bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mismatched donor cell infusion-related syndrome following microtransplant in patients with acute myeloid leukemia
Authors: Cai Bo , Zou Xiaoyan , Ning Xin , Liu Tieqiang , Li Bingxia , Lei Yaqing , Qiao Jianhui , Hu Kaixun , Lei Yangyang , Liu Zhiqing , Yao Bo , Ai Huisheng , Wang Yi , Yu Changlin , Guo Mei 
Published: April 2023

Abstract

Background:
Immunotherapies such as adoptive immune cell infusion and immune-modulating agents are widely used for cancer treatment, and the concomitant symptoms, including cytokine release syndrome (CRS) or immune-related adverse events (irAEs), are frequently reported. However, clinical manifestations induced by mismatched donor granulocyte colony-stimulating factor mobilized peripheral blood mononuclear cell (GPBMC) infusion in patients receiving microtransplant (MST) have not yet been well depicted.

Methods:
We analyzed 88 cycles of mismatched GPBMC infusion in patients with acute myeloid leukemia receiving MST and 54 cycles of chemotherapy without GPBMC infusion as a comparison. Clinical symptoms and their correlation with clinical features, laboratory findings, and clinical response were explored.

Results:
Fever (58.0% [51/88]) and chills (43.2% [38/88]) were the significant early-onset symptoms after GPBMC infusion. Patients possessing less human leukocyte antigen-matching loci with the donor or those with unrelated donors experienced more chills (3 [2–5] loci vs. 5 [3–5] loci, P = 0.043 and 66.7% [12/18] vs. 37.1% [26/70], P = 0.024). On the other hand, those with decreased CD4+/CD8+ T-cell ratio developed more fever (0.8 [0.7–1.2] vs. 1.4 [1.1–2.2], P = 0.007). Multivariable analysis demonstrated that younger patients experienced more fever (odds ratio [OR] = 0.963, 95% confidence interval [CI]: 0.932–0.995, P = 0.022), while patients with younger donors experienced more chills (OR = 0.915, 95% CI: 0.859–0.975, P = 0.006). Elevated ultra-sensitive C-reactive protein levels in the absence of cytokine storm were observed following GPBMC infusion, which indicated mild and transient inflammatory response. Although no predictive value of infusion-related syndrome to leukemia burden change was found, the proportion of host pre-treatment activated T cells was positively correlated with leukemia control.

Conclusions:
Mismatched GPBMC infusion in MST induced unique infusion-related symptoms and laboratory changes, which were associated with donor- or recipient-derived risk factors, with less safety and tolerance concerns than reported CRS or irAEs.
Associations of cholecystectomy with the risk of colorectal cancer: a Mendelian randomization study
Authors: Chen Lanlan , Fan Zhongqi , Sun Xiaodong , Qiu Wei , Mu Wentao , Chai Kaiyuan , Cao Yannan , Wang Guangyi , Lv Guoyue 
Published: April 2023

Abstract

Background:
Cholecystectomy is a standard surgery for patients suffering from gallbladder diseases, while the causal effect of cholecystectomy on colorectal cancer (CRC) and other complications are still unknown.

Methods:
We obtained genetic variants associated with cholecystectomy at a genome-wide significant level (P value <5 × 10−8) as instrumental variables (IVs) and performed Mendelian randomization (MR) to identify the complications of cholecystectomy. Furthermore, the cholelithiasis was also treated as the exposure to compare its causal effects to that of cholecystectomy, and multivariable MR analysis was carried out to judge whether the effect of cholecystectomy was independent of cholelithiasis. The study was reported based on Strengthening the Reporting of Observational Studies in Epidemiology Using Mendelian Randomization guidelines.

Results:
The selected IVs explained 1.76% variance of cholecystectomy. Our MR analysis suggested that cholecystectomy cannot elevate the risk of CRC (odd ratio [OR] =1.543, 95% confidence interval [CI]: 0.607–3.924). Also, it was not significant in either colon or rectum cancer. Intriguingly, cholecystectomy might decrease the risk of Crohn's disease (OR = 0.078, 95% CI: 0.016–0.368) and coronary heart disease (OR = 0.352, 95% CI: 0.164–0.756). However, it might increase the risk of irritable bowel syndrome (IBS) (OR = 7.573, 95% CI: 1.096–52.318). Cholelithiasis could increase the risk of CRC in the largest population (OR = 1.041, 95% CI: 1.010–1.073). The multivariable MR analysis suggested that genetic liability to cholelithiasis could increase the risk of CRC in the largest population (OR = 1.061, 95% CI: 1.002–1.125) after adjustment of cholecystectomy.

Conclusions:
The study indicated that cholecystectomy might not increase the risk of CRC, but such a conclusion needs further proving by clinical equivalence. Additionally, it might increase the risk of IBS, which should be paid attention to in clinical practice.
The Steatosis-associated fibrosis estimator (SAFE) score: validation in the general US population
Authors: van Kleef Laurens A. , de Knegt Robert J. , Ayada Ibrahim , Pan Qiuwei , Brouwer Willem Pieter 
Published: April 2023

Background:Noninvasive tests are important in the initial risk stratification of people at risk of fibrosis. The recently developed steatosis-associated fibrosis estimator (SAFE) score may have such potential but awaits external validation.Methods:We analyzed 6973 participants aged 18–80 in the National Health and Nutrition Examination Survey 2017-2020 cycle with data on liver stiffness and SAFE score without prevalent heart failure. Fibrosis was defined as liver stiffness ≥8.0 kPa. Accuracy was evaluated by AUC and assessment of test characteristics at the prespecified cutoffs for ruling out/ruling in fibrosis.Results:The SAFE score categorized 14.7% of the population as high risk, 30.4% as intermediate risk, and 54.9% as low risk for fibrosis. The actual fibrosis prevalence in these groups was 28.0%, 10.9%, and 4.0%, respectively, translating into a positive predictive value of 0.28 at the high-risk cutoff and a negative predictive value of 0.96 at the low-risk cutoff. The AUC of the SAFE score (0.748) was significantly higher than the fibrosis-4 index (0.619) or NAFLD fibrosis score (0.718). However, test performance strongly depended on age categories: 90% of participants aged 18–40 years were considered at low risk for fibrosis, including 89/134 (66%) of clinically significant fibrosis cases. In the oldest group (60–80 y), fibrosis could only be safely ruled out among 17%, corresponding to a high referral rate of up to 83%. The best SAFE score performance was found in the middle-aged group (40–60 y). The results were consistent in target populations with metabolic dysfunction or steatosis.Conclusions:The SAFE score has overall good diagnostic accuracy in detecting fibrosis but was highly dependent on age. The SAFE score lacked sensitivity in younger populations and the ability to rule out fibrosis in older populations.
Intravitreal Fluocinolone Acetonide Implant for Radiation Retinopathy: Report of Preliminary Findings
Authors: Singaravelu Janani , Oakey Zackery B. , Wrenn Jacquelyn M. , Singh Arun D. 
Published: April 2023

Abstract

Purpose:
To assess the efficacy of a 0.18 mg intravitreal fluocinolone acetonide (FA) implant (Yutiq, EyePoint Pharmaceuticals, Watertown, MA) as a treatment option for patients with radiation retinopathy-related cystoid macular edema (CME)

Methods:
A retrospective review of 7 patients treated for uveal melanoma who developed radiation retinopathy-related CME. They were initially treated with intravitreal anti-VEGF and/or steroid injections and then transitioned to intravitreal FA implant. Primary outcomes include BCVA, central subfield thickness (CST), and number of additional injections.

Results:
After FA implant insertion, BCVA and CST remained stable in all patients. The variance in BCVA decreased from 75.5 ETDRS letters (range 0-199 letters) to 29.8 (range 1.2-134) following FA implant insertion. Mean CST was 384 μm (range 165-641) and 354 μm (range 282-493) before and after FA implant insertion, resulting in a 30 μm mean reduction. The number of intravitreal injections (average 4.9, range 2-10) decreased following intravitreal FA implant insertion with only two patients requiring one additional FA implant (average 0.29, range 0-1) over a mean of 12.1 months (range 0.9-18.5) follow-up.

Conclusions:
Intravitreal FA implant is an effective treatment for CME radiation retinopathy. The slow release of steroid allows for sustained control of macular edema, which correlated with stable visual acuity and decreased injection burden for patients.
GROWTH OF A FOCAL SCLERAL NODULE
Authors: Fung Adrian T. , Li Ye 
Published: April 2023

Purpose:
To report a case of a focal scleral nodule (FSN) that demonstrated growth over three years.

Methods:
Case report.

Results:
An asymptomatic emmetropic 15-year-old female patient was referred with an incidental finding of a left fundus lesion on routine examination. On examination, there was an isolated 1.9-mm (vertical) × 1.4-mm (horizontal) diameter-raised, circular, pale, yellow-white lesion with an orange halo located along the inferotemporal vascular arcade. Enhanced-depth imaging optical coherence tomography (EDI-OCT) demonstrated a focal protrusion of the sclera with thinning of the overlying choroid, consistent with focal scleral nodule (FSN). On EDI-OCT, the horizontal basal diameter measured 3138 μm, and its height was 528 μm. Three years later, the lesion had increased in size to 2.7-mm (vertical) × 2.1-mm (horizontal) diameter on color fundus photography and a horizontal basal diameter of 3991 μm and height of 647 μm on EDI-OCT. The patient remained systemically well without visual complaints.

Conclusion:
FSN can increase in size over time, suggesting that scleral remodeling within and around the lesion can occur. Longitudinal observation of FSN can help to inform its clinical course and shed insight into its pathogenesis.
Local analgesia of electroacupuncture is mediated by the recruitment of neutrophils and released β-endorphins
Authors: Shi Jing-tao , Cao Wan-ying , Zhang Xiao-Ning , Wan Hong-Ye , Su Yang-Shuai , Qu Zheng-Yang , Wang Rui , He Wei , Jing Xiang-Hong , Wang Xiao-Yu 
Published: April 2023

Abstract
The efficacy of acupuncture in treating pain diseases has been recognized in clinical practice, and its mechanism of action has been a hot topic in academic acupuncture research. Previous basic research on acupuncture analgesia has focused mostly on the nervous system, with few studies addressing the immune system as a potential pathway of acupuncture analgesia. In this study, we investigated the effect of electroacupuncture (EA) on the β-endorphins (β-END) content, END-containing leukocyte type and number, sympathetic neurotransmitter norepinephrine (NE), and chemokine gene expression in inflamed tissues. To induce inflammatory pain, about 200 µL of complete Frester adjuvant (CFA) was injected into the unilateral medial femoral muscle of adult Wistar rats. Electroacupuncture treatment was performed for 3 days beginning on day 4 after CFA injection, with parameters of 2/100 Hz, 2 mA, and 30 minutes per treatment. The weight-bearing experiment and enzyme-linked immunosorbent assay showed that EA treatment significantly relieved spontaneous pain-like behaviors and increased the level of β-END in inflamed tissue. Injection of anti-END antibody in inflamed tissue blocked this analgesic effect. Flow cytometry and immunofluorescence staining revealed that the EA-induced increase in β-END was derived from opioid-containing ICAM-1+/CD11b+ immune cells in inflamed tissue. In addition, EA treatment increased the NE content and expression of β2 adrenergic receptor (ADR-β2) in inflammatory tissues and upregulated Cxcl1 and Cxcl6 gene expression levels. These findings provide new evidence for the peripheral analgesic effect of acupuncture treatment by recruiting β-END–containing ICAM-1+/CD11b+ immune cells and increasing the β-END content at the site of inflammation.
Risk factors for refracture after proximal femur fragility fracture
Authors: Lourenço Beatriz C. , Amorim-Barbosa Tiago , Lemos Carolina , Rodrigues-Pinto Ricardo 
Published: April 2023

Abstract

Introduction:
Proximal femur fragility fractures (PFFFs) are a growing worldwide concern. Recognizing the risk factors for subsequent fracture is essential for secondary prevention. This study aimed to analyze the risk factors for refracture and mortality rates in patients who suffered a PFFF.

Methods:
Patients aged 65 years or older with PFFF who underwent surgical treatment during the year of 2017 in the same institution were retrospectively analyzed and at least four years after the index fracture were evaluated.

Results:
From a total of 389 patients, 299 patients were included, with a median age of 83 years, and 81% female. Thirty-two (10.7%) suffered a refracture, with a mean time to refracture of 19.8 ± 14.80 months, being the female sex a risk factor for refracture (OR-4.69; CI [1.05–20.95]). The 1-year mortality rate was 15.4%. Seventy-three (24.4%) patients had previous fragility fractures. After the index fracture, 79% remained untreated for osteoporosis. No statistical association was found between antiosteoporotic treatment and refracture. Patients with refracture had higher prefracture functional level compared with patients without refracture (OR-1.33; CI [1.08–1.63]) and were discharged more often to rehabilitation units (31% versus 16%, P =.028). After 4 years of follow-up, patients with refracture had lower functional level compared with patients without. Chronic kidney disease was a risk factor (P = .029) for early refracture (<24 months).

Conclusion:
Female sex and higher prefracture functional level may increase the risk of refracture. Chronic kidney disease was associated with a shorter refracture time. Despite having a PFFF or other fragility fractures, the majority of patients remained untreated for osteoporosis.
Total knee arthroplasty coronal alignment and tibial base stress—a new numerical evaluation
Authors: Vale João , Pinto Luisa V. , Barros Bianca , Diniz Sara , Rodrigues Filipe , Marques Marco , Belinha Jorge , Vilaça Adélio 
Published: April 2023

Abstract

Background:
Total knee arthroplasty (TKA) is one of the most frequently performed orthopedic procedures. The correct positioning and alignment of the components significantly affects prosthesis survival. Considering the current controversy regarding the target of postoperative alignment of TKA, this study evaluated the tension at tibial component interface using two numerical methods.

Methods:
The stress of the prosthesis/bone interface of the proximal tibial component was evaluated using two numerical methods: the finite element method (FEM) and the new meshless method: natural neighbor radial point interpolation method (NNRPIM). The construction of the model was based on Zimmers NexGen LPS-Flex Mobile® prosthesis and simulated the forces by using a free-body diagram.

Results:
Tibiofemoral mechanical axis (TFMA) for which a higher number of nodes are under optimal mechanical tension is between 1° valgus 2° varus. For values outside the interval, there are regions under the tibial plate at risk of bone absorption. At the extremities of the tibial plate of the prosthesis, both medial and lateral, independent of the alignment, are under a low stress. In all nodes evaluated for all TFMA, the values of the effective stresses were higher in the NNRPIM when compared with the FEM.

Conclusion:
Through this study, we can corroborate that the optimal postoperative alignment is within the values that are currently considered of 0 ± 3° varus. It was verified that the meshless methods obtain smoother and more conservative results, which may make them safer when transposed to the clinical practice.
A new clinical severity score for the management of acute small bowel obstruction in predicting bowel ischemia: a cohort study
Authors: Wassmer Charles-Henri , Revol Rebecca , Uhe Isabelle , Chevallay Mickaël , Toso Christian , Gervaz Pascal , Morel Philippe , Poletti Pierre-Alexandre , Platon Alexandra , Ris Frederic , Schwenter Frank , Perneger Thomas , Meier Raphael P.H. 
Published: April 2023

Background:
Small bowel obstruction (SBO) is a common hospital admission diagnosis. Identification of patients who will require a surgical resection because of a nonviable small bowel remains a challenge. Through a prospective cohort study, the authors aimed to validate risk factors and scores for intestinal resection, and to develop a practical clinical score designed to guide surgical versus conservative management.

Patients and Methods:
All patients admitted for an acute SBO between 2004 and 2016 in the center were included. Patients were divided in three categories depending on the management: conservative, surgical with bowel resection, and surgical without bowel resection. The outcome variable was small bowel necrosis. Logistic regression models were used to identify the best predictors.

Results:
Seven hundred and thirteen patients were included in this study, 492 in the development cohort and 221 in the validation cohort. Sixty-seven percent had surgery, of which 21% had small bowel resection. Thirty-three percent were treated conservatively. Eight variables were identified with a strong association with small bowel resection: age 70 years of age and above, first episode of SBO, no bowel movement for greater than or equal to 3 days, abdominal guarding, C-reactive protein greater than or equal to 50, and three abdominal computer tomography scanner signs: small bowel transition point, lack of small bowel contrast enhancement, and the presence of greater than 500 ml of intra-abdominal fluid. Sensitivity and specificity of this score were 65 and 88%, respectively, and the area under the curve was 0.84 (95% CI: 0.80–0.89).

Conclusion:
The authors developed and validated a practical clinical severity score designed to tailor management of patients presenting with an SBO.
The global, regional, and national burden and its trends of inguinal, femoral, and abdominal hernia from 1990 to 2019: findings from the 2019 Global Burden of Disease Study – a cross-sectional study
Authors: Ma Qiuyue , Jing Wenzhan , Liu Xiaoli , Liu Jue , Liu Min , Chen Jie 
Published: April 2023

Background:
Inguinal, femoral, and abdominal hernia repairs are the most common surgical procedure worldwide. However, studies on hernia disease burden are notably limited, in both developed and low-income and middle-income countries (LMICs). We investigated temporal trends in the incidence and prevalence of inguinal, femoral, and abdominal hernias at global, regional, and national levels in 204 countries and territories from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019).

Materials and Methods:
Annual incident cases, prevalent cases, age-standardized incidence rates (ASIRs), and age-standardized prevalence rates (ASPRs) of inguinal, femoral, and abdominal hernias between 1990 and 2019 were extracted from the GBD 2019 study and stratified by sex, age, and location. Percentage changes in incident cases and prevalent cases, and the estimated annual percentage changes of ASIRs and ASPRs were calculated to quantify the trends in the incidence and prevalence of inguinal, femoral, and abdominal hernias. Data analysis for the present study was conducted from 15 June 2022 to 15 July 2022.

Results:
Globally, there were 32.53 million [95% uncertainty interval (UI): 27.71–37.79] prevalent cases and 13.02 million (10.68–15.49) incident cases of inguinal, femoral, and abdominal hernias in 2019, which increased by 36.00% and 63.67%, respectively, compared with 1990. Eighty-six percent of the incident cases were males, the male-to-female ratio was 6 : 1, and most patients were aged 50–69 years. India (2.45 million), China (1.95 million), and Brazil (0.71 million) accounted for more than one-third (39%) of the incident cases worldwide. From 1990 to 2019, the ASIR and ASPR showed a decreasing trend worldwide, except in Central Sub-Saharan Africa, which had an increasing trend in ASIR and ASPR.

Conclusion:
The global incident cases and prevalent cases of inguinal, femoral, and abdominal hernias increased substantially from 1990 to 2019, with a heavier burden observed in males, older adults, and in LMICs such as India and China. In addition, the ASIR and ASPR increased substantially in Central Sub-Saharan Africa. More efforts are warranted for hernia management to reduce the burden of inguinal, femoral, and abdominal hernias, such as by providing safe hernia surgical treatment for males, older adults, and LMICs.
Circulating fibrocyte percentage and neutrophil-lymphocyte ratio are accurate biomarkers of uncomplicated and complicated appendicitis: a prospective cohort study
Authors: Zarog Mohamed , O’Leary Peter , Kiernan Miranda , Bolger Jarlath , Tibbitts Paul , Coffey Stephen , Byrnes Gerard , Peirce Colin , Dunne Colum , Coffey Calvin 
Published: April 2023

Background:
There is increasing evidence that uncomplicated appendicitis (UA) may be treated nonoperatively in cases of UA. This study aimed to evaluate and compare the diagnostic accuracy of circulating fibrocyte percentage (CFP), white blood cell count, C-reactive protein, and neutrophil-lymphocyte ratio (NLR) in diagnosing uncomplicated and complicated appendicitis.

Materials and methods:
Eighty consecutive adult patients presenting with suspected appendicitis were recruited in a cohort-based prospective study between June 2015 and February 2016 at University Hospital Limerick in Ireland. Peripheral venous samples were obtained at the presentation. Clinical, biochemical, radiological, and histopathological parameters were recorded. The CFP was determined by dual-staining for CD45 and collagen-I using flow cytometry analysis and correlated with histopathological diagnoses.

Results:
Of the 46 patients who underwent appendicectomy, 34 (73.9%) had histologically proven acute appendicitis. A comparison of the diagnostic accuracy of biomarkers demonstrated the CFP had the highest diagnostic accuracy for UA (area under the curve=0.83, sensitivity=72.7%, specificity=83.3%, P=0.002). The NLR had the highest diagnostic accuracy in relation to complicated appendicitis (area under the curve=0.84, sensitivity=75.5%, specificity=83.3%, P=0.005).

Conclusions:
CFP and NLR are accurate biomarkers of UA and complicated appendicitis.