bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Comparison of 3 Adjustable-Loop Suspensory Devices for All-Inside ACL Reconstruction: A Time-Zero Full-Construct Model
Authors: Bachmaier Samuel , Monaco Edoardo , Smith Patrick A. , Frank Rachel M. , Matzkin Elizabeth G. , Wijdicks Coen A. 
Published: September 2023

Background: Little is known about the stability of adjustable-loop devices (ALDs) for anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose: To evaluate the stabilization behavior of 3 different types of ALDs for all-inside ACLR in a full-construct surgical technique-based manner. Study Design: Controlled laboratory study. Methods: The femoral and tibial devices of Ultrabutton (Smith & Nephew), Infinity (Conmed), and TightRope II (Arthrex) were applied to quadrupled bovine tendon grafts (n = 8 each) with tibial-sided traction applied (350 N) for graft tensioning in a simulated fully extended knee. Knotless femoral graft fixation was based on either a suture-locking device (SLD; Ultrabutton), button-locking device (BLD; Infinity), or dual-locking device (DLD; TightRope II). All constructs were progressively loaded (50 N/500 cycles) from 50 to 300 N for 3000 cycles (0.75 Hz), including complete unloading situations and pull to failure (50 mm/min). Construct elongation, stiffness, and ultimate load were analyzed. Results: BLD showed significantly greater initial elongation (-2.69 ± 0.15 mm) than DLD (-3.19 ± 0.21 mm; P < .001) but behaved similarly to SLD (-2.93 ± 0.23 mm). While DLD and SLD had the smallest initial elongation at the same significance level, they behaved opposite to each other with gradually increasing peak loading. At the end of testing, DLD had the lowest (-0.64 ± 0.32 mm) and SLD the highest (3.41 ± 1.01 mm) total elongation ( P < .003 for both). SLD displayed significantly higher dynamic elongation (6.34 ± 0.23 mm) than BLD (3.21 ± 0.61 mm) and DLD (2.56 ± 0.31 mm) ( P < .001 for both). The failure load of BLD (865.0 ± 183.8 N) was significantly lower ( P < .026) compared with SLD and DLD (>1000 N). The predominant failure mode was suture rupture and tibial bone breakage with button subsidence (SLD, n = 4). No significant difference in stiffness between constructs was found. Conclusion: While DLD successfully restricted critical construct elongation, BLD partially and SLD completely exceeded the clinical failure threshold (>3 mm) of plastic elongation with loop lengthening during increasing cyclic peak loading with complete unloading. Higher failure loads of SLD and DLD implants (>1000 N) were achieved at similar construct stiffness to BLD. Clinical Relevance: A detailed biomechanical understanding of the stabilization potential is pertinent to the continued evolution of ALDs to improve clinical outcomes.
Sever’s Disease – a common cause of heel pain among sport-active children
Authors: Øllgaard Per 
Published: September 2023

Objectives: Sever’s disease (Calcaneal Apophysitis) is the most common cause of heel pain in growing and active children and adolescents. Studies imply that the prevalence is increasing for children attending sports with repetitive running and jumping. These children are advised to pause their sport when heel pain occurs. However, activity modifications, immobilization, or absolute rest often has a negative impact and can lead to total drop-out.  The objective of the study is to examine whether an intervention based on information and custom-made insoles can decrease pain levels in children between 6-14 years with Sever’s disease and make them return faster to sport activities instead of the conservative treatment with rest and/or activity modification. Methods: The study is a descriptive observational study based on a database from a physiotherapeutic clinical practice. This included 469 children between 6-14 years with diagnosed Sever’s disease who sought an expert in sports physiotherapy due to severe pain and limited sport activity. Baseline information was collected by the physiotherapist. Parents filled a questionnaire as follow up 3 months after the intervention. Results: The children experienced pain for 10,4 months on average. They all reported that their sport activities had been reduced or stopped entirely due to heel pain. All children received an intervention which included information about Sever’s disease and the physiology of the foot, combined with a customized insole that suspend the heel to relieve pressure on the apophysis of the calcaneus. The intervention helped most of the children to resume their sport activity. Conclusion: Sever’s disease is a painful, discomforting condition which causes reduced activity level in sport-active children and even ceasing sports completely, but customized insoles can ease pain and avert or limit immobilization.
Dual enhancement in the radiosensitivity of prostate cancer through nanoparticles and chemotherapeutics
Authors: Jackson Nolan , Hill Iona , Alhussan Abdulaziz , Bromma Kyle , Morgan Jessica , Abousaida Belal , Zahra Yasmin , Mackeyev Yuri , Beckham Wayne , Herchko Steven , Krishnan Sunil , Chithrani Devika Basnagge 
Published: September 2023

Abstract
Background
Radiotherapy (RT) is an essential component in the treatment regimens for many cancer patients. However, the dose escalation required to improve curative results is hindered due to the normal tissue toxicity that is induced. The introduction of radiosensitizers to RT treatment is an avenue that is currently being explored to overcome this issue. By introducing radiosensitizers into tumor sites, it is possible to preferentially enhance the local dose deposited. Gold nanoparticles (GNPs) are a potential candidate that have shown great promise in increasing the radiosensitivity of cancer cells through an enhancement in DNA damage. Furthermore, docetaxel (DTX) is a chemotherapeutic agent that arrests cells in the G2/M phase of the cell cycle, the phase most sensitive to radiation damage. We hypothesized that by incorporating DTX to GNP-enhanced radiotherapy treatment, we could further improve the radiosensitization experienced by cancer cells. To assess this strategy, we analyzed the radiotherapeutic effects on monolayer cell cultures in vitro, as well as on a mice prostate xenograft model in vivo while using clinically feasible concentrations for both GNPs and DTX.

Results
The introduction of DTX to GNP-enhanced radiotherapy further increased the radiotherapeutic effects experienced by cancer cells. A 38% increase in DNA double-strand breaks was observed with the combination of GNP/DTX vs GNP alone after a dose of 2 Gy was administered. In vivo results displayed significant reduction in tumor growth over a 30-day observation period with the treatment of GNP/DTX/RT when compared to GNP/RT after a single 5 Gy dose was given to mice. The treatment strategy also resulted in 100% mice survival, which was not observed for other treatment conditions.

Conclusions
Incorporating DTX to work in unison with GNPs and RT can increase the efficacy of RT treatment. Our study suggests that the treatment strategy could improve tumor control through local dose enhancement. As the concentrations used in this study are clinically feasible, there is potential for this strategy to be translated into clinical settings.
The use of cervical cerclage in asymptomatic twin pregnancies with cervical shortening or dilation: a twelve-year retrospective cohort study
Authors: Tan Hongying 
Published: September 2023

Abstract
Background
To identify the effect and optimal time of cervical cerclage in asymptomatic twin pregnancies with cervical shortening or dilation.

Methods
This observational retrospective study enrolled all women with asymptomatic twin pregnancies who were diagnosed with asymptomatic cervical shortening or dilation at the Second Affiliated Hospital of Wenzhou Medical University between 2010 and 2022. Women included were allocated into the cerclage group (n = 36) and the no cerclage group (n = 22). The cerclage group was further divided into the cerclage group (< 24 weeks group) and the cerclage group (24–28 weeks group) according to the time of cerclage. The no cerclage group was further divided into no cerclage group (< 24 weeks group) and no cerclage group (24–28 weeks group) according to the time of ultrasound-indicated or physical exam indicated cerclage. The rates of PTB < 24, 28, 32 and 34 weeks of gestation, maternal and neonatal outcomes were compared among the groups.

Results
The gestational age (GA) at delivery was higher (P = 0.005) and the interval time between the presentation of the indicated cerclage and delivery was longer in the cerclage group (P < 0.001). The rates of PTB before 28, 32, and 34 weeks of gestation, caesarean section and stillbirth were lower in the cerclage group (P < 0.05). The birthweight of the twins was higher in the cerclage group (P = 0.012). Admissions to the NICU were more frequent in pregnancies with no cerclage (P = 0.008). Subgroup analysis showed that the interval time between the presentation and delivery was longer in the cerclage group (< 24 weeks) (P < 0.001). The GA at delivery and the birthweight of the twins were significantly higher in the cerclage group (< 24 weeks) (P < 0.001). No differences were found in the GA at presentation, the GA at delivery, the interval time between the presentation to delivery and birthweight between the cerclage group (24–28 weeks group) and the control group (24–28 weeks group) (P > 0.05).

Conclusions
Cerclage appears to prolong the GA at delivery and the interval time between the presentation to delivery, and may reduce the incidence of PTB before 28, 32 and 34 weeks of gestation and adverse perinatal outcomes in asymptomatic twin pregnancies with cervical shortening or dilation. Cerclage before 24 weeks of gestation showed longer GA at delivery, longer interval time between the presentation to delivery and higher birthweight of the twins. The GA at presentation, the GA at delivery, the interval time between the presentation to delivery and birthweight in women with cerclage at 24–28 weeks were similar to those in women without cerclage at 24–28 weeks.
Rhinovirus induces airway remodeling: what are the physiological consequences?
Authors: Spector Cassandra , De Sanctis Camden M. , Panettieri Reynold A. , Koziol-White Cynthia J. 
Published: September 2023

Abstract
Background
Rhinovirus infections commonly evoke asthma exacerbations in children and adults. Recurrent asthma exacerbations are associated with injury-repair responses in the airways that collectively contribute to airway remodeling. The physiological consequences of airway remodeling can manifest as irreversible airway obstruction and diminished responsiveness to bronchodilators. Structural cells of the airway, including epithelial cells, smooth muscle, fibroblasts, myofibroblasts, and adjacent lung vascular endothelial cells represent an understudied and emerging source of cellular and extracellular soluble mediators and matrix components that contribute to airway remodeling in a rhinovirus-evoked inflammatory environment.

Main body
While mechanistic pathways associated with rhinovirus-induced airway remodeling are still not fully characterized, infected airway epithelial cells robustly produce type 2 cytokines and chemokines, as well as pro-angiogenic and fibroblast activating factors that act in a paracrine manner on neighboring airway cells to stimulate remodeling responses. Morphological transformation of structural cells in response to rhinovirus promotes remodeling phenotypes including induction of mucus hypersecretion, epithelial-to-mesenchymal transition, and fibroblast-to-myofibroblast transdifferentiation. Rhinovirus exposure elicits airway hyperresponsiveness contributing to irreversible airway obstruction. This obstruction can occur as a consequence of sub-epithelial thickening mediated by smooth muscle migration and myofibroblast activity, or through independent mechanisms mediated by modulation of the β2 agonist receptor activation and its responsiveness to bronchodilators. Differential cellular responses emerge in response to rhinovirus infection that predispose asthmatic individuals to persistent signatures of airway remodeling, including exaggerated type 2 inflammation, enhanced extracellular matrix deposition, and robust production of pro-angiogenic mediators.

Conclusions
Few therapies address symptoms of rhinovirus-induced airway remodeling, though understanding the contribution of structural cells to these processes may elucidate future translational targets to alleviate symptoms of rhinovirus-induced exacerbations.
Effects of levothyroxine replacement therapy on insulin resistance in patients with untreated primary hypothyroidism
Authors: Ostadrahimi Alireza , Manzari Taher , Gohari-Lasaki Sahar , Tutunchi Helda , Mobasseri Majid , Sadra Vahideh , Najafipour Farzad 
Published: September 2023

Abstract
Objectives
This study investigated the effects of levothyroxine replacement therapy on insulin resistance, lipid profile, and thyroid function in patients with untreated primary hypothyroidism. 105 patients with hypothyroidism with indication for levothyroxine replacement were enrolled in the present study. Insulin, fasting blood glucose and lipid profile were assessed at the beginning of diagnosis and three months after levothyroxine replacement. Insulin resistance was calculated by hemostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI).

Results
Our data revealed a significant reduction in body mass index (27.18 ± 4.27 versus 26.81 ± 4.18 kg/m2, p = 0.028), cholesterol (199.79 ± 37.61 versus 178.10 ± 32.25 mg/dl, p < 0.001), triglyceride (160.41 ± 71.86 versus 146 ± 61.11 mg/dl, p = 0.012), low density lipoprotein-cholesterol (123.54 ± 30.7 versus 107.08 ± 26.98 mg/dl, p < 0.001), fasting insulin (8.91 ± 3.92 versus 8.05 ± 2.65 mIU/l, p < 0.001), and thyroid stimulating hormone (47.47 ± 3.4 versus 2.22 ± 1.84 µIU/ml, p < 0.001) levels before and after drug intervention. However, no statistical differences were observed in HOMA-IR, QUICKI, and high density lipoprotein-cholesterol. In conclusion, in patients with untreated primary hypothyroidism, levothyroxine replacement therapy based on HOMA-IR and QUICKI did not improve insulin resistance; however, lipid profile was significantly improved following levothyroxine administration.

Trial registration
This study was registered in the Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20130610013612N10 on the date 2019-09-02.
HAP-assisted multi-aerial base station deployment for capacity enhancement via federated deep reinforcement learning
Authors: Liu Lei , He Haoran , Qi Fei , Zhao Yikun , Xie Weiliang , Zhou Fanqin , Feng Lei 
Published: September 2023

AbstractAerial base stations (AeBSs), as crucial components of air-ground integrated networks, are widely employed in cloud computing, disaster relief, and various applications. How to quickly and efficiently deploy multi-AeBSs for higher capacity gain has become a key research issue. In this paper, we address the 3D deployment optimization problem of multi-AeBSs with the objective of maximizing system capacity. To overcome communication overhead and privacy challenges in multi-agent deep reinforcement learning (MADRL), we propose a federated deep deterministic policy gradient (Fed-DDPG) algorithm for the multi-AeBS deployment decision. Specifically, a high-altitude platform (HAP)-assisted multi-AeBS deployment architecture is designed, in which low-altitude AeBS act as the local nodes to train its own deployment decision model, while the HAP acts as the global node to aggregate the weights of local models. In this architecture, AeBSs do not exchange raw data, addressing data privacy concerns and reducing communication overhead. Simulation results show that the proposed algorithm outperforms fully distributed MADRL algorithms and closely approximates the performance of multi-agent deep deterministic policy gradient (MADDPG), which requires global information during training, but with less training time.
Time of death: behavioral responses of an oceanic whitetip shark, Carcharhinus longimanus, to capture by a longline fishing vessel
Authors: Scott Molly , Royer Mark , Hutchinson Melanie 
Published: September 2023

Abstract
Background
Bycatch mortality in longline fisheries is a major contributor to global declines in shark populations. The duration of time that an animal is hooked and the impacts of hooking on behavior affect the likelihood of mortality. However, limited information exists on the behavior of sharks to longline capture because of difficulties observing hooking events. Using a fortuitous recovery of an archival satellite tag, we describe the movement of an oceanic whitetip shark (Carcharhinus longimanus) and examine the behavior prior to its mortality in response to hooking on a longline.

Results
A 1.5 m (fork length) C.longimanus was tagged and released in good condition by a fisheries observer following initial capture on a US longline fishing vessel. After release, the shark resumed normal vertical behavior within 5 h. Over 198 days, the shark undertook wide-ranging movements throughout the Pacific between Samoa, Niue, and Tonga. The shark was hooked by a second longline vessel while conducting routine yo-yo diving between 0 and 120 m depth. For the first hour after being hooked the shark exhibited high swimming activity with rapid vertical movements between 20 and 40 m indicative of an initial struggle against the line. After this, the shark struggled at the surface for approximately 5 h, until it succumbed to exhaustion and died on the line.

Conclusion
Fight time has a strong influence on the mortality rates of sharks captured in commercial longline fishing operations. Data obtained from this shark offers further understanding of capture behavior and time to mortality on a longline for C.longimanus which may assist managers as they work on options to reduce mortality rates for this threatened species.
Natural ventilation as a passive cooling strategy for multi-story buildings: analytic vertical skycourt formations
Authors: Ali Rasha A. , Megahed Naglaa A. , Shahda Merhan M. , Hassan Asmaa M. 
Published: September 2023

AbstractNatural ventilation has been one of the most important passive cooling strategies for conditioning the built environment. However, several challenges influence natural ventilation in multi-story buildings. Consequently, skycourt presents a passive cooling strategy to provide a direct airflow into the space to cool the surroundings, increase thermal comfort, and reduce the need for mechanical ventilation. Therefore, this study proposes utilizing the skycourt as a passive cooling strategy that helps to enhance natural ventilation in multi-story buildings. The aim of the research is achieved by analyzing various global examples of buildings, based on the skycourt, in different climatic zones; dry, tropical, temperate, and cold. These examples covered all classifications of multi-story buildings (e.g., mid-rise, high-rise, and skyscrapers). Through this analysis, the influence of skycourt in providing natural ventilation is determined, which contributes to reduce energy consumption. Finally, a reference matrix for designers and decision-makers in the four studied climatic zones can be conducted to promote natural ventilation using the skycourt strategy.
The Muschelkalk aquifer of the Molasse basin in SW-Germany: implications on the origin and development of highly saline lithium-rich brines in calcareous hydrothermal reservoirs
Authors: Stober Ingrid , Grimmer Jens , Kraml Michael 
Published: September 2023

AbstractHighly saline lithium-rich hydrothermal fluids (measured chloride concentration up to 44 g kg−1, lithium concentration up to 162 mg kg−1) occur in the deep calcareous Muschelkalk aquifer beneath the northern Alpine foreland (Molasse) basin. We have combined geologic, hydraulic, hydrochemical, and stress field data of the Triassic Muschelkalk aquifer beneath younger sediments of Triassic–Jurassic successions and the Cenozoic Molasse basin of SW-Germany for a synthesis to constrain the origin and development of these brines. In contrast to the regional southeast plunge of Jurassic and Cenozoic strata, low-gradient groundwater flow in the Upper Muschelkalk aquifer is to the north, induced by regional recharge from west, south, and east. The investigated area is seismically active and north trending maximum horizontal stress likely fosters development of necessary fracture permeability for northward flow in the competent carbonates of the Upper Muschelkalk aquifer. The highest lithium concentrations and total dissolved solids (TDS) can be found in the southern parts of the Muschelkalk aquifer. Here, the Muschelkalk Group overlays directly a crystalline basement swell separating two ENE-trending Permocarboniferous troughs. We argue that the highly saline lithium-rich fluids originate from fluid–rock interaction of meteoric water with Variscan crystalline basement rocks and entered the Muschelkalk aquifer on top of the basement swell by permeable faults and fractures. The marginal calcareous sand-rich facies of the Muschelkalk enables the inflow of brines from crystalline basement faults and fractures into the aquifer. We thus argue for an external origin of these brines into the aquifer and further intra-reservoir development by dilution with meteoric water.
Efficient Augmented Intelligence Framework for Bladder Lesion Detection
Authors: Eminaga Okyaz , Lee Timothy Jiyong , Laurie Mark , Ge T. Jessie , La Vinh , Long Jin , Semjonow Axel , Bogemann Martin , Lau Hubert , Shkolyar Eugene , Xing Lei , Liao Joseph C. 
Published: September 2023

PURPOSE Development of intelligence systems for bladder lesion detection is cost intensive. An efficient strategy to develop such intelligence solutions is needed. MATERIALS AND METHODS We used four deep learning models (ConvNeXt, PlexusNet, MobileNet, and SwinTransformer) covering a variety of model complexity and efficacy. We trained these models on a previously published educational cystoscopy atlas (n = 312 images) to estimate the ratio between normal and cancer scores and externally validated on cystoscopy videos from 68 cases, with region of interest (ROI) pathologically confirmed to be benign and cancerous bladder lesions (ie, ROI). The performance measurement included specificity and sensitivity at frame level, frame sequence (block) level, and ROI level for each case. RESULTS Specificity was comparable between four models at frame (range, 30.0%-44.8%) and block levels (56%-67%). Although sensitivity at the frame level (range, 81.4%-88.1%) differed between the models, sensitivity at the block level (100%) and ROI level (100%) was comparable between these models. MobileNet and PlexusNet were computationally more efficient for real-time ROI detection than ConvNeXt and SwinTransformer. CONCLUSION Educational cystoscopy atlas and efficient models facilitate the development of real-time intelligence system for bladder lesion detection.