bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dickkopf‐1 promotes vascular smooth muscle cell foam cell formation and atherosclerosis development through CYP4A11/SREBP2/ABCA1
Authors: Li Xiao , Zheng Tengfei , Zhang Yu , Zhao Yachao , Liu Fengming , Dai Shen , Liu Xiaolin , Zhang Mei 
Published: June 2023

AbstractVascular smooth muscle cells (VSMCs) are considered to be a crucial source of foam cells in atherosclerosis due to their low expression level of cholesterol exporter ATP‐binding cassette transporter A1 (ABCA1) intrinsically. While the definite regulatory mechanisms are complicated and have not yet been fully elucidated, we previously reported that Dickkopf‐1 (DKK1) mediates endothelial cell (EC) dysfunction, thereby aggravating atherosclerosis. However, the role of smooth muscle cell (SMC) DKK1 in atherosclerosis and foam cell formation remains unknown. In this study, we established SMC‐specific DKK1‐knockout (DKK1SMKO) mice by crossbreeding DKK1flox/flox mice with TAGLN‐Cre mice. Then, DKK1SMKO mice were crossed with APOE−/− mice to generate DKK1SMKO/APOE−/− mice, which exhibited milder atherosclerotic burden and fewer SMC foam cells. In vitro loss‐ and gain‐of‐function studies of DKK1 in primary human aortic smooth muscle cells (HASMCs) have proven that DKK1 prevented oxidized lipid‐induced ABCA1 upregulation and cholesterol efflux and promoted SMC foam cell formation. Mechanistically, RNA‐sequencing (RNA‐seq) analysis of HASMCs as well as chromatin immunoprecipitation (ChIP) experiments showed that DKK1 mediates the binding of transcription factor CCAAT/enhancer‐binding protein delta (C/EBPδ) to the promoter of cytochrome P450 epoxygenase 4A11 (CYP4A11) to regulate its expression. In addition, CYP4A11 as well as its metabolite 20‐HETE‐promoted activation of transcription factor sterol regulatory element‐binding protein 2 (SREBP2) mediated the DKK1 regulation of ABCA1 in SMC. Furthermore, HET0016, the antagonist of CYP4A11, has also shown an alleviating effect on atherosclerosis. In conclusion, our results demonstrate that DKK1 promotes SMC foam cell formation during atherosclerosis via a reduction in CYP4A11‐20‐HETE/SREBP2‐mediated ABCA1 expression.
The Impact of Multidisciplinary Approaches to Social Functioning on Surgical Outcomes Following Surgery for Cervical Myelopathy
Authors: Tamai Koji , Terai Hidetomi , Watanabe Shingo , Tashiro Yoji , Omine Toshimitsu , Katsuda Hiroshi , Shimada Nagakazu , Kobayashi Yuto , Nakamura Hiroaki 
Published: June 2023

Study Design.
Prospective cohort study

Objective.
To identify the effects of multidisciplinary approaches (MAs) to improve social functioning (SF) on 1-year surgical outcomes in patients with cervical myelopathy

Summary of Background Data.
Despite significant improvement in cervical myelopathy, a patient’s quality of life (QOL) sometimes does not improve postoperatively. A previous study revealed that SF, rather than myelopathy severity, correlated with QOL improvement after decompression surgery for cervical myelopathy.

Methods.
This study compared two prospective cohorts in Japan. Patients who underwent cervical laminoplasty for cervical myelopathy from 2018 to 2020 were enrolled in the control cohort. Patients who underwent the same surgery with the same indications between 2020 and 2021 were enrolled in the MA cohort. Patients in the control cohort were treated with a standard care protocol and those in the MA cohort were treated with a multidisciplinary protocol that focused on SF improvement. The changes in the total JOA score and in the domains of the JOA scores (upper limb function, lower limb function, upper limb sensory, and lower limb sensory) from preoperatively to 1 year postoperatively were compared between the control and MA cohorts using a mixed-effect model.

Results.
The control and MA cohorts comprised 140 and 31 patients, respectively. The improvement in the Japanese Orthopaedic Association (JOA) score was significantly better in the MA cohort than in the control cohort (P=0.040). In analyses of each JOA score domain, the improvement of upper limb function was significantly better in the MA cohort than in the control cohort (P=0.033). Similarly, the MA cohort demonstrated significantly higher patient-reported outcome for upper extremity function than the control cohort (P<0.001). Additionally, the self-care domain of QOL score at 1 year postoperatively was significantly higher in the MA cohort than in the control cohort (P=0.047).

Conclusion.
MAs to improve/rebuild a patient’s SF were effective in improving cervical myelopathy and self-care domain of QOL. This study is the first to demonstrate the effectiveness of a postoperative MAs in patients with cervical myelopathy.

Level of Evidence.
III
Cell softness reveals tumorigenic potential via ITGB8/AKT/glycolysis signaling in a mice model of orthotopic bladder cancer
Authors: Qiu Shi , Qiu Yaqi , Deng Linghui , Nie Ling , Ge Liming , Zheng Xiaonan , Jin Di , Jin Kun , Zhou Xianghong , Su Xingyang , Cai Boyu , Li Jiakun , Tu Xiang , Gong Lina , Liu Liangren , Liu Zhenhua , Bao Yige , Ai Jianzhong , Lin Tianhai , Yang Lu , Wei Qiang 
Published: June 2023

Abstract

Background:
Bladder cancer, characterized by a high potential of tumor recurrence, has high lifelong monitoring and treatment costs. To date, tumor cells with intrinsic softness have been identified to function as cancer stem cells in several cancer types. Nonetheless, the existence of soft tumor cells in bladder tumors remains elusive. Thus, our study aimed to develop a micro-barrier microfluidic chip to efficiently isolate deformable tumor cells from distinct types of bladder cancer cells.

Methods:
The stiffness of bladder cancer cells was determined by atomic force microscopy (AFM). The modified microfluidic chip was utilized to separate soft cells, and the 3D Matrigel culture system was to maintain the softness of tumor cells. Expression patterns of integrin β8 (ITGB8), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) were determined by Western blotting. Double immunostaining was conducted to examine the interaction between F-actin and tripartite motif containing 59 (TRIM59). The stem-cell-like characteristics of soft cells were explored by colony formation assay and in vivo studies upon xenografted tumor models.

Results:
Using our newly designed microfluidic approach, we identified a small fraction of soft tumor cells in bladder cancer cells. More importantly, the existence of soft tumor cells was confirmed in clinical human bladder cancer specimens, in which the number of soft tumor cells was associated with tumor relapse. Furthermore, we demonstrated that the biomechanical stimuli arising from 3D Matrigel activated the F-actin/ITGB8/TRIM59/AKT/mTOR/glycolysis pathways to enhance the softness and tumorigenic capacity of tumor cells. Simultaneously, we detected a remarkable up-regulation in ITGB8, TRIM59, and phospho-AKT in clinical bladder recurrent tumors compared with their non-recurrent counterparts.

Conclusions:
The ITGB8/TRIM59/AKT/mTOR/glycolysis axis plays a crucial role in modulating tumor softness and stemness. Meanwhile, the soft tumor cells become more sensitive to chemotherapy after stiffening, that offers new insights for hampering tumor progression and recurrence.
Evolving best practices in the surgical management of endometriosis – examining the evidence and expert opinion
Authors: Jorgensen Elisa , Fitzgerald Alison , Clark Nisse 
Published: June 2023

Purpose of review
Endometriosis is a common and often debilitating condition, with multiple theories of pathogenesis. Despite the prevalence of endometriosis, the optimal surgical management remains unclear.

Recent findings
Laparoscopy is the gold standard for the diagnosis of endometriosis, with biopsy confirmation more accurate than visual diagnosis alone. It is not clear from the existing data whether excision of endometriosis is superior to ablation. Improvement in pain has been documented following peritonectomy, however, controlled trials are lacking. It is not clear whether concomitant hysterectomy improves pain associated with endometriosis, although hysterectomy may reduce reoperation rate. Bilateral oophorectomy performed for the treatment of endometriosis may not be curative without simultaneous excision of all visible lesions, and the risks of surgical menopause should be considered. The rate of appendiceal endometriosis is higher than previously suspected, and may not correlate with intraoperative visual findings, suggesting appendectomy should be considered during surgical treatment of endometriosis.

Summary
Despite the prevalence of endometriosis, there is a paucity of data to guide optimal surgical management. More high-quality studies are needed.
Ethnic and Sex Diversity in Academic Plastic Surgery: A Cross-sectional Study
Authors: Tolson Hannah C. , Raikar Danielle-Aditi H. , Morris Bryn E. , Ferguson Elizabeth M. N. , Shahriary Eahsan 
Published: June 2023

Background:
Ethnic, racial, and sex disparities continue to persist in medicine despite efforts to diversify the profession. In competitive surgical specialties such as plastic surgery, those disparities are particularly pronounced. This study aims to evaluate racial, ethnic, and sex diversity in academic plastic surgery.

Methods:
We compiled a list of major plastic surgery professional societies, plastic surgery journal editorial boards, and plastic surgery accreditation boards to evaluate ethnic and sex diversity in society, research, and accreditation domains, respectively. Demographic data were collected and analyzed using the Mann–Whitney U test and the Kruskal–Wallis test.

Results:
White individuals are significantly overrepresented across the professional and research domains, and Asian individuals are overrepresented in the professional domain when compared to non-white races. White individuals make up a total of 74% of the society domain, 67% of the research domain, and 86% of the accreditation domain when compared to all non-white surgeons. Male surgeons made up 79% of the society domain, 83% of the research domain, and 77% of the accreditation domain when compared to all non-male surgeons.

Conclusions:
Ethnic, racial, and sex disparities persist in academic plastic surgery. This study, which looked at societies, editorial boards, and accreditation boards, demonstrated a persistent ethnic, racial, and sex homogeneity among leadership. Changes are required to continue to diversify the field and provide women and underrepresented minorities the tools needed to succeed.
Technical Strategies for Harvest of the Subtotal Pedicled Fillet of Thigh Flap for Reconstruction of External Hemipelvectomy and Hemicorporectomy Defects
Authors: Foglio Aaron M. , McNamara Colin T. , Lindeque Bennie G. , Greyson Mark A. 
Published: June 2023

Summary:
External hemipelvectomy and hemicorporectomy have been described in the literature for a variety of indications. A commonly used reconstructive technique is the pedicled anterior subtotal fillet of thigh flap. However, there are few descriptions regarding the technical pearls of harvest and inset of this flap. Here, we describe our step-by-step technique, as performed in three patients. The flap is pedicled on the common femoral artery and extends longitudinally to the knee to achieve the length required to extend past the midline and resurface sacral pressure ulcers, which are commonly found in patients who undergo this procedure for refractory pelvic osteomyelitis. Additionally, we describe a potential salvage option with late division of the popliteal artery to preserve the option for free tissue transfer of a subtotal fillet of lower leg flap.
Injection of kaolin/carrageenan in the rat knee joint induces progressive experimental knee osteoarthritis
Authors: Amorim Diana , Fonseca-Rodrigues Diana , David-Pereira Ana , Costa Octávia , Lima Antónia Palhares , Nogueira Rosete , Cruz Rute , Martins Ana Sofia , Sousa Liliana , Oliveira Francisco , Pereira Hélder , Pirraco Rogério , Pertovaara Antti , Almeida Armando , Pinto-Ribeiro Filipa 
Published: June 2023

Abstract
Osteoarthritis (OA), the most common joint disorder worldwide, is characterized by progressive degeneration of articular and periarticular structures, leading to physical and emotional impairments that greatly affect the quality of life of patients. Unfortunately, no therapy has been able to halt the progression of the disease. Owing to the complexity of OA, most animal models are only able to mimic a specific stage or feature of the human disorder. In this work, we demonstrate the intraarticular injection of kaolin or carrageenan leads to the progressive degeneration of the rat's knee joint, accompanied by mechanical hyperalgesia and allodynia, gait impairments (reduced contact area of the affected limb), and radiological and histopathological findings concomitant with the development of human grade 4 OA. In addition, animals also display emotional impairments 4 weeks after induction, namely, anxious and depressive-like behaviour, important and common comorbidities of human OA patients. Overall, prolonging kaolin or carrageenan-induced monoarthritis mimics several important physical and psychological features of human OA in both male and female rodents and could be further applied in long-term studies of OA-associated chronic pain.
The elevator speech: An overlooked networking tool
Authors: Hicks Rodney W. 
Published: June 2023

ABSTRACT
One of the overlooked professional networking tools is the elevator speech. Nurse practitioners (NPs) should consider the elevator speech as equally important as their current curriculum vitae and professional biosketch. With advanced planning and practice, NPs can convey the who, what, why, and findings in less than 150 words to expand their network.
Factors Associated With Difficult Endoscopic Ultrasonography-guided Biliary Drainage
Authors: Sugimoto Mitsuru , Takagi Tadayuki , Suzuki Rei , Waragai Yuichi , Konno Naoki , Asama Hiroyuki , Sato Yuki , Irie Hiroki , Nakamura Jun , Takasumi Mika , Hashimoto Minami , Kato Tsunetaka , Yanagita Takumi , Hikichi Takuto , Ohira Hiromasa 
Published: June 2023

Background and Aims:
When endoscopic retrograde cholangiopancreatography-guided biliary drainage is challenging, endoscopic ultrasound-guided biliary drainage (EUS-BD) can be used as an alternate treatment; however, this method requires operator expertise. Therefore, this study aimed to clarify the factors that are associated with a difficult EUS-BD.

Patients and Methods:
Patients who successfully underwent EUS-BD were enrolled in this study. The patients were divided into the easy group and difficult group depending on whether the procedural time was more than 60 minutes, which was the cutoff value elicited from past reports. Patient characteristics and procedural factors were compared between the two groups. The factors associated with difficult procedures were also investigated.

Results:
The patient characteristics were not significantly different between the easy group (n=22) and the difficult group (n=19). The diameter of the punctured bile duct was significantly different between the two groups. In the multivariate analysis, the diameter of the punctured bile duct was the only factor associated with a difficult EUS-BD (odds ratio 0.65, 95% confidence interval 0.46-0.91, P value=0.012). The cutoff value for the diameter of the punctured bile duct in predicting a difficult EUS-BD was 7.0 mm (area under the curve: 0.83, sensitivity 84.2%, specificity 86.4%).

Conclusions:
A nondilated bile duct might be a predictive factor for a difficult EUS-BD. For beginners of EUS-BD, the cutoff value for the punctured bile duct diameter found in this study, 7.0 mm, might become a barometer for puncture point selection.
Agave tequilana Fructans Versus Psyllium plantago for Functional Constipation
Authors: Coss-Adame Enrique , García-Cedillo Maria F. , Bustillo-Armendáriz Gustavo , Huerta-de la Torre Maria F. , Delgado-Bautista Melisa K. , Arenas-Martinez Josealberto , Cassis-Nosthas Lorena 
Published: June 2023

Goal:
The aim of this study was to evaluate the efficacy of supplementation with Agave tequilana Weber blue variety fructans (Predilife) in the improvement of symptoms in functional constipation.

Background:
Fiber supplementation is the first-line treatment for constipation. Fibers-like fructans have a known prebiotic effect.

Materials and Methods:
A randomized, double-blind, study comparing agave fructans (AF) against psyllium plantago (PP). Four groups were randomized. Group 1: AF 5 g (Predilife), group 2: AF 10 g (Predilife), group 3: AF 5 g (Predilife)+10 g maltodextrin (MTDx), and group 4: PP 5 g+10 g MTDx. The fiber was administered once daily for 8 weeks. All fibers were similarly flavored and packaged. Patients kept their usual diet and fiber sources were quantified. Responders were defined as ≥1 complete spontaneous bowel movement from baseline to 8 weeks. Adverse events were reported. The study was registered in Clinicaltrials.gov with registration number NCT04716868.

Results:
Seventy-nine patients were included (group 1: 21, group 2: 18, group 3: 20, and group 4: 20), of which 62 (78.4%) were women. The responders were similar across groups (73.3%, 71.4%, 70.6%, and 69%, P>0.050). After 8 weeks, all groups significantly increased complete spontaneous bowel movements, showing the greatest increase in spontaneous bowel movements in group 3 (P=0.008). All groups improved in symptoms, stool consistency, and quality of life. Diet and fiber intake were similar between groups. Adverse events were mild and similar between groups.

Conclusions:
AF (Predilife) are as effective at different doses and combined with MTDx as PP and are a feasible option for the treatment of functional constipation.
Medical imaging in the assessment of cardiovascular disease risk
Authors: Alcantara Juan Manuel A. , Idoate Fernando , Labayen Idoia 
Published: June 2023

Purpose of review
The prevalence of obesity has exponentially increased during the past years. The assessment of human adipose tissue distribution enables the identification of diverse ectopic adipose tissue depots, and helps to explain its relationship with cardiovascular health status. In this review, we summarize the current methods used in the assessment of human adipose tissue distribution, and we discuss the relationship between ectopic adipose tissue distribution and the risk of developing cardiovascular diseases and metabolic complications.

Recent findings
The reference instruments to assess human adipose tissue distribution nowadays are the computed tomography and the magnetic resonance imaging (MRI). Today, MRI is the preferred imaging technique and enables the measurement of variations in the distribution of body adipose tissue among different phenotypes and individuals. This technique has helped to better understand the relationship between different ectopic adipose tissue depots and its relationship with cardiometabolic health among individuals.

Summary
Although body composition can be assessed by simple techniques, these calculations can provide erroneous results and conclusions, requiring complex interpretations when diverse metabolic situations are concomitantly engaged. Contrarily, medical imaging techniques (e.g. MRI) enables to objectively and unbiasedly measure changes that may occur during longitudinal studies (e.g. pharmacological drug interventions).
Knowledge mapping of diabetic foot research based on Web of Science database: A bibliometric analysis
Authors: Zhao Xiao-Peng , Li Da , Li Cui-Liu , Zhang Yun-Na , Zhao Nai-Rui , Xu Jin-Xiu 
Published: June 2023

Purpose:
To take a systematic bibliometric analysis and generate the knowledge mapping of diabetic foot research, basing on big data from Web of Science Core Collection (WoSCC) database.

Methods:
Two authors retrieved the WoSCC independently, to obtain publications in field of diabetic foot. CiteSpace was used to detect the co-occurrence relationships of authors, keywords, institutions, and countries/regions, co-citation relationships of authors, references, and journals, and distribution of WoS category.

Results:
A total of 10,822 documents were included, with 39,541 authors contributed to this field. “Armstrong DG,” “Lavery LA,” and “Lipsky BA” are the top 3 productive authors, and “Armstrong DG,” “Boulton AJM,” and “Lavery LA” were most commonly cited. The United States, England and China are the most productive countries, and Univ Washington, Univ Manchester and Harvard Univ published the largest quantity of articles. “Diabetes Care,” “Diabetic Med,” and “Diabetologia” are the most frequently cited journals, providing the greatest knowledge base. Clustering analysis of keywords co-occurrence map presented the following hotspots: #1 diabetic wound healing, #2 diabetic polyneuropathy, #3 plantar pressure, #4 diabetic foot infection, #5 endovascular treatment, and #6 hyperbaric oxygen therapy.

Conclusion:
This study performed a global overview of diabetic foot research using bibliometric and visualization methods, which would provide helpful references for researchers focusing on this area to capture the future trend.
Mature cystic teratoma of the ovary with a grossly visible, completely developed intestinal loop: A case report and review of the literature
Authors: Cao Yuanyuan , Wang Bihui , Jia A-Ran , Li Xuejian , Yang Liuqing , Jia Zanhui 
Published: June 2023

Rationale:
The mature cystic teratoma of the ovary (MCTO), is composed of mature differentiated elements, thus showing highly differentiated tissue and highly morphological heterogeneity. Although gastrointestinal epithelium can be identified in 7% to 13% of cases of MCTO, the occurrence of visible, functional, and fully developed loop tissue is rare in clinical practice.

Patient concerns:
A 17-year-old female patient presented with persistent abdominal pain.

Diagnosis:
The patient was diagnosed with MCTO where a visible, functional intestinal loop was observed during laparoscopic surgery. Microscopy of the intestinal structure indicated a well-organized, intact layer of intestinal wall.

Interventions:
An emergency single-port laparoscopic excision of the right ovarian cyst and histopathology were performed.

Outcomes:
After 2 years of follow-up, there were no signs of recurrence in the patient.

Lessons:
The immune signature of CK7−/CK20+ is characteristic of tumors of gastrointestinal origin and can be used to distinguish tumors associated with mature cystic teratoma. Besides, gynecologists should keep an eye on the possibility of malignant transformation malignant transformation of MCTO.