bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can a simple fall cause a rotator cuff tear? Literature review and biomechanical considerations
Authors: Nyffeler Richard W. , Schenk Nicholas , Bissig Philipp 
Published: March 2021

Abstract
Purpose
A simple fall on the shoulder is often referred to as minor trauma that cannot cause a tendon tear but at best reveal a pre-existing rotator cuff pathology. We wanted to know whether this statement was true. The purpose of our study was therefore to summarize the causes of acute rotator cuff tears reported in the literature and provide a biomechanical explanation for tendon tears diagnosed after a fall.

Method
We searched PubMed and included studies reporting rotator cuff tears occurring due to a trauma. The number of cases, the tendons involved, the age of the patients, and the nature of trauma were summarized. In addition, we noted any information provided by the authors on the pathogenesis of acute tendon ruptures.

Results
Sixty-seven articles with a total of 4061 traumatic rotator cuff tears met the inclusion criteria. A simple fall was the most common cause (725 cases) and the supraspinatus tendon was most frequently affected. The postulated pathomechanism is a sudden stretch of the tendon-muscle unit while contracting (eccentric loading).

Conclusion
A simple fall can cause an acute rotator cuff tear and fall-related tears are not restricted to young individuals. They can affect patients of any age. The stresses occurring within the rotator cuff during an attempt to cushion a fall may locally exceed the tensile strength of the tendon fibers and cause a partial or full-thickness tear.
Pneumothorax detection in chest radiographs: optimizing artificial intelligence system for accuracy and confounding bias reduction using in-image annotations in algorithm training
Authors: Rueckel Johannes , Huemmer Christian , Fieselmann Andreas , Ghesu Florin-Cristian , Mansoor Awais , Schachtner Balthasar , Wesp Philipp , Trappmann Lena , Munawwar Basel , Ricke Jens , Ingrisch Michael , Sabel Bastian O. 
Published: March 2021

Abstract
Objectives
Diagnostic accuracy of artificial intelligence (AI) pneumothorax (PTX) detection in chest radiographs (CXR) is limited by the noisy annotation quality of public training data and confounding thoracic tubes (TT). We hypothesize that in-image annotations of the dehiscent visceral pleura for algorithm training boosts algorithm’s performance and suppresses confounders.

Methods
Our single-center evaluation cohort of 3062 supine CXRs includes 760 PTX-positive cases with radiological annotations of PTX size and inserted TTs. Three step-by-step improved algorithms (differing in algorithm architecture, training data from public datasets/clinical sites, and in-image annotations included in algorithm training) were characterized by area under the receiver operating characteristics (AUROC) in detailed subgroup analyses and referenced to the well-established “CheXNet” algorithm.

Results
Performances of established algorithms exclusively trained on publicly available data without in-image annotations are limited to AUROCs of 0.778 and strongly biased towards TTs that can completely eliminate algorithm’s discriminative power in individual subgroups. Contrarily, our final “algorithm 2” which was trained on a lower number of images but additionally with in-image annotations of the dehiscent pleura achieved an overall AUROC of 0.877 for unilateral PTX detection with a significantly reduced TT-related confounding bias.

Conclusions
We demonstrated strong limitations of an established PTX-detecting AI algorithm that can be significantly reduced by designing an AI system capable of learning to both classify and localize PTX. Our results are aimed at drawing attention to the necessity of high-quality in-image localization in training data to reduce the risks of unintentionally biasing the training process of pathology-detecting AI algorithms.

Key Points
• Established pneumothorax-detecting artificial intelligence algorithms trained on public training data are strongly limited and biased by confounding thoracic tubes.
• We used high-quality in-image annotated training data to effectively boost algorithm performance and suppress the impact of confounding thoracic tubes.
• Based on our results, we hypothesize that even hidden confounders might be effectively addressed by in-image annotations of pathology-related image features.
Percutaneous transforaminal endoscopic discectomy in a nine-year-old patient with sciatica: case report, technical note and overview of the literature
Authors: Gadjradj P. S. , Harhangi B. S. 
Published: March 2021

AbstractPercutaneous transforaminal endoscopic discectomy (PTED) is an alternative procedure to open microdiscectomy (OM) to treat sciatica caused by lumbar disk herniation. Even though robust evidence comparing PTED with OM is lacking, PTED is becoming increasingly popular to treat spinal disorders. In this technical report, the surgical technique and outcomes of PTED in a 9-year-old patient are described. Furthermore, an overview of the literature on full-endoscopic techniques to treat sciatica is given, showing that PTED is feasible, safe and effective to treat lumbar disk herniation in the pediatric population.
Physical activity, sedentary behavior and risk of coronary artery disease, myocardial infarction and ischemic stroke: a two-sample Mendelian randomization study
Authors: Bahls Martin , Leitzmann Michael F. , Karch André , Teumer Alexander , Dörr Marcus , Felix Stephan B. , Meisinger Christa , Baumeister Sebastian E. , Baurecht Hansjörg 
Published: March 2021

AbstractAimsObservational evidence suggests that physical activity (PA) is inversely and sedentarism positively related with cardiovascular disease risk. We performed a two-sample Mendelian randomization (MR) analysis to examine whether genetically predicted PA and sedentary behavior are related to coronary artery disease, myocardial infarction, and ischemic stroke.Methods and resultsWe used single nucleotide polymorphisms (SNPs) associated with self-reported moderate to vigorous PA (n = 17), accelerometer based PA (n = 7) and accelerometer fraction of accelerations > 425 milli-gravities (n = 7) as well as sedentary behavior (n = 6) in the UK Biobank as instrumental variables in a two sample MR approach to assess whether these exposures are related to coronary artery disease and myocardial infarction in the CARDIoGRAMplusC4D genome-wide association study (GWAS) or ischemic stroke in the MEGASTROKE GWAS. The study population included 42,096 cases of coronary artery disease (99,121 controls), 27,509 cases of myocardial infarction (99,121 controls), and 34,217 cases of ischemic stroke (404,630 controls). We found no associations between genetically predicted self-reported moderate to vigorous PA, accelerometer-based PA or accelerometer fraction of accelerations > 425 milli-gravities as well as sedentary behavior with coronary artery disease, myocardial infarction, and ischemic stroke.ConclusionsThese results do not support a causal relationship between PA and sedentary behavior with risk of coronary artery disease, myocardial infarction, and ischemic stroke. Hence, previous observational studies may have been biased.Graphic abstract
Vaginal treatment with lactic acid gel delays relapses in recurrent urinary tract infections: results from an open, multicentre observational study
Authors: Diebold Ruth , Schopf Bettina , Stammer Holger , Mendling Werner 
Published: March 2021

Abstract
Purpose
The main objective of this open, prospective, multicentre, observational study is to investigate the relapse rate and tolerability of lactic acid gels in adult female patients with recurrent urinary tract infections during routine practice.

Methods
Data were collected from patients undergoing intermittent short courses of intravaginal treatment with lactic acid gel for prevention of recurrent urinary tract infections. The observation period for individual patients was 4 months, aimed at covering four short courses of intravaginal treatment. Data on UTI relapses, tolerability, handling and satisfaction with the treatment were collected via patient diaries and physician assessments and comprised any adverse events (AEs).

Results
In total, 72 patients were treated. During the last 12 months prior to the study, patients had on average 4.0 UTIs. In the 4 months after commencing treatment, 63.5% of patients had no recurrence of UTI symptoms. Overall efficacy was rated by physicians as ‘excellent/good’ for 96.7% of patients. The patients’ overall acceptance of local treatment was high with 94.1% being ‘(very) satisfied’. Similarly, handling was rated as ‘(very) easy’ by 94.2% of patients. The tolerability was assessed as ‘highly tolerable/tolerable’ by over 98% of patients and physicians alike. Safety analyses reported six AEs of mild intensity, all of which had resolved by the end of the study.

Conclusion
Treatment with lactic acid gel may increase resilience against uropathogens, possibly preventing the need for antibiotic prevention of recurrent urinary tract infections. Treatment was positively assessed by the patients. The physician assessments corroborate these findings.

Trial registration number and date of registration
DRKS00016760, 18.02.2019.
Self-organizing mappings on the flag manifold with applications to hyper-spectral image data analysis
Authors: Ma Xiaofeng , Kirby Michael , Peterson Chris 
Published: March 2021

AbstractA flag is a nested sequence of vector spaces. The type of the flag encodes the sequence of dimensions of the vector spaces making up the flag. A flag manifold is a manifold whose points parameterize all flags of a fixed type in a fixed vector space. This paper provides the mathematical framework necessary for implementing self-organizing mappings on flag manifolds. Flags arise implicitly in many data analysis contexts including wavelet, Fourier, and singular value decompositions. The proposed geometric framework in this paper enables the computation of distances between flags, the computation of geodesics between flags, and the ability to move one flag a prescribed distance in the direction of another flag. Using these operations as building blocks, we implement the SOM algorithm on a flag manifold. The basic algorithm is applied to the problem of parameterizing a set of flags of a fixed type.
Rock Stress Measurements for Unlined Pressure Tunnels: A True Triaxial Laboratory Experiment to Investigate the Ability of a Simplified Hydraulic Jacking Test to Assess Fracture Normal Stress
Authors: Ødegaard Henki , Nilsen Bjørn 
Published: March 2021

AbstractTo avoid hydraulic failure of unlined pressure tunnels, knowledge of minimum principal stress is needed. Such knowledge is only obtainable from in situ measurements, which are often time-consuming and relatively costly, effectively limiting the number of measurements typically performed. In an effort to enable more stress measurements, the authors propose a simplified and cost-effective stress measuring method; the Rapid Step-Rate Test (RSRT), which is based on existing hydraulic testing methods. To investigate the ability of this test to measure fracture normal stresses in field-like conditions, a true triaxial laboratory test rig has been developed. Hydraulic jacking experiments performed on four granite specimens, each containing a fracture, have been performed. Interpretation of pressure-, flow- and acoustic emission (AE) data has been used to interpret fracture behaviour and to assess fracture normal stresses. Our experimental data suggest that the proposed test method, to a satisfactory degree of reliability, can measure the magnitude of fracture normal stress. In addition, a clear correlation has been found between fracture closure and sudden increase in AE rate, suggesting that AE monitoring during testing can serve as a useful addition to the test. The rapid step-rate test is also considered relevant for field-scale measurements, with only minor adaptions. Our findings suggest that the RSRT can represent a way to get closer to the ideal of performing more testing along the entire length of pressure tunnel, and not only at key locations, which requires interpolation of stress data with varying degree of validity.
A Step Towards Optimization of the qNMR Workflow: Proficiency Testing Exercise at an GxP-Accredited Laboratory
Authors: Monakhova Yulia B. , Diehl Bernd W. K. 
Published: March 2021

AbstractQuantitative nuclear magnetic resonance (qNMR) is considered as a powerful tool for multicomponent mixture analysis as well as for the purity determination of single compounds. Special attention is currently paid to the training of operators and study directors involved in qNMR testing. To assure that only qualified personnel are used for sample preparation at our GxP-accredited laboratory, weighing test was proposed. Sixteen participants performed six-fold weighing of the binary mixture of dibutylated hydroxytoluene (BHT) and 1,2,4,5-tetrachloro-3-nitrobenzene (TCNB). To evaluate the quality of data analysis, all spectra were evaluated manually by a qNMR expert and using in-house developed automated routine. The results revealed that mean values are comparable and both evaluation approaches are free of systematic error. However, automated evaluation resulted in an approximately 20% increase in precision. The same findings were revealed for qNMR analysis of 32 compounds used in pharmaceutical industry. Weighing test by six-fold determination in binary mixtures and automated qNMR methodology can be recommended as efficient tools for evaluating staff proficiency. The automated qNMR method significantly increases throughput and precision of qNMR for routine measurements and extends application scope of qNMR.
Differences in the expression of caveolin-1 isoforms in cancer-associated and normal fibroblasts of patients with oral squamous cell carcinoma
Authors: Kaya S. , Wiesmann Nadine , Goldschmitt J. , Krüger M. , Al-Nawas B. , Heider J. 
Published: March 2021

Abstract
Objectives
For many years, tumor development has been viewed as a cell-autonomous process; however, today we know that the tumor microenvironment (TME) and especially cancer-associated fibroblasts (CAFs) significantly contribute to tumor progression. Caveolin-1 (Cav-1) is a scaffolding protein which is involved in several cancer-associated processes as important component of the caveolae. Our goal was to shed light on the expression of the two different isoforms of Cav-1 in normal fibroblasts (NFs) and CAFs of patients with oral squamous cell carcinoma (OSCC).

Materials and methods
Fibroblasts from normal mucosa and CAFs were isolated and propagated in vitro. Gene expression of the different Cav-1 isoforms was assessed via quantitative real-time PCR (qPCR) and supplemented by protein expression analysis.

Results
We could show that the Cav-1β isoform is more highly expressed in NFs and CAFs compared to Cav-1α. Furthermore, the different Cav-1 isoforms tended to be differently expressed in different tumor stages. However, this trend could not be seen consistently, which is in line with the ambiguous role of Cav-1 in tumor progression described in literature. Western blotting furthermore revealed that NFs and CAFs might differ in the oligomerization profile of the Cav-1 protein.

Conclusion
These differences in expression of Cav-1 between NFs and CAFs of patients with OSCC confirm that the protein might play a role in tumor progression and is of interest for further analyses.

Clinical relevance
Our findings support a possible role of the two isoforms of Cav-1 in the malignant transformation of OSCC.
Precise point positioning with GPS and Galileo broadcast ephemerides
Authors: Carlin Luca , Hauschild André , Montenbruck Oliver 
Published: March 2021

AbstractFor more than 20 years, precise point positioning (PPP) has been a well-established technique for carrier phase-based navigation. Traditionally, it relies on precise orbit and clock products to achieve accuracies in the order of centimeters. With the modernization of legacy GNSS constellations and the introduction of new systems such as Galileo, a continued reduction in the signal-in-space range error (SISRE) can be observed. Supported by this fact, we analyze the feasibility and performance of PPP with broadcast ephemerides and observations of Galileo and GPS. Two different functional models for compensation of SISREs are assessed: process noise in the ambiguity states and the explicit estimation of a SISRE state for each channel. Tests performed with permanent reference stations show that the position can be estimated in kinematic conditions with an average three-dimensional (3D) root mean square (RMS) error of 29 cm for Galileo and 63 cm for GPS. Dual-constellation solutions can further improve the accuracy to 25 cm. Compared to standard algorithms without SISRE compensation, the proposed PPP approaches offer a 40% performance improvement for Galileo and 70% for GPS when working with broadcast ephemerides. An additional test with observations taken on a boat ride yielded 3D RMS accuracy of 39 cm for Galileo, 41 cm for GPS, and 27 cm for dual-constellation processing compared to a real-time kinematic reference solution. Compared to the use of process noise in the phase ambiguity estimation, the explicit estimation of SISRE states yields a slightly improved robustness and accuracy at the expense of increased algorithmic complexity. Overall, the test results demonstrate that the application of broadcast ephemerides in a PPP model is feasible with modern GNSS constellations and able to reach accuracies in the order of few decimeters when using proper SISRE compensation techniques.
Central Asian wild tulip conservation requires a regional approach, especially in the face of climate change
Authors: Wilson Brett , Dolotbakov Aibek , Burgess Benjamin J. , Clubbe Colin , Lazkov Georgy , Shalpykov Kaiyrkul , Ganybaeva Myskalai , Sultangaziev Ormon , Brockington Samuel F. 
Published: March 2021

AbstractTulips (Tulipa spp.) are one of the most widely appreciated plants worldwide, nevertheless species taxonomy and biogeography are often poorly understood. Most wild tulips inhabit the mountains of Central Asia, a recognised biodiversity hotspot, and a centre of tulip diversity. Despite the presence of several country-level endemic Tulipa species, most taxa span the borders of several nations. With no globally Red Listed tulip taxa from this region national level conservation assessments are an important resource. Nonetheless, threats posed to tulips are still inadequately understood, especially climate change, and given the trans-national nature of most species, distributional information is restricted and often misleading. Here we collate 330 species records from the Global Biodiversity Information Facility with 85 newly collected records, to undertake species distribution modelling (MaxEnt) for ten native Central Asian species. This work showed that regional level models provide a much more comprehensive understanding of species’ extinction risks, proportions of habitat in different countries, and limitations in protected area coverage. Furthermore, our climate modelling, the first of its kind for tulips, suggests that climate change will have a significant negative impact on the range size of all species; including those that are currently widespread. We therefore add climate change to the list of threats affecting tulip populations in Central Asia, which already includes livestock overgrazing, urbanisation, wild collection, and mining. Overall, our work shows that although national information is important, a regional approach is crucial not just for tulip conservation efforts, but likely for Central Asian plant conservation in general.
Conservation genetics of the yellow-bellied toad (Bombina variegata): population structure, genetic diversity and landscape effects in an endangered amphibian
Authors: Pröhl Heike , Auffarth Jana , Bergmann Tjard , Buschmann Holger , Balkenhol Niko 
Published: March 2021

AbstractRevealing patterns of genetic diversity and barriers for gene flow are key points for successful conservation in endangered species. Methods based on molecular markers are also often used to delineate conservation units such as evolutionary significant units and management units. Here we combine phylo-geographic analyses (based onmtDNA) with population and landscape genetic analyses (based on microsatellites) for the endangered yellow-bellied toadBombina variegataover a wide distribution range in Germany. Our analyses show that two genetic clusters are present in the study area, a northern and a southern/central one, but that these clusters are not deeply divergent. The genetic data suggest high fragmentation among toad occurrences and consequently low genetic diversity. Genetic diversity and genetic connectivity showed a negative relationship with road densities and urban areas surrounding toad occurrences, indicating that these landscape features act as barriers to gene flow. To preserve a maximum of genetic diversity, we recommend considering both genetic clusters as management units, and to increase gene flow among toad occurrences with the aim of restoring and protecting functional meta-populations within each of the clusters. Several isolated populations with especially low genetic diversity and signs of inbreeding need particular short-term conservation attention to avoid extinction. We also recommend to allow natural gene flow between both clusters but not to use individuals from one cluster for translocation or reintroduction into the other. Our results underscore the utility of molecular tools for species conservation, highlight outcomes of habitat fragmentation onto the genetic structure of an endangered amphibian and reveal particularly threatened populations in need for urgent conservation efforts.
Contact Versus Education: An Explorative Comparison Between the Contact and Education Strategy Considering Albinism Related Stigma in Tanzanian High Schools
Authors: De Groot T. M. M. , Meurs P. , Jacquet W. , Peters R. M. H. 
Published: March 2021

AbstractAlbinism in Tanzania causes fierce health-related stigma. Little research has focused on the impact of stigma reduction strategies aiming to reduce albinism related stigma. Therefore, this research assessed the impact of two short video interventions among high school students in Tanzania on their attitude towards people with albinism: a contact intervention (n = 95) and an education intervention (n = 97). A mixed method design was used. Directly before and after the interventions impact was measured among all participants through the Albinism Social Distance Scale for Adolescents (ASDS-A), knowledge items, and entertainment items. After these measurements focus group discussions were conducted, 16 in total (n = 80). Both interventions caused a significant increase in the levels of correct knowledge about albinism. The education intervention entailed a significant positive change in attitude measured through the ASDS-A, whereas the contact intervention did not have a significant effect. In terms of entertainment value, the respondents were more enthusiastic about the contact intervention. The study suggests that education interventions on their own can be a successful tool in decreasing albinism related stigma. Additionally, qualitative findings show many positive outcomes for the contact intervention. Therefore, we would recommend using a combination of these two interventions, which has also proved successful in the past. However, more research on the effect of a combination of the two strategies is recommended.