bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perioperative outcomes in an age-adapted analysis of the German StuDoQ|Pancreas registry for PDAC
Authors: Tschaidse Tengis , Hofmann Felix O. , Renz Bernhard , Hungbauer Maximilian , Klinger Carsten , Buhr Heinz J. , Uhl Waldemar , Mees Sören Torge , Keck Tobias , Reissfelder Christoph , Ghadimi Michael , D’Haese Jan G. , Werner Jens , Ilmer Matthias 
Published: January 2025

Abstract
Background
Pancreatic ductal adenocarcinoma (PDAC) typically occurs in an older patient population. Yet, early-onset pancreatic cancer (EOPC) has one of the fastest growing incidence rates. This study investigated the influence of age and tumor location on postoperative morbidity and mortality in a large, real-world dataset.

Methods
Patients with confirmed PDAC undergoing pancreatic surgery between 01/01/2014 and 31/12/2019 were identified from the German StuDoQ|Pancreas registry. After categorization into early- (EOPC; < 50 years), middle- (MOPC; 50 -70 years), and late-onset (LOPC; > 70 years), and stratification into pancreaticoduodenectomy (PD) or distal pancreatectomy (DP), differences in morbidity and mortality as well as clinicopathologic parameters were analyzed.

Results
In total, 3011 patients were identified. No difference in the occurrence of postoperative pancreatic fistula (POPF), postpancreatectomy hemorrhage (PPH) or delayed gastric emptying (DGE) between different age groups and resection techniques was detected. However, in patients undergoing PD, major complications (Clavien-Dindo ≥ 3a) were observed more frequently in LOPC (30,7%) than in MOPC (26,2%) and EOPC (16,9%; p < 0,01). Mortality almost tripled from EOPC (2,4%) to MOPC (3,6%) to LOPC (6,6%, p < 0,01) and significantly higher failure to rescue (FTR) rates could be observed (EOPC 14,3%, MOPC 13,6%; LOPC 21,6%; p < 0,05). In centers with DGAV certification for pancreatic surgery, the risk of complications was significantly decreased in PD (OR 0,79; 95% CI 0,65–0,94; p = 0,010).

Conclusion
Age has a pronounced impact on the perioperative outcomes after pancreatic resections of PDAC. This effect is more prevalent in PD compared to DP. Pancreatic surgery-specific complications, such as POPF, DGE or PPH do not occur more frequently in the elderly. Overall, the risk of major complications and mortality increases in elderly patients mainly secondary to higher FTR rates.
Characteristics of abdominal herniation and its associations among patients operated in a Sudanese tertiary hospital: a retrospective review
Authors: Bakry Ahmed Abdellateef Hassan , Ahmed Khabab Abbasher Hussien Mohamed , Eljack Mohammed Mahmoud Fadelallah , Ahmed Ghassan E. Mustafa 
Published: January 2025

Abstract
Background & aims
Hernia is a very common surgical condition affecting all ages and both sexes. Data regarding abdominal wall hernias is essential to hernia management in an institution. With the absence of data regarding the prevalence, characteristics, and associations of abdominal wall hernias in Sudanese patients, we aimed to describe and find the possible differences in the spectrum of abdominal hernias, their rates, and associated predisposing factors.

Methodology
This was a retrospective cross-sectional chart review of surgical patients admitted at a Sudanese tertiary teaching Hospital, Department of Surgery, from January 2019-December 2021. Data were collected from the medical records using a checklist. The data obtained included age, gender, occupation, chronic medical conditions, past medical history (PMH), and year of admission. Data were analyzed using SPSS 22.

Results
Results showed that between January 2019 and December 2021, a total of 1158 patients were admitted to the department of surgery, and abdominal hernia had a frequency of 16.23% (n = 188). There was a male predominance (55.3%), ages below 20 years constituted the majority of cases (45.2%), and those between (50–60 years) were the least. The most frequent subtype was the inguinal hernia. The association between sociodemographic variables, PMH, chronic medical conditions, and the diagnosis was found to be statistically significant. The rate of recurrence was found to be 10.1%.

Conclusion
There was a high rate of abdominal Herniation, and a difference between subtypes of abdominal herniation regarding demographic data, past medical history, and comorbidities.
Comparative study of pulpal response following direct pulp capping using synthesized fluorapatite and hydroxyapatite nanoparticles
Authors: Salem Eman M. , Abdelfatah Omnia M. , Hanafy Rania A. , El-Sharkawy Rehab M. , Elnawawy Ghadir , Alghonemy Wafaa Yahia 
Published: January 2025

Abstract
Objective
This study aimed to investigate and compare the histological response of rabbit dental pulp after direct pulp capping with 3 different materials: mineral trioxide aggregate (MTA), nanoparticles of fluorapatite (Nano-FA), and nanoparticles of hydroxyapatite (Nano-HA) after 4 and 6-week time intervals.

Material and methods
A total of 72 upper and lower incisor teeth from 18 rabbits were randomly categorized into 3 groups)24 incisors from six rabbits each. MTA Group: teeth were capped with MTA. Nano-FA Group: teeth were capped with fluorapatite nanoparticles. Nano-HA Group: teeth were capped with hydroxyapatite nanoparticles. Blood samples were collected to examine some antioxidant enzymes nitric oxide (NO), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). After that, three rabbits from each group were euthanized after 4 and 6 weeks, respectively. Pulp tissues of all teeth in all groups were histologically observed.

Results
The obtained results showed that both Nano-HA induced the formation of thick dentin bridges with irregular dentin patterns at 6 weeks, while MTA and Nano-FA induced no dentin bridge with no tubular dentin pattern. Blood examination at the two intervals revealed no significant increase or decrease in the values of NO, SOD, CAT, GPx, GSH, and TNF-α. However, there was a significant increase in p-values of IL-6 in the Nano-FA treated group compared to both MTA and Nano-HA treated groups at the two intervals. Regarding the inflammatory reaction of the dental pulp, the MTA and Nano-HA groups displayed moderate inflammation, followed by Nano-FA, which showed the highest prevalence of nonpathological inflammation. Histological results were consistent with the blood examination. After 4 weeks, the Nano-FA and Nano-HA groups showed pulp fibrosis at the operating site, but the MTA showed only granulation tissues. Plus, dilated blood vessels appeared in the Nano-FA group. After 6 weeks, MTA and Nano-FA groups showed pulp fibrosis at the operating site with the persistence of dilated blood vessels with Nano-FA. The nano-HA group showed dentin bridge formation at the operating site.

Conclusion
MTA and Nano-HA could be considered favorable materials for direct pulp capping, while Nano-FA produces nonpathological inflammatory cell reactions. Moreover, the Nano-HA was the best in dentin bridge formation. Although nano-FA increased the operating site closure, it was noticed that it significantly increased IL-6 compared to MTA at the two intervals and significantly increased IL-6 compared to Nano-HA at 6 weeks, which may be manifested as some nonpathological inflammations in the Nano-FA group compared to the other groups, but it was deemed acceptable to direct pulp capping procedures.
Free Open Access Medical Education (FOAMed) use in medical students: a literature review
Authors: Morgan Jacqueline 
Published: January 2025

Abstract
Purpose
Free Open Access Medical Education (FOAMed) is an emergent phenomenon within medical education. The rise of FOAMed resources has meant that medical education needs no longer be confined to the lecture theatre or the hospital setting, but rather, can be produced and shared amongst any individual or group with access to internet and a suitable device. This study presents a review of the use of FOAMed resources by students as part of their university medical education.

Method
A literature search of terms relevant to the topic of FOAMed use by medical students was completed and reviewed. The included results were subsequently analysed and categorised through qualitative analysis.

Results
The increasingly digital cohort of medical students, fitting into the Gen Z and millennial generations, are generations that have taken strongly to FOAMed resources (Toohey et al., Western J Emerg Med 337–343, 2016, Shorey et al., Nurse Educ Pract 57:103247, 2021), with many of their learning styles being applicable to the methods of study that students were faced with in the online-heavy medical curriculums due to the COVID-19 pandemic (Marshall and Wolanskyj-Spinner, Mayo Clinc Proceedings 95:1135–7, 2020). However, despite the increasing use of FOAMed resources by these students, observed university study recommendations fail to recommend or integrate these resources into the curriculum. This review presents an exploration of the use of FOAMed resources by students as part of their university medical education.

Conclusion
This literature review found that students are increasingly utilising FOAMed as an integral part of their medical education, demonstrating self-determined learning. However, most of the literature on this topic is of the descriptive type, with little literature available on how universities are incorporating this form of student learning into the formal curriculum.
The complexity of home-based rehabilitation technology implementation for post-stroke motor rehabilitation in the Netherlands
Authors: te Boekhorst Karlijn E. , Kuipers Sanne J. , Ribbers Gerard M. , Cramm Jane M. 
Published: January 2025

Abstract
Background
Rehabilitation technology is a growing field, but the sustainable implementation of these technologies, particularly in home settings, is lacking. The aim of this study was to explore the factors influencing the uptake of stroke rehabilitation technology among various stakeholders, including developers, healthcare professionals, individuals who had strokes, strategic experts, management and innovation staff, health insurers, and the National Health Care Institute.

Methods
In total, 22 semi-structured interviews were conducted with a purposive stakeholder sample. The Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework was used as the theoretical basis for the interview design. The interview content was analysed to generate (sub)themes representing factors influencing the implementation of home-based rehabilitation technology. These (sub)themes were organised according to the NASSS framework domains to ensure a systematic and theoretically grounded analysis.

Results
Ten influencing factors emerged, nine of which fell within six of the seven NASSS domains. These factors include: (1) the unpredictable aftermath of stroke, (2) technology (mis)alignment with care delivery processes and end users’ preferences, (3) disparities in the assessment of technology’s value, (4) differences in commercial and university developers’ interests, (5) patient group capabilities, (6) perceived workload, (7) formal implementation plans in rehabilitation centres, (8) laws and regulations, and (9) the financial system. The factor that did not align with a single NASSS domain was: (10) the fragmentation of responsibilities among diverse stakeholders.

Conclusion
This study shows that the sustainable implementation of home-based rehabilitation technology faces several challenges across multiple domains of the NASSS framework. Effective collaboration among stakeholders is crucial for addressing these challenges but is currently hindered by fragmented responsibilities. To improve collaboration, it is essential to clearly define the roles and responsibilities of all stakeholders. Additionally, national-level policies adopting a systems approach are necessary to align these responsibilities and foster effective collaboration.
Health commodity management information system (Dagu-2 Software) implementation status in public health facilities of South-western Oromia, Ethiopia: a mixed method study
Authors: Gudeta Tadesse , Berhanu Nimona , Bekele Azmeraw , Boche Bekele , Mulugeta Tidenek , Tilahun Gizachew , Bayisa Bodena , Kleineidam Julia 
Published: January 2025

Abstract
Background
To ensure the complete traceability of healthcare commodities, robust end-to-end data management protocols are needed for the supply chain. In Ethiopia, digital tools like Dagu-2 are used in the lower levels of the healthcare supply chain. However, there is a lack of information regarding the implementation status, factors, and challenges of Dagu-2, as it is a recent upgrade from the offline Dagu-1 application. Thus, this study aimed to assess the implementation status of Dagu-2 in public health facilities in Southwestern Oromia, Ethiopia.

Methods
The study employed a sequential explanatory mixed method design to investigate the implementation status of the Dagu2 program in 33 public health facilities in the Southwestern Oromia region of Ethiopia. Study participants were selected using a two-step approach. Firstly, public hospitals and health centers that had implemented Dagu-2 were identified. Secondly, 65 logistic practitioners, including store managers and pharmacy heads, who met the eligibility criteria were selected for the quantitative study. Quantitative data were collected using validated and reliable self-administered questionnaires and analysed using SPSS version 23. We run both descriptive and inferential statistical analyses. Fisher's exact test was used to discern the relationship between dependent and independent variables at p < 0.05. The qualitative data were gathered through in-depth interviews and underwent manual thematic analysis.

Results
Out of 65 questionnaires, 61 were completed (93.8% response rate). About 77.0% reported using Dagu-2 for operational and strategic decisions, and 80.3% used it for logistics performance monitoring. Roughly 78.7% of the participants indicated a positive implementation status for Dagu-2. Antivirus usage (p = 0.018) and administrative support (p = 0.002) significantly associated with the implementation. External support and user-friendliness facilitated the implementation, while infrastructure constraints, connectivity absence, weak management support, and project handover gaps were major obstacles.

Conclusion
Overall, the study revealed a promising implementation process and service quality improvements. However, challenges such as lack of management support, limited ICT infrastructure, absence of connectivity, weak management support, and project handover gaps became obstacles for successful implementation. To ensure an effective healthcare system, leveraging technology tools and securing stakeholder support through training are essential.
Alone or in combination, hyaluronic acid and chondroitin sulfate alleviate ECM degradation in osteoarthritis by inhibiting the NF-κB pathway
Authors: Ma Yiran , Yang Xin , Jiang Min , Ye Wangjuan , Qin Hong , Tan Songwen 
Published: January 2025

Abstract
Backgrounds
Osteoarthritis (OA) significantly impacts the elderly, leading to disability and decreased quality of life. While hyaluronic acid (HA) and chondroitin sulfate (CS) are recognized for their therapeutic potential in OA, their effects on extracellular matrix (ECM) degradation are not well understood. This study investigates the impact of HA and CS, individually and combined, on ECM degradation in OA and the underlying mechanisms.

Methods
OA was modeled in rats through anterior cruciate ligament transection and in cells using IL-1β pretreatment. Treatments included HA and CS, alone or combined, with and without PMA (an NF-κB pathway activator). Cartilage tissue was analyzed using HE and Saffron O-fast green staining, with degradation assessed via the OARSI score. Inflammatory factors were measured by ELISA, and ECM-related proteins were detected by immunohistochemistry, immunofluorescence, and Western blotting. Chondrocyte viability was assessed using CCK8.

Results
HA and CS treatments significantly reduced cartilage damage, decreased inflammatory factor release, alleviated ECM degradation, and inhibited NF-κB pathway activation compared to the OA group (P < 0.05). The combination of HA and CS further enhanced these therapeutic effects (P < 0.05). However, these benefits were reversed when PMA was introduced (P < 0.05).

Conclusion
HA and CS, whether used alone or in combination, mitigate ECM degradation in osteoarthritis by inhibiting the NF-κB pathway, offering potential therapeutic benefits for OA management.
Two-dimensional cell membrane chromatography guided screening of myocardial protective compounds from Yindan Xinnaotong soft capsule
Authors: Shao Si-Min , Ji Xuan , Wang Xing , Liu Run-Zhou , Cai Yu-Ru , Lin Xiaobing , Zeng Ze-Jie , Chen Ling , Yang Liu , Yang Hua , Gao Wen 
Published: January 2025

Abstract
Background
Cell membrane chromatography (CMC) is a biochromatography with a dual function of recognition and separation, offering a distinct advantage in screening bioactive compounds from Chinese medicines (CMs). Yindan Xinnaotong soft capsule (YD), a CM formulation, has been widely utilized in the treatment of cardiovascular disease. However, a comprehensive mapping of the myocardial protective active compounds remains elusive.

Purpose
To establish a stable and efficient 2D H9c2/CMC-RPLC-MS system, and to utilize it for screening the active compounds of YD that are associated with myocardial protection.

Methods
An imidazole-modified silica gel exhibiting high modification efficiency and protein binding capacity was synthesized to enhance the longevity and efficiency of H9c2/CMC. Subsequently, the potentially bioactive compounds of YD were screened by integrating the 2D H9c2/CMC-RPLC-MS system with a high-content component knockout strategy. Additionally, an RNA-seq approach was employed to predict the targets and mechanisms of YD and the active compounds for myocardial protection.

Results
The developed imidazole-modified H9c2/CMC exhibits remarkable selectivity, specificity, stability, and reproducibility. Following three rounds of screening, a total of 24 potential myocardial protective compounds were identified, comprising 8 flavonoids, 8 phenolic acids, 4 saponins, and 4 tanshinones. Bioinformatic analysis utilizing RNA-seq indicated that the FOXO signaling pathway, with FOXO3 identified as a key target, plays a significant role in the cardioprotective effects of YD. Furthermore, all 24 screened compounds exhibit strong binding affinities with FOXO3 evaluated by molecular docking.

Conclusion
A highly stable and efficient 2D imidazole-modified H9c2/CMC-RPLC-MS system was developed, allowing for the screening of potentially active compounds from YD. Through the integration of the bioinformatic analysis, the pharmacodynamic foundation of YD for myocardial protection has been comprehensively characterized.

Graphical Abstract
Profiling of pathogenic variants in Japanese patients with sarcoglycanopathy
Authors: Shimazaki Rui , Saito Yoshihiko , Awaya Tomonari , Minami Narihiro , Kurosawa Ryo , Hosokawa Motoyasu , Ohara Hiroaki , Hayashi Shinichiro , Takeuchi Akihide , Hagiwara Masatoshi , Hayashi Yukiko K. , Noguchi Satoru , Nishino Ichizo 
Published: January 2025

Abstract
Background
Sarcoglycanopathies (SGPs) are limb-girdle muscular dystrophies (LGMDs) that can be classified into four types, LGMDR3, LGMDR4, LGMDR5, and LGMDR6, caused by mutations in the genes, SGCA, SGCB, SGCG, and SGCD, respectively. SGPs are relatively rare in Japan. This study aims to profile the genetic variants that cause SGPs in Japanese patients.

Methods
Clinical course and pathological findings were retrospectively reviewed in Japanese patients with SGP. Genetic analyses were performed using a combination of targeted resequencing with a hereditary muscle disease panel, whole genome sequencing, multiplex ligation-dependent probe amplification, and long-read sequencing. The structures of transcripts with aberrant splicing were also determined by RT-PCR, RNA-seq, and in silico prediction.

Results
We identified biallelic variants in SGC genes in 53 families, including three families with LGMDR6, which had not been identified in Japan so far. SGCA was the most common causative gene, accounting for 56% of cases, followed by SGCG, SGCB, and SGCD, at 17%, 21%, and 6%, respectively. Missense variants in SGCA were very frequent at 78.3%, while they were relatively rare in SGCB, SGCG, and SGCD at 11.1%, 18.2%, and 16.6%, respectively. We also analyzed the haplotypes of alleles carrying three variants found in multiple cases: c.229C > T in SGCA, c.325C > T in SGCB, and exon 6 deletion in SGCG; two distinct haplotypes were found for c.229C > T in SGCA, while each of the latter two variants was on single haplotypes.

Conclusions
We present genetic profiles of Japanese patients with SGPs. Haplotype analysis indicated common ancestors of frequent variants. Our findings will support genetic diagnosis and gene therapy.
Effect of intramuscular treatment with different iron dextran dosages and non-inferiority study to gleptoferron
Authors: Hennig-Pauka Isabel , Ganter Martin , Bornhorn Dirk , Lyons Wesley , Marco Enric , Almond Glen , Schneider Bettina , Kreienbrock Lothar , Pedersen Ken Steen 
Published: January 2025

Abstract
Background
Prevention of iron deficiency in suckling piglets by intramuscular injection of a standardized amount of iron dextran or gleptoferron in the first days of life can lead to over- or underdosage with respective health risks. Currently, combined iron products containing an active substance against coccidia are also used on farms. When using a combination product targeting two diseases, an adjustment of the necessary amount of iron to prevent anaemia in the frame of a farm-specific treatment protocol is not possible. The aim of this study was to test if iron dextran, which can be used in flexible volumes, is statistically non-inferior to a combinatory product, containing gleptoferron and toltrazuril. In addition, different administration schemes for iron dextran with respect to time point and dosage were compared on a conventional farm. Within each out of 17 litters eight healthy piglets were allocated to one of the four treatment groups on the second day of life: (1) 200 mg iron dextran, (2) 200 mg gleptoferron and 45 mg toltrazuril in combination, (3) 300 mg iron dextran, (4) 200 mg iron dextran and additional intramuscular administration of 200 mg iron dextran on day 11 of life. Pigs of groups 1, 3 and 4 received toltrazuril orally. Red blood cell measures were determined prior to treatment on day 2 of life and at weaning. Body weights were measured on day 2, 24, 74 and 160 of life.

Results
Iron dextran was non-inferior compared to gleptoferron within a tolerance range of ± 5 g haemoglobin/L. In total, treatment groups did not differ with respect to red blood cell parameters and average daily weight gain. The 50% pigs with intermediate birth weights profited from an additional iron dextran administration with respect to higher haemoglobin concentrations at weaning.

Conclusions
In this investigation gleptoferron and iron dextran appear equally appropriate for prevention of iron deficiency anaemia. Piglets of different birth weights might profit differently from an additional iron administration, so that usage of a product containing iron as a single substance is of advantage to allow a flexible adjustment of dosage during the suckling period.