bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of surgical performance using articulated (ArtiSential®) and conventional instruments for colorectal laparoscopic surgery: A single‐centre, open, before‐and‐after, prospective study
Authors: Shin Hye Rim , Oh Heung‐Kwon , Ahn Hong‐min , Lee Tae‐Gyun , Choi Mi Jeoung , Jo Min Hyeong , Singhi Anuj Naresh , Kim Duck‐Woo , Kang Sung‐Bum 
Published: October 2024

AbstractAimRigid surgical instruments limit movement whereas articulated instruments offer better control in small spaces and allow for intuitive and ergonomic movements. However, the effectiveness of the use of articulated instruments in improving colorectal laparoscopic outcomes remains unclear. The aim of this work was to determine whether colorectal laparoscopic surgical proficiency improved when multijoint instruments were used instead of conventional ones.MethodWe enrolled 70 consecutive patients (n = 20 for conventional instruments) aged 19–80 years who underwent elective laparoscopic surgery for colorectal diseases. Unedited surgery videos were validated using the modified Global Operative Assessment of Laparoscopic Skills (mGOALS) scale. Learning curves were analysed using a cumulative sum control chart for mGOALS grades.ResultsThe surgery type, length of hospital stay and 30‐day postoperative complication rates were comparable between the groups, and the surgeon's mGOALS grades were similar (p = 0.190). However, in the articulated group, the scores were significantly higher for depth perception (p = 0.012) and tissue‐handling domains (p = 0.046), while surgical duration was significantly shorter and intraoperative blood loss was significantly lower (p = 0.022), compared with those in the conventional (p = 0.002) group. Learning curve findings indicated that the first 10 and subsequent 40 surgeries in the articulated group were within the inexperienced and experienced phases, respectively. The mGOALS score in the experienced phase improved in the articulated group compared with that in the conventional group (p = 0.036).ConclusionsThe use of articulated instruments in laparoscopic colorectal surgery showed potential benefits. Further studies are needed to confirm these findings.
Changing Landscape of Open Offers in Liver Transplantation in the Machine Perfusion Era: Exposure, Equity, and Economics
Authors: Wehrle Chase J. , Gross Abby , Fares Sami , Kusakabe Jiro , Calderon Esteban , Shanmugarajah Kumaran , Uysal Melis , Fleischer Christina M. , Allkushi Erlind , Schold Jesse D. , Khalil Mazhar , Pita Alejandro , Fujiki Masato , Schlegel Andrea , Miller Charles , Hashimoto Koji , Wakam Glenn K. 
Published: October 2024

ABSTRACTBackgroundOpen offers (OOs) in liver transplantation (LT) result from bypassing the traditional allocation system. Little is known about the trends of OOs or the differences in donor/recipient characteristics compared to traditionally placed organs. We aim to quantify modern practices regarding OOs and understand NMP's impact, focusing on social determinants of health (SDH), cost, and graft‐associated risk.MethodsLTs from 1/1/2018 to 12/31/2023 at a single center were included. NMP was implemented on 10/1/2022. The CDC (centers for disease control)‐validated social vulnerability index (SVI) and donor risk index (DRI) were calculated. Comprehensive complications index (CCI), Clavien‐Dindo grades, patient and graft survival, and costs of transplantation were included.Results1162 LTs were performed; 193 (16.8%) from OOs. OOs were more common in the post‐NMP era (26.5% vs. 13.3%, p < 0.001). Pre‐NMP, patients receiving OOs had longer waitlist times (118 vs. 69 days, p < 0.001), lower MELDs (17 vs. 25 points, p < 0.001), and riskier grafts (DRI = 1.8 vs. 1.6, p = 0.004) compared to standard offers. Post‐NMP, recipients receiving OOs demonstrated no difference in waitlist time (27 vs. 20 days, p = 0.21) or graft risk (DRI = 2.03 vs. 2.23, p = 0.17). OO recipient MELD remained lower (16 vs. 22, p < 0.001). OO recipients were more socially vulnerable (SVI), pre‐NMP (0.41 vs. 0.36, p = 0.004), but less vulnerable after NMP (0.23 vs. 0.36, p = 0.019). Despite increased graft risk, pre‐NMP OO‐LTs were less expensive in the 90‐day global period ($154 939 vs. $178 970, p = 0.002) and the 180‐days pre‐/post‐LT ($208 807 vs. $228 091, p = 0.021). Cost trends remained similar with NMP.ConclusionOOs are increasingly utilized and may be appealing due to demonstrated cost reductions even with NMP. Although most OO‐related metrics in our center remain similar before and after machine perfusion, programs should take caution that increasing use does not worsen organ access for socially vulnerable populations.
Public Acceptance of Living Donor Liver Transplant for Colorectal Liver Metastases: A Web‐Based Survey
Authors: Chávez‐Villa Mariana , Pope‐Collins Elizabeth , Dokus Katherine , Martens John , Keller Elizabeth , Nickels Mark , Byrne Matthew , Hernandez‐Alejandro Roberto , Al‐Judaibi Bandar 
Published: October 2024

ABSTRACTBackgroundRecent advancements in cancer treatment and post‐transplant management have expanded the population of living donor liver transplant (LDLT) candidates. We aimed to examine variations in public acceptance of LDLT based on patient diagnosis, including unresectable colorectal liver metastases (uCRLM).MethodsA web‐based survey collected demographic information and general perceptions about organ donation in different settings. Respondents indicated their likelihood of being a living liver donor for a family member with genetic liver disease, alcohol‐related liver disease (ALD), and uCRLM. Differences in the likelihood of donation between scenarios were compared.ResultsThere were 491 survey respondents (female [76.5%], Caucasians [87.4%], and had at least a college degree [98.2%]). Most (82.4%) were aware of the option of living liver donation before the study and 95% supported living organ donation in general. Over 80% were registered as organ donors. Ninety percent indicated that they would be likely to donate to a family member with a genetic liver disease if they qualified as a living donor; significantly more than ALD (59%) and uCRLM (71%) (p < 0.001). Willingness to donate to patients with uCRLM was significantly higher (p < 0.001) than the hypothetical patient with ALD with a clinically accepted recovery period of 6 months.ConclusionsThis study is the first of its kind to assess the public acceptance of living liver donation for uCRLM. Respondents were as or more supportive of donating to uCRLM as they were of generally accepted indications for LT. Further surveys with a broader respondent pool are warranted.
What do we mean by “agency”? A framework and tools for supporting visitors' agency in museums and science centers
Authors: Letourneau Susan M. , Schloss Dana , Perez Sylvia , Aucapina Franklin , Baburyan Michael , Curto Kate , Gomez Edwin , McDonald Truck , Multani Satbir , Taylor Trevor , Tumolo Sam , Umer Laycca 
Published: October 2024

AbstractAgency is a central value within museums and science centers, but it has not been defined and operationalized in ways that can guide museum practice or support inclusion for new audiences. In this project, an interdepartmental group of science center staff co‐created a conceptual framework for noticing and supporting visitors' agency. The framework includes four interconnected aspects of agency: physical environment, social engagement, choice and autonomy, and relevance and empowerment. Conceptualizing agency as multifaceted led to more expansive approaches for supporting it, allowing staff to move beyond open‐endedness to consider a wider range of supports and structures that can make museum experiences more inviting and inclusive. The framework informed the development of practical tools for use by exhibit/program developers and facilitators. Tools are freely available and guide museum staff in questioning current practices and integrating the four facets of agency into planning, prototyping, and observation of interactive experiences.
Integrated multiomic analyses: An approach to improve understanding of diabetic kidney disease
Authors: Hill Claire , McKnight Amy Jayne , Smyth Laura J. 
Published: October 2024

AbstractAimDiabetes is increasing in prevalence worldwide, with a 20% rise in prevalence predicted between 2021 and 2030, bringing an increased burden of complications, such as diabetic kidney disease (DKD). DKD is a leading cause of end‐stage kidney disease, with significant impacts on patients, families and healthcare providers. DKD often goes undetected until later stages, due to asymptomatic disease, non‐standard presentation or progression, and sub‐optimal screening tools and/or provision. Deeper insights are needed to improve DKD diagnosis, facilitating the identification of higher‐risk patients. Improved tools to stratify patients based on disease prognosis would facilitate the optimisation of resources and the individualisation of care. This review aimed to identify how multiomic approaches provide an opportunity to understand the complex underlying biology of DKD.MethodsThis review explores how multiomic analyses of DKD are improving our understanding of DKD pathology, and aiding in the identification of novel biomarkers to detect disease earlier or predict trajectories.ResultsEffective multiomic data integration allows novel interactions to be uncovered and empathises the need for harmonised studies and the incorporation of additional data types, such as co‐morbidity, environmental and demographic data to understand DKD complexity. This will facilitate a better understanding of kidney health inequalities, such as social‐, ethnicity‐ and sex‐related differences in DKD risk, onset and progression.ConclusionMultiomics provides opportunities to uncover how lifetime exposures become molecularly embodied to impact kidney health. Such insights would advance DKD diagnosis and treatment, inform preventative strategies and reduce the global impact of this disease.
Impact Absorption Power of Polyolefin Fused Filament Fabrication 3D‐Printed Sports Mouthguards: In Vitro Study
Authors: Nassani Leonardo Mohamad , Storts Samuel , Novopoltseva Irina , Place Lauren Ann , Fogarty Matthew , Schupska Pete 
Published: October 2024

ABSTRACTBackground/AimThis study aims to evaluate and compare the impact absorption capacities of thermoformed ethylene vinyl acetate (EVA) mouthguards and 3D‐printed polyolefin mouthguards used in sports dentistry applications. The objective is to determine whether 3D‐printed polyolefin mouthguards offer superior impact toughness compared to traditional EVA mouthguards commonly used in sports settings.Materials and MethodsSix material samples were assessed: five pressure‐formed EVA mouthguards (PolyShok, Buffalo Dental, Erkoflex, Proform, and Drufosoft) and one 3D‐printed synthetic polymer (polyolefin). The materials were evaluated using a modified American Society for Testing and Materials (ASTM) D256 Test Method A for Izod pendulum impact resistance of plastics. Polyolefin samples were 3D‐printed using fused filament fabrication (FFF) technology. Notably, the FFF process included samples printed with notches placed either parallel or perpendicular to the build direction. This orientation served as a study factor, allowing for comparison of material behavior under different printing conditions. Impact testing was conducted using an Izod impact tester to assess the materials' performance under controlled impact conditions.ResultsThe study achieved a high power (1.0) in power analysis, indicating strong sensitivity to detect significant differences. Among molded materials, PolyShok showed significantly lower impact toughness compared to others (p = 0.06). The mean impact absorption of EVA materials was 5.4 ± 0.3 kJ/m2, significantly lower than polyolefin materials, which demonstrated 12.9 ± 0.7 kJ/m2 and superior performance (p = 0.0). Horizontal‐notched polyolefin samples exhibited higher impact strength compared to vertical‐notched samples (p = 0.009).Conclusions3D‐printed polyolefin mouthguards exhibited significantly higher impact toughness than thermoformed EVA mouthguards. While EVA materials demonstrated structural robustness, their lower impact resistance and observed tearing in other test specimens suggest the need for alternative testing standards to better reflect real‐world conditions. 3D‐printed mouthguards fabricated with build orientations perpendicular to the direction of impact demonstrate significantly enhanced impact absorption. Further research into manufacturing methods and testing protocols is recommended to optimize mouthguard performance under impact scenarios.
Accuracy and Consistency of Gemini Responses Regarding the Management of Traumatized Permanent Teeth
Authors: Portilla Nicolas Dufey , Garcia‐Font Marc , Nagendrababu Venkateshbabu , Abbott Paul V. , Sanchez Jose Antonio Gonzalez , Abella Francesc 
Published: October 2024

ABSTRACTBackgroundThe aim of this cross‐sectional observational analytical study was to assess the accuracy and consistency of responses provided by Google Gemini (GG), a free‐access high‐performance multimodal large language model, to questions related to the European Society of Endodontology position statement on the management of traumatized permanent teeth (MTPT).Materials and MethodsThree academic endodontists developed a set of 99 yes/no questions covering all areas of the MTPT. Nine general dentists and 22 endodontic specialists evaluated these questions for clarity and comprehension through an iterative process. Two academic dental trauma experts categorized the knowledge required to answer each question into three levels. The three academic endodontists submitted the 99 questions to the GG, resulting in 297 responses, which were then assessed for accuracy and consistency. Accuracy was evaluated using the Wald binomial method, while the consistency of GG responses was assessed using the kappa‐Fleiss coefficient with a confidence interval of 95%. A 5% significance level chi‐squared test was used to evaluate the influence of question level of knowledge on accuracy and consistency.ResultsThe responses generated by Gemini showed an overall moderate accuracy of 80.81%, with no significant differences found between the responses of the academic endodontists. Overall, high consistency (95.96%) was demonstrated, with no significant differences between GG responses across the three accounts. The analysis also revealed no correlation between question level of knowledge and accuracy or consistency, with no significant differences.ConclusionsThe results of this study could significantly impact the potential use of Gemini as a free‐access source of information for clinicians in the MTPT.
Influence of Using a Puncturing Method and Cooldown Period Before Pressing the Second‐Layered Sheet on the Final Thickness of Double‐Layered Sports Mouthguards: An Experimental Study
Authors: Uma Uthai , Tretanyuth Peerathat , Panitchumroen Puripat , Chomin Sirawish 
Published: October 2024

ABSTRACTAimThe thickness of the mouthguard is a crucial factor in its protective ability for athletes. This study aimed to investigate the final thickness of double‐layered sports mouthguards, which were fabricated using different methods before pressing the second layer.Materials and MethodsSeven upper working models (n = 7 per group) were prepared for mouthguard fabrication. The first 3‐mm mouthguard sheet underwent heating, pressing, and vacuuming onto the model, followed by various protocols before the second 3‐mm sheet was pressed. Group 1: The second sheet was pressed immediately. Group 2: The first sheet underwent a 1‐h cooldown period before pressing the second sheet. Group 3: The interproximal areas of the first sheet were punctured followed by immediate pressing of the second sheet. Group 4: The first sheet was punctured followed by a 1‐h cooldown before pressing the second sheet. After 24 h, the mouthguard thickness was measured at various points on the left and right central incisors and first molars using a digital caliper. The thickness analysis was performed using SPSS 29.0 with one‐way ANOVA and Tukey post hoc analysis.ResultsAt the labial surface of the central incisors, Group 4 exhibited the highest thickness, while Group 3 had the lowest (p < 0.001). Groups 1 and 2 did not show significant differences in thickness. At the incisal edges, Group 3 again had the lowest thickness (p < 0.05), with no significant differences observed among the other groups. There were no significant differences in thickness across all areas at the first molars, including cusp tips, pits, and buccal surfaces (p > 0.05). Group 4 demonstrated greater uniformity at the central incisors in thickness compared with the other groups.ConclusionsUsing the puncturing method at interproximal areas combined with a cooldown period could enhance mouthguard thickness at the labial surfaces of the central incisors and improve its thickness uniformity.
Somatic variant analysis of resected brain tissue in epilepsy surgery patients
Authors: Sanders Maurits W. C. B. , Koeleman Bobby P. C. , Brilstra Eva H. , Jansen Floor E. , Baldassari Sara , Chipaux Mathilde , Sim Nam Suk , Ko Ara , Kang Hoon‐Chul , Blümcke Ingmar , Lal Dennis , Baulac Stéphanie , Lee Jeong Ho , Aronica Eleonora , Braun Kees P. J. 
Published: October 2024

AbstractWe studied the distribution of germline and somatic variants in epilepsy surgery patients with (suspected) malformations of cortical development (MCD) who underwent surgery between 2015 and 2020 at University Medical Center Utrecht (the Netherlands) and pooled our data with four previously published cohort studies. Tissue analysis yielded a pathogenic variant in 203 of 663 (31%) combined cases. In 126 of 379 (33%) focal cortical dysplasia (FCD) type II cases and 23 of 37 (62%) hemimegalencephaly cases, a pathogenic variant was identified, mostly involving the mTOR signaling pathway. Pathogenic variants in 10 focal epilepsy genes were found in 48 of 178 (27%) FCDI/mild MCD/mMCD with oligodendroglial hyperplasia and epilepsy cases; 36 of these (75%) were SLC35A2 variants. Six of 69 (9%) patients without a histopathological lesion had a pathogenic variant in SLC35A2 (n = 5) or DEPDC5 (n = 1). A germline variant in blood DNA was confirmed in all cases with a pathogenic variant in tissue, with a variant allele frequency (VAF) of ~50%. In seven of 114 patients (6%) with a somatic variant in tissue, mosaicism in blood was detected. More than half of pathogenic somatic variants had a VAF < 5%. Further analysis of the correlation between genetic variants and surgical outcomes will improve patient counseling and may guide postoperative treatment decisions.
Fatigue Crack Segmentation and Characterization of Additively Manufactured Ti‐6Al‐4V Using X‐Ray Computed Tomography
Authors: Hejazi Bardia , Compart Amaya , Fritsch Tobias , Wagner Ruben , Weidner Anja , Biermann Horst , Benz Christopher , Sander Manuela , Bruno Giovanni 
Published: October 2024

ABSTRACTX‐ray computed tomography (XCT) is extremely useful for the non‐destructive analysis of additively manufactured (AM) components. AM components often show manufacturing defects such as lack‐of‐fusion (LoF), which are detrimental to the fatigue life of components. To better understand how cracks initiate and propagate from internal defects, we fabricated Ti‐6Al‐4V samples with an internal cavity using electron beam powder bed fusion. The samples were tested in high‐cycle and very high‐cycle fatigue regimes. XCT was used to locate crack initiation sites and to determine characteristic properties of cracks and defects with the aid of deep learning segmentation. LoF defects exposed to the outer surface of the samples after machining were found to be as detrimental to fatigue life as the internal artificial defects. This work can benefit industries that utilize the AM of high‐strength, lightweight alloys, in the design and manufacturing of components to improve part reliability and fatigue life.
Ecological but Not Biological Traits of European Riverine Invertebrates Respond Consistently to Anthropogenic Impacts
Authors: Sinclair James S. , Stubbington Rachel , Schäfer Ralf B. , Barešová Libuše , Bonada Núria , Csabai Zoltán , Jones J. Iwan , Larrañaga Aitor , Murphy John F. , Pařil Petr , Polášek Marek , Rasmussen Jes J. , Straka Michal , Várbíró Gábor , Verdonschot Ralf C. M. , Welti Ellen A. R. , Haase Peter 
Published: October 2024

ABSTRACTAimTo determine which riverine invertebrate traits respond consistently to anthropogenic impacts across multiple biogeographic regions.LocationEurope.Time Period1981–2021.Major Taxa StudiedRiverine invertebrates.MethodsWe compiled a database of riverine invertebrate community time series for 673 sites across six European countries spanning six freshwater ecoregions. We compared trait responses to anthropogenic impacts (quantified as changes in ‘ecological quality’) among regions for seven ‘ecological’ traits, which reflect habitat preferences, and nine ‘biological’ traits (e.g., morphology or life history), which represent taxon‐specific attributes that can influence ecosystem processes.ResultsFour ecological traits (current, microhabitat, salinity and trophic preferences) and one biological trait (dispersal mode) responded consistently across regions. These responses were primarily driven by spatial differences among poorer to better quality sites. Responses to temporal changes in quality were comparable but less pronounced.Main ConclusionsConsistent responses to anthropogenic impacts across multiple ecological traits indicate these traits may improve broader scale measurements, comparisons and predictions of community responses. However, we could not use ecological traits to identify the actions of specific stressors because multiple traits always responded as a group. Inconsistent responses across almost all biological traits indicated that these traits may be less predictive of impacts across regions. Predictions of how biological traits, and associated ecosystem processes, respond to anthropogenic impacts may be most effective at regional scales where responses are more consistent.
New nomenclature and subclassification of steatotic liver disease and loss of skeletal muscle mass: A longitudinal cohort study
Authors: Kim Aryoung , Kang Danbee , Choi Sung Chul , Sinn Dong Hyun , Gwak Geum‐Youn 
Published: October 2024

AbstractAimsIdentifying risk factors for sarcopenia is important due to its significant effect on health. The association between sarcopenia and the newly proposed steatotic liver disease (SLD) and its subclassification has largely been unexplored.MethodsThis longitudinal cohort study included 67 905 adults who underwent at least two health checkup examinations. SLD participants were categorized as cryptogenic SLD, metabolic dysfunction‐associated SLD, metabolic dysfunction‐associated alcoholic liver disease, or alcoholic liver disease. Appendicular skeletal muscle mass (ASM) was evaluated by bioelectrical impedance analysis.ResultsThe average duration of follow‐up was 5.9 years. The annual ASM change was −31.0 g (95% CI −32.3, −29.6) and −38.3 g (−40.3, −36.3) in participants without and with SLD, respectively. When assessed based on SLD severity, annual ASM loss was fastest in SLD participants with Fibrosis‐4 score ≥1.3, followed by those with Fibrosis‐4 score <1.3 and those without SLD. In multivariable adjusted analysis, annual ASM loss was fastest in participants with metabolic dysfunction‐associated alcoholic liver disease (−49.8 g; −93.1, −6.5), followed by those with metabolic dysfunction‐associated SLD (−24.7 g; −60.4, 11.1), and alcoholic liver disease (−24.4 g; −91.1, 42.3), and slowest in those with cryptogenic SLD (reference). This pattern was more pronounced in participants with Fibrosis‐4 score ≥1.3.ConclusionThe loss of skeletal muscle mass was fastest in the participants with metabolic dysfunction‐associated alcoholic liver disease, followed by participants with metabolic dysfunction‐associated SLD, alcoholic liver disease, and cryptogenic SLD. Particular attention to prevent sarcopenia should be given to SLD patients with cardiometabolic risk factors or alcohol consumption, especially in patients with advanced fibrosis.