bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporal determinization of mutating finite automata: Reconstructing or restructuring
Authors: Lamperti Gianfranco 
Published: December 2019

SummaryA mutating finite automaton (MFA) is a nondeterministic finite automaton (NFA) that changes its morphology over discrete time by a sequence of mutations. This results in a sequence of NFAs, the initial NFA, and one mutated NFA for each mutation. Some application domains, including model‐based diagnosis of discrete‐event systems in artificial intelligence and model‐based testing in software engineering, require temporal determinization of MFAs. Determinizing an MFA temporally means generating a deterministic finite automaton (DFA) that is equivalent to the mutated NFA as soon as a mutation occurs. Since, in computation time, the classical Subset Construction determinization algorithm may be less than optimal when applied to MFAs, a conservative algorithm is proposed, called Subset Restructuring, which, instead of constructing the new DFA from scratch based on the mutated NFA, generates the new DFA by updating the previous DFA based on the mutation occurred. Subset Restructuring is sound and complete, thereby yielding the same DFA generated by Subset Construction. Results from massive experimentation indicate the viability of Subset Restructuring, especially so when large MFAs change by small mutations.
Prevention of stillbirth: impact of two‐stage screening for vasa previa
Authors: Zhang W. , Geris S. , Beta J. , Ramadan G. , Nicolaides K. H. , Akolekar R. 
Published: December 2019

ABSTRACTObjectivesTo examine the feasibility and effectiveness of a two‐stage ultrasound screening strategy for detection of vasa previa and to estimate the potential impact of screening on prevention of stillbirth.MethodsThis was a retrospective study of data from prospective screening for vasa previa in singleton pregnancies, undertaken at the Fetal Medicine Unit at Medway Maritime Hospital, UK, between 2012 and 2018. Women booked for prenatal care and delivery in our hospital had routine ultrasound examinations at 11–13 and 20–22 weeks' gestation. Those with velamentous cord insertion at the inferior part of the placenta at the first‐trimester scan and those with low‐lying placenta at the second‐trimester scan were classified as high‐risk for vasa previa and had transvaginal sonography searching specifically for vasa previa, at the time of the 20–22‐week scan. The management and outcome of cases with suspected vasa previa is described. We excluded cases of miscarriage or termination at < 24 weeks' gestation.ResultsThe study population of 26 830 singleton pregnancies included 21 (0.08%; 1 in 1278) with vasa previa. In all cases of vasa previa, the diagnosis was made at the 20–22‐week scan and confirmed postnatally by gross and histological examination of the placenta. At the 11–13‐week scan, cord insertion was classified as central in 25 071 (93.4%) cases, marginal in 1680 (6.3%), and velamentous in 79 (0.3%). In 16 (76.2%) of the 21 cases of vasa previa, cord insertion at the first‐trimester scan was classified as velamentous at the inferior part of the placenta, in two cases (9.5%) as marginal and in three cases (14.3%) as central. The 21 cases of vasa previa were managed on an outpatient basis with serial scans for measurement of cervical length and elective Cesarean section at 34 weeks' gestation; all babies were liveborn but there was one neonatal death. In the study population, there were 83 stillbirths, none of which had evidence of vasa previa on postnatal examination. On the assumption that, if we had not diagnosed prenatally all 21 cases of vasa previa in our population, half of these cases would have resulted in stillbirth, then the potential impact of screening is prevention of 10.6% (10/94) of stillbirths.ConclusionA two‐stage strategy of screening for vasa previa can be incorporated into routine clinical practice, and such a strategy could potentially reduce the rate of stillbirth. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Dynamic contact area ratio in shoulder instability: an innovative diagnostic technique measuring interplay of bony lesions
Authors: Weel Hanneke , Krekel Peter R. , Willigenburg Nienke , Willems W. Jaap , Randelli Pietro , Compagnoni Riccardo , van Deurzen Derek F. P. 
Published: December 2019

AbstractPurposeThe hypothesis of this study is that Dynamic Contact Area Ratio of the humerus and glenoid, measured with CT scans, is significantly reduced in patients with anterior shoulder instability compared to the Dynamic Contact Area Ratio in a control group of people without shoulder instability.MethodsPreoperative CT scans of patients who underwent surgery for anterior shoulder instability were collected. Additionally, the radiologic database was searched for control subjects. Using a validated software tool (Articulis) the CT scans were converted into 3-dimensional models and the amount the joint contact surface during simulated motion was calculated.ResultsCT scans of 18 patients and 21 controls were available. The mean Dynamic Contact Area Ratio of patients was 25.2 ± 6.7 compared to 30.1 ± 5.1 in healthy subjects (p = 0.014).ConclusionDynamic Contact Area Ratio was significantly lower in patients with anterior shoulder instability compared to controls, confirming the hypothesis of the study. The findings of this study indicate that calculating the Dynamic Contact Area Ratio based on CT scan images may help surgeons in diagnosing anterior shoulder instability.Level of evidenceIII.
Outcomes After Surgery for Unilateral Dominant Primary Aldosteronism in Sweden
Authors: Sellgren Fredrik , Koman Anna , Nordenström Erik , Hellman Per , Hennings Joakim , Muth Andreas 
Published: December 2019

AbstractBackgroundPrimary aldosteronism (PA) is the most common cause of secondary hypertension. Surgery is the mainstay of treatment for unilateral dominant PA, but reported cure rates varies. The aim of the present study was to investigate contemporary follow‐up practices and cure rates after surgery for PA in Sweden.MethodsPatients operated for PA and registered in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009–2015 were identified. Patient data were extracted, and follow‐up data (1–24 months) was recorded. Doses of antihypertensive medication and potassium supplementation were calculated using defined daily doses (DDD), and the Primary Aldosteronism Surgical Outcome (PASO) criteria were used to evaluate outcomes.ResultsOf 190 registered patients, 171 (47% female, mean age 53 years, median follow‐up 3.7 months) were available for analysis. In 75 patients (44%), missing data precluded evaluation of biochemical cure according to the PASO criteria. Minimal invasive approach was used in 168/171 patients (98%). Complication rate (Clavien‐Dindo >3a) was 3%. No mortality was registered. Pre/postoperatively 98/66% used antihypertensives (mean DDD 3.7/1.5). 89/2% had potassium supplementation (mean DDD 2.0/0) before/after surgery. Complete/partial biochemical and clinical success according to the PASO criteria were achieved in 92/7% and 34/60%, respectively.ConclusionIn this study, reflecting contemporary clinical practice in Sweden complete/partial biochemical and clinical success after surgery for PA was 92/7% and 34/60%. Evaluation of biochemical cure was hampered by lack of uniform reporting of relevant outcome measures. We suggest mandatory reporting of surgical outcomes using the PASO criteria for all units performing surgery for PA.
A multicentre development and validation study of a novel lower gastrointestinal bleeding score—The Birmingham Score
Authors: Smith Samuel C. L. , Bazarova Alina , Ejenavi Efe , Qurashi Maria , Shivaji Uday N. , Harvey Phil R. , Slaney Emma , McFarlane Michael , Baker Graham , Elnagar Mohamed , Yuzari Sarah , Gkoutos Georgios , Ghosh Subrata , Iacucci Marietta 
Published: December 2019

AbstractPurposeLower gastrointestinal bleeding (LGIB) is common and risk stratification scores can guide clinical decision-making. There is no robust risk stratification tool specific for LGIB, with existing tools not routinely adopted. We aimed to develop and validate a risk stratification tool for LGIB.MethodsRetrospective review of LGIB admissions to three centres between 2010 and 2018 formed the derivation cohort. Using regressional analysis within a machine learning technique, risk factors for adverse outcomes were identified, forming a simple risk stratification score—The Birmingham Score. Retrospective review of an additional centre, not included in the derivation cohort, was performed to validate the score.ResultsData from 469 patients were included in the derivation cohort and 180 in the validation cohort. Admission haemoglobin OR 1.07(95% CI 1.06–1.08) and male gender OR 2.29(95% CI 1.40–3.77) predicted adverse outcomes in the derivation cohort AUC 0.86(95% CI 0.82–0.90) which outperformed the Blatchford 0.81(95% CI 0.77–0.85), Rockall 0.60(95% CI 0.55–0.65) and AIM65 0.55(0.50–0.60) scores and in the validation cohort AUC 0.80(95% CI 0.73–0.87) which outperformed the Blatchford 0.77(95% CI 0.70–0.85), Rockall 0.67(95% CI 0.59–0.75) and AIM 65 scores 0.61(95% CI 0.53–0.69). The Birmingham Score also performs well at predicting adverse outcomes from diverticular bleeding AUC 0.87 (95% CI 0.75–0.98). A score of 7 predicts a 94% probability of adverse outcome.ConclusionThe Birmingham Score represents a simple risk stratification score that can be used promptly on patients admitted with LGIB.
Genetic polymorphism patterns suggest a genetic driven inflammatory response as pathogenesis in appendicitis
Authors: Dimberg Jan , Rubér Marie , Skarstedt Marita , Andersson Manne , Andersson Roland E. 
Published: December 2019

Abstract
Purpose
The pathogenesis of appendicitis is not well understood. Environmental factors are regarded most important, but epidemiologic findings suggest a role of inflammatory and genetic mechanisms. This study determines the association of single nucleotide polymorphisms (SNPs) of inflammatory genes with appendicitis.

Methods
As part of a larger prospective study on the diagnostic value of inflammatory variables in appendicitis, the genotype frequency of 28 polymorphisms in 26 inflammatory response genes from the appendicitis and control patients was analyzed in blood samples from 343 patients, 100 with appendicitis, and 243 with non-specific abdominal pain, using TaqMan SNP genotyping assays.

Results
Associations with appendicitis were found for SNPs IL-13 rs1800925 with odds ratio (OR) 6.02 (95% CI 1.52–23.78) for T/T versus C/C + T/T, for IL-17 rs2275913 with OR 2.38 (CI 1.24–4.57) for A/A vs G/G + GA, for CCL22 rs223888 with OR 0.12 (0.02–0.90), and for A/A vs G/G + GA. Signs of effect modification of age for the association with appendicitis were found for IL-13 rs1800925 and CTLA4 rs3087243. Stratified analysis showed difference in association with severity of disease for IL-17 rs2275913 and CD44 rs187115.

Conclusions
The association of gene variants on risk of appendicitis and its severity suggest an etiologic role of genetically regulated inflammatory response. This may have implications for understanding the prognosis of untreated appendicitis as a possible self-limiting disorder and for understanding the inverse association of appendicitis with ulcerative colitis.
Time trends of vitamin D concentrations in northern Sweden between 1986 and 2014: a population-based cross-sectional study
Authors: Summerhays Eva , Eliasson Mats , Lundqvist Robert , Söderberg Stefan , Zeller Tanja , Oskarsson Viktor 
Published: December 2019

AbstractPurposeVitamin D, produced through cutaneous photosynthesis or ingested via foods or supplements, has generated considerable research interest due to its potential health effects. However, epidemiological data on the time trends of vitamin D status are sparse, especially from northern Europe. We examined the time trend of vitamin D concentrations in northern Sweden between 1986 and 2014.MethodsWe used data on 11,129 men and women (aged 25–74 years) from seven population-based surveys (the Northern Sweden MONICA study), recruited between 1986 and 2014. Serum vitamin D (25-hydroxyvitamin D) status was measured using a one-step immunoassay (Abbott Architect). Multivariable linear regression models, adjusted for age, sex, and a number of other variables, were used to estimate the time trend of vitamin D concentrations.ResultsThe mean value of vitamin D in the entire study population was 19.9 ng/mL [standard deviation (SD) 7.9], with lower values in men (19.4 ng/mL; SD 7.5) than in women (20.5 ng/mL; SD 8.2). Using the survey in 1986 as reference category, the multivariable-adjusted mean difference [95% confidence interval (CI)] in ng/mL was 2.7 (2.2, 3.3) in 1990, 3.2 (2.7, 3.7) in 1994, 1.6 (1.0, 2.1) in 1999, − 2.0 (− 2.5, − 1.4) in 2004, 1.0 (0.4, 1.5) in 2009, and 3.1 (2.5, 3.6) in 2014.ConclusionIn this large cross-sectional study, we observed no clear upward or downward trend of vitamin D concentrations in northern Sweden between 1986 and 2014.
Outcomes of superior capsule reconstruction for massive rotator cuff tears and risk factors for postoperative retear
Authors: Ohta Satoru , Komai Osamu , Onochi Yuuki 
Published: December 2019

AbstractIntroductionSuperior capsule reconstruction (SCR) has been used for the tendon grafting of massive rotator cuff tears when primary repair is difficult. We examined the postoperative outcomes of SCR for massive rotator cuff tears and the risk factors for postoperative retear.Materials and methodsThrough this retrospective comparative study, we evaluated 35 patients with an average age of 75.3 (57–90) years who underwent SCR using the technique developed by Mihata et al. Clinical outcomes were evaluated 1 year postoperatively using the Japan Orthopedic Association (JOA) score, University of California Los Angeles (UCLA) shoulder score, elevation angle and the Sugaya classification, which uses a 5-point scale evaluation on magnetic resonance imaging in which types 4 and 5 are considered retears. We also investigated the progression of fatty degeneration before and after surgery and the rupture site of the graft. Acromio-humeral distance (AHD), before and after surgery was measured through X-rays. Rotator cuff tear-related shoulder arthritis was evaluated on plain X-rays using the Hamada stage. Risks of retear were identified using multiple regression analyses for sex, age, Hamada stage and JOA score.ResultsThe JOA score improved from 62.3 ± 9.49 (SD) preoperatively to 84.6 ± 5.66 (SD) postoperatively (P < 0.001). The UCLA score improved from 15.3 ± 3.77 (SD) preoperatively to 30.1 ± 3.11 (SD) postoperatively (P < 0.001). AHD increased from 4.03 mm preoperatively to 6.23 mm postoperatively (P < 0.001).Postoperative retear was observed in seven of the 35 patients. Moreover, retear was observed in five of nine patients with a Hamada stage ≥ 4. Multiple regression analysis revealed that age ≥ 80 years, male sex and Hamada stage ≥ 4 were risk factors for retear.ConclusionsWhile the postoperative outcomes of SCR are favorable, age, sex and degree of arthropathic change should be considered for surgical indications of SCR.
Endoscopic transnasal transmaxillary approach to the upper parapharyngeal space and the skull base
Authors: Liu Quan , Wang Huan , Zhao Weidong , Song Xiaole , Sun Xicai , Yu Hongmeng , Wang Dehui , Fernandez-Miranda Juan C. , Snyderman Carl H. 
Published: December 2019

AbstractPurposeTreatment of tumors arising in the upper parapharyngeal space (PPS) or the floor of the middle cranial fossa is challenging. This study aims to present anatomical landmarks for a combined endoscopic transnasal and anterior transmaxillary approach to the upper PPS and the floor of the middle cranial fossa and to further evaluate their clinical application.MethodsDissection of the upper PPS using a combined endoscopic endonasal transpterygoid and anterior transmaxillary approach was performed in six cadaveric heads. Surgical landmarks associated with the approach were defined. The defined approach was applied in patients with tumors involving the upper PPS.ResultsThe medial pterygoid muscle, tensor veli palatini muscle and levator veli palatini muscle were key landmarks of the approach into the upper PPS. The lateral pterygoid plate, foramen ovale and mandibular nerve were important anatomical landmarks for exposing the parapharyngeal segment of the internal carotid artery through a combined endoscopic transnasal and anterior transmaxillary approach. The combined approach provided a better view of the upper PPS and middle skull base, allowing for effective bimanual techniques and bleeding control. Application of the anterior transmaxillary approach also provided a better view of the inferior limits of the upper PPS and facilitated control of the internal carotid artery.ConclusionsImproving the knowledge of the endoscopic anatomy of the upper PPS allowed us to achieve an optimal approach to tumors arising in the upper PPS. The combined endoscopic transnasal and anterior transmaxillary approach is a minimally invasive alternative approach to the upper PPS.
Neonatal cardiac hypertrophy: the role of hyperinsulinism—a review of literature
Authors: Paauw Nina D. , Stegeman Raymond , de Vroede Monique A. M. J. , Termote Jacqueline U. M. , Freund Matthias W. , Breur Johannes M. P. J. 
Published: December 2019

AbstractHypertrophic cardiomyopathy (HCM) in neonates is a rare and heterogeneous disorder which is characterized by hypertrophy of heart with histological and functional disruption of the myocardial structure/composition. The prognosis of HCM depends on the underlying diagnosis. In this review, we emphasize the importance to consider hyperinsulinism in the differential diagnosis of HCM, as hyperinsulinism is widely associated with cardiac hypertrophy (CH) which cannot be distinguished from HCM on echocardiographic examination. We supply an overview of the incidence and treatment strategies of neonatal CH in a broad spectrum of hyperinsulinemic diseases. Reviewing the literature, we found that CH is reported in 13 to 44% of infants of diabetic mothers, in approximately 40% of infants with congenital hyperinsulinism, in 61% of infants with leprechaunism and in 48 to 61% of the patients with congenital generalized lipodystrophy. The correct diagnosis is of importance since there is a large variation in prognoses and there are various strategies to treat CH in hyperinsulinemic diseases.Conclusion: The relationship between CH and hyperinsulism has implications for clinical practice as it might help to establish the correct diagnosis in neonates with cardiac hypertrophy which has both prognostic and therapeutic consequences. In addition, CH should be recognized as a potential comorbidity which might necessitate treatment in all neonates with known hyperinsulinism.What is Known:• Hyperinsulinism is currently not acknowledged as a cause of hypertrophic cardiomyopathy (HCM) in textbooks and recent Pediatric Cardiomyopathy Registry publications.What is New:• This article presents an overview of the literature of hyperinsulinism in neonates and infants showing that hyperinsulinism is associated with cardiac hypertrophy (CH) in a broad range of hyperinsulinemic diseases.• As CH cannot be distinguished from HCM on echocardiographic examination, we emphasize the importance to consider hyperinsulinism in the differential diagnosis of HCM/CH as establishing the correct diagnosis has both prognostic and therapeutic consequences.
Seasonal variation in exploitative competition between honeybees and bumblebees
Authors: Wignall Veronica R. , Campbell Harry Isabella , Davies Natasha L. , Kenny Stephen D. , McMinn Jack K. , Ratnieks Francis L. W. 
Published: December 2019

AbstractHoneybees (Apis mellifera) and bumblebees (Bombusspp.) often undergo exploitative competition for shared floral resources, which can alter their foraging behaviour and flower choice, even causing competitive exclusion. This may be strongest in summer, when foraging conditions are most challenging for bees, compared to other times of the year. However, the seasonal dynamics of competition between these major pollinator groups are not well understood. Here, we investigate whether the strength of exploitative competition for nectar between honeybees and bumblebees varies seasonally, and whether competitive pressure is greatest in summer months. We carried out experimental bee exclusion trials from May to late September, using experimental patches of lavender, variety Grosso, in full bloom. In each trial, we compared the numbers of honeybees (HB) foraging on patches from which bumblebees had been manually excluded (bumblebee excluded, BBE) versus control (CON) patches, HB(BBE-CON). This measure of exploitative competition varied significantly with season. As expected, mean HB(BBE-CON)was significantly greater in summer trials than in spring or autumn trials. This was despite high nectar standing crop volumes in BBE patch flowers in spring and autumn trials. Mean HB(BBE-CON)was not different between spring and autumn trials. Our results show that nectar competition between honeybees and bumblebees varies seasonally and is stronger in summer than spring or autumn, adding to current understanding of the seasonality of resource demand and competition between bee species. This information may also help to inform conservation programs aiming to increase floral resources for bees by showing when these resources are most needed.
The inhibitory control of pheasants (Phasianus colchicus) weakens when previously learned environmental information becomes unpredictable
Authors: Griffin Kandace R. , Beardsworth Christine E. , Laker Philippa R. , van Horik Jayden O. , Whiteside Mark A. , Madden Joah R. 
Published: December 2019

AbstractInhibitory control (IC) is the ability to intentionally restrain initial, ineffective responses to a stimulus and instead exhibit an alternative behaviour that is not pre-potent but which effectively attains a reward. Individuals (both humans and non-human animals) differ in their IC, perhaps as a result of the different environmental conditions they have experienced. We experimentally manipulated environmental predictability, specifically how reliable information linking a cue to a reward was, over a very short time period and tested how this affected an individual’s IC. We gave 119 pheasants (Phasianus colchicus) the opportunity to learn to associate a visual cue with a food reward in a binary choice task. We then perturbed this association for half the birds, whereas control birds continued to be rewarded when making the correct choice. We immediately measured all birds’ on a detour IC task and again 3 days later. Perturbed birds immediately performed worse than control birds, making more unrewarded pecks at the apparatus than control birds, although this effect was less for individuals that had more accurately learned the initial association. The effect of the perturbation was not seen 3 days later, suggesting that individual IC performance is highly plastic and susceptible to recent changes in environmental predictability. Specifically, individuals may perform poorly in activities requiring IC immediately after information in their environment is perturbed, with the perturbation inducing emotional arousal. Our finding that recent environmental changes can affect IC performance, depending on how well an animal has learned about that environment, means that interpreting individual differences in IC must account for both prior experience and relevant individual learning abilities.