bluuebunny/crossref_metadata_2025_split huggingface dataset:
3D endoscopy shows enhanced anatomical details and depth perception vs 2D: a multicentre study
Authors: Tomazic Peter Valentin , Sommer Fabian , Treccosti Andreas , Briner Hans Rudolf , Leunig Andreas 
Published: December 2020

Abstract
Purpose
The current standard endoscopic technique is a high resolution visualisation up to Full HD and even 4 K. A recent development are 3D endoscopes providing a 3-dimensional picture, which supposedly gives additional information of depth, anatomical details and orientation in the surgical field. Since the 3D-endoscopic technique is new, little scientific evidence is known whether the new technique provides advantages for the surgeon compared to the 2D-endoscopic standard technique in FESS. This study compares the standard 2D-endoscopic surgical technique with the new commercially available 3D-endoscopic technique.

Methods
The prospective randomized interventional multicenter study included a total of 80 referred patients with chronic rhinosinusitis with and without polyps without prior surgery. A bilateral FESS procedure was performed, one side with the 2D-endoscopic technique, the other side with the 3D-endoscopic technique. The time of duration was measured. Additionally, a questionnaire containing 20 items was completed by 4 different surgeons judging subjective impression of visualisation and handling.

Results
2D imaging was superior to 3D apart from “recognition of details”, “depth perception” and “3D effect”. For usability properties 2D was superior to 3D apart from “weight of endoscopes”. Mean duration for surgery was 26.1 min for 2D and 27.4 min. for 3D without statistical significance (P = 0.219).

Conclusion
Three-dimensional endoscopy features improved depth perception and recognition of anatomic details but worse overall picture quality. It is useful for teaching purposes, yet 2D techniques provide a better outcome in terms of feasibility for routine endoscopic approaches.
Der schleichende Niedergang der Demokratie in Benin. Konsequenzen für die Förderung von Rechtsstaatlichkeit und gutem Regieren in der internationalen Zusammenarbeit mit Westafrika
Authors: Preuß Hans-Joachim 
Published: December 2020

ZusammenfassungBenin, Afrikas ehemalige Modelldemokratie, steht vor einem Scheideweg. Nach einem friedlichen Systemwechsel und der anschließenden Herausbildung und Konsolidierung demokratischer Institutionen hat ein Abschwung begonnen, dessen Ende noch nicht abzusehen ist. 30 Jahre nach der demokratischen Erneuerung hat die ärmere Bevölkerung bisher keine demokratische Dividende erhalten, und checks and balances werden als Hindernisse für Reformen wahrgenommen. Hat das Modell ausgedient, wird sich ein weiterer Staat Afrikas für ein autokratisches System entscheiden?
Land degradation risk mapping using topographic, human-induced, and geo-environmental variables and machine learning algorithms, for the Pole-Doab watershed, Iran
Authors: Torabi Haghighi Ali , Darabi Hamid , Karimidastenaei Zahra , Davudirad Ali Akbar , Rouzbeh Sajad , Rahmati Omid , Sajedi-Hosseini Farzaneh , Klöve Björn 
Published: December 2020

AbstractLand degradation (LD) is a complex process affected by both anthropogenic and natural driving variables, and its prevention has become an essential task globally. The aim of the present study was to develop a new quantitative LD mapping approach using machine learning techniques, benchmark models, and human-induced and socio-environmental variables. We employed four machine learning algorithms [Support Vector Machine (SVM), Multivariate Adaptive Regression Splines (MARS), Generalized Linear Model (GLM), and Dragonfly Algorithm (DA)] for LD risk mapping, based on topographic (n = 7), human-induced (n = 5), and geo-environmental (n = 6) variables, and field measurements of degradation in the Pole-Doab watershed, Iran. We assessed the performance of different algorithms using receiver operating characteristic, Kappa index, and Taylor diagram. The results revealed that the main topographic, geoenvironmental, and human-induced variable was slope, geology, and land use change, respectively. Assessments of model performance indicated that DA had the highest accuracy and efficiency, with the greatest learning and prediction power in LD risk mapping. In LD risk maps produced using SVM, GLM, MARS, and DA, 19.16%, 19.29%, 21.76%, and 22.40%, respectively, of total area in the Pole-Doab watershed had a very high degradation risk. The results of this study demonstrate that in LD risk mapping for a region, topographic, and geological factors (static conditions) and human activities (dynamic conditions, e.g., residential and industrial area expansion) should be considered together, for best protection at watershed scale. These findings can help policymakers prioritize land and water conservation efforts.
Metformin, chronic nephropathy and lactic acidosis: a multi-faceted issue for the nephrologist
Authors: Mariano Filippo , Biancone Luigi 
Published: December 2020

AbstractMetformin is currently considered a first-line therapy in type 2 diabetic patients. After issuing warnings for decades about the risks of lactic acidosis in patients with chronic nephropathy, metformin is now being re-evaluated. The most recent evidence from the literature has demonstrated both a low, acceptable risk of lactic acidosis and a series of favorable effects, which go beyond its hypoglycemic activity. Patients treated with metformin show a significant mortality reduction and lower progression towards end-stage renal disease in comparison with those treated with other hypoglycemic drugs. Concerning lactic acidosis, in the last few years it has been shown how lactic acidosis almost always developed when patients kept taking the drug in the face of a concomitant disease or situation such as sepsis, fever, diarrhea, vomiting, which reduced metformin renal clearance. Actually, clearance of metformin is mainly renal, both by glomerular filtration and tubular secretion (apparent clearance 933–1317 ml/min, half-life < 3 h). As regards treatment, in cases of lactic acidosis complicated by acute kidney injury, continuous renal replacement therapy (CRRT) plays a crucial role. Besides the elimination of metformin, CRRT improves survival by correcting acidosis, electrolyte alterations, and maintaining fluid balance. Lactic acidosis almost always develops because of preventable drug accumulation. Therefore, prevention is a key factor. Patients should be aware that discontinuation for a limited time does not affect their health, even when it may be inappropriate, but it may avoid a serious, potentially fatal adverse event.
Incidental Findings in the Trauma Population: Interdisciplinary Approach and Electronic Medical Record Reminder Association with Pre-Discharge Reporting and Medicolegal Risk
Authors: Smith Lou M. , King Sarah A. , Shealy Jordan A. , Heidel Robert E. , Morin-Ducote Garnetta I. , Husband Leland D. , Callison John C. , Rosen Brenton A. , Savoy Rachel A. , Daley Brian J. 
Published: December 2020

BACKGROUND:
Incidental findings (IFs) are reported in 20% or more of trauma CT scans. In addition to the importance of patient disclosure, there is considerable legal pressure to avoid missed diagnoses. We reported previously that 63.5% of IFs were disclosed before discharge and with 20% were nondisclosed. We initiated a multidisciplinary systemic plan to effect predischarge disclosure by synoptic CT reports with American College of Radiology recommended follow-up, electronic medical records discharge prompts, and provider education.

STUDY DESIGN:
Prospective observational series patients from November 2019 to February 2020 were included. Statistical analysis was performed with SPSS, version 21 (IBM Corp).

RESULTS:
Eight hundred and seventy-seven patients underwent 1 or more CT scans for the evaluation of trauma (507 were male and 370 were female). Mean age of the patients was 57 years (range 14 to 99 years) and 96% had blunt injury. In 315 patients, there were 523 IFs (1.7 per patient); the most common were lung (17.5%), kidney (13%), and liver (11%). Radiology report compliance rate was 84% (210 of 249 patients). There were 66 studies from outside facilities. Sixteen IFs were suspicious for malignancy. A total of 151 patients needed no follow-up and 148 patients needed future follow-up evaluation. Predischarge IF disclosure compliance rate was 90.1% (286 patients); 25 were post discharge. Four patients remained undisclosed. Compared with our previous report, clearer reporting and electronic medical records prompts increased predischarge disclosure from 63.5% to 90.1% (p < 0.01, chi-square test) and decreased days to notification from 29.5 (range 0 to 277) to 5.2 (range 0 to 59) (p < 0.01, Mann-Whitney U test).

CONCLUSIONS:
Timely, complete disclosure of IFs improves patient outcomes and reduces medicolegal risk. Collaboration among trauma, radiology, and information technology promotes improved disclosure in trauma populations.
Learning to Read: Successful Program-Based Remediation Using the Surgical Council on Resident Education (SCORE) Curriculum
Authors: Williams Taylor P. , Hancock Kevin J. , Klimberg Suzanne V , Radhakrishnan Ravi S. , Tyler Douglas S. , Perez Alexander 
Published: December 2020

BACKGROUND:
The Surgical Council on Resident Education (SCORE) curriculum is aligned with the American Board of Surgery (ABS) objectives. Our program adopted the SCORE curriculum in 2015 after poor ABS In-Training Examination (ABSITE) performance and lowest quartile ABS Certifying Exam (CE) and Qualifying Exam (QE) first-time pass rates. We examined the association of SCORE use with ABSITE performance and ABS board exam first-time pass rate.

STUDY DESIGN:
At a single institution, a retrospective review of surgery residents' SCORE metrics and ABSITE percentile was conducted for academic years 2015 to 2019. Metrics analyzed on the SCORE web portal were mean total minutes and total visits per resident for all residents using SCORE that year. First-time pass rates of the ABS QE and CE were examined from 2013 to 2019. Chi-square and linear regression analysis were performed, and a 95% level of confidence was assumed (alpha = 0.05).

RESULTS:
Yearly data from categorical general surgery residents showed a significant increase in total minutes, total visits, and ABSITE percentile. Combined first time pass rates for the ABS QE and CE significant increased from 70.8% in 2013 to 2015 to 93.9% in 2016 to 2019 (p = 0.018).

CONCLUSIONS:
Increased longitudinal use of the SCORE curriculum was associated with programmatic improvements in ABSITE performance and ABS board exam first-time pass rate.
The Current State of Infectious Disasters Preparedness Around the World: A Qualitative Systematic Review (2007-2019)
Authors: Sharififar Simintaj , Jahangiri Katayoun , Khoshvaghti Amir 
Published: December 2020

AbstractInfectious disasters have specific features which require special approaches and facilities. The main challenge is the rate of spread, and their ability to traverse the Earth in a short time. The preparedness of hospitals to face these events is therefore of the utmost importance. This study was designed to assess the preparedness of countries facing biological events worldwide. A qualitative systematic review was done from PubMed (National Library of Medicine, Bethesda, MD), Scopus (Elsevier, Amsterdam, Netherlands), Web of Science (Thomson Reuters, New York, NY), ProQuest (Ann Arbor, MI), and Google Scholar (Google Inc, Mountain View, CA). Two journals were searched as key journals. The search period was from January 1, 2007 to December 30, 2018. Twenty-one (21) documents were selected including 7 (33%) from Asia, 7 (33%) from Europe, 4 (19%) from USA, 2 (10%) from Africa, and 1 (5%) multi-continental. Forty-six (46) common sub-themes were obtained and categorized into 13 themes (infection prevention control, risk perception, planning, essential support services, surveillance, laboratory, vulnerable groups, education and exercise and evaluation, human resource, clinical management of patients, risk communication, budget, and coordination). Not all articles discussed all the identified categories. There is an extended process required to reach complete preparedness for confronting biological events, including adequate and well-managed budget. Medical centers may have trouble dealing with such events, at least in some respects, but most developed countries seem to be more prepared in this regard.
Minimal flows with arbitrary centralizer
Authors: ZUCKER ANDY 
Published: December 2020

AbstractGiven a G-flow X, let
$\mathrm{Aut}(G, X)$
, or simply
$\mathrm{Aut}(X)$
, denote the group of homeomorphisms of X which commute with the G action. We show that for any pair of countable groups G and H with G infinite, there is a minimal, free, Cantor G-flow X so that H embeds into
$\mathrm{Aut}(X)$
. This generalizes results of [2, 7].
A multi-institutional outbreak of New Delhi metallo-β-lactamase–producing Escherichia coli with subsequent acquisition of the Klebsiella pneumoniae carbapenemase gene
Authors: Solter Ester , Kwong Jason C. , Walton Aaron , Sherry Norelle , Howden Benjamin P. , Grayson M. Lindsay , Schwartz David , Temkin Elizabeth , Frenk Sammy , Carmeli Yehuda , Schwaber Mitchell J. 
Published: December 2020

AbstractWe characterized 57 isolates from a 2-phase clonal outbreak of New Delhi metallo-β-lactamase–producing Eschericha coli, involving 9 Israeli hospitals; all but 1 isolate belonged to sequence-type (ST) 410. Most isolates in the second phase harbored blaKPC-2 in addition to blaNDM-5. Genetic sequencing revealed most dual-carbapenemase–producing isolates to be monophyletically derived from a common ancestor.
Prolonged nightly fasting and lower-extremity functioning in community-dwelling older adults
Authors: Estrada-deLeón Daniela B. , Struijk Ellen A. , Caballero Francisco Félix , Sotos Prieto Mercedes , Rodríguez-Artalejo Fernando , Lopez-Garcia Esther 
Published: December 2020

AbstractIt is unknown if time-restricted feeding confers a protective effect on the physical function of older adults. The aim of this study was to assess prolonged nightly fasting in association with performance-based lower-extremity function (LEF) in a large population of community-dwelling older adults. A cross-sectional study was carried out among 1226 individuals ≥64 years from the Seniors-ENRICA-II (Study on Nutrition and Cardiovascular Risk in Spain) cohort. Habitual diet was assessed through a validated diet history. Fasting time was classified into the following categories: ≤9, 10–11 and ≥12 h/d (prolonged nightly fasting). Performance-based LEF was assessed with the Short Physical Performance Battery (SPPB). After adjusting for potential confounders, a longer fasting period was associated with a higher likelihood of impaired LEF (OR for the second and third categoriesv.≤ 9 h/d fasting: 2·27 (95 % CI 1·56, 3·33) and 2·70 (95 % CI 1·80, 4·04), respectively;Ptrend< 0·001). Fasting time showed a significant association with the SPPB subtests balance impairment (OR for highestv.shortest fasting time: 2.48; 95 % CI 1·51, 4·08;Ptrend= 0·001) and difficulty to rise from a chair (OR 1·47; 95 % CI 1·05, 2·06;Ptrend= 0·01). The risk associated with ≥12 h fasting among those with the lowest levels of physical activity was three times higher than among those with ≤9 h fasting with the same low level of physical activity. Prolonged nightly fasting was associated with a higher likelihood of impaired LEF, balance impairment, and difficulty to rise from a chair in older adults, especially among those with low levels of physical activity.
Intrusive imagery in anxiety disorders in adolescents
Authors: Ghita Ana , Tooley Emma , Lawrence Peter J. 
Published: December 2020

AbstractBackground:Mental imagery plays an important role in models of anxiety disorders in adults. This understanding rests on qualitative and quantitative studies. Qualitative studies of imagery in anxious adolescents have not been reported in the literature.Aims:To address this gap, we aimed to explore adolescents’ experiences of spontaneous imagery in the context of anxiety disorders.Method:We conducted one-to-one semi-structured interviews, with 13 adolescents aged 13–17 years with a DSM-5 anxiety disorder, regarding their experiences of spontaneous imagery. We analysed participants’ responses using thematic analysis.Results:We identified five superordinate themes relating to adolescents’ influences on images, distractions from images, controllability of images, emotional responses to imagery and contextual influences on imagery.Conclusions:Our findings suggest that spontaneous images are an important phenomenon in anxiety disorders in adolescents, associated with negative emotions during and after their occurrence. Contextual factors and adolescents’ own cognitive styles appear to influence adolescents’ experiences of images in anxiety disorders.
Dosimetric comparison of constant dose rate volumetric modulated arc therapy (CDR-VMAT) and intensity-modulated radiation therapy (IMRT) for gallbladder cancer
Authors: Gedam Varsha R. , Pradhan Anirudh 
Published: December 2020

AbstractAim:To study the feasibility of constant dose rate volumetric modulated arc therapy (CDR-VMAT) in radiotherapy for gallbladder cancer by comparing dosimetric parameter suggested by International Commission on Radiation Units and Measurements-83 (ICRU-83) with step and shoot intensity-modulated radiation therapy (SS IMRT).Methods:For this study, we selected 21 post-operative gallbladder cancer patients, which were treated with the IMRT technique from 2016 to 2019. For each patient, we generated SS IMRT plan and CDR-VMAT plan and were dosimetrically compared by parameters suggested by ICRU-83 for PTV. Homogeneity Index (HI) and Conformity Index (CI) were also calculated. For evaluation of Organ at Risk (OAR), we compared the mean doses, volume doses to the right kidney, left kidney, both kidneys combined, liver and max dose to the spinal cord. Monitor units (MUs) and treatment delivery time were also compared.Results:On comparing, we found that CDR-VMAT plans were highly conformed as CI and PCI (CI define by Paddick) were found more (0·98 ± 0·01 vs. 0·97 ± 0·03 and 0·86 ± 0·05 vs. 0·85 ± 0·05) than IMRT plans but not statistically significant. Better dose HI was found for IMRT plans with statistical significant difference (p < 0·001). The tumour coverage was found similar 98·24% and 97·83% for SS IMRT and CDR-VMAT, respectively. For D2%, the maximum dose to PTV was significantly lower in IMRT (p = 0·001). D50% and mean dose to PTV were also comparable to IMRT with no statistically significant difference. The OAR parameters were comparable in both the techniques. The mean doses and volume doses V10, V20 and V30 to the right kidney, left kidney and liver were also comparable with no significant difference (p > 0·05) was noted among them. However, the maximum dose to the spinal cord was significantly less in CDR-VMAT (21·1 Gy vs. 25·1Gy) than SS IMRT with p = 0·006. More MUs were associated with the CDR-VMAT technique, but shorter treatment delivery time than the IMRT technique.Conclusions:On dosimetric comparison of two treatment techniques, we conclude that CDR-VMAT can be a valid option in radiotherapy as it achieved highly conformed dose distribution, comparable tumour coverage and OAR sparing as IMRT technique for gallbladder cancer.
Orbital Forcing Strongly Influences Seasonal Temperature Trends During the Last Millennium
Authors: Lücke Lucie J. , Schurer Andrew P. , Wilson Rob , Hegerl Gabriele C. 
Published: December 2020

AbstractInsolation changes caused by the axial precession induce millennial trends in last millennium temperature, varying with season and latitude. A characteristic seasonal trend pattern can be detected in both insolation and modeled surface temperature response. In the extratropical Northern Hemisphere, the maximum insolation trend occurs around April/May, while the minimum trend occurs between July and September. The temperature trend lags behind insolation trend by around a month. Hence orbital forcing potentially affects long‐term trends in proxy data, which are often sensitive to a distinct seasonal window. We find that tree‐ring reconstructions based on early growing season dominated records show different millennial trends from those for late summer dominated proxies. The differential response is similar to that seen in pseudo proxy reconstructions when considering proxy seasonality. This suggests that orbital forcing has influenced long‐term trends in climate proxies. It is therefore vital to use seasonally homogeneous data for reconstructing multicentennial variability.
Predictable Variations of the Carbon Sinks and Atmospheric CO2Growth in a Multi‐Model Framework
Authors: Ilyina T. , Li H. , Spring A. , Müller W. A. , Bopp L. , Chikamoto M. O. , Danabasoglu G. , Dobrynin M. , Dunne J. , Fransner F. , Friedlingstein P. , Lee W. , Lovenduski N. S. , Merryfield W.J. , Mignot J. , Park J.Y. , Séférian R. , Sospedra‐Alfonso R. , Watanabe M. , Yeager S. 
Published: December 2020

AbstractInter‐annual to decadal variability in the strength of the land and ocean carbon sinks impede accurate predictions of year‐to‐year atmospheric carbon dioxide (CO2) growth rate. Such information is crucial to verify the effectiveness of fossil fuel emissions reduction measures. Using a multi‐model framework comprising prediction systems initialized by the observed state of the physical climate, we find a predictive skill for the global ocean carbon sink of up to 6 years for some models. Longer regional predictability horizons are found across single models. On land, a predictive skill of up to 2 years is primarily maintained in the tropics and extra‐tropics enabled by the initialization of the physical climate. We further show that anomalies of atmospheric CO2growth rate inferred from natural variations of the land and ocean carbon sinks are predictable at lead time of 2 years and the skill is limited by the land carbon sink predictability horizon.
The Sensitivity of British Weather to Ocean Tides
Authors: Arnold Alex K. , Lewis Huw W. , Hyder Patrick , Siddorn John , O’Dea Enda 
Published: December 2020

AbstractTides in shelf seas greatly impact ocean mixing and temperature structure. Using a regional‐coupled ocean–atmosphere prediction system, at ocean coastal process and atmosphere convection permitting scales, we assess the influence of tides on British weather by comparing simulations with and without tides. In summer, when seasonal stratification is particularly sensitive to tides, the sea‐surface temperature is up to 6 K cooler in simulations with tidal mixing. Tides cool the air temperature over the sea by up to 3 K, and nearby land by up to 1.4 K. The mean air temperature across Great Britain land areas cools by 0.3 K with tides. Changes in near‐surface stability result in decreases in summer mean wind speeds over the ocean. A 6% reduction in summer precipitation is found with tides, consistent with cooler temperatures. This study has implications for climate projections since global‐coupled models typically do not include tides.