bluuebunny/crossref_metadata_2025_split huggingface dataset:
The FibroScan-aspartate aminotransferase score can stratify the disease severity in a Japanese cohort with fatty liver diseases
Authors: Fujii Hideki , Fukumoto Shinya , Enomoto Masaru , Uchida-Kobayashi Sawako , Kimura Tatsuo , Tamori Akihiro , Nadatani Yuji , Takashima Shingo , Nishimoto Naoki , Kawada Norifumi 
Published: July 2021

AbstractThis study aimed to prove that the FibroScan-aspartate aminotransferase (FAST) scores can be used to stratify disease severity in a Japanese cohort with fatty liver diseases [metabolic dysfunction-associated fatty liver disease (MAFLD) and nonalcoholic fatty liver disease (NAFLD)]. All the participants (n = 2254) underwent liver stiffness measurements and controlled attenuation parameter assessments. We compared the clinical characteristics of the patients with MAFLD and NAFLD using the FAST scores and explored the independent determinants of FAST scores ≥ 0.35, which indicated possible progressive disease. Overall, MAFLD was diagnosed in 789 patients (35.0%), while NAFLD was diagnosed in 618 (27.4%). The proportion of patients that had a condition that suggested progressive liver disease was higher in those with MAFLD than in those with NAFLD [68 (8.6%) vs 48 (7.7%)]. The area under the receiver-operating characteristic curve of the FAST score for diagnosing advanced fibrosis was 0.969 in MAFLD and 0.965 in NAFLD. Multivariate analyses determined that diabetes mellitus, alanine aminotransferase (ALT) levels, fatty liver index, and Fibrosis-4 index independently predict FAST scores ≥ 0.35 in patients with MAFLD. ALT levels had the strongest correlation with the FAST scores (p = 0.7817). The FAST score could stratify the disease severity in the Japanese cohort with fatty liver diseases.
Alterations in cartilage quantification before and after injections of mesenchymal stem cells into osteoarthritic knees
Authors: Sekiya Ichiro , Katano Hisako , Mizuno Mitsuru , Koga Hideyuki , Masumoto Jun , Tomita Makoto , Ozeki Nobutake 
Published: July 2021

AbstractSeveral studies have reported improvement in knee pain following mesenchymal stem cell (MSC) injections for knee osteoarthritis (OA). We developed a novel 3D magnetic resonance imaging (MRI) analysis software program that provides “projected cartilage area ratios” for automatic detection of changes in cartilage amounts. The primary objective of this prospective interventional study was to compare alterations in the projected cartilage area ratio (thickness ≥ 1.5 mm) at the femoral posteromedial region between 30 weeks before and 30 weeks after synovial MSC injections. Secondary objectives were to assess the clinical scores and safety of MSC injections. Patients with OA who complained of knee pain underwent autologous synovial MSC injections into the knee at time 0 and again 15 weeks later. MRI examinations were performed at − 30, − 15, − 1, and 30 weeks. Patients showing < 3% decreases in the projected cartilage area ratio (thickness ≥ 1.5 mm) at the femoral the posteromedial region from − 30 weeks to − 15 weeks were excluded from the study. The Lysholm Knee Score, Knee Injury and Osteoarthritis Outcome Scale (KOOS), and Numerical Rating Scale (NRS) scores were evaluated at − 30, − 15, − 5, − 2, 0, 5, 10, 15, 20, 25, and 30 weeks. Five patients were excluded because 3D MRI analysis showed no cartilage loss at − 15 weeks. Ultimately, eight OA patients underwent MSC injections. The projected cartilage area ratio significantly decreased by 0.07 in the 30 weeks before MSC injections (p = 0.01), but no further decreases occurred in the 30 weeks after MSC injections. The projected cartilage area ratio at the femoral posteromedial region showed a significant difference between 30 weeks before and 30 weeks after MSC injections. The Lysholm Knee Score, KOOS, and NRS values improved significantly after the injections. MSC injection could not be ruled out as the cause of two adverse events: transient knee pain and itching in both hands. Fully automatic 3D MRI analysis showed that synovial MSC injections suppressed cartilage loss in patients with progressive OA.Trial registration: Intraarticular injections of synovial stem cells for osteoarthritis of the knee (Number UMIN 000026732). Date of registration; June 1, 2017. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000029967.
An assessment of urbanization sustainability in China between 1990 and 2015 using land use efficiency indicators
Authors: Jiang Huiping , Sun Zhongchang , Guo Huadong , Weng Qihao , Du Wenjie , Xing Qiang , Cai Guoyin 
Published: July 2021

AbstractThe sustainability of China’s rapid urbanization is of significance in the implementation of the 2030 Agenda for Sustainable Development. Here we integrated Earth observation and census data to estimate the relationship between land, population and economic domains of urbanization in 433 cities over 25 years using land use efficiency indicators. We find that the rise in ratio of land consumption to population growth rates (LCRPGR) was paralleled by a decline in ratio of economic growth to land consumption rates (EGRLCR). LCRPGR and EGRLCR of cities in Northeast China showed an abnormal and intense dynamics compared to other regions, suggesting that the northeastern region is more vulnerable to socioeconomic and environmental changes. The spatial expansion of superlarge cities in Central China may be unrestrained and should be the focus of strengthened regulations now and in the near future. The resource-dependent cities faced severe challenges for more effective actions of both economic transformation and population migration. Nonetheless, the gap of land use efficiency indicators between different income groups of the cities has been narrowed between 1990 and 2015, indicating that the evolution of urbanization in China is heading toward a more sustainable and coordinated process.
Decoupling density from tallness in analysing the life cycle greenhouse gas emissions of cities
Authors: Pomponi Francesco , Saint Ruth , Arehart Jay H. , Gharavi Niaz , D’Amico Bernardino 
Published: July 2021

AbstractThe UN estimate 2.5 billion new urban residents by 2050, thus further increasing global greenhouse gases (GHG) emissions and energy demand, and the environmental impacts caused by the built environment. Achieving optimal use of space and maximal efficiency in buildings is therefore fundamental for sustainable urbanisation. There is a growing belief that building taller and denser is better. However, urban environmental design often neglects life cycle GHG emissions. Here we offer a method that decouples density and tallness in urban environments and allows each to be analysed individually. We test this method on case studies of real neighbourhoods and show that taller urban environments significantly increase life cycle GHG emissions (+154%) and low-density urban environments significantly increase land use (+142%). However, increasing urban density without increasing urban height reduces life cycle GHG emissions while maximising the population capacity. These results contend the claim that building taller is the most efficient way to meet growing demand for urban space and instead show that denser urban environments do not significantly increase life cycle GHG emissions and require less land.
The largest plagiogranite on Earth formed by re-melting of juvenile proto-continental crust
Authors: Gamal El Dien Hamed , Li Zheng-Xiang , Abu Anbar Mohamed , Doucet Luc S. , Murphy J. Brendan , Evans Noreen. J. , Xia Xiao-Ping , Li Jiangyu 
Published: July 2021

AbstractThe growth of continental crust through melt extraction from the mantle is a critical component of the chemical evolution of the Earth and the development of plate tectonics. However, the mechanisms involved remain debated. Here, we conduct petrological and geochemical analyses on a large (up to 5000 km2) granitoid body in the Arabian-Nubian shield near El-Shadli, Egypt. We identify these rocks as the largest known plagiogranitic complex on Earth, which shares characteristics such as low potassium, high sodium and flat rare earth element chondrite-normalized patterns with spatially associated gabbroic rocks. The hafnium isotopic compositions of zircon indicate a juvenile source for the magma. However, low zircon δ18O values suggest interaction with hydrothermal fluids. We propose that the El-Shadli plagiogranites were produced by extensive partial melting of juvenile, previously accreted oceanic crust and that this previously overlooked mechanism for the formation of plagiogranite is also responsible for the transformation of juvenile crust into a chemically stratified continental crust.
Mitarbeiter im professionellen europäischen Fußball – Vergleich der Personalstruktur in der Sportmedizin, -wissenschaft und Physiotherapie zwischen der Bundesliga, La Liga, Serie A und der Premier League
Authors: Droste Jan-Niklas , Fisser Samuel , Gebhardt Matthias , Edler Christopher , Lippie Edward , McAleer Stephen , Del Vescovo Riccardo , Bloch Hendrik , Riepenhof Helge 
Published: July 2021

Zusammenfassung
Einleitung Im europäischen Profifußball konnten in letzten Jahren Länder- und Liga-spezifisch signifikante Unterschiede von Verletzungswahrscheinlichkeiten und Ausfallzeiten beobachtet werden. Ein möglicher Grund könnte neben Faktoren wie Einsatzzeit oder unterschiedlicher Vorbereitung die medizinische und sportwissenschaftliche Betreuung sein. Aus diesem Grund wurde eine Befragung der Fußballclubs der laut UEFA 4 besten europäischen Fußballligen bezüglich ihrer personellen Aufstellung in den Bereichen Medizin, Physiotherapie, Massage, Sportwissenschaft und Athletik- sowie „Strength & Conditioning“-Training durchgeführt, um den Personaleinsatz der Bundesliga mit den ersten Ligen der anderen Länder zu vergleichen. Grundlage ist eine Befragung aller 78 Mannschaften der erstklassigen Fußballligen der 4 europäischen Länder Deutschland (Bundesliga), Spanien (La Liga), Italien (Serie A) und England (Premier League). Jede Mannschaft wurde persönlich kontaktiert und der Personaleinsatz der einzelnen Fachbereiche mittels Fragebogens erfasst. In der Bundesliga zeigte sich im Vergleich zu den 3 weiteren Ligen insgesamt eine hochsignifikant geringere Mitarbeiterzahl (6,9 vs. 11,02; p < 0,0001). Die Anzahl der Ärzte ist in der Bundesliga im Vergleich signifikant erhöht (2,2 vs. 1,76; p = 0,0259), die Anzahl der mehr als 80 % ihrer gesamten ärztlichen Tätigkeit für die Mannschaft tätigen Ärzte allerdings hochsignifikant niedriger (0,2 vs. 1,45; p < 0,0001). Auch in der Gruppe der Physiotherapeuten (1,8 vs. 3,6; p < 0,001), Masseure (2,1 vs. 2,69; p = 0,0094), Sportwissenschaftler (0,3 vs. 1,12; p < 0,0001) sowie Athletiktrainer und Strengh & Conditioning Coaches (0,5 vs. 1,83; p < 0,0001) zeigten sich signifikant niedrigere Zahlen der Personalstruktur in der Bundesliga im Vergleich mit den gruppierten Ergebnissen der 3 anderen Ligen.
Schlussfolgerung Es zeigten sich in dieser Untersuchung signifikante Unterschiede der Personalstruktur im Bereich Sportmedizin und Sportwissenschaft zwischen der deutschen Bundesliga im Vergleich zu La Liga, Serie A und der Premier League mit einer höheren und enger an die Mannschaft gebundenen personellen Ausstattung letzterer 3 Ligen. Ob dies ein Grund für die Unterschiede der Verletzungshäufigkeiten zwischen diesen Ligen ist, sollte weiter untersucht werden. Insbesondere sollte auf die länderspezifischen Berufsunterschiede und deren Ausbildung sowie deren Tätigkeitsfelder näher eingegangen werden.
Kontrazeption und Adipositas
Authors: Römer Thomas 
Published: July 2021

Zusammenfassung
Ziel Die Kontrazeption bei Patientinnen mit einer Adipositas stellt eine klinisch spezielle Situation dar. Das erhöhte Risiko für venöse Thrombembolien ist zu beachten. Außerdem können spezielle Nebenwirkungen von Kontrazeptionsmethoden auftreten, und auch die Sicherheit einzelner Kontrazeptionsmethoden ist eingeschränkt.
Methodik Selektive Literatursuche
Ergebnisse Bei Patientinnen mit einer Adipositas sind weitere Risikofaktoren für Thrombembolien zu erfassen, da sich hieraus oft Kontraindikationen ergeben, vor allem für die Anwendung kombinierter hormoneller Kontrazeptionsmethoden. Bei adipösen Patientinnen ist bei der Anwendung von Gestagenmonopräparaten häufiger mit Blutungsstörungen zu rechnen. Die Daten bezüglich der Wirksamkeit einzelner Methoden sind limitiert. Einschränkungen bestehen für das transdermale kontrazeptive Pflaster. Bei höhergradiger Adipositas empfehlen die Leitlinien die Anwendung einer Hormon- oder Kupferspirale. Nach bariatrischer Chirurgie bedürfen Frauen bis zu 18 Monate einer sicheren Kontrazeption. Nach Malabsorptionschirurgie sind orale Kontrazeptiva zu vermeiden.
Schlussfolgerungen Die Wahl der Kontrazeptionsmethode bei adipösen Patientinnen bedarf einer individuellen Lösung, die abhängig von den Risikofaktoren für Thrombembolien, der Wirksamkeit und den Nebenwirkungen ist. Für die Notfallkontrazeption sind auch gewichtsbedingte Einschränkungen zu beachten.
Sport reduziert den diabetesassoziierten Verlust kognitiver Fähigkeiten bei Typ-2-Diabetes-Patienten
Authors: Klein Caroline , Müssig Karsten , Adamek Henning E. 
Published: July 2021

ZusammenfassungKognitive Defizite entwickeln sich bei T2D-Patienten häufig auf dem Boden metabolischer Störungen. Neben den eher mild ausfallenden, aber klinisch relevanten diabetesassoziierten kognitiven Dysfunktionen geht T2 D ebenfalls mit einem erhöhten Risiko für Demenz verschiedener Ursachen einher. Die zugrunde liegenden Mechanismen, die zu einer diabetesassoziierten kognitiven Dysfunktion führen, sind nicht vollständig geklärt. Trainingsinterventionen bieten die Möglichkeit, mögliche metabolische Risikofaktoren zu verringern und gleichzeitig dadurch die diabetesassoziierten kognitiven Verschlechterungen zu reduzieren. Unklar ist allerdings noch, welche Trainingsart und -intensität den größten gesundheitlichen Nutzen bringt, da bisherige Studienergebnisse wegen unterschiedlicher Kohorten, Interventionsmethoden und Interventionsdauern schwer zu vergleichen sind.
Conception and Feasibility of a Digital Tele-Guided Abdomen, Thorax, and Thyroid Gland Ultrasound Course for Medical Students (TELUS study)
Authors: Höhne Elena , Recker Florian , Schmok Erik , Brossart Peter , Raupach Tobias , Schäfer Valentin Sebastian 
Published: July 2021

Abstract
Purpose Medical education has been transformed during the COVID-19 pandemic, creating challenges regarding adequate training in ultrasound (US). Due to the discontinuation of traditional classroom teaching, the need to expand digital learning opportunities is undeniable. The aim of our study is to develop a tele-guided US course for undergraduate medical students and test the feasibility and efficacy of this digital US teaching method.
Materials and Methods A tele-guided US course was established for medical students. Students underwent seven US organ modules. Each module took place in a flipped classroom concept via the Amboss platform, providing supplementary e-learning material that was optional and included information on each of the US modules. An objective structured assessment of US skills (OSAUS) was implemented as the final exam. US images of the course and exam were rated by the Brightness Mode Quality Ultrasound Imaging Examination Technique (B-QUIET). Achieved points in image rating were compared to the OSAUS exam.
Results A total of 15 medical students were enrolled. Students achieved an average score of 154.5 (SD ± 11.72) out of 175 points (88.29 %) in OSAUS, which corresponded to the image rating using B-QUIET. Interrater analysis of US images showed a favorable agreement with an ICC (2.1) of 0.895 (95 % confidence interval 0.858 < ICC < 0.924).
Conclusion US training via teleguidance should be considered in medical education. Our pilot study demonstrates the feasibility of a concept that can be used in the future to improve US training of medical students even during a pandemic.
Fetal Echocardiography in Predicting Postnatal Outcome in Borderline Left Ventricle
Authors: Vorisek Carina Nina , Bischofsberger Lucy , Kurkevych Andrii , Yürökür Uygar , Wolter Aline , Gembruch Ulrich , Berg Christoph , Hudel Helge , Thul Josef , Jux Christian , Akintürk Hakan , Schranz Dietmar , Axt-Fliedner Roland 
Published: July 2021

Abstract
Objectives Prenatal prediction of postnatal univentricular versus biventricular circulation in patients with borderline left ventricle (bLV) remains challenging. This study investigated prenatal fetal echocardiographic parameters and postnatal outcome of patients with a prenatally diagnosed bLV.
Methods We report a retrospective study of bLV patients at four prenatal centers with a follow-up of one year. BLV was defined as z-scores of the left ventricle (LV) between –2 and –4. Single-ventricle palliation (SVP), biventricular repair (BVR), and no surgical or catheter-based intervention served as the dependent outcome. Prenatal ultrasound parameters were used as independent variables. Cut-off values from receiver operating characteristic curves (ROC) were determined for significant discrimination between outcomes.
Results A total of 54 patients were diagnosed with bLV from 2010 to 2018. All were live births. Out of the entire cohort, 8 (15 %) received SVP, 34 (63 %) BVR, and 12 (22 %) no intervention. There was no significant difference with regard to genetic or extracardiac anomalies. There were significantly more patients with endocardial fibroelastosis (EFE) in the SVP group compared to the BVR group (80 % vs. 10 %), (p < 0.001). Apex-forming LV (100 % vs. 70 %) and lack of retrograde arch flow (20 % vs. 80 %) were associated with no intervention (p < 0.001). With respect to BVR vs. SVP, the LV sphericity index provided the highest specificity (91.7 %) using a cutoff value of ≤ 0.5.
Conclusion The majority of bLV patients maintained biventricular circulation. EFE, retrograde arch flow, and LV sphericity can be helpful parameters for counseling parents and further prospective studies can be developed.
Treatment of the Middle Third and Septal Deformity: A Trizonal Approach
Authors: Kinberg Eliezer C. , Lawson William 
Published: July 2021

AbstractGenetic, developmental, traumatic factors can produce a wide variety of nasal septal deformities in caudal–cephalic/dorsal–maxillary planes alone or in combination. These can be corrected by an endonasal approach through a transfixion incision by resecting, transposing, or utilizing principles of cartilage biomechanics. The authors are proposing a “Rosetta Stone” based on a trizonal analysis of the deviated nose that considers the contribution of each region to the deformity. Clinical assessment of the deviated nose should be segmental as well as global. Surgical correlation of the nasal bones, perpendicular, and quadrilateral plates, lateral cartilages, and turbinates may be necessary to achieve a satisfactory cosmetic and functional results.
Cerebral Blood Flow of the Neonatal Brain after Hypoxic–Ischemic Injury
Authors: Tierradentro-García Luis Octavio , Saade-Lemus Sandra , Freeman Colbey , Kirschen Matthew , Huang Hao , Vossough Arastoo , Hwang Misun 
Published: July 2021

Objective Hypoxic–ischemic encephalopathy (HIE) in infants can have long-term adverse neurodevelopmental effects and markedly reduce quality of life. Both the initial hypoperfusion and the subsequent rapid reperfusion can cause deleterious effects in brain tissue. Cerebral blood flow (CBF) assessment in newborns with HIE can help detect abnormalities in brain perfusion to guide therapy and prognosticate patient outcomes.
Study Design The review will provide an overview of the pathophysiological implications of CBF derangements in neonatal HIE, current and emerging techniques for CBF quantification, and the potential to utilize CBF as a physiologic target in managing neonates with acute HIE.
Conclusion The alterations of CBF in infants during hypoxia-ischemia have been studied by using different neuroimaging techniques, including nitrous oxide and xenon clearance, transcranial Doppler ultrasonography, contrast-enhanced ultrasound, arterial spin labeling MRI, 18F-FDG positron emission tomography, near-infrared spectroscopy (NIRS), functional NIRS, and diffuse correlation spectroscopy. Consensus is lacking regarding the clinical significance of CBF estimations detected by these different modalities. Heterogeneity in the imaging modality used, regional versus global estimations of CBF, time for the scan, and variables impacting brain perfusion and cohort clinical characteristics should be considered when translating the findings described in the literature to routine practice and implementation of therapeutic interventions.
Key Points
Arthroscopically Assisted Eaton–Littler Trapeziometacarpal Ligamentoplasty
Authors: Moungondo Fabian G.P. , Gkotsi Antonia , Camus Emmanuel , Van Overstraeten Luc , Schuind Frédéric A. 
Published: July 2021

Abstract
Background Eaton–Littler ligamentoplasty has proven its efficacy in the treatment of trapeziometacarpal (TMC) instability.
Description of Technique In this article, we describe the arthroscopically assisted Eaton–Littler ligamentoplasty through two clinical cases.
Patients and Methods Arthroscopy is used to accurately place the metacarpal bone tunnel and pass the slip of flexor carpi radialis tendon in the latter. This procedure avoids soft-tissue dissection and could improve the outcome of this well-known surgery.
Results The two clinical cases showed good short-term outcome with a decrease of pain and good function.
Conclusions Arthroscopy to assist Eaton–Littler TMC ligamentoplasty is technically feasible, allowing a less invasive surgery. A larger prospective controlled study with a longer term outcome is mandatory to assess the real advantages of this modified procedure.
The Incidence of Accessory Ossicles of the Wrist: A Radiographic Study
Authors: Gursoy Merve , Coban Istemihan , Mete Berna Dirim , Bulut Tugrul 
Published: July 2021

Abstract
Objective Accessory ossicles of the wrist are generally asymptomatic and detected incidentally as radiological findings. These bones are rarely symptomatic but can produce pain in cases of impingement or direct trauma. More frequently, these bones are misinterpreted as avulsion fractures in trauma patients, which may lead to unnecessary immobilization and overtreatment. The aim of this study is to determine the incidence of accessory ossicles of the wrist and also determine if the incidence is related to age, gender, or ongoing wrist pain.
Materials and Methods A total of 1146 wrist radiographs were included in the study. All radiographs were analyzed for the presence of 20 different accessory ossicles of the wrist. Patients were also divided into two groups, as with and without accessory ossicle. Two groups were compared in terms of age, gender, and side.
Results About 113 accessory ossicles were detected in 111 (9.7%) radiographs. The most common accessory ossicles were os triangulare and os ulnostyloideum, and the least common accessory ossicles were os gruberi and os praetrapezium. Patients who had accessory ossicle had a significantly higher age than those who did not have accessory ossicle. There was no significant difference between the patients with and without accessory ossicle in terms of gender and side.
Conclusions The results of this study showed that the most common accessory ossicles in the wrist were os triangulare and os ulnostyloideum, and the incidence of accessory bones increased with age.
Clinical Relevance Since accessory ossicles of the wrist can be confused with fractures in trauma patients and are frequently ignored in patients presenting with pain, it is very important to know the incidence and distribution of these ossicles. Therefore, this study is important, in that it provides potentially guiding anatomical data for clinicians in terms of diagnosis and management.