bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of using ultrasonic shears in reducing seroma formation after axillary lymph node dissection in breast cancer patients
Authors: Elshoura Yousra Mohsen , Refaat Ahmed , Hassan Basma Hussein Abdelaziz , Awad Philobater Bahgat Adly , Ahmed Mohamed Wael , Mokhtar Sherif , Khalaf Emad Salah El din 
Published: December 2024

Abstract
Background
Axillary lymph node dissection (ALND) is an essential step in the management of breast cancer. ALND is conventionally performed using radio frequency electrosurgery. The post-operative complications of utilizing such energy (such as prolonged drainage time, seroma, or infection) lead to prolonged recovery. Hence, it may delay the initiation of adjuvant chemo/radiotherapy for this critical category of patients. Using ultrasound shears provides a wide spectrum of tissue effects via mechanical oscillation. The absence of an electric circuit in ultrasound shears reduces thermal injury and accordingly cellular damage.

Objective
Comparing utilization of ultrasound shears in axillary lymph node dissection to conventional radio frequency electrosurgery in terms of operative time, post-operative drainage amount and days, post-operative pain, the incidence of seroma or infection, and lymph node yield.

Methods
This study is a randomized control trial. It includes 56 breast cancer ALND cases performed in conjunction with either BCS or MRM; being upfront surgery cases or post-neoadjuvant therapy cases, 28 patients underwent ALND using ultrasound shears and 28 underwent ALND using radio frequency electrosurgery.

Results
The mean age of the study population was 51 ± 11.7 years, with a mean BMI of 39. The mean operative time in the ultrasound shear group was 29.4. ± 7.6 min and 31.6 ± 5.1 min in the conventional group. The mean amount of drainage in the ultrasound shear group was 319.6 ± 75.4 ml and 407.5 ± 75.2 ml in the conventional group. The mean drainage days in the ultrasound shear group were 8 ± 1 day and 12 ± 2.2 days in the conventional group. Seroma formation was recorded in 6 of the ultrasound shear groups and 9 in the conventional group. Seroma followed by infection was found in 10% of the ultrasound shear group versus 21% in the conventional group. Seroma formation and wound infection were significantly related to the conventional group (p-value = 0.01).

Conclusion
Our study recommends the utilization of ultrasound shears in ALND as it is a safe and accurate method that allows faster post-operative recovery with shorter drainage time and lower incidence of seroma or infection, without affecting operative time or lymph node yield.

Trial registration
Trial no.: PACTR202402831197428. Date of approval: 19/02/2024
Staff education compared with active real-time waste segregation to reduce the environmental impact of hip and knee arthroplasty
Authors: Prakash Rohan , Nasser Ahmed , Sharma Akshat , Eastwood Deborah , Reed Mike , Agrawal Yuvraj 
Published: December 2024

AimsArthroplasty has been shown to generate the most waste among all orthopaedic subspecialties, and it is estimated that hip and knee arthroplasty generate in excess of three million kg of waste annually in the UK. Infectious waste generates up to ten times more CO2 compared with recycled waste, and previous studies have shown that over 90% of waste in the infectious stream is misallocated. We assessed the effect of real-time waste segregation by an unscrubbed team member on waste generation in knee and hip arthroplasty cases, and compared this with a simple educational intervention during the ‘team brief’ at the start of the operating list across two sites.MethodsWaste was categorized into five categories: infectious, general, recycling, sharps, and linens. Each category was weighed at the end of each case using a digital weighing scale. At Site A (a tertiary orthopaedic hospital), pre-intervention data were collected for 16 total knee arthroplasy (TKA) and 15 total hip arthroplasty (THA) cases. Subsequently, for ten TKA and ten THA cases, an unscrubbed team member actively segregated waste in real-time into the correct streams. At Site B (a district general hospital), both pre- and post-intervention groups included ten TKA and ten THA cases. The intervention included reminding staff during the ‘team brief’ to segregate waste correctly.ResultsActive real-time waste segregation reduced infectious waste by a mean of 2.51 kg (95% CI 1.492 to 3.542) in TKA, and 1.83 kg in THA cases (p = 0.004). Educational intervention reduced infectious waste by a mean of 3.52 kg in TKA and 2.09 kg in THA cases (p = 0.026). Total waste was significantly reduced in both groups post-intervention for TKA cases.ConclusionSimple educational measures alone can significantly reduce the amount of infectious waste. Extrapolated nationally, our results would yield a reduction of approximately 315,004 kg to 594,577 kg of CO2 annually, which equates to 70 to 132 gasoline-powered passenger vehicles driven for a year.Cite this article: Bone Jt Open 2024;5(12):1119–1124.
The feasibility of a visuo-cognitive training intervention using a mobile application and exercise with stroboscopic glasses in Parkinson’s: Findings from a pilot randomised controlled trial
Authors: Das Julia , Barry Gill , Walker Richard , Vitorio Rodrigo , Celik Yunus , McDonald Claire , Storey Bryony , Oman Paul , Morris Rosie , Stuart Samuel 
Published: December 2024

Background
There is currently no pharmacological treatment for visuo-cognitive impairments in Parkinson’s disease. Alternative strategies are needed to address these non-motor symptoms given their impact on quality of life. Novel technologies have potential to deliver multimodal rehabilitation of visuo-cognitive dysfunction, but more research is required to determine their feasibility in Parkinson’s.

Objective
To determine the feasibility and preliminary efficacy of a home-based, technological visuo-cognitive training (TVT) intervention using a mobile application and exercise with stroboscopic glasses compared to non-technological care in people with Parkinson’s.

Methods
This 18-month, parallel, two-arm pilot trial took place between July 2021-December 2022. Participants were community-dwelling individuals with a diagnosis of Parkinson’s, aged over 50 years. Participants were randomly allocated to one of two active four-week interventions, TVT (n = 20) or standard care (SC) (n = 20). A physiotherapist delivered 8 home visits over 4 weeks, lasting 45–60 mins. Participants were evaluated at baseline and then on completion of the intervention. Primary outcomes were feasibility of the study design and intervention (recruitment/retention, adherence, assessment time scale, equipment and safety). Exploratory outcomes included assessments of cognitive, visual, clinical and motor function. (Blinding of participants was not possible due to the nature of the intervention)

Results
The recruitment rate was 60% (40/67), and the retention rate was 98% (39/40). Adherence to both arms of the intervention was high, with participants attending 98% of visits in the TVT group and 96% of visits in the SC group. 35% (9/20) of participants in the TVT group experienced mild symptoms associated with use of the stroboscopic glasses which included dizziness, queasiness and unsteadiness. There were minimal between group differences, with both interventions having positive effects on a variety of clinical, cognitive, and physical performance outcomes.

Conclusions
Our findings suggest that home-based TVT with a physiotherapist is feasible in people with Parkinson’s and could provide an alternative approach to addressing cognitive and motor dysfunction in this population. We make recommendations for future trials and invite ensuing studies to improve upon the design and utilise stroboscopic visual training and digital tools to investigate this emerging area of multimodal rehabilitation.
This trial was prospectively registered at ISRCTN (registration number: ISRCTN46164906; https://doi.org/10.1186/ISRCTN46164906).
Differences in emergency hospitalization trauma patients during and after the COVID-19 pandemic
Authors: Chang Haifeng , Li Siyuan , Ke Xijie , Zhou Zhenyu , Zhang Lijun , Yang Baisong , Ji Bilei , Jiang Liming , Yang Yang , Huang Ting , Zhang Gengwei 
Published: December 2024

Background
The spread of COVID-19 has a huge impact on the medical system, affecting the normal order of routine patients, especially obvious effect on the Shenzhen Third People’s Hospital as the designated hospital for COVID-19 patients. After the epidemic was loosened in early December 2022, the normal medical order gradually restored in China. How much was the impact on the admission and treatment of emergency trauma patients during and after the epidemic? This study aims to compare the differences between trauma patients admitted to the emergency department during and after the COVID-19 pandemic.

Methods and findings
The study included all trauma patients admitted through the emergency department from January 2020 to March 2024. Clinical data were collected, and a retrospective comparative analysis was performed on the characteristics of the two groups of trauma patients during and after the pandemic, including gender, age, average length of hospital stay, proportions of admissions to various departments, proportions of severe cases, proportions of surgical patients, and mortality rates, using statistical methods for analysis.
The proportion of male patients during the pandemic (69.98%) was higher than after the pandemic (67.01%). The proportion of patients under 60 years of age during the pandemic was higher than that after the pandemic. There was no significant difference in the average hospital stay between patients during and after the pandemic (P>0.05). Comparisons between the two groups in terms of admissions to departments such as otolaryngology, hepatobiliary surgery, hepatic surgery, orthopedics, urology, neurosurgery, gastroenterology surgery, thoracic surgery, ophthalmology and intensive care unit showed no significant differences (P>0.05). The proportion of surgical patients during the pandemic (75.09%) was higher than after the pandemic (69.53%). The mortality rate during the pandemic (0.13%) was lower than after the pandemic (2.45%).

Conclusion
The COVID-19 pandemic has impacted trauma patients admitted through the emergency department, with increases in the proportion of male and younger patients, surgical cases, and a decrease in mortality rates during the pandemic.
A Function of Language Analysis Through Language Features Showed by Stella Grant in the Five Feet Apart Movie (2019
Authors: Haya Aqilla Fadia , Wulandari Dwi 
Published: December 2024

Movie is the combination of audio and visual language in a movie makes it acceptable to the audience. This study aims to examine the language function and features used by women in the movie based on Stella's utterances. The researcher used features of language mentioned by Jennifer Coates’ (2013) and Roman Jakobson's (1960) theory function of language. This study used a descriptive qualitative method employed purposive sampling to collect data from the Five Feet Apart (2019) movie and the Five Feet Apart movie script. The results revealed that the main female characters use all language features. Features that Stella uses such as minimal responses, hedges, tag questions, questions, commands and directives, swearing and taboo languages, and compliments. Additionally, Stella mostly used expressive functions. The research also shows the social factor that Stella mostly used is a topic factor. Thus, it can be concluded that as the main female character, Stella Grant wants to express her feelings to her speech partner through her utterances which is included in the features of language
Global stability and asymptotic profiles of a partially degenerate reaction diffusion Cholera model with asymptomatic individuals
Authors: Wang Shengfu , Nie Linfei 
Published: December 2024

Abstract
Considering the prevalence of asymptomatic individuals during the spread of disease, this article develops a model of degenerate reaction diffusion Cholera with asymptomatic individuals. First, the well-posedness of model is studied, including the global existence of solutions and the existence of attractor. Second, the basic reproduction number

ℛ

0

{{\mathcal{ {\mathcal R} }}}_{0}

is defined to determine whether the disease is vanishing or persistent. In particular, we also analyze the asymptotic behavior of the endemic steady state when the diffusion rate of susceptible or asymptomatic individuals tends to 0 or infinity. Finally, by fitting the theoretical results with some numerical simulations, we find that the spatial distribution of disease and local epidemic risk are less affected by the mobility of susceptible populations, whereas the mobility of asymptomatic or symptomatic populations significantly affects the spatial and temporal distribution of infected populations. In addition, we found that the proportion of asymptomatic individuals to infected individuals is also a key factor in disease epidemics, and how to quickly diagnose asymptomatic individuals for disease control and prevention should be of a particular concern.
The debate between electricity and heat, efficacy and safety of irreversible electroporation and radiofrequency ablation in the treatment of liver cancer: A meta-analysis
Authors: Xing Rong , Liu Yutong , Liu Yang , Jiang Haihong , Liu Chao , Du Jiru 
Published: December 2024

Abstract
Both irreversible electroporation (IRE) and radiofrequency ablation (RFA) are viable ablation methods for localized treatment of liver tumors. We conducted a meta-analysis to access the efficacy and safety of IRE and RFA in liver cancer treatment. Clinical studies on IRE and RFA for the treatment of liver cancer were collected from PubMed and CNKI until June 2023. We screened the literature for ablation success rates at 1 month post-operation, extracting keywords such as “ablation success rate,” “technical success rate,” “recurrence rate,” and “complication” for meta-analysis. A total of 37 articles were included: 24 related to RFA involving 1,685 cases and 13 related to IRE involving 524 cases. The results demonstrate that ablation success rates at post-operative 1 month for IRE and RFA were 86% (95% CI: 82–89%) and 87% (95% CI: 81–92%), respectively. Technical success rates were 96% (95% CI: 88–100%) and 99% (95% CI: 96–100%). In addition, the recurrence rate was 16% (95% CI: 12–22%) in RFA group and 16% (95% CI: 9–23%) in IRE group. In terms of safety, the RFA had a complication rate of 28% (95% CI: 10–50%) and the IRE had a rate of 26% (95% CI: 13–43%). In conclusion, IRE and RFA exhibit similar ablation success rates at 1 month post-operation and comparable complication rates, making them both safe and effective treatment options.
Enhancing Wrist Telerehabilitation: Integrating Haptic Feedback and Remote Evaluation Models
Authors: Sadeghi Mohammad , Rottke Vanessa , Abbasimoshaei Alireza , Kern Thorsten A. 
Published: December 2024

Abstract
Stroke patients with hemiparesis often face significant challenges in accessing consistent and effective rehabilitation therapy due to limitations in mobility and the availability of specialized care. To address this, a new telerehabilitation system is introduced for stroke patients with hemiparesis. It consists of two internetconnected robots for remote wrist rehabilitation. A cloudbased website serves as a centralized interface for patients and doctors, allowing remote control of the system during therapy sessions. To enhance the haptic feedback and stability of the system, a torque/velocity control algorithm is implemented. These control algorithms incorporate damping and spring terms from an impedance control algorithm to synchronize and maintain the positions of both end effectors. Additionally, a wrist evaluation model has been introduced to calculate stiffness and damping coefficients, essential for monitoring patient progress and improving treatment efficacy. The wrist model is evaluated using multiple linear regression method. Experimental testing demonstrates the potential of the proposed approach in enhancing telerehabilitation system performance.
Multifrequency image reconstruction for electrical impedance tomography
Authors: Battistel Alberto , Wilkie Jack , Chen Rongqing , Möller Knut 
Published: December 2024

Abstract
Electrical Impedance Tomography (EIT) is a medical imaging technique that is primarily used to monitor the respiration of a patient. Because EIT is based on electrical measurements, it is a safe, non-invasive, and cost-effective imaging technique. However, the EIT image reconstruction is a severely ill-posed problem that gives low spatial resolution where only large variations in tissue conductivity can be visualized. Furthermore, widely used time difference EIT relies on a single frequency alternating current measurement which does not allow for discrimination of different tissues on their conductivity spectra. Here we show the application of a new EIT reconstruction algorithm which correlates measurements taken at different frequencies to include the spectral dependency of the tissue properties. The algorithm is tested on a simulated phantom using data for muscle and lung tissue from the literature. It shows that contrary to a standard EIT image reconstruction, the frequency dependence of the tissues is retained, which can be used to further improve distinguishability in EIT images.
Concordance analysis between deep learning model predictions and electrocardiography thresholds from cardiology guidelines
Authors: Bender Theresa , Hempel Philip , Spicher Nicolai 
Published: December 2024

Abstract
Deep learning models for the classification of electrocardiograms (ECGs) are able to learn disease-specific patterns, but they are rarely implemented in medical practice due to their "black box" nature. Post-hoc explainable artificial intelligence (XAI) methods compute regions of interest (ROI) which are of importance for a model’s decision making. However, it needs to be further analyzed whether a model focuses on the morphological or rhythmical information within the ROIs. We evaluate a pre-trained ResNet for sinus bradycardia (SB) and sinus tachycardia (ST) classification on the PTBXL dataset using the XAI method Integrated Gradients. We compare the confidence of the model predictions to ECG features used by clinicians using correlation analysis. Correlation is highest for RR intervals (SB: 0.44) and atrial as well as ventricular heart rates (ST: 0.51), with the majority exceeding clinical thresholds for both disorders, indicating that the model learned rhythmical features. Except for QT intervals in ST classification, morphological features such as duration and amplitudes of P-/T-waves do not show any correlation.
Mesh Refinement Compensation via Regression in thermal necrosis FEM
Authors: Busch Christoph , Rupitsch Stefan J. , Moeller Knut 
Published: December 2024

Abstract
Finite Element Models (FEM) for simulating various physical phenomena are indispensable in today’s research. They are also applied in high-frequency (HF) surgical applications to simulate Joule heating and thermal necrosis formation in biological tissue. One challenge lies in choosing an appropriate mesh size, balancing between sufficiently accurate simulation results and a coarse mesh for fast computations. In this contribution, we investigate, using three mesh sizes (coarse, medium, and fine), the extent to which regression analysis of discrete simulation results of necrosis dimensions can compensate for mesh refinement in an FEM for HF soft coagulation. We conducted exponential regression analysis on discrete simulation results of the necrosis zone. It has been found that while it is generally possible, if the FEM simulation results already deviate significantly from the true solution, regression analysis cannot compensate for errors arising from the numerical method. Therefore, a coarse mesh with subsequent regression analysis can be utilized to determine necrosis propagation in depth, with a maximum error of only -3.4 % compared to the fine mesh within the considered interval. However, for the necrosis in the lateral direction, the maximum error is 44.3 %, which is too large. Even the mid-size mesh is not accurate enough in the lateral direction, necessitating the use of a fine mesh for the lateral direction.
Exploring the Influence of the Knitted Structure Morphology on Synthetic Surgical Mesh Behaviour
Authors: Civilini Vittoria , Giacalone Vincenzo 
Published: December 2024

Abstract
Despite the wide variety of knitting patterns present in the global market for synthetic meshes, the influence of mesh morphology on the mechanical behaviour of these devices is not yet clear. The goal of this project is to determine how the mechanical properties of monofilament polypropylene warp-knitted meshes are influenced by their morphological characteristics. Multivariate linear regression models were developed using nine meshes to quantify a correlation between these two crucial aspects. Additionally, porous mesoscale Finite Element (FE) models were implemented in Abaqus to replicate in vitro tests conducted in a previous study. High values of the determination coefficient were obtained for all the models and their robustness was confirmed by good performance in a leave one out validation method. The porous FE models successfully replicated the multidirectional behaviour of the meshes after the calibration of the elastic modulus based on the uniaxial tensile test. This combined approach demonstrates valuable results paving the way for advancements in hernia treatment and meshes design.
Design optimization of a self-expanding polymeric microstent for the treatment of Fallopian tube occlusions
Authors: Dierke Ariane , Supp Laura , Borowski Finja , Stiehm Michael , Bock Andrea , Zygmunt Marek , Schmitz Klaus-Peter , Siewert Stefan 
Published: December 2024

Abstract
Involuntary childlessness represents a sensitive and emotionally moving topic. Depending on the method, reproductive treatments are associated with significant physical, psychological and financial burdens. Female sterility is caused by Fallopian tube occlusions in one of three cases. Our previously described microstent technology opens up new therapeutic possibilities to restore the lumen of the Fallopian tube without surgery. In this work, Finite Element Analysis was performed for design optimization of a polymeric selfexpanding microstent which had a limited crimping diameter by self-contact resulting in challenging loading behavior during application preparation. Three different stent designs were investigated. A bilinear constitutive material model considering isotropic hardening was used for modeling of the microstent. To evaluate the stent variations, the following criteria were defined: self-contact, maximum stresses (von Mises stress) and volume of stress above 45 MPa. All microstent designs were crimped to a diameter of 1.0 mm using Finite Element Analysis. Stent design version 1 and 2 were limited to crimping diameter considering self-contact. The wave-shaped cell design of version 3 completely prevented self-contact up to a diameter of 1.0 mm. Consequently, stent design version 3 offers the greatest potential for a self-expanding polymeric microstent for minimally invasive treatment of Fallopian tube occlusions.
Antibacterial and cytotoxic properties of endophytic extracts for oral application
Authors: Doll-Nikutta Katharina , Caruso Daniel , Firoozbahr Meysam , Winkel Andreas , Zaferanloo Bita , Stiesch Meike 
Published: December 2024

Abstract
Endophytic fungal extracts possess great potential as alternative antibacterial substances. Here, two extracts from the Australian endemic plant Eremophila longifolia were shown to reduce biomass and metabolic activity of the oral bacteria Streptococcus oralis and Porphyromonas gingivalis. As the effective concentration towards S. oralis was lower than the cytotoxic concentration towards oral epithelial cells, more detailed studies are warranted in the future.