bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimizing Surgeon Radiation Exposure During Operative Treatment of Pediatric Supracondylar Humerus Fractures
Authors: Montgomery Blake K. , Cidambi Emily O. , Birch Craig M. , Wang Kemble , Miller Patricia E. , Kim Don-Soo , Shore Benjamin J. 
Published: April 2023

Background:
Orthopaedic surgeons are exposed to high levels of radiation, which may lead to higher rates of cancer among orthopaedic surgeons. There are a series of techniques currently practiced to pin supracondylar humerus fractures including pinning the arm on the C-arm itself, using a plexiglass rectangle or a graphite floating arm board; however, the variation in radiation exposure to the surgeon is unknown. We aimed to determine how the position of the C-arm affects radiation exposure to the surgeon during the treatment of a pediatric supracondylar humerus fracture.

Material and Methods:
A simulated operating room was created to simulate a closed reduction and percutaneous pinning of a supracondylar humerus fracture. A phantom model was used to simulate the patient’s arm. We assessed performing the procedure with the arm on plexiglass, graphite, or on top of the C-arm image receptor. The C-arm was positioned either with the source down and image receptor up (standard position) or with the source up and image receptor down (inverted position). Radiation exposure was recorded from levels corresponding to the surgeon’s head, midline, and groin. The estimated effective dose equivalent was calculated to account for the varying radiation sensitivity of different organs.

Results:
We found the effective dose equivalent, or the overall body damage from radiation, was 5.4 to 7.8% higher than the surgeon when the C-arm was in the inverted position (source up, image receptor down). We did not find any differences in radiation exposure to the surgeon when the arm was supported on plexiglass versus graphite.

Conclusion:
The C-arm positioned in the standard fashion exposes the surgeon to less damaging radiation. Therefore, when the surgeon is standing, we recommend using the C-arm in the standard position.

Clinical Relevance:
Orthopaedic surgeons who stand should use the C-arm in the standard position to pin supracondylar humerus fractures to lower the risk of ionizing radiation exposure.
Malondialdehyde levels in diabetic retinopathy patients: a systematic review and meta-analysis
Authors: Jiang Fanwen , Zhou Lin , Zhang Chun , Jiang Hui , Xu Zhuping 
Published: April 2023

Abstract

Background:
It remains unclear whether circulating malondialdehyde (MDA) levels change in people with diabetic retinopathy (DR). This systematic review compared circulating MDA levels in diabetic people with and without DR.

Methods:
The authors searched PubMed, Medline (Ovid), Embase (Ovid), and Web of Science for case-control studies conducted before May 2022 in English that compared circulating MDA levels in people with and without DR. The following MeSH search terms were used: (“malondialdehyde” or “thiobarbituric acid reactive substances (TBARS)” or “lipid peroxidation” or “oxidative stress”) and “diabetic retinopathy.” Newcastle–Ottawa Quality Assessment Scale was used to evaluate the quality of the included studies. Random-effects pairwise meta-analysis pooled the effect size with standardized mean difference (SMD) and 95% confidence intervals (CIs).

Results:
This meta-analysis included 29 case-control studies with 1680 people with DR and 1799 people with diabetes but not DR. Compared to people without DR, the circulating MDA levels were higher in those with DR (SMD, 0.897; 95% CI, 0.631 to 1.162; P < 0.001). The study did not identify credible subgroup effects or publication bias and the sensitivity analysis confirmed the robustness of the study.

Conclusions:
Circulating MDA levels are higher in people with DR compared to those without. Future comparative studies that use more specific methods are required to draw firm conclusions.

Registration:
PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; No. CRD42022352640.
COL1A1–PDGFB Fusion Gene Detection Through Bulk RNA-Seq and Transcriptomic Features of Dermatofibrosarcoma Protuberans
Authors: Peng Rui , Zhang Guohong , Li Hang 
Published: April 2023

BACKGROUND
Dermatofibrosarcoma protuberans (DFSP) is a cutaneous sarcoma with obscure origin and multidirectional differentiation. Application of RNA-Seq in the detection of COL1A1–PDGFB is still at early stages.

OBJECTIVE
We aim to test the efficacy of fusion gene detection using bulk RNA-Seq in DFSPs, explore altered molecular pathways and biological processes for evidences of tumor origin and cell identity shift.

MATERIALS AND METHODS
Dermatofibrosarcoma protuberans and normal dermis samples were acquired for RNA-Seq. Fusion gene detection was performed using STAR-Fusion. RNA-Seq 2G yielded differentially expressed genes. Altered pathways, key gene ontology terms, and similar cell/tissue types were identified with gene set enrichment analysis. xCell was used for cell types enrichment analysis.

RESULTS
28/30 CD34(+) cases were positive for COL1A1–PDGFB. 406 upregulated and 543 downregulated genes were determined. Among the top 10 upregulated genes, 6 had neural distribution, function, or disease correlation. The upregulated genes were related to synapse, trans-synaptic signaling, neural development, and extracellular matrix. Similarities between DFSP and nervous system components were highlighted, with fibroblast cellular abundancy increased during xCell analysis.

CONCLUSION
Bulk RNA-Seq provided with high detection rate of COL1A1-PDGFB. Dermatofibrosarcoma protuberans showed fibroblastic activity and neural features, which validated DFSP's fibroblast origin and tendency of neural differentiation.
The Lions Eye Bank of Western Australia: 35 Years of Eye Banking (1986–2021)
Authors: Kezic Jelena M. , Buckland Lisa , Wiffen Steven 
Published: April 2023

Purpose:
The purpose of this study was to review the trends in preparation, storage, and usage of donor corneal tissue from 35 years of eye banking at the Lions Eye Bank of Western Australia (LEBWA).

Methods:
Donor and recipient records for the period July 1986 to July 2021 were evaluated with relation to donor demographics, cause of death, storage medium, corneal utilization, type of corneal graft, and indication for graft.

Results:
Six thousand two hundred nine eyes from 3328 donors were retrieved in the 35-year period reviewed. Sixty-six percent of eye donors were male, and 33% were female. The median age of donor was 61 years (2–98 years). The most frequent cause of donor death was a cardiac event, followed by intracerebral hemorrhage and malignancy. A total of 5219 corneal transplants were performed, with a corneal utilization rate of 84%. Storage of corneal tissue was primarily in Optisol-GS until 2010, when organ culture medium was introduced. Of 5219 recipients, 52% were male and 47% were female. The median recipient age was 63 years (1–98 years). Penetrating keratoplasty was the most common surgery performed over the 35-year period, followed by endothelial keratoplasty. The most common indications for grafts were ectasia/thinning, repeat corneal transplants, endothelial dystrophies, and postcataract surgery edema.

Conclusions:
We present trends in the acquisition and utilization of corneal tissue across 35 years at LEBWA. The most significant changes over this period include methods of corneal storage and advances in surgical techniques that has led to a greater usage of endothelial grafts.
Three-dimensional Medical Printing and Associated Legal Issues in Plastic Surgery: A Scoping Review
Authors: Knoedler Leonard , Knoedler Samuel , Kauke-Navarro Martin , Knoedler Christoph , Hoefer Simon , Baecher Helena , Gassner Ulrich M. , Machens Hans-Guenther , Prantl Lukas , Panayi Adriana C. 
Published: April 2023

Summary:
Three-dimensional printing (3DP) represents an emerging field of surgery. 3DP can facilitate the plastic surgeon’s workflow, including preoperative planning, intraoperative assistance, and postoperative follow-up. The broad clinical application spectrum stands in contrast to the paucity of research on the legal framework of 3DP. This imbalance poses a potential risk for medical malpractice lawsuits. To address this knowledge gap, we aimed to summarize the current body of legal literature on medical 3DP in the US legal system. By combining the promising clinical use of 3DP with its current legal regulations, plastic surgeons can enhance patient safety and outcomes.
Mincle-GSDMD-mediated release of IL-1β small extracellular vesicles from hepatic macrophages in ethanol-induced liver injury
Authors: Zhang Quanri , Liu Weiwei , Bulek Katarzyna , Wang Han , McMullen Megan R. , Wu Xiaoqin , Welch Nicole , Zhang Renliang , Dasarathy Jaividhya , Dasarathy Srinivasan , Nagy Laura E. , Li Xiaoxia 
Published: April 2023

Background:
Macrophage-inducible C-type lectin (Mincle) is expressed on hepatic macrophages and senses ethanol (EtOH)-induced danger signals released from dying hepatocytes and promotes IL-1β production. However, it remains unclear what and how EtOH-induced Mincle ligands activate downstream signaling events to mediate IL-1β release and contribute to alcohol-associated liver disease (ALD). In this study, we investigated the association of circulating β-glucosylceramide (β-GluCer), an endogenous Mincle ligand, with severity of ALD and examined the mechanism by which β-GluCer engages Mincle on hepatic macrophages to release IL-1β in the absence of cell death and exacerbates ALD.

Method and Results:
Concentrations of β-GluCer were increased in serum of patients with severe AH and correlated with disease severity. Challenge of hepatic macrophages with lipopolysaccharide and β-GluCer induced formation of a Mincle and Gsdmd-dependent secretory complex containing chaperoned full-length gasdermin D (Hsp90-CDC37-NEDD4) with polyubiquitinated pro-IL-1β and components of the Caspase 8-NLRP3 inflammasome loaded as cargo in small extracellular vesicles (sEVs). Gao-binge EtOH exposure to wild-type, but not Mincle

−/−
and Gsdmd

−/−
, mice increased release of IL-1β-containing sEVs from liver explant cultures. Myeloid-specific deletion of Gsdmd similarly decreased the formation of sEVs by liver explant cultures and protected mice from EtOH-induced liver injury. sEVs collected from EtOH-fed wild-type, but not Gsdmd

−/−
, mice promoted injury of cultured hepatocytes and, when injected into wild-type mice, aggravated Gao-binge EtOH-induced liver injury.

Conclusion:
β-GluCer functions as a danger-associated molecular pattern activating Mincle-dependent gasdermin D-mediated formation and release of IL-1β-containing sEVs, which in turn exacerbate hepatocyte cell death and contribute to the pathogenesis of ALD.
Integrated hepatology and addiction care for inpatients with alcohol use disorder improves outcomes: a prospective study
Authors: Mahle Rachael , McLean Diaz Paige , Marshall Chantelle , Goodman Russell P. , Schaefer Esperance , Luther Jay 
Published: April 2023

Background:
Growing literature highlights the need to integrate hepatology and addiction care to improve outcomes for patients with alcohol use disorder and alcohol-associated liver disease. However, prospective data for this approach are lacking.

Methods:
We prospectively examined the efficacy of an integrated hepatology and addiction medicine approach on alcohol use and hepatology outcomes in inpatients with alcohol use disorder.

Findings:
An integrated approach improved the uptake of medical alcohol therapy, hepatic fibrosis screening, and viral hepatitis vaccination compared with a historical control of patients who received addiction medicine care alone. There were no differences in the rates of early alcohol remission. The integration of hepatology and addiction care may improve outcomes in patients with alcohol use disorder.
Prevalence of alcohol-associated liver disease: a systematic review and meta-analysis
Authors: Amonker Sachin , Houshmand Aryo , Hinkson Alexander , Rowe Ian , Parker Richard 
Published: April 2023

Background:
Alcohol-associated liver disease (ALD) is a common cause of morbidity and premature mortality. To date, there has been no systematic synthesis of the prevalence of ALD. This systematic review was done with the aim of reporting the prevalence of ALD across different health care settings.

Methods:
PubMed and EMBASE were searched for studies reporting the prevalence of ALD in populations subjected to a universal testing process. Single-proportion meta-analysis was performed to estimate the prevalence of all ALD, alcohol-associated fatty liver, and alcohol-associated cirrhosis, in unselected populations, primary care, and among patients with alcohol-use disorder (AUD).

Results:
Thirty-five studies were included reporting on 513,278 persons, including 5968 cases of ALD, 18,844 cases of alcohol-associated fatty liver, and 502 cases of alcohol-associated cirrhosis. In unselected populations, the prevalence of ALD was 3.5% (95% CI, 2.0%–6.0%), the prevalence in primary care was 2.6% (0.5%–11.7%), and the prevalence in groups with AUD was 51.0% (11.1%–89.3%). The prevalence of alcohol-associated cirrhosis was 0.3% (0.2%–0.4%) in general populations, 1.7% (0.3%–10.2%) in primary care, and 12.9% (4.3%–33.2%) in groups with AUD.

Conclusions:
Liver disease or cirrhosis due to alcohol is not common in general populations and primary care but very common among patients with coexisting AUD. Targeted interventions for liver disease such as case finding will be more effective in at-risk populations.
The integrated analysis strategy of unstable hypoxanthine, a potential quality marker in Shuxuetong injection based on standard addition method and multi-level pharmacokinetics by LC-MS/MS
Authors: Xing Yanchao , Wang Xiaoming , Wang Xianrui , Zhao Xizi , Guo Yaqing , Huang Yuhong , Teka Tekleab , Han Lifeng , Pan Guixiang 
Published: April 2023

Objective:
As an injection made from traditional Chinese medicine, Shuxuetong (SXT) injection is used for the treatment of ischemic stroke. Hypoxanthine is regarded as one of its potential quality markers. The purpose of this study is to lay the foundation for the quality control of SXT injection by the analysis of the quantitation and pharmacokinetic behavior for hypoxanthine.

Methods:
A quantitative method of hypoxanthine in SXT injection based on standard addition method by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was established for the first time. On the other hand, a determination method of hypoxanthine in rat plasma samples after administration of SXT was also successfully established based on LC-MS/MS.

Results:
It was found that the content of hypoxanthine was higher using conventional liquid-mass spectrometry technology compared to the application of LC-MS/MS combined standard addition method in the same batch of SXT injection. The ratio of low, medium and high dose of intravenous SXT were 1: 2: 4, and the AUC0-t was 848.34 ± 324.53, 1483.94 ± 497.74, and 3074.84 ± 910.29 μg·h/L, respectively. AUC0-t shows good linear dose-dependent relationship.

Conclusions:
The influences of endogenous substance tend to be eliminated through calibrating the concentration level of the target compound by the introduction of standard addition method. The added allopurinol could inhibit the conversion of the target compound, and ensure the accuracy of the detection during the pharmacokinetic studies. “Blank biological matrix” obtained from pretreatment of blank plasma successfully distinguished endogenous and drug-derived hypoxanthine. There is a good linear relationship between the blood concentration of intravenous hypoxanthine and the dosage of administration. Similarly, there was no drug accumulation in the multiple medium-dosage group, which is similar to the pharmacokinetic characteristics of the single medium-dosage group.
Using Collaborative Online International Learning to Support Global Midwifery Education
Authors: Saftner Melissa A. , Ayebare Elizabeth 
Published: April 2023

Background and Local Problem:
The COVID-19 pandemic created a gap in global health learning, requiring creative solutions to bridge the divide. Collaborative online international learning (COIL) is a program between universities located in different geographic areas that aims to build cross-cultural learning and collaboration.

Intervention:
Faculty members from Uganda and the United States worked collaboratively to plan a 2-session COIL activity for nursing and midwifery students. Twenty-eight students from the United States and Uganda participated in the pilot quality improvement project.

Measures:
Students completed a 13-question REDCap survey measuring satisfaction, time commitment for the activity, and increase in knowledge about differently resourced healthcare systems. Students also were asked to provide qualitative feedback in that survey.

Results:
Survey results indicate a high level of satisfaction and an increased understanding of a new healthcare system. The majority of students wanted more scheduled activity times, the opportunity to meet face to face, and/or more robust sessions in the future.

Conclusion:
This COIL activity between students in the United States and Uganda was a no-cost activity that provided global health learning opportunities for students during the global pandemic. The COIL model is replicable, adaptable, and customizable for a variety of courses and time spans.
Bibliometric Analysis of the Role of Pyroptosis in Sepsis
Authors: Gu Bowen , Wu Meifen , Wang Han , Zhuang Jian , Xiong Weiping , Xiao Yingkai , Lei Liming 
Published: April 2023

ABSTRACT

Background:
Emerging evidence has demonstrated that pyroptosis plays a vital role in the development of sepsis. However, few studies have examined this field systemically. We performed the first bibliometric analysis to draw conclusions from and visualize related publications to determine the trends and hotspots in pyroptosis research on sepsis.

Methods:
A total of 267 publications were retrieved from the Web of Science Core Collection from January 1, 2007 to December 21, 2021. Then, VOSviewer and CiteSpace were used for further analysis.

Results:
The publications in this field showed an upward trend annually, especially after 2014. Most of the articles were authored by Chinese and American scholars and published in Frontiers in Immunology. Timothy R Billiar published the most related articles, while Shi JJ was cited the most frequently. Co-citation analysis showed that the top 5 co-cited references in this field were in Nature and JAMA's leading co-cited journals. The keywords in this field revolve around the mechanisms of pyroptosis. Guanylate binding protein might be the hotspot, however, based on cluster analysis.

Conclusion:
The growing interest of researchers in pyroptosis in sepsis reflects the increasing understanding of its underlying mechanisms and the discovery of more clinical effects. These findings suggest that pyroptosis may hold significant potential as a therapeutic target for various diseases.
Digital Health: A New Frontier
Authors: Barracca Antonio , Ledda Stefano , Mancosu Gianmaria , Pintore Giovanni , Quintaliani Giuseppe , Ronco Claudio , Kashani Kianoush B. 
Published: April 2023

ABSTRACT
The Food and Drug Administration defines digital health (DH) as “a convergence of people, information, technology, and connectivity to improve health care and health outcomes”. Information and communication technologies are categorized under the DH umbrella. While still in their infancy, these technologies have great potential to revolutionize the clinical approaches to bedside management and overall health care. Over the past few decades, there has been a substantial improvement in the technology in smart wearable devices that enabled them to enhance their abilities to collect patient-related data, including physiological and behavioral information in the Internet of things. This has resulted in implementing several controlled clinical trials that have confirmed their validity and safety. These digital diagnostics have led to the expansion of digital therapies and specialized software (for example, apps) capable of effectively and measurably guiding patients’ progress toward improving their clinical condition. These technologies are clinically validated treatments for many diseases with particular effectiveness in pathological conditions related to behavior and psychological factors. In this review paper, we describe the outlines of some of the recent progress made in this field.
Obstructive sleep apnea and ambulatory blood pressure abnormalities in children with chronic kidney disease
Authors: Kumar Suryendru , Goyal Abhishek , Atlani Mahendra , Malik Shikha , Pakhare Abhijit , Maheshwari Mahesh , Kumar Amber , Raina Rupesh , Bhatt Girish Chandra 
Published: April 2023

Background
Obstructive sleep apnea (OSA) and hypertension are common complications in children with chronic kidney disease (CKD). Progression of CKD can aggravate OSA and hypertension whereas worsening sleep apnea can make hypertension difficult to treat in CKD patients. We, therefore, conducted a prospective study to evaluate the association between OSA and hypertension in pediatric patients with CKD.

Method
In this prospective observational study consecutive children with CKD stage 3–5 (nondialysis dependent) underwent overnight polysomnography and 24-h ambulatory blood pressure monitoring (ABPM). The detailed clinical features and investigations were recorded in a prestructured performa.

Results
Twenty-two children completed overnight polysomnography and 24-h ABPM was performed within 48 h of performing polysomnography. The median (IQR) age of the study population was 11 (8.5–15.5) years, with an age range of 5–18 years. Moderate-severe OSA defined as apnea-hypopnea index (AHI ≥5) was seen in 14 (63.6%) children, periodic limb movement syndrome in 20 (91%) and poor sleep efficacy in 9 (40.9%) children. Ambulatory blood pressure was abnormal in 15 (68.2%) children with CKD. Of them, 4 (18.2%) had ambulatory hypertension, 9 (40.9%) had severe ambulatory hypertension and 2 (9.1%) had masked hypertension. A statistically significant correlation of sleep efficiency with nighttime DBP SD score/Z score (SDS/Z) (r = −0.47; P = 0.02); estimated glomerular filtration rate with SBP loads (r = −0.61; P < 0.012); DBP loads (r = −0.63; P < ) and BMI with SBP load (r = 0.46; P = 0.012) was found.

Conclusion
Our preliminary findings suggest that ambulatory blood pressure abnormalities, OSA, periodic limb movement syndrome and poor sleep efficiency are highly prevalent in children with CKD stages 3–5.