bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Three-in-One Wonder”: A Retrospective Cohort Study on Modified Robotic-Assisted Transoral Thyroidectomy
Authors: Wen Xiaoyong , Zhou Shiwei , Wu Peng , Li Wu , Li Hui , Wang Zhiyuan , Zhang Lu , Li Jigang , Peng Xiaowei 
Published: December 2024

Importance With advancements in robotic surgery, robotic-assisted thyroidectomy is gaining popularity. The introduction of the 3-port transoral robotic thyroidectomy (T-TORT) offers an alternative approach with potential benefits in postoperative recovery compared to traditional methods. Objective To assess the safety and feasibility of T-TORT in comparison to the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Design A retrospective cohort study with 1:1 propensity score matching was conducted to compare perioperative outcomes between T-TORT and TOETVA. The learning curve was analyzed using cumulative summation (CUSUM). Setting Tertiary A hospital. Participants One hundred sixty-two patients who underwent either T-TORT or TOETVA were included. Intervention or Exposures The T-TORT group underwent three-port robotic thyroidectomy, while the TOETVA group received standard transoral vestibular endoscopic thyroidectomy. Main Outcomes and Measures Demographics and perioperative data were compared. The learning curve was evaluated using CUSUM. Results Compared with the TOETVA group the operation time in minutes of the T-TORT group was relatively longer (136.14 ± 36.52 vs 122.49 ± 34.85, P = .012), the postoperative stay, in days, was shorter (2.77 ± 0.78 vs 3.51 ± 0.95, P < .001), the drainage volume on a postoperative day 1 (POD1) and POD2, in milliliter, was less (POD1 56.57 ± 23.29 vs 65.12 ± 26.04, P = .029 and POD2 27.43 ± 25.29 vs 38.21 ± 25.09, P = .008). The other statistics, including bleeding amount, retrieved and metastatic central lymph nodes, visual analog scale score, and drainage volume on an operative day were comparable between the 2 groups. Meanwhile, there were no significant differences between the 2 groups in postoperative complication rates. The turning point of the learning curve was in the 16th case with a hemithyroidectomy with central neck dissection (CND) and the 21st case with a bilateral thyroidectomy with CND. Conclusions and Relevance T-TORT is a safe and feasible option with enhanced postoperative recovery compared to TOETVA. It may be a preferable choice in specific clinical situations. Trial Registration This study was registered at the Chinese Clinical Trial Registry (UIN: ChiCTR2300069021, https://www.chictr.org.cn ) in accordance with the World Medical Association’s Declaration of Helsinki, 2013.
Effects of Tangduqing Granules on Insulin Resistance and Their Association with AhR and PPARs Regulation in Type 2 Diabetic Rats Exposed to Persistent Organic Pollutants
Authors: Zhang Lu , Guo Shengnan , Gao Yue , Jiang Murong , Liu Qiumei , Yang Wenli , Liu Yao , Qian Rui , Wu Shentao , Liu Hongyi 
Published: December 2024

Objectives Tang Du Qing granules, a traditional Chinese medicine for diabetes, may alleviate insulin resistance induced by persistent organic pollutant exposure. This study aims to explore the mechanism by which Tang Du Qing granules improve insulin resistance in rats exposed to PCB126. Methods Male ZDF (fa/fa) rats were divided into a PCB126-exposed group and a model control group. Male ZDF (fa/+) rats served as the normal control group. Normal controls received a regular diet with olive oil via gavage, while the model control group received special feed with olive oil. PCB126 group received special feed with PCB126 in olive oil for 8 weeks. Post-exposure, the positive drug treatment group received CH223191, and Tang Du Qing granules were administered at high, medium, and low doses for 4 weeks. Relevant biochemical indicators and molecular signaling changes were assessed. Results PCB126 exposure increased levels of FBG, FINS, HOMA-IR and elevated serum TG, TC, and FFA in ZDF (fa/fa) rats compared to the model control group ( P < .05). The Tang Du Qing-treated group showed decreased FBG, FINS, HOMA-IR levels, and reduced serum TC, TG, and FFA compared to PCB126-exposed control group ( P < .05). Additionally, the Tang Du Qing-treated group downregulated hepatic AhR, CD36, and TNFα expression, while upregulating PPARα, PPARγ, GLUT4, and FGF21 expression ( P < .05). Conclusion Tang Du Qing granules ameliorate glucose and lipid toxicity and insulin resistance induced by PCB126 exposure in ZDF (fa/fa) rats by modulating the imbalance between AhR and PPARs and related molecular signals.
A Novel Simulation Model and Training Program for Minimally Invasive Surgery of Hallux Valgus
Authors: Morales Sergio , Lam Peter , Amy Cerrato Rebecca , Mococain Pablo , Ruz Cristian , Filippi Jorge , Villa Andrés , Varas Julián 
Published: December 2024

Category: Bunion Introduction/Purpose: Minimally Invasive Surgery (MIS) for Hallux Valgus (HV) has become popular with similar results as open surgery with added benefits such as lower post-operative opioid use and improved cosmesis. However, adopting this technique faces challenges due to a pronounced learning curve. This study aims to address these challenges by developing and validating an innovative simulation model and training program, targeting enhanced proficiency in HV MIS. Methods: A training program and a simulation model for HV MIS were designed based on recommendations from three experts. The phantoms were created using computed tomography scans of a patient with mild HV deformity, with iterative refinement through 3D printing and testing. Four experts performed a satisfaction survey of the phantoms. Participants, categorized into two groups based on MIS experience, underwent blind assessments. Evaluation parameters, including Objective Structured Assessment of Technical Skills (OSATS), surgical time, and X-ray usage. Four orthopedic surgeons without MIS experience took the program that encompassed six-session instructional lessons, hands-on practice on simulated models, and immediate feedback. The program concluded with a cadaveric surgery and a program evaluation survey. Four foot and ankle surgeons with vast experience performed the same procedure with one simulated model in order to compare the two groups' initial performance.The desired performance for novices was set at 80% of experts' performance for OSATS score. Results: Expert evaluation of the phantoms indicated high satisfaction with anatomical representation, handling properties, and utility as a training tool. The expert group consistently outperformed novices at the initial assessment across all outcomes, demonstrating OSATS scores of 24 points (range 23-25) vs. 15.5 (range 12-17) (p=.01), median surgical times of 22.75 minutes (range 12-27) vs. 48.75 minutes (38-60) (p=.02), and median X-ray usage of 70 (range 53-102) vs. 232.5 (range 112-280) (p=.02). Novices exhibited a significant improvement in OSATS scores from the fifth session onward (p = .01), reaching the desired performance of 20 points. Performance at the final training with the phantom did not differ from cadaveric surgery outcomes for all parameters. All trained novices expressed high satisfaction regarding the training program and reported that this program effectively enhanced their surgical skills and confidence. Conclusion: This study validated a simulation phantom model and training program, allowing non-experienced HV MIS orthopedic foot and ankle surgeons to enhance their surgical proficiency and effectively complete a substantial portion of the learning curve at the fifth session, and this performance was successfully transferred to a cadaveric model. [Figure: see text]
Acute Complications and Safety Analysis of In-Hospital vs In-Office Based Flexor Tenotomy Procedure for the Treatment of Forefoot Deformity
Authors: Gauthier Chase , Bakaes Yianni , Gonzalez Tyler , Jackson J. Benjamin 
Published: December 2024

Category: Lesser Toes; Other Introduction/Purpose: A Flexor Tenotomy (FT) is a procedure that can be performed in a minimally invasive fashion for the treatment of a symptomatic flexible hammertoe or diabetic ulcers on the tip of the toe or dorsally over the PIP joint. Today, there is conflicting data regarding its complication rate and limited data for patient-reported outcomes following the procedure. Additionally, the safety of this procedure has not been rigorously studied in the in-hospital vs the in-office location of service. Our study looks to evaluate the rate of acute complications, recurrences, revisions, and patient-reported outcomes for both in-hospital and in-office FT procedures. Methods: A retrospective review was conducted for patients who had undergone FT procedure at Prisma Health – Midlands between February 1st, 2021, and April 31st, 2023. Data collected included demographic data, complications, revision rates, hospital readmission, and PROMIS scores preoperatively and at 3 and 6 months postoperatively. Rates of complications, revisions, readmissions, and differences between preoperative and postoperative PROMIS scores were calculated and compared between in-hospital and in-office clinical settings. Results: A total of 130 patients were evaluated. There was found to be no significant difference in the rate of complications, revisions, or readmission between the in-hospital and in-office groups (P=0.277, 0.327, 0.837, respectively). Additionally, there was a significant decrease in Pain Interference PROMIS scores at 3 and 6 months in the in-patient group and a significant increase in Physical Function PROMIS scores at 3 months in the in-office group (P=0.001, 0.028, 0.041, respectively). Finally, there was no significant difference in the change of PI, PF, or mobility PROMIS scores between the in-hospital and in-office groups at 3 (P=0.194, 0.379, 0.734, respectively) or 6 months postoperatively (P=0.364, 0.598, 0.25). Conclusion: We found similar rates of complications, revision procedures, readmissions, and change in patient-reported outcomes between FT performed in either an in-hospital or in-office setting. These findings suggest that FT is a safe and effective procedure, regardless of the clinical setting in which it is performed.
Evaluating Morphology of the Peritalar Joints Using Surface Mapping Based 3D Remodeling Technique: A Large Sample Sized Cadaveric Study
Authors: Wallace Conor , Zhu Mingjie , Nocek Michael , Huang Jingdian , Nolte Charles , Wittels Stephen , Alder Catherine , Challapalli Ariyani , Baldini Todd , Orr Caley M. , Myerson Mark , Li Shuyuan 
Published: December 2024

Category: Hindfoot; Ankle Introduction/Purpose: Recent studies have highlighted the important role of peritalar joint congruence in maintaining the alignment of the hindfoot. Peritalar subluxation is associated with a variety of pathological deformities including flatfoot, cavovarus foot, clubfoot, as well as foot and ankle stress fractures. To date, studies of peritalar joint congruence have all been performed using either XR, WBCT based direct measurements, or 3D segmentation and analysis. However, none of these techniques can demonstrate the cartilage location nor disruption, nor the exact location of the articulation on the bone surface. Data bias caused by the limitations of these study methodologies is therefore inevitable. This study used 3D surface mapping to assess morphometrics of the cartilage surfaces of the peritalar joints. Methods: 18 fresh-frozen cadaveric feet without trauma nor surgery or significant deformities were dissected to expose the calcaneus, cuboid, talus, navicular bones, and their articular surfaces. Surface mapping of the articular surfaces and bones was completed using an Artec Spider 3D Scanner. Further digital analysis was completed using GeoMagic Studio 10 and Materialise Mimics 22. Descriptive and comparative analyses were performed using SAS software. Paired T-test was used to compare the size of articular surfaces in each joint. Statistical significance level was set to P < .05. Results: Detailed information of the articular surfaces is summarized in Table 1. The average articular area on both sides of the joint matched each other well in the posterior facets of the subtalar joint (5% difference), and calcaneocuboid joint (6% difference) without significant statistical difference, but not in the anterior & middle facets of the subtalar joint, nor the talonavicular joint. In the anterior & middle facets of the subtalar joint, the cartilage articular area on the talus side was 121% of that on the calcaneus mostly due to the difference between middle facet (p < 0.05); and in the talonavicular joint the cartilage articular area on the navicular was 144% of that on the talus (p < 0.05). Conclusion: The cartilage articular surfaces in certain peritalar joints do not match its opposing surface in size. In the talonavicular joint, it is easy to understand since area of the socket must be much smaller than that of the ball in order for the joint to glide and rotate. There must be functional reasons for this phenomenon to happen in the anterior and middle facets of the subtalar joint, which need further investigation. This study shows that the extent of subluxation of the peritalar joints may be physiological and should not necessarily be considered as pathological.
Evaluation of the Impact of Tibiotalar Fusion and Total Ankle Arthroplasty on Simulated Driving
Authors: Bedard Alexandre , Desautels Éric , Gagnon Guillaume , Angers Magalie , Bedard Sonia , Cabana François , Hamel Mathieu , Lebel Karina , Champagne Philippe-Hugo 
Published: December 2024

Category: Ankle Arthritis; Ankle Introduction/Purpose: Tibiotalar Fusion (TF) and total ankle arthroplasty (TAA) are both viable choices for addressing tibiotalar osteoarthritis. Nevertheless, a definitive agreement on the most effective approach to restore optimal function, particularly in terms of safe emergency braking during car driving, is yet to be established. The primary aim of this investigation was to evaluate the break reaction time (BRT), total braking time (TBT), and maximal braking force (MBF) in individuals who underwent TF and TAA using a validated driving simulator. Secondary outcomes encompassed patient-reported measures of pain and functional outcomes. Methods: This observational study assesses the emergency braking capabilities of individuals undergoing either total ankle arthroplasty (TAA) or tibiotalar fusion (TF) in simulated driving scenarios. The participants were categorized into three groups: 1) TAA, 2) TF, and 3) Healthy Elderly (HE) aged 75 years and older, deemed still fit for driving. To be eligible for evaluation on the driving simulator, patients in the TAA and TF groups were required to have a minimum of a 1-year follow-up. Break reaction time (BRT), total braking time (TBT), and maximal braking force (MBF) were recorded with and without distraction during a single visit to the research center. Additionally, Ankle Osteoarthritis Scale (AOS) results were collected for all participants in TF and TAA. Results: This study, conducted between 2018 and 2022, included a total of 84 participants, with 21 TF, 21 TAA, and the remaining 42 serving as healthy elderly controls (HE). There was no significant difference between the TF and TAA groups with respect to MBF (p=0.4921), BRT (p=0.8734) or TBT (p= 0.7989). The TAA group and the TF group were significantly faster than the HE regarding TBT with a distraction (p=0.0463 and p=0.0049 respectively). The AOS score was significantly better in the TAA group compared to the TF group (p=0.002). Conclusion: The emergency braking capacity in total ankle arthroplasty (TAA) patients is not inferior to that in tibiotalar fusion (TF) patients. Both groups also performed better than elderly drivers meeting a minimally acceptable braking safety threshold. Thus, both treatment options appear to have a similar impact on braking capacity.
Excellent Outcomes Following the Use of Platelet-Rich Plasma for Plantar Plate Injuries: A Retrospective Review
Authors: Samsonov Alan P. , Butler James J. , Kennedy John G. 
Published: December 2024

Category: Midfoot/Forefoot; Sports Introduction/Purpose: The purpose of this study was to evaluate outcomes following the use of Platelet-Rich Plasma (PRP) for Plantar Plate Injuries. Methods: Retrospective chart review identified 13 patients who underwent a PRP injection for the treatment of plantar plate injuries. Pre-operative magnetic resonance imaging (MRI) scans were obtained and the grade of the plantar plate injury was recorded. Clinical outcomes assessed included: pre- and post-operative foot and ankle outcome score (FAOS), visual analog scale (VAS), complications, failures, secondary surgical procedures, and return to sport data. Results: Thirteen patients with a mean follow-up time of 22.1±10.4 months were included. There were 6 patients that were grade 1, 4 patients were grade 2 and 3 patients were grade 3. There was a statistically significant improvement in both FAOS (53.1 -> 86.7) and VAS scores (4.5 -> 1.1) following injection of PRP to the plantar plate. No complications were observed. There was 1 failure, which underwent a plantar condylectomy at 8.1 weeks following PRP injection. Ten patients played sport pre-operatively, all of which (100%) returned to sport at a mean time of 5.3 weeks following PRP injection. Conclusion: This retrospective review demonstrated improvement clinical and functional outcomes following injection of PRP for plantar plate injuries. There was a 100% return to sport rate at a mean time of 5.3 weeks. The failure rate was 7.7%. Further comparative studies with longer follow-up are warranted to determine the precise role of PRP for the management of plantar plate injuries.
Prevalence of Sexual Dysfunction in Patients with Epilepsy: A Cross-Sectional Study from a Tertiary Care Facility
Authors: Malik Yogender , Mattoo S. K. , Singh Parampreet , Grover Sandeep 
Published: December 2024

Aim: This study aimed to investigate the prevalence of sexual dysfunction in individuals with epilepsy and its impact on overall quality of life. Methods: One hundred and twenty patients diagnosed with epilepsy and 50 healthy controls were assessed on Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14) to estimate the prevalence of sexual dysfunction. Epilepsy patients were additionally evaluated for psychiatric morbidity using structured diagnostic interview. Results: On CSFQ-14, 97.5% of epilepsy patients experienced sexual dysfunction, surpassing controls. CSFQ’s suggested cutoff norms revealed prevalence of impaired pleasure/arousal (97.5%) to be the most common dysfunction, followed by reduced desire (93.33%), orgasm dysfunction (89.16%), painful erection (61.7%), and painful orgasm (30%). Compared to healthy subjects, epilepsy patients displayed significantly higher prevalence of sexual dysfunction across all domains ( P < .001). Patients with psychiatric morbidity had significantly higher prevalence of sexual dysfunction, when compared to those without psychiatric morbidity. Overall, the presence of sexual dysfunction had a significant negative impact on the quality of life. Conclusion: The present study suggests a very high prevalence of sexual dysfunction in epilepsy patients and emphasizes the need for holistic care in epilepsy patients. Healthcare providers must recognize and address sexual dysfunction to enhance the overall quality of life of patients with epilepsy.
Requesting euthanasia or assisted suicide when it is illegal: a qualitative study about relatives’ experiences of patients hospitalized in French Palliative Care Units
Authors: De Cock Camille , Mathieu-Nicot Florence , Trimaille Hélène , Giffard Mathilde , Chassagne Aline 
Published: December 2024

Background: In countries where euthanasia and assisted suicide are not allowed, such as France, little is known about how a request for euthanasia and/or assisted suicide, expressed by an end-of-life patient, impacts their relatives. Aim: To understand the experiences of relatives of patients in the advanced stages of a serious illness, hospitalized in a Palliative Care Unit (PCU), and requesting euthanasia or assisted suicide in the French context where these practices are illegal. Design: We conducted a qualitative study in five French PCUs over the course of 1 year. Following the principles of grounded theory, semi-structured interviews were conducted with the relatives of patients who had explicitly requested euthanasia or assisted suicide to a healthcare professional. Two interviews were scheduled: the first within 48 h of the initial request (D1), and the second one a week later (D7). Methods: We conducted in-depth face-to-face interviews with relatives of patients requesting euthanasia or assisted suicide, in PCUs within a specific region of France, prior to the French Claeys-Leonetti Law. A thematic analysis of the data was performed. Results: Ten semi-structured interviews were conducted. Five families (patients and their relatives) were included, and eight relatives were interviewed. The discussions between patients and their relatives about requesting euthanasia or assisted suicide varied significantly from one family to another. Five main themes emerged: denouncing end-of-life conditions; the desire to have a peaceful death; the different levels of support and accompaniment for the request; values in favor of euthanasia and assisted suicide; boundaries and barriers. Conclusion: Requests for euthanasia and/or assisted suicide are generally understood by relatives. However, receiving and discussing such requests is a challenging and emotionally demanding task, generating significant suffering. All relatives seem to experience some degree of suffering, although its expression varies greatly between individuals. We encourage healthcare professionals to identify the nature of this suffering and to invite patients and their relatives to openly discuss these issues and to proactively address the request.
Menin inhibitors in the treatment of acute myeloid leukemia
Authors: Huls Gerwin , Woolthuis Carolien M. , Schuringa Jan Jacob 
Published: December 2024

Abstract
Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by the (oligo)clonal expansion of myeloid progenitor cells. Despite advances in treatment, AML remains challenging to cure, particularly in patients with specific genetic abnormalities. Menin inhibitors have emerged as a promising therapeutic approach, targeting key genetic drivers of AML, such as KMT2A (lysine methyl transferase 2A) rearrangements and NPM1 mutations. Here, we review the clinical value of menin inhibitors, highlighting their mechanism of action, efficacy, safety, and potential to transform AML treatment.