bluuebunny/crossref_metadata_2025_split huggingface dataset:
Good functional outcome but high rates of instability recurrence after posterior open‐wedge glenoid osteotomy for the treatment of posterior shoulder instability with increased glenoid retroversion at mid‐term follow‐up
Authors: Hinz Maximilian , Fritsch Lorenz , Siebenlist Sebastian , Lacheta Lucca , Pogorzelski Jonas , Rupp Marco‐Christopher , Scheiderer Bastian 
Published: December 2024

AbstractPurposeTo evaluate clinical, functional and radiological mid‐term outcomes following posterior open‐wedge glenoid osteotomy (POWGO) for the treatment of posterior shoulder instability (PSI) associated with increased glenoid retroversion.MethodsPatients who underwent POWGO for the treatment of symptomatic PSI with glenoid retroversion >10° and participated in a previous study assessing short‐term outcomes were included after a minimum follow‐up of 5 years. Clinical (Rowe score and physical examination) and functional outcomes (Oxford Shoulder Instability Score [OSIS] and visual analogue scale [VAS] for pain) were assessed. Preoperative versus follow‐up magnetic resonance imaging (MRI) assessments were compared for changes in posterior humeral head subluxation (PHHS) and progression of osteoarthritis (shoulder osteoarthritis severity [SOAS] score).ResultsEight patients (nine shoulders) were included 92.0 months (88.0–109.5 months) post‐operatively, of which seven patients (eight shoulders) underwent MRI. Shoulder function was good (Rowe score: 80.0 [76.3–91.3], OSIS: 41.0 [31.0–41.5]) and pain levels were low (VAS for pain: 3.0 [1.0–3.0]) at follow‐up. Overall, the degree of PHHS did not change between preoperatively and follow‐up (p > 0.05). Four shoulders demonstrated PHHS preoperatively, of which two had a centred humeral head at follow‐up. Shoulder osteoarthritis progressed significantly (SOAS score: 17.0 [11.0–24.5] to 33.0 [31.0–45.0], p = 0.018). Residual PSI was evident in 75.0% of shoulders.ConclusionAt mid‐term follow‐up, POWGO for PSI associated with increased glenoid retroversion led to good functional outcomes but failed to reliably restore posterior shoulder stability and prevent osteoarthritis progression.Level of EvidenceLevel IV.
Infratuberositary slope‐decreasing anterior closed wedge proximal tibial osteotomy is safe and shows rapid bone healing
Authors: Schuster Philipp , Mayer Philipp , Schubert Ilona , Leiprecht Janina , Micioi Gregoire , Reuter Benoit , Richter Jörg , Dickschas Jörg 
Published: December 2024

AbstractPurposeDifferent techniques of slope‐decreasing anterior closed‐wedge proximal tibial osteotomy (ACW‐PTO) have been described. To determine the peri‐ and post‐operative complication rate and obtain data on bone healing in ACW‐PTO with an infratuberositary approach.MethodsA total of 170 consecutive ACW‐PTO of two sports‐orthopaedic centres were retrospectively evaluated (97 and 73, respectively). Routine follow‐up was performed after 6 weeks and was available in 166 cases (97.7%). Medical charts and x‐rays of these cases were reviewed with regard to technique‐specific complications. Lateral x‐rays (n = 155) at 6 weeks post‐operatively were evaluated with regard to bone healing (completely healed, partially healed or with no or delayed signs of bone healing). A multivariate binary logistic regression was performed to detect factors that influence bone healing.ResultsThere was one case with haematoma and superficial wound‐healing problems after 5 weeks with progression to a deep wound infection and revision surgery (plate exchange) at 11 weeks after the index surgery. One case with delayed bone healing was treated with plate exchange combined with revision anterior cruciate ligament reconstruction after 4 months. The further course of both cases was uneventful. No other complications were observed. Therefore, the overall complication rate was 1.2% (2 out of 166). Radiologic evaluation at 6 weeks showed complete healing in 104 cases (67.1%), partial healing in 50 cases (32.3%) and delayed healing only in the aforementioned case (0.6%), respectively. All cases of partial healing showed complete healing at 12 weeks. In regression analysis, a completely closed osteotomy (odds ratio [OR] = 3.5, p = 0.003) and compression of the osteotomy (OR = 2.5, p = 0.026) were significantly associated with complete bone healing at 6 weeks.ConclusionsACW‐PTO using an infratuberositary approach is very safe with regard to complication rate and shows rapid bone healing. The osteotomy should be completely closed and compression should be applied for optimal bone healing.Study DesignCase series with pooled data of two centres.Level of EvidenceLevel 4.
Enhancing Polypropylene/Polyethylene Blend Performance Through Compatibilization for A Sustainable Future: A Mini Review Focusing on Establishing Bio‐Derived Filler Based Hybrid Compatibilizer System
Authors: Zhan Ke , Elder Thomas , Peng Yucheng 
Published: December 2024

AbstractPolypropylene (PP) and polyethylene (PE) are widely used polymers but significantly contribute to plastic waste. Effective recycling of PP and PE is essential for reducing plastic pollution and enhancing sustainability. Collection of post‐consumer PP and PE wastes forming comingled mixtures is routinely done due to the difficulty of sorting. While polymer blending offers a cost‐effective way to recycle these mixtures, their inherent immiscibility limits the development of high‐performance blends. This review provides an overview of recent advances in compatibilization strategies aimed at enhancing the PP/PE blend performance, with a focus on using bio‐derived fillers as sustainable compatibilizers. Mechanical properties of the PP/PE blends compatibilized by various approaches, including non‐reactive, reactive, and bio‐derived filler compatibilizations are summarized and discussed in terms of their advantages and weaknesses. Simultaneous incorporation of bio‐derived fillers and commercial compatibilizers potentially provides PP/PE blends with more desirable mechanical performance. Furthermore, the review summarizes the rheological and crystallization behaviors of compatibilized blends, emphasizing the significant impact of compatibilization on the processing‐structure‐property relationships within the blends. Current challenges and future directions in using bio‐derived fillers to enhance PP/HDPE compatibilization are discussed. This review provides insight into a sustainable future by endowing plastic waste with desirable properties for broader applications.
Redox regulation of cancer stem cells: Biology and therapeutic implications
Authors: Du Min , Zhang Jian , Wicha Max S. , Luo Ming 
Published: December 2024

AbstractCancer stem cells (CSCs) are a small group of tumor cells with the capacity to undergo self‐renewal and differentiation. These cells not only initiate and maintain tumor growth, but also confer resistance to current cancer therapies. CSCs display a high degree of plasticity and can be generated under therapeutic stress via dedifferentiation from non‐stem‐like tumor cells, suggesting the necessity simultaneously targeting CSCs and bulk tumor cells to achieve the best therapeutic effect. Despite the findings that therapeutic stress induces CSC plasticity, the mechanisms underpinning CSC formation and therapeutic resistance are not fully defined. Tumor cells display elevated levels of reactive oxygen species (ROS), contributed by rapid proliferation, enhanced metabolic demands and oncogenic signaling. CSCs achieve redox homeostasis partly by regulating redox‐sensitive transcription factors (TFs), including NRF2, HIF‐1α, BACH1, NF‐kB, FOXOs, AP‐1, and others. This review aims to summarize the roles and underlying mechanisms of these TFs in regulation of CSCs and tumor progression from the perspectives of stem cell maintenance, metabolic reprogramming, epithelial–mesenchymal transition (EMT) and angiogenesis. We also discuss the potentials of utilizing specific inhibitors for these TFs in suppressing drug resistance and metastasis by repressing CSC activity, an approach that may provide new targeted therapies for advanced cancer and improve patient outcome.
Functional Capacity and Quality of Life in Elderly Patients With Knee Osteoarthritis
Authors: Fazaa Alia , Rachdi Mariem , Salem Leila Ben , El Ghardallou Meriam , Miladi Saoussen , Boussaa Hiba , Makhlouf Yasmine , Abdelghani Kaouther Ben , Laatar Ahmed 
Published: December 2024

ABSTRACTBackgroundKnee Osteoarthritis (KOA) can cause considerable impairment of functional capacity and quality of life (QoL), especially in elderly individuals.ObjectivesTo evaluate the impact of KOA on the functional capacity and QoL of elderly patients and to identify the factors associated with their impairment.MethodsThis was a cross‐sectional study including patients aged 65 years or more with primary KOA. Functional capacity was assessed using the WOMAC index and QoL using the WHOQOL‐OLD instrument. The p significance level was set at 0.05.ResultsFifty patients were included, 3 men and 47 women, with a mean age of 71.9 ± 6.3 years. The mean WOMAC total score was 49.2 ± 21.7, WOMAC pain 12 ± 5.2, WOMAC function 33.4 ± 15.2 and WOMAC stiffness 4 ± 2.6. Factors associated with better functional capacity were the use of analgesics, functional rehabilitation and physical activity. The mean WOQOL‐OLD total score was 84.2 ± 13.4. The autonomy and intimacy dimensions had the highest scores (92.1 ± 13.8 and 91.3 ± 16.5 respectively). The death and dying dimension had the lowest score (69.9 ± 37.1). Factors associated with a poor QoL were diabetes, unilateral involvement, duration of KOA, absence of analgesic treatment and the absence of physical activity. Functional limitation was significantly associated with poorer QoL.ConclusionIn our study, KOA was found to be associated with impaired functional capacity and QoL among elderly patients. Comorbidities, inadequate use of analgesics and lack of physical activity seem to be determining factors contributing to this impairment.
Carnitine supplementation in progressive supranuclear palsy
Authors: Dixit Devika , Zhao Yang , Bardhi Olgert , Daneshmand Arvin , Phillips Jonathan , Bala Trina , Rosenthal Martin , Mohr Alicia , Kandiah Prem , Kamel Amir Y. 
Published: December 2024

AbstractMitochondrial dysfunction has been implicated in the pathogenesis of several neurodegenerative disorders, including progressive supranuclear palsy (PSP). PSP is a Parkinsonian syndrome characterized by a rapidly progressive state that manifests itself as tremors, bradykinesia, and supranuclear gaze palsy. Carnitine plays an essential role in mitochondrial function by transporting fatty acids across the mitochondrial membrane to be used in energy production. Mitochondrial dysfunction can bring about rapid neuronal depolarization and a calcium‐mediated cellular apoptosis owing to a loss of oxidative metabolism, likely contributing to the PSP disease process. A White man aged 65 years with PSP presented with small bowel obstruction and severe malnutrition as a result of prior gastrointestinal surgeries for which a gastrostomy tube was placed. During his hospitalization, the patient was found to be deficient in both free and total carnitine. He was treated with levocarnitine supplementation and exhibited marked improvement in tremors, fatigue, and physical therapy activities. Posthospitalization follow‐up showed sustained improvement in symptoms with continued levocarnitine supplementation. Treatment of PSP remains largely supportive in nature. No studies have investigated the role of carnitine supplementation in PSP. To our knowledge, this is the first case report to identify improvement in PSP symptoms after carnitine repletion and supportive care. Numerous animal studies have reported on carnitine supplementation in the context of mitochondrial dysfunction associated with neurodegenerative diseases, such as Parkinson disease and Alzheimer disease. Further investigation is necessary to elucidate the precise role of carnitine and other nutrition supplements in the pathophysiology of PSP.
The workforce scheduling and routing problem with park‐and‐loop
Authors: Cabrera Nicolás , Cordeau Jean‐François , Mendoza Jorge E. 
Published: December 2024

AbstractThis article introduces formulations and an exact algorithm for the workforce scheduling and routing problem with park‐and‐loop. This problem extends the standard workforce scheduling and routing problem by allowing the use of walking subtours in the routes. We introduce a compact arc‐based formulation as well as a path‐based formulation with an exponential number of variables. To efficiently solve the latter, we propose a branch‐price‐and‐cut algorithm that leverages state‐of‐the‐art techniques, including a tailored version of the pulse algorithm to solve the pricing problem and the separation of subset row inequalities to strengthen the lower bound. We report on computational experiments carried out on a set of instances with up to 75 tasks adapted from the literature. The results show that our method systematically outperforms a standard MIP solver, proving optimality for 241 out of 324 instances. We also report experiments on the closely‐related service technician routing and scheduling problem, where our method delivered 12 new best solutions on a 54‐instance testbed from the literature.
Treatments and Outcomes of Pediatric Head and Neck Lymphatic Malformations: A 20‐Year Single Institution Experience
Authors: Zhao Jared , Thompson Elaine , Weiss Clifford Raabe , Walsh Jonathan 
Published: December 2024

AbstractObjectiveExamine the management and outcomes of pediatric head and neck lymphatic malformations (HNLMs).Study DesignRetrospective case series.SettingTertiary academic hospital.MethodsPatients aged 18 years or younger treated for HNLMs at Johns Hopkins Hospital from 2000 to 2023 were identified. Demographics, clinical characteristics, and treatment courses were recorded from charts. Outcome measures included estimated clinical post‐treatment size reduction and complications. Fisher's exact test was performed for comparisons between treatments.ResultsWe identified 101 pediatric patients (50.5% female) with HNLMs. Fifty‐two received unimodal treatment, 11 received multimodal treatment, and 38 underwent active observation or no treatment. Of those who received treatment, 44% had their first treatment before 2 years of age. 54.5% of all patients received sclerotherapy. Sclerotherapy caused nearly complete or complete resolution in 52.2% (n = 24) of low‐stage (de Serres Stages 1‐3) HNLMs and complete resolution in 26.1%. Most (71.4%) high‐stage (de Serres Stages 4‐5) malformations demonstrated limited size reduction response to all treatments. Surgery had a higher all‐inclusive complication rate (25%) compared to sclerotherapy (17%). Multimodal treatment strategies were most often used to treat microcystic malformations of all stages, achieving a 42.9% nearly complete or complete resolution rate.ConclusionLow‐stage and macrocystic pediatric HNLMs respond well to treatment. Sclerotherapy had the lowest complication rate. High‐stage malformations had limited size reduction response to multimodal treatment. As new medical therapies continue to develop, opportunities for improved treatment algorithms will emerge.
National Trends and Benchmarks for Operative Time and Hospital Length of Stay in Parotidectomies
Authors: Calcano Gabriela A. , Rourk Katelyn S. , Glasgow Amy , Habermann Elizabeth B. , Henson Jammie , Price Daniel L. , Tasche Kendall K. , Van Abel Kathryn M. , Moore Eric J. , Yin Linda X. 
Published: December 2024

AbstractObjectiveThe extent of parotidectomy for benign tumors has de‐escalated in the United States. We aim to define modern benchmarks for operative time and hospital length of stay (LOS) in parotidectomy and identify risk factors that may prolong these benchmarks.Study DesignThis is a retrospective cross‐sectional study of all adults who underwent parotidectomy for a primary parotid neoplasm between January 2011 and December 2021 using the American College of Surgeons National Surgical Quality Improvement Program database.MethodsThe extent of parotidectomy was defined using Current Procedural Terminology codes. Prolonged operative time and LOS were defined as above the 75th percentile (longer than 194 minutes and more than 1 day, respectively). Multivariable logistic regression was used to identify patient and surgical risk factors that predict prolonged operative time or LOS.ResultsBenign parotidectomies are mostly performed as outpatient procedures in the United States (average LOS <1 day). Prolonged operative time was independently associated with malignant tumors versus benign tumors (adjusted odds ratio [aOR]: 2.7, 95% confidence interval [CI]: 2.4‐3.0), total parotidectomy with facial nerve sacrifice versus lesser extent of parotidectomy (aOR: 2.3, 95% CI: 1.7‐3.0), and simultaneous reconstructive procedures versus none (P < .001 for all). These features were similarly independently associated with prolonged LOS (P < .001 for all). Complication rates were universally low.ConclusionThe majority of superficial parotidectomies in this country are performed as outpatient procedures requiring <3 hours of operative time, with low complication rates. Malignant tumors, greater extent of parotidectomy, and simultaneous procedures were independently associated with prolonged operative time and LOS. These national benchmarks can inform operating room and hospital bed resource assignments.
Dissecting the Circadian Clock and Toll‐like Receptor Gene Alterations in Meniere's Disease and Vestibular Migraine
Authors: Yang Ming‐Yu , Wu Ching‐Nung , Lin Yu‐Tsai , Tsai Ming‐Hsien , Hwang Chung‐Feng , Yang Chao‐Hui 
Published: December 2024

AbstractObjectiveTo investigate alterations in the expression of circadian clock and Toll‐like receptor (TLR) genes in peripheral blood (PB) leukocytes of patients with Meniere's disease (MD) and vestibular migraine (VM), and determine whether these gene expressions can differentiate MD from VM.Study DesignObservational prospective study.SettingTertiary academic medical center.MethodsPB leukocytes were collected from patients diagnosed with MD and VM during recent vertigo attacks, as well as from healthy controls. The expression levels of 9 circadian clock genes and 6 TLR genes were analyzed using real‐time quantitative reverse transcriptase‐polymerase chain reaction.ResultsSixty‐nine participants were enrolled, including 28 patients with MD, 14 patients with VM, and 27 healthy controls. Both MD and VM groups showed lower expression of PER1 compared to the control group (P < .01). The VM group exhibited significantly lower expression of PER1, PER2, CRY1, BMAL1, CLOCK, and TIM compared to the MD group (all P < .001). The MD group had higher TLR9 expression than the control group, and elevated TLR4, TLR8, and TLR9 expression compared to the VM group (P < .05). In the VM group, patients with severe dizziness handicaps had significantly lower expression of PER2, CRY1, CRY2, and CK1ε compared to those with mild to moderate handicaps (P < .05).ConclusionThis study identifies distinct alterations in the circadian clock and TLR gene expression in MD and VM, suggesting potential differences in the pathogenesis of these 2 vertiginous disorders and highlighting the possibility of these gene expressions as biomarkers for differentiation.
Hiatal Hernia and Zenker's Diverticulotomy Outcomes
Authors: Wallerius Katherine P. , Peraza Lazaro R. , Ali Hawa M. , O'Byrne Thomas J. , Awadallah Andrew S. , Bayan Semirra L. , Song Louis Wong Kee , Ekbom Dale C. 
Published: December 2024

AbstractObjectiveTo compare reflux symptoms, Zenker's diverticulum recurrence, and clinical outcomes in patients with and without a history of hiatal hernia who underwent Zenker's diverticulotomy (ZD).Study DesignSingle institution retrospective review.SettingTertiary care academic hospital.MethodsA retrospective review of patients with and without a history of hiatal hernia who underwent ZD via an open stapler, rigid endoscopic CO2 laser, stapler, or harmonic scalpel technique from January 2006 to December 2020 was performed. Data were abstracted for patient demographics, reflux symptoms, and rates of adverse events and symptomatic recurrence.ResultsA total of 426 patients were included in the study, 97 (22.8%) of which had a history of hiatal hernia. Eleven patients (11.3%) with a history of hiatal hernia had undergone Nissen fundoplication prior to ZD. Patients with a history of hiatal hernia showed less symptomatic improvement postoperatively. Significant differences were noted in the change in the Eating Assessment Tool (EAT‐10) (P < .01) and Reflux Symptom Index (RSI) (P = .03) where patients without a history of hiatal hernia improved more than hiatal hernia patients. Despite these differences in symptom relief, rates of postoperative complications and rates of recurrence did not significantly differ between groups. The median time to recurrence was similar for both groups.ConclusionPatients without a history of hiatal hernia had significantly larger improvements in EAT‐10 and RSI scores compared to patients with a history of hiatal hernia. However, these differences in scores may not represent clinically meaningful differences. There were no significant differences in postoperative adverse events or in recurrence of the Zenker's diverticulum between groups.
Neutrophil‐to‐Lymphocyte Ratio and Pembrolizumab Outcomes in Oral Cavity Squamous Cell Carcinoma
Authors: Truong Angeline A. , Lee Rex H. , Wu Xin , Algazi Alain P. , Kang Hyunseok , El‐Sayed Ivan H. , George Jonathan R. , Heaton Chase M. , Ryan William R. , Jeon Yena , Kim Mi‐Ok , Ha Patrick K. , Wai Katherine C. 
Published: December 2024

AbstractObjectiveTo determine the relationship between pretreatment neutrophil‐to‐lymphocyte ratio (NLR) and 6‐month progression‐free survival (PFS)/2‐year overall survival (OS) among patients with recurrent or metastatic (R/M) oral cavity cancer on pembrolizumab.Study DesignThis study was a retrospective, observational study performed at a tertiary care academic center.SettingParticipants included patients with oral cavity squamous cell carcinoma (OCSCC) who began pembrolizumab treatment at the University of California, San Francisco between May 2016 and May 2022.MethodsThe primary outcome was a 6‐month PFS. The secondary outcome was a 2‐year OS. NLR was treated as a continuous variable. Disease progression was determined using radiographic criteria, adopted from the Response Evaluation Criteria in Solid Tumors.ResultsFifty‐two patients with OCSCC were included. Immune checkpoint inhibitor (ICI) indication was recurrence/metastasis for all patients. The median pretreatment NLR was 5.7 (interquartile range: 3.6‐7.6). Twenty‐seven (55%) patients received pembrolizumab alone. Of those receiving treatment for R/M prior to ICI, 9 (18%) received salvage surgery and adjuvant therapy, 2 (4%) received chemotherapy alone, 1 (2%) received chemoradiation, and 10 (20%) received salvage surgery. Nineteen (36.5%) patients had distant metastases at the start of ICI. Six‐month PFS was 46%. Two‐year OS was 44%. NLR was independently associated with 6‐month PFS [hazard ratio, HR: 1.05 (95% confidence interval, CI: 1.01‐1.11), P = .028] and 2‐year OS [HR: 1.12 (95% CI: 1.05‐1.20), P < .001].ConclusionHigher pretreatment NLR was associated with poorer 6‐month PFS and 2‐year OS in OCSCC patients treated with pembrolizumab.
How to be a Better Surgeon: The Evidence for Surgical Coaching
Authors: Padia Reema , Wang Cynthia , Henry LaKeisha , Ishman Stacey L. , Jamal Nausheen 
Published: December 2024

AbstractSurgical coaching has made a positive contribution to surgical training and practice; however, the otolaryngology–head and neck surgery literature is lacking. The operating environment for practicing surgeons, and specifically otolaryngologists, is continually changing due to advancements in technology and new practice patterns. These changes in practice, however, have not come with a coordinating system for operative feedback once surgical training is completed. In this commentary, we explore surgical coaching, its applicability to otolaryngology, and encourage its more widespread acceptance and implementation.