bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes Following Suture Button Fixation for the Management of Ligamentous Lisfranc Injuries: A Systematic Review
Authors: Butler James J. , Fur Rachel Lai Fat , DeClouette Brittany , Cole Wendell , Samsonov Alan P. , Kennedy John G.
Published: December 2024

Category:

Midfoot/Forefoot

Introduction/Purpose:

The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.

Methods:

During January 2024, the PubMed, Embase and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries. Data regarding patient demographics, pathological characteristics, subjective clinical outcomes, radiological outcomes, complications and failure rates were extracted and analysed.

Results:

Ten studies were included. In total, 100 patients (100 feet) underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 30.5±10.3 months. The AOFAS score improved from a weighted mean pre-operative score of 52.9±11.8 to a weighted mean post-operative score of 89.0±5.4. The VAS score improved from a weighted mean pre-operative score of 7.7±0.6 to a weighted mean post-operative score of 2.1±0.4. In total, 100% of patients returned to sport at a mean time of 22.3±4.8 weeks. The complication rate was 13.5%, the most common of which was residual midfoot stiffness (3.0%). No failures nor secondary surgical procedures were recorded.

Conclusion:

This systematic review demonstrated improvement in subjective clinical with a moderate complication rate at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries. No failures nor secondary surgical procedures were recorded. Further high quality comparative studies are warranted to determine the optimal role of suture button fixation in the management of ligamentous Lisfranc injuries.
Outcomes Following Treatment of Symptomatic Accessory Navicular with Pes Planus Correction: A Systematic Review
Authors: Jimenez Mosquea Thelma R. , Ubillus Hugo A. , Walls Raymond J.
Published: December 2024

Category:

Midfoot/Forefoot; Other

Introduction/Purpose:

The presence of an accessory navicular (AN) can disrupt the attachment of the tibialis posterior tendon (TPT), potentially resulting in a flattened medial longitudinal arch. The Kidner procedure aims to alleviate painful AN by correcting the abnormal TPT insertion, thus aiding in arch elevation. Subtalar arthroeresis (STA) serves to prevent excessive subtalar joint eversion, thereby averting arch collapse in flatfoot deformity. Conversely, the addition of a medial column reinforcement through osteotomy has been proposed to further stabilize the corrected foot shape. Literature on AN treatment often overlooks options for flatfoot deformity. This study compares outcomes of Kidner alone, Kidner with STA, and Kidner with medial column reinforcement for symptomatic AN with flatfoot, seeking to provide valuable treatment insights.

Methods:

In February 2024, a systematic review was conducted on the PubMed, Embase, and Cochrane Library databases to identify clinical studies investigating outcomes of the Kidner procedure alone, Kidner with STA, and Kidner with osteotomies for managing symptomatic accessory navicular (AN) with flatfoot deformity. The level of evidence (LoE) in the included studies was assessed according to the criteria set by the Journal of Bone and Joint Surgery. Information pertaining to subjective clinical outcomes, radiological findings, and complications was gathered and subjected to analysis.

Results:

This review included 19 studies, comprising one with Level II evidence, thirteen with Level III, and five with Level IV. Among 525 cases, 246 underwent Kidner procedure, 166 the Kidner + STA and 113 the Kidner + medial osteotomy. The weighted mean age was 15.7 ± 3.9 years for the Kidner cohort, 12.4 ± 2.7 years for the Kidner + STA and 25.29 ± 12.1 years for the Kidner + osteotomy, with weighted-mean follow-up of 67.8, 44.06 and 25.01 months, respectively. Pre-operative AOFAS mean scores were 46.0, 56.4 and 52.8, with post-operative scores of 85.5, 89.7 and 89.7, respectively. At final follow-up, Meary’s angle improved 0.7 degrees in the Kidner, 13.2 degrees in the Kidner + STA and 10.86 degrees in Kidner + osteotomy.

Conclusion:

This review highlights the effectiveness of different procedures in managing symptomatic accessory navicular with flatfoot deformity. The three approaches demonstrated improvements in subjective clinical outcomes and radiological parameters. Kidner alone experienced less radiologic improvement, suggesting that augmentation with either STA or osteotomy may provide better correction. Despite limitations in study design and heterogeneity among included studies, our findings underscore the importance of individualized treatment approaches. Further research with larger sample sizes and longer follow-up periods is warranted to validate these findings and optimize treatment strategies for this challenging condition.
Outcomes of Osteosynthesis of Large Os Subfibulare in Patients with Chronic Lateral Ankle Instability with Large Os Subfibulare
Authors: Yoon Yeo Kwon , Park Kwang Hwan , Shim Dong Woo , Han Seung Hwan , Lee Jin Woo
Published: December 2024

Category:

Ankle; Sports

Introduction/Purpose:

Os subfibulare is commonly found in patients with chronic lateral ankle instability (CLAI). When performing lateral ligament reconstruction for CLAI, excision of a large OS can cause massive lateral ligament defects.The purpose of this study is to evaluate clinical and radiological outcomes among patients who underwent osteosynthesis of the OS for chronic lateral ankle instability with a large OS (≥10 mm).

Methods:

A retrospective analysis was performed on 28 ankles with CLAI and a large OS (≥10 mm) that underwent osteosynthesis of the OS between June 2007 and July 2021 and had a minimum follow-up of 2 years. Visual Analog Scale for pain, Karlsson–Peterson ankle score, and Medical Outcomes Study Short Form Health Survey-36 Physical Component Summary (SF-36 PCS), talar tilt angle, and anterior displacement of the talus were used to assess clinical and radiological outcomes.

Results:

The mean follow-up period was 78.9 months (range, 24.0 to 177.0 months) and the mean OS size was 15.4 mm (range, 12.2 to 21.0 mm). Mean ± SD Visual Analogue Scale for pain, Karlsson–Peterson ankle score, SF-36 PCS, talar tilt angle, and anterior displacement of the talus improved significantly, from preoperative values of 5.3 ± 1.8, 38.4 ± 10.6, 45.6 ± 10.8, 11.1 ± 5.7, and 7.3 ± 1.9, to 0.9 ± 1.4, 88.7 ± 12.6, 80.2 ± 12.3, 3.9 ± 2.0, and 4.8 ± 1.3, respectively, by the last follow-up. The overall complication rate was 10.7% (three ankles); the reoperation rate was 7.1% (two ankles).

Conclusion:

Osteosynthesis of the OS produced satisfactory outcomes in patients with CLAI with a large OS. This method may be a viable surgical option for patients with this condition.
Outcomes of Tibiotalocalcaneal Arthrodesis in Charcot Neuroarthropathy According to Severity of Preoperative Deformity
Authors: Kim Sunghoo , Choi YoungRak
Published: December 2024

Category:

Diabetes; Hindfoot

Introduction/Purpose:

Patients who have severe hindfoot Charcot neuroarthropathy and require surgical intervention often present with several medical comorbidities. When they undergo reconstructive surgery (tibiotalocalcaneal arthrodesis), they may inadvertently suffer from various complications, including infections, nonunion, delayed ambulation, and subsequent limb amputation. Therefore, appropriate treatment plans should be established to avoid potential complications, and prognosis should be predicted before surgery. This study aims to explore the influence of the preoperative deformity degree in hindfoot Charcot neuroarthropathy on the outcomes of tibiotalocalcaneal arthrodesis.

Methods:

Twenty patients who underwent tibiotalocalcaneal arthrodesis because of hindfoot Charcot neuroarthropathy were evaluated retrospectively. They were classified into the severe deformity group if the tibiotalar angle was < 80 degrees or >100 degrees or if they had severe osteolysis of the talar body. Those without such conditions were categorized into the mild deformity group. Their demographics, comorbidity, and various surgical outcomes, including the presence of bony union, ambulation status, and performance of major amputation, were compared between the two groups.

Results:

With the numbers available, demographics and comorbidity did not significantly differ between the two groups. Postoperative outcomes, including postoperative infections, malalignment, bony union rates, time to union, and the rate of poor clinical outcomes, did not significantly vary between the two groups with the numbers available. The patients with a history of preoperative wound and postoperative infection showed worse clinical outcomes although tibiotalocalcaneal arthrodesis was performed after the preoperative wound was relieved.

Conclusion:

The severity of preoperative deformity and the osteolysis of the talar body were not associated with the outcomes of tibiotalocalcaneal arthrodesis on hindfoot Charcot neuroarthropathy. The presence of preoperative wound might be related to poor outcomes, and more caution is needed in treating these patients.
Patient Pain and Function after Correction of Posterior Malleolar Malunion
Authors: Zhang Hui , Li Yaxing , Gan Tingjiang
Published: December 2024

Category:

Trauma; Hindfoot

Introduction/Purpose:

The management of an ankle malunion involving the posterior malleolus remains challenging, and only a few published studies described the operative treatment of complex posterior malleolar malunion. A transfibular approach allows for direct visualization of the articular reduction of the posterior malleolus, but the reports of its use for correcting posterior malleolar malunion are rare. This study aims to evaluate the results of the intra-articular osteotomy via a transfibular approach for correcting an ankle malunion involving the posterior malleolus.

Methods:

We conducted a retrospective review of 26 patients with a symptomatic malunited ankle fracture involving posterior malleolus were treated with the intra-articular osteotomy via a transfibular approach in our department. Radiographic assessments were performed using plain radiographs and computed tomographic (CT) scans. Clinical outcomes were assessed using the AOFAS ankle-hindfoot score, visual analog scale (VAS), active range of motion of ankle, and the 36-Item Short-Form Health Survey score.

Results:

Postoperatively, anatomic correction of articular surface and anatomic reduction of syndesmosis were achieved in all patients as judged by CT scans. No evidence of progression had been found in 18 of 26 patients (69.2%) at final follow- up. The median AOFAS score improved from 42.0 to 81.5 (P < .001). Median pain VAS score decreased from 6.0 to 1.0 (P < .001). A favorable clinical outcome was associated with a short time interval from original injury to correction surgery and a lower grade of preoperative arthritis, but not with the posterior malleolar fragment size. However, time interval, the posterior malleolar fragment size, and the grade of preoperative arthritis showed no correlation with the progression of arthritis grade after surgery.

Conclusion:

An intra-articular osteotomy via a transfibular approach demonstrated an improved function and pain after operative treatment of malunited ankle fracture with a displaced posterior malleolar fragment.
Patient Reported Outcomes Following Triple Arthrodesis for Adult Acquired Flat Foot Deformity: Minimum Two Year Follow Up
Authors: Kelly Tyler , Shah Ashish , Scheinberg Mila
Published: December 2024

Category:

Midfoot/Forefoot; Hindfoot

Introduction/Purpose:

The posterior tibial tendon (PTT) acts as the primary dynamic stabilizer of the medial longitudinal arch and insufficiency of the PTT can result in a broad range of symptoms from asymptomatic to debilitating arthritis in association with flat foot deformity. Staging of AAFD is based on the degree of deformity and broken into four groups. Triple arthrodesis (TA), a simultaneous fusion of the talonavicular, subtalar, and calcaneocuboid joint, is used for patients with intractable pain, instability, and stage 3-4 deformity due to hindfoot pathology. The purpose of this study was to identify patient-specific variables that independently influence PROMIS, Foot Function Index (FFI), and VAS scores as well as complication rates.

Methods:

A retrospective analysis was conducted of patients that underwent Triple Arthrodesis at our facility from 2014-2021. Patients were selected if they underwent an isolated triple arthrodesis. All cases included either a gastrocnemius recession versus a percutaneous tendo-achilles lengthening depending on the patient’s Silverskiold examination. The electronic medical record was utilized to collect basic patient demographics, previous foot and ankle surgeries, hardware failures, additional procedures, and surgical complications. To evaluate outcomes, we compared Patient Reported Outcomes Measurement Information System (PROMIS) survey scores with the general population and pre-operative vs. post-operative Visual Analog Scale (VAS) scores. Foot Function Index (FFI) scores and scores were utilized as a validation tool for our results. One hundred and thirty two patients met the criteria for our study with a total of 50 participants completing the PROMIS and FFI surveys.

Results:

The average time point at which the outcomes were collected was 5.50 years postoperatively, ranging from 1.65 to 7.57 years. The average PROMIS physical function was 38.35, pain interference was 61.52, and depression was 49.82 for this population. The mean FFI scores were 58.56 for pain, 60.07 for disability, 48.07 for activity limitation. There was a significant decrease in preoperative and postoperative VAS scores from 5.4 to 2.55 (p < 0.001). Three patients experienced wound complication related to decreased sensation.

Conclusion:

Our results indicated that only PROMIS depression scores were within one standard deviation of the population mean following a triple arthrodesis procedure. PROMIS physical function and pain interference were both outside of one standard deviation for the population.
The influence of the wire and arc additive  manufacturing parameters on the  surface irregularities
Authors: Ozaner Ozan Can , Talemi Reza , Tjahjowidodo Tegoeh , Sharma Abhay
Published: December 2024

Wire and arc additive manufacturing (WAAM) has been demonstrated to be a pioneering process for producing small- to large-scale components with its high deposition rate and flexible deposition capability. However, WAAM has critical drawbacks, including pronounced surface irregularities and the need for secondary machining operations. The presence of surface irregularities also negatively affects the surface flatness/waviness of the as-built part and the effective wall width and height after machining. To enhance surface properties, examining the impact of WAAM parameters is necessary. As a result, this study explores the impact of wire feed speed (WFS) and traveling speed parameters on single-material WAAMed samples made of stainless steel 309L. The study examined surface irregularities such as flatness, distortion, and effective wall thickness using detailed three-dimensional scanning techniques. Hardness measurements were also conducted to evaluate hardness distribution along the deposition direction. The analysis focused on the interaction between WAAM process parameters and surface irregularities. The results indicate that the heat input is the most influential deposition criterion affecting surface irregularities, such as flatness and distortion. These findings contribute to a deeper understanding of the complex interplay of deposition parameters, providing valuable information for optimizing the WAAM processes. In conclusion, this study offers insights into the intricate dynamics of WAAM. It highlights the crucial role of WFS, travel speed, and heat input in shaping surface properties.
Comparative efficacy of six types of scoliosis-specific exercises on adolescent idiopathic scoliosis: a systematic review and network meta-analysis
Authors: Wang Zhenghui , Zhu Wenpan , Li Guang , Guo Xuejun
Published: December 2024

Background

Adolescent idiopathic scoliosis (AIS) stands as the predominant spinal deformity in adolescents, manifesting symptoms including back pain, functional limitations, cosmetic worries, and respiratory dysfunction. At present, six approaches of scoliosis-specific exercises are globally practiced, encompassing Schroth exercise, the Scientific Exercise Approach to Scoliosis (SEAS), the Dobomed, the side shift exercise, active self-correction, and the Functional Individual Therapy of Scoliosis (FITS). However, there is no systematic review and meta-analysis comparing the efficacy of these six types of scoliosis-specific exercises on adolescent idiopathic scoliosis.

Objective

To evaluate and compare the efficacy of six types of scoliosis-specific exercises on spinal deformity and quality of life in AIS.

Materials and methods

A systematic search was performed on PubMed, EMBASE, and the Cochrane Library from their inception to September 2023. Two independent auditors screened all studies according to predefined inclusion and exclusion criteria. Clinical trials were compiled to investigate the effects of six exercise interventions on spinal deformity and quality of life in AIS.

Results

Twenty-four studies were included, with a sample size of 1069 subjects. After meta-analysis, it was shown that SEAS ranked first in reducing Cobb angles (SUCRA: 84.8%); active self-correction and Schroth significantly improved the angles of trunk rotation in AIS (SUCRA: 86.6% and SUCRA: 79.1%, respectively); active self-correction and Schroth showed significant improvements in quality of life (SUCRA: 76.6% and SUCRA: 76.0%, respectively).

Conclusion

According to the current findings, active self-correction demonstrated superior short-term benefits compared to other exercise interventions in ameliorating spinal deformity and improving quality of life for adolescents with idiopathic scoliosis. Meanwhile, Schroth exhibited long-term effects in improving both spinal deformity and quality of life.

Registration information

This review was registered on PROSPERO on June 20, 2023 (ID: CRD42023433152).
Association of maxillofacial injuries with traumatic brain injuries in paediatric patients: a case–control study
Authors: Suprabha Baranya Shrikrishna , Wilson Michael Lowery , Baptist Joanna , Subramanian Sadhvi Shankar , Shenoy Ramya , Jahanjoo Fatemeh , Radhakrishnan Jeedhu , Kamath V. Mayur , Anagha N. P. , Chaurasia Diksha
Published: December 2024

Background

Traumatic brain injuries (TBIs) are among the most challenging conditions to accurately diagnose in children, and many TBIs are underdiagnosed. Patients with maxillofacial injury may be at risk for TBI. The objective of this study was to analyse the association between maxillofacial injuries and TBI among paediatric patients. Analysis of the factors associated with the occurrence of TBI among paediatric patients with maxillofacial injuries was the secondary objective.

Method

This case-control study included 192 cases defined as paediatric patients with maxillofacial injuries and 192 controls defined as all paediatric patients with traumatic injuries to other body locations and with no maxillofacial injuries. The medical records of patients aged 0–18 years, who underwent treatment at a tertiary care hospital were screened. Patient demographic data, causes of trauma, and the presence, type, and severity of TBI were recorded. For the cases, the presence of facial fracture, type and severity of the maxillofacial injuries were recorded. The odds ratio was obtained to determine the association between maxillofacial injuries and TBI. Multiple logistic regression analysis was performed to study the associations of all the recorded study variables with the occurrence of TBI in patients with maxillofacial injuries.

Results

A statistically significant difference was seen between the cases and controls for TBI occurrence, with 53% of cases recording TBI, compared to 32% among controls, with an odds ratio of 2.5. Multiple logistic regression analysis with the presence/absence of TBI among the cases as the dependent variable revealed a significant association of road traffic accidents (RTA), longer duration of hospital stays, and dentoalveolar fracture with TBI.

Conclusion

Paediatric patients with maxillofacial injuries need to be screened for TBI, as the risk of occurrence of TBI is 2.5 times greater in these patients than in those with injuries involving other parts of the body. RTA and prolonged hospitalization are factors associated with TBI among paediatric patients with maxillofacial injuries. The presence of only dentoalveolar injuries decreases the likelihood of a TBI.
The association between different timeframes of air pollution exposure and COVID-19 incidence, morbidity and mortality in German counties in 2020
Authors: Hermanns Sophie , von Schneidemesser Erika , Caseiro Alexandre , Koch Susanne
Published: December 2024

Background

Ambient air pollution is a known risk factor for several chronic health conditions, including pulmonary dysfunction. In recent years, studies have shown a positive association between exposure to air pollutants and the incidence, morbidity, and mortality of a COVID-19 infection, however the time period for which air pollution exposure is most relevant for the COVID-19 outcome is still not defined. The aim of this study was to analyze the difference in association when varying the time period of air pollution exposure considered on COVID-19 infection within the same cohort during the first wave of the pandemic in 2020.

Methods

We conducted a cross-sectional study analyzing the association between long- (10- and 2-years) and short-term (28 days, 7 days, and 2 days) exposure to NO2 and PM2.5 on SARS-CoV-2 incidence, morbidity, and mortality at the level of county during the first outbreak of the pandemic in spring 2020. Health data were extracted from the German national public health institute (Robert-Koch-Institute) and from the German Interdisciplinary Association for Intensive Care and Emergency Medicine. Air pollution data were taken from the APExpose dataset (version 2.0). We used negative binomial models, including adjustment for risk factors (age, sex, days since first COVID-19 case, population density, socio-economic and health parameters).

Results

We found that PM2.5 and NO2 exposure 28 days before COVID-19 infection had the highest association with infection, morbidity as well as mortality, as compared to long-term or short-term (2 or 7 days) air pollutant exposure. A 1 μg/m3 increase in PM2.5 was associated with a 31.7% increase in incidence, a 20.6% need for ICU treatment, a 23.1% need for mechanical ventilation, and a 55.3% increase in mortality; an increase of 1 μg/m3 of NO2 was associated with an increase for all outcomes by 25.2 – 29.4%.

Conclusions

Our findings show a positive association between PM2.5 and NO2 exposure and the clinical course of a SARS-CoV2 infection, with the strongest association to 28 days of exposure to air pollution. This finding provides an indication as to the primary underlying pathophysiology, and can therefore help to improve the resilience of societies by implementing adequate measures to reduce the air pollutant impact on health outcomes.

Trial registration

Not applicable.
Tracking of serum lipids from prepuberty to young adulthood: results from the KiGGS cohort study
Authors: Truthmann Julia , Schienkiewitz Anja , Kneuer Antje , Du Yong , Scheidt-Nave Christa
Published: December 2024

Background

Universal lipid screening in childhood for early detection and treatment of familial hypercholesterolemia is under discussion, but will also detect children with multifactorial dyslipidemia. Results from population-based studies can support the design of public health strategies. As few previous studies considered pubertal changes in serum lipid levels, we examined tracking of serum lipids from prepuberty to young adulthood in a population-based cohort.

Methods

This longitudinal study includes 692 children from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS; baseline: 2003–2006, follow-up: 2014–2017) who were 6–8 years old at baseline, at least 18 years old at follow-up, and had measurements of serum total cholesterol (TC), high-density and non-high-density lipoprotein cholesterol (HDL-C; non-HDL-C) at both time points. We calculated proportions of participants by life stage-specific risk categories applying cut points for young children and young adults. We used correlation coefficients to estimate serum lipid tracking from childhood to young adulthood. The association between follow-up and baseline lipid levels was examined in sex-specific multivariable linear regression models including body mass index (BMI), health-related behaviors and medication use as covariables.

Results

The correlation coefficient between baseline and follow-up was 0.60 for non-HDL-C, 0.56 for TC, and 0.43 for HDL-C and was higher in males than in females. 67% of participants had acceptable and 9% had borderline/elevated non-HDL-C levels at both time points. Of participants with borderline/elevated non-HDL-C levels at baseline 32% remained in this category and 68% improved. Non-HDL-C levels at baseline explained 53% of the variance in levels at follow-up in males and 28% in females. After adjustment for covariables, the explained variance increased to 62% in males and 45% in females. An increase in BMI z-scores from childhood to young adulthood in all sexes and oral contraceptive use in females was positively associated with higher levels at follow-up.

Conclusions

Non-HDL-C levels in prepuberty are moderate predictors of levels in young adulthood, along with increasing BMI from childhood to young adulthood, and oral contraceptive use among women. Comprehensive strategies including public health interventions targeting elevated lipid levels and obesity in combination, are essential to prevent premature cardiovascular events.
Identifying an effective Chinese herbal medicine for reducing postoperative hidden bleeding and stabilizing blood volume following intertrochanteric femur fracture: a Bayesian network meta-analysis of randomized controlled trials
Authors: Wu Xiaowei , Yan Linglan , Wu Tianran , Tu Shaochen , Lin Yanbin
Published: December 2024

Objective

Chinese herbal medicine (CHM) is extensively utilized in managing hidden bleeding following an intertrochanteric femur fracture (IFF). Despite its widespread use, the most effective CHM approach for addressing hidden bleeding post-IFF remains unclear. A Bayesian network meta-analysis was conducted to identify a CHM that both effectively reduces hidden bleeding and stabilizes blood volume after IFF.

Methods

Comprehensive electronic searches were performed on databases in both Chinese and English, including the Chinese National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform (Wanfang), China Science and Technology Journal Database (VIP), PubMed, Web of Science, and Cochrane Library. All randomized controlled trials (RCTs) employing CHM to address hidden bleeding post-IFF, up to December 31, 2023, were thoroughly reviewed. The analysis utilized Stata17.0 and Review Manager 5.4 software, tailored to the frequentist framework.

Results

Thirty-one articles were included, encompassing 17 interventions and 2076 patients. The systematic analysis revealed that: For improving postoperative haemoglobin (HB), the top three interventions were conventional treatment combined with Yiqi Buxue decoction, Yangxue Rougan decoction, and Sanqi powder; For reducing hidden bleeding post-surgery, the leading interventions were conventional treatment combined with Siwu decoction, Yangxue Rougan decoction, and Qitian Keli prescription; For enhancing the Harris score, the top interventions were conventional treatment combined with Bazhen decoction, Danggui Buxue decoction, and Sanqi powder; Descriptive analysis indicated minimal adverse reactions and enhanced safety overall.

Conclusion

CHM presents a viable method for treating hidden blood loss after IFF. Yangxue Rougan decoction notably excels in reducing hidden bleeding and stabilizing HB levels, making it a preferred option. Nevertheless, further rigorous RCT studies are essential to compare various CHM treatments to establish the most effective options for clinicians.

PROSPERO registration number CRD42023489292.
OTULIN confers cisplatin resistance in osteosarcoma by mediating GPX4 protein homeostasis to evade the mitochondrial apoptotic pathway
Authors: Zheng Zehang , Zeng Yunhao , Bao Xing , Huang Chuang , Guo Fengjing , Xu Fei , Luo Zhengqiang
Published: December 2024

Background

Osteosarcoma (OS), the most prevalent primary malignant bone tumor in children and adolescents, arises from bone-forming mesenchymal cells. Despite advancements in surgical resection and neoadjuvant chemotherapy (cisplatin, doxorubicin, and methotrexate), chemotherapy resistance remains a significant challenge, leading to poor survival rates in patients with metastatic or recurrent OS.

Methods

In this study, we focused on the role of OTULIN, a key linear deubiquitinating enzyme, in OS chemoresistance. In addition, mechanistic investigations were carried out to identify potential downstream targets of OTULIN involved in cisplatin resistance.

Results

Our results demonstrated that OTULIN expression was significantly upregulated in OS tissues and cell lines following cisplatin treatment but not in response to doxorubicin or methotrexate. High OTULIN expression was associated with reduced survival in sarcoma patients. Furthermore, immunohistochemical analysis of prechemotherapy and postchemotherapy OS tissues revealed increased OTULIN expression in postchemotherapy samples. In vitro results demonstrated that OTULIN plays a critical role in mediating cisplatin resistance in OS. Mechanistically, GPX4 could be a downstream target of OTULIN, conferring cisplatin resistance to OS by blocking the mitochondrial apoptotic pathway but not ferroptosis. Specifically, OTULIN prevents the proteasomal degradation of GPX4 by reducing its ubiquitin level, thereby conferring resistance to cisplatin in OS cells.

Conclusion

This study highlights the importance of OTULIN in OS chemoresistance and provides a promising approach for targeting the OTULIN-GPX4 axis to improve the prognosis of OS patients. Our findings offer new insights into the molecular mechanisms underlying OS chemoresistance and suggest potential therapeutic targets for future clinical interventions.
Alteration of Rice Root Endophytic Bacterial Community Composition by Meloidogyne graminicola and Identification of Potential Biocontrol Agent
Authors: Kunda Pranamita , Mondal Sandip , De Debjit , Dhal Paltu Kumar , Mukherjee Abhishek
Published: December 2024

Introduction

Rice root gall is a severe infection caused by the rice root-knot nematode Meloidogyne graminicola. Overuse of chemical nematicides intensifies the need for a suitable biocontrol agent. Nematode infestation in plants alters the associated microbiome; however, their correlations need to be better understood. Hence, this work aimed to unravel the changes in indigenous endophytic bacterial community composition of rice root because of infection caused by M. graminicola and also to identify dominant bacteria strains as a potential biological control agent.

Material & Methods

The endophytic bacterial community of non-infected rice root and gall was analysed using a 16 S rRNA gene-based metagenomics approach. The dominant endophytic bacterial community was further isolated and screened for its PGP and nematicidal activity using bacterial cell suspension and culture filtrate to identify a potential biocontrol agent.

Result and Discussion

Our results show that nematode infection has altered the bacterial community composition, and a distinct community existed between gall and non-infected roots. This shift in the microbial community is associated with reduced species richness due to infection. We also observed that a few endophytic genera like Chryseobacterium, Rhizobium, Gemmata, and Pseudomonas that were unique to gall are reported to have been associated either with nematode or may have been recruited by plants as a growth promoter to combat nematode infection. Other bacterial endophytes that are specific to the non-infected root microbiome, like Delftia, Bacillus, Pantoea, Acidovorax, and Azorhizobium, are hypothesised to remain associated with rice seeds, and they possess biological control/plant growth promotion abilities. Further, after screening all isolates, Enterobacter sp. strain SSNI 8 isolated from a non-infected root was evaluated for its efficiency in acting as a nematicidal agent against M. graminicola, and we found that the strain showed 90% nematode mortality with its culture filtrate which may possess some secondary metabolites antagonistic to the nematode.

Conclusion

Overall, this study provided a comprehensive view of endophytes associated with gall in non-infected roots and identified a potential biocontrol agent.
Association between body temperature and all-cause mortality in patients with sepsis: analysis of the MIMIC-IV database
Authors: Zhao Yunuo , Zhang Bo
Published: December 2024

Background

Abnormal body temperature (fever or hypothermia) is a critical symptom in sepsis and is strongly associated with clinical prognosis and disease progression. Given the duality and variability of body temperature fluctuations throughout the disease course, further research is essential to refine clinical strategies for temperature management in sepsis patients.

Methods

We extracted clinical data of sepsis patients from the MIMIC-IV database. A restricted cubic spline (RCS) curve was employed to describe the non-linear relationship between body temperature and clinical outcomes. Based on peak temperature within the first 24 h after admission, patients were categorized into three groups: < 36 °C, 36–38 °C, and > 38 °C. We subsequently matched patients one-to-one into three cohorts using a pairwise propensity score matching (PSM) approach. Alongside clinical data, we conducted log-rank and McNemar tests, and established multiple models, including multiple Cox regression, overlap-weighted (OW) adjusted Cox regression, multiple logistic regression, and OW-adjusted multiple logistic regression, to investigate the impact of temperature on clinical outcomes.

Results

A total of 35,499 sepsis patients were included in my study: 311 with a temperature below 36 °C, 27,538 with a temperature between 36 and 38 °C, and 7650 with a temperature above 38 °C. The RCS analysis revealed a non-linear, U-shaped relationship between body temperature and 28-day, ICU, and in-hospital mortality. Patients with hypothermia had significantly higher 28-day mortality (54.34% vs. 19.28%), ICU mortality (44.37% vs. 12.89%), and in-hospital mortality (49.20% vs. 17.46%) compared to those with hyperthermia. Among patients younger than 65 years, hyperthermia was a protective factor against 28-day mortality relative to normal body temperature, while the opposite was observed in patients aged 65 and older. This trend was consistent in the analysis of ICU and in-hospital mortality.

Conclusions

Among sepsis patients admitted to the ICU, a peak temperature below 36 °C within the first 24 h of admission was associated with higher 28-day mortality. However, no significant difference in clinical prognosis was observed between normothermic and hyperthermic patients.
Clinicopathological significance of c-MET and HER2 altered expression in bladder cancer
Authors: Naguib Engy Mohammed , Ismail EF , Badran DI , Sherief MH , El-Abaseri TB
Published: December 2024

Background

Tumor recurrence or metastasis after surgery is a significant factor influencing bladder cancer (BC) prognosis. Novel molecular biomarkers are necessary to determine each patient’s specific outcome because current biomarkers have limited power for predicting prognosis. The proto-oncogene MET encodes c-MET, a tyrosine kinase receptor. When c-MET attaches to its ligand, it triggers several steps in the signal transduction cascade that control cell survival, proliferation, and invasion. c-MET is overexpressed in several carcinomas. The HER2 gene encodes another receptor tyrosine kinase (RTK). HER2 overexpression is linked to altered proliferation and increased aggressiveness in several malignancies. Identifying crosstalk partners of RTKs implicated in bladder cancer development may have a unique role in predicting aggressiveness. This study explored the expression status of c-MET and HER2 in human BC and their clinical significance in disease outcomes.

Methods

A quantitative real-time polymerase chain reaction was done on 40 BC patients who had undergone transurethral resection (TUR) or radical cystectomy and had a pathologically verified diagnosis of primary tumor without prior chemoradiotherapy as well as 20 patients with benign diseases who served as controls. The c-MET and HER2 expression levels were investigated, and their relationship with clinicopathological features was analyzed.

Results

c-MET and HER2 gene expression were significantly higher, 6.1- and 4.5-fold, in the study group compared to the controls. The frequency of c-MET and HER2 overexpression in the study group was 80% (32/40) and 90% (36/40), respectively. c-MET overexpression was associated with pathological stage(P = 0.002), tumor grade (P = 0.019), muscle invasion (P = 0.008), and node involvement (P = 0.017), while HER2 overexpression was associated with pathological stage(P = 0.033), invasion to muscles (P = 0.003), and node involvement (P = 0.005). Based on the Log-rank test, patients expressing both c-MET and HER2 had the poorest disease-free survival rates among all studied patients (median = 10 m, 3.0–16.9 95%CI).

Conclusion

There is a possible correlation between c-MET and HER2 gene overexpression and poor clinical outcomes in patients with BC.
Cost-effectiveness of ten commonly used antipsychotics in first-episode schizophrenia in the UK: economic evaluation based on a de novo discrete event simulation model
Authors: Zhou Junwen , Millier Aurelie , Aballea Samuel , Francois Clement , Jin Huajin , Williams Ryan , Lennox Belinda , Tsiachristas Apostolos , Toumi Mondher
Published: December 2024

Background

Previous economic evidence about interventions for schizophrenia is outdated, non-transparent and/or limited to a specific clinical context.

Aims

We developed a de novo discrete event simulation (DES) model for estimating the cost-effectiveness of interventions in schizophrenia in the UK.

Method

The DES model was developed based on the structure of previous models, populated with demographic, clinical and cost data from the UK, and antipsychotics' effects from recent network meta-analyses. We simulated treatment pathways for patients with first-episode schizophrenia including events such as relapse, remission, treatment discontinuation, cardiovascular disease and death and estimated costs (2020£) taking the National Health Service perspective and quality-adjusted life years (QALYs) over ten years. Using the model, we ranked ten first-line antipsychotics based on their QALYs and cost-effectiveness.

Results

Amisulpride was associated with the highest QALYs, followed by risperidone long-acting injection (LAI), aripiprazole-LAI (6.121, 6.084, 6.070, respectively) and others (5.947–6.058). The most cost-effective antipsychotics were amisulpride, olanzapine and risperidone-LAI, with total probability of rankings of 1, ≤2, ≤3, that is, 95%, 89%, 80%, respectively; meanwhile, the least cost-effective were cariprazine, lurasidone and quetiapine, with total probability of rankings of 10, ≥9, ≥8, that is, 96%, 92%, 81%, respectively. Results were robust across sensitivity analyses and influenced primarily by relapse relevant parameters.

Conclusions

Our findings suggest amisulpride (or risperidone-LAI where oral treatment is inappropriate) as the best overall first-line option based on QALYs and cost-effectiveness. Our ranking may be used to guide decision-making between antipsychotics. Our model is open source and could be applied to the other settings.
RNA gain-of-function mechanisms in short tandem repeat diseases
Authors: Davenport Mackenzie L. , Swanson Maurice S.
Published: December 2024

As adaptors, catalysts, guides, messengers, scaffolds, and structural components, RNAs perform an impressive array of cellular regulatory functions often by recruiting RNA-binding proteins (RBPs) to form ribonucleoprotein complexes (RNPs). While this RNA–RBP interaction network allows precise RNP assembly and the subsequent structural dynamics required for normal functions, RNA motif mutations may trigger the formation of aberrant RNP structures that lead to cell dysfunction and disease. Here, we provide our perspective on one type of RNA motif mutation, RNA gain-of-function mutations associated with the abnormal expansion of short tandem repeats (STRs) that underlie multiple developmental and degenerative diseases. We first discuss our current understanding of normal polymorphic STR functions in RNA processing and localization followed by an assessment of the pathogenic roles of STR expansions in the neuromuscular disease myotonic dystrophy. We also highlight ongoing questions and controversies focused on STR-based insights into the regulation of nuclear RNA processing and export as well as the relevance of the RNA gain-of-function pathomechanism for other STR expansion disorders in both coding and noncoding genes.
The morphology of a smartphonopathic hand – smartphone use and the median nerve cross-sectional area
Authors: Hasib Syed Wajahat , Usmani Ambreen , Anwar Syed Faraz , Mumtaz Asra
Published: December 2024

Objective: To investigate and compare the median nerve-cross sectional area at the wrist region of the dominant and non-dominant hands of high- and low- smartphone users.
Method: This descriptive cross-sectional study was based on 128 human subjects conducted at Bahria University Health Sciences Karachi Campus from January to June 2022. The sample size was calculated using the method of sample size for frequency in a population www.openepi.com which is an open-source calculator, version 3-SSPropor using the following equation: Sample size n = [DEFF*Np(1-p)]/[(d²/Z²1-α/2*(N-1)+p*(1-P)]. The subjects were from MBBS, BDS, DPT, and Dental House Officers. They were grouped into two categories: high-smartphone users and low-smartphone users, based on the smartphone addiction scale (SAS). Ultrasound was carried out on each subject’s wrist regions at the carpal tunnel level. The readings were compared between the dominant and non-dominant hands of each individual.
Results: In this descriptive cross-sectional study on 128 subjects, the difference between the median nerve cross-sectional areas (MN-CSAs) of the dominant and non-dominant hand of the high-smartphone group was highly significant (p=0.007). The difference between the MN-CSAs of the dominant and non-dominant hand of the low-smartphone group was significant too (p=0.0103).
Conclusion: Smartphone overuse resulted in an enlarged median nerve, especially in the dominant hand.
doi: https://doi.org/10.12669/pjms.41.1.9958
How to cite this: Hasib SW, Usmani A, Anwar SF, Mumtaz A. The morphology of a smartphonopathic hand – smartphone use and the median nerve cross-sectional area. Pak J Med Sci. 2025;41(1):200-204. doi: https://doi.org/10.12669/pjms.41.1.9958
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
MODERN DIGITAL METHODS AND PRACTICES FOR IMPROVING THE WORKFLOW OF A MANUFACTURING ENTERPRISE
Authors: Nagimzyanov S. D.
Published: December 2024

The work studies such principles and practices of work process implementation as gamification, information systems of knowledge control and testing. Their application in production, and specifically in the process of employees' work.
DIGITAL TECHNOLOGY DEVELOPMENT TRENDS IN AGRICULTURE
Authors: Minakov Andrey , Safiullin Il'nur , Mikhaylova Valerikovna , Zakharova Galina , Asadullin Nail'
Published: December 2024

Ensuring sustainable rates of Russian agriculture development requires significant investment, which is due to the introduction of digital technologies in the industry. The solution to this issue in practice is impossible without the implementation of federal projects and programs by the state. In recent years, certain trends in increasing production volumes have been achieved in the agricultural sector of Russia, which is also positively influenced by the digital solutions introduced into agriculture. Technologies with a quick payback have become especially popular among farmers of our country: fuel and lubricant consumption monitoring sensors; cloud solutions, the main purpose of which is forecasting, accounting, planning; digital solutions for agricultural enterprises with an industrial type of production; and the least - technologies related to forecasting or modeling due to their longer payback. By 2022, there is a decrease in the gap in the indicators characterizing the availability of websites, use of internet, computer networks in agricultural formations and the average values for all organizations in the country. The development and implementation of digital technologies in agricultural production requires the use of an integrated approach that would include the interaction of the state and business in the industry in order to achieve higher indicators. At the same time, we must not forget about legal support, and it is also necessary to improve the technological, organizational, financial, personnel components in solving the problem under consideration.