bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upright positioning facilitates the absorption of macular hole-related oedema
Authors: Forsaa Vegard A. , Lindtjørn Birger , Dahlø Kristian , Ushakova Anastasia , Krohn Jørgen 
Published: February 2025

Abstract

Purpose
To investigate changes in macular hole-related oedema depending on positioning.

Methods
Prospective interventional study of 40 patients with primary macular hole (MH). Optical coherence tomography scanning was done at 9 a.m., 1 p.m., and 3 p.m. Between the first and second scanning, the patients were instructed to stay upright, whereas they were positioned recumbent thereafter. Automated mean retinal thickness measurements were derived from the ETDRS grid for the central, parafoveal, and perifoveal subfields. Mean ocular perfusion pressure (MOPP) was calculated for all time points. Primary endpoints were changes in MH-related oedema from 9 a.m.−1 p.m., and from 1 p.m.−3 p.m.

Results
In upright position from 9 a.m.−1 p.m., the mean parafoveal retinal thickness decreased from 362 μm (SD = 56) to 350 μm (SD = 51) (P < 0.001). The reduction of MH-related oedema when upright was positively correlated with a reduction in MOPP. Eyes with vitreomacular traction (VMT) exhibited significantly less reduction in MH-related oedema compared to eyes without VMT. In recumbent position from 1 p.m.−3 p.m., the mean parafoveal retinal thickness increased to 356 μm (SD = 52) (P = 0.002).

Conclusion
MH-related oedema belongs to the non-vasogenic cystoid maculopathies. The decrease in MH-related oedema when upright and its positive correlation to a reduction in MOPP is therefore unexpected. In recumbent position, the situation is reversed, and the oedema increases. This may be related to subtle leakage from the retinal capillaries. The presence of VMT seems to counteract the resolution of the oedema. In a clinical setting, upright positioning after MH surgery facilitates absorption of the oedema which is beneficial for MH closure.

Key messages

What is known
:

Macular hole formation is associated with cystoid macular oedema, possibly due to hydration of the outer retinal layers exposed to the hypotonic vitreous fluid. This oedema promotes the elevation of the hole edges from the retinal pigment epithelium.

What is new
:

Macular hole-related oedema decreases when the patients are upright and increases, in parallel with an increase in mean minimum macular hole diameter, when they are recumbent.

The reduction of macular oedema is correlated with a reduction in mean ocular perfusion pressure, indicating that the oedema is influenced by subtle leakage from retinal capillaries.

The results suggest that upright positioning might be beneficial in the early postoperative period of macular hole surgery.
The prognostic value of the tumor-stroma ratio compared to tumor-infiltrating lymphocytes in triple-negative breast cancer: a review
Authors: Andour Layla , Hagenaars Sophie C. , Gregus Barbara , Tőkes Anna Mária , Karancsi Zsófia , Tollenaar Rob A. E. M. , Kroep Judith R. , Kulka Janina , Mesker Wilma E. 
Published: February 2025

Abstract
Previous literature extensively explored biomarkers to personalize treatment for breast cancer patients. The clinical need is especially high in patients with triple-negative breast cancer (TNBC) due to its aggressive nature and limited treatment modalities. This review aims to evaluate the value of tumor-infiltrating lymphocytes (TILs) and tumor-stroma ratio (TSR) as prognostic biomarkers in TNBC patients and assess their clinical potential. A literature search was conducted in PubMed, Embase, Emcare, Web of Science, and Cochrane Library. Papers comparing survival outcomes of TNBC patients with low/high or negative/positive TSR and immune cells were included. The most frequently mentioned subgroups of TILs were selected and reported in this review. Data from 43 articles on TILs and eight articles on TSR were included. Among TNBC patients, high CD8 expression was generally associated with better survival. Notable, the poor survival outcomes were related to high intra-tumoral PD-L1 expression, whereas high stromal PD-L1 expression more often was correlated with favorable outcomes. For the TSR, a high amount of stroma in the primary tumor of TNBC patients was consistently associated with worse survival. This review highlights that a high number of CD8-positive T-cells is a promising prognostic factor for TNBC patients. PD-L1 expression analyzed for intra-tumoral and stromal expression separately reports strong but contrasting information. Finally, the TSR shows potential to be an important prognostic marker, especially for TNBC patients. Utilizing both biomarkers, either on itself or combined, could enhance clinical decision-making and personalization of treatment.
Global dysregulation of circular RNAs in frontal cortex and whole blood from DM1 and DM2
Authors: Srinivasan Arvind , Magner Dorota , Kozłowski Piotr , Philips Anna , Kajdasz Arkadiusz , Wojciechowski Paweł , Wojciechowska Marzena 
Published: February 2025

Abstract
Myotonic dystrophy type 1 (DM1) and type 2 (DM2) are autosomal dominant neuromuscular disorders associated with expansions of microsatellites, respectively, in DMPK and CNBP. Their pathogenesis is linked to the global aberrant alternative splicing (AAS) of many genes and marks mostly muscular and neuronal tissues, while blood is the least affected. Recent data in DM1 skeletal muscles indicated that abnormalities in RNA metabolism also include global upregulation of circular RNAs (circRNAs). CircRNAs are a heterogeneous group considered splicing errors and by-products of canonical splicing. To elucidate whether circRNA dysregulation is an inherent feature of the myotonic environment, we perform their analysis in the frontal cortex and whole blood of DM1 and DM2 patients. We find a global elevation of circRNAs in both tissues, and its magnitude is neither correlated with the differences in their parental gene expression nor is associated with AAS published earlier. Aberrantly spliced cassette exons of linear transcripts affected in DM1 and DM2 are not among the circularized exons, which unique genomic features prerequisite back-splicing. However, the blueprint of the AAS of linear RNAs is found in a variety of circRNA isoforms. The heterogeneity of circRNAs also originates from the utilization of exonic and intronic cryptic donors/acceptors in back splice junctions, and intron-containing circRNAs are more characteristic of the blood. Overall, this study reveals circRNA dysregulation in various tissues from DM1 and DM2; however, their levels do not correlate with the AAS in linear RNAs, suggesting a potential independent regulatory mechanism underlying circRNA upregulation in myotonic dystrophy.
Recurrence and survival after robotic vs laparoscopic liver resection in very-early to early-stage (BCLC 0-A) hepatocellular carcinoma
Authors: Bernardi Lorenzo , Balzano Emanuele , Roesel Raffaello , Senatore Annamaria , Pezzati Daniele , Catalano Gabriele , Garo Maria Luisa , Tincani Giovanni , Majno-Hurst Pietro , Ghinolfi Davide , Cristaudi Alessandra 
Published: February 2025

Abstract

Background
Robotic (RLR) and laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) provide similar short-term outcomes, but data focused on recurrence and survival are still lacking. We hypothesized non-inferior oncologic results of RLR compared to LLR for HCC of stage BCLC 0-A.

Methods
RLRs and LLRs on patients with HCC of stage BCLC 0-A and preserved liver function (Child A or B if cirrhosis) were retrospectively reviewed. Propensity score matching (PSM) was used to mitigate selection bias. The primary endpoints were recurrence-free (RFS) and overall survival (OS); secondary endpoints were incidence, pattern, and treatment of recurrences.

Results
After 1:1 PSM, two groups (RLR = 68; LLR = 68) of patients with similar characteristics, liver function and HCC features were obtained: median age 71-years, males 73.5%, underlying cirrhosis 91.2% (Child A, 96.8%, MELD ≤ 9, 96.0%), portal hypertension 22.1%, single-HCC 90.4%. Two- and 5-year RFS were 78.0 vs 59.0% and 54.0 vs 53.0% (p = 0.107), while OS was 97.0 vs 90.0% and 87.0 vs 90.0% (p = 0.951) for RLR vs LLR, respectively. Incidence of HCC recurrence was similar (35.3 vs 39.7%; p = 0.723). Recurrences developed mostly within the liver (29.4 vs 30.9%; p = 1.000) and within 2 years after hepatectomy (19.1 vs 32.4%, p = 0.116) in RLR vs LLRs. Curative-intent treatment of recurrences did not differ (liver transplantation 19.6%, redo-resection 15.7%, locoregional treatments 52.9%) except for a tendency toward more redo-resections for recurrences after RLR.

Conclusions
Oncologic outcomes of RLR were not inferior to those of LLR in selected HCC patients of stage BCLC 0-A with underlying cirrhosis. Both techniques guaranteed similar salvageability in case of HCC recurrence.
Deep brain stimulation of the hypothalamic region: a systematic review
Authors: Mofatteh Mohammad , Mohamed Abdulkadir , Mashayekhi Mohammad Sadegh , Skandalakis Georgios P. , Neudorfer Clemens , Arfaie Saman , MohanaSundaram ArunSundar , Sabahi Mohammadmahdi , Anand Ayush , Aboulhosn Rabii , Liao Xuxing , Horn Andreas , Ashkan Keyoumars 
Published: February 2025

Abstract

Background
Deep brain stimulation (DBS) has been successfully used for the treatment of circuitopathies including movement, anxiety, and behavioral disorders. The hypothalamus is a crucial integration center for many peripheral and central pathways relating to cardiovascular, metabolic, and behavioral functions and constitutes a potential target for neuromodulation in treatment-refractory conditions. To conduct a systematic review, investigating hypothalamic targets in DBS, their indications, and the primary clinical findings.

Methods
PubMed, Scopus, and Web of Science databases were searched in accordance with the PRISMA guideline to identify papers published in English studying DBS of the hypothalamus in humans.

Results
After screening 3,148 papers, 34 studies consisting of 412 patients published over two decades were included in the final review. Hypothalamic DBS was indicated in refractory headaches (n = 238, 57.8%), aggressive behavior (n = 100, 24.3%), mild Alzheimer’s disease (n = 58, 14.1%), trigeminal neuralgia in multiple sclerosis (n = 5, 1.2%), Prader-Willi syndrome (n = 4, 0.97%), and atypical facial pain (n = 3, 0.73%). The posterior hypothalamus was the most common DBS target site across 30 studies (88.2%). 262 (63.6%) participants were males, and 110 (26.7%) were females. 303 (73.5%) patients were adults whereas 33 (8.0%) were pediatrics. The lowest mean age of participants was 15.25 ± 4.6 years for chronic refractory aggressiveness, and the highest was 68.5 ± 7.9 years in Alzheimer’s disease patients. The mean duration of the disease ranged from 2.2 ± 1.7 (mild Alzheimer’s disease) to 19.8 ± 10.1 years (refractory headaches). 213 (51.7%) patients across 29 studies (85.3%) reported symptom improvements which ranged from 23.1% to 100%. 25 (73.5%) studies reported complications, most of which were associated with higher voltage stimulations.

Conclusions
DBS of the hypothalamus is feasible in selected patients with various refractory conditions ranging from headaches to aggression in both pediatric and adult populations. Future large-scale studies with long-term follow-up are required to validate the safety and efficacy data and extend these findings.
Has a fast treatment transition from surgical to endovascular operations improved the survival of aneurysmal subarachnoid hemorrhage?
Authors: Asikainen Aleksanteri , Rautalin Ilari , Raj Rahul , Korja Miikka , Niemelä Mika 
Published: February 2025

Abstract

Background
Several studies have attributed decreasing case fatality rates (CFRs) of aneurysmal subarachnoid hemorrhage (aSAH) to the gradually increasing use of endovascular treatment without considering improvements in other outcome-affecting factors. To assess the independent effect of a treatment modality on CFRs, we investigated CFR changes in a high-volume center rapidly transitioning from surgical to endovascular operations as the first-line treatment for all aSAH patients except those with middle cerebral artery (MCA) aneurysms.

Methods
We identified all surgically/endovascularly treated aSAH patients in Helsinki University Hospital (HUH) during 2012–2017. As the treatment shift occurred in 2015, we defined two treatment eras: surgical (2012–2014) and endovascular (2015–2017). We compared time-dependent changes in 1-year CFRs between non-MCA and MCA patients using a Poisson regression model. To analyze consistency in operation rates, we also identified sudden-death and conservatively treated aSAHs in the HUH catchment area via two externally validated registers.

Results
Of all 665 hospitalized aSAH cases in the HUH catchment area, 557 (84%) received operative treatment; 367 (66%) underwent surgical and 190 (34%) endovascular operations. Between the treatment eras, endovascular treatment for non-MCA cases increased from 21 to 79%, whereas 99% of the MCA cases were treated surgically during the whole study-period. Among the operatively treated patients, the 1-year CFRs decreased similarly in patients with non-MCA (42%; from 14 to 8%; adjusted risk ratio (aRR) = 0.66 (95% CI 0.37–1.19)) and MCA aneurysms (42%; from 15 to 9%; aRR = 0.66 (0.16–1.60)). The proportion of operatively treated patients, their clinical condition on admission, and amount of bleeding on the first CT-scan remained unchanged over time.

Conclusions
We found similar CFR decreases in aSAH groups with and without undergoing a fast transition from surgery to endovascular operations, providing real-world evidence on the small independent effect of endovascular treatment on the decreasing CFRs in high-volume centers.
Coated sutures for use in oral surgery: a comprehensive review
Authors: Makrygiannis Ioannis H. , Nikolaidis Alexandros K. , Tilaveridis Ioannis , Kouvelas Alexis D. , Lykakis Ioannis Ν. , Venetis Gregory 
Published: February 2025

Abstract

Introduction
Clinicians have access to a variety of suture materials for effective wound repair. Recent studies have suggested utilizing coatings on sutures to enhance their properties. Literature indicates that such coatings may improve the tensile strength of sutures and augment their antimicrobial capabilities. Various materials, including zinc oxide (ZnO) nanoparticles, silver nanoparticles, and antimicrobial agents, have been investigated. This study aims to elucidate the materials utilized for coating sutures, identify the types of sutures employed, and detail the properties imparted by each coating.

Method
A systematic search was conducted in the Scopus, Web of Science, and PubMed databases using the keywords “coat*,” “sutures,” and “oral surgery.”

Results
20 articles met the inclusion criteria and were incorporated into this review. The literature is sparse regarding comparative studies on sutures with specific coatings. Triclosan-coated sutures have not shown a significant reduction in microbial load in oral surgery. However, silver nanoparticle coatings have been effective in reducing wound contamination. Antiseptic-coated silk sutures demonstrated significantly lower microbial colonization compared to controls. Notably, sutures with lycopene coatings did not exhibit superior antimicrobial or mechanical properties to uncoated sutures. ZnO nanoparticle-coated silk fibers displayed higher tensile strength than their uncoated counterparts. Other coatings, such as silicone or wax, have been developed to reduce suture friction.

Conclusion
In oral surgery, the effectiveness of coatings remains limited, potentially due to the high microbial load present in the anatomical region. Many coated materials are available for use in oral surgical sutures, but further research is necessary. Timely removal of sutures is recommended to minimize the risk of surgical wound infections, along with maintaining good oral hygiene.
An adaptive, provable correct simplex architecture
Authors: Maderbacher Benedikt , Schupp Stefan , Bartocci Ezio , Bloem Roderick , Ničković Dejan , Könighofer Bettina 
Published: February 2025

Abstract
Simplex architectures optimize performance and safety by switching between an advanced controller and a base controller. We propose an approach to synthesize the switching logic and extensions of the base controller in the Simplex architectures to achieve high performance and provable correctness for a rich class of temporal specifications by maximizing the time the advanced controller is active. We achieve provable correctness by performing static verification of the baseline controller. The result of this verification is a set of states that is proven to be safe, called the recoverable region. We employ proofs on demand to ensure that the base controller is safe in those states that are visited during runtime, which depends on the advanced controller. Verification of hybrid systems is often overly conservative, resulting in smaller recoverable regions that cause unnecessary switches to the baseline controller. To avoid these switches, we invoke targeted reachability queries to extend the recoverable region at runtime. In case the recoverable region cannot be extended using the baseline controller, we employ a repair procedure. This tries to synthesize a patch for the baseline controller and can further extend the recoverable region. Our offline and online verification relies upon reachability analysis since it allows observation-based extension of the known recoverable region. We implemented our methodology on top of the state-of-the-art tool HyPro which allowed us to automatically synthesize verified and performant Simplex architectures for advanced case studies, like safe autonomous driving on a race track.
Paternalism attitudes and the happiness value of fundamental freedoms
Authors: Konrad Kai A. , Simon Sven A. 
Published: February 2025

Abstract
Governmental regulations and prohibitions may effectively reduce self-harming behavior, but might also restrict personal freedom rights. This paper investigates into individuals’ preferences for the trade-off between being protected from taking self-harming actions by the state, and the desire to be free to choose. We introduce the Paternalism Preference Index to measure this preference. Our results indicate considerable heterogeneity in how individuals support, or object to, such governmental prescriptions. More importantly, we show the importance of the paternalism preference in a survey on life satisfaction during the Covid-19 pandemic. We find a reversed relationship between the preference for paternalistic state interventions and the valuation of personal freedoms. Individuals who prefer to have a larger choice set at the expense of committing potentially self-harming actions derive a higher value from personal freedoms in terms of life satisfaction.
A cluster of patterns for trusted computing
Authors: Fernandez Eduardo B. , Muñoz Antonio 
Published: February 2025

Abstract
The proliferation of Internet of Things and cyberphysical systems has introduced unprecedented challenges in ensuring the integrity and confidentiality of critical data, making robust security mechanisms essential. There are several mechanisms intended to assure trust with respect to the software loaded into the system and the trustworthiness of the boot process. These mechanisms start from a Root of Trust (RoT), from where all the other trusts, e.g., for components and software are derived. As part of the RoT, a Secure Storage is needed. This Secure Storage can be considered as part of the RoT or considered a separate component. After a RoT is established, a Trusted Boot can be performed. The execution of computational processes can then be supported by using separate execution zones (Zone Isolation). More complex trust functions such as remote attestation can be performed by a Trusted Platform Module
(TPM). In this paper, we propose security patterns for these components. The abstraction power of patterns can be used to define the basic aspects that each of these components must have, thus serving as reference for designers and for security evaluation.
Overcoming water quality effects in biological monitoring: a case study of amphipod in situ exposures in Ontario agricultural streams
Authors: Hammond Matthew , Brown Lisa , Struger John , Grapentine Lee , Palace Vince , Bartlett Adrienne J. 
Published: February 2025

Abstract
Bioindicators add valuable understanding of biological impacts to contaminant monitoring programs. However, attributing effects (e.g., mortality and growth impairment) to contaminant exposures is challenging because of potential confounding by environmental variables. We assessed the influence of four water quality variables (temperature, dissolved oxygen, pH, and conductivity) on contaminant effects assessments during in situ exposures of the amphipod Hyalella azteca in six agricultural and urban watersheds in southern Ontario, Canada (2005–06, 2008–10). We further tested whether sampling in specific months of the growing season would minimize confounding effects. While high toxicity from organophosphate and carbamate pesticides increased mortality and reduced growth in caged amphipods, warmer stream temperatures also affected endpoints, increasing mortality and improving growth. Seasonal patterns indicated early summer (June) as optimal for detecting impacts when: (1) stream pesticide concentrations were highest, (2) acetylcholinesterase (AChE) inhibition (a biomarker of organophosphate/carbamate exposure) was highest, and (3) stream temperature was below its seasonal peak. Specifically, higher correlations among organophosphate pesticide concentrations, AChE inhibition, and mortality indicated better attribution of cause in this month (r = 0.53—0.76, p < 0.05). Ability to discriminate between pesticide-impacted sites and reference sites was also greater than other months (June = 100% correct assignment as high-impact or reference site). Considering sampling times of stream bioindicators that maximize pesticide responses and limit confounding effects of water quality may improve the accuracy and resource-efficiency of biological monitoring programs.
Subjective School Experience and Well-Being during the COVID-19 Pandemic
Authors: Fernandez-Urbano Roger , Salza Guido , Samuel Robin 
Published: February 2025

Abstract
School life is an important determinant of adolescents’ subjective well-being. While there is now an extensive literature on the impact of the COVID-19 pandemic on adolescents’ well-being, adolescents’ school experience during the pandemic and how it relates to different dimensions of their subjective well-being has received little attention. This study addresses this gap by examining the relationship between young people’s school experience and their cognitive and affective subjective well-being during the COVID-19 pandemic in Luxembourg. We rely on a unique two-wave panel dataset that contains granular information about young people’s lives shortly after the onset of the pandemic in July 2020 and one year later in July 2021. Our study extends the current scientific knowledge on the COVID-19 pandemic by highlighting that while school experience has a weak relationship with affective subjective well-being (i.e., happiness), it is strongly associated with cognitive subjective well-being (i.e., life satisfaction), particularly one year after the pandemic outbreak for those with more negative feelings about school. Our study also reveals that our results on cognitive well-being are stratified by social status.