bluuebunny/crossref_metadata_2025_split huggingface dataset:
First-in-Human Study of ABY-029, a Novel Fluorescent Peptide that Targets EGFR, Applied to Soft-Tissue Sarcomas
Authors: Samkoe Kimberley S. , Sardar Hira Shahzad , Gunn Jason R. , Elliott Jonathan Thomas , Mansur Sally , Feldwisch Joachim , Pogue Brian W. , Linos Konstantinos , Paulsen Keith D. , Henderson Eric R. 
Published: December 2024

Abstract
ABY-029, an anti-EGFR Affibody molecule conjugated to IRDye 800CW, recently underwent first-in-human testing in soft-tissue sarcoma. The FDA Exploratory Investigational New Drug status was obtained for the phase 0 clinical trial in which study objectives were to determine whether a biological variance ratio (BVR) of 10 was achievable, whether fluorescence intensity correlated with EGFR expression, and whether doses were well tolerated. Patients (N = 12) with soft-tissue sarcoma were recruited based on positive EGFR IHC staining of diagnostic biopsies. ABY-029 was administered at a microdose (30 nmol, n = 3), medium dose (90 nmol, n = 3), or high dose (171 nmol, n = 6) 1 to 3 hours prior to surgery. Following tumor resection, ex vivo tissue was imaged to determine the mean fluorescence intensity, BVR, and other contrast measures. EGFR expression was correlated with IHC. For micro, medium, and high doses, mean BVR (SD) values in cross-sectional slices were 4 (4), 10 (6), and 7 (8) for the whole tumor region and 6 (5), 13 (11), and 8 (6) for pathology-confirmed regions of interest, respectively. Strong linear correlations were found between all ABY-029 contrast metrics and total EGFR (r≥ 0.86; P &lt; 0.029) in cross-sectional tissue slices and between mean fluorescence intensity and EGFR percent area (r = 0.63; P &lt; 0.0001) in excised region-of-interest tissue sections. No ABY-029–related adverse events were observed. When administered above the microdose, ABY-029 demonstrated a high correlation with EGFR expression and contrast values that were encouraging for translation to clinical practice. Contrast values were similar to those observed with antibody agents but with a substantially reduced imaging-to-resection time and no drug-related adverse events.
4. A Lodger Returns
Authors: Hilfling Josefine 
Published: December 2024

Henrik Pontoppidan’s major novel A Fortunate Man (1898-1905) is told by a heterodiegetic omniscient narrator. A short section of the novel was originally published as the short story "Heart’s Delight" (1885). This short story is in the first edition told by a homodiegetic narrator, but in a revised second edition (1886), it is told by a heterodiegetic narrator. By tracing the epigenetic changes from the two versions of "Heart’s Delight" to A Fortunate Man, this essay argues that the change of voice in "Heart’s Delight" not only made it possible for Pontoppidan to later embed the short story in A Fortunate Man; it also resolved the unintended deficient narration (Phelan 2017) of the first edition of the short story and made it more stylistically coherent because it already featured characteristics typical of omniscient narration. Homodiegetic narration resembling omniscient narration anchored in single versions of texts, has previously been described by narrative critics (Skov Nielsen 2004; Shen 2013). This essay combines narratology and genetic criticism to explain the origin of inconsistencies in single texts and across versions and works.
10. A Genetic and Biographical Analysis of Barbara Pym’s Companion Character
Authors: Loughman Jane 
Published: December 2024

Jessie Morrow, the paid companion of the elderly Miss Doggett, is a prominent character in Barbara Pym’s fictional world. The first time Pym wrote about Jessie was in a 1939-40 draft of Crampton Hodnet, and the final iteration (and the only contemporaneously published version) of Jessie is in Jane and Prudence (1953). In between these two appearances of Jessie, Pym created similar companion characters. In the span of roughly ten years, Pym’s characterisation of the companion significantly changed via these variants across her manuscripts and typescripts. There is minimal scholarship that examines the transformations, which may be due to the minimal endogenetic material that would be useful in a genetic analysis — drafts, typescripts, and sketches — on the companion character in the ten-year period between the first and last iteration of Jessie. Expanding the endogenesis to include Pym’s diaries and letters facilitates a study of Pym’s creative process; on the ‘narrative’ level of narratology, the consideration of autobiographic material allows an interpretation of the characterisation changes that Pym made to Jessie and her companion ‘variants.’ There is a tendency in studies of Pym and of her work to read her characters as stand-ins for Pym herself. This chapter postulates that the companion character is not a mirror image of Pym, but rather a persona adopted on-the-page in tandem with the fictive personae Pym adopted off-the-page throughout her life.
Palliative and end-of-life care for patients with pleural mesothelioma: A cohort study
Authors: Wakefield Donna , Ward Tom , Edge Hannah , Mayland Catriona R , Gardiner Clare 
Published: December 2024

Background: Pleural mesothelioma is a rare and incurable cancer, with complex physical and psychological symptoms. Despite recent advances in treatment, prognosis remains poor (average 8–15 months) with a lack of research on palliative and end-of-life care. Aim: To examine markers suggestive of quality palliative and end-of-life care, including receipt of specialist palliative care, advance care planning, fewer unplanned hospital admissions at end-of-life. To compare variables with socio-economic position to identify if inequalities exist. Design: A cohort study, retrospectively reviewing the medical notes from diagnosis to death for all patients diagnosed with pleural mesothelioma between 01/01/2016 and 31/12/2021. Setting/participants: Over 5 years, n = 181 patients were diagnosed with pleural mesothelioma across Teesside (north-east England), n = 30 were alive at study commencement and excluded. For the 151-patient cohort, demographics were as follows: 92% male, 79% aged 70–89 years and 26% in the lowest socio-economic quintile (based on area-level deprivation). Results: Median survival was 246 days. Within the final 90 days of life, 69% of patients had at least 1 unplanned hospital admission, with 20% having 3+ (range 0–7). Those with the highest socio-economic position had less admissions on average. Specialist palliative care was received by patients, at home 34%, in hospital 26%, in hospice 11%. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions, were in the final 24 h of life for 18% of patients (median 7 days). Disease specific findings included police attendance for expected deaths and lack of signposting. Conclusion: Patients with pleural mesothelioma have unplanned admissions to hospital towards the end of life, with possible inequalities; they receive late advance care planning and face challenges unique to their disease. It is important that patients receive high quality palliative end-of-life care through accessing specialist palliative care or have guidance/signposting to other potential sources of support.
A study on CT detection image generation based on decompound synthesize method
Authors: Fu Jintao , Liu Renjie , Zeng Tianchen , Cong Peng , Liu Ximing , Sun Yuewen 
Published: December 2024

Background: Nuclear graphite and carbon components are vital structural elements in the cores of high-temperature gas-cooled reactors(HTGR), serving crucial roles in neutron reflection, moderation, and insulation. The structural integrity and stable operation of these reactors heavily depend on the quality of these components. Helical Computed Tomography (CT) technology provides a method for detecting and intelligently identifying defects within these structures. However, the scarcity of defect datasets limits the performance of deep learning-based detection algorithms due to small sample sizes and class imbalance. Objective: Given the limited number of actual CT reconstruction images of components and the sparse distribution of defects, this study aims to address the challenges of small sample sizes and class imbalance in defect detection model training by generating approximate CT reconstruction images to augment the defect detection training dataset. Methods: We propose a novel CT detection image generation algorithm called the Decompound Synthesize Method (DSM), which decomposes the image generation process into three steps: model conversion, background generation, and defect synthesis. First, STL files of various industrial components are converted into voxel data, which undergo forward projection and image reconstruction to obtain corresponding CT images. Next, the Contour-CycleGAN model is employed to generate synthetic images that closely resemble actual CT images. Finally, defects are randomly sampled from an existing defect library and added to the images using the Copy-Adjust-Paste (CAP) method. These steps significantly expand the training dataset with images that closely mimic actual CT reconstructions. Results: Experimental results validate the effectiveness of the proposed image generation method in defect detection tasks. Datasets generated using DSM exhibit greater similarity to actual CT images, and when combined with original data for training, these datasets enhance defect detection accuracy compared to using only the original images. Conclusion: The DSM shows promise in addressing the challenges of small sample sizes and class imbalance. Future research can focus on further optimizing the generation algorithm and refining the model structure to enhance the performance and accuracy of defect detection models.
Associations of Muscle-Strengthening Activity and Cognitive Function in Community-Dwelling Middle-Aged and Older Adults
Authors: Zhang Yuzi , DeFina Laura F. , Leonard David , Chen Baojiang , Hébert Emily T. , Barlow Carolyn E. , Pavlovic Andjelka , Kohl Harold W. 
Published: December 2024

Objective To determine the associations between muscle-strengthening activity (MSA) and cognitive function among middle-aged and older adults. Methods This cross-sectional study included 2973 participants aged ≥55 in the Cooper Center Longitudinal Study. Participants self-reported leisure-time physical activity. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). The associations of reported MSA frequency (0–1 vs. ≥2 sessions/week) and volume (zero, low: ≤250, medium: 250–420, high: >420 MET minutes/week) with mild cognitive impairment (MCI, defined as MoCA<26) and MoCA total score were examined using logistic and linear regression. Results Individuals who participated in ≥2 MSA sessions/week had a significantly higher MoCA total score. Participants with medium MSA volume were significantly associated with lower odds of being classified as MCI and associated with a higher MoCA total score than those with zero volume. Conclusions Engaging in MSA is associated with cognitive health among middle-aged and older adults independent of aerobic exercise.
Serious infections and tuberculosis adversely impact outcomes of juvenile onset systemic lupus erythematosus in India
Authors: Chatterjee Rudrarpan , Pattanaik Sarit Sekhar , Misra Durga P , Agarwal Vikas , Lawrence Able , Misra Ramnath , Aggarwal Amita 
Published: December 2024

Background Infections are a major cause of morbidity and mortality in juvenile systemic lupus erythematosus (SLE). We assessed the incidence and risk factors for major infections in juvenile SLE. Methods A retrospective review of 225 patients of juvenile SLE (ACR 1997 criteria) with age <18 years visiting the rheumatology clinic at a single centre between 2000 to 2020 was done from case records and the hospital electronic health records. Serious infection was defined as the need for hospitalization, or infection resulting in disability or death. Cox regression was used to determine factors associated with a serious infection and the effect of serious infection on overall survival. Results We reviewed 225 children (197 girls, mean age 13.89 ± 3.42 years) with a cumulative follow up of 1153.45 person-years. Eighty serious infections occurred in 63 (28% of the cohort) children at a rate of 69.35 serious infections per 1000 person-years. A second serious infection occurred in 12 children and 5 of them developed three infections. Among the cases with known etiology (78.75% of cases), bacterial infections were most common ( N = 33) including S. Aureus (11) , E. Coli (7) , K. Pneumoniae (3) , E. Fecalis (3) , S. Pneumoniae (2) , Acinetobacter spp. (2) , Citrobacter (2) , Salmonella (2) and P. Aeruginosa (1). Twenty six (32.5%) opportunistic infections occurred: Mycobacterium tuberculosis (18), Cytomegalovirus (3), disseminated Herpes zoster (4) and invasive candidiasis (1) with 15 (83.3%) of the tuberculosis cases being extrapulmonary. On multivariate analysis, fever (HR 8.51, 1.17–61.44), gastrointestinal involvement (HR 4.73, 1.13–19.94), current steroid dose (HR 1.36,1.14–1.62), average cumulative steroid dose per year (HR 1.004, 1.002–1.005) and cyclophosphamide (HR 2.22, 1.11–4.46) were associated with serious infection. Hospitalization rates were significantly higher in those with any serious infection (Rate-ratio 2.79, 1.81–3.77) as was damage accrual (SLICC damage index 1.04 vs 0.22). Serious infection-free survival at 1 year and 5 years was 84% (79.1–89.2) and 72% (65.4–79.2). There were 19 deaths with infection attributable mortality in 10 (52.6%). Serious infection predisposed to higher overall mortality with recurrent infections conferring a hazard ratio of 36.02 (8.07–160.62). Conclusion Serious infections are a major cause of mortality and damage in SLE. Constitutional symptoms, gastrointestinal involvement, current and cumulative steroid dose and cyclophosphamide predict serious infections. TB prophylaxis in patients with SLE should be considered in endemic areas, especially when using high-dose steroid therapy.
Opportunities for Incorporation of Primary Palliative Care in Acute Care Surgery: A Narrative Review
Authors: Lynn Anna Y. , Miller Samuel M. , Brackett Alexandria , Kodadek Lisa M. 
Published: December 2024

Background Palliative care is highly relevant to acute care surgery due to the patient populations and severity of illness. Efforts to routinely incorporate palliative care principles in the practice of acute care surgery by the primary surgical team may benefit patients and their families. Methods We present a narrative review of the literature examining the current state of incorporation of primary palliative care in acute care surgery, including basic principles and strategies, evolving approaches, limitations, and opportunities for growth. Results Implementation begins with early identification of patients who may benefit from primary palliative care. Primary palliative interventions may include medical symptom management, patient and caregiver support, and use of frameworks for communication in the setting of severe illness. Significant barriers to primary palliative care practice exist, including institutional differences in approaches to primary palliative care, socioeconomic and cultural factors, and varying patient and clinician perspectives about the role of primary palliative care. Over the last few decades, there has been increased awareness of a role for primary palliative care in acute care surgery, leading to recent advances in quality, education, and advocacy. Conclusions Despite the known benefits of primary palliative care, it is still underutilized in acute care surgical patients. Shifting attitudes toward primary palliative care are helping to increase its use in surgical settings as well as promote education for surgical trainees. However, it is important to recognize the many opportunities for improvement of primary palliative care incorporation in acute care surgery.
Pediatric supracondylar humerus fracture with fascicular median nerve injury: The role of neuromuscular ultrasound in diagnosis and management – a case report
Authors: Giray Esra , Keles Aslinur 
Published: December 2024

Background Supracondylar humerus fractures are the most common type of elbow fractures in children. Nerve injuries, primarily neuropraxia, are frequent complications and are often managed with a “wait-and-see” approach. Electroneuromyography (ENMG) is the standard method for evaluating peripheral nerve injuries, while ultrasound (US) is valuable for localizing lesions. Objective This case report aims to highlight the beneficial role of US in the follow-up and rehabilitation of nerve injuries following pediatric supracondylar humerus fractures. Case presentation A 4-year-old boy presented with a supracondylar humerus fracture that was treated with closed reduction and K-wire fixation. He exhibited weakness in the first two fingers of his left hand, difficulty grasping, and nail changes. Ultrasound revealed a median nerve lesion adjacent to the fracture site. ENMG indicated an acute severe axonal injury involving the branch innervating the flexor carpi radialis muscle. Following rehabilitation, there was improvement in hand grip strength, measured using a JAMAR hand dynamometer, and in health-related quality of life (QoL), assessed by the Pediatric Outcomes Data Collection Instrument (PODCI) score. Follow-up ENMG showed signs of mild reinnervation. Conclusion Pre-ENMG ultrasound provides crucial information regarding which nerve should be examined with a nerve conduction study and identifies the initial muscle to be evaluated during needle EMG. This aids in accurately localizing nerve damage and guiding effective treatment.
Does Decompressive Chevron Osteotomy Decrease Subchondral Bone Density of the First Metatarsophalangeal Joint in Hallux Rigidus?
Authors: Tanel Luca , Nogier Alexis , Van Rooij Floris , Agu Chinyelum , Saffarini Mo , Lalevee Matthieu , Beaudet Philippe 
Published: December 2024

Background: To investigate the impact of decompressive chevron osteotomy on subchondral bone density at the first metatarsophalangeal (MTP) joint. Methods: Sixteen feet (12 patients) with hallux rigidus underwent decompressive chevron osteotomy. Standing cone beam 3D computed tomography (3DCT) were assessed preoperatively and at 4-month follow-up, and clinical data were collected. Radiologic measurements, including bone density using Hounsfield units (HU), were conducted. Statistical analyses were performed to evaluate changes and correlations. Results: Postoperative bone density significantly decreased in proximal (Pre, 650.9 ± 149.1; Post, 312.4 ± 115.9; P < .001) and distal (Pre, 910.4 ± 143.3; Post, 639.0 ± 167.1; P < .001) components of the first MTP joint and the first tarsometatarsal (TMT) (Pre, 762.9 ± 166.6; Post, 611.5 ± 165.9; P < .001) joint. No significant difference was measured at the tibiotalar joint (Pre, 497.5 ± 143.6; Post, 534.3 ± 130.7; P = .065). Length of the first metatarsal (Pre, 60.4 ± 3.4; Post, 54.3 ± 3.0; P < .001) and metatarsal protrusion index (MPI) (Pre, −0.9 ± 3.0; Post, −9.0 ± 3.6; P < .001) significantly decreased postoperatively. Clinical assessments showed significant improvements in pain on the visual analog scale (−5.3 ± 1.9). Conclusion: Decompressive chevron osteotomy leads to a significant decrease in subchondral bone density of the first MTP joint. A decrease in bone density occurs also in the first TMT joint. Level of Evidence: Level IV, radiographic study.
Prosthetic hip dislocation: a pilot multicentre observational study
Authors: Afzal Sadia , Ammori Mohannad Basil , Hodhody Ghazal , Kennedy James , Hoggett Lee , Board Tim ,   North West Orthopaedic Research Collaborative (NWORC)
Published: December 2024

Background: Total hip arthroplasty is one of the most successful and cost-effective interventions for improving quality of life. Dislocation is a well-recognised complication with a significant health and economic burden. The aim of this study was to establish the current management practices for patients presenting with a prosthetic hip dislocation. This was measured through the primary outcome of definitive management, either in the form of revision surgery or the consideration for this through a referral pathway. The secondary outcome measured the number of dislocations per patient resulting in consideration for definitive management. Methods: Between January and July 2019, 186 patients who sustained a prosthetic hip dislocation were identified from 13 separate institutions. Data were retrospectively collected including patient demographics, co-morbidities, details of the arthroplasty, number of dislocations, and management, both in the acute setting and after discharge. Results: 149 patients who sustained 200 dislocations were included. The median (interquartile range) interval between primary total hip arthroplasty and first dislocation was 6 (0–13) years. An urgent reduction was achieved either in the emergency department or operating theatre in 3 (1.5%) and 188 (94%) cases, respectively, and 2 (1%) underwent urgent revision. Only 55 patients (36.9%) received definitive management, either in the form of revision surgery or consideration for this. The number of dislocations was the only independent predictor of definitive management ( p = 0.001, odds ratio [OR] 1.332; 95% confidence intervals 1.130–1.570). Conclusions: There is a lack of consensus regarding the definitive management of patients with prosthetic hip dislocation. Our study highlights the need for a standardised pathway for the management of this complication. We aim to expand this study to a national level to propose a data-driven management algorithm for prosthetic hip dislocations.
Long COVID-19 outcomes of patients with pre-existing dementia
Authors: Hadidchi Roham , Pakan Rachel , Alamuri Tharun , Cercizi Noel , Al-Ani Yousef , Wang Stephen H , Henry Sonya , Duong Tim Q 
Published: December 2024

Background Although COVID-19 has been linked to worse acute outcomes in patients with some neurodegenerative disorders, its long-term impact on dementia remains unclear. Objective To investigate the outcomes of COVID-19 survivors with dementia. Methods This retrospective study evaluated 9806 patients with dementia in the Montefiore Health System (January 2016 to July 2023). Comparisons were made between dementia patients with and without a positive SARS-CoV-2 polymerase-chain-reaction test who had a follow-up at least two weeks post-infection. Outcomes included all-cause mortality, major adverse cardiovascular events (MACE), new-onset dysphagia, dyspnea, fatigue, new-onset sleep disturbances, altered mental status, first-time fall, headache, new-onset depression, and new-onset anxiety. Adjusted hazard ratios (aHR) were computed adjusting for age, sex, race, ethnicity, and pre-existing comorbidities. Results Dementia patients with COVID-19 were younger, more likely to be male, and had a higher prevalence of major pre-existing comorbidities compared to those without COVID-19. Patients who survived acute COVID-19 were more likely to die than non-COVID controls after adjusting for covariates (aHR = 1.65 [1.43, 1.91]). COVID-19 was significantly associated with higher risk of MACE (aHR = 1.58 [1.41, 1.78]), new-onset dysphagia (aHR = 1.64 [1.42, 1.91]), dyspnea (aHR = 1.27 [1.12, 1.44]), fatigue (aHR = 1.42 [1.22, 1.65]), new-onset sleep disturbances (aHR = 1.36 [1.15, 1.60]), altered mental status (aHR = 1.36 [1.16, 1.59]), and first-time fall (aHR = 1.34 [1.09, 1.65]). Conclusions COVID-19 increases the risk of mortality and other adverse health outcomes in dementia patients. These findings highlight the need for closer follow-up and management strategies for dementia patients post-COVID-19.