bluuebunny/crossref_metadata_2025_split huggingface dataset:
Superparamagnetic Iron Oxide (SPIO) For Axillary Mapping in Patients with Ductal Carcinoma In Situ Undergoing Mastectomy: Single Institution Experience
Authors: Addae Jamin Kweku , Sweeting Raeshell Sharawn , Meszoely Ingrid Marie , McCaffrey Rachel Louise , Kauffmann Rondi Marie , Kelley Mark Carlton , Grau Ana Magdalena , Hewitt Kelly 
Published: September 2023

Abstract
Purpose Unnecessary axillary surgery can potentially be avoided in patients with DCIS undergoing mastectomy. Current guidelines recommend upfront sentinel lymph node biopsy during the index operation due to the potential of upstaging to invasive cancer. This study reviews a single institution’s experience with de-escalating axillary surgery using superparamagnetic iron oxide dye for axillary mapping in patients undergoing mastectomy for DCIS.
Methods This is a retrospective single-institution cross-sectional study. All medical records of patients who underwent mastectomy for a diagnosis of DCIS from August 2021 to January 2023 were reviewed and patients who had SPIO injected at the time of the index mastectomy were included in the study. Descriptive statistics of demographics, clinical information, pathology results, and interval sentinel lymph node biopsy were performed.
Results A total of 41 participants underwent 45 mastectomies for DCIS. The median age of the participants was 58 years (IQR=17; range 25 to 76 years), and the majority of participants were female (97.8%). The most common indication for mastectomy was diffuse extent of disease (31.7%). On final pathology, 75.6% (34/45) of mastectomy specimens had DCIS without any type of invasion and 15.6% (7/45) had invasive cancer. Of the 7 cases with upgrade to invasive disease, 2 (28.6%) of them underwent interval sentinel lymph node biopsy. All Sentinel lymph nodes biopsied were negative for cancer.
Conclusion
The use of superparamagnetic iron oxide dye can prevent unnecessary axillary surgery in patients with DCIS undergoing mastectomy.
Principle-Guided Psychotherapy for Children and Adolescents (FIRST): Study Protocol for a Randomized Controlled Effectiveness Trial in Outpatient Clinics
Authors: Bailin Abby , Cho Evelyn , Sternberg Ariel , Evans Spencer C. , Hollinsaid Nathan L. , Bearman Sarah Kate , Weisz John R. 
Published: September 2023

Abstract
Background: Hundreds of youth psychotherapy randomized trials have generated scores of helpful empirically supported treatments (ESTs). However, the standardized structure of many ESTs and their focus on a single disorder or homogeneous cluster of problems may not be ideal for clinically referred youths who have comorbidity and whose treatment needs may shift from week to week. This concern has prompted development of flexible transdiagnostic, modular youth psychotherapies. One of these, designed for efficient training and implementation, is FIRST—a transdiagnostic intervention built on five empirically supported principles of change (i.e., feeling calm, increasing motivation, repairing thoughts, solving problems, and trying the opposite) and targeting common internalizing and externalizing youth mental health disorders and problems. FIRST has shown promise in improving youth mental health in three open trials. Now, in a more rigorous test, we seek to (1) conduct a randomized controlled trial comparing FIRST to usual care in real-world clinical practice settings; (2) examine a promising candidate mediator of change—regulation of negative emotions; and (3) explore variables that may influence clinicians’ treatment implementation.
Methods:This is an assessor-naïve randomized controlled effectiveness trial in youth outpatient community clinics in New England and Texas. Using double randomization, clinic-employed clinicians and treatment-referred youths (7–15 years old) are independently randomly allocated (1:1) to FIRST or usual care. We aim to recruit 212 youth participants, all referred through normal community pathways, with elevated symptoms of anxiety, depression, conduct problems, or post-traumatic stress. This study will test the effectiveness of FIRST compared to usual care on mental health outcomes, examine whether those outcomes are mediated by regulation of negative emotions, and explore clinician factors that may be associated with FIRST implementation and outcomes. Session recordings are coded to assess treatment fidelity.
Discussion: This study will evaluate the effectiveness of FIRST in youth community mental health settings, relative to the care usually provided in those settings. If FIRST is found to be effective, it could offer an efficient and practical method to increase use of empirically supported treatment principles in real-world practice contexts.
Trial registration: NIH Clinical Trials Registry, NCT04725721. Registered 27 January 2021, https://clinicaltrials.gov/ct2/show/study/NCT04725721
Prph2 mutant knock-in mice recapitulate all features of human central areolar choroidal dystrophy and reveals an aberrant synaptic remodelling and microglial activation
Authors: Cuenca Nicolas , Ruiz-Pastor María José , Sánchez-Sáez Xavier , Kutsyr Oksana , Albertos-Arranz Henar , Sánchez-Castilo Carla , Ortuño-Lizarán Isabel , Martínez-Gil Natalia , Vidal-Gil Lorena , Méndez Lucía , Sánchez-Martín Manuel , Maneu Victoria , Lax Pedro 
Published: September 2023

Abstract
Purpose Central areolar choroidal dystrophy is an inherited disorder characterized by progressive choriocapillaris atrophy and retinal degeneration, usually associated with mutations in the PRPH2 gene. We aimed to generate and characterize a mouse model with the p.Arg195Leu mutation previously described in patients.Methods Heterozygous (Prph2WT/KI) and homozygous (Prph2KI/KI) mice have been generated using the CRISPR/Cas9 system to introduce the Arg195Leu mutation. Retinal function was assessed by electroretinography and optomotor test at 1, 3, 6, 9, 12, and 20 months of age. The structural integrity of the retinas was evaluated at the same ages using optical coherence tomography. Immunofluorescence and transmission electron microscope images of the retina were also analyzed.Results Genetic sequencing confirmed that both Prph2WT/KI and Prph2KI/KI mice presented the p.Arg195Leu mutation. A progressive loss of retinal function was found in both mutant groups, with significantly reduced visual acuity from 3 months of age in Prph2KI/KI and from 6 months of age in Prph2WT/KI mice. Decreased amplitudes in the electroretinography responses were observed from 1 month of age in Prph2KI/KI and from 6 months of age in Prph2WT/KI. Morphological analysis of the retinas correlated with functional findings, showing a progressive decrease in retinal thickness of mutant mice, with earlier and more severe changes in the homozygous mutant mice. We corroborated the alteration of the outer segment structure, and we found changes in the synaptic connectivity in the outer plexiform layer as well as gliosis and signs of microglial activation.Conclusions The new Prph2WT/KI and Prph2KI/KI murine models show a pattern of retinal degeneration similar to that described in human patients with CACD and appear as good models to study the mechanisms involved in the onset and the progression of the disease, as well as to test the efficacy of new therapeutic strategies.
Endoscopic Iatrogenic Esophageal Perforation and Management: A Retrospective Outcome Analysis in the Modern Era
Authors: Montminy Eric , Jones Blake , Heller J. Christie , Attwell Augustin 
Published: September 2023

Abstract
Introduction:
Iatrogenic esophageal perforation (IEP) is a severe adverse event (AE) of upper endoscopy procedures (UEPs) associated with morbidity. Management has shifted from surgery to endotherapy with clip placement (CP), self-expanding metal stent (SEMS), and vacuum therapy (VT). Limited analyses measure outcomes during contemporary interventional endoscopy periods.
Methods:
IEPs associated with EGD, upper EUS, small bowel enteroscopy (SBE), and ERCP at a 3-hospital academic center from January 2010 to December 2022 were identified retrospectively from a centralized AE database. Additional information was obtained from medical records. Statistical analysis was performed using Microsoft Excel and STATA.
Results:
Thirty-two IEPs from 26 EGDs, 4 EUS, 1 SBE, and 1 ERCP were identified. IEPs occurred mostly after dilation (bougie N = 7; balloon, N = 5) or foreign body removal (N = 6). Most IEPs occurred in the lower esophagus (N = 10) or gastroesophageal junction (N = 8). Diagnosis was made at a median 2 hours after the injury by endoscopy (N = 14), CT scan (N = 12), esophagram (N = 5), or x-ray (N = 1). Initial treatment included conservative therapy alone (N = 7), CP (N = 3), SEMS (N = 14), SEMS plus CP (N = 3), or surgery (N = 3). Eleven patients required additional treatment including repeat SEMS or adjustment (N = 4) or VT (N = 1). No surgical interventions were required after 2013. The median hospital stay was 3 days. Disposition included discharge to home (N = 25), long-term care facility (N = 2), 4 deaths (12.5% of IEPs), and 1 unknown.
Conclusions:
IEPs are rare and occur throughout the esophagus after any UEP. The majority are recognized immediately and managed with endotherapy, or rarely, surgery today. These characteristics likely explain the low mortality in this study.
Preoperative predictors of successful External Cephalic Version with breech presentation at term: a single centre experience
Authors: Duan Zhengrong , Chen Aner , Li Xiuxiu , He Xiaobo 
Published: September 2023

Abstract
Objective
To determine the factors associated with the external cephalic version (ECV) and evaluate the success rate ECV of at term in China.
Methods
207 consecutive patients who attempted ECV with a breech presentation at term were included from January 2017 to January 2023. Patients with a successful ECV were divided into the ECV success group. Patients who performed ECV but had a repeat breech presentation were divided into the ECV failure group. The factors for ECV success was carried out by multiple logistic regression analyses.
Results
The success rate of ECV was 68.6%(142/207) among 207 pregnancies with breech presentation at term. The reasons for failed ECV were not turning at all after four to five attempts(38/65, 58.5%), followed by fetal distress(7/65, 10.8%). Three predictive factors were identified and associated with a successful ECV: larger AFI, the use of tubutaline and lower HC/FL ratio.
Conclusions
This ECV prediction model based on a Chinese population to predict the success of ECV that is easy to use and incorporates a limited number of objective patient characteristics. The level of AFI, use of tubutaline, and ratio of HC/FL are independent determinants of the final presentation.
Relative anterior spinal overgrowth in mild and moderate adolescent idiopathic scoliosis: A retrospective study
Authors: Zhang Haoyang , Yao Benshun , Ye Xin , Li Shuailin , Pan Yingsen , Zhao Jinze , Shi Guoqing , Li Xiaoming , Lv Lijiang , Ying Xiaoming 
Published: September 2023

Abstract
Study design Retrospective study
Objective To determine whether the phenomenon of relative anterior spinal overgrowth (RASO) can occur regardless of scoliotic segments and scoliosis severity, and to clarify the regularity of vertebral body height changes in adolescent idiopathic scoliosis (AIS) patients.
Methods In total, 125 patients with AIS and 179 non-scoliotic adolescents were recruited for this study. The anterior vertebral body height (VBHa) and posterior vertebral body height (VBHp) were measured on lateral spine radiographs, and the VBHa/VBHp ratio was calculated. The ratios at the same levels between the two groups and different levels within the two groups were compared, as were the ratios among different segmental scolioses in the AIS group. The correlation between scoliosis severity and the ratio of the different vertebrae was subsequently analyzed.
Results Between T6 and L5, the VBHa/VBHp ratios were consistently higher in the AIS group than in the control group (P<0.001). Increasing trends were observed for the ratios of T7 to T10 and L1 to L5. There were no statistically significant differences among the ratios for different segmental scolioses at all levels. The Pearson coefficient for the analysis of the correlation between scoliosis severity and VBHa/VBHp ratios showed statistically significant positive correlations with T7 (P<0.05), T8 (P<0.05), and T11 (P<0.05), and negative correlations with L5 (P<0.05).
Conclusion The present study confirmed that RASO in patients with mild to moderate AIS is a generalized phenomenon regardless of the scoliosis severity and scoliotic segments. We speculate that the overgrowth on each vertebra is coordinated to maintain the integration of different vertebrae so that the spinal and truncal functions in patients with AIS can be maintained to the greatest extent possible.
Utilizing the Radiographic Union Score for Hip (RUSH) to Evaluate the Healing of Subtrochanteric Fractures after Intramedullary Fixation
Authors: Zhou Tian Jian , Jiang Song , Ren Jin Ke , Zhang Xuan , Liu Wang Xing , Yan Peng , Li Jian Wang , Zeng Tong , Xu Zhong Shi 
Published: September 2023

Abstract

Background
Prompt identification of fracture healing is crucial for medical decision-making and clinical research. This study aims to assess the effectiveness of the Radiographic Union Score for Hip (RUSH) in subtrochanteric fractures and determine the optimal scoring threshold for fracture healing.
Methods
We obtained 94 sets of X-ray films from the postoperative follow-up of 35 patients who underwent intramedullary nail fixation for subtrochanteric fractures. Six orthopedic surgeons evaluated the imaging data and determined fracture healing based on subjective judgment. They then scored the X-ray images using the RUSH form. After four weeks, the same observers reevaluated 47 randomly selected sets of radiographs. Subsequently, Subsequently, the observers and study designer conducted a consensus meeting where they agreed on whether the fractures had healed. We used Fleiss kappa to evaluate agreement among observers based on subjective impressions, and the intraclass correlation coefficient assessed RUSH score consistency. Regression analysis examined the relationship between scores and fracture healing consensus using a receiver operator characteristic (ROC) curve.
Results
Based on overall impressions, the agreement level among orthopedic surgeons for determining the healing status of subtrochanteric fractures was moderate (Kappa = 0.564, 95% CI: 0.511–0.616). However, utilizing the RUSH scoring system can improve the consistency to a substantial level of agreement (ICC = 0.748, 95% CI: 0.663–0.817). Regarding intraobserver reliability, there were significant differences among orthopedic surgeons in judging fracture healing based on overall impressions. However, using the RUSH scoring form, the attending group achieved better intraobserver consistency than the resident group. Regression analysis and ROC curve analysis revealed a strong correlation between the RUSH total score, cortical bone score, cancellous bone score, and consensus on fracture healing. The AUC values are 0.769 (95% CI: 0.670–0.868), 0.779 (95% CI: 0.681–0.876), and 0.771 (95% CI: 0.674–0.867), respectively.
Conclusions
Our study highlights the effectiveness of the RUSH scoring system in enhancing interobserver agreement and intraobserver consistency when evaluating subtrochanteric fracture healing in orthopedic surgeons. We propose a cutoff value of 21 for determining fracture healing by simplifying the system to include eight cortical bone-related items.
Morphologic and morphometric bilateral analysis and sexual dimorphism in sciatic nerves of adults: an anatomic investigation of cadaveric specimens in Uganda with implications on sciatic nerve neuropathologies
Authors: Kegoye Eric Simidi , Ojewale Abdulfatai Olakunle , Ezekiel Winnie , Usman Ibe Michael , Aigbogun Eric Osamudiamwen , Adewale Adesanya Olamide , Fernandez Edgar Mario , Kasozi Keneth Iceland , Nalugo Halima , Echoru Isaac , Afodun Adam Moyosore , Kenganzi Ritah , Segun Okeniran Olatayo , Ssempijja Fred 
Published: September 2023

Abstract
Background
The Sciatic nerve (SN) depicts sex and side-associated dimorphic features that are of clinical relevancy. The study investigated the sex and side-related morphologic and morphometric variations of the nerve using cadavers.
Methods
A cross-sectional cadaveric study on 62 Ugandan cadavers were used. Continuous variables were reported using descriptive statistics and discrete variables were reported as percentages. Ordinary two-way ANOVA was used to compare the dimensions and percentages of patterns of the SN.
Results
The study identified six categories of exit patterns of the SN, type A (“Below and undivided”) occurred in a majority of cases (62.9%), a penta furcate branching pattern dominated the whole population, “Bifurcate” termination pattern was found in most SNs (90.3% and 87.1% for right and left limbs respectively) while the rest have the trifurcate termination pattern, with no side or sex-related variations. The average dimensions of SN were within normal ranges, and show no side-related differences but with a sex effect (are significantly higher in males than females), mean length of the SN in centimeters (length A: Males, right limbs = 30.58 ± 9.00; left limbs = 31.30 ± 6.20; Females, right = 26.07 ± 6.58; left = 26.30 ± 5.56), the mean level of termination of SN in centimeters (length B: Males, right = 8.5 ± 4; left = 8.2 ± 3.9; Females, right = 7.76 ± 3.8; left = 7.82 ± 3.5), mean SN diameters in millimeters: mean exit diameter (Males: right = 11.69 ± 1.92; left = 11.67 ± 2.16; Females, right = 8.41 ± 2.24; left = 9.28 ± 1.99), mean midthigh diameter (Males: right = 8.86 ± 1.56; left = 9.64 ± 1.88; Females, right = 7.12 ± 1.46; left = 8.28 ± 1.89), mean terminal end diameter (Males, right = 9.47 ± 2.07; left = 9.86 ± 2.32; Females, right = 7.5 ± 1.62; left = 8.4 ± 2.24).
Conclusions
Most SNs show normal anatomical characteristics with rare cases of sex-related dimorphism in the termination level and morphometry (length and diameter) of the nerve. The observed sexual dimorphisms in sciatic nerves are of great clinical and surgical interest and a warranty for more investigations in different populations, especially through the use of advanced techniques such as ultrasonographic anatomy techniques.
Efficacy and Safety of Raltitrexed plus Oxaliplatin Transvascular Intervention in the Treatment of Intermediate to Advanced Hepatocellular Carcinoma: A Single-arm Meta-analysis
Authors: Peng Yishan , Deng Jingduo , Chen Zhi , Yu Wenke , Yang Bin , Nie Yu , Cheng Yuan 
Published: September 2023

Abstract
Background
The incidence of primary hepatocellular carcinoma (HCC) has remained high worldwide, and patients with advanced unresectable HCC are not in the minority. Previous studies have shown that oxaliplatin plus raltitrexed via Hepatic Arterial Infusion Chemotherapy(HAIC) can prolong Overall Survival(OS) and Progression-Free Survival(PFS) in patients with advanced HCC. However, almost all studies on this regimen for advanced HCC were non-randomized controlled trials and had all sample sizes, which may lead to a lack of validity of the results obtained. Therefore, the aim of this meta-analysis was to evaluate the efficacy and safety of raltitrexed plus oxaliplatin transvascular intervention in patients with intermediate to advanced HCC.
Methods
To find relevant studies, we extracted metrics including Overall Remission Rate(ORR), median OS(mOS), median PFS(mPFS), and Adverse Events(AEs) by systematically searching Pubmed, Embase, Cochrane Library and Web of Science data bases for further analysis.
Results
Seven studies involving 419 patients were finally included. In terms of efficacy against tumors, the ORR across studies combined was 55.9%(95%CI = 46.1%-65.7%), the mPFS and mOS of 5.68 months and 12.47 months. The most common adverse reactions were elevated ALT (incidence: 49.2%, ≥Grade III: 4.6%), abdominal pain (incidence: 47.8%, ≥Grade III: 2.2%) and fever (incidence: 42.9%). The most common adverse event greater than grade 3 was AST elevation, with an incidence of 12.8%.
Conclusion
The results of this analysis suggested that raltitrexed plus oxaliplatin transvascular intervention has good efficacy and safety in patients with intermediate and advanced HCC, but larger and multicenter clinical trials are still needed to confirm this fact.
Registration Information
This meta-analysis has completed registration with PROSPERO, the registration number is CRD42023421097.
Immuno-antioxidative reno-modulatory effectiveness of Echinacea purpurea extract against bifenthrin-induced renal poisoning
Authors: Abdel-Wahhab Khaled , Elqattan Ghada , Hassan Laila , Sayed Rehab , El-Sahra Doaa , Mannaa Fathia 
Published: September 2023

Abstract
Echinacea purpurea is a precious medicinal herb. Many civilizations utilize it as a natural medicine. Its extracts provide antifungal, antiviral, antibacterial, and antioxidative activities and are utilized for treating the common cold in addition to respiratory and urinary illnesses. Using male albino rats (160-200g), an in vivo study was conducted to examine the ameliorative potential and investigate the anti-inflammatory, antioxidant, and chemical detoxifying activities of Echinacea purpurea ethanolic extract (EEE) against bifenthrin-induced renal injury. The animals were divided into four groups and orally treated for 30 days as follows: normal control; animals were treated with EEE (465 mg/kg/day) dissolved in water; healthy animals were given bifenthrin (7mg/kg/day) dissolved in olive oil and the last group was administered EEE one-hour prior bifenthrin intoxication. It was noticed that the administration of the animals with bifenthrin caused significant elevations in serum values of ALAT, ASAT, urea, creatinine, the renal inflammatory and apoptotic markers (IL-1β, TNF-α, IFN-γ and caspase-3), and the oxidative stress and antioxidant markers in kidney (MDA and NO) while, renal GSH, GPx, and SOD values showed about two-fold decrement in compared to normal control. EEE treatment resulted in a considerable restoring of all these parameters to near the control values. Moreover, the extract improved the histological architecture of the kidney. It was concluded that Echinacea purpurea extract has ameliorative potential and chemo-preventive efficacy against bifenthrin-induced renal injury, as well as the significant role of its anti-inflammatory, antioxidant, and chemical detoxifying activities.
Investigation of the creatine biosynthesis negative feedback loop via creatine mediated control of arginine:glycine amidinotransferase expression in human HAP1 cells implies an intracellular creatine sensing mechanism
Authors: Tropak Michael B. , Tkachyova Ilona , Gu Ray , Lee Alex , Schulze Andreas 
Published: September 2023

Abstract
Cellular homeostasis of creatine (CT), integral part of the energy buffering and -transducing system connecting intracellular sites of ATP production and -utilization, comprises of mechanisms that increase CT, i.e., biosynthesis and cellular uptake, and CT-lowering processes, such as export and non-enzymatic conversion to creatinine. The negative feedback loop by which CT controls its biosynthesis via suppression of the rate-limiting enzyme arginine:glycine amidinotransferase (AGAT) is not well understood. We have used CRISPR to tag the C-terminus of AGAT with a nanoluc luciferase (NLuc) reporter in HAP1 cells. A biphasic decay of AGAT-NLuc in response to increasing extracellular CT was observed, whereas the decrease in AGAT-NLuc expression was directly proportional to the rise in intracellular CT levels with an approximate IC50 of 1–2 mM. CRISPR generated HAP1 CT transporter (CrT) null cells and HAP1 CrT null cells stably expressing a CrT-GFP fusion protein further demonstrated that the biphasic response to extracellular CT is mediated by a high-affinity (Km 9–10 µM) CrT dependent, saturable mechanism and a CrT independent, unsaturable uptake process. The direct response to intracellular CT suggests the existence of an intracellular CT sensing system enabling a dynamic cell response to changing CT concentration that is relevant for cellular CT homeostasis.