bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic versus open cancellous bone grafting for scaphoid delayed/nonunion in adults (SCOPE-OUT): study protocol for a randomized clinical trial
Authors: Kjaer Morten , Rasmussen Jeppe Vejlgaard , Gvozdenovic Robert 
Published: April 2023

Abstract

Background
Scaphoid non-union results in pain and decreased hand function. Untreated, almost all cases develop degenerative changes. Despite advances in surgical techniques, the treatment is challenging and often results in a long period with a supportive bandage until the union is established. Open, corticocancellous (CC) or cancellous (C) graft reconstruction and internal fixation are often preferred. Arthroscopic assisted reconstruction with C chips and internal fixation provides minimal trauma to the ligament structures, joint capsule, and extrinsic vascularization with similar union rates. Correction of deformity after operative treatment is debated with some studies favouring CC, and others found no difference. No studies have compared time to union and functional outcomes in arthroscopic vs. open C graft reconstruction. We hypothesize that arthroscopic assisted C chips graft reconstruction of scaphoid delayed/non-union provides faster time to union, by at least a mean 3 weeks difference.

Methods
Single site, prospective, observer-blinded randomized controlled trial. Eighty-eight patients aged 18–68 years with scaphoid delayed/non-union will be randomized, 1:1, to either open iliac crest C graft reconstruction or arthroscopic assisted distal radius C chips graft reconstruction. Patients are stratified for smoking habits, proximal pole involvement and displacement of > / < 2 mm. The primary outcome is time to union, measured with repeated CT scans at 2-week intervals from 6 to 16 weeks postoperatively. Secondary outcomes are Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH), visual analogue scale (VAS), donor site morbidity, union rate, restoration of scaphoid deformity, range of motion, key-pinch, grip strength, EQ5D-5L, patient satisfaction, complications and revision surgery.

Discussion
The results of this study will contribute to the treatment algorithm of scaphoid delayed/non-union and assist hand surgeons and patients in making treatment decisions. Eventually, improving time to union will benefit patients in earlier return to normal daily activity and reduce society costs by shortening sick leave.

Trial registration
ClinicalTrials.gov NCT05574582. Date first registered: September 30, 2022. Items from the WHO trial registry are found within the protocol.
Developing African arbovirus networks and capacity strengthening in arbovirus surveillance and response: findings from a virtual workshop
Authors: Braack Leo , Wulandhari Shobiechah A. , Chanda Emmanuel , Fouque Florence , Merle Corinne S. , Nwangwu Udoka , Velayudhan Raman , Venter Marietjie , Yahouedo A. Gildas , Lines Jo , Aung Poe Poe , Chan Kallista , Abeku Tarakegn A. , Tibenderana James , Clarke Sian E. 
Published: April 2023

AbstractThis meeting report presents the key findings and discussion points of a 3-h virtual workshop, held on 21 September 2022, and organized by the “Resilience Against Future Threats through Vector Control (RAFT)” research consortium. The workshop aimed to identify priorities for advancing arbovirus research, network and capacity strengthening in Africa. Due to increasing human population growth, urbanization and global movement (trade, tourism, travel), mosquito-borne arboviral diseases, such as dengue, Chikungunya and Zika, are increasing globally in their distribution and prevalence. This report summarizes the presentations that reviewed the current status of arboviruses in Africa, including: (i) key findings from the recent WHO/Special Programme for Research & Training in Tropical Diseases (WHO/TDR) survey in 47 African countries that revealed deep and widespread shortfalls in the capacity to cope with arbovirus outbreak preparedness, surveillance and control; (ii) the value of networking in this context, with examples of African countries regarding arbovirus surveillance; and (iii) the main priorities identified by the breakout groups on “research gaps”, “networks” and “capacity strengthening”.
Graphical abstract
A higher intramuscular fat in vastus medialis is associated with functional disabilities and symptoms in early stage of knee osteoarthritis: a case–control study
Authors: Taniguchi Masashi , Fukumoto Yoshihiro , Yagi Masahide , Hirono Tetsuya , Yamagata Momoko , Asayama Akihiro , Okada Shogo , Nakai Ryusuke , Kobayashi Masashi , Ichihashi Noriaki 
Published: April 2023

Abstract
Background
The characteristics of muscle degeneration in individual quadriceps in early knee osteoarthritis (OA) and the association of muscle quantity and quality on knee dysfunction remain unclear. This study aimed to clarify the characteristics of muscle degeneration in individual quadriceps muscles in early knee OA and elucidate the association of muscle volume and intramuscular adipose tissue (intraMAT) with knee dysfunction, including functional disabilities, symptoms, and joint morphology.

Methods
Fifty participants were categorized into early knee OA and healthy control groups. 3.0 T magnetic resonance imaging (MRI) using T1-weighted and Dixon methods and 3D SPACE in the thigh muscle and knee joint regions was performed. Quadriceps muscle volume, intraMAT, and whole-organ MRI score (WORMS) were assessed. The Knee Society Score (KSS) was used to evaluate functional disabilities and knee symptoms. Univariate analysis of variance was conducted with covariates to clarify the differences in muscle volume and intraMAT between the two groups. Multiple linear regression analyses were performed using the KSS function and symptom subcategories and WORMS as dependent variables and muscle volume, intraMAT, and the presence of early knee OA as independent variables, such as potential confounders.

Results
The quadriceps intraMAT, especially in the vastus medialis (VM), was significantly higher in patients with early knee OA than in healthy controls. The VM intraMAT, not muscle volume, was significantly associated with KSS function [B =  − 3.47; 95% confidence interval [CI], − 5.24 to − 1.71; p < 0.001] and symptom scores [B =  − 0.63; 95% CI, − 1.09 to − 0.17; p = 0.008], but not with WORMS.

Conclusion
These findings suggest that higher VM intraMAT is characteristic of quadriceps muscle degeneration in early knee OA and its increase is associated with functional disabilities and symptoms.
Ectopic parotid gland in the left cheek: a case report
Authors: Borji Soheila , Moharrami Yeganeh Pegah 
Published: April 2023

Abstract
Background
The parotid glands are one of the major components of the salivary glands. Their function is to secrete serous saliva to facilitate chewing and swallowing. The normal position of the parotid glands is anterior to and below the lower half of the ear; superficial, posterior, and deep to the ramus of the mandible.

Case presentation
In this article, we present a rare case of an ectopic left parotid gland located in the left cheek of a 45-year-old Middle-Eastern female who presented with a painless mass inside the left side of her face. Magnetic resonance imaging revealed a well-defined mass in the left buccal fat, which was isosignal with the right parotid gland.

Conclusion
Further evaluations of detected cases are necessary to obtain more information regarding the pathogenesis and possible etiologies of this condition. There is a need for more reports of similar cases, as well as diagnostic and etiologic studies, to understand the cause of this condition further.
Mirtazapine-induced neutropenic sepsis in an older person: a case report
Authors: Maidwell-Smith Alice , Kirk Charlotte 
Published: April 2023

Abstract
Background
Mirtazapine is a frequently prescribed psychotropic drug for depression in older age. It is considered safe and has a side-effect profile uniquely favorable to an older person affected by reduced appetite, difficulty maintaining body weight, or insomnia. However, it is largely unknown that mirtazapine can cause a dangerous decline in neutrophil count.

Case presentation
We present a case of mirtazapine-induced severe neutropenia in a 91-year-old white British woman requiring drug withdrawal and granulocyte-colony stimulating factor administration.

Conclusion
This case is of significance because mirtazapine is regarded as a safe, and often preferable, antidepressant in older age. However, this case demonstrates a rare, life-threatening side effect of mirtazapine and calls for greater pharmacovigilance when prescribing it. There is no previous report of mirtazapine-induced neutropenia requiring drug withdrawal and granulocyte-colony stimulating factor administration in an older person.
Gender differences in the associations between body mass index, depression, anxiety, and stress among endocrinologists in China
Authors: Xie Fei , Jiang Licong , Liu Yuanli , Wang Mingxiao , Liu Huanzhong , Jiang Feng , Wu Yinuo , Tang Yi-Lang 
Published: April 2023

Abstract
Background
Depression, anxiety, and stress symptoms have been found to be associated with overweight or obesity, but the gender differences in the associations have not been well-examined. Based on a national sample of endocrinologists in China, we examined such associations with a focus on gender differences.

Methods
Data were collected from endocrinologists in China using an online questionnaire, which included demographic data, body weight, and height. Depression, anxiety, and stress symptoms were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21).

Results
In total, 679 endocrinologists (174 males and 505 females) completed the survey. One-fourth (25.6%) were classified as overweight, with a significant gender difference (48.9% in males vs. 17.6% in females, p < 0.05). Overall, 43.4% of the participants endorsed probable depressive symptoms (54.6% in males and 39.6% in females, p = 0.004), 47.6% for anxiety (51.7% in males vs. 46.1% in females, p = 0.203), and 29.6% for stress symptoms (34.5% in males vs. 27.92% in females, p = 0.102). After controlling for confounders, in the whole group, male gender (aOR = 4.07, 95% CI:2.70–6.14, p < 0.001), depression (aOR = 1.05, 95% CI:1.00-1.10, p = 0.034) and age (aOR = 1.03, 95% CI:1.00-1.05, p = 0.018) were positively associated with overweight. In males, depression (aOR = 1.14, 95% CI:1.05–1.25, p = 0.002), administration position (aOR = 4.36, 95% CI:1.69–11.24, p = 0.002), and night shifts/month (aOR = 1.26, 95% CI:1.06–1.49, p = 0.008) were positively associated with overweight, while anxiety (aOR = 0.90, 95% CI:0.82–0.98, p = 0.020) was negatively associated with overweight. In females, only age (aOR = 1.04, 95% CI:1.01–1.07, p = 0.014) was significantly associated with overweight status, while depression and anxiety were not associated with overweight. Stress symptoms were not associated with overweight in either gender.

Conclusions
One-fourth of endocrinologists in China are overweight, with a rate in males nearly triple the one in females. Depression and anxiety are significantly associated with overweight in males but not females. This suggests possible differences in the mechanism. Our findings also highlight the need to screen depression and overweight in male physicians and the importance of developing gender-specific interventions.
Gayet–Wernicke encephalopathy: a complication not to be overlooked in patients with catatonic schizophrenia
Authors: Messedi Neila , Turki Mariem , Charfi Rihab , Ellouze Sahar , Chaari Imen , Aribi Lobna , Halouani Najla , Aloulou Jihen 
Published: April 2023

Abstract
Background
Gayet–Wernicke's encephalopathy (GWE) is a life-threatening neurological emergency caused by vitamin B1 deficiency. This is a rare complication, which may be reversible if managed promptly. However, any diagnostic or therapeutic delay exposes to the risk of serious sequelae. Although this pathology frequently occurs in chronic alcohol users, it can also occur in any situation of severe undernutrition. In this context, we report a case of GWE occurring after severe undernutrition complicating prolonged catatonia in a patient suffering from schizophrenia.

Case presentation
He was a 47-year-old patient, suffering from esophageal stenosis, and followed in psychiatry for schizophrenia, who was hospitalized for a catatonic relapse. He was put on benzodiazepine with parenteral rehydration. Faced with the persistence of food refusal, and the appearance of signs of undernutrition, a parenteral diet was introduced. The evolution was marked by the deterioration of his general and neurological condition, with the appearance of mental confusion. The examination showed a central vestibular syndrome, and brain magnetic resonance imaging showed a hyperintense signaling in the periaqueductal area, in mammillary bodies, and in medial thalamic nuclei on T2-FLAIR sequences. GWE was suspected and parental vitamin B1 therapy was initiated. Laboratory testing confirmed the diagnosis, showing a low thiamine blood level of 32 nmol/l [normal range: 78 to 185 nmol/l]. Regression of neurological symptoms was observed within 2 weeks of treatment.

Conclusion
Through this illustration, we draw the attention of the psychiatrist, who must think about preventing this complication, by supplementing any patient at risk of developing GWE with vitamin B1.
Leveraging technology for waste sustainability: understanding the adoption of a new waste management system
Authors: Vorobeva Darina , Scott Ian J. , Oliveira Tiago , Neto Miguel 
Published: April 2023

AbstractMany countries are under escalating pressure to meet legally binding targets in relation to recycling and waste management. This paper explores how innovative tools, including blockchain, economic incentives, and gamification, encourage consumer adoption of a novel household waste management system. We focus on developing a comprehensive framework that combines UTAUT2 (the unified theory of acceptance and use of technology 2) with novel features in the waste management context and additional behavioral construct, intention to recommend the system to others. We tested the proposed model using the partial least square structural equation modeling approach based on a survey of 400 respondents. The results indicate that in addition to effort expectancy, social influence, and hedonic motivation, trust, a property of blockchain technology, also impacts the respondent’s behavioral intention to use the new system. Furthermore, trust has a significant effect on both the level of system use and intention to recommend waste management system to others. The role of gamification was identified as a moderator between behavioral intention and system use and between trust and system use but not between system use and facilitating conditions. This result demonstrates that gamification can be valuable to increase adoption in users with otherwise low levels of behavioral intention. However, we did not find a strong link between either economic incentives, facilitating conditions, or performance expectancy and behavioral intention. The paper concludes by presenting the application of the proposed framework and the implications for the design of future consumer-facing waste management systems. The introduction of the novel features such as blockchain and gamification is discussed.
Lenvatinib Plus Pembrolizumab in Previously Treated Advanced Endometrial Cancer: Updated Efficacy and Safety From the Randomized Phase III Study 309/KEYNOTE-775
Authors: Makker Vicky , Colombo Nicoletta , Herráez Antonio Casado , Monk Bradley J. , Mackay Helen , Santin Alessandro D. , Miller David S. , Moore Richard G. , Baron-Hay Sally , Ray-Coquard Isabelle , Ushijima Kimio , Yonemori Kan , Kim Yong Man , Guerra Alia Eva M. , Sanli Ulus A. , Bird Steven , Orlowski Robert , McKenzie Jodi , Okpara Chinyere , Barresi Gianmaria , Lorusso Domenica 
Published: April 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. We report the final prespecified analysis for overall survival (OS), along with updated progression-free survival (PFS) and objective response rate (ORR), and safety from the open-label, randomized, phase III Study 309/KEYNOTE-775. In total, 827 patients with advanced, recurrent, or metastatic endometrial cancer (EC) were randomly assigned to receive lenvatinib 20 mg orally once daily plus pembrolizumab 200 mg intravenously once every 3 weeks (n = 411) or chemotherapy of the treating physician's choice (doxorubicin 60 mg/m2 intravenously once every 3 weeks or paclitaxel 80 mg/m2 intravenously once weekly [3 weeks on; 1 week off] [n = 416]). Efficacy was reported for patients with mismatch repair proficient (pMMR) tumors and all-comers, and by subgroups (histology, prior therapy, MMR status). Updated safety was also reported. Lenvatinib plus pembrolizumab showed benefits in OS (pMMR HR, 0.70; 95% CI, 0.58 to 0.83; all-comer HR, 0.65; 95% CI, 0.55 to 0.77), PFS (pMMR HR, 0.60; 95% CI, 0.50 to 0.72; all-comer HR, 0.56; 95% CI, 0.48 to 0.66), and ORR (pMMR patients, 32.4% v 15.1%; all-comers, 33.8% v 14.7%) versus chemotherapy. OS, PFS, and ORR favored lenvatinib plus pembrolizumab in all subgroups of interest. No new safety signals were observed. Lenvatinib plus pembrolizumab continued to show improved efficacy versus chemotherapy and manageable safety in patients with previously treated advanced EC.
Biomechanical Comparison of Facet Versus Laminar C2 Screws
Authors: Meynard Alexandre , Fréchède Bertrand , Pommier Benjamin , Mitton David , Barrey Cédric 
Published: April 2023

BACKGROUND:
Transpedicular or transisthmic screws for C2 instrumentation represent the gold standard; however, the anatomy is not always compatible (hypoplastic pedicles, procidentia of the vertebral artery). Laminar screws (LS) have been proposed as a rescue technique and recently, bicortical facet screws (FS). To date, the biomechanical property of FS remains unknown.

OBJECTIVE:
To compare the pull-out resistance of bicortical facet (FS) vs laminar (LS) C2 screws.

METHODS:
Thirty-two human cadaveric C2 vertebrae were screened by CT scan imaging and dual x-ray absorptiometry before receiving both techniques and were randomized according to side and sequence (FS or LS first). Screw positioning was validated using 2-dimensional x-rays. Sixty-four mechanical tests were performed using pure tensile loading along the axis of the screws until pull-out. Mean pull-out strengths were compared using paired tests, multivariate and survival analysis (Kaplan-Meier curves).

RESULTS:
The morphometric data were consistent with previous studies. Over 64 tests, the mean pull-out strength of LS (707 ± 467 N) was significantly higher than that of FS (390 ± 230 N) (P = .0004). Bone mineral density was weakly correlated with pull-out strength (r = 0.42 for FS and r = 0.3 for LS). Both techniques were mechanically equivalent for vertebrae in which intralaminar cortical grip was not achievable for LS. The mean pull-out strength for LS with laminar cortical grip (1071 ± 395 N) was significantly higher than that of LS without (423 ± 291 N) (P < .0001).

CONCLUSION:
Our results suggest that bicortical FS of C2 offer less mechanical resistance than LS.
A Multicenter, Propensity Score–Matched Assessment of Endoscopic Versus Microscopic Approaches in the Management of Pituitary Adenomas
Authors: Findlay Matthew C. , Drexler Richard , Khan Majid , Cole Kyril L. , Karbe Arian , Rotermund Roman , Ricklefs Franz L. , Flitsch Jörg , Smith Timothy R. , Kilgallon John L. , Honegger Jürgen , Nasi-Kordhishti Isabella , Gardner Paul A. , Gersey Zachary C. , Abdallah Hussein M. , Jane John A. , Marino Alexandria C. , Knappe Ulrich J. , Uksul Nesrin , Rzaev Jamil A. , Galushko Evgeniy V. , Gormolysova Ekaterina V. , Bervitskiy Anatoliy V. , Schroeder Henry W. S. , Eördögh Márton , Losa Marco , Mortini Pietro , Gerlach Rüdiger , Antunes Apio C. M. , Couldwell William T. , Budohoski Karol P. , Rennert Robert C. , Azab Mohammed , Karsy Michael 
Published: April 2023

BACKGROUND AND OBJECTIVES:
There is considerable controversy as to which of the 2 operating modalities (microsurgical or endoscopic transnasal surgery) currently used to resect pituitary adenomas (PAs) is the safest and most effective intervention. We compared rates of clinical outcomes of patients with PAs who underwent resection by either microsurgical or endoscopic transnasal surgery.

METHODS:
To independently assess the outcomes of each modality type, we sought to isolate endoscopic and microscopic PA surgeries with a 1:1 tight-caliper (0.01) propensity score–matched analysis using a multicenter, neurosurgery-specific database. Surgeries were performed between 2017 and 2020, with data collected retrospectively from 12 international institutions on 4 continents. Matching was based on age, previous neurological deficit, American Society of Anesthesiologists (ASA) score, tumor functionality, tumor size, and Knosp score. Univariate and multivariate analyses were performed.

RESULTS:
Among a pool of 2826 patients, propensity score matching resulted in 600 patients from 9 surgery centers being analyzed. Multivariate analysis showed that microscopic surgery had a 1.91 odds ratio (OR) (P = .03) of gross total resection (GTR) and shorter operative duration (P < .01). However, microscopic surgery also had a 7.82 OR (P < .01) for intensive care unit stay, 2.08 OR (P < .01) for intraoperative cerebrospinal fluid (CSF) leak, 2.47 OR (P = .02) for postoperative syndrome of inappropriate antidiuretic hormone secretion (SIADH), and was an independent predictor for longer postoperative stay (β = 2.01, P < .01). Overall, no differences in postoperative complications or 3- to 6-month outcomes were seen by surgical approach.

CONCLUSION:
Our international, multicenter matched analysis suggests microscopic approaches for pituitary tumor resection may offer better GTR rates, albeit with increased intensive care unit stay, CSF leak, SIADH, and hospital utilization. Better prospective studies can further validate these findings as matching patients for outcome analysis remains challenging. These results may provide insight into surgical benchmarks at different centers, offer room for further registry studies, and identify best practices.