bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adjuvant Chemotherapy in the Treatment of Intraductal Papillary Mucinous Neoplasms of the Pancreas: Systematic Review and Meta‐Analysis
Authors: Chong Eric , Ratnayake Bathiya , Dasari Bobby V. M. , Loveday Benjamin P. T. , Siriwardena Ajith K. , Pandanaboyana Sanjay 
Published: September 2021

AbstractBackgroundThe present systematic review aimed to compare survival outcomes of invasive intraductal papillary mucinous neoplasms (IIPMNs) treated with adjuvant chemotherapy versus surgery alone and to identify pathologic features that may predict survival benefit from adjuvant chemotherapy.MethodA systematic search of MEDLINE, PubMed, Scopus, and EMBASE was performed using the PRISMA framework. Studies comparing adjuvant chemotherapy and surgery alone for patients with IIPMNs were included. Primary endpoint was overall survival (OS). A narrative synthesis was performed to identify pathologic features that predicted survival benefits from adjuvant chemotherapy.ResultsEleven studies and 3393 patients with IIPMNs were included in the meta‐analysis. Adjuvant chemotherapy significantly reduced the risk of death in the overall cohort (HR 0.57, 95% CI 0.38–0.87,p = 0.009) and node‐positive patients (HR 0.29, 95% CI 0.13–0.64,p = 0.002). Weighted median survival difference between adjuvant chemotherapy and surgery alone in node‐positive patients was 11.6 months (95% CI 3.83–19.38,p = 0.003) favouring chemotherapy. Adjuvant chemotherapy had no impact on OS in node‐negative patients (HR 0.53, 95% CI 0.20–1.43,p = 0.209). High heterogeneity (I2 > 75%) was observed in pooled estimates of hazard ratios. Improved OS following adjuvant chemotherapy was reported for patients with stage III/IV disease, tumour size > 2 cm, node‐positive status, grade 3 tumour differentiation, positive margin status, tubular carcinoma subtype, and presence of perineural or lymphovascular invasion.ConclusionAdjuvant chemotherapy was associated with improved OS in node‐positive IIPMNs. However, the findings were limited by marked heterogeneity. Future large multicentre prospective studies are needed to confirm these findings and explore additional predictors of improved OS to guide patient selection for adjuvant chemotherapy.
Anatomical study between the correlation of the arcuate eminence and the superior semicircular canal
Authors: García-Barrios A. , Cisneros A. I. , Obon J. , Crovetto R. , Benito J. , Whyte J. 
Published: September 2021

Abstract
Objective
To study the anatomical correlation between the arcuate eminence and the superior semicircular canal.

Material and methods
A study of the height of the arcuate eminence was carried out in 295 temporal bones. In addition, 30 temporals with different heights of the arcuate eminence (10 flat, 10 prominent and 10 very prominent) were randomly selected and radiological tests were performed by computed tomography (Pöschl projection) and subsequent dissection by milling until the apex of the superior semicircular canal was found, establishing, with both methods, the anatomical relationship with the arcuate eminence.

Results
The arcuate eminence was classified as: smooth, when there was no relief (1.7%); flat, measured less than 1 mm (20.3%), prominent, measured between 1 and 2 mm, in (62%), and very prominent, measured above 2 mm (12.6%). The tomographic study (CT) and its subsequent dissection by bone milling showed a direct relationship between the arcuate eminence and the semicircular canal only when it was flat, while the rest of the types corresponded to the presence of pneumatized peri-labyrinthine cells and/or cancellous bone without a direct anatomical relationship with the apex of the superior semicircular canal.

Conclusion
The correlation between the arcuate eminence and the superior semicircular canal is direct only when it is flat (1 mm), being related to peri-labyrinthine cells and/or cancellous bone when the arcuate eminence is prominent or very prominent.
Psychische Gesundheit von Contergan-geschädigten Menschen
Authors: Niecke Alexander 
Published: September 2021

Zusammenfassung
Hintergrund
Sechs Jahrzehnte nach der pränatalen pharmakogenen Schädigung durch Thalidomid prägen vielfältige biopsychosoziale Folgeschädigungen das klinische Bild von Menschen mit Contergan-Behinderungen.

Fragestellung
Wie lässt sich das erst in der zweiten Lebenshälfte sichtbar gewordene hohe Ausmaß psychischer Störungen näher verstehen?

Material und Methode
Literaturüberblick zum aktuellen Stand der empirischen Forschung mit Diskussion weiterführender Fragen.

Ergebnisse
Menschen mit thalidomidinduzierten Schwerstbehinderungen zeigten jahrzehntelang bemerkenswerte Kompensationsleistungen. Ein sehr hoher Bildungsstatus sowie eine gute berufliche und soziale Integration wurden über viele Jahre erreicht. In der jüngeren Vergangenheit ist es jedoch zur zunehmenden sozialen Desintegration gekommen. Erstmals wurde eine hohe Rate psychischer Störungen, bei gleichzeitig bestehenden Barrieren im Zugang zur psychotherapeutischen Versorgung, beschrieben.

Schlussfolgerung
Das große Vorkommen psychischer Störungen im Alter kann einerseits als durch multidimensionale, teilweise bereits pränatal erworbene Traumatisierungen verursacht, andererseits als eine lange Zeit zugunsten einer Monostigmatisierung bestehende selektive Nichtwahrnehmung des Psychischen verstanden werden. Nicht nur für die Betroffenen ist es wichtig, dass der Fall Contergan im kollektiven Gedächtnis erinnert wird.
Lower and upper bound estimates of inequality of opportunity for emerging economies
Authors: Hufe Paul , Peichl Andreas , Weishaar Daniel 
Published: September 2021

AbstractEquality of opportunity is an important normative ideal of distributive justice. In spite of its wide acceptance and economic relevance, standard estimation approaches suffer from data limitations that can lead to both downward and upward biased estimates of inequality of opportunity. These shortcomings may be particularly pronounced for emerging economies in which comprehensive household survey data of sufficient sample size is often unavailable. In this paper, we assess the extent of upward and downward bias in inequality of opportunity estimates for a set of twelve emerging economies. Our findings suggest strongly downward biased estimates of inequality of opportunity in these countries. To the contrary, there is little scope for upward bias. By bounding inequality of opportunity from above, we address recent critiques that worry about the prevalence of downward biased estimates and the ensuing possibility to downplay the normative significance of inequality.
Methotrexat-Versorgung vor dem Einsatz von Biologika bei rheumatoider Arthritis
Authors: Pardey Nicolas , Zeidler Jan , Nellenschulte Tim Fritz , Stahmeyer Jona T. , Hoeper Kirsten , Witte Torsten 
Published: September 2021

Zusammenfassung
Hintergrund
Seit vielen Jahren erweitern Biologika die Therapieoptionen bei rheumatoider Arthritis (RA). Der Einsatz dieser biologischen „disease-modifying antirheumatic drugs“ (bDMARDs) ist gemäß deutscher und europäischer Behandlungsleitlinien jedoch erst bei Ausschöpfung der Methotrexat (MTX)-Erstlinientherapie von mindestens 20 mg/Woche indiziert. Ziel der Studie ist es, die Leitliniengerechtigkeit der MTX-Verordnung im ambulanten Sektor vor der Biologikatherapie zu überprüfen.

Methodik
Es wurden Routinedaten der AOK-Niedersachsen der Jahre 2013 bis 2016 für alle Versicherten zur Verfügung gestellt, die im Studienzeitraum eine RA-Diagnose sowie eine bDMARD-Verordnung aufweisen. Innerhalb eines patientenindividuellen Beobachtungszeitraums von 180 Tagen vor der ersten bDMARD-Verordnung wurde die maximal verordnete MTX-Dosierung untersucht.

Ergebnisse
Die Studienpopulation umfasst 405 Patienten (90 inzident, 315 prävalent). Bei 60,0 % der inzidenten Patienten und 67,0 % der prävalenten Patienten wurde eine maximale MTX-Verordnung von < 20 mg/Woche beobachtet. Männer weisen im Mittel mit 17,1 ± 4,8 mg eine höhere MTX-Maximaldosierung als Frauen auf (14,9 ± 5,0 mg; p < 0,0001); 29,6 % der Studienpopulation erhielten im Beobachtungszeitraum ausschließlich orale Verordnungen. Umstellungen auf eine parenterale Applikationsform wurden bei 12,4 % der Patienten festgestellt.

Diskussion
Ein gezielter Einsatz des gesamten vorgesehenen Therapiespektrums vor der Initiierung einer bDMARD-Therapie kann zu einer kosteneffizienten Versorgung der RA beitragen. Die Studie zeigt Indizien für mögliche Defizite in der ambulanten MTX-Verordnungspraxis auf und kann für eine effiziente Therapie sensibilisieren.
Stellenwert von Mycophenolat-Mofetil zur Behandlung der interstitiellen Lungenerkrankung bei systemischer Sklerose
Authors: Schneider Udo , Siegert Elise , Gläser Sven , Krüger Klaus ,   die Kommission Pharmakotherapie der DGRh, Krause Andreas 
Published: September 2021

ZusammenfassungDie interstitielle Lungenbeteiligung bei systemischer Sklerose (SSc-ILD) ist eine häufige Organkomplikation mit erheblicher Mortalität. Therapeutisch kommen in erster Linie Immunsuppressiva zum Einsatz, insbesondere Cyclophosphamid (CYC) und Mycophenolat-Mofetil (MMF). Neuere Daten zeigen zudem eine Wirksamkeit der Biologika Rituximab und Tocilizumab. Die therapeutischen Optionen wurden zuletzt durch die Zulassung des Antifibrotikums Nintedanib erweitert, dessen Stellenwert insbesondere bei den trotz Immunsuppression progredient fibrosierenden Verläufen der ILD liegt. Die in dieser Übersicht zusammengestellten Daten aus kontrollierten Studien zur Wirksamkeit und Sicherheit von CYC und MMF sprechen für einen bevorzugten Einsatz von MMF. Dem entgegen steht die noch immer fehlende Zulassung von MMF für diese Indikation. Diese wird für eine verbesserte und vereinfachte Versorgung von Patienten mit SSc-ILD dringend benötigt.
Biallelic variants in YRDC cause a developmental disorder with progeroid features
Authors: Schmidt Julia , Goergens Jonas , Pochechueva Tatiana , Kotter Annika , Schwenzer Niko , Sitte Maren , Werner Gesa , Altmüller Janine , Thiele Holger , Nürnberg Peter , Isensee Jörg , Li Yun , Müller Christian , Leube Barbara , Reinhardt H. Christian , Hucho Tim , Salinas Gabriela , Helm Mark , Jachimowicz Ron D. , Wieczorek Dagmar , Kohl Tobias , Lehnart Stephan E. , Yigit Gökhan , Wollnik Bernd 
Published: September 2021

AbstractThe highly conserved YrdC domain-containing protein (YRDC) interacts with the well-described KEOPS complex, regulating specific tRNA modifications to ensure accurate protein synthesis. Previous studies have linked the KEOPS complex to a role in promoting telomere maintenance and controlling genome integrity. Here, we report on a newborn with a severe neonatal progeroid phenotype including generalized loss of subcutaneous fat, microcephaly, growth retardation, wrinkled skin, renal failure, and premature death at the age of 12 days. By trio whole-exome sequencing, we identified a novel homozygous missense mutation, c.662T > C, in YRDC affecting an evolutionary highly conserved amino acid (p.Ile221Thr). Functional characterization of patient-derived dermal fibroblasts revealed that this mutation impairs YRDC function and consequently results in reduced t6A modifications of tRNAs. Furthermore, we established and performed a novel and highly sensitive 3-D Q-FISH analysis based on single-telomere detection to investigate the impact of YRDC on telomere maintenance. This analysis revealed significant telomere shortening in YRDC-mutant cells. Moreover, single-cell RNA sequencing analysis of YRDC-mutant fibroblasts revealed significant transcriptome-wide changes in gene expression, specifically enriched for genes associated with processes involved in DNA repair. We next examined the DNA damage response of patient’s dermal fibroblasts and detected an increased susceptibility to genotoxic agents and a global DNA double-strand break repair defect. Thus, our data suggest that YRDC may affect the maintenance of genomic stability. Together, our findings indicate that biallelic variants in YRDC result in a developmental disorder with progeroid features and might be linked to increased genomic instability and telomere shortening.
Transsphenoidal pituitary adenoma resection: do early post-operative cortisol levels predict permanent long-term hypocortisolism?
Authors: Butenschoen Vicki M. , von Werder Alexander , Bette Stefanie , Schmette Veronika , Schwendinger Nina , Meyer Bernhard , Gempt Jens 
Published: September 2021

AbstractTranssphenoidal surgery provides a minimal invasive treatment for pituitary adenoma. Our aim is to evaluate the endocrinological outcomes after adenoma resection focusing on the corticotroph function, and to identify prognostic factors for an impaired hypothalamic–pituitary–adrenal-axis function (HPA) and the reliability of postoperative early morning serum cortisol measurements. We performed a retrospective analysis of all patients treated for pituitary adenoma from April 2006 to January 2019 in our neurosurgical department. Pituitary function was assessed pre- and postoperatively as well as at 6 weeks to 12 weeks and at 1-year follow-up. Two hundred eleven patients were included. Nine percent of the patients recovered from a preoperative adrenal insufficiency, 10.4% developed a new need for hormone substitution, and a long-term deficiency of the hypothalamic–pituitary–adrenal-axis was observed in 30.9%. Cortisol measurements 5 days after surgery had a lower area under the curve (AUC) than cortisol levels detected after 6 to 12 weeks (AUC 0.740 vs. AUC 0.808) in predicting an intact corticotrope function. The cut-off value determined for cortisol measured after 6 weeks was 6.95 µg/dl (sensitivity of 94%, specificity of 68%). Postoperative early morning cortisol levels seem to be less sensitive and specific in predicting long-term corticotroph function than measurements after 6 weeks and 1 year, emphasizing the importance of endocrine follow-up testing.
Ethanol inactivation of orthonairoviruses in ixodid ticks
Authors: Schulz A. , Methling K. , Lalk M. , Eisenbarth A. , Keller M. , Groschup M. H. 
Published: September 2021

AbstractIxodid ticks represent vectors and reservoirs for a broad range of zoonotic pathogens. Collected ticks from field studies are therefore usually stored in ethanol, which in higher concentrations effectively inactivates most of the known tick-borne pathogens. Although commonly practiced as gold standard for inactivation, hardly any scientific data demonstrate that ethanol sufficiently penetrates the comparatively thick cuticula of ticks. Therefore, Amblyomma hebraeum tick pools were stored for 21 days in ethanol (96%). Afterwards, the ethanol was removed and the ticks were homogenized. Quantitative 1H-NMR spectroscopic analysis was applied to determine the residual concentration of ethanol inside the ticks. 1H-NMR spectroscopic analysis revealed that ethanol constituted 28.3–42.6 mg of the total weight of three ticks in the pools (89.9–121.5 mg). In addition, the low-pathogenic Hazara orthonairovirus (HAZV) was used as a cell culture model for this study. The virus was exposed to ethanol concentrations between 0 and 60% and incubated under various temperature conditions for four time periods. Afterwards, the residual virus infectivity was determined by titration. Following ethanol exposure, HAZV did not grow in cells after 9 h of exposure to an ethanol concentration of 25%. These results demonstrate an extremely low ethanol resistance of the virus, which was generally in line with previously reported ethanol inactivation data for Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV). After prolonged storage and impregnation, comparable ethanol concentrations are achieved in the ticks, indicating the suitability of this inactivation method also for Bunyaviruses in ticks. At the very least, a massive virus inactivation can be assumed. Definitive proof of virus inactivation would require a bioassay of ethanol-treated infected ticks under appropriate biosafety conditions.
Self-supervised representation learning for surgical activity recognition
Authors: Paysan Daniel , Haug Luis , Bajka Michael , Oelhafen Markus , Buhmann Joachim M. 
Published: September 2021

AbstractPurpose: Virtual reality-based simulators have the potential to become an essential part of surgical education. To make full use of this potential, they must be able to automatically recognize activities performed by users and assess those. Since annotations of trajectories by human experts are expensive, there is a need for methods that can learn to recognize surgical activities in a data-efficient way. Methods: We use self-supervised training of deep encoder–decoder architectures to learn representations of surgical trajectories from video data. These representations allow for semi-automatic extraction of features that capture information about semantically important events in the trajectories. Such features are processed as inputs of an unsupervised surgical activity recognition pipeline. Results: Our experiments document that the performance of hidden semi-Markov models used for recognizing activities in a simulated myomectomy scenario benefits from using features extracted from representations learned while training a deep encoder–decoder network on the task of predicting the remaining surgery progress. Conclusion: Our work is an important first step in the direction of making efficient use of features obtained from deep representation learning for surgical activity recognition in settings where only a small fraction of the existing data is annotated by human domain experts and where those annotations are potentially incomplete.
Consumer attitudes towards the mountain product label: Implications for mountain development
Authors: Bassi Ivana , Carzedda Matteo , Grassetti Luca , Iseppi Luca , Nassivera Federico 
Published: September 2021

AbstractTo protect and promote the originality and authenticity of mountain foodstuffs, the European Union set Regulation No 1151/2012 to create the optional quality term “mountain product”. Our research aimed at exploring the attractiveness of the mountain product label for consumers, considering both attitude towards the label itself and purchase intentions. We propose a model to investigate relationships between four latent constructs — mountain attractiveness, mountain food attractiveness, attitude towards the mountain product label, and purchase intention — which have been tested, thus confirming the statistical relevance of the relationships. All 47 items selected for describing the latent constructs are suitable for this purpose. Ridge and LASSO results also show that 17 items of the first three constructs are relevant in explaining purchase intentions. Some contextual variables, such as age, income, geographical origin of consumers, and knowledge of mountain products and mountains for tourism purposes, can positively influence consumers’ behavior. These findings could support the design of mountain development strategies, in particular marketing actions for both the product and the territory.
Tourism management in national parks: Šumava and Bayerischer Wald (Bavarian Forest) in the Czech-German borderland
Authors: Kołodziejczyk Krzysztof 
Published: September 2021

AbstractAlong the Czech-German border there are four national parks, two Czech and two German, arranged in cross-border ‘pairs’. This article focuses on the southern ‘pair’ formed by the parks of Šumava and Bayerischer Wald (Bavarian Forest). The aim is to evaluate and compare tourism organization in their areas, taking into account selected aspects of management: the network of hiking trails with its related infrastructure, transport accessibility, a typology of tourist centers, as well as directions and destinations of tourist movements. Based on the results, it can be concluded that the availability of geographical space for tourists is much greater in the German than in the Czech national park, and the tourism infrastructure is clearly more extensive there, including the network of tourist trails. This is mainly due to the longer and fairly uninterrupted development of tourism in this area. Šumava National Park can be identified as a model in terms of how to adjust the directions of tourist movements and the layout of the tourist trail network to the needs of natural environment. On the basis of observations in both national parks, it is possible to indicate various solutions that, after appropriate adaptation, may bring benefits to other protected areas.
Early results after aortic annuloplasty with a complete external Dacron band
Authors: Kvitting John-Peder Escobar , Beitnes Jan Otto , Lundblad Runar 
Published: September 2021

Abstract
Objective
This study evaluates the early results of our initial experience with aortic annuloplasty using a complete external Dacron band in the setting of type Ic or type II aortic regurgitation (AR).

Methods
From May 2017 to August 2019, 16 patients (88% bicuspid aortic valves, no patients with connective tissue disorders) underwent aortic annuloplasty with an external complete Dacron band. Clinical and echocardiographic follow-up was 100% complete. Clinical and echocardiographic follow-up averaged 24.4 ± 9.3 and  15.1 ±  8.3 months, respectively.

Results
Mean cardiopulmonary and cross-clamp times were 105 ± 15 (72–127) and 86 ± 15 (51–113) min, respectively. Early and late mortality was 0%, with no incidents of endocarditis or cerebrovascular events during the follow-up. Two patients were re-operated during the follow-up, one due recurrent aortic regurgitation (12 months after the first operation) yielding a freedom from reoperation due to AR at 1 year and 3 years of 100% ± 0% and 93.3% ± 5.7%, respectively. Based on the latest echocardiogram, five patients had either none or trivial AR, six had mild AR, and three had mild-to-moderate AR.

Conclusions
The early clinical and echocardiographic results after using a complete external Dacron band are promising; however, more data and longer follow-up are needed to determine its role in annular management during aortic valve repair.
Degree sum conditions for hamiltonian index
Authors: Liu Ze-meng , Xiong Li-ming 
Published: September 2021

AbstractIn this note, we show a sharp lower bound of $$\min \left\{{\sum\nolimits_{i = 1}^k {{d_G}({u_i}):{u_1}{u_2} \ldots {u_k}}} \right.$$

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is a path of (2-)connected G on its order such that (k-1)-iterated line graphs Lk−1(G) are hamiltonian.
Weak optimal inverse problems of interval linear programming based on KKT conditions
Authors: Liu Xiao , Jiang Tao , Li Hao-hao 
Published: September 2021

AbstractIn this paper, weak optimal inverse problems of interval linear programming (IvLP) are studied based on KKT conditions. Firstly, the problem is precisely defined. Specifically, by adjusting the minimum change of the current cost coefficient, a given weak solution can become optimal. Then, an equivalent characterization of weak optimal inverse IvLP problems is obtained. Finally, the problem is simplified without adjusting the cost coefficient of null variable.