bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional outcome after interdisciplinary, acute rehabilitation in COVID-19 patients: a retrospective study
Authors: Elmer Nancy , Reißhauer Anett , Brehm Katharina , Drebinger Daniel , Schaller Stefan J. , Schwedtke Christine , Liebl Max E. 
Published: July 2024

Abstract
Background
Survivors of severe COVID-19 often exhibit a variety of sequelae including loss of mobility and ADL (activities of daily living) capacity. Acute rehabilitation (AR) is an interdisciplinary rehabilitation intervention applied early while still in a hospital setting. The goal of AR is to improve functional limitations and to increase functional independence at discharge. It is established in the treatment of patients with other severe diseases such as sepsis, polytrauma, or stroke. Data concerning AR in COVID-19 are sparse.

Aim
To evaluate the changes in physical function during AR in patients after severe COVID-19.

Methods
This monocentric, retrospective observational study examined the functional outcomes of a sample of COVID-19-patients who received interdisciplinary AR at a university hospital. Inclusion criteria were a positive SARS-CoV-2 test in 05/2020–01/2022 and transfer to AR after intensive care treatment. 87 patients were elegible for evaluation, 3 of whom were excluded because of death during AR. Data were extracted from the hospital information system. In a pre-post analysis, mobility (Charité Mobility Index), ADL (Barthel Index), and oxygen demand were assessed. In addition, discharge location after AR, factors associated with AR unit length of stay, and functional improvements were analyzed.

Results
Data of 84 patients were analyzed. Mobility increased significantly from a median of 4 [1.25-6] CHARMI points at admission to a median of 9 [8.25-9] at discharge (p < 0.001). ADL increased significantly from a median of 52.5 [35.0-68.75] Barthel Index points at admission to a median of 92.5 [85–95] at discharge (p < 0.001). Oxygen demand decreased from 80.7 to 30.5% of patients. The majority (55.9%) of patients were discharged home, while 36.9% received direct follow-up rehabilitation. Older age correlated significantly with lower scores on the discharge assessment for mobility (Spearman’s ϱ = -0.285, p = 0.009) and ADL (Spearman’s ϱ = -0.297, p = 0.006).

Conclusion
Acute rehabilitation is a viable option for COVID-19 patients with severe functional deficits after ICU treatment to achieve functional progress in mobility and ADL, reduce oxygen requirements and enable follow-up rehabilitation.

Trial registration number and date of registration for prospectively registered trials
Trial registration number: DRKS00025239. Date of registration: 08 Sep 2021.
Physics-informed neural network estimation of material properties in soft tissue nonlinear biomechanical models
Authors: Caforio Federica , Regazzoni Francesco , Pagani Stefano , Karabelas Elias , Augustin Christoph , Haase Gundolf , Plank Gernot , Quarteroni Alfio 
Published: July 2024

Abstract
The development of biophysical models for clinical applications is rapidly advancing in the research community, thanks to their predictive nature and their ability to assist the interpretation of clinical data. However, high-resolution and accurate multi-physics computational models are computationally expensive and their personalisation involves fine calibration of a large number of parameters, which may be space-dependent, challenging their clinical translation. In this work, we propose a new approach, which relies on the combination of physics-informed neural networks (PINNs) with three-dimensional soft tissue nonlinear biomechanical models, capable of reconstructing displacement fields and estimating heterogeneous patient-specific biophysical properties and secondary variables such as stresses and strains. The proposed learning algorithm encodes information from a limited amount of displacement and, in some cases, strain data, that can be routinely acquired in the clinical setting, and combines it with the physics of the problem, represented by a mathematical model based on partial differential equations, to regularise the problem and improve its convergence properties. Several benchmarks are presented to show the accuracy and robustness of the proposed method with respect to noise and model uncertainty and its great potential to enable the effective identification of patient-specific, heterogeneous physical properties, e.g. tissue stiffness properties. In particular, we demonstrate the capability of PINNs to detect the presence, location and severity of scar tissue, which is beneficial to develop personalised simulation models for disease diagnosis, especially for cardiac applications.
Homosexualität im Alter – Wahrung der Identität im Pflegekontext. Eine Literaturübersicht.
Authors: Boldt Dietmar , Brandstötter-Gugg Cornelia 
Published: July 2024

ZusammenfassungFür ältere und hochaltrige homosexuelle Menschen ist die Wahrung der Identität im Pflegekontext häufig erschwert. Neben der generell vorherrschenden Tabuisierung oder Abwertung von Sexualität im Alter sind homosexuelle Personen zusätzlich oft mit heteronormativen Strukturen bis hin zu Diskriminierungserlebnissen konfrontiert. Literatur zum ethischen Handeln im Gesundheitswesen greift den Anspruch der Nichtexklusivität auf. Achtung und Würde stehen hierbei an erster Stelle und sollen allen Personen gleichermaßen zukommen.Diese systematische Literaturübersicht verfolgt das Ziel, anhand von wissenschaftlicher Literatur ethische Ansätze und pflegerische Unterstützungsangebote herauszuarbeiten, die bei der Wahrung der Identität älterer und hochaltriger (> 60) homosexueller Menschen helfen können. Forschungsfrage: „Wie kann die Identität homosexueller älterer Menschen durch die Unterstützung von Pflegepersonen gewahrt werden?“Anhand eines narrativen Reviews konnten sechs relevante Studien identifiziert werden. Die Recherche wurde in den Datenbanken PubMed und CINAHL durchgeführt.Drei Hauptkategorien wurden identifiziert, die für das Thema Homosexualität im Alter mit seinen Herausforderungen übergreifende Maßnahmenempfehlungen darstellen: Aufklärung und Schulung von Fachkräften, strukturelle Rahmenbedingungen und ein sicheres Umfeld durch eine bedarfsgerechte Versorgung.Pflegepersonen können die Wahrung der Identität homosexueller älterer Personen durch Anerkennung in Form von Zuwendung durch pflegerische Betreuung und soziale Wertschätzung fördern. Zudem ist es wichtig, dass eine rechtliche sowie strukturelle Gleichstellung homosexueller Personen im Pflegekontext und darüber hinaus erfolgt. Eine Auseinandersetzung mit ethischen Grundsätzen und Ansätzen ist hierfür unerlässlich.
The use of diffusion tensor imaging in spinal pathology: a comprehensive literature review
Authors: Scullen Tyler , Milburn James , Aria Kevin , Mathkour Mansour , Tubbs R. Shane , Kalyvas James 
Published: July 2024

Abstract
Study design
We reviewed the available literature systematically without meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Objective
To evaluate contemporary literature on use of spinal diffusion tensor imaging(sDTI) in spinal pathology.

Background
sDTI reveals the location and functional state of critical long tracts and is a potentially useful adjunct in disease management.

Methods
Studies were included if they presented or discussed data from investigative or therapeutic procedures involving sDTI on human subjects in the setting of surgically amenable spinal pathology. Studies were excluded if they were (1) restricted to computational models investigating parameters using data not obtained clinically, (2) about cranial DTI methods, (3) about spinal pathology data not related to surgical management, (4) discussions or overviews of methods/techniques with minimal inclusion of objective experimental or clinical data.

Results
Degenerative pathologies of interest were restricted to either cervical myelopathy (22/29,75.9%) or lumbar spondylosis 7/29,24.1%). Mass-occupying lesions included intradural pathology and discussed preoperative (7/9,77.8%) and intraoperative imaging(2/9,22.2%) as an adjunct to surgery 22.2%. Traumatic pathology focused on spinal cord injury prognosis and severity grading.

Conclusions
sDTI seems useful in surgical decision making and outcome measurements and in establishing clinical prognoses over a wide range of surgical pathologies. Further research is warranted with longer follow-up and larger population sizes in a prospective and controlled protocol.
Clinical management of bone loss in cervical total disc arthroplasty: literature review and treatment recommendations
Authors: Spece Hannah , Khachatryan Armen , Phillips Frank M. , Lanman Todd H. , Andersson Gunnar B. J. , Garrigues Grant E. , Bae Hyun , Jacobs Joshua J. , Kurtz Steven M. 
Published: July 2024

Abstract
Purpose
Cervical total disc replacement (cTDR) has been established as an alternative treatment for degenerative cervical radiculopathy and myelopathy. While the rate of complications for cTDR is reasonably low, recent studies have focused on bone loss after cTDR. The purpose of this work is to develop a clinical management plan for cTDR patients with evidence of bone loss. To guide our recommendations, we undertook a review of the literature and aimed to determine: (1) how bone loss was identified/imaged, (2) whether pre- or intraoperative assessments of infection or histology were performed, and (3) what decision-making and revision strategies were employed.

Methods
We performed a search of the literature according to PRISMA guidelines. Included studies reported the clinical performance of cTDR and identified instances of cervical bone loss.

Results
Eleven case studies and 20 cohort studies were reviewed, representing 2073 patients with 821 reported cases of bone loss. Bone loss was typically identified on radiographs during routine follow-up or by computed tomography (CT) for patients presenting with symptoms. Assessments of infection as well as histological and/or explant assessment were sporadically reported. Across all reviewed studies, multiple mechanisms of bone loss were suspected, and severity and progression varied greatly. Many patients were reportedly asymptomatic, but others experienced symptoms like progressive pain and paresthesia.

Conclusion
Our findings demonstrate a critical gap in the literature regarding the optimal management of patients with bone loss following cTDR, and treatment recommendations based on our review are impractical given the limited amount and quality evidence available. However, based on the authors’ extensive clinical experience, close follow-up of specific radiographic observations and serial radiographs to assess the progression/severity of bone loss and implant changes are recommended. CT findings can be used for clinical decision-making and further follow-up care. The pattern and rate of progression of bone loss, in concert with patient symptomatology, should determine whether non-operative or surgical intervention is indicated. Future studies involving implant retrieval, histopathological, and microbiological analysis for patients undergoing cTDR revision for bone loss are needed.
Exploring optimal microscopic keyhole access to the skull base: an anatomical evaluation of transciliary supraorbital and transpalpebral orbitofrontal craniotomy approaches
Authors: Corecha Santos Romel , Gupta Bhavika , Sabahi Mohammadmahdi , Dabecco Rocco , Santiago Raphael Bastianon , Najera Edinson , Kaye Brandon , Adada Badih , Yu Alexander , Mandel Mauricio , Borghei-Razavi Hamid 
Published: July 2024

AbstractPurpose: The past two decades have witnessed the rise of keyhole microscopic minimally invasive surgeries, including the transciliary supraorbital approach (TCA) and transpalpebral approach (TPA), commonly known as the transorbital approach. This study aims to elucidate the nuances, specific indications, and advantages of each approach. Methods: A series of dissections were conducted on five formalin-fixed, alcohol-preserved cadaver heads. The TCA was performed on one side, and the TPA on the other. Virtual measurements of working angles for both approaches were recorded. Additionally, three clinical cases were presented to illustrate the practical application of the techniques. Results: For TCA, the craniotomy dimensions were 1.7 cm x 2.5 cm (Cranial-Caudal (CC) x Lateral-Lateral (LL)), while for TPA, they measured 2.1 cm x 2.9 cm (CC x LL). The measurements of anterior clinoid processes (ACP) were obtained and compared between approaches. In the TCA, the mean ipsilateral ACP measurement was 62 mm (Range: 61 –63 mm), and the mean contralateral ACP measurement was 71.2 mm (Range: 70 –72 mm). In TPA, these measurements were 47.8 mm (Range: 47 –49 mm) and 62.8 mm (Range: 62 –64 mm), respectively. TCA exhibited an average cranial-caudal angle of 14.9°, while TPA demonstrated an average of 8.3°. Conclusion: The anterior cranial fossa was better exposed by a TCA, which also featured shorter operative times, enhanced midline visualization, and a quicker learning curve. Conversely, the middle fossa was better exposed by a TPA, making it an excellent option for middle fossa pathologies, including those in the anterior temporal lobe. After sphenoid bone wing drilling, the TPA offers superior visualization from the lateral to the medial aspect and enhances the CC angle. Additionally, the TPA reduces the risk of postoperative frontalis palsy based on anatomic landmarks. However, the TPA requires a greater cranial osteotomy, and due to unfamiliarity with eyelid anatomy, the learning curve for most neurosurgeons is lengthier for this procedure.
Decalogue for mastering robotic transanal minimally invasive surgery (rTAMIS)
Authors: Guadalajara H. , Leon-Arellano M. , Dominguez-Tristancho J. L. , García-Olmo D. 
Published: July 2024

AbstractThis manuscript offers a detailed description of our successful tips for mastering transanal robotic surgery. It covers various aspects, including patient positioning, management of abdominal pressures to maintain a stable pneumorectum, platform positioning, camera alignment, trocar positioning to minimize collisions, instruments used, and approaches to tumor resection.
Revealing Detailed Cartilage Function Through Nanoparticle Diffusion Imaging: A Computed Tomography & Finite Element Study
Authors: Tuppurainen Juuso , Paakkari Petri , Jäntti Jiri , Nissinen Mikko T. , Fugazzola Maria C. , van Weeren René , Ylisiurua Sampo , Nieminen Miika T. , Kröger Heikki , Snyder Brian D. , Joenathan Anisha , Grinstaff Mark W. , Matikka Hanna , Korhonen Rami K. , Mäkelä Janne T. A. 
Published: July 2024

AbstractThe ability of articular cartilage to withstand significant mechanical stresses during activities, such as walking or running, relies on its distinctive structure. Integrating detailed tissue properties into subject-specific biomechanical models is challenging due to the complexity of analyzing these characteristics. This limitation compromises the accuracy of models in replicating cartilage function and impacts predictive capabilities. To address this, methods revealing cartilage function at the constituent-specific level are essential. In this study, we demonstrated that computational modeling derived individual constituent-specific biomechanical properties could be predicted by a novel nanoparticle contrast-enhanced computer tomography (CECT) method. We imaged articular cartilage samples collected from the equine stifle joint (n = 60) using contrast-enhanced micro-computed tomography (µCECT) to determine contrast agents’ intake within the samples, and compared those to cartilage functional properties, derived from a fibril-reinforced poroelastic finite element model. Two distinct imaging techniques were investigated: conventional energy-integrating µCECT employing a cationic tantalum oxide nanoparticle (Ta2O5-cNP) contrast agent and novel photon-counting µCECT utilizing a dual-contrast agent, comprising Ta2O5-cNP and neutral iodixanol. The results demonstrate the capacity to evaluate fibrillar and non-fibrillar functionality of cartilage, along with permeability-affected fluid flow in cartilage. This finding indicates the feasibility of incorporating these specific functional properties into biomechanical computational models, holding potential for personalized approaches to cartilage diagnostics and treatment.
HeartMate 3 for Heart Failure with Preserved Ejection Fraction: In Vitro Hemodynamic Evaluation and Anatomical Fitting
Authors: Langer Nina , Stephens Andrew F. , Šeman Michael , McGiffin David , Kaye David M. , Gregory Shaun D. 
Published: July 2024

AbstractHeart failure with preserved ejection fraction (HFpEF) constitutes approximately 50% of heart failure (HF) cases, and encompasses different phenotypes. Among these, most patients with HFpEF exhibit structural heart changes, often with smaller left ventricular cavities, which pose challenges for utilizing ventricular assist devices (VADs). A left atrial to aortic (LA-Ao) VAD configuration could address these challenges, potentially enhancing patient quality of life by lowering elevated mean left atrial pressure (MLAP). This study assessed the anatomical compatibility and left atrial unloading capacity using a simulated VAD-supported HFpEF patient. A HeartMate3-supported HFpEF patient in an LA-Ao configuration was simulated using a cardiovascular simulator. Hemodynamic parameters were recorded during rest and exercise at seven pump flow rates. Computed tomography scans of 14 HFpEF (NYHA II–III) and six heart failure with reduced ejection fraction patients were analysed for anatomical comparisons. HFpEF models were independently assessed for virtual anatomical fit with the HM3 in the LA-Ao configuration. Baseline MLAP was reduced from 15 to 11 mmHg with the addition of 1 L/min HM3 support in the rest condition. In an exercise simulation, 6 L/min of HM3 support was required to reduce the MLAP from 29 to 16 mmHg. The HM3 successfully accommodated six HFpEF patients without causing interference with other cardiac structures, whereas it caused impingement ranging from 4 to 14 mm in the remaining patients. This study demonstrated that the HM3 in an LA-Ao configuration may be suitable for unloading the left atrium and relieving pulmonary congestion in some HFpEF patients where size-related limitations can be addressed through pre-surgical anatomical fit analysis.
State of the Art Modelling of the Breast Cancer Metastatic Microenvironment: Where Are We?
Authors: Nuckhir Mia , Withey David , Cabral Sara , Harrison Hannah , Clarke Robert B. 
Published: July 2024

AbstractMetastatic spread of tumour cells to tissues and organs around the body is the most frequent cause of death from breast cancer. This has been modelled mainly using mouse models such as syngeneic mammary cancer or human in mouse xenograft models. These have limitations for modelling human disease progression and cannot easily be used for investigation of drug resistance and novel therapy screening. To complement these approaches, advances are being made in ex vivo and 3D in vitro models, which are becoming progressively better at reliably replicating the tumour microenvironment and will in the future facilitate drug development and screening. These approaches include microfluidics, organ-on-a-chip and use of advanced biomaterials. The relevant tissues to be modelled include those that are frequent and clinically important sites of metastasis such as bone, lung, brain, liver for invasive ductal carcinomas and a distinct set of common metastatic sites for lobular breast cancer. These sites all have challenges to model due to their unique cellular compositions, structure and complexity. The models, particularly in vivo, provide key information on the intricate interactions between cancer cells and the native tissue, and will guide us in producing specific therapies that are helpful in different context of metastasis.
A polynomial-time dynamic programming algorithm for an optimal picking problem in automated warehouses
Authors: Barbato Michele , Ceselli Alberto , Righini Giovanni 
Published: July 2024

AbstractWe consider an optimization problem arising when a set of items must be selected and picked up from given locations in an automated storage and retrieval system by a crane of given capacity, minimizing the overall distance traveled. The problem has been classified as open in a recent taxonomy of optimal picking problems in automated warehouses. In this paper, we analyze some non-trivial properties of the problem and we describe a polynomial-time dynamic programming algorithm to solve it to proven optimality.
Hot deformation behavior of laser powder bed fusion newly developed MS400 grade maraging steel
Authors: Król Mariusz , Snopiński Przemysław , Nowak Agnieszka J. , Radoń Adrian , Karpiński Marcin , Kowalski Aleksander , Osadnik Małgorzata , Burian Wojciech , Żak Artur , Jóźwik Bartosz 
Published: July 2024

AbstractIn this work, the hot deformation mechanism of as-printed laser powder bed fusion process (LPBF) newly developed MS400 grade maraging steel was investigated. The optimization processes allowed for obtaining samples with an average density of 8.200 ± 0.002 g cm−3 and hardness of 417 ± 5 HV. The hot compression procedure of maraging steel was carried out with the DIL 805 A/D dilatometer at different temperatures in the range of 1050 °C-1200 °C and strain rates of 0.01 s−1–1 s−1 in an inert gas atmosphere. The measured melt flow stress data were used to develop a constitutive model to determine the behavior of the alloy during hot deformation. The proposed equation can be used as an input to the finite element analysis to obtain the flow stress at a given strain, strain rate and temperature, useful for predicting flow localization or fracture during thermomechanical simulation. The activation energy for hot deformation was calculated to be 388.174 kJ mol−1, which corresponds to that of M350 grade. The proposed equation can be used during finite element analysis to calculate the flow stress at any strain, strain rate and temperature to determine the location of a flow or crack during a thermomechanical simulation.
An efficient image classification and segmentation method for crime investigation applications
Authors: Sedik Ahmed , Kolivand Hoshang , Albeedan Meshal 
Published: July 2024

AbstractThe field of forensic science is experiencing significant growth, largely driven by the increasing integration of holographic and immersive technologies, along with their associated head-mounted displays. These immersive systems have become increasingly vital in resolving critical crimes as they facilitate communication, interaction, and collaboration. Given the sensitive nature of their work, crime investigators require substantial technical support. There is a pressing need for accurate documentation and archiving of crime scenes, which can be addressed by leveraging 3D scanned scenes to accurately represent evidence and expected scenarios. This study aims to develop an enhanced AR. system that can be deployed on hologram facilities such as the Microsoft HoloLens. The proposed system encompasses two main approaches, namely image classification and image segmentation. Image classification utilizes various deep learning models, including lightweight convolutional neural networks (CNNs) and convolutional Long-Short Term Memory (ConvLSTM). Additionally, the image segmentation approach is based on the fuzzy active contour model (FACM). The effectiveness of the proposed system was evaluated for both classification and segmentation tasks, utilizing metrics such as accuracy, sensitivity, precision, and F1 score. The simulation results indicate that the proposed system achieved a 99% accuracy rate in classification and segmentation tasks, positioning it as an effective solution for detecting bloodstain patterns in AR applications.