bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of femoral obliquity angle and T1 pelvic angle in predicting quality of life after spinal surgery in adult spinal deformities
Authors: Perna Andrea , Proietti Luca , Smakaj Amarildo , Velluto Calogero , Meluzio Maria Concetta , Rovere Giuseppe , Florio Daniela , Zirio Gianfranco , Tamburrelli Francesco Ciro 
Published: November 2021

Abstract
Background
Adult spinal deformities (ASD) represent a growing clinical condition related to chronic pain, disability and reduction in quality of life (QoL). A strong correlation among spinal alignment, spinopelvic parameters and QoL after spinal fusion surgery in ASD patients was thoroughly investigated over the last decade, However, only few studies focused on the relationship between lumbo-pelvic-femoral parameters - such as Femoral Obliquity Angle (FOA), T1 Pelvic Angle (TPA) and QoL.

Methods
Radiological and clinical data from 43 patients surgically treated with thoracolumbar posterior spinal fusion for ASD between 2015 and 2018 were retrospectively analyzed. The primary outcomes were the correlation between preoperative spino-pelvic-femoral parameters and postoperative clinical, functional outcomes and QoL. Secondary outcomes were: changes in sagittal radiographic parameters spino-pelvic-femoral, clinical and functional outcomes and the rate of complications after surgery.

Results
Using Spearman’s rank correlation coefficients, spinopelvic femoral parameters (FOA, TPA, pre and post-operative) are directly statistically correlated to the quality of life (ODI, SRS-22, pre and post-operative; > 0,6 strong correlation, p <  0.05). Stratifying the patients according pre preoperative FOA value (High FOA ≥ 10 and Normal/Low FOA <  10), those belonging to the first group showed worse clinical (VAS: 5.2 +/− 1.4 vs 2.9 +/− 0.8) and functional outcomes (ODI: 35.6+/− 6.8 vs 23.2 +/− 6.5) after 2 years of follow-up and a greater number of mechanical complications (57.9% vs 8.3% p <  0.0021).

Conclusion
Based on our results, preoperative FOA and TPA could be important prognostic parameters for predicting disability and quality of life after spinal surgery in ASD patients and early indicators of possible spinal sagittal malalignment. FOA and TPA, like other and better known spinopelvic parameters, should always be considered when planning corrective surgery in ASD patients.
Gender disparities among medical students choosing to pursue careers in medical research: a secondary cross-sectional cohort analysis
Authors: Snyder Austin , Xiang David , Smith Alison , Esswein Shannon , Toubat Omar , Di Capua John , Kwan Jennifer M. , Daye Dania 
Published: November 2021

Abstract
Background
Though the proportion of women in medical schools has increased, gender disparities among those who pursue research careers still exists. In this study, we seek to better understand the main factors contributing to the existing gender disparities among medical students choosing to pursue careers in medical research.

Methods
A secondary cross-sectional cohort analysis of previously published data was conducted using a 70-item survey that was sent to 16,418 medical students at 32 academic medical centers, and was IRB exempt from the need for ethical approval at the University of Illinois at Chicago and the University of Pennsylvania. Data was collected from September 2012 to December 2014. Survey results were analyzed using chi-square tests and Cramer’s V to determine gender differences in demographic characteristics (training stage, race/ethnicity, marital status, parental status, financial support, and parental career background), career sector choice, career content choice, specialty choice, foreseeable career obstacles, and perceptions about medical research careers.

Results
Female respondents were more likely to be enrolled in MD-only programs, while male respondents were more likely to be enrolled in MD/PhD programs. More male students selected academia as their first-choice career sector, while more female respondents selected hospitalist as their first-choice career sector. More female respondents identified patient care and opportunities for community service as their top career selection factors, while more male respondents identified research and teaching as their top career selection factors. Student loan burden, future compensation, and work/life balance were the most reported obstacles to pursuing a career in medical research.

Conclusions
There are many factors from a medical student’s perspective that may contribute to the existing gender disparities in pursuing a career in medical research. While much progress has been made in attracting nearly equal numbers of men and women to the field of medicine, active efforts to bridge the gap between men and women in medical research careers are needed.
Mitochondria-targeted accumulation of oxygen-irrelevant free radicals for enhanced synergistic low-temperature photothermal and thermodynamic therapy
Authors: Hu Hongzhi , Deng Xiangtian , Song Qingcheng , Yang Wenbo , Zhang Yiran , Liu Weijian , Wang Shangyu , Liang Zihui , Xing Xin , Zhu Jian , Zhang Junzhe , Shao Zengwu , Wang Baichuan , Zhang Yingze 
Published: November 2021

Abstract
Background
Although lower temperature (< 45 °C) photothermal therapy (LPTT) have attracted enormous attention in cancer therapy, the therapeutic effect is still unsatisfying when applying LPTT alone. Therefore, combining with other therapies is urgently needed to improve the therapeutic effect of LPTT. Recently reported oxygen-irrelevant free radicals based thermodynamic therapy (TDT) exhibit promising potential for hypoxic tumor treatment. However, overexpression of glutathione (GSH) in cancer cells would potently scavenge the free radicals before their arrival to the specific site and dramatically diminish the therapeutic efficacy.

Methods and results
In this work, a core–shell nanoplatform with an appropriate size composed of arginine–glycine–aspartate (RGD) functioned polydopamine (PDA) as a shell and a triphenylphosphonium (TPP) modified hollow mesoporous manganese dioxide (H-mMnO2) as a core was designed and fabricated for the first time. This nanostructure endows a size-controllable hollow cavity mMnO2 and thickness-tunable PDA layers, which effectively prevented the pre-matured release of encapsulated azo initiator 2,2′-azobis[2-(2-imidazolin-2-yl) propane] dihydrochloride (AIBI) and revealed pH/NIR dual-responsive release performance. With the mitochondria-targeting ability of TPP, the smart nanocomposites (AIBI@H-mMnO2-TPP@PDA-RGD, AHTPR) could efficiently induce mitochondrial associated apoptosis in cancer cells at relatively low temperatures (< 45 °C) via selectively releasing oxygen-irrelevant free radicals in mitochondria and facilitating the depletion of intracellular GSH, exhibiting the advantages of mitochondria-targeted LPTT/TDT. More importantly, remarkable inhibition of tumor growth was observed in a subcutaneous xenograft model of osteosarcoma (OS) with negligible side effects.

Conclusions
The synergistic therapy efficacy was confirmed by effectively inducing cancer cell death in vitro and completely eradicating the tumors in vivo. Additionally, the excellent biosafety and biocompatibility of the nanoplatforms were confirmed both in vitro and in vivo. Taken together, the current study provides a novel paradigm toward oxygen-independent free-radical-based cancer therapy, especially for the treatment of hypoxic solid tumors.

Graphical Abstract
Deep venous thrombosis in an individual with statin-exposed anti-SRP myopathy: case report and review of literature
Authors: Li Jiali , Yan Mingming , Qin Jiao , He Lingyan , Dai Cao , Wen Rui 
Published: November 2021

Abstract
Background
Immune-mediated necrotizing myopathy (IMNM) is characterized by proximal muscle weakness, elvated serum muscle enzyme levels, myopathic electromyography findings, and necrotic muscle fiber with few inflammatory cell infiltration in muscle biopsies. Statins, the first line drug to lower triglyceride and cholesterol level in blood, have been reported to be associated with statins-induced necrotizing autoimmune myopathy (SINAM). Although anti-3-hydroxy-3-methylglutarylcoenzyme-A reductase (anti-HMGCR) myopathy is considered as the leading myopathy related to the statins medication, anti-signal recognition particle (SRP) myopathy were also identified in several cases with statin exposure. The risk of deep venous thrombosis (DVT) is substantially high in individuals with autoimmune inflammatory diseases. But few studies have reported the occurrence and recommendation for treatment of DVT in patients with anti-SRP myopathy. Here, we reported a statin-exposed anti-SRP myopathy individual developed DVT who was successfully treated with catheter-directed thrombolysis (CDT) and systemic anticoagulants therapy.

Case presentation
A 56-year-old Chinese female came to the outpatient room with gradually progressive bilateral lower-extremity weakness. Magnetic resonance imaging revealed myopathy in bilateral thighs. Serum anti-SRP antibody was positive. She was diagnosed with anti-SRP myopathy. When treated with corticosteroids and immunosuppressants, the patient developed mild edema and pain of left lower extremity. Angiography and ultrasound revealed diffuse venous thrombosis of left lower extremity. Therapy was initiated with CDT and lower molecular weight heparin, then switched to once daily oral rivaroxaban. Meanwhile, steroids combined with tacrolimus were also carried on while simvastatin was discontinued. One month later, patient’s symptoms were resolved and only partial thrombosis in left femoral vein was remained.

Conclusion
The prevalence of DVT in patient with anti-SRP myopathy was rare. No well-established treatment strategy is available to manage the IMNM and DVT at the same time. The systemic anticoagulants therapy combined CDT can be an effective therapeutic approach to address extensive DVT in patient with anti-SRP myopathy.
Chromium removal from tannery effluents by adsorption process via activated carbon chat stems (Catha edulis) using response surface methodology
Authors: Bayisa Yigezu Mekonnen , Bullo Tafere Aga , Akuma Desalegn Abdissa 
Published: November 2021

Abstract
Objective
In tannery processing, water consumption is high, which generates wastewater as a by-product and numerous pollutants such as chromium heavy metals that make adverse effects of water bodies and the surrounding environment. This study analyzed, chromium (VI) removal from wastewater through activated carbon chat stem was investigated. Adsorption is a common treatment method via activated carbon due to its cost-effective, profitable, and removal efficiency of these heavy metals.

Results
The proximate analysis of moisture content of chat stem has 6%, activated carbon ash content of 17.35%, volatile materials of 20.12%, and fixed carbon contents of 56.53%, which are well-matched the standards quality of activated carbon. As the process parameter varies, the increment of the chromium removal efficiency was from 62.5 to 97.03%. The maximum adsorption efficiency was observed at 30 g/L dosage of the adsorbent, at pH 4, and contact time at 180 min of activated carbon from chat stem waste was found 97.03%. FTIR was used to characterize the surface of the chat stem before and after adsorption. Langmuir and Freundlich are used for short contact time’s adsorption isotherm 0.9839 and 0.9995 respectively, which conformed, no visible change in the corrosion state.
Assessment of autonomic function by long-term heart rate variability: beyond the classical framework of LF and HF measurements
Authors: Hayano Junichiro , Yuda Emi 
Published: November 2021

AbstractIn the assessment of autonomic function by heart rate variability (HRV), the framework that the power of high-frequency component or its surrogate indices reflects parasympathetic activity, while the power of low-frequency component or LF/HF reflects sympathetic activity has been used as the theoretical basis for the interpretation of HRV. Although this classical framework has contributed greatly to the widespread use of HRV for the assessment of autonomic function, it was obtained from studies of short-term HRV (typically 5‑10 min) under tightly controlled conditions. If it is applied to long-term HRV (typically 24 h) under free-running conditions in daily life, erroneous conclusions could be drawn. Also, long-term HRV could contain untapped useful information that is not revealed in the classical framework. In this review, we discuss the limitations of the classical framework and present studies that extracted autonomic function indicators and other useful biomedical information from long-term HRV using novel approaches beyond the classical framework. Those methods include non-Gaussianity index, HRV sleep index, heart rate turbulence, and the frequency and amplitude of cyclic variation of heart rate.
Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement
Authors: Jacobs Jonathan P. , Gupta Arpana , Bhatt Ravi R. , Brawer Jacob , Gao Kan , Tillisch Kirsten , Lagishetty Venu , Firth Rebecca , Gudleski Gregory D. , Ellingson Benjamin M. , Labus Jennifer S. , Naliboff Bruce D. , Lackner Jeffrey M. , Mayer Emeran A. 
Published: November 2021

Abstract
Background
There is growing recognition that bidirectional signaling between the digestive tract and the brain contributes to irritable bowel syndrome (IBS). We recently showed in a large randomized controlled trial that cognitive behavioral therapy (CBT) reduces IBS symptom severity. This study investigated whether baseline brain and gut microbiome parameters predict CBT response and whether response is associated with changes in the brain-gut-microbiome (BGM) axis.

Methods
Eighty-four Rome III-diagnosed IBS patients receiving CBT were drawn from the Irritable Bowel Syndrome Outcome Study (IBSOS; ClinicalTrials.gov NCT00738920) for multimodal brain imaging and psychological assessments at baseline and after study completion. Fecal samples were collected at baseline and post-treatment from 34 CBT recipients for 16S rRNA gene sequencing, untargeted metabolomics, and measurement of short-chain fatty acids. Clinical measures, brain functional connectivity and microstructure, and microbiome features associated with CBT response were identified by multivariate linear and negative binomial models.

Results
At baseline, CBT responders had increased fecal serotonin levels, and increased Clostridiales and decreased Bacteroides compared to non-responders. A random forests classifier containing 11 microbial genera predicted CBT response with high accuracy (AUROC 0.96). Following treatment, CBT responders demonstrated reduced functional connectivity in regions of the sensorimotor, brainstem, salience, and default mode networks and changes in white matter in the basal ganglia and other structures. Brain changes correlated with microbiome shifts including Bacteroides expansion in responders.

Conclusions
Pre-treatment intestinal microbiota and serotonin levels were associated with CBT response, suggesting that peripheral signals from the microbiota can modulate central processes affected by CBT that generate abdominal symptoms in IBS. CBT response is characterized by co-correlated shifts in brain networks and gut microbiome that may reflect top-down effects of the brain on the microbiome during CBT.
Prevalence of depression, anxiety and stress during the COVID-19 pandemic: a cross-sectional study among Palestinian students (10–18 years)
Authors: Radwan Eqbal , Radwan Afnan , Radwan Walaa , Pandey Digvijay 
Published: November 2021

AbstractBackgroundThe COVID-19 pandemic considers a threat to students’ well-being and mental health. The current descriptive cross-sectional study aims to identify psychological distress among school students during the lockdown period.MethodsThis study was carried out in a sample of 420 primary and secondary school students from June 10 to July 13, 2020, in the Gaza Strip in Palestine. Data was collected using an online questionnaire that included informed consent, socio-demographic questions, and a psychometric scale (DASS-21).ResultsThe results revealed that most students experienced moderate to severe levels of anxiety (89.1%) and depression (72.1%), whereas less than half of them (35.7%) experienced moderate to severe stress. Stress, anxiety and depression scores were significantly different across gender, age groups, family size, and family's economic status. The results showed that gender (β = -0.174,p < 0.001), age (β = −0.155,p = 0.001) and economic level of family (β = −0.147,p = 0.002) were negative predictors correlated with stress. Family size (β = 0.156,p = 0.001) played a positive role in stress. It was found that gender (β = −0.105,p = 0.031), age (β = −0.135,p = 0.006) and economic level of family (β = −0.136,p = 0.005) were negative predictors correlated with anxiety, whereas family size (β = 0.139,p = 0.004) played a positive role in anxiety. For depression, gender (β = −0.162,p = 0.001), age (β = −0.160,p = 0.001) and economic level of family (β = −0.131,p = 0.007) were negative predictors correlated with depression, whereas family size (β = −0.133,p = 0.006) was found to be a positive predictor. Concerns about the influence of COVID-19 on economic, education, and daily life were positively correlated to the levels of depression, anxiety and stress, whereas the availability of social support was negatively correlated.ConclusionThe development of a health protocol for influenced students is urgently needed to maintain them remain resilient during dangerous times.
The use of autologous platelet-rich fibrin matrix combined with meniscal repair in the treatment of parameniscal cyst: clinical results and cyst recurrence after 2-year of follow up
Authors: Screpis Daniele , Piovan Gianluca , Natali Simone , Pasqualotto Stefano , Magnanelli Stefano , Iacono Venanzio , Farinelli Luca , Grassi Marco , Zorzi Claudio 
Published: November 2021

Abstract
Purpose
Parameniscal cysts are associate with horizontal meniscal tears. Arthroscopic meniscal repair and the excision of the cyst by mini-open approach represent a valid treatment. However, the recurrence of cyst is still a current issue. Therefore, biological factors may be considered to promote the biological repair and avoid recurrence. The aim of the present study was to report the clinical results and the rate of recurrence of the cyst after minimum 2-year of follow up in a cohort of patients treated by meniscal repair and autologous platelet-rich fibrin matrix augment.

Methods
Patients with lateral parameniscal cyst undergoing arthroscopic meniscal repair and autologous platelet-rich fibrin matrix augment between 2016 and 2019 were retrospectively reviewed in March 2021. Inclusion criteria were absence of prior surgery on the affected knee with minimum 2-year of follow-up. Exclusion criteria were concomitant ligament lesions, rheumatic diseases and knee osteoarthritis. After reviewing the database, each selected patient was contacted and asked to participate in the study; at the follow-up evaluation all patient signed an informed consent. Tegner-Lysholm knee score, IKDC and NRS were collected before surgery and at follow-up.

Results
This study included 15 patients (8 male) with mean age of 32.8 years old. No recurrence of the cysts was observed. The Tegner-Lysholm knee score and IKDC subjective scores increased respectively from 41.3 ± 5.4 and 37.6 ± 5.1 at baseline to 92.3 ± 4.6 and 89.4 ± 2.6 at the final follow up. Concerning pain relief, the Numeric Pain Rating Scale (NRS) displayed a significant improvement reaching at the follow up a score of 1,3 ± 1.1 in comparison to 6.8 ± 0.9 at the baseline.

Conclusion
Surgical management of symptomatic lateral parameniscal cyst with cyst excision, autologous PRP membrane application and meniscus repair demonstrated excellent subjective clinical outcome with any cyst reoccurrence.

Level of evidence
III, retrospective cohort study.
Impact of simultaneous placement of implant and block bone graft substitute: an in vivo peri-implant defect model
Authors: Le Thieu Minh Khai , Homayouni Amin , Hæren Lena Ringsby , Tiainen Hanna , Verket Anders , Ellingsen Jan Eirik , Rønold Hans Jacob , Wohlfahrt Johan Caspar , Cantalapiedra Antonio Gonzalez , Muñoz Fernando Maria Guzon , Mendaña Maria Permuy , Lyngstadaas Ståle Petter , Haugen Håvard Jostein 
Published: November 2021

Abstract

Background

Insufficient bone volume around an implant is a common obstacle when dental implant treatment is considered. Limited vertical or horizontal bone dimensions may lead to exposed implant threads following placement or a gap between the bone and implant. This is often addressed by bone augmentation procedures prior to or at the time of implant placement. This study evaluated bone healing when a synthetic TiO
2
block scaffold was placed in circumferential peri-implant defects with buccal fenestrations.

Methods

The mandibular premolars were extracted and the alveolar bone left to heal for 4 weeks prior to implant placement in six minipigs. Two cylindrical defects were created in each hemi-mandible and were subsequent to implant placement allocated to treatment with either TiO
2
scaffold or sham in a split mouth design. After 12 weeks of healing time, the samples were harvested. Microcomputed tomography (MicroCT) was used to investigate defect fill and integrity of the block scaffold. Distances from implant to bone in vertical and horizontal directions, percentage of bone to implant contact and defect fill were analysed by histology.

Results

MicroCT analysis demonstrated no differences between the groups for defect fill. Three of twelve scaffolds were partly fractured. At the buccal sites, histomorphometric analysis demonstrated higher bone fraction, higher percentage bone to implant contact and shorter distance from implant top to bone 0.5 mm lateral to implant surface in sham group as compared to the TiO
2
group.

Conclusions

This study demonstrated less bone formation with the use of TiO
2
scaffold block in combination with implant placement in cylindrical defects with buccal bone fenestrations, as compared to sham sites.