bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Low-Intensity Pulsed Ultrasound on the Graft-Bone Healing of Artificial Ligaments: An In Vitro and In Vivo Study
Authors: Liu Xingwang , Sun Kai , Xu Pengzhi , Yu Zhongshen , Lei Zeming , Zhou Huihui , Li Jutao , Li Xi , Zhu Zhiyong , Wang Huisheng , Chen Chen , Bai Xizhuang 
Published: March 2022

Background: As many researchers have focused on promoting the graft-bone healing of artificial ligaments, even with numerous chemical coatings, identifying a biosafe, effective, and immediately usable method is still important clinically. Purpose: (1) To determine whether a low-intensity pulsed ultrasound system (LIPUS) promotes in vitro cell viability and osteogenic differentiation and (2) to assess the applicability and effectiveness of LIPUS in promoting the graft-bone healing of artificial ligaments in vivo. Study Design: Controlled laboratory study. Methods: Polyethylene terephthalate (PET) sheets and grafts were randomly assigned to control and LIPUS groups. MC3T3-E1 preosteoblasts were cultured on PET sheets. Cell viability and morphology were evaluated using a live/dead viability assay and scanning electron microscopy. Alkaline phosphatase activity, calcium nodule formation, and Western blot were evaluated for osteogenic differentiation. For in vivo experiments, the effect of LIPUS was evaluated via an extra-articular graft-bone healing model in 48 rabbits: the osteointegration and new bone formation were tested by micro–computed tomography and histological staining, and the graft-bone bonding was tested by biomechanical testing. Results: Cell viability was significantly higher in the LIPUS group as compared with control (living and dead compared between control and LIPUS groups, P = .0489 vs P = .0489). Better adherence of cells and greater development of extracellular matrix were observed in the LIPUS group. Furthermore, LIPUS promoted alkaline phosphatase activity, calcium nodule formation, and the protein expression of collagen 1 ( P = .0002) and osteocalcin ( P = .0006) in vitro. Micro–computed tomography revealed higher surrounding bone mass at 4 weeks and newly formed bone mass at 8 weeks in the LIPUS group ( P = .0014 and P = .0018). Histological analysis showed a narrower interface and direct graft-bone contact in the LIPUS group; the surrounding bone area at 4 weeks and the mass of newly formed bone at 4 and 8 weeks in the LIPUS group were also significantly higher as compared with control (surrounding bone, P < .0001; newly formed bone, P = .0016 at 4 weeks and P = .005 at 8 weeks). The ultimate failure load in the LIPUS group was significantly higher than in the control group ( P < .0001 at 4 weeks; P = .0008 at 8 weeks). Conclusion: LIPUS promoted the viability and osteogenic differentiation of MC3T3-E1 preosteoblasts in vitro and enhanced the graft-bone healing of PET artificial ligament in vivo. Clinical Relevance: LIPUS is an effective physical stimulation to enhance graft-bone healing after artificial ligament implantation.
Arthroscopic Quantitative Measurement of Medial Clear Space for Deltoid Injury of the Ankle: A Cadaveric Comparative Study With Stress Radiography
Authors: Chiang Chao-Ching , Lin Chien-Fu Jeff , Tzeng Yun-Hsuan , Teng Ming-Hung , Yang Tzu-Cheng 
Published: March 2022

Background: The deltoid ligament (DL) is an important stabilizer of the ankle. DL injury of varying severity can occur alone or with syndesmotic injury and fibular fracture. Limited diagnostic tools are available to assess DL injury quantitatively. Purpose: To establish an arthroscopic quantitative assessment of DL injury and to compare its performance with that of external rotation stress (ERS) and gravity stress (GS) radiography. Study Design: Controlled laboratory study. Methods: In total, 24 cadaveric lower extremities were divided into 4 groups: group 1 consisted of intact DL, group 2 of superficial DL disruption, group 3 of deep DL disruption, and group 4 of complete DL (superficial and deep) disruption. All specimens underwent sequential sectioning of syndesmotic ligaments, and medial clear space (MCS) was measured with ankle arthroscopy, ERS radiography, and GS radiography at different stages of syndesmotic sectioning. Results: For noninjured deltoid (group 1) and injured deltoid (groups 2-4), area under the receiver operating characteristic curve (AUC) of measurement of MCS was 0.939 for arthroscopy, 0.932 for ERS radiography, and 0.874 for GS radiography, with a significant difference between arthroscopy and GS radiography ( P = .014). For incomplete deltoid injury (groups 1-3) and complete deltoid injury (group 4), the AUC of MCS was 0.811 for arthroscopy, 0.656 for ERS radiography, and 0.721 for GS radiography, with a significant difference between arthroscopy and ERS radiography ( P < .001) and between arthroscopy and GS radiography ( P = .035). For all stages of syndesmotic sectioning, cutoff values of arthroscopic MCS with intact fibula were ≤2.5 mm for intact DL, between 2.5 and 3.5 mm for partial DL injury (superficial or deep), and ≥3.5 mm for complete DL injury. Arthroscopy was unable to detect a difference between superficial deltoid injury (group 2) and deep deltoid injury (group 3) in partial DL injury, with a measured MCS between 2.5 and 3.5 mm. The intraclass correlation coefficient of interrater reliability was 0.975 for arthroscopy, 0.917 for ERS radiography, and 0.811 for GS radiography. Conclusion: Arthroscopic MCS measurement can differentiate intact DL, partial DL injury, and complete DL injury. Compared with ERS and GS radiography, arthroscopic MCS measurement has greater accuracy with excellent interrater reliability. Clinical Relevance: For patients with suspected DL injury, arthroscopic MCS is useful for determining deltoid lesion severity based on defined cutoff values for consideration in preoperative planning to improve surgical outcomes.
Salvianolic acid B attenuates the inflammatory response in atherosclerosis by regulating MAPKs/ NF-κB signaling pathways in LDLR-/- mice and RAW264.7 cells
Authors: Zhang Yifan , Feng Xiaoteng , Du Min , Ding Jie , Liu Ping 
Published: March 2022

Objectives: Salvianolic acid B (Sal B) is the main effective water-soluble component of Salvia miltiorrhiza. In this study, the anti-inflammatory effect of Sal B was explored in high-fat-diet (HFD)-induced LDLR-/- mice and oxidized low-density-lipoprotein (ox-LDL)-induced or lipopolysaccharide (LPS)-induced RAW264.7 cells. Methods: The LDLR-/- mice were randomly divided into four groups after 12 weeks of high-fat diet. Then, the mice were administrated with 0.9% saline or Sal B (25 mg/kg) or Atorvastatin (1.3 mg/kg) for 12 weeks. RAW 264.7 cells were induced with ox-LDL/LPS, or ox-LDL/LPS plus different concentrations of Sal B (1.25 μg/mL, 2.5 μg/mL, 5 μg/mL), or ox-LDL plus Sal B plus MAPKs activators. ELISA was used for detecting serum lipid profiles and inflammatory cytokines, RT-qPCR used for gene expression, Oil Red O used for plaque sizes, and immunofluorescence staining used for NF-κB p65 and TNF-α production. Inflammation-related proteins and MAPKs pathways were detected by Western Blot. Results: The results showed that Sal B decreased the levels of serum lipids (TC, TG, and LDL-C), attenuated inflammatory cytokines, and improved lipid accumulation in the aorta. Sal B also attenuated the elevation of inflammatory cytokines induced by ox-LDL or LPS in RAW264.7 cells, and the phosphorylation of MAPKs/NF-κB pathways in the aorta and RAW264.7 cells, resulting in a significant decrease in the contents of p-JNK, p-ERK 1/2, p-P38, p-IκB, and p-NF-κB p65. Conclusions: Sal B could exert anti-inflammatory effects on atherosclerosis via MAPKs/NF-κB signaling pathways in vivo and in vitro.
Fluconazole-Induced adrenal insufficiency following allogeneic hematopoietic cell transplant
Authors: Freyer Craig W. , Loren Alison W. 
Published: March 2022

Introduction Adrenal insufficiency (AI) is a potentially life-threatening endocrine abnormality rarely associated with azole antifungals. Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) are at high risk of invasive fungal infection and frequently receive azoles. Signs and symptoms of AI, such as gastrointestinal symptoms, lethargy, and electrolyte disturbances frequently overlap with common alloHCT toxicities, such that azole-induced AI may be under-reported in this population. Case Report We report the first published case of azole-induced AI following alloHCT. The patient presented with orthostasis and nonspecific gastrointestinal and failure to thrive symptoms in the setting of roughly 6 weeks of fluconazole prophylaxis. The patient was found to have primary AI diagnosed via low serum cortisol and inadequate response to cosyntropin. Management & Outcome AI symptoms resolved with hydrocortisone supplementation and recurred upon rechallenge with fluconazole. The patient had fluconazole permanently discontinued with resolution of symptoms. We rate this case as a probable adverse drug reaction on the Naranjo scale. Discussion AI may be underreported and misdiagnosed in the alloHCT population given the presence of multiple toxicities with overlapping features. Clinicians must be diligent in investigating adrenal function in patients undergoing alloHCT on azole antifungals who present with symptoms of AI.
How Do Risky Behaviors and Mental Health Differ Among Students Based on Undergraduate Class Status?
Authors: Jennings Mathis Karen , Carden Holly , Tavares Alexis , Al Sanea Alia 
Published: March 2022

Objective: The purpose of this study was to examine the relationships among undergraduate class status, risky behaviors (i.e., alcohol and marijuana use, sexual activity), life satisfaction, and ability to cope. Methods: Undergraduate students ( N = 2,961) completed an electronic survey to assess for mental health status and risky behaviors. Results: Compared with others, first-year students reported fewer days of having at least one alcoholic drink, fewer days of having five or more alcoholic drinks in a row, and less frequency of marijuana use. First-year students reported fewer sexual partners and less frequency of sexual activity compared with others. First-year students were more likely to report greater life satisfaction, being able to cope with difficult situations, and greater self-worth, compared with others. Conclusions: As undergraduate students progress through their academic career, they are more likely to engage in risky behaviors and experience life dissatisfaction.
Development of a polygenic risk score to improve detection of peripheral artery disease
Authors: Wang Fudi , Ghanzouri Ilies , Leeper Nicholas J , Tsao Philip S , Ross Elsie Gyang 
Published: March 2022

Introduction: Peripheral artery disease (PAD) is a major cause of cardiovascular morbidity and mortality, yet timely diagnosis is elusive. Larger genome-wide association studies (GWAS) have now provided the ability to evaluate whether genetic data, in the form of genome-wide polygenic risk scores (PRS), can help improve our ability to identify patients at high risk of having PAD. Methods: Using summary statistic data from the largest PAD GWAS from the Million Veteran Program, we developed PRSs with genome data from UK Biobank. We then evaluated the clinical utility of adding the best-performing PRS to a PAD clinical risk score. Results: A total of 487,320 participants (5759 PAD cases) were included in our final genetic analysis. Compared to participants in the lowest 10% of PRS, those in the highest decile had 3.1 higher odds of having PAD (95% CI, 3.06–3.21). Additionally, a PAD PRS was associated with increased risk of having coronary artery disease, congestive heart failure, and cerebrovascular disease. The PRS significantly improved a clinical risk model (Net Reclassification Index = 0.07, p < 0.001), with most of the performance seen in downgrading risk of controls. Combining clinical and genetic data to detect risk of PAD resulted in a model with an area under the curve of 0.76 (95% CI, 0.75–0.77). Conclusion: We demonstrate that a genome-wide PRS can discriminate risk of PAD and other cardiovascular diseases. Adding a PAD PRS to clinical risk models may help improve detection of prevalent, but undiagnosed disease.
AMEERA-5: a randomized, double-blind phase 3 study of amcenestrant plus palbociclib versus letrozole plus palbociclib for previously untreated ER+/HER2– advanced breast cancer
Authors: Bardia Aditya , Cortes Javier , Hurvitz Sara A. , Delaloge Suzette , Iwata Hiroji , Shao Zhi-Ming , Kanagavel Dheepak , Cohen Patrick , Liu Qianying , Cartot-Cotton Sylvaine , Pelekanou Vasiliki , O’Shaughnessy Joyce 
Published: March 2022

Background: For estrogen receptor–positive (ER+)/human epidermal growth factor receptor 2–negative (HER2–) advanced breast cancer (ABC), the current standard first-line treatment includes an aromatase inhibitor in combination with a cyclin-dependent kinase 4/6 inhibitor. When resistance occurs, often related to the occurrence of ESR1 mutations, selective estrogen receptor modulators or degraders (SERDs) may be used, alone or in combination regimens. Amcenestrant (SAR439859), an optimized oral SERD, has shown clinical antitumor activity in combination with palbociclib in patients with ER+/HER2– ABC and, as monotherapy, in patients with and without ESR1 mutations. Here, we describe the study design of AMEERA-5, an ongoing, prospective, phase 3, randomized, double-blind, multinational study comparing the efficacy and safety of amcenestrant plus palbociclib versus letrozole plus palbociclib in patients with advanced (locoregional recurrent or metastatic) ER+/HER2– breast cancer. Methods: Patients are pre-/postmenopausal women and men with no prior systemic therapy for ABC. The planned enrollment is 1066 patients. Patients are randomized 1:1 to either amcenestrant 200 mg plus palbociclib 125 mg or letrozole 2.5 mg plus palbociclib 125 mg. Amcenestrant, letrozole, and their matching placebos are taken once daily continuously; palbociclib is taken once daily for 21 days, followed by 7 days off-treatment for a 28-day cycle. Treatment continues until disease progression, unacceptable toxicity, or decision to stop treatment. Pre-/perimenopausal women and men receive goserelin subcutaneously. Randomization is stratified by de novo metastatic disease, menopausal status, and visceral metastases. The primary endpoint is progression-free survival. The key secondary endpoint is overall survival; others are safety, pharmacokinetics, and quality of life. Conclusions: AMEERA-5 is evaluating the efficacy and safety of amcenestrant in combination with palbociclib as first-line therapy in pre-/postmenopausal women and men with ER+/HER2– ABC. ClinicalTrials Identifier: NCT04478266.
Rotational alignment of the femoral trochlea in Asians: Implication on implant choice and position for managing isolated patellofemoral osteoarthritis
Authors: Li Michelle Kar Lam , Wan Samuel Yik-Cheung , Lo Kelvin Chin Hei , Hung Yuk Wah , Fan Jason Chi Ho 
Published: March 2022

Introduction Maltracking of the patella is a key contributor to early failure of patellofemoral arthroplasty (PFA). Native femoral trochlear morphology dictates implant rotation and patella tracking of in-lay PFA implants. This is the first study amongst Asians designed to assess the normal rotational alignment of the trochlear groove and evaluate its implication on PFA implant choice and position. Methods Trochlear inclination angle (TIA) was measured from 211 magnetic resonance images of Asian knees retrieved from a single centre in Hong Kong. TIA assesses rotation of the femoral trochlear groove relative to the axis perpendicular to Whiteside’s line (anteroposterior axis of the femur). Results The mean trochlear inclination in normal Asian knees was 11.5°  ±  2.5° (mean  ±  standard deviation) internal rotation. High-grade dysplastic knees, according to Dejour classification, were significantly more internally rotated with a mean of 12.8°  ±  3.6° (p = 0.025). Conclusion Trochlear inclination in Asians is comparable to Caucasians. In-lay PFA implants do not alter native pathological bony trochlear anatomy, and may result in patella maltracking in patients with high grade trochlear dysplasia or excessive trochlear inclination. These patients may benefit from on-lay implants, which allows restoration of normal trochlear inclination, as well as lateralisation and deepening of the trochlear groove. Patella tracking is however, dynamic and multi-factorial. Further clinical studies are therefore warranted to reconcile our anatomical findings with clinical outcomes.
Influence different polishing systems on roughness and colour stability of chairside CAD/CAM blocks with laminate veneer thickness
Authors: Sasany Rafat , Ergün Kunt Göknil , Koca Mehmet Faruk 
Published: March 2022

Objective: The aim of this study was to evaluate the effect of different polishing systems on the colour stability of different laminate veneer blocks for chair-side CAD-CAM after ultraviolet (UV) ageing. Methods: About 240 sample (13 × 13 × 0.7) were prepared from four different CAD-CAM blocks IPS e.max CAD (IP), IPS Empress CAD (IE), Mark II (M) and Lava Ultimate (LU)) with A1 shade. Each group was divided into five subgroups ( n = 12) according to the control (C) and four different polishing system: Sof-Lex (S), Edenta (E), Identoflex (I) and Zircon Brite (Z). Surface roughnesses (Ra) were measured by a profilometer before and after polishing. The baseline colour values were recorded according to the CIELab system. The colour coordinates (L*, a* and b*) of the samples were measured before and after UV ageing, and colour differences (ΔE00) were calculated by using the CIEDE2000 colour difference formula. A two-way ANOVA and Tukey test methods were used to analyse the data (α = 0.05). Results: A significant interaction was observed between CAD-CAM blocks and polishing system ( p < 0.001). The higher Ra and colour difference was calculated in LU in the Z group after polished and the lower Ra and colour difference was calculated in the IP in the S group after polished. For the IP group, the glazing procedure showed higher Ra and ΔE values with Z group than polished S system, whereas there is no statistical differences. Conclusion: It is concluded that polishing with the Sof-Lex system improves significantly smoothness and colour stability. However, there is no success in using the Zircon Brite polishing system.
Posterior Glenoid Osteotomy With Capsulolabral Repair Improves Resistance Forces in a Critical Glenoid Bone Loss Model
Authors: Marcaccio Stephen E. , O’Donnel Ryan M. , Schilkowsky Rachel , Owens Meng Brett D. , Bokshan Steven L. 
Published: March 2022

Background: There is no widespread consensus on the surgical treatment of posterior shoulder instability with critical posterior glenoid bone loss. Hypothesis: That opening posterior glenoid wedge osteotomy with soft tissue repair would improve the resistance forces of instability when compared with soft tissue repair alone in the setting of 20% critical bone lose. Study Design: Controlled laboratory study. Methods: Native glenoid retroversion was measured on 9 shoulders using computed tomography (CT) scans. The humerus was potted in 90° of forward flexion and 30° of internal rotation relative to the scapula, and a posterior dislocation was performed to create a posterior capsulolabral injury model. The specimens were each taken through a fixed sequence of testing: (1) posteroinferior capsulolabral tear, (2) no glenoid bone loss with posteroinferior capsulolabral repair, (3) 20% posterior glenoid bone loss with posteroinferior capsulolabral repair, and (4) 20% glenoid bone loss with posterior glenoid opening wedge osteotomy and posteroinferior capsulolabral repair. Bone loss was created using a sagittal saw. The resultant peak forces with 1 cm of posterior translation were measured. A 1-way repeated-measures analysis of variance was used to compare mean force values. Results: After the initial dislocation event, all shoulders had a resultant posterior capsulolabral injury. The resulting labral injury was extended from 6- to 9-o’clock in all specimens to homogenize the extent of injury. Repairing the capsulolabral complex in the 20% posterior glenoid bone loss group did not result in a statistically significant increase in resistance force compared with the labral deficient group (34.1 vs 22.2 N; P = .068). When 20% posterior bone loss was created, the posterior glenoid osteotomy with capsulolabral repair was significantly stronger (43.8 N) than the posterior repair alone both with (34.1 N) and without (31.8 N) bone loss ( P = .008 and .045, respectively). Conclusion: In the setting of critical posterior glenoid bone loss, an opening wedge posterior glenoid osteotomy with capsulolabral repair improved resistance to posterior humeral translation significantly compared with capsulolabral repair alone. Clinical Relevance: The results of this biomechanical cadaveric study may aid in surgical planning for this complex patient population.
Patterns and predictors of adaptive skills in 2- to 7-year-old children with Down syndrome
Authors: Schworer Emily K. , Esbensen Anna J. , Nguyen Vivian , Bullard Lauren , Fidler Deborah J. , Daunhauer Lisa A. , Mervis Carolyn B. , Becerra Angela M. , Abbeduto Leonard , Thurman Angela John 
Published: March 2022

AbstractBackgroundThere is substantial variability in adaptive skills among individuals with Down syndrome. Few studies, however, have focused on the early developmental period or on the potential sources of variability in adaptive skills. This study characterizes adaptive skills in young children with Down syndrome and investigates child characteristics associated with adaptive skills.MethodsParticipants were 44 children with Down syndrome ranging in age from 2.50 to 7.99 years (M= 4.66 years,SD= 1.46). The Vineland Adaptive Behavior Scales-3 (VABS-3) Comprehensive Interview Form was used to assess adaptive behavior in the three core domains: socialization, daily living, and communication skills. Caregivers also reported on motor skills and autism spectrum disorder symptoms. Child cognitive abilities were assessed.ResultsAnalyses comparing mean standard score performance across the three VABS-3 core domains demonstrated significant differences between all pairs of domains, resulting in a group-level pattern of socialization > daily living > communication skills. At the individual level, 10 different patterns of relative strength and weakness were identified, with only 18% of participants evidencing significant differences between adaptive skill domain standard scores corresponding to the group-level pattern of significant differences. Child characteristics (cognitive abilities, motor skills, and autism spectrum disorder symptoms) were significantly associated with VABS-3 adaptive domain standard scores.ConclusionThese findings underscore the importance of individualizing intervention programs focused on improving the adaptive skills of young children with Down syndrome based on consideration of the child’s relative adaptive strengths and weaknesses.