bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes after implantation of a sutureless aortic bioprosthesis with concomitant mitral valve surgery: the SURE-AVR registry
Authors:   on behalf of the SURE-AVR investigators, Baghai Max , Glauber Mattia , Fontaine Raphael , Castillo Jose Cuenca , Walker Antony H. , Livi Ugolino , Montiel José , Royse Alistair , Bisleri Gianluigi , Pacini Davide , Argano Vincenzo , Roumy Aurelien , Asimakopoulos George , Solinas Marco 
Published: May 2021

Abstract
Background
Early treatment of aortic valve stenosis is recommended in eligible symptomatic patients with severe aortic valve stenosis who would otherwise have a poor prognosis. The sutureless aortic valve bioprosthesis offers an alternative to standard aortic valve replacement with a sutured valve, but limited data are available in patients who have undergone multiple valve procedures involving the new, sutureless technology. We sought to investigate outcomes in high operative risk patients with previous or concomitant valve surgery who were implanted with a sutureless valve.

Methods
SURE-AVR is an ongoing, prospective, multinational registry of patients undergoing aortic valve replacement. In-hospital and post-discharge outcomes up to 5 years were collected.

Results
The study population comprised 78 patients (mean ± SD: age 73.6 ± 7.6 years, logistic EuroSCORE 18.0 ± 17.5) enrolled at 13 sites who presented for concomitant or previous mitral valve repair (n = 45) or replacement (n = 33), with or without additional concomitant procedures, and were implanted with a sutureless valve. Mean ± SD overall aortic cross-clamp time was 109 ± 41 min and cardiopulmonary bypass time was 152 ± 49 min. Mean ± SD aortic pressure gradients decreased from 37.6 ± 17.7 mmHg preoperatively to 13.0 ± 5.7 mmHg at hospital discharge, and peak aortic pressure gradient from 61.5 ± 28.7 to 23.4 ± 10.6 mmHg. Early events included 1 death, 1 transient ischaemic attack, and 1 bleed (all 1.3%); a permanent pacemaker implantation was required in 6 patients (7.7%), and 2 reoperations (not valve related) (2.6%) took place. Over a median follow-up of 55.5 months (Q1 13.4, Q3 68.6), 12 patients died (6 cardiovascular and 6 non-cardiovascular, both 2.1% per patient-year). Five-year survival was 81.3%. Late paravalvular leak occurred in 2 patients (0.7% per patient-year) and permanent pacemaker implantation was required in 3 patients (0.1% per patient-year). There was no apparent rise in mean or peak aortic pressure gradient over the study.

Conclusions
These results suggest that the sutureless implant is a technically feasible procedure during mitral surgery and is associated with good clinical outcomes.
Acute manic state with psychotic features in a teenager with autoimmune encephalitis: a case report
Authors: Wallengren Sara , Johansson Björn Axel , Rask Olof 
Published: May 2021

Abstract
Introduction
Autoimmune disorders have become increasingly acknowledged as having a more causative role in encephalitis than previously assumed. Anti-N-methyl-d-aspartate receptor encephalitis seems to be the most prevalent disorder. Symptoms of the neuropsychiatric phase in children and adolescents include abnormal behavior, seizures, and neurologic symptoms. We present a report on a teenage girl with predominantly psychiatric symptoms, highlighting the need for awareness of the disease and multidisciplinary collaboration.

Case presentation
Our patient, a 17-year-old girl of Middle Eastern origin, had no earlier medical history, but a family history of autoimmune disease. One morning, she could not recognize her mother and soon developed increased energy and pressured speech. The condition worsened, with paranoid delusions. In the emergency unit, she ran around speaking incoherently. The condition was interpreted as a full-scale mania. After pediatric clearance, the patient was admitted to the Department of Child and Adolescent Psychiatry. Mood-stabilizing treatment was initiated with second-generation psychotics and lithium, but this brought no improvement. A multidisciplinary discussion was held with physicians from psychiatry and neurology. A lumbar puncture showed N-methyl-d-aspartate receptor antibodies, and autoimmune treatment was initiated. Computed tomography thorax/abdomen revealed a right-sided ovarian tumor. After salpingo-oophorectomy, our patient’s mental status gradually improved, as demonstrated by repeated testing. Seven months post discharge she was in a stable relationship and performing well in school.

Conclusion
This case underlines the importance of collaboration between child and adolescent psychiatry and pediatrics, and gives pointers for timely diagnosis. Manic adolescents who do not respond to mood-stabilizing treatment should be subjected to further consultations and investigations. Psychiatrists and neurologists should develop an integrated approach to the management of brain disorders.
Cervical spine injury after virtual reality gaming: a case report
Authors: Baur D. , Pfeifle C. , Heyde C. E. 
Published: May 2021

Abstract
Background
We report a patient who fractured the seventh cervical vertebra while playing a virtual reality (VR) game, without any other trauma.
This case report aims to describe the spinal trauma incurred during the use of a VR headset in a video game.

Case presentation
The Caucasian patient presented with pain and swelling in the lower cervical spine at our clinic after playing a video game involving a combination of shoulder, arm and head movements while wearing a VR headset. Preexisting comorbidities were not present in the 31-year-old male. No history of regular medication use or drug abuse was recorded. After performing a clinical examination and radiological diagnostics, we found a dislocated traumatic fracture of the spinous process of the seventh cervical vertebra. After a soft tissue defect was excluded through magnetic resonance imaging (MRI) diagnostics, a conservative therapy regimen with pain therapy and immobilization was started.
After hospitalization, outpatient controls were conducted at 4, 6 and 12 weeks. At 6 weeks after hospitalization, the patient had recovered from the injury without complications.

Conclusions
Rapid movements during VR gaming can lead to injuries of the cervical spine. In addition to rapid movements, the additional weight of the VR headset as well as the decoupling of audiovisual stimuli from the perceived proprioceptive information should be considered. Determining whether this is an isolated incident induced by unknown preexisting factors or whether the trauma mechanism alone can lead to severe spinal trauma needs to be studied further with additional cases.
Challenges in exploring and manipulating the human skin microbiome
Authors: Boxberger Manon , Cenizo Valérie , Cassir Nadim , La Scola Bernard 
Published: May 2021

AbstractThe skin is the exterior interface of the human body with the environment. Despite its harsh physical landscape, the skin is colonized by diverse commensal microbes. In this review, we discuss recent insights into skin microbial populations, including their composition and role in health and disease and their modulation by intrinsic and extrinsic factors, with a focus on the pathobiological basis of skin aging. We also describe the most recent tools for investigating the skin microbiota composition and microbe-skin relationships and perspectives regarding the challenges of skin microbiome manipulation.
Comparison of cephalometric measurements between conventional and automatic cephalometric analysis using convolutional neural network
Authors: Jeon Sangmin , Lee Kyungmin Clara 
Published: May 2021

Abstract
Objective
The rapid development of artificial intelligence technologies for medical imaging has recently enabled automatic identification of anatomical landmarks on radiographs. The purpose of this study was to compare the results of an automatic cephalometric analysis using convolutional neural network with those obtained by a conventional cephalometric approach.

Material and methods
Cephalometric measurements of lateral cephalograms from 35 patients were obtained using an automatic program and a conventional program. Fifteen skeletal cephalometric measurements, nine dental cephalometric measurements, and two soft tissue cephalometric measurements obtained by the two methods were compared using paired t test and Bland-Altman plots.

Results
A comparison between the measurements from the automatic and conventional cephalometric analyses in terms of the paired t test confirmed that the saddle angle, linear measurements of maxillary incisor to NA line, and mandibular incisor to NB line showed statistically significant differences. All measurements were within the limits of agreement based on the Bland-Altman plots. The widths of limits of agreement were wider in dental measurements than those in the skeletal measurements.

Conclusions
Automatic cephalometric analyses based on convolutional neural network may offer clinically acceptable diagnostic performance. Careful consideration and additional manual adjustment are needed for dental measurements regarding tooth structures for higher accuracy and better performance.
A genetic-based pairwise trip planner recommender system
Authors: Qomariyah Nunung Nurul , Kazakov Dimitar 
Published: May 2021

AbstractThe massive growth of internet users nowadays can be a big opportunity for the businesses to promote their services. This opportunity is not only for e-commerce, but also for other e-services, such as e-tourism. In this paper, we propose an approach of personalized recommender system with pairwise preference elicitation for the e-tourism domain area. We used a combination of Genetic Agorithm with pairwise user preference elicitation approach. The advantages of pairwise preference elicitation method, as opposed to the pointwise method, have been shown in many studies, including to reduce incosistency and confusion of a rating number. We also performed a user evaluation study by inviting 24 participants to examine the proposed system and publish the POIs dataset which contains 201 attractions used in this study.
The role of domestic violence in fatal mass shootings in the United States, 2014–2019
Authors: Geller Lisa B. , Booty Marisa , Crifasi Cassandra K. 
Published: May 2021

Abstract
Background
Fatal mass shootings, defined as four or more people killed by gunfire, excluding the perpetrator, account for a small percentage of firearm homicide fatalities. Research has not extensively focused on the role of domestic violence (DV) in mass shootings in the United States. This study explores the role of DV in mass shootings in the United States.

Methods
Using 2014–2019 mass shooting data from the Gun Violence Archive, we indexed our data by year and mass shooting and collected the number of deaths and injuries. We reviewed news articles for each mass shooting to determine if it was 1) DV-related (i.e., at least one victim of a mass shooting was a dating partner or family member of the perpetrator); 2) history of DV (i.e., the perpetrator had a history of DV but the mass shooting was not directed toward partners or family members); or 3) non-DV-related (i.e., the victims were not partners or family members, nor was there mention of the perpetrator having a history of DV). We conducted descriptive analyses to summarize the percent of mass shootings that were DV-related, history of DV, or non-DV-related, and analyzed how many perpetrators died during the incidents. We conducted one-way ANOVA to examine whether there were differences in the average number of injuries or fatalities or the case fatality rates (CFR) between the three categories. One outlier and 17 cases with unknown perpetrators were excluded from our main analysis.

Results
We found that 59.1% of mass shootings between 2014 and 2019 were DV-related and in 68.2% of mass shootings, the perpetrator either killed at least one partner or family member or had a history of DV. We found significant differences in the average number of injuries and fatalities between DV and history of DV shootings and a higher average case fatality rate associated with DV-related mass shootings (83.7%) than non-DV-related (63.1%) or history of DV mass shootings (53.8%). Fifty-five perpetrators died during the shootings; 39 (70.9%) died by firearm suicide, 15 (27.3%) were killed by police, and 1 (1.8%) died from an intentional overdose.

Conclusions
Most mass shootings are related to DV. DV-related shootings had higher CFR than those unrelated to DV. Given these findings, restricting access to guns by perpetrators of DV may affect the occurrence of mass shootings and associated casualties.
Evaluation of the surgical and prosthetic success of All-on-4 restorations: a retrospective cohort study of provisional vs. definitive immediate restorations
Authors: Korsch Michael , Walther Winfried , Hannig Matthias , Bartols Andreas 
Published: May 2021

Abstract
Background
All-on-4 concept allows an immediate restoration, which is frequently a provisional restoration (PR), and will be replaced by a definitive restoration (DR) a few months later. However, this approach involves much higher treatment efforts and costs, compared to a DR immediately after implantation. PRs were mostly incorporated in the introductory phase of the All-on-4 concept in our respective clinics. Today, PRs are only used for referred patients and bimaxillary restorations. The aim of the study was to investigate whether PRs and DRs have comparable success rates.

Methods
A total of 126 patients with 136 All-on-4 restorations supported by 544 implants were included in this retrospective cohort study. The observation period was 1 year. In 42 cases, a PR was placed initially and replaced by a DR 3 months later. In 94 cases, a DR was placed immediately. Biological, technical, and severe (loss of an implant or PR/DR) complications associated with PRs and DRs were compared. The absence of a serious complication was considered a success.

Results
A total of 27 patients were affected by 33 complications, 19 biological (2 PR and 17 DR) and 14 technical (6 in PR and 8 in DR) in the first 3 months. Eight patients had ten severe complications (1 PR and 9 DR). Severe complications were all implant losses. Implant survival rate was 98.2% (99.4% PR and 97.6 DR), and restoration survival rate was 94.4% (97.6% PR and 92.6% DR). Six out of the ten implant losses occurred in the posterior maxillae of male patients. After 3 months, ten complications occurred in six patients within 1 year. One of these complications was an implant loss in the posterior maxillae of a male patient.

Conclusion
PRs and DRs showed comparable complication rates during the observation period. Only in male patients did implant losses occur more frequently in the posterior maxilla.
Parties beyond national borders: exploring the activities of Israeli political parties abroad
Authors: Friedman Avital , Kenig Ofer 
Published: May 2021

AbstractIn recent decades it has become a common practice for political parties to have active branches operating outside of their countries. The main reason for this practice is to mobilize potential voters living abroad. Israel, however, is a country in which citizens cannot vote abroad yet some parties nevertheless invest resources for sustaining their activities and branches outside of the country. Using the Israeli case, we aim to uncover additional incentives for parties to be present and active abroad. To do so, we map the activities of Israeli parties abroad and analyse their incentives, relying on documents and in-depth interviews with the parties’ directors of external relations. We find that parties’ activities can be divided into two basic groups. The first one includes diaspora-oriented activities, focusing mainly on maintaining ties with the Jewish communities abroad and gaining control over the institutions of the Zionist organizations. The second is focused on the Israeli state, by both improving the position of the party domestically and promoting Israel internationally according to the party’s ideology.
Assessing public perception of a sand fly biting study on the pathway to a controlled human infection model for cutaneous leishmaniasis
Authors: Parkash Vivak , Jones Georgina , Martin Nina , Steigmann Morgan , Greensted Elizabeth , Kaye Paul , Layton Alison M. , Lacey Charles J. 
Published: May 2021

Abstract
Background
A controlled human infection model (CHIM) involves deliberate exposure of volunteers to pathogens to assess their response to new therapies at an early stage of development. We show here how we used public involvement to help shape the design of a CHIM to support future testing of candidate vaccines for the neglected tropical disease cutaneous leishmaniasis, a disease transmitted by the bite of infected sand flies in tropical regions.

Methods
We undertook a public involvement (PI) consultation exercise to inform development of a study to test the safety and effectiveness of a sand fly biting protocol using uninfected sand flies (FLYBITE: ClinicalTrials.gov ID NCT03999970) and a CHIM using Leishmania major-infected sand flies (LEISH_Challenge: ClinicalTrials.gov ID NCT04512742), both taking place in York, UK. We involved 10 members of the public including a patient research ambassador and a previous CHIM volunteer. The session took place at The University of York, UK and examined draft study volunteer-facing material and included the CHIM study design, potential adverse events and therapeutic interventions at study endpoints. A discussion of the scientific, ethical, humanitarian and economic basis for the project was presented to the participants to provoke discourse. An inductive, thematic analysis was used to identify the participants’ key concerns.

Results
Themes were identified relating to i) quality of volunteer-facing written information, ii) improving study design, and iii) factors to motivate involvement in the research. Group participants responded positively to the overall study aims. Initial concerns were expressed about potential risks of study involvement, but further explanation of the science and mitigations of risk secured participant support. Participants provided advice and identified improved terminology to inform the volunteer-facing material. Lastly, treatment options were discussed, and excision of any cutaneous lesion was favoured over alternatives as a treatment.

Conclusion
The consultation exercise provided invaluable information which led to improved study design and enhanced clarity in the volunteer-facing material. The session also reinforced the need to maintain public trust in scientific rigour prior to initiation of any study. The investigators hope that this description strengthens understanding of PI in clinical research, and encourages its use within other studies.
An associational study: preschool teachers’ acceptance and self-efficacy towards Educational Robotics in a pre-service teacher training program
Authors: Schina Despoina , Valls-Bautista Cristina , Borrull-Riera Anna , Usart Mireia , Esteve-González Vanessa 
Published: May 2021

Abstract
Purpose
This study explores pre-service preschool teachers’ acceptance and self-efficacy towards Educational Robotics (ER) during a university course, and also examines their perceptions of the course.

Methodology
This is a one-group intervention study with an associational research design that includes both quantitative and qualitative research methods: two pre-questionnaires and two post-questionnaires on pre-service teachers’ acceptance and self-efficacy towards ER, and participants’ training journals.

Findings
The results show that pre-service teachers’ acceptance and self-efficacy towards ER improved after they completed the ER teacher training course. There was a significant difference between the start and the end of the ER training in the pre-service teachers’ acceptance of ER in the areas of perceived ease of use, enjoyment and attitudes, and in their self-efficacy. The findings based on the training journals show that participants positively evaluated the course. The participants also provided suggestions for improving it, such as additional training sessions, resources and time for experimentation.

Value
Our study reveals the impact of an ER training program and showcases the importance of integrating ER in pre-service teachers’ education.
The hepatoprotective effect of gooseberry and black mulberry extracts against carbon tetrachloride-induced liver injury in rats
Authors: Elmasry Shimaa , Moawad Mahmoud 
Published: May 2021

Abstract
Background
Liver is the vital organ of the human body responsible for nutrition, immunity, and metabolism. Carbon tetrachloride (CCl4) is an environmental pollutant that causes hepatotoxicity. This study aimed to evaluate the possible hepatoprotective effect of aqueous and ethanolic extracts of gooseberry and black mulberry on liver injury induced by CCl4 in rats.

Results
CCl4 caused significant (P≤0.05) elevation in the liver function tests and hydroxyproline (a major marker of fibrosis); also, there was a significant increase in the hepatic malondialdehyde (MDA), nitric oxide (NO), and plasma inflammatory biomarkers, whereas a significant decrease in the hepatic reduced glutathione (GSH), glutathione peroxidase (GPx), and plasma adiponectin levels was observed in the CCl4-treated group compared with control. These results were also confirmed by histological examination of liver tissue. Administration of gooseberry or black mulberry extracts alone decreased the hepatic level of hydroxyproline, ameliorated the antioxidant/oxidant status in liver tissue, and decreased the pro-inflammatory cytokines compared to normal control. Treatment with the tested extracts along with CCl4 was effectively able to ameliorate the abovementioned imbalances induced by CCl4 and protect the liver tissue.

Conclusion
These results indicate that gooseberry and black mulberry extracts have a hepatoprotective effect against carbon tetrachloride-induced liver injury in rats.