bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sacral schwannoma: case report and review of the literature
Authors: Cuesta Juan Pablo , Rodríguez Laura Cristina , Bastidas Nicolás , Hernández Michel 
Published: November 2022

Schwannomas are tumors of the macroglia cells, most frequently localized to the brain, in the pontocerebellar angle. We present the case of a 53 year-old female patient who presented multiple times with diffuse abdominal pain and was initially diagnosed as having a complex right adnexal mass. Exploratory laparotomy found a retroperitoneal mass and later on, the presence of a sacral schwannoma was found, suspected initially on contrast magnetic resonance imaging of the abdomen and pelvis, and confirmed by means of lesional biopsy and histopathology. This is a rare and unusual presentation accounting for only 5% of this tumor location and poses a challenge for imaging diagnosis, directly impacting the approach to the patient and any future interventions. There are few reports in the literature about giant sacral schwannomas, but these tumors have been found to extend within the spinal space towards the vertebral space, even occupying part of the abdomen. Hence, the importance of recognizing the presence of this tumor as well as its imaging features.
eHealth literacy of patients attending a primary care clinic in Malaysia and its associated factors: A cross-sectional study
Authors: Wong Swee Shiuan , Lim Hooi Min , Chin Adrian Jian Zhi , Chang Felicia Wen Si , Yip Kah Chun , Teo Chin Hai , Abdullah Adina , Ng Chirk Jenn 
Published: November 2022

Background People are overloaded with online health information (OHI) of variable quality. eHealth literacy is important for people to acquire and appraise reliable information to make health-related decisions. While eHealth literacy is widely studied in developed countries, few studies have been conducted among patients in low- and middle-income countries (LMICs). Objective We aimed to determine the level of eHealth literacy in patients attending a primary care clinic in Malaysia and its associated factors. Methods A cross-sectional study using a self-administered questionnaire was conducted in an urban primary care clinic. We used a systematic random sampling method to select patients aged 18 years and above who attended the clinic. The eHealth literacy scale (eHEALS) was used to measure eHealth literacy. Results A total of 381 participants were included. The mean eHEALS was 24.4 ± 7.6. The eHEALS statements related to skills in appraising OHI were scored lower than statements related to looking for online resources. Higher education level of attending upper secondary school (AOR 2.53, 95% CI 1.05–6.11), tertiary education (AOR 4.05, 95% CI 1.60–10.25), higher monthly household income of >US$470 (AOR 1.95, 95% CI 1.07–3.56), and those who had sought OHI in the past month (AOR 1.95, 95% CI 1.13–3.36) were associated with a higher eHealth literacy level. Conclusions This study found a low eHealth literacy level among primary care patients in Malaysia. While the patients were confident in searching for OHI, they lacked skills in appraising them. Our findings inform the interventions for improving eHealth literacy in LMICs, especially educating the public about OHI appraisal.
Clinical Outcome of Sacroiliac Rod Fixation for Fragility Fracture of the Pelvis Rommens and Hoffman Classification Type IVb: Case Series
Authors: Gamada Hisanori , Yanagisawa Yohei , Teruya Shotaro , Eda Yusuke , Nakagawa Tsukasa , Yamazaki Masashi 
Published: November 2022

Introduction Fragility fracture of the pelvis (FFP), generally involving Rommens and Hoffman classification type IVb (H-shaped) requires spinopelvic fixation (SPF). We report the clinical outcome of sacroiliac rod fixation (SIRF) for FFP type IVb in a case series. Materials and Methods In this retrospective observational study, six patients (mean age, 80.3 years; range, 74-85 years) with FFP type IVb who underwent SIRF since October 2019 and could be followed up for ≥1 year postoperatively were included. All patients were injured in low-energy falls, a patient had a femoral neck fracture, and other had a humeral neck fracture and distal radius fracture. Results The mean (range) operative time was 135 (98-200) min, and mean blood loss was 103 (80-130) g. All patients achieved bone union in an average of 4.3 months. No implant failure or surgical site infection requiring reoperation occurred. No patient complained of iliac screw irritation or requested removal. One patient developed a T12 vertebral fracture at 3 weeks postoperatively. The mean final follow-up period was 17.8 months (13-22 months) and mean final modified Majeed Score (maximum 76 points as the items “work” and “sexual intercourse” were omitted for this study) was 71.7 (56-76). Conclusions SIRF is a less invasive surgical technique than SPF that uses only an S1 pedicle screw and iliac screw. SIRF using the “within ring” concept showed good clinical outcome in FFP type IVb.
Comparative analysis of core and perfusion lesion volumes between commercially available computed tomography perfusion software
Authors: Suomalainen Olli P , Martinez-Majander Nicolas , Sibolt Gerli , Bäcklund Katariina , Järveläinen Juha , Korvenoja Antti , Tiainen Marjaana , Forss Nina , Curtze Sami 
Published: November 2022

Introduction: Computed tomography perfusion (CTP) imaging has become an important tool in evaluating acute recanalization treatment candidates. Large clinical trials have successfully used RAPID automated imaging analysis software for quantifying ischemic core and penumbra, yet other commercially available software vendors are also on the market. We evaluated the possible difference in ischemic core and perfusion lesion volumes and the agreement rate of target mismatch between OLEA, MIStar, and Syngo.Via versus RAPID software in acute recanalization treatment candidates. Patients and methods: All consecutive stroke-code patients with baseline CTP RAPID imaging at Helsinki University Hospital during 8/2018–9/2021 were included. Ischemic core was defined as cerebral blood flow <30% than the contralateral hemisphere and within the area of delay time (DT) >3s with MIStar. Perfusion lesion volume was defined as DT > 3 s (MIStar) and Tmax > 6 s with all other software. A perfusion mismatch ratio of ⩾1.8, a perfusion lesion volume of ⩾15 mL, and ischemic core <70 mL was defined as target mismatch. The mean pairwise differences of the core and perfusion lesion volumes between software were calculated using the Bland-Altman method and the agreement of target mismatch between software using the Pearson correlation. Results: A total of 1606 patients had RAPID perfusion maps, 1222 of which had MIStar, 596 patients had OLEA, and 349 patients had Syngo.Via perfusion maps available. Each software was compared with simultaneously analyzed RAPID software. MIStar showed the smallest core difference compared with RAPID (−2 mL, confidence interval (CI) from −26 to 22), followed by OLEA (2 mL, CI from −33 to 38). Perfusion lesion volume differed least with MIStar (4 mL, CI from −62 to 71) in comparison with RAPID, followed by Syngo.Via (6 mL, CI from −94 to 106). MIStar had the best agreement rate with target mismatch of RAPID followed by OLEA and Syngo.Via. Discussion and conclusion: Comparison of RAPID with three other automated imaging analysis software showed variance in ischemic core and perfusion lesion volumes and in target mismatch.
Factors Related to the Inconstancy of Sustentaculum Tali Fragments in Intra-Articular Calcaneus Fractures
Authors: Park Chul-Hyun , Choi Hongjoon , Park Jeongjin 
Published: November 2022

Category: Trauma Introduction/Purpose: Since intra-articular fractures are common in calcaneus fractures, anatomical reduction is important. Several ligaments such as spring ligament and deltoid ligament are attached to the Sustentaculum tali (ST). It is known that ST fragment is constant in calcaneus fracture. However, few studies have been reported to prove this. Therefore, we studied to establish criteria for the inconstancy of ST fragments through the analysis of computed tomography (CT) of the unaffected calcaneus, to confirm the prevalence of ST fragment inconstancy by applying these criteria, and to analyze the factors related to the inconstancy of the ST fragment. Methods: From 2012 to 2020, CT scans of calcaneus fractures of 122 patients (101 men and 21 women) were taken, and angulation and diastasis of ST fragment were measured in the semi-coronal plane. As a control, angulation and diastasis were measured in 62 unaffected calcaneus. After establishing criteria for the inconstancy of ST fragments, we evaluated the prevalence of ST fragment inconstancy. After, we analyzed related factors. Patient factors included age, BMI, smoking, and diabetes. Radiographic factors included the degree of comminution of the posterior facet, location of the outermost fracture line of the posterior facet, presence of an intra-articular fracture of the ST, and width of the ST fragment. Results: The upper limit of the 95% CI of angulation and diastasis was 7.58° and 2.51 mm, respectively. Based on these criteria, the inconstancy of the ST fragment was observed in 34.5%. The width of the ST fragment was significantly smaller in the inconstant group. Severe comminution of the posterior facet, intra-articular fracture of the ST, and diabetes were significantly higher in the inconstant group. The inconstancy of the ST fragment was significantly associated with the width of the ST fragment (p < 0.001) (Table 1). Cut-off values for the inconstancy of the ST fragment were 20.5 mm for the width of the ST fragment. Conclusion: In intra-articular calcaneal fractures, ST fragment inconstancy was observed in 34.5%. The width of the ST fragment was significantly associated with the inconstancy of the ST fragment.
Outcomes of Bone Graft for Periprosthetic Osteolysis after Total Ankle Arthroplasty
Authors: Park Kwang Hwan , Yoon Yeokwon , Park Jae Han , Han Seung Hwan , Lee Jin Woo 
Published: November 2022

Category: Ankle Arthritis Introduction/Purpose: Periprosthetic osteolysis after total ankle arthroplasty (TAA) is a substantial problem. It has potential to affect implant survival. To prevent implant failure, it is important to decide an appropriate timing of surgical intervention such as bone graft. We report our outcomes of bone graft for osteolysis after TAA. Methods: We retrospectively evaluated our consecutive series of 470 primary TAAs performed between May 2004 and August 2019 and identified those who received operative management for periprosthetic osteolysis. A total of 43 bone graft procedures were performed. Location of osteolytic lesion, bone grafting method, histologic findings and clinical outcome parameters using visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, Ankle Osteoarthritis Scale (AOS) pain and disability score were evaluated. Mean follow-up period was 52.9 months (range, 24 to 120). Results: Total 61 osteolytic lesion were observed. 31 tibial cysts (50.8%), 24 talar cyst (39.3%) and 6 fibular cyst (9.8%) were treated and 17 ankles (39.5%) had multiple lesions. Autogenous iliac bone graft with polyethylene inlay exchange was performed in most of patients. All clinical scores improved significantly at the last follow-up (p<0.05) after operation. Five patients needed a repetitive bone graft procedure and one patient needed bone graft and additional bone cementation twice. There was one implant failure and overall survival rate after bone graft was 97.7%. Conclusion: Bone graft for periprosthetic osteolysis could improve clinical outcomes and implant survivorship. However, further study is needed for demonstrating etiology of newly developed osteolysis even after the bone graft.
Minimally Invasive Intra-Calcaneal Fractures vs Conservative Treatment: A Propensity Score Matched Cohort Series
Authors: Reichert Ines , Ahluwalia Raju S. , Musabahi Omar , Lyle Shirley 
Published: November 2022

Category: Trauma; Hindfoot Introduction/Purpose: We prospectively assessed the impact of minimally invasive internal fixation of displaced intra-articular calcaneal fractures (DIACF) results in better health outcomes up to 2 years post- injury than non-operative management. Methods: All isolated calcaneal fractures were reviewed and the decision to treat was made by a multidisciplinary meeting. Operative-treatment protocol involved sinus-tarsi approach or per-cutaneous reduction & internal fixation under the care of a fellowship-trained-foot and ankle surgeon. Non-operative protocol involved symptomatic management with no attempt at closed reduction. All fractures were classified, and the MOXFQ/EQ5D-L scores were used to assess general and disease-specific outcomes respectively. Secondary outcome measures included return to work and return to leisure activity levels. Statistical analysis was performed to assess normality of data (Shapiro Wilk test/Q-Q plots). Propensity matching was conducted using nearest neighbour matching, followed by regression analysis and modelling to compare baseline covariates between the two different groups. Results: Between 2015-2019 total of 93 patients met the inclusion criteria. After propensity score matching 44 patients were found in the surgical/ treatment group. The mean age was 40 (vs. 43.3) in the surgical group, no significant difference in age, sex, peripheral vascular disease, smoking status, laterality, and baseline Bohlers and Guisane angle in the propensity score matched sample. The surgically treated group had a higher Sanders class(p<0.05), higher MOXFQ at 12 months (p<0.05) and EQ-5DL scores at 24 months(p<0.05) and were more likely to return to work at 12m (95% vs 77%)(p<0.05), and physical activity levels at 12m (57% vs 36%)(p=0.054). The wound complication rate was 14.8%, no patients required further surgery; whilst non-operative- treatment mandated surgery for arthritis (6), and or/an injection (7 vs.3). Conclusion: Both non-operative and operative treatments are valid in DIACF. MIS-surgery offers better functional outcomes for severer injury patterns, and a less-likely need for arthritis intervention at 2yrs.
Inhibition of platelet activation suppresses reactive enteric glia and mitigates intestinal barrier dysfunction during sepsis
Authors: Cheng Bo , Du Mengyu , He Shuxuan , Yang Lan , Wang Xi , Gao Hui , Chang Haiqing , Gao Wei , Li Yan , Wang Qiang , Li Yansong 
Published: November 2022

AbstractBackgroundIntestinal barrier dysfunction, which is associated with reactive enteric glia cells (EGCs), is not only a result of early sepsis but also a cause of multiple organ dysfunction syndrome. Inhibition of platelet activation has been proposed as a potential treatment for septic patients because of its efficacy in ameliorating the organ damage and barrier dysfunction. During platelet activation, CD40L is translocated from α granules to the platelet surface, serving as a biomarker of platelet activation a reliable predictor of sepsis prognosis. Given that more than 95% of the circulating CD40L originate from activated platelets, the present study aimed to investigate if inhibiting platelet activation mitigates intestinal barrier dysfunction is associated with suppressing reactive EGCs and its underlying mechanism.MethodsCecal ligation and puncture (CLP) was performed to establish the sepsis model. 24 h after CLP, the proportion of activated platelets, the level of sCD40L, the expression of tight-junction proteins, the intestinal barrier function and histological damage of septic mice were analyzed. In vitro, primary cultured EGCs were stimulated by CD40L and LPS for 24 h and EGCs-conditioned medium were collected for Caco-2 cells treatment. The expression of tight-junction proteins and transepithelial electrical resistance of Caco-2 cell were evaluated.ResultsIn vivo, inhibiting platelet activation with cilostazol mitigated the intestinal barrier dysfunction, increased the expression of ZO-1 and occludin and improved the survival rate of septic mice. The efficacy was associated with reduced CD40L+platelets proportion, decreased sCD40L concentration, and suppressed the activation of EGCs. Comparable results were observed upon treatment with compound 6877002, a blocker of CD40L-CD40-TRAF6 signaling pathway. Also,S-nitrosoglutathione supplement reduced intestinal damage both in vivo and in vitro. In addition, CD40L increased release of TNF-α and IL-1β while suppressed the release ofS-nitrosoglutathione from EGCs. These EGCs-conditioned medium reduced the expression of ZO-1 and occludin on Caco-2 cells and their transepithelial electrical resistance, which could be reversed by CD40-siRNA and TRAF6-siRNA transfection on EGCs.ConclusionsThe inhibition of platelet activation is related to the suppression of CD40L-CD40-TRAF6 signaling pathway and the reduction of EGCs activation, which promotes intestinal barrier function and survival in sepsis mice. These results might provide a potential therapeutic strategy and a promising target for sepsis.
Development and Control of a Magnetorheological Damper-Based Brake Pedal Simulator for Vehicle Brake-by-Wire Systems
Authors: Wang Daoming , Wang Biao , Zi Bin , Bai Xianxu , Chen Wuwei 
Published: November 2022

AbstractRecent developments have demonstrated that the brake pedal simulator (BPS) is becoming an indispensable apparatus for the break-by-wire systems in future electric vehicles. Its main function is to provide the driver with a comfortable pedal feel to improve braking safety and comfort. This paper presents the development and control of an adjustable BPS, using a disk-type magnetorheological (MR) damper as the passive braking reaction generator to simulate the traditional pedal feel. A detailed description of the mechanical design of the MR damper-based BSP (MRDBBPS) is presented in this paper. Several basic performance experiments on the MRDBBPS prototype are conducted. A return-to-zero (RTZ) algorithm is proposed to avoid hysteresis and improve the repeatability of the pedal force. In addition, an RTZ algorithm-based real-time current-tracking controller (RTZRC) is designed in consideration of the response lag of the coil circuit. Finally, an experimental system is established by integrating the MRDBBPS prototype into a self-developed automotive MR braking test bench (AMRBTB), and several control and braking experiments are performed. This research proposes a RTZRC control algorithm which can significantly increase the tracking accuracy of the brake pedal characteristic curve, particularly at a high pedal velocity. Additionally, the designed MRDBBPS prototype can achieve an effective and favorable control of the AMRBTB with a good repeatability.
tRF-3013b inhibits gallbladder cancer proliferation by targeting TPRG1L
Authors: Zou Lu , Yang Yang , Zhou Biyu , Li Weijian , Liu Ke , Li Guoqiang , Miao Huijie , Song Xiaoling , Yang Jiahua , Geng Yajun , Li Maolan , Bao Runfa , Liu Yingbin 
Published: November 2022

Abstract
Background
tRNA-derived fragments (tRFs) are newly discovered noncoding RNAs and regulate tumor progression via diverse molecular mechanisms. However, the expression and biofunction of tRFs in gallbladder cancer (GBC) have not been reported yet.

Methods
The expression of tRFs in GBC was detected by tRF and tiRNA sequencing in GBC tissues and adjacent tissues. The biological function of tRFs was investigated by cell proliferation assay, clonal formation assay, cell cycle assay, and xenotransplantation model in GBC cell lines. The molecular mechanism was discovered and verified by transcriptome sequencing, fluorescence in situ hybridization (FISH), target gene site prediction, and RNA binding protein immunoprecipitation (RIP).

Results
tRF-3013b was significantly downregulated in GBC compared with para-cancer tissues. Decreased expression of tRF-3013b in GBC patients was correlated with poor overall survival. Dicer regulated the production of tRF-3013b, and its expression was positively correlated with tRF-3013b in GBC tissues. Functional experiments demonstrated that tRF-3013b inhibited GBC cell proliferation and induced cell-cycle arrest. Mechanically, tRF-3013b exerted RNA silencing effect on TPRG1L by binding to AGO3, and then inhibited NF-κB. TPRG1L overexpression could rescue the effects of tRF-3013b on GBC cell proliferation.

Conclusions
This study indicated that Dicer-induced tRF-3013b inhibited GBC proliferation by targeting TPRG1L and repressed NF-κB, pointing to tRF-3013b as a novel potential therapeutic target of GBC.
Association of lactate to albumin ratio and bicarbonate with short-term mortality risk in patients with acute myocardial infarction
Authors: Zhu Jia-Liang , Liu Hui , Wang Li-Li , Lu Xue-Hao , Yin Hai-Yan , Lyu Jun , Wei Jian-Rui 
Published: November 2022

Abstract
Background
Previous studies have indicated that the ratio of lactate/albumin (L/A) has predictive value for the prognosis of critically ill patients with heart failure. Some studies have also indicated that a low serum bicarbonate concentration is inversely related to the mortality risk of patients with cardiogenic shock. However, the value of bicarbonate and the L/A ratio for predicting the mortality risk of patients with acute myocardial infarction (AMI) is still unclear. We therefore conducted a retrospective study to research this problem.

Methods
The subjects of this study were patients with AMI, and the data source was the Medical Information Mart for Intensive Care III database. The primary endpoint was 30-day all-cause mortality after admission. The Receiver operating characteristic (ROC) curve was used to compare the predictive value of L/A ratio, lactate and albumin for end-point events. The effects of different L/A ratio levels and different bicarbonate concentrations on 7-day and 30-day all-cause mortality were compared using Kaplan–Meier (K-M) curves. Hazard ratios for different L/A ratio and different bicarbonate concentrations were investigated using COX proportional hazards models.

Results
The Area Under Curve (AUC) of L/A ratio, lactate, and albumin were 0.736, 0.718, and 0.620, respectively. (1) L/A ratio: The patients were divided into three groups according to their L/A ratio: tertile T1 (L/A ratio ≤ 0.47), tertile T2 (L/A ratio ≤ 0.97), and tertile T3 (L/A ratio > 0.97). The T2 and T3 groups had higher 30-day all-cause mortality risks than the T1 group. The restricted cubic spline (RCS) model indicated that there was a nonlinear relationship between L/A ratio and 30-day mortality (P < 0.05). (2) Bicarbonate concentration: The patients were also divided into three groups based on their bicarbonate concentration: G1 (22–27 mmol/L), G2 (< 22 mmol/L), and G3 (> 27 mmol/L). The G2 and G3 groups had higher 30-day all-cause mortality risks than the G1 group. The RCS model indicated that there was a nonlinear relationship between bicarbonate concentration and 30-day mortality (P < 0.05). The RCS model indicated that there was a nonlinear relationship between hemoglobin level and 30-day all-cause mortality (P < 0.05).

Conclusion
L/A ratio and bicarbonate concentration and hemoglobin level have predictive value for predicting 30-day mortality in patients with acute myocardial infarction.