bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transvaginal Ultrasound Simulation: Educational Benefits on Obstetrics and Gynaecology Clerkship
Authors: Hartup Lindsay A. , Lewis Ariana L. , Medrano Gabriel A. 
Published: January 2025

ABSTRACTBackgroundTransvaginal ultrasound (TVUS) is the primary imaging modality in obstetrics and gynaecology (OB/GYN); however, it is highly user dependent. TVUS education for medical students is often sporadic and inconsistent. Simulation‐based training (SBT) is a well‐established innovation for learners to safely develop proficiency.ApproachA TVUS curriculum was developed using motivational theory and SBT. Five 2‐h educational sessions were held at the beginning of five OB/GYN clerkships, including didactics on TVUS indications/technique, TVUS simulation and a pathology competition. A digital nine‐question survey assessing students' experience and comfort level with TVUS was administered after the clerkship. Students who completed their clerkship prior to the curriculum being delivered or were not present for it were administered the same survey. These students served as the control group.EvaluationEighty‐nine of 111 (80.1%) students who participated in the curriculum and 77/211 (36.4%) who did not participate completed the postclerkship survey. Twenty‐seven of 84 (32.1%) in the simulation group who observed a TVUS performed one during their OB/GYN clerkship compared to 13/76 (17.1%) students in the control group (p = 0.04). Students present for the TVUS curriculum reported greater understanding of the TVUS they observed during their OB/GYN clerkship, OR 3.11 [1.71, 5.78] (p < 0.001); increased comfort recognising normal anatomy, OR 6.63 [3.55, 12.74] (p < 0.001); and gynecologic pathology, OR 7.56 [4.09, 14.33] (p < 0.001), on TVUS.ImplicationsImplementation of TVUS simulation curricula should be considered in undergraduate medical education given the potential to improve educational experience during the OB/GYN clerkship.
Improving Examination Skills in Neuromuscular Disorders Through an Educational Video
Authors: Villar‐Quiles Rocio Nur , Bouaoud Jebrane , Foy Jean Philippe , Behin Anthony , Masingue Marion , Nguyen Tan Mai , Iniesto Miguel , Stojkovic Tanya , Idbaih Ahmed 
Published: January 2025

ABSTRACTBackgroundThe acquisition of practical skills is a key objective of medical education. Improving knowledge and skills is essential for early diagnosis of patients suffering from neuromuscular (NM) diseases.ApproachMultimedia tools have proved to be useful and effective for learning clinical skills. We developed a video to learn the NM examination, the main pathological signs and their semiological value.We developed a video to learn the NM examination, the main pathological signs and their semiological value.EvaluationTwenty‐seven medical students (group A) watched the NM video. A control group (B, n = 15) watched a control video on OMS examination. Both groups filled out NM and control questionnaires before and after watching the video. Group A significantly improved their score on the NM questionnaire (6.36 ± 1.62 vs. 9.12 ± 0.69, p < 0.001) but not on the control questionnaire. Group B significantly improved the score on the control questionnaire (6.03 ± 1.39 vs. 8.22 ± 1.12, p < 0.0001) but not on the NM questionnaire. Students self‐scored their NM knowledge at 5/10 and 7.4/10 on a visual analogue scale (VAS) before and after watching the NM video. The overall usefulness of the NM video was scored 8.7/10. Students considered it useful for learning the NM examination, illustrating rare semiological signs, preparing for practical evaluations and reinforcing self‐confidence.ImplicationsDidactic videos can be used to complement classical teaching to improve the learning of practical skills and to strengthen students' self‐confidence. They can also be useful for other medical disciplines and health professionals, improving the recognition and management of these rare diseases.
Persisting Gaps in Cytomegalovirus Prevention and Management After Solid Organ Transplantation in a Resource‐Limited Setting
Authors: Santoro‐Lopes Guilherme , Guimarães Luiz Felipe Abreu , Clemente Wanessa Trindade , Stucchi Raquel Silveira Bello , Abdala Edson , Santos Daniel Wagner de Castro Lima , Ferreira Gustavo Fernandes , Haddad Luciana Bertocco Paiva , Pierrotti Ligia Camera 
Published: January 2025

ABSTRACTBackgroundCytomegalovirus (CMV) infection remains among the leading complications after solid organ transplantation (SOT). Large international surveys mainly focused on high‐income countries, detected considerable variability in the management of this infection after SOT. Limited data are available from resource‐limited settings.MethodsA questionnaire‐based cross‐sectional study was performed. All transplant programs (TP) registered at the Brazilian Organ Transplantation Society (ABTO) were invited to participate.ResultsSixty‐one TP participated in the study. Of these, 59 (97%) reported using at least 1 preventive strategy (prophylaxis or preemptive therapy [PET]). Prophylaxis was reported by only 39 (64%). PET was used by 52 (85%), predominantly for R+ recipients (n = 42/61; 70%). CMV monitoring was performed weekly in only 22 of 52 (42%) TP. This was significantly more common in TP reporting turnaround times ≤72 h for quantitative nuclear acid amplification tests (p < 0.001). Intravenous (IV) ganciclovir was the predominant drug chosen for prophylaxis (21/39 TP; 54%) and for PET (44/52 TP; 77%). Lack of regular access to valganciclovir was significantly associated with the choice of IV ganciclovir for prophylaxis and PET (p = 0.002 for both comparisons). Only 8 (13%) TP had access to molecular diagnostic tests for ganciclovir resistance, and 14 (23%) had access to effective therapy for highly resistant infections.ConclusionThese results suggest that strategies to improve the management of CMV after SOT in such a resource‐limited setting are needed and should include not only targeted educational programs but also initiatives to tackle economic and structural barriers.
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PD‐L1, PD‐1, and CTLA‐4 mRNA In Situ Expression by Canine Oral Melanoma Cells and Immune Cells of the Tumour Microenvironment
Authors: Foiani Greta , Melchiotti Erica , Capello Katia , Porcellato Ilaria , Brachelente Chiara , Iussich Selina , Giacobino Davide , Morello Emanuela , Martano Marina , Buracco Paolo , Vascellari Marta 
Published: January 2025

ABSTRACTCanine oral melanoma (OM) exhibits poor prognosis and limited treatment options. The success of immune checkpoint inhibitors (ICIs) in human melanoma has driven interest in similar therapeutic approaches in the dog, although the immunosuppressive mechanisms adopted by canine OM remain unclear. This study aimed to evaluate the expression of the immune checkpoints PD‐1/PD‐L1 and CTLA‐4 by RNAscope in situ hybridization (ISH) in canine OM, to investigate their expression pattern and explore their potential role in melanoma progression. Twenty‐four formalin‐fixed, paraffin‐embedded canine OM were included in the study. PD‐L1 expression by tumour cells was detected in 100% melanomas (score 1–3), especially at the host‐tumour interface. PD‐1 and CTLA‐4 expression by tumour cells was detected in 13/24 (54%, score 1–2) and 18/24 (75%, score 1) melanomas, respectively. Dual ISH‐immunohistochemistry with Melanoma Triple Cocktail, CD3, CD20 and Iba1 demonstrated the expression of tested immune checkpoints in neoplastic and immune cells. Notably, PD‐1 and CTLA‐4 were predominantly expressed by tumour‐infiltrating T lymphocytes, while PD‐L1 was primarily expressed by tumour‐associated macrophages. PD‐1 expression in neoplastic cells was significantly correlated with mitotic count (p < 0.05), while no associations were found between immune checkpoint expression and disease‐free interval or overall survival. Whole tumour PD‐L1 and PD‐1 expression, assessed by image analysis, correlated to PD‐L1 scores in neoplastic cells and the grade of tumour‐infiltrating lymphocytes, respectively. Collectively, PD‐L1, PD‐1 and CTLA‐4 likely contribute to immunosuppression in canine OM. Further studies are warranted to investigate whether ISH can serve as a biomarker for selecting patients suitable for ICI treatment.
Biomechanical Analysis for Enhanced Expulsion-Proof Intervertebral Fusion Device
Authors: Tang Shaolong , Pan Dan , Chen Siyuan , Li Hengyuan , Ye Zhaoming 
Published: January 2025

Abstract
This study aimed to compare the sinking and shifting characteristics of an enhanced expulsion-proof intervertebral fusion device (EEIFD) with a traditional transforaminal lumbar interbody fusion device (TTLIFD). Five specimens of each device were selected for analysis. Four mechanical tests—compression, subsidence, expulsion, and torque—were conducted for each cage. Additionally, a blade-cutting torque test was performed on the EEIFD, with load–displacement curves and mechanical values recorded. In static axial compression, static subsidence, and dynamic subsidence tests, the EEIFD demonstrated performance comparable to the TTLIFD. In expulsion testing, the maximum expulsion force for the EEIFD when the blade was rotated out (534.02 ± 21.24 N) was significantly higher than when the blade was not rotated out (476.97 ± 24.45 N) (P = 6.81 × 10−4). Moreover, the maximum expulsion force for the EEIFD with blade rotation (534.02 ± 21.24 N) was significantly higher than that of the TTLIFD (444.01 ± 12.42 N) (P = 9.82 × 10−5). These findings indicated that the EEIFD effectively enhanced expulsion prevention and antisubsidence performance.
Evaluating the Biomechanical Effects and Real-World Usability of a Novel Ankle Exo for Runners
Authors: Nurse Cameron A. , Wolf Derek N. , Rodzak Katherine M. , Teater Rachel H. , Ice Chad C. , Fine Shimra J. , Holtzman Elisa C. , Zelik Karl E. 
Published: January 2025

Abstract
Achilles tendon overuse injuries are common for long-distance runners. Ankle exos (exoskeletons and exosuits) are wearable devices that can reduce Achilles tendon loading and could potentially aid in the rehabilitation or prevention of these injuries by helping to mitigate and control tissue loading. However, most ankle exos are confined to controlled lab testing and are not practical to use in real-world running. Here, we present the design of an unpowered ankle exo aimed at reducing the load on the Achilles tendon during running while also overcoming key usability challenges for runners outside the lab. We fabricated a 500-gram ankle exo prototype that attaches to the outside of a running shoe. We then evaluated the reliability, acceptability, transparency during swing phase, and offloading assistance provided during treadmill and outdoor running tests. We found that the exo prototype reliably assisted 95–99% of running steps during indoor and outdoor tests, was deemed acceptable by more than 80% of runners in terms of comfort and feel, and did not impede natural ankle dorsiflexion during leg swing for 86% of runners. During indoor tests, the exo reduced peak Achilles tendon loads for most participants during running; however, reductions varied considerably, between near zero and 12%, depending on the participant, condition (speed and slope) and the precise tendon load metric used. This next-generation ankle exo concept could open new possibilities for longitudinal and real-world research on runners, or when transitioning into the return-to-sport phase after an Achilles tendon injury.
We're All In This Together: Evaluating the Dynamics of Designers' Moods Throughout the Collaborative Design Process and Their Impact on Project Outcomes
Authors: Harris Megan , Toh Christine 
Published: January 2025

Abstract
In this paper, we use sentiment analysis to understand the change in moods of individual designers and teams throughout a collaborative design project. Although there is much research on design psychology, the impact of psychological and emotional characteristics on creativity, and group affective tone, there is limited longitudinal research on the dynamic nature of mood and affective tone over the course of a design project. This leaves a gap in our understanding of how the complex emotional states and interactions of emotional states among team members affect the ability of the team to work together effectively and achieve expected design outcomes. Research that fills this gap can help improve design outcomes and educational strategies. Thus, a longitudinal study was conducted using the self-reflections of student teams collected from three different points over the course of a semester-long design project, to understand how the variation in designers' moods during a collaborative project design activities influence design project outcomes and quality of collaborative work. Our results show that time was a significant predictor of change in moods amongst teams, but not for individuals. We also show that divergence of team members' moods with respect to tone, positive tone, and negative emotion were negatively related to project outcomes. These results provide a foundation for future systematic investigations of team-based affect on design outcomes and show how design can be viewed through the lens of Symbolic Interactionism, evident in how team members create meaning and shared understanding within the design context.
On the Climbing Ability of Passively Suspended Tracked Robots
Authors: Reina Giulio , Mantriota Giacomo 
Published: January 2025

Abstract
This article investigates the obstacle-climbing ability of a novel passively articulated robot, Polibot, which is compared to a standard tracked robot using a fixed-wheel configuration. Two test cases are analyzed: the traverse of a single obstacle and the navigation upward along a vertical surface. Both scenarios are analytically solved using a quasistatic Newton–Euler approach. The dynamic equilibrium of the system is also defined using an energetic approach, focusing on the energy loss from the wheel-ground slippage. Understanding the role played by the different energy components contributes to shedding light on the fundamental mechanisms underlying the negotiation of obstacles and highly challenging terrain, in general, by suspended tracked robots. Finally, experimental results are presented to validate the proposed approach in real-world conditions.
Flow Diverter Technology for the Treatment of Intracranial Aneurysms: A Review
Authors: Gopisetty Shrimai , Budidi Uday Kumar , Shaik Khasim Beebi 
Published: January 2025

Abstract
The treatment of Intracranial aneurysms has evolved substantially over the past two decades, transitioning from open skull surgery to less invasive endovascular techniques. The rapid advancement of various endovascular procedures is the main impetus driving this evolution. The flow-diverting devices are less invasive and cost-effective than endovascular approaches like clipping, platinum coiling, and stent-assisted coiling. Flow diverters are endovascular devices inserted into the brain artery to restrict blood flow to an aneurysm, promoting gradual thrombus formation within an aneurysm sac. While using the current generation flow diverters in treating diverse aneurysms appears to be efficient, each device is different in design, material composition, occlusion rate and deployment system. At times, it becomes challenging to determine the most appropriate device best suited for every patient because of these distinguished factors. To address this, the present review aims to provide a comprehensive overview of ten flow-diverting devices. It explains their design specifications, material compositions, six-month and one-year occlusion rates, and their respective advantages and limitations. By offering a detailed analysis of these devices, this review seeks to empower researchers and neurosurgeons alike. Researchers can stay abreast of the latest advancements in flow-diverting technology, while neurosurgeons can make informed decisions when selecting the most appropriate device for each patient’s specific needs.
Experimental Study on Controlling Flow Separation of Compressor Cascades With Self-Excited Sweeping Jet Actuator
Authors: Zeng Cong , Chen Shaowen , Zheng Longye , Zhang Yimin , Wang Shiqi 
Published: January 2025

Abstract
The sweeping jet actuator (SJA), widely studied as a potential flow control method in compressors and turbines, results in unnecessary performance losses due to its requirement for additional energy and mass input. In this study, a self-excited sweeping jet actuator (SSJA) method was introduced to enhance the application feasibility of SJA. The SSJA was arranged inside the blade, utilizing the pressure difference between the pressure and suction surfaces; therefore, additional energy input is no longer necessary. Wind tunnel tests were conducted to explore the effects and mechanisms of SSJA layout, size, and pressure difference between the blade surfaces in controlling flow separation in a compressor cascade with controlled diffusion airfoils (CDAs). Key aerodynamic parameters were measured using a five-hole pressure probe, and oil-flow visualization was also performed to represent flow characteristics. Results show that by using SSJA in the compressor cascade, a significant reduction of 27.04% of the total pressure loss coefficient at 2 deg incidence was obtained. This control effect has great potential for application in the field of passive flow control. The streamwise vortices (SVs) induced by SSJA enhance the momentum exchange between the mainstream and the boundary layer near the suction surface, which reduces the suction side boundary layer separation and thus greatly reduces the flow losses. In addition, due to the different flow separation characteristics and actuation conditions at different incidences, the SSJA flow control effect is sensitive to incidences.
2′-Fucosyllactose inhibits human norovirus replication in human intestinal enteroids
Authors: Patil Ketki , Ayyar B. Vijayalakshmi , Hayes Nicole M. , Neill Frederick H. , Bode Lars , Estes Mary K. , Atmar Robert L. , Ramani Sasirekha 
Published: January 2025

ABSTRACT

Human noroviruses (HuNoVs) are the leading cause of acute gastroenteritis worldwide. Currently, there are no targeted antivirals for the treatment of HuNoV infection. Histo-blood group antigens (HBGAs) on the intestinal epithelium are cellular attachment factors for HuNoVs; molecules that block the binding of HuNoVs to HBGAs thus have the potential to be developed as antivirals. Human milk oligosaccharides (HMOs) are glycans in human milk with structures analogous to HBGAs. HMOs have been shown to act as decoy receptors to prevent the attachment of multiple enteric pathogens to host cells. Previous X-ray crystallography studies have demonstrated the binding of HMO 2′-fucosyllactose (2′FL) in the same pocket as HBGAs for some HuNoV strains. We evaluated the effect of 2′FL on the replication of a globally dominant GII.4 Sydney [P16] HuNoV strain using human intestinal enteroids (HIEs) from adults and children. A significant reduction in GII.4 Sydney [P16] replication was seen in duodenal and jejunal HIEs from multiple adult donors, all segments of the small intestine from an adult organ donor, and in two pediatric duodenal HIEs. However, 2′FL did not inhibit HuNoV replication in two infant jejunal HIEs that had significantly lower expression of α1–2-fucosylated glycans. 2′FL can be synthesized in large scale, and safety and tolerance have been assessed previously. Our data suggest that 2′FL has the potential to be developed as a therapeutic for HuNoV gastroenteritis.

IMPORTANCE
Human noroviruses infect the gastrointestinal tract and are a leading cause of acute gastroenteritis worldwide. Common symptoms of norovirus include diarrhea, vomiting, and stomach cramps. Virus shedding and symptoms are prolonged and debilitating in immunocompromised patients. Currently, there are no approved vaccines or targeted antivirals for treating human norovirus infection. Human intestinal enteroids derived from intestinal stem cells allow the successful replication of norovirus in the laboratory and can be used as a physiologically relevant model system to evaluate antivirals. We discovered that 2′-fucosyllactose (2′FL), an oligosaccharide naturally occurring in human milk, inhibits GII.4 norovirus replication in HIEs from multiple donors and thus has the potential to be developed as a therapeutic for human norovirus. These findings have high translational potential since 2′FL from several manufacturers has a “generally recognized as safe” status and can be synthesized on a large scale for immediate application.
Epithelial-to-mesenchymal transition and live cell extrusion contribute to measles virus release from human airway epithelia
Authors: Hippee Camilla E. , Durnell Lorellin A. , Kaufman Justin W. , Murray Eileen , Singh Brajesh K. , Sinn Patrick L. 
Published: January 2025

ABSTRACT

Measles virus (MeV) is a highly contagious respiratory virus transmitted via aerosols. To understand how MeV exits the airways of an infected host, we use unpassaged primary cultures of human airway epithelial cells (HAE). MeV typically remains cell-associated in HAE and forms foci of infection, termed infectious centers, by directly spreading cell-to-cell. We previously described the phenomenon in which infectious centers detach
en masse
from HAE and remain viable. Here, we investigate the mechanism of this cellular detachment. Via immunostaining, we observed loss of tight junction and cell adhesion proteins within infectious centers. These morphological changes indicate activation of epithelial-to-mesenchymal transition (EMT). EMT can contribute to wound healing in respiratory epithelia by mobilizing nearby cells. Inhibiting TGF-β, and thus EMT, reduced infectious center detachment. Compared with uninfected cells, MeV-infected cells also expressed increased levels of sphingosine kinase 1 (SK1), a regulator of live cell extrusion. Live cell extrusion encourages cells to detach from respiratory epithelia by contracting the actomyosin of neighboring cells. Inhibition or induction of live cell extrusion impacted infectious center detachment rates. Thus, these two related pathways contributed to infectious center detachment in HAE. Detached infectious centers contained high titers of virus that may be protected from the environment, allowing the virus to live on surfaces longer and infect more hosts.

IMPORTANCE
Measles virus (MeV) is an extremely contagious respiratory pathogen that continues to cause large, disruptive outbreaks each year. Here, we examine mechanisms of detachment of MeV-infected cells. MeV spreads cell-to-cell in human airway epithelial cells (HAE) to form groups of infected cells, termed “infectious centers”. We reported that infectious centers ultimately detach from HAE as a unit, carrying high titers of virus. Viral particles within cells may be more protected from environmental conditions, such as ultraviolet radiation and desiccation. We identified two host pathways, epithelial-to-mesenchymal transition and live cell extrusion, that contribute to infectious center detachment. Perturbing these pathways altered the kinetics of infectious center detachment. These pathways influence one another and contribute to epithelial wound healing, suggesting that infectious center detachment may be a usurped consequence of the host’s response to infection that benefits MeV by increasing its transmissibility between hosts.