bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of electrophysical agents in fibromyalgia: A systematic review and network meta-analysis
Authors: Gikaro John Marwa , Bigambo Francis Manyori , Minde Victor Mark , Swai Elia Asanterabi 
Published: April 2023

Objective To examine the effectiveness of electrophysical agents in fibromyalgia. Data sources CINAHL, Cochrane Library, Embase, Medline, PEDro, and Web of Science were searched from their inceptions to March 27, 2023. Methods This study was registered in PROSPERO (CRD42022354326). Methodological quality of included trials was assessed using PEDro scale, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. The primary outcomes were pain, functional status, and mood. Results Fifty-four studies involving 3045 patients with fibromyalgia were eligible for qualitative synthesis and 47 (pain), 31 (functional status), and 26 (mood) for network meta-analysis. The network consistency model revealed that, when compared with true control, transcutaneous electrical nerve stimulation and microcurrent improved pain symptoms ( P = 0.006 and P = 0.037, respectively); repetitive transcranial magnetic stimulation improved patient functional status ( P = 0.018); and microcurrent ( P = 0.001), repetitive transcranial magnetic stimulation ( P = 0.022), and no treatment ( P = 0.038) significantly improved mood after intervention. Surface under the cumulative ranking indicated that microcurrent was most likely to be the best for managing pain and mood (surface under the cumulative ranking: 70% and 100%, respectively); low-level laser therapy for pain and mood (80% and 70%, respectively); and repetitive transcranial magnetic stimulation for improving functional status and mood (80% and 70%, respectively). Conclusion This review found low to moderate quality evidence that microcurrent, laser therapy, and repetitive transcranial magnetic stimulation are the most effective electrophysical agents for improving at least one outcome in fibromyalgia.
Appreciating the experience of multiple sclerosis fatigue
Authors: Van Denend Toni , Gecht-Silver Maureen , Kish Jacqueline , Plow Matthew , Preissner Katharine 
Published: April 2023

Introduction: Fatigue is one of the most common symptoms experienced by people with multiple sclerosis (MS) and can have a significant negative impact on participation in valued roles and activities. Understanding and supporting the management of MS fatigue is a priority to promote participation in life roles. This study explored how participants with MS who were enrolled in a fatigue management randomized clinical trial describe and explain their fatigue experience using a secondary qualitative analysis of interventionists’ treatment notes. Method: Clinical documentation including the subjective and objective portions of 85 treatment notes were collected and analyzed using a qualitative research design with multiphase coding. Results: Four major themes were identified including Fatigue Nature, Struggle, and Responding to the Reality of Fatigue with an overarching identified theme of Impact on Participation. Under the major themes, subthemes (11 total) were also identified and provided nuanced detail into each theme. Conclusion: People with MS fatigue describe their experience in a variety of ways. Findings will support occupational therapy practitioners to enhance empathy, understanding, and collaboration when working with clients with MS fatigue.
DNA methyltransferase expression (DNMT1, DNMT3a and DNMT3b) as a potential biomarker for anti-VEGF diabetic macular edema response
Authors: Camacho Pedro , Ribeiro Edna , Pereira Bruno , Varandas Teresa , Nascimento João , Henriques José , Dutra-Medeiros Marco , Delgadinho Mariana , Oliveira Ketlyn , Silva Carina , Brito Miguel 
Published: April 2023

Purpose DNA methylation is involved in Diabetic Retinopathy progression showing a metabolic memory mechanism. However, the association of DNA methyltransferase with diabetic macular edema is still unknown. We aimed to describe the differences in DNA methyltransferase gene expression in patients with different diabetic macular edema responses. Methods A total of 27 diabetic patients, aged 59–90 years, were prospectively enrolled in this cross-sectional study. The participants were classified into control group (CG, n = 11), diabetic macular edema responders (rDME, n = 9) and non-responder diabetic macular edema (nrDME, n = 7) after anti-vascular endothelial growth factor (anti-VEGF) treatment. Only cases with a complete ophthalmological examination, digital 133° color fundus, and SD-OCT assessments were used. After RNA extraction and first-strand cDNA synthesis, quantitative real-time PCR was performed with specific primers on the CFX Connect™ Real-Time PCR Detection System to assess differential transcriptional expression patterns. Results The DNMT1 gene showed a positive correlation (r = 0.617; p = 0.043) with Best Corrected Visual Acuity (BCVA) in CG, a positive correlation (r = 0.917; p = 0.010) with HbA1c in nrDME and a negative correlation (r = −0.659; p = 0.049) with GCL-IPL thickness in rDME. DNMT3A gene showed a positive correlation (r = −0.890; p = 0.001) with Sub-foveal Choroidal thickness in rDME whereas DNMT3b gene showed a negative correlation (r = −0.815; p = 0.007) with HbA1c and RNFL (r = −0.664; p = 0.026) in CG. Conclusions Patients with similar metabolic profile risk factors showed associated DNA methyltransferase transcriptional expression patterns differences fitting with the anti-VEGF diabetic macular edema response. Further studies are needed to clarify if these results (1) reflect disease evolution, (2) translate the therapeutic impact, (3) or can help to predict the therapeutic resistance profile.
Correlation of NNMT and DKK1 Protein Expression With Clinicopathological Characteristics and Prognosis of Breast Cancer
Authors: Liang Tairong , Wu Xiuqian , Wang Lan , Song Tiantian , Wu Peishan , Niu Yongdong , Huang Haihua 
Published: April 2023

Background: Nicotinamide N-methyltransferase (NNMT) and Dickkopf-1 (DKK1) play an important role in the development of breast cancer, and the purpose of this study was designed to examine the clinical and prognostic significance of NNMT and DKK1 in breast cancer. Methods: The GEPIA2 database was used to evaluate the expression and survival of NNMT mRNA and DKK1 mRNA of breast cancer. Then an immunohistochemical study was carried out on 374 cases of breast tissue to identify the protein expression and significance of NNMT and DKK1. Next, the prognostic significance of DKK1 in breast cancer was explored by COX and Kaplan-Meier models. Results: Protein NNMT expression was correlated with lymph node metastasis and histological grade ( P < .05) while protein DKK1 expression was related to tumor size, pT stage, histological grade, and Ki-67 ( P < .05). Protein DKK1 was related to disease-specific survival (DSS), and low DKK1 expression indicated a poor prognosis of breast cancer patients ( P < .05). Combined expression of protein NNMT and protein DKK1 predicted different prognosis of DSS ( P < .05). Conclusions: Nicotinamide N-methyltransferase and DKK1 were linked to breast cancer malignancy and invasion. Breast cancer patients with low DKK1 expression had a worse prognosis. Oncotypes of NNMT and DKK1 expression predicted patient outcomes.
Guiding the Lean Design of a Hospital’s New Laboratory: A Case Study
Authors: Audibert Pablo Flores , Heim Joseph A. , Vetch Angela 
Published: April 2023

Purpose: To present the process used by a clinical laboratory to guide the design of their new facility, part of a major campus expansion at a pediatric hospital. Objective: The primary objective was to generate information about arrangement and allocation of laboratory space and functional flows in the early phases of the expansion project. Background: Seattle Children's Hospital has increased the capacity of their primary campus in response to growing demand for specialized services. The clinical laboratory was identified as one of the functional groups that would move their operations to the new building. Methods: The clinical laboratory team agreed on a three-stage process to guide the development of their initial design specifications: formulate the concept, develop design alternatives, and evaluate those alternatives. Case Study: The different tasks were executed successfully. The process defined—based on Plan, Do, Check, Act (PDCA)—provided a context for collaboration among sections of the clinical laboratory, reducing silo thinking, so common in the specialized sections within a large clinical laboratory. Discussion: The process was developed to guide the lean design efforts, even when initial space and location parameters had not yet been decided and was sufficiently flexible to accommodate changes in the project constraints and emergent information generated by the concurrent design activities of other hospital functional groups to be included in the campus expansion. The three-stage process allowed the team to review each laboratory section’s complexity, create multiple conceptual designs for review, and ultimately increase the likelihood of an efficient physical configuration that would satisfy a diverse group of stakeholders.
Social Needs Assessment and Linkage to Community Health Workers in a Large Urban Hospital System
Authors: Shi Marc , Fiori Kevin , Kim Ryung S. , Gao Qi , Umanski Galina , Thomas Iby , Telzak Andrew , Chambers Earle 
Published: April 2023

Objectives: Identifying social needs is a growing priority in primary care, but there is significant variation in how patients access services to meet such needs. This study identifies predictors of successful linkage with a community health worker (CHW) among patients with social needs seen in an outpatient setting. Methods: This study uses a cross-sectional analysis of social needs assessments administered in an urban health system between April 2018 and December 2019. Social needs included: food insecurity, housing quality, housing instability, healthcare cost, healthcare related transportation, utilities, care for dependents, legal assistance, safety, and getting along with household members. Patients with at least 1 social need and accepting help were included in the analysis. On contact with a CHW, patients were entered into a separate database. The primary outcome was successful “linkage,” defined by having a positive social needs assessment in the medical record and a corresponding record in the CHW database. Multivariate logistic regression was used to assess predictors of linkage. Results: Among patients with at least 1 social need accepting help, 25% (758/3064) were linked to a CHW. Positive predictors included female gender (OR 1.28 [95% CI 1.01-1.63]), Spanish language preference compared to English (1.51 [1.14-1.03]), and having a food related need (1.35 [1.03-1.79]). Negative predictors included age 18 to 65 (0.34 [0.17-0.71] for age 18-24) and 0 to 5 (0.45 [0.24-0.78]) compared to over 65, non-Hispanic White race compared to Hispanic race (0.39 [0.18-0.84]), and having needs of getting along with household members (0.52 [0.38-0.71]) and safety (0.64 [0.42-0.98]). Conclusions: Twenty-five percent of patients who had at least 1 social need and were accepting help had a successful CHW linkage. Predictors of linkage suggest areas of further system-level improvements to screening and referral interventions to target at risk patients and communities.
Spinal Orthoses in the Treatment of Osteoporotic Thoracolumbar Vertebral Fractures in the Elderly: A Systematic Review With Quantitative Quality Assessment
Authors: Pieroh Philipp , Spiegl Ulrich J. A. , Völker Anna , Märdian Sven , von der Höh Nicolas H. , Osterhoff Georg , Heyde Christoph-E. ,   Spine Section of the German Society for Orthopaedics and Trauma
Published: April 2023

Study Design Systematic review. Objectives Spinal orthoses are frequently used to non-operatively treat osteoporotic vertebral fractures (OVF), despite the available evidence is rare. Previously systematic reviews were carried out, presenting controversial recommendations. The present study aimed to systematic review the recent and current literature on available evidence for the use of orthoses in OVF. Methods A systematic review was conducted using PubMed, Medline, EMBASE and CENTRAL databases. Identified articles including previous systematic reviews were screened and selected by three authors. The results of retrieved articles were presented in a narrative form, quality assessment was performed by two authors using scores according to the study type. Results Thirteen studies (n = 5 randomized controlled trials, n = 3 non- randomized controlled trials and n = 5 prospective studies without control group) and eight systematic reviews were analyzed. Studies without comparison group reported improvements in pain, function and quality of life during the follow-up. Studies comparing different types of orthoses favor non-rigid orthoses. In comparison to patients not wearing an orthosis three studies were unable to detect beneficial effects and two studies reported about a significant improvement using an orthosis. In the obtained quality assessment, three studies yielded good to excellent results. Previous reviews detected the low evidence for spinal orthoses but recommended them. Conclusion Based on the study quality and the affection of included studies in previous systematic reviews a general recommendation for the use of a spinal orthosis when treating OVF is not possible. Currently, no superiority for spinal orthoses in OVF treatment was found.
Clinical Evaluation of the Osteoporotic Fracture Treatment Score (OF-Score): Results of the Evaluation of the Osteoporotic Fracture Classification, Treatment Score and Therapy Recommendations (EOFTT) Study
Authors: Ullrich Bernhard W. , Schnake Klaus John , Schenk Philipp , Katscher Sebastian , Bäumlein Martin , Zimmermann Volker , Schwarz Falko , Schmeiser Gregor , Scherer Michael , Müller Michael , Sprengel Kai , Liepold Katja , Schramm Simon , Baron Hagen-Christopher , Siekmann Holger , Franck Alexander , Scheyerer Max J. , Kirtas Seyma , Spiegl Ulrich J. A. , Osterhoff Georg ,   Working Group Osteoporotic Fractures of the Spine Section of the German Society of Orthopaedics and Trauma
Published: April 2023

Study Design Multicenter prospective cohort study. Objective The study aims to validate the recently developed OF score for treatment decisions in patients with osteoporotic vertebral compression fractures (OVCF). Methods This is a prospective multicenter cohort study (EOFTT) in 17 spine centers. All consecutive patients with OVCF were included. The decision for conservative or surgical therapy was made by the treating physician independent of the OF score recommendation. Final decisions were compared to the recommendations given by the OF score. Outcome parameters were complications, Visual Analogue Scale, Oswestry Disability Questionnaire, Timed Up & Go test, EQ-5D 5 L, and Barthel Index. Results In total, 518 patients (75.3% female, age 75 ± 10) years were included. 344 (66%) patients received surgical treatment. 71% of patients were treated following the score recommendations. For an OF score cut-off value of 6.5, the sensitivity and specificity to predict actual treatment were 60% and 68% (AUC .684, P < .001). During hospitalization overall 76 (14.7%) complications occurred. The mean follow-up rate and time were 92% and 5 ± 3.5 months, respectively. While all patients in the study cohort improved in clinical outcome parameters, the effect size was significantly less in the patients not treated in line with the OF score’s recommendation. Eight (3%) patients needed revision surgery. Conclusions Patients treated according to the OF score’s recommendations showed favorable short-term clinical results. Noncompliance with the score resulted in more pain and impaired functional outcome and quality of life. The OF score is a reliable and save tool to aid treatment decision in OVCF.
Geriatric Odontoid Fractures: Treatment Algorithms of the German Society for Orthopaedics and Trauma Based on Expert Consensus and a Systematic Review
Authors: Osterhoff Georg , Scholz Matti , Disch Alexander C. , Katscher Sebastian , Spiegl Ulrich J. A. , Schnake Klaus John , Scheyerer Max J. 
Published: April 2023

Study Design Systematic review/expert consensus. Objectives Fractures of the axis represent the most frequent injury of the spine in elderly patients. Both, operative and non-operative treatment are associated with a high rate of complications and mortality. The aim of this article was to summarize the current literature on the management of odontoid fractures in geriatric patients and to weigh it based on an expert consensus process. Methods In a joint consensus process, members of the Spine Section of the German Orthopaedic and Trauma Society (DGOU) aimed to formulate recommendations for the diagnostic workup and treatment of odontoid fractures in geriatric patients. Based on the previously published recommendations, this article is an updated version with incorporating a systematic review of the recent literature. Results Based on the new data available, the recommendations established in the initial consensus process were adapted. Conclusions Computed tomography represents the diagnostic standard for patients with suspected injuries of the upper cervical spine. Anderson/D’Alonzo odontoid fractures type 1, non-displaced type 2, and type 3 can be treated conservatively. Even non-unions do not necessarily result in poor clinical outcome. In Anderson/D’Alonzo type 2 fractures, surgical therapy offers the advantage of relatively safe osseous healing with no increased complication rate even in elderly patients and can thus be recommended. In very high aged patients, however, a case-by-case decision should be made. When surgical stabilization of osteoporotic odontoid fractures is indicated, posterior techniques are biomechanically advantageous and can be considered the standard.
Association Between Preoperative Multidimensional Psychological Distress and Physical Function After Surgery for Sports-Related Injury
Authors: Morriss Nicholas J. , Kim Billy I. , Poehlein Emily , Park Caroline N. , Lentz Trevor A. , Green Cynthia L. , Lau Brian C. 
Published: April 2023

Background: Psychological distress after orthopaedic surgery can lead to worse outcomes, including higher levels of disability and pain and lower quality of life. The 10-item Optimal Screening for Prediction for Referral and Outcome–Yellow Flag (OSPRO-YF) survey screens for multiple psychological constructs relevant to recovery from orthopaedic injury and may be useful to preoperatively identify patients who may require further psychological assessment and possible intervention after surgery. Purpose/Hypothesis: To determine the association between the OSPRO-YF and physiological patient-reported outcomes (PROs). It was hypothesized that higher OSPRO-YF scores (indicating worse psychological distress) would be associated with worse PRO scores at time of return to sport. Study Design: Case series; Level of evidence, 4. Methods: This study evaluated 107 patients at a single, academic health center who were assessed at a sports orthopaedics clinic and ultimately treated surgically for injuries to the knee, shoulder, foot, or ankle. Preoperatively, patients completed the OSPRO-YF survey as well as the following PRO measures: Patient-Reported Outcomes Measurement Information System (PROMIS), Single Assessment Numeric Evaluation, numeric rating scale for pain; American Shoulder and Elbow Surgeons standardized shoulder assessment form for patients with shoulder injuries, the International Knee Documentation Committee score (for patients with knee injuries), and the Foot and Ankle Ability Measure (FAAM; for patients with foot or ankle injuries). At the time of anticipated full recovery and/or return to sport, patients again completed the same PRO surveys. Multivariable regression was used to evaluate the association between total OSPRO-YF score at baseline and PRO scores at the time of functional recovery. Results: The baseline OSPRO-YF score predicted postoperative PROMIS Physical Function and FAAM Sports scores only. A 1-unit increase in the OSPRO-YF was associated with a 0.55-point reduction in PROMIS Physical Function (95% CI, –1.05 to –0.04; P = .033) indicating worse outcomes. Among patients who underwent ankle surgery, a 1-unit increase in OSPRO-YF was associated with a 6.45-point reduction in FAAM Sports (95% CI, –12.0 to –0.87; P = .023). Conclusion: The study findings demonstrated that the OSPRO-YF survey predicts certain long-term PRO scores at the time of expected return to sport, independent of baseline scores.
Ocular biometry, anterior chamber morphometry, and their relationship with serum ferritin levels in children with beta thalassemia major
Authors: Naz Şimdivar Göksu Hande , Kurumoğlu Incekalan Tuğba , Tuncel Defne Ay 
Published: April 2023

Background: Ocular biometry and anterior segment evaluations are important to determine ocular development and pathological changes, especially in thalassemia patients in Mediterranean countries such as Turkey. Objectives: The objectives of this study were to compare ocular biometry and anterior segment parameters in children with thalassemia major and healthy controls and to examine the relationship between ferritin levels, anthropometric measurements, and ocular parameters. Design: This is a prospective case-control study. Methods: The height, weight, body mass index, and occipitofrontal circumference values of the participants were recorded. Anterior and vitreous chamber depth, lens thickness, axial length, central corneal thickness, anterior chamber volume, iridocorneal angle, pupil diameter, and mean keratometry were measured. Measurements were compared between patients and healthy children, and between patients with ferritin levels above and below 1000 ng/mL. Results: This study included 40 patients and 45 controls. Height, weight, and body mass index were significantly lower while ferritin level and occipitofrontal circumference were significantly higher in patients compared with the controls ( p < 0.001 for all). There were no statistically significant differences in the other ocular parameters ( p > 0.05). In comparisons between patients with ferritin levels below ( n = 15) and above 1000 ng/mL ( n = 25), there were no significant differences in age, height, weight, body mass index, occipitofrontal circumference, or ocular parameters ( p > 0.05). Occipitofrontal circumference and mean keratometry value were positively correlated in patients with ferritin levels below 1000 ng/mL ( r = 0.573, p = 0.025), while body mass index was negatively correlated with pupil diameter in patients with ferritin levels above 1000 ng/mL ( r = −0.469, p = 0.018). Conclusion: Children with thalassemia showed significant growth retardation and large occipitofrontal circumference but did not differ from controls in terms of biometrics and anterior segment morphology. Our results demonstrated a positive correlation between the occipitofrontal circumference and mean keratometry value in children with ferritin levels below 1000 ng/mL and a negative correlation between body mass index and pupil diameter in children with ferritin levels above 1000 ng/mL.