bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of autologous platelet-rich plasma for diabetic foot ulcer healing: a systematic review and meta-analysis of randomized controlled trials
Authors: Deng Juan , Yang Mei , Zhang Xingyu , Zhang Hongmin 
Published: May 2023

Abstract
Background
The occurrence of a diabetic foot ulcer (DFU) is a significant complication of diabetes that often precedes the need for amputation. Autologous platelet-rich plasma (Au-PRP), a substance abundant in various growth factors and cytokines, is increasingly being recognized as a promising method for promoting ulcer healing due to its potential similarities to the physiological wound healing process.

Methods
The databases Medline, EMBASE, PubMed, and the Cochrane Library were systematically accessed on January 26, 2023, without any consideration for the date of publication. The selection and assessment of research studies were conducted autonomously, based on predetermined criteria and methodological standards. Two researchers gathered data and evaluated the potential for bias separately. We utilize the Stata 17.0 software to conduct data analysis and generate relevant visual representations.

Results
The results of the meta-analysis indicate that autologous PRP has a significant positive effect on the healing rate (RR = 1.42, 95% CI 1.30–1.56, P < 0.001), reduces the healing time (MD = − 3.13, 95% CI − 5.86 to − 0.39, P < 0.001), accelerates the reduction of ulcer area (MD = 1.02, 95% CI 0.51–1.53, P < 0.001), decreases the rate of amputation (RR = 0.35, 95% CI 0.15–0.83, P < 0.001), and does not increase the incidence of adverse events (RR = 0.96, 95% CI 0.57–1.61, P > 0.05) when compared to conventional therapy.

Conclusions
Au-PRP therapy has been shown to facilitate the process of wound healing and represents a viable and secure therapeutic alternative for individuals with DFU.
Quick Epidural Top-up with Alkalinized Lidocaine for emergent caesarean delivery (QETAL study): protocol for a randomized, controlled, bicentric trial
Authors: Lechat Thomas , d’Aprigny Thomas , Henriot Jérémy , Arthur Jill , Sylla Dienabou , Bénard Antoine , Nouette-Gaulain Karine 
Published: May 2023

Abstract
Background
General anesthesia in pregnant women can be associated with significant maternal and fetal morbidity. Emergency caesarean section can be performed by converting labor epidural analgesia to surgical anesthesia by injecting high-dose short-acting local anesthetics through the epidural catheter. The effectiveness and the delay to obtain surgical anesthesia depends upon the protocol used. Data indicate that alkalinization of local anesthetics may shorten their onset of action and increase their effectiveness. This study investigates whether alkalinization of adrenalized lidocaine could increase the efficacy and decrease the delay of onset of surgical anesthesia via an indwelling epidural catheter, thus decreasing the necessity to resort to general anesthesia for emergency caesarean deliveries.

Methods
This study will be a bicentric, double-blind, randomized, controlled trial with two parallel groups of 66 women who require emergency caesarian deliveries and who have been receiving epidural labor analgesia. The number of subjects in groups will be unbalanced with a 2:1 ratio of experimental:control. In both groups, all eligible patients will have had an epidural catheter placed for labor analgesia with levobupicaine or ropivacaine. Patient randomization will occur when the decision is made by the surgeon that an emergency caesarean delivery is indicated. Surgical anesthesia will be obtained by injecting 20 mL of 2% lidocaine with epinephrine 1:200,000, or 10 mL 2% lidocaine with epinephrine 1:200,000 plus 2 mL sodium bicarbonate 4.2% (total of 12 mL). The primary outcome will be the rate of conversion to general anesthesia for failure of the epidural to provide adequate analgesia. This study will be powered to detect a 50% reduction in the incidence of general anesthesia, from 80 to 40%, with a confidence ratio of 90%.

Discussion
Sodium bicarbonate could be used to avoid general anesthesia for emergency caesarean deliveries by providing reliable and effective surgical anesthesia in women with pre-existing labor epidural catheters is promising. This randomized controlled trial seeks to determine the optimal local anesthetic mixture for converting epidural analgesia to surgical anesthesia for emergency caesarean sections. This may decrease the need for general anesthesia for emergency caesarian section, shorten the time to fetal extraction, and improve safety and patient satisfaction.

Trial registration
ClinicalTrials.gov NCT05313256. Registered on 6 April 2022
Sex-based differences in cardiovascular proteomic profiles and their associations with adverse outcomes in patients with chronic heart failure
Authors: de Bakker Marie , Petersen Teun B. , Akkerhuis K. Martijn , Harakalova Magdalena , Umans Victor A. , Germans Tjeerd , Caliskan Kadir , Katsikis Peter D. , van der Spek Peter J. , Suthahar Navin , de Boer Rudolf A. , Rizopoulos Dimitris , Asselbergs Folkert W. , Boersma Eric , Kardys Isabella 
Published: May 2023

Abstract
Background
Studies focusing on sex differences in circulating proteins in patients with heart failure with reduced ejection fraction (HFrEF) are scarce. Insight into sex-specific cardiovascular protein profiles and their associations with the risk of adverse outcomes may contribute to a better understanding of the pathophysiological processes involved in HFrEF. Moreover, it could provide a basis for the use of circulating protein measurements for prognostication in women and men, wherein the most relevant protein measurements are applied in each of the sexes.

Methods
In 382 patients with HFrEF, we performed tri-monthly blood sampling (median follow-up: 25 [13–31] months). We selected all baseline samples and two samples closest to the primary endpoint (PEP: composite of cardiovascular death, heart transplantation, left ventricular assist device implantation, and HF hospitalization) or censoring. We then applied an aptamer-based multiplex proteomic assay identifying 1105 proteins previously associated with cardiovascular disease. We used linear regression models and gene-enrichment analysis to study sex-based differences in baseline levels. We used time-dependent Cox models to study differences in the prognostic value of serially measured proteins. All models were adjusted for the MAGGIC HF mortality risk score and p-values for multiple testing.

Results
In 104 women and 278 men (mean age 62 and 64 years, respectively) cumulative PEP incidence at 30 months was 25% and 35%, respectively. At baseline, 55 (5%) out of the 1105 proteins were significantly different between women and men. The female protein profile was most strongly associated with extracellular matrix organization, while the male profile was dominated by regulation of cell death. The association of endothelin-1 (Pinteraction < 0.001) and somatostatin (Pinteraction = 0.040) with the PEP was modified by sex, independent of clinical characteristics. Endothelin-1 was more strongly associated with the PEP in men (HR 2.62 [95%CI, 1.98, 3.46], p < 0.001) compared to women (1.14 [1.01, 1.29], p = 0.036). Somatostatin was positively associated with the PEP in men (1.23 [1.10, 1.38], p < 0.001), but inversely associated in women (0.33 [0.12, 0.93], p = 0.036).

Conclusion
Baseline cardiovascular protein levels differ between women and men. However, the predictive value of repeatedly measured circulating proteins does not seem to differ except for endothelin-1 and somatostatin.
The costs associated with stroke care continuum: a systematic review
Authors: Lucas-Noll Jorgina , Clua-Espuny José L. , Lleixà-Fortuño Mar , Gavaldà-Espelta Ester , Queralt-Tomas Lluïsa , Panisello-Tafalla Anna , Carles-Lavila Misericòrdia 
Published: May 2023

AbstractStroke, a leading cause of death and long-term disability, has a considerable social and economic impact. It is imperative to investigate stroke-related costs. The main goal was to conduct a systematic literature review on the described costs associated with stroke care continuum to better understand the evolution of the economic burden and logistic challenges. This research used a systematic review method. We performed a search in PubMed/MEDLINE, ClinicalTrial.gov, Cochrane Reviews, and Google Scholar confined to publications from January 2012 to December 2021. Prices were adjusted using consumer price indices of the countries in the studies in the years the costs were incurred to 2021 Euros using the World Bank and purchasing power parity exchange rate in 2020 from the Organization for Economic Co-operation and Development with the XE Currency Data API. The inclusion criteria were all types of publications, including prospective cost studies, retrospective cost studies, database analyses, mathematical models, surveys, and cost-of-illness (COI) studies. Were excluded studies that (a) were not about stroke, (b) were editorials and commentaries, (c) were irrelevant after screening the title and abstract,(d) grey literature and non-academic studies, (e) reported cost indicators outside the scope of the review, (f) economic evaluations (i.e., cost-effectiveness or cost–benefit analyses); and (g) studies not meeting the population inclusion criteria. There may be risk of bias because the effects are dependent on the persons delivering the intervention. The results were synthetized by PRISMA method. A total of 724 potential abstracts were identified of which 25 articles were pulled for further investigation. The articles were classified into the following categories: 1)stroke primary prevention, 2) expenditures related to acute stroke care, 3) expenditures for post-acute strokes, and 4) global average stroke cost. The measured expenditures varied considerably among these studies with a global average cost from €610-€220,822.45. Given the great variability in the costs in different studies, we can conclude that we need to define a common system for assessing the costs of strokes. Possible limitations are related to clinical choices exposed to decision rules that trigger decisions alerts within stroke events in a clinical setting. This flowchart is based on the guidelines for acute ischemic stroke treatment but may not be applicable to all institutions.
Thermoluminescence and radiocarbon dating of pre-colonial ceramics and organic midden material from the US Virgin Islands: outline for a revised chronology
Authors: Torres Joshua , Toftgaard Casper Jacobsen , Delbey Thomas , Brewer David , Farchette John , de La Fuente Guillermo , Rasmussen Kaare Lund 
Published: May 2023

Abstract
A sample of 128 pottery shards curated by the National Museum of Denmark, from seven archaeological sites in the US Virgin Islands, has been dated using the thermoluminescence dating (TL) technique with the purpose of refining local pre-colonial pottery chronology. The results of the TL-dating generally confirm chronologies offered by Wild for St. John and there is considerable variation identified in traditional frameworks due to overlap in distributions of various pottery styles. The results of this study show that the Virgin Islands offer a viable space for the application of TL-dating, and that TL-dating offer a reliable addition to the traditional radiometric radiocarbon technique in pre-colonial midden contexts. Using the TL-technique for dating of pottery assemblages allows for a nuanced chronology and better understanding of settlement timing, socio-cultural interaction, and information transmission.

Graphical Abstract
Unified platform for storing, retrieving, and analysing biomechanical applications data using graph database
Authors: Hribernik Matevž , Tomažič Sašo , Umek Anton , Kos Anton 
Published: May 2023

AbstractSensors and smart equipment are frequently used in biomechanical systems and applications in sports and rehabilitation to measure various physical quantities. Various sensors, measuring different parameters, can produce a large amount of data at high speeds and volumes that must be stored for real-time or post-processing and analysis. In addition to sensor data, metadata is an important component and can vary between biomechanical applications. Currently however, each application typically has its own unique data flow and storage solution. In this research, we present a universal data model solution that can be applied to any sensor-based biomechanical application in sport and physical rehabilitation. Our proposed cloud platform architecture allows for the manipulation of sensor data and metadata using a combination of Big Data and conventional techniques. The main idea of this research is to develop a platform that allows a universal way for any biomechanical application to handle its data regardless of the type of data and metadata. This is achieved by creating a universal data model, and implementing this data model in a generalized architecture using a graph database. We demonstrate the benefits of this approach using examples from existing biomechanical systems and describe the development of the cloud platform architecture and the underlying data model. We also provide an example of the use of this platform in a sport shooting application. This approach is unique in that it allows data from different sources and applications to be stored and processed using the same procedures and techniques, facilitating data analysis and application development. We envision this system will expand to multiple different biomechanical applications in the future. We expect that in time, the ability to compare various data and store different biomechanical datasets will become necessity. With the advantages of modern recommender systems and utilization of artificial intelligence, huge amounts of relevant and well-prepared data with useful metadata are required thus having such system is an important advantage for future biomechanical systems development. With the increase of people’s awareness and usage of devices that increase well-being and quality of life, presented platform and similar systems will play a pivotal role in shaping the future lifestyle.
Prospective Randomized Trial of Docetaxel Versus Best Supportive Care in Patients With Non–Small-Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy
Authors: Shepherd Frances A. , Dancey Janet , Ramlau Rodryg , Mattson Karin , Gralla Richard , O’Rourke Mark , Levitan Nathan , Gressot Laurent , Vincent Mark , Burkes Ronald , Coughlin Susan , Kim Yong , Berille Jocelyne 
Published: May 2023

PURPOSE To evaluate whether treatment with single-agent docetaxel would result in longer survival than would best supportive care in patients with non–small-cell lung cancer who had previously been treated with platinum-based chemotherapy. Secondary end points included assessment of response (docetaxel arm only), toxicity, and quality of life. PATIENTS AND METHODS: Patients with performance statuses of 0 to 2 and stage IIIB/IV non–small-cell lung cancer with either measurable or evaluable lesions were eligible for entry onto the study if they had undergone one or more platinum-based chemotherapy regimens and if they had adequate hematology and biochemistry parameters. They were excluded if they had symptomatic brain metastases or if they had previously been treated with paclitaxel. Patients were stratified by performance status and best response to cisplatin chemotherapy and were then randomized to treatment with docetaxel 100 mg/m2 (49 patients) or 75 mg/m2 (55 patients) or best supportive care. Patients in both arms were assessed every 3 weeks. RESULTS One hundred four patients (103 of whom were eligible for entry onto the study) were well balanced for prognostic factors. Of 84 patients with measurable lesions, six (7.1%) achieved partial responses (three patients at each dose level). Time to progression was longer for docetaxel patients than for best supportive care patients (10.6 v 6.7 weeks, respectively; P < .001), as was median survival (7.0 v 4.6 months; log-rank test, P = .047). The difference was more significant for docetaxel 75 mg/m2 patients, compared with corresponding best supportive care patients (7.5 v 4.6 months; log-rank test, P = .010; 1-year survival, 37% v 11%; χ2 test, P = .003). Febrile neutropenia occurred in 11 patients treated with docetaxel 100 mg/m2, three of whom died, and in one patient treated with docetaxel 75 mg/m2. Grade 3 or 4 nonhematologic toxicity, with the exception of diarrhea, occurred at a similar rate in both the docetaxel and best supportive care groups. CONCLUSION Treatment with docetaxel is associated with significant prolongation of survival, and at a dose of 75 mg/m2, the benefits of docetaxel therapy outweigh the risks.
MLH1 Loss in Primary Prostate Cancer
Authors: Nourmohammadi Abadchi Sanaz , Sena Laura A. , Antonarakis Emmanuel S. , Pritchard Colin C. , Eshleman James R. , Konnick Eric Q. , Salipante Stephen J. , Shenderov Eugene , Lotan Tamara L. 
Published: May 2023

PURPOSE Among mismatch repair-deficient (MMRd) prostate cancers, loss of MLH1 is relatively uncommon and few cases have been reported in detail. METHODS Here, we describe the molecular features of two cases of primary prostate cancer with MLH1 loss detected by immunohistochemistry, and in one case, confirmed via transcriptomic profiling. RESULTS Both cases were microsatellite stable on standard polymerase chain reaction (PCR)–based microsatellite instability (MSI) testing, but showed evidence of MSI on a newer PCR-based long mononucleotide repeat (LMR) assay and by next-generation sequencing. Germline testing was negative for Lynch syndrome–associated mutations in both cases. Targeted or whole-exome tumor sequencing using multiple commercial/academic platforms (Foundation, Tempus, JHU, and UW-OncoPlex) showed modestly elevated, though variable, tumor mutation burden estimates (2.3-10 mutations/Mb) consistent with MMRd, but without identifiable pathogenic single-nucleotide or indel mutations in MLH1. Copy-number analysis confirmed biallelic MLH1 loss in one case and monoallelic MLH1 loss in the second case, without evidence of MLH1 promoter hypermethylation in either. The second patient was treated with single-agent pembrolizumab and demonstrated a short-lived prostate-specific antigen response. CONCLUSION These cases highlight the challenges in identifying MLH1-deficient prostate cancers using standard MSI testing and commercial sequencing panels, and support the utility of immunohistochemical assays and LMR- or sequencing-based MSI testing for detection of MMRd prostate cancers.
Visual environment of rearing sites affects larval response to perceived risk in poison frogs
Authors: Fouilloux Chloe A. , Stynoski Jennifer L. , Yovanovich Carola A. M. , Rojas Bibiana 
Published: May 2023

ABSTRACT
Turbidity challenges the visual performance of aquatic animals. Here, we use the natural diversity of ephemeral rearing sites occupied by tadpoles of two poison frog species to explore the relationship between environments with limited visibility and individual response to perceived risk. To compare how species with diverse natural histories respond to risk after developing in a range of photic environments, we sampled wild tadpoles of (1) Dendrobates tinctorius, a rearing-site generalist with facultatively cannibalistic tadpoles and (2) Oophaga pumilio, a small-pool specialist dependent on maternal food-provisioning. Using experimental arenas, we measured tadpole activity and space use first on a black and white background, and then on either black or white backgrounds where tadpoles were exposed to potentially predatory visual stimuli. The effects of rearing environment on D. tinctorius tadpoles were clear: tadpoles from darker pools were less active than tadpoles from brighter pools and did not respond to the visual stimuli, whereas tadpoles from brighter pools swam more when paired with conspecifics versus predatory insect larvae, suggesting that tadpoles can visually discriminate between predators. For O. pumilio, tadpoles were more active on experimental backgrounds that more closely matched the luminosity of their rearing sites, but their responses to the two visual stimuli did not differ. Larval specialisation associated with species-specific microhabitats may underlie the observed responses to visual stimuli. Our findings demonstrate that light availability in wild larval rearing conditions influences risk perception in novel contexts, and provides insight into how visually guided animals may respond to sudden environmental disturbances.
Life before limb: What about life after limb loss? A perspective from a low middle class income country: A Surgical Perspective
Authors: Siddiqui Nadeem Ahmed , Pirzada Ammar , Virji Safna Naozer 
Published: May 2023

doi: https://doi.org/10.12669/pjms.39.4.7038
How to cite this: Siddiqui NA, Pirzada A, Virji SN. Life before limb: What about life after limb loss? A perspective from a low middle class income country: A Surgical Perspective. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7038
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
COVID-19 prevention efforts at Al-Zahraa University in the eyes of the students: A cross-sectional study from Iraq
Authors: Al-Kazzaz Hassan 
Published: May 2023

Background: For institutions in Iraq, the new coronavirus disease 2019 (COVID-19) pandemic has become a problem. In terms of the dissemination of COVID-19, Al Zahraa University is particularly risky due to the presence of susceptible, high-risk populations there. Methods: A total of 182 undergraduates at the Health and Medical Technology College took part. A cross-sectional, questionnaire-based study was done to evaluate the COVID-19 preventative measures for students at Al-Zahra University for Women. The study questionnaire received a 100% response rate, and the data were collected and analyzed. Results: It showed that of the participants, 53 (29.1%) were 20 years old, and 151 (82.9%) lived in Karbala. 120 (65.9%) students did not think the university applied preventive measures against COVID-19, and 94 (52%) thought the university ensured mask-wearing on campus. Regarding social distancing, 161 (88.4%) believed it was not enforced. 158 (86.8%) and 116 (63.7%) of the participants, respectively, thought that there were no preventive measures against Covid-19 in the campus cafeteria or no preventive measures when using university transportation. Conclusions: During the COVID-19 pandemic, Al-Zahraa University's execution of prevention and control measures were weak. Interventions are urgently needed to improve the effectiveness of its preventive measures. The inadequacy of COVID-19 safety measures highlights the need for national guidance.
Safety and Modern Compulsory Insurance of Drivers’ Civil Liability (CTP): Social Aspect
Authors: Skubriy E. , Mel'nichuk I. 
Published: May 2023

Th e article summarizes the issues of safety on the roads of Russia and the need to comply with the country’s legislation on drivers’ insurance of their liability for violations of traffic rules that led to tra ffi c accidents that caused the death of people and damage to citizens’ property. Some directions are proposed to change the situation with safety on the roads of Russia.