bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pharmacological Effects of a Ginseng-Containing Chinese Medicine Formula in Treating Hepatocellular Carcinoma Based on Comprehensive Bioinformatics and Experimental Validation
Authors: Gao Tianqi , Zhou Ruisheng , Huang Dan , Wu Dailin , Gao Yong , Yuan Yi , Li Jing , Huang Shangyi , Xian Yanfang , Tang Ying , Lin Zhixiu , Zhou Daihan , Wang Shutang 
Published: December 2024

Ginseng-containing Shentao Ruangan granules (STR) have been a well-known Chinese medicine prescription for the treatment of hepatocellular carcinoma (HCC) in China for decades. This study aimed to establish an in silico experimental framework to decipher the underlying mechanism of STR in the treatment of HCC. Microarray analysis, network pharmacology, RNA-sequencing (RNA-seq), bioinformatics analysis, and in vivo and in vitro experiments were used as integrated approaches to uncover the effects and mechanisms of action of STR. The introduction of STR significantly suppresses the proliferation and metastasis of HepG2 and Huh7 cells. STR treatment notably suppressed the growth of transplanted Huh7 tumors. Furthermore, STR administration reduced the expression of various epithelial-to-mesenchymal transition (EMT)-related proteins including N-cadherin, vimentin, and [Formula: see text]-catenin. By employing a systems biology approach, 21 common genes were identified across RNA-seq data, TCGA-HCC dataset, and network pharmacology analysis. Finally, of these genes nine were found to be associated with both OS and PFS in patients with HCC within the TCGA cohort. Validation of candidate genes by qPCR and WB identified a significant downregulation in the expression of pGSK3[Formula: see text] and RELA protein with increasing concentrations of STR. These results elucidated the mechanism by which STR inhibits tumor growth and EMT of HCC may be related to the GSK3[Formula: see text]/RELA pathway.
Association of Social Isolation and Plasma Metabolites With the Risk of Venous Thromboembolism
Authors: Xiang Hao , Gan Xiaoqin , Zhang Yanjun , Zhang Yuanyuan , Ye Ziliang , Yang Sisi , Huang Yu , Wu Yiting , Zhang Yiwei , Qin Xianhui 
Published: December 2024

BACKGROUND:
To explore the association of social isolation with venous thromboembolism (VTE) risk and the mediating role of metabolomics on this association.

METHODS:
Overall, 236 026 participants free of VTE and with complete metabolomics data at baseline from the UK Biobank were included. Social isolation was constructed based on the frequency of friend/family visits, weekly group activities, and living alone. The study outcome was incident VTE, including deep vein thrombosis or pulmonary embolism. Least absolute shrinkage and selection operator regression was applied to create a social isolation–associated metabolic signature. We estimated hazard ratios of study outcomes in relation to social isolation/metabolic signature and calculated the proportion of social isolation–VTE association mediated by the metabolic signature.

RESULTS:
During a median follow-up of 12.5 years, 6681 VTE cases were recorded. Social isolation was positively associated with VTE risk (versus without social isolation; hazard ratio, 1.17 [95% CI, 1.09–1.27]). A metabolic signature for social isolation was constructed using 28 metabolites. This metabolic signature showed significant association with VTE risk (per SD increment; hazard ratio, 1.16 [95% CI, 1.13–1.19]) and mediated 11.0% (95% CI, 7.0–19.8) of the increased VTE risk associated with social isolation. 11 metabolites in the metabolic signature also significantly mediated the association between social isolation and VTE risk, with mediation proportions ranging from 0.5% to 2.6%. Similar results were found for incident deep vein thrombosis and pulmonary embolism, respectively.

CONCLUSIONS:
Social isolation was positively associated with VTE risk. The metabolic signature for social isolation, especially the 11 major metabolites included, significantly mediated the association between social isolation and VTE risk.
Predictors and Outcomes of Hematoma Expansion and Neurological Decline in Intracerebral Hemorrhage: A Multisite Mobile Stroke Unit Study
Authors: Gulati Asish K. , Ma Tianwen , Rolle Isaiah , Peterson Ryan , Pirlog Bianca , Chen Justine , Heckathorn Megan , Ratcliff Jonathan , Bianchi Nicolas , Fleming Carol , Frankel Michael , Grotta James , Bowry Ritvij , Parker Stephanie , Hicks William , Navalkele Digvijaya 
Published: December 2024

Background
Hemorrhagic stroke, particularly intracerebral hemorrhage, is one of the leading causes of permanent disability worldwide. Early hematoma expansion (HE) is a key factor in neurological deterioration (ND) and functional outcomes post intracerebral hemorrhage. This observational cohort study examines the predictors and outcomes of HE and ND in spontaneous intracerebral hemorrhage patients using data from 3 Mobile Stroke Units (MSUs) in the United States.

Methods
Patients diagnosed with spontaneous intracerebral hemorrhage within 4 hours of last known well were included. Data collection involved initial and follow‐up non‐contrast (computerized tomography) CT scans from MSUs and emergency departments, from which the rate of HE and ND were determined. The interrater reliability for radiographic signs of HE was also assessed. Predictive factors were analyzed using multiple logistic regression models.

Results
Of the 55 patients who met the inclusion criteria, 27% experienced HE within the first 4 hours from last known well with the majority of HE occurring within the first 60 to120 minutes. Significant predictors of HE were a history of diabetes and blend sign on initial MSU CT scans. Predictors of ND included initial hematoma volume and the presence of hydrocephalus. Patients with HE and ND had a higher discharge modified‐Rankin Scale score and mortality rates. Interrater agreement on radiographic signs of HE varied, with moderate agreement on some signs and little to none on others.

Conclusion
Highest HE was seen within 60 to120 minutes from last known well for patients between MSU and emergency department transport. The blend sign and a history of diabetes emerged as key predictors of HE, whereas initial hematoma volume and hydrocephalus were significant for ND. Interventions to prevent HE and ND should be tested on the MSU in future studies.
An Online Survey of Knowledge, Attitude, and Prevalence of Substance Use in School-Going Adolescents of a Regional Area of Punjab, India
Authors: Garg Jasmin , Sidhu Amrinder Singh , Goel Shikha , Kaur Parvarjot 
Published: December 2024

Background: Substance use can begin in adolescence and can lead to school drop-out, involvement in criminal activities, and development of mental health disorders. Good awareness is an important protective factor for keeping adolescents away from substance abuse. This study was planned to describe the knowledge, attitude and prevalence of substance use in school-going adolescents from a regional area of Punjab. Methods: An online survey was conducted recruiting 6927 students of 9th to 12th class. They were administered the English and Punjabi translated version of the “Knowledge and Attitude Questionnaire to Substance Abuse” and asked for ever use of substances using WHO-ASSIST. The association of sociodemographic variables with knowledge, attitude, and prevalence was analyzed. Results: Most of the school students had poor knowledge and attitudes regarding substance use. They had limited awareness of the harms and treatment of substance abuse. Social stigma for substance abuse was evident in the majority of students. About 3.3% of students reported ever use of substances. The commonest reported substances were alcohol, tobacco, and cannabis. The knowledge and attitudes were poor in students of urban areas, private schools, students of classes 9th and 10th, and those of middle socioeconomic status. Ever use was higher in males, students from rural areas, and classes 11th and 12th. Conclusions: There is inadequate knowledge and attitude for substance abuse among school-going adolescents in this regional area of Punjab. Students reported a low prevalence of ever use in the online survey.
Associations Between Childhood ADHD and Lifestyle Risk Factors for Chronic Diseases From Adolescence to Early Adulthood
Authors: Li Yueqi , Xian Hong , Arnold Lauren D. , Jen Chang Jen 
Published: December 2024

Objective: To examine the association between childhood ADHD and lifestyle risk factors (physical inactivity and high fast-food consumption) from adolescence to early adulthood. Methods: This retrospective cohort study used secondary data from Wave I to III of the National Longitudinal Study of Adolescent Health (Add Health) in a national representative sample of adolescents ( n = 6,814). Multivariable Poisson regression and Generalized Estimating Equation were used to estimate adjusted relative risks (aRRs) and corresponding 95% confidence intervals (95% CIs), controlling for confounders. Results: Childhood ADHD was associated with an increased risk of high fast-food consumption (aRR = 1.49, 95% CI [1.23, 1.80]) in early adulthood, but not in adolescence (aRR = 1.11, 95% CI [0.90, 1.37]), after adjusting for confounders. The associations between childhood ADHD and physical inactivity were not statistically significant from adolescence to early adulthood. Conclusion: Findings of this study extend the current understanding of the impact of childhood ADHD on greater risk of fast-food consumption, which underscores the importance to develop interventions for promoting healthy diet in children with ADHD.
No Association Between Patient Reported Outcomes and Ankle and Hindfoot Osteoarthritis Radiographic Severity
Authors: Kulkarni Ronit , Dusch Timothy , Pottanat Paul J. , Morningstar Joshua L. , Gross Christopher E. , Scott Daniel J. 
Published: December 2024

Category: Ankle Arthritis; Ankle Introduction/Purpose: The Kellgren-Lawrence scale has been used as a valid and reliable system to grade osteoarthritis. This study seeks to examine the association between preoperative Kellgren-Lawrence (KL) scale grade of ankle or hindfoot arthritis and postoperative outcome measures (PROMs) in patients undergoing total ankle arthroplasty (TAA), ankle arthrodesis (AA), or hindfoot arthrodesis. Methods: A retrospective review was conducted of 254 ankles (250 patients) with minimum 6-month follow-up, undergoing TAA, AA, or hindfoot arthrodesis from 2016-2022. Patients were identified by having undergone surgery via CPT codes (27702, 27870, 27815, or 27825). 131 patients (51.6%) underwent TAA. Of patients undergoing various ankle and hindfoot fusions, involved joints were tibio-talar (n=83; 32.7%), sub-talar (n=46; 18.1%), talo-navicular (n=15; 5.9%) and calcaneocuboid 1 (0.3%). Preoperative KL grade of the joint undergoing arthrodesis/arthroplasty was evaluated. Data collected included demographics, medical history, PROMs (FAOS, FAAM, VAS, SSS-8, PDI, and PCS), postoperative complications, readmission and reoperation rates. The final cohort mean age was 58.26 (range 18-85) years with mean BMI 31.97 (range 17.85-61.38) kg/m2 and mean follow-up of 1.69 (range 0.50-6.13) years. Results: The overall cohort was primarily KL grade 3 and 4 at each of the examined joints. There were no significant differences in demographics or procedure performed between groups, with the exception of age, which was statistically significantly associated with an increased KL grade for the TN joint (p=.006). Preoperatively, the tibiotalar joints with a KL grade of 3 were associated with significantly higher preoperative SSS-8 scores (p=.002). A preoperative KL grade of 2 at the subtalar joint was associated with significantly lower preoperative FAOS recreation scores (p=.030). Postoperatively, there was no statistically significant difference in patient reported outcomes with any of the examined joints KL grade. Lastly, there was no statistically significant association between KL score of any joint and postoperative complication, readmission, or reoperation. Conclusion: There was no association between preoperative Kellgren-Lawrence grade and post-operative PROMs or mean 1.69 year outcomes following TAA, AA, or hindfoot arthrodesis. Surgeons should be aware that, at least for patients indicated for TAA or ankle/hindfoot arthrodesis, preoperative KL grade does not seem to impact short term PROM scores.
Nonunion Rate and Clinical Outcomes Following Percutaneous Modified Lapidus Procedure with Intramedullary Nail Fixation and Early Weightbearing
Authors: Dai Amos , Hembree Walter C. , Rodriguez Materon Solangel , Alkaramany Eslam , Salomao Barbachan Mansur Nacime , Guyton Gregory P. 
Published: December 2024

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Minimally invasive surgery (MIS) techniques have largely focused on first metatarsal osteotomies in hallux valgus correction, but have also been used for joint preparation in foot and ankle surgery. Concurrently, new fixation methods allow early weightbearing protocols with the open Lapidus procedure, with nonunion rates comparable to those of more traditional protocols requiring prolonged nonweightbearing. We aimed to assess the nonunion rate and clinical results of a percutaneous modified Lapidus (PML) technique with axial nail fixation (Phantom Lapidus Intramedullary Nail: Paragon28, Englewood, CO USA) and early weightbearing. Methods: A retrospective chart review was performed for a consecutive series of 88 feet in 70 patients who underwent the PML technique from June 2018 to January 2023 by two fellowship-trained orthopedic foot and ankle surgeons. Indications for surgery included moderate to severe hallux valgus deformity with or without first tarsometatarsal joint (TMT) instability, first TMT arthritis, adolescent bunion, and failed prior surgery. All patients initiated weightbearing in a controlled ankle motion (CAM) boot within 12 days from surgery. Nonunion rate was defined as a symptomatic nonunion (confirmed with CT scan) that underwent revision surgery. Patients were also sent follow-up questionnaires to obtain postoperative visual analog scale (VAS) pain scores, Patient-Reported Measurement Information System (PROMIS) Physical Function scores, PROMIS Pain Interference scores, and ability to return to work. Results: Overall nonunion rate was 9.1%. All nonunions were successfully treated with nail retention, medial plate augmentation and bone grafting. There was a 15.9% all-cause reoperation rate on the 1st ray. There were 3 minor wound complications (3.4%). Average tourniquet time for the PML technique (cases performed in isolation) was 65 minutes. Survey response rate was 50%. Average follow-up time from surgery to survey response was 3.4 years (SD 1.3, range 1.2 - 5.7). VAS scores improved from 3.5 (SD 2.6) preoperatively to 0.7 (SD 1.1, range 0 – 5). Mean postoperative PROMIS Physical Function and Pain Interference scores were 56.1 (SD 6.8) and 43.6 (SD 6.6), respectively. All patients who were employed within 6 months prior to surgery were able to return to work. Conclusion: The PML technique combined with early weightbearing yields low rate of wound complications and nonunion rates comparable to historical cohorts using prolonged weightbearing protocols. For the patient, this technique additionally provides improved cosmesis and accelerated rehabilitation.
Novel Cross Screw with Staple for First MTP Joint Arthrodesis Compared to Dorsal Plate Fixation: Retrospective Clinical and Radiographic Evaluation
Authors: Arndt Stephen R. , Zahra Shirin , Moldavsky Mark 
Published: December 2024

Category: Lesser Toes; Other Introduction/Purpose: Retrospective study investigating patient reported outcomes and radiographic evaluation of crossed screws used in conjunction with a compressive nitinol staple (CS+S) for arthrodesis of the 1st metatarsophalangeal (MTP) joint. Dorsal plating (DP) group for 1st MTP joint was used for as control group. Methods: Pre-op and post-op Visual Analog Score (VAS) were assessed. Radiographic Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), Interphalangeal Angle (IPA) Dorsiflexion Angle (DFA), and distance of fibular sesamoid (DFS) were measured pre-op and post-op. Student t-test assuming equal variance (p≤0.05) was performed to determine significance. Fusion was determined by assessing post operative radiographs. Results: DP Group had 40 patients, age 65.3±8.4, 12M, 28F, BMI 30.4±6.2. In the CS+S group 14 patients were included age 66.64±8.4, 5M, 9F, BMI 25.0±3.8. DP had a average follow up time of 4±3months with 95% fusion rate; CS+S had 100% fusion rate at an average follow up of 1.9±2months. Pre-op and Post-op DP and CS+S VAS scores were (7.9±0.9; 1.3±1) and (8.0±0.8; 0.7±0.9), respectively (p≤0.05). Pre and post-op HVA, IMA, IPA, DFA and DFS for DP are 19.9±11.25o, 8.32±7.19o (p≤0.05); 11.41±4.58o, 9.09±3.23o (p≤0.05); 9.99±4.84o, 12.95±4.12o (p≤0.05); 22.59±9.21o, 23.71±7.41o (p≥0.05); and 12.82±2.65mm, 12.35±2.62mm (p≥0.05) respectively. Pre and post-op HVA, IMA, IPA, DFA angles and DFS for CS+S are 21.71±10.5o, 5.57±5.08o (p≤0.05); 10.54±4.43o, 7.98±2.79o (p≤0.05); 11.99±6.28o, 14.47±5.22o (p≥0.05); 22.26±8.90o, 22.44±8.97o (p≥0.05); and 13.24±2.17mm, 12.13±1.56mm (p≥0.05) respectively. Conclusion: Both Cross Screw + Staple and Dorsal Plate groups result in significant improvements in VAS scores and radiographic parameters. The Cross Screw + Staple group had 100% fusion rate with significantly less follow up time compared to Dorsal Plate Group. Performing the procedure with Cross Screws + Staple has the benefits of a smaller incision, lower profile implant, less hardware irritation while providing continuous compression across the joint. potential benefits may be decreased OR room time and reduced hospital cost.
Osteochondral Repair with Autologous Cartilage Transplantation with or without Bone Grafting: A Short Pilot Study in Mini-Pigs
Authors: Woo Shim Dong , Lee Wonwoo , Woo Lee Jin , Soo Kim Bom 
Published: December 2024

Category: Basic Sciences/Biologics; Other Introduction/Purpose: Treatment strategies for osteochondral defects, for which particulated autologous cartilage transplantation (PACT) is an emerging treatment strategy, aim to restore the structure and function of the hyaline cartilage. Herein, we compared the efficacy of PACT with control or human transforming growth factor-β (rhTGF-β), and clarified the necessity of bone graft (BG) with PACT to treat shallow osteochondral defects in a porcine model. Methods: Two skeletally mature male micropigs received 4 osteochondral defects in each knee. The 16 defects were randomized to (1) empty control, (2) PACT, (3) PACT with BG, or (4) rhTGF-β. Animals were euthanized after 2 months and histomorphometry, immunofluorescence analysis, semiquantitative evaluation (O’Driscoll score), and magnetic resonance observation of cartilage repair tissue (MOCART) score were performed. Results: Hyaline cartilages, glycosaminoglycan synthesis, and collagen type II staining were more abundant in the PACT than in the control and rhTGF-β groups. The O’Driscoll score was significantly different between groups (P < 0.001), with both PACT groups showing superiority (P = 0.002). PACT had the highest score (P = 0.002), with improved restoration of subchondral bone compared with PACT with BG. The MOCART score showed significant differences between groups (P = 0.021); MOCART and O’Driscoll scores showed high correlation (r = 0.847, P < 0.001). Conclusion: Treatment of osteochondral defects with PACT improved tissue quality compared with that with control or rhTGF-β in a porcine model. BG, in addition to PACT, may be unnecessary for shallow osteochondral defects. Clinical Relevance. BG may not be necessary while performing PACT.
Outcomes and Complications of Wright Medical INVISION Talus for Complex Total Ankle Arthroplasty
Authors: Conway Yvonne C. , Cassinelli Spenser , Whitlow Scott , Lundeen Gregory A. 
Published: December 2024

Category: Ankle Arthritis; Ankle Introduction/Purpose: The INVISION Total Ankle Arthroplasty System (Wright Medical Technology/Stryker) is a modular ankle arthroplasty used for patients with limited bone stock. There is limited early survivorship and clinical outcomes data for this device. The aim of this study is to report on early implant survivorship and complications specifically with regards to the talar component of the INVISION Total Ankle System performed in complex and revision total ankle replacements. Methods: This is a single-institution retrospective review of patients who underwent TAA using the INVISION talus implant between 2018 and 2023. INVISION was chosen in cases with significant talar bone loss. Demographics, reoperation, complications, and radiographic data were collected. Immediate postoperative images were used to measure the height of bone remaining underneath the talar tray at the thinnest remaining portion of the posterior talus. A total of 8 components in 7 different patients that underwent INVISION talar component placement met inclusion criteria with a mean follow-up of 105 weeks. Patient demographics consisted of 71% female(n=5), 29% male(n=2) with mean age of 56 years old. The INVISION talar component was used as a primary implant to address severe AVN of the talus (n= 3), and as a revision talar component to address post infection bone loss (n= 3) and failed total ankle arthroplasty due to aseptic loosening/osteolysis/subsidence (n = 2). Results: Talar implant survivorship was 88%. One patient had implant failure resulting in conversion to a total talus due to loss of fixation of the talar component. Another patient developed a stress fracture 2 years postoperatively in the posterior talus (Figure 1.C) that was successfully treated with a subtalar fusion. The average measured minimum posterior talus thickness underneath the tray for all patients was 4.6mm (range 0.5mm – 10.0 mm). This measurement was not able to be obtained for one patient with a prior subtalar fusion due to talar continuity with calcaneus. In the two patients that had either implant failure or required reoperation, the talar thickness measured 0.5mm and 2.9mm, respectively. None of the implants with greater than 3mm had loss of fixation or ingrowth. Conclusion: The INVISION talus tray is a reliable option for addressing severe talar bone loss in TAA. We caution surgeons using this implant if there is < 3 mm of bone height in the posterior talus. Although the pegs of the talar plate are primarily fixated anterior within the talus, the tray appears to rely on the entire length of the talus to distribute the weightbearing forces. If a surgeon measures >3mm posterior talar height underneath the talar plate, alternative treatments such as subtalar fusion in conjunction with the INVISION talar component placement or total talus should be considered.