bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Fixation Prior to Fasciectomy Leads to Substantial Improvement of Advanced Dupuytren’s PIP Contractures at Mean Follow-up 15 Months
Authors: Qiu Bowen , Hammert Warren , Wilbur Danielle 
Published: June 2023

Background: The Digit Widget is an external fixation device that can be used to reverse proximal interphalangeal joint (PIPJ) contractures in the hand. Our hypothesis is that usage of the Digit Widget prior to fasciectomy in patients with severe Dupuytren’s proximal interphalangeal (PIP) contractures will result in short-term improvement and maintenance of the PIPJ contracture after fasciectomy. Methods: Patients who underwent placement of the Digit Widget soft tissue distractor prior to fasciectomy for Dupuytren’s disease were identified between January 2015 and December 2018. Multiple fingers were considered separately. Patient Reported Outcome Measurement Information System (PROMIS) Physical Function (PF), Pain Interference, and Depression scores were collected. Patients treated for contractures from etiologies other than Dupuytren’s were not included. Multiple linear regression was used to compare initial PIP contractures, PF scores, and final contractures. Results: There were 28 fingers in 24 patients with average age of 56 ± 12 (30.5-69.9) years. Initial mean PIPJ contracture was 81° (50°-120°), which had corrected to 23° at time of removal. Average time between application and fasciectomy was 58 (28-112) days. At final follow-up, average 449 (58-1641) days, the average contracture was 39° (0°-105°). Contracture immediately following fasciectomy was found to be strongly correlated with the contracture at final follow-up. There was no statistical relationship between final PROMIS PF scores and final change in contracture. Conclusions: Digit Widget external fixation is an effective treatment for the correction of advanced PIPJ contractures related to Dupuytren’s disease, with an average of 52% improvement in contracture at 15 months.
Spontaneous Rupture of the Extensor Pollicis Longus Tendon: A Systematic Review
Authors: Lister Rachel C. , Bradford Henry C. , Joo Alex , Carr Catherine W. , Delancy Anna , Naram Aparajit , Rothkopf Douglas M. , Shufflebarger John V. 
Published: June 2023

Background: Extensor pollicis longus (EPL) rupture and tenosynovitis of the third dorsal compartment is often described in association with a history of rheumatoid arthritis or in the setting of a distal radius fracture. However, the literature suggests multiple other potential factors that may lead to a seemingly spontaneous rupture. Methods: We performed a systematic review following guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The search consisted of headings and keywords related to tendon injuries, tendinopathy, hand surgery, tendon transfer, and injections, as published in reports and studies. Citations were screened by title and abstract against predetermined inclusion and exclusion criteria by 2 independent reviewers, with a third reviewer resolving discrepancies. To be eligible, articles had to meet the following inclusion criterion: describe cases of spontaneous EPL rupture or tenosynovitis of the third dorsal compartment. The exclusion criterion was any history of distal radius fracture or rheumatoid arthritis. Results: We identified 29 articles that met the inclusion criterion. Conclusions: A myriad of prodromal events or predisposing factors ultimately led to EPL rupture or tenosynovitis of the third compartment. Methods of reconstruction described included primary repair, tendon grafting, and tendon transfer techniques; all with generally good outcomes. These results highlight the inherent fragility of this tendon and support the historical recommendation for early release of the EPL tendon in the setting of tenosynovitis of the third dorsal compartment.
Partner engagement for planning and development of non-pharmacological care pathways in the AIM-Back trial
Authors: Ballengee Lindsay A , King Heather A , Simon Corey , Lentz Trevor A , Allen Kelli D , Stanwyck Catherine , Gladney Micaela , George Steven Z , Hastings S Nicole 
Published: June 2023

Background/Aims Embedded pragmatic clinical trials are increasingly recommended for non-pharmacological pain care research due to their focus on examining intervention effectiveness within real-world settings. Engagement with patients, health care providers, and other partners is essential, yet there is limited guidance for how to use engagement to meaningfully inform the design of interventions to be tested in pain-related pragmatic clinical trials. This manuscript aims to describe the process and impacts of partner input on the design of two interventions (care pathways) for low back pain currently being tested in an embedded pragmatic trial in the Veterans Affairs health care system. Methods Sequential cohort design for intervention development was followed. Engagement activities were conducted with 25 participants between November 2017 and June 2018. Participants included representatives from multiple groups: clinicians, administrative leadership, patients, and caregivers. Results Partner feedback led to several changes in each of the care pathways to improve patient experience and usability. Major changes to the sequenced care pathway included transitioning from telephone-based delivery to a flexible telehealth model, increased specificity about pain modulation activities, and reduction of physical therapy visits. Major changes to the pain navigator pathway included transitioning from a traditional stepped care model to one that offers care in a feedback loop, increased flexibility regarding pain navigator provider type, and increased specificity for patient discharge criteria. Centering patient experience emerged as a key consideration from all partner groups. Conclusion Diverse input is important to consider before implementing new interventions in embedded pragmatic trials. Partner engagement can increase acceptability of new care pathways to patients and providers and enhance uptake of effective interventions by health systems. Trial registration NCT#04411420. Registered on 2 June 2020.
Robotic-assisted radical prostatectomy is pushing the boundaries: a national survey of frailty using the national surgical quality improvement program
Authors: Abou Heidar Nassib F. , Ayoub Christian Habib , Abou Mrad Anthony , Abdul Khalek Jad , Tamim Hani , El-Hajj Albert 
Published: June 2023

Background: Robotic-assisted radical prostatectomy (RARP) has been found to be comparable and, in some cases, favorable to open surgical approaches, while being used in a frailer population. Objectives: We aimed to illustrate the trend in population frailty and compare morbidity and mortality postoperatively in patients who underwent RARP. Design and Methods: The National Surgical Quality Improvement Program data set was used to select patients who underwent RARP between the years 2011–2019. Age, frailty indicators, surgical characteristics, and perioperative morbidity and mortality were compared between the years 2011–2019 using the chi-square test (χ2) for categorical variables and the one-way analysis of variance (ANOVA) for continuous variables. Results: Our patient population consisted of 66,683 patients who underwent RARP. There was an increase in mean age and frailty indicated by an increase in 5-item frailty score ⩾2, metabolic syndrome index = 3, and American Society of Anesthesiologists’ (ASA) class ⩾3 between the years 2011–2019 ( p < 0.001). Whereas the rate of mortality and morbidity, indicated by postoperative Clavien–Dindo grade ⩾4 and major morbidity, remained the same over the same period ( p > 0.264). Furthermore, operative time and length of stay decreased over the same period ( p < 0.001). Conclusion: RARP is being performed on more frail patients, with no added morbidity or mortality.
Oligonucleotide nanoassemblies with allyl bromide scaffold-based small molecules
Authors: Abbas Sk Jahir , Yesmin Sabina , Xia Fangfang , Ali Sk Imran , Xiao Zeyu , Tan Weihong 
Published: June 2023

AbstractThe development of oligonucleotide nanoassemblies with small molecules has shown great potential in bio-medical applications. However, the interaction of negatively charged oligonucleotides with halogenated small molecules represents a scientific challenge. Here, we introduced a distinct allyl bromide halogenated scaffold, which exhibits specific interaction with adenine nucleic bases of the oligonucleotides, thus leading to the formation of self-assembled nanostructures.

Graphical abstract
Population structure and insecticide response of Gammarus spp. in agricultural and upstream forested sites of small streams
Authors: Schneeweiss Anke , Schreiner Verena C. , Liess Matthias , Röder Nina , Schwenk Klaus , Schäfer Ralf B. 
Published: June 2023

AbstractExposure to pesticides may cause adaptation not only in agricultural pests and pathogens, but also in non-target organisms. Previous studies mainly searched for adaptations in non-target organisms in pesticide-polluted sites. However, organisms may propagate heritable pesticide effects, such as increased tolerance, to non-exposed populations through gene flow. We examined the pesticide tolerance—as one of the pre-assumptions of local adaptation—of the freshwater crustacean Gammarus spp. (at genus level reflecting the gammarid community). The pesticide tolerance was quantified in acute toxicity tests using the insecticide imidacloprid. Gammarids were sampled at pesticide-polluted agricultural sites (termed agriculture), least impacted upstream sites (termed refuge) and transitional sites (termed edge) in six small streams of south-west Germany. Furthermore, we examined the population genetic structure of Gammarus fossarum and the energy reserves (here lipid content) of G. fossarum as well as of Gammarus spp. at the three site types (i.e. agriculture, edge and refuge). We found significantly lower imidacloprid tolerance of Gammarus spp. from agricultural sites compared to edge and refuge sites, potentially due to higher environmental stress at agricultural sites, as indicated by a slightly lower lipid content per mg gammarid tissue. We found no differences in pesticide tolerance between edge and refuge populations, indicating no propagation of pesticide effects to edges. The genetic structure among G. fossarum populations showed significant differentiation between streams, but not within a stream across the site types. We suggest that high gene flow within each stream hindered population differentiation and resulted in similar (pre)adaptations to local stress levels between site types, although they exhibited different pesticide pollution. Further studies on target genes (e.g., conferring pesticide tolerance), population structure and fitness of different phenotypes in particular among non-target organisms are required for adjacent pristine ecosystems to detect potential propagations of pesticide effects.
A multi-omics analysis reveals CLSPN is associated with prognosis, immune microenvironment and drug resistance in cancers
Authors: Chen Yihong , Wen Haicheng , Li Yin , Han Ying , Tan Jun , Guo Cao , Cai Changjing , Liu Ping , Peng Yinghui , Liu Yihan , Wang Xinwen , Zeng Shan , Feng Ziyang , Shen Hong 
Published: June 2023

Abstract
Background
Immunotherapy is effective only in limited patients. It is urgent to discover a novel biomarker to predict immune cells infiltration status and immunotherapy response of different cancers. CLSPN has been reported to play a pivotal role in various biological processes. However, a comprehensive analysis of CLSPN in cancers has not been conducted.

Methods
To show the whole picture of CLSPN in cancers, a pan-cancer analysis was conducted in 9125 tumor samples across 33 cancer types by integrating transcriptomic, epigenomic and pharmacogenomics data. Moreover, the role of CLSPN in cancer was validated by CCK-8, EDU, colony formation and flow cytometry in vitro and tumor cell derived xenograft model in vivo.

Results
CLSPN expression was generally upregulated in most cancer types and was significantly associated with prognosis in different tumor samples. Moreover, elevated CLSPN expression was closely correlated with immune cells infiltration, TMB (tumor mutational burden), MSI (microsatellite instability), MMR (mismatch repair), DNA methylation and stemness score across 33 cancer types. Enrichment analysis of functional genes revealed that CLSPN participated in the regulation of numerous signaling pathways involved in cell cycle and inflammatory response. The expression of CLSPN in LUAD patients were further analyzed at the single-cell level. Knockdown CLSPN significantly inhibited cancer cell proliferation and cell cycle related cyclin-dependent kinase (CDK) family and Cyclin family expression in LUAD (lung adenocarcinoma) both in vitro and in vivo experiments. Finally, we conducted structure-based virtual screening by modelling the structure of CHK1 kinase domain and Claspin phosphopeptide complex. The top five hit compounds were screened and validated by molecular docking and Connectivity Map (CMap) analysis.

Conclusion
Our multi-omics analysis offers a systematic understanding of the roles of CLSPN in pan-cancer and provides a potential target for future cancer treatment.
Assessment of autoantibodies in paediatric population with primary immunodeficiencies: a pilot study
Authors: Pieniawska-Śmiech Karolina , Lewandowicz-Uszyńska Aleksandra , Zemelka-Wiacek Magdalena , Jutel Marek 
Published: June 2023

Abstract
Background
The correlation between primary immunodeficiencies (PIDs) and autoimmunity shows ethnic and geographical diversity. The aim of our study was to accumulate more data in paediatric PID population.

Methods
58 children aged 1–17 and with PID (study group) and 14 age-matched immunocompetent individuals (control group) were included in the study. Serum levels of 17 different specific IgG antibodies against autoantigens were measured by means of a quantitative enzyme immunoassay. Immunoglobulin levels were analysed in relation to a detailed medical examination.

Results
Autoantibodies against one or more antigens were detected in the sera of 24.14% (n = 14) subjects in the study group. The most frequent were anti-thyroid peroxidase (anti-TPO) antibodies (n = 8; 13.8%). Anti-TPO antibody levels were elevated more often in PID patients with a positive family history of autoimmune diseases (p = 0.04). The screening for anti-deamidated gliadin peptide (DGP) and anti-tissue transglutaminase (tTG) antibodies in our series allowed identifying two previously undiagnosed cases of coeliac disease in PID patients. There was no statistically significant difference between the study and the control group in terms of the autoantibodies prevalence.

Conclusions
This study provides data on the prevalence of autoantibodies in paediatric population diagnosed with PID. Selected autoantibodies (i.e. anti-tTG, anti-DGP) might be useful for the screening of PID to avoid the delay of diagnosis of an autoimmune disease.
Opioid-free anesthesia with lidocaine for improved postoperative recovery in hysteroscopy: a randomized controlled trial
Authors: Cha NH , Hu Y , Zhu GH , Long X , Jiang JJ , Gong Yuan 
Published: June 2023

Abstract
Background
Anesthesia with opioids negatively affects patients’ quality of recovery. Opioid-free anesthesia attempts to avoid these effects. This study aimed to evaluate the effect of opioid-free anesthesia on the quality of recovery, using lidocaine on patients undergoing hysteroscopy.

Methods
A parallel-group, randomized, double-blind, controlled trial was conducted in Yichang Central Peoples’ Hospital, Hubei Province, China, from January to April, 2022. We included 90 female patients (age: 18–65 years, American Society of Anesthesiologists Physical Status Class I–II) scheduled for elective hysteroscopy, 45 of whom received lidocaine (Group L), and 45 received sufentanil (Group S). Patients were randomly allocated to receive either lidocaine or sufentanil perioperatively. The primary outcome was the quality of postoperative recovery, which was assessed using the QoR-40 questionnaire (a patient-reported outcome questionnaire measuring the quality of recovery after surgery).

Results
The two groups were similar in age, American Society of Anesthesiology physical status, height, weight, body mass index, and surgical duration. The QoR scores were significantly higher in Group L than Group S. The incidence of postoperative nausea and vomiting, as well as the time to extubation were significantly lower in Group L than Group S.

Conclusion
Opioid-free anesthesia with lidocaine achieves a better quality of recovery, faster recovery, and a shorter time to extubation than general anesthesia with sufentanil.

Trial registration
The trial was registered on January 15, 2022 in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/showprojen.aspx?proj=149386), registration number ChiCTR2200055623.(15/01/2022).
Dexmedetomidine versus haloperidol for sedation of non-intubated patients with hyperactive delirium during the night in a high dependency unit: study protocol for an open-label, parallel-group, randomized controlled trial (DEX-HD trial)
Authors: Minami Takuma , Watanabe Hirotoshi , Kato Takao , Ikeda Kaori , Ueno Kentaro , Matsuyama Ai , Maeda Junya , Sakai Yoji , Harada Hisako , Kuriyama Akira , Yamaji Kyohei , Kitajima Naoki , Kamei Jun , Takatani Yudai , Sato Yuki , Yamashita Yugo , Mizota Toshiyuki , Ohtsuru Shigeru 
Published: June 2023

Abstract
Background
Delirium is common in critically ill patients. Haloperidol has long been used for the treatment of delirium. Dexmedetomidine has recently been used to treat delirium among intubated critically ill patients. However, the efficacy of dexmedetomidine for delirium in non-intubated critically ill patients remains unknown. We hypothesize that dexmedetomidine is superior to haloperidol for sedation of patients with hyperactive delirium, and would reduce the prevalence of delirium among non-intubated patients after administration. We will conduct a randomized controlled trial to compare dexmedetomidine and haloperidol for the treatment of nocturnal hyperactive delirium in non-intubated patients in high dependency units (HDUs).

Methods
This is an open-label, parallel-group, randomized controlled trial to compare the efficacy and safety of dexmedetomidine and haloperidol for nocturnal hyperactive delirium in non-intubated patients at two HDUs of a tertiary hospital. We will recruit consecutive non-intubated patients who are admitted to the HDU from the emergency room, and allocate them in a 1:1 ratio to the dexmedetomidine or haloperidol group in advance. The allocated investigational drug will be administered only when participants develop hyperactive delirium (Richmond Agitation-Sedation Scale [RASS] score ≥1 and a positive score on the Confusion Assessment Method for the ICU between 19:00 and 6:00 the next day) during the night at an HDU. Dexmedetomidine is administered continuously, while haloperidol is administered intermittently. The primary outcome is the proportion of participants who achieve the targeted sedation level (RASS score of between -3 and 0) 2h after the administration of the investigational drug. Secondary outcomes include the sedation level and prevalence of delirium on the day following the administration of the investigational drugs, and safety. We plan to enroll 100 participants who develop nocturnal hyperactive delirium and receive one of the two investigational drugs.

Discussion
This is the first randomized controlled trial to compare the efficacy and safety of dexmedetomidine and haloperidol for sedation of non-intubated critically ill patients with hyperactive delirium in HDUs. The results of this study may confirm whether dexmedetomidine could be another option to sedate patients with hyperactive delirium.

Trial registration
Japan Registry of Clinical Trials, jRCT1051220015, registered on 21 April 2022.
AT1R gene rs389566 polymorphism contributes to MACCEs in hypertension patients
Authors: Luo Jun-Yi , Du Guo-Li , Hao Yang-Min , Liu Fen , Zhang Tong , Fang Bin-Bin , Li Xiao-Mei , Gao Xiao-Ming , Yang Yi-Ning 
Published: June 2023

Abstract
Objective
To investigate the possible association between AT1R gene polymorphisms and major adverse cardiovascular and cerebrovascular events (MACCEs) in hypertension patients combined with or without coronary artery disease (CAD) in Xinjiang.

Methods
374 CAD patients and 341 non-CAD individuals were enrolled as study participants and all of them have a hypertension diagnosis. AT1R gene polymorphisms were genotyped by SNPscan™ typing assays. During the follow-up in the clinic or by telephone interview, MACCEs were recorded. Kaplan–Meier curves and Cox survival analyses were used to explore the association between AT1R gene polymorphisms and the occurrence of MACCEs.

Results
AT1R gene rs389566 was associated with MACCEs. The TT genotype of the AT1R gene rs389566 had a significantly higher probability of MACCEs than the AA + AT genotype (75.2% vs. 24.8%, P = 0.033). Older age (OR = 1.028, 95% CI: 1.009–1.0047, P = 0.003) and TT genotype of rs389566 (OR = 1.770, 95% CI: 1.148–2.729, P = 0.01) were risk factors of MACCEs. AT1R gene rs389566 TT genotype may be a predisposing factor for the occurrence of MACCEs in hypertensive patients.

Conclusion
We should also pay more attention to the prevent of MACCEs in hypertension patients combined with CAD. Especially those elderly hypertensive patients carrying AT1R rs389566 TT genotype requires avoidance of unhealthy lifestyle, better management of blood pressure control and reduce the occurrence of MACCEs.
Meta-analysis of differences in neutrophil to lymphocyte ratio between hypertensive and non-hypertensive individuals
Authors: Sarejloo Shirin , Dehesh Moein , Fathi Mobina , Khanzadeh Monireh , Lucke-Wold Brandon , Ghaedi Arshin , Khanzadeh Shokoufeh 
Published: June 2023

AbstractThis study systematically reviewed the evidence regarding differences in the neutrophil to lymphocyte ratio (NLR) level between hypertensive and normotensive individuals as well as between patients with dipper and non-dipper hypertension (HTN). PubMed, Scopus, and Web of Science databases were systematically searched up to 20 December 2021. This was done without any limitation with regard to date, publication, or language. Pooled weighted mean differences (WMD) with 95% confidence intervals (95% CI) were reported. We assessed the quality of studies based on the Newcastle–Ottawa Scale (NOS). In total, 21 studies were included in our study. There was a significant increase in NLR levels for the hypertensive group in comparison to the control group (WMD = 0.40, 95%CI = 0.22–0.57, P < 0.0001). In addition, the NLR levels were higher in the non-dipper than in the dipper group (WMD = 0.58, 95%CI = 0.19–0.97, P = 0.003). Our findings showed that hypertensive patients had higher level of NLR than normotensive individuals.