bluuebunny/crossref_metadata_2025_split huggingface dataset:
Meta‐Analysis and Meta‐Regression of Risk Factors for Surgical Site Infections in Hepatic and Pancreatic Resection
Authors: Mentor Keno , Ratnayake Bathiya , Akter Nasreen , Alessandri Giorgio , Sen Gourab , French Jeremy J. , Manas Derek M. , Hammond John S. , Pandanaboyana Sanjay 
Published: August 2020

AbstractBackgroundThe risk factors for surgical site infection (SSI) after HPB surgery are poorly defined. This meta‐analysis aimed to quantify the SSI rates and risk factors for SSI after pancreas and liver resection.MethodsThe PUBMED, MEDLINE and EMBASE databases were systematically searched using the PRISMA framework. The primary outcome measure was pooled SSI rates. The secondary outcome measure was risk factor profile determination for SSI.ResultsThe overall rate of SSI after pancreatic and liver resection was 25.1 and 10.4%, respectively (p < 0.001). 32% of pancreaticoduodenectomies developed SSI vs 23% after distal pancreatectomy (p < 0.001). The rate of incisional SSI in the pancreatic group was 9% and organ/space SSI 16.5%. Biliary resection during liver surgery was a risk factor for SSI (25.0 vs 15.7%, p = 0.002). After liver resection, the incisional SSI rate was 7.6% and the organ space SSI rate was 10.2%. Pancreas‐specific SSI risk factors were pre‐operative biliary drainage (p < 0.001), chemotherapy (p < 0.001) and radiotherapy (p = 0.007). Liver‐specific SSI risk factors were smoking (p = 0.046), low albumin (p < 0.001) and significant blood loss (p < 0.001). The rate of organ/space SSI in patients with POPF was 47.7% and in patients without POPF 7.3% (p < 0.001). Organ/space SSI rate was 43% in patients with bile leak and 10% in those without (p < 0.001).ConclusionsThe risk factors for SSI following pancreatic and liver resections are distinct from each other, with higher SSI rates after pancreatic resection. Pancreaticoduodenectomy has increased risk of SSI compared to distal pancreatectomy. Similarly, biliary resections during liver surgery increase the rates of SSI.
Endogenous stochastic optimisation for relief distribution assisted with unmanned aerial vehicles
Authors: Escribano Macias Jose , Goldbeck Nils , Hsu Pei-Yuan , Angeloudis Panagiotis , Ochieng Washington 
Published: August 2020

AbstractUnmanned aerial vehicles (UAVs) have been increasingly viewed as useful tools to assist humanitarian response in recent years. While organisations already employ UAVs for damage assessment during relief delivery, there is a lack of research into formalising a problem that considers both aspects simultaneously. This paper presents a novel endogenous stochastic vehicle routing problem that coordinates UAV and relief vehicle deployments to minimise overall mission cost. The algorithm considers stochastic damage levels in a transport network, with UAVs surveying the network to determine the actual network damages. Ground vehicles are simultaneously routed based on the information gathered by the UAVs.
A case study based on the Haiti road network is solved using a greedy solution approach and an adapted genetic algorithm. Both methods provide a significant improvement in vehicle travel time compared to a deterministic approach and a non-assisted relief delivery operation, demonstrating the benefits of UAV-assisted response.
A decade of marine mammal acoustical presence and habitat preference in the Bering Sea
Authors: Seger Kerri D. , Miksis-Olds Jennifer L. 
Published: August 2020

AbstractAs Arctic seas rapidly change with increased ocean temperatures and decreased sea ice extent, traditional Arctic marine mammal distributions may be altered, and typically temperate marine mammal species may shift poleward. Extant and seasonal odontocete species on the continental shelves of the Bering and Chukchi Seas include killer whales (Orcinus orca), sperm whales (Physeter microcephalus), beluga whales (Delphiapterus leucas), harbor porpoises (Phocoena phocoena), and Dall’s porpoises (Phocoenoides dalli). Newly documented, typically temperate odontocete species include Risso’s dolphins (Grampus griseus) and Pacific white-sided dolphins (Lagenorhynchus obliquidens). Until recently, recording constraints limited sampling rates, preventing the acoustic detection of many of these high frequency-producing (> 22 kHz) species in the Arctic seas. Using one of the first long-term datasets to record frequencies up to 50 kHz in these waters, clicks, buzzes, and whistles have been detected, classified, and paired with environmental data to explore which variables best parameterize habitat preference. Typically temperate species were associated temporally with cold Bering Sea Climate Regimes in tandem with negative Pacific Decadal Oscillations. Typically Arctic species’ strongest explanatory variables for distribution were largely species and site specific. Regardless of species, however, the environmental cues (e.g. percent ice cover or zooplankton community structure) marine mammals use for locating viable habitat space are ones that will change as temperatures increase. This 10-year dataset documents the current state and tracks recent dynamics of odontocetes and their habitats along the Pacific Arctic Corridor to contribute to ongoing discussions about future Arctic conditions.
Non-technical skills for urological surgeons (NoTSUS): development and evaluation of curriculum and assessment scale
Authors: Aydın Abdullatif , Griffin Cora M. , Brunckhorst Oliver , Al-Jabir Ahmed , Raison Nicholas , Aya Haleema , McIlhenny Craig , Brewin James , Shabbir Majid , Palou Redorta Joan , Khan Muhammad Shamim , Dasgupta Prokar , Ahmed Kamran 
Published: August 2020

Abstract
Objective
In the last decade non-technical skills (NTS) have emerged as a vital area for improvement within surgery. This study aims to develop and evaluate a Non-technical Skills for Urological Surgeons (NoTSUS) training curriculum and assessment scale.

Methods
This international, longitudinal and observational study began with a 3-round Delphi methodology to refine curriculum contents and rating scale. Sessions with up to four participants were delivered where each candidate undertook an independent scenario within the validated full immersion simulation environment. Candidates were assessed using both the NoTSS (Non-technical Skills for Surgeons) and NoTSUS rating scales by NTS-trained and non-trained experts. A post-training evaluation survey was distributed.

Results
62 participants comprising trainees (n = 43) and specialists (n = 19) undertook the NoTSUS course. The NoTSS and NoTSUS scales correlated well, with a mean difference of 3.3 in the overall total (p = 0.10, r = 0.53). However, there was significant differences in scores between the NoTSS-trained and non-trained raters (n = 28, p = 0.03). A one-way ANOVA test revealed significant improvement throughout the four simulation scenarios in each session (p = 0.02). The NoTSUS curriculum received positive feedback from participants and demonstrated educational value and acceptability.

Conclusions
The NoTSUS curriculum has demonstrated high educational value for NTS training aimed at urologists, with marked improvement throughout sessions. Correlation of NoTSUS and NoTSS scales proves its suitability for evaluating NTS in future training. Demonstration of inter-rater reliability indicates that the scale is reliable for use in assessment by expert faculty members. Furthermore, qualitative feedback from participants suggests gain of transferrable skills over the course.
Combining the best interest standard with shared decision-making in paediatrics—introducing the shared optimum approach based on a qualitative study
Authors: Streuli Jürg Caspar , Anderson James , Alef-Defoe Sierra , Bergsträsser Eva , Jucker Jovana , Meyer Stephanie , Chaksad-Weiland Sophia , Vayena Effy 
Published: August 2020

AbstractPaediatric decision-making is the art of respecting the interests of child and family with due regard for evidence, values and beliefs, reconciled using two important but potentially conflicting concepts: best interest standard (BIS) and shared decision-making (SD-M). We combine qualitative research, our own data and the normative framework of the United Nations Convention on the Rights of Children (UNCRC) to revisit current theoretical debate on the interrelationship of BIS and SD-M. Three cohorts of child, parent and health care professional interviewees (Ntotal = 47) from Switzerland and the United States considered SD-M an essential part of the BIS. Their responses combined with the UNCRC text to generate a coherent framework which we term the shared optimum approach (SOA) combining BIS and SD-M. The SOA separates different tasks (limiting harm, showing respect, defining choices and implementing plans) into distinct dimensions and steps, based on the principles of participation, provision and protection. The results of our empirical study call into question reductive approaches to the BIS, as well as other stand-alone decision-making concepts such as the harm principle or zone of parental discretion.Conclusion: Our empirical study shows that the BIS includes a well-founded harm threshold combined with contextual information based on SD-M. We propose reconciling BIS and SD-M within the SOA as we believe this will improve paediatric decision-making.What is Known:• Parents have wide discretion in deciding for their child in everyday life, while far-reaching treatment decisions should align with the child’s best interest.• Shared decision-making harbours potential conflict between parental authority and a child’s best interest.What is New:• The best interest standard should not be used narrowly as a way of saying “Yes” or “No” to a specific action, but rather in a coherent framework and process which we term the shared optimum approach.• By supporting this child-centred and family-oriented process, shared decision-making becomes crucial in implementing the best interest standard.
Weather suitability for outdoor tourism in three European regions in first decades of the twenty-first century
Authors: Anna Błażejczyk , Milica Pecelj , Oleh Skrynyk , Błażejczyk Krzysztof , Olesya Skrynyk 
Published: August 2020

AbstractOutdoor tourism and recreational activities strongly depend on actual meteorological conditions. Traditionally, in three studied regions, the peak of tourists’ streams concentrates in summer months. In the present study, we assess suitability of weather conditions for various forms of outdoor tourism in different regions of Serbia, Poland and Ukraine. Additionally, how the location of the station differentiates temporal patterns of weather suitability will be discussed. To analyse the suitability of weather conditions for various forms of outdoor recreation, we have chosen 23 meteorological stations of the national weather networks which represent different tourism areas and destinations. For each weather station, daily data for the period 2000–2017 of air temperature, relative humidity, total cloud cover and wind speed (at 10 m above ground) for 12 UTC as well as the daily maximum and minimum temperature, precipitation totals and snow cover depth were applied. Suitability of climate for outdoor recreation and tourism is assessed by the Weather Suitability Index (WSI) based on Błażejczyk’s bio-thermal weather classification. The results of research show that passive forms of recreation (sun and air bathing) are preferred mostly in months from May till August or September. For the active forms of recreation, weather in summer months is very oppressive, especially in the resorts located in the south (Serbia, southern Ukraine). Active forms of recreation are preferred there in autumn, winter and spring months.
Emergency endovascular treatment of cavernous internal carotid artery acute bleeding with flow diverter stent: a single-center experience
Authors: Giorgianni Andrea , Agosti Edoardo , Terrana Alberto , Pozzi Fabio , Sileo Giorgio , Nativo Luca , Balbi Sergio , Motta Alessandro , Castelnuovo Paolo , Locatelli Davide , Turri-Zanoni Mario 
Published: August 2020

Abstract
Background and objective
To describe our single-center experience in the treatment of cavernous internal carotid artery (ICA) acute bleeding with flow diverter stent (FDS), as a single endovascular procedure or combined with an endoscopic endonasal approach.

Methods
We analyze a case series of 5 patients with cavernous ICA acute bleeding, i.e., 3 iatrogenic, 1 post-traumatic, and 1 erosive neoplastic. After an immediate nasal packing to temporarily bleeding control, patients underwent digital subtraction angiography (DSA) to identify the site of the ICA injury. A concomitant balloon occlusion test (BOT) was performed, to exclude post-occlusive ischemic neurological damage. An FDS was placed with parallel intravenous infusion of abciximab in 3 cases and tirofiban in 2 cases. In two patients, an innovative “sandwich technique” combining the endovascular reconstruction with an extracranial intrasphenoidal cavernous ICA resurfacing with autologous flaps or grafts by endoscopic endonasal approach was performed.

Results
No patient had periprocedural ischemic-hemorrhagic complications. All patients had a regular clinical evolution, without general complications or new onset of focal neurological deficits. No further bleeding occurred in 3 patients, while 2 cases experienced a mild rebleeding in a period ranging from 5 to 15 days after the endovascular procedure. In these two cases, we proceeded with an endoscopic endonasal procedure to resurface the exposed ICA wall in the sphenoid sinus.

Conclusions
Although the treatment of choice for cavernous ICA acute bleeding remains the occlusion of the injured vessel, in cases of poor hemodynamic compensation at the BTO, the endovascular FDS emergency placement can be effective. A combined endoscopic endonasal technique to support the extracranial side of the vessel using autologous flaps or grafts can be performed to prevent the risk of rebleeding.
Machine learning in neurosurgery: a global survey
Authors: Staartjes Victor E. , Stumpo Vittorio , Kernbach Julius M. , Klukowska Anita M. , Gadjradj Pravesh S. , Schröder Marc L. , Veeravagu Anand , Stienen Martin N. , van Niftrik Christiaan H. B. , Serra Carlo , Regli Luca 
Published: August 2020

Abstract
Background
Recent technological advances have led to the development and implementation of machine learning (ML) in various disciplines, including neurosurgery. Our goal was to conduct a comprehensive survey of neurosurgeons to assess the acceptance of and attitudes toward ML in neurosurgical practice and to identify factors associated with its use.

Methods
The online survey consisted of nine or ten mandatory questions and was distributed in February and March 2019 through the European Association of Neurosurgical Societies (EANS) and the Congress of Neurosurgeons (CNS).

Results
Out of 7280 neurosurgeons who received the survey, we received 362 responses, with a response rate of 5%, mainly in Europe and North America. In total, 103 neurosurgeons (28.5%) reported using ML in their clinical practice, and 31.1% in research. Adoption rates of ML were relatively evenly distributed, with 25.6% for North America, 30.9% for Europe, 33.3% for Latin America and the Middle East, 44.4% for Asia and Pacific and 100% for Africa with only two responses. No predictors of clinical ML use were identified, although academic settings and subspecialties neuro-oncology, functional, trauma and epilepsy predicted use of ML in research. The most common applications were for predicting outcomes and complications, as well as interpretation of imaging.

Conclusions
This report provides a global overview of the neurosurgical applications of ML. A relevant proportion of the surveyed neurosurgeons reported clinical experience with ML algorithms. Future studies should aim to clarify the role and potential benefits of ML in neurosurgery and to reconcile these potential advantages with bioethical considerations.
Contrasting multi-taxa functional diversity patterns along vegetation structure gradients of woody pastures
Authors: Jakobsson Simon , Wood Heather , Ekroos Johan , Lindborg Regina 
Published: August 2020

AbstractWoody pastures represent keystone habitats for biodiversity in agricultural landscapes, contributing to increased resource availability, landscape heterogeneity and structural variability. High taxonomic diversity is closely linked to vegetation structure in woody pastures, but examining functional characteristics of species assemblages can shed more light on the ecological mechanisms driving divergent responses to habitat characteristics and help guide good management practices. To this end, we use a multi-taxa approach to investigate how plant, bat and bird taxonomic and functional diversity are affected by pasture tree and shrub density, structural complexity and proximate forest cover in southern Sweden. In particular, we use a trait exclusion approach to estimate the sensitivity of diversity-environment relationships to specific traits. We found little congruence between corresponding diversity metrics across taxa. Bird species richness responded stronger to environmental variables than functional diversity metrics, whereas the functional response to the environment was stronger than the taxonomic response among plants and bats. While increasing tree densities increased the taxonomic diversity of all three taxa, a simultaneous functional response was only evident for plants. Contrasting measures of vegetation structure affected different aspects of functional diversity across taxa, driven by different traits. For plants and birds, traits linked to resource use contributed particularly to the functional response, whereas body mass had stronger influence on bat functional diversity metrics. Multi-taxa functional approaches are essential to understand the effects of woody pasture structural attributes on biodiversity, and ultimately inform management guidelines to preserve the biological values in woody pastures.
Factors affecting the number of sentinel lymph nodes removed in patients having surgery for breast cancer
Authors: Dixon J. Michael , Grewar Julia , Twelves Dominique , Graham Ashley , Martinez-Perez Carlos , Turnbull Arran 
Published: August 2020

Abstract
Purpose
The goal of sentinel lymph node biopsy is to establish the presence or absence of cancer cells in regional axillary nodes. The number of sentinel nodes harvested from each patient varies. The aim of this study was to determine what factors influence the number of sentinel nodes excised at sentinel node biopsy.

Methods
Data from 426 patients with breast cancer who underwent sentinel lymph node biopsy at the Edinburgh Breast Unit by 10 different experienced breast surgeons were included in this analysis. Univariate and multivariable statistical analysis was performed.

Results
In the multivariate analysis the number of sentinel nodes biopsied varied significantly between operating surgeon (p < 0.0001) and was also statistically associated with the use of neoadjuvant chemotherapy (p < 0.0001) and with the number of involved lymph nodes (p < 0.0001). More nodes were removed in patients who received neoadjuvant chemotherapy and had metastases in sentinel lymph nodes.

Conclusions
This study shows that the surgeon plays a pivotal and significant role in determining the numbers of sentinel nodes removed by sentinel lymph node biopsy. Surgeons should monitor their own data on the average numbers of sentinel nodes they remove. Some surgeons may not be removing sufficient numbers of sentinel nodes to maintain a low false negative rate for this procedure.
Using patient perspectives to inform communication training materials for health care professionals discussing BRCA mutation testing
Authors: Shilling Valerie , Catt Susan , Jenkins Valerie , Fallowfield Lesley 
Published: August 2020

Abstract
Purpose
As demand for genetic testing grows and a wide range of health care professionals (HCPs) are potentially involved in discussions about testing and delivering results, we developed an educational package to help HCPs with these conversations.

Methods
To inform the content of training materials, we conducted interviews with 11 women four of whom had BRCA1 and seven with BRCA2 mutations. Five women had or were currently receiving breast cancer treatment. Ages ranged from 38 to 77 years. Interviews were audio-recorded, transcribed verbatim and analysed using the Framework approach to thematic analysis.

Results
We identified 18 themes and 12 subthemes across the interviews, encompassed by six overarching themes: risk, decision-making, information and understanding, communication and improvement, accessing the system: process and frustration, emotional and social drivers.

Conclusions
The findings informed the didactic components of an educational communication workshop and a summary document for attendees. Qualitative interviews provide an important way of incorporating the patient perspective into communication training materials for HCPs by highlighting key issues that matter most to the patient.
Integrating CSR with Business Strategy: A Tension Management Perspective
Authors: Siltaloppi Jaakko , Rajala Risto , Hietala Henri 
Published: August 2020

AbstractIntegrating corporate social responsibility (CSR) into a for-profit organization’s business activities is fraught with tensions. This paper reports a case study of a construction company, exploring how different tensions emerged to challenge company-level aspirations for strategic CSR integration. The study identifies three types of persistent CSR tensions and four management practices, discussing how the management practices led the organization to navigate CSR tensions in both active and defensive ways. Furthermore, the study explicates why the case company succeeded in integrating CSR into formal business strategy and shared attitudes but struggled with CSR integration in the domain of day-to-day operations. The paper contributes to the CSR literature by developing a tension-centric perspective on CSR development. It highlights the necessity of tension navigation at both the organizational and the action levels, the key role of active (as opposed to defensive) navigation of CSR tensions, and the importance of alignment between organizational and action levels in navigating tensions for sustaining strategic focus on CSR over time.
Epithelioid hemangioendothelioma of the right atrium invaded the superior vena cava: case report and review of literature
Authors: Huang Wenpeng , Li Liming , Gao Jianbo , Gao Jian-Bo 
Published: August 2020

AbstractEpithelioid hemangioendothelioma (EHE) is a rare hemangioma that can occur anywhere in the body. It occurs most commonly in the liver and lungs, rarely from the heart, and the etiology or risk factors are unclear. So far, timely detection and radical resection is a more acceptable treatment. Reviewing the literature, few cases of cardiac EHE have been reported. We present a rare case of EHE of the right atrium invaded the superior vena cava.