bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the postoperative hemodynamic changes in varicose vein surgery related with small saphenous vein reflux
Authors: Park Joon-Kee , Woo Shin-Young , Yang Shin-Seok , Kim Dong-Ik 
Published: July 2023

Purpose To evaluate the postoperative hemodynamic changes in varicose vein surgery related with SSV reflux using APG. Methods Totals of 181 limbs and 178 patients who underwent high ligation and stripping (HLS) (87 limbs), radiofrequency ablation (RFA) (43 limbs), or endovenous laser ablation (EVLA) (51 limbs) for SSV reflux from 1995 to 2022 were enrolled. We measured venous volume (VV), venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) preoperatively and at postoperative one and 6 months. Results Comparing preoperative results to those at postoperative 1 month, the reduction rates of VV, VFI, and RVF were 27, 53, and 31%, while EF increased by 18% ( p < 0.001). Comparing preoperative and postoperative 6 month, the reduction rates of VV, VFI, and RVF were 27, 45, and 35%, while EF increased by 27% ( p < 0.001). Conclusions There were hemodynamic improvement in the lower leg after varicose vein surgery including HLS, RFA, and EVLA.
The development and reliability testing of the Functional Lower-Limb Amputee Gait Assessment
Authors: Gailey Robert S , Gaunaurd Ignacio A , Kirk-Sanchez Neva J , Gard Steven A , Kristal Anat 
Published: July 2023

Objective The study purpose was three-fold: (a) to describe the development of the Functional Lower-Limb Amputee Gait Assessment, (b) to determine its reliability with two groups of raters, physical therapists, and certified prosthetists, and (c) to determine the agreement on its results between the two groups. Design A reliability study. Setting Institution for higher education. Participants Five physical therapists and five certified prosthetists. Intervention Not applicable. Main measure The gait of people with unilateral lower limb amputation was evaluated using the Functional Lower-Limb Amputee Gait Assessment. Kappa statistic was used to analyze reliability. Results The intra-rater reliability of nine gait deviations in the physical therapists’ group and eight in the certified prosthetists’ group was between moderate and almost perfect agreement (kappa = .41–1). In the physical therapists’ group, the inter-rater reliability of four gait deviations was moderate (kappa = .41–.6). In the certified prosthetists’ group, the inter-rater reliability of six gait deviations was moderate to substantial (kappa = .41–.8). Three gait deviations achieved moderate agreement in both groups of clinicians (kappa = .41–.6). Conclusions Most gait deviations included in the Functional Lower-Limb Amputee Gait Assessment appear stable over time when used by the same clinician. Six gait deviations in the certified prosthetists’ group and four in the physical therapists’ group may be used by multiple clinicians, and three gait deviations may be used across both professions to assist in communication and collaboration on the best course of treatment for a patient with a unilateral lower limb amputation.
An alginate-Based tube gel delivering 2-deoxy-D-ribose for stimulation of wound healing
Authors: Abid Safina , Zulfiqar Saima , Anjum Muhammad A , Bullock Anthony J , MacNeil Sheila , Yar Muhammad 
Published: July 2023

Developing multifunctional wound dressings capable of inducing rapid angiogenesis and with antibacterial activity would be attractive for diabetic and superficial wound healing. Hydrogels delivered from tubes have several desirable features -they are easy to apply, keep the wound moist, reduce the entry of microorganisms and avoid the need for painful dressing removal. Previously we reported that 2 deoxy-D-ribose (2dDR) delivered from a variety of dressings is capable of promoting wound healing by stimulating angiogenesis. Alginate hydrogels are an ideal vehicle to deliver a bioactive agent capable of promoting wound healing. In this study we developed and evaluated a tube hydrogel capable of delivering 2dDR with the aim of achieving a stable, convenient to administer and biologically effective wound treatment. Further, we included the stabilizer 2-phenoxy ethanol which provided antimicrobial activity. We synthesized hydrogels by the Green method, using simple mixing of sodium alginate, propylene glycol, 2-phenoxy ethanol and 2dDR in water. FTIR (Fourier transformation infrared spectroscopy) analysis confirmed an absence of undesirable chemical changes in the gel components, and SEM images of the freeze-dried gels showed porous structures. When 2dDR alginate gel (2dDR-SA hydrogel) was placed in PBS at 37°C, almost 92% of 2dDR was released within 7 days. When tested on cultured cells, 2dDR-SA hydrogels did not inhibit metabolic activity or proliferation, achieving up to 90 and 98% of control respectively over 7 days. 2dDR-SA hydrogel also showed anti-bacterial activity against E. coli, Pseudomonas aeruginosa, Staphylococcus aureus, and MRSA which was attributable to the stabilizer 2-phenoxy ethanol in the hydrogel. Stimulation of angiogenesis in the chorioallantoic membrane assay by 2dDR-SA hydrogel was found to be significant compared to the blank-SA. Wound healing potential was studied in full-thickness wounds in rats where acceleration of wound healing was seen. H&E staining of the wound tissue showed an enhanced number of blood vessels and re-epithelization, and a reduced number of inflammatory cells in 2dDR-SA treated animals compared to blank-hydrogels while Masson’s trichrome staining showed increased collagen deposition. In summary we describe a convenient to apply hydrogel which has promise for use in a range of superficial skin wounds including applications in chronic wound care.
Incidence and Prognostic Associations of Early Postoperative Stroke and Death Among Patients Undergoing Inner Branched Thoracic Endovascular Repair of Aortic Arch Pathologies: A Systematic Review and Meta-Analysis
Authors: Gao Jiang-Ping , Guo Wei , Zhang Hong-Peng 
Published: July 2023

Objective: The objective of this systematic review was to assess the incidences and associations of early postoperative stroke and death among patients undergoing inner branched thoracic endovascular aortic repair (TEVAR) of arch pathologies. Methods: Electronic bibliographic sources (PUBMED, EMBASE, and CENTRAL) were searched up to February 2022 using a combination of thesaurus and free-text terms to identify the studies using branched TEVAR to treat aortic arch disease. The systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. All observational studies investigating the prognosis of inner branched TEVAR in the treatment of aortic arch pathologies were included. Independent extraction of articles was performed by two authors using predefined data fields, including study quality indications. All pooled analyses were based on a random-effects or fixed model according to the heterogeneity. Results: A total of 23 case series totaling 532 participants were included after screening. After optimized selection (largest sample size, most detailed data, lowest risk of bias) from the overlapping data, 12 studies with 289 participants were included in data synthesis. The pooled incidence of 30-day postoperative stroke was 10.6% (95% CI 7.0%–14.2%; p=.41, I2=3%). Pooled 30-day mortality was 4.9% (95% CI 2.0%–7.8%; p=.38, I2=7%). Combined early stroke/death was 15.7% (95% CI 11.2%–20.3%; p=.30, I2=15%). Subgroup analyses of 11 studies (without data missing) showed that a higher incidence of 30-day postoperative stroke was found in studies with aged participants (age≥71.3 years, p=.010), the higher percentage of COPD (≥30%, p= .011) and non–dissection-related pathologies (≥60.8%, p=.011). The higher 30-day postoperative mortality was found in studies with a high percentage of previous coronary artery disease (≥34.5%, p=.023). Conclusions: This review demonstrated that there were acceptable rates of 30-day postoperative stroke and death among patients undergoing inner branched TEVAR. It is strongly necessary to perform a rigorous risk assessment of aortic plaque embolism and coronary artery disease when the surgical plan of the inner branched TEVAR is determined. Clinical Impact Treatment arch pathologies with inner branched TEVAR provides acceptable early stroke rate and mortality. Aortic pathology mainly influenced the early stroke rate, and early recognizing high-risk patients for aortic plaque embolism is of supreme importance for reducing the early stroke rate. In addition, the history of coronary artery disease was strongly associated with early mortality, and attention should be paid to the coronary artery assessment and perioperative management of these patients.
Case Presentation: Re-revision Quad Tendon Repair and Vastus Advancement
Authors: Vadhera Amar S. , Gursoy Safa , Sivasundaram Lakshman , Lee Jonathan S. , Singh Harsh , Bunachita Sean , Chahla Jorge 
Published: July 2023

Background: The quadriceps tendon is crucial in allowing knee extension, attaching distally to the patella. While ruptures of the tendon are rare, retear can lead to muscle atrophy and complex tendon deficits with retraction which may make revision repairs difficult to perform. To avoid re-rupture, the repair is commonly augmented with an allograft or autograft, theoretically strengthening the repair. Indications: Patients are indicated for surgery when presenting with a chronic, symptomatic quadriceps rupture verified on provocative testing and advanced imaging. Technique Description: Adhesions and fibrotic tissues around the vastus muscles and tendon are released. Sutures and anchor materials from the previous reconstruction are removed. Fibrotic tissues at the distal end of the retracted quad tendon are removed. The tendon is then loosened from the proximal aspect with the applied traction through the suspension suture placed distal to the tendon. The gap is measured and a V-Y quadricepsplasty was performed at twice the length of the measured gap. In the proximal aspect of the tendon, the limbs of the V-plasty are left incomplete. Next, traction is applied to allow for a tightening exertion to the patella. The proximal Y limb is sutured together in a side-to-side fashion to allow for tendon distalization while retaining the distal traction of the patellar tendon. The medial and lateral limbs were then closed with a suture, completing the tendon advancement. Fibrotic tissues around the superior pole of the patella are removed to prepare for tendon reattachment. Two anchors on the medial and lateral sides are placed, and the suture threads from both anchors are tied in a Krackow configuration. The medial and lateral-sided suture knots are then tied together over the tendon and covered again with the Achilles allograft, completing the repair. Results: Outcomes of revision quadriceps repair have been promising, with good to excellent functional outcomes, successful return to activities, and objective outcomes. Discussion/Conclusion: Although initial studies report favorable outcomes following current repair techniques, there is a lack of quality literature on outcomes following primary or revision quadriceps repair. Future studies are necessary to determine the reliability, efficacy, and clinical outcomes following this procedure. 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.
Challenges and opportunity in mobility among older adults – key determinant identification
Authors: Maresova Petra , Krejcar Ondrej , Maskuriy Raihan , Bakar Nor Azlina Abu , Selamat Ali , Truhlarova Zuzana , Horak Jiri , Joukl Miroslav , Vítkova Lucie 
Published: July 2023

Abstract
Background
Attention is focused on the health and physical fitness of older adults due to their increasing age. Maintaining physical abilities, including safe walking and movement, significantly contributes to the perception of health in old age. One of the early signs of declining fitness in older adults is limited mobility. Approximately one third of 70-year-olds and most 80-year-olds report restrictions on mobility in their apartments and immediate surroundings. Restriction or loss of mobility is a complex multifactorial process, which makes older adults prone to falls, injuries, and hospitalizations and worsens their quality of life while increasing overall mortality.

Objective
The objective of the study is to identify the factors that have had a significant impact on mobility in recent years and currently, and to identify gaps in our understanding of these factors. The study aims to highlight areas where further research is needed and where new and effective solutions are required.

Methods
The PRISMA methodology was used to conduct a scoping review in the Scopus and Web of Science databases. Papers published from 2007 to 2021 were searched in November 2021. Of these, 52 papers were selected from the initial 788 outputs for the final analysis.

Results
The final selected papers were analyzed, and the key determinants were found to be environmental, physical, cognitive, and psychosocial, which confirms the findings of previous studies. One new determinant is technological. New and effective solutions lie in understanding the interactions between different determinants of mobility, addressing environmental factors, and exploring opportunities in the context of emerging technologies, such as the integration of smart home technologies, design of accessible and age-friendly public spaces, development of policies and regulations, and exploration of innovative financing models to support the integration of assistive technologies into the lives of seniors.

Conclusion
For an effective and comprehensive solution to support senior mobility, the determinants cannot be solved separately. Physical, cognitive, psychosocial, and technological determinants can often be perceived as the cause/motivation for mobility. Further research on these determinants can help to arrive at solutions for environmental determinants, which, in turn, will help improve mobility. Future studies should investigate financial aspects, especially since many technological solutions are expensive and not commonly available, which limits their use.
Enhancement of PD-L1-attenuated CAR-T cell function through breast cancer-associated fibroblasts-derived IL-6 signaling via STAT3/AKT pathways
Authors: Chuangchot Nisa , Jamjuntra Pranisa , Yangngam Supaporn , Luangwattananun Piriya , Thongchot Suyanee , Junking Mutita , Thuwajit Peti , Yenchitsomanus Pa-Thai , Thuwajit Chanitra 
Published: July 2023

Abstract
Background
Carcinoma-associated fibroblasts (CAFs) play a critical role in cancer progression and immune cell modulation. In this study, it was aimed to evaluate the roles of CAFs-derived IL-6 in doxorubicin (Dox) resistance and PD-L1-mediated chimeric antigenic receptor (CAR)-T cell resistance in breast cancer (BCA).

Methods
CAF conditioned-media (CM) were collected, and the IL-6 level was measured by ELISA. CAF-CM were treated in MDA-MB-231 and HCC70 TNBC cell lines and siIL-6 receptor (IL-6R) knocked down (KD) cells to determine the effect of CAF-derived IL-6 on Dox resistance by flow cytometry and on increased PD-L1 through STAT3, AKT and ERK1/2 pathways by Western blot analysis. After pre-treating with CM, the folate receptor alpha (FRα)-CAR T cell cytotoxicity was evaluated in 2D and 3D spheroid culture assays.

Results
The results showed a significant level of IL-6 in CAF-CM compared to that of normal fibroblasts (NFs). The CM with high IL-6 level significantly induced Dox resistance; and PD-L1 expression through STAT3 and AKT pathways in MDA-MB-231 and HCC70 cells. These induction effects were attenuated in siIL-6R KD cells. Moreover, the TNBC cell lines that were CM-treated with STAT3 and an AKT inhibitor had a reduced effect of IL-6 on PD-L1 expression. BCA cells with high IL-6 containing-CM treatment had resistance to cancer cell killing by FRα CAR-T cells compared to untreated cells.

Conclusion
These results highlight CAF-derived IL-6 in the resistance of chemotherapy and T cell therapy. Using inhibitors of IL6-STAT3/AKT-PD-L1 axis may provide a potential benefit of Dox and CAR-T cell therapies in BCA patients.
Pancreatic CT perfusion: quantitative meta-analysis of disease discrimination, protocol development, and effect of CT parameters
Authors: Skornitzke Stephan , Vats Neha , Mayer Philipp , Kauczor Hans-Ulrich , Stiller Wolfram 
Published: July 2023

Abstract
Background
This study provides a quantitative meta-analysis of pancreatic CT perfusion studies, investigating choice of study parameters, ability for quantitative discrimination of pancreatic diseases, and influence of acquisition and reconstruction parameters on reported results.

Methods
Based on a PubMed search with key terms ‘pancreas’ or ‘pancreatic,’ ‘dynamic’ or ‘perfusion,’ and ‘computed tomography’ or ‘CT,’ 491 articles published between 1982 and 2020 were screened for inclusion in the study. Inclusion criteria were: reported original data, human subjects, five or more datasets, measurements of pancreas or pancreatic pathologies, and reported quantitative perfusion parameters. Study parameters and reported quantitative measurements were extracted, and heterogeneity of study parameters and trends over time are analyzed. Pooled data were tested with weighted ANOVA and ANCOVA models for differences in perfusion results between normal pancreas, pancreatitis, PDAC (pancreatic ductal adenocarcinoma), and non-PDAC (e.g., neuroendocrine tumors, insulinomas) and based on study parameters.

Results
Reported acquisition parameters were heterogeneous, except for contrast agent amount and injection rate. Tube potential and slice thickness decreased, whereas tube current time product and scan coverage increased over time. Blood flow and blood volume showed significant differences between pathologies (both p < 0.001), unlike permeability (p = 0.11). Study parameters showed a significant effect on reported quantitative measurements (p < 0.05).

Conclusions
Significant differences in perfusion measurements between pathologies could be shown for pooled data despite observed heterogeneity in study parameters. Statistical analysis indicates most influential parameters for future optimization and standardization of acquisition protocols.

Critical relevance statement
Quantitative CT perfusion enables differentiation of pancreatic pathologies despite the heterogeneity of study parameters in current clinical practice.

Graphical abstract
Radiomic signatures from T2W and DWI MRI are predictive of tumour hypoxia in colorectal liver metastases
Authors: Bodalal Zuhir , Bogveradze Nino , ter Beek Leon C. , van den Berg Jose G. , Sanders Joyce , Hofland Ingrid , Trebeschi Stefano , Groot Lipman Kevin B. W. , Storck Koen , Hong Eun Kyoung , Lebedyeva Natalya , Maas Monique , Beets-Tan Regina G. H. , Gomez Fernando M. , Kurilova Ieva 
Published: July 2023

Abstract
Background
Tumour hypoxia is a negative predictive and prognostic biomarker in colorectal cancer typically assessed by invasive sampling methods, which suffer from many shortcomings. This retrospective proof-of-principle study explores the potential of MRI-derived imaging markers in predicting tumour hypoxia non-invasively in patients with colorectal liver metastases (CLM).

Methods
A single-centre cohort of 146 CLMs from 112 patients were segmented on preoperative T2-weighted (T2W) images and diffusion-weighted imaging (DWI). HIF-1 alpha immunohistochemical staining index (high/low) was used as a reference standard. Radiomic features were extracted, and machine learning approaches were implemented to predict the degree of histopathological tumour hypoxia.

Results
Radiomic signatures from DWI b200 (AUC = 0.79, 95% CI 0.61–0.93, p = 0.002) and ADC (AUC = 0.72, 95% CI 0.50–0.90, p = 0.019) were significantly predictive of tumour hypoxia. Morphological T2W TE75 (AUC = 0.64, 95% CI 0.42–0.82, p = 0.092) and functional DWI b0 (AUC = 0.66, 95% CI 0.46–0.84, p = 0.069) and b800 (AUC = 0.64, 95% CI 0.44–0.82, p = 0.071) images also provided predictive information. T2W TE300 (AUC = 0.57, 95% CI 0.33–0.78, p = 0.312) and b = 10 (AUC = 0.53, 95% CI 0.33–0.74, p = 0.415) images were not predictive of tumour hypoxia.

Conclusions
T2W and DWI sequences encode information predictive of tumour hypoxia. Prospective multicentre studies could help develop and validate robust non-invasive hypoxia-detection algorithms.

Critical relevance statement
Hypoxia is a negative prognostic biomarker in colorectal cancer. Hypoxia is usually assessed by invasive sampling methods. This proof-of-principle retrospective study explores the role of AI-based MRI-derived imaging biomarkers in non-invasively predicting tumour hypoxia in patients with colorectal liver metastases (CLM).

Graphical Abstract
Copper chelation suppresses epithelial-mesenchymal transition by inhibition of canonical and non-canonical TGF-β signaling pathways in cancer
Authors: Poursani Ensieh M. , Mercatelli Daniele , Raninga Prahlad , Bell Jessica L. , Saletta Federica , Kohane Felix V. , Neumann Daniel P. , Zheng Ye , Rouaen Jourdin R. C. , Jue Toni Rose , Michniewicz Filip T. , Schadel Piper , Kasiou Erin , Tsoli Maria , Cirillo Giuseppe , Waters Shafagh , Shai-Hee Tyler , Cazzoli Riccardo , Brettle Merryn , Slapetova Iveta , Kasherman Maria , Whan Renee , Souza-Fonseca-Guimaraes Fernando , Vahdat Linda , Ziegler David , Lock John G. , Giorgi Federico M. , Khanna KumKum , Vittorio Orazio 
Published: July 2023

AbstractBackgroundMetastatic cancer cells exploit Epithelial-mesenchymal-transition (EMT) to enhance their migration, invasion, and resistance to treatments. Recent studies highlight that elevated levels of copper are implicated in cancer progression and metastasis. Clinical trials using copper chelators are associated with improved patient survival; however, the molecular mechanisms by which copper depletion inhibits tumor progression and metastasis are poorly understood. This remains a major hurdle to the clinical translation of copper chelators. Here, we propose that copper chelation inhibits metastasis by reducing TGF-β levels and EMT signaling. Given that many drugs targeting TGF-β have failed in clinical trials, partly because of severe side effects arising in patients, we hypothesized that copper chelation therapy might be a less toxic alternative to target the TGF-β/EMT axis.ResultsOur cytokine array and RNA-seq data suggested a link between copper homeostasis, TGF-β and EMT process. To validate this hypothesis, we performed single-cell imaging, protein assays, and in vivo studies. Here, we used the copper chelating agent TEPA to block copper trafficking. Our in vivo study showed a reduction of TGF-β levels and metastasis to the lung in the TNBC mouse model. Mechanistically, TEPA significantly downregulated canonical (TGF-β/SMAD2&3) and non-canonical (TGF-β/PI3K/AKT, TGF-β/RAS/RAF/MEK/ERK, and TGF-β/WNT/β-catenin) TGF-β signaling pathways. Additionally, EMT markers of MMP-9, MMP-14, Vimentin, β-catenin, ZEB1, and p-SMAD2 were downregulated, and EMT transcription factors of SNAI1, ZEB1, and p-SMAD2 accumulated in the cytoplasm after treatment.ConclusionsOur study suggests that copper chelation therapy represents a potentially effective therapeutic approach for targeting TGF-β and inhibiting EMT in a diverse range of cancers.