bluuebunny/crossref_metadata_2025_split huggingface dataset:
Creation of a Custom 3D Algorithm for Proper Alignment of Straight Nails in Tibiotalocalcaneal Arthrodesis
Authors: Subasi Omer , Tung Wei Shao , Hollander Julian , Ghandour Samir , Taseh Atta , Nassour Nour , Aratikatla Adarsh , Ebrahimi Alireza , Burgesson Bernard , Ashkani-Esfahani Soheil , Kwon John Y. 
Published: December 2024

Category: Hindfoot; Ankle Introduction/Purpose: Tibiotalocalcaneal (TTC) arthrodesis is a complex procedure for severe ankle and hindfoot pathologies like end-stage osteoarthritis or avascular necrosis of the talus. Proper calcaneal fixation with the talus and tibia is crucial for postoperative stability and neurovascular protection in intramedullary nailing. A cadaveric study by Hyer et al. showed that a wire placed anterograde through the tibial shaft may miss the calcaneus medially. Methodologic limitations included a limited number of cadavers, non-loaded specimens, and a lack of critical examination of hindfoot alignment. This study aims to determine the feasibility of using weightbearing computed tomography (WBCT) and 3D segmentation software to ascertain an optimal entry point for a straight intramedullary nail in TTC arthrodesis in weightbearing patients. Methods: A total of 100 normal ankles (48 left, 52 right) from 52 patients (Age: 39.9 ± 16.7 years; Gender: 68% F; BMI: 28.1 ± 5.8 kg/m^2) with WBCT scans were obtained and subsequently segmented for inclusion in the study. A novel mathematical algorithm was developed to determine the 3D intersection of the distal tibial central axis extension at the inferior calcaneus. The algorithm approximates the central axis by mapping the center point of the tibial medulla at each CT slice, from the shaft to the tibiotalar joint using 3D surface contours in the axial plane. Then, the central axis is extended through the talus and calcaneus to approximate its exit point on the inferior surface of the calcaneus for each individual ankle (Figure 1a). A 2D linear transformation (affine transformation) was applied to obtain a heat map of all intersection points on the inferior surface of the calcaneus. Results: The mean (SD) polar angle of the central axis with respect to the ground was 84.9 ± 2.3 degrees. The root mean (SD) square error of the affine transformation was 1.62 ± 1.02 mm, demonstrating the validity of mapping. The exit points of the central axis across all patients fall predominantly along the sustentaculum tali (Figure 1b). Conclusion: A straight nail passing through the sustentaculum tali places surrounding neurovascular structures at risk and can also compromise the biomechanical stability of the implant. Our novel 3D algorithm shows that intraoperative adjustment of the starting point lateral to the central tibial axis is required to obtain optimal alignment of the hindfoot nail. Additionally, the novel algorithm can also be used preoperatively to estimate the required calcaneal medialization and ensure precise implant positioning. Proper nail alignment may potentially improve the success of TTC arthrodesis and decrease the risk of postoperative complications, including implant failure.
Debridement, Antibiotics, and Implant Retention (DAIR) vs 1.5-Stage Revision vs 2-Stage Revision in Periprosthetic Ankle Joint Infection: A Systematic Review
Authors: Izzo Antonio , Carbone Claudia , Festa Enrico , Balato Giovanni , Mariconda Massimo , Lintz François , Bernasconi Alessio 
Published: December 2024

Category: Ankle Arthritis; Ankle Introduction/Purpose: Total ankle replacement (TAR) is gaining momentum as surgical option in end-stage ankle osteoarthritis. Periprosthetic joint infection (PJI) is one of the most common complications and its management may be challenging. Our aim was to define the eradication rate and limits of the surgical procedures performed to treat PJI after TAR. Methods: This systematic review followed the PRISMA checklist and was registered in the Open Science Framework platform. Multiple databases were searched including clinical studies in which PJI after TAR was diagnosed and treated. Data were harvested regarding the cohort, the study design, the diagnostic criteria and the surgical treatment for PJI. The methodological index for nonrandomized studies (MINORS) was used to assess the methodological quality of studies. Three groups were built based on the surgical procedure performed by authors: Group 1 for debridement, antibiotics, and implant retention (DAIR), Group 2 for 1.5-stage revision (1.5-stage) and Group 3 for 2-stage revision procedures (2-stage). Results: Fourteen cohorts (eight studies,152 infected TARs, 152 patients; 44% females, mean age: 61.4 years) were included. All studies had a retrospective design. Ankle pain with swelling and increased local temperature usually led to a suspicion of PJI. In 100% of cases the diagnosis was confirmed through synovial fluid analysis with positive blood tests. Microorganisms were identified in 92% (range,64%-100%) of cases. The definition of eradication of the infection was heterogenous ( ‘no more surgery’ (4 studies)), normal clinical-serological markers (2 studies), negative intraoperative cultures (2 studies). The eradication rate in DAIR, 1.5-stage and 2-stage groups was 64% (39/58 patients) 91% (11/12) and 89% (47/54),respectively. The incidence of below-knee amputation was 6.5% at 38.6-month follow-up. MINORS score was 8/16 for noncomparative studies and 14.6/24 for comparative ones (moderate quality). Conclusion: Decision-making in PJI after TAR is based on small-sample retrospective studies of moderate quality. In this review, the estimated effectiveness of DAIR and exchange procedures to eradicate the infection was two-thirds and nine-tenths, respectively. In case of failure, below-knee amputation is not uncommon.
Differences in Postoperative Outcomes of Common Foot and Ankle Procedures Performed by Orthopedic Surgeons and Podiatrists
Authors: Chao Myra S. , Heo Kevin Yunhao , Coleman Michelle M. , Guyton Gregory P. 
Published: December 2024

Category: Ankle; Midfoot/Forefoot Introduction/Purpose: In the United States, there has been a substantial rise in podiatrists to address the increasing prevalence of foot and ankle pathologies. Although this may improve accessibility to foot and ankle care, there may be differences in the quality of care delivered by podiatrists compared to orthopedic surgeons. Some studies have found that patients treated by podiatrists have higher postoperative complication rates and length of hospital stay. With a growing emphasis on patient-centered care, there is a need for research investigating these differences so patients can make informed decisions when selecting providers. The purpose of our study is to compare postoperative complications in common foot and ankle procedures performed by orthopedic surgeons and podiatrists. Methods: A national database was queried to identify patients 18 years and older who underwent forefoot surgery (including fusion and bunionectomy), hindfoot or midfoot fusion, rotational ankle fracture fixation, ankle arthrodesis, or ankle arthroplasty from 2009-2022. Provider variable codes were then utilized to identify patients who underwent the corresponding procedures by orthopedic surgeons and podiatrists. Univariate analyses and multivariate logistic regressions were performed to compare 90-day rates of medical and surgical complications between the two provider categories for each procedure while controlling for age, sex, diabetes, smoking, and obesity. Results: Overall, 34,807 patients underwent foot and ankle (F&A) procedures by an orthopedic surgeon and 43,787 patients by a podiatric surgeon. Orthopedic patients were older (51.77 versus 50.79; p< 0.001), had a higher comorbidity index (Charlson Comorbidity Score 1.13 versus 0.97; p< 0.001), and were more likely to undergo surgery from an inpatient facility (16.18% versus 2.18%; p< 0.001). Comparing 90-day complication rates, podiatry patients exhibited higher rates of complications, including neuritis, nonunion, prosthetic complications, and wound debridement across various procedures when compared to orthopedic surgeons. Conclusion: Common foot and ankle procedures performed by podiatrists may be associated with higher postoperative complications affecting quality of care which could be attributed to differences in training, case volume and variety, and surgical techniques between orthopedic surgeons and podiatrists. Although access to foot and ankle procedures has improved, these data raise questions about the safety of procedures performed by podiatrists. Thus, additional highly powered studies are needed to investigate these postoperative differences to ensure that patients have all the information necessary to make informed decisions regarding their care.
Does Subspecialty Matter: Outcomes after Ankle Fracture Surgery
Authors: Zhu Justin , Seddio Anthony , Gouzoulis Michael , Grauer Jonathan N. 
Published: December 2024

Category: Ankle; Trauma Introduction/Purpose: Orthopaedists are increasingly pursuing subspecialization after residency. However, few studies have compared ankle fracture surgery outcomes between orthopaedists from different subspecialty backgrounds. This study aims to investigate the effect of subspecialization on patient outcomes following surgical intervention for ankle fractures. Methods: The PearlDiver M161 Ortho administrative dataset was utilized to identify patients (average age: 54.48) who received ankle fracture surgery. Cohorts were created based on the subspecialty of the operating surgeon (foot & ankle, trauma, non-foot & ankle non-trauma). Rates of surgeon-reported medical and surgical adverse events within 90 days were compared between the three fellowship cohorts using multivariate logistic regression with the “non-foot&ankle non-trauma” cohort serving as the reference. 5-year implant removal rates were also compared between cohorts using a Kaplan-Meier curve. Results: Data from 146,421 patients receiving ankle fracture surgery were assessed (70.0% female). No significant differences were found in 5-year implant removal rates between the fellowship cohorts (p=0.8). Compared to the other cohorts, the foot&ankle subspecialty cohort demonstrated significant decreases in major adverse events (OR: 0.82 [0.74-0.91], p< 0.001), which was comprised of decreases in acute kidney injuries (OR: 0.75 [0.62-0.91], p=0.005), pneumonia (OR: 0.70 [0.56-0.87], p=0.002), and urinary tract infections (OR: 0.79 [0.68-0.91], p=0.001) following ankle fracture surgery. The foot & ankle cohort also demonstrated lower readmission rates (OR: 0.79 [0.67-0.93], p< 0.005). Conclusion: Foot & ankle surgeons demonstrated superior perioperative outcomes and readmission rates for their patients following ankle fracture surgery compared to trauma surgeons and orthopaedic surgeons of other subspecialty backgrounds.
Alzheimer's disease: A case study involving EEG-based fE/I ratio and pTau-181 protein analysis through nasal administration of Saraswata Ghrita
Authors: Badal Robin , Ranjan Shivani , Kumar Lalan , Shekhawat Lokesh , Patel Ashok Kumar , Yadav Pramod , Prajapati Pradeep Kumar 
Published: December 2024

Background Alzheimer's disease (AD) is a progressive neurodegenerative disorder that impairs memory, language, and cognitive functions and currently has no definitive cure. Saraswata Ghrita (SG), a traditional Ayurvedic remedy administered nasally, offers a holistic approach and is believed to directly affect brain functions through its unique delivery route. Objective This study aimed to evaluate the effectiveness of SG in improving cognitive function and neurochemical biomarkers in a patient with AD. Key outcomes included electroencephalography-based excitation/inhibition (fE/I) ratio, and levels of phosphorylated Tau-181 (pTau-181), serotonin, dopamine, acetylcholine, and dehydroepiandrosterone (DHEA). Methods A 90-day proof-of-concept clinical trial was conducted with one AD patient. Nasal administration of SG was performed twice daily. Measurements included EEG spectral power analysis across 1–48 Hz, cognitive function assessed by Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Quality of Life in Alzheimer's Disease (QoL-AD) scales, and biochemical analyses of pTau-181, serotonin, dopamine, acetylcholine, and DHEA. Results Notable improvements were observed: ADAS-Cog score decreased from 40 to 36, QoL-AD score increased from 23 to 31, MMSE score improved from 13 to 18, and MoCA score increased from 8 to 13. Biochemical markers showed a decrease in pTau-181 (12.50 pg/ml to 6.28 pg/ml), an increase in acetylcholine (13.73 pg/ml to 31.83 pg/ml), while serotonin and DHEA levels rose, and dopamine levels decreased (39.14 pg/ml to 36.21 pg/ml). Conclusions SG demonstrated potential in enhancing cognitive functions and neurochemical markers in AD, with the nasal route proving safe and effective. These findings suggest the value of traditional Ayurvedic treatments in contemporary AD management.
A Protocol for a Mixed Methods, Single-Arm, Hybrid Effectiveness-Implementation Trial Evaluating a 12-week Yoga Intervention Delivered by Videoconference for Young Adults Diagnosed With Cancer
Authors: Wurz Amanda , McLaughlin Emma , Janzen Anna , Cripps Hannah , Huang Longlong , Molina Heather , Cowley Lauren , Dreger Julianna , Culos-Reed S. Nicole , Quinn Kaitlyn , Currey in memory of Lisa , Pacelli Maria-Hélèna , Coombs Melissa , Shamshad Sundas 
Published: December 2024

Background Cancer among young adults (18-39 years) is relatively rare, but remains a leading cause of disability, morbidity, and mortality. Identifying strategies to support young adults’ health following a diagnosis of cancer is important. Yoga may enhance health and could be delivered by videoconference. However, little research exploring yoga, and no research exploring videoconference delivery of yoga has been conducted with this cohort. We worked with young adults affected by cancer and developed, piloted, and refined a yoga intervention delivered by videoconference. Objective To evaluate our yoga intervention in a full-scale, mixed methods, single-arm, hybrid effectiveness-implementation trial. Methods Young adults 18 years or older, diagnosed with cancer between the ages of 18-39 years of age, and at any stage along the cancer trajectory are eligible. Participants receive 2 yoga classes/week over 12-weeks by videoconference and complete assessments at baseline, post-intervention, and 6- and 12-month follow-ups. Assessments include self-reported questionnaires (ie, stress, yoga barriers, physical activity behaviour, fatigue, cognition, cancer-related symptoms, general health, health-related quality of life, self-compassion, mindfulness, group identification), physical assessments (ie, aerobic endurance, flexibility, range of motion, balance, functional mobility), and a semi-structured interview (post-intervention only; exploring perceptions of acceptability, feasibility, and experiences). Quality improvement cycles occur every 6 months. Repeated measures analysis of variance will be conducted to explore effectiveness, descriptive statistics and responder/non-responder analyses will be used to explore implementation, and qualitative interview data, analyzed using content analysis and reflexive thematic analysis, will bolster effectiveness and implementation findings. Discussion As the first full-scale trial to evaluate yoga delivered by videoconference for this cohort, findings will make substantial contributions to young adults' supportive cancer care. Conclusion This protocol, reporting on yoga delivered by videoconference for young adults diagnosed with cancer, will enhance transparency and reproducibility and provide a reference for forthcoming trial results. Trial registration NCT05314803 at clinicaltrials.gov .
Impact of clinical factors on accuracy of ovarian cancer detection via platelet RNA profiling
Authors: Jopek Maksym A. , Sieczczyński Michał , Pastuszak Krzysztof , Łapińska-Szumczyk Sylwia , Jassem Jacek , Żaczek Anna J. , Rondina Matthew T. , Supernat Anna 
Published: December 2024

Abstract
Ovarian cancer (OC) presents a diagnostic challenge, often resulting in poor patient outcomes. Platelet RNA sequencing, which reflects host response to disease, shows promise for earlier OC detection. This study examines the impact of sex, age, platelet count, and the training on cancer types other than OC on classification accuracy achieved in the previous platelet-alone training data set. A total of 339 samples from healthy donors and 1396 samples from patients with cancer, spanning 18 cancer types (including 135 OC cases) were analyzed. Logistic regression was applied to verify our classifiers’ performance and interpretability. Models were tested at 100% specificity and 100% sensitivity levels. Incorporating patient age as an additional feature along with gene expression increased sensitivity from 68.6% to 72.6%. Models trained on data from both sexes and on female-only data achieved a sensitivity of 68.6% and 74.5%, respectively. Training solely on OC data reduced late-stage sensitivity from 69.1% to 44.1% but increased early-stage sensitivity from 66.7% to 69.7%. This study highlights the potential of platelet RNA profiling for OC detection and the importance of clinical variables in refining classification accuracy. Incorporating age with gene expression data may enhance OC diagnostic accuracy. The inclusion of male samples deteriorates classifier performance. Data from diverse cancer types improves advanced cancer detection but negatively affects early-stage diagnosis.
Genome-wide CRISPR/Cas9 screen identifies AraC-daunorubicin-etoposide response modulators associated with outcomes in pediatric AML
Authors: Nguyen Nam H. K. , Rafiee Roya , Parcha Phani K. , Tagmount Abderrahmane , Rubnitz Jeffrey , Ribeiro Raul , Cao Xueyuan , Pounds Stanley B. , Vulpe Christopher D. , Lamba Jatinder K. 
Published: December 2024

Abstract
Cytarabine, daunorubicin, and etoposide (ADE) have been the standard backbone of induction chemotherapy regimen for patients with pediatric acute myeloid leukemia (pAML) for &gt;5 decades. However, chemoresistance is still a major concern, and a significant proportion of pAML becomes resistant to ADE treatment and relapse, leading to poor survival. Therefore, there is a considerable need to identify mechanisms mediating drug resistance for overcoming chemoresistance. Herein, we performed synthetic lethal CRISPR/Cas9 screens using the ADE components to identify response markers. We further integrated significant markers in 3 independent pAML clinical cohorts treated with only an ADE regimen to identify drug response biomarkers with prognostic significance. We were able to identify several mediators that represent clinically and biologically significant marker genes for ADE treatment, such as BCL2, CLIP2, and VAV3, which are resistant markers to ADE, with high expression associated with poor outcomes in pAML treated with ADE, and GRPEL1, HCFC1, and TAF10, which are sensitive markers to ADE, with high expression showing beneficial outcomes. Notably, BCL2, CLIP2, and VAV3 knockdowns in their expression in AML cell lines sensitized the cells more to the ADE components, suggesting that these modulators should be further studied as potential therapeutic targets to overcome chemoresistance.
Microplastic contamination in Czech drinking water: insights from comprehensive monitoring
Authors: Halfar Jan , Heviánková Silvie , Brožová Kateřina , Čabanová Kristina , Valigůrová Alice , Motyka Oldřich 
Published: December 2024

AbstractThe growth of global plastic production and the associated increase in microplastic pollution in the environment has attracted increasing attention from both scientists and the general public. Drinking water from public water supply systems is essential for human life and therefore ensuring its high quality is a priority. The aim of this study was to detect and identify microplastics in drinking water from public water supply systems. Water samples were collected from various locations across the Czech Republic during two sampling campaigns in 2021 and 2023. A total of 58 samples and 580 particles were analyzed using μ-FTIR (micro-Fourier-transform infrared spectroscopy). These particles were categorized by material, shape, color, and quantity. Of the analyzed particles, 196 were identified as microplastics. Except for one sample, where no microplastics were detected, the concentration ranged from 20 to 180 microplastics per liter during the first campaign and from 20 to 120 microplastics per liter in the second campaign. In the first campaign, fibers and transparent microplastics were predominantly detected, while in the second collection, fragments and blue microplastics were more common. The most frequently observed materials were paper with polyethylene coating, polyethylene terephthalate (PET), and polyester (PES). This study also provides data on the average daily intake of microplastics via drinking water, calculated as 2 and 2.1 MP/kg/day, with all results undergoing statistical evaluation. Furthermore, the study addresses new European legislation and the proposed standardized methodology, which represents a significant step toward achieving consistent results across studies and, upon its adoption, will likely influence the direction of research on microplastics in drinking water. However, as discussed in the study, the methodology contains several problematic aspects, which are elaborated upon. With the planned inclusion of microplastics on the EU list of substances to be monitored, it is essential to continue research and collect more data. This study confirms the presence of microplastics and provides detailed information on their characteristics in drinking water supplied by public water systems in the Czech Republic.Highlights

Two drinking water sampling campaigns were carried out.

Microplastics were found in 57 out of 58 analyzed drinking water samples.

The average MP concentrations in two campaigns amounted 68.3 and 65 MP/L.

Material, shape, and color of all detected microplastics were identified.

Average daily MP intake via drinking water was calculated as 2 and 2.1 MP/kg/day.

Graphical abstract