bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of deep learning enables high diagnostic accuracy in detecting syndesmotic instability on weight‐bearing CT scanning
Authors: Borjali Alireza , Ashkani‐Esfahani Soheil , Bhimani Rohan , Guss Daniel , Muratoglu Orhun K. , DiGiovanni Christopher W. , Varadarajan Kartik Mangudi , Lubberts Bart 
Published: October 2023

AbstractPurposeDelayed diagnosis of syndesmosis instability can lead to significant morbidity and accelerated arthritic change in the ankle joint. Weight‐bearing computed tomography (WBCT) has shown promising potential for early and reliable detection of isolated syndesmotic instability using 3D volumetric measurements. While these measurements have been reported to be highly accurate, they are also experience‐dependent, time‐consuming, and need a particular 3D measurement software tool that leads the clinicians to still show more interest in the conventional diagnostic methods for syndesmotic instability. The purpose of this study was to increase accuracy, accelerate analysis time, and reduce interobserver bias by automating 3D volume assessment of syndesmosis anatomy using WBCT scans.MethodsA retrospective study was conducted using previously collected WBCT scans of patients with unilateral syndesmotic instability. One‐hundred and forty‐four bilateral ankle WBCT scans were evaluated (48 unstable, 96 control). We developed three deep learning models for analyzing WBCT scans to recognize syndesmosis instability. These three models included two state‐of‐the‐art models (Model 1—3D Convolutional Neural Network [CNN], and Model 2—CNN with long short‐term memory [LSTM]), and a new model (Model 3—differential CNN LSTM) that we introduced in this study.ResultsModel 1 failed to analyze the WBCT scans (F1 score = 0). Model 2 only misclassified two cases (F1 score = 0.80). Model 3 outperformed Model 2 and achieved a nearly perfect performance, misclassifying only one case (F1 score = 0.91) in the control group as unstable while being faster than Model 2.ConclusionsIn this study, a deep learning model for 3D WBCT syndesmosis assessment was developed that achieved very high accuracy and accelerated analytics. This deep learning model shows promise for use by clinicians to improve diagnostic accuracy, reduce measurement bias, and save both time and expenditure for the healthcare system.Level of evidenceII.
There is no difference in the efficacy of anterior cruciate ligament reconstruction using autograft combined with or without ligament augmentation: a systematic review and meta‐analysis
Authors: Man Qian , Gao Yitian , Wang Hangle , Ma Yong , Meng Qingyang 
Published: October 2023

AbstractPurposeThis study aims to determine the efficacy of anterior cruciate ligament reconstruction (ACLR) using autograft combined with or without ligament augmentation.MethodsA computerized search of the databases was conducted, including PubMed, Web of Science, Embase, Scopus and the Cochrane Library. Only prospective or retrospective comparative studies with a minimum 2‐year follow‐up were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel–Haenszel analysis was used for the pooling of results. Sensitivity analysis was performed to maintain the stability of results. The egger test was applied to assess the publication bias.ResultsFourteen studies were included. The total cohort was 1353 patients (non‐augmented group: 763 patients; augmented group: 590 patients). There were three Randomized Controlled Trials (RCTs, Level I), six retrospective comparative studies (Level III) and five case–control studies (Level III). The follow‐up rate was ≥ 88% and the follow‐up periods were ≥ 24 months in all included studies. The augmented graft used to compare with autograft included the Ligament Augmentation Device (LAD), the Ligament Advanced Reinforcement System (LARS) artificial ligament, FiberTape, hamstring tendon allograft, degradable poly (urethane urea). No significant differences were observed between the augmented and non‐augmented groups regarding postoperative patient‐reported outcomes (PROs), including the International Knee Documentation Committee score, Lysholm score and Tegner score, knee laxity, including KT‐1000, side‐to‐side difference, Lachman test and pivot shift and rate of graft failure.ConclusionsACLR using autografts combined with ligament augmentation shows no advantages in PROs, knee laxity and graft failure rate compared with using autografts only.Level of evidenceLevel III.Trial registrationThe research protocol was registered at the PROSPERO database (CRD42022324784).
p53 stabilisation potentiates [177Lu]Lu-DOTATATE treatment in neuroblastoma xenografts
Authors: Berglund Hanna , Salomonsson Sara Lundsten , Mohajershojai Tabassom , Gago Fernando Jose Ferrer , Lane David P. , Nestor Marika 
Published: October 2023

Abstract
Purpose
Molecular radiotherapy is a treatment modality that is highly suitable for targeting micrometastases and [177Lu]Lu-DOTATATE is currently being explored as a potential novel treatment option for high-risk neuroblastoma. p53 is a key player in the proapoptotic signalling in response to radiation-induced DNA damage and is therefore a potential target for radiosensitisation.

Methods
This study investigated the use of the p53 stabilising peptide VIP116 and [177Lu]Lu-DOTATATE, either alone or in combination, for treatment of neuroblastoma tumour xenografts in mice. Initially, the uptake of [177Lu]Lu-DOTATATE in the tumours was confirmed, and the efficacy of VIP116 as a monotherapy was evaluated. Subsequently, mice with neuroblastoma tumour xenografts were treated with placebo, VIP116, [177Lu]Lu-DOTATATE or a combination of both agents.

Results
The results demonstrated that monotherapy with either VIP116 or [177Lu]Lu-DOTATATE significantly prolonged median survival compared to the placebo group (90 and 96.5 days vs. 50.5 days, respectively). Notably, the combination treatment further improved median survival to over 120 days. Furthermore, the combination group exhibited the highest percentage of complete remission, corresponding to a twofold increase compared to the placebo group. Importantly, none of the treatments induced significant nephrotoxicity. Additionally, the therapies affected various molecular targets involved in critical processes such as apoptosis, hypoxia and angiogenesis.

Conclusion
In conclusion, the combination of VIP116 and [177Lu]Lu-DOTATATE presents a promising novel treatment approach for neuroblastoma. These findings hold potential to advance research efforts towards a potential cure for this vulnerable patient population.
Exploring spaces of semi-directed level-1 networks
Authors: Linz Simone , Wicke Kristina 
Published: October 2023

AbstractSemi-directed phylogenetic networks have recently emerged as a class of phylogenetic networks sitting between rooted (directed) and unrooted (undirected) phylogenetic networks as they contain both directed as well as undirected edges. While various spaces of rooted phylogenetic networks and unrooted phylogenetic networks have been analyzed in recent years and several rearrangement moves to traverse these spaces have been introduced, little is known about spaces of semi-directed phylogenetic networks. Here, we propose a simple rearrangement move for semi-directed phylogenetic networks, called cut edge transfer (CET), and show that the space of semi-directed level-1 networks with precisely k reticulations is connected under CET. This level-1 space is currently the predominantly used search space for most algorithms that reconstruct semi-directed phylogenetic networks. Our results imply that every semi-directed level-1 network with a fixed number of reticulations and leaf set can be reached from any other such network by a sequence of CETs. By introducing two additional moves, R$$^+$$

+

and R$$^-$$

-

, that allow for the addition and deletion, respectively, of a reticulation, we then establish connectedness for the space of all semi-directed level-1 networks on a fixed leaf set. As a byproduct of our results for semi-directed phylogenetic networks, we also show that the space of rooted level-1 networks with a fixed number of reticulations and leaf set is connected under CET, when translated into the rooted setting.
Waiting times between examinations with intravascularly administered contrast media: a review of contrast media pharmacokinetics and updated ESUR Contrast Media Safety Committee guidelines
Authors: van der Molen Aart J. , Dekkers Ilona A. , Geenen Remy W. F. , Bellin Marie-France , Bertolotto Michele , Brismar Torkel B. , Correas Jean-Michel , Heinz-Peer Gertraud , Mahnken Andreas H. , Quattrocchi Carlo C. , Radbruch Alexander , Reimer Peter , Roditi Giles , Romanini Laura , Sebastià Carmen , Stacul Fulvio , Clement Olivier 
Published: October 2023

Abstract
The pharmacokinetics of contrast media (CM) will determine how long safe waiting intervals between successive CT or MRI examinations should be. The Contrast Media Safety Committee has reviewed the data on pharmacokinetics of contrast media to suggest safe waiting intervals between successive contrast-enhanced imaging studies in relation to the renal function of the patient.

Clinical relevance statement
Consider a waiting time between elective contrast-enhanced CT and (coronary) angiography with successive iodine-based contrast media administrations in patients with normal renal function (eGFR > 60 mL/min/1.73 m2) of optimally 12 h (near complete clearance of the previously administered iodine-based contrast media) and minimally 4 h (if clinical indication requires rapid follow-up).

Key Points
• Pharmacokinetics of contrast media will guide safe waiting times between successive administrations.
• Safe waiting times increase with increasing renal insufficiency.
• Iodine-based contrast media influence MRI signal intensities and gadolinium-based contrast agents influence CT attenuation.
MRI-derived extracellular volume as a biomarker of cancer therapy cardiotoxicity: systematic review and meta-analysis
Authors: Folco Gianluca , Monti Caterina B. , Zanardo Moreno , Silletta Francesco , Capra Davide , Secchi Francesco , Sardanelli Francesco 
Published: October 2023

Abstract
Objectives
MRI-derived extracellular volume (ECV) allows characterization of myocardial changes before the onset of overt pathology, which may be caused by cancer therapy cardiotoxicity. Our purpose was to review studies exploring the role of MRI-derived ECV as an early cardiotoxicity biomarker to guide timely intervention.

Materials and methods
In April 2022, we performed a systematic search on EMBASE and PubMed for articles on MRI-derived ECV as a biomarker of cancer therapy cardiotoxicity. Two blinded researchers screened the retrieved articles, including those reporting ECV values at least 3 months from cardiotoxic treatment. Data extraction was performed for each article, including clinical and technical data, and ECV values. Pooled ECV was calculated using the random effects model and compared among different treatment regimens and among those who did or did not experience overt cardiac dysfunction. Meta-regression analyses were conducted to appraise which clinical or technical variables yielded a significant impact on ECV.

Results
Overall, 19 studies were included. Study populations ranged from 9 to 236 patients, for a total of 1123 individuals, with an average age ranging from 12.5 to 74 years. Most studies included patients with breast or esophageal cancer, treated with anthracyclines and chest radiotherapy. Pooled ECV was 28.44% (95% confidence interval, CI, 26.85−30.03%) among subjects who had undergone cardiotoxic cancer therapy, versus 25.23% (95%CI 23.31−27.14%) among those who had not (p = .003).

Conclusion
A higher ECV in patients who underwent cardiotoxic treatment could imply subclinical changes in the myocardium, present even before overt cardiac pathology is detectable.

Clinical relevance statement
The ability to detect subclinical changes in the myocardium displayed by ECV suggests its use as an early biomarker of cancer therapy–related cardiotoxicity.

Key Points
• Cardiotoxicity is a common adverse effect of cancer therapy; therefore, its prompt detection could improve patient outcomes.
• Pooled MRI-derived myocardial extracellular volume was higher in patients who underwent cardiotoxic cancer therapy than in those who did not (28.44% versus 25.23%, p = .003).
• MRI-derived myocardial extracellular volume represents a potential early biomarker of cancer therapy cardiotoxicity.
Assessment of seasonal forecasting errors of the ECMWF system in the eastern Indian Ocean
Authors: Mayer Michael , Balmaseda Magdalena Alonso , Johnson Stephanie , Vitart Frederic 
Published: October 2023

AbstractThe interannual variability of the Equatorial Eastern Indian Ocean (EEIO) is highly relevant for the climate anomalies on adjacent continents and affects global teleconnection patterns. Yet, this is an area where seasonal forecasting systems exhibit large errors. Here we investigate the reasons for these errors in the ECMWF seasonal forecasting system SEAS5 using tailored diagnostics and a series of numerical experiments.Results indicate that there are two fundamental and independent sources of forecast errors in the EEIO. The first one is of atmospheric nature and is largely related with too strong and stable easterly atmospheric circulation present in the equatorial Indian Ocean. This induces an easterly bias which leaves the coupled model predominantly in a state with a shallow thermocline and cold SSTs in the EEIO. The second error is of oceanic origin, associated with a too shallow thermocline, which enhances the SST errors arising from errors in the wind. Ocean initial conditions, which depend on both the quality of the assimilation and the ocean model, play an important role in this context. Nevertheless, it is found that the version of the ocean model used for the forecast can also play a non-negligible role at the seasonal time scales, by amplifying or damping the subsurface errors in the initial conditions.Errors in the EEIO are regime-dependent, having different causes in the warm (deep thermocline) regime with strong atmospheric convection and in the cold (shallow thermocline) regime. Errors also exhibit decadal variations, which challenges the calibration methods used in seasonal forecasts.
Intake reminders are effective in enhancing adherence to direct oral anticoagulants in stroke patients: a randomised cross-over trial (MAAESTRO study)
Authors: Dietrich Fine , Polymeris Alexandros A. , Albert Valerie , Engelter Stefan T. , Hersberger Kurt E. , Schaedelin Sabine , Lyrer Philippe A. , Arnet Isabelle 
Published: October 2023

Abstract
Background
Direct oral anticoagulants (DOAC) effectively prevent recurrent ischaemic events in atrial fibrillation (AF) patients with recent stroke. However, excellent adherence to DOAC is mandatory to guarantee sufficient anticoagulation as the effect quickly subsides.

Aim
To investigate the effect of intake reminders on adherence to DOAC.

Methods
MAAESTRO was a randomised, cross-over study in DOAC-treated AF patients hospitalised for ischaemic stroke. Adherence was measured by electronic monitoring for 12 months. After an observational phase, patients were randomised to obtain an intake reminder either in the first or the second half of the subsequent 6-month interventional phase. The primary outcome was 100%-timing adherence. Secondary outcomes were 100%-taking adherence, and overall timing and taking adherence. We analysed adherence outcomes using McNemar’s test or mixed-effects logistic models.

Results
Between January 2018 and March 2022, 130 stroke patients were included, of whom 42 dropped out before randomisation. Analysis was performed with 84 patients (mean age: 76.5 years, 39.3% women). A 100%-timing adherence was observed in 10 patients who were using the reminder, and in zero patients without reminder (p = 0.002). The reminder significantly improved adherence to DOAC, with study participants having 2.7-fold increased odds to achieve an alternative threshold of 90%-timing adherence (OR 2.65; 95% CI 1.05–6.69; p = 0.039). A similar effect was observed for 90%-taking adherence (OR 3.06; 95% CI 1.20–7.80; p = 0.019). Overall timing and taking adherence increased significantly when using the reminder (OR 1.70; 95% CI 1.55–1.86, p < 0.01; and OR 1.67; 95% CI 1.52–1.84; p < 0.01).

Conclusion
Intake reminders increased adherence to DOAC in patients with stroke attributable to atrial fibrillation.

Trial registration
ClinicalTrials.gov: NCT03344146.
Contribution of T helper 17 cells and interleukin-17 to the pathogenesis of primary immune thrombocytopenia in Egyptian children
Authors: Hassan Tamer , Zakaria Marwa , Diaa Asmaa , Abdalla Ayman E. L. Sayed , Ahmed AL Sayed M. Sayed , Abdelmonem Doaa M. , Abdelaziz Eman 
Published: October 2023

AbstractThough pathogenesis of primary immune thrombocytopenia (ITP) is still rendered unclear, yet there are many research efforts that have been directed to the role of T helper 17 (Th17) and interleukin 17 (IL-17) in the pathogenesis of this disease. The Th17 cell, which produces IL-17, is a subset of T helper cells. Interleukin 17 is pro-inflammatory cytokine that is recently proved to have a crucial role in the emergence of autoimmune diseases. We aimed to investigate the role of T helper17 cells and interleukin-17 in the pathogenesis of ITP in Egyptian children. This study was carried out on 100 children with ITP and 100 apparently healthy children as a control group. Patients were subjected to full medical history taking, thorough physical examination and routine investigations according to our local standards. Percentage of Th17 cells was measured by flow cytometry in study groups. Also, serum IL-17 was measured in in study groups by ELISA. Th 17 cells were significantly higher in patients compared to controls. Moreover, 3.1-fold increased serum levels of IL-17 were observed in patients with ITP compared to controls. Newly diagnosed patients had significantly higher percentage of Th-17cells as well as higher IL-17 levels than patients with either persistent or chronic ITP. Conclusion: We concluded that Th 17 cells and IL-17 seem to play an important role in the pathogenesis of ITP in Egyptian children.

What is Known -- What is New:• The pathogenesis of ITP is heterogeneous A novel subset of CD4+ T cells, distinct from Th1 and Th2, was recently identified. It is characterized by the production of IL-17 and, therefore, designated as Th17 cells. Several studies support a pivotal role for serum cytokines in the pathogenesis of ITP and provide evidence to suggest that helper Tlymphocytes polarize into Th1 and Th2 immune response. we aimed to investigate the role of T helper17 cells and interleukin-17 in the pathogenesis of ITP in Egyptian children.
Diaphragmatic muscle function in term and preterm infants
Authors: Fouzas Sotirios , Vervenioti Aggeliki , Tsintoni Asimina , Dassios Theodore , Karatza Ageliki A. , Dimitriou Gabriel 
Published: October 2023

AbstractWe aimed to assess the determinants of diaphragmatic function in term and preterm infants. 149 infants (56 term; 93 preterm, of whom 14 were diagnosed with bronchopulmonary dysplasia—BPD) were studied before discharge. Diaphragmatic function was assessed by measurement of the maximum transdiaphragmatic pressure (Pdimax)—a measure of diaphragmatic strength, and the pressure–time index of the diaphragm (PTIdi)—a measure of the load-to-capacity ratio of the diaphragm. The Pdimax was higher in term than preterm infants without BPD (90.1 ± 16.3 vs 81.1 ± 11.8 cmH2O; P = 0.001). Term-born infants also had lower PTIdi compared to preterms without BPD (0.052 ± 0.014 vs 0.060 ± 0.017; P = 0.006). In term and preterm infants without BPD, GA was the most significant predictor of Pdimax and PTIdi, independently of the duration of mechanical ventilation and oxygen support. In infants with GA < 32 weeks (n = 30), the Pdimax was higher in infants without BPD compared to those with BPD (76.1 ± 11.1 vs 65.2 ± 11.9 cmH2O; P = 0.015). Preterms without BPD also had lower PTIdi compared to those with BPD (0.069 ± 0.016 vs 0.109 ± 0.017; P < 0.001). In this subgroup, GA was the only significant independent determinant of Pdimax, while BPD and the GA were significant determinants of the PTIdi. Conclusions: Preterm infants present lower diaphragmatic strength and impaired ability to sustain the generated force over time, which renders them prone to diaphragmatic fatigue. In very preterm infants, BPD may further aggravate diaphragmatic function.

What is Known:• The diaphragm of preterm infants has limited capacity to undertake the work of breathing effectively.• The maximum transdiaphragmatic pressure (a measure of diaphragmatic strength) and the pressure–time index of the diaphragm (a measure of the load-to-capacity ratio of the muscle) have not been extensively assessed in small infants.

What is New:• Preterm infants have lower diaphragmatic strength and impaired ability to sustain the generated force over time, which renders them prone to diaphragmatic fatigue.• In very preterm infants, bronchopulmonary dysplasia may further impair diaphragmatic function.
Oral somatosensory alterations and salivary dysfunction in head and neck cancer patients
Authors: Riantiningtyas Reisya Rizki , Valenti Alexandre , Dougkas Anestis , Bredie Wender L. P. , Kwiecien Camille , Bruyas Amandine , Giboreau Agnès , Carrouel Florence 
Published: October 2023

Abstract
Purpose
Patients with head and neck cancer (HNC) are at high risk of malnutrition due to eating difficulties partly mediated by sensory alterations and salivary dysfunction. Clinical studies have mostly focused on taste and smell alterations, while changes in oral somatosensory perception are largely understudied. The study aimed to investigate oral somatosensory (tactile, texture, chemesthetic, and thermal) responses and salivary functions of HNC patients in comparison to healthy controls.

Methods
A cross-sectional study was conducted using psychophysical tests in HNC patients (n = 30) and in age- and gender-matched control subjects (n = 30). The tests included measurements of point-pressure tactile sensitivity, whole-mouth chemesthetic stimulation, food texture discrimination, and temperature discrimination. Salivary functions, including hydration, saliva consistency, pH, volume, and buffering capacity, were also evaluated.

Results
HNC patients demonstrated significantly lower chemesthetic sensitivity (for medium and high concentrations, p < 0.05), thermal sensitivity (p = 0.038), and salivary functions (p = 0.001). There were indications of lower tactile sensitivity in the patient group (p = 0.101). Patients were also less sensitive to differences in food roughness (p = 0.003) and firmness (p = 0.025).

Conclusion
This study provided evidence that sensory alterations in HNC patients extend beyond their taste and smell. The measurements demonstrated lower somatosensory responses, in part associated with their reduced salivary function. Oral somatosensory alterations and salivary dysfunction may consequently impart the eating experience of HNC patients. Thus, further investigations on food adjustments for this patient group seem warranted.