bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of novel fabricated ballastless track on new designed long-span urban bridges
Authors: Yang Yi , Xin Tao , Li Qiuyi , Wang Sen , Dai Chuanqing , Kong Chao 
Published: November 2024

AbstractFabricated ballastless track has witnessed increasingly wide application in large-span bridges of municipal railways. The current ballastless track standard is applicable to bridges with a main span of 200 m to 400 m. For the main span is longer than 400 m, it is necessary to ensure the travelling safety and comfort on the fabricated tracks. In this study, static and dynamic analysis models of train-track-bridge are established to explore the influence of complex ambient temperature changes and concrete shrinkage and creep on bridge deformation, followed by the analysis of the deformation coordination between long-span bridge and fabricated ballastless tracks, thereby revealing the dynamic response of the train-track-bridge system under the complex influence of temperature. The results show that when a train runs at a speed of 160 km/h, the existing ballastless track design standard is still applicable to a bridge span of 688 m. Compared with CRTS type III track, the adoption of the novel prefabricated ballastless track on long-span urban bridges provides higher safety and greater comfort, with comprehensive power performance improved by more than 10%. This design comprehensively takes into account the deformation coordination and dynamic performance of the rail bridge, providing a basis for the design and application of fabricated ballastless tracks on long-span bridges of urban railways.
Customizing GPT for natural language dialogue interface in database access
Authors: Kim Jin-Dong , Okubo Kousaku 
Published: November 2024

AbstractThe paper presents Anatomy3DExplorer, a customized ChatGPT designed as a natural language dialogue interface for exploring 3D models of anatomical structures. It illustrates the significant potential of large language models (LLMs) as user-friendly interfaces for database access. Furthermore, it showcases the seamless integration of LLMs and database APIs, within the GPTS framework, offering a promising and straightforward approach.
Cost-Effectiveness of Total Neoadjuvant Therapy With Selective Nonoperative Management for Locally Advanced Rectal Cancer: Analysis of Data From the Organ Preservation for Rectal Adenocarcinoma Trial
Authors: Widmar Maria , McCain Mason , Mishra Meza Akriti , Ternent Charles , Briggs Andrew , Garcia-Aguilar Julio 
Published: October 2024

PURPOSE
The clinical efficacy of total neoadjuvant therapy (TNT) followed by selective nonoperative management (NOM) for locally advanced rectal cancer (LARC) was examined in the Organ Preservation for Rectal Adenocarcinoma (OPRA) trial. We investigated the cost and quality-of-life implications of adopting this treatment approach.

METHODS
We analyzed clinical, cost, and quality-of-life outcomes for TNT with selective NOM in comparison with chemoradiotherapy (CRT)-surgery-adjuvant chemotherapy (standard of care [SOC]) using data from OPRA, prospective cohorts, and published studies. Cost-effectiveness was evaluated over varying willingness-to-pay thresholds, and sensitivity analyses evaluated cost-effectiveness for different surgical contexts and SOC variants as well as a 10-year time horizon.

RESULTS
SOC was dominated by TNT with selective NOM in the base case analysis. TNT in which CRT was followed by consolidation chemotherapy (CNCT) was the least costly at $89,712 in Medicare proportionate US dollars (MP$), followed by TNT in which induction chemotherapy was followed by CRT (INCT) at MP$90,259 and SOC at MP$98,755. INCT was the preferred strategy, with 4.56 quality-adjusted life years, followed by CNCT at 4.42 and SOC at 4.29. TNT with selective NOM dominated SOC in all sensitivity analyses except when SOC omitted adjuvant chemotherapy without an impact on disease-free survival. CNCT was more cost effective than SOC when the proportion of patients entering NOM after TNT was ≥22% or ≥43%, for SOC with and without adjuvant therapy, both well below the rates seen in OPRA.

CONCLUSION
TNT with selective NOM is cost effective. The cost-effectiveness of CNCT with NOM relative to SOC is dependent on CNCT being made available to a sufficiently large proportion of patients with LARC. Additional analyses are needed to validate these findings from a societal perspective and in the context of other emerging treatment paradigms for LARC.
Human Peripancreatic Adipose Tissue Paracrine Signaling Impacts Insulin Secretion, Blood Flow, and Gene Transcription
Authors: Bergman Bryan C , Zemski Berry Karin , Garfield Amanda , Keller Amy , Zarini Simona , Bowen Sophia , McKenna Colleen , Kahn Darcy , Pavelka Jay , Macias Emily , Uhlson Charis , Johnson Chris , Russ Holger A , Viesi Carlos H , Seldin Marcus , Liu Chengyang , Doliba Nicolai M , Schoen Jonathan , Rothchild Kevin , Hazel Kweku , Naji Ali 
Published: November 2024

Abstract

Context
Adipose tissue accumulation around nonadipose tissues is associated with obesity and metabolic disease. One relatively unstudied depot is peripancreatic adipose tissue (PAT) that accumulates in obesity and insulin resistance and may impact β-cell function. Pancreatic lipid accumulation and PAT content are negatively related to metabolic outcomes in humans, but these studies are limited by the inability to pursue mechanisms.

Objective
We obtained PAT from human donors through the Human Pancreas Analysis Program to evaluate differences in paracrine signaling compared to subcutaneous adipose tissue (SAT), as well as effects of the PAT secretome on aortic vasodilation, human islet insulin secretion, and gene transcription using RNA sequencing.

Results
PAT had greater secretion of interferon-γ and most inflammatory eicosanoids compared to SAT. Secretion of adipokines negatively related to metabolic health were also increased in PAT compared to SAT. We found no overall effects of PAT compared to SAT on human islet insulin secretion; however, insulin secretion was suppressed after PAT exposure from men compared to women. Vasodilation was significantly dampened by PAT conditioned media, an effect explained almost completely by PAT from men and not women. Islets treated with PAT showed selective changes in lipid metabolism pathways while SAT altered cellular signaling and growth. RNA sequencing analysis showed changes in islet gene transcription impacted by PAT compared to SAT, with the biggest changes found between PAT based on sex.

Conclusion
The PAT secretome is metabolically negative compared to SAT, and impacts islet insulin secretion, blood flow, and gene transcription in a sex-dependent manner.
Relationship Between Extracellular Water to Total Body Water Ratio and Severe Diabetic Retinopathy in Type 2 Diabetes
Authors: Kajitani Nao , Umakoshi Hironobu , Kajitani Yusuke , Kaneko Hiroki , Matsuzaki Chitose , Miyachi Yasutaka , Sakamoto Ryuichi , Ogawa Yoshihiro 
Published: November 2024

Abstract

Context
Diabetic retinopathy (DR) is a common microvascular complication of diabetes, and identifying the risk factors for severe DR is important.

Objective
We aimed to investigate the relationship between severe DR and the extracellular water to total body water ratio (ET ratio).

Methods
Retrospective cross-sectional study at the Department of Endocrinology, Metabolism, and Diabetes, Kyushu University Hospital. A total of 205 adults with type 2 diabetes (T2D) were included. The patients were divided into 2 groups: nonproliferative DR (non-PDR; n = 161, 126 with no DR and 35 with simple DR) and proliferative DR (PDR; n = 44, 18 with preproliferative DR and 26 with PDR). The ET ratio was measured using bioelectrical impedance analysis.

Results
The ET ratio was significantly higher in the PDR group than in the non-PDR group (0.390 vs 0.398; P &lt; .0001). Multivariate logistic regression analysis showed that the ET ratio was significantly associated with PDR, independent of known risk factors for DR progression. In the subgroup analysis by age, multivariate logistic regression analysis revealed a significant association between the ET ratio and PDR, independent of known risk factors for DR progression in patients younger than 60 years. However, in patients 60 years and older, only the urinary albumin to creatinine ratio (UACR) showed a significant association with PDR in a model using the UACR and the ET ratio.

Conclusion
In patients with T2D younger than 60 years, the ET ratio may be a useful indicator for identifying severe DR.
Impaired Muscle Parameters in Individuals With Premature Ovarian Insufficiency: A Pilot Study
Authors: Samad Navira , Chiu Wei Ling , Nguyen Hanh H , Lu Zhong X , Zacharin Margaret , Ebeling Peter R , Teede Helena , Scott David , Milat Frances , Vincent Amanda J 
Published: November 2024

Abstract

Context
Although bone loss is a recognized consequence of premature ovarian insufficiency (POI), the impact on skeletal muscle health is less well-defined.

Objective
To compare muscle mass and function parameters between women with POI and controls.

Methods
Cross-sectional study from a tertiary health network and community between 2017 and 2023. Participants were women aged 20 to 40 years with POI associated with Turner syndrome (TS; n = 11) and spontaneous normal karyotype POI (s-POI; n = 7) compared with age- and body mass index (BMI)-matched controls (n = 45).

Results
All women with POI (mean age 28.70 ± 5.58) were using hormone therapy. Appendicular lean mass (ALM)/total fat mass and ALM/ BMI was lower in the POI group. Height-adjusted muscle mass parameters did not differ between groups. Compared with controls, women with TS and s-POI had lower muscle strength (TS 19.72 ± 4.89; s-POI 22.73 ± 5.35; controls 28.67 ± 5.65 kg; P &lt; .001) and muscle quality (TS 11.09 ± 2.06; s-POI 10.89 ± 2.01; controls 14.10 ± 1.99 kg/kg; P &lt; .001). Higher C-reactive protein levels, higher depression scores, and lower sex-steroid and physical activity levels were observed in women with POI (P &lt; .05). Creatinine/cystatin C ratio, insulin-like growth factor-1, and transthyretin did not differ between groups.

Conclusion
Despite hormone therapy usage, women with POI exhibited compromised muscle parameters compared with age-matched controls. Potential contributory factors were identified. Further research is required to clarify pathophysiology and inform management strategies.
Efficacy of Tocilizumab in Refractory Graves Orbitopathy From Real-World Clinical Practice: An Observational Study
Authors: Wang Mingyang , Qin Bixuan , Liu Cuihong , Liu Honglei , Li Dongmei 
Published: November 2024

Abstract

Context
The efficacy of tocilizumab (TCZ) in treating Graves orbitopathy (GO) remains uncertain due to the small sample sizes of earlier studies, and there is a lack of research on the drug for juvenile GO.

Objective
To evaluate the effectiveness of TCZ in treating GO that is resistant to conventional therapy.

Design
This observational study at a tertiary care center included 79 Chinese GO patients, 15 of whom were pediatric patients, with 52 of these patients having moderate to severe active GO (all adult patients having steroid-resistant GO). Intravenous infusion of TCZ 8 mg/kg was given every 28 days for 4 months. Changes from baseline in visual acuity (VA), intraocular pressure (IOP), proptosis, clinical activity score (CAS), and thyrotropin receptor antibody (TRAb) levels throughout TCZ therapy were assessed at baseline (T0), the fifth month (T4), and follow-up (T5). Additionally, improvements in CAS by at least 2 points and CAS &lt; 4 points at T4 and T5 were evaluated.

Results
Significant improvements were found in VA, IOP, proptosis, CAS, and TRAb levels in the adult group, and proptosis in the pediatric group at T5 (P &lt; .05). Additionally, significant improvements were identified in TRAb levels and CAS (active GO at T0) in the pediatric group at T4 (P &lt; .05). In the adult and pediatric group with active GO at T5, 71.4% and 60% experienced a decrease in CAS by ≥ 2 points, respectively; 89.3% and 60% achieved the response criterion of low activity disease (CAS &lt; 4 points), respectively.

Conclusion
TCZ emerged as a valuable therapeutic option for Chinese patients with active, corticosteroid-resistant, moderate to severe GO.
Colectiva Feminista en Construcción
Authors: Ortiz Aurora Santiago 
Published: November 2024

Abstract
Colectiva Feminista en Construcción (La Cole) is a Black feminist political organization that emerged in 2014 in San Juan, Puerto Rico. This article discusses the ways La Cole’s public discourse around sexism, racism, and homophobia in the archipelago is articulated through the collective’s presence at marches, demonstrations, and on social media. While core membership is small, La Cole has been able to convene collaborators and supporters to organize against the imposition of neoliberal economic and public policies that negatively impact the most dispossessed populations in Puerto Rico, namely Black, poor, queer, and trans women. La Cole has constructed a transnational intersectional feminist pedagogy as a means of political education both within the organization itself and more broadly in Puerto Rico’s public sphere. The organization’s pedagogical strategies include the rewriting of Christmas songs and plenas, an Afro Puerto Rican musical genre, and their Radical Feminist School, a political education space open to nonmembers. Through these pedagogical interventions La Cole simultaneously calls attention to the ways state and structural gender-based violence and femicides, housing precarity, and austerity measures affect the most marginalized sectors of the archipelago while carving out their identity as a decolonial Black feminist political organization.
“Enhancing Human Dignity Here and Around the World”
Authors: Upton Azzam Aisha A. 
Published: November 2024

Abstract
In the second half of the twentieth century, Black sororities began establishing chapters and social programs across the globe, an intentional social action that Aisha A. Upton Azzam conceptualizes as the Black sorority movement (BSM). In this piece, Upton Azzam explores the style and extent of such international engagement. She illuminates the marginalized aspect of the movement’s international activism while clarifying how such activism may have also employed the very neoliberal, neocolonial, and patriarchal ideas and practices that the movement explicitly stated that they wished to resist and overturn.
The challenges, opportunities and future of comparative physiology in the Global South: perspectives of early-career researchers
Authors: Bars-Closel Melissa , Capparelli Mariana V. , Conradie Shannon R. , Diele-Viegas Luisa Maria , Donaldson Ashleigh C. , Kosmala Georgia K. , Madelaire Carla B. , de Mello Daniela M. D. , Majelantle Tshepiso L. , Martins Mariana F. , Moreira Daniel C. , Ngcamphalala Celiwe A. , Noakes Matthew J. , Shankar Anusha , Webster Andrea B. 
Published: October 2024

ABSTRACT
Researchers in the Global South (GS, developing countries) make valuable contributions to the field of comparative physiology, but face economic and scientific disparities and several unique challenges compared with colleagues in the Global North (developed countries). This Perspective highlights some of the challenges, knowledge gaps and disparities in opportunity faced by GS researchers, especially those at early-career stages. We propose collaborative solutions to help address these issues, and advocate for promoting investment and cultural and societal change for a more inclusive research community. Additionally, we highlight the role of GS researchers in contributing expert knowledge on local biodiversity and the environment; this knowledge can help to shape the future of comparative physiology, allowing us to achieve a better understanding of the evolution of physiological mechanisms and to develop innovative solutions to environmental and biomedical challenges. With this Perspective, we hope to highlight the need to foster a more diverse, equitable and inclusive research landscape in comparative physiology; one that empowers GS scientists to address the global challenges associated with biodiversity loss, climate change and environmental pollution.
Education is necessary but not sufficient for addressing disparities in concussion knowledge, attitudes, and perceptions
Authors: Wilkes James R. , Krusen Sarah , Calandra Lindsey M. , Wu Joe , Arbogast Kristy B. , Master Christina L. 
Published: October 2024

ABSTRACT

Introduction
Concussion leads to immediate cognitive, physiological, psychological, and emotional consequences that, if left untreated, may persist resulting in longer-term effects. Concussion education programs provide students with the knowledge necessary for them to make an informed decision to seek care should an injury occur.

Methods
In this observational cohort study, youth participating in public middle or high school athletics in a suburban county in Pennsylvania were asked to complete a survey to assess their concussion knowledge, attitudes, and perceptions before and after concussion education.

Results
All students increased scores from pre- to posteducation (mean difference, 0.08 to 0.67). Students from noncontact sports, higher grades, and higher Child Opportunity Index (COI) schools tended to have higher scores both before and after concussion education compared to students from contact sports, lower grades, or lower COI schools.

Discussion
Disparities were identified before and after the educational intervention between sport participation, grade level, and schools with different COI. Although concussion education was successful, with students showing improvement in all questions related to concussion knowledge, attitudes, and perceptions, this study identifies a need for the development of more equitable educational support systems. Understanding these differences may provide opportunities for targeted educational strategies, which might result in improved outcomes for younger athletes, those participating in contact sports, and those from lower COI schools.
SECEC Grammont Award 2024: The critical role of posture adjustment for range of motion simulation in reverse total shoulder arthroplasty preoperative planning
Authors: Moroder Philipp , Poltaretskyi Sergii , Raiss Patric , Denard Patrick J. , Werner Brian C. , Erickson Brandon J. , Griffin Justin W. , Metcalfe Nick , Siegert Paul 
Published: November 2024

AimsThe objective of this study was to compare simulated range of motion (ROM) for reverse total shoulder arthroplasty (rTSA) with and without adjustment for scapulothoracic orientation in a global reference system. We hypothesized that values for simulated ROM in preoperative planning software with and without adjustment for scapulothoracic orientation would be significantly different.MethodsA statistical shape model of the entire humerus and scapula was fitted into ten shoulder CT scans randomly selected from 162 patients who underwent rTSA. Six shoulder surgeons independently planned a rTSA in each model using prototype development software with the ability to adjust for scapulothoracic orientation, the starting position of the humerus, as well as kinematic planes in a global reference system simulating previously described posture types A, B, and C. ROM with and without posture adjustment was calculated and compared in all movement planes.ResultsAll movement planes showed significant differences when comparing protocols with and without adjustment for posture. The largest mean difference was seen in external rotation, being 62° (SD 16°) without adjustment compared to 25° (SD 9°) with posture adjustment (p < 0.001), with the highest mean difference being 49° (SD 15°) in type C. Mean extension was 57° (SD 18°) without adjustment versus 24° (SD 11°) with adjustment (p < 0.001) and the highest mean difference of 47° (SD 18°) in type C. Mean abducted internal rotation was 69° (SD 11°) without adjustment versus 31° (SD 6°) with posture adjustment (p < 0.001), showing the highest mean difference of 51° (SD 11°) in type C.ConclusionThe present study demonstrates that accounting for scapulothoracic orientation has a significant impact on simulated ROM for rTSA in all motion planes, specifically rendering vastly lower values for external rotation, extension, and high internal rotation. The substantial differences observed in this study warrant a critical re-evaluation of all previously published studies that examined component choice and placement for optimized ROM in rTSA using conventional preoperative planning software.Cite this article: Bone Joint J 2024;106-B(11):1284–1292.
Frail patients require instrumentation of a more proximal vertebra for a successful outcome after surgery for adult spine deformity
Authors: Onafowokan Oluwatobi O. , Jankowski Pawel P. , Das Ankita , Lafage Renaud , Smith Justin S. , Shaffrey Christopher I. , Lafage Virginie , Passias Peter G. 
Published: November 2024

AimsThe aim of this study was to investigate the impact of the level of upper instrumented vertebra (UIV) in frail patients undergoing surgery for adult spine deformity (ASD).MethodsPatients with adult spinal deformity who had undergone T9-to-pelvis fusion were stratified using the ASD-Modified Frailty Index into not frail, frail, and severely frail categories. ASD was defined as at least one of: scoliosis ≥ 20°, sagittal vertical axis (SVA) ≥ 5 cm, or pelvic tilt ≥ 25°. Means comparisons tests were used to assess differences between both groups. Logistic regression analyses were used to analyze associations between frailty categories, UIV, and outcomes.ResultsA total of 477 patients were included (mean age 60.3 years (SD 14.9), mean BMI 27.5 kg/m2 (SD 5.8), mean Charlson Comorbidity Index (CCI) 1.67 (SD 1.66)). Overall, 74% of patients were female (n = 353), and 49.6% of patients were not frail (237), 35.4% frail (n = 169), and 15% severely frail (n = 71). At baseline, differences in age, BMI, CCI, and deformity were significant (all p = 0.001). Overall, 15.5% of patients (n = 74) had experienced mechanical complications by two years (8.1% not frail (n = 36), 15.1% frail (n = 26), and 16.3% severely frail (n = 12); p = 0.013). Reoperations also differed between groups (20.2% (n = 48) vs 23.3% (n = 39) vs 32.6% (n = 23); p = 0.011). Controlling for osteoporosis, baseline deformity, and degree of correction (by sagittal age-adjusted score (SAAS) matching), frail and severely frail patients were more likely to experience mechanical complications if they had heart failure (odds ratio (OR) 6.6 (95% CI 1.6 to 26.7); p = 0.008), depression (OR 5.1 (95% CI 1.1 to 25.7); p = 0.048), or cancer (OR 1.5 (95% CI 1.1 to 1.4); p = 0.004). Frail and severely frail patients experienced higher rates of mechanical complication than ‘not frail’ patients at two years (19% (n = 45) vs 11.9% (n = 29); p = 0.003). When controlling for baseline deformity and degree of correction in severely frail and frail patients, severely frail patients were less likely to experience clinically relevant proximal junctional kyphosis or failure or mechanical complications by two years, if they had a more proximal UIV.ConclusionFrail patients are at risk of a poor outcome after surgery for adult spinal deformity due to their comorbidities. Although a definitively prescriptive upper instrumented vertebra remains elusive, these patients appear to be at greater risk for a poor outcome if the upper instrumented vertebra is sited more distally.Cite this article: Bone Joint J 2024;106-B(11):1342–1347.