bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender influence on career trajectory as a shoulder and elbow surgeon
Authors: Haff Christopher W , Childers Justin T , Forbes Jessica M , Lack Benjamin T , Jackson Garrett R , Sabesan Vani J 
Published: January 2025

Background Women continue to make up a minority of orthopedic surgeons, especially shoulder and elbow surgeons. There exists no study that investigates the effect of gender on one's academic career as a shoulder and elbow orthopedic surgeon, which was the purpose of this cross-sectional study. Methods The American Shoulder and Elbow Surgeons website was used to identify surgeons. Demographics, education, and current professional roles were obtained using the websites of institutions, hospital employers, physicians, LinkedIn, and Doximity. Research productivity metrics were obtained using SCOPUS and Google Scholar. Outcome measures included current academic/leadership roles, and research productivity. Statistical analysis was performed using the Chi-squared test and Mann–Whitney U test. Results Totally, 893 surgeons were identified, 60 being female (6.7%). Males had a significantly higher average h-index ( P = 0.003), total number of publications ( P = 0.019), citations ( P = 0.03) and ASES membership ranks than female surgeons ( P = 0.037; P = 0.004). There were no significant differences between genders in current professional or leadership roles. Discussion Female surgeons had a significantly lower number of citations, publications, and h-index but equal leadership positions such as fellowship director, residency director, chief of service, and department chair compared to their male counterparts. Level of evidence Level III, cross-sectional study.
Enhancing prostate cancer segmentation in bpMRI: Integrating zonal awareness into attention-guided U-Net
Authors: Wei Chao , Liu Zheng , Zhang Yibo , Fan Lianhui 
Published: January 2025

Purpose Prostate cancer (PCa) is the second most common cancer in males worldwide, requiring improvements in diagnostic imaging to identify and treat it at an early stage. Bi-parametric magnetic resonance imaging (bpMRI) is recognized as an essential diagnostic technique for PCa, providing shorter acquisition times and cost-effectiveness. Nevertheless, accurate diagnosis using bpMRI images is difficult due to the inconspicuous and diverse characteristics of malignant tumors and the intricate structure of the prostate gland. An automated system is required to assist the medical professionals in accurate and early diagnosis with less effort. Method This study recognizes the impact of zonal features on the advancement of the disease. The aim is to improve the diagnostic performance through a novel automated approach of a two-step mechanism using bpMRI images. First, pretraining a convolutional neural network (CNN)-based attention-guided U-Net model for segmenting the region of interest which is carried out in the prostate zone. Secondly, pretraining the same type of Attention U-Net is performed for lesion segmentation. Results The performance of the pretrained models and training an attention-guided U-Net from the scratch for segmenting tumors on the prostate region is analyzed. The proposed attention-guided U-Net model achieved an area under the curve (AUC) of 0.85 and a dice similarity coefficient value of 0.82, outperforming some other pretrained deep learning models. Conclusion Our approach greatly enhances the identification and categorization of clinically significant PCa by including zonal data. Our approach exhibits exceptional performance in the accurate segmentation of bpMRI images compared to current techniques, as evidenced by thorough validation of a diverse dataset. This research not only enhances the field of medical imaging for oncology but also underscores the potential of deep learning models to progress PCa diagnosis and personalized patient care.
Heterogeneous focal adhesion cytoskeleton nanoarchitectures from microengineered interfacial curvature to oversee nuclear remodeling and mechanotransduction of mesenchymal stem cells
Authors: Fan Huayu , Zhao Hui , Hou Yan , Meng Danni , Jiang Jizong , Lee Eon-Bee , Fu Yinzheng , Zhang Xiangdong , Chen Rui , Wang Yongtao 
Published: January 2025

Abstract

Background
Interfacial heterogeneity is widely explored to reveal molecular mechanisms of force-mediated pathways due to biased tension. However, the influence of cell density,, curvature, and interfacial heterogeneity on underlying pathways of mechanotransduction is obscure.

Methods
Polydimethylsiloxane (PDMS)-based stencils were micropatterned to prepare the micropores for cell culture. The colonies of human mesenchymal stem cells (hMSCs) were formed by controlling cell seeding density to investigate the influences of cell density, curvature and heterogeneity on mechanotransduction. Immunofluorescent staining of integrin, vinculin, and talin-1 was conducted to evaluate adhesion-related expression levels. Then, immunofluorescent staining of actin, actinin, and myosin was performed to detect cytoskeleton distribution, especially at the periphery. Nuclear force-sensing mechanotransduction was explained by yes-associated protein (YAP) and laminA/C analysis.

Results
The micropatterned colony of hMSCs demonstrated the coincident characters with engineered micropores of microstencils. The cell colony obviously developed the heterogeneous morphogenesis. Heterogeneous focal adhesion guided the development of actin, actinin, and myosin together to regulate cellular contractility and movement by integrin, vinculin, and talin-1. Cytoskeletal staining showed that actin, actinin, and myosin fibers were reorganized at the periphery of microstencils. YAP nuclear translocation and laminA/C nuclear remodeling were enhanced at the periphery by the regulation of heterogeneous focal adhesion (FA) and cytoskeleton arrangement.

Conclusions
The characters of the engineered clustering colony showed similar results with prepared microstencils, and colony curvature was also well adjusted to establish heterogeneous balance at the periphery of cell colony. The mechanism of curvature, spreading, and elongation was also investigated to disclose the compliance of FA and cytoskeleton along with curvature microarrays for increased nuclear force-sensing mechanotransduction. The results may provide helpful information for understanding interfacial heterogeneity and nuclear mechanotransduction of stem cells.
Severe fever with thrombocytopenia syndrome complicated with aspergillus endocarditis and multiple organ infarctions after glucocorticoid treatment in an immunocompetent man: a case report
Authors: Zhao Yuxi , Wu Xiaoxin , Wang Xinyu , Li Lanjuan 
Published: January 2025

Abstract

Background
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease characterized by leukopenia and thrombocytopenia, and aspergillosis is a common complication in severe cases. Previous studies have reported cases of SFTS complicated with invasive pulmonary aspergillosis (IPA) and central nervous system aspergillosis. Here, we present the first case of an immunocompetent patient with SFTS who progressed to IPA and Aspergillus endocarditis after glucocorticoid treatment, and embolism of the vegetations from the left ventricle led to multiple infarctions in the brain, kidney, and spleen.

Case presentation
A 66-year-old male farmer developed altered mental status during SFTS. His consciousness improved during the treatment of glucocorticoids, intravenous immunoglobulin, and ribavirin, but he developed embolisms in the spleen and right kidney, initially attributed to atrial fibrillation, and the anticoagulant agent was not administered due to the high risk of bleeding. Later, He was diagnosed with SFTS-associated IPA (SAPA), for which voriconazole was administered. However, he subsequently experienced a recurrence of altered mental status, accompanied by headache, blindness, and muscle weakness. Brain magnetic resonance imaging (MRI) revealed multiple cerebral embolisms and abscess. The echocardiography showed the vegetations in the left ventricle, suggesting multi-organ embolism caused by infective endocarditis (IE). Aspergillus fumigatus was confirmed through pathology and culture of the excised vegetations. The patient was eventually discharged with improved consciousness and muscle strength, but his vision showed minimal recovery.

Conclusion
Clinicians should be wary of aspergillosis in severe patients with SFTS, particularly those receiving glucocorticoid treatment. In patients with SAPA, cerebral aspergillosis and embolic stroke caused by Aspergillus endocarditis should also be considered when mental status alters. Furthermore, the possibility of Aspergillosis in other organs should be considered in high-risk patients.
Biomechanical models in the lower-limb exoskeletons development: a review
Authors: Firouzi Vahid , Seyfarth Andre , Song Seungmoon , von Stryk Oskar , Ahmad Sharbafi Maziar 
Published: January 2025

Abstract
Lower limb exoskeletons serve multiple purposes, like supporting and augmenting movement. Biomechanical models are practical tools to understand human movement, and motor control. This paper provides an overview of these models and a comprehensive review of the current applications of them in assistive device development. It also critically analyzes the existing literature to identify research gaps and suggest future directions. Biomechanical models can be broadly classified as conceptual and detailed models and can be used for the design, control, and assessment of exoskeletons. Also, these models can estimate unmeasurable or hard-to-measure variables, which is also useful within the aforementioned applications. We identified the validation of simulation studies and the enhancement of the accuracy and fidelity of biomechanical models as key future research areas for advancing the development of assistive devices. Additionally, we suggest using exoskeletons as a tool to validate and refine these models. We also emphasize the exploration of model-based design and control approaches for exoskeletons targeting pathological gait, and utilizing biomechanical models for diverse design objectives of exoskeletons. In addition, increasing the availability of open source resources accelerates the advancement of the exoskeleton and biomechanical models. Although biomechanical models are widely applied to improve movement assistance and rehabilitation, their full potential in developing human-compatible exoskeletons remains underexplored and requires further investigation. This review aims to reveal existing needs and cranks new perspectives for developing more effective exoskeletons based on biomechanical models.
Parental perception of treatment options for mucopolysaccharidosis: a survey to bridge the gap for personalized medicine
Authors: Wiesinger Anna-Maria , Lagler Florian B. 
Published: January 2025

Abstract

Background
Mucopolysaccharidosis (MPS) are a group of lysosomal storage diseases with substantial unmet medical needs—for both patients and caregivers. Approved therapies are limited, and the perception of investigative ones remains enigmatic.

Method
Using an innovative survey concept based on the discrete choice experiment method (DEC) with neuronopathic and non-neuronopathic patient scenarios, we aimed to evaluate how parents of children with MPS perceive different approved and innovative therapies. The questionnaire was distributed via patient organizations in Germany, Switzerland, and Austria.

Results
Most likely parents would choose an approach to repurposed treatments for their child (neuronopathic: 82%, 14/17 and non-neuronopathic: 94%, 16/17), followed by enzyme replacement therapy (ERT, both 88%, 15/17), hematopoietic stem cell therapy (HSCT, 70%, 12/17 and 76%, 13/17), and finally gene therapy (GT, 58%, 10/17 and 53%, 9/17). The general attitudes strongly influenced decision-making regarding treatment options. While over 80% of respondents who held a positive attitude toward ERT, HSCT, and ITTs indicated they would opt for these therapies in both neuronopathic and non-neuronopathic cases, only about half of the parents with a favorable general view of gene therapy (GT) expressed a positive perception of its likelihood as a treatment option. Furthermore, most parents found mild infections, injection site reactions (ISRs), hypertonia, and treatment-related hospitalizations acceptable and indicated patient organizations as their main source of information.

Conclusions
This study provides an innovative survey method, thereby offering the rationale for a quantitative risk–benefit model and the importance of patient and caregiver-centered information dissemination, especially for innovative therapies.
Dynamic analysis of SPAFIR epidemic model considering pseudoinfection and perturbations
Authors: Nie Xiaoqian , Hu Yuhan , Yan Weijun 
Published: January 2025

Abstract
In this paper, the “pseudoinfection phenomenon” and “individual behavioral responses” are taken into account in the SIR epidemic model, and the deterministic and stochastic models are analyzed dynamically. Through the exploration of the deterministic SPAFIR (Susceptible-Pseudoinfected-Alert-Fragile-Infected-Recovered) model, the conditions for the equilibrium points’ existence and stability are determined. With the assistance of the Pontryagin maximum principle, this paper introduces a Hamiltonian function with a penalty term and the optimal control strategy is obtained by comparing the three groups of strategies. The optimal control strategy requires multiple control measures to inhibit the infectious disease spread. Further considering the stochastic SPAFIR model, the existence of the uniqueness of a global positive solution and the existence of a stationary distribution for the stochastic model are proved, and the condition for disease extinction is also verified. Random perturbations of the effective contact rates can slow the pace of spreading the infectious diseases. Results of theoretical analysis and the system’s responsiveness to variations in effective contact rates are verified by numerical simulations, and the outcomes indicate that active prevention education and community encouragement can both inhibit infection spread.
Effects of spray dried plasma on litter growth performance and oxidative stress and inflammation of sows kept in a hot environment
Authors: Bailey Hannah M. , Fanelli Natalia S. , Campbell Joy M. , Stein Hans H. 
Published: January 2025

Abstract

Background
Feeding spray dried plasma (SDP) to weanling pigs improves growth, but there is a lack of research on how SDP impacts oxidative stress and inflammatory response in lactating sows, and performance of their piglets after weaning. Therefore, an experiment was conducted to test the hypothesis that sows fed a diet with SDP in late gestation and lactation have improved reproductive performance and reduced inflammation compared with sows fed no SDP. The second hypothesis was that pigs weaned from sows fed 0.5% SDP in lactation have reduced diarrhea incidence and improved growth performance during the initial 14 d of the nursery period regardless of dietary SDP.

Results
The percent of low vitality or starved pigs during lactation was less (P < 0.05) from sows fed 0.5% dietary SDP compared with sows fed the diet without SDP. Dietary SDP did not influence oxidative stress markers in the plasma of sows, but serum cytokines increased (P < 0.05) in sows fed the diet with 0.5% SDP compared with sows fed the diet without SDP. Pigs weaned from young sows fed no SDP or from mature sows fed 0 or 0.5% SDP had a greater gain to feed ratio when fed a phase 1 diet containing 6% SDP compared with pigs fed a diet without SDP, but the gain to feed ratio of pigs weaned from young sows fed 0.5% dietary SDP was not affected by dietary SDP in phase 1 (interaction, P < 0.05). Regardless of sow treatment, pigs fed a phase 1 diet with 6% SDP had greater (P < 0.05) growth performance than pigs fed a phase 1 diet without SDP, and pigs fed the phase 1 diet with 6% SDP had reduced (P < 0.05) diarrhea incidence in phase 1.

Conclusions
Feeding 0.5% dietary SDP to sows may reduce the number of mummified pigs and increase pig vitality during lactation, but adding 0.5% SDP to sow diets during lactation did not improve post-weaning performance of pigs fed a starter diet with 6% SDP.
Relationship between muscle activation and sagittal knee joint biomechanics in patients with patellofemoral pain syndrome: a cross-sectional study
Authors: Choi Byung Sun , Kwon Soon Bin , Jeon Sehyeon , Kim Myeongjun , Ku Yunseo , Ro Du Hyun , Han Hyuk-Soo 
Published: January 2025

Abstract

Background
Patellofemoral pain syndrome (PFPS) is one of the most common conditions affecting the knee joint, yet its pathomechanics remain unclear. The aim of this study was to investigate changes in muscle activation and gait patterns and to analyze the relationship between muscle activation and kinetic gait patterns in patients with PFPS.

Methods
This study included 31 patients with PFPS and 28 healthy volunteers without any symptoms. The sagittal plane motion of the knee joint, representing primary movement of the knee joint, was evaluated to identify changes in gait patterns. Electromyography (EMG) was used to measure muscle activation of vastus medialis (VM), vastus lateralis (VL), semitendinosus (ST), and gastrocnemius (GCM) muscles during gait analysis. Biomechanical features were analyzed during the three phases of the gait cycle; weight acceptance (WA), single limb support (SLS), and swing limb advancement (SLA) (0 ~ 12%, 13 ~ 50%, and 51 ~ 100% of the gait cycle, respectively).

Results
The average knee extension moment (KEM) during WA was lower in the patient group and no significant differences were observed in the knee flexion angle (KFA). With respect to muscle activation, the patient group showed significantly higher muscle activation of the ST muscle in all phases. As the absolute value of the moment increased, the activation of the VM, VL, and ST muscles increased more rapidly in the patient group, especially when KEM was under −1% body weight × height (Bw × Ht) or over 5% Bw × Ht.

Conclusions
Patients with PFPS exhibit elevated muscle activation, particularly in response to changes in the knee extension moment, which is likely a compensatory mechanism to manage knee joint loading during gait. These results highlight altered neuromuscular adaptations in PFPS, suggesting targeted therapies may help improve functional outcomes.

Level of evidence III, cross-sectional study
Understanding social behaviours across neurodiverse young people: roles of social cognition and self-regulation
Authors: Iturmendi-Sabater Iciar , Anagnostou Evdokia , Fournier Marc A. , Crosbie Jennifer , Schachar Russell , Nicolson Robert , Georgiadis Stelios , Kelley Elizabeth , Jones Jessica , Brian Jessica , Lin Hsiang-Yuan , Lai Meng-Chuan 
Published: January 2025

Background
Differences in social behaviours are common in young people with neurodevelopmental conditions (NDCs). Recent research challenges the long-standing hypothesis that difficulties in social cognition explain social behaviour differences.

Aims
We examined how difficulties regulating one's behaviour, emotions and thoughts to adapt to environmental demands (i.e. dysregulation), alongside social cognition, explain social behaviours across neurodiverse young people.

Method
We analysed cross-sectional behavioural and cognitive data of 646 6- to 18-year-old typically developing young people and those with NDCs from the Province of Ontario Neurodevelopmental Network. Social behaviours and dysregulation were measured by the caregiver-reported Adaptive Behavior Assessment System Social domain and Child Behavior Checklist Dysregulation Profile, respectively. Social cognition was assessed by the Neuropsychological Assessment Affect-Recognition and Theory-of-Mind, Reading the Mind in the Eyes Test, and Sandbox continuous false-belief task scores. We split the sample into training (n = 324) and test (n = 322) sets. We investigated how social cognition and dysregulation explained social behaviours through principal component regression and hierarchical regression in the training set. We tested social cognition-by-dysregulation interactions, and whether dysregulation mediated the social cognition–social behaviours association. We assessed model fits in the test set.

Results
Two social cognition components adequately explained social behaviours (13.88%). Lower dysregulation further explained better social behaviours (β = −0.163, 95% CI −0.191 to −0.134). Social cognition-by-dysregulation interaction was non-significant (β = −0.001, 95% CI −0.023 to 0.021). Dysregulation partially mediated the social cognition–social behaviours association (total effect: 0.544, 95% CI 0.370–0.695). Findings were replicated in the test set.

Conclusions
Self-regulation, beyond social cognition, substantially explains social behaviours across neurodiverse young people.
Diabetes Technology Trends: A Review of the Latest Innovations
Authors: Lundgrin Erika L , Kelly Clare A , Bellini Natalie , Lewis Claudia , Rafi Ebne , Hatipoglu Betul 
Published: January 2025

Abstract

Context
Over the last decade, diabetes management tools such as continuous glucose monitors, automated insulin delivery systems, and connected insulin pens have experienced exponential growth. These technologies are more readily being adopted to manage diabetes due to increased availability. This mini-review provides information about recent innovations available in the United States for diabetes management to improve patient outcomes.

Evidence Acquisition
A systematic search was conducted using Medline, PubMed, ScienceDirect, and Embase databases, as well as the Cochrane Library to identify peer-reviewed articles published between 2014 and 2024, in English, and focused on treatment using technology in diabetes care.

Evidence Synthesis
Diabetes technology has significantly eased the burden of both glucose measurement and insulin delivery, which has, overall, improved diabetes management. Advancements in accuracy and glycemic outcomes have been demonstrated through rigorous clinical and observational trials, underscoring their potential to transform diabetes care. The literature suggests that the use of diabetes technologies promotes patient self-efficacy and enhances the quality of life for individuals with both type 2 and type 1 diabetes.

Conclusion
Diabetes technology has been shown to improve important aspects of diabetes care, from glycemic control to patient satisfaction and quality of life. It is important to assess the role of technology in type 1 and type 2 diabetes and individualize treatment goals and objectives.
Durvalumab-induced Type 1 Diabetes in a Patient With Pre-existing GADA-positive Diabetes and Preserved Insulin Secretion
Authors: Nakatake Nobuhiro , Matsuda Megumi , Kontani Hiroki 
Published: January 2025

Abstract
Predicting the onset of type 1 diabetes mellitus (T1D) in patients treated with immune checkpoint inhibitors (ICI) remains challenging. ICI-induced T1D (ICI-T1D) is a rare but serious complication that leads to complete insulin depletion. While diabetes-associated autoantibodies, such as glutamic acid decarboxylase antibodies (GADA), are typically absent in non-ICI-related fulminant T1D, they are relatively common in ICI-T1D. However, it is unclear whether these autoantibodies are detectable before the development of ICI-T1D. We present the case of a 61-year-old man with diabetes who had strongly positive GADA and preserved insulin secretion prior to initiating ICI therapy. Following treatment with durvalumab, he developed ICI-T1D, characterized by complete insulin depletion. Notably, the onset of ICI-T1D was precisely tracked on a daily basis, facilitating the timely initiation of insulin therapy and preventing diabetic ketoacidosis. Although the cost-effectiveness of pretreatment GADA screening and intensive monitoring remains a concern, early detection of diabetes-associated autoantibodies and vigilant glucose monitoring after ICI administration may help predict ICI-T1D and enable early therapeutic intervention.