bluuebunny/crossref_metadata_2025_split huggingface dataset:
Canonical Wnt signaling activation by chimeric antigen receptors for efficient cardiac differentiation from mouse embryonic stem cells
Authors: Sogo Takahiro , Nakao Shu , Tsukamoto Tasuku , Ueyama Tomoe , Harada Yukihiro , Ihara Dai , Ishida Tomoaki , Nakahara Masato , Hasegawa Koji , Akagi Yuka , Kida Yasuyuki S. , Nakagawa Osamu , Nagamune Teruyuki , Kawahara Masahiro , Kawamura Teruhisa 
Published: February 2023

Abstract
Background
Canonical Wnt signaling is involved in a variety of biological processes including stem cell renewal and differentiation, embryonic development, and tissue regeneration. Previous studies reported the stage-specific roles of the Wnt signaling in heart development. Canonical Wnt signal activation by recombinant Wnt3a in the early phase of differentiation enhances the efficiency of myocardial cell production from pluripotent stem cells. However, the hydrophobicity of Wnt proteins results in high cost to produce the recombinant proteins and presents an obstacle to their preparation and application for therapeutics, cell therapy, or molecular analysis of Wnt signaling.

Methods
To solve this problem, we generated an inexpensive molecule-responsive differentiation-inducing chimeric antigen receptor (designated as diCAR) that can activate Wnt3a signaling. The extracellular domains of low-density-lipoprotein receptor-related protein 6 (LRP6) and frizzeled-8 (FZD8) were replaced with single-chain Fv of anti-fluorescein (FL) antibody, which can respond to FL-conjugated bovine serum albumin (BSA-FL) as a cognate ligand. We then analyzed the effect of this diCAR on Wnt signal activation and cardiomyocyte differentiation of mouse embryonic stem cells in response to BSA-FL treatment.

Results
Embryonic stem cell lines stably expressing this paired diCAR, named Wnt3a-diCAR, showed TCF/β-catenin-dependent transactivation by BSA-FL in a dose-dependent manner. Treatment with either Wnt3a recombinant protein or BSA-FL in the early phase of differentiation revealed similar changes of global gene expressions and resulted in efficient myocardial cell differentiation. Furthermore, BSA-FL-mediated signal activation was not affected by a Wnt3a antagonist, Dkk1, suggesting that the signal transduction via Wnt3a-diCAR is independent of endogenous LRP6 or FZD8.

Conclusion
We anticipate that Wnt3a-diCAR enables target-specific signal activation, and could be an economical and powerful tool for stem cell-based regeneration therapy.
International and Multicenter Prospective Controlled Study of Dysphagia After Anterior Cervical Spine Surgery
Authors: Falavigna Asdrubal , Arruda André de Oliveira , Righesso Neto Orlando , Dozza Diego , Guyot Juan Pablo , Yurac Ratko , Jalón Pablo Gustavo , Avila José Maria Jiménez , Zárate Barón , Scheverin Nicolas , Ghogawala Zoher 
Published: February 2023

BACKGROUND:
In the context of anterior approach to the cervical spine, dysphagia is a common complication and still without a clear distinction of risk factors.

OBJECTIVE:
To analyze the risk factors of dysphagia after cervical spine surgery.

METHODS:
Multicenter prospective study evaluated patients who underwent anterior cervical spine surgery for degenerative pathologies, studying surgical, anesthesia, base disease, and radiological variables (preoperatively, 24 hours, 1 and 3 weeks, and 6 months after surgery), with control group matched. Postoperative dysphagia was assessed by Swallowing Satisfaction Index and Swallowing Questionnaire; besides, based on multiple logistic regression model, a risk factor analysis correlation was applied.

RESULTS:
In total, 233 cervical patients were evaluated; most common level approached was C5-C6 (71.8%). All showed same decreasing trade for dysphagia incidence—with more cases on cervical group (P < .05); severe cases were rare. At postoperative day 1, identified risk factors were approach to C3-C4 (4.11, P < .01), loss of preoperative cervical lordosis (2.26, P < .01), intubation attempts ≥2 (3.10, P < .01), and left side approach (1.85, P = .02); at day 7, body mass index ≥30 (2.29, P = .02), C3-C4 (3.42, P < .01), and length of surgery ≥90 minutes (2.97, P = .005); and at day 21, C3-C4 were kept as a risk factor (3.62, P < .01).

CONCLUSION:
A high incidence level of dysphagia was identified, having a clear decreasing trending (number of cases and severity) through postoperative time points; considering possible risk factors, strongest correlation was the approach at the C3-C4 level—statistically significant at the 24 hours, 7 days, and 21 days assessment.
Mayer-Rokitansky-Küster-Hauser syndrome - a review based on recent advances in medicine
Authors: Tomkiewicz Julia , Tomkiewicz Michał , Olko Paweł , Radulski Jakub , Licak Gabriela , Bętkowska Paulina , Paluch Michał , Sałata Piotr , Szczuraszek Paulina , Szczuraszek Hugo 
Published: February 2023

Introduction

Meyer-Rokitanski-Küster-Hauser syndrome, also reffered to as Müllerian aplasia, is a congenital disorder characterized by agenesis or hypoplasia of the uterus and upper part of the vagina in female with normal female karyotype (46,XX). In these women the external genitalia have a normal structure and their internal endocrine organs function properly. Most often, this syndrome is diagnosed in adolescence due to primary amenorrhea.

Material and methods

This review was based on available data collected in the PubMed data base and Google Scholar data and published between 2011 and 2021. The research was done by looking through keywords such as:“Mayer-Rokitansky-Küster-Hauser syndrome”, “MRKH syndrome”, “uterine agenesis” and “primary amenorrhea”, "vaginal agenesis", "uterus transplantation".

Conclusions

Recent scientific achievements have shown how much can be changed in the lives of patients with MRKH syndrome. It should be remembered that this is a disease that needs treatment by specialists in many fields. Treatment should include not only medical side of problem but also should take care of psychical side of patients life. During the last 10 years several advances have been made in MRKH syndrome research, especially within the fields of genetics, non-surgical management, and uterus transplantation as the first available fertility treatment.
ANATOMIC FACTORS ASSOCIATED WITH PARTIAL DISTAL BICEPS TENDON TEARS: A COMPARATIVE CONTROL STUDY
Authors: Boyle A.B. , George C.M. , MacLean S.B.M. 
Published: February 2023

A larger radial tuberosity, and therefore a smaller radioulnar space, may cause mechanical impingement of the DBT predisposing to tear. We sought to investigate anatomic factors associated with partial DBT tears by retrospectively reviewing 3-T MRI scans of elbows with partial DBT tears and a normal elbow comparison group3-T MRI scans of elbows with partial DBT tears and elbows with no known pathology were reviewed retrospectively by two independent observers. Basic demographic data were collected and measurements of radial tuberosity length, radial tuberosity thickness, radio-ulnar space, and radial tuberosity-ulnar space were made using simultaneous tracker lines and a standardised technique. The presence or absence of enthesophytes and the presence of a single or double DBT were noted.26 3-T MRI scans of 26 elbows with partial DBT tears and 30 3-T MRI scans of 30 elbows without pathology were included. Basic demographic data was comparable between the two groups. The tear group showed statistically significant larger mean measurements for radial tuberosity length (24.3mm vs 21.3mm, p=0.002), and radial tuberosity thickness (5.5mm vs 3.7mm, p=<0.0001. The tear group also showed statistically significant smaller measurements for radio-ulnar space (8.2mm vs 10.0mm, p=0.010), and radial tuberosity-ulnar space (7.2mm vs 9.1mm, p=0.013). There was a statistically significant positive correlation between partial DBT tears and presence of enthesophytes (p=0.007) as well as between partial DBT tears and having two discrete DBTs rather than a single or interdigitating tendon (p=<0.0001).Larger radial tuberosities, and smaller radio-ulnar and radial tuberosity-ulnar spaces are associated with partial DBT tears. This may be due to chronic impingement, tendon delamination and consequent weakness which ultimately leads to tears. Enthesophytes may be associated with tears for the same reason. Having two discrete DBTs that do not interdigitate prior to insertion is also associated with partial tears.
INCREASED RISK OF UNDERGOING HIP ARTHROPLASTY AT A YOUNGER AGE IN OBESE AUSTRALIANS
Authors: Truong A.P. , Wall C.J. , Stoney J. , Graves S.E. , Lorimer M.F. , de Steiger R.N. 
Published: February 2023

Obesity is a known risk factor for hip osteoarthritis. The aim of this study was to compare the incidence of obesity in Australians undergoing hip replacements (HR) for osteoarthritis to the general population.A cohort study was conducted comparing data from the Australian Bureau of Statistics and the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) from 2017-18. Body mass index (BMI) data for patients undergoing primary total hip replacement and resurfacing for osteoarthritis were obtained from the AOANJRR. The distribution of HR patients by BMI category was compared to the general population, in age and sex sub-groups.During the study period, 32,495 primary HR were performed for osteoarthritis in Australia. Compared to the general population, there was a higher incidence of Class I, II, and III obesity in patients undergoing HR in both sexes aged 35 to 74 years old. Class III obese females and males undergoing HR were on average 6 to 7 years younger than their normal weight counterparts. Class III obese females and males aged 55-64 years old were 2.9 and 1.7 times more likely to undergo HR, respectively (p<0.001).There is a strong association between increased BMI and relative risk of undergoing HR. Similar findings have been noted in the United States of America, Canada, United Kingdom, Sweden and Spain. A New Zealand Registry study and recent meta-analysis have also found a concerning trend of Class III obese patients undergoing HR at a younger age.Obese Australians are at increased risk of undergoing HR at a younger age. A national approach to address the prevalence of obesity is needed.
COMPARISON OF RATES OF ASEPTIC LOOSENING IN HIGH OFFSET VERSUS STANDARD OFFSET CEMENTLESS FEMORAL STEMS
Authors: Faveere A. , Milne L. , Holder C. , Graves S.E. 
Published: February 2023

Increasing femoral offset in total hip replacement (THR) has several benefits including improved hip abductor strength and enhanced range of motion. Biomechanical studies have suggested that this may negatively impact on stem stability. However, it is unclear whether this has a clinical impact. Using data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), the aim of this study was to determine the impact of stem offset and stem size for the three most common cementless THR prostheses revised for aseptic loosening.The study period was September 1999 to December 2020. The study population included all primary procedures for osteoarthritis with a cementless THR using the Corail, Quadra-H and Polarstem. Procedures were divided into small and large stem sizes and by standard and high stem offset for each stem system. Hazard ratios (HR) from Cox proportional hazards models, adjusting for age and gender, were performed to compare revision for aseptic loosening for offset and stem size for each of the three femoral stems.There were 55,194 Corail stems, 13,642 Quadra-H stem, and 13,736 Polarstem prostheses included in this study. For the Corail stem, offset had an impact only when small stems were used (sizes 8-11). Revision for aseptic loosening was increased for the high offset stem (HR=1.90;95% CI 1.53–2.37;p<0.001).There was also a higher revision risk for aseptic loosening for high offset small size Quadra-H stems (sizes 0-3). Similar to the Corail stem, offset did not impact on the revision risk for larger stems (Corail sizes 12-20, Quadra-H sizes 4-7). The Polarstem did not show any difference in aseptic loosening revision risk when high and standard offset stems were compared, and this was irrespective of stem size.High offset may be associated with increased revision for aseptic loosening, but this is both stem size and prosthesis specific.
COST-EFFECTIVENESS AND PATIENT SATISFACTION OUTCOMES OF SINGLE-STAGE VERSUS TWO-STAGE REVISION SHOULDER ARTHROPLASTY
Authors: Gupta A. , Launay M. , Maharaj J. , Salhi A. , Hollman F. , Tok A. , Gilliland L. , Pather S. , Cutbush K. 
Published: February 2023

Complications such as implant loosening, infection, periprosthetic fracture or instability may lead to revision arthroplasty procedures. There is limited literature comparing single-stage and two-stage revision shoulder arthroplasty. This study aims to compare clinical outcomes and cost benefit between single-stage and two-stage revision procedures.Thirty-one revision procedures (mean age 72+/-7, 15 males and 16 females) performed between 2016 and 2021 were included (27 revision RSA, 2 revision TSA, 2 failed ORIFs). Two-stage procedures were carried out 4-6 weeks apart. Single-stage procedures included debridement, implant removal and washout, followed by re-prep, re-drape and reconstruction with new instrumentations. Clinical parameters including length of stay, VAS, patient satisfaction was recorded preoperatively and at mean 12-months follow up. Cost benefit analysis were performed.Seven revisions were two-stage procedures and 24 were single-stage procedures. There were 5 infections in the two-stage group vs 14 in the single-stage group. We noted two cases of unstable RSA and 8 other causes for single-stage revision. Majority of the revisions were complex procedures requiring significant glenoid and/or humeral allografts and tendon transfers to compensate for soft tissue loss. No custom implants were used in our series.Hospital stay was reduced from 41+/-29 days for 2-stage procedures to 16+/-13 days for single-stage (p<0.05). VAS improved from 9+/-1 to 2+/-4 for two-stage procedures and from 5+/-3 to 1+/-2 for single-stages. The average total cost of hospital and patient was reduced by two-thirds. Patient satisfaction in the single-stage group was 43% which was comparable to the two-stage group.All infections were successfully treated with no recurrence of infection in our cohort of 31 patients. There was no instability postoperatively. 3 patients had postoperative neural symptoms which resolved within 6 months.Single-stage procedures for revision shoulder arthroplasty significantly decrease hospital stay, improve patients’ satisfaction, and reduced surgical costs.
STEPPING BEYOND COUNTS, FEASIBILITY OF PASSIVELY COLLECTED QUALITATIVE GAIT METRICS USING A SMARTPHONE-BASED CARE MANAGEMENT PLATFORM FOLLOWING TOTAL JOINT ARTHROPLASTY
Authors: Fary C. , Abshagen S. , Van Andel D. , Ren A.N. , Anderson M.B. , Klar B. 
Published: February 2023

Advances in algorithms developed with sensor data from smart phones demonstrates the capacity to passively collect qualitative gait metrics. The purpose of this feasibility study was to assess the recovery of these metrics following joint reconstruction. A secondary data analysis of an ethics approved global, multicenter, prospective longitudinal study evaluating gait quality data before and after primary total knee arthroplasty (TKA, n=476), partial knee arthroplasty (PKA, n=139), and total hip arthroplasty (THA, n=395). A minimum 24 week follow-up was required (mean 45±12, range 24 - 78). Gait bouts and gait quality metrics (walking speed, step length, timing asymmetry, and double support percentage) were collected from a standardized smartphone operating system. Pre- and post-operative values were compared using paired-samples t-tests (p<0.05).A total of 595 females and 415 males with a mean age of 61.9±9.3 years and mean BMI of 30.2±6.1 kg/m2 were reviewed. Walking speeds were lowest at post-operative week two (all, p<.001). Speeds exceeded pre-operative means consistently by week 21 (p=0.015) for PKA, and week 13 (p=0.007) for THA. The average weekly step length was lowest in post-operative week two (all, p<0.001). PKA and THA cases achieved pre-operative step lengths by week seven (p=0.064) and week 9 (p=0.081), respectively. The average weekly gait asymmetry peaked at week two post-operatively (all, p <0.001). Return to pre-operative baseline asymmetry was achieved by week 11 (p=0.371) for TKA, week six (p=0.541) for PKA, and week eight (p=.886) for THA. Double limb support percentages peaked at week two (all, p<0.001) and returned to pre-operative levels by week 24 (p=0.089) for TKA, week 12 (p=0.156) for PKA, and week 10 (p=0.143) for THA.Monitoring gait quality in real-world settings following joint reconstruction using smartphones is feasible, and may provide the advantage of removing the Hawthorne effect related to typical gait assessments and in-clinic observations.
GERIATRIC ANKLE TRAUMA: EXPERIENCE OF THE ACUTE HINDFOOT NAIL
Authors: Ramage D. , Burgess A.G. , Powell A. , Tangrood Z.J. 
Published: February 2023

Ankle fractures represent the third most common fragility fracture seen in elderly patients following hip and distal radius fractures. Non-operative management of these see complication rates as high as 70%. Open reduction and internal fixation (ORIF) has complication rates of up to 40%. With either option, patients tend to be managed with a non-weight bearing period of six weeks or longer. An alternative is the use of a tibiotalocalcaneal (TTC) nail. This provides a percutaneous treatment that enables the patient to mobilise immediately. This case-series explores the efficacy of this device in a broad population, including the highly comorbid and cognitively impaired.We reviewed patients treated with TTC nail for acute ankle fractures between 2019 and 2022. Baseline and surgical data were collected. Clinical records were reviewed to record any post-operative complication, and post-operative mobility status and domicile. 24 patients had their ankle fracture managed with TTC nailing. No intra-operative complications were noted. There were six (27%) post-operative complications; four patients had loosening of a distal locking screw, one significant wound infection necessitating exchange of nail, and one pressure area from an underlying displaced fracture fragment. All except three patients returned to their previous domicile. Just over two thirds of patients returned to their baseline level of mobility.This case-series is one of the largest and is also one of the first to include cognitively impaired patients. Our results are consistent with other case-series with a favourable complication rate when compared with ORIF in similar patient groups. The use of a TTC nail in the context of acute, geriatric ankle trauma is a simple and effective treatment modality. This series shows acceptable complication rates and the majority of patients are able to return to their baseline level of mobility and domicile.
TESTING IN VEIN: ARE ROUTINE BLOOD TESTS REQUIRED FOR UNCOMPLICATED ARTHROPLASTY? A RETROSPECTIVE COHORT STUDY
Authors: Kioa G. , Hunter S. , Blackett J. 
Published: February 2023

Routine post-operative bloods following all elective arthroplasty may be unnecessary. This retrospective cohort study aims to define the proportion of post-operative tests altering clinical management.Clinical coding identified all elective hip or knee joint replacement under Hawkes Bay District Health Board contract between September 2019-December 2020 (N=373). Uni-compartmental and bilateral replacements, procedures performed for cancer, and those with insufficient data were excluded. Demographics, perioperative technique, and medical complication data was collected. Pre- and post-operative blood tests were assessed. Outcome measures included clinical intervention for abnormal post-operative sodium (Na), creatinine (Cr), haemoglobin (Hb), or potassium (K) levels. A cost-benefit analysis assessed unnecessary testing.350 patients were Included. Median age was 71 (range 34-92), with 46.9% male. Only 26 abnormal post-operative results required intervention (7.1%). 11 interventions were for low Na, 4 for low K, and 4 for elevated Cr. Only 7 patients were transfused blood products. Older age (p=0.009) and higher ASA (p=0.02) were associated with intervention of any kind. Abnormal preoperative results significantly predicted intervention for Na (p<0.05) and Cr (p<0.05). All patients requiring treatment for K used diuretic medication. Preoperative Hb level was not associated with need for transfusion. Overall, there were 1027 unnecessary investigations resulting in $18,307 excess expenditure.Our study identified that the majority of elective arthroplasty patients do not require routine postoperative blood testing. We recommend investigations for patients with preoperative electrolyte abnormality, those taking diuretics, and patients with significant blood loss noted intra-operatively. In future, a larger, randomised controlled trial would be useful to confirm these factors.
EFFICACY AND SAFETY OF DIFFERENT TRAPEZIUM IMPLANTS FOR TRAPEZIOMETACARPAL JOINT OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Seth I. , Bulloch G. , Seth N. , Fogg Q. , Hunter-Smith D.J. , Rozen W.M. 
Published: February 2023

The trapeziometacarpal joint (TMCJ) is the most common hand joint affected by osteoarthritis (OA), and trapezium implant arthroplasty is a potential treatment for recalcitrant OA. This meta-analysis aimed to investigate the efficacy and safety of various trapezium implants as an interventional option for TMCJ OA. Web of Science, PubMed, Scopus, Google Scholar, and Cochrane library databases were searched for relevant studies up to May 2022. Preferred Reported Items for Systematic Review and Meta-Analysis guidelines were adhered to and registered on PROSPERO. The methodological quality was assessed by National Heart, Lung, and Blood Institute tools for observational studies and the Cochrane risk of bias tool. Subgroup analyses were performed on different replacement implants, the analysis was done via Open Meta-Analyst software and P values < 0.05 were considered statistically significant.A total of 123 studies comprising 5752 patients were included. Total joint replacement (TJR) implants demonstrate greater significant improvements in visual analogue scale pain scores postoperatively. Interposition with partial trapezial resection implants was associated with the highest grip strength and highest reduction in the Disabilities of the Arm, Shoulder, and Hand score. Revision rates were highest in TJR (12.3%), and lowest in interposition with partial trapezial resection (6.2%).Total joint replacement and interposition with partial trapezial resection implants improve pain, grip strength, and DASH scores more than other implant options. Future studies should focus on high-quality randomized clinical trials comparing different implants to accumulate higher quality evidence and more reliable conclusions.