bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of critical-sized bone defects in the treatment of fracture-related infection: a systematic review and pooled analysis
Authors: Bezstarosti H. , Metsemakers W. J. , van Lieshout E. M. M. , Voskamp L. W. , Kortram K. , McNally M. A. , Marais L. C. , Verhofstad M. H. J. 
Published: August 2020

Abstract
Purpose
This systematic review determined the reported treatment strategies, their individual success rates, and other outcome parameters in the management of critical-sized bone defects in fracture-related infection (FRI) patients between 1990 and 2018.

Methods
A systematic literature search on treatment and outcome of critical-sized bone defects in FRI was performed. Treatment strategies identified were, autologous cancellous grafts, autologous cancellous grafts combined with local antibiotics, the induced membrane technique, vascularized grafts, Ilizarov bone transport, and bone transport combined with local antibiotics. Outcomes were bone healing and infection eradication after primary surgical protocol and recurrence of FRI and amputations at the end of study period.

Results
Fifty studies were included, describing 1530 patients, the tibia was affected in 82%. Mean age was 40 years (range 6–80), with predominantly male subjects (79%). Mean duration of infection was 17 months (range 1–624) and mean follow-up 51 months (range 6–126). After initial protocolized treatment, FRI was cured in 83% (95% CI 79–87) of all cases, increasing to 94% (95% CI 92–96) at the end of each individual study. Recurrence of infection was seen in 8% (95% CI 6–11) and amputation in 3% (95% CI 2–3). Final outcomes overlapped across treatment strategies.

Conclusion
Results should be interpreted with caution due to the retrospective and observational design of most studies, the lack of clear classification systems, incomplete data reports, potential underreporting of adverse outcomes, and heterogeneity in patient series. A consensus on classification, treatment protocols, and outcome is needed to improve reliability of future studies.
Introducing multiple-choice questions to promote learning for medical students: effect on exam performance in obstetrics and gynecology
Authors: Jud Sebastian M. , Cupisti Susanne , Frobenius Wolfgang , Winkler Andrea , Schultheis Franziska , Antoniadis Sophia , Beckmann Matthias W. , Heindl Felix 
Published: August 2020

Abstract
Purpose
Testing is required in medical education. The large number of exams that students face requires effective learning strategies. Various methods of improving knowledge retention and recall have been discussed, two of the most widely evaluated of which are test-enhanced learning and pause procedures. This study investigated the effect of voluntary multiple-choice questions on students’ performance.

Methods
In a prospective study from April 2013 to March 2015, 721 students were randomly assigned to receive supplementary online material only (control group) or additional multiple-choice questions (investigative group) accompanying lectures. Their performance in the final exam was evaluated.

Results
A total of 675 students were ultimately included, with 299 randomly assigned to the investigative group and 376 to the control group. Students in the investigative group scored significantly better in relation to grades and points (2.11 vs. 2.49; 33 vs 31.31; p < 0.05). The effect declined over time.

Conclusion
This is the first study of the use of voluntary multiple-choice questions to improve medical students’ performance. The results support test-enhanced learning and the feasibility of implementing multiple-choice questions in lectures.
Simulation of the effect of mucociliary clearance on the bronchial distribution of inhaled radon progenies and related cellular damage using a new deposition and clearance model for the lung
Authors: Farkas Árpád 
Published: August 2020

AbstractMost of the current dosimetry models of inhaled short-lived radon decay products assume uniform activity distributions along the bronchial airways. In reality, however, both deposition and clearance patterns of inhaled radon progenies are highly inhomogeneous. Consequently, a new deposition-clearance model has been developed that accounts for such inhomogeneities and applied together with biophysical models of cell death and cell transformation. The scope of this study was to apply this model which is based on computational fluid and particle dynamics methods, in an effort to reveal the effect of mucociliary clearance on the bronchial distribution of deposited radon progenies. Furthermore, the influence of mucociliary clearance on the spatial distribution of biological damage due to alpha-decay of the deposited radon progenies was also studied. The results obtained demonstrate that both deposition and clearance of inhaled radon progenies are highly non-uniform within a human airway bifurcation unit. Due to the topology of the carinal ridge, a slow clearance zone emerged in this region, which is the location where most of the radio-aerosols deposit. In spite of the slow mucus movement in this zone, the initial degree of inhomogeneity of the activity due to the nonuniform deposition decreased by a factor of about 3 by considering the effect of mucociliary clearance. In the peak of the airway bifurcation, the computed cell death and cell transformation probabilities were lower when considering deposition and clearance simultaneously, compared to the case when only deposition was considered. However, cellular damage remained clustered.
Impact of pre-stroke dependency on outcome after endovascular therapy in acute ischemic stroke
Authors: Oesch Lisa , Arnold Marcel , Bernasconi Corrado , Kaesmacher Johannes , Fischer Urs , Mosimann Pascal J. , Jung Simon , Meinel Thomas , Goeldlin Martina , Heldner Mirjam , Volbers Bastian , Gralla Jan , Sarikaya Hakan 
Published: August 2020

Abstract
Background and purpose
Current demographic changes indicate that more people will be care-dependent due to increasing life expectancy. Little is known about impact of preexisting dependency on stroke outcome after endovascular treatment (EVT).

Methods
We compared prospectively collected baseline and outcome data of previously dependent vs. independent stroke patients (prestroke modified Rankin Scale score of 3–5 vs. 0–2) treated with EVT. Outcome measures were favorable 3-month outcome (mRS ≤ 3 for previously dependent and mRS ≤ 2 for independent patients, respectively), death and symptomatic intracranial hemorrhage (sICH).

Results
Among 1247 patients, 84 (6.7%) were dependent before stroke. They were older (81 vs. 72 years of age), more often female (61.9% vs. 46%), had a higher stroke severity at baseline (NIHSS 18 vs. 15 points), more often history of previous stroke (32.9% vs. 9.1%) and more vascular risk factors than independent patients. Favorable outcome and mortality were to the disadvantage of independent patients (26.2% vs. 44.4% and 46.4% vs. 25.5%, respectively), whereas sICH was comparable in both cohorts (4.9% vs. 5%). However, preexisting dependency was not associated with clinical outcome and mortality after adjusting for outcome predictors (OR 1.076, 95% CI 0.612–1.891; p = 0.799 and OR 1.267, 95% CI 0.758–2.119; p = 0.367, respectively).

Conclusion
Our study underscores the need for careful selection of care-dependent stroke patients when considering EVT, given a less favorable outcome observed in this cohort. Nonetheless, EVT should not systematically be withheld in patients with preexisting disability, since prior dependency does not significantly influence outcome.
Vascular risk factors, white matter lesions and cognitive impairment in Parkinson’s disease: the PACOS longitudinal study
Authors: Nicoletti Alessandra , Luca Antonina , Baschi Roberta , Cicero Calogero Edoardo , Mostile Giovanni , Davì Marco , La Bianca Giuseppe , Restivo Vincenzo , Zappia Mario , Monastero Roberto 
Published: August 2020

Abstract
Background
Vascular risk factors (VRFs) may be associated with cognitive decline in early Parkinson’s disease (PD) but results are inconclusive. The identification of modifiable risk factors is relevant for prevention and treatment.

Methods
Parkinson’s disease (PD) patients of the PACOS cohort who underwent a baseline and follow-up neuropsychological evaluation were enrolled in the study. PD with Mild Cognitive Impairment (MCI) and dementia (PDD) were diagnosed according to the MDS criteria. A Baseline 1.5 T brain MRI was used to calculate the white matter lesions (WMLs) burden using the Wahlund visual scale. Laboratory data, presence of hypertension, diabetes and use of anti-hypertensive drugs were collected and the Framingham Risk (FR) score was calculated. VRFs predicting PD-MCI and PDD were evaluated using Cox proportional hazard regression model.

Results
Out of 139 enrolled patients, 84 (60.4%) were classified as normal cognition (NC) and 55 (39.6%) as MCI at baseline. At follow-up 28 (33.3%) PD-NC developed MCI and 4 (4.8%) PDD (follow-up time 23.5 ± 10.3 months). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD. At multivariate analysis among PD-NC a systolic blood pressure (SBP) > 140 mmHg was the stronger predictor of MCI (adjHR 4.04; 95% CI 1.41–11.3) while the presence of MCI at baseline (adj HR 7.55; 95% CI 1.76–32.3) and a severe WMLs burden (adj HR 2.80; 95% CI 0.86–9.04) were the strongest predictors of PDD, even if this latter association has a trend towards significance.

Conclusion
Hypertension represents the most important modifiable risk factor for PD-MCI in the PACOS cohort, increasing the risk of about four times.
Random Geometric Complexes and Graphs on Riemannian Manifolds in the Thermodynamic Limit
Authors: Lerario Antonio , Mulas Raffaella 
Published: August 2020

AbstractWe investigate some topological properties of random geometric complexes and random geometric graphs on Riemannian manifolds in the thermodynamic limit. In particular, for random geometric complexes we prove that the normalized counting measure of connected components, counted according to isotopy type, converges in probability to a deterministic measure. More generally, we also prove similar convergence results for the counting measure of types of components of eachk-skeleton of a random geometric complex. As a consequence, in the case of the 1-skeleton (i.e., for random geometric graphs) we show that the empirical spectral measure associated to the normalized Laplace operator converges to a deterministic measure.
Financial toxicity and employment status in cancer survivors. A systematic literature review
Authors: Mols Floortje , Tomalin Bianca , Pearce Alison , Kaambwa Billingsley , Koczwara Bogda 
Published: August 2020

Abstract
Background
Financial toxicity has traditionally been attributed to the rising costs of cancer care. As ability to work impacts one’s financial situation, limited employment and reduced income may also contribute to financial toxicity. We examined evidence of the association between financial toxicity and employment status in cancer survivors.

Methods
A systematic literature review was performed via PubMed, Web of Science, CINAHL, and PsycINFO with search terms including “Cancer,” “Financial toxicity,” and “Employment” on September 25, 2019.

Results
Thirty-one papers met eligibility criteria. Thirteen studies were rated as having high quality, 16 as adequate, and two as low. Being actively treated for cancer had serious negative consequences on employment and medical expenditures. Unemployment, changed or reduced employment, lost days at work, poor work ability, and changes to employment were associated with a higher risk of financial toxicity. Patients who were younger, non-white, unmarried, of low education, living with dependents, residing in non-metropolitan service areas, with lower income, and of low socioeconomic status were more at risk of financial toxicity. Other variables associated with financial toxicity included having a mortgage/personal loan, higher out of pocket costs and household bills, limited health insurance, more severely ill, on active treatment, and lower functioning or quality of life.

Conclusion
Cancer negatively affects employment, and these changes are significant contributors to financial toxicity. Researchers, healthcare professionals, and patients themselves should all cooperate to tackle these complex issues.
Respiratory characteristics and related intraoperative ventilatory management for patients with COVID-19 pneumonia
Authors: Aoyama Hiroko , Uchida Kanji 
Published: August 2020

AbstractA substantial proportion of patients with coronavirus disease 19 (COVID-19) develop severe respiratory failure. Although the exact pathophysiology of severe COVID-19 pneumonia remains unknown and the characteristics of these patients are heterogeneous, the acute respiratory failure often fulfills criteria for acute respiratory distress syndrome (ARDS) and the clinical characteristics are also consistent with what is previously known about ARDS. Cohort studies also report distinctively high association between perioperative COVID-19 and postoperative mortality. In this special article, we review several publications on the pathophysiology of COVID-19, and discuss intraoperative ventilatory management for patients with COVID-19 based on the respiratory characteristics of COVID-19 pneumonia in light of the ongoing controversy of clinical phenotypes.
Characterization of two newly isolated Staphylococcus aureus bacteriophages from Japan belonging to the genus Silviavirus
Authors: Kitamura Naoya , Sasabe Eri , Matsuzaki Shigenobu , Daibata Masanori , Yamamoto Tetsuya 
Published: August 2020

AbstractTwo Staphylococcus aureus bacteriophages, KSAP7 and KSAP11, were isolated from sewage and characterized. Based on morphology and DNA sequences, they were assigned to the genus Silviavirus, subfamily Twortvirinae, family Herelleviridae, whose members are hypothesized to be suitable for bacteriophage therapy. The KSAP7 and KSAP11 genomes were 137,950 and 138,307 bp in size, respectively. Although their DNA sequences were almost identical, evidence of site-specific DNA rearrangements was found in two regions. Changes in the number of PIEPEK amino acid sequence repeats encoded by orf10 and the insertion/deletion of a 541-bp sequence that includes a possible tail-related gene were identified.
Parental positive regard and expressed emotion—prediction of developing attention deficit, oppositional and callous unemotional problems between preschool and school age
Authors: Pauli-Pott Ursula , Bauer Lotte , Becker Katja , Mann Christopher , Müller Viola , Schloß Susan 
Published: August 2020

AbstractParental expressed emotion and positive reinforcement are assumed to affect the development of oppositional and callous-unemotional behaviors in children at risk of attention deficit hyperactivity disorder (ADHD). As longitudinal research on this issue is scarce, we analyzed the respective links between preschool and school age. 138 five-year-old (m = 58.2, s = 6.2 months) children (59% boys) with elevated ADHD symptoms (according to screening) were assessed at the ages of five and eight years. At 5 years, maternal expressed emotion (using the Five Minute Speech Sample) and positive regard of child (using a standardized at-home observation procedure) were assessed. At 5 and 8 years, symptoms of ADHD, oppositional defiant disorder (ODD), and callous-unemotional (CU) behaviors were measured using a multi-informant approach. Multiple linear regression analyses revealed that positive regard specifically predicted a decrease in ODD symptoms between preschool and school age. The expression of high negative emotion specifically predicted an increase in CU behaviors. The development of ADHD symptoms was not predicted by parenting. Knowledge on these specific links can help to elaborate diagnostic and counseling processes in preschoolers with high ADHD symptoms. Underlying mechanisms and the role of neurocognitive deficits of the preschool child should be further analyzed.
The interplay between mothers’ and children behavioral and psychological factors during COVID-19: an Italian study
Authors: Di Giorgio Elisa , Di Riso Daniela , Mioni Giovanna , Cellini Nicola 
Published: August 2020

AbstractItaly has been the first nation outside of Asia to face the COVID-19 outbreak. To limit viral transmission of infection, by March 10th, 2020, the Italian Government has ordered a national lockdown, which established home confinement, home (smart) working, and temporary closure of non-essential businesses and schools. The present study investigated how these restrictive measures impacted mothers and their pre-school children’s behavioral habits (i.e., sleep timing and quality, subjective time experience) and psychological well-being (i.e., emotion regulation, self-regulation capacity). An online survey was administered to 245 mothers with pre-school children (from 2 to 5 years). Mothers were asked to fill the survey thinking both on their habits, behaviors, and emotions and on those of their children during the quarantine, and retrospectively, before the national lockdown (i.e., in late February). A general worsening of sleep quality and distortion of time experience in both mothers and children, as well as increasing emotional symptoms and self-regulation difficulties in children, was observed. Moreover, even when the interplay between the behavioral and psychological factors was investigated, the factor that seems to mostly impact both mothers' and children's psychological well-being was their sleep quality. Overall, central institutions urgently need to implementing special programs for families, including not only psychological support to sustain families with working parents and ameliorating children's management.
How Does Collaborative Reflection Unfold in Online Communities? An Analysis of Two Data Sets
Authors: Prilla Michael , Blunk Oliver , Chounta Irene-Angelica 
Published: August 2020

AbstractPeople can learn a lot through (collaborative) reflection at work: In organizations, staff debate experiences and due to issues every day, thus reflecting together and learning from each other. While this is desirable, it is often hindered by differences in time and space. Online discussions in community-like systems may provide a means to overcome this issue and enable staff to share experiences and learn from them. In this paper, we study two different data sets from two software systems to support online collaborative reflection in order to analyze what possible factors influence the occurrence of aspects of reflection in online discussions, like experiences, suggestions and learning. Our results include findings that partially approve existing models of (collaborative) reflection, but also others that add to or even challenge these models. Overall, we found that collaborative reflection may take different paths towards learning. From this we derive that facilitation mechanisms need to take up these paths, and that facilitation may be successful in different ways than anticipated from existing literature. We describe possible facilitation mechanisms and discuss their implementation.
Basin-wide spatial conditional extremes for severe ocean storms
Authors: Shooter Rob , Tawn Jonathan , Ross Emma , Jonathan Philip 
Published: August 2020

AbstractPhysical considerations and previous studies suggest that extremal dependence between ocean storm severity at two locations exhibits near asymptotic dependence at short inter-location distances, leading to asymptotic independence and perfect independence with increasing distance. We present a spatial conditional extremes (SCE) model for storm severity, characterising extremal spatial dependence of severe storms by distance and direction. The model is an extension of Shooter et al. 2019 (Environmetrics 30, e2562, 2019) and Wadsworth and Tawn (2019), incorporating piecewise linear representations for SCE model parameters with distance and direction; model variants including parametric representations of some SCE model parameters are also considered. The SCE residual process is assumed to follow the delta-Laplace form marginally, with distance-dependent parameter. Residual dependence of remote locations given conditioning location is characterised by a conditional Gaussian covariance dependent on the distances between remote locations, and distances of remote locations to the conditioning location. We apply the model using Bayesian inference to estimates extremal spatial dependence of storm peak significant wave height on a neighbourhood of 150 locations covering over 200,000 km2 in the North Sea.
Oxygen separation from air by the combined temperature swing and pressure swing processes using oxygen storage materials Y1−x(Tb/Ce)xMnO3+δ
Authors: Klimkowicz Alicja , Hashizume Takao , Cichy Kacper , Tamura Sayaka , Świerczek Konrad , Takasaki Akito , Motohashi Teruki , Dabrowski Bogdan 
Published: August 2020

AbstractHexagonal Y1−xRxMnO3+δ (R: other than Y rare earth elements) oxides have been recently introduced as promising oxygen storage materials that can be utilized in the temperature swing processes for the oxygen separation and air enrichment. In the present work, the average and local structures of Tb- and Ce-substituted Y0.7Tb0.15Ce0.15MnO3+δ and Y0.6Tb0.2Ce0.2MnO3+δ materials were studied, and their oxygen storage-related properties have been evaluated. The fully oxidized samples show the presence of a significant amount of the highly oxygen-loaded the so-called Hex3 phase, attaining an average oxygen content of δ ≈ 0.41 for both compositions. Extensive studies of the temperature swing process conducted in air and N2 over the temperature range of 180–360 °C revealed large and reversible oxygen content changes taking place with only a small temperature differences and the high dependence on the oxygen partial pressure. Significant for practical performance, the highest reported for this class of compounds, oxygen storage capacity of 1900 μmol O g−1 in air was obtained for the optimized materials and swing process. In the combined temperature–oxygen partial pressure swing process, the oxygen storage capacity of 1200 μmol O g−1 was achieved.
Bidirectional Associations between Popularity, Popularity Goal, and Aggression, Alcohol Use and Prosocial Behaviors in Adolescence: A 3-Year Prospective Longitudinal Study
Authors: Malamut Sarah T. , van den Berg Yvonne H. M. , Lansu Tessa A. M. , Cillessen Antonius H. N. 
Published: August 2020

AbstractAdolescents’ popularity and popularity goal have been shown to be related to their aggression and alcohol use. As intervention efforts increasingly aim to focus on prosocial alternatives for youth to gain status, it is essential to have a comprehensive understanding of how popularity and popularity goal are associated with aggression and substance use as well as prosocial behaviors over time. The current study examined the bidirectional associations of aggression (overt and relational aggression), alcohol use, and prosocial behavior with popularity and popularity goal in adolescence across 3 years using cross-lagged panel analyses. Participants were 839 Dutch adolescents (Mage = 13.36, SD = 0.98; 51.3% girls). The results indicated that popularity was consistently positively associated with popularity goal, but popularity goal did not significantly predict subsequent popularity. Popularity positively predicted elevated aggression and alcohol use, but lower levels of prosocial behavior. For the full sample, alcohol use and overt aggression in grade 7 both predicted subsequent popularity in grade 8. However, when considering gender differences, overt aggression no longer was a significant predictor of popularity. These results were discussed in terms of the dynamic interplay between popularity, popularity goal, and behaviors, and in terms of implications for prevention and intervention efforts.