bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Subchondral Bone Condition During Microfracture Affects the Repair of the Osteochondral Unit in the Cartilage Defect in the Rat Model
Authors: Sumii Junichi , Nakasa Tomoyuki , Kato Yuichi , Miyaki Shigeru , Adachi Nobuo 
Published: June 2023

Background: Microfracture (MF) is frequently performed as a first-line treatment for articular cartilage defects. Although good clinical outcomes are often obtained in the short term, poor clinical outcomes sometimes occur because of subchondral bone deterioration. The condition of the subchondral bone treated with MF may affect the repair of the osteochondral unit. Purpose: To analyze histological findings of the osteochondral unit after performing MF on subchondral bone in different states—normal, absorption, and sclerosis—in a rat model. Study Design: Controlled laboratory study. Methods: Full-thickness cartilage defects (5.0 × 3.0 mm) were created in the weightbearing area of the medial femoral condyle in both knees of 47 Sprague-Dawley rats. Five MF holes were created within the cartilage defect using a 0.55-mm needle to a depth of 1 mm at 0 weeks (normal group), 2 weeks (absorption group), and 4 weeks (sclerosis group) after the cartilage defect was created. In the left knee, MF holes were filled with β-tricalcium phosphate (β-TCP). At 2 and 4 weeks after MF, knee joints were harvested and histologically analyzed. Results: MF holes were enlarged at 2 weeks and further enlarged at 4 weeks in all groups. In the absorption group, osteoclast accumulation around the MF holes and cyst formation were observed. The trabecular bone surrounding the MF holes was thickened in the sclerosis group. The diameter of the MF hole was largest in the absorption group at 2 and 4 weeks after MF compared with the other groups. No subchondral bone cysts were observed after β-TCP implantation. Pineda scores in all groups were significantly better with β-TCP implantation than without β-TCP implantation at 2 and 4 weeks. Conclusion: MF for subchondral bone with bone absorption induced enlargement of the MF holes, cyst formation, and delay of cartilage defect coverage. Implantation of β-TCP into the MF holes enhanced remodeling of the MF holes and improved repair of the osteochondral unit compared with MF only. Therefore, the condition of the subchondral bone treated with MF affects repair of the osteochondral unit in a cartilage defect.
Tocilizumab Associated With Survival in Patients Hospitalized for COVID-19 Acute Respiratory Distress Syndrome and Low Urine Output
Authors: Fadel Raef Ali , Scott Ashley , Parsons Austin , Murskyj Ivanna , Nasiri Nour , Abu Sayf Alaa , Ouellette Daniel 
Published: June 2023

Background Acute respiratory distress syndrome (ARDS) with oliguria is associated with increased mortality. Interleukin-6 (IL-6) plays an integral role in the pathophysiology of both disease processes. Patients who experience severe COVID-19 have demonstrated higher IL-6 levels compared to baseline, and use of tocilizumab has demonstrated efficacy in such cohorts. We set out to investigate the relationship between tocilizumab use, COVID-19 ARDS, low urine output, and mortality. Methods Retrospective cohort review of adult patients aged ≥ 18 years with COVID-19 and moderate or severe ARDS, admitted to the intensive care unit (ICU) of a tertiary referral center in metropolitan Detroit. Patients were analyzed based on presence of oliguria (defined as ≤ 0.7 mL/kg/h) on the day of intubation and exposure to tocilizumab while inpatient. The primary outcome was inpatient mortality. Results One hundred and twenty-eight patients were analyzed, 103 (80%) with low urine output, of whom 30 (29%) received tocilizumab. In patients with low urine output, risk factors associated with mortality on univariate analysis included Black race ( P  =  .028), lower static compliance ( P  =  .015), and tocilizumab administration ( P  =  .002). Tocilizumab (odds ratio 0.245, 95% confidence interval 0.079-0.764, P  =  .015) was the only risk factor independently associated with survival on multivariate logistic regression analysis. Conclusion In this retrospective cohort review of patients hospitalized with COVID-19 and moderate or severe ARDS, tocilizumab administration was independently associated with survival in patients with low urine output ≤ 0.7 mL/kg/h on the day of intubation. Prospective studies are needed to investigate the impact of urine output on efficacy of interleukin-targeted therapies in the management of ARDS.
Synthesis and characterization of innovative resveratrol nanobelt-like particles and assessment of their bioactivity, antioxidative and antibacterial properties
Authors: Tomić Nina , Matić Tamara , Filipović Nenad , Mitić Ćulafić Dragana , Boccacccini Aldo R , Stevanović Magdalena M 
Published: June 2023

Recently, many studies have shown various beneficial effects of polyphenol resveratrol (Res) on human health. The most important of these effects include cardioprotective, neuroprotective, anti-cancer, anti-inflammatory, osteoinductive, and anti-microbial effects. Resveratrol has cis and trans isoforms, with the trans isoform being more stable and biologically active. Despite the results of in vitro experiments, resveratrol has limited potential for application in vivo due to its poor water solubility, sensitivity to oxygen, light, and heat, rapid metabolism, and therefore low bioavailability. The possible solution to overcome these limitations could be the synthesis of resveratrol in nanoparticle form. Accordingly, in this study, we have developed a simple, green solvent/non-solvent physicochemical method to synthesize stable, uniform, carrier-free resveratrol nanobelt-like particles (ResNPs) for applications in tissue engineering. UV–visible spectroscopy (UV-Vis) was used to identify the trans isoform of ResNPs which remained stable for at least 63 days. The additional qualitative analysis was performed by Fourier transform infrared spectroscopy (FTIR), while X-ray diffraction (XRD) determined the monoclinic structure of resveratrol with a significant difference in the intensity of diffraction peaks between commercial and nano-belt form. The morphology of ResNPs was evaluated by optical microscopy and field-emission scanning electron microscope (FE-SEM) that revealed a uniform nanobelt-like structure with an individual thickness of less than 1 μm. Bioactivity was confirmed using Artemia salina in vivo toxicity assay, while 2,2–diphenyl-1-picrylhydrazylhydrate (DPPH) reduction assay showed the good antioxidative potential of concentrations of 100 μg/ml and lower. Microdilution assay on several reference strains and clinical isolates showed promising antibacterial potential on Staphylococci, with minimal inhibitory concentration (MIC) being 800 μg/ml. Bioactive glass-based scaffolds were coated with ResNPs and characterized to confirm coating potential. All of the above make these particles a promising bioactive, easy-to-handle component in various biomaterial formulations.
Risk of cancer versus risk of cancer diagnosis? Accounting for diagnostic bias in predictions of breast cancer risk by race and ethnicity
Authors: Gard Charlotte C , Lange Jane , Miglioretti Diana L , O’Meara Ellen S , Lee Christoph I , Etzioni Ruth 
Published: June 2023

Objectives Cancer risk prediction may be subject to detection bias if utilization of screening is related to cancer risk factors. We examine detection bias when predicting breast cancer risk by race/ethnicity. Methods We used screening and diagnosis histories from the Breast Cancer Surveillance Consortium to estimate risk of breast cancer onset and calculated relative risk of onset and diagnosis for each racial/ethnic group compared with non-Hispanic White women. Results Of 104,073 women aged 40–54 receiving their first screening mammogram at a Breast Cancer Surveillance Consortium facility between 2000 and 2018, 10.2% (n = 10,634) identified as Asian, 10.9% (n = 11,292) as Hispanic, and 8.4% (n = 8719) as non-Hispanic Black. Hispanic and non-Hispanic Black women had slightly lower screening frequencies but biopsy rates following a positive mammogram were similar across groups. Risk of cancer diagnosis was similar for non-Hispanic Black and White women (relative risk vs non-Hispanic White = 0.90, 95% CI 0.65 to 1.14) but was lower for Asian (relative risk = 0.70, 95% CI 0.56 to 0.97) and Hispanic women (relative risk = 0.82, 95% CI 0.62 to 1.08). Relative risks of disease onset were 0.78 (95% CI 0.68 to 0.88), 0.70 (95% CI 0.59 to 0.83), and 0.95 (95% CI 0.84 to 1.09) for Asian, Hispanic, and non-Hispanic Black women, respectively. Conclusions Racial/ethnic differences in mammography and biopsy utilization did not induce substantial detection bias; relative risks of disease onset were similar to or modestly different than relative risks of diagnosis. Asian and Hispanic women have lower risks of developing breast cancer than non-Hispanic Black and White women, who have similar risks.
Implant breakage and revision factors for modular fluted tapered stems in revision total hip arthroplasty
Authors: Lucena Thibaut , Cavaignac Etienne , Courtot Louis , Marot Vincent , Chiron Philippe , Reina Nicolas 
Published: June 2023

Purpose: Modular stems in revision total hip arthroplasties allow diaphyseal fixation and optimal restoration of the architecture of the proximal femur. Several studies report metaphyseal implant breakage having a negative impact on survivorship. The aim of the study was to evaluate the outcome of an uncemented modular fluted tapered stem (MFT) in revision surgery. Methods: In a retrospective study, 316 patients who had revision surgery using the same design of MFT implant (Modular Revision Stem [MRS], Lima Corporate, Italy) between 2012 and 2017 were identified. Patients were male in 51% of cases and mean age was 74 years. Indications were 110 periprosthetic fractures, 98 periprosthetic joint infection, 97 aseptic loosening, 10 instability and 1 other cause. Survivorship, complications, clinical and radiographic outcomes, were assessed. Mean follow-up was 5 years. Results: There was no implant breakage. At 5-year follow-up, the survivorship, free from revision for aseptic loosening and free of revision for any reason were 96% and 87%, respectively. At last follow-up (8 years), these figures were 92% and 71%, respectively. 31 implants were revised. The risk of revision for any cause was higher for extreme length metaphyseal implants, hazard ratio was 3.7 (95% CI, 1.82–7.52). A mean stem subsidence of 9 mm was noted in 37 cases; 4 were revised for aseptic loosening. The Harris Hip Score at final follow-up was 82. Conclusions: At 5-year follow-up, the MFT implant showed a good survivorship and outcomes with no specific complications. Unlike literature reports, no specific complications occurred with this design. Stem junction positioning and therefore metaphyseal length may be key to optimise long-term survivorship. However, a longer follow-up is needed as implant breakage is more often seen after long implantation times.
A Delphi consensus study on the treatment of slipped capital femoral epiphysis: Considerable consensus in mild and moderate slips and limited consensus in severe slips
Authors: Karagüven Doğaç , Demir Pervin , Yüksel Selcen , Ömeroğlu Hakan 
Published: June 2023

Purpose: The aim of this expert consensus study was to establish consensus on the treatment of different types of slipped capital femoral epiphysis and on the use of prophylactic screw fixation of the contralateral unaffected side. Methods: In this study, a four-round Delphi method was used. Questionnaires including all possible theoretical slip scenarios were sent online to 14 participants, experienced in the field of children’s orthopedics and in the treatment of hip disorders in children. Results: In-situ fixation was considered to be the first treatment choice in all types of mild slip scenarios and in moderate, stable ones. Performing in-situ fixation was not favored in moderate, unstable, and in all severe slip scenarios. In moderate to severe, unstable slip scenarios, there was consensus on the use of gentle closed or open reduction and internal fixation. Any consensus was not established in the optimal treatment of severe, stable slips. There was also consensus on the use of prophylactic screw fixation of the contralateral side in case of co-existing endocrine disorder and younger age. Conclusions: The establishment of consensus on the treatment of all types of slipped capital femoral epiphysis even among the experienced surgeons does not seem to be possible. The severity of the slip and stability of the slip are the primary and secondary determinants of the surgeons’ treatment choices, respectively. In-situ fixation is still the preferred treatment option in several slip types. Gentle capital realignment by closed or open means is recommended in displaced, unstable slips. Prophylactic screw fixation of the contralateral side is indicated under certain circumstances. Level of evidence: level V.
Anatomical Landmarks and Branching Patterns of the Greater Auricular Nerve
Authors: Salim Swafiya Busaidy , Amuti Thomas , Butt Fawzia 
Published: June 2023

Study Design Descriptive cross-sectional study. Background: The greater auricular nerve (GAN) courses over the sternocleidomastoid muscle (SCM) to supply the area of skin over the parotid gland (PG), the lower auricle and over the mastoid. It is vulnerable to injury during rhytidectomies and parotidectomies, resulting in sensory losses and pain. Although previous studies have identified suitable landmarks, injury to the GAN in the Kenyan setting still occurs. This study therefore aimed at identifying specific landmarks for the GAN and describing its branching pattern. Objective: To determine the anatomical landmarks of the GAN and its branching patterns. Methods: Forty six nerves were studied. The skin and fascia of the neck was carefully dissected to reveal the platysma muscle, which was reflected to expose the GAN. The distance of the emergence of the GAN on the posterior border of the sternocleidomastoid muscle as measured from the mastoid process (MP) was measured. Its perpendicular distance from the tragus to the point of branching was also measured. Its distance to the external jugular vein (EJV) was taken using a ruler and a pair of dividers. Finally, the nerve was described according to McKinney’s point. The pattern of branching was described as either type 1 (no branching), type 2 (2 branches) or type 3 (3 branches). The position of branching was classified as either anterior, posterior or middle. Collected data was coded into SPSS software (Version 21.0, Chicago, Illinois), and means ± standard deviation were calculated. Representative photos were taken. Results: The mean distance of the point of emergence of the nerve was 9.13 cm +/− 1.66 cm from the MP, while its distance from the tragus was 6.93 cm +/− 1.55. It was also located at a distance of 1.67 cm from the EJV. It mainly bifurcated into two branches (55.6%) and trifurcated in 4.4% of the cases. It remained undivided in 40% of the cases. In our study, the nerve mainly bifurcates in the anterior third of the SCM (22.2%). Conclusions: The GAN in our population mainly bifurcates, and it is more likely to divide closer to the parotid gland. The data presented in the study may be helpful in avoiding its iatrogenic injury.
Understanding the Barriers to COVID-19 Vaccine Among Hispanic/Latinx Communities
Authors: Milo Razel Bacuetes , Aguayo Claudia , Chico Allison Rae , Rozo José Andrés , Vásquez Iris , Calero Patricia , Burkard Joseph 
Published: June 2023

Objective: COVID-19 disproportionally affected Hispanic/Latinx populations exacerbating systemic health inequities. The pilot study aimed to explore barriers to COVID-19 vaccination across Hispanic/Latinx communities in Southern California. Methods: Cross-sectional survey of 200 participants to identify common barriers to vaccine hesitancy among Hispanics/Latinx individuals in Southern California utilizing a 14-item survey and questionnaire in English and Spanish. Results: Of the 200 participants that completed questionnaires, 37% identified a knowledge deficit, 8% identified misinformation, and 15% identified additional barriers such as awaiting appointments, immigration status, transportation issues, or religious reasons as barriers to not receiving the COVID-19 vaccine. Wald statistics denoted that household members with COVID-19 infection within the past 3 months saw a medical provider within the last year, wearing a mask in public often, and barriers to vaccination (not knowing enough about the vaccine) predicted vaccine. These variables indicated changes in the likelihood of obtaining vaccination. Conclusion: The most crucial factor for increasing vaccination rates was directly reaching out to the community and actively conducting surveys to address the barriers and concerns encountered by Hispanic/Latinx participants.
The Validity and Efficacy of a Preventative Intervention Model for Reducing Ulcer Recurrence in Diabetic Patients in Indonesia
Authors: Jais Suriadi , Pratama Kharisma , Pradika Jaka , Haryanto Haryanto 
Published: June 2023

Introduction It is important to reduce foot problems by preventing the recurrence of ulcers in diabetes mellitus (DM) patients. In Indonesia, interventions for the prevention of ulcer recurrence remain scarce. Objective The present study aimed to evaluate the validity and efficacy of a proposed intervention model for preventing the recurrence of ulcers in DM patients. Method Sixty-four DM patients were selected to participate in this quasi-experimental study and divided into two groups: intervention ( n  =  32) and control ( n  =  32). The intervention group received preventive treatment while the control group received standard care. Two trained nurses supported this study. Results Of the 32 participants in the intervention group, 18 (56.20%) were male, 25 (78.10%) were non-smokers, 23 (71.90%) had neuropathy, 14 (43.80%) had foot deformities, four (12.50%) had recurring ulcers, and 20 (62.50%) had a previous ulcer  < 12 months ago. Of the 32 participants in the control group, 17 (53.10%) were male, 26 (81.25%) were non-smokers, 17 (46.90%) had neuropathy, 19 (69.40%) had foot deformities, 12 (37.50%) had recurring ulcers, and 24 (75.00%) had a previous ulcer < 12 months ago. The mean (SD) age [62 (11.28) and 59 (11.11) years], ankle-brachial index [1.19 (0.24) and 1.11 (0.17)], HbA1C [9.18 (2.14%) and 8.91 (2.75%)], and DM duration [10.22 (6.71) and 10.13 (7.54)] of the intervention and control groups did not differ significantly. The content validity of the proposed intervention model was strong (I-CVI > 0.78). When the proposed screening tool for predicting the risk of ulcer recurrence in DM patients (NASFoHSkin) was used in the intervention group, its predictive validity, sensitivity, and specificity were 4, 100%, and 80%, respectively, while in the control group it was 4, 83%, and 80%, respectively. Conclusion Inspection/examination, foot care, and blood glucose control can decrease ulcer recurrence in DM patients.
Ocular complications of diabetes mellitus in a pediatric population and proposals for screening and follow-up programs
Authors: Diplotti Laura , Pignatto Silvia , Franco Francesca , Zanatta Manuela , Veritti Daniele , Cogo Paola , Lanzetta Paolo 
Published: June 2023

Background: Diabetes mellitus (DM) is one of the world’s greatest health emergencies of the 21st century. Ocular complications of DM are commonly chronic and progressive, but vision loss can be effectively prevented or delayed with early detection and timely treatment. Therefore, regular comprehensive ophthalmologic examinations are mandatory. Ophthalmic screening and dedicated follow-up for adults with DM are well established, whereas, there is no consensus on optimal recommendations for the pediatric population, reflecting the lack of clarity about the current burden of disease in this age group. Objectives: To determine the epidemiology of ocular complications of diabetes and to assess optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) macular features in a pediatric population with DM. To review ophthalmological screening and follow-up plans for the diabetic pediatric population. Design: Observational study. Methods: Retrospective consecutive cohort study of all 165 diabetic patients (330 eyes) aged 0–18 years, examined between January 2006 and September 2018 at the Pediatric Department of ‘S. Maria della Misericordia’ Udine Hospital who underwent at least one complete ophthalmologic examination at the Ophthalmology University Clinic at the Udine Hospital. OCT and OCTA data were available for 37 patients (72 eyes, 2 excluded). The associations between ocular complications and selected potential risk factors were evaluated by univariate analyses. Results: No patient had signs of ocular diabetic complications or any macular morphological or micro-vascular impairment, regardless of any potential risk factor. The prevalence of strabismus and refractive errors in the study group, was found to be similar to non-diabetic pediatric populations. Conclusion: Screening and follow-up of ocular diabetic complications in children and adolescents could be performed less frequently than in adults with diabetes. There is no need to screen potentially treatable visual disorders in diabetic children earlier or more frequently than in the healthy children thus reducing time spent in hospital and permitting a better tolerance to medical examinations in diabetic pediatric patients. We described the OCT and OCTA patterns in a pediatric population with DM.
kboolnet: a toolkit for the verification, validation, and visualization of reaction-contingency (rxncon) models
Authors: Carretero Chavez Willow , Krantz Marcus , Klipp Edda , Kufareva Irina 
Published: June 2023

Abstract
Background
Computational models of cell signaling networks are extremely useful tools for the exploration of underlying system behavior and prediction of response to various perturbations. By representing signaling cascades as executable Boolean networks, the previously developed rxncon (“reaction-contingency”) formalism and associated Python package enable accurate and scalable modeling of signal transduction even in large (thousands of components) biological systems. The models are split into reactions, which generate states, and contingencies, that impinge on reactions; this avoids the so-called “combinatorial explosion” of system size. Boolean description of the biological system compensates for the poor availability of kinetic parameters which are necessary for quantitative models. Unfortunately, few tools are available to support rxncon model development, especially for large, intricate systems.

Results
We present the kboolnet toolkit (https://github.com/Kufalab-UCSD/kboolnet, complete documentation at https://github.com/Kufalab-UCSD/kboolnet/wiki), an R package and a set of scripts that seamlessly integrate with the python-based rxncon software and collectively provide a complete workflow for the verification, validation, and visualization of rxncon models. The verification script VerifyModel.R checks for responsiveness to repeated stimulations as well as consistency of steady state behavior. The validation scripts TruthTable.R, SensitivityAnalysis.R, and ScoreNet.R provide various readouts for the comparison of model predictions to experimental data. In particular, ScoreNet.R compares model predictions to a cloud-stored MIDAS-format experimental database to provide a numerical score for tracking model accuracy. Finally, the visualization scripts allow for graphical representations of model topology and behavior. The entire kboolnet toolkit is cloud-enabled, allowing for easy collaborative development; most scripts also allow for the extraction and analysis of individual user-defined “modules”.

Conclusion
The kboolnet toolkit provides a modular, cloud-enabled workflow for the development of rxncon models, as well as their verification, validation, and visualization. This will enable the creation of larger, more comprehensive, and more rigorous models of cell signaling using the rxncon formalism in the future.