bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated levels of arginase activity are related to inflammation in patients with COPD exacerbation
Authors: Rodríguez-Guzmán Marcel Jose , Peces-Barba Romero Germán , Pérez Rial Sandra , Serrano del Castillo Cristina , Palomero Rodríguez Miguel Ángel , Mahillo-Fernandez Ignacio , Villar-Álvarez Felipe 
Published: August 2021

Abstract
Introduction
Within the pathogenesis of the chronic obstructive pulmonary disease (COPD) there are interactions between different inflammatory mediators that are enhanced during an exacerbation. Arginase is present in bronchial epithelial cells, endothelial, fibroblasts and alveolar macrophages, which make it a probable key enzyme in the regulation of inflammation and remodelling. We aimed to find a potential relationship between arginase activity, inflammatory mediators in COPD patients in stable phase and during exacerbations.

Methods
We performed a prospective, observational study of cases and controls, with 4 study groups (healthy controls, stable COPD, COPD during an exacerbation and COPD 3 months after exacerbation). We measured arginase, inflammation markers (IL-6, IL-8, TNF-∝, IFN-γ and C reactive protein), and mediators of immunity: neutrophils, monocytes, total TCD3 + lymphocytes (CD3ζ), CD4 + T cells, CD8 + T cells, NK cells.

Results
A total of 49 subjects were recruited, average age of 69.73 years (59.18% male). Arginase activity is elevated during an exacerbation of COPD, and this rise is related to an increase in IL-6 production. The levels of IL-6 and IL-8 remained elevated in patients with COPD at 3 months after hospital exacerbation.
We did not find a clear relationship between arginase activity, immunity or with the degree of obstruction in COPD patients.

Conclusions
Arginase activity is elevated during an exacerbation of COPD, and it could be related to an increase in the production of IL-6. Levels of IL-6, IL-8, and arginase activity remain elevated in patients with COPD at 3 months after hospital exacerbation. Arginase activity could contribute to the development of COPD.
LncRNA MANCR positively affects the malignant progression of lung adenocarcinoma
Authors: Liu Chang , Li Haifeng , Li Xiaojing , Zhao Xuejing , Zhang Xia 
Published: August 2021

Abstract
Background
LncRNA MANCR (mitosis-related lncRNA, LINC00704) is deemed as a pivotal regulator in various cancers, yet the biological function it performs in lung adenocarcinoma (LUAD) was rarely reported. We made an in-depth study to clarify its effect during the progression of this cancer.

Methods
Expression data and clinical information were first accessed from TCGA LUAD dataset (https://portal.gdc.cancer.gov/repository). Differentially expressed lncRNAs were identified. R package “survival” determined the survival significance of the lncRNA MANCR. GSEA software was applied to conduct single sample enrichment analysis. qRT-PCR was used to examine MANCR expression. The expression levels of related proteins were tested using Western blot assay. The impact of MANCR on cancer cell biological behaviors was investigated via cell function experiments.

Results
MANCR was significantly upregulated in LUAD cells. It also resulted in a poor prognosis. When MANCR expression was down-regulated, the expression of proteins related to invasion and migration, cell cycle and proliferation was decreased, while the expression of proteins associated with apoptosis was elevated. Furthermore, in vitro experiments revealed that silencing MANCR inhibited cancer cell functions, blocked cell cycle progression while promoting cell apoptosis.

Conclusion
LncRNA MANCR can lead to enhanced proliferative, invasive and migratory abilities of cancer cells while reducing cell apoptosis. Hence, MANCR might be a novel biomarker of LUAD.
Knee pain in young adult women- associations with muscle strength, body composition and physical activity
Authors: Ericsson Ylva B , McGuigan Fiona E , Akesson Kristina E 
Published: August 2021

AbstractBackgroundKnee pain is studied mostly in older age groups, although in young adults it may be an indicator of future impaired musculoskeletal health. Therefore, the aim of this study was to examine the longitudinal association between knee pain and thigh muscle strength in young adult women and to explore the associations between muscle strength, body composition, physical activity and knee pain.MethodsThe PEAK-25 cohort consists of women aged 25 at baseline (N=1064). At the 10-year follow-up n=728 attended for DXA-measured body composition and muscle strength assessment and n=797 answered the questionnaire on health and lifestyle. Independent samples t-test was used to compare women with and without knee pain, Spearman correlation was used to test the longitudinal association between strength and knee pain.ResultsKnee pain was reported by one third of the women at follow-up (n=260, 33%), although physical activity levels were similar in those with and without pain (high level 50 vs 45 % (p= 0.18). Body composition differed, however. Women with knee pain had higher BMI (25.6 vs 24.1), fat mass index (9.2 vs 8.2) and % total body fat mass (34.7 vs 33.2). Simultaneously, they had lower % lean mass (total body 61.5 vs 62.8; legs 20.6 vs 21.0) and lower thigh muscle strength (extensors 184.9 vs 196.8, flexors 96.6 vs 100.9,p<0.05), but slightly higher hamstrings-to -quadriceps ratio (0.53 vs 0.51,p=0.04). Muscle strength at baseline weakly correlated with knee pain at follow-up (extensor rs= -0.04; flexor -0.02,p>0.2). Overweight women had higher absolute thigh muscle strength, but lower weight-adjusted strength than normal weight women (p<0.001). Leg lean mass explained 26-34% of the variation in muscle strength and adjustment for physical activity level had little effect.ConclusionKnee pain is already common among women in their mid-thirties. Lower thigh muscle strength in the mid-twenties was not associated with future knee pain, however women with knee pain tended to have lower thigh muscle strength and a body composition of higher body fat combined with lower lean mass. Maintaining a healthy body composition and adequate thigh muscle strength may be beneficial for knee joint health.
Operative management of fragility fractures of the pelvis – a systematic review
Authors: Wilson Daniel G. G. , Kelly Joshua , Rickman Mark 
Published: August 2021

AbstractBackgroundThe incidence of osteoporotic pelvic fractures in elderly patient is rising. This brings an increasing burden on health and social care systems as these injuries often lead to prolonged hospital admissions, loss of independence, morbidity and mortality. Some centres now advocate stabilisation of these injuries to reduce pain, facilitate early mobilisation, decrease hospital stay and restore independence. A systematic review of the literature was planned to establish the evidence for this intervention.MethodsA systematic review was performed according to PRISMA guidelines. A clinical librarian performed a search of the following databases: NHS Evidence, TRIP, the Cochrane Database of Systematic Reviews, MEDLINE and EMBASE. Seventeen eligible studies were identified with 766 patients.ResultsThe quality of evidence was poor with no good quality randomised trials. The majority of injuries were minimally displaced. Posterior ring injuries were most often stabilised with percutaneous screws which were sometimes augmented with void filler. A number of techniques were described for stabilisation of the anterior ring although fixation of the anterior ring was frequently not performed.There was consistent evidence from the included studies that operative intervention significantly improved pain. Complications were minimal but there were increased failure rates when a single unaugmented sacroiliac joint screw was used. The limited availability of non-operative comparators made it difficult to draw firm conclusions about the efficacy of surgical over non-surgical management in these patients.ConclusionsOperative management of fragility fractures of the pelvis should be considered for patients failing a brief period of non-operative management, however prospective randomised trials need to be performed to provide improved evidence for this intervention. Surgeons should consider which fixation techniques for fragility fractures of the pelvis are robust enough to allow immediate weightbearing, whilst minimising operative morbidity and post-operative complications.PROSPERO Systematic Review ID: CRD42020171237.
Weight-bearing knee flexion angle better correlates with patient-reported outcome measures than non-weight-bearing condition in total knee arthroplasty: a three-dimensional analysis study
Authors: Kage Tomofumi , Inui Hiroshi , Tomita Tetsuya , Yamazaki Takaharu , Taketomi Shuji , Yamagami Ryota , Kono Kenichi , Kawaguchi Kohei , Sameshima Shin , Tanaka Sakae 
Published: August 2021

Abstract
Background
This study aims to elucidate and compare the relationship between the knee flexion angle and patient-reported outcome measures (PROM) in both non-weight-bearing (NWB) and weight-bearing (WB) conditions.

Methods
This retrospective cohort study included 61 knees (47 patients) who underwent total knee arthroplasty. The knee flexion angle was measured by three conditions: NWB in manual goniometer, NWB in fluoroscopic three-dimensional (3D) analysis and WB in the fluoroscopic 3D analysis. The PROM was evaluated by postoperative 2011 Knee Society Score (2011 KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Correlations between the knee flexion angle and PROM was analyzed using Spearman’s correlation coefficient. Additionally, whether the angular difference between NWB and WB correlated with the PROM or not was evaluated.

Results
The NWB knee flexion angle in a goniometer, NWB in 3D analysis, and WB in 3D analysis were 124.6° ± 8.4°, 118.0° ± 10.5°, and 109.5° ± 13.3°, respectively. The angular difference was 8.5° ± 12.8°. No PROM correlation existed in NWB using a goniometer. Moreover, significant positive correlations in 2011 KSS symptoms (r = 0.35) and 2011 KSS functional activities (r = 0.27) were noted in NWB using 3D analysis. Significant positive correlations existed in 2011 KSS symptoms (r = 0.32), 2011 KSS functional activities (r = 0.57), KOOS pain (r = 0.37), KOOS activity of daily living (ADL; r = 0.45), KOOS sports (r = 0.42), and KOOS quality of life (r = 0.36) in WB using 3D analysis. Significant negative correlations were noted in 2011 KSS functional activities (r = − 0.45), KOOS ADL (r = − 0.30), and KOOS sports (r = − 0.38) in angular difference.

Conclusions
The WB knee flexion angle better correlated with PROM compared with NWB by evaluation of 3D analysis. The larger the angular difference existed between NWB and WB, the lower the PROM score.
Benchmarking total hip replacement constructs using noninferiority analysis: the New Zealand joint registry study
Authors: Wyatt Michael , Frampton Chris , Whitehouse Michael , Deere Kevin , Sayers Adrian , Kieser David 
Published: August 2021

Abstract
Background
The aim of this study was to compare the relative performance of total hip replacement constructs and discern if there is substantial variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis.

Methods
All patients who underwent a primary total hip replacement (THR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of hip prostheses were compared with the best performing contemporary construct. Construct failure was estimated using the 1-Kaplan Meier survival function method to estimate net failure. The difference in failure between the contemporary benchmark and other constructs was examined.

Results
In total 135,432 THR were recorded comprising 1035 different THR constructs. Notably 328 constructs were used just once. Forty-eight constructs (62,251 THR) had > 500 procedures at risk at 3 years post-primary of which 28 were inferior by at least 20% relative risk of which, 10 were inferior by at least 100% relative risk. Sixteen constructs were identified with > 500 procedures at risk at 10 years with 9 inferior by at least 20%, of which one was inferior by > 100% relative risk. There were fewer constructs noninferior to the best practice benchmark when we performed analysis by gender. In females at 10 years, from 5 constructs with > 500 constructs at risk, 2 were inferior at the 20% margin. In males at 10 years, there were only 2 eligible constructs of which one was inferior at the 20% margin.

Conclusions
We discerned that there is substantial variability in construct performance and at most time points, just over half of constructs are inferior to the best performing construct by at least 20%. These results can facilitate informed decision-making when considering THR surgery.
A novel rapid measurement of hallux valgus parameters using the built-in photo edit function of smartphones
Authors: Huang Tianji , Wang Lin , Lu Chao , Zhong Weiyang , Zhao Zenghui , Luo Xiaoji 
Published: August 2021

Abstract
Objective
The objective of this study was to assess the accuracy and reliability of and time taken by a novel method using the built-in photo-edit function of smartphones compared with PACS in measuring hallux valgus parameters.

Methods
Seventy patients (124 ft) admitted to our hospital with a diagnosis of hallux valgus without previous surgical procedures were retrospectively reviewed. The foot radiographs of all the patients were extracted from PACS. The hallux valgus angle (HVA) and the first and second intermetatarsal angles (IMAs) were measured by PACS and by this novel method using the built-in photo-edit function of a smartphone. The results of these two methods were compared, and the accuracy and reliability were assessed between these two methods.

Results
The average parameters measured by PACS were as follows: HVA average: 37.43 ± 9.61°; IMA average: 13.37 ± 4.01°. The average parameters measured by smartphones were as follows: HVA average: 37.09 ± 9.52° and IMA average: 13.49 ± 3.91°. When compared by the independent-samples T test, the average parameters between PACS and smartphones were not significantly different (HVA PACS vs HVA smartphones: P = 0.776; IMA PACS vs IMA smartphones: P = 0.816). The variability of the HVA (F = 0.166, P = 0.992) and IMA (F = 0.215, P = 0.982) measurements was similar for the PACS and smartphones. The ICCs of the average parameters of four measurements of HVA and IMA between PACS and smartphones were 0.995 (0.991–0.997) and 0.970 (0.958–0.979), indicating that the two methods were highly correlated. For the smartphone measurement, the interobserver and intraobserver reliability was very good for HVA and IMA. The average measurement time of PACS was 25.41 ± 0.86 s, and the average measurement time of smartphones was 20.29 ± 1.22 s. The smartphone time was significantly faster than that of PACS by approximately 5 s (P<0.001).

Conclusion
This novel method using the built-in photo-edit function of smartphones is accurate, reliable, convenient and time-saving in measuring the angles of hallux valgus.
Colonic J-pouch versus side-to-end anastomosis for rectal cancer: a systematic review and meta-analysis of randomized controlled trials
Authors: Wang Zheng 
Published: August 2021

AbstractBackgroundThis study aims to compare colonic J-pouch and side-to-end anastomosis for rectal cancer in terms of surgical and bowel functional outcomes and quality of life (QoL).MethodsA systematic literature search was performed in PubMed, Embase and Cochrane. The last search was performed on March 28, 2021. All randomized controlled trials comparing colonic J-pouch with side-to-end anastomosis for rectal cancer were enrolled. The main outcomes were bowel functional outcomes and QoL. The secondary outcomes were surgical outcomes including operative time, postoperative hospital stay, complications, and mortality.ResultsNine articles incorporating 7 trials with a total of 696 patients (330 by J-pouch and 366 by side-to-end) were enrolled in this meta-analysis. The bowel functional outcomes were comparable between J-pouch and side-to-end groups in terms of stool frequency, urgency, and incomplete defecation at the short term (< 8 months), medium term (8–18 months), and long term (> 18 months) follow up evaluations. No difference was observed between groups with regards to QoL (SF-36: physical function, social function, and general health perception). Besides, surgical outcomes were also similar in two groups.ConclusionThe currently limited evidence suggests that colonic J-pouch and side-to-end anastomosis are comparable in terms of bowel functional outcomes, QoL, and surgical outcomes. Surgeons may choose either of the two techniques for anastomosis. A large sample randomized controlled study comparing colonic J-pouch and side-to-end anastomosis for rectal cancer is warranted.
The effect of subsequent immunosuppressant use in organ-transplanted patients on prostate cancer incidence: a retrospective analysis using the Korean National Health Insurance Database
Authors: Lee Hyung Ho , Joung Jae Young , Kim Sung Han 
Published: August 2021

Abstract
Backgrounds
Prostate cancer (PC) is the most common solid organ cancer. However, there is still no definite consensus before and after organ transplantation (TPL). We aimed to analyze whether PC incidence increased in TPL patients with subsequent use of immunosuppressants using the Korean National Health Insurance Database.

Methods
TPL patients between 2003 and 2015(N = 12,970) were age- and year-matched to non-TPL patients (N = 38,910) in a 1:3 ratio. Multivariate Cox regression analysis adjusted for significant prognostic clinicopathological parameters, including the duration of immunosuppressant agent use (0–300 or > 300 days), and Kaplan–Meier analysis with log-rank test were used to evaluate the association of TPL with PC incidence between the groups.

Results
Median overall survival was 4.86 years; overall mortality rate was 3.4% (n = 1761). Regardless of differences in baseline characteristics between the groups, multivariate analysis for PC incidence showed that age, immunosuppressant use, and TPL organ subtypes were significant factors for the overall population, whereas only age was significant in the TPL group (p < 0.05). After adjusting for age, underlying disease, and prescribed medication (aspirin, statin), multiple subgroup analysis models for PC incidence were evaluated. PC incidence was increased in the TPL group (hazard ratio [HR] 1.965, p < 0.001); however, PC incidence in the TPL group became insignificant after adjusting for immunosuppressant use (p = 0.194). Kaplan–Meier curves also showed that PC incidence was significantly different according to age and TPL with the use of immunosuppressants between the TPL and non-TPL groups.

Conclusions
PC incidence was higher in the TPL group using immunosuppressants than in the non-TPL group.
Trial registration: The study was retrospectively registered.
Elevated lactate in Mauriac syndrome: still a mystery
Authors: Touilloux Brice , Lu Henri , Campos-Xavier Belinda , Superti-Furga Andrea , Hauschild Michael , Bouthors Thérèse , Tran Christel 
Published: August 2021

Abstract
Background
The Mauriac syndrome was described in 1930 as a peculiar combination of poorly controlled diabetes mellitus type 1, stunted growth and glycogenic hepatopathy. More recently, lactic acidosis was recognized as an additional feature, often induced by insulin treatment.

Case presentation
A 17-year old girl known for diabetes type 1A and Mauriac syndrome was admitted to the emergency room with hyperglycemia of > 41 mmol/l without ketoacidosis. Under a standard insulin regimen, hyperglycemia was rapidly corrected but marked hyperlactatemia occurred.

Conclusions
The mechanism of impaired glucose utilization and lactate elevation independent of ketoacidosis in Mauriac syndrome is intriguing. The rarity of Mauriac syndrome and its resemblance to glycogen storage diseases suggest the presence of a specific metabolic or genetic predisposition that remains to be identified.
Relationship between women’s decision-making power over their own health care and use of modern contraception in the Democratic Republic of the Congo: a cross-sectional secondary data analysis
Authors: Butler Megan G. , Walker Melanie , Pablo Lesley A. , Bartels Susan A. 
Published: August 2021

Abstract
Background
In sub-Saharan Africa, the use of modern contraception (MC) is a critical intervention aimed at reducing mortality rates associated with unintended, high-risk pregnancies. However, among Congolese women aged 15–49, the prevalence of MC use is low. Research suggests that women’s general participation in decision-making is important in increasing MC use. However, little is known about the specific role of women’s decision-making power over their own health care and how it relates to MC use. Thus, this study aimed to investigate the relationship between women’s decision-making power over their own health care and use of MC.

Methods
A cross-sectional secondary data analysis was conducted using the most recent data from the 2013–2014 Democratic Republic of the Congo (DRC) Demographic and Health Survey. Women who were considered in need of contraception based on their family planning preferences were included in the study population (N = 6422). Multivariate logistic regression was used to determine whether women’s decision-making power over their own health care was associated with the use of MC.

Results
Only one in ten women reported using a modern method of contraception. Logistic regression showed that women who made decisions alone regarding their own health care were more likely to use MC than women who had no say in these decisions, even after controlling for important covariates (OR 1.48; 95% CI 1.00, 2.17).

Conclusion
The results of this study lend further support that promoting women’s autonomy and right to independently make decisions regarding their own health may be important in increasing the use of MC in the DRC. However, in order to effectively empower women to negotiate for the use of MC, qualitative research is needed to further assess the relationship between decision-making power and MC use.