bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of minimally invasive Achilles tendon scraping and plantaris tendon removal in patients with chronic midportion Achilles tendinopathy: A longer-term follow-up study
Authors: Ruergård Anna , Spang Christoph , Alfredson Håkan 
Published: January 2019

Background: Treatment with ultrasound and colour Doppler–guided minimally invasive Achilles tendon scraping and plantaris tendon removal has shown promising short-term results in patients with chronic painful midportion Achilles tendinopathy. Methods: In a follow-up study, 182 consecutive patients (241 tendons) who had undergone Achilles tendon scraping and plantaris tendon removal were contacted on telephone by an independent investigator. The patients who answered the telephone call were included, and they answered a questionnaire on telephone and then also sent their written answers. The questionnaire included information about patient satisfaction with the result of the treatment, time to return to full Achilles tendon loading activity, and a pain score (Visual Analogue Scale-VAS). Results: The follow-up period was 5.8 years (mean) (range of 2–13 years) after surgery. Altogether, 110 patients (136 Achilles tendons), 52 years (mean)(range 18-73) old at surgery could be reached and were included. In total, 81 tendons were operated with the Achilles scraping procedure alone, and for 55 Achilles operations also a plantaris tendon removal was performed. For 93% of the operated tendons, the patients were satisfied with the surgical outcome and the VAS had decreased from 74 preoperatively to 8 postoperatively. Nine male patients (9 tendons), five operated with scraping + plantaris removal, had remaining tendon pain during loading and were not satisfied. Their VAS score ranged from 22 to 91. For 21% of the operated tendons, some occasional mild discomfort not preventing from full tendon loading, was reported. There were no differences in pain reduction and satisfaction rates between men and women, and between Achilles scraping alone and scraping plus plantaris removal. Conclusion: Ultrasound and colour Doppler–guided surgical Achilles tendon scraping and plantaris tendon removal in patients with chronic painful midportion Achilles tendinopathy show remaining good clinical outcomes and high satisfaction rates in this longer-term follow-up.
How I treat early-relapsing follicular lymphoma
Authors: Casulo Carla , Barr Paul M. 
Published: January 2019

Abstract
Follicular lymphoma (FL) is the most frequently occurring indolent non-Hodgkin lymphoma, with generally favorable outcomes but a variable clinical course. Recent studies have elucidated the consistent and reproducible frequency of early disease progression in FL, occurring in ∼20% of patients. Relapse of FL within 24 months of chemoimmunotherapy (POD24) is now established as a robust marker of poor survival, leading to increased risk of death. Currently, there is no established method of identifying patients at risk for early disease progression at the time of their FL diagnosis. However, numerous studies worldwide are investigating clinical, pathologic, and radiographic biomarkers to help predict POD24, thereby improving subsequent outcomes and adapting therapy based on individual risk. There is also a paucity of standardized treatments for patients with POD24, but investigations are ongoing testing novel targeted therapies and autologous stem cell transplantation strategies. This review provides an overview of early-relapsing FL and our approach to patient management based on recent available data.
Reduced bone formation in males and increased bone resorption in females drive bone loss in hemophilia A mice
Authors: Weitzmann M. Neale , Roser-Page Susanne , Vikulina Tatyana , Weiss Daiana , Hao Li , Baldwin W. Hunter , Yu Kanglun , del Mazo Arbona Natalia , McGee-Lawrence Meghan E. , Meeks Shannon L. , Kempton Christine L. 
Published: January 2019

Abstract
Hemophilia A (HA), a rare X-linked recessive genetic disorder caused by insufficient blood clotting factor VIII, leaves affected individuals susceptible to spontaneous and traumatic hemorrhage. Although males generally exhibit severe symptoms, due to variable X inactivation, females can also be severely impacted. Osteoporosis is a disease of the skeleton predisposing patients to fragility fracture, a cause of significant morbidity and mortality and a common comorbidity in HA. Because the causes of osteoporosis in HA are unclear and in humans confounded by other traditional risk factors for bone loss, in this study, we phenotyped the skeletons of F8 total knockout (F8TKO) mice, an animal model of severe HA. We found that trabecular bone accretion in the axial and appendicular skeletons of male F8TKO mice lagged significantly between 2 and 6 months of age, with more modest cortical bone decline. By contrast, in female mice, diminished bone accretion was mostly limited to the cortical compartment. Interestingly, bone loss was associated with a decline in bone formation in male mice but increased bone resorption in female mice, a possible result of sex steroid insufficiency. In conclusion, our studies reveal a sexual dimorphism in the mechanism driving bone loss in male and female F8TKO mice, preventing attainment of peak bone mass and strength. If validated in humans, therapies aimed at promoting bone formation in males but suppressing bone resorption in females may be indicated to facilitate attainment of peak mass in children with HA to reduce the risk for fracture later in life.
Acute fibrinolysis shutdown occurs early in septic shock and is associated with increased morbidity and mortality: results of an observational pilot study
Authors: Schmitt Felix Carl Fabian , Manolov Vasil , Morgenstern Jakob , Fleming Thomas , Heitmeier Stefan , Uhle Florian , Al-Saeedi Mohammed , Hackert Thilo , Bruckner Thomas , Schöchl Herbert , Weigand Markus Alexander , Hofer Stefan , Brenner Thorsten 
Published: January 2019

Abstract
Background
Septic coagulopathy represents a very dynamic disease entity, tilting from initial hypercoagulability towards a subsequent hypocoagulable disease state, entitled overt disseminated intravascular coagulation. Acute fibrinolysis shutdown has recently been described to be a crucial component of initial hypercoagulability in critically ill patients, although the underlying pathomechanisms, the specific temporal kinetics and its outcome relevance in patients with sepsis remain to be determined.

Methods
In total, 90 patients (30 with septic shock, 30 surgical controls and 30 healthy volunteers) were enrolled. Blood samples were collected at sepsis onset or prior and immediately after the surgical procedure as well as 3 h, 6 h, 12 h, 24 h, 48 h and 7 d later, whereas blood samples from healthy volunteers were collected once. Besides viscoelastic and aggregometric point-of-care testing (POCT), enzyme-linked immunosorbent and thrombin generation assays and liquid chromatography–mass spectrometry-based measurements were performed.

Results
As assessed by viscoelastic POCT, fibrinolysis shutdown occurred early in sepsis. Significant increases in tissue plasminogen activator had no effect on thromboelastometrical lysis indices (LIs). Contrariwise, plasminogen activator inhibitor-1 was already significantly increased at sepsis onset, which was paralleled by significantly increased LIs in patients suffering from septic shock in comparison with both control groups. This effect persisted throughout the 7-day observation period and was most pronounced in severely ill as well as non-surviving septic patients. Thromboelastometrical LI, therefore, proved to be suitable for early diagnosis [e.g. LI 45 min: area under the curve (AUC) up to 0.933] as well as prognosis (e.g. LI 60 min: AUC up to 1.000) of septic shock.

Conclusions
Early inhibition of plasminogen activation leads to acute fibrinolysis shutdown with improved clot stability and is associated with increased morbidity and mortality in septic patients.
Trial registration This study was approved by the local ethics committee (Ethics Committee of the Medical Faculty of Heidelberg; Trial-Code No. S247-2014/German Clinical Trials Register (DRKS)-ID: DRKS00008090; retrospectively registered: 07.05.2015). All study patients or their legal representatives signed written informed consent.
Cost-effectiveness of early intervention in psychosis: systematic review
Authors: Aceituno David , Vera Norha , Prina A. Matthew , McCrone Paul 
Published: January 2019

BackgroundEarly intervention in psychosis (EIP) has been developed as an approach to improve the prognosis of people with psychotic disorders and it has been claimed to be a more efficient model of care. However, the evidence is not definitive and doubts have spread regard to the economic outcomes of EIP services amid the usually restricted mental health budget.AimsWe aimed to review the cost-effectiveness evidence of EIP services worldwide.MethodWe systematically reviewed the economic literature about EIP following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement guidelines. Studies were selected according to previously stated criteria and analysed with standardised critical appraisal tools for trial-based economic evaluations and modelling studies.ResultsA total of 16 studies were selected after applying the eligibility criteria. Most of them were economic evaluations alongside clinical trials. The overall evidence was consistent in the cost-effectiveness of EIP compared with standard care for first episode of psychosis and the Clinical High Risk for Psychosis paradigm. Such evidence was replicated among different health systems, but mainly in high-income countries. The methodological quality of such evidence, however, was moderate and heterogeneity was significant across the studies.ConclusionsThere is consistent evidence that the implementation of EIP services might be a cost-effective alternative across different health systems. Such evidence, nevertheless, derives from heterogeneous and sometimes methodologically flawed studies, reducing the certainty of such statement. More efforts must be done to rigorously assess the value of this intervention, before expanding it among systems where mental health budgets are more constrained.Declaration of interestNone.
Fast Running Does Not Contribute More to Cumulative Load than Slow Running
Authors: HUNTER JESSICA G. , GARCIA GINA L. , SHIM JAE KUN , MILLER ROSS H. 
Published: January 2019

ABSTRACT

Purpose
As running speed increases there are concomitant changes in loads associated with tibial stress fracture risk. Runners often include multiple speeds in their training, but the effect of speed distribution on load accumulation is unknown. We studied how running at different proportions of speed within a given running distance affects the cumulative loading of the vertical average loading rate, cumulative peak absolute tibial free moment, and cumulative peak axial tibial load. These loads were compared between two proportions of speed: running all distance at normal self-selected speed, and running the same distance at a combination of slow/fast speeds with the same average speed as normal. Also, the contributions of slow and fast running to the combined condition were compared.

Methods
Forty-three recreational runners (age, 18–49 yr; 29 female, 14 male) ran around a 50-m indoor track for three laps each at self-selected slow, normal, and fast speeds. Per-step peak loads and cumulative loads per kilometer were calculated at each speed and for each speed distribution, respectively.

Results
Only cumulative vertical average loading rate was lower at normal speed compared with the slow/fast speed combination. The contribution of fast speed running to cumulative tibial load was less than the contribution of slow speed running.

Conclusions
Running at a combination of slow and fast speeds, rather than a single moderate speed, increased cumulative vertical average loading rate but not cumulative tibial load or free moment. Fast running can be included in a training program without necessarily increasing the cumulative load. Total distance and average speed may not be sufficient information to estimate cumulative load from running training.
Novel Approach to Characterize Heterogeneity in an Aerobic Exercise Intervention
Authors: HALL SAMANTHA E. , LAWAL OLUWASEYI A. , CLARK CAMERON M. , TYNDALL AMANDA V. , HILL MICHAEL D. , SAJOBI TOLULOPE T. , POULIN MARC J. 
Published: January 2019

ABSTRACT

Purpose
Exercise intervention studies for brain health can be difficult to interpret due to heterogeneity in exercise intensity, exercise duration, and in adherence to the exercise intervention. This study aimed to characterize heterogeneity in these components in a cohort of healthy middle-age and older adults who participated in a prescribed 6-month supervised aerobic exercise intervention as part of the Brain in Motion study.

Methods and Results
Group-based multitrajectory analysis (GBMTA) was used to characterize variation in the trajectory of exercise intensity and duration for male and female participants in the first 3 months of the exercise program. The GBMTA for males and females revealed two distinct trajectory subgroups, namely, “high-increasing” (HI) and “low-increasing” (LI). Logistic regression was used to assess the association between the identified latent subgroups and (i) demographic characteristics; (ii) physiological characteristics, including cardiovascular and cerebrovascular function; (iii) genetic characteristics; and (iv) adherence with American College of Sports Medicine guidelines on exercise for older adults. Of the 196 participants, 54.1% met the American College of Sports Medicine aerobic exercise targets for intensity and duration during the intervention. Aerobic fitness (maximal oxygen uptake; odds ratio, 1.27; P < 0.01) was significantly different between these trajectory subgroups in males, and cerebrovascular function (cerebrovascular resistance; odds ratio, 0.14; P < 0.01) was significantly different between these trajectory subgroups in females.

Conclusion
This novel approach to tracking a prespecified exercise program highlights that there are individual and group-specific variations within a prescribed exercise intervention. Characterizing exercise adherence in this way holds promise in developing optimized exercise prescriptions tailored to individual baseline characteristics, and additionally highlighting those participants at greatest risk of not meeting minimum dosage requirements for physiological and/or cognitive health.
Added value of diffusion-weighted imaging for evaluation of extramural venous invasion in patients with primary rectal cancer
Authors: Ahn Ju Hee , Kim Seung Ho , Son Jung Hee , Jo Sung Jae 
Published: January 2019

Objective:
To evaluate the added value of diffusion-weighted imaging (DWI) to T 2 weighted imaging (T 2WI) for detection of extramural venous invasion (EMVI) in patients with primary rectal cancer.

Methods:
79 patients (50 men, 29 females, mean age 67.4 years, range 37–87 years) who had undergone rectal MRI and subsequently received surgical resection were included. The rectal MRI consisted of T 2WI in three planes and axial DWI (b-values, 0, 1000 s mm–2). Two radiologists blinded to the pathologic results independently reviewed the T 2WI first, and then the combined T 2WI and DWI 4 weeks later. They recorded their confidence scores for EMVI on a 5-point scale (0: definitely negative and 4: definitely positive). The diagnostic performance of each reading session for each reader was compared by pairwise comparison of receiver operating characteristic curves. The area under the ROC curve (AUC) was considered as the diagnostic performance. The result of a histopathological examination served as the reference standard for EMVI.

Results:
For both readers, the diagnostic performance was not significantly different between the two image sets (for reader 1, AUC, 0.828 and 0.825, p = 0.9426 and for reader 2, AUC, 0.723 and 0.726, p = 0.9244, respectively).

Conclusion:
There was no added value of DWI to T2WI for detection of EMVI in patients with primary rectal cancer.

Advances in knowledge:
High-resolution T2WI alone is sufficient to assess EMVI and a supplementary DWI has no added value in patients with primary rectal cancer.
Outcomes in Patients With Cirrhosis on Primary Compared to Secondary Prophylaxis for Spontaneous Bacterial Peritonitis
Authors: Bajaj Jasmohan S. , Tandon Puneeta , O'Leary Jacqueline G. , Wong Florence , Biggins Scott W. , Garcia-Tsao Guadalupe , Kamath Patrick S. , Maliakkal Benedict , Fallon Michael B. , Lai Jennifer C. , Thuluvath Paul J. , Vargas Hugo E. , Subramanian Ram M. , Thacker Leroy R. , Reddy K. Rajender ,   On behalf of NACSELD (North American Consortium for the Study of End-Stage Liver Disease)
Published: January 2019

OBJECTIVES:
Antibiotic prophylaxis is recommended for prevention of the first episode of spontaneous bacterial peritonitis (SBP; primary prophylaxis 1°) and subsequent episodes (secondary prophylaxis 2°). We aimed to compare outcomes in cirrhotic inpatients on 1° vs 2° SBP prophylaxis.

METHODS:
Data from North American Consortium for the Study of End-Stage Liver Disease were evaluated for cirrhosis details, reasons for admission/medications, inpatient course recorded, and outcomes over 90 days. Outcomes (intensive care units, acute kidney injury, inpatient/90-day mortality) were compared between the 2 groups after propensity-matching on admission model for end-stage liver disease (MELD) score and serum albumin.

RESULTS:
Among the 2,731 patients enrolled, 305 were on 1° and 187 on 2° SBP prophylaxis. After propensity-matching, 154 patients remained in each group. Patients on 1° prophylaxis were more likely to have admission systemic inflammatory response syndrome (P = 0.02), with higher intensive care unit admissions (31% vs 21%; P = 0.05) and inpatient mortality (19% vs 9%; P = 0.01) than the 2° prophylaxis group. Patients on 2° prophylaxis had higher total (22% vs 10%; P = 0004), readmission (16% vs 9%; P = 0.03), and nosocomial (6% vs 0.5%; P = 0.01) SBP rates with predominant Gram-negative organisms compared to 1° prophylaxis patients. At 90 days, 1° prophylaxis patients had a higher mortality (35% vs 22%; P = 0.02) and acute kidney injury incidence (48% vs 30%; P = 0.04) compared to 2° prophylaxis patients.

DISCUSSION:
In this inpatient cirrhosis study, despite prophylaxis, a high proportion of patients developed SBP, which was associated with mortality. Cirrhotic inpatients on 1° prophylaxis had worse outcomes than those on 2° prophylaxis when propensity-matched for the MELD score and serum albumin during the index admission and 90-day follow-up.
Comparing the Real-World Effectiveness of Competing Colonoscopy Preparations: Results of a Prospective Trial
Authors: Gu Phillip , Lew Daniel , Oh Sun Jung , Vipani Aarshi , Ko Jeffrey , Hsu Kevin , Mirakhor Ebrahim , Pattisapu Varun , Bullen Tia , Fuller Garth , Spiegel Brennan M.R. , Almario Christopher V. 
Published: January 2019

OBJECTIVES:
National societies provide little guidance regarding which colonoscopy bowel preps are best tolerated and most effective; this reflects a lack of comparative effectiveness studies that directly evaluate the available preps in a “real-world” setting. To address this gap, we conducted a prospective, commercially unfunded comparative effectiveness study of currently available bowel preps and measured their impact on bowel cleansing.

METHODS:
We included patients aged ≥18 years, who presented for an outpatient colonoscopy at a large medical center serving more than 70 academic and community-based endoscopists who are free to prescribe the bowel prep of their choice. The primary outcome was bowel cleansing quality as measured by the Boston Bowel Preparation Scale. We performed regression models with random effects on the outcomes to adjust for confounding.

RESULTS:
Approximately 4,339 colonoscopies were performed by 75 endoscopists. Magnesium citrate, MiraLAX with Gatorade, MoviPrep, OsmoPrep, Prepopik/Clenpiq, and Suprep all had significantly higher prep tolerability compared with GoLYTELY (all P < 0.05). For bowel cleansing, Suprep (7.28 ± 1.66; P < 0.001), MoviPrep (7.11 ± 1.62; P = 0.004), and MiraLAX with Gatorade (7.09 ± 1.64; P < 0.001) had higher total Boston Bowel Preparation Scale scores compared with GoLYTELY (6.67 ± 1.87); there were no significant differences among the remaining preps. Split-prep dosing was associated with better cleansing; however, men, opioid and tricyclic antidepressent users, and patients with diabetes and cirrhosis had worse cleansing (all P < 0.05).

CONCLUSIONS:
In this prospective, real-world comparative effectiveness study of available bowel preps, we found that MiraLAX with Gatorade, MoviPrep, and Suprep were prospectively associated with superior tolerability and bowel cleansing.
Alcoholic and Nonalcoholic Fatty Liver Disease and Liver-Related Mortality: A Cohort Study
Authors: Chang Yoosoo , Cho Yong Kyun , Cho Juhee , Jung Hyun-Suk , Yun Kyung Eun , Ahn Jiin , Sohn Chong Il , Shin Hocheol , Ryu Seungho 
Published: January 2019

OBJECTIVES:
We compared liver-related mortality by fibrosis severity between 2 types of fatty liver disease (FLD), nonalcoholic FLD (NAFLD) and alcoholic FLD (AFLD), in a large cohort of nonobese and obese individuals.

METHODS:
A cohort study was performed with 437,828 Korean adults who were followed up for up to 14 years. Steatosis was diagnosed based on ultrasonography; fibrosis severity was determined by the fibrosis 4 (FIB-4) score. Vital status and liver-related deaths were ascertained through linkage to national death records.

RESULTS:
The prevalence of NAFLD and AFLD was 20.9% and 4.0%, respectively. During 3,145,541.1 person-years of follow-up, 109 liver-related deaths were identified (incidence rate of 3.5 per 105 person-years). When changes in fatty liver status, FIB-4 scores, and confounders during follow-up were updated as time-varying covariates, compared with the reference (absence of both excessive alcohol use and FLD), the multivariable-adjusted hazard ratios with 95% confidence intervals for liver-related mortality among those with low, intermediate, and high FIB-4 scores were 0.43 (0.19–0.94), 2.74 (1.23–6.06), and 84.66 (39.05–183.54), respectively, among patients with NAFLD, whereas among patients with AFLD, the corresponding hazard ratios (95% confidence intervals) were 0.67 (0.20–2.25), 5.44 (2.19–13.49), and 59.73 (27.99–127.46), respectively. The associations were more evident in nonobese individuals than in obese individuals (P for interaction = 0.004).

DISCUSSION:
In this large cohort of young and middle-aged individuals, NAFLD and AFLD with intermediate to high fibrosis scores were associated with an increased risk of liver-related mortality in a dose-dependent manner, especially among nonobese individuals.