bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic treatment of scaphoid nonunion, a new algorithm after six years practice
Authors: Windhofer Christian , Ivusic Patrik , Jakob Peter , Lill Markus , Schauer Josef 
Published: January 2025

Abstract

Introduction:
Scaphoid nonunion is still a challenging problem in hand surgery. Till now most of the patients have been treated with open revision, bone grafting and internal stabilization.
Arthroscopy plays an increasing role in hand surgery since the last decade. Three years after starting the use of arthroscopic treatment of scaphoid nonunion we analyzed our results and modified our therapy protocol.
Material and Methods:
In 2017, we started arthroscopic treatment of scaphoid nonunion at our department. Debridement is done arthroscopically as well as insertion of radius cancellous bone graft. Fixation has been accomplished with K-wires and/or head compression screws percutaneously, by help of x-ray.
Till 2020, we treated 24 patients, observing three delayed unions, treated successfully by extra corporal shockwave therapy and modifying the fixation.
Analyzing these results, we modified our fixation methods and all patients, got shockwave therapy additionally.
Results:
Comparing the success rate with the 28 operated after 2020, the adaption of our algorithm showed an improvement of our results concerning healing rate. There we found only one ongoing nonunion in the proximal 1/3. The median time to healing was comparable in the two groups, operation time showed no significant difference.
After a median follow-up of 30 months, we found an excellent range of motion, a significant reduction in pain and grip strength matchable with the unaffected hand in all 52 patients. DASH and Mayo Wrist Score showed satisfactory results, and 45 patients came back to their earlier occupation and sports.
Conclusion:
Arthroscopy has a fix place in the algorithm for scaphoid nonunion in our institution. We think an adequate and stabile fixation adopted to the section of the nonunion is indispensable.
The distal radius is a sufficient donor-site for cancellous bone grafting.
Extra corporal shockwave therapy should be used routinely in scaphoid nonunion.
Level of evidence: IV
Harnessing Artificial Intelligence for Language Learning: A Mixed-Methods Study on ChatGPT Integration in Secondary Education
Authors: Jose Luijim 
Published: January 2025

Abstract

The integration of artificial intelligence (AI) in education holds transformative potential, particularly in language learning. This study explores the integration of ChatGPT into secondary school language education in the Philippines, addressing key challenges such as lack of personalized feedback, low engagement, and limited resources. Employing a mixed-methods approach, data were collected through surveys from 150 teachers and 500 students and focus group discussions. Findings reveal that ChatGPT effectively supports vocabulary development, grammar exercises, and conversational practice, significantly enhancing student engagement and tailoring instruction to diverse learner needs. Teachers highlighted the need for training workshops and technical support to ensure effective implementation. The study culminates in the development of a practical handbook, providing educators and learners with actionable strategies for leveraging ChatGPT in language learning. These strategies include customizable prompts, interactive simulations, and techniques to address challenges in traditional language instruction. This research underscores the potential of AI to create inclusive, adaptive, and engaging educational environments, paving the way for scalable improvements in language education.
Impact of Sarcopenia During Induction Treatment in Patients with Unresectable Locally Advanced Pancreatic Cancer: A Scoring Model for indication of Conversion Surgery
Authors: Uemura Sho , Tanaka Masayuki , Kitago Minoru , Yagi Hiroshi , Abe Yuta , Hasegawa Yasushi , Hori Shutaro , Nakano Yutaka , Kitagawa Yuko 
Published: January 2025

Abstract

Background
Chemotherapeutic advances have increased opportunities for conversion surgery (CS) of unresectable locally advanced (UR-LA) pancreatic cancer (PC). However, the optimal indications for CS remain unclear. We aimed to identify predictive factors of prognosis in UR-LA PC, and evaluate indication for CS using these factors including sarcopenia.
Methods
In this retrospective study, we reviewed consecutive patients with UR-LA PC who had received chemo(radio)therapy as an initial treatment between 2015 and 2023. We examined relevant clinical variables and CT findings at initial diagnosis and at 6 months after starting treatment.
Results
Ten of the 41 patients had undergone CS. Tumor size at 6 months, clinical lymph node metastasis at diagnosis, and changes in sarcopenia over 6 months were associated with overall survival (OS) (multivariate analysis: hazard ratio = 3.25, 2.79 and 3.51, respectively). Each of these factors was assigned a value of 1, resulting in a scoring system ranging from 0 to 3 points. There was a significant difference in OS between the patients who scored 0 points and those who scored 1 to 3 points (median OS: 30.3 months v.s. 17.3 months, P = 0.013). CS was associated with better OS among patients who scored 0 (not reached v.s. 25.5 months, P = 0.039).
Conclusions
Change in sarcopenia is a novel predictor of the prognosis of patients with UR-LA PC. Patients with favorable scores in our simple scoring model, which incorporates three prognostic factors identified by the current analysis, may achieve better survival after CS than that achieved induction therapy alone.
NcFER1 and NcRbohC1 regulates pollen germination on stigma after pollination in waterlily
Authors: Wang Jing-Hua , Cao Jing , Yang Zhi-Juan , Jin Qi-Jiang , Wang Yan-Jie , Su Qun , Wang Hong-Yan , Sun Chun-Qing , Xu Ying-Chun 
Published: January 2025

Abstract

The hybridization between hardy and tropical waterlilies is the main way to breed new varieties of waterlilies with strong cold resistance and rich flower colors. However, there is a hybridization barrier between hardy and tropical waterlilies, which seriously affects the breeding process of waterlilies. Therefore, it is necessary to study the mechanism of hybridization barriers in waterlilies. The results showed that the pollen of tropical waterlily could not germinate on the stigma of hardy waterlily. ROS plays an important role in the recognition of pollen and stigma of waterlily during pollination, and is involved in the regulation of pollen germination on stigma of waterlily. Rbohs is the main source of ROS in stigma of waterlily, and NcFER1 and NcRbohC1 are the main regulatory factors of ROS in stigma of waterlily. These results suggest that pre-fertilization barrier is the main cause of hybridization barrier between hardy and tropical waterlilies. NcRbohC1 may be the downstream element of NcFER1 in waterlily, and NcFER1 may regulate the metabolism of ROS in stigma of waterlily through the signaling pathway of FER-Rac/Rops-Rbohs, but its specific mechanism remains unclear.
Prediction of Prognosis in Brain Metastasis with Artificial-intelligence-driven Methods for Whole Brain Radiotherapy
Authors: Ozkan Emine Elif , Serel Tekin Ahmet 
Published: January 2025

Abstract

Background: Inferentially 24%–45% of cancer patients develop brain metastases in their course. Individual survival estimation for these patients is substantial to distinguish the subset of patients who may not benefit from whole brain irradiation (WBI) due to a short survival time.
Aim: This study aimed to search on variables and evaluate an artificial intelligence algorithm to identify the subgroup of patients who will benefit from WBI.
Methods: The data of 345 patients with brain metastasis who were treated with 30 Gy in 10 fractions of WBI were retrospectively analyzed. In this cohort totally 15 clinical / laboratory factors are evaluated with 15 models of machine learning algorithms using Python 2.3, Pycaret library.
Results: Gradient Boosting Regressor was found to be the accurate modelling with a 0.68 R2 value and 12.90 mean absolute value (MAE). Prediction error for gradient Boosting Regressor was calculated as R2: 0.841. When the importance of features was investigated, time from diagnosis to metastasis was found to be the most important predictive variable for survival.
Conclusion: The results of this study enables to identify patients who may have early death and provides a consequential decision guide in terms of whole brain radiotherapy or additional labor intense techniques.
Analysis of the factors affecting the pelvic floor muscle strength of women in the early postpartum period by different modes of delivery
Authors: Lin HuanYu , Lu XuHong , Zhang Fan , Yu Shu , Yu Min , Gao TianMing , Wei Wei , Wang QiuYue , Song Dan , Liu YiLei 
Published: January 2025

Abstract

Background
The detrimental impacts of childbirth and other factors on pelvic floor muscle strength compromise women's physiological and psychological well-being, and specialists have yet to achieve consensus regarding the effects of various delivery methods on pelvic floor muscle strength. This article examines the impact of various delivery procedures on pelvic floor muscle strength during the early postpartum phase.
Methods
A total of 1154 women who delivered in the Department of Obstetrics and Gynecology at Zhongshan Hospital, Dalian University, and underwent pelvic floor surface electromyography assessment at 6–8 weeks postpartum were selected as study subjects. They were categorized into vaginal delivery and cesarean section groups based on the mode of delivery, to analyze the risk factors affecting pelvic floor muscular strength in the early postpartum period for both groups.
Results
In vaginal delivery, hypertension, episiotomy, and perineal laceration were all independent risk factors for abnormal anterior resting potentials; second stage of labor ≥ 2h, episiotomy, and perineal laceration were all independent risk factors for abnormal fast muscle potentials; weight gain of > 16kg during pregnancy, second stage of labor ≥ 2h, episiotomy, and perineal laceration were all independent risk factors for abnormal slow muscle potentials; and episiotomy and perineal laceration were all independent risk factors for abnormal posterior resting potentials. Among cesarean deliveries, pre-pregnancy BMI > 24 kg/m2, pregnancy weight gain of 11.5–16 kg, and hypertension were independent risk factors for abnormal anterior resting potentials; pre-pregnancy BMI > 24 kg/m2 and pre-eclampsia were independent risk factors for abnormal fast muscle potentials; a history of uterine leiomyosarcoma was an independent risk factor for abnormal slow muscle potentials; and pregnancy weight gain of > 16 kg and premature rupture of the membranes were all independent risk factors for abnormal posterior resting potentials; perineal incision and perineal laceration were all independent risk factors for abnormal posterior resting potentials. Preterm rupture of fetal membranes were independent risk factors for abnormalities of the posterior resting potential.
Conclusions
Labor and delivery can adversely affect pelvic floor muscular strength to varying extents; nevertheless, cesarean sections provide some protective benefits to pelvic floor muscle strength, albeit they may induce resting muscle tension in the pelvic floor. The independent risk variables influencing early pelvic floor muscle strength differ between the two groups. The ideal method of delivery for women should be determined based on the current labor circumstances to facilitate a seamless delivery.
Higher incidence of trocar site hernia with gallbladder extraction via umbilical versus epigastric trocar port: a multicentre retrospective analysis of laparoscopic cholecystectomy
Authors: Bodegraven Eduard A. , Oosterwijk Paulieke C , Aalten Sanne M. , Schaafsma Boudewijn E , Smeenk Robert M 
Published: January 2025

Abstract

Background
Trocar site hernia (TSH) is a known complication of laparoscopic cholecystectomy (LC). Gallbladder extraction is typically performed through the umbilical or epigastric trocar port. However, data on the incidence of TSH in relation to the extraction site is limited. This study aimed to evaluate the need for surgical repair of TSH following gallbladder extraction through the umbilical versus epigastric trocar port.
Methods
A retrospective cohort study was conducted across two Dutch general hospitals. It assessed the occurrence of TSH after LC and examined commonly described risk factors in relation to the TSH location.
Results
Among 2 377 patients that underwent LC, the extraction site of the gallbladder was known in 1756 patients. Gallbladder extraction was performed via the umbilical trocar port in 929 (53%) of cases and via the epigastric trocar port in 827 (47%) of cases. TSH repair was required in 36 (2.1%) patients, with a higher incidence in patients with gallbladder extraction through the umbilical trocar port (3.2%) compared to the epigastric trocar port (0.7%), (p < 0.001).
Conclusion
The need for operative repair of a TSH after a LC is significantly reduced when the gallbladder is retrieved through the epigastric trocar site port compared to the umbilical trocar site port.
Practice Variation in the Use of Steroid-sparing Therapies in Childhood Steroid Sensitive Nephrotic Syndrome: Results from a Prospective Cohort Study
Authors: Aguilar-González Angie , Zardynezhad Ava , Morgan Catherine , Dart Allison , Mammen Cherry , Parekh Rulan , Geier Pavel , Benoit Genevieve , Filler Guido , Feber Janusz , Tee James , Arora Steven , Noone Damien , Grisaru Silviu , Chanchlani Rahul , Okpere Augustina , Samuel Susan 
Published: January 2025

Abstract

Background
Steroid-sparing therapies are often used to prolong disease remission while minimizing steroid toxicity in childhood steroid-sensitive nephrotic syndrome (SSNS). This study aims to describe practice variation in the use of steroid-sparing medications for childhood SSNS in Canada.
Methods
Children (1–18 years) with nephrotic syndrome (NS) from eleven Pediatric nephrology centers in Canada were enrolled into the Canadian Childhood Nephrotic Syndrome (CHILDNEPH) prospective cohort from 2013–2019. Data, including time to first relapse for children treated with cyclophosphamide, tacrolimus, mycophenolate, cyclosporine and rituximab were analyzed using summary statistics. Participants who received steroid-sparing therapies prior to enrolment were excluded.
Results
Of the 371 children enrolled, 321 (86.5%) had SSNS and 133 met the study criteria. Median age at enrollment was 3.0 years (IQR: 2.0-6.3). Median follow-up period was 3.0 years (IQR 1.0–4.0). Timing of initiation and choice of steroid-sparing therapy varied across centers. The majority (72.2%) initiated therapies after a median of 3 relapses (IQR: 2–4). Cyclophosphamide and tacrolimus were the most frequently used initial therapies at 39.1% and 23.3% respectively. Thirty (22.6%) patients switched to a second medication after a median time of 4 months (IQR 0.25-11); of which, 40% switched from either cyclophosphamide or mycophenolate to tacrolimus. There were no statistically significant differences in time to first relapse with initial therapies (log rank P-value 0.36).
Conclusions
Significant variation in the use of steroid-sparing therapies exists in the treatment of SSNS. A clinical trial is needed to examine the efficacy of these medications to optimize treatment and decrease practice variation.
Demographic and Prognostic Factors Affecting Survival in Invasive Mucinous Adenocarcinoma: A National Cancer Database Analysis
Authors: Demangone Michael Richard , Hsia Beau , Malan Augustus , Taghizadeh Catherine , Moroz Mark , Brown Timothy J. 
Published: January 2025

Abstract

Purpose
Invasive mucinous adenocarcinoma (IMA) is a rare lung tumor with a distinctive histology of goblet and columnar cells characterized by diverse growth patterns. The outcomes and prognosis of IMA are poorly defined owing to its rarity. This study uses the National Cancer Database (NCDB) to study the demographic and prognostic factors affecting the overall survival and mortality rates of IMA patients.
Methods
We identified IMA patients from the NCDB (2004–2020) using ICD-O-3 code 8253. Time-to-event outcomes were analyzed with Kaplan-Meier, log-rank tests, and Cox regression models to assess factors influencing survival.
Results
A total of 6202 IMA patients were identified. Older age was linked to poorer survival (2-year = 53.6%, 5-year = 30.9%, 10-year = 12.4%). Female patients had better survival rates than males (2-year = 70.8% vs. 60.7%, p < 0.001). Lower income (<$46,277 and $46,227-$57,856) and lack of radiation therapy were associated with higher mortality (HR = 1.35, p < 0.001). Medicaid insurance also correlated with worse survival compared to private insurance (HR = 1.46, p < 0.001).
Conclusion
Male gender, Black or White race, and lower income brackets were associated with increased mortality in IMA. Further, being insured by Medicaid and not undergoing radiation therapy are associated with poorer survival outcomes.
A Middle-aged Man with Dyspnea and Hoarseness: An Unusual Case of Vocal Cord Paralysis
Authors: Tabatabaeifar Seyedeh Nadia , Ahmadpour Mahsa , Fallahi Mohammad Javad 
Published: January 2025

Abstract

Background: Pleuroparenchymal fibroelastosis (PPFE) is a rare and distinct form of interstitial pneumonia predominantly affecting the upper lung zones. It is characterized by fibrotic thickening of the visceral pleura and adjacent subpleural parenchyma. While common complications include spontaneous pneumothorax and pneumomediastinum, vocal cord paralysis (VCP) or paresis has been increasingly recognized as a potential manifestation in recent reports. This case highlights the unique association between idiopathic PPFE (IPPFE) and VCP, emphasizing its novelty and clinical relevance.Case presentation: We report a case of a middle-aged man presenting with progressive dyspnea, hoarseness, and left-sided vocal cord paralysis. Imaging studies revealed upper lobe-dominant fibrotic changes consistent with IPPFE. A comprehensive evaluation ruled out secondary causes of PPFE and other potential etiologies of VCP. Despite supportive management, the patient’s VCP persisted, likely due to architectural distortion of the lung affecting the recurrent laryngeal nerve pathway.Conclusions: This case adds to the limited but growing body of literature on the association between PPFE and VCP. Understanding this rare complication is crucial for early recognition and appropriate management, as it highlights the diverse clinical manifestations of PPFE and its impact on patient outcomes.
"Totally No Tube" laparoscopic technique in the management of adrenal diseases: a safe and efficient practice
Authors: Cui Yun , Zhou Xiaoguang , Cui Liyan , Kang Na , Zhou Quan , Xu Tong , Zeng Song , Li Xin , Song Liming 
Published: January 2025

Abstract

Background
Laparoscopic adrenal surgery has become a common procedure for some adrenal diseases. The necessity of surgical related tubes, such as abdominal drainage tubes, catheters and endotracheal tubes, are controversial. These materials may induce regional tissue inflammation and be accompanied with uncomfortable. In this study, we evaluated the safety and feasibility of “Totally No Tube (TNT)” transperitoneal laparoscopic technique in adrenal surgery.
Methods
From January 2021 to December 2023, a total of 67 patients who were underwent TNT laparoscopic adrenal surgery were reviewed, and 78 patients who were underwent conventional laparoscopic adrenal surgery were included as the control group. A retrospectively analysis was conducted on indicators such as the time of anesthesia and operation, intraoperative blood loss, postoperative hospital stay, postoperative visual analogue scale, Quality of Recovery-40 score, time to first ambulation after surgery, total hospitalization cost, and postoperative complications in both groups.
Results
All 145 patients underwent surgery without grade II-IV complications. The TNT group showed significantly shorter postoperative hospital stay, lower postoperative pain score, better QOR-40 score, earlier ambulation after surgery, lower total hospitalization cost, and fewer certain postoperative complications. There were no significant differences in anesthesia time, operation time, and intraoperative blood loss.
Conclusion
TNT transperitoneal laparoscopic adrenal surgery is safe and well tolerated when strict selection criteria are followed. It indicates a similar rate of postoperative complications compared to the common laparoscopic approaches. Concurrently, it offers advantages such as less postoperative discomfort, more satisfaction with recovery from surgery, and lower healthcare expenditure.
Designing an Electromechanical Capture System for In-Air Capturing of Winged RLVs
Authors: Luyten Briek , Singh Sunayna , Zandbergen B.T.C. 
Published: January 2025

Abstract

In-air capturing (IAC) is a promising concept for recovering winged reusable launch vehicles (RLVs) using a towing aircraft(TA), without the need for any propulsion on board the RLV. In this paper, the preliminary electromechanical design ofan airborne device is presented, which is central to this IAC technique. The device is an autonomous system, towedby the TA, and docks with a boom attached to the nose of the RLV. A design space exploration and load analysis areperformed using a simplified towing model, revealing significantly higher towing loads compared to previous estimates.The design of a probe-drogue docking mechanism is proposed, which uses a set of actuated wedges to lock the RLVboom in place. Actuator and sensor solutions are studied, aiming at a redundant and robust mechanism design. Basedon reference commercial components, the size, weight, and power (SWaP) footprints of essential avionics are estimated,and a preliminary dimensioning of the required battery system is performed. Finally, a comprehensive, electromechanicalcomputer-aided design (CAD) model is developed, with which the overall inertial properties of the vehicle are estimated.The position of its centre of gravity is studied, revealing the need for a forward trim mass. Compared to previous designstudies, the estimated total mass is increased to 175.44 kg, while the design’s overall safety factor grows to 1.51.