bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy
Authors: Porcaro Antonio Benito , Rizzetto Riccardo , Amigoni Nelia , Tafuri Alessandro , Shakir Aliasger , Tiso Leone , Cerrato Clara , Antoniolli Stefano Zecchini , Lacola Vincenzo , Gozzo Alessandra , Odorizzi Katia , Orlando Rossella , Di Filippo Giacomo , Brunelli Matteo , Migliorini Filippo , De Marco Vincenzo , Artibani Walter , Cerruto Maria Angela , Antonelli Alessandro 
Published: June 2021

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.
Post San Antonio update—my top three abstracts!
Authors: Suppan Christoph 
Published: June 2021

SummaryRecent findings support the role of alpelisib in advanced HR-positive breast cancer harboring a PIK3CA mutation. A retrospective biomarker analysis on the intrinsic subtypes of HR-positive breast cancer reveals a subgroup that will not benefit under the addition of a CDK 4/6 inhibitor treatment. The detection of circulating tumor cells before start and during tumor treatment is associated with worse outcome in metastatic breast cancer patients.
Congestive heart failure and comorbidity as determinants of colorectal cancer perioperative outcomes
Authors: Basso Cristina , Gennaro Nicola , Dotto Matilde , Ferroni Eliana , Noale Marianna , Avossa Francesco , Schievano Elena , Aceto Paola , Tommasino Concezione , Crucitti Antonio , Incalzi Raffaele Antonelli , Volpato Stefano , Petrini Flavia , Carron Michele , Pace Maria Caterina , Bettelli Gabriella , Chiumiento Fernando , Corcione Antonio , Montorsi Marco , Trabucchi Marco , Maggi Stefania , Corti Maria Chiara 
Published: June 2021

AbstractThere has been an increase in surgical interventions in frailer elderly with concomitant chronic diseases. The purpose of this paper was to evaluate the impact of aging and comorbidities on outcomes in patients who underwent surgery for the treatment of colorectal cancer (CRC) in Veneto Region (Northeastern Italy). This is a retrospective cohort study in patients ≥ 40 years who underwent elective or urgent CRC surgical resection between January 2013 and December 2015. Independent variables included: age, sex, and comorbidities. We analyzed variables associated with the surgical procedure, such as stoma creation, hospitalization during the year before the index surgery, the surgical approach used, the American Society of Anesthesiologists (ASA) score, and the Charlson Comorbidity Index score. Eight thousand four hundred and forty-seven patients with CRC underwent surgical resection. Patient age affected both pre- and post-resection LOS as well as the overall survival (OS); however, it did not affect the 30-day readmission and reoperation rates. Multivariate analysis showed that age represented a risk factor for longer preoperative and postoperative LOS as well as for 30-day and 365-day mortality, but it was not associated with an increased risk of 30-day reoperation and 30-day readmission. Chronic Heart Failure increased the 30-day mortality risk by four times, the preoperative LOS by 51%, and the postoperative LOS by 33%. Chronic renal failure was associated with a 74% higher 30-day readmission rate. Advanced age and comorbidities require a careful preoperative evaluation and appropriate perioperative management to improve surgical outcomes in older patients undergoing elective or urgent CRC resection.
A River Flood and Earthquake Risk Assessment of Railway Assets along the Belt and Road
Authors: Wang Qianzhi , Liu Kai , Wang Ming , Koks Elco E. 
Published: June 2021

AbstractMitigating the disaster risk of transportation infrastructure networks along the Belt and Road is crucial to realizing the area’s high trade potential in the future. This study assessed the exposure and risk of existing and planned railway assets to river flooding and earthquakes. We found that about 9.3% of these railway assets are exposed to a one in 100 year flood event, and 22.3% are exposed to a one in 475 year earthquake event. The combined flood and earthquake risk of physical damage to railway assets, expressed by expected annual damage (EAD), is estimated at USD 1438 (between 966 and 2026) million. Floods contribute the majority of the risk (96%). China has the highest EAD for both floods and earthquakes (between USD 240 and 525 million in total). Laos and Cambodia are the countries with the highest EAD per km from flooding (USD 66,125–112,154 and USD 31,954–56,844 per km, respectively), while Italy and Myanmar have the highest EAD per km from earthquakes (USD 1000–3057 and USD 893–3019 per km, respectively). For the newly built and planned projects along the Belt and Road, the EAD is estimated at USD 271 (between 205 and 357) million. The China–Indochina Peninsula Economic Corridor and China–Pakistan Economic Corridor have the highest absolute EAD and EAD per km, with EADs reaching USD 95 and USD 67 million, and USD 18 and USD 17 thousand per km, on average, respectively. For railway segments with high risks, we found that if the required adaptation cost within 20 years to realize a 10% increase of the railway quality is below 8.4% of the replacement cost, the benefits are positive.
The system, the resident, and the preceptor: a&nbsp;curricular approach to continuity of care training
Authors: Merbaum Allyson , Kulasegaram Kulamakan , Stoller Rebecca , Fernando Oshan , Freeman Risa 
Published: June 2021

Background Continuity of care (CoC) is integral to the practice of comprehensive primary care, yet research in the area of CoC training in residency programs is limited. In light of distributed medical education and evolving accreditation standards, a rigorous understanding of the context and enablers contributing to CoC education must be considered in the design and delivery of residency training programs.
Approach At our preceptor-based community academic site, we developed a system—resident—preceptor (SRP) framework to explore factors that influence a resident’s perception regarding CoC, and established variables in each area to enhance learning. We then implemented a two-year educational SRP intervention (SRPI) to one cohort of residents and their preceptors to integrate critical education factors and align teaching of continuity of care within curricular goals.
Evaluation Evaluation of the intervention was based on resident interviews and faculty focus groups, and a qualitative phenomenological approach was used to analyze the data. While some factors identified are inherent to family medicine, the opportunity for reflection is a unique component to inculcate CoC learning.
Reflection The SRP innovation provides a unique framework to facilitate residents’ understanding and development of CoC competency. Our model can be applied to all residency programs, including traditional academic sites as well as distributed training sites, to enhance CoC education.
Association between hyperkalemia, RAASi non-adherence and outcomes in chronic kidney disease
Authors: Santoro Antonio , Perrone Valentina , Giacomini Elisa , Sangiorgi Diego , Alessandrini Davide , Degli Esposti Luca 
Published: June 2021

Abstract
Background
Hyperkalemia is relatively frequent in CKD patients treated with renin-angiotensin-aldosterone-system inhibitors (RAASi).

Aim
The aim of the present study was to estimate the increased risk of cardiovascular events and mortality due to sub-optimal adherence to RAASi in CKD patients with hyperkalemia.

Methods
An observational retrospective cohort study was conducted, based on administrative and laboratory databases of five Local Health Units. Adult patients discharged from the hospital with a diagnosis of CKD, who were prescribed RAASi between January 2010 and December 2017, were included. We evaluated the appearance of documented episodes of hyperkalemia, RAASi therapy adherence and the effects of these two variables on cardiovascular events, death and dialysis inception for study patients.

Results
Of the 9241 selected patients, 4451 met all the criteria for study inclusion. Among them, 1071 had at least one documented episode of hyperkalemia, while 3380 did not. After propensity score matching based on several variables we obtained 2 groups of patients. The appearance of hyperkalemia caused treatment discontinuation in 21.8% of patients previously on RAASi therapy, and sub-optimal adherence (proportion of days covered  < 80%) in 33.6% of them. Non-adherence to RAASi therapy among hyperkalemia patients was associated with a higher risk of cardiovascular events (hazard ratio [HR] 1.45, confidence interval [CI] 1.02–2.08; p < 0.05). Moreover, in non-adherent hyperkalemia patients, the risk of death increased by 126% (HR 2.26, CI 1.62–3.15; p < 0.001) compared with adherent patients.

Conclusions
In a large cohort of CKD patients treated with RAASi, we observed that following hyperkalemia onset, non-adherence to RAASi medication can result in an increased risk of cardiovascular events and death.

Graphical abstract
Die Soziale Marktwirtschaft nach der Corona-Krise: Fit für den Systemwettbewerb im 21. Jahrhundert
Authors: Schmidt Christoph M. 
Published: June 2021

ZusammenfassungDie Soziale Marktwirtschaft ist auch in Zeiten des verschärften Systemwettbewerbs mit den USA und China die geeignete Wirtschafts- und Gesellschaftsordnung für Deutschland und Europa, um die Volkswirtschaft auf einen nachhaltigen Wachstumspfad zu führen. Nur ein wirtschaftlich erfolgreiches Europa wird erfolgreich dabei mitwirken, das 21. Jahrhundert auf Basis der eigenen Werte als eine Ära der weltumspannenden materiellen Prosperität und ökologischen Nachhaltigkeit zu gestalten. Daher gilt es vor allem, die europäische Klimapolitik marktwirtschaftlich auszugestalten und die eigene Regeltreue und Vorbildlichkeit bei der Umsetzung globaler Vertragswerke mit hoher Bereitschaft zum Finanz- und Technologietransfer zu verbinden.
Elucidation of Regional Mechanical Properties of Brain Tissues Based on Cell Density
Authors: Zhang Chi , Qian Long , Zhao Hongwei 
Published: June 2021

AbstractResearch on the mechanical properties of brain tissue has received extensive attention. However, most of the current studies have been conducted at the phenomenological level. In this study, the indentation method was used to explore the difference in local mechanical properties among different regions of the porcine cerebral cortex. Further, hematoxylin-eosin and immunofluorescence staining methods were used to determine the correlation between the cellular density at different test points and mechanical properties of the porcine cerebral cortex. The frontal lobe exhibited the strongest viscosity. The temporal lobe displayed the lowest sensitivity to changes in the indentation speed, and the occipital lobe exhibited the highest shear modulus. Additionally, the shear modulus of different areas of the cerebral cortex was negatively correlated with the total number of local cells per unit area and positively correlated with the number of neuronal cell bodies per unit area. Exploration of the mechanical properties of the local brain tissue can provide basic data for the establishment of a finite element model of the brain and mechanical referential information for the implantation position of brain chips.
Synthesis and Characterization of Ordered Mesoporous MCM-41 From Natural Chlorite and its Application in Methylene Blue Adsorption
Authors: Wang Zhizeng , Zhao Qinyi , Wang Dongyun , Cui Chong 
Published: June 2021

AbstractMesoporous materials have a wide range of applications in the fields of nanotechnology, biotechnology, information technology, and medicine, but historically, the resource materials used for their synthesis have been expensive. Natural silicate minerals are characterized by their abundance, low cost, and large SiO2 contents, making them an alternative silicon source for mesoporous silica. The objective of the present study was to determine the utility of natural chlorite as the source of Si for synthesizing hexagonal mesoporous silica materials (MCM-41). The natural chlorite was pretreated by acid leaching and calcination, followed by a hydrothermal reaction with cetyltrimethylammonium bromide (CTAB) as the template, and subsequent calcination to prepare MCM-41. The structures and the porosity of MCM-41 were characterized by powder X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM), 29Si magic-angle spinning solid-state nuclear magnetic resonance spectroscopy (29Si MAS NMR), and N2 adsorption–desorption measurements. The mechanism of structural evolution from natural chlorite to MCM-41 was investigated using these techniques. Calcination of chlorite results in amorphization and partial structural breakdown, while subsequent acid leaching dissolves the Mg and Al in the octahedral sheets to leave the Si–O framework as a silicon source. 29Si MAS NMR results revealed that the ratio of Q4/Q3 increased from 0.91 to 1.21 after hydrothermal synthesis of MCM-41 from leached chlorite, demonstrating more polymerization of the Si–O structure in MCM-41. The final MCM-41 products were amorphous SiO2, with a large surface area of 630 m2/g, a pore volume of 0.46 mL/g, and a narrow pore-size distribution of 2.8 nm. MCM-41 showed favorable adsorption toward methylene blue (MB) with a monolayer adsorption capacity of up to 302 mg/g, indicating potential for application in adsorption.
PRENEX NORMAL FORM THEOREMS IN SEMI-CLASSICAL ARITHMETIC
Authors: FUJIWARA MAKOTO , KURAHASHI TAISHI 
Published: June 2021

AbstractAkama et al. [1] systematically studied an arithmetical hierarchy of the law of excluded middle and related principles in the context of first-order arithmetic. In that paper, they first provide a prenex normal form theorem as a justification of their semi-classical principles restricted to prenex formulas. However, there are some errors in their proof. In this paper, we provide a simple counterexample of their prenex normal form theorem [1, Theorem 2.7], then modify it in an appropriate way which still serves to largely justify the arithmetical hierarchy. In addition, we characterize a variety of prenex normal form theorems by logical principles in the arithmetical hierarchy. The characterization results reveal that our prenex normal form theorems are optimal. For the characterization results, we establish a new conservation theorem on semi-classical arithmetic. The theorem generalizes a well-known fact that classical arithmetic is
$\Pi _2$
-conservative over intuitionistic arithmetic.
The African Adoption of the Portuguese Crusade during the Fifteenth and Sixteenth Centuries
Authors: Simmons Adam 
Published: June 2021

AbstractThe Portuguese engagement with the continent of Africa following the conquest of Ceuta in 1415 was framed, among numerous conditions, as a crusade (Portuguese: cruzada). However, crusading influences on Portuguese expansion are often sidelined in favour of economic motives. Unlike North and north-east Africa's connected histories with the Crusades (1095–1291) and the continual role of crusading in the following centuries, the fifteenth century offered a new arena. Kongo's adoption of Christianity in the late fifteenth century was the first time that an African power can be viewed as engaging in crusading ideology as a Latin Christian power. Significantly, Kongo was converted by Portuguese missionaries who were undertaking their own crusade. Yet, the crusading influence on Kongo's early development of its Christianity has hitherto been overlooked in Africanist scholarship. Similarly, the situation in Kongo remains a lacuna in Crusades scholarship too. This article calls for a closer discussion between the histories of Africa and the Crusades through the case of Kongo and comparative African examples, such as Benin and Ndongo, to highlight the need to better connect these histories.
The Evolution of Tunisian Salafism after the Revolution: FromLa Maddhabiyyato Salafi-Malikism
Authors: Merone Fabio , Blanc Théo , Sigillò Ester 
Published: June 2021

AbstractWhat shape does Salafism take in Tunisia after the ban of the Salafi-Jihadi group Ansar al-Shari‘a and the wave of securitization carried out by national authorities? This article argues that a constraining legal context put Salafism's doctrinal rigidity in tension with its survival and ultimately prompted a residual current of Salafi actors to accommodate their stance toward Malikism, the prevalent school (madhhab) in the country. This adaptation is at odds with contemporary Salafism, which traditionally dismisses all four law schools (lā madhabiyya), rejects their blind imitation (taqlῑd), and claims the superiority of the Qur'an, hadith, and consensus of thesalaf(pious predecessors) over jurisprudence (fiqh). To account for this puzzle, this article scrutinizes the historical development of Salafism and the evolution of its stance toward Malikism across three generational waves. It notably shows how religious securitization associated with the promotion of a “moderate” Islam pushed Salafi actors to redefine their ideology to preserve their preaching and teaching activities. We call Salafi-Malikism the outcome of this adaptive strategy. Drawing on the Tunisian case, we argue that, despite its purist claims, Salafism is not an immutable religious current, but can take different trajectories to survive in constraining environments.
Model-based yield gap analysis and constraints of rainfed sorghum production in Southwest Ethiopia
Authors: Habte Abera , Worku Walelign , Gayler Sebastian , Ayalew Dereje , Mamo Girma 
Published: June 2021

AbstractFor ensuring food demand of the fast growing population in developing countries, quantification of crop yield gaps and exploring production constraints are very crucial. Sorghum is one of the most important climate change resilient crops in the rainfed farming systems of semi-arid tropics. However, there is little information about yield gaps and production constraints. This study aimed at analysing existing yield gaps and exploring major constraints of sorghum production in Southwest Ethiopia. A crop simulation model approach using AquaCrop and DSSAT was used to estimate potential yield and analyse the yield gaps. Model calibration and evaluation was performed using data from field experiments conducted in 2018 and 2019. Sorghum production constraints were assessed using a survey. The actual and water-limited yield of sorghum ranged from 0.58 to 2.51 and 3.6 to 6.47 t/ha, respectively for the period 2003–17. The regional yield gaps of sorghum for the targeted period were 3.02–3.95 t/ha with a mean value of 3.51 t/ha. Majority of respondent farmers considered seasonal rainfall risk (98%), poor soil fertility (86%), lack of improved varieties (78%) and inadequate weed management (56%) as major factors responsible for the existing yield gaps. The mean exploitable yield gap (2.5 t/ha) between water-limited and actual yield showed the level of existing opportunity for improvement in the actual productivity of sorghum. The gaps also call for introduction of proper interventions such as adoption of improved varieties, planting date adjustment, conservation tillage, fertilizer application and on time weed management.
Improving the monitoring of conservation programmes: lessons from a grant-making initiative for threatened species
Authors: Badalotti Alessandro , van Galen Laura , Vié Jean-Christophe , Stephenson P. J. 
Published: June 2021

AbstractMany conservation projects have weak capacity to monitor their target species and the threats they face, compromising adaptive management. We assessed 74 vertebrate and plant conservation projects worldwide that were supported by the SOS–Save Our Species Programme (now IUCN Save Our Species) during 2012–2015. Our aim was to determine how and where monitoring efforts were focused, identify trends in data availability and make recommendations for improvement. Project managers reported more of a decrease in threats (73%) and improved habitat conditions (68%) than positive population changes (19%), primarily because of the focus of their objectives and limited time to collect population data. More population data were collected on reptiles and amphibians than mammals and birds, contrary to global trends. This probably reflects a greater focus of mammal and bird projects on improving habitats or reducing threats. There were geographical differences in data availability. Lessons learnt that could be applied to future project portfolios include: a common strategic framework should be developed, along with a set of common indicators against which projects can align and demonstrate their contributions; more guidance and capacity building support should be provided to grantees; and a greater allocation of project budgets should be dedicated to monitoring.
A coin hoard from Ayasuluk and the arrival of silver gigliati from Mediterranean Europe in early 14th-century western Anatolia
Authors: Baker Julian , Pancar Lale 
Published: June 2021

AbstractIn 1972 a hoard of eight fine silver coins was discovered in or near the baptistery of the basilica of St John in Ayasuluk. It is now conserved at the Ephesus Archaeological Museum in Selçuk. The coins were minted in southern France, southern Italy and on the island of Rhodes, between ca AD 1303 and 1319 or perhaps a little later. Accordingly, a concealment date of ca 1320 or a bit later is proposed. While the currency which they represent (the gigliato) is well known from other finds of the area, the present hoard is relatively early and from a particularly significant location. This currency found great success in commercial contexts in the eastern Aegean and western Anatolia during the period ca 1325 to ca 1370. By contrast, this study reveals two initial phases in the establishment and further dissemination of the gigliato in a concentrated part of western Anatolia, one in 1304 and another before and after ca 1317. On both occasions the Catalans were instrumental in shaping these processes: initially as conquerors on behalf of the Byzantine emperors and then, from their new base in Greece, as allies of the Aydinogullari rulers of Ayasuluk. Additionally, it is proposed that this new gigliato currency might have been minted at Rhodes from the summer of 1319, after which it rapidly reached the Ephesus area in a military context.