bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneous Reconstruction of the Esophagus and Posterior Tracheal Wall Using a Combination of Free Jejunal and Mesenteric Flaps: A Case Report
Authors: Goishi Keiichi , Abe Yoshiro , Harada Hiroshi , Ikushima Kenta , Nakagawa Mai , Mima Shunsuke , Hashimoto Ichiro 
Published: November 2024

ABSTRACTFree jejunal transfer is one of the most useful procedures for reconstructing circumferential defects following total pharyngolaryngoesophagectomy (TPLE). When an extended resection of the surrounding soft tissue is performed in addition to the TPLE, the defect may require another flap in addition to the jejunal flap to reconstruct the soft tissue defect. In such multiple defects, the choice of reconstruction method remains unanswered and unsolved. Herein, our objective was to clarify the utility of our newly developed technique of simultaneous reconstruction of two defects in the neck using a combination of free jejunal and mesenteric flaps. An 81‐year‐old man had defects in the upper esophagus, total larynx/pharynx, and posterior tracheal wall caused by the resection of invasive upper esophagus cancer anterior to the membranous part of the trachea. A chimera flap composed of a 15 cm free jejunal and mesenteric flap along with 15 cm of surplus mesentery was harvested; the jejunum was inserted into the esophageal defect and the mesentery was placed on the tracheal defect. The patient exhibited a favorable postoperative course at 8 months with no recurrence or stenosis in the reconstructed respiratory or gastrointestinal tract. This method offers a straightforward vessel anastomosis, making it a good and reasonable option for reconstructing partial tracheal defects along with TPLE.
Improving independent purchasing skills in postsecondary students with disabilities
Authors: Welch Addison L. , Skinner Christopher H. , Collins Hannah L. , Chutna Mitchell R. , Smith Cate , Cihak David , Wilhoit Brian 
Published: November 2024

AbstractAn experimental design was used to evaluate the effects of a classroom‐based purchasing skills intervention designed to teach postsecondary students with intellectual and developmental disabilities the one‐dollar‐more purchasing strategy. The experimental group students (n = 12) completed the intervention first,and the control group participants (n = 9) did not receive the intervention until experimental procedures ceased. The intervention included eight intervention sessions. Each session included researcher‐led, small‐group instruction designed to enhance acquisition of the one‐dollar‐more strategy, followed by response card learning trials designed to enhance skill development. The response card trials contained different price points that reflected common items available for purchase in community retail settings. Results showed significant improvement in the experimental group's ability to provide the correct amount of dollar bill across 20 purchase prices up to $39 within 10 s. No significant changes were observed in the control group. However, individual analysis showed that some students who received the intervention did not show socially valid improvements. Also, group data suggest that most of the improvement may have occurred after three intervention sessions. Although our group data showed increases in purchasing skill acquisition (accuracy), fluency (within 10 s), and generalization (different values), discussion focuses on future research designed to enhance the efficacy of this intervention across all students and to assess for generalization to natural settings.
The Benefits of PROSPER‐Based Intervention for International Preschool Teachers in Hong Kong: Evidence From the EASP Program
Authors: Lee Alfred S. Y. , Fung Wing Kai , Chung Kevin Kien Hoa , Datu Jesus Alfonso Daep , Cheung Ryan Yat Ming 
Published: November 2024

ABSTRACTLimited research has examined the well‐being of international preschool teachers, while intervention targeting their well‐being is even rarer. The objective of this study was to examine the effectiveness of a 2‐month EASP (i.e., Early Advancement in Social‐Emotional Health and Positivity) positive psychological intervention program based on the PROSPER—which stands for positivity, relationship, outcome, strength, purpose, engagement, and resilience– framework on international preschool teachers' well‐being in Hong Kong. Eighty‐three teachers (Mage = 34.44 years, SD = 8.43, range = 19–53; female = 95.18%) were randomly assigned to the intervention (n = 44) and waitlist control groups (n = 39). Teachers completed survey measures of PROSPER well‐being at baseline and after the intervention. The results of the multivariate regression analyses revealed that the intervention did not have significant overall effects on the PROSPER well‐being, Wilks' lambda F(7, 56) = 1.28, p = 0.28, η2 = 0.14. Yet, findings of univariate analyses suggested the intervention yielded significant medium effects on participants' relationship, outcome, strength and engagement (b = 0.26 to 0.45, 95% CI [0.04, 0.95], p = 0.02 to 0.03, η2 = 0.07 to 0.08). The findings underscore the practical utility of the PROSPER framework in supporting international preschool teachers' well‐being but, at the same time, highlight the need to further examine how cultural variations might implicate its effectiveness.
Security strategies for AI systems in Industry 4.0
Authors: Bairaktaris Julius A. , Johannssen Arne , Tran Kim Phuc 
Published: November 2024

AbstractThe recent emergence and widespread adoption of Artificial Intelligence (AI) across various industries have not only increased efficiency and innovation but also introduced complex security challenges. Addressing these security challenges is an ever‐evolving area of research that seeks to mitigate issues affecting a wide range of individuals and sectors. Understanding the threats and vulnerabilities posed by these systems, and how to effectively defend against them, has become more crucial than ever. This paper aims to provide an overview of the most common attack vectors and their respective defense strategies, focusing particularly on those relevant to Industry 4.0. A major area of interest is adversarial machine learning, a relatively new field that focuses on corrupting, confusing, and manipulating AI models by intervening in different phases of their life cycle. The key findings indicate that FLAME offers the best protection against data poisoning attacks for neural network image detection models in a federated learning environment. Additionally, due to the specific threat model in Industry 4.0, defensive distillation emerges as the most promising defense strategy against evasion attacks.
The rhizosphere bacterial community of water yam (Dioscorea alata L.) under limited water conditions
Authors: Kihara Shunta , Yamamoto Kosuke , Shiwa Yuh , Matsutani Minenosuke , Kikuno Hidehiko , Shiwachi Hironobu 
Published: November 2024

AbstractIntroductionYam cultivation in West Africa, the largest yam production area, has expanded to the northern Guinea savanna, which receives an annual rainfall of 800–1000 mm. However, variations in rainfall are problematic for the stable productivity of yams. Integrated soil fertility management is urgently needed to improve and stabilise yam productivity. Plants have complex interactions with bacterial communities, influencing their health and environmental adaptability. Although the growth of water yams (Dioscorea alata L.) at various rainfall levels might be related to their interaction with the bacterial community, their structure under water limitation is yet to be elucidated. Here, we evaluated the bacterial community structure in the rhizosphere (Rh) and roots of ‘A‐19’ under water limitation conditions.Materials and MethodsPlants were grown under normal conditions, and watering was reduced to less than 70% for 1 month. Rh and root samples were collected for DNA extraction, and downstream amplicon sequencing analyses were performed.ResultsThe dry weight of the shoots, particularly the leaves, decreased under water limitation. Bacterial diversity in the rhizocompartments was significantly reduced. However, bacterial community composition was not affected by water limitation. Despite water‐limited conditions, bacterial community structure was robust in the Burkholderia‐Caballeronia‐Paraburkholderia and Streptomyces clades. These taxa accounted for approximately 60% of the relative abundance in the roots under water limitation.Conclusionidentifying bacterial community composition of ‘A‐19’ under water‐limited conditions provides fundamental information for developing integrated soil fertility management strategies across rainfall gradients in West Africa. Our study indicates that ‘A‐19’ has a robust bacterial community structure for beneficial interactions with bacteria despite soil water conditions.
In search of a sound scientific basis for quantification of soil precompression stress
Authors: Schjønning Per , Lamandé Mathieu 
Published: November 2024

AbstractSoil compaction is a serious threat to soil functions and ecosystem services. Persistent soil deformation takes place when mechanical stress exceeds soil strength. Risk assessment models typically assume soil to be elastic to a precompression stress level and plastic above this threshold. Currently used procedures for estimating soil precompression stress imply applied stress in a logarithmic form that has been criticized. We performed uniaxial, confined compression tests on 117 soil samples with a well‐defined stress history. Strain and stress were recorded at 200 levels of stress in the range of 0–1 MPa. Soil compressibility was calculated as incremental strain per incremental stress, using stress in arithmetic scale. For a given sample, a local minimum in compressibility appeared close to the preload applied to the sample prior to the compression test. This yield stress is suggested as an expression of soil precompression stress. Not all samples displayed a yield stress. Primarily soil exposed to a high preload did not exhibit a clear stress level with change in compressibility. This indicates that a physically based stress level pointing out a transition to plastic conditions will not exist for all soils. Our observation calls for new concepts in risk assessment. Tests with interpolation between a limited number of data points indicate that the yield stress—if existing—may be detected from classical compression data.
Deployment stressors, mental health outcomes, and protective factors among wives of reserve soldiers during the Israel‐Hamas War: A latent profile analysis approach
Authors: Zerach Gadi 
Published: November 2024

AbstractDeployment to active conflict zones significantly affects military families, with spouses often experiencing heightened stress and mental health challenges. However, research on non‐US military spouses, particularly those of reserve soldiers, who may face unique stressors compared to active‐duty personnel, remains scarce. This study examined perceived stress profiles among Israeli spouses of reserve soldiers during the ongoing Israel‐Hamas War, and their associations with deployment stressors, mental health outcomes, and psychological protective factors. A volunteer sample of Israeli spouses of reserve soldiers (n = 293) responded to self‐report questionnaires in a cross‐sectional study. Using latent profile analysis of the ratings of perceived stress, three distinct profiles were identified: low (35.1%), moderate (43.5%), and high (21.3%). Higher levels of deployment stressors (e.g., fear of spouse getting physically injured) predicted membership in the moderate and high‐stress profiles, while better household management was associated with lower stress profiles. The high‐stress profile reported significantly greater symptoms of depression and anxiety compared to the low and moderate stress profiles. In contrast, the low‐stress profile exhibited higher levels of resilience, self‐compassion, and perceived social support. These findings highlight the variability in spouses' stress responses during wartime deployment and identify key factors associated with psychological adjustment. Results suggest that deployment‐related fears, household management abilities, and psychological resources are crucial in shaping stress profiles and mental health outcomes among military spouses.
A transnational language teacher educator's autoethnographic pursuit of reflexivity in Hong Kong
Authors: Uştuk Özgehan 
Published: November 2024

AbstractLanguage teacher educators all around the world work in multiple countries and institutions throughout their careers across institutional, national, and academic cultures. As higher education becomes more transnational in some regions (including Hong Kong), it has also become more common for language teacher educators to construct transnational identities. This autoethnographic self‐study shares the author's transnational identity as informed by professional tensions he experienced while transitioning to a new institutional and academic culture in Hong Kong as a language teacher educator. As he narrates his story, he unpacks how his philosophies and practices informed one another as he constructed his professional identities in different cultural contexts and contact zones and elaborates on his identity work while revising his practices in his new professional contact zone. As an early‐career language teacher educator, he shows how engaging in autoethnographic narrative helped him to adopt a reflexive lens to critically examine his professional engagements across academic cultures and discourses.
Digitale Technologien in der primären Knieendoprothetik – Nutzungsdichte im deutschsprachigen Raum
Authors: Pohlig Florian , Becker Roland , Ettinger Max , Calliess Tilman , Hinterwimmer Florian , Tibesku Carsten O. , Schnurr Christoph , Graichen Heiko , Savov Peter , Pagano Stefano , Bieger Ralf , Gollwitzer Hans 
Published: November 2024

Zusammenfassung
Hintergrund
Digitale Assistenzsysteme werden weltweit zunehmend in der primären Knieendoprothetik eingesetzt. Ziel war es, die Nutzungsdichte digitaler Hilfsmittel, die bevorzugten Alignmentstrategien sowie die Hindernisse und Vorteile der Implementierung dieser Technologien im deutschsprachigen Raum zu analysieren.

Material und Methoden
Es wurde eine Online-Umfrage mit 57 Fragen zu digitalen Tools in der primären Knieendoprothetik sowie deren Nutzung unter den Mitgliedern der Arbeitsgemeinschaft Endoprothetik (AE) durchgeführt. Folgende Technologien und deren Nutzung wurden abgefragt: Navigation, Robotik, patientenspezifische Instrumente, Individualimplantate sowie die Nutzung von Augmented Reality.

Ergebnisse
Die Umfrage ergab, dass 18 % der Kliniken Navigations- und 17 % Robotiksysteme in der primären Knieendoprothetik einsetzen. Die Hauptgründe für die Nichtnutzung dieser Technologien waren die hohen Anschaffungs- und laufenden Kosten sowie der zusätzliche perioperative Zeitaufwand. Patientenspezifische Instrumente und Individualimplantate spielen aktuell nur eine untergeordnete Rolle in Deutschland. Patientenindividuelle Alignmentstrategien wie kinematisches (Navigation: 35 %; Robotik: 44 %) und funktionelles Alignment (Navigation: 15 %; Robotik: 35 %) werden bei Einsatz digitaler Assistenzsysteme bevorzugt. Dies stellt einen deutlichen Unterschied zur konventionellen Operationsmethodik dar, bei der die klassische mechanische Ausrichtung der Prothese dominiert (79 %).

Diskussion
Die Ergebnisse zeigen eine vergleichsweise hohe Nutzungsdichte digitaler Tools, die von den Operateuren genutzt werden, um personalisierte Alignmentstrategien in der primären Knieendoprothetik im deutschsprachigen Raum umzusetzen. Dies konnte insbesondere für Zentren mit hohem Operationsvolumen gezeigt werden. Gegen die Nutzung wurden vorrangig ökonomische Gründe aufgeführt. Zukünftige Entwicklungen sollten daher, potenziell durch eine Verschlankung der Systeme, auf eine Reduktion der Investitions- und laufenden Kosten abzielen.

Graphic abstract
United for change: deliberative coalition formation to change the status quo
Authors: Elkind Edith , Grossi Davide , Shapiro Ehud , Talmon Nimrod 
Published: November 2024

AbstractWe study a setting in which a community wishes to identify a strongly supported proposal from a space of alternatives, in order to change the status quo. We describe a deliberation process in which agents dynamically form coalitions around proposals that they prefer over the status quo. We formulate conditions on the space of proposals and on the ways in which coalitions are formed that guarantee deliberation to succeed, that is, to terminate by identifying a proposal with the largest possible support. Our results provide theoretical foundations for the analysis of deliberative processes such as the ones that take place in online systems for democratic deliberation support.
Informed consent in gynecological oncology: a JAGO/NOGGO survey on real-world practices in daily clinical routine
Authors: Biersack M. G. , Volmer L. L. , Geißler C. , Fromme J. , Fröhlich S. , Pietzner K. , Sehouli J. , Beck M. H. 
Published: November 2024

Abstract
Purpose
Informed consent is a quintessential element of contemporary medicine, reflecting the fundamental right of patients to participate in decision-making regarding their health. Despite its critical importance, there is a lack of data on real-world practices regarding patient informed consent in the context of modern, high-pressure medical environments.

Methods
We conducted a multinational multicentric survey from February 24, 2022, to September 14, 2022, investigating the practices and challenges surrounding informed consent in hospitals across Germany, Austria, and Switzerland with the use of a specifically developed questionnaire.

Results
Drawing on over 200 responses from gynecologists, the survey shows a critical need for structured training in conducting informed consent discussions with over 80% of participants expressing interest in courses addressing this aspect. Notably, a considerable portion of the physicians (59.9%) reported conducting discussions on procedures they had never personally witnessed. Significant disparities between types of hospitals and professional groups were observed in the frequency of informed consent discussions, with limitations arising from factors such as time constraints, language barriers, and insufficient resources for patient education. Moreover, the psychological burden experienced by physicians after informed-consent discussions underscores the need for systemic changes to alleviate concerns regarding patient safety, legal repercussions, and patient satisfaction.

Conclusion
This study serves as a call to action, emphasizing the need of enhancing resources and support for medical professionals to uphold the principles of empathic and comprehensive patient information and shared decision-making.

Trial registry
DRKS00028295, 25.07.2024
Clinical outcome of subdural versus subgaleal drain after burr-hole drainage for chronic subdural hematoma
Authors: Carter Sophie H. , de Rooij Maud J. , Ahmadian Narjes , de Wit Anouk , van der Zwan Albert , Robe Pierre A. J. T. 
Published: November 2024

Abstract

Background
Chronic subdural hematoma (CSDH) is commonly treated by burr-hole drainage with subgaleal or subdural drain insertion, mostly based on surgeon’s preference. We analyzed the recurrence rate and clinical outcomes after burr-hole drainage for CSDH and subdural or subgaleal drain insertion in a single center, retrospective cohort study.

Methods
700 cases of burr-hole drainage for CSDH between 2017 and 2022 were included. Subdural drain insertion was compared to subgaleal drain insertion. The primary outcome were the rates of recurrence and reoperation. The secondary outcomes consisted of morbidity, postoperative complications, and mortality.

Results
Baseline characteristics were comparable. The recurrence and reoperation rate after subdural drainage were respectively 15.3% (38/249) and 9.6% (24/249). The recurrence and reoperation rate after subgaleal drainage were respectively 13.4% (55/409) and 10.8% (44/409). There were no significant associations found in recurrence and reoperation rate between both drain insertions. No differences in morbidity, complication rate and mortality between drain insertion locations was found.

Conclusion
We found relative equipoise between subdural or subgaleal drain insertion concerning recurrence, reoperation rate or clinical outcome. A large multicenter randomized controlled trial could be designed to further assess the outcomes of subdural and subgaleal drain placement after burr-hole drainage for CSDH.
Technical report on intra-operative trigeminal root mapping in percutaneous lesioning for trigeminal neuralgias
Authors: Sindou Marc , Brinzeu Andrei 
Published: November 2024

Abstract

Purpose
Percutaneous lesioning-techniques for treating refractory Trigeminal Neuralgias not amenable to Micro-Vascular Decompression remain useful in neurosurgical practice. Success, avoidance of complications and reduction of side-effects depend on the accurate location of the lesion-maker especially for Radio-Frequency-Thermo-Rhizotomy (RF-Th-Rh).
Added to X-ray-guidance, Intra-Operative Neurophysiology can be of significant help to achieve optimal accuracy of the surgery.
Based on previous research, this article aims to describe the simplest way to use direct electrical stimulation of the trigeminal root to evoke clinically observable muscle responses allowing to precisely position the tip of the needle for accurate lesioning.

Technique to evoke specific localizing muscle responses
Masticatory twitches can be easily produced by stimulating the motor root, through orthodromic conduction to the masticatory muscles.
Evoked Muscle Responses (EMRs) can be elicited in the facial nerve territory by stimulating the sensory rootlets, through Trigemino-Facial Reflexes’ pathways (TFRs). Responses in the Orbicularis Oculi is the well-known and readily used “Blink reflex”. On the contrary, TFRs in the lower territory of the facial nerve escaped clinical investigations not having been explored under direct stimulation of the trigeminal root. For both, stimulation at 5 c/s produces better observable twitches (because saccadic) than at 50 c/s which elicits tetanic contractions.

Conclusion
The localizing-value of these facial EMRs (associated to evocation of paresthesias) and of the masticatory responses, justifies mapping the trigeminal root before lesioning. Their use could be extended to the other lesioning-techniques: not only Glycerol Neurolysis but also to Balloon Compression (to ascertain location of the trocar at the contact of the TGN inside the Meckel cave) and Open partial Rhizotomies (before deciding to cut the rootlets corresponding to the trigger-zone). This is of importance since lesioning-techniques are needed because not all trigeminal neuralgias are responsive to or even indications of Micro-Vascular Decompression.
Complete genome sequences of two novel Ralstonia jumbo phages isolated from leaf litter compost
Authors: Sasaki Ryota , Miyashita Shuhei , Takahashi Hideki 
Published: November 2024

AbstractTwo Ralstonia phages, FLC1-1B and FLC4-3B, were isolated from leaf litter compost, using Ralstonia pseudosolanacearum, which is a causal agent of bacterial wilt disease, as a host. The genomic DNA sequences of FLC1-1B and FLC4-3B were determined and found to be 290,008 bp and 291,257 bp in length, respectively, and they were therefore classified as jumbo phages. However, they did not show high similarity to any jumbo phage genomic sequence in the NCBI nt database. The closest hit in a BLAST search was the jumbo phage ripduovirus RP12, with only 35% coverage and 77% sequence identity, whereas the FLC1-1B and FLC4-3B sequences were 99.0% identical. Based on these findings, FLC1-1B and FLC4-3B should be classified as members of a new genus in the order Caudoviricetes. FLC4-3B was found to suppress wilt disease in tomato plants, suggesting that it has potential as a biocontrol agent for managing R. pseudosolanacearum infections.