bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rates of diabetic ketoacidosis with empagliflozin use during hospitalization for acute heart failure
Authors: Huang Cheng‐Wei , Lee Janet S. , Lee Ming‐Sum 
Published: January 2024

AbstractThere is concern that sodium‐glucose cotransporter‐2 inhibitors during hospitalization for acute heart failure (aHF) may precipitate diabetic ketoacidosis (DKA). A retrospective study of all hospitalization encounters for aHF defined by a primary HF International Classification of Diseases (ICD)‐10 code in 15 Kaiser Permanente Southern California medical centers hospitalized between January 1, 2021 and August 31, 2023 was performed to describe rates of DKA with empagliflozin use. DKA was defined by the presence of either a DKA ICD‐10 code or ketoacidosis lab criteria (bicarbonate <18 mmol/L and urine ketone 1+ or more or elevated serum beta‐hydroxybutyrate within 12 h) during hospitalization. Among 21,630 hospital encounters (15,518 patients) for aHF, 1678 (8%) had empagliflozin use. There were 2 (0.1%) probable DKA cases in empagliflozin encounters and 15 (0.1%) in nonexposed encounters. These rates were similar when stratified by diabetes status and ejection fraction. Empagliflozin may be safe during aHF hospitalization.
高血糖と循環不全により救急搬送された脊椎の気腫性骨髄炎の1例(Emphysematous osteomyelitis of the spine with concomitant hyperglycemia and circulatory failure: a case report)
Authors: 透 野田 , 忠幸 平井 , 正樹 岡島 
Published: January 2024

要旨70歳代の女性。先行する腰痛と意識障害，循環不全にて救急搬送された。著明な高血糖と脱水の所見があり，また，画像検査および血液検査，尿検査にて腰椎の気腫性骨髄炎と尿路感染，血小板減少の所見を認めた。尿路感染に起因する気腫性骨髄炎により糖尿病性ケトアシドーシスと高血糖高浸透圧状態，感染性の播種性血管内凝固を発症したものと診断し，集学的治療を行った。感染に対しては来院時より抗生剤投与が行われ，また，入院3日目に腰椎の椎弓切除ならびに椎間板の掻把が行われた。血液，尿，椎間板のいずれからもEscherichia coliが検出された。入院61日目の時点で，全身状態は安定したが椎体の感染に対して加療が継続されている。気腫性骨髄炎は稀な疾患であるが死亡率も高く，適切な全身管理ならびに抗生剤投与，必要時の迅速な外科的介入が必要である。
Cerebral Blood Flow Patterns in Patients With Low‐Flow Carotid Artery Stenosis, a 4D‐PCMRI Assessment
Authors: Zarrinkoob Laleh , Myrnäs Sanne , Wåhlin Anders , Eklund Anders , Malm Jan 
Published: January 2024

BackgroundCompromised cerebral blood flow can contribute to future ischemic events in patients with symptomatic carotid artery disease. However, there is limited knowledge of the effects on cerebral hemodynamics resulting from a reduced internal carotid artery (ICA) blood flow rate (BFR).PurposeInvestigate how reduced ICA‐BFR, relates to BFR in the cerebral arteries.Study TypeProspective.SubjectsThirty‐eight patients, age 72 ± 6 years (11 female).Field Strength/Sequence3‐Tesla, four‐dimensional phase‐contrast magnetic resonance imaging (4D‐PCMRI).AssessmentPatients with ischemic stroke or transient ischemic attack were evaluated regarding the degree of stenosis. 4D‐PCMRI was used to measure cerebral BFR in 38 patients with symptomatic carotid stenosis (≥50%). BFR in the cerebral arteries was assessed in two subgroups based on symptomatic ICA‐BFR: reduced ICA‐flow (<160 mL/minutes) and preserved ICA‐flow (≥160 mL/minutes). BFR laterality was defined as a difference in the paired ipsilateral‐contralateral arteries.Statistical TestsPatients were grouped based on ICA‐BFR (reduced vs. preserved). Statistical tests (independent sample t‐test/paired t‐test) were used to compare groups and hemispheres. Significance was determined at P < 0.05.ResultsThe degree of stenosis was not significantly different, 80% (95% confidence interval [CI] = 73%–87%) in the reduced ICA‐flow vs. 72% (CI = 66%–76%) in the preserved ICA‐flow; P = 0.09. In the reduced ICA‐flow group, a significantly reduced BFR was found in the ipsilateral middle cerebral artery and anterior cerebral artery (A1), while significantly increased in the contralateral A1. Retrograde BFR was found in the posterior communicating artery and ophthalmic artery. Significant BFR laterality was present in all paired arteries in the reduced ICA‐flow group, contrasting the preserved ICA‐flow group (P = 0.14–0.93).Data Conclusions4D‐PCMRI revealed compromised cerebral BFR due to carotid stenosis, not possible to detect by solely analyzing the degree of stenosis. In patients with reduced ICA‐flow, collaterals were not sufficient to maintain symmetrical BFR distribution to the two hemispheres.Evidence Level2Technical EfficacyStage 3
A novel cell biological tool to explain mechanics and dynamics in fission yeast
Authors: Rasheed Muhammad Ali , Mohy‐ud‐Din Raza , Anwar Tehreem , Faiz Muhammad 
Published: January 2024

AbstractThe Rho guanosine triphosphatase hydrolase enzyme (GTPase) is required for the control of the actin cytoskeleton, but its activation in vivo condition is unknown. The study's goal was to find a new synthetic nanobody VHH (P‐36 tagged with mNeonGreen) that interacts strongly with the Rho GTPase. We present the first novel synthetic nanobody, VHH (P‐36 tagged with mNeonGreen), tested in fission yeast cells and found to have a particular interaction with Rho1GTPase. Plasmids were constructed by using of certain enzymes to digest the pDUAL‐pef1a vector plasmid to produce a protein that was encoded by cloned genes. A varied VHH library was created synthetically, then transformed into yeast cells, and positive clones were chosen using chemical agents. To investigate protein interactions and cellular reactions, several studies were carried out, such as live cell imaging, growth curve analysis, coimmunoprecipitation, structural analysis, and cell therapies. Prism and RStudio were used for the statistical analysis. The presence of VHH (P‐36) has no effect on the growth pattern making it an appropriate model for studying cytokinesis in vivo. According to a computational biological study, its affinity to interact with Rho1GTPase with all the complementarity‐determining region (CDR) regions found on VHH (P‐36) is extremely strong. We were able to track its subcellular target by localization using a fluorescent confocal microscope, ensuring the maintenance of cell polarity and morphology. Spheroplast analysis revealed a circular‐shaped cell with an even distribution of Rho1 tagged VHH (P‐36), indicating that the interaction occurs near the plasma membrane. The introduction of latrunculin‐A (Lat‐A) disrupted Rho GTPase localization, demonstrating the control over actin production, and the cell did not show evidence of mitotic phase commencement while Lat‐A was present. Finally, this important biological tool can aid in our understanding of the mechanics and dynamics of cytokinesis in relation to Rho1GTPase.
Fitting digital visualization board transitions to shop floor tasks
Authors: Mathiasen John Bang , Clausen Pernille 
Published: January 2024

AbstractThe increased digitalization of shop floors has provided unprecedented opportunities for real‐time sharing of process and resource details. Visualization boards (VBs), which provide ubiquitous technology‐enabled renderings of such details, salient to a local shop‐floor setting, have the potential to play a significant role in this regard. Critical to the effectiveness of this role is the fit between VB design and shop‐floor needs. In our study, we apply task‐technology‐fit theory in case examinations focused on identifying mismatch, implications of mismatch, and putative best practices in designs for future interventions. Our assessment capitalizes on both core operations management design principles as well as technology management design principles. We develop grounded propositions regarding guidelines that should be applied in future VB designs and deployments.
Association of omental pedicled flap with anastomotic leak following low anterior resection for rectal cancer
Authors: Ali Danish , Syed Maria , Gamboa Adriana C. , Hawkins Alexander T. , Regenbogen Scott E. , Holder‐Murray Jennifer , Silviera Matthew , Ejaz Aslam , Balch Glen C. , Khan Aimal 
Published: January 2024

AbstractBackground and ObjectivesAnastomotic leak following colorectal anastomosis adversely impacts short‐term, oncologic, and quality‐of‐life outcomes. This study aimed to assess the impact of omental pedicled flap (OPF) on anastomotic leak among patients undergoing low anastomotic resection (LAR) for rectal cancer using a multi‐institutional database.MethodsAdult rectal cancer patients in the US Rectal Cancer Consortium, who underwent a LAR for stage I–III rectal cancer with or without an OPF were included. Patients with missing data for surgery type and OPF use were excluded from the analysis. The primary outcome was the development of anastomotic leaks. Multivariable logistic regression was used to determine the association.ResultsA total of 853 patients met the inclusion criteria and OPF was used in 106 (12.4%) patients. There was no difference in age, sex, or tumor stage of patients who underwent OPF versus those who did not. OPF use was not associated with an anastomotic leak (p = 0.82), or operative blood loss (p = 0.54) but was associated with an increase in the operative duration [β = 21.42 (95% confidence interval = 1.16, 41.67) p = 0.04].ConclusionsAmong patients undergoing LAR for rectal cancer, OPF use was associated with an increase in operative duration without any impact on the rate of anastomotic leak.
Restricted kinematically aligned total knee arthroplasty with an anatomically designed implant can restore constitutional coronal lower limb alignment
Authors: Ogawa Hiroyasu , Nakamura Yutaka , Akiyama Haruhiko 
Published: January 2024

AbstractPurposeRestricted kinematically aligned total knee arthroplasty (rKA‐TKA) may not restore the constitutional varus alignment in most patients with knee osteoarthritis. This study aimed to investigate (1) the extent to which constitutional lower limb alignment can be restored by rKA‐TKA using an anatomically designed implant and (2) which lower limb alignment parameters are associated with patient‐reported outcome measures (PROMs).MethodsThis study included 60 patients who underwent rKA‐TKA using an anatomically designed implant. Radiographic alignment parameters, including mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), coronal hip–knee–ankle angle (HKA), coronal joint line obliquity (JLO), posterior tibial slope (PTS), single‐leg standing knee flexion angle (KFA), sagittal JLO, and arithmetic HKA (aHKA), were evaluated preoperatively and postoperatively. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used for clinical evaluation.ResultsThe mLDFA, MPTA, and aHKA showed no significant differences before and after surgery. Coronal HKA and PTS have significantly changed from 8.1 ± 8.7° and 9.9 ± 8.6° preoperatively to 3.5 ± 3.1° and 2.5 ± 2.0° postoperatively, respectively (p < 0.001 for each comparison). The postoperative WOMAC total score was significantly correlated with the KFA (r = 0.4063, p = 0.0034) and sagittal JLO (r = −0.3435, p = 0.0157). Postoperative KFA is a causal factor for the increased postoperative WOMAC total score (r = 1.416, 95% confidence interval: 0.491–2.342, p = 0.003).ConclusionrKA‐TKA using an anatomically designed implant can restore constitutional coronal lower limb alignment, while postoperative KFA and sagittal JLO were associated with poor PROMs. Care should be taken for the postoperative KFA because it is a risk factor for poor PROMs.Level of Evidence: Level III, case–control study.
Preoperative joint line obliquity, a newly identified factor for overcorrection, can be incorporated into a novel preoperative planning method to optimise alignment in high tibial osteotomy
Authors: Jung Se‐Han , Jung Min , Chung Kwangho , Kim Sungjun , Kang Kyoung‐Tak , Park Jisoo , Sim Woongseob , Choi Chong‐Hyuk , Kim Sung‐Hwan 
Published: January 2024

AbstractPurposeThe aim of this study was to analyse the factors associated with additional postoperative alignment changes after accurate bony correction by selecting only patients with well‐performed bony correction as planned and develop a method of incorporating significant factors into preoperative planning.MethodsAmong 104 consecutive patients who underwent medial open wedge high tibial osteotomy (MOWHTO) between October 2019 and July 2022, 61 with well‐performed bony corrections were retrospectively reviewed. The major criterion for well‐performed bony correction was a difference of <1° between the simulated medial proximal tibial angle (MPTA) and the actual postoperative MPTA as measured in three dimensions. Radiographic parameters, such as the joint line convergence angle (JLCA) and joint line obliquity (JLO), were measured preoperatively and postoperatively, utilising standing and supine whole lower extremity anteroposterior, valgus and varus stress radiographs. Multiple linear regression analysis identified the factors affecting alignment changes, and a prediction model was developed. A method for applying this prediction model to preoperative planning was proposed.ResultsPreoperative JLCA on standing (preJLCAstd), preoperative JLCA on 0° valgus stress radiograph (vgJLCA0), and preoperative JLO (preJLO) were significantly correlated with JLCA change (∆JLCA) (p < 0.001, p < 0.001, p = 0.006). The prediction model was estimated as ∆JLCA = 0.493 × (vgJLCA0) − 0.727 × (preJLCAstd) + 0.189 × (preJLO) − 1.587 in. (R = 0.815, modified R2 = 0.646, p < 0.001). The proposed method resulted in a reduced overcorrection rate (p = 0.003) and an improved proportion of acceptable alignments (p = 0.013).ConclusionPreJLCAstd, vgJLCA0 and preJLO can be used to estimate ∆JLCA. PreJLO was recently identified as a significant factor associated with additional alignment changes. Utilising the proposed preoperative planning and a prediction model with these factors shows promise in calibrating postoperative alignment after MOWHTO.Level of EvidenceLevel III, retrospective cohort study.
Significant improvements in clinical outcome measures and patient satisfaction after combined all‐arthroscopic meniscal allograft transplantation and autologous chondrocyte implantation: A single‐centre longitudinal study
Authors: Pawelczyk Johannes , Fanourgiakis Ilias , Feil Sven , Siebold Rainer 
Published: January 2024

AbstractPurposeThe optimal treatment approach for the complex pathology of meniscal insufficiency and coexisting full‐thickness cartilage defects remains unclear. The purpose of this study was to evaluate the viability, safety, and efficacy of this combined surgical approach at medium‐term follow‐up.MethodsThis is a single‐centre longitudinal study with blinded outcome assessment. All consecutive patients treated with combined all‐arthroscopic meniscal allograft transplantation (MAT) with bone bridge fixation and ACI using chondrospheres at our institution between 2001 and 2021 were eligible for inclusion. Twenty patients with an average follow‐up of 72.6 ± 34.4 months were included in the statistical analysis. Clinical outcomes were assessed pre‐ and postoperatively using the IKDC Subjective Knee Form, Lysholm Score, Tegner Activity Scale, KOOS, and Visual Analog Scale (VAS) for patient satisfaction. Failure and reoperation rates were assessed, and cartilage regeneration tissue was evaluated on postoperative MRI.ResultsIKDC scores significantly improved from 52.1 ± 16.9 to 68.5 ± 16.3 (p = 0.003). Lysholm scores improved from 61.5 ± 21.7 to 78.5 ± 12.9 (p = 0.004). Tegner scores improved from 3.5 (1–4) to 4.0 (2–6) (p = 0.014). KOOS scores improved significantly across all subcategories, except ‘symptoms’, where improvements did not reach statistical significance. VAS for overall patient satisfaction showed improvements but did not reach statistical significance. The combined procedure was successful in 17 patients (85%). Eight patients had to undergo reoperation (40%), comprising mostly small, arthroscopic procedures. Seven reoperations were directly attributable to meniscal allograft transplantation (46.7%). Postoperative Magnetic Resonance Observation of Cartilage Repair Tissue scores were 68.9 ± 16.8 (n = 14).ConclusionCombined arthroscopic MAT and autologous chondrocyte implantation (ACI) is a viable, safe, and effective treatment approach for younger patients with meniscal insufficiency and coexisting full‐thickness cartilage damage, where alternative treatment options are limited. The combined surgical procedure achieved significant improvements in clinical outcome measures and patient satisfaction with acceptable failure and high arthroscopic reoperation rates. MAT is the limiting part of this combined procedure, with most failures and reoperations being attributable to MAT, as opposed to ACI.Level of Evidence: Level III.
Research on internal two‐phase flow in the local micro‐clearance design of a high‐speed ball bearing with under‐race lubrication
Authors: Gong Ping , Liu Zhenxia , Yu Qingjie , Chen Fei 
Published: January 2024

AbstractIn this research, an angular contact ball bearing with two‐half inner rings is used as a carrier. Considering the two‐phase flow characteristics of oil and air in the bearing, the flow characteristics of lubricating oil inside the bearing with under‐race lubrication are studied. Based on the volume of fluid (VOF) method and the standard k–ε turbulent flow model, the characteristics of oil and air two‐phase flow inside the ball bearing are analysed. The bearing internal pressure field distribution, streamline distribution, and other flow properties for the different radial working clearances, pocket clearances and guide clearances are determined. The distribution of the lubricating oil in key areas is observed. The oil phase volume fraction of the key lubrication areas, such as the cage pocket surface and the inner and outer ring surfaces is used to evaluate the influence of different structural parameters on the bearing lubrication performance. The lubrication influences of the inner and outer guides of the cage are evaluated, and the internal flow characteristics of the bearing are analysed with different guide clearances. The results show that with the radial working clearance range from 0.100 to 0.145 mm, the pressure in the working contact area of the bearing decreases 26%. The pocket clearance ranges from 0.48 to 0.28 mm, and the pressure in the working contact area of the bearing significant increases from 0.642 to 1.165 MPa. From this perspective, the larger the radial working clearance and pocket clearance are, the more favourable it is for bearing lubrication. For bearings with under‐ring lubrication, when the bearing adopts outer guidance, the distribution of lubricating oil in the key areas of the bearing is worse than that for internal guidance. However, the pressure in the working contact area of the bearing slightly increases from 0.642 to 0.759 MPa with the inner guide clearance increasing from 0.4 to 0.8 mm.
Terahertz dielectric spectroscopy based thermal‐oxidative aging analysis of polyvinyl chloride
Authors: Zhang Xiansheng , Feng Tianli , Li Yizhang , Shang Jingcheng 
Published: January 2024

AbstractPolyvinyl chloride (PVC) is a polymer widely used in the world whereas safety problems owing to PVC aging are often reported. Thermal‐oxidative aging is known the main cause of its performance deterioration and lifetime decreasing. The existing PVC aging detection methods are complicated, making it difficult to achieve rapid on‐site diagnosis. The purpose of this paper is to evaluate the degree of PVC aging by means of terahertz technology. Samples were subject to thermal‐oxidative aging, and the corresponding dielectric spectra were measured by a terahertz time‐domain spectrometer. It turns out that the aging dependent dielectric spectra conforms to the physicochemical theory. Moreover, numerical correlation between the change in permittivity and the degree of aging, underlying a new solution for the aging forecast aimed at plastics.
AI‐based motion artifact severity estimation in undersampled MRI allowing for selection of appropriate reconstruction models
Authors: Beljaards Laurens , Pezzotti Nicola , Rao Chinmay , Doneva Mariya , van Osch Matthias J. P. , Staring Marius 
Published: January 2024

AbstractBackgroundMagnetic Resonance acquisition is a time consuming process, making it susceptible to patient motion during scanning. Even motion in the order of a millimeter can introduce severe blurring and ghosting artifacts, potentially necessitating re‐acquisition. Magnetic Resonance Imaging (MRI) can be accelerated by acquiring only a fraction of k‐space, combined with advanced reconstruction techniques leveraging coil sensitivity profiles and prior knowledge. Artificial intelligence (AI)‐based reconstruction techniques have recently been popularized, but generally assume an ideal setting without intra‐scan motion.PurposeTo retrospectively detect and quantify the severity of motion artifacts in undersampled MRI data. This may prove valuable as a safety mechanism for AI‐based approaches, provide useful information to the reconstruction method, or prompt for re‐acquisition while the patient is still in the scanner.MethodsWe developed a deep learning approach that detects and quantifies motion artifacts in undersampled brain MRI. We demonstrate that synthetically motion‐corrupted data can be leveraged to train the convolutional neural network (CNN)‐based motion artifact estimator, generalizing well to real‐world data. Additionally, we leverage the motion artifact estimator by using it as a selector for a motion‐robust reconstruction model in case a considerable amount of motion was detected, and a high data consistency model otherwise.ResultsTraining and validation were performed on 4387 and 1304 synthetically motion‐corrupted images and their uncorrupted counterparts, respectively. Testing was performed on undersampled in vivo motion‐corrupted data from 28 volunteers, where our model distinguished head motion from motion‐free scans with 91% and 96% accuracy when trained on synthetic and on real data, respectively. It predicted a manually defined quality label (‘Good’, ‘Medium’ or ‘Bad’ quality) correctly in 76% and 85% of the time when trained on synthetic and real data, respectively. When used as a selector it selected the appropriate reconstruction network 93% of the time, achieving near optimal SSIM values.ConclusionsThe proposed method quantified motion artifact severity in undersampled MRI data with high accuracy, enabling real‐time motion artifact detection that can help improve the safety and quality of AI‐based reconstructions.