bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical evaluation of S1 alar screws application in short-segment lumbosacral fixation and fusion for spine infection with severe S1 vertebral body loss
Authors: Fang Weizhi , Liu Weijun , Li Qingbo , Cai Lei , Wang Wei , Yi Xincheng , Jiao Hongbo , Yao Zhi 
Published: September 2022

Abstract
Background
The one-stage posterior approach for treating spinal infection has recently been generally accepted. However, severe vertebral body loss caused by infection remains a major challenge in posterior surgery. This study was conducted to evaluate the clinical application and outcomes of S1 alar screws used in the one-stage posterior surgery of short-segment lumbosacral fixation and fusion after debridement for infection with severe S1 vertebral body loss.

Methods
The clinical features and treatment outcomes of 7 patients with spinal infections from August 2016 to August 2021 who were treated with one-stage posterior surgery using S1 alar screws were retrospectively analyzed. The clinical data, including patient data, visual analogue scale (VAS), Oswestry Disability Index (ODI), fusion time and complications of the patients, were recorded.

Results
All 7 patients were followed up for an average duration of 14.57 months (range, 12—18 months). The VAS score decreased significantly from 7.3 preoperatively (range, 6—8) to 2.6 postoperatively (range, 2—3). The ODI score demonstrated a steady and gradual increase from 73.8 preoperatively (range, 68—75) to 33.6 postoperatively (range, 30—37). Bony fusion time was observed approximately 6.8 months after surgery. Two patients in our study experienced the postoperative local pain, which could be relieved by analgesics and disappeared 3 months after the operation. There were no complications of intraoperative fracture, posterior wound infection or neurovascular injury.

Conclusions
S1 alar screws are suitable for use in the operation and could be an alternative option to S1 pedicle screws for short-segment lumbosacral fixation and fusion with severe S1 vertebral body loss caused by spinal infection, which could provide satisfactory clinical outcomes.
Long-term survival of hybrid total hip replacement for prior failed proximal femoral nail antirotation: a retrospective study with a median 10-year follow-up
Authors: Wang Lin , Yu Minji , Zhang Yaodong , Wang Shuxin , Zhao Mingdong , Yu Mingliang , Li Si , Gao Songtao , Xiong Min , Yu Weiguang 
Published: September 2022

Abstract
Background
Hybrid total hip replacement (THR) is commonly used in the management of proximal femur fractures in elderly individuals. However, in the context of the revision, the literature on hybrid THR is limited, and differences in the long-term survival outcomes reported in the literature are obvious. This retrospective study aimed to evaluate the long-term survival of hybrid THR for failed proximal femoral nail antirotation (PFNA) in elderly individuals aged ≥ 75 years.

Methods
An observational cohort of 227 consecutive individuals aged ≥ 75 years who experienced hybrid THRs following prior primary PFNAs was retrospectively identified from the Joint Surgery Centre, the First Affiliated Hospital, Sun Yat-sen University. Implant survival was estimated using the Kaplan–Meier method. The primary end point was the implant survivorship calculated using the Kaplan–Meier method with revision for any reason as the end point; secondary end points were the function score measured using the modified Harris Hip Score (mHHS) and the incidence of main orthopaedic complications.

Results
In total, 118 individuals (118 THRs) were assessed as available. The median follow-up was 10 (3–11) years. The 10-year survivorship with revision for any reason as the endpoint was 0.914 (95% confidence interval [CI], 0.843–0.960). The most common indication for revision was aseptic loosening (70.0%), followed by periprosthetic fracture (30.0%). At the final follow-up, the median functional score was 83.6 (79.0–94.0). Among the 118 patients included in this study, 16 experienced 26 implant-related complications. The overall incidence of key orthopaedic complications was 13.5% (16/118).

Conclusion
For patients aged ≥ 75 years old with prior failed PFNAs, hybrid THR may yield satisfactory long-term survival, with good functional outcomes and a low rate of key orthopaedic complications.
Online student tutorials for effective peer teaching in digital times: a longitudinal quantitative study
Authors: Festl-Wietek Teresa , Kern Nils , Erschens Rebecca , Griewatz Jan , Zipfel Stephan , Herrmann-Werner Anne 
Published: September 2022

Abstract
Background
Peer-assisted learning represents a favoured method of teaching in universities. The COVID-19 pandemic has necessitated transferring medical education to digital formats, and subsequently, the question has arisen of whether online tutorials might be effective. This study, thus, investigated the efficacy of online tutorials in a communication course by assessing the interaction, verbal communication, and nonverbal communication of tutors and students.

Methods
Second-year medical students were invited to participate in this longitudinal quantitative study. Validated and self-developed questionnaires (e.g., Jefferson Empathy Scale) including 39 questions (rated on a 7- or 5-point Likert scale) were used to assess the different variables including interaction, verbal and nonverbal communication and students’ learning success.

Results
Out of 165 medical students, 128 took part in the study. The students as well as tutors reported that they found each other likeable (Mstudents = 4.60±0.71; Mtutors = 4.38±0.53; p > .05). Learning success increased throughout the communication course (Cohen’s d = 0.36–0.74). The nonverbal and verbal communication in the simulated patient (SP) encounter was also rated as high by all three groups (Mnonverbal = 3.90±0.83; Mverbal = 4.88±0.35).

Conclusions
Interaction as well as nonverbal and verbal communication occurred in the online format, indicating that online tutorials can be effective. The implementation of SPs increases the efficiency of synchronous online learning as it enhances the simulation of a real patient–physician encounter. Thus, online tutorials are a valuable amendment to medical education.
Assessing equity of access and affordability of care among South Sudanese refugees and host communities in two districts in Uganda: a cross-sectional survey
Authors: King Jessica , Prabhakar Pallavi , Singh Neha , Sulaiman Munshi , Greco Giulia , Mounier-Jack Sandra , Borghi Josephine 
Published: September 2022

AbstractBackgroundThe vast majority of refugees are hosted in low and middle income countries (LMICs), which are already struggling to finance and achieve universal health coverage for their own populations. While there is mounting evidence of barriers to health care access facing refugees, there is more limited evidence on equity in access to and affordability of care across refugee and host populations. The objective of this study was to examine equity in terms of health needs, service utilisation, and health care payments both within and between South Sudanese refugees and hosts communities (Ugandan nationals), in two districts of Uganda.MethodsParticipants were recruited from host and refugee villages from Arua and Kiryandongo districts. Twenty host villages and 20 refugee villages were randomly selected from each district, and 30 households were sampled from each village, with a target sample size of 2400 households. The survey measured condition incidence, health care seeking and health care expenditure outcomes related to acute and chronic illness and maternal care. Equity was assessed descriptively in relation to household consumption expenditure quintiles, and using concentration indices and Kakwani indices (for expenditure outcomes). We also measured the incidence of catastrophic health expenditure- payments for healthcare and impoverishment effects of expenditure across wealth quintiles.ResultsThere was higher health need for acute and chronic conditions in wealthier groups, while maternal care need was greater among poorer groups for refugees and hosts. Service coverage for acute, chronic and antenatal care was similar among hosts and refugee communities. However, lower levels of delivery care access for hosts remain. Although maternal care services are now largely affordable in Uganda among the studied communities, and service access is generally pro-poor, the costs of acute and chronic care can be substantial and regressive and are largely responsible for catastrophic expenditures, with service access benefiting wealthier groups.ConclusionsEfforts are needed to enhance access among the poorest for acute and chronic care and reduce associated out-of-pocket payments and their impoverishing effects. Further research examining cost drivers and potential financing arrangements to offset these will be important.
Congenital tremor and splay leg in piglets – insights into the virome, local cytokine response, and histology
Authors: Stenberg Hedvig , Hellman Stina , Lindström Lisa , Jacobson Magdalena , Fossum Caroline , Hayer Juliette , Malmberg Maja 
Published: September 2022

Abstract
Background
Atypical porcine pestivirus (APPV) is a neurotropic virus associated with congenital tremor type A-II. A few experimental studies also indicate an association between APPV and splay leg. The overarching aim of the present study was to provide insights into the virome, local cytokine response, and histology of the CNS in piglets with signs of congenital tremor or splay leg.

Results
Characterization of the cytokine profile and virome of the brain in piglets with signs of congenital tremor revealed an APPV-associated upregulation of Stimulator of interferon genes (STING). The upregulation of STING was associated with an increased expression of the gene encoding IFN-α but no differential expression was recorded for the genes encoding CXCL8, IFN-β, IFN-γ, IL-1β, IL-6, or IL-10. No viral agents or cytokine upregulation could be detected in the spinal cord of piglets with signs of splay leg or in the brain of piglets without an APPV-infection. The histopathological examination showed no lesions in the CNS that could be attributed to the APPV-infection, as no difference between sick and healthy piglets could be seen.

Conclusion
The results from this study provide evidence of an APPV-induced antiviral cytokine response but found no lesions related to the infection nor any support for a common causative agent.
Relationships of serum CC16 levels with smoking status and lung function in COPD
Authors: Gribben Kelli C. , Poole Jill A. , Nelson Amy J. , Farazi Paraskevi A. , Wichman Christopher S. , Heires Art J. , Romberger Debra J. , LeVan Tricia D. 
Published: September 2022

AbstractBackgroundThe club cell secretory protein (CC16) has anti-inflammatory and antioxidant effects, and low CC16 serum levels have been associated with both risk and progression of COPD, yet the interaction between smoking and CC16 on lung function outcomes remains unknown.MethodsUtilizing cross-sectional data on United States veterans, CC16 serum concentrations were measured by ELISA and log transformed for analyses. Spirometry was conducted and COPD status was defined by post-bronchodilator FEV1/FVC ratio < 0.7. Smoking measures were self-reported on questionnaire. Multivariable logistic and linear regression were employed to examine associations between CC16 levels and COPD, and lung function with adjustment for covariates. Unadjusted Pearson correlations described relationships between CC16 level and lung function measures, pack-years smoked, and years since smoking cessation.ResultsThe study population (N = 351) was mostly male, white, with an average age over 60 years. An interaction between CC16 and smoking status on FEV1/FVC ratio was demonstrated among subjects with COPD (N = 245, p = 0.01). There was a positive correlation among former smokers and negative correlation among current or never smokers with COPD. Among former smokers with COPD, CC16 levels were also positively correlated with years since smoking cessation, and inversely related with pack-years smoked. Increasing CC16 levels were associated with lower odds of COPD (ORadj = 0.36, 95% CI 0.22–0.57, Padj < 0.0001).ConclusionsSmoking status is an important effect modifier of CC16 relationships with lung function. Increasing serum CC16 corresponded to increases in FEV1/FVC ratio in former smokers with COPD versus opposite relationships in current or never smokers. Additional longitudinal studies may be warranted to assess relationship of CC16 with smoking cessation on lung function among subjects with COPD.
Peroxisome proliferator-activated receptor gamma gene variants modify human airway and systemic responses to indoor dibutyl phthalate exposure
Authors: Leung Clarus , Ryu Min Hyung , Bølling Anette Kocbach , Maestre-Batlle Danay , Rider Christopher F. , Hüls Anke , Urtatiz Oscar , MacIsaac Julie L. , Lau Kevin Soon-Keen , Lin David Tse Shen , Kobor Michael S. , Carlsten Chris 
Published: September 2022

Abstract
Background
Single nucleotide polymorphisms (SNPs) of peroxisome proliferator-activated receptor gamma (PPAR-γ; gene: PPARG) and oxidative stress genes are associated with asthma risk. However, whether such variants modulate responses to dibutyl phthalate (DBP), a common plasticizer associated with increased asthma development, remains unknown. The purpose of this study is to investigate how SNPs in PPARG and oxidative stress genes, as represented by two separate genetic risk scores, modify the impact of DBP exposure on lung function and the airway and systemic response after an inhaled allergen challenge.

Methods
We conducted a double-blinded human crossover study with sixteen allergen-sensitized participants exposed for three hours to DBP and control air on distinct occasions separated by a 4-week washout. Each exposure was followed by an allergen inhalation challenge; subsequently, lung function was measured, and blood and bronchoalveolar lavage (BAL) were collected and analyzed for cell counts and allergen-specific immunoglobulin E (IgE). Genetic risk scores for PPAR-γ (P-GRS; weighted sum of PPARG SNPs rs10865710, rs709158, and rs3856806) and oxidative stress (OS-GRS; unweighted sum of 16 SNPs across multiple genes) were developed, and their ability to modify DBP effects were assessed using linear mixed-effects models.

Results
P-GRS and OS-GRS modified DBP effects on allergen-specific IgE in blood at 20 h (interaction effect [95% CI]: 1.43 [1.13 to 1.80], p = 0.005) and 3 h (0.99 [0.98 to 1], p = 0.03), respectively. P-GRS also modified DBP effects on Th2 cells in blood at 3 h (− 25.2 [− 47.7 to − 2.70], p = 0.03) and 20 h (− 39.1 [− 57.9 to − 20.3], p = 0.0005), and Th2 cells in BAL at 24 h (− 4.99 [− 8.97 to − 1.01], p = 0.02). An increasing P-GRS associated with reduced DBP effect on Th2 cells. Neither GRS significantly modified DBP effects on lung function parameters.

Conclusions
PPAR-γ variants modulated several airway and systemic immune responses to the ubiquitous chemical plasticizer DBP. Our results suggest that PPAR-γ variants may play a greater role than those in oxidative stress-related genes in airway allergic responses to DBP.
Trial registration: This study reports results from The Phthalate-Allergen Immune Response Study that was registered on ClinicalTrials.gov with identification NCT02688478.
A review on the role of MEG8 lncRNA in human disorders
Authors: Ghafouri-Fard Soudeh , Khoshbakht Tayyebeh , Hussen Bashdar Mahmud , Taheri Mohammad , Shojaei Seyedpouzhia 
Published: September 2022

AbstractMaternally expressed 8 (MEG8) is a long non-coding RNA which is expressed in the nucleus. It is highly expressed in adrenal, placenta and brain. Recent studies have shown contribution of MEG8 in different disorders ranging from neoplastic ones to diabetic nephropathy, atherosclerosis, ischemic stroke, trophoblast dysfunction and abortion, Henoch-Schonlein purpura and osteoarthritis. It has an oncogenic role in the development of lung, pancreatic and liver cancer. In the current review, we summarize the role of this lncRNA in mentioned disorders, based on the evidence obtained from in vitro, in vivo and human studies.
In vitro assessment of multipotential therapeutic importance of Hericium erinaceus mushroom extracts using different solvents
Authors: Suleiman Waleed Bakry , Shehata Reda M. , Younis Ahmed M. 
Published: September 2022

AbstractInfectious disease is one of the major threats to humans and it is the second leading cause of death worldwide. Edible mushrooms have many nutritional and medicinal values to human health. The medicinal properties of edible mushroom extract in inhibiting pathogenic microorganisms had advantages over the use of chemically synthetic antimicrobial compounds due to less unwanted side effects and can combat microbial resistance. This study hypothesized that the polarity affects the extraction quality ofHericium erinaceusfruiting bodies which was prepared and subsequently affects its activity as an antimicrobial against six tested microorganisms, including MRSA, andStreptococcus mutans,Enterobacter cloaca,Salmonella typhimurium, andCandida lipolytica; antiviral against Hepatitis A virus (HAV) virus; antioxidant using 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay; and anti-inflammatory potential. So, the mushroom was quantitatively evaluated to assess its content of flavonoids, alkaloids, tannins, saponins, carbohydrates, protein, nitrogen, and oil. The current research clarified here that aquatic extract has a significant activity as an antioxidant (IC50 = 53.7 µg/mL) and antiviral (IC50 = 24.97 µg/mL), while ethyl acetate extract showed a reasonable antimicrobial activity rather than all tested extract against tested microorganisms. Unfortunately, all extracts under investigation possess low anti-inflammatory action according to the adopting protocol. The superior results of both water and ethyl acetate extracts were later investigated by HPTLC and GC–MS for preliminary prediction of the chemical constitution of those extracts.H. erinaceusmushroom succeeded to establish promising antimicrobial, antiviral, and antioxidant activities while it has low anti-inflammatory activity. Both HPTLC and GC–MS could identify the chemical constituents of the mushroom crude extract.Graphical Abstract
CT patterns and serial CT Changes in lung Cancer patients post stereotactic body radiotherapy (SBRT)
Authors: Al-Umairi Rashid , Tarique Usman , Moineddin Rahim , Jimenez-Juan Laura , Kha Lan Chau , Cheung Patrick , Oikonomou Anastasia 
Published: September 2022

Abstract
Background
To evaluate computed tomography (CT) patterns of post-SBRT lung injury in lung cancer and identify time points of serial CT changes.

Materials and methods
One hundred eighty-three tumors in 170 patients were evaluated on sequential CTs within 29 months (median). Frequencies of post-SBRT CT patterns and time points of initiation and duration were assessed. Duration of increase of primary lesion or surrounding injury without evidence of local recurrence and time to stabilization or local recurrence were evaluated.

Results
Post-SBRT CT patterns could overlap in the same patient and were nodule-like pattern (69%), consolidation with ground glass opacity (GGO) (41%), modified conventional pattern (39%), peribronchial/patchy consolidation (42%), patchy GGO (24%), diffuse consolidation (16%), “orbit sign” (21%), mass-like pattern (19%), scar-like pattern (15%) and diffuse GGO (3%). Patchy GGO started at 4 months post-SBRT. Peribronchial/patchy consolidation and consolidation with GGO started at 4 and 5 months respectively. Diffuse consolidation, diffuse GGO and orbit sign started at 5, 6 and 8 months respectively. Mass-like, modified conventional and scar-like pattern started at 8, 12 and 12 months respectively. Primary lesion (n = 11) or surrounding injury (n = 85) increased up to 13 months. Primary lesion (n = 119) or surrounding injury (n = 115) started to decrease at 4 and 9 months respectively. Time to stabilization was 20 months. The most common CT pattern at stabilization was modified conventional pattern (49%), scar-like pattern (23%) and mass-like pattern (12%). Local recurrence (n = 15) occurred at a median time of 18 months.

Conclusion
Different CT patterns of lung injury post-SBRT appear in predictable time points and have variable but predictable duration. Familiarity with these patterns and timeframes of appearance helps differentiate them from local recurrence.
Evaluating Palin Stammering Therapy for School Children (Palin STSC 8–14): protocol for a feasibility randomised controlled trial comparing Palin STSC(8–14) with usual treatment
Authors: Millard S. K. , Murphy S. , Barton G. , Leathersich M. , Mills G. , Rixon L. , Shepstone L. , Sims E. , Joffe V. 
Published: September 2022

Abstract
Background
Having a stammer can have a significant effect on a child’s social, emotional and educational development. With approximately 66,000 children in the UK having a stammer, there is a need to establish an adequate evidence base to inform clinical practice. We describe a feasibility trial to explore the effectiveness of a new therapy programme for children aged 8–14: Palin Stammering Therapy for School Children (Palin STSC(8–14)). Preliminary data from the Michael Palin Centre, where the programme was developed, indicate that Palin STSC(8–14) is effective in reducing stammering frequency and impact for children, with beneficial effects for parents too. We will investigate the feasibility of the methods required for a definitive randomised controlled trial to investigate the application of this therapy by NHS speech and language therapists (SLTs), compared with ‘treatment as usual’ (TAU), beyond the specialist context in which it was developed.

Methods
This is a two-arm feasibility cluster-randomised controlled trial of Palin STSC(8–14) with TAU control arm, and randomisation at the level of the SLT. Quantitative and qualitative data will be collected to examine the following: the recruitment and retention of therapists and families, the acceptability of the research processes and the therapeutic intervention and the appropriateness of the therapy outcome measures. Assessments will be completed by children and parents at baseline and 6 months later, including measures of stammering severity; the impact of child’s stammering on both children and parents; child temperament, behaviour and peer relations, anxiety; quality of life; and economic outcomes. There will also be a qualitative process evaluation, including interviews with parents, children, SLTs and SLT managers to explore the acceptability of both the research and therapy methods. Treatment fidelity will be examined through analysis of therapy session records and recordings.

Discussion
The findings of this feasibility trial will inform the decision as to whether to progress to a full-scale randomised controlled trial to explore the effectiveness of Palin STSC(8–14) when compared to Treatment as Usual in NHS SLT services. There is a strong need for an evidence-based intervention for school age children who stammer.

Trial registration
ISRCTN. ISRCTN17058884. Registered on 18 December 2019.