bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of the hot porous layer in the gas flow in the inner coma
Authors: Mokhtari O. , Skorov Yu. V. , Rezac L. , Marschall R. , Belousov D. , Pinzón-Rodríguez O. , Küppers M. , Thomas N. 
Published: December 2024

Aims. The objective of this work is to study the influence of a highly non-isothermal porous dust layer on the formation of a comet’s inner coma. We studied the water gas activity of comet 67P/Churyumov-Gerasimenko to find a link between the gas properties around the comet and the properties of the dust surface crust. The effects on the radiative transfer spectral lines were studied and compared with MIRO remote sensing observations.
Methods. For cases of spherical and complex nucleus shapes, we validated surface boundary conditions for gas flow obtained from the two-layer consistent thermophysical model. This model accurately estimates the properties of the sublimation products as the gas diffuses through the layer. The gas expansion was then modeled using a 3D parallel implementation of a direct simulation Monte Carlo algorithm. A multi-beam linear interpolation was used to extract the gas density, velocity, and temperature profiles along a given line of sight. Finally, the radiative transfer equation was used to calculate the brightness temperature of the water vapor.
Results. The presence of a porous layer results in an increase in gas temperature and a decrease in gas density at the surface. The gas has a greater acceleration due to the higher initial temperature and increased conversion of translational energy to kinetic energy. This reduces the difference in density between the different models, with the densest gas being the coolest, and increases the terminal expansion velocity of the hotter gas. While the gas density differences are small at large distances, the observable water absorption lines are significantly affected.
Conclusions. The presence of a porous layer has a large effect on the properties of the gas in the coma, which can be seen by comparing the spectral lines. This demonstrates the potential interest of the approach in improving surface activity models and placing physical constraints on the dust layer.
Current Developments from Silicon Valley – How Artificial Intelligence is Changing Gynecology and Obstetrics
Authors: Griewing Sebastian , Gremke Niklas , Wagner Uwe , Wallwiener Markus , Kuhn Sebastian ,   Commission Digital Medicine of the German Society for Gynecology and Obstetrics
Published: December 2024

AbstractArtificial intelligence (AI) has become an omnipresent topic in the media. Lively discussions are being held on how AI could revolutionize the global healthcare landscape. The development of innovative AI models, including in the medical sector, is increasingly dominated by large high-tech companies. As a global technology epicenter, Silicon Valley hosts many of these technological giants which are muscling their way into healthcare provision with their advanced technologies. The annual conference of the American College of Obstetrics and Gynecology (ACOG) was held in San Francisco from 17 – 19 May 2024. ACOG celebrated its AI premier, hosting two sessions on current AI topics in gynecology at their annual conference. This paper provides an overview of the topics discussed and permits an insight into the thinking in Silicon Valley, showing how technology companies grow and fail there and examining how our American colleagues perceive increased integration of AI in
gynecological and obstetric care. In addition to the classification of various, currently popular AI terms, the article also presents three areas where artificial intelligence is being used in gynecology and looks at the current developmental status in the context of existing obstacles to implementation and the current digitalization status of the German healthcare system.
Ernährungsmedizinische Versorgung an deutschen Krankenhäusern – Ergebnisse einer Umfrage unter Ärzten
Authors: Rau Monika , Ferschke Melanie , Mühling Ramona , Fromhold-Treu Sophie , Geier Andreas , Pirlich Matthias , Hahn Sigrid 
Published: December 2024

ZusammenfassungMangelernährung betrifft 20–30% der Krankenhauspatienten und geht mit einer erhöhten Morbidität und Mortalität einher. Ein regelmäßiges Screening sowie multiprofessionelle Ernährungsteams sind für das Erkennen und die Behandlung entscheidend. Ziel dieser Umfrage ist es, die ernährungsmedizinische Versorgungssituation in deutschen Akutkliniken zu erfassen.Die Onlineumfrage wurde zwischen 11/2022–08/2023 über medizinische Fachgesellschaften und personalisiert an Chefärzte des deutschen Krankenhausregisters verschickt. Die Umfrage basiert auf einem Instrument der Hochschule Fulda.An der Befragung nahmen 182 Ärzte teil, von denen 53% angaben, dass ihr Krankenhaus ein Ernährungsteam hat, das am häufigsten organisatorisch der Gastroenterologie angegliedert war. In 88% der Ernährungsteams ist ein Facharzt – meistens ein Facharzt für Gastroenterologie – tätig. Zu den häufigsten Fragestellungen an das Ernährungsteam gehören die Mangelernährung, die parenterale/enterale Ernährung und der Überleitungsprozess. Krankenhäuser mit Ernährungsteam führen zu 83%, Krankenhäuser ohne Ernährungsteam nur zu 47% ein regelmäßiges Screening auf Mangelernährung durch. Als häufigstes Screeninginstrument wird der NRS-2002 verwendet. Bei positivem Screening wird in Kliniken mit Ernährungsteam in 57% automatisch das Team hinzugezogen. In Einrichtungen ohne Ernährungsteam sind standardisierte Abläufe aufgrund von Personalmangel oft nicht möglich.Die Umfrage zeigt eine ungleiche ernährungsmedizinische Versorgungssituation in deutschen Krankenhäusern. Krankenhäuser mit Ernährungsteam screenen häufiger auf Mangelernährung. Eine verbesserte Finanzierung und Standardisierung sind erforderlich, um die ernährungsmedizinische Versorgungssituation zu optimieren.
Der Effekt interpersoneller Fähigkeiten von Therapeut:innen auf die
therapeutische Allianz
Authors: Schwartz Brian , Rubel Julian A. , Lutz Wolfgang , Schöttke Henning 
Published: December 2024

Zusammenfassung
Ziel der Studie Interpersonelle Fähigkeiten von Therapeut:innen spielen
eine zentrale Rolle bei Therapeutenunterschieden im Therapieergebnis. Ebenso
wird die Stärke der therapeutischen Allianz von Therapeutenvariablen
beeinflusst. Das Ziel der Studie war es daher, Therapeutenunterschiede in der
Allianz zu erfassen und den Effekt interpersoneller Fähigkeiten von
Therapeut:innen auf die therapeutische Allianz zu untersuchen.
Methodik Interpersonelle Fähigkeiten von 99 angehenden Therapeut:innen
wurden in einer Gruppendiskussion mit der Skala Therapie-Relevante
Interpersonelle Verhaltensweisen (TRIB) gemessen. Die Therapeut:innen
behandelten n=1031 ambulante Psychotherapiepatient:innen im Rahmen der
Ausbildung zum/zur Psychologischen Psychotherapeut:in. Die Allianz wurde zum
Therapieende mit dem Assessment for Signal Clients (ASC) erfasst. Mit
hierarchisch linearen Modellen wurde die Allianz, unter Kontrolle von weiteren
Patienten- und Therapeutenvariablen, aus den interpersonellen Fähigkeiten
vorhergesagt. Zudem wurde die Ausgangsbelastung als Moderator des Effekts
untersucht.
Ergebnisse Der Therapeuteneffekt (TE) in der Allianz betrug 7,3%.
Interpersonelle Fähigkeiten waren ein signifikanter Prädiktor der Allianz
(b=0,104, p<0,001) und konnten 1,8% der Gesamtvarianz über alle
Kontrollvariablen hinaus aufklären. Der TE wurde auf 5,7% reduziert, was
bedeutet, dass 23,0% der Therapeutenunterschiede in der Allianz auf
interpersonelle Fähigkeiten zurückzuführen waren. Der Moderationseffekt durch
die Ausgangsbelastung wurde zwar nur marginal signifikant (b=0,069,
p=0,061), der Zusammenhang zwischen interpersonellen Fähigkeiten und
Allianz verschwand aber bei geringer Patientenbelastung.
Diskussion Mit der TRIB Skala können interpersonelle Fähigkeiten bereits
vor Ausbildungsbeginn erfasst werden. Die Vorhersage ist vor dem Hintergrund der
mehrjährigen zeitlichen Distanz zwischen den Erhebungen von interpersonellen
Fähigkeiten und Allianz zu betrachten, wobei sie für die selektive Stichprobe
von für die Ausbildung ausgewählten Therapeut:innen gilt.
Schlussfolgerung Interpersonelle Fähigkeiten können die Allianz
vorhersagen. Der Einfluss interpersoneller Fähigkeiten von Therapeut:innen auf
die Allianz steigt mit zunehmender Ausgangsbelastung der Patient:innen an,
während bei gering belasteten Patient:innen kein signifikanter Zusammenhang
besteht. Mittels videobasierter Ratingsysteme können die interpersonellen
Fähigkeiten individueller Therapeut:innen automatisiert gemessen,
Therapeut:innen mit Defiziten identifiziert und gezielt trainiert werden.
Assessment of Ophthalmology Residency Training in Switzerland: A Trainee-Based Survey
Authors: Khamsy Lilly , Turgut Ferhat , Saad Amr , Vicini Rino , Foa Nastasia , Villard Frédéric , Vez Sarah , Karal-Biechl Anne Catherine , Bühler Virginie 
Published: December 2024

Abstract
Background This study aimed to evaluate the current status of ophthalmology residency training in Switzerland and provide insights for enhancing training programs.
Materials and Methods The survey covered demographic data such as gender, age, workplace, and year of residency, as well as working conditions, current practical and diagnostic skills, interest in scientific work, and future plans. It consisted of 16 multiple choice questions (MCQ), 5 multiple select questions (MSQ), 8 free-text, 6 Net Promoter Score (NPS), and 4 Likert scale questions. All Young Swiss Ophthalmologists (YSO) members received an invitation to participate in the survey using an online form. All collected data were anonymized, and participants provided their consent for data collection, analysis, and publication.
Results The survey assessed the perspectives of 63 Swiss ophthalmology residents on their training experiences. Respondents indicated the greatest interest in specializing in cataract and vitreoretinal surgery, followed by cornea, glaucoma, refractive surgery, and lid surgery. They also expressed a great need for improved supervision, structured curricula, and alignment of clinical and research duties. While pursuing additional surgical training and private practice autonomy, residents also expressed a preference for balanced workloads that emphasize patient care over full-time academic work.
Conclusion The survey indicates a need to standardize ophthalmology residency training in Switzerland to ensure comprehensive and uniform education. It also highlights specific areas for improvement, such as the absence of surgical training. Ongoing assessments are necessary to evaluate future developments.
Neoadjuvante Therapie des resektablen, nicht-kleinzelligen Lungenkarzinoms
Authors: Welcker Katrin , Jonigk Danny , Kropf-Sanchen Cornelia , Tufman Amanda , Draube Andreas , Stenzinger Albrecht , Zaatar Mohamed , Thomas Michael 
Published: December 2024

ZusammenfassungDie Behandlungsaussichten beim nicht-kleinzelligen Lungenkarzinom (NSCLC) haben sich durch die Integration von Immuncheckpoint-Inhibitoren in multimodale Therapiekonzepte deutlich erweitert. Aktuell rücken kombinierte, Immuncheckpoint-Inhibitor-basierte Therapiekonzepte auch in frühe, resektable Stadien des NSCLC vor. Die neoadjuvante und perioperative Chemoimmuntherapie eröffnet einen vielversprechenden neuen präoperativen Behandlungsansatz, impliziert aber auch einige neue Fragen und Herausforderungen. Mit den erweiterten perioperativen Therapiemöglichkeiten und der Aussicht auf eine weitere mögliche Verbesserung der Rezidivfreiheit nach Tumorresektion verschiebt sich damit auch die Notwendigkeit, therapierelevante Befunde zur Bildgebung, molekularen und histopathologischen Diagnostik frühzeitig und umfassend zu erheben, weiter nach vorne: Alle Patienten mit Lungenkarzinom sollen unabhängig von der Therapieintention in einem interdisziplinären Tumorboard mit thoraxonkologischer Schwerpunktexpertise vorgestellt werden. Dies ist regelhaft in zertifizierten Lungenkrebszentren gegeben.Ein standardisiertes Vorgehen trägt zur optimierten prätherapeutischen Diagnostik bei und erleichtert die Abstimmung für das bestmögliche multimodale Vorgehen im interdisziplinären Tumorboard. Bei zentral gelegenen resektablen Tumoren erhöhen sich durch die neoadjuvante Behandlung z.B. die Aussichten auf ein möglichst parenchymsparendes Vorgehen. Einige Fragestellungen lassen sich noch nicht abschließend beantworten. Die perioperative Systemtherapie mit molekular-zielgerichteten und Immuncheckpoint-Inhibitoren ist Gegenstand zahlreicher laufender Studien. Die erhebliche Dynamik bei den Neuzulassungen und die Entwicklung perioperativer Therapiekonzepte macht eine kontinuierliche Anpassung der diagnostischen Algorithmen und Standards erforderlich. Die Integration in die prächirurgische Standardroutine macht eine zügige Einordnung der relevanten Befunde sowie enge Abstimmung zwischen den diagnostischen und interventionellen Fachdisziplinen unerlässlich.
Tenodese de bíceps proximal – Análise biomecânica em ovinos: Comparação entre âncora metálica, âncora sem nós bioabsorvível onlay e parafuso de interferência
Authors: Orso Amauri João , Dallanora Mateus Franceschi , Piluski Paulo Cesar Faiad , Rodriguez Carlos Humberto Castillo , Bonadiman João Artur , Lech Osvandré 
Published: December 2024

Resumo
Objetivo Avaliar biomecanicamente diferentes dispositivos de fixação do bíceps proximal no úmero de ovinos, comparando sua força de fixação até a falha, deslocamento do tendão e local de falha em cada técnica.
Métodos Foram realizados 27 ensaios em úmero de ovinos, separando-os em 3 grupos: grupo A com tenodese com âncoras metálicas (n = 11), grupo B com âncoras bioabsorvíveis sem nós (n = 8) e grupo C com parafusos de interferência metálicos (n = 8), realizando a tenodese com o próprio bíceps dos ovinos mantendo sua inserção distal nativa. Os três métodos foram submetidos a máquina universal de ensaio de tração.
Resultados Não se observou diferença estatisticamente significativa quanto à força de fixação até a falha e deslocamento entre os tendões fixados pelas diferentes técnicas. Em relação ao padrão de rupturas, observou-se que a maioria das rupturas das âncoras metálicas aconteceu ao nível da junção miotendínea, a maioria âncoras de suturas sem nós teve falha por escorregamento da interface fio-parafuso e todos os parafusos de interferência tiveram falha via escorregamento do tendão.
Conclusão As três técnicas com âncora metálica, âncora bioabsorvível sem nós e parafuso de interferência mostraram-se amplamente resistentes às cargas de tração para tenodese do cabo longo do bíceps em ovinos. Não houve diferença estatisticamente significativa entre os três grupos. Estudos com resistência em carga cíclica podem fornecer dados mais valiosos para a comparação dos grupos.
Precisão da ressonância magnética na detecção de rupturas do ligamento cruzado anterior e do ligamento cruzado posterior e correlações artroscópicas subsequentes: Uma investigação
Authors: Yadav Vijendra , Chandrashekhar Chidanand Kaudki Janekunte , Ram Rishi Pothuri , Mohammed Rafeeq 
Published: December 2024

Resumo
Objetivo Este estudo examinou a precisão da ressonância magnética (RM) como modalidade diagnóstica para detecção da ruptura de ligamentos do joelho, em que a artroscopia é o padrão-ouro. O estudo investigou a sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo dos resultados da RM em uma coorte de 200 pacientes em comparação à artroscopia diagnóstica.
Métodos Nossa instituição realizou um exame clínico abrangente de todos os pacientes com lesões no joelho e aqueles com achados afirmativos sugestivos de ruptura ligamentar foram submetidos à RM. O estudo incluiu 200 pacientes com rupturas do ligamento cruzado anterior (LCA) e do ligamento cruzado posterior (LCP) confirmadas por RM que, posteriormente, foram submetidos à artroscopia para fins diagnósticos e terapêuticos. Os resultados foram submetidos a vários testes estatísticos para comparação e análise dos desfechos.
Resultados O estudo demonstrou sensibilidade e especificidade notavelmente altas, com acurácia quase ideal para o diagnóstico de lesões do LCA e do LCP por meio de RM em comparação à artroscopia. Os pacientes com resultados afirmativos à RM poderiam ser submetidos a procedimentos artroscópicos diagnósticos ou terapêuticos.
Conclusão O estudo enfatiza a importância da RM como método não invasivo e altamente preciso para avaliação das lesões ligamentares do joelho. Embora a RM possa ser usada na investigação de primeira linha, deve-se enfatizar que a artroscopia continua a ser o padrão-ouro para o diagnóstico de rupturas do LCA e do LCP. Este estudo recomenda o uso da RM como uma valiosa ferramenta de triagem em pacientes com suspeita de ruptura de ligamentos do joelho, com potencial para reduzir o número de artroscopias diagnósticas em indivíduos com achados clínicos inconclusivos, o que minimiza o desconforto do paciente e os custos de saúde.
Comparação entre métodos de fixação externa circular e de fixação com placa e parafuso nas fraturas do pilão tibial
Authors: Schueda Marco Antonio , Gubert Leonardo Maranhão , Dal Vesco Yan Celuppi , Dal Piva Fernanda Fossa , Niada Felipe Guglielmi , Mehanna Ryad Fayez 
Published: December 2024

Resumo
Objetivo Comparar os métodos de fixação de fraturas do pilão tibial entre pacientes atendidos em um hospital.
Métodos Foram analisados os prontuários de 28 pacientes que realizaram procedimento cirúrgico para fratura do pilão tibial, sendo 15 deles tratados com fixador externo circular e 13 com fixação interna por placa e parafusos. Foram analisados idade, sexo, fatores agravantes, energia do trauma (alta ou baixa), presença de lesão de tecidos moles, ocorrência de fraturas associadas e desfechos clínicos.
Resultados O sexo mais acometido foi o masculino, na faixa etária entre 40 e 60 anos. O mecanismo de trauma em sua maioria foi acidentes automobilísticos e a lesão associada em 100% dos casos foi a fratura do terço distal da fíbula. O padrão de fratura observado nos pacientes tratados com fixador externo circular foram AO 43C3 e 43C2. Já os padrões de fratura prevalentes observado no grupo de fixação interna foram AO 43C1, 43C2 e 43C3.
Conclusão A escolha terapêutica individualizada é de extrema importância para um melhor desfecho funcional. Também é imprescindível ressaltar que o perfil da fratura e dos pacientes do grupo fixador externo circular e de fixação interna por placa e parafusos tende a ser bastante heterogêneo, pois as fraturas de pior classificação e mais frequentemente associadas a lesões de partes moles costumam ser manejadas com fixação externa circular, enquanto aqueles com fraturas de menor gravidade e menor incidência de lesão de partes moles tendem a ser manejados por redução aberta e fixação interna. Observa-se que os desfechos clínicos e radiográficos tendem a ser similares entre ambos os grupos apesar das particularidades de cada método.
Imaging of Pleural Tuberculosis: A Narrative Review
Authors: Rai Santosh P.V. , K. Livingstone Yvette , Alok Kale , Akshita Goel 
Published: December 2024

AbstractPleural tuberculosis is the second most common type of extrapulmonary tuberculosis (TB) after TB lymphadenitis and presents secondary to pulmonary TB in most cases. TB pleuritis develops due to a delayed hypersensitivity response precipitated by the discharge of tubercular bacilli in the pleural space typically within 6 to 9 months of the initial TB infection. TB empyema on the other hand is multibacillary and purulent, often seen in cases of pulmonary TB. Longstanding pleural TB can also present as fibrothorax, chylothorax, or empyema necessitans. It shows features similar to pleural mesothelioma in later stages and is important to be considered as a differential, especially in endemic regions. This review article aims to provide an in-depth knowledge into the basic anatomy of pleural space, pathophysiology of pleural TB, and imaging features helpful in making a diagnosis.
Guiding Device for Subdurostomy Catheters in the Management of Chronic Subdural Hematoma: Moscote–Agrawal Subdurostomy Catheter Introducer
Authors: Moscote-Salazar Luis Rafael , Agrawal Amit , Florez William , Chacon Ariana 
Published: December 2024

AbstractThe drainage of chronic subdural hematoma is a very frequently performed neurosurgical procedure. The management often requires subdurostomy with catheter placement for hematoma drainage. Sometimes, the catheter misplacement can lead to complications that could be catastrophic. This technical note introduces the Moscote–Agrawal guiding device, a tool designed to enhance the accuracy and safety of catheter placement during subdurostomy. We hope that this concept can be adapted by neurosurgeons around the world to minimize procedural risks, improve outcomes, and ensure the safety of neurosurgical practices.
Challenges in the Management of Dislodged Coronary Stent Embolization: A Case Report
Authors: Bekler Ozkan 
Published: December 2024

AbstractAlthough device embolization is a rare complication in percutaneous coronary interventions (PCI), its mortality and morbidity are serious complications. With the increasing prevalence of complicated procedures, invasive cardiologists encounter device embolization daily. Different devices and techniques are utilized to retrieve these devices. Most devices used during PCIs are infection stents. More infrequently, the tip of diverting wires, angioplasty balloons, or balloon holders may break and embolize distally into the arteries. A 51-year-old man with non-ST elevation myocardial infarction was presented for restoration of the ring of the stent, which was stripped in the first diagonal ostium, with snare communication. The patient had an anterior myocardial infarction and underwent stent implantation in the left anterior descending artery (LAD) 1 month ago. While the stripped stent was being retracted, the LAD stent had been inserted, causing the stent implanted a month ago to be retracted. Additionally, the dissection was observed in the proximal LAD, and the procedure was terminated by stenting the LAD-Diagonal bifurcation lesion using the mini-crush technique. This case report highlights the importance of constant vigilance that invasive cardiologists must show when removing the embolized device. The maturity of the technique depends on the operator's experience with the methods of use and the material possibilities in the laboratory.
A novel hydraulic swing actuator with high torque density for legged robots
Authors: Zong Huaizhi , Ai Jikun , Fang Lizhou , Luo Yuanchun , Zhang Junhui , Xu Bing 
Published: December 2024

Abstract
Hydraulic swing actuators hold significant potential for legged robots due to their ability to deliver high torque directly to joints. However, their practical implementation is hindered by issues such as internal leakage, excessive size, and redundant weight, which restrict the dynamic performance of legged robots. To address these challenges, this paper proposes a novel circular swing hydraulic actuator that offers a compact design and a high torque-to-mass ratio inspired by the snail’s structures. First, the basic motion principle of the circular swing actuator is introduced, drawing from the snail’s spiral motion. Then, the split-shell mechanical structure with enhanced machinability and better assembly precision is presented, with a final dimension of ϕ153 × 70 mm3. Its mechanical properties are validated through numerical simulations and experiments, achieving a torque-to-weight ratio of 471.7 Nm kg−1. Additionally, a customized sealing system ensures minimal internal leakage and zero external leakage. Step response and position control experiments demonstrate that the actuator’s frequency response and tracking accuracy meet the requirements for legged robot joints driven by hydraulic systems. This circular swing actuator provides a promising solution for designing agile, high-performance legged robots.