bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of patella height after patella fracture on clinical outcome: a 13-year period
Authors: Sebastian Pesch , Michael Zyskowski , Frederik Greve , Michael Müller , Marcus Wurm , Moritz Crönlein , Peter Biberthaler , Chlodwig Kirchhoff 
Published: April 2021

Abstract
Introduction
The incidence of patella fracture is statistically low (0.5–1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987–997, 2005]. In the latter research, patella fractures if treated surgically present an overall inferior functional outcome. Little is known about the influence of the postoperative patella height on the clinical outcome. Therefore, the aim of our study was to analyse the influence of the patella height on the patients’ functional outcome after surgery.

Methods
In this retrospective study the in-house trauma register of our level I University trauma center was screened for patients suffering patella fractures treated surgically. Patella height of the same patients was evaluated on lateral X-rays using the Insall–Salvati Ratio (ISR). The patients’ X-rays were analyzed at two time points for the ISR, whereas group A presents ISR data right after surgery and group B data at the latest follow up (minimum 6 weeks). The change of mean ISR at both time points was tested for significance. The functional outcome was measured by the “Munich Knee Questionaire” (MKQ). These MKQ results of different patella heights and fracture types were compared.

Results
The screening of our in-house trauma register revealed 375 patients between the years 2003 and 2016. Out of these 54 patients (34f, 20 m) were enrolled. In detail the follow-up time for ISR between group A and B accounted for a mean of 503.8 ± 655.7 days. The MKQ was assessed at a mean of 1367.0 ± 1042.8 days after surgery. According to the AO-classification 10% AO.34 type B and 90% AO.34 type C fractures were found. Group A showed in 9.1% a patella baja and in 27.3% a patella alta compared to group B presenting 20.0% patella baja and 14.5% patella alta. There was no significant difference in functional outcome referring to the MKQ in patella alta (MKQ 69.0% ± 18.2) or baja (MKQ 67.1% ± 17.9) (p = 0.9). No significant functional difference between AO34.type B (MKQ 74.5% ± 11.0) and AO34.type C fractures (MKQ 64.0% ± 15.0) resulted (p = 0.1).

Conclusion
Our results demonstrate that different postoperative patella heights apparently do not influence the functional outcome in the short follow-up.
Electrophysiology as a prognostic indicator of visual recovery in diabetic patients undergoing cataract surgery
Authors: Wang Hao , Li Fuliang , Li Jiawen , Lin Jun , Liu Meifang , Wang Gang , Wang Min , Ran Li , Robson Anthony G. , Li Shiying 
Published: April 2021

Abstract
Purpose
Visual outcomes after cataract surgery in diabetic patients with retinal or visual pathway disease are difficult to predict as the fundus may be obscured, and assessment of visual potential is challenging. This study assessed the value of visual electrophysiology as a prognostic indicator of visual recovery in diabetic patients with cataract, prior to cataract surgery.

Methods
Forty-one diabetic patients (aged 52–80; 74 eyes) and 13 age-matched non-diabetic control patients (21 eyes) were examined prior to cataract surgery. Pre-surgical examinations included best-corrected visual acuity (BCVA), slit-lamp bio-microscopy, ISCEV-standard full-field electroretinography (ffERG), and flash visual evoked potential (flash VEP) testing. Electrophysiological assessments included quantification of the DA and LA ERG, oscillatory potentials (OPs; OP1, OP2, OP3, OP4) and flash VEP P1, P2, and P3 components. Post-operative BCVA was measured in all cases and the diabetic patients grouped according to the severity of visual acuity loss: mild (logMAR ≤ 0.1), moderate (0.1 < logMAR < 0.5), or severe (logMAR ≥ 0.5). A fourth group included those without diabetes. The pre-surgical electrophysiological data was compared between the four groups by analysis of variance.

Results
The severity of post-surgical visual acuity loss in the diabetic patients was classified as mild (N=22 eyes), moderate (N=31 eyes), or severe (N=21 eyes). In the group without diabetes, post-surgical visual impairment was classified as mild (N=21 eyes). The pre-operative DA 10.0 ERG a-wave amplitudes, DA 3.0 ERG OP2 amplitudes, and the LA 3.0 a- and b-wave amplitudes showed best significant differences among the four groups. The flash VEP did not show significant difference between groups.

Conclusion
Electrophysiological assessment of diabetic patients with cataract can provide a useful measure of retinal function. Full-field ERG components, including the DA 10.0 ERG a-wave, DA 3.0 ERG OP2 component, and the LA 3.0 a- and b-wave amplitudes, are of prognostic value in predicting post-surgical visual acuity, and may inform the surgical management of cataract patients with diabetes.
Bronchopulmonary dysplasia: a predictive scoring system for very low birth weight infants. A diagnostic accuracy study with prospective data collection
Authors: El Faleh Ikbel , Faouzi Mohamed , Adams Mark , Gerull Roland , Chnayna Jamel , Giannoni Eric , Roth-Kleiner Matthias ,   for the Swiss Neonatal Network
Published: April 2021

AbstractOur aim was to develop and validate a predictive risk score for bronchopulmonary dysplasia (BPD), according to two clinically used definitions: 1. Need for supplementary oxygen during ≥ 28 cumulative days, BPD28, 2. Need for supplementary oxygen at 36 weeks postmenstrual age (PMA), BPD36. Logistic regression was performed in a national cohort (infants born in Switzerland with a birth weight < 1501 g and/or between 23 0/7 and 31 6/7 weeks PMA in 2009 and 2010), to identify predictors of BPD. We built the score as the sum of predicting factors, weighted according to their ORs, and analysed its discriminative properties by calculating the area under the ROC (receiver operating characteristic) curves (AUCs). This score was then applied to the Swiss national cohort from the years 2014–2015 to perform external validation. The incidence of BPD28 was 21.6% in the derivation cohort (n= 1488) and 25.2% in the validation cohort (n= 2006). The corresponding numbers for BPD36 were 11.3% and 11.1%, respectively. We identified gestational age, birth weight, antenatal corticosteroids, surfactant administration, proven infection, patent ductus arteriosus and duration of mechanical ventilation as independent predictors of BPD28. The AUCs of the BPD risk scores in the derivation cohort were 0.90 and 0.89 for the BPD28 and BPD36 definitions, respectively. The corresponding AUCs in the validation cohort were 0.92 and 0.88, respectively.Conclusion: This score allows for predicting the risk of a very low birth weight infant to develop BPD early in life and may be a useful tool in clinical practice and neonatal research.What is Known:• Many studies have proposed scoring systems to predict bronchopulmonary dysplasia (BPD).• Such a risk prediction may be important to identify high-risk patients for counselling parents, research purposes and to identify candidates for specific treatment.What is New:• A predictive risk score for BPD was developed and validated in a large national multicentre cohort and its performance assessed by two indices of accuracy.• The developed scoring system allows to predict the risk of BPD development early but also at any day of life with high validity.
Deep learning-based automatic surgical step recognition in intraoperative videos for transanal total mesorectal excision
Authors: Kitaguchi Daichi , Takeshita Nobuyoshi , Matsuzaki Hiroki , Hasegawa Hiro , Igaki Takahiro , Oda Tatsuya , Ito Masaaki 
Published: April 2021

Abstract
Background
Dividing a surgical procedure into a sequence of identifiable and meaningful steps facilitates intraoperative video data acquisition and storage. These efforts are especially valuable for technically challenging procedures that require intraoperative video analysis, such as transanal total mesorectal excision (TaTME); however, manual video indexing is time-consuming. Thus, in this study, we constructed an annotated video dataset for TaTME with surgical step information and evaluated the performance of a deep learning model in recognizing the surgical steps in TaTME.

Methods
This was a single-institutional retrospective feasibility study. All TaTME intraoperative videos were divided into frames. Each frame was manually annotated as one of the following major steps: (1) purse-string closure; (2) full thickness transection of the rectal wall; (3) down-to-up dissection; (4) dissection after rendezvous; and (5) purse-string suture for stapled anastomosis. Steps 3 and 4 were each further classified into four sub-steps, specifically, for dissection of the anterior, posterior, right, and left planes. A convolutional neural network-based deep learning model, Xception, was utilized for the surgical step classification task.

Results
Our dataset containing 50 TaTME videos was randomly divided into two subsets for training and testing with 40 and 10 videos, respectively. The overall accuracy obtained for all classification steps was 93.2%. By contrast, when sub-step classification was included in the performance analysis, a mean accuracy (± standard deviation) of 78% (± 5%), with a maximum accuracy of 85%, was obtained.

Conclusions
To the best of our knowledge, this is the first study based on automatic surgical step classification for TaTME. Our deep learning model self-learned and recognized the classification steps in TaTME videos with high accuracy after training. Thus, our model can be applied to a system for intraoperative guidance or for postoperative video indexing and analysis in TaTME procedures.
Initial experience using a handheld fully articulating software-driven laparoscopic needle driver in TAPP inguinal hernia repair
Authors: Needham Victoria , Camacho Diego , Malcher Flavio 
Published: April 2021

Abstract
Background
The laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair is a widely performed minimally invasive operation, but can present considerable ergonomic challenges for the surgeon. Our objective was to determine if a novel handheld software-driven laparoscopic articulating needle driver can mitigate these difficulties.

Methods
The video recordings of a consecutive series of TAPP cases by a single surgeon using the articulating device were compared with a series of cases using straight-stick laparoscopy. Two critical steps of the procedure were analyzed for time: mesh fixation and peritoneal suture closure. These steps were then compared before and after 10 initial consecutive cases to analyze whether the surgeon demonstrated improvement. A cost analysis was also performed between the two techniques.

Results
For mesh fixation, the surgeon averaged 227 s using tacker devices, compared with 462.4 s using the novel laparoscopic device (p = 0.06). For the peritoneal closure component of the operation, the surgeon improved the time per suture pass during closure from 60.61 s during the first 10 cases to 38.84 s after the first 10 cases (p = 0.0004), which was comparable to the time per stitch for standard laparoscopy (34.8 s vs 34.84 s, p = 0.997). Left-sided inguinal hernia repairs using the articulating device demonstrated a significantly longer time per stitch during peritoneal closure compared to the right side after first 10 cases (left: 40.62 s; right: 27.91, p = 0.005). Our direct cost analysis demonstrated that suture closure of the peritoneum using the articulating device was more cost-effective than tack fixation.

Conclusions
After only a 10 case initial experience, a laparoscopic hand-held articulating needle driver is comparable to standard laparoscopy to complete suture mesh fixation and peritoneal closure for TAPP inguinal hernia repair. Further, the feasibility of suture mesh fixation minimizes the need for costly tacker devices. This instrument appears to be a promising tool in this largely minimally invasive era of hernia repair.
First insights into chlorhexidine retention in the oral cavity after application of different regimens
Authors: Reda Bashar , Hollemeyer Klaus , Trautmann Simone , Volmer Dietrich A. , Hannig Matthias 
Published: April 2021

Abstract
Objectives
This in situ study aimed to determine and compare the chlorhexidine (CHX) retention in the oral cavity after the application of different CHX pharmaceutical regimens.

Methods
Five volunteers used different CHX treatment regimens including mouth rinses, dental spray and toothpaste gel. After the application of the different CHX regimens, 2-μl samples were taken from saliva and buccal mucosa pellicle as well as the dental pellicle samples formed on standardized enamel surfaces. Sample collection was conducted at six time points within 12 h. Retention of CHX was measured using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry.

Results
CHX retention values in the oral mucosa pellicle were significantly higher than those in saliva. CHX remained in the mucosal pellicle at microgrammes per millilitre levels for 12 h after mouth rinsing, 10 h after spray application and 2 h after using the toothpaste. CHX was detected in the dental pellicle for at least 12 h after application of mouth rinsing and spray. Retention of CHX after mouth rinsing or spray application was significantly higher than the retention after using toothpaste.

Conclusions
Oral mucosa was the favourable site for CHX retention. Higher mouth rinse concentration and longer rinsing time produced a slight increase in CHX retention. CHX spray provided considerable retention values, whereas toothpaste gel delivered the lowest retention after application. MALDI-TOF was a sensitive method with excellent limits of quantification for CHX detection.
Creating collaboration for contentious projects on managed aquifer recharge: two cases from Finland
Authors: Laukka Vuokko , Katko Tapio S. , Peltonen Lasse , Rajala Riikka 
Published: April 2021

AbstractIn Finland, community water supply has increasingly relied on natural groundwater and artificially recharged groundwater as the raw water source. Several managed aquifer recharge (MAR) projects have been co-created with involved parties and have proceeded well, while some cases have raised considerable resistance among the stakeholders. It seems that success or failure in MAR cooperation is related to management cultures and the ways in which various interests are taken into account, from the very beginning and throughout the process. Empirically, this paper builds on comparison between two conflictual case studies in Finland: one in the Tampere region and the other in the Turku region. The study analyses the major constraints of these projects through the lens of collaborative rationality, also drawing upon discourse analysis and negotiation theory. The material is gathered through thematic interviews of stakeholders, newspaper articles and a stakeholder workshop. The results indicate that conventional management approaches, drawing from expert-based instrumental rationality, were insufficient in both cases. The collaborative rationality framework suggests that legitimacy for the groundwater projects should be gained through joint knowledge production and inclusive multiparty interaction for creating options for collaboration. Both cases lacked the tools and know-how for authentic dialogue and collaboration. The emerging paradigm emphasizes more collaborative approaches for natural resources management and urban planning. While MAR projects operate inside these areas and are highly complex in nature, it is essential to embrace the emerging paradigm in order to promote MAR systems along with their huge potential.
Optimization Over the Boolean Hypercube Via Sums of Nonnegative Circuit Polynomials
Authors: Dressler Mareike , Kurpisz Adam , de Wolff Timo 
Published: April 2021

AbstractVarious key problems from theoretical computer science can be expressed as polynomial optimization problems over the boolean hypercube. One particularly successful way to prove complexity bounds for these types of problems is based on sums of squares (SOS) as nonnegativity certificates. In this article, we initiate optimization problems over the boolean hypercube via a recent, alternative certificate called sums of nonnegative circuit polynomials (SONC). We show that key results for SOS-based certificates remain valid: First, for polynomials, which are nonnegative over the n-variate boolean hypercube with constraints of degree d there exists a SONC certificate of degree at most $$n+d$$

n
+
d

. Second, if there exists a degree d SONC certificate for nonnegativity of a polynomial over the boolean hypercube, then there also exists a short degree d SONC certificate that includes at most $$n^{O(d)}$$

n

O
(
d
)

nonnegative circuit polynomials. Moreover, we prove that, in opposite to SOS, the SONC cone is not closed under taking affine transformation of variables and that for SONC there does not exist an equivalent to Putinar’s Positivstellensatz for SOS. We discuss these results from both the algebraic and the optimization perspective.
Presidential Election 2022: A Euroclash Between a “Liberal” and a “Neo-Nationalist” France Is Coming
Authors: Chopin Thierry , Faure Samuel B. H. 
Published: April 2021

AbstractThe main question surrounding the re-election of Macron is the uncertain balance of France’s flexilateral policy vis-à-vis the EU in a post-Brexit and COVID-19 context: Strengthening European integration by changing France’s practice towards the EU or taking an inter-governmentalist turn by using – in a very classical way – Europe as an “Archimedes’ lever” to defend national interests.
Europhile Public vs Eurosceptic Governing Elite in Hungary?
Authors: Göncz Borbála , Lengyel György 
Published: April 2021

AbstractThe threat of an epidemic narrows the scope for political competition. As Fidesz’s position within the EU has weakened significantly with the withdrawal from the European People’s Party, and the COVID-19 crisis is generating serious social tensions, the questions seem to be more open in the spring of 2022 than during the previous three elections.
The Regional Comprehensive Economic Partnership Agreement and Its Expected Effects on World Trade
Authors: Flach Lisandra , Hildenbrand Hannah-Maria , Teti Feodora 
Published: April 2021

AbstractThe Regional Comprehensive Economic Partnership agreement creates the world’s largest free trade zone. The agreement has the potential to increase trade relations among its members and further promote the development of regional value chains in “Factory Asia”. This article presents the topics included in the recently concluded agreement, details the existing economic linkages between its members and discusses the expected consequences for its member states and third countries.
China’s Investments in Germany and the Impact of the COVID-19 Pandemic
Authors: Xia Xinming , Liu Wan-Hsin 
Published: April 2021

AbstractThis paper analyses how China’s investments in Germany have developed over time and the potential impact of the COVID-19 pandemic in this regard, based on four different datasets, including our own survey in mid-2020. Our analysis shows that Germany is currently one of the most attractive investment destinations for Chinese investors. Chinese state-owned enterprises have played an important role as investors in Germany — particularly in large-scale projects. The COVID-19 pandemic has had some negative but rather temporary effects on Chinese investments in Germany. Germany is expected to stay attractive to Chinese investors who seek to gain access to advanced technologies and know-how in the future.
The European Green Deal — More Than Climate Neutrality
Authors: Wolf Sarah , Teitge Jonas , Mielke Jahel , Schütze Franziska , Jaeger Carlo 
Published: April 2021

AbstractThe European Green Deal aims at climate neutrality for Europe by 2050, implying a significant acceleration of emission reductions. To gain the necessary support, it needs to reduce regional and social inequalities in Europe. We present objectives in terms of jobs, growth and price stability to complement the emission reduction targets and sketch a proof-of-concept investment profile for reaching these goals. Substantial additional annual public investments, of about 1.8% of pre-COVID-19 GDP, are proposed for the next decade. Their allocation includes retrofitting the European building stock, consciously fostering a renewal of the European innovation system as well as complementary measures in the fields of education and health. The scenario outlined in this article is meant as an input to the urgently needed discussion on how the European Green Deal can shift the EU economy to a new development path that realises a carbon-neutral Europe by 2050 while strengthening European cohesion.
Effect of antiepileptic drugs in glioma patients on self-reported depression, anxiety, and cognitive complaints
Authors: van der Meer Pim B. , Koekkoek Johan A. F. , van den Bent Martin J. , Dirven Linda , Taphoorn Martin J. B. 
Published: April 2021

Abstract
Introduction
AEDs have been associated with depression, anxiety, and cognitive impairment, all frequent complications of glioma and its subsequent treatment, with considerable morbidity and an adverse effect on health-related quality of life. This study aimed to determine the independent association between AED use and self-reported depression, anxiety, and subjective cognitive impairment in glioma patients.

Methods
In this multicenter cross-sectional study, depression and anxiety were assessed with the HADS and subjective cognitive impairment was assessed with the MOS-CFS. Univariable logistic regression analyses were performed on all potential confounding predictor variables. Potential confounders were included in the multivariable analyses if p-value < 0.1, to evaluate whether use of AEDs was independently related to depression, anxiety, and/or subjective cognitive impairment.

Results
A total of 272 patients were included. Prevalence of depression differed significantly between patients not using (10%) and using AEDs (21%, unadjusted Odds Ratio [uOR] = 2.29 [95%CI 1.05–4.97], p = 0.037), but after correction for confounders the statistical significant difference was no longer apparent (adjusted Odds Ratio [aOR] = 1.94 [95%CI 0.83–4.50], p = 0.125). Prevalences of anxiety (aOR = 1.17 [95%CI 0.59–2.29], p = 0.659) and subjective cognitive impairment (aOR = 0.83 [95%CI 0.34–2.04], p = 0.684) did not differ significantly before or after adjustment of confounders between patients not using (19% and 16%, respectively) and using AEDs (26% and 21%, respectively).

Conclusions
Our results indicate AED use was not independently associated with concurrent depression, anxiety, or subjective cognitive impairment in glioma patients. Alternative factors seem to have a greater contribution to the risk of developing neuropsychiatric symptoms in glioma patients.
Self-knowledge and the Paradox of Belief Revision
Authors: Merlo Giovanni 
Published: April 2021

AbstractTo qualify as a fully rational agent, one must be able rationally to revise one’s beliefs in the light of new evidence. This requires, not only that one revise one’s beliefs in the right way, but also that one do so as a result of appreciating the evidence on the basis of which one is changing one’s mind. However, the very nature of belief seems to pose an obstacle to the possibility of satisfying this requirement – for, insofar as one believes that p, any evidence that not-p will strike one as misleading and, on the face of it, believing that a certain piece of evidence is misleading is incompatible with appreciating the fact that such evidence should bear on the question at hand. Call this the ‘Paradox of Belief Revision’. This paper introduces the Paradox of Belief Revision, compares it with Kripke’s Dogmatism Paradox, and suggests that we may be able to see a way out of the former if we assume that rational agents are systematically aware of their own beliefs as beliefs they have.