bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability and Validity of a New Transfer Assessment Form for Stroke Patients
Authors: Kitamura Shin , Otaka Yohei , Murayama Yudai , Ushizawa Kazuki , Narita Yuya , Nakatsukasa Naho , Kondo Kunitsugu , Sakata Sachiko 
Published: May 2020

IntroductionTransferring is a basic skill that is essential for mobility independence and indispensable for expanding activities of daily living of stroke patients using a wheelchair. Therefore, transfer independence is an important issue that greatly affects daily life in the hospital and at home. To offer an effective intervention to acquire a skill, developing an assessment for individual subtasks that comprise transferring would assist the identification of specific tasks that prevent independence in patients and facilitate interventions to improve transferring independence.ObjectiveTo examine the reliability and validity of a newly developed transfer assessment form, the Bed‐wheelchair transfer Tasks Assessment Form (BTAF), for stroke patients to evaluate subtasks required for transferring.DesignValidation and test‐retest studies.SettingSubacute rehabilitation wards in Japan.ParticipantsA total of 82 therapists for verifying content validity; 30 patients for validation and test‐retest study.InterventionsNot applicable.Main Outcome MeasuresThe content validity was initially assessed based on a questionnaire. Subsequently, four occupational therapists used the form to evaluate the video‐recorded transferring performances of stroke participants. Two assessors evaluated each performance once and then 2 weeks later. The inter‐rater reliability, intra‐rater reliability, internal consistency, and concurrent validity were examined.ResultsFleiss's κ coefficient for inter‐rater reliability for each item of the form was 0.66 or more. Cohen's κ coefficient for intra‐rater reliability for each item was 0.73 or more. Cronbach's coefficient alpha ranged from 0.90 to 0.93. Spearman's rank correlation coefficients between the mean scores of our form and scores of the functional independence measure item “transfer to bed/chair/wheelchair” ranged from 0.53 to 0.78 (P < .01).ConclusionsThe form demonstrated good reliability and validity. Its usefulness and efficacy should be further investigated in stroke patients to facilitate rehabilitation.
Effect of equilibration time on clinical and neonatal outcomes in human blastocysts vitrification
Authors: Mitsuhata Shingo , Hayashi Momoko , Fujii Yoshitaka , Motoyama Hiroaki , Endo Yuji 
Published: May 2020

AbstractPurposeProlonged exposure to equilibration solutions may be detrimental to an embryo's developmental potential, whereas a shorter exposure may affect the penetration of cryoprotectants into blastomeres. The purpose of this study was to evaluate the effects of different equilibration times on the clinical and neonatal outcomes of human blastocyst vitrification.MethodsThis is a retrospective study based on data collected between November 2008 and November 2015. A total of 192 blastocysts (80 non‐expanded and 112 expanded) obtained from 167 patients were analyzed. The blastocysts were divided into two groups according to their equilibration time: 8‐11 minutes or 12‐15 minutes. The clinical and neonatal outcomes of warmed blastocysts were evaluated.ResultsThe survival, implantation, and live birth rates of non‐expanded blastocysts were not different between the two groups, but they significantly improved for the expanded blastocysts in the 12‐15 minutes group compared to the 8‐11 minutes group. The results were similar for the neonatal outcomes after vitrified embryo transfer, when partitioned by equilibration time and blastocyst stage at vitrification.ConclusionsFor the non‐expanded blastocysts, a shortened equilibration time (8‐11 minutes) is sufficient for effective vitrification.
Stability and stabilization for singularly perturbed systems with Markovian jumps
Authors: Wang Guoliang , Xu Lei 
Published: May 2020

SummaryThis article focuses on the stability and stabilization problems of singularly perturbed jump systems. Here, the singularly perturbed parameter (SPP) is also with Markov switching and satisfies any with positive bound predefined. First, stability conditions expressed ϵi‐free but involving its bound are developed by constructing an ϵi‐dependent Lyapunov function. Then, a method for state feedback stabilization controller depending on SPP is proposed, whose conditions are given in terms of linear matrix inequalities. Moreover, some special cases about deterministic SPP are considered too. Finally, two practical examples are used to demonstrate the effectiveness and superiorities of the proposed methods.
Using grooving and corner strip‐batten techniques for seismic strengthening of square reinforced concrete columns with fiber‐reinforced polymer composites
Authors: Saljoughian Alireza , Mostofinejad Davood 
Published: May 2020

AbstractThis study represents the results of an empirical program investigating the behavior of square reinforced concrete (RC) columns retrofitted using longitudinal carbon fiber‐reinforced polymer (CFRP) composites under simulated seismic loading. The main challenges to tackle are the premature buckling and the debonding of the longitudinal FRP composites on the tension and compression sides of the columns, respectively. To postpone both, the two versions of the grooving methods (GM), that is, the externally bonded reinforcement on grooves (EBROG) and the externally bonded reinforcement in grooves (EBRIG), were employed and the results were compared with those obtained under the traditional externally bonded reinforcement (EBR) procedure. Another aspect of the study involves investigating the influence of the recently developed corner strip‐batten (CSB) method on confining column specimens. For these purposes, seven half‐scale RC columns strengthened using FRP sheets were subjected to reversal cyclic loading. Experimental results exhibited that using the EBRIG and EBROG methods simultaneously with CSB technique could prevent altogether the debonding and buckling of longitudinal CFRP sheets. It was also found that the application of FRP strips utilizing the GM and CSB methods could produce an important increment in the performance of the RC columns in different terms such as ductility and lateral strength.
Evaluation of different wind fields for the investigation of the dynamic response of offshore wind turbines
Authors: Nybø Astrid , Nielsen Finn Gunnar , Reuder Joachim , Churchfield Matthew J. , Godvik Marte 
Published: May 2020

AbstractAs the size of offshore wind turbines increases, a realistic representation of the spatiotemporal distribution of the incident wind field becomes crucial for modeling the dynamic response of the turbine. The International Electrotechnical Commission (IEC) standard for wind turbine design recommends two turbulence models for simulations of the incident wind field, the Mann spectral tensor model, and the Kaimal spectral and exponential coherence model. In particular, for floating wind turbines, these standard models are challenged by more sophisticated ones. The characteristics of the wind field depend on the stability conditions of the atmosphere, which neither of the standard turbulence models account for. The spatial and temporal distribution of the turbulence, represented by coherence, is not modeled consistently by the two standard models. In this study, the Mann spectral tensor model and the Kaimal spectral and exponential coherence model are compared with wind fields constructed from offshore measurements and obtained from large‐eddy simulations. Cross sections and durations relevant for offshore wind turbine design are considered. Coherent structures from the different simulators are studied across various stability conditions and wind speeds through coherence and proper orthogonal decomposition mode plots. As expected, the standard models represent neutral stratification better than they do stable and unstable. Depending upon the method used for generating the wind field, significant differences in the spatial and temporal distribution of coherence are found. Consequently, the computed structural design loads on a wind turbine are expected to vary significantly depending upon the employed turbulence model. The knowledge gained in this study will be used in future studies to quantify the effect of various turbulence models on the dynamic response of large offshore wind turbines.
Synthesis and biological evaluation of α- and β-hydroxy substituted amino acid derivatives as potential mGAT1–4 inhibitors
Authors: Andreß Janina C. , Böck Michael C. , Höfner Georg , Wanner Klaus T. 
Published: May 2020

AbstractIn this study, we report the synthesis and biological evaluation of a variety of α- and β-hydroxy substituted amino acid derivatives as potential amino acid subunits in inhibitors of GABA uptake transporters (GATs). In order to ensure that the test compounds adopt a binding pose similar to that presumed for related larger GAT inhibitors, lipophilic residues were introduced either at the amino nitrogen atom or at the alcohol function. Several of the synthesized compounds were found to exhibit similar inhibitory activity at the GAT subtypes mGAT2, mGAT3, and mGAT4, respectively, as compared with the reference N-butylnipecotic acid. Hence, these compounds might serve as starting point for future developments of more complex GAT inhibitors.
Lokale Lappenplastiken als letzter Versuch vor der Unterschenkelamputation: eine Übersicht
Authors: Jakubietz Rafael G. , Meffert Rainer H. , Jakubietz Michael G. , Seyfried Florian , Schmidt Karsten 
Published: May 2020

Zusammenfassung
Hintergrund
Die Weichgewebsrekonstruktion bei alten Patienten stellt eine Herausforderung dar. Der freie Gewebetransfer kann bei gesunden Patienten trotz hohen Alters mit hoher Erfolgsrate durchgeführt werden. Bei multimorbiden Patienten, die für den freien Gewebetransfer nicht in Betracht kommen, werden häufig lokale Lappenplastiken eingesetzt, welche mit einer hohen Komplikationsrate assoziiert sind. Gerade solche Rettungseingriffe müssen so gewählt werden, dass eine Amputation durch die Wahl der Entnahmestelle nicht nachteilig beeinflusst wird oder gar unmöglich wird.

Methode
Drei distal basierte lokale Lappenplastiken wie Suralis‑, Peronaeus-brevis- und Propellerlappenplastik werden im Hinblick auf die Platzierung der Entnahmestelle sowie die Komplikationen der Wundheilungsstörung diskutiert.

Ergebnisse
Die Entnahmestelle der Suralislappenplastik ist nachteilig, da die proximale, dorsale Wadenregion betroffen ist, die im Falle einer Unterschenkelamputation die Weichteildeckung des Stumpfes ermöglicht.

Schlussfolgerung
Soll eine lokale Lappenplastik als „Rettungseingriff“ als Versuch der Vermeidung einer Unterschenkelamputation bei für einen freien Gewebetransfer nichtgeeigneten Patienten zum Einsatz kommen, gilt es, Lappenplastiken zu wählen, die die Entnahmestelle außerhalb der dorsalen, proximalen Wade platzieren, um die Weichteildeckung einer Stumpfbildung potenziell zu ermöglichen.
Toxicity of fluoride: critical evaluation of evidence for human developmental neurotoxicity in epidemiological studies, animal experiments and in vitro analyses
Authors: Guth Sabine , Hüser Stephanie , Roth Angelika , Degen Gisela , Diel Patrick , Edlund Karolina , Eisenbrand Gerhard , Engel Karl-Heinz , Epe Bernd , Grune Tilman , Heinz Volker , Henle Thomas , Humpf Hans-Ulrich , Jäger Henry , Joost Hans-Georg , Kulling Sabine E. , Lampen Alfonso , Mally Angela , Marchan Rosemarie , Marko Doris , Mühle Eva , Nitsche Michael A. , Röhrdanz Elke , Stadler Richard , van Thriel Christoph , Vieths Stefan , Vogel Rudi F. , Wascher Edmund , Watzl Carsten , Nöthlings Ute , Hengstler Jan G. 
Published: May 2020

AbstractRecently, epidemiological studies have suggested that fluoride is a human developmental neurotoxicant that reduces measures of intelligence in children, placing it into the same category as toxic metals (lead, methylmercury, arsenic) and polychlorinated biphenyls. If true, this assessment would be highly relevant considering the widespread fluoridation of drinking water and the worldwide use of fluoride in oral hygiene products such as toothpaste. To gain a deeper understanding of these assertions, we reviewed the levels of human exposure, as well as results from animal experiments, particularly focusing on developmental toxicity, and the molecular mechanisms by which fluoride can cause adverse effects. Moreover, in vitro studies investigating fluoride in neuronal cells and precursor/stem cells were analyzed, and 23 epidemiological studies published since 2012 were considered. The results show that the margin of exposure (MoE) between no observed adverse effect levels (NOAELs) in animal studies and the current adequate intake (AI) of fluoride (50 µg/kg b.w./day) in humans ranges between 50 and 210, depending on the specific animal experiment used as reference. Even for unusually high fluoride exposure levels, an MoE of at least ten was obtained. Furthermore, concentrations of fluoride in human plasma are much lower than fluoride concentrations, causing effects in cell cultures. In contrast, 21 of 23 recent epidemiological studies report an association between high fluoride exposure and reduced intelligence. The discrepancy between experimental and epidemiological evidence may be reconciled with deficiencies inherent in most of these epidemiological studies on a putative association between fluoride and intelligence, especially with respect to adequate consideration of potential confounding factors, e.g., socioeconomic status, residence, breast feeding, low birth weight, maternal intelligence, and exposure to other neurotoxic chemicals. In conclusion, based on the totality of currently available scientific evidence, the present review does not support the presumption that fluoride should be assessed as a human developmental neurotoxicant at the current exposure levels in Europe.
Combined hepatocellular-cholangiocarcinoma: which preoperative clinical data and conventional MRI characteristics have value for the prediction of microvascular invasion and clinical significance?
Authors: Wang Xiaolong , Wang Wentao , Ma Xijuan , Lu Xin , Li Shaodong , Zeng Mengsu , Xu Kai , Yang Chun 
Published: May 2020

Abstract
Objectives
To explore which preoperative clinical data and conventional MRI findings may indicate microvascular invasion (MVI) of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and have clinical significance.

Methods
The study enrolled 113 patients with histopathologically confirmed cHCC-CCA (MVI-positive group [n = 56], MVI-negative group [n = 57]). Two radiologists retrospectively assessed the preoperative MRI features (qualitative analysis of morphology and dynamic enhancement features), and each lesion was assigned according to the LI-RADS. Preoperative clinical data were also evaluated. Logistic regression analyses were used to assess the relative value of these parameters as potential predictors of MVI. Recurrence-free survival (RFS) rates after hepatectomy in the two groups were estimated using Kaplan–Meier survival curves and compared using the log-rank test.

Results
The majority of cHCC-CCAs were categorized as LR-M. On multivariate analysis, a higher serum AFP level (OR, 0.523; 95% CI, 0.282–0.971; p = 0.040), intratumoral fat deposition (OR, 14.368; 95% CI, 2.749–75.098; p = 0.002), and irregular arterial peritumoral enhancement (OR, 0.322; 95% CI, 0.164–0.631; p = 0.001) were independent variables associated with the MVI of cHCC-CCA. After hepatectomy, patients with MVI of cHCC-CCA showed earlier recurrence than those without MVI (hazard ratio [HR], 0.402; 95% CI, 0.189–0.854, p = 0.013).

Conclusion
A higher serum AFP level and irregular arterial peritumoral enhancement are potential predictive biomarkers for the MVI of cHCC-CCA, while intratumoral fat detected on MRI suggests a low risk of MVI. Furthermore, cHCC-CCAs with MVI may have worse surgical outcomes with regard to early recurrence than those without MVI.

Key Points
• Higher serum levels of AFP combined with irregular arterial peritumoral enhancement are independent risk factors for the MVI of cHCC-CCA, while fat deposition might be a protective factor.
• cHCC-CCA with MVI may have a higher risk of early recurrence after surgery.
• Most cHCC-CCAs were categorized as LR-M in this study, and no significant difference was found in MVI based on LI-RADS category.
Surgery in times of COVID-19—recommendations for hospital and patient management
Authors: Flemming S. , Hankir M. , Ernestus R.-I. , Seyfried F. , Germer C.-T. , Meybohm P. , Wurmb T. , Vogel U. , Wiegering A. 
Published: May 2020

Abstract
Background
The novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has escalated rapidly to a global pandemic stretching healthcare systems worldwide to their limits. Surgeons have had to immediately react to this unprecedented clinical challenge by systematically repurposing surgical wards.

Purpose
To provide a detailed set of guidelines developed in a surgical ward at University Hospital Wuerzburg to safely accommodate the exponentially rising cases of SARS-CoV-2 infected patients without compromising the care of emergency surgery and oncological patients or jeopardizing the well-being of hospital staff.

Conclusions
The dynamic prioritization of SARS-CoV-2 infected and surgical patient groups is key to preserving life while maintaining high surgical standards. Strictly segregating patient groups in emergency rooms, non-intensive care wards and operating areas prevents viral spread while adequately training and carefully selecting hospital staff allow them to confidently and successfully undertake their respective clinical duties.
Acquired resistance to osimertinib in patients with non-small-cell lung cancer: mechanisms and clinical outcomes
Authors: Mu Yuxin , Hao Xuezhi , Xing Puyuan , Hu Xingsheng , Wang Yan , Li Teng , Zhang Jinyao , Xu Ziyi , Li Junling 
Published: May 2020

Abstract
Purpose
Osimertinib, a third-generation epidermal growth factor receptor tyrosine-kinase inhibitor (EGFR-TKI), has demonstrated substantial clinical benefit in patients with non-small-cell lung cancer (NSCLC) who were resistant to early-generation EGFR-TKIs and had acquired a T790M mutation. The aim of our study was to identify the mechanisms underlying resistance to osimertinib and to correlate them with clinical outcomes.

Methods
We retrospectively analyzed patients with advanced NSCLC who received osimertinib for T790M-mutated acquired resistance to prior EGFR-TKIs between March 1, 2017 and December 31, 2018. Patients with paired molecular data of pre-osimertinib and after resistance development, which were not confirmed with small-cell lung cancer (SCLC) transformation, were included in the molecular analysis set.

Results
Of 49 patients evaluated in the molecular analysis set, 24 patients maintained T790M mutation, while 25 patients exhibited T790M-loss. Molecular modifications were identified in 27 of 49 patients including EGFR acquired mutations (C797S, C796S, G796S, V802I, V834L, E758D and G724S), non-EGFR-dependent mutations (PIK3CA, ALK, BRAF, KRAS and TP53), EGFR amplification and MET amplification. At data cutoff, median progression-free survival (PFS) was 9.3 months in the T790M-retain group compared with 7.8 months in T790M-loss patients (P = 0.053). Median PFS was significantly longer in patients with EGFR-dependent resistance mechanism (13.5 months) than in those with alternative pathway activation (8.2 months; P = 0.012).

Conclusions
The study revealed heterogeneous mechanisms of resistance to osimertinib in advanced NSCLC patients and their association with clinical outcomes. Patients who maintained T790M mutation or with EGFR-dependent resistance mechanism had longer clinical outcome benefits.
Development and initial evaluation of a novel simulation model for comprehensive brain tumor surgery training
Authors: Grosch Anne Sophie , Schröder Timo , Schröder Torsten , Onken Julia , Picht Thomas 
Published: May 2020

Abstract
Background
Increasing technico-manual complexity of procedures and time constraints necessitates effective neurosurgical training. For this purpose, both screen- and model-based simulations are under investigation. Approaches including 3D printed brains, gelatin composite models, and virtual environments have already been published. However, quality of brain surgery simulation is limited due to discrepancies in visual and haptic experience. Similarly, virtual training scenarios are still lacking sufficient real-world resemblance. In this study, we introduce a novel simulator for realistic neurosurgical training that combines real brain tissue with 3D printing and augmented reality.

Methods
Based on a human CT scan, a skull base and skullcap were 3D printed and equipped with an artificial dura mater. The cerebral hemispheres of a calf’s brain were placed in the convexity of the skullcap and tumor masses composed of aspic, water, and fluorescein were injected in the brain. The skullcap and skull base were placed on each other, glued together, and filled up with an aspic water solution for brain fixation. Then, four surgical scenarios were performed in the operating room as follows: (1) simple tumor resection, (2) complex tumor resection, (3) navigated biopsy via burr hole trepanation, and (4) retrosigmoidal craniotomy. Neuronavigation, augmented reality, fluorescence, and ocular—as well as screen-based (exoscopic)—surgery were available for the simulator training. A total of 29 participants performed at least one training scenario of the simulator and completed a 5-item Likert-like questionnaire as well as qualitative interviews. The questionnaire assessed the realism of the tumor model, skull, and brain tissue as well as the capability for training purposes.

Results
Visual and sensory realism of the skull and brain tissue were rated,”very good,” while the sensory and visual realism of the tumor model were rated “good.” Both overall satisfaction with the model and eligibility of the microscope and neurosurgical instruments for training purposes were rated with “very good.” However, small size of the calf’s brain, its limited shelf life, and the inability to simulate bleedings due to the lack of perfusion were significant drawbacks.

Conclusion
The combination of 3D printing and real brain tissue provided surgical scenarios with very good real-life resemblance. This novel neurosurgical model features a versatile setup for surgical skill training and allows for efficient training of technological support like image and fluorescence guidance, exoscopic surgery, and robotic technology.