bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome Quality Beyond the Mean – An Analysis of 43,231 Pancreatic Surgical Procedures Related to Hospital Volume
Authors: Hunger Richard , Mantke Rene 
Published: November 2020

Objective:
The aim of this study was to examine whether elevated in-hospital mortality rates in lower volume hospitals are only valid on average or also apply for individual hospitals.

Summary of Background Data:
Various studies demonstrated a volume-outcome relationship in pancreatic surgery with increased mortality in low volume hospitals. However, almost all studies assessed quality indicators only for groups of hospitals by averaged measures, neglecting variability of hospital performance.

Methods:
The German nationwide hospital discharge data (diagnosis-related groups-statistics) was used to determine risk-adjusted in-hospital mortality for all distal pancreatectomies (DP), pancreatoduodenectomies (Whipple-proce-dure, PD), and pylorus-preserving pancreatoduodenectomies (PPD) performed between 2011 and 2015. Hospitals were stratified according to annual and 5-year total procedure volume and examined in relation to average in-hospital mortality of the highest volume quintile.

Results:
Lowest adjusted mortality rates were observed in highest volume quintiles for each pancreatic resection procedure, with 6.2% for DP, 8.3% for PD, and 5.7% for PPD in the 5-year observation period. With these mortality rates as reference values the analysis revealed that a non-negligible proportion of hospitals performed equal or better (DP: 430/784, 54.5%; PD: 269/611, 44.0%; PPD: 255/565, 45.1%) than the hospitals of the highest volume quintile.

Conclusions:
High quality of care, with in-hospital mortality rates less or equal to high-volume hospitals, is also achieved in hospitals with lesser procedure volume. Therefore, mere volume seems not suitable as proximal measure for assessing individual hospital quality. instead, more sophisticated certification systems, that allow accurate quality assessment and better reflect clinical variability, should preferred to fixed minimum volume thresholds.
A Deep Learning Pipeline to Automate High-Resolution Arterial Segmentation With or Without Intravenous Contrast
Authors: Chandrashekar Anirudh , Handa Ashok , Shivakumar Natesh , Lapolla Pierfrancesco , Uberoi Raman , Grau Vicente , Lee Regent 
Published: November 2020

Background:
Existing methods to reconstruct vascular structures from a computerized tomography (CT) angiogram rely on contrast injection to enhance the radio-density within the vessel lumen. However, pathological changes in the vasculature may be present that prevent accurate reconstruction. In aortic aneurysmal disease, a thrombus adherent to the aortic wall within the expanding aneurysmal sac is present in >90% of cases. These deformations prevent the automatic extraction of vital clinical information by existing image reconstruction methods.

Aim:
In this study, a deep learning architecture consisting of a modified U-Net with attention-gating was implemented to establish a high-throughput and automated segmentation pipeline of pathological blood vessels in CT images acquired with or without the use of a contrast agent.

Methods and Results:
Seventy-Five patients with paired noncontrast and contrast-enhanced CT images were randomly selected from an ongoing study (Ethics Ref 13/SC/0250), manually annotated and used for model training and evaluation. Data augmentation was implemented to diversify the training data set in a ratio of 10:1. The performance of our Attention-based U-Net in extracting both the inner (blood flow) lumen and the wall structure of the aortic aneurysm from CT angiograms was compared against a generic 3-D U-Net and displayed superior results. Implementation of this network within the aortic segmentation pipeline for both contrast and noncontrast CT images has allowed for accurate and efficient extraction of the morphological and pathological features of the entire aortic volume.

Conclusions:
This extraction method can be used to standardize aneurysmal disease management and sets the foundation for complex geometric and morphological analysis. Furthermore, this pipeline can be extended to other vascular pathologies.
Percutaneous Transhepatic Choledochoscopic Lithotomy (PTCSL) is Effective for the Treatment of Intrahepatic and Extrahepatic Choledocholithiasis
Authors: Zhuo Hua , Chen ZeMing , Lin RunZhui , Yang ShaoHua , Zhuang HongCai , He Chao , Liu Xingmu 
Published: November 2020

Background:
To explore percutaneous transhepatic choledochoscopic lithotomy (PTCSL) as a treatment for intrahepatic and extrahepatic choledocholithiasis.

Patient and Methods:
A retrospective review of 67 patients with intrahepatic and extrahepatic choledocholithiasis treated by PTCSL from January 2014 to January 2019, including 36 males and 31 females, with an average age of 66 years. During the operation, the doctor established a channel through a 16-Fr Amplatz sheath and removed the stone in the channel with the aid of nephroscope. The clinical efficacy and complications of all patients were analyzed.

Results:
Sixty-seven patients (67/67, 100%) had their stones successfully removed in the first operation. Only 2 patients (2/67, 3.0%) developed mild reactive pleural effusion after the operation, and 1 patient (1/67, 1.5%) with cholangiocarcinoma after the operation. The incidence of severe bleeding during the operation was 0%.

Conclusion:
PTCSL is a minimally invasive, simple, effective and easy to repeat procedure for use in the clinic. It is an effective surgical treatment and is worthy of clinical use.
Activities of Daily Living Performance in Persons With Dementia
Authors: Burch Kari , Burch Brent D. 
Published: November 2020

Introduction:
Persons living with dementia require assistance in making day-to-day and health care decisions. Health care professionals select treatments based on the care partner (CP) report of the person’s function; however, the accuracy of CPs’ appraisal has received limited exploration.

Methods:
Retrospective analyses of observational, programmatic data were performed across 161 dyads (CPs and persons with dementia) participating in an evidence-based, community-level dementia intervention program. We examined the differences in the appraisal of activities of daily living performance by CPs versus occupational therapists specialized in dementia treatment and investigated factors related to this discrepancy.

Results:
The discrepancy in the assessment of function is common between CPs and clinicians. CPs tend to overestimate the abilities of persons with dementia. Appraisal discrepancy was most strongly associated with (1) sex of the person with dementia, (2) timing of assessment performance, (3) number of behavioral symptoms of the person with dementia, and (4) cognitive abilities of the person with dementia.

Discussion:
Many factors influence the ability of CPs to appraise the function of persons with dementia. The inaccurate appraisal could result in insufficient daily assistance for, or even unnecessary health care utilization, of the person with dementia. Timeliness of intervention is crucial as their health status may change quickly.
The acute vs. chronic effect of exercise on insulin sensitivity: nothing lasts forever
Authors: DiMenna Fred J. , Arad Avigdor D. 
Published: November 2020

Regular exercise causes chronic adaptations in anatomy/physiology that provide first-line defense for disease prevention/treatment (‘exercise is medicine’). However, transient changes in function that occur following each exercise bout (acute effect) are also important to consider. For example, in contrast to chronic adaptations, the effect of exercise on insulin sensitivity is predominantly rooted in a prolonged acute effect (PAE) that can last up to 72 h. Untrained individuals and individuals with lower insulin sensitivity benefit more from this effect and even trained individuals with high insulin sensitivity restore most of a detraining-induced loss following one session of resumed training. Consequently, exercise to combat insulin resistance that begins the pathological journey to cardiometabolic diseases including type 2 diabetes (T2D) should be prescribed with precision to elicit a PAE on insulin sensitivity to serve as a first-line defense prior to pharmaceutical intervention or, when such intervention is necessary, a potential adjunct to it.
Video Abstract: http://links.lww.com/CAEN/A27
Novel biomarkers for subtle myocardial involvement in type I diabetes mellitus
Authors: El-Saiedi Sonia A. , Hafez Mona H. , Sedky Yasser M. , Sharaf Sahar A. , Kamel Mona S. , AbdelMassih Antoine F. 
Published: November 2020

Background
Evaluation of certain biomarkers could be used to predict left ventricular (LV) and right ventricular (RV) function impairment in children with type 1 diabetes mellitus. The aim of this study was to determine the best cardiac biomarker for prediction of diabetic cardiomyopathy.

Methodology
This study was designed as case-control study. A total of 55 children with type 1 diabetes mellitus (group/G1) and 55 healthy controls (G2) were subjected to echocardiography including 3D-Speckle Tracking Echocardiography and tissue Doppler imaging for assessment of RV and LV systolic and diastolic functions. As well as HbA1c, troponin I, brain natriuretic peptide (BNP), plasma cardiotrophin (CT-1), activin-A, transforming growth factor-β, and human insulin-like growth factor binding protein-7 (IGFBP-7) measurements.

Results
Diabetic patients showed RV and LV systo-diastolic dysfunction compared to controls, the best predictor of LV systolic dysfunction was CT-1 (sensitivity: 69%, while IGFBP-7 was found to be the best predictor of RV systolic dysfunction (sensitivity: 63%). BNP was found to the best predictor of diastolic RV and LV dysfunction (sensitivity: 82% for both).

Conclusion
CT-1 has proven to be a diagnostic superiority in LV systolic dysfunction whilst BNP continues to prove every day through our study and through many others that it is the chief marker of diastolic dysfunction and HFpEF. This potential accuracy and the increasing availability of BNP in the outpatient setting make it clear that it should be used as a screening test for diabetic patients.
Radial basis Taylor series method and its applications
Authors: Karamanli Armagan 
Published: November 2020

Purpose
The study aims to present a new meshless method based on the Taylor series expansion. The compact supported radial basis functions (CSRBFs) are very attractive, can be considered as a numerical tool for the engineering problems and used to obtain the trial solution and its derivatives without differentiating the basis functions for a meshless method. A meshless based on the CSRBF and Taylor series method has been developed for the solutions of engineering problems.

Design/methodology/approach
This paper is devoted to present a truly meshless method which is called a radial basis Taylor series method (RBTSM) based on the CSRBFs and Taylor series expansion (TSE). The basis function and its derivatives are obtained without differentiating CSRBFs.

Findings
The RBTSM does not involve differentiation of the approximated function. This property allows us to use a wide range of CSRBF and weight functions including the constant one. By using a different number of terms in the TSE, the global convergence properties of the RBTSM can be improved. The global convergence properties are satisfied by the RBTSM. The computed results based on the RBTSM shows excellent agreement with results given in the open literature. The RBTSM can provide satisfactory results even with the problem domains which have curved boundaries and irregularly distributed nodes.

Originality/value
The CSRBFs have been widely used for the construction of the basic function in the meshless methods. However, the derivative of the basis function is obtained with the differentiation of the CSRBF. In the RBTSM, the derivatives of the basis function are obtained by using the TSE without differentiating the CSRBF.
A recipe for food promotion: effects of color brightness on food evaluations and behavioral intentions
Authors: Cai Ruiying , Chi Christina Geng-Qing 
Published: November 2020

Purpose
Building upon humans’ trichromatic vision systems, dual-process theory and halo effects, this paper aims to examine the effects of red and green color brightness of food pictures on customers’ evaluations and purchase intention of restaurant food.

Design/methodology/approach
The proposed hypotheses were tested across three experimental designed studies on a total of 575 participants. Multilevel analysis, analysis of variance and multivariate analysis of variance were applied for data analysis.

Findings
This paper provides empirical evidence of the effects of red brightness and green brightness on customers’ affective and cognitive evaluation of food and purchase intention in Study 1. Study 2 validates the effects of red and green brightness on food evaluation with the presence of nutrition information. Study 3 further elaborates on the halo effects of color brightness on customers’ favorable intentions to patronize a restaurant and willingness to pay for a meal in a controlled lab experiment.

Research limitations/implications
One main limitation is that this paper focuses on unveiling the role of color brightness and does not consider other picture properties, which opens an avenue for future research.

Practical implications
This paper includes implications for food promotion and management of customers’ experience via food pictures.

Originality/value
This paper is one of the first attempts to reveal the effects of red and green brightness of food pictures on customers’ food evaluation and food consumption behavioral intentions.
Parametric optimization of fused deposition modelling process using Grey based Taguchi and TOPSIS methods for an automotive component
Authors: R. Sakthivel Murugan , S. Vinodh 
Published: November 2020

Purpose
This paper aims to optimize the process parameters of the fused deposition modelling (FDM) process using the Grey-based Taguchi method and the results to be verified based on a technique for order preference by similarity to ideal solution (TOPSIS) and analytical hierarchy process (AHP) calculation.

Design/methodology/approach
The optimization of process parameters is gaining a potential role to develop robust products. In this context, this paper presents the parametric optimization of the FDM process using Grey-based Taguchi, TOPSIS and AHP method. The effect of slice height (SH), part fill style (PFS) and build orientation (BO) are investigated with the response parameters machining time, surface roughness and hardness (HD). Multiple objective optimizations were performed with weights of w1 = 60%, w2 = 20% and w3 = 20%. The significance of the process parameters over response parameters is identified through analysis of variance (ANOVA). Comparisons are made in terms of rank order with respect to grey relation grade (GRG), relative closeness and AHP index values. Response table, percentage contributions of process parameters for both GRG and TOPSIS evaluation are done.

Findings
The optimum factor levels are identified using GRG via the Grey Taguchi method and TOPSIS via relative closeness values. The optimized factor levels are SH (0.013 in), PFS (solid) and BO (45°) using GRG and SH (0.013 in), PFS (sparse-low density) and BO (45°) using TOPSIS relative closeness value. SH has higher significance in both Grey relational analysis and TOPSIS which were analysed using ANOVA.

Research limitations/implications
In this research, the multiple objective optimizations were done on an automotive component using GRG, TOPSIS and AHP which showed a 27% similarity in their ranking order among the experiments. In the future, other advanced optimization techniques will be applied to further improve the similarity in ranking order.

Practical implications
The study presents the case of an automotive component, which illustrates practical relevance.

Originality/value
In several research studies, optimization was done on the standard test specimens but not on a real-time component. Here, the multiple objective optimizations were applied to a case automotive component using Grey-based Taguchi and verified with TOPSIS. Hence, an effort has been taken to find optimum process parameters on FDM, for achieving smooth, hardened automotive components with enhanced printing time. The component can be explored as a replacement for the existing product.
Is the CIT susceptible to misleading information? A constructive replication
Authors: klein Selle Nathalie , Waxman Danna , Volz Katja , Ambach Wolfgang , Ben‐Shakhar Gershon 
Published: November 2020

AbstractThe Concealed Information Test (CIT) utilizes psychophysiological measures to detect crime‐related knowledge in a suspect's memory. In other words, it can discriminate between knowledgeable (guilty) and unknowledgeable (innocent) suspects. The majority of CIT research is however conducted in controlled laboratory settings, which are more resistant to external influences than realistic forensic settings. Such influences include retroactive memory interferences which may threaten the validity of the CIT. One notable example is the misinformation effect – retroactive memory distortions caused by exposure to misleading information regarding a past event. The current study is a constructive replication of Volz et al. (J Forensic Sci2017;63:1419) examining the effects of misleading information on the CIT. Participants underwent a three‐stage experiment including a mock crime, exposure to misleading information, and a CIT. Results show that when misleading information was presented, explicit memory of the mock crime was reduced, but the physiological responses to the critical CIT items were only partially attenuated. This could suggest that the detection of crime‐relevant information, using skin conductance and respiration measures, might be possible even when suspects are exposed to misleading information.
Isocitrate dehydrogenase 1 gene variants analysis of glioma patients from Pakistan
Authors: Naz Huma , Bashir Qamar , Rashid Naeem , Shahzad Naveed 
Published: November 2020

AbstractVarious somatic isocitrate dehydrogenase 1 (IDH1) gene variants have been reported to drive lower‐grade gliomas and secondary glioblastomas. In the current study, we explored the IDH1 variants in the glioma biopsy samples of patients from Pakistan. We explored the incidence of isocitrate dehydrogenase 1 gene variants by hotspot sequencing in 80 formalin‐fixed paraffin‐embedded tissues of different types of glioma biopsy samples. Structural modeling of the identified variants in isocitrate dehydrogenase 1 protein was done to see their possible consequences. The frequently described p.Arg132 variants were not found in any of the glioma types. However, in our study, we identified nonsynonymous variants at the residues p.R109 and p.G136 in astrocytomas and p.R100 in oligodendroglioma. These variants are affecting a part of the conserved domain in isocitrate dehydrogenase 1. Both of p.R100 and p.R109 variants are rare and described before, whereas the p.G136 variant identified in this study has never been described previously. Structural modeling showed that variants of these residues would directly affect the substrate binding and hence the enzyme activity.
Non‐invasive haemoglobin measurement as an index test to detect pre‐operative anaemia in elective surgery patients – a prospective study
Authors: Wittenmeier E. , Paumen Y. , Mildenberger P. , Smetiprach J. , Pirlich N. , Griemert E.‐V. , Kriege M. , Engelhard K. 
Published: November 2020

SummaryNon‐invasive haemoglobin measurement using absolute values lacks the precision to be the sole basis for the treatment of pre‐operative anaemia. However, it can possibly serve as a screening test, indexing ‘anaemia’ with high sensitivity when values remain under prespecified cut‐off values. Based on previous data, non‐invasive haemoglobin cut‐off values (146 g.l−1 for women and 152 g.l−1 for men) detect true anaemia with 99% sensitivity. An index test with these prespecified cut‐off values was verified by prospective measurement of non‐invasive and invasive haemoglobin pre‐operatively in elective surgical patients. In 809 patients, this showed an estimated sensitivity (95%CI) of 98.9% (94.1–99.9%) in women and 96.4% (91.0–99.0%) in men. This saved invasive blood tests in 9% of female and 28% of male patients. In female patients, a lower non‐invasive haemoglobin cut‐off value (138 g.l−1) would save 28% of invasive blood tests with a sensitivity of 95%. The target 99% sensitivity would be reached by non‐invasive haemoglobin cut‐off values of 152 g.l−1 in female and 162 g.l−1 in male patients, saving 3% and 9% of invasive blood tests, respectively. Bias and limits of agreement between non‐invasive and laboratory haemoglobin levels were 2 and − 25 to 28 g.l−1, respectively. Patient and measurement characteristics did not influence the agreement between non‐invasive and laboratory haemoglobin levels. Although sensitivity was very high, the index test using prespecified cut‐off values just failed to reach the target sensitivity to detect true anaemia. Nevertheless, with respect to blood‐sparing effects, the use of the index test in men may be clinically useful, while an index test with a lower cut‐off (132 g.l−1) could be more clinically appropriate in women.
PAR2 induces ovarian cancer cell motility by merging three signalling pathways to transactivate EGFR
Authors: Jiang Yuhong , Lim Junxian , Wu Kai‐Chen , Xu Weijun , Suen Jacky Y. , Fairlie David P. 
Published: November 2020

Background and PurposeSpecific cellular functions mediated by GPCRs are often associated with signalling through a particular G protein or β‐arrestin. Here, we examine signalling through a GPCR, protease‐activated receptor 2 (PAR2), in a high‐grade serous ovarian cancer cell line (OV90).Experimental ApproachHuman ovarian cancer tissues (n = 1,200) and nine human ovarian cancer cell lines were assessed for PAR2 expression. PAR2 signalling mechanisms leading to cell migration and invasion were dissected using cellular assays, western blots, CRISPR‐Cas9 gene knockouts, pharmacological inhibitors of PAR2 and downstream signalling proteins in OV90 cancer cells.Key ResultsPAR2 was significantly overexpressed in clinical ovarian cancer tissues and in OV90 ovarian cancer cells. PAR2 agonists, an endogenous protease (trypsin) and a synthetic peptide (2f‐LIGRL‐NH2), induced migration and invasion of OV90 ovarian cancer cells through activating a combination of Gαq/11, Gα12/13 and β‐arrestin1/2, but not Gαs or Gαi. This novel cooperative rather than parallel signalling resulted in downstream serial activation of Src kinases, then transactivation of epidermal growth factor receptor (EGFR), followed by downstream MEK–ERK1/2–FOS/MYC/STAT3–COX2 signalling. Either a PAR2 antagonist (I‐191), CRISPR‐Cas9 gene knockouts (PAR2 or Gα proteins or β‐arrestin1/2), or inhibitors of each downstream protein attenuated human ovarian cancer cell motility.Conclusion and ImplicationsThis study highlights a novel shared signalling cascade, requiring each of Gαq/11, Gα12/13 and β‐arrestin1/2 for PAR2‐induced ovarian cancer cell migration and invasion. This mechanism controlling a cellular function is unusual in not being linked to a specific individual G protein or β‐arrestin‐mediated signalling pathway.