bluuebunny/crossref_metadata_2025_split huggingface dataset:
Leukocyte-Rich Platelet-Rich Plasma Is Predominantly Anti-inflammatory Compared With Leukocyte-Poor Platelet-Rich Plasma in Patients With Mild-Moderate Knee Osteoarthritis: A Prospective, Descriptive Laboratory Study
Authors: Jayaram Prathap , Mitchell Parker J.T. , Shybut Theodore B. , Moseley Bruce J. , Lee Brendan 
Published: May 2023

Background: Platelet-rich plasma (PRP) has been used extensively in clinical practice to treat patients with symptomatic knee osteoarthritis (OA). Leukocyte-poor PRP (LP-PRP) has been clinically preferred over leukocyte-rich PRP (LR-PRP); however, it is unclear which cytokine mediators of pain and inflammation are present in LR-PRP and LP-PRP from patients with mild to moderate knee OA in order to rationalize a specific formulation. Hypothesis: LP-PRP would be predominantly anti-inflammatory and have reduced nociceptive pain mediators compared with LR-PRP from the same individual with mild to moderate knee OA. Study Design: Controlled laboratory study. Methods: A total of 24 unique samples of PRP were prepared in order to assess 48 samples of LR-PRP and LP-PRP taken from 12 patients (6 male and 6 female) with symptomatic knee OA of Kellgren-Lawrence grade 2 to 3. Patients underwent blood collection for LR-PRP and LP-PRP preparation through a double-spin protocol to obtain baseline whole blood, platelet concentration, and white blood cell subtypes. LR-PRP and LP-PRP from the same patient were produced at the same time and underwent a comprehensive panel through Luminex (multicytokine profiling) to assess key mediators of inflammation: interleukin 1 receptor antagonist (IL-1Ra), interleukin 4, 6, 8, and 10 (IL-4, IL-6, IL-8, and IL-10), IL-1β, tissue necrosis factor α (TNF-α), and matrix metalloproteinase 9 (MMP-9). To assess mediators of nociceptive pain, nerve growth factor (NGF) and tartrate resistant acid phosphatase 5 (TRAP5) were also assessed. Results: LR-PRP from patients with mild to moderate knee OA expressed significantly more IL-1Ra, IL-4, IL-8, and MMP-9 compared with LP-PRP formulations from the same patients. No significant differences were found between LR-PRP and LP-PRP in mediators of nociceptive pain—namely, NGF and TRAP5. Other mediators including TNF-α, IL-1β, IL-6, and IL-10 were also found to have no significant expression differences between LR-PRP and LP-PRP. Conclusion: LR-PRP expressed significantly more IL-1Ra, IL-4, and IL-8, suggesting that LR-PRP may be more anti-inflammatory than LP-PRP. MMP-9 was expressed in higher concentrations in LR-PRP, suggesting that LR-PRP may be more chondrotoxic than LP-PRP. Clinical Relevance: LR-PRP was found to have a robust expression of anti-inflammatory mediators compared with LP-PRP and may be beneficial to patients with long-term knee OA where chronic low-grade inflammation is present. Mechanistic clinical trials are needed to elucidate the key mediators in both LR-PRP and LP-PRP to assess their effect on long-term progression of knee OA.
An International, Multicenter Evaluation of Comprehensive Medication Management by Pharmacists in ICU Recovery Centers
Authors: Stollings Joanna L. , Poyant Janelle O. , Groth Christine M. , Rappaport Stephen H. , Kruer Rachel M. , Miller Emily , Whitten Jessica A. , Mcintire Allyson M. , McDaniel Cara M. , Betthauser Kevin D. , Mohammad Rima A. , Kenes Michael T. , Korona Rebecca Bookstavar , Barber Alexandra E. , MacTavish Pamela , Dixit Deepali , Yeung Siu Yan A. 
Published: May 2023

Background Post-intensive care syndrome (PICS) is defined as a new or worsening impairment in physical, cognitive, or mental health following critical illness. Intensive care unit recovery centers (ICU-RC) are one means to treat patients who have PICS. The purpose of this study is to describe the role of pharmacists in ICU-RCs. Research Question What is the number and type of medication interventions made by a pharmacist at an ICU-RC at 12 different centers? Study Design and Methods This prospective, observational study was conducted in 12 intensive care units (ICUs)/ICU-RCs between September 2019 and July 2021. A full medication review was conducted by a pharmacist on patients seen at the ICU-RC. Results 507 patients were referred to the ICU-RC. Of these patients, 474 attended the ICU-RC and 472 had a full medication review performed by a pharmacist. Baseline demographic and hospital course data were obtained from the electronic health record and at the ICU-RC appointment. Pharmacy interventions were made in 397 (84%) patients. The median number of pharmacy interventions per patient was 2 (interquartile range [IQR] = 1,3). Medications were stopped and started in 124 (26%) and 91 (19%) patients, respectively. The number of patients that had a dose decreased and a dose increased was 51 (11%) and 43 (9%), respectively. There was no difference in the median total number of medications that the patient was prescribed at the start and end of the patient visit (10, IQR = 5, 15). Adverse drug event (ADE) preventive measures were implemented in 115 (24%) patients. ADE events were identified in 69 (15%) patients. Medication interactions were identified in 30 (6%) patients. Interpretation A pharmacist plays an integral role in an ICU-RC resulting in the identification, prevention, and treatment of medication-related problems. This paper should serve as a call to action on the importance of the inclusion of a pharmacist in ICU-RC clinics.
Comparison of differing dose levels of methotrexate for patients with primary central nervous system lymphoma
Authors: Schrum Daniel P , Moorman Meredith T , Li Zhiguo , Dillon Mairead , Peters Katherine B , McKinney Matthew , Patel Mallika P 
Published: May 2023

Introduction It has long been established that high-dose methotrexate is an essential part of therapy for primary central nervous system lymphoma. When regimens utilizing high-dose methotrexate were first studied, a dose of 8 g/m2 was used. More recently, reduced dosing strategies have been studied and adopted in attempts to reduce rates of adverse events. Studies utilizing 3.5 g/m2 of methotrexate have shown promising outcomes and improved rates of adverse events but there have never been any randomized head-to-head studies of differing dose levels of high-dose methotrexate. The purpose of this study was to compare efficacy and safety of different dosing strategies of high-dose methotrexate (HD-MTX) for primary central nervous system lymphoma (PCNSL). Methods This single center retrospective review was conducted between 07/01/2013 to 6/3/2020. The patient population was separated into two arms based upon dose of methotrexate. The high intensity (HiHD) arm was defined as patients who received doses > 3.5 g/m2, while the low intensity (LiHD) arm received ≤ 3.5 g/m2. The primary endpoint was overall response rate (ORR) and secondary endpoints include efficacy via 2-year overall survival (OS), progression to transplant, and utilization of consolidation or salvage therapy. Safety was assessed through monitoring of relevant laboratory studies. Results A total of 92 patients were included in this analysis. Baseline demographics were similar between groups, with the LiHD group trending toward older age. There were 78 patients eligible for assessment for ORR; there was no significant difference between the two groups (42.0% LiHD vs. 44.4% HiHD; p = 1.0). Rates of OS, progression to transplant and progression to consolidation chemotherapy were not different between groups. There were statistically significantly higher rates of renal and/or hepatic dysfunction with the first dose in the HiHD group compared with the LiHD group (11.5% LiHD vs. 64.3% HiHD; p ≤ 0.01). Conclusions In this PCNSL patient cohort, there is no difference in terms of efficacy between HiHD LiHD methotrexate, but patients in the HiHD group had higher rates of renal and hepatic dysfunction. Limitations include small sample size and disparity between group sizes.
Push and Fluff technique for optimization of clot integration with stent-retriever: An in vitro model
Authors: Pinheiro Agostinho C. , Nogueira Raul G. , Grandfield Ryan M. , Lin Shao-Pow , Majjhoo Aniel Q. , Aghaebrahim Amin Nima , Abraham Michael G. , Mazaris Paul , Singer Justin A. , Al-Bayati Alhamza R. , Verhey Leonard H. , Lin Eugene , Haussen Diogo C. 
Published: May 2023

Background For stent–retriever (SR) thrombectomy, technical developments such as the Push and Fluff technique (PFT) appear to have a significant impact on procedural success. This study aimed to (1) quantify the enhancement in clot traction when using PFT as compared to the standard unsheathing technique (SUT) and (2) to evaluate the performance of PFT in new versus established users of the technique. Methods Operators were divided between established PFT and SUT users. Each experiment was labeled according to the SR size, utilized technique, and operator experience. A three-dimensional-printed chamber with a clot simulant was used. After each retriever deployment, the SR wire was connected to a force gauge. Tension was applied by pulling the gauge until clot disengagement. The maximal force was recorded. Results A total of 167 experiments were performed. The median overall force to disengage the clot was 1.11 pounds for PFT and 0.70 pounds for SUT (an overall 59.1% increment with PFT; p < 0.001). The PFT effect was consistent across different retriever sizes (69% enhancement with the 3  ×  32mm device, 52% with the 4  ×  28mm, 65% with the 4  ×  41mm, 47% with the 6  ×  37mm). The ratio of tension required for clot disengagement with PFT versus SUT was comparable between physicians who were PFT versus SUT operators (1.595 [0.844] vs. 1.448 [1.021]; p: 0.424). The PFT/SUT traction ratio remained consistent from passes 1 to 4 of each technique in SUT users. Conclusion PFT led to reproduceable improvement in clot engagement with an average ∼60% increase in clot traction in this model and was found not to have a significant learning curve.
Changes and thresholds in the Oxford Shoulder Score following shoulder arthroplasty: Minimal clinically important difference, minimal important and detectable changes, and patient-acceptable symptom state
Authors: Liu Perry , Afzal Irrum , Asopa Vipin , Clement Nick D , Patel Vipul 
Published: May 2023

Background The minimal clinically important difference, minimal important change, minimal detectable change and patient-acceptable symptom state are poorly defined for the Oxford Shoulder Score following shoulder arthroplasty. The study's aim was to calculate their values. Methods One hundred patients underwent shoulder arthroplasty and completed pre and 1-year postoperative Oxford Shoulder Score. Patient satisfaction was assessed at 1-year using a visual analogue scale from 0 to 100: ‘very satisfied’ (>80), ‘satisfied’ (>60–80), and ‘unsatisfied’ (≤60). The difference between patients recording ‘unsatisfied’ ( n  =  11) and ‘satisfied’ ( n  =  16) was used to define the minimal clinically important difference. MICcohort was calculated as the change in Oxford Shoulder Score for those satisfied (>60). Receiver-operating characteristic curve analysis was used to determine the MICindividual and patient-acceptable symptom state. Distribution-based methodology was used for the minimal detectable change. Results The minimal clinically important difference was 6.9 (95% confidence interval 0.7–13.1, p  =  0.039). The MICcohort was 11.6 (95% confidence interval 6.8–16.4) and MICindividual 13. The minimal detectable change was 6.6 and the patient-acceptable symptom state was defined as ≥29. Discussion The minimal clinically important difference and minimal important change can assess whether there is a clinical difference between two groups and whether a cohort/patient has had a meaningful change in their Oxford Shoulder Score, respectively. These were greater than measurement error (minimal detectable change), suggesting a real change. The patient-acceptable symptom state can be used as a marker of achieving satisfaction.
Unplanned 30-Day ER Visit Rate and Factors Associated With ER Visits After Ambulatory Sinus Surgery
Authors: Yu Alison J. , Rice Dale , Ge Marshall , Wrobel Bozena , Gallagher Tyler , Smith Stephanie , Ference Elisabeth 
Published: May 2023

Background Emergency room (ER) visits after surgery can be inconvenient and costly to the patient and the healthcare system. Estimates of the 30-day ER visit rate following ambulatory sinus procedures and their risk factors are largely unknown in the literature. Objective To determine the 30-day postoperative ER visit rate following ambulatory sinus procedures and the causes and risk factors associated with ER visits. Methods This is a retrospective, cohort study using data from the State Ambulatory Surgery and Services Databases (SASD) and the State Emergency Department Databases (SEDD) for California, New York, and Florida in 2019. We identified adult (18 years old) patients with chronic rhinosinusitis who underwent ambulatory sinus procedures from the SASD. Cases were linked to the SEDD to identify ER visits occurring within 30 days after the procedure. Logistic regression models were used to identify patient- and procedure-related risk factors associated with the 30-day postoperative ER visit. Results Among the 23 239 patients, the 30-day postoperative ER visit rate was 3.9%. The most common reason for ER visit was bleeding (32.7%). A total of 56.9% of the ER visits occurred within the first week. In the multivariate analysis, factors associated with ER visits included Medicare (odds ratio [OR] 1.29 [1.09-1.52], P  =  .003), Medicaid (OR 2.06 [1.69-2.51], P < .001), self-pay/no insurance (OR 1.44 [1.03-2.00], P  =  .031), chronic kidney disease/end-stage renal disease (OR 1.63 [1.06-2.51], P =  .027), chronic pain/opioid use (OR 2.70 [1.02-7.11], P  =  .045), and a disposition other than home (OR 12.61 [8.34-19.06], P < .001). Conclusion The most common reason for ER visit after ambulatory sinus procedures was bleeding. An increased ER visit rate was associated with certain demographic factors and medical comorbidities but not with procedure characteristics. This information can help us identify the patient populations who are at higher risk for ER visits to improve their postoperative recovery.
Advancing Equity in Early Childhood Development in China: Progress in Meeting Sustainable Development Goal Target 4.2
Authors: Li Zeyi , Rao Nirmala 
Published: May 2023

Sustainable Development Goal (SDG) 4.2 states, “By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education”. Progress towards the goal is measured by indicators of children’s developmental status (Indicator 4.2.1) and participation in at least 1 year of pre-primary education prior to primary school (Indicator 4.2.2). A literature review and analyses of policy documents were conducted to evaluate China’s progress in achieving SDG Target 4.2. This review found that, on the one hand, national data on SDG Target Indicator 4.2.1 are unavailable. The extant data are mainly based on limited samples and collected using different methods, including direct assessment and parent report. On the other hand, data on SDG Target Indicator 4.2.2 are available on the UNESCO database. That stated differences exist between data reported to UNESCO by the government and data provided by the Ministry of Education. Efforts need to be continued to ensure that reliable data, which are the foundation of evidence-based policy-making, are collected and reported.
Characteristics of preoperative atrial fibrillation in geriatric patients with hip fracture and construction of a clinical prediction model: a retrospective cohort study
Authors: Fu Mingming , Zhang Yaqian , Zhao Yuqi , Guo Junfei , Hou Zhiyong , Zhang Yingze , Wang Zhiqian 
Published: May 2023

Abstract
Introduction
Atrial fibrillation is the most common atrial arrhythmia in the perioperative period and is associated with prolonged hospital stay, increased costs, and increased mortality. However, there are few data on the predictors and incidence of preoperative atrial fibrillation in hip fracture patients. Our aim was to identify predictors of preoperative atrial fibrillation and to propose a valid clinical prediction model.

Methods
Predictor variables included demographic and clinical variables. LASSO regression analyzes were performed to identify predictors of preoperative atrial fibrillation, and models were constructed and presented as nomograms. Area under the curve, calibration curve, and decision curve analysis (DCA) were used to examine the discriminative power, calibration, and clinical efficacy of the predictive models. Bootstrapping was used for validation.

Results
A total of 1415 elderly patients with hip fractures were analyzed. Overall, 7.1% of patients had preoperative atrial fibrillation, and they were at significant risk for thromboembolic events. Patients with preoperative AF had a significantly longer delay in surgery than those without preoperative atrial fibrillation (p < 0.05). Predictors for preoperative atrial fibrillation were hypertension (OR 1.784, 95% CI 1.136–2.802, p < 0.05), C-reactive protein at admission (OR 1.329, 95% CI 1.048–1.662, p < 0.05), systemic inflammatory response index at admission (OR 2.137, 95% CI, 1.678–2.721 p < 0.05), Age-Adjusted Charlson Comorbidity Index (OR 1.542, 95% CI 1.326–1.794, p < 0.05), low potassium(OR 2.538, 95% CI 1.623–3.968, p < 0.05), anemia(OR 1.542, 95% CI 1.326–1.794, p < 0.05). Good discrimination and calibration effect of the model was showed. Interval validation could still achieve the C-index value of 0.799. DCA demonstrated this nomogram has good clinical utility.

Conclusion
This model has a good predictive effect on preoperative atrial fibrillation in elderly patients with hip fractures, which can help to better plan clinical evaluation.
Diagnostic performance of a high-spatial-resolution voxelwise analysis of neuromelanin-sensitive imaging in early-stage idiopathic Parkinson’s disease
Authors: Seong Minjung , Park Seongbeom , Sung Young Hee , Kim Eung Yeop 
Published: May 2023

Abstract
Background
Quantitative assessments of neuromelanin (NM) of the substantia nigra pars compacta (SNpc) in neuromelanin-sensitive MRI (NM-MRI) to determine its abnormality have been conducted by measuring either the volume or contrast ratio (CR) of the SNpc. A recent study determined the regions in the SNpc that are significantly different between early-stage idiopathic Parkinson’s disease (IPD) patients and healthy controls (HCs) using a high spatial-resolution NM-MRI template, which enables a template-based voxelwise analysis to overcome the susceptibility of CR measurement to inter-rater discrepancy. We aimed to assess the diagnostic performance, which has not been reported, of the CRs between early-stage IPD patients and HCs using a NM-MRI template.

Methods
We retrospectively enrolled early-stage IPD patients (n = 50) and HCs (n = 50) who underwent 0.8-mm isovoxel NM-MRI and dopamine-transporter PET as the standard of reference. A template-based voxelwise analysis revealed two regions in nigrosomes 1 and 2 (N1 and N2, respectively), with significant differences in each substantia nigra (SNpc) between IPD and HCs. The mean CR values of N1, N2, volume-weighted mean of N1 and N2 (N1 + N2), and whole SNpc on each side were compared between IPD and HC using the independent t-test or the Mann-Whitney U test. The diagnostic performance was compared in each region using receiver operating characteristic curves.

Results
The mean CR values in the right N1 (0.149459 vs. 0.194505), left N1 (0.133328 vs. 0.169160), right N2 (0.230245 vs. 0.278181), left N2 (0.235784 vs. 0.314169), right N1 + N2 (0.155322 vs. 0.278143), left N1 + N2 (0.140991 vs. 0.276755), right whole SNpc (0.131397 vs. 0.141422), and left whole SNpc (0.127099 vs. 0.137873) significantly differed between IPD patients and HCs (all p < 0.001). The areas under the curve of the left N1 + N2, right N1 + N2, left N1, right N1, left N2, right N2, left whole SNpc, and right whole SNpc were 0.994 (sensitivity, 98.0%; specificity, 94.0%), 0.985, 0.804, 0.802, 0.777, 0.766, 0.632, and 0.606, respectively.

Conclusion
Our NM-MRI template-based CR measurements revealed significant differences between early-stage IPD patients and HCs. The CR values of the left N1 + N2 demonstrated the highest diagnostic performance.
Comprehensive transcriptomic analyses identify KDM genes-related subtypes with different TME infiltrates in gastric cancer
Authors: Zhang Haichao , Wang Haoran , Ye Li , Bao Suyun , Zhang Ruijia , Che Ji , Luo Wenqin , Yu Cheng , Wang Wei 
Published: May 2023

AbstractHistone lysine demethylases (KDMs) have been reported in various malignances, which affect transcriptional regulation of tumor suppressor or oncogenes. However, the relationship between KDMs and formation of tumor microenvironment (TME) in gastric cancer (GC) remain unclear and need to be comprehensively analyzed.In the present study, 24 KDMs were obtained and consensus molecular subtyping was performed using the "NMF" method to stratify TCGA-STAD into three clusters. The ssGSEA and CIBERSORT algorithms were employed to assess the relative infiltration levels of various cell types in the TME. The KDM_score was devised to predict patient survival outcomes and responses to both immunotherapy and chemotherapy.Three KDM genes-related molecular subtypes were Figured out in GC with distinctive clinicopathological and prognostic features. Based on the robust KDM genes-related risk_score and nomogram, established in our work, GC patients’ clinical outcome can be well predicted. Furthermore, low KDM genes-related risk_score exhibited the more effective response to immunotherapy and chemotherapy.This study characterized three KDM genes-related TME pattern with unique immune infiltration and prognosis by comprehensively analyses of transcriptomic profiling. Risk_score was also built to help clinicians decide personalized anticancer treatment for GC patients, including in prediction of immunotherapy and chemotherapy response for patients.
The impact of general and central obesity for all-cause hospitalization among Iranian adults: a 20 year follow-up-results from the TLGS cohort
Authors: Ramezankhani Azra , Azizi Fereidoun , Hasheminia Mitra , Hadaegh Farzad 
Published: May 2023

Abstract
Background
Few studies have examined the effect of obesity indices on total number of hospitalizations. We examined the associations between body mass index (BMI) and waist circumference (WC) and rate of all-cause hospitalizations among Iranian adult participated in the Tehran Lipid and Glucose Study cohort.

Methods
This study included 8202 individuals (3727 men) aged ≥ 30 years, who were followed for a median of 18 years. Participants were categorized into three groups according to their baseline BMI: normal weight, overweight and obese. In addition, they were classified according to WC in two categories: normal WC and high WC. Negative Binomial regression model was used to estimate the incidence rate ratios (IRRs) and 95% confidence interval (95% CI) of all-cause hospitalizations in relation to obesity indices.

Results
The overall crude rate of all-cause hospitalizations were 77.6 (95% CI, 73.9–81.2) and 76.9 (73.4–80.3) per 1000 person-year in men and women, respectively. The covariate adjusted rate of all-cause hospitalizations was 27% higher in obese men than normal weight men (IRR (95% CI): 1.27 (1.11–1.42)). Among women, overweight and obese individuals had 17% (1.17 (1.03–1.31)) and 40% (1.40 (1.23–1.56)) higher rate of hospitalization compared to normal weight women. Having high WC was associated with 18% (1.18 (1.08–1.29)) and 30% (1.30 (1.18–1.41)) higher rate of all-cause hospitalization in men and women, respectively.

Conclusions
Obesity and high WC were associated with increased hospitalization rates during long-term follow-up. Our findings suggests that successful obesity prevention programs may decrease the number of hospitalizations, particularly, in women.