bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Hyperdynamic Arteriovenous Fistula Aneurysm After Long Time Renal Transplantation
Authors: Klüsch Victoria , Aper Thomas , Sonnenschein Kristina , Becker Lena Sophie , Umminger Julia , Haverich Axel , Rustum Saad 
Published: October 2022

We report a case of a 53-year old male with a giant aneurysm of an arteriovenous fistula (AVF) in the left arm, which was created several years ago due to renal failure secondary to Alport’s syndrome. The AVF had not been used for over 38 years after successful renal transplantation at the age of 15. In the following, the patient underwent a regular follow-up with regularly visits by physicians and/or a nephrologist. A growth of the unused AVF over time was noticed, but surgical resection was not performed or recommended. Finally, the patient presented in our clinic with a severe hyperdynamic AVF aneurysm, so that we decided to treat the aneurysmal AVF surgically including exclusion the arteriovenous anastomose and reconstruction of the left arm vessels. Conclusion Closure of arteriovenous fistula should be considered in patients who underwent successful renal transplantation to avoid potential complications that may result from the presence of unused fistula especially, in patients who are predisposed to aneurysm formation in the future.
Use of the duplication range concept for understanding morphology and predicting prognosis in thumb polydactyly
Authors: Saito Susumu , Makino Aiko , Yamanaka Hiroki , Tsuge Itaru , Morimoto Naoki 
Published: October 2022

This study systematically and comprehensively analysed 129 thumb polydactylies in 122 patients using a duplicating range concept based on the level of skin and skeletal bifurcation. Numerical levels were defined along the longitudinal axis of the ulnar thumb duplicate from distal to proximal: level 0 (thumb tip) to level 6 (carpometacarpal joint). The relationships between duplication range and morphological parameters were evaluated. Nail asymmetry was associated with skin bifurcation levels 0 to 2. Proximal phalangeal asymmetry and interphalangeal joint deviation, associated with skin bifurcation levels were assigned scores of 1 to 2.5 and 1 to 2, respectively. Metacarpophalangeal joint deviation had a bimodal distribution, at levels 1.5 and 4 of the longitudinal axes. Morphological similarity was found in patients with the same duplication range. The duplication range concept could potentially improve our understanding of morphology variation and predicting prognoses in thumb polydactyly. Level of evidence: III
Evaluation of a convolutional neural network to identify scaphoid fractures on radiographs
Authors: Li Tao , Yin Yaobin , Yi Zhe , Guo Zhe , Guo Zhenlin , Chen Shanlin 
Published: October 2022

This study aimed to develop and evaluate a convolutional neural network for identifying scaphoid fractures on radiographs. A dataset of 1918 wrist radiographs (600 patients) was taken from an orthopaedic referral centre between 2010 to 2020. A YOLOv3 and a MobileNetV3 convolutional neural network were trained for scaphoid detection and fracture classification, respectively. The diagnostic performance of the convolutional neural network was compared with the majority decision of four hand surgeons. The convolutional neural network achieved a sensitivity of 82% and specificity of 94%, with an area under the receiver operating characteristic of 92%, whereas the surgeons achieved a sensitivity of 76% and specificity of 96%. The comparison indicated that the convolutional neural network’s performance was similar to the majority vote of surgeons. It further revealed that convolutional neural network could be used in identifying scaphoid fractures on radiographs reliably, and has potential to achieve the expert-level performance. Level of evidence: III
Outcomes of bipedicle V-Y ‘cup’ flap for repair of volar oblique fingertip amputations
Authors: Cevik Kadir , Arik Atilla , Eskandari Metin Manouchehr 
Published: October 2022

We used bipedicle V-Y ‘cup’ flaps to reconstruct 13 consecutive volar oblique fingertip amputations encountered in a nearly 2-year period. All flaps survived completely with no bone protuberance, scarring or neuroma evident at the end of follow-up (mean, 7 months; range 4–13 months). Two of the 13 patients had moderate or severe tenderness, three had moderate or severe cold intolerance and two had noticeable hook nails. There were no significant (≥10°) flexion contracture in the interphalangeal joints. The mean static two-point discrimination score was 4 mm (range 3–6) and the modal Semmes–Weinstein monofilament test score was 3.6 g (range 3.2–4.2). All patients were satisfied with their surgical outcomes. The bipedicle V-Y ‘cup’ flap provides good results in terms of fingertip contour, padding and sensation, and has a low complication rate when used to treat volar oblique fingertip amputations. Level of evidence: IV
Pretreatment with gonadotropin-releasing hormone antagonist protects against chemotherapy-induced testicular damage in mice
Authors: Levi Mattan , Shalgi Ruth , Ben-Aharon Irit 
Published: October 2022

Background: Testicular toxicity following chemotherapy is of increasing importance with the continuous improvement of survival rates. Gonadotropin-releasing hormone (GnRH) was suggested to protect testis against such toxicity; however, its suppressive quality and mechanism of action are still unclear. We examined whether and how pretreatment with GnRH antagonist protects against the testicular damage caused by chemotherapy. Methods: Mature male mice were injected subcutaneously eight times in 2-day intervals with either saline or GnRH antagonist (Cetrotide; 1 g/mg), followed by an intraperitoneal injection with either saline or cyclophosphamide (CTX;100 mg/kg BW) and sacrificed 2 weeks or 3 months later. Testicular weight, epididymis weight, epididymal sperm count and sperm motility were measured. Serum anti-Müllerian hormone (AMH) was measured by enzyme-linked immunosorbent assay. Immunohistochemistry (Ki-67), immunofluorescence (PCNA, CD34), terminal transferase-mediated deoxyuridine 5-triphosphate nick-end labeling (TUNEL) and computerized analysis were performed to examine testicular proliferation, apoptosis and vascularization. Quantitative real-time PCR was used to assess the amount of spermatogonial reserve (Id4 and Gfra1 mRNAs). Results: Pretreatment with GnRH antagonist transiently reduced testicular weight, epididymal weight, germinal proliferation and sperm count; it also abolished the permanent long-term effect of CTX on these parameters and prevented cyclophosphamide-induced testicular toxicity characterized by apoptosis and serum AMH increase and irreversible loss of spermatogonial reserve. Conclusions: Our findings imply that pretreatment with GnRH antagonist temporarily reduces spermatogenesis and may be used as pretreatment for reducing chemotherapeutic testicular toxicity.
Sport Specialization Classification and Injury Risk in Female Athletes
Authors: Okoruwa Ehiamen T. , Abbott Alexandra , Stamm Michaela , Mulcahey Mary K. 
Published: October 2022

Background: Description of possible detrimental effects of sport specialization specific to adolescent female athletes is limited in current literature with no consensus on sport specialization classification. Hypothesis: Specialized female athletes will have higher rates of injury, body image issues, and menstrual dysfunction, regardless of the specialization classification utilized. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: Retrospective data was obtained from questionnaires from female athletes in local high schools (n = 229; 13–18 years of age). The 3-point specialization scale was used to analyze differences in injury rates, body image issues, and menstrual dysfunction within low, moderate, and highly specialized athletes. When comparing accuracy of specialization scales in identifying high risk athletes, three peer-reviewed specialization classification scales were utilized—a 3-point scale, a 6-point scale, and a binary self-selection scale. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for studied variables (a priori p ≤ 0.05). Results: Of 229 athletes surveyed, 219 (95.6%) completed the 3-point specialization classification questions and were included in the study. 91 athletes (41.6%) were categorized as low specialization (LS), 59 (26.9%) were moderately specialized (ModS), and 69 (31.5%) were highly specialized (HS). ModS athletes were more likely to have a history of stress fractures (SFx) compared to LS athletes ( p = 0.02; OR 3.62; 95% CI 1.27–10.26). Compared to LS athletes, HS athletes were more likely to have injury history ( p = 0.01; OR 2.93; 95% CI 1.38–6.24) and a history of concussion ( p < 0.01; OR 5.00; 95% CI 1.86–13.42). Conclusion: Among female high school athletes, higher levels of specialization are associated with greater risk of injuries overall, and greater risk of concussions and SFx. This study did not demonstrate significant associations between specialization and body image issues or menstrual dysfunction. Clinical Relevance: This study further strengthens the association between injury and sport specialization and suggests that combining specialization scales better improves risk stratification which overall aids in preventing athlete injury.
Early Sport Specialization and Long-term Throwing Arm Health in College Baseball Players
Authors: Wilkins Samuel J. , Bell David R. , Kahanov Leamor , Martin Malissa , Post Eric G. 
Published: October 2022

Background: Early sport specialization is associated with increased risk of overuse injuries in several sports, including baseball. However, limited evidence exists evaluating how early sport specialization affects patient-reported outcome measures as they age. The purpose of this study was to determine differences in Kerlan-Jobe Orthopedic Clinic (KJOC) Shoulder and Elbow Scores among collegiate baseball players based on the grade when a participant first reported high specialization behaviors. Hypothesis: Baseball players who were highly specialized at a younger age will have worse throwing arm health while participating in college. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 752 college baseball players was contacted through their institution’s athletic trainer. We measured baseball specialization and KJOC scores using the validated Baseball and Sport Experience survey. Data were summarized using means and SDs, medians and interquartile ranges (IQRs), and frequencies and percentages. A Kruskal-Wallis test was used to determine differences in mean KJOC scale scores based on the earliest time the participant reported high-level specialization. Results: A total of 294 baseball players completed the survey (response rate: 39.1%). Of the 294 participants, 280 completed the KJOC scale questions to generate a total KJOC score (median: 90.5; IQR: 76.6-97.2). No significant differences in KJOC total scores ( P = 0.78) existed based on the grade period in which the athlete was first highly specialized. Conclusion: Early baseball specialization as a youth baseball player may not impact throwing arm health in college baseball athletes. Clinical Relevance: Early specialization has been linked to increased risk for overuse injuries in certain sports, but may not lead to poorer throwing arm health in college baseball players. Sports medicine clinicians and researchers may use this information to educate various stakeholders about the benefits and risks associated with early sport specialization.
Impact of metformin on the clinical and metabolic parameters of women with polycystic ovary syndrome: a systematic review and meta-analysis of randomised controlled trials
Authors: Abdalla Mohammed Altigani , Shah Najeeb , Deshmukh Harshal , Sahebkar Amirhossein , Östlundh Linda , Al-Rifai Rami H. , Atkin Stephen L. , Sathyapalan Thozhukat 
Published: October 2022

Context: Polycystic ovary syndrome (PCOS) is one of the commonest endocrine disorders affecting women of reproductive age, and metformin is a widely used medication in managing this condition. Aim: To review the available literature comprehensively on the therapeutic impact of metformin on the clinical and metabolic parameters of women with PCOS. Data source: We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library and the Web of Science and selected sources for grey literature from their inception to April 2020. An updated search in PubMed was performed in June 2022. Data synthesis: Two reviewers selected eligible studies and extracted data, and the review is reported following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: In 24 eligible randomised controlled trials (RCTs) involving 564 participants who received metformin therapy, metformin was associated with significant reduction in body weight by 3.13 kg (95% CI: −5.33, −0.93), body mass index (BMI) by 0.82 kg/m² (95% CI: −1.22, −0.41), fasting blood glucose [standardised mean difference (SMD): −0.23; 95% CI: −0.40, −0.06], low-density lipoprotein cholesterol (LDL-C) (SMD: −0.41; 95% CI: −0.85, 0.03), total testosterone (SMD: −0.33; 95% CI: −0.49, −0.17), androstenedione (SMD: −0.45; 95% CI: −0.70, −0.20), 17-hydroxyprogesterone (17-OHP) (SMD: −0.58; 95% CI: −1.16, 0.00) and increase the likelihood of clinical pregnancy rate [odds ratio (OR): 3.00; 95% CI: 1.95, 4.59] compared with placebo. Conclusion: In women with PCOS, metformin use has shown a positive impact in reducing body weight, BMI, total testosterone, androstenedione, 17-OHP, LDL-C, fasting blood glucose and increasing the likelihood of pregnancy in women with PCOS.
A cost analysis of ankle fractures treated by orthopedic surgeons with or without foot and ankle fellowship training at ambulatory surgery centers and hospitals
Authors: Barfield Matthew , Jackson J Benjamin , Gonzalez Tyler 
Published: October 2022

Introduction: Ankle fractures are commonly treated by orthopedic surgeons. Fellowship versus non-fellowship training often adds a different perspective, use of specialty-specific implants, comfort with outpatient procedures, and may contribute to cost differences between surgeons. To assess the impact of fellowship training on the value of care provided, the difference in cost of ankle fracture open reduction internal fixation procedures between foot and ankle trained orthopedic surgeons and non-foot and ankle trained orthopedic surgeons over the past 10 years was retrospectively evaluated. We additionally evaluated the cost differences of ankle fracture open reduction internal fixations between hospitals, hospital-owned ambulatory surgery centers, and physician-owned ambulatory surgery centers. The study also assessed the costs effects of inpatient versus outpatient procedures and ankle open reduction internal fixation procedure volume of the surgeon observed within the timeframe of the study. Methods: Patient data was collected from electronic medical records and billing documents for patients who underwent an ankle open reduction internal fixation procedure performed by an orthopedic surgeon in our hospital system and local hospital-owned ambulatory surgery centers between the years 2010 and 2020. Data were also collected from a physician-owned ambulatory surgery center for patients who underwent an ankle open reduction internal fixation procedure performed by an orthopedic surgeon between the years 2015 and 2020. Statistical analyses were performed to observe potential cost differences among all variables. Results: Procedures performed by fellowship-trained orthopedic surgeons were significantly less costly than those performed by non-foot and ankle trained orthopedic surgeons when performed at ambulatory surgery centers but not at hospitals. Procedures performed at ambulatory surgery centers were found to be significantly less costly than those performed at hospitals. In addition, it was noted that procedures performed at hospital-owned ambulatory surgery centers were less costly than physician-owned ambulatory surgery centers. It was also found that procedure cost decreased with an increase in surgeon volume. Conclusion: An ankle fracture open reduction internal fixation performed by a foot and ankle trained orthopedic surgeon in a hospital-owned ambulatory surgery center is the lowest cost option available, and an increase in volume of open reduction internal fixations is associated with a further decrease in cost when within our hospital system between the years 2010 and 2020.
Feasibility of using activity trackers and apps to increase physical activity in whole families: The Step it Up Family intervention
Authors: Schoeppe Stephanie , Salmon Jo , Williams Susan , Power Deborah , Waters Kim , Alley Stephanie , Rebar Amanda L. , Hayman Melanie , Duncan Mitch J , Vandelanotte Corneel 
Published: October 2022

Objective This study examined the feasibility of an activity tracker and app intervention to increase physical activity in whole families. Methods This was a single-arm feasibility study with pre–post-intervention measures. Between 2017 and 2018, 40 families (58 children aged 6–10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family programme in Queensland, Australia. It was delivered using Garmin activity trackers and apps, weekly motivational text messages and an introductory session. Online surveys and semi-structured interviews conducted with parents assessed intervention usage, acceptability, usability, perceived usefulness, use of physical activity self-management strategies and programme influence. Analyses included descriptive statistics, Wilcoxon signed-rank test and qualitative content analysis. Results Overall, 38 families completed the post-intervention survey (95% family retention; 90% children, 95% mothers, 88% fathers). Garmin activity tracker usage was high (i.e. nearly 24/7 during the 6 weeks intervention). Families also used the Garmin apps regularly (i.e. mostly 2–6 times per week). Further, 80% of mothers and 52% of fathers read the motivational mobile text messages. Usability and perceived usefulness of the Garmin activity trackers and apps were rated high. Both parents significantly increased their use of physical activity self-management strategies from pre to post-intervention. Parents expressed that the intervention had increased awareness of physical (in)activity in the family, encouraged to be active and promoted outdoor family activities. Conclusions Using activity trackers and apps to increase physical activity in the whole family was well received by children and parents which suggests that this intervention approach is feasible. However, further testing is needed amongst more diverse family populations. These early findings support the implementation of a randomised controlled trial to examine intervention efficacy.
Psychological Factors Associated With Return to Play After Ulnar Collateral Ligament Reconstruction: A Systematic Review
Authors: Chen Aaron Z. , Greaves Kaylre M. , Fortney Thomas A. , Saltzman Bryan M. , Trofa David P. , Ahmad Christopher S. 
Published: October 2022

Background: The role of psychological factors in return to play (RTP) after ulnar collateral ligament (UCL) reconstruction remains unclear. Purpose: To perform a systematic review of the literature to (1) identify the specific psychological factors that affect RTP after UCL reconstruction and (2) determine the proportion of failures to RTP after UCL reconstruction because of psychological factors. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted. We queried the Cochrane Database of Systematic Reviews, Ovid/Embase, PubMed, and Web of Science databases to identify studies examining psychological factors and RTP after UCL reconstruction. Data pertaining to study characteristics and design, clinical and demographic characteristics, and psychological factors were collected. Patients were pooled across included studies, weighted means were calculated, and descriptive statistical analysis was performed. Results: A total of 8 studies consisting of 378 patients were included for analysis. The mean time to RTP was 12.2 months, and the overall RTP rate was 89.4%. Psychological factors affecting RTP included loss of interest, fear of reinjury, individual personality traits, personal reasons, and psychological concerns. While clinical factors accounted for 46.2% (n = 24) of failures to RTP, psychological factors comprised 40.4% (n = 21) of the reasons for failure to RTP. The most commonly cited psychological factors affecting RTP were loss of interest (n = 15 [28.8%]) and fear of reinjury (n = 3 [5.8%]). Conclusion: Psychological factors represented a substantial proportion of failures to RTP after UCL reconstruction, especially in adolescent athletes. Future prospective studies and multicenter initiatives are needed to more thoroughly evaluate the psychological concerns of patients before and after UCL reconstruction.
Wearable Devices’ Use in Geriatric Care between Patient-Centeredness and Psychology of Patients
Authors: Elkefi Safa , Asan Onur 
Published: October 2022

Wearable devices have potentials for monitoring elderly patients’ health. Many efforts have been made to encourage its use among this population. However, not all of them are succeeding in improving the wearables’ use. In this study, we explored the impact of patient-centered practice in healthcare on wearable devices’ use and the role of this technology use in improving patients’ mental health. We found that a majority of 84.96% of the elderly people who responded to the surveys reported using wearable devices in the last 12 months to monitor or track health activity. For the patient-centered care impact, making sure patients understand next steps and standing by their feelings improve the use of wearable devices (OR=5.95 P=0.011, OR=1.04 P=0.028). However, people who were involved in decision making did not use wearable devices (OR=0.77 P=0.014). For the impact of technology use, wearable users were less likely to experience severe depression and anxiety levels (P=0.0038, OR=0.436). Designers of wearable devices need to create patient-centered features that go with the patients’ needs to ensure the acceptability of this technology.
PRL2 phosphatase enhances oncogenic FLT3 signaling via dephosphorylation of the E3 ubiquitin ligase CBL at tyrosine 371
Authors: Chen Hongxia , Bai Yunpeng , Kobayashi Michihiro , Xiao Shiyu , Cai Wenjie , Barajas Sergio , Chen Sisi , Miao Jinmin , Meke Frederick Nguele , Vemula Sasidhar , Ropa James P. , Croop James M. , Boswell H. Scott , Wan Jun , Jia Yuzhi , Liu Huiping , Li Loretta S. , Altman Jessica K. , Eklund Elizabeth A. , Ji Peng , Tong Wei , Band Hamid , Huang Danny T. , Platanias Leonidas C. , Zhang Zhong-Yin , Liu Yan 
Published: October 2022

Abstract
Acute myeloid leukemia (AML) is an aggressive blood cancer with poor prognosis. FMS-like tyrosine kinase receptor-3 (FLT3) is one of the major oncogenic receptor tyrosine kinases aberrantly activated in AML. Although protein tyrosine phosphatase PRL2 is highly expressed in some subtypes of AML compared with normal human hematopoietic stem and progenitor cells, the mechanisms by which PRL2 promotes leukemogenesis are largely unknown. We discovered that genetic and pharmacological inhibition of PRL2 significantly reduce the burden of FLT3-internal tandem duplications–driven leukemia and extend the survival of leukemic mice. Furthermore, we found that PRL2 enhances oncogenic FLT3 signaling in leukemia cells, promoting their proliferation and survival. Mechanistically, PRL2 dephosphorylates the E3 ubiquitin ligase CBL at tyrosine 371 and attenuates CBL-mediated ubiquitination and degradation of FLT3, leading to enhanced FLT3 signaling in leukemia cells. Thus, our study reveals that PRL2 enhances oncogenic FLT3 signaling in leukemia cells through dephosphorylation of CBL and will likely establish PRL2 as a novel druggable target for AML.