bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increasing the Knee Arc of Motion in Patients With Arthrogryposis: Minimum 2-year Follow-up
Authors: Huser Aaron J. , Brown Michael W. , Nugraha Hans K. , Feldman David S. 
Published: October 2024

Background:
Surgery for knee flexion contractures in patients with arthrogryposis multiplex congenital (AMC) have achieved extension to redirect the arc of motion and improve ambulation but has not demonstrated maintained increases in total range of motion (ROM). This study aimed to review the clinical outcomes of combined posterior knee release, proximal femoral shortening, and nerve decompression in patients with arthrogryposis.

Methods:
A retrospective chart and radiographic review were performed on patients with AMC who underwent treatment for knee flexion deformities ≥30 degrees. ROM, ambulation status, and orthotic use were reviewed and analyzed. Complications were recorded.

Results:
Twenty-nine patients with 51 knees and a mean age of 5.7 years were included. The mean follow-up was 36.9 months. The mean ROM increased from 49 to 80 degrees between pre-op and latest follow-up (P<0.0001). The mean final follow-up flexion deformity was 10 degrees (P<0.0001). Preoperative ROM was moderately correlated with final ROM (rs=0.51). The percentage of ambulatory patients improved from 39% to 93%. Five limbs experienced a fracture either intraoperatively or postoperatively, and 5 limbs required a return trip to the operating room.

Conclusions:
Improved ambulation and knee ROM can be maintained in patients with AMC at a minimum 2-year follow-up. Prospective investigation and longer follow-up are required to validate these findings.

Level of Evidence:
Level IV—therapeutic.
Assessment of Adolescent and Parent Willingness to Participate in a Comparative Study of Scoliosis Braces
Authors: Morgan Sara J. , Brown Zelphia C. , Ahmed Mohamed M. , Bauer Jennifer M. , Murphy Joshua S. , Roye Benjamin D. , Truong Walter H. 
Published: October 2024

Objective:
Adolescents with idiopathic scoliosis (IS) are often prescribed an orthosis to prevent curve progression and avoid surgery. Standard-of-care scoliosis orthoses are designed for full-time (FT) wear, which can be burdensome for some patients. Nighttime (NT) hypercorrective scoliosis orthoses are another option that has a lower impact on daily life, however, additional research is needed to guide the prescription of NT orthoses. The aim of this study was to assess the willingness of patients with IS and their parents/guardians to enroll in a randomized controlled study on bracing in scoliosis.

Methods:
A cross-sectional study was conducted to survey adolescents with IS and their parents/guardians. Eligibility criteria for adolescent participants included: (1) diagnosis of IS, (2) no previous orthosis use, (3) currently seeing a provider for their scoliosis, and (4) able to communicate in English. Parent/guardian participants were the parent or guardian of an adolescent participant and were able to communicate in English. Separate online surveys were designed for adolescents and their parents/guardians. Surveys provided information about a hypothetical study and queried respondents about whether they would participate in the study, their willingness to randomize brace treatment, and their preferences for NT or FT bracing. Descriptive statistics were used to summarize survey data.

Results:
One hundred four adolescent/parent dyads completed the survey (104 adolescents and 103 parents). Most participants (adolescents: 55.8%, parents: 55.3%) indicated an interest in study participation, and approximately one-third of participants (adolescents: 31.8%, parents: 30.1%) reported that they would be willing to randomize to brace type. Most participants (adolescent: 77.0%, parent: 81.6%) preferred the NT brace if they needed brace treatment.

Conclusions:
High-quality evidence is needed to inform the use of FT and NT scoliosis orthoses. Approximately a third of respondents would enroll in a randomized trial, indicating that multiple collaborative sites will be needed to recruit a sufficient sample into a randomized study on scoliosis bracing. Study findings also demonstrate support from adolescents and their parents/guardians for research on scoliosis bracing.
Perioperative Management of Tibial Spine Fractures in Pediatric Patients: A Delphi Study to Identify Principles of Treatment
Authors: Brenner Madison , Johnson Benjamin , Shea Kevin , Ganley Theodore , Wilson Philip L. ,   PRiSM Tibial Spine Research Interest Group; SCORE Quality Improvement Registry, Ellis Henry B. 
Published: October 2024

Background:
The Delphi technique is a structured, iterative group survey method utilized to reach a consensus among experts in a field regarding topics with evidence-based equipoise. Currently, there are few studies at the highest levels of evidence published on the perioperative tibial spine management, making it an ideal subject to utilize expert opinion to reach consensus decision.

Hypothesis/Purpose:
The purpose of this study was to utilize a Delphi-method survey to achieve consensus statements regarding the perioperative management of tibial spine fractures.

Methods:
Before study initiation, 3 rounds of surveys were agreed upon, maintaining the traditional Delphi principles. Consensus was defined as 75% agreement or disagreement on a Likert scale. An anonymous survey consisting of 50 statements describing the management of tibial spine fractures preoperative and postoperative in varying scenarios was distributed to a group of 44 pediatric sports medicine orthopaedic surgeons utilizing an electronic survey software system.

Results:
Of 44 surgeons invited to participate, 24 responded to round 1, 28 responded to round 2, and 25 responded to round 3. Consensus was achieved for the following: use of x-ray to determine initial treatment; casting for a minimum of 3 weeks for nonoperative management, but <3 weeks if treated with surgical fixation; advanced imaging to avoid missing concomitant injury; the necessity of physical therapy, but not continuous passive motion (CPM); and for arthroscopic surgical intervention. It was also agreed that functional testing is important in return-to-play (RTP) decision-making, though the specific timelines and clearance criteria could not be agreed upon. There were statements that displayed continued disagreement, including the role of aspiration, preoperative range of motion management, and the timing of surgical scheduling.

Conclusions:
Utilizing a Delphi methodology with experienced surgeons on tibial spine treatment, consensus in the management of tibial spine fracture was achieved for definitive management strategies. Further study will be important to optimize our management of this youthful population with tibial spine fractures.
Prostate Brachytherapy With Cs-131
Authors: Smith Ryan P. , Mohammed Mohammed A. , Beriwal Sushil , Benoit Ronald M. 
Published: October 2024

Objective:
We sought to compare our results of patients treated with Cs-131 prostate brachytherapy (PB) as monotherapy to recently published results of patients treated with stereotactic body radiotherapy.

Methods:
We analyzed data from patients treated at our institution with Cs-131 PB as monotherapy who had at least 5 years of follow-up and who prospectively completed expanded prostate cancer index composite questionnaires at baseline, 1 year, 2 years, and 5 years. We compared our data with the recently published data from radiation therapy oncology group (RTOG) 0938 and PACE-B (NCT01584258).

Results:
A total of 138 patients were included in our cohort. Using RTOG 0938’s definition, the frequency of a decline in urinary function in our PB cohort was 43% compared with 41.3% in RTOG 0938. According to PACE-B’s definition, our PB cohort had minimal clinically important differences in the urinary incontinence domain of 26.4% and in the urinary obstructive/irritative domain of 40.7% at 2 years compared with PACE-B’s reported rate of 32% and 33%, respectively. The frequency of a >5-point change in the expanded prostate cancer index composite bowel summary score at 5 years was 25% compared with 30.7% in RTOG 0938. Our bowel difference at 2 years was 23% compared with PACE-B’s reported 24%. Our 5-year biochemical disease free survival (bDFS) was 97.8%, compared with 91.3% in RTOG 0938 and 95.8% in PACE-B.

Conclusions:
Low dose rate (LDR) PB with Cs-131 as monotherapy provides excellent biochemical control of prostate cancer in low and intermediate-risk patients. Our cohort of patients had modest differences in patient-reported urinary and bowel quality of life compared with baseline. These differences were comparable to recently published stereotactic body radiotherapy data. When comparing prostate cancer treatments in terms of patient convenience and available resources, PB certainly should be considered.
Comparative study of labour analgesia onset with injection of loading dose through epidural needle versus catheter
Authors: Chen XiaoPing , Tang YingYing , Yu QingQing , Sun LiHong , Li Hua , Wang LuYang , Jiao Cuicui , Chen XinZhong 
Published: October 2024

BACKGROUND
Rapid onset of epidural analgesia is an important concern for the parturient. Commonly, the local anaesthetic mixture is administered through the epidural catheter. Drugs administered through the epidural needle might decrease the onset time and enhance the spread of medication within the epidural space.

OBJECTIVES
The primary aim of this study was to compare the onset time of analgesia when a loading dose of dilute local anaesthetic opioid mixture was injected through either the Tuohy needle or a single end-hole epidural catheter.

DESIGN
A prospective, double-blinded, randomised clinical trial.

SETTING
Single university hospital, from November 2022 to August 2023.

PARTICIPANTS
A total of 200 healthy nulliparous women who requested epidural analgesia for labour were randomly allocated to the needle group (n = 100) or the catheter group (n = 100).

INTERVENTIONS
In the needle group, after identification of the epidural space, a test dose of 3 ml 0.1% ropivacaine with 0.3 μg ml−1 sufentanil was injected through the Tuohy needle followed 3 min later by a 15 ml loading dose of the same mixture over 30 s. Then the catheter was inserted into the epidural space. In the catheter group, after identification of the epidural space, a catheter was advanced into the epidural space and the ropivacaine/sufentanil mixture was injected in an identical manner though the catheter.

MAIN OUTCOME MEARSURES
The primary outcome was the onset time of labour analgesia (defined as the time from drug administration to adequate analgesia). Adequate analgesia was defined as a visual analogue score 10 mm or less during uterine contractions.

RESULTS
Median [IQR] onset time of labour analgesia did not differ significantly between the two groups (needle group: 20 [16 to 30] minutes; catheter group: 20 [15 to 25] minutes, P = 0.232).

CONCLUSION
Compared with bolus injection though a single end-hole epidural catheter, injection through the epidural needle did not shorten the analgesia onset time for adequate labour analgesia.

TRIAL REGISTRATION
ClinicalTrials.gov (NCT05594771).
Neighborhood-level deprivation mediates racial and ethnic disparities in HCC diagnosis in Texas
Authors: Sokale Itunu O. , Thrift Aaron P. , El-Serag Hashem B. , Oluyomi Abiodun O. 
Published: October 2024

Background:
Texas has the highest HCC rates in the United States, and the greatest burden is among Hispanics. Racial and ethnic disparities in HCC incidence have multiple underpinning factors. We conducted a mediation analysis to examine the role of neighborhood disadvantage (Area Deprivation Index) as a potential mediator of the association between neighborhood race and ethnicity distribution and neighborhood HCC case counts in Texas.

Methods:
The primary outcome measure was counts of new HCC diagnoses per census tract based on Texas Department of State Health Services Texas Cancer Registry data. The primary exposure of interest was the race and ethnicity-based Index of Concentration at the Extremes (non-Hispanic Black ICE or Hispanic ICE). We assessed Area Deprivation Index as a potential mediator of the association between Black/Hispanic ICE and HCC case counts. We adjusted the analyses for selected census tract characteristics.

Results:
We analyzed 4934 census tracts containing 13,632 new HCC diagnoses reported to Texas Cancer Registry between 2016 and 2020. Racial minority (Black/Hispanic ICE)-concentrated neighborhoods had a higher socioeconomic disadvantage. The results of the mediation analyses showed that compared to non-Hispanic White–concentrated census tracts, non-Hispanic Black–concentrated census tracts and Hispanic-concentrated census tracts had higher case counts of HCC (total effects: adjusted case count ratio: 1.03 [95% CI, 1.02–1.04] and adjusted case count ratio: 1.09 [95% CI, 1.08–1.10], respectively). Approximately 48% and 15% of the neighborhood-level disparity in HCC case counts were attributable to neighborhood socioeconomic disadvantage in Black and Hispanic minoritized neighborhoods, respectively.

Conclusions:
Neighborhood HCC case counts varied by neighborhood race and ethnicity distribution. The variations were partly explained by neighborhood deprivation, with a stronger effect among Black-concentrated census tracts.
Association of gut microbiota and gut metabolites and adverse outcomes in biliary atresia: A longitudinal prospective study
Authors: Jain Vandana , Dalby Matthew J. , Alexander Emma C. , Burford Charlotte , Acford-Palmer Holly , Serghiou Iliana R. , Teng Nancy M.Y. , Kiu Raymond , Gerasimidis Konstantinos , Zafeiropoulou Konstantina , Logan Michael , Verma Anita , Davenport Mark , Hall Lindsay J. , Dhawan Anil 
Published: October 2024

Background:
The Kasai portoenterostomy (KPE) aims to re-establish bile flow in biliary atresia (BA); however, BA remains the commonest indication for liver transplantation in pediatrics. Gut microbiota-host interplay is increasingly associated with outcomes in chronic liver disease. This study characterized fecal microbiota and fatty acid metabolites in BA.

Methods:
Fecal samples were prospectively collected in newly diagnosed BA infants (n = 55) before and after KPE. Age-matched healthy control (n = 19) and cholestatic control (n = 21) fecal samples were collected. Fecal 16S rRNA gene amplicon sequencing for gut microbiota and gas chromatography for fecal fatty acids was performed.

Results:
Increased abundance of Enterococcus in pre-KPE BA and cholestatic control infants, compared to healthy infants, was demonstrated. At the early post-KPE time points, increased alpha diversity was revealed in BA versus healthy cohorts. A lower relative abundance of Bifidobacterium and increased Enterococcus, Clostridium, Fusobacterium, and Pseudomonas was seen in infants with BA. Fecal acetate was reduced, and fecal butyrate and propionate were elevated in early post-KPE BA infants. Higher post-KPE alpha diversity was associated with nonfavorable clinical outcomes (6-month jaundice and liver transplantation). A higher relative abundance of post-KPE Streptococcus and Fusobacterium and a lower relative abundance of Dorea, Blautia, and Oscillospira were associated with nonfavorable clinical outcomes. Blautia inversely correlated to liver disease severity, and Bifidobacterium inversely correlated to fibrosis biomarkers. Bifidobacterium abundance was significantly lower in infants experiencing cholangitis within 6 months after KPE.

Conclusions:
Increased diversity, enrichment of pathogenic, and depletion of beneficial microbiota early post-KPE are all factors associated with nonfavorable BA outcomes. Manipulation of gut microbiota in the early postsurgical period could provide therapeutic potential.
Virtual follow-up after cataract surgery: systematic review
Authors: Hanna Angelica , Martinez Diana Lucia , Popovic Marko , Ahmed Iqbal Ike K. , Teichman Joshua 
Published: October 2024

Topic:
To examine the association between virtual postoperative follow-up care and patient outcomes after cataract surgery.

Clinical Relevance:
Cataract surgery is a safe and commonly performed surgery. Follow-up visits are used to monitor for complications. It is uncertain whether virtual follow-up provides a safe alternative to in-person review.

Methods:
MEDLINE, Embase, and CINAHL were searched from inception to October 2023 for relevant articles containing original data. Studies that (1) included patients who were seen in a virtual follow-up (ie, telephone or video call) for postoperative appointments after cataract surgery and (2) reported patient outcomes were included. Risk of bias (RoB) was assessed using the Newcastle-Ottawa and RoB2 assessment tools. Descriptive statistics were used to summarize findings. The review was registered in PROSPERO (registration number, CRD42023477207), and PRISMA guidelines were followed.

Results:
The search yielded 1710 records with 7 studies included in this review. The 7 studies reported on 2113 cataract surgeries in 1994 patients. The studies ranged between 2004 and 2020. Most of the studies (5/7) included only patients with uneventful cataract surgery. Virtual follow-ups were all conducted by telephone. The follow-up calls were made at varying timepoints including postoperative day 1 (n = 3), day 7 (n = 2), and day 14 (n = 1). 2 observational studies directly compared patients who had a telephone follow-up with a control group who had an in-person follow-up. There were no significant differences in complication rates (P = .22) or visual acuity (P = .28) between these follow-up groups. None of the studies reported serious adverse outcomes from replacing in-person follow-up with telephone follow-up. One study used virtual follow-up in conjunction with in-person visits for elderly patients and found that additional telephone follow-up was associated with decreased surgical recovery time and decreased patient anxiety. 3 studies reported on patient perceptions about telephone follow-up. A common theme was that patients preferred telephone reviews and found them to be more convenient than in-person follow-up.

Conclusions:
For patients with uneventful cataract surgery, virtual follow-ups seem to be a safe alternative to in-person visits and were preferred by patients. These conclusions are preliminary given the limited literature base, and further study is needed.
New dietary trends and alternative proteins: the emergence of novel food allergens
Authors: Awad Yara , Bernard Hervé , Adel-Patient Karine , Hazebrouck Stéphane 
Published: October 2024

Purpose of the review
New dietary trends driven by environmental and health considerations will undoubtedly lead to the emergence of novel food allergens. Assessment of the allergenic risk of new or modified protein-containing food sources and ingredients, as well as surveillance of emerging food allergies, is then required.

Recent findings
Developments of in silico and in vitro models apprehending protein capacity to cross-react with other homologous proteins and to induce a de novo allergic sensitization are ongoing to better integrate multiple parameters such as 3D structural information or major histocompatibility complex class II (MHC-II) presentation propensity. However, the effects of food matrices and food processing still need to be addressed in these models. Consequently, clinical and postmarket surveillance remain of critical importance to alert on emergent food allergies, which are modulated by regional dietary practices.

Summary
Monitoring of the emergence of food allergens requires close collaborations between allergologists, consumers, patient associations and food safety authorities. We also need to get a consensus on an acceptable level of allergenic risk that offers the possibility to develop and market innovative and sustainable food products.
Neuro-immune cell interactions in the regulation of intestinal immune homeostasis
Authors: Hou Xiaoxiao , Artis David 
Published: October 2024

Purpose of review
Bidirectional regulation between neurons and immune cells in the intestine governs essential physiological processes, including digestion, metabolism and motility, while also controlling intestinal inflammation and maintaining tissue homeostasis. This review covers recent advances and future research challenges focused on the regulatory molecules and potential therapeutic targets in neuron-immune interactions within the intestine.

Recent findings
Recently identified molecular and cellular pathways have been shown to regulate neuron-immune cell cross talk in the context of maintaining tissue homeostasis, modulating inflammation, and promoting intestinal repair. Additionally, behaviors governed by the central nervous system, including feeding and stress responses, can play key roles in regulating intestinal immunity and inflammation.

Summary
This review emphasizes recent progress in understanding the complex interplay between the nervous system and intestinal immune system and outlines future research directions. These advances have the potential to lead to innovative therapies targeting gastrointestinal disorders including inflammatory bowel diseases, allergic responses and cancer.
Emerging trends and hotspots in lung cancer-prediction models research
Authors: Ma Qiong , Jiang Hua , Tan Shiyan , You Fengming , Zheng Chuan , Wang Qian , Ren Yifeng 
Published: October 2024

Objective:
In recent years, lung cancer-prediction models have become popular. However, few bibliometric analyses have been performed in this field.

Methods:
This study aimed to reveal the scientific output and trends in lung cancer-prediction models from a global perspective. In this study, publications were retrieved and extracted from the Web of Science Core Collection (WoSCC) database. CiteSpace 6.1.R3 and VOSviewer 1.6.18 were used to analyze hotspots and theme trends.

Results:
A marked increase in the number of publications related to lung cancer-prediction models was observed. A total of 2711 institutions from in 64 countries/regions published 2139 documents in 566 academic journals. China and the United States were the leading country in the field of lung cancer-prediction models. The institutions represented by Fudan University had significant academic influence in the field. Analysis of keywords revealed that lncRNA, tumor microenvironment, immune, cancer statistics, The Cancer Genome Atlas, nomogram, and machine learning were the current focus of research in lung cancer-prediction models.

Conclusions:
Over the last two decades, research on risk-prediction models for lung cancer has attracted increasing attention. Prognosis, machine learning, and multi-omics technologies are both current hotspots and future trends in this field. In the future, in-depth explorations using different omics should increase the sensitivity and accuracy of lung cancer-prediction models and reduce the global burden of lung cancer.
Effectiveness of Nurse-Driven Protocols in Reducing Catheter-Associated Urinary Tract Infections
Authors: Su Liangliang 
Published: October 2024

Background:
Catheter-associated urinary tract infections (CAUTIs) are common health care–associated infections linked to indwelling urinary catheters. Nurse-driven protocols (NDPs) empower nurses to direct care without physician orders, potentially enhancing patient outcomes and reducing infection rates.

Purpose:
This systematic review and meta-analysis aimed to evaluate the effectiveness of NDPs for preventing CAUTIs and reducing catheter utilization rates.

Methods:
Databases searched included Cochrane Library, PubMed, Embase, and others. Ten studies involving 27, 965 NDP-treated patients and 30, 230 controls were reviewed, examining catheter utilization rates and CAUTI incidence.

Results:
Use of NDPs significantly lowered catheter utilization rates (34.84% vs 49.40%) and CAUTI incidence (2.867% vs 6.503%). Risk ratio analysis revealed a 29.48% decrease in catheter utilization and a 55.91% reduced CAUTI risk with NDP implementation.

Conclusions:
Using NDPs demonstrate superior efficacy in reducing catheter use and CAUTI occurrence compared to traditional methods. Further research is warranted to solidify evidence-based nursing practices in this area.