bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of First Tarsometatarsal Joint Morphology and Instability in the Etiology of Hallux Valgus: A Case-Control Study
Authors: Zhang Ming-Zhu 
Published: December 2024

Category: Midfoot/Forefoot; Bunion Introduction/Purpose: The morphology of foot joints is believed to significantly impact the development of various foot disorders. The relationship of the first tarsometatarsal joint (TMT1) morphology and hallux valgus (HV) is not well understand, and the influence of TMT1 morphology on TMT1 instability has not been fully explored. This study aimed to investigate the TMT1 morphology and its potential correlation with HV and TMT1 instability. Methods: Weightbearing CT (WBCT) scans of 82 consecutive feet with hallux valgus and 79 controls were reviewed in this case-control study. Using Mimics software and WBCT scans, the three-dimensional (3D) models of TMT1 were constructed. The height of the TMT1 facet (FH), superior, middle, and inferior facet width (SFW, MFW, and IFW) were measured on anteroposterior view of the first metatarsal base. On the lateral view, the inferior lateral facet height and angle (ILFH and ILFA) were measured. TMT1 instability was evaluated using the TMT1 angle. Results: Compared with the control group, the HV group suggested significantly wider MFW (9.6mm in HV, 8.8mm in control), lower ILFH (1.7mm in HV, 2.5mm in control), smaller ILFA (17.7° in HV, 24.3° in control), and larger TMT1 angle (1.9° in HV, 0.9° in control) (All P < 0.05). No significant differences were found between the two groups in FH, SFW, and IFW (All P > 0.05). Four types of TMT1 (continuous-flat, separated-flat, continuous-protruded, and separated-protruded) were identified according to the TMT1 morphology. The continuous-flat type possessed significantly larger HVA, IMA and TMT1 angles compared with other types (All P < 0.001). Conclusion: This study suggests an association between TMT1 morphology and the severity of HV, and identifies four TMT1 types. Notably, the continuous-flat type is found to be associated with more severe HV and TMT1 instability.
The Unspoken Complication Following MIS Bunion Surgery
Authors: Genuth Gil 
Published: December 2024

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: Hallux valgus (HV) is a common orthopedic foot and ankle condition involving deformity and subsequent pain and dysfunction of the first ray. Surgical interventions, such as open and minimally invasive surgery (MIS), are frequently utilized if nonoperative management is insufficient . In recent years, MIS has been increasingly used and has been regarded as one of the most innovative surgical interventions for HV. As with all new surgical techniques complications can occur. The most common complications after MIS bunion surgery are infections and hardwear removal. Nonunion after MIS bunion correction can be surgically challenging. Recent publications report 1% of non-unions after MIS bunion correction. Despite this prevalence the orthopedic literature is lacking information about how to treat patients who have non-unions after MIS bunion surgeries. Methods: We would like to present our experience and treatment protocol for non- union after MIS bunion surgery. Treatment Protocol: 1. Nonunion definition- No signs or minimal signs on consecutive x-rays or CT scan of bony union at the osteotomy site 6 months or more after index MIS bunion surgery. 2. Rull out reversible causes for nonunion. 3. Surgery- An open surgery is performed. Removal of MIS screws, debridement and refreshing of the osteotomy site, adding bone graft (autologous/synthetic), fixing the nonunion site with a dorsal plate and a lag screw if needed. 4. Post op protocol- non-weight bearing for 2 weeks followed by 4 weeks of partial weight bearing in a post-op shoe. All patients receive Vit D supplements for 3 months after surgery. (1000 IU per day). 5. Follow up in clinic with x rays at 6 weeks, 3 months and 6 months after revision surgery. Results: We would present a case sereis of 6 cases of nonunions following MIS bunion surgery treated according to the presented treatment protocol and achieved full union 3 months after the revision surgery. Conclusion: Nonunion after MIS bunion correction can be surgically challenging. The suggested treatment protocol shows high union rates for revision cases.
The Use of FIXUS AI Deep Learning Model for the Detection of Intra-articular Calcaneal Fractures on X-rays
Authors: Taseh Atta , Ghandour Samir , Gholipour Alireza , Sirls Evan , Fenelon Micheka , Waryasz Gregory R. , Guss Daniel , Bejarano-Pineda Lorena , DiGiovanni Christopher W. , Ashkani-Esfahani Soheil , Kwon John Y. 
Published: December 2024

Category: Hindfoot; Trauma Introduction/Purpose: Fractures of the calcaneus are the most frequent form of fractures among the tarsal bones. The treatment plan depends on various fracture characteristics, particularly the extension of the fracture line into the subtalar joint surfaces. While X-rays are the primary diagnostic tool, Computed Tomography (CT) scans are often necessary as they provide a more detailed description of these fractures, especially if the articular surfaces are involved. Although informative, CT scans expose patients to higher doses of ionizing radiation, and they might not be readily available in certain settings. This study aims to develop a deep learning model that will first detect calcaneal fractures and then classify the type of fracture based on its extension into the subtalar joint surfaces. Methods: A retrospective case-control study was conducted. Patients aged >18 years who sustained a calcaneal fracture were included in the case group, along with the same number of healthy adults for the control group. Various X-ray views of the foot including anterior, posterior, lateral, along with the axial and lateral calcaneal views were obtained. Two experienced orthopaedic researchers screened the dataset and confirmed the type of fracture. Two models were developed using an Inception V3 architecture and a split ratio of 60:20:20 for training, validation, and testing purposes. The first model was designed for fracture detection, and the second one was designed for detecting intra-articular fracture extension, if present. Conventional model metrics including sensitivity, specificity, Youden index, area under the receiver operating characteristic curve (AUC), and F1 score were reported for each model. A p-value below 0.05 was statistically significant. Baseline values are presented in median and interquartile ranges (IQR). Results: A total of 1102 individuals (n=551 for each group) with a female-to-male ratio of 1.6:1 were included. Baseline comparisons showed a significant difference in the age of the groups [cases: 55 (IQR 42, 67) years; controls: 62 (IQR 51, 72 years), p-value < 0.001]. The first model for fracture detection demonstrated a high performance with an AUC of 0.99 and a Youden index of 0.96. The intra-articular fracture detection model showed a slightly lower performance with an AUC of 0.97 and a Youden index of 0.88 (Table 1, Figure 1). Conclusion: Our study showed promising results with the utility of deep learning methods for detecting calcaneal fractures and classifying intra- vs extra-articular fractures. This algorithm may help facilitate the diagnosis and treatment of patients with suspected calcaneal fractures, serving as a decision-support tool in settings where CT scanning is not available.
High-risk MCL: recognition and treatment
Authors: Jain Preetesh , Wang Michael 
Published: December 2024

Abstract
Significant progress in determining the molecular origins and resistance mechanisms of mantle cell lymphoma (MCL) has improved our understanding of the disease’s clinical diversity. These factors greatly impact the prognosis of patients with MCL. Given the dynamic alterations in MCL clones and disease evolution, it is crucial to recognize high-risk prognostic factors at diagnosis and relapse. Clinical factors include a high MCL International Prognostic Index score with a high Ki-67 proliferation index, early disease progression within 24 months of first-line treatment, &gt;3 previous lines of therapy at relapse, and an aggressive (blastoid or pleomorphic) histology. Molecular aberrations include dysregulated cyclin D1, an aberrant SOX11-CD70 axis, upregulated Musashi-2, MYC rearrangement, metabolic reprogramming, and epigenetic changes. Other factors that contribute to high-risk MCL include an immune-depleted microenvironment and clone adaptability with complex chromosomal anomalies and somatic mutations in TP53, NSD2, CCND1, CDKN2A, BIRC3, SP140, KMT2D, NFkBIE, SMARCA4, and NOTCH2. Ultra-high-risk MCL is indicated by the coexistence of multiple high-risk prognostic factors in the relapse setting and can portend very short progression-free survival. As MCL treatments advance toward cellular therapies, resistance to anti-CD19 chimeric antigen receptor T-cell therapy is also observed. These findings necessitate revisiting the prognostic impact of high-risk factors, current management strategies, new bi- and trispecific T-cell engagers, combination therapies, novel therapeutic targets, and next-generation clinical trials for patients with high-risk MCL. This article provides a comprehensive update on recognizing and managing high-risk MCL and encompass current practices and future directions.
Advancing drug development in myelodysplastic syndromes
Authors: Mina Alain , McGraw Kathy L. , Cunningham Lea , Kim Nina , Jen Emily Y. , Calvo Katherine R. , Ehrlich Lori A. , Aplan Peter D. , Garcia-Manero Guillermo , Foran James M. , Garcia Jacqueline S. , Zeidan Amer M. , DeZern Amy E. , Komrokji Rami , Sekeres Mikkael A. , Scott Bart , Buckstein Rena , Tinsley-Vance Sara , Verma Amit , Wroblewski Tanya , Pavletic Steven , Norsworthy Kelly 
Published: December 2024

Abstract
Myelodysplastic syndromes/neoplasms (MDSs) are heterogeneous stem cell malignancies characterized by poor prognosis and no curative therapies outside of allogeneic hematopoietic stem cell transplantation. Despite some recent approvals by the US Food and Drug Administration, (eg, luspatercept, ivosidenib, decitabine/cedazuridine, and imetelstat), there has been little progress in the development of truly transformative therapies for the treatment of patients with MDS. Challenges to advancing drug development in MDS are multifold but may be grouped into specific categories, including criteria for risk stratification and eligibility, response definitions, time-to-event end points, transfusion end points, functional assessments, and biomarker development. Strategies to address these challenges and optimize future clinical trial design for patients with MDS are presented here.
Quasi-Static and Dynamic Collapse Behavior of Circular Foam-Filled Tubes Inspired by Bamboos
Authors: Liu Kai , Yu Zhenhao , Wang Kaiyun , Jing Lin 
Published: December 2024

AbstractThe axial collapse mechanical behavior and energy absorption characteristics of circular foam-filled tubes mimicking the bamboo characteristics under quasi-static and low-velocity impact loads were investigated via experiments and numerical simulations in this study. The crushing deformation process, load-displacement responses, the strain field and temperature field distribution characteristics of foam-filled tubes were explored. The energy absorption mechanism and crashworthiness performance of specimens were evaluated and compared with conventional empty tubes. Effects of ambient temperature on axial collapse behavior and crashworthiness indices were also clarified. The results revealed that the superior energy absorption capacity of foam-filled tubes was attributed to the strengthening effect of bionic joints and the filling effect of aluminium foam. The energy absorption (EA), specific energy absorption (SEA), and other crashworthiness indices of foam-filled tubes under axial impact load were greatly improved than that of quasi-static load. Compared to conventional empty tubes, the foam-filled tube had a larger energy-absorbing effectiveness factor under both quasi-static and dynamic loads. The increased temperature weakens the crashworthiness performance and energy absorption ability of the foam-filled tube. The SEA values ranged from 28.2 J/g to 22.1 J/g for the quasi-static load and 31.9 J/g to 26.3 J/g for the dynamic load when the temperature elevated from −50 ℃ to 100 ℃.
Solid lipid nanoparticles for increased oral bioavailability of acalabrutinib in chronic lymphocytic leukaemia
Authors: Sinha Swagata , Ravi Punna Rao , Somvanshi Makarand , Rashmi S. R. 
Published: December 2024

AbstractAcalabrutinib (ACP) is a first-line treatment for chronic lymphocytic leukemia but suffers from poor and variable oral bioavailability due to its pH-dependent solubility, CYP3A4 metabolism, and P-gp efflux. Thus, the objective of this study was to improve the solubility and dissolution behaviour, in turn enhancing bioavailability, by formulating solid lipid nanoparticles (SLNs). ACP loaded SLNs (ACP-SLNs) were prepared via solvent-free hot emulsification followed by a double sonication process. A combination of glyceryl di-behenate and stearyl palmitate along with Tween 80 was used as the lipid phase to dissolve ACP. A 1% w/v Poloxomer188 solution served as the aqueous phase. The optimized ACP-SLNs were spherical in shape and had particle size of 234.7–257.5 nm, PDI of 0.261–0.320 and loading efficiency of 18.70 ± 1.78%. A typical biphasic release pattern was observed from ACP-SLNs in the in vitro dissolution studies under gastrointestinal and plasma pH conditions (> 90% drug release at pH 4.5 ± 0.2, 6.8 ± 0.2 (representing GIT), and 7.4 ± 0.2 (representing plasma) at 8, 16 and 24 h, respectively). The freeze-dried product was stable when stored at 5 °C for over 6 months. Compared with the bulk drug suspension, the ACP-SLNs suspension resulted in 2.29-fold increase in oral bioavailability and more importantly 2.46-fold increase in the distribution of drug to spleen. Additionally, inhibition of lymph production and flow by administering cycloheximide resulted in 46.01% decrease in the overall absorption of ACP-SLNs, indicating the significance of lymphatic uptake process in the oral absorption of ACP-SLNs.
Graphical Abstract
Sex identification in rainbow trout using genomic information and machine learning
Authors: Kudinov Andrei A. , Kause Antti 
Published: December 2024

AbstractSex identification in farmed fish is important for the management of fish stocks and breeding programs, but identification based on visual characteristics is typically difficult or impossible in juvenile or premature fish. The amount of genomic data obtained from farmed fish is rapidly growing with the implementation of genomic selection in aquaculture. In comparison to mammals and birds, ray-finned fishes exhibit a greater diversity of sex determination systems, with an absence of conserved genomic regions. A group of genomic markers located on a standard genotyping array has been reported to potentially be linked with sex determination in rainbow trout. However, the set of markers suitable for sex identification may vary between populations. Sex identification from genomic data is usually performed using probabilistic methods, where suitable markers are known beforehand. In our study, we demonstrated the use of the Extreme Gradient Boosting approach from the supervised machine learning gradient boost framework to predict sex from unimputed genomic data, when the suitability of the markers was unknown a priori. The accuracy of the method was assessed using four simulated datasets with different genotyping error rates and one real dataset from the Finnish Rainbow Trout Breeding Program. The method showed high prediction quality on both simulated and real datasets. For simulated datasets with low (5%) and high (50%) genotyping error rates, the accuracies were 1.0 and 0.60, respectively. In the real data, the method achieved a prediction accuracy of 98%, which is suitable for routine use.
Predicting kidney graft function and failure among kidney transplant recipients
Authors: Yao Yi , Astor Brad C. , Yang Wei , Greene Tom , Li Liang 
Published: December 2024

Abstract
Background
Graft loss is a major health concern for kidney transplant (KTx) recipients. It is of clinical interest to develop a prognostic model for both graft function, quantified by estimated glomerular filtration rate (eGFR), and the risk of graft failure. Additionally, the model should be dynamic in the sense that it adapts to accumulating longitudinal information, including time-varying at-risk population, predictor-outcome association, and clinical history. Finally, the model should also properly account for the competing risk by death with a functioning graft. A model with the features above is not yet available in the literature and is the focus of this research.

Methods
We built and internally validated a prediction model on 3,893 patients from the Wisconsin Allograft Recipient Database (WisARD) who had a functioning graft 6 months after kidney transplantation. The landmark analysis approach was used to build a proof-of-concept dynamic prediction model to address the aforementioned methodological issues: the prediction of graft failure, accounted for competing risk of death, as well as the future eGFR value, are updated at each post-transplant time. We used 21 predictors including recipient characteristics, donor characteristics, transplant-related and post-transplant factors, longitudinal eGFR, hospitalization, and rejection history. A sensitivity analysis explored a less conservative variable selection rule that resulted in a more parsimonious model with reduced predictors.

Results
For prediction up to the next 1 to 5 years, the model achieved high accuracy in predicting graft failure, with the AUC between 0.80 and 0.95, and moderately high accuracy in predicting eGFR, with the root mean squared error between 10 and 18 mL/min/1.73m2 and 70%-90% of predicted eGFR falling within 30% of the observed eGFR. The model demonstrated substantial accuracy improvement compared to a conventional prediction model that used only baseline predictors.

Conclusion
The model outperformed conventional prediction model that used only baseline predictors. It is a useful tool for patient counseling and clinical management of KTx and is currently available as a web app.
The association between PM2.5 and frailty: evidence from 122 cities in China and 7 countries in Europe
Authors: Wen Yanchao , Zhu Guiming , Cao Kexin , Liang Jie , Lu Xiangfeng , Wang Tong 
Published: December 2024

Abstract
Background
The accelerated aging process worldwide is placing a heavy burden on countries. PM2.5 particulate matter exposure is a significant factor affecting human health and is crucial in the aging process.

Methods
We utilized data from China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Aging, and Retirement in Europe (SHARE) to study the relationship between PM2.5 exposure and the frailty index. Acquire PM2.5 exposure data for China and Europe, match them according to geographic location within the database. Our study used frailty index to evaluate frailty, which comprises 29 items. We examined the association between PM2.5 and frailty index using fixed-effects regression models and Mendelian randomization (MR) analysis.

Results
We first examined the association between PM2.5 and frailty index using fixed-effects regression models, revealing a notable positive link across populations in China (coefficient = 0.0003, P = 0.0380) and Europe (Coefficient = 0.0019, P < 0.0001). This suggests that PM2.5 exposure is a significant risk factor for frailty, leading to accelerated frailty. Moreover, our MR analysis uncovered a possible causal association (OR = 1.2933, 95%CI: 1.2045–1.3820, P < 0.0001) between PM2.5 exposure and the frailty index.

Conclusions
Our findings indicate that long-term exposure to PM2.5 in the environment is a risk factor for physical frailty and may have a potential causal relationship. Given the rapid global aging trend, public health measures are needed to reduce PM2.5 concentrations and prevent frailty.
Application of 3D-printed porous prosthesis for the reconstruction of infectious bone defect with concomitant severe soft tissue lesion: a case series of 13 cases
Authors: Chen Zhuo , Yang Yiyuan , Liu Bingchuan , Li Xingcai , Tian Yun 
Published: December 2024

Abstract
Background
Treating infectious bone defects combined with large soft-tissue lesions poses significant clinical challenges. Herein, we introduced a modified two-stage treatment approach involving the implantation of 3D-printed prostheses and flap repair to treat large segmental infectious tibial bone defects.

Method
We conducted a retrospective study of 13 patients treated at our center between April 2018 and March 2022 for tibial infections owing to posttraumatic infection and chronic osteomyelitis combined with soft tissue defects. The average defect length was 14.0 cm (range, 5.7–22.9 cm). The flap area ranged from 14 × 5 to 15 × 8 + 25 × 15 cm. Sural neurocutaneous, lesser saphenous neurocutaneous, and local fasciocutaneous flaps were used to repair the skin defects. In the second stage, 3D-printed prostheses were designed and implanted. Union rate, complications, and functional outcomes were assessed at the final follow-up.

Result
The average follow-up period was 31.1 months (range, 17–47 months), with an average interval of 208.1 days (range, 139–359 days) between the two stages. According to our criteria, 7 of the 13 patients achieved radiographic healing without intervention. Two patients developed prosthesis-related complications and underwent revision surgery. Two patients experienced recurrent infections leading to prosthesis removal and debridement surgery, with the infection ultimately eradicated in one and the other undergoing amputation. Three patients experienced noninfectious flap-related complications, however, all eventually healed through surgical intervention.

Conclusion
The use of 3D-printed porous titanium prostheses combined with flap soft-tissue repair for the treatment of infectious tibial bone defects did not increase the rate of infection recurrence and provided good functional recovery, offering more options for the treatment of infectious bone defects.
Training needs of German healthcare professionals regarding sexual health and sex workers: results of a nationwide, cross-sectional survey
Authors: Reinehr Sabrina , Neuendorff Nina R. , van der Veen Raquel , Langenbach Benedikt P. , Thieme Andreas 
Published: December 2024

Abstract
Background
Sexual health is an important aspect of human well-being. In terms of sexual health and healthcare, sex workers might need more specialized care than others, given their higher risk for both discrimination and various sexually transmitted diseases. However, little is known about the quality of healthcare professionals’ training regarding sexual health and healthcare of sex workers in Germany.

Methods
In an online survey, 130 physicians, 63 psychotherapists, and 154 medical students reported their perceived quality of training regarding sexual health problems in all their patients and regarding sex workers’ health issues specifically.

Results
A substantial share of respondents reported to have experienced inadequate training regarding both sexual health problems in general and specific issues concerning sex workers. However, most respondents reported feeling rather comfortable when dealing with these topics. There was a positive correlation between feeling comfortable when treating sexual health problems/ sex workers and the perceived training on these topics.

Conclusions
The results of this study indicate that sexual health issues and sex workers’ specific healthcare requirements are not sufficiently addressed in the curricula of German healthcare professionals. Future adaptations of these curricula might be necessary.