bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stabilization of Microsurgical Anastomosis Using Fat-piece Graft With Autologous Fibrin Glue in Autologous Breast Reconstruction
Authors: Ikusaka Keisuke , Satake Toshihiko , Noto Minami , Katsuragi Ryohei , Tsukura Kahori , Ikeda Tatsuya , Taki Kyona , Tachibana Gaku , Kobayashi Kohta , Onoda Satoshi 
Published: February 2025

Summary:
Flap loss is a severe complication of autologous breast reconstruction. Most flap losses are caused by thrombosis of the anastomosed artery or vein. To prevent vascular disorders, we placed a fat-piece graft around the vessel anastomosis and stabilized the graft and the vessel with autologous fibrin glue. From February 2020 to September 2023, 163 patients underwent autologous breast reconstruction, including 179 breasts, using a deep inferior epigastric perforator flap and autologous fibrin glue to stabilize the internal mammary artery and vein at the Toyama University Hospital. Information on complications was collected retrospectively. No flap losses were observed during the study period; however, 1 hematoma and 1 infection occurred. Stabilization of the pedicle geometry may reduce the risk of kinking, and filling the dead space around the anastomosis reduced vessel spasms. Moreover, autologous fibrin glue may decrease complications such as hematoma, infection, and wound healing disturbance. The factors that may lower the risk of complications include flap design, assessment using multidetector computed tomography, selection of perforator and recipient vessels, vascular anastomosis method, postoperative management, and so on. In addition to these factors, this technique, stabilization of vessels using a fat-piece graft and fibrin glue, may lead to fewer complications during autologous breast reconstruction.
Global burden of HBV-related liver disease: Primary liver cancer due to chronic HBV infection increased in over one-third of countries globally from 2000 to 2021
Authors: Danpanichkul Pojsakorn , Duangsonk Kwanjit , Chen Vincent L. , Saokhieo Preenapun , Dejvajara Disatorn , Sukphutanan Banthoon , Aboona Majd B. , Lopimpisuth Chawin , Pang Yanfang , Ibrahim Andrew F. , Fallon Michael B. , Huang Daniel Q. , Kim Donghee , Singal Amit G. , Yang Ju Dong , Aqel Bashar A. , Terrault Norah A. , Wijarnpreecha Karn 
Published: February 2025

Backgrounds &Aims:
Hepatitis B virus (HBV)-related liver disease ranks as the seventh leading cause of mortality. Despite advances in prevention and treatment, global disparities in the burden of primary liver cancer (PLC) persist. We evaluate global trends in the prevalence, incidence, and death of HBV-related liver disease.

Approach and Results:
Data from the Global Burden of Disease Study 2021 evaluated acute HBV infection, HBV-related cirrhosis, and HBV-related liver cancer prevalence, incidence, and death. In 2021, there were 7.30 million cases of acute HBV, 283.64 million cases of HBV-related cirrhosis, and 288,110 cases of HBV-related PLC. HBV-related PLC accounted for 39% of the global incidence of PLC; Western Pacific had the highest rates for HBV-related PLC, with an incidence of 5.24 and a death rate of 4.38 per 100,000 population. Between 2000-2021, age-standardized incidence, prevalence, and death rates from HBV-related liver disease decreased; however, the incidence of HBV-related PLC rose in 65 countries from 2000 to 2021. In parallel, age-standardized prevalent rates from HBV-related PLC increased in Europe (Annual percent change [APC]: 0.77%, 95% confidence interval [CI] 0.72 to 0.81%) and the Americas (APC: 1.05%, 95%CI 1.00 to 1.10%).

Conclusion:
From 2000 to 2021, decreases in HBV-related liver disease incidence and prevalence were observed; however, more than one-third of countries showed an increase in the incidence of HBV-related PLC. These findings highlight the need for strengthened HBV treatment efforts to reduce the risk of liver cancer.
Establishing Consensus with Users of Research Irradiator Devices to Facilitate Source Type Replacement
Authors: Fennesy Danette R. , Gutiérrez Janet M. , Patlovich Scott J. , Emery Robert J. 
Published: February 2025

Abstract
The ability to irradiate cells, tissues, and other biological materials with high-energy photons has been an essential tool in the discovery of numerous biomedical research advancements. Historically, such irradiation was accomplished using sealed sources of radioactive materials in the form of 137Cs or 60Co. After the tragic events of 11 September 2001, a particular focus was placed on the vulnerability that irradiators represented due to the potential malicious acts that might lead to the creation of a radiological exposure or dispersal device. To mitigate this risk exposure, the United States Department of Energy National Nuclear Security Administration (NNSA) developed programs to both enhance the security associated with these devices and to incentivize the replacement of the units with x-ray-based technology. However, a significant barrier to engagement with the exchange program is the hesitancy on the part of the research community that does not wish to disrupt existing and established research protocols. This hesitancy stems from an inherent desire to adhere to the scientific process with the strict control of variables so that a single aspect can be isolated and then determined to result in an effect. A change from a gamma source to an x-ray source introduces a variable that warrants careful consideration and could have significant scientific and data-related impacts. Described here is the process undertaken by the radiation safety program for a major academic biomedical research institution to successfully transition from the use of gamma irradiators to x-ray devices without disrupting or negatively impacting critical research activities. The key to this successful transition was the establishment of consensus amongst the scientific and administrative communities prior to any formal commitment to the NNSA for the replacement endeavor. Ultimately, the researchers have found success in the transition and use of the x-ray irradiator replacements.
Comprehensive Review of CRCPD Efforts in the Disposition of Disused Radioactive Sources
Authors: McBurney Ruth E. , Steves Kimberly 
Published: February 2025

Abstract
The Conference of Radiation Control Program Directors (CRCPD), a national non-profit, non-governmental organization dedicated to radiation protection, established a National Radioactive Material Disposition Program to assist state radiation control programs, licensees, and members of the public in managing orphan sources and otherwise unwanted or disused radioactive material. The program consists of several services including technical assistance with disposition options; financial assistance to radiation control programs for the disposition of orphan sources; and the Source Collection and Threat Reduction (SCATR) Program for financial and logistical assistance in the disposal of unwanted sources. For the past 18 years, the CRCPD has partnered with the Department of Energy’s National Nuclear Security Administration (NNSA) to provide outreach to licensees and assistance in the disposal of disused sources, through the SCATR Program. The overarching goal of the SCATR Program is to design and execute a comprehensive and cost-effective process for identifying and reducing the threat of diversion of radioactive material for misuse, focusing on those sources that have a commercial disposal path. During the time the program has been in place, the scope has expanded to include higher activity sources, such as irradiators, and source collections in unusual circumstances. Progress toward the goals, disposal and transportation issues, and ancillary concerns being addressed by CRCPD are discussed.
Monitoring and Remediation of Tritium Contamination in Groundwater at a New Jersey Nuclear Power Plant
Authors: Tuccillo Karen , Vouglitois James , Schwartz Paul 
Published: February 2025

Abstract
The New Jersey Department of Environmental Protection’s (NJDEP) Bureau of Nuclear Engineering (BNE) has an ongoing program to monitor the concentrations of tritium in groundwater associated with leaks from nuclear power plants. Numerous monitoring wells are sampled on a routine basis to monitor the progress of licensee remedial activities and to ensure that off-site groundwater is not impacted by the leaks. The results of this program have demonstrated that off-site groundwater, including drinking water sources, have not been impacted by these leaks, and that ongoing remedial activities have successfully reduced the level of tritium contamination in on-site groundwater. An important lesson learned was that facility construction activities, such as building foundations, buried pipes and tunnels, cofferdams, and sheet piling, disturb confining layers, creating pathways to deeper aquifers. Proper plume characterization must include sampling in the formation to which the contaminant was released, as well as concurrent sampling of the underlying aquifers that were disturbed by facility construction.
CRCPD E-43 Committee for Interagency Environmental Data Sharing and Communications Endorsed RadResponder Threshold Sets
Authors: Slubowski Jill , Leek Angela , Irwin William , Hass Amy , Haskins Hillary , Azmat Sahar , Wentworth Theodore (TR) , Bruner Brennan , Mulligan Patrick , Hardeman Jim , Day Jeffrey 
Published: February 2025

Abstract
Situational awareness is critical in radiological emergency response as it enables responders to understand and interpret real-time data to make informed decisions during high-stress situations. Effective situational awareness involves collecting accurate data on radiation levels, contamination zones, and potential exposure risks, and visualizing this data in a comprehensible format. Tools like RadResponder play a key role in this process by allowing users to assign severity levels to data records and view them on an event map, thus facilitating rapid and informed decision-making. The CRCPD E-43 committee has developed enhanced threshold sets for RadResponder to improve situational awareness during radiological incidents. These threshold sets, based on science and informed by nationally recognized reference documents or regulations, are designed to help responders quickly assess radiation levels and make informed decisions regarding public safety and emergency worker doses. By providing clear, easily identifiable values and a standardized approach to data visualization, these threshold sets enhance the effectiveness of radiological emergency response efforts. The committee also recommends upgrades to the RadResponder system for better visibility and management of threshold sets, ensuring responders can efficiently access vital information during emergencies.
Long-term Outcomes of Descemet Stripping Automated Endothelial Keratoplasty Versus Descemet Membrane Endothelial Keratoplasty Under a Failed Penetrating Keratoplasty Graft
Authors: Snyder Alyssa J. , Bauer Alex J. , Straiko Michael D. , Terry Mark A. , Chen Jessica 
Published: February 2025

Purpose:
To compare long-term outcomes of Descemet membrane endothelial keratoplasty (DMEK) versus Descemet stripping automated endothelial keratoplasty (DSAEK) under a failed penetrating keratoplasty (PKP) graft.

Methods:
We retrospectively reviewed consecutive surgeries (Febuary 2007–September 2023) that received a DSAEK graft (n = 52) or DMEK graft (n = 51) under a failed PKP. Postoperative complication rates of primary graft failure (PGF), late endothelial graft failure, graft rejection, rebubble, and steroid response were recorded. Endothelial cell loss (ECL) at 6-month, 2-year, and 5-year postoperative visits were calculated. Graft survival time and survival probability at 5 years was determined using a Kaplan–Meier analysis. Twelve DMEK and 17 DSAEK eyes had 5-year follow-up. Eyes with a glaucoma filtration tube, trabeculectomy, or anterior chamber intraocular lens were excluded.

Results:
Rebubble rate was significant between DSAEK and DMEK cohorts (5.8%, 29.4%, P = 0.0017*). Rate of rejection, late endothelial graft failure, steroid response, 6-month ECL, 2-year ECL, 5-year ECL, survival probability, and 5-year mean survival time were not significant between DSAEK and DMEK cohorts [(9.6%, 5.9%, P = 0.7155), (13.5%, 9.8%, P = 0.7602), (9.6%, 11.8%, P = 0.7602), (32.0% ± 21.0%, 41.65% ± 25.6%, P = 0.1949), (55.8% ± 21.6%, 62.5% ± 19.8%, P = 0.4463), (59.5% ± 35.0%, 72.5% ± 5.7%, P = 0.3468), (88.5%, 84.3%, P = 0.483), (53.9 ± 2.4 confidence interval, 49.1–58.6 months, 52.7 ± 2.9 confidence interval, 47.0–58.5 months)]. PGF occurred in 0/52 (0%) and 3/51 (5.9%) eyes in the DSAEK and DMEK cohorts with nonsignificant trends favoring DSAEK (P = 0.1178).

Conclusions:
The only significant difference between DSAEK and DMEK cohorts was rebubble rate. However, nonsignificant trends favored PGF and ECL in the DSAEK cohort. Further investigation is warranted to determine if DSAEK provides better short-term and similar long-term outcomes compared with DMEK under a failed PKP.
The Use of Biodegradable Temporizing Matrix in Reconstruction Postvascular Anomaly Excision in the Pediatric Patient
Authors: Shilova Maria , Choy Kay T. , Das Gupta Romi , Stefanutti Giorgio , Storey Kristen , Griffin Bronwyn , Rashid Mudassir , Kimble Roy M. 
Published: February 2025

Background:
Reconstructing sites postvascular anomaly excision, particularly in high-tension areas or large excision zones, is challenging and often requires full-thickness grafts or flaps. The consideration of long-term scar outcomes, especially in pediatric cases, is crucial to prevent scar contractures from hindering growth. Acellular dermal matrices, such as biodegradable temporizing matrix (BTM), provide a valuable alternative reconstructive option following vascular anomaly excision.

Objective:
This article describes a reconstructive technique used for children undergoing excision of vascular anomalies via a case series of patients managed with this technique.

Methods:
This is a prospective study of 10 consecutive pediatric patients who underwent BTM reconstruction postvascular anomaly excision at a tertiary pediatric hospital. The indications for excision, the operative process for each child, postoperative management, and subsequent scar outcomes are described. The Brisbane Burn Scar Impact Profile was used to assess scar outcomes.

Results:
A range of vascular anomalies were excised, involving up to 15% of the total body surface area. In these patients, BTM served as a neodermis for subsequent split-thickness skin grafting. There was partial split skin graft loss in 2 patients, but in no cases was the dermal template lost, nor were there any cases of sepsis. Symptom control was achieved in all patients.

Conclusions:
In our experience, BTM offers a practical and safe reconstructive option for pediatric patients requiring excision of their vascular anomaly. It spares patients from more extensive procedures, has low rates of infection, and provides acceptable scar results.
Usefulness of MRI T1 Mapping in Predicting Postoperative Pancreatic Fistula After Distal Pancreatectomy
Authors: Kitagawa Noriyuki , Shimizu Akira , Yamada Akira , Kubota Koji , Notake Tsuyoshi , Masuo Hitoshi , Yamazaki Shiori , Hirano Shohei , Yokokawa Yoshiharu , Soejima Yuji 
Published: February 2025

Objectives:
Postoperative pancreatic fistula (POPF) is the most significant and potentially lethal complication of pancreatectomy. This study evaluated the association between MRI pancreatic T1 mapping and POPF and developed a new, useful, and noninvasive predictor of distal pancreatectomy (DP).

Methods:
The study included 39 patients who underwent preoperative MRI T1 mapping using the Modified Look-Locker Inversion Recovery Sequence (MOLLI) followed by DP between January 2018 and July 2024. Patients with (POPF (+), n=15) and those without POPF (POPF (-), n=24) were compared for their characteristics, perioperative outcomes, and parameters derived from MRI. The circular region of interest was positioned on the pancreatic head, ventral side of the portal vein, and transection site to measure the T1 mapping value. The data were analyzed using R1 values (R1=1/T1), and the cut-off values were calculated using the receiver operating characteristic (ROC) curve.

Results:
The R1 value of the pancreatic transection site in the POPF (+) group was significantly higher than that in the POPF (-) group (1.180 vs. 1.066 sec-1; P<0.001). The R1 value of the pancreatic transection site was an independent risk factor for grade B/C POPF (odds ratio, 5.01; P=0.005). To predict POPF, a cutoff R1 value of 1.116 sec-1 at the transection site was obtained by maximizing the Youden index.

Conclusions:
High R1 values at the pancreatic transection site indicate a higher possibility of developing grade B/C POPF. Preoperative MRI T1 mapping may be valuable for predicting POPF after DP.
A Comprehensive Examination of Just Culture Principles in Nurses’ Transition to Practice
Authors: Baker Manisa , Toothaker Rebecca , Walker Danielle , Flexner Randi Sue , McQuiston Linda S , Hromadik Lora 
Published: February 2025

Background:
Transition to practice from a nursing student to registered nurse comes with challenges. Just culture is taught in nursing education, yet not easily translated into practice.

Purpose:
The purpose of this study was to the understand NGN’s perception of just culture from transition to practice.

Methods:
A secondary data analysis was conducted from a mixed-methods longitudinal study. Just culture perceptions were assessed at 2 time points, while in school and 6 months after graduation.

Results:
Data converged around the beliefs of just culture and willingness to report safety events. Other aspects of just culture, such as continuous improvement and fear of reporting, not only change across time as NGN transition to practice but are divergent.

Conclusion:
Students and NGN participants reported understanding the concept of just culture; however, challenges remain with institutional and societal norms.
SimZones Approach to a Competency-Based Objective Structured Clinical Examination
Authors: Klenke-Borgmann Laura , Mattson Nate 
Published: February 2025

Background:
Competency-based education (CBE) can be achieved through purposeful structuring of experiential learning. Yet, there is scant guidance for nurse educators to operationalize this transition.

Purpose:
To describe a semester-long CBE simulation curriculum for third-year nursing students, using the SimZone (Zone 0-3) framework.

Methods:
Zone 0 ensured foundational knowledge. Objective Structured Clinical Examination (OSCE) Prep Lab 1 (Zone 1) and Prep Lab 2 (Zone 2) provided deliberate skill practice and small group simulation practice, respectively. Zone 3 was the summative OSCE.

Results:
Students’ (n = 107) performance was assessed on patient safety, clinical judgment, assessment, and communication. Initially, 64% of students were deemed competent, increasing to 92% after additional practice and to 100% with further iteration. Students also reviewed their OSCE recordings and completed reflective writing.

Conclusion:
This approach may serve as a model for other nursing programs to implement competency-based curricula through leveled simulations and iterative learning.
Effect of Electroacupuncture on Delayed-Onset Muscle Soreness Induced by Eccentric Exercise in Young Untrained Men: Randomized Controlled Trial
Authors: Komine Shoichi , Miura Ikuru , Hu Teng , Ogata Akihiro , Tamai Shinsuke , Tokinoya Katsuyuki , Oh Sechang , Wada Shota , Takekoshi Kazuhiro , Ito Go , Isobe Tomonori , Matsui Takashi , Ohmori Hajime 
Published: February 2025

Abstract

Objective
This study aimed to compare the effects of ipsilateral electroacupuncture (IEA) at the site of exercise-induced pain and those of contralateral electroacupuncture (CEA) on delayed-onset muscle soreness (DOMS), muscle injury markers, and oxidative stress following eccentric exercise.

Design
Nineteen young men were randomly assigned to receive either CEA or IEA. All participants performed eccentric exercise using the biceps brachii muscle of the nondominant arm to induce muscle damage. Six sets of five repetitions were completed at 70% of maximal muscle strength. Electroacupuncture stimulation was applied to the dominant arm in the CEA group and the nondominant arm in the IEA group. Electroacupuncture stimulation was applied in both groups from 7 days before exercise to 4 days after exercise.

Results
Palpation pain was significantly lower in the IEA group than the CEA group at 72 and 96 hours after exercise. The muscle injury markers increased following exercise, but these changes were not significantly influenced by IEA stimulation. IEA suppressed exercise-induced oxidative stress at 72 hours after exercise.

Conclusions
This study suggests that the direct electroacupuncture on the damaged muscle before and after eccentric exercise effectively reduces DOMS. Electroacupuncture might suppress increases in oxidative stress elicited by eccentric exercise.
Effects of Botulinum Neurotoxin on Muscle Mass and Volume in Individuals with Spastic Cerebral Palsy: A Systematic Review and Meta-analysis
Authors: Lin Ai-Chieh , Su Yu-Chi , Lin Yu-Ching 
Published: February 2025

Abstract

Objective
To comprehensively survey the impact of botulinum neurotoxin (BoNT) on muscle volume or mass in treating lower limb spasticity in individuals with spastic cerebral palsy (CP).

Design
We searched PubMed, Embase, Web of Science, and the Cochrane Library up to May 15, 2024. We focused on changes in the volume or mass of the gastrocnemius, triceps surae, or entire distal lower limb muscles at various follow-up periods. Meta-regression analysis was conducted to assess the moderating effects of age and gross motor function classification system (GMFCS) level.

Results
Our analysis included 11 cohort studies. A significant decrease in gastrocnemius muscle volume or mass was observed 2 to 3 months post-BoNT treatment (SMD −0.496, 95% CI [−0.810, −0.181]) but not at earlier (SMD −0.134, [−0.397, 0.129]) or later (SMD −0.223, [−1.199, 0.752]) periods. The triceps surae and entire distal lower limb muscles showed no changes. Older patients (P = 0.026) and those with GMFCS I-II levels (P = 0.0191) had more pronounced decreases.

Conclusion
The present study showed a decrease in muscle volume or mass of the BoNT-injected gastrocnemius after a short follow-up period but not in the triceps surae or the distal lower limb in individuals with spastic CP.
Determining the incidence of concomitant traumatic brain injury in patients with acute spinal cord injury: a ten-year cross-sectional study
Authors: Dionne Antoine , Briand Marie-Michèle , Richard-Denis Andréane , Lim Victor , Le Minh Tri , Mac-Thiong Jean-Marc 
Published: February 2025

ABSTRACT

Objective
A concomitant traumatic brain injury (TBI) is often seen in patients with acute traumatic spinal cord injury (TSCI). Unfortunately, the exact epidemiology of concomitant TBI-TSCI remains unknown. Our objective was to determine the incidence of concomitant TBI-TSCI and identify clinical factors associated with its occurence.

Design
A prospective cross-sectional study of 476 TSCI patients was conducted. In all patients, baseline characteristics were routinely collected and the presence of a TBI was sought prospectively by a specialized neurosurgeon using standardized diagnostic criteria based on clinical and radiological variables.

Results
Out of the 476 included patients, 250 (53%) had isolated TSCI and 226 (47%) had concomitant TBI-TSCI. Almost 85% of diagnosed TBI were mild. At the univariate level, patients with concomitant TBI-TSCI were more likely to present a history of drug/alcohol abuse (p = 0.014), be involved in a motor vehicle accident (p < 0.001), sustain a high energy mechanism (p < 0.001) or present tetraplegia rather than paraplegia(p = 0.021). These factors all remained significant at the multivariate level.

Discussion
A concomitant TBI can be found in around 50% of TSCI individuals. There are several clinical variables that should increase clinical suspicion of underlying TBI and warrant further investigation to facilitate prompt identification and treatment of affected patients.