bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical results after very early, early and late arthroscopic arthrolysis of the knee
Authors: Eggeling Lena , Klepsch Leonard , Akoto Ralph , Frosch Karl-Heinz
Published: September 2021

Purpose

Impaired patient outcome can be directly related to a loss of motion of the knee following surgical procedures. If conservative therapy fails, arthroscopic arthrolysis is an effective procedure to improve range of motion (ROM). The purpose of this study was to evaluate the outcome of patients undergoing very early (< 3 months), early (3 to 6 months), and late (> 6 months) arthroscopic arthrolysis of the knee.

Methods

With a follow-up on average at 35.1 ± 15.2 (mean ± SD, 24 to 87) months, 123 patients with post-operative motion loss (> 10° extension deficit/ < 90° of flexion) were included between 2013 and 2018 in the retrospective study, while eight patients were lost to follow-up. A total of 115 patients were examined with a minimum follow-up of two years. Twenty percent (n = 23) of patients of this study population had a post-operative motion loss after distal femoral fracture, 10.4% (n = 12) after tibial head fracture, 57.4% (n = 66) after anterior/posterior cruciate ligament (ACL/PCL) reconstruction, 8.7% (n = 10) after infection of the knee, and 3.4% (n = 4) after patella fracture. Thirty-seven patients received very early (< 3 months, mean 1.8 months) arthroscopic arthrolysis, and 37 had early (3 to 6 months, mean 4.3 months) and 41 late (> 6 months, mean 9.8 months) arthroscopic arthrolysis after primary surgery.

Results

The average ROM increased from 73.9° before to 131.4° after arthroscopic arthrolysis (p < 0.001). In the group of very early (< 3 months) arthroscopic arthrolysis 76% (n = 28) of the patients had a normal ROM (extension/flexion 0/140°), in the group of early (3–6 months) arthrolysis 68% (n = 25) of the patients and in the group of late arthrolysis 41.5% (n = 17) of the patients showed a normal ROM after surgery (p = 0.005). The total ROM after arthrolysis was also significantly increased in the group of very early and early arthrolysis (136.5° and 135.3° vs. 123.7°, p < 0.001). A post-operative flexion deficit occurred significantly less in the group of very early and early arthroscopic arthrolysis compared to the late arthroscopic arthrolysis (3.9° and 4.2° vs. 16.6°, p < 0.001). Patients treated with very early (< 3 months) and early (3 to 6 months) showed a significantly increased post-operative Tegner score of 4.8 ± 1 and 4.7 ± 1.1 compared to 3.8 ± 1.1 in the group of late arthroscopic arthrolysis (> 6 months, p < 0.001).

Conclusions

An arthroscopic arthrolysis is highly effective and leads to good to excellent mid-term results. An early arthroscopic arthrolysis within 6 months after primary surgery leads to significantly improved ROM and functional scores compared to the late arthrolysis (> 6 months).
Patients with renal transplant and moderate-to-severe LUTS benefit from urodynamic evaluation and early transurethral resection of the prostate
Authors: Righetto Marialaura , Mancini Mariangela , Modonutti Daniele , Calpista Arturo , Beltrami Paolo , Dal Moro Fabrizio
Published: September 2021

Purpose

To assess long-term renal function and micturition pattern of males submitted to transurethral resection of the prostate (TURP) for moderate-to-severe lower urinary tract symptoms (LUTS) after renal transplantation (RT). To investigate the role of clinical and urodynamic (UD) parameters for bladder outlet obstruction (BOO) diagnosis in these patients.

Methods

Retrospective data analysis of ≥ 50 years old patients who underwent RT between 01/2005 and 12/2016. Patients with moderate-to-severe LUTS after RT who underwent a urologic evaluation and a UD study were included. TURP was performed in case of BOO diagnosis. Kidney function and micturition patterns were evaluated before, 3, 12, 24, 36, and 48 months after TURP. Predictors of BOO were assessed at univariable and multivariable logistic regression models. Statistical analysis was performed with STATA16.

Results

233 male patients ≥ 50 years underwent RT. 71/233 (30%) patients developed voiding LUTS. 52/71 (73%) patients with moderate-to-severe LUTS underwent UD. TURP was performed in 36/52 (69%) patients, with BOO diagnosis. Median (interquartile range) follow-up was 108 (75–136) months. Maximum flow at flowmetry (Qmax), International Prostate Symptom Score and post-voided residual volume improved significantly after surgery. Serum creatinine decreased and glomerular filtration rate improved significantly at follow-up, especially when TURP was performed ≤ 6 months from RT. At the multivariable model, bladder capacity ≥ 300 mL (OR = 1.74, CI 95% 1.03–3.15, p = 0.043) and detrusor pressure at Qmax (OR = 2.05, CI 95% 1.48–3.02, p = 0.035) were the independent predictors of BOO.

Conclusion

RT patients with moderate-to-severe LUTS at risk for BOO and graft failure are better identified by UD than clinical parameters. Bladder capacity and voiding pressure are key for the early diagnosis of BOO.
DNS of a turbulent boundary layer using inflow conditions derived from 4D-PTV data
Authors: Appelbaum Jason , Ohno Duncan , Rist Ulrich , Wenzel Christoph
Published: September 2021

Unsteady, 3D particle tracking velocimetry (PTV) data are applied as an inlet boundary condition in a direct numerical simulation (DNS). The considered flow case is a zero pressure gradient (ZPG) turbulent boundary layer (TBL) flow over a flat plate. The study investigates the agreement between the experimentally measured flow field and its simulated counterpart with a hybrid 3D inlet region. The DNS field inherits a diminishing contribution from the experimental field within the 3D inlet region, after which it is free to spatially evolve. Since the measurement does not necessarily provide a spectrally complete description of the turbulent field, the spectral recovery of the flow field is analyzed as the TBL evolves. The study summarizes the pre-processing methodology used to bring the experimental data into a form usable by the DNS as well as the numerical method used for simulation. Spectral and mean flow analysis of the DNS results show that turbulent structures with a characteristic length on the order of one average tracer particle nearest neighbor radius $${\bar{r}}_{\text {NN}}$$

r

¯

NN

or greater are well reproduced and stay correlated to the experimental field downstream of the hybrid inlet. For turbulent scales smaller than $${\bar{r}}_{\text {NN}}$$

r

¯

NN

, where experimental data are sparse, a relatively quick redevelopment of previously unresolved turbulent energy is seen. The results of the study indicate applicability of the approach to future DNS studies in which specific upstream or far field boundary conditions (BCs) are required and may provide the utility of decreasing high initialization costs associated with conventional inlet BCs.

Graphic abstract
Evaluation of dynamic behaviour of porous media including micro-cracks by ordinary state-based peridynamics
Authors: Ozdemir M. , Oterkus S. , Oterkus E. , Amin I. , Nguyen C. T. , Tanaka S. , El-Aassar A. , Shawky H.
Published: September 2021

Reliable evaluation of mechanical response in a porous solid might be challenging without any simplified assumptions. Peridynamics (PD) perform very well on a medium including pores owing to its definition, which is valid for entire domain regardless of any existed discontinuities. Accordingly, porosity is defined by randomly removing the PD interactions between the material points. As wave propagation in a solid body can be regarded as an indication of the material properties, wave propagation in porous media under an impact loading is studied first and average wave speeds are compared with the available reference results. A good agreement between the present and the reference results is achieved. Then, micro-cracks are introduced into porous media to investigate their influence on the elastic wave propagation. The micro-cracks are considered in both random and regular patterns by varying the number of cracks and their orientation. As the porosity ratio increases, it is observed that wave propagation speed drops considerably as expected. As for the cases with micro-cracks, the average wave speeds are not influenced significantly in random micro-crack configurations, while regular micro-cracks play a noticeable role in absorbing wave propagation depending on their orientation as well as the number of crack arrays in y-direction.
Altered relationship between cortisol response to social stress and mediotemporal function during fear processing in people at clinical high risk for psychosis: a preliminary report
Authors: Davies Cathy , Appiah-Kusi Elizabeth , Wilson Robin , Blest-Hopley Grace , Bossong Matthijs G. , Valmaggia Lucia , Brammer Michael , Perez Jesus , Allen Paul , Murray Robin M. , McGuire Philip , Bhattacharyya Sagnik
Published: September 2021

Evidence suggests that people at Clinical High Risk for Psychosis (CHR) have a blunted cortisol response to stress and altered mediotemporal activation during fear processing, which may be neuroendocrine–neuronal signatures of maladaptive threat responses. However, whether these facets are associated with each other and how this relationship is affected by cannabidiol treatment is unknown. We examined the relationship between cortisol response to social stress and mediotemporal function during fear processing in healthy people and in CHR patients. In exploratory analyses, we investigated whether treatment with cannabidiol in CHR individuals could normalise any putative alterations in cortisol-mediotemporal coupling. 33 CHR patients were randomised to 600 mg cannabidiol or placebo treatment. Healthy controls (n = 19) did not receive any drug. Mediotemporal function was assessed using a fearful face-processing functional magnetic resonance imaging paradigm. Serum cortisol and anxiety were measured immediately following the Trier Social Stress Test. The relationship between cortisol and mediotemporal blood-oxygen-level-dependent haemodynamic response was investigated using linear regression. In healthy controls, there was a significant negative relationship between cortisol and parahippocampal activation (p = 0.023), such that the higher the cortisol levels induced by social stress, the lower the parahippocampal activation (greater deactivation) during fear processing. This relationship differed significantly between the control and placebo groups (p = 0.033), but not between the placebo and cannabidiol groups (p = 0.67). Our preliminary findings suggest that the parahippocampal response to fear processing may be associated with the neuroendocrine (cortisol) response to experimentally induced social stress, and that this relationship may be altered in patients at clinical high risk for psychosis.
Prechoroidal cleft thickness correlates with disease activity in neovascular age-related macular degeneration
Authors: Cozzi Mariano , Monteduro Davide , Parrulli Salvatore , Ristoldo Federica , Corvi Federico , Zicarelli Federico , Staurenghi Giovanni , Invernizzi Alessandro
Published: September 2021

Purpose

The purpose of this study was to investigate the structural variations of the hyporeflective pocket of fluid (prechoroidal cleft) located between Bruch’s membrane and the hyperreflective material within the pigment epithelial detachment (PED) in patients with neovascular age-related macular degeneration (nAMD).

Methods

In this retrospective, observational case series study, patients diagnosed with nAMD and prechoroidal cleft associated with other activity signs of the macular neovascularization (MNV) were included. Structural optical coherence tomography (OCT) scans were evaluated to obtain anatomical measurements of prechoroidal cleft and PED at three different visits (T0, inactive MNV; T1, active MNV; T2, treated inactive MNV). The variations in size of the cleft and the PED were correlated with nAMD activity.

Results

Twenty-nine eyes from 27 patients were included. The subfoveal measurements showed a significant increase of prechoroidal cleft height and width from T0 to T1 (P < 0.05) and a subsequent decrease of the cleft height after treatment with anti-VEGF agents (P = 0.004). A similar significant trend was observed for the greatest prechoroidal cleft height and width, obtained assessing the whole OCT raster. In the multivariate analysis, the cleft height was significantly affected by both time (P = 0.001) and PED height (P < 0.0001). By contrast, the effect of fibrovascular tissue size within the PED was not significant. Visual acuity did not correlate with prechoroidal cleft size.

Conclusion

Prechoroidal cleft increased in association with MNV reactivation and decreased after treatment. Our results suggest that prechoroidal cleft could represent an accumulation of fluid actively exudating from the MNV and should be considered a sign of nAMD activity.
Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report
Authors: Lempert Maximilian , Halvachizadeh Sascha , Salfelder Clara Charlotte , Neuhaus Valentin , Pape Hans-Christoph , Jukema Gerrolt Nico
Published: September 2021

Purpose

The management of severe soft tissue injuries to the extremities with full-thickness wounds poses a challenge to the patient and surgeon. Dermal substitutes are used increasingly in these defects. The aim of this study was to investigate the impact of the type of injury on the success rate of Matriderm® (MD)-augmented split-thickness skin grafting, as well as the role of negative pressure wound therapy (NPWT) in preconditioning of the wounds, with a special focus on the reduction of the bioburden.

Methods

In this study, 45 wounds (44 affecting lower extremities (97.7%)), resulting from different types of injuries: soft tissue (ST), soft tissue complications from closed fracture (F), and open fracture (OF) in 43 patients (age 55.0 ± 18.2 years, 46.7% female), were treated with the simultaneous application of MD and split-thickness skin grafting. The study was designed as a retrospective cohort study from March 2013 to March 2020. Patients were stratified into three groups: ST, F, and OF. Outcome variables were defined as the recurrence of treated wound defects, which required revision surgery, and the reduction of bioburden in terms of reduction of number of different bacterial strains. For statistical analysis, Student’s t-test, analysis of variance (ANOVA), Mann–Whitney U test, and Pearson’s chi-squared test were used.

Results

There was no significant difference in the rate of recurrence in the different groups (F: 0%; OF: 11.1%; ST: 9.5%). The duration of VAC therapy significantly differed between the groups (F: 10.8 days; OF: 22.7 days; ST: 12.6 days (p < 0.05)). A clinically significant reduction of bioburden was achieved with NPWT (bacterial shift (mean (SD), F: − 2.25 (1.89); OF: − 1.9 (1.37); ST: − 2.6 (2.2)).

Conclusion

MD-augmented split-thickness skin grafting is an appropriate treatment option for full-thickness wounds with take rates of about 90%. The complexity of an injury significantly impacts the duration of the soft tissue treatment but does not have an influence on the take rate. NPWT leads to a relevant reduction of bioburden and is therefore an important part in the preconditioning of full-thickness wounds.
Purely ropivacaine-based TEA vs single TAP block in pain management after elective laparoscopic colon surgery within an upgraded institutional ERAS program
Authors: Bumblyte Vilma , Rasilainen Suvi K. , Ehrlich Anu , Scheinin Tom , Kontinen Vesa K. , Sevon Aino , Vääräniemi Heikki , Schramko Alexey A.
Published: September 2021

Background

The aim of this study was to compare thoracic epidural analgesia (TEA) with transversus abdominis plane (TAP) block in post-operative pain management after laparoscopic colon surgery.

Methods

One hundred thirty-six patients undergoing laparoscopic colon resection randomly received either TEA or TAP with ropivacaine only. The primary endpoint was opioid requirement up to 48 h postoperatively. Intensity of pain, time to onset of bowel function, time to mobilization, postoperative complications, length of hospital stay, and patients’ satisfaction with pain management were also assessed.

Results

We observed a significant decrease in opioid consumption on the day of surgery with TEA compared with TAP block (30 mg vs 14 mg, p < 0.001). On the first two postoperative days (POD), the balance shifted to opioid consumption being smaller in the TAP group: on POD 1 (15.2 mg vs 10.6 mg; p = 0.086) and on POD 2 (9.2 mg vs 4.6 mg; p = 0.021). There were no differences in postoperative nausea/vomiting or time to first postoperative bowel movement between the groups. No direct blockade-related complications were observed and the length of stay was similar between TEA and TAP groups.

Conclusion

TEA is more efficient for acute postoperative pain than TAP block on day of surgery, but not on the first two PODs. No differences in pain management-related complications were detected.
Stochastic smoothing of point processes for wildlife-vehicle collisions on road networks
Authors: Borrajo M. I. , Comas C. , Costafreda-Aumedes S. , Mateu J.
Published: September 2021

Wildlife-vehicle collisions on road networks represent a natural problem between human populations and the environment, that affects wildlife management and raise a risk to the life and safety of car drivers. We propose a statistically principled method for kernel smoothing of point pattern data on a linear network when the first-order intensity depends on covariates. In particular, we present a consistent kernel estimator for the first-order intensity function that uses a convenient relationship between the intensity and the density of events location over the network, which also exploits the theoretical relationship between the original point process on the network and its transformed process through the covariate. We derive the asymptotic bias and variance of the estimator, and adapt some data-driven bandwidth selectors to estimate the optimal bandwidth. The performance of the estimator is analysed through a simulation study under inhomogeneous scenarios. We present a real data analysis on wildlife-vehicle collisions in a region of North-East of Spain.
Psychological distress after esophageal cancer surgery and the predictive effect of dispositional optimism: a nationwide population-based longitudinal study
Authors: Liu Yangjun , Pettersson Erik , Schandl Anna , Markar Sheraz , Johar Asif , Lagergren Pernilla
Published: September 2021

Purpose

To examine the trajectory of psychological distress from 1 to 2 years after esophageal cancer surgery, and whether dispositional optimism could predict the risk of postoperative psychological distress.

Methods

This Swedish nationwide longitudinal study included 192 patients who had survived for 1 year after esophageal cancer surgery. We measured dispositional optimism with the Life Orientation Test-Revised (LOT-R) 1 year post-surgery and psychological distress with the Hospital Anxiety and Depression Scale 1, 1.5, and 2 years post-surgery. Latent growth curve models were used to assess the trajectory of postoperative psychological distress and to examine the predictive validity of dispositional optimism.

Results

One year after surgery, 11.5% (22 of 192) patients reported clinically significant psychological distress, and the proportion increased to 18.8% at 1.5 years and to 25.0% at 2 years post-surgery. Higher dispositional optimism predicted a lower probability of self-reported psychological distress at 1, 1.5, and 2 years after esophageal cancer surgery. For each point increase in the LOT-R sum score, the odds of psychological distress decreased by 44% (OR, 0.56; 95% CI, 0.40 to 0.79).

Conclusion

The high prevalence and longitudinal increase of self-reported psychological distress after esophageal cancer surgery indicate the unmet demands for timely psychological screening and interventions. Measuring dispositional optimism may help identify patients at higher risk of developing psychological distress, thereby contributing to the prevention of postoperative psychological distress.
Non-minimality of spirals in sub-Riemannian manifolds
Authors: Monti Roberto , Socionovo Alessandro
Published: September 2021

We show that in analytic sub-Riemannian manifolds of rank 2 satisfying a commutativity condition spiral-like curves are not length minimizing near the center of the spiral. The proof relies upon the delicate construction of a competing curve.
Uniqueness for linear integro-differential equations in the real line and applications
Authors: Felipe-Navarro Juan-Carlos
Published: September 2021

In this work we prove the uniqueness of solutions to the nonlocal linear equation $$L \varphi - c(x)\varphi = 0$$

L
φ
-
c
(
x
)
φ
=
0

in $$\mathbb {R}$$
R
, where L is an elliptic integro-differential operator, in the presence of a positive solution or of an odd solution vanishing only at zero. As an application, we deduce the nondegeneracy of layer solutions (bounded and monotone solutions) to the semilinear problem $$L u = f(u)$$

L
u
=
f
(
u
)

in $$\mathbb {R}$$
R
when the nonlinearity is of Allen–Cahn type. To our knowledge, this is the first work where such uniqueness and nondegeneracy results are proven in the nonlocal framework when the Caffarelli–Silvestre extension technique is not available. Our proofs are based on a nonlocal Liouville-type method developed by Hamel, Ros-Oton, Sire, and Valdinoci for nonlinear problems in dimension two.
How I do it: the trans-laminar, facet-joint sparing minimal invasive approach for ventral dural repair in spontaneous intracranial hypotension—a 2-dimensional operative video
Authors: Corniola Marco V. , Meling Torstein R.
Published: September 2021

Background

We describe the minimally invasive, facet-sparing postero-lateral approach to the thoracic spine for a ventral dural repair in a patient with intracranial hypotension secondary to a spontaneous dural breach.

Methods

We performed a minimally invasive approach using a short paramedian posterior skin incision followed by a 10 × 10 mm targeted trans-laminar approach, to achieve a microsurgical repair of a symptomatic ventral dural defect causing severe disability.

Conclusion

The facet-sparing postero-lateral approach is safe and effective in the surgical management of thoracic dural tears, even in the most anterior ones, and avoids the traditional costotransversectomy.
Systematic review and meta-analysis of diagnostic studies of proximal surface caries
Authors: Janjic Rankovic Mila , Kapor Svetlana , Khazaei Yegane , Crispin Alexander , Schüler Ina , Krause Felix , Ekstrand Kim , Michou Stavroula , Eggmann Florin , Lussi Adrian , Huysmans Marie-Charlotte , Neuhaus Klaus , Kühnisch Jan
Published: September 2021

Aim

This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail.

Material and methods

PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated.

Results

From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81–0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited.

Conclusion

The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies.

Clinical relevance

BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.
Apportioning deformation among depth intervals in an aquifer system using InSAR and head data
Authors: Smith Ryan G. , Hashemi Hossein , Chen Jingyi , Knight Rosemary
Published: September 2021

Land surface subsidence due to excessive groundwater pumping is an increasing concern in California, USA. Interferometric Synthetic Aperture Radar (InSAR) is a remote sensing technique for measuring centimeter-to-millimeter surface deformation at 10–100 m spatial resolution. Here, a data-driven approach that attributes deformation to individual depth intervals within an aquifer system by integrating head data acquired from each of three screened intervals in a monitoring well with InSAR surface deformation measurements was developed. The study area was the Colusa Basin in northern Central Valley. To reconstruct the surface deformation history over the study area, 13 ALOS-PALSAR scenes acquired between 2006 and 2010 were processed. Up to ~3-cm year−1long-term subsidence and up to ~6 cm seasonal subsidence were observed using the InSAR technique. The technique developed in this paper integrates the InSAR-observed seasonal deformation rate and the co-located head measurements in multiple depth intervals to estimate the elastic skeletal storage coefficient, the time delay between the head change and the observed deformation, and subsequently the deformation of each depth interval. This technique can be implemented when hydraulic head measurements within each depth interval are not correlated with each other. Using this approach, the depth interval that contributed the most to the total subsidence, as well as storage parameters for all intervals, are estimated. The technique can be used for identification of the depth interval within the aquifer system responsible for deformation.
Exploration of predictors of benefit from nivolumab monotherapy for patients with pretreated advanced gastric and gastroesophageal junction cancer: post hoc subanalysis from the ATTRACTION-2 study
Authors: Kang Yoon-Koo , Morita Satoshi , Satoh Taroh , Ryu Min-Hee , Chao Yee , Kato Ken , Chung Hyun Cheol , Chen Jen-Shi , Muro Kei , Kang Won Ki , Yeh Kun-Huei , Yoshikawa Takaki , Oh Sang Cheul , Bai Li-Yuan , Tamura Takao , Lee Keun-Wook , Hamamoto Yasuo , Kim Jong Gwang , Chin Keisho , Oh Do-Youn , Minashi Keiko , Cho Jae Yong , Tsuda Masahiro , Sameshima Hiroki , Chen Li-Tzong , Boku Narikazu
Published: September 2021

Background

The phase 3 ATTRACTION-2 study demonstrated that nivolumab monotherapy was superior to placebo for patients with pretreated advanced gastric or gastroesophageal junction cancer, but early progression of tumors in some patients was of concern.

Methods

This post hoc analysis statistically explored the baseline characteristics of the ATTRACTION-2 patients and extracted a single-factor and double-factor combinations associated with early disease progression or early death. In the extracted patient subgroups, the 3-year restricted mean survival times of progression-free survival and overall survival were compared between the nivolumab and placebo arms.

Results

Two single factors (age and peritoneal metastasis) were extracted as independent predictors of early progression, but none of them, as a single factor, stratified patients into two subgroups with significant differences in restricted mean survival time. In contrast, two double-factor combinations (serum sodium level and white blood cell count; serum sodium level and neutrophil–lymphocyte ratio) stratifying patients into two subgroups with significant differences in the restricted mean survival time were extracted. Additional exploratory analysis of a triple-factor combination showed that patients aged < 60 years with peritoneal metastasis and low serum sodium levels (approximately 7% of all patients) might receive less benefit from nivolumab, and patients aged ≥ 60 years with no peritoneal metastasis and normal serum sodium levels might receive higher benefit.

Conclusions

A combination of age, peritoneal metastasis, and serum sodium level might predict benefit from nivolumab as salvage therapy in advanced gastric or gastroesophageal junction cancer patients, especially less benefit for patients having all three risk factors.
Understanding strategy assessment in IS management
Authors: Mueller Benjamin , Urbach Nils
Published: September 2021

In our research, we suggest a process theory for explaining the strategy assessment process and its effect in information systems (IS) planning. The proposed theory is derived from an analysis of practitioners and the practices they employ. Based on a multiple-case study design, we look at the IS management teams of three corporate IS departments and how they prepare for strategy development. The analysis of the projects reveals a stable pattern of activities employed by the three teams to assess their departments’ strategic positions and existing strategy. Along with this procedural understanding, our research also produces a detailed look at the outcomes of these managerial practices.
Female sexual dysfunction in multiple system atrophy: a prospective cohort study
Authors: Raccagni Cecilia , Indelicato Elisabetta , Sidoroff Victoria , Daniaux Martin , Bader Angelika , Toth Bettina , Jelisejevas Lukas A. , Hochleitner Margarethe , Fanciulli Alessandra , Leys Fabian , Eschlboeck Sabine , Kaindlstorfer Christine , Boesch Sylvia , Wenning Gregor K.
Published: September 2021

Purpose

The diagnosis of probable multiple system atrophy relies on the presence of severe cardiovascular or urogenital autonomic failure. Erectile dysfunction is required to fulfil the latter criterion in men, whereas no corresponding item is established for women. In this study, we aimed to investigate sexual dysfunction in women with multiple system atrophy.

Methods

We administered the Female Sexual Function Index questionnaire and interviewed women with multiple system atrophy and age-matched controls regarding the presence of “genital hyposensitivity.”

Results

We recruited 25 women with multiple system atrophy and 42 controls. Female Sexual Function Index scores in sexually active women with multiple system atrophy were significantly lower (multiple system atrophy = 10; 15.4, 95% CI [10.1, 22.1], controls = 37; 26.1 [24.1, 28.1], p = 0.0004). The lowest scores concerned the domains of desire, arousal and lubrication. Genital hyposensitivity was reported by 56% of the patients with multiple system atrophy and 9% controls (p < 0.0001).

Conclusions

Sexual dysfunction is highly prevalent in women with multiple system atrophy. Screening for disturbances in specific sexual domains should be implemented in the clinical evaluation of women with suggestive motor symptoms.
Liquid Chromatography Analysis of Reactive Oxoammonium Cations
Authors: Rohland Philip , Schreyer Kristin , Burges Rene , Fritz Nicole , Hager Martin D. , Schubert Ulrich S.
Published: September 2021

This study presents the first liquid chromatography method for the quantitative and qualitative analysis of highly reactive oxoammonium cations based on a simple derivatization reaction. Rapid 1,2-electrophilic addition reactions with olefins were used to transform these reactive species into analyzable derivates. Three model substances were chosen to represent each of the main application fields of oxoammonium cations and to demonstrate the versatility of the method. The measuring protocol was validated according to the ICH and USP guidelines. The method revealed an excellent linearity (R2 = 0.9980–0.9990) with a low limit of detection (0.16–0.14 mmol L−1) and a low limit of quantification (0.55–0.43 mmol L−1). The protocol was finally used to determine the oxoammonium cations in the presence of their corresponding radical, showing a robustness against impurity concentration of up to approx. 30%.
Rurally rooted cross-border migrant workers from Myanmar, Covid-19, and agrarian movements
Authors: Borras Saturnino M. , Franco Jennifer C. , Ra Doi , Kramer Tom , Kamoon Mi , Phyu Phwe , Ju Khu Khu , Vervest Pietje , Oo Mary , Shell Kyar Yin , Soe Thu Maung , Dau Ze , Phyu Mi , Poine Mi Saryar , Jumper Mi Pakao , Mon Nai Sawor , Oo Khun , Thu Kyaw , Khine Nwet Kay , Naing Tun Tun , Papa Nila , Htwe Lway Htwe , Reang Lway Hlar , Jay Lway Poe , Jai Naw Seng , Xu Yunan , Wang Chunyu , Ye Jingzhong
Published: September 2021

This paper examines the situation of rurally rooted cross-border migrant workers from Myanmar during the Covid-19 pandemic. It looks at the circumstances of the migrants prior to the global health emergency, before exploring possibilities for a post-pandemic future for this stratum of the working people by raising critical questions addressed to agrarian movements. It does this by focusing on the nature and dynamics of the nexus of land and labour in the context of production and social reproduction, a view that in the context of rurally rooted cross-border migrant workers necessarily requires interrelated perspectives on labour, agrarian, and food justice struggles. This requires a rethinking of the role of land, not as a factor in either production or social reproduction, but as a central component in both spheres simultaneously. The question is not ‘whether’ it is necessary and desirable to forge multi-class coalitions and struggles against external capital, while not losing sight of the exploitative relations within rural communities and the household; rather, the question is ‘how’ to achieve this. It will require a messy recursive process, going back and forth between theoretical exploration and practical politics.
Management and Business Ethics in Central and Eastern Europe: Introduction to Special Issue
Authors: Soulsby Anna , Remišová Anna , Steger Thomas
Published: September 2021

This special issue focuses on the developments in ethical standards in the post-communist countries of Central and Eastern Europe (CEE) including the former Soviet Union. Over thirty years have elapsed since the demise of the Soviet Bloc and, despite some common institutional features, the societies have had very different experiences with uneven developments across the region since the collapse of communism. In this special issue, the authors explore business and management ethics situated within the context of the challenges that face these still transforming post-communist societies. The papers cover a range of issues and countries including Albania, Belarus, Bulgaria, Croatia, the Czech Republic, Estonia, Hungary, Kyrgyzstan, Latvia, Lithuania, North Macedonia, Poland, Romania, Russia, Slovakia, Slovenia. Potential further avenues for research are identified in the field of business ethics in post-communist societies.
Models of pancreatic ductal adenocarcinoma
Authors: Dennaoui Rayane , Shrestha Hridaya , Wagner Kay-Uwe
Published: September 2021

Although pancreatic cancer remains to be a leading cause of cancer-related deaths in many industrialized countries, there have been major advances in research over the past two decades that provided a detailed insight into the molecular and developmental processes that govern the genesis of this highly malignant tumor type. There is a continuous need for the development and analysis of preclinical and genetically engineered pancreatic cancer models to study the biological significance of new molecular targets that are identified using various genome-wide approaches and to better understand the mechanisms by which they contribute to pancreatic cancer onset and progression. Following an introduction into the etiology of pancreatic cancer, the molecular subtypes, and key signaling pathways, this review provides an overview of the broad spectrum of models for pancreatic cancer research. In addition to conventional and patient-derived xenografting, this review highlights major milestones in the development of chemical carcinogen-induced and genetically engineered animal models to study pancreatic cancer. Particular emphasis was placed on selected research findings of ligand-controlled tumor models and current efforts to develop genetically engineered strains to gain insight into the biological functions of genes at defined developmental stages during cancer initiation and metastatic progression.
Demographic modeling informs functional connectivity and management interventions in Graham’s beardtongue
Authors: Jones Matthew R. , Winkler Daniel E. , Massatti Rob
Published: September 2021

Functional connectivity (i.e., the movement of individuals across a landscape) is essential for the maintenance of genetic variation and persistence of rare species. However, illuminating the processes influencing functional connectivity and ultimately translating this knowledge into management practice remains a fundamental challenge. Here, we combine various population structure analyses with pairwise, population-specific demographic modeling to investigate historical functional connectivity in Graham’s beardtongue (Penstemon grahamii), a rare plant narrowly distributed across a dryland region of the western US. While principal component and population structure analyses indicated an isolation-by-distance pattern of differentiation across the species’ range, spatial inferences of effective migration exposed an abrupt shift in population ancestry near the range center. To understand these seemingly conflicting patterns, we tested various models of historical gene flow and found evidence for recent admixture (~ 3400 generations ago) between populations near the range center. This historical perspective reconciles population structure patterns and suggests management efforts should focus on maintaining connectivity between these previously isolated lineages to promote the ongoing transfer of genetic variation. Beyond providing species-specific knowledge to inform management options, our study highlights how understanding demographic history may be critical to guide conservation efforts when interpreting population genetic patterns and inferring functional connectivity.
Unveiling the gravitational universe at μ-Hz frequencies
Authors: Sesana Alberto , Korsakova Natalia , Sedda Manuel Arca , Baibhav Vishal , Barausse Enrico , Barke Simon , Berti Emanuele , Bonetti Matteo , Capelo Pedro R. , Caprini Chiara , Garcia-Bellido Juan , Haiman Zoltan , Jani Karan , Jennrich Oliver , Johansson Peter H. , Khan Fazeel Mahmood , Korol Valeriya , Lamberts Astrid , Lupi Alessandro , Mangiagli Alberto , Mayer Lucio , Nardini Germano , Pacucci Fabio , Petiteau Antoine , Raccanelli Alvise , Rajendran Surjeet , Regan John , Shao Lijing , Spallicci Alessandro , Tamanini Nicola , Volonteri Marta , Warburton Niels , Wong Kaze , Zumalacarregui Miguel
Published: September 2021

We propose a space-based interferometer surveying the gravitational wave (GW) sky in the milli-Hz to μ-Hz frequency range. By the 2040s, the μ-Hz frequency band, bracketed in between the Laser Interferometer Space Antenna (LISA) and pulsar timing arrays, will constitute the largest gap in the coverage of the astrophysically relevant GW spectrum. Yet many outstanding questions related to astrophysics and cosmology are best answered by GW observations in this band. We show that a μ-Hz GW detector will be a truly overarching observatory for the scientific community at large, greatly extending the potential of LISA. Conceived to detect massive black hole binaries from their early inspiral with high signal-to-noise ratio, and low-frequency stellar binaries in the Galaxy, this instrument will be a cornerstone for multimessenger astronomy from the solar neighbourhood to the high-redshift Universe.
Characteristics and Role of Neutrophil Extracellular Traps in Asthma
Authors: Chen Fei , Yu Min , Zhong Yonghong , Wang Lina , Huang Huaqiong
Published: September 2021

Abstract

Asthma is a common chronic respiratory disease that affects millions of people worldwide. The incidence of asthma has continued to increase every year. Bronchial asthma involves a variety of cells, including airway inflammatory cells, structural cells, and neutrophils, which have gained more attention because they secrete substances that play an important role in the occurrence and development of asthma. Neutrophil extracellular traps (NETs) are mesh-like structures composed of DNA, histones, and non-histone molecules that can be secreted from neutrophils. NETs can enrich anti-bacterial substances and limit pathogen migration, thus having a protective effect in case of inflammation. However, despite of their anti-inflammatory properties, NETs have been shown to trigger allergic asthma and worsen asthma progression. Here, we provide a systematic review of the roles of NETs in asthma.
Tariff elimination versus tax avoidance: free trade agreements and transfer pricing
Authors: Mukunoki Hiroshi , Okoshi Hirofumi
Published: September 2021

We explore the new roles of rules of origin (ROO) when multinational enterprises (MNEs) manipulate their transfer prices to avoid a high corporate tax. The ROO under a free trade agreement (FTA) require exporters to identify the origin of exports to be eligible for a preferential tariff rate. We find that a value-added criterion of ROO restricts abusive transfer pricing by MNEs. Interestingly, an FTA with ROO can induce MNEs to shift profits from a low- to high-tax country. Because the ROO augment tax revenues inside FTA countries, they can transform a welfare-reducing FTA into a welfare-improving one.
Between Food and Respect for Nature: On the Moral Ambiguity of Norwegian Stakeholder Opinions on Fish and Their Welfare in Technological Innovations in Fisheries
Authors: Laursen Danielle Caroline , Meijboom Franck L. B.
Published: September 2021

Innovation in fisheries is a global development that focuses on a broad range of aims. One example is a project that aims to develop technology for key phases of the demersal fishery operation to improve product quality and safeguard fish welfare. As this step to include welfare is novel, it raises questions associated with stakeholder acceptance in a wider aim for responsible innovation. How do stakeholders (a) value fish and their welfare and (b) consider the relation between welfare and other relevant values? To address these questions, an approach combining desk research with an empirical study was used. The desk study analysed the ethical and biological arguments for whether fish welfare should be accounted for in this context. The empirical study explored how fish and their welfare are perceived by Norwegian professionals in this industry, by conducting semi-structured interviews and subsequently analysing the results based on a labelling method we developed. The desk study showed a consensus that welfare should be considered in its own right, while at face value the interviews presented a rather instrumental view on this theme. However, analysis of the interview results leads to a more nuanced picture, where fish and their welfare are viewed from the perspective of respect for nature. Despite the apparent divergence between stakeholder opinions and the literature on the importance of welfare, we present three steps that enables professionals to be responsive to both the (moral) views of stakeholders and accounting for welfare in the innovation process fisheries.
A rapid heating and high magnetic field thermal analysis technique
Authors: Kesler Michael S. , McGuire Michael A. , Conner Ben , Rios Orlando , Murphy Bart , Carter William , Henderson Hunter B. , Ludtka Gerard M. , Kisner Roger A.
Published: September 2021

A new thermal analysis technique is described that allows measurements to be performed on bulk samples at extreme heating and cooling rates and in high magnetic fields. High heating rates, up to 1000 °C min−1, are achieved through electromagnetic induction heating of a custom-built apparatus fitted with commercial thermal analysis heads and sensor. Rapid cooling rates, up to 100 °C min−1, are enabled by gas quenching and the small thermal mass of the induction furnace. The custom apparatus is designed to fit inside a superconducting magnet capable of fields up to 9 Tesla. This study demonstrates that the instrument is capable of collecting accurate thermal analysis data in high magnetic fields and rapidly acquiring data for dynamic processes. While the full potential of the technique is still unrealized, currently, it can provide insight into phenomena at time scales relevant to heat treatment in many industrial processes and into little understood effects of high magnetic field processing.
Chatbot breakthrough in the 2020s? An ethical reflection on the trend of automated consultations in health care
Authors: Parviainen Jaana , Rantala Juho
Published: September 2021

Many experts have emphasised that chatbots are not sufficiently mature to be able to technically diagnose patient conditions or replace the judgements of health professionals. The COVID-19 pandemic, however, has significantly increased the utilisation of health-oriented chatbots, for instance, as a conversational interface to answer questions, recommend care options, check symptoms and complete tasks such as booking appointments. In this paper, we take a proactive approach and consider how the emergence of task-oriented chatbots as partially automated consulting systems can influence clinical practices and expert–client relationships. We suggest the need for new approaches in professional ethics as the large-scale deployment of artificial intelligence may revolutionise professional decision-making and client–expert interaction in healthcare organisations. We argue that the implementation of chatbots amplifies the project of rationality and automation in clinical practice and alters traditional decision-making practices based on epistemic probability and prudence. This article contributes to the discussion on the ethical challenges posed by chatbots from the perspective of healthcare professional ethics.
A domain specific language notation for a language learning activity generation tool
Authors: Sebastián Gabriel , Tesoriero Ricardo , Gallud Jose A.
Published: September 2021

Globalization has increased the need for society to master new languages. This need has encouraged the launch of many applications dedicated to language learning. This paper presents a graphical notation for a domain specific language to represent language learning activities. It describes how this notation enables developers to represent language learning activity characteristics using workflow, presentation, content, media and activity model conforming a metamodel that defines the abstract syntax of the domain specific language. This notation is implemented as part of an integrated development environment to build model-based applications. Finally, this proposal is evaluated with a framework that uses the cognitive dimensions of notations for notational systems. The proposed graphic diagram editor exceeds the experience that the user has with the reflexive model editor. In relation to the creation and editing of workflow models and presentation/activity models, the proposed graphical notation its more intuitive and easy to maintain visually than the traditional reflexive tree notation used by many model-based development frameworks.