bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colorectal surgeons’ perspectives on the efficacy of intraoperative bowel perfusion technology with a focus on indocyanine green fluorescence angiography
Authors: Singaravelu Ashokkumar , Entee Philip D. Mc , Boland Patrick A. , Moynihan Alice , McCarrick Cathleen , Vahrmeijer Alexander L. , Arezzo Alberto , Boni Luigi , Hompes Roel , Cahill Ronan A. 
Published: February 2025

Abstract

Background
Level one evidence supports indocyanine green fluorescence angiography (ICGFA) use reducing anastomotic leak rates in colorectal surgery. We surveyed surgeons exploring perceptions and factors affecting its use in daily practice and adoption as routine standard of care.

Methods
Validated electronic survey distributed via the Irish Association of Coloproctology, Royal College of Surgeons in Ireland, European Society of Surgical Oncology, European Association for Endoscopic Surgery, Milan Colorectal Congress and social media.

Results
200 colorectal surgeons (143 consultants) responded. 147 (73.5%) surgeons already use ICGFA, with 90 (61.2%) using it routinely and 69 (46.9%) having a concomitant research interest. Strong clinical evidence base (83.5%) and protocol standardisation (78%) were overall rated most important for bowel perfusion technology with a majority of surgeons rating lack of standardisation and inter-user variability as challenges (similar between consultants and non-consultants). Lack of training and staff, reliability concerns and data security were perceived as significant barriers by selective users compared to non-users, and cost and operating time were perceived as significant barriers by selective users compared to routine users. Most surgeons (41.5%) ideated a number needed to treat (NNT) between 20 and 40 acceptable to advocate routine ICGFA use with 28% requiring a NNT < 20. Most surgeons (38.5%) indicate a per case cost savings of €250–500 supports routine use with 17% advocating it > €750.

Conclusions
With now a strong evidence base regarding clinical benefit, the survey respondents articulate remaining challenges for ICGFA as standard of care. Levels of expected benefit are largely in keeping with its reported performance.
Robotic versus laparoscopic heller myotomy for esophageal achalasia: an updated systematic review and meta-analysis
Authors: Aiolfi Alberto , Damiani Riccardo , Manara Michele , Cammarata Francesco , Bonitta Gianluca , Biondi Antonio , Bona Davide , Bonavina Luigi 
Published: February 2025

Abstract

Background
The surgical treatment for esophageal achalasia has evolved over the years, with laparoscopic Heller myotomy (LHM) and partial fundoplication becoming widely used worldwide. More recently, an increased interest in the robotic Heller myotomy (RHM) has arisen.

Purpose
Compare short-term and functional outcomes of RHM vs. LHM.

Methods
Systematic review and meta-analysis. PubMed, MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were queried. Primary outcome was esophageal perforation (EP). Risk ratio (RR), standardized mean difference (SMD), and 95% confidence intervals (95% CI) were effect size and relative inference measures. PROSPERO Registration Number: CRD42024512644.

Results
Fourteen observational studies (12962 patients) were included. Of those, 2503 (19.3%) underwent RHM. The patient age ranged from 34 to 66 years and 51.7% were males. EP occurred in 259 patients (1.99%). The cumulative incidence of EP was 1.67% for RHM and 2.07% for LHM. Compared to LHM, RHM was associated with a reduced risk of EP (RR: 0.31; 95% CI 0.16–0.59). No differences were found in term of dysphagia requiring reoperation or additional endoscopic procedures (RR: 0.47; 95% CI 0.20–1.09) and postoperative Eckardt score (SMD: -0.42; 95% CI -0.94, 0.11). Blood loss, conversion to open, operative time, and hospital length of stay were comparable.

Conclusions
RHM may be associated with a reduced risk of EP compared to LHM. However, because of selection bias, diverse surgeon expertise, variations in surgical technique, and prior endoscopic procedures these findings should not be viewed as conclusive while the superiority of one approach over the other remains to be established.
High relevance of invasive fungal disease in chronic liver transplant failure: a comprehensive cross-sectional study
Authors: Puzalkova Aleksandra V. , Hofmann Katharina , Pfeffer Tilman , Klein Isabel M. , Mehrabi Arianeb , Merle Uta , Stenzinger Albrecht , Penzel Roland , Flechtenmacher Christa , Schirmacher Peter 
Published: February 2025

Abstract
Invasive fungal infection (IFI) is a severe complication in organ transplant patients and a major diagnostic and therapeutic challenge. The aim of this comprehensive retrospective study was the characterization of IFI in context of chronic liver transplant failure regarding prevalence, morphological changes, and inducing fungal species. All explanted liver transplants due to chronic transplant failure from Heidelberg University Hospital were extensively reexamined for the presence of mycotic infection. Special stains were performed to uncover severity and associated conditions of IFI and fungal species were identified on the molecular level. Light-microscopic examination revealed fungal infection in 41 (27.5%) of 149 explanted livers with chronic transplant failure, with 68% representing newly specified cases compared to primary reports. We could show an increase of the proportion of mycotic infections during the investigated time period (1991–2021) as well as a shorter transplant survival when compared to the non-affected organs. Typically, large bile ducts were affected, accompanied by acute inflammation with frequent abscess and bile concrement formation. In 35 of 41 cases, the identification of the fungal species was achieved, revealing Candida albicans as prominent species (74.3%). In three autopsy livers of patients that died after liver transplantation of septic multiorgan failure, Candida spp. could be identified. Our data show the underestimated prevalence and high diagnostic and clinical relevance of mycotic infection in chronic liver transplant failure. Adapting diagnostic procedures, molecular pathological analyses, and therapeutic strategies is relevant to identify and prevent chronic transplant organ failure caused by IFIs.
Minimally invasive approach to peritonitis from left colonic perforation: a retrospective multicenter observational study
Authors: Ceresoli Marco , Ferro Carola Anna Paolina , La Greca Antonio , Cioffi Stefano Piero Bernardo , Biloslavo Alan , Podda Mauro , Coccolini Federico ,   the Study Collaborative Group, Massante Lorena , Palmisano Dario , Braga Marco , Cozza Valerio , Fico Valeria , Tropeano Giuseppe , Altieri Gaia , Damiani Riccardo , Altomare Michele , Virdis Francesco , Cimbanassi Stefania , Germani Paola , Gioia Adriana , Ciriotto Davide , Murzi Valentina , Pilia Tiziana , Dessì Alessia , Pisanu Adolfo , Facchin Rossella , Zocco Giuseppe , Cremonini Camilla , Tartaglia Dario 
Published: February 2025

Abstract

Background
Laparoscopic procedures have nowadays become the gold standard in multiple abdominal diseases, but in the emergency setting, especially in major surgery, laparoscopy still represents an obstacle for most surgeons. This multicentric study aims to define the surgical approach for emergency resective surgery in left colonic perforation peritonitis, determine the factors influencing the choice between MIS and open surgery, and identify factors associated with laparotomic conversion.

Methods
Retrospective data from 516 patients treated for left colonic perforation between January 2019 and December 2023 across six Italian centers was collected. Variables analyzed included patient demographics, disease and surgical characteristics, post-operative complications, and long-term outcomes. Univariate and multivariate regression models were performed to identify factors associated with surgical choice and likelihood of conversion.

Results
Only 24.5% of patients underwent laparoscopic approach, with a conversion rate of 52.8%. MIS was associated to lower CCI and MPI and less severe septic status at arrival. MIS was mostly performed by colorectal surgeons, compared to acute care surgeons. The post-operative outcome, considering LOS, ICU admission, post-operative complications and mortality rate, was better in the MIS group. The multivariate regression model revealed that CCI, MPI, and night-time surgery were negatively associated with MIS while colorectal surgeons had a positive association. Laparotomic conversion more commonly occurred in older patients with a higher MPI and CCI and more severe septic status; these patients had a worse post-operative outcome. MPI was the only factor with statistical significance in the univariate analysis, associated with conversion.

Conclusion
Although MIS is associated with better post-operative outcomes, it is underutilized in the emergency setting. Patients requiring laparotomic conversion had higher morbidity and mortality compared to those who underwent successful laparoscopy. Limiting factors for MIS include logistic factors, patient severity, and surgical skills, therefore careful patient selection and surgical training is crucial.
Rock Failure Characteristics Evaluated Under True Triaxial Loading from Micro-mechanical Viewpoint
Authors: Poorsolhjouy Payam , Mews Kim Sarah , Misra Anil 
Published: February 2025

Abstract
Geomaterials are widely known to exhibit loading-path-dependent mechanical behavior. The path dependence becomes more evident in triaxial loading conditions where the three principal stresses can have different histories, thereby creating a rich combination of complicated loading regimes. True triaxial loading which allows for independently varying the principal stresses, therefore, is the ideal experiment to investigate this behavior. In this work, we have used the Granular Micromechanics Approach (GMA) to derive the macroscopic behavior of rock-like granular materials by studying the behavior of inter-granular contacts in all directions. The work is motivated by the recent true triaxial experiments on sandstones showing the effect of Lode angle and mean stress on the stress state at failure. In this paper, we have analyzed the experimental loading condition as well as an additional loading scenario in which both the Lode angle and the mean stress are kept constant. Our micro-mechanical analysis shows that these two loading paths result in different failure envelopes. Accordingly, a priori assumptions of the failure criteria that are based upon stress states, and only weakly on loading paths, are shown to lead to misleading results. The GMA can be used as a theoretical-numerical predictive alternative to experimental measurements for evaluating the load-path dependency of failure. Further, GMA is shown to be able to asses failure stress state as well as the failure mode based on localization analysis.
Meteorin-like levels of oral fluids in periodontal health and diseases: a comparative cross-sectional study
Authors: Saglam Ebru , Toraman Ayse , Savran Levent , Saglam Mehmet , Koseoglu Serhat 
Published: February 2025

Abstract

Objectives
Cytokines are critical role in the pathogenesis of periodontal diseases. Meteorin-like (Metrnl), a protein released in the oral mucosa, is a novel cytokine associated with various inflammatory diseases. This study aimed to evaluate levels of salivary and gingival crevicular fluid (GCF), interleukin − 1 beta (IL-1β), interleukin − 10 (IL-10), and Metrnl in periodontal disease.

Materials and methods
It was formed three groups of 20 individuals each: the healthy, gingivitis, and periodontitis (Stage III, Grades A and B) groups. The enzyme-linked immunosorbent assay method measured IL-1β, IL-10, and Metrnl levels in salivary and GCF samples. Clinical periodontal measurement including probing pocket depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival index (GI) and percentage of bleeding on probing (%BOP); and biochemical parameters were evaluated using statistical analysis.

Results
Salivary concentrations and GCF total amount of IL-1β were significantly higher in the periodontal disease groups (p < 0.001). There was no significant difference among the groups in either salivary concentrations or GCF total amount of IL-10 (p > 0.05). Salivary Metrnl concentrations were significantly lower in the periodontitis group (p = 0.002). Salivary Metrnl concentrations had significant negative correlations with %BOP, PD, and CAL (p < 0.05). GCF total amount of Metrnl had significant negative correlations with GCF total amount of IL-1β (p = 0.03). The receiver operating characteristics curve showed: area under the curve (AUC) = 0.731 for salivary Metrnl concentrations to discriminate periodontitis from periodontal health and gingivitis.

Conclusion
Based on the findings of this study, Metrnl, as an immunoregulatory cytokine, may have an important relationship with periodontitis. Additional studies are needed to fully elucidate the functional effect of Metrnl in periodontal disease.

Clinical relevance

Background In knock-out experimental studies, it has been reported that Metrnl acts as an inflammation-related immunoregulatory cytokine. The findings relating it to inflammatory diseases support the idea that Metrnl may play a role in the pathogenesis of a variety of inflammatory diseases.

Added value of this study
Although Metrnl is a protein abundantly secreted in the oral mucosa, to the authors’ knowledge there has been no study evaluating it in gingivitis and periodontitis, inflammatory diseases. In this study, the levels of Metrnl in oral fluids, such as GCF and saliva, were examined in the presence of different periodontal diseases.

Clinical implications
Metrnl can be useful in distinguishing periodontal destruction from periodontal health.
Lagging regions between economic restructuring and addressing societal challenges
Authors: Hansmeier Hendrik , Koschatzky Knut , Stahlecker Thomas 
Published: February 2025

Abstract
In addition to continuously improving and renewing their economic structures to remain competitive, regions are increasingly called upon to address major societal challenges. Although this duality of structural and transformative change is becoming more widely recognised in the recent geographical innovation literature, there is still a lack of perspectives on economically lagging regions. This article empirically examines the opportunities for and obstacles to the nature, extent and direction of innovation-induced change in lagging regions. The analyses are based on qualitative case studies conducted in ten lagging regions in Germany that have received federal funding to implement alliances, develop innovation and steer change. The results suggest that regional structural laggardness, which is primarily expressed in a lack of actors and network relationships, limited innovation capacities as well as fragmented socio-demographic and institutional settings, seems to be a major barrier to induce transformative change. Put differently, lagging regions, already struggling to innovate, appear to be even more challenged to meet the demands of comprehensive transformation processes. As this dual challenge of innovation and transformation could increase spatial disparities, it seems necessary to consider economic restructuring and transformative change of structurally lagging regions in a more integrated way and to adapt policy instruments accordingly.
Community Impact of Capacity-Building to Develop Trauma Resilient Communities
Authors: Gilmer Todd P. , Center Kimberly , Romero Natalie J. , Burgos Lila , Greene Joelle , Siantz Elizabeth , Palinkas Lawrence A. , Lansing Amy E. 
Published: February 2025

Abstract
This paper explores the impact of an initiative designed to promote trauma resilient communities by mitigating social determinants of health and reducing health disparities through capacity-building partnerships. Nine regional partnerships in Los Angeles County were funded to build community capacity to adapt to and recover from traumatic events through outreach and engagement with community members, training related to the impact of trauma, linkages of community members to existing services, and developing new services for target populations. Primary quantitative and qualitative data on community impact were gathered from agency leads (N = 10), partnership members (N = 136), and community members (N = 42). A convergent sequential mixed methods design (qual → QUAN → qual) was selected to provide both breadth and depth of understanding about the impact of community capacity-building from multiple perspectives. From January 2018 through July 2023, partnerships conducted over 30,000 community capacity-building activities with over 1.4 M community members and created 101,370 successful linkages to resources and services among 12,663 unique community members. Agency leads, partnership members, and community members converged on three main themes describing the initiative’s impact: (1) Building more empowered and resilient communities; (2) Normalizing help-seeking and reducing the stigma of mental health; and (3) Connections within partnerships/families and with community members. On average, 82% of partnership members endorsed medium to large positive changes in the impacts identified during qualitative analysis. Future work should examine whether contracting with community-based organizations is an effective approach for health systems to promote health equity.
MP: motion program synthesis with machine learning interpretability and knowledge graph analogy
Authors: Cai Cheng-Hao 
Published: February 2025

Abstract
The advancement of physics-based engines has led to the popularity of virtual reality. To achieve a more realistic and immersive user experience, the behaviours of objects in virtual scenes are expected to conform to real-world physical laws accurately. This increases the workload and development time for developers. To facilitate development on physics-based engines, this paper proposes MP that is a motion program synthesis approach based on machine learning and analogical reasoning. MP follows the paradigm of test-driven development, where programs are generated to fit test cases of motions subject to multiple environmental factors such as gravity and airflows. To reduce the search space of code generation, regression models are used to find variables that cause significant influences to motions, while analogical reasoning on knowledge graphs is used to find operators that work for the found variables. Besides, constraint solving is used to probabilistically estimate the values of constants in motion programs. Experimental results have demonstrated that MP is efficient in various motion program generation tasks, with random forest regressors achieving low data and time requirements.
Multicriteria decision support for sustainable energy planning: an evaluation of alternative scenarios for the solar power plant site selection
Authors: Yildiz Ozge Acuner , Cebi Selcuk , Yildiz Omer 
Published: February 2025

Abstract
Solar energy is a renewable source that is suitable for local applications due to its low operating costs, its environmentally friendly structure, its simpler technology infrastructure, and its clean and inexhaustible supply. In Türkiye, the installation of solar power plants (SPP) is increasing in direct proportion to the demand for renewable energy. Within this scope, the site selection problem is vital in order to effectively solve the energy problems, minimize the existing costs, and ensure sustainability. The final decision of the SPP location selection involves numerous subjective and objective evaluation factors, making it a challenging and complex decision-making process. In this study, a new integrated model is introduced that combines fuzzy set theory, analytic hierarchy process (AHP), geographic information systems (GIS), and information axiom methods to address the SPP site selection problems. In this paper, an application has been presented to illustrate the effectiveness of the proposed model. In the context of this study, the most suitable location for a solar power plant (SPP) was identified among six different provinces in Türkiye (Erzurum, Kayseri, Mersin, Mugla, Sanliurfa, and Van) by considering both quantitative and qualitative criteria. These provinces have different characteristics and are located in different regions of Türkiye. The result of this investigation was that Mersin was determined to be the most appropriate location for the SPP. Furthermore, a sensitivity analysis has been performed in order to examine the impact of the weights of the evaluation criteria on the results of the application.
Factors Influencing Young People’s STEM Career Aspirations and Career Choices: A Systematic Literature Review
Authors: Zhou Yingying , Shirazi Shaista 
Published: February 2025

Abstract
Science, Technology, Engineering, and Mathematics (STEM) career aspirations and choices provide critical insights into students’ motivations and attitudes toward STEM careers. With the rapid evolution of technology and societal shifts following the COVID-19 pandemic, there is a pressing need to update our understanding of the factors influencing students’ STEM career aspirations and choices. This systematic review aims to identify the most influential factors reported in research on young people’s (11–19 and undergraduate) STEM career aspirations and choices over the past decade or so, as well as highlight prevailing trends in current empirical studies. Seven databases including Australia Education Index, British Education Index, ERIC, ProQuest, PsycINFO, Web of Science, and Google Scholar were searched for publications between January 2009 and December 2022 in English. 159 papers were screened as eligible using the Preferred Reporting Items for Systematic Literature Reviews (PRISMA) protocol and reviewed for general trends. A further 12 papers were screened for in-depth review which are career aspiration/choice factor studies that reflect students’ voices on STEM career aspirations. Self-motivation, social persuasion, self-efficacy, personal utility, and positive STEM experiences were among the identified influential factors. While previous determinants such as ease of occupation and peer pressure have reduced effects, future studies should focus on cultural, regional, and societal implications, as well as the intersectionality of these factors. Furthermore, research into social media, utility impact, and viewpoints on the changing nature of work and technological advancement is critical for guiding policies to encourage young people to enter STEM disciplines.