bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower Extremity Injury Rates on Artificial Turf Versus Natural Grass Surfaces in the National Football League During the 2021 and 2022 Seasons
Authors: Venishetty Nikit , Xiao Angel X. , Ghanta Ramesh , Reddy Rohit , Pandya Nirav Kiritkumar , Feeley Brian T. 
Published: August 2024

Background: It has been argued that the use of artificial turf football fields in the National Football League (NFL) increases player injury risk compared with natural grass surfaces. Purpose/Hypothesis: The purpose of this study was to quantify the rate of lower extremity injuries occurring in NFL players on artificial turf compared with natural grass surfaces and characterize the time missed due to injury and proportion of injuries requiring surgery. It was hypothesized that lower extremity injuries requiring surgical intervention would occur at a higher rate on artificial turf than on natural grass. Study Design: Descriptive epidemiology study. Methods: Lower extremity injury data for the 2021 and 2022 NFL seasons were obtained using publicly available records. Data collected included injury type, player position, player age, playing surface, weeks missed due to injury, and whether the patient underwent season-ending or minor surgery. Multivariable logistic regression was performed to determine the risk of season-ending surgery according to playing surface. Results: When combining injuries for the 2021 and 2022 seasons (N = 718 injuries), the incidence rate of lower extremity injury was 1.22 injuries/game for natural grass and 1.42 injuries/game for artificial turf. The odds of a season-ending surgery were found to be significantly higher on artificial turf compared with natural grass (odds ratio = 1.60; 95% CI, 1.28-1.99; P < .05), while additional variables, including weather, age, position, week of injury occurrence, and history of prior injury, did not influence the odds of season-ending surgery. Conclusion: The 2021 and 2022 NFL seasons of our analysis demonstrated a higher incidence rate of injuries on artificial turf surfaces compared with natural grass surfaces. In addition, the odds of injury requiring season-ending surgery were found to be significantly higher on artificial turf compared with natural grass.
Thrombomodulin (p.Cys537Stop) is released from cells by an unusual membrane insertion/leakage mechanism
Authors: Bernard Clara , Pin Andréa , Hézard Nathalie , Ernest Vincent , Falaise Céline , Roze Camille , Simoncini Stéphanie , Lacroix Romaric , Morange Pierre-Emmanuel , Peiretti Franck 
Published: August 2024

Abstract
Expression of the thrombomodulin (TM) variant c.1611C&gt;A (p.Cys537Stop) leads to the synthesis of a protein with no cytoplasmic tail and a transmembrane domain shortened by 3 amino acids (TM536). However, little is known regarding the release mechanism and properties of TM536. Using umbilical vein endothelial cells and peripheral blood-derived endothelial colony-forming cells from a heterozygous carrier of the TM536 variant as well as overexpression cell models, we demonstrated that TM536 is released from cells by an unusual mechanism. First, TM536 is inserted into the endoplasmic reticulum (ER) membrane, then, because of the low hydrophobicity of its intramembrane domain, it escapes from it and follows the conventional secretory pathway to be released into the extracellular compartment without the involvement of proteolysis. This particular secretion mechanism yields a soluble TM536, which is poorly modified by chondroitin sulfate glycosaminoglycan compared with conventionally secreted soluble forms of TM, and therefore has a suboptimal capacity to mediate thrombin-dependent activation of protein C (PC). We also showed that TM536 cellular trafficking was altered, with retention in the early secretory pathway and increased sensitivity to ER-associated degradation. As expected, activation of ER-associated degradation increased TM536 degradation and reduced its release. The expression of TM536 at the cell surface was low, and its distribution in lipid raft-like membrane microdomains was altered, resulting in low thrombin-dependent PC activation on the cell surface.
A novel deletion in the BLOC1S6 Gene Associated with Hermansky-Pudlak syndrome type 9 (HPS-9)
Authors: Kahani Seyyed Mohammad , Saray Ali Rabbizadeh , Kahaei Mir Salar , Dehghani Ali , Mohammadi Pouria , Garshasbi Masoud 
Published: August 2024

Abstract
Background
Hermansky-Pudlak Syndrome (HPS), a rare autosomal recessive disorder, is characterized by oculocutaneous albinism, bleeding diathesis, and sometimes severe lung problems and inflammatory bowel disease. Symptoms include skin and hair pigmentation variations, along with visual impairments. Variants in eleven genes encoding protein complexes essential for membrane trafficking and intracellular endosomal transport pathways underlie various recognized HPS subtypes. This study focuses on HPS-9, a subtype of Hermansky-Pudlak Syndrome caused by a variant in the BLOC1S6 gene, which is a subunit of the BLOC1 complex. In this study, a novel Copy Number Variation (CNV) in the aforementioned gene in an Iranian family is reported. The study aims to better understand the etiology of HPS-9 symptoms by identifying and confirming the variant and determining whether the gene is expressed despite the deletion. There have only been five reports of this syndrome in the literature thus far. Our novel CNV represents a significant contribution to understanding the genetic basis of HPS-9.

Results
This study investigates a male patient presenting with albinism. Whole Exome Sequencing (WES) identified a homozygous deletion of approximately 350 bp using CNV analysis. The deletion affects the intronic region of the BLOC1S6 gene, causing uncertainties in defining the exact boundaries due to WES limitations. Primer walking and GAP-PCR techniques were used to define the deletion boundaries. Subsequent assessments of this variant across other family members helped identify homozygous affected members and heterozygous carriers. The absence of BLOC1S6 expression in the affected individual was confirmed through Real-time PCR experiments. These findings underscore the importance of understanding the implications for the patient’s healthcare and potential therapeutic approaches.

Conclusion
This study introduces a case of Hermansky-Pudlak Syndrome Type 9 (HPS-9) caused by a homozygous deletion in the BLOC1S6 gene. We identified an approximately 7-kb deletion encompassing exon 1 and the intronic region of the gene. The absence of BLOC1S6 expression, confirmed via Real-time PCR, highlights the importance of studying the pathogenicity of the deletion and its impact on the patient’s health. Our findings contribute to the sparse knowledge on HPS-9 and underscore the need for further exploration into the genetic causes of this rare disorder.
Comparison of gait analysis before and after unilateral total knee arthroplasty for knee osteoarthritis
Authors: Fukui Jun , Matsui Yasumoto , Mizuno Takafumi , Watanabe Tsuyoshi , Takemura Marie , Ishizuka Shinya , Imagama Shiro , Arai Hidenori 
Published: August 2024

Abstract
Background
Gait ability can be objectively assessed using gait analysis. Three-dimensional gait analysis, the most commonly used analytical method, has limitations, such as a prolonged examination, high system costs, and inconsistently reported gait symmetry in patients with knee osteoarthritis (OA). Therefore, we aimed to evaluate the gait symmetry and changes before and after unilateral total knee arthroplasty (TKA) using the Walkway analyzer, a sheet-type gait analyzer.

Methods
The healthy group included 38 participants from the Locomotor Frailty and Sarcopenia Registry study with lower limb pain or Kellgren–Lawrence classification grade 3 or 4 OA. The OA group included 34 participants from the registry study who underwent unilateral TKA. The walking speed, step length, step width, cadence, stride time, stance time, swing phase time, double-limb support phase time, stride, step length, and step width were analyzed per side using the Walkway gait analyzer.

Results
No significant differences between the right and left sides were observed in the healthy group. In the OA group, the time indices and stance phase (p = 0.011) and the double-limb support phase time (p = 0.039) were longer on the contralateral side and the swing phase was longer on the affected side (p = 0.004) pre-operatively. However, these differences disappeared post-operatively. There were no significant differences in the spatial indices. Thus, this study revealed that patients undergoing unilateral TKA had an asymmetric gait pre-operatively, with a time index compensating for the painful side, and an improved symmetric gait post-operatively.

Conclusions
The Walkway analyzer employs a simple test that requires only walking; hence, it is expected to be used for objective evaluation in actual clinical practice.
Exploring the immunometabolic potential of Danggui Buxue Decoction for the treatment of IBD-related colorectal cancer
Authors: Zhang Yang , Kang Qianming , He Luying , Chan Ka Iong , Gu Hui , Xue Wenjing , Zhong Zhangfeng , Tan Wen 
Published: August 2024

AbstractDanggui Buxue (DGBX) decoction is a classical prescription composed of Astragali Radix (AR) and Angelicae Sinensis Radix (ASR), used to enrich blood, and nourish Qi in Chinese medicine, with the potential to recover energy and stimulate metabolism. Chronic inflammation is a risk factor in the development of inflammatory bowel disease (IBD)-related colorectal cancer (CRC). More importantly, AR and ASR have anti-inflammatory and anti-cancer activities, as well as prefiguring a potential effect on inflammation-cancer transformation. We, therefore, aimed to review the immunometabolism potential of DGBX decoction and its components in this malignant transformation, to provide a helpful complement to manage the risk of IBD-CRC. The present study investigates the multifaceted roles of DGBX decoction and its entire components AR and ASR, including anti-inflammation effects, anti-cancer properties, immune regulation, and metabolic regulation. This assessment is informed by a synthesis of scholarly literature, with more than two hundred articles retrieved from PubMed, Web of Science, and Scopus databases within the past two decades. The search strategy employed utilized keywords such as “Danggui Buxue”, “Astragali Radix”, “Angelicae Sinensis Radix”, “Inflammation”, and “Metabolism”, alongside the related synonyms, with a particular emphasis on high-quality research and studies yielding significant findings. The potential of DGBX decoction in modulating immunometabolism holds promise for the treatment of IBD-related CRC. It is particularly relevant given the heterogeneity of CRC and the growing trend towards personalized medicine, but the precise and detailed mechanism necessitate further in vivo validation and extensive clinical studies to substantiate the immunometabolic modulation and delineate the pathways involved.
Graphical Abstract
Serum and urinary monocyte chemoattractant protein-1 as markers of inflammation and renal damage in dogs with naturally occurring leishmaniosis
Authors: Pantaleo Valeria , Furlanello Tommaso , Ventura Laura , Solano-Gallego Laia 
Published: August 2024

AbstractBackgroundRenal disease in canine leishmaniosis is of great importance owing to increased risk of mortality. In human visceral leishmaniosis, monocyte chemoattractant protein-1 (MCP-1) has been used as a marker of renal damage and inflammation. The purpose of this study was first to determine the serum MCP-1 and urinary MCP-1-to-creatinine ratio (uMCP-1/Cr) in healthy dogs and dogs with leishmaniosis at diagnosis, and second to determine whether these markers can differentiate disease severity at diagnosis.MethodsIn total, 19 healthy seronegative dogs and 38 dogs with leishmaniosis were included in the study. Dogs with leishmaniosis were classified as LeishVet clinical staging and as International Renal Interest Society (IRIS) staging. Serum and urinary MCP-1 concentrations were measured with an enzyme-linked immunosorbent assay. A receiver operating characteristic (ROC) curve determined disease severity at diagnosis between two LeishVet groups (Stage II versus stage III and IV).ResultsDogs in Leishvet stages IIb, III, and IV had a median serum MCP-1 and uMCP-1/Cr concentration higher than healthy dogs (P < 0.0001). No statistical differences were found in serum MCP-1 and uMCP-1/Cr between dogs in LeishVet stage IIa and healthy dogs. The dogs in LeishVet stage IV had significantly higher serum MCP-1 and uMCP-1/Cr compared with the dogs in LeishVet stage IIa (P < 0.0001). Serum MCP-1 and uMCP-1 were significantly higher in dogs in IRIS stage I and II + III + IV compared with healthy dogs. Dogs stage II + III + IV of IRIS had a significantly higher serum MCP-1 compared with dogs in IRIS stage I (P < 0.0001). The area under the ROC curve for serum MCP-1 was 0.78 [95% confidence interval (CI) 0.64–0.93] and for uMCP-1/Cr it was 0.86 (95% CI, 0.74–0.99). The optimal cutoff value for serum MCP-1 and uMCP-1/Cr was 336.85 pg/ml (sensitivity of 79% and specificity of 68%) and 6.89 × 10−7(sensitivity of 84% and specificity of 79%), respectively.ConclusionsSerum MCP-1 and uMCP-1/Cr are increased in dogs with leishmaniosis compared with healthy dogs, suggesting the presence of inflammation and renal injury. Serum MCP-1 and uMCP-1/Cr were more elevated in the advanced stages of the disease compared with the moderate stages and, therefore, can be markers of the severity of the disease process.Graphical Abstract
Advancing healthcare with artificial intelligence: diagnostic accuracy of machine learning algorithm in diagnosis of diabetic retinopathy in the Brazilian population
Authors: dos Reis Mateus A. , Künas Cristiano A. , da Silva Araújo Thiago , Schneiders Josiane , de Azevedo Pietro B. , Nakayama Luis F. , Rados Dimitris R. V. , Umpierre Roberto N. , Berwanger Otávio , Lavinsky Daniel , Malerbi Fernando K. , Navaux Philippe O. A. , Schaan Beatriz D. 
Published: August 2024

Abstract
Background
In healthcare systems in general, access to diabetic retinopathy (DR) screening is limited. Artificial intelligence has the potential to increase care delivery. Therefore, we trained and evaluated the diagnostic accuracy of a machine learning algorithm for automated detection of DR.

Methods
We included color fundus photographs from individuals from 4 databases (primary and specialized care settings), excluding uninterpretable images. The datasets consist of images from Brazilian patients, which differs from previous work. This modification allows for a more tailored application of the model to Brazilian patients, ensuring that the nuances and characteristics of this specific population are adequately captured. The sample was fractionated in training (70%) and testing (30%) samples. A convolutional neural network was trained for image classification. The reference test was the combined decision from three ophthalmologists. The sensitivity, specificity, and area under the ROC curve of the algorithm for detecting referable DR (moderate non-proliferative DR; severe non-proliferative DR; proliferative DR and/or clinically significant macular edema) were estimated.

Results
A total of 15,816 images (4590 patients) were included. The overall prevalence of any degree of DR was 26.5%. Compared with human evaluators (manual method of diagnosing DR performed by an ophthalmologist), the deep learning algorithm achieved an area under the ROC curve of 0.98 (95% CI 0.97–0.98), with a specificity of 94.6% (95% CI 93.8–95.3) and a sensitivity of 93.5% (95% CI 92.2–94.9) at the point of greatest efficiency to detect referable DR.

Conclusions
A large database showed that this deep learning algorithm was accurate in detecting referable DR. This finding aids to universal healthcare systems like Brazil, optimizing screening processes and can serve as a tool for improving DR screening, making it more agile and expanding care access.
Virtual power plants: an in-depth analysis of their advancements and importance as crucial players in modern power systems
Authors: Abdelkader Sobhy , Amissah Jeremiah , Abdel-Rahim Omar 
Published: August 2024

Abstract
Background
Virtual power plants (VPPs) represent a pivotal evolution in power system management, offering dynamic solutions to the challenges of renewable energy integration, grid stability, and demand-side management. Originally conceived as a concept to aggregate small-scale distributed energy resources, VPPs have evolved into sophisticated enablers of diverse energy assets, including solar panels, wind turbines, battery storage systems, and demand response units. This review article explores the evolution of VPPs and their pivotal roles as major stakeholders within contemporary power systems. The review opens with a definition of VPPs that clarifies both their fundamental traits and technological foundations. A historical examination of their development highlights major turning points and milestones that illustrate their transforming journey.

Main text
The methodology used for this article entailed a thorough examination to identify relevant studies, articles, and scholarly works related to virtual power plants. Academic databases were used to gather relevant literature. The literature was organized into categories helping to structure and present information in a logical flow based on the outline created for the review article. The discussions in the article show that the various functions that VPPs perform in power systems are of major interest. VPPs promote the seamless integration of renewable energy sources and provide optimum grid management by aggregating distributed energy resources, which improves sustainability. One of the important components of this evaluation involves taking market and policy considerations. Examining worldwide market patterns and forecasts reveals that VPP usage is rising, and that regulatory frameworks and incentives have a bigger impact on how well they integrate.

Conclusion
Overcoming obstacles is a necessary step towards realizing full VPP potential. For VPPs to be widely adopted, it is still essential to address technological and operational challenges as they arise. Diverse stakeholders must work together to overcome market obstacles and promote the expansion of the VPP market. This analysis highlights the potential for VPPs to propel the evolution of contemporary power systems toward a more sustainable and effective future by highlighting areas for future research and development.
Implementing policies and predictive stochastic models to restrict borderline personality disorder’s access to restricted medications: comorbidity with factitious disorder, functional neurological disorder and medically unexplained symptoms
Authors: Lazzari C. G. 
Published: August 2024

IntroductionWe are facing increased access to hospital beds and increased use of restricted medications by people with borderline personality disorder (BPD). Our former research shows BPD comorbidity with factitious conditions, functional neurological disorder and medically unexplained symptoms. We also registered that persons with BPD might craft or exaggerate symptoms to access restricted medications. In the worst cases, they might share these medications (benzodiazepines, hypnotics, and anxiolytics) with street values for profit or other recreational purposes.ObjectivesTo generate forecasting models and preventive policies to deal with BPD factitious disorders and improve the effectiveness of the UK National Healthcare Service (NHS) in reducing unnecessary admissions to general and psychiatric hospitals. More selective policies will capture and discourage BPD’s feigning and exaggerating symptoms for accessing restricted medications.MethodsThe underlying analysis framework is stochastic forecasting. We used current knowledge and data to complete systematic future predictions extracted from recent trends. A logical-mathematical model generated the required expressions. We identify four major model components to be introduced in the model: BPD (A), factious disorders (B), prescribing restricted medications (C), antisocial behaviours (D), and access to hospital beds (E).ResultsThe Boolean expression becomes [A then B then C then D then E], or [A ⇒ (B ⇒ (C ⇒ (D ⇒ E))] with a truth density of 96.875% (Figure 1).ConclusionsBPD should alert healthcare of the risks of symptom exaggeration and factitious mental diseases. These conditions are used to access often restricted medications, such as benzodiazepines, sleep tablets, and anxiolytics, for personal and communal use. Street sharing of these last increases local criminality. In worst cases, a hospital bed is granted without preventive triage. The risk is the indoor access to these medications. We advocate policies for the discontinuation of community prescription of these drugs.Disclosure of InterestNone Declared
Anxiety in patients with ankylosing spondylitis in southern-Tunisia: Level and associated factors
Authors: Feki A. , Sellami I. , Ketata N. , Baklouti M. , Gassara Z. , Ben Djemaa S. , Ben Djemaa S. , Ezzeddine M. , Kallel M. H. , Fourati H. , Akrout R. , Mejdoub Y. , Baklouti S. 
Published: August 2024

IntroductionAnkylosing spondylitis (AS) is the second most common rheumatic disease after rheumatoid arthritis. The significant functional impact of this chronic disease can affect patients’ mental health.ObjectivesThe aim of this study was to determine the prevalence of anxiety in subjects with AS in Southern-Tunisia and to identify its associated factors.MethodsIt was a retrospective study conducted in 2021 over a period of 5 years on patients with AS consulting the rheumatology department at the Hedi Chaker University Hospital in SFAX, Southern-Tunisia. The “Anxiety and Depression scale” was used to screen for anxiety. A score ≥11 defined confirmed anxiety symptoms.ResultsOf the 62 patients, 35 were male (56.5%), giving a male to female ratio of 1.3. Twenty-seven patients (43.5%) were aged between 35 and 50 years. The level of education was primary in 19 cases (30.6%) and university in 15 cases (24.2%). A family history of chronic disease was present in 32 cases (51.6%). Severe fatigue was noted among 27 patients (43.5%). Quality of life was poor in 39 patients (62.9%). The mean anxiety score was 11.35±4.6. Thirty-four subjects (54.8%) had confirmed anxiety symptoms and 19 (30.5%) had borderline symptoms. Confirmed anxiety was significantly associated with the educational level (p=0.03) (illiterate: 87.5%, primary: 68.4%, secondary: 35% and university: 46.7%). Similarly, having a family history of chronic disease (OR=3.3; p=0.02), suffering from severe fatigue (OR=36, p<0.01), having associated depression (HAD score≥11) (OR=19.5; p<0.001) and having poor quality of life [Ankylosing spondylitis quality of life questionnaire (Asqol) Score ≥13] (OR=15.8; p<0.001) were statistically associated with higher prevalence of confirmed anxiety symptoms.ConclusionsIt was found that patients treated for AS frequently suffer from psychological co-morbidities, particularly anxiety, which can lead to a further deterioration in their quality of life and even their withdrawal from active life. Thus, anxiety should not be ignored when treating these patients.Disclosure of InterestNone Declared