bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lower Extremity Considerations in the Pregnant Patient
Authors: Black Alexandra T. , Yancovitz Sara , Rouse Angela , Logan Daniel 
Published: May 2023

There remains a paucity of literature on musculoskeletal dysfunction, biomechanics, and pathologies of the lower extremity during pregnancy. There are a multitude of physiologic changes that affect a large percentage of patients throughout pregnancy. Podiatric pathologies observed during gestation can be debilitating for this population, ranging from musculoskeletal and biomechanical causes to traumatic injuries and thromboembolic events. This literature review aims to provide an updated review of lower extremity considerations during pregnancy. The authors seek to provide guidance to clinicians based on a review of the available evidence today, and we aim to address deficiencies in research involving the pregnant population. Levels of Evidence: Level V
Hamstring Stiffness and Strength Responses to Repeated Sprints in Healthy Nonathletes and Soccer Players With Versus Without Previous Injury
Authors: Freitas Sandro R. , Radaelli Régis , Oliveira Raúl , Vaz João R. 
Published: May 2023

Background: The effect of 10 × 30 m repeated sprints on passive and active stiffness of semitendinosus (ST) and biceps femoris long head (BFlh), and knee flexor maximal voluntary isometric contraction (MVIC) and rate of force development (RFD), and whether athletes with previous hamstring injury have a different response, is unknown. Hypothesis: Repeated sprints would (1) increase BFlh stiffness and decrease ST stiffness and knee flexors MVIC and RFD in healthy participants; and (2) greater magnitude of response would be seen in athletes with previous hamstring injury. Study Design: Case series (experiment I) and case control (experiment II) study designs. Level of Evidence: Level 3. Methods: Healthy nonathletes attended 2 replicated sessions (experiment I, n = 18), while soccer players with (n = 38) and without (n = 67) previous hamstring injury attended 1 testing session (experiment II). Results: In both experiments, the knee flexors MVIC and RFD decreased after the sprints ( P < 0.05). In experiment I, the ST and BFlh passive stiffness reduced after the sprints ( P < 0.02), while a small BFlh active stiffness increase was noted ( P = 0.02); however, no correlation was observed between the 2 testing sessions for the postsprint muscle stiffness responses ( r = -0.07-0.44; P > 0.07). In experiment II, only an ST passive stiffness reduction was observed after the sprints ( P < 0.01). No differences were noted between injured and noninjured lower limbs for any variable ( P > 0.10). Conclusion: Repeated sprints are likely to decrease the knee flexor’s maximal and rapid strength, and to alter the hamstring stiffness in the nonathlete population. Previous hamstring injury does not apparently affect the footballer’s hamstring functional and mechanical responses to repeated sprints. Clinical Relevance: The responses of hamstring stiffness and knee flexor strength to repeated sprints are unlikely to be associated with hamstring injury.
Evolution of Pneumococcal Vaccine Recommendations and Criteria for Decision Making in 5 Western European Countries and the United States
Authors: Noharet-Koenig Roxane , Lasota Katarzyna , Faivre Pascaline , Langevin Edith 
Published: May 2023

Objectives Pneumococcal vaccine recommendations have become increasingly complex. This study aims to understand how national immunization technical advisory groups (NITAGs) and health technology assessment (HTA) agencies of 5 European countries and the United States formed their pneumococcal vaccine recommendations, by providing reviewed evidence and key drivers for new recommendations. Methods Centers for Disease Control and Prevention, European Centre for Disease Prevention and Control, and National Health Authorities Web sites were screened to capture the evolution of pneumococcal recommendations. A narrative review was conducted on NITAGs and HTA bodies’ Web sites. Assessments of pneumococcal vaccines published from 2009 to 2022 were included. Results Thirty-four records were identified including 21 assessments for risk groups, 17 for elderly, and 12 for children. Burden of disease and vaccine characteristics were almost systematically reviewed during assessments. All 6 countries recommended the use of higher-valent pneumococcal vaccine (PCV; i.e., PCV10 and PCV13) in childhood vaccination programs, given their broader serotype coverage and their comparable profile to PCV7. PCV13 was progressively added to the vaccine schedule (in addition to polysaccharide vaccine) in at least the high-risk group, given the high burden in this population and expected additional benefits of PCV13. For the elderly, unlike the United States, European countries issued negative recommendation for PCV13 routine use because of substantial herd effects from childhood vaccination program making PCV13 likely not cost-effective. Conclusions This research provides an overview of decision-making processes for higher-valent PCVs recommendations and could be of interest to anticipate the place of next generation of PCVs in the vaccination landscape. Highlights By describing evidence-based criteria for decision making, this study emphasizes the framework analysis of NITAGs and HTA bodies when assessing pneumococcal vaccines and demonstrates that variation exists between countries and also according to population evaluated. While the burden of disease and immunogenicity/efficacy data were almost systematically reviewed by national stakeholders, economic assessments were reported to a lesser extent but played a major role in the limited use of PCV13 in the adult population.
Risk prediction for dermatomyositis-associated hepatocellular carcinoma
Authors: Zhang Xusheng , Ma Yongxin , Liu Kejun , Chen Long , Ding Lin , Ma Weihu , Chen Bendong 
Published: May 2023

Abstract
Objective
To explore dermatomyositis signature genes as potential biomarkers of hepatocellular carcinoma and their associated molecular regulatory mechanisms.

Methods
Based on the mRNA-Seq data of dermatomyositis and hepatocellular carcinoma in public databases, five dermatomyositis signature genes were screened by LASSO regression analysis and support vector machine (SVM) algorithm, and their biological functions in dermatomyositis with hepatocellular carcinoma were investigated, and a nomogram risk prediction model for hepatocellular carcinoma was constructed and its predictive efficiency was initially evaluated. The immune profile in hepatocellular carcinoma was examined based on the CIBERSORT and ssGSEA algorithms, and the correlation between five dermatomyositis signature genes and tumor immune cell infiltration and immune checkpoints in hepatocellular carcinoma was investigated.

Results
The expression levels of five dermatomyositis signature genes were significantly altered in hepatocellular carcinoma and showed good diagnostic efficacy for hepatocellular carcinoma, suggesting that they may be potential predictive targets for hepatocellular carcinoma, and the risk prediction model based on five dermatomyositis signature genes showed good risk prediction efficacy for hepatocellular carcinoma and has good potential for clinical application. In addition, we also found that the upregulation of SPP1 expression may activate the PI3K/ART signaling pathway through integrin-mediated activation, which in turn regulates the development and progression of hepatocellular carcinoma.

Conclusion
LY6E, IFITM1, GADD45A, MT1M, and SPP1 are potential predictive targets for new-onset hepatocellular carcinoma in patients with dermatomyositis, and the upregulation of SPP1 expression may activate the PI3K/ART signaling pathway through the mediation of integrins to promote the development and progression of hepatocellular carcinoma.
Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study
Authors: MacLeod Heather , Veillette Nathalie , Klein Jennifer , Delli-Colli Nathalie , Egan Mary , Giroux Dominique , Kergoat Marie-Jeanne , Gingrich Shaen , Provencher Véronique 
Published: May 2023

AbstractBackgroundWhen there are safety concerns, healthcare professionals (HCPs) may disregard older adults’ wishes to return or remain at home. A paradigm shift is needed for HCPs to move from labelling older adults as living at risk to helping them live with risk. The Living with Risk: Decision Support Tool (LwR:DST) was developed to support older adults and HCPs with difficult decision-making regarding living with risk. The study objectives were to: (1) validate, and (2) pilot-test the LwR:DST in hospital and community settings.MethodsThe study was conducted across Canada during the pandemic. The LwR:DST’s content was validated with quantitative and qualitative data by: (1) 71 HCPs from hospital and community settings using the Delphi method, and (2) 17 older adults and caregivers using focus groups. HCPs provided feedback on the LwR:DST’s content, format and instruction manual while older adults provided feedback on the LwR:DST’s communication step. The revised LwR:DST was pilot-tested by 14 HCPs in one hospital and one community setting, and 17 older adults and caregivers described their experience of HCPs using this approach with them. Descriptive and thematic analysis were performed.ResultsThe LwR:DST underwent two iterations incorporating qualitative and quantitative data provided by HCPs, older adults and caregivers. The quantitative Delphi method data validated the content and the process of the LwR:DST, while the qualitative data provided practical improvements. The pilot-testing results suggest that using the LwR:DST broadens HCPs’ clinical thinking, structures their decision-making, improves their communication and increases their competence and comfort with risk assessment and management. Our findings also suggest that the LwR:DST improves older adults’ healthcare experience by feeling heard, understood and involved.ConclusionsThis revised LwR:DST should help HCPs systematically identify frail older adults’ risks when they remain at or return home and find acceptable ways to mitigate these risks. The LwR:DST induces a paradigm shift by acknowledging that risks are inherent in everyday living and that risk-taking has positive and negative consequences. The challenges involved in integrating the LwR:DST into practice, i.e., when, how and with whom to use it, will be addressed in future research.
Extracellular status of thrombospondin-2 in type 2 diabetes mellitus and utility as a biomarker in the determination of early diabetic kidney disease
Authors: Lin Zhenzhen , Zhang Didong , Zhang Xinxin , Guo Wanxie , Wang Wenjun , Zhang Yingchao , Liu Zhen , Bi Yanxue , Wu Maolan , Lin Zhuofeng , Lu Xuemian 
Published: May 2023

Abstract
Objective
Thrombospondin-2 (TSP-2) is a multifunctional matricellular glycoprotein correlated with glucose homeostasis, insulin sensitivity, and estimated glomerular filtration rate. Investigation of the association of TSP-2 with type 2 diabetes mellitus (T2DM) and the potential diagnostic value of serum TSP-2 for detecting early diabetic kidney disease (DKD) is needed.

Research design and methods
An enzyme-linked immunosorbent assay was used for detection serum TSP-2 levels in 494 Chinese T2DM subjects. The protein expression of TSP-2 in the kidney and other tissues were tested by western blotting.

Results
Serum TSP-2 levels in T2DM subjects were significantly higher than in healthy individuals. Serum TSP-2 correlated positively with triglycerides, serum uric acid, creatinine, platelets, and urinary albumin-to-creatinine ratio (UACR), but negatively with estimated glomerular filtration rate, after adjusting for age, sex, and T2DM duration. Logistic regression analysis demonstrated an independent association between serum TSP-2 and early DKD. Furthermore, the high UACR identified at risk of early DKD increased significantly from 0.78 (95%CI 0.73–0.83) to 0.82 (95%CI 0.77–0.86, p < 0.001) when added to a clinical model consisting of TSP-2 and age. In db/db mice, serum TSP-2 levels were elevated. TSP-2 expression was markedly increased in the kidney tissue compared with that in db/m and m/m mice. Furthermore, serum TSP-2 expression correlated well with UACR in mice.

Conclusions
TSP-2 is a novel glycoprotein associated with early DKD in patients with T2DM. The paradoxical increase of serum TSP-2 in T2DM individuals may be due to a compensatory response to chronic inflammatory and renal vascular endothelial growth, warranting further investigation.
A systematic review and meta-analysis on the efficacy outcomes of selective serotonin reuptake inhibitors in depression in Alzheimer’s disease
Authors: Zhang Jinli , Zheng Xiaohui , Zhao Zhenying 
Published: May 2023

Abstract
Background
Depressive symptoms are the most common neuropsychiatric symptoms in patients with Alzheimer’s disease (AD). However, despite being common, no definite consensus recommendations exist for the management of depression in AD.

Objective
To assess the effects of selective serotonin reuptake inhibitors (SSRIs) on the alleviation of depressive symptoms in patients with AD.

Material and methods
Medline, Scopus, Web of Science, Google Scholar, and PsychINFO were electronically searched from inception until October 2022. Response to therapy and mean depression scores between the treatment (or before) and placebo (or after) groups were the primary outcomes. For depression scores, the standard mean deviation and accompanying 95% confidence interval were determined. The risk of bias was determined using the funnel plot, trim and fill, Egger’s and Begg’s analyses.

Results
SSRIs attenuated depressive symptoms in patients with AD (0.905 SMD, 95%CI, 0.689 to 1.121, p < 0.000). At individual SSRI level, escitalopram, paroxetine, and sertraline significantly alleviated depressive symptoms in AD patients (0.813 SMD, 95%CI, 0.207 to 1.419, p = 0.009, 1.244 SMD, 95%CI, 0.939 to 1.548, p < 0.000, and 0.818 SMD, 95%CI, 0.274 to 1.362, p < 0.000). The funnel plot, trim and fill, Begg’s test (p = 0.052), and Egger’s test (p = 0.148), showed no significant risk of publication bias.

Conclusion
Our meta-analysis supports the use of SSRIs for the alleviation of depression in patients with AD. However, we recommend larger randomized clinical trials that would compare the efficacy of different SSRIs in AD patients with depression.
Hsp90 is a potential risk factor for ovarian cancer prognosis: an evidence of a Chinese clinical center
Authors: Duan Cancan , Li KuoKuo , Pan Xiaohua , Wei Zhaolian , Xiao Lan 
Published: May 2023

Abstract
Background
The potential treatment effects of heat shock protein 90 (Hsp90) inhibitors in ovarian cancer (OC) are controversial. This research aims to investigate the relationship between the level of Hsp90 in peripheral blood and the prognosis of OC patients, as well as the clinicopathological indicators.

Materials and methods
We retrospectively collected the clinicopathological indicators of OC patients who were admitted to the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Anhui Medical University from 2017 to 2022. Hsp90 level in patient blood was detected by enzyme-linked immunosorbent assay, and the correlation between Hsp90 level and OC prognosis was systematically investigated. Kaplan–Meier method was used to draw the survival curve, and the average survival time and survival rate were calculated. The log-rank test and Cox model were used for univariate survival analysis, and the Cox proportional hazards model was applied for multivariate survival analysis. Based on the TCGA dataset of OC obtained by cBioPortal, Pearson’s correlation coefficients between Hsp90 level values and other mRNA expression values were calculated to further conduct bioinformatics analysis. GSEA and GSVA analysis were also conducted for gene functional enrichment. The expression of Hsp90 in OC tissues were evaluated and compared by Immunohistochemical staining.

Results
According to the established screening criteria, 106 patients were selected. The enzyme-linked immunosorbent assay results showed that 50.94% OC patients with abnormal Hsp90 level. According to the outcome of Kaplan–Meier curves, the results revealed that the abnormal level of Hsp90 was suggested to poor prognosis (P = 0.001) of OC patients. Furthermore, the result of multivariate Cox proportional hazards regression model analysis also predicted that abnormal Hsp90 level (HR = 2.838, 95%CI = 1.139–7.069, P = 0.025) was linked to poor prognosis, which could be an independent prognostic factor for the prognosis of OC patients. Moreover, top 100 genes screened by Pearson’s value associated with Hsp90, indicating that Hsp90 participated in the regulation of ATF5 target genes, PRAGC1A target genes and BANP target genes and also enriched in the metabolic processes of cell response to DNA damage stimulus, response to heat and protein folding.

Conclusion
Hsp90 level is positively associated with OC mortality and is a potential prognostic indicator of OC.
Dissociation protocols used for sarcoma tissues bias the transcriptome observed in single-cell and single-nucleus RNA sequencing
Authors: Truong Danh D. , Lamhamedi-Cherradi Salah-Eddine , Porter Robert W. , Krishnan Sandhya , Swaminathan Jyothishmathi , Gibson Amber , Lazar Alexander J. , Livingston J. Andrew , Gopalakrishnan Vidya , Gordon Nancy , Daw Najat C. , Navin Nicholas E. , Gorlick Richard , Ludwig Joseph A. 
Published: May 2023

Abstract
Background
Single-cell RNA-seq has emerged as an innovative technology used to study complex tissues and characterize cell types, states, and lineages at a single-cell level. Classification of bulk tumors by their individual cellular constituents has also created new opportunities to generate single-cell atlases for many organs, cancers, and developmental models. Despite the tremendous promise of this technology, recent evidence studying epithelial tissues and diverse carcinomas suggests the methods used for tissue processing, cell disaggregation, and preservation can significantly bias gene expression and alter the observed cell types. To determine whether sarcomas – tumors of mesenchymal origin – are subject to the same technical artifacts, we profiled patient-derived tumor explants (PDXs) propagated from three aggressive subtypes: osteosarcoma (OS), Ewing sarcoma (ES), desmoplastic small round cell tumor (DSRCT). Given the rarity of these sarcoma subtypes, we explored whether single-nuclei RNA-seq from more widely available archival frozen specimens could accurately be identified by gene expression signatures linked to tissue phenotype or pathognomonic fusion proteins.

Results
We systematically assessed dissociation methods across different sarcoma subtypes. We compared gene expression from single-cell and single-nucleus RNA-sequencing of 125,831 whole-cells and nuclei from ES, DSRCT, and OS PDXs. We detected warm dissociation artifacts in single-cell samples and gene length bias in single-nucleus samples. Classic sarcoma gene signatures were observed regardless of the dissociation method. In addition, we showed that dissociation method biases could be computationally corrected.

Conclusions
We highlighted transcriptional biases, including warm dissociation and gene-length biases, introduced by the dissociation method for various sarcoma subtypes. This work is the first to characterize how the dissociation methods used for sc/snRNA-seq may affect the interpretation of the molecular features in sarcoma PDXs.
Association between previous cataract surgery and cognition among middle-aged and older Chinese: the China health and retirement longitudinal study (CHARLS)
Authors: Zhao Xiaohuan , Wei Kunchen , Sun Junran , Chen Jieqiong , Wang Yimin , Chen Yuhong , Zhu Xinyue , Sun Xiaodong , Li Tong , Zhou Minwen 
Published: May 2023

Abstract
Background
Cataract is the primary cause of blindness globally, and surgery offers the only method by which to remove cataracts. We aimed to examine whether previous cataract surgery is associated with cognitive function.

Methods
Our study included 13,824 participants. Data from the baseline of the China Health and Retirement Longitudinal Study (CHARLS) were used. The participants were categorized into two groups: with and without previous cataract surgery. Weighted multiple linear regression was used to obtain the β and 95% confidence intervals (CI).

Results
The participants who had previous cataract surgery (n = 261) scored lower in cognition, including both memory and mental state, than those without previous cataract surgery. After adjusting for socioeconomic factors and metabolic measures, a negative association was evident between previous cataract surgery and cognition (β = −0.647, 95% CI: −1.244, − 0.049). Furthermore, the participants who were older and female demonstrated a decline in cognition, while living in cities and having higher levels education were associated with higher cognition.

Conclusions
Better cognitive function was associated with less previous cataract surgery or cataract occurrence. This suggests that a period of vision loss due to cataract leads to cognitive decline, however further studies are need to dissect the impact of vision loss and cataract surgery on cognitive decline.