bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-Reported Outcomes After Surgical Treatment of Early Osteoarthritis of the First Carpometacarpal Joint
Authors: Hazewinkel Merel H. J. , DiGiovanni Peter , Miyamura Satoshi , Lans Jonathan , Chen Neal C. , Lunn Kiera , Jupiter Jesse B. 
Published: May 2022

Background: The goals of this study are to describe the reoperation rates in patients who underwent Wilson osteotomy compared with patients who underwent carpometacarpal (CMC) arthroplasty for early-stage arthritis and to evaluate the factors influencing the patient-reported outcomes. Methods: Retrospectively, 52 patients who underwent surgery for stage I/II osteoarthritis of the thumb carpometacarpal were identified, consisting of 17 (33%) patients who underwent Wilson osteotomy and 35 (67%) who underwent carpometacarpal arthroplasty. A total of 28 (55%) patients completed the outcome questionnaires, consisting of 11 (39%) patients who underwent Wilson osteotomy and 17 (61%) patients who underwent carpometacarpal arthroplasty. We performed a multivariable linear regression model to identify factors associated with the Numeric Rating Scale (NRS) pain intensity at final follow-up. Results: Among the patients who underwent CMC arthroplasty, 2 had a reoperation. Among the patients who underwent Wilson osteotomy, 3 had a reoperation. Among the patients who completed the outcome questionnaires, the median quick Disabilities of the Arm, Shoulder and Hand score was 10 and the median NRS Pain Intensity score was 0. In multivariable analysis, the postoperative Patient-Reported Outcomes Measurement Information System Pain Interference (PROMIS PI) was independently associated with higher postoperative NRS pain scores. Conclusion: In younger patients with stage I/II CMC osteoarthritis, Wilson osteotomy may be a reasonable alternative to CMC arthroplasty. Outcomes were similar between both groups at mid-term follow-up, with only a slightly higher pain score in the osteotomy group. In patients with stage I/II carpometacarpal osteoarthritis, the PROMIS PI is the main factor indicating successful outcomes.
Volumetric surveillance of brain aneurysms: Pitfalls of MRA
Authors: Raghuram Ashrita , Patel Rishi , Varon Alberto , Sabotin Ryan , Sanchez Sebastian , Derdeyn Colin P , Jabbour Pascal , Hasan David M. , Samaniego Edgar A. 
Published: May 2022

Introduction Untreated brain aneurysms are usually surveilled with serial MR imaging and evaluated with 2D multiplanar measurements. The assessment of aneurysm growth may be more accurate with volumetric analysis. We evaluated the accuracy of a magnetic resonance angiography (MRA) segmentation pipeline for aneurysm volume measurement and surveillance. Methods A pipeline to determine aneurysm volume was developed and tested on two aneurysm phantoms imaged with time-of flight (TOF) MRA and 3D rotational angiography (3DRA). The accuracy of the pipeline was then evaluated by reconstructing 10 aneurysms imaged with contrast enhanced-MRA (CE-MRA) and 3DRA. This calibrated and refined post-processing pipeline was subsequently used to analyse aneurysms from our prospectively acquired database. Volume changes above the threshold of error were considered true volume changes. The accuracy of these measurements was analysed. Results TOF-MRA reconstructions were not as accurate as CE-MRA reconstructions. When compared to 3DRA, CE-MRA underestimated aneurysm volume by 7.8% and did not accurately register the presence of blebs. Eighteen aneurysms (13 saccular and 5 fusiform) were analysed with the optimized 3D volume reconstruction pipeline, with a mean follow-up time of 11 months. Artifact accounted for 10.2% error in volume measurements using serial CE-MRA. When this margin of error was used to assess aneurysms volume in serial imaging with CE-MRA, only two fusiform aneurysms changed in volume. The variations in volume of these two fusiform aneurysms were caused by intra-mural and intrasaccular thrombosis. Conclusions CE-MRA and TOF-MRA 3D volume reconstructions may not register minor morphological changes such as the appearance of blebs. CE-MRA underestimates volume by 7.8% compared to 3DRA. Serial CE-MRA volume measurements had a larger margin of error of approximately 10.2%. MRA-based volumetric measurements may not be appropriate for aneurysm surveillance.
Corynebacterium pyruviciproducens-peptidoglycan: A novel bacterial peptidoglycan inhibiting overexpression of MyD88 in macrophages
Authors: Wang Lin , Ma Yuan , Shi Jinfang , Zhang Yang , Tong Jia , Han Qingzhen 
Published: May 2022

Objectives: Bacterial peptidoglycan (PGN) is an essential ligand of TLR2 inducing inflammatory damage by boosting MyD88 overexpression in pathogen invasion, such as Methicillin-resistant Staphylococcus aureus (MRSA) infection. CP-PGN is a novel PGN from an adjuvant bacterium, displaying anti-infection immune regulation. This study aimed to clarify the unique moderation of MyD88 expression by CP-PGN. Methods: Compared with other ligands of TLR2, high expression of MyD88 in macrophages was established by MRSA and virus to investigate the immunomodulation of CP-PGN. Results: Compared with PGN derived from MRSA (M-PGN) and chemosynthetic Pam3CSK4 of model agonists of TLR2, CP-PGN could inhibit overexpression of MyD88 in a time- and dose-dependent way in infected macrophages by MRSA or Abelson leukemia virus. CP-PGN also promoted more anti-inflammatory IL-10 and less pro-inflammatory TNF-α in immature primary macrophages. Furthermore, IL-10 secretion induced by CP-PGN was reduced most significantly by blocking the dimer formation of MyD88 with ST2825 and lowering down expression by si-MyD88. Conclusion: CP-PGN could inhibit MyD88 overexpression by infection to moderate inflammatory cytokines. Therefore, CP-PGN is a novel potential ligand of TLR2 to induce inflammatory balance in the process of host defense against invading pathogens.
Distribution characteristics of ApoE gene polymorphism in the Tibetan population of Qinghai
Authors: Xie Yan-Ling , Li Jian-Xun , Ji Wei-Zhong , Yao Yong-Li 
Published: May 2022

Objective: To understand the distribution characteristics of the relative frequencies of apolipoprotein E (APOE) alleles in Tibetans of Qinghai province, to provide a basis for subsequent research. Method: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine the APOE genotypes and analyze the distribution characteristics in 96 indigenous Tibetans randomly selected from the Medical Examination Center of Qinghai Provincial People’s Hospital, and the results of this study were compared with those of other ethnic groups in China. Results: The frequencies of E2, E3, and E4 alleles in the 96 subjects were 1.563%, 89.062%, and 9.375%, respectively, and the genotype frequencies were E2/E2 (0%), E2/E3 (3.125%), E2/E4 (0%), E3/E3 (78.125%), E3/E4 (18.750%), and E4/E4 (0%), respectively. The frequency distribution of the ε2 allele in the Tibetan population was lower than that of the Northern Han, Southern Hakka, Hui, Mongolian, and Dai populations of China. The frequency distribution of the ε4 allele in the Tibetan population was of no significant difference compared with that of the Northern Han, Southern Hakka, Hui, and Mongolian populations, but was higher than that of the Dai population. The frequency distribution of the ε3 allele in the Tibetan population was of no significant difference compared with that of the Northern Han, Mongolian, and Dai populations, but higher than that of the Southern Hakka and Mongolian populations. Conclusion: There are ethnic differences in the frequency distribution of the three common alleles of APOE.
Linguistic adaptation and psychometric properties of the health literacy questionnaire in serbian language among people with chronic diseases
Authors: Arsenović Sladjana , Oyewole Olufemi , Trajković Goran , Osborne Richard H , Wiltshire-Fletcher Megan , Gazibara Teodora , Kisić Tepavčević Darija , Pekmezović Tatjana , Gazibara Tatjana 
Published: May 2022

Objective To translate the Health Literacy Questionnaire (HLQ) to Serbian language and examine its psychometric characteristics. Methods This cross-sectional study was conducted among 295 people with chronic diseases from the Foča region (Republic of Srpska, Bosnia and Herzegovina). The HLQ was translated according to the translation integrity procedure. Construct validity was tested using confirmatory factor analysis (CFA) using the maximum likelihood estimator and reliability was estimated using the α and ω coefficients. Results Minor linguistic differences in 17 items were observed between the original and the initial forward translation and were corrected. The parameters of one-factor CFA on domains 3 and 8 fitted well. The parameters of the CFA for domains 1, 2, 4, 5, 6, 7 and 9 were acceptable after modification using residuals’ correlation. The α and ω coefficients for all domains were good to excellent (>0.80). Conclusion Each domain of the HLQ in Serbian has acceptable construct validity and overall good reliability. This study adds to the growing evidence that the HLQ is a useful tool to provide in-depth multidimensional information on health literacy to improve researchers and policymakers understanding of the health literacy strengths, needs and preferences across cultures and languages.
Efficacy of prolonged-release fampridine versus placebo on walking ability, dynamic and static balance, physical impact of multiple sclerosis, and quality of life: an integrated analysis of MOBILE and ENHANCE
Authors: Hupperts Raymond , Gasperini Claudio , Lycke Jan , Ziemssen Tjalf , Feys Peter , Xiao Shan , Acosta Carlos , Koster Thijs , Hobart Jeremy 
Published: May 2022

Background: MOBILE and ENHANCE were similarly designed randomized trials of walking-impaired adults with relapsing-remitting or progressive multiple sclerosis (MS) who received placebo or 10 mg prolonged-release (PR)-fampridine twice daily for 24 weeks. Both studies showed sustained and clinically meaningful improvement in broad measures of walking and balance over 24 weeks of PR-fampridine treatment. Objective: To evaluate the functional benefits and safety of PR-fampridine versus placebo using a post hoc integrated efficacy analysis of MOBILE and ENHANCE data. Methods: Data from the intention-to-treat (ITT) populations of MOBILE and ENHANCE studies were pooled in a post hoc analysis based on the following outcome measures: 12-item MS Walking Scale (MSWS-12), Timed Up and Go (TUG) speed, Berg Balance Scale (BBS), MS Impact Scale physical impact subscale (MSIS-29 PHYS), EQ-5D utility index score, visual analogue scale (VAS), and adverse events. The primary analysis was the proportion of people with MS (PwMS) with a mean improvement in MSWS-12 score (⩾8 points) from baseline over 24 weeks. A subgroup analysis based on baseline characteristics was performed. Findings: In the ITT population ( N = 765; PR-fampridine, n = 383; placebo, n = 382), a greater proportion of PR-fampridine–treated PwMS than placebo-treated PwMS achieved a clinically meaningful improvement in the MSWS-12 scale over 24 weeks (44.3% versus 33.0%; p < 0.001). PR-fampridine MSWS-12 responders demonstrated greater improvements from baseline in TUG speed, BBS score, MSIS-29 PHYS score, and EQ-5D utility index and VAS scores versus PR-fampridine MSWS-12 nonresponders and placebo. Subgroup analyses based on baseline characteristics showed consistency in the effects of PR-fampridine. Conclusion: The pooled analysis of MOBILE and ENHANCE confirms previous evidence that treatment with PR-fampridine results in clinically meaningful improvements in walking, mobility and balance, self-reported physical impact of MS, and quality of life and is effective across a broad range of PwMS.
Exploring the impact of COVID-19 movement control orders on eating habits and physical activity in low-resource urban settings in Malaysia
Authors: Lim Shiang Cheng , Kataria Ishu , Ngongo Carrie , Usek Venessa Sambai , Kudtarkar Shashank Rajkumar , Chandran Arunah , Mustapha Feisul Idzwan 
Published: May 2022

Background: The COVID-19 pandemic led Malaysia to introduce movement control orders (MCOs). While MCOs were intended to slow the spread of COVID-19, the effects of such measures on the noncommunicable disease (NCD) risk factors have not been fully explored. This exploratory study aimed to understand the effect of the MCO on the eating habits and physical activity levels of the urban poor in Malaysia as well as potential health promotion interventions during the COVID-19 pandemic. Methods: This rapid assessment used a mixed-method approach in three low-cost public flats in Kuala Lumpur targeting the B40, which is the bottom 40% of the economic spectrum. A total of 95 community members participated in a quantitative phone survey, while 21 respondents participated in a qualitative phone survey, including 12 community members and nine community health volunteers (CHVs). Results: The movement restriction imposed during the MCO significantly reduced the frequency and duration of respondents’ physical activity. At the same time, respondents reported significantly increased consumption of home-cooked meals. More than half of respondents reduced their consumption of packaged snack foods (53.7%), street desserts (54.7%), fast food (50.5%), soft drinks (50.5%), and 3-in-1 or instant drinks (50.5%) due to limited access during the MCO. B40 communities were receptive to potential interventions to encourage healthier eating and physical activity leveraging digital approaches under the ‘new normal’. Reported concerns included internet accessibility and affordability, functionality, and digital literacy. Conclusion: The COVID-19 pandemic requires innovation to address diseases and risk factors at the community level. While movement restrictions reduced physical activity, they created opportunities for low-income individuals to have greater control over their diet, enabling them to adopt healthier eating habits. Lifestyle changes experienced by vulnerable populations provide an opportunity for creative and technology-enabled interventions to promote healthy eating and exercise.
Ultrasound-detected inflammation is more common in clinically manifest hand osteoarthritis than in painless bony enlarged finger joints: subanalysis of the population-based Bruneck study
Authors: Gasperi Nina , Schreiber Nikolaus , Bosch Philipp , Adinolfi Antonella , Kleyer Arnd , Hagen Melanie , Gasperi Christiane , Weger Martin , Kiechl Stefan , Willeit Johann , Schett Georg , Iagnocco Annamaria , Gasperi Arno , Mayr Agnes , Dejaco Christian 
Published: May 2022

Purpose: The aim of this article is to examine the extent of structural and inflammatory lesions by ultrasound in elderly subjects with hand osteoarthritis (HOA) fulfilling the ACR classification criteria (Group A), in subjects with painless enlarged finger joints (Group B), and in individuals without clinical abnormalities at hands (Group C). Methods: This study was nested within the population-based, prospective Bruneck study; 293 subjects of ⩾65 years of age were assessed. Clinical and ultrasound assessment was conducted at wrists and finger joints. Gray scale synovitis (GSS), Power Doppler (PD), osteophytes, and erosions were scored semiquantitatively (0–3). The Short Form Score for the Assessment and Quantification of Chronic Rheumatic Affections of the Hands (SF-SACRAH), the Health Assessment Questionnaire (HAQ), and the Functional Index for Hand Osteoarthritis (FIHOA) were retrieved. Results: Most subjects had ⩾1 ultrasound abnormality, of which osteophytes were the most prevalent finding in all groups (Group A: 100%, Group B: 99.4%, and Group C: 93.9%). GSS and PD-signals were more common in Group A than in Group B (94% versus 67% and 33% versus 13%, respectively). In Group C, GSS was observed in 39.4% of subjects. In subjects with HOA, the SF-SACRAH correlated with osteophyte scores (corrcoeff = 0.48), and the FIHOA correlated with the osteophyte (corrcoeff = 0.42) and PD scores (corrcoeff = 0.33). Conclusion: GSS and PD were more frequent in patients with symptomatic HOA than in cases with painless bony enlargements and subjects without clinical joint abnormalities. Functional restriction in HOA is associated with structural and inflammatory ultrasound changes.
Electronic health records post-implementation challenges in selected hospitals: A qualitative study in the Central Region of southern Ghana
Authors: Mensah Nathan K , Boadu Richard O , Adzakpah Godwin , Lasim Obed U , Amuakwa Ruth D , Taylor-Abdulai Hannah B , Chatio Samuel T 
Published: May 2022

Background Electronic health records (EHRs) are useful tools in healthcare settings but implementation in low and middle-income countries (LMIC) face challenges. Objective To explore post-implementation challenges affecting the deployment of EHRs and their use in selected health facilities in Ghana. Method Using a qualitative research approach, 21 in-depth interviews were conducted with health workers in two hospitals in the study area in Ghana, in February and June 2020. Purposive sampling was used to select participants. All interviews were audio recorded, transcribed, and coded into themes using QSR Nvivo12 software to aid thematic analyses. Results Post-implementation challenges were grouped into lack of technological, logistical and managerial support, and inadequate training. Inadequate equipment was the most reported post-implementation challenge that affected EHR use. Unreliable Internet and network connectivity was a source of frustration, which caused staff to develop negative attitudes towards use of the system. Lack of funding stalled implementation of the system and limited its use to critical care units only. It was also the reason replacement of equipment delayed. Conclusion While EHR post-implementation challenges facing health facilities are surmountable, managerial support, backed with the requisite logistical and technical support is needed. It is not enough to rely on funding; health institutions should prioritise emerging EHR post-implementation challenges in their operating budgets. Implications A national framework is needed to guide effective and sustainable EHR implementation across the country.
The Reorganization of a Psychiatric Unit During COVID-19: A Reflection for Psychiatric Hospital Design
Authors: Sturge Jodi , Starrenburg Ferdi 
Published: May 2022

Objective: The COVID-19 pandemic has impacted healthcare systems worldwide. Although this disease has primarily impacted general medicine intensive care units, other areas of healthcare including psychiatry were modified in response to corona measures to decrease the transmission of the disease. Reflecting on the modifications to the environment provides an opportunity to design psychiatric environments for future pandemics or other demands for healthcare. Background: The therapeutic environment of psychiatric wards was modified in Friesland, the Netherlands, in response to COVID-19. During this time, an interdisciplinary team met consistently to contribute to the preliminary design of a new psychiatric hospital. Methods: During the first 18 months of the pandemic, clinical reflections were made to describe the impact of COVID-19 on the psychiatric care environment. Architects have created a preliminary design of a new psychiatric hospital based on these reflections, monthly collaborative design discussions based on virtual mock-ups and evidence-based design based on theoretical concepts and research. Results and conclusions: This theoretical and reflective study describes how an inpatient psychiatric environment was restructured to manage infection during COVID-19. The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19. The number of patients accessing care decreased, patient autonomy was restricted, and the function of designated behavioral support spaces changed to manage the risk of infection. However, these challenging times have provided an opportunity to reflect on theories and consider the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions.
Risk Factors for Failure of Conservative Management of Insertional Achilles Tendinosis
Authors: Kunkle Bryce F. , Baxter Nicholas A. , Caughman Alexander M. , Barcel John A. , Scott Daniel J. , Gross Christopher E. 
Published: May 2022

Introduction: While many patients benefit from nonoperative treatment of insertional Achilles tendinopathy (IAT), some elect for surgical debridement and reconstruction. The purpose of this study is to determine the relationship of patient demographic characteristics, comorbidity profiles, and radiological parameters with failure of conservative management of IAT. Methods: A retrospective chart review was performed to identify patients who received either surgical or nonsurgical treatment of IAT at an academic institution from September 2015 to June 2019 (N = 226). Demographic and comorbidity data, and the presence and magnitude of relevant radiological parameters were collected and compared between the surgically (n = 48) and nonsurgically (n = 178) treated groups. Results: No significant differences could be detected between groups regarding demographic factors or previous procedures. The surgery group was significantly more likely to have evidence of Haglund’s deformity on clinical exam (83% vs 69%, P = .005), lower SF-12 physical scores (25.5 vs 35.5, P < .001), higher VAS pain scores (6.3 vs 5.3, P = .033), any mental illness (33% vs 20%, P = .044), and depression (27% vs 12%, P = .012). Discussion: Patients who received surgery for IAT were significantly more likely to have evidence of Haglund’s deformity on clinical exam, depression, higher VAS pain scores, and lower SF-12 physical scores. Both patients and surgeons should be aware of the higher rates of failure of conservative treatment in these patients. Level of Evidence: Level III
Extracellular Vesicles from Hypoxic Pretreated Urine-Derived Stem Cells Enhance the Proliferation and Migration of Chondrocytes by Delivering miR-26a-5p
Authors: Wan Sha , Bao Dingsu , Li Jia , Lin Kefu , Huang Qi , Li Qiang , Li Lang 
Published: May 2022

Objective Stem-cell therapy is a promising treatment for cartilage defects. The newly identified urine-derived stem cells (USCs), which have multipotency and sufficient proliferative ability, are promising candidates for several tissue engineering therapies. In this study, we investigated the role of USC extracellular vehicles (EVs) in promoting the proliferation and migration of chondrocytes. Design USCs were characterized by measuring induced multipotent differentiation and flow cytometry analysis of surface marker expression. The EVs were isolated from USCs under normoxic conditions (nor-EVs) and hypoxic conditions (hypo-EVs). Transmission electron microscopy and western blot analysis characterized the EVs. The chondrocytes were cultured in the USC-EVs. CCK-8 assay and EdU staining detected the proliferation of chondrocytes, and transwell assay detected their migration. miR-26a-5p expression in EVs was detected by quantitative real-time polymerase chain reaction (qRT-PCR). The target relationship of miR-26a-5p and phosphatase and tensin homolog (PTEN) was predicted and confirmed. The roles of EVs-miR-26a-5p and PTEN on the proliferation and migration of chondrocytes were also investigated. Results Hypo-EVs showed a superior effect in promoting the proliferation and migration of chondrocytes than nor-EVs. Mechanistically, USC-EVs delivered miR-26a-5p into chondrocytes to overexpress miR-26a-5p. PTEN was identified as an miR-26a-5p target in chondrocytes. The effects of EVs-miR-26a-5p on promoting the proliferation and migration of chondrocytes were mediated by its regulation of PTEN. Conclusion Our study suggested that hypoxic USC-EVs may represent a promising strategy for osteoarthritis by promoting the proliferation and migration of chondrocytes via miR-26a-5p transfer.