bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis and Simulation of Driving Behavior at Inner City Intersections
Authors: Weinreuter Hannes , Strelau Nadine-Rebecca , Deml Barbara , Heizmann Michael
Published: August 2024

Inner city intersections are a challenging scenario for human drivers as well as for the development of autonomous vehicles. This is especially the case for unsignalized intersections where theright before leftrule applies. At these intersections, ambiguous situations can arise. In this chapter, we cover two aspects of this intersection type: First, we use driving data from a field study conducted in inner city traffic to analyze the relationship between intersections and human driving behavior. For that, we describe the intersection, its surrounding environment and the traffic there by features that constitute an intersection’s complexity (e.g. street width, visibility conditions, number of cooperation vehicles). With those we are able to predict features describing the driving behavior reliably. Second, we propose a decision making algorithm for unsignalized inner city T-junctions. The algorithm is modeled as a discrete event system and does not rely on any explicit communication. Instead, only the observable state is used. This includes the map, the positions and velocities of the cooperation vehicles and the driving pattern. We introduce the algorithm in detail and present results of a comprehensive simulation for validation. The algorithm is able to drive through all situations in the simulation safely.
Design and Evaluation of V2X Communication Protocols for Cooperatively Interacting Automobiles
Authors: Delooz Quentin , Maksimovski Daniel , Festag Andreas , Facchi Christian
Published: August 2024

This chapter studies two key communication services for the support of cooperative driving capabilities using Vehicle-to-Everything (V2X) communications: sensor data sharing and maneuver coordination. Based on the current state of the art in research and pre-standardization of V2X communications, we enhance the protocol design for both services and assess their performance by discrete-event simulations in highway and city scenarios. The first part of this chapter addresses the performance improvement of sensor data sharing by two complementary strategies. The shared sensor data are adapted to the available resources on the used channel. Furthermore, the redundancy of the transmitted information is reduced to lower the load on the wireless channel, whereas several approaches are proposed and assessed. The second part of the chapter analyzes cooperative maneuver coordination protocols. We propose a distributed approach based on the explicit exchange of V2X messages, which introduces priorities in maneuver coordination and studies several communication patterns for the negotiation and coordination of maneuvers among two and more vehicles. The results demonstrate the potential of V2X communications for automated driving, showcase several approaches for enhancements of sensor data sharing and maneuver coordination, and indicate the performance of these enhancements.
Interaction-Aware Motion Planning as a Game
Authors: Burger Christoph , Yan Shengchao , Burgard Wolfram , Stiller Christoph
Published: August 2024

Motion planning for automated vehicles (AVs) in mixed traffic, where AVs share the road with human-driven vehicles, is a challenging task. To reduce the complexity, state-of-the-art planning approaches often assume that the future motion of surrounding vehicles can be predicted independently of the AV’s plan. This separation can lead to suboptimal, overly conservative behavior especially in highly interactive traffic situations. In this work, we introduce a motion planning algorithm to generate interaction-aware behavior for highly interactive scenarios. The presented algorithm is based upon a reformulation of a bi-level optimization problem, which frames interactions between a human driver and a AV as a Stackelberg game. In contrast to existing works, the algorithm can account for general nonlinear state and input constraints. Further, we introduce mechanisms to integrate cooperation and courtesy into motion planning to prevent overly aggressive driving behavior.
The Rhetoric of Reaction in Spain: Radical Right, Gender, and Immigration
Authors: Fernández-Suárez Belén
Published: August 2024

This chapter provides an analysis of VOX’s political discourse on gender equality and immigration. VOX belongs to the European radical right and is characterized by conservatism, centralist nationalism, and nativism. The literature reviewed establishes a dialogue between migration studies and gender studies concerning the rise of these traditionalist and nationalist forces in Europe. The objectives are to present VOX’s main arguments on the role of women, gender equality, and immigration in Spain and to explore the relationship between these recurring topics in their political discourse. The methodology is qualitative, grounded on document analysis of VOX materials (program, statutes, founding manifesto) and parliamentary discourses in the Congress of Deputies in the XIII and XIV Legislatures. The results indicate that arguments and proposals regarding immigration seek to strengthen border control, toughen penalties, and consider irregular migration as a crime, targeting Muslim migrants. Regarding gender issues, their nativist vision implies to preserve traditional roles, oppose feminism, and promote natalist policies reinforcing mothers’ roles in caregiving. To conclude, VOX associates Muslim immigration with a perceived thret to women’s freedom in Western countries, link it to sexual crimes against women.
Frequentist Probability Logic
Authors: Aldini Alessandro , Graziani Pierluigi , Tagliaferri Mirko
Published: August 2024

In this paper, we present a logic $$\textbf{FPL}$$
FPL
(Frequentist Probability Logic) to reason about probabilities with a relative frequency interpretation. We show that it is possible to interpret the language of $$\textbf{FPL}$$
FPL
with the standard semantics for propositional logic. $$\textbf{FPL}$$
FPL
can give a peculiar frequentist interpretation of a probability operator. We then give a proof system for the language, prove that the traditional theorems of probability hold, and prove soundness and completeness.
Sigma-1 receptor targeting inhibits connexin 43 based intercellular communication in chronic neuropathic pain
Authors: Denaro Simona , D’Aprile Simona , Torrisi Filippo , Zappalà Agata , Marrazzo Agostino , Al-Khrasani Mahmoud , Pasquinucci Lorella , Vicario Nunzio , Parenti Rosalba , Parenti Carmela
Published: August 2024

Background and objective

Neuropathic pain is a chronic condition characterized by aberrant signaling within the somatosensory system, affecting millions of people worldwide with limited treatment options. Herein, we aim at investigating the potential of a sigma-1 receptor (σ1R) antagonist in managing neuropathic pain.

Methods

A Chronic Constriction Injury (CCI) model was used to induce neuropathic pain. The potential of (+)-MR200 was evaluated following daily subcutaneous injections of the compound. Its mechanism of action was confirmed by administration of a well-known σ1R agonist, PRE084.

Results

(+)-MR200 demonstrated efficacy in protecting neurons from damage and alleviating pain hypersensitivity in CCI model. Our results suggest that (+)-MR200 reduced the activation of astrocytes and microglia, cells known to contribute to the neuroinflammatory process, suggesting that (+)-MR200 may not only address pain symptoms but also tackle the underlying cellular mechanism involved. Furthermore, (+)-MR200 treatment normalized levels of the gap junction (GJ)-forming protein connexin 43 (Cx43), suggesting a reduction in harmful intercellular communication that could fuel the chronicity of pain.

Conclusions

This approach could offer a neuroprotective strategy for managing neuropathic pain, addressing both pain symptoms and cellular processes driving the condition. Understanding the dynamics of σ1R expression and function in neuropathic pain is crucial for clinical intervention.
Protocol-based CT-guided brachytherapy for patients with prostate cancer and previous rectal extirpation—a curative approach
Authors: Schubert Philipp , Strnad Vratislav , Weißmann Thomas , Schweizer Claudia , Lotter Michael , Kreppner Stephan , Karius Andre , Fietkau Rainer , Merten Ricarda
Published: August 2024

Objective

There are numerous curative treatment possibilities for prostate cancer. In patients who have undergone rectal extirpation for rectal cancer treatment, curative options are limited due to anatomic changes and previous irradiation of the pelvis. In this analysis, we validate the feasibility of CT-guided transperineal interstitial brachytherapy for this specific scenario.

Patients and methods

We analyzed the treatment procedures and outcomes of 5 patients with metachronic nonmetastatic prostate cancer. Ultrasound-guided brachytherapy was not possible in any of the patients. Of these 5 patients, 3 were treated for prostate cancer using temporary brachytherapy with Ir-192 only, and 2 were treated with external-beam radiation therapy and temporary brachytherapy as a boost. CT-guided brachytherapy was performed in all patients. We analyzed the feasibility, efficacy, treatment-related toxicity, and quality of life (EORTC-30, IEFF, IPSS, and ICIQ questionnaires) of the treatments.

Results

Median follow-up was 35 months. Two out of five patients received boost irradiation (HDR 2 × 9 Gy, PDR 30 Gy). Three out of five patients were treated with PDR brachytherapy in two sessions up to a total dose of 60 Gy. Dosimetric parameters were documented as median values as follows: V100 94.7% (94.5–98.4%), D2bladder 64.3% (50.9–78.3%), D10urethra 131.05% (123.2%–141.2%), and D30urethra 122.45% (116.2%–129.5%). At the time of analysis, no biochemical recurrence had been documented. Furthermore, neither early nor late side effects exceeding CTCAE grade 2 were documented.

Conclusion

CT-guided transperineal brachytherapy of the prostate in patients with previous rectal surgery and radiation therapy is safe and represents a possible curative treatment option. Brachytherapy can be considered for patients with metachronic prostate cancer in this specific scenario, albeit preferably in experienced high-volume centers.
Mechanical and thermal analysis of basalt grid reinforced particleboards containing flame retardants
Authors: Mayer Aaron Kilian , Brinker Sascha , Mai Carsten
Published: August 2024

Flame retardants and other additives can reduce the performance of adhesives used to produce wood-based panels such as particleboards (PB). Basalt reinforcement was evaluated to compensate for the loss of bending strength to allow the panels to be used in the construction sector. A basalt grid with a grammage of 200 g m−2 was used to reinforce PB containing 15 m% nitrogen-phosphate based flame retardant. The modulus of rupture (MOR) and modulus of elasticity (MOE) of the reinforced panels were higher (69% and 24%, respectively) than those of corresponding reference panels. The thermal analysis revealed that the addition of the flame retardant could result in the PB being upgraded to Euroclass B with a reduced crack formation, as identified via 3D-microscopy. Consequently, the use of basalt grid as a reinforcement material could be a way to reinforce panels that contain strength-reducing additives.
Human Exposure to Heavy Metals over the Last 100 Years
Authors: Brudecki Kamil , Pasieka Agnieszka , Franczak Renata , Pankowska Anna , Kołodziej Małgorzata , Lorenc-Brudecka Jadwiga , Łokas Edyta
Published: August 2024

The primary objective of the presented research was to assess the impact of intense global economic development, over the last 100 years, on the bioaccumulation of heavy metals in the human body. This evaluation was conducted based on the measurement of heavy metals in human hair samples collected 100 years ago in present-day southern Poland.In this study, concentrations of lead (Pb), cadmium (Cd), arsenic (As), zinc (Zn), copper (Cu), iron (Fe), and selenium (Se) were measured in 61 hair samples,28 of which were obtained from individuals who lived 100 years ago, while the remaining 33 constituted the contemporary control group. The concentrations were determined using a triple quadrupole inductively coupled plasma mass spectrometer (Agilent 8900). Statistical analysis of the obtained results was conducted using the Principal Cmponent Analysis and the non-parametric Mann-Whitney test. In the case of As, Pb, Cd, and Fe, the concentrations were significantly higher in individuals who lived 100 years ago compared to those living today. Over this period, the median concentrations were shown to have decreased by 95%, 94%, 85%, and 69% for As, Pb, Cd, and Fe, respectively. No statistically significant differences were observed for Cu, Zn, and Se. The results obtained for Pb, Cd, As, and Fe unequivocally indicate that the population studied from 100 years ago was more exposed to internal contamination with these metals than people who live nowadays.
Building Momentum: platformised organising and the democratic deficit
Authors: Piazzo Robin , Keeling Silvia
Published: August 2024

The literature focussing on digital platforms as intraorganisational intermediaries underlines a key shortcoming of this model that has not been addressed by the literatures on digital social movements, advocacy, and activism. This limitation is related to the fact that platform-based organisations usually exploit widespread representations of digital technologies as tools for democratisation, but then offer low-quality internal democracy. This has implications for these organisations’ internal and external legitimacy, which are vital for mobilising and engaging supporters and the general public. This article proposes an historical and processual study of the hybrid organisation Momentum, with the aim of exploring the organisational implications of the cyber-democratising discourse and its impact on the internal legitimacy of platform-based organisations.
Development of plate-type and tubular chemiluminescence immunoassay against African swine fever virus p72
Authors: Miao Chun , Shao Junjun , Yang Sicheng , Wen Shenghui , Ma Yunyun , Gao Shandian , Chang Huiyun , Liu Wei
Published: August 2024

African swine fever (ASF) is a highly contagious and fatal viral disease that has caused huge economic losses to the pig and related industries worldwide. At present, rapid, accurate, and sensitive laboratory detection technologies are important means of preventing and controlling ASF. However, because attenuated strains of African swine fever virus (ASFV) are constantly emerging, an ASFV antibody could be used more effectively to investigate the virus and control the disease on pig farms. The isolation of ASFV-specific antibodies is also essential for the diagnosis of ASF. Therefore, in this study, we developed two chemiluminescence immunoassays (CLIAs) to detect antibodies directed against ASFV p72: a traditional plate-type blocking CLIA (p72-CLIA) and an automatic tubular competitive CLIA based on magnetic particles (p72-MPCLIA). We compared the diagnostic performance of these two methods to provide a feasible new method for the effective prevention and control of ASF and the purification of ASFV. The cut-off value, diagnostic sensitivity (Dsn), and diagnostic specificity (Dsp) of p72-CLIA were 40%, 100%, and 99.6%, respectively, in known background serum, whereas those of p72-MPCLIA were 36%, 100%, and 99.6%, respectively. Thus, both methods show good Dsn, Dsp, and repeatability. However, when analytical sensitivity was evaluated, p72-MPCLIA was more sensitive than p72-CLIA or a commercial enzyme-linked immunosorbent assay. More importantly, p72-MPCLIA reduced the detection time to 15 min and allowed fully automated detection. In summary, p72-MPCLIA showed superior diagnostic performance and offered a new tool for detecting ASFV infections in the future.

Key points

• Two chemiluminescence immunoassay (plate-type CLIA and tubular CLIA) methods based on p72 monoclonal antibody (mAb) were developed to detect ASFV antibody.

• Both methods show good diagnostic performance (Dsn (100%), Dsp (99.6%), and good repeatability), and p72-MPCLIA detects antibodies against ASFV p72 with high efficiency in just 15 min.
Pseudoendocrine sarcoma: a rare new entity with unique radiologic and pathologic/molecular characteristics
Authors: Corey Zachary , Fanburg-Smith Julie C. , French Cristy N. , Walker Eric A. , Kamerow Harry N. , Cochran Eric L. , Smith Jessica D. , Flemming Donald J. , Murphey Mark D.
Published: August 2024

Pseudoendocrine sarcoma is a rare, recently described intermediate grade sarcoma of uncertain phenotype that most commonly affects the paraspinal location in older patients with a distinctive endocrine/paraganglioma-like morphology and unique CTNNB1 point mutation. While these tumors appear as epithelial or even benign endocrine tumors, these lack markers for such and are highlighted by nuclear expression of beta-catenin. This case is the first among the previously reported only twenty-five cases of this entity, including one original series and a few case reports, to correlate the radiologic imaging with the pathologic features. Furthermore, this case illustrates the oldest-to-date patient with this unique location as a palpable painful chest wall/paraspinal location, with new morphologic observations and, finally, this is only the second case to have this specific CTNNB1 hotspot point mutation for this rare entity.
Interleukin-7 expression by CAR-T cells improves CAR-T cell survival and efficacy in chordoma
Authors: Wu Huantong , Xu Zhuofan , Qi Maoyang , Liu Penghao , Zhang Boyan , Wang Zhenglin , Chen Ge , Liu Xiaohai , Liu Junqi , Wei Wei , Duan Wanru , Chen Zan
Published: August 2024

Chordoma is a rare bone tumor that frequently recurs after surgery, and the prognosis is poor with current treatments. This study aimed to identify potential novel immunotherapeutic targets for chordomas by identifying target proteins in clinical samples as well as tumor microenvironmental factors to enhance efficacy. Fourteen chordoma samples were analyzed by single-cell RNA sequencing, and B7–H3 and IL-7 were identified as potential targets and potentiators, respectively. B7–H3-targeted chimeric antigen receptor T (CAR-T) cells and B7–H3 CAR-T cells expressing IL-7 were synthesized and their anti-tumor activity evaluated in vitro, including in primary chordoma organoid models. The B7–H3 CAR-T/IL-7 therapy showed enhanced cytotoxicity and prolonged duration of action against tumor cells. Additionally, IL-7 modulated favorable subpopulations of cultured CAR-T cells, diminished immune checkpoint expression on T-cell surfaces, and enhanced T-cell functionality. The incorporation of IL-7 molecules into the B7–H3 CAR structure augmented CAR-T-cell function and improved CAR-T-cell efficacy, thus providing a novel dual therapeutic strategy for chordoma treatment.
A coddling of the sagittal suture: inequality in spring-assisted expansion
Authors: Ng Jinggang J. , Chang Ashley E. , Villavisanis Dillan F. , Shakir Sameer , Massenburg Benjamin B. , Wu Meagan , Romeo Dominic J. , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A.
Published: August 2024

Purpose

We examined differences in long-term morphometric outcomes of spring-mediated cranioplasty (SMC) for various forms of isolated nonsyndromic sagittal craniosynostosis.

Methods

A retrospective review was performed of children who underwent SMC from 2011 to 2020 at the Children’s Hospital of Philadelphia. Cephalic indices (CI), Whitaker grades, parietal bone thickness, and degree of suture fusion were assessed. Frontal bossing and vertex-nasion-opisthocranion (VNO) angles were compared to a normal control group.

Results

Fifty-four subjects underwent surgery at age 3.6 ± 1.0 months with follow-up of 6.3 ± 1.8 years. Mean CI was 75.2 ± 4.1 at 5.9 ± 2.0 years postoperatively. Mean CI were 75.8 ± 4.1 (n = 32), 76.4 ± 4.0 (n = 22), and 77.1 ± 4.8 (n = 11) at 5, 7, and 9+ years postoperatively, respectively. Three (5.6%) required reoperation for persistent scaphocephalic cranial deformity. Fifty-one (94.4%) were Whitaker Grade I. On physical examination, 12 (22.2%) demonstrated craniofacial abnormalities. At long-term follow-up, there were no differences in frontal bossing angle (102.7 ± 5.2 degrees versus 100.7 ± 5.6 degrees, p = .052) and VNO angle (44.9 ± 3.3 degrees versus 43.9 ± 2.2 degrees, p = .063) between study and control groups. Younger age at surgery predicted a lower Whitaker grade, more normalized VNO angle, and greater change in CI during active expansion. Increased percentage fused of the posterior sagittal suture predicted a higher Whitaker grade, while decreased anterior fusion was associated with frontal bossing and temporal hollowing.

Conclusions

Overall, children undergoing spring-mediated cranioplasty for sagittal craniosynostosis demonstrated maintenance of CI, favorable cosmetic outcomes, and a low reoperation rate at mid-term follow-up. Early intervention is associated with improved aesthetic outcomes, and regional fusion patterns may influence long-term craniofacial dysmorphology.
Barbed suture in neck dissection: a randomized clinical study on efficacy, safety and aesthetic outcome
Authors: Doescher Johannes , Emmanuel Benjamin , Greve Jens , Schuler Patrick J. , Sommer Fabian , Laban Simon , Veit Johannes , Hoffmann Thomas K.
Published: August 2024

Purpose

The resection of lymph nodes/neck dissection is a typical part of the surgical treatment of head and neck malignancies. The aim of this study was to compare subcutaneous closure using single knotted, braided suture (VicrylTM, standard arm) with continuous self-locking, monofilament barbed suture (V-LocTM, experimental arm).

Methods

Neck Lock was a randomized clinical trial at a single tertiary referral center. It was conducted from 2016 till 2022 with a follow-up period of 3 months. Assessment of safety and aesthetic outcome was double-blinded. 68 patients were randomized after application of exclusion criteria. Subcutaneous wound closure was performed in an intrapatient randomized fashion for suture technique. The primary endpoint was the duration of subcutaneous sutures. Wound healing and scar formation were recorded at multiple postoperative intervals as secondary endpoints.

Results

The median age was 61 years, 89.7% were male. 92.6% suffered from a squamous cell carcinoma. There was a significant difference in median subcutaneous suture time (p = 0.024) between the experimental (6:11 ± 2:30 min) and standard (7:01 ± 2.42 min) arms. There was no significant difference in safety when assessing adverse events (AEs). At least one AE occurred in 14.7% vs. 5.9%, for barbed and smooth sutures respectively (p = 0.16).

Conclusion

For neck dissection of head and neck malignancies, subcutaneous wound closure with self-locking sutures offers significant time savings over the single knot technique with similar safety and aesthetic results.

Trial registration information

The trial was registered with WHO acknowledged primary registry “German Clinical Trials Register” under the ID DRKS00025831 (https://drks.de/search/de/trial/DRKS00025831).
Nochmals Odysseus. Zum normativen Status vorausschauender Autorisierungen von Zwangsbehandlungen für Situationen einer temporären Kompetenzbeeinträchtigung
Authors: Hallich Oliver
Published: August 2024

Mit dem Ausdruck „Odysseus-Anweisung“ werden dokumentierte Behandlungswünsche kompetenter Personen für Phasen einer vorübergehenden Kompetenzbeeinträchtigung bezeichnet, mittels derer diese Personen ein Handeln gegen ihre Präferenzen in der vorausgesehenen Situation der Kompetenzbeeinträchtigung autorisieren. Im Zentrum der ethischen Diskussion der Odysseus-Anweisungen steht im Allgemeinen die Frage nach ihrer „moralischen Autorität“ oder „Respektabilität“. Es wird gefragt, ob Odysseus-Anweisungen moralische Autorität in dem Sinne besitzen, dass sie bei Einschlägigkeit und Anwendbarkeit in der Akutsituation ein Handeln gegen den Patientenwillen moralisch geboten machen. Im vorliegenden Beitrag wird argumentiert, dass es in der Akutsituation Gründe geben kann, gegen eine einschlägige und anwendbare Odysseus-Anweisung zu handeln, da ein Handeln entsprechend einer Odysseus-Anweisung gerechtfertigt, aber gleichwohl falsch sein kann. Dazu wird nach einer einleitenden Darstellung des Problems und einigen terminologischen Präzisierungen zunächst die Unterscheidung zwischen Gerechtfertigt Sein und Richtig Sein auf einer allgemeinen Ebene erläutert und dann auf Odysseus-Anweisungen übertragen und zwischen der Anwendung dieser Unterscheidung auf der Einzelfallebene und der Prinzipienebene differenziert. Abschließend wird dafür plädiert, dass, da ein Handeln entsprechend einer Odysseus-Anweisung gerechtfertigt, aber falsch sein kann, Odysseus-Anweisungen die von ihnen autorisierten Zwangsbehandlungen auch bei vorhandener Einschlägigkeit und Anwendbarkeit nicht zu moralisch gebotenen machen und deren Befolgung nicht rechtlich bindend gemacht werden sollte. Sie sind nicht als normativ gleichrangig mit anderen Patientenverfügungen, die sich z. B. auf Zustände der Demenz beziehen, anzusehen.
Predicting axial-bearing capacity of fully grouted rock bolting systems by applying an ensemble system
Authors: Hosseini Shahab , Jodeiri Shokri Behshad , Mirzaghorbanali Ali , Nourizadeh Hadi , Entezam Shima , Motallebiyan Amin , Entezam Alireza , McDougall Kevin , Karunasena Warna , Aziz Naj
Published: August 2024

In this paper, the potential of the five latest artificial intelligence (AI) predictive techniques, namely multiple linear regression (MLR), multi-layer perceptron neural network (MLPNN), Bayesian regularized neural network (BRNN), generalized feed-forward neural networks (GFFNN), extreme gradient boosting (XGBoost), and their ensemble soft computing models were evaluated to predict of the maximum peak load (PL) and displacement (DP) values resulting from pull-out tests. For this, 34 samples of the fully cementitious grouted rock bolts were prepared and cast. After conducting pull-out tests and building a dataset, twenty-four tests were randomly considered as a training dataset, and the remaining measurements were chosen to test the models’ performance. The input parameters were water-to-grout ratio (%) and curing time (day), while peak loads and displacement values were the outputs. The results revealed that the ensemble XGBoost model was superior to the other models. It was because having higher values of R2 (0.989, 0.979) and VAF (99.473, 98.658) and lower values of RMSE (0.0201, 0.0435) were achieved for testing the dataset of PL and DP’ values, respectively. Besides, sensitivity analysis proved that curing time was the most influential parameter in estimating values of peak loads and displacements. Also, the results confirmed that the ensemble XGBoost method was positioned to predict the axial-bearing capacity of the fully cementitious grouted rock bolting system with extreme performance and accuracy. Eventually, the results of the ensemble XGBoost modeling technique suggested that this novel model was more economical, less time-consuming, and less complicated than laboratory activities.
Does surgeon or hospital volume influence outcome in dedicated colorectal units?—A Viennese perspective
Authors: Schuld Gabor J. , Schlager Lukas , Monschein Matthias , Riss Stefan , Bergmann Michael , Razek Peter , Stift Anton , Unger Lukas W.
Published: August 2024

Objective

A clear relationship between higher surgeon volume and improved outcomes has not been convincingly established in rectal cancer surgery. The aim of this study was to evaluate the impact of individual surgeon’s caseload and hospital volume on perioperative outcome.

Methods

We retrospectively analyzed 336 consecutive patients undergoing oncological resection for rectal cancer at two Viennese hospitals between 1 January 2015 and 31 December 2020. The effect of baseline characteristics as well as surgeons’ caseloads (low volume: 0–5 cases per year, high volume > 5 cases per year) on postoperative complication rates (Clavien-Dindo Classification groups of < 3 and ≥ 3) were evaluated.

Results

No differences in baseline characteristics were found between centers in terms of sex, smoking status, or comorbidities of patients. Interestingly, only 14.7% of surgeons met the criteria to be classified as high-volume surgeons, while accounting for 66.3% of all operations. There was a significant difference in outcomes depending on the treating center in univariate and multivariate binary logistic regression analysis (odds ratio (OR) = 2.403, p = 0.008). Open surgery was associated with lower complication rates than minimally invasive approaches in univariate analysis (OR = 0.417, p = 0.003, 95%CI = 0.232–0.739) but not multivariate analysis. This indicated that the center’s policy rather than surgeon volume or mode of surgery impact on postoperative outcomes.

Conclusion

Treating center standards impacted on outcome, while individual caseload of surgeons or mode of surgery did not independently affect complication rates in this analysis. The majority of rectal cancer resections are performed by a small number of surgeons in Viennese hospitals.
Can we improve the management of inoperable malignant bowel obstruction? Results of a feasibility study of elemental diet as an alternative to parenteral nutrition in patients with advanced gynaecological cancer
Authors: Allan Lindsey L. , Skene Simon S. , Eastley Kate Bennett , Herbertson Rebecca , Smith Eleanor , Michael Agnieszka
Published: August 2024

Purpose

Nutrition support in inoperable bowel obstruction (IBO) remains challenging. Parenteral nutrition (PN) is recommended if the prognosis is > 2 months. An elemental diet (ED) is licensed for strictures in Crohn’s disease but has not been used in malignant bowel obstruction. The aim of this study was to evaluate the use of ED in patients with IBO and provide a proof of concept of ED as an acceptable feeding option.

Methods

This was a mixed-methods single-arm feasibility study. The primary endpoint was to provide a ‘proof of concept’ of ED as an acceptable feeding option for patients with IBO. Secondary endpoints included taste acceptability, incidences of vomiting and pain, the proportion of women who tolerated ED, the number of cartons drunk, quality of life (QOL) and the number of women treated with chemotherapy. Patients (> 18 years) with CT-confirmed IBO who could tolerate 500 ml of liquid in 24 h remained on the trial for 2 weeks.

Results

A total of 29 patients were recruited; of those, 19 contributed to the analysis for the primary endpoint; 13 (68.4%) participants tolerated the ED; 26 patients contributed to MSAS and EORTC QLQ questionnaires at baseline to allow for the assessment of symptoms. At the start of the study, 18 (69%) of patients experienced vomiting, reducing to 4 (25%) by the end of day 15 of the study; 24 (92%) of patients reported pain at consent, reducing to 12 (75%) by the end of day 15. QOL scores improved from 36.2 (95% CI 27.7–44.7) at baseline to 53.1 (95% CI 40.3–66) at the end of day 15; 16 (84%) participants commenced chemotherapy within the first week of starting ED. The number of cartons across all participants showed a median of 1.3 cartons per day (range 0.8 to 2.5).

Conclusion

ED is well tolerated by patients with IBO caused by gynaecological malignancies and may have a positive effect on symptom burden and QOL.
Pipeline and dataset generation for automated fact-checking in almost any language
Authors: Drchal Jan , Ullrich Herbert , Mlynář Tomáš , Moravec Václav
Published: August 2024

This article presents a pipeline for automated fact-checking leveraging publicly available language models and data. The objective is to assess the accuracy of textual claims using evidence from a ground-truth evidence corpus. The pipeline consists of two main modules—the evidence retrieval and the claim veracity evaluation. Our primary focus is on the ease of deployment in various languages that remain unexplored in the field of automated fact-checking. Unlike most similar pipelines, which work with evidence sentences, our pipeline processes data on a paragraph level, simplifying the overall architecture and data requirements. Given the high cost of annotating language-specific fact-checking training data, our solution builds on the question answering for claim generation method, which we adapt and use to generate the data for all models of the pipeline. Our strategy enables the introduction of new languages through machine translation of only two fixed datasets of moderate size. Subsequently, any number of training samples can be generated based on an evidence corpus in the target language. We provide open access to all data and fine-tuned models for Czech, English, Polish, and Slovak pipelines, as well as to our codebase that may be used to reproduce the results.  We comprehensively evaluate the pipelines for all four languages, including human annotations and per-sample difficulty assessment using Pointwise $${\mathcal {V}}$$
V
-information. The presented experiments are based on full Wikipedia snapshots to promote reproducibility. To facilitate implementation and user interaction, we develop the FactSearch application featuring the proposed pipeline and the preliminary feedback on its performance.
Analysis of phase shift between pulse oscillations of macro- and microvascular cerebral blood flow in patients with traumatic brain injury
Authors: Kasprowicz Magdalena , Hendler Marta , Ziółkowski Arkadiusz , Nasr Nathalie , Czosnyka Marek
Published: August 2024

Purpose

After a traumatic brain injury (TBI), monitoring of both macrovascular and microvascular blood circulation can potentially yield a better understanding of pathophysiology of potential secondary brain lesions. We investigated the changes in phase shift (PS) between cardiac-induced oscillations of cerebral blood flow (CBF) measured at macro (ultrasound Doppler) and microvascular (laser Doppler) level. Further we assessed the impact of intracranial pressure (ICP) on PS in TBI patients. A secondary aim was to compare PS to TCD-derived cerebral arterial time constant (τ), a parameter that reflects the circulatory transit time.

Methods

TCD blood flow velocities (FV) in the middle cerebral artery, laser Doppler blood microcirculation flux (LDF), arterial blood pressure (ABP), and ICP were monitored in 29 consecutive patients with TBI. Eight patients were excluded because of poor-quality signals. For the remaining 21 patients (median age = 23 (Q1: 20–Q3: 33); men:16,) data were retrospectively analysed. PS between the fundamental harmonics of FV and LDF signals was determined using spectral analysis. τ was estimated as a product of cerebrovascular resistance and compliance, based on the mathematical transformation of FV and ABP, ICP pulse waveforms.

Results

PS was negative (median: −26 (Q1: −38–Q3: −15) degrees) indicating that pulse LDF at a heart rate frequency lagged behind TCD pulse. With rising mean ICP, PS became more negative (R = −0.51, p < 0.019) indicating that delay of LDF pulse increases. There was a significant correlation between PS and cerebrovascular time constant (R = −0.47, p = 0.03).

Conclusions

Pulse divergence between FV and LDF became greater with elevated ICP, likely reflecting prolonged circulatory travel time.
Variations of the extrapsoas course of the lumbar plexus with implications for the lateral transpsoas approach to the lumbar spine: a cadaveric study
Authors: Benes Michal , Zido Michal , Machac Petr , Kaiser Radek , Khadanovich Anhelina , Nemcova Simona , Kunc Vojtech , Kachlik David
Published: August 2024

Background

Together with an increased interest in minimally invasive lateral transpsoas approach to the lumbar spine goes a demand for detailed anatomical descriptions of the lumbar plexus. Although definitions of safe zones and essential descriptions of topographical anatomy have been presented in several studies, the existing literature expects standard appearance of the neural structures. Therefore, the aim of this study was to investigate the variability of the extrapsoas portion of the lumbar plexus in regard to the lateral transpsoas approach.

Methods

A total of 260 lumbar regions from embalmed cadavers were utilized in this study. The specimens were dissected as per protocol and all nerves from the lumbar plexus were morphologically evaluated.

Results

The most common variation of the iliohypogastric and ilioinguinal nerves was fusion of these two nerves (9.6%). Nearly in the half of the cases (48.1%) the genitofemoral nerve left the psoas major muscle already divided into the femoral and genital branches. The lateral femoral cutaneous nerve was the least variable one as it resembled its normal morphology in 95.0% of cases. Regarding the variant origins of the femoral nerve, there was a low formation outside the psoas major muscle in 3.8% of cases. The obturator nerve was not variable at its emergence point but frequently branched (40.4%) before entering the obturator canal. In addition to the proper femoral and obturator nerves, accessory nerves were present in 12.3% and 9.2% of cases, respectively.

Conclusion

Nerves of the lumbar plexus frequently show atypical anatomy outside the psoas major muscle. The presented study provides a compendious information source of the possibly encountered neural variations during retroperitoneal access to different segments of the lumbar spine.
Integrating artificial intelligence with expert knowledge in global environmental assessments: opportunities, challenges and the way ahead
Authors: Muccione Veruska , Vaghefi Saeid Ashraf , Bingler Julia , Allen Simon K. , Kraus Mathias , Gostlow Glen , Wekhof Tobias , Colesanti-Senni Chiara , Stammbach Dominik , Ni Jingwei , Schimanski Tobias , Yu Tingyu , Wang Qian , Huggel Christian , Luterbacher Juerg , Biesbroek Robbert , Leippold Markus
Published: August 2024

With new cycles of global environmental assessments (GEAs) recently starting, including GEO-7 and IPCC AR7, there is increasing need for artificial intelligence (AI) to support in synthesising the rapidly growing body of evidence for authors and users of these assessments. In this article, we explore recent advances in AI and connect them to the different stages of GEAs showing how some processes can be automatised and streamlined. The meticulous and labour-intensive nature of GEAs serves as both a valuable strength and a challenge to staying pertinent and current in today’s era of urgency and the pursuit of the latest knowledge. Utilising AI tools for reviewing and synthesizing scientific literature holds the evident promise of substantially lessening the workload for experts and expediting the assessment process. This, in turn, could lead to more frequent report releases and a smoother integration of the latest scientific advancements into actionable measures. However, successful outcomes can only be achieved if domain experts co-develop and oversee the deployment of such tools together with AI researchers. Otherwise, these tools run the risk of producing inaccurate, incomplete, or misleading information with significant consequences. We demonstrate this through a few examples that compare recently deployed large language models (LLMs) based tools in their performance in capturing nuanced concepts in the context of the reports of the Intergovernmental Panel on Climate Change (IPCC). We recommend establishing ethical committees and organising dedicated expert meetings to develop best practice guidelines, ensuring responsible and transparent integration of AI into GEAs.
Treatment of anal fistulas with Obsidian RFT®: just another autologous compound platelet-rich fibrin foam?
Authors: Dawoud C. , Girgis K. , Stift A. , Harpain F. , Riss S.
Published: August 2024

Background

Sphincter-preserving techniques like autologous compound platelet-rich fibrin foam have gained popularity, offering potential for better functional outcomes in anal fistula treatment. The present study aimed to evaluate the efficacy and safety of Obsidian RFT®.

Methods

The study conducted a retrospective analysis from January 2018 to December 2022 on patients who received anal fistula closure with Obsidian RTF® at the Department of General Surgery, Medical University of Vienna. Clinical diagnosis, complemented by radiographic imaging, was employed to confirm inconclusive cases.

Demographic and fistula characteristics and postoperative data were collected from electronic records following STROCSS criteria.

Results

Fifteen patients received Obsidian RFT® treatment for anal fistulas. We found no intra- and postoperative complications. The median hospital stay was 3 days. After a median follow-up of 32 months, a closure rate of 53.3% was detected.

Non-significant differences were observed in various variables, yet trends emerged, indicating associations between abscess presence and non-healing fistulas. A distinct age threshold (≥ 42.7 years) served as an indicator for an inability to achieve anal fistula cure.

Conclusion

Obsidian RFT® represents a safe, minimally invasive operative procedure. Approximately half the patients experienced healing, with better outcome in a younger population.

Trial Registration

Ethical Approval number Medical University of Vienna (#1258/2018). This study was registered retrospectively in ClinicalTrials.gov (NCT06136325).
Late quaternary palaeoclimates in the lower Kürtün valley (Samsun, Northern Türkiye) through multi-proxy analysis of palaeosoil sediments
Authors: Uzun Ali , Sandıkçıoğlu Merve , Kayseri Özer Mine Sezgül , Küçükuysal Ceren
Published: August 2024

Palaeoclimatic and palaeoenvironmental proxy data are presented for the Late Quaternary based on mineralogical, geochemical and palynological analysis of a palaeosoil-sediment section in the lower Kürtün Valley (Samsun region, Northern Türkiye). The geochronology along the section is established based on OSL and radiocarbon dating. The base of the palaeosoil-sediment section consists of a palaeo-terrace fill of the Kürtün Creek dated to 108 ± 9 ka, corresponding to the last interglacial period (MIS5c). After this warm and humid period, the last ice age began. Sea level dropped and the Kürtün Stream deepened its bed. Fluvial terrace deposits were covered with colluvial materials and a palaeosoil sequence formed. The bottommost part of the palaeosoil formation carries the fingerprints of a dry climate of 68 ± 9 ka ago (MIS4). The middle part of the section coincides with MIS2 (28,959 cal BP) and is characterized by humid conditions with arid pulses accompanied by the occurrences of calcrete nodules. The palaeosoil-sediment section ends with the records of MIS1 (8381 cal BP), corresponding to warmer and more humid conditions. This study emphasizes the importance of palaeosoil-calcrete formation in the lower Kürtün Valley for explaining climate changes from MIS5c to MIS1. The results are compatible with studies conducted in the Eastern Mediterranean. High-resolution multi-proxy studies are recommended to better understand the connection between local climates and global climate phenomena in the Late Quaternary.
Three-way decision in machine learning tasks: a systematic review
Authors: Campagner Andrea , Milella Frida , Ciucci Davide , Cabitza Federico
Published: August 2024

In this article, we survey the applications of Three-way decision theory (TWD) in machine learning (ML), focusing in particular on four tasks: weakly supervised learning and multi-source data management, missing data management, uncertainty quantification in classification, and uncertainty quantification in clustering. For each of these four tasks we present the results of a systematic review of the literature, by which we report on the main characteristics of the current state of the art, as well as on the quality of reporting and reproducibility level of the works found in the literature. To this aim, we discuss the main benefits, limitations and issues found in the reviewed articles, and we give clear indications and directions for quality improvement that are informed by validation, reporting, and reproducibility standards, guidelines and best practice that have recently emerged in the ML field. Finally, we discuss about the more promising and relevant directions for future research in regard to TWD.
A Note on the Codegree of Finite Groups
Authors: Lewis Mark L. , Yan Quanfu
Published: August 2024

Let$$\chi $$χbe an irreducible character of a groupG,  and$$S_c(G)=\sum _{\chi \in \textrm{Irr}(G)}\textrm{cod}(\chi )$$Sc(G)=∑χ∈Irr(G)cod(χ)be the sum of the codegrees of the irreducible characters ofG. Write$$\textrm{fcod} (G)=\frac{S_c(G)}{|G|}.$$fcod(G)=Sc(G)|G|.We aim to explore the structure of finite groups in terms of$$\textrm{fcod} (G).$$fcod(G).On the other hand, we determine the lower bound of$$S_c(G)$$Sc(G)for nonsolvable groups and prove that ifGis nonsolvable, then$$S_c(G)\geqslant S_c(A_5)=68,$$Sc(G)⩾Sc(A5)=68,with equality if and only if$$G\cong A_5.$$G≅A5.Additionally, we show that there is a solvable group so that it has the codegree sum as$$A_5.$$A5.
Intergroup cooperation in the lab: asymmetric power relations and redistributive policies
Authors: Mitterbacher Kerstin , Palan Stefan , Fleiß Jürgen
Published: August 2024

We study intra- and intergroup cooperation in the production and distribution of a jointly created good. Over several periods, members of one group can choose whether or not to contribute to the good’s production. Members of the other group vote to implement a fair or a discriminatory sharing policy for the good’s proceeds. More cooperative behavior by members of an outgroup renders ingroup members more willing to cooperate in turn. Our experiment documents reciprocity in intergroup cooperation settings. This reciprocity at times leads to mutually beneficial cooperation but when one group defects, it may also lead to cooperation breaking down. Understanding how one group’s cooperation influences another group’s decisions can improve resource allocation as well as influence policy-makers’ decisions towards fairer distribution strategies.
A game theoretic approach for tradable white certificates regarding energy rebound and government intervention
Authors: Safarzadeh Soroush , Rasti-Barzoki Morteza , Altmann Jörn , Moon Ilkyeong
Published: August 2024

In recent decades, many government administrations have tracked energy efficiency programs (EEPs) against environmental concerns. This was done so that it could potentially be useful as a supportive mechanism for smart technologies applied under the smart city concept. To facilitate this, tradable white certificates (TWCs) have been implemented as popular financial instruments used by energy-intensive sectors to boost cleaner production. In this study, we address an industrial EEP development with a TWC instrument as a multi-agent problem. We study this problem for the first time in the context of a supply chain that includes a manufacturer, an energy producer, and household energy consumers. Furthermore, we explore a new monopolistic pricing model for energy services and energy-efficient products, regarding the rebound effect, energy consumption, and social welfare. Additionally, we discuss two revenue-cost-sharing contracts and compare them as contracts using a comprehensive parametric and experimental analysis. The results show that the second proposed contract has some advantages over the first one. However, the second contract leads to less production than the first one does, while at the same time leading to less social welfare. Also, the findings suggest that the second investigated contract is a more appropriate instrument for the obligated parties than the first one when the aim is to improve the performance of TWC schemes. These findings can provide better circumstances for governance to optimize the critical parameters’ level on TWC schemes with the lowest analytical cost.

Graphical abstract