bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operative Sanierung einer penilen Elephantiasis
Authors: Zugor Vahudin , Addali Mustapha , Hager Benjamin , Kajaia David 
Published: December 2024

Zusammenfassung
Enorm große Genitallymphödeme, wie die penoskrotale Elephantiasis, ist ein seltenes Krankheitsbild. Sie ist meistens ein Folgezustand rezidivierender, entzündlicher Prozesse, Traumata oder Malignome, wobei weltweit die Hauptursache die lymphatische Filariasis ist. Weiterhin stellt sie eine Herausforderung sowohl für den Patienten als auch für das behandelnde Team dar. Durch Verlegung der Lymphbahnen entsteht zunächst ein lokales Ödem. Im weiteren Verlauf kommt es durch Fibrosierung und damit Verschlechterung der Lymphabflusswege zu rezidivierenden Infekten mit irreversibler elephantiastischer harter Schwellung und Hautveränderungen. Je nach klinischem Stadium kommen konservative bzw. operative Therapieverfahren infrage. Wobei bislang ein evidenzbasiertes Therapieregime fehlt. Eine interdisziplinäre Zusammenarbeit zwischen Ärzten, Physiotherapeuten und eine aktive Mitarbeit des Patienten sind für den Erfolg der Therapie von entscheidender Bedeutung.
In Vivo Acquisition of Human Retinal Double-Pass Images during Simulated Intraocular Lens Implantation
Authors: Sperlich Karsten , Bohn Sebastian , Gerlach Mario , Schubert Julia , Stolz Heinrich , Guthoff Rudolf , Stachs Oliver 
Published: December 2024

Abstract
Background The aim of the study was to capture images that form on the human retina after the simulated implantation of an intraocular lens (IOL). White light was used rather than the commonly used near-infrared light, which is unsuitable for the examination of diffractive IOLs. For this purpose, a special optical setup was developed to investigate the influence of the IOL design on two-dimensional retinal images in vivo.
Materials and Methods A double-pass ophthalmoscopic setup with a scientific CCD camera system was developed. Imaging the retinal image of a white LED located at infinity provides access to the double-pass point spread function of the natural eye. Subsequently, a see-through device for simulated IOL implantation (VirtIOL, 10Lens S. L. U., Terrassa, Spain) was integrated to investigate the influence of the IOL design on the retinal image quality of complex scenarios.
Results Retinal images were acquired from an incoherent white point light source. Combined with simulated IOL implantation, retinal images were acquired from the point light source, letters, and a United States Airforce target on a 6-m distant monitor. As expected, the double-pass images obtained with a monofocal IOL were sharper than those obtained with a multifocal IOL.
Conclusion The method opens up access to double-pass point spread function for white light, thus solving the problem of infrared light-based methods providing incorrect results when examining diffractive IOLs. This approach may be helpful for the investigation of perception in the future.
Integrating Stakeholder Priorities for the Optimization of Care of the Preterm Infant in a Safety-Net NICU
Authors: Sewell Elizabeth , Locsin Miguel , Bugg George , Bugg Kimarie , McGinnis Kate , Jackson Mary , Maitre Nathalie , Peagler Sierra , Robinson Dana , Serano Andrea , Roberts Jessica 
Published: December 2024

Objective This study aimed to engage clinical and community stakeholders to create a prioritization matrix of interventions to reduce neonatal brain injury and improve neurodevelopmental outcomes.
Study Design We collaborated with our community partner to establish a Lived Experience Advisory Group (LEAG). Faculty performed a literature review to identify neonatal neuroprotective interventions; additional priorities from the LEAG were also included. Project leaders scored and presented intervention bundles for impact. Stakeholder priorities for value/feasibility were obtained via questionnaire. Mean values were incorporated into a prioritization matrix.
Results Themes from discussions with LEAG members included the role of the neonatal intensive care unit (NICU) parent, the experience of trauma, shared decision-making, communication and trust with the health care team, and bias in medical care. Five interventions were placed in the highest priority quadrant of the prioritization matrix: thermoregulation, maternal antepartum steroids, delayed cord clamping, optimized oxygen delivery, and optimized glucose regulation.
Conclusion It is feasible to incorporate community and parent values into clinically oriented neuroprotective intervention bundles for preterm infants. This clinical–community collaboration is vital to ensure that our project objectives meet the needs and priorities of the population it is intended to serve.
Key Points
Kombinationstherapie bei pulmonaler arterieller Hypertonie – Switch von Selexipag zu intravenösem Treprostinil
Authors: Heine Alexander , Obst Anne , Opitz Christian F. , Halank Michael , Richter Manuel , Lange Tobias , Ewert Ralf 
Published: December 2024

ZusammenfassungAktuell ist ein breites Spektrum von Substanzen zur Behandlung von Patienten mit pulmonaler arterieller Hypertonie verfügbar. Die aktuellen Empfehlungen orientieren sich bei der initialen medikamentösen Therapie an dem Risiko der Patienten. Bei Patienten mit hohem Risiko wird schon initial eine Triple-Kombination verschiedener Substanzen unter Einbeziehung von Prostanoiden empfohlen.
In der prospektiven, einarmigen, unverblindeten Studie sollte geklärt werden, ob PAH-Patienten unter einer Triple-Therapie von der Umstellung von Selexipag auf intravenöses Treprostinil profitieren. Primärer Endpunkt war das Erreichen eines „Low-Risk“-Status nach 6 (12) Monaten.
Es wurden 27 PAH-Patienten (45 [37; 61] Jahre, 77,8% Frauen) eingeschlossen. Bei Studienbeginn wurden sie einem „Low-Risk“- (n=1), „Intermediate“- (n=12) oder „High-Risk“-Status (n=14) zugeordnet. Eine Verlaufsbeobachtung erfolgte im Mittel über 8 (Spanne 5–11) Monate bei 22 Patienten. Ein Patient wurde nach 4 Monaten erfolgreich transplantiert, weitere 4 Patienten verstarben (in 1 Fall septische Komplikationen unklarer Genese; in 3 Fällen progredientes Rechtsherzversagen). Der primäre Endpunkt (Erreichen des „Low-Risk“-Status) wurde von 12/21 (57,1%) Patienten erreicht (ein weiterer Patient verblieb im „Low-Risk“-Status).

Diese Daten geben (trotz der geringen Zahl von Patienten) einen Hinweis darauf, dass auch bei etablierter Triple-Therapie durch den Wechsel von Selexipag auf intravenöses Treprostinil eine klinische Verbesserung einzelner Patienten möglich ist.
Sleep-Disordered Breathing in Children with Achondroplasia: 17 Years' Experience from a Multidisciplinary Team
Authors: Guerdile Maria Jose , Fano Virginia , Pino Mariana del , Leske Vivian 
Published: December 2024

AbstractThe aim of this study was to describe sleep-disordered breathing (SDB) and treatment in children with achondroplasia (ACH). A retrospective longitudinal study was conducted at the Sleep Unit, Hospital de Pediatría Garrahan. Children with ACH, aged 0 to 18 years, referred for SDB due to clinical symptoms or foramen magnum stenosis (FMS) with at least one polysomnography (PSG) between 2002 and 2019 were included in the study. The primary outcomes included SDB typification and therapeutic interventions. We included 89 patients; 79.7% had one PSG, 13.4% had two PSGs, and 5.6% had three PSGs. The first PSG confirmed SDB in 65.16% patients. Obstructive sleep apnea (OSA) was present in 59.6% patients, central sleep apnea (CSA) in 1.72% patients, OSA + CSA in 4.49% patients, and normal PSG in 34.83% patients. OSA was mild in 32.07% patients, moderate in 18.86% patients, and severe in 49.05% patients. Clinical and airway evaluation, central imaging, evoked potentials, and PSG were considered before each therapeutic decision. After the first PSG, patients received one or more treatments as needed: watchful waiting; nasal steroids; ear, nose, and throat surgery; foramen magnum decompression; and noninvasive ventilation. A second PSG was available in 18 patients and 72.22% had SDB. A third PSG was available in 10 patients and 77.8% had SDB. We reconfirm an elevated frequency of SDB in ACH children and underline the need for a multidisciplinary and stepwise longitudinal approach.
Variability in Palliative Care and Discharge Disposition in a National Sample of Pediatric Patients: A Retrospective Study
Authors: Chu Francesca M. , Palama Brett K. , Hoehn K. Sarah 
Published: December 2024

AbstractThis study investigates factors associated with palliative care consultation (PCC) and discharge disposition among pediatric patients who were declared death by neurological criteria (DNC). It hypothesizes PCC is associated with longer stays and chronic conditions. It aims to identify disparities in PCC rates and factors associated with the continuation of technological (somatic) support after brain death, which is costly and indicates difficulties families face in accepting brain death diagnoses. This retrospective observational study used the Pediatric Health Information System database and included patients ≤21 years old who were declared DNC between 2015 and 2022; demographics, diagnoses, discharge disposition, and PCC status were extracted. Generalized linear mixed-effects models were developed. Of 3,169 patients from 44 hospitals, 14.2% (n = 449) received PCC, and 3.1% (n = 97) were discharged as “not expired,” indicating continued technological support after brain death, with transfer to a location other than the pediatric intensive care unit. PCC rates varied from 0 to 80.0% (median 11.0%); the percentage “not expired” ranged from 0 to 33% (median 0.4%). PCC was associated with longer stay in days (adjusted odds ratio [aOR] = 1.01, p < 0.001) and malignant condition (aOR = 2.69, p < 0.001), and negatively associated with trauma (aOR = 0.59, p < 0.001). Discharge as “not expired” was twice as likely in trauma than nontrauma patients (aOR = 2.00, p = 0.006), and less likely in Black than White patients (aOR = 0.34, p = 0.002). PCC rates were lower in trauma patients and higher in malignant conditions and longer stays. White patients had higher rates of discharge as “not expired,” indicating continued ventilatory support at family request. Further research is needed to integrate palliative care and mitigate disparities.
Coccygectomy: Therapeutic Results of 12 Cases of Posttraumatic Coccygodynia
Authors: Barry Louncény Fatoumata , Bah Alpha Boubacar , Bah Mohamed Lamine , Kponou Arnold Sagbo , Atakla Hugues Ghislain , Donzo Ansoumane , Souare Ibrahima Sory , Cherif Mohamed , Bah Djenaba , Diallo Aminata Rouguiatou , Keita Fode Ibrahima Kourala , Doumbouya Ibrahima Sory , Conde Alpha Youssouf , Balde Souleymane , Beavogui Luc Kézély , Souare Ibrahima Sory 
Published: December 2024

Abstract
Introduction Coccygodynia is pain localized in the coccygeal region. Symptoms can be relieved after conservative treatment. In refractory cases, surgical treatment gives good clinical results. We report 12 cases of posttraumatic coccygodynia refractory to conservative treatment managed surgically.
Materials and Methods This was a retrospective analysis including the records of all patients operated on in the neurosurgery departments and units of the Conakry University Hospital and the Sino-Guinean Friendship Hospital for posttraumatic coccygodynia refractory to conservative treatment over a 4-year period from January 2019 to December 2022 with a minimum postoperative follow-up of 12 months.
Results Twelve cases were identified over a 4-year period with a mean age of 36 years and a male predominance (7 males/5 females). Coccygodynia was the main complaint and was present in all patients. The mean visual analog scale was 8.7 and the mean body mass index was 24.1. Sacrococcygeal computed tomography scans were performed in all patients. The indication for surgery was given after failure of conservative treatment. Three patients underwent partial resection of the coccyx and nine underwent total resection. All patients underwent postoperative sacrococcygeal radiography. Progress was favorable in 75% of patients. Morbidity included two cases of surgical site infection and zero mortalities.
Conclusion Although the number of cases in this study was small, our positive results in terms of symptom improvement and satisfaction rates suggest that coccygectomy is a relatively safe and effective means of treating traumatic coccygodynia when nonsurgical methods have failed.
Genotype First Approach as a Diagnostic Strategy for Precision Medicine in Moroccan Families with Nephronophthisis
Authors: Batta Ourayna , Cherkaoui Imane J. , Rahmuni Yasmina , Amllal Nada , Soulami Kenza , Sefiani Abdelaziz , Lyahyai Jaber 
Published: December 2024

AbstractNephronophthisis is a group of autosomal recessive kidney diseases characterized by chronic tubulointerstitial abnormalities leading to kidney failure. The incidence of nephronophthisis varies globally, and its genetic heterogeneity presents significant difficulties in diagnosis. Herein, we present a molecular diagnosis of four unrelated Moroccan families fulfilling the clinical criteria of nephronophthisis. As first diagnosis step, screening for a homozygous NPHP1 gene deletion, the most common mutation, was performed by using multiplex polymerase chain reaction. Additionally, clinical exome sequencing was carried out on patients in whom no NPHP1 deletion was identified. Three novel pathogenic variants in NPHP1, INVS, and NPHP4 genes were identified and confirmed by Sanger sequencing in the proband and other family members. These variants are absent from genetic databases of patients and controls of Moroccan origin. The bioinformatics analysis classified these variants as pathogenic. Our findings expand the genotypic spectrum of nephronophthisis and highlight the importance of genetic testing in patients from low- and middle-income countries to obtain a precise diagnosis of nephronophthisis. This helps facilitate an appropriate and personalized genetic counseling and improves clinical outcomes for patients with this condition.
A cultural evolution theory for contemporary polarization trends in moral opinions
Authors: Eriksson Kimmo , Vartanova Irina , Strimling Pontus 
Published: December 2024

AbstractWhile existing theories of political polarization tend to suggest that the opinions of liberals and conservatives move in opposite directions, available data indicate that opinions on a wide range of moral issues move in the liberal direction among both liberals and conservatives. Moreover, some political scientists have hypothesized that this movement follows an S-shaped curve among liberals and a similar, but later, S-shaped curve among conservatives, so that polarization on a given issue first increases (as opinions at an initial stage move faster among liberals) and then decreases (as opinions at a later stage move faster among conservatives). Here we show that these dynamics are explained by Moral Argument Theory, a cultural evolution theory positing that opinion shifts on moral issues arise from a certain content bias in social opinion transmission. This theory also yields several other specific predictions about trends and polarization in moral opinions, which we test against longitudinal data on 55 moral issues from the General Social Survey (sample sizes between 1798 and 57,809 per issue). The predictions are generally confirmed. We conclude that a cultural evolution perspective can provide valuable insights for social science in understanding contemporary societal changes.
Nanostructured zinc carbonate hydroxide microflakes: assessing the toxicity against erythrocytes and L929 cells in vitro
Authors: Prokopiuk Volodymyr , Onishchenko Anatolii , Pazura Yuliia , Bespalova Iryna , Kökbaş Umut , Tryfonyuk Liliya , Mateychenko Pavlo , Kot Kateryna , Kurmangaliyeva Saulesh , Kot Yurii , Yefimova Svetlana , Tkachenko Anton 
Published: December 2024

Abstract
Nanostructured materials have been suggested to be used as a source of dietary zinc for livestock animals. In this study, we assessed the cytotoxicity of newly synthesized nanostructured zinc carbonate hydroxide (ZnCH) Zn5(CO3)(OH)6 microflakes. Cytotoxicity of the microflakes was assessed against murine L929 cell line and rat mature erythrocytes. Viability, motility, cell death pathways, implication of Ca2+, reactive oxygen species and reactive nitrogen species (RNS) signaling, caspases, and alterations of cell membranes following exposure of L929 cells to the microflakes were assessed. To assess hemocompatibility of the Zn-containing microflakes, osmotic fragility and hemolysis assays were performed, as well as multiple eryptosis parameters were evaluated. Our findings indicate a dose-response cytotoxicity of ZnCH microflakes against L929 cells with no toxicity observed for low concentrations (10 mg l−1 and below). At high concentrations (25 mg l−1 and above), ZnCH microflakes promoted nitrosyl stress, Ca2+- and caspase-dependent apoptosis, and altered lipid order of cell membranes in a dose-dependent manner, evidenced by up to 7-fold elevation of RNS-dependent fluorescence, 2.9-fold enhancement of Fura 2-dependent fluorescence, over 20-fold elevation of caspases-dependent fluorescence (caspase-3, caspase-8, and caspase-9), and up to 4.4-fold increase in the ratiometric index of the NR12S probe. Surprisingly, toxicity to enucleated mature erythrocytes was found to be lower compared to L929 cells. ZnCH microflakes induced eryptosis associated with oxidative stress, nitrosyl stress, Ca2+ signaling and recruitment of caspases at 25–50–100 mg l−1 . Eryptosis assays were found to be more sensitive than evaluation of hemolysis. Zn5(CO3)(OH)6 microflakes show no cytotoxicity at low concentrations indicating their potential as a source of zinc for livestock animals.
Generation of shear flows induced by AE / EPM in LHD plasma
Authors: Varela J. , Hidalgo C. , Tokuzawa T. , Nagaoka K. , Tanaka K. , Nagasaki K. , Ohdachi S. , Ida K. , Du X. , Cappa A. , Sharapov S. , Zarzoso D. , Spong D.A. , Garcia L. , Ghai Y. , Ortiz J. 
Published: December 2024

Abstract
The generation of shear flows (SFs) by Alfven Eigenmodes (AEs) and energetic particle modes (EPMs) have important effects on the operation of future nuclear fusion reactors, because SFs regulate the saturation of the AEs/EPMs, the transport of EPs and thermal plasma, as well as the formation of transport barriers among other consequences. The aim of this study is the analysis of SFs generation during the saturation phase of AEs and EPMs in LHD plasma. Experiments performed in the 23rd and 24th LHD experimental campaigns are dedicated to explore the destabilization of AEs/EPMs in discharges with different heating patterns, thermal plasma and magnetic field configurations. In particular, the shots 176490 and 179697 show the destabilization of MHD bursts and energetic-ion-driven resistive interchange modes (EIC), respectively. Charge exchange spectroscopy measurements in both discharges indicate that the generation of SFs by AE/EPM is uncorrelated with the perturbation induced by the neutral beam injector (NBI). Nonlinear simulations performed using the gyro-fluid code FAR3d show the generation of zonal structures, especially SFs, induced during the saturation phase of Toroidal Alfven Eigenmodes (TAEs) triggered in the MHD burst as well as by the

1

/

1

EIC in the bursting phase. The simulations indicate that SFs are caused by the radial electric fields powered by energy transfers from the unstable AE/EPM towards the thermal plasma. The strongest SFs are measured during the EIC bursting phase once the

1

/

1

EPM overlaps with nearby resonances at the plasma periphery. Likewise, the largest SFs during the MHD burst are observed once TAEs radially overlap in the inner-middle plasma region.
Phosphorus diffusion model in surrounding rock from phosphogypsum-based cemented paste backfill under multifactor coupling effect
Authors: Li Yufei , Yao Nan , Ye Yicheng , Wu Menglong , Guan Wenchao , Chen Guan 
Published: December 2024

Abstract
Phosphogypsum (PG) is filled in the solidified filling body formed in the goaf of underground mines, and its leaching of toxic and harmful ions infiltrates and spreads to the groundwater in the surrounding rock, and there is a potential risk of environmental pollution. In order to grasp the diffusion law of pollutant ions in surrounding rock from phosphogypsum-based cemented paste backfill (PCPB), the diffusion coefficient equation of P ions in surrounding rock was established based on the electrolyte solution theory, taking phosphorus (P) ions leached from PCPB as the research object. Adopting Fick’s second law, the diffusion model of P ions in the surrounding rock from PCPB under multi-factor coupling was established by comprehensively considering the effects of multiple factors such as P ion binding capacity in the surrounding rock, time dependence of P ions diffusion coefficients, structural defects of the surrounding rock, stress level, temperature, and so on, and the effects of different factors on the diffusion of P ions in the surrounding rock were analysed. The results show that the larger the concentration of P ions in the surrounding rock, the larger the diffusion coefficient is. The larger the diffusion distance is, the smaller the concentration of P ions in the surrounding rock is. P ions binding capacity and time are negatively correlated with the diffusion coefficient, and the coefficient of deterioration effect of the surrounding rock, the coefficient of stress influence and temperature are positively correlated with the diffusion coefficient. Temperature is the most significant factor affecting the diffusion coefficient of P ions, and after a temperature of 40 °C, the diffusion coefficient of P ions increases rapidly.
Self - adaptive canny edge detection with reinforcement learning and dominant texture color patterns for melanoma segmentation and classification in dermoscopic images
Authors: J C Kavitha , D Subitha , D Nagarajan 
Published: December 2024

Abstract
Melanoma, considered to be the most rapidly increasing cancer, has had great emphasis placed on its diagnosis. This paper proposes a powerful edge detection framework Self-adaptive Canny Edge Detection using Reinforcement Learning (CRL-Edge) that integrates Canny edge detection with reinforcement learning. This approach adaptively fine-tunes the threshold parameters of the canny so as to enhance the edge continuity particularly for images with weak boundaries. The research also focusses on proposing a feature extraction method Dominant Texture Color Patterns (DTCP) that effectively helps in classifying malignant melanoma from dermoscopic images. This method is proposed based on the extraction of texture and color features that are dominant in a particular local region. The RGB color channel that consists of texture patterns with more intensity variations is said to be a dominant texture feature and a color channel that has maximum color intensity variations is a dominant color feature. The texture-color patterns are combined together to form a pattern that is assigned a unique texture-color value that describes the image features. The proposed feature of texture and color is analyzed in dermoscopic color images to classify lesions as benign or malignant, using CatBoost, a gradient boosting technique. The CatBoost is compared with other gradient boosting algorithms like Random Forest, XGBoost and Light GBM. The experiments were conducted on two different databases, the ISIC Archive and the PH2 database. The images were evaluated, on the basis of performance metrics such as sensitivity, specificity, accuracy, precision, F1-score and AUC. The experiment results show that CRL-Edge segmentation provides better segmentation accuracy and the DTCP descriptor using CatBoost classifier provides enhanced classification accuracy for classifying malignant lesion. The new method is compared with different state-of-art methods and has demonstrated the best performance.