bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic wheel-rail interaction of a train crossing a turnout under traction/braking behaviour and research on rail wear of the turnout
Authors: Xiang Kailai , Li Tianyi , Shen Binran , Zheng Zhaoguang , Yan Zheng , Ma Qiantao , Xu Jingmang , Wang Ping , Qian Yao 
Published: October 2024

In order to study the dynamic behaviour of a vehicle passing through turnouts under traction and braking conditions, as well as its influence on the wear of turnout rails, a high-speed vehicle-turnout rigid-flexible coupling dynamic model is established based on the coupling dynamic theory of vehicle and turnout, using China’s No. 18 high-speed turnout and CRH380 high-speed EMU as prototypes. The model is used to analyse wheel-rail creep characteristics, wheel-rail contact mechanics, and wheel-rail wear under traction and braking conditions. The results indicate that when a high-speed train passes through a turnout under traction or braking conditions, the longitudinal creepage of the wheel-rail will change due to the rotative speed difference generated by traction or braking. Furthermore, due to the existence of the lead curve, the longitudinal creep rate of the wheel-rail becomes even more complex when passing through the turnout in the diverging route. The calculations reveal that the traction behaviour of the train leads to a significant increase in wear at the front of the switch rail and nose rail, while the wear number of the switch rail in the heel of the frog after 6m increases significantly under braking conditions. The different impact characteristics of vehicle traction and braking conditions on turnout rail wear obtained in this study can provide guidance for optimizing and grinding the profiles of turnout rails at the throat of railway stations.
Selective Cytotoxicity and Gene Expression Profiles in Response to Methanolic Extract of Phyllanthus amarus Extract against MCF-7 Breast Cancer Cells
Authors: Chen Wei , Hong Qing , Chen Jianing , Bi Yinghui 
Published: October 2024

Background Breast cancer, a malignant tumor, is the most common cancer type among women worldwide. Conventional chemotherapy treatments for breast cancer often cause adverse side effects in normal tissues and can lead to treatment failure. Plant-derived natural compounds offer an effective alternative with fewer side effects for cancer patients. Phyllanthus amarus is a medicinal plant widely distributed in China, India, and Brazil and reported to be used for the treatment of various types of cancer. Purpose This study was aimed to investigate the anticancer efficacy of methanolic extract of P. amarus against MCF-7 breast cancer cells. Methods We probed the anticancer activity in MCF-7 breast cancer cells by isolating the methanolic extract of P. amarus leaf extract (MEPA). The standard chemotherapy drug docetaxel is combined with MEPA to increase the drug efficacy. Moreover, the intracellular reactive oxygen species (ROS), alterations in mitochondrial membrane potential (MMP), nuclear condensation, and apoptotic activation were investigated in MCF-7 cells. Additionally, the customized PCR array comprising of cell cycle, apoptosis, mTOR, and JAK-STAT-related genes was studied during different MEPA treatments. Results In the MCF-7 breast cancer cells, the MEPA and docetaxel combination demonstrated strong cytotoxicity, with IC50 values of 45 and 2.6 µg/mL, respectively. MEPA and docetaxel together exhibited enhanced alterations in MMP and increased generation of ROS in MCF-7 cells. Furthermore, the combination of docetaxel with MEPA induces nuclear condensation and apoptotic cell death. During MEPA treatment, the gene expression profiles in MCF-7 cells were accessed. The JAK-STAT, mTOR signaling pathway, apoptosis, and cell growth-related genes were strongly affected by the dose-dependent administration of MEPA. Conclusion This study suggests that MEPA could be a useful alternative treatment for breast cancer. When combined with traditional chemotherapy, MEPA might offer better results with fewer side effects. More in vivo studies are needed to confirm MEPA’s effectiveness in animal models.
Aftermath of the Fourth Taiwan Strait Crisis: Media Discourse Analysis of Taiwan and India’s Perception of China’s Threat
Authors: Tu Chang-Ching , Lin Hsiao-Chen , Chang Chen-Yuan , Doddi Chandu 
Published: October 2024

This study examines Taiwan and India’s media discourse and political elite statements from 1 July 2022 to 1 October 2023, starting from the fourth Taiwan Strait crisis in 2022. We conducted a discourse analysis of over 121,901 news texts using extensive data analysis and text-mining software. Additionally, our research team conducted expert focus group discussions with renowned think tanks and research centres in New Delhi, India. Building upon the data text analysis findings, we further explored India’s stance on the Taiwan Strait conflict, its perception of the Chinese threat and the impact of the ongoing ‘new normal’ crisis on India’s Indo-Pacific strategic layout. The aim was to uncover common security needs and intersecting interests between the two countries, considering their different national interests and geopolitical considerations. Based on the analysis of textual mining and expert discussions, this study reveals the following: First, India is concerned about the current situation in the Taiwan Strait. Second, the current tensions in the Taiwan Strait will influence India’s strategic layout. Third, there is a growing consensus within India regarding the Chinese threat. In light of these findings, this study suggests that Taiwan and India share interests in democratic values, maritime traffic security and high-tech industry supply chains. Taiwan possesses expertise in China studies and a deep understanding of China’s military threat, while Taiwan and India possess specific technological capabilities. Based on these foundations, there are potential opportunities for further dialogue, exchange and cooperation in relevant fields between India and Taiwan.
Low-value surgical innovation under peer-review: A sham study of abstracts on proximal humerus fractures submitted to scientific meetings
Authors: Razaeian Sam , Zhang Dafang , Krettek Christian 
Published: October 2024

Background Innovation has in common the promise of benefit for patients; however, past experience has shown that this promise is not always delivered. Instead, low-value innovation might encourage treatment variation and dilute the available body of evidence. This study aims to investigate (1) whether the peer-review process is capable of filtering out low-value innovation appropriately, and (2) whether low-value surgical innovation would be preferred more often than nonoperative innovation by peer-reviewers in the treatment of proximal humeral fractures in the elderly. Materials and methods Two duplicated sham scientific abstracts, respectively introducing a low-value surgical innovation and a valuable nonsurgical innovation, were submitted to nineteen peer-reviewed scientific meetings worldwide for orthopedic trauma surgery with submission deadlines between 01/01/2022 and 31/12/2022. Decision regarding abstract acceptance was compared. Results There was a high acceptance rate for the abstract introducing low-value surgical innovation (12 out of 19 (63.2 %)), which was higher than that of a nonoperative duplicate (10 out of 19 (52.6 %)), but this difference was not statistically significant ( p = 0.5). The majority of the ten meetings that accepted both abstracts placed both in equivalent programmatic tiers (oral presentation (4) and poster presentation (2)). In three meetings, the surgical abstract received superior program placement (oral presentation). In one case, it was the opposite. Conclusion There is a high acceptance rate for low-value surgical innovation among peer-reviewed scientific meetings. However, we can not conclude that low-value surgical innovation is preferred more often than nonoperative innovation by peer-reviewers as the differences in acceptance rate were small and not statistically significant. The peer-review process may be suitable as value-based medicine emerges. Scientists should be encouraged to pursue value-based innovation.
Knowledge of Palliative Care in Men and Women Diagnosed With Metastatic Breast Cancer
Authors: Robles-Rodriguez Evelyn , Weinmann Ashley , Grana Generosa , Carter Teralyn , Jerome-D’Emilia Bonnie 
Published: October 2024

Purpose The purpose of this study was to evaluate knowledge of Palliative Care (PC) and the impact of systemic and patient-related factors on the use of PC in a diverse population of men and women diagnosed with metastatic breast cancer. Methodology A telephone administered survey was used with patients receiving treatment at a Cancer Center in an urban area of the Northeast US. Descriptive statistics and chi square analysis were used. Findings Of the 101 participants, 44% had no knowledge of PC and only 21.78% indicated that they were receiving palliative care. Participants who reported being followed by palliative care were less likely to have been treated in the emergency department in the past year ( P = 0.003) or to have been hospitalized ( P = 0.042). However, when asked about symptom burden, using the Edmonton Symptom Assessment Scale, patients who reported being followed by PC were more likely to report severe pain as compared to patients not receiving PC ( P < 0.001). There were no associations found between race/ethnicity or social determinants of health and knowledge of PC or receipt of services. Conclusions This sample of men and women diagnosed with metastatic breast cancer and being treated in a Cancer Center had limited knowledge and exposure to Palliative Care services across race and ethnicity. While no specific disparity was noted, the utilization of PC was low. Whether a function of a lack of referrals or patient preference, an effort should be made to increase PC referrals for all patients diagnosed with cancer.
A Randomized, Double-Blind, Controlled Trial to Assess the Effects of Lactoferrin at Two Doses vs. Active Control on Immunological and Safety Parameters in Healthy Adults
Authors: Peterson Ross D. , Guarneiri Liana L. , Adams Caryn G. , Wilcox Meredith L. , Clark Anthony J. , Rudemiller Nathan P. , Maki Kevin C. , Malinczak Carrie-Anne 
Published: October 2024

Recombinant human lactoferrin (rhLF) is of commercial interest for immune support as a food ingredient. The objective was to evaluate the immunogenicity/alloimmunization potential of Helaina rhLF (effera™) from K. phaffii over a 28-day period compared to bovine LF (bLF). Study 1 was a randomized, double-blind, parallel arm, controlled trial where 66 healthy adults were randomly allocated to 1 of 3 groups: high-dose rhLF (3.4 g/d), low-dose rhLF (0.34 g/d), or bLF (3.4 g/d). Participants completed a 28-day supplementation period with follow-up visits on Days 28, 56, and 84. Study 2 was a 12-week observational study with no intervention that enrolled 24 healthy adults. In both studies, serum was obtained for analysis of anti-LF antibody levels as the primary endpoint. In Study 1, change from baseline to Day 56 in serum anti-bLF antibodies in the bLF group (least squares geometric mean and 95% confidence interval for the post/pre ratio: 3.01; 2.08, 4.35) was greater than the changes in serum anti-hLF antibodies in the low-dose rhLF (1.07; 0.77, 1.49; P < 0.001) and high-dose rhLF (1.02; 0.62, 1.70; P < 0.001) groups. The rhLF groups had similar changes to the observational study, indicating no change in anti-hLF antibodies and no evidence of alloimmunization following ingestion. Changes in safety outcomes were similar between groups and within normal ranges. These results show that under the conditions of the protocol, no increased anti-hLF antibodies or adverse events were identified following ingestion of effera™ as a food ingredient at an intake level up to 3.4 g/d in healthy adults (clinicaltrials.gov: NCT06012669).
Comparative performance of video-otoscopy and CT in the diagnosis of external ear disease in cats
Authors: Gracz Magdalena , Vandenabeele Sophie , Rodrigues Tania N , Duchateau Luc , Saunders Jimmy H , Stock Emmelie 
Published: October 2024

Objectives The aim of the study was to compare CT with video-otoscopy for detecting external ear canal masses in cats and to describe CT features of feline external ear disease. Methods This retrospective study evaluated the external ear canals of cats that underwent both CT and video-otoscopy. Two blinded observers reviewed the CT scans and their findings were compared with video-otoscopy results evaluated by one blinded observer. Results Of the 32 examined ears, 13 had an external ear canal mass detected by both CT and video-otoscopy. No false positives were identified. All 19 ears without masses were correctly identified as true negatives, resulting in perfect agreement for mass detection (kappa = 1.000). On histopathology, 9/13 masses were diagnosed as polyps, 1/13 masses was diagnosed as carcinoma, 2/13 did not undergo histopathology and 1/13 masses seen on video-otoscopy was diagnosed as otitis externa with granulomatous tissue formation. Of the 16 cats examined, 12 had a mass in the external ear canal diagnosed by video-otoscopy: six domestic shorthairs, five Maine Coons and one Oriental Shorthair cat. Of these cats, 11 had a unilateral mass and one had a bilateral mass. There was very low agreement between CT and video-otoscopy for ear canal wall enhancement and erythema (kappa = 0.033), as well as for ear canal thickening and stenosis (weighted kappa = 0.056). There was no significant difference between chronic and non-chronic clinical signs in terms of the presence of ear canal wall mineralisation ( P = 0.223). Conclusions and relevance There is high agreement between video-otoscopy and CT in detecting external ear canal masses in cats. However, there is very low agreement between CT and video-otoscopy for ear canal wall enhancement, erythema, thickening and stenosis. The presence of external ear canal mineralisation did not correlate with the chronicity of clinical signs.
Robot-assisted percutaneous scaphoid fixation: patient-reported outcomes and learning curve at two centres
Authors: Yi Zhe , Qi Weiya , Lim Rebecca Qian Ru , Chen Wei , Chen Shanlin , Liu Bo 
Published: October 2024

This study describes patient-reported outcomes of robot-assisted percutaneous scaphoid fracture fixation of 62 patients from two medical centres and the learning curve of this new technique. One attempt to place the guidewire was sufficient in 97% of cases. All fractures achieved radiographic union at a mean of 9 weeks. There were no complications observed. At a mean follow-up of 36 months (range 12–68 months), the mean patient-rated wrist evaluation (PRWE) was 2 (range 0–22) and the mean Mayo Wrist Score was 96 (range 70–100). After the initial ten to 20 cases, the learning phase was reasonably surmountable with a marked reduction of operative duration and improvement of the screw accuracy. Level of evidence: IV
Total elbow allograft augmented with vascularized periosteal grafts for salvage of a failed distal humeral joint replacement for Ewing sarcoma reconstruction
Authors: Soldado Francisco , Gonzalez-Morgado Diego , Guillen-Distefano Juan Sebastian 
Published: October 2024

Vascularized periosteal grafts have been used to promote bone union in massive bone defects. We present a child with a failed distal humeral joint replacement for Ewing sarcoma reconstruction, successfully treated with a total elbow allograft augmented by vascularized periosteal grafts. Level of evidence: V
Assessing age-related risks of gastrointestinal pathologies: a comparative study of gastroscopy outcomes across decades
Authors: Nguyen Lac , Räsänen Noora , Berggren Filippa , Nieuwenhoven Michiel A. van 
Published: October 2024

Background: Esophagogastroduodenoscopy (EGD) is the gold standard method for diagnosing upper gastrointestinal (GI) pathology. Swedish guidelines recommend patients over 50 years with new-onset dyspeptic symptoms undergo direct gastroscopy to rule out malignancy. However, the incidence of dysplasia or cancer in patients aged 61–70 years remains unclear. Objectives: To investigate the referral factors and endoscopic findings in patients aged 61–70 years and compare the result with age groups 51–60 and 41–50 years from our previous studies to establish whether there is an age cutoff for upper GI cancer risk. Design: A retrospective observational study was conducted to evaluate EGD referrals and outcomes in patients aged 61–70 years. Methods: We analyzed EGD referrals for patients aged 61–70 years within Region Örebro County from January 2019–April 2020 to January 2022–2023. Clinical data, including symptoms, medications, and laboratory results, were collected from medical records. Statistical analysis, including odds ratios (OR) and positive predictive values (PPV), was conducted to evaluate pathological outcomes based on referral factors. Results: A total of 1003 referrals were analyzed. Statistically significant differences in pathological findings were observed between the 41–50 years reference group and the older groups (51–60 years: OR 2.08, p < 0.001; 61–70 years: OR 3.05, p < 0.001). However, no statistically significant difference in cancer incidence was found between the age groups. Conclusion: The most common pathological findings were benign, including hiatal hernia, gastroesophageal reflux disease/esophagitis, or gastritis. The incidence of cancer was low in all three groups. These results suggest that the “test-and-treat” strategy, currently recommended for patients under 50 years, may be appropriate for patients aged 51–70 years as well. Trial registration: NCT04585516.
Prediction of Incident Diabetic Retinopathy in Adults With Type 1 Diabetes Using Machine Learning Approach: An Exploratory Study
Authors: Montaser Eslam , Shah Viral N. 
Published: October 2024

Background: Early detection and intervention are crucial for preventing vision-threatening diabetic retinopathy (DR) in adults with type 1 diabetes (T1D). This exploratory study uses machine learning on continuous glucose monitoring (CGM) data to identify factors influencing DR and predict high-risk individuals for timely intervention. Methods: Between June 2018 and March 2022, adults with T1D with incident DR or no retinopathy (control) were identified. The CGM data were collected retrospectively for up to seven years before the date of defining incident DR or no retinopathy. A mixture of three machine learning algorithms was trained and evaluated in two different scenarios, using different glycemic features extracted from CGM traces (scenario 1), and the two principal components (two PCs; exposure to hyperglycemia and hypoglycemia risk) of those features (scenario 2). Classifiers were evaluated through 10-fold cross-validation using the receiver operating characteristic area under the curve (AUC-ROC) to select the best classification model. Results: The CGM data of 30 adults with incident DR (mean±SD age of 21.2±9.4 years, glycated hemoglobin [HbA1c] of 8.6%±1.0%, and body mass index [BMI] of 24.5±4.8 kg/m2) and 30 adults without DR (age of 41.8±14.7 years, HbA1c of 7.0%±0.9%, and BMI of 26.2±3.6 kg/m2) were included in this analysis. In scenario 2, classifiers outperformed scenario 1, resulting in an average AUC-ROC increase to 0.92 for two of three models, indicating that the two PCs captured vital classification data, representing the most discriminative aspects and enhancing model performance. Conclusion: Machine learning approaches using CGM data may have potential to aid in identifying adults with T1D at risk of DR.
Long-term risks of cardiovascular-specific mortality among myeloproliferative neoplasms patients
Authors: Tang Meiling , Chen Ying , Zhou Yanying , Zhuang Xinran , Fu Yuxin , Chen Jinzheng , Wei Rongfang , Chen Yan 
Published: October 2024

Background: The myeloproliferative neoplasm (MPN) is a heterogeneous group of clonal hyperplasia hematopoietic stem cell disorders, predominantly affecting middle-aged and elderly individuals, with a slow disease progression. With advancements in disease-related research, the survival rates of MPN patients have significantly improved. This research primarily focuses on cardiovascular disease mortality (CVM) and prognostic factors in MPN patients, aiming to provide clinicians with more comprehensive references. Methods: A total of 24,277 patients were included in the Surveillance, Epidemiology, and End Results (SEER) database. Cumulative mortality was assessed using a competing risk model, univariate and multivariate regression analysis of cardiovascular disease (CVD) mortality risk factors, and a comparison of standardized mortality ratio (SMR) and general population CVM. Results: Among the 24,277 patients included in this study, a total of 8841 deaths occurred during the follow-up period, with 2429 attributed to CVD. Notably, the risk of CVM was found to be significantly higher in patients with MPNs compared to the general population. Furthermore, this risk increased over time. CVD emerged as the predominant cause of death among individuals aged over 80 years and younger patients exhibited a significantly elevated SMR. Additionally, age, race, marital status, and insurance status were identified as independent prognostic factors for CVM. Conclusion: The incidence of cardiovascular events in patients with MPNs is significantly higher compared to the general population. Early screening and assessment of cardiac health should be implemented in MPN patients to prevent the occurrence of cardiovascular events and enhance their prognosis.
Clinical features and treatment of newly diagnosed multiple myeloma with secondary myelofibrosis: a retrospective study
Authors: Xu Han , Xu Yujie , Wang Mengying , Mao Chunxia , Huang Junxia , Li Tianlan , Gao Yan , Liu Shanshan , Zhou Jingjing , Zhang Yi , Feng Xianqi 
Published: October 2024

Background: Secondary myelofibrosis (SMF) is characterized by the excessive deposition of fibrous tissue on top of the primary disease, often causing clinical manifestations to be overshadowed by the primary disease. Unfortunately, current staging systems do not incorporate myelofibrosis, leading to potential treatment delays for SMF. Objectives: To evaluate the prognosis of patients with multiple myeloma (MM) complicated with myelofibrosis Design: The study included the clinical data and treatment results of 208 newly diagnosed multiple myeloma (NDMM) patients who were treated in the Affiliated Hospital of Qingdao University from January 2014 to August 2020, and performed a retrospective analysis. Methods: All patients underwent bone marrow biopsy, and MF severity was classified into grades 0–3 according to the 2016 WHO criteria. Treatment efficacy was evaluated based on the International Myeloma Working Group (IMWG) standard and SPSS was used for analysis. Results: The MM patients without SMF exhibited better treatment response ( p < 0.05). Importantly, increasing degrees of myelofibrosis were associated with a significant reduction in median progression-free survival (PFS; p < 0.05). MM-SMF patients exhibited significantly shorter median PFS and overall survival (OS; p < 0.05). In the MM-SMF group, neutrophil–lymphocyte ratio >2.39, monocyte–lymphocyte ratio ⩽0.18, and platelet–lymphocyte ratio ⩽61.6 were associated with significantly reduced median PFS and OS ( p < 0.05). Notably, the use of bortezomib-based regimens did not significantly impact prognosis in MM-SMF patients, while lenalidomide-based regimens significantly extended median OS but did not significantly affect median PFS. Conclusion: Myelofibrosis emerges as an important prognostic indicator for predicting the survival outcomes of NDMM patients. In the era of new therapeutics, there is a pressing need to explore novel treatment strategies in order to improve the prognosis of patients with multiple myeloma complicated by myelofibrosis.