bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic performance of DSC perfusion MRI to distinguish tumor progression and treatment-related changes: a systematic review and meta-analysis
Authors: Fu Rongwei , Szidonya Laszlo , Barajas Ramon F , Ambady Prakash , Varallyay Csanad , Neuwelt Edward A 
Published: March 2022

Abstract

Background
In patients with high-grade glioma (HGG), true disease progression and treatment-related changes often appear similar on magnetic resonance imaging (MRI), making it challenging to evaluate therapeutic response. Dynamic susceptibility contrast (DSC) MRI has been extensively studied to differentiate between disease progression and treatment-related changes. This systematic review evaluated and synthesized the evidence for using DSC MRI to distinguish true progression from treatment-related changes.

Methods
We searched Ovid MEDLINE and the Ovid MEDLINE in-process file (January 2005–October 2019) and the reference lists. Studies on test performance of DSC MRI using relative cerebral blood volume in HGG patients were included. One investigator abstracted data, and a second investigator confirmed them; two investigators independently assessed study quality. Meta-analyses were conducted to quantitatively synthesize area under the receiver operating curve (AUROC), sensitivity, and specificity.

Results
We screened 1177 citations and included 28 studies with 638 patients with true tumor progression, and 430 patients with treatment-related changes. Nineteen studies reported AUROC and the combined AUROC is 0.85 (95% CI, 0.81–0.90). All studies contributed data for sensitivity and specificity, and the pooled sensitivity and specificity are 0.84 (95% CI, 0.80–0.88), and 0.78 (95% CI, 0.72–0.83). Extensive subgroup analyses based on study, treatment, and imaging characteristics generally showed similar results.

Conclusions
There is moderate strength of evidence that relative cerebral blood volume obtained from DSC imaging demonstrated “excellent” ability to discriminate true tumor progression from treatment-related changes, with robust sensitivity and specificity.
Prognostic value of O6-methylguanine-DNA methyltransferase methylation in isocitrate dehydrogenase mutant gliomas
Authors: Lam Keng , Eldred Blaine S C , Kevan Bryan , Pianka Sean , Eldred Brittany A , Zapanta Rinonos Serendipity , Yong William H , Liau Linda M , Nghiemphu Phioanh L , Cloughesy Timothy F , Green Richard M , Lai Albert 
Published: March 2022

Abstract

Background
Patients with isocitrate dehydrogenase (IDH) mutant gliomas have been associated with longer survival time than those that are IDH wild-type. Previous studies have shown the prognostic value of O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation for glioblastoma multiforme (GBM), which are predominantly IDH wild-type. Little is known of the prognostic value of MGMT methylation status for IDH mutant gliomas.

Methods
We retrospectively identified IDH mutant gliomas patients between 2011 and 2020 that were tested for MGMT promoter methylation. We generated Kaplan–Meier estimator curves and performed Cox proportional hazard models for overall survival (OS) and progression-free survival (PFS) to compare the outcomes of MGMT promoter methylated versus MGMT unmethylated patients.

Results
Of 419 IDH mutant gliomas with MGMT promoter methylation testing, we identified 54 GBMs, 223 astrocytomas, and 142 oligodendrogliomas. 62.3% patients had MGMT methylated tumors while 37.7% were MGMT unmethylated. On Kaplan–Meier analysis, median OS for all MGMT methylated patients was 17.7 years and 14.6 years for unmethylated patients. Median PFS for all MGMT methylated patients was 7.0 years and for unmethylated patients 5.2 years. After univariate subgroup analysis, MGMT methylation is only prognostic for OS and PFS in GBM, and for OS in anaplastic oligodendroglioma and anaplastic oligodendroglioma for OS. In multivariate analysis, MGMT unmethylated GBM patients carry a higher risk of death (HR 7.72, 95% CI 2.10–28.33) and recurrence (HR 3.85, 95% CI 1.35–10.96).

Conclusions
MGMT promoter methylation is associated with better OS and PFS for IDH mutant GBM. MGMT promoter methylation testing for other IDH mutant glioma subtypes may not provide additional information on prognostication.
Blue is a Colour for Help: The Role of Police in De-escalating Threats to a Large University
Authors: Viñas-Racionero Rosa , Scalora Mario J , Ramzah Hassan 
Published: March 2022

Abstract
University police officers often belong to threat assessment teams, which aim to preventing targeted attacks by pre-emptively identifying and managing individuals who pose a threat towards others. This study seeks to describe the partnership formed between a university police department and a research team to examine the effectiveness of threat management practices through analysis of 332 cases (2006–16). Officers in these cases dealt with numerous concerns, including disruptive behaviour, threats, partner violence, sexual aggression, stalking, workplace violence, and extremist activity. Management of concerning individuals required conflict resolution strategies and coordination with other actors such as student affairs, other police agencies, and mental health services. The effectiveness of the threat management interventions was such that the use of physical, academic, or legal sanctions was rarely needed. Individuals generally ceased their threatening behaviour within 3 months of the interventions and virtually all cases resolved without physical violence occurring on the college campus.
Impedance of Extracellular Fluid, Volume, and Local Tissue Water Can Be Reliably Measured in People With Lower Limb Lymphedema
Authors: Jönsson Charlotta , Johansson Karin , Bjurberg Maria , Brogårdh Christina 
Published: February 2022

AbstractObjectiveLower limb lymphedema (LLL) is a chronic condition. To be able to evaluate changes of LLL over time and effects of interventions, reliable measurement methods are important. Currently, there is limited knowledge of the reliability of commonly used measurement methods in LLL. The study objective was to evaluate the test–retest (intrarater) reliability of impedance of extracellular fluid, volume, and local tissue water measurements in people with unilateral or bilateral LLL and measurement errors both for a group of people and for a single individual.MethodsForty-two people with mild to moderate unilateral or bilateral, primary or secondary LLL were measured twice, 2 weeks apart. Impedance of extracellular fluid was measured by bioimpedance spectroscopy and calculated as arm-to-leg ratio, volume with circumference measurements every 4 cm, and local tissue water with tissue dielectric constant at 14 points. Test–retest reliability was evaluated using the intraclass correlation coefficient [ICC(2,1)], changes in the mean, SE of measurement in relative terms (SEM%), and the smallest real difference in relative terms (SRD%).ResultsFor the impedance ratio, the reliability was high [ICC(2,1) = 0.79–0.90] and the measurement errors were acceptable (SEM% = 5.0%–5.2%; SRD% = 14.0%–14.4%). For volume, the reliability was high (ICC = 0.99) and the measurement errors were low (SEM% = 1.1%–1.7%; SRD% = 3.1%–4.6%). For the tissue dielectric constant, the reliability was fair to excellent [ICC(2,1) = 0.68–0.96] and the measurement errors were acceptable (SEM% = 4.2%–9.7%; SRD% = 11.7%–26.8%).ConclusionsMeasurements of impedance of extracellular fluid, volume, and local tissue water are reliable in people with mild to moderate LLL. The measurement errors were acceptable in all 3 methods indicating that real, clinical changes in lymphedema can be measured both for a group of people and a single individual.ImpactThe results from this test–retest reliability study can help clinicians and researchers to interpret if real clinical changes in lymphedema occur over time or after an intervention in people with mild to moderate LLL.
Globalization, Gender, and the Family
Authors: Keller Wolfgang , Utar Hale 
Published: February 2022

Abstract
Facing the same labour demand shock through imports from China, we show that men and women make different labour market and family adjustments that result in significant long-run gender inequality. The gender gap is driven by the female biological clock. Using population registers and matched employer-employee data from Denmark, we document that especially women in their late 30s, towards the end of their biological clock, decide to have a baby as the shock causes displacement. High-earning women in leadership positions and women who need to acquire new human capital are central because their new employment would require particularly high investments that are incompatible with having a newborn in the short time remaining on the biological clock. While children penalize women in the labour market, we show that due to the biological clock an otherwise gender-neutral shock leads to a gender gap in the labour market.
Take-home Naloxone at Opioid Treatment Programs: A Lifesaver
Authors: Katzman Joanna G. , Bhatt Snehal , Comerci George D. 
Published: February 2022

Opioid-related overdose deaths have increased almost 30% in the US since the COVID-19 pandemic began. Tragically, many of these deaths could be prevented with widespread availability of naloxone. One innocuous harm-reduction strategy would be the federal government mandating the provision of take-home naloxone and brief overdose education to patients at opioid treatment programs.
Take-home naloxone, for instance, may be used by a friend or a family member to save the life of the patient receiving treatment for opioid use disorder. Importantly, many studies demonstrate that patients receiving take-home naloxone at an opioid treatment program will use the naloxone to reverse an overdose of someone in their social network. Other successful indications for mandated take-home naloxone include: federal inmates leaving incarceration if they have an opioid substance use disorder diagnosis and federal police officers on active duty.
This editorial describes the various organizations, medical societies, and governmental agencies who may consider making robust actionable recommendations regarding naloxone for persons with opioid use disorder. The authors strongly recommend that professional organizations include take-home naloxone as a best practice for any patient who may be at an elevated risk for an opioid overdose.
Assessment of Kratom Use Disorder and Withdrawal Among an Online Convenience Sample of US Adults
Authors: Smith Kirsten E. , Dunn Kelly E. , Rogers Jeffrey M. , Garcia-Romeu Albert , Strickland Justin C. , Epstein David H. 
Published: February 2022

Introduction
Since 2007, kratom use in the United States has increased, centered around nonmedical self-treatment of pain, psychiatric, and substance use disorder symptoms. Reports of kratom withdrawal have emerged amidst description of therapeutic effects, yet we know little about disordered use. Our objective was to assess Diagnostic and Statistical Manual-5 substance use disorder for kratom (“kratom use disorder,” KUD) and examine kratom withdrawal symptoms among those who ever used regularly. We also sought to identify clinical characteristics of respondents who qualified for current, remitted, or never KUD.

Methods
Between April and May 2021, we re-recruited online respondents who reported lifetime kratom use on an unrelated survey into our cross-sectional kratom survey study, permitting a diverse sample of current and former kratom-using persons.

Results
A total of 129/289 (44.6%) evaluable surveys were obtained. Over half (52.7%) of respondents never met KUD diagnostic criteria; 17.8% were assessed remitted, and 29.5% met current (past-year) KUD threshold. For past-year KUD, severity was: 14.0% mild, 7.0% moderate, and 8.5% severe. Pain, psychiatric symptoms, and polydrug use were found across all groups. KUD symptoms reflected increased use, tolerance, withdrawal, unsuccessful quit attempts, and craving; 9.3% reported decreases in important social, occupational, or recreational activities because of use. Withdrawal symptoms were moderate and included gastrointestinal upset, restlessness, anxiety, irritability, fatigue/low energy, and craving.

Conclusions
As assessed here, tolerance and withdrawal are primary KUD features rather than psychosocial impairments. As kratomis often used among persons with a myriad of health conditions, clinicians should be aware of and assess for kratom use and withdrawal.
Efficacy and Safety of a New Sustained-release Pregabalin Formulation Compared With Immediate-release Pregabalin in Patients With Peripheral Neuropathic Pain
Authors: Han Kyung Ah , Lee Yong-Ho , Son Hyun-Shik , Song Ki-Ho , Kim Sang Yong , Chung Choon Hee , Jang Hak Chul , Lee Kwan-Woo , Cha Bong Yun , Song Kee-Ho , Ko Young Kwon , Lee Pyung-Bok , Kim Beom Joon , Kim Sohee , An Taewon , Kim Yong-Chul 
Published: February 2022

Objective:
This study investigated whether a new sustained-release (SR) pregabalin formulation is noninferior to immediate-release (IR) pregabalin in alleviating peripheral neuropathic pain in Korean patients.

Materials and Methods:
This was a randomized, double-blind, active-controlled phase 3 study of patients with diabetic peripheral neuropathy or postherpetic neuralgia from 41 sites in South Korea in 2017-2018. Eligible patients were randomized (1:1) to receive once-daily SR pregabalin or twice-daily IR pregabalin (150 to 600 mg/d) in a double-dummy manner for 12 weeks according to a stratified permuted block randomization scheme. The primary endpoint was the Daily Pain Rating Scale score at the end of treatment, averaged from the last 7 available scores.

Results:
A total of 319 of 371 (86.0%) randomized patients completed the 12-week treatment (SR pregabalin: n=154; IR pregabalin: n=165; per-protocol set: n=296). The least square mean difference between both groups for the primary endpoint was 0.06 (SE 0.19); (95% confidence interval −0.31 to 0.42), with the lower limit of the confidence interval above the pre-specified margin (−0.78; P
noninferiority<0.0001). Drug-related treatment-emergent adverse events (TEAEs) were comparable between both groups. The incidence of drug-related TEAEs leading to treatment discontinuation was low (SR pregabalin: 2.7%; IR pregabalin: 1.1%). No serious drug-related TEAEs or deaths occurred.

Discussion:
The results demonstrate that the new once-daily SR pregabalin formulation is noninferior to twice-daily IR pregabalin in reducing peripheral neuropathic pain and is well tolerated in Korean patients with diabetic peripheral neuropathy or postherpetic neuralgia after 12 weeks of treatment.
How do orthopaedic surgery residency program websites feature diversity? An analysis of 187 orthopaedic surgery programs in the United States
Authors: Cohen Samuel A. , Xiao Michelle , Zhuang Thompson , Michaud John , Wadhwa Harsh , Shapiro Lauren , Kamal Robin N. 
Published: February 2022

Background:
The orthopaedic surgery residency program website represents a recruitment tool that can be used to demonstrate a program’s commitment to diversity and inclusion to prospective applicants. The authors assessed how orthopaedic surgery residency programs demonstrated diversity and inclusion on their program websites and whether this varied based on National Institutes of Health (NIH) funding, top-40 medical school affiliation, university affiliation, program size, or geographic region.

Methods:
The authors evaluated 187 orthopaedic surgery residency program websites for the presence of 12 elements that represented program commitment to diversity and inclusion values, based on prior work and Accreditation Council for Graduate Medical Education (ACGME) recommendations. Mann-Whitney U and Kruskal-Wallis tests were used to assess whether NIH funding and other program characteristics were associated with commitment to diversity and inclusion on affiliated residency websites.

Results:
Orthopaedic surgery residency websites included a mean of 4.9±2.1 diversity and inclusion elements, with 21% (40/187) featuring a majority (7+) of elements. Top 40 NIH-funded programs (5.4±2.0) did not have significantly higher website diversity scores when compared with nontop-40 programs (4.8±2.1) (P=0.250). University-based or affiliated programs (5.2±2.0) had higher diversity scores when compared with community-based programs (3.6±2.2) (P=0.003).

Conclusions:
Most orthopaedic surgery residency websites contained fewer than half of the diversity and inclusion elements studied, suggesting opportunities for further commitment to diversity and inclusion. Inclusion of diversity initiatives on program websites may attract more diverse applicants and help address gender and racial or ethnic disparities in orthopaedic surgery.

Level of Evidence:
Level V.
Outcome of distal femoral osteotomy for the correction of varus deformities originating in the distal femur: a prospective study
Authors: Bagherifard Abolfazl , Jabalameli Mahmoud , Tabrizian Pouria , Yahyazadeh Hooman , Salariyeh Mostafa , Mohammadpour Mehdi 
Published: February 2022

Background:
The authors hypothesized that implication of distal femur osteotomy (DFO) in patients with varus deformities that originated in the distal femur will reduce the rate of joint-line obliquity, thereby improving the radiographic, clinical, and functional outcomes of the patients. Here, the authors aimed to evaluate the outcome of DFO in the correction of varus deformities that originated in the distal femur.

Methods:
In a prospective study, 27 patients (31 knees) with varus deformities located in the distal femur who underwent a lateral biplane closed wedge DFO were included. Radiographic evaluations included the joint-line obliquity, medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), and joint-line convergence angle (JLCA). Lysholm-Tegner score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used for the evaluation of functional outcome. The union of the osteotomy site was assessed radiographically.

Results:
At the final evaluation session, the mean preoperative varus angle significantly improved from 12.7±3.4 degrees to 1.6±1.6 degrees (P<0.001). The mean preoperative LDFA significantly improved from 96±2.1 degrees to 87.9±1.1 degrees (P<0.001). The mean preoperative JLCA significantly improved from 3.1±0.4 degrees to 2±0.3 degrees (P<0.001). The mean preoperative Lysholm-Tegner scores also improved considerably from 66.4±2 degrees to 88.9±2.6 degrees (P<0.001). The mean KOOS of the patients improved from 63.9±4.1 degrees to 86.1±4.6 degrees. Only one patient (3.2%) was observed to have joint-line obliquity (greater than±4 degrees). Bone union was seen in all patients at an average period of 9±1.9 wk.

Conclusions:
DFO results in small rate of joint-line obliquity, as well as acceptable radiographic, clinical, and functional outcomes in patients with varus deformities located in the distal femur.

Level of Evidence:
Level III.
Surgical outcomes of intramedullary screw fixation for metacarpal fractures: a systematic review
Authors: Wolf G. Jacob , Goodloe J. Brett , Bailey Evan P. , Barcel John A. , Daley Dane N. 
Published: February 2022

Background:
Metacarpal fractures account for 33.3% of hand fractures. New surgical techniques have been developed to address this common injury, including retrograde intramedullary (IM) screw fixation. This technique has grown in popularity in recent years and has shown promising results but has been met with skepticism by some surgeons because of the lack of adequate large-scale outcome studies. The purpose of this study was to review all existing literature on clinical and functional outcomes for metacarpal fractures managed operatively with IM screw fixation.

Methods:
A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Clinical and functional outcomes as well as complications were analyzed.

Results:
The database search yielded 12 studies, including a total of 554 metacarpal fractures that were surgically managed with IM screw fixation. Average follow-up after surgery was 23.1 wk. Fracture union rate was 100%. Postoperative grip strength was shown to average 99.3% that of the contralateral uninjured hand. Total active range of motion averaged 249.8 degrees. The overall complication rate was 5.6%, and 3.1% required a second surgery.

Conclusions:
This systematic review demonstrated that intramedullary screw fixation for metacarpal fractures yields excellent clinical and functional outcomes with low complication rates. IM screw fixation provides rigid internal fixation with minimal soft-tissue dissection without extramedullary hardware, thus precluding the need for prolonged postoperative immobilization and limiting the potential for extensor tendon adhesions and digital stiffness. IM screw fixation is a viable and safe option for surgical management of metacarpal fractures.

Level of Evidence:
Level III.
Long-Term Outcomes After Treatment for Type B Ulnar Polydactyly
Authors: Goebel Gunnar J. , Dawson Steven , Loewenstein Scott N. , Adkinson Joshua M. 
Published: February 2022

Background:
Type B ulnar polydactyly is a common congenital hand difference and can be treated with either ligation or surgical excision. There is a paucity of literature, however, evaluating long-term patient reported outcomes of these treatments. The purpose of this study was to compare the long-term outcomes after ligation and excision for the management of type B ulnar polydactyly.

Methods:
We created a database of patients who underwent treatment for type B ulnar polydactyly at a single pediatric health system from 2005 to 2014. We administered the Patient Reported Outcomes Measurement Information System (PROMIS) Pediatric Upper Extremity survey to patients through telephone and assessed for their satisfaction.

Results:
We successfully collected outcomes from 69 of 173 eligible patients treated in infancy (40% response rate). The mean follow-up was 11.1±2.5 years, and the average age of the participant at the time of the survey was 11.7±2.6 years of age. Twenty-four patients were treated with in-office ligation and 45 underwent formal surgical excision. Ten patients who were initially treated with ligation required future treatment with surgery because of symptomatic neuroma stump or persistent polydactyly (42%). Patients who were treated with surgical excision rated significantly higher satisfaction with their treatment than those who underwent ligation (P=0.003). Patients in both cohorts rated similar satisfaction with the esthetic appearance of their hand (P=0.07). There was no significant difference in PROMIS-rated hand function between the ligation and surgical cohort (P=0.765) and treated adolescents PROMIS scores were not statistically different than age-matched controls without polydactyly.

Conclusion:
While ligation and surgical excision result in similar function and esthetics, patient satisfaction is higher after surgery. Furthermore, a significant number of patients fail ligation and ultimately undergo surgery for symptomatic neuroma or persistent polydactyly. Counseling parents of patients with type B ulnar polydactyly should include these considerations to assist them in selecting the best treatment for their child.

Level of Evidence:
Level III.