bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Fate of Delayed Unions After Isolated Ankle Fusion
Authors: Lause Gregory E. , Parker Emily B. , Stupay Kristen L. , Chiodo Christopher P. , Bluman Eric M. , Martin Elizabeth A. , Miller Christopher P. , Smith Jeremy T. 
Published: June 2023

Background: Nonunion remains the most common major complication of ankle arthrodesis. Although previous studies have reported delayed union or nonunion rates, few have elaborated on the clinical course of patients experiencing delayed union. In this retrospective cohort study, we sought to understand the trajectory of patients with delayed union by determining the rate of clinical success and failure and whether the extent of fusion on computed tomography scan (CT) was associated with outcomes. Methods: Delayed union was defined as incomplete (<75%) fusion on CT between 2 and 6 months postoperatively. Thirty-six patients met the inclusion criterion: isolated tibiotalar arthrodesis with delayed union. Patient-reported outcomes were obtained including patient satisfaction with their fusion. Success was defined as patients who were not revised and reported satisfaction. Failure was defined as patients who required revision or reported being not satisfied. Fusion was assessed by measuring the percentage of osseous bridging across the joint on CT. The extent of fusion was categorized as absent (0%-24%), minimal (25%-49%), or moderate (50%-74%). Results: We determined the clinical outcome of 28 (78%) patients with mean follow-up of 5.6 years (range, 1.3-10.2). The majority (71%) of patients failed. On average, CT scans were obtained 4 months after attempted ankle fusion. Patients with minimal or moderate fusion were more likely to succeed clinically than those with “absent” fusion ( P = .040). Of those with absent fusion, 11 of 12 (92%) failed. In patients with minimal or moderate fusion, 9 of 16 (56%) failed. Conclusion: We found that 71% of patients with a delayed union at roughly 4 months after ankle fusion required revision or were not satisfied. Patients with less than 25% fusion on CT had an even lower rate of clinical success. These findings may help surgeons in counseling and managing patients experiencing a delayed union after ankle fusion. Level of Evidence: Level IV, retrospective cohort study.
Peripapillary vessel density in healthy people, primary open-angle glaucoma, and normal-tension glaucoma
Authors: Arish Mohammad , Momeni-Moghaddam Hamed , Alborzi Moniba , Maleki Alireza , Daneshvar Ramin , Heidari Hamid-Reza 
Published: June 2023

ObjectiveTo compare peripapillary vessel density using optical coherence tomography angiography (OCT-A) in eyes of healthy people, primary open-angle glaucoma (POAG), and normal-tension glaucoma (NTG).MethodsThirty patients with POAG, 27 patients with NTG, and 29 healthy individuals in the control group were assessed. Capillary vessels in peripapillary retinal nerve fiber layer (RNFL) represented by whole image RPC (radial peripapillary capillary) density in an AngioDisc scan 4.5 × 4.5 mm centered on the optic disc, and ONH morphological variables (disc area, rim area, cup to disc area ratio (CDR)), and average peripapillary RNFL thickness were measured.ResultsDifferences in mean RPC, RNFL, disc area, rim area, and CDR between the groups were statistically significant (P < 0.05). The difference in RNFL thickness and rim area was not significant between NTG and healthy groups, while RPC and CDR showed a statistically significant difference between all pairs. The vessel density in the POAG group was 8.25% and 11.7% lower compared to the NTG and healthy groups, respectively; while the mean difference was less (2.97%) for the NTG and healthy group. In the POAG group, 67.2% of the variation in RPC can be explained by a model containing CDR and RNFL thickness, and in normal eyes 38.8% of the changes using a model containing RNFL.ConclusionThe peripapillary vessel density is reduced in both types of glaucoma. The vessel density in NTG was significantly lower than in the healthy eyes, despite the lack of significant difference in RNFL thickness and neuroretinal rim area between them.
Voices from a pandemic: Understanding how young adults on the autism spectrum use computer-mediated communication
Authors: Ritzman Mitzi J , Subramanian Roma 
Published: June 2023

This study investigated the benefits and challenges of computer-mediated communication use among a sample of young adults who identify with the autism spectrum via semistructured interviews. The interviews revealed that participants enjoyed using computer-mediated communication technologies (e.g. Discord, Facebook, Steam, and Zoom) to fulfill various social gratifications, as found in previous research. They appreciated that computer-mediated communication supports neurodiversity in social communication by altering the communication environment in various ways, such as the inclusion of asynchronous options and decreased sensory input. However, it is noteworthy that several mentioned that computer-mediated communication could not replace in-person interaction because it makes deep social connection difficult. Participants also discussed negative attributes of computer-mediated communication such as promoting social comparison and instant gratification. The findings are inherently valuable to learning more about young adults’ use of technology for social communication. In addition, they provide insight into how to integrate technology into the design of interventions to support the development of social connections among individuals who identify with autism. Lay abstract This study investigated the benefits and challenges of online communication use among a sample of young adults who identify on the autism spectrum via semi-structured interviews. The interviews revealed that participants enjoyed using online forms of communication for social purposes. Participants appreciated how this type of communication changes the social environment in ways that support neurodiversity, such as the static nature of the communication context and decreased sensory input. However, some participants noted that online communication could not replace inperson interaction because it makes deep social connection difficult. Participants also discussed negative attributes of online communication such as promoting social comparison and instant gratification. The findings are inherently valuable to learning more about young adults’ use of technology for social communication. In addition, this information may provide insight into how to integrate technology into the design of interventions to support the development of social connections among individuals who identify on the autism spectrum.
Chocolate Touch Versus Lutonix Drug-Coated Balloon for Femoropopliteal Lesions in Diabetes: The Chocolate Touch Study
Authors: Böhme Tanja , Zeller Thomas , Shishehbor Mehdi H. , Werner Martin , Brodmann Marianne , Parise Helen , Holden Andrew , Lichtenberg Michael , Parikh Sahil A. , Kashyap Vikram S. , Pietras Cody , Tirziu Daniela , Beschorner Ulrich , Krishnan Prakash , Niazi Khusrow A. , Wali Andreas U. , Lansky Alexandra J. 
Published: June 2023

Background: The randomized Chocolate Touch Study demonstrated that in patients undergoing treatment of femoropopliteal artery lesions, the Chocolate Touch drug-coated balloon (DCB) was safe and had superior efficacy at 12 months compared with the Lutonix DCB. We report the prespecified diabetes subanalysis comparing outcomes among patients with and without diabetes mellitus (DM). Methods: Patients with claudication or ischemic rest pain (Rutherford class 2–4) were randomized to Chocolate Touch or Lutonix DCB. The primary efficacy endpoint was DCB success defined as primary patency at 12 months (peak systolic velocity ratio <2.4 by duplex ultrasound without clinically driven target lesion revascularization in the absence of bailout stenting). The primary safety endpoint was freedom from major adverse events at 12 months, a composite of target limb-related death, major amputation, or reintervention. Results: A total of 313 patients (38% DM [n=119]) were randomized to either Chocolate Touch (n=66/152) or Lutonix DCB (n=53/161). Among patients with DM, DCB success was 77.2% and 60.5% (p=0.08), and in non-DM patients, DCB success was 80% and 71.3% (p=0.2114) for the Chocolate Touch and Lutonix DCB, respectively. The primary safety endpoint was similar for both cohorts regardless of DM status (interaction test, p=0.96). Conclusions: This randomized trial demonstrated similar safety and efficacy for the treatment of femoropopliteal disease with the Chocolate Touch DCB compared with using the Lutonix DCB regardless of DM status at 12 months. Clinical Impact This substudy of the Chocolate Touch Study demonstrated similar safety and efficacy for treatment of femoropopliteal disease of the Chocolate Touch DCB compared with the Lutonix DCB regardless of diabetes (DM) status at 12 months. Endovascular therapy has become the therapy of choice for the treatment of most symptomatic femoropopliteal lesions regardless of DM status. These results give clinicians another option when treating femoropopliteal disease in this high-risk patient population.
Sub-anaesthetic dose of propofol attenuates mechanical allodynia in chronic post-ischaemic pain via regulation of PTEN/PI3K/IL-6 signalling
Authors: Leung Siu Yi Doreen , Meng Fei , Liu Jingjing , Liu Aijia Jessica , Ng Hei Lui Lhotse , Cheung Chi Wai , Sau Ching Wong Stanley 
Published: June 2023

Background: Propofol is an intravenous anaesthetic drug that has been shown to reduce inflammatory pain. Complex regional pain syndrome (CRPS) type I is a pain condition characterized by autonomic, motor and sensory disturbance. The chronic post-ischaemic pain (CPIP) model is a well-established model to recapture CRPS-I syndromes pre-clinically by non-invasive ischaemic-reperfusion (IR) injury. In this study, we investigated the analgesic effects of propofol and underlying mechanisms in mitigating CRPS pain using the CPIP model. Methods: Sub-anaesthetic dose of propofol (25 mg/kg) was intravenously delivered to the CPIP model and sham control. Nociceptive behavioural changes were assayed by the von Frey test. Molecular assays were used to investigate expression changes of PTEN, PI3K, AKT and IL-6 underlying propofol-mediated analgesic effects. Pharmacological inhibition was applied for PTEN/PI3K/AKT pathway manipulation. Results: Both pre- and post-operative administration of propofol attenuated mechanical allodynia induced by CPIP. Propofol could modulate PTEN/PI3K/AKT signalling pathway by increasing active PTEN and reducing phosphorylated PI3K, phosphorylated AKT and IL-6 expression in the spinal dorsal horn, which promoted pain relief in the CPIP model. Inhibition of PTEN with bpV abolished the analgesic effects produced by propofol in CPIP mice. Conclusion: Sub-anaesthetic dose of propofol administration resulted in the activation of PTEN, inhibition of both PI3K/AKT signalling and IL-6 production in the spinal cord, which dramatically reduced CPIP-induced pain. Our findings lay the foundation in using propofol for the treatment of CRPS with great therapeutic implications.
The importance of trusting conditions for organizations’ readiness to implement mHealth to support healthy lifestyle behaviors: An interview study within Swedish child and school healthcare
Authors: Fagerström Maria , Löf Marie , Müssener Ulrika , Thomas Kristin 
Published: June 2023

Objective To explore perceptions among nurses, managers, and policymakers regarding organizational readiness to implement mHealth for the promotion of healthy lifestyle behaviors in child and school healthcare. Methods Individual semi-structured interviews with nurses ( n = 10), managers ( n = 10), and policymakers ( n = 8) within child and school healthcare in Sweden. Inductive content analysis was used for data analysis. Results Data showed that various trust-building aspects in health care organizations may contribute to readiness to implement mHealth. Several aspects were perceived to contribute trusting conditions: (a) how health-related data could be stored and managed; (b) how mHealth aligned with current organizational ways of working; (c) how implementation of mHealth was governed; and (d) camaraderie within a healthcare team to facilitate use of mHealth in practice. Poor capability to manage health-related data, as well as lack of governance of mHealth implementation were described as dealbreakers for readiness to implement mHealth in healthcare organizations. Conclusions Healthcare professionals and policymakers perceived that trusting conditions for mHealth implementation within organizations were central for readiness. Specifically, governance of mHealth implementation and the ability to manage health-data produced by mHealth were perceived critical for readiness.
Enhancing Diabetes Health Outcomes Among Haitian Migrants Living in Dominican Bateyes
Authors: Molina Rosalia , Enriquez Maithe 
Published: June 2023

Purpose The purpose of this study was to better understand the factors that influence the ability of batey adults to self-manage their type 2 diabetes mellitus (T2DM). Methods A qualitative descriptive approach was used to conduct in-depth, individual interviews in Spanish. Participants (n = 12) were health care workers and members of a nongovernmental organization (NGO) that provides direct diabetes care to batey residents via free, pop-up, mobile medical clinics. Conventional content analysis was used to identify categories and common themes in the data. Results Participants described daily existence in the bateyes as a constant “scarcity of resources.” Additionally, four themes and one subtheme emerged that participants felt impacted diabetes health outcomes and the ability of NGO health care workers to provide diabetes care. Conclusions NGO members, while committed to serve and improve health outcomes for the batey population, often felt overwhelmed. Findings from this qualitative descriptive study may be used to inform novel interventions, which are needed, to enhance the diabetes outcomes of the batey residents who are living with T2DM. In addition, strategies are needed to build diabetes care infrastructure in the batey community.
Enkurin: a novel marker for myeloproliferative neoplasms from platelet, megakaryocyte, and whole blood specimens
Authors: Seetharam Sumanth Mosale , Liu Yi , Wu Jason , Fechter Lenn , Murugesan Kanagavel , Maecker Holden , Gotlib Jason , Zehnder James , Paulmurugan Ramasamy , Krishnan Anandi 
Published: June 2023

AbstractImpaired protein homeostasis, though well established in age-related disorders, has been recently linked with the pathogenesis of myeloproliferative neoplasms (MPNs). However, little is known about MPN-specific modulators of proteostasis, thus impeding our ability for increased mechanistic understanding and discovery of additional therapeutic targets. Loss of proteostasis, in itself, is traced to dysregulated mechanisms in protein folding and intracellular calcium signaling at the endoplasmic reticulum (ER). Here, using ex vivo and in vitro systems (including CD34+ cultures from patient bone marrow and healthy cord/peripheral blood specimens), we extend our prior data from platelet RNA sequencing in patients with MPN and discover select proteostasis-associated markers at RNA and/or protein levels in each of platelet, parent megakaryocyte, and whole blood specimens. Importantly, we identify a novel role in MPNs for enkurin (ENKUR), a calcium mediator protein originally implicated only in spermatogenesis. Our data reveal consistent ENKUR downregulation at both RNA and protein levels across specimens from patients with MPN and experimental models (including upon treatment with thapsigargin, an agent that causes protein misfolding in the ER by selective loss of calcium), with a concomitant upregulation of a cell cycle marker, CDC20. Silencing of ENKUR using short hairpin RNA in CD34+–derived megakaryocytes further confirms this association with CDC20 at both RNA and protein levels and indicates a likely role for the PI3K/Akt pathway. Together, our work sheds light on enkurin as a novel marker of MPN pathogenesis and indicates further mechanistic investigation into a role for dysregulated calcium homeostasis and ER and protein folding stress in MPN transformation.
Activated protein C modulates T-cell metabolism and epigenetic FOXP3 induction via α-ketoglutarate
Authors: Gupta Dheerendra , Elwakiel Ahmed , Ranjan Satish , Pandey Manish Kumar , Krishnan Shruthi , Ambreen Saira , Henschler Reinhard , Rana Rajiv , Keller Maria , Ceglarek Uta , Shahzad Khurrum , Kohli Shrey , Isermann Berend 
Published: June 2023

Abstract
A direct regulation of adaptive immunity by the coagulation protease activated protein C (aPC) has recently been established. Preincubation of T cells with aPC for 1 hour before transplantation increases FOXP3+ regulatory T cells (Tregs) and reduces acute graft-versus-host disease (aGVHD) in mice, but the underlying mechanism remains unknown. Because cellular metabolism modulates epigenetic gene regulation and plasticity in T cells, we hypothesized that aPC promotes FOXP3+ expression by altering T-cell metabolism. To this end, T-cell differentiation was assessed in vitro using mixed lymphocyte reaction or plate-bound α-CD3/CD28 stimulation, and ex vivo using T cells isolated from mice with aGVHD without and with aPC preincubation, or analyses of mice with high plasma aPC levels. In stimulated CD4+CD25− cells, aPC induces FOXP3 expression while reducing expression of T helper type 1 cell markers. Increased FOXP3 expression is associated with altered epigenetic markers (reduced 5-methylcytosine and H3K27me3) and reduced Foxp3 promoter methylation and activity. These changes are linked to metabolic quiescence, decreased glucose and glutamine uptake, decreased mitochondrial metabolism (reduced tricarboxylic acid metabolites and mitochondrial membrane potential), and decreased intracellular glutamine and α-ketoglutarate levels. In mice with high aPC plasma levels, T-cell subpopulations in the thymus are not altered, reflecting normal T-cell development, whereas FOXP3 expression in splenic T cells is reduced. Glutamine and α-ketoglutarate substitution reverse aPC-mediated FOXP3+ induction and abolish aPC-mediated suppression of allogeneic T-cell stimulation. These findings show that aPC modulates cellular metabolism in T cells, reducing glutamine and α-ketoglutarate levels, which results in altered epigenetic markers, Foxp3 promoter demethylation and induction of FOXP3 expression, thus favoring a Treg-like phenotype.
Theranostic RGD@Fe3O4-Au/Gd NPs for the targeted radiotherapy and MR imaging of breast cancer
Authors: Amraee Azadeh , Alamzadeh Zahra , Irajirad Rasoul , Sarikhani Abolfazl , Ghaznavi Habib , Ghadiri Harvani Hossein , Mahdavi Seied Rabi , Shirvalilou Sakine , Khoei Samideh 
Published: June 2023

Abstract
Background
As a radiosensitizing agent in magnetic resonance imaging (MRI), gadolinium is disadvantageous in that it confers a rather high toxicity and low longitudinal comfort time (r1). We hypothesized that gadolinium when combined with gold-coated iron oxide nanoparticles (NPs), might deliver better radiosensitization in MRI-based cancer theranostics. After being synthesized ligand/receptor RGD@Fe3O4-Au/Gd nanoparticles, they were characterized via some methods, such as visible–ultraviolet spectroscopy (UV–VIS), Fourier transform infrared spectroscopy (FTIR), dynamic light scattering (DLS), and transmission electron microscope (TEM). Using relaxometry, the parameters of contrast change in T1-weighted MRI and the rate of radiation sensitivity on cancerous (MCF-7, SK-BR-3 and MDA-MB-231 (and reference (MCF-10a) breast cell lines were investigated.

Results
The presence of ultra-small iron oxide, gold, gadolinium, and RGD peptide as components of the RGD@Fe3O4-Au/Gd nanocomplex was confirmed by UV–visible, FTIR, EDX and XRD tests. With a size ranging from 4.124 nm (DLS) to 15 nm (TEM), these NPs exhibited a surface charge of –45.7 mV and a magnetic saturation of 3 emu/g. The concentrations of iron, gadolinium and gold samples in the nanocomplex were 1000, 1171 and 400 parts per million (ppm), respectively. In the relaxometry test, the rates of r2/r1 and r1 NPs were 1.56 and 23.5 mM−1 s−1. The dose increase factor for targeted (RGD@Fe3O4-Au/Gd) and non-targeted (Fe3O4-Au/Gd) NPs at 6 MV and 2 Gy was 89.1 and 59.1, respectively.

Conclusion
Owing to an enhanced signal-to-noise ratio (SNR), as confirmed by the MRI of RGD receptor-expressing MDA-MB-231 cells, RGD@Fe3O4-Au/Gd NPs were found to confer higher radiosensitization and an overall better performance as a novel radiosensitizer for MRI-based breast cancer theranostics than Fe3O4-Au/Gd nanocomplex.

Graphical Abstract
Disease burden of tuberculosis and post-tuberculosis in Inner Mongolia, China, 2016–2018 — based on the disease burden of post-TB caused by COPD
Authors: Jing Caimei , Zheng Huiqiu , Wang Xuemei , Wang Yanling , Zhao Yifan , Liu Sijia , Zhao Jing , Du Qianqian 
Published: June 2023

Abstract
Background
Tuberculosis (TB) remains one of the most serious infectious diseases worldwide. China has the second highest TB burden globally, but existing studies have mostly neglected the post-tuberculosis (post-TB) disease burden. This study estimated the disease burden of TB and post-TB in Inner Mongolia, China, from 2016 to 2018.

Methods
Population data were collected from TB Information Management System. Post-TB disease burden was defined as the burden caused by Chronic Obstructive Pulmonary Disease (COPD) occurring after patients with TB were cured. To estimate the incidence rate of TB, standardized mortality rate, life expectancy, and cause eliminated life expectancy, using descriptive epidemiological, abridged life table and cause eliminated life table. On this basis, the Disability-Adjusted Life Years (DALY), Years Lived with Disability (YLD) and Years of Life Lost (YLL) due to TB were further be estimated. The data were analyzed using Excel 2016 and SPSS 26.0. Joinpoint regression models were used to estimate the time and age trends of the disease burden of TB and post-TB.

Results
The TB incidence in 2016, 2017, and 2018 was 41.65, 44.30, and 55.63/100,000, respectively. The standardized mortality in the same period was 0.58, 0.65, and 1.08/100,000, respectively. From 2016 to 2018, the total DALYs of TB and post-TB were 5923.33, 6258.03, and 8194.38 person-years, and the DALYs of post-TB from 2016 to 2018 were 1555.89, 1663.33, and 2042.43 person-years. Joinpoint regression showed that the DALYs rate increased yearly from 2016 to 2018, and the rate of males was higher than that of females. TB and post-TB DALYs rates showed a rising tendency with increasing age (AAPC values were 149.6% and 157.0%, respectively, P < 0.05), which was higher in the working-age population and elderly.

Conclusion
The disease burden of TB and post-TB was heavy and increased year by year in Inner Mongolia from 2016 to 2018. Compared with the youngster and females, working-age population and the elderly and males had a higher disease burden. Policymakers should be paid more attention to the patients’ sustained lung injury after TB cured. There is a pressing need to identify more effective measures for reducing the burden of TB and post-TB of people, to improve their health and well-being.