bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in Trampoline-Related Knee Injuries Between Children and Adults: A Cross-Sectional Study
Authors: Husen Martin , Engrav Samantha K. , Saul Dominik , Stuart Michael J. , Milbrandt Todd A. , Levy Bruce A. , Krych Aaron J. , Saris Daniël B.F. 
Published: November 2023

Background: Little is known about the specific risk of knee injuries due to trampoline accidents in adults compared with children. Purpose: To investigate the differences in trampoline-related knee injuries between children and adults and identify risk factors and protective strategies to reduce injury incidence. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Data on 229 consecutive patients treated for trampoline-related knee injuries in a single institution were prospectively collected, analyzed, and included. Risk factors, injury patterns, and clinical treatments were compared between skeletally immature and skeletally mature patients. Logistic regression was used to determine the odds ratios for specific risk factors for trampoline-related injuries—including body mass index (BMI), trauma mechanism, patient age, and accident location. Results: A total of 229 patients met the inclusion criteria; 118 (52%) patients (women, 54.2%; mean age, 8.5 ± 4.1 years) were skeletally immature at the time of injury, and 111 (48%) patients (women, 72%; mean age, 31.9 ± 13.1 years) had closed physes on initial presentation and were classified as skeletally mature. A total of 63 patients (28%) required surgical treatment for their knee injury. Overall, 50 anterior cruciate ligament (ACL) tears, 46 fractures, 39 meniscal tears, 31 ligamentous tears other than ACL, 22 patellar dislocations, and 38 soft tissue injuries, such as lacerations, were recorded. Skeletally mature patients had 7.8 times higher odds (95% CI, 1.6-46.8; P < .05) and 19.1 increased odds (95% CI, 5.5-74.9; P < .05) of an ACL tear or another ligamentous tear, respectively, compared with skeletally immature patients. Patients who described instability and giving way of the knee as relevant trauma mechanisms had odds of 3.11 (95% CI, 0.9-14.8; P < .05) of an ACL tear compared with other trauma mechanisms. Meniscal tears were observed more frequently in the skeletally mature cohort ( P < .05). An elevated BMI was associated with a significantly higher relative risk of an ACL tear, a ligamentous tear other than the ACL, and an injury requiring surgery. A third of surgically treated patients were subject to a delayed diagnosis. Conclusion: Adults had a significantly increased risk of ligamentous and meniscal tears and required operative intervention more often than skeletally immature individuals. Elevated BMI, age, and instability events in terms of trauma mechanism conveyed an increased risk of structural damage to the knee.
Breath–Body–Mind Core Techniques to Manage Medical Student Stress
Authors: Gerbarg Patricia L , Cruz-Cordero Yaidy L , Conte Vincent A , García Martha E , Braña Angel , Estape Estela S , Brown Richard P 
Published: November 2023

Objectives This pilot study evaluated the feasibility of a live, interactive, synchronous, online, manualized intervention, Breath–Body–Mind Introductory Course (BBM-IC), for medical students. BBM-IC includes breathing, movement, and attention-focus techniques for stress management and better emotion regulation, energy, sleep, and mental focus. Methods Medical students attending a 2-h BBM demonstration were invited to participate in the 12-h BBM-IC and weekly 45-min 6-week group practice. Measures were obtained using Survey Monkey: patient health questionnaire (PHQ9), generalized anxiety disorder-7 (GAD-7), exercise-induced feeling inventory (EFI), sleep quality scale (SQS), and body perception questionnaire-short form (BPQ-SF) at pre-BBM-IC (T1), post-BBM-IC (T2), and 6 weeks post (T3). Perceived stress scale (PSS) and meditation practices questionnaire (MPQ) were measured at baseline (T1) only. Results Twelve medical students participated in BBM-IC 4-h daily for 3 days. Six attended practice sessions and completed 6-week post-tests. Mean scores comparison identified two variable sets with significant improvements: EFI tranquility ( p < .005) and supradiaphragmatic reactivity ( p < .040). Two measures reached near significance: SQS ( p ≤ .060) and PHQ9 ( p ≤ .078). Conclusion This pilot study provided preliminary evidence that BBM-IC may reduce stress and anxiety symptoms while improving mood, energy, mental focus, and other correlates of psychophysiological state in medical students. Taking time for self-care is challenging for medical students, as reflected in the small study enrollment. Designating time for BBM as a requirement within the medical curriculum would probably enable more students to participate and acquire skills to reduce the effects of stress on their physical and psychological health, as well as the health of their patients.
The Use of Doppler to Assess Hemodynamic Alterations in Maternal Common Femoral Veins in Uncomplicated Pregnancies: A Cohort Study
Authors: Yasin Erah , Mehmood Ifra , Fatima Zareen , Liaqat Mahjabeen , Butt Sabar , Haider Zeshan 
Published: November 2023

Objective: Pregnancy can induce the slowing of blood flow in the lower extremity veins and associated complications such as varicose veins. The objective of this study was to report the hemodynamic alterations in uncomplicated pregnancies during second and third trimesters using spectral Doppler. The specific aim was to compare the venous diameter and mean flow velocities of maternal common femoral veins (CFVs) during second and third trimesters of pregnancy. This was designed to assess the extent of pregnancy-induced hemodynamic changes as well as to establish a normative range of these values. Materials and Methods: This cohort study was conducted with 230 women during second and third trimesters of pregnancy. Grayscale sonography and spectral Doppler were used to record the diameter and mean flow velocity of maternal CFVs bilaterally. An independent sample t test was performed for the comparison of these between women with second and third trimesters of pregnancy. Statistical significance was set a P ≤ .05, a priori. Results: There was significant dilatation and a corresponding decrease in mean blood flow velocities in the CFVs in the participants in their third trimester compared with the second trimester of pregnancy. Conclusion: In this large cohort of participants, the CFV demonstrated statistically significant distension and slowing of blood flow with the advancement of their pregnancies.
Long-term safety and efficacy of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis and at least oneF508delallele: 144-week interim results from a 192-week open-label extension study
Authors: Daines Cori L. , Tullis Elizabeth , Costa Stefano , Linnemann Rachel W. , Mall Marcus A. , McKone Edward F. , Polineni Deepika , Quon Bradley S. , Ringshausen Felix C. , Rowe Steven M. , Selvadurai Hiran , Taylor-Cousar Jennifer L. , Withers Nicholas J. , Ahluwalia Neil , Moskowitz Samuel M. , Prieto-Centurion Valentin , Tan Yaoyuan Vincent , Tian Simon , Weinstock Tanya , Xuan Fengjuan , Zhang Yaohua , Ramsey Bonnie , Griese Matthias 
Published: November 2023

BackgroundIn two pivotal phase 3 trials, up to 24 weeks of treatment with elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) was efficacious and safe in patients with cystic fibrosis (CF) ≥12 years of age who have at least oneF508delallele. The aim of this study is to assess long-term safety and efficacy of ELX/TEZ/IVA in these patients.MethodsIn this phase 3, open-label, single-arm extension study, participants withF508del–minimal function (from a 24-week parent study; n=399) orF508del–F508del(from a 4-week parent study; n=107) genotypes receive ELX/TEZ/IVA at the same dose (ELX 200 mg once daily, TEZ 100 mg once daily and IVA 150 mg every 12 h). The primary end-point is safety and tolerability. A prespecified interim analysis was conducted when the last participant reached the Week 144 visit.ResultsAt the Week 144 interim analysis, mean duration of exposure to ELX/TEZ/IVA in the extension study was 151.1 weeks. Exposure-adjusted rates of adverse events (AEs) (586.6 events per 100 participant-years) and serious AEs (22.4 events per 100 participant-years) were lower than in the ELX/TEZ/IVA treatment group in the 24-week parent study (1096.0 and 36.9 events per 100 participant-years, respectively); most participants had AEs classified as mild (16.4% of participants) or moderate (60.3% of participants) in severity. 14 participants (2.8%) had AEs that led to treatment discontinuation. Following initiation of ELX/TEZ/IVA, participants had increases in forced expiratory volume in 1 s (FEV1) percentage predicted, Cystic Fibrosis Questionnaire-Revised respiratory domain score and body mass index, and had decreases in sweat chloride concentration and pulmonary exacerbation rates that were maintained over the interim analysis period. The mean annualised rate of change in FEV1% pred was +0.07 (95% CI −0.12–0.26) percentage points among the participants.ConclusionsELX/TEZ/IVA was generally safe and well tolerated, with a safety profile consistent with the 24-week parent study. Participants had sustained improvements in lung function, respiratory symptoms, CF transmembrane conductance regulator function, pulmonary exacerbation rates and nutritional status. These results support the favourable safety profile and durable, disease-modifying clinical benefits of ELX/TEZ/IVA.
Management of tracheobronchial amyloidosis: a review of the literature
Authors: Smesseim Illaa , Cobussen Paul , Thakrar Ricky , Daniels Hans 
Published: November 2023

IntroductionTracheobronchial amyloidosis is a rare idiopathic disorder characterised by extracellular deposition of misfolded protein fibrils in the tracheobronchial tree. It presents with nonspecific symptoms. Deciding on the best treatment approach can be challenging due to the lack of a treatment guideline. We undertook a review to assess the therapeutic options for tracheobronchial amyloidosis and to highlight gaps within the existing evidence.MethodsWe performed a literature search from 1 January 1990 until 1 March 2022 to identify relevant literature regarding patient characteristics, symptoms, management and prognosis for patients with tracheobronchial amyloidosis.Results77 studies consisting of 300 patients were included. We found a great heterogeneity in the management of tracheobronchial amyloidosis patients. Although a fifth of the reported patients were managed with a wait-and-see approach, many different treatments were used as a single intervention, or multiple treatments were combined. An interesting finding is the slightly higher percentage of patients with Sjögren syndrome (n=5, 1.7%) and tracheobronchial amyloidosis compared to the normal population (0.5–1.0%).ConclusionsThere is a great heterogeneity in the management of tracheobronchial amyloidosis patients. The treatment is still based on expert opinion due to the lack of a treatment guideline. Various treatment approaches include a wait-and-see approach, external beam radiotherapy, therapeutic bronchoscopy, immunosuppressive treatment and surgery.
Clinical effects of different center of rotation reconstructions in total hip arthroplasty after femoral neck fractures: a cohort study including a follow-up analysis on patient’s mobility and daily living ability
Authors: Nieschk Christopher , Abelmann-Brockmann Johanna , Lisitano Leonard , Fenwick Annabel , Röttinger Heinz , Ecker Michael , Mayr Edgar , Röttinger Timon 
Published: November 2023

Abstract
Background
The aim of this study is a clinical evaluation of the center of rotation (COR) placement towards a patient’s recovery with respect to daily living ability and mobility. In past experiments based on three-dimensional (3D) models, medialization of the COR in total hip arthroplasty (THA) showed a negative influence on muscle strength of the abductors and reaction force of the hip joint. This contradicts paradigms, where reduced hip loading forces are claimed to increase functional outcomes.

Methods
The plain X-rays of 110 patients who underwent THA after a femoral neck fracture between January 2019 and January 2021 were retrospectively evaluated. A Barthel Index on discharge was obtained in 69 cases. 47 patients were available for a follow-up interview concerning the Barthel Index, Parker mobility score (PMS), and pain levels (NRS) 6 and 12 months after surgery.

Results
Medialization of the COR had a significantly negative effect on the need for care (Barthel Index) at patient discharge (Spearman correlation 0.357, p = 0.013). The effect on the PMS is still existent at 6 and 12 months (Spearman correlation 0.471, p = 0.009 at 6 months; 0.472, p = 0.008 at 12 months). Mann–Whitney U tests showed that the groups with medialized COR performed significantly worse than the lateralized groups. This was seen for the Barthel Index at discharge and at 6 months after surgery and for the PMS at 6 and 12 months. The accurately reconstructed CORs showed no significant differences from the lateralized rotation centers in need of care and mobility.
The superior COR placement group showed significantly reduced mobility at 12 months in contrast to the inferior COR placement group (p = 0.008), and the group of accurately reconstructed rotation centers showed significantly less pain than the inferior COR placement group (p = 0.007 after 6 months, p = 0.026 after 12 months). Especially the combination of both (superomedialization) leads to reduced mobility (Spearman correlation 0.67, p =  < 0.001).

Conclusions
COR superior displacement, COR medialization, and the combination of both (superomedialization, Spearman p =  < 0.001) lead to reduced mobility while inferior displacement showed increased pain. According to our results, we recommend an exact vertical COR restoration, while horizontal medial displacement needs to be avoided.

Level of evidence

III.
Regulation of hormone pathways in wheat infested by Blumeria graminis f. sp. tritici
Authors: Bai Shuangyu , Long Jiaohui , Cui Yuanyuan , Wang Zhaoyi , Liu Caixia , Liu Fenglou , Wang Zhangjun , Li Qingfeng 
Published: November 2023

AbstractBackgroundWheat powdery mildew is an obligate biotrophic pathogen infecting wheat, which can pose a serious threat to wheat production. In this study, transcriptome sequencing was carried out on wheat leaves infected byBlumeria graminisf. sp.triticifrom 0 h to 7 d.ResultsKEGG and GO enrichment analysis revealed that the upstream biosynthetic pathways and downstream signal transduction pathways of salicylic acid, jasmonic acid, and ethylene were highly enriched at all infection periods. Trend analysis showed that the expressions of hormone-related genes were significantly expressed from 1 to 4 d, suggesting that 1 d-4 d is the main period in which hormones play a defensive role. During this period of time, the salicylic acid pathway was up-regulated, while the jasmonic acid and ethylene pathways were suppressed. Meanwhile, four key modules and 11 hub genes were identified, most of which were hormone related.ConclusionThis study improves the understanding of the dynamical responses of wheat toBlumeria graminisf. sp.triticiinfestation at the transcriptional level and provides a reference for screening core genes regulated by hormones.
Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi
Authors: Filisa-Kaphamtengo Florence , Ngoma Jonathan , Mukhula Victoria , Matemvu Zaithwa , Kapute Deborah , Banda Peter , Phiri Tamara , Mipando Mwapatsa , Hosseinipour Mina C. , Katundu Kondwani G. H. 
Published: November 2023

Abstract
Background
Dyslipidaemia among individuals with diabetes is a significant modifiable risk factor for atherosclerotic cardiovascular diseases (ASCVDs). ASCVDs are a major cause of mortality and morbidity globally, especially in people with diabetes. In Malawi, limited data exist on the prevalence and biochemical characteristics of diabetic dyslipidaemia. This study investigated the prevalence and biochemical characteristics of dyslipidaemia in individuals attending the diabetes clinic at Kamuzu Central Hospital, the largest tertiary referral hospital in Central Malawi.

Methods
Using a cross-sectional design, sociodemographic, medical and anthropometric data were collected from 391 adult participants who were enrolled in the study. Blood samples were analysed for glycosylated haemoglobin (HBA1c) and fasting lipid profiles. The prevalence of dyslipidaemia was calculated, and the biochemical characteristics of the dyslipidaemia were defined. The associations between dyslipidaemia and risk factors such as sociodemographic characteristics, obesity, and HBA1c levels were evaluated using logistic regression analysis.

Results
Prevalence of dyslipidaemia was observed in 71% of the participants, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality among the study participants. None of the participants were receiving any lipid-lowering therapy. On bivariate analysis, dyslipidemia was positively associated with female sex [OR 1.65 (95% CI 1.05- 2.58); p = 0.09], age ≥ 30 years [OR 3.60 (95% CI 1.17-7.68); p = 0.001] and overweight and obesity [OR 2.11 (95% CI 1.33-3.34); p = 0.002]. On multivariate analysis, being overweight or obese was an independent predictor of dyslipidaemia [AOR 1.8;(95% CI 1.15- 3.37); p = 0.04].

Conclusion
Dyslipidaemia was highly prevalent among individuals with diabetes in this study, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality. Overweight and obesity were also highly prevalent and positively predicted dyslipidaemia. This study highlights the importance of appropriately addressing dyslipidaemia, overweight and obesity among individuals with diabetes in Malawi and other similar settings in Africa as one of the significant ways of reducing the risk of ASCVDs among this population.
Leptospirosis-associated meningitis in a patient with sjögren’s syndrome: a case report
Authors: Zhang Yifan , Zheng Yong 
Published: November 2023

Abstract
Background
Leptospirosis is a zoonotic disease that afflicts both humans and animals. It progresses from flu-like symptoms to more severe hepatic and renal failure, and may also lead to aseptic meningitis. Individuals with autoimmune diseases (ADs) are potentially more susceptible to Leptospirosis. Thus far, limited data has documented the association between Leptospirosis and autoimmune disorders.

Case presentation
The patient had a definitive pathological diagnosis of Sjögren’s syndrome (SS). Due to recurrent headaches, the patient sought consultation with a neurologist. Lumbar puncture revealed elevated white blood cells and protein levels in the cerebrospinal fluid, along with decreased glucose. Tuberculous meningitis was suspected. Radiographic imaging exhibited meningeal enhancement, ventricular enlargement, and hydrocephalus. The patient commenced treatment with anti-tuberculosis therapy and corticosteroids. Subsequently, high-throughput sequencing (HTS) of cerebrospinal fluid identified the presence of Leptospira interrogans. The patient was ultimately diagnosed with Leptospiral meningitis, and underwent antimicrobial and immunosuppressive therapy, resulting in stabilization of the condition and gradual symptom recovery.

Conclusions
The case highlights the challenges in diagnosing and managing leptospirosis-related meningitis in the presence of ADs and emphasizes the importance of utilizing HTS for accurate pathogen detection. The potential correlation between leptospirosis and SS warrants further investigation, as does the need for multidisciplinary involvement in treatment strategies for such complex cases.
A phase I study of the combination of atezolizumab, tiragolumab, and stereotactic body radiation therapy in patients with metastatic multiorgan cancer
Authors: Roussot Nicolas , Fumet Jean-David , Limagne Emeric , Thibaudin Marion , Hervieu Alice , Hennequin Audrey , Zanetta Sylvie , Dalens Lorraine , Fourrier Théo , Galland Loick , Jacob Pierre , Bertaut Aurélie , Rederstorff Emilie , Chevalier Cédric , Ghirardi Sarah , Gilbert Elodie , Khoukaz Azzat , Martin Etienne , Nicolet Constance , Quivrin Magali , Thibouw David , Vulquin Noémie , Truc Gilles , Rouffiac Magali , Ghiringhelli Francois , Mirjolet Céline 
Published: November 2023

Abstract
Background
Immunotherapy targeting the PD-1/PD-L1 pathway is a standard of care in a number of metastatic malignancies, but less than a fifth of patients are expected to respond to ICIs (Immune Checkpoint Inhibitors). In a clinical trial, combining the anti-TIGIT (T cell immunoreceptor with Ig and ITIM domains) Mab (monoclonal antibody) tiragolumab with atezolizumab improved outcomes in non-small cell lung cancer. In preclinical models, SBRT (Stereotactic Body Radiation Therapy) could increase expression levels of the inhibitory co-receptors TIGIT and PD-L1. We aim to assess the combination of tiragolumab with atezolizumab and SBRT in metastatic, previously treated by ICIs, non-small cell lung cancer, head and neck cancer, bladder cancer, and renal cell cancer.

Methods
This phase I study (ClinicalTrials.gov NCT05259319) will assess the efficacy and safety of the combination of atezolizumab with tiragolumab and stereotactic body radiation therapy in patients with histologically proven metastatic non-small cell lung cancer, renal cell cancer, bladder cancer, and head and neck cancer previously treated. First part: 2 different schedules of SBRT in association with a fixed dose of atezolizumab and tiragolumab will be investigated only with metastatic non-small cell lung cancer patients (cohort 1). The expansion cohorts phase will be a multicentric, open-label study at the recommended scheme of administration and enroll additional patients with metastatic bladder cancer, renal cell cancer, and head and neck cancer (cohort 2, 3 and 4). Patients will be treated until disease progression, unacceptable toxicity, intercurrent conditions that preclude continuation of treatment, or patient refusal in the absence of progression or intolerance. The primary endpoint of the first phase is the safety of the combination in a sequential or concomitant scheme and to determine the expansion cohorts phase recommended scheme of administration. The primary endpoint of phase II is to evaluate the efficacy of tiragolumab + atezolizumab + SBRT in terms of 6-month PFS (Progression-Free Survival). Ancillary analyses will be performed with peripheral and intratumoral immune biomarker assessments.

Trial registration
This study is registered on ClinicalTrials.gov: NCT05259319, since February 28th, 2022.