bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Risk Factors for Flap Coverage After Total Ankle Arthroplasty
Authors: Cunningham Daniel J. , Ryan Sean P. , Hong Cierra , Mithani Suhail K. , Adams Samuel B. 
Published: February 2021

Background: Wound complications following total ankle arthroplasty (TAA) can have a significant impact on patient morbidity, particularly when they require flap coverage. We sought to determine the risk factors associated with the need for flap coverage after TAA and hypothesized that medical and operative risk factors such as diabetes and additional procedures would be associated with the need for flap coverage after TAA. Methods: We performed a single-center retrospective review of TAAs from April 2007 to February 2019. Patient demographics and medical comorbidities were collected, in addition to other procedures performed at the time of TAA. Patients were stratified by the need for flap coverage, and unadjusted inferential statistics were performed to evaluate the risk factors associated with subsequent need for flap coverage. Results: Among 2065 patients undergoing TAA, 28 (1.4%) patients required flap coverage after the index arthroplasty. Patients requiring flap coverage were older ( P = .045), had higher Charlson comorbidity indices ( P = .017), and had higher rates of diabetes and pulmonary disease ( P = .038). Patients requiring flap coverage also had higher rates of additional procedures ( P = .043, P = .007). The most common flap was a radial forearm free flap, which was performed in 14 (50%) patients. Twenty-one patients (75%) requiring flap coverage had a stable, plantigrade foot at median 1.5-year follow-up. Conclusion: Patient and operative risk factors, including advanced age, increased comorbidity burden, diabetes, pulmonary disease, and increased number of simultaneous procedures, were significantly associated with need for subsequent flap coverage. This should be considered as the indications for TAA expand. Level of Evidence: Level III, retrospective, prognostic cohort study.
Effect of Gender Differences on Patient-Reported Outcomes and Complications in Total Ankle Replacement
Authors: Fletcher Amanda N. , Mody Kush S. , Adams Samuel B. , DeOrio James K. , Easley Mark E. , Nunley James A. 
Published: February 2021

Background: The purpose of this study was to evaluate gender differences in patient outcomes and complications following total ankle replacement (TAR). Methods: Consecutive patients who underwent primary TAR from July 2007 through May 2016 were prospectively followed and retrospectively reviewed. Demographic, operative, patient-reported outcomes (PROs), and complication data were collected and analyzed. PROs included the visual analog scale (VAS), 36-Item Short-Form Health Survey (SF-36), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale, and Short Musculoskeletal Function Assessment (SMFA). A total of 475 patients were evaluated, including 248 males (52.2%) and 227 females (47.8%) with an average of 56.8 months follow-up. Results: Women were more likely to have inflammatory arthritis (13.7% vs 2.8%; P < .01) and significantly worse preoperative SF-36 total, SF-36 mental health component, AOFAS total, AOFAS pain, SMFA function, and SMFA bother scores (all P < .05). Both genders demonstrated significant improvement in PROs at 1, 2, and 5 years. The magnitude of improvement was similar between genders for all PROs (all P < .05) with the exception of SF-36 physical function, which was greater in men. Females underwent more nonrevision reoperations (32.2% vs 22.6%; P = .0191), but there was no significant difference in failure rates (male 7.3% vs female 3.5%; P = .07). The reoperation and failure rates at 2 years postoperation were 10.1% and 1.6% for men and 18.5% and 0.9% for women, respectively. Conclusion: Women undergoing TAR were more likely to have worse preoperative PROs and higher rates of nonrevision reoperations, which remains true when controlling for their increased incidence of inflammatory arthritis. However, women reported similar improvements in PROs and had similar prosthetic survival rates as men. Increased understanding of these disparities, combined with gender-based interventions, may further advance patient outcomes. Level of Evidence: Level III, therapeutic, retrospective comparative series
Pro-inflammatory adiponectin in pediatric-onset multiple sclerosis
Authors: Nyirenda Mukanthu H , Fadda Giulia , Healy Luke M , Mexhitaj Ina , Poliquin-Lasnier Laurence , Hanwell Heather , Saveriano Alexander W , Rozenberg Ayal , Li Rui , Moore Craig S , Belabani Chahrazed , Johnson Trina , O’Mahony Julia , Arnold Douglas L , Yeh E Ann , Marrie Ruth Ann , Dunn Shannon , Banwell Brenda , Bar-Or; Amit 
Published: February 2021

Background: Being obese is associated with both increased risk of developing multiple sclerosis (MS) and greater MS disease activity. Objectives: The objective of this study is to investigate levels and potential pathophysiologic contribution of serum adipose-hormones (adipokines) in pediatric-onset MS. Methods: Following a Luminex adipokine screen, adiponectin (APN) and its isoforms were quantified by enzyme-linked immunosorbent assay (ELISA) in 169 children with incident acquired demyelinating syndromes (ADS), prospectively ascertained as having either MS or other forms of inflammatory central nervous system (CNS) demyelination. The effect of recombinant APN and APN-containing sera was assessed on functional responses of normal human peripheral blood myeloid and T cells and on human CNS-derived microglia. Results: Compared to other cohorts, children with MS harbored higher serum APN levels, principally driven by higher levels of the low-molecular-weight isoform. Recombinant APN and pediatric MS serum-induced APN-dependent pro-inflammatory activation of CD14+ monocytes and of activated CD4+ and CD8+ T cells (both directly and indirectly through myeloid cells). APN induced human microglia activation while inhibiting their expression of molecules associated with quiescence. Conclusions: Elevated APN levels in children with MS may contribute to enhanced pro-inflammatory states of innate and adaptive peripheral immune responses and breach CNS-resident microglia quiescence, providing a plausible and potentially targetable mechanism by which APN contributes to MS disease activity.
In Silico Identification of Contradictory Role of ADAMTS5 in Hepatocellular Carcinoma
Authors: Zhu Zhipeng , Xu Jiuhua , Wu Xiaofang , Lin Sihao , Li Lulu , Ye Weipeng , Huang Zhengjie 
Published: February 2021

Background: ADAMTS5 has different roles in multiple types of cancers and participates in various molecular mechanisms. However, the prognostic value of ADAMTS5 in patients with hepatocellular carcinoma (HCC) still remains unclear. We carried the study to evaluate the prognostic value and identified underlying molecular mechanisms in HCC. Methods: Firstly, the association of ADAMTS5 expression and clinicopathological parameters was evaluated by in GSE14520. Next, ADAMTS5 expression in HCC was performed using GSE14520, GSE36376, GSE76427 and The Cancer Genome Atlas (TCGA) profile. Furthermore, Kaplan-Meier analysis, Univariate and Multivariate Cox regression analysis, subgroup analysis was performed to evaluate the prognostic value of ADAMTS5 in HCC. Finally, GO enrichment analysis, gene set enrichment analysis (GSEA) and weighted gene co-expression network analysis (WGCNA) were performed to revealed underlying molecular mechanisms. Result: The expression of ADAMTS5 was positively correlated with the development of HCC. Next, high ADAMTS5 expression was significantly associated with poorer survival (all P < 0.05) and the impact of ADAMTS5 on all overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), disease specific survival (DSS) and progression free interval (PFI) was specific for HCC among other 29 cancer types. Subgroup analysis showed that ADAMTS5 overexpression was significantly associated with poorer OS in patients with HCC. Finally, ADAMTS5 might participate in the status conversion from metabolic-dominant to extracellular matrix-dominant, and the activation of ECM-related biological process might contribute to high higher mortality risk for patients with HCC. Conclusion: ADAMTS5 may play an important role in the progression of HCC, and may be considered as a novel and effective biomarker for predicting prognosis for patients with HCC.
XPD Polymorphisms and Risk of Hepatocellular Carcinoma and Gastric Cancer: A Meta-Analysis
Authors: Zhou Qiang , Fu Yu , Wen Lijia , Deng Yu , Chen Junhong , Liu Kai 
Published: February 2021

Background: Cancer is associated with genetic variants of DNA repair genes that alter DNA repair capacity. The aim of this meta-analysis was to evaluate the relations between the rs13181 and rs1799793 XPD gene polymorphisms and risk for hepatocellular carcinoma (HCC) and gastric cancer. Methods: Relevant publications were systematically sought from Web of Science, Pubmed, and China Academic Journals Full-text Database. The selection of eligible studies was performed by 2 independent authors. A total of 32 case-control studies were included. Meta-analyses were undertaken in all study participants and each ethnic group. Results: The risk of HCC was significantly increased with the XPD rs13181 G allele (P = 0.028, pooled odds ratio (OR) = 1.36, 95% confidence interval (CI) = 1.03-1.80) in all study participants. A subgroup analysis by ethnicity showed that the association was significant in Chinese (P = 0.009, pooled OR = 1.49, 95% CI = 1.11-2.02), but not in Caucasians (P = 0.619, pooled OR = 1.17, 95% CI = 0.64-2.13). Meta-analysis of the XPD rs1799793 polymorphism and HCC showed an association between its variant T allele and increased HCC risk in all study participants (P = 0.017, pooled OR = 1.23, 95% CI = 1.04-1.46, all Chinese). Our results showed no associations between the XPD rs13181 G allele and rs1799793 T allele and gastric cancer risk (rs13181: P = 0.298, pooled OR = 1.10, 95% CI = 0.92-1.31; rs1799793: P = 0.068, pooled OR = 1.31, 95% CI = 0.98-1.74). Conclusions: This meta-analysis demonstrated that the XPD rs13181 G allele and rs1799793 T allele have significant associations with HCC and may be risk factors for HCC in the Chinese population. Current evidence indicated that they are not related to gastric cancer risk.
Combination of Serum Neurofilament Light Chain Levels and MRI Markers to Predict Cognitive Function in Ischemic Stroke
Authors: Peng Yuan , Li Qianfeng , Qin Lei , He Yating , Luo Xun , Lan Yue , Chen Xin , Wang Xin , Wang Qing Mei 
Published: February 2021

Background: It is important to predict poststroke cognitive outcome to guide individualized treatment and prevention strategy. We aimed to evaluate the predictive value of the combination of a serum biomarker for axonal damage (neurofilament light chain [NfL]) and neuroimaging markers (volume of infarction and white matter hyperintensities [WMH]) for neuronal abnormality in poststroke cognitive outcome. Methods: A total of 1028 patients were screened; among them, 144 patients with acute ischemic stroke (stroke group) and 30 patients without stroke (control group) were enrolled. Serum NfL levels of samples obtained from both groups were measured through single molecule array assay. Neuroimaging markers of neuroaxonal injury, including infarct volume and WMH in the stroke group were quantified on magnetic resonance images using an in-house MATLAB code (MATLAB 2017; MathWorks). The primary outcome was the functional independence measure (FIM) cognitive subscores on discharge. We assessed the association of serum NfL levels and neuroimaging markers with cognitive outcome. The prognosis value of the combination of serum NfL levels and imaging markers for predicting FIM cognitive subscores on discharge was calculated using the area under curve (AUC) of the receiver operating characteristic. Results: Serum NfL levels of the stroke group were 9-fold higher than those of the control group (1449.7 vs 157.2 pg/mL, n = 144/30, P < .001). There was a correlation of serum NfL levels with infarct volume ( r = 0.530, P < .001) and functional outcome, including FIM cognitive subscores ( r = −0.387, P < .001) and FIM motor subscores on admission ( r = −0.306, P < .001), but not with WMH volume after adjusting for infarct volume ( r = −0.196, P = .245). Serum NfL levels on admission independently predicted poststroke FIM cognitive subscores on discharge (AUC = 0.672, P < .001). The predictive value for poststroke cognitive outcome was improved by combining serum NfL levels with infarct and WMH volume (AUC = 0.760, P < .001). Conclusion: The combination of serum NfL levels with volume of infarct and WMH shows an improved predictive value for cognitive function during acute rehabilitation phase after stroke, providing a promising panel of biomarkers for prognosis and guidance of treatment.
Scoping review of the rolling resistance testing methods and factors that impact manual wheelchairs
Authors: Ott Joseph , Pearlman Jonathan 
Published: February 2021

Introduction Rolling resistance (RR) is a drag force acting on manual wheelchairs that is associated with increased propulsion force and is linked to secondary disabling conditions of the upper limbs. A scoping review was conducted to understand how RR of manual wheelchairs has been measured and to identify limitations of those test methods and the factors tested. Methods A total of 42 papers were identified and reviewed, and test methods were categorized based on the measurement style of RR, testing level, and if multiple parameters could be tested. Additionally, 34 articles were reviewed for what factors were tested. Results Seven different testing methods categories were identified: drag test, treadmill, motor draw, deceleration, physiological expenditure, ergometer/dynamometer, and robotic test rig. Relevant articles were categorized into testing factor categories: camber, toe, tire type, tire pressure, caster type, mass, mass distribution, and type of surface. Conclusions The variety of testing methods suggests the need for a standardized method that can be used for wheelchair wheel design and selection to reduce RR. It is important to use adjustments, such as a forward rear axle position to mitigate RR as well as using high-pressure pneumatic tires that are properly inflated.
Hypoalbuminemia and Elevated CRP are Risk Factors for Deep Infections and Urinary Tract Infections After Lumbar Spine Surgery in a Large Retrospective Patient Population
Authors: Yoshida Brandon , Nguyen Ailene , Formanek Blake , Alam Milad , Wang Jeffrey C. , Buser Zorica 
Published: February 2021

Study Design: Retrospective cross-sectional study. Objectives: To determine if pre-operative albumin and CRP can predict post-operative infections after lumbar surgery. Methods: Patients who underwent an anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), or lumbar discectomy were identified using a patient record database (PearlDiver) and were included in this retrospective study. Patients were stratified by Charlson Comorbidity Index (CCI) scores and pre-operative albumin and CRP status. Post-operative complications included deep infections and urinary tract infections within 3 months of the surgery and revisions within 1 year of the surgery. Results: 74,280 patients were included in this study. 21,903 had pre-operative albumin or CRP lab values. 7,191 (33%), 12,183 (56%), and 2,529 (12%) patients underwent an ALIF, PLIF, and a lumbar discectomy, respectively. 16,191 did not have any complication (74%). The most common complication was UTI (16%). Among all patients, hypoalbuminemia was a significant risk factor for deep infection and UTI after ALIF, deep infection, UTI, and surgical revision after PLIF, and deep infection after lumbar discectomy. Elevated CRP was a significant risk factor for deep infection after ALIF, UTI after PLIF, and deep infection after lumbar discectomy in patients with a CCI ≤ 3. Conclusions: Pre-operative hypoalbuminemia and elevated CRP were significant risk factors for deep infection, UTI, and/or revision, after ALIF, PLIT, and/or lumbar discectomy. Future studies with a larger population of patients with low albumin and high CRP values are needed to further elaborate on the current findings.
The inflammatory profile of cerebrospinal fluid, plasma, and saliva from patients with severe neuropathic pain and healthy controls-a pilot study
Authors: Jönsson Mika , Gerdle Björn , Ghafouri Bijar , Bäckryd Emmanuel 
Published: February 2021

Abstract
Background
Neuropathic pain (NeuP) is a complex, debilitating condition of the somatosensory system, where dysregulation between pro- and anti-inflammatory cytokines and chemokines are believed to play a pivotal role. As of date, there is no ubiquitously accepted diagnostic test for NeuP and current therapeutic interventions are lacking in efficacy. The aim of this study was to investigate the ability of three biofluids - saliva, plasma, and cerebrospinal fluid (CSF), to discriminate an inflammatory profile at a central, systemic, and peripheral level in NeuP patients compared to healthy controls.

Methods
The concentrations of 71 cytokines, chemokines and growth factors in saliva, plasma, and CSF samples from 13 patients with peripheral NeuP and 13 healthy controls were analyzed using a multiplex-immunoassay based on an electrochemiluminescent detection method. The NeuP patients were recruited from a clinical trial of intrathecal bolus injection of ziconotide (ClinicalTrials.gov identifier NCT01373983). Multivariate data analysis (principal component analysis and orthogonal partial least square regression) was used to identify proteins significant for group discrimination and protein correlation to pain intensity. Proteins with variable influence of projection (VIP) value higher than 1 (combined with the jack-knifed confidence intervals in the coefficients plot not including zero) were considered significant.

Results
We found 17 cytokines/chemokines that were significantly up- or down-regulated in NeuP patients compared to healthy controls. Of these 17 proteins, 8 were from saliva, 7 from plasma, and 2 from CSF samples. The correlation analysis showed that the most important proteins that correlated to pain intensity were found in plasma (VIP > 1).

Conclusions
Investigation of the inflammatory profile of NeuP showed that most of the significant proteins for group separation were found in the less invasive biofluids of saliva and plasma. Within the NeuP patient group it was also seen that proteins in plasma had the highest correlation to pain intensity. These preliminary results indicate a potential for further biomarker research in the more easily accessible biofluids of saliva and plasma for chronic peripheral neuropathic pain where a combination of YKL-40 and MIP-1α in saliva might be of special interest for future studies that also include other non-neuropathic pain states.
Analysis and review of trichomes in plants
Authors: Wang Xiaojing , Shen Chao , Meng Pinghong , Tan Guofei , Lv Litang 
Published: February 2021

Abstract
Background
Trichomes play a key role in the development of plants and exist in a wide variety of species.

Results
In this paper, it was reviewed that the structure and morphology characteristics of trichomes, alongside the biological functions and classical regulatory mechanisms of trichome development in plants. The environment factors, hormones, transcription factor, non-coding RNA, etc., play important roles in regulating the initialization, branching, growth, and development of trichomes. In addition, it was further investigated the atypical regulation mechanism in a non-model plant, found that regulating the growth and development of tea (Camellia sinensis) trichome is mainly affected by hormones and the novel regulation factors.

Conclusions
This review further displayed the complex and differential regulatory networks in trichome initiation and development, provided a reference for basic and applied research on trichomes in plants.
Clinical and endoscopic features of aorto-duodenal fistula resulting in its definitive diagnosis: an observational study
Authors: Ichita Chikamasa , Sasaki Akiko , Sumida Chihiro , Kimura Karen , Nishino Takashi , Tasaki Junichi , Masuda Sakue , Koizumi Kazuya , Kawachi Jun , Kako Makoto 
Published: February 2021

Abstract
Background
Upper gastrointestinal (GI) bleeding is the most important presentation of an aorto-duodenal fistula (ADF). Early diagnosis is difficult, and the disease is associated with high mortality. The present study aimed to examine the clinical and the endoscopic characteristics of ADF in eight patients who presented to our hospital. We also sought to clarify the diagnostic approach towards the disease.

Methods
The present study examined the clinical and the endoscopic/computed tomography (CT) characteristics of ADF in eight patients who were definitively diagnosed with this condition in a 12-year period at our hospital.

Results
The patients comprised of five men and three women, with a mean age of 69.8 years. Upper gastrointestinal bleeding was the chief complaint for all the patients. Out of these, two patients presented with shock. The patients’ mean haemoglobin at presentation was 7.09 g/dL, and the mean number of blood transfusions was 7.5. All patients had undergone intervention to manage an aortic pathology in the past. As the first investigation, an upper GI endoscopy in 5 and a CT scan in 3 patients were performed. In cases where CT scan was performed first, no definitive diagnosis was obtained, and the diagnosis was confirmed by performing an upper GI endoscopy. In cases where endoscopy was performed first, definitive diagnosis was made in only one case, and the other cases were confirmed by the CT scan. In some cases, tip attachments, converting to long endoscopes, and marking clips were found useful.

Conclusions
In patients who have undergone intervention to manage an aortic pathology and have episodes of upper gastrointestinal bleeding, ADF cannot be definitively diagnosed with only one investigation. In addition, when performing upper GI endoscopy in cases where an ADF is suspected, tip attachment, converting to a long endoscope, and using marking clips can be helpful.
The use of eculizumab in Capnocytophaga canimorsus associated thrombotic microangiopathy: a case report
Authors: Bjørkto Magnus Holter , Barratt-Due Andreas , Nordøy Ingvild , Dörje Christina , Galteland Eivind , Lind Andreas , Hilli Abdulkarim , Aukrust Pål , Mjøen Geir 
Published: February 2021

Abstract
Background
The use of complement inhibition is well established for complement mediated thrombotic microangiopathy, but its role in secondary forms of thrombotic microangiopathy is debated. We here present a case of thrombotic microangiopathy triggered by Capnocytophaga canimorsus, illustrating the diagnostic difficulties in discriminating between different thrombotic microangiopathies, and the dilemmas regarding how to treat this disease entity.

Case presentation
A previously healthy 56-year-old woman presented with fever and confusion. She was diagnosed with sepsis from Capnocytophaga canimorsus and thrombotic microangiopathy. Marked activation of both T-cells, endothelium and complement were documented. She was successfully treated with antimicrobial therapy, the complement inhibitor eculizumab and splenectomy. After several weeks, a heterozygote variant in complement factor B was localized, potentially implying the diagnosis of a complement mediated TMA over an isolated infection related TMA.

Conclusions
We discuss the possible interactions between complement activation and other findings in severe infection and argue that complement inhibition proved beneficial to this patient’s rapid recovery.