bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dual lamellar keratoplasty combined with phacoemulsification and intraocular Lens implantation in a case of severe chemical burn
Authors: Fernández-Vega-Cueto Luis , Lisa Carlos , Alvarado-Villacorta Rosa , Alfonso José F. 
Published: February 2025

Purpose To present successful visual rehabilitation of a patient who suffered from a severe chemical burn by performing a new alternative surgical approach termed dual lamellar keratoplasty combined with phacoemulsification and intraocular lens implantation. Methods A 45-year-old man with a history of caustic soda eye injury in his left eye leading to a limbal stem cell deficiency, persistent epithelial defect, corneal scarring, and progressive vision loss was admitted. No posterior segment alterations were noted. Once the ocular surface was stabilized, simple limbal epithelial transplantation was performed; however, deep corneal scarring, Descemet folds, and lens opacity were detected. Therefore, 6 months later, simultaneously Deep anterior lamellar keratoplasty (DALK) and Descemet stripping with automated endothelial keratoplasty (DSAEK), combined with cataract surgery was performed for visual rehabilitation. Results After 15 months of follow-up, anterior segment reconstruction was achieved, and visual acuity improved from hand motion to 0.5 LogMAR unit. No intraoperative or postoperative complications were noted. Conclusion This new modified procedure seems to be efficacy and safe for visual rehabilitation avoiding open-sky surgery-related risks by combining DALK, DSAEK and cataract surgery in a case of severe ocular burn.
Patterns of management for post-traumatic elbow stiffness: A comparative study of open and arthroscopic approaches
Authors: Patel Apurvakumar , Ibrahim Kerollos G , Oshikoya Olamide , Conlon Matthew , Epstein Jason , Kachooei Amir R ,   Rothman Florida Elbow Expert (ROFLEEX) Group
Published: February 2025

Background Post-traumatic elbow stiffness (PTES) often results in significant functional impairment. Open elbow arthrolysis (OEA) and arthroscopic elbow arthrolysis (AEA) are two surgical management options. This study aimed to compare the incidence, demographics, and treatment patterns of patients with PTES undergoing OEA and AEA from 2014 to 2023. Methods A retrospective analysis was conducted using the TriNetX database. Patients diagnosed with elbow stiffness (ICD-10 codes M25.621, M25.622, M25.629) were included. Rates of OEA (CPT 24149, 24006) and AEA (CPT 29837, 29838) were identified. Demographic characteristics and simultaneous surgical procedures were assessed. Results A total of 30,624 patients were diagnosed with PTES, with 848 undergoing OEA (2.8%) and 361 undergoing AEA (1.2%). The mean age for OEA patients was 44.3 ± 17.6 years, while AEA patients had a mean age of 37.9 ± 18.9 years. OEA was more common in males (61.2%) and non-Hispanic/Latino patients (68.3%). AEA showed higher rates in younger patients and non-Hispanic/Latino individuals (72.7%). Discussion The study highlights a preference for OEA in older patients with complex conditions, while AEA is more common in younger patients. Despite the growing trend toward minimally invasive techniques, OEA remains prevalent. Further research is needed to understand the drivers of these trends.
Evaluating Diaphragmatic Paralysis After Pediatric Cardiac Surgery and the Role of Plication in Outcome Improvement: Insights From a Single-Center Experience
Authors: Elgayar Mohamed M. , Negm Mahmoud A. , Nasr Emad Gamaleldin , Abdullah Hedaia , Hamed Sayed , Honsy Hatem 
Published: February 2025

Introduction Diaphragmatic paralysis (DP) is a significant complication following cardiac surgery, particularly impacting neonates and infants. This retrospective study aims to evaluate the incidence of DP, identify risk factors, and assess the impact of diaphragmatic plication as a definitive management strategy. Methods We analyzed the clinical records of pediatric patients who underwent cardiac surgery at our center from 2016 to 2023. Cases of DP were identified, potential risk factors examined, and the effectiveness of plication assessed. Patients were categorized into early and late groups based on the timing of DP diagnosis relative to surgery. Results Out of 2,331 pediatric cardiac surgery patients (median age 7.2 months), DP was identified in 60 patients (2.6%), with a higher incidence of left-sided paralysis in 37 patients (61.7%). Diaphragmatic paralysis was more frequently associated with specific procedures, such as bidirectional Glenn, arterial switch operations, and Blalock-Taussig-Thomas shunt. Patients with DP had significantly longer intensive care unit (ICU) stays (21 vs 4 days, P < .001) and total hospital stays (38 vs 11 days, P < .001). Following plication, median mechanical ventilation (MV) hours significantly decreased (73-13 h, P < .001), and ICU stays were reduced (15-3 days, P < .001). Early plication was associated with shorter MV time and hospital stays. Conclusion Diaphragmatic paralysis is a notable complication after cardiac surgery. Diaphragmatic plication proves to be an effective intervention, reducing MV duration and hospital stays. These findings underscore the importance of early recognition and intervention for improved postoperative outcomes.
C-reactive protein expression in acute ischemic stroke blood clots: Implications for etiology
Authors: Liu Wenyi , Sahin Cansu , Güner Sak Nazan , Giraud Alice , Messina Pierluca , Bozsak Franz , Darcourt Jean , Sacchetti Federico , Januel Anne-Christine , Bellanger Guillaume , Pagola Jorge , Juega Jesus , Imamura Hirotoshi , Ohta Tsuyoshi , Spelle Laurent , Chalumeau Vanessa , Mircic Uros , Stanarčević Predrag , Vukašinović Ivan , Ribo Marc , Sakai Nobuyuki , Cognard Christophe , Doyle Karen 
Published: February 2025

Introduction: C-reactive protein (CRP) is a prototypic inflammation marker, with elevated levels associated with an increased risk of cerebrovascular events. To determine whether CRP could be a useful biomarker of stroke etiology, we investigated CRP expression in acute ischemic stroke (AIS) clots from large-artery atherosclerosis (LAA), cardio-embolism (CE) and cryptogenic (Crypt) subtypes. Patients and methods: We analysed clot samples from AIS patients (LAA, CE, Crypt; n = 50 each), collected across five stroke centres in France, Serbia, Spain, and Japan between February 2021 and February 2024, as part of the prospective Clotbase International Registry of 460 patients who underwent mechanical thrombectomy. Clot components were assessed using Martius Scarlet Blue staining. CRP expression was examined using immunohistochemistry and its co-localisation with clot components was detected using immunofluorescence. Clinical parameters were compared across etiologies. Results: CRP expression varied significantly among clots. Most clots (65%) had minimal (⩽1%) CRP and 35% showed substantial (>1%) CRP. CE group had significantly more clots with substantial CRP than LAA and Crypt (48% vs 30% and 26%; p = 0.048). Clots with substantial CRP contained more fibrin (28.9%) than those with low CRP (20.6%; p = 0.005). Confocal microscopy showed CRP co-localised with fibrin and white blood cells (WBCs). Discussion and conclusion: Significantly more AIS clots of CE expressed substantial CRP compared to those of LAA and Crypt, suggesting CE strokes may be more strongly linked to inflammation. Clots with substantial CRP expression displayed significantly more fibrin compared to those with minimal CRP expression, suggesting a potential association between inflammation and fibrin-rich clots. Further study of the relationship between CRP, fibrin and WBCs in clots may improve our understanding of the processes of thrombo-inflammation.
Characterization of polyethylene and polyurethane microplastics and their adsorption behavior on Cu2+ and Fe3+ in environmental matrices
Authors: Zanoni Ilaria , Briccolani Lucia , Faccani Lara , Blosi Magda , Ortelli Simona , Crosera Matteo , Marussi Giovanna , Albonetti Stefania , Costa Anna Luisa 
Published: February 2025

Abstract
As the world faces growing environmental challenges, understanding the nature of microplastics—such as Low-Density Polyethylene (LDPE) and Polyurethane (PU)—and their transformation in water-based environments is necessary for predicting and mitigating their effects. In this study, we investigated their physicochemical characteristics, presence of impurities, colloidal behavior, and sorption capacity to understand better how microplastics behave and transform in the environment, including their role in transporting heavy metals. The two types of microparticles investigated fall into distinct size ranges, approximately 70 microns for PE particles and around 5 microns for PU particles. Both samples showed a spherical morphology and an evident surface micro-roughness. The elemental and thermal analysis did not show the presence of any significant metal impurities. The zeta-potential measurements as a function of pH provided insights into the dispersion behavior of microplastics (MPs) in freshwaters, suitable for the growth of Zebrafish (Egg water) and Daphnia magna (Elendt M7 Water). Both materials showed in bidistilled water negative zeta potential (ZP) at natural pH (ZP = − 51.0 ± 4.3 mV at pH = 6.6 and ZP = − 29.5 ± 1.4 mV at pH = 5.6 for LDPE and PU, respectively), justified by the presence of surface-active charged impurities. In saline media, ZP vs. pH curves were flatter, with ZP values near 0 mV, confirming the reduced colloidal stability from higher ionic strength and double-layer compression. Finally, we assessed the metal adsorption capacity to establish the role of microplastics in the transport of heavy metals in the environment. We observed selective adsorption for Cu2⁺ ions, which was both medium-dependent (more ions adsorbed in Elendt M7) and plastic-dependent, with PU showing a stronger affinity for Cu2⁺ in MilliQ and Egg water. On the contrary, both plastics showed similar adsorption capacity for Fe3⁺ ions across all media.
Efficacy and safety of ketamine and esketamine in reducing the incidence of postpartum depression: an updated systematic review and meta-analysis
Authors: Darwish Moaz Yasser , Helal Abdallah A. , Othman Yousif Ahmed , Mabrouk Manar Alaa , Alrawi Aya , Ashraf Taha Abd-ElSalam , Abdelsattar Nada K. , Sayed Fatma Mohammed , Abd-ElGawad Mohamed 
Published: February 2025

Abstract

Background
Postpartum depression (PPD) is categorized by the Disorders-Fifth Edition as depression that begins during pregnancy or within the first month after giving birth. Ketamine and esketamine have shown promising results in the treatment of several depressive disorders, which suggests that they may have a role in the prevention of PPD. This systematic review and meta-analysis aim to update evidence about the efficacy and safety of using ketamine and esketamine to reduce PPD incidence.

Methods
We searched four databases, PubMed, Scopus, Web of Science, and Cochrane, to collect relevant studies. We included studies which investigated the preventive effect of ketamine or esketamine on PPD among women after giving birth through caesarean or vaginal delivery. We extracted PPD occurrence rate, PPD score, pain score and side effects. Finally, a meta-analysis was conducted using RevMan software.

Results
Twenty-one eligible studies were incorporated in the current systematic review and meta-analysis involving 4,389 pregnant women. Esketamine was the intervention in 14 studies, and ketamine was used in 7 studies. In subgroup analysis, both ketamine and esketamine were significantly effective in reducing the incidence of short-term PPD (ketamine: RR = 0.72, 95% CI [0.56, 0.93], P = 0.01; esketamine: RR = 0.43, P < 0.0001). Esketamine only significantly reduced the incidence of long-term PPD (RR = 0.44, P < 0.00001). Low doses and high doses were effective in reducing the incidence of both short-term (high dose: RR = 0.48, P = 0.0005; low dose: RR = 0.46, P = 0.002) and long-term PPD (high dose: RR = 0.54, P < 0.0001; low dose: RR = 0.61, P = 0.009). Regarding the risk of side effects, patients in the Ketamine/esketamine group showed statistically significant higher rates of developing dizziness (P = 0.0007), blurred vision (P = 0.02), vomiting (P = 0.004) and hallucinations (P = 0,002) than women in the control group.

Conclusion
Both ketamine and esketamine are effective in lowering the incidence of short-term PPD. On the other hand, only esketamine is effective in reducing the incidence of long-term PPD. It is recommended to use smaller doses for a more tolerable treatment period since doses less than 0.5 mg are significantly effective. Temporary side effects such as dizziness, blurred vision, vomiting and hallucinations were reported.
Assessing brain-muscle networks during motor imagery to detect covert command-following
Authors: Fló Emilia , Fraiman Daniel , Sitt Jacobo Diego 
Published: February 2025

Abstract

Background
In this study, we evaluated the potential of a network approach to electromyography and electroencephalography recordings to detect covert command-following in healthy participants. The motivation underlying this study was the development of a diagnostic tool that can be applied in common clinical settings to detect awareness in patients that are unable to convey explicit motor or verbal responses, such as patients that suffer from disorders of consciousness (DoC).

Methods
We examined the brain and muscle response during movement and imagined movement of simple motor tasks, as well as during resting state. Brain-muscle networks were obtained using non-negative matrix factorization (NMF) of the coherence spectra for all the channel pairs. For the 15/38 participants who showed motor imagery, as indexed by common spatial filters and linear discriminant analysis, we contrasted the configuration of the networks during imagined movement and resting state at the group level, and subject-level classifiers were implemented using as features the weights of the NMF together with trial-wise power modulations and heart response to classify resting state from motor imagery.

Results
Kinesthetic motor imagery produced decreases in the mu-beta band compared to resting state, and a small correlation was found between mu-beta power and the kinesthetic imagery scores of the Movement Imagery Questionnaire-Revised Second version. The full-feature classifiers successfully distinguished between motor imagery and resting state for all participants, and brain-muscle functional networks did not contribute to the overall classification. Nevertheless, heart activity and cortical power were crucial to detect when a participant was mentally rehearsing a movement.

Conclusions
Our work highlights the importance of combining EEG and peripheral measurements to detect command-following, which could be important for improving the detection of covert responses consistent with volition in unresponsive patients.
ASA score is an independent predictor of 1-year outcome after moderate-to-severe traumatic brain injury
Authors: Kiwanuka Olivia , Lassarén Philipp , Fletcher-Sandersjöö Alexander , Tatter Charles , Tjerkaski Jonathan , Nelson David W. , Thelin Eric P. 
Published: February 2025

Abstract

Purpose
This study aimed to investigate whether incorporating pre-injury health status, measured by the American Society of Anesthesiologists (ASA) score, improves outcome prediction models for moderate-to-severe traumatic brain injury (msTBI) patients.

Methods
We conducted a retrospective single-center study of msTBI patients (2005–2021). The primary outcome was 1-year Glasgow Outcome Scale (GOS, dichotomized as GOS1-3 (unfavorable) vs. 4–5 (favorable)), and secondary outcome was 90-day mortality. Logistic regression evaluated the contribution of ASA score to the International Mission for Prognosis and Clinical Trials in Traumatic Brain Injury (IMPACT) core + CT outcome prediction model incorporating age, admission GCS, pupillary reactivity, Marshall CT classification, hypoxia, hypotension, epidural hematoma, and subarachnoid hemorrhage.

Results
Among the 720 adult patients that were included 51% had an unfavorable GOS at 1 year. The 90-day mortality was 19%. ASA score and TRISS were independently associated with both outcomes (p < 0.001). Incorporating the ASA score to our IMPACT model significantly enhanced its explanatory value of dichotomized GOS (35% vs. 32% variance explained, p < 0.001) and improved the model’s prognostic accuracy.

Conclusion
In this retrospective single-center cohort study, we found that ASA score improves existing prognostic models for msTBI. Incorporating this simple comorbidity measure could enhance outcome prediction and support more personalized acute management. Future prospective studies are needed to validate these results.
Students’ perspective on new teaching concepts for medical studies: case- and competency-based learning in radiology
Authors: Masthoff Max , Pawelka Friedrich , Zak Gisela , de Leng Bas , Darici Dogus , Schindler Philipp , Heindel Walter , Helfen Anne 
Published: February 2025

Abstract

Objective
This study aimed to evaluate medical students’ perception of a new radiology teaching format for abdominal diagnostics. The format transitioned traditional lectures and seminars to a case- and competency-based course that incorporates technology-enhanced individual case-work, small group discussions, and concise lectures.

Materials and methods
235 students (23.5 ± 2.6 years, 72.3% female, 93.3% response rate, November 2023–June 2024) completed a questionnaire before (12 items) and after (20 items) the course, assessing perceived importance of course content, competency gains in abdominal imaging, enjoyment of learning, interest in a radiology career, and pedagogical perception of the teaching concept. Responses were recorded on a 1–10 scale (no agreement to strong agreement) or dichotomously (yes/no). The new course format was compared with a cohort of students who had previously (May 2022–June 2023) attended traditional lectures (n = 169) and/or seminars (n = 234).

Results
Students strongly agreed before the course that radiology content in abdominal diagnostics is important, and they found the content highly relevant and applicable to their work as doctors following the course. Significant improvement was observed in perceived competency in modality selection and description and interpretation of common pathologies, with the strongest effect for CT and MRI data. The new format was rated more motivating and significantly better in pedagogical and content quality than traditional lectures and seminars, although it did not influence students’ interest in pursuing a radiology career.

Conclusion
From the students’ perspective, case- and competency-based teaching enhances skill acquisition, learning success, and enjoyment in radiology.

Clinical relevance statement
From a student perspective, case- and competency-based teaching in radiology may enhance imaging competency, contributing to the development of more skilled healthcare providers.

Key Points

Case- and competency-based teaching concepts may improve students’ learning.

Students reported improved perceived competency in decision-making and image interpretation with the new teaching method.

Case- and competency-based teaching was perceived as more engaging, motivating, and pedagogically superior to traditional lectures.

Graphical Abstract
Plectin, a novel regulator in migration, invasion and adhesion of ovarian cancer
Authors: Bai Lanning , Qian Xueqian , Zhang Hui , Yuan Yi , Cui Xiaodong , Cheng Min , Han Yangyang 
Published: February 2025

Abstract

Background
Ovarian cancer (OC) is one of the most prevalent gynecologic malignancies and exhibites the highest fatality rate among all gynecologic malignancies. The absence of an early diagnostic biomarker and therapeutic target contributes to an overall 5-year survival rate ranging from 30 to 50%. Plectin (PLEC), a 500 kDa scaffolding protein, has gained prominence in recent years due to its pivotal role in various cellular biological functions such as cell morphology, migration and adhesion, while the accurate role of PLEC in OC remains elusive.

Results
In this study, our findings demonstrate that PLEC exerts a positive influence on the progression of OC, encompassing cellular proliferation, migration, invasion, and adhesion both in vitro and in vivo.

Conclusions
The results providing new insights for the diagnosis and treatment in OC.
Drivers influencing the adoption of cryptocurrency: a social network analysis approach
Authors: Kajol K. , Devarakonda Srijanani , Singh Ranjit , Baker H. Kent 
Published: February 2025

Abstract
Cryptocurrency has gained popularity as a potential new global payment method. It has the potential to be faster, cheaper, and more secure than existing payment networks, making it a game-changer in the global economy. However, more research is needed to identify the factors driving cryptocurrency adoption and understand its impact. We use social network analysis (SNA) to identify the influencing factors and reveal the impact of each on cryptocurrency adoption. Our analysis initially revealed 44 influential factors, which were later reduced to 25 factors, each exerting a different influence. Based on the SNA, we classify these factors into highly, moderately, and least influential categories. Discomfort and optimism are the most influential determinants of adoption. Moderately influential factors include trust, risk, relative advantage, social influence, and perceived behavioral control. Price/value, facilitating conditions, compatibility, and usefulness are the least influential. The factors affecting cryptocurrency adoption are interdependent. Our findings can help policymakers understand the factors influencing cryptocurrency adoption and aid in developing appropriate legal frameworks for cryptocurrency use.
Monte Carlo simulations of backscattered electron coefficients and average penetration depths for Cu, Au, and Al under electron irradiation
Authors: Alsharari Sami Mohammed 
Published: February 2025

Abstract
Understanding and analyzing backscattered electron coefficients (BSCs) and average penetration depths (APDs) are critical in material science and electron microscopy. However, despite their importance, there are relatively few studies that cover a wide range of energies and a variety of materials for accurately calculating BSCs and APDs. Therefore, a Monte Carlo (MC) simulation was conducted to examine and explore the electron backscattering coefficients and average penetration depths of copper (Cu), gold (Au), and aluminum (Al) when bombarded by energetic electrons with energies ranging from 0 to 60 kilo-electron volts (keV) at normal incidence. The results showed strong agreement with experimental data. First, for the BSCs, we have deviations ranging from 0.3 to 5.4%. Second, the empirical calibration adjustment resulted in an excellent agreement with the experimental data of APDs. For Cu, the deviation was 3.32% at 5 keV. The exceptional agreement was observed at 9 keV for Au, with a deviation of just 0.08%. In the case of Al, the adjustment achieved a strong agreement with a deviation of 2.01%. These findings improve our understanding of backscattered electrons behavior by providing accurate simulations for Cu, Au, and Al across a wide energy range, resolving discrepancies, especially for low-Z materials such as aluminum (Z = 13). The improved accuracy in predicting APD and the original BSC results support scanning electron microscopy (SEM) applications, particularly in compositional and topographic imaging.