bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Dorsal Cheilectomy and Hallux Metatarsal Phalangeal Joint Arthroscopy for the Treatment of Hallux Rigidus
Authors: Gauthier Chase , Lewis Thomas L. , O'Keefe John , Bakaes Yianni , Vignaraja Vikram , Benjamin Jackson J. , Kaplan Jonathan , Ray Robbie , Gonzalez Tyler 
Published: April 2024

Introduction/Purpose: Minimally invasive dorsal cheilectomy (MIDC) has become a popular alternative to an open approach for treating Hallux Rigidus, although the current literature is divided on its effectiveness regarding complications and patient reported outcomes. To combat a portion of the complications related to the MIDC approach, a first metatarsophalangeal (MTP) joint arthroscopy can often be added to the procedure. The combined procedure has been demonstrated to be effective at improving patient reported outcomes without increasing the complication rate relative to an open procedure. This study looks to examine the effectiveness of the MIDC with first MTP arthroscopy procedure in patients with hallux rigidus with minimum 1 year follow up. Methods: This was a multicenter retrospective review was conducted for adult patients treated with MIDC and first MTP arthroscopy between 3/1/2020 and 8/1/2022, with at least one year of postoperative follow-up data. Patient charts were reviewed for demographic information, operative time, pre and postoperative first MTP range of motion (ROM), visual analog scale (VAS), Manchester-Oxford Foot Questionnaire (MOXFQ), and EQ5DLD scores. Continuous data was expressed as a mean and standard deviation, categorical data was expressed as a percentage. Wilcoxon Rank Sum test was used to compare continuous variables. All P < 0.05 was considered significant. Results: A total of 31 patients were included in the study with an average follow-up time of 16.5 months (range: 12 to 26.2). There was 1 (3.2%) complication of an underservice EHL tendon tear, 2 (6.5%) patients were converted to a MTP fusion, and 1 (3.2%) patient underwent revision cheilectomy and capsular release for MTP joint contracture. There was a significant improvement in patient’s ROM in dorsiflexion (50 vs 89.6 degrees, P=0.002), but not in plantarflexion (11.3 vs 18.6 degrees, P=0.07). There was a significant improvement in patient’s postoperative VAS pain scores (6.4 vs 2.1, P< 0.001), MOXFQ pain scores (58.1 vs 30.7, P=0.001), MOXFQ Walking/Standing scores (56.6 vs 20.6, P=0.001), MOXFQ Social Interaction scores (47.3 vs 19.36, P=0.002), and MOXFQ Index scores (54.7 vs 22.4, P< 0.001). Conclusion: We found that MIDC with first MTP arthroscopy was effective at improving patient reported outcomes, specifically patient’s pain scores, at one year with low complication and revision rates. These results demonstrate MIDC and first MTP arthroscopy’s is an effective treatment for early-stage hallux rigidus and may be considered as an alternative to an open approach.
Surprise Billing in Foot and Ankle Surgery and Its Effect on Patient Satisfaction
Authors: McCahon Joseph , Moncman Tara G. , Radack Tyler , Miller Mark , Parekh Selene , Pedowitz David I. , Daniel Joseph 
Published: April 2024

Introduction/Purpose: Patients undergoing foot and ankle surgery may find themselves facing unexpected medical bills. This is known as surprise billing and has caused financial hardship for many patients, prompting policymakers to pass the “No Surprise Act”. The purpose of this study was to determine the incidence of surprise bills in patient undergoing foot and ankle surgery and the effect of surprise billing on patient satisfaction. Methods: This was a retrospective study of patients who underwent a foot and ankle surgery from May 2021 to November 2022 at a large multi-state institution. Patients completed a questionnaire regarding the incidence of surprise bills following their surgery, the details regarding those bills, and how those bills affected the surgical satisfaction. Results: Of the 771 responses, 23% of participants received at least one surprise bill following their foot and ankle procedure, with 39% of these bills being greater than $1000. The most common surprise bill came from the surgical facility (46%) followed by anesthesia (42%). Furthermore, the incidence of surprise billing before and after the implementation of the “No Surprise Act” on January 1st, 2022 was not found be significantly different (p=0.134). Patients who received surprise bills reported being significantly less satisfied with their surgery (p < 0.001) and felt their billing experience affected their surgical satisfaction. Conclusion: Despite recent legislative efforts, surprise billing in foot and ankle surgery is common and can negatively affect patient surgical satisfaction. Although surgeons may be unable to limit the amount of bills patients receive postoperatively, increased communication and education regarding the perioperative billing process may prove to be beneficial for both patient satisfaction and the doctor-patient relationship.
Total Ankle Replacement with Built-in Antibiotic Spacer: A Paradigm Shift in the Management of Infected Ankles
Authors: Lalli Trapper , Smith Abigail , Strong Reyanne , Koutlas Nathaniel , Sanders James O. 
Published: April 2024

Introduction/Purpose: Infection of an ankle fracture is a devastating complication that can lead to chronic pain, limited motion or amputation. Traditional treatment strategies after infection involve aggressive surgical debridement, implant removal and prolonged antibiotic therapy. Non-anatomic cement spacers for the tibiotalar joint have previously been described with mixed results. Articulating spacers have shown improved outcomes and may be used as definitive treatment. Currently, there are no prefabricated TAR spacers on the market. The use of 3D printing to create custom implants is emerging, however, there is a paucity of literature regarding their use. We present a case of post-infectious ankle arthritis in 14 year old patient treated with a 3D printed total ankle replacement with built in antibiotic spacer (TAR-AS). Methods: A CT scan was performed in accordance with computer aided design (CAD) parameters. Bilateral lower extremities were scanned to allow the unaffected side to be mirrored and be the basis for implant design. Slice spacing less than 1.25mm with pixel size of 0.5mm. The studies were in DICOM files and within a timeframe where no significant change in patient anatomy had occurred. The implants were fabricated by selective laser melting (SLM) of cobalt chrome alloy (CoCrMo) by Restor3d (Durham, NC). Our design incorporated a stacked gyroid component to facilitate antibiotic cement impregnation. In terms of surgical technique, the custom TAR-AS followed a similar approach to a patient specific TAR procedure. Prior to implantation, the gyroid component of the TAR-AS was filled with Simplex bone cement with tobramycin (Stryker). Results: At six months postoperatively, our patient reported no limitation in activities. AOFAS scores improved from 46/100 preoperatively to 83/100 at six months postoperatively. Radiographic parameters showed no signs of implant failure, loosening or change in alignment. Intraoperative cultures remained negative. Conclusion: We present a case demonstrating the utilization of 3D generated prostheses for treatment of post-infection ankle arthritis. The TAR-AS represents a significant advancement in the management of ankle infections. This innovative approach combines the benefits of joint replacement and continued antibiotic elution. With further research and continued technological advancements, the TAR-AS has the potential to become the gold standard for the treatment of infected TAR. Despite the promising results, challenges remain in the implementation of TAR-AS. Long term follow up studies are needed to evaluate the durability and longevity of the implant. Total ankle with built in antibiotic spacer Superior view of tibial tray with antibiotic cement packed in gyroid
Mineralogical zoning of the PGE–Cu–Ni orebodies in the central part of the Oktyabr'sky Deposit, Norilsk District, Russia
Authors: Tolstykh Nadezhda D. , Krivolutskaya Nadezhda A. , Canhimbue Lyudmila S. , Gongalsky Bronislav I. , Kuzmin Ivan A. 
Published: April 2024

AbstractMineralogical features of two orebodies, lenses (C-3 and C-4), at the central part of the Oktyabr'sky deposit have been investigated. Multidirectional mineralogical zoning in the northern and southern orebodies is shown, confirming the hypothesis of their formation from various magmatic flows, which have individual features and their own modes of formation. The southern C-3 and northern C-4 orebodies differ in their mineralogical associations: C-3 is characterised by a high-sulfur association of sulfides; and C-4 contains minerals with a sulfur deficit (talnakhite, sugakiite). Variations in Fe and Ni ratios in pentlandite are controlled by the volatility of sulfur during ore crystallisation. Direct crystallisation zoning is observed in the disseminated ores of the C-4 orebody (borehole RT-107), where the fugacity of sulfur ($f_{S_2}$) increases from bottom to top. In contrast in orebody C-3 (borehole RT-30) $f_{S_2}$ decreases in the same direction. This reverse zoning coincides with the vectors of the evolution of ore systems in various blocks of the Main Ore Body of the Oktyabr'sky deposit. The difference in typomorphic features of disseminated ores of the southern and northern orebodies is confirmed by differences in the associations of platinum-group element minerals (PGMs). Disseminated ores in picritic gabbro-dolerites and massive pyrrhotite ores in the exocontact of the intrusion within the southern orebody differ in the specialisation of PGMs: the former is characterised by minerals of the Pd–Bi–Sb–Te system, the latter by only Pt minerals. The similarity of these types of ores lies in the similar reverse mineralogical and geochemical zoning from top to bottom along the sections, caused by the evolution of the sulfide melt in this direction. The formation of reverse zoning of disseminated ores (zones of ‘marginal reversion’) is probably due to the action of a mechanism of repeated influx of a melt of an increasingly primitive composition into the upper parts of the crystallising flow. Unidirectional trends in massive and disseminated ores are more likely to be due to the action of the same type of mechanism.
Unscheduled health care interactions in patients with multiple myeloma receiving T-cell redirection therapies
Authors: Howard Anna J. , Concepcion Isabel , Wang Alice X. , Hamadeh Issam S. , Hultcrantz Malin , Mailankody Sham , Tan Carlyn , Korde Neha , Lesokhin Alexander M. , Hassoun Hani , Shah Urvi A. , Maclachlan Kylee H. , Rajeeve Sridevi , Landau Heather J. , Scordo Michael , Shah Gunjan L. , Lahoud Oscar B. , Chung David J. , Giralt Sergio , Usmani Saad Z. , Firestone Ross S. 
Published: April 2024

Abstract
Outcomes for patients with relapsed/refractory multiple myeloma (R/RMM) have dramatically improved after the development and now growing utilization of B-cell maturation antigen–targeted chimeric antigen receptor (CAR) T-cell therapy and bispecific antibody (BsAb) therapy. However, health care utilization as a quality-of-life metric in these growing populations has not been thoroughly evaluated. We performed a retrospective cohort study evaluating the frequency and cause of unscheduled health care interactions (UHIs) among patients with R/RMM responding to B-cell maturation antigen–targeted BsAb and CAR T-cell therapies (N = 46). This included the analysis of remote UHIs including calls to physicians’ offices and messages sent through an online patient portal. Our results showed that nearly all patients with R/RMM (89%) receiving these therapies required a UHI during the first 125 days of treatment, with a mean of 3.7 UHIs per patient. Patients with R/RMM responding to BsAbs were significantly more likely to remotely contact their physicians’ offices (1.8-fold increase; P = .038) or visit an urgent care center (more than threefold increase; P = .012) than patients with R/RMM responding to CAR T-cell therapies. This was largely due to increased reports of mild upper respiratory tract infections in BsAb patients. Our results underscore the need to develop preemptive management strategies for commonly reported symptoms that patients with R/RMM experience while receiving CAR T-cell or BsAb therapies. This preemptive management may significantly reduce unnecessary health care utilization in this vulnerable patient population.
Phytonano silver for cosmetic formulation- synthesis, characterization, and assessment of antimicrobial and antityrosinase potential
Authors: George Neethu , Devi D. Gayathri 
Published: April 2024

AbstractNovel formulations of silver nanoparticles remain exciting if it is applicable for cosmetic purposes. This study proposes a value-added brand-new nanomaterial for improving skin complexion by inhibiting melanin development. This work aims to develop cost effective, efficient, natural silver nanoparticles phytomediated by aqueous extract of leaf sheath scales of Cocos nucifera (Cn-AgNPs) having potential as tyrosinase inhibitors hindering melanin synthesis. The formation of Cn-AgNPs was assessed spectrophotometrically and confirmed by the sharp SPR spectrum at 425 nm. The chemical composition profiling was characterized by X-ray diffraction (XRD) and Fourier Transform Infrared (FTIR) spectroscopy. The morphology was confirmed by Field Emission Scanning Electron Microscopy (FESEM) and the thermal stability was assessed by Thermogravimetric analysis (TGA). Pharmacological application studies supported the materialization of Cn-AgNPs with significant antityrosinase potential and considerably improved antibacterial and antioxidant properties. Cn-AgNPs showed potential antibacterial effects against gram-positive and negative strains, including prominent infectious agents of the skin. Antioxidant capacity was confirmed with an IC50 of 57.8 μg/mL by DPPH radical scavenging assay. Furthermore, in vitro melanin content determination was performed using SK-MEL cells. Cell line studies proved that Cn-AgNPs decrease the melanin content of cells. The IC50 value obtained was 84.82 μg/mL. Hence Cn-AgNPs is proposed to be acting as a whitening agent through lessening cellular melanin content and as a significant inhibitor of tyrosinase activity. The antioxidant properties and antibacterial effects can contribute to skin rejuvenation and can prevent skin infections as well. This evidence proposes the development of a new nanostructured pharmaceutical and cosmetic formulation from Cocos nucifera leaf sheath scales.
Two synergistic types of muscles were detected during forearm rotation exercise by T2 cumulative frequency curves using 0.2 T magnetic resonance imaging
Authors: Takamori Masayoshi , Akiyama Sumikazu , Seo Yoshiteru , Mizushima Takashi 
Published: April 2024

AbstractThe purpose of this study was the detection and characterization of synergistic muscle activity. Using T2-map MRI, T2values for 10 forearm muscles in 11 healthy adult volunteers were obtained in the resting state and after isotonic forearm supination and pronation exercises with the elbow extended. T2was normalized by Z = (T2e–T2r)/SDr, where T2ewas T2after exercise, while T2rand SDrwere the reference values of 34 ms and 3 ms, respectively. Using the cumulative frequency curves of Z values (CFZ), we detected 2 and 3 synergistic muscles for supination and pronation, respectively, and divided these into 2 types, one activated by exercise strength dependently, and the other, independent of exercise strength, activated by only a smaller fraction of the participants. We also detected co-contraction for the supination. Thus, CFZ is a useful visualization tool to detect and characterize not only synergistic muscle, but also co-contraction muscle.
Fine scale diversity in the lava: genetic and phenotypic diversity in small populations of Arctic charr Salvelinus alpinus
Authors: Leblanc Camille A. , Räsänen Katja , Morrissey Michael , Skúlason Skúli , Ferguson Moira , Kristjánsson Bjarni K. 
Published: April 2024

Abstract
Background
A major goal in evolutionary biology is to understand the processes underlying phenotypic variation in nature. Commonly, studies have focused on large interconnected populations or populations found along strong environmental gradients. However, studies on small fragmented populations can give strong insight into evolutionary processes in relation to discrete ecological factors. Evolution in small populations is believed to be dominated by stochastic processes, but recent work shows that small populations can also display adaptive phenotypic variation, through for example plasticity and rapid adaptive evolution. Such evolution takes place even though there are strong signs of historical bottlenecks and genetic drift. Here we studied 24 small populations of the freshwater fish Arctic charr (Salvelinus alpinus) found in groundwater filled lava caves. Those populations were found within a few km2-area with no apparent water connections between them. We studied the relative contribution of neutral versus non-neutral evolutionary processes in shaping phenotypic divergence, by contrasting patterns of phenotypic and neutral genetic divergence across populations in relation to environmental measurements. This allowed us to model the proportion of phenotypic variance explained by the environment, taking in to account the observed neutral genetic structure.

Results
These populations originated from the nearby Lake Mývatn, and showed small population sizes with low genetic diversity. Phenotypic variation was mostly correlated with neutral genetic diversity with only a small environmental effect.

Conclusions
Phenotypic diversity in these cave populations appears to be largely the product of neutral processes, fitting the classical evolutionary expectations. However, the fact that neutral processes did not explain fully the phenotypic patterns suggests that further studies can increase our understanding on how neutral evolutionary processes can interact with other forces of selection at early stages of divergence. The accessibility of these populations has provided the opportunity for long-term monitoring of individual fish, allowing tracking how the environment can influence phenotypic and genetic divergence for shaping and maintaining diversity in small populations. Such studies are important, especially in freshwater, as habitat alteration is commonly breaking populations into smaller units, which may or may not be viable.
The effect of white grub (Maladera Verticalis) larvae feeding on rhizosphere microbial characterization of aerobic rice (Oryza sativa L.) in Puer City, Yunnan Province, China
Authors: Wang Guang , Li Zhengfei , Yang Baoyun , Yang Huquan , Zhang Yujie , Zeng Qingping , Yan Chaojianping , He Yanyan , Peng Yuejin , Wang Wenqian , Chen Bin , Du Guangzu 
Published: April 2024

Abstract
Background
Rhizosphere microorganisms are vital in plants’ growth and development and these beneficial microbes are recruited to the root-zone soil when experiencing various environmental stresses. However, the effect of white grub (Maladera verticalis) larvae feeding on the structure and function of rhizosphere microbial communities of aerobic rice (Oryza sativa L.) is unclear.

Results
In this study, we compared physicochemical properties, enzyme activities, and microbial communities using 18 samples under healthy and M. verticalis larvae-feeding aerobic rice rhizosphere soils at the Yunnan of China. 16 S rRNA and ITS amplicons were sequenced using Illumina high throughput sequencing. M. verticalis larvae feeding on aerobic rice can influence rhizosphere soil physicochemical properties and enzyme activities, which also change rhizosphere microbial communities. The healthy and M. verticalis larvae-feeding aerobic rice rhizosphere soil microorganisms had distinct genus signatures, such as possible_genus_04 and Knoellia genera in healthy aerobic rice rhizosphere soils and norank_f__SC − I−84 and norank_f__Roseiflexaceae genera in M. verticalis larvae-feeding aerobic rice rhizosphere soils. The pathway of the metabolism of terpenoids and polyketides and carbohydrate metabolism in rhizosphere bacteria were significantly decreased after M. verticalis larvae feeding. Fungal parasite–wood saprotroph and fungal parasites were significantly decreased after M. verticalis larvae feeding, and plant pathogen–wood saprotroph and animal pathogen–undefined saprotroph were increased after larvae feeding. Additionally, the relative abundance of Bradyrhizobium and Talaromyces genera gradually increased with the elevation of the larvae density. Bacterial and fungal communities significantly correlated with soil physicochemical properties and enzyme activities, respectively.

Conclusions
Based on the results we provide new insight for understanding the adaptation of aerobic rice to M. verticalis larvae feeding via regulating the rhizosphere environment, which would allow us to facilitate translation to more effective measures.
Exploring the knowledge and skills for effective family caregiving in elderly home care: a qualitative study
Authors: Hailu Gebrezabher Niguse , Abdelkader Muntaha , Asfaw Feven , Meles Hailemariam Atsbeha 
Published: April 2024

Abstract
Background
Family caregivers play a crucial role in providing physical, emotional, and social support to the elderly, allowing them to maintain their independence and stay in their preferred living environment. However, family caregivers face numerous challenges and require specific knowledge and skills to provide effective care. Therefore, understanding the knowledge and skills required for effective family caregiving in elderly home care is vital to support both the caregivers and the elderly recipients.

Methods
The research was carried out in Mekelle City, Ethiopia, utilizing the phenomenology study design and purposive sampling technique. A total of twenty-two in-depth interviews were conducted. Individuals with experience in providing care for elderly people in their homes were targeted. Data was gathered through the use of an open-ended guide, transcribed word-for-word, inputted into ATLAS.ti8 software, and translated. Codes and themes were then extracted from the transcribed data, and a thematic analysis was performed. To minimize personal biases, the collected data were coded independently by the data collection assistants and the PI. The analysis was carried out by authors who were not involved in the data collection process. The interviews were conducted in a quiet place.

Results
A total of 22 in-depth interviews were conducted as part of this research. The results indicated that although the participants had knowledge about common health problems experienced by older people, they were uninformed about how to manage these conditions at home and were unaware of specialized healthcare resources for the elderly. Furthermore, they had limited knowledge about suitable exercise routines, strategies to prevent falls, and home healthcare practices for older individuals. On the other hand, they exhibited a solid comprehension and awareness of abusive behaviors specifically directed at older adults.

Conclusion
The results emphasized the importance of enhancing education and training for family caregivers in handling elderly health issues, raising awareness about specialized healthcare services catered to the elderly, improving understanding of activities of daily living (ADLs) and fall prevention, and offering inclusive training in healthcare tasks related to elder care.

Recommendation
Participants should receive comprehensive education and training programs to enhance their knowledge and skills in managing these conditions. Efforts should also be made to raise awareness about the availability of geriatric hospitals or specialized nurses for the elderly. Participants need to be educated about suitable exercise routines for the elderly and fall prevention strategies. Healthcare skills training is also necessary for participants, focusing on activities such as wound dressing, vital sign monitoring, and establishing a specific schedule for changing positions.