bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of a novel proximal femoral bionic nail and three conventional cephalomedullary nails for reverse obliquity intertrochanteric fractures: a finite element analysis
Authors: Yang Yanjiang , Tong Yu , Cheng Xiaodong , Zhu Yanbin , Chen Wei , Cui Yunwei , Zhang Qi , Zhang Yingze 
Published: June 2024

PurposeConventional cephalomedullary nails (CMNs) are commonly employed for internal fixation in the treatment of reverse obliquity intertrochanteric (ROI) fractures. However, the limited effectiveness of conventional CMNs in addressing ROI fractures results in significant implant-related complications. To address challenges associated with internal fixation, a novel Proximal Femoral Bionic Nail (PFBN) has been developed.MethodsIn this study, a finite element model was constructed using a normal femoral specimen, and biomechanical verification was conducted using the GOM non-contact optical strain measurement system. Four intramedullary fixation approaches—PFBN, Proximal Femoral Nail Antirotation InterTan nail (ITN), and Gamma nail (Gamma nail)—were employed to address three variations of ROI fractures (AO/OTA 31-A3). The biomechanical stability of the implant models was evaluated through the calculation of the von Mises stress contact pressure and displacement.ResultsCompared to conventional CMNs, the PFBN group demonstrated a 9.36%–59.32% reduction in the maximum VMS at the implant. The A3.3 ROI fracture (75% bone density) was the most unstable type of fracture. In comparison to conventional CMNs, PFBN demonstrated more stable data, including VMS values (implant: 506.33 MPa, proximal fracture fragment: 34.41 MPa), contact pressure (13.28 MPa), and displacement (17.59 mm).ConclusionCompared to the PFNA, ITN, and GN, the PFBN exhibits improvements in stress concentration, stress conduction, and overall model stability in ROI fractures. The double triangle structure aligns better with the tissue structure and biomechanical properties of the proximal femur. Consequently, the PFBN has significant potential as a new fixation strategy for the clinical treatment of ROI fractures.
The threshold effect of triglyceride glucose index on diabetic kidney disease risk in patients with type 2 diabetes: unveiling a non-linear association
Authors: Wang Huabin , Chen Guangming , Sun Dongmei , Ma Yongjun 
Published: June 2024

BackgroundPrevious studies have confirmed that the triglyceride glucose (TyG) index, recognized as a reliable marker of insulin resistance, is an important risk factor for diabetic kidney disease (DKD). However, it is still unclear whether the DKD risk continues to increase linearly with the elevation of TyG index. This study aimed to thoroughly investigated the intrinsic relationship between TyG index and DKD risk in type 2 diabetes (T2D).MethodsThis cross-sectional study included 933 patients with T2D in China, who were categorized into DKD and non-DKD groups and stratified by TyG index levels. Logistic regression analysis identified the independent risk factors for DKD. The association between DKD risk and TyG index was evaluated using the restricted cubic spline (RCS) curves analysis. The R package ‘CatPredi’ was utilized to determine the optimal cut-off point for the relationship between DKD risk and TyG index, followed by threshold effect analysis.ResultsThe prevalence of DKD was 33.01%. After adjusting for confounding factors, TyG index was identified as a prominent clinical risk factor for DKD, showing the highest odds ratio (OR 1.57 (1.26 - 1.94), P&lt;0.001). RCS analysis revealed a non-linear relationship with a threshold interval effect between the TyG index and DKD risk. When TyG index ≤ 9.35, DKD risk plateaued at a low level; however, when TyG index &gt; 9.35, DKD risk increased gradually with rising TyG index. Among patients with TyG index &gt; 9.35, each 1-unit increase was associated with a 1.94-fold increased DKD risk (OR=1.94 (1.10 - 3.43), P=0.022).ConclusionThe DKD risk presented a threshold effect with the increase of TyG index, initially stable at a low level, and then gradually rising when the TyG index is above 9.35.
Do professionalism, leadership, and resilience combine for professional identity formation? Evidence from confirmatory factor analysis
Authors: Ryan Aine , Moran Catherine N. , Byrne David , Hickey Anne , Boland Fiona , Harkin Denis W. , Guraya Shaista S. , Bensaaud Abdelsalam , Doyle Frank 
Published: June 2024

IntroductionProfessional identity formation (PIF) is an ongoing, self-reflective process involving habits of thinking, feeling and acting like a physician and is an integral component of medical education. While qualitative work has suggested that PIF is informed by professionalism, resilience, and leadership, there is a dearth of quantitative work in this area. Multiple methods build rigor and the present study aimed to quantitatively assess the relative psychometric contributions of professionalism, resilience, and leadership constructs to informing PIF, using a latent factor analysis approach.MethodsWe analyzed data from the PILLAR study, which is an online cross-sectional assessment of a pre-clinical cohort of medical students in the RCSI University of Medicine and Health Sciences, Dublin, using established and validated quantitative measures in each area of interest: PIF, professionalism, leadership and resilience. A total of 76 items, combining four validated scales, along with a selection of demographic questions, were used. The hypothesis that PIF is informed by, and correlates with, professionalism, resilience and leadership was examined by conducting a confirmatory factor analysis of a proposed three-factor higher-order model. Model estimation used Maximum Likelihood Method (MLM) with geomin rotation. The hypothesized (measurement) model was examined against an alternative (saturated) model, as well as a three-factor model.ResultsLatent variable analysis from 1,311 students demonstrated that a three-factor higher-order model best fit the data; suggesting PIF is informed by professionalism, resilience, and leadership, and that these constructs are statistically distinct and account for differential aspects of PIF. This higher-order model of PIF outperformed both the saturated model and the three-factor model. The analysis of which component may be the most or least influential was inconclusive, and the overall model was not influenced by year of training.DiscussionBuilding upon existing conceptual contentions, our study is the first to quantitatively support the contribution of professionalism, resilience, and leadership to the development of professional identity, and to delineate the inter-relationships between PIF and these constructs. This information can be used by medical educators when designing curricula and educational strategies intended to enhance PIF. Future work should seek to assess the influence of these constructs longitudinally.
Age-related differences in the intrinsic connectivity of the hippocampus and ventral temporal lobe in autistic individuals
Authors: Chen Lang , Abate Meghan , Fredericks Mackenzie , Guo Yuanchun , Tao Zhizhen , Zhang Xiuming 
Published: June 2024

IntroductionAlthough memory challenges in autistic individuals have been characterized recently, the functional connectivity of the hippocampus and ventral temporal lobe, two structures important for episodic and semantic memory functions, are poorly understood in autistic individuals. Moreover, age-related differences in the functional connectivity associated with these two memory networks are unrevealed.MethodsThe current study investigated age-related differences in intrinsic connectivity of the hippocampal and ventral temporal lobe (vTL) memory networks in well-matched ASD (n = 73; age range: 10.23–55.40 years old) and Non-ASD groups (n = 74; age range: 10.46–56.20 years old) from the open dataset ABIDE-I. Both theory-driven ROI-to-ROI approach and exploratory seed-based whole-brain approach were used.Results and discussionOur findings revealed reduced connectivity in ASD compared to Non-ASD peers, as well as an age-related reduction in the connectivity of hippocampal and vTL networks with triple networks, namely, the default mode network (DMN), the central executive network (CEN), and the salience network (SN), potentially underpinning their challenges in memory, language, and social functions. However, we did not observe reliable differences in age-related effects between the ASD and Non-ASD groups. Our study underscores the importance of understanding memory network dysfunctions in ASD across the lifespan to inform educational and clinical practices.
Efficacy and safety of Danhong injection for treating myocardial infarction: a systematic review and meta-analysis of randomized controlled trials
Authors: Yang Shiyi , Wang Yin , Shen Hailiang , Chen Tianhang , Du Haixia 
Published: June 2024

ObjectiveDanhong injection (DHI) is widely used in the treatment of myocardial infarction (MI). We aimed to systematically review the efficacy and safety of DHI in a randomized controlled experiment on MI.MethodsWe searched the randomized controlled trials (RCTs) of DHI for MI published before 2 April 2023 in China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang database, China Science and Technology Journal Database (VIP), PubMed, Web of Science, Cochrance Library, and Embase databases. The methodological quality of the included studies was evaluated using the Cochrane Handbook 5.3 criteria using the RevMan software, and meta-analysis was performed and a forest map was drawn.ResultsA total of 38 trials included 3877 patients, including 2022 cases in the DHI treatment group and 1855 cases in the control group. Meta-analysis showed that the total effective rate (RR = 1.18%, 95% CI [1.14–1.12]) during treatment with DHI was higher than that of the control group. The prevalence of cardiac arrhythmia (RR = 0.55%, 95% CI [0.46–0.65]) was lower than that of the control group. The incidence of heart rate failure (RR = 0.45%, 95% CI [0.30–0.70]) was lower than that of the control group. The prevalence of cardiogenic shock (RR = 0.33%, 95% CI [0.11–1.04]) was p &gt; 0.05, and the difference was not statistically significant. There was no statistically significant difference in LVEF between the two groups (MD = 0.00%, 95% CI [0.00–0.00]). CK-MB (MD = −0.81%, 95% CI [−0.92∼ −0.69]) was lower than the control group. hs-CRP (MD = −1.09, 95% CI [−1.22∼ −0.97]) was lower than the control group. The incidence of adverse reactions (RR = 0.37, The 95% CI [0.17–0.82]) was lower than that in the control group.ConclusionBasing on our study, the use of DHI in the treatment of myocardial infarction patients is effective, can improve cardiac function, reduce the incidence of adverse reactions, and improve the overall quality of life.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023390973.
Involvement of autophagy in mesaconitine-induced neurotoxicity in HT22 cells revealed through integrated transcriptomic, proteomic, and m6A epitranscriptomic profiling
Authors: Lin Xiaohuang , Zhang Jian , Wu Zekai , Shi Yuan , Chen Mengting , Li Maodong , Hu Hong , Tian Kun , Lv Xiaoqi , Li Chutao , Liu Yang , Gao Xinyue , Yang Qiaomei , Chen Kunqi , Zhu An 
Published: June 2024

Background: Mesaconitine (MA), a diester-diterpenoid alkaloid extracted from the medicinal herb Aconitum carmichaelii, is commonly used to treat various diseases. Previous studies have indicated the potent toxicity of aconitum despite its pharmacological activities, with limited understanding of its effects on the nervous system and the underlying mechanisms.Methods: HT22 cells and zebrafish were used to investigate the neurotoxic effects of MA both in vitro and in vivo, employing multi-omics techniques to explore the potential mechanisms of toxicity.Results: Our results demonstrated that treatment with MA induces neurotoxicity in zebrafish and HT22 cells. Subsequent analysis revealed that MA induced oxidative stress, as well as structural and functional damage to mitochondria in HT22 cells, accompanied by an upregulation of mRNA and protein expression related to autophagic and lysosomal pathways. Furthermore, methylated RNA immunoprecipitation sequencing (MeRIP-seq) showed a correlation between the expression of autophagy-related genes and N6-methyladenosine (m6A) modification following MA treatment. In addition, we identified METTL14 as a potential regulator of m6A methylation in HT22 cells after exposure to MA.Conclusion: Our study has contributed to a thorough mechanistic elucidation of the neurotoxic effects caused by MA, and has provided valuable insights for optimizing the rational utilization of traditional Chinese medicine formulations containing aconitum in clinical practice.
Trending ticks: using Google Trends data to understand tickborne disease prevention
Authors: Yang Cheng-Xian , Baker Lauri M. , McLeod-Morin Ashley 
Published: June 2024

IntroductionTicks and pathogens they carry seriously impact human and animal health, with some diseases like Lyme and Alpha-gal syndrome posing risks. Searching for health information online can change people’s health and preventive behaviors, allowing them to face the tick risks. This study aimed to predict the potential risks of tickborne diseases by examining individuals’ online search behavior.MethodsBy scrutinizing the search trends across various geographical areas and timeframes within the United States, we determined outdoor activities associated with potential risks of tick-related diseases. Google Trends was used as the data collection and analysis tool due to its accessibility to big data on people’s online searching behaviors. We interact with vast amounts of population search data and provide inferences between population behavior and health-related phenomena. Data were collected in the United States from April 2022 to March 2023, with some terms about outdoor activities and tick risks.Results and DiscussionResults highlighted the public’s risk susceptibility and severity when participating in activities. Our results found that searches for terms related to tick risk were associated with the five-year average Lyme Disease incidence rates by state, reflecting the predictability of online health searching for tickborne disease risks. Geographically, the results revealed that the states with the highest relative search volumes for tick-related terms were predominantly located in the Eastern region. Periodically, terms can be found to have higher search records during summer. In addition, the results showed that terms related to outdoor activities, such as “corn maze,” “hunting,” “u-pick,” and “park,” have moderate associations with tick-related terms. This study provided recommendations for effective communication strategies to encourage the public’s adoption of health-promoting behaviors. Displaying warnings in the online search results of individuals who are at high risk for tick exposure or collaborating with outdoor activity locations to disseminate physical preventive messages may help mitigate the risks associated with tickborne diseases.
Updated global epidemiology atlas of human prion diseases
Authors: Gao Li-Ping , Tian Ting-Ting , Xiao Kang , Chen Cao , Zhou Wei , Liang Dong-Lin , Cao Run-Dong , Shi Qi , Dong Xiao-Ping 
Published: June 2024

IntroductionHuman prion disease (PrD), a group of fatal and transmissible neurodegenerative diseases, consists of Creutzfeldt–Jakob disease (CJD), kuru, fatal familial insomnia (FFI), Gerstmann-Sträussler-Scheinker disease (GSS), and variably protease-sensitive prionopathy (VPSPr). The emergence of bovine spongiform encephalopathy (BSE) in cattle and variant CJD (vCJD) has greatly threatened public health, both in humans and animals. Since the 1990's, dozens of countries and territories have conducted PrD surveillance programs.MethodsIn this study, the case numbers and alternative trends of different types of PrD globally and in various countries or territories from 1993 to 2020 were collected and analyzed based on the data from the websites of the international and national PrD surveillance programs, as well as from relevant publications.ResultsThe total numbers of the reported PrD and sporadic CJD (sCJD) cases in 34 countries with accessible annual case numbers were 27,872 and 24,623, respectively. The top seven countries in PrD cases were the USA (n = 5,156), France (n = 3,276), Germany (n = 3,212), Italy (n = 2,995), China (n = 2,662), the UK (n = 2,521), Spain (n = 1,657), and Canada (n = 1,311). The annual PrD case numbers and mortalities, either globally or in the countries, showed an increased trend in the past 27 years. Genetic PrD cases accounted for 10.83% of all reported PrD cases; however, the trend varied largely among the different countries and territories. There have been 485 iatrogenic CJD (iCJD) cases and 232 vCJD cases reported worldwide.DiscussionThe majority of the countries with PrD surveillance programs were high- and upper-middle-income countries. However, most low- and lower-middle-income countries in the world did not conduct PrD surveillance or even report PrD cases, indicating that the number of human PrD cases worldwide is markedly undervalued. Active international PrD surveillance for both humans and animals is still vital to eliminate the threat of prion disease from a public health perspective.
Multicentric data analysis of the learning curve for laparoscopic Shull's repair of pelvic floor defects
Authors: Cianci S. , Ronsini C. , Riemma G. , Palmara V. , Romeo P. , La Verde M. , Laganà A. S. , Capozzi V. , Andreoli G. , Palumbo M. , Torella M. 
Published: June 2024

IntroductionPelvic organs prolapse remains a significant health concern affecting millions of women worldwide. The use of native tissues to suspend the apex has acquired relevance in urogynecologic surgery. One of the most commonly used procedures performed without mesh is the technique described by Shull, consisting of suturing the vaginal apex to the uterosacral ligaments. The objective of the study is to evaluate the learning curve of laparoscopic Shull's repair for the correction of pelvic floor defects, including the surgery time and surgical outcomes.Materials and methodsThis is a retrospective study conducted at the Policlinico G. Martino, University of Messina, Messina, Italy, and Policlinico Vanvitelli, Vanvitelli University, Naples, Italy. All patients affected by grade I-IV POP, consisting of apical prolapse with or without cystocele, and who underwent laparoscopic Shull's technique for prolapse correction were enrolled. The endpoints to estimate the learning curve for the procedure were the percentage of laparoscopic procedures completed, operative time, and the early complication rate.ResultsA total of 31 laparoscopic Shull repairs were collected for the study. To evaluate the learning curve of the technique, we divided the 31 cases into three different groups: Procedures 0–10; 11–20; 21–31. The parameter for evaluating technique learning was the operative time. Group 21–31 demonstrated an operative time of 97 min (SD 20), compared with 121 min (SD 23) in group 0–10 and 120 min (SD 13) in group 11–20. A comparison of these means through ANOVA showed a p-value of 0.01 for the entire system, and 0.95 for the comparison between 0 and 10 and 11–20, 0.04 for 0–10 vs. 21–31, and 0.02 between 11 and 20 and 21–31.ConclusionsThe rate of surgical improvement in terms of time became effective after an average of 20 procedures. However, the improvement seems to be effective case by case for surgeons skilled in basic endoscopy.
Key Determinants of COVID-19 Vaccination Take-Up in Remote Rural Areas: Evidence From Colombia
Authors: Cantet Natalia , Ibañez Marcela , Muñoz-Mora Juan Carlos , Quintero Laura Maria 
Published: June 2024

ObjetivesThe adoption of vaccines was a crucial factor in overcoming the COVID-19 pandemic. However, vaccination rates between rural and urban areas varied greatly. In this paper, our objective is to understand the individual and institutional factors associated with the uptake of vaccines in remote rural areas in Colombia.MethodsWe interviewed a random sample of 800 households (1,592 individuals) in remote rural areas of Antioquia (Colombia) during February 2022 when vaccinations were available. Then, we use a linear probability model to explain the uptake of the COVID-19 vaccine.ResultsThe results indicate that the probability of having at least the first dose of the COVID-19 vaccine is positively associated with access to information, trust in police and army, and the perceived risk of contracting COVID-19. Trust in the church is negatively related to vaccination.ConclusionInstitutions can play a critical role in the management of pandemics. Timely information on the risks associated with the disease and perceived riskiness are key factors that mobilize the population to take the COVID-19 vaccine.
A Case of Middle Ear Tuberculosis in Childhood
Authors: Чекан В.Л. , Тишковская О.В. , Сахаров И.В. , Кукса Е.Н. 
Published: June 2024

Туберкулезный средний отит является редкой локализацией внелегочных форм туберкулеза. Несмотря на научные достижения в области диагностики, лечения и профилактики заболеваний, вызванных микобактериями туберкулеза, данная проблема до сих пор остается актуальной для врачей различных специальностей. Диагностика туберкулезного поражения среднего уха всегда представляет большие трудности ввиду отсутствия патогномоничных признаков заболевания. Редкость встречаемости подчеркивает важность хирургического лечения с последующим культуральным и патологоанатомическим исследованием. В данной статье рассматривается случай туберкулезного среднего отита у ребенка женского пола в возрасте 3 лет 8 месяцев на момент хирургического лечения. Для диагностики использованы компьютерная томография (КТ), магнитно-резонансная томография (МРТ), патогистологическое, культуральное и бактериологическое исследования. Учитывая редкость встречаемости данного заболевания, мы полагаем, что описание этого клинического случая позволит врачам-оториноларингологам лучше ориентироваться в диагностике специфических форм среднего отита у детей.
Tuberculous otitis media is a rare localization of extrapulmonary forms of tuberculosis. Despite scientific advances in the field of diagnosis and treatment, prevention of diseases caused by Mycobacterium tuberculosis, this problem still remains relevant for doctors of various specialties. Diagnosis of tuberculous lesions of the middle ear always presents great difficulties due to the absence of pathognomonic signs of the disease. The rarity of occurrence emphasizes the importance of surgical treatment followed by culture and pathological examination. This article discusses a case of tuberculous otitis media in 3 years 8 months at the time of surgical treatment. Computed tomography (CT), magnetic resonance imaging (MRI), pathohistological, cultural and bacteriological studies were used for diagnosis. Considering the rarity of occurrence of this disease, we believe that the description of this clinical case will allow otorhinolaryngologists to better navigate the diagnosis of specific forms of otitis media in children.