bluuebunny/crossref_metadata_2025_split huggingface dataset:
YOLOv8 algorithm-aided detection of patellar instability or dislocation on knee joint MRI images
Authors: Li Ting , Gharaibeh Nadeer M , Jia Shanru , Qinaer Zierdi , Aihemaiti Saidaitiguli , HaNaTe AiShengBaTi , Wu Gang 
Published: December 2024

Background Patellar instability (PI) or patellar dislocation (PD) is challenging to diagnose accurately based on medical history and clinical manifestations alone. While X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) are commonly employed for detecting PI or PD, computer vision has not yet been widely utilized for this purpose. Purpose To explore the feasibility of computer vision, specifically the You Only Look Once (YOLO) algorithm, in identifying patellar instability or dislocation. Material and Methods A total of 550 patients (190 diagnosed with patellar instability or dislocation) were divided into a training set (n = 360), validation set (n = 90), and external test set (n = 100). Four indicators were measured on transverse knee MRI scans to determine the presence of patellar instability, and 450 images were labeled using Labelme software. YOLO version 8 (YOLOv8) was refined using these labeled images and validated on 100 unlabeled images. The diagnostic accuracy of YOLOv8 was compared with that of a junior radiologist. Results The sensitivity, specificity, and accuracy of the refined YOLO model and the junior radiologist were 62%, 97%, and 83%, and 62%, 82%, and 74%, respectively. Although the YOLO model demonstrated slightly higher accuracy, the difference did not reach statistical significance ( P = 0.093). The YOLO model required approximately 14.01 ± 10.34 ms to interpret each image, significantly shorter than the 9.55 ± 2.39 s required by the radiologist ( P < 0.001). Conclusion The refined YOLOv8 model is not inferior to junior radiologists in identifying patellar instability or dislocation and offers a significantly faster interpretation time.
Early career occupational therapists’ perceptions of occupational justice in practice in Singapore
Authors: Tay Valenie , Chua Philiana , Gnoh Nathaniel , Goh Kaylynn , Dancza Karina M. 
Published: December 2024

Introduction: Occupational justice addresses social, political and economic factors influencing occupational participation as a human right. Implementing occupational justice is challenging due to institutional, personal, environmental and cultural barriers, and may be further complicated in non-Western contexts. Early career occupational therapists often struggle to apply these principles while transitioning from education to practice, despite their desire to advocate for justice-focused practices. Methods: This qualitative descriptive study, grounded in social constructivism, explored the experiences of early career occupational therapists applying occupational justice in Singapore. Using snowball sampling of 2020 and 2021 graduates, participants engaged in one-time semi-structured interviews, which were transcribed verbatim and thematically analysed. Findings: Of 140 potential participants, 10 responded and completed the study. Four themes were developed: (1) Feeling uncertain about occupational justice, (2) Perceived relevance in the Singaporean context, (3) Early career challenges and (4) Aspiration to be agents of change. Conclusion: Early career occupational therapists expressed uncertainty in applying occupational justice concepts, often confusing them with occupation-centred practice. Despite recognising individual influences, they felt ill-prepared to tackle systemic barriers and advocate for broader social change. However, participants were aware and willing to support occupational justice ideals, suggesting a need for more guidance to integrate individual therapeutic goals with societal advocacy.
Robotic-assistance and computer-navigation have similar rates of intraoperative fracture and return to the operating room within 1 year to fluoroscopy-only direct anterior total hip arthroplasty
Authors: Bendich Ilya , Chiu Yu-Fen , Sarpong Nana , Gonzalez Della Valle Alejandro , Su Edwin , McLawhorn Alexander 
Published: December 2024

Introduction: The use of technology in direct anterior approach (DAA) total hip arthroplasty (THA) is expanding. Although the use of computer-navigation (CN-THA) and robotics (RA-THA) has previously demonstrated improved component positioning, it is important to understand whether its use is associated with differences in intraoperative complications or early return to the operating room when compared to fluoroscopy-only (manual-THA) DAA THA. Methods: 3433 DAA THAs (226 RA-THA, 1007 CN-THA, 2200 manual-THA) performed at a single institution were retrospectively reviewed. Cohorts were adjusted for age, sex, BMI, femoral fixation, history of spine fusion, and Charlson Co-morbidity Index (CCI) using Inverse Probability of Treatment Weight (IPTW). Operative times were identified. Intraoperative fractures and re-operations within 1 year were identified via chart review. Results: There were no statistically significant differences in intraoperative fracture among the cohorts (0.4% RA-THA, 0.4% CN-THA, 0.4% manual-THA; p > 0.529). There were also no statistically significant differences ( p > 0.589) among the cohorts in rates of return to the operating room within 1 year for postoperative fracture (0.0% RA-THA, 0.4% CN-THA, 0.4% manual-THA), dislocation (0.0% RA-THA, 0.0% CN-THA, 0.1% manual-THA), infection (0.4% RA-THA, 0.7% CN-THA, 0.5% manual-THA), or other aetiologies (0.0% RA-THA, 0.2% CN-THA, 0.1% manual-THA). Conclusions: This study did not find a statistically significant difference in intraoperative fracture or re-operations within 1 year between DAA THA performed with RA, CN, or manual techniques. The introduction of technology to THA is not associated with increase in reoperations within one-year.
Minimum Acceptable Diet and Associated Factors among 6–23 Months Age Children in Wondo Genet District, Sidama Region, Ethiopia
Authors: Gujo Amelo Bolka , Kare Assefa Philipos 
Published: December 2024

Background: Inappropriate child feeding practices can have significant negative effects on the well-being and survival of children under two years old. This study was aimed at assessing the minimum acceptable diet (MAD) and associated factors among 6 to 23 months age children in Wondo Genet district, Sidama region, Ethiopia. Methods: A community-based cross-sectional study was conducted from 1 to 30 July in 2023 among 422 children aged 6 to 23 months. Multi-stage sampling method was applied to select kebeles and study participants. Trained data collectors gathered data using pretested questionnaire. Data was entered into EPI Info 7 and analyzed using IBM SPSS version 26. MAD as a composite indicator was produced based on the proportion of children aged 6 to 23 months who met the minimum meal frequency (MMF) and minimum dietary diversity (MDD) on the previous day. To assess the factors determining adherence to MAD, multi-variable logistic regression analyses were employed. The outputs were presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CI). Results: In this study, 419 mothers/caretakers participated with a response rate of 99.3%. The proportion of children who met the MAD were 26.5% (95% CI: 22.29%, 30.71%). Increased odds of meeting MAD were associated with being from food-secured households (AOR = 2.39, 95% CI: 1.48 to 3.86), utilization of growth monitoring services (AOR = 2.05, 95% CI: 1.23 to 3.39), mother attended formal education (AOR = 1.88, 95% CI: 1.15 to 3.08), and being in age range of 12-23 months (AOR = 2.14, 95% CI: 1.26 to 3.63). Conclusion: The prevalence of MAD was very low. Factors associated with a MAD included maternal education, child age, growth monitoring service utilization, and food security. To enhance MAD provision, it is crucial to strengthen child feeding practices tailored to the local context.
Heart Rate and its Variability From Short-Term ECG Recordings as Potential Biomarkers for Detecting Mild Cognitive Impairment
Authors: Xavier Anjo , Noble Sneha , Joseph Justin , Ghosh Aishwarya , Issac Thomas Gregor 
Published: December 2024

Background: Alterations in Heart Rate (HR) and Heart Rate Variability (HRV) reflect autonomic dysfunction associated with neurodegeneration making them biomarkers suitable for detecting Mild Cognitive Impairment (MCI). Methods: The study involves 297 urban Indian participants [48.48% (144) were male and 51.51% (153) were female]. MCI was detected in 19.19% (57) of participants and the rest, 80.8% (240) of them were healthy. ECG recordings spanning 10 s were collected and R-peaks were detected. Machine learning algorithms like were employed to further validate the features. Results: The mean of R-to-R (NN) intervals ( P = .0021), the RMS of NN intervals ( P = .0014), the SDNN ( P = .0192) and the RMSSD ( P = .0206) values differ significantly between MCI and non-MCI. Machine learning classifiers, SVM, DA, and NB show a high accuracy of 80.801% on RMS feature input. Conclusion: HR and its variability can be considered potential biomarkers for detecting MCI.
The effect of benralizumab on inflammation in severe asthma: a real-life analysis
Authors: Visca Dina , Ardesi Francesco , Zappa Martina , Grossi Sarah , Pignatti Patrizia , Vanetti Marco , Pini Laura , Sotgiu Giovanni , Centis Rosella , Migliori Giovanni Battista , Spanevello Antonio 
Published: December 2024

Background: Benralizumab is a monoclonal antibody treatment for severe eosinophilic asthma (SEA). Few studies investigated its role in airway inflammation and its correlation with lung function. Objectives: The aim of the present study is to assess its effect after 1 year of treatment, focusing on airway inflammation. Design: This is a retrospective observational study, in an Italian tertiary reference centre specialised in diagnosis and management of severe asthma patients. Methods: We conducted a monocentric retrospective study including SEA patients treated with benralizumab for 1 year. Clinical, functional and inflammatory data were collected at baseline, 6 (T6) and 12 (T12) months. Results: Twenty-two SEA patients on benralizumab were included. We observed a reduction in exacerbations rate and systemic steroid treatment ( p < 0.0001) as well as an improvement in asthma control ( p < 0.0001), health-related quality of life ( p = 0.017) and lung function pre-BD FEV1 (L) ( p = 0.02) and percentage ( p = 0.004) and post-BD FEV1 (L) ( p = 0.01) and percentage ( p = 0.003) from baseline to T6 and T12. A reduction in sputum eosinophil percentage was observed at T6 and T12 ( p < 0.005). We found a positive correlation between the variation of sputum eosinophils percentage and FEV1 (L) at T12 (rho = −0.79, p = 0.04). Moreover, the improvement of FEF25%–75% from baseline to 6 (rho = −0.53, p = 0.03) and 12 (rho = −0.62, p = 0.01) months negatively correlated with the duration of asthma disease. In our cohort 12/22 patients were super-responders at T6 and 15/22 at T12. Furthermore, clinical remission was reached by 12/22, and all of them obtained blood and sputum eosinophils counts normalisation. Conclusion: Our data confirm that it is a rapid and effective treatment for SEA acting on clinical, functional, systemic and airway inflammatory outcomes. Our results highlight the role of induced sputum as a promising non-invasive technique to investigate pathophysiologic mechanisms in severe asthma treated with biologics. Finally, a negative correlation between small airway improvement and the duration of asthma may suggest that a prompt referral to asthma centres may delay lung function worsening. Additional studies are needed to investigate more in-depth the role of induced sputum in the management of asthma, response to treatment and remission.
Innovations in Genicular Outcomes Registry (IGOR): protocol for a real-world registry study of treatments for knee osteoarthritis
Authors: Dasa Vinod , Mihalko William , Rivadeneyra Adam , Urban Joshua , Wickline Andrew , Rogenmoser David , Concoff Andrew , Spitzer Andrew , Mont Michael A. 
Published: December 2024

Background: Osteoarthritis (OA) is the leading cause of disability among US adults and most commonly affects the knee. Guidelines for knee OA treatment include behavioral, nonpharmacological, pharmacological, and surgical interventions. While emerging knee OA treatments show promise for pain control, data gaps remain regarding the efficacy, safety, comparative effectiveness, and real-world value of treatments. Objectives: The Innovations in Genicular Outcomes Registry (IGOR) is prospectively collecting real-world data to assess clinical effectiveness, safety, health-related quality of life, and healthcare resource utilization of knee OA treatments. Design: The IGOR is a prospective, observational, longitudinal, multicenter registry (NCT05495334) examining knee OA pain treatment outcomes at intervals up to 18 months after treatment. Methods and analysis: All clinical management decisions are made via shared decision-making involving both the physician and the patient. Index joint-directed treatments may include various intra-articular injections, oral opioid and nonopioid medications (including nonsteroidal anti-inflammatory drugs), cryo nerve blocks, radiofrequency ablations, novel treatment modalities, other physical therapy modalities (including muscle strengthening), and total knee arthroplasties. Patient-reported assessments along with physician-provided medical record data are recorded. Regular data quality assessments are conducted for each site, and an outside monitor ensures data quality and integrity. A steering committee ensures transparency and oversees administrative, legal, ethical, and scientific decisions. Treatment outcomes within and between therapies are compared. Ethics: Ethical approval was granted by Advarra, Inc. (protocol number, Pro00050981). Discussion: Data from the IGOR registry study will further elucidate the effectiveness, safety, and real-world value of knee OA treatments individually or in combination. Characterization of real-world treatment patterns will help better understand the impact of specific treatments. Trial registration: Clinicaltrials.gov, NCT05495334.
Adipose mesenchymal stem cell conditioned medium and extract: A promising therapeutic option for regenerative breast cancer therapy
Authors: Kazemi Faezeh , Sadeghian Fatemeh , Pirsadeghi Ali , Asadi Fatemeh , Javdani Hossein , Yousefi-Ahmadipour Aliakbar 
Published: December 2024

Introduction: Breast cancer is the second most common cancer and a leading cause of cancer death in U.S. women. The tumor microenvironment, especially nearby adipocytes, plays a crucial role in its progression. Therefore, this study aimed to investigate the effects of human adipose mesenchymal stem cells-derived conditioned medium (SUP) and extract (CE) from on breast cancer cells. Methods: Human adipose-derived mesenchymal stem cells were isolated and characterized by flow cytometry using Cluster of Differentiation (CD) markers (CD34, CD45, CD90, and CD105). The differentiation potential was confirmed via adipogenic and osteogenic induction. MCF-7 and MDA-MB-231 cells were treated with SUP and CE, and cell viability was assessed using the 3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay at 24, 48, and 72 h. Doubling time, colony formation, wound healing, and gene expression for key cancer-related genes ( TIMP1, TIMP2, MMP2, PDL1, IDO, Bax, caspase 3, and caspase 9) were also evaluated. Results: Both SUP and CE significantly inhibited the viability of MCF-7 and MDA-MB-231 cells, reduced their doubling time, and suppressed colony formation. In wound healing assays, cell migration was notably impaired in MDA-MB-231 cells but less so in MCF-7 cells. Real-time polymerase chain reaction revealed downregulation of TIMP1, MMP2, PDL1, and IDO in MDA-MB-231 cells after treatment, while CE increased certain gene expressions in MCF-7 cells. Bax, caspase 3, and caspase 9 expressions were significantly upregulated in MDA-MB-231 cells but not in MCF-7 cells after treatment. Conclusion: Human adipose-derived mesenchymal stem cells-derived SUP and CE exhibit antitumor effects on breast cancer cells, suggesting a potential therapeutic strategy to suppress tumor progression. Mesenchymal stem cells-SUP and CE could be a safe and novel regenerative approach for breast reconstruction postmastectomy without tumor recurrence risk.
Retrospective observational study of safety, performance, and duration of use of battery-powered intraosseous access device in pediatric patients
Authors: Philbeck Thomas E , McDonald John G , Carew Melvin , Ross Christopher 
Published: December 2024

Background: To demonstrate the safety and performance of the Arrow EZ-IO Intraosseous Vascular Access System, particularly in the pediatric patient population, a retrospective observational study was conducted in 2021 and 2022. Methods: Following study design, IRB approval, and investigator selection, data were collected for all patients needing intraosseous access—adult and pediatric. The primary endpoint was the success rate for achieving intraosseous access; the secondary endpoint was the rate of adverse events. Following initial data collection, additional data were collected and a sub-set analysis was conducted to demonstrate the same in pediatric patients only, which is the focus of this report. Results: Data for 106 pediatric cases were collected. The success rate for achieving intraosseous access and infusion was 96.2%. There were three adverse events in two patients (1.9%); none serious or previously unreported. The mean duration of device use was 60 h (SD = 46). For 46 patients, the device was used for up to 48 h, and for another 45 patients, the device was used for a longer duration. Conclusions: This report is the first characterization of the safety and performance of the Arrow EZ-IO Intraosseous Vascular Access System when used in the pediatric population for longer dwell times (>24 h), with no serious complications reported. Performance and safety objectives were met. The results of this real-world evidence study are in alignment with findings from the clinical literature concluding that, for pediatric patients, the Arrow EZ-IO Intraosseous Vascular Access System is safe and effective for providing vascular access in urgent, emergent, and medically necessary situations, in which intravenous access is difficult or impossible to obtain. In addition, this study supports the use of intraosseous access for dwell times greater than 24 h.
Analysis of the relationship between antineoplastic drugs and suicide-related adverse events based on the food and drug administration adverse event reporting system database
Authors: Zhao Nan , Wang Huimin , Xu Huilin , Tang Xixian , Cao Dedong 
Published: December 2024

Background: The potential association between new antineoplastic drugs and an increased risk of suicide-related adverse drug reactions remains unclear. This study aims to utilize the FAERS public database to analyze suicide-related adverse drug reactions associated with common antitumor drugs and to investigate potential risk signals for such adverse drug reactions. Methods: This study was a retrospective analysis utilizing the FAERS database. The FAERS database was examined for reports of suicide-related adverse events associated with antitumor drugs, spanning from 2004 to 2023. To identify and verify adverse event signals, we employed reporting odds ratios, proportional reporting ratios, and Bayesian methods (Bayesian Confidence Propagation Neural Network). Additionally, logistic regression analysis was performed to assess outcomes in tumor patients. Results: A total of 223,781 suicide-related adverse event reports were screened, of which 3790 involved common antitumor drugs. The top five drugs reported were tretinoin ( n = 1220), methotrexate ( n = 664), celecoxib ( n = 505), rituximab ( n = 107), and imatinib ( n = 105). Risk signal analysis indicated that, with the exception of tretinoin (ROR = 6.317), the reporting odds ratio values for the other drugs were below 2. Among cancer patients, the most frequently reported adverse events included suicidal ideation ( n = 233), completed suicide ( n = 131), and suicide attempts ( n = 97). Regression analysis revealed that risk factors for patient death included indication (OR = 0.967, p < 0.01), gender (OR = 0.57, p < 0.01), and type of adverse event (OR = 4.644, p < 0.01). Conclusion: The findings suggest that antineoplastic drugs may not statistically increase the risk of suicide-related adverse events. However, specific tumor types and suicide-related adverse events may contribute to increased mortality in cancer patients. Further research is warranted to elucidate the risk of suicide-related adverse events in oncology patients.
Accuracy of virtual reality in automated measurement and diagnosis of strabismus
Authors: Wang Yu-meng , Liu Jiawen , Chen Wei-wei , Jiang Mei-xia , Fu Jing 
Published: December 2024

Background To explore the accuracy of VR technology for strabismus screening. Methods In this cross-sectional study, a total of 191 subjects were included. Examinations included VR technology based on infrared, the cover-uncover test, and the prism alternating cover test (PACT) at various gaze positions, specifically at distances of 33 cm and 6 m. The accuracy of VR in diagnosing strabismus and quantifying the degree of strabismus was evaluated by comparing the VR results to the average outcomes of manual examinations conducted by the two physicians, considered the gold standard. Results A total of 88 healthy individuals, 81 exotropia patients, 17 esotropia patients, and five vertical strabismus patients were included in this study, and each subject was screened for less than 2 min. The sensitivity of VR for screening strabismus was 80.3% and the specificity was 80%, displaying moderately consistent with the manual results (Kappa = 0.598, p < .001). The sensitivity for diagnosing exotropia was 76.5% and the specificity was 91.8%, also showing strong agreement with the manual results (Kappa = 0.695, p < 0.001). The sensitivity for diagnosing esotropia was 94.1% and the specificity was 95.4%, with strong agreement with the manual results (Kappa = 0.755, p < .001). The sensitivity for diagnosing vertical strabismus was 80% and the specificity was 98.9%, with strong agreement with manual results (Kappa = 0.719, p < .001). For ocular deviation angle calculations, intraclass correlation coefficient (ICC) was used to compare the agreement between VR and manual results. It showed moderately agreement for exotropia in the near mode (ICC = 0.587, range, −0.036–0.826) and less agreement for exotropia in far mode (ICC = 0.349, range, −0.042–0.615). ICC was in good agreement (ICC = 0.701, range, 0.358–0.879) for the esotropic far mode results (6 m) and not statistically significant for the esotropic near mode results (33 cm). ICC was in good agreement (ICC = 0.606, range = −0.143 to 0.946) for the vertical-near-mode results (33 cm) and not statistically significant for the vertical-far-mode results (6 m). Conclusions This novel technique for strabismus screening, which utilizes virtual reality technology, enables quick, precise, and straightforward diagnosis of strabismus. It has also shown notable efficacy in accurately measuring the angle of deviation in cases of exotropia.