bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes After Derotational Distal Femoral Osteotomy for Recurrent Patellar Dislocations With Increased Femoral Anteversion: A Systematic Review and Meta-analysis
Authors: Hao Kuo , Niu Yingzhen , Feng Ao , Wang Fei 
Published: July 2023

Background: An increased femoral anteversion angle (FAA) is a predisposing factor for recurrent patellar dislocations (RPDs), and combined procedures including derotational distal femoral osteotomy (DDFO) have been shown to be good options. Purpose: To investigate the safety and effectiveness of combined DDFO on clinical and radiological outcomes to treat RPDs with an increased FAA. Study Design: Systematic review; Level of evidence, 4. Methods: This review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. We searched 7 databases for articles from inception to March 10, 2023, that reported outcomes after combined DDFO in patients with an RPD and increased FAA. Two reviewers independently extracted data and assessed study quality. Outcomes evaluated were functional scores, redislocation rates, complications, satisfaction, and radiological parameters. A meta-analysis was performed to pool functional scores, with data reported as mean differences (MDs) and 95% confidence intervals (CIs). Results: Included were 8 studies of 189 knees from 183 patients, with a mean patient age of 22.4 years and a mean follow-up of 33.4 months. The mean preoperative FAA ranged from 31° to 42.70°, and the mean postoperative FAA ranged from 10° to 19.08°. Significant improvements were found in the Kujala score (MD, 26.96 [95% CI, 23.54 to 30.37]), Lysholm score (MD, 26.17 [95% CI, 22.13 to 30.22]), visual analog scale score for pain (MD, –2.61 [95% CI, –3.12 to –2.10]), and Tegner activity score (MD, 1.33 [95% CI, 0.86 to 1.79]). No subluxation or redislocation occurred. The overall complication rate was 10.6%, and most of the complications were pain (60%) and limited knee activity (20%). The overall satisfaction rate was 83.3%. The patellar tilt angle significantly decreased from 40.7° ± 11.9° to 20.5° ± 8.7° and from 26.35° ± 6.86° to 11.65° ± 2.85° in 2 studies. Conclusion: Combined DDFO was found to be safe and effective for the treatment of RPDs and an increased FAA by addressing both patellar dislocations and torsional malalignment. However, because of the lack of comparisons, it remains to be investigated when DDFO should be combined in such patients.
Professionalism, Ethics, and Realism of Television Medical Dramas as Perceived by Saudi Medical Students
Authors: Alahmari Abdussalam A. 
Published: July 2023

Objectives Since their debut, medical dramas have been popular, particularly among medical students. This study examined how much time medical students spend watching medical TV shows and their impressions of the shows’ professionalism, ethics, and realism. Methods A survey on medical students’ medical drama viewing behavior and perceptions with regard to bioethics was given to 341 first- to fifth-year undergraduate medical students at a university in Al Majmaah, Saudi Arabia. The poll gathered demographic information, TV medical drama watching habits, bioethical and professional concerns in medical dramas, and the sources of bioethical knowledge. Results The most popular medical dramas were The Good Doctor, Grey's Anatomy, and House M.D. Compared with English-language television medical dramas, Arabic ones were less popular. Ninety-one percent of students watched television alone. There was no statistically significant difference in respondents’ perceptions of ethics accuracy based on year of study, gender, or whether they discussed it with friends. In comparison to students who had not seen any medical dramas, those who had were more inclined to view them as a credible source of ethical advice ( P-value .04). Conclusions There is a high interest in medical programs among medical students, and these programs can be used to teach them about the ethical aspects of practicing medicine.
Biplanar Proximal Tibial Opening-Wedge Osteotomy for a Chronic PCL Tear With Medial Compartment Arthritis
Authors: Banovetz Mark T. , Braaten Jacob A. , Homan Morgan D. , Kennedy Nicholas I. , LaPrade Robert F. 
Published: July 2023

Background: Chronic posterior cruciate ligament (PCL) insufficiency leads to instability of the knee, resulting in increased loading of the medial and patellofemoral compartments. Chronic PCL insufficiency progressively damages the menisci and chondral surfaces and can accentuate and worsen varus malalignment. Biplanar proximal tibial opening-wedge osteotomy (BPTO) is a treatment option for chronic PCL tears with medial compartment arthritis which concurrently treats sagittal (flat slope) and varus coronal alignment. Indications: Opening-wedge BPTO is indicated in active patients who present with varus malalignment and flat slope with concomitant degenerative medial compartment osteoarthritis and PCL insufficiency. In general, BPTO is contraindicated in patients with a significantly elevated body mass index (BMI), smokers, or in those who have advanced tricompartmental osteoarthritis. Technique Description: Preoperative long-leg radiographs are essential to preoperative evaluation. Ideal coronal alignment following correction would have the mechanical axis pass through the apex of the lateral tibial eminence to properly off-load the medial compartment. Magnetic resonance imaging (MRI) studies are also useful for determining the presence and extent of concomitant soft tissue and chondral injury, especially in the lateral compartment. This video demonstrates the senior author’s preferred technique for a biplanar proximal tibial opening (PTO) with concomitant chondroplasty and partial medial meniscectomy (PMM). The senior author’s preferred order of operations is also displayed and involves first performing an arthroscopy, then proceeding with the open portions of the case, including the medial approach and subsequent osteotomy. Results: Past studies have supported PTO as a reliable treatment option for varus malalignment. Bode et al reported a 5-year survival rate of 96% of patients with an overall complication rate of 8.6%. The authors also reported that Lysholm scores were also significantly improved at 60-month follow-up compared with preoperative scores. Discussion: This is a technique for the correction of a varus malalignment with concomitant flat slope and PCL insufficiency with biplanar open-wedge PTO. This operation corrects the mechanical axis and sagittal slope of the knee and restores proper load distribution across the tibiofemoral articulation. In conclusion, a biplanar open-wedge PTO is a useful alternative to joint arthroplasty for active patients with a chronic PCL tear, medial compartment arthritis, and varus malalignment. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Therapeutic effects of engineered exosome-based miR-25 and miR-181a treatment in spinocerebellar ataxia type 3 mice by silencing ATXN3
Authors: Tang Zhenchu , Hu Shenglan , Wu Ziwei , He Miao 
Published: July 2023

Abstract
Background
Spinocerebellar ataxia type 3 (SCA3) is the most common autosomal dominant hereditary ataxia worldwide, which is however in a lack of effective treatment. In view of that engineered exosomes are a promising non-invasive gene therapy transporter that can overcome the traditional problem of poor drug delivery, the aim of this study was to evaluate, for the first time, the value of exosome-based microRNA therapy in SCA3 and the therapeutic effects of intravenously administrated ATXN3 targeting microRNAs in transgenic SCA3 mouse models.

Methods
The rabies virus glycoprotein (RVG) peptide–modified exosomes loaded with miR-25 or miR-181a were peripherally injected to enable targeted delivery of miRNAs to the brain of SCA3 mice. The behaviors, ATXN3 level, purkinje cell and other neuronal loss, and neuroinflammation were evaluated 4 weeks after initial treatment.

Results
The targeted and efficient delivery of miR-25 and miR-181a by modified exosomes substantially inhibited the mutant ATXN3 expression, reduced neuron apoptosis and induced motor improvements in SCA3 mouse models without increasing the neuroinflammatory response.

Conclusions
Our study confirmed the therapeutic potential of engineered exosome-based miR-25 and miR-181a treatment in substantially reducing ATXN3 aggregation and cytotoxicity by relying on its targeted and efficient drug delivery performance in SCA3 mice. This treatment method shows a promising prospect for future clinical applications in SCA3.
Hypothermic oxygenated perfusion attenuates DCD liver ischemia–reperfusion injury by activating the JAK2/STAT3/HAX1 pathway to regulate endoplasmic reticulum stress
Authors: Yue Pengpeng , Lv Xiaoyan , You Jian , Zou Yongkang , luo Jun , Lu Zhongshan , Cao Hankun , Liu Zhongzhong , Fan Xiaoli , Ye Qifa 
Published: July 2023

Abstract
Background
Hepatic ischemia–reperfusion injury (IRI) in donation after cardiac death (DCD) donors is a major determinant of transplantation success. Endoplasmic reticulum (ER) stress plays a key role in hepatic IRI, with potential involvement of the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway and the antiapoptotic protein hematopoietic-lineage substrate-1-associated protein X-1 (HAX1). In this study, we aimed to investigate the effects of hypothermic oxygenated perfusion (HOPE), an organ preservation modality, on ER stress and apoptosis during hepatic IRI in a DCD rat model.

Methods
To investigate whether HOPE could improve IRI in DCD livers, levels of different related proteins were examined by western blotting and quantitative real-time polymerase chain reaction. Further expression analyses, immunohistochemical analyses, immunofluorescence staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining, and transmission electron microscopy were conducted to analyze the effects of HOPE on ER stress and apoptosis. To clarify the role of the JAK2/STAT3 pathway and HAX1 in this process, AG490 inhibitor, JAX1 plasmid transfection, co-immunoprecipitation (CO-IP), and flow cytometry analyses were conducted.

Results
HOPE reduced liver injury and inflammation while alleviating ER stress and apoptosis in the DCD rat model. Mechanistically, HOPE inhibited unfolded protein responses by activating the JAK2/STAT3 pathway, thus reducing ER stress and apoptosis. Moreover, the activated JAK2/STAT3 pathway upregulated HAX1, promoting the interaction between HAX1 and SERCA2b to maintain ER calcium homeostasis. Upregulated HAX1 also modulated ER stress and apoptosis by inhibiting the inositol-requiring enzyme 1 (IRE1) pathway.

Conclusions
JAK2/STAT3-mediated upregulation of HAX1 during HOPE alleviates hepatic ER stress and apoptosis, indicating the JAK2/STAT3/HAX1 pathway as a potential target for IRI management during DCD liver transplantation.

Graphical Abstract
Improvement of variables interpretability in kernel PCA
Authors: Briscik Mitja , Dillies Marie-Agnès , Déjean Sébastien 
Published: July 2023

Abstract
Background
Kernel methods have been proven to be a powerful tool for the integration and analysis of high-throughput technologies generated data. Kernels offer a nonlinear version of any linear algorithm solely based on dot products. The kernelized version of principal component analysis is a valid nonlinear alternative to tackle the nonlinearity of biological sample spaces. This paper proposes a novel methodology to obtain a data-driven feature importance based on the kernel PCA representation of the data.

Results
The proposed method, kernel PCA Interpretable Gradient (KPCA-IG), provides a data-driven feature importance that is computationally fast and based solely on linear algebra calculations. It has been compared with existing methods on three benchmark datasets. The accuracy obtained using KPCA-IG selected features is equal to or greater than the other methods’ average. Also, the computational complexity required demonstrates the high efficiency of the method. An exhaustive literature search has been conducted on the selected genes from a publicly available Hepatocellular carcinoma dataset to validate the retained features from a biological point of view. The results once again remark on the appropriateness of the computed ranking.

Conclusions
The black-box nature of kernel PCA needs new methods to interpret the original features. Our proposed methodology KPCA-IG proved to be a valid alternative to select influential variables in high-dimensional high-throughput datasets, potentially unravelling new biological and medical biomarkers.
An insight into the role of the organic acids produced by Enterobacter sp. strain 15S in solubilizing tricalcium phosphate: in situ study on cucumber
Authors: Zuluaga Mónica Yorlady Alzate , de Oliveira André Luiz Martinez , Valentinuzzi Fabio , Jayme Nádia Souza , Monterisi Sonia , Fattorini Roberto , Cesco Stefano , Pii Youry 
Published: July 2023

Abstract
Background
The release of organic acids (OAs) is considered the main mechanism used by phosphate-solubilizing bacteria (PSB) to dissolve inorganic phosphate in soil. Nevertheless, little is known about the effect of individual OAs produced by a particular PSB in a soil–plant system. For these reasons, the present work aimed at investigating the effect of Enterobacter sp. strain 15S and the exogenous application of its OAs on (i) the solubilization of tricalcium phosphate (TCP), (ii) plant growth and (iii) P nutrition of cucumber. To this purpose two independent experiments have been performed.

Results
In the first experiment, carried out in vitro, the phosphate solubilizing activity of Enterobacter 15S was associated with the release of citric, fumaric, ketoglutaric, malic, and oxalic acids. In the second experiment, cucumber plants were grown in a Leonard jar system consisting of a nutrient solution supplemented with the OAs previously identified in Enterobacter 15S (jar’s base) and a substrate supplemented with the insoluble TCP where cucumber plants were grown (jar’s top). The use of Enterobacter 15S and its secreted OAs proved to be efficient in the in situ TCP solubilization. In particular, the enhancement of the morpho-physiological traits of P-starved cucumber plants was evident when treated with Enterobacter 15S, oxalate, or citrate. The highest accumulation of P in roots and shoots induced by such treatments further corroborated this hypothesis.

Conclusion
In our study, the results presented suggest that organic acids released by Enterobacter 15S as well as the bacterium itself can enhance the P-acquisition by cucumber plants.
Exploring differentially expressed genes of Staphylococcus aureus exposed to human tonsillar cells using RNA sequencing
Authors: Bastakoti Srijana , Ajayi Clement , Julin Kjersti , Johannessen Mona , Hanssen Anne-Merethe 
Published: July 2023

Abstract
Background
The nose and the throat are the most predominant colonizing sites of Staphylococcus aureus, and colonization is a risk factor for infection. Nasal colonization is well described; however, we have limited knowledge about S. aureus throat colonization. The main objective of this study was to explore differentially expressed genes (DEGs) in S. aureus throat isolate TR145 exposed to human tonsil epithelial cells (HTEpiC) by using RNA sequencing (RNA-seq) and pathway analysis. DEGs in S. aureus at 1 or 3 hours (h) interaction with its host were explored.

Results
S. aureus was co-cultured in absence and presence of tonsillar cells at 1 or 3 h. Over the 3 h time frame, the bacteria multiplied, but still caused only minor cytotoxicity. Upon exposure to tonsillar cell line, S. aureus changed its transcriptomic profile. A total of 508 DEGs were identified including unique (1 h, 160 DEGs and 3 h, 78 DEGs) and commonly shared genes (1 and 3 h, 270 DEGs). Among the DEGs, were genes encoding proteins involved in adhesion and immune evasion, as well as iron acquisition and transport. Reverse transcription qPCR was done on selected genes, and the results correlated with the RNA-seq data.

Conclusion
We have shown the suitability of using HTEpiC as an in vitro model for investigating key determinants in S. aureus during co-incubation with host cells. Several DEGs were unique after 1 or 3 h exposure to host cells, while others were commonly expressed at both time points. As their expression is induced upon meeting with the host, they might be explored further for future targets for intervention to prevent either colonization or infection in the throat.
The impact of semi-upright position on severity of sleep disordered breathing in patients with obstructive sleep apnea: a two-arm, prospective, randomized controlled trial
Authors: Lukachan Gincy A. , Yadollahi Azadeh , Auckley Dennis , Gavrilovic Bojan , Matelski John , Chung Frances , Singh Mandeep 
Published: July 2023

Abstract
Background
The severity of sleep-disordered breathing is known to worsen postoperatively and is associated with increased cardio-pulmonary complications and increased resource implications. In the general population, the semi-upright position has been used in the management of OSA. We hypothesized that the use of a semi-upright position versus a non-elevated position will reduce postoperative worsening of OSA in patients undergoing non-cardiac surgeries.

Methods
This study was conducted as a prospective randomized controlled trial of perioperative patients, undergoing elective non-cardiac inpatient surgeries. Patients underwent a preoperative sleep study using a portable polysomnography device. Patients with OSA (apnea hypopnea index (AHI) > 5 events/hr), underwent a sleep study on postoperative night 2 (N2) after being randomized into an intervention group (Group I): semi-upright position (30 to 45 degrees incline), or a control group (Group C) (zero degrees from horizontal). The primary outcome was postoperative AHI on N2. The secondary outcomes were obstructive apnea index (OAI), central apnea index (CAI), hypopnea index (HI), obstructive apnea hypopnea index (OAHI) and oxygenation parameters.

Results
Thirty-five patients were included. Twenty-one patients were assigned to the Group 1 (females-14 (67%); mean age 65 ± 12) while there were fourteen patients in the Group C (females-5 (36%); mean age 63 ± 10). The semi-upright position resulted in a significant reduction in OAI in the intervention arm (Group C vs Group I postop AHI: 16.6 ± 19.0 vs 8.6 ± 11.2 events/hr; overall p = 0.01), but there were no significant differences in the overall AHI or other parameters between the two groups. Subgroup analysis of patients with “supine related OSA” revealed a decreasing trend in postoperative AHI with semi-upright position, but the sample size was too small to evaluate statistical significance.

Conclusion
In patients with newly diagnosed OSA, the semi-upright position resulted in improvement in obstructive apneas, but not the overall AHI.

Trial registration
This trial was retrospectively registered in clinicaltrials.gov NCT02152202 on 02/06/2014.
A case presentation of acquired membranous ventricular septum aneurysm as a rare delayed complication of ventricular septal defect repair surgery: 10-year follow-up
Authors: Liu Zhiyue , Liang Ting , Jia Siyu , Zhang Wen , Feng Yuan , Huang He 
Published: July 2023

Abstract
Background
Rare as membranous ventricular septal aneurysms (MVSA) is, the possibility that occurs after ventricular septum defect (VSD) repair surgery is even more uncommon.

Presentation
A girl developed a MVSA 3 years after the VSD repair surgery at the age of 1 and increasing growth was noted during the follow-up. Aneurysm plication was carried done when she was 11 years old because it was observed to have a close relationship to the right coronary and obstructed the right ventricular outflow tract. Postoperative echocardiography follow-up revealed no abnormalities.

Conclusion
Though the prognosis of most patients with VSD repaired surgery was good, there remains varieties type of complications despite surgical advances. Accurate and rapid diagnosis of acute and delayed complications is essential to improve prognosis. In this case, the aneurysm was diagnosed by multiple imaging modalities and the girl underwent successful surgery again which provides direction for awareness and knowledge of delayed complications of VSD repair.
Coronary artery ectasia associated with IgG4-related disease: a case report and literature review
Authors: Tang Muyun , Zhang Zhiyu , Wang Liang , Qian Hao , Wu Wei , Liu Zhenyu , Shen Zhujun , Chen Hua , Guo Zhiwei , Tian Ran , Zhang Shuyang 
Published: July 2023

Abstract
Background
Coronary artery ectasia is defined as a local or diffuse dilatation of the coronary artery more than 1.5 times the diameter of the adjacent normal segment. The etiology of coronary artery ectasia is diverse, and rarely complicated with immunoglobulin G4-related disease (IgG4-related disease). A limited number of cases have been reported, with insidious onset, slow progression but poor prognosis.

Case presentation
we report a patient with coronary artery ectasia combined with IgG4-related disease. He has been diagnosed with IgG4-related disease 5 years after his first percutaneous coronary intervention (PCI). Despite routine treatment with steroids, he develops a large coronary aneurysm and eventually died.

Conclusions
It is suggested that a thorough evaluation should be performed when coronary artery ectasia is diagnosed. The factors such as manifestations of coronary artery thickening, typical imaging features, other aortas involvement, increased serum IgG4 level, etc. should be considered for early diagnosis of key etiologies.