bluuebunny/crossref_metadata_2025_split huggingface dataset:
HEalth-Related Quality of Life-Intervention in Survivors of Breast and Other Cancers Experiencing Cancer-Related Fatigue and Associated Cognitive Symptoms Using TraditionAL Chinese Medicine: The ‘HERBAL’ Trial
Authors: Chan Alexandre , Chan Daniella , Ng Ding Quan , Zheng Huang Fang , Tan Quan Ming , Tan Chia Jie , Toh Jolene Hui Min , Yap Ning Yi , Toh Yi Long , Ke Yu , Wang Edmund Chun Ann , Lim Queenie Pei Ni , Ho Han Kiat , Chew Lita , Tan Tira J. 
Published: January 2025

Introduction: As pharmacological strategies remain limited for relieving fatigue and associated cognitive symptoms, integrative modalities such as traditional Chinese medicine (TCM) could be explored as therapeutic strategies in cancer survivors. Here, we evaluate and report the efficacy and safety of a TCM concoction, modified Xiang Bei Yang Rong Tang (XBYRT), on quality of life (QOL), cancer-related fatigue (CRF), and cognitive symptoms, compared to placebo. Methods: In a single-centered, randomized, double-blinded, placebo-controlled pilot trial conducted from 2019 to 2022, fatigued cancer survivors ≥21 years old were recruited to receive the XBYRT intervention or placebo (5% diluted) once daily for the duration of 8 weeks. Patient-reported outcomes for QOL, CRF, cognition, blood samples for biomarker testing, and adverse events were collected at baseline (T0), 4 weeks (T1), 8 weeks (T2), and 10 weeks (T3) after baseline. Linear regression was performed to evaluate differences between groups at T2 and T3. Results: A total of 1502 patients were screened, with 672 patients considered eligible. Of the eligible, 15 XBYRT and 13 placebo subjects with similar mean ages (58.5 vs 58.4) were recruited. Both groups were predominantly Chinese (93% vs 62%), breast cancer patients (87% vs 62%), and diagnosed with stage 2 cancer (60% vs 46%). Although no significant difference was found in QOL between groups, the XBYRT group exhibited improved emotional fatigue at T3 ( P = .045) and higher BDNF levels at T2 ( P = .047) and T3 ( P = .029). After baseline adjustment, XBYRT was associated with better perceived cognitive impairment at T2 ( P = .011) and T3 ( P = .017), as well as overall perceived cognitive function at T3 ( P = .028). XBYRT is well tolerated, with grade 3 adverse events reported in three XBYRT (20%) and two placebo (15%) subjects. Conclusion: In this pilot study, XBYRT as an integrative therapy is safe and generates encouraging improvements in cognitive and fatigue symptoms. Difficulties with recruitment limited the generalizability of trial findings, thus findings should be verified through a larger, multi-centered trial.
Outcomes of utilizing double-incision technique with combination of cortical button and interference screw fixation for distal biceps rupture: A case series
Authors: Fisher Brandon T , Chong Alexander CM , Feltz Kevin P , Berglund Howard T , Hurd Jason L 
Published: January 2025

Background Distal biceps tendon rupture is an injury that causes a significant reduction in strength and endurance. Combined cortical button and interference screw fixation has been utilized via single-incision technique. There are limited data describing this technique utilizing a double-incision approach. This study describes patient outcomes for primary distal biceps repair with combined cortical button and interference screw fixation via double-incision approach. Methods This is a case series analysis of patients within a single Midwest institution between January 2006 and February 2020. We examined patient demographics, intraoperative efficiency variables, patient outcomes, and postoperative complications. Results Sixty-two cases were included (62 males; 44 acute complete ruptures, 1 acute partial rupture, 8 chronic complete ruptures, 9 chronic partial ruptures). Average operative time was 48 ± 23 min. Nonformal manner postoperative range of motion (ROM) results show 89%–92% within satisfactory elbow ROM parameters. There were two reported postoperative complications, but no instances of neurapraxia, wound dehiscence, synostosis, proximal radius fracture, or fixation failure. Conclusion The findings of this study demonstrate that the described technique is safe, reliable, and effective. This will help surgeons determine the best method of fixation and approach with the goal of minimizing postoperative complications in patients with distal biceps ruptures.
Anti-Bacterial Activity of an Ancient Remedy Against Pathogenic Skin Infections
Authors: Orfali Raha , Ghaffar Safina , Orfali Razan Saud , AlAjlan Lateefa , Alsahli Ruzan , Alaqeel Shaden , Ameen Fuad , Perveen Shagufta 
Published: January 2025

Background/Objectives Skin and soft-tissue infections are among the most common infections and can develop severe local and systemic complications. Bacterial species: Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa and Escherichia coli usually cause skin infections. Studies of plants and natural materials used in ancient medicine to treat infections may assist us in further antibiotic discoveries. In this study, we tested the bactericidal activity of a 1000-years-old Arabic Al-Razi remedy against common skin infections Gram-positive and Gram-negative bacterial strains. Methods The antimicrobial activity was tested by agar diffusion method, after adding specific test sample, zone of inhibition was measured. Minimum inhibitory concentrations (MIC) of Al-Razi full remedy, dropout batches and single ingredients were performed by broth micro dilution assay. Results The mixture of all ingredients of this remedy (vinegar, gum arabic, boswellia, vitriol and aloe) has shown highest antibacterial activity against S. aureus, S. pyogenes, multi drug resistance (MDR) P. aeruginosa and clinical strain of P. aeruginosa. However, the presence of a single ingredient in water has shown no activity against tested bacterial strains except vitriol. Conclusion The AR remedy comprising several ingredients (vinegar, gum arabic, boswellia, vitriol and aloe) had shown great potential to inhibit skin infection bacterial strains ( S. aureus, S. pyogenes, MDR P. aeruginosa and the clinical strain of P. aeruginosa). In contrast, single ingredients (except vitriol) had shown no activity against all tested bacterial strains. These results suggest that combination of natural products has more potential against bacterial infections.
A systematic review of the effect of personal health records on patient activation
Authors: Osovskaya Irina , Blandford Ann , Potts Henry WW 
Published: January 2025

Background Personal health records (PHRs) or patient portals have been on the healthcare policy agenda for many countries as a promising mechanism to support patient-centred healthcare by making medical records accessible to patients and those assisting patients in health self-management. Studies on clinical outcome have been inconsistent. To help us to understand why, we propose to look at measures that precede clinical outcome, specifically patient engagement and activation. Patient activation describes the knowledge, skills and confidence a person has in managing their own health and healthcare. Objective To systematically review the current evidence on the impact of PHRs on patient activation. Methods A literature search was conducted for randomised controlled trials and quasi-experimental studies published up to January 2024 across EMBASE, PsycINFO, CINAHL and PubMed. Publications were included in the study if they examined any association between PHR use and activation. Results The search initially produced 3062 papers for review, of which 88 full-text articles were screened for eligibility. Two reviewers assessed 22 of these articles, and 8 papers were identified as meeting the selection criteria. Among these, seven studies found no statistically significant differences in activation. However, one study reported a significantly greater effect than the others. Data from seven randomised controlled trials and quasi-experimental studies examining the effects of PHRs on patient activation and similar measures were extracted for meta-analysis. Overall, the use of PHRs was associated with a 0.41 standardised mean difference increase in activation (95% confidence interval 0.31–0.51). There was a high degree of heterogeneity ( I² = 98%), with one study showing a much larger effect size compared to the rest. Conclusion Most studies showed little impact on activation, but one study found a large effect. This study notably offered PHRs combined with health coaching and training in the use of the system to their intervention group, which may indicate an important requirement for how to get the best out of a PHR system.
Surgical Repair of Double Outlet Right Ventricle Infants Guided by Three Dimensional-Computed Tomography Cardiac Modeling and Printing
Authors: Ganta Srujan , Ryan Justin R. , Lewis Michael J. , Nigro John J. 
Published: January 2025

Background Double outlet right ventricle (DORV) is a challenging congenital cardiac lesion to surgically master. We utilize computed tomography–guided-three-dimensional (3D) modeling/printing and novel in-house software to delineate anatomical relationships providing operative insight into the surgical approach. Our intent is to highlight this and showcase our technology. Methods We have created a repository of 3D heart reconstructions allowing for review of DORV patients. 3D intraoperative software anatomical manipulation and physical 3D prints were used to gain insight into DORV anatomy with the assistance of an on-site 3D Lab. The software used (Arc 3D Model Viewer) was designed in-house by our 3D Lab, tested and refined through ongoing use by our cardiothoracic surgery team. It allows for the subtraction and addition of anatomical structures and rotation in all axes. Clinicians can pan into the heart and determine specific anatomical boundaries and relationships. Results From 2010 to 2023, our program operated on 71 patients with DORV and our 3D lab has reconstructed 29 3D-hearts. Reconstructions were analyzed using Arc 3D Model Viewer. 3D reconstructions were viewed in our care conferences and intraoperatively allowing for discussion and determination of the optimal operative approach. Overall survival for DORV patients was 96% (68/71) with two mortalities in patients who did not receive 3D reconstructions. Conclusion 3D reconstruction has allowed decision-making to be moved out of the operating room into the preoperative planning phase. 3D reconstruction is now standard for all DORV patients in our surgical service. We hope to demonstrate this technology with our newly developed Arc 3D Model Viewer and summarize our clinical results.
High Mobility Group Box-1 (HMGB1)/microRNA-155 Axis in the Pathogenesis of Type 2 Diabetes Mellitus Associated Periodontitis: A Case Control Study
Authors: Appukuttan Devapriya , Subramanian Sangeetha , Prakash P. S. G. , Victor Dhayanand John , Mathews Leya 
Published: January 2025

Aim: To evaluate the role of the high mobility group box-1 (HMGB1)/miR-155 axis in the pathogenesis of stage III/IV periodontitis with and without type 2 diabetes mellitus (T2DM). Materials and Methods: A total of 48 patients were assigned into four groups (12 per group): group 1: systemically and periodontally healthy (PH), group 2: systemically healthy with stage III/IV periodontitis (PD), group 3: PH with T2DM (PH + T2DM), group 4: stage III/IV periodontitis with T2DM, HbA1c ≤ 7 (PD + T2DM). Site-specific plaque index (SS-PI), gingival index (SS-GI), mean probing pocket depth (M-PPD) and clinical attachment loss (M-CAL) were recorded. Gingival tissue samples were analysed for HMGB1 and miR-155 gene expression by real-time polymerase chain reaction. Results: The miR-155 fold change (FC) increased by 10.29, 8.1 and 5.6 times in groups 4, 3 and 2, respectively. Intergroup comparison of miR-155 FC showed a significant difference between the groups ( p < .05). HMGB1 FC increased by 6.5, 5.9 and 5.23 times in groups 4, 2 and 3, respectively, with no significant difference ( p > .05). miR-155 FC is positively and significantly correlated with M-PPD (group 1, 2 and total sample), site-specific plaque score (SS-PS) (group 4) and SS-GI (total sample). miR-155 could discriminate periodontal health from T2DM + PD based on area under the curve 0.82 ( p < .05) with 83.3% sensitivity, 75% specificity, 76.9% positive and 81.8% negative predictive value and 79.2% diagnostic accuracy. Conclusion: miR-155 is significantly upregulated in the diseased periodontium both in the presence and absence of T2DM. Further, miR-155 could be a potential diagnostic biomarker for diabetes-associated PD. However, the significance of HMGB1 and the HMGB1-miR155 axis in the aetiology of diabetes-associated PD is still unclear and warrants additional investigation.
Hip Arthroscopy and Its Impact on Performance in National Hockey League Players Using Team-Based Advanced Performance Statistics
Authors: LaPrade Christopher M. , LaPrade Matthew D. , Smith Haley E. , Dock Carissa C. , LaPrade Robert F. , Larson Christopher M. 
Published: January 2025

Background: Ice hockey players have a high rate of hip pathology, which can lead to hip arthroscopy. Previous studies have not utilized team-based advanced performance statistics in the setting of hip arthroscopy in National Hockey League (NHL) players. Purpose/Hypothesis: The purpose of this study was to use team-based advanced performance statistics to evaluate postoperative performance after hip arthroscopy in NHL players in comparison with their preoperative performance and matched controls of uninjured skaters. It was hypothesized that there would be no significant difference between preoperative and postoperative performance after hip arthroscopy in NHL players, as well as no difference when compared with matched controls of uninjured players. Study Design: Descriptive epidemiology study. Methods: There were 56 eligible NHL players found through public records who underwent hip arthroscopy over 12 seasons. Team-based advanced performance statistics including icetime, Corsi, Fenwick, goal, and expected goal percentages were recorded for the preinjury season, index season, and first 2 years after return to play (RTP). Relative percentages of each statistic were collected to allow for intrateam comparisons. A control group of NHL players without injury was collected and matched 1:2 by age, years of play, and draft round. Results: The RTP rate after hip arthroscopy at the NHL level was 89% for 1 season and 70% for 2 seasons. There were no significant decreases in performance in any advanced statistics after RTP after hip arthroscopy in comparison with the preinjury season or versus a matched control group of uninjured players. There was a significant decrease in games played in the injury season and the first year after RTP versus the preinjury season and versus a matched control group without differences thereafter. Conclusion: The RTP rate after hip arthroscopy at the NHL level was 89% for 1 season and 70% for 2 seasons. There were no significant decreases in team-based advanced performance statistics after RTP from hip arthroscopy for NHL players versus their preinjury levels or versus a matched control group of uninjured players. This indicates that NHL players who RTP at the NHL level are likely able to return to their previous level of performance, albeit playing in fewer games the first season after surgery.
Automated extraction of post-stroke functional outcomes from unstructured electronic health records
Authors: Fernandes Marta , Gallagher Kaileigh , Turley Niels , Gupta Aditya , Westover M Brandon , Singhal Aneesh B , Zafar Sahar F 
Published: January 2025

Purpose: Population level tracking of post-stroke functional outcomes is critical to guide interventions that reduce the burden of stroke-related disability. However, functional outcomes are often missing or documented in unstructured notes. We developed a natural language processing (NLP) model that reads electronic health records (EHR) notes to automatically determine the modified Rankin Scale (mRS). Method: We included consecutive patients (⩾18 years) with acute stroke admitted to our center (2015–2024). mRS scores were obtained from the Get With the Guidelines registry and clinical notes (if documented), and used as the gold standard to compare against NLP-generated scores. We used text-based features from notes, along with age, sex, discharge status, and outpatient follow-up to train a logistic regression for prediction of good (0–2) versus poor (3–6) mRS, and a linear regression for the full range of mRS scores. The models were trained for prediction of mRS at hospital discharge and post-discharge. The models were externally validated in a dataset of patients with brain injuries from a different healthcare center. Findings: We included 5307 patients, 5006 in train and test and 301 in validation; average age was 69 (SD 15) and 65 (SD 17) years, respectively; 47% female. The logistic regression achieved an area under the receiver operating curve (AUROC) of 0.94 [CI 0.93–0.95] (test) and 0.94 [0.91–0.96] (validation), and the linear model a root mean squared error (RMSE) of 0.91 [0.87–0.94] (test) and 1.17 [1.06–1.28] (validation). Discussion and Conclusion: The NLP-based model is suitable for use in large-scale phenotyping of stroke functional outcomes and population health research.
Nitrogen single and multiple breath washout test and lung imaging to detect treatment-related pulmonary toxicity in paediatric cancer patients and survivors: a systematic review
Authors: Schneider Christine , Koenig Christa , Žarković Maša , Stranzinger Enno , Rivero Tania M. , Rössler Jochen , Kuehni Claudia E. , Latzin Philipp , Schindera Christina , Usemann Jakob 
Published: January 2025

BackgroundSpirometry-based assessment of pulmonary function has limitations in detecting pulmonary toxicity following cancer treatment with chemotherapy, haematopoietic stem cell transplantation, radiotherapy or thoracic surgery. Nitrogen single and multiple breath washout tests are sensitive in assessing peripheral airway function, and lung imaging detects structural abnormalities, but little is known about their use in paediatric cancer patients and survivors. We aimed to 1) identify studies using nitrogen single or multiple breath washout tests and/or lung imaging to assess pulmonary toxicity in paediatric cancer patients and survivors, and 2) describe reported abnormalities.MethodWe systematically searched MEDLINE, Embase and the Cochrane Library for studies published in 1995‒2023. Eligible studies included paediatric cancer patients and survivors under 22 years of age receiving haematopoietic stem cell transplantation, chemotherapy, radiotherapy and/or thoracic surgery who underwent nitrogen single or multiple breath washout tests or lung imaging for detecting pulmonary toxicity. Two independent reviewers identified the studies, performed data extraction and assessed risk of bias.ResultsWe included 12 of 6544 publications. Three studies used nitrogen single or multiple breath washout tests, seven conducted lung imaging using computed tomography and two used both nitrogen single or multiple breath washout tests and lung imaging. Abnormal test results for nitrogen single and multiple breath washout tests and lung imaging were mainly reported following haematopoietic stem cell transplantation (67%). All studies performing lung imaging reported structural abnormalities. Study results were heterogeneous due to varying patient and methodological characteristics.ConclusionWe identified a limited number of studies, mainly after haematopoietic stem cell transplantation, reporting functional and structural lung abnormalities in paediatric cancer patients and survivors. Longitudinal studies with standardised assessments using nitrogen single or multiple breath washout tests and lung imaging are needed to improve our understanding of treatment-related pulmonary toxicity.
Correlation of precisely fabricated geometric characteristics of DNA-origami nanostructures with their cellular entry in human lens epithelial cells
Authors: Guo Yexuan , Xiong Tianze , Yan Hong , Zhang Rui Xue 
Published: January 2025

Abstract
Human lens epithelial cells (hLECs) are critical for lens transparency, and their aberrant metabolic activity and gene expression can lead to cataract. Intracellular delivery to hLECs, especially to sub-cellular organelles (e.g., mitochondrion and nucleus), is a key step in engineering cells for cell- and gene- based therapies. Despite a broad variety of nano- and microparticles can enter cells, their spatial characteristics relevant to cellular uptake and localization remains elusive. To investigate cellular internalization of nanostructures in hLECs, herein, DNA nanotechnology was exploited to precisely fabricate four distinct, mass-controlled DNA-origami nanostructures (DONs) through computer-aided design. Ensembled DONs included the rods, ring, triangle, and octahedron with defined geometric parameters of accessible surface area, effective volume, compactness, aspect ratio, size and vertex number. Atomic force microscopy and agarose gel electrophoresis showed that four DONs self-assembled within 3.5h with up to 59% yield and exhibited structural intactness in cell culture medium for 4 h. Flow cytometry analysis of four Cy5-labelled DONs in hLECs HLE-B3 found time-dependent cellular uptake over 2 h, among which the octahedron and triangle had higher cellular accumulation than the rod and ring. More importantly, the vertex number among other geometric parameters was positively correlated with cellular entry. Confocal images further revealed that four DONs had preferential localization at mitochondria to nucleus at 2 h in HLE-B3 cells, and the degree of their biodistribution varied among DONs as evidenced by Manders’ correlation coefficient. This study demonstrates the DONs dependent cellular uptake and intracellular compartment localization in hLECs, heralding the future design of structure-modulating delivery of nanomedicine for ocular therapy.

Graphical abstract
A new approach for hemodynamics of varicoceles: blood flow patterns based on contrast-enhanced ultrasound
Authors: Zou Penglin , Fan Gaoxiang , Li Zheng , Tao Yuchen , Jia Chao , Liang Hongmei , Tian Ruhui , Shi Qiusheng , Hu Jianlin , Wu Rong 
Published: January 2025

Abstract

Background
Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters. This study included 165 patients with left-sided VC and 50 healthy volunteers. All participants underwent CEUS of the spermatic veins, along with maximum venous diameter and testicular volume measurements and serum sex hormone levels and routine semen analyses. The sperm DNA fragmentation index was measured in 146 patients with VC and 37 healthy controls.

Results
The analyses revealed four distinct blood flow patterns of the spermatic vein: steady flow, intermittent stasis, intermittent reflux, and filling defect. In healthy spermatic veins, the predominant blood flow patterns included steady flow and intermittent stasis. Spermatic veins with VC exhibited a significant increase in the intermittent reflux and filling defect patterns, with the proportion rising as the clinical grade increased. The four patterns were further grouped into the “steady flow & intermittent stasis” and “intermittent reflux & filling defect” patterns for logistic regression analyses; the intermittent reflux & filling defect pattern was revealed as an independent risk factor for impaired sperm concentration, total sperm counts, progressive motility, morphology, and DNA fragmentation index.

Conclusions
This study validated the feasibility of CEUS for assessing the hemodynamics of the spermatic vein and established the intermittent reflux & filling defect pattern as an independent predictor of impaired semen parameters.