bluuebunny/crossref_metadata_2025_split huggingface dataset:
Video‐Based Guided Simulation without Peer or Expert Feedback is Not Enough: A Randomized Controlled Trial of Simulation‐Based Training for Medical Students
Authors: Tejos Rodrigo , Crovari Fernando , Achurra Pablo , Avila Ruben , Inzunza Martín , Jarry Cristian , Martinez Jorge , Riquelme Arnoldo , Alseidi Adnan , Varas Julian 
Published: September 2020

AbstractBackgroundFeedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective.MethodsA prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video‐guided learning (VLG), peer‐feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3‐simple stitches (pre‐assessment and post‐assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores.ResultsNo significant differences were found between PFG and EFG in post‐assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post‐assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5–21); 16.6 (15.5–17.5)) and (20.3 (19.88–21); 16.8 (16–17.5)) vs (15.7 (15–16); 13.3 (12.5–14)) (p < 0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5–9) and 7.4 (4.88–10) vs 3.5 (1.5–6) (p < 0.05)] and SRS scores [5.4 (3.5–7) and 6.3 (4–8.5) vs 3.1 (1.13–4.88) (p < 0.05)], respectively.ConclusionThe video‐guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.
Latent likelihood ratio tests for assessing spatial kernels in epidemic models
Authors: Thong David , Streftaris George , Gibson Gavin J. 
Published: September 2020

AbstractOne of the most important issues in the critical assessment of spatio-temporal stochastic models for epidemics is the selection of the transmission kernel used to represent the relationship between infectious challenge and spatial separation of infected and susceptible hosts. As the design of control strategies is often based on an assessment of the distance over which transmission can realistically occur and estimation of this distance is very sensitive to the choice of kernel function, it is important that models used to inform control strategies can be scrutinised in the light of observation in order to elicit possible evidence against the selected kernel function. While a range of approaches to model criticism is in existence, the field remains one in which the need for further research is recognised. In this paper, building on earlier contributions by the authors, we introduce a new approach to assessing the validity of spatial kernels—the latent likelihood ratio tests—which use likelihood-based discrepancy variables that can be used to compare the fit of competing models, and compare the capacity of this approach to detect model mis-specification with that of tests based on the use of infection-link residuals. We demonstrate that the new approach can be used to formulate tests with greater power than infection-link residuals to detect kernel mis-specification particularly when the degree of mis-specification is modest. This new tests avoid the use of a fully Bayesian approach which may introduce undesirable complications related to computational complexity and prior sensitivity.
Impact of real-time angiographic co-registered optical coherence tomography on percutaneous coronary intervention: the OPTICO-integration II trial
Authors: Schneider Vera S. , Böhm Felix , Blum Katharina , Riedel Matthias , Abdelwahed Youssef S. , Klotsche Jens , Steiner Julia K. , Heuberger Andrea , Skurk Carsten , Mochmann Hans-Christian , Lauten Alexander , Fröhlich Georg , Rauch-Kröhnert Ursula , Haghikia Arash , Sinning David , Stähli Barbara E. , Landmesser Ulf , Leistner David M. 
Published: September 2020

Abstract
Aims
Longitudinal geographic mismatch (LGM) as well as edge dissections are associated with an increased risk of adverse events after percutaneous coronary intervention (PCI). Recently, a novel system of real-time optical coherence tomography (OCT) with angiographic co-registration (ACR) became available and allows matched integration of cross-sectional OCT images to angiography. The OPTICO-integration II trial sought to assess the impact of ACR for PCI planning on the risk of LGM and edge dissections.

Methods
A total of 84 patients were prospectively randomized to ACR-guided PCI, OCT-guided PCI (without co-registration), and angiography-guided PCI. Primary endpoint was a composite of major edge dissection and/or LGM as assessed by post-PCI OCT.

Results
The primary endpoint was significantly reduced in ACR-guided PCI (4.2%) as compared to OCT-guided PCI (19.1%; p = 0.03) and angiography-guided PCI (25.5%; p < 0.01). Rates of LGM were 4.2%, 17.0%, and 22.9% in the ACR-guided PCI, in the OCT-guided PCI, and the angiography-guided PCI groups, respectively (ACR vs. OCT p = 0.04; ACR vs. angiography p = 0.04). The number of major edge dissections was low and without significant differences among the study groups (0% vs. 2.1% vs. 4.3%).

Conclusion
This study for the first time demonstrates superiority of ACR-guided PCI over OCT- and angiography-guided PCI in reducing the composite endpoint of major edge dissection and LGM, which was meanly driven by a reduction of LGM.

Graphical abstract
Destructive and topical treatments of skin lesions in organ transplant recipients and relation to skin cancer
Authors: Green Adele C. , Way Mandy , Oster Mariella , Plasmeijer Elsemieke I. , Jiyad Zainab , O’Rourke Peter , Miura Kyoko , Campbell Scott , Isbel Nicole , Chambers Daniel C. , Hopkins Peter , Ferguson Lisa E. , Davis Marcia Batista , Whiteman David C. , Soyer H. Peter , Marquart Louise 
Published: September 2020

AbstractVarious treatments of keratotic skin lesions and early skin cancers are performed in organ transplant recipients (OTRs) at high risk of skin malignancies but the frequency of their use is unknown. We prospectively assessed the frequency of use of cryotherapy, diathermy, and topical therapies and also investigated their associations with background incidence of histologically-confirmed squamous-cell carcinoma (SCC) and basal cell carcinoma (BCC) in a cohort of OTRs in Queensland, Australia. Median follow-up ranged from 1.7 to 3.2 years across organ transplant groups. Among 285 kidney, 125 lung and 203 liver transplant recipients [382 (62%) male, 380 (62%) immunosuppressed > 5 years, 394 (64%) previously diagnosed with skin cancer], 306 (50%) reported treatment of skin lesions with major types of non-excision therapies during follow-up: 278 (45%) cryotherapy or diathermy; 121 (20%) topical treatments. Of these 306, 150 (49%) developed SCC at double the incidence of those who did not receive these treatments, as assessed by incidence rate ratio (IRR) adjusted for age, sex, type of organ transplant, skin color and history of skin cancer at baseline, calculated by multivariable Poisson regression (IRRadj = 2.1, 95% confidence interval (CI) 1.4–3.1). BCC incidence was not associated with these therapies. Skin lesions in OTRs that are treated with cryotherapy, diathermy, or topical treatment warrant judicious selection and careful follow-up.
Single-centre experience and practical considerations of the benefit of a second cochlear implant in bilaterally deaf adults
Authors: Péus Dominik , Pfluger Andreas , Häussler Sophia Marie , Knopke Steffen , Ketterer Manuel Christoph , Szczepek Agnieszka J. , Gräbel Stefan , Olze Heidi 
Published: September 2020

Abstract
Purpose
Bilateral cochlear implant (CI) implantation is increasingly used in the auditory rehabilitation of bilaterally deafened adults. However, after successful unilateral implantation, objective patient counselling is essential.

Methods
We investigated the extra benefit of a second CI in adults in terms of health-related quality of life, tinnitus, stress, anxiety, depression, quality of hearing, and speech recognition. Hearing ability was assessed by using the Freiburg monosyllable speech discrimination test (FB MS) and the Oldenburg sentence test with azimuth variations. In a prospective patient cohort, we administered validated questionnaires before a CI, after a first CI and after a second CI implantation.

Results
The study included 29 patients, made up of nine women and 20 men. The median time between the first and the second implantation was 23 months. The mean total NCIQ score and TQ before a CI improved significantly after both implantations. Stress, anxiety, and depression were stable over time and were not significantly affected by CI implantations. Speech recognition with noise significantly improved after the first and again after the second CI. Correlation analysis showed a strong connection between auditory performance and HRQoL.

Conclusion
We demonstrated that a unilateral CI benefitted many fields and that the second sequential CI leads again to additional improvement. Bilateral CI implantation should, therefore, be the standard form of auditory rehabilitation in deafened adults.
Inter-hospital transfer for mechanical thrombectomy within the supraregional stroke network NEVAS
Authors: Feil Katharina , Rémi Jan , Küpper Clemens , Herzberg Moriz , Dorn Franziska , Kunz Wolfgang G. , Reidler Paul , Levin Johannes , Hüttemann Katrin , Tiedt Steffen , Heidger Wanja , Müller Katharina , Thunstedt Dennis C. , Dabitz Rainer , Müller Robert , Pfefferkorn Thomas , Hamann Gerhard F. , Liebig Thomas , Dieterich Marianne , Kellert Lars 
Published: September 2020

Abstract
Background
Telemedicine stroke networks are mandatory to provide inter-hospital transfer for mechanical thrombectomy (MT). However, studies on patient selection in daily practice are sparse.

Methods
Here, we analyzed consecutive patients from 01/2014 to 12/2018 within the supraregional stroke network “Neurovascular Network of Southwest Bavaria” (NEVAS) in terms of diagnoses after consultation, inter-hospital transfer and predictors for performing MT. Degree of disability was rated by the modified Rankin Scale (mRS), good outcome was defined as mRS ≤ 2. Successful reperfusion was assumed when the modified thrombolysis in cerebral infarction (mTICI) was 2b-3.

Results
Of 5722 telemedicine consultations, in 14.1% inter-hospital transfer was performed, mostly because of large vessel occlusion (LVO) stroke. A total of n = 350 patients with LVO were shipped via NEVAS to our center for MT. While n = 52 recanalized spontaneously, MT-treatment was performed in n = 178 patients. MT-treated patients had more severe strokes according to the median National institute of health stroke scale (NIHSS) (16 vs. 13, p < 0.001), were more often treated with intravenous thrombolysis (64.5% vs. 51.7%, p = 0.026) and arrived significantly earlier in our center (184.5 versus 228.0 min, p < 0.001). Good outcome (27.5% vs. 30.8%, p = 0.35) and mortality (32.6% versus 23.5%, p = 0.79) were comparable in MT-treated versus no-MT-treated patients. In patients with middle cerebral artery occlusion in the M1 segment or carotid artery occlusion good outcome was twice as often in the MT-group (21.8% vs. 12.8%, p = 0.184). Independent predictors for performing MT were higher NIHSS (OR 1.096), higher ASPECTS (OR 1.28), and earlier time window (OR 0.99).

Conclusion
Within a telemedicine network stroke care can successfully be organized as only a minority of patients has to be transferred. Our data provide clinical evidence that all MT-eligible patients should be shipped with the fastest transportation modality as possible.
Effective elastic properties of composites with randomly distributed thin rigid fibres
Authors: Fedelinski Piotr 
Published: September 2020

AbstractThe aim of the work is to analyse the effective elastic properties of composites with randomly distributed thin rigid fibres. The matrix is linear-elastic, homogenous and isotropic, and the fibres are perfectly connected to the matrix. Two-dimensional models of composites are analysed using the boundary element method (BEM). The method requires division of fibres and external boundaries of the plate into boundary elements. The boundary quantities are interpolated using quadratic shape functions. The direct solutions are: displacements and tractions along the external boundaries, displacements of fibres and interaction forces between the fibres and the matrix. Three numerical examples are presented in the paper: a single fibre in a circular disc, uniformly distributed parallel fibres and randomly distributed and oriented fibres in a square plate. The influence of distribution and orientation of fibres on effective Young’s moduli, Poisson’s ratios and Kirchhoff’s moduli is analysed. The examples demonstrate the accuracy and efficiency of the method.
The mediating role of unhealthy behaviors and body mass index in the relationship between high job strain and self-rated poor health among lower educated workers
Authors: van Oostrom S. H. , Nachat A. , Loef B. , Proper K. I. 
Published: September 2020

Abstract
Objectives
The objective of this study is to examine the mediating role of unhealthy behaviors and body mass index (BMI) in the relationship between high job strain and self-rated poor health in workers with a low education.

Methods
A total of 8369 low educated workers, who participated in the Lifelines cohort study during the period 2012–2017, were included. Self-reported job strain, health behaviors (smoking, physical activity, and fruit and vegetable consumption), and BMI were assessed at baseline, and self-rated health after 2 years. To assess mediation by the health behaviors and BMI, structural equation modeling with logistic and multinomial regression analyses were performed.

Results
Workers with high job strain had a higher odds of poor health (OR 1.34; 95% CI 1.13–1.60) compared to those with low job strain. Workers with high job strain were more likely to have a lack of physical activity (OR 1.14; 95% CI 1.01–1.28), but were not more likely to smoke, to be overweight or obese, or to have a low fruit or vegetable consumption. Workers who smoke, have a lack of physical activity or are overweight or obese are more likely to report poor health (OR 1.37; 95% CI 1.16–1.60, OR 1.25; 95% CI 1.08–1.43, OR 1.37; 95% CI 1.16–1.61, OR 2.25; 95% CI 1.86–2.72). Indirect (mediating) effects of unhealthy behaviors and BMI in the relationship between high job strain and poor health were small and not statistically significant.

Conclusions
No mediating effects of unhealthy behaviors or BMI were found in the relationship between high job strain and self-rated poor health among workers with a low educational level.
Spirulina supplementation improves oxygen uptake in arm cycling exercise
Authors: Gurney Tom , Spendiff Owen 
Published: September 2020

Abstract
Purpose
Spirulina has previously been reported to improve high-intensity exercise performance and hemoglobin. However, spirulina’s effect on arm cycling exercise has yet to be investigated. The purpose of this study was to investigate the responses of spirulina supplementation on hemoglobin and on oxygen uptake, RER and HR during seated arm cycling exercise.

Methods
In a double-blinded randomized crossover design, eleven males untrained in arm cycling ingested 6 g/day of spirulina or placebo for seven days. Seated on the Arm Crank Ergometer, each participant performed a baseline V̇O2max test, and then after supplementation, 2 × 30-min submaximal exercise bouts corresponding to 55% of their V̇O2max, followed by an incremental test to fatigue. A seven-day wash-out period was required between conditions. Oxygen uptake, RER and HR were measured continuously during exercise and hemoglobin measured prior to exercise after both conditions.

Results
Spirulina significantly (p < 0.05) increased Hb in comparison to Placebo (144.1 g/l ± 10.5 Vs 154.5 g/l ± 6.9). After spirulina supplementation, during the 30-min exercise bouts, oxygen uptake and HR were significantly lower (2170 ml/min ± 173 Vs 2311 ml/min ± 189 and 154 bpm ± 14 Vs 149 bpm ± 17), RER was not significantly different. In comparison to placebo, Spirulina significantly increased oxygen uptake at time of fatigue (34.10 ml/min/kg ± 6.03 Vs 37.37 ml/min/kg ± 5.98). Time taken to fatigue was not different.

Conclusion
Spirulina supplementation significantly reduces oxygen uptake and HR during arm cycling submaximal exercise, allowing for an increased oxygen uptake during an incremental test to fatigue.
Mechanical aspects of the semicircular ducts in the vestibular system
Authors: Muller Mees 
Published: September 2020

AbstractThe semicircular ducts (SCDs) of the vestibular system play an instrumental role in equilibration and rotation perception of vertebrates. The present paper is a review of quantitative approaches and shows how SCDs function. It consists of three parts. First, the biophysical mechanisms of an SCD system composed of three mutually connected ducts, allowing endolymph to flow from one duct into another one, are analysed. The flow is quantified by solving the continuity equations in conjunction with the equations of motion of the SCD hydrodynamics. This leads to mathematical expressions that are suitable for further analytical and numerical analysis. Second, analytical solutions are derived through four simplifying steps while keeping the essentials of the coupled system intact. Some examples of flow distributions for different rotations are given. Third, the focus is on the transducer function of the SCDs. The complex structure of the mechano-electrical transduction apparatus inside the ampullae is described, and the consequences for sensitivity and frequency response are evaluated. Furthermore, both the contributions of the different terms of the equations of motion and the influence of Brownian motion are analysed. Finally, size limitations, allometry and evolutionary aspects are taken into account.
Approximation of two-variable functions using high-order Takagi–Sugeno fuzzy systems, sparse regressions, and metaheuristic optimization
Authors: Wiktorowicz Krzysztof , Krzeszowski Tomasz 
Published: September 2020

AbstractThis paper proposes a new hybrid method for training high-order Takagi–Sugeno fuzzy systems using sparse regressions and metaheuristic optimization. The fuzzy system is considered with Gaussian fuzzy sets in the antecedents and high-order polynomials in the consequents of fuzzy rules. The fuzzy sets can be chosen manually or determined by a metaheuristic optimization method (particle swarm optimization, genetic algorithm or simulated annealing), while the polynomials are obtained using ordinary least squares, ridge regression or sparse regressions (forward selection, least angle regression, least absolute shrinkage and selection operator, and elastic net regression). A quality criterion is proposed that expresses a compromise between the prediction ability of the fuzzy model and its sparsity. The conducted experiments showed that: (a) the use of sparse regressions and/or metaheuristic optimization can reduce the validation error compared with the reference method, and (b) the use of sparse regressions may simplify the fuzzy model by zeroing some of the coefficients.
A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients
Authors: Davy Catrina , Heathcote Sharron 
Published: September 2020

Abstract
Background
Oral mucositis is a debilitating consequence of radiotherapy in patients with head and neck cancers. Radiation-induced oral mucositis (RIOM) can cause pain and weight loss, reduce quality of life and affect treatment outcomes.

Methods
A systematic review was undertaken to identify and examine the efficacy of low-cost interventions to mitigate RIOM and to develop clinical guidelines based on the evidence.

Results
The author identified three interventions: benzydamine hydrochloride mouth rinse (BHM), honey and oral glutamine (OG). The search identified twenty-four studies in total. Four studies examined BHM; all findings were favourable, although only one had moderate methodological quality, and the rest were low. The product was poorly tolerated by some participants in one study. Twelve studies examined honey. Eleven of these had favourable results; two studies had moderate methodological quality, and the rest were low. Eight studies examined OG. Six of these had favourable results; two studies had moderate methodological quality, and the rest were low.

Conclusion
The author cannot recommend BHM to mitigate RIOM due to the overall low quality of the studies and poor tolerance to the product. The author cannot recommend honey to mitigate RIOM due to weak evidence supporting the intervention. The author can recommend OG to mitigate RIOM. There is a need for high-quality studies with a consensus of the methodology to reduce heterogeneity and examination of the cost-effectiveness of the interventions.
Can Na18F PET/CT bone scans help when deciding if early intervention is needed in patients being treated with a TSF attached to the tibia: insights from 41 patients
Authors: Lundblad Henrik , Karlsson-Thur Charlotte , Maguire Gerald Q. , Noz Marilyn E. , Zeleznik Michael P. , Weidenhielm Lars 
Published: September 2020

Abstract
Purpose
To demonstrate the usefulness of positron emission tomography (PET)/computed tomography (CT) bone scans for gaining insight into healing bone status earlier than CT or X-ray alone.

Methods
Forty-one prospective patients being treated with a Taylor Spatial Frame were recruited. We registered data obtained from successive static CT scans for each patient, to align the broken bone. Radionuclide uptake was calculated over a spherical volume of interest (VOI). For all voxels in the VOI, histograms and cumulative distribution functions of the CT and PET data were used to assess the type and progress of new bone growth and radionuclide uptake. The radionuclide uptake difference per day between the PET/CT scans was displayed in a scatter plot. Superimposing CT and PET slice data and observing the spatiotemporal uptake of 18F− in the region of healing bone by a time-sequenced movie allowed qualitative evaluation.

Results
Numerical evaluation, particularly the shape and distribution of Hounsfield Units and radionuclide uptake in the graphs, combined with visual evaluation and the movies enabled the identification of six patients needing intervention as well as those not requiring intervention. Every revised patient proceeded to a successful treatment conclusion.

Conclusion
Numerical and visual evaluation based on all the voxels in the VOI may aid the orthopedic surgeon to assess a patient’s progression to recovery. By identifying slow or insufficient progress at an early stage and observing the uptake of 18F− in specific regions of bone, it might be possible to shorten the recovery time and avoid unnecessary late complications.