bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early anakinra treatment improves cardiac outcome of multisystem inflammatory syndrome in children, regardless of disease severity
Authors: Taddio Andrea , Della Paolera Sara , Abbagnato Luisa , Agrusti Anna , Badolato Raffaele , Biscaro Francesca , Caorsi Roberta , Consolaro Alessandro , Dellepiane Rosa Maria , Fabi Marianna , Floretta Ilenia , Gattorno Marco , Giangreco Manuela , La Torre Francesco , Maggio Maria Cristina , Mambelli Lorenzo , Mauro Angela , Mastrolia Maria Vincenza , Meneghel Alessandra , Montin Davide , Ricci Francesca , Simonini Gabriele , Smarrazzo Andrea , Sottile Rita , Stucchi Sara , Tardi Maria , Verdoni Lucio , Zuccotti Gianvincenzo , Zunica Fiammetta , Ravelli Angelo , Cattalini Marco ,   the Italian Society of Pediatric Rheumatology (ReumaPed), Adamoli P , Alberelli M C , Alessio M , Alizzi C , Barone P , Baselli L A , Bennato V , Biscaro F , Boscarol G , Bossi G , Campana A , Campus S , Carone M , Civino A , Conti G , Dei Rossi E , Del Giudice E , Dell'Anna A , De Luca M , Felici E , Filocamo G , Foschini M L , Gallizzi R , Giordano S , Lanciotti S , Lattanzi B , Lazzerotti A , Licciardi F , Manerba A , Mannarino S , Marino A , Marolda A , Martelli L , Martini G , Mazza A , Minasi D , Miniaci A , Minoia F , Olivieri A , Pennoni G , Pignataro R , Ricci F , Rigante D , Rossi M , Santagati C , Soliani M , Sonego S , Sperlì D , Teruzzi B L , Tierno E , Utytatnikova T , Valentini P , Vergine G 
Published: August 2023

Abstract

Objective
The main aim of this study was to define the best treatment option for multisystem inflammatory syndrome in children (MIS-C) and to analyse the role of anakinra.

Methods
This is a multicentre retrospective cohort study. Patients were treated according to the attending physician’s decision. The patients were divided into four groups on the basis of the first treatment at time of admittance: (i) IVIG, (ii) IVIG and methylprednisolone (≤2 mg/kg/day), (iii) IVIG with high-dose methylprednisolone (&gt;2 mg/kg/day) and (iv) anakinra with or without IVIG and/or methylprednisolone. Primary outcomes were defined as the presence of at least one of the following features: death, the failure of initial treatment, meaning the need for additional treatment for clinical worsening and cardiac involvement at the end of follow-up.

Results
Two hundred thirty-nine patients were recruited. At univariate analysis, persistent heart involvement at discharge was more frequent in those not receiving anakinra as initial treatment (3/21 vs 66/189; P = 0.047). After comparisons between the four treatment regimens, adjusting for the propensity score, we observed that early treatment with anakinra was associated with a lower probability of developing persistent heart disease at the end of follow-up (odds ratio: 0.6; 95% CI: 0.4–1.0).

Conclusion
We report that early treatment with anakinra is safe and very effective in patients with severe MIS-C. In addition, our study suggests that early treatment with anakinra is the most favourable option for patients with a higher risk of developing a severe disease outcome.
Disparities in multimorbidity and comorbidities in rheumatoid arthritis by sex across the lifespan
Authors: Stevens Maria A , Dykhoff Hayley J , Kronzer Vanessa L , Myasoedova Elena , Davis John M , Duarte-García Alí , Crowson Cynthia S 
Published: August 2023

Abstract

Objectives
Multimorbidity is burdensome for people with RA. We investigated differences in multimorbidity and comorbidities by sex and age in the RA population.

Methods
This cross-sectional analysis used national administrative claims (OptumLabs® Data Warehouse) from people with RA and non-RA comparators (matched on age, sex, race, census region, index year and length of baseline insurance coverage) from 2010–2019. RA was determined using a validated algorithm. Multimorbidity was defined as ≥2 (MM2+) or ≥5 (MM5+) comorbidities from a validated set of 44 chronic conditions. We used logistic regression to assess associations between characteristics and multimorbidity.

Results
The sample included 154 391 RA patients and 154 391 non-RA comparators. For people aged 18–50 years, RA women (vs RA men) had 7.5 and 4.4 (vs 3.2 and 0.9 in non-RA women vs non-RA men) percentage point increases for MM2+ and MM5+, respectively. For people aged 51+ years, RA women (vs RA men) had 2.1 and 2.5 (vs 1.2 and 0.3 in non-RA women vs non-RA men) percentage point increases for MM2+ and MM5+, respectively. Interactions revealed that differences in multimorbidity between women and men were exacerbated by RA (vs non-RA) (P &lt; 0.05), with more pronounced effects in people aged 18–50. Men had more cardiovascular-related conditions, whereas RA women had more psychological, neurological and general musculoskeletal conditions. Other comorbidities varied by sex and age.

Conclusion
Multimorbidity disproportionately impacts women with RA. Research, clinical and policy agendas for rheumatic diseases should acknowledge and support the variation in care needs by sex and gender across the lifespan.
Differential outcomes of high‐fat diet on age‐related rescaling of cochlear frequency place coding
Authors: Zhang Yu , Lin Guotong , Xue Na , Wang Yi , Du Tingting , Liu Huihui , Xiong Wei , Shang Wei , Wu Hao , Song Lei 
Published: August 2023

AbstractAuditory frequency coding is place‐specific, which depends on the mechanical coupling of the basilar membrane‐outer hair cell (OHC)‐tectorial membrane network. Prestin‐based OHC electromotility improves cochlear frequency selectivity and sensitivity. Cochlear amplification determines the frequency coding wherein discrete sound frequencies find a ‘best’ place along the cochlear length. Loss of OHC is the leading cause of age‐related hearing loss (ARHL) and is the most common cause of sensorineural hearing loss and compromised speech perception. Lipid interaction with Prestin impacts OHC function. It has been established that high‐fat diet (HFD) is associated with ARHL. To determine whether genetic background and metabolism preserve cochlear frequency place coding, we examined the effect of HFD in C57BL/6J (B6) and CBA/CaJ (CBA) on ARHL.We found a significant rescuing effect on ARHL in aged B6 HFD cohort. Prestin levels and cell sizes were better maintained in the experimental B6‐HFD group. We also found that distortion product otoacoustic emission (DPOAE) group delay measurement was preserved, which suggested stable frequency place coding. In contrast, the response to HFD in the CBA cohort was modest with no appreciable benefit to hearing threshold. Notably, group delay was shortened with age along with the control. In addition, the frequency dependent OHC nonlinear capacitance gradient was most pronounced at young age but decreased with age. Cochlear RNA‐seq analysis revealed differential TRPV1 expression and lipid homeostasis. Activation of TRPV1 and downregulation of arachidonic acid led to downregulation of inflammatory response in B6 HFD, which protects the cochlea from ARHL. The genetic background and metabolic state‐derived changes in OHC morphology and function collectively contribute to a redefined cochlear frequency place coding and improved age‐related pitch perception.
Quantitative Romberg on a Force Plate
Authors: Kesler Kyle , Glassman Steven D. , Gum Jeffrey L. , Djurasovic Mladen , Campbell Mitchell J. , Schmidt Grant O. , Carreon Leah Y. 
Published: August 2023

Study Design.
Longitudinal observational cohort.

Objectives.
The purpose of this study was to evaluate the utility of Quantitative Romberg measurements as pre-op and post-op balance outcome measures.

Summary of Background Data.
Cervical spondylotic myelopathy (CSM) is characterized by balance deficiencies produced by impaired proprioception. Evaluation is subjective, and binary physical exam findings lack the precision to assess postoperative outcome improvement.

Methods.
CSM patients were prospectively enrolled to undergo preoperative and postoperative Quantitative Romberg tests on a force plate to record center of pressure (COP) motion for 30 seconds with eyes open followed by eyes closed. Revision cases were excluded. Kinematics of COP movement parameters were compared between preoperative and postoperative state for each patient.

Results.
Twenty-seven CSM patients were enrolled and completed both pre/post-testing. The mean age was 60.0 years, with 13 (48%) males and 9 (33%) smokers. Mean number of surgical levels was 2.48. The minimum mean follow-up was six months. There was a statistically significant improvement in eyes closed after surgery compared with preoperative for total COP motion (523.44 vs. 387.00 cm, P<0.001), average sway speed (17.41 vs. 13.00 cm/s, P<0.001), and total lateral COP motion (253.44 vs. 186.70 cm, P<0.001). There was no statistically significant improvement in the modified Japanese Orthopaedic Association (13.29 vs. 14.29, P=0.28).

Conclusions.
CSM balance findings on Quantitative Romberg testing significantly improve postoperatively in patients with CSM. These findings support this testing as representative of proprioceptive balance deficiencies seen in CSM. Quantitative Romberg may be used as an objective measure of clinical outcome and assist in stratification of surgical interventions, surgery timing, and technique.
Radiographic Predictors of Subaxial Subluxation After Atlantoaxial Fusion
Authors: Takasawa Eiji , Iizuka Yoichi , Takakura Kenta , Inomata Kazuhiro , Tomomatsu Yusuke , Ito Shunsuke , Honda Akira , Ishiwata Sho , Mieda Tokue , Chikuda Hirotaka 
Published: August 2023

Study Design:
A retrospective study.

Objective:
The aim of this study was to clarify preoperative radiographic predictors associated with the development of subaxial subluxation (SAS) after surgery.

Background:
The incidence of atlantoaxial fusion for atlantoaxial instability has been increasing. SAS can develop after surgery despite atlantoaxial fusion with the optimal C1–C2 angle. We hypothesized that preoperative discordant angular contribution in the upper and subaxial cervical spine is associated with the occurrence of postoperative SAS.

Materials and Methods:
Patients who underwent surgery for atlantoaxial instability with a minimum 5-year follow-up and control participants were included. The O–C2 angle, C2 slope (C2S), C2–C7 cervical lordosis (CL), and T1 slope (T1S) were measured. We focused on the angular contribution ratio in the upper cervical spine to the whole CL, and the preoperative C2/T1S ratio was defined as the ratio of C2S to T1S.

Results:
Twenty-seven patients (SAS=11, no-SAS=16; mean age, 60.7 y old; 77.8% female; mean follow-up duration, 6.8 y) and 23 demographically matched control participants were enrolled. The SAS onset was at 4.7 postoperative years. Preoperatively, the O–C2 angle, C2–C7 CL, and T1S were comparable between the SAS, no-SAS, and control groups. The preoperative C2S and C2/T1S ratio were smaller in the SAS group than in the no-SAS or control group (C2S, 11.0 vs. 18.4 vs. 18.7 degrees; C2/T1S ratio, 0.49 vs. 0.77 vs. 0.78, P<0.05). The receiver operating characteristic curve analysis demonstrated that the C2/T1S ratio had higher specificity and similar sensitivity as a predictor of postoperative SAS than C2S (specificity: 0.90 vs. 0.87; sensitivity: 0.73 vs. 0.73). The estimated cutoff values of the C2S and C2/T1S ratio were 14 degrees and 0.58, respectively.

Conclusions:
The preoperative C2/T1S ratio was closely associated with postoperative SAS. Patients with a C2/T1S ratio <0.58 were at a high risk of SAS after atlantoaxial fusion.

Level of Evidence:
Level 4.
Research progress in the mechanism and treatment of osteosarcoma
Authors: Bian Jichao , Liu Yang , Zhao Xiaowei , Meng Chunyang , Zhang Yuanmin , Duan Yangmiao , Wang Guodong 
Published: August 2023

Abstract
Osteosarcoma (OS) is the most common primary malignant bone tumor that more commonly occurs in children and adolescents. The most commonly used treatment for OS is surgery combined with chemotherapy, but the treatment outcomes are typically unsatisfactory. High rates of metastasis and post-treatment recurrence rates are major challenges in the treatment of OS. This underlines the need for studying the in-depth characterization of the pathogenetic mechanisms of OS and development of more effective therapeutic modalities. Previous studies have demonstrated the important role of the bone microenvironment and the regulation of signaling pathways in the occurrence and development of OS. In this review, we discussed the available evidence pertaining to the mechanisms of OS development and identified therapeutic targets for OS. We also summarized the available treatment modalities for OS and identified future priorities for therapeutics research.
Are Physician Assistants Able to Correctly Identify Prescribing Errors? A Cross-Sectional Study
Authors: Gillette Chris , Perry Courtney J. , Ferreri Stefanie P. , Sisson Caroline Grey Bell , Bodner Gayle B. , Jones Caitlin E. , Rogers Samantha D. , Rose Tiffany H. , Ip Edward Hak-Sing , Crandall Sonia J. 
Published: August 2023

Purpose
(1) To describe how often physician assistant (PA) students correctly identify prescribing errors and (2) examine between-cohort differences on ability to correctly identify prescribing errors.

Methods
This was a cross-sectional study of 2 cohorts of PA students at one institution. Students were presented with 3 hypothetical prescriptions, 2 of which contained a prescribing error. For each prescription, students were asked to (1) identify whether an error occurred and (2) indicate the type of error. A simple Poisson regression model analyzed the data.

Results
We received responses from 130 students (72.6% response rate). Approximately 12% (12.3%, n = 16) correctly identified whether all 3 prescriptions were correct. The median number of correctly identified prescriptions was 1 (interquartile range = 1). There was not a statistically significant between-cohort difference identifying the correct number of prescriptions (β = 0.27, P = .10).

Conclusion
Physician assistant students' prescribing error identification was similar to previous research in medical and nursing students. Efforts to improve prescribing training are critical to ensure patient safety.
Teaching to Lead: One Program's Experience With Integrating Personal Leadership Into a Doctor of Physical Therapy Curriculum
Authors: Christy Jennifer B. , Morris David , Lein Donald , Clark Diane , Green-Wilson Jennifer 
Published: August 2023

Background and Purpose.
Doctor of Physical Therapy (DPT) programs accept responsibility for the development of clinical skills and professional behaviors in students. Academic and clinical faculty endeavor to teach and mentor at the highest levels. Doctor of Physical Therapy programs that develop leadership intentionally, specifically personal, or self-leadership may be successful in leading positive change within their graduates' relationships, environments, and patient outcomes. Personal leadership means leading from within as an individual and does not require the individual to have a leadership title or role. It includes characteristics such as authenticity, passion, emotional intelligence, trustworthiness, and credibility.

Case Description.
This case report will unveil how 1 established residential DPT program integrated personal leadership explicitly as a curricular thread. The 3 pillars are leading self, leading others, and leading systems: organizations and communities. The program used evidence-based processes used to build materials, learning activities, and assessments. The program achieved purposeful integration, including academic/clinical faculty development and progressive student learning experiences.

Outcomes.
Program assessment through focus groups and curricular surveys shows that students value the curricular content in personal leadership and are meeting the curricular thread behavioral objectives.

Discussion and Conclusion.
The personal leadership curricular thread shows promise to promote leadership behaviors in students and graduates.
The Relationship Between the Endoscopic Healing Index, Fecal Calprotectin, and Magnetic Resonance Enterography in Crohn’s Disease
Authors: Smith Emily S. , Chen Johnson , Pan Yushan , Mahtani Prerna , Lukin Dana , Ahmed Waseem , Longman Randy , Burakoff Robert , Scherl Ellen , Battat Robert 
Published: August 2023

Introduction:
The serum-based endoscopic healing index (EHI) test identifies endoscopic Crohn’s disease (CD) activity. Data are lacking on the relationship between EHI with other endpoints. We assessed the relationship between EHI and the simplified Magnetic Resonance Index of Activity.

Materials and Methods:
Data were prospectively collected on patients with CD with either an EHI or fecal calprotectin (FCAL) within 90 days of magnetic resonance enterography (MRE). Diagnostic accuracy was assessed using area under the receiver operator characteristics. Proportions with any, severe, and terminal ileum MR inflammation were compared above/below identified thresholds for both EHI and FCAL.

Results:
A total of 241 MREs paired to either EHI or FCAL from 155 patients were included. Both EHI and FCAL had similar accuracy to diagnose inflammation (area under the receiver operator characteristics: EHI: 0.635 to 0.651, FCAL: 0.680 to 0.708). Optimal EHI values were 42 and 26 for inflammation on MRE and endoscopy, respectively. Patients with EHI ≥42 (100% vs. 63%, P=0.002), FCAL >50 µg/g (87% vs. 64%, P<0.001) and FCAL >250 µg/g (90% vs. 75%, P=0.02) had higher rates of simplified Magnetic Resonance Index of Activity ≥1 compared with lower values. EHI differentiated ileitis numerically more than FCAL (delta: 24% to 25% vs. 11% to 21%). Patients with FCAL ≥50 µg/g had higher rates of severe inflammation compared with FCAL <50 µg/g (75% vs. 47%, P<0.001), whereas smaller differentiation existed for EHI threshold of 42 (63% vs. 49%, P=0.35).

Conclusion:
Both EHI and FCAL were specific in their confirmation of inflammation and disease activity on MRE in patients with CD. However, MRE-detected inflammation was frequently present in the presence of low EHI and FCAL in similar proportions.
Research progress and hotspots on macrophages in osteoarthritis: A bibliometric analysis from 2009 to 2022
Authors: Liu Yang , Liu Pei-Dong , Zhang Cheng-Ming , Liu Meng-Rou , Wang Gui-Shan , Li Peng-Cui , Yang Zi-Quan 
Published: August 2023

Background:
Macrophages in the synovium, as immune cells, can be polarized into different phenotypes to play an anti-inflammatory role in the treatment of osteoarthritis. In this study, bibliometric methods were used to search the relevant literature to find valuable research directions for researchers and provide new targets for osteoarthritis prevention and early treatment.

Methods:
Studies about the application of macrophages in the treatment of osteoarthritis were searched through the Web of Science core database from 2009 to 2022. Microsoft Excel 2019, VOSviewer, CiteSpace, R software, and 2 online websites were used to analyze the research status and predict the future development of the trend in research on macrophages in osteoarthritis.

Results:
The number of publications identified with the search strategy was 1304. China and the United States ranked first in the number of publications. Shanghai Jiao Tong University ranked first in the world with 37 papers. Osteoarthritis and Cartilage was the journal with the most publications, and “exosomes,” “stem cells,” “macrophage polarization,” “regeneration,” and “innate immunity” may remain the research hotspots and frontiers in the future.

Conclusion:
The findings from the global trend analysis indicate that research on macrophages in the treatment of osteoarthritis is gradually deepening, and the number of studies is increasing. Exosomes may become a research trend and hotspot in the future.
Evidence of motor imagery for lower limb motor function recovery after stroke: A systematic review and meta-analysis of randomized controlled trials
Authors: Liu Yibo , Han Qing , Li Zekun , Liu Hao , Sun Xu , Ji Yuanyuan 
Published: August 2023

Objective:
To systematically evaluate the efficacy of motor imagery (MI) on lower limb function in patients with stroke based on the existing clinical studies.

Methods:
Eight databases were searched up from the establishment of database to November 2022 to identify eligible studies. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 2 researchers used the Cochrane Systematic Review manual to independently cross-check the quality of the included literature and extract valid data. The RevMan 5.3 statistical software was used to obtain the meta-analysis, through the mean difference (MD) and 95% confidence intervals (CI).

Results:
A total of seventeen studies with 939 patients were included in the systematic review. The overall quality of the included studies was moderate. Meta-analysis showed that Fugl-Meyer Assessment of the lower extremity (FMA-LE) (MD = 4.86, 95%CI: 4.31, 5.42, P < .00001), berg balance scale (MD = 6.18, 95%CI: 4.57, 7.78, P < .00001), functional ambulation category (MD = 0.87, 95%CI: 0.41, 1.32, P = .0002), and the Modified Barthel Index (MD = 6.75, 95%CI: 3.23, 10.28, P = .0002) score improved significantly in the MI group compared with the control group.

Conclusions:
Current evidence shows that MI could effectively improve lower limb motor function and activities of daily living in stroke patients. Due to the limitations of the number and quality of the included studies, the above conclusions need to be verified by more high-quality studies.
The study of different dosages of remazolam combined with sufentanil and propofol on painless gastroscopy: A randomized controlled trial
Authors: Wu Xiaohong , Zeng Lin , Zhang Tianyao , Wu Wei , Tian Ying , Dong Shuhua 
Published: August 2023

Background:
Gastroscopy is one of the most commonly used diagnostic modalities for upper gastrointestinal disorders. Remazolam besylate, a new type of ultrashort-acting benzodiazepine drug, has been less studied in gastroscopy. In this study, we studied the efficacy and safety of remazolam combined with propofol for painless gastroscopy.

Methods:
This is a single-center, randomized controlled clinical trial. Hundred patients undergoing painless gastroscopy were included in this study and randomly divided into 2 groups (n = 50 per group): the remazolam 3 mg group (R3 group) and the remazolam 6 mg group (R6 group). Sufentanil, remazolam, and propofol are used to anesthetize the patients, and then, the effects of different dosages of remazolam on these patients are compared and analyzed. The patient’s general condition, vital signs at different times, the dosage of propofol (mg) and additional times, complications, duration of gastroscopy (minute), awakening time (minute), residence time in the resuscitation room (minute), and adverse reactions were recorded.

Results:
R3 group systolic blood pressure and diastolic blood pressure are more stable (P < .05); The number of additional propofol in R6 group was less (P < .05). The incidence of hypotension was lower in R3 group, as well as the time of awakening and staying in the resuscitation room were shorter (P < .05).

Conclusion:
Remazolam 3mg combined with sufentanil and propofol have less effect on hemodynamics in painless gastroscopy, and the patients have shorter awakening time.