bluuebunny/crossref_metadata_2025_split huggingface dataset:
Femoral neck fracture after femoral head necrosis: a case report and review of the literature
Authors: Xia Weijie , Zhang Aiqi , Qiu Binsong , Chen Yuan , Kong Mingxiang 
Published: May 2023

Abstract
Introduction: Pathological fractures of the femoral neck caused by necrosis of the femoral head are extremely rare. Here, we report a rare case of bilateral femoral head osteonecrosis extending to the femoral neck, with bilateral pathological fractures of the femoral neck occurring within a short period of time.
Case report: A 65-year-old male with a 25-year history of daily consumption of 750 ml of liquor, presented with right hip pain after labor for 1 month. He subsequently sustained a right femoral neck fracture without trauma and underwent a right total hip arthroplasty. Two months later, he suffered a non-traumatic left femoral neck fracture and underwent a left total hip arthroplasty. Histopathological examination revealed osteonecrosis of the femoral head and neck, along with the presence of osteoclasts and granulomatous inflammation. Bone mineral density testing also showed osteoporosis. The bilateral femoral neck fractures were ruled out to be caused by any other pathological factors.
Discussion: This is the first report of pathological fractures of the bilateral femoral neck caused by femoral head necrosis. During the literature review process, we found that this case conforms to the histological characteristics of rapidly destructive hip disease and analyzed the etiology of femoral head necrosis and the pathogenesis of femoral neck fractures.
Explainable Convolutional Autoencoders for Enhanced Representation learning in hyper spectral images
Authors: Sharma Palak , Udendharan R , Roy Galaxy 
Published: May 2023

Abstract
The categorization of pixels in hyperspectral pictures into distinct classifications, such as kinds of land cover, satellite, crops, and urban areas, is a crucial task in remote sensing and image analysis. Due to its capacity to extract spatial and spectral information from hyperspectral data, convolutional autoencoders (CAEs) are a class of neural network design that may be used for this job. In this abstract a technique for hyperspectral image categorization using CAEs is discussed. A CAE is trained as an unsupervised feature extractor, where the encoder learns to extract useful spectral and spatial features from the hyperspectral data and the decoder learns to reconstruct the original data from the lower-dimensional latent representation. When the CAE has been trained, features from the hyperspectral pictures are extracted using the encoder, and a classifier is trained on top of these features for supervised classification.
Research on surface integrity of TC4 titanium alloy by ultrasonic surface rolling peening
Authors: Wang Yi , Liu Yanhou , Wang Dehui , Ma Juan , Han Jinguo 
Published: May 2023

Abstract

In order to investigate the effects of different process parameters on the surface integrity of TC4 specimens and the effect of ultrasonic-assisted rolling strengthening on the enhancement of microstructure and mechanical properties of TC4 specimens, this paper uses TC4 titanium alloy specimens as the test object for ultrasonic-assisted rolling strengthening test. The results show that increasing the spindle speed within a certain range can improve the surface morphology of the specimen, reduce the surface roughness and average profile height, and improve the surface hardness and residual stress. The reach also finds that USRP can refine the surface grain of TC4 and introduce the grain refinement layer and work hardening layer with the same thickness on the surface of the specimen, and the hardness decreases gradually with the increase of depth. After USRP, the surface elastic modulus of the specimen is increased from 96.98 GPa to 112.96 GPa, and the corrosion resistance has also been greatly improved, with corrosion rate reduced by about 95%.
Estimating Health Burden and potential benefits of mitigating particulate matter pollution in Pakistan
Authors: Muddassir Ayesha , Malik Suhaib , Khokhar Muhammad Fahim 
Published: May 2023

Abstract
An increasing trend in PM2.5 concentrations is observed in different provinces of Pakistan. This research was designed to analyze the impact of PM2.5 pollutions on various health endpoints such as ALRI, COPD, IHD and Stroke. An AirQ+ analysis was generated for the year 2019 to understand the long term health burden attributed to the PM2.5 in Pakistan. The annual PM2.5 concentrations over various regions were obtained from Copernicus Atmosphere Monitoring Service database. Furthermore, an impact evaluation on disease morbidity was also generated using counter-factual equations to highlight the importance of reducing PM2.5 concentrations to WHO Air quality guideline and Pak NEQS. Results indicated that Punjab had the highest health burden due to being densely populated also it had the highest PM2.5 concentration of 77.3 µg/m³ and GB being the least populated region had the least health burden attributed to PM2.5 as it has the concentration of 13.89 µg/m³. Overall for 2019 Pakistan’s annual PM2.5 concentration reported was 45.66 µg/m³ and based on this ALRI has the highest estimated attributable proportion percentage of 23.40% followed by COPD (19.40%), IHD (11.88%) and Stroke (10.80%). A slight effort to control the PM2.5 concentrations to permissible limits can significantly help in reducing the health burden and retaining the associated economic cost.
Solubilizer tag effect on PD-L1/inhibitor binding properties for m-terphenyl derivatives
Authors: Surmiak Ewa , Ząber Julia , Plewka Jacek , Wojtanowicz Grzegorz , Kocik-Krol Justyna , Kruc Oskar , Muszak Damian , Rodríguez Ismael , Musielak Bogdan , Skalniak Lukasz , Magiera-Mularz Katarzyna , Holak Tad A. , Kalinowska-Tłuścik Justyna 
Published: May 2023

Abstract
Although heavily studied, the subject of anti-PD-L1 small molecular inhibitors is still elusive. Here, we present a systematic overview of principles behind the successful anti-PD-L1 small molecule inhibitor design on the example of the m-terphenyl scaffold with a particular focus on the neglected influence of the solubilizer tag on the overall affinity towards PD-L1. The inhibitor developed according to the proposed guidelines was characterized through its potency in blocking PD-1/PD-L1 complex formation in HTRF and cell-based assays. The affinity is also explained based on the crystal structure of the inhibitor itself, its co-structure with PD-L1 as well as molecular modeling study. Our results structuralize the knowledge related to the strong pharmacophore feature of the m-terphenyl scaffold preferential geometry and the more complex role of the solubilizer tag in PD-L1 homodimer stabilization.
Construction of Crushed Brick Column Reinforcement as A Sustainable Ground Improvement Technique
Authors: Ng Jun Shen , Hasan Muzamir , Low Yong Ler 
Published: May 2023

Abstract
This researcher investigates the efficiency of crushed brick for reinforcing the soft kaolin by applying the stone column technique. The use of this material complies with sustainability concept and it is cost-effective. The construction of stone column can be done using the vibro-replacement method, where the researchers demonstrated the combination of crushed brick into the soft clay soil. Related geotechnical laboratory works were implemented for determining the properties of crushed brick and kaolin clay. The shear strength parameters were accessed from Unconfined Compression Test (UCT) using 21 samples at different design. Each design has 3 samples, including control sample used, three (3) samples of 10 mm diameter, three (3) samples of 16 mm diameter crushed brick column and they were analysed in different height comprising 60 mm, 80 mm, and 100 mm respectively. The results of shear strength improvement from diameter of 10 mm column with height penetrating ratio of 1.0, 0.6 and 0.8 were 13.33%, 12.31% and 9.79% respectively. While for 16 mm column diameter with height penetrating ratio of 1.0 showing the highest, 16.10% followed by 0.6 and 0.8 indicating 13.49% and 11.35% respectively. Conclusively, the improvement of shear strength of kaolin clay relies on the design of crushed brick column reinforcement.
Revision Total Knee replacement finances: a detailed cost-analysis of operative practice at a regional tertiary referral centre
Authors: Alexiadis Aris , Reynolds Patrick , Al-Mouazzen Louay , Toms Andrew , Phillips John , Waterson Ben 
Published: May 2023

Abstract
Background:
The revision knee complexity classification (RKCC) stratifies knee revision operations depending on their level of complexity from simple revisions (R1) to highly complex cases (R3). Current financial codes used for calculation of reimbursement for knee revision services provided at the Trust, rely on patients’ comorbidities. However, previous research has demonstrated that this approach may not yield an accurate financial account of knee revision arthroplasty cost. This is a single centre study from a secondary and tertiary revision unit, with work previously presented by the authors demonstrating that the majority of complex revision knee replacement within the region, take place in this unit. The aims of this study were to illustrate the current cost profile and renumeration service currently in place for revision knee and show the differences in cost based on complexity of the operation.
Methods:
In this retrospective study, 89 cases who underwent revision knee operations in 2019 were analysed. Data was obtained from a tertiary referral centre where the episodes had occurred. Mean cost, tariff, and subsequent deficit were calculated for the R1, R2 and R3 episodes.
Results:
R2 and R3 episodes were significantly more expensive than R1 episodes. The increase in cost between R3 and R2 episodes was not significant. The total cost of the revision operations was £1,162,343. Tariffs received for R2 and R3 revision operations were significantly more expensive than R1 operations. However, the increase in tariffs received for R3 operations was not significant in relation to R2 operations. The total amount of tariffs received by the Trust was £ 770,996 generating a net deficit of - £ 391,347.
Conclusion
Current financial coding for revision knee does not accurately predict costs associated with revision knee surgery. Net deficit varies depending on the RKCC grade of the knee revision episode with more complex operations resulting in a higher mean net deficit. Implementation of the RKCC could prove to be a useful tool in generating an accurate prediction of the cost associated with knee revision surgery.
Examining the Relationship Between Borderline Personality Traits and Eating Attitudes, and Guilt and Shame
Authors: FARAJI Haydeh , Oğur Songül 
Published: May 2023

AbstractBackground:This study examines the relationship between borderline personality traits, eating attitudes, and guilt and shame.In the literature, although there are separate studies on borderline personality traits, eating attitudes, guilt, and shame, examining the relationship between the three concepts is limited. Therefore, this study aims to address this gap and is considered critical scientific data for mental health professionals in the clinical field.Method: The research was conducted among 213 female (53.1%) and 187 male (46.8%) undergraduate students aged 18-24 studying in Istanbul. Participants were informed about the study, and their informed consent was obtained. Participants were selected by convenience sampling method. The research was shared with the participants face-to-face and via Google Forms. "Socio-Demographic Information Form," "Borderline Personality Questionaire (BPQ)," "Offence-Related Shame and Guilt Scale (ORSGS)," and "Eating Attitude Test Short Form (EAT-26)" were used within the scope of the study. Statistical analyses were transferred to the SPSS 25 program. "Pearson Correlation Analysis," "Independent Groups T-Test," and “ANOVA” were used in the analysis of the data obtained. PROCESS 3.5 was used for mediator role analysis.Results:A significant positive correlation was found between shame and borderline personality traits, affect indecision, self-image, sense of emptiness, and intense anger. A significant positive correlation was found between bulimia and preoccupation with eating and borderline personality traits impulsivity sub-variables.Conclusions:At the end of the study, it was seen that the borderline personality traits, shame, and guilt variables were significantly related to each other. Borderline personality traits and eating attitudes have been found to have a semi-intermediate role in their relationship with shame. It is recommended that clinicians assess self-conscious emotions in clients with eating disorders and explore the possible origin and significance of these effects. This recommendation will likely facilitate the therapy and treatment process.
Efficient and fast screening and separation based on computer aided screening and complex chromatography method for 5-lipoxygenase inhibitors from Poria cocos
Authors: Wu Tong , Hou Wanchao , Li Sainan , Liu Chunming , Zhang Yuchi 
Published: May 2023

Abstract
Poria cocos (Schw.) Wolf (P. cocos) is a traditional Chinese medicinal materia that medicine food homologyl. In this study, based on the β-Amyloid deposition hypothesis of AD, a fast and efficient methods that ultrafiltration-liquid chromatography-mass spectrometry (UF-LC-MS) and molecular docking were developed for the rapid screening and identification of anti-5-lipoxygenase (anti-5-LOX) enzyme active ingredient of P. cocos ethyl acetate extract. Continuous counter-current chromatography (CCC) combined with semi-preparative high performance liquid chromatography (Semi-preparative HPLC) was developed for targeted separation of active components. Five potential 5-LOX inhibitors were screened by ultrafiltration affinity assay in P. cocos. The molecular docking simulation results are consistent with the ultrafiltration experimental results, which further verifies the accuracy of the experiment. Subsequently, five high-purity active ingredients (Tumulosic acid, Polyporenic acid C, 3-Epi-dehydrotumulosic acid, Pachymic acid and Dehydrotrametenolic acid) could be isolated by the established separation method, with the purities of 95.86%, 96.35%, 97.22%, 98.43% and 99.00%, respectively. The established continuous countercurrent chromatography can effectively improve the yield and purity of low content active ingredients in traditional Chinese medicine, and provide ideas and methods for the targeted separation of active ingredients. The methods of screening and isolating active ingredients established in this paper will be helpful for the development of new therapeutic drugs for Alzheimer's disease (AD).
The prognostic nutritional index predicts prognosis after liver resection in elderly patients with early-stage hepatocellular carcinoma
Authors: Hu YaFei , Ma Wen-Jie , Gu Han-Fei , Hu Hai-Jie , Wang Jun-Ke , Liu Fei , Lv Tian-Run , Yang SiQi , Dai Yu-Shi , Zou Rui-Qi , Li Fu-Yu 
Published: May 2023

Abstract
Aims
We aimed to determine the value of the preoperative prognostic nutritional index (PNI) and establish new nomograms to predict recurrence-free and overall survival (RFS and OS) in elderly patients with early-stage hepatocellular carcinoma (HCC).
Methods
Elderly patients (≥ 60 years of age) with very early-stage HCC (CNLC IA-IIA) after curative surgical resection were identified. PNI was calculated by [10 × serum albumin level (gr/dL)] + [0.005 × total lymphocyte count (per mm3)]. Univariate and multivariate Cox analysis was used to screen the variables and construct the nomogram model. ROC and calibration curves were used for model evaluation.
Results
The PNI-high was defined as ≥ 49.5 and ≥ 49.05 for RFS and OS, respectively. The 5-year-RFS rate was 34.1% in the PNI-low group versus 57.4% in the PNI-high group (P = 0.014). The 5-year OS rate in the PNI-low group was significantly lower than that in the PNI-high groups (68.2% vs. 84.4%, P = 0.033). The nomogram prediction models for patients’ RFS and OS were built by incorporating the same three independent survival predictors, including PNI-low, tumor presence of vascular invasion, and low differentiation. These two prediction models demonstrated good calibration and discrimination, with all C‑indexes greater than 0.72. The calibration plots basically coincide with the diagonal, indicating that the observed RFS and OS were close to the predicted outcomes.
Conclusions
The PNI-low, tumor presence of vascular invasion, and low differentiation can be adopted as a decision aid to predict the long-term RFS and OS for elderly patients with resected HCC.
Self-determination: A utopia in frail older people with decreased cognition?
Authors: Hammar Isabelle Andersson , Westgård Theresa , Dahlin-Ivanoff Synneve , Wilhelmson Katarina 
Published: May 2023

Abstract
Background
Self-determination in old age is essential for people’s experiences of good subjective health and quality of life. The knowledge concerning how frail older people with decreased cognition perceive their ability to be self-determined in the different dimension in daily life is, however, limited. The aim of this study was therefore to explore the relationship of self-determination and cognition in frail older people.
Methods
This study was a cross-sectional secondary data analysis using baseline data from a larger CGA-Swed randomized control trial with frail people 75≥. In this study, a total of 119 people responded to the self-determination assessment Impact on Participation and Autonomy-Older persons (IPA-O). The data was analysed with the Fisher’s exact test to test differences in proportions of perceived self-determination. Decreased cognition was broadly defined as a score below 25 points on the Mini Mental State Examination (MMSE). The Relative Risk (RR) with a 95% Confidence Interval (CI) was used to explore the risk of perceiving reduced self-determination.
Results
High degree of self-determination was identified in Financial situation, 94 per cent among participants with intact cognition respectively 92 per cent among those with decreased cognition. Regardless of cognition, approximately a third of the sample perceived low levels of self-determination in Mobility and in Social relationships. For people with decreased cognition, the relative risk for perceiving reduced self-determination was statistically significant higher in activities related to Self-care (item 6, p = 0.044, RR = 2.38), and in Social relationship (item 16, p = 0.041, RR = 3.71) when comparing with the participants with intact cognition.
Conclusion
Perceiving self-determination when being old, frail and having decreased cognition is possible but is dependent upon which activities that are involved. For increased perceptions of self-determination, healthcare needs should be carried out according to older people’s wants and wishes. Frail older people with decreased cognition should be treated as being experts in their own lives, and healthcare professionals should be enablers in supporting the older people to navigate them in reaching their desired direction.
Trial registration:
ClinicalTrials.gov, NCT02773914. Retrospectively registered 16 May 2016.
Synergistic efficacy of repetitive peripheral magnetic stimulation on central intermittent theta burst stimulation for upper limb function in patients with chronic stroke: a double-blinded, randomized controlled trial
Authors: Chang Chi-Shou , Chen Chia-Ling , Chen Rou-Shayn , Chen Hsieh-Ching , Chen Chung-Yao , Chung Chia-Ying , Wu Pei-Hsuan , Wu Ching-Yi , Lin Keh-Chung 
Published: May 2023

Abstract
Background: Non-invasive techniques such as central intermittent theta burst stimulation (iTBS) and repetitive peripheral magnetic stimulation (rPMS) have shown promise to improve motor function for stroke patients. However, the combined efficacy of rPMS and central iTBS has not been extensively studied. This randomized controlled trial aimed to investigate the synergistic effects of rPMS on central iTBS in patients with stroke.
Method: In this study, 28 stroke patients were randomly allocated to receive either 1200 pulses of real or sham rPMS on the radial nerve of the affected limb, followed by 1200 pulses of central iTBS on the ipsilesional hemisphere. The patients received the intervention for 10 sessions over two weeks. The primary outcome measures were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and the Action Research Arm Test (ARAT). Secondary outcomes for activities and participation included the Functional Independence Measure-Self care (FIM-Self care) and the Stroke Impact Scale (SIS). The outcome measures were assessed before and after the intervention.
Results: Both groups showed significant improvement in FMA-UE and FIM-Self care after the intervention, (p<0.05). Only the rPMS + iTBS group had significant improvement in ARAT-Grasp, SIS-Strength and SIS-ADL (p<0.05). However, the change scores in all outcome measures did not differ between two groups.
Conclusions: Overall, the study's findings support that rPMS may have synergistic effects on central iTBS to improve grasp function and participation. In conclusion, these findings highlight the potential of rPMS as an adjuvant therapy for central iTBS in stroke rehabilitation. Further long-term studies are needed to fully investigate the synergistic effects of rPMS on central iTBS.
Trial registration: This trial was registered under ClinicalTrials.gov ID No. NCT04265365, retrospectively registered, on February 11, 2020.
Effect of Higher Glycated Hemoglobin (HbA1c) Levels on rheumatoid arthritis Risk:A Mendelian Randomization Study
Authors: Liu Tuodong , Zhang Qing , Deng Chao , Ni Jiangdong 
Published: May 2023

Abstract
Introduction：Published studies have suggested a potential association between diabetes mellitus (DM) and RA, with glycated hemoglobin (HbA1c) serving as an important biomarker for DM. The purpose of this study was to investigate the causal relationship between HbA1c levels and RA risk using Mendelian randomization (MR) analysis.
methods：A two-sample Mendelian randomization (MR) study was conducted using genetic variants as instrumental variables (IVs) related to HbA1c. Summary statistics from genome-wide association studies (GWAS) were obtained from the publicly accessible Integrative Epidemiology Unit (IEU) OpenGWAS database. A systematic selection process was employed to identify high-quality instrumental single-nucleotide polymorphisms (SNPs) strongly associated with the exposure. Various MR methodologies, such as inverse-variance weighted (IVW) and MR-Egger, were implemented to determine causal effects. The MR-Egger intercept test, Cochran's Q test, and leave-one-out sensitivity analysis were used to evaluate horizontal pleiotropy, heterogeneities, and stability of the association. Odds ratios (OR) and 95% confidence intervals (CI) were computed.
Results：A total of 9 SNPs were identified as final IVs. The MR analysis demonstrated a significant causal relationship between elevated HbA1c levels and an increased risk of seronegative RA [odds ratio (OR) = 1.358, 95% confidence interval (CI), 1.044-1.767]. However, no significant evidence of a causal relationship was observed between HbA1c and seropositive RA [OR = 1.033, 95% CI, 0.850-1.257] or overall RA [OR = 1.093, 95% CI, 0.935-1.278]. Sensitivity analyses supported the robustness of the findings, with no significant evidence of heterogeneity or bias and no potential SNPs affecting the causal link.
Conclusions:This study provides evidence of a causal relationship between HbA1c levels and seropositive RA risk, emphasizing the importance of closely monitoring and managing HbA1c levels in patients. Further research is needed to elucidate shared pathophysiological mechanisms between DM and RA, which may lead to novel therapeutic strategies.