bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of jade moxibustion and traditional moxibustion in the treatment of knee osteoarthritis: A randomized clinical trial
Authors: Yin Yue , Chen Lusheng , Wang Xiangyun , Fang Jing , Zhao Ling , Shen Xueyong 
Published: August 2023

Background:
This study was developed to compare the relative clinical efficacy of traditional moxibustion and Jade moxibustion in an effort to define the most effective approaches to treating knee osteoarthritis.

Methods:
In total, 94 patients were randomly assigned at a 1:1 ratio to the traditional moxibustion (TM) and Jade moxibustion (JM) groups. For JM, a jade kneepad was preheated for 3 minutes via electrification, with the jade in the kneepad being pressed onto acupoints when reaching an initial temperature of 46°C. For patients in the TM group, moxa cones were applied to acupoints for treatment. In total, 12 treatments were performed for patients in each group, with treatment being conducted 3 times per week. Study outcomes included 36-item short-form health survey and Western Ontario and McMaster Universities Osteoarthritis Index knee stiffness scores. In addition, serum levels of osteoarthritis-related cytokines were measured.

Results:
Overall, 89/94 patients completed this study, including 44 and 45 in the TM and JM groups, respectively. The 36-item short-form health survey physical functioning at weeks 12 and 24 (P = .033, 0.001), role-physical at weeks 4 and 24 (P = .030, 0.014), and role-emotional at week 4 (P = .045) were the only scores to differ significantly between the TM and JM groups. Western Ontario and McMaster Universities Osteoarthritis Index stiffness scores in the JM groups improved significantly relative to baseline at weeks 4, 8, 12, and 24 (all P < .01). The scores in the TM group differed significantly at all time points relative to baseline (all P < .01), with no differences between groups (all P > .05). Serum Interleukin-2 levels were lower in both groups (all P < .01). Cartilage oligomeric matrix protein and monocyte chemotactic protein-1 only differed significantly for patients treated via JM (P < .05, P < .01), with the same also being true for Interleukin-1β and Interleukin-8 in the TM group (all P < .01). No significant differences in other cytokines were observed, nor did they differ significantly between groups (all P > .05).

Conclusion:
These results suggest that JM treatment can improve knee osteoarthritis patient quality of life, alleviating joint stiffness and restoring joint function with a level of efficacy comparable to TM.
CT perfusion imaging parameters and serum miR-106a-5p predict short- and long-term prognosis in acute cerebral infarction patients after intravenous thrombolysis
Authors: Du Juan , Guo Guocai , Du Wei 
Published: August 2023

Background:
Some microRNAs have been found to be abnormal in patients with acute cerebral infarction (ACI) after intravenous thrombolysis. This study aimed to measure the expression of miR-106a-5p in ACI patients before and after thrombolytic treatment, and to investigate the prognostic value of miR-106a-5p and computed tomography perfusion imaging (CTPI) parameters in ACI patients receiving thrombolysis.

Methods:
The levels of serum miR-106a-5p were detected by quantitative real-time PCR in 78 ACI patients before thrombolysis, 24 hours after thrombolysis, and 3 months (90 days) after onset. The correlation of miR-106a-5p with continuous variables were analyzed using Pearson correlation analysis. The association of miR-106a-5p and CTPI parameters with prognosis of patients receiving thrombolysis was evaluated by logistic regression analysis. The accuracy and thresholds of miR-106a-5p and CTPI parameters for discriminating patients with unfavorable prognosis after thrombolysis were assessed by receiver operating characteristic analysis.

Results:
Serum miR-106a-5p expression was decreased in ACI patient after thrombolysis. Then, significant correlations of miR-106a-5p with National Institutes of Health Stroke Scale and CTPI parameters were found. Moreover, miR-106a-5p, cerebral blood flow (CBF) and cerebral blood volume (CBV), which are 2 CTPI parameters, were independently correlated with short- and long-term prognosis after thrombolysis. Furthermore, miR-106a-5p, CBF and CBV revealed good accuracy in predicting the prognosis of patients after thrombolysis, and their combination showed the best accuracy.

Conclusion:
Thrombolysis downregulates miR-106a-5p in ACI patients, and miR-106a-5p, CBF and CBV have considerable potentials to predict short- and long-term prognosis in ACI patients receiving intravenous thrombolysis.
How to process synovial fluid samples of gouty arthritis and extract its exosomes for subsequent cytokine analysis
Authors: Li Shaowei , Zhang Shudan , Chen Zhihuang , Zhang Xianxian , Ou Rui , Wei Song , Liu Yingwan , Xu Yiwen , Chen Kaixin , Chen Zhouyi , Shu Xinnong 
Published: August 2023

Background:
The comparative analysis of ultracentrifugation (UC) and polyethylene glycol (PEG)-based precipitation for the isolation of exosomes in gouty arthritis synovial fluid (GASF) is rarely reported, and it is not known whether different isolation methods can influence subsequent cytokine analysis.

Methods:
GA patients were enrolled during a 1-year period from May 2021 to May 2022. Morphology, particle number, size, purity, protein concentration, and biomarker proteins of GASF-derived exosomes in both extraction methods were observed using transmission electron microscopy, nanoparticle tracer analysis, bicinchoninic acid assay, and Western blotting. An ELISA-based assay platform was used to detect the cytokines in exosomes using Meso Scale Discovery.

Results:
Thirty-two cases of fresh GASF were taken and randomly divided between the UC group (n = 16) and the PEG group (n = 16). Transmission electron microscopy images and nanoparticle tracer analysis results showed round vesicles measuring 100 nm on average. The protein expressions of TSG101, CD63, and CD81 in exosomes of the 2 groups were measured via Western blotting. The number and protein concentration of GASF-derived exosome particles from the PEG group were significantly higher than that of the UC group (P < .001). However, in the purity estimation, the UC group reflected significantly higher exosomes extractability (P < .01). Expression of IL-6 and IL-8 in the GASF-derived exosomes were higher in the UC group (P < .05), showing a median of 3.31 (interquartile range, IQR: 0.84–13.16) pg/mL, and a median of 2.87 (IQR: 0.56–13.17) pg/mL, respectively; moreover, IL-1β was mostly undetectable in the PEG group.

Conclusion:
The UC method was found to yield exosomes of a higher purity, albeit at a lower quantity but with more abundant inflammatory cytokines; whereas the opposite was the case for the PEG group. The chemical precipitation method might not be suitable in terms of extracting GASF-derived exosomes for inflammation and immunity studies.
End-of life medical spending and care pathways in the last 12 months of life: A comprehensive analysis of the national claims database in France
Authors: Nze Ossima Arnaud , Szfetel Daniel , Denoyel Bénédicte , Beloucif Omar , Texereau Joelle , Champion Louis , Vié Jean François , Durand-Zaleski Isabelle 
Published: August 2023

Background:
To inform policy makers on efficient provision of end-of-life care, we estimated the 12-month medical expenditures of French decedents in 2015.

Methods:
We estimated total medical expenditures by service type and diagnosis category, and analyzed care pathways for breast cancer, dementia, chronic obstructive lung disease.

Results:
501,121 individuals died in 2015, 59% of whom were in a hospital at the time of death. The aggregated spending totaled 9% of total health expenditures, a mean of €28,085 per capita, 44% of which was spent during the last 3 months of life. Hospital admissions represented over 70% of total expenditures; 21.3% of the population used hospital palliative care services in their last year of life. Analyses performed on breast cancer, dementia and lung disease found that differences in care pathways markedly influenced spending and were not simply explained by patients characteristics.

Conclusion:
Diagnoses and care trajectories, including repeated hospital stays, are the main drivers of the last year of life expenditures. Our data suggests that early identification of patients requiring palliative care and community-based end-of-life service delivery is feasible and could better support patients, families and caregivers with constant or reduced costs.
Anomaly originated flexor digitorum superficialis muscle of the small finger: A case report
Authors: Lee Young-Keun 
Published: August 2023

Rationale:
We present a clinical case of flexor digitorum superficialis (FDS) muscle belly of the small finger originating from the palm of a patient undergoing carpal tunnel surgery with a literature review.

Patients concern:
A 28-year-old right-handed woman visited our hospital with a chief complaint of a continuous tingling sensation and weakness in the right hand, which began after the volar side of her wrist was crushed by a machine during work 2 weeks prior. The patient complained of a continuous tingling sensation in the thumb, index, and middle fingers. The patient had a positive result on Tinel test of the median nerve of the wrist. As electromyography and nerve conduction velocities showed signs of severe injury in the right median nerve, exploration and carpal tunnel release were planned.

Diagnosis:
Carpal tunnel release was performed under regional anesthesia using the classical open approach. The median nerve in the distal forearm and distal portion of the flexor retinaculum appeared to be narrowed and compressed. An anomalous muscle originating from the flexor retinaculum is also observed.

Intervention:
The FDS muscle of the small finger was excised at the flexor retinaculum and musculotendinous junction and sutured to the flexor digitorum profundus tendon.

Outcome:
At the 37-month follow-up, the patient did not experience any tingling sensation or weakness. She showed excellent range of motion of the right small finger. The grip strength was 20 kg on both the right and left sides. Quick disabilities of the arm, shoulder, and hand score was 2.3.

Conclusion:
Asymptomatic small finger FDS muscle anomalies can occur, as demonstrated in this case study. Thus, physicians should familiarize themselves with small finger FDS muscle anomalies during interactions with patients to facilitate future treatments of patient complaints related to the hand, as well as wrist laceration or trauma requiring hand exploration.
Addressing desaturation in a tracheal stenosis patient using the transnasal humidified rapid-insufflation ventilatory exchange technique during tracheostomy: A case report
Authors: Lee Sou Hyun , Cho Eunyoung , Park Ji Hoon , Lee Jae Yun , Hong Ji Hee , Han Hyeji 
Published: August 2023

Rationale:
Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is used in tracheostomy but not in cases of airway obstruction. This case report explores the use of THRIVE for managing airway obstruction during tracheostomy in patients with subglottic and tracheal stenosis, thereby addressing the current knowledge gap and exploring its potential for airway management.

Patient concerns:
A 63-year-old female with subglottic and tracheal stenoses underwent tracheostomy. Multiple attempts to establish a patent airway were unsuccessful, and oxygen saturation dropped to 56%.

Diagnosis:
Endotracheal tube was directed toward the tracheal wall, causing airway obstruction.

Interventions:
THRIVE was administered to the patient. Subsequently, the tube position was adjusted to enhance ventilation.

Outcomes:
The patient’s oxygen saturation increased to 99%. The postoperative complications, including subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium, resolved. The patient was discharged on postoperative day 9.

Lessons:
THRIVE could be considered a temporary measure to enhance oxygenation before initiating a definitive treatment strategy.
Reversible splenial lesion syndrome type II in youth mimicking acute ischemic stroke like onset: A case report
Authors: Li Yan , Wang Zhengyang , Lai Sijia , Li Manfei , Liang Huihui , Qin Hui , Wang Kaihua 
Published: August 2023

Background:
Reversible splenial lesion syndrome (RESLES) is a newly recognized syndrome. Its typical pathologic findings is a reversible progress correlated with transiently reduced diffusion lesion in the splenium of the corpus callosum. The common clinical symptoms include mildly altered states consciousness, delirium, and seizure.

Methods:
We presented a 21-year-old patient with signs of acute ischemic stroke (AIS), including symptoms of weakness on the right upper limb and aphasia, lasting 50 minutes until he was taken to the emergency. He just had a cough 20 days ago.

Results:
An elevated level of white blood cell count, neutrophil count, monocyte count, protein of cerebrospinal fluid was found in laboratory examinations. Magnetic resonance imaging revealed distinct lesions involving white matter in the splenium of the corpus callosum and frontal-parietal cortex on both cerebral hemispheres. Digital subtraction angiography examination was also unremarkable. The patient recovered to baseline within 4 days. We treated the patient with glucocorticoid, antiviral drugs, butylphthalide, and dehydrating drugs. In addition, the follow-up brain magnetic resonance imaging scan showed reduced lesions. AIS-like symptoms did not occur during a 30-day follow-up period.

Conclusion:
This patient with reversible splenial lesion syndrome type II exhibited AIS-like symptoms, which was uncommon on clinical. This case extends the recognized clinical phenotypes for this disorder.
Nalmefene combined noninvasive positive-pressure ventilation in Chinese patients with chronic obstructive pulmonary disease coupled with type II respiratory failure: A meta-analysis
Authors: He Jie , Luo Wei , Mei Yang , Xu Yu , Ding Shilin 
Published: August 2023

Background:
Nalmefene is an opioid system modulator with antagonist activity at the μ and δ receptors and partial agonist activity at the κ receptor. Previous studies have suggested that nalmefene could improve respiratory function in patients with chronic obstructive pulmonary disease (COPD). However, there is no comprehensive systematic review published regarding the clinical efficacy of nalmefene.

Methods:
We explored the following electronic bibliographic databases: EMBASE, Web of Science, PubMed, Wanfang, and Chinese national knowledge infrastructure. To collect data from randomized controlled trials on the therapy of COPD coupled with type II respiratory failure and nalmefene + noninvasive ventilator treatment. The retrieved articles were screened to determine the final inclusion criteria and to extract relevant data, such as the clinical efficacy rate, pulmonary function, blood gas analysis, and adverse reactions. In our study, we used relative risk and weighted mean deviation, as well as a 95% confidence interval for describing nalmefene effectiveness and safety while treating COPD with type II respiratory failure.

Results:
The outcomes of the meta-analysis demonstrated that the clinical efficacy rate of the nalmefene + noninvasive ventilation group was higher than that of the naloxone + noninvasive ventilation and noninvasive ventilation groups. Moreover, the improvement indices of pH value, partial pressure and saturation of blood oxygen, partial pressure of carbon dioxide, and pulmonary function of the nalmefene + noninvasive ventilation group were better than those of the noninvasive ventilation group, and there was no increase in the occurrence of adverse drug reactions.

Conclusion:
Nalmefene combined with noninvasive ventilation can significantly improve the blood gas index and lung function in patients with COPD combined with type II respiratory failure.
Effects of sitting balance training with a wedge on sitting pressure and verticality in young adults: A randomized crossover trial
Authors: Sawa Kota , Ishigami Keisuke , Miyamoto Takuya , Tamura Miko 
Published: August 2023

Background:
In sensory-motor rehabilitation, sitting-balance training using a wedge may enable optimal postural control. The efficacy and mechanism of achieving lateral adaptation to the sitting pressure and postural vertical are unclear.

Methods:
We included 20 healthy participants in a single-blind, randomized crossover trial conducted over 1 day. Sitting pressure was measured while the postural vertical was assessed. The initial training required maximally and laterally inclining the trunk to the left or right, with or without a wedge, 60 times in 2 minutes (0.25 Hz). A repeated-measures 2-way analysis of variance with Bonferroni post hoc analysis was used, and a P value < .05 considered statistically significant.

Results:
After wedge-adaptation training, the pressure on the weight-bearing surface in the postural vertical position increased only on the left side (P < .05). The directional and variability errors of the subjective postural vertical with eyes open and subjective postural vertical were within the range of normative values on verticality.

Conclusion:
Wedge-adaptation during sitting training affected sitting pressure and verticality. Therefore, there is potential for future rehabilitation interventions using sitting training with a wedge in individuals with balance disorders.
Effects of high-intensity interval training with an eccentric hamstring exercise program in futsal players: A randomized controlled trial
Authors: Gómez Elena Muñoz , Atef Hady , Elsayed Shereen Hamed , Zakaria Hoda M. , Navarro Miguel Pérez , Sulé Elena Marqués 
Published: August 2023

Background:
Physiotherapy protocols based on high-intensity interval training (HIIT) or eccentric hamstring exercises like Nordic Curl (NC) have been scarcely studied in futsal players. The objective of this study was to compare the effectiveness of a HIIT combined with an NC exercise program versus a HIIT-only program in futsal players.

Methods:
Twenty-one futsal players were divided into (1) HIIT + NC group (n = 11, mean age = 21.55 [4.25]); and (2) HIIT group (n = 10, mean age = 20.90 [1.29]). The HIIT + NC group performed a HIIT circuit combined with 3 sets of 10 NC repetitions for 4 weeks, while the HIIT group performed the same protocol without NC exercise. Body mass index, intermittent work performance, vertical jump performance without and with arms, isometric strength of quadriceps and hamstrings, and the isometric hamstrings/quadriceps (H/Q) ratio, were assessed before and after the interventions.

Results:
The HIIT + NC group and the HIIT group showed a significant improvement in intermittent work performance after the intervention (P = .04 and P = .01, respectively). Also, both groups showed a trend of increasing quadriceps and hamstring isometric strength, although no significant changes were found (P > .05). In addition, neither the HIIT + NC protocol nor the HIIT protocol was sufficient to yield changes in body mass index nor to improve the vertical jump performance (P > .05).

Conclusion:
Both an isolated HIIT protocol and HIIT in combination with NC exercise improved intermittent work performance in futsal players. The present study’s findings may guide futsal players’ physical preparation and injury prevention programs.
Comparison of Myopia Progression among Myopic Children with Intermittent Exotropia and No Strabismus
Authors: Kim Suzie , Babiuch Allison , Xiao Huijun , Williamson Alexandra 
Published: August 2023

ABSTRACT

Significance
Myopia is a highly prevalent condition in the pediatric population that is commonly comorbid with intermittent exotropia. Our study found a trend towards significance in the reduction of myopia progression with strabismus correction surgery. Further investigations characterizing the interaction between myopia and strabismus may help inform future management guidelines.

Purpose
This study describes and compares myopic progression in the pediatric population with and without intermittent exotropia and its interaction with corrective strabismus surgery.

Methods
This study analyzes a retrospective cohort of 1,239 pediatric myopic patients who were evaluated by pediatric ophthalmologists and optometrists at a tertiary care center from 2012 to 2020. The main outcome measures were the trends in refractive error over time in those with and without intermittent exotropia as well as trends in those who did and did not undergo strabismus surgery.

Results
275 (22%) patients were identified to have intermittent exotropia and 12 (4.4%) of this group underwent surgical correction in the study period. No statistically significant difference was identified in myopic progression between those with intermittent exotropia and those without strabismus and no difference was found in mean annual spherical equivalent change between intermittent exotropia patients who did not undergo surgery compared to those who did.

Conclusions
Pediatric myopic patients generally experience progression in the condition for several years independent of concurrent intermittent exotropia. Corrective strabismus surgery was not found to alter the natural history of myopia in children, though a reduction in myopic progression in surgically treated patients trended towards significance. Increases in the prevalence of different treatment strategies will necessitate further studies to determine best practices for this population.
Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT in Patients With SAPHO Syndrome
Authors: Wang Peipei , Li Chen , Hou Guozhu , Li Zhaohui , Jing Hongli , Zhang Wen , Li Fang 
Published: August 2023

Purpose
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare inflammatory disorder of bone, joints, and skin, with various stages of bone lesions including inflammation and bone marrow fibrosis. Because the inflammation-induced fibrosis and bone marrow fibrosis are important features in SAPHO syndrome, we undertook a prospective investigation to evaluate whether PET/CT with 68Ga-DOTA-FAPI-04, a novel PET agent targeting fibroblast activation protein, was useful in the evaluation of the patients with SAPHO syndrome.

Patients and Methods

68Ga-DOTA-FAPI-04 PET/CT was performed on a cohort of 21 patients with known SAPHO syndrome. All patients underwent 68Ga-DOTA-FAPI-04 and 18F-FDG PET/CT on 2 consecutive days. The positive rates of the PET/CT scans at the sites of the osteoarticular symptom, the uptake values, and agreement with clinical osteoarticular symptom were compared.

Results
A total of 38 sites of involvement were detected. 18F-FDG PET/CT revealed 28 lesions. In contrast, 68Ga-DOTA-FAPI-04 PET/CT detected not only all lesions shown on 18F-FDG PET/CT but additional 10 lesions. 68Ga-DOTA-FAPI-04 scan also demonstrated significantly higher uptake and target-to-background ratio than 18F-FDG studies in the skeletal involvements. The agreement between 68Ga-DOTA-FAPI-04–positive lesions and current osteoarticular lesions was substantial (κ = 0.79, P < 0.001), whereas 18F-FDG had low to moderate agreement with clinical symptoms (κ = 0.52, P < 0.001).

Conclusions

68Ga-DOTA-FAPI-04 has potential as a promising imaging agent for the evaluation of SAPHO syndrome.