bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiation exposure per thrombectomy attempt in modern endovascular stroke treatment in the anterior circulation
Authors: Weyland Charlotte S. , Seker Fatih , Potreck Arne , Hametner Christian , Ringleb Peter A. , Möhlenbruch Markus A. , Bendszus Martin , Pfaff Johannes A. R. 
Published: April 2020

Abstract
Objective
To quantify radiation exposure (RE) of endovascular stroke treatment (EST) in the anterior circulation per thrombectomy attempt and determine causes for interventions associated with high RE.

Methods
A retrospective single-center study of an institutional review board−approved stroke database of patients receiving EST for large vessel occlusions in the anterior circulation between January 2013 and April 2018 to evaluate reference levels (RL) per thrombectomy attempt. ESTs with RE above the RL were analyzed to determine causes for high RE.

Results
Overall, n = 544 patients (occlusion location, M1 and M2 segments of the middle cerebral artery 53.5% and 27.2%, carotid artery 17.6%; successful recanalization rate 85.7%) were analyzed. In the overall population, DAP (in Gy cm2, median (IQR)) was 113.7 (68.9–181.7) with a median fluoroscopy time of 31 min (IQR, 17–53) and a median of 2 (IQR, 1–4) thrombectomy attempts. RE increased significantly with every thrombectomy attempt (DAP1, 68.7 (51.2–106.8); DAP2, 106.4 (84.8–115.6); p value1vs2, < 0.001; DAP3, 130.2 (89.1–183.6); p value2vs3, 0.044; DAP4, 169.9 (128.4–224.1); p value3vs4, 0.001; and DAP5, 227.6 (146.3–294.6); p value4vs5, 0.019). Procedures exceeding the 90th percentile of the attempt-dependent radiation exposure level were associated with procedural complications (n = 17/52, 29.8%) or a difficult vascular access (n = 8/52, 14%).

Conclusions
Radiation exposure in endovascular stroke treatment is depending on the number of thrombectomy attempts. Radiation exposure doubles when three attempts and triples when five attempts are necessary compared with single-maneuver interventions. Procedural complications and difficult vascular access were associated with a high radiation exposure in this collective.

Key Points
• Radiation exposure of endovascular stroke treatment (EST) is dependent on the number of thrombectomy attempts.
• Reference levels as means for quality control in hospitals performing endovascular stroke treatment should be defined by the number of thrombectomy attempts—we suggest 107 Gy cm2, 156 Gy cm2, 184 Gy cm2, 244 Gy cm2, and 295 Gy cm2for 1 to 5 maneuvers, respectively, for EST of the anterior circulation
• Cases with high rates of radiation exposure are associated with periprocedural complications and difficult anatomical access as a probable cause for a high radiation exposure.
Habitual dietary intake of IBD patients differs from population controls: a case–control study
Authors: Peters Vera , Tigchelaar-Feenstra Ettje F. , Imhann Floris , Dekens Jackie A. M. , Swertz Morris A. , Franke Lude H. , Wijmenga Cisca , Weersma Rinse K. , Alizadeh Behrooz Z. , Dijkstra Gerard , Campmans-Kuijpers Marjo J. E. 
Published: April 2020

Abstract
Background
Since evidence-based dietary guidelines are lacking for IBD patients, they tend to follow “unguided” dietary habits; potentially leading to nutritional deficiencies and detrimental effects on disease course. Therefore, we compared dietary intake of IBD patients with controls.

Methods
Dietary intake of macronutrients and 25 food groups of 493 patients (207 UC, 286 CD), and 1291 controls was obtained via a food frequency questionnaire.

Results
38.6% of patients in remission had protein intakes below the recommended 0.8 g/kg and 86.7% with active disease below the recommended 1.2 g/kg. Multinomial logistic regression, corrected for age, gender and BMI, showed that (compared to controls) UC patients consumed more meat and spreads, but less alcohol, breads, coffee and dairy; CD patients consumed more non-alcoholic drinks, potatoes, savoury snacks and sugar and sweets but less alcohol, dairy, nuts, pasta and prepared meals. Patients with active disease consumed more meat, soup and sugar and sweets but less alcohol, coffee, dairy, prepared meals and rice; patients in remission consumed more potatoes and spreads but less alcohol, breads, dairy, nuts, pasta and prepared meals.

Conclusions
Patients avoiding potentially favourable foods and gourmandizing potentially unfavourable foods are of concern. Special attention is needed for protein intake in the treatment of these patients.
Empirical relationships of groundwater head–salinity response to variations of sea level and vertical recharge in coastal confined karst aquifers
Authors: Canul-Macario Cesar , Salles Paulo , Hernández-Espriú Antonio , Pacheco-Castro Roger 
Published: April 2020

AbstractCoastal aquifers are characterized by a mixing zone with freshwater–saltwater interactions, which have a strong relationship with hydrological forcings such as astronomical and storm tides, aquifer recharge and pumping effects. These forcings govern the aquifer hydraulic head, the spatial distribution of groundwater salinity and the saline interface position. This work is an empirical evaluation through time-series analysis between aquifer head and groundwater salinity associated with the sea-level dynamics and the aquifer recharge. Groundwater pressure, temperature and salinity were measured in a confined aquifer in the northwest coast of Yucatan (México) during May 2017–May 2018, along with precipitation. Cross-correlation and linear Pearson correlation (r) analyses were performed with the data time series, separating astronomical and meteorological tides and vertical recharge effects. The results show that the astronomical and meteorological tides are directly correlated with the aquifer head response (0.71 < r < 0.99). Salinity has a direct and strong relationship with the astronomical tide (0.76 < r < 0.98), while the meteorological tide does not (r < 0.5). The vertical recharge showed a moderate correlation with the aquifer head (0.5 < r < 0.7) and a nonsignificant correlation with the groundwater salinity (r < 0.5). In this study, the sea level (r > 0.7) is a more important forcing than the vertical recharge (with 0.5 < r < 0.7). Empirical relationships through time-series analysis and the separation of individual hydrological forcings in the analysis are powerful tools to study, define and validate the conceptual model of the aquifer.
Instance space analysis for a personnel scheduling problem
Authors: Kletzander Lucas , Musliu Nysret , Smith-Miles Kate 
Published: April 2020

AbstractThis paper considers the Rotating Workforce Scheduling Problem, and shows how the strengths and weaknesses of various solution methods can be understood by the in-depth evaluation offered by a recently developed methodology known as Instance Space Analysis. We first present a set of features aiming to describe hardness of test instances. We create a new, more diverse set of instances based on an initial instance space analysis that reveals gaps in the instance space, and offers the opportunity to generate additional instances to add diversity to the test suite. The results of three algorithms on our extended instance set reveal insights based on this visual methodology. We observe different regions of strength and weakness in the instance space for each algorithm, as well as a phase transition from feasible to infeasible instances with more challenging instances at the phase transition boundary. This rigorous and insightful approach to analyzing algorithm performance highlights the critical role played by the choice of test instances, and the importance of ensuring diversity and unbiasedness of test instances to support valid conclusions.
Interdigitated aluminium and titanium sensors for assessing epithelial barrier functionality by electric cell-substrate impedance spectroscopy (ECIS)
Authors: Schmiedinger Thomas , Partel Stefan , Lechleitner Thomas , Eiter Oliver , Hekl Daniel , Kaseman Stephan , Lukas Peter , Edlinger Johannes , Lechner Judith , Seppi Thomas 
Published: April 2020

AbstractElectric cell-substrate impedance spectroscopy (ECIS) enables non-invasive and continuous read-out of electrical parameters of living tissue. The aim of the current study was to investigate the performance of interdigitated sensors with 50 μm electrode width and 50 μm inter-electrode distance made of gold, aluminium, and titanium for monitoring the barrier properties of epithelial cells in tissue culture. At first, the measurement performance of the photolithographic fabricated sensors was characterized by defined reference electrolytes. The sensors were used to monitor the electrical properties of two adherent epithelial barrier tissue models: renal proximal tubularLLC-PK1cells, representing a normal functional transporting epithelium, and human cervical cancer-derivedHeLacells, forming non-transporting cancerous epithelial tissue. Then, the impedance spectra obtained were analysed by numerically fitting the parameters of the two different models to the measured impedance spectrum. Aluminium sensors proved to be as sensitive and consistent in repeated online-recordings for continuous cell growth and differentiation monitoring as sensors made of gold, the standard electrode material. Titanium electrodes exhibited an elevated intrinsic ohmic resistance in comparison to gold reflecting its lower electric conductivity. Analysis of impedance spectra through applying models and numerical data fitting enabled the detailed investigation of the development and properties of a functional transporting epithelial tissue using either gold or aluminium sensors. The result of the data obtained, supports the consideration of aluminium and titanium sensor materials as potential alternatives to gold sensors for advanced application of ECIS spectroscopy.
The influence of maternal mental illness on vaccination uptake in children: a UK population-based cohort study
Authors: Osam Cemre Su , Pierce Matthias , Hope Holly , Ashcroft Darren M. , Abel Kathryn M. 
Published: April 2020

AbstractReduced vaccination uptake is a growing and global public health concern. There is limited knowledge about the effect of maternal mental illness (MMI) on rates of childhood vaccination. This retrospective cohort study examined 479,949 mother-baby pairs born between 1993 and 2015 in the Clinical Practice Research Datalink (CPRD GOLD), a UK-based, primary health-care database. The influence of MMI on children’s vaccination status at two and five years of age was investigated using logistic regression adjusting for sex of the child, child ethnicity, delivery year, maternal age, practice level deprivation quintile and region. The vaccinations were: 5-in-1 (DTaP/IPV/Hib) and first dose MMR by the age of two; and all three doses of 5-in-1, first and second dose of MMR vaccines by the age of five. Exposure to MMI was defined using recorded clinical events for: depression, anxiety, psychosis, eating disorder, personality disorder and alcohol and substance misuse disorders. The likelihood that a child completed their recommended vaccinations by the age of two and five was significantly lower among children with MMI compared to children with mothers without mental illness [adjusted odds ratio (aOR) 0.86, 95% CI 0.84–0.88, p < 0.001]. The strongest effect was observed for children exposed to maternal alcohol or substance misuse (at two years aOR 0.50, 95% CI 0.44–0.58, p < 0.001). In the UK, an estimated five thousand more children per year would be vaccinated if children with MMI had the same vaccination rates as children with well mothers. Maternal mental illness is a hitherto largely unrecognised reason that children may be missing vital vaccinations at two and five years of age. This risk is highest for those children living with maternal alcohol or substance misuse.
Exploring solutions to the privacy paradox in the context of e-assessment: informed consent revisited
Authors: Muravyeva Ekaterina , Janssen José , Specht Marcus , Custers Bart 
Published: April 2020

AbstractPersonal data use is increasingly permeating our everyday life. Informed consent for personal data use is a central instrument for ensuring the protection of personal data. However, current informed consent practices often fail to actually inform data subjects about the use of personal data. This article presents the results of a requirements analysis for informed consent from both a legal and usability perspective, considering the application context of educational assessment. The requirements analysis is based on European Union (EU) law and a review of current practices. As the main outcome, the article presents a blueprint which will be the basis for the development of an informed consent template that supports data controllers in establishing an effective and efficient informed consent form. Because the blueprint, and subsequently, the template, distinguishes between legal and usability requirements, it also provides the basis for the mapping of legal requirements in other (non-European) contexts.
Development of Fireground Exposure Simulator (FES) Prop for PPE Testing and Evaluation
Authors: Horn Gavin P. , Kerber Steve , Lattz Jeffery , Kesler Richard M. , Smith Denise L. , Mayer Alex , Fent Kenneth W. 
Published: April 2020

AbstractResearch on the performance of personal protective equipment (PPE) for the Fire Service is challenged by the ability to repeatedly and feasibly test new designs, interventions and wear trials in realistic conditions that appropriately simulate end use environments. To support firefighter PPE research and firefighter PPE acclimation/training, a multidisciplinary team has developed a low cost, easily replicable approach for simulating conditions commonly encountered by firefighters operating on the interior of a residential structure fire. The testing enclosure can be used with either stationary mannequins or firefighters conducting typical fireground activities, providing a method to study a wide range of PPE and physiological studies as well as training activities that may support developing new technologies and standardized testing opportunities. Environmental gas concentrations and firefighters’ local temperatures were measured during trials and compared to data collected from simulated fireground activities and fireground responses with good agreement.
A comparison of different approaches to detect the transitions from regular to chaotic motions in SMA oscillator
Authors: Syta Arkadiusz , Bernardini Davide , Litak Grzegorz , Savi Marcelo A. , Jonak Kamil 
Published: April 2020

AbstractIt is well known that dynamical systems that include devices based on shape memory alloys (SMA) can exhibit a wide spectrum of responses: periodic, quasi-periodic and chaotic motions. In view of the different types of possible applications, it is important to recognize the qualitative features of the system vibrations. To this end, various methods have been proposed in the literature and evaluated in different conditions. In this work, a comparison between some of the available methods is proposed, focusing attention on their ability to detect the regular–chaotic and chaotic–regular transitions. The specific system under consideration is a thermomechanical SMA oscillator with superelastic behavior subject to harmonic excitation. The diagnostic methods compared are 0–1 test, maximum Lyapunov exponent and the recurrence indicators. The obtained results show that each method used is suitable for distinguishing between the regular and non-regular response of the SMA oscillator, so one of them can be chosen, taking into account, for example, the length and a sampling of the collected data.
Communicating treatment risks and benefits to cancer patients: a systematic review of communication methods
Authors: van de Water L. F. , van Kleef J. J. , Dijksterhuis W. P. M. , Henselmans I. , van den Boorn H. G. , Vaarzon Morel N. M. , Schut K. F. , Daams J. G. , Smets E. M. A. , van Laarhoven H. W. M. 
Published: April 2020

Abstract
Purpose
Cancer patients are increasingly involved in decision-making processes. Hence, clinicians need to inform patients about the risks and benefits of different treatment options in order for patients to make well informed decisions. The aim of this review is to determine the effects of methods of communicating prognostic information about (1) disease progression (survival, progression, recurrence and remission), (2) side effects and complications and (3) health-related quality of life (HRQL) on cognitive, affective and behavioral outcomes in cancer patients.

Methods
A literature search was performed to select articles that were published up to November 2019 and that examined verbal and/or visual risk communication interventions in an oncological clinical setting.

Results
The search yielded 14,875 studies; 28 studies were ultimately included. For disease progression information, we found that framing affects treatment choice. Furthermore, limiting the amount of progression information in a graphical display could benefit patients’ understanding of risks and benefits. For prognostic information about side effects and complications, precise and defined risk information was better understood than information presented in words. When displaying HRQL data, no consensus was found on which graph type to use.

Conclusion
Great heterogeneity in the results and methodology and in the compared communication formats precluded us from drawing any further conclusions. Practical implications for clinicians are to consider the effects that different types of framing might have on the patient and to not rely exclusively on words to describe risks, but rather include at least some form of numbers or visualization.
The Effect of Filtration with Natural Esker Sand on the Removal of Organic Carbon and Suspended Solids from the Effluent of Experimental Recirculating Aquaculture Systems
Authors: Lindroos Antti-Jussi , Lindholm-Lehto Petra , Pulkkinen Jani , Kiuru Tapio , Vielma Jouni 
Published: April 2020

AbstractWe studied the effect of sand filtration with natural esker material on the removal of total organic carbon (TOC), total suspended solids (TSS), and turbidity from the effluent of an experimental recirculating aquaculture system (RAS) farm. Separate experiments were performed with the same esker sand: (1) a soil column experiment in 2017 where the effluent (mean TOC 8.14 mg L−1) was percolated vertically through a 50-cm-thick sand column with the infiltration 1 m day−1; (2) a sand filtration experiment with water-saturated conditions in 2018 where the effluent from the woodchip denitrification (mean TOC 26.84 mg L−1) was infiltrated through a sand layer with the retention time of 1.2 days. In experiment 2, infiltration of 25 L day−1 through a 31-cm sand layer and 40 L day−1 through a 50-cm sand layer were studied. Both experiments were performed in association with rainbow trout (Oncorhynchus mykiss) grow-out trials. In sand filtration with vertical water flow through a soil column, the removal of TSS was 40%, while of TOC 6%, partly due to the small thickness of the soil column and coarse sand material. In water-saturated conditions, mean removal of TOC (3 mg L−1 1.2 day−1), TSS (1.2 mg L−1 1.2 day−1), and turbidity (0.4 FTU 1.2 day−1) reached 11% (TOC), 18% (TSS), and 15% (turbidity), even with the retention time of only 1.2 days. The removal of TOC in water-saturated conditions correlated with the removal of TSS and turbidity.
Multimodal mixed reality visualisation for intraoperative surgical guidance
Authors: Cartucho João , Shapira David , Ashrafian Hutan , Giannarou Stamatia 
Published: April 2020

Abstract
Purpose
In the last decade, there has been a great effort to bring mixed reality (MR) into the operating room to assist surgeons intraoperatively. However, progress towards this goal is still at an early stage. The aim of this paper is to propose a MR visualisation platform which projects multiple imaging modalities to assist intraoperative surgical guidance.

Methodology
In this work, a MR visualisation platform has been developed for the Microsoft HoloLens. The platform contains three visualisation components, namely a 3D organ model, volumetric data, and tissue morphology captured with intraoperative imaging modalities. Furthermore, a set of novel interactive functionalities have been designed including scrolling through volumetric data and adjustment of the virtual objects’ transparency. A pilot user study has been conducted to evaluate the usability of the proposed platform in the operating room. The participants were allowed to interact with the visualisation components and test the different functionalities. Each surgeon answered a questionnaire on the usability of the platform and provided their feedback and suggestions.

Results
The analysis of the surgeons’ scores showed that the 3D model is the most popular MR visualisation component and neurosurgery is the most relevant speciality for this platform. The majority of the surgeons found the proposed visualisation platform intuitive and would use it in their operating rooms for intraoperative surgical guidance. Our platform has several promising potential clinical applications, including vascular neurosurgery.

Conclusion
The presented pilot study verified the potential of the proposed visualisation platform and its usability in the operating room. Our future work will focus on enhancing the platform by incorporating the surgeons’ suggestions and conducting extensive evaluation on a large group of surgeons.
Corticosteroid therapy for the management of paradoxical inflammatory reaction in patients with pulmonary tuberculosis
Authors: Done Macky M. , Akkerman Onno W. , Al-Kailany Wud , de Lange Wiel C. M. , de Jonge Gonda , Kleinnijenhuis Johanneke , Stienstra Riejanne , van der Werf Tjip S. 
Published: April 2020

Abstract
Background
Paradoxical reaction after the initiation of tuberculosis treatment is defined as increased inflammation following effective antimycobacterial treatment. This is a phenomenon that can severely complicate a patient’s recovery, potentially leading to further morbidity and residual deficits. Paradoxical reaction remains poorly understood regarding its pathophysiology and management. Only a limited number of reports look critically at the available therapeutic options, with evidence of the efficacy of prednisolone therapy being primarily limited to extrapulmonary PR only.

Case
We describe two HIV negative patients who were admitted to our department with pulmonary tuberculosis, presenting with inflammatory patterns attributable to PR and their response to adjunctive steroid therapy.

Discussion and Conclusions
The presented cases further highlight the need for immunological studies and randomized trials for corticosteroid therapy are needed to better understand this phenomenon as well as provide an evidence-base for anti-inflammatory treatment. Furthermore, by means of this case series, we are also able to highlight the potential variability in the symptomatology of the lesser known PR phenomenon, in which we observed a hypotensive shock-like syndrome not previously described in literature.