bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy Efficiency Improvement in Industrial Brownfield Heritage Buildings: Case Study of “Beko”
Authors: Pavlović Jelena , Šabanović Ana , Ćuković-Ignjatović Nataša
Published: June 2023

Brownfield sites often form on industrial sites of once successful companies dating from the era of industrialization, due to loss of active function and despite their historical significance. Accompanied by urban decline, they contribute to continuous pollution, decrease in economic values, as well as loss of local identity. On the other hand, they represent a reserve of space of great potential in central urban locations. The main purpose of this research is to examine possibilities for improvement by their reuse, while preserving built-in cultural values and acknowledging contemporary requirements. A review of contemporary literature considering the concept of brownfield sites provides a starting theoretical basis for understanding their strengths and potentials, as well as the problems when redeveloping such sites. The subject of the research is exploring strategies for brownfield revitalization while reactivating industrial buildings through adaptive reuse. This includes sustainable solutions in accordance with modern requirements, especially energy efficiency, as one of the main concepts of existing building stock improvement that recognizes importance of responsible energy resources management. The paper includes a case study of the previously devastated brownfield site of “Beko” industrial building, located in the central urban area of Belgrade. Its former state, as well as parts of the documentation for reconstruction and its conversion into a modern business facility “Kalemegdan Business Center,” is thoroughly analyzed, emphasizing the positive results of energy efficiency improvements despite the restrictions intended for historic buildings alterations. The aim of the paper is to create a theoretical platform that provides firm arguments in favor of realizing the importance and potentials of industrial brownfield sites revitalization at present, as well as the constraints regarding its practical implementation considering buildings of cultural value.
Challenges and Potentials of Green Roof Retrofit: A Case Study
Authors: Miletić Nikola , Zeković Bojana , Ignjatović Nataša Ćuković , Ignjatović Dušan
Published: June 2023

Green roofs are becoming common practice in building new public buildings and are considered the roofs for the future since they address the issue of energy and environment simultaneously, providing social, environmental and economic benefits. Despite these benefits, retrofitting an existing building with a green roof is not widely practiced. Undergoing such a project is no small task since it requires a thorough investigation of existing building's constraints, functional, material, and technological to even begin considering design options. Therefore, this process requires specific, case-sensitive approach, especially with the aim of improving the building’s energy performance. This paper presents a methodological approach and design proposals of a green roof retrofit project, through a case study of Belgrade’s “City Housing” building. This retrofit project presents an interesting research topic since it incorporates three distinct roofs, of all of different types, different ways of accessibility and levels of privacy, varying top-to-bottom from a simple extensive roof through a semi-public semi/intensive roof garden to a ground-level public park with trees and intensive vegetation. Also, since this building provides socially significant services, it is frequently visited by general public which presents a potential for introducing educational and demonstration elements in the retrofit project, not only the functional and technological ones. That way, this project can be a showcase example, promoting greening the roofs of Belgrade’s existing public buildings as a way of improving their energy performance.
COGNIBUILD: Cognitive Digital Twin Framework for Advanced Building Management and Predictive Maintenance
Authors: Agostinelli Sofia
Published: June 2023

According to contemporary challenges of digital evolution in management and maintenance of construction processes, the present study aims at defining valuable strategies for building management optimization. As buildings’ and infrastructures’ Digital Twins (DT) are directly connected to physical environment through the Internet of Things (IoT), asset management and control processes can be radically transformed. The proposed DT framework connects building information model (BIM) three-dimensional objects to information about the planned maintenance of components, supplying system’s self-learning capabilities through input data coming from Building Management Systems (BMSs), ticketing, as well as maintenance activities’ data flow both as-needed or unexpected. The concept of real-time acquisition and data processing set the basis for the proposed system architecture, allowing to perform analysis and evaluate alternative scenarios promptly responding to unexpected events with a higher accuracy over time. Moreover, the integration of artificial intelligence (AI) allows the development of maintenance predictive capabilities, optimizing decision-making processes and implementing strategies based on the performed analysis, configuring a scalable approach useful for different scenarios. The proposed approach is related to the evolution from reactive to proactive strategies based on Cognitive Digital Twins (CDTs) for Building and Facility Management, providing actionable solutions through operational, monitoring and maintenance data. Through the integration of BIM data with information systems, BMS, IoT and machine learning, the optimization and real-time automation of maintenance activities are performed, radically reducing failures and systems’ breakdowns. Therefore, integrating different technologies in a virtual environment allows to define data-driven predictive models supporting Building Managers in decision-making processes improving efficiency over time and moving from reactive to proactive approaches.
A New Generation of Territorial Healthcare Infrastructures After COVID-19. The Transition to Community Homes and Community Hospitals into the Framework of the Italian Recovery Plan
Authors: Brambilla Andrea , Brusamolin Erica , Arruzzoli Stefano , Capolongo Stefano
Published: June 2023

COVID-19 disrupted existing processes and accelerated the rethinking of healthcare spaces, functions, and model of care, stressing the ineffectiveness of the territorial health network in the Italian National Health System (NHS). Within the framework of European Recovery Plan (Next Generation EU), Italy’s Piano Nazionale di Ripresa e Resilienza (PNRR) allocated €15.63 Bn in the Mission 6 “Health” to strengthen proximity networks, facilities, and telemedicine for territorial healthcare. Aware of the importance that the physical built environment plays in the process of care delivery and health promotion and prevention, €3 Bn has been allocated to the planning, design, and construction of two new low-care typologies in a vision of person-centered healthcare: the Community Home (Casa della Comunità-CdC), and the Community Hospital (Ospedale di Comunità-OdC). It has been estimated that 795 new CdCs and 381 new OdCs will completed before 2026 as novel buildings or renovation of existing healthcare facilities. Although in European context several best practices are present in terms of integration of healthcare architectures into the urban context (Spanish Health Centers or Swedish Primary Care Centers), the Italian experience is generally outdated, with some regional exceptions; there is the need to understand the architectural characteristics of such new typologies. Therefore, the aim of the paper is to shed light on the spatial, functional, technological, and organizational needs and requirements of CdC and OdCs and to map the different regional requirements in a systematic and structured framework. The methods adopted in the study include a review of national and regional guidelines, data collection from National agency for regional health services (AGENAS) databases, and comparison matrix development of the different requirements in Italian regions. The results will highlight technological and architectural implications of territorial health centers implementation.
Rights Claims in Anti-abortion Campaigns in Poland and Sweden
Authors: Selberg Rebecca , Kolankiewicz Marta
Published: June 2023

This chapter presents two case analyses, one situated in Sweden and the other in Poland, where attempts have been made to intervene in the existing laws regulating access to abortion. The first case involves the lawsuits filed by midwives in Sweden who claimed to have been discriminated against on the grounds of their religion when they had been turned down for work due to their objection to performing abortion as part of the job description. The second is that of a Polish civic legislative initiative aimed at restricting the prevailing abortion legislation in Poland in cases of foetal anomalies. We explore the rights claims deployed in these anti-abortion campaigns with an aim to contribute to the growing feminist scholarship on rhetorical devices and mobilisation tactics employed in the struggles over access to abortion. The two cases illustrate how anti-abortion mobilisations have been using rights claims that traditionally had been employed by feminist movements fighting for access to abortion. While it can be observed that this trend is part of a broader development of what has been described as a transnational anti-gender movement’s appeal to the law, our analyses illustrate different and context-sensitive ways in which rights claims are articulated.
Integrable Wilson loops in ABJM: a Y-system computation of the cusp anomalous dimension
Authors: Correa Diego H. , Giraldo-Rivera Victor I. , Lagares Martín
Published: June 2023

Abstract

We study the integrability properties of Wilson loops in the 𝒩 = 6 three-dimensional Chern-Simons-matter (ABJM) theory. We begin with the construction of an open spin chain that describes the anomalous dimensions of operators inserted along the contour of a 1/2 BPS Wilson loop. Moreover, we compute the all-loop reflection matrices that govern the interaction of spin-chain excitations with the boundary, including their dressing factors, and we check them against weak- and strong-coupling results. Furthermore, we propose a Y -system of equations for the cusped Wilson line of ABJM, and we use it to reproduce the one-loop cusp anomalous dimension of ABJM from a leading-order finite-size correction. Finally, we write a set of BTBA equations consistent with the Y -system proposal.
The arthroscopic treatment of anterior shoulder instability with glenoid bone loss shows similar clinical results after Latarjet procedure and iliac crest autograft transfer
Authors: Bockmann Benjamin , Nebelung Wolfgang , Gröger Falk , Leuzinger Jan , Agneskirchner Jens , Brunner Ulrich , Seybold Dominik , Streich Jörg , Bartsch Stefan , Schicktanz Katharina , Maier Dirk , Königshausen Matthias , Patzer Thilo , Venjakob Arne Johannes
Published: June 2023

Purpose

Recurrent anterior shoulder instability caused by critical bone loss of the glenoid is a challenging condition for shoulder surgeons. The purpose of this prospective multicenter trial was to compare the arthroscopic transfer of the coracoid process (Latarjet procedure) with the arthroscopic reconstruction of the glenoid using iliac crest autografts.

Methods

A prospective multi‐center trial was performed in nine orthopaedic centres in Austria, Germany and Switzerland between July 2015 and August 2021. Patients were prospectively enrolled and received either an arthroscopic Latarjet procedure or an arthroscopic iliac crest graft transfer. Standardized follow‐up after 6 months and mimimum 24 months included range of motion, Western Ontario stability index (WOSI), Rowe score and subjective shoulder value (SSV). All complications were recorded.

Results

177 patients (group Latarjet procedure: n = 110, group iliac crest graft: n = 67) were included in the study. WOSI (n.s.), SSV (n.s.) and Rowe score (n.s.) showed no difference at final follow‐up. 10 complications were seen in group Latarjet procedure and 5 in group iliac crest graft; the frequency of complications did not differ between the two groups (n.s.).

Conclusion

The arthrosopic Latarjet procedure and arthroscopic iliac crest graft transfer lead to comparable results regarding clinical scores, frequency of recurrent dislocations and complication rates.

Level of evidence

Level II.
Satisfactory long‐term outcomes for combined anterior cruciate ligament reconstruction and lateral closing wedge high tibial osteotomy
Authors: Agostinone Piero , Lucidi Gian Andrea , Dal Fabbro Giacomo , Di Paolo Stefano , Pagano Anna , Viotto Marianna , Neri Maria Pia , Grassi Alberto , Zaffagnini Stefano
Published: June 2023

Purpose

A combined anterior cruciate ligament (ACL) reconstruction and high tibial osteotomy (HTO) is considered a valuable treatment in young patients affected by symptomatic medial osteoarthritis and ACL deficiency. However, only a few studies have investigated the outcomes of this procedure, especially in the long term. Therefore, the aim of this study is to report clinical and radiographic outcomes of ACL reconstruction and lateral closing wedge HTO at a mean of 14 years of follow‐up.

Methods

Patients were prospectively evaluated pre‐operatively, after 6.5 ± 2.7 years and 14.3 ± 2.2 years. Patient‐reported outcome measures (PROMs) were collected, knee laxity was assessed through KT‐1000 arthrometer, and limb alignment and knee osteoarthritis were evaluated on long‐cassette radiographs. Survivorship of the surgical procedure was calculated through the Kaplan–Meier method.

Results

32 patients were initially enrolled and completed the mid‐term evaluation (6.5 ± 2.7 years), and 23 patients (72%) were available for the final evaluation at 14.3 ± 2.2 years after surgery. Statistically significant improvement was found for all the clinical scores (VAS, WOMAC, Tegner, subjective IKDC, objective IKDC) between the pre‐operative status and the mid‐term follow‐up (p < .001). VAS, subjective IKDC and objective IKDC showed no statistically significant differences (p > .05) between the mid‐term and the final follow‐up; a significant decrease of WOMAC (p < .05) and Tegner (p < .001) was found from mid‐term to final follow‐up. Significant progression of osteoarthritis was found for all the knee compartments. The survivorship was 95.7% at 5 years, 82.6% at 10 years, and 72.8% at 15 years.

Conclusions

Combined ACL reconstruction and lateral closing wedge HTO showed satisfactory clinical outcomes and survivorship at a mean of 14 years follow‐up.

Level of evidence

IV.
The mediating role of levers of controls on the association between sustainable leadership and organisational resilience
Authors: Baird Kevin , Su Sophia , Munir Rahat
Published: June 2023

This study examines the mediating role of Simons’ (Levers of control: How managers use innovative control systems to drive strategic renewal, Harvard Business School Press, 1995) levers of control (belief systems, boundary controls, interactive use of controls, diagnostic use of controls) on the association between sustainable leadership and organisational resilience. Data was collected using a mail survey of 410 Australian middle level managers. The results reveal that three of the levers of control (belief systems, interactive use of controls, and diagnostic use of controls) mediate the influence of sustainable leadership on organisational resilience, with sustainable leadership exhibiting both a direct and indirect (through the levers) influence on organisational resilience. The findings contribute to the organisational resilience literature by providing an insight into the crucial role of the levers of control in facilitating the effectiveness of the sustainable leadership approach i.e. through enhancing organisational resilience. Accordingly, managers are advised to enhance organisational resilience through employing a sustainable leadership approach and employing belief systems and the interactive and diagnostic use of controls.
Effective isolation of cannabidiol and cannabidiolic acid free of psychotropic phytocannabinoids from hemp extract by fast centrifugal partition chromatography
Authors: Maly Matej , Benes Frantisek , Binova Zuzana , Zlechovcova Marie , Kastanek Petr , Hajslova Jana
Published: June 2023

Cannabidiol (CBD), together with its precursor cannabidiolic acid (CBDA), is the major phytocannabinoid occurring in most hemp cultivars. To ensure the safe use of these compounds, their effective isolation from hemp extract is required, with special emphasis on the elimination of ∆9-tetrahydrocannabinol (∆9-THC) and ∆9-tetrahydrocannabinolic acid (∆9-THCA-A). In this study, we demonstrate the applicability of fast centrifugal partition chromatography (FCPC) as a challenging format of counter-current preparative chromatography for the isolation of CBD and CBDA free of psychotropic compounds that may occur in Cannabis sativa L. plant extracts. Thirty-eight solvent mixtures were tested to identify a suitable two-phase system for this purpose. Based on the measured partition coefficients (KD) and separation factors (α), the two-phase system consisting of n-heptane:ethyl acetate:ethanol:water (1.5:0.5:1.5:0.5; v:v:v:v) was selected as an optimal solvent mixture. Employing UHPLC-HRMS/MS for target analysis of collected fractions, the elution profiles of 17 most common phytocannabinoids were determined. Under experimental conditions, the purity of isolated CBD and CBDA was 98.9 and 95.1% (w/w), respectively. Neither of ∆9-THC nor of ∆9-THCA-A were present; only trace amounts of other biologically active compounds contained in hemp extract were detected by screening against in-house spectral library using UHPLC-HRMS.

Graphical abstract
Continuous use of visual information about the position of the moving hand
Authors: Brenner Eli , Smeets Jeroen B. J.
Published: June 2023

People generally look at a target when they want to reach for it. Doing so presumably helps them continuously update their judgments about the target’s position and motion. But not looking at their hand does not prevent people from updating judgments about its position on the basis of visual information, because people do respond to experimental perturbations of visual information about the position of their hand. Here, we study such responses by adding jitter to the movement of a cursor that follows participants’ fingers. We analyse the response to the jitter in a way that reveals how the vigour of the response depends on the moment during the movement at which the change in cursor position occurs. We compare the change in vigour to that for equivalent jitter in the position of the target. We find that participants respond to jitter in the position of a cursor in much the same way as they respond to jitter in the target’s position. The responses are more vigorous late in the movement, when adjustments need to be made within less time, but similarly so for the cursor as for the target. The responses are weaker for the cursor, presumably because of the jitter-free kinaesthetic information about the position of the finger.
Combining high pressure and electric fields towards Nannochloropsis oculata eicosapentaenoic acid-rich extracts
Authors: Sousa Sérgio , Carvalho Ana P. , Pinto Carlos A. , Amaral Renata A. , Saraiva Jorge A. , Pereira Ricardo N. , Vicente António A. , Freitas Ana C. , Gomes Ana M.
Published: June 2023

Nannochloropsis oculata is naturally rich in eicosapentaenoic acid (EPA). To turn this microalga into an economically viable source for commercial applications, extraction efficiency must be achieved. Pursuing this goal, emerging technologies such as high hydrostatic pressure (HHP) and moderate electric fields (MEF) were tested, aiming to increase EPA accessibility and subsequent extraction yields. The innovative approach used in this study combined these technologies and associated tailored, less hazardous different solvent mixtures (SM) with distinct polarity indexes. Although the classical Folch SM with chloroform: methanol (PI 4.4) provided the highest yield concerning total lipids (166.4 mglipid/gbiomass), diethyl ether: ethanol (PI 3.6) presented statistically higher values in terms of EPA per biomass, corresponding to 1.3-fold increase. When SM were used in HHP and MEF, neither technology independently improved EPA extraction yields, although the sequential combination of technologies did result in 62% increment in EPA extraction. Overall, the SM and extraction methodologies tested (HHP—200 MPa, 21 °C, 15 min, followed by MEF processing at 40 °C, 15 min) enabled increased EPA extraction yields from wet N. oculata biomass. These findings are of high relevance for the food and pharmaceutical industries, providing viable alternatives to the “classical” extraction methodologies and solvents, with increased yields and lower environmental impact.

Key points

• Et2O: EtOH is a less toxic and more efficient alternative to Folch solvent mixture

• HHP or MEF per se was not able to significantly increase EPA extraction yield

• Combinations of HHP and MEF technologies increased both lipids and EPA yields

Graphical abstract
Correction to: EANM enabling guide: how to improve the accessibility of clinical dosimetry
Authors: Gear Jonathan , Stokke Caroline , Terwinghe Christelle , Gnesin Silvano , Sandström Mattias , Tran‑Gia Johannes , Cremonesi Marta , Cicone Francesco , Verburg Fredrik , Hustinx Roland , Giovanella Luca , Herrmann Ken , Gabiña Pablo Minguez
Published: June 2023

A correction to this paper has been published: https://doi.org/10.1007/s00259-023-06226-z.
Post-traumatic spinal hematoma in diffuse idiopathic skeletal hyperostosis (DISH)
Authors: Vierunen Riku M. , Haapamäki Ville V. , Koivikko Mika P. , Bensch Frank V.
Published: June 2023

Objectives

To determine the incidence of spinal hematoma and its relation to neurological deficit after trauma in patients with spinal ankylosis from diffuse idiopathic skeletal hyperostosis (DISH).

Materials and methods

A retrospective review of 2256 urgent or emergency MRI referrals over a period of 8 years and nine months revealed 70 DISH patients who underwent CT and MRI scans of the spine. Spinal hematoma was the primary outcome. Additional variables were spinal cord impingement, spinal cord injury (SCI), trauma mechanism, fracture type, spinal canal narrowing, treatment type, and Frankel grades during injury, before and after treatment. Two trauma radiologists reviewed MRI scans blinded to initial reports.

Results

Of 70 post-traumatic patients (54 men, median age 73, IQR 66–81) with ankylosis of the spine from DISH, 34 (49%) had spinal epidural hematoma (SEH) and 3 (4%) had spinal subdural hematoma, 47 (67%) had spinal cord impingement, and 43 (61%) had SCI. Ground-level fall (69%) was the most common trauma mechanism. A transverse, AO classification type B spine fracture (39%) through the vertebral body was the most common injury type. Spinal canal narrowing (p < .001) correlated and spinal cord impingement (p = .004) associated with Frankel grade before treatment. Of 34 patients with SEH, one, treated conservatively, developed SCI.

Conclusions

SEH is a common complication after low-energy trauma in patients with spinal ankylosis from DISH. SEH causing spinal cord impingement may progress to SCI if not treated by decompression.

Clinical relevance statement

Low-energy trauma may cause unstable spinal fractures in patients with spinal ankylosis caused by DISH. The diagnosis of spinal cord impingement or injury requires MRI, especially for the exclusion of spinal hematoma requiring surgical evacuation.

Key Points

• Spinal epidural hematoma is a common complication in post-traumatic patients with spinal ankylosis from DISH.

• Most fractures and associated spinal hematomas in patients with spinal ankylosis from DISH result from low-energy trauma.

• Spinal hematoma can cause spinal cord impingement, which may lead to SCI if not treated by decompression.
A self-supervised vision transformer to predict survival from histopathology in renal cell carcinoma
Authors: Wessels Frederik , Schmitt Max , Krieghoff-Henning Eva , Nientiedt Malin , Waldbillig Frank , Neuberger Manuel , Kriegmair Maximilian C. , Kowalewski Karl-Friedrich , Worst Thomas S. , Steeg Matthias , Popovic Zoran V. , Gaiser Timo , von Kalle Christof , Utikal Jochen S. , Fröhling Stefan , Michel Maurice S. , Nuhn Philipp , Brinker Titus J.
Published: June 2023

Purpose

To develop and validate an interpretable deep learning model to predict overall and disease-specific survival (OS/DSS) in clear cell renal cell carcinoma (ccRCC).

Methods

Digitised haematoxylin and eosin-stained slides from The Cancer Genome Atlas were used as a training set for a vision transformer (ViT) to extract image features with a self-supervised model called DINO (self-distillation with no labels). Extracted features were used in Cox regression models to prognosticate OS and DSS. Kaplan–Meier for univariable evaluation and Cox regression analyses for multivariable evaluation of the DINO-ViT risk groups were performed for prediction of OS and DSS. For validation, a cohort from a tertiary care centre was used.

Results

A significant risk stratification was achieved in univariable analysis for OS and DSS in the training (n = 443, log rank test,p < 0.01) and validation set (n = 266,p < 0.01). In multivariable analysis, including age, metastatic status, tumour size and grading, the DINO-ViT risk stratification was a significant predictor for OS (hazard ratio [HR] 3.03; 95%-confidence interval [95%-CI] 2.11–4.35;p < 0.01) and DSS (HR 4.90; 95%-CI 2.78–8.64;p < 0.01) in the training set but only for DSS in the validation set (HR 2.31; 95%-CI 1.15–4.65;p = 0.02). DINO-ViT visualisation showed that features were mainly extracted from nuclei, cytoplasm, and peritumoural stroma, demonstrating good interpretability.

Conclusion

The DINO-ViT can identify high-risk patients using histological images of ccRCC. This model might improve individual risk-adapted renal cancer therapy in the future.
The unremarkable alveolar epithelial glycocalyx: a thorium dioxide-based electron microscopic comparison after heparinase or pneumolysin treatment
Authors: Timm Sara , Lettau Marie , Hegermann Jan , Rocha Maria Linda , Weidenfeld Sarah , Fatykhova Diana , Gutbier Birgitt , Nouailles Geraldine , Lopez-Rodriguez Elena , Hocke Andreas , Hippenstiel Stefan , Witzenrath Martin , Kuebler Wolfgang M. , Ochs Matthias
Published: June 2023

Recent investigations analyzed in depth the biochemical and biophysical properties of the endothelial glycocalyx. In comparison, this complex cell-covering structure is largely understudied in alveolar epithelial cells. To better characterize the alveolar glycocalyx ultrastructure, unaffected versus injured human lung tissue explants and mouse lungs were analyzed by transmission electron microscopy. Lung tissue was treated with either heparinase (HEP), known to shed glycocalyx components, or pneumolysin (PLY), the exotoxin of Streptococcus pneumoniae not investigated for structural glycocalyx effects so far. Cationic colloidal thorium dioxide (cThO2) particles were used for glycocalyx glycosaminoglycan visualization. The level of cThO2 particles orthogonal to apical cell membranes (≙ stained glycosaminoglycan height) of alveolar epithelial type I (AEI) and type II (AEII) cells was stereologically measured. In addition, cThO2 particle density was studied by dual-axis electron tomography (≙ stained glycosaminoglycan density in three dimensions). For untreated samples, the average cThO2 particle level was ≈ 18 nm for human AEI, ≈ 17 nm for mouse AEI, ≈ 44 nm for human AEII and ≈ 35 nm for mouse AEII. Both treatments, HEP and PLY, resulted in a significant reduction of cThO2 particle levels on human and mouse AEI and AEII. Moreover, a HEP- and PLY-associated reduction in cThO2 particle density was observed. The present study provides quantitative data on the differential glycocalyx distribution on AEI and AEII based on cThO2 and demonstrates alveolar glycocalyx shedding in response to HEP or PLY resulting in a structural reduction in both glycosaminoglycan height and density. Future studies should elucidate the underlying alveolar epithelial cell type-specific distribution of glycocalyx subcomponents for better functional understanding.
Changes in diagnosis and operative treatment of insulinoma over two decades
Authors: Wiese D. , Humburg F. G. , Kann P. H. , Rinke A. , Luster M. , Mahnken A. , Bartsch D. K.
Published: June 2023

Purpose

Most insulinomas are small solitary, benign neoplasms. Imaging and surgical techniques improved over the last 20 years. Thus, the aim of the present study was to analyze changes in diagnosis and surgery of insulinoma patients in a referral center over two decades.

Methods

Operated patients with a histologically proven insulinoma were retrieved from a prospective database. Clinico-pathological characteristics and outcomes were retrospectively analyzed with regard to the time periods 2000–2010 (group 1) and 2011–2020 (group 2).

Results

Sixty-one of 202 operated patients with pNEN had an insulinoma, 37 (61%) in group 1 and 24 (39%) in group 2. Of those 61 insulinomas, 49 (80%) were sporadic benign, 8 (13%) benign MEN1-associated insulinomas, and 4 (7%) sporadic malignant insulinomas. In 35 of 37 (95%) patients of group 1 and all patients of group 2, the insulinoma was preoperatively identified by imaging. The most sensitive imaging modality was endoscopic ultrasound (EUS) with correctly diagnosed and localized insulinomas in 89% of patients in group 1 and 100% in group 2. In group 1, significantly less patients were operated via minimally invasive approach compared to group 2 (19% (7/37) vs. 50% (12/24), p = 0.022). Enucleation was the most frequently performed operation (31 of 61, 51%), followed by distal resection (15 of 61, 25%) without significant differences between groups 1 and 2. The rate of relevant postoperative complications was not different between groups 1 and 2 (24% vs. 21%, p = 0.99). Two patients with benign insulinoma (1 out of each group) experienced disease recurrence and underwent a second resection. After a median follow-up of 134 (1–249) months, however, all 57 (100%) patients with benign insulinoma and 3 out of 4 patients with malignant insulinoma had no evidence of disease.

Conclusion

Insulinoma can be preoperatively localized in almost all patients, allowing for a minimally invasive, parenchyma-sparing resection in selected patients. The long-term cure rate is excellent.
COVID-19-related adolescent mortality and morbidity in nineteen European countries
Authors: Cortés Jesus , Aguiar Pedro Manuel Vargues , Ferrinho Paulo
Published: June 2023

Prior to the COVID-19 pandemic, adolescents in most countries experienced a syndemic of malnutrition, obesity, deprivation, mental health problems, inequalities, and the effects of climate change. Today, other factors have added to this burden during the pandemic, and it is important to have an updated reflection. We aimed to assess the risk and protective factors for COVID-19-related adolescent mortality and morbidity in the European region. Three double models were fitted to analyze the relationship between different factors with the number of diagnosed cases and deaths. The 1a and 1b use a multiple Poisson regression. The 2a and 2b are optimized models that use the same variables as prior models but with backward selection with a p value < 0.05 as the limit. Finally, the 3a and 3b models (backward stepwise multivariable Poisson regression) include the variable “fully vaccinated.” All models used the at-risk population (15–19 years or total population) as a regression covariate (offset). Increased access to quality healthcare (IRR 0.68; CI 0.55–0.84), increased private sector involvement (IRR 0.86; CI 0.82–0.90), Gini coefficient (IRR 0.93; CI 0.88–0.99), and full vaccination (IRR 0.94; CI 0.90–0.99) represent protective factors of COVID-19 mortality in this population. Additionally, a positive association between pollution and mortality was found.

  Conclusion: Being fully vaccinated and having access to quality medical care are protective factors against COVID-19 mortality in this age group. Interestingly, the more the pollution, the greater the risk of dying from COVID-19. We stress the great importance of coordination between the public and private sectors to address crises such as the current one.

What is Known:

• Compared to other age groups, adolescents have been little studied, and most studies focused on mental health during the COVID-19 pandemic.

What is New:

• In this study, we show how in 19 European countries, different factors interact, such as socio-demographic, environmental, health system, and control measures with morbidity and mortality by COVID-19, in a very little studied age group as teenagers.
Process model analysis of parenchyma sparing laparoscopic liver surgery to recognize surgical steps and predict impact of new technologies
Authors: Gholinejad Maryam , Edwin Bjørn , Elle Ole Jakob , Dankelman Jenny , Loeve Arjo J.
Published: June 2023

Background

Surgical process model (SPM) analysis is a great means to predict the surgical steps in a procedure as well as to predict the potential impact of new technologies. Especially in complicated and high-volume treatments, such as parenchyma sparing laparoscopic liver resection (LLR), profound process knowledge is essential for enabling improving surgical quality and efficiency.

Methods

Videos of thirteen parenchyma sparing LLR were analyzed to extract the duration and sequence of surgical steps according to the process model. The videos were categorized into three groups, based on the tumor locations. Next, a detailed discrete events simulation model (DESM) of LLR was built, based on the process model and the process data obtained from the endoscopic videos. Furthermore, the impact of using a navigation platform on the total duration of the LLR was studied with the simulation model by assessing three different scenarios: (i) no navigation platform, (ii) conservative positive effect, and (iii) optimistic positive effect.

Results

The possible variations of sequences of surgical steps in performing parenchyma sparing depending on the tumor locations were established. The statistically most probable chain of surgical steps was predicted, which could be used to improve parenchyma sparing surgeries. In all three categories (i–iii) the treatment phase covered the major part (~ 40%) of the total procedure duration (bottleneck). The simulation results predict that a navigation platform could decrease the total surgery duration by up to 30%.

Conclusion

This study showed a DESM based on the analysis of steps during surgical procedures can be used to predict the impact of new technology. SPMs can be used to detect, e.g., the most probable workflow paths which enables predicting next surgical steps, improving surgical training systems, and analyzing surgical performance. Moreover, it provides insight into the points for improvement and bottlenecks in the surgical process.
Estimation of coconut maturity based on fuzzy neural network and sperm whale optimization
Authors: El-Shafeiy Engy , Abohany Amr A. , Elmessery Wael M. , El-Mageed Amr A. Abd
Published: June 2023

Coconut water is the clear liquid found inside coconuts, famous for rehydrating after exercise or while suffering from a minor sickness. The essential issue tackled in this paper is how to estimate the appropriate stage of maturity of coconut water, which is a time-consuming task in the beverage industry since, as the coconut age increases, the coconut water flavor varies. Accordingly, to handle this issue, an adaptive model based on Fuzzy Neural Network and Sperm Whale Optimization, dubbed FNN–SWO, is developed to assess coconut water maturity. The Sperm Whale Optimization (SWO) algorithm is a meta-heuristic optimization algorithm. It is embedded in this model along with neural networks and fuzzy techniques (FNN system), which can be employed as an essential building block in the beverage industry. The proposed FNN–SWO model is trained and tested utilizing fuzzy rules with an adaptive network. In contrast, the SWO algorithm is adopted to determine the optimal weights for the fuzzy rules. Three subsets of data divided according to three levels of coconut water maturity-tender, mature, and very mature, are used to validate the combined FNN–SWO model. Depending on these three subsets of data, a comparison of the proposed FNN–SWO model has been conducted against a set of the most common conventional techniques. These techniques include Support Vector Machine, Naïve Bayes, FNN, Artificial Neural Network, as well as their embedding with other meta-heuristic optimization algorithms. For various key performance indicators, such as recall, F1-score, specificity, and accuracy, the proposed FNN–SWO model provides the best prediction outcomes compared to the current time-consuming techniques. The dominance of the proposed FNN–SWO model is evident from the final findings compared to its time-consuming peers for estimating coconut water maturity on time. As a result, the proposed FNN–SWO model is an effective heuristic for locating optimal solutions to classification problems. It can thereby be reassuringly applicable to other similar prediction problems. Additionally, it would benefit the scientific community interested in evaluating coconut water.
Optimal incompatible Korn–Maxwell–Sobolev inequalities in all dimensions
Authors: Gmeineder Franz , Lewintan Peter , Neff Patrizio
Published: June 2023

We characterise all linear maps $${\mathscr {A}}:\mathbb R^{n\times n}\rightarrow \mathbb R^{n\times n}$$

A
:

R

n
×
n

→

R

n
×
n

such that, for $$1\le p<n$$

1
≤
p
<
n

, $$\begin{aligned} \left\Vert P\right\Vert _{{\text {L}}^{p^{*}}(\mathbb R^{n})}\le c\,\Big (\left\Vert {\mathscr {A}}[P]\right\Vert _{{\text {L}}^{p^{*}}(\mathbb R^{n})}+\left\Vert {\text {Curl}}P\right\Vert _{{\text {L}}^{p}(\mathbb R^{n})} \Big ) \end{aligned}$$

P

L

p

∗

(

R
n

)

≤
c

(

A
[
P
]

L

p

∗

(

R
n

)

+

Curl
P

L

p

(

R
n

)

)

holds for all compactly supported $$P\in {\text {C}}_{c}^{\infty }(\mathbb R^{n};\mathbb R^{n\times n})$$

P
∈

C

c

∞

(

R
n

;

R

n
×
n

)

, where $${\text {Curl}}P$$

Curl
P

displays the matrix curl. Being applicable to incompatible, that is, non-gradient matrix fields as well, such inequalities generalise the usual Korn-type inequalities used e.g. in linear elasticity. Different from previous contributions, the results gathered in this paper are applicable to all dimensions and optimal. This particularly necessitates the distinction of different combinations between the ellipticities of $${\mathscr {A}}$$
A
, the integrability p and the underlying space dimensions n, especially requiring a finer analysis in the two-dimensional situation.
Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early
Authors: Ringbom Ida , Suvisaari Jaana , Sourander Andre , Gissler Mika , Gyllenberg David
Published: June 2023

Psychiatric problems are risk markers for poor educational attainment. The number of adolescents receiving treatment has increased. We investigated whether the association between psychiatric problems in early adolescence and dropping out of school had changed. We used the register-based 1987 and 1997 Finnish Birth Cohort studies, which include all live births in Finland. Hospital districts with incomplete records were excluded, leaving 25,421 participants born in 1987 and 32,025 born in 1997. The main outcome was not having applied for secondary education by the year the cohort members turned 18. Our main predictors were psychiatric and neurodevelopmental disorders diagnosed by specialized services during 1998–2003 and 2008–2013, when the cohort members were 10–16 years old. We found that 511 (2.0) of subjects born in 1987 and 499 (1.6%) born in 1997 dropped out of school. Having any diagnosis at 10–16 of age was associated with dropping out of school early in both cohorts: 3.9% in 1987 and 4.8% in 1997. The highest proportions were in the subgroup with autism spectrum disorders (ASD), 19.4% in 1987 and 16.2% in 1997. Dropping out early increased among adolescents diagnosed with any psychiatric or neurodevelopmental disorder, from 3.9 to 4.8%, with the clearest increase for learning disabilities, from 3.4 to 9.0%. Dropping out decreased for those with depression, from 4.5 to 2.1%. Adolescents with psychiatric and especially neurodevelopmental disorders, need effective interventions to prevent them dropping out of school early. Increased detection of psychopathology did not result in decreased dropout rates.
A review of natural language processing in contact centre automation
Authors: Shah Shariq , Ghomeshi Hossein , Vakaj Edlira , Cooper Emmett , Fouad Shereen
Published: June 2023

Contact centres have been highly valued by organizations for a long time. However, the COVID-19 pandemic has highlighted their critical importance in ensuring business continuity, economic activity, and quality customer support. The pandemic has led to an increase in customer inquiries related to payment extensions, cancellations, and stock inquiries, each with varying degrees of urgency. To address this challenge, organizations have taken the opportunity to re-evaluate the function of contact centres and explore innovative solutions. Next-generation platforms that incorporate machine learning techniques and natural language processing, such as self-service voice portals and chatbots, are being implemented to enhance customer service. These platforms offer robust features that equip customer agents with the necessary tools to provide exceptional customer support. Through an extensive review of existing literature, this paper aims to uncover research gaps and explore the advantages of transitioning to a contact centre that utilizes natural language solutions as the norm. Additionally, we will examine the major challenges faced by contact centre organizations and offer recommendations for overcoming them, ultimately expediting the pace of contact centre automation.
Incurring detriments of unplanned readmission to the intensive care unit following surgery for brain metastasis
Authors: Schweppe Justus August , Potthoff Anna-Laura , Heimann Muriel , Ehrentraut Stefan Felix , Borger Valeri , Lehmann Felix , Schaub Christina , Bode Christian , Putensen Christian , Herrlinger Ulrich , Vatter Hartmut , Schäfer Niklas , Schuss Patrick , Schneider Matthias
Published: June 2023

Object

Postoperative intensive care unit (ICU) monitoring is a common regime after neurosurgical resection of brain metastasis (BM). In comparison, unplanned secondary readmission to the ICU after initial postoperative treatment course occurs in response to adverse events and might significantly impact patient prognosis. In the present study, we analyzed the potential prognostic implications of unplanned readmission to the ICU and aimed at identifying preoperatively collectable risk factors for the development of such adverse events.

Methods

Between 2013 and 2018, 353 patients with BM had undergone BM resection at the authors’ institution. Secondary ICU admission was defined as any unplanned admission to the ICU during the initial hospital stay. A multivariable logistic regression analysis was performed to identify preoperatively identifiable risk factors for unplanned ICU readmission.

Results

A total of 19 patients (5%) were readmitted to the ICU. Median overall survival (mOS) of patients with unplanned ICU readmission was 2 months (mo) compared to 13 mo for patients without secondary ICU admission (p<0.0001). Multivariable analysis identified “multiple BM” (p=0.02) and “preoperative CRP levels > 10 mg/dl” (p=0.01) as significant and independent predictors of secondary ICU admission.

Conclusions

Unplanned ICU readmission following surgical therapy for BM is significantly related to poor OS. Furthermore, the present study identifies routinely collectable risk factors indicating patients that are at a high risk for unplanned ICU readmission after BM surgery.
Past and future rainfall change in sub-regions of Victoria, Australia
Authors: Rauniyar Surendra P. , Power Scott B.
Published: June 2023

We examine rainfall variability and change in three sub-regions of the state of Victoria in Australia: the Murray Basin Victoria (MBVic), southeast Victoria (SEVic), and southwest Victoria (SWVic). These sub-regions represent three different hydrological super-catchments over Victoria and received average cool season rainfall for the 1997–2018 period, about 15%, 11%, and 8% less, respectively, than the 1900–1959 average. All three observed declines are shown to be very unusual in terms of historical variability. On analysing CMIP5 models under different forcing conditions (preindustrial, historical-all, historical-GHGs-only, historical-natural-only, RCP2.6, RCP4.5, and RCP8.5), we estimate that external forcing caused 30% of the observed drying in SWVic, 18% in MBVic, and 17% in SEVic. The external forcing contributions to the observed trend for the 1900–2018 period are estimated to be 56%, 17%, and 24% for SWVic, MBVic, and SEVic, respectively. Taken at face value, these figures suggest that only the 1900–2018 trend in SWVic was dominated by external forcing. Nearly all models underestimate the magnitude of the observed drying. This arises because models underestimate the magnitude of decadal variability, and because models might also underestimate externally forced drying, and/or the contribution of internal variability in the real world to the observed event was unusually large. By 2037, approximately 90% of the models simulate drying in SWVic, even under a low emissions scenario. Under a high emission scenario, the anthropogenically forced drying towards the late twenty-first century is so large in all three sub-regions that internal variability appears too small to offset it.
A combinatorial multi-armed bandit approach to correlation clustering
Authors: Gullo F. , Mandaglio D. , Tagarelli A.
Published: June 2023

Given a graph whose edges are assigned positive-type and negative-type weights, the problem of correlation clustering aims at grouping the graph vertices so as to minimize (resp. maximize) the sum of negative-type (resp. positive-type) intra-cluster weights plus the sum of positive-type (resp. negative-type) inter-cluster weights. In correlation clustering, it is typically assumed that the weights are readily available. This is a rather strong hypothesis, which is unrealistic in several scenarios. To overcome this limitation, in this work we focus on the setting where edge weights of a correlation-clustering instance are unknown, and they have to be estimated in multiple rounds, while performing the clustering. The clustering solutions produced in the various rounds provide a feedback to properly adjust the weight estimates, and the goal is to maximize the cumulative quality of the clusterings. We tackle this problem by resorting to the reinforcement-learning paradigm, and, specifically, we design for the first time a Combinatorial Multi-Armed Bandit (CMAB) framework for correlation clustering. We provide a variety of contributions, namely (1) formulations of the minimization and maximization variants of correlation clustering in a CMAB setting; (2) adaptation of well-established CMAB algorithms to the correlation-clustering context; (3) regret analyses to theoretically bound the accuracy of these algorithms; (4) design of further (heuristic) algorithms to have the probability constraint satisfied at every round (key condition to soundly adopt efficient yet effective algorithms for correlation clustering as CMAB oracles); (5) extensive experimental comparison among a variety of both CMAB and non-CMAB approaches for correlation clustering.