bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Axillary Nerve Danger Zone in Percutaneous Fixation in the Pediatric Shoulder
Authors: Stavinoha Tyler J. , Randhawa Sahej D. , Trivedi Sunny , Dingel Aleksei , Shea Kevin G. , Frick Steven L. 
Published: March 2022

Background:
Adult literature cites an axillary nerve danger zone of 5 to 7 cm distal to the acromion tip for open or percutaneous shoulder surgery, but that may not be valid for younger patients. This study sought to quantify the course of the axillary nerve in adolescent patients with reference to easily identifiable intraoperative anatomic and radiographic parameters.

Methods:
A single-institution hospital database was reviewed for shoulder magnetic resonance images (MRIs) in patients 10 to 17 years old. One hundred and one MRIs from patients with a mean age of 15.6 ± 1.2 years (range, 10 to 17 years) were included. Axillary nerve branches were identified in the coronal plane as they passed lateral to the proximal humerus and were measured in relation to identifiable intraoperative surface and radiographic landmarks, including the acromion tip, apex of the humeral head, lateral physis, and central apex of the physis. The physeal apex height (i.e., 1 “mountain”) was defined as the vertical distance between the most lateral point of the humeral physis (LPHP) and the central intraosseous apex of the physis.

Results:
Axillary nerve branches were found in all specimens, adjacent to the lateral cortex of the proximal humerus. A mean of 3.7 branches (range, 2 to 6) were found. The mean distance from the most proximal branch (BR1) to the most distal branch (BR2) was 11.7 mm. The pediatric danger zone for the axillary nerve branches ranged from 6.6 mm proximal to 33.1 mm distal to the LPHP. The danger zone in relation to percent of physeal apex height included from 62% proximal to 242% distal to the LPHP.

Conclusions:
All branches were found distal to the apex of the physis (1 “mountain” height proximal to the LPHP). Distal to the LPHP, no branches were found beyond a distance of 3 times the physeal apex height (3 “valleys”). In children and adolescents, percutaneous fixation of the proximal humerus should be performed with cortical penetration outside of this range. These parameters serve as readily identifiable intraoperative radiographic landmarks to minimize iatrogenic nerve injury.

Clinical Relevance:
This study provides valuable landmarks for percutaneous approaches to the proximal humerus. The surgical approach for the placement of percutaneous implants should be adjusted accordingly (i.e., performed at least 1 mountain proximal or 3 valleys distal to the LPHP) in order to prevent iatrogenic injury to the axillary nerve.
Rockfall Kinematics from Massive Rock Cliffs: Outlier Boulders and Flyrock from Whitney Portal, California, Rockfalls
Authors: Collins Brian D. , Corbett Skye C. , Horton Elizabeth J. , Gallegos Alan J. 
Published: March 2022

ABSTRACTGeologic conditions and topographic setting are among the most critical factors for assessing rockfall hazards. However, other subtle features of rockfall motion may also govern the runout of rockfall debris, particularly for those sourced from massive cliffs where debris can have substantial momentum during transport. Rocks may undergo collisions with trees and talus boulders, with the latter potentially generating flyrock—launched rock pieces resulting from boulder collisions that follow distinctively different paths than the majority of debris. Collectively, these intricacies of rockfall kinematics may substantially govern the hazards expected from rockfall to both persons and infrastructure located beneath steep cliffs. Here, we investigate the kinematics, including outlier boulder and flyrock trajectories, of seismically triggered rockfalls on 24 June 2020 that damaged campground facilities near Whitney Portal, CA, a heavily used outdoor recreation gateway to the Sierra Nevada mountains. Our results, obtained in part by rockfall runout model simulations, indicate that outlier boulder trajectories resulted from opportunities provided by less steep terrain beyond the talus edge. The influence of trees, initially thought to have served a protective capacity in attenuating rockfall energy, appears to have been negligible for the large boulder volumes (&gt;50 m3) mobilized, although they did potentially deflect the trajectory of flyrock debris. Rockfall outlier boulders from the event were comparable in volume and runout distance to prehistoric boulders located beyond the talus slope, thereby providing some level of confidence in the use of a single rockfall shadow angle for estimating future rockfall hazards at the site.
A Spectrogram Based Novel Approach for Arrhythmia Detection with Convolutional Neural Networks
Authors: Rao Sneha , Singh Vishwa Mohan , Kulkarni Siddhivinayak , Saran Vibhor 
Published: March 2022

Abstract

ECG is one of the most important medical scans which is used for diagnosis of various heart related conditions and diseases. One of the most common of these is arrhythmia, which is caused by the irregularity of the heart beats. Artificial Intelligence has had a major impact in the field of vital monitoring and autonomous medical diagnosis. Therefore, a lot of work has demonstrated its effectiveness in arrhythmia detection. In this paper, we propose a method that tries to improve upon the accuracy of such models with the help of a light weight deep learning architecture that utilized 2D Separable CNN with a group of graphical representations of the ECG signals like the STFT, CWT and MFCC. Our model has achieved an accuracy of 97.41 and an F1 score of 88.20 on a processed version of the MIT-BIH dataset and takes on an average 7.93 times less calculations compared to a simple 2D Convolution model.
Genetic analysis and pregnancy outcomes of fetuses with kidney and urinary tract anomalies
Authors: Yuan Tingting , Ding Lina , Peng Juan , Chen Min , Chen Fei , Xie Yinong , Li Nan , Jian Wei , Chen Jingsi , Chen Jieyun , Wu Xiaojuan , Liu Yu , Zhang Huimin , He Wenzhi , Lin Chunjiao , Gao Zhilin , Li Zhihua 
Published: March 2022

Abstract
Objective: To explore the genetic basis and pregnancy outcomes of congenital anomalies of the kidney and urinary tract (CAKUTs).Methods: We analyzed the ultrasonographic features, results of prenatal diagnostic tests (chromosomal karyotype analysis, chromosomal microarray analysis [CMA], and whole exome sequencing [WES]), and pregnancy outcomes of fetuses with CAKUTs.Results: The main ultrasonographic features of 1197 CAKUTs were hydronephrosis, multicystic dysplastic kidney, renal agenesis, and duplex kidney. Of 413 fetuses that underwent prenatal genetic tests, 80 (19.37%, 80/413) had clinically significant abnormal results, including 27 fetuses with chromosome abnormalities and 40 with pathogenic copy number variations (CNVs)/variations of uncertain significance (VOUSs). Of the 26 fetuses that underwent WES, 13 (50.00%, 13/26) had pathogenic/likely pathogenic point mutations. The incidence of genetic abnormalities was significantly lower for isolated CAKUTs (11.36%, 36/317) than for CAKUTs with additional anomalies (45.83%, 44/96; p < 0.05). The operation rate among live-born children with CAKUTs was 6.75% (51/755). The anteroposterior diameter (APD) of the renal pelvis in the third trimester could predict the necessity of postnatal surgery, and the sensitivity and specificity of APD ≥ 17.5 mm were 63.2% and 94.7%, respectively.Conclusions: The main geneetic causes of isolated CAKUT were copy number variations (CNVs) and genetic abnormalities. CMA has important value in CAKUT fetuses with normal karyotype and can increase the detection rate by 4%; WES can significantly improve the genetic detection rate of CAKUT fetuses. Fetuses with isolated urinary abnormalities have a good prognosis after birth.
Treponema endosymbionts are the dominant bacterial members with ureolytic potential in the gut of the wood-feeding termite, Reticulitermes hesperus
Authors: Lin Jonathan Y , Huang Laibin , Won Sung J , Rodrigues Jorge L.M. 
Published: March 2022

Abstract
Termites are remarkable for their ability to digest cellulose from wood as their main energy source, but the extremely low nitrogen (N) content of their diet presents a major challenge for N acquisition. Besides the activity of N 2 -fixing bacteria in the gut, the recycling of N from waste products by symbiotic microbes as a complementary N-provisioning mechanism in termites remains poorly understood. In this study, we used a combination of high-throughput amplicon sequencing, quantitative PCR, and cultivation to characterize the microbial community capable of degrading urea, a common waste product, into ammonia in the guts of termites ( Reticulitermes hesperus ) from a wild and laboratory-reared colony. Taxonomic analysis indicated that a majority of the urease ( ureC ) genes in the termite gut (53.0%) matched with a Treponema endosymbiont of gut protists previously found in several other termites, suggesting an important contribution to the nutrition of essential cellulolytic protists. Furthermore, analysis of both the 16S rRNA and ureC amplicons revealed that the laboratory colony had decreased diversity and altered community composition for both prokaryotic and ureolytic microbial communities in the termite gut. Estimation by quantitative PCR showed that microbial ureC genes decreased in abundance in the laboratory-reared colony compared to the wild colony. In addition, most of our cultivated isolates appeared to originate from non-gut environments. Together, our results underscore a more important role for ureolysis by endosymbionts within protists than by free-swimming bacteria in the gut lumen of R. hesperus .
Non-HDL-C is associated with the occurrence of acute myocardial infarction in Chinese populations with diabetes
Authors: Chen Chen , Su Hua , Tang Zhenwang , Yue Jianbo , Liu Changhui , Tang Yixin , Luo Xiaotian 
Published: March 2022

Abstract
Background: Non-HDL-C has been associated with the prognosis and long-term prognosis of acute myocardial infarction, but the association between non-HDL-C and the occurrence of acute myocardial infarction in the Chinese population remains unclear. The purpose of this study is to explore whether non-HDL-C is related to the occurrence of acute myocardial infarction in the Chinese, and to further explore its relationship with the occurrence of acute myocardial infarction in subjects with diabetes.Methods and Results: We reviewed the medical records of patients who visited the Department of Cardiology at the First Affiliated Hospital of the University of South China from May 1, 2012 to September 30, 2020. According to inclusion and exclusion criteria, 6558 subjects were included in the non-AMI group and 3386 subjects were included in the AMI group. In the entire population, non-HDL-C was associated with the incidence of acute myocardial infarction, regardless of adjustment for confounding factors. In non-diabetic patients, non-HDL-C, HDL-C, LDL-C was found to be associated with the occurrence of acute myocardial infarction. In subjects with diabetes, non-HDL-C was associated with AMI without adjusting for confounding factors (Model 1) (OR: 1.268, 95%CI 1.035-1.547, P=0.022), and LDL-C was not associated with AMI (OR: 1.129, 95%CI 0.904 -- 1.411, P=0.286), HDL-C was negatively correlated with the incidence of acute myocardial infarction (OR: 0.577, 95%CI 0.418 -- 0.796, P < 0.001). After adjusting for age and sex (Model 2), non-HDL-C was positively correlated with the incidence of acute myocardial infarction (OR: 1.371, 95%CI 1.103-1.704, P=0.004), while the correlation between HDL-C and LDL-C and acute myocardial infarction was not observed. After adjusting for age, sex, hypertension/smoking, and BMI (Model 3), non-HDL-C was positively correlated with the incidence of acute myocardial infarction (OR: 1.381, 95%CI 1.103-1.728, P=0.005), and no correlation was observed between HDL-C and LDL-C and acute myocardial infarction.Conclusions：In subjects with diabetes, after adjusting for confounders associated with coronary heart disease, non-HDL-C was found to be associated with AMI, whereas HDL-C and LDL-C were not associated with AMI. In addition, non-HDL-C can also be found to be related to the occurrence of acute myocardial infarction in patients without diabetes.
Sutureless socket technique after removal of third molars : a multicentric, open, randomized controlled trial
Authors: Takadoum Sarah , Douilly Grégory , De Boutray Marie , Kabani Sarah , Maladière Eric , Demattei Christophe , Lapeyrie Philippe 
Published: March 2022

Abstract
Background: Although wisdom-tooth extraction is a routine intervention, the postoperative period remains marked by local inflammation classically manifesting as pain, edema and trismus. Furthermore, there is no consensus on the best operative techniques, particularly for the mucosal closure stage on impacted mandibular wisdom teeth. Methods: This parallel, randomized, non-blinded study compared pain following removal of impacted third molars, with and without sutures. Patients were electronically allocated 1:1 to extraction with versus without sutures. Patients ≥14 years’ old scheduled for extraction of four impacted wisdom teeth under general anesthesia at three French hospitals were eligible for inclusion. Exclusion criteria included taking antiplatelet agents or anticoagulants, coagulation disorders or immunosuppression, and planned orofacial surgical procedures or emergency pain/infection. The primary objective was pain evaluated by Visual Analogue Scale on Day 3. Secondary outcomes were edema, trismus, healing, complications, painkiller consumption and quality of life on Day 3 and 31. Results: Between June 2016 and November 2018, 100 patients were randomized. Finally, 44 patients in the Suture group and 50 patients in the Without Suture group were analyzed. Mean age was 16.5 years and 66.6% of patients were female. After adjustment on center, age and smoking, no statistical difference was seen between groups for pain on Day 3 (p=0.904). No differences were seen for swelling, trismus, consumption of painkillers, healing, complications or quality of life. Smokers had a 3.65 times higher complications rate (p=0.0244). Conclusions: Sutureless removal of third molars is thus a reliable technique without negative consequence on outcomes, and allows shorter operating time. Smoking is a risk factor for postoperative complications. Trial registration: www.clinicaltrials.gov (NCT02583997), registered 22th October 2015.
IPACK (Infiltration between the Popliteal Artery and the Capsule of the Knee) and Adductor Canal Block (ACB) versus Periarticular Injection (PAI) Enhances Postoperative Pain Control in Anterior cruciate ligament (ACL) repair: A Randomized Controlled Trial
Authors: AlJa'bari Aboud , Khoury Fouad Issa El 
Published: March 2022

Abstract
BACKGROUND:Motor-sparing peripheral nerve blocks, such as the infiltration between the popliteal artery and capsule of the knee (IPACK) and the adductor canal block (ACB), are promising analgesic pathways but supporting literature remains rare. Periarticular injections (PAIs) are becoming an essential multimodal joint analgesia. We hypothesized that ACB and IPACK would lower pain on ambulation on postoperative day (POD) 1 compared to PAI alone.METHODS:This double-blinded randomized controlled trial included 50 patients undergoing ACL repair. Patients either received (1) a PAI (control group, n = 26) or (2) an iPACK with an ACB (intervention group, n = 24). The primary outcome was pain on ambulation on POD 1. Secondary outcomes included numeric rating scale (NRS) pain scores, patient satisfaction, and opioid consumption.RESULTS:The intervention group reported significantly lower pain scores on ambulation than the control group on POD 1 (difference in means [95% confidence interval]; P < .001). In addition, pain scores on ambulation on POD 2 for group B (3.5 [-4.3 to -2.7]) and POD 2 for group A (1.0 [1.9 to 0.1]; with P = .033) were significantly lower. Patients in the intervention group were more satisfied, had less intravenous opioid consumption (post anesthesia care unit, P = .028), and reduced need for intravenous patient-controlled analgesia for the first 24 hours (P = .037).CONCLUSIONS:The addition of iPACK and ACB significantly improves analgesia and reduces opioid consumption after ACL repair compared to PAI alone. This study strongly supports iPACK and ACB use within a multimodal analgesic pathway.
Association between Estradiol and Bone Mineral Density in Adults Aged 40-60 years
Authors: Wang Nan , Zhang Ying , Huang Chengcheng 
Published: March 2022

Abstract
Background: The purpose of this analysis was to explore the relationship between estradiol and total bone mineral density (BMD) in American adults aged 40 to 60 years.Methods: We used a cross-sectional study. Data for the study came from the National Health and Nutrition Examination Survey (NHANES) . The study examined data from a sample of the American population. Results: Data analysis showed a significant association between estradiol levels and total bone mineral density in US adults aged 40 to 60 years. When estradiol levels were below the threshold of 33.3pg/mL, estradiol was positively associated with total BMD in all ethnic groups. There was no significant correlation between estradiol levels above the threshold of 33.3pg/mL. When estradiol levels in men were below the threshold of 40.3pg/mL, estradiol was positively correlated with total BMD. When estradiol levels in women were below the threshold of 25pg/mL, estradiol was positively correlated with total BMD.Conclusions: In the 40-60 year old population, when estradiol level is at a lower concentration, estradiol level is positively correlated with total BMD. Increasing estradiol level can promote bone health. When estradiol levels are at higher concentrations, changes in estradiol levels may have no significant effect on bone health.
p -Coumaric acid protects against D-galactose induced neurotoxicity by attenuating neuroinflammation and apoptosis in mice brain
Authors: Juvekar Archana Ramesh , Daroi Pratibha Atul , Dhage Shrikant 
Published: March 2022

Abstract
D-galactose (D-gal) induced senescence in rodents is a widely used model for assessment of molecules affecting brain ageing. Chronic administration of D-gal causes neuroinflammation leading to cognitive deficit and memory impairment which represent Alzheimer’s dementia. In present study, we investigated the neuroprotective effects of the natural phenol, p-Coumaric acid (PCA) and its underlying mechanism in the chronic D-gal treated mice. Subcutaneous administration of D-gal (150 mg/kg) to Swiss albino mice for 42 consecutive days resulted in cognitive impairment as observed in Morris water maize (MWM) and Y maze test, which was ameliorated by concurrent treatment with PCA (80 mg/kg, and 100 mg/kg, p.o.). Importantly, PCA treatment attenuated the D-gal induced oxidative stress and significantly inhibited acetylcholinesterase (AChE) activity in mice brain. Furthermore, PCA treatment significantly lowered levels of inflammatory marker nuclear factor kappa B (NFκB) and reduced levels of proapoptotic enzyme caspase 3. We also observed that PCA treatment exhibited β-secretase enzyme (BACE1) inhibitory effect. However, our results revealed that PCA treatment failed to decrease the level of advanced glycation end products (AGE) both in vitro and in vivo. Taken together, current study demonstrated the significant neuroprotective effect of PCA against D-galactose induced neuroinflammation, cognitive impairment and apoptosis.
HC-1119, a Deuterated Enzalutamide, Inhibits Migration, Invasion and Metastasis of the AR-positive Triple-negative Breast Cancer Cells
Authors: Wu Xuehong , Feng Wanru , Yang Mao , Liu Xunxi , Gao Mengdi , Li Xinghai , Gan Lin , He Tao 
Published: March 2022

Abstract
Triple-negative breast cancers (TNBCs) are aggressive, and they develop metastasis at earlier stages, relapse more frequently, and exhibits poorer prognosis than other subtypes of breast cancer. Due to the lack of estrogen receptor for endocrine therapy and HER2 for targeted therapy, new targeted therapies for TNBCs are urgently needed. Enzalutamide is a second-generation androgen receptor (AR) inhibitor, and HC-1119 is a new synthetic deuterated enzalutamide. Owing to the isotope effect, HC-1119 has many advantages over enzalutamide, including slow metabolism, high plasma concentration and low brain exposure. However, the efficacy of HC-1119 in inhibition of AR function in triple-negative breast cancer (TNBC) has not been studied. In this study, we found high-level AR expression in both Hs578T and SUM159PT TNBC cell lines. Activation of AR by dihydrotestosterone (DHT) in both cell lines increased AR protein, induced AR-nuclear localization, enhanced cell migration and invasion in culture, and promoted liver metastasis in mice. Importantly, cotreatment with HC-1119 of these cells efficiently abolished all of these effects of DHT on both Hs578T and SUM159PT cells. These results indicate that HC-1119 is a very effective new second-generation AR antagonist that can inhibit the migration, invasion and metastasis of the AR-positive TNBC cells.
Safety, tolerability and acceptability of Lactobacillus crispatus CTV-05 (LACTIN-V) in pregnant women at high-risk of preterm birth
Authors: Bayar Erna , MacIntyre David A , Sykes Lynne , Mountain Katie , Lee Yun , Parks Thomas P , Lee Peter P , Bennett Phillip R 
Published: March 2022

Abstract
BackgroundThe vaginal microbiota is a determinant for the risk of preterm birth (PTB). Dominance of the vaginal niche by Lactobacillus crispatus associates with term delivery. Vaginal administration of Lactobacillus crispatus as a live biotherapeutic in non-pregnant women leads to colonisation and reduced recurrence of bacterial vaginosis and urinary tract infections. This is a first in-pregnancy observational clinical study of live vaginal biotherapeutics (Lactobacillus crispatus CTV-05 (LACTIN-V, Osel)) in a cohort of pregnant women at high-risk of PTB. The primary aim was to explore safety, tolerability and acceptability of LACTIN-V in pregnancy. MethodsPregnant women at high-risk of PTB were offered a course of LACTIN-V at 14 weeks gestation for 5 consecutive days followed by weekly administration for 6 weeks. Participants were followed up at 15, 18-, 20-, 28- and 36-weeks’ gestation and at delivery for assessment of adverse events, compliance, and tolerance. After study completion, women completed a questionnaire to gauge experience and acceptability. Assessment of adverse events was performed in those women completing LACTIN-V therapy and those who commenced LACTIN-V but later withdrew from the study.ResultsA total of 73 women were recruited, of whom 8 withdrew, leaving a final cohort size of 61. Overall patient reported compliance to the full course was high (56/60, 93%). Solicited adverse events were reported in 13 women (19%) including changes in vaginal discharge, odour, colour or consistency of urine, itching and vaginal bleeding. One unsolicited adverse event was reported as haematuria at 38 weeks gestation, but was not judged to be related to LACTIN-V and no serious adverse events occurred. One mild adverse event led to withdrawal from the study. A total of 31 women completed an experience and acceptability questionnaire. Women found LACTIN-V easy and comfortable to use and the majority (30/31, 97%) stated they would use LACTIN-V in future pregnancies. Eight women (8/31, 26%) reported that the schedule of use was difficult to remember. The rate of early PTB <34 weeks in this cohort was 3.3% compared to 7% in a historical cohort of 2190 women at similar background PTB risk.ConclusionsWith satisfactory uptake and good compliance, we demonstrate that LACTIN-V is safe and well accepted in pregnancy, with high tolerability. Further studies are needed to assess rates of Lactobacillus crispatus CTV-05 colonisation and clinical efficacy. Trial RegistrationThe trial is registered at www.clinicaltrials.gov (NCT03992534). Date of registration was June 20, 2019