bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Quadriceps Tendon Autograft Preparation and Fixation on Graft Laxity During Suspensory Anterior Cruciate Ligament Reconstruction: A Biomechanical Analysis
Authors: Bedi Asheesh , Smith Benjamin L. , Mitchell Justin J. , Frank Rachel M. , Hauck Oliver L. , Wijdicks Coen A. 
Published: October 2024

Background: Favorable collagen fibril density and thickness combined with advances in graft preparation and fixation have significantly increased interest in the quadriceps tendon (QT) autograft for anterior cruciate ligament (ACL) reconstruction. While various suspensory techniques have been described, the biomechanical profile of these constructs is largely undefined. Purpose: To compare the biomechanics of suspensory techniques for soft tissue QT autograft fixation in an in vitro model of ACL reconstruction. Study Design: Controlled laboratory study. Methods: Full-thickness QT grafts were harvested using a 9-mm graft blade. Adjustable-loop devices (ALDs) were secured to the graft (n = 6 per group) with a combination implant containing the ALD and suture tape-reinforced whipstitching (tape-reinforced [TR] group), tethered superficially to the graft with a whipstitch (onlay [OL] group), luggage-tagged through and around the graft (luggage tag [LT] group), or staggered behind superficial suturing (staggered [SG] group). Grafts were tested on an electromechanical testing machine following a validated in vitro reconstruction model of intraoperative workflow and postoperative ACL kinematics, cyclic loading, and load to failure. Results: The TR group had significantly less postcyclic tension loss (mean, 24%) compared with the OL (56%; P = .002), LT (69%; P < .001), and SG (90%; P < .001) constructs. Cyclic elongation was below the 3.0-mm threshold defined as clinical failure for TR (1.6 mm), but not for OL (3.3 mm), LT (7.9 mm), and SG (11.3 mm). All constructs were within native ACL stiffness limits (220 ± 72 N/mm) without significant differences. Ultimate loads significantly exceeded a normal ACL loading limit of 454 N for TR (739 N; P = .023), OL (547 N; P = .020), and LT (769 N; P = .001), but not for SG (346 N; P = .236). Conclusion: The TR ALD construct demonstrated the most favorable time-zero biomechanical properties of modern soft tissue QT suspensory constructs, with 32% less tension loss and 52% less cyclic elongation versus the closest construct. Failure loading of all constructs was acceptable with respect to the native ACL except for the SG group, which had suboptimal ultimate load. Clinical Relevance: TR ALD implants may protect soft tissue QT autografts before graft-bone healing in ACL reconstruction by minimizing time-zero laxity and fixation failure.
Effects of the PRECEDE-PROCEDE Model on Self-Care Ability and Quality of Life Among Primipara During Puerperium
Authors: Lei Xueli , Zhou Yanhui 
Published: October 2024

Background Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. Purpose The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. Methods This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. Findings The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups ( P < 0.05), and we also found an interaction effect between grouping and time factors ( P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group ( P < 0.05). Conclusion PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium.
Clinical improvements after endoscopic lung volume reduction with valves in patients with advanced emphysema and a 6-min walk test ≤140 m at baseline
Authors: Saccomanno Jacopo , Kilic Lara , Sgarbossa Thomas , Neumann Konrad , Stanzel Franz , Holland Angelique , Grah Christian , Gesierich Wolfgang , Krist Joanna , Ficker Joachim H. , Eggeling Stephan , Andreas Stefan , Schmidt Bernd , Eisenmann Stephan , Schwick Björn , Franke Karl-Josef , Fertl Andreas , Witzenrath Martin , Hübner Ralf-Harto 
Published: October 2024

BackgroundData regarding the effectiveness and safety of endoscopic lung volume reduction with valves (ELVR) in emphysema patients with a very low 6-min walk test (6MWT) are limited. Patients with severe emphysema and very low exercise capacity, as indicated by a 6MWT ≤140 m, are often excluded from clinical studies on ELVR, assuming limited therapeutic benefits and increased complication risk.Study designs and methodsThis study utilised data from the Lungenemphysemregister e.V., a large German national multi-centre prospective open-label clinical trial, and aimed to assess the outcomes of ELVR in patients with a baseline 6MWT ≤140 m and dyspnoea primarily attributed to hyperinflation.Results54 patients with a baseline 6MWT ≤140 m and 365 patients with a baseline 6MWT between 140 and 450 m were included in the study. Baseline characteristics were representative for patients with advanced lung emphysema. Patients with a 6MWT ≤140 m at baseline had a lower forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide and higher symptom burden. In the 3-month follow-up, patients of both groups showed statistically significant improvements in lung function parameters, exercise capacity and quality of life parameters compared to baseline. Patients with a 6MWT ≤140 m at baseline showed significantly more 6MWT improvement compared to patients with baseline 6MWT between 140 and 450 m. Moreover, complication rates were similar in both groups.InterpretationIn summary, the data indicate that ELVR may be an effective and safe treatment for emphysema patients with a very low 6MWT of ≤140 m if very limited exercise capacity is predominately caused by lung emphysema. Therefore future studies should include emphysema patients with a very low 6MWT.
Laryngeal mask airway or high-flow nasal cannulaversusnasal cannula for advanced bronchoscopy: a randomised controlled trial
Authors: Pikman Gavriely Regina , Freund Ophir , Tiran Boaz , Perluk Tal Moshe , Kleinhendler Eyal , Matot Idit , Bar-Shai Amir , Gershman Evgeni 
Published: October 2024

BackgroundAdvanced bronchoscopic procedures have become a widely prevalent evaluation and treatment modality. These procedures require appropriate sedation and respiratory support. This study directly compares three respiratory support methods during advanced bronchoscopy.MethodsThis three-arm, prospective, block randomised trial included 60 consenting adult patients that were referred for advanced bronchoscopy involving endobronchial ultrasound (EBUS) with transbronchial needle aspiration and met inclusion/exclusion criteria. Patients were randomised to undergo bronchoscopy through a laryngeal mask airway (LMA) or with a high-flow nasal cannula (HFNC) or low-flow nasal cannula (NC), with bronchoscopy performed through a bite block. Demographic, procedural and clinical parameters were compared between the three groups, including complications, oxygenation, ventilation and need for intervention.ResultsAnalysis according to intention to treat was made for the 20 patients in each arm. There were no significant differences in demographic parameters, pre-morbidities and procedure type and duration between groups. Hypoxia was significantly more common in the NC group (90%) compared with the LMA (45%) and HFNC (26%) groups (p<0.01). The need for interventions and their number were also lower in the LMA (40%) and HFNC (52.6%) groups compared with the NC group (90%, p<0.01). A multivariate analysis confirmed both HFNC and LMA as independent predictors of a lower rate of recurrent desaturation events and fewer complications in general compared with NC.ConclusionIn this prospective randomised trial, we demonstrated the advantages of using LMA or HFNC over NC during advanced bronchoscopy with EBUS.
Estimation of tuberculosis mortality burden in spain: a review of the major data sources
Authors: Redin Miriam Roncal , Barroso Diana Gómez , Herrera Laura , Gómez-Castellá Javier , Herrador Zaida ,   Spanish Working Group on Tuberculosis
Published: October 2024

IntroductionIn Spain, notifications of cases of tuberculosis (TB) are registered through the National Epidemiological Surveillance Network (RENAVE). The Minimum Basic Data Set (CMBD) provides information on hospital discharge and the Statistics National Institute (INE) draws on medical death certificates. This study aimed to describe TB mortality in Spain and to compare estimates across data sources, as well as with EU/EEA countries.Material and MethodsA retrospective study of TB data between 2008 −2021 was performed. Mortality rates (MR) were calculated for the three databases as well as fatality rates (CFR) for TB location and HIV status using RENAVE data. Time trends were calculated and the average MR and annual average percentage change for Spain were compared with EU/EEA countries.ResultsBetween 2008 and 2021, 4127 TB deaths were reported to RENAVE, 3877 to INE and 4775 to CMBD. The MR was 0.62 per 100,000 inhabitants for RENAVE, 0.59 for INE and 0.72 for CMBD. A statistically significant downward annual trend was observed. Highest MR across all databases were found in men and in those over 80 years old. CFR was higher for meningeal TB and for HIV patients with a risk ratio of 2.02 (95%CI: 1.82-2.2; p<0.05).ConclusionAlthough the TB MR in Spain has followed a downward annual trend, it is necessary to continue improving prevention, diagnosis and treatment. This will require comprehensive measurement, better knowledge and better use of all information to complement surveillance systems.
Heart rate recovery after the 6-min walk test in people with bronchiectasis
Authors: Sáez-Pérez Juan Antonio , Arbillaga-Etxarri Ane , Alcaraz-Serrano Victoria , Gimeno-Santos Elena , Torres Antoni , Herrero-Cortina Beatriz 
Published: October 2024

BackgroundThe cardiac autonomic response to exercise and during recovery has been poorly explored in bronchiectasis.MethodsA longitudinal study was conducted in adults with bronchiectasis. Sociodemograhic and clinical data were collected at baseline and after 12 months of follow-up. The heart rate recovery after the first (HRR1) and second minute (HRR2) of recovery in the six-minute walk test (6MWT) was estimated in both assessments. Adjusted regression models were used to identify predictors of a delayed HRR1(HRR1≤ 14).Results104 participants with a mean (sd) age of 64 (13) years and mostly woman (67%) were included. A delayed HRR1after the baseline 6MWT was identified in 36% of participants. These participants presented a higher proportion of males, increased body mass index, higher disease severity, more likely to required hospitalisation, more impact on quality of life, lower exercise capacity, lower HR at the end of the 6MWT and lower HRR2. Disease severity (ß, 95%CI) (moderate and severeversusmild, −0.47 (−0.94 to −0.01)) and distance walked (0.34 (0.11 to 0.56)) were the independent variables associated with HRR1. Of the 45 participants who completed the entire follow-up period, 24% exhibited delayed HRR1. The presence of at least two exacerbations during the follow-up period (OR, 95%CI) (16.89 (1.44 to 197.48)) was the only predictor of a delayed HRR1in the assessment completed at the end of the study.ConclusionHRR1is related to disease severity and mainly affected by having severe exacerbations in people with bronchiectasis.
Proteome signature for differential diagnosis of patients with bilateral lung infiltrates
Authors: Oh Yumi , Kim Kyunggon , Kim Ho Jeong , Hong Sang-Bum , Lim Chae-Man , Koh Younsuck , Ahn Hee-Sung , Huh Jin Won 
Published: October 2024

BackgroundThe differential diagnosis of bilateral lung infiltrates and prognosis prediction can be challenging for clinicians in the intensive care unit (ICU). We analysed the proteome from bronchoalveolar lavage fluid (BALF) and determined its usefulness for evaluating the infectious causes and mortality associated with bilateral lung infiltrates.MethodsIn the ICU cohort, 136 patients with bilateral infiltrate on chest radiographs were selected, and bronchoscopy with bronchoalveolar lavage (BAL) was performed. Proteomic profiling of the exosomes in the BALF (n=20) was conducted to identify candidate protein biomarkers potentially associated with infection or mortality. The BAL samples (n=116) were used to measure the candidate biomarker levels.ResultsThe candidate biomarkers, CD20, CLIC4, SCFD1 and TAP1, were selected for the differential diagnosis of infection or mortality. The levels of CD20 were significantly elevated in patients with non-infectious causes, compared with those with infectious causes (248.6±154.5versus177.6±150.9 ng·mL−1, p=0.014). The levels of CLIC4, SCFD1 and TAP1 did not differ between the two groups. As per the receiver operating characteristic analysis, CD20 was a significant predictor of non-infectious causes (area under curve 0.668; 95% confidence interval 0.567–0.769; p=0.002; cut-off value 167.6 ng·mL−1; sensitivity 74.1%; specificity 63.2%). There were no significant differences in the concentrations of the biomarkers between survivors and non-survivors.ConclusionsOur results suggest that CD20 levels in BALF might be a useful biomarker for differentiating non-infectious and infectious diseases in patients with bilateral lung infiltrates.
Effects of acetazolamide on exercise performance in patients with COPD going to high altitude: randomised controlled trial
Authors: Kind Roman F. , Furian Michael , Buergin Aline , Scheiwiller Philipp M. , Mayer Laura , Schneider Simon R. , Lichtblau Mona , Muralt Lara , Mademilov Maamed , Sooronbaev Talant M. , Ulrich Silvia , Bloch Konrad E. 
Published: October 2024

BackgroundIn patients with COPD, preventive treatment with acetazolamide reduces adverse health effects during altitude travel. We investigated whether preventive acetazolamide treatment modifies exercise performance in COPD patients going to high altitude.MethodsIn this randomised, double-blind trial, lowlanders with COPD, forced expiratory volume in 1 s (FEV1) 40–80% predicted, were assigned to acetazolamide (375 mg per 24 h) or placebo treatment starting 24 h before ascent and while staying at 3100 m. Patients performed progressive cycling exercise to exhaustion at 760 m, before taking the study drug, and within 4 h after arrival at 3100 m. The primary outcome was the maximal power output (Wmax).Results103 patients (32 women), mean±sdage 57.2±8.1 years, FEV166±11% predicted, were included in per-protocol analyses. In 53 patients receiving acetazolamide, Wmaxand oxygen uptake (V′O2max) at 760 m and 3100 m were 105±27 and 91±25 W, and 18.0±4.8 and 15.5±3.7 mL·min−1·kg−1(p<0.001, both changes). Corresponding WmaxandV′O2maxin 50 patients receiving placebo were 107±34 and 97±28 W, and 18.9±6.0 and 17.2±5.0 mL·min−1·kg−1(p<0.001, both changes). Between-group differences (95% CI) in altitude-induced Wmaxchanges were −3.0 W (−8.7 to +2.7, p=0.305) and inV′O2maxchanges were −0.8 mL·min−1·kg−1(−2.1 to +0.5, p=0.213). Acetazolamide mitigated the altitude-induced reduction ofPaO2by 0.7 kPa (0.1 to 1.3, p=0.016). At 3100 m, maximal work rate with respiratory exchange ratio ≤1 was greater with acetazolamide than with placebo by 10.1 W (4.0 to 16.2, p=0.022).ConclusionsIn lowlanders with COPD, preventive treatment with acetazolamide did not modify the altitude-induced reduction in maximal work rate. However, acetazolamide enhanced arterial oxygenation and submaximal, moderate-intensity work capacity compared with placebo.
The Interstitial Lung Disease Patient Pathway: From Referral To Diagnosis
Authors: Lough Graham , Abdulqawi Rayid , Amanda Gina , Antoniou Katerina , Azuma Arata , Baldi Milind , Bayoumy Ahmed , Behr Jürgen , Bendstrup Elisabeth , Bouros Demosthenes , Brown Kevin , Chaudhuri Nazia , Corte Tamera J. , Cottin Vincent , Crestani Bruno , Flaherty Kevin R. , Glaspole Ian , Kawano-Dourado Leticia , Keane Michael P. , Kolb Martin , Martinez Fernando J. , Molina-Molina Maria , Ojanguren Iñigo , Pearmain Laurence , Raghu Ganesh , Rottoli Paola , Stanel Stefan C. , Tabaj Gabriela , Vancheri Carlo , Varela Brenda , Wang Bonnie , Wells Athol , Rivera-Ortega Pilar 
Published: October 2024

BackgroundSuspected Interstitial Lung Disease (ILD) patients may be referred to an ILD-specialist centre or non-ILD-specialist centre for diagnosis and treatment. Early referral and management of patients at ILD-specialist centres has been shown to improve survival and reduce hospitalisations. The COVID-19 pandemic has affected the ILD patient diagnostic pathway and prompted centres to adapt.AimsThis study investigates and contrasts ILD patient pathways in ILD-specialist and non-ILD-specialist centres, focusing on referrals, caseloads, diagnostic tools, multi-disciplinary team (MDT) meeting practices, and resource accessibility.MethodsConducted as a cross-sectional study, a global self-selecting survey ran from September 2022 to January 2023. Participants included ILD specialists and healthcare professionals (HCPs) from ILD-specialist centres and non-ILD-specialist centres.ResultsOf 363 unique respondents from 64 countries, 259 were from ILD-specialist centres and 104 from non-ILD-specialist centres. ILD centres had better resource availability, exhibiting higher utilisation of diagnostic tests (median: 12 tests), than non-ILD centres (9 tests); and better access to specialist professions attending MDTs (median: 6 professions at meeting) in specialist centres than non-ILD centres (3 professions at meeting). Transitioning to virtual MDTs allowed HCPs from outside of centres to join meetings in nearly 90% of all centres, increasing regular participation in 60% of specialist centres and 72% of non-ILD centres. For treatment of patients, specialist centres had better access to antifibrotic drugs (91%) compared to non-ILD centres (60%).ConclusionsDiagnostic pathways for ILD patients diverged between specialist centres and non-ILD centres. Disparities in resource and specialist availability existed between centres.
Occurrence and role of Tph cells in various renal diseases
Authors: Ren Junyi , Ma Kuai , Lu Xiangheng , Peng Haoyu , Wang Jia , Nasser Moussa Ide , Liu Chi 
Published: October 2024

AbstractA new population of peripheral helper T (Tph) cells has been identified and contributed to various autoimmune diseases. Tph cells can secrete interleukin-21 (IL-21), interferon (IFN) and C-X-C motif chemokine ligand 13 (CXCL13) to moderate renal disease. Moreover, Tph cells can congregate in huge numbers and immerse within inflamed tissue. Compared to Tfh cells, Tph cells express high programmed cell death protein 1 (PD-1), major histocompatibility complex II (MHC-II), C-C chemokine receptor 2 (CCR2) and C-C chemokine receptor 5 (CCR5) but often lack expression of the chemokine receptor C-X-C chemokine receptor 5 (CXCR5). They display features distinct from other T cells, which are uniquely poised to promote responses and antibody production of B cells within pathologically inflamed non-lymphoid tissues and a key feature of Tph cells. In this review, we summarize recent findings on the role of Tph cells in chronic kidney disease, acute kidney injury, kidney transplantation and various renal diseases.
Rewriting cellular fate: epigenetic interventions in obesity and cellular programming
Authors: Li Rui-lin , Kang Sheng 
Published: October 2024

AbstractExternal constraints, such as development, disease, and environment, can induce changes in epigenomic patterns that may profoundly impact the health trajectory of fetuses and neonates into adulthood, influencing conditions like obesity. Epigenetic modifications encompass processes including DNA methylation, covalent histone modifications, and RNA-mediated regulation. Beyond forward cellular differentiation (cell programming), terminally differentiated cells are reverted to a pluripotent or even totipotent state, that is, cellular reprogramming. Epigenetic modulators facilitate or erase histone and DNA modifications both in vivo and in vitro during programming and reprogramming. Noticeably, obesity is a complex metabolic disorder driven by both genetic and environmental factors. Increasing evidence suggests that epigenetic modifications play a critical role in the regulation of gene expression involved in adipogenesis, energy homeostasis, and metabolic pathways. Hence, we discuss the mechanisms by which epigenetic interventions influence obesity, focusing on DNA methylation, histone modifications, and non-coding RNAs. We also analyze the methodologies that have been pivotal in uncovering these epigenetic regulations, i.e., Large-scale screening has been instrumental in identifying genes and pathways susceptible to epigenetic control, particularly in the context of adipogenesis and metabolic homeostasis; Single-cell RNA sequencing (scRNA-seq) provides a high-resolution view of gene expression patterns at the individual cell level, revealing the heterogeneity and dynamics of epigenetic regulation during cellular differentiation and reprogramming; Chromatin immunoprecipitation (ChIP) assays, focused on candidate genes, have been crucial for characterizing histone modifications and transcription factor binding at specific genomic loci, thereby elucidating the epigenetic mechanisms that govern cellular programming; Somatic cell nuclear transfer (SCNT) and cell fusion techniques have been employed to study the epigenetic reprogramming accompanying cloning and the generation of hybrid cells with pluripotent characteristics, etc. These approaches have been instrumental in identifying specific epigenetic marks and pathways implicated in obesity, providing a foundation for developing targeted therapeutic interventions. Understanding the dynamic interplay between epigenetic regulation and cellular programming is crucial for advancing mechanism and clinical management of obesity.