bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Initial Stability of Oblong, Large Circular, and Multiple-Plug “Snowman” Osteochondral Autografts for Elongated Focal Cartilage Lesions: A Biomechanical Study in a Porcine Model
Authors: Dwivedi Shashank , Kutschke Michael , Nadeem Maheen , Owens Brett D. 
Published: November 2021

Background: Distal femoral osteochondral allograft transplantation (OAT) is an effective treatment of osteochondral lesions in the knee measuring >2 cm2 in select patients. Prior studies have demonstrated that the morphology of the plug can affect graft-host interference fit. To our knowledge, there are no data comparing the initial biomechanical stability of standard cylindrical plugs with multiple-plug and oblong-plug morphologies. Hypothesis: Large cylindrical single-plug (LCSP) and oblong single-plug (OSP) grafts will have greater pull-out strength, and therefore greater initial stability, than multiple-plug (MP) grafts in a cadaveric porcine femur model. Study Design: Controlled laboratory study. Methods: A total of 55 porcine distal femurs were divided into 3 groups—LCSP (n = 18), OSP (n = 19), and MP (n = 18)—according to the plug morphology used. The method of graft harvesting and implantation was based on technique guides for the respective implant systems. The sizes (length × width × depth) of the osteochondral defects created in each of the groups were approximately 20.2 × 20.2 × 9.4–mm for the LCSP group, 14.4 × 30.5 × 7.9–mm for the OSP group, and 14.8 × 14.8 × 9.9–mm for the MP group. Tensile testing was performed on each graft to determine pull-out strength. Results: The pull-out strength was significantly lower in the OSP group (65.7 N) versus the LCSP (133 N; P = .0005) and the MP (117.6 N; P = .001) groups. There was no statistically significant difference in pull-out strength between the LCSP and MP groups ( P = .42). There were no statistically significant differences in displacement at maximum load among any 2 of the 3 groups. Conclusion: These findings suggest that while initial stability may play a role in the clinical outcomes of osteochondral allograft (OCA) implantation, the biological milieu in vivo for each graft setting perhaps has a greater impact on the success of an OAT procedure. Further study is needed on the relationship between OCA biomechanics and clinical outcomes of OAT.
Local Infiltration Analgesia Versus Femoral Nerve Block for Pain Control in Anterior Cruciate Ligament Reconstruction: A Systematic Review With Meta-analysis
Authors: Shin Seong Kee , Lee Do Kyung , Shin Dae Won , Yum Tae Hoon , Kim Jun-Ho 
Published: November 2021

Background: Anterior cruciate ligament reconstruction (ACLR) is often performed on an outpatient basis; thus, effective pain management is essential to improving patient satisfaction and function. Local infiltration analgesia (LIA) and femoral nerve block (FNB) have been commonly used for pain management in ACLR. However, the comparative efficacy and safety between the 2 techniques remains a topic of controversy. Purpose: To compare pain reduction, opioid consumption, and side effects of LIA and FNB after ACLR. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic search of MEDLINE, Embase, and Cochrane Library databases was performed to identify studies comparing pain on the visual analog scale (a 100-mm scale), total morphine-equivalent consumption, and side effects between the 2 techniques after ACLR at the early postoperative period. The LIA was categorized into intra-articular injection and periarticular injection, and subgroup analyses were performed comparing either intra-articular injection or periarticular injection with FNB. Two reviewers performed study selection, risk-of-bias assessment, and data extraction. Results: A total of 10 studies were included in this systematic review and meta-analysis. In terms of VAS pain scores, our pooled analysis indicated that FNB was significantly more effective at 2 hours postoperatively compared with LIA (mean difference, 8.19 [95% confidence interval (CI), 0.75 to 15.63]; P = .03), with no significant difference between the 2 techniques at 4, 8, and 12 hours postoperatively; however, LIA was significantly more effective at 24 hours postoperatively compared with FNB (mean difference, 5.61 [95% CI, −10.43 to −0.79]; P = .02). Moreover, periarticular injection showed a significant improved VAS pain score compared with FNB at 24 hours postoperatively (mean difference, 11.44 [95% CI, −20.08 to −2.80]; P = .009), and the improvement reached the threshold of minimal clinically important difference of 9.9. Total morphine-equivalent consumption showed no difference between the 2 techniques, and side effects were unable to be quantified for the meta-analysis because of a lack of data. Conclusion: Compared with FNB, LIA was not as effective at 2 hours, comparable within 12 hours, and significantly more effective at 24 hours postoperatively for reducing pain after ACLR. Total morphine-equivalent consumption showed no significant differences between the 2 techniques.
Syndecan-2 enriches for hematopoietic stem cells and regulates stem cell repopulating capacity
Authors: Termini Christina M. , Pang Amara , Li Michelle , Fang Tiancheng , Chang Vivian Y. , Chute John P. 
Published: November 2021

Abstract
The discovery of novel hematopoietic stem cell (HSC) surface markers can enhance understanding of HSC identity and function. We have discovered a population of primitive bone marrow (BM) HSCs distinguished by their expression of the heparan sulfate proteoglycan Syndecan-2, which serves as both a marker and a regulator of HSC function. Syndecan-2 expression was increased 10-fold in CD150+CD48–CD34–c-Kit+Sca-1+Lineage– cells (long-term HSCs [LT-HSCs]) compared with differentiated hematopoietic cells. Isolation of BM cells based solely on syndecan-2 surface expression produced a 24-fold enrichment for LT-HSCs and sixfold enrichment for α-catulin+c-kit+ HSCs, and yielded HSCs with superior in vivo repopulating capacity compared with CD150+ cells. Competitive repopulation assays revealed the HSC frequency to be 17-fold higher in syndecan-2+CD34–KSL cells compared with syndecan-2–CD34–KSL cells and indistinguishable from CD150+CD34–KSL cells. Syndecan-2 expression also identified nearly all repopulating HSCs within the CD150+CD34–KSL population. Mechanistically, syndecan-2 regulates HSC repopulating capacity through control of expression of Cdkn1c (p57) and HSC quiescence. Loss of syndecan-2 expression caused increased HSC cell cycle entry, downregulation of Cdkn1c, and loss of HSC long-term repopulating capacity. Syndecan-2 is a novel marker of HSCs that regulates HSC repopulating capacity via control of HSC quiescence.
Gain-of-function mutations in RPA1 cause a syndrome with short telomeres and somatic genetic rescue
Authors: Sharma Richa , Sahoo Sushree S. , Honda Masayoshi , Granger Sophie L. , Goodings Charnise , Sanchez Louis , Künstner Axel , Busch Hauke , Beier Fabian , Pruett-Miller Shondra M. , Valentine Marcus B. , Fernandez Alfonso G. , Chang Ti-Cheng , Géli Vincent , Churikov Dmitri , Hirschi Sandrine , Pastor Victor B. , Boerries Melanie , Lauten Melchior , Kelaidi Charikleia , Cooper Megan A. , Nicholas Sarah , Rosenfeld Jill A. , Polychronopoulou Sophia , Kannengiesser Caroline , Saintomé Carole , Niemeyer Charlotte M. , Revy Patrick , Wold Marc S. , Spies Maria , Erlacher Miriam , Coulon Stéphane , Wlodarski Marcin W. 
Published: November 2021

Abstract
Human telomere biology disorders (TBD)/short telomere syndromes (STS) are heterogeneous disorders caused by inherited loss-of-function mutations in telomere-associated genes. Here, we identify 3 germline heterozygous missense variants in the RPA1 gene in 4 unrelated probands presenting with short telomeres and varying clinical features of TBD/STS, including bone marrow failure, myelodysplastic syndrome, T- and B-cell lymphopenia, pulmonary fibrosis, or skin manifestations. All variants cluster to DNA-binding domain A of RPA1 protein. RPA1 is a single-strand DNA-binding protein required for DNA replication and repair and involved in telomere maintenance. We showed that RPA1E240K and RPA1V227A proteins exhibit increased binding to single-strand and telomeric DNA, implying a gain in DNA-binding function, whereas RPA1T270A has binding properties similar to wild-type protein. To study the mutational effect in a cellular system, CRISPR/Cas9 was used to knock-in the RPA1E240K mutation into healthy inducible pluripotent stem cells. This resulted in severe telomere shortening and impaired hematopoietic differentiation. Furthermore, in patients with RPA1E240K, we discovered somatic genetic rescue in hematopoietic cells due to an acquired truncating cis RPA1 mutation or a uniparental isodisomy 17p with loss of mutant allele, coinciding with stabilized blood counts. Using single-cell sequencing, the 2 somatic genetic rescue events were proven to be independently acquired in hematopoietic stem cells. In summary, we describe the first human disease caused by germline RPA1 variants in individuals with TBD/STS.
Genome-wide identification and expression profiling of Alba gene family members in response to abiotic stress in tomato (Solanum lycopersicum L.)
Authors: Wai Antt Htet , Cho Lae-Hyeon , Peng Xin , Waseem Muhammad , Lee Do-jin , Lee Je-Min , Kim Chang-Kil , Chung Mi-Young 
Published: November 2021

Abstract
Background
Alba (Acetylation lowers binding affinity) proteins are an ancient family of nucleic acid-binding proteins that function in gene regulation, RNA metabolism, mRNA translatability, developmental processes, and stress adaptation. However, comprehensive bioinformatics analysis on the Alba gene family of Solanum lycopersicum has not been reported previously.

Results
In the present study, we undertook the first comprehensive genome-wide characterization of the Alba gene family in tomato (Solanum lycopersicum L.). We identified eight tomato Alba genes, which were classified into two groups: genes containing a single Alba domain and genes with a generic Alba domain and RGG/RG repeat motifs. Cis-regulatory elements and target sites for miRNAs, which function in plant development and stress responses, were prevalent in SlAlba genes. To explore the structure-function relationships of tomato Alba proteins, we predicted their 3D structures, highlighting their likely interactions with several putative ligands. Confocal microscopy revealed that SlAlba–GFP fusion proteins were localized to the nucleus and cytoplasm, consistent with putative roles in various signalling cascades. Expression profiling revealed the differential expression patterns of most SlAlba genes across diverse organs. SlAlba1 and SlAlba2 were predominantly expressed in flowers, whereas SlAlba5 expression peaked in 1 cm-diameter fruits. The SlAlba genes were differentially expressed (up- or downregulated) in response to different abiotic stresses. All but one of these genes were induced by abscisic acid treatment, pointing to their possible regulatory roles in stress tolerance via an abscisic acid-dependent pathway. Furthermore, co-expression of SlAlba genes with multiple genes related to several metabolic pathways spotlighted their crucial roles in various biological processes and signalling.

Conclusions
Our characterization of SlAlba genes should facilitate the discovery of additional genes associated with organ and fruit development as well as abiotic stress adaptation in tomato.
The quality of patients’ self-blood pressure measurements: a cross-sectional study
Authors: Nessler Katarzyna , Krztoń-Królewiecka Anna , Suska Anna , Mann Mitchell R. , Nessler Michał B. , Windak Adam 
Published: November 2021

Abstract
Background
The accurate and independent measurement of blood pressure (BP) by patients is essential for home BP monitoring (HBPM) and determining the quality of hypertension (HTN) control. This study aimed to evaluate the BP self-measurement techniques of hypertensive patients and their accuracy in accordance with established guidelines. We sought to identify the common errors that patients make and suggest improvements that can be implemented in the primary healthcare setting to increase the reliability of HBPM conducted by hypertensive patients.

Methods
One hundred patients diagnosed with HTN completed a questionnaire inquiring about their health and demographic data and BP monitoring practices. Patients were then observed and filmed while measuring their BP on their own devices in five primary healthcare centres in Kraków, Poland. The correctness of their techniques was assessed in accordance with the European Society of Hypertension guidelines on HBPM.

Results
Only 3% of patients measured their BP without error; 60% made three or more errors. The most frequent error, made by 76% of subjects, was incorrect sphygmomanometer cuff placement (above or below heart level, or/and the indicator mark was not aligned with the brachial artery). Regarding patients’ previous instruction for the correct use of their devices, 36% of patients referred to their monitor’s user manual, 22% did not receive any prior assistance, and only 29% were adequately counselled by physicians on how to measure their BP correctly.

Conclusions
Our findings suggest that primary healthcare physicians and their personnel often do not adequately instruct patients on how to measure their BP correctly. Therefore, healthcare systems must provide patients with more adequate training and reference materials on the best practices of BP monitoring.
Clinical outcomes in 2481 unselected real-world patients treated with a polymer-free sirolimus-eluting stent: 3 years results from the NANO multicenter Registry
Authors: Dai Yi , Wang Rutao , Chen Fengying , Zhang Yaojun , Liu Yi , Huang He , Yang Ping , Zhang Ruining , Zheng Bo , Gao Chao , Chen Yundai , Tao Ling 
Published: November 2021

AbstractObjectivesTo evaluate the 3-year clinical outcomes of a polymer-free sirolimus-eluting, Nano plus stent for the treatment of coronary artery disease in the NANO multicenter Registry.BackgroundThe long-term clinical data evaluating the safety and efficacy of the novel polymer-free sirolimus-eluting Nano plus stent (Lepu Medical, Beijing, China) is limited.MethodsThe NANO all-comers Registry trial was a prospective, multicenter clinical registry conducted in 26 centers in China between August 2016 and January 2017. A total of 2481 consecutive patients were exclusively treated with the Nano plus stent. The primary clinical endpoint, target lesion failure (TLF, defined as cardiac death, target vessel nonfatal myocardial infarction, and clinically driven target lesion revascularization [CD-TLR]), was analyzed at 3 years.ResultsAt 3 years, 2295 patients (92.5%) were followed. The incidence of TLF was 6.8% (168/2481). The rate of cardiac death was 3.8% (94/2481), target vessel nonfatal myocardial infarction 0.7% (18/2481), and CD-TLR 2.9% (68/2481). The rate of definite/probable stent thrombosis was 0.5% (13/2481). The risk factors of diabetes mellitus, acute myocardial infarction, age, chronic renal failure, in-stent restenosis, chronic total occlusion, and left ventricular ejection fraction < 40% were the independent predictors of 3-year TLF.ConclusionsAt three years, the rate of TLF was relatively low in patients treated with the polymer-free Nano plus stent. The polymer-free Nano plus stent showed a favorable safety and efficacy profile in real-world patients.Clinical trial registrationURL:https://www.clinicaltrials.gov/. Unique identifier: NCT02929030.
Strategies for working across Canadian practice-based research and learning networks (PBRLNs) in primary care: focus on frailty
Authors: Thandi Manpreet , Wong Sabrina T. , Aponte-Hao Sylvia , Grandy Mathew , Mangin Dee , Singer Alexander , Williamson Tyler 
Published: November 2021

Abstract
Background
Practice based research and learning networks (PBRLNs) are groups of learning communities that focus on improving delivery and quality of care. Accurate data from primary care electronic medical records (EMRs) is crucial in forming the backbone for PBRLNs. The purpose of this work is to: (1) report on descriptive findings from recent frailty work, (2) describe strategies for working across PBRLNs in primary care, and (3) provide lessons learned for engaging PBRLNs.

Methods
We carried out a participatory based descriptive study that engaged five different PBRLNs. We collected Clinical Frailty Scale scores from a sample of participating physicians within each PBRLN. Descriptive statistics were used to analyze frailty scores and patients’ associated risk factors and demographics. We used the Consolidated Framework for Implementation Research to inform thematic analysis of qualitative data (meeting minutes, notes, and conversations with co-investigators of each network) in recognizing challenges of working across networks.

Results
One hundred nine physicians participated in collecting CFS scores across the five provinces (n = 5466). Percentages of frail (11-17%) and not frail (82-91%) patients were similar in all networks, except Ontario who had a higher percentage of frail patients (25%). The majority of frail patients were female (65%) and had a significantly higher prevalence of hypertension, dementia, and depression. Frail patients had more prescribed medications and numbers of healthcare encounters. There were several noteworthy challenges experienced throughout the research process related to differences across provinces in the areas of: numbers of stakeholders/staff involved and thus levels of burden, recruitment strategies, data collection strategies, enhancing engagement, and timelines.

Discussion
Lessons learned throughout this multi-jurisdictional work included: the need for continuity in ethics, regular team meetings, enhancing levels of engagement with stakeholders, the need for structural support and recognizing differences in data sharing across provinces.

Conclusion
The differences noted across CPCSSN networks in our frailty study highlight the challenges of multi-jurisdictional work across provinces and the need for consistent and collaborative healthcare planning efforts.
Assessment of the health status of middle-aged and elderly men with head scale, SF-36, IIEF5, AMS, and IPSS
Authors: Zhu Yi , Li Jian-Hui , Zhao Jing , Zheng Jun-Biao , Liang Qun-Feng , Yu Xiao-Hua , Zhang Shu-Cheng , Shi Hui-Juan , Zhou Wei-Jin , Zhu Qian-Xi 
Published: November 2021

Abstract
Background
Identifying practical and distinguished indicators and influencing factors of male aging may be useful in predicting subsequent aging trends, designing personalized prevention, and improving lifestyle and health.

Methods
A cross-sectional, population-based study was performed in Jiashan County, China in 2016. A total of 690 local male residents, aged 40 to 80 years, were eligible for recruitment. Demographic and lifestyle information was collected through structured interviews. A self-designed head scale, the Medical Outcomes Study 36-item Short Form (SF-36), International Index of Erectile Function (IIEF5), Aging Males’ Symptoms (AMS), and International Prostate Symptom Score (IPSS) were used. Analysis of variance, local polynomial regression smoothing curves, multiple linear regression, and partial correlation analyses were performed.

Results
All the scales deteriorated with increasing age (P < 0.01), especially from the age of 60. The most significant changes between adjacent age groups were found in IIEF5 scores (16.7, 43.5 and 39.4%). Income, nutrition, personality and neighborhood relationship had an effect on SF-36 and AMS after adjusting for age (P < 0.01). Furthermore, neighborhood relationship modified the age effect on the head scale score and IIEF5 (P = 0.03); nutrition modified the relationship between age and SF-36 (P < 0.01).

Conclusions
Recession of reproductive health may be a distinct predictor of male aging. The associations of social inequalities or personality and health offer potential interventions for men’s health in aging. Self-reported scales may limit the precision and more physical fitness tests could be combined for a more precise assessment.
Survey of pretreatment HIV drug resistance and the genetic transmission networks among HIV-positive individuals in southwestern China, 2014–2020
Authors: Xu Xiaoshan , Luo Liuhong , Song Chang , Li Jianjun , Chen Huanhuan , Zhu Qiuying , Lan Guanghua , Liang Shujia , Shen Zhiyong , Cao Zhiqiang , Feng Yi , Liao Lingjie , Xing Hui , Shao Yiming , Ruan Yuhua 
Published: November 2021

AbstractBackgroundPretreatment drug resistance (PDR) can limit the effectiveness of HIV antiretroviral therapy (ART). The aim of this study was to assess the prevalence of PDR among HIV-positive individuals that initiated antiretroviral therapy in 2014–2020 in southwestern China.MethodsConsecutive cross-sectional surveys were conducted in Qinzhou, Guangxi. We obtained blood samples from individuals who were newly diagnosed with HIV in 2014–2020. PDR and genetic networks analyses were performed by HIV-1 pol sequences using the Stanford HIV-database algorithm and HIV-TRACE, respectively. Univariate and multivariate logistic regression models were used to explore the potential factors associated with PDR.ResultsIn total, 3236 eligible HIV-positive individuals were included. The overall prevalence of PDR was 6.0% (194/3236). The PDR frequency to NNRTI (3.3%) was much higher than that of NRTI (1.7%, p < 0.001) and PI (1.2%, p < 0.001). A multivariate logistic regression analysis revealed that PDR was significantly higher among individuals aged 18–29 (adjusted odds ratio (aOR): 1.79, 95% CI 1.28–2.50) or 30–49 (aOR: 2.82, 95% CI 1.73–4.82), and harboring CRF08_BC (aOR: 3.23, 95% CI 1.58–6.59). A total of 1429 (43.8%) sequences were linked forming transmission clusters ranging in size from 2 to 119 individuals. Twenty-two individuals in 10 clusters had the same drug resistant mutations (DRMs), mostly to NNRTIs (50%, 5/10).ConclusionsThe overall prevalence of PDR was medium, numerous cases of the same DRMs among genetically linked individuals in networks further illustrated the importance of surveillance studies for mitigating PDR.
Relationship between malnutrition and possible sarcopenia in the AWGS 2019 consensus affecting mortality in hemodialysis patients: a prospective cohort study
Authors: Kono Kenichi , Moriyama Yoshifumi , Yabe Hiroki , Hara Ayaka , Ishida Takeki , Yamada Tetsuya , Nishida Yusuke 
Published: November 2021

Abstract
Background
The first objective of this study was to determine the relationship between muscle strength or physical performance and mortality, and the second objective was to show the relationship of Geriatric Nutritional Risk Index (GNRI) to muscle strength and physical performance decline.

Methods
We examined handgrip, the 5-times chair stand test, and GNRI in 635 maintenance hemodialysis patients and followed up for 72 months. Predictors for all-cause death were examined using Kaplan-Meier analysis and Cox proportional analysis. The relationship between possible sarcopenia and nutritional disorder (GNRI) was constructed receiver operating characteristic (ROC) curve. We used the Youden index to determine the optimal cutoff points for GNRI.

Results
The multivariate Cox proportional hazard analysis revealed that the GNRI did not show any significance, although handgrip (HR 3.61, 95% CI 1.70–7.68, p < 0.001) and the 5-times chair stand test (HR 1.71 95% CI 1.01–2.90, p = 0.045) were significant predictors for mortality. On the evaluation of possible sarcopenia by handgrip strength, the area under curve (AUC) on ROC curve analysis were 0.68 (95% CI 0.64–0.72), and 5-chair stand, the AUC on ROC were 0.55 (95% CI 0.51–0.60). The cut-off value for the GNRI discriminating those at possible sarcopenia by handgrip strength based on the Youden index was 91.5.

Conclusions
Our study suggests that the handgrip strength test of the AWGS 2019 sarcopenia consensus was a simple and useful tool to predict mortality in chronic hemodialysis patients. Furthermore, GNRI assessment can be a useful tool for screening before assessing possible sarcopenia when it is difficult to perform SARC-F to all patients.