bluuebunny/crossref_metadata_2025_split huggingface dataset:
An overview of patients with intertrochanteric femoral fractures treated with proximal femoral nail fixation using important criteria
Authors: Aygün Ümit , Şenocak Eyüp , Aksay Mehmet Fatih , Çiçek Ali Can , Halaç Orkun , Toy Serdar 
Published: December 2024

Abstract
Background
This study aimed to assess important criteria, including osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union, in patients with intertrochanteric femoral fractures treated with proximal femoral nail (PFN) fixation and to show their effect on clinical outcomes.

Methods
PFN fixation was applied in 73 patients (41 females, 32 males; mean age: 64.5 ± 6.2). The T score, fracture type according to the AO Foundation and Orthopedic Trauma Association (AO/OTA), implant-related complications (IRCs), Harris hip score (HHS), Jensen social function (JSF) score, and Parker-Palmer mobility score (PPMS), postoperative reduction classification, screw position according to the Cleveland zone, Radiographic Union Scale for the Hip (RUSH) score, and tip-apex distance (TAD) were recorded.

Results
Most screws were in central-central (n = 42) and inferior-central (n = 11) positions. IRCs were seen mostly in cases of screws placed in peripheral zones (n = 10) and were not observed in almost any patient with a TAD ≤ 25 mm (n = 52) (p < 0.001). Most of the patients with acceptable or good fracture reduction did not have IRCs (n = 11 and 50, respectively) (p < 0.001). Half of type 3A1 (n = 13) and most type 3A2 (n = 20) fractures showed radiographic union at 3 months, and most type 3A3 (n = 9) fractures showed radiographic union at 5 months (p < 0.05). At 12 months, type 3A2 fractures had the highest HHS (79.2 ± 5.3) and PPMS (3.9 ± 1.5), while type 3A3 fractures had the lowest HHS (70.3 ± 4.6) and PPMS (0.6 ± 2.8) (p < 0.05). At 12 and 24 months, type 3A3 fractures had higher JSF scores (2.8 ± 0.4 and 3.5 ± 0.5, respectively); at 3 months, type 3A1 fractures had higher JSF scores (3.1 ± 0.3) (p < 0.05). The radiographic bone union time was prolonged in patients with a T score ≤ -2.5 standard deviation (SD) (p < 0.05). The HHS and PPMS increased while the RUSH score, considered as the radiographic union, was going towards the 4th month and decreased after the 4th month (p < 0.05).

Conclusions
Considering the criteria (osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union) examined in this study, satisfactory results can be obtained with PFN fixation in the treatment of patients with intertrochanteric femoral fractures.
The biomechanical effects of clear aligner trimline designs and extensions on orthodontic tooth movement: a systematic review
Authors: Nakornnoi Theerasak , Srirodjanakul Watcharee , Chintavalakorn Rochaya , Santiwong Peerapong , Sipiyaruk Kawin 
Published: December 2024

Abstract
Background
Clear aligner treatment (CAT) has emerged as an effective alternative to conventional multibracket systems in orthodontics. The trimline design and extension of aligners may significantly influence their biomechanical performance and tooth movement efficacy.

Aim
To systematically review the biomechanical effects of different aligner trimline designs and extensions on orthodontic tooth movement.

Methods
A systematic search was conducted across PubMed, Scopus, Embase, ProQuest Dissertations & Theses Global, and Google Scholar for studies published between January 2000 and August 2024. The review included any types of empirical research focusing on the influence of trimline of orthodontic aligners on tooth movement efficacy conducted between January 2000 and August 2024. The Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool was used for quality assessment.

Results
Twelve studies met the inclusion criteria, all assessed as having low to moderate risk of bias. Aligner trimline design significantly influenced orthodontic tooth movement efficacy through two primary mechanisms: enhanced force delivery and increased aligner retention. Aligners with straight and extended margins generally exerted higher forces and moments compared to scalloped or shorter designs. This resulted in greater tooth displacement for certain movements, particularly intrusion, translation, tipping, and root torquing. Extended trimlines also demonstrated superior retention. However, the effects varied depending on the type of tooth movement.

Conclusion
Aligner trimline designs and extensions can significantly influence biomechanical performance and tooth movement efficacy in CAT. Straight extended trimlines generally demonstrate superior force delivery and retention, leading to more predictable clinical outcomes. This could reduce the need for revisions, thereby decreasing overall treatment time and increasing patient satisfaction. However, further research is needed to investigate the interactions between aligner trimline designs and other factors to develop evidence-based guidelines for their optimal combination in various clinical scenarios.
A ‘good death’ needs good cooperation with health care professionals – a qualitative focus group study with seniors, physicians and nurses in Germany
Authors: Mohacsi Laura , Stange Lena , Höfig Saskia , Nebel Lisa , Broschmann Daniel , Hummers Eva , Kleinert Evelyn 
Published: December 2024

Abstract
Background
Studies investigating notions of a ‘good death’ tend to focus on specific medical conditions and specific groups of people. Therefore, their results are often poorly comparable, making it difficult to anticipate potential points of conflict in practice. Consequently, the study explores how to achieve a good death from the perspective and experience of physicians, nursing staff, and seniors. The aim of this study is to identify comparable notions of a good death among the participants and to determine factors that may promote or prevent a good death, including those that may lead to futile care.

Methods
The study used a qualitative design with a total of 16 focus group discussions, 5 each with physicians and nursing staff, and 6 with seniors at least 75 years old. The group size ranged between 3 and 9 participants. Analysis was carried out using Qualitative Content Analysis.

Results
Three major aspects affect the quality of death: (1) good communication and successful cooperation, (2) avoidance of death, and (3) acceptance of death. While successful communication and acceptance of death reinforce each other, successful communication counters avoidance of death and vice versa. Acceptance and avoidance of death are in constant tension. Additionally, the role of family and loved ones has been shown to be crucial in the organization of dying (e.g. communicating the patient’s wishes to health care professionals).

Conclusions
Communication and cooperation between patients and all involved caretakers determines quality of death. However, communication depends on several individual and organizational factors such as the personal level of acceptance or avoidance of death and the availability of institutionalized communication channels crossing professional and organizational boundaries. Furthermore, treatment cultures and organizational structures in hospitals and nursing homes often default towards life prolongation. This carries significant potential for problems, particularly because physicians emphasized the need to prevent hospital admissions when no further life-sustaining treatment is desired. In contrast, nurses and seniors were less aware that hospitals may not be the most suitable place for end-of-life care. This, along with the ambivalent role of nursing homes as places of death, holds potential for conflict.

Trial registration
German Clinical Trials Register: DRKS00027076, 05/11/2021.
Progress and challenges in the elimination of hepatitis C among people who inject drugs in Germany: results of a pilot study for a national monitoring system, 10 years after the first data collection
Authors: Steffen Gyde , Krings Amrei , Guttmann Sarah , Lübke Nadine , Meyer-Schlinkmann Kristin , Tiemann Carsten , Timm Jörg , Walker Andreas , Zimmermann Ruth ,   The DRUCK 2.0-study group, Backmund Markus , Dorsch Hans-Peter , Bayer Sebastian , Ciomber Jörg , Gerlich Miriam , Leicht Astrid , Kießling Martin , Neumeier Esther , Nielsen Stine , Rensmann Willehad , Schäffer Dirk , Ostermann Olaf , Stöter Christiane , Wiedemann Stefan , Wimmer Katrin 
Published: December 2024

Abstract
Background
People who inject drugs (PWID) are at high risk of blood-borne infections, and injection drug use contributes significantly to hepatitis C virus (HCV) transmission. The WHO has therefore set targets of reducing HCV incidence and prevalence among PWID and increasing treatment coverage to eliminate HCV by 2030. The DRUCK study (2011–2014) found high HCV prevalence and low treatment coverage among PWID in Germany. To assess progress in the elimination of HCV among PWID, we conducted a cross-sectional study in two German federal states that piloted a future monitoring.

Methods
PWID aged 16 + who injected drugs (previous 12 months) were recruited in low-threshold drug services and opioid agonist treatment (OAT) practices in Berlin and Bavaria between June 2021 and April 2022. Participants completed a questionnaire on sociodemographics, behaviours and access to care, and were tested for hepatitis B virus (HBV) and HCV, and HIV. Data was analysed regarding HCV prevalence, history of treatment, and risk and prevention behaviours. Results were compared with the DRUCK study.

Results
A total of 588 PWID, with a median age of 39 (range: 17–66) years and 68% (399/587) male, were included in the analysis. Of the participants, 61% (353/574) reported receiving OAT and 14% (66/469) recent use of shared needles/syringes during the last 30 days. History of imprisonment was reported by 77% (444/577) and history of homelessness by 75% (428/569) of participants. Among anti-HCV positive participants, viraemic HCV infections decreased by 44% from 66% (904/1361) in 2011–2014 to 37% (160/432) in 2021–2022, while those with cleared HCV infection and treatment history increased from 20% (266/1361) to 34% (148/432).

Conclusions
Despite a decrease since 2011–2014, viraemic HCV prevalence among PWID in Germany remains high, and treatment coverage is still insufficient. To achieve the WHO targets, universal health coverage and targeted integrated testing and treatment for PWID are needed. PWID receiving OAT and people in prison should be offered testing and treatment at any contact with the medical system. A nationwide monitoring system will help assess successes and remaining gaps, and track progress towards elimination of HCV among PWID in Germany.
Brief Communication: Factors associated with willingness to use long-acting injectable Cabotegravir for HIV pre-exposure prophylaxis (PrEP) among female undergraduate students at a Ugandan university
Authors: Atuhaire Bridget , Muteebwa Laban , Nabunya Racheal , Muhindo Richard , Ngabirano Tom Denis , Osingada Charles Peter , Muwanguzi Patience A. 
Published: December 2024

Abstract
Background
We assessed the willingness of female students at a Ugandan public university to use long-acting Cabotegravir (CAB-LA) for HIV prevention, given their high prevalence of HIV risk behaviours.

Methods
Using an online questionnaire, this cross-sectional study surveyed 346 female undergraduate students aged 18–25. Factors influencing their willingness were analysed with modified Poisson regression and robust standard errors.

Results
More than half, 56.7% (95% CI: 51.4 to 61.8), were willing to use CAB-LA. Willingness was significantly associated with being sexually active in the past 3 months, using alcohol in the past 6 months, or being in the 4th year of study compared to the 1st year.

Conclusion
Educational initiatives on innovative HIV prevention strategies, such as CAB-LA, should be introduced early in university students’ studies to increase awareness and acceptance.
Acute kidney injury and tacrolimus toxicity in a kidney transplant recipient treated with nirmaltrevir/ritonavir: a case report
Authors: Rycen Jack , Jefferis Julia , Mudge David 
Published: December 2024

Abstract
Background
Kidney transplant recipients with severe acute respiratory syndrome-coronavirus-2 infection have an increased risk of severe disease and mortality. Nirmaltrevir/ritonavir (Paxlovid) is an effective oral disease-modifying therapy that has been shown to reduce risk of progression to severe disease in high-risk, nonhospitalized adults. However, owing to the potential for serious drug–drug interactions owing to ritonavir-induced inhibition of the CYP3A enzyme, this drug is not suitable option for transplant recipients with mild-moderate severe acute respiratory syndrome-coronavirus-2 infection.

Case presentation
A 57-year-old Caucasian man presented to the emergency department with 48 hours of nausea, vomiting, headaches, and lethargy. At 5 days earlier, he was diagnosed with a mild severe acute respiratory syndrome-coronavirus-2 infection by his general practitioner, who commenced treatment with Paxlovid at 300 mg/100 mg twice daily. Past medical history included kidney transplantation in 2018 for end-stage kidney secondary to hypertensive nephrosclerosis, managed with prednisone, tacrolimus, and mycophenolate. Vaccination status was up-to-date and prophylactic tixagevimab/cilgavimab (Evusheld) had been given > 6 months prior owing to lack of seroconversion. Examination showed a blood pressure of 176/94 mmHg and normal respiratory parameters. Investigations demonstrated a serum creatinine of 213 µmol/L (baseline 130 µmol/L) and tacrolimus trough level of 118 µg/L (baseline 6.9–8.7 µg/L). Treatment included intravenous rehydration, Evusheld and tacrolimus were withheld for 7 days, with recommencement guided by regular therapeutic drug monitoring.

Conclusion
This acute kidney injury was attributed to tacrolimus toxicity resulting from a drug–drug interaction with Paxlovid. While transplant recipients have an increased risk of severe disease, current Australian guidelines recommend against Paxlovid use in adults taking medications that are heavily dependent on CYP3A4 for clearance, including calcineurin and mammalian target of rapamycin inhibitors.
African swine fever virus enhances viral replication by increasing intracellular reduced glutathione levels, which suppresses stress granule formation
Authors: Gao Han , Gu Taoming , Gao Xiaopeng , Song Zebu , Liu Jing , Song Yi , Zhang Guihong , Sun Yankuo 
Published: December 2024

AbstractAfrican swine fever virus (ASFV) is a DNA virus that has significantly impacted the global swine industry. Currently, there are no effective therapies or vaccines against ASFV. Stress granules (SGs), known for their antiviral properties, are not induced during ASFV infection, even though reactive oxygen species (ROS) are generated. The mechanism by which ASFV regulates SGs formation remains unclear. This study demonstrates that ASFV antagonises SGs formation and increases intracellular levels of reduced glutathione (GSH) levels. The use of the GSH inhibitor BSO and the activator NAC confirmed that the ASFV-induced increase in GSH helps to suppress SGs formation and influences viral replication. Additionally, this study revealed that ASFV enhances GSH by upregulating the antioxidant transcription factor NRF2, as well as factors involved in GSH synthesis and regeneration, such as GCLC, and those related to the ferroptosis pathway, such as SLC7A11. Furthermore, the study uncovered that ASFV manipulates intracellular GSH levels by activating the mitochondrial protein AIFM1. This regulatory mechanism helps the virus inhibit the formation of intracellular SGs, thereby creating an optimal environment for viral replication. These findings provide new insights into the molecular strategies employed by ASFV.
DCNN: a novel binary and multi-class network intrusion detection model via deep convolutional neural network
Authors: Shebl Ahmed , Elsedimy E. I. , Ismail A. , Salama A. A. , Herajy Mostafa 
Published: December 2024

AbstractNetwork security become imperative in the context of our interconnected networks and everyday communications. Recently, many deep learning models have been proposed to tackle the problem of predicting intrusions and malicious activities in interconnected systems. However, they solely focus on binary classification and lack reporting on individual class performance in case of multi-class classification. Moreover, many of them are trained and tested using outdated datasets which eventually impact the overall performance. Therefore, there is a need for an efficient and accurate network intrusion detection system. In this paper, we propose a novel intelligent detection system based on convolutional neural network, namely DCNN. The proposed model can be utilized to efficiently analyze and detect attacks and intrusions in intelligent network systems (e.g., suspicious network traffic activities and policy violations). The DCNN model is applied against three benchmark datasets and compared with state-of-the-art models. Experimental results show that the proposed model improved resilience to intrusions and malicious activities for binary as well as multi-class classification, expanding its applicability across different intrusion detection scenarios. Furthermore, our DCNN model outperforms similar intrusion detection systems in terms of positive predicted value, true positive rate, F1 measure, and accuracy. The scores obtained for binary and multi-class classifications on the CICIoT2023 dataset are 99.50% and 99.25%, respectively. Additionally, for the CICIDS-2017 dataset, DCNN attains a score of 99.96% for both binary and multi-class classifications, while the CICIoMT2024 dataset attains a score of 99.98% and 99.86% for binary and multi-class classifications, respectively.
Sarcomatous transformation of IDH-mutant astrocytoma matching to methylation class oligosarcoma following embolization, a case report
Authors: Landvater Ryan , Tripathy Arushi , Nieblas-Bedolla Edwin , Shao Lina , Conway Kyle , Al-Holou Wajd , Ferris Sean P. 
Published: December 2024

AbstractThe mesenchymal transformations of infiltrating gliomas are uncommon events. This is particularly true of IDH-mutant astrocytomas and oligodendrogliomas, in which mesenchymal transformation is exceedingly rare. oligosarcoma is a newly recognized methylation class (MC) that represents transformed 1p/19q co-deleted oligodendrogliomas, but recent studies indicate it may be non-specific. Herein we report the diffuse sarcomatous transformation of a multifocal recurrent astrocytoma from a precursor IDH-mutant astrocytoma, CNS WHO grade 3, in a young patient following embolization therapy and matching to MC oligosarcoma. The sarcomatous recurrence and original tumor showed identical 17q breakpoints with loss of heterozygosity of TP53. Both lack the defining 1p/19q co-deletion or copy-neutral heterozygosity of an oligodendroglioma and oligosarcoma. The findings in this case report both contribute to the apparent heterogeneity of the novel MC oligosarcoma and describe a second reported mesenchymal transformation of an IDH-mutant astrocytoma.
A novel risk model consisting of nine platelet-related gene signatures for predicting prognosis, immune features and drug sensitivity in glioma
Authors: Wei Sanlin , Zhou Junke , Dong Bin 
Published: December 2024

Abstract
Background
Glioma is a malignancy with challenging clinical treatment and poor prognosis. Platelets are closely associated with tumor growth, propagation, invasion, and angiogenesis. However, the role of platelet-related genes in glioma treatment and prognosis remains unclear.

Results
A prognostic risk model was established using nine platelet-related prognostic signature genes (CAPG, CLIC1, GLB1, GNG12, KIF20A, PDIA4, SULF2, TAGLN2, and WEE1), and the risk score of samples were calculated. Subsequently, the glioma samples were divided into high- and low-risk groups based on the median values of risk scores. scRNA-seq analysis revealed that the prognostic genes were primarily located in astrocytes and natural killer cells. The immune infiltration proportions of most immune cells differed significantly between high- and low-risk groups. Moreover, we found AZD7762 as a potential candidate for glioma treatment.

Conclusion
Nine platelet-related prognostic genes identified as prognostic signatures for glioma were closely associated with the TME and may aid in directing the clinical treatment and prognosis of gliomas.
Understanding the intersecting social, technical, and ecological systems challenges associated with emerging contaminants in drinking water using cyanotoxins as an example
Authors: Kirchhoff Christine J. , Mullin Cristina , Denny Reginald , Lemos Maria Carmen , Treuer Galen 
Published: December 2024

AbstractThis paper investigates toxic algal blooms (TABs) and their management as an example of a complex emerging contaminant (EC) problem through the lens of interconnected social, technical, ecological systems (SETS). We use mixed methods including analysis of a national survey of public drinking water systems and interviews with drinking water managers and state regulators. For the first time, we extend SETS to the drinking water context to advance a holistic understanding of the complexity of TABs as a problem for drinking water systems and identify specific intervention points to ease TABs management difficulty. We find that management challenges arise at the intersection of SET domains, and often coincide with circumstances where water managers and existing technologies are pushed outside of their traditional operating spheres or when new technologies are introduced creating cascading SET challenges. ECs that do not behave like traditional contaminants and pollutants require adapting social and technical systems to be responsive to these differences. Understanding how management difficulties arise within SET domains and their intersections will help drinking water managers and state regulators mitigate management difficulties in the future. These findings have implications for understanding and mitigating other EC management challenges as well.