bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adaptive Fuzzy Sliding Mode Controller Design for a New Hand Rehabilitation Robot
Authors: Abbasimoshaei Alireza , Mohammadimoghaddam Majid , Kern Thorsten A. 
Published: September 2020

AbstractHand rehabilitation is one of the most important rehabilitation procedures. Due to the repetitive nature of rehabilitation training, a full robotic system could help the physiotherapists to gain time for creating new training schemes for a larger number of patients. Such a system can be based on live or recorded data and consists of the operator-device, patient-device, and control mechanism. This paper focuses on the design of the patient-device and its control-system in a decoupled training scenario. It presents a robot for hand rehabilitation training fingers and wrist independently based on only two actuators. These two actuators are configurable to allow consecutive training on the wrist and all joints of the fingers. To overcome uncertainties and disturbances, a sliding mode controller has been designed and an adaptive fuzzy sliding mode controller is used to reduce the chattering effects and compensate the varying forces of the patients. The experimental results show an approximate 80% improvement in tracking the desired trajectory by the adaptation.
Investigating the Influence of Haptic Feedback in Rover Navigation with Communication Delay
Authors: Sierotowicz Marek , Weber Bernhard , Belder Rico , Bussmann Kristin , Singh Harsimran , Panzirsch Michael 
Published: September 2020

AbstractSafe navigation on rough terrain in the presence of unforeseen obstacles is an indispensable element of many robotic applications. In such conditions, autonomous navigation is often not a viable option within certain safety margins. Yet, a human-in-the-loop can also be arduous to include in the system, especially in scenarios where a communication delay is present. Haptic force feedback has been shown to provide benefits in rover navigation, also when confronted with higher communication delays. Therefore, in this paper we present the results of a user study comparing various performance metrics when controlling a rover with a car-like interface with and without fictitious force feedback, both with no communication delay and with a delay of 800 ms. The results indicate that with force feedback the navigation is slower, but task performance in the proximity of obstacles is improved.
Overview of the use of 3D printing in forensic medicine
Authors: Schweitzer W. , Thali M. , Aldomar E. , Ebert L. 
Published: September 2020

AbstractIn forensic medicine the use of so-called 3D printing is a niche application, whereas developments elsewhere in this field are rapidly advancing worldwide. The most common and widespread technology is fusion deposit modelling with polylactic acids (PLA). Although the equipment and materials may be relatively inexpensive and 3D printing relatively fast, the resulting end products tend to also have negative properties, such as poor durability and mechanical anisotropy, which may be an issue depending on the application. In forensic medicine, applications in the field of weapons technology and biomechanical models are realistic and 3D printing is already being used for demonstrations at court hearings and in teaching and also as a technique for building spare parts or accessories. Having a low-cost option for rapid prototyping on-site is particularly useful for the development phase. For finished 3D designs more expensive manufacturing options with a choice of materials with significantly broader mechanical or thermal properties are available. As the technology is undergoing major changes, one should carefully consider whether to enter the field oneself, buy own hardware, use a 3D printing service or seek cooperation possibly with a nearby partner.
Energy, orbital and structural stacking landscape of a purine homodimer system
Authors: Sierański Tomasz 
Published: September 2020

AbstractThe multidimensional study, combining the extensive calculations of potential energy surfaces for the parallel-displaced configurations and methods such as energy decomposition and natural bond orbital analysis, has been carried out. The resulted data give an energy, orbital and structural landscapes of this biologically essential system. The balance of the two energy sources, electrostatic and dispersion, is clearly visible. The obtained results, taken as a whole, provide an insight into the hierarchy of intermolecular interactions in the purine system, together with their sources.
Pharmacokinetics and pharmacodynamics of intranasal remimazolam—a randomized controlled clinical trial
Authors: Pesic Marija , Schippers Frank , Saunders Rob , Webster Lyn , Donsbach Martin , Stoehr Thomas 
Published: September 2020

Abstract
Purpose
Remimazolam is a novel and ultra-short-acting sedative currently developed for intravenous use in procedural sedation, general anesthesia, and ICU sedation. However, intravenous administration is not always appropriate, depending on the patient or setting. This study evaluated intranasal administration as a potential alternative route.

Methods
The study used a randomized, double-blind, 9 period cross-over design to compare the pharmacokinetics, pharmacodynamics, and safety of single intranasal doses of 10, 20, and 40 mg remimazolam (as powder or solution) with intranasal placebo and 4 mg intravenous remimazolam.

Results
Intranasal remimazolam powder had a consistent absolute bioavailability of approximately 50%; Tmax was 10 min; AUC and Cmax were dose-proportional. The higher doses of intranasal solution, however, resulted in decreasing bioavailability and loss of dose-proportionality in AUC and Cmax despite complete drug absorption due to partial swallowing of dose and the resulting first-pass effect. Pharmacodynamics were generally consistent with PK. Peak effects (drowsiness, relaxation, any, memory, response time) were in similar ranges after intranasal (10 to 40 mg) as intravenous (4 mg) dosing and were partially, but not consistently, dose-related. Safety results were generally consistent with other benzodiazepines; however, intranasal remimazolam (but not placebo) caused nasal discomfort/pain, in some cases even severe.

Conclusions
Intranasal administration of remimazolam was safe and caused sedative effects. However, the severe pain and discomfort caused by intranasal remimazolam prohibit its use by this route of administration, at least with the currently available intravenous formulation.
What are the outcomes of core decompression without augmentation in patients with nontraumatic osteonecrosis of the femoral head?
Authors: Andronic Octavian , Weiss Ori , Shoman Haitham , Kriechling Philipp , Khanduja Vikas 
Published: September 2020

AbstractPurposeCore decompression (CD) of the femoral head is performed to preserve the hip in avascular necrosis (AVN). The outcome following this procedure differs based on the medical centre and the technique. Also, the time to total hip replacement (THR) and the percentage of patients subsequently undergoing a THR are controversial.MethodsA systematic review was performed following PRISMA guidelines. The search included CENTRAL, MEDLINE, EMBASE, Scopus, AMED and Web of Science Core Collection databases. Studies reporting the outcome of CD for AVN were assessed. Studies using additional implants, vascularized grafts or any type of augmentation were excluded. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist (JBI CAC) tool.Trial registrationInternational prospective register of systematic reviews (PROSPERO) -CRD42018100596.ResultsA total of 49 studies describing 2540 hips were included. The mean weighted follow-up time was 75.1 months and the mean age at surgery was 39 years. Twenty-four of 37 studies reported improvement in all outcome scores, whilst 9/37 studies report only partial improvement post-operatively. Four studies (4/37) described poor clinical outcomes following intervention. Data was pooled from 20 studies, including 1134 hips with a weighted mean follow-up of 56 months. The percentage of hips undergoing THR averaged 38%. The time to THR had a weighted mean of 26 months after CD.ConclusionPooled results from 1134 hips and of these nearly 80% with early stage of osteonecrosis, showed that approximately 38% of patients underwent a total hip replacement at an average of 26 months following core decompression without augmentation.
Recommendation for Photographic Documentation of Safe Laparoscopic Cholecystectomy
Authors: Sebastian Maciej , Sebastian Agata , Rudnicki Jerzy 
Published: September 2020

AbstractBackgroundBile duct injury and vasculobiliary injury are possible complications during laparoscopic cholecystectomy which can lead to increased morbidity, mortality, costs of hospitalization and litigation. Proper documentation of the critical view of safety and safe plane of dissection may play a crucial role for archivization, teaching and medicolegal purposes.MethodsThe study group consisted of 100 patients with symptomatic cholecystolithiasis qualified for laparoscopic cholecystectomy. The critical view of safety was documented on two photographs and safe plain of dissection obtained with laparoscopic ultrasound was documented on one photograph as well as the whole procedure was recorded. The photographs were printed in the operating theatre and videos were stored on an external hard drive.ResultsThe mean time to obtain and analyse photographs was significantly shorter than video, and the size of the stored data was significantly smaller for photographs than videos. The cost of one documentation procedure was significantly lower for video than photographs. Critical view of safety was obtained in 91 patients, and laparoscopic ultrasound was successful in 99 patients. The conversion rate was 2%, and fundus‐first cholecystectomies were performed in 6% of patients. We did not observe any biliary and vascular complications.ConclusionsPhotographic documentation of the critical view of safety and safe plane of dissection should be an inherent part of laparoscopic cholecystectomy. Our proposal of documentation prepared in the operating theatre and stored in the patient's documentation is an example of an easy, fast and cheap method of data archivization.
Diagnosis of left atrial appendage thrombus in patients with atrial fibrillation: delayed contrast-enhanced cardiac CT
Authors: Spagnolo Pietro , Giglio Manuela , Di Marco Daniela , Cannaò Paola M. , Agricola Eustachio , Della Bella Paolo E. , Monti Caterina B. , Sardanelli Francesco 
Published: September 2020

Abstract
Objectives
The current reference standard for diagnosing LAA thrombi is transesophageal echocardiography (TEE), a semi-invasive technique. We aimed to devise an optimal protocol for cardiac computed tomography (CCT) in diagnosing left atrial appendage (LAA) thrombus in patients with atrial fibrillation (AF), using TEE as reference standard.

Methods
Two hundred sixty consecutive patients referred for radiofrequency ablation for AF were prospectively enrolled. All patients underwent CCT and TEE within 2 hours. The CCT protocol included one standard angiographic phase and three delayed acquisitions at 1-, 3-, and 6-min after contrast injection. Thrombi were defined as persisting defects at 6-min delayed acquisition.

Results
TEE demonstrated spontaneous contrast in 52 (20%) patients and thrombus in 10 (4%). In 63 patients (24%), CCT demonstrated LAA early filling defects at angiographic phase. Among them, 15 (6%) had a persistent defect at 1-min, 12 (5%) at 3-min, and 10 (4%) at 6-min. All 10 thrombi diagnosed on TEE were correctly identified by delayed CCT, without any false positives. For all phases, sensitivity and negative predictive were 100%. Specificity increased from 79% for the angiographic phase to 100% at 6-min. Positive predictive value increased from 16% to 100%. Estimated radiation exposure was 2.08 ± 0.76 mSv (mean ± standard deviation) for the angiographic phase and 0.45 ± 0.23 mSv for each delayed phase.

Conclusion
A CCT protocol adding a 6-min delayed phase to the angiographic phase can be considered optimized for the diagnosis of LAA thrombi, with a low radiation dose.

Key Points
• In patients with persistent atrial fibrillation referred for ablation procedures, a cardiac CT examination comprising an angiographic-phase acquisition and, in case of filling defects, a 6-min delayed phase may help reduce the need for transesophageal echocardiography.
• Cardiac CT would provide morphological and volumetric data, along with the potential to exclude the presence of thrombi in the left atrial appendage.
Validation of the German Classification of Diverticular Disease (VADIS)—a prospective bicentric observational study
Authors: Lauscher Johannes C. , Lock Johan F. , Aschenbrenner Katja , Strobel Rahel M. , Leonhardt Marja , Stroux Andrea , Weixler Benjamin , Germer Christoph-Thomas , Kreis Martin E. 
Published: September 2020

Abstract
Purpose
The German Classification of Diverticular Disease was introduced a few years ago. The aim of this study was to determine whether Classification of Diverticular Disease enables an exact stratification of different types of diverticular disease in terms of course and treatment.

Methods
This was a prospective, bicentric observational trial. Patients aged ≥ 18 years with diverticular disease were prospectively included. The primary endpoint was the rate of recurrence within 2 year follow-up. Secondary outcome measures were Gastrointestinal Quality of Life Index, Quality of life measured by SF-36, frequency of gastrointestinal complaints, and postoperative complications.

Results
A total of 172 patients were included. After conservative management, 40% of patients required surgery for recurrence in type 1b vs. 80% in type 2a/b (p = 0.04). Sixty percent of patients with type 2a (micro-abscess) were in need of surgery for recurrence vs. 100% of patients with type 2b (macro-abscess) (p = 0.11). Patients with type 2a reached 123 ± 15 points in the Gastrointestinal Quality of Life Index compared with 111 ± 14 in type 2b (p = 0.05) and higher scores in the “Mental Component Summary” scale of SF-36 (52 ± 10 vs. 43 ± 13; p = 0.04). Patients with recurrent diverticulitis without complications (type 3b) had less often painful constipation (30% vs. 73%; p = 0.006) when they were operated compared with conservative treatment.

Conclusion
Differentiation into type 2a and 2b based on abscess size seems reasonable as patients with type 2b required surgery while patients with type 2a may be treated conservatively. Sigmoid colectomy in patients with type 3b seems to have gastrointestinal complaints during long-term follow-up.

Trial registration
https://www.drks.de ID: DRKS00005576
The role of perineal application of prophylactic negative-pressure wound therapy for prevention of wound-related complications after abdomino-perineal resection: a systematic review
Authors: Meyer Jeremy , Roos Elin , Abbassi Ziad , Toso Christian , Ris Frédéric , Buchs Nicolas C. 
Published: September 2020

Abstract
Background
Closed perineal wounds often fail to heal by primary intention after abdomino-perineal resection (APR) and are often complicated by surgical site infection (SSI) and/or wound dehiscence. Recent evidence showed encouraging results of prophylactic negative-pressure wound therapy (pNPWT) for prevention of wound-related complications in surgery. Our objective was to gather and discuss the early existing literature regarding the use of pNPWT to prevent wound-related complications on perineal wounds after APR.

Methods
Medline, Embase, and Web of Science were searched for original publications and congress abstracts reporting the use of pNPWT after APR on closed perineal wounds.

Results
Seven publications were included for analysis. Two publications reported significantly lower incidence of SSI in pNPWT patients than in controls with a risk reduction of about 25–30%. Two other publications described similar incidences of SSI between the two groups of patients but described SSI in pNPWT patients to be less severe. One study reported significantly lower incidence of wound dehiscence in pNPWT patients than in controls.

Conclusion
The largest non-randomized studies investigating the effect of pNPWT on the prevention of wound-related complications after APR showed encouraging results in terms of reduction of SSI and wound dehiscence that deserve further investigation and confirmation.
The detection of faked identity using unexpected questions and choice reaction times
Authors: Monaro Merylin , Zampieri Ilaria , Sartori Giuseppe , Pietrini Pietro , Orrù Graziella 
Published: September 2020

AbstractThe identification of faked identities, especially within the Internet environment, still remains a challenging issue both for companies and researchers. Recently, however, latency-based lie detection techniques have been developed to evaluate whether the respondent is the real owner of a certain identity. Among the paradigms applied to this purpose, the technique of asking unexpected questions has proved to be useful to differentiate liars from truth-tellers. The aim of the present study was to assess whether a choice reaction times (RT) paradigm, combined with the unexpected question technique, could efficiently detect identity liars. Results demonstrate that the most informative feature in distinguishing liars from truth-tellers is the Inverse Efficiency Score (IES, an index that combines speed and accuracy) to unexpected questions. Moreover, to focus on the predictive power of the technique, machine-learning models were trained and tested, obtaining an out-of-sample classification accuracy of 90%. Overall, these findings indicate that it is possible to detect liars declaring faked identities by asking unexpected questions and measuring RTs and errors, with an accuracy comparable to that of well-established latency-based techniques, such as mouse and keystroke dynamics recording.
Transcriptional and post-transcriptional regulation of the miR171-LaSCL6 module during somatic embryogenesis in Larix kaempferi
Authors: Zang Qiao-Lu , Zhang Yao , Han Su-Ying , Li Wan-Feng , Qi Li-Wang 
Published: September 2020

Abstract
Key message
Expression analysis of Larix kaempferi mature miR171s and their primary transcripts and target gene LaSCL6 during somatic embryogenesis revealed the transcriptional and post-transcriptional regulation of the miR171-LaSCL6 module.

Abstract
Somatic embryogenesis provides a useful experimental system for studying the regulatory mechanisms of plant development. The level and activity of microRNA171 (miR171) fluctuate during somatic embryogenesis in Larix kaempferi, but the underlying mechanisms are still unclear. Here, in L. kaempferi we identified five members of the miR171 family, which cleave LaSCL6 mRNA at different sites. In addition, we improved the method of measuring miRNA activity in a more direct way. Furthermore, we measured the expression patterns of mature miR171s and their primary transcripts during somatic embryogenesis in L. kaempferi and found that their patterns differed, indicating that the transcription of MIR171 genes and the subsequent cleavage of their intermediate products are regulated. Taken together, our findings not only offer a means to study the regulation of miRNA activity, but also provide further insight into the regulation of L. kaempferi somatic embryogenesis by miR171-LaSCL6.
Discharge interventions from inpatient child and adolescent mental health care: a scoping review
Authors: Chen A. , Dinyarian C. , Inglis F. , Chiasson C. , Cleverley Kristin 
Published: September 2020

AbstractThe post-discharge period is an extremely vulnerable period for patients, particularly for those discharged from inpatient children and adolescent mental health services (CAMHS). Poor discharge practices and discontinuity of care can put children and youth at heightened risk for readmission, among other adverse outcomes. However, there is limited understanding of the structure and effectiveness of interventions to facilitate discharges from CAMHS. As such, a scoping review was conducted to identify the literature on discharge interventions. This scoping review aimed to describe key components, designs, and outcomes of existing discharge interventions from CAMHS. Nineteen documents were included in the final review. Discharge interventions were extracted and summarized for pre-discharge, post-discharge, and bridging elements. Results of this scoping review found that intervention elements included aspects of risk assessment, individualized care, discharge preparation, community linkage, psychoeducation, and follow-up support. Reported outcomes of discharge interventions were also extracted and included positive patient and caregiver satisfaction, improved patient health outcomes, and increased cost effectiveness. Literature on discharge interventions from inpatient CAMHS, while variable in structure, consistently underscore the role of such interventions in minimizing patient and family vulnerability post-discharge. However, findings are limited by inadequate reporting and heterogeneity across studies. There is a need for further research into the design, implementation, and evaluation of interventions to support successful discharges from inpatient child and adolescent mental health care.
Prosecutorial Discretion and Republican Non-Domination
Authors: Crummett Dustin 
Published: September 2020

AbstractProsecutors in the US legal system have great power to interfere at their discretion in the lives of citizens, and face relatively few checks on the exercise of this discretion. The vast scope of the criminal law provides a pretext for prosecuting nearly anyone. Meanwhile, other features of the legal system, such as the way plea bargains are structured and the doctrine of prosecutorial immunity, further increase prosecutorial power. And existing institutional restraints on prosecutorial abuses, such as democratic accountability, the grand jury system, and the possibility of a selective prosecution defense, are mostly ineffectual. I draw on republican political theory, including insights from Philip Pettit and Elizabeth Anderson, to argue that this state of affairs gives prosecutors dominating, and therefore unjust, power over vast swathes of the public. I then survey some potential institutional changes which might help ameliorate the problem.
Changes in expressions of genes involved in the regulation of cellular processes in mucopolysaccharidoses as assessed by fibroblast culture-based transcriptomic analyses
Authors: Gaffke Lidia , Pierzynowska Karolina , Krzelowska Karolina , Piotrowska Ewa , Węgrzyn Grzegorz 
Published: September 2020

AbstractRecent studies indicated that apart from lysosomal storage of glycosaminoglycans (GAGs), secondary and tertiary changes in cellular processes may significantly contribute to development of disorders and symptoms occurring in mucopolysaccharidoses (MPS), a group of lysosomal storage diseases in which neurodegeneration is specific for most types and subtypes. In this report, using transcriptomic data, we demonstrate that regulation of hundreds of genes coding for proteins involved in regulations of various cellular processes is changed in cells derived from patients suffering from all types and subtypes of MPS. Among such genes there are 10 which expression is significantly changed in 9 or more (out of 11) MPS types/subtypes; they include IER3IP1, SAR1A, TMEM38B, PLCB4, SIN3B, ABHD5, SH3BP5, CAPG, PCOLCE2, and MN1. Moreover, there are several genes whose expression is changed over log2 > 4 times in some MPS types relative to control cells. The above analysis indicates that significant changes in expression of genes coding for various regulators of cellular processes may considerably contribute to development of cellular dysfunctions, and further appearance of specific symptoms of MPS, including neurodegeneration.