bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional and radiological outcomes and complications of Bernese periacetabular osteotomy through modified Stoppa approach
Authors: Akbulut Deniz , Coskun Mehmet 
Published: October 2024

Background: The Smith-Peterson approach and its modifications provide an extensive exposure and allow osteotomies through a single incision. However, the risk of complications increases when the quadrilateral surface, ischial and pubic osteotomy sites cannot be seen. This study aimed to evaluate the surgical characteristics, complications, and functional and radiological outcomes of patients with acetabular dysplasia who underwent Bernese periacetabular osteotomy (PAO) through modified Stoppa approach and plate-screw fixation. Methods: The study included 31 patients (41 hips) who had undergone PAO using a modified Stoppa approach. The characteristics of patients and the surgical procedure were described. The lateral centre-edge angle (LCEA) and Tönnis roof angle were evaluated in the radiological outcome evaluation. The modified Harris Hip Score (mHHS) was used to evaluate functional outcome. Furthermore, complications were described. Results: The mean age of the patients was 20.4 ± 9.0 years. Of the 31 patients, 21 underwent unilateral Bernese PAO and 10 underwent bilateral Bernese PAO. The mean follow-up period was 25.1 ± 8.8 months. Postoperatively, the mean mHHS improved significantly (68.8 ± 9.4 vs. 88.8 ± 10.0, p < 0.001). Postoperatively, the mean LCEA and Tönnis roof angle improved significantly (17.7 ± 6.0 vs. 42.2 ± 4.8, p < 0.001 for LCEA and 18.3 ± 5.5 vs. 8.0 ± 2.2, p < 0.001 for Tönnis roof angle). There was no significant correlation between preoperative to postoperative improvement in LCEA or Tönnis roof angle and improvement and mHHS ( p > 0.005). 5 complications were identified: 1 transient sciatic nerve palsy, 1 external iliac vein injury, 1 infection, and 2 screw irritations of acetabulum. Conclusions: Performing Bernese PAO through a modified Stoppa approach with plate-screw fixation results in acceptable complication rates, immediate early weight-bearing opportunity, and improved functional and radiological outcomes in patients with acetabular dysplasia.
A Novel ANG-BSA/BCNU/ICG MNPs Integrated for Targeting Therapy of Glioblastoma
Authors: Liu Li-Hong , Liu Yu-Feng , Zhang Hong-Bo , Liu Xiao-Lei , Zhang Han-Wen , Huang Biao , Lin Fan , Li Wei-Hua 
Published: October 2024

Purpose Develop an albumin nanoparticle-based nanoprobe for targeted glioblastoma (GBM) diagnosis and treatment, utilizing Angopep-2 for low-density lipoprotein receptor-related protein (LRP) targeting. Methods Combined albumin-coated superparamagnetic iron oxide (SPIO), Carmustine (BCNU), and indocyanine green (ICG). Assessed morphology, size, Zeta potential, fluorescence, and drug encapsulation. Conducted in vitro fluorescence/MRI imaging and cell viability assays, and in vivo nanoprobe accumulation evaluation in brain tumors. Results ANG-BSA/BCNU/ICG MNPs exhibited superior targeting and cytotoxicity against GBM cells in vitro. In vivo, enhanced brain tumor accumulation during imaging was observed. Conclusion This targeted imaging and drug delivery system holds promise for efficient GBM therapy and intraoperative localization, addressing Blood-brain barrier (BBB) limitations with precise drug delivery and imaging capabilities.
Native kidney biopsy in pregnancy and postpartum: A single centre experience from India
Authors: Mondemu Shreya Srinivas , Parameswaran Sreejith , Ganesh Rajesh Nachiappa , Keepanasseril Anish 
Published: October 2024

Background With the advances in medicine and imaging, renal biopsy is increasingly utilised for identifying pathologies during pregnancy. Methods This retrospective observational study aimed to assess indications and complications among 32 women who underwent native renal biopsies during pregnancy and postpartum from 2015 to 2022. Results The commonest indications for performing the biopsy were nephrotic syndrome and acute kidney injury during pregnancy or immediately postpartum. Most (62.5%) had biopsies performed in the antenatal period. Lupus nephritis was the most common finding on biopsy, and there were no procedure-related serious adverse effects. Most pregnancies were complicated by hypertensive disorders and preterm birth. All except six women with perinatal loss had healthy neonates. Conclusions Even as kidney biopsy remains the gold standard for diagnosing renal pathologies, it should be reserved for women where management in pregnancy would be altered by the result.
Lower leukocytes pretreatment as a possible risk factor for therapy-induced leukopenia in interferon-beta-treated patients with multiple sclerosis
Authors: Protopapa Maria , Schmaul Samantha , Schraad Muriel , Pape Katrin , Zipp Frauke , Bittner Stefan , Uphaus Timo 
Published: October 2024

Background: Interferon-beta (IFN-β) still plays a fundamental role in immunomodulation of people with multiple sclerosis (MS) with low disease activity and in clinically isolated syndrome (CIS). In 2014, pegylated (PEG) interferon was licensed by the European Medicines Agency (EMA) for relapsing-remitting MS (RRMS), enabling a lower dosing frequency. Objectives: Our retrospective study compares laboratory findings and adverse events between subcutaneous (sc.) PEG-IFN-β-1a and IFN-β-1a in RRMS and CIS patients. Design: Patients with CIS or RRMS fulfilling the revised McDonald criteria from 2017 visiting the neurology department of the University Medical Center of the Johannes Gutenberg University Mainz from 2010 to 2019 and treated with sc. PEG-IFN-β-1a or sc. IFN-β-1a ( n = 202) were screened for eligibility. Patients who underwent regular laboratory controls in-house were included in our analysis ( n = 128). Methods: We evaluate disease progression through clinical examination, relapse history, and magnetic resonance imaging (MRI) disease activity (gadolinium-enhancing or new T2 lesions). Relevant laboratory findings such as leukopenia (leukocyte count < 3.5/nl) and neutropenia (neutrophil count <43% of lymphocytes or <1500/µl) were assessed. Telephone interviews evaluated the side effects of the respective medication. A subgroup of patients was analyzed regarding neutrophil quantities and qualities. Results: Patients treated with sc. PEG-IFN-β-1a had significantly lower leukocyte counts ( p = 0.046) and higher incidences of leukopenia ( p = 0.006) and neutropenia ( p = 0.03) compared to sc. IFN-β-1a. Clinical and MRI disease activity showed no significant differences, but people treated with sc. PEG-IFN-β-1a reported more common adverse events such as joint/muscle pain, injection-site reaction, and infections. No serious adverse events were reported. Conclusion: Treatment with sc. PEG-IFN-β-1a compared to unpegylated sc. IFN-β resulted in a significantly greater reduction in leukocyte and neutrophil levels with a higher incidence of side effects. We suggest mandatory monitoring of differential blood counts before and during treatment.
A Nomogram Diagnostic Model for Eustachian Tube Dysfunction in Patients with Tympanic Membrane Perforation
Authors: Chen Xiaoxin , Tong Michael C. F. , Chang Wai Tsz 
Published: October 2024

Objectives Eustachian tube dysfunction (ETD) is a common disease associated with chronic otitis media. A standard diagnostic tool for ETD in patients with tympanic membrane perforation is still lacking. We developed and validated a new diagnostic model for ETD in patients with tympanic membrane perforation. Methods A prospective study was conducted in patients who had tympanic membrane perforation from February to August 2023. We collected clinical characteristics and examination results including otoscopy, nasal endoscopy, tubomanometry, and 5-item Eustachian Tube Score (ETS-5). Univariate and multivariate logistic regression analysis was performed to determine the independent diagnostic factors. Based on this, the nomogram model was constructed. The discrimination and calibration of the nomogram were evaluated using the area under the curve (AUC), the C-index, the calibration curve, and the decision curve analysis (DCA). Results A total of 40 participants were enrolled in the study. ETS-5 score and Eustachian tube opening mucosa inflammation in the nasopharynx were significant predictors in identifying ETD. Based on the above independent predictors, a diagnostic nomogram was successfully established. The sensitivity and specificity of the diagnostic model were 80.0% and 90.0%, respectively. The AUC and the C-index of the diagnostic model were both 0.901, which suggested that the model had a good discrimination power. The calibration curve indicated a good calibration degree of the model. DCA showed that the proposed model was useful for clinical practice. Conclusion The nomogram model is effective and reliable in identifying ETD in patients with tympanic membrane perforation.
Quantitative evaluation of risk factors for low back pain in young patients using synthetic magnetic resonance imaging and proton density fat fraction analyses
Authors: Yang Yuan , Lin Wu-Sheng , Wen Hui-Quan , Luo Xiao-Wen , Zhou Xiang , Zou Feng-Yun , Zhong Shuang-Shuang , Deng Ya-Yin , Shen Li-Shan , Zhang Yong , Li Qing-Ling , Guo Ruo-Mi 
Published: October 2024

Background: Lumbar intervertebral disc and paravertebral muscle degeneration are common causes of chronic low back pain (CLBP). However, the exact etiology of CLBP in young patients remains unclear. Identifying the risk factors for CLBP in young patients could expedite the development of effective preventive recommendations. Objectives: To identify the factors influencing the presence and severity of CLBP in young patients by analyzing the associations between the fat content of the paravertebral muscles, T2 value of the lumbar intervertebral disc (LIVD), and visual analog scale (VAS) score. Design: Data for 23 patients diagnosed with CLBP were compared to those of 20 healthy young individuals. Methods: The T2 values of the LIVD and fat content of the psoas major (PM), multifidus (MF), and erector spinae (ES) muscles for 23 young patients with CLBP and 20 healthy individuals were measured and compared using synthetic magnetic resonance imaging and proton density fat fraction analyses. Moreover, the factors (T2 values and fat content) associated with severe CLBP (assessed using the VAS score) were analyzed. Results: The fat content of the right MF and ES was higher in patients with CLBP than in healthy individuals ( p < 0.05). The T2 values of each LIVD in the CLBP and control groups were not significantly different ( p > 0.05). Moreover, the VAS scores did not correlate with the T2 values of the patients ( p > 0.05). The fat content of the bilateral MF and ES muscles was positively associated with the VAS score in young patients with CLBP (left MF: r = 0.506, p = 0.01; right MF: r = 0.532, p = 0.01; left ES: r = 0.636, p < 0.01; and right ES: r = 0.716, p < 0.01). Conclusion: Degeneration of the MF and ES may contribute to CLBP in young patients. In addition, the severity of CLBP is positively correlated with the degree of fat infiltration in the MF and ES.
Comprehensive framework for developing mHealth-based behavior change interventions
Authors: Rachad Taoufik , El Hafidy Abderrahim , Aabbad Meriem , Idri Ali 
Published: October 2024

Background Understanding human behaviors has been the subject of several studies. Their main goal was to inform behavior change interventions aimed at promoting positive behaviors and improving negative ones. However, as a non-expert in behavioral science, it is extremely difficult for researchers from other disciplines to design and develop evidence-based behavior change interventions. Moreover, all existing frameworks stop at the conceptual stage and do not provide instructions for developing digital-based behavior change interventions. Objective We present an end-to-end framework for the design and development of mHealth-based behavior change interventions by drawing on the synergy of theory, practices, and evidence from previous research. Methods We reconcile the frameworks most used in the literature for the design of behavior change interventions. Therefore, the authors examined the steps of each framework, and the mapping between these steps was carried out through several iterations to obtain five common steps. Results The proposed framework includes five steps: (1) Definition of the scope of the intervention. (2) Understanding and explanation of behavior. (3) Definition of the intervention content and strategies. (4) Implementation of the intervention. (5) Evaluation of the intervention. Each step is explained in detail, while providing researchers with examples and the necessary materials that will boost the success of their interventions. Conclusion This work provides a framework that will guide researchers in the design and implementation of mHealth-based behavior change interventions. It differs from its predecessors in that it goes beyond the conceptual level of intervention design by providing details about the technical implementation of mHealth solutions. Also, explanations and examples for different steps are provided to help researchers and practitioners and design, implement, and evaluate their mHealth-based behavior change interventions.
Revision ACL Reconstruction Surgery: Tips and Tricks
Authors: Hardjosworo Sapto Adji 
Published: October 2024

Introduction: Since Indonesia enjoys more social and economic growth in last past years, more Indonesian especially gen Millennial and gen Z enjoy sports. So the incidence of sports injuries are increasing, among those are ACL injuries. Since the anterior cruciate ligament reconstruction (ACLR) surgeries is increasing, so is the number of revision surgeries for a failed ACLR. The spectrum of ACL failure includes symptoms of recurrent instability, pain, and/or stiffness. Although primary ACL reconstruction is a successful operation, success rates may still range from 75% to 97%. Consequently, several thousand revision ACL reconstructions are performed annually and are unfortunately associated with inferior clinical outcomes when compared with primary reconstructions. Therefore sharing and learning from each other to improve the outcome of revision ACL reconstructions among us is good and beneficial. Discussion: Several factors which contribute to ACL failure may be identified as patient-related, surgeon-related, and biological factors. Among these, malposition of tunnel especially femoral-tunnel and recurrent trauma are the most common causes. In planning the revision ACL surgery, it is paramount to do detailed patient assessment, imaging, and studying details of the previous surgery. Among all, possible infection has to be ruled out prior to revision and identify the need for any bony reconstructive procedure. Osseous malalignment in the coronal or sagittal planes may need correction along with or prior to revision ACL surgery. In revising ACL reconstruction surgery, we need to make decision whether it can be performed as a one-stage or two-stage procedure. Severe tunnel dilatation, infection, or arthrofibrosis necessitates a two-stage approach. Associated meniscus tears and cartilage injuries are more common in revision than in primary surgery and need to be managed appropriately. Extra-articular reconstruction for controlling anterolateral instability is frequently required as well. Conclusion: Though revision ACL reconstruction surgery is not a routine procedure and a complex undertaking one, an excellent result can be achieved with regard to graft stability, return to play, and functional knee instability yet are generally inferior to primary ACL reconstruction. A staged approach with autograft reconstruction is recommended in any circumstance in which a single-stage approach results in suboptimal tunnel position, graft fixation, or biological milieu for enthesis healing. Patient expectations must be tempered because functional outcomes and return to pre-injury sports are usually inferior to a primary surgery.
Meniscus Medial Posterior Root Tear Management
Authors: Parsaoran Butarbutar John Christian , Riantho Albert , Fidiasrianto Kevin , Ivander Gian 
Published: October 2024

Medial meniscus posterior root tear (MMPRT) refers to the avulsion or complete radial tear occurring within a distance of 1 cm from the posterior tibial attachment of the medial meniscus. Root tears result in the extrusion of the meniscus, which subsequently leads to elevated joint contact pressures. These condition increased pressures contribute to the rapid progression of joint space narrowing and the occurrence of subchondral bone edema that were indistinguishable from total meniscectomy. Studies have reported that MMPRT represents A substantial percentage of meniscus tears, accounting for approximately 10 to 20% of all meniscus tears diagnosed. MMPRT frequency was reportedly 21.5% in all arthroscopic surgeries for meniscus medial tear. Nevertheless, despite the significant role that these injuries play in the development of degenerative joint disease, they frequently remain undetected during the initial evaluation. MMPRT are relatively common among middle-aged adults, female sex, and higher BMI with clear onset of significant injury. This might be attributed to aging associated degenerative alteration that makes the meniscus more susceptible to root detachment. The primary objective of managing MMPRT is to mitigate the progression of osteoarthritis by reinstating optimal joint contact pressures and kinematics. Given the unfavourable results observed with conservative treatment, surgical repair is currently regarded as the preferred choice. This approach has demonstrated encouraging clinical outcomes specifically in patients who meet the appropriate indications. Patients undergoing medial meniscus root repair have better functional scores, less osteoarthritis progression, and less conversion to total knee replacement compared to meniscectomy. The most common repair method for MMPRT is using transtibial pull-out repair at anatomic footprint of the meniscus root. Nevertheless, the pull-out suture method exhibits a vulnerability at the location of meniscus suturing, where cuts frequently occur during cyclical loading. Additionally, this technique cannot restore the meniscus extrusion. Furthermore, directly repair of the meniscus to bone may lead to a biologically weak structure at the footprint of the meniscus root. Nonanatomical repair itself shows less tibiofemoral contact area and increased mean contact pressure compared to anatomic repair. Several additional procedures have been proposed to maximize the result of meniscus root repair, including peripheral meniscocapsular release, centralization suture, and root reconstruction to minimize meniscus extrusion. In case of a significant tear gap found, root reconstruction is recommended to address the gap.
Strategies for Cartilage Repair and Regeneration
Authors: Adachi Nobuo 
Published: October 2024

Articular cartilage is a hyaline cartilage consisting of a small number of chondrocytes and the surrounding extracellular matrix. Since articular cartilage lacks blood vessels and nerve fibers, it is quite difficult to work normal wound healing process once it is damaged. For localized cartilage defects, drilling or microfracture techniques that introduce cells from bone marrow, osteochondral autograft harvested from non-weight bearing area of the joint, and autologous cultured chondrocyte implantation have been performed. However, there is no gold standard procedure. The meniscus plays important roles in the knee joints, such as shock absorption, load distribution, and lubrication. For the meniscal tears in the vascularized area, suture is aggressively performed to preserve the function of the meniscus. However, there are still many cases with non-vascularized filed tears and degenerative tears that require extensive partial meniscectomy. Regenerative medicine is expected to be applied to cases of articular cartilage or meniscus injuries that are difficult to treat with conventional therapies, and some clinical applications have been started in Japan. In regenerative medicine, the important factors are the cells to be transplanted, the scaffold for cell proliferation, and the growth factors to promote cell proliferation and cell function. In the regeneration of articular cartilage and meniscus, cells are usually isolated and cultured from biopsied tissues and transplanted alone or with a scaffold, but the high quality control required for cell culture and the two-step process of tissue collection and transplantation in surgery are major barriers to clinical application. We have been attempting to regenerate articular cartilage and meniscus by transplanting small pieces of cartilage or meniscus without culture process. To date, we have confirmed the efficacy of minced tissue as a cell source in vitro and have reported good tissue regeneration of articular cartilage and meniscus in vivo using rabbits and pigs.
Reviewing Revision Anterior Cruciate Ligament Reconstruction: Why and How?
Authors: Syaukat Ahmad , Shiddieqy Pohan Muhammad Alvin 
Published: October 2024

Introduction & Objectives: Revision ACL reconstruction occurred in 3.9- 9.2% cases of ACL repairs cases. Multiple revisions also increased comorbidities and lowers return-to-sport opportunity. We aimed to answer risk factors affecting requirements of revision ACL reconstruction and comparison of different techniques utilized for ACL reconstructions. Materials & Methods: PubMed and Europe PMC database were searched using following MeSH terms: “(“revision” AND ("acl" OR "anterior cruciate ligament") AND "reconstruction" AND "outcomes")”. This systematic review was conducted using PRISMA algorithm, searches yielded 1,649 abstracts for screening After employing screening criteria, final number of 32 relevant peer-reviewed open access studies from years 2018-2023. All authors read and voted for inclusion to paper. All papers were compiled, relevant information extracted, and narrated. Results: Gender was found to play some role in subsequent ACL reconstruction after primary ACL reconstruction failure. Another risk factors for revision ACL reconstruction included younger age (less than 30 years old) and use allograft for reconstruction. Revision ACL reconstruction conducted less than one year after symptoms were first experienced resulted in better outcome. The revision group more frequently experienced failure of the previous meniscal repair. Higher sport activity, or on the opposite, involvement in sport was an outcome of better revision ACL reconstruction. Surgical ACL reconstruction with internal bracing significantly decreased risk of ACL revision. Choices of graft, including greater utilization of autograft, and usage of BTB graft may improve patient outcomes. Conclusions: Younger age, allograft use, higher physical activity, and failure to repair meniscal damage risked revision ACL repair. Newer techniques may prevent ACL re-rupture and improve primary ACL repair outcomes. Choosing autograft and newer techniques results in better outcomes.