bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polymer Everolimus-Eluting Stent as Bailout Stenting for Below-the-Knee Artery Repair in Patients with Critical Limb-Threatening Ischemia: A Real-World National Registry
Authors: Sebbag William , Sauguet Antoine , Demicheli Thibault , Declemy Serge , Lecorvec Tom , Brunet Jérôme , Della Schiava Nellie , Sobocinski Jonathan , Steinmetz Eric , Goueffic Yann 
Published: October 2024

Objectives: Percutaneous old balloon angioplasty is still the preferred treatment for the treatment of below-the-knee (BTK) arteries in chronic limb-threatening ischemia (CLTI). In the case of a suboptimal angioplasty result, a bailout stenting is required. So far, few data are available to assess the outcomes of bailout stenting after BTK angioplasty. This study aims to investigate the 1-year efficacy and safety after implantation of a polymer everolimus-eluting stent (PEES) as bailout stenting for BTK repair in patients with CLTI in a real-world setting. Design: This was a national multicenter prospective observational study. Methods: Patients with CLTI (Rutherford 4 to 6) BTK lesions (including P3) and requiring a bailout PEES due to dissection, thrombosis, or residual stenosis ≥30% after angioplasty were included. The freedom of a major adverse limb event at 12 months of the target limb was the primary endpoint. Results: XIENCE assessed 106 limbs (CLTI, 96.2%; chronic total occlusion, 2.8%) in 106 patients (mean age 77.1 years; males, 71.7%; diabetes mellitus, 66.9%; chronic kidney failure, 36.8%) with CLTI undergoing PEES stenting as a bailout for BTK lesions. Bailout stenting was required after 75.5% and 26.4% of residual stenosis and dissection, respectively. The mean diameter and length of the PEES were 3 mm and 3.4 ± 0.5 cm, respectively. At 1 year, the freedom of a major adverse limb event was 79.6% (95% CI, 71.5%-88.7%), the major amputation rate was 6.2% (95% CI, 1.3%-11%), and the target revascularization rate was 14.9% (95% CI, 6.5%-22.5%). Conclusions: In CLTI patients with BTK lesions, PEES stenting showed safety and efficacy as bailout stenting for BTK arterial lesions. This confirms the need for PEES stenting in a real-world practice. Clinical Impact The XIENCE study introduces the PEES as an effective bailout stenting option for patients with CLTI undergoing BTK revascularization, particularly for lesions under 4 cm. The study focuses on real-world cases where POBA alone is insufficient, demonstrating that PEES significantly improves outcomes by enhancing limb salvage and reducing the need for major amputations. For clinicians, this innovation offers a precise, size-adaptable solution, especially in cases where bailout stenting is required for short, focal lesions, improving both clinical and procedural results.
A Randomized Clinical Trial Study on the Prevention Strategy and Early Detection of Ulcer Recurrence in Patients with Type 2 Diabetes Mellitus Using the Risk of Recurrence Ulcer Tool
Authors: Haryanto Haryanto , Sari Yunita , Panjaitan Elveria , Juminar Juminar , Armstrong David 
Published: October 2024

This study aimed to evaluate the effectiveness of prevention strategies and detect the risk level of recurrence. A randomized controlled trial (RCT) was conducted. Sixty participants were split into two groups: an intervention group consisting of 30 individuals and a control group also with 30 participants. For the intervention group, education and guidance on foot examination, foot care, dietary habits, exercise, and stress management were provided for 1 to 1.5 h each month. However, the control group only received standard care and education through a pamphlet at baseline. The both groups, the baseline risk level of ulcer recurrence score was assessed using INDIFURUTO (Indonesian Diabetic Foot Ulcer Recurrence Assessment Tool). The follow-up period was three months. A General Linear Model (GLM) repeated measures (ANCOVA) analysis was employed to compare the quality of life and risk level between the two groups at baseline and third follow-up. Risk factors for recurrence score in the intervention group significantly decreased after 3 months. These included improvements in mobility ( P = .04), anxiety/depression ( P < .001), EuroQol Visual Analogue Scale score ( P = .004), and INDIFURUTO score ( P = .004). The combination of preventive strategies could reduce the risk of recurrence ulcer and improve the quality of life.Trial registration numberClinicalTrials.gov Identifies: NCT06434922.
Phytochemical Components, Hindering Abilities on Cell Proliferation, Cell Migration and Three-Dimensional Spheroids’ Formation Capacity of Micromeria fruticosa Infusion
Authors: Abdallah Samer , Abu-Reidah Ibrahim , Mousa Ahmed 
Published: October 2024

Objectives The objective of this study was to investigate the potential anti-cancer effects of Micromeria fruticosa plant infusion on uterine cervix cancer cells, aiming to explore its potential as an alternative or supportive therapeutic approach to conventional treatments. Methods Micromeria fruticosa plant infusion was prepared and administered to uterine cervix cancer cells in vitro. Various assays were conducted to assess its impact on cell migration, proliferation, and tumorigenicity. Additionally, the phytochemical composition of the infusion was analyzed by using LC-MS to identify major functional compounds. Results The study revealed that Micromeria fruticosa plant infusion exhibited significant anti-migratory, anti-proliferative, and anti-tumorigenic effects on uterine cervix cancer cells. Analysis of the infusion identified several major functional phytochemicals, which likely contribute to its anticancer properties. Conclusion This research suggests that Micromeria fruticosa plant infusion possesses promising anti-cancer properties against uterine cervix cancer cells. The identified phytochemicals present in the infusion highlight its potential as a source of functional ingredients with anticancer effects. These findings support further exploration of Micromeria fruticosa as a potential therapeutic agent in both nutraceutical and pharmaceutical applications, offering new avenues for the development of alternative or supportive treatments for cervical cancer.
Unraveling the Antidiabetic Effect of Alternantera brasiliana (L.) Kuntze: A Combined in Vitro and in Vivo Approach
Authors: Faloye Kolade O. , Famuyiwa Funmilayo G. , Olanudun Esther A. , Ayoola Marcus D. , Ayoade Peter T. , Ugwo Jeremiah P. , Obaidullah Ahmad J. , Alotaibi Jawaher M. , Akinniyi Ganiyu , Famuyiwa Samson O. 
Published: October 2024

Background of the study This study established the antidiabetic efficacy of Alternantera brasiliana in vitro and in vivo, identified the most active fraction and profiled the chemical constituents of the most active fraction. Methodology The leaf of A. brasiliana was air-dried, pulverized and extracted with methanol and evaluated for its α-amylase activity at different concentrations using in vitro method. The in vivo antidiabetic activity of the extract and glibenclamide was evaluated in glucose loaded and streptozotocin-induced diabetic rats using various doses, while the most active partitioned fraction was identified using glucose loaded method followed by identification of its chemical constituents through GC-MS analysis. Results The extract elicited good α-amylase inhibitory potential with IC50 = 0.45 mg/mL. Also, the 50 mg/kg dose demonstrated the highest percentage blood glucose level reduction and significantly ( P > 0.05) comparable to glibenclamide (5 mg/kg) from 0.5 to 4 h. The streptozotocin-induced antidiabetic assay showed that the 50 mg/kg demonstrated better activity than glibenclamide (5 mg/kg) and was significantly comparable on days 10 and 14. The aqueous methanol fraction was the most active fraction with 53% blood glucose level reduction at 4 h. The secondary metabolite profiling identified 30 chemical compounds whereby 1H-Indole-2-carboxylic acid, 6-(4-ethoxyphenyl)-3-methyl-4-oxo-4,5,6,7-tetrahydro-, isopropyl ester, Benzo[h]quinoline, 2,4-dimethyl-, thymol and 13,5-trioxane as the major constituents. Conclusion The antidiabetic activity demonstrated by the A. brasiliana extract established its antidiabetic efficacy
Medium- to Long-term Outcomes of Fasciotomy for Chronic Exertional Compartment Syndrome: A 6-Year Mean Follow-up Study
Authors: Moore Michael , Lezak Bradley , Berzolla Emily , Hughes Andrew , Seidenberg Julian , Kaplan Daniel , Strauss Eric , Jazrawi Laith 
Published: October 2024

Background: Operative treatment of chronic exertional compartment syndrome (CECS) with fasciotomy is effective for symptomatic resolution, but outcomes at medium- to long-term follow-up are unclear. Hypothesis: Patients will have favorable satisfaction at medium- to long-term follow-up and a high return to sport (RTS) rate after fasciotomy for treatment of CECS. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Retrospective review of patients who underwent fasciotomy for treatment of CECS from 2010 to 2021. Outcomes were assessed using Tegner Activity Scale, symptom resolution, patient satisfaction, return to activities, and EQ-5D-5L survey. Results: Fifty patients (23 male and 27 female) were included. Mean age at time of surgery was 29.0 ± 11.6 years with mean follow-up 6.0 ± 2.3 years (range, 2.6-10.9). Tegner activity scores at final follow-up were improved compared with symptom onset (mean, 5.2 vs 3.3; P < 0.01). Increased preoperative symptom duration correlated with decreased RTS (β = -0.447; P = 0.01) and return to work (RTW) (β = -0.572; P = 0.01). Patients with a previous psychiatric diagnosis (n = 15) had lower rates of RTS (β = -0.358; P = 0.03) and RTW (β = -0.471, P = 0.02). Mean time to RTS was 5.5 ± 6.1 months. Mean visual analogue scale satisfaction rate was 74.4; 36 (72.0%) patients would be willing to have their fasciotomy again. Patients with fasciotomy of 1 to 2 compartments had higher Tegner score at final follow-up ( P = 0.02) than those who had fasciotomy of >3 compartments; 19 (38.0%) patients reported experiencing paresthesia after their operation. No patients experienced major complications. Conclusion: Medium- to long-term outcomes of patients with CECS treated with fasciotomy demonstrated high satisfaction levels and high RTS rate. However, rate of minor complications including paresthesia, swelling, and cramping was high.
Effectiveness of Injury Prevention Program Using a Global Systems Approach on High-Risk Movement Mechanics for Noncontact ACL Injury
Authors: Sheikhi Bahram , Letafatkar Amir , Hadadnezhad Malihe , Hogg Jennifer 
Published: October 2024

Background: Injury prevention training using a global systems approach was designed to develop integrated trunk-lower extremity neuromuscular control using whole-body, rotational forces about the vertical Z-axis during simulated sports movements. Hypothesis: Compared with traditional hip-focused exercises, injury prevention training using a global systems approach could improve kinetic and kinematic measures related to anterior cruciate ligament injury. Study Design: Controlled laboratory study. Level of Evidence: Level 3. Methods: A total of 39 male and female athletes received 6 weeks of either global systems approach (n = 20), or hip-focused strengthening, balance, and plyometrics training (n = 19) exercises. Before and after the training program, participants performed a single-leg vertical drop jump task on their dominant leg. Peak vertical ground-reaction forces (GRFs), peak knee abduction, internal rotation moments, peak hip flexion, hip adduction, knee flexion, knee abduction, contralateral pelvic drop, and lateral trunk flexion angles were assessed. Biomechanical data were compared between the 2 groups using a random-intercept linear mixed-models analysis. Results: A significant group × time interaction effect was found for vertical GRFs ( P = 0.01; change difference relative to baseline: 4.5%), knee abduction moment ( P = 0.01; 14.8%), hip adduction ( P < 0.01; 16.7%), knee abduction ( P < 0.01; 13.8%), contralateral pelvic drop ( P < 0.01; change difference: 26.6%), and lateral trunk flexion ( P = 0.04; 20.37%) angles, favoring the global systems approach group after 6 weeks of training. Conclusion: Participants who trained using the global systems approach had significantly decreased lateral trunk flexion, hip adduction, knee abduction and contralateral pelvic drop angles, peak vertical GRFs, and peak knee abduction moment during a single-leg vertical drop jump compared with participants who trained with hip-focused exercises. Clinical Relevance: Incorporating additional external resistance at the proximal trunk results in improved biomechanics compared with conventional hip-focused exercises.
Effects of Preoperative Cervical Range of Motion on Clinical Outcomes Following Posterior Decompression: A Multicenter Study of Patients With Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Okubo Toshiki , Nagoshi Narihito , Kono Hitoshi , Nojiri Kenya , Fukuda Kentaro , Ikegami Takeshi , Tsuji Takashi , Horiuchi Yosuke , Iga Takahito , Takeda Kazuki , Ozaki Masahiro , Suzuki Satoshi , Matsumoto Morio , Nakamura Masaya , Watanabe Kota , Ishii Ken , Yamane Junichi 
Published: October 2024

Study Design Retrospective multicenter study. Objectives To investigate the impact of preoperative cervical range of motion (ROM) on clinical outcomes after posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL). Methods We analyzed data from 156 patients with cervical OPLL who underwent posterior decompression and were followed for at least 2 years. Patients were divided into two groups based on preoperative gap ROM, which was a novel indicator representing the difference between flexion and extension ROM: the gROM <0° and >0° groups, and their outcomes were compared. Results There were no significant differences in patient demographics or surgical details between the gROM <0° and >0° groups. The gROM <0° group exhibited less lordosis in C2-7 angles before and after surgery compared to the gROM >0° group. Cervical ROM significantly decreased following posterior decompression regardless of whether preoperative gROM was <0° or >0°. Meanwhile, the incidence of perioperative complications was similar between the two groups. Furthermore, both groups showed significant improvement in Japanese Orthopaedic Association (JOA) scores postoperatively; however, there were no significant group differences in JOA scores, recovery rates, or visual analog scale for neck pain between the two groups at the preoperation and final follow-up. Conclusions The incidence of perioperative complications and postoperative clinical outcomes were comparable regardless of the magnitude of preoperative cervical gROM. Although cervical ROM decrease postoperatively, posterior decompression for cervical OPLL can offer favorable clinical outcomes irrespective of the preoperative cervical ROM magnitude, consequently.
Patient-Reported Outcomes After Arthroscopic Superior Capsule Reconstruction With an Acellular Porcine Dermal Xenograft for Irreparable Rotator Cuff Tears
Authors: Ilg Ansgar , Kaiser René , Schneider Stefan , Hollander Karsten , Holz Johannes 
Published: October 2024

Background: Currently, there is no consensus on the adequate management of irreparable rotator cuff tears. Arthroscopic superior capsule reconstruction (SCR) seems to be an alternative treatment option. Purpose/Hypothesis: The purpose of this study was to evaluate patient-reported outcomes up to 2 years after the treatment of irreparable rotator cuff tears with SCR using an acellular porcine dermal xenograft. It was hypothesized that SCR treatment with an acellular porcine dermal xenograft would not result in a significant clinical improvement or pain relief in patients with irreparable rotator cuff tears if the xenograft fails. Study Design: Case series; Level of evidence, 4. Methods: A total of 26 consecutive patients with irreparable rotator cuff tears were enrolled in the study between 2015 and 2019. All patients underwent SCR with acellular porcine dermal xenograft. Patient-reported outcome measures including visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the Veterans RAND 12- Item Health Survey (VR-12), and the Single Assessment Numeric Evaluation (SANE) were followed up for 2 years. For statistical analysis, the 1-way analysis of variance was used to compare means for VAS, ASES, VR-12, and SANE results between pre- and posttreatment. Magnetic resonance imaging (MRI) records were obtained at 1 year postoperatively to evaluate graft integrity. Results: In total, 22 patients were included in the patient-reported outcomes with 4 being lost at final follow-up. The mean VAS score decreased from 4.2 ± 2.5 to 1.0 ± 1.4 ( P < .001) from pretreatment to 2 years postoperatively. The mean ASES – index score improved significantly from 47.7 ± 15.3 to 86.4 ± 12.9 ( P < .001) and the SANE score improved from 34.0 ± 20.4 to 77.3 ± 20.2 ( P < .001). In addition, a clinically important difference in the patients’ quality of life was achieved, as shown by the mean changes in the VR-12 physical (+4.3) and mental scores (+9.3). Based on postoperative MRI, the dermal graft on the humeral side was intact in 15 (68.2%) patients after surgery. Conclusion: Our arthroscopic SCR with an acellular porcine dermal matrix showed significant and continuous improvement in pain and clinical scores up to a 2-year follow-up in patients with irreparable rotator cuff tears, even with structural graft failure. However, further studies and evaluation of larger patient groups are needed to evaluate the long-term effect of this procedure.
Tapping into Efficient Learning: An Exploration of the Impact of Sequential Learning on Skill Gains and Learning Curves in Central Venous Catheterization Simulator Training
Authors: Tzamaras Haroula , Brown Dailen , Moore Jason , Miller Scarlett R. 
Published: October 2024

OBJECTIVE Medical residents learn how to perform many complex procedures in a short amount of time. Sequential learning, or learning in stages, is a method applied to complex motor skills to increase skill acquisition and retention but has not been widely applied in simulation-based training (SBT). Central venous catheterization (CVC) training could benefit from the implementation of sequential learning. CVC is typically taught with task trainers such as the dynamic haptic robotic trainer (DHRT). This study aims to determine the impact of sequential learning on skill gains and learning curves in CVC SBT by implementing a sequential learning walkthrough into the DHRT. METHODS 103 medical residents participated in CVC training in 2021 and 2022. One group ( N = 44) received training on the original DHRT system while the other group ( N = 59) received training on the DHRTsequential with interactive videos and assessment activities. All residents were quantitatively assessed on (e.g. first trial success rate, distance to vein center, overall score) the DHRT or DHRTsequential systems. RESULTS Residents in the DHRTsequential group exhibited a 3.58 times higher likelihood of successfully completing needle insertion on their first trial than those in the DHRT only group and required significantly fewer trials to reach a pre-defined mastery level of performance. The DHRTsequential group also had fewer significant learning curves compared to the DHRT only group. CONCLUSION Implementing sequential learning into the DHRT system significantly benefitted CVC training by increasing the efficiency of initial skill gain, reducing the number of trials needed to complete training, and flattening the slope of the subsequent learning curve.
Vitamin D association with systemic sclerosis and its clinical features: A systematic review, meta-analysis, and meta-regression
Authors: Dhaouadi Tarak , Riahi Awatef , Ben Abdallah Taïeb , Gorgi Yousr , Sfar Imen 
Published: October 2024

Objectives: The aim of this review was to summarize existing data on the contribution of Vitamin D level and/or deficiency/insufficiency to systemic sclerosis susceptibility and its clinical features. Methods: An electronic literature search for eligible studies among all papers published prior to 30 June 2024 was conducted through PubMed, EMBASE, Web of science, and Scopus databases. Meta-analyses estimating pooled raw mean differences, odds ratios, and Pearson r together with subgroup analyses and meta-regressions were performed for the association of Vitamin D with susceptibility to systemic sclerosis and disease presentation. Results: Combined analysis revealed a significant decrease in Vitamin D level in systemic sclerosis patients comparatively to healthy controls, with raw mean differences 95% CI = −11.68 [−15.43 to −7.92] ng/mL, p < 1 E-10. Likewise, Vitamin D insufficiency (Vitamin D < 30 ng/mL) and deficiency (<10 ng/mL) were significantly associated with systemic sclerosis; odds ratios 95% CI = 3.58 [2.59–4.95], p < 1 E-10 and odds ratios 95% CI = 7.67 [3.97–14.83], p < 1 E-10, respectively. Moreover, decreased Vitamin D level was significantly associated with interstitial lung disease occurrence (raw mean differences 95% CI = −3.61 [−6.93 to −0.3], p = 0.003), while Vitamin D deficiency was associated with increased systolic pulmonary arterial pressure, raw mean differences (95% CI = 4.17 [1.44–6.89], p = 0.003). Besides, Vitamin D level was negatively correlated with the modified Rodnan skin score, r (95% CI = −0.26 [−0.44 to −0.08], p = 0.004). Conversely, Vitamin D level was significantly increased in systemic sclerosis patients with cutaneous calcinosis, raw mean differences (95% CI = 4.18 [1.07–7.28], p = 0.008). Conclusion: This meta-analysis showed that decreased Vitamin D level was associated with susceptibility to systemic sclerosis, interstitial lung disease occurrence, increased systolic pulmonary arterial pressure, and higher modified Rodnan skin score. Conversely, calcinosis was found to be associated with increased Vitamin D level. Registration: This review has been registered on PROSPERO: CRD42024565045, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024565045
Pyrocarbon Hemi-Shoulder Arthroplasty Provides Satisfactory Outcomes Following Prior Open Latarjet
Authors: Lajoinie Louis , Garret Jérôme , van Rooij Floris , Saffarini Mo , Godenèche Arnaud 
Published: October 2024

Purpose To assess the clinical and radiographic outcomes, at a minimum follow-up of 4 years, following HSA using pyrocarbon in patients that had prior open Latarjet. Methods The authors retrieved the records of 61 consecutive patients that underwent HSA with a pyrocarbon humeral head at 2 centers between December 2013 and October 2019. Eight patients (9 shoulders) had undergone previous Latarjet procedures without other surgical antecedents. Patients underwent radiological assessment, and clinical assessment including Constant score, Subjective Shoulder Value (SSV), and pain on VAS. Finally, range of motion was assessed, including active forward elevation and external rotation. Results The initial cohort of 9 shoulders, comprised 1 woman and 7 men (1 bilateral), aged 52.5 ± 5.2 at their index HSA, which was performed 27.7 ± 9.3 years following their prior Latarjet procedure. One shoulder required conversion to reverse shoulder arthroplasty, 3 years after HSA. The remaining 8 shoulders were assessed at 6.1 ± 1.6 years (range, 4-8) after the index HSA. Glenoid erosion only progressed in 1 shoulder from mild to moderate. The Constant score was 79.6 ± 12.7, pain on VAS was 1.0 ± 2.1, and SSV was 80.0 ± 25.6. The active forward elevation improved from 96°±41° to 151°±29°, and external rotation from 11°±17° to 32°±8°. Conclusion Patients that underwent HSA using pyrocarbon heads following prior Latarjet had satisfactory clinical scores, and glenoid erosion only progressed in 1 patient. Furthermore, only 1 patient required conversion to RSA. The clinical relevance is that HSA using pyrocarbon heads is a safe treatment and grants satisfactory clinical outcomes in patients with prior Latarjet. Level of Evidence Level III, retrospective comparative study