bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learn from Object Counting: Crowd Counting with Meta‐learning
Authors: Zan Changtong , Liu Baodi , Guan Weili , Zhang Kai , Liu Weifeng 
Published: May 2021

AbstractThe objective of crowd counting is to learn a counter that can estimate the number of people in a single image. So far, most of the proposed work evaluates the crowd density by fitting the constructed density map corresponding to the sample. The performance of those algorithms depends on a large amount of carefully prepared data. However, a significant problem with crowd data sets is the difficulty of labeling. To address such a situation, utilizing object counting data in few‐shot scenes is considered and an efficient algorithm to extract the meta‐information is proposed, thus improving the accuracy and convergence rate of the crowd counting tasks. Specifically, the counting network is trained with only object counting tasks constructed on different domains during the meta‐training phase. Then, the meta‐counter is testing on crowd counting tasks in the meta‐testing stage. Experimentally, it is demonstrated that the above way improves the converge rate and accuracy of crowd counting tasks on three crowd counting datasets when meta‐training on ten‐type object counting tasks.
Endoskopische Tunnelungsverfahren bei Achalasie und Gastroparese
Authors: Schad Christopher Moritz , Wildner Nadia , Gundling Felix 
Published: May 2021

ZusammenfassungSeit der Erstpublikation der peroralen endoskopischen Myotomie (POEM) durch Haruhiro Inoue et al. im Jahr 2008 in Japan haben sich verschiedene neuartige endoskopische Verfahren etabliert, welche nach iatrogener Schaffung eines submukosalen Tunnels als „neuen Raum“ durchgeführt werden 1. Über den künstlich gebildeten Zugangsweg in der Tela submucosa können unter sorgfältiger Schonung der obersten Schleimhautschicht Interventionen im Bereich der Muskelschicht von Ösophagus und Magen durchgeführt werden 2. Diese umfassen z. B. neben der Myotomie der Ösophagusmuskulatur bei Achalasie (POEM) die Durchtrennung des Pylorus bei Gastroparese (Antropyloromyotomie, G-POEM). Weitere Einsatzgebiete sind die Spaltung des Zenker-Divertikels in POEM-Technik („Z-POEM“) sowie die Entfernung subepithelialer Tumoren (STER: submukosale Tunnelung, endoskopische Resektion). Der langfristige Therapieerfolg (mit > 80 % Ansprechen) dieser innovativen Verfahren ist v. a. bei der Achalasie mittlerweile durch kontrollierte Studien belegt 2
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Nicht alles Milchglas ist COVID-19 – Pneumocystis-jirovecii-Pneumonie als Differenzialdiagnose
Authors: Schüßler Meike , Müller Frank , Rauschning Dominic 
Published: May 2021

Zusammenfassung
Anamnese und klinischer Befund Ein 68 Jahre alter männlicher Patient mit einer Psoriasis und einem bullösen Pemphigoid als Grunderkrankungen entwickelte unter einer länger anhaltenden, höher dosierten immunsuppressiven Therapie mit Methylprednisolon eine klinische Beschwerdesymptomatik mit trockenem Reizhusten, einer progredienten Dyspnoe und Fieber.
Untersuchungen und Diagnose Im CT-Thorax zeigten sich beidseitige Milchglasinfiltrate. Nach Ausschluss von COVID-19 wurde eine Pneumocystis-jirovecii-Pneumonie (PCP) nachgewiesen.
Therapie und Verlauf Es wurde daraufhin eine entsprechende hochdosierte Therapie mit Trimethoprim-Sulfamethoxazol zeitnah eingeleitet. Gleichwohl entwickelte sich ein komplizierter Verlauf mit bakterieller Superinfektion und pulmonaler Aspergillose sowie ARDS.
Diskussion und Folgerung In Abgrenzung zu COVID-19 werden der typische Verlauf sowie Diagnostik und Therapie der Pneumocystis-jirovecii-Pneumonie diskutiert. Es wird insbesondere darauf abgehoben, dass auch in einer Pandemiesituation nicht alle Milchglasinfiltrate im CT-Thorax-Bild auf COVID-19 zurückzuführen sind. Mögliche Differenzialdiagnosen sollten stets bedacht und in der Diagnostik berücksichtigt werden.
Zusammenhang von Bildungsstatus und Diabetesoutcomes: Ergebnisse der DIAS-Studie bei Kindern und Jugendlichen mit Typ-1-Diabetes in Deutschland
Authors: Müller-Godeffroy Esther , Mönkemöller Kirsten , Lilienthal Eggert , Heidtmann Bettina , Becker Marianne , Feldhahn Lutz , Freff Markus , Hilgard Dörte , Krone Beate , Papsch Matthias , Schumacher Andrea , Schwab Karl-Otfried , Schweiger Heidemarie , Wolf Johannes , Bollow Esther , Holl Reinhard 
Published: May 2021

Zusammenfassung
Fragestellung Assoziation zwischen Bildungsstand (BldS) der Eltern und diabetesbezogenen Outcomes bei Kindern mit Typ-1-Diabetes in Deutschland und Vergleich mit deren sozioökonomischem Status (SES).
Material und Methode 1781 Kinder und Jugendliche mit Typ-1-Diabetes mellitus unter 18 Jahren aus 13 deutschen Diabeteszentren wurden von Juni 2013 bis Juni 2014 in die Studie eingeschlossen und Assoziationen des familiären BldS mit verschiedenen Diabetesoutcomes analysiert. Die Analyse wurde als Sekundäranalyse anhand des Datensatzes der DIAS-Studie durchgeführt. Diese hatte Assoziationen eines niedrigen SES (gemessen mit einem Index aus BldS, beruflicher Stellung und Haushaltseinkommen der Eltern) mit ungünstigen Diabetes- und Versorgungsoutcomes ermittelt. Die vorliegende Sekundäranalyse untersuchte Assoziationen derselben Outcomes mit dem BldS der Eltern, um zu prüfen, ob sich der BldS als vereinfachter Indikator für die Routinemessung des SES eignet.Die Daten wurden mittels der DPV-Software (Diabetes-Patienten-Verlaufsdokumentation) erfasst, die Analysen erfolgten je nach Verteilungscharakteristika der Outcomes mittels linearer, logistischer, negativ-binomialer oder Poisson-Modellen unter Adjustierung für Alter, Geschlecht, Diabetesdauer, jeweils mit und ohne zusätzliche Adjustierung für Migrationshintergrund.
Ergebnisse Niedriger familiärer BldS war im Vergleich zu mittlerem/hohem BldS mit einer schlechteren glykämischen Einstellung (HbA1c) (8,1 % versus 7,8 %, p < 0,0001/7,6 %, p < 0,0001) und einem geringeren prozentualen Anteil an Insulinpumpennutzung (42,7 % versus 56,3 %, p < 0,0001/52,5 %, p < 0,01) assoziiert. Weiterhin zeigten die Gruppen mit niedrigem im Vergleich zu mittlerem/hohem BldS seltenere tägliche Blutzuckerselbstmessungen, einen höheren Body-Mass-Index und längere stationäre Aufenthalte. Schwere Hypoglykämien und Ketoazidosen traten bei Patienten mit niedrigem BldS nicht häufiger auf. Der BldS der Eltern differenzierte dabei mindestens genauso gut zwischen den sozialen Gruppen wie der mit einem komplexen Indikator gemessene SES.
Zusammenfassung Der BldS der Eltern ist ein bedeutsamer Prädiktor für Gesundheits- und Versorgungsoutcomes bei Kindern mit Typ-1-Diabetes und sollte in der personalisierten Diabetestherapie von Kindern und Jugendlichen mehr Berücksichtigung erfahren. Als kurzer und leicht zu erhebender Indikator bildet er einen guten Näherungswert für die Routineerhebung der individuellen Stellung der Patientinnen und Patienten in der Sozialhierarchie in Diabetes-Standarddokumentationen.
Safety and Efficacy of Different Antithrombotic Strategies after Transcatheter Aortic Valve Implantation: A Network Meta-Analysis
Authors: Navarese Eliano Pio , Grisafi Leonardo , Spinoni Enrico Guido , Mennuni Marco Giovanni , Rognoni Andrea , Ratajczak Jakub , Podhajski Przemysław , Koni Endrin , Kubica Jacek , Patti Giuseppe 
Published: May 2021

Abstract
Background The optimal pharmacological therapy after transcatheter aortic valve implantation (TAVI) remains uncertain. We compared efficacy and safety of various antiplatelet and anticoagulant approaches after TAVI by a network meta-analysis.
Methods A total of 14 studies (both observational and randomized) were considered, with 24,119 patients included. Primary safety endpoint was the incidence of any bleeding complications during follow-up. Secondary safety endpoint was major bleeding. Efficacy endpoints were stroke, myocardial infarction, and cardiovascular mortality. A frequentist network meta-analysis was conducted with a random-effects model. The following strategies were compared: dual antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT), oral anticoagulation (OAC), and OAC + SAPT. The mean follow-up was 15 months.
Results In comparison to DAPT, SAPT was associated with a 44% risk reduction of any bleeding (odds ratio [OR]: 0.56 [95% confidence interval, CI: 0.39–0.80]). SAPT was ranked as the safest strategy for the prevention of any bleeding (p-score: 0.704), followed by OAC alone (p-score: 0.476) and DAPT (p-score: 0.437). Consistent results were observed for major bleeding. The incidence of cardiovascular death and secondary ischemic endpoints did not differ among the tested antithrombotic approaches. In patients with indication for long-term anticoagulation, OAC alone showed similar rates of stroke (OR: 0.92 [95% CI: 0.41–2.05], p = 0.83) and reduced occurrence of any bleeding (OR: 0.49 [95% CI: 0.37–0.66], p < 0.01) versus OAC + SAPT.
Conclusion The present network meta-analysis supports after TAVI the use of SAPT in patients without indication for OAC and OAC alone in those needing long-term anticoagulation.
Autoimmune Coagulation Factor X Deficiency as a Rare Acquired Hemorrhagic Disorder: A Literature Review
Authors: Ichinose Akitada , Osaki Tsukasa , Souri Masayoshi 
Published: May 2021

AbstractCoagulation factor X (F10) amplifies the clotting reaction in the middle of the coagulation cascade, and thus F10 deficiency leads to a bleeding tendency. Isolated acquired F10 deficiency is widely recognized in patients with immunoglobulin light-chain amyloidosis or plasma cell dyscrasias. However, its occurrence as an autoimmune disorder is extremely rare. The Japanese Collaborative Research Group has been conducting a nationwide survey on autoimmune coagulation factor deficiencies (AiCFDs) starting in the last decade; we recently identified three patients with autoimmune F10 deficiency (AiF10D). Furthermore, an extensive literature search was performed, confirming 26 AiF10D and 28 possible cases. Our study revealed that AiF10D patients were younger than patients with other AiCFDs; AiF10D patients included children and were predominantly male. AiF10D was confirmed as a severe type of bleeding diathesis, although its mortality rate was not high. As AiF10D patients showed only low F10 inhibitor titers, they were considered to have nonneutralizing anti-F10 autoantibodies rather than their neutralizing counterparts. Accordingly, immunological anti-F10 antibody detection is highly recommended. Hemostatic and immunosuppressive therapies may help arrest bleeding and eliminate anti-F10 antibodies, leading to a high recovery rate. However, further investigation is necessary to understand the basic characteristics and proper management of AiF10D owing to the limited number of patients.
Design Requirements for Scapholunate Interosseous Ligament Reconstruction
Authors: Werner Frederick W. 
Published: May 2021

Abstract
Background As numerous repairs, reconstructions, and replacements have been used following scapholunate interosseous ligament (SLIL) injury, there is a need to define the structural requirements for any reconstruction or replacement.
Methods Research has been conducted on the force needed to keep the scaphoid and lunate reduced following simulated injury, the failure force of the native SLIL and various replacements, the stiffness of the SLIL and replacements, and the torsional resistance of the scaphoid relative to the lunate.
Results Forces on the order of 50 N are needed to keep the scaphoid and lunate reduced during simple wrist motions in the chronically injured wrist. Even greater forces (up to 110 N) are needed to keep the bones reduced during strenuous activities, such as pushups. The failure force of the entire SLIL has been reported to be as high as 350 N and the failure force of just the dorsal component of the SLIL to be 270 N.
Conclusions The design requirements for a reconstruction or repair may vary depending upon the demands of the patient. In a high demand patient, a reconstruction needs to support the above-mentioned forces during cyclic loading (50 N), when performing strenuous activities (110 N), or during a fall (at least 350 N). Any artificial replacement must undergo careful biocompatibility testing.
Arthroscopic Repair of the Dorsal Intercarpal Ligament Detachment from the Scaphoid
Authors: Merlini Lorenzo , Mathoulin Christophe 
Published: May 2021

Abstract
Background The dorsal intercarpal ligament, whose role in dorsal stability of the wrist has been shown, can be harmed in case of injury to the dorsal scapholunate complex. However, dorsal intercarpal ligament injury also seems to exist isolated posttraumatic forms of dorsal intercarpal ligament rupture, much rarer, through bony avulsion on its scaphoid insertion. The authors report the first description of this lesion, and propose a technique for arthroscopic repair.
Description of Technique Radiocarpal arthroscopy will confirm the bony avulsion of the dorsal intercarpal ligament from the scaphoid. Under arthroscopic control, an anchor can be placed into the dorsal aspect of the scaphoid and the ligament can be reattached along with the dorsal capsule.
Patients and Methods Between 2018 and 2020, seven patients underwent arthroscopic repair of this particular injury. They presented a painful preoperative wrist with decreased range of motion, and were treated arthroscopically, with anchored reinsertion of the ligament on the scaphoid.
Results After a mean follow-up period of 12 months, arthroscopic repair showed decreased pain (6.7 to 0.2), improved range of motion in flexion (66 to 82 degrees) and extension (57 to 87 degrees°), and improved Disabilities of the Arm, Shoulder, and Hand (DASH) score (68.45 to 2.23).
Conclusions This lesion has so far never been reported in the literature, and seems mechanically different from more common injuries of the scapholunate complex and dorsal capsulo-scapholunate septum with which dorsal intercarpal ligament ruptures are frequently associated. Arthroscopic repair with an anchor is possible without difficulty and seems to give very good results at 1-year follow-up (normal strength and range of motion).
Which Asymmetric Tibial Component Is Optimally Designed for Calipered Kinematically Aligned Total Knee Arthroplasty?
Authors: Nedopil Alexander J. , Zamora Tomas , Delman Connor , Howell Stephen M. , Hull Maury L. 
Published: May 2021

AbstractCalipered kinematically aligned (KA) total knee arthroplasty (TKA) restores the patient's prearthritic joint lines and sets internal-external rotation of the tibial component parallel to the flexion-extension (FE) plane, which is not a mechanical alignment (MA) target. Two asymmetric tibial components designed for MA set the tibial component to either a femoral component (FC) target or a tibial tubercle (TT) target. The study determined the optimal asymmetric tibial component to use with KA as the one with smaller IE deviation from the MA target, greater coverage of tibial resection, and lower incidence of cortical overhang. The study included 40 patients treated with bilateral calipered KA TKA with different asymmetric tibial components in opposite knees. A best-fit of a kinematic tibial template to the tibial resection set the template's slot parallel to the knee's FE plane. Each asymmetric tibial component's anterior-posterior (AP) axis was set parallel to the slot. Computer tomography analysis determined the IE deviation (−internal/+ external) of each tibial component from its MA target, tibial resection coverage by the baseplate and insert, and incidence of cortical overhang. The patient-reported Forgotten Joint Score (FJS) and Oxford Knee Score (OKS) determined outcomes. The mean IE deviation from the MA target was 2 degrees external for the FC-target asymmetric tibial component and −8 degrees internal for the TT-target asymmetric tibial component (p < 0.001). Tibial resection coverage by the baseplate (insert) was 88% (84%) for the FC target and 84% (79%) for the TT target (p < 0.001 for baseplate and insert). The FC target insert covered 3 mm more of the posterolateral resection (p < 0.001). Posteromedial coverage was comparable. The incidence of cortical overhang was 2.5% for each baseplate. There was no difference in FJS and OKS. When performing calipered KA, the more optimal design was the asymmetric tibial component with the FC target because of the smaller deviation from its MA target and the greater coverage of the tibial resection by the baseplate and insert.
Interobserver Reliability and Change in the Sagittal Tibial Tubercle–Trochlear Groove Distance with Increasing Knee Flexion Angles
Authors: MacLean Ian S. , Southworth Taylor M. , Dempsey Ian J. , Naveen Neal B. , Huddleston Hailey P. , Lansdown Drew A. , Yanke Adam B. 
Published: May 2021

AbstractThe tibial tubercle–trochlear groove (TT-TG) distance is currently utilized to evaluate knee alignment in patients with patellar instability. Sagittal plane pathology measured by the sagittal tibial tubercle–trochlear groove (sTT-TG) distance has been described in instability but may also be important to consider in patients with cartilage injury. This study aims to (1) describe interobserver reliability of the sTT-TG distance and (2) characterize the change in the sTT-TG distance with respect to changing knee flexion angles. In this cadaveric study, six nonpaired cadaveric knees underwent magnetic resonance imaging (MRI) studies at each of the following degrees of knee flexion: −5, 0, 5, 10, 15, and 20. The sTT-TG distance was measured on the axial T2 sequence. Four reviewers measured this distance for each cadaver at each flexion angle. Intraclass correlation coefficients were calculated to determine interobserver reliability and reproducibility of the sTT-TG measurement. Analysis of variance (ANOVA) tests and Friedman's tests with a Bonferroni's correction were performed for each cadaver to compare sTT-TG distances at each flexion angle. Significance was defined as p < 0.05. There was excellent interobserver reliability of the sTT-TG distance with all intraclass correlation coefficients >0.9. The tibial tubercle progressively becomes more posterior in relation to the trochlear groove (more negative sTT-TG distance) with increasing knee flexion. The sTT-TG distance is a measurement that is reliable between attending surgeons and across training levels. The sTT-TG distance is affected by small changes in knee flexion angle. Awareness of knee flexion angle on MRI is important when this measurement is utilized by surgeons.
Meniscal Suture Influence on Driving Ability 6 Weeks after Anterior Cruciate Ligament Reconstruction with Hamstring Autograft
Authors: Perez-Mozas Maria , Payo-Ollero Jesus , Montiel Veronica , Valenti-Nin Juan Ramon , Valenti-Azcarate Andres 
Published: May 2021

AbstractThe purpose of this study was to determine if driving ability 6 weeks after anterior cruciate ligament (ACL) reconstruction is affected by the addition of a meniscal suture. It was also hypothesized that no differences in the driving performance would be found between right or left knee surgery subgroups. A total of 82 people participated in this prospective cohort study: 36 healthy controls, 26 patients undergoing isolated ACL (iACL) reconstruction with hamstring autograft, and 20 patients undergoing ACL and meniscal suture (ACL-MS) reconstruction. ACL-MS group followed a weight-bearing and movement restriction protocol during the first 2 postoperative weeks, whereas patients undergoing iACL could start range-of-motion exercises and full weight-bearing ambulation on the first postoperative day. A driving simulator that reproduced real-life driving conditions was used to evaluate driving ability. The software analyzed multiple driving and braking variables. Driving performance in the sixth postoperative week was compared with that of a healthy control group. Subgroup analysis considering additional procedures (iACL, ACL-MS) and the side of the operated knee (right, left) was also performed. No statistically significant differences were found in the demographic characteristics nor in the driving performance (collisions, p = 0.897; sidewalk invasions, p = 0.749; pedestrian impact, p = 0.983) between iACL, ACL-MS, and control groups. No statistically significant differences were found in right–left subgroup analysis. The results of the present study show that patients in their sixth postoperative week after right or left ACL reconstruction showed similar driving performance as compared with a healthy control group, regardless of associating or not a meniscal suture, suggesting it is safe to resume driving 6 weeks after the mentioned surgeries.
Allergy Testing Has No Correlation with Intraoperative Histopathology from Revision Total Knee Arthroplasty for Implant-Related Metal Allergy
Authors: Malahias Michael-Alexander , Bauer Thomas W. , Manolopoulos Philip P. , Sculco Peter K. , Westrich Geoffrey H. 
Published: May 2021

AbstractLymphocyte transformation testing (LTT) is often used in the workup for possible metal allergy after total knee arthroplasty (TKA) but the correlation of this test with other diagnostic metal-allergy findings in patients undergoing revision TKA for suspected metal allergy has not been established. A single-center, single-surgeon cohort of 19 TKAs in which both components were revised for presumed implant-related metal allergy based on history, physical, and LTT testing, to nonnickel-containing implants were retrospectively identified. Histopathologic samples obtained intraoperatively were semiquantitatively analyzed using both the Hospital for Special Surgery (HSS) synovial pathology score and the Campbell aseptic lymphocyte-dominant vasculitis-associated lesion (ALVAL) score. As histopathology control group, we included in the study an additional cohort of 17 patients who received aseptic revision TKA and had no history of reported or tested metal sensitivity. All preoperative LTT results were highly reactive to nickel. However, this did not correlate with local periarticular tissue response in 18 of 19 cases which demonstrated a low HSS synovial score (mean: 3.8 ± 2.8, of a maximum score of 28) and the low Campbell ALVAL scores (mean: 2.5/10 ± 1.3, of a maximum score of 10). There were not any significant differences between the study group (suspected implant-related metal allergy) and the control group (nonsuspected implant-related metal allergy) in regard to (1) the Campbell score and (2) the HSS synovial inflammatory score. Knee Society Clinical Rating System (KSCRS) function score improved significantly after revision (mean postoperative increase: 34.0 ± 17. 2; p < 0.001), as well as mean visual analog scale (VAS) pain (mean postoperative decrease: 33.3 ± 26.4; p < 0.01) score. The short-term survival rate (at mean follow-up of 26.1 months) of this patient cohort was 100%. In this cohort of revised TKA patients with suspected nickel allergy based on clinical presentation and LTT positive results, intraoperative histopathology was essentially normal. However, all patients with suspected nickel allergy showed a significant clinical and functional improvement with excellent short-term survival rates. The clinical significance of a positive LTT needs further study.