bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dosimetric evaluation of photons versus protons in postmastectomy planning for ultrahypofractionated breast radiotherapy
Authors: Oonsiri Puntiwa , Nantavithya Chonnipa , Lertbutsayanukul Chawalit , Sarsitthithum Thanaporn , Vimolnoch Mananchaya , Tawonwong Tanawat , Saksornchai Kitwadee 
Published: January 2022

Abstract
Background
Ultrahypofractionation can shorten the irradiation period. This study is the first dosimetric investigation comparing ultrahypofractionation using volumetric arc radiation therapy (VMAT) and intensity-modulated proton radiation therapy (IMPT) techniques in postmastectomy treatment planning.

Materials and methods
Twenty postmastectomy patients (10-left and 10-right sided) were replanned with both VMAT and IMPT techniques. There were four scenarios: left chest wall, left chest wall including regional nodes, right chest wall, and right chest wall including regional nodes. The prescribed dose was 26 Gy(RBE) in 5 fractions. For VMAT, a 1-cm bolus was added for 2 in 5 fractions. For IMPT, robust optimization was performed on the CTV structure with a 3-mm setup uncertainty and a 3.5% range uncertainty. This study aimed to compare the dosimetric parameters of the PTV, ipsilateral lung, contralateral lung, heart, skin, esophageal, and thyroid doses.

Results
The PTV-D95 was kept above 24.7 Gy(RBE) in both VMAT and IMPT plans. The ipsilateral lung mean dose of the IMPT plans was comparable to that of the VMAT plans. In three of four scenarios, the V5 of the ipsilateral lung in IMPT plans was lower than in VMAT plans. The Dmean and V5 of heart dose were reduced by a factor of 4 in the IMPT plans of the left side. For the right side, the Dmean of the heart was less than 1 Gy(RBE) for IMPT, while the VMAT delivered approximately 3 Gy(RBE). The IMPT plans showed a significantly higher skin dose owing to the lack of a skin-sparing effect in the proton beam. The IMPT plans provided lower esophageal and thyroid mean dose.

Conclusion
Despite the higher skin dose with the proton plan, IMPT significantly reduced the dose to adjacent organs at risk, which might translate into the reduction of late toxicities when compared with the photon plan.
Application of computerized virtual preoperative planning procedures in comminuted posterior wall acetabular fractures surgery
Authors: Zheng Yifan , Chen Jianan , Yang Siyu , Ke Xi , Xu Dan , Wang Guodong , Cai Xianhua , Liu Ximing 
Published: January 2022

Abstract
Background
The treatment of comminuted posterior wall acetabular fractures remains challenging due to the difficulty in understanding of fracture patterns and lack of appropriate preoperative planning process. Virtual preoperative planning procedures are now being commonly used in orthopedic surgery to aid in management of such complex problems. Our aim was to evaluate the feasibility and clinical value of a new method by applying computerized virtual preoperative planning procedures in the treatment of comminuted posterior wall acetabular fractures.

Methods
A total of 45 patients with comminuted posterior wall acetabular fractures from June 2014 to December 2018 were retrospectively analyzed. Based on the usage of computerized virtual preoperative planning procedures, they were assigned to group A and group B. In group A (24 patients), the new method was applied before surgery. In group B (21 patients), the conventional surgery was performed without assistance of computerized virtual preoperative planning procedures. The two groups were assessed in terms of blood loss, surgical time, reduction quality, fracture healing time, postoperative complications, and hip function.

Results
There were no significant differences in demographic data between the two groups. Patients in group A had significantly less intraoperative blood loss (429.58 vs 570.24 ml, P < 0.001) and shorter operation time (154.79 vs 181.90 min, P < 0.01) compared to group B. Using the Matta scoring system, the reduction was graded as anatomic in 20 cases, imperfect in three cases and poor in one case in group A, versus 16 cases was graded as anatomic, three as imperfect and two as poor for group B. According to the modified Merle d’Aubigné score, hip function was graded as excellent in 15 cases, good in seven cases, fair in one and poor in one for group A in comparison to 11 cases, seven cases, two cases, and one case for group B, respectively. The reduction quality and hip function did not differ within the two groups (P > 0.05). The general postoperative complication rate in group A and group B was 12.5% and 28.6%, respectively, but the difference between the two groups was not statistically significant.

Conclusion
The application of computerized virtual preoperative planning procedures is feasible in comminuted posterior wall acetabular fractures. It helps orthopedic surgeons better understand the fracture characteristics, enables simulation of the reduction process and preoperative planning of internal fixation methods. This new preoperative planning method using a 3D virtual model is a more effective method than conventional method in surgical treatment of comminuted posterior wall acetabular fractures.
Trial registration retrospectively registered.
Circ_0001947 promotes cell proliferation, invasion, migration and inflammation and inhibits apoptosis in human rheumatoid arthritis fibroblast-like synoviocytes through miR-671-5p/STAT3 axis
Authors: Yang Yang , Lin Shudian , Yang Zhou , Huang Yanyan , Zhan Feng 
Published: January 2022

Abstract
Background
Circular RNAs (circRNAs) have emerged as vital regulators in the development of rheumatoid arthritis (RA). In this study, we aimed to explore the functions and mechanisms of circ_0001947 in RA.

Methods
The expression of circ_0001947, microRNA-671-5p (miR-671-5p) and signal transducer and activator of transcription 3 (STAT3) was determined by quantitative real-time polymerase chain reaction (qRT-PCR) or western blot. Cell Counting Kit-8 (CCK-8) assay, 5′-ethynyl-2′-deoxyuridine (EdU) assay, flow cytometry analysis, transwell assay and wound-healing assay were performed to assess cell proliferation, apoptosis, invasion and migration. The concentrations of inflammatory factors were examined with enzyme-linked immunosorbent assay (ELISA) kits. Dual-luciferase reporter assay was used to analyze the relationships of circ_0001947, miR-671-5p and STAT3.

Results
Circ_0001947 was upregulated in RA patients and RA-FLSs. Knockdown of circ_0001947 repressed cell proliferation, invasion, migration and inflammatory response and facilitated apoptosis in RA-FLSs. Circ_0001947 served as the sponge for miR-671-5p and the inhibitory effect of circ_0001947 in RA-FLS progression was reversed by miR-671-5p inhibition. STAT3 was the target gene of miR-671-5p. MiR-671-5p overexpression restrained RA-FLS growth, invasion, migration and inflammation and promoted apoptosis, but STAT3 upregulation reversed the impacts.

Conclusion
Circ_0001947 contributed to the progression of RA-FLSs by elevating STAT3 through adsorbing miR-671-5p.
Fractures of the distal femur in elderly patients: retrospective analysis of a case series treated with single or double plate
Authors: Nam Dae Jin , Kim Min Seok , Kim Tae Ho , Kim Min Woo , Kweon Suc Hyun 
Published: January 2022

Abstract
Introduction
We evaluated the radiologic and clinical outcomes of a lateral incision single plate with and a single-incision double plating in elderly patients with osteoporotic distal femoral fractures.

Materials and methods
We performed a retrospective study of 82 cases of distal femoral fractures from May 2004 to June 2018. Group A consisted of 42 patients who underwent single-plate fixation. Group B consisted of 40 patients who underwent double-plate fixation. The mean patient age was 77 years (67–87 years) and 76 years (64–86 years) in groups A and B, respectively. All patients were evaluated for procedure duration, time to union, range of knee motion, Lysholm knee score, and presence of complications.

Results
The average procedure time was 81 min (66–92 min) and 110 min (95–120 min) in groups A and B, respectively (p = 0.33). One case in group B required bone grafting after 5 months. The average time to union was 14 weeks (9–19 weeks) and 12.2 weeks (8–19 weeks) (p = 0.63), and the mean range of knee motion was 105° (90–125°) and 110.7° (90°–130°) (p = 0.37) in groups A and B, respectively. There was no significant statistical difference between the two groups in the Lysholm knee score (p = 0.44) and knee society score (p = 0.53).

Conclusion
The clinical and radiological outcomes were similar in the 2 groups. In elderly patients, double plate fixation for distal femoral fractures is an useful method for several advantages such as adequate exposure, easy manipulation, anatomical reduction and stable fixation.
Posterior minimally invasive scoliosis surgery versus the standard posterior approach for the management of adolescent idiopathic scoliosis: an updated meta-analysis
Authors: Yang Honghao , Jia Xiangyuan , Hai Yong 
Published: January 2022

Abstract
Background
Surgical management of adolescent idiopathic scoliosis (AIS) can be performed using standard posterior spinal fusion (PSF) or with a posterior minimally invasive approach. Minimally invasive scoliosis surgery (MISS) has several theoretical advantages, such as less tissue dissection, less blood loss, and earlier recovery. However, the difference in safety and effectiveness between MISS and PSF still needs to be clarified. This updated meta-analysis aimed to compare the outcomes of MISS and standard PSF for the management of AIS.

Methods
A comprehensive literature search of PubMed, EMBASE, MEDLINE, and Cochrane Library without time restriction was performed to identify relevant studies. MISS and PSF were compared in terms of radiographic parameters, estimated blood loss (EBL), blood transfusion rate, operative time (ORT), length of hospital stay (LOS), overall Scoliosis Research Society-22 (SRS-22) score, postoperative pain, and complication rate.

Results
A total of seven studies comprising 767 patients (329 MISS and 438 PSF) with AIS were included. MISS and PSF yielded comparable deformity correction at the last follow-up. There were no significant differences in the overall SRS-22 scores or complication rates between the groups. Nevertheless, greater restoration of thoracic kyphosis (WMD, 2.98; 95% CI 0.58 to 5.37, P = 0.015), less EBL (WMD, −218.76; 95% CI −256.41 to −181.11, P < 0.001), a lower blood transfusion rate (RR, 0.31; 95% CI 0.20 to 0.48, P < 0.001), a shorter LOS (WMD, −1.48; 95% CI −2.48 to −0.48, P = 0.004), less postoperative pain (WMD, 0.57; 95% CI 0.16 to 0.98, P = 0.006), and a longer ORT (WMD, 84.85; 95% CI 33.30 to 136.40, P = 0.001) were observed in the MISS group.

Conclusion
Despite its inherent technical challenges, MISS is a feasible and effective alternative to standard PSF for AIS patients with moderate and flexible curves. MISS was associated with adequate deformity correction, better restoration of sagittal alignment, less EBL, fewer transfusions, shorter LOS, and better pain management compared to PSF. Further research is required to determine the detailed indications for the MISS procedure.
Accuracies of bone resection, implant position, and limb alignment in robotic-arm-assisted total knee arthroplasty: a prospective single-centre study
Authors: Li Chenkai , Zhang Zian , Wang Guanrong , Rong Chun , Zhu Wanping , Lu Xinzhe , Liu Yikai , Zhang Haining 
Published: January 2022

Abstract
Objective
This study assessed the accuracy of robotic-arm-assisted total knee arthroplasty (RATKA) for bone resection, component size prediction, implant placement, and limb alignment.

Methods
This prospective cohort study included 36 patients. All procedures were performed by a single experienced surgeon, using an identical approach and implant designs. The MAKO RIO Robotic Interactive Orthopaedic Arm (Stryker, Mahwah, NJ, USA) system was used. The actual bone resection, implant placement, component size, and postoperative mechanical alignment were recorded, then compared with the preoperative plan.

Results
The mean absolute differences from the plan for the distal (medial and lateral) and posterior (medial and lateral) femoral cuts were 0.39 mm (0.62), 0.49 mm (0.70), 0.62 mm (0.79), and 0.65 mm (0.81), respectively, with 0.57° (0.65) varus. The mean absolute differences in the medial and lateral tibial cuts were 0.56 mm (0.75) and 0.58 mm (0.76), with 0.48° (0.16) varus and 0.54° (0.25) anterior/posterior slope. Of 192 bone resections, 176 (91.7%) were within ≤ 1 mm of the preoperative plan. The accuracies of femoral and tibial component size prediction were 100% and 97.22%, respectively. The mean absolute difference in final limb coronal alignment was 0.92° (0.65). Of the alignments, 18 (75.0%) were within ≤ 1.00° of the plan, and 100% were within ≤ 3.00° of the plan.

Conclusion
RATKA could accurately predict the component size and execute a preoperative plan to achieve precise bone resection, and implant placement, thereby reducing alignment outliers.
Not all patients benefit from the postoperative antifibrinolytic treatment: clinical evidence against the universal use of tranexamic acid following total knee arthroplasty
Authors: Liu Jiacheng , Wang Han , Wu Xiangdong , Lei Yiting , Huang Wei 
Published: January 2022

Abstract
Background
The empirical use of tranexamic acid (TXA) for bleeding remains controversial because of the distinct fibrinolytic phenotypes observed after injury. This study sought to assess the efficacy of postoperative TXA in patients presenting with different fibrinolytic phenotypes after total knee arthroplasty (TKA).

Methods
This retrospective study included 270 patients who underwent primary TKA. The patients were divided into two groups: Group A, received no postoperative TXA, and Group B, received postoperative TXA; they were further categorized into four subgroups based on postoperative fibrinolytic phenotypes (non-fibrinolytic shutdown [NFSD] and fibrinolytic shutdown [FSD]). Fibrinolytic phenotypes were determined using percentage of clot lysis 30 min after maximum strength (LY30) level measured on postoperative day 1 (POD1). Data on perioperative hidden blood loss (HBL), decrease in the hemoglobin level (ΔHb), allogeneic blood transfusion (ABT) rate, fibrin degradation product (FDP) level, D-dimer (D-D) level, prothrombin time (PT), and activated partial thromboplastin time (APTT) as well as clinical baseline data were collected and compared.

Results
No differences in baseline clinical data were noted. Among patients presenting with NFSD, those in Group B had significantly lower HBL and ΔHb on POD1 and POD3 than those in Group A. Among patients presenting with FSD, perioperative HBL and ΔHb were similar between the two groups. No differences were observed in perioperative ABT rate, FDP level, D-D level, PT, and APTT.

Conclusions
Patients exhibit various fibrinolytic phenotypes after TKA. Postoperative antifibrinolytic strategies may be beneficial for patients presenting with NFSD, but not for those presenting with FSD. The LY30 level may guide targeted TXA administration after TKA. However, well-designed prospective randomized controlled trials are needed to obtain more robust data.
Accuracy and reliability of tridimensional electromagnetic sensor system for elbow ROM measurement
Authors: Yamaura Kohei , Mifune Yutaka , Inui Atsuyuki , Nishimoto Hanako , Kataoka Takeshi , Kurosawa Takashi , Mukohara Shintaro , Hoshino Yuichi , Niikura Takahiro , Nagamune Kouki , Kuroda Ryosuke 
Published: January 2022

Abstract
Background
While the precise measurement of the range of motion (ROM) of the elbow joint is important for clinical assessment and rehabilitation, problems include low accuracy and reproducibility in goniometer measurements due to the influence of soft tissue. The purpose of this study was to validate elbow joint motion analysis using a three-dimensional electromagnetic sensor system (EMS).

Methods
The accuracy and reproducibility of the EMS system were evaluated at four angles (0°, 45°, 90°, and 135°) using a model bone of the humerus and forearm. In addition, the maximum extension and maximum flexion of six elbows of six healthy volunteers were assessed by radiographic and EMS measurements. Accuracy was assessed by calculating the mean value of the measurement angle, standard deviation, Pearson’s correlation coefficient, and the Bland–Altman method. Reproducibility was assessed by calculating the intra-rater and inter-rater reliabilities using intraclass correlation coefficients.

Results
In the model bone evaluation, the mean angles of the EMS measurement were 1.2° ± 2.0°, 45.4° ± 2.1°, 91.7° ± 2.4°, and 134.6° ± 2.7° at 0°, 45°, 90°, and 135°, respectively. In the in vivo evaluation, the elbow angles at the maximum extension with the EMS and radiographic angles were 4.7° ± 3.0° and 2.7° ± 2.0°, respectively, and the angles at maximum flexion were 131.8° ± 13.0° and 130.8° ± 4.5°, respectively. There were statistically significant correlations between the EMS and radiographic measurements; the Bland–Altman plots indicated that the two methods were almost in agreement for both extension and flexion.

Conclusions
This method of measuring ROM of the elbow joint using EMS showed high accuracy, reliability, and reproducibility. The current results demonstrated the possibility of using the electromagnetic system to provide an accurate evaluation of the elbow joint in clinical settings.
Development of a standard of care for patients with valosin-containing protein associated multisystem proteinopathy
Authors: Korb Manisha , Peck Allison , Alfano Lindsay N. , Berger Kenneth I. , James Meredith K. , Ghoshal Nupur , Healzer Elise , Henchcliffe Claire , Khan Shaida , Mammen Pradeep P. A. , Patel Sujata , Pfeffer Gerald , Ralston Stuart H. , Roy Bhaskar , Seeley William W. , Swenson Andrea , Mozaffar Tahseen , Weihl Conrad , Kimonis Virginia ,   the VCP Standards of Care Working Group, Fanganiello Roberto , Lee Grace , Mahoney Ryan Patrick , Diaz-Manera Jordi , Evangelista Teresinha , Freimer Miriam , Lloyd Thomas E. , Keung Benison , Kushlaf Hani , Milone Margherita , Needham Merrilee , Palmio Johanna , Stojkovic Tanya , Villar-Quiles Rocío-Nur , Wang Leo H. , Wicklund Matthew P. , Singer Frederick R. , Jones Mallory , Miller Bruce L. , Ahmad Sajjadi S. , Obenaus Andre , Geschwind Michael D. , Al-Chalabi Ammar , Wymer James , Chen Nita , Kompoliti Katie , Wang Stephani C. , Boissoneault Catherine A. , Cruz-Coble Betsaida , Garand Kendrea L. , Rinholen Anna J. , Tabor-Gray Lauren , Rosenfeld Jeffrey , Guo Ming , Peck Nathan 
Published: January 2022

AbstractValosin-containing protein (VCP) associated multisystem proteinopathy (MSP) is a rare inherited disorder that may result in multisystem involvement of varying phenotypes including inclusion body myopathy, Paget’s disease of bone (PDB), frontotemporal dementia (FTD), parkinsonism, and amyotrophic lateral sclerosis (ALS), among others. An international multidisciplinary consortium of 40+ experts in neuromuscular disease, dementia, movement disorders, psychology, cardiology, pulmonology, physical therapy, occupational therapy, speech and language pathology, nutrition, genetics, integrative medicine, and endocrinology were convened by the patient advocacy organization, Cure VCP Disease, in December 2020 to develop a standard of care for this heterogeneous and under-diagnosed disease. To achieve this goal, working groups collaborated to generate expert consensus recommendations in 10 key areas: genetic diagnosis, myopathy, FTD, PDB, ALS, Charcot Marie Tooth disease (CMT), parkinsonism, cardiomyopathy, pulmonology, supportive therapies, nutrition and supplements, and mental health. In April 2021, facilitated discussion of each working group’s conclusions with consensus building techniques enabled final agreement on the proposed standard of care for VCP patients. Timely referral to a specialty neuromuscular center is recommended to aid in efficient diagnosis of VCP MSP via single-gene testing in the case of a known familial VCP variant, or multi-gene panel sequencing in undifferentiated cases. Additionally, regular and ongoing multidisciplinary team follow up is essential for proactive screening and management of secondary complications. The goal of our consortium is to raise awareness of VCP MSP, expedite the time to accurate diagnosis, define gaps and inequities in patient care, initiate appropriate pharmacotherapies and supportive therapies for optimal management, and elevate the recommended best practices guidelines for multidisciplinary care internationally.
Islet amyloid polypeptide cross-seeds tau and drives the neurofibrillary pathology in Alzheimer’s disease
Authors: Zhang Guoxin , Meng Lanxia , Wang Zhihao , Peng Qinyu , Chen Guiqin , Xiong Jing , Zhang Zhentao 
Published: January 2022

AbstractBackgroundThe pathologic accumulation and aggregation of tau is a hallmark of tauopathies including Alzheimer’s disease (AD). However, the molecular mechanisms mediating tau aggregation in AD remain elusive. The incidence of AD is increased in patients with type 2 diabetes (T2DM), which is characterized by the amyloid deposition of islet amyloid polypeptide (IAPP) in the pancreas. However, the molecular mechanisms bridging AD and T2DM remain unknown.MethodsWe first examined the presence of IAPP in the neurofibrillary tangles of AD patients. Then we tested the effect of IAPP on tau aggregation. The biochemical and biological characteristics of the IAPP-tau fibrils were tested in vitro. The seeding activity and neurotoxicity of the IAPP-tau fibrils were confirmed in cultured neurons. Lastly, the effect of IAPP on tau pathology and cognitive impairments was determined by injecting the IAPP-tau fibrils and IAPP fibrils into the hippocampus of tau P301S mice.ResultsWe found that IAPP interacts with tau and accelerates the formation of a more toxic strain, which shows distinct morphology with enhanced seeding activity and neurotoxicity in vitro. Intrahippocampal injection of the IAPP-tau strain into the tau P301S transgenic mice substantially promoted the spreading of tau pathology and induced more severe synapse loss and cognitive deficits, when compared with tau fibrils. Furthermore, intracerebral injection of synthetic IAPP fibrils initiated tauopathy in the brain of tau P301S transgenic mice.ConclusionsThese observations indicate that IAPP acts as a crucial mediator of tau pathology in AD, and provide a mechanistic explanation for the higher risk of AD in individuals with T2DM.