bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of tocilizumab in critically ill patients with COVID-19: an observational study
Authors: Youssef Ghada A. , Wagih Khalid M. , Hamid Hossam M. Abdel 
Published: September 2023

Abstract
Background
Since the coronavirus disease 2019 (COVID-19) outbreak has rapidly propagated with a high mortality rate, it is currently considered a global emergency. Worldwide, the number of patients with severe acute respiratory syndrome caused by coronavirus 2 is steadily rising. Pneumonia, severe symptoms of acute respiratory distress syndrome (ARDS), and multiple organ failure can all occur in COVID-19 patients.

Aim of the work
To compare the clinical symptoms and inflammatory markers before and after the administration of 2 doses of tocilizumab, acknowledging that the second dose is given within 24–48 h following the first dose.

Patients and methods
Baseline CBC with differential, liver function tests, kidney function tests, D dimer, serum ferritin, and CRP were withdrawn. Two doses of tocilizumab were given over 2 days; the first dose was 8 mg/kg diluted in 100 cc saline 0.9% administered over 1 h while the second dose (4 mg/kg diluted in 100 cc saline 0.9%) was given after 24 h. Follow-up inflammatory markers were withdrawn after 3 days following the second dose of tocilizumab. Clinical symptoms were evaluated 48 h following the second dosage of tocilizumab. Oxygen therapy was evaluated on the second and the thirtieth days following tocilizumab administration.

Results
The administration of tocilizumab highly and significantly improves some clinical symptoms (bony aches, fatigue, fever), oxygen therapy, and PO2/FiO2 ratio. Also, its administration showed no significant effect on the inflammatory markers other than CRP which showed a marked increase. Tocilizumab treatment resulted in worsened expectoration. Tocilizumab showed neither effect on patients’ fate and mortality nor on hospital stay. A mean age of 61 was statistically and highly significant in increased patient mortality. Renal impairment significantly affected the length of hospital stay. The effect of timing of tocilizumab administration on patients’ fate and mortality showed non-statistically significant improvement when given from day 6 to day 10 since the onset of symptoms.

Conclusion
The administration of tocilizumab highly and significantly improves clinical symptoms, oxygen therapy, and PO2/FiO2 ratio, with no significant effect on inflammatory markers other than CRP which showed a marked increase, which may be attributed to early withdrawal of inflammatory markers. Tocilizumab shows neither the effect on patients’ fate and mortality nor on hospital stay although the mean age of 61 was statistically highly significant on increased patients’ mortality and renal impairment significantly affected length of hospital stay.
Long-term Experience of LINAC Single-Dose Radiosurgery for Skull Base Meningiomas: A Retrospective Single-Center Study of 241 Cases
Authors: Ortiz García Isabel M. , Rodríguez Valero Paula , Jorques Infante Ana M. , Cordero Tous Nicolás , Expósito Hernández José , Olivares Granados Gonzalo 
Published: September 2023

BACKGROUND AND OBJECTIVES:
Stereotactic radiosurgery (SRS) is increasingly applied to treat meningiomas, attributable to their increased incidence in older individuals at greater surgical risk. To evaluate the effectiveness of treatment with linear accelerator (LINAC)–based stereotactic radiosurgery in skull base meningiomas as either primary treatment or postresection adjuvant therapy.

METHODS:
This study included 241 patients diagnosed with skull base meningiomas treated by single-dose SRS, with a median age of 59 years. SRS was primary treatment in 68.1% (n = 164) and adjuvant treatment in 31.9% (n = 77), using LINAC (Varian 600, 6 MeV). The median tumor volume was 3.2 cm3, and the median coverage dose was 14 Gy. Bivariate and multivariate analyses were performed to determine predictive factors for tumor progression, clinical deterioration, and complications. Kaplan-Meier analysis was used for survival analysis.

RESULTS:
After the median follow-up of 102 months, the tumor control rate was 91.2% (n = 220). Progression-free survival rates were 97.07%, 90.1%, and 85.7% at 5, 10, and 14 years, respectively. Clinical improvement was observed in 56 patients (23.2%). In multivariate analysis, previous surgery (hazard ratio 3.8 [95%CI 1.136-12.71], P = .030) and selectivity (hazard ratio .21 [95%CI 0.066-0.677], P = .009) were associated with tumor progression and increased maximum dose (odds ratio [OR] 4.19 [95% CI 1.287-13.653], P = .017) with clinical deterioration. The permanent adverse radiation effect rate was 6.2% (n = 15) and associated with maximum brainstem dose >12.5 Gy (OR 3.36 [95% CI .866-13.03], P = .08) and cerebellopontine angle localization (OR 3.93 [95% CI 1.29-11.98], P = .016).

CONCLUSION:
Treatment of skull base meningiomas with single-dose SRS using LINAC is effective over the long term. Superior tumor control is obtained in patients without previous surgery. Adverse effects are related to localization in the cerebellopontine angle, and maximum brainstem radiation dose was >12.5 Gy.
Surgical Strategies in the Treatment of Giant Pituitary Adenomas
Authors: Joshi Krishna C. , Kolb Bradley , Khalili Bobak F. , Munich Stephan A. , Byrne Richard W. 
Published: September 2023

BACKGROUND AND OBJECTIVES:
The management of giant pituitary adenomas (GPAs) is challenging due to associated endocrinopathies and the close proximity of these tumors to critical structures, such as the optic nerves, structures of the cavernous sinus, and hypothalamus. The objective of this review article was to summarize the current management strategies for giant pituitary adenomas, including the role of open and endoscopic surgical approaches and the role of medical and radiation therapy in conjunction with surgery.

METHODS:
We conducted a retrospective review of GPAs operated at our institute between January 2010 and March 2023. Surgical approaches, extent of resection, and associated complications were documented. Furthermore, we conducted a thorough literature review to identify relevant studies published in the past decade, which were incorporated along with insights gained from our institutional case series of GPAs to analyze and integrate both the existing knowledge base and our institution's firsthand experience in the management of GPAs.

RESULTS:
A total of 46 giant pituitary adenomas (GPAs) were operated on, using various surgical approaches. Transsphenoidal approach was used in 25 cases and a staged approach using transsphenoidal and pterional was used in 15 cases. Other approaches included transcortical-transventricular, transcallosal, pterional/orbitozygomatic, and subfrontal approaches. Complications and technical nuances were reported.

CONCLUSION:
The management of giant pituitary adenomas remains complex, often involving several modalities—open or endoscopic resection, radiosurgery, and medical management of both the tumor and associated endocrinopathies. Surgical resections are often challenging procedures that require careful consideration of several factors, including patient characteristics, tumor location, and size, and the experience and skill of the surgical team.
DAXX safeguards heterochromatin formation in embryonic stem cells
Authors: Canat Antoine , Veillet Adeline , Batrin Renaud , Dubourg Clara , Lhoumaud Priscillia , Arnau-Romero Pol , Greenberg Maxim V. C. , Bonhomme Frédéric , Arimondo Paola B. , Illingworth Robert , Fabre Emmanuelle , Therizols Pierre 
Published: September 2023

ABSTRACT
Genomes comprise a large fraction of repetitive sequences folded into constitutive heterochromatin, which protect genome integrity and cell identity. De novo formation of heterochromatin during preimplantation development is an essential step for preserving the ground-state of pluripotency and the self-renewal capacity of embryonic stem cells (ESCs). However, the molecular mechanisms responsible for the remodeling of constitutive heterochromatin are largely unknown. Here, we identify that DAXX, an H3.3 chaperone essential for the maintenance of mouse ESCs in the ground state, accumulates in pericentromeric regions independently of DNA methylation. DAXX recruits PML and SETDB1 to promote the formation of heterochromatin, forming foci that are hallmarks of ground-state ESCs. In the absence of DAXX or PML, the three-dimensional (3D) architecture and physical properties of pericentric and peripheral heterochromatin are disrupted, resulting in de-repression of major satellite DNA, transposable elements and genes associated with the nuclear lamina. Using epigenome editing tools, we observe that H3.3, and specifically H3.3K9 modification, directly contribute to maintaining pericentromeric chromatin conformation. Altogether, our data reveal that DAXX is crucial for the maintenance and 3D organization of the heterochromatin compartment and protects ESC viability.
Nectophore coordination and kinematics by physonect siphonophores
Authors: Strock Shirah , Costello John H. , Daniels Joost , Katija Kakani , Colin Sean P. 
Published: September 2023

ABSTRACT
Siphonophores are ubiquitous and often highly abundant members of pelagic ecosystems throughout the open ocean. They are unique among animal taxa in that many species use multiple jets for propulsion. Little is known about the kinematics of the individual jets produced by nectophores (the swimming bells of siphonophores) or whether the jets are coordinated during normal swimming behavior. Using remotely operated vehicles and SCUBA, we video recorded the swimming behavior of several physonect species in their natural environment. The pulsed kinematics of the individual nectophores that comprise the siphonophore nectosome were quantified and, based on these kinematics, we examined the coordination of adjacent nectophores. We found that, for the five species considered, nectophores located along the same side of the nectosomal axis (i.e. axially aligned) were coordinated and their timing was offset such that they pulsed metachronally. However, this level of coordination did not extend across the nectosome and no coordination was evident between nectophores on opposite sides of the nectosomal axis. For most species, the metachronal contraction waves of nectophores were initiated by the apical nectophores and traveled dorsally. However, the metachronal wave of Apolemia rubriversa traveled in the opposite direction. Although nectophore groups on opposite sides of the nectosome were not coordinated, they pulsed with similar frequencies. This enabled siphonophores to maintain relatively linear trajectories during swimming. The timing and characteristics of the metachronal coordination of pulsed jets affects how the jet wakes interact and may provide important insight into how interacting jets may be optimized for efficient propulsion.
The Predictive Utility of MammaPrint and BluePrint in Identifying Patients with Locally Advanced Breast Cancer Who are Most Likely to Have Nodal Downstaging and a Pathologic Complete Response After Neoadjuvant Chemotherapy
Authors: Blumencranz Peter , Habibi Mehran , Shivers Steve , Acs Geza , Blumencranz Lisa E. , Yoder Erin B. , van der Baan Bastiaan , Menicucci Andrea R. , Dauer Patricia , Audeh William , Cox Charles E. 
Published: September 2023

Abstract
Background
Neoadjuvant chemotherapy (NCT) increases the feasibility of surgical resection by downstaging large primary breast tumors and nodal involvement, which may result in surgical de-escalation and improved outcomes. This subanalysis from the Multi-Institutional Neo-adjuvant Therapy MammaPrint Project I (MINT) trial evaluated the association between MammaPrint and BluePrint with nodal downstaging.

Patients and Methods
The prospective MINT trial (NCT01501487) enrolled 387 patients between 2011 and 2016 aged ≥ 18 years with invasive breast cancer (T2–T4). This subanalysis includes 146 patients with stage II–III, lymph node positive, who received NCT. MammaPrint stratifies tumors as having a Low Risk or High Risk of distant metastasis. Together with MammaPrint, BluePrint genomically (g) categorizes tumors as gLuminal A, gLuminal B, gHER2, or gBasal.

Results
Overall, 45.2% (n = 66/146) of patients had complete nodal downstaging, of whom 60.6% (n = 40/66) achieved a pathologic complete response. MammaPrint and combined MammaPrint and BluePrint were significantly associated with nodal downstaging (p = 0.007 and p < 0.001, respectively). A greater proportion of patients with MammaPrint High Risk tumors had nodal downstaging compared with Low Risk (p = 0.007). When classified with MammaPrint and BluePrint, more patients with gLuminal B, gHER2, and gBasal tumors had nodal downstaging compared with HR+HER2−, gLuminal A tumors (p = 0.538, p < 0.001, and p = 0.013, respectively).

Conclusions
Patients with genomically High Risk tumors, defined by MammaPrint with or without BluePrint, respond better to NCT and have a higher likelihood of nodal downstaging compared with patients with gLuminal A tumors. These genomic signatures can be used to select node-positive patients who are more likely to have nodal downstaging and avoid invasive surgical procedures.
Birmingham Hip Resurfacing at 20 years
Authors: Dhawan Rohit , Young David A. , Van Eemeren Anthony , Shimmin Andrew 
Published: September 2023

AimsThe Birmingham Hip Resurfacing (BHR) arthroplasty has been used as a surgical treatment of coxarthrosis since 1997. We present 20-year results of 234 consecutive BHRs performed in our unit.MethodsBetween 1999 and 2001, there were 217 patients: 142 males (65.4%), mean age 52 years (18 to 68) who had 234 implants (17 bilateral). They had patient-reported outcome measures collected, imaging (radiograph and ultrasound), and serum metal ion assessment. Survivorship analysis was performed using Kaplan-Meier estimates. Revision for any cause was considered as an endpoint for the analysis.ResultsMean follow-up was 20.9 years (19.3 to 22.4). Registry data revealed that 19 hips (8.1%) had been revised and 26 patients (12%) had died from causes unrelated to the BHR. Among the remaining 189 hips, 61% were available for clinical follow-up at 20 years (n = 115) and 70% of patients had biochemical follow-up (n = 132). The cumulative implant survival rate at 20 years for male patients was 96.5% (95% confidence interval (CI) 93.5 to 99.6), and for female patients 87% (95% CI 79.7 to 94.9). The difference was statistically significant (p = 0.029). The mean Oxford Hip Score, Hip disability and Osteoarthritis Outcome Score, and Forgotten Joint Score were 45 (29 to 48), 89 (43 to 100), and 84 (19 to 100), respectively. The mean scores for each of the five domains of the EuroQol five-dimension three-level questionnaire were 1.2, 1.0, 1.2, 1.3, and 1.1, and mean overall score 82.6 (50 to 100). Ultrasound showed no pseudotumour. Mean cobalt and chromium levels were 32.1 nmol/l (1 to 374) and 45.5 nmol/l (9 to 408), respectively.ConclusionThis study shows that BHRs provide excellent survivorship and functional outcomes in young male patients. At 20 years, soft-tissue imaging and serum metal ion studies suggest that a metal-on-metal resurfacing implant can be well tolerated in a group of young patients.Cite this article: Bone Joint J 2023;105-B(9):946–952.
Annual incidence and assessment of risk factors for early-onset deep surgical site infection following primary total knee arthroplasty in osteoarthritis
Authors: Bourget-Murray Jonathan , Piroozfar Sophie , Smith Christopher , Ellison Jennifer , Bansal Rohit , Sharma Rajrishi , Evaniew Nathan , Johnson Andrew , Powell James N. 
Published: September 2023

AimsThis study aims to determine difference in annual rate of early-onset (≤ 90 days) deep surgical site infection (SSI) following primary total knee arthroplasty (TKA) for osteoarthritis, and to identify risk factors that may be associated with infection.MethodsThis is a retrospective population-based cohort study using prospectively collected patient-level data between 1 January 2013 and 1 March 2020. The diagnosis of deep SSI was defined as per the Centers for Disease Control/National Healthcare Safety Network criteria. The Mann-Kendall Trend test was used to detect monotonic trends in annual rates of early-onset deep SSI over time. Multiple logistic regression was used to analyze the effect of different patient, surgical, and healthcare setting factors on the risk of developing a deep SSI within 90 days from surgery for patients with complete data. We also report 90-day mortality.ResultsA total of 39,038 patients underwent primary TKA for osteoarthritis during the study period. Of these, 275 patients developed a deep SSI within 90 days of surgery, representing a cumulative incidence of 0.7%. The annual infection rate did not significantly decrease over the seven-year study period (p = 0.162). Overall, 13,885 (35.5%) cases were excluded from the risk analysis due to missing data. Risk factors associated with early-onset deep SSI included male sex, American Society of Anesthesiologists grade ≥ 3, blood transfusion, acute length of stay, and surgeon volume < 30 TKAs/year. Early-onset deep SSI was not associated with increased 90-day mortality.ConclusionThis study establishes a reliable baseline infection rate for early-onset deep SSI after TKA for osteoarthritis using robust Infection Prevention and Control surveillance data, and identifies several potentially modifiable risk factors.Cite this article: Bone Joint J 2023;105-B(9):971–976.
Barriers to Community Participation for Adults Aging With an Intellectual Disability in Ireland: A Longitudinal Study
Authors: McCausland Darren , McCallion Philip , Carroll Rachael , McCarron Mary 
Published: September 2023

Abstract
Social inclusion is associated with better health and quality of life. Community participation is essential to inclusion and is an established human right. However, people with intellectual disability experience limitations and challenges to their participation. This study examined difficulties older Irish adults had participating in community. A sample of 609 individuals was followed over a six-year period to explore rates of difficulty experienced and associated factors. The proportion reporting the difficulties measured increased over time. Aging was associated with increased difficulty participating in community but was just one of multiple factors. Contrary to policy, more adults with intellectual disability may face exclusion from community as they age. More person-centered supports are needed to address individual needs to better support inclusion.
Performance during the Glittre-ADL test between patients with and without post-tuberculosis bronchiectasis: A cross-sectional study
Authors: Motta Cristiane Pires , Olimpio da Silva Davi Luiz , da Costa Lohana Resende , Galhardo Giselle Faria , Lopes Agnaldo José 
Published: September 2023

Background
Post-tuberculosis bronchiectasis (PTBB) is gaining recognition as an important chronic lung disease, representing a neglected condition with a significant burden for the individual. Recently, the Glittre-ADL test (TGlittre) has been proposed for the assessment of functional capacity, which incorporates tasks of daily living demanding the upper and lower extremities. This study used TGlittre to compare patients with PTBB to patients with non-post-tuberculosis bronchiectasis (NPTBB) and evaluate the determinants of performance during TGlittre.

Methods
This is a cross-sectional study in which 32 patients with PTBB and 29 with NPTBB underwent TGlittre. In addition, they completed Short Form-36 (SF-36), handgrip strength, quadriceps muscle strength (QMS) and pulmonary function tests (PFTs).

Results
Both PTBB and NPTBB required much more time to perform the TGlittre compared to the predicted values, although they did not differ statistically from each other [152 (124–200) vs. 145 (117–179)% predicted, p = 0.41]. Regarding the PFTs, the PTBB participants showed significantly lower values than the NPTBB participants in forced vital capacity (FVC, 60 ± 14.5 vs. 78.2 ± 22.2% predicted, p<0.001) and total lung capacity [82 (66–95) vs. 93 (82–105)% predicted, p = 0.028]. In the PTBB group, FVC (p<0.001) and QMS (p = 0.001) were the only significant independent variables to predict TGlittre time, explaining 71% of the variability in TGlittre time. In the NPTBB group, maximal expiratory pressure (p = 0.002), residual volume/TLC (p = 0.001) and QMS (p = 0.032) were the significant independent variables for predicting TGlittre time, explaining 73% of the variability in TGlittre time.

Conclusions
PTBB patients have lower than expected performance on TGlittre, though similar to NPTBB patients. The PTBB patients had a greater reduction in lung volume than NPTBB patients. Furthermore, the performance on TGlittre in PTBB patients is largely explained by lung volume and QMS.
Bezugnahmen auf den Nationalsozialismus in der populären Musik: Lesarten zu Laibach, Death in June, Feindflug, Rammstein und Marduk, Reinhard Kopanski (2022)
Authors: Höpflinger Anna-Katharina 
Published: September 2023

Review of: Bezugnahmen auf den Nationalsozialismus in der populären Musik: Lesarten zu Laibach, Death in June, Feindflug, Rammstein und Marduk, Reinhard Kopanski (2022)
Münster and New York: Waxmann, 528 pp.,
ISBN 978-3-83094-252-8, p/bk, €49.90
ISBN 978-3-83099-252-3, e-book, €44.99
Chicago Classification v4.0 Stratifies Acid Burden and Abnormal Impedance-pH Variables Better Than Chicago Classification v3.0 Chicago Classification v4.0 and GERD
Authors: Ribolsi Mentore , Marchetti Lorenzo , Savarino Edoardo , Gyawali C. Prakash , Cicala Michele 
Published: September 2023

INTRODUCTION:
Gastroesophageal reflux disease (GERD) severity increases with esophageal body hypomotility, but the impact of Chicago Classification (CC) v4.0 criteria on GERD diagnosis is incompletely understood.

METHODS:
In patients with GERD evaluated with high-resolution manometry and pH-impedance monitoring, CCv3.0 and CCv4.0 diagnoses were compared.

RESULTS:
In 247 patients, hypomotility diagnosis decreased from 45.3% (CCv3.0) to 30.0% (CCv4.0, P < 0.001). In contrast, within patients with ineffective esophageal motility, proportions with pathological acid exposure increased from 38% (CCv3.0) to 88% (CCv4.0); baseline impedance and esophageal clearance demonstrated similar findings (P < 0.05 for each comparison).

DISCUSSION:
CCv4.0 hypomotility criteria are more specific in supporting GERD evidence compared with CCv3.0.