bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulation Training in Neuroangiography—Validation and Effectiveness
Authors: Kreiser Kornelia , Ströber Lea , Gehling Kim G. , Schneider Frederick , Kohlbecher Stefan , Schulz Christian M. , Zimmer Claus , Kirschke Jan S. 
Published: April 2020

Abstract
Purpose
Simulators are increasingly used in the training of endovascular procedures; however, for the use of the Mentice vascular interventional system trainer (VIST) simulator in neuroradiology, the validity of the method has not yet been proven. The study was carried out to test the construct validity of such a simulator by demonstrating differences between beginner and expert neurointerventionalists and to evaluate whether a training effect can be demonstrated in repeated cases for different levels of experience.

Methods
In this study 4 experts and 6 beginners performed 10 diagnostic angiographies on the VIST simulator (Mentice AB, Gothenburg, Sweden). Of the cases four were non-recurring, whereas three were repeated once and ten subjects performed all tasks. Additionally, another expert performed only five non-recurring cases. The simulator recorded total time, fluoroscopy time, amount of contrast medium and number of material changes. Furthermore, gaze direction and heart rate were recorded, and subjects completed a questionnaire on workload.

Results
Beginners and experts showed significant differences in total duration time, fluoroscopy time and amount of contrast agent (all p < 0.05). Gaze direction, dwell time and heart rate were similar between both groups. Only beginners improved during training with respect to total duration time, fluoroscopy time and amount of contrast agent. If a case was previously known to them, the total duration and fluoroscopy time were significantly shortened (p < 0.001).

Conclusion
This study demonstrated both the construct validity of a diagnostic neuroangiography simulator as well as a significant training effect for beginners. Therefore, in particular beginner neurointerventionalists should use such simulation tools more extensively in their initial training.
Inpatient hypoglycaemia: understanding who is at risk
Authors: Ruan Yue , Moysova Zuzana , Tan Garry D. , Lumb Alistair , Davies Jim , Rea Rustam D. 
Published: April 2020

Abstract
Aims/hypothesis
We analysed data obtained from the electronic patient records of inpatients with diabetes admitted to a large university hospital to understand the prevalence and distribution of inpatient hypoglycaemia.

Methods
The study was conducted using electronic patient record data from Oxford University Hospitals NHS Foundation Trust. The dataset contains hospital admission data for patients coded for diabetes. We used the recently agreed definition for a level 1 hypoglycaemia episode as any blood glucose measurement <4 mmol/l and a level 2 hypoglycaemia episode as any blood glucose measurement <3 mmol/l. Any two or more consecutive low blood glucose measurements within a 2 h time window were considered as one single hypoglycaemic episode.

Results
We analysed data obtained from 17,658 inpatients with diabetes (1696 with type 1 diabetes, 14,006 with type 2 diabetes, and 1956 with other forms of diabetes; 9277 men; mean ± SD age, 66 ± 18 years) who underwent 32,758 hospital admissions between July 2014 and August 2018. The incidence of level 1 hypoglycaemia was 21.5% and the incidence of level 2 hypoglycaemia was 9.6%. Recurrent level 1 and level 2 hypoglycaemia occurred, respectively, in 51% and 39% of hospital admissions in people with type 2 diabetes with at least one hypoglycaemic episode, and in 55% and 45% in those with type 1 diabetes. The incidence of level 2 hypoglycaemia in people with type 2 diabetes, when corrected for the number of people who remained in hospital, remained constant for the first 100 h at approximately 0.15 events per h per admission. With regards to the hypoglycaemia distribution during the day, after correcting for the number of blood glucose tests per h, there were two clear spikes in the rate of hypoglycaemia approximately 3 h after lunch and after dinner. The highest rate of hypoglycaemia per glucose test was seen between 01:00 hours and 05:00 hours. Medication had a significant impact on the incidence of level 2 hypoglycaemia, ranging from 1.5% in people with type 2 diabetes on metformin alone to 33% in people treated with a combination of rapid-acting insulin analogue, long-acting insulin analogue and i.v.-administered insulin.

Conclusions/interpretation
Retrospective analysis of data from electronic patient records enables clinicians to gain a greater understanding of the incidence and distribution of inpatient hypoglycaemia. This information should be used to drive evidence-based improvements in the glycaemic control of inpatients through targeted medication adjustment for specific populations at high risk of hypoglycaemia.
Effect of Shoot Cutting on Trace Metal Concentration in Leaves and Capitula of Potential Phytoaccumulator, Invasive Erigeron annuus (Asteraceae)
Authors: Pliszko Artur , Klimek Beata , Kostrakiewicz-Gierałt Kinga 
Published: April 2020

AbstractThe effect of shoot cutting was tested on cadmium, lead and zinc concentration in leaves and capitula of Erigeron annuus, an invasive species, which is considered as a potential phytoremediator. Plant material and soil were collected in the city center of Kraków, southern Poland, considered as one of the most contaminated cities in Europe. We proved that the concentration of zinc in leaves and capitula was higher after regrowth, concentration of cadmium was lower in capitula than in leaves, and the average value of bio-concentration factor for zinc and cadmium was less than 1, whereas for lead it was greater than 1 in both plant organs. Our results suggested that E. annuus can be potentially used for phytoremediation of lead and cutting the shoots can promote effectiveness of zinc removal from the contaminated soil.
Research productivity during orthopedic surgery residency correlates with pre-planned and protected research time: a survey of German-speaking countries
Authors:   For the Society of Arthroscopy and Joint Surgery (AGA) Residents Forum, Research Working Group, Voss Andreas , Andreß Björn , Pauzenberger Leo , Herbst Elmar , Pogorzelski Jonas , John Dominik , Smolen Daniel , Roessler Philip P. , Tobert Daniel G. , Sieker Jakob T. 
Published: April 2020

Abstract
Purpose
The purpose of this study was to identify modifiable factors associated with research activity among residents working in orthopedic surgery and traumatology.

Methods
Residents at 796 university-affiliated hospitals in Austria, Germany, and Switzerland were invited to participate. The online survey consisted of questions that ascertained 13 modifiable and 17 non-modifiable factors associated with the residents’ current research activities. Responses of 129 residents were analyzed. Univariate linear regression was used to determine the association of individual factors with the current research activity (hours per week). The impact of significant non-modifiable factors (with unadjusted p values < 0.05) was controlled for using multivariate linear regression.

Results
The univariate analysis demonstrated six non-modifiable factors that were significantly associated with the current research activity: a University hospital setting (p < 0.001), an A-level hospital setting (p = 0.024), Swiss residents (p = 0.0012), the completion of a dedicated research year (p = 0.007), female gender (p = 0.016), and the department’s size (p = 0.048). Multivariate regression demonstrated that the number of protected research days per year (p < 0.029) and the percentage of protected days, that were known 1 week before (p < 0.001) or the day before (p < 0.001), were significantly associated with a higher research activity.

Conclusions
As hypothesized, more frequent and predictable protected research days were associated with higher research activity among residents in orthopedic surgery and traumatology.

Level of evidence
III.
A new technique of laparoscopic fixation of the uterus to the anterior abdominal wall with the use of overfascial mesh in the treatment of pelvic organ prolapse
Authors: Śliwa Jakub , Kryza-Ottou Anna , Zimmer-Stelmach Aleksandra , Zimmer Mariusz 
Published: April 2020

Abstract
Introduction and hypothesis
Pelvic organ prolapse is one of the most common pathological conditions in postmenopausal women. There is still a lack of fully effective and safe surgical techniques, especially in the advanced stages of apical defects. The purpose of the video is to present a new technique of laparoscopic treatment in women with an advanced stage of genital prolapse, stage III and IV according to the POP-Q scale. The technique involves uterine fixation for the anterior abdominal wall using overfascial mesh.

Methods
We used a live-action surgical demonstration to describe laparoscopic fixation of the uterus to the anterior abdominal wall with the use of overfascial mesh.

Results
This video provides a step-by-step approach to laparoscopic fixation of the uterus to the anterior abdominal wall with the use of overfascial mesh. The video can be used to educate and train those performing female pelvic reconstructive surgery.

Conclusions
Based on our experience, this technique of laparoscopic suspension of the uterus to the anterior abdominal wall with the use of overfascial mesh is an effective, safe, and easy procedure for the treatment of advanced stages of pelvic organ prolapse.
Multimodal spectral focusing CARS and SFG microscopy with a tailored coherent continuum from a microstructured fiber
Authors: Herdzik Krzysztof P. , Bourdakos Konstantinos N. , Johnson Peter B. , Lister Adam P. , Pitera Aleksandra P. , Guo Chun-yu , Horak Peter , Richardson David J. , Price Jonathan H. V. , Mahajan Sumeet 
Published: April 2020

AbstractWe report a technologically novel microscopy system for bioimaging based on a 100 fs titanium:sapphire (Ti:Sa) laser pumped coherent continuum from a tailored, 9-cm long, all normal dispersion (ANDi) fiber, enabling concurrent image contrast with (a) spectral focusing coherent anti-Stokes Raman scattering (SF-CARS) (spanning 900–3200 cm−1) and (b) sum frequency generation (SFG). Both modalities were efficiently excited with power levels at the microscope focus compatible with biological samples. Moreover, using the continuum, images were recorded in the back-scattering (epi-detection) geometry, without the necessity for an expensive, computer-controlled, spatial light modulator (SLM), clearly demonstrating the strong signal levels achieved. Image contrast from the multiple modalities provided greater chemical and structural insights than imaging with any single technique in isolation. Numerical simulations supported these developments in regard to both the optimum fiber length for SC generation and the achievement of high spectral resolution in SF-CARS via careful group delay dispersion matching across the pump and Stokes pulses using just an inexpensive sequence of short glass blocks inserted into the Stokes beam. We show bio-images of mouse tissue recorded concurrently via label/stain-free contrast from multiple modalities: CARS, two-photon auto-fluorescence (TPaF) and second harmonic/sum frequency generation (SHG/SFG). Overall, our approach delivers optimum performance in back-scattered (epi-) detection configuration, suited for thick samples, at reduced complexity and cost. The addition of this simple fiber add-on to lasers already widely used for TPF microscopy can thus extend the capabilities of a significant number of existing microscopy laboratories.
High level of EZH2 expression is linked to high density of CD8-positive T-lymphocytes and an aggressive phenotype in renal cell carcinoma
Authors: Eichenauer Till , Simmendinger Luca , Fraune Christoph , Mandelkow Tim , Blessin Niclas C. , Kluth Martina , Hube-Magg Claudia , Möller Katharina , Clauditz Till , Weidemann Sören , Dahlem Roland , Fisch Margit , Riechardt Silke , Simon Ronald , Sauter Guido , Büscheck Franziska , Rink Michael 
Published: April 2020

Abstract
Purpose
Enhancer of zeste homolog 2 (EZH2), the catalytic part of the Polycomb repressive complex 2 (PRC2), has a prognostic role in renal cell carcinoma (RCC) and was recently shown to modulate the immune response by reducing tumor cell immunogenicity.

Methods
To investigate whether the prognostic role of EZH2 might be driven by a modified immune environment, more than 1800 RCCs were analyzed in a tissue microarray for EZH2 expression and CD8 positive lymphocytes were quantitated by automated digital imaging.

Results
EZH2 positivity was found in 75.2% of 1603 interpretable tumors. In clear cell RCC, high EZH2 expression was significantly linked to high ISUP, Furmann, and Thoenes grade (p < 0.0001 each), advanced stage (p < 0.0001), nodal (p = 0.0190) and distant metastasis (p < 0.0001) as well as shortened overall (p < 0.0027) and recurrence free survival (p < 0.0001). The density of CD8+ cells varied from 0 to 5048 cells/mm2 (Median 120 cells/mm2). A high CD8+ count was significantly associated with high ISUP, Fuhrmann, and Thoenes grade (p < 0.0001 each), advanced tumor stage (p = 0.0041), distant metastasis (p = 0.0026) as well as reduced overall survival (p = 0.0373) and recurrence free survival (p = 0.0450). The density of CD8+ cells continuously increased with raising EZH2 levels (p < 0.0001).

Conclusion
Our data support a striking prognostic role of both EZH2 expression and the density of CD8+ cells in RCC. The tight relationship of EZH2 expression and CD8+ cell counts in RCC is consistent with models suggesting that EZH2 overexpression can be caused by high lymphocyte content in certain tumor types. Such a mechanism could explain the unique finding of high lymphocyte counts driving poor prognosis in RCC patients.
Dynamical and thermodynamical drivers of variability in European summer heat extremes
Authors: Suarez-Gutierrez Laura , Müller Wolfgang A. , Li Chao , Marotzke Jochem 
Published: April 2020

AbstractWe use the 100-member Max Planck Institute Grand Ensemble (MPI-GE) to disentangle the contributions from colocated dynamic atmospheric conditions and local thermodynamic effects of moisture limitation as drivers of variability in European summer heat extremes. Using a novel extreme event definition, we find that heat extremes with respect to the evolving mean climate increase by 70% under a moderate warming scenario during the twenty-first century. With a multiple regression approach, we find that the dynamical mechanisms representing blocking and anticyclonic conditions are the main driver of variability in extreme European summer temperatures, both in past and future climates. By contrast, local thermodynamic drivers play a secondary role in explaining the total variability in extreme temperatures. We also find that considering both dynamical and thermodynamical sources of variability simultaneously is crucial. Assessing only one type of drivers leads to an overestimation of their effect on extreme temperatures, particularly when considering only thermodynamical drivers. Lastly, we find that although most past and future heat extremes occur under favorable dynamical atmospheric conditions; this occurs 10–40% less frequently over Central Europe in the twenty-first century. By contrast, heat extremes over Central Europe occur 40% more frequently under concurrent extreme moisture limitation in the twenty-first Century. Our findings highlight a new type of neutral-atmosphere, moisture-driven heat extremes, and confirm that the increase in European heat extremes and associated variability increase are dominated by the local thermodynamic effect of moisture limitation.
Assessment of heavy metal pollution in Vistula river (Poland) sediments by using magnetic methods
Authors: Szczepaniak-Wnuk Iga , Górka-Kostrubiec Beata , Dytłow Sylwia , Szwarczewski Piotr , Kwapuliński Piotr , Karasiński Jakub 
Published: April 2020

AbstractThe present study evaluated the level of heavy metal (HM) pollution in Vistula river sediments in a highly urbanized Warsaw agglomeration (Poland). Magnetometry was used to assess the pollution level by measuring the fine fractions (0.071 mm and < 0.071 mm) of sediments collected from the surface layer of the riverbank. The magnetic methods (e.g., mass magnetic susceptibility χ, temperature-dependence magnetic susceptibility, and hysteresis loop parameters) were supplemented by microscopy observations and chemical element analyses. The results showed the local impact of Warsaw’s activity on the level of HM pollution, indicated by the maximum concentrations of magnetic particles and HM in the city center. The sediment fraction < 0.071 mm was dominated by magnetite and by a large amount of spherical-shaped anthropogenic magnetic particles. The pollution from the center of Warsaw was transported down-river over a relatively short distance of approximately 11 km. There was a gradual decrease in the concentrations of magnetic particles and HM in areas located to the north of the city center (down-river); furthermore, χ and concentrations of HM did not decrease to the values observed for the area to the south of Warsaw (up-river). The study showed two possible sources of sediment pollution: traffic-related and heat and power plant emissions. The influence of an additional source of pollution cannot be excluded as the amount of spherules in the sediments at the center was extremely high. The present study demonstrates that magnetometry has a practical application in detecting and mapping HM pollution in river systems.
Kommunikationspräfenzen im Kontext von Adipositas
Authors: Hansen Solveig Lena , Bammel Hendrik , Lübeck Nicole , Seibel Regina , Schankweiler Pia 
Published: April 2020

Zusammenfassung
Hintergrund
Das Thema Körpergewicht weist aktuelle einige Herausforderungen für die Arzt-Patienten-Kommunikation auf.

Ziel der Arbeit
Die vorliegende Studie untersucht Kommunikationspräferenzen von Personen mit Adipositas und erarbeitet praktische Empfehlungen für deren Beratung.

Material und Methoden
Qualitative Inhaltsanalyse halb strukturierter, leitfadengestützter Interviews mit 20 Teilnehmenden eines Gewichtsreduktionsprogramms.

Ergebnisse
Das Thema wurde meist von Ärzten im Zusammenhang mit anderen Erkrankungen angesprochen. Inhalte der Gespräche waren oft medizinische Informationen und Risiken. Es konnten sechs verschiedene Typen der Ansprache herausgearbeitet werden. Entscheidend für eine gelungene Kommunikation erwies sich weniger die konkrete Wortwahl als die Art der Ansprache und Haltung des Arztes. Wir entwickeln die Struktur für eine individualisierte Beratung und erarbeiten ein „5-G-Modell“ als Leitfaden.
Constitutive TSH receptor activation as a hallmark of thyroid autonomy
Authors: Führer Dagmar 
Published: April 2020

AbstractSince its cloning more than 30 years ago, the thyrotropin receptor (TSHR) has emerged as a pivotal player in thyroid physiology and pathophysiology. In particular, hyperthyroidism due to autoimmune disease or thyroid autonomy is linked with TSHR activation via autoantibodies or mutations respectively. This review summarises clinical aspects of constitutive TSH receptor activation by naturally occurring somatic or germline TSHR mutations resulting in TSH-independent thyroid function and cell proliferation.
Coupling effects in QD dimers at sub-nanometer interparticle distance
Authors: Dibenedetto Carlo Nazareno , Fanizza Elisabetta , Brescia Rosaria , Kolodny Yuval , Remennik Sergei , Panniello Annamaria , Depalo Nicoletta , Yochelis Shira , Comparelli Roberto , Agostiano Angela , Curri Maria Lucia , Paltiel Yossi , Striccoli Marinella 
Published: April 2020

AbstractCurrently, intensive research efforts focus on the fabrication of meso-structures of assembled colloidal quantum dots (QDs) with original optical and electronic properties. Such collective features originate from the QDs coupling, depending on the number of connected units and their distance. However, the development of general methodologies to assemble colloidal QD with precise stoichiometry and particle-particle spacing remains a key challenge. Here, we demonstrate that dimers of CdSe QDs, stable in solution, can be obtained by engineering QD surface chemistry, reducing the surface steric hindrance and favoring the link between two QDs. The connection is made by using alkyl dithiols as bifunctional linkers and different chain lengths are used to tune the interparticle distance from few nm down to 0.5 nm. The spectroscopic investigation highlights that coupling phenomena between the QDs in dimers are strongly dependent on the interparticle distance and QD size, ultimately affecting the exciton dissociation efficiency.
Modeling the Supporting Ecosystem Services of Depressional Wetlands in Agricultural Landscapes
Authors: Mushet David M. , Roth Cali L. 
Published: April 2020

AbstractWe explored how a geographic information system modeling approach could be used to quantify supporting ecosystem services related to the type, abundance, and distribution of landscape components. Specifically, we use the Integrated Valuation of Ecosystem Services and Tradeoffs model to quantify habitats that support amphibians and birds, floral resources that support pollinators, native-plant communities that support regional biodiversity, and above- and below-ground carbon stores in the Des Moines Lobe ecoregion of the U.S. We quantified services under two scenarios, one that represented the 2012 Des Moines Lobe landscape, and one that simulated the conversion to crop production of wetlands and surrounding uplands conserved under the USDA Agricultural Conservation Easement Program (ACEP). While ACEP easements only covered 0.35% of the ecoregion, preserved wetlands and grasslands provided for 19,020 ha of amphibian habitat, 21,462 ha of grassland-bird habitat, 18,798 ha of high-quality native wetland plants, and 27,882 ha of floral resources for pollinators. Additionally, ACEP protected lands stored 257,722 t of carbon that, if released, would result in costs in excess of 45-million USD. An integrated approach using results from a GIS-based model in combination with process-based model quantifications will facilitate more informed decisions related to ecosystem service tradeoffs.