bluuebunny/crossref_metadata_2025_split huggingface dataset:
What’s behind 68Ga-PSMA-11 uptake in primary prostate cancer PET? Investigation of histopathological parameters and immunohistochemical PSMA expression patterns
Authors: Rüschoff Jan H. , Ferraro Daniela A. , Muehlematter Urs J. , Laudicella Riccardo , Hermanns Thomas , Rodewald Ann-Katrin , Moch Holger , Eberli Daniel , Burger Irene A. , Rupp Niels J. 
Published: August 2021

Abstract
Purpose
Prostate-specific membrane antigen (PSMA-) PET has become a promising tool in staging and restaging of prostate carcinoma (PCa). However, specific primary tumour features might impact accuracy of PSMA-PET for PCa detection. We investigated histopathological parameters and immunohistochemical PSMA expression patterns on radical prostatectomy (RPE) specimens and correlated them to the corresponding 68Ga-PSMA-11-PET examinations.

Methods
RPE specimens of 62 patients with preoperative 68Ga-PSMA-11-PET between 2016 and 2018 were analysed. WHO/ISUP grade groups, growth pattern (expansive vs. infiltrative), tumour area and diameter as well as immunohistochemical PSMA heterogeneity, intensity and negative tumour area (PSMA%neg) were correlated with spatially corresponding SUVmax on 68Ga-PSMA-11-PET in a multidisciplinary analysis.

Results
All tumours showed medium to strong membranous (2–3 +) and weak to strong cytoplasmic (1–3 +) PSMA expression. Heterogeneously expressed PSMA was found in 38 cases (61%). Twenty-five cases (40%) showed at least 5% and up to 80% PSMA%neg. PSMA%neg, infiltrative growth pattern, smaller tumour area and diameter and WHO/ISUP grade group 2 significantly correlated with lower SUVmax values. A ROC curve analysis revealed 20% PSMA%neg as an optimal cutoff with the highest sensitivity and specificity (89% and 86%, AUC 0.923) for a negative PSMA-PET scan. A multiple logistic regression model revealed tumoural PSMA%neg (p < 0.01, OR = 9.629) and growth pattern (p = 0.0497, OR = 306.537) as significant predictors for a negative PSMA-PET scan.

Conclusions
We describe PSMA%neg, infiltrative growth pattern, smaller tumour size and WHO/ISUP grade group 2 as parameters associated with a lower 68Ga-PSMA-11 uptake in prostate cancer. These findings can serve as fundament for future biopsy-based biomarker development to enable an individualized, tumour-adapted imaging approach.
The Effect of Minimally Invasive Gastrectomy for Gastric Cancer on Postoperative Gallstone Formation
Authors: Ikegame Ko , Hikage Makoto , Fujiya Keiichi , Kamiya Satoshi , Tanizawa Yutaka , Bando Etsuro , Notsu Akifumi , Terashima Masanori 
Published: August 2021

AbstractBackgroundGallstones are known to occur quite frequently after gastrectomy. Most of the studies about postoperative cholelithiasis have focused on open gastrectomy, whereas laparoscopic gastrectomy has recently gained popularity as a type of minimally invasive surgery (MIS). Hence, the efficacy of MIS in preventing post‐gastrectomy gallstone formation remains to be elucidated. This study aimed to evaluate the risk of gallstone formation after MIS for clinical stage I/IIA gastric cancer.MethodsA total of 1166 patients undergoing gastrectomy for clinical stage I/IIA gastric cancer between 2009 and 2016 were included in this study. Gallstones were detected on abdominal ultrasound and/or computed tomography. Multivariate logistic regression analysis was used to determine factors associated with postoperative gallstone formation.ResultsGallstone formation was observed in 174 patients (15%), of whom 22 (2%) experienced symptomatic cholelithiasis. In multivariate analysis, the following were identified as risk factors for post‐gastrectomy gallstone formation: open approach with an odds ratio (OR) of 1.670 and a 95% confidence interval (CI) of 1.110–2.510 (P = 0.014), older age (OR 1.880; 95% CI 1.290–2.730; P < 0.001), high body mass index (OR 1.660; 95% CI 1.140–2.420; P = 0.008), Roux‐en‐Y (RY) reconstruction (OR 1.770; 95% CI 1.230–2.530; P = 0.002), hepatic branch vagotomy (OR 1.600; 95% CI 1.050–2.440; P = 0.029), and intra‐abdominal infectious complications (OR 3.040; 95% CI 1.680–5.490; P < 0.001).ConclusionOur study suggested that MIS along with the preservation of the hepatic vagus nerve and non‐RY reconstruction could help prevent post‐gastrectomy gallstone development.
Aerodynamics of inclined cylindrical bodies free-flying in a hypersonic flowfield
Authors: Seltner Patrick M. , Willems Sebastian , Gülhan Ali , Stern Eric C. , Brock Joseph M. , Aftosmis Michael J. 
Published: August 2021

Abstract
The influence of the flight attitude on aerodynamic coefficients and static stability of cylindrical bodies in hypersonic flows is of interest in understanding the re/entry of space debris, meteoroid fragments, launch-vehicle stages and other rotating objects. Experiments were therefore carried out in the hypersonic wind tunnel H2K at the German Aerospace Center (DLR) in Cologne. A free-flight technique was employed in H2K, which enables a continuous rotation of the cylinder without any sting interferences in a broad angular range from 0$$^{\circ }$$

∘

to 90$$^{\circ }$$

∘

. A high-speed stereo-tracking technique measured the model motion during free-flight and high-speed schlieren provided documentation of the flow topology. Aerodynamic coefficients were determined in careful post-processing, based on the measured 6-degrees-of-freedom (6DoF) motion data. Numerical simulations by NASA’s flow solvers Cart3D and US3D were performed for comparison purposes. As a result, the experimental and numerical data show a good agreement. The inclination of the cylinder strongly effects both the flowfield and aerodynamic loads. Experiments and simulations with concave cylinders showed marked difference in aerodynamic behavior due to the presence of a shock–shock interaction (SSI) near the middle of the model.

Graphic abstract
Strukturierung des Notfallmanagements in Pflegeheimen: Ergebnisse interprofessioneller Fokusgruppeninterviews
Authors: Schwabe Sven , Bleidorn Jutta , Günther Andreas , Krause Olaf , Schneider Nils , Poeck Juliane 
Published: August 2021

Zusammenfassung
Hintergrund
Notfallsituationen in Pflegeeinrichtungen führen zu einer steigenden Zahl von Rettungsdiensteinsätzen und Krankenhauszuweisungen, die häufig als vermeidbar eingeordnet werden und oft nicht den Behandlungswünschen der Bewohner entsprechen. Der Umgang mit Notfallsituationen wird durch strukturelle Bedingungen, Unsicherheiten und Kommunikationsschwierigkeiten zwischen den behandelnden Akteuren beeinträchtigt.

Ziel
Im Innovationsfonds-Projekt NOVELLE wird interprofessionell eine Musterhandlungsempfehlung für Pflegefachpersonen zur Strukturierung des Notfallmanagements in Pflegeeinrichtungen entwickelt.

Material und Methoden
Der qualitative Forschungsprozess wurde nach der Grounded Theory als iteratives Wechselspiel zwischen Datenerhebung, -auswertung und Konzeptentwicklung organisiert. Zwischen Januar und April 2021 wurden 6 Fokusgruppeninterviews mit insgesamt 24 Pflegefachpersonen, Ärzten sowie Medizinethikern und ein Interview mit einer Medizinjuristin durchgeführt. Diese fanden als Videokonferenzen statt, wurden digital aufgezeichnet, wörtlich transkribiert und mit MAXQDA kodiert und ausgewertet.

Ergebnisse
Handlungsempfehlungen zu Verbesserung und Strukturierung des Notfallmanagements lassen sich gliedern in: 1) Ersteinschätzung; 2) Assessment mit pflegefachlicher Beurteilung und Einbindung des Bewohnerwillens; 3) Organisation der Weiterversorgung. Die Bausteine enthalten Maßnahmen, Ergebnisse und Entscheidungen und lassen sich in Form eines Algorithmus anordnen.

Diskussion
Handlungsempfehlungen zur Verbesserung des Notfallmanagements sollten die Kompetenzen der Pflegefachpersonen stärken, eine strukturierte Einbindung des Bewohnerwillens ermöglichen, die Kontextbedingungen berücksichtigen und bei der Kommunikation mit Weiterversorgern unterstützen.
Transcatheter aortic valve implantation in patients with a small aortic annulus: performance of supra-, intra- and infra-annular transcatheter heart valves
Authors: Voigtländer Lisa , Kim Won-Keun , Mauri Victor , Goßling Alina , Renker Matthias , Sugiura Atsushi , Linder Matthias , Schmidt Tobias , Schofer Niklas , Westermann Dirk , Reichenspurner Hermann , Nickenig Georg , Blankenberg Stefan , Hamm Christian , Conradi Lenard , Adam Matti , Sinning Jan-Malte , Seiffert Moritz 
Published: August 2021

Abstract
Background
A small aortic annulus is associated with increased risk of prosthesis–patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI). Whether specific transcatheter heart valve (THV) designs yield superior hemodynamic performance in these small anatomies remains unclear.

Methods
Data from 8411 consecutive patients treated with TAVI from May 2012 to April 2019 at four German centers were retrospectively evaluated. A small aortic annulus was defined as multidetector computed tomography-derived annulus area < 400 mm2. TAVI was performed with a balloon-expanding intra-annular (Sapien-3, n = 288), self-expanding intra-annular (Portico, n = 110), self-expanding supra-annular (Evolut, n = 179 and Acurate-Neo, n = 428) and mechanically expanding infra-annular (Lotus, n = 64) THV according to local practice. PPM was defined as indexed effective orifice area ≤ 0.85cm2/m2.

Results
A small annulus was found in 1069 (12.7%) patients. PPM was detected in 38.3% overall with a higher prevalence after implantation of a balloon-expanding intra-annular or mechanically expanding infra-annular THV compared to self-expanding intra- and supra-annular THV. Multivariable analysis linked self-expanding THV (Evolut: Odds ratio [OR] 0.341, Acurate-Neo: OR 0.436, Portico: OR 0.291), postdilatation (OR 0.648) and age (OR 0.968) to lower rates of PPM, while aortic valve calcification was associated with an increased risk (OR 1.001). Paravalvular regurgitation > mild was more frequent after TAVI with self-expanding THV (p = 0.04).

Conclusion
In this large contemporary multicenter patient population, a substantial number of patients with a small aortic anatomy were left with PPM after TAVI. Self-expanding supra- and intra-annular THV demonstrated superior hemodynamics in these patients at risk, however at the cost of higher rates of residual paravalvular regurgitation.

Graphic abstract
A Modified Calculation Improves the Accuracy of Predicted Postoperative Lung Function Values in Lung Cancer Patients
Authors: Schlachtenberger G. , Doerr F. , Menghesha H. , Hagmeyer L. , Leschczyk T. , Gaisendrees C. , Michel M. , Wahlers T. , Hekmat K. , Heldwein M. B. 
Published: August 2021

Abstract
Purpose
Preoperative pulmonary function testing is mandatory for non-small cell lung cancer (NSCLC) surgery. The predicted postoperative FEV1 (ppoFEV1) is used for further risk stratification. We compared the ppoFEV1 with the postoperative FEV1 (postFEV1) in order to improve the calculation of the ppoFEV1.

Methods
87 patients voluntarily received an FEV1 assessment 1 year after surgery. ppoFEV1 was calculated according to the Brunelli calculation. Baseline characteristics and surgical procedure were compared in a uni- and multivariate analysis between different accuracy levels of the ppoFEV1. Parameters which remained significant in the multinominal regression analysis were evaluated for a modification of the ppoFEV1 calculation.

Results
Independent factors for a more inaccurate ppoFEV1 were preoperative active smoking (odds ratio (OR) 4.1, confidence interval (CI) 3.6–6.41; p = 0.01), packyears (OR 4.1, CI 3.6–6.41; p = 0.008), younger age (OR 1.1, CI 1.01–1.12; p = 0.03), and patients undergoing pneumectomy (OR 5.55, CI 1.35–23.6; p = 0.01). For the customized ppoFEV1 we excluded pneumonectomies. For patients < 60 years, an additional lung segment was added to the calculation. ppoFEV1 = preFEV1 × $$1-\left(\frac{\text{Lung segments resected} + 1}{\text{Total number of segments}}\right)$$

1
-

Lung segments resected
+
1

Total number of segments

. For actively smoking patients with more than 30 packyears we subtracted one lung segment from the calculation ppoFEV1 = PreFEV1 × $$1-\left(\frac{\text{Lung segments resected} - 1}{\text{Total number of segments}}\right)$$

1
-

Lung segments resected
-
1

Total number of segments

.

Conclusion
We were able to enhance the predictability of the ppoFEV1 with modifications. The modified ppoFEV1 (1.828 l ± 0.479 l) closely approximates the postFEV1 of 1.823 l ± 0.476 l, (0.27%) while the original ppoFEV1 calculation is at 1.78 l ± 0.53 (2.19%). However, if patients require pneumectomy, more complex techniques to determine the ppoFEV1 should be included to stratify risk.
Efficacy and safety of N-acetyl-l-leucine in Niemann–Pick disease type C
Authors: Bremova-Ertl Tatiana , Claassen Jens , Foltan Tomas , Gascon-Bayarri Jordi , Gissen Paul , Hahn Andreas , Hassan Anhar , Hennig Anita , Jones Simon A. , Kolnikova Miriam , Martakis Kyriakos , Raethjen Jan , Ramaswami Uma , Sharma Reena , Schneider Susanne A. 
Published: August 2021

AbstractObjectiveTo investigate the safety and efficacy ofN-acetyl-l-leucine (NALL) on symptoms, functioning, and quality of life in pediatric (≥ 6 years) and adult Niemann–Pick disease type C (NPC) patients.MethodsIn this multi-national, open-label, rater-blinded Phase II study, patients were assessed during a baseline period, a 6-week treatment period (orally administered NALL 4 g/day in patients ≥ 13 years, weight-tiered doses for patients 6–12 years), and a 6-week post-treatment washout period. The primary Clinical Impression of Change in Severity (CI-CS) endpoint (based on a 7-point Likert scale) was assessed by blinded, centralized raters who compared randomized video pairs of each patient performing a pre-defined primary anchor test (8-Meter Walk Test or 9-Hole Peg Test) during each study periods. Secondary outcomes included cerebellar functional rating scales, clinical global impression, and quality of life assessments.Results33 subjects aged 7–64 years with a confirmed diagnosis of NPC were enrolled. 32 patients were included in the primary modified intention-to-treat analysis. NALL met the CI-CS primary endpoint (mean difference 0.86, SD = 2.52, 90% CI 0.25, 1.75,p = 0.029), as well as secondary endpoints. No treatment-related serious adverse events occurred.ConclusionsNALL demonstrated a statistically significant and clinical meaningfully improvement in symptoms, functioning, and quality of life in 6 weeks, the clinical effect of which was lost after the 6-week washout period. NALL was safe and well-tolerated, informing a favorable benefit-risk profile for the treatment of NPC.Clinicaltrials.gov identifierNCT03759639.
Extreme lateral supracerebellar infratentorial approach for tentorial arteriovenous fistula associated with a giant venous ectasia: how I do it
Authors: Papadimitriou Kyriakos , Belouaer Amani , Starnoni Daniele , Daniel Roy Thomas 
Published: August 2021

Abstract
Background
Surgery of tentorial dural arteriovenous fistulas (DAVF) associated with large ectatic vein remains challenging due to the intimate neurovascular relationships in the incisural space. Interruption of the arterialized vein requires a good knowledge of the regional anatomy and a precise preoperative evaluation.

Methods
We describe the key steps extreme lateral supracerebellar infratentorial (ELSI) approach for tentorial DAVF with a video illustration. The surgical anatomy is described along with the advantages and limitations of this approach.

Conclusions
In cases of tentorial DAVF where the foot of the arterialized vein is located in the infratentorial compartment, ELSI offers good surgical exposure and outcomes.
Intracranial pulse pressure waveform analysis using the higher harmonics centroid
Authors: Zakrzewska Agnieszka P. , Placek Michał M. , Czosnyka Marek , Kasprowicz Magdalena , Lang Erhard W. 
Published: August 2021

Abstract
Background
The pulse waveform of intracranial pressure (ICP) is its distinctive feature almost always present in the clinical recordings. In most cases, it changes proportionally to rising ICP, and observation of these changes may be clinically useful. We introduce the higher harmonics centroid (HHC) which can be defined as the center of mass of harmonics of the ICP pulse waveform from the 2nd to 10th, where mass corresponds to amplitudes of these harmonics. We investigate the changes in HHC during ICP monitoring, including isolated episodes of ICP plateau waves.

Material and methods
Recordings from 325 patients treated between 2002 and 2010 were reviewed. Twenty-six patients with ICP plateau waves were identified. In the first step, the correlation between HHC and ICP was examined for the entire monitoring period. In the second step, the above relation was calculated separately for periods of elevated ICP during plateau wave and the baseline.

Results
For the values averaged over the whole monitoring period, ICP (22.3 ± 6.9 mm Hg) correlates significantly (R = 0.45, p = 0.022) with HHC (3.64 ± 0.46). During the ICP plateau waves (ICP increased from 20.9 ± 6.0 to 53.7 ± 9.7 mm Hg, p < 10−16), we found a significant decrease in HHC (from 3.65 ± 0.48 to 3.21 ± 0.33, p = 10−5).

Conclusions
The good correlation between HHC and ICP supports the clinical application of pressure waveform analysis in addition to the recording of ICP number only. Mean ICP may be distorted by a zero drift, but HHC remains immune to this error. Further research is required to test whether a decline in HHC with elevated ICP can be an early warning sign of intracranial hypertension, whether individual breakpoints of correlation between ICP and its centroid are of clinical importance.
Investigation of gene–environment interactions in relation to tic severity
Authors: Abdulkadir Mohamed , Yu Dongmei , Osiecki Lisa , King Robert A. , Fernandez Thomas V. , Brown Lawrence W. , Cheon Keun-Ah , Coffey Barbara J. , Garcia-Delgar Blanca , Gilbert Donald L. , Grice Dorothy E. , Hagstrøm Julie , Hedderly Tammy , Heyman Isobel , Hong Hyun Ju , Huyser Chaim , Ibanez-Gomez Laura , Kim Young Key , Kim Young-Shin , Koh Yun-Joo , Kook Sodahm , Kuperman Samuel , Leventhal Bennett , Madruga-Garrido Marcos , Maras Athanasios , Mir Pablo , Morer Astrid , Münchau Alexander , Plessen Kerstin J. , Roessner Veit , Shin Eun-Young , Song Dong-Ho , Song Jungeun , Visscher Frank , Zinner Samuel H. , Mathews Carol A. , Scharf Jeremiah M. , Tischfield Jay A. , Heiman Gary A. , Dietrich Andrea , Hoekstra Pieter J. 
Published: August 2021

AbstractTourette syndrome (TS) is a neuropsychiatric disorder with involvement of genetic and environmental factors. We investigated genetic loci previously implicated in Tourette syndrome and associated disorders in interaction with pre- and perinatal adversity in relation to tic severity using a case-only (N = 518) design. We assessed 98 single-nucleotide polymorphisms (SNPs) selected from (I) top SNPs from genome-wide association studies (GWASs) of TS; (II) top SNPs from GWASs of obsessive–compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD); (III) SNPs previously implicated in candidate-gene studies of TS; (IV) SNPs previously implicated in OCD or ASD; and (V) tagging SNPs in neurotransmitter-related candidate genes. Linear regression models were used to examine the main effects of the SNPs on tic severity, and the interaction effect of these SNPs with a cumulative pre- and perinatal adversity score. Replication was sought for SNPs that met the threshold of significance (after correcting for multiple testing) in a replication sample (N = 678). One SNP (rs7123010), previously implicated in a TS meta-analysis, was significantly related to higher tic severity. We found a gene–environment interaction for rs6539267, another top TS GWAS SNP. These findings were not independently replicated. Our study highlights the future potential of TS GWAS top hits in gene–environment studies.
Static analysis of composite beams on variable stiffness elastic foundations by the Homotopy Analysis Method
Authors: Doeva Olga , Masjedi Pedram Khaneh , Weaver Paul M. 
Published: August 2021

AbstractNew analytical solutions for the static deflection of anisotropic composite beams resting on variable stiffness elastic foundations are obtained by the means of the Homotopy Analysis Method (HAM). The method provides a closed-form series solution for the problem described by a non-homogeneous system of coupled ordinary differential equations with constant coefficients and one variable coefficient reflecting variable stiffness elastic foundation. Analytical solutions are obtained based on two different algorithms, namely conventional HAM and iterative HAM (iHAM). To investigate the computational efficiency and convergence of HAM solutions, the preliminary studies are performed for a composite beam without elastic foundation under the action of transverse uniformly distributed loads considering three different types of stacking sequence which provide different levels and types of anisotropy. It is shown that applying the iterative approach results in better convergence of the solution compared with conventional HAM for the same level of accuracy. Then, analytical solutions are developed for composite beams on elastic foundations. New analytical results based on HAM are presented for the static deflection of composite beams resting on variable stiffness elastic foundations. Results are compared to those reported in the literature and those obtained by the Chebyshev Collocation Method in order to verify the validity and accuracy of the method. Numerical experiments reveal the accuracy and efficiency of the Homotopy Analysis Method in static beam problems.
Contextual movement models based on normalizing flows
Authors: Fadel Samuel G. , Mair Sebastian , da Silva Torres Ricardo , Brefeld Ulf 
Published: August 2021

AbstractMovement models predict positions of players (or objects in general) over time and are thus key to analyzing spatiotemporal data as it is often used in sports analytics. Existing movement models are either designed from physical principles or are entirely data-driven. However, the former suffers from oversimplifications to achieve feasible and interpretable models, while the latter relies on computationally costly, from a current point of view, nonparametric density estimations and require maintaining multiple estimators, each responsible for different types of movements (e.g., such as different velocities). In this paper, we propose a unified contextual probabilistic movement model based on normalizing flows. Our approach learns the desired densities by directly optimizing the likelihood and maintains only a single contextual model that can be conditioned on auxiliary variables. Training is simultaneously performed on all observed types of movements, resulting in an effective and efficient movement model. We empirically evaluate our approach on spatiotemporal data from professional soccer. Our findings show that our approach outperforms the state of the art while being orders of magnitude more efficient with respect to computation time and memory requirements.