bluuebunny/crossref_metadata_2025 huggingface dataset:
Subtotal Cholecystectomy Results in High Peri‐operative Morbidity and Its Risk‐Profile Should be Emphasised During Consent
Authors: Lucocq James , Hamilton David , Scollay John , Patil Pradeep
Published: October 2022

Background

Subtotal cholecystectomy aims to reduce the likelihood of bile duct injury but risks a multitude of less severe, yet significant complications. The primary aim of the present study was to report peri‐operative outcomes of subtotal laparoscopic cholecystectomy (SLC) relative to total laparoscopic cholecystectomy (TLC) to inform the consent process.

Method

All laparoscopic cholecystectomies between 2015 and 2020 in one health board were included. The peri‐operative outcomes of SLC (n = 87) and TLC (n = 2650) were reported. Pre‐operative variables were compared between the two groups to identify risk factors for SLC. The outcomes between the SLC and TLC were compared using univariate, multivariate and propensity analysis.

Results

Risk factors for SLC included higher age, male gender, cholecystitis, increased biliary admissions, ERCP, cholecystostomy and emergency cholecystectomy. Following SLC, rates of post‐operative complication (45.9%), imaging (37.9%) intervention (28.7%) and readmission (29.9%) were significant. The risk profile was vastly heightened compared to that of TLC: intra‐operative complications (RR 9.0; p < 0.001), post‐operative complications [bile leak (RR 58.9; p < 0.001), collection (RR 12.2; p < 0.001), retained stones (RR 7.2; p < 0.001) and pneumonia (RR 5.4; p < 0.001)], post‐operative imaging (RR 4.4; p < 0.001), post‐operative intervention (RR 12.3; p < 0.001), prolonged PLOS (RR 11.3; p < 0.001) and readmission (RR 4.5; p < 0.001). The findings were consistent using multivariate logistic regression and propensity analysis.

Conclusion

The relative morbidity associated with SLC is significant and high‐risk patients should be counselled for the peri‐operative morbidity of subtotal cholecystectomy.
Predictors of Liver Failure in Non‐Cirrhotic Patients Undergoing Hepatectomy
Authors: Orozco Gabriel , Gupta Meera , Villagomez Diego , Shah Malay , Marti Francesc , Mei Xiaonan , Ancheta Alexandre , Desai Siddharth , Salama Fady , Benrajab Karim , Davenport Daniel , Gedaly Roberto
Published: October 2022

Background

Post‐hepatectomy liver failure (PHLF) is associated with high mortality following liver resection. There have been limited studies evaluating predictors of PHLF and clinically significant PHLF in non‐cirrhotic patients.

Methods

This was a retrospective cohort study using the National Surgical Quality Improvement Program database (NSQIP) to evaluate 8,093 non‐cirrhotic patients undergoing hepatectomy from 2014 to 2018. Primary endpoints were PHLF and clinically significant PHLF (PHLF grade B or C).

Results

Among all patients, 4.74% (n = 383) developed PHLF and 2.5% clinically significant PHLF (n = 203). The overall 30‐day mortality was 1.35% (n = 109), 11.5% (n = 44) in patients with PHLF, and 19.2% in those with clinically significant PHLF. Factors associated with PHLF were: metastatic liver disease (OR = 1.84, CI = 1.14–2.98), trisectionectomy (OR = 3.71, CI = 2.59–5.32), right total lobectomy (OR = 4.17, CI = 3.06–5.68), transfusions (OR = 1.99, CI = 1.52–2.62), organ/space SSI (OR = 2.84, CI = 2.02–3.98), post‐operative pneumonia (OR = 2.43, CI = 1.57–3.76), sepsis (OR = 2.27, CI = 1.47–3.51), and septic shock (OR = 5.67, CI = 3.43–9.36). Patients who developed PHLF or clinically significant PHLF had 2–threefold increased risk of perioperative mortality. Post‐hepatectomy renal failure (OR = 8.47, CI = 3.96–18.1), older age (OR = 1.04, CI = 1.014–1.063), male sex (OR = 1.83, CI = 1.07–3.14), sepsis (OR = 2.96, CI = 1.22–7.2), and septic shock (OR = 3.92, CI = 1.61–9.58) were independently associated with 30‐mortality in patients with clinically significant PHLF.

Conclusion

PHLF in non‐cirrhotic patients increased the risk of perioperative mortality and is associated with the extent of hepatectomy and infectious complications. Careful evaluation of the liver remnant, antibiotic prophylaxis, nutritional assessment, and timely management of post‐operative infections could decrease major morbidity and mortality following hepatectomy.
Magnetooptical properties of one-dimensional aperiodic magneto-photonic crystals based on Kolakoski sequences
Authors: Parvini Tahereh Sadat , Khazaei Nezhad Mehdi
Published: October 2022

Magnetooptical properties of one-dimensional aperiodic structures formed by stacking together magnetic and nonmagnetic layers according to the Kolakoski self-generation scheme are studied theoretically using the 4$$\times$$×4 transfer matrix method. The effect of the generation stage of the sequence, and the helicity and direction of light propagation through the magneto-photonic crystals on the transmission/reflection spectra as well as Faraday and ellipticity rotations, have been investigated. Our results reveal that this kind of aperiodic magneto-photonic crystals can be used for the fabrication of multifrequency laser cavities, and optical filters/sensors.
An auditory-responsive interneuron descending from the cricket brain: a new element in the auditory pathway
Authors: Rogers Stephen M. , Kostarakos Konstantinos , Hedwig Berthold
Published: October 2022

Crickets receive auditory information from their environment via ears located on the front legs. Ascending interneurons forward auditory activity to the brain, which houses a pattern recognition network for phonotaxis to conspecific calling songs and which controls negative phonotaxis to high-frequency sound pulses. Descending brain neurons, however, which are clearly involved in controlling these behaviors, have not yet been identified. We describe a descending auditory-responsive brain neuron with an arborization pattern that coincides with the ring-like auditory neuropil in the brain formed by the axonal arborizations of ascending and local interneurons, indicating its close link to auditory processing. Spiking activity of this interneuron occurs with a short latency to calling song patterns and the neuron copies the sound pulse pattern. The neuron preferentially responds to short sound pulses, but its activity appears to be independent of the calling song pattern recognition process. It also receives a weaker synaptic input in response to high-frequency pulses, which may contribute to its short latency spiking responses. This interneuron could be a crucial part in the auditory-to-motor transformation of the nervous system and contribute to the motor control of cricket auditory behavior.
Certification as dysplasia unit and its impact on large loop electrosurgical excision (LEEP)
Authors: Hanczuk Tatjana , Weiss Martin , Henes Leon , Engler Tobias , Neis Felix , Henes Melanie
Published: October 2022

Purpose

This study evaluates the overall treatment indicators and outcomes of patients who underwent loop electrosurgical excision procedure (LEEP) at the Department of Women’s Health Tübingen and the impact of certification as a dysplasia unit on treatment quality.

Methods

Retrospective data analysis of 1596 patients from 2013 to 2018 who underwent LEEP excision at the Department of Women’s Health Tübingen. Data of cytology, colposcopy, biopsy, LEEP histology, repeat LEEP histology and general characteristics were collected and analyzed descriptively.

Results

85.4% (1364) of patients had CIN 2 + and 14.6% (232) had CIN 1 or normal findings on LEEP histology. The proportion of CIN 2 + excisions increased significantly from 82.4% in 2013 to 89% in 2018. The concordance of HSIL biopsy and LEEP histology was 89.1% in 2013 and 92.6% in 2018. In 2018, more biopsies and colposcopies were performed before excision. Complete resection (R0) was achieved in 88.3% of all excisions. R0 rates in patients with CIN 3 increased in 2014–2017 compared to 2013, resulting in fewer Re-LEEP excisions and hysterectomies.

Conclusion

Certification as a dysplasia unit and the associated requirements have improved the diagnostic quality for patients with cervical dysplasia undergoing LEEP. This was demonstrated by several treatment indicators such as the number of colposcopies and biopsies and treatment outcomes such as an increased proportion of CIN 2 + excisions and R0 resections.
Is endolymphatic sac surgery an efficient treatment of Menière's disease patients? A systematic literature search and meta-analysis
Authors: Szott Franziska A. , Westhofen M. , Hackenberg S.
Published: October 2022

Purpose

The purpose of this work is to assess the treatment efficiency of endolymphatic sac surgery in patients with Menière's disease.

Methods

This study provides a systematic literature review and meta-analysis based on the guidelines of the Cochrane Collaboration and the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. The main inclusion criteria of the literature review were the classification categories according to the American Academy of Otolaryngology-Head and Neck Surgery guidelines of 1985 and 1995.

Results

An effect of 9.25 dB postoperative weighted average hearing loss in surgically treated individuals is classified as "clinically not significant" according to American Academy of Otolaryngology-Head and Neck Surgery 85/95. In contrast, the deterioration by 26.23% in speech comprehension is considered as "clinically significant." An improvement of functional level scale assessment by two categories and vertigo control by assessment in category B can be observed.

Conclusion

The findings of this meta-analysis indicate that endolymphatic sac surgery may be beneficial as a treatment for Menière's disease in terms of a positive impact on functional level scale and vertigo control while yielding a negative impact on pure tone average hearing loss and on speech comprehension.
Cholesteatoma surgery in the pediatric population: remaining challenges in the era of mastoid obliteration
Authors: Kroon Victor J. , Mes Steven W. , Borggreven Pepijn. A. , van de Langenberg Rick , Colnot David R. , Quak Jasper J.
Published: October 2022

Purpose

To present the first pediatric study on the safety and efficacy of mastoid obliteration using S53P4 bioactive glass (BAG) for cholesteatoma surgery.

Methods

A single-center retrospective cohort study was conducted. Inclusion criteria were pediatric cases (≤ 18 years) and at least at least one year of follow-up including non-echo planar diffusion-weighted MRI to assess cholesteatoma recidivism. Both canal wall up (CWU) and canal wall down (CWD) procedures were evaluated.

Results

A total of 61 cases (56 patients) were included. Most cases had an otologic history before the development of the cholesteatoma. CWU procedure was performed in 18 cases (30%) and CWD procedure in 43 cases (70%). The cholesteatoma recidivism rate was 33% after a mean follow-up period of 58 months. Kaplan–Meier curve estimated a 5-year recidivism rate of 40%. Few complications were seen that were all minor and resolved spontaneously or after local or systemic treatment. Control of the infection (merchant grade 0–1) was achieved in 98% of the cases. Closure of the air–bone gap within 20 dB was achieved in 22% of the cases with complete audiometric evaluation.

Conclusion

In this MRI-controlled study, we show the safety and efficacy of S53P4 BAG for mastoid obliteration in a pediatric cholesteatoma cohort. Postoperative complications were both rare and minor, and a dry ear was achieved in almost all patients. Nevertheless, persistent hearing loss and the apparent high recidivism rate reflect the challenging nature of pediatric cholesteatoma.
Flexible endoscopic evaluation of swallowing in children with type 1 spinal muscular atrophy
Authors: Zang Jana , Johannsen Jessika , Denecke Jonas , Weiss Deike , Koseki Jana-Christiane , Nießen Almut , Müller Frank , Nienstedt Julie Cläre , Flügel Till , Pflug Christina
Published: October 2022

Purpose

This study aimed to report on implementing flexible endoscopic evaluation of swallowing (FEES) in infants and toddlers with type 1 spinal muscular atrophy (SMA). In addition, a comparison of FEES results and clinical scores was carried out.

Methods

A prospective pilot study was conducted including ten symptomatic children with SMA type 1 (two SMN2 copies). They started treatment with one of the three currently approved therapies for SMA at a median age of 3.8 months (range 0.7–8.9). FEES was performed according to a standard protocol using Penetration–Aspiration Scale (PAS) and Murray Secretion Scale as a primary outcome. The Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) for motor function, Neuromuscular Disease Swallowing Status Scale (NdSSS), Oral and Swallowing Abilities Tool (OrSAT), and single clinical swallowing-related parameters were also assessed.

Results

Distinct swallowing disorders were already evident in eight children at inclusion. The most common findings from FEES were pharyngeal secretion pooling, penetration, and aspiration of saliva and food as well as delayed initiation of swallowing. Despite an average increase in motor function, no comparable improvement was found in swallowing function. None of the surveyed clinical scores showed a significant dependence on PAS in a mixed linear model.

Conclusions

Valuable information regarding the status of dysphagia can be gathered endoscopically, particularly concerning secretion management and when oral intake is limited. Currently available clinical tools for children with type 1 may represent a change in nutritional status but are not yet mature enough to conclude swallowing ability. Further development is still required.
Do I care for you or for me? Processing of protected and non-protected moral values in subjects with extreme scores on the Dark Triad
Authors: Ueltzhöffer Kai , Roth Corinna , Neukel Corinne , Bertsch Katja , Nüssel Friederike , Herpertz Sabine C.
Published: October 2022

Protected moral values facilitate empathic concern for others, who are exposed to an existential threat, so that one spontaneously helps without taking into account utilitarian cost–benefit considerations. Subjects scoring high on the “Dark Triad” machiavellism, psychopathy, and narcissism are prone to ignore such appeals for selfless help. Until now, data on moral processing and moral decision-making following requests for altruistic help, which directly contrast appeals to protected and non-protected values in subjects with high and low scores on Dark Triad traits, have been missing. In this pilot study 25 healthy subjects with high and 27 with low Dark Triad scores participated in this functional magnetic resonance imaging study. We used a script-driven imagery paradigm to directly contrast requests for selfless help appealing to protected versus non-protected, negotiable moral values. Appeals to protected versus non-protected moral values elicited stronger activations in a large network including insula, amygdala, supramarginal gyrus, and dorsolateral prefrontal cortex. Non-protected values evoked stronger activation in superior frontal sulcus, occipito-temporal junction, and posterior cingulate cortex. During decision-making, high-scorers on the Dark Triad showed increased activations in the superior parietal lobule, precuneus, and intraparietal sulcus. Behaviorally, protected versus non-protected values strongly reduced the reliance on personal cost–benefit calculations in low-scorers, while high-scorers continued to rely on utilitarian deliberations. Data suggest that appeals to protected versus non-protected values activate distinct brain regions associated with strong moral emotions, other-directed cognition, and rule-based decision-making processes. High-scorers display an increased reliance on cost–benefit calculations, which persists even when protected values are threatened.
A systematic review of local field potential physiomarkers in Parkinson’s disease: from clinical correlations to adaptive deep brain stimulation algorithms
Authors: van Wijk Bernadette C. M. , de Bie Rob M. A. , Beudel Martijn
Published: October 2022

Deep brain stimulation (DBS) treatment has proven effective in suppressing symptoms of rigidity, bradykinesia, and tremor in Parkinson’s disease. Still, patients may suffer from disabling fluctuations in motor and non-motor symptom severity during the day. Conventional DBS treatment consists of continuous stimulation but can potentially be further optimised by adapting stimulation settings to the presence or absence of symptoms through closed-loop control. This critically relies on the use of ‘physiomarkers’ extracted from (neuro)physiological signals. Ideal physiomarkers for adaptive DBS (aDBS) are indicative of symptom severity, detectable in every patient, and technically suitable for implementation. In the last decades, much effort has been put into the detection of local field potential (LFP) physiomarkers and in their use in clinical practice. We conducted a research synthesis of the correlations that have been reported between LFP signal features and one or more specific PD motor symptoms. Features based on the spectral beta band (~ 13 to 30 Hz) explained ~ 17% of individual variability in bradykinesia and rigidity symptom severity. Limitations of beta band oscillations as physiomarker are discussed, and strategies for further improvement of aDBS are explored.
Resilient Level Ancestor, Bottleneck, and Lowest Common Ancestor Queries in Dynamic Trees
Authors: Gualà Luciano , Leucci Stefano , Ziccardi Isabella
Published: October 2022

We study the problem of designing a resilient data structure maintaining a tree under the Faulty-RAM model [Finocchi and Italiano, STOC’04] in which up to $$\delta $$
δ
memory words can be corrupted by an adversary. Our data structure stores a rooted dynamic tree that can be updated via the addition of new leaves, requires linear size, and supports resilient (weighted) level ancestor queries, lowest common ancestor queries, and bottleneck vertex queries in $$O(\delta )$$

O
(
δ
)

worst-case time per operation.
Short-time effects of spa rehabilitation on pain, mood and quality of life among patients with degenerative or post-surgery musculoskeletal disorders
Authors: Maccarone Maria Chiara , Magro Giacomo , Albertin Claudio , Barbetta Giovanni , Barone Salvatore , Castaldelli Camilla , Manica Patrizia , Marcoli Silvia , Mediati Magda , Minuto Domenico , Poli Patrizia , Sigurtà Christian , Raffaetà Gloria , Masiero Stefano
Published: October 2022

Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated.
$${\mathscr {A}}$$-quasiconvexity and partial regularity
Authors: Conti Sergio , Gmeineder Franz
Published: October 2022

We establish the first partial regularity result for local minima of strongly $${\mathscr {A}}$$
A
-quasiconvex integrals in the case where the differential operator $${\mathscr {A}}$$
A
possesses an elliptic potential $${\mathbb {A}}$$
A
. As the main ingredient, the proof works by reduction to the partial regularity for full gradient functionals. Specialising to particular differential operators, the results in this paper thereby equally yield novel partial regularity theorems in the cases of the trace-free symmetric gradient, the exterior derivative or the div-curl-operator.
Positive lifestyle behaviours and emotional health factors are associated with low back pain resilience
Authors: Roberts K. E. , Beckenkamp P. R. , Ferreira M. L. , Duncan G. E. , Calais-Ferreira L. , Gatt J. M. , Ferreira P.
Published: October 2022

Purpose

To evaluate the relationship between lifestyle behaviours, emotional health factors, and low back pain (LBP) resilience.

Methods

This retrospective longitudinal study utilised 1,065 twins with a recent history of LBP from the Washington State Twin Registry. A lifestyle behaviour score was built using variables of body mass index, physical activity engagement, sleep quality, smoking status, and alcohol consumption. An emotional health score was built using variables of the absence of depressed mood, perceived stress, and active coping. The main outcome was LBP resilience, assessed as recovery (“bouncing back”), and sustainability (maintaining high levels of function despite LBP).

Results

After adjusting for covariates, there was no relationship between the lifestyle behaviour score (OR 1.05, 95% CI 0.97–1.15, p = 0.218) and the emotional health score (OR 1.08, 95% CI 0.98–1.19, p = 0.142) with the likelihood of recovering from LBP. There was however, evidence of a positive association between the lifestyle behaviour score (β 0.20, 95% CI 0.04–0.36, p = 0.013), the emotional health score (β 0.22, 95% CI 0.00–0.43, p = 0.049), and greater levels of sustainability. These results were confirmed by a within-pair analysis (lifestyle behaviour score: β 1.79, 95% CI 0.05–3.53, p = 0.043) and (emotional health score: β 0.52, 95% CI 0.09–0.96, p = 0.021) adjusting for genetic and early shared environmental confounding.

Conclusion

Findings from this study suggest that people who adopt optimal lifestyle behaviours and positive emotional factors are more likely to be resilient and maintain high levels of function despite suffering from LBP.
Imaging of traumatic mandibular fractures in young adults using CT-like MRI: a feasibility study
Authors: Feuerriegel Georg C. , Ritschl Lucas M. , Sollmann Nico , Palla Benjamin , Leonhardt Yannik , Maier Lisa , Gassert Florian T. , Karampinos Dimitrios C. , Makowski Marcus R. , Zimmer Claus , Wolff Klaus-Dietrich , Probst Monika , Fichter Andreas M. , Burian Egon
Published: October 2022

Objectives

To assess and compare the diagnostic performance of CT-like images based on a three- dimensional (3D) T1-weighted spoiled gradient-echo sequence (3D T1 GRE) with CT in patients with acute traumatic fractures of the mandible.

Materials and methods

Subjects with acute mandibular fractures diagnosed on conventional CT were prospectively recruited and received an additional 3 T MRI with a CT-like 3D T1 GRE sequence. The images were assessed by two radiologists with regard to fracture localization, degree of dislocation, and number of fragments. Bone to soft tissue contrast, diagnostic confidence, artifacts, and overall image quality were rated using a five-point Likert-scale. Agreement of measurements was assessed using an independent t-test.

Results

Fourteen subjects and 22 fracture sites were included (26 ± 3.9 years; 4 females, 10 males). All traumatic fractures were accurately detected on CT-like MRI (n = 22, κ 1.00 (95% CI 1.00–1.00)). There was no statistically significant difference in the assessment of the fracture dislocation (axial mean difference (MD) 0.06 mm, p = 0.93, coronal MD, 0.08 mm, p = 0.89 and sagittal MD, 0.04 mm, p = 0.96). The agreement for the fracture classification as well as the inter- and intra-rater agreement was excellent (range κ 0.92–0.98 (95% CI 0.96–0.99)).

Conclusion

Assessment of mandibular fractures was feasible and accurate using CT-like MRI based on a 3D T1 GRE sequence and is comparable to conventional CT.

Clinical relevance

For the assessment of acute mandibular fractures, CT-like MRI might become a useful alternative to CT in order to reduce radiation exposure particularly in young patients.
Prefecture-specific prevalence of overweight/obesity is associated with regional variation in the incidence of treated ESKD in Japan
Authors: Wakasugi Minako , Narita Ichiei
Published: October 2022

Background

Overweight/obesity is a significant risk factor for chronic kidney disease and end-stage kidney disease (ESKD) in the general population. This study evaluated the impact of sex- and prefecture-specific prevalence of overweight/obesity on standardized incidence rates (SIRs) of treated ESKD in Japan.

Methods

We conducted an ecological study of all prefectures in Japan (n = 47) using data from the Japanese Society of Dialysis Therapy, national census, the NDB Open Data, and the Statistics of Physicians, Dentists and Pharmacists. We calculated the prevalence of overweight/obesity and proteinuria, standardized mortality ratio, and ratio of nephrology specialists for each prefecture, and explored associations of these variables with sex- and prefecture-specific SIRs of treated ESKD using bivariate association analysis, multiple regression analysis, and structural equation modeling (SEM).

Results

Prefecture-specific SIRs ranged from 0.72 to 1.24 for men and 0.69–1.41 for women. Prefecture-specific SIRs were significantly correlated with both the prevalence of overweight/obesity and prevalence of proteinuria. The prevalence of overweight/obesity showed direct, positive, and significant associations with prefecture-specific SIRs in men (standardized estimate (β) = 0.43, p < 0.001) and women (β = 0.40, p < 0.001). The prevalence of proteinuria showed a significant association with prefecture-specific SIRs only in women (β = 0.33, p = 0.01). The SEM models explained 26% of the variance in SIR for men and 28% for women.

Conclusions

Our findings provide evidence that the prefecture-specific prevalence of overweight/obesity in Japan can explain regional variation in prefecture-specific SIRs of treated ESKD in both sexes.
Seismic fragility assessment of bridges with as-built and retrofitted splice-deficient columns
Authors: Opabola Eyitayo A. , Mangalathu Sujith
Published: October 2022

A significant proportion of existing bridges in high seismic regions were constructed prior to the 1970s. As a result of poor reinforcement detailing, pre-1970s bridge columns are susceptible to lap-splice or shear failure in the plastic region. Given the high economic impact of retrofitting all pre-1970s reinforced concrete (RC) bridges, it is essential to identify the most vulnerable bridges for retrofit prioritisation. Analytical fragility functions are useful for quantifying the seismic vulnerability of existing bridge stock. However, the accuracy of these fragility functions relies on the adequacy of the adopted modelling approach. This paper presents a hinge-type modelling approach for capturing the seismic response of as-built splice-deficient and retrofitted RC bridge columns. Fragility analysis is carried out for typical seat and diaphragm abutment two-span bridges using the proposed hinge-type modelling approach. The results showed that the vulnerability of the bridges depends on the column failure mode and the limit state under consideration. Also, the common notion that the column is the most vulnerable component may not necessarily be true. The study underscored that retrofitting columns without retrofitting other components may not effectively mitigate the damage and associated risk.
Effect of damping model and inelastic deformation on the prediction of vertical seismic acceleration demand on steel frames
Authors: Gremer Nadia , Adam Christoph , Furtmüller Thomas
Published: October 2022

This study addresses the modeling of different energy dissipation mechanisms for numerical prediction of the vertical acceleration demand in regular moment-resisting steel frame structures. One of the issues discussed is the consideration of viscous damping in the structural model. It is shown that well-established Rayleigh-damping may highly overestimate the damping of the vertical modes, resulting in much too low vertical acceleration response predictions. A study with different damping models provides an appropriate damping modeling strategy that leads to reasonable predictions of both horizontal and vertical frame acceleration demands. Another open question is the effect of inelastic material behavior on the vertical acceleration demand on the considered regular structures. The results of a shell model of a frame structure exposed to high intensity ground motion excitation demonstrate that inelastic material behavior has virtually no impact on the vertical acceleration demand, while structural inelasticity leaves the horizontal acceleration response significantly smaller compared to the elastic demand. This leads to the conclusion that common frame models that capture the inelastic horizontal response but behave elastic in the vertical direction are suitable for the computation of both the horizontal and vertical acceleration demand.
High Performance on Atari Games Using Perceptual Control Architecture Without Training
Authors: Gulrez Tauseef , Mansell Warren
Published: October 2022

Deep reinforcement learning (DRL) requires large samples and a long training time to operate optimally. Yet humans rarely require long periods of training to perform well on novel tasks, such as computer games, once they are provided with an accurate program of instructions. We used perceptual control theory (PCT) to construct a simple closed-loop model which requires no training samples and training time within a video game study using the Arcade Learning Environment (ALE). The model was programmed to parse inputs from the environment into hierarchically organised perceptual signals, and it computed a dynamic error signal by subtracting the incoming signal for each perceptual variable from a reference signal to drive output signals to reduce this error. We tested the same model across three different Atari games Breakout, Pong and Video Pinball to achieve performance at least as high as DRL paradigms, and close to good human performance. Our study shows that perceptual control models, based on simple assumptions, can perform well without learning. We conclude by specifying a parsimonious role of learning that may be more similar to psychological functioning.
Unbalanced Multi-marginal Optimal Transport
Authors: Beier Florian , von Lindheim Johannes , Neumayer Sebastian , Steidl Gabriele
Published: October 2022

Entropy-regularized optimal transport and its multi-marginal generalization have attracted increasing attention in various applications, in particular due to efficient Sinkhorn-like algorithms for computing optimal transport plans. However, it is often desirable that the marginals of the optimal transport plan do not match the given measures exactly, which led to the introduction of the so-called unbalanced optimal transport. Since unbalanced methods were not examined for the multi-marginal setting so far, we address this topic in the present paper. More precisely, we introduce the unbalanced multi-marginal optimal transport problem and its dual and show that a unique optimal transport plan exists under mild assumptions. Furthermore, we generalize the Sinkhorn algorithm for regularized unbalanced optimal transport to the multi-marginal setting and prove its convergence. For cost functions decoupling according to a tree, the iterates can be computed efficiently. At the end, we discuss three applications of our framework, namely two barycenter problems and a transfer operator approach, where we establish a relation between the barycenter problem and the multi-marginal optimal transport with an appropriate tree-structured cost function.
Periodontitis and Preeclampsia in Pregnancy: A Systematic Review and Meta-Analysis
Authors: Le Quynh-Anh , Akhter Rahena , Coulton Kimberly Mathieu , Vo Ngoc Truong Nhu , Duong Le Thi Yen , Nong Hoang Viet , Yaacoub Albert , Condous George , Eberhard Joerg , Nanan Ralph
Published: October 2022

Objectives

A conflicting body of evidence suggests localized periodontal inflammation spreads systemically during pregnancy inducing adverse pregnancy outcomes. This systematic review and meta-analysis aim to specifically evaluate the relationship between periodontitis and preeclampsia.

Methods

Electronic searches were carried out in Medline, Pubmed, Embase, Lilacs, Cochrane Controlled Clinical Trial Register, CINAHL, ClinicalTrials.gov, and Google Scholar with no restrictions on the year of publication. We identified and selected observational case–control and cohort studies that analyzed the association between periodontal disease and preeclampsia. This meta-analysis was conducted following the PRISMA checklist and MOOSE checklist. Pooled odds ratios, mean difference, and 95% confidence intervals were calculated using the random effect model. Heterogeneity was tested with Cochran’s Q statistic.

Results

Thirty studies including six cohort- and twenty-four case–control studies were selected. Periodontitis was significantly associated with increased risk for preeclampsia (OR 3.18, 95% CI 2.26 – 4.48, p < 0.00001), especially in a subgroup analysis including cohort studies (OR 4.19, 95% CI 2.23 – 7.87, p < 0.00001). The association was even stronger in a subgroup analysis with lower-middle-income countries (OR 6.70, 95% CI 2.61 – 17.19, p < 0.0001).

Conclusions

Periodontitis appears as a significant risk factor for preeclampsia, which might be even more pronounced in lower-middle-income countries. Future studies to investigate if maternal amelioration of periodontitis prevents preeclampsia might be warranted.
C*-algebraic approach to interacting quantum field theory: inclusion of Fermi fields
Authors: Brunetti Romeo , Dütsch Michael , Fredenhagen Klaus , Rejzner Kasia
Published: October 2022

We extend the C*-algebraic approach to interacting quantum field theory, proposed recently by Detlev Buchholz and one of us (KF) to Fermi fields. The crucial feature of our approach is the use of auxiliary Grassmann variables in a functorial way.
High payload watermarking based on enhanced image saliency detection
Authors: Khan Ahmed , Wong KokSheik
Published: October 2022

Nowadays, images are circulated rapidly over the internet and they are subject to some risk of misuses. To address this issue, various watermarking methods are proposed in the literature. However, most conventional methods achieve a certain trade-off among imperceptibility and high capacity payload, and they are not able to improve these criteria simultaneously. Therefore, in this paper, a robust saliency-based image watermarking method is proposed to achieve high payload and high quality watermarked image. First, an enhanced salient object model is proposed to produce a saliency map, followed by a binary mask to segments the foreground/background region of a host image. The same mask is then consulted to decompose the watermark image. Next, the RGB channels of the watermark are encrypted by using Arnold, 3-DES and multi-flipping permutation encoding (MFPE). Furthermore, the principal key used for encryption is embedded in the singular matrix of the blue channel. Moreover, the blue channel is encrypted by using the Okamoto-Uchiyama homomorphic encryption (OUHE) method. Finally, these encrypted watermark channels are diffused and embedded into the host channels. When the need arises, more watermarks can be embedded into the host at the expense of the quality of the embedded watermarks. Our method can embed watermark of the same dimension as the host image, which is the first of its kind. Experimental results suggest that the proposed method maintains robustness while achieving high image quality and high payload. It also outperforms the state-of-the-art (SOTA) methods.
Attitudes of non-participating general practitioners and community pharmacists towards interprofessional medication management in primary care: an interview study
Authors: Moecker Robert , Fuchs Andreas ,   ARMIN Study Group, Eickhoff Christiane , Mueller Uta , Schulz Martin , Fuchs Andreas , Braun Dorit , Maywald Ulf , Doehler Catharina , Maetzler Mike , Auerbach Anja , Kuhn Urs Dieter , Moeckel Anke , Honscha Christine , Donner Susanne , Fink Stefan , Wagner Kathrin , Meid Andreas D. , Moecker Robert , Ruff Carmen , Seidling Hanna M. , Stoll Felicitas , Weissenborn Marina , Wirbka Lucas , Haefeli Walter E. , Weissenborn Marina , Seidling Hanna M.
Published: October 2022

Background

Interprofessional medication management in primary care is a recognized strategy for improving medication safety, but it is poorly implemented in Germany. As a pilot project, ARMIN [Arzneimittelinitiative Sachsen-Thüringen] was initiated in 2014 to establish better interprofessional medication management between general practitioners and community pharmacists.

Aim

The aim of this study was to explore the views of non-participating general practitioners and community pharmacists towards interprofessional medication management within ARMIN and to identify barriers to participation.

Method

This was an interview study comprising a series of semi-structured telephone interviews. In total, 36 general practitioners and 15 community pharmacists were interviewed in the period between March and June 2020. Data were analyzed using thematic analysis as an inductive approach and the consolidated framework for implementation research as a deductive approach.

Results

Many general practitioners and community pharmacists had a generally positive attitude towards interprofessional medication management. However, various barriers were identified and categorized into five major themes: (I) collaboration between general practitioners and community pharmacists, e.g. concerning general practitioners’ professional sovereignty and pharmacists’ fear of jeopardizing their relationship with general practitioners when interfering in therapy; (II) eligibility for participation, e.g., the fact that patients had to be insured with a specific statutory health insurance fund; (III) local circumstances, e.g. many pharmacists could not find a collaborating general practitioner (and vice versa). Moreover, patient demand was low, probably because patients were not aware of the program; (IV) information technology, e.g. concerning the lack of available software and data security concerns; and (V) cost–benefit ratio, e.g. the fact that potential benefits were outweighed by program-associated costs.

Conclusion

The perceived discrepancy between positive attitudes and multiple prevalent barriers indicates considerable potential for further interprofessional collaboration between general practitioners and community pharmacists.
Development and evaluation of an assessment of the age-appropriateness/inappropriateness of formulations used in children
Authors: Duncan Jennifer C. , Bracken Louise E. , Nunn Anthony J. , Peak Matthew , Turner Mark A.
Published: October 2022

Background

Medicines designed for adults may be inappropriate for use in children in terms of strength, dosage form and/or excipient content. There is currently no standardised method of assessing the age-appropriateness of a medicine for paediatric use.

Aim

To develop and test a tool to assess whether a dosage form (formulation) is appropriate for children and estimate the proportion of formulations considered ‘inappropriate’ in a cohort of hospitalised paediatric patients with a chronic illness.

Method

A multi-phase study: patient data collection, tool development, case assessments and tool validation. Inpatients aged 0–17 years at two UK paediatric/neonatal hospitals during data collection periods between January 2015 and March 2016. Written informed consent/assent was obtained. Medicines assessed were new or regularly prescribed to inpatients as part of their routine clinical care. All medicine administration episodes recorded were assessed using the Age-appropriate Formulation tool. The tool was developed by a consensus approach, as a one-page flowchart. Independent case assessments were evaluated in 2019.

Results

In 427 eligible children; 2,199 medicine administration episodes were recorded. Two assessors reviewed 220 episodes in parallel: percentage exact agreement was found to be 91.7% (99/108) and 93.1% (95/102). In total, 259/2,199 (11.8%) medicine administration episodes involved a dosage form categorised as ‘age-inappropriate’.

Conclusion

A novel tool has been developed and internally validated. The tool can identify which medicines would benefit from development of an improved paediatric formulation. It has shown high inter-rater reliability between users. External validation is needed to further assess the tool’s utility in different settings.
Spectral reflection and crop parameters: can the disentanglement of primary and secondary traits lead to more robust and extensible prediction models?
Authors: Rose Maren , Rose Till , Kage Henning
Published: October 2022

Recently the application of spectral reflection data for the prediction of crop parameters for applications in precision agriculture, such as green area index (GAI), total aboveground dry matter (DM), and total aboveground nitrogen content (N content) increases. However, the usability of vegetation indices (VI) for the prediction of crop parameters is strongly limited by the fact that most VI calibrations are only valid for specific crops and growth periods. The results of the presented study based on the differentiation of primary (main driver of the reflectance signal) and secondary (not directly related to reflectance signal) crop parameters. For GAI prediction, a universal (without crop-specific parametrization) simple ratio vegetation index (SR) provided good calibration (R2 adj. = 0.90, MAE = 0.32, rMAE = 22%) and evaluation results (MAE = 0.33, rMAE = 18%). The disentanglement of primary and secondary traits allowed the development of a functional two-step model for the estimation of the N content during vegetative growth (MAE = 19.2 g N m−1, rMAE = 44%). This model was based on fundamental, crop-specific relationships between the crop parameters GAI and N content. Additionally, an advanced functional approach was tested enabling the whole-season prediction of DM and confirming a reliable GAI estimation throughout the whole growing season (R2 = 0.89–0.93).
Approach for graph-based individual branch modelling of meadow orchard trees with 3D point clouds
Authors: Straub Jonas , Reiser David , Lüling Nils , Stana Alexander , Griepentrog Hans W.
Published: October 2022

The cultivation of meadow orchards provides an ecological benefit for biodiversity, which is significantly higher than in intensively cultivated orchards. However, the maintenance of meadow orchards is not economically profitable. The use of automation for pruning would reduce labour costs and avoid accidents. The goal of this research was, using photogrammetric point clouds, to automatically calculate tree models, without additional human input, as basis to estimate pruning points for meadow orchard trees. Pruning estimates require a knowledge of the major tree structure, containing the branch position, the growth direction and their topological connection. Therefore, nine apple trees were captured photogrammetrically as 3D point clouds using an RGB camera. To extract the tree models, the point clouds got filtered with a random forest algorithm, the trunk was extracted and the resulting point clouds were divided into numerous K-means clusters. The cluster centres were used to create skeleton models using methods of graph theory. For evaluation, the nodes and edges of the calculated and the manually created reference tree models were compared. The calculated models achieved a producer’s accuracy of 73.67% and a user's accuracy of 74.30% of the compared edges. These models now contain the geometric and topological structure of the trees and an assignment of their point clouds, from which further information, such as branch thickness, can be derived on a branch-specific basis. This is necessary information for the calculation of pruning areas and for the actual pruning planning, needed for the automation of tree pruning.
Effect of Thickness and Outlet Area Fraction of Macroporous Gas Diffusion Layers on Oxygen Transport Resistance in Water Injection Simulations
Authors: García-Salaberri Pablo A.
Published: October 2022

Enhanced water removal through the gas diffusion layer (GDL) is important for the design of high-performance proton exchange fuel cells. In this work, the effects of GDL thickness and open area fraction at the GDL/flow field interface are examined under water invasion for a carbon-paper GDL (similar to Toray TGP-H series). Both uncompressed and inhomogeneously compressed samples are considered. Transport in heterogeneous, macroporous GDLs is modeled by means of a hybrid 3D discrete/continuum formulation based on a subdivision of the porous medium into control volumes due to the lack of a well-defined separation between pore and layer scales. Capillary-dominated transport of liquid water is simulated with an invasion percolation algorithm, while oxygen diffusion is simulated with a continuum formulation. Model predictions are validated with previous numerical and experimental data. It is shown that the combination of thin GDLs ($$\mathrm {thickness} \sim 100\; \mu \mathrm {m}$$

thickness
∼
100

μ
m

) and high GDL/flow field open area fractions can facilitate water removal/oxygen supply from/to the catalyst layer and can provide a more uniform oxygen distribution over large cell active areas. In agreement with previous work, porous flow fields with pore sizes comparable to the GDL thickness are good candidates to meet the above requirements, while improving water removal from the flow field (higher gas-phase velocity than conventional millimeter-sized channels) and ensuring a more uniform assembly compression.
High-Temperature Hydrogen Attack on 2.25Cr-1Mo Steel: The Roles of Residual Carbon, Initial Microstructure and Carbide Stability
Authors: Alshahrani M. A. M. , Ooi S. W. , Colliander M. Hörnqvist , El-Fallah G. M. A. M. , Bhadeshia H. K. D. H.
Published: October 2022

High temperature hydrogen attack is a damage mechanism that occurs in critical steel components in petrochemical plants and refineries when the hydrogen penetrates the steel and reacts with the carbides within to produce pores containing methane. With the motivation of understanding the role of carbide stability on the reaction with hydrogen, samples of a classic 2$$\frac{1}{4}$$

1
4

Cr-1Mo steel were subjected to a variety of heat treatments that generate a corresponding variety of precipitates, prior to exposure to high-pressure hydrogen in an autoclave. Using quantitative carbide, porosity and microstructural characterisation, it has been possible to demonstrate the roles of four variables: (a) the carbon residue present in the ferrite; (b) the non-equilibrium chemical composition of carbide; (c) the fraction of the carbide that is closest to the thermodynamic equilibrium state and (d) the initial microstructural state, i.e., whether it is martensitic or bainitic prior to heat treatment.