bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity and reliability of the Thai version of the pediatric obstructive sleep apnea screening tool
Authors: Tanphaichitr Archwin , Chuenchod Pitchayanan , Ungkanont Kitirat , Banhiran Wish , Vathanophas Vannipa , Gozal David 
Published: June 2021

AbstractObjectiveObstructive sleep apnea (OSA) is highly prevalent in children and requires an expensive and relatively unavailable sleep study for diagnosis. This study was undertaken to translate the previously validated pediatric OSA screening tool (POSAST) to the Thai language and assess its accuracy and test–retest reliability in at‐risk symptomatic children.Study DesignProspective cross‐sectional cohort study.MethodsPediatric patients clinically referred for suspected OSA who underwent overnight polysomnography (PSG) were recruited, and caregivers completed the Thai version of the POSAST. The same questionnaire was completed again after 2–4 weeks. The reliability of the questionnaire was determined by internal consistency and test–retest reliability. The validity of the questionnaire was assessed by constructing receiver operating characteristic (ROC) curves to identify the equation‐derived score and total additive score cutoff points that identify high risk for moderate and severe OSA (AHI of ≥ 5 events/h).ResultsOne hundred and ten subjects completed the study. The mean age was 8.4 ± 2.9 years. The mean apnea‐hypopnea index (AHI) was 10.9 ± 11.9 events/h. Test–retest reliability (Pearson correlation coefficient = 0.96, p < .001) and internal consistency between each question (Cronbach's alpha coefficient = 0.82, p < .001) were excellent. An equation‐derived score cut‐off of 1.9 yielded 78.4% sensitivity, 50.0% specificity, 76.3% positive predictive value (PPV), and 52.9% negative predictive value (NPV), while a total additive score cut‐off of 8 corresponded to 81.1% sensitivity, 52.8% specificity, 77.9% PPV, and 57.6% NPV for diagnosing moderate and severe OSA (AHI ≥ 5 events/h).ConclusionThe internal consistency and reproducibility of the Thai version of the POSAST are satisfactory, display acceptable validity, and the instrument can be used for screening symptomatic Thai children for OSA.
Recent Advances in Electrocatalysts for Alkaline Hydrogen Oxidation Reaction
Authors: Zhao Ruopeng , Yue Xin , Li Qinghua , Fu Gengtao , Lee Jong‐Min , Huang Shaoming 
Published: June 2021

AbstractWith the rapid development of anion‐exchange membrane technology and adequate supply of high‐performance non‐noble metal oxygen reduction reaction (ORR) catalysts in alkaline media, the commercialization of anion exchange membrane fuel cells (AEMFCs) become possible. However, the kinetics of the anodic hydrogen oxidation reaction (HOR) in AEMFCs is significantly decreased compared to the HOR in proton exchange membrane fuel cells (PEMFCs). Therefore, it is urgent to develop HOR catalysts with low price, high activity, and robust stability. However, comprehensive timely reviews on this specific subject do not exist enough yet and it is necessary to update reported major achievements and to point out future investigation directions. In this review, the current reaction mechanisms on HOR are summarized and deeply understood. The debates between the mechanisms are greatly harmonized. Recent advances in developing highly active and stable electrocatalysts for the HOR are reviewed. Moreover, the side reaction control is for the first time systematically introduced. Finally, the challenges and future opportunities in the field of HOR catalysis are outlined.
Extending traditional water supplies in inland communities with nontraditional solutions to water scarcity
Authors: Scruggs Caroline E. , Heyne Catherine M. 
Published: June 2021

AbstractUrban communities around the world are grappling with the challenges associated with population increases, drought, and projected water shortages. With a substantial global shortfall between water supply and demand expected by 2030, water planning strategies must adapt to a new reality characterized by higher temperatures and less precipitation, requiring new ways of thinking about water management, use, and governance. Commonplace strategies such as water conservation and nonpotable water reuse might not be sufficient to adequately stretch water supplies in water‐scarce parts of the industrialized world. In the United States, planned potable water reuse (i.e., purification of domestic wastewater for reuse as drinking water) is emerging as a way forward to mitigate water shortages without significant changes to lifestyle, behavior, or infrastructure. But potable reuse is not the only solution: paradigm shifting and disruptive options that more holistically address water scarcity, such as composting toilets and market‐based approaches to water use, are also gaining traction, and they could be pursued alongside or instead of potable water reuse. However, these options would require more significant changes to lifestyles, behavior, infrastructure, and governance. While all of the options considered offer advantages, they each come with new concerns and challenges related to cost, public perception, social norms, and policy. The goal of this work is to consider a number of plausible solutions to water scarcity—partial and complete, traditional and disruptive—to stimulate forward‐looking thinking about the increasingly common global problem of water scarcity.This article is categorized under:
Engineering Water > Sustainable Engineering of Water
Engineering Water > Planning Water
Robust approach to thermal resummation: Standard Model meets a singlet
Authors: Schicho Philipp M. , Tenkanen Tuomas V. I. , Österman Juuso 
Published: June 2021

AbstractPerturbation theory alone fails to describe thermodynamics of the electroweak phase transition. We review a technique combining perturbative and non-perturbative methods to overcome this challenge. Accordingly, the principal theme is a tutorial of high­temperature dimensional reduction. We present an explicit derivation with a real singlet scalar and compute the thermal effective potential at two-loop order. In particular, we detail the dimensional reduction for a real-singlet extended Standard Model. The resulting effective theory will impact future non-perturbative studies based on lattice simulations as well as purely perturbative investigations.
Retinal arteriolar tortuosity and fractal dimension are associated with long-term cardiovascular outcomes in people with type 2 diabetes
Authors: Sandoval-Garcia Emmanuel , McLachlan Stela , Price Anna H. , MacGillivray Thomas J. , Strachan Mark W. J. , Wilson James F. , Price Jackie F. 
Published: June 2021

Abstract
Aims/hypothesis
Our aim was to determine whether quantitative retinal traits in people with type 2 diabetes are independently associated with incident major cardiovascular events including CHD and stroke.

Methods
A total of 1066 men and women with type 2 diabetes, aged 65–74 years, were followed up over 8 years in the population-based Edinburgh Type 2 Diabetes Study. Using retinal photographs taken at baseline and specialist software, a number of quantitative retinal traits were measured, including arteriolar and venular widths and tortuosity as well as fractal dimension (a measure of the branching pattern complexity of the retinal vasculature network). Incident CHD events occurring during follow-up included fatal and non-fatal myocardial infarction, first episodes of angina and coronary interventions for CHD. Incident cerebrovascular events included fatal and non-fatal stroke or transient ischaemic attack. Cox proportional hazard regression analyses were performed to identify the association of the retinal traits with cardiovascular events in the population with retinal data available (n = 1028).

Results
A total of 200 participants had an incident cardiovascular event (139 CHD and 61 cerebrovascular events). Following adjustment for age and sex, arteriolar tortuosity and fractal dimension were associated with cerebrovascular events (HR 1.27 [95% CI 1.02, 1.58] and HR 0.74 [95% CI 0.57, 0.95], respectively), including with stroke alone (HR 1.30 [95% CI 1.01, 1.66] and HR 0.73 [95% CI 0.56, 0.97], respectively). These associations persisted after further adjustment for established cardiovascular risk factors (HR 1.26 [95% CI 1.01, 1.58] and HR 0.73 [95% CI 0.56, 0.94], respectively). Associations generally reduced in strength after a final adjustment for the presence of diabetic retinopathy, but the association of fractal dimension with incident cerebrovascular events and stroke retained statistical significance (HR 0.73 [95% CI 0.57, 0.95] and HR 0.72 [95% CI 0.54, 0.97], respectively). Associations of retinal traits with CHD were generally weak and showed no evidence of statistical significance.

Conclusions/interpretation
Arteriolar tortuosity and fractal dimension were associated with incident cerebrovascular events, independent of a wide range of traditional cardiovascular risk factors including diabetic retinopathy. These findings suggest potential for measurements of early retinal vasculature change to aid in the identification of people with type 2 diabetes who are at increased risk from stroke.

Graphical abstract
Peronealsehnenpathologien
Authors: Willegger Madeleine , Hirtler Lena , Schwarz Gilbert M. , Windhager Rein﻿hard , Chiari Catharina 
Published: June 2021

ZusammenfassungPeronealsehnenpathologien sind selten, jedoch häufig unterdiagnostiziert. Eine Assoziation mit einer chronisch lateralen Sprunggelenkinstabilität sowie mit einer varischen Rückfußachse kann bestehen. Pathologien der Sehnen lassen sich in 3 Kategorien einteilen: Tendinitis und Tenosynovitis, Sehnenrisse und Rupturen sowie Sehnensubluxation und Sehnenluxation. Die Magnetresonanztomographie ist die Standardmethode zur radiologischen Beurteilung. Die Diagnose und Behandlung basieren jedoch in erster Linie auf Anamnese und klinischer Untersuchung. Eine primär konservative Therapie kann versucht werden, ausgenommen bei Peronealsehnenluxationen des professionellen Sportlers. Die chirurgische Therapie sollte gezielt auf die zugrunde liegende Pathologie abgestimmt werden und kann dementsprechend divers von der tendoskopischen Synovektomie bis zur anatomischen Reparatur des superioren peronealen Retinakulums mit Vertiefung der retromalleolären Rinne ausfallen. Die postoperativen Ergebnisse zeigen eine hohe Patientenzufriedenheit und niedrige Reluxationsraten.
The Hilbert scheme of a pair of linear spaces
Authors: Ramkumar Ritvik 
Published: June 2021

AbstractLet $$\mathcal {H}_{a,b}^n$$

H

a
,
b

n

denote the component of the Hilbert scheme whose general point parameterizes an a-plane union a b-plane meeting transversely in $${\mathbf {P}}^n$$

P

n

. We show that $$\mathcal {H}_{a,b}^n$$

H

a
,
b

n

is smooth and isomorphic to successive blow ups of $$\mathbf {Gr}(a,n) \times \mathbf {Gr}(b,n)$$

Gr
(
a
,
n
)
×
Gr
(
b
,
n
)

or $$\text {Sym}^2 \mathbf {Gr}(a,n)$$

Sym
2

Gr

(
a
,
n
)

along certain incidence correspondences. We classify the subschemes parameterized by $$\mathcal {H}_{a,b}^n$$

H

a
,
b

n

and show that this component has a unique Borel fixed point. We also study the birational geometry of this component. In particular, we describe the effective and nef cones of $$\mathcal {H}_{a,b}^n$$

H

a
,
b

n

and determine when the component is Fano. Moreover, we show that $$\mathcal {H}_{a,b}^n$$

H

a
,
b

n

is a Mori dream space for all values of a, b, n.
The contemporary model of vertebral column joint dysfunction and impact of high-velocity, low-amplitude controlled vertebral thrusts on neuromuscular function
Authors: Haavik Heidi , Kumari Nitika , Holt Kelly , Niazi Imran Khan , Amjad Imran , Pujari Amit N. , Türker Kemal Sitki , Murphy Bernadette 
Published: June 2021

AbstractPurposeThere is growing evidence that vertebral column function and dysfunction play a vital role in neuromuscular control. This invited review summarises the evidence about how vertebral column dysfunction, known as a central segmental motor control (CSMC) problem, alters neuromuscular function and how spinal adjustments (high-velocity, low-amplitude or HVLA thrusts directed at a CSMC problem) and spinal manipulation (HVLA thrusts directed at segments of the vertebral column that may not have clinical indicators of a CSMC problem) alters neuromuscular function.MethodsThe current review elucidates the peripheral mechanisms by which CSMC problems, the spinal adjustment or spinal manipulation alter the afferent input from the paravertebral tissues. It summarises the contemporary model that provides a biologically plausible explanation for CSMC problems, the manipulable spinal lesion. This review also summarises the contemporary, biologically plausible understanding about how spinal adjustments enable more efficient production of muscular force. The evidence showing how spinal dysfunction, spinal manipulation and spinal adjustments alter central multimodal integration and motor control centres will be covered in a second invited review.ResultsMany studies have shown spinal adjustments increase voluntary force and prevent fatigue, which mainly occurs due to altered supraspinal excitability and multimodal integration. The literature suggests physical injury, pain, inflammation, and acute or chronic physiological or psychological stress can alter the vertebral column’s central neural motor control, leading to a CSMC problem. The many gaps in the literature have been identified, along with suggestions for future studies.ConclusionSpinal adjustments of CSMC problems impact motor control in a variety of ways. These include increasing muscle force and preventing fatigue. These changes in neuromuscular function most likely occur due to changes in supraspinal excitability. The current contemporary model of the CSMC problem, and our understanding of the mechanisms of spinal adjustments, provide a biologically plausible explanation for how the vertebral column’s central neural motor control can dysfunction, can lead to a self-perpetuating central segmental motor control problem, and how HVLA spinal adjustments can improve neuromuscular function.
Dynamical systems as a level of cognitive analysis of multi-agent learning
Authors: Barfuss Wolfram 
Published: June 2021

AbstractA dynamical systems perspective on multi-agent learning, based on the link between evolutionary game theory and reinforcement learning, provides an improved, qualitative understanding of the emerging collective learning dynamics. However, confusion exists with respect to how this dynamical systems account of multi-agent learning should be interpreted. In this article, I propose to embed the dynamical systems description of multi-agent learning into different abstraction levels of cognitive analysis. The purpose of this work is to make the connections between these levels explicit in order to gain improved insight into multi-agent learning. I demonstrate the usefulness of this framework with the general and widespread class of temporal-difference reinforcement learning. I find that its deterministic dynamical systems description follows a minimum free-energy principle and unifies a boundedly rational account of game theory with decision-making under uncertainty. I then propose an on-line sample-batch temporal-difference algorithm which is characterized by the combination of applying a memory-batch and separated state-action value estimation. I find that this algorithm serves as a micro-foundation of the deterministic learning equations by showing that its learning trajectories approach the ones of the deterministic learning equations under large batch sizes. Ultimately, this framework of embedding a dynamical systems description into different abstraction levels gives guidance on how to unleash the full potential of the dynamical systems approach to multi-agent learning.
Klimaanpassung von Logistikstandorten – eine Szenarienanalyse
Authors: Bücken Felix , Kanning Helga 
Published: June 2021

ZusammenfassungFür die Entwicklung von Klimaanpassungsstrategien sind Logistikstandorte aus zwei Perspektiven bedeutsam: Einerseits sind Logistikunternehmen selbst aufgrund ihrer großen Liegenschaften und des hohen Versiegelungsgrads besonders von den Folgen des Klimawandels betroffen, andererseits erhöhen sie durch ihre umfassenden Flächenversiegelungen die Vulnerabilität der Kommunen, in denen sie angesiedelt sind. Sowohl Logistikunternehmen als auch Kommunen sind daher gefragt, klimaangepasste Gewerbeflächen zu entwickeln. Mithilfe einer kritisch reflektierten Szenarienanalyse zeigt dieser Beitrag verschiedene Positionen beteiligter Akteure (Logistikunternehmen, Kommunen, Intermediäre) auf und identifiziert Hemmnisse sowie Konfliktfelder zur Anpassung an Klimafolgen. Dazu werden 3 Szenarien vorgestellt, die verschiedene Gestaltungs- und Entwicklungsperspektiven der Anpassung und Flächennutzung illustrieren. Aus der Diskussion der Szenarien im Rahmen von 3 Workshops lassen sich 4 zentrale Handlungsfelder ableiten, die für die Anpassung von Logistikstandorten besonders bedeutsam sind: Interkommunale Zusammenarbeit, intrakommunale Herausforderungen, wie z. B. mangelnde personelle Ressourcen in den Verwaltungen, mehr Zukunftsorientierung der Logistik sowie Sensibilisierung und Kommunikation. Dabei wird die Verantwortung für die Umsetzung geeigneter Maßnahmen in Kooperation durch Unternehmen, Kommunen und Intermediäre gesehen.
Universalisierung und Entpolitisierung von Klimawandelanpassung?
Authors: Bruns Antje , Fünfgeld Hartmut 
Published: June 2021

ZusammenfassungIn dem Maße, wie sich Klimawandelanpassung als Handlungsfeld von Kommunen, regionalen Gebietskörperschaften sowie Beratungs- und Planungsbüros verstetigt, findet eine zunehmende Standardisierung und Universalisierung von Konzepten, Ansätzen und Methoden statt. Diese Vereinheitlichung trägt zur Wissensintegration und -diffusion sowie zu einer weiteren Professionalisierung des Handlungsfeldes bei und bietet dadurch vermeintliche und tatsächliche Vorteile, z. B. bezüglich der Erprobung und Übertragbarkeit von Good Practices und im Bereich der Weiterbildung und des Kapazitätsaufbaus. Gleichzeitig birgt die Abkehr von einer prinzipiellen Vielfalt auf der Wissens- und der Handlungsebene auch Problematiken. Eine Orientierung an technologischen Innovationen, die möglicherweise zu neu entstehende Pfadabhängigkeiten führen und zugleich die Lern- und Veränderungsfähigkeit untergraben und den Blick auf notwendige Wertediskurse verstellen, können die Folge sein. In der Praxis wird Klimawandelanpassung häufig auf das Mach- und Umsetzbare reduziert, ohne z. B. Gerechtigkeitsfragen zu stellen. Vor dem Hintergrund dieser Beobachtungen beleuchten wir das Verhältnis von Wissensproduktion und Anpassungspraxis schlaglichtartig aus Perspektive einer kritischen Angewandten Geographie: (1) Epistemologien und Methoden sowie (2) theoretisch-konzeptuelle Ansätze (in) der Anpassungsforschung (3) eine deutliche Orientierung an Erfolgsgeschichten und (4) Prozesse der Wissensproduktion für eine konsensorientierte Politik der Klimaanpassung. Der Artikel möchte so einen Beitrag zur Auseinandersetzung mit aktuellen wissensbasierten Praktiken im Kontext des Handlungsfeldes Klimawandelanpassung leisten.
Der AKTIN-Monatsbericht: Plädoyer für ein standardisiertes Reporting in der Notaufnahme
Authors: Greiner Felix , Erdmann Bernadett , Thiemann Volker S. , Baacke Markus , Grashey Rupert , Habbinga Kirsten , Kombeiz Alexander , Majeed Raphael W. , Otto Ronny , Wedler Katrin , Brammen Dominik , Walcher Felix 
Published: June 2021

Zusammenfassung
Hintergrund
Vor dem Hintergrund der steigenden Inanspruchnahme und aktuellen Veränderungen in der Notfallversorgung ist eine standardisierte Erfassung relevanter Kennzahlen in Notaufnahmen zwingend erforderlich.

Ziel der Arbeit
Es werden die Konsentierung von Inhalten und technische Umsetzung eines automatisierten Reportings für Notaufnahmen des AKTIN-Notaufnahmeregisters beschrieben. Ziel war ein aussagefähiger Monatsbericht zur Prozesssteuerung und Qualitätssicherung.

Material und Methoden
Datengrundlage ist der Datensatz Notaufnahme V2015.1 der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin e. V. (DIVI). Die Konsentierung der Inhalte erfolgte auf Basis von externen Referenzen und fachlicher Expertise; die technische Entwicklung erfolgte anhand eines Testdatensatzes. Mit der Software R und Apache Formatting Objects Processor (FOP) wird der finale Bericht im PDF-Format automatisiert erstellt.

Ergebnisse
Der Bericht enthält unter anderem Angaben zu Fallzahlen, Demografie der Patienten, Vorstellungsgründen, Ersteinschätzung, Verbleib und ausgewählten Prozesszeiten in Form von Tabellen und Grafiken. Er wird monatsweise automatisch oder auf Anforderung aus den Routinedaten generiert. Fehlende Werte und Ausreißer werden zur Abschätzung der Datenqualität separat ausgewiesen.

Diskussion
Beim AKTIN-Monatsbericht handelt es sich um ein Instrument, welches das Versorgungsgeschehen aufbereitet und visualisiert. Die konsentierten Kennzahlen sind praxistauglich und bilden auch die Vorgaben des Gemeinsamen Bundesausschusses zur Ersteinschätzung ab. Die Nutzung von Interoperabilitätsstandards erlaubt eine automatische Erfassung im Alltag, gewährleistet eine Unabhängigkeit von einzelnen IT-Systemen und kann als Grundlage für ein klinikübergreifendes Benchmarking dienen.
Long-term outcome and quality of life after CNS cavernoma resection: eloquent vs. non-eloquent areas
Authors: Shoubash Loay , Baldauf Jörg , Matthes Marc , Kirsch Michael , Rath Matthias , Felbor Ute , Schroeder Henry W. S. 
Published: June 2021

AbstractThe aim of this study is to analyze the long-term quality of life after surgery of cavernoma. A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12). Forty-one lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit, and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years (SD 4.6), the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. Regarding QoL assessment of 44 patients (EG n = 27, NEG n = 14) attended the last follow-up. Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles. At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. The QoL comparison between eloquent and non-eloquent cavernomas created interesting and new data after prolonged follow-up. These results add value for decision-making as well as patient counseling for future encountered cases. Preoperative evaluation of QoL is recommended for future studies to assess QoL dynamics.