bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subway track foundation settlement deformation prediction based on the BiLSTM-AdaBoost model
Authors: Dang Xifeng , Yin Xiao , Liu Jianwei , Wu Jincheng , Wang Xin , Liu Yongqiang , Sun Shoubin 
Published: May 2024

Abstract
The rapid economic expansion has spurred extensive construction near subway networks, impacting the stability of their track foundations. Consequently, it’s crucial to monitor and predict settlement in subway track foundations. However, the dynamic deformation patterns often exhibit nonlinearity and non-stationarity, posing challenges for traditional linear regression models. To tackle this, our study integrates the BiLSTM (bi-directional long short-term memory) network with the AdaBoost ensemble learning algorithm. Using settlement data from Shanghai metro monitoring points, the model is trained and evaluated employing R2 (coefficient of determination), MAE (mean absolute error), and RMSE (root mean square error). Results show that our proposed model displays superior predictive accuracy compared to the LSTM and the BiLSTM, with an average training set R2 of 0.99, test set R2 of 0.78, average MAE of 0.32 mm, and average RMSE of 0.4 mm. Consequently, for forecasting subway track foundation deformations, employing our network model ensures highly accurate predictive capabilities.
Un/published: Presence and Absence in Contemporary Erasure Poetry
Authors: Schaefer Heike 
Published: May 2024

Abstract
Erasure is a popular form of appropriative poetry that refashions found material by partially effacing it. Made of salvaged fragments and deletion marks, erasure poetry puts processes of obliteration on display and provides a structural analogy for both the social erasure of marginalized groups and the critical rewriting of hegemonic discourses. This essay understands erasure as a constraint-based appropriative practice and differentiates it from other forms of conceptual and documentary poetry. It argues that erasures use the oscillation between presence (of the retained words, the redaction marks and elisions, and the newly created poem) and absence (of some of the words and material and medial features of the prior text) to destabilize the boundaries between the published and unpublished, between what is heard and what is silenced, between the sayable and what exceeds representation. Reading poems by Tracy Smith, Janet Holmes, and Jen Bervin that erase the Declaration of Independence and the poetry of Emily Dickinson respectively, the essay shows how erasures intervene in public conversations about social justice by repurposing and revising their intertexts, allowing new speakers, knowledges, and narratives to emerge. Erasures prompt a layered reading that directs the readers back to the source and its sociocultural contexts while drawing them deeper into the imaginative and discursive world of the erasure poem.“Erasure poetry allows us to read in recognition of what is absent or missing and to imagine new voices and perspectives emerging from the cleared and transformed spaces of the page.”
Stackable Medical-Grade Skincare for the Cosmetic Medicine Patient: A Long-Term Pilot Assessment
Authors: Pryor Sydney , Semersky Alec , Sabev Tiffany , Few Julius 
Published: May 2024

Abstract

Background
Multiple intrinsic and extrinsic factors influence aging and lead to visible changes in the skin, including dryness, fine lines and wrinkles, loss of elasticity, surface roughness, uneven pigmentation, and loss of luminosity. Although it is well established that a single combination of topicals can address multiple signs of skin aging, it is common for patients’ at-home skin treatment routines to include multiple different topicals with different active ingredients. The layering of active ingredients can cause skin irritation, and lead to noncompliance with a consistent routine. Further, multiple active ingredients may exacerbate irritation from in-office aesthetic treatments.

Objectives
To assess the long-term efficacy, safety, tolerability, and patient adherence to a Stackable Treatment topical routine consisting of 4 complementary topical formulations.

Methods
This study examined a daily topical routine (Stackable Treatment routine) consisting of 4 topical formulas with different active ingredients, and evaluated the routine's safety, tolerability, and efficacy in a composite of in-office treatment patients who applied the routine for a minimum of 1 year.

Results
Of the 14 patients, 0 experienced adverse reactions. Improvements to multiple skin parameters were observed, including improvements to skin hydration, surface texture, pigmentation, vasculature, and the appearance of scars. The majority of patients continue to use the Stackable Treatment routine after the study's conclusion.

Conclusions
The combination of low incidence of irritation, high patient satisfaction, and overall efficacy of the routine indicates the Stackable Treatment routine may be well suited as a foundational skin care regimen that can complement in-office aesthetic treatments.

Level of Evidence: 4
Laparotomy for Traumatic Splenic Injury: Should we Increase our Efforts to Preserve the Spleen?
Authors: Jakob D A , Müller M , Kolitsas A , Exadaktylos A K , Demetriades D 
Published: May 2024

Abstract

Background
In trauma laparotomy the spleen is removed very liberally, and often little effort is made for splenic preservation.

Aims
The aim of this study was to assess the effect of surgical management (splenic repair vs. splenectomy) on outcomes in patients undergoing trauma laparotomy.

Methods
This is a trauma registry (TQIP) study (2013–2019), including adult patients with severe splenic injuries (grades III-V) undergoing trauma laparotomy. Characteristics and outcomes of patients who underwent splenic repair vs. splenectomy within 6 hours of admission were compared using different statistical approaches, i.e. 1:1 exact matching with consecutive conditional logistic regression analysis as primary analysis, multivariable logistic regression, propensity score matching and inverse-probability weighting as sensitivity analyses. The primary outcome was in-hospital mortality.

Results
A total of 11,247 patients with a severe splenic injury undergoing trauma laparotomy within 6 hours of admission were identified. Of these, 10,820 (96.2%) patients underwent splenectomy and 427 (3.8%) patients splenic repair within 6 hours of admission. Among patients who underwent an initial splenic salvage procedure, 23 (5.3%) patients underwent a splenectomy during the subsequent hospital stay. 400 patients with splenic preservation, were matched with 400 patients who underwent splenectomy (matched for age, sex, hypotension, trauma mechanism as well as AIS spleen grades 3,4,5 and AIS groups (AIS 0-2, AIS 3, AIS 4-5) for head, face, neck, thorax, spine, and lower & upper extremity). The mortality was significantly lower in the group of patients with splenic repair (6.5% vs 12.8%, p=0.002). The mortality benefit was subsequently verified by conditional regression analysis (aOR 0.4, CI 95% 0.2; 0.9). Multivariable logistic regression, propensity score matching, and inverse-probability weighting confirmed the lower mortality in the splenic repair group.

Conclusion
In trauma laparotomy splenic repair was independently associated with lower mortality compared with splenectomy. Splenectomy was required in approximately 5% of the patients after initial splenic repair. The findings provide evidence that efforts for spleen preservation in trauma laparotomy should be considered in selected cases.
Enough Is Enough – How Many Rectal Suction Biopsies Do You Need to Diagnose Hirschsprung’s Disease?
Authors: Metzger S , Neeser H R , Robbiani I , Rodewald A K , Nigbur T , Di Natale A , Moehrlen U , Tharakan S J 
Published: May 2024

Abstract

Background
Rectal suction biopsy (RSB) is the gold-standard for diagnosing Hirschsprung’s disease (HD) in infants. However, despite this being a common procedure no standard exists on how many biopsy specimens and at which level they should be taken.

Aims
The aim of this study is to determine the conclusiveness of RSB specimens in relation to their location within the rectum in diagnosing HD. With this, we would like to define how many specimens are necessary to diagnose HD and eventually propose a standardized protocol to conduct RSB.

Methods
We reviewed the epidemiological data and pathology results of 92 patients undergoing RSB between January 2011 and May 2022 at our institution. We perform RSB by taking 4 specimens at 1 cm, 3 cm and 5 cm above the dentate line, as well as one specimen at the dentate line.

Results
We included 92 patients who had 115 biopsies performed with a mean of 3.77 specimens per session. Of the specimens taken at 1 cm above the dentate line 73.9% were conclusive, at 3 cm 75.9% and at 5 cm 79.2%. Specimens taken at the dentate line were squamous or transitional epithelia in 31.5% and therefore of no use for HD diagnostics. If the specimen at 3 cm was conclusive, the whole session was more likely to be diagnostic.

Conclusion
We propose that taking a total of three specimens, namely one at 1 cm, one at 3 cm and further biopsy at 3 or 5 cm above the dentate line, is enough to diagnose or exclude HD.
Compatibility of Family Planning and Surgical Training in Switzerland
Authors: Faes S , Ferreirinha J , Weber M 
Published: May 2024

Abstract

Background
Surgeons undertake a long training and have stressful work schedules during optimal childbearing age. Training and career plans can entice young surgeons to renounce part-time work and delay pregnancy, risking pregnancy complications and infertility.

Aims
This survey study aims to determine the prevalence and constraints of part-time work and family planning among young surgeons in Switzerland.

Methods
An anonymous, voluntary survey was distributed to young board-certified surgeons. It queried work schedules and desire for part-time work as well as history of pregnancies and use of assisted reproductive treatment.

Results
A total of 375 surgeons participated, 308 were included (157 female, 151 male). There were no differences in current age (male median 37 (IQR 5), female 37 (6), p=0.93), median age at medical school graduation (male 26 (2), female 26 (2), p=0.90), and mean time to board certification (male 8.3 (SD 2.4), female 8.2 (SD 2.7), p=0.61). Female surgeons had a higher rate of part-time employment (38% vs 19%, p=0.0002). More male surgeons had children compared to their female counterparts (70% vs 45%, p&lt;0.0001). Female surgeons were older (median 35 (IQR 4.5)) than male surgeons (median 33.5 (IQR 3.25), p=0.0002) and female partners of male surgeons (median 32 (IQR 3), p&lt;0.0001) at birth of their first child. Female surgeons more frequently desired further children (71% vs 38%, p&lt;0.0001) and delayed pregnancy due to training (74% vs 22%, p&lt;0.0001). Female surgeons had longer time to conceive (&gt;12 months 24% vs 10%, p=0.014), lower spontaneous pregnancy rates (82% vs 93%, p=0.029) and higher rates of assisted reproductive treatment (14% vs 4%, p=0.0089). Female surgeons more frequently perceived their gender as a negative career influence (67% vs 5%, p&lt;0.0001).

Conclusion
Whilst part-time work and family planning are challenging for surgeons of both genders, female surgeons face striking inequities when trying to consolidate family planning with their profession.
Minimally-Invasive Robotic-Assisted Resection for Intrathoracic Goiter – A Feasible Alternative to Thoracotomy and Sternotomy
Authors: Hotz A S , Gelpke H , Zehnder A , Schmidt S , Goldmann A 
Published: May 2024

Abstract

Background
Goiter is a common presentation in daily clinical practice. It usually grows slowly and in rare cases with intrathoracic extension. There is no clear definition of intrathoracic goiters. The incidence in the literature varies from 3% to 7%. Most intrathoracic goiters are localized in the anterior mediastinum, with less than 25% are localized in the posterior mediastinum. This presents a challenge for surgical resection. Traditionally, the intrathoracic portions have been resected via sternotomy for anterior goiters and thoracotomy for posterior goiters. With the increasing use of robotic surgery, new possibilities for minimally invasive surgery and especially robotic procedures have emerged. This may reduce morbidity and length of hospital stay.

Aims
The study aims to show that minimal-invasive, robotic-assisted resection for intrathoracic goiter is safe and feasible.

Methods
During the study period from January 2021 to December 2023, 548 thyroid operations were performed in our clinic. All operations were prospectively recorded in the Eurocrine registry and retrospectively analyzed. Goiter was defined as intrathoracic according to perioperative findings (caudal border not visible on sonography and/ or further preoperative investigations ordered). Primary and secondary endpoints were outcome, conversion rate, and incidence of intrathoracic goiter.

Results
In our clinic, 19/548 patients (3.5%) presented with intrathoracic goiter. 17/19 patients were operated via conventional cervical approach. In 2 patients, minimal-invasive robotic mobilization of the large posterior portion of the goiter was performed in combination with conventional cervical thyroidectomy. No conversion was required. Based on our cases, we present robotic intrathoracic thyroid mobilization as a novel technique to avoid thoracotomy.
The rate of recurrent nerve palsy in intrathoracic goiter was 1/28 (3.5%) nerves at risk and occurred with conventional approach. No secondary bleeding or other complications were observed.

Conclusion
The minimal-invasive robotic approach seems to be a promising alternative to open procedures such as thoracotomy and can reduce morbidity and length of hospital stay.
High-Intensity Focused Ultrasound Therapy for an Osteoidosteoma in a Pediatric Finger: A Case Report
Authors: Hüppi J , Zechmann-Müller N , Binkert C 
Published: May 2024

Abstract

Background
High intensity focused ultrasound (HIFU) is a non-ionizing and non-invasive application for benign and malign disease. Ultrasonic waves are concentrated to achieve high level of energy and therefore necrosis due to coagulation.

Aims
We will describe one pediatric case where an osteoidosteoma war successfully treated by HIFU.

Methods
A seven-year-old boy presented in our department for hand surgery due to indolent swelling of the distal phalanx of the right ring finger. Neither recent trauma, nor positive family history was present. Clinical examination showed significant enlargement of the distal phalanx with minimal pain on palpation and unlimited mobility. Conventional radiography showed discrete fuzzy sclerosis of the metaphyseal part of the growth plate. MRI was not conclusive. Bone biopsy showed reactive change with no signs for acute inflammatory event. Periodic checks were performed, with no change in clinical and radiographic aspect. Nine months after the first appointment, the patient presented with pain after minor trauma and increase of the swelling. Radiography showed a nidus in the distal phalanx leading to a suspected diagnosis of an osteoidosteoma. Therefore, MRI-guided HIFU (MR-HIFU) was recommended one year after the first appointment.

Results
MR-HIFU was performed to destroy the osteoidosteoma. Six months after the intervention the patient presented with no further exponential growth and the difference to the other phalanges was minimized. Furthermore, radiography showed no retention of the nidus with a plane distal phalanx.

Conclusion
MR-HIFU is a promising approach in the non-invasive treatment of tumorous neoplasm. Because of its non-ionizing ultrasonic waves, there is no upper limit in dosing. The deposition of heat is in general limited by the surrounding tissue. The main factors preventing MR-HIFU treatment are thick bone around the nidus, a superficial position with risk for skin burn and the vicinity to neural structures. Osteoidosteomas are generally rather small and therefore well suited for MR-HIFU.
Preoperative MRCP is not Associated with Lower Complication Rates but Shorter Hospital Stay in Laparoscopic Cholecystectomy
Authors: Zeindler J , Hess G F , Sedlaczek P , Muenst S , Bolli M , Kollmar O , Soysal S D 
Published: May 2024

Abstract

Background
Laparoscopic cholecystectomy is a very common procedure and while preoperative magnetic resonance cholangiopancreatography (pMRCP) is widely used for detection of choledocholithiasis and preoperative planning, the benefits in patients with normal preoperative cholestatic parameters remain unclear.

Aims
We aimed to investigate a large cohort of patients after laparoscopic cholecystectomy to analyse the impact of pMRCP on complication rates.

Methods
This retrospective cohort study consecutively includes all patients receiving elective or acute laparoscopic cholecystectomy between 2010 and 2020. Exclusion criteria were conversion to open cholecystectomy and preoperatively elevated cholestatic parameters. Complication rates were recorded and patients stratified depending on the use of pMRCP for preoperative planning.

Results
3163 patients underwent laparoscopic cholecystectomy between 2010 and 2020, 2568 of which showed normal cholestatic parameters preoperatively. Of these patients, 684/2568 (27%) were male and 1884/2568 (73%) female. The most frequent indications for laparoscopic cholecystectomy were cholecystolithiasis in 72% (1845/2568) of cases, followed by cholecystitis in 18% (465/2568). The majority of patients (2267/2568, 88%) indeed received pMRCP, while the remaining 301/2568 patients did not. Postoperative complication rates did not significantly differ between the two groups (396/2267 (17%) in the pMRCP group and 58/301 (19%) without pMRCP, p=0.469). One case of pancreatitis occurred in the pMRCP group, versus two reported cases in the other group. Interestingly, the length of hospital stay after cholecystectomy was significantly shorter in the group with pMRCP versus without (4 days (range 1-61 days) versus 7 days (range 1 – 66 days), respectively, p = 0.023).

Conclusion
Preoperative MRCP seems to not prevent complications in laparoscopic cholecystectomy, since postoperative complication rates were comparable between the two patient groups with and without pMRCP. However, postoperative hospital stay was significantly shorter in patients undergoing pMRCP compared to patients without pMRCP.
Evaluation of the Low Anterior Resection Syndrome and Quality of Life in Patients Having Undergone Sphincter Sparing Rectal Cancer Surgery
Authors: Fiechter J , Sguinzi R , Bafumi L , Gremaud B , Geng B , Bühler L , Egger B 
Published: May 2024

Abstract

Background
In order to avoid abdomino-perineal amputation and permanent colostomy in patients with low rectal cancer sphincter sparing low anterior resection (SSLAR) techniques with/without neoadjuvant radio-chemotherapy are administered. However, a lot of SSLAR-patients have life quality limiting symptoms afterwards, like fecal urgency, incontinence, constipation and sensation of incomplete rectal emptying. Such symptoms are defined as “low anterior resection syndrome” (LARS). LARS quantification can be made by a specific and validated quality of life (QoL) questionnaire (see annex).

Aims
Assessment of the QoL in patients after SSLAR suffering from LARS before and after specific therapy.

Methods
This is a monocentric, retrospective cohort study including patients having undergone SSLAR for rectal cancer 2014 - 2021. Initial LARS-scores were obtained by completion of the specific questionnaire. Patients with a minor LARS (scores 21-29) were treated with electrostimulation and bio-feedback physiotherapy. Those with a major LARS (scores &gt;29) were first investigated by anal manometry followed by physiotherapy. After treatment LARS-scores were obtained again.

Results
Of 136 identified SSLAR-patients, 68 did not fulfill the inclusion criteria’s (see annex). Of the remaining 54 patients, 20.4% had a minor, 37% a major and 42.6% no LARS. Of all LARS-patients, 13 completed pelvic physiotherapy, 4 are still completing and 14 (26%) refused such a treatment. The mean-LARS score was 32.77 and 22.92, before and after treatment, respectively (p=0.004). Risk factor analysis (diabetes, type of anastomosis, neoadjuvant radio-chemotherapy, previous operations, nicotine, alcohol) did not reveal any significant difference between groups.

Conclusion
More than 50% of patients undergoing SSLAR are suffering from LARS, more than one third from major LARS. QoL is impressively improved by specific physiotherapeutic measures. In order to avoid later treatment hesitancy (26%), we began to initiate early specific physiotherapy as a standard in all SSLAR-patients.
Impact of Virtual Reality Distraction on Pain and Anxiety for Bedside Abdominal VAC Dressing Change (VIRPA) – A Randomized Controlled Clinical Trial
Authors: Barberá Carbonell B , Hübner M , Grass F , Djafarrian R 
Published: May 2024

Abstract

Background
Virtual reality (VR) distraction techniques are promising adjuncts to reduce pain and anxiety.

Aims
This study assessed the impact of VR distraction during bedside change of vacuum assisted closure (VAC) dressings.

Methods
In this non-blinded randomized superiority trial, patients scheduled for bedside change of a subcutaneous VAC dressing were allocated to receive distraction through VR masks in addition to a standardized pain protocol (intervention) or pain protocol alone (control). Primary endpoints were pain scores assessed by a visual analogue scale (VAS:0-10), secondary outcomes were anxiety (State Trait Anxiety Inventory (STAI-Y:20-80), VAS:0-10), hemodynamic parameters and satisfaction (VAS:0-10).

Results
Nineteen and twenty-one patients were randomized to receive intervention and control, respectively. Baseline characteristics were well balanced including age (61±11 vs. 62±17), sex (female: 9 vs. 13), American Society of Anesthesiologists (ASA) scores (≥3: 18 vs. 18, all non-significant). Pre- and postoperative pain levels were 2.2±2.2 vs. 2.0±2.1 (p=0.38) for the intervention group compared with 2.6±2.1 vs. 2.2±1.6 (p=0.26), with no significant difference between the groups (p=0.38). Similar findings for blood pressure and heart rates. Anxiety was reduced in both groups post VAC change in the intervention and control group: STAI 40±12 pre-VAC vs. 30±8 post VAC and 45±14 pre-VAC vs. 32±9 post VAC (both p&lt;0.01), ΔVAS -2 (interquartile range IQR 0, -3) vs. -2 (IQR 0, -5), both p&lt;0.01. Postinterventional satisfaction was 8.3±1.9 (intervention) vs. 7.5±2.4 (p=0.11).

Conclusion
In this study, pain and anxiety were well managed with a standardized pain protocol with or without adjunct VR distraction. Further studies will focus on patients with insufficient control of pain and anxiety with a standard protocol.