bluuebunny/crossref_metadata_2025_split huggingface dataset:
Types of Retears After Knot-tying and Knotless Suture Bridge Rotator Cuff Repair: A Systematic Review and Meta-analysis
Authors: Prasathaporn Niti , Thamrongskulsiri Napatpong , Itthipanichpong Thun , Limskul Danaithep 
Published: November 2022

Background: In conventional double-row repair for rotator cuff tears, tying the medial row of anchor sutures can strangulate the tendon. The knotless medial row technique has been recommended to improve vascularity and reduce retear rates. The researchers divided the retear pattern into 2 categories: type 1 (failure at the tendon-bone interface) and type 2 (failure at the musculotendinous junction with healed footprint). Purpose: To compare studies on knot-tying versus knotless double-row repair for rotator cuff tears according to retear type and clinical and radiological outcomes. Study Design: Systematic review; Level of evidence, 3. Methods: A search of the PubMed, Embase, Scopus, and Cochrane databases was performed following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included were studies that directly compared the knot-tying and knotless double-row techniques and provided postoperative patient-reported outcomes and retear rates. The Methodology Index for Non-Randomized Studies (MINORS) criteria were used for methodological quality assessment of the included studies. Odds ratios (ORs) were calculated for dichotomous outcomes, and mean differences (MDs) were calculated for continuous outcomes. Results: Included were 12 studies (n = 1411 shoulders); 1 study had level 1 evidence, 3 studies had level 2 evidence, and 8 studies had level 3 evidence. The MINORS score ranged from 15 to 19, indicating that the methodology was fair to good. There was no statistically significant difference in retear rate between techniques (OR, 0.99; 95% CI, 0.67-1.47; P = .96); however, more type 1 retears were seen in the knotless technique (OR, 0.42; 95% CI, 0.23-0.77; P = .005), and more type 2 retears were seen in the knot-tying technique (OR, 3.15; 95% CI, 1.70-5.83; P = .0003). Higher postoperative Constant scores were seen in the knot-tying technique (MD, 1.28; 95% CI, 0.03-2.53; P = .04); however, there were no significant differences between techniques regarding other postoperative outcomes. Conclusion: There was no significant difference in overall retear rates between the knotless and knot-tying techniques, and both techniques demonstrated similar clinical outcomes. However, type 2 retear rates were significantly greater after knot-tying repair, and type 1 retear rates were significantly greater after knotless repair.
Factors Associated with Nonunion and Infection Following Ankle Arthrodesis using a Large Claims Database
Authors: Wong Liam H. , Chrea Bopha , Meeker James E. , Yoo Jung , Atwater Lara C. 
Published: November 2022

Category: Ankle; Ankle Arthritis Introduction/Purpose: Complications such as nonunion and infection following ankle arthrodesis can lead to increased patient morbidity and financial burden from repeat operations. Improved knowledge on complication likelihood and associated risk factors can improve patient selection and inform post-ankle arthrodesis surveillance protocols. Methods: This is a large retrospective, database study with structured query of a national insurance claims database (PearlDiver Technologies) for patients treated with ankle arthrodesis from 2015 through 2019 as identified by ICD-10 codes. Patients with any operation one year prior to or following ankle arthrodesis were excluded from analysis to prevent attributing complications to another operation. Likelihoods of nonunion and infection within one-year and three-years following ankle arthrodesis were analyzed using Kaplan-Meier estimations. Patient characteristics associated with the identified complications following ankle arthrodesis were analyzed using multivariable logistic regression analyses; data included age at time of operation, sex, obesity, smoking record, diabetes, and the Elixhauser Comorbidity Index score. Results: Our query yielded 2,463 patients in the five-year period who underwent ankle arthrodesis. Nonunion occurred in 11% (95% CI, 10-12) of patients within one-year of ankle arthrodesis and 16% (95% CI, 14-17) of patients within three-years. Infection occurred in 3.9% (95% CI, 3.1-4.7) of patients within one-year of ankle arthrodesis and in 6.2% (95% CI, 5.1-7.2) of patients within three-years. Obese patients increased odds of nonunion on multivariable analysis (OR 1.6 [95% CI, 1.3-2.0]; P<0.001). On multivariable analysis, diabetes (OR 1.7 [95% CI, 1.2-2.6]; P=0.010) and each one-unit increase in Elixhauser Comorbidity Index scores (OR 1.1 [95% CI, 1.1-1.2]; P<0.001) contributed to increased odds of infection after ankle arthrodesis. Conclusion: Nonunion and infection are common complications following ankle arthrodesis with a three-year probability of 16% and 6%, respectively. Over one-quarter of patients with nonunion post-ankle arthrodesis experience a delay in diagnosis past one- year. The risk of post-ankle arthrodesis nonunion is highest in patients with obesity; the risk of infection is highest in patients with diabetes or an elevated Elixhauser Comorbidity Index score. Although diabetes and its associated 'poor biology' is often viewed as the culprit in an obese diabetic who fails to heal, our research suggests that we should pay more attention to the mechanical and biologic consequences of obesity.
Relationship Between Talofibular Impingement and Increased Talar Tilt in Incongruent Varus Ankle Osteoarthritis
Authors: Yoon Youngsik , Kyung Min Gyu , Cho Yun Jae , Lee Dong-Oh , Lee Dong Yeon , Park HyeSun 
Published: November 2022

Category: Ankle; Ankle Arthritis Introduction/Purpose: Recently, talofibular bony impingement has been postulated to be a source of ankle pain. This study aimed to evaluate the relationship between talofibular impingement and increased talar tilt in incongruent varus ankle OA patients using bilateral weightbearing CT. Methods: Incongruent varus ankle osteoarthritis was defined as a talar tilt of more than 4° on standard ankle anteroposterior radiographs. We retrospectively reviewed 30 patients with unilateral incongruent varus ankle osteoarthritis with normal alignment of the contralateral ankle. All patients underwent bilateral weightbearing computed tomography and standing plain radiographs. The talar tilt and the distance between the talar lateral process and lateral malleolar tip were measured from a standing ankle anteroposterior radiograph of both sides. Talar and fibular spurs were assessed on the coronal and axial views of weightbearing computed tomography. After simulating the correction of the talar tilt in varus ankle osteoarthritis, talofibular bony impingement was reassessed. Results: On the varus side, the distance between the talar lateral process and the lateral malleolar tip was significantly shorter than that on the contralateral side (p < .001). Talar spur was present in the varus side of all 30 patients on the axial view of weightbearing computed tomography and in the control side of 10 patients. After the simulation of talar tilt correction, talofibular impingement (overlap) occurred in all 30 patients with a larger extent in the severe talar tilt subgroup (p < .001). Conclusion: Talofibular impingement by lateral gutter osteophytes is closely related to increased talar tilt in patients with incongruent varus ankle osteoarthritis. Therefore, lateral gutter osteophytes should be resected to stabilize mortise and improve clinical outcomes.
Accessory Soleus: Posterior Ankle Pain in Two Adolescent Athletes
Authors: Zhang Hui , Cammack Paul M. 
Published: November 2022

Category: Sports Introduction/Purpose: Accessory soleus muscles are a rare cause of posterior ankle pain and swelling in adolescent athletes. The increased accessibility of MRI imaging has been a helpful aid its proper diagnosis and treatment. Different surgical treatment also exists including partial fasciotomy as well as surgical excision. This case report offers 2 cases of adolescent athletes with this finding causing pain and swelling in the posterior ankle limiting rigorous athletic activities that were treated with surgical excision of the accessory soleus. Methods: Two patients were evaluated in clinic for posterior ankle pain during participation in rigorous athletic activities. The first patient was a 13-year-old girl with posterior ankle pain and swelling while playing softball that limited her ability to pitch more than one inning. The second patient was a 17-year-old boy with posterior ankle pain and swelling that limited his ability to perform at peak performance during basketball games. Both patients had MRI evaluation of the ankles after months of no improvement with nonoperative treatment. MRI demonstrated accessory soleus muscles that was attributed to be the cause of their symptoms. After unsatisfactory symptom relief with nonoperative treatment measures, the two patients underwent surgical excision of the accessory soleus muscle. Results: Both patients underwent surgical excision of the accessory soleus muscle through a posteromedial approach. The accessory soleus muscle was found just anterior and medial to the Achilles tendon. The muscle was detached from its insertion into the calcaneus distally and traced back proximally. The muscle was then truncated proximally approximately 5-6 cm proximal to its insertion on the calcaneus. Both patients began weight bearing to tolerance in a walking boot immediately postoperatively. Both patients experienced resolution of their symptoms after surgical excision. Conclusion: Accessory soleus muscles are rare anomalous muscles of the posterior ankle that can cause pain and swelling with activity. Increased accessibility of MRI imaging has led to its diagnosis and treatment. Surgical excision is a reasonable surgical treatment option when nonoperative treatment fails to alleviate symptoms.
Supply and demand relationship of ecosystem services from the perspective of hydropower development
Authors: Zhang Yu , Fu Bin , Zhu Xiaokang , Donyu Dorjee 
Published: November 2022

The supply and demand of ecosystem services is a popular research topic, however, studies on ecosystem services related to hydropower are rare. We selected hydropower stations in the Lhasa River of the Qinghai-Tibet Plateau as the beneficiaries of hydropower development. We then identified three ecosystem services. We assessed the supply of ecosystem services and the demand of hydropower for them. Finally, we discussed the relationship between hydropower and watersheds. The results demonstrated the following: (1) Water yield was 309.0 ± 110.3 mm, with a decreasing spatial pattern from the northeast to the southwest. Soil conservation was 119.2 ± 224.6 t/(hm2⋅a), with a spatial pattern that was high in the southeast and low in the northwest. Flood mitigation was 21.3 ± 2.9 mm, and the lower values were in lower elevation areas. (2) Hydropower has produced demands for the three services. The demand for the water yield of the five stations was 0.45 × 108 m3 − 1.64 × 108 m3. The demand for soil conservation from the Pangduo and Zhikong stations were 7.87 and 4.53 times their storage capacity, respectively. The demand for the flood mitigation of these two stations were 1.49 times and 1.09 times that of their flood regulation storage capacities. (3) The supply of the water yield service was greater than the demand for nearly the entire year, with an ecosystem supply and demand index between 4.73 and 14.06. The supply and demand of soil conservation services was nearly balanced. The flood mitigation service provided by the upstream ecosystem of Pangduo was 70.18 times the demand and 20.58 times the service of Zhikong. The results demonstrated that hydropower has a strong dependence on ecosystem services. This indicated that both enhancement and mitigation should be considered in the design payment of ecosystem service roles.
Characteristics and outcomes of patients triaged as critically ill in the emergency department of a tertiary care hospital in Bhutan
Authors: Giri Sweta , Watts Melanie , LeVine Shankar , Tshering Ugyen 
Published: November 2022

Abstract
Background
In Bhutan, where the Emergency Medical System is forming and evolving, the number of acutely ill patients requiring critical care, both in the emergency departments and intensive care units, is steadily increasing. Given the lack of baseline data and the ever-increasing number of critical care patients, this study was aimed at describing the characteristics and outcomes of patients triaged as critically ill in the emergency department.

Methods
An observational study was conducted over a yearlong period in the emergency department where all patients triaged as critically ill were approached for inclusion in the study. A case record form was used for the purpose of data collection. Epidata analysis was used for descriptive analysis and SPSS was used for binary logistic regression.

Results
A total of 657 critically ill patients of all age groups visited the emergency department over the 1-year study period, with adults constituting the majority (81%). The majority (67%) of these patients had a favorable outcome of surviving to discharge. The most common diagnosis among critically ill neonates was neonatal sepsis. Among the critically ill pediatrics and adults, sepsis, respiratory illnesses, and trauma were the most common diagnoses. Intubation followed by mechanical ventilation and blood product transfusion were the most common lifesaving interventions performed on critically ill patients.

Conclusion
The findings from this study constitute the first ever local database, at the national referral hospital in Bhutan, of critically ill patients treated in the emergency department. It highlights the central role the emergency department plays in their management and provides information for strengthening critical care services. It also highlights the areas of improvement and identifies high yield areas of training for the emergency department.
Subretinal abscess: causative pathogens, clinical features and management
Authors: Gallo Beatrice , Testi Ilaria , Pavesio Carlos 
Published: November 2022

Abstract
Purpose
To review the literature on endogenous subretinal abscess (SRA).

Methods
We searched in the literature for the terms ‘subretinal abscess’, ‘chorio-retinal abscess’ and ‘choroidal abscess’.

Results
A total of 122 patients were identified, of whom 20 patients (22 eyes) had no identified systemic infective foci (group 1) and 102 (120 eyes) had systemic infective foci (group 2). The mean age for group 1 was 44.6 years (range 2 weeks-82 years) and for group 2 was 43.2 years (range 1–89 years). The responsible pathogen was identified in 90% and 95% of cases, respectively. In group 1 the most frequent causative agents were Aspergillus and Nocardia, while in group 2 were Nocardia, Mycobacterium Tuberculosis and Klebsiella. In both groups the most common symptoms were reduced vision (70% and 72.5%, respectively), pain (65% and 29.4%, respectively) and redness (35% and 17.6%, respectively). For group 1 there was no difference between mean initial and final visual acuity (1.7 logMAR, range 0–3 logMAR), while for group 2 mean initial and final visual acuities were 0.8 logMAR and 0.6 logMAR, respectively. Final visual acuity was significantly better in group 2 (p = 0.003). Anterior segment inflammation was seen in 77.3% of cases of group 1 and 66.7% of cases of group 2. In both groups the abscess most common locations were posterior pole (45.4% and 32.5%, respectively) and temporal periphery (13.6% and 13.3%, respectively). Clinical features included hemorrhages (76.5% and 76.3%, respectively) and subretinal fluid (75% in both groups). Diabetes mellitus (20% and 25.5%) and immunosuppressive drug intake (35% and 23.5%) were the main predisposing factors for SRA. Combination of systemic and intravitreal antibiotics/antifungals and vitrectomy was the main therapeutic strategy for both groups. Systemic treatment alone was used mainly for cases of tubercular etiology. The timing of vitrectomy differed between the two groups, as it more commonly followed the use of systemic and intravitreal antibiotics in the forms associated with systemic infective foci. Additional abscess drainage or intralesional antibiotics were performed in 23.8% of cases.

Conclusion
At present no guideline exists for the treatment of subretinal abscess. Systemic broad-spectrum antibiotic treatment is of primary importance and should be used in all cases unless contraindicated. Combination of systemic and local treatment is the most frequently adopted strategy.
WGDTree: a phylogenetic software tool to examine conditional probabilities of retention following whole genome duplication events
Authors: Henry C. Nicholas , Piper Kathryn , Wilson Amanda E. , Miraszek John L. , Probst Claire S. , Rong Yuying , Liberles David A. 
Published: November 2022

Abstract
Background
Multiple processes impact the probability of retention of individual genes following whole genome duplication (WGD) events. In analyzing two consecutive whole genome duplication events that occurred in the lineage leading to Atlantic salmon, a new phylogenetic statistical analysis was developed to examine the contingency of retention in one event based upon retention in a previous event. This analysis is intended to evaluate mechanisms of duplicate gene retention and to provide software to generate the test statistic for any genome with pairs of WGDs in its history.

Results
Here a software package written in Python, ‘WGDTree’ for the analysis of duplicate gene retention following whole genome duplication events is presented. Using gene tree-species tree reconciliation to label gene duplicate nodes and differentiate between WGD and SSD duplicates, the tool calculates a statistic based upon the conditional probability of a gene duplicate being retained after a second whole genome duplication dependent upon the retention status after the first event. The package also contains methods for the simulation of gene trees with WGD events. After running simulations, the accuracy of the placement of events has been determined to be high. The conditional probability statistic has been calculated for Phalaenopsis equestris on a monocot species tree with a pair of consecutive WGD events on its lineage, showing the applicability of the method.

Conclusions
A new software tool has been created for the analysis of duplicate genes in examination of retention mechanisms. The software tool has been made available on the Python package index and the source code can be found on GitHub here: https://github.com/cnickh/wgdtree.
The compact genome of Caenorhabditis niphades n. sp., isolated from a wood-boring weevil, Niphades variegatus
Authors: Sun Simo , Kanzaki Natsumi , Dayi Mehmet , Maeda Yasunobu , Yoshida Akemi , Tanaka Ryusei , Kikuchi Taisei 
Published: November 2022

Abstract
Background
The first metazoan genome sequenced, that of Caenorhabditis elegans, has motivated animal genome evolution studies. To date > 50 species from the genus Caenorhabditis have been sequenced, allowing research on genome variation.

Results
In the present study, we describe a new gonochoristic species, Caenorhabditis niphades n. sp., previously referred as C. sp. 36, isolated from adult weevils (Niphades variegatus), with whom they appear to be tightly associated during its life cycle. Along with a species description, we sequenced the genome of C. niphades n. sp. and produced a chromosome-level assembly. A genome comparison highlighted that C. niphades n. sp. has the smallest genome (59 Mbp) so far sequenced in the Elegans supergroup, despite being closely related to a species with an exceptionally large genome, C. japonica.

Conclusions
The compact genome of C. niphades n. sp. can serve as a key resource for comparative evolutionary studies of genome and gene number expansions in Caenorhabditis species.
Propofol maintains Th17/Treg cell balance in elderly patients undergoing lung cancer surgery through GABAA receptor
Authors: Cui Can , Zhang Dengwen , Sun Ke , Zhu Yi , Xu Jindong , Kang Yin , Zhang Guangyan , Cai Yujin , Mao Songsong , Long Ruichun , Ma Jue , Dong Song , Sun Yi 
Published: November 2022

AbstractPropofol is widely used in clinical anesthesia due to its advantages of rapid onset and less adverse reactions. This study focused on the role of propofol in the balance of Th17/Treg in elderly patients with lung cancer during perioperative period. Patients undergoing lung cancer surgery were anesthetized by propofol or sevoflurane. Veinal blood was collected at different time points to evaluate the changes of Th17/Treg cell. Propofol better maintained the balance of Th17/Treg in vivo. The peripheral blood of patients with lung cancer was collected in vitro before surgery. Cluster of differentiation (CD)4+T cells were obtained and then treated with propofol at different concentrations and γ-aminobutyric acid A (GABAA) receptor antagonists. Propofol affected Th17/Treg cell balance by increasing Th17 cells, decreasing Treg cells, thus elevating Th17/Treg ratio, and inhibited invasion and migration of lung cancer cells through GABAA receptor, which was counteracted by GABAA receptor inhibitors. Subsequently, tumor in situ model of lung cancer in aged mice was established. Propofol anesthetized mice had lower change of Th17/Treg ratio, higher survival rate and less metastasis. In brief, propofol regulated balance of Th17/Treg in elderly patients undergoing lung cancer surgery through GABAA receptor. Additionally, propofol could inhibit metastasis of lung cancer.
Trait anxiety is related to Nx4’s efficacy on stress-induced changes in amygdala-centered resting state functional connectivity: a placebo-controlled cross-over trial in mildly to moderately stressed healthy volunteers
Authors: Nanni-Zepeda Melanni , Alizadeh Sarah , Chand Tara , Kasties Vanessa , Fan Yan , van der Meer Johan , Herrmann Luisa , Vester Johannes C. , Schulz Myron , Naschold Britta , Walter Martin 
Published: November 2022

AbstractBackgroundThe multicomponent drug Neurexan (Nx4) was shown to reduce the neural stress network activation. We now investigated its effects on stress-induced resting state functional connectivity (RSFC) in dependence of trait anxiety (TA), an acknowledged vulnerability factor for stress-induced psychopathologies.MethodsNx4 was tested in a randomized placebo-controlled crossover trial. Resting state fMRI scans were performed before and after a psychosocial stress task and exploratively analyzed for amygdala centered RSFC. Effects of Nx4 on stress-induced RSFC changes were evaluated and correlated to TA levels. A subgroup analysis based on TA scores was performed.ResultsMultiple linear regression analysis revealed a significant correlation between TA and Nx4 effect on stress-induced RSFC changes between right amygdala and pregenual anterior cingulate cortex (pgACC) and ventro-medial prefrontal cortex (vmPFC). For participants with above average TA, a significant amelioration of the stress-induced RSFC changes was observed.ConclusionsThe data add evidence to the hypothesis that Nx4’s clinical efficacy is based on a dampened activation of the neural stress network, with a greater neural response in subjects with anxious personality traits. Further studies assessing clinically relevant outcome measures in parallel to fMRI are encouraged to evaluate the real-world benefit of Nx4.Trial registrationNCT02602275.