bluuebunny/crossref_metadata_2025 huggingface dataset:
Aberrant choroid plexus formation drives the development of treatment-related brain toxicity
Authors: Bender Tamara , Schickel Esther , Schielke Celine , Debus Jürgen , Grosshans David R. , Durante Marco , Schroeder Insa S.
Published: February 2025

Brain tumors are commonly treated with radiotherapy, but the efficacy of the treatment is limited by its toxicity to the normal tissue including post-irradiation contrast enhanced lesions often linked to necrosis. The poorly understood mechanisms behind such brain lesions were studied using cerebral organoids. Here we show that irradiation of such organoids leads to dose-dependent growth retardation and formation of liquid-filled cavities but is not correlated with necrosis. Instead, the radiation-induced changes comprise of an enhancement of cortical hem markers, altered neuroepithelial stem cell differentiation, and an increase of ZO1+/AQP1+/CLDN3+-choroid plexus (CP)-like structures accompanied by an upregulation of IGF2 mRNA, known to be expressed in CP and cerebrospinal fluid. The altered differentiation is attributed to changes in the WNT/BMP signaling pathways. We conclude that aberrant CP formation can be involved in radiation-induced brain lesions providing additional strategies for possible countermeasures.
Predicted action-effects shape action representation through pre-activation of alpha oscillations
Authors: Wang Xin , Chen Shitao , Wang Keyang , Cao Liyu
Published: February 2025

Actions are typically accompanied by sensory feedback (or action-effects). Action-effects, in turn, influence the action. Theoretical accounts of action control assume a pre-activation of action-effects prior to action execution. Here we show that when participants were asked to report the time of their voluntary keypress using the position of a fast-rotating clock hand, a predictable action-effect (i.e. a 250 ms delayed sound after keypress) led to a shift of visuospatial attention towards the clock hand position of action-effect onset, thus demonstrating an influence of action-effects on action representation. Importantly, the attention shift occurred about 1 second before the action execution, which was further preceded and predicted by a lateralisation of alpha oscillations in the visual cortex. Our results indicate that when the spatial location is the key feature of action-effects, the neural implementation of the action-effect pre-activation is achieved through alpha lateralisation.
Spin polarised quantised transport via one-dimensional nanowire-graphene contacts
Authors: Burrow Daniel , Toscano-Figueroa Jesus C. , Guarochico-Moreira Victor H. , Omari Khalid , Grigorieva Irina V. , Thomson Thomas , Vera-Marun Ivan J.
Published: February 2025

Graphene spintronics offers a promising route to achieve low power 2D electronics for next generation classical and quantum computation. As device length scales are reduced to the limit of the electron mean free path, the transport mechanism crosses over to the ballistic regime. However, ballistic transport has yet to be shown in a graphene spintronic device, a necessary step towards realising ballistic spintronics. Here, we report ballistic injection of spin polarised carriers via one-dimensional contacts between magnetic nanowires and a high mobility graphene channel. The nanowire-graphene interface defines an effective constriction that confines charge carriers over a length scale smaller than that of their mean free path. This is evidenced by the observation of quantised conductance through the contacts with no applied magnetic field and a transition into the quantum Hall regime with increasing field strength. These effects occur in the absence of any constriction in the graphene itself and occur across several devices with transmission probability in the range T = 0.08 − 0.30.
Resolving the fundamentals of the J-integral concept by multi-method in situ nanoscale stress-strain mapping
Authors: Meindlhumer Michael , Alfreider Markus , Sheshi Noel , Hohenwarter Anton , Todt Juraj , Rosenthal Martin , Burghammer Manfred , Salvati Enrico , Keckes Jozef , Kiener Daniel
Published: February 2025

The integrity of structural materials is oftentimes defined by their resistance against catastrophic failure through dissipative plastic processes at the crack tip, commonly quantified by the J-integral concept. However, to date the experimental stress and strain fields necessary to quantify the J-integral associated with local crack propagation in its original integral form were inaccessible. Here, we present a multi-method nanoscale strain- and stress-mapping surrounding a growing crack tip in two identical miniaturized fracture specimens made from a nanocrystalline FeCrMnNiCo high-entropy alloy. The respective samples were tested in situ in a scanning electron microscope and a synchrotron X-ray nanodiffraction setup, with detailed analyzes of loading states during elastic loading, crack tip blunting and general yielding, corroborated by a detailed elastic-plastic finite element model. This complementary in situ methodology uniquely enabled a detailed quantification of the J-integral along different integration paths from experimental nanoscale stress and strain fields. We find that conventional linear-elastic and elastic-plastic models, typically used to interpret fracture phenomena, have limited applicability at micron to nanoscale distances from propagating cracks. This for the first time unravels a limit to the path-independence of the J-integral, which has significant implications in the development and assessment of modern damage-tolerant materials and microstructures.
Heteroresistance in Enterobacter cloacae complex caused by variation in transient gene amplification events
Authors: Kupke Johannes , Brombach Julian , Fang Yuwen , Wolf Silver A. , Thrukonda Lakshmipriya , Ghazisaeedi Fereshteh , Kuropka Benno , Hanke Dennis , Semmler Torsten , Nordholt Niclas , Schreiber Frank , Tedin Karsten , Lübke-Becker Antina , Steiner Ulrich K. , Fulde Marcus
Published: February 2025

Heteroresistance (HR) in bacteria describes a subpopulational phenomenon of antibiotic resistant cells of a generally susceptible population. Here, we investigated the molecular mechanisms and phenotypic characteristics underlying HR to ceftazidime (CAZ) in a clinical Enterobacter cloacae complex strain (ECC). We identified a plasmid-borne gene duplication-amplification (GDA) event of a region harbouring an ampC gene encoding a β-lactamase bla
DHA-1 as the key determinant of HR. Individual colonies exhibited variations in the copy number of the genes resulting in resistance level variation which correlated with growth onset (lag times) and growth rates in the presence of CAZ. GDA copy number heterogeneity occurred within single resistant colonies, demonstrating heterogeneity of GDA on the single-cell level. The interdependence between GDA, lag time and antibiotic treatment and the strong plasticity underlying HR underlines the high risk for misdetection of antimicrobial HR and subsequent treatment failure.
Hydrodeoxygenation of oleic acid over NiCu bimetallic catalysts supported on Mo-modified niobium phosphate
Authors: Wei Ruiping , Yao Mingzhu , Wang Ziqi , Liu Huijun , Xia Rongying , Yang Lei , Ma Guanghui , Gao Lijing , Pan Xiaomei , Xiao Guomin
Published: February 2025

The present study involves the synthesis of a series of Mo-modified NbOPO4 supports, which were subsequently utilized for the preparation of supported NiCu bimetallic catalysts via a hydrothermal method.
t
BuOK-Mediated Selective 1,2-Silacarboxylation of Arylalkenes with Si-B/Si-Si/Si-Li Reagents and CO2
Authors: Gao Liuzhou , Meng Linghui , Wen Yan , Hu Jingyi , Sun Yuxin , Wang Shenglong , Wang Guoqiang , Wang Yidong
Published: February 2025

An operationally simple base-mediated silylacarboxylation of arylalkenes is developed to synthesize valuable β-silyl functionalized phenylacetic acid derivatives utilizing carbon dioxide and silanion reagents. The protocol is applicable to diversified sets...
Chemoselective transition-metal-free acylation of thioamides by N–C(S) bond cleavage using acyclic twisted thioamides
Authors: Zhang Jin , He Yang , Zhu Xinhao , Guo Yan , Wang Xiaogang , Wang Ruihong , Szostak Michal
Published: February 2025

A new method for chemoselective transition-metal-free acylation of thioamides with ketones by N–C(S) bond cleavage is reported.
Transition-metal-free synthesis of C3,5-difunctionalized oxindole derivatives
Authors: Liu Yifeng , Zhang Pengyan , Feng Liangjie , Zhang Zhuan , Liang Taoyuan
Published: February 2025

A new one-pot iodine and Selectfluor co-catalyzed oxidative difunctionalization and fluorooxidation reaction has been developed, which provides an effective route to synthesize a variety of C3-fluoro-C5-azo oxindoles.
Prediction of High Photoconversion Efficiency and Photocatalytic Water Splitting in Vertically Stacked TMD Heterojunctions MX₂/WS₂ and MX₂/MoSe₂ (M = Cr, Mo, W; X= S, Se, Te)
Authors: Ma Jiancheng , Kuang Xiao-Yu , Pang Jiafei , Wanying Xie , Mao Ai-Jie , Yang Jinni
Published: February 2025

Based on two-dimensional (2D) transition metal dichalcogenides (TMDs) exhibiting strong light-matter interactions and spin-valley locking properties, we construct two types of MX2/WS2 and MX2/MoSe2 (M=Cr, Mo, W, and X=S, Se,...
A discrete platinum(ii)-metallacycle with enhanced red emission for imaging-guided synergistic cancer photothermal-chemotherapy
Authors: Liu Tianying , Meng Yujia , Liang Xufeng , Zhang Jianxia , Yu Wenqiang , Cheng Yushan , Zhou Yao , Wang Haotian , Duan Hui , Zou Jiaye , Bai Yiqiao , Chen Huanren , Han Ying , Yao Yong
Published: February 2025

A discrete Pt(ii)-metallacycle with PPy and 90° Pt(ii) (Pt) as building blocks was constructed via “coordination-driven self-assembly”, which showed enhanced red emission in water and can be applied in imaging-guided cancer photothermal-chemotherapy.
An Inhomogeneously‐Loaded Diaphragm in a Microwave Rectangular Waveguide
Authors: Haddab Abdulaziz H. , Kuester Edward F.
Published: February 2025

This paper demonstrates a method to control the resonant transmission due to Fabry–Perot and Fano resonances through a dielectric‐loaded slot in a thick conducting diaphragm embedded in a rectangular waveguide. It is shown that the location of these resonances can be controlled by introducing a gap of a different dielectric constant in the middle of the slot. The two kinds of resonances are adjusted to overlap, forming a complex behaviour with potential applications as a bandpass filter with a relatively narrow notch in the passband response. The theoretical projections are confirmed through both full‐wave numerical simulations and experimental measurements. A new fabrication approach was used to overcome the shortcomings in construction that caused some discrepancies with the theory in a previous study.
Design and control of isolated current‐fed DC–DC converters for fuel cell stacks EIS incorporating wide‐frequency‐range of perturbations
Authors: Shen Jiabin , Wang Jiacheng
Published: February 2025

Electrochemical impedance spectroscopy (EIS) performed by power converters makes in situ diagnostics possible for fuel cell stacks (FCS) in end applications without displacing and dismantling the stack. Previously published solutions, however, fall short of adequately generating a wide frequency range of perturbations covering all internal information of an FCS. The practical challenges and limitations of achieving converter generated perturbations at various frequencies are revealed in this paper. The high‐end frequencies are constrained by the converter control bandwidth, whereas the low‐end ones may cause significant ripples on the converter output. To address these issues, this paper proposes the use of isolated current‐fed DC–DC converters for the design of an FCS power converter considering the output characteristics of the FCS operating at desired conditions and incorporating wide‐frequency‐range of EIS perturbations. Moreover, the oscillations resulting from EIS operations are tackled by properly guiding them from the load side to a primary side energy storage. A fuel‐cell‐dedicated power conditioning converter capable of presenting a wide‐range frequencies of EIS perturbations is thus achieved. A design case is presented, and its simulation and experimental results verify the effectiveness of the proposed solution.
WaveMic: Speech recognition of Chinese digit numbers from radio signals
Authors: Lan Shengchang , Yang Changhao , Liu Beijia , Chen Juwen
Published: February 2025

In recent years, the use of millimetre wave radio signals for speech recognition has rapidly developed. The absence of high‐frequency components resulting from the material vibration constraints of fully viewed indoor objects has undermined the recognition accuracy in this field. This paper presents a new solution to the Chinese digits speech recognition problem by reconstructing the high‐frequency harmonic and non‐harmonic components with the radio signals received by millimetre wave radar sensors. A time–frequency analysis was conducted to convert the phase variations extracted from the radar I/Q signals to spectrograms. An improved threshold strategy was used to enhance the harmonic components on the spectrogram. Subsequently, a CycleGAN‐based network was constructed to recover non‐harmonic components on the spectrograms. An evaluation experiment was performed with a 77‐GHz frequency modulated continuous wave radar sensor to use the induced vibrations of aluminium foils, glass, and anti‐static bags to recognise the speeches of standard Chinese digit numbers (0–9). The F1 score in the speech recognition experiment reached 96.6%, with a micro average accuracy exceeding 98.3%. These results show that the proposed method can improve recognition accuracy by generating finer signatures from radio signals.
VA-ECMO-assistierte Reanimation beim refraktären Herz-Kreislauf-Stillstand
Authors: Kriz Marvin , Schrage Benedikt
Published: February 2025

Was ist neu?

Eine Metaanalyse von Low et al. (2023) zeigt, dass die extrakorporale kardiopulmonale Reanimation (ECPR) gegenüber der konventionellen kardiopulmonalen Reanimation (CCPR) mit einer signifikant höheren Überlebensrate assoziiert ist. Darüber hinaus zeigten sich verbesserte neurologische Langzeitergebnisse innerhalb der ersten 90 Tage nach Verwendung der ECPR. Zudem reduziert ein höheres Zentrumsvolumen die Sterblichkeitswahrscheinlichkeit, was die Bedeutung erfahrener, spezialisierter Zentren unterstreicht.

Die Metaanalyse von Low et al. (2023) zeigt, dass ECPR bei einem IHCA vorteilhaft sein kann. Im Vergleich zur CCPR wurde bei IHCA eine signifikante Reduktion der Krankenhausmortalität mit ECPR festgestellt (OR 0,42). In der aktualisierten Metaanalyse von Low et al. (2024) konnte auch für einen OHCA eine Sterblichkeitsreduktion nachgewiesen werden (OR 0,67), was die potenzielle Wirksamkeit von ECPR in beiden Szenarien unterstreicht.

Eine Studie von Okada et al. (2023) verdeutlicht, dass eine schnellere Kanülierung entscheidend für den Erfolg der ECPR ist. In Japan erfolgt die Kanülierung häufig in der Notaufnahme statt im Operationssaal, was die Low-Flow-Zeit bis zum Beginn der ECPR verkürzt, das Risiko von Multi-Organversagen und Hirnschäden verringert und zu besseren Überlebenschancen führt.

Der mobile Einsatz einer VA-ECMO (venoarterielle extrakorporale Membran-Oxygenierung) kann in ländlichen Regionen sinnvoll sein, wobei die richtige Auswahl der Patient*innen wichtig ist. Optimierte Algorithmen zur Vermeidung von „Post-Reperfusionsschäden“ könnten das Outcome verbessern.
Zöliakie: Neue pharmakologische Therapien
Authors: Schuppan Detlef , Neufang Sibylle , Wanger Beate
Published: February 2025

Was ist neu?

Trotz der glutenfreien Diät leiden 30–50% der diagnostizierten Betroffenen weiterhin an Beschwerden – mit Zeichen der Entzündung, u.a. wegen unvermeidbarer minimaler Gluten-Kontaminationen im Alltag.

Vielversprechende therapeutische Ansätze sind zurzeit in klinischer Phase-2-Entwicklung, u.a. ein Hemmstoff der intestinalen TG2, blockierende Antikörper gegen Interleukin-15 oder Ox40-Ligand, die Verbesserung der intestinalen Barriere mittels eines Sirtuin-6-Agonisten, sowie nanopartikuläre Therapien, die über Adressierung der Milz oder Leber eine Toleranz gegenüber Gluten induzieren können.
Update zu COPD und kardiovaskulären Ereignissen
Authors: Leitner Maximilian , Blum Anna Maria , Bals Robert
Published: February 2025

Was ist neu?

COPD (chronisch-obstruktive Lungenerkrankung) ist eng mit kardiovaskulären Erkrankungen assoziiert. Koexistieren COPD und Herz-Kreislauf-Erkrankungen, steigen Hospitalisierungsrate, Symptomlast, die Gefahr schwerer kardiovaskulärer Ereignisse sowie die Gesamtmortalität an.

Das Risiko kardiovaskulärer Ereignisse steigt während und kurze Zeit nach einer Exazerbation an. Schwere Exazerbationen stellen das höchste Risiko bezüglich kardiovaskulärer Ereignisse dar.

Die Mechanismen, die beide Krankheitskomplexe verbinden, sind komplex und schließen eine systemische Entzündung, oxidativen Stress, endotheliale Dysfunktion, autonome Dysregulation und Hypoxämie mit ein.

COPD-Patienten sollen leitliniengerecht therapiert werden. In Bezug auf das kardiovaskuläre Risikoprofil gibt es keine zu bevorzugende Therapiekombination.

Ein frühes Screening und die konsequente Einstellung kardiovaskulärer Risikofaktoren sind von zentraler Bedeutung. Die leitliniengerechte Behandlung der COPD hat einen positiven Effekt auf kardiovaskuläre Endpunkte. Auch die Behandlung von kardiovaskulären Erkrankungen mit Statinen, Betablockern und ggf. SGLT-2-Hemmern kann positive Auswirkungen auf den Verlauf einer COPD haben. Akute Exazerbationen einer COPD (AEOPD) sind während der Erkrankung und danach mit einem deutlich erhöhten kardiovaskulären Risiko assoziiert, sodass die davon betroffenen Patienten diesbezüglich evaluiert werden sollten.
Protein-Energie-Malnutrition im Alter
Authors: Wirth Rainer , Pourhassan Maryam , Volkert Dorothee
Published: February 2025

Was ist neu?

Appetitverlust und die damit verbundene Reduktion der Nahrungsaufnahme ist Teil eines typischen Reaktionsmusters, das bei vielen akuten und chronischen Erkrankungen aktiviert wird. Während dieses als „sickness behaviour“ beschriebene Verhaltensmuster wahrscheinlich früher einen evolutionären Vorteil für die Spezies darstellte, stehen in unserer alternden Gesellschaft heute eher die gesundheitlichen Kollateralschäden der daraus entstehenden Malnutrition im Vordergrund.

Vor wenigen Jahren hat sich die „Global Leadership Initiative on Malnutrition“ (GLIM) auf weltweit einheitliche Diagnosekriterien für die Protein-Energie-Malnutrition geeinigt, die inzwischen zunehmend Anwendung in Klinik und Forschung finden.

Neben dem o.g. Verhaltensmuster, das wesentlich durch Inflammation getriggert wird, können zahlreiche andere Faktoren zur Malnutrition beitragen. Bezogen auf ältere Menschen reicht das Spektrum vom Malignom bis zum Versorgungsdefizit bei funktionell beeinträchtigten Menschen. Häufig spielen mehrere Faktoren eine Rolle. Die zahlreichen Faktoren, die potenziell beteiligt sein können, wurden im sog. DoMAP-Modell zusammengefasst.

Malnutrition hat vielfältige Folgen, da alle Organsysteme für eine adäquate Funktion und Struktur ausreichend Nährstoffe und Energie benötigen. Insbesondere die Muskulatur und das Immunsystem werden durch eine unzureichende Energie- und Proteinaufnahme stark beeinträchtigt, weshalb Muskelatrophie und Sarkopenie, Infektanfälligkeit und Wundheilungsstörungen zu den wichtigsten Folgen der Malnutrition gehören.

Die günstigen Effekte einer adäquaten Ernährungstherapie wurden in Metaanalysen und evidenzbasierten Leitlinien zusammengefasst. Trotzdem ist die adäquate Therapie der krankheitsbedingten Malnutrition in unserem Gesundheitssystem leider eher die Ausnahme. Spätestens die sog. EFFORT-Studie hat als große randomisierte kontrollierte Studie eindrucksvoll zeigen können, wie effektiv ein strukturiertes und individualisiertes Ernährungsmanagement für mangelernährte Krankenhaus-Patienten ist.

Der individuelle Therapieerfolg sollte durch ein regelmäßiges Monitoring der Nahrungsaufnahme und des Körpergewichts erfolgen. Patienten mit ausgeprägter Malnutrition benötigen nach Beginn der Ernährungstherapie zusätzlich ein Elektrolyt-Monitoring, um die Entwicklung eines Refeeding-Syndroms nicht zu übersehen.
Lymphödem
Authors: Mühlberg Katja Sibylle
Published: February 2025

Was ist neu?

Der Verzicht auf Kompression in der Therapie chronischer Extremitäten-Lymphödeme steigert das Risiko erysipelbedingter Komplikationen und führt zu einer hohen gesundheitsökonomischen Belastung. Nächtliche Kompressionsverfahren zeigen Vorteile und eine hohe Therapieadhärenz.

Aufgehoben wurde die Empfehlung, bei Erysipel auf Kompression zu verzichten. Im Gegenteil, Kompression ist explizit erwünscht.

Lymphödembetroffene Extremitäten zeigen im Vergleich zu nicht betroffenen Extremitäten eine starke Assoziation zu malignen Hauttumoren.

Mittels ICG-Lymphografie wurden 4 verschiedene anatomische Lymphbahnregionen am Bein differenziert, deren funktioneller Ausfall je nach betroffenem Bündel mit dem Schweregrad des Lymphödems korreliert.

Dem vaskularisierten Lymphknotentransfer wurde bezüglich Volumenreduktion, Funktionalität und Lebensqualität hinreichend Evidenz bescheinigt.

Je höher der BMI, umso höher das Risiko für Lymphödeme.

Metaanalysen belegen den Nutzen eines aktiven Lebensstils mit Bewegung und sportlichen Aktivitäten, in Einheit mit umfassender Patientenedukation. Tragbare apparative Kompressionssysteme sind eine vielversprechende Alternative zu bisherigen pneumatischen Kompressionsapparaten.

Das St.-George’s-Klassifikationssystem zeigt erstmals umfassend Zusammenhänge zwischen primären Lymphödemen und systemischen bzw. syndromalen Erkrankungen sowie vaskulären Malformationen. Als „Work-in-progress“-Algorithmus ist es eine wertvolle Hilfe zur Diagnosesicherung und um therapeutische Ansätze zu finden. Klassifikationen, die sich an der zeitlichen Manifestierung primärer Lymphödeme orientieren, wurden verlassen.
Human-Centered Design and Iterative Refinement of Tools and Methods to Implement a Surveillance and Risk Prediction System for Clinical Deterioration in Ambulatory Cancer Care
Authors: France Daniel J. , Nath Paromita , Slagle Jason , Anders Shilo , Salwei Megan , Vogus Timothy , Slater Hannah , Reale Carrie , Novak Laurie , Parker-Danley Lori-Anne , Kohutek Zachary , Agarwal Rajiv , Harris Joyce , Yudiskas Barbara , Conwill Ralph , Smith Terrell , Rhodes Evan , Schremp Emma , Gillaspie Erin A. , Wright Adam , Freundlich Robert E. , Myles Ryan , Faiman Janelle , Mahadevan Sankaran , Weinger Matthew
Published: February 2025

Background A common cause of preventable harm is the failure to detect and appropriately respond to clinical deterioration. Timely intervention is needed, particularly in medically complex patients, to mitigate the effects of adverse events, disease progression, and medical error. This challenging problem requires clinical surveillance, early recognition, timely notification of the appropriate clinicians, and effective intervention.

Objectives We determined the feasibility of designing, developing, and implementing the tools and processes to create a surveillance-and-risk prediction system to detect clinical deterioration in cancer outpatients.

Methods We used systems engineering and iterative human-centered design to develop a functional prototype of a surveillance-and-risk prediction system. The system includes passive surveillance involving wearable sensors, active surveillance involving patient event and symptom reporting as well as extraction of selected patient data from the electronic health record (EHR), a predictive model, and communication of estimated risk to clinicians. System usability was evaluated using patient and clinician interviews and clinician ratings using the System Usability Scale (SUS).

Results Fifty of 71 recruited patients enrolled in the feasibility study. Patient-reported outcome measures and clinical data extracted from the EHR were the best predictors of a patient's 7-day risk of experiencing unplanned treatment events (UTEs, i.e., emergency room visits, hospital admissions, or major treatment changes). Deep learning neural network models using these predictors demonstrated modest performance in predicting 7-day UTE risk (PROMS, F-measure: 0.900, area under the receiver operating characteristic curve [AUC-ROC]: 0.983; clinical data from EHR F-measure: 0.625, AUC-ROC: 0.983). Patient risk scores were communicated to clinicians using a risk communication prototype rated favorably by clinicians with a SUS score of 76 out of 100 (median = 80; range: 60–85).

Conclusion We demonstrate the feasibility of a surveillance-and-risk prediction system for detecting and reporting clinical deterioration in cancer outpatients. Future research is needed to fully implement and evaluate system adoption and effectiveness under different clinical situations.
Outcome of Arthroscopic Dorsal Peripheral Repairs of the Triangular Fibrocartilage with a Positive Hook Test and an Intact Foveal Ligament
Authors: Ecker Jeff , Pavleski Karolina , de Jong Jess , Jones Zoe , Andrijich Courtney
Published: February 2025

Background This study was performed to determine whether an arthroscopic dorsal peripheral triangular fibrocartilage complex (TFCC) repair can stabilize symptomatic distal radioulnar joint (DRUJ) instability in patients with a positive hook test, an intact foveal insertion, and a dorsal peripheral detachment of the TFCC.

Materials and Methods All patients who had an isolated arthroscopic dorsal peripheral TFCC repair performed by the primary author between August 2018 and April 2023 were included in the study. Functional measures of range of motion (ROM), gross grip, lateral pinch, force plate, pronation strength, supination strength, visual analogue scale (VAS) at rest, VAS on use, patient rated wrist evaluation (PRWE), and disabilities of the arm, shoulder, and hand (DASH) were recorded pre- and postoperatively.

Results For this study 31 patients met the inclusion criteria. Measures taken at a mean of 13.8 months post-surgery demonstrated improvement in all functional parameters, with the exception of ulnar deviation and pronation which remained unchanged. Resolution of symptomatic DRUJ instability was documented in all cases. There were no cases of recurrent instability. There were no complications.

Conclusions Arthroscopic dorsal TFCC repair can successfully resolve symptomatic DRUJ instability in patients with a positive hook test, a dorsal peripheral detachment of the TFCC, and an intact foveal insertion.

Level of Evidence I-4
The Effect of Episiotomy Applied in Vaginal Delivery on Breastfeeding
Self-Efficacy and Mother-Infant Attachment in the Postpartum
Period
Authors: Yılmaz Esencan Tuğba , Yıldırım Ayça Demir , Yıldız Mehtap
Published: February 2025

Objective  The aim of this study was to examine the effect of episiotomy
applied in vaginal delivery on breastfeeding self-efficacy and mother-infant
attachment in the postpartum period.

Methods  This descriptive study includes 110 puerperal women who were
registered in 3 family health centers in a district in Istanbul between July and
December 2022 and had a vaginal delivery. Data was collected using a descriptive
information form, maternal bonding scale and postpartum breastfeeding
self-efficacy scale.

Results  The mean age of the participants was 30.04±5.13 years. 61.9% of
the puerperal women were multiparous, the mean gestational age at delivery was
39±1.21 weeks, and 72.7% had an episiotomy at delivery. There was a
statistically significant correlation between the number of deliveries, having
problems during labor, and episiotomy application (p=0.005, p=0.044). There was
no statistically significant difference between the maternal bonding scale
scores and postpartumbreastfeeding self-efficacy scale scores of women who
underwent episiotomy at delivery and women who did not.

Conclusion  Episiotomy alone had no effect on maternal bonding and
postpartum breastfeeding self-efficacy, and episiotomy-induced pain was found to
be an effective factor in the postpartum period.
Outcomes of Retained Gastrointestinal Debris During Upper Endoscopy
Authors: Jacob Jake Sheraj , Than Jeffrey , Tang Christine , Cano Joseph , Sheikh Rehman , Wolfson Sharon , Thrift Aaron P. , Munnur Uma , Sealock Robert J.
Published: February 2025

Background
Gastrointestinal debris retention (GIDR) during endoscopy can result in aborted procedures, intubation, and aspiration. GIDR has increased significance with the uptake of Glucagon-like peptide-1 receptor agonist (GLP-1RA) use. Outcome analysis is vital to risk-stratify patients with GIDR during endoscopy. Our study evaluates the effect of GIDR on endoscopic complications.
Methods
This is a retrospective review of patients who underwent endoscopy between May 2016 and December 2021 with documented GIDR. The study included 138 patients with GIDR and 275 controls. Propensity score matching between patients with GIDR and controls was performed in a 1:2 ratio based on age, sex, body mass index (BMI), and American Society of Anesthesiologists (ASA) status. T-tests and chi square tests were used to compare continuous and categorical variables.
Results
The GIDR group had a lower age and BMI, with no difference in sex, race, ASA status, or use of monitored anesthesia care (MAC). GIDR was more frequently encountered when indications were abnormal imaging, pain, and pancreatico-biliary. Amount of GIDR was quantified as “large” in 37.7% of cases, and size of debris was associated with rate of aborted procedures.
Conclusion
Our study did not demonstrate a significant increase in the post-procedural complications in patients with GIDR. Further, the GIDR group had higher rates of opiate use which can guide stratification of retention risk.
Internal traction in endoscopic full-thickness resection for gastric subepithelial lesions arising from the muscularis propria: a comparative study
Authors: Li Jun , Hou Xiaojia , Chen Kan , Peng Kangsheng , Huang Chao , Liu Feng
Published: February 2025

Background: Effective tissue traction is crucial for gastric endoscopic full-thickness resection (EFTR) to ensure a clear visual field for the dissection site. We aim to evaluate the effectiveness of internal traction using a novel clip-with-spring device in assisting gastric EFTR.
Patients: A total of 26 patients with gastric subepithelial lesions from the muscularis propria were enrolled for internal traction-assisted EFTR (IT-EFTR) and other 26 patients for non-assisted EFTR (NA-EFTR) were enrolled as controls.
Results: The average tumor size was 1.5 ± 0.4 cm. All EFTRs were completed successfully with an average total procedure time of 62.4 ± 43.0 min and perforation time of 37.2 ± 29.9 min. En bloc resection was achieved in 50 patients (96.2%). IT-EFTR significantly improved the serosa exposure score (3.4 ± 0.9 vs. 1.9 ± 0.7, P < 0.001) and shortened the total procedure time (33.0 ± 21.8 vs. 91.8 ± 38.6 min, P < 0.001) and the perforation time (19.0 ± 18.8 vs. 55.5 ± 27.8 min, P < 0.001), when compared with NA-EFTR; The complication rates had no significant difference between the two groups. However, the visual analogue score after operation was significantly lower (4.2 ± 1.0 vs. 4.7 ± 0.7, P = 0.037) and the postoperative hospital stay (3.7 ± 2.1 vs. 4.8 ± 1.3, P = 0.038) was significantly shorter in patients of IT-ERTR group than that of NA-EFTR group.
Conclusions: Internal traction using the novel clip-with-spring device could significantly improve the safety and efficacy of gastric EFTR in the distal stomach.
Conventional small-bowel capsule endoscopy reading versus proprietary artificial intelligence auxiliary systems:a systematic review with meta-analysis
Authors: Cortegoso Valdivia Pablo , Fantasia Stefano , Kayali Stefano , Deding Ulrik , Gualandi Noemi , Manno Mauro , Toth Ervin , Dray Xavier , Yang Shiming , Koulaouzidis Anastasios
Published: February 2025

Background: Small-bowel capsule endoscopy (SBCE) is the gold standard for diagnosing small bowel (SB) pathologies, but its time-consuming nature and potential for human error make it challenging. Several proprietary artificial intelligence (AI) auxiliary systems, based on convolutional neural networks (CNN) and integrated into SBCE reading platforms, are available on the market and offer the opportunity to improve lesion detection and reduce reading times. This meta-analysis aims to evaluate the performance of proprietary AI auxiliary platforms in SBCE compared to conventional, human-only reading.
Methods: A systematic literature search was conducted to identify studies comparing AI-assisted SBCE readings to conventional readings by gastroenterologists. Performance measures such as accuracy, sensitivity, specificity, and reading times were extracted and analyzed. The methodological transparency was assessed using the Methodological Index for Non-randomized Studies (MINORS) assessment tool.
Results: Of 669 identified studies, 104 met the inclusion criteria and 6 were included in the analysis. The quality assessment revealed high methodological transparency for all included studies. The pooled analysis showed that AI-assisted reading achieved significantly higher sensitivity and comparable specificity to conventional reading, with a higher log diagnostic odds ratio and no substantial heterogeneity. Additionally, AI integration substantially reduced in reading times, with a mean decrease of 12-fold compared to conventional reading.
Conclusions: AI-assisted SBCE reading outperforms conventional human review in terms of detection accuracy and sensitivity, remarkably reducing reading times. AI in this setting could be a game-changer in reducing endoscopy services' workload and supporting novice readers' training.
Comparison of traction vs. snare as rescue methods for challenging colorectal endoscopic submucosal dissection: A propensity score-matched study
Authors: Takahashi Keitaro , Iwama Takuya , Tanaka Kazuyuki , Miyazawa Yuki , Kuroda Shohei , Horiuchi Masashi , Saito Seisuke , Muto Momotaro , Ando Katsuyoshi , Ueno Nobuhiro , Kashima Shin , Moriichi Kentaro , Tanabe Hiroki , Fujiya Mikihiro
Published: February 2025

Background: To address the challenges of difficult colorectal endoscopic submucosal dissection (ESD), conversion to snare resection (rescue-snare ESD: rSnare), a variant of hybrid ESD, is commonly proposed. However, rSnare is associated with a lower en bloc resection rate compared to conventional ESD. Traction-assisted ESD has emerged as a technique to facilitate dissection, but its effectiveness as a rescue method remains unclear. This study is the first to compare the effectiveness of rSnare and rescue-traction-assisted ESD (rTraction).
Methods: This retrospective study involved 1464 consecutive lesions from 1372 patients with superficial colorectal neoplasms across eight institutions. Among these, 162 lesions required rescue methods of rSnare or rTraction. After propensity score matching, 88 lesions treated with either rSnare or rTraction were analyzed.
Results: The rTraction group exhibited significantly higher en bloc resection and R0 resection rates (93.2% and 77.3%, respectively) compared to the rSnare group (45.5% and 38.6%, respectively). However, the average procedure time was significantly longer in the rTraction group (122.3 ± 72.5 min) compared to the rSnare group (92.2 ± 54.2 min). In the rTraction group, univariable and multivariable analyses identified traction initiation time >75 minutes as the only independent predictor of procedure durations exceeding 120 minutes.
Conclusions: Utilizing a traction device as a rescue technique in difficult colorectal ESD resulted in higher en bloc and R0 resection rates compared to conversion to snare resection. Initiating traction within 75 minutes may contribute to reducing the overall procedure time for challenging colorectal ESD cases.
Impact of Endoscopic Ultrasound-guided biliary drainage on the management of difficult biliary cannulation in patients with distal malignant biliary obstruction
Authors: Spadaccini Marco , Binda Cecilia , Mauro Aurelio , Legros Romain , Colombo Matteo , Giacchetto Carmelo Marco , Andreozzi Marta , Carrara Silvia , Ramai Daryl , Albouys Jérémie , Mazza Stefano , Coluccio Chiara , Facciorusso Antonio , Fabbri Carlo , Anderloni Andrea , Hassan Cesare , Jacques Jeremie , Repici Alessandro , Fugazza Alessandro
Published: February 2025

Background: Biliary drainage (BD) in patients with distal malignant biliary obstruction (DMBO) implies a higher risk of difficult biliary cannulation (DBC) during endoscopic retrograde cholangiopancreatography (ERCP). After standard cannulation failure, the endoscopist may proceed with advanced cannulation techniques and/or, with endoscopic ultrasound-guided biliary drainage (EUS-BD).
Materials: This was a retrospective study of consecutive patients with DMBO and dilated common bile duct (CBD, > 12mm) that underwent ERCP for endoscopic BD in four European centers. The rates of DBC, technical and, clinical success, and procedure-related adverse events (AEs) were assessed. The predictive factors for AEs were also investigated through regression analysis. EUS-BD approach was considered as first option after standard cannulation failure or as final option after advanced cannulation failure.
Results: A total of 1016 patients with DMBO were included in the study, with 524(51.6%) matching the definition of DBC. Clinical success was achieved in 956 cases (94.1%). One-hundred-sixty-seven patients (16,4%) experienced procedural-related AEs. Subjects with DBC showed a higher risk for AEs (p = 0.003), however, patients undergoing “early” EUS-BD showed a risk of AEs comparable to those managed with standard cannulation (p = 0.3776). The attempt of any advanced cannulation technique was independently associated with the occurrence of AEs (p = 0.001).
Conclusions: The risk of AEs is higher in patients with DMBO, and DBC, this appears to be mainly related to the advanced cannulation techniques. In patients with dilated CBD (>12mm) “early” EUS-BD may minimize the risk of adverse events.
Endoscopic Vacuum Therapy for the Management of Non-Variceal Upper Gastrointestinal Bleeding: A Valuable Resource for the Endoscopist’s Toolbox
Authors: Mega Paulo Ferreira , de Moura Eduardo Guimarães Hourneaux , Bestetti Alexandre Moraes , Ramai Daryl , Kumar Atul , Hajjar Ludhmila Abrahão , Thompson Christopher C. , de Moura Diogo Turiani Hourneaux
Published: February 2025

Background and study aims: Endoscopic Vacuum Therapy (EVT) is a well-established method for managing gastrointestinal perforations. During the COVID epidemic, case reports demonstrated the effective use of EVT in controlling COVID related diffuse duodenal bleeding. Due to its unique mechanism of action, this approach may also be effective for other types of Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB). This study aims to assess EVT in the treatment of NVUGIB.
Patients and methods: This retrospective analysis of a prospectively collected database includes patients who underwent EVT for the treatment of NVUGIB. The primary outcome was clinical success. Secondary outcomes included technical success and safety. Subgroup analysis comparing outcomes for patients with and without COVID was conducted.
Results: A total of 19 patients underwent EVT for NVUGIB, with 57.9% having failed other therapies. Technical success occurred in all patients, and clinical success was achieved in 89.5%. There was no difference in clinical success rates between patients with or without COVID (88% versus 91%, respectively). No procedure-related adverse events occurred.
Conclusion: EVT appears to be safe and effective in the management of NVUGIB. This approach could be particularly useful in refractory or diffuse bleeding. Larger studies are warranted to validate these findings.
Analogues of the Potent and Selective ERβ Agonist trans-4-(4-Hydroxyphenyl)cyclohexanemethanol: Synthesis and Evaluation
Authors: Donaldson William A. , Chaudhury Subhabrata , Wetzel Edward A. , Elmansy Mohamed F. , Hanson Alicia M. , Brown-Ford Sandra , Gleason Alexandra , Perera K. L. Iresha Sampathi , Sem Daniel S.
Published: February 2025

Activation of estrogen receptor-beta (ERβ) has potential benefits for vasomotor symptoms as well as memory consolidation in menopausal women. Ten 4-(4-substituted cyclohexyl)phenols were synthesized and evaluated as ERβ agonists in a TR-FRET ligand displacement assay. Four of the more potent compounds, all of which contained fluoroalkyl groups as the 4-substituent, were further assessed for agonist and antagonist activity in cell-based functional assays for ERβ and ERα. The 4-(4-fluoroalkyl-cyclohexyl)phenols were all >50-fold selective for ERβ over ERα, and none were found to be antagonists for either ERβ or ERα at 7,250 nM. Detection of 200 μM of trans-4-(4-(fluoromethyl)cyclohexyl)phenol in the presence of mouse brain homogenate was possible by 19F NMR spectroscopy.
Functional Assessment of Congenital Radioulnar Synostosis in Children
Authors: Moghamis Isam Sami , Abuhejleh Hasan , Abuodeh Yousef , Nasef Hazem Mohamad , Thanaraj Harris Manova , Preez Ilse Du , Kawas Mohamad Alaa
Published: February 2025

Background Congenital radioulnar synostosis (CRUS) is a rare condition caused by segmentation failure in embryonic life. The forearm is usually fixed in pronation, affecting the upper limb and hand functions. Treatment ranges from observation to surgical options to restore limb function and prevent disease recurrence. The study aimed to assess the functional outcome of patients with CRUS.

Methods We conducted a prospective evaluation of eight patients with CRUS between 2010 and 2020. The data involved history, physical examination, and functional assessment using the ABILHAND-Kids functional scale to determine children's adaptation to this deformity and the indication for surgical management. A control sample of four patients was included in the study for comparison.

Results Eight patients with 11 limb deformities were included in the study. The affected limbs' range of motion (ROM) was compared with the ROM of the unaffected limbs and the control patients. There were no statistically significant differences in ROM between the two groups except for fixed pronation deformity of the synostosis (p = 0.0133). The average ABILHAND-Kids score for all children was 38.625 ± 3.021, close to the average score of 42. Only one patient with bilateral involvement underwent surgical correction of the deformity 5 years from the initial presentation.

Conclusion CRUS is a rare congenital condition that can affect daily living activities. Surgical correction is rarely indicated and is only preserved for patients with bilateral involvement and significant functional impairment.
“You will be defeated by a tripod and a camera:” Sedat Peker and the antihero narrative in contemporary politics
Authors: Altınordu Ateş
Published: February 2025

In May and June of 2021, a series of YouTube videos posted by Sedat Peker, a Turkish crime boss, disclosed inside information implicating senior government officials and other public figures in major corruption scandals and crimes. Peker quickly gained popularity and became for the opposition a symbol of the impending fall of the Erdoğan regime. Based on a systematic analysis of these videos and the public debate they engendered, this article argues that the efficacy of Peker’s political campaign depended as much on the stylistic elements and cultural references of his performances as on the grave nature of his allegations about public officials. By showing how the antihero narrative—a genre ubiquitous in contemporary popular culture—is put to use in political performances, the study fills an important gap in narrative genre analysis in cultural sociology.
Resource productivity and sustainability—a comparison of two European countries
Authors: Malatyinszki Szilárd , Zéman Zoltán , Kálmán Botond Géza
Published: February 2025

This research analyzes resource productivity by identifying key elements and their effects. The goal is to examine resource productivity and GDP-DMC correlations in EU member states, notably Hungary and the Netherlands. Researchers selected Eurostat sustainability statistics based on literature. Regression and path models were used to examine the data. GDP is strongly influenced by DMC, according to the research. The research also found that circular material usage might unexpectedly increase material consumption and lower national GDP. The ratio of GDP to DMC, Resource Productivity, oversimplifies sustainability analysis since its numerator and denominator are not independent. SEM showed that GDP and DMC are not separately explained. GDP is the only evident dependent variable, according to this study. The findings show that understanding the complex relationship between material use and economic production is essential to improving resource productivity and sustainability. Hungary and the Netherlands must develop measures to boost resource productivity while balancing economic development and environmental sustainability.
Refashioning linguistic expertise: Translanguaging TESOL in social media
Authors: Lee Tong King , Wei Li
Published: February 2025

This article examines the performative reconfiguration of linguistic expertise and the mode of TESOL at the intersection of language teaching, networked technology, and the culture of ludification. Applying van Dijck and Alinejad’s (2020 ‘Social media and trust in scientific expertise: Debating the COVID-19 pandemic in The Netherlands’, Social Media + Society, 6/4) distinction of institutional versus networked models of communication, it addresses the shifting ecology of foreign language education in an age of digital platforms in which linguistic expertise is no longer the exclusive preserve of institutional establishments, but rather can be claimed or self-professed by individuals operating on the basis of multiplex networks. A case example of networked TESOL in social media is presented to explore how the affordances of the networked model give rise to a radically different teacher-student dynamic than in the standard classroom, speaking to the idea of translanguaging pedagogy. The article discusses the implications of networked TESOL for theory and practice in applied linguistics in the post-multilingual era, proposing the idea of ludic literacy, where the instructor-influencer’s persona tends toward the performative and the sardonic, and where resources are flexibly orchestrated across the boundaries of languages, modes, and media.
A new ensemble learning method stratified sampling Blending (ssBlending) optimizes conventional blending and improves prediction performance
Authors: Miao Na , Yang Mengke , Han Pingping , Qiao Jiakun , Che Zhaoxun , Xu Fangjun , Dai Xiangyu , Zhu Mengjin
Published: February 2025

Motivation

Ensemble learning, as a powerful machine learning method, improves overall prediction performance by combining the prediction results of multiple base models. Blending, as a popular ensemble learning method, can train multiple base models, input the resulting prediction results to further train meta model and obtain final prediction results. However, conventional blending divides the training set by simple random sampling, which causes bias and large variance, thus affecting the stability and accuracy of prediction performance. In this study, we propose a new algorithm of stratified sampling blending (ssBlending), which addresses the algorithm instability of conventional blending caused by the random partition of the training set, further improving the prediction accuracy.

Results

We used multiple genotype data sets from different species including animal (pig), plant (loblolly pine), and microorganism (yeast) to test the prediction performance of ssBlending. The across-species multi-dataset verification results reveal that ssBlending is superior to conventional blending in terms of prediction accuracy and stability. In addition, we optimized the training set sampling rate (BestH) to facilitate the practical application of the ssBlending algorithm. In summary, this study proposes a completely new algorithm combing stratification strategy with the conventional blending, which provides more options for ensemble learning in various fields.

Availability and implementation

https://figshare.com/s/23122a18dc8a35f12ff6