bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between work productivity loss and EORTC QLQ-C30 and -BR23 domains from the MONALEESA-7 trial of premenopausal women with HR+/HER2− advanced breast cancer
Authors: Tripathy Debu , Curteis Tristan , Hurvitz Sara , Yardley Denise , Franke Fabio , Babu K. Govind , Wheatley-Price Paul , Im Young-Hyuck , Pencheva Radost , Eddowes Lucy A. , Dionne Pierre-Alexandre , Chandiwana David , Pathak Purnima , Lanoue Brad , Harbeck Nadia 
Published: February 2022

Background: The phase III MONALEESA-7 trial (NCT02278120) assessed ribociclib + endocrine therapy (ET) versus ET in premenopausal women with HR+/HER2− advanced breast cancer (ABC). The relationship between work productivity loss (WPL) and domains of European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) and the breast cancer (BC)-specific module (QLQ-BR23) has not been explored in ABC. In this post hoc analysis (data cutoff, November 30, 2018), we assessed the correlation between the WPL component of the Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaire and EORTC QLQ-C30/BR23 domains. Methods: We analyzed EORTC and WPAI:GH data from 329 patients in both treatment arms of MONALEESA-7 who were employed during the trial. Separate univariable mixed-model repeated measures (MMRM) regression models were fitted for each domain, with WPL as dependent variable and each EORTC domain score as a single fixed-effect covariate. Linear and quadratic relationships were considered based on the Akaike information criterion. Next, two separate multivariable MMRM regression models were fitted with WPL a dependent variable and all QLQ-C30/BR23 domain scores as fixed-effect covariates. The strength of correlation between WPL and EORTC domains was assessed in terms of minimally important differences for the QLQ-C30/BR23 modules. Results: Our univariable analysis showed that greater WPL was statistically significantly associated with lower levels of overall quality of life (QoL) and other functional domains and with higher levels of all symptomatic domains of the QLQ-C30/BR23 modules. Our multivariable analysis determined that this correlation was primarily driven by changes in QoL; physical, role, social, and future perspective domains; and BC-specific symptomatic domains. Conclusion: This analysis determined the QoL domains that correlate with WPL in premenopausal patients with HR+/HER2− ABC. These results may inform prognostic tools to identify and characterize patients with greater risk for WPL and help design interventional strategies to minimize WPL.
Ultrasonographic Changes of the Knee Joint Reflect Symptoms of Early Knee Osteoarthritis in General Population; The Nagahama Study
Authors: Saito Motoo , Ito Hiromu , Okahata Akinori , Furu Moritoshi , Nishitani Kohei , Kuriyama Shinichi , Nakamura Shinichiro , Kawata Tomotoshi , Ikezoe Tome , Tsuboyama Tadao , Ichihashi Noriaki , Tabara Yasuharu , Matsuda Fumihiko , Matsuda Shuichi 
Published: February 2022

Objective Radiographic changes in knee osteoarthritis (OA) are not always associated with symptoms, especially in its early stages. Ultrasonography (US) can detect early changes in the knee joint, but the changes that reflect symptoms have not been fully elucidated. This study aimed to identify US-detectable changes in the knee that are often associated with knee symptoms and demonstrate the feasibility of early diagnosis in symptomatic knee OA using US. Design In this cross-sectional community-based study, 1,667 participants aged ≥60 years (1,103 women [66%]) were included. All participants concurrently underwent US and radiography of the knee and completed the Knee Society Knee Scoring System (KSS) questionnaire. Simple and multiple regression analyses were used to examine the associations between US findings and KSS symptom subscales. Results Among all participants, medial meniscus protrusion and medial osteophytes, age, and body mass index showed significant associations with KSS symptom scores. Among 894 participants with Kellgren-Lawrence (KL) grade ≤1, medial osteophytes and age were significantly associated with KSS symptom score. US measures were more related to KSS symptoms than KL grades. Conclusions Among the knee US-detectable changes, medial osteophytes were strongly associated with knee symptoms. Osteophytes are reliable predictors of symptomatic early knee OA, even in participants with few radiographic OA changes.
Treatment failure and its associated factors among children receiving highly active antiretroviral therapy in Ethiopia: A systematic review and meta-analysis
Authors: Getaneh Temesgen , Negesse Ayenew , Dessie Getenet , Desta Melaku , Assemie Moges Agazhe , Tigabu Agimasie , Gelaye Kihinetu , Alemu Addisu Alehegn , Lebu Sarah 
Published: February 2022

Objectives: Over the last decades, large number of children living with human immunodeficiency virus (HIV) have been successfully enrolled in care and initiated treatment. However, treatment failure is still a major challenge in the track, missing far too many children. National-level evidence on antiretroviral therapy failure and its associated factors among children receiving highly active antiretroviral therapy is required to alleviate this challenge. Methods: PubMed/Medline, EMBASE, CINAHL, Cochrane library, Google, and Google Scholar databases were used to access eligible studies. This meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In addition, Newcastle–Ottawa Scale quality assessment was applied for critical appraisal. Cochran’s Q statistic, funnel asymmetry plot, and Egger’s test were used to assess heterogeneity and publication bias. Random effect model was computed to explore the pooled burden of treatment failure and its associated factors among children living with HIV. Odds ratio with 95% confidence interval was considered to identify associated factors. Result: The overall pooled prevalence of treatment failure among children living with HIV was 16.6%. Whereas virological, immunological, and clinical failure were 4.49%, 5.41%, and 5.71% respectively, where either of parent is deceased (odds ratio = 2.13, 95% confidence interval: 1.4–3.3), opportunistic infection (odds ratio = 1.67, 95% confidence interval: 1.1–2.5), absence of disclosure of status (odds ratio = 1.6, 95% confidence interval: 1.0–2.5), advanced World Health Organization stage (odds ratio = 4.2, 95% confidence interval: 1.6–10.5), and drug substitution (odds ratio = 2.0, 95% CI: 1.5–2.7) were significantly associated factors. Conclusion: The pooled prevalence of treatment failure among children living with HIV in Ethiopia was lower when compared to most African countries. Accordingly, either prevention or early treatment of opportunistic infection and advanced World Health Organization clinical stages, special care for children whose either parents are deceased, advocating disclosure of status, and avoiding drug substitution as much as possible were still needed to prevent treatment failure.
Prevalence and antimicrobial susceptibility of group B streptococci among pregnant women in Ethiopia: A systemic review and meta-analysis study
Authors: Lemma Dereje , Huluka Tufa Kolola , Chelkeba Legese 
Published: February 2022

Objective: Maternal colonization or infection with drug-resistant Group B streptococcus is a serious disease that affects mother, fetus, and infant. The knowledge of maternal colonization and antimicrobial susceptibility test is substantially needed for a nation to formulate a policy or change the already existing one to reduce maternal, fetus, and infant mortality. As a result, the goal of this review was to determine the pooled prevalence Group B streptococcus colonization and antimicrobial susceptibility among Ethiopian pregnant women. Methods: Literature searches were carried out in the electronic biomedical databases and indexing services such as PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and Google Scholar. Original records of research articles, available online from 2014 to December 2020, addressing prevalence and antimicrobial-resistance pattern of Group B streptococcus in pregnant women were identified and screened. Endnote citation manager software version X9 for windows was utilized to collect and organize search outcomes and for removal of duplicate articles. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measures analyses and subgrouping. The I2 index was used to measure heterogeneity between studies and median, and interquartile (25%, 75%) was used to assess antimicrobial susceptibility rate. Results and conclusion: Sixteen original articles were found in both qualitative and quantitative analyses. Group B streptococcus colonization was recorded in 979 of the 5743 pregnant women, resulting in a 16% overall frequency (95% confidence interval: 13%−20%). The estimated prevalence varied significantly between studies with significant heterogeneity (χ2 = 154.31, p = 0.001, I2 = 90.28). Ampicillin (97.8%; interquartile range = 89.5%−100%), penicillin G (95.5%; interquartile range = 89.5%−100%), and vancomycin (100%; interquartile range = 89.5%−100%) susceptibility were all high in Group B streptococcus, whereas tetracycline (29%; interquartile range = 89.5%−100%) susceptibility was low. Group B streptococcus colonization rates in Ethiopian women during pregnancy were virtually similar to those in many underdeveloped countries, and Group B streptococcus isolates were highly sensitive to ampicillin, penicillin G, and vancomycin.
Rostral mandibulectomy for the management of trismus in a cat
Authors: Parsons Kevin , Langley-Hobbs Sorrel , Warren-Smith Christopher , Southerden Peter , Granger Nicolas , Meakin Lee 
Published: February 2022

Case summary A 5-year-old domestic shorthair cat was evaluated for weight loss and poor coat condition due to an inability to open its mouth (trismus) following head trauma 2 months previously. Contrast CT, electromyography and temporal muscle biopsy identified findings consistent with muscle atrophy, denervation and degeneration. Conservative treatment failed to improve the trismus so a rostral mandibulectomy was performed. Following surgery, the patient resumed normal grooming behaviour and was able to eat soft food unaided. The cat re-presented 5 months postoperatively at which time its body condition had improved; however, episodes of sneezing had been noted. An oronasal fistula was diagnosed and treated successfully with a silicon nasal septum button. Follow-up at 30 months reported an excellent outcome. Relevance and novel information Management of trismus with rostral mandibulectomy may be associated with a good return to function, including prehension and ingestion of food, and restoration of normal grooming activity. Rostral mandibulectomy could be considered for animals with trismus for other aetiologies such as masticatory myositis where other management options are not available.
Use of a High-Fidelity Training Simulator for Minimally Invasive Lumbar Decompression Increases Working Knowledge and Technical Skills Among Orthopedic and Neurosurgical Trainees
Authors: Melcher Carolin , Hussain Ibrahim , Kirnaz Sertac , Goldberg Jacob L. , Sommer Fabian , Navarro-Ramirez Rodrigo , Medary Branden , Härtl Roger 
Published: February 2022

Study Design Prospective comparative study. Objective To quantify the educational benefit to surgical trainees of using a high-fidelity simulator to perform minimally invasive (MIS) unilateral laminotomy for bilateral decompression (ULBD) for lumbar stenosis. Methods Twelve orthopedic and neurologic surgery residents performed three MIS ULBD procedures over 2 weeks on a simulator guided by established AO Spine metrics. Video recording of each surgery was rated by three blinded, independent experts using a global rating scale. The learning curve was evaluated with attention to technical skills, skipped steps, occurrence of errors, and timing. A knowledge gap analysis evaluating participants’ current vs desired ability was performed after each trial. Results From trial 1 to 3, there was a decrease in average procedural time by 31.7 minutes. The cumulative number of skipped steps and surgical errors decreased from 25 to 6 and 24 to 6, respectively. Overall surgical proficiency improved as indicated by video rating of efficiency and smoothness of surgical maneuvers, most notably with knowledge and handling of instruments. The greatest changes were noted in junior rather than senior residents. Average knowledge gap analysis significantly decreased by 30% from the first to last trial (P = .001), signifying trainees performed closer to their desired technical goal. Conclusion Procedural metrics for minimally invasive ULBD in combination with a realistic surgical simulator can be used to improve the skills and confidence of trainees. Surgical simulation may offer an important educational complement to traditional methods of skill acquisition and should be explored further with other MIS techniques.
The Clinical Characteristics, Risk Classification System, and Web-Based Nomogram for Primary Spinal Ewing Sarcoma: A Large Population-Based Cohort Study
Authors: Huang Zhangheng , Tong Yuexin , Kong Qingquan 
Published: February 2022

Background The goal of this study was to determine the clinical characteristics of patients with primary spinal Ewing sarcoma (PSES) and to create a prognostic nomogram. Methods Clinical information related to patients diagnosed with PSES between 2004 and 2015 was extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Independent prognostic factors were identified using univariate and multivariate Cox analyses to construct nomograms predicting overall survival in patients with PSES. Calibration curves and receiver operating characteristic curves were used to assess the model’s prediction accuracy, while decision curve analysis was used to assess the model’s clinical utility. Results The overall number of 314 patients with PSES were screened from the SEER database between 2004 and 2015. Race, chemotherapy, age, and disease stage were found to be independent predictive factors for overall survival in both univariate and multivariate Cox analyses. The training and validation cohorts’ calibration curves, receiver operating characteristic curves, and decision curve analysis showed that the nomogram has strong discrimination and clinical value. Furthermore, a new risk classification system has been constructed that can divide all patients into 2 risk groups. Conclusions Based on a broad population, the research demonstrates statistical evidence for the clinical features and prognostic variables of patients with PSES. The constructed prognostic nomogram provides a more precise prediction of prognosis for PSES patients.
Effect of Surgeon Experience on Long-Term Patient Outcomes in Surgical Repair of Acute Achilles Tendon Rupture
Authors: Saarensilta Annukka , Juthberg Robin , Edman Gunnar , Ackermann Paul W. 
Published: February 2022

Background: The effect of surgeon experience on patient outcomes after surgical Achilles tendon rupture (ATR) repair has so far been unknown. Purpose: To examine whether patient-reported and functional outcomes as well as adverse events after surgical ATR repair differ between orthopaedic specialist surgeons and resident surgeons. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively analyzed data from 295 patients treated with surgical ATR repair with standardized techniques. The level of surgeon experience (specialist vs resident) and number of adverse events (rerupture, infection, and deep venous thrombosis) were recorded. Patient-reported and functional outcomes were assessed 12 months postoperatively using the validated Achilles tendon total rupture score (ATRS) and the heel-rise test, respectively. Analysis of covariance was used to compare differences in outcomes between specialist surgeons and resident surgeons. Pearson chi-square or Fisher exact test was used for analysis of adverse events. Results: The mean ATRS at 12 months for patients operated on by resident surgeons was significantly higher compared with specialist surgeons (85.9 [95% CI, 80.3-91.5] vs 77.8 [95% CI, 73.8-81.9]; P = .028). In addition, the lateral difference (operated vs unoperated side) in mean total concentric work and number of heel-rise repetitions at 12 months was smaller in patients operated on by resident surgeons ( P = .011 and 0.015, respectively). The number of adverse events did not differ significantly between the 2 groups. Conclusion: Resident surgeons achieved patient-reported and functional outcomes at least as good as those of specialist surgeons in surgical ATR repair, with a similar risk of adverse events.
Biomechanical Analysis of Coracoid Stability After Coracoplasty: How Low Can You Go?
Authors: Heilmann Lukas F. , Sussiek Julia , Raschke Michael J. , Langer Martin F. , Frank Andre , Wermers Jens , Michel Philipp A. , Dyrna Felix , Schliemann Benedikt , Katthagen J. Christoph 
Published: February 2022

Background: Arthroscopic coracoplasty is a procedure for patients affected by subcoracoid impingement. To date, there is no consensus on how much of the coracoid can be resected with an arthroscopic burr without compromising its stability. Purpose: To determine the maximum amount of the coracoid that can be resected during arthroscopic coracoplasty without leading to coracoid fracture or avulsion of the conjoint tendon during simulated activities of daily living (ADLs). Study Design: Controlled laboratory study. Methods: A biomechanical cadaveric study was performed with 24 shoulders (15 male, 9 female; mean age, 81 ± 7.9 years). Specimens were randomized into 3 treatment groups: group A (native coracoid), group B (3-mm coracoplasty), and group C (5-mm coracoplasty). Coracoid anatomic measurements were documented before and after coracoplasty. The scapula was potted, and a traction force was applied through the conjoint tendon. The stiffness and load to failure (LTF) were determined for each specimen. Results: The mean coracoid thicknesses in groups A through C were 7.2, 7.7, and 7.8 mm, respectively, and the mean LTFs were 428 ± 127, 284 ± 77, and 159 ± 87 N, respectively. Compared with specimens in group A, a significantly lower LTF was seen in specimens in group B ( P = .022) and group C ( P < .001). Postoperatively, coracoids with a thickness ≥4 mm were able to withstand ADLs. Conclusion: While even a 3-mm coracoplasty caused significant weakening of the coracoid, the individual failure loads were higher than those of the predicted ADLs. A critical value of 4 mm of coracoid thickness should be preserved to ensure the stability of the coracoid process. Clinical Relevance: In correspondence with the findings of this study, careful preoperative planning should be used to measure the maximum reasonable amount of coracoplasty to be performed. A postoperative coracoid thickness of 4 mm should remain.
Clarifying Inaccurate Terminology: The Important Difference Between Dysphagia and Swallowing Dysfunction
Authors: Rameau Anaïs , Katz Philip , Andreadis Katerina , Drenis Sotirios , Joseph Ian Theophilus , Tran Angela , Han Gloria , Sarhadi Kamron Shawn , Kaufman Matthew , Belafsky Peter 
Published: February 2022

Background: Dysphagia refers to the patient’s subjective experience. It is a symptom and should be differentiated from objective signs of swallowing impairment observed by healthcare providers. We hypothesized that there is rampant misuse of the term dysphagia in the medical literature. Objective: To evaluate the prevalence of the inaccurate use of the term dysphagia in the medical literature. Methods: A comprehensive database search was performed in PubMed, Ovid Embase, and the Cochrane Library to identify all 2019 English articles in the adult medicine literature containing the term dysphagia in the title, abstract and major topic in the medical subject heading. Risk factors for incorrect use of the term dysphagia were evaluated. Results: Our search yielded 2427 unique articles, 10% of which was randomly selected, accessed and included in the final analysis. The term dysphagia was misused in 39.1% (95/243) of these articles. The top specialties misusing the term were rehabilitation medicine, speech pathology and neurology. On univariate analysis, only the first author being a speech language pathologist was associated with significant odds of term misuse (OR = 12.2, 95% CI [1.2, 121.5]). Articles from Europe, the U.S.A and Korea had the highest incidence of misuse. Odds of incorrect use of dysphagia were significantly increased in cross-sectional studies (OR = 20.9, 95% CI [2.4-184.1]). Conclusion: The inaccurate use of the term dysphagia is widespread in the contemporary medical literature. This confusion undermines the patient’s experience, leads to misapplication of assessment tools, reduces data mining accuracy, and hinders innovation and patient care.
A randomized, placebo-controlled, double-blind trial of canakinumab in children and young adults with sickle cell anemia
Authors: Rees David C. , Kilinc Yurdanur , Unal Selma , Dampier Carlton , Pace Betty S. , Kaya Banu , Trompeter Sara , Odame Isaac , Mahlangu Johnny , Unal Sule , Brent Julie , Grosse Regine , Fuh Beng R. , Inusa Baba P. D. , Koren Ariel , Leblebisatan Goksel , Levin Carina , McNamara Elizabeth , Meiser Karin , Hom Douglas , Oliver Stephen J. 
Published: February 2022

Abstract
Excessive intravascular release of lysed cellular contents from damaged red blood cells (RBCs) in patients with sickle cell anemia (SCA) can activate the inflammasome, a multiprotein oligomer promoting maturation and secretion of proinflammatory cytokines, including interleukin-1β (IL-1β). We hypothesized that IL-1β blockade by canakinumab in patients with SCA would reduce markers of inflammation and clinical disease activity. In this randomized, double-blind, multicenter phase 2a study, patients aged 8 to 20 years with SCA (HbSS or HbSβ0-thalassemia), history of acute pain episodes, and elevated high-sensitivity C-reactive protein &gt;1.0 mg/L at screening were randomized 1:1 to received 6 monthly treatments with 300 mg subcutaneous canakinumab or placebo. Measured outcomes at baseline and weeks 4, 8, 12, 16, 20, and 24 included electronic patient-reported outcomes, hospitalization rate, and adverse events (AEs) and serious AEs (SAEs). All but 1 of the 49 enrolled patients were receiving stable background hydroxyurea therapy. Although the primary objective (prespecified reduction of pain) was not met, compared with patients in the placebo arm, patients treated with canakinumab had reductions in markers of inflammation, occurrence of SCA-related AEs and SAEs, and number and duration of hospitalizations as well as trends for improvement in pain intensity, fatigue, and absences from school or work. Post hoc analysis revealed treatment effects on weight, restricted to pediatric patients. Canakinumab was well tolerated with no treatment-related SAEs and no new safety signal. These findings demonstrate that the inflammation associated with SCA can be reduced by selective IL-1β blockade by canakinumab with potential for therapeutic benefits. This trial was registered at www.clinicaltrials.gov as #NCT02961218.