bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of psoas and gluteus medius muscles attenuation on hip fracture type
Authors: Yerli Mustafa , Yüce Ali , Ayaz Mustafa B , Bayraktar Tahsin O , Erkurt Nazım , Dedeoğlu Süleyman S , İmren Yunus , Gürbüz Hakan 
Published: June 2022

Introduction: Sarcopenia is defined as a progressive loss of muscle mass and function with increased age. The measurement of muscle mass and attenuation on the axial computed tomography (CT) scan has been reported to be a good indicator for sarcopenia in previous literature. This study aimed to compare muscle mass between the intertrochanteric fracture and femoral neck fracture groups by accurately measuring muscle mass around the hip joint using a CT scan. Methods: The cases were matched according to age and gender on a 1-to-1 basis. As a result, a total of 400 patients, 200 patients in each group with the same age and gender characteristics, were included in the study. At the disc of L4-L5 level, the cross-sectional area (CSA) of the psoas muscle was evaluated, and at the disc of L5-S1 level, the CSA of the psoas, iliacus and gluteus medius muscles were evaluated. In addition, attenuation was evaluated using the average Hounsfield Unit (HU) for the specific area. Results: The mean age of 400 patients (262 females, 138 male) included in the study was 78.49 ± 7.67 years. It was observed that the mean HU values of the patients in the femoral neck fracture group were significantly higher than the intertrochanteric fracture group ( p < 0.001, p = 0.008; respectively). At the same time, the mean HU values of the gluteus medius muscle were higher in the femoral neck fracture group ( p < 0.001), but in contrast with the psoas muscle, the CSA values of gluteus medius muscle were significantly higher in the intertrochanteric fracture group ( p = 0.017). Conclusions: Fatty degeneration of the psoas muscle among the muscles around the hip may affect the type of hip fracture. Elderly patients with strong psoas muscles may experience femoral neck fracture due to contraction and torsion during falling.
Outcomes analysis of anterior and lateral approach for open repair of hip abductor tendons
Authors: Requicha Francisco , Edwards Suzanne M , Rickman Mark S , Comley Andrew S 
Published: June 2022

Background: Gluteal tendons tears are increasingly being recognised as a cause of recalcitrant trochanteric pain, but there is a paucity of robust studies analysing the type of tears, results and predictors of outcome. Methods: Patients with gluteal tendon tears resistant to conservative treatment who underwent isolated open repair (IR) or total hip arthroplasty and concomitant repair (THA+repair) with a minimum 1-year follow-up were retrospectively assessed separately. Type of tear, surgical approach, and fixation methods were registered. Complications and postoperative outcomes were analysed: visual analogue scale (VAS) of pain, VAS satisfaction, and activity level. Univariate regressions and multivariable models were developed. Results: 90 cases were included: 62 cases underwent IR and 28 cases THA+repair, with an average follow-up of 3.9 years and 2.6 years, respectively. 13 complications were found ( n = 5 IR, n = 8 THA+repair), including 9 re-operations ( n = 4 IR, n = 5 THA+repair). Mean VAS pain score was 3.02 (SD 2.74) for the IR and 2.32 (SD 2.43) for THA+repair group. Mean VAS satisfaction was 7.09 (SD 3.07) and 7.68 (SD 2.71) for the IR and THA+repair group, respectively. In the IR group 61.4% returned to all pre-injury activities, whereas in the THA+repair group 79% did. Full-thickness tears had higher VAS pain scores ( p = 0.0175), and there was trend ( p > 0.05) towards higher complications, re-tears and lower VAS satisfaction in this type of tears in both groups. No statistically significant differences were found in outcomes when comparing THA+repair through direct anterior (DAA) with lateral approach (LA). Conclusions: Isolated gluteal tendon repair or THA+repairs seem to be safe procedures with high levels of satisfaction at short- to mid-term follow-up. The presence of a full-thickness tear is a predictor of inferior outcomes.
Host Transcriptional Signatures Predict Etiology in Community-Acquired Pneumonia: Potential Antibiotic Stewardship Tools
Authors: Siljan William W , Sivakumaran Dhanasekaran , Ritz Christian , Jenum Synne , Ottenhoff Tom HM , Ulvestad Elling , Holter Jan C , Heggelund Lars , Grewal Harleen MS 
Published: June 2022

Background: Current approaches for pathogen identification in community-acquired pneumonia (CAP) remain suboptimal, leaving most patients without a microbiological diagnosis. If better diagnostic tools were available for differentiating between viral and bacterial CAP, unnecessary antibacterial therapy could be avoided in viral CAP patients. Methods: In 156 adults hospitalized with CAP classified to have bacterial, viral, or mixed viral-bacterial infection based on microbiological testing or both microbiological testing and procalcitonin (PCT) levels, we aimed to identify discriminatory host transcriptional signatures in peripheral blood samples acquired at hospital admission, by applying Dual-color-Reverse-Transcriptase-Multiplex-Ligation-dependent-Probe-Amplification (dc-RT MLPA). Results: In patients classified by microbiological testing, a 9-transcript signature showed high accuracy for discriminating bacterial from viral CAP (AUC 0.91, 95% CI 0.85-0.96), while a 10-transcript signature similarly discriminated mixed viral-bacterial from viral CAP (AUC 0.91, 95% CI 0.86-0.96). In patients classified by both microbiological testing and PCT levels, a 13-transcript signature showed excellent accuracy for discriminating bacterial from viral CAP (AUC 1.00, 95% CI 1.00-1.00), while a 7-transcript signature similarly discriminated mixed viral-bacterial from viral CAP (AUC 0.93, 95% CI 0.87-0.98). Conclusion: Our findings support host transcriptional signatures in peripheral blood samples as a potential tool for guiding clinical decision-making and antibiotic stewardship in CAP.
Immune Response to SARS-CoV-2 Vaccine among Heart Transplant Recipients: A Systematic Review
Authors: Shoar Saeed , Prada-Ruiz Adriana C. Carolina , Patarroyo-Aponte Gabriel , Chaudhary Ashok , Sadegh Asadi Mohammad 
Published: June 2022

Background Heart transplant (HTX) recipients are at a significantly higher risk of adverse clinical outcomes, due to chronic immunosuppression and co-existence of other chronic conditions, when contracting the SARS-CoV-2 infection. Although vaccination against SARS-CoV-2 is currently the most promising measure for the prevention of severe Coronavirus Disease 2019 (COVID-19) among solid organ transplant recipients, the extent of immune response and its protective efficacy among patients receiving HTX has not been sufficiently studied. Methods We performed a systematic review of the literature by inquiring PubMed/Medline to identify original studies among HTX recipients, who had received at least one dose of the SARS-CoV-2 vaccine. Data on the measured humoral or cellular immune response was collected from all the eligible studies. Factors associated with a poor immune response were further investigated within these studies. Results A total of 12 studies comprising 563 HTX recipients were included. The average age of the study participants was 60.8 years. Sixty four percent of the study population were male. Ninety percent of the patients had received an mRNA vaccine (Pfizer/ BNT162b2 or Moderna/mRNA-1273). A positive immune response to SARS-CoV-2 vaccine was variably reported in 0% to 100% of the patients. Older age (> 65 years), vaccine dose (first, second, or third), time since HTX to the first dose of the vaccine, the time interval between the latest dose of the vaccine and measurement of the immune response, and the type of immunosuppressive regimen were all indicated as potential determinants of a robust immune response to the SARS-CoV-2 vaccination. Conclusion HTX recipients demonstrate a weaker immune response to the vaccination against SARS-CoV-2 compared to the general population. Older age, anti-metabolite agents such as mycophenolate mofetil, and vaccination during the first year following the HTX have been indicated as potential determinants of a poor immune response.
Prognosis and Remodeling after Endovascular Repair for Acute, Subacute, and Chronic Type B Aortic Dissection
Authors: Zhao Yang , Yao Chen , Yin Henghui , Wang Mian , Li Zilun , Wang Jingsong , Hu Zuojun , Wang Shenming , Chang Guangqi 
Published: June 2022

Purpose: Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) is already well introduced, but the best time point to perform TEVAR has not been defined. This study was to report mid- to long-term outcomes and aortic remodeling of TEVAR in patients with TBAD. Materials and Methods: In total, 318 TBAD patients from June 2001 to May 2016 were retrospectively reviewed. Patients were divided into 3 groups depending on interval between dissection onset to TEVAR: acute (0–7 days), subacute (8–30 days), and chronic (>30 days). Clinical and morphological data were collected and analyzed. Results: The follow-up aorta-related mortality rates in the 3 groups were 17.6%, 2.6%, 4.2%, and the proximal stent-induced new entry rates were 11.8%, 1.6%, 2.8%, respectively. Aortic remodeling was satisfied in both the acute and subacute group, but the false lumen diameter did not decrease (p>0.05) in the chronic group. Compared with the VIRTUE classification (acute, 0–14 days; subacute, 15–92 days; chronic, >92 days), mid- to long-term outcomes of patients within the first overlapped interval between the 2 classifications (8–14 days) were similar to that of subacute patients (15–30 days), while aortic remodeling of patients in the second overlapped interval (31–92 days) was similar to that of chronic patients (>92 days). Conclusions: This study suggests that TEVAR for subacute TBAD is associated with a low long-term rate of aorta-related death. Aortic remodeling of chronic dissections is not satisfactory. Additional results suggest that the subacute phase (8–30 days) may be the optimal time to perform TEVAR for uncomplicated TBAD.
A Comparative Cost Analysis of Local Anesthesia versus Brachial Plexus Block for Complex Hand Surgery
Authors: Baradaran Aslan , Meng Fanyi , Jaberi Mehrad Mojtahed , Finlayson Roderick , Thibaudeau Stephanie 
Published: June 2022

Background: Local anesthesia has shown to be safe and cost-effective for elective hand surgery procedures performed outside of the operating room. The economic benefits of local anesthesia compared to regional anesthesia for hand surgeries performed in the operating room involving repair of tendons, nerves, arteries, or bones are unclear. This study aimed to compare costs pertinent to hand surgeries performed in the main operating room under local anesthesia (LA) or brachial plexus (BP) block. Methods: We performed a cross-sectional study on the first 70 randomized patients from a prospective controlled trial of anesthesia modalities for hand surgery. The primary objective was to determine the mean anesthesia-related cost, and the secondary objectives were to analyze block performance time, block onset time, duration of anesthesia, duration of surgery, and time in the recovery room. Results: The mean anesthesia-related cost of performing hand surgery under LA as a wrist and/or digital block was $236 ± 30, compared to $435 ± 43 for BP, a difference of $199 per case. The mean block performance time was shorter for LA (1.3 minutes) versus BP (7.0 minutes). The mean anesthesia-related time was longer in BP (30.7 ± 16 minutes) compared to LA (17.7 ± 6.7 minutes), and consequently the total anesthesia time was longer in BP. Conclusions: We demonstrated that local anesthesia compared to brachial plexus block achieved substantial cost savings in complex hand surgeries by decreasing major expenses. In an era of cost-consciousness, the use of LA represents an important modality for health systems to optimize patient flow and increase cost-effectiveness.
Barriers to adult vaccination in Canada: A qualitative systematic review
Authors: Stratoberdha Doris , Gobis Barbara , Ziemczonek Adrian , Yuen Jamie , Giang Annita , Zed Peter J. 
Published: June 2022

Background: In recent years, Canadian health care professionals have observed an increase in vaccine refusal. The objective of this study is to review published literature and identify the main themes related to vaccine hesitancy and barriers to vaccination in Canadian adults and recent immigrants. Methods: A qualitative systematic review was performed. A comprehensive search of MEDLINE (1946 to January 2021) and EMBASE (1974 to January 2021) was conducted to identify existing literature that addressed the primary research question. Studies were eligible for inclusion if the study population involved 1) the general population, 2) Indigenous populations, 3) recent immigrants to Canada or 4) Canadian health care professionals. Results: Thirty-four studies were included with a focus on the general population ( n = 22), health care professionals ( n = 10) and recent immigrant populations ( n = 2). The most frequently reported barriers were lack of vaccine information (41%), lack of access to vaccination (38%), fear of adverse reactions (38%), financial reasons (29%), lack of awareness of vaccine existence (29%), antivaccine sentiments (24%), notion that older adults do not need vaccination (18%), misconceptions on vaccine effectiveness (12%), potential sexual health promotion stigma (6%) and fear of needles (3%). Interpretation: Barriers to vaccination among Canadians and recent immigrants continue to be a challenge in the health care system. Conclusions: The greatest yield in improving vaccination rates is likely to come from supporting vaccine-hesitant individuals in shifting their thinking to greater vaccine acceptance. Pharmacists are well positioned to address vaccine hesitancy and involvement through education, facilitation and administration of vaccines. Can Pharm J (Ott) 2022;155:xx-xx.
Paclitaxel–bevacizumab combination in advanced non-squamous non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric study
Authors: Bilger Geoffroy , Toffart Anne-Claire , Darrason Marie , Duruisseaux Michaël , Ulmer Lucie , Wang Pascal , Leprieur Etienne Giroux , Girard Nicolas , Massiani Marie Ange , Bore Paul , Descourt Renaud , Pinsolle Julian , Valery Solene , Monnet Isabelle , Swalduz Aurélie , Tissot Claire , Fournel Pierre , Baranzelli Anne , Cortot Alexis B. , Decroisette Chantal 
Published: June 2022

Introduction: Compared with docetaxel, the phase-III trial, ULTIMATE, showed a signiﬁcant improvement of progression-free survival (PFS) with paclitaxel–bevacizumab combination (PB) as second- or third-line treatment in advanced non-small cell lung cancer (NSCLC). With the increase of immunotherapy treatment in ﬁrst-line settings, the optimal treatment after first-line failure must be redefined. Methods: This multicentric retrospective study identified all advanced NSCLC patients treated with PB as second-line therapy and beyond. The main efficacy outcomes assessed were objective response rate (ORR), disease control rate (DCR), PFS, and overall survival (OS). The adverse events were reported according to Common Terminology Criteria for Adverse Events (CTCAE). Results: From January 2010 to February 2020, 314 patients in 16 centers received the PB combination. Most patients were male (55%), with a median age of 60 years (19–82), 95% had adenocarcinoma, 27% had a performance status ⩾2, 45% had brain metastases at the time of inclusion. They mostly received the PB combination either in second (20%) or in third-line (39%), and 28% were treated just after ICI failure. ORR and DCR were 40% and 77%, respectively; median PFS and OS were 5.7 [interquartile range (IQR): 3.2–9.6] and 10.8 [IQR: 5.3–19.6] months, respectively. All grade adverse events concerned 82% of patients, including 53% asthenia and 39% neurotoxicity, and 25% of patients continued monotherapy (mostly with bevacizumab) alone due to toxicity. Median PFS for patients treated after ICI failure (ICI+) was significantly superior compared with those not previously treated with ICI (ICI−): 7.0 [IQR: 4.2–11.0] versus 5.2 [IQR: 2.9–8.8] months, p = 0.01, without statistically significant difference for OS between these two groups. In multivariate analysis, factors associated with superior PFS were previous ICI treatment and performance status of 0–1. Only a performance status of 0–1 was associated with superior OS. Conclusion: PB combination as second-line treatment or beyond for advanced non-squamous NSCLC had acceptable toxicity and a clinically relevant efficacy and is an option as salvage treatment for these patients, more particularly after ICI progression.
The Relationship Between Human-rated Errors and Tablet-based Postural Sway During the Balance Error Scoring System in Military Cadets
Authors: Ross Jeremy D. , Hoch Matthew C. , Malvasi Steven R. , Cameron Kenneth L. , Roach Megan H. 
Published: June 2022

Background: The Balance Error Scoring System (BESS) is commonly accepted as a valid measure of postural stability. However, reliability values have varied, and subtle changes undetectable with the human eye may exist postinjury. The inertial measurement unit in commercially available tablets has been used to quantify postural sway (instrumented Balance Error Scoring System [iBESS] volume). However, iBESS has not been validated in a military population, and the stability of the tests beyond 1 week is unknown. Hypothesis: iBESS volume is capable of objectively measuring postural sway during the traditional BESS. Study Design: Prospective repeated-measures study. Level of Evidence: Level 3. Methods: Eighty-three cadets (40.96% women; age 20.0 ± 1.44 years; height 68.7 ± 4.1 inches; weight 166.7 ± 30.2 lb) with no history of concussion or lower extremity injury agreed to participate. All participants completed the BESS at baseline and 6 months post baseline. During testing, a tablet equipped with an inertial measurement unit was positioned on the participant’s sacrum to capture postural sway. Results: Moderate to strong correlations were exhibited between baseline measurements for single-limb (SL)-firm ( r = 0.84; P < 0.01), tandem (TAN)-firm ( r = 0.85; P < 0.01), double-limb (DL)-foam ( r = 0.50; P < 0.01), SL-foam ( r = 0.59; P < 0.01), and TAN-foam ( r = 0.79; P < 0.01). Balance improved significantly at 6 months for SL-firm human-rated errors (Effect Size [ES] = 0.32) and for SL-firm (ES = 0.38), DL-foam (ES = 0.21), and SL-foam iBESS volume (ES = 0.35). Moderate to strong correlations were exhibited between human-rated and iBESS change scores for SL-firm ( r = 0.71; P < 0.01), TAN-firm ( r = 0.75; P < 0.01), and TAN-foam ( r = 0.71; P < 0.01), and a weak correlation was exhibited for DL-foam ( r = 0.29; P < 0.01) and SL-foam ( r = 0.40; P < 0.01). Conclusion: Moderate to strong correlations existed between human-rated BESS errors and iBESS volume at baseline and between change scores. In addition, iBESS volume may be more sensitive to balance changes than the human-rated BESS. Clinical Relevance: This evidence supports the use of iBESS volume as a valid measure of postural stability in military cadets. iBESS volume may provide clinicians with an objective and more sensitive measure of postural stability than the traditional human-rated BESS.
Occlusion on a Single Implant-Supported Crown: Any differences?
Authors: Al-Ani Ziad , Maghaireh Hassan 
Published: June 2022

Dental implants react biomechanically to the occlusal forces placed on them, in a different fashion to teeth, which can make them prone to overloading. This can lead to a range of mechanical problems, including screw loosening, ceramic chipping, and fracture of components, but it can also be associated with biological complications such as later peri-implantitis. Appropriate occlusal loading is essential to maintain long-term stability of implant-retained restorations. Clinicians must be aware that, to varying extents, complications do occur with single implant-retained crowns. Dental implants are not a panacea; it is unwise to describe implants as being either perfect or permanent because they are neither. Patients need to understand, well in advance of having implant-based treatment, that the placement of titanium in their jaw(s) will not stop their parafunctional habits, such as clenching or bruxism. Insertion of titanium screws of various types and roughness will certainly not alter their susceptibility to their own plaque-induced inflammatory periodontal disease which is often manifested as peri-mucositis, or later as peri-implantitis in susceptible patients. Based on the available data, this paper provides recommendations to optimise clinical outcomes for single implant-supported crowns. When designing implants, the focus should be on achieving axial forces during chewing. It is wise to minimise horizontal and non-axial loads to avoid potential damage to ceramic or other prosthetic components, and to minimise the risks of bone resorption occurring around the implants themselves at a later stage. Occlusal relationships of implant-retained restorations should be carefully evaluated on a regular basis. Accurate occlusal records of the starting point are extremely helpful in assessing the ongoing status of any restorations.
Review of Current Morphometric Standards in Craniosynostosis
Authors: Kreinces Jason , DeSimone Joseph , Graifman Gillian , Zellner Elizabeth 
Published: June 2022

Background/Purpose: In craniosynostosis, diagnostic imaging is crucial for identifying skull abnormalities, planning for surgical correction, and post-operative and follow-up evaluations. However, classifying postoperative corrected skull morphology is a highly subjective task for all craniofacial surgeons. Initially, many surgeons utilized the Whittaker categorization test as the post-operative outcome measure, which is based on the subjective esthetic appearance as determined by the surgeon, patient, and patient’s family. While the advancement of 3D imaging and anthropometric measurements techniques has allowed various research groups to produce normative skull models to serve as treatment guides, it is still difficult to determine the objective morphological standard. The purpose of this study is to review the current standards for classifying normal skull morphology. Methods: This paper is a review of the current surgical standards of normal cranial morphology. A systematic literature review following PRISMA guidelines was performed; all published studies over a 40-year period from 1980 to 2020 were reviewed that assessed cranial morphology of healthy pediatric samples. Results: A review of the strategies utilized by some of the major medical device manufacturers in craniosynostosis correction surgery is presented. Many of these companies have progressed to using 3D normative skull construction and 3D surface analysis to measure cranial morphology. However, many variations remain among industry standards. Conclusion: Normative head shapes and cohort data matched to similar population groups have a crucial function in the diagnosis, pre-operative planning, and post-operative evaluations in craniofacial surgery. However, industry standards for “normal head shape” utilized in surgical analysis and planning remain diverse and can be somewhat opaque to the craniofacial community. Despite the advancement of 3D imaging techniques, most reported outcomes following craniofacial surgical interventions are still subjectively defined.