bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caring for terminally Ill patients: the impact on oncologists
Authors: Somasundaram Nagavalli , Ibrahim Halah , Govindasamy Ranitha , Hamid Nur Amira Binte Abdul , Ong Simon Yew Kuang , Krishna Lalit Kumar Radha 
Published: September 2024

Abstract
Background
Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists’ professional identity formation (PIF).

Methods
From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists’ sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis.

Results
Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms.

Conclusion
Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care — ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession.
Criteria-based outpatient scheduling at a nephrology clinic: prospective evaluation of patient pre-assessment and its corresponding adaptive scheduling strategy
Authors: Klaas Ruben , Lok-Visser Jedidja , Doornebal Joan , Roelofs Ton , Rachuba Sebastian , Leeftink Gréanne 
Published: September 2024

Abstract
Background
Outpatient Clinics (OCs) are under pressure because of increasing patient volumes and provider shortages. At the same time, many patients with chronic diseases receive routine follow-up consultations that are not always necessary. These patients block access to care for patients that are in actual need for care. Pre-assessing patient charts has shown to reduce unnecessary outpatient visits. However, the resulting late cancellations due to the pre-assessment, challenge efficient alignment of capacity with actual patient demand, leading to either empty slots or overtime.
This study aims to develop a method to analyse the effect of pre-assessing patients before inviting them to the OC. This involves 1) to select who should come and 2) to optimize the impact of pre-assessment on the schedule and efficient use of OC staff.

Methods
This prospective mixed-methods evaluation study consists of 1) an expert meeting to determine a pre-assessment strategy; 2) a retrospective cohort study to review the impact of this strategy (12 months of a Dutch nephrology OC); 3) mathematical optimization to develop an optimal criteria-based scheduling strategy; and 4) a computer simulation to evaluate the developed strategy. Primary outcomes are the staff idle time and staff overtime. Secondary outcomes evaluate the number of weekly offered appointments.

Results
The expert group reached consensus about the pre-assessment criteria. 875 (18%) of the realized appointments in 2022 did not meet the OC visit pre-assessment criteria. In the best performing scheduling strategy, 94 slots (87% of the available capacity) should be scheduled on a weekly basis. For this schedule, 26.8% of the OC weeks will experience idle time ($$\mu$$
μ
=2.51, $$\sigma$$
σ
=1.44 appointment slots), and 21% of the OC weeks will experience overtime ($$\mu$$
μ
=2.26, $$\sigma$$
σ
=1.65 appointment slots) due to the variation in patient appointment requests. Using the pre-assessment strategy combined with the best performing scheduling strategy under full capacity (108 slots), up to 20% increase in patient demand can be handled with equal operational performance.

Conclusions
This evaluation study allows OC managers to virtually test operational impact of pre-assessment strategies on the capacity of their OC, and shows the potential of increasing efficient use of scarce healthcare capacity.

Trial registration
Not applicable.
Analyzing the morphology and avian β-defensins genes (AvβD) expression in the small intestine of Cobb500 broiler chicks fed with sodium butyrate
Authors: Alsafy Mohamed A.M. , Abdellatif Islam A. , El-Gendy Samir A. A. , Abumandour Mohamed M.A. , Noreldin Ahmed , Bassuoni Naglaa F. 
Published: September 2024

Abstract
Background
Sodium butyrate is a potential antibiotic growth promoter and has had advantageous effects on the poultry industry.

Methods
Evaluating the effect of sodium butyrate on the intestinal villi and the humoral part of innate immunity of the male Cobb 500 broiler using scanning electron microscopy and quantitative real-time PCR analysis, the control group and treated group of Cobb 500 with SB supplemented received water containing 0.98 mg sodium butyrate.

Results
The administration of sodium butyrate changed the villi characters, as the shape changed from tongue to long tongue. They were mainly parallel to each other and long finger-like at the duodenum. The tips of the villi in the control group appeared thin-slight curved with a prominent center in the duodenum, thin rectangular in the jejunum, and ileum in the control group. In contrast, in the treatment group, they changed to thick rectangular in the duodenum and ileum zigzag shape in the jejunum. The epithelium lining of the duodenal villi showed a dome shape, the jejunal villi showed a polygonal shape, and the ileal villi appeared scales-like. The epithelium lining showed irregular microfolds and many different-sized pores, and the treatment group showed islands of long microvilli in the duodenum and solitary long microvilli in the ileum. Real-time PCR of AvBD 1, 2, 10, and 12 significantly (P < 0.01). The better expression of AvBD 1, 2, and 12 was determined in the duodenum, while AvBD 10 was in the jejunum.

Conclusion
Sodium butyrate enhanced the chicks’ growth and small intestine parameters, modified the morphology of the intestinal villi, and improved the humoral part of innate immunity.
Gross and scanning electron microscopic features of the oral cavity (palate, tongue, and sublingual floor) of the Egyptian long-eared hedgehog (Hemiechinus auratus aegyptius)
Authors: Abumandour Mohamed M. A. , Hanafy Basma G. 
Published: September 2024

AbstractThe study was focused on the anatomical characteristics of the Egyptian long-eared hedgehog's oral cavity by using gross and scanning electron microscopic examinations. The upper lip had an elongated T-shaped snout-like structure. The hard palate had a triangular rostral part (which had a semicircular area and a caudal ridged area with the first 3 or 4 ridges) and a caudal part (which contained seven or eight slightly oblique ridges with raphae). The diamond-incisive papilla is flanked on both sides by a groove and a fissure. The hard palate surface had glandular openings and a microplicae system. The uneven, soft palate's surface had multiple grooves and folds with 12–16 Gemmal papillae. The Gemmal papillary surface had three to four taste pores with microplicae and glandular openings. The dorsal lingual surface had six filiform subtypes: pointed (on the tip, rostral border, and median apical region), triangular (on the lateral apical and circumvallate regions), bifurcated (on the median tip only), leaf-like (on the median body region), branched (on the lateral root region), and small pointed papillae (on the median root). There were two fungiform subtypes: ovals (on the rostral border and lateral region) and rounds (on the median apical region and body). The caudal root part had a triangular arrangement of three circumvallate papillae. In conclusion, the finding confirmed its oral cavity adaptation with its insectivorous feeding habits and Egyptian environment.
Graphical Abstract
Hyperplastic ovarian stromal cells express genes associated to tumor progression: a case study
Authors: Sharma Arpna , Becker Frank , Tao Xuelian , Baddela Vijay Simha , Koczan Dirk , Ludwig Carolin , Vanselow Jens 
Published: September 2024

AbstractThe current study presents the analysis of stromal cells obtained from an hyperplastic left-ovary of a Holstein cow. Cultured hyperplastic stromal cells displayed a fibroblast-like morphology and ceased proliferation after the 8th passage. The non-cancerous nature of stromal cells was confirmed by in vitro cell proliferation and migration assays. Negligible amounts of E2 were detected in the spent media of cultured stromal cells, which suggests that stromal cells were non-estradiol synthesizing cells. As revealed in immunofluorescence and gene expression analysis, the hyperplastic stromal cells explicitly expressed vimentin in their cytoskeleton. Upon hematoxylin staining, a highly dense population of stromal cells was observed in the stromal tissue of the hyperplastic ovary. To explore genome-wide alterations, mRNA microarray analysis was performed using Affymetrix Bovine Gene 1.0ST Arrays compared to normal ovarian derived stromal cells. The microarray identified 1396 differentially expressed genes, of which 733 were up- and 663 down-regulated in hyperplastic stromal cells. Importantly, asporin (ASPN) and vascular cell adhesion molecule 1 (VCAM1) were among the highly up-regulated genes. Higher expression of ASPN was also confirmed by immunohistochemistry and RT-qPCR analysis. Ingenuity pathway analysis (IPA) identified about 98 significantly enriched (-log (p value ≥ 1.3) canonical pathways, importantly of which the “Sirutin Signaling Pathway” and “Mitochondrial Dysfunction” were highly activated while “Oxidative phosphorylation” was inhibited. Additionally, higher proportion of hyperplastic stromal cells in the S-phase of cell cycle, could be attributed to higher expression levels of cell proliferation genes such as CCND2 and CDK6.
Nano-selenium supplementation: improving growth, digestibility and mineral absorption in freshwater fish, Catla catla
Authors: Ahmad Nisar , Hussain Syed Makhdoom , Ali Shafaqat , Tahir Muhammad Farrukh , Sarker Pallab K. , Shahid Mudassar 
Published: September 2024

Abstract
Background
This research investigated the impact of selenium-nanoparticles (Se-NPs) supplemented in sunflower meal (SM)-based diets on digestibility, mineral absorption, and growth performance of Catla catla. Se-NPs were added to seven test meals in varying amounts (0, 0.5, 1, 1.5, 2, 2.5 and 3 mgkg− 1). A total of 315 fish were evenly allocated three replicate tanks, with 15 fish per tank, and given diets equivalent to (5%) of their wet biomass daily for a period of 90 days.

Results
The test diet (T-D) supplemented with 1.5 mgkg− 1 Se-NPs yielded remarkable results, including a significant increase in mean weight gain (14 g), an impressive average weight gain percentage (208%), a 100% survival rate, with no mortality observed and the highest specific growth rate (1.25). Moreover, 1.5 mgkg− 1 Se-NPs (T-D-IV) demonstrated superior nutritional digestibility (CP, 76%; CF, 79% and GE, 74%). Additionally, the diet 1.5 mgkg− 1 Se-NPs showed enhanced mineral absorption (K, P, Ca, Na, Zn, Cu and Fe) than other diets.

Conclusion
It was practically proven that the growth indices, nutrient absorption, and mineral status of C. catla were significantly improved by Se-NPs supplemented SM-based diets, with the optimum level of supplementation being 1.5 mgkg− 1.
Changes in soft tissue dimensions following horizontal guided bone regeneration with a split-thickness flap design – evaluation of 8 cases with a digital method
Authors: Somodi Kristof , Dobos Andrea , Bartha Ferenc , Solyom Eleonora , Windisch Peter , Palkovics Daniel , Molnar Balint 
Published: September 2024

Abstract
Background
Peri-implant soft tissue corrections are often indicated following alveolar ridge augmentation, due to the distortion of the keratinized mucosa at the area of augmentation. The objective of the current study was to evaluate the dimensional soft tissue changes following horizontal guided bone regeneration (GBR) utilizing 3D digital data.

Methods
8 mandibular surgical sites with horizontal alveolar ridge deficiencies were treated utilizing a resorbable collagen membrane and a split-thickness flap design. Baseline and 6-month follow-up cone-beam computed tomography (CBCT) scans were reconstructed as 3D virtual models and were superimposed with the corresponding intraoral scan. Linear changes of supracrestal vertical- horizontal soft tissue alterations were measured in relation to the alveolar crest at the mesial- middle- and distal aspect of the surgical area. Soft tissue dimensions were measured at baseline and at 6-month follow-up.

Results
Preoperative supracrestal soft tissue height measured midcrestally averaged at 2.37 mm ± 0.68 mm, 2.37 mm ± 0.71 mm and 2.64 mm ± 0.87 mm at the mesial-, middle- and distal planes. Whereas postoperative supracrestal soft tissue height was measured at 2.62 mm ± 0.72 mm, 2.67 mm ± 0.67 mm and 3.69 mm ± 1.02 mm at the mesial, middle and distal planes, respectively. Supracrestal soft tissue width changed from 2.14 mm ± 0.72 mm to 2.47 mm ± 0.46 mm at the mesial, from 1.72 mm ± 0.44 mm to 2.07 mm ± 0.67 mm and from 2.15 mm ± 0.36 mm to 2.36 mm ± 0.59 mm at the mesial, middle and distal planes, respectively. Additionally the buccal horizontal displacement of supracrestal soft tissues could be observed.

Conclusions
The current study did not report significant supracrestal soft tissue reduction following horizontal GBR with a split-thickness flap. Even though there was a slight increase in both vertical and horizontal dimensions, differences are clinically negligible.

Trail registration
The trail was approved by the U.S. National Library of Medicine (www.clinicaltrials.gov); trial registration number: NCT05538715; registration date: 09/09/2022.
Efficiency assessment of intelligent patient-specific instrumentation in total knee arthroplasty: a prospective randomized controlled trial
Authors: Liao Guoqing , Duoji Jinmei , Mu Lishuai , Zhang Yiling , Liu Xingyu , Cai Daozhang , Zhao Chang 
Published: September 2024

Abstract
Background
In total knee arthroplasty (TKA), the practical use of patient-specific instrumentation (PSI) has been reported previously with both advantage and disadvantage. The application of artificial intelligent (AI) forces overwhelmingly development of medical industries, while the impact of AI on PSI efficiency remains unknown. Thus, this study aimed to assess the efficiency of Intelligent-PSI (i-PSI) in TKA, compared with the conventional instrumentation-TKA (CI).

Methods
102 late-stage OA patients who met inclusive criteria were recruited in this prospective randomized controlled trial and separated into two groups (i-PSI vs. CI). In both groups, an AI preoperative planning engine was applied for surgery decision making. In CI group, conventional instrumentation was applied for bony resection, while resection of i-PSI group was completed with i-PSI. A convolutional neural network was applied to automatically process computer tomography images and thus produced i-PSI. With the help of three-dimension printing, the workflow of production was largely simplified. AI-driven preoperative planning guided resection and alignment decisions. Resection measurement, perioperative radiography and perioperative clinical outcomes were analyzed to verify efficiency of i-PSI.

Results
In resection outcomes, smaller deviation of lateral and medial distal femoral resection were found in i-PSI group than CI group (P = 0.032 and 0.035), while no difference was found in other resection planes. In radiography outcomes, postoperative coronal alignments of i-PSI group, including postoperative Hip–knee–ankle axis (HKA) (P = 0.025), postoperative HKA outliners (P = 0.042), Femoral coronal alignment (FCA) (P = 0.019) and Joint line convergence angle (JLCA) (P = 0.043) showed closer to neutral position than CI group. Moreover, Femoral sagittal alignment (FSA) of i-PSI group showed closer to neutral position than CI group(P = 0.005). No difference was found in other alignments. In clinical outcomes, i-PSI group seemed to cost more surgical time than CI group (P = 0.027), while others showed no differences between the two groups.

Conclusion
Intelligent Patient-specific Instrumentation in TKA achieved simplified production flow than conventional PSI, while also showed more accurate resection, improved synthesis position and limb alignment than conventional instrumentation. Above all, this study proved that i-PSI being an applicable and promising tool in TKA.
Predictive factors for deep medial collateral ligament release in adjusted mechanical alignment total knee arthroplasty
Authors: Thongpulsawasdi Nimit , Achawakulthep Chaiwat , Intiyanaravut Tawan , Anusitviwat Chirathit , Yuenyongviwat Varah 
Published: September 2024

Abstract
Background
Total knee arthroplasty (TKA) demands precision in achieving optimal alignment and soft tissue balance, especially in cases of medial compartment osteoarthritis where the need for medial soft tissue release is critical yet challenging to ascertain.

Objective
This study aims to systematically investigate the relationship between preoperative data, initial knee conditions and the necessity for deep collateral ligament (MCL) release in adjusted mechanical alignment total knee arthroplasty.

Methods
We conducted a retrospective study involving 61 TKA patients who underwent adjusted mechanical alignment robotic-assisted procedures. Soft tissue release was carried out when clinically indicated. We collected and statistically analyzed patient demographics, initial knee conditions, and surgical details.

Results
Among the patients, 52% required deep MCL release. Notably, patients without soft tissue release exhibited lower initial hip-knee-ankle (HKA) angles, reduced varus-valgus stress test angles, and a greater range of flexion. We identified a predictive threshold HKA angle of 6.250 degrees, demonstrating high sensitivity and specificity for determining the need for deep MCL release.

Conclusion
This study underscores the significance of the initial HKA angle and varus-valgus stress tests in predicting deep MCL release during TKA. The established HKA angle threshold simplifies surgical decision-making, reducing the likelihood of unnecessary soft tissue release.
Research progress on macrophage polarization during osteoarthritis disease progression: a review
Authors: Yin Xiangzhi , Wang Quan , Tang Yijie , Wang Tianrui , Zhang Yingze , Yu Tengbo 
Published: September 2024

AbstractPrimary osteoarthritis (OA) is a prevalent degenerative joint disease that mostly affects the knee joint. It is a condition that occurs around the world. Because of the aging population and the increase in obesity prevalence, the incidence of primary OA is increasing each year. Joint replacement can completely subside the pain and minimize movement disorders caused by advanced OA, while nonsteroidal drugs and injection of sodium hyaluronate into the joint cavity can only partially relieve the pain; hence, it is critical to search for new methods to treat OA. Increasing lines of evidence show that primary OA is a chronic inflammatory disorder, with synovial inflammation as the main characteristic. Macrophages, as one of the immune cells, can be polarized to produce M1 (proinflammatory) and M2 (anti-inflammatory) types during synovial inflammation in OA. Following polarization, macrophages do not come in direct contact with chondrocytes; however, they affect chondrocyte metabolism through paracrine production of a significant quantity of inflammatory cytokines, matrix metalloproteinases, and growth factors and thus participate in inducing joint pain, cartilage injury, angiogenesis, and osteophyte formation. The main pathways that influence the polarization of macrophages are the Toll-like receptor and NF-κB pathways. The study of how macrophage polarization affects OA disease progression has gradually become one of the approaches to prevent and treat OA. Experimental studies have found that the treatment of macrophage polarization in primary OA can effectively relieve synovial inflammation and reduce cartilage damage. The present article summarizes the influence of inflammatory factors secreted by macrophages after polarization on OA disease progression, the main signaling pathways that induce macrophage differentiation, and the role of different polarized types of macrophages in OA; thus, providing a reference for preventing and treating primary OA.
Primary intracardiac leiomyoma: rare case report and literature review
Authors: Al-Maghrabi Haneen , Aluthman Uthman , Jamjoom Ahmed , Zabani Ibrahim , Al-Maghrabi Jaudah 
Published: September 2024

AbstractBenign cardiac neoplasms are relatively uncommon. Cardiac leiomyomas are usually diagnosed as a benign metastasizing leiomyoma or as a part of intravenous leiomyomatosis spectrum. Primary cardiac leiomyomas are extremely rare and should be diagnosed after ruling out the involvement of systemic leiomyomas. Only nine cases were found in the literature that described De novo occurrence of primary intra-cardiac leiomyoma. In this study, we present a case of 60-year-old female patient with a large pedunculated mass located in the left ventricle. Histopathology examination and immunohistochemistry aid confirmed the diagnosis of benign leiomyoma. No evidence of extra cardiac lesions was detected in the patient. The patient remained healthy with no signs of recurrence four years after the surgical resection. Benign cardiac tumors are not often seen, but when they do occur, they can present a serious risk to life. This is particularly significant because these tumors can detach and cause embolization, leading to the development of strokes. Moreover, these individuals do not show any clinical symptoms, making their detection quite challenging. When there is a suspicion, it is advised to utilize echocardiography and other imaging techniques to verify the presence of a tumor. In this report, we present a rare case and provide differential diagnoses, along with a review of the literature.