bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Lateral Femoral Condyle Index Is Not a Risk Factor for Primary Noncontact Anterior Cruciate Ligament Injury
Authors: Nowak Emma K. , Beaulieu Mélanie L. , Beynnon Bruce D. , Ashton-Miller James A. , Sturnick Daniel R. , Wojtys Edward M. 
Published: November 2021

Background: The lateral femoral condyle index (LFCI)—a recently developed measure of the sphericity of the lateral femoral condyle—was reported to be a risk factor for anterior cruciate ligament (ACL) injury. However, issues have been raised regarding how the index was measured and regarding the patient group and the knee in which it was measured. Purpose: To investigate the association between the LFCI and the risk of sustaining a primary, noncontact ACL injury, and to examine whether this association was moderated by the posterior-inferior–directed slope of the lateral tibial plateau. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A secondary analysis was conducted of deidentified magnetic resonance images of the uninjured knees of 86 athletes with ACL injury and the corresponding knees of 86 control athletes, matched for sports team, sex, and age. From those images, we measured the LFCI and the posterior-inferior–directed slope of the middle region articular cartilage surface of the tibial plateau’s lateral compartment. Conditional logistic regressions were performed to determine whether the LFCI was significantly associated with ACL injury risk and whether the lateral tibial compartment middle cartilage slope moderated this association. Data were analyzed for female and male participants separately as well as for both groups combined. Results: The LFCI was not found to be significantly associated with experiencing a primary, noncontact ACL injury for all analyses. The lateral tibial slope measure was not found to moderate the association between the LFCI and ACL injury. A conditional logistic regression analysis using the LFCI data of the injured knees, instead of the uninjured knees, of the participants with ACL injury revealed that the LFCI was significantly associated with ACL injury. Conclusion: In this population of athletically active female and male participants, the LFCI was not found to be a risk factor for noncontact ACL injury, regardless of the geometric features of the lateral tibial slope.
Femoral Positioning of the Anterolateral Ligament Graft With and Without Ultrasound Location of the Lateral Epicondyle
Authors: Castoldi Marie , Cavaignac Marie , Marot Vincent , Reina Nicolas , Mouarbes Dany , Berard Emilie , Cavaignac Etienne 
Published: November 2021

Background: In anterior cruciate ligament (ACL) reconstruction with anterolateral ligament (ALL) reconstruction, precise positioning of the ALL graft on the femur and tibia is key to achieve rotational control. The lateral femoral epicondyle is often used as a reference point for positioning of the ALL graft and can be located by palpation or with ultrasound guidance. Purpose: To compare the ALL graft positioning on the femoral side between an ultrasound-guided technique and a palpation technique for the location of the lateral epicondyle. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 120 patients receiving a primary combined ACL and ALL reconstruction between June and December 2019 were included. The location of the lateral epicondyle was determined by palpation in the palpation group (n = 60) and with preoperative ultrasound guidance in the ultrasound group (n = 60). Groups were comparable in age, sex, body mass index (BMI), and operated side. The planned positioning of the femoral ALL graft was proximal and posterior to the lateral epicondyle. The effective positioning of the femoral ALL graft was evaluated on postoperative lateral radiographs. The primary outcome was location of the graft in a 10-mm quadrant posterior and proximal to the lateral epicondyle. Results were analyzed in 2 subgroups according to BMI. Results: All 60 anterolateral grafts (100%) in the ultrasound group were positioned in a 10-mm quadrant posterior and proximal to the lateral epicondyle, as opposed to 52 (87%) in the palpation group ( P = .006). Errors in graft positioning with palpation occurred in overweight patients (BMI >25) as well as nonoverweight patients ( P = .3). Conclusion: Femoral positioning of the ALL graft posterior and proximal to the lateral epicondyle is more reproducible with ultrasound guidance when compared with palpation alone, regardless of BMI.
Comparative Assessment of Platinum Salts and Taxane Group Hypersensitivity Reactions, The Role of Skin Tests in Diagnosis?
Authors: Terzioğlu Kadriye , Ayhan Murat 
Published: November 2021

Purpose We aimed to investigate the role of skin tests (ST) in the diagnosis of hypersensitivity reactions (HSRs) with platinum salts (PS) and taxane (TX) groups drugs and their reliability in patient management. Materials and Method Patients' data who developed immediate HSR with PS and TX were recorded and ST was performed. The gradual challenge was applied to all patients with ST negative and grade 1–2 with the suspect drug. Results In total, the data of 104 patients (74 with PS, 30 with TX) who developed HSR against PS and TX were shared. The gradual challenge was applied to 72 ST negative and grade 1–2 patients (46 PS group, 26 TX group). The gradual challenge was negative in 39 patients in the PS group and 23 patients in the Tx group. The negative predictive value (NPV) for PS was 83% and NPV for TX was 88%. We found significantly higher skin test positivity in patients with PS and TX and grade 3 HSR ( p = 0.007, p = 0.001). A significant correlation was found between skin test positivity and early onset of symptoms ( p = 0.001 for PS, p = 0.015 for TX). In terms of symptoms witnessed in HSR, we observed the itching, urticaria, hypotension, syncope, and abdominal pain symptoms significantly more in the group with a positive skin test ( p < 0.024, p < 0.001, p < 0.001, p < 0.002, and p < 0.025, respectively). Conclusions We found very high NPV values for PS and TX. We found that the gradual challenge applied to patients with negative skin tests is reliable if Grade 3 HSR is not observed and with this approach, unnecessary desensitization processes and/or drug alterations can be avoided.
Circulating microRNAs are associated with variability in fasting blood glucose over 12-months and target pathways related to type 2 diabetes: A pilot study
Authors: Flowers Elena , Allen Isabel E , Kanaya Alka M , Aouizerat Bradley E 
Published: November 2021

Introduction MicroRNAs (miRs) may be important regulators of risk for type 2 diabetes (T2D). Circulating miRs may provide information about which individuals are at risk for T2D. The purpose of this study was to assess longitudinal associations between circulating miR expression and variability in fasting blood glucose (FBG) and to identify miR-targeted genes and biological pathways. Methods Variability in FBG was estimated using standard deviation from participants ( n = 20) in a previously completed yoga trial. Expression of 402 miRs was measured using hydrogel particle lithography. MirTarBase was used to identify mRNAs, and miRPathDB was used to identify pathways targeted by differentially expressed miRs. Results Six circulating miRs (miR-192, miR-197, miR-206, miR-424, miR-486, and miR-93) were associated with variability in FBG and targeted 143 genes and 23 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Six mRNAs ( AKT1, CCND1, ESR1, FASN, SMAD7, and VEGFA) were targeted by at least two miRs and four of those were located in miR-targeted KEGG pathways. Conclusions Circulating miRs are associated with variability in FBG in individuals at risk for T2D. Further studies are needed to determine whether miRs may be prodromal biomarkers that can identify which individuals are at greatest risk to progress to T2D and which biological pathways underlie this risk.
Oral Chinese Patent Medicine Combined With Oxaliplatin-Based Chemotherapy Regimen for the Treatment of Colorectal Cancer: A Network Meta-Analysis
Authors: Tang Mo , He Bin , Zhai Jiawei , Wang Lei 
Published: November 2021

Objective: To access the comparative effectiveness and safety of different oral Chinese patent medicine (OCPM) versus oxaliplatin-based chemotherapy regimen (C) alone for colorectal cancer (CRC) through network meta-analysis (NMA). Methods: Several electronic databases were searched for randomized controlled trials (RCTs) concentrated on the use of OCPM to treat CRC with C from the inception of the databases to January 10, 2021. We performed frequentist NMA and indirect comparison to compare study outcomes from the included RCTs. The risk of bias of each study was assessed using the Cochrane risk of bias tool. Confidence in evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). Results: A total of 31 RCTs with 1985 participants comparing 10 OCPM, namely, Antike (ATK), Shenyi (SY), Huachansu (HCS), Boerning (BEN), Xiaoaiping (XAP), Jinlong (JL), Compound matrine (CC), Pingxiao (PX), Xihuang pill (XHW), Kangaiping (KAP) were identified. The methodological quality of included RCTs was not very high. The results of the NMA showed that the comparisons were all indirect. Among diverse OCPM, ATK + C had the highest objective response rate (ORR) with a P-score of .63 with risk ratio (RR) of 1.37 (95% CI 1.12-1.66); with a RR of 1.96 (1.26-3.05), SY + C had the highest performance status with a P-score of .73; KAP + C had the lowest nausea and vomiting with a P-score of .91 and with a RR of 0.29 (0.10-0.79); and JL + C had lowest leukopenia with a P-score of .95 with a RR of 0.47 (0.31-0.72). The results of pairwise comparison suggested no difference in outcomes among 10 kinds of OCPM + C. The comparison-adjusted funnel plots suggested that there might not be small-study effects for outcomes. According to the CINeMa approach, the confidence rating of this NMA ranged from “very low” to “low” for various comparisons. Conclusion: Based on the NMA, ATK + C, SY + C, KAP + C and JL + C were associated with more preferable and options for CRC patients when referring to ORR, performance status, nausea and vomiting, and leukopenia, respectively. However, owing to the limitations of this research, the above conclusions require further verification by more high-quality RCTs. PROSPERO registration: CRD42020160658.
The role of sex and gender in the changing levels of anxiety and depression during the COVID-19 pandemic: A cross-sectional study
Authors: Seens Hoda , Modarresi Shirin , Fraser James , MacDermid Joy C , Walton David M , Grewal Ruby 
Published: November 2021

Background: Several studies have assessed the impact of the COVID-19 pandemic on anxiety and depression, but have not focused on the role of sex and gender. This study compared changes in the levels of anxiety and depression (pre- and post-COVID) experienced by individuals of various sexes and genders. Methods: We used a cross-sectional online survey that assessed pre- and post-COVID symptoms of anxiety (Generalized Anxiety Disorder-2) and depression (Patient Health Questionnaire-9). General linear modeling (fixed model factorial analysis of variance) was used to evaluate changes in anxiety and depression between pre- and post-pandemic periods and explore differential effects of sex and gender on those changes. Results: Our study included 1847 participants from 43 countries and demonstrated a percentage increase of 57.1% and 74.2% in anxiety and depression, respectively. For the Generalized Anxiety Disorder-2 scale (maximum score 6), there was a mean increase in anxiety by sex for male, female, and other of 1.0, 1.2, and 1.4, respectively; and by gender for man, woman, and others of 0.9, 1.3, and 1.6, respectively. For the Patient Health Questionnaire-9 (maximum score 27), there was a mean increase in depressive symptoms by sex for male, female, and other of 3.6, 4.7, and 5.5 respectively; and by gender for man, woman, and others of 3.3, 4.8, and 6.5, respectively. Conclusion: During COVID-19, there was an increase in anxiety and depressive symptoms for all sexes and genders, with the greatest increases reported by those identifying as non-male and non-men.
Diagnosis and Localization of Cerebrospinal Fluid Rhinorrhea: A Systematic Review
Authors: Xie Michael , Zhou Kelvin , Kachra Shamez , McHugh Tobial , Sommer Doron D. 
Published: November 2021

Background Cerebrospinal fluid (CSF) rhinorrhea results from abnormal communications between the subarachnoid and sinonasal spaces. Accurate preoperative diagnosis and localization are vital for positive clinical outcomes. However, the diagnosis and localization of CSF rhinorrhea remain suboptimal due to a lack of accurate understanding of test characteristics. Objective This systematic review aims to assess the diagnostic accuracy of various tests and imaging modalities for diagnosing and localizing CSF rhinorrhea. Methods A systematic review of the MEDLINE and EMBASE databases was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Our search identified 4039 articles—53 cohort studies and 24 case series describing 1622 patients were included. The studies were heterogeneous and had a wide range of sensitivities and specificities. Many specificities were incalculable due to a lack of true negative and false positive results, thus precluding a meta-analysis. Median sensitivities and specificities were calculated for cohort studies of the following investigations: high-resolution computed tomography (HRCT) 0.93/0.50 (sensitivity/specificity), magnetic resonance cisternography (MRC) 0.94/0.77, computed tomography cisternography (CTC) 0.95/1.00, radionuclide cisternography (RNC) 0.90/0.50, and contrast-enhanced magnetic resonance cisternography (CEMRC) 0.99/1.00, endoscopy 0.58/1.00, topical intranasal fluorescein (TIF) 1.00/incalculable, intrathecal fluorescein (ITF) 0.96/1.00. Case series were reviewed separately. Etiology and site-specific data were also analyzed. Conclusion MR cisternography is more accurate than high-resolution CT at diagnosing and localizing CSF rhinorrhea. CT cisternography, contrast-enhanced MR cisternography, and radionuclide cisternography have good diagnostic characteristics but are invasive. Intrathecal fluorescein shows promising data but has not been widely adopted for purely diagnostic use. Office endoscopy has limited data but does not sufficiently diagnose CSF rhinorrhea independently. These findings confirm with current guidelines and evidence.
Decreased serum C1Q/TNF-related protein 4 concentrations are associated with type 2 diabetes mellitus
Authors: Liu Zheng , Lu Jinhua , Zhang Daiyi , Niu Lijuan , Shi Bimin 
Published: November 2021

Objective: To detect serum C1Q/TNF-related protein 4 (CTRP4) concentrations in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and evaluate the correlation between CTRP4 and other variables in T2DM. Method: Sixty-five patients with newly diagnosed T2DM and eighty-nine healthy volunteers were enrolled in this study. Anthropometric and biochemical data of the study participants was collected, and serum CTRP4 concentrations were detected by enzyme-linked immunosorbent assay (ELISA) kit. The correlation between serum CTRP4 and other indexes was analyzed by Spearman correlation analysis. Trend χ2 test and binary multivariate stepwise logistic regression were performed to assess the correlation between CTRP4 and the risk of T2DM. Results: Serum CTRP4 concentrations in the T2DM group were significantly lower than those in the control group ( P < .01). Spearman correlation analysis showed that CTRP4 concentrations were negatively correlated with BMI, hs-CRP, HOMA-IR, FBG and TG ( r = - 0.430, - 0.453, - 0.371, - 0.361, - 0.506, P < .05), and positively correlated with HDL-c ( r = 0.303, P < .05). Trend χ2 test indicated that with the increase of CTRP4 levels in the population, the risk of T2DM presented a general downward trend ( P < .01). Binary multivariate stepwise logistic regression suggested that serum CTRP4 was an independent impact factor for T2DM and high serum CTRP4 levels were related to the decreased risk of T2DM (P < .05). Conclusions: Serum CTRP4 concentrations decrease in patients with newly diagnosed T2DM. Serum CTRP4 levels are negatively associated with the risk of T2DM.
Improved visualization of the chorda tympani nerve using ultra‐high-resolution computed tomography
Authors: Fujiwara Masahiro , Watanabe Yoshiyuki , Kashiwagi Nobuo , Ohta Yumi , Sato Takashi , Nishigaki Megumi , Tomiyama Noriyuki 
Published: November 2021

Background Recognition of the anatomical course of the chorda tympani nerve (CTN) is important for preventing iatrogenic injuries during middle-ear surgery. Purpose This study aims to compare visualization of the CTN using two computed tomography (CT) methods: conventional high-resolution CT (C-HRCT) and ultra‐high-resolution CT (U-HRCT). Materials and methods We performed a retrospective visual assessment of 59 CTNs in normal temporal bones of 54 consecutive patients who underwent both C-HRCT and U-HRCT. After dividing CTN into three anatomical segments (posterior canaliculus, tympanic segment, and anterior canaliculus), two neuroradiologists scored the visualizations on a four-point scale. Results On C-HRCT, the visual scores of the posterior canaliculus, tympanic segment, and anterior canaliculus were 3.5 ± 0.7, 1.6 ± 0.6, and 3.1 ± 0.7, respectively. The respective values were significantly higher in all segments on U-HRCT: 3.9 ± 0.2, 2.4 ± 0.6, 3.5 ± 0.6 ( p < 0.01). Although the difference in scores between methods was greatest for the tympanic segment, the visual score on U-HRCT was lower for the tympanic segment than for the anterior and posterior segments ( p < 0.01). Conclusion Ultra‐high-resolution CT provides superior visualization of the CTN, especially the tympanic segment.
Can the coronavirus disease 2019 (COVID-19) cause choroiditis and optic neuropathy?
Authors: Zor Kürşad Ramazan , Yıldırım Biçer Gamze , Tutaş Günaydın Nesrin , Küçük Erkut , Yılmaz Uğur 
Published: November 2021

Objectives: We aim to investigate the involvement of the choroid and retinal nerve fiber layer (RNFL) in COVID-19 patients using spectral domain optical coherence tomography. Methods: This cross-sectional study was conducted between April and June 2020. 40 patients (23 female and 17 male) with COVID-19 and 42 healthy individuals (26 female and 16 male) were included in the study. The OCT scans were performed 4 weeks after the COVID-19 diagnosis. Results: In the COVID-19 group, in the right eyes, the mean nasal choroidal thickness was 295.70 ± 7,046 μm ( p = 0.017), mean subfoveal choroidal thickness was 333.25 ± 6,353 μm ( p = 0.003), mean temporal choroidal thickness was 296.63 ± 6,324 μm ( p = 0.039), and mean RNFL was 89.23 ± 1.30 μm ( p = 0.227). In the left eyes, mean nasal choroidal thickness was 287.88 ± 9,033 μm ( p = 0.267), mean subfoveal choroidal thickness was 333.80 ± 9,457 μm ( p = 0.013), mean temporal choroidal thickness was 298.50 ± 9,158 μm ( p = 0.079), and mean RNFL was 89.48 ± 1,289 μm ( p = 0.092). Compared with the control group, the patient group had significant thickening of the choroidal thickness in all quadrants of the right eyes, and significant thickening of the subfoveal choroidal thickness in the left eyes. There was no significant difference in the RNFL thickness between groups ( p > 0.05). Conclusion: COVID-19 may cause a subclinical involvement in the choroidal layer.
Multi-institution Assessment of the Accuracy of Cardiac Computed Tomography in Preparation for Superior Cavopulmonary Connection
Authors: Nunes Mariana De Oliveira , Overman David M. , Casey Susan A. , Witt Dawn R. , Schmidt Christian W. , Griffin Lindsay , Rigsby Cynthia K. , Han B. Kelly 
Published: November 2021

Background Patients with single ventricle (SV) congenital heart disease (CHD) undergo several interventions in the first years of life. Advanced diagnostics are required for interstage assessment of anatomy, but are associated with significant diagnostic risk. We sought to evaluate image quality, risk, and accuracy of cardiac computed tomography (CCT) for evaluation of anatomy prior to superior cavopulmonary connection (SCPC) compared to surgical findings across 2 institutions. Methods A retrospective evaluation of image quality, risk, and accuracy of pre-SCPC CCT was performed at 2 institutions between January 1, 2010 and September 30, 2016. Results CCT was performed in 90 SV CHD patients with a median age of 4.03 months (interquartile range [IQR] 3.36, 5.33) prior to SCPC. Image quality was optimal (84%) or good (16%) in all patients, without significant discrepancy compared to surgical findings. 7 patients (8%) required interventional cardiac catheterization subsequent to CCT and before surgical intervention. 49% of scans were performed without sedation, 43% of scans were performed with mild to moderate sedation, and 8% of scans were performed with general anesthesia. The median total procedural dose-length product (DLP) was 18 (IQR 14, 26) mGy*cm, estimating an age adjusted radiation dose of 1.4 millisievert (mSv). One minor (1%) adverse event was reported within 24 h of the CCT. Surgical complications were unrelated to the presurgical findings. Conclusions CCT for pre-SCPC evaluation is safe, with excellent accuracy for anatomy at the time of surgical intervention across 2 institutions. In select patients, noninvasive evaluation with CCT may be indicated.
Management of Interrupted Aortic Arch With Associated Anomalies: A Single-Center Experience
Authors: Onalan Mehmet A. , Temur Bahar , Aydın Selim , Suzan Dilek , Demir Ibrahim H. , Odemis Ender , Erek Ersin 
Published: November 2021

Objectives Interrupted aortic arch (IAA) includes a broad spectrum of associated anomalies. In this study, we present our surgical management and patient-specific decisions regarding IAA anomalies with early- and mid-term outcomes. Methods The medical records of 25 patients undergoing IAA repair between 2014 and 2019 were retrospectively reviewed. Sixteen patients had type B (64%) interruptions, 7 had type A (28%) interruptions, and 2 had type C (8%) interruptions. Fourteen patients had an isolated ventricular septal defect, and 3 of them had associated left ventricular outflow tract obstruction. Other associated anomalies were functional single ventricle (n = 5), Taussig–Bing anomaly (n = 3), aortopulmonary window (n = 1), multiple ventricular septal defects (n = 1), and truncus arteriosus with dextrocardia (n = 1). The initial operation age was 17.2 ± 14 (range: 1 - 60) days. Results Single-stage total repair was performed for 15 patients. Six patients underwent aortic arch repair and pulmonary artery banding. Four patients with left ventricular outflow tract obstruction or who were premature underwent the hybrid procedure. The aortic arch repair was performed in 16 cases (64%) by the anterior patch augmentation technique, in 3 cases (12%) by the reverse left subclavian artery flap technique, and in 3 cases (12%) by direct end-to-end anastomosis. Postoperative early mortality occurred in 4 (16%) patients, and sternal closure was delayed in 13 (52%) patients. Three patients who underwent a hybrid procedure due to left ventricular outflow tract obstruction underwent biventricular repair 8 to 13 months later. Eight patients (38%) required reintervention due to arch restenosis during the follow-up period. The mean follow-up was 37.1 ± 21.7 months. Conclusion Planning surgical treatment according to the characteristics of the patients and accompanying anomalies may improve the results.