bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity and reliability of a wearable-controlled serious game and goniometer for telemonitoring of wrist fracture rehabilitation
Authors: Meijer Henriëtte A. W. , Graafland Maurits , Obdeijn Miryam C. , Schijven Marlies P. , Goslings J. Carel 
Published: April 2021

Abstract
Purpose
To determine the validity of wrist range of motion (ROM) measurements by the wearable-controlled ReValidate! wrist-rehabilitation game, which simultaneously acts as a digital goniometer. Furthermore, to establish the reliability of the game by contrasting ROM measurements to those found by medical experts using a universal goniometer.

Methods
As the universal goniometer is considered the reference standard, inter-rater reliability between surgeons was first determined. Internal validity of the game ROM measurements was determined in a test–retest setting with healthy volunteers. The reliability of the game was tested in 34 patients with a restricted range of motion, in whom the ROM was measured by experts as well as digitally. Intraclass-correlation coefficients (ICCs) were determined and outcomes were analyzed using Bland–Altman plots.

Results
Inter-rater reliability between experts using a universal goniometer was poor, with ICCs of 0.002, 0.160 and 0.520. Internal validity testing of the game found ICCs of − 0.693, 0.376 and 0.863, thus ranging from poor to good. Reliability testing of the game compared to medical expert measurements, found that mean differences were small for the flexion–extension arc and the radial deviation-ulnar deviation arc.

Conclusion
The ReValidate! game is a reliable home-monitoring device digitally measuring ROM in the wrist. Interestingly, the test–retest reliability of the serious game was found to be considerably higher than the inter-rater reliability of the reference standard, being healthcare professionals using a universal goniometer.

Trial registration number
(internal hospital registration only) MEC-AMC W17_003 #17.015.
Advanced MR techniques in glioblastoma imaging—upcoming challenges and how to face them
Authors: Auer Timo A. 
Published: April 2021

Key Points• The management of gliomas has changed dramatically since the presentation of the revised WHO Classification of Tumors of the Central Nervous System in 2016 emphasizing the tumor heterogeneity based on their molecular profile.• The need for a more noninvasive characterization of glioblastomas (GBM) by establishing reliable imaging biomarkers to predict patient outcome and improve therapy monitoring is bigger than ever.• Multiparametric MRI, including promising newer techniques like electrical property tomography and mapping, may have the potential to provide enough information for intelligent imaging postprocessing algorithms to face the challenge by decoding GBM heterogeneity noninvasively.
Population dynamics and genotypic richness of threatened Acropora species and their hybrid in the U.S. Virgin Islands
Authors: Nylander-Asplin Hannah F. , Hill Ronald L. , Doerr Jennifer C. , Greer Lisa , Fogarty Nicole D. 
Published: April 2021

AbstractAcropora cervicornisandA. palmatahave experienced substantial losses in coral cover throughout the Caribbean, but their hybrid (A. prolifera) appears to be increasing at some sites. The shifts in relative abundance could result from hybridization with subsequent asexual fragmentation, recent increased hybridization, or a disproportionate loss in the parental species. Here, acroporid taxa from three U.S. Virgin Islands sites were genotyped revealing 35 hybrid genotypes, suggesting multiple hybridization events. Genotypic richness inA. cervicornis(0.62),A. prolifera(0.64), andA. palmata(0.68) was not significantly different across sites. To further explore acroporid dynamics at these sites, we analyzed existing photo transects from 2009 to 2017 to reveal significant losses ofA. cervicornisbut stable hybrid percent cover. High genotypic richness and stable populations suggest acroporid hybrids may become the primary shallow reef-builders in some locations previously occupied by the parental species.
Passive flow control mechanisms with bioinspired flexible blades in cross-flow tidal turbines
Authors: Hoerner Stefan , Abbaszadeh Shokoofeh , Cleynen Olivier , Bonamy Cyrille , Maître Thierry , Thévenin Dominique 
Published: April 2021

Abstract
State-of-the-art technologies for wind and tidal energy exploitation focus mostly on axial turbines. However, cross-flow hydrokinetic tidal turbines possess interesting features, such as higher area-based power density in array installations and shallow water, as well as a generally simpler design. Up to now, the highly unsteady flow conditions and cyclic blade stall have hindered deployment at large scales because of the resulting low single-turbine efficiency and fatigue failure challenges. Concepts exist which overcome these drawbacks by actively controlling the flow, at the cost of increased mechatronical complexity. Here, we propose a bioinspired approach with hyperflexible turbine blades. The rotor naturally adapts to the flow through deformation, reducing flow separation and stall in a passive manner. This results in higher efficiency and increased turbine lifetime through decreased structural loads, without compromising on the simplicity of the design.

Graphic abstract
A Comparison of Reliability Coefficients for Ordinal Rating Scales
Authors: de Raadt Alexandra , Warrens Matthijs J. , Bosker Roel J. , Kiers Henk A. L. 
Published: April 2021

AbstractKappa coefficients are commonly used for quantifying reliability on a categorical scale, whereas correlation coefficients are commonly applied to assess reliability on an interval scale. Both types of coefficients can be used to assess the reliability of ordinal rating scales. In this study, we compare seven reliability coefficients for ordinal rating scales: the kappa coefficients included are Cohen’s kappa, linearly weighted kappa, and quadratically weighted kappa; the correlation coefficients included are intraclass correlation ICC(3,1), Pearson’s correlation, Spearman’s rho, and Kendall’s tau-b. The primary goal is to provide a thorough understanding of these coefficients such that the applied researcher can make a sensible choice for ordinal rating scales. A second aim is to find out whether the choice of the coefficient matters. We studied to what extent we reach the same conclusions about inter-rater reliability with different coefficients, and to what extent the coefficients measure agreement in a similar way, using analytic methods, and simulated and empirical data. Using analytical methods, it is shown that differences between quadratic kappa and the Pearson and intraclass correlations increase if agreement becomes larger. Differences between the three coefficients are generally small if differences between rater means and variances are small. Furthermore, using simulated and empirical data, it is shown that differences between all reliability coefficients tend to increase if agreement between the raters increases. Moreover, for the data in this study, the same conclusion about inter-rater reliability was reached in virtually all cases with the four correlation coefficients. In addition, using quadratically weighted kappa, we reached a similar conclusion as with any correlation coefficient a great number of times. Hence, for the data in this study, it does not really matter which of these five coefficients is used. Moreover, the four correlation coefficients and quadratically weighted kappa tend to measure agreement in a similar way: their values are very highly correlated for the data in this study.
Testicular cancer follow-up costs in Germany from 2000 to 2015
Authors: Michaeli Thomas , Michaeli Julia , Michaeli Daniel 
Published: April 2021

Abstract
Purpose
Advances in testicular cancer screening and therapy increased 10-year survival to 97% despite a rising incidence; eventually expanding the population of survivors requiring follow-up. We analyzed 10-year follow-up costs after testicular cancer treatment in Germany during 2000, 2008, and 2015.

Methods
Testicular cancer follow-up guidelines were extracted from the European Association of Urology. Per patient costs were estimated with a micro-costing approach considering direct and indirect medical expenses derived from expert interviews, literature research, and official scales of tariffs. Three perspectives covering costs for patients, providers, and insurers were included to estimate societal costs. Cost progression was compared across cancer histology, stage, stakeholders, resource use, and follow-up years.

Results
Mean 10-year follow-up costs per patient for stage I seminomatous germ-cell tumors (SGCT) on surveillance declined from EUR 11,995 in 2000 to EUR 4,430 in 2015 (p < 0.001). Advanced SGCT spending shrank from EUR 13,866 to EUR 9,724 (p < 0.001). In contrast, expenditure for stage II SGCT increased from EUR 7,159 to EUR 9,724 (p < 0.001). While insurers covered 32% of costs in 2000, only 13% of costs were reimbursed in 2015 (p < 0.001). 70% of SGCT follow-up resources were consumed by medical imaging (x-ray, CT, ultrasound, FDG-PET). Spending was unevenly distributed across follow-up years (years 1–2: 50%, years 3–5: 39%, years 5–10: 11%).

Conclusions
The increasing prevalence of testicular cancer survivors caused German statutory insurers to cut per patient cost by up to 80% by budgeting services and decreasing reimbursement rates. The economic burden was gradually redistributed to patients and providers.
The adult orthodontic patient over 40 years of age: association between periodontal bone loss, incisor irregularity, and increased orthodontic treatment need
Authors: Meyer-Marcotty Philipp , Klenke Daniela , Knocks Larissa , Santander Petra , Hrasky Valentina , Quast Anja 
Published: April 2021

Abstract
Objectives
Adult orthodontic treatment, especially in patients over 40 years, is steadily increasing. One causal factor for the treatment need in this age group is periodontal breakdown. The aim of this study was to detect correlations between periodontal problems and orthodontic parameters in interdisciplinary patients.

Methods
This observational, cross-sectional study included 118 patients over 40 years (51 men/67 women; mean age, 58.03 years) classified into three groups according to periodontal breakdown (group I, controls; group II, moderate periodontitis; group III, severe periodontitis). Clinical periodontal and orthodontic parameters as well as the index of orthodontic treatment need (IOTN) were assessed and compared between the groups.

Results
A gradual deterioration of all periodontal and orthodontic parameters according to periodontal bone loss (lowest values in group I; highest values in group III) was observed. Especially groups I and III differed significantly regarding the overjet (p < 0.001) and the little indices of the maxilla (p < 0.001) and mandible (p < 0.010). The IOTN was highest in group III: 90% of the patients with severe periodontitis were classified to have moderate to very great treatment need.

Conclusions
The higher the degree of periodontal breakdown was, the more severe were overjet, overbite, irregularity of the anterior teeth, and the orthodontic treatment need.

Clinical relevance
Adult patients over 40 years represent a challenge for an orthodontic/periodontal treatment approach with high incidence of pathologic tooth migration, orthodontic treatment need, and periodontal breakdown. Therefore, this special patient collective requires a focus in clinical orthodontics and research.
A systematic review of shared decision making interventions in child and youth mental health: synthesising the use of theory, intervention functions, and behaviour change techniques
Authors: Hayes Daniel , Edbrooke-Childs Julian , Town Rosa , Wolpert Miranda , Midgley Nick 
Published: April 2021

AbstractReviews around interventions to improve shared decision making (SDM) for child and youth mental health have produced inconclusive findings on what approaches increase participation. Importantly, the previous reviews did not explore the use of theory, as well as mechanisms of change (intervention functions) and active units of change (behaviour change techniques). The aim of this review was to explore these factors and ascertain how, if at all, these contribute to SDM. Five databases were searched up until April 2020. Studies met inclusion criteria if they were: (a) an intervention to facilitate SDM; (b) aimed at children, adolescence, or young people aged up to 25, with a mental health difficulty, or their parents/guardians; and (c) included a control group. Data were extracted on patient characteristics, study design, intervention, theoretical background, intervention functions, behaviour change techniques, and SDM. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Eight different interventions met inclusion criteria. The role of theory to increase SDM remains unclear. Specific intervention functions, such as ‘education’ on SDM and treatment options and ‘environmental restructuring’ using decision aids, are being used in SDM interventions, as well as ‘training’ for clinicians. Similarly, behaviour change techniques linked to these, such as ‘adding objects to the environment’, ‘discussing pros/cons’, and clinicians engaging in ‘behavioural practice/rehearsal’. However, as most studies scored low on the quality assessment criteria, as well as a small number of studies included and a low number of behaviour change techniques utilised, links between behaviour change techniques, intervention functions and increased participation remain tentative. Intervention developers and clinicians may wish to consider specific intervention functions and behaviour change techniques to facilitate SDM.
Scene Walk: a non-photorealistic viewing tool for first-person video
Authors: Wang Xiaomeng , Blackwell Alan F. , Jones Richard , Nguyen Hieu T. 
Published: April 2021

AbstractScene Walk is a video viewing technique suited to first-person video recorded from wearable cameras. It integrates a 2D video player and visualisation of the camera trajectory into a non-photorealistic partial rendering of the 3D environment as reconstructed from image content. Applications include forensic analysis of first-person video archives, for example as recorded by emergency response teams. The Scene Walk method is designed to support the viewer’s construction and application of a cognitive map of the context in which first-person video was captured. We use methods from wayfinding research to assess the effectiveness of this non-photorealistic approach in comparison to actual physical experience of the scene. We find that Scene Walk does allow viewers to create a more accurate and effective cognitive map of first-person video than is achieved using a conventional video browsing interface and that this model is comparable to actually walking through the original environment.
Removal of sacral neuromodulation quadripolar tined-lead using a straight stylet: description of a surgical technique
Authors: Agnello M. , Vottero M. , Bertapelle P. 
Published: April 2021

Abstract
Background
Up to 7.5% of tined-lead removals in patients having sacral neuromodulation (SNM) therapy are associated with a lead breakage. It is still unclear what adverse effects can be caused by unretrieved fragments. The aim of our study was to describe the lead removal technique we have been using for the last 2 years in our centre.

Methods
We retrospectively enrolled patients who had lead removal between January 2018 and January 2020 using our standardized technique. The novelty of the technique is in the use of the straight stylet, which is available in the quadripolar tined-lead kit. The stylet gives the electrode greater stiffness, reducing interactions with surrounding tissues and probability of damage or breakage during removal.

Results
In 59 patients (42 women, mean age 57.2 years [range 40–79 years]) the lead was removed using our standardized technique. In 44 of 59 patients, the tined-lead was removed within 2 months from the SNM-test, due to lack of beneficial effects. In 15 patients the electrode was removed because of failure of definitive implantation. Meantime from definitive implantable pulse generator (IPG) implantation to lead removal was 67.9 months. We recorded only 1 case of lead-breakage during removal: a female patient with a non-tined lead fixed on sacral bone, placed 18 years previously using an open technique.

Conclusions
Lead breakage during removal is not uncommon and adverse effects of retained fragments may occur. Our technique has been safely used for the last 2 years in our centre, with no episodes of lead breakage or retained fragments, except for one non-tined electrode.
“It's Not Just in My Head, and It's Not Just Irrelevant”: Autistic Negotiations of Menopausal Transitions
Authors: Karavidas Marianna , de Visser Richard O. 
Published: April 2021

AbstractPhysical and psychological changes during menopause can be especially tumultuous for autistic people: difficulties with sensory sensitivity and daily functioning may be exacerbated. Through individual interviews, we examined the language used by seven peri- or post-menopausal autistic people to construct their experiences, and to consider the implications for their wellbeing and identities. Our analysis, which utilised thematic decomposition, yielded three discursive themes. The theme “Uncertainty about Changes” addressed how limited awareness and understanding of menopause combined with difficulties recognising internal states. However, with “Growing Self-Awareness and Self-Care”, some participants made conscious efforts to resist negative societal constructions of both autism and menopause. The theme “Navigating Support Options” addressed the interpersonal and systemic barriers participants faced when seeking support. There is a need for accessible information for autistic people experiencing menopause, and greater professional awareness.
Management of sepsis and septic shock in the emergency department
Authors: Gavelli Francesco , Castello Luigi Mario , Avanzi Gian Carlo 
Published: April 2021

AbstractEarly management of sepsis and septic shock is crucial for patients’ prognosis. As the Emergency Department (ED) is the place where the first medical contact for septic patients is likely to occur, emergency physicians play an essential role in the early phases of patient management, which consists of accurate initial diagnosis, resuscitation, and early antibiotic treatment. Since the issuing of the Surviving Sepsis Campaign guidelines in 2016, several studies have been published on different aspects of sepsis management, adding a substantial amount of new information on the pathophysiology and treatment of sepsis and septic shock. In light of this emerging evidence, the present narrative review provides a comprehensive account of the recent advances in septic patient management in the ED.
Evaluation of Histopathological Risk Model in a Cohort of Oral Squamous Cell Carcinoma Patients Treated with Accompanying Neck Dissection
Authors: Rahman N. , Conn B. 
Published: April 2021

AbstractTo investigate the applicability of the validated histological risk model in a cohort of oral cavity squamous cell carcinoma patients treated concurrently with neck dissections. Primary tumours from 85 patients with primary excision of T1 and T2 Oral Squamous Cell Carcinomas (TNM 7th edition) including neck dissection were scored by three pathologists in consensus according to the validated risk model. The risk score data, along with traditional dataset values, were analysed to determine possible association with nodal metastasis and extracapsular spread. Seventy-two patients (54%) were classified with low or intermediate risk and 62 (46%) patients were ‘high risk’. A chi squared test showed that cases with nodal metastasis were highly statistically significant with the overall risk model score (X2 = 22.62 p = 0.0001). None of the neck dissections from tumours with low risk score showed evidence of metastasis (NPV = 100%) suggesting the risk score may also be a useful tool for predicting an absence of metastasis. Risk assessment of low-stage oral squamous cell carcinoma primary tumours may be predictive of the presence or absence of metastasis at presentation. Knowledge of the risk score and its constituent parts may inform treatment decisions at multidisciplinary meetings. Low risk squamous cell carcinoma may be a rare variant with low metastatic potential and excellent long-term survival.
Effect of glutamic acid foliar applications on lettuce under water stress
Authors: Franzoni Giulia , Cocetta Giacomo , Ferrante Antonio 
Published: April 2021

AbstractThe yield and quality of leafy vegetables can be compromised by reduced water availability. Glutamic acid is involved in different biological processes and among them it plays an important role in chlorophyll and proline biosynthesis. The aim of this work was to evaluate the possible efficacy of glutamic acid in counteracting water stress in romaine lettuce. Lettuce plants were grown in pots filled with substrate and subjected to water deprivation. A glutamic acid solution (1.9 mM) was applied as foliar treatment, both in stressed and non-stressed plants. The effect of the treatment was evaluated at different time points during the experiment in order to evaluate changes at a molecular, physiological, biochemical and agronomic level. Yield was reduced by 35% in stressed plants, while no significant changes in quality parameters were observed, except for nitrate content, which increased under water stress. At a molecular level, the expression of genes encoding for ROS scavenging enzymes was monitored but, apparently, glutamic acid did not significantly prevent the water stress response. Slightly positive effects deriving from glutamic acid application were found for nitrate and proline contents, suggesting that a possible mode of action of glutamic acid would involve a role for these molecules. Further studies are required, also on other crop species, for confirming these results. Different concentrations and application modes should be also tested.