bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroplasty for femoral neck fractures is at risk for under restoration of lateral femoral offset
Authors: Shah Harsh N , Barrett Andrew A , Finlay Andrea K , Arora Prerna , Bellino Michael J , Bishop Julius A , Gardner Michael J , Miller Matthew D , Huddleston James I , Maloney William J , Goodman Stuart B , Amanatullah Derek F 
Published: April 2023

Purpose: The aim of the study was to determine the restoration of hip biomechanics through lateral offset, leg length, and acetabular component position when comparing non-arthroplasty surgeons (NAS) to elective arthroplasty surgeons (EAS). Methods: 131 patients, with a femoral neck fracture treated with a THA by 7 EAS and 20 NAS, were retrospectively reviewed. 2 blinded observers measured leg-length discrepancy, femoral offset, and acetabular component position. Multivariate logistic regression models examined the association between the surgeon groups and restoration of lateral femoral, acetabular offset, leg length discrepancy, acetabular anteversion, acetabular position, and component size, while adjusting for surgical approach and spinal pathology. Results: NAS under-restored 4.8 mm of lateral femoral offset (43.9 ± 8.7 mm) after THA when compared to the uninjured side (48.7 ± 7.1 mm, p  = 0.044). NAS were at risk for under-restoring lateral femoral offset when compared to EAS ( p  = 0.040). There was no association between lateral acetabular offset, leg length, acetabular position, or component size and surgeon type. Conclusions: Lateral femoral offset is at risk for under-restoration after THA for femoral neck fractures, when performed by surgeons that do not regularly perform elective THA. This indicates that lateral femoral offset is an under-appreciated contributor to hip instability when performing THA for a femoral neck fracture. Lateral femoral offset deserves as much attention and awareness as acetabular component position since a secondary analysis of our data reveal that preoperative templating and intraoperative imaging did not prevent under-restoration.
Expanding the Lifestyle Medicine Inpatient Consultation Services at Loma Linda University Health: A Transformative Tool for Chronic Diseases Management in Tertiary Care Settings
Authors: Annam Rachel , Florian Rosemarie , Johnson Sara , Mondala Melisa , Wilson April , Rea Brenda 
Published: April 2023

Lifestyle Medicine (LM) is an emerging field dedicated to the prevention, management, and reversal of chronic diseases by promoting healthy lifestyle choices. LM utilizes six pillars targeting the root causes of diseases to promote health, improve clinical outcomes and significantly enhance overall quality of life. They include plant-based nutrition, physical activity, sleep health, tobacco cessation/managing risky alcohol use, and spiritual/emotional well-being. LM holds great promise as an evidence-based solution for the rising rates of chronic diseases and healthcare costs in the United States. Loma Linda University Health (LLUH), a pioneer of LM, has successfully implemented a phased expansion of its novel LM inpatient consultation services to positively impact the trajectory of morbidity and mortality among patients with chronic conditions and/risk factors admitted to the hospital. This was achieved by boosting awareness, hiring LM-trained providers to meet growing demand, and making consultations accessible hospital-wide. The service has been very well received and saw a 50-fold increase in consultations between 2016 and 2022. It is also reimbursed by all major insurers. LLUH’s experience shows that establishing and growing an inpatient LM consultation service is a viable clinical and cost-effective chronic care model that can be utilized in a tertiary care setting.
Neuromotor Treatment of Arthrogenic Muscle Inhibition After Knee Injury or Surgery
Authors: Dos Anjos Typhanie , Gabriel François , Vieira Thais Dutra , Hopper Graeme Philip , Sonnery-Cottet Bertrand 
Published: April 2023

Background: Persistent weakness of the quadriceps muscles and extension deficit after knee injuries are due to specific alterations in neural excitability - a process known as arthrogenic muscle inhibition (AMI). The effects of a novel neuromotor reprogramming (NR) treatment based on the use of proprioceptive sensations associated with motor imagery and low frequency sounds have not been studied in AMI after knee injuries. Hypothesis: This study aimed to assess quadriceps electromyographic (EMG) activity and the effects on extension deficits in persons with AMI who completed 1 session of NR treatment. We hypothesized that the NR session would activate the quadriceps and improve extension deficits. Study Design: Case series. Level of Evidence: Level 4. Methods: Between May 1, 2021 and February 28, 2022, patients who underwent knee ligament surgery or sustained a knee sprain with a deficit of >30% of the vastus medialis oblique (VMO) on EMG testing in comparison with the contralateral limb after their initial rehabilitation were included in the study. The maximal voluntary isometric contraction of the VMO measured on EMG, the knee extension deficit (distance between the heel and the table during contraction), and the simple knee value (SKV) were assessed before and immediately after completion of 1 session of NR treatment. Results: A total of 30 patients with a mean age of 34.6 ± 10.1 years (range, 14-50 years) were included in the study. After the NR session, VMO activation increased significantly, with a mean increase of 45% ( P < 0.01). Similarly, the knee extension deficit significantly improved from 4.03 ± 0.69 cm before the treatment to 1.93 ± 0.68 after the treatment ( P < 0.01). The SKV was 50 ± 5.43% before the treatment, and this increased to 67.5 ± 4.09% after the treatment ( P < 0.01). Conclusion: Our study indicates that this innovative NR method can improve VMO activation and extension deficits in patients with AMI. Therefore, this method could be considered a safe and reliable treatment modality in patients with AMI after knee injury or surgery. Clinical Relevance: This multidisciplinary treatment modality for AMI can enhance outcomes through the restoration of quadriceps neuromuscular function and subsequent reduction of extension deficits after knee trauma.
Myasthenia Gravis Exacerbation Following Immunization With the BNT162b2 mRNA COVID-19 Vaccine: Report of a Case and Review of the Literature
Authors: Papadopoulou Marianna , Stefanou Maria-Ioanna , Palaiodimou Lina , Tsivgoulis Georgios 
Published: April 2023

Acute exacerbations of Myasthenia Gravis (MG) may be triggered by infections and certain drugs. No consensus has been reached on vaccines and the risk for developing myasthenic crisis. During the COVID-19 pandemic, MG patients are considered at high risk for severe illness, and vaccination is strongly recommended. We report the case of a 70-year-old woman with MG, diagnosed 2 years earlier, that developed myasthenic crisis 10 days after the second dose of the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). The patient had no previous MG exacerbations in her history. Following increase of oral pyridostigmine and prednisone treatment, the patient underwent immunoglobulin and plasma exchange therapy. Due to persisting symptoms, immunotherapy was switched to rituximab, under which a clinical remission was achieved. MG patients infected with SARS-CoV-2 may develop severe acute respiratory distress syndrome and have a higher mortality compared to the general population. In addition, reports of new-onset MG following COVID-19 infection accumulate. By contrast, since the beginning of the vaccination program, only 3 cases of new-onset MG after COVID-19 vaccinations have been published and 2 cases of severe MG exacerbation. Vaccinations in MG patients have always been debated, but most studies confirm their safety. In the era of COVID-19 pandemic, vaccination protects against infection and severe illness, especially in vulnerable populations. The rare occurrence of side effects should not discourage clinicians from recommending COVID-19 vaccination, but close follow-up of MG patients is recommended during the post-vaccination period.
Intravoxel incoherent motion for differentiating residual/recurrent tumor from post-treatment change in patients with high-grade glioma
Authors: Tunlayadechanont Padcha , Panyaping Theeraphol , Chansakul Thanissara , Hirunpat Pornrujee , Kampaengtip Adun 
Published: April 2023

Purpose To investigate the diagnostic value of f derived from IVIM technique and to correlate it with rCBV derived from DSC for the differentiation of residual/recurrent tumor from post-treatment change in patients with high-grade glioma. Materials and Methods Patients who underwent MR imaging with IVIM and DSC studies for evaluation of high-grade glioma after standard treatment were enrolled in this retrospective study. For qualitative analysis, the f and rCBV maps were interpreted as hypoperfused or hyperperfused in each parameter. Quantitative analysis was performed using ROI analysis in f and rCBV parameters. The lesions were divided into residual/recurrent tumor and post-treatment change groups. Results Nineteen patients with high-grade glioma were included. In qualitative analysis, the f-map shows higher sensitivity (100.0%) than rCBV map (92.3%), while the rCBV map shows higher specificity (100.0%) than the f-map (83.3%). In quantitative analysis, the optimal cutoff values of 1.19 for f and 1.06 for rCBV are shown to provide high diagnostic value with high sensitivity (91.7%) for both parameters but slightly higher specificity of rCBV (85.7%) than f (71.4%). The correlation between f and rCBV was good with ICC of 0.810. Conclusion The f value measured by IVIM technique, non-contrast perfusion technique, has high diagnostic performance and potential to be an alternative method to CBV measured by DSC for differentiation between residual/recurrent tumor and post-treatment change in patients with high-grade glioma.
Repair of Ramp Lesions of the Medial Meniscus With ACL Reconstruction Can Better Restore Knee Stability: A Cadaveric Study
Authors: Li Shuzhen , Qin Yu , Wang Hao , Qin Zhi , Jiang Lianjian , Zhu Shengwang , Zeng Feng , Sun Ke , Wen Jieming , Yin Dong 
Published: April 2023

Background: Ramp lesions of the medial meniscus have an impact on joint stability in anterior cruciate ligament (ACL)–deficient knees, but the impact of lesion length and repair is unclear. Purpose/Hypothesis: The purpose of this cadaveric study was to evaluate the effect of medial meniscal ramp lesion repair on the biomechanics of ACL-deficient knee joints. It was hypothesized that (1) ramp lesions will increase the anterior tibial translation (ATT), internal rotation (IR), and external rotation (ER) in ACL-deficient knee joints; (2) increasing the length of the ramp lesion will further increase the ATT, IR, and ER; and (3) repairing the ramp lesion will reduce the ATT, IR, and ER after ACL reconstruction. Study Design: Controlled laboratory study. Methods: Included were 9 fresh-frozen cadaveric specimens (4 left knees, 5 right knees; 6 males and 3 females; mean age, 60 years [range, 40-73 years]). The specimens were tested on a biomechanical rig. Two external loading conditions were applied: a 134-N anterior tibial load and 5-N·m internal/external tibial torque with the knee at full extension and at 15°, 30°, 60°, and 90° of flexion. ATT was tracked via a high-speed video camera. The following knee states were tested: intact; ACL-deficient; ACL-deficient combined with a 5-, 10-, 15-, or 20 mm–long ramp lesion of the medial meniscus; ACL reconstruction; and ACL reconstruction combined with ramp lesion repair. The ATT, IR, and ER at all knee angles were analyzed by 1-way analysis of variance. Results: The ATT, IR, and ER were significantly increased after cutting of the ACL ( P < .05). The ATT, IR, and ER continued to increase when ACL deficiency was combined with ramp lesions of 5 to 20 mm in length ( P < .05). The ATT, IR, and ER significantly decreased after ACL reconstruction and ACL reconstruction combined with ramp lesion repair ( P < .05). Conclusion: The laxity of knees with ACL deficiency combined with a ramp lesion of the medial meniscus increased more obviously as the ramp lesion increased in length. In a cadaveric model, ACL reconstruction combined with ramp repair improved knee joint stability.
Injuries and Use of Safety Equipment in River Surfing
Authors: Wende Christina , Lambert Christophe , Hoeher Juergen , Balke Maurice 
Published: April 2023

Background: River surfing (also called “rapid surfing”) involves surfing on stationary waves that are artificially created or placed in rivers and is gaining popularity, especially among surfers in landlocked areas but also among athletes without experience in ocean surfing. Different wave setups, types of boards, and types of fins, as well as the use of safety equipment, can lead to overuse and injuries. Purpose: To analyze the incidence, mechanisms, and risk factors of river surfing–related injuries for different types of waves and to evaluate the usage and appropriateness of safety equipment. Study Design: Descriptive epidemiology study. Methods: An online survey was distributed via social media to river surfers in German-speaking countries to collect information on demographics, injury history for the previous 12 months, wave site attended, use of (safety) equipment, and health issues. The survey was accessible between November 2021 and February 2022. Results: A total of 213 participants completed the survey: 195 participants from Germany, 10 from Austria, 6 from Switzerland, and 2 from other countries. The mean age was 36 years (range, 11-73 years), 72% (n = 153) were male, and 10% (n = 22) took part in competitions. Overall, 60% (n = 128) of surfers experienced 741 surfing-related injuries over the previous 12 months. The most common mechanisms of injury were contact with the bottom of the pool/river (n = 75 [35%]), with the board (n = 65 [30%]), and with the fins (n = 57 [27%]). The most frequent injury types were contusions/bruises (n = 256), cuts/lacerations (n = 159), abrasions (n = 152), and overuse (n = 58). Injuries affected mainly the feet/toes (n = 90), head/face (n = 67), hand/fingers (n = 51), knee (n = 49), lower back (n = 49), and thighs (n = 45). Earplugs were used by 50 (24%) participants, and a helmet was used regularly by 38 (18%) participants and never by 175 (82%) participants. Conclusion: The most frequent types of injury in river surfers were contusions/bruises, cuts/lacerations, and abrasions. The main mechanisms of injury were contact with the bottom of the pool/river, with the board, or with the fins. The feet/toes were more prone to injuries, followed by the head/face and hand/fingers.
Neurological Adverse Effects Following Administration of COVID-19 Vaccination: A Meta-Analysis
Authors: Ahmad Shwan A. , Abbas Yadgar N. , Ahmed Jaafar O. , Mahmood Zana H. , Kakamad Fahmi H. , Baba Hiwa O. , Salih Karzan M. , Karim Sanaa O. , Mohammed Shvan H. , Hassan Marwan N. , Salih Rawezh Q. , Kakamad Suhaib H. 
Published: April 2023

Introduction During the previous year, a variety of serious neurological problems associated with the COVID-19 vaccination have been documented, including encephalopathy, Guillain-Barré syndrome, transverse myelitis, and Bell’s palsy. Objective In the current study, neurological complications reported post-COVID-19 vaccination were systematically reviewed. The current meta-analysis aims to provide clinicians with a comprehensive understanding of this uncommon adverse event. Method Web of Science, MEDLINE on OVID, PubMed, and Google Scholar were searched for English-language papers published after January 1, 2020. Result Thirty articles were included in this study (21 case series and 9 cohort studies). The studies comprised 22,780 patients who got COVID-19 vaccinations and had at least 1 neurological adverse event. Across the majority of event types, females (54%) reported more adverse events than males (40%). The median duration from vaccination to the development of neurological symptoms was 12 days (0-41 days) in case series studies and 10 days (0-30 days) in cohort studies. Stroke is by far the most common neurological side effect of SARS-CoV-2 vaccines, followed by Bell’s palsy and seizures. Conclusion Concerns regarding the safety of COVID-19 vaccinations are being backed up by a growing number of studies that demonstrate neurological side effects.
CIRP attenuates acute kidney injury after hypothermic cardiovascular surgery by inhibiting PHD3/HIF-1α-mediated ROS-TGF-β1/p38 MAPK activation and mitochondrial apoptotic pathways
Authors: Zhang Peiyao , Bai Liting , Tong Yuanyuan , Guo Shengwen , Lu Wenlong , Yuan Yue , Wang Wenting , Jin Yu , Gao Peng , Liu Jinping 
Published: May 2023

Abstract
Background
The ischemia–reperfusion (IR) environment during deep hypothermic circulatory arrest (DHCA) cardiovascular surgery is a major cause of acute kidney injury (AKI), which lacks preventive measure and treatment. It was reported that cold inducible RNA-binding protein (CIRP) can be induced under hypoxic and hypothermic stress and may have a protective effect on multiple organs. The purpose of this study was to investigate whether CIRP could exert renoprotective effect during hypothermic IR and the potential mechanisms.

Methods
Utilizing RNA-sequencing, we compared the differences in gene expression between Cirp knockout rats and wild-type rats after DHCA and screened the possible mechanisms. Then, we established the hypothermic oxygen–glucose deprivation (OGD) model using HK-2 cells transfected with siRNA to verify the downstream pathways and explore potential pharmacological approach. The effects of CIRP and enarodustat (JTZ-951) on renal IR injury (IRI) were investigated in vivo and in vitro using multiple levels of pathological and molecular biological experiments.

Results
We discovered that Cirp knockout significantly upregulated rat Phd3 expression, which is the key regulator of HIF-1α, thereby inhibiting HIF-1α after DHCA. In addition, deletion of Cirp in rat model promoted apoptosis and aggravated renal injury by reactive oxygen species (ROS) accumulation and significant activation of the TGF-β1/p38 MAPK inflammatory pathway. Then, based on the HK-2 cell model of hypothermic OGD, we found that CIRP silencing significantly stimulated the expression of the TGF-β1/p38 MAPK inflammatory pathway by activating the PHD3/HIF-1α axis, and induced more severe apoptosis through the mitochondrial cytochrome c-Apaf-1-caspase 9 and FADD-caspase 8 death receptor pathways compared with untransfected cells. However, silencing PHD3 remarkably activated the expression of HIF-1α and alleviated the apoptosis of HK-2 cells in hypothermic OGD. On this basis, by pretreating HK-2 and rats with enarodustat, a novel HIF-1α stabilizer, we found that enarodustat significantly mitigated renal cellular apoptosis under hypothermic IR and reversed the aggravated IRI induced by CIRP defect, both in vitro and in vivo.

Conclusion
Our findings indicated that CIRP may confer renoprotection against hypothermic IRI by suppressing PHD3/HIF-1α-mediated apoptosis. PHD3 inhibitors and HIF-1α stabilizers may have clinical value in renal IRI.
Guillain–Barre syndrome after myocardial infarction: a case report and literature review
Authors: Wen Pu-yuan , Chen Xian-wen , Zhang Min , Chu Wen-zheng , Wu Hong-liang , Ren Chao 
Published: May 2023

Abstract
Background
Guillain–Barre syndrome after myocardial infarction occurs infrequently, and its occurrence following percutaneous coronary intervention is extremely rare. Due to the high mortality rate of myocardial infarction and the disability of Guillain–Barre syndrome, early identification of Guillain–Barre syndrome after myocardial infarction and early intervention can decrease the mortality rate, lead to early recovery, and provide a better outcome.

Case presentation
Herein, we reported a rare case of Guillain–Barre syndrome after myocardial infarction treated with percutaneous coronary intervention. The patient was a 75-year-old woman from China who was admitted to hospital due to sudden loss of consciousness. Electrocardiography showed acute myocardial infarction in the right ventricle and inferior and posterior walls. The patient underwent emergency percutaneous intervention of the posterior collateral artery of the right coronary artery. Soon after, her condition worsened resulting in limb weakness and numbness. Unfortunately, she continued to develop respiratory failure, and treated with intravenous immunoglobulin and ventilator-assisted breathing. A physical examination showed hypotonia of all four limbs, complete quadriplegia, bulbar palsy, dysarthria, and tendon areflexia. Serum immunoglobulin (Ig) G anti-ganglioside antibody analysis was positive with anti-GT1a antibodies (+ +), anti-GM1 antibodies ( +), anti-GM2 antibodies ( +), and anti-GM4 antibodies ( +), and he was diagnosed with Guillain–Barre syndrome after myocardial infarction. She was discharged due to poor response to treatment. The patient died two days after being discharged.

Conclusions
Myocardial infarction and/or percutaneous coronary intervention may activate immune-mediated response and cause severe complications. Clinician should be alert to Guillain–Barre syndrome after myocardial infarction and/or percutaneous coronary intervention.
CAA-derived IL-6 induced M2 macrophage polarization by activating STAT3
Authors: Zhao Chongru , Zeng Ning , Zhou Xiaomei , Tan Yufang , Wang Yichen , Zhang Jun , Wu Yiping , Zhang Qi 
Published: May 2023

Abstract
Background
Tumor-associated macrophages (TAMs) are the most abundant types of immune cells in the tumor microenvironment (TME) of breast cancer (BC). TAMs usually exhibit an M2 phenotype and promote tumor progression by facilitating immunosuppression. This study aimed to investigate the effect of CAA-derived IL-6 on macrophage polarization in promoting BC progression.

Methods
Human BC samples and adipocytes co-cultured with 4T1 BC cells were employed to explore the properties of CAAs. The co-implantation of adipocytes and 4T1 cells in mouse tumor-bearing model and tail vein pulmonary metastasis model were constructed to investigate the impact of CAAs on BC malignant progression in vivo. The functional assays, qRT-PCR, western blotting assay and ELISA assay were employed to explore the effect of CAA-derived IL-6 on macrophage polarization and programmed cell death protein ligand 1 (PD-L1) expression.

Results
CAAs were located at the invasive front of BC and possessed a de-differentiated fibroblast phenotype. CAAs facilitated the malignant behaviors of 4T1 cells in vitro, and promoted 4T1 tumor growth and pulmonary metastasis in vivo. The IHC staining of both human BC specimens and xenograft and the in vitro experiment indicated that CAAs could enhance infiltration of M2 macrophages in the TME of 4T1 BC. Furthermore, CAA-educated macrophages could enhance malignant behaviors of 4T1 cells in vitro. More importantly, CAAs could secret abundant IL-6 and thus induce M2 macrophage polarization by activating STAT3. In addition, CAAs could upregulate PD-L1 expression in macrophages.

Conclusions
Our study revealed that CAAs and CAA-educated macrophages enhanced the malignant behaviors of BC. Specifically, CAA-derived IL-6 induced migration and M2 polarization of macrophages via activation STAT3 and promoted macrophage PD-L1 expression, thereby leading to BC progression.