bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of the first lockdown of the COVID-19 pandemic on the trauma surgery clinic of a German Level I Trauma Center
Authors: Wähnert Dirk , Colcuc Christian , Beyer Georg , Kache Markus , Komadinic Adrian , Vordemvenne Thomas 
Published: April 2021

Abstract
Purpose
The effects of the first pandemic wave on a German Level I Trauma Center should be evaluated to find ways to redistribute structural, personnel, and financial resources in a targeted manner in preparation for the assumed second pandemic wave.

Methods
We examined the repercussions of the first wave of the pandemic on the trauma surgery clinic of a Level I Trauma Center and compared the data with data from 58 other trauma clinics. The results could aid in orientating the distribution of structural, financial, and human resources (HR) during the second wave. The period between March 16 and April 30, 2020 was compared with the data over the same period during 2019. Information was collected from the HR department, central revenue management, and internal documentation.

Results
The proportion of trauma surgical patients in the emergency room decreased by 22%. The number of polytrauma cases increased by 53%. Hospital days of trauma surgery patients in the intensive and intermediate care wards increased by 90%. The number of operations decreased by 15%, although the operating time outside of normal working hours increased by 44%. Clinics with more than 600 beds recorded a decrease in cases and emergencies by 8 and 9%, respectively, while the Trauma Center showed an increase of 19 and 12%. The results reflect the importance of level I trauma centers in the lockdown phase.

Conclusion
To reduce the risk of an increased burden on the healthcare infrastructure, it suggests the care of trauma and COVID-19 patients should be separated locally, when possible.
Intention-to-treat-Prinzip
Authors: Laky Brenda , Heuberer Philipp R. , Herbst Elmar , Lattermann Christian , Günther Daniel , Schüttler Karl Friedrich , Wafaisade Arasch , Mathis Dominic , Rössler Philip P. , Kopf Sebastian ,   AGA Research Komitee
Published: April 2021

ZusammenfassungDieser Artikel gibt einen Überblick über das Prinzip des „intention to treat“ (ITT; Patienten werden so ausgewertet, wie sie randomisiert wurden), „per protocol“ (PP; nicht protokollgemäß behandelte Patienten werden von der Analyse ausgeschlossen) und „as treated“ (AT; Patienten werden unter der Behandlung ausgewertet, die sie tatsächlich erhalten haben) für randomisierte klinische Studien in der Orthopädie. Eine ITT-Analyse soll die Aufrechterhaltung der Vorteile einer zufälligen Behandlungszuteilung zur Vergleichbarkeit der Behandlungsgruppen hinsichtlich bekannter und unbekannter Einflussfaktoren gewährleisten. Dabei kann es jedoch bei Protokollverletzungen zu einer Abschwächung des Behandlungseffekts kommen, sodass zusätzliche PP- bzw. AT-Analysen zur klareren Beurteilung des Behandlungseffekts sinnvoll sind. Vielmehr kann durch die Anwendung aller Prinzipien das Ergebnis einer randomisiert-kontrollierten Studie (RCT) auf Robustheit geprüft und so als Sensitivitätsanalyse genutzt werden.
Exploring the effects of quantum decoherence on the excited-state dynamics of molecular systems
Authors: Heller Eric R. , Joswig Jan-Ole , Seifert Gotthard 
Published: April 2021

AbstractFewest-switches surface hopping (FSSH) is employed in order to investigate the nonadiabatic excited-state dynamics of thiophene and related compounds and hence to establish a connection between the electronic system, the critical points in configuration space and the deactivation dynamics. The potential-energy surfaces of the studied molecules were calculated with complete active space self-consistent field and time-dependent density-functional theory. They are analyzed thoroughly to locate and optimize minimum-energy conical intersections, which are essential to the dynamics of the system. The influence of decoherence on the dynamics is examined by employing different decoherence schemes. We find that irrespective of the employed decoherence algorithm, the population dynamics of thiophene give results which are sound with the expectations grounded on the analysis of the potential-energy surface. A more detailed look at single trajectories as well as on the excited-state lifetimes, however, reveals a substantial dependence on how decoherence is accounted for. In order to connect these findings, we describe how ensemble averaging cures some of the overcoherence problems of uncorrected FSSH. Eventually, we identify carbon–sulfur bond cleavage as a common feature accompanying electronic transitions between different states in the simulations of all thiophene-related compounds studied in this work, which is of interest due to their relevance in organic photovoltaics.
Dose escalation study of targeted alpha therapy with [225Ac]Ac-DOTA-substance P in recurrence glioblastoma – safety and efficacy
Authors: Królicki Leszek , Bruchertseifer Frank , Kunikowska Jolanta , Koziara Henryk , Pawlak Dariusz , Kuliński Radosław , Rola Rafał , Merlo Adrian , Morgenstern Alfred 
Published: April 2021

Abstract
Glioblastoma is the most common and malignant primary brain tumour, with a poor prognosis. Introduction of new treatment options is critically important. The study aimed to assess the appropriateness of escalation doses and toxicity of [225Ac]Ac-DOTA-SP therapy.

Material and methods
A total of 21 patients (age of 43.0 ± 9.5 years), with histologically confirmed recurrent or conversion glioblastoma grade 4 following a standard therapy, have been included in the study. One to 2 intracavitary port-a-cath systems were stereotactically inserted. Patients were treated with escalation dose protocol with 10, 20 and 30 MBq per cycle totally 1–6 doses of [225Ac]Ac-DOTA-SP in 2-month intervals. Therapeutic response was monitored by clinical performance status and MRI imaging.

Results
Treatment was well tolerated with mostly mild temporary adverse effects (oedema, epileptic seizures, aphasia, hemiparesis) mainly in the group of patients treated with 30 MBq of [225Ac]Ac-DOTA-SP. Only one patient treated with 30 MBq revealed thrombopenia grade 3. There was no other grade 3 and 4 toxicity related to [225Ac]Ac-DOTA-treatment in all groups. The median overall survival time from the primary diagnosis (OS-d) was 35.0 months and from the diagnosis of the recurrence/conversion (OS-r/c) was 13.2 months. From the start of treatment with [225Ac]Ac-DOTA-SP, the median PFS was 2.4 months, and the OS-t was 9.0 months. There were no statistically significant differences between the investigated dose escalation groups.

Conclusions
Treatment of recurrent glioblastoma with [225Ac]Ac-DOTA-SP is safe and well tolerated up to 30 MBq per cycle. The escalation dose protocol showed good tolerability. Only mild temporary adverse effects were observed. No remarkable haematological, kidney and liver toxicity was seen.
Retroesophageal right subclavian artery associated with a bicarotid trunk and an ectopic origin of vertebral arteries
Authors: Buffoli Barbara , Verzeletti Vincenzo , Hirtler Lena , Rezzani Rita , Rodella Luigi Fabrizio 
Published: April 2021

AbstractA rare branching pattern of the aortic arch in a female cadaver is reported. An aberrant right subclavian artery originated from the distal part of the aortic arch and following a retroesophageal course was recognized. Next to it, from the left to the right, the left subclavian artery and a short bicarotid trunk originating the left and the right common carotid artery were recognized. An unusual origin of the vertebral arteries was also identified. The left vertebral artery originated directly from the aortic arch, whereas the right vertebral artery originated directly from the right common carotid artery. Retroesophageal right subclavian artery associated with a bicarotid trunk and ectopic origin of vertebral arteries represents an exceptional and noteworthy case.
Artificial intelligence in radiology: 100 commercially available products and their scientific evidence
Authors: van Leeuwen Kicky G. , Schalekamp Steven , Rutten Matthieu J. C. M. , van Ginneken Bram , de Rooij Maarten 
Published: April 2021

Abstract
Objectives
Map the current landscape of commercially available artificial intelligence (AI) software for radiology and review the availability of their scientific evidence.

Methods
We created an online overview of CE-marked AI software products for clinical radiology based on vendor-supplied product specifications (www.aiforradiology.com). Characteristics such as modality, subspeciality, main task, regulatory information, deployment, and pricing model were retrieved. We conducted an extensive literature search on the available scientific evidence of these products. Articles were classified according to a hierarchical model of efficacy.

Results
The overview included 100 CE-marked AI products from 54 different vendors. For 64/100 products, there was no peer-reviewed evidence of its efficacy. We observed a large heterogeneity in deployment methods, pricing models, and regulatory classes. The evidence of the remaining 36/100 products comprised 237 papers that predominantly (65%) focused on diagnostic accuracy (efficacy level 2). From the 100 products, 18 had evidence that regarded level 3 or higher, validating the (potential) impact on diagnostic thinking, patient outcome, or costs. Half of the available evidence (116/237) were independent and not (co-)funded or (co-)authored by the vendor.

Conclusions
Even though the commercial supply of AI software in radiology already holds 100 CE-marked products, we conclude that the sector is still in its infancy. For 64/100 products, peer-reviewed evidence on its efficacy is lacking. Only 18/100 AI products have demonstrated (potential) clinical impact.

Key Points
• Artificial intelligence in radiology is still in its infancy even though already 100 CE-marked AI products are commercially available.
• Only 36 out of 100 products have peer-reviewed evidence of which most studies demonstrate lower levels of efficacy.
• There is a wide variety in deployment strategies, pricing models, and CE marking class of AI products for radiology.
Mindfulness and false memories: state and dispositional mindfulness does not increase false memories for naturalistic scenes presented in a virtual environment
Authors: Ayache Julia , Abichou Kouloud , La Corte Valentina , Piolino Pascale , Sperduti Marco 
Published: April 2021

AbstractMindfulness attracted increased research interests in the last decade, reporting an overall beneficial effect of this practice on cognitive performances. Nevertheless, recently a possible detrimental impact of mindfulness has been underlined. While the effect of mindfulness on memory remains under-explored, recent studies have observed an increased false-memory susceptibility after mindfulness practice. A possible explanatory mechanism has been suggested, related to the nature of the studied material. For semantically related information, mindfulness would increase false memories; however, the addition of rich perceptual information could prevent this detrimental effect. The present study aimed to verify this hypothesis by testing the impact of state mindfulness induced by a short meditation session, and dispositional mindfulness on the production of false memory for pictorial material presented in a complex virtual environment. We employed a virtual reality version of the Deese–Roediger–McDermott paradigm (DRM), a classical protocol to induce false memories. Contrary to previous studies, we did not observe any effect of mindfulness on false or correct memories (free recall and recognition) after a short mindfulness practice session compared to a control condition. Nonetheless, we found a beneficial effect of mindfulness practice on memory sensitivity. Additionally, we reported a positive and negative effect of dispositional mindfulness on memory outcomes. While the Non-Reactivity facet was associated with overall better memory performances, we observed an association between the Acting with Awareness facet and an increased recollection of lures. We discuss these findings in line with a recent proposal on the link between mindfulness and episodic memory.
Tumor mutation burden testing: a survey of the International Quality Network for Pathology (IQN Path)
Authors: Fenizia Francesca , Wolstenholme Nicola , Fairley Jennifer A. , Rouleau Etienne , Cheetham Melanie H. , Horan Martin P. , Torlakovic Emina , Besse Benjamin , Al Dieri Raed , Tiniakos Dina G. , Deans Zandra C. , Patton Simon J. , Normanno Nicola 
Published: April 2021

AbstractWhile tumour mutation burden (TMB) is emerging as a possible biomarker for immune-checkpoint inhibitors (ICI), methods for testing have not been standardised as yet. In April 2019, the International Quality Network for Pathology (IQN Path) launched a survey to assess the current practice of TMB testing. Of the 127 laboratories that replied, 69 (54.3%) had already introduced TMB analysis for research purposes and/or clinical applications. Fifty laboratories (72.5%) used targeted sequencing, although a number of different panels were employed. Most laboratories tested formalin-fixed paraffin-embedded material (94.2%), while 18/69 (26%) tested also cell-free DNA. Fifty-five laboratories used both single nucleotide variants and indels for TMB calculation; 20 centers included only non-synonymous variants. In conclusion, the data from this survey indicate that multiple global laboratories were capable of rapidly introducing routine clinical TMB testing. However, the variability of testing methods raises concerns about the reproducibility of results among centers.
Efficient implementation of the ‘non-biopsy approach’ for the diagnosis of childhood celiac disease in the Netherlands: a national prospective evaluation 2010–2013
Authors: Meijer Caroline R. , Schweizer Joachim J. , Peeters Anne , Putter Hein , Mearin M. Luisa 
Published: April 2021

AbstractThe aim of this study was (1) to prospectively evaluate the nationwide implementation of the ESPGHAN-guidelines for the diagnosis of celiac disease (CD), (2) to investigate the incidence and clinical presentation of diagnosed childhood CD (0–14 years) in the Netherlands, and (3) to compare the findings with national survey data from 1975 to 1990 and 1993 to 2000 using the same approach. From 2010 to 2013, all practicing paediatricians were invited to report new celiac diagnoses to the Dutch Pediatric Surveillance Unit. Data were collected via questionnaires. A total of 1107 children with newly diagnosed CD were reported (mean age, 5.8 years; range, 10 months–14.9 years; 60.5% female). After the introduction of the non-biopsy approach in 2012, 75% of the diagnoses were made according to the guideline with a significant decrease of 46.3% in biopsies. The use of EMA and HLA-typing significantly increased with 25.8% and 62.1%, respectively. The overall incidence rate of childhood CD was 8.8-fold higher than in 1975–1990 and 2.0-fold higher than in 1993–2000. During the study period, the prevalence of diagnosed CD was 0.14%, far below 0.7% of CD identified via screening in the general Dutch paediatric population. Clinical presentation has shifted towards less severe and extra-intestinal symptoms.Conclusion: ESPGHAN guidelines for CD diagnosis in children were effectively and rapidly implemented in the Netherlands. Incidence of diagnosed CD among children is still significantly rising with a continuous changing clinical presentation. Despite the increasing incidence of diagnoses, significant underdiagnosis still remains.

What is Known:• Since 2000 the incidence of diagnosed childhood CD in the Netherlands has shown a steady rise.• The rise in incidence has been accompanied by a changing clinical presentation at diagnosis.

What is New:• The ESPGHAN guidelines 2012 for CD diagnosis were effectively and rapidly implemented in the Netherlands.• The incidence of diagnosed childhood CD in the Netherlands has continued to rise significantly during the reported period.
Short-term outcome in robotic vs laparoscopic and open rectal tumor surgery within an ERAS protocol: a retrospective cohort study from the Swedish ERAS database
Authors: Asklid Daniel , Ljungqvist Olle , Xu Yin , Gustafsson Ulf O. 
Published: April 2021

AbstractBackgroundAdvantages of robotic technique over laparoscopic technique in rectal tumor surgery have yet to be proven. Large multicenter, register-based cohort studies within an optimized perioperative care protocol are lacking. The aim of this retrospective cohort study was to compare short-term outcomes in robotic, laparoscopic and open rectal tumor resections, while also determining compliance to the enhanced recovery after surgery (ERAS)®Society Guidelines.MethodsAll patients scheduled for rectal tumor resection and consecutively recorded in the Swedish part of the international ERAS® Interactive Audit System between January 1, 2010 to February 27, 2020, were included (N = 3125). Primary outcomes were postoperative complications and length of stay (LOS) and secondary outcomes compliance to the ERAS protocol, conversion to open surgery, symptoms delaying discharge and reoperations. Uni- and multivariate comparisons were used.ResultsRobotic surgery (N = 827) had a similar rate of postoperative complications (Clavien–Dindo grades 1–5), 35.9% compared to open surgery (N = 1429) 40.9% (OR 1.15, 95% CI (0.93, 1.41)) and laparoscopic surgery (N = 869) 31.2% (OR 0.88, 95% CI (0.71, 1.08)). LOS was longer in the open group, median 9 days (IRR 1.35, 95% CI (1.27, 1.44)) and laparoscopic group, 7 days (IRR 1.14, 95% CI (1.07, 1.21)) compared to the robotic group, 6 days. Pre- and intraoperative compliance to the ERAS protocol were similar between groups.ConclusionsIn this multicenter cohort study, robotic surgery was associated with shorter LOS compared to both laparoscopic and open surgery and had lower conversion rates vs laparoscopic surgery. The rate of complications was similar between groups.
Early stage white etching crack identification using artificial neural networks
Authors: Liu Xiaodi , Azzam Baher , Harzendorf Freia , Kolb Johann , Schelenz Ralf , Hameyer Kay , Jacobs Georg 
Published: April 2021

AbstractWhite Etching Cracks (WEC) in gearbox bearings is a major concern in the wind turbine industry, which can lead to a premature failure of the gearbox. Though many hypotheses regarding the generation of WEC have been proposed over the decades, the answer is still disputable. To trace back the failures to earlier stages before they occur, an innovative sensor-set has been utilized on a test rig to monitor the influencing factors that lead to WEC. This paperwork seeks to recognize abnormal patterns from recorded sensor data and derive statements of sensible sensor combinations in WEC early detection. A Long Short Term Memory (LSTM) network-based autoencoder is proposed for the anomaly detection (AD) task. Employing an auto-associative sequence-to-sequence predictor, a model is trained to reconstruct the normal time series data without WEC. The reconstruction error of testing time series data is evaluated for the determination of its anomaly. The results show that the specified LSTM autoencoder framework can qualitatively distinguish anomalies from collected multivariate time series data. Moreover, the anomaly score evaluated via reconstruction-error-based metrics can discriminate normal and abnormal behaviors in the study. This investigation’s results entail a significant step towards early WEC risk detection and more cost-efficient wind turbine technology if this approach can be further applied on stream data with plausible thresholds in monitoring system.
Evaluation of a novel deep tissue transvaginal near-infrared laser and applicator in an ovine model
Authors: Zipper Ralph , Pryor Brian 
Published: April 2021

AbstractPhotobiomodulation therapy (PBMT) is an effective means of treating muscle spasm and pain. A novel near-infrared laser system has been commercialized for the treatment of myofascial pelvic pain in women (SoLá Therapy, UroShape, LLC). This study was undertaken to determine if this device is capable of delivering therapeutic levels of irradiance to the pelvic muscles and to identify the surface irradiance required to achieve this goal. This novel class IV near-infrared laser and transvaginal applicator were used to deliver near-infrared light energy through the vaginal mucosa of an adult Suffolk/Dorset Ewe. Irradiance was measured on the surface of the levator ani muscle, inside the levator ani muscle, and inside the bladder. Measurements were taken at powers of 5 W and 0.5 W. 3.0% of vaginal surface irradiance was measured inside of the levator ani muscle. 4.4% of vaginal surface irradiance was measured inside the bladder. At 5 W, the novel laser system provided a surface irradiance of 738 mW/cm2. At 0.5 W, the system provided a surface irradiance of 74 mW/cm2. A novel class IV near-infrared laser and transvaginal applicator delivered therapeutic irradiance to the levator ani muscle and bladder of an anesthetized ewe at a power setting of 5 W. A power setting of 0.5 W failed to deliver therapeutic energy into either the levator ani muscle or bladder. Clinical applications targeting deeper tissues such as the pelvic muscles and or bladder should consider power settings that exceed 0.5 W and or irradiance of ≥ 75 mW/cm2.
Regional medical practice variation in high-cost healthcare services
Authors: Berger Michael , Czypionka Thomas 
Published: April 2021

AbstractMagnetic resonance imaging (MRI) is a popular yet cost-intensive diagnostic measure whose strengths compared to other medical imaging technologies have led to increased application. But the benefits of aggressive testing are doubtful. The comparatively high MRI usage in Austria in combination with substantial regional variation has hence become a concern for its policy makers. We use a set of routine healthcare data on outpatient MRI service consumption of Austrian patients between Q3-2015 and Q2-2016 on the district level to investigate the extent of medical practice variation in a two-step statistical analysis combining multivariate regression models and Blinder–Oaxaca decomposition. District-level MRI exam rates per 1.000 inhabitants range from 52.38 to 128.69. Controlling for a set of regional characteristics in a multivariate regression model, we identify payer autonomy in regulating access to MRI scans as the biggest contributor to regional variation. Nevertheless, the statistical decomposition highlights that more than 70% of the regional variation remains unexplained by differences between the observable district characteristics. In the absence of epidemiological explanations, the substantial regional medical practice variation calls the efficiency of resource deployment into question.