bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring personalized postoperative non-invasive tissue oximetry in DIEP flap breast reconstruction
Authors: Lindelauf Anouk A. M. A. , Vranken Nousjka P. A. , Schols Rutger M. , Bouman Esther A. C. , Weerwind Patrick W. , van der Hulst René R. W. J. 
Published: August 2021

Abstract
Early detection of vascular compromise after autologous breast reconstruction is crucial to enable timely re-exploration for flap salvage. Several studies proposed non-invasive tissue oximetry for early identification of ischemia of deep inferior epigastric perforator (DIEP) flaps. The present study aimed to explore the utility of non-invasive tissue oximetry following DIEP flap surgery using a personalized oxygenation threshold.

Methods
Patients undergoing immediate/delayed DIEP flap surgery were included in this prospective observational study. DIEP flap tissue oxygenation (StO2) was monitored continuously using near-infrared spectroscopy. A baseline measurement was performed by positioning one sensor at the marked position of the major inferior epigastric perforator on the abdomen. A new sensor was positioned postoperatively on the transplanted tissue. In unilateral procedures, postoperative StO2 values of the native breast were also obtained. Measurements were continued for 24 h.

Results
Thirty patients (42 flaps) were included. Fourteen patients (46.7%) had an uncomplicated postoperative course. A minor complication was observed in thirteen patients; in five patients, at least one major complication occurred, requiring re-exploration. Median StO2 readings were significantly lower in patients with major complications compared to uncomplicated cases. In fourteen unilateral DIEP flap procedures, StO2 values of the native breast were similar to the preoperative baseline measurement (92%; p = 0.452).

Conclusions
Non-invasive tissue oximetry following DIEP flap surgery could aid in early detection of vascular compromise. StO2 values of the native breast and abdominal wall preoperatively can be used interchangeably and can serve as personalized reference value.
Level of evidence: Level IV, diagnostic / prognostic study.
Risk Factors for Postoperative Urinary Retention After Endoscopic Hernia Repair: Age and Unilateral Operation make the Difference
Authors: Di Natale S. , Slieker J. , Soppe S. , Bieri U. , Keerl A. , Nocito A. 
Published: August 2021

AbstractBackgroundPostoperative urinary retention (POUR) is a common complication after inguinal hernia repair that may result in catheter‐related infections or injuries, longer hospital stays, and thus, higher overall costs. Our aim was to assess the incidence of POUR after endoscopic total extraperitoneal (TEP) inguinal hernia repair and identify its risk factors.MethodsWe retrospectively analyzed all data that were included in a prospective Hernia Database for patients undergoing a TEP inguinal hernia repair at our institution between July 2012 and May 2018. POUR was defined as the inability to urinate spontaneously after surgery, thus requiring a bladder catheter.ResultsData from 1570 patients were included. Sixty‐five patients developed POUR, which was an incidence of 4.1%. In the univariate analysis, patients over 50 years of age (1.6% vs. 5.5%), patients with higher American Society of Anesthesiologists (ASA) score (ASA‐1 2.7% vs. ASA‐3 12.5%), previous prostate surgery (3.9% vs. 10.9%), unilateral operation (1.9% vs. 6.0%), and intraoperative drain placement (2.1% vs. 4.9%) developed POUR more often than younger patients. After multivariate adjustment, advanced age and unilateral surgery remained risk factors for POUR.ConclusionAdvanced age and unilateral inguinal hernia repair, possibly due to a lack of catheterization, were risk factors for POUR. Due to increasing outpatient inguinal hernia repairs worldwide, it is imperative to identify patients who are at risk of POUR to apply prophylactic measures and reduce readmission, and thus, reduce health‐care costs.
Error estimation on extracorporeal trajectory determination from body scans
Authors: Riva F. , Buck U. , Buße K. , Hermsen R. , Mattijssen E. J. A. T. , Kerkhoff W. 
Published: August 2021

AbstractThis study explores the magnitude of two sources of error that are introduced when extracorporeal bullet trajectories are based on post-mortem computed tomography (PMCT) and/or surface scanning of a body. The first source of error is caused by an altered gravitational pull on soft tissue, which is introduced when a body is scanned in another position than it had when hit. The second source of error is introduced when scanned images are translated into a virtual representation of the victim’s body. To study the combined magnitude of these errors, virtual shooting trajectories with known vertical angles through five “victims” (live test persons) were simulated. The positions of the simulated wounds on the bodies were marked, with the victims in upright positions. Next, the victims were scanned in supine position, using 3D surface scanning, similar to a body’s position when scanned during a PMCT. Seven experts, used to working with 3D data, were asked to determine the bullet trajectories based on the virtual representations of the bodies. The errors between the known and determined trajectories were analysed and discussed. The results of this study give a feel for the magnitude of the introduced errors and can be used to reconstruct actual shooting incidents using PMCT data.
The fetus in the age of the genome
Authors: Schmitz Dagmar , Henn Wolfram 
Published: August 2021

AbstractDue to a number of recent achievements, the field of prenatal medicine is now on the verge of a profound transformation into prenatal genomic medicine. This transformation is expected to not only substantially expand the spectrum of prenatal diagnostic and screening possibilities, but finally also to advance fetal care and the prenatal management of certain fetal diseases and malformations. It will come along with new and profound challenges for the normative framework and clinical care pathways in prenatal (and reproductive) medicine. To adequately address the potential ethically challenging aspects without discarding the obvious benefits, several agents are required to engage in different debates. The permissibility of the sequencing of the whole fetal exome or genome will have to be examined from a philosophical and legal point of view, in particular with regard to conflicts with potential rights of future children. A second requirement is a societal debate on the question of priority setting and justice in relation to prenatal genomic testing. Third, a professional-ethical debate and positioning on the goal of prenatal genomic testing and a consequential re-structuring of clinical care pathways seems to be important. In all these efforts, it might be helpful to envisage the unborn rather not as a fetus, not as a separate moral subject and a second “patient”, but in its unique physical connection with the pregnant woman, and to accept the moral quandaries implicitly given in this situation.
Quantitative sensorische Testung im Rahmen neuropathischer Schmerzen und ihre Bedeutung für die Physiotherapie
Authors: Adler Magdalena , Taxer Bernhard 
Published: August 2021

Zusammenfassung
Hintergrund
Neuropathische Schmerzsyndrome zeichnen sich durch hohe Chronifizierungsraten sowie lange und intensive Schmerzepisoden aus. Ein treffsicheres Erkennen stellt eine Grundkompetenz von Physiotherapeuten dar, ermöglicht eine ursachengerechte Therapie und kann die Entstehung von Folgeschäden verhindern. Die quantitative sensorische Testung (QST) wird im medizinischen Rahmen als Ergänzung zur klinischen Sensibilitätsprüfung eingesetzt, konnte inzwischen eine beachtliche Stellung in der Forschung einnehmen, wird in der klinischen Praxis jedoch weniger häufig eingesetzt.

Fragestellung
Welchen Mehrwert hat die QST in der Untersuchung neuropathischer Schmerzen? Was sind die Ursachen für die begrenzte klinische Anwendung der QST? Was sind potenzielle Wege für einen erfolgreichen Übertrag der QST in die physiotherapeutische Praxis?

Methode
Literaturrecherche im Zuge einer Bachelorarbeit Physiotherapie.

Ergebnisse
Als valides Untersuchungsinstrument, das zur Evaluierung des gesamten somatosensorischen Profils geeignet ist, bietet die QST vor allem im Bereich der Small-fibre-Neuropathien einen erheblichen Vorteil gegenüber konventionellen Testverfahren. Diese kleinen Fasern scheinen insbesondere in der Frühphase von Neuropathien betroffen zu sein und können über konventionelle Testverfahren nicht evaluiert werden. Das macht den Einsatz von Teilaspekten der QST zu einem nützlichen Instrument für Physiotherapeuten und medizinisches Personal, was besonders in der Früherkennung von Neuropathien von großem Nutzen ist.

Diskussion
Trotz des bestehenden großen Nutzens existieren bis dato noch Limitationen, die den klinischen Routineeinsatz der QST behindern. Einige davon können durch exakte Testausführungen und Vorkehrungen bis zu einem gewissen Grad überwunden werden, andere, für die Klinik hochrelevante Bereiche wie die hohen Anschaffungskosten der Geräte und der hohe zeitliche Aufwand der Durchführung konnten bislang noch nicht zufriedenstellend gelöst werden. Weniger umfassende Testprotokolle sowie die Entwicklung handlicher und kostengünstiger Testgeräte könnten diesbezüglich erste Lösungsansätze darstellen. Die Ergänzung der konventionellen Bedside-Untersuchung um Testungen zur Wärmesensibilität und Schmerzschwellenbestimmung kann eine weitere Möglichkeit darstellen, um den dargestellten Mehrwert der QST in den klinischen Alltag zu integrieren.

Schlussfolgerung
Die QST steuert einen wesentlichen Beitrag zur Untersuchung und Diagnose von Neuropathien bei. Physiotherapeuten sind dazu angehalten, Teilaspekte aus der QST in eine standardmäßige Untersuchung zu implementieren, um sowohl in der Früherkennung als auch in der Behandlung positiv einzuwirken.
Online and transparent self-adaptation of stream parallel patterns
Authors: Vogel Adriano , Mencagli Gabriele , Griebler Dalvan , Danelutto Marco , Fernandes Luiz Gustavo 
Published: August 2021

AbstractSeveral real-world parallel applications are becoming more dynamic and long-running, demanding online (at run-time) adaptations. Stream processing is a representative scenario that computes data items arriving in real-time and where parallel executions are necessary. However, it is challenging for humans to monitor and manually self-optimize complex and long-running parallel executions continuously. Moreover, although high-level and structured parallel programming aims to facilitate parallelism, several issues still need to be addressed for improving the existing abstractions. In this paper, we extend self-adaptiveness for supporting autonomous and online changes of the parallel pattern compositions. Online self-adaptation is achieved with an online profiler that characterizes the applications, which is combined with a new self-adaptive strategy and a model for smooth transitions on reconfigurations. The solution provides a new abstraction layer that enables application programmers to define non-functional requirements instead of hand-tuning complex configurations. Hence, we contribute with additional abstractions and flexible self-adaptation for responsiveness at run-time. The proposed solution is evaluated with applications having different processing characteristics, workloads, and configurations. The results show that it is possible to provide additional abstractions, flexibility, and responsiveness while achieving performance comparable to the best static configuration executions.
Do delusions have and give meaning?
Authors: Ritunnano Rosa , Bortolotti Lisa 
Published: August 2021

AbstractDelusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: (1) delusions are meaningful, despite being described as irrational and implausible beliefs; (2) some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions.
Characterization of Tribological and Mechanical Properties of the Si3N4 Coating Fabricated by Duplex Surface Treatment of Pack Siliconizing and Plasma Nitriding on AISI D2 Tool Steel
Authors: Najafizadeh Mojtaba , Ghasempour-Mouziraji Mehran , Sadeghi Behzad , Cavaliere Pasquale 
Published: August 2021

AbstractSilicon nitride (Si3N4) coating was deposited on AISI D2 tool steel through employing duplex surface treatments—pack siliconizing followed by plasma nitriding. Pack cementation was performed at 650 °C, 800 °C, and 950 °C for 2 and 3 hours by using various mixtures to realize the silicon coating. X-ray diffraction analyses and scanning electron microscopy observations were employed for demonstrating the optimal process conditions leading to high coating adhesion, uniform thickness, and composition. The optimized conditions belonging to siliconizing were employed to produce samples to be further processed via plasma nitriding. This treatment was performed with a gas mixture of 75 pct H2-25 pct N2, at the temperature of 550 °C for 7 hours. The results showed that different nitride phases such as Si3N4-β, Si3N4-γ, Fe4N, and Fe3N can be recognized as coatings reinforcements. It was demonstrated that the described composite coating procedure allowed to obtain a remarkable increase in hardness (80 pct higher with respect to the substrate) and wear resistance (30 pct decrease of weight loss) of the tool steel.
Immunotherapy in Hepatocellular Carcinoma
Authors: Fulgenzi Claudia A. M. , Talbot Thomas , Murray Sam M. , Silletta Marianna , Vincenzi Bruno , Cortellini Alessio , Pinato David J. 
Published: August 2021

Opinion statementPatients with hepatocellular carcinoma (HCC) have been traditionally deprived from highly effective systemic therapy options in the past decades. The multi-targeted tyrosine kinase inhibitor sorafenib, approved in 2008, remained the only treatment option for advanced HCC for over a decade. A number of molecularly targeted therapies such as lenvatinib, regorafenib, cabozantinib, and ramucirumab have significantly widened treatment options in patients with advanced HCC. However, emergence of resistance and long-term toxicity from treatment are barriers to long-term survivorship. Immunotherapy is at the focus of intense research efforts in HCC. Whilst targeting of programmed cell death 1 (PD-1) and cytotoxic T lymphocyte 4 (CTLA-4) is associated with radiologically measurable disease-modulating effects in HCC, monotherapies fell short of demonstrating evidence of significant survival extension in advanced disease. Atezolizumab and bevacizumab were the first immunotherapy regimen to demonstrate clear superiority in improving the survival of patients with unresectable HCC compared to sorafenib, paving the way for immunotherapy combinations. As the treatment landscape of HCC rapidly evolves, with immunotherapy integrating within early- and intermediate-stage disease treatment algorithms, lack of level 1 evidence on sequencing of therapeutic strategies and lack of head-to-head comparisons across immunotherapy combinations will affect prescribing of immunotherapy in routine practice. In the absence of predictive biomarkers, choice of immunotherapy over kinase inhibitors will continue to remain an empirical exercise, guided by balancing anti-tumour efficacy with toxicity considerations in the individual patient.
A Classical Source for Petrarch’s Conceit of the Binding Knot of Hair: Apuleius’s Metamorphoses
Authors: Caporicci Camilla 
Published: August 2021

AbstractThe conceit of the beloved’s hair ensnaring and binding the poet’s heart and soul is common in Renaissance poetry and particularly widespread in the tradition of Petrarchan love lyric. The topos can be traced back to Petrarch’s canzoniere, or Rerum vulgarium fragmenta, in which Laura’s golden hair is often described in terms of knots and laces tying both the poet’s heart and soul. No classical antecedent has previously been identified for the image. In this study, I propose a possible classical source for the characteristic Petrarchan motif of Laura’s binding hair knot: Apuleius’s Metamorphoses, a manuscript of which the poet owned and which he read and annotated several times. In particular, I show how passages such as Lucius’s celebration of the beauty of women’s hair (Metamorphoses, II.8–9), and especially his declaration of love to Photis, an oath he takes on ʻthat sweet knot of your hair with which you have bound my spiritʼ (ibid., III.23), can be convincingly regarded as a source for Petrarch’s conceit. In addition to the value inherent in the detection of a new source for an influential Petrarchan topos, the present study may have some further implications. It could offer novel arguments for the dating of a series of Petrarchan poems, and it could foster a potentially fruitful reappraisal of the influence of Apuleius’s work on Petrarch’s vernacular poetry.
Can Facebook likes predict the purchase probability of electricity storage systems?
Authors: Poier Stefan 
Published: August 2021

AbstractThis study among owners of photovoltaic systems investigates whether users' Big Five personality traits derived from their Facebook likes contribute to whether or not they adopt an electricity storage. It is based on the finding that the digital footprint, especially the Facebook likes, can in part predict the personality of users better than friends and family. The survey was conducted among 159 Facebook users in Germany who owned a photovoltaic system. For comparison, a control sample with data from the German Socio-Economic Panel with 425 photovoltaic owners among 7286 individuals was used. The results show that, for extraversion, agreeableness, and neuroticism, the mean scores could be sufficiently predicted. However, a positive correlation could only be detected for extraversion. The comparison of the user groups could not provide satisfying results. None of the Big Five personality traits could be used to distinguish the two user groups from each other. Although the results did not support the hypotheses, this study offers insights into the possibilities of combining data mining, personality psychology, and consumer research.
Micrometer Level Control Design of Piezoelectric Actuators: Fuzzy Approach
Authors: Chen Yung-Yue , Gieng Sang-Tac , Liao Wen-Yang , Huang Te-Chuan 
Published: August 2021

AbstractIn this investigation, a fuzzy-based micrometer level control design with a guaranteed trajectory tracking performance for piezoelectric actuators which naturally have hysteresis effects is proposed. Nominal dynamics of the controlled piezoelectric actuators are described by adopting Takagi and Sugeno fuzzy models initially. Via interpolating Takagi and Sugeno local fuzzy model, a robust fuzzy-based controller is developed to eliminate hysteresis, modeling uncertainties and external disturbances. Meanwhile, the tracking error is expected to be reduced as small as possible with respect to all bounded desired trajectories. This proposed fuzzy-based controller has an easy to implement control structure. The trajectory tracking design problem of piezoelectric actuators of this study is transferred to a linear matrix inequality problem, and based on the convex optimization technique, the solution of the trajectory tracking design problem of piezoelectric actuators can be solved efficiently. From the simulation results, it is obvious that this proposed fuzzy-based control design possesses robustness property and can converge tracking errors to zero in micrometer level.
Guerrilla War in Portuguese Africa: An Assessment of the Balance of Force in Mozambique
Authors: Opello Walter C. 
Published: August 2021

The status of the guerrilla wars in Angola, Mozambique and Guinea-Bissau has long been a topic of debate. While the coup d'etat in Portugal has affected the struggle for liberation in all three territories, the complexion of the debate appears to have changed most significantly with respect to the hostilities in Mozambique. This article presents an assessment of the balance of military force in Mozambique from the inception of the guerrilla war in 1964 through April 1974. Such an assessment provides an interesting perspective to recent military and political developments in that territory.Five phases can be discerned in the fighting in Mozambique since the beginning of the war in 1964. The first phase began in September of that year and ran roughly to the end of 1965. This phase was marked by the initial military successes of the nationalists, the Frente de Libertaca'o de Mozambique (FRELIMO), and the loss of some territory and population by the Portuguese in the districts of Cabo Delgado and Niassa. The second phase, which began in 1966 and ended at the close of 1969, was characterized by an increase in the ability of FRELIMO to concentrate military force on more heavily defended Portuguese positions but with a decrease in the limits of the zones of fighting in Cabo Delgado and Niassa. Phase three ran roughly through the twelve months of 1970 and was marked by a change in Portuguese counterinsurgency strategy which began with the launching of a number of highly successful counteroffensives against FRELIMO bases and sanctuaries. The fourth phase, which began in 1971 and ended in the first months of 1973, was characterized by a diminishing of the level of fighting in Cabo Delgado and Niassa and a concomitant shifting of the focus of military activities to the district of Tete. The fifth phase, which began in the summer of 1973, has been characterized by the spread of military activities from Tete to the northern sectors of Vila Pery and Beira districts. Each phase is discussed in detail below.