bluuebunny/crossref_metadata_2025_split huggingface dataset:
A variable time headway model for the mixed car-following process considering multiple front vehicles information in foggy weather
Authors: Liang Ziwei , Pang Mingbao 
Published: March 2024

Abstract
The aim of this work is to investigate the fog-related variable time headway (FVTH) model of connected and automated mixed flow considering multiple front vehicles information in a reduced visibility environment for driving safety. The car-following modes of mixed vehicles are analysed and the vehicle ratio for each mode based on Markov chain models is derived, where the number of front vehicles, the connected and automated vehicles penetration rate and the platoon intensity are considered. The combined coupling effect of visibility and driving speed on time headway is explored, and a variable time headway strategy is proposed. Their relationship equations are deduced as the FVTH model. The perturbation method is used to discuss the stability of traffic flow and obtain its stability judgement conditions. The proposed model was validated and the effects were discussed via simulation experiments. The results indicate that the acceleration and deceleration times of vehicles and collision possibility decrease significantly using the proposed method. When penetration rate is 50%, the number of front vehicles is three and platoon intensity is zero, the time to return to a stable state is reduced by 18.9%–30.3% and 24.7%–39.4%, respectively, and Time-Exposed Time to collision is reduced by 26.1%–48.9% and 43.7%%–65.4%, respectively, compared with the basic intelligent driver model (IDM) method, and the IDM method that considers multiple front vehicles information. As visibility decreases, the reduced degree of these indicator values increases. The driving efficiency and safety level can be enhanced.
First data on early instar Afrotropical Miltogramminae (Diptera: Sarcophagidae) reveal unexpected morphological diversity
Authors: Szpila Krzysztof , Walczak Kinga , Soszyńska Agnieszka , Pape Thomas 
Published: March 2024

Abstract
First instar larvae of the genera Hoplacephala Macquart, 1846 and Lamprometopia Macquart, 1846 are described for the first time, along with the first instar larva of an Afrotropical species of the genus Phylloteles Loew, 1844. Their morphology is analyzed using a combination of various microscopy techniques, confirming their close phylogenetic affinity with other members of the tribe Sarcotachinini. Substantial morphological differences are observed between the investigated genera, as well as in comparison to other known larvae of Miltogramminae. Noteworthy unique character states are identified in the shape of the cephaloskeleton, the sculpture of the integument, and the shape of the papilla of the thoracic and abdominal segments. The larva of Hoplacephala sp. stands out as the most peculiar, featuring a massive cephaloskeleton, integument armoured by cuticular scales, and modification of body papillae into fleshy processes. The first instar larva of Phylloteles picifrons Pape, 1985 possesses a large, bladder-like structure with unknown function dorsally on the first thoracic segment. All documented larvae are characterized by a maxillary palpus forming a distinct protuberance with elongated second sensillum basiconicum and the absence of a dorsal bridge of the cephaloskeleton. This last character state indicates a parasitic or parasitoid life history for all studied taxa.
Breast Implant Illness May Be Rooted in Mast Cell Activation: A Case-Controlled Retrospective Analysis
Authors: Nagy Èva S. , Westaway Mark , Danieletto Suzanne , Afrin Lawrence B. 
Published: March 2024

Objective:
To investigate the possible association between breast implant illness (BII) and mast cell activation syndrome (MCAS), which often manifests increased mast cells (MCs) in assorted tissues and may explain BII symptoms.

Background:
Mechanisms by which implants cause BII symptoms remain unclear, but BII and MCAS symptom profiles heavily overlap, warranting investigation of potential linkage.

Methods:
We retrospectively analyzed 20 implant patients who underwent explantation and total capsulectomy; 15 self-reported preoperatively they had BII (subject group); 5 felt they did not [control group 1 (CG1)]. Five prophylactic mastectomy patients constituted control group 2 (CG2). Subjects and CG1 patients completed BII symptom questionnaires preoperatively and multiple points postoperatively. With CD117 staining, average and maximum mast cell counts (MCCs) in resected tissues were determined.

Results:
Mean BII symptom score 2 weeks postexplantation was reduced by 77% (P < 0.0001), and 85% by 9 months. Analysis suggested BII in CG1 patients, too, who improved similarly. Among CG2 patients, healthy breast tissue showed mean and maximum MCCs of 5.0/hpf and 6.9/hpf. Mean and maximum MCCs in capsules in BII patients were 11.7/hpf and 16.3/hpf, and 7.6/hpf and 13.3/hpf in CG1 patients. All intergroup comparisons were significantly different (P < 0.0001).

Conclusions:
MCCs in peri-implant capsules in BII patients are increased; some implanted patients appear to have unrecognized BII. Given that neoantigenic/xenobiotic exposures commonly trigger dysfunctional MCs in MCAS to heighten aberrant mediator expression driving inflammatory and other issues, further investigation of whether BII represents an implant-driven escalation of preexisting MCAS and whether an MCAS diagnosis flags risk for BII seems warranted.
Alaska Pollock-derived Gelatin Sealant has Higher Sealing Strength than, and Comparable Biocompatibility with, Fibrin Sealant in Porcine and Rat Dural Injury Models
Authors: Ono Takumi , Suzuki Taku , Nagoshi Narihito , Masugi Yohei , Maeda Kosuke , Hashimoto Shogo , Watanabe Shiharu , Iwamoto Takuji , Taguchi Tetsushi , Nakamura Masaya 
Published: March 2024

Study Design.
Burst strength study in porcine dural models and functional and histological study in rat dural models.

Objective.
This study aimed to investigate the sealing strength and biocompatibility of Alaska pollock-derived gelatin (ApGltn) and fibrin sealants in disrupted dural injuries.

Summary of Background Data.
Disruption of the dura mater occurs during spine surgery, leading to cerebrospinal fluid leakage. Fibrin sealant is usually applied to ruptured sites; however, it lacks sealing strength. A novel biocompatible sealant composed of ApGltn was recently demonstrated to have good burst strength and biocompatibility in the porcine aorta.

Methods.
Ten porcine dura maters with central holes were covered with ApGltn and fibrin sealants (five samples per group). The maximum burst strength of each sealant was measured, and histological examination was performed after burst testing. Twenty-seven dura maters of male Wistar rats were used for functional and histopathological evaluations. The rats were treated with three surgical interventions: defect + ApGltn sealant; defect + fibrin sealant; defect alone (nine rats per group). Macroscopic confirmation of the sealant, hindlimb motor function analysis, and histopathological examination were performed at two, four, and eight weeks after the procedure.

Results.
The maximum burst strength of the ApGltn sealant was ~4.4 times higher than that of the fibrin sealant (68.1±12.1 vs. 15.6±8.7 mmHg; P<0.001). Histological examination confirmed that the ApGltn sealant showed tight adhesion to the dural surface, whereas a gap was observed between the fibrin sealant and the dura mater. In the rat model, the ApGltn sealant resulted in spinal function and dural histological findings similar to those of the fibrin sealant.

Conclusion.
The ApGltn sealant had a higher sealing strength than, and comparable effect on dura regeneration with, the fibrin sealant.
Robot-assisted Microsurgery: Lessons Learned from 50 Consecutive Cases
Authors: Struebing Felix , Bigdeli Amir , Weigel Jonathan , Gazyakan Emre , Vollbach Felix , Panayi Adriana C. , Vogelpohl Julian , Boecker Arne , Kneser Ulrich 
Published: March 2024

Background:
The potential of robot-assisted surgery in plastic and reconstructive surgery remains to be established, especially in free tissue transfer. This prospective study aimed to present our experience and findings from the first 50 consecutive cases of robot-assisted microsurgery using the Symani surgical system.

Methods:
A prospective database was maintained, recording patient demographics and surgical details for all cases of robot-assisted microsurgery in a large academic institution. All surgeons underwent an intensive training program with the Symani surgical system.

Results:
A total of 50 patients who underwent robot-assisted microsurgical reconstruction were identified. Free microsurgical tissue transfer was performed in 45 cases, targeted muscle reinnervation in four cases, and lymphovenous anastomoses in a single case. A total of 94 robot-assisted anastomoses and coaptations were performed, (46 venous and 30 arterial anastomoses, 16 nerve coaptations, two lymphovenous anastomoses). Six cases involved perforator-to-perforator anastomoses. Ninety-eight percent of attempted anastomoses were completed using the robot. Size-mismatch anastomoses, seen in 37.8% of cases, took significantly longer. Minor complications occurred in three cases and major in six cases. There were three cases of microvascular compromise requiring revision. One partial flap loss and no complete flap loss occurred.

Conclusions:
Our study highlights the immense potential of robot-assisted microsurgery, and a feasible and effective modality for various microsurgical procedures, with outcomes comparable to those of conventional microsurgery. Despite challenges, such as increased operating times and higher costs, the technology offers significant advantages, such as enhanced precision and motion scaling. We identify a slow learning curve and a necessity for higher caseloads.
Feasibility of hepatitis C elimination by screening and treatment alone in high-income countries
Authors: Tian Feng , Forouzannia Farinaz , Feng Zeny , Biondi Mia J. , Mendlowitz Andrew B. , Feld Jordan J. , Sander Beate , Wong William W.L. 
Published: March 2024

Background and Aims:
Despite the availability of highly effective direct-acting antiviral therapy, chronic hepatitis C (CHC) continues to cause a major public health burden. In many high-income countries, treatment rates have been declining, which was exacerbated by the impact of the COVID-19 pandemic, threatening the ability to meet the World Health Organization (WHO)’s targets for eliminating HCV as a public health threat by 2030. We sought to model the impact of CHC in Canada, a resource-rich country with ongoing immigration from HCV-endemic regions; which relies exclusively on risk-based screening for case identification.

Approach and Results:
We developed an agent-based model to characterize the HCV epidemic in a high-income country with ongoing immigration. Combinations of prevention such as harm reduction, screening, and treatment strategies were considered. Model parameters were estimated from the literature and calibrated against historical HCV data. Sensitivity analyses were performed to assess uncertainty. Under the current status quo of risk-based screening, we predict the incidence of CHC-induced decompensated cirrhosis, HCC, and liver-related deaths would decrease by 79.4%, 76.1%, and 62.1%, respectively, between 2015 and 2030, but CHC incidence would only decrease by 11.1%. The results were sensitive to HCV transmission rate and an annual number of people initiating treatment.

Conclusions:
Current risk-based screening, and subsequent treatment, will be inadequate to achieve WHO goals. With extensive scale-up in screening, and treatment, the mortality target may be achievable, but the target for preventing new CHC cases is unlikely reachable, highlighting the importance of developing enhanced harm-reduction strategies for HCV elimination.
Safety and efficacy of off-label bulevirtide monotherapy in patients with HDV with decompensated Child-B cirrhosis—A real-world case series
Authors: Dietz-Fricke Christopher , Degasperi Elisabetta , Jachs Mathias , Maasoumy Benjamin , Reiter Florian P. , Geier Andreas , Grottenthaler Julia M. , Berg Christoph P. , Sprinzl Kathrin , Zeuzem Stefan , Gödiker Juliana , Schlevogt Bernhard , Herta Toni , Wiegand Johannes , Soffredini Roberta , Wedemeyer Heiner , Deterding Katja , Reiberger Thomas , Lampertico Pietro 
Published: March 2024

Background and Aims:
Chronic hepatitis D is the most debilitating form of viral hepatitis frequently progressing to cirrhosis and subsequent decompensation. However, the HDV entry inhibitor bulevirtide is only approved for antiviral treatment of patients with compensated disease. We aimed for the analysis of real-world data on the off-label use of bulevirtide in the setting of decompensated liver cirrhosis.

Approach and Results:
We conducted a retrospective study in patients with HDV with decompensated liver disease at German, Austrian, and Italian centers. We included 19 patients (47% male, mean age: 51 years) with liver cirrhosis Child-Pugh B. The median MELD score was 12 (range 9–17) at treatment initiation. The median observation period was 41 weeks. Virologic response was achieved in 74% and normal alanine aminotransferase was observed in 74%. The combined response was achieved by 42%. The most relevant adverse events included self-limited alanine aminotransferase flares, an asymptomatic increase in bile acids, and the need for liver transplantation. Despite bile acid increases, adverse events were considered unrelated. Clinical and laboratory improvement from Child-Pugh B to A occurred in 47% (n = 9/19). Improvements in the amount of ascites were observed in 58% of the patients initially presenting with ascites (n = 7/12).

Conclusions:
This report on off-label bulevirtide treatment in patients with decompensated HDV cirrhosis shows similar virologic and biochemical response rates as observed in compensated liver disease. Significant improvements were observed in surrogates of hepatic function and portal hypertension. However, this improvement was not seen in all patients. Controlled trials are needed to confirm the safety and efficacy of bulevirtide in decompensated HDV cirrhosis.
Central retinal artery occlusion after cardioversion of atrial fibrillation
Authors: Lagha Lilia , Kalogeropoulos Dimitrios , Goverdhan Srinivas , Lotery Andrew J 
Published: March 2024

Central retinal artery occlusion (CRAO) is a vascular ophthalmic emergency. Often caused by a sudden interruption of blood flow to the eye, with profound and painless vision loss, resulting in irreversible cell damage. An impacted embolus at the narrowest part of the central retinal artery is the most common cause.
Cardioversion is a medical procedure used to restore a normal heart rhythm in individuals with atrial fibrillation (AF). In some cases, cardioversion can lead to thromboembolic complications. If an embolus reaches the central retinal artery, it can block the blood flow to the retina, resulting in CRAO and subsequent vision loss.
Development of Crystalline Corneal Opacities (Steroid Keratopathy) in Dogs After Treatment With Ophthalmic Corticosteroids
Authors: Quantz Katelin R. , Jongnarangsin Kamontip K. , Harman Christine D. , Koehl Kristin L. , Jacobson Amanda L. , Nallasamy Nambi , Shaw Gillian C. , Pirie Christopher G. , Komáromy András M. 
Published: March 2024

Purpose:
To retrospectively evaluate and describe the relationship between the use of topical corticosteroids and the development of crystalline corneal opacities (steroid keratopathy) in a colony of research Beagles and Beagle-derived dogs.

Methods:
Medical records of 73 purpose-bred Beagles and Beagle-derived dogs were reviewed from June 2012 to May 2021. All dogs were treated with topical ophthalmic corticosteroids for at least 21 days. In addition to regular ophthalmic examination, some dogs also had a systemic lipid profile (n = 6) performed to work up further and characterize the crystalline corneal opacities. Globes of 3 dogs were examined histopathologically.

Results:
Axial stromal crystalline corneal opacities were appreciated in 25 eyes of 14 dogs after a median of 141 days after initiating treatment (35–396 days). Multiple corticosteroids were used, including neomycin-polymyxin b-dexamethasone 0.1% ophthalmic ointment, prednisolone acetate 1% ophthalmic suspension, and difluprednate 0.05% ophthalmic emulsion (Durezol). Resolution of corneal opacity was documented in 4 of 25 eyes when ophthalmic corticosteroids were discontinued after a median of 406.5 days (271–416 days). Histopathologic examination revealed a dense band of acellular material, poorly staining with periodic acid–Schiff, subtending the corneal epithelium, and being surrounded by spindle cells.

Conclusions:
This case series documents the onset of steroid keratopathy in Beagles and Beagle-derived dogs after treatment with ophthalmic corticosteroids. Clinical resolution of steroid keratopathy lesions may be possible after discontinuation of ophthalmic corticosteroids.
Effect of laparoscopic sleeve gastrectomy on male reproductive function in Chinese men with obesity: a prospective cohort study
Authors: Gao Xiang , Li Pengzhou , Wang Guohui , Li Weizheng , Song Zhi , Zhu Shaihong , Zhu Liyong 
Published: March 2024

Background:
Obesity is a widely recognized global public health issue, and bariatric surgery has emerged as an effective intervention for alleviating obesity associated health complications. However, the impact of bariatric surgery on male reproductive function remains inconclusive in the literature. The current understanding of the impact of laparoscopic sleeve gastrectomy (LSG) on male reproductive function remains ambiguous, despite its status as the most commonly performed bariatric surgery. This prospective cohort study aimed to investigate the impact of LSG on erectile function and semen quality.

Patients and methods:
A total of 34 obese patients were enrolled in this study and underwent LSG. Prior to the operation and at 3, 6, and 12 months postoperation, all participants were required to complete the International Index of Erectile Function-5 (IIEF-5) questionnaire and undergo a nocturnal erectile function test and semen quality analysis.

Results:
Within 12 months postoperation, BMI, blood lipids, and insulin resistance showed significant improvement. The IIEF-5 score increased significantly (18.88±5.97 vs. 23.78±3.19, P<0.05), and the frequency and duration of erections significantly improved compared to baseline. Sperm concentration, total motility, survival rate, and sperm morphology parameters exhibited a significant decline at 3 months but demonstrated a significant improvement at 6 and 12 months postoperation. At 12 months, sperm concentration was shown to be correlated with changes in zinc (r=0.25, P=0.033) as well as changes in testosterone (r=0.43, P=0.013).

Conclusions:
LSG has beneficial effects on erectile function, despite a transient decline in semen quality at 3 months postoperatively, followed by a significant improvement at 12 months.
Utilization and safety of off-label prothrombin complex concentrate (4F-PCC) in a nonsurgical population
Authors: Sandquist Katherine , Kaucher Kevin , Newell Joshua , Sarangarm Preeyaporn , Burnett Allison 
Published: March 2024

The aim of this study was to evaluate and describe the utilization and safety of 4F-PCC in a nonanticoagulated, nonsurgical patient population at an academic, tertiary care center.
This retrospective, single-center chart review evaluated nonanticoagulated adult patients at least 18 years of age who had at least one dose of 4F-PCC administered between January 1, 2017, and September 30, 2022, for a nonsurgical indication. Hemostatic efficacy following 4F-PCC administration was the primary outcome, and secondary outcomes included an assessment of blood product administration, thrombotic events within 30 days post4F-PCC administration, in-hospital mortality, and the length of hospital stay.
A total of 59 patients met the inclusion criteria, and 10 patients received 4F-PCC for coagulopathy associated with liver disease, 34 for intracranial hemorrhage (ICH), and 15 for other indications. For the primary outcome of hemostatic efficacy, 17 non-ICH patients (85%) had achieved hemostasis post-4F-PCC, and among the ICH patient population, 18 (64%) did not show expansion on repeat CT post4F-PCC, suggesting hemostasis. Blood product and hemostatic agent usage was frequent, with 72.9% of patients requiring products post-4F-PCC. Acute thromboembolic events occurred in six patients (10.2%), and in-hospital mortality occurred in 55.9% of patients.
Off-label 4F-PCC use is common despite a lack of robust guidance for use. Following 4F-PCC administration, blood product use was frequent, the incidence of in-hospital mortality was high, and thromboembolic complications such deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke were reported. Further studies are needed to validate the off-label administration of 4F-PCC in nonanticoagulated patients.
Ruthenium-based antivenom attenuates Crotalus atrox venom mediated coagulopathy in rabbits
Authors: Nielsen Vance G. 
Published: March 2024

Background
The Western diamondback rattlesnake (Crotalus atrox) is a medically important venomous snake in the Southwestern United States, injuring humans, and their companion animals. The goals of this investigation were to utilize a rabbit model of subcutaneous envenomation to assess Crotalus atrox venom coagulopathy and determine the efficacy of a ruthenium-containing antivenom (RA) in attenuating it.

Methods
Sedated New Zealand White rabbits had viscoelastic measurements of whole blood coagulation kinetics obtained from ear artery samples. Crotalus atrox venom (4 mg/kg) was injected subcutaneously and changes in coagulation determined over three hours and compared to samples obtained prior to envenomation. Other rabbits had site-directed RA injected 5 min after venom injection.

Results
A significant decrease in the velocity of clot growth and thrombus strength was observed in animals injected with venom alone. Site-directed administration of RA resulted in no change in coagulation over the 3 h following venom injection. The interaction of antivenom administration and time was significantly different in the cases of clot growth velocity and strength.

Conclusions
A novel rabbit model was used to define the toxicodynamic profile of coagulopathy of Crotalus atrox venom and demonstrate the efficacy of RA. Future investigation is planned involving other medically important venoms and RA administration.
Central Line Repair in Pediatric Patients in the Pediatric Emergency Department by Emergency Physicians—A Single-Center Experience
Authors: Baer Aluma , Weiser Giora 
Published: March 2024

Introduction
Central venous catheters are more common with advanced treatments for a variety of conditions. These catheters may need to be repaired after local damage. This has been performed by those more involved with catheter placement such as pediatric surgeons and interventional radiologists. Gastroenterologists who treat many of these patients have also been involved with catheter repair. Repair by pediatric emergency physicians has not been explored. Such repairs by the emergency physician may be time saving and avoid unnecessary admissions.

Methods
This was a retrospective study of a single center's experience with catheter repair. The performers and outcomes were compared.

Results
During the study period, 52 catheter repairs were performed on 7 children. Forty of the repairs were performed by a pediatric emergency physician, 5 by pediatric surgeons, and 5 by interventional radiology. All but 1 repair was successful. Infectious complications were reported in 3 cases. None required catheter removal. The length of stay was significantly shorter for repair by emergency physician.

Conclusions
Central line catheter repair can be performed successfully by pediatric emergency physician with minimal complications. A dedicated process of repair tutoring is required and may avoid infectious complications.