bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial disparities in disease‐specific mortality and surgical management of patients with ductal carcinoma in situ with microinvasion
Authors: Chen J. C. , Handley Demond , Elsaid Mohamed I. , Fisher James L. , Owusu‐Brackett Nicci , Azap Lovette , Bhattacharyya Oindrila , Pawlik Timothy M. , Carson William E. , Obeng‐Gyasi Samilia 
Published: April 2024

AbstractBackground and ObjectivesGiven persistent racial disparities in breast cancer outcomes, this study explores racial differences in disease‐specific mortality and surgical management among patients with microinvasive ductal carcinoma in situ (DCIS‐MI).MethodsThe Surveillance, Epidemiology, and End Results Program was queried for patients aged 18+ years with DCIS‐MI between January 1, 2010 and December 31, 2018. The study cohort was divided into non‐Hispanic Black (NHB) and non‐Hispanic White (NHW) patients. Disease‐specific mortality was evaluated using Cox proportional hazards models.ResultsA total of 3400 patients were identified, of which 569 (16.7%) were NHB and 2831 (83.3%) were NHW. Compared with NHW patients, NHB patients had more positive lymph nodes (7.6% vs. 3.9% p < 0.001). In addition, NHB women were more likely to undergo axillary lymph node dissection (6.0% vs. 3.8%, p = 0.044) and receive chemotherapy (11.8% vs. 7.2%, p < 0.001). There were no racial differences in breast surgery type (p = 0.168), reconstructive surgery (p = 0.362), or radiation therapy (p = 0.342). Overall, NHB patients had worse disease‐specific mortality (adjusted hazard ratio 2.13, 95% confidence interval [CI]: 1.10–4.14) with mortality risks diverging from NHW women after 3 years (6 years rate ratio [RR] 2.12, 95% CI: 1.13–4.34; 9 years RR 2.32, 95% CI: 1.24–4.35).ConclusionsNHB women with DCIS‐MI present with higher nodal disease burden and experience worse disease‐specific mortality than NHW women.
Tendon cross‐sectional area on magnetic resonance imaging and anthropometric characteristics can be used to predict insufficient four‐strand hamstring autograft diameter in anterior cruciate ligament reconstruction: A systematic review
Authors: Vivekanantha Prushoth , Grzela Patrick , Wong Stephanie , Mansour Fadi , Khalik Hassaan Abdel , Johnson Jansen , Hantouly Ashraf , de SA Darren 
Published: April 2024

AbstractPurposeTo evaluate the utility of semitendinosus tendon (ST) and gracilis tendon (GT) cross‐sectional area (CSA) on magnetic resonance imaging (MRI) and anthropometric characteristics in preoperative estimation of graft diameter in patients undergoing anterior cruciate ligament reconstruction (ACLR) with four‐strand hamstring autografts.MethodsThree databases were searched on 29 August 2023. The authors adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) and R‐AMSTAR (Revised Assessment of Multiple Systematic Review) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Data on demographics, anthropometric characteristics, imaging techniques, tendon CSA, correlation coefficients, sensitivities, specificities, regression models and cutoffs for predicting intraoperative graft diameters above 8 mm were recorded.ResultsForty‐six studies comprising 4140 patients were included. Twelve of 19 (63.2%) studies reporting on ST + GT CSA found a moderate to very high correlation with intraoperative graft diameter. Five of 10 (50%) and one of seven (14.3%) studies reporting on ST CSA and GT CSA, respectively, found a moderate to high correlation with intraoperative graft diameter. Cutoffs of ST + GT CSA for predicting graft diameters above 8 mm ranged from 15.8 to 31.2 mm2. Nine of 35 (25.7%) studies that reported on height found a moderate to very high correlation with graft diameter. Seven of 33 (21.2%) studies reporting on weight found a moderate correlation with graft diameter.ConclusionOf the MRI parameters assessed, ST + GT CSA was the most reliable predictor of graft diameter. However, cutoffs, sensitivities, and specificities for predicting diameters above 8 mm were highly variable. Anthropometric characteristics in general were less predictive of graft diameter than MRI parameters. This information can be used by clinicians to predict patients at risk for ACLR failure due to insufficient graft size.Level of EvidenceLevel IV.
Better clinical outcomes and return to sport rates with additional medial meniscus root tear repair in high tibial osteotomy for medial compartmental knee osteoarthritis
Authors: Guo Hailong , Li Qingyu , Zhang Zirui , Feng Ao , Qin Shiqi , Liu Lei , Sun Ran , Wang Xiaofeng 
Published: April 2024

AbstractPurposeThis retrospective study aimed to investigate whether the repair of medial meniscus posterior root tears (MMPRTs) is effective for improving clinical outcomes and return to sports rates in young patients (50 years old or younger) with medial compartment knee osteoarthritis (KOA) and MMPRTs.MethodsBetween 2016 and 2019, 153 patients with KOA and MMPRTs who underwent open‐wedge high tibial osteotomy (OWHTO) were retrospectively included. The patients were divided into OWHTO combined with MMPRT repair (n = 73) and isolated OWHTO (n = 80) groups. Lysholm scores, Hospital for Special Surgery (HHS) scores, Tegner scores, flexion contracture, range of knee flexion, return to sports rates and postoperative complications were compared. Radiological outcomes, including hip–knee–ankle angle (HKA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA) and Kellgren–Lawrence (K‐L) grade, were compared between the two groups.ResultsAfter a mean follow‐up of 30.1 ± 3.0 months, the OWHTO + Repair group observed better clinical outcomes compared with the OWHTO group (Lysholm score: 86.7 ± 7.4 vs. 81.6 ± 6.9, p = 0.023. HHS score: 85.4 ± 8.20 vs. 80.5 ± 7.1, p = 0.039). The OWHTO + Repair group had higher Tegner scores and return to sports rates than the OWHTO group (Tegner score: 6 vs. 5, p = 0.020; return to sports rates: 38% vs. 15%, p = 0.001). No fracture or major complications occurred. Radiological outcomes showed no significant differences between the two groups (HKA: 181.1 ± 2.7 vs. 180.1 ± 1.5 n.s; MPTA: 90.1 ± 1.8 vs. 89.2 ± 1.4, n.s; JLCA:1.9 ± 0.7 vs. 2.1 ± 0.7, n.s).ConclusionsAdditional MMPRT repair during OWHTO was associated with better clinical outcomes and higher rates of return to sports in young patients with medial compartment KOA and MMPRTs.Level of EvidenceLevel III.
Static spacers play a crucial role in the treatment of complex periprosthetic joint infections of the knee
Authors: Lunz Andre , Omlor Georg W. , Voss Moritz N. , Geisbüsch Andreas , Renkawitz Tobias , Lehner Burkhard 
Published: April 2024

AbstractPurposeTo determine the superior spacer design, a growing number of studies are comparing treatment results between patients having been treated with articulating and static knee spacers in the setting of two‐stage revision for periprosthetic joint infection (PJI). In contrast, the primary objective of this study was to compare preoperative characteristics between patients from both spacer groups and examine whether significant differences were present prior to spacer implantation.MethodsThis retrospective, single‐centre, cohort study examined the preoperative situation of 80 consecutive knee PJIs between 2017 and 2020. All patients underwent two‐stage revision, with 35 (44%) receiving an articulating and 45 (56%) a static spacer.ResultsNo significant differences were observed in terms of patient gender (p = 0.083), age (p = 0.666), comorbidity (p = 0.1) and preoperative clinical function (p = 0.246). Static spacers were significantly more often used in the presence of a periarticular fistula (p = 0.033), infection of a revision implant (p < 0.001), higher degree of bone loss (p < 0.001) and infection caused by a difficult‐to‐treat pathogen (p = 0.038). Complication and revision rates were similar for both spacer types during the interim period, while patients with articulating spacers demonstrated a superior clinical function (p < 0.001) during the interim period and after reimplantation.ConclusionStatic spacers are being utilised in significantly more complex and unfavourable preoperative scenarios. Therefore, a preoperative selection bias may be at least partially accountable for any disparities observed in postoperative outcomes. To achieve the best possible results, surgeons should know and respect the distinct indications of static and articulating spacers and consequently understand and use them as complementary surgical options.Level of EvidenceLevel III.
Return to badminton play following an ACL injury is common, but only a few return to previous performance
Authors: Kaldau Niels Christian , Andersen Frederik Flensted , Barfod Kristoffer Weisskirchner , Hersnaes Peter Nyby , Hölmich Per 
Published: April 2024

AbstractPurposeTo report how many badminton players return to badminton after an anterior cruciate ligament (ACL) injury and to which level.MethodsPatients in Denmark from 2000 to 2018, registered in the Danish National Patient Register with a diagnosis of ACL rupture and badminton as a primary sport were asked about a return to sport (RTS) and return to performance (RTP) after ACL injury. RTP was defined as the return to full participation in the same sport, same level and same preinjury performance. To investigate the likelihood of RTS and return to preinjury level, a binominal logistic regression was used.ResultsBadminton was the primary sport for 900 participants. Only 435 players were injured during badminton, and 626 participants intended to RTP. RTS was achieved by 396 (63%) and 117 (19%) returned to the same performance as their preinjury level. However, 273 (44%) returned to full participation at the same level as the preinjury level but did not perform as well. Males had a significantly higher RTS than females, and RTP was also higher among males [221 (68%) vs. 175 (58%), odds ratio, OR: 1.67, p = 0.003 and 74 (23%) vs. 43 (14%), OR: 1.58, p = 0.05].ConclusionReturn to badminton was achieved by 396 (63%), but only 117 (19%) returned to the same performance as their preinjury level after ACL injury. Females are less successful in RTS and RTP. Future research on improving RTS and the RTP rates in badminton, in general, and specifically for females is needed.Level of EvidenceLevel II.
Unicondylar knee arthroplasty demonstrating a significant increased risk for aseptic revisions compared to unconstrained and constrained total knee arthroplasty: An analysis of aseptic revisions after unicondylar and primary total knee arthroplasty of the German Arthroplasty Registry
Authors: Straub Josina , Szymski Dominik , Walter Nike , Wu Yinan , Melsheimer Oliver , Grimberg Alexander , Alt Volker , Steinbrueck Arnd , Rupp Markus 
Published: April 2024

AbstractPurposeDue to ageing population, the implantation rate of total knee arthroplasties (TKAs) is continuously growing. Aseptic revisions in primary knee arthroplasty are a major cause of revision. The aim of the following study was to determinate the incidence and reasons of aseptic revisions in constrained and unconstrained TKA, as well as in unicondylar knee arthroplasties (UKAs).MethodsData collection was performed using the German Arthroplasty Registry. Reasons for aseptic revisions were calculated. Incidence and comparison of aseptic revisions were analysed using Kaplan–Meier estimates. A multiple χ2 test with Holm's method was used to detect group differences in ligament ruptures.ResultsOverall, 300,998 cases of knee arthroplasty with 254,144 (84.4%) unconstrained TKA, 9993 (3.3%) constrained TKA and 36,861 (12.3%) UKA were analysed. Aseptic revision rate in UKA was significantly increased compared to unconstrained and constrained TKA (p < 0.0001). In constrained TKA, a 2.0% revision rate for aseptic reasons were reported after 1 year, while in unconstrained TKA 1.1% and in UKA, 2.7% of revisions were identified. After 7 years in constrained TKA 3.3%, in unconstrained TKA 2.8%, and in UKA 7.8% sustained aseptic revision. Ligament instability was the leading cause of aseptic revision accounting for 13.7% in unconstrained TKA. In constrained TKA, 2.8% resulted in a revision due to ligament instability. In the UKA, the most frequent cause of revisions was tibial loosening, accounting for 14.6% of cases, while progression of osteoarthritis accounted for 7.9% of revisions. Ligament instability was observed in 14.1% of males compared to 15.9% of females in unconstrained TKA and in 4.6% in both genders in UKA.ConclusionIn patients with UKA, aseptic revision rates are significantly higher compared to unconstrained and constrained TKA. Ligament instability was the leading cause of aseptic revision in unconstrained TKA. In UKA, the most frequent cause of revisions was tibial loosening, while progression of osteoarthritis was the second most frequent cause of revisions. Comparable levels of ligament instability were observed in both sexes.Level of EvidenceLevel III, cohort study.
Elucidating carbon sources of hydrothermal vent animals using natural 14C abundances and habitat water temperature
Authors: Nomaki Hidetaka , Chen Chong , Ogawa Nanako O. , Miyairi Yosuke , Ohkouchi Naohiko , Makabe Akiko , Kawagucci Shinsuke , Yokoyama Yusuke , Shimanaga Motohiro 
Published: April 2024

AbstractDeep‐sea hydrothermal vents host exceptional ecosystems with lush animal communities primarily relying on organic matter (OM) produced by chemoautotrophic microbes. Though energy sources and food webs at vents have been extensively studied, the exact carbon sources of chemosynthetic primary production, such as methane (CH4) and carbon dioxide (CO2) in the vent fluid or bottom water, have not been elucidated quantitatively across spatial scales. Here, we investigate carbon and nitrogen sources of 12 vent animal species at the Iheya North field, Okinawa Trough inhabiting different distances from the central venting area and with various feeding ecologies using natural‐abundance radiocarbon (Δ14C) in combination with conventional stable carbon and nitrogen isotope ratios (δ13C and δ15N). Our results show that generally, animals living closer to vent orifices were more depleted in 14C, indicating they assimilate more carbon from vent fluid CO2. Those relying on methanotrophs, however, exhibited low Δ14C values regardless of distance due to the lack of methane in the non‐vent‐influenced bottom water. Organisms with low Δ14C values also tend to exhibit low δ15N values, implying NH4+ assimilation into biomass in environments with high NH4+ concentrations. Our results demonstrate that 14C can clearly distinguish between chemoautotrophically fixed carbon originating from the vent fluid and detrital OM derived from surface primary production, and also discriminate between CO2‐ and CH4‐based chemoautotrophy. Although vent animals rely on vent fluid energetically, our results highlight that the dependency on vent fluids as carbon source varies greatly depending on habitat, as well as carbon fixation pathways of microbial primary producers.
The Effect of Coenzyme Q10 Supplementation on Bile Acid Metabolism: Insights from Network Pharmacology, Molecular Docking, and Experimental Validation
Authors: Jin Mengcheng , Zou Tangbin , Huang Hairong , Chen Ming , Zou Haoqi , Chen Baoyan , Lai Chengze , Li Huawen , Zhang Peiwen 
Published: April 2024

ScopeBile acids play a crucial role in lipid absorption and the regulation of lipid, glucose, and energy homeostasis. Coenzyme Q10 (CoQ10), a lipophilic antioxidant, has been recognized for its positive effects on obesity and related glycolipid metabolic disorders. However, the relationship between CoQ10 and bile acids has not yet been evaluated.Methods and resultsThis study assesses the impact of CoQ10 treatment on bile acid metabolism in mice on a high‐fat diet using Ultra‐Performance Liquid Chromatography‐tandem Mass Spectrometry. CoQ10 reverses the reduction in serum and colonic total bile acid levels and alters the bile acid profile in mice that are caused by a high‐fat diet. Seventeen potential targets of CoQ10 in bile acid metabolism are identified by network pharmacology, with six being central to the mechanism. Molecular docking shows a high binding affinity of CoQ10 to five of these key targets. Further analyses indicate that farnesoid X (FXR) receptor and Takeda G‐protein coupled receptor 5 (TGR5) may be crucial targets for CoQ10 to regulate bile acid metabolism and exert beneficial effects.ConclusionThis study sheds light on the impact of CoQ10 in bile acids metabolism and offers a new perspective on the application of CoQ10 in metabolic health.
A feeling of not being alone – Patients' with COPD experiences of a group‐based self‐management education with a digital website: A qualitative study
Authors: Berglund Mia , Andersson Susanne , Kjellsdotter Anna 
Published: April 2024

AbstractAimTo describe patients' with chronic obstructive pulmonary disease (COPD) experiences of group‐based self‐management education with a digital website.DesignA qualitative approach with a phenomenologicalmethod. Patients participating in an earlier study, with self‐experience of COPD as a special competence, were involved as research partners at the design of this study.MethodsEleven individual and two group interviews with five participants in each group were conducted.ResultsGroup‐based self‐management education with a digital website supports learning. Sharing experiences with others in similar situations creates security and reduces the feeling of being alone. Based on questions and discussion in the group, and through self‐reflection, general information is transformed into useful knowledge and understanding of one's own situation. COPD information on the website provides an opportunity to gain knowledge continuously based on needs that contributes to learning. This research has demonstrated that adapting learning activities to individual learning styles increases sustainability of learning. Sharing experiences reduces feelings of loneliness. It is therefore important to create spaces for sharing experiences and in‐depth reflection that support learning over time.
Mathematical results for the ‘Master Fund Strategy’ for legacy donations under the assumption of annual compounding
Authors: Jegers Marc 
Published: April 2024

AbstractIn recent issues of this journal, Solow, Symes and Webb (2023, 2024) present a new way to structure legacies by creating an intermediate fund which they call a Master Fund. They prove some interesting properties of this approach, comparing it with the traditional approach whereby the whole bequest is transferred to a Charity Fund. Their main mathematical results are obtained under continuous compounding, and numerical results are derived under (a more realistic) annual compounding assumption. In this note, additional practical results are obtained mathematically under the assumption of annual compounding. Specifically, it is shown that using a Master Fund always results in a time after which the annual amount of money a beneficiary organisation receives is greater than that without using the Master Fund. While the foregoing statement might not be true for the net present value, conditions on the annual investment, disbursement and discount rates under which this is the case are also provided.
Application of Time‐Driven Activity‐Based Costing for Head and Neck Microvascular Free Flap Reconstruction
Authors: Yalamanchi Pratyusha , Marentette Lawrence J. , Fendrick A. Mark , Chinn Steven B. , Prince Mark E.P. , Rosko Andrew J. , Shuman Andrew G. , Spector Matthew E. , Stucken Chaz L. , Malloy Kelly M. , Casper Keith A. 
Published: April 2024

AbstractObjectiveTraditional hospital accounting fails to provide an accurate cost of complex surgical care. Here we describe the application of time‐driven activity‐based costing (TDABC) to characterize costs of head and neck oncologic procedures involving free tissue transfer.Study DesignRetrospective cohort study.SettingSingle tertiary academic medical center.MethodsAn analysis of head and neck oncologic procedures involving microvascular free flap reconstruction from 2018 to 2020 (n = 485) was performed using TDABC methodology to measure cost across operative case and postoperative admission, using quantity of time and cost per unit of each resource to characterize resource utilization. Univariate and generalized linear mixed models were used to examine associations between patient and hospital characteristics and cost of care delivery.ResultsThe total cost of care delivery was $41,905.77 ± 21,870.27 with operating room (OR) supplies accounting for only 10% of the total cost. Multivariable analyses identified significant cost drivers including operative time, postoperative length of stay, number of return trips to the OR, postoperative complication, number of free flaps performed, and patient transfer from another hospital or via emergency department admission (P < .05).ConclusionOperative time and postoperative length of stay, but not operative supplies, were primary drivers of cost of care for head and neck oncology cases involving free tissue transfer. TDABC offers granular cost characterization to inform cost optimization through unused capacity identification and postoperative admission efficiencies.
Troubleshooting Upper Airway Stimulation Therapy Using Drug‐Induced Sleep Endoscopy
Authors: Kaffenberger Thomas M. , Plawecki Andrea , Kaki Praneet , Boon Maurits , Huntley Colin 
Published: April 2024

AbstractObjectiveThis study assesses the utility of drug‐induced sleep endoscopy (DISE) in guiding further treatment for patients with obstructive sleep apnea (OSA) who have difficulty tolerating upper airway stimulation (UAS) or have inadequate response to therapy.Study DesignWe conducted a retrospective analysis of UAS patients at our institution who underwent DISE, post‐UAS, and evaluated the efficacy of different electrode configurations and maneuvers.SettingA tertiary care hospital.MethodsOut of 379 patients who received UAS therapy, 34 patients who underwent DISE post‐UAS (DISE‐UAS) were included. Palatal coupling (PC) was assessed with UAS stimulation alone, jaw thrust alone, and both simultaneously during DISE.ResultsAmong 34 patients, 5 had suboptimal adherence to UAS therapy, 19 had suboptimal therapy efficacy with residual OSA burden, and 10 had both. During DISE‐UAS, PC was observed in 7 patients (21%) with UAS stimulation alone, 9 patients (26%) with jaw thrust alone, and 8 patients (24%) with both maneuvers combined. Notably, 10 patients (29%) did not exhibit PC with any maneuver. Based on DISE‐UAS findings, 13 patients were recommended oral appliance therapy (OAT), and 8 patients underwent further surgical interventions.ConclusionDISE‐UAS is a valuable adjunct in troubleshooting UAS therapy for patients intolerant to CPAP or with suboptimal therapy efficacy. This study provides an algorithm for targeted multimodality therapy based on DISE findings, facilitating personalized management approaches.