bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Fish Skin Grafts for Wound Management: Report of 5 Pediatric Cases
Authors: Doan M , Cherry I , Tarhini L , de Buys Roessingh A 
Published: May 2024

Abstract

Background
Managing wounds and scars in children presents a significant challenge for surgical and rehabilitation teams. Studies have already explored the potential of fish skin grafts with Omega-3 in hard-to-heal lower extremity chronic ulcers and deep-burn management.

Aims
The purpose of this study is to assess the safety and outcome of intact fish skin grafts with Omega-3 when used as skin replacement therapy in the pediatric population.

Methods
This article was conducted in adherence to our hospital's ethical guidelines. Patients enrolled in this study were identified retrospectively. Their medical records were reviewed, and data was collected concerning patient demographics, initial mode of injury, indication for fish skin placement, operative data, postoperative care, complications and outcomes. The acellular dermal matrix was obtained from North Atlantic codfish skin (Gadus morhua) farmed in Isafjordur, Iceland.

Results
All patients underwent meticulous wound debridement and patch application under general anesthesia and were discharged the same day. Wound surface ranged between 10 and 110 cm2 (mean: 53 cm2). Standard analgesic medications were taken for a maximum period of 48 hours in all patients. Upon follow-up at our outpatient clinic, shrinkage in the wound surface was observed in all patients after a few days, followed by early wound granulation. Two patients underwent subsequent split-thickness grafting to achieve healing. The mean time required to achieve complete epithelialization was 48.6 days (range: 29 – 62 days). No hypersensitivity or allergic reaction was reported. The definitive outcome was satisfactory in all wounds, meaning complete wound coverage.

Conclusion
The findings from this case series reveal that fish skin grafts with Omega-3 can be an effective and a safe scaffold in the process of repairing damaged tissues in the pediatric population. We have been able to accomplish a quality skin replacement therapy, with no donor site morbidity.
Ultrasound-Based Measurement of Dorsal Scaphoid Displacement During Watson Test in Scapholunate Ligament Lesion
Authors: Huber N , Schweizer A , Reissner L 
Published: May 2024

Abstract

Background
Scapholunate ligament lesion (SLL) is the most common ligament lesion in the wrist. The diagnosis of scapholunate ligament injuries in clinical practice is not standardised and there are various clinical and radiological methods that have varying degrees of reliability.

Aims
The aim of our work was to find a method that was simple, easily reproducible and did not require expensive and time- consuming second-tier examinations. We therefore assessed the reliability of sonography during Watson test (WT) in detecting SLL.

Methods
20 patients with MRI and intraoperatively confirmed SLL were assessed preoperatively between July 2020 and April 2023. Sonography was performed on the scaphoid dorsal subluxation (DS) in wrist neutral and during WT and compared with the healthy contralateral side. The DS was measured by two independent investigators and intra- and interobserver reliability were assessed.

Results
We found a statistically significant difference between DS of the scaphoid of the healthy (0.89 mm, SD 0.67 mm) compared to the pathological side (1.67 mm, SD 0.95 mm). Reliability was very good, and SEM was lower than 0.4 mm for all measurements.

Conclusion
Sonographic measurement during WT showed promising results with very good reliability; this method could be routinely adopted for the detection and diagnosis of SLL without the need for second-tier examinations.
A Multicenter Exploration of the APRI/ALBI Score in Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy’ (ALPPS)
Authors: Jonas J P , Linecker M , Müller P C , Sander S , Ardiles V , Wen Z , Romic I , Kysela M , Truant S , Reese T , Rauchfuss F , Ullmer F , Wahba R , Hahn O , Guidetti C , Fernandez-Placencia R , Robles Campos R , Sparrelid E , Petrowsky H , Santol J , Eshmuminov D , Oberkofler C , Rössler F , Amann M , Ignatavicius P , Oberholzer J , Starlinger P 
Published: May 2024

Abstract

Background
Perioperative morbidity and mortality remain a point of concern for the Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy (ALPPS) procedure. Post-hepatectomy liver failure (PHLF) after the second step poses the most significant risk factor for futile outcome. Recovery of liver function after the first step of ALPPS is critically important to allow for sufficient liver function after this surgery. The APRI+ALBI score has been proposed as an easily assessable score to monitor liver function and its dynamic recovery.

Aims
We explored if the APRI+ALBI score was able to assess liver function recovery after the first step of ALPPS and allow for optimal timing of the 2nd step.

Methods
Based on the ALPPS registry, patients from 2012 to 2020 with available APRI+ALBI score were included. Postoperative outcomes (PHLF A – C, PHLF B + C, 90-day mortality and severe morbidity) were defined as per standard definitions. The APRI/ALBI score was monitored perioperatively.

Results
Overall, 464 patients from 16 international participating centers in the ALPPS registry were included. Clinically relevant PHLF (B + C) was observed in 7.5 % and of these 63 % of patients ultimately died due to liver failure. The APRI+ALBI score immediately increased after each surgical intervention and continuously decrease thereafter. Failure of the APRI+ALBI score to decrease until the 2nd step of ALPPS predicted PHLF B+C (p = 0.001; AUC 0.78). Particularly patients with high APRI+ALBI scores and short interstage intervals were at risk to develop PHLF B+C.

Conclusion
The APRI+ALBI score objectifies liver function recovery after the 1st step of ALPPS and failure to sufficiently decreased is associated with a higher risk for PHLF B+C. This might allow for optimized planning of the 2nd step of ALPPS to allow for sufficient liver function recovery to minimize the risk for PHLF B+C and associated futile outcome.
Full Robotic Versus Open ALPPS: A Bi-Institutional Comparison of Perioperative Outcomes
Authors: Müller P C , Guidetti C , Magistri P , Jonas J P , Odorizzi R , Kron P , Guerrini G , Oberkofler C E , Di Sandro S , Clavien P A , Petrowsky H , Di Benedetto F 
Published: May 2024

Abstract

Background
In primarily unresectable liver tumors, ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy) may offer curative two stage hepatectomy trough a fast and extensive hypertrophy. However, concerns have been raised about the invasiveness of the procedure. Full robotic ALPPS has the potential to reduce the postoperative morbidity trough a less invasive access.

Aims
The aim of this study was to compare the perioperative outcomes of open and full robotic ALPPS.

Methods
The bicentric study included open ALPPS cases from the University Hospital Zurich, Switzerland and robotic ALPPS cases from the University of Modena and Reggio Emilia, Italy from 01/2015 to 07/2022. Main outcomes were intraoperative parameters and overall complications.

Results
Open and full robotic ALPPS was performed in 36 and 7 cases. Robotic ALPPS was associated with less blood loss after both stages (418±237ml vs. 319±197ml; P=0.04 and 631±354ml vs. 258±53ml; P=0.01) as well as a higher rate of interstage discharge (86% vs. 37%; P=0.02). OT was longer with robotic ALPPS after both stages (371±70min vs. 449±81min; P=0.01 and 282±87min vs. 373±90min; P=0.02). After ALPPS stage 2, there was no difference for overall complications (86% vs. 86%; P=1.00) and major complications (43% vs. 39%; P=0.86). The total length of hospital stay was similar (23±17 days vs. 26±13; P=0.56).

Conclusion
Robotic ALPPS was safely implemented and showed potential for improved perioperative outcomes compared to open ALPPS in an experienced robotic center. The robotic approach might bring the perioperative risk profile of ALPPS closer to interventional techniques of portal vein embolization/liver venous deprivation.
Robotic-Assisted Treatment of Large Incisional Abdominal Wall Hernias: A Cost Analysis
Authors: Mongelli F , Sabbatini F , la Regina D , Murgante Testa N , Pini R 
Published: May 2024

Abstract

Background
Robotic-assisted treatment of ventral hernia offers many advantages, however, studies reported higher costs for robotic surgery compared to other surgical techniques.

Aims
We aimed at comparing hospital costs in patients undergoing large ventral hernia repair with either robotic or open surgery.

Methods
We retrospectively searched from a prospectively maintained database patients who underwent robotic or open surgery for the treatment of the large ventral hernias from January 2016 to December 2022. The primary endpoint was to assess the costs incurred by the hospital in both groups. For eligible patients, data was extracted analyzed using a propensity score-matching.

Results
During the study period, 67 patients were retrieved from our database. 34 patients underwent robotic-assisted surgery while 33 underwent open surgery. Mean age was 66.4 years ±4.1 years, 50% of patients were male. After a propensity score-matching, a similar total cost of 18,297±8,435 EUR vs. 18,024±7,514, p=0.913 in robotic-assisted and open surgery groups were noted. Robotic surgery showed higher operatory theatre-related costs (7,532±2,091 EUR vs. 3,351±1,872 EUR, p&lt;0.001), which were fully compensated by a shorter hospital stay of 5.3±4.5 vs. 10.4±5.2 days, p=0.002 (costs: 4,265±4,366 EUR vs. 7,373±4,698 EUR, p=0.032).

Conclusion
Our study showed that in the treatment of large ventral hernia, robotic surgery had higher operatory theatre-related costs, however, they were fully compensated by shorter hospital stays and resulting in similar total costs.
Mapping the differential impact of spontaneous and conversational laughter on brain and mind: an fMRI study in autism
Authors: Cai Ceci Qing , Lavan Nadine , Chen Sinead H Y , Wang Claire Z X , Ozturk Ozan Cem , Chiu Roni Man Ying , Gilbert Sam J , White Sarah J , Scott Sophie K 
Published: May 2024

Abstract
Spontaneous and conversational laughter are important socio-emotional communicative signals. Neuroimaging findings suggest that non-autistic people engage in mentalizing to understand the meaning behind conversational laughter. Autistic people may thus face specific challenges in processing conversational laughter, due to their mentalizing difficulties. Using fMRI, we explored neural differences during implicit processing of these two types of laughter. Autistic and non-autistic adults passively listened to funny words, followed by spontaneous laughter, conversational laughter, or noise-vocoded vocalizations. Behaviourally, words plus spontaneous laughter were rated as funnier than words plus conversational laughter, and the groups did not differ. However, neuroimaging results showed that non-autistic adults exhibited greater medial prefrontal cortex activation while listening to words plus conversational laughter, than words plus genuine laughter, while autistic adults showed no difference in medial prefrontal cortex activity between these two laughter types. Our findings suggest a crucial role for the medial prefrontal cortex in understanding socio-emotionally ambiguous laughter via mentalizing. Our study also highlights the possibility that autistic people may face challenges in understanding the essence of the laughter we frequently encounter in everyday life, especially in processing conversational laughter that carries complex meaning and social ambiguity, potentially leading to social vulnerability. Therefore, we advocate for clearer communication with autistic people.
Effects of Different Storage Times on the Stability of 12 Traditional Chinese Medicine Decoction Pieces
Authors: Xie Rui-Fang , Feng Yi-Ming , Li Shan-Ni , Kong Wei-Song , Zhou Gui , Zhou Xin 
Published: May 2024

Abstract
As storage time increases, the quality of traditional Chinese medicines (TCMs) may change, and stability is an essential aspect of ensuring the safety and efficacy of TCMs. In this study, the effects of different storage times on the stability of 12 decoction pieces were evaluated. High-performance liquid chromatography was used to determine the contents of the active components in the 12 decoction pieces. The chemical composition data were analyzed using fingerprinting and clustering heatmap (CH). Results showed that during storage, significant variations (relative standard deviation &gt; 10%) were observed in the levels of paeoniflorin in Paeoniae Radix Alba and Paeoniae Radix Rubra, hesperidin in Citri Reticulatae Pericarpium and Citri Reticulatae Pericarpium Viride, bufothionine in Siccus Bufo and chlorogenic acid in White Chrysanthemi Flos and Lonice Raejaponicae Caulis. However, calycosin-7-glucoside and calycosin in Astragali Radix Praeparata Cum Melle and chlorogenic acid in Lonicerae Japonicae Flos, Yellow Chrysanthemi Flos and Mori Folium were all &lt;10%, which is consistent with the CH. Decoction pieces can be stored for up to six months, but it is recommended that volatile oil-containing and animal-based decoction pieces should not be stored for more than one month. This study provides new perspectives for the stability and quality control studies of TCM.
Privacy-Preserving Breast Cancer Prediction Based on Logistic Regression
Authors: Chen Shuangquan , Li Jinguo , Zhang Kai , Di Aoran , Lu Mengli 
Published: May 2024

Abstract
With the increasing strain on today’s healthcare resources, there is a growing demand for pre-diagnosis testing. In response, researchers have suggested diverse machine learning models for disease prediction, among which logistic regression stands out as one of the most effective models. Its objective is to enhance the accuracy and efficiency of pre-diagnosis testing, thereby alleviating the burden on healthcare resources. However, when multiple medical institutions collaborate to train models, the untrusted cloud server may pose a risk of private data leakage, enabling participants to steal data from one another. Existing privacy-preserving methods often suffer from drawbacks such as high communication costs, long training times and lack of security proofs. Therefore, it is imperative to jointly train an excellent model collaboratively and uphold data privacy. In this paper, we develop a highly optimized two-party logistic regression algorithm based on CKKS scheme. The algorithm optimizes ciphertext operations by employing ciphertext segmentation and minimizing the multiplication depth, resulting in time savings. Furthermore, it utilizes least squares to approximate sigmoid functions within specific intervals that cannot be handled by homomorphic encryption. Finally, the proposed algorithm is evaluated on a breast cancer dataset, and simulation experiments demonstrate that the model’s prediction accuracy, after machine learning training, exceeds 96% for two-sided encrypted data.
Australian innovative activity and international technology, 1854–2016
Authors: Fleming Grant , Liu Zhangxin Frank , Merrett David , Ville Simon 
Published: May 2024

Abstract
Has Australia’s focus as a producer and exporter of natural resources—often considered low technology industries—constrained the development of its innovation system? We exploit a new digital database from the Commonwealth Patent Office to investigate this question. We find that the focus of domestic innovativeness supported key industries for Australian development and complemented technological specialization by foreign patent applicants, particularly in European and American manufacturing. The results support the argument that shifts in national technological orientation is a relatively long game and that technical advantage is shaped by a nation’s stage of economic development.
Quantifying the mortality impact of Il Piano Marshall
Authors: Vilà Gregori Galofré 
Published: May 2024

Abstract
The Marshall Plan is often hailed as history’s most successful structural adjustment program. However, its direct impacts and its impact on public health outcomes, particularly mortality rates, remain uncertain. Using data for Italian provinces, I find that each additional million dollars in the Italian European Recovery Program was related to a decrease of one to two deaths per 1,000 people or a decline in the Italian crude death rate by 3–7 percent. The effect is driven by the grants in food and drugs (rather than reconstruction grants). This finding is robust to a range of specifications using models in levels and differences, region dummies, placebo tests, a difference-in-differences framework, coarsened exact matching, and a border-municipal research design. The largest mortality reductions came from drops in communicable and infectious diseases.
Cortico-limbic interactions and carotid atherosclerotic burden during chronic stress exposure
Authors: Gharios Charbel , van Leent Mandy M T , Chang Helena L , Abohashem Shady , O’Connor David , Osborne Michael T , Tang Cheuk Y , Kaufman Audrey E , Robson Philip M , Ramachandran Sarayu , Calcagno Claudia , Mani Venkatesh , Trivieri Maria Giovanna , Seligowski Antonia V , Dekel Sharon , Mulder Willem J M , Murrough James W , Shin Lisa M , Tawakol Ahmed , Fayad Zahi A 
Published: May 2024

Abstract

Background and Aims
Chronic stress associates with cardiovascular disease, but mechanisms remain incompletely defined. Advanced imaging was used to identify stress-related neural imaging phenotypes associated with atherosclerosis.

Methods
Twenty-seven individuals with post-traumatic stress disorder (PTSD), 45 trauma-exposed controls without PTSD, and 22 healthy controls underwent 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI). Atherosclerotic inflammation and burden were assessed using 18F-FDG PET (as maximal target-to-background ratio, TBR max) and MRI, respectively. Inflammation was assessed using high-sensitivity C-reactive protein (hsCRP) and leucopoietic imaging (18F-FDG PET uptake in spleen and bone marrow). Stress-associated neural network activity (SNA) was assessed on 18F-FDG PET as amygdala relative to ventromedial prefrontal cortex (vmPFC) activity. MRI diffusion tensor imaging assessed the axonal integrity (AI) of the uncinate fasciculus (major white matter tract connecting vmPFC and amygdala).

Results
Median age was 37 years old and 54% of participants were female. There were no significant differences in atherosclerotic inflammation between participants with PTSD and controls; adjusted mean difference in TBR max (95% confidence interval) of the aorta 0.020 (−0.098, 0.138), and of the carotids 0.014 (−0.091, 0.119). Participants with PTSD had higher hsCRP, spleen activity, and aorta atherosclerotic burden (normalized wall index). Participants with PTSD also had higher SNA and lower AI. Across the cohort, carotid atherosclerotic burden (standard deviation of wall thickness) associated positively with SNA and negatively with AI independent of Framingham risk score.

Conclusions
In this study of limited size, participants with PTSD did not have higher atherosclerotic inflammation than controls. Notably, impaired cortico-limbic interactions (higher amygdala relative to vmPFC activity or disruption of their intercommunication) associated with carotid atherosclerotic burden. Larger studies are needed to refine these findings.
Italian Association of Hospital Cardiologists Position Paper ‘Gender discrepancy: time to implement gender-based clinical management’
Authors: Lucà Fabiana , Pavan Daniela , Gulizia Michele Massimo , Manes Maria Teresa , Abrignani Maurizio Giuseppe , Benedetto Francesco Antonio , Bisceglia Irma , Brigido Silvana , Caldarola Pasquale , Calvanese Raimondo , Canale Maria Laura , Caretta Giorgio , Ceravolo Roberto , Chieffo Alaide , Chimenti Cristina , Cornara Stefano , Cutolo Ada , Di Fusco Stefania Angela , Di Matteo Irene , Di Nora Concetta , Fattirolli Francesco , Favilli Silvia , Francese Giuseppina Maura , Gelsomino Sandro , Geraci Giovanna , Giubilato Simona , Ingianni Nadia , Iorio Annamaria , Lanni Francesca , Montalto Andrea , Nardi Federico , Navazio Alessandro , Nesti Martina , Parrini Iris , Pilleri Annarita , Pozzi Andrea , Rao Carmelo Massimiliano , Riccio Carmine , Rossini Roberta , Scicchitano Pietro , Valente Serafina , Zuccalà Giuseppe , Gabrielli Domenico , Grimaldi Massimo , Colivicchi Furio , Oliva Fabrizio 
Published: May 2024

Abstract
It has been well assessed that women have been widely under-represented in cardiovascular clinical trials. Moreover, a significant discrepancy in pharmacological and interventional strategies has been reported. Therefore, poor outcomes and more significant mortality have been shown in many diseases. Pharmacokinetic and pharmacodynamic differences in drug metabolism have also been described so that effectiveness could be different according to sex. However, awareness about the gender gap remains too scarce. Consequently, gender-specific guidelines are lacking, and the need for a sex-specific approach has become more evident in the last few years. This paper aims to evaluate different therapeutic approaches to managing the most common women’s diseases.
AL–AMYLOIDOSIS RELATED ADVANCED HEART FAILURE DIAGNOSED THROUGH F–18–FLUTEMETANOL PET SCAN
Authors: Calabrese A , Ghisletti A , Gori M , Iorio A , Giammarresi A , Quarta G , Cirelli C , Limonta R , Monticelli M , Fiori E , Galli M , Erba P , Senni M 
Published: May 2024

Abstract

Background
Systemic amyloidosis (SA) is a group of rare diseases in which abnormal misfolded proteins, amyloid fibrils, accumulate in tissue. The gold standard for diagnosis is tissue biopsy of the affected organ, but it is invasive and needs specific proteomic or immunohistochemistry analyses to characterize the involved protein. We report a case of a complex diagnosis of SA in an advanced heart failure (HF) patient.

Methods and Results
A 68–year–old woman with history of recurrent uveitis started to complain dyspnea in 2022, after Covid19. Since her symptoms worsened, in June 2023 she was diagnosed in another center with restrictive cardiomyopathy with preserved left ventricular (LV) ejection fraction. She underwent coronary angiography (unremarkable), cardiac MRI (aspecific fibrosis), and a FDG–PET scan which showed non–homogeneous LV fixation. The patient was treated with steroids for the suspicion of an immunologic–inflammatory disease, without benefit. Fourteen months after the initial presentation, she was admitted to our centre for advanced inotrope–dependent HF. She had mildly increased LV hypertrophy and severe systolic dysfunction with restrictive physiology and, notably, peri–orbital subcutaneous hemorrhages (Figure 1). Hematological screening for amyloidosis showed elevated serum free lambda light chains. Repeated cardiac MRI scan was consistent with infiltrative disease. A total–body PET scan with dual tracer was performed. The control session with F–18–FDG showed mild aspecific cardiac uptake in the basal septum and lateral wall (Figure 2), while off–label use of F–18–Flutemetanol, an Alzheimer‘s disease approved experimental tracer that binds to amyloid fibrils beta sheets with very high sensitivity and specificity, showed intense cardiac, hepatic, pulmonary and muscular uptake, with wash–out–timing diagnostic for AL–SA (Figure 3). Periumbilical fat biopsy confirmed the clinical suspicion of SA. Hematological investigations led to the diagnosis of stage I–A lambda micromolecular multiple myeloma, with systemic amyloidosis and a IIIb cardiac prognostic score.

Conclusions
Endomyocardial biopsy is an invasive procedure and periumbilical fat biopsy discriminates the amyloid protein type only by proteomic analysis, which is available in very few Italian centres. The off–label use of Alzheimers’ PET tracers could reduce the delay of cardiac AL–SA diagnosis, allowing early disease identification and prompting timely hematological therapy.