bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure to suicidality in professionals working with oncology patients: An online survey
Authors: Senf Bianca , Maiwurm Paula , Fettel Jens 
Published: July 2020

AbstractObjectiveTo explore and describe exposure to suicidality in healthcare providers (HCP) working with oncological patients. Special emphasis was put on five central aspects from the HCPs perspective: Exposure, Confidence, Expertise, Distress, and Education.MethodsA 48‐item online questionnaire was developed and distributed to HCPs working with cancer patients. Three hundred fifty‐four answered questionnaires were analyzed.ResultsOverall 83.3% of HCPs reported to have encountered at least one suicidal patient in the last year. Feeling confident in talking about suicidality was reported by 72.1% of HCPs, with 71.2% of nurses reporting feeling insecure compared with only 5.1% of psychotherapists. Similarly, 22.3% of HCPs felt overwhelmed when confronted with a patient who substantiated his suicidality during consultation. A lack of personal knowledge concerning suicidality in general and in oncological patients in particular, was reported by 39.6% and 49.8%, respectively. In total, 88.1% of HCPs reported feeling distressed when confronted with suicidality, while 81.1% of participants wanted further education regarding suicidality in cancer patients despite that 73.2% had already received some sort of psycho‐oncology education.ConclusionsDespite the well‐documented fact of elevated suicide rates in cancer patients, there remain deficits in knowledge, which induce feelings of insecurity and helplessness in HCPs. There is a demand for further education concerning the treatment of suicidal cancer patients. Therefore, special curricula addressing this topic should be devised. A general debate about suicidality in cancer patients could help raise awareness of this problem and generate means of prevention.
Novel methods for the analysis of toxicants in bronchoalveolar lavage fluid samples from e‐cigarette, or vaping, product use‐associated lung injury cases: Selected petroleum distillates
Authors: De Jesús Víctor R. , Chambers David M. , Reese Christopher , Braselton Martha , Espinosa Paul , Corstvet Joseph , Blount Benjamin C. 
Published: July 2020

RationaleOver 2700 e‐cigarette, or vaping, product use‐associated lung injury (EVALI) cases were reported to the Centers for Disease Control and Prevention (CDC) during August 2019–February 2020. Bronchoalveolar lavage (BAL) fluid samples from 51 EVALI and 99 non‐EVALI cases were analyzed for toxicants including petroleum distillates. We describe a novel method to measure petroleum distillates in BAL fluid using gas chromatography–mass spectrometry (GC/MS).Methodsn‐Hexane, n‐heptane, n‐octane, methylcyclopentane, and cyclohexane were measured in BAL fluid specimens by headspace solid‐phase microextraction/GC/MS. We created and characterized BAL fluid pools from non‐EVALI individuals to determine assay accuracy, precision, linearity, limits of detection (LODs), and analytical specificity. All measurements were conducted in accordance with the rigorous method validation procedures of CDC's Division of Laboratory Sciences.ResultsMatrix validation experiments showed that calibration curves in BAL fluid and saline had similar slopes, with differences less than 5%. Assay precision ranged from 1.98% to 18%. In addition, the LODs for the five analytes ranged from 0.05 to 0.10 μg/L, and their linearity was confirmed with R2 values >0.99. The analysis of selected petroleum distillates in BAL fluid analysis was shown to be comparable with their analysis in blood in which the 95th percentiles are below detection.ConclusionsWe developed and validated a method to quantify petroleum distillates in BAL fluid specimens using GC/MS. The assay provided precise and accurate analyses of EVALI and non‐EVALI BAL fluid specimens in support of CDC's EVALI response. This method is applicable to the determination of a broad range of volatile organic compounds in BAL fluid specimens.
Computed tomography, not bioelectrical impedance analysis, is the proper method for evaluating changes in skeletal muscle mass in liver disease
Authors: Ohara Masatsugu , Suda Goki , Kimura Megumi , Maehara Osamu , Shimazaki Tomoe , Shigesawa Taku , Suzuki Kazuharu , Nakamura Akihisa , Kawagishi Naoki , Nakai Masato , Sho Takuya , Natsuizaka Mitsuteru , Morikawa Kenichi , Ogawa Koji , Sakamoto Naoya 
Published: July 2020

AbstractBackgroundSarcopenia is associated with poor prognosis in patients with chronic liver disease (CLD). As rapid skeletal muscle wasting predicts worse prognosis and a novel therapy for sarcopenia needs to be evaluated for validation, accurate evaluation methods for relative changes in muscle mass are crucial.MethodsWe screened CLD patients who had skeletal muscle mass evaluation between June 2015 and December 2017. Patients were included if they had adequate information, were followed for >6 months, and had skeletal muscle mass evaluation by both bioelectrical impedance analysis (BIA) and computed tomography (CT) imaging at baseline and the second evaluation point. We compared BIA and CT imaging in terms of their ability to quantify skeletal muscle mass and identify relative changes in muscle mass in CLD patients.ResultsOf the screened 447 CLD patients, 110 were included in this study, and 71 (64.5%) were men. The median age was 68 (range 21 to 90) years. In total, 83 (75.5%) and 32 (29.1%) patients had liver cirrhosis and hepatocellular carcinoma, respectively. Of them, 50 (45.5%) patients were liver cirrhosis patients without hepatocellular carcinoma through the observation period. Skeletal muscle mass index (SMI) by BIA, psoas muscle mass index (PMI), and SMI based on CT imaging were significantly correlated at baseline [SMI by simple CT method and SMI by BIA (r = 0.61, P < 0.01), SMI by BIA and PMI (r = 0.65, P < 0.01), and SMI by simple CT method and PMI (r = 0.82, P < 0.01), respectively] and second evaluation point [SMI by simple CT method and SMI by BIA (r = 0.51, P < 0.01), SMI by BIA and PMI (r = 0.58, P < 0.01), and SMI by simple CT method and PMI (r = 0.92, P < 0.01), respectively]. Similar to previous reports, based on the PMI and SMI by simple CT method, patients with more severe liver dysfunction experienced more rapid skeletal muscle mass loss (ΔSimple method/years and ΔPMI/years in patients with Child‑Pugh Classes A, B, and C: Child‑Pugh A, −3.34%; B, −11.77%; C, −18.78%; and Child‑Pugh A, −0.78%; B, −6.33%; C, −7.71%, respectively). Completely opposite results were obtained based on SMI by BIA (Child‑Pugh A, −0.70%; B, 1.42%; C, 12.48%). A subgroup analysis revealed that in patients with fluid retention and diuretic administration, SMI by BIA increased with time (P < 0.01).ConclusionsFor accurate evaluation of the relative changes in skeletal muscle mass in patients with CLD, CT imaging method, and not BIA, is one of the proper methods.
Towards reducing the time needed for load testing
Authors: AlGhamdi Hammam M. , Bezemer Cor‐Paul , Shang Weiyi , Hassan Ahmed E. , Flora Parminder 
Published: July 2020

AbstractThe performance of large‐scale systems must be thoroughly tested under various levels of workload, as load‐related issues can have a disastrous impact on the system. However, load testing often requires a large amount of time, running from hours to even days. In our prior work, we reduced the execution time of a load test by detecting repetitiveness in individual performance metric values, such as CPU utilization, that are observed during the test. However, as we explain in this paper, disregarding combinations of performance metrics may miss important information about the load‐related behavior of a system. In this paper we revisit our prior approach, by proposing an approach that reduces the execution time of a load test by detecting whether a test no longer exercises new combinations of the observed performance metrics. We study three open source systems, in which we use our new and prior approaches to reduce the execution time of a 24‐hour load test. We show that our new approach is capable of reducing the execution time of the test to less than 8.5 hours, while preserving a coverage of at least 95% of the combinations that are observed between the performance metrics during the 24‐hour tests.
Sustainable use of sugarcane bagasse ash and marble slurry dust in crusher sand based concrete
Authors: Murugesan Thangavel , Vidjeapriya Ramamurthy , Bahurudeen Abdulsalam 
Published: July 2020

AbstractProduction of ordinary Portland cement is consuming enormous energy and releases high carbon dioxide. Additionally, the use of river sand as fine aggregate has a direct effect on the erosion of river banks due to excess sand mining and hence, the use of river sand in concrete is banned in many developing countries. Hence, the assessment of concrete with blended cement and locally available alternative fine aggregates is the need for current construction practices. India becomes the ‐largest sugar producing country, a massive volume of bagasse ash (44,200 t/day) is discarded as waste. Similarly, marble processing plants dispose of marble slurry dust. An exploration of the use of agricultural and mining wastes in crusher sand‐based concrete is not yet reported. The current investigation focuses on the potential use of bagasse ash and marble slurry dust as pozzolan and alternative to crusher sand respectively in concrete and interlocking paver blocks. Compressive strength and capability against abrasion were investigated for bagasse ash and marble slurry dust blended concrete and paver block. Besides, water‐based tests were adopted to examine durability performance. Results from the study indicate an enhancement in abrasion resistance and a substantial reduction in permeability for blended concrete than control concrete. Optimum replacement levels were found to be 20% for bagasse ash and 25% for marble mining powder.
TeV-scale Majorogenesis
Authors: Abe Yoshihiko , Hamada Yu , Ohata Takahiro , Suzuki Kenta , Yoshioka Koichi 
Published: July 2020

Abstract
The Majoron, the Nambu-Goldstone boson of lepton number symmetry, is an interesting candidate for dark matter as it deeply connects the dark matter and neutrino physics. In this paper, we consider the Majoron dark matter as pseudo Nambu-Goldstone boson with TeV-scale mass. The heavy Majoron generally has the large decay constant and tiny Yukawa couplings to light right-handed neutrinos which are required by cosmological and astrophysical observations. That makes it difficult to realize the desired amount of the relic abundance of Majoron dark matter. We consider three improved scenarios for the generation of Majoron, dubbed as Majorogenesis, in the early universe and find in all cases the parameter space compatible with the relic abundance and cosmic-ray constraints.
CT-based patient-specific instrumentation for total knee arthroplasty in over 700 cases: single-use instruments are as accurate as standard instruments
Authors: Gaukel Stefan , Vuille-dit-Bille Raphael N. , Schläppi Michel , Koch Peter P. 
Published: July 2020

Abstract
Purpose
Efforts in total knee arthroplasty are made to improve accuracy for a correct leg axis and reduce component malpositioning using patient-specific instruments. It was hypothesized that use of patient-specific instruments (vs. computer-navigated and conventional techniques) will reduce the number of outliers. Our second hypothesis was that single-use instrumentation will lead to the same accuracy compared to patient-specific instruments made of metal.

Methods
708 primary total knee arthroplasties between 2014 and 2018 using computer tomography (CT)-based patient-specific cutting block technique and a preoperative planning protocol were retrospectively reviewed. Preoperative data [hip–knee–angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), tibial slope, femoral component flexion] was compared to postoperative performed standard radiological follow-up X-rays. Differences of > 3° between measurements were defined as outliers.

Results
Overall 500 prostheses using standard instrumentation and 208 prostheses using single-use instruments were implanted. Preoperative HKA axes (− 1.2°; p < 0.001), femoral component flexion (Δ 0.8°, p < 0.001), LDFA (Δ − 1.5°, p < 0.001), MPTA (Δ − 0.5°, p < 0.001) and tibial posterior slopes (Δ 0.5°, p < 0.001), respectively, were different from postoperative axes. More outliers occurred using standard (vs. single-use) instruments (p < 0.001) regarding postoperative HKA (ranges of standard- vs. single-use: instruments: HKA 178.0°–180.5° vs. 178.0°–180.5°, femoral component flexion 0.0°–6.0° vs. 0.0°–4.5°, LDFA 90.0°–91.0° vs. 90.0°–90.0°, MPTA 90.0°–90.0° vs. 90.0°–90.0°, tibial posterior slope − 10° to 10° vs. − 1° to 10°). No differences were seen for other angles measured. Comparing both systems, total number of outliers was higher using standard (8%) vs. single-use instruments (4.3%).

Conclusion
This study shows a high accuracy of CT-based patient-specific instrumentation concerning postoperative achieved knee angles and mechanical leg axes. Single-use instruments showed a similar accuracy.

Level of evidence
III.
Optimal dividends and capital injection under dividend restrictions
Authors: Lindensjö Kristoffer , Lindskog Filip 
Published: July 2020

AbstractWe study a singular stochastic control problem faced by the owner of an insurance company that dynamically pays dividends and raises capital in the presence of the restriction that the surplus process must be above a given dividend payout barrier in order for dividend payments to be allowed. Bankruptcy occurs if the surplus process becomes negative and there are proportional costs for capital injection. We show that one of the following strategies is optimal: (i) Pay dividends and inject capital in order to reflect the surplus process at an upper barrier and at 0, implying bankruptcy never occurs. (ii) Pay dividends in order to reflect the surplus process at an upper barrier and never inject capital—corresponding to absorption at 0—implying bankruptcy occurs the first time the surplus reaches zero. We show that if the costs of capital injection are low, then a sufficiently high dividend payout barrier will change the optimal strategy from type (i) (without bankruptcy) to type (ii) (with bankruptcy). Moreover, if the costs are high, then the optimal strategy is of type (ii) regardless of the dividend payout barrier. We also consider the possibility for the owner to choose a stopping time at which the insurance company is liquidated and the owner obtains a liquidation value. The uncontrolled surplus process is a Wiener process with drift.
Comparison of machine learning algorithms to predict clinically significant prostate cancer of the peripheral zone with multiparametric MRI using clinical assessment categories and radiomic features
Authors: Bernatz Simon , Ackermann Jörg , Mandel Philipp , Kaltenbach Benjamin , Zhdanovich Yauheniya , Harter Patrick N. , Döring Claudia , Hammerstingl Renate , Bodelle Boris , Smith Kevin , Bucher Andreas , Albrecht Moritz , Rosbach Nicolas , Basten Lajos , Yel Ibrahim , Wenzel Mike , Bankov Katrin , Koch Ina , Chun Felix K.-H. , Köllermann Jens , Wild Peter J. , Vogl Thomas J. 
Published: July 2020

Abstract
Objectives
To analyze the performance of radiological assessment categories and quantitative computational analysis of apparent diffusion coefficient (ADC) maps using variant machine learning algorithms to differentiate clinically significant versus insignificant prostate cancer (PCa).

Methods
Retrospectively, 73 patients were included in the study. The patients (mean age, 66.3 ± 7.6 years) were examined with multiparametric MRI (mpMRI) prior to radical prostatectomy (n = 33) or targeted biopsy (n = 40). The index lesion was annotated in MRI ADC and the equivalent histologic slides according to the highest Gleason Grade Group (GrG). Volumes of interest (VOIs) were determined for each lesion and normal-appearing peripheral zone. VOIs were processed by radiomic analysis. For the classification of lesions according to their clinical significance (GrG ≥ 3), principal component (PC) analysis, univariate analysis (UA) with consecutive support vector machines, neural networks, and random forest analysis were performed.

Results
PC analysis discriminated between benign and malignant prostate tissue. PC evaluation yielded no stratification of PCa lesions according to their clinical significance, but UA revealed differences in clinical assessment categories and radiomic features. We trained three classification models with fifteen feature subsets. We identified a subset of shape features which improved the diagnostic accuracy of the clinical assessment categories (maximum increase in diagnostic accuracy ΔAUC = + 0.05, p < 0.001) while also identifying combinations of features and models which reduced overall accuracy.

Conclusions
The impact of radiomic features to differentiate PCa lesions according to their clinical significance remains controversial. It depends on feature selection and the employed machine learning algorithms. It can result in improvement or reduction of diagnostic performance.

Key Points
• Quantitative imaging features differ between normal and malignant tissue of the peripheral zone in prostate cancer.
• Radiomic feature analysis of clinical routine multiparametric MRI has the potential to improve the stratification of clinically significant versus insignificant prostate cancer lesions in the peripheral zone.
• Certain combinations of standard multiparametric MRI reporting and assessment categories with feature subsets and machine learning algorithms reduced the diagnostic performance over standard clinical assessment categories alone.
Interdisziplinäre Kommunikation: Augenarztbriefe an diabetologische Schwerpunktpraxen (DSP)
Authors: Stock Lydia , Roeck Daniel , Fritsche Andreas , Ziemssen Tjalf , Ziemssen Focke 
Published: July 2020

Zusammenfassung
Hintergrund
Arztbriefe und Befundbögen spielen für die interdisziplinäre Zusammenarbeit von Hausarzt, Internist, Diabetologe und Augenarzt als Informations- und Kommunikationsmittel in der Vermeidung, Verzögerung und Therapie der diabetischen Retinopathie (DR) eine zentrale Rolle.

Methode
In einer Querschnittstudie (NCT02311504) wurden die augenärztlichen Briefe sowie weitere klinische Parameter aus der elektronischen Patientenakte (ePA) für 810 Patienten mit Diabetes extrahiert. Neben einer formalen Kategorisierung wurden die Dokumente auf ihre Aktualität und den inhaltlichen Aufbau hin überprüft und entsprechend den Themenkomplexen der nationalen Versorgungsleitlinie (NVL) für Netzhautkomplikationen analysiert.

Ergebnisse
Für 59 % aller Patienten lag in den DSP ein augenärztlicher Befundbericht vor; 26 % der Dokumente wurden elektronisch generiert, 73 % handschriftlich verfasst; 55 % entsprachen dem Standardbogen der NVL, 21 % waren selbst entworfene Formularbögen der Augenarztpraxen, 16 % ausführliche Augenarztbriefe, 5 % Kurzbriefe und 3 % Kurzmitteilungen. Das durchschnittliche Alter des aktuellsten vorliegenden Berichts lag bei 19 Monaten. Ein Viertel der Dokumente war zum Zeitpunkt der Stichprobe älter als 2 Jahre; 75 % aller Patienten wurden in den letzten 12 Monaten augenärztlich betreut mit einer augenärztlichen Berichtsquote von nur 40 %. Die Prävalenz der berichteten DR lag für die Formulare bei 12 %, in ausführlichen Briefen bei 32 %.

Schlussfolgerung
Obwohl standardisierte Formulare in der augenärztlichen Kommunikation mit den DSP einen hohen Verbreitungsgrad haben, kann die Berichtsquote verbessert werden, um eine zeitnahe Berücksichtigung relevanter Befunde zu ermöglichen. Die hohe Anzahl handgeschriebener Dokumente wies hier auf ein großes Potenzial elektronischer Formate in der interdisziplinären Kommunikation hin.
Constraints on the pre-eruptive magmatic history of the Quaternary Laacher See volcano (Germany)
Authors: Rout Smruti Sourav , Wörner Gerhard 
Published: July 2020

AbstractBa zonation patterns in sanidine phenocrysts from mafic and intermediate phonolite and crystal-rich cumulates from the Laacher See volcano (12.9 ka) in western Germany document diffusion times suggestive of periodic recharge events throughout the magma reservoir’s entire lifespan of ~ 24 ky. Phenocrysts analysed from samples that formed late at the base of the compositionally zoned magma reservoir by mixing and mingling between a resident phonolite magma and recharging basanite show resorption and thin (2–10 μm) late-stage Ba-rich overgrowth. Short diffusion profiles across these boundaries give diffusion times of ~ 1.5–3 years at most, which are interpreted to be the maximum duration between the most recent recharge by the basanite and eruption. The lack of such late overgrowth in samples from other parts of the phonolite reservoir suggests that effect of this mixing and mingling was limited to the crystal-rich base. Sanidines in the cumulates, by contrast, are generally devoid of zoned crystals. Only rare cumulate crystals with resorbed outer boundaries and very thin overgrowths (a few microns) with very sharp compositional changes imply the remobilization of cumulates only months before eruption. Based on the diffusion timescales and storage temperatures obtained in a previous study, we present a genetic model for the conditions and timing of storage and (re-)activation of the magma system prior to the eruption of Laacher See, which is the largest volcanic event in Central Europe since the last glaciation.
Prognostic impact of CD73 expression and its relationship to PD-L1 in patients with radically treated pancreatic cancer
Authors: Tahkola Kyösti , Ahtiainen Maarit , Kellokumpu Ilmo , Mecklin Jukka-Pekka , Laukkarinen Johanna , Laakkonen Joni , Kenessey Istvan , Jalkanen Sirpa , Salmi Marko , Böhm Jan 
Published: July 2020

AbstractImmune suppressing molecule CD73 is overexpressed in various cancers and associated with poor survival. Little is so far known about the predictive value of CD73 in pancreatic ductal adenocarcinoma (PDAC). The purpose of this study was to investigate the prognostic significance of CD73 in PDAC. The study material consisted of 110 radically treated patients for PDAC. Tissue microarray blocks were constructed and stained immunohistochemically using CD73 antibody. Staining intensity and numbers of stained tumour cells, inflammatory cells, stroma, and blood vessels were assessed. High-level CD73 expression in tumour cells was positively associated with PD-L1 expression, perineural invasion, and histopathological grade. CD73 positivity in tumour-infiltrating lymphocytes was significantly associated with lymph node metastasis. Lymphocytic CD73 positivity was also associated with staining positivity in both stroma and vascular structures. In addition, CD73 positivity in vascular structures and stroma were associated with each other. There were no significant associations between CD73 positive tumour cells and CD73 positivity in any other cell types. PD-L1 expression was associated with CD73 staining positivity in stroma (p = 0.007) and also with histopathological grade (p = 0.033) and T class (p = 0.016) of the primary tumour. CD73 positivity in tumour cells was significantly associated with poor disease-specific (p = 0.021) and overall survival (p = 0.016). In multivariate analysis, CD73 positivity in tumour cells was an independent negative prognostic factor together with histopathological grade, TNM stage, and low immune cell score. In conclusion, high CD73 expression in tumour cells is associated with poor survival in PDAC independently of the number of tumour-infiltrating lymphocytes or TNM stage.