bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rates of diabetic retinopathy among cluster analysis—identified type 2 diabetic mellitus subgroups
Authors: Scott Rachel A. , Lu Vivian I. , Grove Nathan , Patnaik Jennifer L. , Manoharan Niranjan 
Published: October 2023

Abstract
Purpose
To determine whether phenotypic clustering of patients with diabetes mellitus (DM) is associated with more advanced diabetic retinopathy (DR).

Methods
Retrospective cohort study of 495 patients with no prior DR treatment seen at a tertiary care clinic 2014–2020. Four previously identified clusters from Ahlqvist’s 2018 paper were reproduced utilizing baseline hemoglobin A1c, body mass index, and age at DM diagnosis. Age-adjusted Cox proportional hazard ratios were used to compare clusters with reference as the lowest risk cluster.

Results
All four type 2 DM clusters were replicated with our cohort. There was a significant difference in racial distribution among clusters (p = 0.018) with severe insulin-resistant diabetes (SIRD) having the higher percentage of Caucasians and lower percentage of Hispanics compared to other groups and a higher percentage of African Americans comprising the severe insulin-deficient diabetes (SIDD) cluster than other groups. Rates of proliferative diabetic retinopathy were higher in mild obesity-related diabetes (MOD) (28%), SIDD (24%), mild age-related diabetes (MARD) (20%), and lowest in SIRD (7.9%), overall p = 0.004. Rates of vitreous hemorrhage were higher in MOD (p = 0.032) and MARD (0.005) compared to SIRD.

Conclusion
Baseline clinical measures may be useful in risk stratifying patients for progression to retinopathy requiring intervention.
Technological advancements in surgical laparoscopy considering artificial intelligence: a survey among surgeons in Germany
Authors: Lünse Sebastian , Wisotzky Eric L. , Beckmann Sophie , Paasch Christoph , Hunger Richard , Mantke René 
Published: October 2023

Abstract
Purpose
The integration of artificial intelligence (AI) into surgical laparoscopy has shown promising results in recent years. This survey aims to investigate the inconveniences of current conventional laparoscopy and to evaluate the attitudes and desires of surgeons in Germany towards new AI-based laparoscopic systems.

Methods
A 12-item web-based questionnaire was distributed to 38 German university hospitals as well as to a Germany-wide voluntary hospital association (CLINOTEL) consisting of 66 hospitals between July and November 2022.

Results
A total of 202 questionnaires were completed. The majority of respondents (88.1%) stated that they needed one assistant during laparoscopy and rated the assistants’ skillfulness as “very important” (39.6%) or “important” (49.5%). The most uncomfortable aspects of conventional laparoscopy were inappropriate camera movement (73.8%) and lens condensation (73.3%). Selected features that should be included in a new laparoscopic system were simple and intuitive maneuverability (81.2%), automatic de-fogging (80.7%), and self-cleaning of camera (77.2%). Furthermore, AI-based features were improvement of camera positioning (71.3%), visualization of anatomical landmarks (67.3%), image stabilization (66.8%), and tissue damage protection (59.4%). The reason for purchasing an AI-based system was to improve patient safety (86.1%); the reasonable price was €50.000–100.000 (34.2%), and it was expected to replace the existing assistants’ workflow up to 25% (41.6%).

Conclusion
Simple and intuitive maneuverability with improved and image-stabilized camera guidance in combination with a lens cleaning system as well as AI-based augmentation of anatomical landmarks and tissue damage protection seem to be significant requirements for the further development of laparoscopic systems.
Validating an advanced smartphone application for thermal advising in cold environments
Authors: Eggeling Jakob , Rydenfält Christofer , Halder Amitava , Toftum Jørn , Nybo Lars , Kingma Boris , Gao Chuansi 
Published: October 2023

AbstractThe ClimApp smartphone application was developed to merge meteorological forecast data with personal information for individualized and improved thermal warning during heat and cold stress and for indoor comfort in buildings. For cold environments, ClimApp predicts the personal thermal stress and strain by the use of the Insulation REQuired model that combines weather and personal physiological data with additional consideration of the Wind Chill index based on the local weather forecast. In this study, we validated the individualized ClimApp index relative to measurements and compared it with the Universal Temperature Climate Index (UTCI). To this aim, 55 participants (27 females) were exposed to at least 1 h in an outdoor environment of 10 °C or below (average 1.4 °C air temperature, 74.9% relative humidity, and 4.7 m/s air velocity) inputting their activity level and clothing insulation as instructed by ClimApp. The UTCI and ClimApp indices were calculated and compared to the participants’ perceived thermal sensation. The ClimApp index root mean square deviation (RMSD) was below the standard deviation of the perceived thermal sensation which indicates a valid prediction and the UTCI RMSD was higher than the standard deviation which indicates an invalid prediction. The correlation of ClimApp and UTCI to the perceived thermal sensation was statistically significant for both models.
A paper biosensor for overcoming matrix effects interfering with the detection of sputum pyocyanin with competitive immunoassays
Authors: Adrover-Jaume Cristina , Clemente Antonio , Rodríguez-Urretavizcaya Bárbara , Vilaplana Lluïsa , Marco M. Pilar , Rojo-Molinero Estrella , Oliver Antonio , de la Rica Roberto 
Published: October 2023

AbstractDetecting sputum pyocyanin (PYO) with a competitive immunoassay is a promising approach for diagnosing Pseudomonas aeruginosa respiratory infections. However, it is not possible to perform a negative control to evaluate matrix-effects in competitive immunoassays, and the highly complex sputum matrix often interferes with target detection. Here, we show that these issues are alleviated by performing competitive immunoassays with a paper biosensor. The biosensing platform consists of a paper reservoir, which contains antibody-coated gold nanoparticles, and a substrate containing a competing recognition element, which is a piece of paper modified with an albumin-antigen conjugate. Detection of PYO with a limit of detection of 4.7·10−3 µM and a dynamic range between 4.7·10−1 µM and 47.6 µM is accomplished by adding the sample to the substrate with the competing element and pressing the reservoir against it for 5 min. When tested with patient samples, the biosensor was able to qualitatively differentiate spiked from non-spiked samples, whereas ELISA did not show a clear cut-off between them. Furthermore, the relative standard deviation was lower when determining sputum with the paper-based biosensor. These features, along with a mild liquefaction step that circumvents the use of harsh chemicals or instruments, make our biosensor a good candidate for diagnosing Pseudomonas infections at the bedside through the detection of sputum PYO.
Graphical Abstract
How often is prophylactic parastomal mesh placement performed after rectal resection without sphincter preservation? An analysis of German nationwide hospital discharge data among 41,697 patients
Authors: Paasch C. , Kobelt E. , Lünse S. , Heisler S. , Lorenz R. , Hunger R. , Mantke R. 
Published: October 2023

Abstract
Purpose
The European Hernia Society guidelines of parastomal hernias, published in 2017, strongly recommend prophylactic synthetic non-absorbable mesh upon the construction of a permanent end colostomy to reduce the incidence of parastomal hernias. This study aims to evaluate the implementation of the guidelines in Germany.

Methods
This is a retrospective multicentric analysis conducted in December 2022 at the University Hospital Brandenburg an der Havel. Anonymous data on rectal resection without sphincter preservation in the period 2010–2020 were extracted from the German nationwide hospital discharge data set. Individuals with a hernia and < 18 years old were excluded. Another exclusion criterion was a performed colectomy or proctocolectomy with an ileoanal pouch and placement of an absorbable mesh. The primary endpoint was the annual rate of prophylactic parastomal mesh placement following rectal resection without sphincter preservation in Germany. Cases reporting both non-absorbable mesh placement and rectal resection without sphincter preservation were considered prophylactic mesh insertions.

Results
A total of 41,697 patients received a rectal resection without sphincter preservation and without non-absorbable mesh placement. Among these individuals, 27,089 were male and 14,608 were female. The rate of reoperations (3.1%) and the length of hospital stay (25.3 days ± 19.32) remained almost constant during these 10 years. The rate of prophylactic mesh placement was increasing from 0.2% (n = 8) in 2010 to 6.4% (n = 198) in 2020.

Conclusions
Currently, only the minority of patients who have undergone rectal resection without sphincter preservation receive prophylactic mesh insertion.
Fuzzy Observables: from Weak Markov Kernels to Markov Kernels
Authors: Beneduci Roberto 
Published: October 2023

AbstractWe provide a proof based on transfinite induction that every weak Markov kernel is equivalent to a Markov kernel. We only assume the space where the weak Markov kernel is defined to be second countable and metrizable. That generalizes some previous results where the kernel is required to be defined on a standard Borel space (which is second countable and completely metrizable) and the framework is the theory of stochastic operators. This property of weak Markov kernels is at the root of the characterization of a commutative POVM as the fuzzification of a spectral measure through a Markov kernel. As a result, the characterization of commutative POVMs is also generalized. We then revisit the relationships between weak Markov kernels, Markov kernels, commutative POVMs and fuzzy observables.
Linking Up Bell Beakers in the Iberian Peninsula
Authors: Jiménez-Puerto Joaquín , Aubán Joan Bernabeu 
Published: October 2023

AbstractMany studies in complexity theory employ agent-based models whose interactions can be expressed as networks. In such models, the pattern of interactions between actors is crucial, and the network topology that emerges from the raw data can be characterized through many metrics. One tool previously used in archaeology studies has the potential to deal with networks in social contexts at different scales of analysis: social network analysis (SNA). This discipline has been applied successfully in a wide range of archaeological problems, providing valuable insights and a different perspective. It also could be helpful to quantify concepts associated with social complexity, such as robustness or resilience. In this work, we propose some methodologic possibilities for consideration in the phase definition of the adaptive cycle model (ACM), using SNA tools. To illustrate the process, we will present a case study from the Copper Age in the Iberian Peninsula: the Bell Beaker phase.
The suitability of common reed (Phragmites australis) for load-bearing structural materials
Authors: Albrecht Kaspar , Neudecker Felix , Veigel Stefan , Bodner Sabine , Keckes Jozef , Gindl-Altmutter Wolfgang 
Published: October 2023

AbstractBesides wood, the most widely used natural structural material, dicotyledonous fibre plants such as flax or hemp, and monocotyledonous grasses such as cereal straw or bamboo have been shown to be suitable for application in materials. Common reed is a less well-characterised plant resource in this regard. Therefore, common reed stems were characterised in uniaxial tension in the present study, aiming at acquiring basic information about the mechanical characteristics of this material. Furthermore, laboratory-scale composite beams were manufactured and tested in bending. Compared to wood species with similar density, common reed stem walls showed a comparable average modulus of elasticity of 8 GPa and a very good average tensile strength of 150 MPa. After a mild alkali pre-treatment, reed showed excellent adhesive bonding, enabling the manufacture of high-density composite beams with roughly 130 MPa bending strength and 12–13 GPa modulus of elasticity. Same as untreated common reed stem walls, also reed biocomposite beams compared very favourably with established wood-based materials of similar structure, density, and adhesive content. In summary, it was thus demonstrated that common reed is a highly suitable raw material for bio-based load-bearing structural materials.
Family, a racialized space: A phenomenological approach to examining Afghan refugee families’ language policies in Norway
Authors: Mirvahedi Seyed Hadi 
Published: October 2023

AbstractIn this paper, I put forward and apply a phenomenological understanding of body and embodied experience to examine refugee families’ identity (trans)formation and language ideologies and practices. In particular, Kitarō Nishida’s (1870–1945) notion of historical body was adopted to investigate how Afghan refugee families’ lived experiences of forced mobility and life in different countries before their settlement in Norway influence their own as well as their children’s raciolinguistic and cultural/national identities, which in turn, affect their language ideologies and practices. Based on a thematic analysis of the interviews conducted with parents in three families, it was found that, having left Afghanistan at a young age with no hope to return to as well as their forced stays in different countries, Afghan parents have not developed a strong Afghan national identity. This embodied experience was entangled with painful emotions as well that resulted in the parents’ desire for their children to develop strong attachment to Norway and a Norwegian identity. Yet, parents’ wish does not seem to readily realize because the racial differences become an important marker of identity for the children as they grow up and enter the society, leading them to seek their roots. The study contributes to our better understanding of the complexities and nuances of transnational populations’ language ideologies and practices as well as identification and integration processes into the host society.
Inclusiveness of Access Policies to Maternity Care for Migrant Women Across Europe: A Policy Review
Authors: Pařízková Alena , Clausen Jette Aaroe , Balaam Marie-Clare , Haith-Cooper Melanie , Roosalu Triin , Migliorini Laura , Kasper Anne 
Published: October 2023

Abstract
Introduction
Despite the interconnectedness of the European Union, there are significant variations in pregnant women’s legal status as migrants and therefore their ability to access maternity care. Limited access to maternity care can lead to higher morbidity and mortality rates in migrant women and their babies. This study aimed to investigate and compare maternal health access policies and the context in which they operate across European countries for women who have migrated and are not considered citizens of the host country.

Methods
The study adopted a mixed-methods research design exploring policies on migrant women’s access to maternity care across the migration regimes. Data were extracted from legal documents and research reports to construct a new typology to identify the inclusiveness of policies determining access to maternity care for migrant women.

Results
This study found inconsistency in the categorisation of migrants across countries and significant disparities in access to maternity care for migrant women within and between European countries. A lack of connection between access policies and migration regimes, along with a lack of fit between policies and public support for migration suggests a low level of path dependency and leaves space for policy innovation.

Discussion
Inequities and inconsistencies in policies across European countries affect non-citizen migrant women’s access to maternity care. These policies act to reproduce structural inequalities which compromise the health of vulnerable women and newborns in reception countries. There is an urgent need to address this inequity, which discriminates against these already marginalised women.
Application of molecular imprinting approach for alkaloids analysis in food and nutraceuticals: review and perspective
Authors: Emara Samy , Kamal Maha , Sallam Ibrahim E. , Serag Ahmed , Farag Mohamed A. 
Published: October 2023

AbstractAlkaloids are major dietary components well known for their pharmacological activities. Herbal matrices require extensive processing due to their high level of complexity in order to isolate their alkaloidal contents. Molecularly imprinted polymers (MIPs) are tailored receptors with a highly specific molecular recognition, which is the most important function of receptors. They can hence be utilized in applications wherein selective binding activities are of significance, such as solid phase extraction (SPE), chromatographic separation and chemical sensors. This review presents on recent applications of MIPs to analyze alkaloids in plants and bio-fluid samples as well as herbal formulations. We discuss the development of nano-sized MIPs for various applications, particularly in biomimetic sensors for electrochemical detection of various alkaloids. Due to its easier phase separation compared to common MISPEs, magnetic MISPEs were also discussed in order to explore the potential benefits of this approach for further phytochemical applications.
The impact of the transversus abdominis plane block (TAP) on stress response measured through the complete blood– derived inflammatory markers
Authors: Espadas-González Lorena , Usón-Casaús Jesús M. , Pastor-Sirvent Nieves , Santella Massimo , Ezquerra-Calvo Javier , Pérez-Merino Eva M 
Published: October 2023

AbstractThis study aims to evaluate the effect of the transversus abdominis plane (TAP) block on the blood cells and the inflammatory markers neutrophil– to– lymphocyte ratio (NLR), platelet– to– lymphocyte ratio (PLR), and systemic immune– inflammation index (SII) after the laparoscopic ovariectomy (LapOV) in dogs. 72 healthy bitches undergoing LapOV were randomly allocated to the no– TAP group of dogs under inhaled anesthesia (IA), the TAP– S group (IA and TAP with saline), and the TAP– B group (IA and TAP with bupivacaine). The NLR, PLR, and SII were calculated 1 h before ovariectomy (T0) and at 2−3 h (T1), 6−8 h (T2), and 20−24 h (T3) post– surgery. The number of dogs requiring postoperative analgesic rescue with buprenorphine and the doses administered in each group were recorded. Significant changes were observed in all groups’ postoperative NLR, PLR, and SII over time. Between groups, no differences were observed in any of the ratios at any control point (NLR at T0−T3:p = 0.17, 0.36, 0.80, and 0.95; PLR at T0−T3:p = 0.70, 0.62, 0.21, 0.87; SII at T0−T3:p = 0.29, 0.65, 0.09, and 0.34). A significantly lower number of dogs required analgesic rescue in the TAP-B group (p = 0.0001) and a lower number of doses were administered (p = 0.001). There is no difference in the inflammatory response measured through the complete blood– derived inflammatory markers after the LapOV in dogs when the postoperative pain is managed entirely with opioids or with the TAP block with bupivacaine. The hydrodissection associated with the TAP block technique does not increase the inflammatory response.
Evaluation of modified coblation endoscopic lingual lightening in multilevel surgery for obstructive sleep apnea hypopnea syndrome: an open intervention study
Authors: Duan Xiangqiang , Zhu Minhui , Zhang Caiyun , Li Meng , Cai Yupeng , Chen Shicai , Zheng Hongliang 
Published: October 2023

Abstract
Purpose
To evaluate the efficacy and safety of modified coblation endoscopic lingual lightening to address retrolingual obstruction in multilevel surgery for obstructive sleep apneae (OSA).

Methods
Patients with OSA due to retropalatal and retrolingual obstructions were enrolled. Group 1 consisted of patients who underwent modified coblation endoscopic lingual lightening combined with H-uvulopalatopharyngoplasty, while group 2 comprised patients treated by H-uvulopalatopharyngoplasty alone. Objective parameters and subjective evaluations were recorded preoperatively and at 6 months postoperatively.

Results
The mean (standard deviation) apnea-hypopnea index (AHI) declined from 51.5 (18.9) to 14.3 (7.2) in group 1, and from 51.7 (15.8) to 28.5 (16.9) in group 2. The mean (standard deviation) percentage change in AHI was higher in group 1 than in group 2 (73.2 [10.9] vs. 48.9 [22.4], P < 0.01). The surgical response rate differed significantly between groups 1 and 2 (88.5 [23/26] vs. 46.7 [14/30], P < 0.01). Other outcomes, including the lowest oxygen saturation, Epworth Sleepiness Scale score, snoring visual analog scale score, and subjective improvement rate, were also significantly better in group 1 than in group 2.

Conclusion
Without increasing complications, modified coblation endoscopic lingual lightening significantly improved surgical outcomes as part of multilevel surgery in patients with OSA due to multilevel obstruction.
Prospective evaluation of core number of biopsy for renal tumor: are multiple cores preferable?
Authors: Iguchi Toshihiro , Matsui Yusuke , Toji Tomohiro , Sakurai Jun , Tomita Koji , Uka Mayu , Umakoshi Noriyuki , Kawabata Takahiro , Munetomo Kazuaki , Mitsuhashi Toshiharu , Hiraki Takao 
Published: October 2023

Abstract
Purpose
This single-center, single-arm, prospective, open-label study was conducted to evaluate the optimal number of cores (single or multiple) in renal tumor biopsy.

Materials and methods
Forty-four biopsies of 44 tumors (mean diameter, 2.7 ± 1.0 cm; range, 1.6–5.0 cm) were included. Biopsy was performed under ultrasound or computed tomography fluoroscopy guidance using an 18-gauge cutting needle and the co-axial method. Two or more specimens were obtained, which were divided into first and subsequent specimens. “First specimen” and “all specimens” were histologically evaluated (i.e., appropriateness of specimen, histological diagnosis, subtype, and Fuhrman grade of renal cell carcinoma [RCC]) blindly and independently by two board-certified pathologists.

Results
Multiple specimens were successfully and safely obtained in all the biopsies. All tumors were histologically diagnosed; 40 malignancies included 39 RCCs and 1 solitary fibrous tumor, and 4 benign lesions included 2 angiomyolipomas, 1 oncocytoma, and 1 capillary hemangioma. In all RCCs, the subtype could be determined (32 clear cell RCCs, 4 chromophobe RCCs, and 3 papillary RCCs), and the Furman grade was determined in 38 RCCs. When only the first specimen was evaluated, 22.7% of the specimens were inappropriate for diagnosis, and 34 (77.3%) were histologically diagnosed. The diagnostic yield was significantly lower than that of all specimens (P = 0.0044). Univariate analysis revealed that smaller lesions were a significant predictor of diagnostic failure (P = 0.020).

Conclusion
Biopsy with multiple cores significantly improved diagnostic yield. Thus, operators should obtain multiple cores during renal tumor biopsy.