bluuebunny/crossref_metadata_2025_split huggingface dataset:
Precision and accuracy of four handheld blood lactate analyzers across low to high exercise intensities
Authors: Mentzoni Fredrik , Skaugen Martin , Eythorsdottir Ingrid , Roterud Stian , Johansen Espen Spro , Losnegard Thomas 
Published: August 2024

Abstract
Purpose
To evaluate the precision and accuracy in measured blood lactate concentrations among four commonly used handheld lactate analyzers compared to two stationary analyzers.

Methods
Venous blood samples were taken at exercise intensities ranging from low to high. The blood lactate concentration was measured simultaneously with four pairs of handheld lactate analyzers (two new units of each brand: Lactate Plus, Lactate Pro2, Lactate Scout 4, and TaiDoc TD-4289), and compared with two stationary analyzers (Biosen C-Line and YSI Sport 1500). Measurements were repeated for a range of blood lactate concentrations (measured with Biosen) from 0.88 to 4.89 mM with a median difference between measurements of 0.10 mM.

Results
The mean relative differences to the Biosen analyzer were $$-$$
-
7% (Plus), 7% (Pro), $$-$$
-
10% (Scout), 42% (Tai), and $$-$$
-
32% (Ysi). The residual standard errors after linear regression against Biosen were 0.18 mM (Plus), 0.20 mM (Pro), 0.22 mM (Scout), 0.15 mM (Tai), and 0.06 mM (Ysi). Accordingly, a blood lactate concentration of 3 mM measured with Biosen yielded 95% prediction intervals that were 0.72 mM (Plus), 0.80 mM (Pro), 0.87 mM (Scout), 0.60 mM (Tai), and 0.23 mM (Ysi) wide.

Conclusion
Compared to our two stationary analyzers, the precision of the four handheld lactate analyzers evaluated in this study was poor. Among the four, Tai was the most precise; however, this analyzer had low accuracy with a substantial mean difference to the reference analyzer.
A new vessel filled and heart-beating human corpse model for VATS lobectomy training
Authors: Verzeletti Vincenzo , Lione Luigi , Bonis Alessandro , Sella Nicolò , Cannone Giorgio , Melan Luca , Rebusso Alessandro , Faccioli Eleonora , Porzionato Andrea , Comacchio Giovanni Maria , Nicotra Samuele , Dell’Amore Andrea , Rea Federico 
Published: August 2024

Abstract
Background
Nowadays, video-assisted thoracic surgery (VATS) lobectomy represents the treatment of choice for early-stage lung cancer. Over the years, different methods for VATS training have evolved. The aim of this study is to present an innovative beating-heart filled-vessel cadaveric model to simulate VATS lobectomies.

Methods
Via selective cannulation of the cadaver heart, the pulmonary vessels were filled with a gel to improve their haptic feedback. An endotracheal tube with a balloon on its tip then allowed movement of the heart chambers, transmitting a minimum of flow to the pulmonary vessels. A simulated OR was created, using all instrumentation normally available during surgery on living patients, with trainees constantly mentored by experienced surgeons. At the end of each simulation, the participants were asked 5 questions on a scale of 1 to 10 to evaluate the effectiveness of the training method (“1” being ineffective and “10” being highly effective).

Results
Eight models were set up, each with a median time of 108 min and a cost of €1500. Overall, 50 surgeons were involved, of which 39 (78%) were consultants and 11 (22%) were residents (PGY 3–5). The median scores for the 5 questions were 8.5 (Q1; IQR1–3 8-9), 8 (Q2; IQR1–3 7–9), 9 (Q3; IQR1–3 8–10), 9 (Q4; IQR1–3 8–10), and 9 (Q5; IQR1–3 8–10). Overall, the model was most appreciated by young trainees even though positive responses were also provided by senior surgeons.

Conclusions
We introduce a new beating-heart filled-vessel cadaveric model to simulate VATS lobectomies. From this initial experience, the model is cost effective, smooth to develop, and realistic for VATS simulation.
Perspectives on sustainability among surgeons: findings from the SAGES-EAES sustainability in surgical practice task force survey
Authors: Sathe Tejas S. , Alseidi Adnan , Bellato Vittoria , Ganjouei Amir Ashraf , Foroutani Laleh , Hall Ryan P. , Potapov Oleksii , Bello Ricardo J. , Johnson Shaneeta M. , Marconi Stefania , Francis Nader , Barach Paul , Sanchez-Casalongue Manuel , Nijhawan Sheetal , Oslock Wendelyn M. , Miller Benjamin , Samreen Sarah , Chung Jimmy , Marfo Nana , Huo Bright , Lim Robert B. , Vandeberg Jonathan , Alimi Yewande R. , Pietrabissa Andrea , Arezzo Alberto , Frountzas Maximos , Rems Miran , Eussen M. M. M. , Bouvy N. D. , Sylla Patricia 
Published: August 2024

Abstract
Background
Surgical care significantly contributes to healthcare-associated greenhouse gas emissions (GHG). Surgeon attitudes about mitigation of the impact of surgical practice on environmental sustainability remains poorly understood. To better understand surgeon perspectives globally, the Society of American Gastrointestinal and Endoscopic Surgeons and the European Association for Endoscopic Surgery established a joint Sustainability in Surgical Practice (SSP) Task Force and distributed a survey on sustainability.

Methods
Our survey asked about (1) surgeon attitudes toward sustainability, (2) ability to estimate the carbon footprint of surgical procedures and supplies, (3) concerns about the negative impacts of sustainable interventions, (4) willingness to change specific practices, and (5) preferred educational topics and modalities. Questions were primarily written in Likert-scale format. A clustering analysis was performed to determine whether survey respondents could be grouped into distinct subsets to inform future outreach and education efforts.

Results
We received 1024 responses, predominantly from North America and Europe. The study revealed that while 63% of respondents were motivated to enhance the sustainability of their practice, less than 10% could accurately estimate the carbon footprint of surgical activities. Most were not concerned that sustainability efforts would negatively impact their practice and showed readiness to adopt proposed sustainable practices. Online webinars and modules were the preferred educational methods. A clustering analysis identified a group particularly concerned yet willing to adopt sustainable changes.

Conclusion
Surgeons believe that operating room waste is a critical issue and are willing to change practice to improve it. However, there exists a gap in understanding the environmental impact of surgical procedures and supplies, and a sizable minority have some degree of concern about potential adverse consequences of implementing sustainable policies. This study uniquely provides an international, multidisciplinary snapshot of surgeons’ attitudes, knowledge, concerns, willingness, and preferred educational modalities related to mitigating the environmental impact of surgical practice.
Risk factors for and treatment of anastomotic strictures after Ivor Lewis esophagectomy
Authors: Doran Sophie L. F. , Digby Maria G. , Green Sophie V. , Kelty Clive J. , Tamhankar Anand P. 
Published: August 2024

Abstract
Introduction
Anastomotic strictures following esophagectomy occur frequently and impact on nutrition and quality of life. Although strictures are often attributed to ischemia and anastomotic leaks, the role of anastomosis size and pyloroplasty is not well evaluated. Our study aims to assess the rate of and risk factors for anastomotic stricture following esophagectomy, and the impact of treatment with regular endoscopic balloon dilatations.

Methods
Consecutive patients (n = 207) undergoing Ivor Lewis esophagectomy performed by two surgeons at our institution were included. Data on patient demographics, surgical outcomes and anastomotic strictures were recorded. Relationship of anastomotic strictures with circular stapler size, pyloroplasty and anastomotic leak was analyzed. Treatment of strictures with endoscopic balloon dilatation was reviewed and percentage weight loss at 1 year was evaluated.

Results
Anastomotic strictures occurred in 17.4% of patients. Patient demographics between those with and without stricture were similar. Stricture rate was similar in patients with or without pyloroplasty (13.9% vs 21.7%, respectively, p = 0.14) and in those with or without an anastomotic leak (25.0% vs 16.6%, respectively, p = 0.345). Stricture risk increased with smaller sized stapler (25 mm = 33.3%, 28 mm = 15.3%, 31 mm = 4.8%; p = 0.027).
The median number of dilatations required to fully treat strictures was 2 (IQR: 1–3). The median length of time from surgery to first dilatation was 2.9 months (IQR: 2.0–4.7) and to last dilatation was 6.1 months (IQR: 4.8–10.0). Median maximum dilatation diameter was 20 mm (IQR: 18.0–20.0). There were no complications from dilatations. Percentage weight loss at 1 year in patients with strictures was similar to those without strictures (8.7% vs 11.1%, respectively, p = 0.090).

Conclusions
Post-esophagectomy anastomotic strictures are common and not necessarily related to anastomotic leaks or absence of pyloroplasty. Smaller anastomosis size was strongly linked with stricture formation. A driven approach with regular endoscopic balloon dilation is safe and effective in treating these strictures with no excess weight loss at 1 year once treated.
The safety and efficacy of endoscopic approaches for the management of Zenker’s diverticulum: a multicentre retrospective study
Authors: Norton Benjamin , Siggens Katie , Papaefthymiou Apostolis , Telese Andrea , Duku Margaret , Murino Alberto , Johnson Gavin , Murray Charles , Mohammadi Borzoueh , Mughal Muntzer , Bisschops Raf , Bhandari Pradeep , Birchall Martin , Haidry Rehan 
Published: August 2024

Abstract
Introduction
Minimally invasive endoscopic options are safe and effective alternatives to surgery for the treatment of symptomatic Zenker’s diverticulum (ZD). However, there is no consensus on the gold-standard approach. We compared the safety and efficacy of Zenker’s peroral endoscopic myotomy (Z-POEM), flexible diverticulotomy (FD), and rigid diverticulotomy (RD) for the management of ZD.

Methods
Patients undergoing treatment for ZD at three UK tertiary referral centres were identified and analysed between 2013 and 2023. Patient demographics, procedural details, clinical success, and 30-day adverse events (AE) were recorded. The primary outcomes were technical and clinical success defined as a fall in Dakkak and Bennett dysphagia score to ≤ 1 without re-intervention.

Results
There was no difference in baseline characteristics amongst 126 patients undergoing intervention (50 RD, 31 FD, 45 Z-POEM). Technical success for RD, FD, and Z-POEM was 80%, 100%, and 100%, respectively (p < 0.001). Over a mean follow-up of 11.0 months (95% CI 8.2–13.9), clinical success amongst those treated was 85.3% (RD), 74.1% (FD), and 83.7% (Z-POEM; p = 0.48) with recurrence in 17.2% (RD), 20.0% (FD), and 8.3% (Z-POEM; p = 0.50). AEs were equivalent between groups (p = 0.98). During this time, 11 patients underwent surgical myotomy with low clinical success (36.4%) and high morbidity.

Conclusion
Endoscopic options for the treatment of ZD show equivalent rates of success, but failed RD often led to open myotomy with worse outcomes. Flexible endoscopic modalities are both safe and highly effective treatments that may be considered first-line in experienced centres and should be offered before surgery.

Graphical abstract
Minimally invasive colorectal cancer surgery: an observational study of medicare advantage and fee-for-service beneficiaries
Authors: Bakillah Emna , Sharpe James , Wirtalla Chris , Goldberg Drew , Altieri Maria S. , Aarons Cary B. , Keele Luke J. , Kelz Rachel R. 
Published: August 2024

Abstract
Background
Enrollment of Medicare beneficiaries in medicare advantage (MA) plans has been steadily increasing. Prior research has shown differences in healthcare access and outcomes based on Medicare enrollment status. This study sought to compare utilization of minimally invasive colorectal cancer (CRC) surgery and postoperative outcomes between MA and Fee-for-Service (FFS) beneficiaries.

Methods
A retrospective cohort study of beneficiaries  ≥ 65.5 years of age enrolled in FFS and MA plans was performed of patients undergoing a CRC resection from 2016 to 2019. The primary outcome was operative approach, defined as minimally invasive (laparoscopic) or open. Secondary outcomes included robotic assistance, hospital length-of-stay, mortality, discharge disposition, and hospital readmission. Using balancing weights, we performed a tapered analysis to examine outcomes with adjustment for potential confounders.

Results
MA beneficiaries were less likely to have lymph node (12.9 vs 14.4%, p < 0.001) or distant metastases (15.5% vs 17.0%, p < 0.001), and less likely to receive chemotherapy (6.2% vs 6.7%, p < 0.001), compared to FFS beneficiaries. MA beneficiaries had a higher risk-adjusted likelihood of undergoing laparoscopic CRC resection (OR 1.12 (1.10–1.15), p < 0.001), and similar rates of robotic assistance (OR 1.00 (0.97–1.03), p = 0.912), compared to FFS beneficiaries. There were no differences in risk-adjusted length-of-stay (β coefficient 0.03 (− 0.05–0.10), p = 0.461) or mortality at 30-60-and 90-days (OR 0.99 (0.95–1.04), p = 0.787; OR 1.00 (0.96–1.04), p = 0.815; OR 0.98 (0.95–1.02), p = 0.380). MA beneficiaries had a lower likelihood of non-routine disposition (OR 0.77 (0.75–0.78), p < 0.001) and readmission at 30-60-and 90-days (OR 0.76 (0.73–0.80), p < 0.001; OR 0.78 (0.75–0.81), p < 0.001; OR 0.79 (0.76–0.81), p < 0.001).

Conclusions
MA beneficiaries had less advanced disease at the time of CRC resection and a greater likelihood of undergoing a laparoscopic procedure. MA enrollment is associated with improved health outcomes for elderly beneficiaries undergoing operative treatment for CRC.
Long-term disease-specific quality of life after laparoscopic Nissen fundoplication in patients with borderline GERD
Authors: Wang Theresa N. , Jalilvand Anahita D. , Sharma Shuchi , An Bryan W. , Perry Kyle A. , Sweigert Patrick J. 
Published: August 2024

Abstract
Background
Historically, DeMeester score over 14.7 has been used to diagnose GERD. The 2022 American Gastroenterological Association clinical guidelines define GERD based on acid exposure time (AET) instead of DeMeester score. We aim to compare outcomes after laparoscopic Nissen fundoplication (LNF) in patients based on differing GERD diagnostic criteria.

Methods
Patients who underwent first-time LNF between 2009 and 2017 were identified. Demographics, objective GERD evaluation, and outcomes were maintained in an IRB-approved database. Disease-specific quality of life was assessed with a survey (GERD-HRQL) with higher values representing more symptomatic disease. Descriptive statistics, Fischer’s exact test and logistic regression were used to analyze the data, p-value < 0.05.

Results
225 patients were stratified into two groups: borderline GERD (AET 4–6%, n = 25.11%) and GERD (AET ≥ 6%, n = 200.89%). The mean age was 50.1 ± 13.4 years and 169 (75%) were female. Baseline GERD-HRQL was lower in the borderline group (24.3 vs 30.0, p = 0.031). Short-term (5 weeks [IQR 4, 8]), medium-term (14 months [IQR 7.25, 31]) and long-term (6.75 years [IQR 5.5, 8]) follow-up was performed. GERD-HRQL scores did not differ between borderline and GERD patients at short-(6.0 vs 7.1, p = 0.630), medium-(12.0 vs 12.1, p = 0.818), or long-term follow-up (10.0 vs 9.0, p = 0.757). The absolute long-term improvement in GERD-HRQL was −12.3 (p = 0.022) vs. −21.3 (p < 0.001). At long-term follow-up there was no difference in PPI use (50% vs 47%, p = 0.852), satisfaction (58% vs 76%, p = 0.187), willingness to repeat the procedure given the benefit of hindsight (75% vs 85%, p = 0.386), or need for reoperation (14% vs 13%, p = 0.910).

Conclusion
Both patients with borderline GERD and GERD achieve GERD-HRQL improvements at 7 years following laparoscopic Nissen fundoplication and demonstrate similar long-term PPI usage and satisfaction with surgical results. Borderline GERD patients have lower GERD-HRQL at baseline, and thus have smaller improvements in their QOL scores. Anti-reflux surgery should be considered for patients with a diagnosis of borderline GERD refractory to medical therapy.
Sheffer stroke operation on L-algebras via an algorithmic approach
Authors: Gürsoy Necla Kırcalı , Öner Tahsin , Gürsoy Arif , Ülker Alper 
Published: August 2024

AbstractIn this study, we introduce the Sheffer stroke L-algebra and prove some fundamental theorems, propositions and lemmas of Sheffer Stroke L-algebras. The notions of filter and ultrafilter for Sheffer stroke L-algebra are studied. We give subalgebra and normal subset definitions of a Sheffer stroke L-algebras. Moreover, a homomorphism between Sheffer stroke L-algebras is introduced and isomorphism theorems are presented. Finally, we give three new algorithms for Sheffer stroke L-algebras. Thus, it is contributed to researchers on different application areas by presenting an algorithmic approach on this subject, for the first time in the literature.
Exploring patients and caregivers needs and experiences in oncological physiotherapy: a call for collaborative care
Authors: Medina-Rincón Almudena , San Miguel-Pagola Marta , Gargallo-Aguarón Pablo , Roldán-Pérez Patricia , Francín-Gallego Marina , Villa-García Lorena , Buesa-Estéllez Almudena 
Published: August 2024

Abstract
Purpose
This study explores whether the full potential of physiotherapy is reaching cancer patients and their caregivers at all stages of the oncological process, aiming to identify gaps and opportunities for improving care.

Methods
The World Cafe co-design methodology facilitated discussions among cancer patients and caregivers. This dynamic, inclusive, and engaging approach fostered diverse perspectives and deeper insights through collaborative and flexible discussions. Sessions were recorded, transcribed, and qualitatively analyzed.

Results
Sixteen participants were involved (eight cancer survivors and eight caregivers). The mean age of cancer survivors was 63.8 years, while the average age of caregivers was 59.3 years. Breast cancer was the most prevalent diagnosis among patients, and most caregivers had lost their family members to cancer. Analysis revealed two primary themes: “feeling cared for” and “the role of physiotherapy in the oncological process.” Key findings highlight the need for more humanized healthcare, with professionals providing support through effective communication and empathy. Significant gaps were detected in both systematic referrals to physiotherapists and their integration into care teams. Testimonies highlighted the lack of knowledge about the full potential of physiotherapy in oncology, hindering access. There was also a demand for recognizing specialized oncological physiotherapists.

Conclusions
These findings highlight significant gaps in physiotherapy care for cancer survivors and caregivers, including unmet needs due to the lack of information, resources, and effective communication. Future efforts should focus on increasing the visibility of physiotherapy, integrating specialized physiotherapists into oncology teams, and enhancing the emotional education of healthcare professionals to provide more humanized care.
From nexus thinking to nexus implementation in South Europe and beyond: mutual learning between practitioners and policymakers
Authors: Özcan Zeynep , Willaarts Barbara , Klessova Svetlana , Caucci Serena , Prista Luisa , Adamos Giannis , Laspidou Chrysi 
Published: August 2024

Abstract
The Water-Energy-Food-Ecosystems (WEFE) nexus presents a complex web of interactions, capturing the attention of both academia and policymakers. Sectoral policies wield significant impacts across WEFE domains, necessitating a nuanced approach to sustainability initiatives. For a decade, research and policy discussions across Europe have sought to comprehend these interconnections and develop strategies that minimize unintended consequences while maximizing co-benefits. The NEXUSNET Regional Forum convened in Split, Croatia on September 28, 2023, spotlighting stakeholders-practitioners who shape and are shaped by the WEFE nexus. With a focus on Southern Europe, the forum delved into challenges and opportunities, fostering the exchange of experiences and mutual learning among practitioners and policymakers. Diverse organizations were represented by esteemed panelists contributing to a comprehensive exploration of the WEFE nexus. The forum unfolded across three sessions: “Sectoral perspective viewpoint”, “Implementation of nexus cases”, and “Bridging the gap between nexus research and policy”. This paper distills the outcomes, providing a synthesis that transcends individual sessions. It offers a cohesive overview of the forum’s rich discussions, emphasizing the collaborative efforts required to navigate the intricacies of the WEFE nexus and elevate its societal and policy impact.
Minimally invasive far lateral tubular microdiscectomy: surgical technique and case series of 176 patients
Authors: Chau Anthony Minh Tien , Lerch Aaron , Waser Barton , Green Lauren , Papacostas Jason , Tsahtsarlis Antonio , McMillen Jason , Campbell Robert , Wood Martin , Amato Damian 
Published: August 2024

Abstract
Background
Far lateral (extraforaminal) disc herniations comprise approximately 10% of symptomatic lumbar disc herniations. They represent operative challenges due to accessibility and surgical unfamiliarity. Surgical strategies in the past have included open discectomy and posterior lumbar interbody fusion. Tubular microdiscectomies have gained traction due to their minimally invasive advantages, including reduced morbidity, pain and length of hospital stay.

Methods
We report our retrospective single institution consecutive case series of tubular far lateral microdiscectomies. One hundred and seventy-six patients were operated on over an eight-year period. Clinical outcomes were assessed after institutional ethics approval. We additionally describe our surgical technique with an illustrative video case.

Results
Over a mean follow-up of 21 weeks, 77% of patients had good or excellent clinical outcomes according to the MacNab criteria. 12% of patients underwent reoperation at the index level for symptom recurrence or persistence. Mean length of hospital stay was 1.3 days. There was a 1% rate of both postoperative haematoma and infection. Mean operation duration was 86 minutes.

Conclusion
This case series represents the largest currently reported in the literature. Minimally invasive microdiscectomies performed through tubes allow for precise localisation, reduced tissue disruption and favourable clinical outcomes. Our results appear consistent with a review of the literature, demonstrating the safety and efficacy of this approach.
Formation of the Positronium Antihydride Molecules ($$\bar{\textrm{H}}\textrm{Ps}$$) in Low Energy, 5-Body Collisions of Antihydrogen Ion $$\bar{\textrm{H}}^+$$ with Positronium Atoms Ps
Authors: Froelich Piotr , Yamashita Takuma , Kino Yasushi , Jonsell Svante , Hiyama Emiko 
Published: August 2024

AbstractIn this paper we present the first pilot calculation of the elastic and inelastic cross sections for the 5-body scattering of antihydrogen ions with positronium atoms. These cross sections have not been calculated before and are not known experimentally. In particular, we focus on the collisional rearrangement reactions $$\bar{{ \mathrm H}}^+ + \textrm{Ps} \rightarrow {\bar{\textrm{H}}}\textrm{Ps} +{\mathrm{e^+}}$$

H

¯

+

+
Ps
→

H

¯

Ps
+

e
+

which deplete the $$\bar{\textrm{H}}^+$$

H

¯

+

ions and result in stable atomcules $$\bar{\textrm{H}}\textrm{Ps}$$

H

¯

Ps

. To better understand the mechanism of this rearrangement, we study the 3-dimensional, angle resolved positron densities of the 3- and 4-body fragments in the initial and final states of the rearrangement collision.