bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 lock-down period on orthopedic and trauma surgical activity in a northern Italian hospital
Authors: Turati Marco , Gatti Simone , Rigamonti Luca , Zatti Giovanni , Munegato Daniele , Crippa Marco , Benedettini Erik , Piscitelli Daniele , Bigoni Marco , Turati Riccardo 
Published: November 2024

ObjectivesThis study aims to describe the impact of COVID-19 on Orthopedic and Trauma surgical activity in a single level-I trauma center in Northern Italy during the lockdown period. We proposed comparing surgical procedures performed during the outbreak and in the same period the previous year.MethodsIn this single-center retrospective epidemiological cohort study, the “lockdown cohort” of patients who were treated from March 1st to May 24th, 2020, was compared to the “control cohort” who received treatment during the same period in 2019. The primary outcome was to evaluate the differences between the lockdown and control cohorts regarding surgical volumes. The secondary outcome was to evaluate any differences in the type of surgical procedures performed in the two cohorts in the elective and emergency setting.ResultsOrthopedic surgical activity has suffered a global reduction of 72.4% during the lockdown period (from 36 ± 6.1 to 10.7 ± 8.4 per week; p &lt; 0.01), with the ratio of emergency to elective operations increasing from 0.7:1 in 2019 to 3.3:1 in 2020. Elective surgery has in fact been almost completely suspended and was affected with a reduction of 88.9% (from 20.8 ± 5.2 to 4.3 ± 2.8 cases per week; p &lt; 0.01), while emergency trauma surgery suffered a 49.7% reduction (from 15.1 ± 3.2 to 8.2 ± 6.1 cases per week; p &lt; 0.01).ConclusionThe COVID-19 outbreak severely impacted Italy, particularly the Lombardy region, and affected the national health system. The 2020 COVID-19 lockdown has heavily conditioned our Orthopedic and Trauma department surgical activity.
Identifying biomarkers of endoplasmic reticulum stress and analyzing immune cell infiltration in chronic obstructive pulmonary disease using machine learning
Authors: Zhang Shuaiyang , Duan Hangyu , Yan Jun 
Published: November 2024

BackgroundEndoplasmic reticulum stress (ERS) is a crucial factor in the progression of chronic obstructive pulmonary disease (COPD). However, the key genes associated with COPD and immune cell infiltration remain to be elucidated. Therefore, this study aimed to identify biomarkers pertinent to the diagnosis of ERS in COPD and delve deeper into the association between pivotal genes and their possible interactions with immune cells.MethodsWe selected the genetic data of 189 samples from the Gene Expression Omnibus database, including 91 control and 98 COPD samples. First, we identified the differentially expressed genes between patients with COPD and controls and then screened the ERS genes associated with COPD. Second, 22 core ERS genes associated with COPD were screened using the Least Absolute Shrinkage and Selection Operator (LASSO) regression model and Support Vector Machine Recursive Feature Elimination (SVM-RFE), and the predictive effects of the screened core genes in COPD were evaluated. Third, we explored immune cell infiltration associated with COPD and conducted an in-depth analysis to explore the possible connections between the identified key genes and their related immune cells.ResultsA total of 66 differentially expressed endoplasmic reticulum stress–related genes (DE-ERGs) were identified in this study, among which 12 were upregulated and 54 were downregulated. The 22 key genes screened were as follows: AGR3, BCHE, CBY1, CHRM3, CYP1B1, DCSTAMP, DDHD1, DMPK, EDEM3, EDN1, FKBP10, HSPA2, KPNA2, LGALS3, MAOB, MMP9, MPO, MTTP, PIK3CA, PTGIS, PURA, and TMCC1. Their expression was significantly different between COPD and healthy samples, and the difference between the groups was significant. Receiver operating characteristic curve analysis revealed that CBY1 (area under the curve [AUC] = 0.800), BCHE (AUC = 0.773), EDEM3 (AUC = 0.768), FKBP10 (AUC = 0.760), MAOB (AUC = 0.736), and MMP9 (AUC = 0.729) showed a strong ability to distinguish COPD samples from normal samples. Immune cell infiltration results associated with the three key genes were also obtained.ConclusionThe insights of our study have the potential to present new evidence for exploring emerging diagnostic signs of COPD while also contributing to a better understanding of its developmental mechanisms.
Investigating the feasibility and effectiveness of bacterial culture in negative pressure wound drainage fluid
Authors: Wu Junjie , Chang Zhengqi 
Published: November 2024

PurposeTo analyze the feasibility and effectiveness of bacterial culture in negative pressure wound drainage (NPWD) fluid in patients with Pyogenic Vertebral Osteomyelitis (PVO).MethodsA retrospective analysis was performed on 17 patients with PVO who were treated with negative pressure drainage at the Department of Orthopedics in our hospital from January 1, 2018 to December 31, 2021. Data was obtained while the patients were in the hospital, including 12 males and 5 females with an average age of 57.71 ± 9.93 years. After applying the negative pressure drainage technique, the drainage fluid was collected and a bacterial culture was performed. The positive rate of bacterial culture in the drainage fluid was recorded. Comparing the positive rate of specimen culture obtained by this surgical method with other methods reported in the literature, the effectiveness of negative pressure drainage in the treatment of PVO was analyzed.ResultsAll patients were placed with negative pressure sponge during operation and underwent continuous negative pressure aspiration after operation. The average of total drainage volume was 186.47 ± 29.44 mL. The drainage fluid was successfully retained for bacterial culture, and the results of bacterial culture were negative in 3 patients. Pathogenic bacteria were successfully obtained from negative pressure drainage fluid in 14 cases, with a positive rate of 82.4% (14/17).ConclusionUsing negative pressure drainage to retain drainage fluid for bacterial culture can significantly increase the positive rate, which is helpful for the diagnosis of PVO and rational antibiotic treatment.
Effect of fatty liver disease on liver function and fibrosis in patients with chronic hepatitis B: a cross-sectional study
Authors: Fang Xiaohui , Yin Yuhang , Zhao Haonan , Wang Cai’e , Li Hui , Shang Yiyang , Li Jiayu , Gao Yue , Méndez-Sánchez Nahum , Qi Xingshun 
Published: November 2024

PurposeChronic hepatitis B (CHB) and fatty liver disease (FLD) are common chronic liver diseases, both of which can progress to advanced liver diseases with poor outcome. However, it remains controversial whether the presence of FLD aggravates the disease severity of CHB patients.Patients and methodsAll consecutive outpatients who were diagnosed with CHB at our department between March 1, 2021 and September 30, 2023 were retrospectively screened. They were divided into FLD and non-FLD groups. Liver function parameters and non-invasive indicators of liver fibrosis, including liver stiffness measurement (LSM) value, fibrosis-4 index (FIB-4) score, and aspartate aminotransferase to platelet ratio index (APRI) score, were compared between the two groups. Subgroups analyses were performed in HBeAg-positive, HBeAb-positive, HBV DNA &gt; 10 IU/mL, mild FLD, and moderate/severe FLD patients.ResultsOverall, 201 CHB patients were included, of whom 76 (37.81%) had FLD. In the overall analyses, CHB patients with FLD had a significantly higher alanine aminotransferase (ALT) (47.04 ± 53.28 vs. 32.95 ± 35.10, p = 0.003) than those without FLD, but there was no significant difference in the LSM value (7.79 ± 5.16 vs. 8.19 ± 4.99, p = 0.508), FIB-4 score (1.13 ± 0.75 vs. 1.28 ± 0.99, p = 0.679), and APRI score (0.41 ± 0.46 vs. 0.36 ± 0.47, p = 0.535) between CHB patients with and without FLD. The above-mentioned statistical results in all subgroup analyses were nearly consistent with those in the overall analyses.ConclusionFLD may intensify abnormal liver function reflected by increased ALT level in CHB patients, but not influence the progression of liver fibrosis.
The diagnostic and prognostic value of soluble ST2 in Sepsis
Authors: Ye Xinghua , Wang Jia , Hu Le , Zhang Ying , Li Yixuan , Xuan Jingchao , Han Silu , Qu Yifan , Yang Long , Yang Jun , Wang Junyu , Wei Bing 
Published: November 2024

ObjectiveTo determine the diagnostic and prognostic value of soluble suppression of tumorigenicity 2 (sST2) in patients with sepsis.MethodsA total of 113 critically ill patients were enrolled at the emergency department of Beijing Chaoyang Hospital Jing Xi Branch. Venous blood levels of sST2 were measured using the AFIAS-6 dry fluorescence immunoassay analyzer. Based on Sepsis 3.0 criteria, patients were categorized into a sepsis group (76 cases) and a non-sepsis group (37 cases). The sepsis group was further divided into non-survivors (38 cases) and survivors (38 cases) based on 28-day survival outcomes. The vital signs, blood gas analysis, routine blood tests, liver and kidney function tests, procalcitonin (PCT), C-reactive protein (CRP), sST2, left ventricular ejection fraction (LVEF), and other basic characteristics of the patients were recorded. Further, the SOFA, qSOFA and APACHE II scores of each patient were calculated. Statistical analysis was performed using SPSS 25.0, including logistic regression and ROC curve analysis to assess prognostic factors.ResultsThe serum sST2 levels in the sepsis group (125.00 ± 60.32 ng/mL) were significantly higher than in the non-sepsis group (58.55 ± 39.03 ng/mL) (p &lt; 0.05). The SOFA score (8.08 ± 2.88), APACHE II score (18.00 ± 4.72), blood sST2 levels (168.06 ± 36.75 ng/mL) and lactic acid levels (2.89 ± 3.28) in the non-survivor group were significantly higher than the survivor group (p &lt; 0.05). Multiple logistic regression analysis showed that sST2, SOFA score, APACHE II score and lactic acid levels were independent risk factors for poor prognosis in patients with sepsis. The ROC curve analysis of the above indexes showed no significant differences between the AUC of sST2 (0.912) and the SOFA score (0.929) (z = 0.389, p = 0.697), or the APACHE II score (0.933) (z = 0.484, p = 0.627). However, there was a significant difference between the AUC of sST2 (0.912) and lactic acid levels (0.768) (z = 2.153, p = 0.030).ConclusionBlood levels of sST2 show a clinically diagnostic and prognostic value in sepsis. Further, sST2 shows a similar predictive ability as the SOFA and APACHE II scores in determining the prognosis of sepsis patients. However, sST2 has a higher predictive ability than lactic acid levels in determining prognosis in sepsis.
Effect of extracorporeal shock wave therapy on nerve conduction: a systematic review and meta-analysis
Authors: Yang Liuxin , Li Xuan , Li Shuhan , Yang Jiao , Meng Dianhuai 
Published: November 2024

BackgroundExtracorporeal shock wave therapy (ESWT), as a non-invasive physical agent modality, was effective in relieving spasticity, reducing pain, and improving dysfunction. This systematic review and meta-analysis aimed to investigate the effect of ESWT on nerve conduction, and to find out whether the ESWT group is superior to the control or other comparison groups, thus providing support for guiding the rehabilitation of peripheral nerve injury in clinical work.MethodsPubMed, Web of Science, the Cochrane Library, and Embase were searched from inception to August 20, 2024. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the PROSPERO database (registration number CRD42024500891). It aimed to compare (1) the ESWT group (ESWT) and baseline, and (2) subgroup analyses: ESWT and the control group (Control), ESWT and the local corticosteroid injection group (LCI), ESWT combined with physical therapy (ESWT + PT) and PT alone, and ESWT and PT. Outcome indicators extracted were nerve conduction study results: sensory nerve action potential (SNAP) amplitude, SNAP distal latency, sensory nerve conduction velocity (SNCV), compound muscle action potential (CMAP) amplitude, motor nerve distal latency (MNDL), motor nerve conduction velocity (MNCV), H/M ratio and H-reflex latency.ResultsA total of 879 papers were identified through the database searches. Twenty-four trials were included in the systematic review, and 22 trials were included in the meta-analysis. The results showed that: (1) compared to the baseline, ESWT reduced SNAP distal latency mid-term (MD, −0.39; 95% CI: −0.52, −0.26; I2 = 85%), and improved SNCV both short-term (MD, 4.36; 95% CI: 1.23, 7.49; I2 = 91%) and mid-term (MD, 2.65; 95% CI: 1.79, 3.51; I2 = 61%). At the same time, it reduced MNDL short-term (MD, −0.61; 95% CI: −0.91, −0.30; I2 = 92%), but had no significant effect on MNCV. (2) Subgroup analyses showed that ESWT was superior to Control but not significantly better than LCI, especially in SNCV. The excitatory effect of ESWT + PT on the sensory and motor nerves was significantly better than that of PT alone.ConclusionESWT had some excitatory effect on peripheral nerves, especially on sensory nerve studies. Although the efficacy of this treatment was superior to that of the control group, and the combined treatment with PT was more effective than PT alone, its efficacy might not exceed that of LCI.Systematic review registrationUnique identifier: PROSPERO (CRD42024500891).
Synergistic effects of combined motor and language interventions on stroke rehabilitation: a holistic approach
Authors: Saber-Moghadam Reihaneh , Zeinalzadeh Afsaneh , Jamali Jamshid , Farzadfard Mohammad Taghi , Sobhani-Rad Davood 
Published: November 2024

BackgroundStroke patients typically suffer from a range of symptoms, such as motor and language impairments, due to shared neural networks. The recovery process after stroke is intricate and requires a comprehensive approach. While previous studies have investigated the motor and language interventions independently, this study aimed to explore the relationship between these domains and compared the effectiveness of individual interventions versus their combined use.MethodsWe divided 45 stroke patients into three groups: Speech and Language Therapy (SLT) group; Arm Ability Training (AAT) group; and consecutive combination of SLT and AAT group. Participants attended 40-min sessions three days a week for three weeks. Standardized assessments, including picture naming test, syntactic comprehension test, and Test d’Evaluation des Membres Supérieurs de Personnes Âgées (TEMPA) test, were conducted pre-and post-treatment and during the first and second weeks of the intervention.ResultsWithin-group comparisons demonstrated a significant enhancement in test scores for all groups post-intervention compared to pre-intervention (p &lt; 0.05). Between-group comparisons revealed significant differences (p &lt; 0.05) in performance on the picture naming test during the first week, the syntactic comprehension test in the second week, the functional rating subscale of Tempa test changes pre-and post-treatment and the first week, and the length of the time subscale of Tempa test improvements from pre-intervention to the first week.ConclusionFindings underscored the mutual and synergistic benefits of integrating motor and language in stroke rehabilitation. While SLT and AAT were effective when applied independently, their combined application yielded superior outcomes, emphasizing the holistic advantages of integrating these interventions, as supported by existing literature on dual-task rehabilitation strategies.Clinical trial registrationhttps://irct.behdasht.gov.ir/search/result?query=IRCT20200114046134N1, IRCT20200114046134N1.
Combination of triple chemotherapy and sequential re-irradiation as salvage for recurrent treatment-refractory hemangiopericytoma of extraspinal dura: a case report
Authors: Wang Min , Lv Wanrui , Chen Xi , Cheng Ke 
Published: November 2024

IntroductionHemangiopericytoma (HPC) in the central nervous system (CNS) is rare. Our report aims to present an HPC case with multiple surgeries at the lumbar spine, and demonstrates an effective treatment as salvage.Case reportIn this report, we present the case of a young girl with recurrent meningeal invasion of lumbar spinal HPC. The patient underwent multiple surgeries to remove the tumors, and adjuvant radiotherapy was administered after the initial resection. And it presented a pathological anaplastic transformation with subsequent accelerated recurrence. A combination therapy approach involving triple chemotherapy and sequential re-irradiation was found to be effective as salvage treatment at the third recurrence.ConclusionsSurgical resection remains the primary treatment modality for HPC in the spine, despite its high tendency for local recurrence and the risk of metastasis. For unresectable recurrent HPC, combining chemotherapy and sequential re-irradiation might be a highly effective, and safe reference regimen as the salvage treatment for the refractory case.
Superior survival benefits of triple combination immunotherapy compared to standard chemotherapy as second-line treatment for advanced biliary tract cancer: a retrospective analysis
Authors: Shang Peipei , Xu Heming , Zeng Tianmei , Lou Cheng , Wei Wei , Yang Guang , Cheng Zhuo , Cui Xiaowen , Hong Weipeng , Shen Weidong , Lian Zhicong , Yuan Zhengang 
Published: November 2024

BackgroundAdvanced biliary tract cancer (BTC) is associated with a poor prognosis and limited options for second-line treatment. The TOPAZ-1 and KEYNOTE-966 trials have demonstrated the benefits of combining immune checkpoint inhibitors (ICIs) with chemotherapy in treating BTC. However, the efficacy of FOLFOX as a second-line therapy is limited, highlighting the need for more effective treatment approaches.MethodsThis retrospective study compared a triple regimen—comprising ICIs, tyrosine kinase inhibitors, and chemotherapy—to standard chemotherapy in patients with metastatic BTC who had progressed on first-line gemcitabine-based therapy. The primary endpoint was progression-free survival (PFS), with secondary endpoints including overall survival (OS), overall response rate (ORR), disease control rate (DCR), and safety.ResultsOf the 121 patients, 86 received the triple regimen and 35 received standard chemotherapy. The triple regimen showed a significantly higher ORR (37.2% vs. 2.8%, p &lt; 0.0001) and DCR (89.5% vs. 71.4%). The median PFS was 6 months for the triple regimen compared to 2.0 months for standard chemotherapy (HR 0.29, p &lt; 0.0001). The median OS was 16.0 months for the triple regimen versus 6.0 months for standard chemotherapy (HR 0.35, p &lt; 0.0001). Treatment-related adverse events were comparable between the groups.ConclusionThe triple combination of immunotherapy offers superior survival benefits compared to standard chemotherapy as a second-line treatment for advanced BTC, warranting further investigation for potential clinical adoption.
Opportunistic infections among schoolchildren who were on antiretroviral therapy in Ethiopia: a systematic review and meta-analysis
Authors: Birhanu Molla Yigzaw , Telayneh Animut Takele , Kassie Abere , Tegegne Eniyew , Jemberie Selamawit Shita 
Published: November 2024

IntroductionThe most common and severe cause of morbidity and mortality among HIV- positive children is opportunistic infections (OIs). All HIV-infected children are at risk of developing a variety of OIs. Healthcare workers, programmers, and other stakeholders are in doubt about using the onset and predictors of OIs among schoolchildren on antiretroviral therapy (ART) due to the presence of conflicting results found in the primary studies. Hence, this study was conducted to provide a single figure of onset and specific predictors of OIs by overcoming the existing heterogeneity in Ethiopia.MethodsThe included studies were searched from different national and international databases systematically. The included studies were cohort in design and published in English between 2015 and 2022. The data were extracted using a validated Microsoft Excel tool after the quality of the included studies was assured. The extracted data were exported to Stata Version 17.0 for further management and analysis. The presence of heterogeneity across studies was checked using the Chi-square test and quantified using the I2 test. Various methods, including forest plots, publication bias assessment, sensitivity tests, subgroup analysis, and meta-regression, were employed to determine the source of heterogeneity, but none were successful. The overall onset of OIs was estimated by pooling the incidence of primary studies using a random-effects meta-analysis model. The predictors were identified using meta-regression and the presence of significant association was declared using a p-value of 0.05 with 95% CI. The strength of association was reported using an adjusted hazard ratio with 95% CI.ResultsEleven studies were included in this systematic review and meta-analysis. The onset of OIs among schoolchildren on ART in Ethiopia was 5.58 (95% CI: 4.50, 6.67) per 100 children-years of OI-free observations. Those children who had no parents had a 1.41 (95% CI: 1.10, 1.80) times higher chance of getting OIs when compared with those children having one or both parents. Children who had poor ART adherence had a 2.96 (95% CI: 1.66, 5.29) times higher chance of experiencing OIs than children who had good ART adherence. Finally, the chance of experiencing OIs among rural children was 2.15 (95% CI: 1.63, 2.83) times higher than their counterparts in Ethiopia.ConclusionsThree in every 33 schoolchildren on ART developed OIs in Ethiopia. Predictors of OIs included schoolchildren without parents, those with poor adherence to ART, and rural residents. This suggests that social support, medication adherence, and access to healthcare services may play important roles in preventing and controlling OIs among schoolchildren living with HIV in rural areas.