bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interobserver variability, detection rate, and lesion patterns of 68Ga-PSMA-11-PET/CT in early-stage biochemical recurrence of prostate cancer after radical prostatectomy
Authors: Miksch Jonathan , Bottke Dirk , Krohn Thomas , Thamm Reinhard , Bartkowiak Detlef , Solbach Christoph , Bolenz Christian , Beer Meinrad , Wiegel Thomas , Beer Ambros J. , Prasad Vikas 
Published: March 2020

Abstract
Purpose
68Ga-PSMA-11-PET/CT is increasingly used in early-stage biochemical recurrence of prostate cancer to detect potential lesions for an individualized radiotherapy concept. However, subtle findings especially concerning small local recurrences can still be challenging to interpret and are prone to variability between different readers. Thus, we analyzed interobserver variability, detection rate, and lesion patterns systematically in a homogeneous patient population with low-level biochemical recurrence.

Methods
We analyzed 68Ga-PSMA-11-PET/CTs in 116 patients with status post-prostatectomy and PSA levels up to 0.6 ng/ml. None of them received ADT or radiotherapy beforehand. Images were interpreted and blinded by two nuclear medicine physicians (R1 and R2). Findings were rated using a 5-point scale concerning local recurrence, lymph nodes, bone lesions, and other findings (1: definitely benign, 2: probably benign, 3: equivocal, 4: probably malignant, 5: definitely malignant). In findings with substantial discrepancies of 2 or more categories and/or potentially leading to differences in further patient management, a consensus reading was done with a third reader (R3). Interobserver agreement was measured by Cohens Kappa analysis after sub-categorizing our classification system to benign (1 + 2), equivocal (3), and malignant (4 + 5). Time course of PSA levels after salvage treatment of patients rated as positive (4 + 5) was analyzed.

Results
The overall detection rate (categories 4 and 5) was 50% (R1/R2, 49%/51%) and in the PSA subgroups 0–0.2 ng/ml, 0.21–0.3 ng/ml, and 0.31–0.6 ng/ml 24%/27%, 57%/57%, and 65%/68%, respectively. Local recurrence was the most common lesion manifestation followed by lymphatic and bone metastases. The overall agreement in the Cohens Kappa analysis was 0.74 between R1 and R2. For local, lymphatic, and bone sites, the agreement was 0.76, 0.73, and 0.58, respectively. PSA levels of PSMA PET/CT-positive patients after salvage treatment decreased in 75% (27/36) and increased in 25% (9/36). A decrease of PSA, although more frequent in patients with imaging suggesting only local tumor recurrence (86%, 18/21), was also observed in 67% (10/15) of patients with findings of metastatic disease.

Conclusions
In a highly homogeneous group of prostate cancer patients with early-stage biochemical recurrence after radical prostatectomy, we could show that 68Ga-PSMA-11-PET/CT has a good detection rate of 50% which is in accordance with literature, with clinically relevant findings even in patients with PSA < 0.21 ng/ml. The interobserver variability is low, particularly concerning assessment of local recurrences and lymph nodes. Therefore, PSMA-PET/CT is a robust diagnostic modality in this patient group for therapy planning.
Adipose Tissue in Multiple Symmetric Lipomatosis Shows Features of Brown/Beige Fat
Authors: Schiltz Daniel , Tschernitz Sebastian , Ortner Christine , Anker Alexandra , Klein Silvan , Felthaus Oliver , Biermann Niklas , Schreml Julia , Prantl Lukas , Schreml Stephan 
Published: March 2020

Abstract
Introduction
Multiple symmetric lipomatosis (MSL) (syn.: Launois–Bensaude Syndrome, benign symmetric lipomatosis) is a rare disease of fatty tissue. The pathophysiology of MSL still remains unclear, although several approaches have been described in order to understand it. Beside morphological characteristics and some molecular cell biological approaches, little is known about the histological and immunohistochemical characterization of adipose tissue from patients with MSL.

Methods
From the 45 patients with MSL in our database, 10 were included in the study. Fat tissue samples were collected from affected and unaffected areas. The forearm served as a control area as this area is not affected in MSL. The specimens were analyzed after selected stainings were taken (hematoxylin–eosin = HE, Elastica van Gieson, Ladewig, CD200, CIDEA, myf5, p107, Prdm16, Sca-1, syndecan, UCP1, MAC387, Glut4).

Results
In patients suffering from MSL, no macroscopic or microscopic morphological difference could be found between affected and unaffected adipose tissue in HE stainings. The majority of samples showed positivity for UCP1 (9/10 clinically affected tissues, 7/10 clinically unaffected tissues) and CD200.

Conclusion
Marker profiles support the hypothesis that affected adipose tissue derives from brown or beige adipose tissue rather than from white fat.

Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Barriers to Effective Transfusion Practices in Limited‐Resource Settings: From Infrastructure to Cultural Beliefs
Authors: Mohammed Alhassan Datti , Ntambwe Papytcho , Crawford Ana Maria 
Published: March 2020

AbstractBackgroundSurgery and anesthesia are indivisible parts of health care, but safe and timely care requires more than operating rooms and skilled providers. One vital component of a functional surgical system is reliable blood transfusion. While almost half of all blood is donated in high‐income countries (HICs), over eighty percent of the global population lives outside of these countries. High‐income countries have on average 30 donations per 1000 people, and the average age of transfusion recipient is over 65. Most low‐income countries (LICs) have fewer than five donations per 1000 people, where maternal hemorrhage and childhood anemia are the most common indications for transfusion. In LICs, greater than 50% of blood is administered to children under 5 years of age. This study aims to snapshot, by survey, available resources for transfusion and then discusses the infrastructure and cultural barriers to optimal transfusion practice.MethodsIn January 2019, a 10‐question survey was sent electronically to physician anesthesiologists working in low‐ and middle‐income countries to examine resources and practice patterns for blood transfusion. Subsequent discussions illustrate obstacles contributing to low availability of blood products and illuminate infrastructure and cultural barriers preventing optimal transfusion practices.Survey ResultsAcquiring whole blood takes hours. Clinicians wait days to receive packed red blood cells or platelets. Fresh frozen plasma is available but untimely. For many, protocols for massive transfusion are rare, and for transfusion, ratios are nonexistent. Complete blood counts take hours, and coagulation profiles are severely delayed.Discussion of Infrastructure and Cultural BarriersWith few voluntary, unpaid, donors and inconsistent supply of testing kits, donated blood is unsafe. Donors are seasonal for farming communities, endemic malaria areas, and student donors recruited through schools. Cultural beliefs fuel distrust. Transfusion specialists, concentrated in urban areas, see rural patients presenting late. Inadequate triaging and supervision jeopardize patients to shock. Inadequate blood storage leads to waste. Modeling systems from HICs fail to overcome hurdles faced by clinicians working with distinctive belief systems and unique patient populations.
Epidemiological Comparisons and Risk Factors for Pre‐hospital and In‐Hospital Mortality Following Traumatic Injury in Malawi
Authors: Purcell Laura N. , Mulima Gift , Reiss Rachel , Gallaher Jared , Charles Anthony 
Published: March 2020

AbstractBackgroundIn sub‐Saharan Africa, trauma is a leading cause of mortality in people less than 45 years. Injury mechanism and cause of death are difficult to characterize in the absence of pre‐hospital care and a trauma surveillance database. Pre‐hospital deaths (PHD) and in‐hospital deaths (IHD) of trauma patient were compared to elucidate comprehensive injury characteristics associated with mortality.MethodsA retrospective, descriptive analysis of adults (≥ 13 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi, from February 2008 to May 2018 was performed. Utilizing an emergency department‐based trauma surveillance database, univariate and bivariate analysis was performed to compare patient and injury characteristics of pre‐hospital and in‐hospital deaths. A Poisson multivariate regression was performed, predicting the relative risk of PHD.ResultsBetween February 2008 and May 2018, 131,020 adult trauma patients presented to KCH, with 2007 fatalities. Of those patients, 1130 (56.3%) and 877 (43.7%) were PHD and IHD, respectively. The majority were men, with a mean age of 33.4 years (SD 12.1) for PHD and 37.4 years (SD 15.5) for IHD, (p < 0.001). Head injuries (n = 545, 49.2% vs. n = 435, 49.7%) due to assaults (n = 255, 24.7% vs. n = 178, 21.8%) and motor vehicle collisions (MVC) (n = 188, 18.2% vs. n = 173, 21.2%) were the leading cause of both groups (PHD vs. IHD). Transportation to the hospital was primarily police (n = 663, 60.1%) for PHD and ambulance (n = 401, 46.4%) for IHD. Patients who were transported to KCH by the police (RR 1.97, 95% 1.52–2.55, p < 0.001) when compared to transport via minibus had an increased relative risk of PHD. Patients with a head or spine (RR 1.32, 95% CI 1.34–1.53, p < 0.001), chest (RR 1.34, 95% CI 1.11–1.62, p = 0.002) or abdomen and pelvis (RR 1.30, 95% CI 1.14–1.53, p = 0.004) when compared to extremity injury had an increased relative risk of PHD.ConclusionsHead injury from assaults and MVC is the leading cause of PHD and IHD in Malawi. The majority of patients are transported via police if PHD. Of IHD patients, the majority are transported by ambulance, most often from outside hospitals. Both are consistent with the absence of a pre‐hospital system in Malawi. Improving pre‐hospital care, with a particular focus on head injury and strategies for vehicular injury prevention within a trauma system, will reduce adult trauma mortality in Malawi.
Towards bridging the grey digital divide: changes in internet access and its predictors from 2002 to 2014 in Germany
Authors: Huxhold Oliver , Hees Elena , Webster Noah J. 
Published: March 2020

AbstractThe internet is an indispensable aspect of modern society. It facilitates long distance communication, access to information, health care interventions, as well as multiple opportunities for social participation. Despite increasing pervasiveness of this technology, persistent inequalities exist in who has access to the internet. In particular, older adults lag behind in having internet access, thus putting them at risk for social exclusion. In order to gain a better understanding about the determinants of thisgrey digital divide, the current study contrasts influencing factors of internet access, comparing samples from 2002 to 2014 across age groups (40 to 54 years, 55 to 69 years and 70 to 85 years) using data from the German Ageing Survey (DEAS). Logistic regression confirmed that the likelihood of having internet access was lower with higher age at both time points. However, the percentages of people with internet access grew primarily in the middle and older age groups between 2002 and 2014. Furthermore, being male and having a higher education were both associated with greater odds of internet access. However, gender and education differences in internet access were significantly less pronounced in 2014 in contrast to 2002. Finally, both greater income and cognitive ability were associated with greater odds of internet access, while providing care for a grandchild was significantly associated with internet access only among the oldest age group. In an attempt towards bridging the grey digital divide, the current study serves as a basis for identifying groups mostly affected by this increasingly important form of social inequality.
Validation of the HIV Pre-exposure Prophylaxis Stigma Scale: Performance of Likert and Semantic Differential Scale Versions
Authors: Siegler Aaron J. , Wiatrek Sarah , Mouhanna Farah , Amico K. Rivet , Dominguez Karen , Jones Jeb , Patel Rupa R. , Mena Leandro A. , Mayer Kenneth H. 
Published: March 2020

AbstractStigma regarding HIV pre-exposure prophylaxis (PrEP) is commonly implicated as a factor limiting the scale-up of this highly effective HIV prevention modality. To quantify and characterize PrEP stigma, we developed and validated a brief HIV PrEP Stigma Scale (HPSS) among a group of 279 men who have sex with men (MSM). Scale development was informed by a theoretical model to enhance content validity. We assessed two scale versions, Semantic Differential and Likert, randomizing the order in which scales were presented to participants. Both scales demonstrated high internal consistency. The Likert scale had substantially better construct validity and was selected as the preferred option. Scale scores demonstrated construct validity through association with constructs of interest: healthcare distrust, HIV knowledge, perceived proportion of friends/partners on PrEP, perceived community evaluation of PrEP, and perceived effectiveness of PrEP. The scale accounted for 25% of the total variance in reported willingness to be on PrEP, indicating the substantial role PrEP stigma may have on decisions to initiate PrEP. Given increased efforts to roll-out PrEP, having a valid tool to determine the level and types of PrEP stigma in individuals, groups, and communities can help direct implementation plans, identify goals for stigma reduction, and monitor progress over time.
Phase 1 study to evaluate safety, tolerability and pharmacokinetics of a novel intra-tympanic administered thiosulfate to prevent cisplatin-induced hearing loss in cancer patients
Authors: Viglietta Vissia , Shi Fuxin , Hu Qi-Ying , Ren Yong , Keilty John , Wolff Heather , McCarthy Ryan , Kropp Jason , Weber Pete , Soglia John 
Published: March 2020

SummaryCisplatin is a widely used chemotherapy for the treatment of certain solid tumors. Ototoxicity and subsequent permanent hearing loss remain a serious dose-limiting side effect associated with cisplatin treatment. To date, no therapies have been approved to prevent or treat cisplatin-induced hearing loss (CIHL). Sodium thiosulfate effectively inactivates cisplatin through covalent binding and may provide protection against cisplatin-induced ototoxicity. DB-020 is being developed as a novel formulation of sodium thiosulfate pentahydrate in 1% sodium hyaluronate for intratympanic injection (IT), enabling the delivery of high concentrations of thiosulfate into the cochlea prior to cisplatin administration. In the DB-020-002 phase 1a single-ascending dose study, healthy volunteers were enrolled into 5 cohorts to receive different doses of DB-020 via IT injection. Cohorts 1–4 received unilateral injections while Cohort 5 received bilateral injections. Plasma thiosulfate pharmacokinetics was measured, and safety and audiometric data were collected throughout the study. This study has demonstrated that intratympanic administration of DB-020 results in nominal systemic increases in thiosulfate levels, hence it should not compromise cisplatin anti-tumor efficacy. Furthermore, DB-020 was safe and well tolerated with most adverse events reported as transient, of mild-to-moderate severity and related to the IT administration procedure. These results support the design and execution of the ongoing proof-of-concept study, DB-020-002, to assess otoprotection using DB-020 in cancer patients receiving cisplatin without negatively impacting cisplatin anti-tumor efficacy.
Global vulnerability of soil ecosystems to erosion
Authors: Guerra Carlos A. , Rosa Isabel M. D. , Valentini Emiliana , Wolf Florian , Filipponi Federico , Karger Dirk N. , Nguyen Xuan Alessandra , Mathieu Jerome , Lavelle Patrick , Eisenhauer Nico 
Published: March 2020

Abstract
Context
Soil erosion is one of the main threats driving soil degradation across the globe with important impacts on crop yields, soil biota, biogeochemical cycles, and ultimately human nutrition.

Objectives
Here, using an empirical model, we present a global and temporally explicit assessment of soil erosion risk according to recent (2001–2013) dynamics of rainfall and vegetation cover change to identify vulnerable areas for soils and soil biodiversity.

Methods
We used an adaptation of the Universal Soil Loss Equation together with state of the art remote sensing models to create a spatially and temporally explicit global model of soil erosion and soil protection. Finally, we overlaid global maps of soil biodiversity to assess the potential vulnerability of these soil communities to soil erosion.

Results
We show a consistent decline in soil erosion protection over time across terrestrial biomes, which resulted in a global increase of 11.7% in soil erosion rates. Notably, soil erosion risk systematically increased between 2006 and 2013 in relation to the baseline year (2001). Although vegetation cover is central to soil protection, this increase was mostly driven by changes in rainfall erosivity. Globally, soil erosion is expected not only to have an impact on the vulnerability of soil conditions but also on soil biodiversity with 6.4% (for soil macrofauna) and 7.6% (for soil fungi) of these vulnerable areas coinciding with regions with high soil biodiversity.

Conclusions
Our results indicate that an increasing proportion of soils are degraded globally, affecting not only livelihoods but also potentially degrading local and regional landscapes. Similarly, many degraded regions coincide with and may have impacted high levels of soil biodiversity.
Considerations about the quality assessment of travel time and travel distance distributions in transport modelling: a proposal for a standardized methodology
Authors: Pestel Eric 
Published: March 2020

AbstractIn travel demand modelling, trip distance distributions or trip time distributions are used to evaluate how well a model fits with observed sample data. Therefore, the comparison of distributions is an essential part in the model validation process. Despite its importance, the common modelling guidelines from the UK, the USA or Austria provide little information about the correct structure and handling of such distributions. Likewise, common statistical methods are not practicable for the validation of transport models. This lack of rules leads to individual solutions, which complicate a model validation and the comparison of models. For example, when comparing two distributions the quality indicator strongly depends on the number of classes. Therefore, guidelines for model validation need to suggest an appropriate way to determine the number of classes. The paper suggests a method for evaluating trip distance distributions and trip time distributions within the model validation process of a travel demand model. It proposes (a) indicators for a classification which consider mode-specific trip distances and trip times (b) a generic classification method based on an equiquantile class width, quality indicators for comparing two distributions and (c) to use relative frequencies instead of absolute frequencies for the calculation of the quality indicators.
Analysis of the Semantic Scope of Two Korean Terms Equivalent to English Court
Authors: Wojtasik-Dziekan Emilia 
Published: March 2020

AbstractThe article aims to analyze the semantic fields of two Korean terms in the field of a specialized judicial terminology, i.e.courtandtribunal, which are usually reflected in English by one hypernym termcourt. This analysis, although carried out on limited Korean data, is intended to indicate the differences between the use of these two different Korean terms and to indicate the reasons whycourtis currently the most common English equivalent. At the same time, the author, by pointing to the historical and cultural background, explains the reasons why the termcourtis not always correct. The methods used in compiling the data are to highlight differences in the semantics of Korean terms covered by an English hypernymcourt.
Genetic parameters of birth weight trait in dromedary camels (Camelus dromedarius)
Authors: Bene Szabolcs , Szabó Ferenc , Polgár J. Péter , Juhász Judit , Nagy Péter 
Published: March 2020

AbstractBirth weight data of dromedary calves from the database of one of the world’s largest dairy herds (Dubai, UAE) were analyzed for the period from 2007 to 2018. The assessment included the data of 4124 camel calves that were classified into six ecotypes (Emirate, Emirate crossed, Black, Pakistanian, Saudi-Sudanian, and Saudi crossed). The aim of the study was to describe the heritability of birth weight of calves and the breeding value of sires. Genetic parameters of birth weight were estimated by ANOVA model and two BLUP animal models as well. The mean value of the camel calves’ birth weight was 34.75 ± 5.67 kg. The direct heritability of birth weight (h2d = 0.09 ± 0.04–0.11 ± 0.03) was rather low, so was the maternal heritability (h2m = 0.23 ± 0.10–0.50 ± 0.06). The maternal effect from environmental origin (c2 = 0.23 ± 0.08) far exceeded the results previously calculated in cattle. There was no difference in reliability between BLUP1 and BLUP2 models, and both of them were more accurate than the ANOVA model. Based on the results of this study, we conclude that the birth weight of dromedary calves was more influenced by the dam’s intrauterine rearing capacity and by the environment, management, and feeding of the pregnant female camels than the hereditary growth potential. Considerable differences were found among male dromedaries in their breeding values for the birth weight trait.
Water quality in recirculating aquaculture system using woodchip denitrification and slow sand filtration
Authors: Lindholm-Lehto Petra , Pulkkinen Jani , Kiuru Tapio , Koskela Juha , Vielma Jouni 
Published: March 2020

AbstractIn recirculating aquaculture system (RAS), ammonium excreted by the fish is typically transformed to less toxic nitrate by microbial activity in bioreactors. However, nitrate-nitrogen load can be harmful for the receiving water body when released from the RAS facility. A new type of water treatment system for a RAS was designed, including a passive woodchip denitrification followed by a sand filtration introduced into a side-loop of an experimental RAS, rearing rainbow trout (Oncorhynchus mykiss). In the process, woodchips acted as a carbon source for the denitrification, aiming at a simultaneous nitrogen removal and reduction of water consumption while sand filtration was used to remove organic matter and recondition the circulating water. A variety of chemical analyses and toxicological tests were performed to study the suitability of the process and to ensure the absence of harmful or toxic substances in the system. The results did not show increased toxicity, and no increased mortality was reported for the raised species. After the start-up of the system, the concentrations of fatty acids (e.g., hexadecanoic acid <LOD-1.21 mg L−1) and heavy metals (e.g., Cd < LOD-0.45 μg L−1, Pb < LOD-14 μg L−1) remained at very low levels and below those of known toxic effects. In the beginning of the experiment, good denitrification efficiency was achieved, but it declined after 1 month, showing the need for improved stability and dimensioning of the application.