bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome following soft tissue coverage with a medial gastrocnemius flap of an exposed or infected total knee arthroplasty
Authors: Wiberg Rebecca , Mukka Camilla , Backman Olof , Stålhult Göran , Edmundsson David , Mukka Sebastian 
Published: June 2023

Background: Soft tissue defects or periprosthetic infections after total knee arthroplasty (TKA) are severe complications that may lead to loss of the arthroplasty or the limb. Reconstructions with medial gastrocnemius flaps (MGF) are occasionally used to provide soft tissue coverage around the knee. Aims: The study aimed to establish the rate of implant survivorship after MGF reconstruction for soft tissue coverage in the treatment of exposed or infected TKA and to establish functional outcome. Methods: A retrospective analysis was performed on all patients who received soft tissue coverage with an MGF of an exposed or infected TKA between 2000 and 2017 at the Department of Hand and Plastic Surgery at Umeå University Hospital. The outcomes were implant survivorship and patient-reported outcome measures (PROMs) using the five-level EQ-5D version and The Knee Injury and Osteoarthritis Outcome Score. Results: Forty-seven patients (mean age = 67 years, 30 women) were included. The mean time between flap coverage and follow-up was 6.7 (±3.4) years. Implant survivorship was observed in 28 of 47 (59.6%) patients at follow-up. Flap failure was rare, with only 3 of 47 (6.4%) cases. Of the 20 patients who answered the PROMs, 10 of 20 experienced moderate to severe pain or discomfort. Conclusions: Due to unfavorable underlying conditions, MGF reconstruction after TKA is often associated with a compromised functional outcome. Because donor site morbidity is limited and flap failure is unusual, the procedure can be considered prophylactically in a small subset of patients with risk factors to prevent soft tissue defects and periprosthetic joint infection.
Validation of the BODY-Q Chest module in Finnish trans men undergoing chest wall masculinization
Authors: Saarinen Mirjam , Ojala Kaisu , Suominen Sinikka , Repo Jussi 
Published: June 2023

Background and objective: The aim of gender affirmation surgery is to ease gender dysphoria. In transgender men, chest wall masculinization is the most common gender affirmation surgery. The BODY-Q Chest module is currently the only instrument developed to measure health-related quality of life (HRQL) in men undergoing chest wall surgery. Linguistic validation and cultural adaption to Finnish were performed previously. The study aims to validate the BODY-Q Chest module in transgender men who have undergone surgical chest wall masculinization. Methods: All transgender patients who underwent chest wall masculinization at Helsinki University Hospital between 2005 and 2018 were invited to the study. The BODY-Q Chest module comprises two scales—chest and nipple. Data were obtained using the BODY-Q Chest module, the 15D questionnaire, and specifically targeted items designed by the authors. The statistical analyses were conducted to exclude selection bias, evaluate validity of the instrument, and compare it to other instruments. Results: Of the 220 patients invited, 123 participated in the survey (response rate 56%). Ceiling effects were observed with 18.9% and 20.5% scoring maximum points. Cronbach’s alpha was 0.92 and 0.88 for the chest and nipple scales, respectively. In exploratory factor analysis, both scales loaded to one factor confirming unidimensionality. Correlation with the generic 15D questionnaire was low. Conclusions: The BODY-Q Chest module provides valid scores with sufficient consistency and reliability when measuring HRQL in transgender men undergoing chest wall masculinization. Moreover, it offers specificity that existing or generic instruments cannot provide. Ceiling effect was expected due to the postoperative status of participants.
Abdominal Penetrating Aortic Ulcer and Endovascular Treatments: A Systematic Review and Meta-Analysis
Authors: Wang Bing , Qiu Chenyang , Yu Xinyu , He Yangyan , Chen Tianchi , Lin Ruoran , Wang Xiaohui , Pan Jun , Wang Xun , Zhang Hunkun , Wu Ziheng 
Published: June 2023

Background Abdominal penetrating aortic ulcer (aPAU) is defined as an ulceration of the aortic intima and media lamina, even with rupture of the internal elastic lamina. Recently, there have been an increasing number of publications on endovascular treatment for aPAU. This review aimed to assess the efficacy and safety of endovascular treatment and provide clinicians with the latest evidence-based medical data. Methods 3 academic databases (Embase, PubMed, and Scopus) were systematically searched for literature reporting on aPAU from 1986 (the earliest appearance of the concept of aPAU) to September 1, 2021, and related data were collected and evaluated. A fixed/random effects model was used to construct the forest plots. Funnel plots and linear regression tests were used to assess the publication bias. Results 6 articles including 121 patients were included in the analysis. The average age was 71.4 years, with 72.7% of males and 85.6% with hypertension. Saccular aneurysms (SA) were the most prevalent complication (35.5%). Endovascular treatment had a perioperative mortality rate of .24% (95% CI, .00-2.70). The technical success rate was 99.15% (95% CI, 96.49-100). The type-II endoleak rate was 5.69% (95% CI, .00-12.13). The 1-year survival rate was 95.69% (95% CI, 90.49-100). The revascularization rate was 7.20% (95% CI, .07-14.32). Endovascular treatments for aPAU would lead to a high rate of technical success, few complications, and satisfactory 1-year survival. Conclusions aPAU are a common disease that mainly affects elderly males with hypertension and hyperlipidemia. Endovascular treatment is required when an ulcer progresses rapidly or manifests symptoms. Endovascular treatment is associated with high technical success, low complication, and satisfactory 1-year survival. Further investigation into the long-term results of endovascular treatment is necessary.
Differential In Vivo Effects on Cancer Models by Recorded Magnetic Signals Derived From a Healing Technique
Authors: Bengston William , Cizdziel Paul , Tanaka Akane , Matsuda Hiroshi 
Published: June 2023

Previous research on “healing-with-intent” has reasonably demonstrated the validity of the phenomenon at least when a human healer is present and involved. However, in order for healing to be adopted into more conventional therapies, it must be able to be made scalable. The present study tests the effects of a scalable recording of the Bengston Healing Method on 3 cancer models. BalbC mice engrafted with 4T1 breast cancer cells, C57BL mice with melanoma B16 cells, and C3H mice with bladder MBT-2 wells were exposed to a recording of healing intent for 4 hours/day for approximately 1 month. In the breast cancer model, there was significant tumor suppression and a reduction of anemia marker HCT in treated vs control mice. In the melanoma model, there were no significant differences except for a reduction in platelet count among the treated mice. For unknown reasons, tumor growth never became evident in the bladder cancer model. While the effects of the recording seem to vary by model, there appears reason to pursue scalable delivery systems in multiple models and with multiple doses.
Automated Radiographic Measurements of Knee Osteoarthritis
Authors: Rayegan H. , Nguyen H.C. , Weinans H. , Gielis W.P. , Ahmadi Brooghani S.Y. , Custers R.J.H. , van Egmond N. , Lindner C. , Arbabi V. 
Published: June 2023

Objective Herewith, we report the development of Orthopedic Digital Image Analysis (ODIA) software that is developed to obtain quantitative measurements of knee osteoarthritis (OA) radiographs automatically. Manual segmentation and measurement of OA parameters currently hamper large-cohort analyses, and therefore, automated and reproducible methods are a valuable addition in OA research. This study aims to test the automated ODIA measurements and compare them with available manual Knee Imaging Digital Analysis (KIDA) measurements as comparison. Design This study included data from the CHECK (Cohort Hip and Cohort Knee) initiative, a prospective multicentre cohort study in the Netherlands with 1,002 participants. Knee radiographs obtained at baseline of the CHECK cohort were included and mean medial/lateral joint space width (JSW), minimal JSW, joint line convergence angle (JLCA), eminence heights, and subchondral bone intensities were compared between ODIA and KIDA. Results Of the potential 2,004 radiographs, 1,743 were included for analyses. Poor intraclass correlation coefficients (ICCs) were reported for the JLCA (0.422) and minimal JSW (0.299). The mean medial and lateral JSW, eminence height, and subchondral bone intensities reported a moderate to good ICC (0.7 or higher). Discrepancies in JLCA and minimal JSW between the 2 methods were mostly a problem in the lateral tibia plateau. Conclusions The current ODIA tool provides important measurements of OA parameters in an automated manner from standard radiographs of the knee. Given the automated and computerized methodology that has very high reproducibility, ODIA is suitable for large epidemiological cohorts with various follow-up time points to investigate structural progression, such as CHECK or the Osteoarthritis Initiative (OAI).
Multiple sclerosis health-related quality of life utility values from the UK MS register
Authors: Heather A , Goodwin E , Green C , Morrish N , Ukoumunne OC , Middleton RM , Hawton A 
Published: June 2023

Background New interventions for multiple sclerosis (MS) commonly require a demonstration of cost-effectiveness using health-related quality of life (HRQoL) utility values. The EQ-5D is the utility measure approved for use in the UK NHS funding decision-making. There are also MS-specific utility measures – e.g., MS Impact Scale Eight Dimensions (MSIS-8D) and MSIS-8D-Patient (MSIS-8D-P). Objectives Provide EQ-5D, MSIS-8D and MSIS-8D-P utility values from a large UK MS cohort and investigate their association with demographic/clinical characteristics. Methods UK MS Register data from 14,385 respondents (2011 to 2019) were analysed descriptively and using multivariable linear regression, with self-report Expanded Disability Status Scale (EDSS) scores. Results The EQ-5D and MSIS-8D were both sensitive to differences in demographic/clinical characteristics. An inconsistency found in previous studies whereby mean EQ-5D values were higher for an EDSS score of 4 rather than 3 was not observed. Similar utility values were observed between MS types at each EDSS score. Regression showed EDSS score and age were associated with utility values from all three measures. Conclusions This study provides generic and MS-specific utility values for a large UK MS sample, with the potential for use in cost-effectiveness analyses of treatments for MS.
A novel approach to directly measuring wheel and caster rolling resistance accurately predicts user-wheelchair system-level rolling resistance
Authors: Wilson-Jene Holly , Cowan Rachel E , Pearlman Jonathan 
Published: June 2023

Introduction Clinical practice guidelines for preservation of upper extremity recommend minimizing wheelchair propulsion forces. Our ability to make quantitative recommendations about the effects of wheelchair configuration changes is limited by system-level tests to measure rolling resistance (RR). We developed a method that directly measures caster and propulsion wheel RR at a component-level. The study purpose is to assess accuracy and consistency of component-level estimates of system-level RR. Methods The RR of N = 144 simulated unique wheelchair-user systems were estimated using our novel component-level method and compared to system-level RR measured by treadmill drag tests, representing combinations of caster types/diameters, rear wheel types/diameters, loads, and front-rear load distributions. Accuracy was assessed by Bland-Altman limits of agreement (LOA) and consistency by intraclass correlation (ICC). Results Overall ICC was 0.94, 95% CI [0.91–0.95]. Component-level estimates were systematically lower than system-level (−1.1 N), with LOA +/−1.3 N. RR force differences between methods were constant over the range of test conditions. Conclusion Component-level estimates of wheelchair-user system RR are accurate and consistent when compared to a system-level test method, evidenced by small absolute LOA and high ICC. Combined with a prior study on precision, this study helps to establish validity for this RR test method.
Human Trafficking Education: A Pilot Study of Integration into Medical School Curriculum
Authors: Das Devika M , Talbott Jennifer MV , Dutcher Jordan S , Buras Matthew , Lim Elisabeth , Vegunta Suneela , David Paru , Kling Juliana M 
Published: June 2023

OBJECTIVES Few medical schools incorporate formal education on human trafficking (HT) and sex trafficking (ST) into their curriculum. Our objective was to develop, implement, and evaluate education on HT and ST in the first-year medical student curriculum. METHODS The curriculum included a standardized patient (SP) experience and lecture. As part of their mandatory sexual health course, students interviewed an SP who presented with red flags for ST and then participated in a discussion led by a physician-facilitator in an observed small group setting. A multiple-choice survey to assess knowledge about HT and ST was developed and administered to students before and after the SP interview. RESULTS Of the 50 first-year medical students, 29 (58%) participated in the survey. Compared with the students’ baseline scores (according to the percentage of correct responses), scores after the educational intervention showed a significant increase in percentage correct on questions related to trafficking definition and scope (elder care, P = .01; landscaping, P = .03); victim identification ( P < .001); referral to services ( P < .001); legal issues ( P = .01); and security ( P < .001). On the basis of the feedback, a 2-hour lecture, which was adapted from the American Medical Women's Association–Physicians Against the Trafficking of Humans “Learn to Identify and Fight Trafficking” training, was presented the next year to all first-year medical students as part of their longitudinal clinical skills course and before the SP case. Curriculum objectives included learning trafficking definitions, victim/survivor identification, intersections with health care, the local impact of HT, and available resources. CONCLUSION This curriculum fulfills course objectives and could be replicated at other institutions. Further evaluation of this pilot curriculum is necessary to evaluate its effectiveness.
Effectiveness and safety of anti-CGRP monoclonal antibodies in patients over 65 years: a real-life multicentre analysis of 162 patients
Authors: Muñoz-Vendrell Albert , Campoy Sergio , Caronna Edoardo , Alpuente Alicia , Torres-Ferrus Marta , Nieves Castellanos Candela , Olivier Marina , Campdelacreu Jaume , Prat Joan , Camiña Muñiz Javier , Molina Martínez Francisco José , Mínguez-Olaondo Ane , Ruibal Salgado Marta , Santos Lasaosa Sonia , Navarro Pérez María Pilar , Morollón Noemí , López Bravo Alba , Cano Sánchez Luis Miguel , García-Sánchez Sonia María , García-Ull Jésica , Rubio-Flores Laura , Gonzalez-Martinez Alicia , Quintas Sonia , Echavarría Íñiguez Ana , Gil Luque Sendoa , Castro-Sánchez María Victoria , Adell Ortega Vanesa , García Alhama Jessica , Berrocal-Izquierdo Nuria , Belvís Robert , Díaz-Insa Samuel , Pozo-Rosich Patricia , Huerta-Villanueva Mariano 
Published: June 2023

Abstract
Background
Anti-CGRP monoclonal antibodies have shown notable effectiveness and tolerability in migraine patients; however, data on their use in elderly patients is still lacking, as clinical trials have implicit age restrictions and real-world evidence is scarce. In this study, we aimed to describe the safety and effectiveness of erenumab, galcanezumab and fremanezumab in migraine patients over 65 years old in real-life.

Methods
In this observational real-life study, a retrospective analysis of prospectively collected data from 18 different headache units in Spain was performed. Migraine patients who started treatment with any anti-CGRP monoclonal antibody after the age of 65 years were included. Primary endpoints were reduction in monthly migraine days after 6 months of treatment and the presence of adverse effects. Secondary endpoints were reductions in headache and medication intake frequencies by months 3 and 6, response rates, changes in patient-reported outcomes and reasons for discontinuation. As a subanalysis, reduction in monthly migraine days and proportion of adverse effects were also compared among the three monoclonal antibodies.

Results
A total of 162 patients were included, median age 68 years (range 65–87), 74.1% women. 42% had dyslipidaemia, 40.3% hypertension, 8% diabetes, and 6.2% previous cardiovascular ischaemic disease. The reduction in monthly migraine days at month 6 was 10.1 ± 7.3 days. A total of 25.3% of patients presented adverse effects, all of them mild, with only two cases of blood pressure increase. Headache and medication intake frequencies were significantly reduced, and patient-reported outcomes were improved. The proportions of responders were 68%, 57%, 33% and 9% for reductions in monthly migraine days ≥ 30%, ≥ 50%, ≥ 75% and 100%, respectively. A total of 72.8% of patients continued with the treatment after 6 months. The reduction in migraine days was similar for the different anti-CGRP treatments, but fewer adverse effects were detected with fremanezumab (7.7%).

Conclusions
Anti-CGRP mAbs are safe and effective treatments in migraine patients over 65 years old in real-life clinical practice.

Graphical Abstract
Effects of the factor Xa inhibitor rivaroxaban on the differentiation of endothelial progenitor cells
Authors: Sohma Ryoichi , Sakuma Masashi , Obi Syotaro , Nishino Setsu , Inoue Ken-ichi , Kishimoto Satoko , Lu Tianyang , Toyoda Shigeru , Inoue Teruo 
Published: June 2023

Abstract
Background
We evaluated the efficacy of the factor Xa inhibitor rivaroxaban on the differentiation ability of vascular endothelial progenitor cells (EPCs), which play roles in vascular injury repair and atherogenesis. Antithrombotic treatment in patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is challenging, and current guidelines recommend oral anticoagulant monotherapy 1 year or more after PCI. However, biological evidence of the pharmacological effects of anticoagulants is insufficient.

Methods
EPC colony-forming assays were performed using peripheral blood-derived CD34-positive cells from healthy volunteers. Adhesion and tube formation of cultured EPCs were assessed in human umbilical cord-derived CD34-positive cells. Endothelial cell surface markers were assessed using flow cytometry, and Akt and endothelial nitric oxide synthase (eNOS) phosphorylation were examined using western blot analysis of EPCs. Adhesion, tube formation and endothelial cell surface marker expression was observed in EPCs transfected with small interfering RNA (siRNA) against protease-activated receptor (PAR)-2. Finally, EPC behaviors were assessed in patients with atrial fibrillation undergoing PCI in whom warfarin was changed to rivaroxaban.

Results
Rivaroxaban increased the number of large EPC colonies and increased the bioactivities of EPCs, including adhesion and tube formation. Rivaroxaban also increased vascular endothelial growth factor receptor (VEGFR)-1, VEGFR-2, Tie-2, and E-selectin expression as well as Akt and eNOS phosphorylation. PAR-2 knockdown increased the bioactivities of EPCs and endothelial cell surface marker expression. Patients in whom the number of large colonies increased after switching to rivaroxaban showed better vascular repair.

Conclusions
Rivaroxaban increased the differentiation ability of EPCs, leading to potential advantages in the treatment of coronary artery disease.
Risk prediction of gestational diabetes mellitus in women with polycystic ovary syndrome based on a nomogram model
Authors: Ouyang Peilin , Duan Siqi , You Yiping , Jia Xiaozhou , Yang Liqin 
Published: June 2023

AbstractWomen with polycystic ovary syndrome are prone to develop gestational diabetes mellitus, a disease which may have significant impact on the postpartum health of both mother and infant. We performed a retrospective cohort study to develop and test a model that could predict gestational diabetes mellitus in the first trimester in women with polycystic ovary syndrome. Our study included 434 pregnant women who were referred to the obstetrics department between December 2017 and March 2020 with a diagnosis of polycystic ovary syndrome. Of these women, 104 were diagnosed with gestational diabetes mellitus in the second trimester. Univariate analysis revealed that in the first trimester, Hemoglobin A1c (HbA1C), age, total cholesterol(TC), low-density lipoprotein cholesterol (LDL-C), SBP (systolic blood pressure), family history, body mass index (BMI), and testosterone were predictive factors of gestational diabetes mellitus (P < 0.05). Logistic regression revealed that TC, age, HbA1C, BMI and family history were independent risk factors for gestational diabetes mellitus. The area under the ROC curve of the gestational diabetes mellitus risk prediction model was 0.937 in this retrospective analysis, demonstrating a great discriminatory ability. The sensitivity and specificity of the prediction model were 0.833 and 0.923, respectively. The Hosmer–Lemeshow test also showed that the model was well calibrated.
High HSPB1 expression predicts poor clinical outcomes and correlates with breast cancer metastasis
Authors: Huo Qin , Wang Juan , Xie Ni 
Published: June 2023

Abstract
Background
Heat shock protein beta-1 (HSPB1) is a crucial biomarker for pathological processes in various cancers. However, the clinical value and function of HSPB1 in breast cancer has not been extensively explored. Therefore, we adopted a systematic and comprehensive approach to investigate the correlation between HSPB1 expression and clinicopathological features of breast cancer, as well as determine its prognostic value. We also examined the effects of HSPB1 on cell proliferation, invasion, apoptosis, and metastasis.

Methods
We investigated the expression of HSPB1 in patients with breast cancer using The Cancer Genome Atlas and immunohistochemistry. Chi-squared test and Wilcoxon signed-rank test were used to examine the relationship between HSPB1 expression and clinicopathological characteristics.

Results
We observed that HSPB1 expression was significantly correlated with the stage N, pathologic stages, as well as estrogen and progesterone receptors. Furthermore, high HSPB1 expression resulted in a poor prognosis for overall survival, relapse-free survival, and distant metastasis-free survival. Multivariable analysis showed that patients with poor survival outcomes had higher tumor, node, metastasis, and pathologic stages. Pathway analysis of HSPB1 and the altered neighboring genes suggested that HSPB1 is involved in the epithelial-to-mesenchymal transition. Functional analysis revealed showed that transient knockdown of HSPB1 inhibited the cell migration/invasion ability and promoted apoptosis.

Conclusions
HSPB1 may be involved in breast cancer metastasis. Collectively, our study demonstrated that HSPB1 has prognostic value for clinical outcomes and may serve as a therapeutic biomarker for breast cancer.