bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training in obstetrics and gynecology between reality and vision: results of a JAGO–NOGGO survey in 601 physicians (NOGGO—Monitor-12 trial)
Authors: von Waldenfels Gabriel , Beck Maximilian Heinz , Semmler Janina , Gerber Annika , Hennigs André , Vochem Ruth , Blohmer Jens-Uwe , Schmalfeldt Barbara , Pietzner Klaus , Sehouli Jalid 
Published: April 2024

Abstract
Purpose
The primary objective of this study was to establish a benchmark by collecting baseline data on surgical education in obstetrics and gynecology in Germany, including factual number of operations performed.

Materials and methods
A nationwide anonymous survey was conducted in Germany between January 2019 and July 2019 utilizing a specially designed questionnaire which addressed both residents and senior trainers.

Results
A total of 601 participants completed the survey, comprising 305 trainees and 296 trainers. The trainees reported performing a median of 125 non-obstetric surgeries (IQR: 41–332) and 75 obstetric procedures (IQR: 27–168) independently. While most last-year residents managed to meet the targeted numbers for minor surgical procedures outlined in the logbook, they fell short of achieving the required numbers for major operations, such as hysterectomies or more complex laparoscopies. Although both trainees and trainers emphasized the significance of surgical training, the overall quality of the training was rated poorly, particularly by trainees. This was attributed to a high proportion of administrative tasks and a deficiency in teaching time within the operating theater. External fellowship and mentoring programs, as well as the implementation of regular, centralized reviews of residency training, were identified as potentially beneficial by both trainees and trainers.

Conclusion
The findings of this survey should serve as a wake-up call both within and outside of Germany, highlighting the importance of comprehensive and structured surgical training to enhance long-term patient care and increase satisfaction among obstetrics and gynecology trainees.
TMS of the left primary motor cortex improves tremor intensity and postural control in primary orthostatic tremor
Authors: Schoeberl Florian , Dowsett James , Pradhan Cauchy , Grabova Denis , Köhler Angelina , Taylor Paul , Zwergal Andreas 
Published: April 2024

AbstractA ponto-cerebello-thalamo-cortical network is the pathophysiological correlate of primary orthostatic tremor. Affected patients often do not respond satisfactorily to pharmacological treatment. Consequently, the objective of the current study was to examine the effects of a non-invasive neuromodulation by theta burst repetitive transcranial magnetic stimulation (rTMS) of the left primary motor cortex (M1) and dorsal medial frontal cortex (dMFC) on tremor frequency, intensity, sway path and subjective postural stability in primary orthostatic tremor. In a cross-over design, eight patients (mean age 70.2 ± 5.4 years, 4 female) with a primary orthostatic tremor received either rTMS of the left M1 leg area or the dMFC at the first study session, followed by the other condition (dMFC or M1 respectively) at the second study session 30 days later. Tremor frequency and intensity were quantified by surface electromyography of lower leg muscles and total sway path by posturography (foam rubber with eyes open) before and after each rTMS session. Patients subjectively rated postural stability on the posturography platform following each rTMS treatment. We found that tremor frequency did not change significantly with M1- or dMFC-stimulation. However, tremor intensity was lower after M1- but not dMFC-stimulation (p = 0.033/ p = 0.339). The sway path decreased markedly after M1-stimulation (p = 0.0005) and dMFC-stimulation (p = 0.023) compared to baseline. Accordingly, patients indicated a better subjective feeling of postural stability both with M1-rTMS (p = 0.007) and dMFC-rTMS (p = 0.01). In conclusion, non-invasive neuromodulation particularly of the M1 area can improve postural control and tremor intensity in primary orthostatic tremor by interference with the tremor network.
Defining distal splenopancreatectomy by the mesopancreas
Authors: Safi S.-A. , Alexander A. , Neuhuber W. , Haeberle L. , Rehders A. , Luedde T. , Esposito I. , Fluegen G. , Knoefel W. T. 
Published: April 2024

Abstract
Background
The implementation of the pathologic CRM (circumferential resection margin) staging system for pancreatic head ductal adenocarcinomas (hPDAC) resulted in a dramatic increase of R1 resections at the dorsal resection margin, presumably because of the high rate of mesopancreatic fat (MP) infiltration. Therefore, mesopancreatic excision (MPE) during pancreatoduodenectomy has recently been promoted and has demonstrated better local disease control, fueling the discussion of neoadjuvant downsizing regimes in MP + patients. However, it is unknown to what extent the MP is infiltrated in patients with distal pancreatic (tail/body) carcinomas (dPDAC). It is also unknown if the MP infiltration status affects surgical margin control in distal pancreatectomy (DP). The aim of our study was to histopathologically analyze MP infiltration and elucidate the influence of resection margin clearance on recurrence and survival in patients with dPDAC. Furthermore, the results were compared to a collective receiving MPE for hPDAC.

Method
Clinicopathological and survival parameters of 295 consecutive patients who underwent surgery for PDAC (n = 63 dPDAC and n = 232 hPDAC) were evaluated. The CRM evaluation was performed in a standardized fashion and the specimens were examined according to the Leeds pathology protocol (LEEPP). The MP area was histopathologically evaluated for cancerous infiltration.

Results
In 75.4% of dPDAC patients the MP fat was infiltrated by vital tumor cells. The rates of MP infiltration and R0CRM– resections were similar between dPDAC and hPDAC patients (p = 0.497 and 0.453 respectively). MP– infiltration status did not correlate with CRM implemented resection status in dPDAC patients (p = 0.348). In overall survival analysis, resection status and MP status remained prognostic factors for survival. In follow up analysis. surgical margin clearance in dPDAC patients was associated with a significant improvement in local recurrence rates (5.2% in R0CRM– resected vs. 33.3 in R1/R0CRM + resected, p = 0.002).

Conclusion
While resection margin status was not affected by the MP status in dPDAC patients, the high MP infiltration rate, as well as improved survival in MP– dPDAC patients after R0CRM– resection, justify mesopancreatic excision during splenopancreatectomy. Larger scale studies are urgently needed to validate our results and to study the effect on neoadjuvant treatment in dPDAC patients.
Functional expression of the proton sensors ASIC1a, TMEM206, and OGR1 together with BKCa channels is associated with cell volume changes and cell death under strongly acidic conditions in DAOY medulloblastoma cells
Authors: Pissas Karolos-Philippos , Gründer Stefan , Tian Yuemin 
Published: April 2024

AbstractFast growing solid tumors are frequently surrounded by an acidic microenvironment. Tumor cells employ a variety of mechanisms to survive and proliferate under these harsh conditions. In that regard, acid-sensitive membrane receptors constitute a particularly interesting target, since they can affect cellular functions through ion flow and second messenger cascades. Our knowledge of these processes remains sparse, however, especially regarding medulloblastoma, the most common pediatric CNS malignancy. In this study, using RT-qPCR, whole-cell patch clamp, and Ca2+-imaging, we uncovered several ion channels and a G protein-coupled receptor, which were regulated directly or indirectly by low extracellular pH in DAOY and UW228 medulloblastoma cells. Acidification directly activated acid-sensing ion channel 1a (ASIC1a), the proton-activated Cl− channel (PAC, ASOR, or TMEM206), and the proton-activated G protein-coupled receptor OGR1. The resulting Ca2+ signal secondarily activated the large conductance calcium-activated potassium channel (BKCa). Our analyses uncover a complex relationship of these transmembrane proteins in DAOY cells that resulted in cell volume changes and induced cell death under strongly acidic conditions. Collectively, our results suggest that these ion channels in concert with OGR1 may shape the growth and evolution of medulloblastoma cells in their acidic microenvironment.
Evaluation of the prognostic potential of histopathological subtyping in high-grade serous ovarian carcinoma
Authors: Zelisse Hein S. , Hwan Robin A. , van de Vijver Marc J. , Dijk Frederike , Mom Constantijne H. , Hooijer Gerrit K. J. , van Gent Mignon D. J. M. , Snijders Malou L. H. 
Published: April 2024

AbstractHigh-grade serous ovarian carcinoma (HGSOC) can be categorized into four gene expression-based subtypes, with supposedly distinct prognoses and treatment responses. Murakami et al. translated these gene expression-based subtypes into the histopathological mesenchymal, immunoreactive, solid and proliferative, and papilloglandular subtypes, showing differences in survival outcomes. Miyagawa et al. refined these criteria to improve the interobserver concordance. The current retrospective study evaluated the interobserver variability and the prognostic differences between the histopathologic subtypes using the criteria of both Murakami et al. and Miyagawa et al. in 208 HGSOC cases. The mesenchymal subtype was considered first, followed by the immunoreactive subtype. Non-conforming cases were categorized as solid and proliferative or papilloglandular. The mesenchymal subtype was identified in 122 patients (58.7%) for both criteria. Using the criteria of Murakami et al., 10 cases (4.8%) were immunoreactive, 26 (12.5%) solid and proliferative, and 50 (24%) papilloglandular, with a concordance rate of 62.5% (κ = 0.34, p < .001). Using the Miyagawa et al. criteria, 23 cases (11%) were immunoreactive, 20 (9.6%) solid and proliferative, and 43 (20.7%) papilloglandular. No survival differences were observed between the subtypes. The fair reproducibility of the histopathological subtype classification of HGSOC and the lack of survival differences among these subtypes indicate the need for further refinement of the criteria and exploration of their correlation with overall survival outcomes before clinical application.
High prevalence of haemosporidian parasites in Eurasian jays
Authors: Schumm Yvonne R. , Lederer-Ponzer Naemi , Masello Juan F. , Quillfeldt Petra 
Published: April 2024

AbstractAvian haemosporidians are vector-borne parasites, infecting a great variety of birds. The order Passeriformes has the highest average infection probability; nevertheless, some common species of Passeriformes have been rather poorly studied. We investigated haemosporidians in one such species, the Eurasian jay Garrulus glandarius (Corvidae), from a forest population in Hesse, Central Germany. All individuals were infected with at least one haemosporidian genus (overall prevalence: 100%). The most common infection pattern was a mixed Haemoproteus and Leucocytozoon infection, whereas no Plasmodium infection was detected. Results on lineage diversity indicate a rather pronounced host-specificity of Haemoproteus and Leucocytozoon lineages infecting birds of the family Corvidae.
Analysing Equilibrium States for Population Diversity
Authors: Lengler Johannes , Opris Andre , Sudholt Dirk 
Published: April 2024

AbstractPopulation diversity is crucial in evolutionary algorithms as it helps with global exploration and facilitates the use of crossover. Despite many runtime analyses showing advantages of population diversity, we have no clear picture of how diversity evolves over time. We study how the population diversity of $$(\mu +1)$$

(
μ
+
1
)

algorithms, measured by the sum of pairwise Hamming distances, evolves in a fitness-neutral environment. We give an exact formula for the drift of population diversity and show that it is driven towards an equilibrium state. Moreover, we bound the expected time for getting close to the equilibrium state. We find that these dynamics, including the location of the equilibrium, are unaffected by surprisingly many algorithmic choices. All unbiased mutation operators with the same expected number of bit flips have the same effect on the expected diversity. Many crossover operators have no effect at all, including all binary unbiased, respectful operators. We review crossover operators from the literature and identify crossovers that are neutral towards the evolution of diversity and crossovers that are not.
A prospective case series to evaluate subcostal nerve injury with high-resolution ultrasound in posterior retroperitoneoscopic adrenalectomy
Authors: van Uitert Allon , Chaman-Baz Hossein A. , van der Wal Selina E. I. , Zhu Xiaoye , Wijntjes Juerd , Timmers Henri J. L. M. , Witjes J. Alfred , van Alfen Nens , Langenhuijsen Johan F. 
Published: April 2024

Abstract
Background
Posterior retroperitoneoscopic adrenalectomy has several advantages over transabdominal laparoscopic adrenalectomy regarding operating time, blood loss, postoperative pain, and recovery. However, postoperatively several patients report chronic pain or hypoesthesia. We hypothesized that these symptoms may be the result of damage to the subcostal nerve, because it passes the surgical area.

Methods
A prospective single-center case series was performed in adult patients without preoperative pain or numbness of the abdominal wall who underwent unilateral posterior retroperitoneoscopic adrenalectomy. Patients received pre- and postoperative questionnaires and a high-resolution ultrasound scan of the subcostal nerve and abdominal wall muscles was performed before and directly after surgery. Clinical evaluation at 6 weeks was performed with repeat questionnaires, physical examination, and high-resolution ultrasound. Long-term recovery was evaluated with questionnaires, and photographs from the patients were examined for abdominal wall asymmetry.

Results
A total of 25 patients were included in the study. There were no surgical complications. Preoperative visualization of the subcostal nerve was possible in all patients. At 6 weeks, ultrasound showed nerve damage in 15 patients, with no significant association between nerve damage and postsurgical pain. However, there was a significant association between nerve damage and hypoesthesia (p = 0.01), sensory (p < 0.001), and motor (p < 0.001) dysfunction on physical examination. After a median follow-up of 18 months, 5 patients still experienced either numbness or muscle weakness, and one patient experienced chronic postsurgical pain.

Conclusion
In this exporatory case series the incidence of postoperative damage to the subcostal nerve, both clinically and radiologically, was 60% after posterior retroperitoneoscopic adrenalectomy. There was no association with pain, and the spontaneous recovery rate was high.

Graphical Abstract
“Like not having an arm”: a qualitative study of the impact of visitor restrictions on cancer care during the COVID-19 pandemic
Authors: Holdsworth Laura M. , Siden Rachel , Wong Bonnie O. , Verano Mae , Lessios Anna Sophia , Tabor Holly K. , Schapira Lidia , Aslakson Rebecca 
Published: April 2024

Abstract
Purpose
Visitor restriction policies to prevent the spread of COVID-19 among patients and clinicians were widespread during the pandemic, resulting in the exclusion of caregivers at key points of cancer care and treatment decision-making. The aim of this study was to explore how visitor restrictions impacted cancer treatment decision-making and care from patient and physician perspectives.

Methods
Sixty-seven interviews, including 48 cancer patients and 19 cancer and palliative care physicians from four academic cancer centers in the USA between August 2020 and July 2021.

Results
Visitor restrictions that prevented caregivers from participating in clinic appointments and perioperative hospital care created challenges in cancer care that spanned three domains: practical, social, and informational. We identified eight themes that characterized challenges within the three domains across all three groups, and that these challenges had negative emotional and psychological consequences for both groups. Physicians perceived that patients’ negative experiences due to lack of support through the physical presence of caregivers may have worsened patient outcomes.

Conclusions
Our data demonstrate the tripartite structure of the therapeutic relationship in cancer care with caregivers providing critical support in the decision-making and care process to both patients and physicians. Caregiver absences led to practical, psychosocial, and informational burdens on both groups, and likely increased the risk of burnout among physicians. Our findings suggest that the quality of cancer care can be enhanced by engaging caregivers and promoting their physical presence during clinical encounters.
Comparison of PAS and adenoids in patients with and without maxillary micrognathia before orthodontic treatment
Authors: Tabellion Maike , Schneider Jan Lucas Felix Gustav , Linsenmann Constanze Charlotte , Lisson Jörg Alexander 
Published: April 2024

Abstract
Objective
Craniofacial anomalies are widely discussed as predisposing factors of breathing disorders. Since many more cofactors exist, this study investigated the association between maxillary micrognathia and morphological changes of posterior airway space and adenoids in these patients.

Material and methods
Cephalometric radiographs of n = 73 patients were used for data acquisition. The patients were divided into two groups according to certain skeletal characteristics: maxillary micrognathia (n = 34, 16 female, 18 male; mean age 10.55 ± 3.03 years; defined by a SNA angle < 79°) and maxillary eugnathia (n = 39, 19 female, 20 male; mean age 10.93 ± 3.26 years; defined by a SNA angle > 79°). The evaluation included established procedures for measurements of the maxilla, posterior airway space and adenoids. Statistics included Kolmogorov–Smirnov-, T- and Mann–Whitney-U-Tests for the radiographs. The level of significance was set at p < 0.05.

Results
The cephalometric analysis showed differences in the superior posterior face height and the depth of the posterior airway space at palatal level among the two groups. The depth of the posterior airway space at mandibular level was the same for both groups, just as the size of the area taken by adenoids in the nasopharynx.

Conclusions
Skeletal anomalies affect the dimension of the posterior airway space. There were differences among the subjects with maxillary micrognathia and these with a normal maxilla. However, the maxilla was only assessed in the sagittal direction, not in the transverse. This study showed that the morphology of the maxilla relates to the posterior airway space whereas the adenoids seem not to be affected.

Clinical relevance
Maxillary micrognathia is significantly associated with a smaller depth of the posterior airway space at the palatal level compared to patients with maxillary eugnathia.
The efficacy of psychological prevention, and health promotion interventions targeting psychological health, wellbeing or resilience among forced migrant children and youth: a systematic review and meta-analysis
Authors: Giles Clover Jack , Västhagen Maja , van Leuven Livia , Edenius Anna , Ghaderi Ata , Enebrink Pia 
Published: April 2024

Abstract
There are over 40 million displaced children and youth worldwide and there is a need promote their mental wellbeing. This study aimed to synthesize evidence regarding promotion interventions to increase wellbeing, resilience, and quality of life (primary outcomes), and prevention interventions to reduce internalizing and externalizing symptoms (secondary outcomes) in this population. The review protocol was registered with PROSPERO (CRD42022329978). Medline, PsycINFO, and Web of Science were searched. Inclusion criteria were: ≥ 10 participants, sample ≤ 18 years of age, no parental participation, explicated forced migrant populations, implementation in non-clinical context, and validated measures. Fifteen studies (N interventions = 18, N participants = 5741) were eligible. Two studies included outcomes related to wellbeing and quality of life. The remaining studies reported depression, PTSD, anxiety, internalizing and externalizing behaviours, and behavioural and emotional problems. There was only sufficient data to perform random-effects meta-analysis of depression scores. No significant effects were observed in comparison to control condition in randomized trials (n = 4994, k = 5) but a small significant positive trend was observed in within-group analyses (n = 537, k = 12). Cochrane’s risk of bias tools and the GRADE certainty of evidence tool were applied. No studies achieved low risk of bias and certainty of evidence was very low. In sum, there remains a dearth of rigorous intervention studies investigating the effects of promotive and preventative psychological interventions on the wellbeing, resilience, and quality of life of forcibly displaced minors. However, the few eligible studies in this review indicate promise.
Microbe and bioprocess performances for sustainable production of biobased 2,3-butanediol in a sugarcane biorefinery; a technoeconomic and environmental analysis
Authors: Sikazwe Manasseh K. , Louw Jeanne , Görgens Johann F. 
Published: April 2024

AbstractIndustrial production of bio-based 2,3-butanediol via microbial conversion of sugars is intended to provide viable investment opportunities accompanied by reduced greenhouse gas emissions, compared to current fossil-based products. The potential impacts on the product minimum selling price and life cycle greenhouse gas emissions of further technology developments resulting in enhanced product yield, volumetric productivity and/or titres were assessed though a 33 full-factorial design. Aspen Plus® was employed to simulate multiple scenarios for 2,3-butanediol production from A-molasses in a biorefinery annexed to an existing sugarcane mill for subsequent techno-economic analysis. A 10% singular improvement in product yield, titre and volumetric productivity reduced the minimum selling price by 3.6%, 1.4% and 0.1%, whereas titre improvements reduced greenhouse gas emissions twice as much as product yield for a 10% step change. At the current state of technology, biobased 2,3-butanediol can achieve the minimum performance required to be a feasible alternative to fossil-based 2,3-butanediol with an estimated best minimum selling price of 1434$ t−12,3-BDO and greenhouse gas emissions 6.5 times less than those recorded for fossil-derived 1,4-butanediol. The minimum selling price and greenhouse gas emissions values can be reduced further by at least 16% and 14%, respectively, warranting further investment in strain and bioprocess performance enhancement. Overall, the research demonstrated that technological efforts intended to enhance the viability of biobased 2,3-butanediol production also minimized greenhouse gas emissions, integrating environmental and economic objectives for a sustainable bioeconomy.
Graphical abstract