bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metastatic rectal cancer in the ampulla of Vater: A unique case
Authors: Samara Athina A. , Sgantzou Ioanna‐Konstantina , Diamantis Alexandros , Kokkalis Alexandros , Tsapakidis Konstantinos , Tolia Maria , Christodoulidis Gregory , Rountas Christos , Zacharoulis Dimitris 
Published: July 2021

AbstractBackgroundA metastatic lesion located in the ampulla of Vater is considered extremely rare, with only 32 cases reported globally.CaseA 65‐year‐old patient was primarily diagnosed with a rectal adenocarcinoma. Twenty‐four months later as part of the oncological follow‐up, the patient was diagnosed with a single secondary tumor in the ampulla of Vater. After undergoing a pancreaticoduodenectomy (Whipple procedure), the patient experienced an uneventful recovery and received adjuvant chemotherapy. Sixteen months later the patient remained disease‐free.ConclusionTo the best of our knowledge, the present case represents the first reported metastatic tumor in the ampulla of Vater, originating from a rectal adenocarcinoma. This case underlines the critical role of immunohistochemistry in arriving at a correct diagnosis in order to guide clinical decision‐making.
Quantitative study on landscape colors of plant communities in urban parks based on natural color system and M‐S theory in Nanjing, China
Authors: Shen Shiguang , Yao Yao , Li Canliu 
Published: July 2021

AbstractPlant color landscape plays an important role in improving the quality of visual landscapes, regulating the emotion of landscape space, and highlighting the characteristics of urban landscapes. How to reasonably quantify and create rich plant color landscapes to achieve the best visual perception of the plant color landscape at different visual scales, so as to better meet the aesthetic needs of the public, has become a hot and difficult issue in the plant color design and application. Therefore, this article selects four typical urban parks in Nanjing to study the color characteristics of plant communities. The natural color system color card is used to extract plant color data. The color harmony and suitability degree of the plant community and external environment are quantitatively evaluated according to the Moon‐Spencer (M‐S) color harmony theory. The correlation between the chromaticity difference, color harmony, and color suitability of the plant landscape color is strong, whereas that between the chromaticity difference and lightness difference of the plant landscape color is weak. Among the four urban parks, the color harmony is the highest, and the appropriate color is the lowest in Xuanwu Lake Park. In addition, among the 12 selected plant community landscapes, the plant community number A3 in Xuanwu Lake Park has the highest color harmony and D3 in Gulin Park has the lowest color harmony. In short, the quantitative study of the plant community landscape color can provide new ideas for improving the optimal allocation of the plant community landscape color in urban parks.
Examining the roles of cognitive flexibility, emotion recognition, and metacognitions in adult Attention Deficit and Hyperactivity Disorder with predominantly inattentive presentation
Authors: Aydın Orkun , Balıkçı Kuzeymen , Sönmez İpek , Ünal‐Aydın Pınar , Spada Marcantonio M. 
Published: July 2021

AbstractThe evaluation of cognitive functions in Attention Deficit and Hyperactivity Disorder (ADHD) is fundamental to improve the efficacy of therapeutic interventions. However, the role of specific higher‐order cognitive functions in adult ADHD, including cognitive flexibility, emotion recognition, and metacognitions, remains unclear. Therefore, in the current study, we aimed to examine these three distinct higher‐order cognitive functions among adult ADHD individuals. Forty patients with ADHD with predominantly inattentive presentation and 42 healthy controls participated in the study. The Adult Attention Deficit and Hyperactivity Disorder Scale (AADHDS), the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), and the Metacognitions Questionnaire‐30 (MCQ‐30) were administered. Results indicated that patients with ADHD had worse metacognitions scores, in specific subdimensions, relative to healthy controls. However, cognitive flexibility and emotion recognition did not differ between the groups. Moreover, the cognitive confidence subdimension of the MCQ‐30 was found to be sole significant predictor in the attention deficit subdimension of the AADHDS. Our findings suggest that lack of cognitive confidence may contribute to ADHD symptomatology despite regularly functioning cognitive flexibility and emotion recognition. Therefore, metacognitions could be a suitable target to alleviate the severity of ADHD symptoms.
Binge‐eating disorder is associated with an unfavorable body mass composition in patients with non‐alcoholic fatty liver disease
Authors: Forlano Roberta , Harlow Christopher , Mullish Benjamin H. , Thursz Mark R. , Manousou Pinelopi , Yee Michael 
Published: July 2021

AbstractThe interaction between eating disorders and non‐alcoholic fatty liver disease (NAFLD) remains unexplored, especially with regards to binge‐eating disorder (BED). Our team conducted a service evaluation project in order to assess risk factors for the presence of BED among patients with NAFLD and the impact of BED on body mass composition. The overall prevalence of patients screening positive to BED Screener‐7 (BEDS‐7) was 28.4%, while a previous diagnosis of depression and marital status (as single or separated) were independently associated with positive BED. Furthermore, patients with positive BEDS‐7 had higher BMI, with greater visceral component and overall lower muscle mass. There was no difference in terms of liver disease severity as assessed by noninvasive markers of fibrosis. However, as body mass composition and sarcopenia have been shown to be associated to disease progression in patients with NAFLD, further studies are required to ascertain the long‐term impact of BED in these patients. Moreover, further work is warranted to identify to implement multidisciplinary approach within clinical psychology for the management of patients with BED, who may be particularly challenging in terms of achieving lifestyle modifications. As a hepatology community, we should address NAFLD with a more holistic approach.
Cardiac output states in patients with severe functional tricuspid regurgitation: impact on treatment success and prognosis
Authors: Unterhuber Matthias , Kresoja Karl‐Patrik , Besler Christian , Rommel Karl‐Philipp , Orban Mathias , von Roeder Maximilian , Braun Daniel , Stolz Lukas , Massberg Steffen , Trebicka Jonel , Zachäus Markus , Hausleiter Jörg , Thiele Holger , Lurz Philipp 
Published: July 2021

AimsTo investigate whether there is evidence for distinct cardiac output (CO) based phenotypes in patients with chronic right heart failure associated with severe tricuspid regurgitation (TR) and to characterize their impact on TR treatment and outcome.Methods and resultsA total of 132 patients underwent isolated transcatheter tricuspid valve repair (TTVR) for functional TR at two centres. Patients were clustered according to k‐means clustering into low [cardiac index (CI) < 1.7 L/min/m2], intermediate (CI 1.7–2.6 L/min/m2) and high CO (CI > 2.6 L/min/m2) clusters. All‐cause mortality and clinical characteristics during follow‐up were compared among different CO clusters. Mortality rates were highest for patients in a low (24%) and high CO state (42%, log‐rank P < 0.001). High CO state patients were characterized by larger inferior vena cava diameters (P = 0.003), reduced liver function, higher incidence of ascites (P = 0.006) and markedly reduced systemic vascular resistance (P < 0.001) as compared to TTVR patients in other CO states. Despite comparable procedural success rates, the extent of changes in right atrial pressures (P = 0.01) and right ventricular dimensions (P < 0.001) per decrease in regurgitant volume following TTVR was less pronounced in high CO state patients as compared to other CO states. Successful TTVR was associated with the smallest prognostic benefit among low and high CO state patients.ConclusionsPatients with chronic right heart failure and severe TR display distinct CO states. The high CO state is characterized by advanced congestive hepatopathy, a substantial decrease in peripheral vascular tone, a lack of response of central venous pressures to TR reduction, and worse prognosis. These data are relevant to the pathophysiological understanding and management of this important clinical syndrome.
Treating symptoms and reversing remodelling: clinical and echocardiographic 1‐year outcomes with percutaneous mitral annuloplasty for mild to moderate secondary mitral regurgitation
Authors: Witte Klaus K. , Kaye David M. , Lipiecki Janusz , Siminiak Tomasz , Goldberg Steven L. , von Bardeleben Ralph S. , Sievert Horst , Levy Wayne C. , Starling Randall C. 
Published: July 2021

AbstractAimsTo determine the effects of percutaneous mitral annuloplasty on symptoms, walk distance and left ventricular (LV) structure and function in patients with mild or moderate secondary mitral regurgitation (SMR).Methods and resultsThis was a pooled analysis of patients (n = 68) who, despite guideline‐directed medical therapy had symptomatic heart failure (HF) with mild (n = 25) or moderate (n = 43) SMR treated with percutaneous mitral annuloplasty as part of the TITAN, TITAN II, or REDUCE‐FMR trials. Primary outcomes were changes in symptoms, 6‐min walk distance, and quality of life assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ) after 1 year. Secondary analyses included changes in LV structure and function. At 1 year, New York Heart Association class status was maintained (48%) or improved (46%) in most patients, mean KCCQ scores increased from baseline by 10 units [95% confidence interval (CI) 3 to17; P < 0.01] and mean 6‐min walk test distance increased by 34 m (95% CI 12 to 57; P < 0.01). SMR grade improved in 25% of patients and was maintained in 58% of patients with changes in mean regurgitant volume of −7 mL (95% CI −11 to −3; P < 0.001), vena contracta −0.11 cm (95% CI −0.20 to −0.02; P < 0.05), and effective regurgitant orifice area −0.03 cm2 (95% CI −0.06 to −0.01; P < 0.05). There were non‐significant improvements in LV ejection fraction and volumes. Survival over 1 year was 89% with no difference between mild (96%) and moderate (86%) SMR (log‐rank P = 0.22). Progression‐free survival was 70% (82% in mild vs. 63% in moderate SMR; P = 0.16). Freedom from HF hospitalization was 73% (87% in mild SMR vs. 66% in moderate SMR; P = 0.07).ConclusionAmong patients with symptomatic HF and mild or moderate SMR on guideline‐directed medical therapy, percutaneous mitral annuloplasty was associated with improvements in symptoms, SMR, a stabilization of LV structure and function, and high survival rates.
Seismic design of multiple‐rocking systems: A gradient‐based optimization approach
Authors: Marzok Ameer , Lavan Oren 
Published: July 2021

AbstractSelf‐centering concentrically braced frames (SC‐CBFs) have shown many advantages towards structural damage‐free seismic behavior. These systems could be designed either with a single rocking section at the base or with multiple rocking sections along their height. Initial design methodologies for both cases have been proposed with an emphasis on the former case. These methods focused on simplicity of the design process and mostly relied on parametric studies. Thus, the obtained designs may violate some displacement constraints when verified using nonlinear time history analysis (NLTHA) or lead to conservative designs that may be expensive. Furthermore, focusing on simplicity, these methods are tailored for regular structures. This paper takes a different approach that leads to minimum cost designs for irregular structures that satisfy the constraints exactly when verified using NLTHA. The proposed approach allows for multiple rocking sections along the height of the designed buildings, if these lead to cost reductions. Of course, this comes with more demanding computing resources. Nevertheless, these are kept reasonable for practical use on a personal computer. For that purpose, the NLTHA is performed using the computationally efficient Mixed Lagrangian Formalism. Furthermore, an efficient gradient‐based optimization framework is developed. The framework is applied for the design of 8, 12, and 20‐story spine SC‐CBFs and an irregular 12‐story building with a setback level. These have shown promising results while revealing also non‐traditional designs. This demonstrates the power of using optimization for the design of these lateral load resisting systems.
Individualized real‐time prediction of working memory performance by classifying electroencephalography signals
Authors: Mirjalili Mina , Zomorrodi Reza , Daskalakis Zafiris J. , Hill Sean , Rajji Tarek K. 
Published: July 2021

AbstractAn individualized model that predicts trial‐by‐trial working memory performance is instrumental for personalized interventions. Here, we propose a single‐trial electroencephalography (EEG) classification process predicting individuals' responses, that is, target correct versus target non‐correct during a working memory task, N‐back. We used event‐related (de‐)synchronization (ERD and ERS) prior to an anticipatory cue as features. The proposed comprehensive process addresses single‐trial EEG classification challenges such as temporal overlap between training and testing datasets, feature selection's stability, and significance of the classification accuracy which have been often overlooked. Our model identified for the first time a few (ranged between 4 and 10) brain regions and oscillations where ERD and ERS predicted an individual's performance. Mean (SD) prediction accuracy across 50 participants (mean age [SD] = 28.56 [7.55]) was 69.51% (8.41). Accuracy was significantly above chance in 34 participants. This machine learning‐based approach provides a proof of principle for individualizing EEG targets for potential interventions.
Employment and Prices in a Simple Macroeconomy
Authors: Goeree Jacob K. , Holt Charles A. 
Published: July 2021

This exercise sets up interlinked labor and goods markets in a classroom macroeconomy. Students with worker roles are endowed with labor that can be consumed or sold to firms that post wages, purchase labor, and produce goods that can be either consumed or sold to workers. The money from sales is used by firms to purchase labor in the next period. Complicated record keeping is avoided by using ordinary playing cards to represent money and goods. The exercise can stimulate a discussion of potential output, unemployment, and the role of money in determining wages and prices.Use: This experiment can be used in introductory macroeconomics classes to teach concepts of the circular flow, real and money wages, unemployment, and labor market equilibrium and in intermediate classes to consider Keynesian and quantity theories.Time required: Fifteen minutes for reading instructions, 30 to 45 minutes for trading (depending on the number of periods), and 15 minutes for discussion.Materials: You will need one copy of the instructions for each person and one deck of ordinary playing cards for each replicated group of two workers and one firm. No money or other incentives are required.
Simulating the Effects of Railroad Mergers
Authors: Park Joon Je , Babcock Michael W. , Lemke Kenneth , Weisman Dennis L. 
Published: July 2021

The purpose of this paper is to add to the empirical literature regarding merger simulation analysis by examining the effect of railroad mergers on railroad market power. This is done by measuring railroad profits and revenue/variable cost ratios corresponding to different degrees of intrarailroad competition for movements of Kansas export wheat to Houston, Texas.Two models are developed to achieve the objectives of the study. A network model of the wheat logistics system is used to identify the least cost transportation routes from the Kansas study area to the market at Houston. A profit improvement algorithm, which identifies Nash equilibrium prices, is developed to measure the amount by which railroads can profitably raise their prices above variable cost.The results of the study have implications for U.S. railroad merger policy. The paper indicates that railroad mergers do not necessarily increase railroad market power or make railroad shippers worse off. Instead, the study demonstrates that the impact of railroad mergers on shippers and railroads depends on factors that vary geographically, such as the degree of intrarailroad and intermodal competition in the area.
A systematic review on the effect of inorganic surface coatings in large animal models and meta‐analysis on tricalcium phosphate and hydroxyapatite on periimplant bone formation
Authors: Damerau Jeanne‐Marie , Bierbaum Susanne , Wiedemeier Daniel , Korn Paula , Smeets Ralf , Jenny Gregor , Nadalini Johanna , Stadlinger Bernd 
Published: July 2021

AbstractThe aim of the present systematic review was to analyse studies using inorganic implant coatings and, in a meta‐analysis, the effect of specifically tricalcium phosphate (TCP) and hydroxyapatite (HA) implant surface coatings on bone formation according to the PRISMA criteria. Inclusion criteria were the comparison to rough surfaced titanium implants in large animal studies at different time points of healing. Forty studies met the inclusion criteria for the systematic review. Fifteen of these analyzed the bone‐to‐implant contact (BIC) around the most investigated inorganic titanium implant coatings, namely TCP and HA, and were included in the meta‐analysis. The results of the TCP group show after 14 days a BIC being 3.48% points lower compared with the reference surface. This difference in BIC decreases to 0.85% points after 21–28 days. After 42–84 days, the difference in BIC of 13.79% points is in favor of the TCP‐coatings. However, the results are not statistically significant, in part due to the fact that the variability between the studies increased over time. The results of the HA group show a significant difference in mean BIC of 6.94% points after 14 days in favor of the reference surface. After 21–28 days and 42–84 days the difference in BIC is slightly in favor of the test group with 1.53% points and 1.57% points, respectively, lacking significance. In large animals, there does not seem to be much effect of TCP‐coated or HA‐coated implants over uncoated rough titanium implants in the short term.
Concentration and competition in the Brazilian credit market
Authors: Borilli Felipe 
Published: July 2021

AbstractCompetition and concentration effects in the banking sector is still a highly object questioned in the public policy. Problems of asymmetric information and high interest rates prompt the discussion on whether bank competition is good or bad for efficiency, or more generally, for social welfare. In recent years, a lot of research work has been carried out investigating the nature of competition in the banking industry. Since the 2008 financial crisis, competition in the banking industry has been characterized with low interest rates, low credit growth, increased regulation and compliance requirements. The objective of this study is to analyze the national credit market by calculating and analyzing concentration and competition indicators, between 2010 and 2020. To compare and estimate indexes of concentration, such as the Herfindahl‐Hirschman index and competition through the Lerner index. The results suggest that the concentration has decreased in the period considered so as competitiveness, suggesting that there is less competition in the market. Despite the limitations pointed out, the results suggest that bank concentration in the Brazilian financial market has been decreasing over the last few years due to an increase position and importance of new players such as Digital Banks, Fintechs and High‐Techs firms, which caused a decrease in the market share of large banks. Although, competition levels are not improving, showing that the market share is being absorbed by Financial Institutions with a considerable size and perhaps not by new entrants in the market.
The Italian version of the Reflective Functioning Questionnaire: Validity within a sample of adolescents and associations with psychological problems and alexithymia
Authors: Bizzi Fabiola , Riva Anna , Borelli Jessica L. , Charpentier‐Mora Simone , Bomba Monica , Cavanna Donatella , Nacinovich Renata 
Published: July 2021

AbstractObjectivesThis study aims to test the psychometric proprieties of the Reflective Functioning Questionnaire (RFQ) applied to younger (13–16 years) and older (17–20 years) Italian adolescents examining (1) the factorial structure of RFQ; (2) its invariance across age and sex; (3) correlations between RFQ subscale scores, as well as the associations of the RFQ with (4) psychological problems and alexithymia dimensions.MethodsA cross‐sectional study was conducted with 593 adolescents between the ages of 13 and 20 years old recruited from the community within Italy. These participants completed the RFQ, Symptom Checklist‑90, and Toronto Alexithymia Scale.ResultsThe two‐factor structure of the RFQ was confirmed. However, higher internal consistency of RFQ was obtained by removing two items that seemed problematic within this sample. Using a six‐item version of RFQ, the two‐factor structure was invariant across adolescent age and sex. Significant correlations among RFQ subscale scores, and between RFQ subscales with both psychological problems and alexithymia dimensions were found.ConclusionsPreliminary results reveal a short version of RFQ (six‐item) is a suitable measure to assess mentalizing in adolescents in the Italian context.
Clients in context: Environment, class, race, and therapists' perceptions of generalized anxiety disorder
Authors: Joy Eileen E. , Bartholomew Theodore T. 
Published: July 2021

AbstractEvidence‐based practice necessitates the inclusion of client identity and contextual information when conceptualizing diagnosis.ObjectiveTo examine how therapists' perceptions of Generalized Anxiety Disorder is influenced by client environmental contextual and identity factors, like class and race.MethodTherapists (n = 138; 76% women; Mage = 38.3) were randomly assigned three of six client vignettes and asked to provide diagnostic recommendations, confidence in diagnosis, and perception of client's concerns. Vignettes differed in their description of client class, race, and contextual factors. A linear mixed‐model was used to test confidence in diagnosis and generalized linear mixed‐models were conducted to predict diagnosis and client concerns.ResultsTherapists altered diagnosis, confidence, and client concerns based on client contextual factors—but not identity factors.ConclusionsTherapists consider contextual factors in making clinical decisions, with overall tendency towards diagnosis regardless of if symptoms met the diagnostic criteria of being “excessive” given the environmental context.