bluuebunny/crossref_metadata_2025_split huggingface dataset:
Formalism versus pragmatism – A comparative legal and empirical analysis of the German and Dutch criminal justice systems with regard to effectiveness and efficiency
Authors: Hofmann Robin 
Published: May 2021

The German and the Dutch criminal justice systems not only share a common legal history but also follow the inquisitorial tradition with the prosecution playing a strong role. Despite these commonalities, there are a number of remarkable differences between the two jurisdictions, particularly with a view to procedural law and legal practices. While the German criminal law is known for being formal and rather doctrinal, the Dutch system is strongly driven by pragmatism and efficiency. This efficiency has become an important factor for the progressing Europeanization of criminal law and increasingly influences German criminal procedural law. This article compares selected aspects of the Dutch and German criminal justice systems. While previous legal comparative studies of the two neighbouring countries have focused on substantive criminal law, this paper will mainly deal with procedural criminal law and prosecutorial practices. The emphasis will be on criminal justice effectiveness and efficiency. Some of the questions addressed are: what constitutes an efficient criminal justice system? How is efficiency defined and implemented in legal practice? A variety of indicators for criminal justice efficiency are proposed and applied to criminal proceedings, prosecutorial practices and the sentencing systems in both countries.
Depression, anxiety and stress among Swedish university students before and during six months of the COVID-19 pandemic: A cohort study
Authors: Johansson Fred , Côté Pierre , Hogg-Johnson Sheilah , Rudman Ann , Holm Lena w. , Grotle Margreth , Jensen Irene , Sundberg Tobias , Edlund klara , Skillgate Eva 
Published: May 2021

Aims: The COVID-19 pandemic has had a profound effect on societies and citizens worldwide, raising concerns about potential mental health impacts. We aimed to describe trajectories of depression, anxiety and stress symptoms during the COVID-19 outbreak compared to before the outbreak, and to determine if trajectories were modified by pre-pandemic loneliness, poor sleep quality and mental health problems. Methods: We conducted a cohort study with 1836 Swedish university students entering the study before 13 March 2020, the onset of the pandemic, with follow-ups within three (FU1) and six months (FU2) of the outbreak. Generalized Estimating Equations were used to estimate mean differences in symptom levels over time-periods, and to estimate potential effect modifications. Results: We found small differences in mean levels of the depression, anxiety and stress scale (DASS-21) over time. Compared to before the pandemic, depression increased by 0.25 points of 21 (95% CI: 0.04 to 0.45) at FU1 and decreased by 0.75/21 (95% CI:−0.97 to −0.53) at FU2. Anxiety decreased from baseline to FU1 by 0.09/21 (95% CI: −0.24 to 0.07) and by 0.77/21 (95% CI: −0.93 to −0.61) to FU2. Stress decreased from baseline to FU1 by 0.30/21 (95% CI: −0.52 to −0.09) and by 1.32/21 (95% CI: −1.55 to −1.09) to FU2. Students with pre-pandemic loneliness, poor sleep quality or pre-pandemic mental health problems did not have worse trajectories of mean mental health symptoms. Conclusions: Symptom levels were relatively stable during the first three months of the pandemic, while there was a slight decrease during the summer months, probably due to seasonality effects.
Investigations on spark pre-chamber ignition and subsequent turbulent jet main chamber ignition in a novel optically accessible test rig
Authors: Vera-Tudela Walter , Barro Christophe , Boulouchos Konstantinos 
Published: May 2021

Turbulent jet ignition (TJI) is a promising strategy to ignite diluted air-fuel mixtures; this is usually generated by igniting a fraction of the mixture inside a small pre-chamber. Nevertheless, the processes that take place inside the pre-chamber, as well as the injection of the turbulent jet into the main chamber and its subsequent re-ignition are not fully understood. The current work presents an experimental investigation that studies the effects of the nozzle size, turbulence level, and air-fuel mixture on the pre-chamber ignition and main chamber re-ignition and combustion. To accomplish this, a series of experiments have been carried out under different boundary conditions. To understand the phenomena taking place in the pre- and main chamber, two different approaches were taken: On one hand, (1) pressure-based diagnostics were applied by fitting a pressure sensor in each of the chambers. This was done to trace the pressure evolution during the whole combustion event and to calculate the heat-release. On the other hand, (2) optical diagnostics were setup on both combustion chambers, using dual schlieren setups synchronized at the same frame rate. The optically accessible test rig and the combination of schlieren in the pre-chamber (PC) & main-chamber (MC) allows to visualize the ignition, flame propagation, quenching mechanisms and re-ignition under a wide range of boundary conditions. This combined with the pressure traces and heat-release give a full understanding of the ignition and combustion processes. Higher turbulence levels and equivalence ratios increase the propagation of the flame front and the peak pressure in the pre-chamber. The resulting higher nozzle-exit velocities lead, on one hand, to faster mixing and therefore to a larger portion of main chamber fuel within the jet, which decrease the main chamber combustion duration. On the other hand, to high quenching and longer re-ignition times, which show the adverse effect.
Fenestrated and Branched Endovascular Aortic Repair of Thoracoabdominal Aortic Aneurysm With More Than 4 Target Visceral Vessels due to Renovisceral Arterial Anatomical Variations: Feasibility and Early Results
Authors: Eleshra Ahmed , Panuccio Giuseppe , Spanos Konstantinos , Rohlffs Fiona , Tsilimparis Nikolaos , Kölbel Tilo 
Published: May 2021

Purpose: This study describes technical success, feasibility, and early results of fenestrated and branched endovascular aortic repair (F/B-EVAR) for treatment of thoracoabdominal aortic aneurysms (TAAAs) or pararenal aneurysms with more than 4 target visceral vessels (TVs) due to renovisceral arterial anatomical variations. Materials and Methods: Patients with TAAAs or pararenal aortic aneurysms who had more than 4 TVs due to renovisceral arterial anatomical variations of renal, celiac, and/or superior mesenteric arteries and received F/B-EVAR between January 2017 and September 2019 at a single aortic center were included in this study. We analyzed technical success, feasibility, and early outcomes. Results: Twelve patients (mean age 70±10 years, 9 males) were included. The anatomical variations included 6 right accessory renal arteries, 8 left accessory renal arteries, and 1 celiac artery variant. Stent-grafts were fenestrated, branched or combined in 6, 5, or 1 patients, respectively. The mean operating time was 346±120 minutes, the mean fluoroscopy time was 80±29 minutes, and the mean radiation dose area product was 430±219 Gy·cm2. The mean contrast volume was 129±45 mL. The total number of TVs was 64; 5 TVs in 9 patients, 6 in 2 patients, and 7 in 1 patient. Technical success was achieved in all cases. The mean intensive care unit stay was 6±5 days, and the mean total hospital stay was 14±10 days. One patient died early (30-day). Early morbidities included respiratory complication in 1 patient, renal insufficiency in 1 patient, and wound infection in 2 patients. No spinal cord ischemia, stroke, or bowel ischemia occurred. Early computed tomography angiography showed 100% patency of the bridging covered stents and TVs. The mean follow-up was 13±4.3 months. No mortality or adverse major event occurred during the follow-up. Two patients with developed type Ic endoleak related to 1 right renal artery and 1 celiac artery covered stent. Patency of the TVs during follow-up was 100%. Conclusion: The use of F/B-EVAR for the treatment of TAAA with more than 4 TVs due to renovisceral arterial anatomical variations in our own experience is feasible and not related to increased morbidity and mortality.
MicroRNA-1253 Suppresses Cell Proliferation Migration and Invasion of Osteosarcoma by Targeting MMP9
Authors: Mo Jianwen , Zheng Tiansheng , Lei Li , Dai Peng , Liu Jun , He Huabin , Shi Jin , Chen Xi , Guo Tianting , Yuan Bin , Ji Guanglin 
Published: May 2021

Purpose: MicroRNAs play an important role in osteosarcoma (OS) development and progress. Although miR-1253 was considered as a tumor-inhibitor in some cancers, it’s function in the OS is not clear. Methods: In our study, we examined the expression of miR-1253 in OS cells and osteoblast cells using quantitative real-time PCR. The proliferation of OS cells was measured by BrdU assay, and we performed transwell to detect migration and invasion of OS cells. Meanwhile, EMT proteins were tested by western blot. We used Bioinformatics to predict the target genes of miR-1253 and found out Matrix metalloproteinases9 (MMP9) was one of that. The direct combination between miR-1253 and MMP9 was verified by double luciferase reporting experiment. Quantitative real-time PCR and western blot were used to detect the expression of MMP9. Results: We found that the expression level of miR-1253 in OS cells was significantly lower than that in osteoblast cells. Overexpression of miR-1253 could significantly inhibit OS cell proliferation, migration, invasion and EMT. And then, MMP9 was predicted as a downstream target of miR-1253 by Bioinformatics analysis. Further experiments showed that miR-1253 could reduce the protein level of MMP9 by directly binding to the 3’-UTR of MMP9. Afterward, we performed a rescue experiment, in which both MMP9 and miR-1253 were overexpressed. Compared with the groups overexpressed miR-1253 alone, cell proliferation, migration and invasion in co-overexpression groups were improved. Conclusions: In summary, these results suggested that miR-1253 down-regulated in OS cells, and could suppress the proliferation, migration and invasion of OS cells. Its molecular regulatory mechanism was that inhibits the expression of the downstream target gene MMP9 by directly binding, thus affect OS cell functions. Therefore, miR-1253 has the potential to become a biomarker and therapeutic target for OS therapy.
Sphygmomanometer-induced hemostasis following iatrogenic guidewire perforation during lower extremity angioplasty
Authors: Chait Jesse , Ostrozhynskyy Yuriy , Marks Natalie , Singh Nikita , Hingorani Anil , Ascher Enrico 
Published: May 2021

Objectives Iatrogenic guidewire perforation is a well-known complication of lower extremity angioplasty that is often benign or can be easily treated with endovascular techniques. However, perforations that occur in arterial side branches may be more challenging to manage. If bleeding persists, open surgery and fasciotomy may be required to evacuate the resulting hematoma and prevent compartment syndrome. These subsequent procedures increase morbidity and, if the angioplasty was performed in the outpatient setting, necessitate patient transfer to a hospital. To address these challenges, we describe a non-invasive hemostasis technique involving serial sphygmomanometer cuff inflations over the affected site in a series of five patients who experienced this complication at our office. Methods We retrospectively reviewed the medical records of consecutive patients undergoing lower extremity angioplasty that were found to have an arterial guidewire perforation on completion angiogram at our outpatient center between February 2012 and February 2017. Patients found to have iatrogenic guidewire perforations were administered intravenous protamine sulfate and were transferred to the surgical recovery room. Patients received ibuprofen or acetaminophen for pain management. A blood pressure cuff was placed around the site of perforation, and patients received serial cuff inflation cycles with repeated examinations of both limbs until patients reported cessation of pain and there were no signs of a developing hematoma. Patients were observed for two hours before they were discharged home. A follow-up duplex ultrasound examination was completed within one week of the intervention. Results Over the course of five years, 536 angioplasties were performed at our outpatient office. Five of these patients experienced iatrogenic guidewire perforation (0.93%). Perforations occurred in branches of the anterior or posterior tibial artery. All of these patients were successfully managed with the aforementioned hemostasis technique. None of these patients required transfer to a hospital for further management, and no complications were reported at follow-up. Conclusions Complications of iatrogenic guidewire perforations in lower extremity arterial side branches can be safely and effectively managed by applying external compression around the affected site with an automatic blood pressure cuff.
Trends in benzodiazepine receptor agonists use and associated factors in the Belgian general older population: analysis of the Belgian health interview survey data
Authors: Pétein Catherine , Spinewine Anne , Henrard Séverine 
Published: May 2021

Background: Benzodiazepine receptor agonists (BZRA), which include benzodiazepines and z-drugs, are commonly prescribed for insomnia and anxiety in older adults, and used often long term. Yet, the risk–benefit ratio of BZRA use in older adults may be unfavorable and many recommendations suggest avoidance or a maximal treatment duration of 4 weeks. The aim of this study was to describe trends of BZRA use in older adults and associated factors. Methods: Using data from the Belgian Health Interview Survey in 2004 ( n = 3594), 2008 ( n = 2917), and 2013 ( n = 2048), prevalence standardized for age, sex, and region were calculated to assess trends of BZRA use in people ⩾65 years. Analysis of associated factors to BZRA use was performed using a sub-sample of 2013 data for which variables assessing sleeping disorder and anxiety disorder were not missing ( n = 1286). Variables from seven main topics were explored using multivariate logistic regression: socio-demographic factors, geriatric factors, comorbidities, subjective health and mental health indicators, social health indicators, medication use and healthcare services use. Results: Overall, standardized prevalence of BZRA use decreased significantly between 2004 and 2013 [22% to 18%, prevalence difference (95% confidence interval, CI): −4.0% (−6.8; −1.3)]. Factors associated with BZRA use in multivariable analysis included female gender [adjusted odds ratio (aOR) (95%CI) : 1.62 (1.14; 2.29)], poor mental health [aOR (95%CI): 1.73 (1.13–2.63)] a fall in the past 12 months [aOR (95%CI): 1.52 (1.02; 2.26), reporting a sleeping disorder [aOR (95%CI): 1.92 (1.35; 2.72)], polypharmacy [aOR (95%CI): 2.51 (1.75; 3.60)], and trazodone use [aOR (95%CI): 4.05 (1.64; 10.21)]. Conclusion: Despite an encouraging decline observed from 2004 to 2013, BZRA use remained highly prevalent in Belgian older adults. Promotion of alternatives to BZRA in treatment of sleeping problems need to be continued. Among BZRA older users, women, the oldest (⩾85 years) and high-risk subgroups should be targeted in deprescribing interventions.
Exploring Occupational Health Professionals Understanding and Needs in Regard to Total Worker Health (TWH)
Authors: Olszewski Kimberly A. , Wolf Debra M. , Wenskovitch John 
Published: May 2021

Background: Occupational health professionals (OHPs) are in a unique position to impact the health and well-being of employees at work and outside of work. One way of achieving this holistic health goal is to integrate the concept of Total Worker Health® (TWH) into the organization’s culture. It is critical for OHPs to develop the ability to incorporate TWH into their practices, yet there are gaps in our understanding of OHP’s attitudes toward change and toward TWH, their level of TWH knowledge, and the number of OHPs who have adopted TWH. Methods: An electronic survey was administered to a national sample of 4,777. This cross-sectional study used Qualtrics to record survey responses measuring knowledge of TWH, attitude toward change, resistance to change, transformational leadership ability, perception of organizational readiness, and leadership commitment. Findings: The total sample size was 253 (5.3%). Most respondents were bachelors prepared nurses (75.1%) with greater than 10 years’ experience (71.5%) and employed in manufacturing (42.6%). Approximately 74% ( n = 125) of respondents knew about TWH, but did not have a program in place or were unsure of the existence of one. A high percentage (74.0%) were open to implementing TWH, had favorable attitudes toward change ( M = 3.9 on a 5-point Likert-type scale), but needed education on how to move forward (56.0%). Conclusions/Application to Practice: Findings suggest that most OHPs know about TWH, but generally have not adopted the TWH concept at their worksites. However, they are open to implementing TWH programs and have favorable attitudes toward change.
Do Adult Spinal Deformity Patients Undergoing Surgery Continue to Improve From 1-Year to 2-Years Postoperative?
Authors: Zuckerman Scott L. , Lai Christopher S. , Shen Yong , Cerpa Meghan , Lee Nathan J. , Kerolus Mena G. , Ha Alex S. , Buchanan Ian A. , Devin Clinton J. , Lehman Ronald A. , Lenke Lawrence G. 
Published: May 2021

Objective: Evaluate clinical improvement as measured by patient-reported outcomes (PROs) during the 1 to 2-year interval. Study Design: Retrospective Cohort. Methods: A single-institution registry of ASD patients undergoing surgery was queried for patients with ≥6 level fusions. Demographics and radiographic variables were collected. PROs collected were the ODI and SRS-22r scores at: preoperative, 1-year and 2-years. Outcome measures of clinical improvement during the 1-2 year time interval were: 1) group medians, 2) percent minimum clinically important difference (MCID), and 3) percent minimal symptom scale (MSS)(ODI < 20 or SRS-pain + function >8). Wilcoxon rank-sum tests, chi-squared tests, Kruskal-Wallis tests, and logistic regression were performed. Results: 157 patients undergoing ASD surgery with minimum of 1-year follow-up were included. Mean age was 53.2 and mean instrumented levels was 13.1. Preoperative alignment was: Neutral Alignment (NA) 49%, Coronal Malalignment (CM) 17%, Sagittal Malalignment (SM 17%), and Combined Coronal/Sagittal Malalignment (CCSM) 18%. Preoperative to 1-year, and preoperative to 2-years, all ODI/SRS-22r significantly improved ( P < .001). In all patients, the only significant improvement in PROs between 1-and 2-year postoperative were those reaching ODI MCID (69% 1-year vs. 84% 2-years; P < .001). Subgroup analysis: ≥55 years had an improved median ODI (18 vs. 8; P = .047) and an improved percent achieving ODI MCID (73% vs. 84%, P = .048). CCSM patients experienced significant improvement in SRS-appearance score (75% vs. 100%; P = .050), along with those with severe preoperative SM >7.5 cm (73% vs. 100%; P = .032). Conclusions: Most ASD patients experience the majority of PRO improvement by 1-year postoperative. However, subsets of patients that may continue to improve up to 2-years postoperative include patients ≥55 years, combined coronal/sagittal malalignment, and those with severe sagittal malalignment ≥7.5 cm.
Structural Barriers to Student Disability Disclosure in US-Allopathic Medical Schools
Authors: Meeks Lisa M , Case Ben , Stergiopoulos Erene , Evans Brianna K , Petersen Kristina H 
Published: May 2021

Introduction: Leaders in medical education have expressed a commitment to increase medical student diversity, including those with disabilities. Despite this commitment there exists a large gap in the number of medical students self-reporting disability in anonymous demographic surveys and those willing to disclose and request accommodations at a school level. Structural elements for disclosing and requesting disability accommodations have been identified as a main barrier for students with disabilities in medical education, yet school-level practices for student disclosure at US-MD programs have not been studied. Methods: In August 2020, a survey seeking to ascertain institutional disability disclosure structure was sent to student affairs deans at LCME fully accredited medical schools. Survey responses were coded according to their alignment with considerations from the AAMC report on disability and analyzed for any associations with the AAMC Organizational Characteristics Database and class size. Results: Disability disclosure structures were collected for 98 of 141 eligible schools (70% response rate). Structures for disability disclosure varied among the 98 respondent schools. Sixty-four (65%) programs maintained a disability disclosure structure in alignment with AAMC considerations; 34 (35%) did not. No statistically significant relationships were identified between disability disclosure structures and AAMC organizational characteristics or class size. Discussion: Thirty-five percent of LCME fully accredited MD program respondents continue to employ structures of disability disclosure that do not align with the considerations offered in the AAMC report. This structural non-alignment has been identified as a major barrier for medical students to accessing accommodations and may disincentivize disability disclosure. Meeting the stated calls for diversity will require schools to consider structural barriers that marginalize students with disabilities and make appropriate adjustments to their services to improve access.
Fabrication of microfluidic channel of polydimethylsiloxane using X-ray lithography and its surface nanostructuring
Authors: Mondal Puspen , Saundarkar Shweta , Khantwal Nitin , Tiwari Pragya , Srivastava A. K. 
Published: May 2021

The microfluidic devices have attracted considerable attention for their wide range of applications in healthcare, disease diagnosis, and environmental monitoring. We present the fabrication technique, surface wetting, and bonding of a polydimethylsiloxane (PDMS) microfluidic device that will be used as an electroosmotic micromixerfor biomolecules. This technique essentially requires micromold preparation and casting of PDMS. The hardened mold was fabricated on SU-8 using X-ray lithography (XRL) beamline, BL-7, Indus-2 as the synchrotron radiation source at Raja Ramanna Centre for Advanced Technology(RRCAT). The PDMS casting and thermal cross-linking was performed by spin-coating, followed by heating with specific thermocycle. This cross-linked PDMS was bonded with smooth surfaces that were treated with different reactive plasmas using a deep reactive-ion etching (DRIE) system. In a micro fluidic channel, the flow is usually a highly ordered laminar flow and due to lack of turbulence the mixing is very difficult for larger molecules such as peptides, proteins and high-molecular-weight nucleic acids. Here, we propose a microscale mixing device where active mixers are moved by external forces, such as an applied electric field. The dimensions of the fabricated device were generated through computer simulation using the finite-element based COMSOL Multiphysics 5. 4 software. The hydrophobic nature of PDMS hinders the mobility of biomolecules through the microchannel. In this work, plasma-induced surface wettability of PDMS with application of sulfur hexafluoride (SF6) and oxygen (O2) gas recipes was investigated. As a result, the SF6 plasma–treated microchannels became stable hydrophilic and exhibited an increased adhesion or reduced air-bubble trapping during filling with aqueous solutions.