bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemical neurolysis of the genicular nerves for chronic refractory knee pain: an observational cohort study
Authors: Shaikh Wassi , Miller Scott , McCormick Zachary L , Patel Prachi Milan , Teramoto Masaru , Walega David R 
Published: February 2023

Abstract

Objective
Evaluate outcomes of genicular nerve chemical neurolysis (GChN) in a real-world population with chronic knee pain.

Design
Restrospective, observational cohort study.

Setting
Tertiary academic medical center.

Subjects
Consecutive patients who had undergone GChN ≥3 months prior.

Methods
Standardized surveys were collected by telephone and included the numerical rating scale, opioid analgesic use, and Patient Global Impression of Change. Age, sex, body mass index, duration of pain, history of arthroplasty, lack of effect from previous radiofrequency ablation, percentage relief from a prognostic block, and volume of phenol used at each injection site were extracted from charts. Descriptive statistics were calculated, and logistic regression analyses were performed to identify factors influencing treatment outcome.

Results
At the time of follow-up after GChN (mean ± SD: 9.9 ± 6.1 months), 43.5% (95% CI = 33.5–54.1) of participants reported ≥50% sustained pain reduction. On the Patient Global Impression of Change assessment, 45.9% (95% CI = 35.5–56.7) of participants reported themselves to be “very much improved” or “much improved.” Of 40 participants taking opioids at baseline, 11 (27.5%; 95% CI = 14.6–43.9) ceased use. Of participants with a native knee treated, 46.3% reported ≥50% pain reduction, whereas of participants with an arthroplasty in the treated knee, 33.3% reported this threshold of pain reduction (P = .326). Logistic regression analyses did not reveal associations between treatment success and any of the factors that we evaluated.

Conclusions
GChN could provide a robust and durable treatment effect in a subset of individuals with chronic knee pain with complicating factors traditionally associated with poor treatment outcomes, such as those with pain refractory to radiofrequency ablation or those who have undergone arthroplasty.
Seeing like an economist: using the case of Dutch healthcare reform to bring professions and their epistemologies back in the field of new economic sociology
Authors: Engelen Ewald , Mosciaro Mayra , Kaika Maria 
Published: February 2023

Abstract
The article scrutinizes the Dutch healthcare market system to provide empirical grounding to the debates around the extent to which rationally constructed markets can develop as originally planned. Focusing on one specific pricing device, we document how the perceived economic ‘rationalities’ embedded in its design are challenged by the unforeseen and unanticipated ‘irrationalities’ of daily practices. We trace how healthcare professionals developed informal ways to adapt to the rules and expectations embedded in that device, resulting in forms of ‘counter performativity’ that threaten the quality and accessibility of Dutch healthcare. The main theoretical contribution of the article is to bridge the gap between ‘Actor Network Theory-based economic sociology’ and its emphasis on (counter-) performativity and the agency of devices with the older European continental inflections building on Weber, Durkheim and Bourdieu, by drawing attention to the distinct epistemologies of different professions, using insights from James Scott and the sociology of the professions.
Empagliflozin attenuates doxorubicin-induced cardiotoxicity by activating AMPK/SIRT-1/PGC-1α-mediated mitochondrial biogenesis
Authors: Chen Meicong 
Published: February 2023

Abstract
We aimed to probe the functions and possible mechanisms of empagliflozin in doxorubicin (Dox)-caused cardiotoxicity. First, a cardiotoxicity rat model was built by continuously injecting Dox intraperitoneally. Then, empagliflozin (30 mg/kg) was gavaged into the rats. Next, echocardiography was utilized for checking the cardiac function of rats, and H&E staining for observing pathological alterations of the myocardial tissues. Besides, biochemical assays and Enzyme-linked Immunosorbent Assay were adopted to detect the creatine kinase isoenzyme (CK-MB), N-terminal pro-brain natriuretic peptide (NT-proBNP), adenosine triphosphate (ATP), adenosine diphosphate (ADP), and adenosine monophosphate (AMP) levels in rat serum and superoxide dismutase (SOD), malondialdehyde acid (MDA), and catalase (CAT) in myocardial tissue, respectively. Furthermore, the expression of AMPK/SIRT-1/PGC-1α signaling pathway-related proteins in the myocardial tissues was tested by Western blot. Continuous intraperitoneal injection of Dox greatly elevated left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD), reduced fractional shortening (FS) and ejection fraction (EF), and notably up-regulated CK-MB and NT-proBNP level in rats’ serum, thus impairing cardiac function. Empagliflozin treatment could ameliorate myocardial histopathological damage and alleviate cardiac function and tissue damage by down-regulating LVEDD and LVESD, up-regulating EF and FS, and inhibiting CK-MB and NT-proBNP level in serum. Additionally, empagliflozin improved Dox-induced excessive oxidative stress and dysregulation of energy metabolism. Furthermore, empagliflozin activated the AMPK/SIRT-1/PGC-1α signaling pathway in Dox-caused cardiotoxicity rats. In conclusion, in addition to bettering the cardiac tissue and function injury caused by Dox, empagliflozin also improves excessive oxidative stress and energy metabolism. Notably, empagliflozin may exert cardioprotective effects through activating the AMPK/SIRT-1/PGC-1α pathway.
Cause analysis of expressway traffic accidents based on accident statistics of Hunan provincial expressway in 2012–2018
Authors: Liu Xinyu , Huang Shengjun , Chen Qun 
Published: February 2023

Abstract
Based on the 2012–2018 accident statistics on the Hunan Provincial Expressway in China, this paper analyses the proportion to which various factors contribute to accidents, as well as the trends over time. From 2012 to 2018, the total number of general procedure handling accidents (i.e. major accidents) increased first and then decreased, while the number of accidents and deaths per 1000 kilometres decreased year by year. The total number of simple procedure handling accidents (i.e. minor accidents) increased year by year, but the number of accidents per 1000 kilometres remained relatively stable. Speeding, fatigued driving, improper driving operation, failure to maintain a safe distance from the preceding vehicle and pedestrians entering the expressway are the main causes of general procedure handling accidents. Failure to maintain a safe distance from the preceding vehicle as required and improper driving operation accounted for approximately 2/3 of the simple procedure handling accidents. In view of the accidents caused by these factors, how to use law enforcement, education, science and technology and facilities construction to further reduce the occurrence of expressway traffic accidents is discussed.
Postoperative Dural Sac Cross-Sectional Area as an Association for Outcome After Surgery for Lumbar Spinal Stenosis
Authors: Hermansen Erland , Myklebust Tor Å. , Weber Clemens , Brisby Helena , Austevoll Ivar M. , Hellum Christian , Storheim Kjersti , Aaen Jørn , Banitalebi Hasan , Brox Jens I. , Grundnes Oliver , Rekeland Frode , Solberg Tore , Franssen Eric , Indrekvam Kari 
Published: February 2023

Study Design.
Prospective cohort study.

Objective.
The aim was to investigate the association between postoperative dural sac cross-sectional area (DSCA) after decompressive surgery for lumbar spinal stenosis and clinical outcome. Furthermore, to investigate if there is a minimum threshold for how extensive a posterior decompression needs to be to achieve a satisfactory clinical result.

Summary of Background Data.
There is limited scientific evidence for how extensive lumbar decompression needs to be to obtain a good clinical outcome in patients with symptomatic lumbar spinal stenosis.

Materials and Methods.
All patients were included in the Spinal Stenosis Trial of the NORwegian Degenerative spondylolisthesis and spinal STENosis (NORDSTEN)-study. The patients underwent decompression according to three different methods. DSCA measured on lumbar magnetic resonance imaging at baseline and at three months follow-up, and patient-reported outcome at baseline and at two-year follow-up were registered in a total of 393 patients. Mean age was 68 (SD: 8.3), proportion of males were 204/393 (52%), proportion of smokers were 80/393 (20%), and mean body mass index was 27.8 (SD: 4.2).
The cohort was divided into quintiles based on the achieved DSCA postoperatively, the numeric, and relative increase of DSCA, and the association between the increase in DSCA and clinical outcome were evaluated.

Results.
At baseline, the mean DSCA in the whole cohort was 51.1 mm2 (SD: 21.1). Postoperatively the area increased to a mean area of 120.6 mm2 (SD: 46.9). The change in Oswestry disability index in the quintile with the largest DSCA was −22.0 (95% CI: −25.6 to −18), and in the quintile with the lowest DSCA the Oswestry disability index change was −18.9 (95% CI: −22.4 to −15.3). There were only minor differences in clinical improvement for patients in the different DSCA quintiles.

Conclusion.
Less aggressive decompression performed similarly to wider decompression across multiple different patient-reported outcome measures at two years following surgery.
Hypoalbuminemia as a Predictor of Mortality, Disability, and Readmission in Patients Undergoing Spine Surgery
Authors: Randell Zane , Martin Brook , Hendrickson Nathan , Brodke Darrel , Spiker Ryan , Lawrence Brandon , Spina Nicholas 
Published: February 2023

Study Design.
Retrospective Cohort Study

Objective.
To clarify the association between preoperative albumin status and mortality and morbidity in lumbar spine surgery.

Summary of Background Data.
Hypoalbuminemia is a known marker of inflammation and is associated with frailty. Hypoalbuminemia is an identified risk factor for mortality following spine surgery for metastases, yet has not been well studied among spine surgical cohorts outside of metastatic cancer.

Methods.
We identified patients with preoperative serum albumin lab values who underwent lumbar spine surgery at a US public university health system between 2014 and 2021. Demographic, comorbidity, and mortality data were collected along with pre- and postoperative Oswestry Disability Index (ODI) scores. Any cause readmission within one year of surgery was recorded. Hypoalbuminemia was defined as <3.5 g/dL in serum. We examined Kaplan-Meier survival plots based on serum albumin. Multivariable regression models were used to identify the association between preoperative hypoalbuminemia with mortality, readmission and ODI, while controlling for age, sex, race, ethnicity, procedure and Charlson Comorbidity Index.

Results.
Of 2,573 patients, 79 were identified as hypoalbuminemic. Hypoalbuminemic patients had significantly greater adjusted risk of mortality through 1 year (OR 10.2; 95% CI 3.1 - 33.5; P<0.001), and 7 years (HR 4.18; 95% CI 2.29 – 7.65; P<0.001). Hypoalbuminemic patients had ODI scores 13.5 points higher (95%CI 5.7 – 21.4; P<0.001) at baseline. Adjusted readmission rates were not different between groups through 1 year (OR 1.15; 0.5 – 2.62; P=0.75) or through full surveillance (HR 0.82; 95%CI 0.44 – 1.54; P=0.54).

Conclusion.
Preoperative hypoalbuminemia was strongly associated with postoperative mortality. Hypoalbuminemic patients did not have demonstrably worse outcomes in their functional disability beyond 6 months. Within the first 6 months following surgery, the hypoalbuminemic group improved at a similar rate to the normoalbuminemic group despite having greater preoperative disability. However, causal inference is limited in this retrospective study.
Generating universal chimeric antigen receptor expressing cell products from induced pluripotent stem cells: beyond the autologous CAR-T cells
Authors: Deng Xinyue , Zhou Jianfeng , Cao Yang 
Published: February 2023

Abstract
Adoptive therapeutic immune cells, such as chimeric antigen receptor (CAR)-T cells and natural killer cells, have established a new generation of precision medicine based on which dramatic breakthroughs have been achieved in intractable lymphoma treatments. Currently, well-explored approaches focus on autologous cells due to their low immunogenicity, but they are highly restricted by the high costs, time consumption of processing, and the insufficiency of primary cells in some patients. Induced pluripotent stem cells (iPSCs) are cell sources that can theoretically produce indefinite well-differentiated immune cells. Based on the above facts, it may be reasonable to combine the iPSC technology and the CAR design to produce a series of highly controllable and economical “live” drugs. Manufacturing hypoimmunogenic iPSCs by inactivation or over-expression at the genetic level and then arming the derived cells with CAR have emerged as a form of “off-the-shelf” strategy to eliminate tumor cells efficiently and safely in a broader range of patients. This review describes the reasonability, feasibility, superiority, and drawbacks of such approaches, summarizes the current practices and relevant research progress, and provides insights into the possible new paths for personalized cell-based therapies.
Connexin 43-modified bone marrow stromal cells reverse the imatinib resistance of K562 cells via Ca2+-dependent gap junction intercellular communication
Authors: Li Xiaoping , Xiao Yunshuo , Wang Xiaoqi , Huang Ruihao , Wang Rui , Deng Yi , Rao Jun , Gao Qiangguo , Yang Shijie , Zhang Xi 
Published: February 2023

Abstract

Background:
Imatinib mesylate (IM) resistance is an emerging problem for chronic myeloid leukemia (CML). Previous studies found that connexin 43 (Cx43) deficiency in the hematopoietic microenvironment (HM) protects minimal residual disease (MRD), but the mechanism remains unknown.

Methods:
Immunohistochemistry assays were employed to compare the expression of Cx43 and hypoxia-inducible factor 1α (HIF-1α) in bone marrow (BM) biopsies of CML patients and healthy donors. A coculture system of K562 cells and several Cx43-modified bone marrow stromal cells (BMSCs) was established under IM treatment. Proliferation, cell cycle, apoptosis, and other indicators of K562 cells in different groups were detected to investigate the function and possible mechanism of Cx43. We assessed the Ca2+-related pathway by Western blotting. Tumor-bearing models were also established to validate the causal role of Cx43 in reversing IM resistance.

Results:
Low levels of Cx43 in BMs were observed in CML patients, and Cx43 expression was negatively correlated with HIF-1α. We also observed that K562 cells cocultured with BMSCs transfected with adenovirus-short hairpin RNA of Cx43 (BMSCs-shCx43) had a lower apoptosis rate and that their cell cycle was blocked in G0/G1 phase, while the result was the opposite in the Cx43-overexpression setting. Cx43 mediates gap junction intercellular communication (GJIC) through direct contact, and Ca2+ is the key factor mediating the downstream apoptotic pathway. In animal experiments, mice bearing K562, and BMSCs-Cx43 had the smallest tumor volume and spleen, which was consistent with the in vitro experiments.

Conclusions:
Cx43 deficiency exists in CML patients, promoting the generation of MRD and inducing drug resistance. Enhancing Cx43 expression and GJIC function in the HM may be a novel strategy to reverse drug resistance and promote IM efficacy.
Neuropathy, Ataxia, and Retinitis Pigmentosa Syndrome
Authors: Finsterer Josef 
Published: February 2023

AbstractObjectives:To provide an overview about the phenotype, genotype, treatment, and outcome of neuropathy, ataxia, and retinitis pigmentosa (NARP) syndrome.Methods:Systematic review by application of appropriate search terms.Results:NARP syndrome is a syndromic mitochondrial disorder due to pathogenic variants inMT-ATP6. The canonical phenotypic features of NARP syndrome include proximal muscle weakness, axonal neuropathy, cerebellar ataxia, and retinitis pigmentosa. Noncanonical phenotypic features in NARP include epilepsy, cerebral or cerebellar atrophy, optic atrophy, cognitive impairment, dementia, sleep apnea syndrome, hearing impairment, renal insufficiency, and diabetes. So far, 10 pathogenic variants inMT-ATP6have been associated with NARP, NARP-like syndrome, or NARP/maternally inherited Leigh overlap syndrome. Most pathogenicMT-ATP6variants are missense, but a few truncating pathogenic variants have been reported. The most common variant responsible for NARP is the transversion m.8993T>G. Only symptomatic treatment for NARP syndrome is available. In most of the cases, patients die prematurely. Patients with late-onset NARP survive longer.Conclusions:NARP is a rare, syndromic, monogenic mitochondrial disorder due to pathogenic variants inMT-ATP6.The nervous system and the eyes are most commonly affected. Although only symptomatic treatment is available, the outcome is usually fair.
What Is in the Myopathy Literature?
Authors: Lacomis David 
Published: February 2023

Abstract
This update begins with the results of a positive trial of intravenous immunoglobulin in dermatomyositis and a study of molecular and morphologic patterns in inclusion body myositis that may explain treatment refractoriness. Single center reports of muscular sarcoidosis and immune-mediated necrotizing myopathy follow. There is also a report of caveolae-associated protein 4 antibodies as a potential biomarker and cause of immune rippling muscle disease. The remainder covers updates on muscular dystrophies as well as congenital and inherited metabolic myopathies with an emphasis on genetic testing. Rare dystrophies, including one involving ANXA11 mutations and a series on oculopharyngodistal myopathy, are discussed.
Earlobe Rejuvenation: A Review of Current Treatment Modalities
Authors: Azzawi Soraya , Aigen Alyx Rosen 
Published: February 2023

BACKGROUND
As one of the defining features of the face, the ear influences perceptions of beauty. Despite its significance, comparatively little is known about rejuvenation options for the ear.

OBJECTIVE
To provide a comprehensive review of minimally invasive options for earlobe rejuvenation.

METHODS
& Materials: Cochrane, Embase, and PubMed were used to identify articles exploring minimally invasive treatments for ear rejuvenation.

RESULTS
Topical medications, peels, fillers, lasers, photodynamic therapy, and dermabrasion are safe and efficacious for managing a variety of concerns related to earlobe aesthetics.

CONCLUSION
Numerous minimally invasive treatment modalities are available for earlobe rejuvenation; further investigation is needed to design a grading system and treatment algorithm.
Variable ventilation versus stepwise lung recruitment manoeuvres for lung recruitment
Authors: Vivona Luigi , Huhle Robert , Braune Anja , Scharffenberg Martin , Wittenstein Jakob , Kiss Thomas , Kircher Michael , Herzog Paul , Herzog Moritz , Millone Marco , Gama de Abreu Marcelo , Bluth Thomas 
Published: February 2023

BACKGROUND
Variable ventilation recruits alveoli in atelectatic lungs, but it is unknown how it compares with conventional recruitment manoeuvres.

OBJECTIVES
To test whether mechanical ventilation with variable tidal volumes and conventional recruitment manoeuvres have comparable effects on lung function.

DESIGN
Randomised crossover study.

SETTING
University hospital research facility.

ANIMALS
Eleven juvenile mechanically ventilated pigs with atelectasis created by saline lung lavage.

INTERVENTIONS
Lung recruitment was performed using two strategies, both with an individualised optimal positive-end expiratory pressure (PEEP) associated with the best respiratory system elastance during a decremental PEEP trial: conventional recruitment manoeuvres (stepwise increase of PEEP) in pressure-controlled mode) followed by 50 min of volume-controlled ventilation (VCV) with constant tidal volume, and variable ventilation, consisting of 50 min of VCV with random variation in tidal volume.

MAIN OUTCOME MEASURES
Before and 50 min after each recruitment manoeuvre strategy, lung aeration was assessed by computed tomography, and relative lung perfusion and ventilation (0% = dorsal, 100% = ventral) were determined by electrical impedance tomography.

RESULTS
After 50 min, variable ventilation and stepwise recruitment manoeuvres decreased the relative mass of poorly and nonaerated lung tissue (percent lung mass: 35.3 ± 6.2 versus 34.2 ± 6.6, P = 0.303); reduced poorly aerated lung mass compared with baseline (−3.5 ± 4.0%, P = 0.016, and −5.2 ± 2.8%, P < 0.001, respectively), and reduced nonaerated lung mass compared with baseline (−7.2 ± 2.5%, P < 0.001; and −4.7 ± 2.8%, P < 0.001 respectively), while the distribution of relative perfusion was barely affected (variable ventilation: −0.8 ± 1.1%, P = 0.044; stepwise recruitment manoeuvres: −0.4 ± 0.9%, P = 0.167). Compared with baseline, variable ventilation and stepwise recruitment manoeuvres increased P
aO2 (172 ± 85mmHg, P = 0.001; and 213 ± 73 mmHg, P < 0.001, respectively), reduced P
aCO2 (−9.6 ± 8.1 mmHg, P = 0.003; and −6.7 ± 4.6 mmHg, P < 0.001, respectively), and decreased elastance (−11.4 ± 6.3 cmH2O, P < 0.001; and −14.1 ± 3.3 cmH2O, P < 0.001, respectively). Mean arterial pressure decreased during stepwise recruitment manoeuvres (−24 ± 8 mmHg, P = 0.006), but not variable ventilation.

CONCLUSION
In this model of lung atelectasis, variable ventilation and stepwise recruitment manoeuvres effectively recruited lungs, but only variable ventilation did not adversely affect haemodynamics.

TRIAL REGISTRATION
This study was registered and approved by Landesdirektion Dresden, Germany (DD24-5131/354/64).