bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy Outcomes After Laparoscopic Radiofrequency Ablation of Uterine Leiomyomas Compared With Myomectomy
Authors: Allen Antoinette , Schembri Michael , Parvataneni Ram , Waetjen L. Elaine , Varon Shira , Salamat-Saberi Naghmeh , Tassone Shawn , Williams Nicole , Kho Kimberly A. , Jacoby Vanessa L. 
Published: February 2024

OBJECTIVE:
To compare pregnancy outcomes after laparoscopic radiofrequency ablation and myomectomy.

METHODS:
The ULTRA (Uterine Leiomyoma Treatment With Radiofrequency Ablation) study is an ongoing multicenter prospective cohort study with longitudinal follow-up up to 5 years comparing outcomes of radiofrequency ablation with myomectomy in premenopausal women older than age 21 years with symptomatic uterine leiomyomas. Participants were queried every 6 months after surgery to assess the incidence of pregnancy and pregnancy outcomes.

RESULTS:
Among 539 women enrolled in ULTRA, a total of 37 participants (mean age at first pregnancy 35.0±4.7 years) conceived 43 times as of March 2023 (22 radiofrequency ablation, 21 myomectomy). The average length of follow-up time after all procedures was 2.5±1.0 years. The baseline miscarriage rate in the study population was 33.3%. In participants who underwent radiofrequency ablation, 9 of 22 pregnancies (40.9%, 95% CI, 20.3–61.5%) ended in first-trimester miscarriage, 11 resulted in live births (50.0%, 95% CI, 29.1–70.9%), one resulted fetal death at 30 weeks of gestation, and one resulted in uterine rupture during miscarriage treatment with misoprostol 10 weeks after radiofrequency ablation. Among the live births in the radiofrequency ablation group, 45.5% were by vaginal delivery. In the myomectomy group, 9 of 21 pregnancies (42.9%, 95% CI, 21.7–64.0%) ended in first-trimester miscarriage and 12 resulted in live births (57.1%, 95% CI, 36.0–78.3%). There were no significant differences in the likelihood of live birth or miscarriage between the study groups.

CONCLUSION:
Full-term pregnancy and vaginal delivery are achievable after radiofrequency ablation of leiomyomas. However, in this interim analysis, the miscarriage rate in both radiofrequency ablation and myomectomy groups was higher than expected for women in this age group. Long-term data collection in the ongoing ULTRA study aims to further understand pregnancy outcomes after radiofrequency ablation compared with myomectomy.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT0210094.
Anatomical Observation and Clinical Significance of the Medial Branch of the Lumbar Dorsal Rami
Authors: Liu Zexian , Chen Junjie , Fang Duopei , Xu Yejie , Zhou Xinying , Zheng Zhiyang , Zhang Zhenfeng , Fan Chaohui , Luo Shiwen , Liu Zezheng , Li Qingchu , Zhao Qinghao 
Published: February 2024

Study Design.
Anatomical study.

Objective.
This study aimed to elaborate on the anatomical characteristics of the medial branch of the lumbar dorsal rami and to discuss its possible clinical significance.

Summary of Background Data.
Radiofrequency ablation targeting the medial branch of the lumbar dorsal rami has been increasingly used in the clinical management of facetogenic low back pain (FLBP). Nonetheless, attention is also being given to complications such as atrophy of the lumbar soft tissues and muscles. Therefore, a more detailed understanding of the innervation pattern on the facet joint may improve the precision of nerve ablation therapy for FLBP.

Methods.
An anatomical study of eight human specimens was carried out. The anatomic characteristics of the medial branch were observed and recorded.

Results.
The medial branch originates from the lumbar dorsal rami, running close to the root of the posterolateral side of the superior articular process of the inferior cone. When passed through the mamillo-accessory ligament, it turns direction to the medial and caudal side, running in the multifidus muscle. In our study, each medial branch sent out two to five branches along the way. All the medial branches in L1-L4 gave off one to two small branches when crossing the facet joint and innervated the joint of the lower segment. Nineteen medial branches (23.75%) gave off recurrent branches to innervate the joint at the upper segment.

Conclusion.
The anatomical features of the medial branch remain similar in each lumbar segment. There are two types of joint branches, including the articular fibers that emanate from the medial branch as it runs along the medial border of the facet joint and the recurrent branch from the medial branch that innervates the upper facet joint. Moreover, an anastomotic branch was found in the medial branches between different segments.
Neoadjuvant therapy with immune checkpoint inhibitors in combination with chemotherapy vs. chemotherapy alone in HER2(–) locally advanced gastric cancer: A propensity score-matched cohort study
Authors: Xu Gehan , Liu Tianjiao , Shen Jingyi , Guan Quanlin 
Published: February 2024

Abstract

Background:
This study aims to compare the efficacy between neoadjuvant immune checkpoint inhibitors (ICIs) plus chemotherapy vs. chemotherapy, and neoadjuvant triplet vs. doublet chemotherapeutic regimens in locally advanced gastric/esophagogastric junction cancer (LAGC).

Methods:
We included LAGC patients from 47 hospitals in China’s National Cancer Information Database (NCID) from January 2019 to December 2022. Using propensity score matching (PSM), we retrospectively analyzed the efficacy between neoadjuvant ICIs plus chemotherapy vs. chemotherapy alone, and neoadjuvant triplet vs. doublet chemotherapeutic regimens. The primary study result was the pathologic complete response (pCR) rate. The secondary study results were disease-free survival (DFS) and overall survival (OS).

Results:
A total of 1205 LAGC patients were included. After PSM, the ICIs plus chemotherapy and the chemotherapy cohorts had 184 patients each, while the doublet and triplet chemotherapy cohorts had 246 patients each. The pCR rate (14.13% vs. 7.61%, χ
2 = 4.039, P = 0.044), and the 2-year (77.60% vs. 61.02%, HR = 0.67, 95% con­fidence interval [CI] 0.43–0.98, P = 0.048) and 3-year (70.55% vs. 61.02%, HR = 0.58, 95% CI 0.32–0.93, P = 0.048) DFS rates in the ICIs plus chemotherapy cohort were improved compared to those in the chemotherapy cohort. No significant increase was observed in the OS rates at both 1 year and 2 years. The pCR rates, DFS rates at 1–3 years, and OS rates at 1–2 years did not differ significantly between the doublet and triplet cohorts, respectively. No differences were observed in postoperative complications between any of the group comparisons.

Conclusions:
Neoadjuvant ICIs plus chemotherapy improved the pCR rate and 2–3 years DFS rates of LAGC compared to chemotherapy alone, but whether short-term benefit could translate into long-term efficacy is unclear. The triplet regimen was not superior to the doublet regimen in terms of efficacy. The safety after surgery was similar between either ICIs plus chemotherapy and chemotherapy or the triplet and the doublet regimen.
Flap Reconstruction Results in Longer Overall Treatment Time in Patients Treated with Surgery and Adjuvant Radiotherapy for Carcinoma of the Oral Cavity and Larynx
Authors: Drescher Nicolette R. , Latortue Tayna , Brisson Ryan J. , Cassidy Vincent D. , Amdur Robert J. , Mendenhall William M. , Hitchcock Kathryn E. 
Published: February 2024

Objective:
There is an inverse relationship between cancer cure and overall treatment time (OTT) in patients treated with surgical resection and radiotherapy (RT).

Methods:
OTT was evaluated based on the reconstruction procedure in 420 patients with oral cavity and larynx cancers treated with surgery and RT between 1991 and 2020.

Results:
With OTT >85 days, the difference between no versus yes flap reconstruction was ~20 percentage points and significant for all comparisons: primary closure (+/− skin graft), 49%, vs. rotation or free flap, 71% (P<0.0001); primary closure (+/− skin graft), 49%, versus free flap without bone, 66% (P=0.0358); and primary closure (+/− skin graft), 49%, versus free flap with bone, 82% (P<0.0001).

Conclusions:
The use of flap reconstructions results in substantial increases in OTT. Findings suggest a need to reevaluate current policies regarding the choice of reconstruction and starting RT sooner after surgery.
Diagnosis and Treatment of Pouch Disorders in Children: A Systematic Review
Authors: Nallapaneni Padmini , Picoraro Joseph A 
Published: February 2024

BACKGROUND:
Restorative proctocolectomy and ileal pouch anal anastomosis has become the surgical procedure of choice in pediatric patients with medically-refractory ulcerative colitis or familial adenomatous polyposis. This systematic review aims to assess the diagnosis and treatment of pouch disorders in pediatric patients who undergo ileal pouch anal anastomosis.

METHODS:
A literature search was performed on MEDLINE, Google Scholar and EMBASE for all publications describing outcomes of pediatric ileal pouch anal anastomosis. Studies between January 1, 2000 and September 7, 2022 published in English were included. Studies were excluded based on title, abstract and full-length review.

RESULTS:
Thirty-three studies were included in this review, all of which were retrospective in nature. The outcomes of 2643 pediatric patients were included in the 33 studies. Pouch disorders described include anastomotic leaks, pouch strictures, pouch failure, pouchitis, cuffitis and de novo Crohn’s disease of the pouch.

CONCLUSIONS:
The reported incidence of disorders of the pouch in children varies widely and is likely attributable to differences in definitions and follow-up periods across studies. Pouchitis was the most frequently described outcome. The overall rate of pouch failure in children is relatively low with de novo Crohn’s disease of the pouch the most significant risk factor. Management is largely informed by clinical practices in adult patients with scant data on treatment efficacy in children. Multicenter, prospective studies are needed in the pediatric population in order to accurately identify risk factors, standardize the assessment of pouch complications, and determine effective treatment strategies. See 20-minute symposium video.
Can researchers trust ICD-10 coding of medical comorbidities in orthopaedic trauma patients?
Authors: Arthur Rodney , Mayberry R. Miles , Odum Susan , Kempton Laurence B. ,   Evidence-Based Musculoskeletal Injury and Trauma Collaborative (EMIT)
Published: February 2024

Abstract

Objectives:
The 10th revision of the International Classification of Diseases (ICD-10) coding system may prove useful to orthopaedic trauma researchers to identify and document populations based on comorbidities. However, its use for research first necessitates determination of its reliability. The purpose of this study was to assess the reliability of electronic medical record (EMR) ICD-10 coding of nonorthopaedic diagnoses in orthopaedic trauma patients relative to the gold standard of prospective data collection.

Design:
Nonexperimental cross-sectional study.

Setting:
Level 1 Trauma Center.

Patients/Participants:
Two hundred sixty-three orthopaedic trauma patients from 2 prior prospective studies from September 2018 to April 2022.

Intervention:
Prospectively collected data were compared with EMR ICD-10 code abstraction for components of the Charlson Comorbidity Index (CCI), obesity, alcohol abuse, and tobacco use (retrospective data).

Main Outcome Measurements:
Percent agreement and Cohen's kappa reliability.

Results:
Percent agreement ranged from 86.7% to 96.9% for all CCI diagnoses and was as low as 72.6% for the diagnosis “overweight.” Only 2 diagnoses, diabetes without end-organ damage (kappa = 0.794) and AIDS (kappa = 0.798) demonstrated Cohen's kappa values to indicate substantial agreement.

Conclusion:
EMR diagnostic coding for medical comorbidities in orthopaedic trauma patients demonstrated variable reliability. Researchers may be able to rely on EMR coding to identify patients with diabetes without complications or AIDS. Chart review may still be necessary to confirm diagnoses. Low prevalence of most comorbidities led to high percentage agreement with low reliability.

Level of Evidence:
Level 1 diagnostic.
Comparative outcomes after treatment of peri-implant, periprosthetic, and interprosthetic femur fractures: which factors increase mortality risk?
Authors: Shah Jay K. , Abwini Laith Z. , Tang Alex , Yang Jason I. , Keller David M. , Menken Luke G. , Liporace Frank A. , Yoon Richard S. 
Published: February 2024

Abstract

Objectives:
To compare mortality rates between patients treated surgically for periprosthetic fractures (PPF) after total hip arthroplasty (THA), total knee arthroplasty (TKA), peri-implant (PI), and interprosthetic (IP) fractures while identifying risk factors associated with mortality following PPF.

Design:
Retrospective.

Setting:
Single, Level II Trauma Center.

Patients/Participants:
A retrospective review was conducted of 129 consecutive patients treated surgically for fractures around a pre-existing prosthesis or implant from 2013 to 2020. Patients were separated into 4 comparison groups: THA, TKA, PI, and IP fractures.

Intervention:
Revision implant or arthroplasty, open reduction and internal fixation (ORIF), intramedullary nailing (IMN), percutaneous screws, or a combination of techniques.

Main Outcome Measurements:
Primary outcome measures include mortality rates of different types of PPF, PI, and IP fractures at 1-month, 3-month, 6-month, 1-year, and 2-year postoperative. We analyzed risk factors associated with mortality aimed to determine whether treatment type affects mortality.

Results:
One hundred twenty-nine patients were included for final analysis. Average follow-up was similar between all groups. The overall 1-year mortality rate was 1 month (5%), 3 months (12%), 6 months (13%), 1 year (15%), and 2 years (22%). There were no differences in mortality rates between each group at 30 days, 90 days, 6 months, 1 year, and 2 years (P-value = 0.86). A Kaplan–Meier survival curve demonstrated no difference in survivorship up to 2 years. Older than 65 years, history of hypothyroidism and dementia, and discharge to a skilled nursing facility (SNF) led to increased mortality. There was no survival benefit in treating patients with PPFs with either revision, ORIF, IMN, or a combination of techniques.

Conclusion:
The overall mortality rates observed were 1 month (5%), 3 months (12%), 6 months (13%), 1 year (15%), and 2 years (22%), and no differences were found between each group at all follow-up time points. Patients aged 65 and older with a history of hypothyroidism and/or dementia discharged to an SNF are at increased risk for mortality. From a mortality perspective, surgeons should not hesitate to choose the surgical treatment they feel most comfortable performing.

Level of Evidence:
Level III.
Morphological and Quantitative Parametric MRI Follow-up of Cartilage Changes Before and After Intra-articular Injection Therapy in Patients With Mild to Moderate Knee Osteoarthritis
Authors: Tschopp Marcel , Pfirrmann Christian W.A. , Brunner Florian , Fucentese Sandro F. , Galley Julien , Stern Christoph , Sutter Reto , Catanzaro Sabrina , Kühne Nathalie , Rosskopf Andrea B. 
Published: February 2024

Background
Intra-articular injections are routinely used for conservative treatment of knee osteoarthritis (OA). The detailed comparative therapeutic effects of these injections on cartilage tissue are still unclear.

Objective
The aim of this study was to detect and compare knee cartilage changes after intra-articular injection of glucocorticoid, hyaluronic acid, or platelet-rich plasma (PRP) to placebo using quantitative (T2 and T2* mapping) and morphological magnetic resonance imaging parameters in patients with mild or moderate osteoarthritis.

Materials and Methods
In a double-blinded, placebo-controlled, single-center trial, knees with mild or moderate osteoarthritis (Kellgren-Lawrence grade 1–3) were randomly assigned to an intra-articular injection with 1 of these substances: glucocorticoid, hyaluronic acid, PRP, or placebo. Cartilage degeneration on baseline and follow-up magnetic resonance imaging scans (after 3 and 12 months) was assessed by 2 readers using quantitative T2 and T2* times (milliseconds) and morphological parameters (modified Outerbridge grading, subchondral bone marrow edema, subchondral cysts, osteophytes).

Results
One hundred twenty knees (30 knees per treatment group) were analyzed with a median patient age of 60 years (interquartile range, 54.0–68.0 years). Interreader reliability was good for T2 (ICC, 0.76; IQR, 0.68–0.83) and T2* (ICC, 0.83; IQR, 0.76–0.88) measurements. Morphological parameters showed no significant changes between all groups after 3 and 12 months. T2 mapping after 12 months showed the following significant (P = 0.001–0.03) changes between groups in 6 of 14 compartments: values after PRP injection decreased compared with glucocorticoid in 4 compartments (complete medial femoral condyle and central part of lateral condyle) and compared with placebo in 2 compartments (anterior and central part of medial tibial plateau); values after glucocorticoid injection decreased compared with placebo in 1 compartment (central part of medial tibial plateau). No significant changes were seen for T2 and T2* times after 3 months and T2* times after 12 months. No correlation was found between T2/T2* times and Kellgren-Lawrence grade, age, body mass index, or pain (Spearman ρ, −0.23 to 0.18).

Conclusions
Platelet-rich plasma injection has a positive long-term effect on cartilage quality in the medial femoral compartment compared to glucocorticoid, resulting in significantly improved T2 values after 12 months. For morphological cartilage parameters, injections with glucocorticoid, PRP, or hyaluronic acid showed no better effect in the short or long term compared with placebo.
Data-driven discovery of gene expression markers distinguishing pediatric acute lymphoblastic leukemia subtypes
Authors: Nourbakhsh Mona , Tom Nikola , Schrøder Lassen Anna , Brasch Lind Petersen Helene , Kristoffer Stoltze Ulrik , Wadt Karin , Schmiegelow Kjeld , Tiberti Matteo , Papaleo Elena 
Published: February 2024

AbstractAcute lymphoblastic leukemia (ALL), the most common cancer in children, is overall divided into two subtypes, B-cell precursor ALL (B-ALL) and T-cell ALL (T-ALL), which have different molecular characteristics. Despite massive progress in understanding the disease trajectories of ALL, ALL remains a major cause of death in children. Thus, further research exploring the biological foundations of ALL is essential. Here, we examined the diagnostic, prognostic, and therapeutic potential of gene expression data in pediatric patients with ALL. We discovered a subset of expression markers differentiating B- and T-ALL:CCN2,VPREB3,NDST3,EBF1, RN7SKP185, RN7SKP291, SNORA73B, RN7SKP255, SNORA74A, RN7SKP48, RN7SKP80, LINC00114, a novel gene (ENSG00000227706), and 7SK. The expression level of these markers all demonstrated significant effects on survival of the patients, comparing the two subtypes. We also discovered four expression subgroups in the expression data with eight genes driving separation between two of these predicted subgroups. A subset of the 14 markers could separate B- and T-ALL in an independent cohort of patients with ALL. This study can enhance our knowledge of the transcriptomic profile of different ALL subtypes.
Implementing remote monitoring for COVID-19 patients in primary care
Authors: Holtz Svea , Köhler Susanne M. , Chabiera Peter Jan , Dauletbaev Nurlan , Deutsch Kim , Oftring Zoe , Lawin Dennis , Niekrenz Lukas , Euler Teresa , Gloeckl Rainer , Koczulla Rembert , Rohde Gernot , Dreher Michael , Vogelmeier Claus F. , Kuhn Sebastian , Müller Beate Sigrid 
Published: February 2024

AbstractBackgroundIn Germany, most patients with coronavirus disease 2019 (COVID-19) are treated in an outpatient setting. To improve assessments of the health status of COVID-19 outpatients, various remote monitoring models have been developed. However, little information exists on experiences acquired with remote monitoring in an outpatient setting, particularly from a patient perspective. The aim of our ‘COVID-19@home’ study was therefore to implement and evaluate an app-based remote monitoring concept for acute and post-acute COVID-19-patients in primary care. In this paper, we focus on the patients’ evaluation of our remote monitoring approach.MethodsPatients with acute COVID-19 measured heart rate, blood pressure, oxygen saturation, and body temperature daily for 28 days. Patients with post-acute COVID-19 determined the same parameters for 12 weeks, supplemented by lung parameters and daily step count. The data were documented using the ‘SaniQ’ smartphone app. COVID-19 symptoms were assessed daily using an app-based questionnaire. Patients’ GPs could access the data on the ‘SaniQ Praxis’ telemedicine platform. We used an app-based questionnaire consisting of 11 questions presented with a 4-point Likert scale to evaluate patient satisfaction. Data were analyzed descriptively.ResultsOf the 51 patients aged 19-77 years that participated in the study, 42 completed the questionnaire. All patients rated home monitoring as ‘very good’ or ‘rather good’ and were able to integrate the measuring processes into their daily routines. Overall, 93% would recommend the app and the measuring devices to their family and friends. About 60% felt that their COVID-19 treatment had benefited from home monitoring. Only few patients were unsettled by the app and use of the measuring devices. During the course of the study, the implementation process was optimized.ConclusionsThe use of remote monitoring in COVID-19 patients is feasible and was evaluated positively by most study patients. However, it is difficult to imagine how general practices could cope with monitoring patients with acute diseases without any further organizational support. Future research should address cost-effectiveness and changes in such clinical outcomes as hospitalization and mortality.
The dimensionality of the Death Anxiety Inventory-Revised in Colombian-aged adults
Authors: Campo-Arias Adalberto , Reyes-Rojas Monica , Ceballos-Ospino Guillermo Augusto 
Published: February 2024

AbstractThe Death Anxiety Inventory-Revised (DAI-R) is a relatively new instrument to quantify anxiety about death in different contexts. However, the dimensionality in the elderly population is unknown. The study aimed to corroborate the dimensionality of the DAI-R among Colombian-aged adults. A psychometric study was conducted with the participation of 100 aged adults (M=68.82, SD=4.82; 52% were male gender). This scale has 17 items, grouped into four dimensions or factors, and a dichotomous answer pattern. Dimensionality was tested using confirmatory factor analysis (CFA), and goodness-of-fit indicators were computed. The CFA showed unacceptable goodness-of-fit indicators, and the four-dimensional structure of the DAI-R was rejected. In conclusion, the DAI-R has an unsatisfactory four-dimensional structure among Colombian-aged adults. Further research should corroborate this finding with a large sample size.