bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteoarthritis or arthritis? Toward understanding of primary Sjögren’s syndrome patients with arthralgia
Authors: Gao Ronglin , Pu Jincheng , Wu Zhenzhen , Tang Jianping , Wang Xuan 
Published: January 2023

Abstract
Objective
To identify primary Sjögren’s syndrome (pSS) patients with arthralgia at risk for osteoarthritis (OA) or arthritis.

Methods
This study included 368 pSS patients admitted to a mono-centric from March 2010 to December 2020. Patients were divided into groups according to whether complicated with OA or arthritis. Data were analyzed to determine the differences in demographical characteristics, symptoms, and laboratory examination.

Results
The involvement of the OA joints was predominately knee and spine sites (including cervical and lumbar spine degeneration). When diagnosing arthritis, it was mainly peripheral symmetric polyarthritis, the most affected sites were the interphalangeal and metacarpophalangeal joints. There were significant differences in age, disease duration, uric acid (UA), and total cholesterol (TC) between pSS-OA and pSS-nOA patients (P < 0.050). Logistic regression analysis showed that age (OR = 1.965; P = 0.009) and joint pain (OR = 3.382; P < 0.001) were dangerous factors associated with OA. Interestingly, although the level of UA, TC, and triglycerides (TG) was shown to be positive with OA, there was no statistical significance after the OR was computed in the four-cell table. In pSS-arthritis, EULAR Sjögren's syndrome disease activity index (ESSDAI) (P = 0.011), the frequency of joint pain (P < 0.001), and muscular involvement (P = 0.037) were higher than non-arthritis group. In pSS patients only presenting with joint pain, arthritis patients had higher ESSDAI and system involvements, but lower UA and TG levels compared with OA group (P < 0.050).

Conclusion
In pSS patients with arthralgia, OA accounted for the majority. pSS patients with advanced age and more pronounced metabolic characteristics, such as elevated blood lipids and uric acid, was a key factor in groups at risk for OA. However, arthritis patients had higher rates of dry mouth and eye, higher disease activity, antibodies positive, and more organs damage. In the future, it may be necessary to be more cautious in the diagnosis of joint manifestations in pSS patients in order to make the appropriate treatments.
Epidemiological characteristics and comparative outcome of blast versus gunshot injuries of the extremities in Somalia
Authors: Mohamed Abdullahi Yusuf , Ibrahim Hassan Salad , Taşkoparan Hüseyin , Ibrahim Yasin Barkhad 
Published: January 2023

Abstract
Background
War conflicts and terror-related injuries constitute a significant public health problem in Somalia. We aim to characterize and compare the injury characteristics of gunshot and blast injuries of the extremities.

Methods
The data of 333 patients with gunshot and blast injuries of the extremities over three years were retrospectively reviewed. The demographics, injury characteristics, and outcomes were analyzed.

Results
Most of the patients had injuries due to gunshot casualties compared with blast victims (n = 222, 66.7% vs. n = 111, 33.3%). Patients with gunshot wounds (GSW) had a more significant proportion of males than those with blast wounds (BW) (95.5% vs. 85.6%, P < 0.001). There were more open extremity fractures in GSW casualties (96.4% vs. 81.1%). The BW victims had significantly higher associated injuries (52.3% vs. 18.5%, P < 0.001). The BW group had a higher injury severity score (ISS ≥ 16 in 55%, P < 0.001). The need for an intensive care unit (ICU) admission was significantly higher in the BW patients (18% vs. 6.3%, P < 0.001); as well as the length of hospital stay (LOS) was higher in the BW group compared with the GW patients (> 2-week hospital stay in 31% vs. 19%, P < 0.04). About a 2.7% mortality rate was observed in BW (P < 0.014).

Conclusion
Gunshot and explosion injuries comprise the majority of war and terror-related trauma of the extremities. These injury mechanisms differ in the body regions involved, the severity of the injury, duration of hospital stay, need for ICU admission, and mortality. Assessment and management of such devastating casualties require a complex and multidisciplinary approach.
A feasibility study of reduced full-of-view synthetic high-b-value diffusion-weighted imaging in uterine tumors
Authors: Tang Qian , Zhou Qiqi , Chen Wen , Sang Ling , Xing Yu , Liu Chao , Wang Kejun , Liu Weiyin Vivian , Xu Lin 
Published: January 2023

Abstract
Objectives
This study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b value diffusion-weighted images (rFOV-syDWIs) in the clinical application of cervical cancer based on image quality and diagnostic efficacy.

Methods
We retrospectively evaluated the data of 35 patients with cervical cancer and 35 healthy volunteers from May to November 2021. All patients and volunteers underwent rFOV-DWI scans, including a 13b-protocol: b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, and 1500 s/mm2 and a 5b-protocol: b = 0, 100, 400, 800,1500 s/mm2. rFOV-syDWIs with b values of 1200 (rFOV-syDWIb=1200) and 1500 (rFOV-syDWIb=1500) were generated from two different multiple-b-value image datasets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by the Levene’s test and Shapiro–Wilk test, the inter-modality differences of quantitative measurements were, respectively, examined by Wilcoxon signed-rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann–Whitney U test.

Results
A higher inter-reader agreement between SNRs and CNRs was found in 13b-protocol and 5b-protocol rFOV-syDWIb=1200/1500 compared to 13b-protocol rFOV-sDWIb=1200/1500 (p < 0.05). AUC of 5b-protocol syADCmean,b=1200/1500 and syADCminimum,b=1200/1500 was equal or higher than that of 13b-protocol sADCmean,b=1200/1500 and sADCminimum,b=1200/1500.

Conclusions
rFOV-syDWIs provide better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shorten scan time, and synthetic ADCs offer reliable diagnosis value as scanned 13b-protocol DWIs.
Multi-modal artificial intelligence for the combination of automated 3D breast ultrasound and mammograms in a population of women with predominantly dense breasts
Authors: Tan Tao , Rodriguez-Ruiz Alejandro , Zhang Tianyu , Xu Lin , Beets-Tan Regina G. H. , Shen Yingzhao , Karssemeijer Nico , Xu Jun , Mann Ritse M. , Bao Lingyun 
Published: January 2023

Abstract
Objectives
To assess the stand-alone and combined performance of artificial intelligence (AI) detection systems for digital mammography (DM) and automated 3D breast ultrasound (ABUS) in detecting breast cancer in women with dense breasts.

Methods
430 paired cases of DM and ABUS examinations from a Asian population with dense breasts were retrospectively collected. All cases were analyzed by two AI systems, one for DM exams and one for ABUS exams. A selected subset (n = 152) was read by four radiologists. The performance of AI systems was based on analysis of the area under the receiver operating characteristic curve (AUC). The maximum Youden’s index and its associated sensitivity and specificity were also reported for each AI systems. Detection performance of human readers in the subcohort of the reader study was measured in terms of sensitivity and specificity.

Results
The performance of the AI systems in a multi-modal setting was significantly better when the weights of AI-DM and AI-ABUS were 0.25 and 0.75, respectively, than each system individually in a single-modal setting (AUC-AI-Multimodal = 0.865; AUC-AI-DM = 0.832, p = 0.026; AUC-AI-ABUS = 0.841, p = 0.041). The maximum Youden’s index for AI-Multimodal was 0.707 (sensitivity = 79.4%, specificity = 91.2%). In the subcohort that underwent human reading, the panel of four readers achieved a sensitivity of 93.2% and specificity of 32.7%. AI-multimodal achieves superior or equal sensitivity as single human readers at the same specificity operating points on the ROC curve.

Conclusion
Multimodal (ABUS + DM) AI systems for detecting breast cancer in women with dense breasts are a potential solution for breast screening in radiologist-scarce regions.
Complications of cochlear implants with MRI scans in different body regions: type, frequency and impact
Authors: Alberalar Nilüfer Deniz , Reis Jonas , Piechotta Paula Louise , Beetz Nick Lasse , Fehrenbach Uli , Geisel Dominik , Thomas Andreas , Busse Harald , Denecke Timm 
Published: January 2023

Abstract
Objectives
The aim was to assess the type, frequency and impact of MRI-related complications in patients with cochlear implants (CI) and MRI indications in different body regions.

Methods
For that purpose, the institutional radiology database of a single tertiary hospital was searched for patients with a CI who underwent MRI between 2001 and 2018. The number of MRI examinations and complications were retrieved from the patient record. Examinations were categorized into five distinct body regions or combinations thereof. Records of CI artifacts in the head also included basic information on diagnostic image quality.

Results
Out of 1017 MRI database entries (examinations) of patients with a CI, 91 records were after implantation (71 patients) and 66 were attempted (no contraindications, 49 patients). In four cases (4/66, 6.1%), the magnet was dislocated and had to be replaced surgically. Three out of four severe complications occurred for examination regions outside the head. Thirteen MRI examinations were aborted due to pain (19.7%) and one because of artifacts—resulting in 48 scans (72.7%) completed successfully (36 patients). All cranial scans featured device artifacts in all sequences, but the majority of them did not affect proper imaging diagnostics in the respective region.

Conclusion
This retrospective, single-center analysis of patients with MRI-conditional cochlear implants shows that MRI-related complications were common, at least in models with a fixed magnet, despite appropriate precautions and compliance with the manufacturers’ guidelines. MRI examinations of CI patients should therefore be indicated strictly until the exact causes have been clarified.
Synthesis and preclinical evaluation of novel 99mTc-labeled PSMA ligands for radioguided surgery of prostate cancer
Authors: Kunert Jan-Philip , Müller Max , Günther Thomas , Stopper León , Urtz-Urban Nicole , Beck Roswitha , Wester Hans-Jürgen 
Published: January 2023

Abstract
Background
Radioguided surgery (RGS) has recently emerged as a valuable new tool in the management of recurrent prostate cancer (PCa). After preoperative injection of a 99mTc-labeled prostate-specific membrane antigen (PSMA) inhibitor, radioguided intraoperative identification and resection of lesions is facilitated by means of suitable γ-probes. First clinical experiences show the feasibility of RGS and suggest superiority over conventional lymph node dissection in recurrent PCa. However, commonly used [99mTc]Tc-PSMA-I&S exhibits slow whole-body clearance, thus hampering optimal tumor-to-background ratios (TBR) during surgery. We therefore aimed to develop novel 99mTc-labeled, PSMA-targeted radioligands with optimized pharmacokinetic profile to increase TBR at the time of surgery.

Methods
Three 99mTc-labeled N4-PSMA ligands were preclinically evaluated and compared to [99mTc]Tc-PSMA-I&S. PSMA affinity (IC50) and internalization were determined on LNCaP cells. Lipophilicity was assessed by means of the distribution coefficient logD7.4 and an ultrafiltration method was used to determine binding to human plasma proteins. Biodistribution studies and static µSPECT/CT-imaging were performed at 6 h p.i. on LNCaP tumor-bearing CB17-SCID mice.

Results
The novel N4-PSMA tracers were readily labeled with [99mTc]TcO4− with RCP > 95%. Comparable and high PSMA affinity was observed for all [99mTc]Tc-N4-PSMA-ligands. The ligands showed variable binding to human plasma and medium to low lipophilicity (logD7.4 − 2.6 to − 3.4), both consistently decreased compared to [99mTc]Tc-PSMA-I&S. Biodistribution studies revealed comparable tumor uptake among all [99mTc]Tc-N4-PSMA-ligands and [99mTc]Tc-PSMA-I&S, while clearance from most organs was superior for the novel tracers. Accordingly, increased TBR were achieved. [99mTc]Tc-N4-PSMA-12 showed higher TBR than [99mTc]Tc-PSMA-I&S for blood and all evaluated tissue. In addition, a procedure suitable for routine clinical production of [99mTc]Tc-N4-PSMA-12 was established. Labeling with 553 ± 187 MBq was achieved with RCP of 98.5 ± 0.6% (n = 10).

Conclusion
High tumor accumulation and favorable clearance from blood and non-target tissue make [99mTc]Tc-N4-PSMA-12 an attractive tracer for RGS, possibly superior to currently established [99mTc]Tc-PSMA-I&S. Its GMP-production according to a method presented here and first clinical investigations with this novel radioligand is highly recommended.
Low-complexity selective mapping technique for PAPR reduction in downlink power domain OFDM-NOMA
Authors: Mounir Mohamed , Youssef Mohamed Ibrahim , Aboshosha Ashraf Mohamed 
Published: January 2023

AbstractTo support ultra-massive connectivity, non-orthogonal multiple access (NOMA) techniques are expected to be used in 6G instead of conventional orthogonal multiple access (OMA) techniques. Furthermore, given that orthogonal frequency division multiplexing (OFDM) was used by 4G and 5G, NOMA is expected to be combined with OFDM to mitigate frequency selectivity in multipath channels. However, after passing through nonlinear high power amplifiers (HPAs), OFDM-NOMA has reportedly suffered from nonlinear distortion due to the high peak-to-average power ratio (PAPR) problem, thus reducing users’ achievable data rates, sum rate capacity, and users’ bit error rate after going through nonlinear HPAs. Many PAPR reduction techniques have been introduced in the literature; however, high PAPR reduction gain comes at the expense of computational complexity. In this paper, a novel selective mapping (SLM) scheme for PAPR reduction in OFDM-NOMA systems is proposed. By utilizing the structure of the OFDM-NOMA transmitter, the proposed SLM scheme achieves the same performance as that of the conventional SLM scheme while requiring less computational complexity.
Treatment strategy for spontaneous coronary artery dissection based on anatomical characteristics
Authors: Ma Yuanji , Zhong Xin , Yin Jiasheng , Lu Hao , Pan Congcong , Huang Dong , Ge Junbo 
Published: January 2023

Abstract
Objectives
To compare the clinical and angiographic characteristics of high-risk and low-risk spontaneous coronary artery dissection (SCAD) patients to determine the optimal treatment strategy.

Background
SCAD is a rare and emerging cause of acute coronary syndrome and sudden cardiac death, especially in young female patients. However, the indication of percutaneous coronary intervention (PCI) in patients with SCAD remains elusive.

Methods
We evaluated the clinical and angiographic characteristics of all SCAD patients admitted to our center from 2012 to 2020. The outcomes of the high-risk and low-risk SCAD patients according to the location of the lesion segment with dissection or intramural hematoma were compared. Further analyses were performed to evaluate the vessel healing or residual dissection in the patients receiving the follow-up angiography.

Results
A total of 81 SCAD patients were enrolled in the present study, in which 38 patients were categorized as high-risk group, defined as involvement of the left main artery or proximal segment of any main coronary artery. PCI was the more common treatment approach in the high-risk group (68.4%), while conservative treatment was more common in the low-risk group (62.8%). The incidence of major adverse cardiac events, defined as cardiac death, myocardial infarction, unstable angina pectoris, severe arrhythmias, or heat failure, within 1 year follow-up was similar between the two groups. 57 patients (70.4%) received the follow-up angiography after 1 year. The high- and low-risk groups had a similar rate of vessel healing among the PCI treatment patients. However, more patients achieved spontaneous healing in the low-risk group than the high-risk group among the conservative treatment patients (86.4% vs. 33.3%, p < 0.05).

Conclusions
Conservative management remains the recommended treatment strategy for the low-risk SCAD patients. PCI could be considered in high-risk SCAD patients with favorable clinical outcomes and vessel healing. Characterization of lesion anatomy may be an important indicator for treatment decision.
Historical-architectural analysis of Cartagena de Indias heritage
Authors: Saba Manuel , Carrascal Jorge Luis Álvarez , Cruz Alfonso Rafael Cabrera 
Published: January 2023

AbstractIn the last four decades, the historical heritage of Cartagena de Indias has been at the center of national and international attention due to its classification as a World Heritage Site according to the United Nations Educational, Scientific and Cultural Organization (UNESCO). Many historians and architects in the past have narrated the heroic deeds of the city of Cartagena, its role in the independence of Colombia, as well as the history of its construction. Its history, extension and majesty currently attract hundreds of thousands of tourists each year. Tourism representing the second source of income in the region after industry. However, today the heritage continues to suffer from several challenges that deserve to be faced by the community in general, the scientific community and institutions. Its particular state of conservation and some state of deterioration has generated a call for attention by UNESCO to categorize it as heritage at risk due to the effects of climate change (UNESCO 2016), which represented a crucial moment for the authors offering several points of reflection that have given life to this work. Part of the problems of deterioration and decay of the fortifications is due to a deep lack of knowledge on the part of civil society and the authorities about the construction history and the stratification of interventions on the heritage. For this reason, the objective of this paper is to analyze the history of the interventions and modifications of the fortifications, including the submarine defense system of Cartagena de Indias, as well as to evaluate the state of the city at the end of the Spanish viceroyalty. In this work, history, architecture and engineering come together, proposing a journey into the past, a broad vision of heritage and its current problems. In the conclusions, the authors matured a series of recommendations as a result of the present investigation and their personal experience in heritage management. It is considered essential to apply these measures in the short-medium term for the heritage protection and its conservation for future generations.
Predictability of orthodontic tooth movement with aligners: effect of treatment design
Authors: Castroflorio Tommaso , Sedran Ambra , Parrini Simone , Garino Francesco , Reverdito Matteo , Capuozzo Riccardo , Mutinelli Sabrina , Grybauskas Simonas , Vaitiekūnas Mantas , Deregibus Andrea 
Published: January 2023

Abstract
Backgrounds
The present study was designed to define: (1) which are the less predictable OTM with Invisalign aligners when the treatment plan is designed by expert operators, (2) if the presence and shape of attachments influence the predictability of OTM and (3) if patients’ demographics influence OTM predictability. The sample comprises 79 prospectively recruited patients (mean age 30.8 years; SD 12.0; 23 M, 56 F), treated by expert operators with an average of 27 aligners (SD 15) in the maxillary arch and 25 aligners (SD 11) in the mandibular arch. Post-treatment digital models and final virtual treatment plan models were exported from ClinCheck® software as STL files and subsequently imported into Geomagic Qualify ®software, to compare final teeth positions. The differences were calculated and tested for statistical significance for each tooth in the mesial–distal, vestibular–lingual and occlusal–gingival directions, as well as for angulation, inclination and rotation. In addition, the statistical significance of categorical variables was tested.

Results
The lack of correction was significant for all movements and in all group of teeth (P < 0.01) except for the rotation of maxillary first molar. The prescribed OTM, the group of teeth and movement, the frequency of aligner change and the use of attachment influence the outcome. The greatest discrepancies in predicted and achieved tooth position were found for angular movements and rotation of teeth characterized by round-shaped crowns, for a ratio of approximately 0.4° per 1° prescribed. Optimized attachments for upper canines and lower premolar rotation seem not working properly. Second molar movements are mostly unexpressed. Furthermore, changing the aligner every 14 days will reduce the lack of correction of the 12% with respect to 7 days aligner change.

Conclusions
Predictability of orthodontic movement with aligners still has limitations related to the biomechanics of the system: the shape of some attachments and the characteristics of aligner material need to be redefined. However, the results of this study allow to properly design the virtual treatment plan, revealing how much overcorrection is needed and which attachments are most effective.
High intake of dietary phytochemical index may be related to reducing risk of diabetic nephropathy: a case–control study
Authors: Bahrampour Niki , Mirzababaei Atieh , Hosseininasab Dorsa , Abaj Faezeh , Clark Cain C. T. , Mirzaei Khadijeh 
Published: January 2023

Abstract
Objective
Diabetic nephropathy (DN) is involved in 40% of patients with type 2 diabetes, Phytochemical index (PI) foods are known as antioxidant and anti-inflammatory agents. Higher intake of phytochemicals can improve glucose tolerance, hypertension and complications of DN. This study sought to discern the relationship between dietary PI and DN.

Methods
This was a case–control study which was conducted between 210 diabetic women. General characteristics, blood pressure, biochemical serum levels, and anthropometric measurements were evaluated. Physical activity and dietary intakes were assessed via short form of physical activity questionnaire and 147 items-validated food frequency questionnaires, respectively. Then, PI was calculated through method of McCarty and divided to 2 groups of lower and higher of median. Independent samples T tests were used to identify differences in quantitative variables. To investigate the relationship between dietary PI and risk of DN, logistic regression was used. The odds ratio (OR) of DN, and its 95% confidence interval (CI), in each groups of PI were shown.

Results
The percentage of daily intake of energy from fruits and vegetables were higher than the other sources of phytochemical rich foods. Higher consumption of vitamin A was seen in higher group of PI among the control group, after adjusting for energy intake. In the higher adherence of median of dietary PI group, intake of fruits, vegetables, legumes, grains, and olives of controls were higher than cases. In addition, soy consumption was statistically different between lower and higher adherence of median of dietary PI among cases. There was an inverse relationship between dietary PI and risk of DN (OR = 0.44; 95% CI: 0.25–0.77; P = 0.04). After adjusting for potential confounders, the association remained significant, albeit with lower odds of having DN (OR = 0.15; 95% CI: 0.06–0.36; P < 0.001).

Conclusion
Finally, the present study found evidence indicating an inverse relationship between consumption of foods rich in phytochemicals and risk of DN in this sample.