bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Tibial Plateau Slope and Depth Influence ACL Strain In Vivo?
Authors: Foody Jacqueline N. , Tayne Samantha , Englander Zoë A. , Kosinski Andrzej S. , Amendola Annunziato , Spritzer Charles E. , Wittstein Jocelyn R. , DeFrate Louis E. 
Published: December 2024

Background: The anterior cruciate ligament (ACL) is loaded under tension when the tibia translates anteriorly relative to the femur. The shape of the articular surfaces of the tibiofemoral joint may influence the amount of anterior tibial translation under compressive loading. Thus, a steep lateral tibial plateau and a shallow medial plateau are thought to be risk factors for ACL injury. Purpose/Hypothesis: The purpose of this study was to evaluate whether tibial plateau slope and depth influence peak ACL strain during a single-leg jump. We hypothesized that there would be a significant correlation between tibial plateau slope and depth with ACL strain. Study Design: Descriptive laboratory study. Methods: A total of 17 healthy participants (8 male, 9 female) were assessed using magnetic resonance imaging (MRI) and high-speed biplanar radiography to obtain peak ACL strain during a single-leg jump. Two orthopaedic surgeons used the sagittal plane MRI scans to measure the medial and lateral tibial plateau slopes and the medial tibial plateau depth. The intraclass correlation coefficient was used to assess measurement reliability, and the Spearman rank correlation was used to evaluate the relationship between measurements of tibial morphology and peak ACL strain during the single-leg jump. Results: The overall range of intraclass correlation coefficients for intra- and interrater reliability of the medial and lateral tibial plateau slopes and medial plateau depth was 0.59 to 0.97. No significant correlations were found between peak ACL strain and any of the slope or depth measurements. Conclusion: In this cohort of healthy participants, correlations between any of the tibial plateau measurements with peak ACL strain during a single-leg jump were not detected. These findings are consistent with prior work, suggesting that tibial plateau slope and depth may not be linked to risk for ACL rupture. However, it is possible that tibial plateau morphology may interact with other factors to increase ACL injury risk or that individuals with extreme slope angles may produce differing results. Clinical Relevance: This study enhances the knowledge of the loading mechanisms for the ACL and thus improves the understanding of risk factors for ACL injury.
Trends and Complications of Medial Patellofemoral Ligament Reconstruction Among Applicants for the American Board of Orthopaedic Surgery Part II and Maintenance of Certification Examinations: Analysis of Data Over a 15-Year Period
Authors: Chilelli Brian J. , Bhatia Sanjeev , Das Victoria , Patel Ronak M. 
Published: December 2024

Background: Medial patellofemoral ligament reconstruction (MPFLR) and tibial tubercle osteotomy (TTO) are commonly performed surgical procedures that often have a high learning curve. Purpose: To review the American Board of Orthopaedic Surgery (ABOS) Part II oral examination case list and the Maintenance of Certification (MOC) examination case list databases for trends in MPFLR (isolated and with concurrent TTO) and complication rates. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We reviewed the ABOS Part II and MOC case list databases for diagnosis codes relating to patellar instability and Current Procedural Terminology codes specific to MPFLR and TTO regarding cases submitted by applicants for these examinations between 2003 and 2017 (for ABOS Part II) and between 2010 and 2017 (for MOC). Data were analyzed using generalized estimating equations with a binomial distribution and logit link to determine how trends in MPFLR changed over the study period in these applicant groups (ABOS vs MOC) as well as any influence on complication rates. Results: In the ABOS group, the number of MPFLRs performed by surgeons increased a mean 3% each year, ranging from 66 in 2003 to 184 in 2015 (injury rate ratio, 1.03; 95% CI, 1.02-1.04; P < .001). In the MOC group, the mean number of MPFLRs did not change significantly (range, 119 in 2011 vs 230 in 2013; P = .772). In the ABOS group, after adjusting for patient age and examination year, MPFLR combined with TTO was associated with 92% greater odds of having a complication versus isolated MPFLR (odds ratio, 1.92; 95% CI, 1.24-2.98; P = .004), whereas the MOC group demonstrated no significant difference in the odds of having a complication between cases with versus without a concurrent TTO ( P = .214). Conclusion: In the current study, the number of MPFLRs performed by the less experienced surgeons in the ABOS group increased a mean 3% each year, whereas this number remained stable for the more experienced MOC group. Additionally, there were significantly more complications with MPFLR and concomitant TTO among the ABOS Part II candidates compared with the MOC candidates. These findings may be helpful in surgical decision making and education in patellofemoral instability.
The Effect of Online Group Education on Promoting Knowledge, Motivation, Self-Efficacy, Self-Care Behaviors and Preventing Uncontrolled Blood Pressure in Hypertensive Patients: A Quasi-Experiment Study
Authors: Upoyo Arif Setyo , Sari Yunita , Taufik Agis , Anam Akhyarul , Kuswati Ani 
Published: December 2024

Introduction Hypertensive patients may lack time to visit clinics and attend educational sessions, resulting in poor blood pressure control. Uncontrolled blood pressure in people with hypertension can increase the risk of heart disease and stroke. Objective The specific purpose of this study was to determine the effect of online group education on knowledge, motivation, self-efficacy, self-care behavior, and blood pressure control of hypertensive patients. Method The research method used a quasi-experiment method. The subjects were hypertensive patients in Indonesia. The sampling technique used was cluster random sampling. Total sampling consisted of 96 participants, consisting of 48 intervention groups and 48 control groups. The inclusion criteria in the study were patients with primary hypertension who were willing to become research respondents. The exclusion criteria in this study were respondents who were sick and unable to follow therapy, had hearing problems, and had complications of other diseases (kidney disease, heart disease, diabetes mellitus, and stroke). Data collection methods include observation. The instruments used were the HKLS, HBP-SCP questionnaire, and Sphygmomanometer digital. Result Data analysis using repeated ANOVA and Friedman tests. There was a significant decrease in systolic ( p < .001) and diastolic ( p = .001) blood pressure and an increase in knowledge ( p < .001), motivation ( p < .001), self-efficacy ( p < .001), and self-care behavior ( p < .001) in the intervention group. Conclusion Online group education effectively reduces blood pressure and increases self-care behaviors in hypertensive patients.
Multi-Objective Trajectory Optimization for Rigid-Flexible Coupling Spray-Painting Robot Integrated with Coating Process Constraints
Authors: Xu Feng , Zi Bin , Wang Jingyuan , Yu Zhaoyi 
Published: December 2024

AbstractRobot-automated spraying is widely used in various fields, such as the automotive, metalworking, furniture, and aerospace industries. Spraying quality is influenced by multiple factors, including robot speed, acceleration, end-effector trajectory, and spraying process constraints. To achieve high-quality spraying under the influence of multiple factors, this study proposes a multi-objective optimization method for the spraying trajectory that integrates spraying process constraints into the optimization process. First, a 7-degree-of-freedom rigid-flexible coupling serial spray painting robot system is introduced, which includes a motion decoupling mechanism and a tension amplification mechanism. Subsequently, a paint deposition model for the spray gun was established, and the influence of process constraints on spraying quality was analyzed. Trajectory planning for the spray painting robot, based on the septic B-spline interpolation method, was then performed. Based on this foundation, objective functions and constraint equations for spraying trajectory optimization were established. A multi-objective trajectory optimization method for spraying by the robot is proposed based on the NSGA-II, which integrates the spraying process constraints. Finally, a prototype system of a 7-degree-of-freedom rigid-flexible coupling serial spray painting robot was constructed. Simulations and spraying experiments were conducted to verify the effectiveness of the proposed multi-objective trajectory optimization method. This paper presents a multi-objective optimization method for the spraying trajectory of a robot. In the proposed method, the optimized spraying trajectory is generated with the spraying process as the constraint and time, energy consumption, and impact during the spraying operation of the robot as the optimization objectives.
Facilitating person-centered patient participation in kidney care—a process evaluation of a quasi-experimental study incorporating a tool and training of local implementation teams
Authors: Årestedt Liselott , Uhlin Fredrik , Eldh Ann Catrine 
Published: December 2024

Abstract
Background
The transfer of innovations into healthcare is laden with challenges. Although healthcare professionals are expected to adopt and fulfil new policies, a more person-centered healthcare with conditions for preference-based patient participation is anticipated.

Methods
The aim of the study was to evaluate two implementation strategies for person-centered patient participation in kidney care, including dissemination of a clinical toolkit, and additional training and support of internal facilitators. Nine Swedish kidney care units joined the study (August 2019–September 2021), strategically organized into: a control group (three sites, no support); a standard dissemination group (three sites, with a tool for patient participation and guidance disseminated to the site managers); and a facilitated implementation group (three sites, with the tool and guidance disseminated as above, plus a six-month support program for designated internal facilitators). This process evaluation was comprised of repeat interviews with managers (n = 10), internal facilitators (n = 5), recordings, and notes from the interventions, and Alberta Context Tool survey data (n = 78). Hybrid analyses comprised mixed methods: descriptive and comparative statistics, and qualitative descriptive analysis.

Results
None of the control group sites addressed patient participation. While the standard dissemination sites’ managers received and appreciated the toolkit, they made no attempts to make further use of it. In the facilitated implementation group, five internal facilitators from three sites engaged in the support program. They welcomed the opportunity to learn about preference-based patient participation, and about implementation, including potentially enhanced opportunities for preference-based patient participation via the tool. Each site’s facilitators developed a separate strategy for the dissemination of the tool: the tool was used with a few patients in each site, and only some staff were involved. Although noting a general interest in improving patient participation, the internal facilitators described limited local support. Rather, they suggested a longer support program and more local backing and engagement.

Conclusions
Facilitating person-centered patient participation is complex, given the need to address attitudes, beliefs, and behaviors. This study indicates slow uptake and change, and more efficient strategies are needed to ensure the fundamentals of care remain accessible to all.
Gabapentinoid use and the risk of fractures in patients with inflammatory arthritis: nested case–control study in the Clinical Practice Research Datalink Aurum
Authors: Scott Ian C. , Daud Noor , Bailey James , Twohig Helen , Hider Samantha L. , Mallen Christian D. , Jordan Kelvin P. , Muller Sara 
Published: December 2024

Abstract
Background
Gabapentinoids are increasingly prescribed in inflammatory arthritis (IA), despite no trial evidence for efficacy at managing pain in this population. Observational studies in non-IA populations suggest gabapentinoids are associated with fractures but are limited by methodological heterogeneity/potential residual confounding. Patients with IA generally have an increased risk of fracture so may be particularly vulnerable. We examined the relationship between fractures and gabapentinoids in patients with IA who had all been prescribed a gabapentinoid at some point (to minimise confounding by indication).

Methods
Our matched case–control study used linked national data from English primary care (Clinical Practice Research Datalink Aurum) and Hospital Episode Statistics. A cohort was constructed of adults with IA, contributing data 01/01/2004–31/03/2021, and ever prescribed oral gabapentinoids. Cases with an incident fracture post-cohort inclusion were ascertained and 1:5 risk set-matched (on age/gender/gabapentinoid type) with controls. Gabapentinoid prescription exposure was categorised as follows: (a) current (overlapping with fracture date); (b) recent (ending 1–60 days pre-fracture); and (c) remote (ending > 60 days pre-fracture). Conditional logistic regression models determined ORs with 95% CIs for fractures with current or recent vs. remote gabapentinoid use, adjusting for confounders.

Results
A total of 2485 cases (mean age 63.0 years; 79.4% female) and 12,244 controls (mean age 62.7 years; 79.6% female) were included. Of cases: 1512 received gabapentin, 910 pregabalin, and 63 both drugs; 65.6% were remote, 5.5% recent, and 28.9% current users. In adjusted models, current gabapentinoid use had an increased risk of fracture (OR vs. remote: 1.36 [95% CI 1.22, 1.51]). Similar associations were seen with gabapentin (OR 1.38 [1.19, 1.60]) and pregabalin (OR 1.40 [1.18, 1.66]). Similar or higher levels of association were seen for all gabapentin/pregabalin doses except moderate/very high dose gabapentin. Associations were strongest in those starting gabapentinoids more recently.

Conclusions
Our study suggests a modest association between current gabapentinoid use and fractures in patients with IA, after accounting for measured and time-invariant unmeasured confounding. Whilst other unmeasured confounding remains possible, given the absence of evidence for gabapentinoid efficacy in patients with IA who are particularly vulnerable to fractures, this highlights a need for efforts to deliver safer gabapentinoid prescribing in this population.
Differences in constitutive gene expression of cytochrome P450 enzymes and ATP-binding cassette transporter gene expression between a susceptible and a highly macrocyclic lactone-resistant Haemonchus contortus isolate in the absence of drug-inducible expression
Authors: Jakobs Natalie , Andreotti Sandro , Ramünke Sabrina , von Samson-Himmelstjerna Georg , Krücken Jürgen 
Published: December 2024

Abstract
Background
Anthelmintic resistance in ruminants is a widespread problem that has a severe impact on productivity and animal welfare. The helminth Haemonchus contortus is generally considered the most important parasite in small ruminants due to its high pathogenicity and the widespread occurrence of anthelmintic resistance in it. Although the molecular mechanisms associated with resistance against the anthelmintics benzimidazoles (BZs) and levamisole are relatively well understood, the resistance mechanisms against the widely used anthelmintic macrocyclic lactones (MLs) ivermectin (IVM) and moxidectin (MOX) remain poorly understood. Detoxifying enzymes and xenobiotic transporters have been frequently proposed to play a role in ML resistance in multiple organisms, including nematodes.

Methods
The reference genome of H. contortus was screened for cytochrome P450 genes (cyp genes) by using the Basic Local Alignment Search Tool, and maximum-likelihood phylogenetic analysis was used to assign the sequences to gene families. Fourth-stage larvae of the susceptible (McMaster) and the ML-resistant (Berlin-selected) H. contortus isolates were generated in vitro and compared regarding basal expression levels of cyp genes and ATP-binding cassette (ABC) transporters by using RNA sequencing. The resistant isolate was further incubated with 100 nM IVM or MOX for 3, 6 and 12 h, and the effects of incubation time and drugs were evaluated.

Results
Twenty-five cyp genes were identified in the H. contortus genome and assigned to 13 different families. The ML-resistant isolate showed significantly higher and lower constitutive expression of 13 and four cyp genes, respectively. Out of the 50 ABC transporter genes, only six showed significantly higher expression in the ML-resistant isolate, while 12 showed lower expression. The fold changes were in general low (range 0.44–5.16). Only pgp-13 showed significant downregulation in response to IVM (0.77 fold change at 6 h, 0.96 fold change at 12 h) and MOX (0.84 fold change at 12 h). In contrast, mrp-5 was significantly, albeit minimally, upregulated in the presence of IVM, but not MOX, after 12 h (1.02 fold change).

Conclusions
Despite little observable ML-inducible gene expression in the isolate examined here, some of the changes in the baseline expression levels might well contribute to ML resistance in the context of additional changes in a multigenic resistance model. However, neither cyp genes nor the ABC transporters appear to be the main drivers that can explain the high levels of resistance observed in the resistant isolate examined here.

Graphical Abstract
Pediatric menisci: normal aspects, anatomical variants, lesions, tears, and postsurgical findings
Authors: Araújo Flávia Ferreira , Guimarães Júlio Brandão , da Cruz Isabela Azevedo Nicodemos , Morimoto Leticia dos Reis , Filho Alípio Gomes Ormond , Nico Marcelo Astolfi Caetano 
Published: December 2024

Abstract
The reported incidence of meniscal tears in the pediatric age group has increased because of increased sports participation and more widespread use of MRI. Meniscal injury is one of the most commonly reported internal derangements in skeletally immature knees and can be associated with early degenerative joint disease leading to disability. The pediatric meniscus has particularities, and knowledge of normal anatomy, anatomical variations, and the patterns of meniscal injury in the pediatric age group is essential to provide a correct diagnosis.

Critical relevance statement
Accurate MRI interpretation of pediatric meniscal injuries is crucial. Understanding age-specific anatomy, vascularity, and variations can improve diagnostic precision, guiding targeted treatments to prevent early joint degeneration and disability.

Key Points

Meniscal lesions are common injuries in skeletally immature knees.

Awareness of anatomical meniscus variants, patterns of injury, and associated injuries is essential.

Meniscal tears in pediatric patients should be repaired if possible.

Graphical Abstract
CT imaging findings of invasive pulmonary fungal infections in hemato-oncologic children
Authors: Alamo Leonor , Ceppi Francesco , Tenisch Estelle , Beigelman-Aubry Catherine 
Published: December 2024

Abstract
Hemato-oncologic children form a heterogeneous group with a wide spectrum of ages, malignancy types, and immunosuppression grades during the different phases of their treatment. Immunosuppression is caused by multiple factors, including the malignancy itself, bone marrow suppression secondary to therapy, and wide use of steroids and antibiotics, among others. At the same time, the risk of infections in these patients remains high because of prolonged hospitalizations or the need for long-timing implanted devices between other features. In this context, a pulmonary fungal infection can rapidly turn into a life-threatening condition that requires early diagnosis and appropriate management. This pictorial essay illustrates the main imaging findings detected in chest computed tomography examinations performed in pediatric hemato-oncologic patients with proven pulmonary invasive fungal infections caused by Candida, Aspergillus, or Mucor. In addition, it describes useful clues for limiting differential diagnoses, reviews the literature on pediatric patients, and compares imaging findings in adults and children.

Critical relevance statement
The main fungal pathogens causing invasive fungal infections (IFI) in hemato-oncologic children are Candida, Aspergillus, and Mucor. This review describes the most frequently affected organs and the most common imaging findings detected in chest CT exams in children with pulmonary IFI.

Key Points

To review the main computed tomography imaging findings suggesting pulmonary invasive fungal infection (IFI) in hemato-oncologic children.

To describe differences between pediatric and adult patients with proven pulmonary IFI.

To provide useful clues for limiting the differential diagnosis of pulmonary IFI in pediatric patients.

Graphical Abstract
Fully automated MRI-based convolutional neural network for noninvasive diagnosis of cirrhosis
Authors: Zheng Tianying , Zhu Yajing , Chen Yidi , Mai Shengshi , Xu Lixin , Jiang Hanyu , Duan Ting , Wu Yuanan , Qu Yali , Chen Yinan , Song Bin 
Published: December 2024

Abstract
Objectives
To develop and externally validate a fully automated diagnostic convolutional neural network (CNN) model for cirrhosis based on liver MRI and serum biomarkers.

Methods
This multicenter retrospective study included consecutive patients receiving pathological evaluation of liver fibrosis stage and contrast-enhanced liver MRI between March 2010 and January 2024. On the training dataset, an MRI-based CNN model was constructed for cirrhosis against pathology, and then a combined model was developed integrating the CNN model and serum biomarkers. On the testing datasets, the area under the receiver operating characteristic curve (AUC) was computed to compare the diagnostic performance of the combined model with that of aminotransferase-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4), and radiologists. The influence of potential confounders on the diagnostic performance was evaluated by subgroup analyses.

Results
A total of 1315 patients (median age, 54 years; 1065 men; training, n = 840) were included, 855 (65%) with pathological cirrhosis. The CNN model was constructed on pre-contrast T1- and T2-weighted imaging, and the combined model was developed integrating the CNN model, age, and eight serum biomarkers. On the external testing dataset, the combined model achieved an AUC of 0.86, which outperformed FIB-4, APRI and two radiologists (AUC: 0.67 to 0.73, all p < 0.05). Subgroup analyses revealed comparable diagnostic performances of the combined model in patients with different sizes of focal liver lesions.

Conclusion
Based on pre-contrast T1- and T2-weighted imaging, age, and serum biomarkers, the combined model allowed diagnosis of cirrhosis with moderate accuracy, independent of the size of focal liver lesions.

Critical relevance statement
The fully automated convolutional neural network model utilizing pre-contrast MR imaging, age and serum biomarkers demonstrated moderate accuracy, outperforming FIB-4, APRI, and radiologists, independent of size of focal liver lesions, potentially facilitating noninvasive diagnosis of cirrhosis pending further validation.

Key Points

This fully automated convolutional neural network (CNN) model, using pre-contrast MRI, age, and serum biomarkers, diagnoses cirrhosis.

The CNN model demonstrated an external testing dataset AUC of 0.86, independent of the size of focal liver lesions.

The CNN model outperformed aminotransferase-to-platelet ratio index, fibrosis-4 index, and radiologists, potentially facilitating noninvasive diagnosis of cirrhosis.

Graphical Abstract