bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intermetatarsal Screw Fixation Reduced Intermetatarsal Angle Following Modified Lapidus Procedures
Authors: Reed Logan , Luque-Sanchez Kevin S. , Awad Shadi K. , Mihas Alexander K. , Young Sean M. , Patch David A. , Johnson Michael D. 
Published: November 2022

Category: Midfoot/Forefoot Introduction/Purpose: The Modified Lapidus arthrodesis is a historically established surgical technique for treatment of hallux valgus, providing quality patient outcomes and reproducible results. Addition of a transverse first to second intermetatarsal screw spanning the base of the metatarsals in this procedure can increase stability. However, no study evaluates the radiographical parameters following application of this intermetatarsal screw fixation to procedures without first to second intermetatarsal screw fixation. The purpose of this study was to assess the quality of radiographic parameters between individuals receiving a first to second intertarsal screw fixation to those that did not receive intermetatarsal screw fixation following a non-saw cut Modified Lapidus procedure. Methods: A retrospective review was performed on 74 patients that underwent a Modified Lapidus arthrodesis between 2016- 2020 at a single institution. Preoperative indications for the procedure included first ray instability, first ray hypermobility, hallux abductovalgus, and metatarsal primus elevatus. Inclusion criteria consisted of skeletally mature patients undergoing non sawcut Modified Lapidus procedure. Patients that received the procedure due to a traumatic event or patients with concomitant second metatarsal arthrodesis were excluded. Review of patient's charts was performed. Basic demographics data, implant type, and radiographic parameters including intermetatarsal angle (IMA) and first metatarsal length were obtained from preoperative as well as postoperative films. Results: A total of 74 patients who underwent a Modified Lapidus arthrodesis were included in the study. A group of 43 patients received the Modified Lapidus arthrodesis with the addition of a first to second intermetatarsal screw fixation compared to a group of 31 patients who only received the Modified Lapidus arthrodesis procedure. The average IMA in all patients prior to surgery was 13°. The patients who received intermetatarsal screw fixation had significantly higher IMA reductions between preoperative and postoperative films than those who did not receive the intermetatarsal screw (-8.41° vs. -5.78°, p=.005). The difference in first metatarsal length on preoperative and postoperative films was less in patients who received the screw fixation but this was not statistically significant. Conclusion: The Modified Lapidus procedure is a commonly used procedure to treat hallux valgus. The results of this study found that the addition of a first to second intermetatarsal significantly reduced the IMA when compared to individuals who did not receive the screw construct. These findings will help surgeons further delineate if an intermetatarsal screw is required and how it will contribute to the radiographic parameters of interest.
The Effect of Diabetes on Ankle Fracture Outcomes in the UK: A National Collaborative Assessment of Current Guidelines, Management and Surgical Choices in Ankle Fractures
Authors: Reichert Ines , Ahluwalia Raju S. , Wek Cesar , Stringfellow Thomas , Coffeyy Duncan , Tan Sze Ping 
Published: November 2022

Category: Trauma; Ankle Introduction/Purpose: Objectives: Ankle fractures associated with diabetes experience more complications with standard Open-Reduction-Internal-Fixation (ORIF) following AO-principles than those without diabetes. It is unclear if augmented/extended fixation strategies can improve this. This aim of this study was to understand utilisation of extended/augmented/ORIF techniques (e.g., hind-foot-nail (HFN) and present outcomes of ankle fractures associated with diabetes. Secondarily the study aimed to evaluate compliance with national guidelines on early post-operative weight bearing. Methods: Research, Design & Methods: A national-multicentre retrospective cohort study was conducted between Jan - Jun 2019 of 56 UK centres (10 Major-Trauma-Units and 46 Trauma-Units). Institutional approval was obtained by all centres. 1360 complex-ankle-fractures were enrolled. Demographics, fixation choice and surgical outcomes were obtained. Statistical analysis was performed including propensity matching comparing patients with and without diabetes. Results: 316pts (23.2%) had diabetes, 7.4% had neuropathy, with a mean age 63.9yrs (vs.49.3yrs in non-diabetes), with greater frailty >4 (24% vs.14% (non-diabetes) (p<0.03). 79.7% underwent standard AO-principles-ORIF; those with peripheral neuropathy were more likely to undergo extended/augmented-techniques. Overall wound complications were higher with diabetes (15.8% vs. 8.8% (p<0.02). 13% of patients with diabetes underwent augmented/extended techniques without a difference in complications to a matched control group without diabetes. Conclusion: Diabetic ankle fractures occur in older, frailer persons; whilst lower than expected neuropathy rates suggest a need for improved assessment. Contrary to current guidelines most patients remain non-weightbearing post-surgery. Extended/Augmented surgical techniques can allow earlier weight-bearing without increasing complications. MDT screening/management may improve surgical selection and under-utilisation of these techniques and promote early mobilisation.
End-Stage Tibiotalar Osteoarthritis and Chronic Strontium Toxicity
Authors: Ricci Gianni , Collier Watson B. 
Published: November 2022

Category: Ankle Arthritis; Ankle Introduction/Purpose: Metal toxicity due to environmental sources or orthopedic implants has been a primary focus in recent literature. Specifically, in orthopedics, total joint arthroplasty regarding metal-on-metal articulation with cobalt-chromium articulation has adverse local and systemic effects. In particular, strontium toxicity is less known metal toxicity that can cause many systemic effects such as severe osteoporosis. Methods: This is the first reported case of strontium toxicity and end-stage tibiotalar osteoarthritis. Results: We present a case of a 68-year-old female with bilateral ankle pain and deformity that were refractory to conservative measures, including physical therapy and anti-inflammatory medications. She was diagnosed with bilateral osteoarthritis and osteoporosis secondary to strontium toxicity by exclusion after extensive workup with a multi-disciplinary approach. The patient pursued conservative measures with ankle-foot orthosis, physical therapy, and anti-inflammatory medications. After the failure of conservative measures with over two years of follow-up, we recommended operative intervention to improve function and pain with staged bilateral tibiotalocalcaneal fusions utilizing an intramedullary device. Since she is moving out of state, she chose to pursue operative intervention at a different institution in order to establish long-term follow-up. The patient was placed on teriparatide for her osteoporosis secondary to strontium toxicity. Conclusion: Low doses of strontium can be beneficial to bone health and improve adverse events relating to osteoporosis. However, high doses of strontium can be detrimental leading to severe systemic complications. Although strontium toxicity is quite rare, this case demonstrates its deleterious effects on the quality of the bone leading to debilitating osteoarthritis and significant deformity in the foot and ankle.
The Efficacy and Safety of Tranexamic Acid in Foot and Ankle Surgery: A Systematic Review and Meta- Analysis
Authors: Salameh Motasem , Attia Ahmed K. , Hsu Raymond Y. , Blankenhorn Brad D. 
Published: November 2022

Category: Basic Sciences/Biologics; Other Introduction/Purpose: Tranexamic acid (TXA) use is increasing in Orthopedic practice specially among arthroplasty surgeons. It was proven to decrease the estimated blood loss and need for blood transfusion in hip, knee and shoulder arthroplasty as well as pelvis and acetabulum surgery. There was no reported increase risk of thromboembolic events with the use of TXA in orthopedic practice. This systematic review and meta analysis aimed on reporting on the available evidence on the use of TXA in foot and ankle surgery. Methods: The current meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electronic-based search on MEDLINE (PubMed), EMBASE, Google Scholar, SCOPUS, and Cochrane databases to November 2021. Clinical studies on tranexamic acid use in foot and ankle surgeries reporting at least one of the desired outcomes; estimated blood loss (EBL), Hemoglobin difference between pre- and post-op, or complications were included. To assess risk of bias, the Joanna Briggs institute critical appraisal tool was used for case series and the Newcastle Ottawa scale for comparetive studies. The level of evidence was assigned according to the Cochrane Book Review Group. Results: A total of 718 foot and ankle procedures were included. Out of those, 491 (68.38%) procedures received tranexamic acid while 221 (31.64%) served as controls and did not receive tranexamic acid. In the TXA group, 34 (6.92%) procedures received local TXA injection in one study, while the remaining majority of 457 (93.08%) procedures received intravenous (IV) TXA. Among the control group, saline was used a placebo in 113 (51.13%) controls in 3 studies, while no placebo was used in the remaining 108 (48.87%) controls. The pooled mean EBL for the TXA group was 57.75 mL [95% CI: 44.80 to 70.70, I2 = 98.31%] while the pooled mean EBL for the control group was 299.26 mL [95% CI: 212.43 to 386.09, I2= 98.96%] with statistical significance Figure 1. No significant difference was found between the two groups in terms of change of hemoglobin and risk of thromboembolic events and other complications. Figure 2,3 Conclusion: This systematic review and metaanalysis showed that the use of TXA in foot and ankle surgery was safe with no increased risk in thromboembolic events. The lower risk of bleeding using TXA despite being stastically significant, did not reach clinical significance and did not affect the post operative hemoglobin level. TXA can be considered in foot and ankle surgery in special cases with higher risk of bleeding or in cases where the use of tourniquet is contraindicated.
Vitamin D Status and Fracture Healing: A Systematic Review of 63 Studies
Authors: Singh Priya K. , O'Sullivan Lucy , Vankara Ashish , Raad Micheal , Aiyer Amiethab A. 
Published: November 2022

Category: Other Introduction/Purpose: There is little consensus on the effects of vitamin D on fracture healing. This review aims to clarify that effect in addition to determining trends in the classification of deficiency and supplementation. Methods: This systematic review searched Pubmed, Embase, and Web of Science for manuscripts related to vitamin D status/deficiency and fracture healing. Two independent reviewers screened articles, graded evidence quality, and extracted data. A total of 38 human studies, 11 in vivo studies and 14 systematic reviews were analyzed. Results: The median vitamin D deficiency prevalence reported amongst the human studies was 41.2% which is comparable to subset of patients with deficiency defined as <20 ng/mL, 43.3%. Amongst the 9 human studies reporting vitamin D supplementation, the exact dosage varied greatly. No RCTs reported any radiographic evidence of increased fracture union with any form of supplementation. Several RCTs reported reduction in pain with smaller daily supplementation compared to placebo or single large boluses. Animal studies reported mixed results, with some showing no significant effects of vitamin D status on the biomechanical properties of bone, while others demonstrated a correlation between supplementation improved biomechanical stiffness. Furthermore, the metabolite 24,25D may be a mediator in Vitamin D's probable osteoprotective effects. Conclusion: While the role of vitamin D in fracture healing appears to be osteoprotective in animal models, the degree and significance of its effects on human fracture healing and prevention remains inconclusive. We recommend standardizing the definitions for vitamin D deficiency to be <20 ng/mL for deficiency and >30 ng/mL for sufficiency. Although there is no radiographic evidence, daily smaller doses of vitamin D supplementation seem to have a stronger impact on clinical fracture healing than large boluses.
Long-Term Use of a Temporary Keratoprosthesis and Perfluorocarbon in Traumatic Retinal Detachment Repair
Authors: Govindaraju Viren K. , Trese Matthew G.J. , Gupta Chirag , Williams George A. 
Published: November 2022

Purpose: To present a technique for optimizing repair of traumatic retinal detachments (RDs). Methods: A patient was followed in an outpatient setting with clinical examinations, optical coherence tomography, widefield fundus photography, and anterior segment imaging. Results: The patient presented with a total RD after ruptured globe repair. The patient had combined corneal and retinal surgery with placement of a temporary keratoprosthesis (TKP) and vitrectomy with perfluorocarbon liquid (PFCL) to reattach the retina. The TKP and PFCL were left in the eye for 2 weeks before a planned silicone oil exchange and penetrating keratoplasty were performed. Four months postoperatively, the patient presented with a partially attached retina and improved vision. Conclusions: In this case, a ruptured globe decompensated several months after primary repair. The prolonged use of the TKP allowed for optimal surgical visualization, enhanced office-based assessment, and limited endothelial cell loss of the donor corneal tissue.
Coping in caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation
Authors: Amonoo Hermioni L. , Johnson P. Connor , Nelson Ashley M. , Clay Madison A. , Daskalakis Elizabeth , Newcomb Richard A. , Deary Emma C. , Mattera Elizabeth F. , Yang Daniel , Cronin Katherine , Boateng Kofi , Lee Stephanie J. , LeBlanc Thomas W. , El-Jawahri Areej 
Published: November 2022

Abstract
Caregivers of patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) must cope with substantial caregiving burden, high rates of psychological distress, and diminished quality of life (QOL). However, data describing coping strategies before HSCT and the association between coping, QOL, and psychological outcomes in this population are lacking. We conducted a secondary analysis of data collected during a multisite randomized clinical trial of a supportive care intervention in HSCT recipients and their caregivers. Caregivers completed the Brief COPE, Hospital Anxiety and Depression Scale, and the Caregiver Oncology Quality of Life Questionnaire to measure coping strategies, psychological distress, and QOL, respectively. We grouped coping into 2 higher-order domains: approach-oriented (ie, emotional support and active coping) and avoidant (ie, self-blame and denial). We used the median split method to describe the distribution of coping and multivariate linear regression models to assess the relationship between coping and caregiver outcomes. We enrolled 170 caregivers, with a median (range) age of 53 (47-64) years. Most were White (87%), non-Hispanic (96%), and female (77%). Approach-oriented coping was associated with less anxiety (β = −0.210, P = .003), depression symptoms (β = −0.160, P = .009), and better QOL (β = 0.526, P = .002). In contrast, avoidant coping was associated with more anxiety (β = 0.687, P&lt;.001), depression symptoms (β = 0.579, P &lt; .001), and worse QOL (β = −1.631, P &lt; .001). Our findings suggest that coping is related to distress and QOL among caregivers of HSCT recipients even before transplant. Hence, caregivers of patients with hematologic malignancies undergoing HSCT may benefit from resources that facilitate adaptive coping with the demands of caregiving.
Transcriptional reprogramming of infiltrating neutrophils drives lung pathology in severe COVID-19 despite low viral load
Authors: Eddins Devon J. , Yang Junkai , Kosters Astrid , Giacalone Vincent D. , Pechuan-Jorge Ximo , Chandler Joshua D. , Eum Jinyoung , Babcock Benjamin R. , Dobosh Brian S. , Hernández Mindy R. , Abdulkhader Fathma , Collins Genoah L. , Orlova Darya Y. , Ramonell Richard P. , Sanz Ignacio , Moussion Christine , Eun-Hyung Lee F. , Tirouvanziam Rabindra M. , Ghosn Eliver E. B. 
Published: November 2022

Abstract
Troubling disparities in COVID-19–associated mortality emerged early, with nearly 70% of deaths confined to Black/African American (AA) patients in some areas. However, targeted studies on this vulnerable population are scarce. Here, we applied multiomics single-cell analyses of immune profiles from matching airways and blood samples of Black/AA patients during acute SARS-CoV-2 infection. Transcriptional reprogramming of infiltrating IFITM2+/S100A12+ mature neutrophils, likely recruited via the IL-8/CXCR2 axis, leads to persistent and self-sustaining pulmonary neutrophilia with advanced features of acute respiratory distress syndrome (ARDS) despite low viral load in the airways. In addition, exacerbated neutrophil production of IL-8, IL-1β, IL-6, and CCL3/4, along with elevated levels of neutrophil elastase and myeloperoxidase, were the hallmarks of transcriptionally active and pathogenic airway neutrophilia. Although our analysis was limited to Black/AA patients and was not designed as a comparative study across different ethnicities, we present an unprecedented in-depth analysis of the immunopathology that leads to acute respiratory distress syndrome in a well-defined patient population disproportionally affected by severe COVID-19.
Relevance of the pyroptosis-related inflammasome drug targets in the Chuanxiong to improve diabetic nephropathy
Authors: Li ChangYan , Ma JingYuan , Mali Niroj , Zhang Le , Wei Tao , Shi LuYao , Liu Fang , WenXing Fan , Yang Jing 
Published: November 2022

Abstract
Background
A chronic inflammatory disease caused by disturbances in metabolism, diabetic nephropathy (DN) is a chronic inflammatory disease. Pyroptosis is a novel form of programmed cell death in many inflammation-related diseases, including DN. Therefore, pyroptosis could be a promising target for DN therapy.

Methods
To get the components and pharmacodynamic targets of Chuanxiong, we identified by searching TCMID, TCMSP, ETCM and HERB databases. Then, from the Molecular Signatures Database (MSigDB) and Gene Ontology (GO) database, pyroptosis genes were collected. Identification of critical genes in DN by bioinformatics analysis and then using the ConsensusClusterPlus package to divide the express data of diff genes into some subgroups with different levels of pyroptosis; the WGCNA machine algorithm was used to simulate the mechanism Chuanxiong improving DN.

Results
In this study, we found DHCR24, ANXA1, HMOX1, CDH13, ALDH1A1, LTF, CHI3L1, CACNB2, and MTHFD2 interacted with the diff genes of DN. We used GSE96804 as a validation set to evaluate the changes of APIP, CASP6, CHMP2B, CYCS, DPP8, and TP53 in four different cell proapoptotic states. WGCNA analysis showed that DHCR24, CHI3L1, and CACNB2 had significant changes in different cell proapoptotic levels. In the experimental stage, we also confirmed that the active ingredients of Chuanxiong could improve the inflammatory state and the levels of pyroptosis under high glucose.

Conclusion
The improvement of DN by Chuanxiong is related to the change of pyroptosis.
Cost-effectively dissecting the genetic architecture of complex wool traits in rabbits by low-coverage sequencing
Authors: Wang Dan , Xie Kerui , Wang Yanyan , Hu Jiaqing , Li Wenqiang , Yang Aiguo , Zhang Qin , Ning Chao , Fan Xinzhong 
Published: November 2022

Abstract
Background
Rabbit wool traits are important in fiber production and for model organism research on hair growth, but their genetic architecture remains obscure. In this study, we focused on wool characteristics in Angora rabbits, a breed well-known for the quality of its wool. Considering the cost to generate population-scale sequence data and the biased detection of variants using chip data, developing an effective genotyping strategy using low-coverage whole-genome sequencing (LCS) data is necessary to conduct genetic analyses.

Results
Different genotype imputation strategies (BaseVar + STITCH, Bcftools + Beagle4, and GATK + Beagle5), sequencing coverages (0.1X, 0.5X, 1.0X, 1.5X, and 2.0X), and sample sizes (100, 200, 300, 400, 500, and 600) were compared. Our results showed that using BaseVar + STITCH at a sequencing depth of 1.0X with a sample size larger than 300 resulted in the highest genotyping accuracy, with a genotype concordance higher than 98.8% and genotype accuracy higher than 0.97. We performed multivariate genome-wide association studies (GWAS), followed by conditional GWAS and estimation of the confidence intervals of quantitative trait loci (QTL) to investigate the genetic architecture of wool traits. Six QTL were detected, which explained 0.4 to 7.5% of the phenotypic variation. Gene-level mapping identified the fibroblast growth factor 10 (FGF10) gene as associated with fiber growth and diameter, which agrees with previous results from functional data analyses on the FGF gene family in other species, and is relevant for wool rabbit breeding.

Conclusions
We suggest that LCS followed by imputation can be a cost-effective alternative to array and high-depth sequencing for assessing common variants. GWAS combined with LCS can identify new QTL and candidate genes that are associated with quantitative traits. This study provides a cost-effective and powerful method for investigating the genetic architecture of complex traits, which will be useful for genomic breeding applications.
Modeling the metabolic evolution of mixotrophic phytoplankton in response to rising ocean surface temperatures
Authors: Gonzalez Logan M. , Proulx Stephen R. , Moeller Holly V. 
Published: November 2022

Abstract
Background
Climate change is expected to lead to warming in ocean surface temperatures which will have unequal effects on the rates of photosynthesis and heterotrophy. As a result of this changing metabolic landscape, directional phenotypic evolution will occur, with implications that cascade up to the ecosystem level. While mixotrophic phytoplankton, organisms that combine photosynthesis and heterotrophy to meet their energetic and nutritional needs, are expected to become more heterotrophic with warmer temperatures due to heterotrophy increasing at a faster rate than photosynthesis, it is unclear how evolution will influence how these organisms respond to warmer temperatures. In this study, we used adaptive dynamics to model the consequences of temperature-mediated increases in metabolic rates for the evolution of mixotrophic phytoplankton, focusing specifically on phagotrophic mixotrophs.

Results
We find that mixotrophs tend to evolve to become more reliant on phagotrophy as temperatures rise, leading to reduced prey abundance through higher grazing rates. However, if prey abundance becomes too low, evolution favors greater reliance on photosynthesis. These responses depend upon the trade-off that mixotrophs experience between investing in photosynthesis and phagotrophy. Mixotrophs with a convex trade-off maintain mixotrophy over the greatest range of temperatures; evolution in these “generalist” mixotrophs was found to exacerbate carbon cycle impacts, with evolving mixotrophs exhibiting increased sensitivity to rising temperature.

Conclusions
Our results show that mixotrophs may respond more strongly to climate change than predicted by phenotypic plasticity alone due to evolutionary shifts in metabolic investment. However, the type of metabolic trade-off experienced by mixotrophs as well as ecological feedback on prey abundance may ultimately limit the extent of evolutionary change along the heterotrophy-phototrophy spectrum.