bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between attachment site of tibialis anterior muscle and shape of tibia: anatomical study of cadavers
Authors: Kimata Kentaro , Otsuka Shun , Yokota Hiroki , Shan Xiyao , Hatayama Naoyuki , Naito Munekazu 
Published: July 2022

AbstractBackgroundTibialis anterior (TA) muscle is the largest dorsiflexor of the ankle joint and plays an important role during gait movement. However, descriptions of the TA attachment site are inconsistent even among major anatomy textbooks, and its origin, especially the attachment site for the tibia, has not been reported in detail. This study is the first experimental attempt to investigate the origin of the TA in detail, paying particular attention to the relationship with the shape of the tibia, including sex differences.MethodsForty legs (20 males, 20 females) from twenty Japanese cadavers were examined. Gross anatomical examination of the TA's attachment site to the tibia and the tibia's shape was performed.ResultsThe location of the distal end of the TA's attachment on tibia was significantly more distal in males than in females (p < 0.01). The anterior border of the tibia had a gentle S‐like curve, with a medially convex curve in the proximal region and a laterally convex curve in the distal region in frontal plane. The most protruding point of the distal curve of the anterior border located significantly more proximal in females than in males (p = 0.02).ConclusionsThere were sex differences in the distal end of the attachment site on tibia of the TA and the shape of the tibia. Consequently, the variations in the attachment site of TA were considered to provide for differences in function of TA. In males, the TA may enable advantageous power exertion, whereas in females it may work efficiently for dorsiflexion of ankle, respectively. Sex differences in TA's attachment site and the shape of the tibia may be involved in gait movement as well as frequency of lower leg disorders such as chronic exertional compartment syndrome.
Simulation-based randomized trial of medical emergency cognitive aids
Authors: Sellmann Timur , Alchab Samer , Wetzchewald Dietmar , Meyer Joerg , Rassaf Tienush , Thal Serge C. , Burisch Christian , Marsch Stephan , Breuckmann Frank 
Published: July 2022

Abstract
Background
Medical emergencies are complex and stressful, especially for the young and inexperienced. Cognitive aids (CA) have been shown to facilitate management of simulated medical emergencies by experienced teams. In this randomized trial we evaluated guideline adherence and treatment efficacy in simulated medical emergencies managed by residents with and without CA.

Methods
Physicians attending educational courses executed simulated medical emergencies. Teams were randomly assigned to manage emergencies with or without CA. Primary outcome was risk reduction of essential working steps. Secondary outcomes included prior experience in emergency medicine and CA, perceptions of usefulness, clinical relevance, acceptability, and accuracy in CA selection. Participants were grouped as “medical” (internal medicine and neurology) and “perioperative” (anesthesia and surgery) regarding their specialty. The study was designed as a prospective randomized single-blind study that was approved by the ethical committee of the University Duisburg-Essen (19-8966-BO). Trial registration: DRKS, DRKS00024781. Registered 16 March 2021—Retrospectively registered, http://www.drks.de/DRKS00024781.

Results
Eighty teams participated in 240 simulated medical emergencies. Cognitive aid usage led to 9% absolute and 15% relative risk reduction. Per protocol analysis showed 17% absolute and 28% relative risk reduction. Wrong CA were used in 4%. Cognitive aids were judged as helpful by 94% of the participants. Teams performed significantly better when emergency CA were available (p < 0.05 for successful completion of critical work steps). Stress reduction using CA was more likely in “medical” than in “perioperative” subspecialties (3.7 ± 1.2 vs. 2.9 ± 1.2, p < 0.05).

Conclusions
In a high-fidelity simulation study, CA usage was associated with significant reduction of incorrect working steps in medical emergencies management and was characterized by high acceptance. These findings suggest that CA for medical emergencies may have the potential to improve emergency care.
Towards defining morphologic parameters of normal parous and nulliparous breast tissues by artificial intelligence
Authors: Ogony Joshua , de Bel Thomas , Radisky Derek C. , Kachergus Jennifer , Thompson E. Aubrey , Degnim Amy C. , Ruddy Kathryn J. , Hilton Tracy , Stallings-Mann Melody , Vachon Celine , Hoskin Tanya L. , Heckman Michael G. , Vierkant Robert A. , White Launia J. , Moore Raymond M. , Carter Jodi , Jensen Matthew , Pacheco-Spann Laura , Henry Jill E. , Storniolo Anna Maria , Winham Stacey J. , van der Laak Jeroen , Sherman Mark E. 
Published: July 2022

Abstract
Background
Breast terminal duct lobular units (TDLUs), the source of most breast cancer (BC) precursors, are shaped by age-related involution, a gradual process, and postpartum involution (PPI), a dramatic inflammatory process that restores baseline microanatomy after weaning. Dysregulated PPI is implicated in the pathogenesis of postpartum BCs. We propose that assessment of TDLUs in the postpartum period may have value in risk estimation, but characteristics of these tissues in relation to epidemiological factors are incompletely described.

Methods
Using validated Artificial Intelligence and morphometric methods, we analyzed digitized images of tissue sections of normal breast tissues stained with hematoxylin and eosin from donors ≤ 45 years from the Komen Tissue Bank (180 parous and 545 nulliparous). Metrics assessed by AI, included: TDLU count; adipose tissue fraction; mean acini count/TDLU; mean dilated acini; mean average acini area; mean “capillary” area; mean epithelial area; mean ratio of epithelial area versus intralobular stroma; mean mononuclear cell count (surrogate of immune cells); mean fat area proximate to TDLUs and TDLU area. We compared epidemiologic characteristics collected via questionnaire by parity status and race, using a Wilcoxon rank sum test or Fisher’s exact test. Histologic features were compared between nulliparous and parous women (overall and by time between last birth and donation [recent birth: ≤ 5 years versus remote birth: > 5 years]) using multivariable regression models.

Results
Normal breast tissues of parous women contained significantly higher TDLU counts and acini counts, more frequent dilated acini, higher mononuclear cell counts in TDLUs and smaller acini area per TDLU than nulliparas (all multivariable analyses p < 0.001). Differences in TDLU counts and average acini size persisted for > 5 years postpartum, whereas increases in immune cells were most marked ≤ 5 years of a birth. Relationships were suggestively modified by several other factors, including demographic and reproductive characteristics, ethanol consumption and breastfeeding duration.

Conclusions
Our study identified sustained expansion of TDLU numbers and reduced average acini area among parous versus nulliparous women and notable increases in immune responses within five years following childbirth. Further, we show that quantitative characteristics of normal breast samples vary with demographic features and BC risk factors.
Network analysis of synovial RNA sequencing identifies gene-gene interactions predictive of response in rheumatoid arthritis
Authors: Sciacca Elisabetta , Surace Anna E. A. , Alaimo Salvatore , Pulvirenti Alfredo , Rivellese Felice , Goldmann Katriona , Ferro Alfredo , Latora Vito , Pitzalis Costantino , Lewis Myles J. 
Published: July 2022

Abstract
Background
To determine whether gene-gene interaction network analysis of RNA sequencing (RNA-Seq) of synovial biopsies in early rheumatoid arthritis (RA) can inform our understanding of RA pathogenesis and yield improved treatment response prediction models.

Methods
We utilized four well curated pathway repositories obtaining 10,537 experimentally evaluated gene-gene interactions. We extracted specific gene-gene interaction networks in synovial RNA-Seq to characterize histologically defined pathotypes in early RA and leverage these synovial specific gene-gene networks to predict response to methotrexate-based disease-modifying anti-rheumatic drug (DMARD) therapy in the Pathobiology of Early Arthritis Cohort (PEAC). Differential interactions identified within each network were statistically evaluated through robust linear regression models. Ability to predict response to DMARD treatment was evaluated by receiver operating characteristic (ROC) curve analysis.

Results
Analysis comparing different histological pathotypes showed a coherent molecular signature matching the histological changes and highlighting novel pathotype-specific gene interactions and mechanisms. Analysis of responders vs non-responders revealed higher expression of apoptosis regulating gene-gene interactions in patients with good response to conventional synthetic DMARD. Detailed analysis of interactions between pairs of network-linked genes identified the SOCS2/STAT2 ratio as predictive of treatment success, improving ROC area under curve (AUC) from 0.62 to 0.78. We identified a key role for angiogenesis, observing significant statistical interactions between NOS3 (eNOS) and both CAMK1 and eNOS activator AKT3 when comparing responders and non-responders. The ratio of CAMKD2/NOS3 enhanced a prediction model of response improving ROC AUC from 0.63 to 0.73.

Conclusions
We demonstrate a novel, powerful method which harnesses gene interaction networks for leveraging biologically relevant gene-gene interactions leading to improved models for predicting treatment response.
Level of health literacy in Latvia and Lithuania: a population-based study
Authors: Gatulytė Ieva , Verdiņa Valērija , Vārpiņa Zane , Lublóy Ágnes 
Published: July 2022

Abstract
Background
Measuring and understanding the level of health literacy serves as a starting point for developing various policies in health care. The consequences of weak health literacy competencies are severe; they result in riskier health behaviour, poorer health status, more frequent emergency visits and hospitalizations. This research has three aims: i) measure the level of health literacy in the populations of Latvia and Lithuania; ii) investigate which demographic and socioeconomic determinants are associated with it; and iii) discuss the means of improving its current level.

Methods
We employ a validated survey tool, the 47-item European Health Literacy Questionnaire (HLS-EU-Q). In addition to the 47 questions in the domains of health care, disease prevention, and health promotion, the participants’ demographic and socioeconomic characteristics are assessed. Face-to-face paper-assisted surveys are conducted with randomly selected residents from Latvia and Lithuania. The level of health literacy is measured by the health literacy index. Spearman correlation analyses and multiple regressions models are employed for investigating the association between the health literacy level and its determinants. The survey tool is complemented with in-depth interviews with six healthcare industry experts in order to assess the most promising ways to improve the level of health literacy.

Results
The stratified random sampling with quota elements assured a representative sample in terms of gender, urban/rural distribution and regions. In Latvia, 79% of the population possesses weak health literacy competencies. In Lithuania, 73% of the population can be characterized with inadequate or problematic level of health literacy. The most important determinants of the health literacy level include age, financial situation, social status, and ethnicity. In particular, elderly (aged 76 and over) and the Latvian-speaking population are less health literate, while those having better financial situation and higher social status are more health literate. The three most promising ways to improve the level of health literacy, as suggested by the healthcare industry experts, include health education in schools, provision of structured health-related information in Latvian and Lithuanian, and guidelines for the most common health problems.

Conclusions
The proportion of population with inadequate or problematic level of health literacy is higher in Latvia and Lithuania than in several other European countries. There is an urgent need to develop policies to improve it.
Crateva unilocularis Buch-Ham leaf extract improves glucose metabolism via regulation of insulin secretion and sensitivity in vitro and in vivo
Authors: Park Chul-Min , Jeong Bong-Hwa , Sharma Raj Bhesh , Kim Hyun-Jung , Kim Dong-Wook , Rhyu Dong-Young 
Published: July 2022

AbstractCrateva unilocularisBuch-Ham has traditionally been used in Nepal for the treatment and prevention of diabetes. However, scientific verification through studies on the preventive effect ofC. unilocularison diabetes has not been done properly. In this study we investigated the effect ofC. unilocularisleaf extract (CULE) on glucose uptake and insulin resistance. The effect of CULE on glucose uptake in an in vivo system was measured using zebrafish. In the cell-free system, enzymes activities related to diabetes were measured. Moreover, in the cell-cultured system, RIN-m5F pancreatic beta cells, 3T3-L1 adipocytes, and L6 myotubes were used to measure the effect of CULE on insulin secretion and glucose metabolism. CULE effectively enhanced glucose uptake in zebrafish larvae, and inhibited the activity of dipeptidyl peptidase-IV (DPP-IV) and protein tyrosine phosphatase-1B (PTP-1B) enzymes related to insulin secretion and insulin signaling activation. Also, CULE significantly increased insulin secretion with suppression of NO production in RIN-m5F pancreatic beta cells. In L6 myotubes and TNF-α-induced insulin resistance model of 3T3-L1 adipocytes, CULE significantly increased glucose uptake and immunofluorescence staining of glucose transporter (GLUT)4 protein. Furthermore, the regulatory response of glucose metabolism by CULE was a close correlation with the activation of insulin signaling (IRβ, PI3K, AKT) and 5′-AMP-activated protein kinase (AMPK)α and the reduction of p38 mitogen-activated protein kinase (MAPK) in TNF-α-induced insulin resistance model of 3T3-L1 adipocytes. Thus, our results suggest that CULE may act as a potential agent for the prevention and treatment of metabolic syndrome associated with type 2 diabetes.
Practical significance of item misfit and its manifestations in constructs assessed in large-scale studies
Authors: Fährmann Katharina , Köhler Carmen , Hartig Johannes , Heine Jörg-Henrik 
Published: July 2022

AbstractWhen scaling psychological tests with methods of item response theory it is necessary to investigate to what extent the responses correspond to the model predictions. In addition to the statistical evaluation of item misfit, the question arises as to its practical significance. Although item removal is undesirable for several reasons, its practical consequences are rarely investigated and focus mostly on main survey data with pre-selected items. In this paper, we identify criteria to evaluate practical significance and discuss them with respect to various types of assessments and their particular purposes. We then demonstrate the practical consequences of item misfit using two data examples from the German PISA 2018 field trial study: one with cognitive data and one with non-cognitive/metacognitive data. For the former, we scale the data under the GPCM with and without the inclusion of misfitting items, and investigate how this influences the trait distribution and the allocation to reading competency levels. For non-cognitive/metacognitive data, we explore the effect of excluding misfitting items on estimated gender differences. Our results indicate minor practical consequences for person allocation and no changes in the estimated gender-difference effects.
Presence of microplastics in drinking water from different freshwater sources in Flanders (Belgium), an urbanized region in Europe
Authors: Semmouri Ilias , Vercauteren Maaike , Van Acker Emmanuel , Pequeur Emmy , Asselman Jana , Janssen Colin 
Published: July 2022

AbstractMicroplastics (MPs) are emerging contaminants of concern in aquatic ecosystems. Up to now, only a few studies about MP contamination in drinking water have been published. In this study, we analysed drinking water originating from ground water, surface water and treated sewage water for the presence of MPs, collected in different drinking water treatment plants (DWTP, n = 9) and water taps (TW, n = 9) in the geographic region of Flanders (Belgium). We report measured microplastic concentrations, size distributions, and polymer types using μFTIR spectroscopy in the range of 25–1000 μm. The MPs’ abundances in the DWTP and TW samples were on average 0.02 ± 0.03 MPs L− 1 and 0.01 ± 0.02 MPs L− 1, respectively. We did not find significant differences comparing the obtained MP concentrations according to the origin of the water. Polypropylene (PP) and polyethylene terephthalate (PET) were the most common polymer types detected in the samples. Next, based on several theoretical assumptions, we extrapolated the measured MP concentrations in our samples to cover the full theoretical MP size range (1–5000 μm) to obtain estimates of the actual MP contamination levels. The rescaled particle concentrations (1 μm – 5000 mm) were on average 5.59 MPs L− 1 and 3.76 MPs L− 1 for the DWTP and TW samples, respectively. Based on a standard consumption of two liters of drinking water per day in combination with the measured concentration in this study, Flemish people consume 0.02 MPs per capita per day via drinking water. These findings contribute in our understanding of the microplastic pollution of drinking water, which is of concern due to the potential uptake of MPs in the human body.
Performance assessment of radio occultation data from GeoOptics by comparing with COSMIC data
Authors: Chang Hyeyeon , Lee Jiyun , Yoon Hyosang , Morton Y. Jade , Saltman Alex 
Published: July 2022

AbstractResponding to the ever-growing demand for environmental information, the National Oceanic and Atmospheric Administration (NOAA) seeks to enter into contracts to purchase Global Navigation Satellite System (GNSS) radio occultation (RO) observations produced by commercial vendors at a low-cost. GeoOptics is one commercial vendor awarded a contract with NOAA. GeoOptics operates the Community Initiative for Cellular Earth Remote Observation (CICERO) constellation of low-earth-orbiting (LEO) 6U CubeSats. The 6U-sized CICERO will enable the deployment of GNSS array consisting of RO satellites in the Earth’s atmosphere to obtain many atmospheric observations which can improve weather forecasting. Applying GeoOptics RO data to reliable weather forecasting requires an assessment of its performance. This study analyzes the performance of GeoOptics CubeSats measurements by comparing it with the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) missions (COSMIC-1 and COSMIC-2). The performance analysis was carried on data coverage capabilities and measurement quality. The analysis of data coverage confirmed that GeoOptics can acquire global observational coverage with adequate low-altitude penetration capability, while there should be updated in local time coverage. The analysis of RO measurement quality showed that GeoOptics RO measurements are comparable to those of COSMIC-2, even though GeoOptics exhibited a lower signal-to-noise ratio (SNR). The potential of GeoOptics allows for the development of a GNSS array in the Earth’s atmosphere and a large amount of effective RO measurements to be obtained for reliable weather forecasting.
Graphical Abstract
Changing mortality amongst hospitalised children with Severe Acute Malnutrition in KwaZulu-Natal, South Africa, 2009 – 2018
Authors: Ndlovu S , David-Govender C , Tinarwo P , Naidoo KL 
Published: July 2022

Abstract
Background
The under-five mortality rates of children in South Africa (SA) remain high despite successful HIV prevention and treatment programs. The in-hospital mortality of children with severe acute malnutrition remains a key obstacle. This study identifies and describes changes in the mortality of under-five children with severe acute malnutrition (SAM) following the implementation of HIV and malnutrition prevention and treatment programmes.

Methods
This was a retrospective review of in-hospital mortality records and databases. The study was based at a large referral hospital in KwaZulu-Natal (KZN), where HIV and malnutrition rates are high, and SAM children are managed with standard WHO guidelines. Records of children under five years old who died from 2009 to 2018 were analysed.

Results
Of the 698 under-five children who died in this period, 285 (40, 8% of all under-5 deaths) were classified as having SAM. The number of HIV-infected SAM deaths dropped significantly, especially those below six months of age, mirroring the expansion of HIV treatment and prevention programmes. Despite this and a significant drop in the proportion of SAM admissions identified, there was no change in SAM case fatality rates over the ten years. Septicaemia remained the most common cause of death in children with SAM.

Conclusions
Despite significant decreases in HIV-related malnutrition deaths over ten years, the lack of change in SAM case fatality rates is a concern at this referral hospital. Standardised WHO inpatient management protocols, may require review, especially where underlying medical conditions may contribute to SAM deaths in HIV-negative children.