bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Virtual Reality Training in the Rehabilitation of Orthopedic Ankle Injuries: A Systematic Review and Meta-analysis
Authors: Elaraby Abd El Rahman , Shahien Mostafa , Jahan Alhadi M. , Etoom Mohammad , Bekhet Amira Hassan 
Published: February 2023

Introduction: Orthopedic ankle injuries are considered among the most common musculoskeletal injuries. A wide variety of modalities and techniques have been used for the management of these injuries, and virtual reality (VR) is one modality that has been examined in ankle injuries rehabilitation. Purpose: This study aims to systemically review previous studies evaluating the effect of virtual reality in rehabilitating orthopedic ankle injuries. Methods: We searched six online databases: PubMed, Web of Science (WOS), Scopus, the Physiotherapy Evidence Database (PEDro), Virtual Health Library (VHL), and Cochrane Central Register of Controlled Trials (CENTRAL). Results: Ten randomized clinical trials met the inclusion criteria. Our results showed that VR had a significant effect on overall balance compared to conventional physiotherapy (SMD = 0.359, 0.009–0.710 P = 0.04), [ I 2= 17%, P = 0.30]. Compared with conventional physiotherapy, VR programs significantly improved gait parameters such as speed and cadence, muscle power, and perceived ankle instability; however, no significant difference was detected in the foot and ankle ability measure (FAAM). Additionally, significant improvements in static balance and perceived ankle instability were reported after the use of VR balance and strengthening programs. Finally, only two articles were deemed to have good quality, and the other studies’ quality ranged from poor to fair. Conclusion: VR rehabilitation programs can be used to rehabilitate ankle injuries, as they are regarded as safe interventions and have promising effects. However, there is a need for studies with high quality since most included studies’ quality varied from poor to fair.
Fibrinogen as a Predictor of Early Neurological Deterioration in Acute Ischemic Stroke – Evidence From the Indian Population
Authors: Mehta Vishal , Sharma Akhya , Jyoti Divya , Prabhakar Rathod , Kumar Ritesh , Guria Rishi T. , Sharma Chandra B. 
Published: February 2023

Background Early neurological deterioration (END) is a common occurrence in ischemic stroke and contributes significantly to poor outcomes. Although multiple factors that predict END have already been identified, the role of fibrinogen – a key component of the coagulation pathway, is controversial. Objective To assess the role of fibrinogen in predicting END and poor hospital outcome in patients with acute ischemic stroke. Design Single-centre prospective observational study. Methods 141 patients with acute ischemic stroke were analyzed in this prospective observational study from a single tertiary-care hospital in East India. END was defined as a worsening of ≥2 points on the National Institutes of Health Stroke Scale (NIHSS) within 7 days of admission. A score of 3-5 on the Modified Rankin Scale (mRS), a stroke recurrence event or death during hospital stay was considered poor hospital outcome. We performed univariate analysis using age, sex, body-mass index (BMI), hypertension, diabetes, NIHSS scores, stroke etiology, blood glucose and lipid parameters and plasma fibrinogen to develop a logistic regression model to establish the independent predictors of END and poor outcome. Results Age (Odds Ratio (OR) 1.034 [95% CI 1.001-1.069], P = .046), NIHSS score at admission (OR 1.152 [95% CI 1.070-1.240], P < .001) and fibrinogen (OR 1.011 [95%CI 1.006-1.015], P < .001) were independent predictors of END in patients with acute ischemic stroke. Factors independently associated with poor outcome were NIHSS score at admission (OR 1.257 [95% CI 1.150-1.357], P < .001), fasting plasma glucose (OR 1.007 [95% CI 1.001-1.013], P = .020), and fibrinogen [OR 1.004 [95% CI 1.000-1.007], P = .038). Conclusion The significant role of fibrinogen in determining neurological worsening and subsequent poor outcomes in patients with acute ischemic stroke may help in early prognostication and guided therapeutic interventions.
Clinical, Radiographic, and Patient-Perceived Outcome After Radial Hemi-Wrist Arthroplasty With a New Implant: 20 Cases With 5-Year Follow-up
Authors: Reiser Daniel , Sagerfors Marcus , Wretenberg Per , Pettersson Kurt , Fischer Per 
Published: February 2023

Background: Distal component loosening is a common mode of failure in total wrist arthroplasty (TWA). A radial hemi-wrist arthroplasty (RHWA) has the potential to avoid problems related to the distal component in TWA. The aim of this study is to investigate clinical outcomes following surgical treatment with a new RHWA design. Methods: In this pilot study of 20 consecutive RHWAs, patients were assessed preoperatively and postoperatively for range of motion, grip strength, Visual Analog Scale (VAS) pain scores, and functional scoring using Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH), and Canadian Occupational Performance Measure. Radiographs were analyzed at 12 months and 5 years (mean, 5.1 years) postoperatively. Results: A total of 46 secondary surgeries were undertaken in 16 wrists, including 7 revisions. Another 6 patients are waiting for revision to radiocarpal arthrodesis. In non-revised patients, the DASH and PRWE scores improved, and wrist range of motion remained largely unchanged except for wrist flexion, which decreased. The VAS pain score during activity was reduced, and hand grip strength remained largely unchanged. Conclusions: The new implant resulted in improved functional scoring and improved VAS pain scores in non-revised patients, but many cases needed secondary surgery due to persistent pain. The high revision rate is a major concern, and further use of the implant in its current form cannot be recommended.
Multi-environment Genomic Selection in Rice Elite Breeding Lines
Authors: Nguyen Van Hieu , Morantte Rose Imee Zhella , Lopena Vitaliano , Verdeprado Holden , Murori Rosemary , Ndayiragije Alexis , Katiyar Sanjay Kumar , Islam Md Rafiqul , Juma Roselyne Uside , Flandez-Galvez Hayde , Glaszmann Jean-Christophe , Cobb Joshua N. , Bartholomé Jérôme 
Published: February 2023

Abstract
Background
Assessing the performance of elite lines in target environments is essential for breeding programs to select the most relevant genotypes. One of the main complexities in this task resides in accounting for the genotype by environment interactions. Genomic prediction models that integrate information from multi-environment trials and environmental covariates can be efficient tools in this context. The objective of this study was to assess the predictive ability of different genomic prediction models to optimize the use of multi-environment information. We used 111 elite breeding lines representing the diversity of the international rice research institute breeding program for irrigated ecosystems. The lines were evaluated for three traits (days to flowering, plant height, and grain yield) in 15 environments in Asia and Africa and genotyped with 882 SNP markers. We evaluated the efficiency of genomic prediction to predict untested environments using seven multi-environment models and three cross-validation scenarios.

Results
The elite lines were found to belong to the indica group and more specifically the indica-1B subgroup which gathered improved material originating from the Green Revolution. Phenotypic correlations between environments were high for days to flowering and plant height (33% and 54% of pairwise correlation greater than 0.5) but low for grain yield (lower than 0.2 in most cases). Clustering analyses based on environmental covariates separated Asia’s and Africa's environments into different clusters or subclusters. The predictive abilities ranged from 0.06 to 0.79 for days to flowering, 0.25–0.88 for plant height, and − 0.29–0.62 for grain yield. We found that models integrating genotype-by-environment interaction effects did not perform significantly better than models integrating only main effects (genotypes and environment or environmental covariates). The different cross-validation scenarios showed that, in most cases, the use of all available environments gave better results than a subset.

Conclusion
Multi-environment genomic prediction models with main effects were sufficient for accurate phenotypic prediction of elite lines in targeted environments. These results will help refine the testing strategy to update the genomic prediction models to improve predictive ability.
Preliminary evaluation of SaCoVLM video laryngeal mask-guided intubation in airway management for anesthetized children
Authors: Zhi Juan , Deng Xiao-Ming , Zhang Yan-Ming , Wei Ling-Xin , Wang Qian-Yu , Yang Dong 
Published: February 2023

Abstract
Backgrounds
To preliminary evaluate the application of novel SaCoVLM video laryngeal mask -guided intubation for anesthetized children.

Methods
One hundred twenty-four children with microtia (ages 5-15 years,) who required general intubation anaesthesia, were enrolled in the study. After induction of general anesthesia,guided tracheal intubation under direct vision of the SaCoVLM was performed. Our primary outcome was first-pass success rate of guided tracheal tube placement. Secondary outcome included glottic visualization grades, the first-attempt success rate of LMA placement, the time for LMA placement and time to endotracheal intubation as well as the time for LMA removal after successful intubation, the fiberoptic grade of laryngeal view, the baseline and postinduction hemodynamic parameters were also recorded,and the incidence 24 h complications after operation.

Results
The first-pass success rate of guided tracheal tube placement was 91.1% (95%CI = 1.04–1.14), the status of glottic visualization was classified: grade 1 in 27cases, grade 2 in 36 cases, grade 3 in 41 cases and grade 4 in 20 cases. The first success rate of LMA placement was 92.7% (95%CI = 1.03–1.13), the time for LMA insertion was 15.7 (±9.1) s, intubation time was 30.9 (±17.6) s and withdrawl time was 24.9 (±9.3) s. The incidence of postoperative sore throat at 2 h was 29%, and 16.1% at 24 h, without dysphagia and hypoxia.

Conclusion
The SaCoVLM video laryngeal mask-guided intubation is feasible in children, with a high success rate, could be a new promising device to guide intubation in airway management.

Trial registration
This study was approved by the University’s Institutional Review Board and written informed consent was obtained from all subjects participating in the trial. The trial was registered prior to patient enrollment at clinicaltrials.gov (ChiCTR2200061481, http://www.chictr.org.cn. Principal investigator: Juan Zhi; Date of registration: 26/06/2022.
Effect of one-lung ventilation on the correlation between left and right cerebral saturation
Authors: Zhang Cai-Juan , Ma Jia-Hui , Jin Fan , Li Xiu-Hua , Jia Hui-Qun , Mu Dong-Liang 
Published: February 2023

Abstract
Background
To investigate if the correlation between left and right cerebral tissue oxygen saturation (SctO2) was affected by one-lung ventilation (OLV) in patients undergoing lung cancer surgery.

Methods
Patients who underwent surgery for lung cancer were enrolled. Left and right SctO2 were collected during anesthesia. The primary outcome was the correlation between left and right SctO2 at 30 min after OLV which was analysed by Pearson correlation and linear regression model. Secondary outcomes included the trend of left–right SctO2 change over the first 30 min after OLV, correlation of left–right SctO2 during OLV for each patient; maximal difference between left–right SctO2 and its relationship with postoperative delirium.

Results
Left–right SctO2 was moderately correlated at baseline (r = 0.690, P < 0.001) and poorly correlated at 30 min after OLV (r = 0.383, P < 0.001) in the Pearson correlation analysis. Linear regression analysis showed a poor correlation between left and right SctO2 at 30 min after OLV (r = 0.323, P < 0.001) after adjusting for confounders. The linear mixed model showed a change in left–right SctO2 over the first 30 min after OLV that was statistically significant (coefficient, -0.042; 95% CI, -0.070–-0.014; P = 0.004). For the left–right SctO2 correlation during OLV in each patient, 62.9% (78/124) patients showed a strong correlation, 19.4% (24/124) a medium correlation, and the rest a poor correlation. The maximal difference between the left and right SctO2 was 13.5 (9.0, 20.0). Multivariate analysis showed that it was not associated with delirium (odds ratio [OR], 1.023; 95% CI, 0.963–1.087; P = 0.463).

Conclusions
The correlation between left and right SctO2 was affected by one-lung ventilation in patients undergoing lung cancer surgery. This result indicates the requirement of bilateral SctO2 monitoring to reflect brain oxygenation.

Trial registration
This study was a secondary analysis of a cohort study approved by the Clinical Research Review Board of Peking University First Hospital (#2017–1378) and was registered in the Chinese Clinical Trial Registry on 10/09/2017 (http://www.chictr.org.cn, ChiCTR-ROC-17012627).
Identification of key biomarkers and immune infiltration in the thoracic acute aortic dissection by bioinformatics analysis
Authors: Luo Jun , Shi Haoming , Ran Haoyu , Zhang Cheng , Wu Qingchen , Shao Yue 
Published: February 2023

Abstract
Background
Thoracic acute aortic dissection (TAAD), one of the most fatal cardiovascular diseases, leads to sudden death, however, its mechanism remains unclear.

Methods
Three Gene Expression Omnibus datasets were employed to detect differentially expressed genes (DEGs). A similar function and co-expression network was identified by weighted gene co-expression network analysis. The least absolute shrinkage and selection operator, random forest, and support vector machines-recursive feature elimination were utilized to filter diagnostic TAAD markers, and then screened markers were validated by quantitative real-time PCR and another independent dataset. CIBERSORT was deployed to analyze and evaluate immune cell infiltration in TAAD tissues.

Results
Twenty-five DEGs were identified and narrowed down to three after screening. Finally, two genes, SLC11A1 and FGL2, were verified by another dataset and qRT-PCR. Function analysis revealed that SLC11A1 and FGL2 play significant roles in immune-inflammatory responses.

Conclusion
SLC11A1 and FGL2 are differently expressed in aortic dissection and may be involved in immune-inflammatory responses.
Eradication therapy may decrease the risk of immune thrombocytopenia after Helicobacter pylori infection: a retrospective cohort study in Taiwan
Authors: Koseki Mitsuhiro , Sheu Ming‑Jen , Tsai Kang-Ting , Ho Chung-Han , Liu Hsiao-Hua , Lin Hung-Jung , Lin Chien-Liang , Huang Chien-Cheng 
Published: February 2023

Abstract
Background
Helicobacter pylori (HP) eradication therapy (HPE) is recommended for patients with unexplained immune thrombocytopenia (ITP); however, the role of HPE in preventing ITP in patients with HP infection remains unclear. Therefore, this study was designed to clarify it.

Methods
This study was conducted at a tertiary medical center and included all adult patients with HP infection between January 1, 2016 and December 31, 2018. We compared the risk of developing ITP between patients with and without HPE. All patients were followed up until December 31, 2020.

Results
After excluding patients with thrombocytopenia, 1995 adult patients with HP infection, including 1188 patients with HPE and 807 patients without HPE, were included in this study. The mean age of the patients with HPE was 57.9 years, whereas that of those without HPE was 61.6 years. The percentage of males was 56% in patients with HPE and 59% in those without HPE. Patients without HPE had a higher risk of ITP than those with HPE after adjusting for age, sex, the Charlson Comorbidity Index, and comorbidities [adjusted odds ratio (OR) 1.76; 95% confidence interval (CI) 1.16–2.68]. Stratified analyses showed that the higher risk was found only in males (adjusted OR: 1.70; 95% CI 1.03–2.80). In addition to HPE, male sex and anemia were independent predictors of ITP in patients with HP infection.

Conclusion
This study showed that adult patients with HP infection not receiving HPE had a higher risk of developing ITP. We suggest that HPE should be considered, particularly in males and those who have anemia, to prevent ITP.
Impact of the body mass index on the retention of the anorectal mucosa after double-stapled ileal pouch-anal anastomosis for ulcerative colitis
Authors: Kimura Hideaki , Toritani Kenichiro , Kunisaki Reiko , Tatsumi Kenji , Koganei Kazutaka , Sugita Akira , Endo Itaru 
Published: February 2023

Abstract
Background
Double-stapled ileal pouch-anal anastomosis (DS-IPAA) is easy to construct and has a good functional outcome in patients with ulcerative colitis (UC). However, retention of the anorectal mucosa may lead to a subsequent risk of inflammation and neoplasia. This study aimed to identify factors associated with the retention of a large amount of anorectal mucosa after DS-IPAA.

Methods
The medical records of 163 patients who had undergone one-stage total proctocolectomy and DS-IPAA for UC between 2007 and 2020 were retrospectively reviewed. The patients were divided into two groups according to the length of the retained mucosa. The high anastomosis group was defined as having a retained mucosal length of ≥ 30 mm in the anterior or posterior wall. Clinical factors were compared between the high and low anastomosis groups.

Results
The high anastomosis group showed a significantly higher body mass index (BMI) (high vs. low: 23.2 vs. 19.0), longer operation time (304 vs. 263) and greater blood loss (357 vs. 240). In the multivariate analysis, high BMI was the only factor significantly associated with high anastomosis (odds ratio 1.32). There was a positive correlation between BMI and the length of the retained mucosa.

Conclusions
In DS-IPAA, BMI showed the strongest association with the retention of a large amount of the anorectal mucosa. In high BMI patients, although the risk of inability of anastomosis is little than that of IPAA with mucosectomy, the possible retention of a large amount of mucosa should be considered.
New logarithm-based discrimination formula for differentiating thalassemia trait from iron deficiency anemia in pregnancy
Authors: Shuang Xiao , Zhenming Wang , Zhu Mei , Si Sun , Zuo Li 
Published: February 2023

Abstract
Background
Thalassemia trait (TT) and iron deficiency anemia (IDA) are the most common conditions of microcytic hypochromic anemia (MHA) in pregnant women. Accurate discrimination between TT and IDA is an important issue, and better methods are urgently needed. Although considerable RBC formulas and indices have been developed since 1973, distinguishing between IDA and TT is still a challenging problem due to the diversity of various anemic populations. To address this problem, we assessed the diagnostic function of 43 different differential formulas in patients with microcytic anemia by using accuracy measures and recommending a new log-based differential formula.

Methods
The data of 430 pregnant women (229 with TT and 201 with IDA) were enrolled, and 44 formula performances were evaluated with receiver operating characteristic (ROC) analysis.

Results
The newly introduced logarithm-based formula XS-1 performs better than the general discriminant index with sensitivity and specificity of 82.10 and 89.05, which are better than other formulas. In the pregnant population, the Shine and Lal and Roth..SVM. formulas have shown excellent performance, while other formulas showed poorer discriminative abilities in our study than in the original authors.

Conclusion
The logarithm-based formula XS-1 can be used to screen thalassemia and iron deficiency anemia during the first trimester. Considering the particularity of pregnancy, medical personnel in different regions should choose a screening formula similar to that of the local region and population when identifying thalassemia in pregnancy. Any formula should be independently verified locally before use. For the convenience of the health care team and experimental scientists, a web-based tool has been established at http://yyy.yiyiy.top/XS-1/ by which users can easily get their desired screening test result without going through the underlying mathematical and computational details.
Accurate diagnosis of isolated iliac vein thrombosis in third trimester pregnancy with clues on great saphenous vein reflux: a case report and review of literature
Authors: Wei Zhanghong , Li Jingzhi , Liang Lijun , Luo Hui 
Published: February 2023

Abstract
Background
Pregnancy is known to be a risk factor for venous thromboembolism (VTE). We report the case of a pregnant patient with difficult to diagnose iliac vein thrombosis, establishing a definite diagnosis by clues of great saphenous vein reflux.

Case presentation
A 37-year-old G1P0 woman at 35 weeks of assisted twin gestation presented with a complaint of persistent left lower limb edema and tenderness. A vascular ultrasound was used to examine the bilateral lower limb. Doppler of left lower extremity revealed continuous great saphenous vein reflux. Right saphenofemoral veins demonstrated venous stasis and no reflux. Unilateral continuous great saphenous vein reflux suggested left iliac veins obstruction or extrinsic compression. Anterograde venography showed a completely occlusive filling defect of the left external iliac vein, which is the definitive diagnosis of acute deep venous thrombosis. The patient underwent a cesarean delivery following inferior vena cava filter (IVCF) placement, and no signs of deep venous thrombosis (DVT) or pulmonary embolism (PE) were reported after delivery.

Conclusion
In pregnant women with suspected deep vein thrombosis, it is imperative to assess the presence of unilateral continuous great saphenous vein reflux.
Deep learning-based multifeature integration robustly predicts central lymph node metastasis in papillary thyroid cancer
Authors: Wang Zhongzhi , Qu Limeng , Chen Qitong , Zhou Yong , Duan Hongtao , Li Baifeng , Weng Yao , Su Juan , Yi Wenjun 
Published: February 2023

Abstract
Background
Few highly accurate tests can diagnose central lymph node metastasis (CLNM) of papillary thyroid cancer (PTC). Genetic sequencing of tumor tissue has allowed the targeting of certain genetic variants for personalized cancer therapy development.

Methods
This study included 488 patients diagnosed with PTC by ultrasound-guided fine-needle aspiration biopsy, collected clinicopathological data, analyzed the correlation between CLNM and clinicopathological features using univariate analysis and binary logistic regression, and constructed prediction models.

Results
Binary logistic regression analysis showed that age, maximum diameter of thyroid nodules, capsular invasion, and BRAF V600E gene mutation were independent risk factors for CLNM, and statistically significant indicators were included to construct a nomogram prediction model, which had an area under the curve (AUC) of 0.778. A convolutional neural network (CNN) prediction model built with an artificial intelligence (AI) deep learning algorithm achieved AUCs of 0.89 in the training set and 0.78 in the test set, which indicated a high prediction efficacy for CLNM. In addition, the prediction models were validated in the subclinical metastasis and clinical metastasis groups with high sensitivity and specificity, suggesting the broad applicability of the models. Furthermore, CNN prediction models were constructed for patients with nodule diameters less than 1 cm. The AUCs in the training set and test set were 0.87 and 0.76, respectively, indicating high prediction efficacy.

Conclusions
The deep learning-based multifeature integration prediction model provides a reference for the clinical diagnosis and treatment of PTC.