bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There a Benefit to Rigid Fixation in Calcaneal Lengthening Osteotomy in Painful Pediatric Idiopathic Flatfoot Deformity? Comparing Results of Kirschner Wire Versus Plate Fixation
Authors: Tippabhatla Abhishek , Torres-Izquierdo Beltran , William Matthew , Pereira Daniel , Meyer Zachary , Hosseinzadeh Pooya 
Published: September 2023

Introduction:Flexible flatfoot (FF) is a common pediatric condition that is mostly asymptomatic, and surgical intervention is only considered when painful FF is refractory to conservative treatment. Calcaneal lengthening osteotomy (CLO) is one of the most commonly used procedures to address painful FF. Traditionally, Kirschner wires (K-wires) were used for fixation, but there has been a recent increase in the use of plates. We compared the clinical and radiographic outcomes of these 2 fixation methods.Methods:This single-center retrospective study included children aged 8 to 18 years with symptomatic FF that received CLO using K-wire or plate fixation. Primary outcomes include weight-bearing radiographic measurements and complications after surgery. Secondary outcomes included patient-reported outcomes. Statistical significance was held at 0.05.Results:Among 102 feet (65 patients), 42 feet (41.2%) underwent K-wire and 60 feet (58.8%) underwent plate fixation. No differences in casting duration (P=0.525) and time-to-radiographic healing (P=0.17) were noted. Total complications were higher in the plate cohort (12 vs. 2,P=0.04) due to a higher rate of reoperations (16.7%) for hardware-related pain [10 vs. 0; odds ratio 17.74, 95% CI (1.01, 310.54),P<0.05], and infection rates were similar. Both interventions significantly improved (P≤ 0.001) aneteroposterior (AP) Talo-first metatarsal and calcaneal pitch angles. Irrespective of intervention, CLO significantly improved pain at 6 months and mobility scores at 12 months. Neither modality demonstrated superior pain or mobility scores at final follow-up.Conclusion:Both K-wire and plate fixations lead to similar radiographic and functional outcomes after CLO in painful, pediatric flatfeet. Compared with K-wire fixation, plates cause a 17.7-fold increased risk of reoperations for painful hardware, with 16.7% of plated cases requiring reoperation. Noting this, along with the higher costs associated with using plates, our study advocates for K-wire fixation for children undergoing CLO.Level of Evidence:Level III
Increasing Cervical Kyphosis Correlates With Cervical Degenerative Disk Disease in Patients With Adolescent Idiopathic Scoliosis
Authors: Lin Adrian , Skaggs David L. , Andras Lindsay M. , Tolo Vernon , Tamrazi Benita , Illingworth Kenneth D. 
Published: September 2023

Study Design.
Retrospective review.

Objective.
Our goal was to investigate the incidence of cervical degenerative disk disease (DDD) in patients with adolescent idiopathic scoliosis (AIS), before surgical intervention.

Summary of Background Data.
AIS is often associated with thoracic hypokyphosis and compensatory cervical kyphosis. In adults, cervical kyphosis is associated with DDD. Although cervical kyphosis has been reported in up to 60% AIS patients, the association with cervical DDD has not been reported.

Materials and Methods.
A retrospective review was conducted from January 2014 to December 2019 of all consecutive AIS patients. Inclusion criteria were AIS patients over 10 years of age with cervical magnetic resonance imaging and anterior-posterior and lateral spine radiographs within 1 year of each other. Magnetic resonance imaging were reviewed for evidence of cervical DDD. Severity of cervical changes were graded using the Pfirrmann classification and by a quantitative measure of disk degeneration, the magnetic resonance signal intensity ratio.

Results.
Eighty consecutive patients were included (mean age: 14.1 years, SD=2.5 years). Increasing cervical kyphosis was significantly correlated to decreasing thoracic kyphosis (r=0.49, P<0.01) and increasing major curve magnitude (r=0.22, P=0.04). Forty-five patients (56%) had the presence of DDD (grades 2–4) with a mean cervical kyphosis of 11.1° (SD=9.5°, P<0.01). More cervical kyphosis was associated with more severe cervical DDD as graded by Pfirrmann classification level (P<0.01). Increasing cervical kyphosis was also positively associated with increasing magnetic resonance signal intensity ratio (P<0.01). Nine patients had ventral cord effacement secondary to DDD with a mean cervical kyphosis of 22.8° (SD=8.6°) compared with 2.6° (SD=11.2°) in those who did not (P<0.01).

Conclusions.
Cervical kyphosis was significantly associated with increasing severity of cervical DDD in patients with AIS. Patients with evidence of ventral cord effacement had the largest degree of cervical kyphosis with a mean of 22.8±8.6°. This is the first study to evaluate the association between cervical kyphosis in AIS with cervical DDD.
High Mechanical Power and Driving Pressures are Associated With Postoperative Respiratory Failure Independent From Patients’ Respiratory System Mechanics*
Authors: Tartler Tim M. , Ahrens Elena , Munoz-Acuna Ricardo , Azizi Basit A. , Chen Guanqing , Suleiman Aiman , Wachtendorf Luca J. , Costa Eduardo L.V. , Talmor Daniel S. , Amato Marcelo B.P. , Baedorf-Kassis Elias N. , Schaefer Maximilian S. 
Published: September 2023

OBJECTIVES:
High mechanical power and driving pressure (ΔP) have been associated with postoperative respiratory failure (PRF) and may be important parameters guiding mechanical ventilation. However, it remains unclear whether high mechanical power and ΔP merely reflect patients with poor respiratory system mechanics at risk of PRF. We investigated the effect of mechanical power and ΔP on PRF in cohorts after exact matching by patients’ baseline respiratory system compliance.

DESIGN:
Hospital registry study.

SETTING:
Academic hospital in New England.

PATIENTS:
Adult patients undergoing general anesthesia between 2008 and 2020.

INTERVENTION:
None.

MEASUREMENTS AND MAIN RESULTS:
The primary exposure was high (≥ 6.7 J/min, cohort median) versus low mechanical power and the key-secondary exposure was high (≥ 15.0 cm H2O) versus low ΔP. The primary endpoint was PRF (reintubation or unplanned noninvasive ventilation within seven days). Among 97,555 included patients, 4,030 (4.1%) developed PRF. In adjusted analyses, high intraoperative mechanical power and ΔP were associated with higher odds of PRF (adjusted odds ratio [aOR] 1.37 [95% CI, 1.25–1.50]; p < 0.001 and aOR 1.45 [95% CI, 1.31–1.60]; p < 0.001, respectively). There was large variability in applied ventilatory parameters, dependent on the anesthesia provider. This facilitated matching of 63,612 (mechanical power cohort) and 53,260 (ΔP cohort) patients, yielding identical baseline standardized respiratory system compliance (standardized difference [SDiff] = 0.00) with distinctly different mechanical power (9.4 [2.4] vs 4.9 [1.3] J/min; SDiff = –2.33) and ΔP (19.3 [4.1] vs 11.9 [2.1] cm H2O; SDiff = –2.27). After matching, high mechanical power and ΔP remained associated with higher risk of PRF (aOR 1.30 [95% CI, 1.17–1.45]; p < 0.001 and aOR 1.28 [95% CI, 1.12–1.46]; p < 0.001, respectively).

CONCLUSIONS:
High mechanical power and ΔP are associated with PRF independent of patient’s baseline respiratory system compliance. Our findings support utilization of these parameters for titrating mechanical ventilation in the operating room and ICU.
A genetic variant in the immune-related gene ERAP1 affects colorectal cancer prognosis
Authors: Zou Danyi , Cai Yimin , Jin Meng , Zhang Ming , Liu Yizhuo , Chen Shuoni , Yang Shuhui , Zhang Heng , Zhu Xu , Huang Chaoqun , Zhu Ying , Miao Xiaoping , Wei Yongchang , Yang Xiaojun , Tian Jianbo 
Published: September 2023

Abstract

Background:
Findings on the association of genetic factors and colorectal cancer (CRC) survival are limited and inconsistent, and revealing the mechanism underlying their prognostic roles is of great importance. This study aimed to explore the relationship between functional genetic variations and the prognosis of CRC and further reveal the possible mechanism.

Methods:
We first systematically performed expression quantitative trait locus (eQTL) analysis using The Cancer Genome Atlas (TCGA) dataset. Then, the Kaplan–Meier analysis was used to filter out the survival-related eQTL target genes of CRC patients in two public datasets (TCGA and GSE39582 dataset from the Gene Expression Omnibus database). The seven most potentially functional eQTL single nucleotide polymorphisms (SNPs) associated with six survival-related eQTL target genes were genotyped in 907 Chinese CRC patients with clinical prognosis data. The regulatory mechanism of the survival-related SNP was further confirmed by functional experiments.

Results:
The rs71630754 regulating the expression of endoplasmic reticulum aminopeptidase 1 (ERAP1) was significantly associated with the prognosis of CRC (additive model, hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.08–1.88, P = 0.012). The results of dual-luciferase reporter assay and electrophoretic mobility shift assay showed that the A allele of the rs71630754 could increase the binding of transcription factor 3 (TCF3) and subsequently reduce the expression of ERAP1. The results of bioinformatic analysis showed that lower expression of ERAP1 could affect the tumor immune microenvironment and was significantly associated with severe survival outcomes.

Conclusion:
The rs71630754 could influence the prognosis of CRC patients by regulating the expression of the immune-related gene ERAP1.

Trial Registration:
No. NCT00454519 (https://clinicaltrials.gov/)
18F-prostate specific membrane antigen positron emission tomography/computerized tomography for lymph node staging in medium/high risk prostate cancer: A systematic review and meta-analysis
Authors: Lv Zhengtong , Song Liuqi , Wang Miao , Hou Huimin , Li Haodong , Wang Xuan , Wang Jianye , Wang Jianlong , Liu Ming 
Published: September 2023

Abstract

Background:
Lymph node staging of prostate cancer (PCa) is important for planning and monitoring of treatment. 18F-prostate specific membrane antigen positron emission tomography/computerized tomography (18F-PSMA PET/CT) has several advantages over 68Ga-PSMA PET/CT, but its diagnostic value requires further investigation. This meta-analysis focused on establishing the diagnostic utility of 18F-PSMA PET/CT for lymph node staging in medium/high-risk PCa.

Methods:
We searched the EMBASE, PubMed, Cochrane library, and Web of Science databases from inception to October 1, 2022. Prostate cancer, 18F, lymph node, PSMA, and PET/CT were used as search terms and the language was limited to English. We additionally performed a manual search using the reference lists of key articles. Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies. Sensitivity, specificity, the positive and negative likelihood ratio (PLR and NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and 95% confidence interval (CI) were used to evaluate the diagnostic value of 18F-PSMA PET/CT. Stata 17 software was employed for calculation and statistical analyses.

Results:
A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis. At the patient level, the results of each consolidated summary were as follows: sensitivity of 0.57 (95% CI 0.39–0.73), specificity of 0.95 (95% CI 0.92–0.97), PLR of 11.2 (95% CI 6.6–19.0), NLR of 0.46 (95% CI 0.31–0.68), DOR of 25 (95% CI 11–54), and AUC of 0.94 (95% CI 0.92–0.96). At the lesion level, the results of each consolidated summary were as follows: sensitivity of 0.40 (95% CI 0.21–0.62), specificity of 0.99 (95% CI 0.95–1.00), PLR of 40.0 (95% CI 9.1–176.3), NLR of 0.61 (95% CI 0.42–0.87), DOR of 66 (95% CI 14–311), and AUC of 0.86 (95% CI 0.83–0.89).

Conclusions:

18F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa. The diagnostic efficacy was almost equivalent to that reported for 68Ga-PSMA PET/CT.

Registration:
International Prospective Register of Systematic Reviews (PROSPERO), No. CRD42023391101.
The Effectiveness of Using CO2 Fractional Laser and Mebo Burn Ointment Together in Treating Scars on the Face after Surgery
Authors: Zhang Jiaqi , Ge Jun , Chen Chen , Shi Fen , Wang Yongzhen , Zhang Jinming , Liang Weiqiang 
Published: September 2023

Background:
This study aimed to investigate the efficacy and safety of CO2 fractional laser combined with Mebo burn ointment in treating facial postoperative scars.

Methods:
Sixty patients with facial postoperative scars in the department of plastic surgery of Sun Yat-sen Memorial Hospital from January 2020 to June 2022 were divided into a control group (30 cases) and a study group (30 cases). Both groups received CO2 fractional laser treatment, but the study group also received Mebo burn ointment application.

Results:
The study found that both methods resulted in a significant decrease in Sawada score and a significant increase in Investigator Global Assessment score after treatment (P < 0.05), with the study group showing a more significant improvement and higher patient satisfaction (P < 0.05). All patients experienced varying degrees of bleeding, swelling, and erythema immediately after treatment, with two cases of pigmentation and two cases of persistent erythema in the control group, and one case of pigmentation and one case of persistent erythema in the study group. Adverse reactions were minimal, with the study group showing better tolerance.

Conclusions:
The study suggests that CO2 fractional laser combined with Mebo burn ointment is an effective and safe treatment for facial postoperative scars.
Bioimpedance analysis predicts the etiology of cirrhosis in a prospective cohort study
Authors: El-Serag Hashem B. , Akhdar Ghida , Thrift Aaron P. , Luster Michelle , Khaderi Saira , Alsarraj Abeer , Duong Hao , Kanwal Fasiha 
Published: September 2023

Background:
Obesity is associated with an increased risk of developing cirrhosis. However, body mass index (BMI) and waist-to-hip ratio (WHR) may not be indicative of body composition parameters that predispose to cirrhosis. Bioimpedance analysis (BIA) is a noninvasive cost-efficient method for more detailed estimation of body composition.

Methods:
We examined patients with cirrhosis who underwent BIA as part of enrollment into a prospective cohort study. We examined the correlation between BIA variables, BMI, and WHR. We performed sex-adjusted and race-adjusted and race-specific multivariable logistic regression analyses to examine the association between anthropometric variables and risk factors [NAFLD, alcohol-associated liver disease (ALD), and HCV].

Results:
We analyzed data from 348 cirrhosis patients; 23.3% were women; 48.3% were non-Hispanic White; 19.3% were Hispanic; and 30.7% were African American. The cirrhosis etiology was 21.8% NAFLD, 56.9% HCV mostly cured, and 11.5% ALD. Several BIA variables correlated well with BMI, and others showed modest correlations, but none correlated well with WHR. Higher body fat mass and basal metabolic rate were positively associated, while higher lean body mass, dry lean mass, total body water, or skeletal muscle mass were negatively associated with NAFLD. Associations between these BIA parameters and ALD-related cirrhosis were in the opposite direction. These associations of BIA variables were seen only in Hispanic and non-Hispanic White patients but not non-Hispanic Blacks. BIA variables were more predictive of cirrhosis etiology than BMI or WHR.

Conclusions:
Among patients with cirrhosis, several BIA-derived measurements indicative of body fat and muscle are associated with NAFLD and ALD etiology. BIA variables show stronger associations, as well as race/ethnicity-specific associations, with cirrhosis etiology than those of BMI or WHR.
In-Hospital Receipt of Ivermectin Is Associated With No Benefit in Mortality, Disease Progression, or Length of Stay for Patients With Mild to Moderate COVID-19
Authors: Hasse Adam , Korwek Kimberly , Poland Russell E. 
Published: September 2023

Background
Use of the antiparasitic agent ivermectin as a potential treatment for early coronavirus disease 2019 (COVID-19) is not recommended, yet inpatient administration continues to be seen.

Methods
This was a retrospective analysis of more than 100,000 patients admitted to a large health system of community hospitals for COVID-19 to assess the association of ivermectin administration, either early in disease course or at higher severity, with mortality and disease progression (intensive care unit admission or use of mechanical ventilation). Propensity match analysis was used to account for covariates.

Results
Of the 122,002 patients hospitalized with COVID-19 included in this analysis, 1.1% (1380) received ivermectin while at mild to moderate severity (on room air or nasal cannula), and 0.2% (n = 293) received the drug while severe (noninvasive or mechanical ventilation). Among those who received it with mild to moderate severity, there was no effect on relative risk (RR) of mortality (RR, 1.01; 95% confidence interval [CI], 0.802–1.27), intensive care unit admission (RR, 0.984; 95% CI, 0.865–1.12), or use of mechanical ventilation (RR, 0.976; 95% CI, 0.777–1.23), but an increase in average length of stay (mean days, 8.0 vs 7.5; P < 0.001). Of those who received their first dose of ivermectin with more severe COVID-19, there was an increase in the RR of mortality (RR, 1.63; 95% CI, 1.34–1.99; P < 0.001).

Conclusion
Among hospitalized patients admitted with mild to moderate COVID-19, in-hospital administration of ivermectin provides no benefit in mortality or disease progression when administered early in the disease course, and may contribute to excess mortality when administered to patients at more severe disease states.
Facial Palsy After Multisystem Inflammatory Syndrome in Children
Authors: Mandelia Yamini , Moravec Katherine , Bryant Kathleen Kinney , Dalzell William A.B. 
Published: September 2023

Abstract
COVID-19 pandemic has affected the pediatric and adult populations in different ways. Although adults experience more respiratory disease, pediatric population has been struck by multisystem inflammatory syndrome in children. There have been multiple case reports of Bell’s palsy associated with acute COVID-19 infection. We present the first known case of unilateral facial palsy after multisystem inflammatory syndrome in children in a pediatric patient.
Nurses' Attitudes Toward Patients Who Use Cannabis
Authors: McCall Darci , Rapoza Sarah , Liverman Wendi , Carter Jeremy 
Published: September 2023

Abstract

Background
Cannabis has been cited as the most frequently used drug in this country, and intolerance toward substance use is a recognized concern in nursing. The twofold purpose of this descriptive study was to determine (a) what, if any, were the differences between nurses' attitudes of patient cannabis use in states in which cannabis was legal versus illegal and (b) how do nurses working in diverse care settings differ in their attitudes regarding patient cannabis use.

Methods
A sample of 809 registered nurses from across the United States were recruited to take part in this study in October 2018. A previously validated 20-question survey was used to collect participants' perceptions of and attitudes toward patient cannabis use. Demographic information collected included age, gender, educational level, years in practice, primary area of practice, and legal status of cannabis in state of practice. An independent t test and analysis of variance were used to analyze group differences.

Findings
Findings from this study indicated that there was no significant difference in attitudes of nurses in states in which cannabis use was legal (M = 28.76, SD = 7.83) and states in which it was illegal (M = 29.43, SD = 7.65), t(807) = 1.202, p = .230. In addition, no significant differences were found in attitudes across six areas of practice, F(5) = 1.531, p = .178. Furthermore, nursing attitudes were largely positive toward patient cannabis use (M = 29.04, SD = 7.762; range: 20–100).

Conclusions
Findings from this study indicate that cannabis use may not carry the same perceived stigma as other illicit substances for nurses and unbiased care may be provided regardless of personal beliefs.
Interplay of Depression, Smoking Intention, and Smoking Behavior in Chinese Dai Adolescents
Authors: Zhao Xiang , Davey Gareth , Wan Xiangxing 
Published: September 2023

Abstract
Tobacco smoking and depression are important contributors to the burden of disease in China, and their onset typically occurs in adolescence. However, there is no consensus on the nature and underlying mechanisms of their interplay, and related studies on Chinese adolescents and ethnic minorities are limited. This study tested the mediation role of depression in the link between smoking intention and behavior in relation to sex. A secondary analysis was conducted on data from a survey of 1,322 Chinese Dai middle school students aged 15–19 years (M = 17.02 years; 773 female students and 542 male students) in Xishuangbanna, China. We found that the mediation role of depression between smoking intention and smoking behavior was nonsignificant, although smoking intention and depression both had significant associations with smoking behavior. Therefore, depression might be better theorized as an underlying predictor of smoking intention or that other volitional factors may link smoking intention and smoking behavior more closely. Nevertheless, depression was a significant independent variable for smoking behavior even when smoking intention was adjusted. Women perceived more depression than men with similar smoking intention levels, yet the relationship between smoking intention and smoking behavior was stronger in men. Although it seems that men were abler to translate their smoking intention into actual smoking, the high level of depression among young women who reported higher levels of smoking intention is noteworthy. Tobacco control for Chinese adolescents could incorporate sex-specific psychological therapies for negative emotions and for the internalization of problems by children.
Risk and Protective Factors for the Use of Illicit Drugs
Authors: Ventura Carla Aparecida Arena , Moll Marciana Fernandes , Zanardo Ana Beatriz Rizzo , Ferreira Paulo Sergio , Eugenio Samira Janis , de Ávila Domingos Stefany Guimarães 
Published: September 2023

Abstract
This article aimed to describe the perspective of people who make harmful use of illicit substances on the contributions of risk and protective factors to the development of problems related to drug use. One hundred eleven participants were recruited from a health service for drug users in a city in the interior of the state of São Paulo through posters with information, distribution of brochures, and snowball sampling technique. The sample consists of 51.9% men and 48.1% women, with 81.3% single and 10.3% married. Among them, 54.2% of participants completed high school, 64.1% were Catholic, and 34% rarely practiced their religion. The results on risk factors were classified into three domains, namely, “personal characteristics and behaviors,” “family circumstances,” and “other social pressures,” and those on protective factors were also classified into three domains, namely, “personal characteristics and behaviors,” “family circumstances,” and “circumstances in the community.” The data make it possible to guide the incorporation of multiple strategies to protect the consumption of illicit drugs in human biopsychosocial development, especially among children and adolescents.