bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making Drug Approval Decisions in the Face of Uncertainty: Cumulative Evidence versus Value of Information
Authors: Dijk Stijntje W. , Krijkamp Eline , Kunst Natalia , Labrecque Jeremy A. , Gross Cary P. , Pandit Aradhana , Lu Chia-Ping , Visser Loes E. , Wong John B. , Hunink M. G. Myriam 
Published: June 2024

Background The COVID-19 pandemic underscored the criticality and complexity of decision making for novel treatment approval and further research. Our study aims to assess potential decision-making methodologies, an evaluation vital for refining future public health crisis responses. Methods We compared 4 decision-making approaches to drug approval and research: the Food and Drug Administration’s policy decisions, cumulative meta-analysis, a prospective value-of-information (VOI) approach (using information available at the time of decision), and a reference standard (retrospective VOI analysis using information available in hindsight). Possible decisions were to reject, accept, provide emergency use authorization, or allow access to new therapies only in research settings. We used monoclonal antibodies provided to hospitalized COVID-19 patients as a case study, examining the evidence from September 2020 to December 2021 and focusing on each method’s capacity to optimize health outcomes and resource allocation. Results Our findings indicate a notable discrepancy between policy decisions and the reference standard retrospective VOI approach with expected losses up to $269 billion USD, suggesting suboptimal resource use during the wait for emergency use authorization. Relying solely on cumulative meta-analysis for decision making results in the largest expected loss, while the policy approach showed a loss up to $16 billion and the prospective VOI approach presented the least loss (up to $2 billion). Conclusion Our research suggests that incorporating VOI analysis may be particularly useful for research prioritization and treatment implementation decisions during pandemics. While the prospective VOI approach was favored in this case study, further studies should validate the ideal decision-making method across various contexts. This study’s findings not only enhance our understanding of decision-making strategies during a health crisis but also provide a potential framework for future pandemic responses. Highlights This study reviews discrepancies between a reference standard (retrospective VOI, using hindsight information) and 3 conceivable real-time approaches to research-treatment decisions during a pandemic, suggesting suboptimal use of resources. Of all prospective decision-making approaches considered, VOI closely mirrored the reference standard, yielding the least expected value loss across our study timeline. This study illustrates the possible benefit of VOI results and the need for evidence accumulation accompanied by modeling in health technology assessment for emerging therapies.
Sulcus-Deepening Trochleoplasty With Medial Patellofemoral Ligament Reconstruction: Outcomes at 10 to 20 Years
Authors: Dejour David H. , Pineda Tomas , Demey Guillaume , van Rooij Floris , Guarino Amedeo 
Published: June 2024

Background: Recent systematic reviews on the outcomes of sulcus-deepening trochleoplasty with adjuvant medial patellofemoral ligament (MPFL) reconstruction at a follow-up of 2 to 6 years have found that the procedure grants good clinical outcomes with low redislocation rates. However, there is a lack of evidence in the literature regarding mid- and long-term follow-ups. Purpose: To evaluate the radiographic and clinical outcomes of thick-flap sulcus-deepening trochleoplasty with MPFL reconstruction at a minimum follow-up of 10 years to assess the signs of patellofemoral arthritis, incidence of recurrent dislocation, and grade of patient satisfaction. Study Design: Case series; Level of evidence, 4. Methods: The authors evaluated a retrospective series of 43 patients (48 knees) who underwent sulcus-deepening trochleoplasty between 2003 and 2013. All patients underwent thick-flap sulcus-deepening trochleoplasty with additional MPFL reconstruction. All patients were assessed at a minimum follow-up of 10 years by an independent clinician who noted any patellar redislocation or reoperations in the operated knee and collected the International Knee Documentation Committee (IKDC), Kujala, and satisfaction scores. Furthermore, a radiographic examination was performed to assess patellar height using the Caton-Deschamps index and patellofemoral arthritis using the Iwano classification. Results: At a mean follow-up of 14.8 ± 2.1 years (range, 10-20 years), 4 patients (4 knees) were lost to follow-up (8.3%). The satisfaction, Kujala, and IKDC scores were 8.2 ± 1.6, 77.5 ± 14.4, and 65.7 ± 13.5, respectively. Only 1 patient reported a traumatic patellar dislocation (2%). Radiographs at the final follow-up were available for 34 knees, which revealed Iwano grade 1 in 14 knees (41%), Iwano grade 2 in 7 knees (21%), and no patellofemoral arthritis in 13 knees (38%). Conclusion: Sulcus-deepening trochleoplasty with MPFL reconstruction provides satisfactory results and prevents patellar redislocations with no or minimal patellofemoral arthritis.
Ultrasound guided arterial access for combat medics: A blinded proof-of-concept study using echogenic needles
Authors: van de Voort Jan C , Stark Pieter W , van Dongen Thijs TCF , Borger van der Burg Boudewijn LS , Hoencamp Rigo 
Published: June 2024

Background: Obtaining percutaneous vascular access in hemodynamically unstable patients with constricted vessels can be challenging. Training combat medics in this procedure is necessary for administration of fluid and blood products and introducing endovascular bleeding control tools in pre-hospital settings. Echogenic coated needles might provide better ultrasound visibility in invasive procedures and hereby lower complications. The primary aim was to evaluate the efficacy of a microteaching program for obtaining ultrasound-guided femoral artery access for ultrasound inexperienced combat medics. The secondary aim was to assess the additional value of innovative echogenic coated needles in ultrasound-guided vascular access. Methods: Combat medics participated in a four-step microteaching program. The program consisted of a theoretical and step-by-step practical part with three different models including live and dead tissue & a REBOA Access Task Trainer. During the final test, all participants had to obtain femoral artery access on a pressurized post-mortem human specimen model with both echogenic coated and conventional needles. Self-perceived and observed performance as well as procedure times were scored. Results: All nine participants succeeded in blood vessel visualization and obtaining vascular access in the two models within 3 minutes and were significantly faster during the second attempt on the pressurized post-mortem human specimen model. Scoring comparison and usability preference by ultrasound inexperienced personnel showed a significant difference in favor of the echogenic coated needles. Conclusion: Microteaching may be an effective approach to train combat medics in obtaining ultrasound-guided percutaneous femoral artery access. The use of echogenic coatings on needles could be a valuable adjunct and provide advantage in obtaining vascular access. Future research should focus on realistic simulation of austere situations and further evaluation of the use of echogenic coated instruments for vascular access in these pre-hospital settings.
Induced Moderate Hypothermia in Aortic Rupture With Retroperitoneal Bleeding: A Randomized Porcine Study
Authors: Pirouzram Artai , Wikström Maria , Larzon Thomas , Tamás Éva , Nilsson Kristofer F. 
Published: June 2024

Objective: Induced hypothermia improves outcome in aortic arch surgery, neonatal neurointensive care, and transplant surgery for example. In contrast, spontaneous hypothermia has been associated with worse outcomes in patients suffering from hemorrhagic shock, mostly explained by its adverse effects on the coagulation system. We investigated if induced hypothermia would impair short-term survival in experimental aortic rupture with retroperitoneal bleeding. Methods: Anesthetized pigs were randomized into 2 groups: hypothermia by peritoneal lavage of ice-cold Ringer’s acetate and external cooling ( n = 10) and normothermia ( n = 10). Aortic rupture with retroperitoneal bleeding was induced by endovascular means creating a 6 mm hole in the retroperitoneal portion of abdominal aorta. Survival (primary outcome), hemodynamics, and arterial blood gases including lactate were collected and analyzed up to 180 min after aortic rupture. Results: The body temperature (mean ± standard deviation) in the hypothermic group was 31.5 ± 1.0 °C and 38.7 ± 0.4 °C in the normothermic group at the time for aortic rupture. Survival up to 180 min after the retroperitoneal bleeding was significantly higher in the hypothermic compared with the normothermic group ( P = 0.023). Conclusions: Induced hypothermia did not impair survival in this experimental retroperitoneal aortic bleeding model in anesthetized pigs. This finding may indicate a minor role for the coagulation system in this type of bleeding.
Collateral effects of the COVID-19 pandemic on endocrine treatments for breast and prostate cancer in the UK: a cohort study
Authors: Barclay Nicola L. , Català Marti , Jödicke Annika M. , Prieto-Alhambra Daniel , Newby Danielle , Delmestri Antonella , Man Wai Yi , Serrano Àlvar Roselló , Moncusí Marta Pineda ,   The OPTIMA Consortium
Published: June 2024

Background: The COVID-19 pandemic affected cancer screening, diagnosis and treatments. Many surgeries were substituted with bridging therapies during the initial lockdown, yet consideration of treatment side effects and their management was not a priority. Objectives: To examine how the changing social restrictions imposed by the pandemic affected incidence and trends of endocrine treatment prescriptions in newly diagnosed (incident) breast and prostate cancer patients and, secondarily, endocrine treatment-related outcomes (including bisphosphonate prescriptions, osteopenia and osteoporosis), in UK clinical practice from March 2020 to June 2022. Design: Population-based cohort study using UK primary care Clinical Practice Research Datalink GOLD database. Methods: There were 13,701 newly diagnosed breast cancer patients and 12,221 prostate cancer patients with ⩾1-year data availability since diagnosis between January 2017 and June 2022. Incidence rates (IR) and incidence rate ratios (IRR) were calculated across multiple time periods before and after lockdown to examine the impact of changing social restrictions on endocrine treatments and treatment-related outcomes, including osteopenia, osteoporosis and bisphosphonate prescriptions. Results: In breast cancer patients, aromatase inhibitor (AI) prescriptions increased during lockdown versus pre-pandemic [IRR: 1.22 (95% confidence interval (CI): 1.11–1.34)], followed by a decrease post-first lockdown [IRR: 0.79 (95% CI: 0.69–0.89)]. In prostate cancer patients, first-generation antiandrogen prescriptions increased versus pre-pandemic [IRR: 1.23 (95% CI: 1.08–1.4)]. For breast cancer patients on AIs, diagnoses of osteopenia, osteoporosis and bisphosphonate prescriptions were reduced across all lockdown periods versus pre-pandemic (IRR range: 0.31–0.62). Conclusion: During the first 2 years of the pandemic, newly diagnosed breast and prostate cancer patients were prescribed more endocrine treatments compared to pre-pandemic due to restrictions on hospital procedures replacing surgeries with bridging therapies. But breast cancer patients had fewer diagnoses of osteopenia and osteoporosis and bisphosphonate prescriptions. These patients should be followed up in the coming years for signs of bone thinning. Evidence of poorer management of treatment-related side effects will help assess resource allocation for patients at high risk for bone-related complications.
Operative Repair of Hamstring Injuries From the Jackling Position in Rugby
Authors: Thompson Joshua W. , Plastow Ricci , Kayani Babar , Moriarty Peter , Stirling Ben , Haddad Fares S. 
Published: June 2024

Background: The jackling position within rugby has not been previously described as a mechanism for proximal hamstring injuries. Hypothesis: Acute surgical repair of proximal hamstring avulsion injuries sustained from the jackling contact position enables a return to a previous level of sporting activity with low risk of recurrence. Study Design: Case series; Level of evidence, 4. Methods: This study included 54 professional rugby players (mean age, 26 ± 4.8 years) who underwent acute primary surgical repair of complete, proximal hamstring avulsion injuries. The mean follow-up time was 17 months (range, 12-24 months). Mean isometric hamstring strength and function testing was performed at 3 months and 1 year after repair. Results: Of the 54 players, 51 (94.4%) returned to their preinjury level of sporting activity. The mean time from surgical repair to full sporting activity was 7 months (range, 4-12 months). No patients had recurrence of the primary injury. At 1 year postoperatively, patients had significantly restored mean isometric hamstring muscle strength when compared with the uninjured leg at 0° (98.4% ± 2.8%), 15° (95.9% ± 2.9%), and 45° (92.9% ± 4.1%); improved Lower Extremity Functional Score (78.0 ± 2.0); and improved Marx activity rating score (14.3 ± 1.5) ( P < .001 for all). Conclusion: Acute surgical repair of proximal hamstring avulsion injuries caused by the contact jackling position produced a high return to preinjury level of sporting activity, increased muscle strength, and improved functional outcome scores, with a low risk of recurrence at short-term follow-up.
Impact of Perceived Access and Treatment Knowledge on Medication Preferences for Opioid Use Disorder
Authors: Jaffe Kaitlyn , Patel Shivam , Chen Liying , Slat Stephanie , Bohnert Amy , Lagisetty Pooja 
Published: June 2024

Background: Medications for opioid use disorders (MOUDs) are effective, but most people with opioid use disorder (OUD) do not receive treatment. Prior research has explored patients’ structural barriers to access and perceptions of MOUD. Little research has considered treatment knowledge and perceptions outside of the patient population. Members of the public without OUD themselves (eg, family, friends) can significantly influence treatment decisions of persons with OUD. Considering these gaps, we conducted an original survey with a diverse sample of US adults to explore knowledge and preferences toward OUD treatments. Methods: We conducted an online survey with 1505 White, Black, and Latino/a Americans including a small percentage (8.5%) with self-reported lifetime OUD. The survey used vignettes to describe hypothetical patients with OUD, provide basic treatment information (ie, methadone, buprenorphine, naltrexone, nonmedication treatment), and then assessed treatment preferences. Using multivariable logistic regression, we examined associations between covariates of interest (eg, perceived access, knowledge, demographics) and preference for MOUD versus nonmedication treatment. Results: There were 523 White, 502 Black, and 480 Latino/a respondents. Across racial/ethnic subsamples, respondents had the greatest knowledge of nonmedication treatments, with Black (72.7%) and Latino/a (70.2%) respondents having significantly greater knowledge compared to White respondents (61.8%). However, after viewing the vignette, a greater proportion of respondents chose methadone (35.8%) or buprenorphine (34.8%) as their first-choice treatment for hypothetical patients. Multivariable logistic regression suggested that among Black respondents, those with knowledge of nonmedication treatment were more likely to choose MOUD than those without knowledge (odds ratio = 2.41, 95% confidence interval = 1.34-4.34). Perceived treatment access did not affect treatment choice. Conclusions: Across racial groups, knowledge and perceived access to nonmedication treatment was greater than for MOUD, but many still selected MOUD as a first-choice treatment. Significant findings emphasized the importance of treatment knowledge around decision-making, highlighting opportunities for tailored education efforts to improve uptake of evidence-based treatment.
Fiber Bundle Topology Optimization for Surface Flows
Authors: Deng Yongbo , Zhang Weihong , Zhu Jihong , Xu Yingjie , Korvink Jan G 
Published: June 2024

AbstractThis paper presents a topology optimization approach for the surface flows on variable design domains. Via this approach, the matching between the pattern of a surface flow and the 2-manifold used to define the pattern can be optimized, where the 2-manifold is implicitly defined on another fixed 2-manifold named as the base manifold. The fiber bundle topology optimization approach is developed based on the description of the topological structure of the surface flow by using the differential geometry concept of the fiber bundle. The material distribution method is used to achieve the evolution of the pattern of the surface flow. The evolution of the implicit 2-manifold is realized via a homeomorphous map. The design variable of the pattern of the surface flow and that of the implicit 2-manifold are regularized by two sequentially implemented surface-PDE filters. The two surface-PDE filters are coupled, because they are defined on the implicit 2-manifold and base manifold, respectively. The surface Navier-Stokes equations, defined on the implicit 2-manifold, are used to describe the surface flow. The fiber bundle topology optimization problem is analyzed using the continuous adjoint method implemented on the first-order Sobolev space. Several numerical examples have been provided to demonstrate this approach, where the combination of the viscous dissipation and pressure drop is used as the design objective.
Wood defect detection based on the CWB-YOLOv8 algorithm
Authors: An Hao , Liang Zhihong , Qin Mingming , Huang Yuxiang , Xiong Fei , Zeng Guojian 
Published: June 2024

AbstractAs an important renewable resource, wood is widely used in various industries. When addressing wood defects that limit the amount of wood used during processing, manual inspection and other technologies are not suitable for automated production scenarios. In this paper, we first establish our own dataset, which includes information about multiple tree species and multiple defects types, to enhance the overall applicability of the proposed model. Second, target detection technology involving deep learning is used for defect detection. The conditional parametric convolution (CondConv), Wise-IoU, and BiFormer modules are used to improve upon the latest YOLOv8 algorithm. Based on the experimental findings, the suggested approach exhibits notable improvements in terms of both the mAP@0.5 index and the mAP@0.5:0.95 index, surpassing the performance of the YOLOv8 algorithm by 3.5% and 5.8%, respectively. It also has advantages over other target detection algorithms. The proposed method can effectively improve wood utilization and automated wood processing technology.
Investigating the Anti-inflammatory Effect of Quinoline Derivative: N1-(5-methyl-5H-indolo[2,3-b]quinolin-11-yl)benzene-1,4-diamine Hydrochloride Loaded Soluble Starch Nanoparticles Against Methotrexate-induced Inflammation in Experimental Model
Authors: Medhat Dalia , El-Bana Mona A. , El-Tantawy El-Sayed Ibrahim , Ahmed Abdullah A. S. , El-Naggar Mehrez E. , Hussein Jihan 
Published: June 2024

Abstract
Background
It is necessary to develop advanced therapies utilizing natural ingredients with anti-inflammatory qualities in order to lessen the negative effects of chemotherapeutics.

Results
The bioactive N1-(5-methyl-5H-indolo[2,3-b]quinolin-11-yl)benzene-1,4-diamine hydrochloride (NIQBD) was synthesized. After that, soluble starch nanoparticles (StNPs) was used as a carrier for the synthesized NIQBD with different concentrations (50 mg, 100 mg, and 200 mg). The obtained StNPs loaded with different concentrations of NIQBD were coded as StNPs-1, StNPs-2, and StNPs-3. It was observed that, StNPs-1, StNPs-2, and StNPs-3 exhibited an average size of 246, 300, and 328 nm, respectively. Additionally, they also formed with homogeneity particles as depicted from polydispersity index values (PDI). The PDI values of StNPs-1, StNPs-2, and StNPs-3 are 0.298, 0.177, and 0.262, respectively.
In vivo investigation of the potential properties of the different concentrations of StNPs loaded with NIQBD against MTX-induced inflammation in the lung and liver showed a statistically substantial increase in levels of reduced glutathione (GSH) accompanied by a significant decrease in levels of oxidants such as malondialdehyde (MDA), nitric oxide (NO), advanced oxidation protein product (AOPP), matrix metalloproteinase 9/Gelatinase B (MMP-9), and levels of inflammatory mediators including interleukin 1-beta (IL-1β), nuclear factor kappa-B (NF-κB) in both lung and liver tissues, and a significant decrease in levels of plasma homocysteine (Hcy) compared to the MTX-induced inflammation group. The highly significant results were obtained by treatment with a concentration of 200 mg/mL.
Histopathological examination supported these results, where treatment showed minimal inflammatory infiltration and congestion in lung tissue, a mildly congested central vein, and mild activation of Kupffer cells in liver tissues.

Conclusion
Combining the treatment of MTX with natural antioxidant supplements may help reducing the associated oxidation and inflammation.
In silico prediction of polyketide biosynthetic gene clusters in the genomes of Hypericum-borne endophytic fungi
Authors: Petijová Linda , Henzelyová Jana , Kuncová Júlia , Matoušková Martina , Čellárová Eva 
Published: June 2024

Abstract
Background
The search for new bioactive natural compounds with anticancer activity is still of great importance. Even though their potential for diagnostics and treatment of cancer has already been proved, the availability is still limited. Hypericin, a naphthodianthrone isolated essentially from plant source Hypericum perforatum L. along with other related anthraquinones and bisanthraquinones belongs to this group of compounds. Although it has been proven that hypericin is synthesized by the polyketide pathway in plants, none of the candidate genes coding for key enzymes has been experimentally validated yet. Despite the rare occurrence of anthraquinones in plants, their presence in microorganisms, including endophytic fungi, is quite common. Unlike plants, several biosynthetic genes grouped into clusters (BGCs) in fungal endophytes have already been characterized.

Results
The aim of this work was to predict, identify and characterize the anthraquinone BGCs in de novo assembled and functionally annotated genomes of selected endophytic fungal isolates (Fusarium oxysporum, Plectosphaerella cucumerina, Scedosporium apiospermum, Diaporthe eres, Canariomyces subthermophilus) obtained from different tissues of Hypericum spp. The number of predicted type I polyketide synthase (PKS) BGCs in the studied genomes varied. The non-reducing type I PKS lacking thioesterase domain and adjacent discrete gene encoding protein with product release function were identified only in the genomes of C. subthermophilus and D. eres. A candidate bisanthraquinone BGC was predicted in C. subthermophilus genome and comprised genes coding the enzymes that catalyze formation of the basic anthraquinone skeleton (PKS, metallo-beta-lactamase, decarboxylase, anthrone oxygenase), putative dimerization enzyme (cytochrome P450 monooxygenase), other tailoring enzymes (oxidoreductase, dehydrogenase/reductase), and non-catalytic proteins (fungal transcription factor, transporter protein).

Conclusions
The results provide an insight into genetic background of anthraquinone biosynthesis in Hypericum-borne endophytes. The predicted bisanthraquinone gene cluster represents a basis for functional validation of the candidate biosynthetic genes in a simple eukaryotic system as a prospective biotechnological alternative for production of hypericin and related bioactive anthraquinones.