bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asphalt pavement raveling recognition based on deep learning algorithms
Authors: Peng Yi , Yu Xinyi , Huang Yixin , Kong Lingyun , Liu Tangzhi , Liu Guangjiu , Zhu Hongzhou 
Published: October 2024

Abstract
Pavement raveling can lead to the development of issues such as potholes. Monitoring and providing real-time early warnings for road surface developments is crucial for timely maintenance planning and effectively controlling the occurrence and progression of surface issues. To achieve intelligent identification of raveling distress on asphalt pavement surfaces, we utilized a portable laser-based pavement surface scanning device to collect raveling images, followed by histogram equalization to eliminate noise caused by environmental factors. Additionally, data enhancement strategies such as rotation and mirroring were used to enrich training data and expand the sample size. A convolutional neural network was employed to perform multi-layer convolution and pooling operations on the images to quickly extract features of distress. Finally, five pre-trained transfer learning models—ResNet-18, DenseNet, VGG16, Inception, and EfficientNet—were introduced to identify the asphalt surface disease data and the normal surface data. The results showed that the accuracy and loss of the training sets of several models exhibited a positive trend, with the EfficientNet model demonstrating stable and superior performance under the same training conditions. The precision matrix, confusion matrix, precision, recall, and F1 score were used as evaluation indexes to assess the effectiveness of the models for identifying pavement raveling. The EfficientNet and Inception models had the best accuracy and comprehensive performance, with accuracy rates of 0.96 and 0.95, respectively. The precision, recall, and F1 score are 0.95, 0.96, and 0.96 for the EfficientNet model, respectively. A total of 146 images correctly predicted raveling disease and only four normal images were incorrectly predicted as diseased. For example, the EfficientNet model’s identification accuracy for pockmark disease on the PC platform was 0.963, verifying the model’s feasibility in practical applications. The principal contribution of this paper lies in the efficient and precise identification of asphalt pavement raveling, which adversely affects vehicular traveling comfortability. This provides theoretical and technical support for the intelligent identification of asphalt pavement defects and enhancing road asset maintenance management in the pavement engineering industry.
Chain event graphs for assessing activity-level propositions in forensic science in relation to drug traces on banknotes
Authors: Robertson Gail , Wilson Amy L , Smith Jim Q 
Published: October 2024

Abstract
Graphical models can be used to compare support given by evidence to propositions put forward by competing parties during court proceedings. Such models can also be used to evaluate support for activity-level propositions, that is, propositions referring to the nature of activities associated with evidence and how this evidence came to be at a crime scene. Graphical methods can be used to show different scenarios that might explain the evidence in a case and to distinguish between evidence requiring evaluation by a jury and quantifiable evidence from the crime scene. Such visual representations can be helpful for forensic practitioners, police, and lawyers who may need to assess the value that different pieces of evidence make to their arguments. In this article, we demonstrate how chain event graphs (CEGs) can be applied to a drug trafficking case. We show how different evidence (i.e. expert judgement and data from a crime scene) can be combined using a CEG and show how the hierarchical model deriving from the graph can be used to evaluate the degree of support for different activity-level propositions in the case. We also develop a modification of the standard CEG to simplify its use in forensic applications.
Further Evidence for Strong Nonneutrality of Yeast Synonymous Mutations
Authors: Shen Xukang , Song Siliang , Li Chuan , Zhang Jianzhi 
Published: October 2024

Abstract
Although synonymous mutations are commonly assumed neutral or nearly so, recent years have seen reports of fitness effects of synonymous mutations detected under laboratory conditions. In a previous study, we used genome editing to construct thousands of yeast mutants each carrying a synonymous or nonsynonymous mutation in one of 21 genes, and discovered that most synonymous and most nonsynonymous mutations are deleterious. A concern was raised that this observation could be caused by the fitness effects of potential CRISPR/Cas9 off-target edits and/or secondary mutations, and an experiment that would be refractory to such effects was proposed. Using genome sequencing, we here show that no CRISPR/Cas9 off-target editing occurred, although some mutants did carry secondary mutations. Analysis of mutants with negligible effects from secondary mutations and new data collected from the proposed experiment confirms the original conclusion. These findings, along with other reports of fitness effects of synonymous mutations from both case and systematic studies, necessitate a paradigm shift from assuming (near) neutrality of synonymous mutations.
Association Between Mycobacterium tuberculosis Sensitization and Insulin Resistance Among US Adults Screened for Type 2 Diabetes Mellitus
Authors: Magodoro Itai M , Aluoch Aloice , Claggett Brian , Nyirenda Moffat J , Siedner Mark J , Wilkinson Katalina A , Wilkinson Robert J , Ntusi Ntobeko A B 
Published: October 2024

Abstract

Background
Type 2 diabetes mellitus (T2DM) may be a long-term sequela of infection with Mycobacterium tuberculosis (Mtb) by mechanisms that remain to be fully explained. We evaluated the association between Mtb sensitization and T2DM and, via mediation analysis, the extent to which it is mediated by insulin resistance and/or β-cell failure.

Methods
Adults were assessed for T2DM by fasting plasma glucose, 2-hour oral glucose tolerance testing, and hemoglobin A1c; β-cell dysfunction and insulin resistance by homoeostasis model assessment 2; and Mtb sensitization by tuberculin skin testing. Associations between Mtb sensitization and T2DM were modeled with probit regression and decomposed into indirect effects of β-cell dysfunction and insulin resistance. Analyses were adjusted for sociodemographic, behavioral, and clinical characteristics.

Results
We included 1843 adults. Individuals with Mtb sensitization were older than those without Mtb (median [IQR], 54 [39–64] vs 47 [33–62] years). As compared with being uninfected, Mtb sensitization was associated with T2DM (adjusted absolute risk difference, 9.34% [95% CI, 2.38%–15.0%]; P &lt; .001) and increased insulin resistance (adjusted median difference, 0.16 [95% CI, .03–.29]; P = .014) but not β-cell dysfunction (adjusted median difference, −3.1 [95% CI, −10.4 to 4.3]; P = .42). In mediation analyses, insulin resistance mediated 18.3% (95% CI, 3.29%–36.0%; P = .020) of the total effect of the association between Mtb sensitization and T2DM.

Conclusions
Definitive prospective studies examining incident T2DM following tuberculosis are warranted. Notwithstanding, our findings suggest that exposure to Mtb may be a novel risk factor for T2DM, likely driven by an increase in insulin resistance.
How Much Does Prosthetic Joint Infection and Its Successful Treatment Affect Patient-reported Quality of Life?
Authors: Cooper Darcie , Athan Eugene , Yates Piers , Aboltins Craig , Davis Joshua S. , Manning Laurens ,   on behalf of the Australasian Society for Infectious Diseases Clinical Research Network
Published: October 2024

Background
Uncomplicated joint replacement improves pain and other patient-reported outcome measures (PROMs) such as joint function scores and quality-of-life measures. However, the overall impact of periprosthetic joint infection (PJI) and its successful treatment on PROMs is poorly defined. In this study, we describe quality-of-life scores using the 12-item Short Form survey, version 2 (SF-12v2), collected as part of a large, prospective, observational study of PJI.

Questions/purposes
(1) Do patients with newly diagnosed PJI have lower quality-of-life scores than the general age-matched population? (2) Are lower quality-of-life scores for patients with PJI sustained for ≥ 12 months? (3) What factors are associated with a good functional outcome at 12 months, defined by achieving a physical component summary (PCS) score of > 50 on the SF-12v2 (that is, above the age-adjusted population mean) or an increase of > 8.9 or more from baseline?

Methods
The PIANO (Prosthetic joint Infection in Australia and New Zealand, Observational study) cohort was a prospective, longitudinal, multicenter cohort study of 783 patients with newly diagnosed PJI recruited across 27 centers between July 2014 and December 2017. All participants were followed for 2 years. SF-12v2 scores were collected at diagnosis (baseline) and 3, 12, and 24 months after diagnosis. Treatment success was defined as being alive with no clinical or microbiological evidence of infection and no ongoing use of antibiotics for the index joint.

Results
After exclusion of 6.6% (52) who had died, 4.2% (33) with PJI of joints other than hips and knees, and those with incomplete data sets (200 [25.5%]), 498 patients had complete SF-12v2 data sets available. At baseline, the median (IQR) PCS score was 37 (30 to 46), which increased to 41 (34 to 49; p < 0.001) at 12 months. Both measures were lower than those for the general age-matched population norm. There was no further improvement in PCS scores between 12 and 24 months. By contrast, the median (IQR) mental component summary score of the SF-12v2 was similar to age-adjusted population norms (48 [37 to 57]) at baseline. Only 40% of patients with PJI achieved a good functional outcome at 12 months. After adjustment for other factors, treatment success of PJI increased the odds of a good functional outcome by 67% (95% CI 11% to 154%; p = 0.02).

Conclusion
PJIs have a large effect on the PCS score of the SF-12v2 quality-of-life measure at baseline, which is sustained for at least 2 years. Successful treatment of PJI increases the likelihood of a good functional outcome. These data can be used to set expectations for patients presenting with PJI and can be used to inform future clinical studies in which quality-of-life measures are incorporated into clinical endpoints.

Level of Evidence
Level II, therapeutic study.
Comparing Different Pathways in Medical Education and Surgical Training: A Global Survey of Surgeons
Authors: Bucknor Alexandra , Pedreira Rachel , Bhat Deepa , Zamani Maryam , Nugent Nora , Furnas Heather J. 
Published: October 2024

Background:
Currently, interest in surgical careers is declining globally, whereas aging populations are contributing to a rising demand for surgical procedures. Surgeons who conduct scientific investigations and share clinical advances internationally pay little attention to comparing differences in ways nations attract, educate, and train their surgeons. This study compares international pathways toward surgeon development with the aim of seeking best practices and improving the outlook of surgery as an attractive career.

Methods:
A 70-question anonymous survey was distributed internationally to surgeons of all specialties. Data were analyzed in SPSS Statistics for Macintosh (IBM). A value of P less than 0.05 indicates statistical significance.

Results:
The 463 respondents from the United States (59%), the United Kingdom (16%), Europe (10%), Canada (5%), and the rest of the world (10%) averaged age 46, and 64% were women. Non-US/Canadian respondents (93%) attended 5- and 6-year medical schools; US respondents were far more likely (91%) to attend nonmedical 4-or-more–year university before medical school. Weekly training-hour mandates spanned less than or equal to 48 (9%) to 80 or more (45%); 76% surpassed mandate hours, and just 9% reported accurate hours. Average educational debt ranged from $14,000 (Europe) to $179,000 (US). Few (19%) felt training allowed family building.

Conclusion:
Based on best practices from different countries, the authors recommend a 6-year maximum university/medical education requirement, elimination of nonsurgical training years (mandatory in some countries), single-program surgical training, objective measure of work hours, optimizing weekly hours, improved support for family building, and end-of-training certification options.
Thinning of the Medial Sural Artery Perforator Flap: The Anatomical Examination of the Medial Sural Artery Perforator Branch
Authors: Banjongleelahong Kittituch , Vongviriyangoon Tara , Piyaman Parkpoom , Akaranuchat Nutthawut 
Published: October 2024

Background:
The medial sural artery perforator (MSAP) flap is thin, pliable, and versatile. This study aims to understand the anatomical basis of the MSAP flap and the subcutaneous course of the perforator for safe flap thinning.

Methods:
A total of 24 MSAP flaps were dissected under red silicone dye injection guidance. Full-thickness horizontal slides of flaps were performed, and the perforator courses were identified in the subcutaneous plane. Slides were placed on a millimeter board, and the perforator patterns were photographed and observed with loupes.

Results:
A total of 68 perforator courses were identified: type 1: 30.9%, type 2: 57.3%, and type 3: 11.8%. They traveled 1–25 mm to the subdermal plexus, with percentile 2.5 at 1 mm, percentile 90 at 18.2 mm, percentile 95 at 21.65 mm, and percentile 100 at 25 mm. The mean flap thickness was 7.75 ± 1.7 mm, with an average of 5.7 ± 1.3 perforators per flap. Perforators clustered between 2 and 18.4 cm from the popliteal crease and 0–8 cm from the posterior midline of the leg. The dominant perforators accounted for 45.2% (62 of 137), averaging 2.58 per flap. The medial sural artery branching pattern types were type 1: 37.5%, type 2: 50%, and type 3: 12.5%. The average pedicle length was 16.2 ± 1.3 cm, and the mean external diameter of the medial sural artery was 1.98 ± 0.13 mm.

Conclusions:
MSAPs branch within a maximal radius of 2.5 cm after emerging from the deep fascia. To maintain vascularity, the safe suprafascial dissection should be 2.5 cm apart from the point of emerging.
Renal denervation – radiofrequency vs. ultrasound: insights from a mixed treatment comparison meta-analysis of randomized sham controlled trials
Authors: Bangalore Sripal , Maqsood M. Haisum , Bakris George L. , Rao Sunil V. , Messerli Franz H. 
Published: October 2024

Background and aims:
Multiple randomized trials have shown that renal denervation (RDN) reduces blood pressure (BP) when compared with sham control but the antihypertensive efficacy of radiofrequency vs. ultrasound-based RDN is uncertain. We aimed to compare the outcomes of radiofrequency RDN (rRDN) and ultrasound RDN (uRDN), when compared with sham in patients with hypertension.

Methods:
PubMed, EMBASE, and clinicaltrials.gov databases were searched for randomized sham-controlled trials (RCTs) of rRDN or uRDN or for trials of rRDN vs. uRDN. Primary efficacy outcome was 24-h ambulatory SBP. A mixed treatment comparison meta-analysis was performed comparing the efficacy and safety against sham and against each other.

Results:
Among 13 RCTs that enrolled 2285 hypertensive patients, rRDN reduced 24-h ambulatory SBP [(MD = 2.34 mmHg; 95% confidence interval (95% CI): 0.72–3.95], office SBP (MD = 5.04 mmHg; 95% CI: 2.68–7.40)], and office DBP (MD = 2.95 mmHg; 95% CI: 1.68–4.22) when compared with sham. Similarly, uRDN reduced 24-h ambulatory SBP (MD = 4.74 mmHg; 95% CI: 2.80–6.67), day-time ambulatory SBP (MD = 5.40 mmHg; 95% CI: 3.68–7.13), night-time ambulatory SBP (MD = 3.84 mmHg; 95% CI: 0.02–7.67), and office SBP (3.98 mmHg; 95% CI: 0.78–7.19) when compared with sham. There was significantly greater reduction in 24-h ambulatory SBP (MD = 2.40 mmHg; 95% CI: 0.09–4.71), day-time ambulatory SBP (MD = 4.09 mmHg; 95% CI: 1.61–6.56), and night-time ambulatory SBP (MD = 5.76 mmHg; 95% CI: 0.48–11.0) with uRDN when compared with rRDN. For primary efficacy outcome, uRDN ranked #1, followed by rRDN (#2), and sham (#3).

Conclusion:
In hypertensive patients, rRDN and uRDN significantly reduced 24-h ambulatory and office SBP when compared with sham control with significantly greater reduction in ambulatory BP with uRDN than with rRDN at 4 months (mean) of follow-up. A large-scale randomized head-to-head trial of rRDN or uRDN is warranted to evaluate if there are differences in efficacy.
The impact of 3 different dietary interventions on overweight or obese adults: A network meta-analysis
Authors: Liao Tianrong , Su Jiayu , Quan Tingwei , Luo Yu , Zeng Yiqian , Chen Dandan , Tang Hongzhen 
Published: October 2024

Objective:
This network meta-analysis aims to investigate and compare the effectiveness of 3 dietary interventions – Mediterranean, ketogenic, and low-fat diet – on overweight and obese adults, with a comparison to traditional low-calorie diet.

Methods:
A systematic review was conducted in both Chinese and English databases, including the China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), SinoMed, PubMed, Web of Science, Cochrane Library and Embase to identify relevant randomized controlled trials (RCTs) up to January 31, 2024. Two researchers independently screened and extracted data from the identified literature. The quality of these studies was assessed using the Cochrane bias risk assessment tool. A random-effects network meta-analysis was performed using Review Manager 5.4.1 and Stata 16.0 software.

Results:
A total of 17 randomized controlled trials involving 5802 subjects were included in this study. The network meta-analysis revealed a descending order of effectiveness for reducing body weight (BW), body mass index (BMI), and waist circumference (WC): ketogenic diet > low-fat diet > low-calorie diet > Mediterranean diet.

Conclusions:
The ketogenic diet was identified as the most effective intervention for reducing BW, BMI, and WC in the studied dietary comparisons. It consistently showed superior outcomes, ranking highest in effectiveness among the 4 evaluated dietary approaches. Nevertheless, additional high-quality randomized controlled trials are necessary to validate these findings.
Contrast-enhanced ultrasound findings of sclerotic nodules in Wilson disease: A case report
Authors: Hu Cong , Liu Kun , Liu Aihua , Huang Weiling , Zhao Zhiwei , Jiang Yuancheng , Chen Yixin , Zhang Qi , Wang Ying , Wu Meng 
Published: October 2024

Rationale:
Wilson disease is an autosomal recessive genetic disease found by Samuel Alexander Kinnier Wilson and prevalent in childhood and adolescents.

Patient concerns:
An 18-year-old female patient presented to our hospital with a continuous decrease of 3 blood cell lines for more than 10 days, and diagnosed as decompensated cirrhosis. Ultrasonography showed diffuse lesions in the hepatic parenchyma, with multiple hypoechoic light masses in the parenchyma, the outline was still clear, and the internal echo was uneven. Contrast-enhanced ultrasound showed that the nodules were enhanced rapidly and uniformly, with an initial enhancement time of 9 seconds and a peak time of 17.2 seconds. The washing time was slightly earlier than that of the hepatic parenchyma and showed slightly higher enhancement in the delayed phase. Finally, ultrasound-guided biopsies showed unexplained liver cirrhosis.

Diagnoses:
Combined with clinical examination, it was inferred to be Wilson disease. It is difficult to diagnose hepatolenticular degeneration because of its concealed incidence, complex clinical manifestations, expensive detection of the ATP7B gene, and lack of other specific imaging signs.

Outcomes:
After admission, the patient was given symptomatic support treatment such as liver protection.

Interventions:
The patient was discharged after improvement of symptoms.

Lessons:
Here, the results of contrast-enhanced ultrasound in our case may provide a new idea for the diagnosis of Wilson.
Comparison of orexigenic and anorexigenic neuropeptide levels in hyperemesis gravidarum patients with normal pregnant women: A prospective cohort study
Authors: Yilmaz Mehmet , Aksin Şerif , Balsak Deniz , Aboalhasan Yasmin , Batmaz İbrahim 
Published: October 2024

Background:
The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (α-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG).

Methods:
Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants’ age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, α-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay.

Results:
No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (α-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the α-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020).

Conclusion:
α-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.