bluuebunny/crossref_metadata_2025_split huggingface dataset:
Beyond Borders: Rethinking Pakistan’s National Security in a Global Context
Authors: Mir Tawseef Ahmad 
Published: August 2023

Syed Shahid Hussain Bukhari, Pakistan’s Security and the India–US Strategic Partnership: Nuclear Politics and Security Competition (Routledge, 2021). Pp. ix+264, £ 38.99. Arshad Ali, Pakistan’s National Security Approach and Post-Cold War Security: Uneasy Co-Existence (Routledge, 2021). Pp. x+232, £ 38.99. M. Raymond Izarali & Dalbir Ahlawat (eds.), Terrorism, Security and Development in South Asia: National, Regional and Global Implications (Routledge, 2021). Pp. xiii+316, £ 39.16.
Agreement Between Two-Concentration and One-Concentration Area Under the Curve (AUC) Estimates When Using Bayesian Modeling to Dose Vancomycin in Patients With Obesity
Authors: Covington Elizabeth W. , Watkins Addison M. 
Published: August 2023

Background: Vancomycin Bayesian modeling provides 24-hour area under the curve (AUC24) estimations. However, the agreement between two-concentration and one-concentration Bayesian estimates in patients with obesity is unknown. Objective: The purpose of this study was to determine the agreement between two-concentration and one-concentration Bayesian AUC24 estimates in patients with obesity receiving vancomycin. Methods: This retrospective within-subjects cohort study included patients with obesity and two vancomycin concentrations. The first concentration was hidden from dosing software to record the one-concentration AUC24. AUC24 estimates were categorized into 1 of 3 groups: <400, 400 to 600, or >600 mg*h/L. Patients were excluded for vancomycin duration less than 48 hours or renal dysfunction. The primary outcome was AUC24 agreement with two versus one concentration. Secondary outcomes included the AUC24 category, matching of AUC24 categorization, and correlation between two-concentration versus one-concentration AUC24. AUC24 estimate agreement was assessed by Bland Altman plot and bias via linear regression. Statistical analyses were performed using SPSS (version 20.0). Results: A total of 31 patients were included. The mean difference in AUC24 between two versus one concentration was 11.4 mg*h/L (95% limits of agreement = −72 to 95 mg*h/L). Linear regression indicated the presence of proportional bias at higher AUC24 values (β = 0.16; P = 0.015). Matching of AUC24 categorization with two versus one concentration was 87% (27/31 patients). Conclusion and Relevance: This study demonstrated overall agreement between AUC24 estimates when using two versus one vancomycin concentration in patients with obesity, though proportional bias was detected at higher AUC24. Future studies with larger sample sizes are needed to confirm these results.
Three-Dimensional Distance Mapping to Identify Safe Zones for Lateral Column Lengthening
Authors: Efrima Ben , Barbero Agustin , Ramalingam Kuharajan , Indino Cristian , Maccario Camilla , Usuelli Federico Giuseppe 
Published: August 2023

Background: Evans (E-LCL) and Hintermann LCL (H-LCL) lateral column lengthening osteotomies are standard surgical solutions for flexible, progressive collapsing feet. E-LCL is performed between the anterior and middle facets and endangers specific os calcis subtalar joint (OCST) subtypes without distinct facets. H-LCL is oriented between the posterior and middle facets and should be suitable for all OCSTs. Both osteotomies are associated with increased subtalar osteoarthritis, indicating iatrogenic damage. Distance mapping (DM) enables visualization of the relative distance between 2 articular surfaces represented by color patterns. This study aims to measure the safe zones for LCL using 3-dimensional (3D) models and DM; we hypothesize that it could be measured with high reproducibility. Methods: Two raters categorized 200 feet across 134 patients into OCSTs based on the Bruckner classification. Four angles were measured independently. The proximal and distal extents of the posterior safe zone (PSZ) angles were determined for H-LCL osteotomies; similarly, the proximal and distal extents of the anterior safe zone (ASZ) angles were identified for E-LCL osteotomies. Consequently, the surface available for safe osteotomies were calculated. An interclass correlation was used to assess the agreement between the 2 raters. Additionally, analysis of variance and Mann-Whitney U test were used to compare the safe zones between OCSTs. Results: The mean proximal and distal extents of the PSZ angles were 68 ± 7 and 75 ± 5 degrees from a line parallel to the lateral border of the calcaneus, respectively, and the proximal and distal extent of the ASZ angles were 89 ± 6 and 95 ± 5 degrees, respectively. There were no statistically significant differences between the OCSTs. Two raters measured the angles with good to excellent interrater and intrarater agreement. In 18 cases, we were unable to plan for H-LCL or E-LCL osteotomies. Conclusion: Distance mapping could be used to measure the safe zone, tailor a preoperative plan, and potentially reduce the risk for iatrogenic damage in LCL. 3D models and DM can increase the reliability of preoperative plans in bones with complex 3D structures. Level of Evidence: Level III, retrospective comparative study.
Minimally Invasive Transverse Distal Metatarsal Osteotomy (MITO) for Hallux Valgus Correction: Early Outcomes of Mild to Moderate vs Severe Deformities
Authors: Yoon Yeo Kwon , Tang Zhi Hao , Shim Dong Woo , Rhyu Hyeong-Jun , Han Seung Hwan , Lee Jin Woo , Park Kwang Hwan 
Published: August 2023

Background: We compared the radiological and clinical outcomes of mild to moderate and severe hallux valgus (HV) treated with minimally invasive distal metatarsal transverse osteotomy (MITO) performed by a single surgeon. Methods: Eighty-four patients who underwent MITO between May 2018 and March 2020 were recruited and followed for at least 24 months. The severe group was defined as having a preoperative hallux valgus angle (HVA) >40 degrees or preoperative first-to-second intermetatarsal angle (1-2 IMA) >16 degrees; the mild to moderate group was defined as having an HVA <40 degrees and a 1-2 IMA <16 degrees. Pre- and postoperative measurements of the HVA, 1-2 IMA, distal metatarsal articular angle, and tibial sesamoid position were obtained. The visual analog scale for pain, the Foot and Ankle Outcome Score, and the Medical Outcomes Study Short Form Health Survey–36 physical component summary were used to assess clinical outcomes. Results: A total of 116 feet were included in this study and median follow-up period of 29.0 months (range, 24-52 months). Both groups showed significant improvements in all radiologic parameters postoperatively, with the degrees of correction greater in the severe group than in the mild to moderate group. All clinical scores improved significantly from the preoperative to the last follow-up visit. Final clinical outcomes and degrees of improvement were comparable in both groups. Conclusion: This study showed that short-term radiographic results for patients with either mild to moderate or severe HV treated with MITO were favorable. Overall clinical outcomes were comparable to those of conventional treatments. In this series, we found MITO with screw fixation to be a satisfactory surgical option for patients with mild to severe HV deformities. Level of Evidence: Level III, retrospective comparative study.
3D-Printed Modular Endoprosthesis Reconstruction Following Total Calcanectomy in Calcaneal Malignancy
Authors: Gong Taojun , Lu Minxun , Wang Jie , Zhang Yuqi , Wang Yitian , Tang Fan , Li Zhuangzhuang , Zhou Yong , Min Li , Luo Yi , Tu Chongqi 
Published: August 2023

Background: The use of 3D-printed endoprosthesis has been proposed as a viable limb-salvage procedure following total calcanectomy in patients with calcaneal malignancy. However, certain drawbacks persist concerning the prosthetic design. In this case series, we designed a modular endoprosthesis incorporating a novel drainage system, aiming to improve the functional outcomes and to promote wound healing. Methods: We retrospectively analyzed patients with calcaneal malignancy who underwent 3D-printed modular endoprosthesis reconstruction. Clinically, we evaluated functional outcomes using the 10-cm visual analog scale (VAS) score, the 1993 version of the Musculoskeletal Tumor Society (MSTS-93) score, and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Complications were also recorded. Results: Five male patients met the final inclusion criteria. The median age was 20 years (range 13-47 years). The median follow-up time was 28 months (range, 13-65 months). Median postoperative functional MSTS-93, VAS, and AOFAS scores were 27 points (range, 25-29), 0 points (range, 0-1), and 86 points (range, 83-93), respectively. Wound healing was observed in all patients, and there were no complications related to the endoprosthesis at the last follow-up. Conclusion: The use of 3D-printed modular endoprosthesis was associated with satisfactory short-term outcomes in patients undergoing calcaneal reconstruction. The incorporation of a novel design featuring an integrated draining system has the potential to enhance wound healing and expedite functional recovery. Level of Evidence: Level IV, case series.
Living at the Intersections of Race and Gender in Diversified Mentoring: Experiences of Minoritized Women Leaders in Higher Education
Authors: Manongsong Ague Mae , Ghosh Rajashi 
Published: August 2023

Problem There is chronic underrepresentation of minoritized women in higher education leadership positions. A primary reason is that mentoring support is either lacking or rarely considers how the intersection of their race and gender creates a double bind. Further, there is a dearth of studies examining the lived experiences of mentoring support received by minoritized women leaders. Solution Through semi-structured interviews of fifteen participants, our interpretative phenomenological study adds to the extant literature by exploring how women of color (WOC) leaders navigated the challenges posed by the differences in gender and/or racial identities with their mentors in diversified mentoring relationships (DMRs). Our findings indicate that aspiring minoritized women leaders can thrive under the double bind in DMRs with successful coping strategies. Stakeholders University administration and HRD practitioners can apply the findings to leverage DMRs as a critical tool for developing the leadership identity of women of color in higher education.
Mitochondrial reactivity following acute exposure to experimental pain testing in people with HIV and chronic pain
Authors: Gilstrap Shannon R , Hobson Joanna M , Owens Michael A , White Dyan M , Sammy Melissa J , Ballinger Scott , Sorge Robert E , Goodin Burel R 
Published: August 2023

Background: Physical stressors can cause a physiological response that can contribute to an increase in mitochondrial dysfunction and Mitochondrial DNA damage (mtDNA damage). People living with HIV (PWH) are more likely to suffer from chronic pain and may be more susceptible to mitochondrial dysfunction following exposure to a stressor. We used Quantitative Sensory Testing (QST) as an acute painful stressor in order to investigate whether PWH with/without chronic pain show differential mitochondrial physiological responses. Methods: The current study included PWH with ( n = 26), and without ( n = 29), chronic pain. Participants completed a single session that lasted approximately 180 min, including QST. Blood was taken prior to and following the QST battery for assays measuring mtDNA damage, mtDNA copy number, and mtDNA damage-associated molecular pattern (DAMP) levels (i.e., ND1 and ND6). Results: We examined differences between those with and without pain on various indicators of mitochondrial reactivity following exposure to QST. However, only ND6 and mtDNA damage were shown to be statistically significant between pain groups. Conclusion: PWH with chronic pain showed greater mitochondrial reactivity to laboratory stressors. Consequently, PWH and chronic pain may be more susceptible to conditions in which mitochondrial damage/dysfunction play a central role, such as cognitive decline.
Clinical Presentation and Outcomes of Sacral Stress Fractures in Athletes: A Case Series of 13 Patients
Authors: Shankar Dhruv S. , Gillinov Lauren A. , Buldo-Licciardi Michael , Vargas Luilly , Cardone Dennis A. 
Published: August 2023

Background: Sacral stress fractures are a rare cause of low back pain in athletes. Given the low incidence of these fractures, there is a scarcity of data on symptomatology, risk factors, and clinical outcomes. Hypothesis: Patients diagnosed with sacral stress fractures would be athletes presenting with low back pain. Study Design: Case series of 13 patients with sacral stress fractures. Level of Evidence: Level 4. Methods: We conducted a retrospective review of medical records to identify patients diagnosed with sacral stress fractures at a single academic institution. Fractures were diagnosed on noncontrast T2-weighted magnetic resonance imaging scans and categorized using the Bakker classification system. Subjects were administered an electronic survey that asked about (1) the onset, time course, and location of pain and other symptoms; (2) time to treatment and treatment modalities pursued; (3) sports performance and time to return to sport; and (4) risk factors for stress fractures. Results: Of 18 eligible patients, 13 (72.2%) completed the survey with mean follow-up of 49.6 months (range, 1-144 months). Mean age was 28.0 years (range, 18-52 years); 9 patients (69.2%) were female, of whom 7 (77.8%) were premenopausal. The most common fracture type was Bakker type B (8 patients; 61.5%). Most patients presented with acute lumbosacral back pain in the setting of running/jogging activities. All patients underwent nonoperative treatment for an average of 3.8 months (range, 0-8 months) and three-quarters reported pain resolution at last follow-up. Rate of return to sport was 83.3%, but most patients reported ongoing deficits in running performance. Conclusion: Sacral stress fractures commonly present as acute lumbosacral back pain provoked by running sports. While the pain associated with these fractures prevents most athletes from participating in sports, nonoperative management appears to be an effective treatment modality with a high rate of return to sport.
Ultra-low-dose emergency chest computed tomography protocols in three vendors: A technical note
Authors: Mussmann Bo , Skov Peter Marshall , Lorentzen Morten H , Skjøt-Arkil Helene , Graumann Ole , Andersen Michael B , Jensen Janni 
Published: August 2023

Background In suspected community-acquired pneumonia (CAP), chest CT is superior to the routinely obtained radiographs (CXR), but administers higher radiation doses. However, ultra-low-dose CT (ULDCT) has shown promising results. Purpose To compare radiation dose and image quality using standard and ULDCT protocols designed for a multicenter study encompassing three CT scanner models from GE, Canon, and Siemens. Material and methods Patients with suspected CAP were referred for non-contrast standard dose chest CT (NCCT) and ULDCT. Effective radiation dose and Contrast-to-Noise Ratio (CNR) was calculated. Results Mean effective doses were GE ( n = 10) 6.93 mSv in NCCT and 0.27 mSv in ULDCT; Canon ( n = 9) 3.48 in mSv NCCT and 1.11 mSv in ULDCT; Siemens ( n = 10) 2.85 mSv in NCCT and 0.45 mSv in ULDCT. CNR was reduced by 29–39% in ULDCT. Conclusion The proposed CT protocols yielded dose reductions of 96%, 68%, and 84% using a GE, Canon, and Siemens scanner, respectively.
Usage Trends and Safety Profile of Recombinant Human Bone Morphogenetic Protein-2 for Spinal Column Tumor Surgery: A National Matched Cohort Analysis
Authors: Munim Mohammed A. , Berlinberg Elyse , Federico Vincent P. , Nolte Michael T. , Prabhu Michael , Pawlowski Hanna , Patel Karan S. , Colman Matthew W. 
Published: August 2023

Study Design Retrospective Cohort Analysis. Objective The purpose of this study is to investigate national rates of rhBMP-2 utilization in spinal tumor surgery and examine its association with postoperative complications, revisions, and carcinogenicity. Methods All patients diagnosed with primary or metastatic spinal tumors with subsequent surgical intervention involving a spinal fusion procedure were identified in PearlDiver. Patients were 1:1 matched into 2 cohorts according to rhBMP-2 usage. Postoperative complications and revisions were examined at 1 month, 3 months, 6 months, and 1 year after fusion. New cancer incidence following spinal tumor surgery was assessed until 5 years postoperatively. Results A total of 11,198 patients underwent fusion surgery after resection of spinal tumors between 2005 and 2020, with 909 cases reporting the use of rhBMP-2 (8.1%). An annualized analysis revealed that the proportion of spine tumor fusion procedures utilizing rhBMP-2 has been significantly decreasing ( R2 = .859, P < .001), with the most recent annual utilization rate at 1.1%. At least 3 months after surgery, significantly increased incidences of surgical site (11.4% vs 3.3%, P = .03) and systemic infections (8.1% vs 1.6%, P = .02) were observed in patients who underwent fusion with rhBMP-2. Across all time points, no significant differences were observed in survival, implant removal, revision rates, or new cancer diagnoses. Conclusion This analysis demonstrated significantly declining national utilization rates. Spinal tumor cases utilizing rhBMP-2 sustained greater rates of surgical site and systemic infections. rhBMP-2 usage did not significantly reduce the risk of mortality, implant failure, or reoperation.
Rates and Causes of Reoperations Following Spinal Cord Stimulation Within a 2-12 year Period
Authors: Papadopoulos Dimitrios V. , Suk Madeline S. , Andreychik David , Nikolaou Vasileios , Haak Michael 
Published: August 2023

Study design Retrospective study. Objective Spinal cord stimulation has been mainly used for the management of postsurgical persistent neuropathic. The purpose of the study was to evaluate the rate and causes for reoperation following spinal cord stimulation, and to identify risk factors for reoperation. Methods A retrospective study was conducted including patients who underwent surgical implantation of spinal cord stimulators within a 10-year period. The medical records of the included patients were reviewed for reoperations, demographics and certain clinical parameters. Demographics and clinical parameters were compared between patients with and without reoperations, and between patients with and without surgical site infections. Results Overall, 1014 index procedures and 175 reoperations were performed within the study period. At least 1 reoperation was performed in 97 (9.5%) cases. The most common cause for revision was lead migration or lead misplacement (n = 31, 3.0%). In 31 (3.1%) cases the stimulator was removed due to no pain relief. Surgical site infection that required reoperation developed in 30 cases (2.9%). Younger age was associated with a need for reoperation (Odds Ratio [OR]: .97,95% Confidence Interval [CI]:0.95-.99, P = .005), while higher Body Mass index and diabetes were associated with development of infection (OR: 1.05, 95% CI: 1.00-1.11, P = .036 and OR: 2.42, 95% CI: 1.05-5.47, P = .033 respectively). Conclusions The results of this study indicate that certain measures could improve the overall reoperation rate after spinal cord stimulation, such as accurate positioning of the spinal cord stimulators and design of smaller generators. Moreover, preoperative optimization of patients could result in lower complication rate, lower reoperations rate, and subsequently better clinical outcomes.
Grip strength cut-points from the Swiss DO-HEALTH population
Authors: Gagesch Michael , Wieczorek Maud , Abderhalden Lauren A. , Lang Wei , Freystaetter Gregor , Armbrecht Gabriele , Kressig Reto W. , Vellas Bruno , Rizzoli René , Blauth Michael , Orav E. John , Egli Andreas , Bischoff-Ferrari Heike A. 
Published: August 2023

Abstract
Background
While grip strength (GS) is commonly assessed using a Dynamometer, the Martin Vigorimeter was proposed as an alternative method especially in older adults. However, its reference values for Swiss older adults are missing. We therefore aimed to derive sex- and age-specific GS cut-points for the dominant and non-dominant hand (DH; NDH) using the Martin Vigorimeter. Additionally, we aimed to identify clinically relevant weakness and assess convergent validity with key markers of physical function and sarcopenia in generally healthy Swiss older adults.

Methods
This cross-sectional analysis includes baseline data from Swiss participants enrolled in DO-HEALTH, a 3-year randomized controlled trial in community-dwelling adults age 70 + . For both DH and NDH, 4 different definitions of weakness to derive GS cut-points by sex and age category (≤ 75 vs. > 75 years) were used: i) GS below the median of the 1st quintile, ii) GS below the upper limit of the 1st quintile, iii) GS below 2-standard deviation (SD) of the sex- and age-specific mean in DO-HEALTH Swiss healthy agers (i.e. individuals without major chronic diseases, disabilities, cognitive impairment or mental health issues) and iv) GS below 2.5-SD of the sex- and age-specific mean in DO-HEALTH Swiss healthy agers. To assess the proposed cut-points’ convergent validity, we assessed their association with gait speed, time to complete the 5 Times Sit-To-Stand (5TSTS) test, and present sarcopenia.

Results
In total, 976 participants had available GS at the DH (mean age 75.2, 62% women). According to the 4 weakness definitions, GS cut-points at the DH ranged from 29–42 and 25–39 kPa in younger and older women respectively, and from 51–69 and 31–50 kPa in younger and older men respectively. Overall, weakness prevalence ranged from 2.0% to 19.3%. Definitions of weakness using the median and the upper limit of the 1st GS quintile were most consistently associated with markers of physical performance. Weak participants were more likely to have lower gait speed, longer time to complete the 5TSTS, and sarcopenia, compared to participants without weakness.

Conclusions
In generally healthy Swiss older adults, weakness defined by the median or the upper limit of the 1st GS quintile may serve as reference to identify clinically relevant weakness. Additional research is needed in less healthy populations in order to derive representative population-based cut-points.

Trial registration
ClinicalTrials.gov Identifier: NCT01745263.
Inductive line tunneling FET using epitaxial tunnel layer with Ge-source and charge enhancement insulation
Authors: Lin Jyi-Tsong , Chang Yen-Chen 
Published: August 2023

AbstractIn this paper, we propose an inductive line tunneling FET using Epitaxial Tunnel Layer with Ge-Source and Charge Enhancement Insulation (CEI ETL GS-iTFET). The CEI ETL GS-iTFET allows full overlap between the gate and source regions, thereby enhancing the line tunneling. In addition, a germanium layer is introduced on the source side to form a heterojunction, effectively improving the device's conduction current. An ETL is incorporated to combat point tunneling leakage, resulting in a steeper subthreshold swing. Furthermore, a CEI consisting of Si3N4 is introduced between the germanium source and the Schottky metal, which effectively reduces carrier losses in the inversion layer and improves the overall device performance. This study presents a calibration-based approach to simulations, taking into account practical process considerations. Simulation results show that at VD = 0.2 V, the CEI ETL GS-iTFET achieves an average subthreshold swing (SSavg) of 30.5 mV/dec, an Ion of 3.12 × 10–5 A/μm and an Ion/Ioff ratio of 1.81 × 1010. These results demonstrate a significantly low subthreshold swing and a high current ratio of about 1010. In addition, the proposed device eliminates the need for multiple implantation processes, resulting in significant manufacturing cost reductions. As a result, the CEI ETL GS-iTFET shows remarkable potential in future low-power device competition.