bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low early complication rates after arthroscopic meniscus repair and meniscectomy
Authors: Lai Wilson C. , Mange Tyler R. , Karasavvidis Theofilos , Lee Yu‐Po , Wang Dean 
Published: July 2023

AbstractPurposeTo evaluate the 30‐day complication rates after arthroscopic meniscus repair and meniscectomy using the American College of Surgeons National Surgical Quality Improvement Program (ACS‐NSQIP) database, with subgroup analysis of patients aged > 40 years.MethodsNSQIP registries between 2006 and 2019 were queried using Current Procedural Terminology codes to identify patients undergoing arthroscopic meniscus repair (CPT 29882, 29883) and meniscectomy (29880, 29881). The following 30‐day complications were assessed: pulmonary embolism (PE), venous thromboembolism (VTE), surgical site infection (SSI), reoperation, and readmission. Complications rates between treatment groups were compared using multivariate logistic regression analyses adjusted for sex, age, steroid use, and smoking/dyspnoea/COPD. A subgroup analysis was performed for patients aged > 40 years.ResultsA total 6354 meniscus repairs and 99,372 meniscectomies were identified. Complication rates were < 1% for both meniscus repair and meniscectomy. Meniscus repair was associated with significantly higher rates of PE, VTE, and readmission compared to meniscectomy: PE (0.2% vs 0.1%, p < 0.001), VTE (0.8% vs 0.4%, p < 0.001), superficial SSI (0.1% vs 0.2%, n.s), deep SSI (0.07% vs 0.1%, n.s), reoperation (0.5% vs 0.4%, n.s), and readmission (0.9% vs 0.8%, p = 0.003). Among patients aged > 40 years, complication rates were < 1.3% for both meniscus repair and meniscectomy. Similar trends and rates were found in patients aged > 40 years undergoing meniscus repair versus meniscectomy: PE (0.38% vs 0.12%, p < 0.001), VTE (1.07% vs 0.46%, p < 0.001), superficial SSI (0.03% vs 0.19%, n.s), deep SSI (0.1% vs 0.06%, n.s), reoperation (0.48% vs 0.43%, n.s), and readmission (1.2% vs 0.85%, p = 0.01).ConclusionArthroscopic meniscus repair and meniscectomy are both low‐risk procedures with 30‐day complication rates < 1% overall and < 1.3% among patients aged > 40 years. These findings support meniscus repair whenever feasible in the setting of preserved articular cartilage. Understanding of the short‐term complication rates after arthroscopic meniscus repair and meniscectomy can aid surgeons in providing comprehensive preoperative counselling to patients considering such treatments, specifically when discussing the risks and benefits of meniscus repair.Level of evidenceIII.
Mechanistic aspects of ameliorative effects of Eicosapentanoic acid ethyl ester on methotrexate-evoked testiculopathy in rats
Authors: Abbas Noha A. T. , El-Sayed Shaimaa S. , Abd El-Fatah Samaa Salah , Sarhan Walaa M. , Abdelghany Eman M. A. , Sarhan Omnia , Mahmoud Shireen S. 
Published: July 2023

Abstract
Disrupted spermatogenesis and testicular injury are among the devastating outcomes of methotrexate. A major contributor to methotrexate-induced testiculopathy is oxidative damage which triggers apoptosis and altered autophagy responses. Eicosapentaenoic acid ethyl ester (EPA-E) is an antihyperlipidemic derivative of omega-3 fatty acids that exhibited affinity to peroxisome proliferator-activated receptor-γ (PPAR-γ) that possesses both antioxidant and autophagy modulating properties. This is an exploratory study aiming at assessing the effectiveness of EPA-E to alleviate testicular damage induced by methotrexate. The specific exploratory hypothesis of this experiment is: EPA-E administration for 1 week to methotrexate-treated rats reduces testicular damage compared to control rats. As a secondary outcome, we were interested in identifying the implicated mechanism that mediates the action of EPA-E. In adult male Wistar rats, testiculopathy was achieved by a single methotrexate injection (20 mg/kg, ip). Rats received vehicle, EPA-E (0.3 g/kg/day, po) alone or with selective PPAR-γ antagonist (bisphenol A diglycidyl ether, BADGE) at 30 mg/kg/day, ip for 1 week. EPA-E recuperated methotrexate-attenuated serum total testosterone while reduced testicular inflammation and oxidative stress, restoring superoxide dismutase (SOD) while reducing malondialdehyde (MDA) and 8–hydroxy–2′-deoxyguanosine (8-OHdG). Methotrexate-induced testicular apoptosis (caspase-3 and p53) was suppressed upon EPA-E treatment. Besides, EPA-E curbed methotrexate-induced abnormal autophagy by downregulating LC3A/B and beclin-1. Interestingly, BADGE-coadministration reversed EPA-E beneficial actions. Collectively, our findings suggest PPAR-γ role in EPA-E-mediated mitigation of methotrexate-evoked testiculopathy via suppression of oxidative stress, apoptosis, as well as abnormal autophagy. Furthermore, EPA-E could be used as a preventive therapy for some testiculopathies mediated by oxidative stress.
Graphical Abstract
Retrograde amnesia abolishes the self-reference effect in anterograde memory
Authors: Stendardi Debora , De Luca Flavia , Gambino Silvia , Ciaramelli Elisa 
Published: July 2023

AbstractIs retrograde amnesia associated with an ability to know who we are and imagine what we will be like in the future? To answer this question, we had S.G., a patient with focal retrograde amnesia following hypoxia, two brain-damaged (control) patients with no retrograde memory deficits, and healthy controls judge whether each of a series of trait adjectives was descriptive of their present self, future self, another person, and that person in the future, and later recognize studied traits among distractors. Healthy controls and control patients were more accurate in recognizing self-related compared to other-related traits, a phenomenon known as the self-reference effect (SRE). This held for both present and future self-views. By contrast, no evidence of (present or future) SRE was observed in SG, who concomitantly showed reduced certainty about his personality traits. These findings indicate that retrograde amnesia can weaken the self-schema and preclude its instantiation during self-related processing.
The Impact of Obesity on the Resolution of Hypertension Following Adrenalectomy for Primary Hyperaldosteronism
Authors: Chidambaram Swathikan , Van Den Heede Klaas , Damji Samir , Meeran Karim , Todd Jeannie , Wernig Florian , Palazzo Fausto , Di Marco Aimee N. 
Published: July 2023

AbstractBackgroundThis study aims to determine the impact of patient obesity on the resolution of hypertension and pill burden post‐adrenalectomy for PA. Primary hyperaldosteronism (PA) is the most common cause of secondary hypertension that may be remedied with surgery (unilateral adrenalectomy). Obesity may independently cause hypertension through several mechanisms including activation of the renin–angiotensin–aldosterone pathway. The influence of obesity on the efficacy of adrenalectomy in PA has not been established.MethodsThis is a retrospective analysis of prospectively collected data on patients undergoing adrenalectomy for PA at a single, tertiary‐care surgical centre from January 2015 to December 2020. Electronic health records of patients were screened to collect relevant data. The primary outcomes of the study include post‐operative blood pressure, the reduction in the number of anti‐hypertensive medications and potassium supplementation burden post‐adrenalectomy.ResultsFifty‐three patients were included in the final analysis. There was a significant reduction in the blood pressure and the number of anti‐hypertensive medications in all patients after adrenalectomy (p < 0.001). Of the 34 patients (64.2%) with pre‐operative hypokalaemia, all became normokalaemic and were able to stop supplementation. However obese patients required more anti‐hypertensive medications to achieve an acceptable blood pressure than overweight or normal BMI patients (p < 0.01). Multivariate logistic regression analysis showed that male gender and BMI were independent predictors of resolution of hypertension (p <0.01).ConclusionUnilateral adrenalectomy improves the management of hypertension and hypokalaemia when present in patients with PA. However, obesity has an independent deleterious impact on improvement in blood pressure post‐adrenalectomy for PA.
Standardised Competency‐Based Training of Medical Doctors and Associate Clinicians in Inguinal Repair with Mesh in Sierra Leone
Authors: Ashley Thomas , Ashley Hannah F. , Wladis Andreas , Nordin Pär , Ohene‐Yeboah Michael , Rukas Rimantas , Lipnickas Vytautas , Smalle Isaac O. , Holm Kristina , Kalsi Herta , Palmu Juuli , Sahr Foday , Beard Jessica H. , Löfgren Jenny , Bolkan Håkon A. , van Duinen Alex J. 
Published: July 2023

AbstractIntroductionIn low‐income settings, there is a high unmet need for hernia surgery, and most procedures are performed with tissue repair techniques. In preparation for a randomized clinical trial, medical doctors and associate clinicians received a short‐course competency‐based training on inguinal hernia repair with mesh under local anaesthesia. The aim of this study was to evaluate feasibility, safety and effectiveness of the training.MethodsAll trainees received a one‐day theoretical module on mesh hernia repair under local anaesthesia followed by hands‐on training. Performance was assessed using the American College of Surgeon’s Groin Hernia Operative Performance Rating System. Patients were followed up two weeks and one year after surgery. Outcomes of the patients operated on during the training trial were compared to the 229 trial patients operated on after the training.ResultsDuring three surgical camps, seven medical doctors and six associate clinicians were trained. In total, 129 patients were operated on as part of the training. Of the 13 trainees, 11 reached proficiency. Patients in the training group had more wound infections after two weeks (8.5% versus 3.1%; p = 0.041). There was no difference in recurrence and mortality after one year, and none of the deaths were attributed to the surgery.Discussion and conclusionMesh repair is the international standard for inguinal hernia repair worldwide. Nevertheless, this is not widely accessible in low‐income settings. This study has demonstrated that short‐course intensive hands‐on training of MDs and ACs in mesh hernia repair is effective and safe.Trial Registration: International Clinical Trial Registry ISRCTN63478884.
Vegetation dynamics and land-use change at the Neolithic lakeshore settlement site of Ploča Mičov Grad, Lake Ohrid, North Macedonia
Authors: Brechbühl Sarah , van Vugt Lieveke , Gobet Erika , Morales-Molino César , Volery Joseph , Lotter André F. , Ballmer Ariane , Brugger Sandra O. , Szidat Sönke , Hafner Albert , Tinner Willy 
Published: July 2023

AbstractDetailed knowledge about the interactions between vegetation, climate and land use during the Mesolithic and Neolithic, at the transition from foraging to farming, is still scarce in the Balkans. Here we present a palaeoecological study combining pollen, spores and charcoal found in sedimentary cores from Lake Ohrid, Ploča Mičov Grad, North Macedonia, with a particular focus on the vegetation dynamics during the Late Glacial-Holocene and the Mesolithic-Neolithic transitions. Our record begins at ca. 13,500 cal bp (11,550 cal bc) when partially open vegetation, consisting mainly of Pinus, Abies and deciduous Quercus tree stands grew on the hilly flanks of the bay of Ploča. From 12,650 cal bp (cal 10,700 bc), herbs dominated the record until the onset of the Holocene (ca. 11,700 cal bp; 9750 cal bc), when increasing temperatures led to the establishment of pine-deciduous oak forests including Alnus, Fraxinus ornus, Tilia, Ulmus and Abies. These forests persisted until 7,500 cal bp (cal 5550 bc), when deforestation started due to Neolithic land use. This first phase of Neolithic activities in the Ploča Mičov Grad area precedes the earliest archaeological structures so far recorded by almost 1,000 years. Our data suggest two phases of human land use between 7,500 and 6,300 cal bp (5550–4350 cal bc), when high values of Cerealia type pollen and other cultural indicators indicate intense arable and pastoral farming activities. Once human activities decreased, forests were able to re-establish quickly (within 100–250 years), although the composition changed with disturbance-adapted Ostrya type (mostly Ostrya carpinifolia) and Fagus becoming more important. We conclude that forests were resilient to early human disturbance, despite intensive land use and logging activities gradually leading to forest composition changes. Many of these composition changes can still be seen today, suggesting the legacy of Neolithic farmers is still present in today’s landscape.
Speed limits: the effects of industrial food processing and food texture on daily energy intake and eating behaviour in healthy adults
Authors: Lasschuijt Marlou , Camps Guido , Mars Monica , Siebelink Els , de Graaf Kees , Bolhuis Dieuwerke 
Published: July 2023

Abstract
Purpose
Frequent consumption of industrially processed foods has been associated with obesity. However, it is unknown what drives this association. Food textures of industrially processed foods that stimulate energy overconsumption may be an important driver of this association. Therefore, this study aimed to determine the independent and combined effects of food texture and level of industrial food processing (based on the NOVA classification) on daily energy intake and eating behaviour.

Methods
Eighteen healthy adults (F/M: 11/7, 23 ± 3 y, 22.1 ± 2.0 kg/m2) participated in a 2 × 2 randomized crossover dietary intervention with four conditions (total of 288 meals): hard unprocessed, hard (ultra-)processed, soft unprocessed and soft (ultra-)processed. Daily diets were offered ad libitum and were equal in energy density (1 kcal/g). Food Intake (g) was measured by pre- and post-consumption weighing of the plates. Eating behaviour parameters were derived from video annotations.

Results
Daily energy intake and food intake were, respectively, 33% (571 ± 135 kcal) and 14% (247 ± 146 g) lower in the hard compared to the soft conditions (main texture p < 0.001). Energy intake was lower in both hard conditions compared to the (ultra)processed soft condition (Tukey p < 0.04). Eating rate (g/min) was on average 85% slower (P < 0.001) in the hard compared to the soft conditions (p < 0.001). Level of processing did not affect food intake.

Conclusion
Consumption of hard-textured foods reduces daily energy intake of (ultra-) processed foods. This preliminary investigation shows that there is great variability in food properties that affect energy and food intake beyond industrial food processing. However, findings should be interpreted with precaution considering the limited sample size of this trial. Future classification systems for public health messaging should include energy intake rate to help reduce overconsumption.

Clinical trial registry
NCT04280146, https://www.clinicaltrials.gov, February 21st 2020.
Effect of isolated and combined ingestion of caffeine and citrulline malate on resistance exercise and jumping performance: a randomized double-blind placebo-controlled crossover study
Authors: Haugen Markus Estifanos , Vårvik Fredrik Tonstad , Grgic Jozo , Studsrud Henrik , Austheim Espen , Zimmermann Erik Mathias , Falch Hallvard Nygaard , Larsen Stian , van den Tillaar Roland , Bjørnsen Thomas 
Published: July 2023

Abstract
Purpose
The aim of this study was to explore the isolated and combined effects of caffeine and citrulline malate (CitMal) on jumping performance, muscular strength, muscular endurance, and pain perception in resistance-trained participants.

Methods
Using a randomized and double-blind study design, 35 resistance-trained males (n = 18) and females (n = 17) completed four testing sessions following the ingestion of isolated caffeine (5 mg/kg), isolated CitMal (12 g), combined doses of caffeine and CitMal, and placebo. Supplements were ingested 60 min before performing a countermovement jump (CMJ) test (outcomes included jump height, rate of force development, peak force, and peak power), one-repetition maximum (1RM) squat and bench press, and repetitions to muscular failure in the squat and bench press with 60% of 1RM. Pain perception was evaluated following the repetitions to failure tests. The study was registered at ISRCTN (registration number: ISRCTN11694009).

Results
Compared to the placebo condition, isolated caffeine ingestion and co-ingestion of caffeine and CitMal significantly enhanced strength in 1RM bench press (Cohen’s d: 0.05–0.06; 2.5–2.7%), muscular endurance in the squat (d: 0.46–0.58; 18.6–18.7%) and bench press (d: 0.48–0.64; 9.3–9.5%). However, there was no significant difference between isolated caffeine ingestion and caffeine co-ingested with CitMal, and isolated CitMal supplementation did not have an ergogenic effect in any outcome. No main effect of condition was found in the analysis for CMJ-derived variables, 1RM squat and pain perception.

Conclusion
Caffeine ingestion appears to be ergogenic for muscular strength and muscular endurance, while adding CitMal does not seem to further enhance these effects.
Endothelial ILK induces cardioprotection by preventing coronary microvascular dysfunction and endothelial-to-mesenchymal transition
Authors: Reventun P. , Sánchez-Esteban S. , Cook-Calvete A. , Delgado-Marín M. , Roza C. , Jorquera-Ortega S. , Hernandez I. , Tesoro L. , Botana L. , Zamorano J. L. , Zaragoza C. , Saura M. 
Published: July 2023

AbstractEndothelial dysfunction is an early event in coronary microvascular disease. Integrin-linked kinase (ILK) prevents endothelial nitric oxide synthase (eNOS) uncoupling and, thus, endothelial dysfunction. However, the specific role of endothelial ILK in cardiac function remains to be fully elucidated. We hypothesised that endothelial ILK plays a crucial role in maintaining coronary microvascular function and contractile performance in the heart. We generated an endothelial cell-specific ILK conditional knock-out mouse (ecILK cKO) and investigated cardiovascular function. Coronary endothelial ILK deletion significantly impaired cardiac function: ejection fraction, fractional shortening and cardiac output decreased, whilst left ventricle diastolic internal diameter decreased and E/A and E/Eʹ ratios increased, indicating not only systolic but also diastolic dysfunction. The functional data correlated with extensive extracellular matrix remodelling and perivascular fibrosis, indicative of adverse cardiac remodelling. Mice with endothelial ILK deletion suffered early ischaemic-like events with ST elevation and transient increases in cardiac troponins, which correlated with fibrotic remodelling. In addition, ecILK cKO mice exhibited many features of coronary microvascular disease: reduced cardiac perfusion, impaired coronary flow reserve and arterial remodelling with patent epicardial coronary arteries. Moreover, endothelial ILK deletion induced a moderate increase in blood pressure, but the antihypertensive drug Losartan did not affect microvascular remodelling whilst only partially ameliorated fibrotic remodelling. The plasma miRNA profile reveals endothelial-to-mesenchymal transition (endMT) as an upregulated pathway in endothelial ILK conditional KO mice. Our results show that endothelial cells in the microvasculature in endothelial ILK conditional KO mice underwent endMT. Moreover, endothelial cells isolated from these mice and ILK-silenced human microvascular endothelial cells underwent endMT, indicating that decreased endothelial ILK contributes directly to this endothelial phenotype shift. Our results identify ILK as a crucial regulator of microvascular endothelial homeostasis. Endothelial ILK prevents microvascular dysfunction and cardiac remodelling, contributing to the maintenance of the endothelial cell phenotype.
Das Zweitmeinungsverfahren in der Elektrophysiologie
Authors: Rütz Eva , Bartels Denise , Vogler Julia , Tilz Roland R. 
Published: July 2023

ZusammenfassungGesetzlich versicherte Patient:innen haben die Möglichkeit, vor Durchführung bestimmter Prozeduren zulasten ihrer Krankenversicherung eine zweite Meinung neben der ihres primären Behandlers einzuholen. Auf Seiten der Behandler:innen wie auch der Zweitmeiner:innen entstehen hierdurch verschiedene rechtliche Pflichten und Fragestellungen. Dieser Beitrag erläutert in Grundzügen, welche Pflichten jeweils für Behandler:innen und Zweitmeiner:innen bestehen und wer als Zweitmeiner:in geeignet ist. Ein besonderer Fokus liegt hierbei zum einen auf der Aufklärung über die Möglichkeit der Einholung einer Zweitmeinung durch den/die Behandler:innen. Zum anderen werden die Anforderungen an die Zweitmeiner:innen und deren Aufgaben dargestellt.
Recurrent atypical teratoid/rhabdoid tumors (AT/RT) reveal discrete features of progression on histology, epigenetics, copy number profiling, and transcriptomics
Authors: Johann Pascal D. , Altendorf Lea , Efremova Emma-Maria , Holsten Till , Steinbügl Mona , Nemes Karolina , Eckhardt Alicia , Kresbach Catena , Bockmayr Michael , Koch Arend , Haberler Christine , Antonelli Manila , DeSisto John , Schuhmann Martin U. , Hauser Peter , Siebert Reiner , Bens Susanne , Kool Marcel , Green Adam L. , Hasselblatt Martin , Frühwald Michael C. , Schüller Ulrich 
Published: July 2023

AbstractAtypical teratoid/rhabdoid tumors (AT/RT) are the most common malignant brain tumors manifesting in infancy. They split into four molecular types. The major three (AT/RT-SHH, AT/RT-TYR, and AT/RT-MYC) all carry mutations in SMARCB1, the fourth quantitatively smaller type is characterized by SMARCA4 mutations (AT/RT-SMARCA4). Molecular characteristics of disease recurrence or metastatic spread, which go along with a particularly dismal outcome, are currently unclear. Here, we investigated tumor tissue from 26 patients affected by AT/RT to identify signatures of recurrences in comparison with matched primary tumor samples. Microscopically, AT/RT recurrences demonstrated a loss of architecture and significantly enhanced mitotic activity as compared to their related primary tumors. Based on DNA methylation profiling, primary tumor and related recurrence were grossly similar, but three out of 26 tumors belonged to a different molecular type or subtype after second surgery compared to related primary lesions. Copy number variations (CNVs) differed in six cases, showing novel gains on chromosome 1q or losses of chromosome 10 in recurrences as the most frequent alterations. To consolidate these observations, our cohort was combined with a data set of unmatched primary and recurrent AT/RT, which demonstrated chromosome 1q gain and 10 loss in 18% (n = 7) and 11% (n = 4) of the recurrences (n = 38) as compared to 7% (n = 3) and 0% (n = 0) in the primary tumors (n = 44), respectively. Similar to the observations made by DNA methylation profiling, RNA sequencing of our cohort revealed AT/RT primary tumors and matched recurrences clustering closely together. However, a number of genes showed significantly altered expression in AT/RT-SHH recurrences. Many of them are known tumor driving growth factors, involved in embryonal development and tumorigenesis, or are cell-cycle-associated. Overall, our work identifies subtle molecular changes that occur in the course of the disease and that may help define novel therapeutic targets for AT/RT recurrences.