bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percent Weightbearing in Foot and Ankle X-rays
Authors: Martella Jessica , Chen Jie 
Published: November 2022

Category: Other; Ankle; Hindfoot; Midfoot/Forefoot Introduction/Purpose: Weightbearing x-rays remain standard of care in diagnosing and evaluating foot and ankle injuries and are crucial for clinicians to evaluate foot alignment and ligamentous injuries. Failure for patients to place adequate body weight on x-ray may produce a radiograph that inaccurately demonstrates foot alignment and injury. The objective of the study was to evaluate the percentage of body weight a patient puts on his/her foot during weight bearing x-ray. Methods: Study participants (n= 278) included patients requiring a clinically indicated x-ray. They were asked to place body weight on foot/ankle during x-ray. The radiograph categories included: lateral foot, AP ankle, oblique ankle and lateral ankle. The scale was concealed from patients and wrapped in a pad and placed on platform as to avoid any bias. The scale measured the weight each patient placed on their foot during each radiograph. The scale was connected to Bluetooth and data was recorded on computer during imaging. The percent of body weight placed on x-ray was calculated using weight during radiograph and weight measured in clinic. Results: Acute injury was defined as pain/injury of duration less than or equal to 3 months with chronic being pain greater than 3 months. Percent bodyweight data in both acute and chronic groups is as follows. Lateral foot acute: mean= 47.39%, max=84.94%, median=46.90%, min= 6.25%; lateral foot chronic: mean=54.80%, max =99.87%, median=54.44%, min=11.56%. AP ankle acute: mean= 56.74%, max=99.51%, median=56.36%, min=6.63%; AP ankle chronic: mean=58.90%, max=97.90%, median=58.42%, min=11.58%. Oblique ankle acute: mean=57.68%, max=98.32%, median=57.40%, min =6.27%; oblique ankle chronic: mean=58.91%, max=96.15%, median=58.46%, min=17.17%. Lateral ankle acute: mean= 50.42%, max=97.92%, median=50.41%, min=11.52%; lateral ankle chronic: mean= 50.03%, max=82.12%, median=50.32%, min=14.10%. Please see attached graphs. Conclusion: Preliminary data suggests patients are not placing full body weight during weightbearing x-ray (lateral foot, AP ankle, oblique ankle, lateral ankle). In lateral foot x-rays, patients with acute injuries place less weight during x-ray as compared with patients of chronic conditions (p=0.02). In the categories of AP ankle, oblique ankle and lateral ankle x-rays, the difference in means between acute/chronic was not statistically significant. We plan to further analyze the data to determine how injury type and time since injury changes the percent body weight placed on foot during x-ray as this may affect how patients are diagnosed via radiographs.FIG
Can Sociodemographic Factors be Used to Help Predict Outcomes in Charcot Neuroarthropathy?
Authors: Martinazzi Brandon J. , Mansfield Kirsten N. , Dopke Kelly , Ptasinski Anna , Stauch Chris M. , Koroneos Zachary , Nam Hannah , Kirchner Gregory , Aynardi Michael C. 
Published: November 2022

Category: Diabetes; Other Introduction/Purpose: The diabetic Charcot foot, or Charcot neuroarthropathy, is a devastating condition that arises secondary to longstanding diabetes, peripheral neuropathy, and trauma. One of the many challenges associated with the Charcot patient is the lack of data exploring factors that may predict long-term outcomes. Therefore, the purpose of this study was to evaluate how certain sociodemographic factors may influence mortality and the need to undergo lower extremity amputation in patients with Charcot. Methods: Following institutional board approval, all patients from 2015-2021 with a diagnosis of Charcot Foot were queried using hospital electronic medical records. Demographics collected included sex, age, race, and insurance coverage. Outcomes recorded were the need to undergo major amputation and mortality rate. Statistical analysis was then run to determine if sex, age, race, and insurance coverage was associated with increased risk of needing a major amputation or death. Results: From 2015-2021, 80 Charcot patients with a mean age of 60 (Range, 84-32) were identified. Of these patients, 58 were male, 26 were female, 71 were white, 3 were African American, and 6 were identified as other. In our cohort, 47 patients had government funded insurance and 33 had private insurance. Amputation occurred in 22 patients and death in 15. Government funded insurance (RR: 9.8, 95% CI:1.4-71.1, P = 0.0236) and age over 65 was associated with an increased risk of death (RR: 2.5, 95% CI: 1.02 to 6.17; P = 0.044). No statistically significant increased risk of death or amputation was found in white, African American, male, or female patients. Government insurance was also not associated with an increased risk for amputation (Table 1). Conclusion: Charcot Neuroarthropathy is associated with high rates of morbidity and mortality. In our cohort, there was an increased risk of mortality in patients with government funded insurance and patients over the age of 65. Further investigation exploring the role of sociodemographic factors is warranted.
Few Randomized Controlled Trials in Foot and Ankle Orthopaedics Include Sociodemographic Patient Data
Authors: Martinazzi Brandon J. , Kirchner Gregory , Nam Hannah , Mansfield Kirsten N. , Dopke Kelly , Ptasinski Anna , Bonaddio Vincenzo , Koroneos Zachary , Aynardi Michael C. 
Published: November 2022

Category: Other Introduction/Purpose: Social determinants of health play a major role in patient care. Factors such as race, education, and income have all been shown to impact patient outcomes in orthopaedic surgery. While retrospective studies are often limited by data availability, prospective randomized controlled trials (RCTs) are able to select their own patient demographics to be included in their analyses. However, the representation of sociodemographic data within RCTs regarding foot and ankle surgery is undefined. Therefore, the purpose of this study was to determine the incidence of sociodemographic data being reported in contemporary foot and ankle RCTs. Methods: RCTs within the PubMed database from 2016-2021 were searched using the search term 'Foot and Ankle Surgery.' Each article's journal of publication, year of publication, and outcome of interest were recorded. Articles were separated into the following outcomes of interest: Infection prevention, pain control, surgical outcomes, and non-operative outcomes. The full text of each article was reviewed to identify sociodemographic variables within the results or tables versus any part of the article (i.e., results or otherwise). Sociodemographic variables collected were race, ethnicity, insurance status, income, work status, and education. We then used the Fisher exact test to compare inclusion of sociodemographic data by journal, year, and outcome type. Results: A total of 34 studies across 15 different journals were included in our analysis. Of the 34 studies, 12 were grouped into operative outcomes, 11 into pain control, 7 into non-operative outcomes, and 4 into infection prevention. Race was reported in the results in 2 studies (5.9%), ethnicity in 1 (2.9%), insurance status in 0, income in 0, work status in 1 (2.9%) and education in 1 (2.9%). In any section other than the results, race was reported in 3 studies (8.8%), ethnicity in 1 (2.9%), insurance status in 3 (8.8%), income in 4 (11.8%), work status in 2 (5.9%), and education in 1 (2.9%). There was no difference found when comparing sociodemographic data to journal (p=0.127), year of publication (p=0.495), or outcome studies (p=0.439). Conclusion: The overall rate of sociodemographic data reported in foot and ankle RCTs is low. There was no difference in the reporting of sociodemographic data between journal, year of publication, or outcome of study.
Hemoglobin A1C in Charcot: Can It Predict a BKA?
Authors: Martinazzi Brandon J. , Manto Kristen , Bonaddio Vincenzo , Kirchner Gregory , Nam Hannah , Aynardi Michael C. 
Published: November 2022

Category: Diabetes; Ankle; Trauma; Other Introduction/Purpose: Charcot Foot is a serious and potentially limb-threatening complication of longstanding diabetes, peripheral neuropathy, and trauma. One of the many challenges that surgeons face when treating the Charcot Foot is predicting long-term outcomes. Therefore, the purpose of this study was to determine if hemoglobin A1C level was associated with an increased risk of BKA in Charcot Foot patients. Methods: Following institutional board approval, all patients from 2015-2021 with a diagnosis of Charcot Foot were queried using hospital electronic medical records. Patients were separated into two groups. Group A consisted of patients with a diagnosis of Charcot and a hemoglobin A1C3 6.5%, while group B consisted of patients with a diagnosis of Charcot and hemoglobin A1C < 6.5%. Statistical analysis was then performed to determine the relative risk of a BKA in patients exposed to a hemoglobin A1C3 6.5%, compared to those with a hemoglobin A1C < 6.5%. Only patients with a documented A1C around the time of diagnosis were included. Results: From 2015 to 2021, 80 patients were diagnosed with Charcot Foot. Of these patients, 59 met our inclusion criteria. Of the 59 patients, 20.3% (12/59) went on to require a BKA and 79.6% (47/59) did not. In our cohort, 54.2% of patients had a hemoglobin A1C3 6.5% and 45.8% (27/59) had a hemoglobin A1C < 6.5%. The relative risk of BKA in patients with an A1C3 6.5% was 2.5 (95% CI: 0.76-8.4; p=0.13). Conclusion: Charcot Foot is a debilitating and potentially limb-threatening complication. While our results suggest an associated increased risk of BKA in patients with an A1C3 6.5%, there was no statistical significance found. As such, further investigation is needed.
Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study
Authors: Ragab Khalid Mohamed , El-Kassas Mohamed , Madkour Ahmad , Okasha Hussein Hassan , Agwa Ramy Hassan , Ghoneem Elsayed Awad 
Published: November 2022

Background: Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients. Methods: Data of pediatric patients (<18 years) referred for EUS over a 3-year period to the endoscopy units of four Egyptian tertiary centers were retrospectively analyzed. Significant impact was defined as a new diagnosis or treatment attributed to the EUS procedure. Results: Twenty-four diagnostic and five therapeutic EUS procedures were conducted in 29 children with a median age of 9 years. Indications for EUS included assessment of solid pancreatic mass ( n = 3), pancreatic cyst ( n = 2), suspected chronic pancreatitis ( n = 9), pancreatic pseudocyst (PPC) ( n = 5), recurrent hypoglycemia ( n = 1), bile duct mass ( n = 1), subepithelial lesion (esophageal, duodenal or anorectal) ( n = 4), mediastinal mass ( n = 1), pelvic mass ( n = 3), and mass at splenic hilum ( n = 1). Therapeutically, five patients underwent cystogastrostomy for symptomatic PPC with 100% technical and clinical success. EUS was able to diagnose 21 out of the other 24 patients. EUS-guided tissue acquisition was performed in 11 patients with definitive histopathological diagnosis in 10 patients (91%). There was no procedure-related major complication, while minor complications occurred in two cases (transient pain in one case, temporary fever, and vomiting in two cases). Conclusion: Standard linear EUS equipment and accessories can be used safely and effectively in selected pediatric patients for diagnostic and therapeutic purposes.
Functional and quantitative evaluation of the 20S proteasome in serum and intracellular in145 moroccan patients with hematologic malignancies
Authors: Filali Hassan , El Yaagoubi Ouadie Mohamed , Ayoub Lahmadi  , Quessar Asmaa , Antri Said El , Samaki Hamid , Aboudkhil Souad 
Published: November 2022

Abstract
Background
Regulatory degradation of intracellular proteins plays an essential role in most biological processes, particularly in the control of cell proliferation and differentiation.
In eukaryotes, intracellular proteolysis is largely provided by the Ubiquitin / Proteasome system. Alterations and dysfunction of protein degradation by the Ubiquitin / Proteasome system, such as transcription factors, cell cycle regulators or tumor suppressor proteins, have been linked to human.
Pathologies, including blood cancers. Mainly localized in the nucleus and cytoplasm of cells, the proteasome can be detected in the cell culture supernatant or in the peripheral blood of patients.
This study deals with the problems of the search for serum markers specific to certain pathologies and which would be useful in the prevention, diagnosis and monitoring of cancers and which could be used as a therapeutic tool.

Methods
The functional and quantitative analysis of the proteasome is carried out at the serum and subcellular level during a pathological phenomenon in a population of 145 Moroccan patients (sex ratio: 1.10 / average age: 47.9 ± 15, 3 years) using an indirect ELISA test and a follow-up of the fluorescence emitted after enzymatic digestion of specific peptides by proteolytic activity (chymotrypsin-like).

Results
The evolutionary trend proteasome subcellular is significantly linked to the rate of chymotrypsin-like activity. The entire population of 60 patients called back for a second blood test.
After three months of treatment reported a significant drop in the rate and the activity of the proteasome in serum and intracellular level.

Conclusions
Although the serum proteasome level is a potential new tool for the monitoring of.
Patientswithliquid cancer.
Trial registration: retrospectively registered.
The effects of combined spinal-epidural analgesia and epidural anesthesia on maternal intrapartum temperature: a randomized controlled trial
Authors: Yao Zhiping , Zhou Jingxin , Li Shuying , Zhou Wenqin 
Published: November 2022

AbstractBackgroundLabor epidural analgesia has been suggested to be associated with intrapartum fever. We designed this study to investigate the effects of epidural analgesia and combined spinal-epidural analgesia on maternal intrapartum temperature.MethodsFour hundred healthy nullipara patients were randomly assigned to receive either epidural analgesia (EA group) or combined spinal-epidural analgesia (CSEA group). Maternal temperature was measured hourly after analgesia administration. The primary outcome was the incidence of maternal fever, and the secondary outcomes were the duration of analgesia, analgesia to full cervical dilation and analgesia to delivery. Neonatal outcomes and other basic labor events were also recorded.ResultsMaternal temperature gradually increased with time in both analgesia groups during labor. However, the CSEA group had a lower incidence of maternal fever, and a lower mean maternal temperature at 5 h, 6 h, and 9 h after analgesia. In addtion, the CSEA group also had a shorter time of analgesia duration, analgesia to full cervical dilation, analgesia to delivery, and less dose of epidural local anesthetic than the EA group.ConclusionOur findings suggest that combined spinal-epidural analgesia is associated with a lower risk of intrapartum fever than epidural analgesia.Trial registrationChiCTR1900026606. Registered on 16/10/2019.
Expression of 5-hydroxytryptamine 7 receptor in intestinal mucosa correlates with the degree of intestinal inflammation in Crohn’s disease
Authors: Xu Zhangwei , Chen Jason J. , Mei Qiao , Li Yang , Xu Jianming 
Published: November 2022

AbstractBackgroundCrohn’s disease (CD), an inflammatory bowel disease (IBD), is a complex and heterogeneous disease characterized by nonspecific transmural inflammation of the gastrointestinal tract. CD has a variety of potential causes with no effective treatment available yet. Current clinical laboratory findings from patients do not provide direct indication of the status of mucosal inflammation in the intestine. Recently, it has been found that intestinal inflammation is generally associated with increased levels of 5-hydroxytryptamine (5-HT), which acts as an important gastrointestinal signaling molecule in intestinal homeostasis by stimulating specific receptors. Most previous researches were carried out in vitro or with animal models, and there was a lack of authentic clinical research. In this study, clinical specimens from patients with Crohn’s disease were used to investigate the expression of 5-hydroxytryptamine 7 receptor (5-HT7R) in the induction and development of chronic non-specific inflammatory bowel disease.MethodsPatients with CD admitted to the Department of Gastroenterology in the First Affiliated Hospital of Anhui Medical University between June 2014 and January 2018 were recruited, among which 28 were in active disease and 32 were in remission. In addition, 20 patients who had no obvious abnormality by colonoscopy in the hospital during the same time period were recruited into the control group. Data of clinical disease activity (CDAI), CD endoscopic score (SES-CD) and magnetic resonance score (MaRIA) were collected from those two groups of patients. The expression and distribution of 5-HT7R were investigated and their correlations with clinical CDAI, MaRIA, and endoscopic SES-CD scores were analyzed.ResultsOur study demonstrated that 5-HT7R is expressed in intestinal neurons and CD11C-positive cells in human colon. In CD11c/CD86 double-positive cells in the bowel, 5-HT7R expression was significantly increased in the inflammatory area in the bowel of CD patients, and it was closely related to disease severity, MaRIA, and SES-CD scores.ConclusionThe expression of 5-HT7R was significantly correlated with the degree of gut inflammation in CD patients and could be a potential biomarker for disease activity and the therapeutic efficacy in patients with Crohn’s Disease.
The impact of symptom distress on health-related quality of life in liver cancer patients receiving arterial chemoembolization: the mediating role of hope
Authors: Chen Nan-Yan , Chen Kang-Hua , Wang Yi-Wen , Tsai Hsiu-Hsin , Lee Wei-Chen , Weng Li-Chueh 
Published: November 2022

Abstract
Background
Trans-hepatic arterial chemoembolization (TACE) is a treatment option for liver cancer patients. It can prolong patients’ survival but can also cause symptom distress. Symptom distress (SDs) can directly impact quality of life (QOL) and may indirectly influence QOL by lessening hope. In this study, we wanted to explore the mediating effect of hope on the relationship between SDs and QOL among patients with liver cancer receiving TACE.

Methods
A cross-sectional study was conducted from December 20, 2017, to August 6, 2018, at a gastroenterology ward of a medical center. The participants were 92 liver cancer patients (69.6% male, mean age 67.8) who were admitted for TACE treatment. Information on SDs, hope, and QOL was collected by questionnaire on discharge day. Hayes’ PROCESS model was used to test the mediating effect of hope on the relationship between SDs and QOL.

Results
The mean score and standard deviation (SD) of SDs, hope, and QOL were 32.08 (SD = 6.22), 27.09 (SD = 3.51), and 55.16 (SD = 17.33), respectively. SDs negatively impacts quality of life. The total effect of SDs on QOL was − 1.41 (95% confidence interval [CI]: − 1.96, − 0.86). The indirect effect via the mediation of hope was − 0.95 (95% CI: − 1.7, − 0.45). Hope partially mediated the effect of SDs on QOL.

Conclusion
SDs after TACE is vital; it directly reduces a patient’s overall QOL and can indirectly hinder it by reducing the patient’s hope. In addition to symptom management, interventions that help patients maintain their hope are key to improving QOL among patients receiving TACE.
Health and social care of home-dwelling frail older adults in Switzerland: a mixed methods study
Authors: Yip Olivia , Dhaini Suzanne , Esser Jan , Siqeca Flaka , Mendieta Maria Jose , Huber Evelyn , Zeller Andreas , De Geest Sabina , Deschodt Mieke , Zúñiga Franziska , Zullig Leah L. , King Heather A. ,   the INSPIRE consortium, Urfer Pia , Vounatsou Penelope , Obas Katrina , Briel Matthias , Schwenkglenks Matthias , Quinto Carlos , Blozik Eva 
Published: November 2022

Abstract
Background
Home-dwelling frail older adults are often faced with multimorbidity and complex care needs, requiring health and social care systems that support frail older adults to age in place. The objective of this paper was to investigate the types of formal health and social care as well as informal care and social support used by home-dwelling frail older adults; whether they perceive their support as sufficient; and their experience with and preferences for care and support.

Methods
Using an explanatory sequential mixed methods design, we first conducted a secondary analysis of a subset of cross-sectional data from the ImplemeNtation of a community-baSed care Program for home dwelling senIoR citizEns (INSPIRE) population survey using descriptive analysis. Subsequently, we analyzed existing data from interviews in the parent study to help explain the survey results using applied thematic analysis. Results were organized according to adapted domains and concepts of the SELFIE framework and integrated via a joint display table.

Results
Of the parent population survey respondents, 2314 older adults indicating frailty were included in the quantitative arm of this study. Interview data was included from 7 older adults who indicated frailty. Support from health and social, formal and informal caregivers is diverse and anticipated to increase (e.g., for ‘care and assistance at home’ and ‘meal services’). Informal caregivers fulfilled various roles and while some older adults strongly relied on them for support, others feared burdening them. Most participants (93.5%) perceived their overall support to meet their needs; however, findings suggest areas (e.g., assessment of overall needs) which merit attention to optimize future care.

Conclusions
Given the anticipated demand for future care and support, we recommend efforts to prevent fragmentation between health and social as well as formal and informal care.