bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with aspects of functioning one year after hospitalization due to COVID-19
Authors: Larsson Alexandra C. , Palstam Annie , Ashman Kröönström Linda , Sunnerhagen Katharina S. , Persson Hanna C. 
Published: January 2025

Objective To identify factors, present at 3 months after COVID-19 that are associated with the level of functioning 1 year after hospitalization. Design Multicenter prospective observational study. Setting Region Västra Götaland Sweden. Participants Patients ≥ 18 years of age who were followed regarding body functions and activities 3 months and 1 year after discharge from a hospitalization for COVID-19. Main measures Patient-reported outcome measures at 3 months and 1 year, a clinical follow-up at 1 year, and clinical information retrieved from medical charts. Results In total 169 participants were included in the analysis, including 113 males (67%). The mean patient age was 66 (standard deviation (SD) 13, range 21–95). One year after hospitalization, 50 (34%) participants were under the normative value for forced vital capacity and 57 (39%) were under normative value for forced expiratory volume in 1 second. The mean walking distance was 441 m (SD 118 m) in the 6-minute walking test, and 62 (40%) patients reported mobility problems. Older age, female sex, and more self-reported symptoms of physical fatigue were significantly associated with lower levels of functioning 1 year after COVID-19. The initial severity of COVID-19 did not significantly influence functioning at 1 year. Conclusion Previously hospitalized individuals with respiratory difficulties 1 year after COVID-19 may present acceptable lung function on spirometry but be close to their maximal functional performance. The findings highlight the need for in-depth assessments to identify rehabilitation needs.
Posterolateral Corner Reconstruction: A Systematic Review and Meta-analysis of Biomechanical Studies
Authors: Zielinski Kyle P. , Wieland Mark D. , Sequeira Sean B. , Gould Heath P. , Dreese James C. 
Published: January 2025

Background: Surgical reconstruction is the standard treatment for injuries to the posterolateral corner (PLC) of the knee and can be performed using either a fibular-based or combined tibiofibular-based technique. Although some comparative studies have been performed, there is no consensus regarding the reconstructive approach that confers optimal biomechanical properties of the PLC. Purpose: To perform a systematic review and meta-analysis to evaluate the biomechanical properties of the knee after PLC reconstruction with fibular-based and tibiofibular-based techniques. Study Design: Meta-analysis; Level of evidence, 4. Methods: A systematic review was performed by searching the PubMed, Cochrane Library, and Embase databases using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify studies that analyzed the biomechanical properties of PLC reconstruction techniques. Evaluated outcomes included varus laxity and external rotation laxity. The pooled biomechanical data were analyzed by random-effects models and heterogeneity was assessed using the I2 statistic. Results: Eleven studies met the inclusion criteria; 74 cadaveric specimens were included. Seven studies (54 specimens) evaluated the fibular-based Larson reconstruction technique, 3 studies (22 specimens) evaluated a modified fibular-based Larson reconstruction, and 1 study (7 specimens) evaluated the fibular-based Arciero reconstruction. Five studies (45 specimens) evaluated the tibiofibular-based LaPrade reconstruction technique and 2 studies (20 specimens) evaluated a modified LaPrade reconstruction. Data were pooled for fibular-based reconstructions (Larson, modified Larson, and Arciero) and tibiofibular-based reconstructions (LaPrade, modified LaPrade). Pooled analysis revealed no significant difference in varus laxity and external rotation laxity between fibular and tibiofibular reconstructions at 0°, 30°, 60°, and 90° of flexion (all P > .05). Conclusion: No difference in varus laxity and external rotation laxity was observed between fibular-based and tibiofibular-based techniques for PLC reconstruction. Moreover, there was no difference in varus laxity and external rotation laxity observed between the Larson, modified Larson, and LaPrade reconstructions. These results suggest that biomechanical stability after fibular- and tibiofibular-based PLC reconstructions is similar. Further clinical investigation is warranted to validate these cadaveric findings.
The Presence of a Trochlear Bump and Patella Alta May Predict the Risk of Recurrent Instability After Isolated Medial Patellofemoral Ligament Reconstruction: A Systematic Review and Meta-analysis
Authors: Dandu Navya , Elias Tristan J. , Hevesi Mario , Trasolini Nicholas A. , Zavras Athan G. , Haneberg Erik , Yanke Adam B. 
Published: January 2025

Background: Medial patellofemoral ligament reconstruction (MPFLR) is an excellent surgical option for patients with recurrent patellar instability. This technique has demonstrated significant improvements in patient-reported outcomes, high rates of return to sport, and low rates of failure. However, there is debate regarding the use of isolated MPFLR in the setting of concomitant pathoanatomic features such as patella alta, trochlear dysplasia, or a lateralized tibial tubercle. Purpose: To estimate the overall relative effect sizes as well as strength of evidence supporting described risk factors for recurrent instability after isolated MPFLR. Study Design: Systematic review and meta-analysis. Methods: A systematic review was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Embase, Cochrane, and Ovid/MEDLINE databases were queried. Clinical studies for outcomes of isolated MPFLR reporting recurrent instability and associated risk factors were included. Data for each risk factor analyzed by at least 2 studies were extracted, and the heterogeneity of studies was determined by I2 value. For variables evaluated in studies determined to have fair homogeneity, defined as I2 <25%, DerSimonian-Laird random-effects models were generated and effect sizes were represented as mean differences or odds ratios. Results: Nine studies examining risk for recurrent instability after isolated MPFLR were identified, with 5 overlapping risk factors with low heterogeneity between studies: age, sex, tibial tubercle to trochlear groove (TT-TG) distance, Caton-Deschamps Index (CDI), and trochlear dysplasia. There was strong evidence to support the risk of recurrent instability associated with CDI >1.3 (OR, 2.72; P = .02) and dysplasia with a trochlear bump (DeJour type B or D; OR, 3.28; P <.001). Age, sex, and TT-TG distance did not cause an increased risk of recurrent instability with currently available aggregate data. Conclusion: There are signs of increased risk of failure of isolated MPFLR in the setting of DeJour type B and D trochlear dysplasia and patella alta (CDI, >1.3). Currently available data suggest that age, sex, and TT-TG distance do not cause a higher risk of recurrence for patients undergoing isolated MPFLR.
Immunophenotyping of Synovial Tissue in Adolescents Undergoing ACL Reconstruction: What Is the Role of Synovial Inflammation in Arthrofibrosis?
Authors: Romereim Sarah M. , Smykowski Matthew R. , Ball Elaina K. , Carey Edward Grant , Cuadra Mario , Williams Alicia , Hickson Kate , Haim Kara , Sumith Meera , Yu Ziqing , Jin Guangxu , Foureau David , Steuerwald Nury , Odum Susan , Fearing Bailey V. , Riboh Jonathan C. 
Published: January 2025

Background: Loss of motion and arthrofibrosis after anterior cruciate ligament (ACL) reconstruction (ACLR) can be devastating complications for athletes. The cellular and molecular pathogenesis of arthrofibrosis is poorly understood, limiting prevention and treatment options. Synovial inflammation may contribute to post-ACLR arthrofibrosis. Hypothesis: Higher synovial immune cell infiltration and inflammatory/catabolic gene expression patterns at the time of ACLR would correlate with poorer motion-related outcomes. Study Design: Case series; Level of evidence, 4. Methods: Patients aged 10 to 18 years undergoing primary ACLR were enrolled in a prospective pilot study, and synovial tissue biopsy specimens were obtained during ACLR. Flow cytometry and single-cell RNA sequencing explored synovial cell types/frequencies and gene expression. Principal component analysis was performed, followed by clustering which grouped patients into distinct immunophenotypes based on their synovial cell composition. Clinical follow-up data with knee range of motion (ROM), need for lysis of adhesions, and patient-reported outcome measures were collected and compared between immunophenotypes. Results: Enrolled patients (n = 17) underwent ACLR at a median of 37 days after injury. Analysis revealed 3 distinct immunophenotypes. Type 1 consisted of patients with the longest time between injury and surgery and the lowest hematopoietic and T-cell infiltration. Types 2 and 3 had similar times between injury and surgery; type 2 had intermediate while type 3 had the highest hematopoietic and T-cell percentages. Type 3 was associated with worse ROM at 2 and 6 weeks postoperatively; T-cell prevalence and ROM were inversely correlated at those time points. The only patient requiring lysis of adhesions for arthrofibrosis had a type 3 immunophenotype. Conclusion: Synovial immune infiltration after ACL injury shows variability between patients that clusters into 3 immunophenotypes correlating with early ROM and the risk of arthrofibrosis. T-cell recruitment and infiltration were the strongest factors correlated with ROM outcomes and present an exciting venue for future research on post-ACLR arthrofibrosis.
Validation de L’échelle Unidimensionnelle D’Estime de Soi de Ducher (ESD): Validation of Ducher's Unidimensional Self-Esteem Scale (SES)
Authors: de Chazeron I. , Ducher J.-L. , Renoux M. , Brousse G. , Llorca P.-M. 
Published: January 2025

Résumé Objectif Même si l’estime de soi est un concept relativement récent, développé d’abord dans le domaine de la psychologie sociale, elle a pris de plus en plus d’importance en psychiatrie, en particulier en tant que critères diagnostiques. Cependant, elle est peu évaluée en pratique clinique. L’absence d’instrument en permettant une évaluation globale aisée en est peut-être la raison. Il s’agit donc de valider en langue francophone une échelle brève, unidimensionnelle, d’Estime de Soi (ESD), autorisant éventuellement un suivi évolutif par autocorrection. Méthode L’étude a porté sur 106 patients présentant différents troubles psychiatriques, à l’exception de trouble psychotique, stabilisés ou de niveau de gravité variable. La création de l’outil initial comprenait 10 items. Il a été soumis à la sélection d’items suivie d’une analyse factorielle exploratoire. La corrélation entre les items ainsi que la mesure de la cohérence et de la validité convergente ont été ensuite réalisées. Résultats L’évaluation de l’acceptabilité et de la distribution des résultats a conduit à la sélection de 6 items. L’analyse factorielle exploratoire révèle une dimension unique et une bonne fiabilité (Tucker-Lewis Index =0.89). Aucun item n’affiche des corrélations avec un score total inférieur à 0.50 et la notion du construit est cohérente. On note également une bonne consistance interne ce qui confirme que la version ESD à 6 items est optimale. Conclusion Cette nouvelle échelle validée pourra permettre aux thérapeutes d’investiguer de façon plus précise la notion d’estime de soi en clinique ou dans un cadre de recherche.
Incongruent Expectations: A Qualitative Study of the Gendered Experiences of Canadian Young People
Authors: Michaelson Valerie , Pilato Kelly A. , Murray Julie , McIsaac Michael A. , Wadge Stephanie , Steeves Valerie ,   for our grant team writing group
Published: January 2025

While the early mental health of girls and boys is similar, as children age, girls tend to report worse mental health than boys. Explanations for these gendered disparities remain elusive. This study seeks to understand the social context in which mental health experiences are shaped. Utilizing a qualitative, constructivist approach to grounded theory, we conducted virtual semi-structured interviews with young people between ages 11 and 17 years ( n = 20). Our major finding was that girls in particular experience incongruence between expectations about gender equality and everyday experiences of stereotypes, barriers, and discrimination. Girls reported pressures to satisfy multiple gender norms, such as traditional ideals about being feminine (kind and physically attractive) and modern ideas about being high achieving and “smarter than boys.” Findings suggest that young people are unequipped to navigate the incongruence between the expectation that they live in a gender-equal world and their experiences of gender-based constraints, nor do they appear to have the skills to critically identify the structural patterns that undergird their experiences. Explanations for gendered disparities in mental health may be related to the underlying context of discrimination, and both traditional and emerging gendered norms, barriers, and constraints. Finally, we highlight the responsibility of adults to facilitate child development in ways that are responsive to the changing faces of gender discrimination, which readily adapts to social discourse in new and subtle ways.
Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients
Authors: Gonzalez-Ochoa Alejandro J , Szolnoky Gyozo , Hernandez-Ibarra Ana G , Fareed Jawed 
Published: January 2025

Introduction Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19. Methods We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint. Results Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, P = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, P = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, P = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels. Conclusions Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage.
Toward Resilient Maternal, Neonatal and Child Health Care: A Qualitative Study Involving Afghan Refugee Women in Pakistan
Authors: Shafiq Yasir , Muhammad Ameer , Kumar Kantesh , Wajid Ali Zabin , Noor Saba , Suhag Zamir Hussain , Tahir Rehman , Jan Abdullah , Ragazzoni Luca , Barone-Adesi Francesco , Valente Martina 
Published: January 2025

Background: Afghan refugees in Pakistan, particularly in Quetta, Balochistan, encounter formidable barriers in accessing maternal, newborn, and child health (MNCH) services. These challenges have been intensified by the COVID-19 pandemic and entrenched systemic health inequities. Methods: This qualitative study, conducted from February to April 2023, aimed to assess the obstacles within health systems and community environments that hinder MNCH service access among Afghan refugees. The study involved 20 key informants through in-depth interviews and focus group discussions, including Afghan refugee women, community elders, health workers, and representatives from non-governmental organizations and government agencies. The research focused on experiences during the initial four waves of the COVID-19 pandemic (2020-2021), utilizing a conceptual framework integrating Health Emergency Disaster Risk Management (Health-EDRM) with primary health care. Findings: The study identified significant systemic barriers to accessing MNCH services, such as insufficient funding, inadequate health infrastructure, and discriminatory practices within the healthcare workforce. Additionally, community-level obstacles were prominent, including cultural and language differences, geographical isolation, and economic constraints. The integration of Health-EDRM into local health systems was minimal, with many stakeholders either needing to be made aware of or unengaged with the framework. Conclusion: The findings highlight a critical need for comprehensive policy reforms, infrastructure enhancement, and community-centered approaches to address Afghan refugees’ health needs effectively. Strengthening the integration of health-EDRM into health systems is crucial for enhancing resilience and ensuring continuous care during health emergencies. The study calls for concerted efforts to implement culturally sensitive health interventions that include disaster risk management components to improve MNCH outcomes among Afghan refugees in crisis-affected settings. Addressing systemic and community-level barriers makes creating a more resilient and equitable health system for vulnerable populations possible.
Local electromagnetic shielding for thyroid: A study on shielding efficacy and specific absorption rate
Authors: Lin Jiajin , Liu Xiaocao , Li Jing 
Published: January 2025

This study assesses the shielding efficacy of local electromagnetic shield for the thyroid gland. The investigation employed a mechanical model of a thyroid shield gear, integrating it within a high-resolution three-dimensional virtual model (Duke). The simulation environment and biological electromagnetic model were constructed from 1 to 6 GHz, with the Finite-Difference Time-Domain (FDTD) algorithm. The results indicated that the specific absorption rate (SAR) values of the thyroid were significantly elevated under forward irradiation and in the L band (1–2 GHz). In addition, the local electromagnetic shield reduced the SAR values at the thyroid position, with a shielding efficiency ranging from 15 to 40 dB across the evaluated frequency range. Further, the local shielding effectiveness of the thyroid have obvious variety between frequency and polarization. However, the data also indicated a potential increase in SAR values in other tissues, notably the eyes by up to 4 dB. The study determines that local electromagnetic shields markedly reduce radiofrequency radiation to the thyroid, necessitating a balanced design approach that accounts for both protective benefits and side effects on other tissues. The method and result provide a new perspective and quantitative data for thyroid protection, which has important guiding significance for the design and practical application of electromagnetic protection products.
The relative cerebral blood volume (rCBV) < 42% is independently associated with hemorrhagic transformation in anterior circulation large vessel occlusion
Authors: Lakhani Dhairya A , Balar Aneri B , Ali Subtain , Khan Musharaf , Salim Hamza A , Koneru Manisha , Wen Sijin , Wang Richard , Mei Janet , Hillis Argye E , Heit Jeremy J , Albers Gregory W. , Dmytriw Adam A , Faizy Tobias D , Wintermark Max , Nael Kambiz , Rai Ansaar T , Yedavalli Vivek S 
Published: January 2025

Background Pretreatment CT perfusion (CTP) marker relative cerebral blood volume (rCBV) < 42% lesion volume has recently shown to predict poor collateral status and poor 90-day functional outcome. However, there is a paucity of studies assessing its association with hemorrhagic transformation (HT). Here, we aim to assess the relationship between rCBV < 42% lesion volume with HT. Methods In this retrospective study, we included patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO) of anterior circulation who had successful recanalization from two comprehensive stroke centers between 9/1/2017 and 10/01/2023. Successful recanalization was defined as modified treatment in cerebral infarction (mTICI) 2b or greater. Logistic regression analysis and ROC analysis were used to assess the relationship between rCBV <42% and HT. Results In total, 150 patients (median age: 69 years, 58.7% female) met our inclusion criteria. On multivariable logistic regression analysis, taking into account age, sex, hypertension, hyperlipidemia, diabetes, prior stroke or transient ischemic attack, admission National Institute of Health stroke scale (NIHSS), Alberta Stroke Program Early CT Score (ASPECTS), and intravenous thrombolysis, rCBV <34% (aOR:1.01, P < .05), rCBV <38% (aOR:1.01, P < .05) and rCBV <42% (aOR:1.01, P < .05) lesion volumes were independently associated with HT. On ROC analysis rCBV < 42% (AUC = 0.61, P < .05) performed slightly better than rCBV < 38% (AUC = 0.59, P < .05) and rCBV < 34% (AUC = 0.59, P < .05) in predicting HT. Conclusion The rCBV <42% lesion volume is independently associated with HT in AIS-LVO patients who underwent successful recanalization.
Enfortumab vedotin plus pembrolizumab for previously untreated locally advanced or metastatic urothelial carcinoma: a cost-effectiveness analysis
Authors: Zhu Youwen , Liu Kun , Zhu Hong , Li Shan , Yuan Dan 
Published: January 2025

Background: Both the antibody–drug conjugate (ADC) enfortumab vedotin (EV) and programmed death-1 inhibitor pembrolizumab have been shown to provide survival benefits in patients previously treated with locally advanced or metastatic urothelial carcinoma (la/mUC). Cost-effectiveness is necessary to consider whether the increased efficacy of the two therapies will lead to higher prices for first-line treatment of previously untreated la/mUC. Objectives: To guide the choice of EV plus pembrolizumab or chemotherapy for patients with previously untreated la/mUC. Design: The cost-effective analysis. Methods: A Markov model was developed to simulate the lifetime of patients with previously untreated la/mUC to assess the overall cost and efficacy of EV plus pembrolizumab and chemotherapy based on the EV-302/KEYNOTE-A39 trial. Primary outcomes included total cost, life-years (LYs), quality-adjusted LYs (QALYs), the incremental cost-effectiveness ratio (ICER), and incremental net health benefits at the USA and Chinese willingness-to-pay threshold of $150,000/QALY and $35,173/QALY, respectively. Model stability was examined through sensitivity and subgroup analyses. Results: EV plus pembrolizumab and chemotherapy treatment regimens were associated with 2.07–2.16 and 1.04–1.06 QALYs with corresponding costs of $288,347–$532,362 and $24,773–$267,568, respectively. ICERs in the United States and China are $267,491/QALY and $254,339/QALY, respectively. The factors that most strongly influenced model outcomes in unidirectional sensitivity analyses were patient weight and the cost of EV. To achieve greater cost-effectiveness, EV costs would need to be reduced by over 75% and 10% in the United States and China, respectively. Conclusion: While first-line EV plus pembrolizumab has significant health benefits compared to chemotherapy for patients with previously untreated la/mUC, this regimen is not cost-effective at the current price in the United States or China.