bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a Weightbearing CT Artificial Intelligence-Based Automatic Measurement for the M1-M2 Intermetatarsal Angle in Hallux Valgus
Authors: Day Jonathan , de Cesar Netto Cesar , Richter Martinus , Mansur Nacime Salomao , Fernando Celine , Deland Jonathan T. , Ellis Scott J. , Lintz François 
Published: June 2021

Background: Weightbearing cone beam computed tomography (WBCT) has been gaining traction as a useful imaging modality in the diagnosis and follow-up of foot and ankle musculoskeletal pathologies due to the ability to perform quick, low-dose, 3-dimensional (3D) scans. However, the resulting wealth of 3D data renders daily clinical use time-consuming. The aim of this study was to evaluate a new artificial intelligence (AI)–based automatic measurement for the M1-M2 intermetatarsal angle (IMA) in hallux valgus (HV). We hypothesized that automatic and manual measurements would have a strong correlation, and that the AI software would yield better reproducibility and would be faster compared with manual measurements. Methods: This was a multicenter retrospective comparative case-control study in which a total of 128 feet were included from 93 patients who underwent WBCT scans as part of their routine follow-up: 59 feet with symptomatic HV and 69 controls. The IMA was measured automatically using the AI software and manually on digitally reconstructed radiographs (DRRs). The AI software produced both an automatic 2D (auto 2D) and 3D (auto 3D) measurement. Results: There were strong intermethod correlations between the DRR IMA and the auto 2D (HV, r = 0.61; control, r = 0.60; all P < .0001) and auto 3D (HV, r = 0.63; control, r = 0.52; all P < .0001) measurements, respectively. The intrasoftware reproducibility was very close to 100%. Measurements took 23.6 ± 2.31 seconds and 14.5 ± 1.18 seconds, respectively, when taken manually on DRRs and automatically. Controls demonstrated a mean DRR IMA of 8.6 (95% CI, 8.1-9.1), mean auto 2D of 11.2 (95% CI, 10.7-11.7), and mean auto 3D IMA of 11.0 (95% CI, 10.5-11.5). The HV group demonstrated significantly increased IMA compared with controls ( P < .0001), with a mean DRR IMA of 15.4 (95% CI, 14.8-16.1), mean auto 2D of 17.8 (95% CI, 17.2-18.4), and mean auto 3D IMA of 16.8 (95% CI, 16.8-17.4). Conclusion: Measurements generated by the WBCT AI-based automatic measurement system for IMA demonstrated strong correlations with manual measurements, with near-perfect reproducibility. Further developments are warranted in order to make this tool more usable in daily practice, particularly with respect to its use in the presence of hardware in the foot. Level of Evidence: Level III, retrospective comparative study.
Suture Anchor Augmentation for Acute Unstable Isolated Ankle Syndesmosis Disruption in Athletes
Authors: Kim Jin Su , Shin Hyuck Soo 
Published: June 2021

Background: Isolated ankle syndesmosis disruption (without fibula fracture) causes acute pain and may cause chronic instability and pain. The aim of the present study was to evaluate the outcomes after anterior inferior tibiofibular ligament (AITFL) anatomical fixation using anchor sutures for unstable isolated syndesmosis disruption without fibular fractures. Methods: This study assessed 22 athletes who were diagnosed with unstable isolated syndesmosis disruption with a positive external rotation test, had more than 2-mm diastasis on ultrasound, and had complete AITFL rupture on magnetic resonance imaging between 2004 and 2020. Eighteen patients (82%) were elite-level athletes, and the remaining 4 were recreational athletes. Twelve patients (55%) were injured by an external rotation force. The athletes underwent open anatomical suture anchor fixation between the AITFL attachment sites, the fibula and tibia. The mechanism of injury, return-to-play time, and Foot and Ankle Outcome Score (FAOS) were evaluated. Results: All athletes returned to previous play except 1 retired elite athlete. Twenty-two athletes returned to jogging, team training, and official game play at an average of 62, 89, and 102 days, respectively. The final average follow-up FAOS symptom, pain, daily activity, sports activity, and quality of life scores were 98, 97, 100, 99, and 97, respectively. Two athletes were reinjured, and 1 required reoperation in the follow-up period. Conclusion: Athletes with isolated syndesmosis disruption had a high likelihood to return to their previous activity level after suture anchor augmentation. Level of Evidence: Level IV, case series.
Four-Dimensional CT Analysis of Normal Syndesmotic Motion
Authors: Wong Murray T. , Wiens Charmaine , Lamothe Jeremy , Edwards W. Brent , Schneider Prism S. 
Published: June 2021

Background: The syndesmosis ligament complex stabilizes the distal tibiofibular joint while allowing for small amounts of physiologic motion. When injured, malreduction of the syndesmosis is the most important factor that contributes to inferior functional outcomes. Syndesmotic reduction is a dynamic measure, which is not adequately captured by conventional computed tomography (CT). Four-dimensional CT (4DCT) can image joints as they move through range of motion (ROM). The aim of this study was to employ 4DCT to determine in vivo syndesmotic motion with ankle ROM in uninjured ankles. Methods: Uninjured ankles were analyzed in patients who had contralateral syndesmotic injuries, as well as a cohort of healthy volunteers with bilateral uninjured ankles. Bilateral ankle 4DCT scans were performed as participants moved their ankles between maximal dorsiflexion and plantarflexion. Multiple measures of syndesmotic width, as well as sagittal translation and fibular rotation, were automatically extracted from 4DCT using a custom program to determine the change in syndesmotic position with ankle ROM. Results: Fifty-eight ankles were analyzed. Measures of syndesmotic width decreased by 0.7 to 1.1 mm as the ankle moved from dorsiflexion to plantarflexion ( P < .001 for each measure). The fibula externally rotated by 1.2 degrees with ankle ROM ( P < .001), but there was no significant motion in the sagittal plane ( P = .43). No participants with bilateral uninjured ankles had a side-to-side difference in syndesmotic width of 2 mm or greater. Conclusion: 4DCT allows accurate, in vivo syndesmotic measurements, which change with ankle ROM, confirming prior work that was limited to biomechanical studies. Side-to-side syndesmotic measurements are consistent within subjects, validating the method of templating syndesmotic reduction off the contralateral ankle, in a consistent ankle position, to achieve anatomic reduction of syndesmotic injury. Level of Evidence: Level II, prospective cohort study.
Safety and effectiveness of subcutaneously anchored securement for tunneled central catheters in oncological pediatric patients: A retrospective study
Authors: Crocoli Alessandro , Martucci Cristina , Sidro Luca , Delle Donne Daniela , Menna Giuseppe , Pittiruti Mauro , De Pasquale Maria Debora , Strocchio Luisa , Natali Gian Luigi , Inserra Alessandro 
Published: June 2021

Background: Proper securement of central venous catheters plays an important role in onco-hematological pediatric patients. A new subcutaneously anchored securement device has been recently introduced in the clinical practice, and it has been extensively used in children. Method: In our study, we have retrospectively investigated the safety and the effectiveness of such device, reviewing the experience of three Italian pediatric oncological units. We have considered only tunneled catheters (cuffed or non-cuffed) inserted in children with malignancy; all types of tunneled central catheters were included in the analysis (both centrally and peripherally inserted) as long as they were secured with a subcutaneously anchored device. We investigated the incidence of dislodgment and of other catheter-related complications, with special attention to local adverse effects potentially related to the securement device. Results: We collected data from 311 tunneled catheters of different caliber: 80.4% were centrally inserted central catheters (CICC), 15.4% were peripherally inserted (PICC), and 4.2% were femorally inserted. Approximately half of the catheters (51%) were non-cuffed. Incidence of dislodgment was very low (2.6%) and the incidence of local pain or inflammation potentially related to the securement device was minimal (1.9%). Catheter related bacteremias were below 1 episode/1000 catheter days. No symptomatic catheter related thrombosis was reported. There was no significant difference in complications comparing cuffed versus non-cuffed catheters, or CICCs versus PICCs, or hematologic tumors versus solid tumors. Conclusion: In our retrospective analysis of a vast population of oncological pediatric patients with tunneled central catheters, the subcutaneously anchored securement device was tolerated very well, and it was highly effective in preventing dislodgment, both in cuffed and non-cuffed catheters.
How bilinguals refer to Mandarin throwing actions in English
Authors: Nicoladis Elena , Gao Helena Hong 
Published: June 2021

Aims and Objectives: In the present study, we tested how Mandarin-English bilinguals choose English words to refer to prototypical Mandarin throwing actions. Languages differ in how they refer to events. In Mandarin and English, words for throwing actions differ notably on a variety of dimensions so there are few perfect translation equivalents. In previous studies, when faced with the challenge of how to speak about such events, bilinguals sometimes use language-specific ways in each language, sometimes show convergence, sometimes use more general terms, and there are times when they can be quite creative. Design/Methodology: We showed video clips of six prototypical Mandarin throwing actions (corresponding to rēng 扔, diū 丢, pāo 抛, tóu 投, shuāi 摔, shuǎi 甩) to Mandarin-English bilinguals and English monolinguals. Participants labeled the actions and chose the English word most closely corresponding to the action. The bilinguals did the same in Mandarin. Findings/Conclusion: The results showed that the bilinguals chose many of the same words in English as English monolinguals did. However, the bilinguals differed from the monolinguals in two ways: (1) they tended to choose more different responses and (2) they referred to diū 丢 actions most often as throw rather than lob as the monolinguals did. Originality: These results suggest that bilinguals use a variety of strategies to refer to the not-easily-translatable.
Clinical Outcomes After Aggressive Active Early Motion and Modified Kleinert Regimens: Comparison of 2 Consecutive Cohorts
Authors: Jokinen Kaisa , Häkkinen Arja , Luokkala Toni , Karjalainen Teemu 
Published: June 2021

Background Modern multistrand repairs can withstand forces present in active flexion exercises, and this may improve the outcomes of flexor tendon repairs. We developed a simple home-based exercise regimen with free wrist and intrinsic minus splint aimed at facilitating the gliding of the flexor tendons and compared the outcomes with the modified Kleinert regimen used previously in the same institution. Methods We searched the hospital database to identify flexor tendon repair performed before and after the new regimen was implemented and invited all patients to participate. The primary outcome was total active range of motion, and secondary outcomes were Disabilities of Arm, Shoulder, and Hand; grip strength; globally perceived function; and the quality of life. Results The active range of motion was comparable between the groups (mean difference = 14; 95% confidence interval [CI], −8 to 36; P = .22). Disabilities of Arm, Shoulder, and Hand; grip strength; global perceived function; and health-related quality of life were also comparable between the groups. There was 1 (5.3%) rupture in the modified Kleinert group and 4 (15.4%) in the early active motion group (relative risk = 0.3; 95% CI, 0.04-2.5; P = .3). Conclusions Increasing active gliding with a free wrist and intrinsic minus splint did not improve the clinical outcomes after flexor tendon injury at a mean of 38-month follow-up.
Comparison of Marital and Sexual Functioning of the Spouses of Patients with Schizophrenia and Depressive Disorders
Authors: Aggarwal Shivali , Grover Sandeep , Chakrabarti Subho 
Published: June 2021

Aim: This study assessed the various aspects of marital functioning among the spouses of patients with schizophrenia and recurrent depressive disorder (RDD). Methodology: Spouses were assessed on Dyadic Adjustment Scale (DAS), Marital Forgiveness Scale, Quality Marriage Index, New Sexual Satisfaction Scale, and Arizona Sexual Experience Questionnaire. Results: Compared to the spouses of patients with RDD, spouses of patients with schizophrenia reported poor marital adjustment (in the consensus and satisfaction domains of DAS), lower quality of marriage, and significantly lower sexual satisfaction. Spouses did not differ significantly on account of marital forgiveness and prevalence of sexual dysfunction. Higher age of onset of schizophrenia in the patients was associated with better quality of marriage as assessed by using quality of marriage scale, better consensus, and satisfaction as per the DAS. Higher residual psychopathology and poor socio-occupational functioning in patients with schizophrenia were associated with poor marital adjustment and sexual satisfaction. Conclusion: To conclude, the present study depicts that the spouses of patients with schizophrenia have poorer marital adjustment and sexual satisfaction, in comparison to the spouses of patients with RDD.
Bone marrow aspirate concentrate/platelet-rich fibrin augmentation accelerates healing of aseptic upper limb nonunions
Authors: Mazzotta Alessandro , Stagni Cesare , Rocchi Martina , Rani Nicola , Del Piccolo Nicolandrea , Filardo Giuseppe , Dallari Dante 
Published: June 2021

Abstract
Introduction
Nonunions remain a significant burden in orthopedics, often afflicting young males of working age. Positive findings have been published using bone marrow aspirate concentrate (BMAC) and platelet-rich fibrin (PRF) for the treatment augmentation of lower limb nonunions. The aim of this study was to investigate if the treatment augmentation with BMAC and PRF can also accelerate the healing of nonunions of the upper limb.

Materials and methods
Sixty-eight patients (45 men, 23 women) affected by 75 nonunions of long bones of the upper limb were treated and divided into two groups. The first series was treated with standard surgery alone (group A); afterwards, the second series benefited from standard surgery with the addition of BMAC and PRF applied on lyophilized bone chips. Nonunions were classified radiographically according to the Weber–Cech method and prognostically using the Calori and Moghaddam scores. All patients were radiographically assessed at 1.5, 3, 6, 12, and 24 months of follow-up.

Results
Baseline demographic characteristics did not present differences between groups. No differences were documented in terms of complications (two in group A and three in group B). Significant differences were instead documented in terms of healing time. The first healing signs were observed 1.5 months after surgery in 90.7% of patients in group B and 34.4% of group A (p < 0.0005). At 1.5, 3, 6, and 12 months, a higher radiographic score was found for group B (all p < 0.0005), while no difference was found at final follow-up of 24 months (90.6% of group A and 97.7% of group B achieved radiological healing). Faster healing with BMAC/PRF augmentation was confirmed for all bones, as well as for the subgroup of patients affected by atrophic nonunions (p = 0.001).

Conclusion
This study showed the benefits of restoring both mechanical and biological aspects when addressing nonunions of the long bones of the upper limb. In particular, the association of BMAC and PRF to lyophilized bone chips was safe and able to accelerate healing time. These good results were confirmed for humerus, radius, and ulna sites, as well as for challenging atrophic nonunions of the upper limb.
Tumor suppressive role of miR-33a-5p in pancreatic ductal adenocarcinoma cells by directly targeting RAP2A
Authors: Lian Yanfen , Jiang Dongxiao , Sun Jiangtao 
Published: June 2021

Abstract
Background
The suppressive effects of miR-33a-5p have been reported in colorectal cancer and lung cancer. However, the functional role of miR-33a-5p in pancreatic ductal adenocarcinoma (PDAC) has not yet been elucidated.

Methods
The expression of miR-33a-5p was determined using reverse-transcription quantitative PCR (RT-qPCR) in PDAC tissues and cell lines. The association between miR-33a-5p expression and clinical categorical parameters was analyzed by the chi-square test. Cell proliferation was analyzing by Cell Counting Kit -8 (CCK-8) assay. Transwell assay was utilized to assess cell migration and invasion. The interactions between miR-33a-5p and RAP2A were verified by luciferase reporter assay, RT-qPCR, western blot analysis and RNA immunoprecipitation (RIP) assay.

Results
Here, we observed for the first time that miR-33a-5p expression level was significantly decreased in PDAC tissues and cell lines. There was a significant association between decreased miR-33a-5p expression and TNM stage or lymph node metastasis. Overexpression of miR-33a-5p significantly inhibited SW1990 and PANC-1 cell proliferation, migration and invasion. Knockdown of miR-33a-5p remarkedly promoted cell proliferation, migration and invasion in BxPC-3 and ASPC-1. Mechanistically, RAP2A was confirmed as the target of miR-33a-5p in PDAC cells. Moreover, RAP2A overexpression abolished miR-33a-5p-mediated suppressive effects on SW1990 and PANC-1 cells.

Conclusions
Taken together, these results suggest that miR-33a-5p exerted tumor suppressive effects on PDAC cells by targeting RAP2A, which might provide a new theoretical basis for the clinical treatment of PDAC.
Overcoming uncollapsed haplotypes in long-read assemblies of non-model organisms
Authors: Guiglielmoni Nadège , Houtain Antoine , Derzelle Alessandro , Van Doninck Karine , Flot Jean-François 
Published: June 2021

Abstract
Background
Long-read sequencing is revolutionizing genome assembly: as PacBio and Nanopore technologies become more accessible in technicity and in cost, long-read assemblers flourish and are starting to deliver chromosome-level assemblies. However, these long reads are usually error-prone, making the generation of a haploid reference out of a diploid genome a difficult enterprise. Failure to properly collapse haplotypes results in fragmented and structurally incorrect assemblies and wreaks havoc on orthology inference pipelines, yet this serious issue is rarely acknowledged and dealt with in genomic projects, and an independent, comparative benchmark of the capacity of assemblers and post-processing tools to properly collapse or purge haplotypes is still lacking.

Results
We tested different assembly strategies on the genome of the rotifer Adineta vaga, a non-model organism for which high coverages of both PacBio and Nanopore reads were available. The assemblers we tested (Canu, Flye, NextDenovo, Ra, Raven, Shasta and wtdbg2) exhibited strikingly different behaviors when dealing with highly heterozygous regions, resulting in variable amounts of uncollapsed haplotypes. Filtering reads generally improved haploid assemblies, and we also benchmarked three post-processing tools aimed at detecting and purging uncollapsed haplotypes in long-read assemblies: HaploMerger2, purge_haplotigs and purge_dups.

Conclusions
We provide a thorough evaluation of popular assemblers on a non-model eukaryote genome with variable levels of heterozygosity. Our study highlights several strategies using pre and post-processing approaches to generate haploid assemblies with high continuity and completeness. This benchmark will help users to improve haploid assemblies of non-model organisms, and evaluate the quality of their own assemblies.
Putative markers for the detection of early-stage bladder cancer selected by urine metabolomics
Authors: Lin Jia-You , Juo Bao-Rong , Yeh Yu-Hsuan , Fu Shu-Hsuan , Chen Yi-Ting , Chen Chien-Lun , Wu Kun-Pin 
Published: June 2021

Abstract
Background
Early detection of bladder cancer remains challenging because patients with early-stage bladder cancer usually have no incentive to take cytology or cystoscopy tests if they are asymptomatic. Our goal is to find non-invasive marker candidates that may help us gain insight into the metabolism of early-stage bladder cancer and be examined in routine health checks.

Results
We acquired urine samples from 124 patients diagnosed with early-stage bladder cancer or hernia (63 cancer patients and 61 controls). In which 100 samples were included in our marker discovery cohort, and the remaining 24 samples were included in our independent test cohort. We obtained metabolic profiles of 922 compounds of the samples by gas chromatography-mass spectrometry. Based on the metabolic profiles of the marker discovery cohort, we selected marker candidates using Wilcoxon rank-sum test with Bonferroni correction and leave-one-out cross-validation; we further excluded compounds detected in less than 60% of the bladder cancer samples. We finally selected eight putative markers. The abundance of all the eight markers in bladder cancer samples was high but extremely low in hernia samples. Moreover, the up-regulation of these markers might be in association with sugars and polyols metabolism.

Conclusions
In the present study, comparative urine metabolomics selected putative metabolite markers for the detection of early-stage bladder cancer. The suggested relations between early-stage bladder cancer and sugars and polyols metabolism may create opportunities for improving the detection of bladder cancer.
Genome-wide identification and expression analysis of the bHLH transcription factor family and its response to abiotic stress in sorghum [Sorghum bicolor (L.) Moench]
Authors: Fan Yu , Yang Hao , Lai Dili , He Ailing , Xue Guoxing , Feng Liang , Chen Long , Cheng Xiao-bin , Ruan Jingjun , Yan Jun , Cheng Jianping 
Published: June 2021

Abstract
Background
Basic helix-loop-helix (bHLH) is a superfamily of transcription factors that is widely found in plants and animals, and is the second largest transcription factor family in eukaryotes after MYB. They have been shown to be important regulatory components in tissue development and many different biological processes. However, no systemic analysis of the bHLH transcription factor family has yet been reported in Sorghum bicolor.

Results
We conducted the first genome-wide analysis of the bHLH transcription factor family of Sorghum bicolor and identified 174 SbbHLH genes. Phylogenetic analysis of SbbHLH proteins and 158 Arabidopsis thaliana bHLH proteins was performed to determine their homology. In addition, conserved motifs, gene structure, chromosomal spread, and gene duplication of SbbHLH genes were studied in depth. To further infer the phylogenetic mechanisms in the SbbHLH family, we constructed six comparative syntenic maps of S. bicolor associated with six representative species. Finally, we analyzed the gene-expression response and tissue-development characteristics of 12 typical SbbHLH genes in plants subjected to six different abiotic stresses. Gene expression during flower and fruit development was also examined.

Conclusions
This study is of great significance for functional identification and confirmation of the S. bicolor bHLH superfamily and for our understanding of the bHLH superfamily in higher plants.