bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic Rotator Cuff Repair Augmentation With Autologous Microfragmented Lipoaspirate Tissue Is Safe and Effectively Improves Short-term Clinical and Functional Results: A Prospective Randomized Controlled Trial With 24-Month Follow-up
Authors: Randelli Pietro S. , Cucchi Davide , Fossati Chiara , Boerci Linda , Nocerino Elisabetta , Ambrogi Federico , Menon Alessandra 
Published: March 2022

Background: Autologous microfragmented lipoaspirate tissue has been recently introduced in orthopaedics as an easily available source of nonexpanded adipose-derived mesenchymal stem cells. Autologous microfragmented lipoaspirate tissue is expected to create a suitable microenvironment for tendon repair and regeneration. Rotator cuff tears show a high incidence of rerupture and represent an ideal target for nonexpanded mesenchymal stem cells. Purpose: To evaluate the safety and efficacy of autologous lipoaspirate tissue in arthroscopic rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: Consecutive patients referring to the investigation center for surgical treatment of magnetic resonance imaging–confirmed degenerative posterosuperior rotator cuff tears were assessed for eligibility. Those who were included were randomized to receive a single-row arthroscopic rotator cuff repair, followed by intraoperative injection of autologous microfragmented adipose tissue processed with an enzyme-free technology (treatment group) or not (control group). Clinical follow-up was conducted at 3, 6, 12, 18, and 24 months; at 18 months after surgery, magnetic resonance imaging of the operated shoulder was obtained to assess tendon integrity and rerupture rate. Results: An overall 177 patients were screened, and 44 (22 per group) completed the 24-month follow-up. A statistically significant difference in favor of the treatment group in terms of Constant-Murley score emerged at the primary endpoint at 6-month follow-up (mean ± SD; control group, 76.66 ± 10.77 points; treatment group, 82.78 ± 7.00 points; P = .0050). No significant differences in clinical outcome measures were encountered at any of the other follow-up points. No significant differences emerged between the groups in terms of rerupture rate, complication rate, and number of adverse events. Conclusion: This prospective randomized controlled trial demonstrated that the intraoperative injection of autologous microfragmented adipose tissue is safe and effective in improving short-term clinical and functional results after single-row arthroscopic rotator cuff repair. Registration: NCT02783352 (ClinicalTrials.gov identifier).
Influence of exposure to microbial ligands, immunosuppressive drugs and chronic kidney disease on endogenous immunomodulatory gene expression in feline adipose-derived mesenchymal stem cells
Authors: Creamer Danielle G , Schmiedt Chad W , Bullington Anna Claire , Caster Courtney M , Schmiedt Jennifer M , Hurley David J , Berghaus Roy D 
Published: March 2022

Objectives Feline autologous mesenchymal stem cells (MSCs) show promise for immunomodulatory activity, but the functional impact of chronic kidney disease (CKD), concurrent immunosuppressive drug administration or infection is unknown. The study objectives compare endogenous cytokine gene expression (interleukin [IL]-6, IL-10, IL-12p40, IL-18 and transforming growth factor beta [TGF-β]) in adipose-derived MSCs (aMSCs) from cats with and without CKD, following in vitro exposure to microbial ligands and treatment with common immunosuppressive drugs. Methods Previously obtained aMSCs, phenotype CD44+, CD90+, CD105+ and MHCII–, from cats with (n = 6) and without (n = 6) CKD were compared via real-time PCR (RT-PCR) for immunomodulatory gene expression. aMSCs were exposed in vitro to lipopolysaccharide (LPS), peptidoglycan or polyinosinic:polycytidylic acid (Poly I:C), simulating bacterial or viral exposure, respectively. aMSCs were also exposed to ciclosporin, dexamethasone or methotrexate. Gene expression was measured using RT-PCR, and Cq was utilized after each run to calculate the delta cycle threshold. Results aMSCs isolated from healthy and CKD cats showed no significant differences in gene expression in the five measured cytokines. No significant changes in measured gene expression after drug treatment or microbial ligand stimulation were observed between normal or CKD affected cats. Proinflammatory genes (IL-6, IL-12p40 and IL-18) showed altered expression in aMSCs from both groups when compared with the same cells in standard culture after exposure to methotrexate. Poly I:C altered IL-6 and TGF-β gene expression in aMSCs from both healthy and CKD cats when compared with the same cells in standard culture. Conclusions and relevance The five genes tested showed no statistical differences between aMSCs from healthy or CKD cats. There was altered cytokine gene expression between the control and treatment groups of both healthy and CKD cats suggesting feline aMSCs have altered function with immunosuppressive treatment or microbial ligand exposure. Although the current clinical relevance of this pilot study comparing brief exposure to select agents in vitro in aMSCs from a small number of cats is unknown, the study highlights a need for continued investigation into the effects of disease and concurrent therapies on use of cell-based therapies in feline patients.
Factors Affecting Functional Recovery After Volar Locking Plate Fixation for Distal Radius Fractures
Authors: Hosokawa Takafumi , Tajika Tsuyoshi , Suto Morimichi , Chikuda Hirotaka 
Published: March 2022

Background: There is still no certainty about factors delaying functional recovery after surgery, although volar locking plate (VLP) fixation is the mainstay of treatment for distal radius fractures (DRFs), and several good postoperative recoveries have been reported. The purpose of this study was to investigate factors affecting functional recovery after VLP fixation for DRF. Methods: The subjects included 104 patients (84 females, 20 males, mean age: 63.2 ± 13.8 years) treated with VLP fixation for DRF, who could be followed for 1 year. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, grip strength, and range of motion of the wrist joint were measured at 3, 6, and 12 months postoperatively, and the primary outcome was the QuickDASH score. A multiple regression analysis adjusted for age and sex was used to analyze factors affecting functional recovery at 12 months. Results: A multiple regression analysis showed that the factors that significantly influenced the QuickDASH score at 1 year postoperatively were the grip strength ratio to the uninjured side, dominancy of the injured hand, and postoperative ulnar variance, in descending order of involvement. Trauma energy, history of diabetes, fracture type, complications, and range of motion were not included in the model. Conclusions: Smaller grip strength, dominant-hand injury, and larger postoperative ulnar variance significantly worsened the QuickDASH score at 1 year postoperatively. In order to achieve satisfactory functional recovery at 1 year after surgery, we confirmed that it is important to surgically achieve smaller postoperative ulnar variance and increase grip strength.
Patient characteristics predicting prolonged length of hospital stay following robotic-assisted radical prostatectomy
Authors: Hajj Albert El , Labban Muhieddine , Ploussard Guillaume , Zarka Jabra , Abou Heidar Nassib , Mailhac Aurelie , Tamim Hani 
Published: March 2022

Objective: The objective of this study is to determine the preoperative patient characteristics predicting prolonged length of hospital stay (pLOS) following robotic-assisted radical prostatectomy (RARP). Methods: The National Surgical Quality Improvement Program (NSQIP) database was used to select patients who underwent RARP without other concomitant surgeries between 2008 and 2016. Patients’ demographics, comorbidities, and laboratory markers were collected to evaluate their role in predicting pLOS. The pLOS was defined as length of stay (LOS) >2 days. A multinomial logistic regression was constructed adjusting for postoperative surgical complications to assess for the predictors of pLOS. Results: We obtained data for 31,253 patients of which 20,774 (66.5%) patients stayed ⩽1 day, 6993 (22.4%) patients stayed for 2 days, and 3486 (11.2%) patients stayed for >2 days. Demographic variables – including body mass index (BMI) <18.5: odds ratio (OR) = 2.8, 95% confidence interval (CI) = [1.7–4.8]; smoking: OR = 1.2, 95% CI = [1.1–1.4]; and dependent functional status: OR = 3.1, 95% CI = [1.6–6.0] – were predictors of pLOS. Comorbidities – such as heart failure: OR = 4.6, 95% CI = [2.0–10.8]; being dialysis dependent: OR = 2.7, 95% CI = [1.4–5.0]; and predisposition to bleeding: OR = 2.0, 95% CI =  [1.5–2.7] – were the strongest predictors of extended hospitalization. In addition, pLOS was more likely to be associated with postoperative bleeding, renal, or pulmonary complications. Conclusion: Preoperative patient characteristics and comorbidities can predict pLOS. These findings can be used preoperatively for risk assessment and patient counseling.
Mechanical revascularization using Solitaire AB device for acute limb ischemia secondary to popliteal and infrapopliteal embolic occlusion
Authors: Gong Maofeng , Zhou Yangyi , He Xu , Chen Liang , Zhao Boxiang , Kong Jie , Su Haobo , Gu Jianping 
Published: March 2022

Objective Acute limb ischemia is one of the most common arterial emergencies. The data of mechanical revascularization using Solitaire AB device coupled with thromboaspiration for the treatment of popliteal and infrapopliteal acute limb ischemia are limited. The aim of this study was to review the preliminary safety and effectiveness. Methods We performed a single-center retrospective review of patients with popliteal and infrapopliteal acute limb ischemia treated with Solitaire AB device coupled with thromboaspiration from February 2019 to May 2020. Adjunctive balloon angioplasty was performed to correct coexisting atherosclerotic stenosis. Technical success was defined as successful deployment of the Solitaire AB device across the occlusive segment and successful retrieval without the use of adjunctive catheter-directed thrombolysis or balloon angioplasty. Clinical success was defined as the relief of symptoms related to acute limb ischemia. Follow-up outcomes were also reviewed. Results There were 15 consecutive patients who underwent 16 Solitaire AB devices. Technical success was achieved in 11 (73.3%) patients. Of the unsuccessful patients, double-stent retrievers were employed in 1 (6.7%) patient. Two patients who encountered residual clots in distal small arteries underwent adjunctive catheter-directed thrombolysis. An adjunctive balloon angioplasty was required in 1 (6.7%) patient. All patients had notable acute limb ischemia symptom relief after the procedures. Clinical success was achieved in 14 (93.3%) patients. Besides one patient encountered minor amputation, the major amputation was prevented in all patients. No device-related complications or distal embolization events were recorded during the procedures. At the follow-up of 12 months, all surviving patients remained symptom-free, the patency was achieved in 12 (80%) patients and the limb salvage was 100%. Conclusions Preliminary outcomes suggest that mechanical revascularization using Solitaire AB device coupled with manual thromboaspiration appears to be a rapid, safe, and effective modality that appears to reduce the requirement for catheter-directed thrombolysis. Advances in knowledge These findings may add a promising recanalization therapy for acute embolic occlusion of the acute limb ischemia secondary to popliteal and infrapopliteal arteries.
Direct anterior approach for total hip arthroplasty with patients in the lateral decubitus versus supine positions: A prospective, double-blinded, randomized clinical trial
Authors: Xiao Yao , Li Zhanglai , Feng Eryou , Lin Feitai , Zhang Yiyuan , Weng Yan , Chen Jinhua 
Published: March 2022

Purpose The direct anterior approach (DAA) for total hip arthroplasty (THA) can be performed with patients in either in the lateral decubitus or supine position. Prompted by the lack of studies addressing differences between the two positions, this investigation aimed to examine clinical and radiographic outcomes and compare the lateral decubitus versus the supine position for THA using the DAA. Methods Between January 1 and October 1, 2020, 90 patients who underwent primary unilateral THA using the DAA were recruited, with 54 (60%) undergoing THA in the supine position (SP group) and 36 (40%) in the lateral decubitus position (LP group). Technical information, clinical and radiographic outcomes, and patient-reported outcomes, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short-Form-12 (SF-12) were evaluated. All data were subjected to several statistical tests. Results There were no preoperative differences in baseline characteristics between the LP and SP groups, which were also similar in terms of operative duration, length of hospital stay, and blood loss. Radiographic assessment confirmed satisfactory positioning of the prosthesis in both groups. There were no significant differences in terms of CK-MB and hemoglobin levels, Harris Hip Score, WOMAC, UCLA, visual analog scale score, and SF-12. The incidence of complications in the LP group was lower than in the SP group. Conclusion Total hip arthroplasty performed via DAA in the LP and SP groups yielded excellent clinical outcomes, although the incidence of complications in the former was lower than in the latter.
Submandibular Gland Sialocele: A Rare Complication Following Open Treatment of Mandibular Fracture
Authors: Callahan Nicholas , Licht Steven , Houle Ashley 
Published: March 2022

Study Design Case report. Objective A sialocele is a subcutaneous cavity containing saliva, caused by trauma or infection in the parotid or submandibular gland parenchyma, by ductal stenosis or glandular duct laceration with subsequent asymptomatic dilation and swelling. Many cases of parotid sialoceles have been published, but few cases of submandibular sialoceles occurring as a result of surgical trauma have been reported. The purpose of this article is to inform clinicians and to raise awareness about an unusual post-operative condition of a sialocele of the submandibular gland after treatment of a sequele of a mandible fracture. Methods We report a case of a 33-year-old male with a submandibular sialocele in the submandibular gland, that presented on computed tomography as a 10 × 4 × 3 cm right submandibular fluid collection in the submandibular space, and developed after an open reduction and internal fixation of a mandibular fracture through a submandibular approach. Results In the clinical case, the patient presented with sequelae of untreated fractures of the right angle and parasymphysis of the mandible. Both fractures had unfavorable deviations for 2 months, with a diagnosis of pseudoarthrosis, or non-union. In the first surgical stage, extensive debridement at the stie of non-union and precise anatomical reduction and fixation of the bone segments were performed via a submandibular surgical approach. The treatment of the post-operative sialocele occurred in a second surgical procedure, which included surgical exploration and right submandibular gland excision. No complications related to the post-operative approach were observed in a follow-up of 1 month. Conclusions Given the paucity of publications and treatment strategies for submandibular gland sialoceles in the literature, we hope to build a foundation to guide clinicians who encounter these rare adverse events. Surgeons will have a better understanding of the risks involved when they encounter cases like this, where extensive surgical debridement was necessary due to skewed consolidation and extensive pseudoarthrosis after the absence of immediate treatment following the initial trauma.
Soluble uric acid inhibits β2 integrin–mediated neutrophil recruitment in innate immunity
Authors: Ma Qiuyue , Immler Roland , Pruenster Monika , Sellmayr Markus , Li Chenyu , von Brunn Albrecht , von Brunn Brigitte , Ehmann Rosina , Wölfel Roman , Napoli Matteo , Li Qiubo , Romagnani Paola , Böttcher Ralph Thomas , Sperandio Markus , Anders Hans-Joachim , Steiger Stefanie 
Published: March 2022

Abstract
Neutrophils are key players during host defense and sterile inflammation. Neutrophil dysfunction is a characteristic feature of the acquired immunodeficiency during kidney disease. We speculated that the impaired renal clearance of the intrinsic purine metabolite soluble uric acid (sUA) may account for neutrophil dysfunction. Indeed, hyperuricemia (HU, serum UA of 9-12 mg/dL) related or unrelated to kidney dysfunction significantly diminished neutrophil adhesion and extravasation in mice with crystal- and coronavirus-related sterile inflammation using intravital microscopy and an air pouch model. This impaired neutrophil recruitment was partially reversible by depleting UA with rasburicase. We validated these findings in vitro using either neutrophils or serum from patients with kidney dysfunction–related HU with or without UA depletion, which partially normalized the defective migration of neutrophils. Mechanistically, sUA impaired β2 integrin activity and internalization/recycling by regulating intracellular pH and cytoskeletal dynamics, physiological processes that are known to alter the migratory and phagocytic capability of neutrophils. This effect was fully reversible by blocking intracellular uptake of sUA via urate transporters. In contrast, sUA had no effect on neutrophil extracellular trap formation in neutrophils from healthy subjects or patients with kidney dysfunction. Our results identify an unexpected immunoregulatory role of the intrinsic purine metabolite sUA, which contrasts the well-known immunostimulatory effects of crystalline UA. Specifically targeting UA may help to overcome certain forms of immunodeficiency, for example in kidney dysfunction, but may enhance sterile forms of inflammation.
Exosomal microRNA-140-3p from human umbilical cord mesenchymal stem cells attenuates joint injury of rats with rheumatoid arthritis by silencing SGK1
Authors: Huang Yijiang , Chen Liang , Chen Daosen , Fan Pei , Yu Huachen 
Published: March 2022

Abstract
Objective
Over the years, microRNAs (miRNAs) have been involved in the pathogenesis of rheumatoid arthritis (RA). We aim to investigate the role of human umbilical cord mesenchymal stem cells (HUCMSCs)-derived exosomal miR-140-3p in RA development.

Methods
Exosomes(exo) were isolated from human umbilical cord-derived mesenchymal stem cells (HUCMSCs), and this isolation was followed by the transfer of miR-140-3p. RA rat models were constructed by collagen II adjuvant and respectively treated with HUCMSCs-exo or HUCMSCs-exo carrying miR-140-3p mimic/inhibitor, and expression of miR-140-3p and serum- and glucocorticoid-inducible kinase 1 (SGK1) was assessed. Then, RA score and inflammation scoring, fibrosis degree and apoptosis, serum inflammatory response and oxidative stress in joint tissues were determined. The RA synovial fibroblasts (RASFs) were extracted from rats and identified. Conducted with relative treatment, the migration, proliferation and apoptosis in RASFs were determined.

Results
MiR-140-3p was decreased while SGK1 was increased in RA rats. HUCMSCs-exo or upregulated exosomal miR-140-3p improved pathological changes and suppressed inflammation, oxidative stress and fibrosis in RA rats, and also constrained and RASF growth. Overexpression of SGK1 reversed the inhibition of RASF growth caused by overexpression of miR-140-3p.

Conclusion
Upregulated exosomal miR-140-3p attenuated joint injury of RA rats by silencing SGK1. This research provided further understanding of the role of exosomal miR-140-3p in RA development.
The neutrophil percentage-to-albumin ratio is associated with all-cause mortality in critically ill patients with acute myocardial infarction
Authors: Lin Ya , Lin Yanhan , Yue Juanqing , Zou Qianqian 
Published: March 2022

Abstract
Aim
In this study, we evaluated the utility of neutrophil percentage-to-albumin ratio (NPAR) in predicting in critically ill patients with acute myocardial infarction (AMI).

Methods
The information of patients were collected from Medical Information Mart for Intensive Care III database. Admission NPAR was calculated as neutrophil percentage divided by serum albumin. The endpoints of this study were 30-day, 90-day, 180-day, and 365-day all-cause mortality. Cox proportional hazards models and subgroup analyses were used to determine the relationship between admission NPAR and these endpoints.

Results
798 critically ill patients with AMI were enrolled in. After adjustments for age, race and gender, higher admission NPAR was associated with increased risk of 30-day, 90-day, 180-day, and 365-day all-cause mortality in critically ill patients with AMI. And after adjusting for possible confounding variables, two different trends have emerged. Stratified by tertiles, high admission NPAR was independently associated with 180-day and 365-day all-cause mortality in critically ill patients with AMI (tertile 3 vs. tertile 1: adjusted HR, 95% CI 1.71, 1.10–2.66, p < 0.05; 1.66, 1.10–2.51, p < 0.05). In other hand, stratified by quartiles, highest admission NPAR levels were independently associated with 90-day, 180-day and 365-day all-cause mortality (quartile 4 vs. quartile 1: adjusted HR, 95% CI 2.36, 1.32–4.23, p < 0.05; 2.58, 1.49–4.47, p < 0.05; 2.61, 1.56–4.37, p < 0.05). ROC test showed that admission NPAR had a moderate ability to predict all-cause mortality of critically ill patients with AMI. No obvious interaction was found by subgroup analysis in most subgroups.

Conclusions
Admission NPAR was an independent predictor for 180-day and 365-day all-cause mortality in critically ill patients with AMI.
Analyzing differences between restricted mean survival time curves using pseudo-values
Authors: Ambrogi Federico , Iacobelli Simona , Andersen Per Kragh 
Published: March 2022

AbstractHazard ratios are ubiquitously used in time to event analysis to quantify treatment effects. Although hazard ratios are invaluable for hypothesis testing, other measures of association, both relative and absolute, may be used to fully elucidate study results. Restricted mean survival time (RMST) differences between groups have been advocated as useful measures of association. Recent work focused on model-free estimates of the difference in restricted mean survival through follow-up times, instead of focusing on a single time horizon. The resulting curve can be used to quantify the association in time units with a simultaneous confidence band. In this work a model-based estimate of the curve is proposed using pseudo-values allowing for possible covariate adjustment. The method is easily implementable with available software and makes possible to compute a simultaneous confidence region for the curve. The pseudo-values regression using multiple restriction times is in good agreement with the estimates obtained by standard direct regression models fixing a single restriction time. Moreover, the proposed method is flexible enough to reproduce the results of the non-parametric approach when no covariates are considered. Examples where it is important to adjust for baseline covariates will be used to illustrate the different methods together with some simulations.