , Sol Joseph A. , Quindry Tiffany S. , Quindry John C. , Dumke Charles L. 
Published: March 2021

Objective:
To identify physiologic stressors related to cardiovascular disease via changes in metabolic, inflammatory, and oxidative stress biomarkers during 2 weeks of preseason training in wildland firefighters (WLFFs).

Methods:
Participants were recruited from a local hotshot crew and monitored during preseason training. Fitness was assessed via the Bureau of Land Management fitness challenge. Venipuncture blood was collected on days 1, 4, 8, and 11 and analyzed for changes in a lipid and glucose panel, C-reactive protein, and oxidative stress markers 8-isoprostane (8ISO), 3-nitrotyrosine (3NT), lipid hydroperoxides (LOOH), and protein carbonyls.

Results:
The high physical demands of training resulted in significant (P < 0.05) reductions in total cholesterol, glucose, and hemoglobin A1c. A main effect for time was observed in 8ISO, 3NT, and LOOH.

Conclusions:
Alterations in metabolic and oxidative stress markers suggest an acute, high-intensity physical stress during WLFF preseason training.
Health Care Utilization, Lost Work Days, and Bed Days Among U.S. Workers With COPD, by Industry and Occupation
Authors: Kurth Laura , Syamlal Girija 
Published: March 2021

Objective:
To assess health care utilization, lost work days, and bed days among workers with chronic obstructive pulmonary disease (COPD) by industry and occupation.

Methods:
The 2014 to 2018 National Health Interview Survey data were analyzed.

Results:
Among workers with COPD the highest odds of reporting an emergency room (ER) visit and lost work days were observed among workers aged ≥65 years, females, those with no health insurance, and current combustible tobacco users. Workers with COPD in the information industry and computer and mathematical occupation reported highest odds of an ER visit and utilities industry workers reported highest odds for lost work days.

Conclusions:
The high health care utilization and lost work days among workers with COPD in certain industries and occupations underscores the importance of continued surveillance and tailored interventions to reduce disease burden and improve worker health.
The Relationship Between the Functional Gait Assessment and Quality-of-Life Data in Patients Undergoing Vestibular Schwannoma Resection
Authors: Said Mena , Lee Jason , Moshtaghi Omid , Saliba Joe , Richardson Alexander J.W. , Ngo Victoria , Mehranpour Pasha , Schwartz Marc S. , Friedman Rick A. 
Published: March 2021

Objective:
To examine the relationship between the Functional Gait Assessment (FGA) and quality of life (QOL) measurements relating to balance before and after vestibular schwannoma (VS) resection and to assess the role of preoperative FGA in predicting postoperative QOL.

Study Design:
A prospective clinical study of adult patients undergoing VS resection between September 2018 and December 2019. FGA was administered 1 week before and after surgery. Dizziness Handicap Inventory (DHI) and Penn Acoustic Neuroma Quality of Life (PANQOL) were administered preoperatively and at 3 months postoperatively.

Setting:
Single tertiary center.

Patients:
Patients (age ≥ 18 years old) with VS undergoing microsurgical resection. Excluded were patient with previous surgery or radiation.

Intervention:
VS resection.

Main Outcomes and Measures:
Primary outcome: correlation between FGA and QOL surveys. Secondary outcome: correlation between preoperative measurements of balance and postoperative PANQOL.

Results:
One hundred thirty-eight patients were analyzed (mean age: 48 years old, 65.9% female). The translabyrinthine approach was most commonly performed. Under multivariate analysis, preoperative FGA significantly correlated with preoperative PANQOL balance score (p < 0.0001), preoperative PANQOL total score (p = 0.0002), and preoperative DHI (p < 0.0001). However, postoperative FGA did not significantly correlate with postoperative PANQOL balance or total scores (p = 0.446 and p = 0.4, respectively), or postoperative DHI (p = 0.3). Univariate analysis demonstrated that preoperative DHI and preoperative FGA were predictive of changes in postoperative PANQOL balance and total scores. However under multivariate analysis, preoperative FGA did not predict changes in postoperative PANQOL balance or total score (p = 0.24; p = 0.28, respectively). Preoperative DHI remained predictive of changes in postoperative PANQOL balance (p = 0.03) score but not of postoperative PANQOL total score (p = 0.37).

Conclusions:
Although FGA and QOL data significantly correlated in the preoperative setting, our results did not suggest that preoperative FGA can be used to determine postoperative QOL. Additionally, the lack of correlation between FGA and QOL measurements in the acute postoperative setting suggests that further research is needed to determine contributors to postoperative QOL.
Endoscopic Anatomy of the Chorda Tympani: Systematic Dissection, Novel Anatomic Classification, and Surgical Implications
Authors: Molinari Giulia , Yacoub Abraam , Alicandri-Ciufelli Matteo , Monzani Daniele , Presutti Livio , Caversaccio Marco , Anschuetz Lukas 
Published: March 2021

Hypothesis:
A transcanal endoscopic approach enables visualization of the variable course of the chorda tympani inside the middle ear.

Background:
The chorda tympani is the longest intrapetrous branch of the facial nerve. Despite having been investigated in several studies, a description of its tympanic tract from an endoscopic point of view is lacking in the literature.

Methods:
We performed transcanal endoscopic dissections of 44 human cadaveric head and ear specimens. The entry point of the chorda tympani into the middle ear was classified into four categories according to its location, and as covered or dehiscent according to its appearance. The chordal eminence (CE) was defined as absent, shallow, intermediate, prominent, or fused, based on its shape and extension. The relationship of the chorda tympani to adjacent bony and ligamental structures was assessed.

Results:
The tympanic tract of the chorda tympani was divided into three portions. The periannular segment was dehiscent in 54.5% of specimens, with type II being the most frequent entry point configuration (52.3%). In the interossicular segment, the nerve consistently passed lateral to the incus and medial to the malleus. The course of the intrapetrous segment was independent from the conformation of the tensor fold and supratubal recess.

Conclusion:
The transcanal endoscopic approach allows a detailed description of tympanic segment of the chorda tympani. Novel anatomic classifications of the chorda tympani and CE are proposed herein to highlight their possible surgical implications during otologic procedures.
Efficacy of Mirror Biofeedback Rehabilitation on Synkinesis in Acute Stage Facial Palsy in Children
Authors: Baba Shintaro , Kondo Kenji , Yoshitomi Ai , Kanemaru Asako , Nakaya Muneo , Yamasoba Tatsuya 
Published: March 2021

Objectives:
To evaluate the efficacy of mirror biofeedback rehabilitation for synkinesis in severe acute facial paralysis in children.

Methods:
Eight pediatric patients with facial paralysis with an initial electroneurography (ENoG) value less than 10% who underwent mirror biofeedback rehabilitation (the child-rehabilitation group) were enrolled. Seven infants (under age 2 yr) who were unable to undergo rehabilitation (the infant-and-toddler control group) and adult patients (n = 13, range, 33–56 yr) who underwent rehabilitation (the adult-rehabilitation group) comprised the control groups. All the patients enrolled were baseline House–Brackmann (H–B) grade VI at onset. The patients began daily facial biofeedback rehabilitation using a mirror at the first sign of muscle contraction on the affected side and were instructed to keep their eyes symmetrically open using a mirror during mouth movements. The training was continued for 12 months after the onset of facial paralysis. The degree of oral-ocular synkinesis was evaluated by the degree of asymmetry in eye opening width during mouth movements. The synkinesis index was calculated as a percentage of the interpalpebral space width ([normal side – affected side]/normal side). Statistical analyses used non-parametric tests (the Kruskal–Wallis test and Steel–Dwass posthoc test).

Results:
The synkinesis index was significantly lower in the child-rehabilitation group than in the infant-and-toddler control group or the adult-rehabilitation group (p < 0.001).

Conclusion:
Children who underwent mirror biofeedback rehabilitation had less synkinesis than the infant-and-toddler control group, suggesting that mirror biofeedback rehabilitation is more effective in preventing the exacerbation of synkinesis in children.