bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Approach to Military Vascular Injuries
Authors: Demirkiliç U. , Kuralay E. , Yilmaz A. T. , Özal E. , Tatar H. , Öztürk Ö. Y. 
Published: September 2024

Purpose of study: Vascular injuries caused by high-velocity military missiles are associated with bone fracture, soft-tissue, nerve and tendon injuries. In this study we will discuss the surgical strategy and results of vascular injuries, which require a different approach from primary and elective surgical procedure. Basic Methods: Surgical interventions were performed in 116 patients. Vascular lesions were localized on the lower extremity in 53, upper extremity in 55, and nine were in other regions. Vascular injuries were concomitant with bone fracture in 46 and nerve injuries in 36 patients. Vascular repair was performed after orthopedic stabilization in vessels with an ischemic period of less than 4 hours. Principal findings: Fasciotomy was performed after vascular repair in the 22 cases that had arrived after 8 hours. Amputation was required in two cases. There was one mortality. Conclusions: The best results are obtained when a multidisciplinary and emergency approach are used by the team of vascular, orthopedic, plastic and neurosurgeons who are experienced in military injuries.
Transcranial Cerebral Oximetry during Carotid Endarterectomy: Agreement between Frontal and Lateral Probe Measurements as Compared with an Electroencephalogram
Authors: de Letter J. A. M. , Sie T. Han , Moll F. L. , Algra A. , Eikelboom B. C. , Ackerstaff R. G. A. 
Published: September 2024

Objective: Transcranial cerebral oximetry, which is considered a novel technique, was evaluated during carotid endarterectomy. For practical reasons, the use of a single probe attached to the forehead and overlying the territory of the anterior cerebral artery is recommended. Other monitoring systems (transcranial Doppler, electroencephalograms (EEG)) focus more on the territory of the middle cerebral artery. The aim of this study was to evaluate whether a probe in the frontal area is as representative for monitoring cerebral ischaemia during carotid cross-clamping as a probe in the lateral area. Design: Clinical prospective study. Materials: Sixty patients who underwent carotid endarterectomy were studied with continuous and simultaneous EEG and transcranial cerebral oximetry. Forty-three patients (72%) simultaneously underwent frontal and lateral transcranial cerebral oximetry. The lateral probe was only used in 17 patients. Methods: The percentage decrease of transcranial cerebral oximetry was calculated during cross-clamping. Using the EEG findings as the gold standard in order to detect cerebral ischaemia during carotid cross-clamping, the relationship with transcranial cerebral oximetry was described in terms of sensitivity, specificity and the area under the curve in a receiver operating characteristic curve. Results: The 95% confidence interval of the area under the curve of the receiver operating characteristic of the lateral probe was 0.61–1.00 and that of the frontal probe was 0.65–1.00; therefore there is virtually no difference between the two methods. In 18% of the cases the lateral transcranial cerebral oximetry was hindered by practical failures. Conclusion: Considering the lack of additional information and the practical problems experienced with the lateral probe, it was concluded that transcranial cerebral oximetry with a single frontal probe is a practical non-invasive monitoring system and is at least as representative for monitoring cerebral ischaemia during carotid cross-clamping as a lateral probe.
Endothelial Damage Due to Ischemia and Reperfusion is Prevented with SIN-1
Authors: Johnson D. , Freischlag J. A. , Lesniak R. , Kelly H. , Mudaliar J. H. , Cambria R. A. , Seabrook M. D. G. R. , Towne J. B. 
Published: September 2024

Background: Acute ischemia followed by reperfusion results in direct endothelial damage characterized by cell swelling, increased permeability and loss of acetylcholine-mediated vasorelaxation. Ischemia followed by reperfusion in a New Zealand white rabbit hindlimb has been shown to result in loss of acetylcholine-induced relaxation of superficial femoral arteries. This loss of relaxation in response to acetylcholine is a reflection of the decreased nitric oxide availability that occurs with reperfusion injury. The purpose of this investigation was to evaluate the effect of SIN-1, a direct nitric oxide donor, on this endothelial injury. Methods: New Zealand white rabbits underwent complete ischemia of the right hindlimb for 3 h followed by 2 h of reperfusion. Aliquots of 20 ml of either 0.88-mM SIN-1 or normal saline was infused via a lateral branch of the right common iliac artery during the first 20 min of reperfusion. Sham vessels were subjected to the S-h operative intervention to control for anesthetic effect. Control vessels were harvested from rabbits not exposed to ischemia or reperfusion. Superficial femoral artery rings were evaluated in vitro for endothelial cell-mediated relaxation. Rings were contracted with potassium chloride and norepinephrine and then exposed to standardized incremental doses of acetylcholine to measure percent relaxation. Artery sections were sent for hematoxylin and eosin staining. Results: No significant differences were seen in contraction caused by either potassium chloride or norepinephrine in all four experimental groups. Saline infused vessel rings relaxed a mean of 8.42 ± 2.39% and 49.57 ± 8.65% in response to acetylcholine doses of 3 × 10−8 M and 1 × 10−7M, respectively. In contrast, SIN-1 infused vessels relaxed a mean of 57.82 ± 2.65% and 100.23 ± 1.53% to the same doses of acetylcholine. Control and sham arteries showed a similar relaxation response as compared with SIN-1 infused vessels. Differences in relaxation when comparing saline infused vessels with SIN-1 infused, sham and control arteries, were significantly different at each dose of acetylcholine from 3 × 10−8M to 1 × 10−7M ( P < 0.05, ANOVA). Histologic examination of the vessels revealed no morphologic differences among the experimental groups. All vessels werestructurally normal with an intact endothelium. Conclusion: In this model of rabbit hindlimb ischemia, preservation of endothelial cell-mediated vasorelaxation occurs with administration of intra-arterial SIN-1 during reperfusion. This preservation of endothelial function cannot be explained by histologic changes in the arterial wall or attributed to altered arterial contractility in response to potassium chloride or norepinephrine.
Comprehensive Analysis Identifies Hyaluronan Mediated Motility Receptor and Cell Division Cycle 25C as Potential Prognostic Biomarkers in Head and Neck Squamous Cell Carcinoma
Authors: Zhang Hongrui , Xu Yi , Han Haijun , Ye Xiongwei , Cheng Lu , Shen Yueshuang , Wan Xiaochen 
Published: September 2024

Introduction Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, but its pathogenic mechanisms remain unclear. This study aimed to identify the potential biomarkers underlying the diagnosis and treatment of HNSCC. Methods Weighted gene co-expression network analysis (WGCNA) followed by pathway enrichment analysis, analysis of infiltrating immune cells, survival analysis, and methylation analysis were applied to identify the potential hub genes underlying the prognosis of HNSCC. The expression of hub genes was validated by immunofluorescence staining. Results A total of 10,274 differentially expressed genes (DEGs) were identified. Through WGCNA, the yellow module ( R2 = 0.33, P = 2e-14) was confirmed to be the most significantly associated with the histological grade of HNSCC, and the “Cell Cycle” proved to be the most enriched signaling pathway. Based on the results of survival analysis and immune cell infiltration, 10 hub genes ( HMMR, CENPK, AURKA, CDC25C, FEN1, CKS1B, MAJIN, PCLAF, SPC25, and STAG3) were identified. Eight of these (excluding MAJIN and STAG3) were confirmed by performing survival analysis using another dataset (GSE41613). Further, we identified 4 methylation loci in 3 hub genes (cg15122828 and cg20554926 in HMMR, cg12519992 in CDC25C, and cg2655739 in KIAA0101/PCLAF) as being significantly related to survival. Finally, we demonstrated the high mRNA and protein expression of HMMR and CDC25C in HNSCC patients. Conclusion Two real hub genes ( HMMR and CDC25C) and 3 methylation loci were identified that could potentially serve as prognostic and therapeutic targets for HNSCC, which is significant for studying the pathological mechanisms underlying HNSCC and for developing novel therapies for this disease.
Association of health status and hospitalization risk for peripheral artery disease in the PORTRAIT registry
Authors: Cleman Jacob , Romain Gaëlle , Scierka Lindsey E , Labrosciano Clementine , Bradley Brooklyn , Fitridge Robert , Beltrame John , Shishehbor Mehdi H , Spertus John A , Mena-Hurtado Carlos , Smolderen Kim G 
Published: September 2024

Background: Healthcare utilization for patients with peripheral artery disease (PAD) is high, but stratifying patients’ risk of hospitalization at initial evaluation is challenging. We examined the association between health status at PAD presentation and risk of (1) combined all-cause hospital admissions and emergency department (ED) visits and (2) all-cause hospital admissions. Methods: Patients with claudication enrolled at US sites in the PORTRAIT registry were included. Health status was assessed using the Peripheral Artery Questionnaire (PAQ), a PAD-specific patient-reported outcome measure. Crude overall and cause-specific hospital admissions and ED visits were reported by PAQ overall summary score (PAQ-OS) ranges (0–24, 25–49, 50–74, and 75–100). Kaplan–Meier survival and unadjusted and adjusted Cox proportional hazards models examined the association between baseline PAQ scores and (1) combined all-cause hospital admissions or ED visits and (2) all-cause hospital admissions over 12 months. Results: Of 796 patients, 349 (44%) had a hospital admission or ED visit over 12 months. Patients in the lowest (PAQ-OS = 0–24) versus the highest range (PAQ-OS = 75–100) had higher rates of 12-month (53.3% vs 22.4%) hospital admission and ED visits. In the adjusted model, each 10-point decrease in PAQ-OS was associated with a higher risk of all-cause hospital admission and ED visits (HR = 1.1, 95% CI 1.1–1.2, p < 0.0010) and all-cause hospital admission (HR = 1.1, 95% CI 1.1–1.2, p < 0.0010) at 12 months. Conclusion: PAD-specific health status is associated with an increased risk of healthcare utilization. Baseline health status may help stratify risk in patients with PAD, although replication and further validation of results are necessary.
Radiocarpal Fracture Dislocations: A Retrospective Review on Operative Fixation and Postoperative Range of Motion
Authors: Greco Victor E. , Akelman Matthew , Childress Morgan , Wood Taylor R. , Nunez Fiesky , Li Zhongyu J. 
Published: September 2024

Background: Radiocarpal dislocation (RCD) and radiocarpal fracture dislocation (RCFD) are rare but severe injury patterns with multiple types of fixation techniques described. The purpose of this study was to determine the outcomes of RCD and RCDF treated at our institution. Methods: Patients were identified using our institution’s electronic medical records between 2013 and 2022. Seventeen patients met criteria who suffered either RCD or RCFD. Patient charts were reviewed retrospectively with a focus on demographics, mechanism of injury, smoking status, open injury, direction of dislocation, Moneim and Dumontier classification, procedures, complications, final range of motion and subsequent surgeries. Results: Seventeen patients met criteria with an average age of 38.5 years. Thirteen patients sustained dorsal dislocations while 4 sustained volar dislocations. Four were Dumontier type I and 13 were type II. Twelve were Moneim type I and 5 were type II. Fourteen of the 17 patients had at least 6-month follow-up. The average flexion and extension at time of last follow-up was 33.6° and 39.5°, respectively. Average pronation and supination was 80.6° and 63.1°, respectively. Fourteen patients underwent subsequent surgeries, mainly hardware removal, and 5 had complications resulting in unplanned return to the operating room. There was no significant difference in post operative range of motion, complications, or subsequent surgeries based on Moneim or Dumontier classification ( P > 0.11). Conclusions: Radiocarpal dislocation and RCFD are challenging and rare injuries with multiple patterns and variance. With proper fixation and recognition of associated injuries, patients with these injuries can expect to return to work and achieve functional range of motion.
Long-term effects of vagus nerve stimulation on EEG aperiodic components in patients with drug-resistant epilepsy
Authors: Yang Yujiao , Wang Jing , Wang Xiongfei , Tang Chongyang , Deng Jiahui , Yan Zhaofen , Deng Qinqin , Chen Dong , Zhou Jian , Guan Yuguang , Wang Mengyang , Li Tianfu , Luan Guoming 
Published: September 2024

Background: Drug-resistant epilepsy (DRE) affects approximately one-third of epilepsy patients who do not achieve adequate seizure control with medication. Vagus nerve stimulation (VNS) is an adjunctive therapy for DRE, but its long-term effects on cortical excitability remain unclear. Objectives: This study aims to elucidate the long-term effects of VNS on electroencephalography (EEG) aperiodic components in patients with DRE. Our objective is to identify biomarkers that can serve as indicators of therapeutic efficacy and provide mechanistic insights into the underlying neural processes. Design: This longitudinal observational study focused on patients with DRE undergoing VNS therapy at Sanbo Brain Hospital. The reduction in seizure frequency rates was quantified over short-term (⩽1 year), medium-term (1–3 years), and long-term (⩾3 years) intervals to assess the therapeutic efficacy of VNS. Both the periodic and aperiodic components of EEG data were analyzed. Methods: Advanced signal processing techniques were utilized to parameterize the periodic and aperiodic components of EEG data, focusing particularly on “offset” and “exponent.” These measures were compared before and after VNS therapy. Correlation analyses were conducted to explore the relationship between these EEG parameters and clinical outcomes. Results: In all, 18 patients with DRE participated in this study. During the long-term follow-up period, the responder rate was 55.56%. Significant decreases were observed in aperiodic offset ( p = 0.022) and exponent ( p = 0.039) among responders. The impact of age on these results was not significant. Correlation analyses revealed a negative association between therapeutic efficacy and a decrease in offset ( R = −0.546, p = 0.019) and exponent ( R = −0.636, p = 0.019). Conclusion: EEG aperiodic parameters, including offset and exponent, have the potential to serve as promising biomarkers for evaluating the efficacy of VNS. An understanding of the regulatory influence of VNS on cortical excitability through these aperiodic parameters could provide a basis for the development of more effective stimulation parameters and therapeutic strategies.
There is no one size fits all: Elements of implementing virtual bike rides to address loneliness in people living with dementia
Authors: Budak Kübra Beliz , Heins. Pascale , Uribe Franziska Laporte , Felding Simone Anna , Roes Martina 
Published: September 2024

Objective This study aimed to identify factors that hinder or facilitate the implementation of an exergaming technology, SilverFit Mile, which offers virtual cycling, for nursing home residents with dementia in and its potential impact on feelings of loneliness. Methods The study followed a descriptive qualitative approach using semi structured interviews with eight care professionals in nursing homes in the Netherlands and based on the Consolidated Framework for Implementation Research (CFIR). Thematic text analysis was used to analyze the interviews. Results We identified three main themes and twelve subthemes based on the CFIR. The main themes were residents’ personal characteristics, implementation factors, and loneliness. SilverFit Mile was more suitable for those familiar with cycling and those who enjoyed more solitary activities. Organizational factors such as staff's low digital literacy, lack of time, and need for training were found barriers to implementation, while facilitators included fostering social interaction. Conclusions SilverFit Mile was considered positively by care staff based on observations of persons living with dementia. We identified loneliness as a relevant outcome of SilverFit Mile implementation. We argue that SilverFit Mile can foster social interaction between residents and staff through reminiscence or the physical aspect of cycling. However, a better understanding of the connection between loneliness and the use of SilverFit Mile is needed. Overall, our research provides initial ideas about how exergaming technology might address loneliness in dementia.
Public Periodontal Screening Increases Subsequent Regular Dental Visits: The Life Study
Authors: Tamada Y. , Kusama T. , Maeda M. , Murata F. , Osaka K. , Fukuda H. , Takeuchi K. 
Published: September 2024

Introduction: A public oral health screening, periodontal disease screening, has been implemented in Japan, but it remains unclear whether screening encourages subsequent regular dental visits. This study aimed to examine whether people who underwent periodontal disease screening were more likely to regularly visit dentists after undergoing the screening than before using a difference-in-differences (DID) approach. Methods: This study used health care claims data of municipality residents who underwent periodontal disease screening in 2017 or 2018. For each screening recipient, 4 individuals were extracted from those who did not undergo screening as controls. In the DID analysis, we assessed the change in the proportion of dentist visits at least once every 180 d after undergoing screening. Results: A total of 4,050 participants were included in the analysis. The proportion of participants visiting dentists was consistent throughout the study period (approximately 45%) among the participants who did not undergo the screening. However, among the participants who underwent the screening, while the proportion who visited dentists was consistent before screening (approximately 60%), the proportion was higher after screening (1–180 d after, 81.2%). DID analysis indicated that the proportion increased by 12.9% after the screening. In addition, the age-subgroup DID estimates were higher in the younger population (aged 20–35 y, 13.9%; 40–55 y, 12.8%; 60 y, 12.6%). Conclusions: Among people who underwent periodontal disease screening, a higher proportion visited dentists after undergoing the screening than before, suggesting that periodontal disease screening was associated with an increase in subsequent regular dental visits. Knowledge Transfer Statement: Our results provide evidence that a public oral health screening could increase regular dental visits, which has the potential to improve and maintain people’s oral health, especially in the younger population.
Evaluation and Correlation of Radiological and Pathological Response Following Neoadjuvant Short-course Radiotherapy Followed by Chemotherapy Followed by Surgery in Resectable Locally Advanced Adenocarcinoma of the Rectum
Authors: Maulik Pansuriya , Sethi Jaskaran Singh , Pahuja Anjali K. , Antony Varghese , Bhushan Manindra , Singh Shivendra , Goyal Sumit 
Published: September 2024

Background The aim of this article is to evaluate radiological and pathological response rates and correlate them after neoadjuvant short-course radiotherapy (SCRT) followed by chemotherapy in resectable locally advanced adenocarcinoma of the rectum (LARC). Materials and Methods It is a single institutional, prospective observational study from January 2021 to March 2022 including 45 patients with resectable adenocarcinoma of the rectum. Radiotherapy was delivered to a dose of 25 Gy in 5 Gy per fraction using image-guided radiotherapy followed by mFOLFOX-based chemotherapy. After completion of 4–8 cycles of chemotherapy, tumor regression grade (TRG) was evaluated using magnetic resonance imaging and whole-body positron emission tomography. In case of a satisfactory response on imaging (mrTRG), patients underwent appropriate locoregional surgery. Histopathological examination of the surgical specimen was carried out and response to neoadjuvant treatment was assessed (pTRG). Results A significant downstaging of T and N stages (60% and 72%, respectively, p < .0001) was observed after neoadjuvant therapy with a pathological complete response rate of 16%. Conversion of positive circumferential resection margin (CRM) to negative CRM was observed in 71.4% patients. A poor agreement between mrTRG and pTRG ( k 0.133, p .16) was noted. Conclusion Preoperative SCRT in LARC is feasible and well-tolerated with encouraging radiological and pathological response rates. A significant number of patients achieve negative CRM, thereby improving the chances of R0 resection. Significant relief in pain and bleeding can be achieved rapidly leading to an improved quality of life.
Global Lung Function Initiative reference values for multiple breath washout indices
Authors: Ramsey Kathryn A. , Stanojevic Sanja , Chavez Luis , Johnson Noah , Bowerman Cole , Hall Graham L. , Latzin Philipp , O'Neill Katherine , Robinson Paul D. , Stahl Mirjam , Weiner Daniel J. , Zwitserloot Annelies M. , Horsley Alex 
Published: September 2024

BackgroundMultiple breath washout is a lung function test based on tidal breathing that assesses lung volume and ventilation distribution. The aim of this analysis was to use the Global Lung Function Initiative methodology to develop all-age reference equations for the multiple breath washout indices lung clearance index (LCI) and functional residual capacity (FRC).MethodsMultiple breath washout data from healthy individuals were collated from sites. Data were re-analysed using the latest software versions. Reference equations were derived using the lambda-mu-sigma method using the generalised additive models of location shape and scale programme in R. The impact of equipment type, inert tracer gas and equipment dead space volume on the derived reference ranges were investigated.ResultsData from 23 sites (n=3647 test occasions) were submitted. Reference equations were derived from 1579 unique observations from participants between the ages of 2 and 81 years. Equipment type, inert tracer gas and equipment dead space volume did not significantly affect the prediction equations for either LCI or FRC. Reference equations for LCI include age as the only predictor, whereas sex-specific reference equations for FRC included height and age.ConclusionsGlobal Lung Function Initiative reference equations for multiple breath washout variables provide a standard for reporting and interpretation of LCI and FRC.