bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual-mobility bearings for patients with abductor-trochanteric complex insufficiency
Authors: Ozden Vahit E , Dikmen Goksel , Beksac Burak , Tozun Remzi 
Published: May 2018

Introduction: The purpose of this study was to summarise the performance of dual-mobility cup systems for revision total hip arthroplasty in patients with abductor-trochanteric complex deficiency. Methods: We prospectively followed 17 patients (20 hips) with a mean age of 64.5 years (range 33-89 years) who underwent acetabular reconstruction with dual-mobility cups for aseptic loosening in 12 hips, infection treatment as second or single stage in 6 hips, and instability in 2 hips. All of the patients had abductor insufficiency. We evaluated the clinical Harris Hip scores (HHS) and radiographs for migration, loosening, and osteolysis. The survival of the components was calculated according to Kaplan-Meier survivorship analysis, and failure was defined as any dislocation, acetabular component or total hip revision for any reason. Results: The mean duration of follow-up was 38.1 months (range 24-98 months). There were 2 (12.5%) revisions for cemented cup migration after 11 months and 19 months respectively. There were no dislocations. At the last follow-up, the mean HHS increased from 42 points preoperatively to 86 points. The cumulative survival rate of the dual-mobility cup system was 93% (95% confidence interval 88-98.7%) at 5 years, with any revision as the end point. Conclusion: Dual-mobility cups may provide excellent stability in patients with abductor-trochanteric complex insufficiency.
Preferential spinal cord volume loss in primary progressive multiple sclerosis
Authors: Tsagkas Charidimos , Magon Stefano , Gaetano Laura , Pezold Simon , Naegelin Yvonne , Amann Michael , Stippich Christoph , Cattin Philippe , Wuerfel Jens , Bieri Oliver , Sprenger Till , Kappos Ludwig , Parmar Katrin 
Published: May 2018

Background: Little is known on longer term changes of spinal cord volume (SCV) in primary progressive multiple sclerosis (PPMS). Objective: Longitudinal evaluation of SCV loss in PPMS and its correlation to clinical outcomes, compared to relapse-onset multiple sclerosis (MS) subtypes. Methods: A total of 60 MS age-, sex- and disease duration-matched patients (12 PPMS, each 24 relapsing-remitting (RRMS) and secondary progressive MS (SPMS)) were analysed annually over 6 years of follow-up. The upper cervical SCV was measured on 3D T1-weighted magnetization-prepared rapid gradient-echo (MPRAGE) images using a semi-automatic software (CORDIAL), along with the total brain volume (TBV), brain T2 lesion volume (T2LV) and Expanded Disability Status Scale (EDSS). Results: PPMS showed faster SCV loss over time than RRMS ( p < 0.01) and by trend ( p = 0.066) compared with SPMS. In contrast to relapse-onset MS, in PPMS SCV loss progressed independent of TBV and T2LV changes. Moreover, in PPMS, SCV was the only magnetic resonance imaging (MRI) measurement associated with EDSS increase over time ( p < 0.01), as opposed to RRMS and SPMS. Conclusion: SCV loss is a strong predictor of clinical outcomes in PPMS and has shown to be faster and independent of brain MRI metrics compared to relapse-onset MS.
Intratumoral immune cells expressing PD-1/PD-L1 and their prognostic implications in cancer: a meta-analysis
Authors: Kim Younghoon , Wen Xianyu , Cho Nam Yun , Kang Gyeong Hoon 
Published: May 2018

Background: The prognostic value of immune cells expressing programmed cell death 1 (PD-1) and PD-1 ligand 1 (PD-L1) in cancer are controversial, and the potential differential impact of using tissue microarrays and whole tissue sections to assess the positivity of immune cells has not been addressed. Methods: The current study included 30 eligible studies with 7251 patients that evaluated the relationship between tumor-infiltrating lymphocytes expressing PD-1/PD-L1 and overall survival and disease-free survival, or progression-free survival. Subgroup analysis was based on the tissue type of cancer and the type of tissue sampling (tissue microarray or whole tissue section). Results: In the meta-analysis, PD-1-positive and PD-L1-positive tumor-infiltrating lymphocytes had a positive effect on disease-free survival or progression-free survival (hazard ratio [HR] 0.732; 95% confidence interval [CI] 0.565, 0.947; and HR 0.727; 95% CI 0.584, 0.905, respectively). PD-L1-positive tumor-infiltrating lymphocytes had a positive impact on overall survival in studies using tissue microarray (HR 0.586; 95% CI 0.476, 0.721), but had a poor impact when only whole tissue sections were considered (HR 1.558; 95% CI 1.232, 1.969). Lung cancer was associated with good overall survival and disease-free survival (HR 0.639; 95% CI 0.491, 0.831; and HR 0.693; 95% CI 0.538, 0.891, respectively) for PD-1-positive tumor-infiltrating lymphocytes, and colorectal cancer showed favorable disease-free survival (HR 0.471; 95% CI 0.308, 0.722) for PD-L1-positive tumor-infiltrating lymphocytes. Conclusion: Immune cells expressing PD-1 and PD-L1 within tumors are associated with the prognosis. However, the correlation may vary among different tumor types and by the type of tissue sampling used for the assessment.
Erythromycin combined with corticosteroid reduced inflammation and modified trauma-induced tracheal stenosis in a rabbit model
Authors: Enyuan Qin , Mingpeng Xu , Luoman Gan , Jinghua Gan , Yu Li , Wentao Li , Changchun Hou , Lihua Li , Xiaoyan Meng , Lei Zhou , Guangnan Liu 
Published: May 2018

Background: Patients with endotracheal intubation or tracheostomy are subject to benign tracheal stenosis (TS), for which current therapies are unsatisfactory. We conducted a preliminary investigation of drugs and drug combinations for the prevention and treatment of TS in a rabbit model. Methods: Fifty-four rabbits were apportioned into nine groups according to treatment: sham-operated control; untreated TS model; amikacin; budesonide; erythromycin; penicillin; amikacin + budesonide; erythromycin + budesonide; and penicillin + budesonide. TS was induced by abrasion during surgery. The drugs were applied for 7 days before and 10 days after the surgery. Rabbits were killed on the eleventh day. Tracheal specimens were processed for determining alterations in the thicknesses of tracheal epithelium and lamina propria via hematoxylin and eosin. The tracheal mRNA (assessed by real-time quantitative polymerase chain reaction) expressions of the following fibrotic-related factors were determined: transforming growth factor-β1 (TGF- β1), collagen type I (COL1A1), collagen type III (COL3A1), and interleukin-17 (IL-17). The protein levels of TGF-β1, COL1A1, and COL3A1 were determined through immunohistochemistry and integrated optical densities. Results: Compared with all other groups, the untreated TS model had significantly thicker tracheal epithelium and lamina propria, and higher mRNA and protein levels of all targeted fibrotic factors. The mRNA and protein levels of the targeted fibrotic factors in all the drug-treated groups were lower than those of the untreated TS model, and differences were most significant in the erythromycin + budesonide group. Conclusions: Erythromycin combined with budesonide may reduce inflammation and modify fibrosis progression in TS after tracheal injury.
Phase IV study of retention on fingolimod versus injectable multiple sclerosis therapies: a randomized clinical trial
Authors: Cree Bruce A.C. , Arnold Douglas L. , Cascione Mark , Fox Edward J. , Williams Ian M. , Meng Xiangyi , Schofield Lesley , Tenenbaum Nadia 
Published: May 2018

Objective: In relapsing–remitting multiple sclerosis (RRMS), suboptimal adherence to injectable disease-modifying therapies (iDMTs; interferon β-1a/b, glatiramer acetate) is common, reducing their effectiveness. Patient retention on oral fingolimod and iDMTs was evaluated in PREFER MS, a randomized, parallel-group, active-controlled, open-label, 48-week study. Methods: Patients were included if they had RRMS, were aged 18–65 years and had Expanded Disability Status Scale score up to 6, enrolled at 117 US study sites, were treatment naïve or had received only one iDMT class. Patients were randomized 1:1 (fingolimod 0.5 mg/day; preselected iDMT) by interactive voice-and-web-response system without blinding, followed up quarterly, and allowed one study-approved treatment switch after 12 weeks, or earlier for efficacy or safety reasons. The primary outcome was patient retention on randomized treatment over 48 weeks. Secondary endpoints included patient-reported outcomes, brain volume loss (BVL), and cognitive function. Results: Analysis of 433/436 patients receiving fingolimod and 428/439 receiving iDMTs showed that patient retention rate was significantly higher with fingolimod than with iDMTs [352 (81.3%) versus 125 (29.2%); 95% confidence interval 46.4–57.8%; p < 0.0001]. The most common treatment switch was from iDMT to fingolimod for injection-related reasons. Patient satisfaction was greater and BVL less with fingolimod than with iDMTs, with no difference in cognitive function. Adverse events were consistent with established tolerability profiles for each treatment. Conclusions: In RRMS, fingolimod was associated with better treatment retention, patient satisfaction and BVL outcomes than iDMTs. Patients may persist with iDMTs, but many may switch treatment if permitted. Treatment satisfaction fosters adherence, a prerequisite for optimal outcomes.
5-alpha-dihydrotestosterone elevations associated with phentermine use
Authors: Pearson Scott M. , Trujillo Jennifer M. , McDermott Michael T. 
Published: May 2018

Background: A case of 5-alpha-dihydrotestosterone (DHT) elevation associated with phentermine initiation is reported, and possible mechanisms are discussed. There are no published reports of this association in the literature. Methods: Clinical and laboratory information is described. Results: A 72-year-old male with metastatic prostate cancer taking dutasteride to lower his DHT levels initiated phentermine 15 mg daily for weight loss. His DHT level drawn within 1 week prior to starting phentermine was 9.9 pg/ml. When reporting for follow up 2 weeks later, his DHT level had increased to 114 pg/ml. The DHT level was checked again 2 weeks after that visit, and had increased to 174 pg/ml. At that time, phentermine was discontinued, and 1 week later, the DHT level had decreased to 20.1 pg/ml. Over the next 4 months, the patient’s DHT levels were maintained at less than 20 pg/ml. Phentermine 15 mg daily was then reinitiated while his DHT level was 7.5 pg/ml. Two weeks after resuming phentermine, his DHT level had again increased to 196 pg/ml. The patient’s phentermine was then discontinued, and around 1 week later, his DHT level had fallen to 5.1 pg/ml. Conclusion: A 72-year-old male with metastatic prostate cancer experienced profound increases in DHT upon initiation of phentermine despite continuation of his baseline dutasteride therapy. The etiology of these increases is still unclear.
Efficacy and satisfaction with transcutaneous electrostimulation of the posterior tibial nerve in overactive bladder syndrome
Authors: Moratalla Charcos Luz María , Planelles Gómez Jorge , García Mora Belén , Santamaría Navarro Cristina , Vidal Moreno Juan Francisco 
Published: May 2018

Objective: Overactive bladder is a disease with a high prevalence. The management is difficult, because different demographic, social or economic aspects converge. Our objective was to evaluate the efficacy and satisfaction in patients with overactive bladder treated with transcutaneous electrostimulation of the posterior tibial nerve. Methods: This was a prospective and descriptive study of 45 patients with overactive bladder (with or without detrusor overactivity) resistant to pharmacological treatment. Patients received a weekly session for 12 weeks, with a duration of 30 minutes for each of the sessions. There was a screening after 12 sessions, after which if there had been no response, treatment was suspended and maintenance sessions were not continued (six twice-monthly sessions and three monthly sessions). It was considered that the treatment had been effective when it was possible to decrease the number of events, except the maximum voiding volume, the objective of which was to increase. The results were evaluated using a 3-day voiding diary, an overactive bladder short form questionnaire and a satisfaction level questionnaire. Statistical analysis was performed using IBM SPSS Statistics version 19.0. Independent variables with a normal distribution were examined using the t-test. The Wilcoxon signed-rank test was used to compare the averages of the quantitative variables without a normal distribution. Satisfaction was analysed by a binary and ordinal regression analysis, univariate and multivariate. A P value less than 0.05 was considered statistically significant. Results: All the parameters of the study improved to a statistically relevant degree: frequency, nocturia, urgency, maximum voided volume, urge urinary incontinence. The overactive bladder short form questionnaire score improved but was not statistically significant. Conclusions: The use of transcutaneous electrostimulation of the posterior tibial nerve is a safe, effective and minimally invasive alternative in the treatment of overactive bladder when pharmacological treatment has failed. Patients had a good objective and subjective response in our study. Level of evidence: 4.
Surgical Technical Evidence Review of Hip Fracture Surgery Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery
Authors: Siletz Anaar , Childers Christopher P. , Faltermeier Claire , Singer Emily S. , Hu Q. Lina , Ko Clifford Y. , Kates Stephen L. , Maggard-Gibbons Melinda , Wick Elizabeth 
Published: May 2018

Background: Enhanced recovery pathways (ERPs) have been shown to improve patient outcomes in a variety of contexts. This review summarizes the evidence and defines a protocol for perioperative care of patients with hip fracture and was conducted for the Agency for Healthcare Research and Quality safety program for improving surgical care and recovery. Study Design: Perioperative care was divided into components or “bins.” For each bin, a semisystematic review of the literature was conducted using MEDLINE with priority given to systematic reviews, meta-analyses, and randomized controlled trials. Observational studies were included when higher levels of evidence were not available. Existing guidelines for perioperative care were also incorporated. For convenience, the components of care that are under the auspices of anesthesia providers will be reported separately. Recommendations for an evidence-based protocol were synthesized based on review of this evidence. Results: Eleven bins were identified. Preoperative risk factor bins included nutrition, diabetes mellitus, tobacco use, and anemia. Perioperative management bins included thromboprophylaxis, timing of surgery, fluid management, drain placement, early mobilization, early alimentation, and discharge criteria/planning. Conclusions: This review provides the evidence basis for an ERP for perioperative care of patients with hip fracture.
Knotless Fixation Is Stronger and Less Variable Than Knotted Constructs in Securing a Suture Loop
Authors: Denard Patrick J. , Adams Christopher R. , Fischer Nicole C. , Piepenbrink Marina , Wijdicks Coen A. 
Published: May 2018

Background: Historically, tendon-to-bone fixation has relied on knot tying. However, considerable variability exists in knot-tying strength among surgeons. Purpose/Hypothesis: The purpose of this study was to compare the biomechanical properties of knotted and knotless fixation and to evaluate variability among surgeons. The hypothesis was that knotless constructs would be stronger and have less variability as compared with knotted constructs. Study Design: Controlled laboratory study. Methods: A total of 34 orthopaedic surgeons participated in a laboratory study to compare knotted and knotless constructs, where 104 knotted constructs were performed with No. 2 suture, 21 knotless constructs with No. 2 suture (K2 group), and 79 knotless constructs with suture tape (KT group). Mechanical testing was performed to compare load at 3 mm of displacement, load to failure, and stiffness of each construct. Results: The mean load at 3 mm of displacement was greatest in the KT group, with significant differences among all 3 groups ( P < .001). Load to failure was significantly greater in the KT group as compared with the K2 group and the knotted group ( P < .001), but there was no difference between the K2 and knotted groups ( P ≥ .999). Stiffness and displacement were also greatest in the KT group. Based on the F test, the variance in load to failure was significantly different between the knotted and knotless constructs, with the knotted group demonstrating greater variability (SD, 94 N) than the KT (SD, 38 N) and K2 (SD, 17 N) groups ( P < .001). Conclusion: Knotless fixation with suture tape had improved biomechanical performance as compared with knots or knotless fixation with No. 2 suture. In addition, knotless fixation had less variability in biomechanical properties among multiple surgeons. Clinical Relevance: This study may be relevant for surgeons choosing between knotted and knotless constructs as well as for considerations in the design of rotator cuff repair constructs.
Resident and Program Director’s Perceptions of Milestone-Based Feedback in Obstetrics and Gynecology
Authors: Hariton Eduardo , Bortoletto Pietro , Barnes K Lauren , Kaimal Anjali J , Stagg Amy R 
Published: May 2018

Introduction: In July 2014, US residency programs fully implemented the Next Accreditation System including the use of milestone evaluation and reporting. Currently, there has been little investigation into the result of implementation of this new system. Therefore, this study sought to evaluate perceptions of Obstetrics and Gynecology residents and program directors regarding the use of milestone-based feedback and identify areas of deficiency. Methods: A Web-based survey was sent to US-based Obstetrics and Gynecology residents and program directors regarding milestone-based assessment implementation. Results: Out of 245 program directors, 84 responded to our survey (34.3% response rate). Of responding program directors, most reported that milestone-based feedback was useful (74.7%), fair (83.0%), and accurate (76.5%); however, they found it administratively burdensome (78.1%). Residents felt that milestone-based feedback was useful (62.7%) and fair (70.0%). About 64.3% of residents and 74.7% of program directors stated that milestone-based feedback is an effective tool to track resident progression; however, a sizable minority of both groups believe that it does not capture surgical aptitude. Qualitative analysis of free response comments was largely negative and highlighted the administrative burden and lack of accuracy of milestone-based feedback. Conclution: Overall, both Obstetrics and Gynecology program directors and residents report that milestone-based feedback is useful and fair. Issues of administrative burden, timeliness, evaluation of surgical aptitude, and ability to act on assigned milestone levels were identified. Although this study is limited to one specialty, such issues are likely important to all residents, faculty, and program directors who have implemented the Next Accreditation System requirements.
Mobile Telephony and New Business Formation Rates in BRICS and Beyond: Does Human Capital Matter?
Authors: Abubakar Yazid Abdullahi , Mitra Jay , Modupe Adeyeye Mercy 
Published: May 2018

This study examines whether and to what extent ‘domestic’ education level mediates the relationship between mobile phone diffusion and new business formation rates across the developing world, that is, Brazil, Russia, India, China and South Africa (BRICS) and non-BRICS developing countries. Drawing on the knowledge spillover theory (KST) of entrepreneurship, we suggest that the recent rise in domestic education levels might explain the positive association between mobile phone diffusion and new business formation rates. Utilising country-level panel data on 66 developing countries, the results indicate that the mediating effect of education on mobile phone diffusion and new business formation rates is not just limited to developing countries (including BRICS) but that this pattern can also be found in non-BRIC developing nations too, with the exception of the least developed countries (LDCs). We conclude with implications for theory and policy.
Progress in Neuroengineering for brain repair: New challenges and open issues
Authors: Panuccio Gabriella , Semprini Marianna , Natale Lorenzo , Buccelli Stefano , Colombi Ilaria , Chiappalone Michela 
Published: May 2018

Background: In recent years, biomedical devices have proven to be able to target also different neurological disorders. Given the rapid ageing of the population and the increase of invalidating diseases affecting the central nervous system, there is a growing demand for biomedical devices of immediate clinical use. However, to reach useful therapeutic results, these tools need a multidisciplinary approach and a continuous dialogue between neuroscience and engineering, a field that is named neuroengineering. This is because it is fundamental to understand how to read and perturb the neural code in order to produce a significant clinical outcome. Results: In this review, we first highlight the importance of developing novel neurotechnological devices for brain repair and the major challenges expected in the next years. We describe the different types of brain repair strategies being developed in basic and clinical research and provide a brief overview of recent advances in artificial intelligence that have the potential to improve the devices themselves. We conclude by providing our perspective on their implementation to humans and the ethical issues that can arise. Conclusions: Neuroengineering approaches promise to be at the core of future developments for clinical applications in brain repair, where the boundary between biology and artificial intelligence will become increasingly less pronounced.
Crowd-figure-pictograms improve women’s knowledge about mammography screening: results from a randomised controlled trial
Authors: Reder Maren , Thygesen Lau Caspar 
Published: May 2018

AbstractObjectiveTo evaluate the effect of crowd-figure-pictograms on women’s numeric knowledge about mammography screening in a three-armed parallel randomised controlled trial.Results552 women were randomised to receive (1) non-numeric information (n = 192), (2) non-numeric and numeric information (n = 186), or (3) non-numeric and numeric information complemented by crowd-figure-pictograms (n = 174). Baseline numeric knowledge was low (control 0.61, numeric 0.66, and pictogram 0.51 on a scale ranging from 0 to 5). Women in the crowd-figure-pictogram group had a larger knowledge increase than women in the numeric group (2.42 vs 2.06,p= .03). Both groups had significant increases in knowledge compared to the control (0.20,p< .001). Providing numeric information in absolute numbers improves knowledge; even more so when crowd-figure-pictograms are added.Trial registrationGerman Clinical Trials Register DRKS00014736, retrospectively registered 11 May 2018