bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Predictability of Clinical Findings and Radiographs for Detecting Tarsal Coalition
Authors: Nunally Kianna D , Pigeolet Manon , Miller Patricia E , Shea Jodie E , May Collin , Shore Benjamin J 
Published: October 2024

Introduction:
Tarsal coalition is a disorder of the foot characterized by the abnormal union between 2 or more of the tarsal bones. A minority of patients will develop pain and limited motion when reaching adolescence, for whom surgical resection of the coalition may be necessary. The diagnostic value of clinical and radiologic signs remains unclear. The aim of this study is to assess the predictive value of clinical symptoms and plain x-rays to diagnose tarsal coalition in symptomatic patients.

Methods:
We performed a retrospective chart review of patients with clinical suspicion of tarsal coalition between January 2011 and November 2019. Patient demographic data; clinical data on pain, limited motion, peroneal spasm, recurrent, or previous trauma; and radiologic data on the presence and type of coalition were collected. Multivariable general estimating equations analysis was used to assess associations between demographic and clinical characteristics and the likelihood of a positive coalition diagnosis.

Results:
The study cohort was 336 patients (672 feet) with a mean age of 13 years and a 1:1 sex distribution. Thirt-eight percent of feet were diagnosed with a coalition of which 53% were talocalcaneal and 41% were calcaneonavicular. Coalitions were significantly more common in younger patients, males (OR 1.66, P=0.04), patients with lower BMI (OR 0.96, P=0.045), and patients who presented with painful feet (OR 1.59, P=0.04) or feet with limited motion (OR 7.49, P<0.001). Diagnostic utility of plain x-ray compared with CT diagnosis yielded a sensitivity of 76% and a specificity of 94%, with higher sensitivity (90%) in calcaneonavicular coalitions than in talocalcaneal (66%).

Discussion:
Our study shows that limited subtalar movement, male sex, and low BMI have a high predictive value for tarsal coalition in symptomatic patients. Classic clinical findings that were not predictive of coalition in our cohort of symptomatic patients included peroneal spasm, recurrent ankle sprains, and recent trauma. Plain x-rays offer a reliable alternative to CT for diagnosis, especially for calcaneonavicular coalitions.

Level of Evidence:
Level III—retrospective comparative study
Cancer therapy-related interstitial lung disease
Authors: Zhou Chengzhi , Deng Haiyi , Yang Yilin , Wang Fei , Lin Xinqing , Liu Ming , Xie Xiaohong , Luan Tao , Zhong Nanshan 
Published: October 2024

Abstract
With the increasing utilization of cancer therapy, the incidence of lung injury associated with these treatments continues to rise. The recognition of pulmonary toxicity related to cancer therapy has become increasingly critical, for which interstitial lung disease (ILD) is a common cause of mortality. Cancer therapy-related ILD (CT-ILD) can result from a variety of treatments including chemotherapy, targeted therapy, immune checkpoint inhibitors, antibody–drug conjugates, and radiotherapy. CT-ILD may progress rapidly and even be life-threatening; therefore, prompt diagnosis and timely treatment are crucial for effective management. This review aims to provide valuable information on the risk factors associated with CT-ILD; elucidate its underlying mechanisms; discuss its clinical features, imaging, and histological manifestations; and emphasize the clinical-related views of its diagnosis. In addition, this review provides an overview of grading, typing, and staging treatment strategies used for the management of CT-ILD.
Intrafocal Pinning in Distal Extraarticular Radius Fracture: A Retrospective Study Based on Patient Age
Authors: Asiry Abdulaziz , De Villeneuve Bargemon Jean Baptiste , Delclaux Stéphanie , Mansat Pierre , Gandolfi Silvia , Lupon Elise 
Published: October 2024

Background:
Percutaneous intrafocal pinning is one of the many surgical options for extraarticular distal radius fracture with minimal comminution. This study aims to describe the role and indications of intrafocal pinning.

Methods:
This monocentric, retrospective study included 49 patients who underwent intrafocal pinning for distal radius fractures in 2013 in our French hand surgery department. All the patients underwent posteroanterior and lateral x-ray on days 2 and 45 to measure radial inclination, distal radioulnar index, and volar tilt.

Results:
The mean age of the patients was 45.4 years, with women representing approximately 61.2% of the sample (n = 30). The patients were divided into three groups: group A (17–50 y), 26 patients; group B (50–70 y), 15 patients; and group C (>70 y), eight patients. We documented on x-ray images, 21 secondary displacements, including seven in group C. There were three displacements (all in group C) and one surgical revision within 15 days for a previous displacement. The distal radioulnar index increased in all three groups.

Conclusions:
The percutaneous intrafocal pinning fixation technique exposes a high risk of complications, especially for those older than 50 years, for whom this technique should be avoided. Overall, due to the frequency of secondary displacements encountered, our first-line treatment favors plate osteosynthesis for all patients. Pinning fixation should only be considered with caution in younger patients if plate osteosynthesis is not possible, but it requires a strict 6-week immobilization. The fracture morphology must also be considered.
Is My Doctor Human? Acceptance of AI among Patients with Breast Cancer
Authors: Kenig Nitzan , Muntaner Vives Aina , Monton Echeverria Javier 
Published: October 2024

Summary:
Artificial intelligence (AI) is becoming increasingly important in society, and medicine can benefit from its advantages. What scenario can we envision when AI becomes as powerful and accurate as human physicians? How will the traditional patient–doctor relationship be affected by AI? Will patients come to trust and accept AI-assisted healthcare as much as their human counterparts? Our research team has been working on applications of AI in plastic surgery for more than 4 years. Between 2020 and 2024, AI algorithms were developed by the authors and applied on patients for symmetry evaluation after breast cancer surgery. Patients were aware of being evaluated with images for AI model training and assessment. Feedback was reported, and a survey was carried out among patients who underwent evaluation by our team. Among patients with breast cancer who underwent surgical reconstruction, 65% of patients reported very high levels of comfort with AI, given that it was mediated by a human doctor. Patients stated that nondoctor-mediated AI in medicine would greatly reduce trust. The influence of AI on the patient–doctor relationship is an important aspect that will greatly affect medicine. In this preliminary work, patients showed high levels of trust and comfort with the use of AI in healthcare, despite stating that they knew little about AI. Patients insisted that the mediation of a human doctor is key for acceptance. Currently, little is known about the acceptance of AI in medical roles among patients.
Lymphocytic Esophagitis
Authors: El Halabi Maan , Saoud Carla , Nasser Selim M. 
Published: October 2024

Background:
Lymphocytic esophagitis (LyE) is a rare condition that has been reported in several case studies, but its diagnostic criteria and clinical significance are inconsistent. There are no established clinical associations, except for Crohn’s disease in children. Our study aimed to determine if patients with LyE have distinct demographic or clinical characteristics when compared with patients with increased intraepithelial lymphocytes (IEL) in their esophageal biopsy.

Methods:
We conducted a retrospective review of all esophageal biopsies between 2008 and 2023 in 2 medical centers. After excluding cases that met criteria for specific disorders, we identified all cases with increased IEL and compared their clinical, demographic, and endoscopic characteristics to those of LyE.

Results:
We identified 381 cases with increased IEL, of which 15 met the criteria for LyE. Patients diagnosed with LyE showed no distinctive demographic, endoscopic, or associated morbidities. The gradual increase in esophageal IEL was not associated with any differences in demographic, endoscopic, or clinicopathologic findings.

Conclusion:
Our findings suggest that lymphocytic esophagitis is not a well-defined clinicopathologic entity but rather a rare and nonspecific histologic pattern associated with various esophageal disorders. Further studies should aim to differentiate between the underlying causes of this histologic pattern, rather than defining it as a single clinicopathologic entity.
Outcomes of Hydroxyapatite Bone Cement for Craniofacial Reconstruction in 1983 Patients
Authors: Elemosho Abdulaziz , Kluemper Jude C. , Pfahl Emily , Mitchell Kerry-Ann S. 
Published: October 2024

Background:
Hydroxyapatite bone cement (HABC) has evolved to have diverse applications in craniofacial reconstruction. This ranges from filling cranial defects to secondary contouring of residual defects after primary surgeries. This study aims to determine patient outcomes after reconstruction with HABCs.

Methods:
A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. PubMed, Embase, Web of Science, and Cochrane Library databases were queried. The results were limited to English-language literature with extractable data on HABC for craniofacial reconstruction.

Results:
A total of 1983 patients were included in the final analysis from 35 studies. HABCs were mostly used for large defect cranioplasty (21.5%), retrosigmoid (44.6%) and translabyrinthine cranioplasty (8.9%), and correction of residual craniofacial defects after congenital craniofacial surgeries (25%). The rates of cerebrospinal fluid (CSF) leak and infection/explantation were 0% and 7.5% [95% CI: 2.4–11.8] for large defect cranioplasty and 0.8% [0.03–2.07] and 1.5% [95% CI: 0.92–3.3] for retrosigmoid cranioplasty, respectively. The infection/explantation rate was 6.2% [95% CI: 2.6–18.7] for HABCs in the correction of residual craniofacial defects after congenital craniofacial surgeries. The total reoperation rates were 20.4% % [95% CI: 4.8–11.8] for large defect cranioplasty and 12% [95% CI: 3.3–15.3] for correction of residual defects after congenital craniofacial surgeries. Aesthetic satisfaction rates were 93.1% [95% CI: 90.3–98.8] for large defect cranioplasty, 99.4% [95% CI 97.2–99.9] for retrosigmoid cranioplasty, and 92.6% [95% CI: 83.3–95.8] for HABC use in the correction of residual craniofacial defects after congenital craniofacial surgeries.

Conclusion:
HABC is versatile and associated with a high level of patient reported aesthetic satisfaction after cranioplasty and may have a comparably lower complication profile than those of most other alloplastic materials.
Efficacy of Molding Helmet Therapy following Suturectomy for Craniosynostosis: A Single-center, Retrospective Analysis in Japan
Authors: Kurimoto Michihiro , Nawashiro Tomoki , Nagakura Masamune , Kato Mihoko 
Published: October 2024

Craniosynostosis limits normal cranial growth, significantly affecting the growth and development of children. This increase in intracranial pressure results in significant cosmetic and functional losses. This study investigated the efficacy of combining molding helmets with suturectomy for craniosynostosis. Patients who underwent suturectomy and molding helmet therapy for craniosynostosis at a single institution between 2017 and 2024 were included. Changes in cephalic index (CI) and cranial vault asymmetry index (CVAI) were analyzed. A total of 14 patients (12 males, 2 females) were included, with a median age of 4.5 months (2–6 mo). The affected sutures were as follows: sagittal (n=8), bilateral coronal (n=4), unilateral coronal (n=1), and lambdoid (n=1) sutures. The median duration of postoperative molding helmet therapy was 44.5 weeks. For the sagittal suture group, the median preoperative CI, median postoperative CI, and rate of change were 72.0 (68.3–85.8), 77.0 (72.1–86.4), and 0.0646, respectively. For the bilateral coronal suture group, measurements for the same parameters were 104.0 (99.3–110.0), 92.5 (89.1–94.5), and 0.1114, respectively. For the unilateral coronal group, the measured parameters were 89.0 (87.7–91.2), 84.0 (81.2–87.1), and 0.059, respectively. Although all suture types showed improvement in cranial shape, with sagittal synostosis showing the most significant change, our findings did not support the added benefit of molding helmet therapy. Overall, the study suggests that suturectomy is a crucial first step in craniosynostosis treatment, leading to improvements in cranial morphology and growth.
Angiotensin II for Catecholamine Resistant Vasodilatory Shock in Patients with Acute Kidney Injury: A Post-Hoc Analysis of the ATHOS-3 Trial
Authors: Chaba Anis , Zarbock Alexander , Forni Lui G. , Hästbacka Johanna , Korneva Elena , Landoni Giovanni , Pickkers Peter , Bellomo Rinaldo 
Published: October 2024

Abstract

Objective
The combination of catecholamine-resistant vasodilatory shock and acute kidney injury (AKI) is associated with high morbidity and mortality. The role of angiotensin II (ANGII) in this setting is unclear.

Methods
We conducted a post hoc analysis of the Angiotensin II for the Treatment of High-Output Shock (ATHOS) -3 trial which assessed the effect of Intravenous ANG II or placebo in patients with refractory vasodilatory shock in 75 intensive care units across nine countries in North America, Australasia, and Europe.
We included patients with all stages AKI at initiation of ANG II or placebo and assessed 28-day mortality as primary outcome. We studied mean arterial pressure (MAP) response and days alive and free from renal replacement therapy (RRT) up to day seven as secondary outcome.

Results
Of 321 ATHOS-3 patients, 203 (63%) had AKI at randomization, with stage 3 AKI being dominant (67%). Median age was 63 years and median APACHE II score was 30. By day 28, overall, 118 (58%) of patients had died (53% with ANGII vs. 63% with placebo, HR = 0.75, 95% CI [0.52-1.08], p = 0.121). Among AKI stage 3 patients, however, ANGII was associated with significantly lower mortality (48% vs. 67%, HR = 0.57, 95% CI [0.36-0.91], p = 0.024). Additionally, in this subgroup, compared with placebo, patients receiving ANGII were more likely to achieve a MAP response (p < 0.001) and had more days alive and free from RRT (p < 0.001).

Conclusions
Compared with placebo, in patients with catecholamine-resistant vasodilatory shock and stage 3 AKI, ANGII is associated with lower 28-day, greater likelihood of MAP response, and more days alive and free from RRT. These findings support the conduct of future ANGII trials in patients with stage 3 AKI.
Clinical performance of proenkephalin A 119-159 for the early diagnosis of acute kidney injury in patients with sepsis or septic shock
Authors: Schulte Janin , Dépret François , Hartmann Oliver , Pickkers Peter , Laterre Pierre-François , Uhle Florian ,   AdrenOSS-1 study investigators
Published: October 2024

AbstractBackgroundSepsis-associated acute kidney injury (AKI) is a severe condition associated with unfavorable outcomes in critically ill patients, not least because of its delayed diagnosis and management due to limitations in the current standard of care. We aimed to evaluate the performance of sphingotest® penKid® for the early diagnosis of AKI in patients with sepsis or septic shock.MethodsPlasma proenkephalin A 119–159 (penKid) was measured in 120 healthy subjects and 529 critically ill sepsis patients. Subgroup analyses were performed for patients with and without a history of heart failure or hypertension. The clinical performance for the diagnosis of AKI within 48 hours (AKI48h) was calculated using the upper limit of the penKid reference range. To improve clinical decision-making, interpretation bands and likelihood ratios for optimized rule-in and rule-out performance were established.ResultsOf the 529 patients with sepsis or septic shock, 328 were male (62%), and the median age was 66 (interquartile range 56–75) years. Two hundred thirty-four (44%) patients were diagnosed with AKI48h, and those patients presented increased penKid levels on intensive care unit admission compared with patients without AKI48h, with an area under the curve of 0.87 (95% confidence interval [CI] 0.84–0.90, p<0.0001). A penKid cut-off of 89 pmol/L, corresponding to the 97.5thpercentile in the healthy reference population, resulted in 72% sensitivity (95% CI 66–77%), 83% specificity (95% CI 78–87%), 77% positive predictive value (95% CI 71–82%), 79% negative predictive value (95% CI 74–83%), a positive likelihood ratio of 4.2, and a negative likelihood ratio of 0.34 to diagnose AKI48h. An improved performance was obtained when patients with a history of chronic heart failure and/or hypertension were excluded. PenKid cutoff values of 54 pmol/L (>92% sensitivity) and 105 pmol/L (>92% specificity) were derived to establish actionable interpretation bands for diagnostic rule-in and rule-out.ConclusionsThe sphingotest® penKid® assay can facilitate an early diagnosis of AKI up to 48 hours before the KDIGO criteria are met. Based on the present results, the assay was registered as an aid in the early diagnosis of AKI in patients with sepsis or septic shock.
The further development of cold plasma technology: The effectiveness of a contactless, indirect atmospheric cold plasma method for germ reduction on surfaces in vitro and in vivo
Authors: Schmelz Ulrich , Schaal Tom , Hämmerle Gilbert , Tischendorf Tim 
Published: October 2024

AbstractThis study investigates the antimicrobial potential of an indirect cold plasma method for the treatment of wounds. Indirect plasma methods differ from direct methods in that the cold plasma does not come into direct contact with the surface to be treated. The indirect plasma method described here has been implemented in the PLASMOHEAL device. The device generates an aerosol of liquid particles, which is conditioned with plasma reaction products and passed over the areas to be treated without contact. In vitro tests show a significant germ reduction of 3.4 to 4.5 log levels against various microorganisms. In vivo tests on volunteers demonstrate a reduction in E. coli contamination of 4.06 to 5.15 log levels. These results show that indirect plasma methods can achieve equivalent effects to direct methods. The highly effective, pain-free treatment at moderate costs make the indirect plasma method a promising option in modern wound care.
Polygenic risk score analysis suggests hypothyroidism as a risk factor for Alzheimer’s disease
Authors: Piras Ignazio S. , Naymik Marcus A. , Don Janith , Schork Nicholas J. , Saner Don , Huentelman Matthew J. 
Published: October 2024

ABSTRACTUtilizing the All of Us cohort, this study explores the relationship between clinical conditions, and AD risk, shedding light on potential preventative measures. We selected a subset of non-AD affected individuals aged 60 and older (n = 72,044). Polygenic Risk Scores (PRS) were calculated to assess AD risk, which were then associated with medical conditions. A replication study was conducted in the UK Biobank to validate the findings. We found significant association between AD-PRS and nine conditions, with the most significant being hypothyroidism (adj-p < 1.3-06). The AD-PRS was significantly lower in participants with hypothyroidism, and was further confirmed in a replication study using the UK Biobank data (n=390,543; p= 1.3-23). Our results demonstrate that the absence of hypothyroidism might be a factor enhancing AD resilience since it can balance the genetic risk factors, as non-affected individuals exhibited a significantly higher AD-PRS than individuals with hypothyroidism.
nsGSLs on tumors impair anti-tumor immune responses by OT-I T cellsin vitroand support tumor growthin vivo
Authors: Verkerk Tamara , Selten Aimée A.F. , Zandhuis Nordin D. , Zhang Tao , Wuhrer Manfred , Spaapen Robbert M. , van Ham S. Marieke 
Published: October 2024

AbstractTumors often evolve to engage numerous strategies to circumvent detection by the immune system. Our group recently discovered elevated neolacto-series glycosphingolipids (nsGSL) surface levels as a possible immune evasion mechanism of tumors. We demonstrated a direct disruption of both innate and adaptive anti-tumor immunityin vitrowhen expression of nsGSLs was upregulated on established target cells. It remains unclear however, whetherin vivonsGSLs play an active role in tumor development and can aid tumors in evading immune responses.To investigate whether nsGSLs facilitate tumor progressionin vivo, we first established a murine model system using MC38-OVA cell lines with varying cell surface levels of nsGSLs.In vitroanalysis revealed reduced MHC-I accessibility on tumor cells with elevated nsGSLs profiles, leading to diminished activation of OVA-specific OT-I T cells as evidenced by decreased expression of CD25, CD69, and production of IFNγ, which subsequently resulted in decreased tumor cell death. Subsequentin vivoexperiments investigating tumor outgrowth after engraftment of subcutaneously injected MC38-OVA cell lines with low or high cell surface levels of nsGSLs demonstrated better growth of nsGSL-rich tumor cells compared to nsGSL-poor tumors which could be controlled. Together these results suggest that nsGSLs expressed by tumors can facilitate immune evasion and subsequent tumor progression. These data pave the way to explore whether targeting of the GSL pathway with specific inhibitors could be advantageous as a therapy against tumors with high nsGSL levels.
Dental biofilms contain DNase I-resistant Z-DNA and G-quadruplexes
Authors: Evans Dominique C. S. , Kristensen Mathilde F. , Palmén Lorena G. , Knap Inge , Tiwari Manish K. , Schlafer Sebastian , Meyer Rikke L. 
Published: October 2024

AbstracteDNA is a major component of the extracellular matrix of bacterial biofilms, and recent studies have shown that biofilms from many pathogens contain both Z-DNA and G-quadruplex (G4) structures in addition to the canonical B-DNA double helix. These secondary DNA structures provide new emergent functions to the biofilm, most notably by making biofilms more resilient by protecting them from nucleases. In dental biofilms, it is largely unknown what conformation eDNA adopts, and the aim of this study was to determine if dental biofilms contain non-canonical secondary DNA structures.In this study, we visualised B-DNA, G4, and Z-DNA in dental biofilms from 10 healthy subjects and from 10 caries-active subjects using fluorescence immunolabeling and confocal microscopy. eDNA formed large structures surrounding clusters of microorganisms that contained B-DNA, G4, and Z-DNA in the majority of the samples. We also identified microorganisms outside of these large eDNA structures that contained smaller G4 and Z-DNA structures associated to cell surfaces. G4 and Z-DNA are resistant to degradation by the commonly used mammalian DNase I. We verified this resistance in dental biofilms, and we suggest that these structures present a novel target for improved enzyme formulations for controlling oral biofilms and, more broadly, any biofilm that contains G4 and Z-DNA.