bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-cultural adaptation and psychometric testing of the Yoruba lequesne algofunctional index of knee osteoarthritis among patients with knee osteoarthritis
Authors: Akinpelu Aderonke O. , Omosanya Oluwatosin J. , Odole Adesola C. , Adegoke Babatunde O.A. , Oyewole Olufemi O.
Published: November 2023

Background

The Lequesne Algofunctional Index of Knee Osteoarthritis (LAIKOA) is a widely used knee osteoarthritis (KOA) outcome measure and is recommended by many international authorities. It has been cross-culturally adapted to many languages, excluding indigenous Nigerian languages. The aim of this study was to cross-culturally adapt and validate the LAIKOA into Yoruba language.

Methods

This was a validation study. Yoruba LAIKOA was translated and culturally adapted from English version following Beaton’s guidelines (including cognitive debriefing). The Yoruba LAIKOA was psychometrically tested for test-retest reliability, standard error of measurements (SEM), smallest detectable change (SDC), internal consistency, and construct validity among 108 Yoruba-speaking patients with KOA recruited from selected hospitals in Ibadan, Nigeria. Participants completed the Yoruba and English versions of LAIKOA, and the Yoruba version of Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM).

Results

The mean age of participants was 63.60 ± 11.77 years. Acceptable internal consistency was observed for the global index and function domain (α = 0.63–0.82) and good test-retest for items and domains (ICC = 0.81–0.995). Item-to-scale correlation was significant (r = 0.28–0.69). Its three domains demonstrated structural validity when subjected to confirmatory factor analysis (CFI = 0.99, TLI = 0.99, RMSEA = 0.02). Construct validity was supported by the correlation between Yoruba LAIKOA and IKHOAM (r = -0.39, p = 0.011). The overall scores and domain scores of the Yoruba and English versions of LAIKOA did not differ significantly. The Yoruba LAIKOA has no floor or ceiling effects.

Conclusion

The Yoruba LAIKOA is reliable and valid, and it is recommended for use in clinical settings in southwestern Nigeria and other Yoruba-speaking populations.
Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study
Authors: Wang Yu , Wang Qian , Yao Wuyi , Zhao Jingxin , Zhao Xiaobin , He Man
Published: November 2023

Objective

The purpose of this study was to compare the therapeutic effects of Kirschner wire fixation and external fixation in the treatment of proximal humeral fractures in older children and adolescents.

Methods

A retrospective analysis was performed on the clinical data of older children and adolescents who underwent surgery at our institution for proximal humeral fractures between April 2014 and May 2022. One group (n = 28) underwent fracture reduction and Kirschner wire fixation, and the other group (n = 23) underwent external fixation. During the follow-up, the differences in shoulder joint function between the two groups were compared by analysing Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) and Constant-Murley scores. Postoperative complications were also recorded.

Results

The operation time of the Kirschner wire group was shorter than that of the external fixation group (69.07 ± 11.34 min vs. 77.39 ± 15.74 min, P = 0.33). The time to remove the fixator in the external fixation group was shorter than that in the Kirschner wire group (6.74 ± 1.57 vs. 7.61 ± 1.22, P = 0.032). The Quick DASH score and Constant-Murley score of the patients in the external fixation group were significantly better than those in the Kirschner wire group at 3 months after surgery (5.63 ± 4.33 vs. 8.93 ± 6.40, P = 0.040; 93.78 ± 2.43 vs. 91.75 ± 2.15, P = 0.003). There was no significant difference in the Quick DASH score or Constant-Murley score between the patients in the external fixator group and those in the Kirschner wire group at 9 months after the operation (2.77 ± 3.14 vs. 3.17 ± 3.68, P = 0.683; 97.39 ± 1.80 vs. 96.57 ± 2.15, P = 0.152). The most common complication of the two groups was pin tract infection. The incidence rate of infection was higher in the external fixation group than that in the Kirschner wire group (9 vs. 4, P = 0.043).

Conclusion

Both Kirschner wire fixation and external fixation of N-H III and IV proximal humeral fractures in older children and adolescents produce good outcomes. External fixation is a preferred surgical treatment option for paediatric proximal humerus fractures because early mobilization of the affected limb can be realized.
Cementing techniques for total knee arthroplasty in Norwegian hospitals; a questionnaire-based study
Authors: Khan Michelle , Gjertsen Jan-Erik , Fenstad Anne Marie , Refsum Anders , Nguyen Uy , Hallan Geir , Høl Paul Johan , Furnes Ove
Published: November 2023

Background

Cementing technique in total knee arthroplasty (TKA) may influence implant survival. There is limited knowledge about the results with clinically used techniques.

The aim of this study was to investigate cementing techniques for TKA in Norwegian hospitals, to compare widely used techniques to recommendations from the literature, and to investigate variation within hospitals.

Methods

A questionnaire requesting information about cementing techniques were distributed to all Norwegian orthopedic surgeons performing TKAs regularly in 2020. Data was analyzed using descriptive statistical methods.

Results

We acquired 121 responses out of 257 surgeons. They were from 45 out of 56 hospitals, and at least half of the TKA surgeons from 20 hospitals, constituting 79 surgeons. All responders used pulsatile lavage. Cement application to both the tibial plateau and stem (full cementation) was practiced by 61%. Application of cement to both implant and bone was done by 70% of surgeons. Techniques to improve cement penetration were used by 86%. Only 35% of surgeons aimed to get a cement mantle thickness between 3–5 mm. Flexing the knee joint to remove excess cement was done by 82%. We found that in 55% of 20 hospitals the surgeons did not agree on the use of common guidelines in their ward.

Conclusions

The majority of the responders used recommended techniques from the literature when cementing TKA. At more than half of the eligible hospitals, surgeons disagreed about their hospitals’ use of common guidelines. Focusing on developing evidence-based guidelines would be beneficial for TKA-quality.
Comparative study on the clinical efficacy of small plate assisted anatomic plate and traditional double plate in the treatment of Rüedi and Allgöwer II - III pilon fracture
Authors: Ding Wenbin , Xu Jianing , Zhu Ya , Nian Shensheng , Lu Yifeng , Zheng Miaomiao , Zhu Xiang , Wang Zimin , Ji Fang , Tang Hao
Published: November 2023

Objective

The aim of this study was to investigate the clinical efficacy of small plate assisted anatomical plate and traditional double plate in the treatment of Rüedi and Allgöwer II - III pilon fracture.

Methods and materials

The data of 68 patients with pilon fracture admitted to Hospital from June 2017 to June 2020 were retrospectively analyzed. Study group and control group were divided according to different operation methods, with 34 cases in each group. There were 28 cases of Rüedi and Allgöwer II type and 40 cases of Rüedi and Allgöwer III type. Perioperative period data, Ankle joint function score, visual analog scale (VAS) scores and the incidence of incision complications were analyzed between these two groups.

Results

There were no significant differences in full load time, fracture healing time between these two groups (P > 0.05). The operation time, intraoperative blood loss, length of hospital stay, Ankle joint function score and postoperative incision complication rate in observation group were lower than those in control group (P < 0.05).

Conclusion

Small plate assisted anatomic plate is comparable to traditional double plate in the treatment of pilon fracture in terms of complete loading time, fracture healing time, but the former can shorten the operation time, reduce intraoperative blood loss and effectively reduce the incidence of postoperative complications.
Failure in Double-J stent inserting in laparoscopic pyeloplasty of ureteropelvic junction obstruction: the clinical features and outcomes
Authors: Wang Xinyu , Li Jiayi , Fan Songqiao , Li Zonghan , Yang Zhenzhen , Liu Pei , Song Hongcheng , Zhang Weiping
Published: November 2023

Background

Double-J (DJ) stent placement is an important procedure during laparoscopic pyeloplasty (LP). Failing to insert the DJ stent may indicate the patient was also complicated with uretero-vesical junction obstruction (UVJO), and surgeons have to change to another alternative drainage method. In the present study, we analyzed the risk factors of failure of DJ stent placement during the LP and reviewed the clinical outcomes of these challenging pyeloplasties.

Methods

We retrospectively analyzed the clinical data of patients with ureteropelvic junction obstruction (UPJO) who underwent LP in our department from January 2016 to September 2020. For patients who developed a difficult process of inserting the DJ stent, the externalized uretero-pyelostomy (EUP) stent was indwelled. Patients were finally divided into two groups: DJ group and EUP group. The primary outcomes were recurrent UPJO, postoperative uretero-vesical junction obstruction (UVJO) and complications.

Results

A total of 535 patients were included in the study, of which 37 patients (6.9%) failed to insert the DJ stent. Age was younger, and weight was lower (P < 0.05) in the EUP group. Within follow-up, recurrent UPJO occurred in ten (1.87%) patients, nine in the DJ group and one in the EUP group (P > 0.05). The incidence of postoperative UVJO in the EUP group was significantly higher than in the DJ group (10.8% vs. 0.2%, P < 0.01). 74 patients (13.8%) developed complications after surgery, 12 patients (32.4%) in the EUP group, significantly higher than that in the DJ group (32.4% vs. 12.4%, P < 0.01). Compared with the DJ group, the larger APD were observed in the EUP group at three months postoperatively (3.50 [3.02;4.58] vs. 2.20 [1.50;2.88], P < 0.05), but the difference vanished in further follow-up.

Conclusion

The failure of DJ stent placement tends to occur in patients with younger age, lower weight, and larger preoperative APD. Failure may not increase the recurrent UPJO rate, but may indicate a higher probability of postoperative UVJO and may develop more postoperative complications and slower recovery.
A rare case of a combination of ectopic kidney and medial arcuate ligament syndrome: a case report
Authors: Hsu Chun-Kai , Hsu Wen-Tsang , Young Wan-Ling , Wu Shu-Yu
Published: November 2023

Background

Ectopic kidney and median arcuate ligament syndrome are both rare conditions. The clinical presentation and diagnosis of these conditions are not well studied. There are no reports on the combination of these two rare conditions.

Case presentation

We report a 24-year-old woman with fever, dysuria, urinary frequency and left flank pain for two days. The primary diagnoses in the clinic were left acute pyelonephritis and left hydronephrosis due to throbbing pain in the left costovertebral angle and pyuria. However, further computed tomography showed right ectopic pelvic kidney, left renal pelvis dilatation without definite ureteral lesion, good bilateral renal contrast enhancement, and compression of the celiac axis due to obstruction by the median arcuate ligament. Chronic abdominal symptoms were reported by the patient after repeat history taking. The patient’s condition was fully explained and discussed with her and her family, but they refused further therapy. After the acute pyelonephritis began improving, the patient was discharged for follow-up at our outpatient clinic.

Conclusion

We present an extremely rare case of a combination of two rare conditions: ectopic kidney and median arcuate ligament syndrome. No study to date has reported on the relationship between the two diseases. Given the rarity of the two conditions, no evidence or even a hypothesis exists to explain the possible etiology of their combination. More reports are required to enhance the understanding of these rare conditions.
Initial experience with prostatic urethral lift versus enucleation of the prostate: a retrospective comparative study
Authors: Obinata Daisuke , Uehara Rio , Hashimoto Sho , Nakahara Ken , Yoshizawa Tsuyoshi , Mochida Junichi , Yamaguchi Kenya , Takahashi Satoru
Published: November 2023

Background

This study aimed to assess initial results and patient characteristics of prostatic urethral lift (PUL) compared with those of bipolar transurethral enucleation of the prostate (TUEB) in the treatment of benign prostatic hyperplasia (BPH) in older patients.

Methods

This retrospective study was conducted at a single institution and involved 25 consecutive patients with BPH who underwent PUL between April 2022 and May 2023. Patient characteristics, operative details, and pre- and postoperative symptom scores were evaluated. The results were compared with those of a previously reported TUEB group (n = 55).

Results

The mean age of the patients in the PUL group was 74.6 years, and the mean prostate volume was 47.5 ml. The PUL procedure significantly improved urinary symptoms, particularly incomplete emptying (p = 0.041), intermittency (p = 0.005), and weak stream (p = 0.001). The PUL group had higher comorbidity scores (p = 0.048) and included older patients (p = 0.002) than the TUEB group. TUEB showed better improvements in some symptoms and maximum flow rate (p = 0.01) than PUL; however, PUL had a shorter operative time and fewer complications than TUEB (p < 0.001).

Conclusion

The initial results demonstrate the efficacy and safety of PUL in older patients with BPH. Despite TUEB showing better outcomes in certain aspects than PUL, PUL offers advantages such as shorter operative time and fewer complications. Therefore, PUL can be considered a viable option for high-risk older patients with BPH.
Cost of digital technologies and family-observed DOT for a shorter MDR-TB regimen: a modelling study in Ethiopia, India and Uganda
Authors: Rosu Laura , Madan Jason , Bronson Gay , Nidoi Jasper , Tefera Mamo G. , Malaisamy Muniyandi , Squire Bertel S. , Worrall Eve
Published: November 2023

Background

In 2017, the WHO recommended the use of digital technologies, such as medication monitors and video observed treatment (VOT), for directly observed treatment (DOT) of drug-susceptible TB. The WHO’s 2020 guidelines extended these recommendations to multidrug-resistant tuberculosis (MDR-TB), based on low evidence. The impact of COVID on health systems and patients underscored the need to use digital technologies in the management of MDR-TB.

Methods

A decision-tree model was developed to explore the costs of several potential DOT alternatives: VOT, 99DOTS (Directly-observed Treatment, Short-course) and family-observed DOT. Assuming a 9-month, all-oral regimen (as evaluated within the STREAM trial), we constructed base-case cost models for the standard-of-care DOTs in Ethiopia, India, and Uganda, as well as for the three alternative DOT approaches. The models were populated with STREAM Stage 2 clinical trial outcome and cost data, supplemented with market prices data for the digital DOT strategies. Sensitivity analyses were conducted on key parameters.

Results

Modelling suggested that the standard-of-care DOT approach is the most expensive DOT strategy from a societal perspective in all three countries evaluated (Ethiopia, India, Uganda), with considerable direct- and indirect-costs incurred by patients. The second most expensive DOT approach is VOT, with high health-system costs, largely caused by up-front technology expenditure.

Each of VOT, 99DOTS and family-observed DOT would reduce by more than 90% patients’ direct and indirect costs compared to standard of care DOT.

Results were robust to the sensitivity analyses.

Conclusions

While data on the costs and efficacy of alternative DOT approaches in the context of shorter MDR-TB treatment is limited, our modelling suggests alternative DOT approaches can significantly reduce patient costs in all three countries. Health system costs are higher for VOT and lower for 99DOTS and family-observed therapy when compared to standard of care DOT, as low smartphone penetration and internet availability requires the VOT health system to fund the cost of making them available to patients.
Discovery of a new marker to identify myeloid cells associated with metastatic breast tumours
Authors: Bokil Ansooya A. , Le Boulvais Børkja Mathieu , Wolowczyk Camilla , Lamsal Apsana , Prestvik Wenche S. , Nonstad Unni , Pettersen Kristine , Andersen Sonja B. , Bofin Anna M. , Bjørkøy Geir , Hak Sjoerd , Giambelluca Miriam S.
Published: November 2023

Background

Myeloid cells play an essential role in cancer metastasis. The phenotypic diversity of these cells during cancer development has attracted great interest; however, their functional heterogeneity and plasticity have limited their role as prognostic markers and therapeutic targets.

Methods

To identify markers associated with myeloid cells in metastatic tumours, we compared transcriptomic data from immune cells sorted from metastatic and non-metastatic mammary tumours grown in BALB/cJ mice. To assess the translational relevance of our in vivo findings, we assessed human breast cancer biopsies and evaluated the association between arginase 1 protein expression in breast cancer tissues with tumour characteristics and patient outcomes.

Results

Among the differentially expressed genes, arginase 1 (ARG1) showed a unique expression pattern in tumour-infiltrating myeloid cells that correlated with the metastatic capacity of the tumour. Even though ARG1-positive cells were found almost exclusively inside the metastatic tumour, ARG1 protein was also present in the plasma. In human breast cancer biopsies, the presence of ARG1-positive cells was strongly correlated with high-grade proliferating tumours, poor prognosis, and low survival.

Conclusion

Our findings highlight the potential use of ARG1-positive myeloid cells as an independent prognostic marker to evaluate the risk of metastasis in breast cancer patients.

Graphical Abstract
ELF5 drives angiogenesis suppression though stabilizing WDTC1 in renal cell carcinoma
Authors: Li Tushuai , Xu Longjiang , Wei Zhe , Zhang Shaomei , Liu Xingyu , Yang Yanzi , Gu Yue , Zhang Jie
Published: November 2023

Background

Renal cell carcinoma (RCC) is a common malignant tumor of the urinary system. Angiogenesis is a main contributing factor for tumorigenesis. E74-like transcription factor 5 (ELF5) has been verified to participate in the progression of different cancers and can regulate angiogenesis. This study was aimed to explore the functions of ELF5 in RCC.

Methods

Bioinformatics tools were used to predict the expression of ELF5 in RCC. RT-qPCR was applied for testing ELF5 expression in RCC cells. Cell behaviors were evaluated by colony formation, CCK-8, and transwell assays. The tube formation assay was used for determining angiogenesis. Methylation-specific PCR (MSP) was utilized for measuring the methylation level of ELF5 in RCC cells. ChIP and luciferase reporter assays were applied for assessing the binding of ELF5 and ubiquitin-specific protease 3 (USP3). Co-IP and GST pull-down were utilized for detecting the interaction of WD40 and tetratricopeptide repeats 1 (WDTC1) and USP3. Ubiquitination level of WDTC1 was determined by ubiquitination assay.

Results

ELF5 was lowly expressed in RCC cells and tissues. High expression of ELF5 expression notably suppressed RCC cell proliferative, migratory, and invasive capabilities, and inhibited angiogenesis. The tumor growth in mice was inhibited by ELF5 overexpression. ELF5 was highly methylated in RCC samples, and DNA methyltransferases (DNMTs) can promote hypermethylation level of ELF5 in RCC cells. ELF5 was further proved to transcriptionally activate USP3 in RCC. Moreover, USP3 inhibited WDTC1 ubiquitination. ELF5 can promote USP3-mediated WDTC1 stabilization. Additionally, WDTC1 silencing reversed the functions of ELF5 overexpression on RCC progression.

Conclusion

Downregulation of ELF5 due to DNA hypermethylation inhibits RCC development though the USP3/WDTC1axis in RCC.
Ultrasmall PtMn nanoparticles as sensitive manganese release modulator for specificity cancer theranostics
Authors: Guan Guoqiang , Liu Huiyi , Xu Juntao , Zhang Qingpeng , Dong Zhe , Lei Lingling , Zhang Cheng , Yue Renye , Gao Hongchang , Song Guosheng , Shen Xian
Published: November 2023

Manganese-based nanomaterials (Mn-nanomaterials) hold immense potential in cancer diagnosis and therapies. However, most Mn-nanomaterials are limited by the low sensitivity and low efficiency toward mild weak acidity (pH 6.4–6.8) of the tumor microenvironment, resulting in unsatisfactory therapeutic effect and poor magnetic resonance imaging (MRI) performance. This study introduces pH-ultrasensitive PtMn nanoparticles as a novel platform for enhanced ferroptosis-based cancer theranostics. The PtMn nanoparticles were synthesized with different diameters from 5.3 to 2.7 nm with size-dominant catalytic activity and magnetic relaxation, and modified with an acidity-responsive polymer to create pH-sensitive agents. Importantly, R-PtMn-1 (3 nm core) presents “turn-on” oxidase-like activity, affording a significant enhancement ratio (pH 6.0/pH 7.4) in catalytic activity (6.7 folds), compared with R-PtMn-2 (4.2 nm core, 3.7 folds) or R-PtMn-3 (5.3 nm core, 2.1 folds), respectively. Moreover, R-PtMn-1 exhibits dual-mode contrast in high-field MRI. R-PtMn-1 possesses a good enhancement ratio (pH 6.4/pH 7.4) that is 3 or 3.2 folds for T1- or T2-MRI, respectively, which is higher than that of R-PtMn-2 (1.4 or 1.5 folds) or R-PtMn-3 (1.1 or 1.2 folds). Moreover, their pH-ultrasensitivity enabled activation specifically within the tumor microenvironment, avoiding off-target toxicity in normal tissues during delivery. In vitro studies demonstrated elevated intracellular reactive oxygen species production, lipid peroxidation, mitochondrial membrane potential changes, malondialdehyde content, and glutathione depletion, leading to enhanced ferroptosis in cancer cells. Meanwhile, normal cells remained unaffected by the nanoparticles. Overall, the pH-ultrasensitive PtMn nanoparticles offer a promising strategy for accurate cancer diagnosis and ferroptosis-based therapy.

Graphical Abstract
Wrapping pancreaticojejunostomy using the ligamentum teres hepatis during laparoscopic pancreaticoduodenectomy: a propensity score matching analysis
Authors: Wang Jia-Guo , Lei Kai , You Ke , Xu Jie , Liu Zuo-Jin
Published: November 2023

Background and Objective

It is controversial whether wrapping around the pancreaticojejunostomy (PJ) could reduce the rate of postoperative pancreatic fistula (POPF), especially in laparoscopic pancreaticoduodenectomy (LPD). This study aims to summarize our single-center initial experience in wrapping around PJ using the ligamentum teres hepatis (LTH) and demonstrate the feasibility and safety of this method.

Methods

Patients who underwent LPD applying the procedure of wrapping around the PJ were identified. The cohort was compared to the cohort with standard non-wrapping PJ. A 1:1 propensity score matching (PSM) was performed to compare the early postoperative outcomes of the two cohorts. Risk factors for POPF were determined by using univariate and multivariate logistic regression analysis.

Results

Overall, 143 patients were analyzed (LPD without wrapping (n = 91) and LPD with wrapping (n = 52)). After 1:1 PSM, 48 patients in each cohort were selected for further analysis. Bile leakage, DGE, intra-abdominal infection, postoperative hospital stays, harvested lymph nodes, and R0 resection were comparable between the two cohorts. However, the wrapping cohort was associated with significantly less POPF B (1 vs 18, P = 0.003), POPF C (0 vs 8, P = 0.043), and Clavien–Dindo classification level III–V (5 vs 26, P = 0.010). No patients died due to the clinically relevant POPF in the two cohorts. No patients who underwent the LTH wrapping procedure developed complications directly related to the wrapping procedure. After PSM, whether wrapping was an independent risk factor for POPF (OR = 0.202; 95%CI:0.080–0.513; P = 0.001).

Conclusions

Wrapping the LTH around the PJ technique for LPD was safe, efficient, and reproducible with favorable perioperative outcomes in selected patients. However, further validations using high-quality RCTs are still required to confirm the findings of this study.
Oral microbiota disorder in GC patients revealed by 2b-RAD-M
Authors: He Shengfu , Sun Yating , Sun Weijie , Tang Mingyang , Meng Bao , Liu Yanyan , Kong Qinxiang , Li Yongxiang , Yu Jiawen , Li Jiabin
Published: November 2023

Background

Microbiota alterations are linked with gastric cancer (GC). However, the relationship between the oral microbiota (especially oral fungi) and GC is not known. In this study, we aimed to apply 2b-RAD sequencing for Microbiome (2b-RAD-M) to characterize the oral microbiota in patients with GC.

Methods

We performed 2b-RAD-M analysis on the saliva and tongue coating of GC patients and healthy controls. We carried out diversity, relative abundance, and composition analyses of saliva and tongue coating bacteria and fungi in the two groups. In addition, indicator analysis, the Gini index, and the mean decrease accuracy were used to identify oral fungal indicators of GC.

Results

In this study, fungal imbalance in the saliva and tongue coating was observed in the GC group. At the species level, enriched Malassezia globosa (M. globosa) and decreased Saccharomyces cerevisiae (S. cerevisiae) were observed in saliva and tongue coating samples of the GC group. Random forest analysis indicated that M. globosa in saliva and tongue coating samples could serve as biomarkers to diagnose GC. The Gini index and mean decreases in accuracy for M. globosa in saliva and tongue coating samples were the largest. In addition, M. globosa in saliva and tongue coating samples classified GC from the control with areas under the receiver operating curve (AUCs) of 0.976 and 0.846, respectively. Further ecological analysis revealed correlations between oral bacteria and fungi.

Conclusion

For the first time, our data suggested that changes in oral fungi between GC patients and controls may help deepen our understanding of the complex spectrum of the different microbiotas involved in GC development. Although the cohort size was small, this study is the first to use 2b-RAD-M to reveal that oral M. globosa can be a fungal biomarker for detecting GC.
Applications of wearable sensors in upper extremity MSK conditions: a scoping review
Authors: Zadeh Sohrob Milani , MacDermid Joy , Johnson James , Birmingham Trevor B. , Shafiee Erfan
Published: November 2023

Purpose

This scoping review uniquely aims to map the current state of the literature on the applications of wearable sensors in people with or at risk of developing upper extremity musculoskeletal (UE-MSK) conditions, considering that MSK conditions or disorders have the highest rate of prevalence among other types of conditions or disorders that contribute to the need for rehabilitation services.

Materials and methods

The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews guideline was followed in this scoping review. Two independent authors conducted a systematic search of four databases, including PubMed, Embase, Scopus, and IEEEXplore. We included studies that have applied wearable sensors on people with or at risk of developing UE-MSK condition published after 2010. We extracted study designs, aims, number of participants, sensor placement locations, sensor types, and number, and outcome(s) of interest from the included studies. The overall findings of our scoping review are presented in tables and diagrams to map an overview of the existing applications.

Results

The final review encompassed 80 studies categorized into clinical population (31 studies), workers’ population (31 studies), and general wearable design/performance studies (18 studies). Most were observational, with 2 RCTs in workers’ studies. Clinical studies focused on UE-MSK conditions like rotator cuff tear and arthritis. Workers’ studies involved industrial workers, surgeons, farmers, and at-risk healthy individuals. Wearable sensors were utilized for objective motion assessment, home-based rehabilitation monitoring, daily activity recording, physical risk characterization, and ergonomic assessments. IMU sensors were prevalent in designs (84%), with a minority including sEMG sensors (16%). Assessment applications dominated (80%), while treatment-focused studies constituted 20%. Home-based applicability was noted in 21% of the studies.

Conclusion

Wearable sensor technologies have been increasingly applied to the health care field. These applications include clinical assessments, home-based treatments of MSK disorders, and monitoring of workers’ population in non-standardized areas such as work environments. Assessment-focused studies predominate over treatment studies. Additionally, wearable sensor designs predominantly use IMU sensors, with a subset of studies incorporating sEMG and other sensor types in wearable platforms to capture muscle activity and inertial data for the assessment or rehabilitation of MSK conditions.
Relationship between resting-state functional connectivity and change in motor function after motor imagery intervention in patients with stroke: a scoping review
Authors: Tanamachi Kenya , Kuwahara Wataru , Okawada Megumi , Sasaki Shun , Kaneko Fuminari
Published: November 2023

Background

In clinical practice, motor imagery has been proposed as a treatment modality for stroke owing to its feasibility in patients with severe motor impairment. Motor imagery-based interventions can be categorized as open- or closed-loop. Closed-loop intervention is based on voluntary motor imagery and induced peripheral sensory afferent (e.g., Brain Computer Interface (BCI)-based interventions). Meanwhile, open-loop interventions include methods without voluntary motor imagery or sensory afferent. Resting-state functional connectivity (rs-FC) is defined as a significant temporal correlated signal among functionally related brain regions without any stimulus. rs-FC is a powerful tool for exploring the baseline characteristics of brain connectivity. Previous studies reported changes in rs-FC after motor imagery interventions. Systematic reviews also reported the effects of motor imagery-based interventions at the behavioral level. This study aimed to review and describe the relationship between the improvement in motor function and changes in rs-FC after motor imagery in patients with stroke.

Review process

The literature review was based on Arksey and O’Malley’s framework. PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science were searched up to September 30, 2023. The included studies covered the following topics: illusion without voluntary action, motor imagery, action imitation, and BCI-based interventions. The correlation between rs-FC and motor function before and after the intervention was analyzed. After screening by two independent researchers, 13 studies on BCI-based intervention, motor imagery intervention, and kinesthetic illusion induced by visual stimulation therapy were included.

Conclusion

All studies relating to motor imagery in this review reported improvement in motor function post-intervention. Furthermore, all those studies demonstrated a significant relationship between the change in motor function and rs-FC (e.g., sensorimotor network and parietal cortex).
Flat panel CT versus multidetector CT in skull base imaging: are there differences in image quality?
Authors: Schulze Maximilian , Hirt Bernhard , Reimann Katrin
Published: November 2023

Background

Purpose of this study was to compare image quality of the skull base in standard 20s protocol flat panel computed tomography (FPCT) with the new time and dose improved 10s protocol as well as with 128 slice multidetector computed tomography (MDCT).

Methods

10 whole skull preparations were scanned with either 128 slice MDCT(SOMATOM Definition AS+, Siemens, Erlangen) or FPCT (AXIOM-Artis, Siemens, Erlangen) using 10s or 20s protocol.

Results

FPCT provides significantly better image quality and improved delimitation of clinically relevant structures in the anterior, temporal and posterior skull base compared to 128 slice MDCT. The 20s FPCT protocol yielded best delimitability of evaluated skull base structures. However, the shorter, dose saving 10s FPCT protocol was still significantly superior to 128 slice MDCT regarding delimitability of skull base structures and additionally showed no significant inferiority compared with the 20s FPCT protocol.

Conclusions

The 10s FPCT protocol yields a significantly better image quality at a comparable radiation dose exposure in imaging skull base structures compared to MDCT.

Trial registration

371/2017BO2.
BRD4 facilitates osteogenic differentiation of human bone marrow mesenchymal stem cells through WNT4/NF-κB pathway
Authors: Ning Tao , Guo Huihui , Ma Mingming , Zha Zhengang
Published: November 2023

Background

Human bone marrow mesenchymal stem cells (hBMSCs) are a major source of osteoblast precursor cells and are directly involved in osteoporosis (OP) progression. Bromodomain-containing protein 4 (BRD4) is an important regulator for osteogenic differentiation. Therefore, its role and mechanism in osteogenic differentiation process deserve further investigation.

Methods

hBMSCs osteogenic differentiation was evaluated by flow cytometry, alkaline phosphatase assay and alizarin red staining. Western blot was used to test osteogenic differentiation-related proteins, BRD4 protein, WNT family members-4 (WNT4)/NF-κB-related proteins, and glycolysis-related proteins. Metabolomics techniques were used to detect metabolite changes and metabolic pathways. BRD4 and WNT4 mRNA levels were determined using quantitative real-time PCR. Dual-luciferase reporter assay and chromatin immunoprecipitation assay were performed to detect BRD4 and WNT4 interaction. Glycolysis ability was assessed by testing glucose uptake, lactic acid production, and ATP levels.

Results

After successful induction of osteogenic differentiation, the expression of BRD4 was increased significantly. BRD4 knockdown inhibited hBMSCs osteogenic differentiation. Metabolomics analysis showed that BRD4 expression was related to glucose metabolism in osteogenic differentiation. Moreover, BRD4 could directly bind to the promoter of the WNT4 gene. Further experiments confirmed that recombinant WNT4 reversed the inhibition effect of BRD4 knockdown on glycolysis, and NF-κB inhibitors (Bardoxolone Methyl) overturned the suppressive effect of BRD4 knockdown on hBMSCs osteogenic differentiation.

Conclusion

BRD4 promoted hBMSCs osteogenic differentiation by inhibiting NF-κB pathway via enhancing WNT4 expression.
Circ_0020014 mediates CTSB expression and participates in IL-1β-prompted chondrocyte injury via interacting with miR-24-3p
Authors: Zhang Chenpeng , He Wenjun
Published: November 2023

Background

Recent studies have shown that circRNAs are involved in the pathogenesis of osteoarthritis (OA) by affecting various fundamental cellular characteristics of chondrocytes. The purpose of this paper is to investigate the role and regulatory mechanism of hsa_circ_0020014 (circ_0020014) in chondrocytes of OA.

Methods

The inflammatory cytokine interleukin 1 beta (IL-1β) was used to stimulate human chondrocytes. Cell viability, proliferation, and apoptosis were evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), 5-Ethynyl-2′-deoxyuridine (EdU), and flow cytometry assays. Several protein levels were determined by western blotting (WB). Levels of inflammatory cytokines and malondialdehyde (MDA) were determined by enzyme-linked immunosorbent assay (ELISA). Relative expression of circ_0020014 was estimated by real-time polymerase quantitative chain reaction (RT-qPCR). Bioinformatics prediction combined with dual-luciferase reporter, RIP and RNA pull-down assays were done to probe into the regulatory mechanism of circ_0020014.

Results

Circ_0020014 was overexpressed in OA patient-derived articular cartilages and IL-1β-stimulated chondrocytes. Silencing of circ_0020014 lighted IL-1β-prompted chondrocyte proliferation repression, apoptosis, inflammation, and oxidative stress. Mechanically, circ_0020014 functioned as a miR-24-3p molecular sponge to regulate cathepsin B (CTSB) expression. Furthermore, miR-24-3p inhibition alleviated circ_0020014 knockdown-mediation repression of IL-1β-urged chondrocyte injury. In addition, CTSB overexpression whittled miR-24-3p upregulation-mediated suppression of IL-1β-urged chondrocyte injury.

Conclusion

Our findings demonstrated that the circ_0020014/miR-24-3p/CTSB axis was associated with IL-1β-prompted chondrocyte injury, supporting the involvement of circ_0020014 in the OA pathogenesis.
Factors influencing withdrawal of life-supporting treatment in cervical spinal cord injury: a large multicenter observational cohort study
Authors: Shakil Husain , Malhotra Armaan K. , Jaffe Rachael H. , Smith Christopher W. , Harrington Erin M. , Wang Alick P. , Yuan Eva Y. , He Yingshi , Ladha Karim , Wijeysundera Duminda N. , Nathens Avery B. , Wilson Jefferson R. , Witiw Christopher D.
Published: November 2023

Background

Traumatic spinal cord injury (SCI) leads to profound neurologic sequelae, and the provision of life-supporting treatment serves great importance among this patient population. The decision for withdrawal of life-supporting treatment (WLST) in complete traumatic SCI is complex with the lack of guidelines and limited understanding of practice patterns. We aimed to evaluate the individual and contextual factors associated with the decision for WLST and assess between-center differences in practice patterns across North American trauma centers for patients with complete cervical SCI.

Methods

This retrospective multicenter observational cohort study utilized data derived from the American College of Surgeons Trauma Quality Improvement Program database between 2017 and 2020. The study included adult patients (> 16 years) with complete cervical SCI. We constructed a multilevel mixed effect logistic regression model to adjust for patient, injury and hospital factors influencing WLST. Factors associated with WLST were estimated through odds ratios with 95% confidence intervals. Hospital variability was characterized using the median odds ratio. Unexplained residual variability was assessed through the proportional change in variation between models.

Results

We identified 5070 patients with complete cervical SCI treated across 477 hospitals, of which 960 (18.9%) had WLST. Patient-level factors associated with significantly increased likelihood of WLST were advanced age, male sex, white race, prior dementia, low presenting Glasgow Coma Scale score, having a pre-hospital cardiac arrest, SCI level of C3 or above, and concurrent severe injury to the head or thorax. Patient-level factors associated with significantly decreased likelihood of WLST included being racially Black or Asian. There was significant variability across hospitals in the likelihood for WLST while accounting for case-mix, hospital size, and teaching status (MOR 1.51 95% CI 1.22–1.75).

Conclusions

A notable proportion of patients with complete cervical SCI undergo WLST during their in-hospital admission. We have highlighted several factors associated with this decision and identified considerable variability between hospitals. Further work to standardize WLST guidelines may improve equity of care provided to this patient population.
Cu (II)-catalyzed: synthesis of imidazole derivatives and evaluating their larvicidal, antimicrobial activities with DFT and molecular docking studies
Authors: Mullaivendhan Janani , Akbar Idhayadhulla , Gatasheh Mansour K. , Hatamleh Ashraf Atef , Ahamed Anis , Abuthakir Mohamed Hussain Syed , Gurusamy Raman
Published: November 2023

This paper deals with the evaluation of novel imidazole molecules for their antimicrobial and larvicidal activities. A series of imidazole derivatives 1(a–f) and 2(a–e) were prepared by the Mannich base technique using a Cu(II) catalyst. The Cu(phen)Cl2 catalyst was found to be more effective than other methods. FTIR, elemental analyses, mass spectrometry, 1H NMR, and 13C NMR spectroscopy were performed to elucidate the structures of the synthesised compounds. Antimicrobial and larvicidal activities were investigated for all compounds. The antibacterial activity of compounds (2d) and (2a) were highly active in S.aureus (MIC: 0.25 μg/mL) and K.pneumoniae (MIC: 0.25 μg/mL) compared to ciprofloxacin. Compound (1c) was significantly more effective than clotrimazole in C.albicans (MIC: 0.25 μg/mL). Molecular docking studies of compound 2d showed a higher binding affinity for the 1BDD protein (− 3.4 kcal/mol) than ciprofloxacin (− 4.4 kcal/mol). Compound 1c had a higher binding affinity (− 6.0 kcal/mol) than clotrimazole (− 3.1 kcal/mol) with greater frontier molecular orbital energy and reactivity properties of compound 1c (∆E gap = 0.13 eV). The activity of compound 1a (LD50: 34.9 μg/mL) was more effective in the Culex quinquefasciatus than permethrin (LD50: 35.4 μg/mL) and its molecular docking binding affinity for 3OGN protein (− 6.1 kcal/mol). These newly synthesised compounds can act as lead molecules for the development of larvicides and antibiotic agents.
Echinococcus multilocularis and other zoonotic helminths in red foxes (Vulpes vulpes) from a southern German hotspot for human alveolar echinococcosis
Authors: Schneider Carina , Kratzer Wolfgang , Binzberger Andreas , Schlingeloff Patrycja , Baumann Sven , Romig Thomas , Schmidberger Julian
Published: November 2023

Background

We describe the spatial distribution of Echinococcus multilocularis in its main definitive host, the red fox, and the distribution of human cases of alveolar echinococcosis (AE) within a highly endemic focus in southern Germany (13.7–19.9/100,000 in 1992–2018). Human cases were unequally distributed within the endemicity focus. The purpose of the study was to test whether this is reflected in the small-scale distribution of E. multilocularis in foxes.

Methods

Three areas with contrasting numbers of human cases were selected within the counties of Ravensburg and Alb-Donau, Baden-Württemberg, Germany. From 2018 to 2020, a total of 240 fox carcasses were obtained from traditional hunters in these areas. Carcasses were necropsied and examined for the presence of intestinal helminths. The statistical analysis was performed with SAS version 9.4, and the geo-mapping with QGIS version 3.16.0 Hannover.

Results

The prevalence of E. multilocularis in foxes was 44/106 (41.5%) in area I (commune Leutkirch and environs), 30/59 (50.8%) in area II (commune Isny and environs), and 31/75 (41.3%) in area III (commune Ehingen and environs). From 1992 to 2018, a total of nine human cases of alveolar echinococcosis were recorded in area I, five cases were recorded in study area III, and no cases were recorded in area II. No statistically significant differences between the areas were observed (P > 0.05) for intestinal infections with E. multilocularis, and no apparent spatial correlation with the small-scale distribution of human cases was found. Concerning other zoonotic helminths, Toxocara spp. were equally common, with prevalence of 38.7%, 47.4% and 48.0%, respectively, while the frequency of Alaria alata varied among the study areas (0.0–9.4%), probably reflecting the specific habitat requirements for the establishment of its complex life cycle.

Conclusions

Echinococcus multilocularis is highly prevalent in foxes in all the studied areas. The varying number of human AE cases within these areas should therefore be caused by factors other than the intensity of parasite transmission in foxes.

Graphical Abstract
The metabolic spatial covariance pattern of definite idiopathic normal pressure hydrocephalus: an FDG PET study with principal components analysis
Authors: Rau Alexander , Schröter Nils , Blazhenets Ganna , Maurer Christoph , Urbach Horst , Meyer Philipp T. , Frings Lars
Published: November 2023

Identification of patients with idiopathic normal pressure hydrocephalus (iNPH) in a collective with suspected neurodegenerative disease is essential. This study aimed to determine the metabolic spatial covariance pattern of iNPH on FDG PET using an established technique based on scaled subprofile model principal components analysis (SSM-PCA).

We identified 11 patients with definite iNPH. By applying SSM-PCA to the FDG PET data, they were compared to 48 age-matched healthy controls to determine the whole-brain voxel-wise metabolic spatial covariance pattern of definite iNPH (iNPH-related pattern, iNPHRP). The iNPHRP score was compared between groups of patients with definite iNPH, possible iNPH (N = 34), Alzheimer’s (AD, N = 38), and Parkinson’s disease (PD, N = 35) applying pairwise Mann–Whitney U tests and correction for multiple comparisons.

SSM-PCA of FDG PET revealed an iNPHRP that is characterized by relative negative voxel weights at the vicinity of the lateral ventricles and relative positive weights in the paracentral midline region. The iNPHRP scores of patients with definite iNPH were substantially higher than in patients with AD and PD (both p < 0.05) and non-significantly higher than those of patients with possible iNPH. Subject scores of the iNPHRP discriminated definite iNPH from AD and PD with 96% and 100% accuracy and possible iNPH from AD and PD with 83% and 86% accuracy.

We defined a novel metabolic spatial covariance pattern of iNPH that might facilitate the differential diagnosis of iNPH versus other neurodegenerative disorders. The knowledge of iNPH-associated alterations in the cerebral glucose metabolism is of high relevance as iNPH constitutes an important differential diagnosis to dementia and movement disorders.
How legal problems are conceptualized and measured in healthcare settings: a systematic review
Authors: Vest Joshua R. , Hinrichs Rachel J. , Hosler Heidi
Published: November 2023

Legal problems encompass issues requiring resolution through the justice system. This social risk factor creates barriers in accessing services and increases risk of poor health outcomes. A systematic review of the peer-reviewed English-language health literature following the PRISMA guidelines sought to answer the question, how has the concept of patients’ “legal problems” been operationalized in healthcare settings? Eligible articles reported the measurement or screening of individuals for legal problems in a United States healthcare or clinical setting. We abstracted the prevalence of legal problems, characteristics of the sampled population, and which concepts were included. 58 studies reported a total of 82 different measurements of legal problems. 56.8% of measures reflected a single concept (e.g., incarcerated only). The rest of the measures reflected two or more concepts within a single reported measure (e.g., incarcerations and arrests). Among all measures, the concept of incarceration or being imprisoned appeared the most frequently (57%). The mean of the reported legal problems was 26%. The literature indicates that legal concepts, however operationalized, are very common among patients. The variation in measurement definitions and approaches indicates the potential difficulties for organizations seeking to address these challenges.