bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thymic origins of autoimmunity—lessons from inborn errors of immunity
Authors: Bacchetta Rosa , Weinberg Kenneth 
Published: February 2021

AbstractDuring their intrathymic development, nascent T cells are empowered to protect against pathogens and to be operative for a life-long acceptance of self. While autoreactive effector T (Teff) cell progenitors are eliminated by clonal deletion, the intrathymic mechanisms by which thymic regulatory T cell (tTreg) progenitors maintain specificity for self-antigens but escape deletion to exert their regulatory functions are less well understood. Both tTreg and Teff development and selection result from finely coordinated interactions between their clonotypic T cell receptors (TCR) and peptide/MHC complexes expressed by antigen-presenting cells, such as thymic epithelial cells and thymic dendritic cells. tTreg function is dependent on expression of the FOXP3 transcription factor, and induction of FOXP3 gene expression by tTreg occurs during their thymic development, particularly within the thymic medulla. While initial expression of FOXP3 is downstream of TCR activation, constitutive expression is fixed by interactions with various transcription factors that are regulated by other extracellular signals like TCR and cytokines, leading to epigenetic modification of the FOXP3 gene. Most of the understanding of the molecular events underlying tTreg generation is based on studies of murine models, whereas gaining similar insight in the human system has been very challenging. In this review, we will elucidate how inborn errors of immunity illuminate the critical non-redundant roles of certain molecules during tTreg development, shedding light on how their abnormal development and function cause well-defined diseases that manifest with autoimmunity alone or are associated with states of immune deficiency and autoinflammation.
Effect of liquid elasticity on the behaviour of high-speed focused jets
Authors: Franco-Gómez A. , Onuki H. , Yokoyama Y. , Nagatsu Y. , Tagawa Y. 
Published: February 2021

AbstractWe investigate the effect of highly contrasting non-Newtonian liquid properties on the formation of liquid jets with a focused shape. By using two nozzle-free ejection techniques, mechanically impact- and laser-induced, fast jets of a highly elastic (sodium polyacrylate) and weakly elastic (xanthan-gum) diluted polymer solutions are generated. A unique high-speed effect is encountered at the jet ejection onset of the highly elastic solution. Its jet-tip speed is on average 1.4 times faster in comparison to a Newtonian (glycerin/water) and the weakly elastic liquids. We explain this effect occurring as a result of the high viscoelasticity of the sodium polyacrylate solution. Additionally, a ‘bungee jumper’ jet behaviour (Morrison and Harlen in Rheol Acta 49(6):619–632, 2010) is observed in a regime of high speed ($$10<V_j<40$$

10
<

V
j

<
40

m/s) and high viscosity ($$\mu >20$$

μ
>
20

mPa s) not previously examined. We additionally characterise the viscoelastic non-breakup jet limit using the Bazilevskii et al. (Fluid Dyn 40(3):376–392, 2005) ejection criterion. Herein, the extensional rheological parameters are measured implementing a novel DoS-CaBER technique (Dinic et al. in Lab Chip 17(3):460–473, 2017). Our findings may influence results of inkjet printing technologies and recent nozzle-free ejection systems for ejecting liquids with non-Newtonian properties.
Graphical abstract
Prognostic significance of diastolic blood pressure in patients with heart failure with preserved ejection fraction
Authors: Fuchida Aya , Suzuki Sho , Motoki Hirohiko , Kanzaki Yusuke , Maruyama Takuya , Hashizume Naoto , Kozuka Ayako , Yahikozawa Kumiko , Kuwahara Koichiro 
Published: February 2021

AbstractAlthough systolic blood pressure (SBP) is routinely considered when treating acute heart failure (HF), diastolic blood pressure (DBP) is hardly been assessed in the situation. There are no previous studies regarding the predictive value of DBP in elderly patients with HF with preserved ejection fraction (HFpEF) in Japan. This study aimed to investigate the prognostic significance of DBP in patients with acute decompensated HFpEF. We analyzed data of all HFpEF patients admitted to Shinonoi General Hospital for HF treatment between July 2016 and December 2018. We excluded patients with acute coronary syndrome and severe valvular disease. Patients were divided into two groups according to their median DBP; the low DBP group (DBP ≤ 77 mmHg,n = 106) and the high DBP group (DBP > 77 mmHg,n = 100). The primary outcome was HF readmission. In 206 enrolled patients (median 86 years), during a median follow-up of 302 days, the primary outcome occurred in 48 patients. The incidence of HF readmission was significantly higher in the low DBP group (33.0% vs 18.5%,p = 0.024). In Kaplan–Meier analysis, low DBP predicted HF readmission (Log-rank test,p = 0.013). In Cox proportional hazard analysis, low DBP was an independent predictor of HF readmission after adjustment for age, sex, SBP, hemoglobin, serum albumin, serum creatinine, B-type natriuretic peptide, renin-angiotensin system inhibitors, calcium channel blockers, left ventricular ejection fraction, coronary artery disease, and whether they live alone (hazard ratio, 2.229; 95% confidence interval, 1.021–4.867;p = 0.044). Low DBP predicted HF readmission in patients with HFpEF.
Pulmonary hypertension in extremely preterm infants: a call to standardize echocardiographic screening and follow-up policy
Authors: Arjaans Sanne , Zwart Elvira. A. H. , Roofthooft Marc , Kooi Elisabeth M. W. , Bos Arend F. , Berger Rolf M. F. 
Published: February 2021

AbstractPulmonary hypertension (PH) is a frequent complication in extremely preterm born infants that seriously affects outcome. We aimed to describe the prevalence of PH in extremely preterm infants and the policy on screening and follow-up in the ten Dutch intensive care units (NICUs). We performed a retrospective cohort study at the University Medical Centre Groningen on infants with gestational age < 30 weeks and/or birthweight < 1000 g, born between 2012 and 2013. Additionally, we carried out a survey among the Dutch NICUs covering questions on the awareness of PH, the perceived prevalence, and policy regarding screening and following PH in extremely preterm infants. Prevalence of early-onset PH in our study was 26% and 5% for late-onset PH. PH was associated with poor survival and early-onset PH was associated with subsequent development of bronchopulmonary dysplasia (BPD). All the NICUs completed the questionnaire and we found that no standardized policy existed regarding screening and following PH in extremely preterm infants.Conclusion: Despite the frequent occurrence of PH and its clinically important consequences, (inter-)national standardized guidelines regarding screening and following of PH in extremely preterm infants are lacking. Standardizing screening and follow-up will enable early identification of infants with late-onset PH and allow for earlier treatment. Additionally, greater clarity is required regarding the prevalence of early PH as are new preventive treatment strategies to combat BPD.

What is known? • Pulmonary hypertension (PH) substantially impairs the survival of extremely preterm infants. • PH is associated with bronchopulmonary dysplasia (BPD): Early-onset PH predicts the development of BPD. Late-onset PH is prevalent in infants with severe BPD.

What is new? • Pulmonary hypertension (PH) is prevalent in preterm infants. Its consequences for morbidity and mortality justify a standardized policy aimed at early detection to improve prevention and treatment. • No structured policy exists in the Netherlands regarding screening/follow-up for PH in extremely preterm infants.
Perianal streptococcal disease in childhood: systematic literature review
Authors: Gualtieri Renato , Bronz Gabriel , Bianchetti Mario G. , Lava Sebastiano A. G. , Giuliano Elena , Milani Gregorio P. , Jermini Luca M. M. 
Published: February 2021

AbstractGroup A Streptococcus has been associated with a perianal infection. We conducted a systematic review of the literature on childhood streptococcal perianitis in three databases: Excerpta Medica, National Library of Medicine, and Web of Science. The main purposes were to document the clinical features, the tendency to recur, the association with an asymptomatic streptococcal throat carriage, the accuracy of rapid streptococcal tests, and the mechanism possibly underlying the acquisition of this infection. More than 80% of cases are boys ≤7.0 years of age with defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness. Perianitis is associated with a streptococcal tonsillopharyngitis in about every fifth case. The time to diagnosis is ≥3 weeks in 65% of cases. Recurrences occur within 3½ months in about 20% of cases. An asymptomatic group A streptococcal throat carriage occurs in 63% of cases. As compared with perianal Streptococcus A culture, the rapid streptococcal tests have a positive predictive value of 80% and a negative predictive value of 96%. It is hypothesized that digital inoculation from nasopharynx to anus underlies perianitis. Many cases are likely caused directly by children, who are throat and nasal carriers of Streptococcus A. Some cases might occur in children, who have their bottoms wiped by caregivers with streptococcal tonsillopharyngitis or carriage of Streptococcus.Conclusion: Perianitis is an infection with a distinctive presentation and a rather long time to diagnosis. There is a need for a wider awareness of this condition among healthcare professionals.What is Known:•Group A Streptococcus may cause perianitis in childhood.• Systemic antimicrobials (penicillin V, amoxycillin, or cefuroxime) are superior to topical treatment.What is New:•The clinical presentation is distinctive (defecation disorders, perianal pain, local itch, rectal bleeding, or fissure and a sharply demarcated perianal redness).• The time to diagnosis is usually ≥3 weeks.Recurrences occur in about 20% of cases.
Enhancing patient safety through the quality assured use of a low-tech video interpreting system to overcome language barriers in healthcare settings
Authors: Kletečka-Pulker Maria , Parrag Sabine , Doppler Klara , Völkl-Kernstock Sabine , Wagner Michael , Wenzel Thomas 
Published: February 2021

SummaryProfessional interpretation and translation are key issues in the improvement of public health and patient safety in an area of increased migration and multicultural healthcare system needs. Patient safety requires clear and reliable communication to avoid errors in diagnosis, treatment, and neglect of informed consent. Due to the range of languages to be covered, telephone and video interpretation (VI) can be expected to face up to the demands for trained interpreters available on short notice and in more remote healthcare sites.In a pilot project, we implemented a new up to date model video interpretation unit and used a mixed methods approach integrating quantitative and qualitative data in assessing barriers encountered prior to the use of the pilot system and satisfaction with the use of video interpretation in a number of clinical settings, including inpatient and outpatient units, in Austria. Of all respondents (n = 144) 71% reported frequently encountering language barriers, only 37% reported the use of professional interpreters, 81% reported using siblings, parents or other non-professional interpreters, while a considerable percentage (66%) reported using gestures or drawings to communicate, resulting in very low overall satisfaction rate (only 12%) with the prior situation.In the qualitative study the users observed rapid availability, data protection compliance, ability to see the interpreter despite physical distance, absence of potential external influence resulting from personal relationships, user-friendly nature of the technique, legal certainty, absence of the requirement for personal presence, and cost savings as key benefits in the use of the new technology. Of the users of the system 88% (n = 58) rated it as very good (72%) or good (16%).
A vulnerable age group: the impact of cancer on the psychosocial well-being of young adult childhood cancer survivors
Authors: van Erp L. M. E. , Maurice-Stam H. , Kremer L. C. M. , Tissing W. J. E. , van der Pal H. J. H. , de Vries A. C. H. , van den Heuvel-Eibrink M. M. , Versluys B. A. B. , van der Heiden-van der Loo M. , Huizinga G. A. , Grootenhuis M. A. 
Published: February 2021

Abstract
Purpose
This study aimed to increase our understanding of the psychosocial well-being of young adult childhood cancer survivors (YACCS) as well as the positive and negative impacts of cancer.

Methods
YACCS (aged 18–30, diagnosed ≤ 18, time since diagnosis ≥ 5 years) cross-sectionally filled out the “Pediatric Quality of Life Inventory Young Adults” (PedsQL-YA), “Hospital Anxiety and Depression Scale” (HADS), and “Checklist Individual Strengths” (CIS-20R) to measure fatigue and survivor-specific “Impact of Cancer - Childhood Survivors” (IOC-CS), which measures the long-term impact of childhood cancer in several domains. Descriptive statistics (IOC-CS), logistic regression (HADS, CIS-20R), and ANOVA (PedsQL-YA, HADS, CIS-20R) were performed. Associations between positive and negative impacts of childhood cancer and psychosocial outcomes were examined with linear regression analyses.

Results
YACCS (N = 151, 61.6% female, mean age 24.1 ± 3.6, mean time since diagnosis 13.6 ± 3.8) reported lower HRQOL (− .4 ≤ d ≤ − .5, p ≤ .001) and more anxiety (d = .4, p ≤ .001), depression (d = .4, p ≤ .01), and fatigue (.3 ≤ d ≤ .5, p ≤ .001) than young adults from the general Dutch population. They were at an increased risk of experiencing (sub)clinical anxiety (OR = 1.8, p = .017). YACCS reported more impact on scales representing a positive rather than negative impact of CC. Various domains of impact of childhood cancer were related to psychosocial outcomes, especially “Life Challenges” (HRQOL β = − .18, anxiety β = .36, depression β = .29) and “Body & Health” (HRQOL β = .27, anxiety β = − .25, depression β = − .26, fatigue β = − .47).

Conclusion
YACCS are vulnerable to psychosocial difficulties, but they also experience positive long-term impacts of childhood cancer. Positive and negative impacts of childhood cancer were associated with psychosocial outcomes in YACCS. Screening of psychosocial outcomes and offering targeted interventions are necessary to optimize psychosocial long-term follow-up care for YACCS.
Arrow R-CNN for handwritten diagram recognition
Authors: Schäfer Bernhard , Keuper Margret , Stuckenschmidt Heiner 
Published: February 2021

AbstractWe address the problem of offline handwritten diagram recognition. Recently, it has been shown that diagram symbols can be directly recognized with deep learning object detectors. However, object detectors are not able to recognize the diagram structure. We propose Arrow R-CNN, the first deep learning system for joint symbol and structure recognition in handwritten diagrams. Arrow R-CNN extends the Faster R-CNN object detector with an arrow head and tail keypoint predictor and a diagram-aware postprocessing method. We propose a network architecture and data augmentation methods targeted at small diagram datasets. Our diagram-aware postprocessing method addresses the insufficiencies of standard Faster R-CNN postprocessing. It reconstructs a diagram from a set of symbol detections and arrow keypoints. Arrow R-CNN improves state-of-the-art substantially: on a scanned flowchart dataset, we increase the rate of recognized diagrams from 37.7 to 78.6%.
Lung Nodule Classification Using Biomarkers, Volumetric Radiomics, and 3D CNNs
Authors: Mehta Kushal , Jain Arshita , Mangalagiri Jayalakshmi , Menon Sumeet , Nguyen Phuong , Chapman David R. 
Published: February 2021

AbstractWe present a hybrid algorithm to estimate lung nodule malignancy that combines imaging biomarkers from Radiologist’s annotation with image classification of CT scans. Our algorithm employs a 3D Convolutional Neural Network (CNN) as well as a Random Forest in order to combine CT imagery with biomarker annotation and volumetric radiomic features. We analyze and compare the performance of the algorithm using only imagery, only biomarkers, combined imagery + biomarkers, combined imagery + volumetric radiomic features, and finally the combination of imagery + biomarkers + volumetric features in order to classify the suspicion level of nodule malignancy. The National Cancer Institute (NCI) Lung Image Database Consortium (LIDC) IDRI dataset is used to train and evaluate the classification task. We show that the incorporation of semi-supervised learning by means of K-Nearest-Neighbors (KNN) can increase the available training sample size of the LIDC-IDRI, thereby further improving the accuracy of malignancy estimation of most of the models tested although there is no significant improvement with the use of KNN semi-supervised learning if image classification with CNNs and volumetric features is combined with descriptive biomarkers. Unexpectedly, we also show that a model using image biomarkers alone is more accurate than one that combines biomarkers with volumetric radiomics, 3D CNNs, and semi-supervised learning. We discuss the possibility that this result may be influenced by cognitive bias in LIDC-IDRI because malignancy estimates were recorded by the same radiologist panel as biomarkers, as well as future work to incorporate pathology information over a subset of study participants.
Impfung zur Vorbeugung der COVID-19-Erkrankung sowie Impfpriorisierung bei Epilepsie
Authors: Strzelczyk Adam , Knake Susanne , Holtkamp Martin , Schulze-Bonhage Andreas , Lemke Johannes , von Spiczak Sarah , Berkenfeld Ralf , Rosenow Felix , Brandt Christian , Schmitt Friedhelm C. 
Published: February 2021

ZusammenfassungDer Vorstand der Deutschen Gesellschaft für Epileptologie und die Kommission „Epilepsie und Synkopen“ der Deutschen Gesellschaft für Neurologie haben die aktuelle Datenlage zur Impfung zur Vorbeugung der Corona-Virus-Krankheit 2019 (COVID-19) sowie zur Impfpriorisierung bei Menschen mit Epilepsie gesichtet, diese zusammengefasst und geben die unten genannten Empfehlungen ab.
Quality of life in Hungarian polio survivors
Authors: Miszory Erika Viktória , Járomi Melinda , Pakai Annamária 
Published: February 2021

Abstract
Aim
The number of Hungarian polio patients can be estimated at approximately 3000. Polio infection is currently affecting people 56–65 years of age. The aim of the study was to reveal the quality of life of patients living with polio virus in Hungary.

Subject and methods
The quantitative cross-sectional study was conducted in January–April 2017 among polyomyelitis patients living in Hungary. In the non-random, targeted, expert sample selection, the target group was composed of patients infected with poliovirus (N = 268). We have excluded those who refused to sign the consent statement. Our data collection method was an SF-36 questionnaire. Using the IBM SPSS Statistics Version 22 program, descriptive and mathematical statistics (χ2-test) were calculated (p < 0.05).

Results
The mean age of the members of the examined population is 63.5 years; 68.1% were women and 31.90% were men. The majority of the respondents were infected by the polyovirus in 1956 (11.9%), 1957 (24.3%), and 1959 (19.5%). Polio patients, with the exception of two dimensions (mental health, social operation), on the scale of 100 do not reach the “average” quality of life (physical functioning 23 points, functional role 36 points, emotional role 47 points, body pain 48 points, general health 42 points, vitality 50 points, health change 31 points).

Conclusion
The quality of life of polio patients is far below the dimensions of physical function, while the difference in mental health compared to healthy people is minimal. It would be important to educate health professionals about the existing disease, to develop an effective rehabilitation method.
Impact Performance Comparison of Advanced Snow Sport Helmets with Dedicated Rotation-Damping Systems
Authors: DiGiacomo Gina , Tsai Stanley , Bottlang Michael 
Published: February 2021

AbstractRotational acceleration of the head is a principal cause of concussion and traumatic brain injury. Several rotation-damping systems for helmets have been introduced to better protect the brain from rotational forces. But these systems have not been evaluated in snow sport helmets. This study investigated two snow sport helmets with different rotation-damping systems, termed MIPS and WaveCel, in comparison to a standard snow sport helmet without a rotation-damping system. Impact performance was evaluated by vertical drops of a helmeted Hybrid III head and neck onto an oblique anvil. Six impact conditions were tested, comprising two impact speeds of 4.8 and 6.2 m/s, and three impact locations. Helmet performance was quantified in terms of the linear and rotational kinematics, and the predicted probability of concussion. Both rotation-damping systems significantly reduced rotational acceleration under all six impact conditions compared to the standard helmet, but their effect on linear acceleration was less consistent. The highest probability of concussion for the standard helmet was 89%, while helmets with MIPS and WaveCel systems exhibited a maximal probability of concussion of 67 and 7%, respectively. In conclusion, rotation-damping systems of advanced snow sport helmets can significantly reduce rotational head acceleration and the associated concussion risk.
Longitudinal Patterns of Ethical Organisational Culture as a Context for Leaders’ Well-Being: Cumulative Effects Over 6 Years
Authors: Huhtala Mari , Kaptein Muel , Muotka Joona , Feldt Taru 
Published: February 2021

AbstractThe aim of this longitudinal study was to investigate the temporal dynamics of ethical organisational culture and how it associates with well-being at work when potential changes in ethical culture are measured over an extended period of 6 years. We used a person-centred study design, which allowed us to detect both typical and atypical patterns of ethical culture stability as well as change among a sample of leaders. Based on latent profile analysis and hierarchical linear modelling we found longitudinal, concurrent relations and cumulative gain and loss cycles between different ethical culture patterns and leaders’ well-being. Leaders in the strongest ethical culture pattern experienced the highest level of work engagement and a decreasing level of ethical dilemmas and stress. Leaders who gave the lowest ratings on ethical culture which also decreased over time reported the highest level of ethical dilemmas, stress, and burnout. They also showed a continuous increase in these negative outcomes over time. Thus, ethical culture has significant cumulative effects on well-being, and these longitudinal effects can be both negative and positive, depending on the experienced strength of the culture’s ethicality.
An optimization approach for flow simulations in poro-fractured media with complex geometries
Authors: Berrone Stefano , D’Auria Alessandro , Scialò Stefano 
Published: February 2021

AbstractA new discretization approach is presented for the simulation of flow in complex poro-fractured media described by means of the Discrete Fracture and Matrix Model. The method is based on the numerical optimization of a properly defined cost-functional and allows to solve the problem without any constraint on mesh generation, thus overcoming one of the main complexities related to efficient and effective simulations in realistic DFMs.