bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enteral resorbable diet versus standard diet in primary sphincter reconstruction: a prospective randomised trial
Authors: Joos Andreas , Bussen Dieter , Galata Christian , Reißfelder Christoph , Herold Alexander , Seyfried Steffen 
Published: March 2021

Abstract
Aim
Bowel movements after reconstructive anorectal surgery may negatively affect surgical outcome. This study was aimed to assess any differences between a standard diet (SD) and the enteral resorbable diet (ED) in terms of operative outcomes and patient tolerance after fistulectomy with primary sphincter reconstruction.

Method
Adult patients undergoing elective fistulectomy with primary sphincter reconstruction for anorectal and rectovaginal fistulas were eligible for inclusion. Patients were intraoperatively randomised to receive either the ED and peristalsis-inhibiting medication (ED) or a SD. The primary endpoint was the healing rate. Secondary endpoints included continence scores, complications and quality of life. Sample size calculation resulted in the analysis of 60 patients to detect a difference in fistula recurrence of 30% with 70% power and a 5% significance level.

Results
Sixty-six patients (24 women) were prospectively and randomly assigned to the ED (n = 34: 51%) or a SD (n = 32; 48%); mean age was 47 (18-74) years. The primary healing rate was 64 out of 66 patients (96%). No statistical difference in healing rate was seen between the groups. However, patient satisfaction was significantly higher in the SD group (P < 0.0001).

Conclusions
Fistulectomy with primary sphincter reconstruction is a safe method with low complication rates. Postoperative stool behaviour has no significant influence on the healing rate but has a significant negative impact on patient satisfaction. Therefore, maintaining a standard diet seems to be preferable following reconstructive anal surgery.

Trial registration
The trial was registered with the German Clinical Trials Register (DRKS00020524).
TERT promoter mutation and chromosome 6 loss define a high-risk subtype of ependymoma evolving from posterior fossa subependymoma
Authors: Thomas Christian , Thierfelder Felix , Träger Malte , Soschinski Patrick , Müther Michael , Edelmann Dominic , Förster Alexandra , Geiler Carola , Kim Hee-yeong , Filipski Katharina , Harter Patrick N. , Schittenhelm Jens , Eckert Franziska , Ntoulias Georgios , May Sven-Axel , Stummer Walter , Onken Julia , Vajkoczy Peter , Schüller Ulrich , Heppner Frank L. , Capper David , Koch Arend , Kaul David , Paulus Werner , Hasselblatt Martin , Schweizer Leonille 
Published: March 2021

AbstractSubependymomas are benign tumors characteristically encountered in the posterior fossa of adults that show distinct epigenetic profiles assigned to the molecular group “subependymoma, posterior fossa” (PFSE) of the recently established DNA methylation-based classification of central nervous system tumors. In contrast, most posterior fossa ependymomas exhibit a more aggressive biological behavior and are allocated to the molecular subgroups PFA or PFB. A subset of ependymomas shows epigenetic similarities with subependymomas, but the precise biology of these tumors and their potential relationships remain unknown. We therefore set out to characterize epigenetic traits, mutational profiles, and clinical outcomes of 50 posterior fossa ependymal tumors of the PFSE group. On histo-morphology, these tumors comprised 12 ependymomas, 14 subependymomas and 24 tumors with mixed ependymoma–subependymoma morphology. Mixed ependymoma–subependymoma tumors varied in their extent of ependymoma differentiation (2–95%) but consistently exhibited global epigenetic profiles of the PFSE group. Selective methylome analysis of microdissected tumor components revealed CpG signatures in mixed tumors that coalesce with their pure counterparts. Loss of chr6 (20/50 cases), as well as TERT mutations (21/50 cases), were frequent events enriched in tumors with pure ependymoma morphology (p < 0.001) and confined to areas with ependymoma differentiation in mixed tumors. Clinically, pure ependymoma phenotype, chr6 loss, and TERT mutations were associated with shorter progression-free survival (each p < 0.001). In conclusion, our results suggest that subependymomas may acquire genetic and epigenetic changes throughout tumor evolution giving rise to subclones with ependymoma morphology (resulting in mixed tumors) that eventually overpopulate the subependymoma component (pure PFSE ependymomas).
Space, time and number: common coding mechanisms and interactions between domains
Authors: Serrien Deborah J. , Spapé Michiel M. 
Published: March 2021

AbstractSpace, time and number are key dimensions that underlie how we perceive, identify and act within the environment. They are interconnected in our behaviour and brain. In this study, we examined interdependencies between these dimensions. To this end, left- and right-handed participants performed an object collision task that required space–time processing and arithmetic tests that involved number processing. Handedness of the participants influenced collision detection with left-handers being more accurate than right-handers, which is in line with the premise that hand preference guides individual differences as a result of sensorimotor experiences and distinct interhemispheric integration patterns. The data further showed that successful collision detection was a predictor for arithmetic achievement, at least in right-handers. These findings suggest that handedness plays a mediating role in binding information processing across domains, likely due to selective connectivity properties within the sensorimotor system that is guided by hemispheric lateralisation patterns.
Detection of microsatellite instability with Idylla MSI assay in colorectal and endometrial cancer
Authors: Ukkola Iiris , Nummela Pirjo , Pasanen Annukka , Kero Mia , Lepistö Anna , Kytölä Soili , Bützow Ralf , Ristimäki Ari 
Published: March 2021

AbstractUniversal testing of microsatellite instability (MSI) is recommended for colorectal cancer (CRC) and endometrial cancer (EC) to screen for Lynch syndrome and to aid in assessing prognosis and optimal treatment. We compared the performance of Idylla MSI test to immunohistochemistry (IHC) of mismatch repair (MMR) proteins in consecutive series of 100 CRC and 108 EC samples, as well as in retrospective series of 28 CRC and 33 EC specimens with known deficient MMR protein expression. The concordance between the Idylla test and IHC was 100% in all CRC samples (n=128) but lower in EC samples (87.2%; n=141). In the EC samples, sensitivity of Idylla test was 72.7% and specificity 100%. EC MSI/dMMR agreement was 85.4% for MLH1, 87.5% for MSH2, and only 35.3% for MSH6. When we analyzed 14 EC samples that were discrepant, i.e., dMMR using IHC and microsatellite stable using Idylla, with microsatellite markers BAT25 and BAT26, we found four cases to be replication error (RER) positive. All RER positive cases were deficient for MSH6 protein expression. We also re-analyzed EC samples with variable tumor cellularity to determine the limit of detection of the Idylla test and found that a 30% or higher tumor cellularity is required. We conclude that Idylla MSI test offers a sensitive and specific method for CRC diagnostics but is less sensitive in EC samples especially in the case of MSH6 deficiency.
Coagulopathy and its effect on treatment and mortality in patients with traumatic intracranial hemorrhage
Authors: Kinnunen Janne , Satopää Jarno , Niemelä Mika , Putaala Jukka 
Published: March 2021

Abstract
Background
The role of coagulopathy in patients with traumatic brain injury has remained elusive. In the present study, we aim to assess the prevalence of coagulopathy in patients with traumatic intracranial hemorrhage, their clinical features, and the effect of coagulopathy on treatment and mortality.

Methods
An observational, retrospective single-center cohort of consecutive patients with traumatic intracranial hemorrhage treated at Helsinki University Hospital between 01 January and 31 December 2010. We compared clinical and radiological parameters in patients with and without coagulopathy defined as drug- or disease-induced, i.e., antiplatelet or anticoagulant medication at a therapeutic dose, thrombocytopenia (platelet count < 100 E9/L), international normalized ratio > 1.2, or thromboplastin time < 60%. Primary outcome was 30-day all-cause mortality. Logistic regression analysis allowed to assess for factors associated with coagulopathy and mortality.

Results
Of our 505 patients (median age 61 years, 65.5% male), 206 (40.8%) had coagulopathy. Compared to non-coagulopathy patients, coagulopathy patients had larger hemorrhage volumes (mean 140.0 mL vs. 98.4 mL, p < 0.001) and higher 30-day mortality (18.9% vs. 9.7%, p = 0.003). In multivariable analysis, older age, lower admission Glasgow Coma Scale score, larger hemorrhage volume, and conservative treatment were independently associated with mortality. Surgical treatment was associated with lower mortality in both patients with and without coagulopathy.

Conclusions
Coagulopathy was more frequent in patients with traumatic intracranial hemorrhage presenting larger hemorrhage volumes compared to non-coagulopathy patients but was not independently associated with higher 30-day mortality. Hematoma evacuation, in turn, was associated with lower mortality irrespective of coagulopathy.
Multi-patient study for coronary vulnerable plaque model comparisons: 2D/3D and fluid–structure interaction simulations
Authors: Wang Qingyu , Tang Dalin , Wang Liang , Meahara Akiko , Molony David , Samady Habib , Zheng Jie , Mintz Gary S. , Stone Gregg W. , Giddens Don P. 
Published: March 2021

AbstractSeveral image-based computational models have been used to perform mechanical analysis for atherosclerotic plaque progression and vulnerability investigations. However, differences of computational predictions from those models have not been quantified at multi-patient level. In vivo intravascular ultrasound (IVUS) coronary plaque data were acquired from seven patients. Seven 2D/3D models with/without circumferential shrink, cyclic bending and fluid–structure interactions (FSI) were constructed for the seven patients to perform model comparisons and quantify impact of 2D simplification, circumferential shrink, FSI and cyclic bending plaque wall stress/strain (PWS/PWSn) and flow shear stress (FSS) calculations. PWS/PWSn and FSS averages from seven patients (388 slices for 2D and 3D thin-layer models) were used for comparison. Compared to 2D models with shrink process, 2D models without shrink process overestimated PWS by 17.26%. PWS change at location with greatest curvature change from 3D FSI models with/without cyclic bending varied from 15.07% to 49.52% for the seven patients (average = 30.13%). Mean Max-FSS, Min-FSS and Ave-FSS from the flow-only models under maximum pressure condition were 4.02%, 11.29% and 5.45% higher than those from full FSI models with cycle bending, respectively. Mean PWS and PWSn differences between FSI and structure-only models were only 4.38% and 1.78%. Model differences had noticeable patient variations. FSI and flow-only model differences were greater for minimum FSS predictions, notable since low FSS is known to be related to plaque progression. Structure-only models could provide PWS/PWSn calculations as good approximations to FSI models for simplicity and time savings in calculation.
Impact of plasma irradiation on Tribolium castaneum
Authors: Sayed Waheed A. A. , Hassan Reda S. , Sileem Thanaa M. , Rumpold Birgit A. 
Published: March 2021

AbstractRadio frequency plasma (RFP) could provide reliable, compact, cost-effective irradiation applications against insect pests of stored food and feed products. Sensitivity of red flour beetleTribolium castaneumto RFP has been investigated using an irradiation applicator system with the two types of inert gases, argon (Ar) and helium (He), at 100 W for five exposure time levels of 0, 20, 40, 60 and 90 s, respectively. We demonstrated that He RFP was more efficient againstT. castaneumthan Ar RFP. In addition, a positive correlation was observed between mortality percentages of treated insect stages and exposure times for both He and Ar RFP. The adult stage showed the highest tolerance to RFP irradiation followed by larvae and pupae; however, it was more susceptible than larvae within 24 h after He RFP treatments. The optimum exposure time was 90 s with He RFP, where a full mortality at all tested stages was accomplished, while mortalities of 71.4, 65.3 and 36.7% were recorded for pupae, larvae and adult stage, respectively, after an Ar RFP treatment of 90 s. In case of treated adults, the reproduction rate was higher than treated larvae and pupae. Our findings indicated that He RFP was an effective method for inhibitingT. castaneumdevelopment and impacting the insect life cycle and could be considered a promising tool for pest control of stored food.
Insufficient declines in new HIV infection rates amidst high scores in HIV testing and awareness: ‘a game theory simulation’
Authors: Ochanda Perez Nicholas , Ssempala Richard , Kayongo Allan , Odokonyero Tonny 
Published: March 2021

Abstract
Aim
Substantial progress has been made towards the 90–90–90 global targets; however, the pace at which new infections are declining remains undesirable to meet the UNAIDS 2020 global targets of below 500,000 new infections annually. We discussed the possibility of continued HIV incidence amidst remarkable scores in the 90–90–90 global targets.

Subject and methods
A game theory simulation was used to explain micro-level sexual interactions in situations of imperfect information on each partner’s HIV status. A non-cooperative sex game tree was constructed following the Harsanyi transformation in two scenarios; scenario one: a player assigns higher subjective probability that the partner is HIV negative; and in scenario two: a player assigns higher subjective probability that the partner is HIV positive. Subjective expected utilities were computed using hypothetical payoffs.

Results
Accepting unprotected sex is a pure strategy for both players in scenario 1. Player2 is likely to acquire HIV/AIDS. Accepting protected sex is a mixed strategy equilibrium for both players in scenario 2. Player2 is likely to avoid HIV infection.

Conclusion
Choice for safe or risky sex is a function of subjective probabilities individuals attach to their partners being infected or uninfected. More efforts towards addressing factors affecting individual probability distributions on riskiness of their sexual partners is required, especially for young women in Sub-Saharan Africa.
Adaptation and early implementation of the PREdiction model for gene mutations (PREMM5™) for lynch syndrome risk assessment in a diverse population
Authors: Mittendorf Kathleen F. , Ukaegbu Chinedu , Gilmore Marian J. , Lindberg Nangel M. , Kauffman Tia L. , Eubanks Donna J. , Shuster Elizabeth , Allen Jake , McMullen Carmit , Feigelson Heather Spencer , Anderson Katherine P. , Leo Michael C. , Hunter Jessica Ezzell , Sasaki Sonia Okuyama , Zepp Jamilyn M. , Syngal Sapna , Wilfond Benjamin S. , Goddard Katrina A. B. 
Published: March 2021

AbstractLynch syndrome (LS) is the most common inherited cause of colorectal and endometrial cancers. Identifying individuals at risk for LS without personal cancer history requires detailed collection and assessment of family health history. However, barriers exist to family health history collection, especially in historically underserved populations. To improve LS risk assessment in historically underserved populations, we adapted the provider-facing PREdiction Model for gene Mutations (PREMM5™ model), a validated LS risk assessment model, into a patient-facing electronic application through an iterative development process involving expert and patient stakeholders. We report on preliminary findings based on the first 500 individuals exposed to the adapted application in a primary care population enriched for low-literacy and low-resource patients. Major adaptations to the PREMM5™ provider module included reduction in reading level, addition of interactive literacy aids, incorporation of family history assessment for both maternal and paternal sides of the family, and inclusion of questions about individual relatives or small groups of relatives to reduce cognitive burden. In the first 500 individuals, 90% completed the PREMM5™ independently; of those, 94% did so in 5 min or less (ranged from 0.2 to 48.8 min). The patient-facing application was able to accurately classify 84% of patients as having clinically significant or not clinically significant LS risk. Our preliminary results suggest that in this diverse study population, most participants were able to rapidly, accurately, and independently complete an interactive application collecting family health history assessment that accurately assessed for Lynch syndrome risk.
Analogue tuning of particle focusing in elasto-inertial flow
Authors: Banerjee I. , Rosti M. E. , Kumar T. , Brandt L. , Russom A. 
Published: March 2021

AbstractWe report a unique tuneable analogue trend in particle focusing in the laminar and weak viscoelastic regime of elasto-inertial flows. We observe experimentally that particles in circular cross-section microchannels can be tuned to any focusing bandwidths that lie between the “Segre-Silberberg annulus” and the centre of a circular microcapillary. We use direct numerical simulations to investigate this phenomenon and to understand how minute amounts of elasticity affect the focussing of particles at increasing flow rates. An Immersed Boundary Method is used to account for the presence of the particles and a FENE-P model is used to simulate the presence of polymers in a Non-Newtonian fluid. The numerical simulations study the dynamics and stability of finite size particles and are further used to analyse the particle behaviour at Reynolds numbers higher than what is allowed by the experimental setup. In particular, we are able to report the entire migration trajectories of the particles as they reach their final focussing positions and extend our predictions to other geometries such as the square cross section. We believe complex effects originate due to a combination of inertia and elasticity in the weakly viscoelastic regime, where neither inertia nor elasticity are able to mask each other’s effect completely, leading to a number of intermediate focusing positions. The present study provides a fundamental new understanding of particle focusing in weakly elastic and strongly inertial flows, whose findings can be exploited for potentially multiple microfluidics-based biological sorting applications.
Performance measurement and joint production of intended and unintended outputs
Authors: Førsund Finn R. 
Published: March 2021

AbstractThe generation of unintended residuals when producing intended outputs is the key factor behind our serious problems with pollution. The way this joint production is modelled is therefore of crucial importance for our understanding and empirical efforts to change economic activities in order to reduce harmful residuals. Estimation of efficiency and productivity when producing both intended and unintended outputs has emerged as an important research strand. The most popular models in the field are based on weak disposability of the two types of outputs together and null-jointness introduced by Shephard. The purpose of the paper is to show that these model types are built on some questionable assumptions. An alternative model based on the production theory of Frisch introduces technical jointness for the case when the unintended output is unavoidable. The materials balance based on physical laws tells us that when material inputs are used unintended outputs are unavoidable. The modelling of joint production must therefore reflect this. The production of the two types of outputs occurs simultaneously. It is the maximisation of intended outputs for given inputs that engineers are striving at to achieve. The production functions for intended and unintended outputs are linked through common use of inputs. However, separate functions for the two types of output can be estimated because the intended outputs are independent of the unintended ones and vice versa, facilitating calculating separate efficiency and productivity measures using non-parametric DEA methods.
Intensivierung von enzymkatalysierten Reaktionen
Authors: Holtmann Dirk , Hollmann Frank 
Published: March 2021

AbstractProcess intensification aims at enabling bridging the gap between fundamental research such as identification of new catalysts and reactions and their implementation in industrial environments. Especially the field of biocatalysis has seen some tremendous improvements and the development of new tools and approaches to bridge this gap. In this contribution we highlight some recent developments as selected case studies.
Photosymbiose — neuartige Anwendungen in der Biomedizin
Authors: Chávez Myra N. , Fuchs Benedikt , Nickelsen Jörg 
Published: March 2021

AbstractWe have recently proposed a novel strategy named photosynthetic tissue engineering to overcome clinical problems due to hypoxia. The idea is based on transgenic photoautotrophic microorganisms that produce oxygen and at the same time secrete functional recombinant proteins into tissues. In particular, the unicellular green alga Chlamydomonas reinhardtii has successfully been used to boost the regenerative potential of several biomedical devices, such as dermal scaffolds and surgical sutures.
Multi-sided platform and data-driven care research
Authors: Fürstenau Daniel , Klein Stefan , Vogel Amyn , Auschra Carolin 
Published: March 2021

AbstractMulti-sided platforms in healthcare often focus their business model on standardizing care for wide-spread, chronic diseases. However, there is a lack of knowledge surrounding platform business models enabling individualized care coordination for patients with rare diseases. This paper analyses the development of a complex platform business model addressing Amyotrophic Lateral Sclerosis, a severe neurological disease that requires the coordination of a diverse network of medical specialists, care, and equipment providers. A longitudinal case study examines the platform’s development, focusing subsequently on qualitative and efficient care coordination, care research, and active and direct involvement of patients, as well as establishing two business models, namely, care coordination and care research. We reconstruct how these complex platform business models were configured to improve patient care and care research, thereby creating immediate value for patients and insights for long-term care improvements. The ongoing platform development carefully balances value generation for diverse stakeholders and economic sustainability.