bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-to-end automated body composition analyses with integrated quality control for opportunistic assessment of sarcopenia in CT
Authors: Nowak Sebastian , Theis Maike , Wichtmann Barbara D. , Faron Anton , Froelich Matthias F. , Tollens Fabian , Geißler Helena L. , Block Wolfgang , Luetkens Julian A. , Attenberger Ulrike I. , Sprinkart Alois M. 
Published: September 2021

Abstract

Objectives
To develop a pipeline for automated body composition analysis and skeletal muscle assessment with integrated quality control for large-scale application in opportunistic imaging.

Methods
First, a convolutional neural network for extraction of a single slice at the L3/L4 lumbar level was developed on CT scans of 240 patients applying the nnU-Net framework. Second, a 2D competitive dense fully convolutional U-Net for segmentation of visceral and subcutaneous adipose tissue (VAT, SAT), skeletal muscle (SM), and subsequent determination of fatty muscle fraction (FMF) was developed on single CT slices of 1143 patients. For both steps, automated quality control was integrated by a logistic regression model classifying the presence of L3/L4 and a linear regression model predicting the segmentation quality in terms of Dice score. To evaluate the performance of the entire pipeline end-to-end, body composition metrics, and FMF were compared to manual analyses including 364 patients from two centers.

Results
Excellent results were observed for slice extraction (z-deviation = 2.46 ± 6.20 mm) and segmentation (Dice score for SM = 0.95 ± 0.04, VAT = 0.98 ± 0.02, SAT = 0.97 ± 0.04) on the dual-center test set excluding cases with artifacts due to metallic implants. No data were excluded for end-to-end performance analyses. With a restrictive setting of the integrated segmentation quality control, 39 of 364 patients were excluded containing 8 cases with metallic implants. This setting ensured a high agreement between manual and fully automated analyses with mean relative area deviations of ΔSM = 3.3 ± 4.1%, ΔVAT = 3.0 ± 4.7%, ΔSAT = 2.7 ± 4.3%, and ΔFMF = 4.3 ± 4.4%.

Conclusions
This study presents an end-to-end automated deep learning pipeline for large-scale opportunistic assessment of body composition metrics and sarcopenia biomarkers in clinical routine.

Key Points
• Body composition metrics and skeletal muscle quality can be opportunistically determined from routine abdominal CT scans.
• A pipeline consisting of two convolutional neural networks allows an end-to-end automated analysis.
• Machine-learning-based quality control ensures high agreement between manual and automatic analysis.
Prevalence of Hirschsprung-associated enterocolitis in patients with Hirschsprung disease
Authors: Hagens J. , Reinshagen K. , Tomuschat C. 
Published: September 2021

Abstract
Purpose
Hirschsprung's associated enterocolitis (HAEC) is a complication of Hirschsprung's Disease (HD) with considerable morbidity and mortality. The variability in presentation leads to a wide variety of the reported prevalence pre-and postoperatively. This systematic review aimed to clarify the prevalence of HAEC in short—(S-HD), long (L-HD), TCA and the type of operation used.

Methods
A systematic literature-based search for relevant cohorts was performed using Pubmed/Medline, Cochrane Library from its inception to May 2021. Studies reporting on pre-and postoperative enterocolitis, segment length, and surgical procedure (Soave, Swenson, Duhamel) were included. Pooled prevalence and subgroup analysis have been calculated for pre-and postoperative HAEC.

Results
4738 articles were identified from the literature search, among which 57 studies, including 9744 preoperative and 8568 postoperative patients, were included. The groups were sorted by length of the aganglionic segment for further analysis. The pooled prevalence for preoperative HAEC was 18.3% for all types, 15.2% for S-HD and 26.1% for TCA. The pooled prevalence for postoperative HAEC was in total 18.2% for all segment lengths and used techniques. Subgroup analysis showed no significant difference in the occurrence of postoperative enterocolitis between the three techniques.

Conclusion
The prevalence of preoperative HAEC increases with segment length. However, pooled data suggest that the postoperative risk for developing HAEC, independently of the employed method and segment length, is comparable to the preoperative risk.
Analysis of interrater reliability in age assessment of minors: how does expertise influence the evaluation?
Authors: Franceschetti Lorenzo , Merelli Vera Gloria , Corona Susanna , Magli Francesca , Maggioni Lidia , Cummaudo Marco , Tritella Stefania , De Angelis Danilo , Cattaneo Cristina 
Published: September 2021

AbstractNowadays, the clinical forensic medical management of migration flows comprises the age assessment of unaccompanied minors. The process of age estimation is a fundamental pillar for legally ensuring the minors’ rights and their protection needs. The procedure is complex and involves different phases and actors, from medical doctors to law enforcement officers. The present study aimed to investigate the performance of Greulich and Pyle, Demirjian, and Mincer methods when performed by raters both trained and without training. Also, the interrater reliability within groups of raters from different areas of expertise was evaluated. A total of 36 participants were enrolled for this study, divided in two groups according to their level of experience with age estimation methods. Each rater was asked to allocate stages and standards for age assessment, evaluating ten orthopantomograms and ten hand-wrist roentgenograms. The interrater reliability expressed through the Fleiss Kappa coefficient and the agreement with the reference standard were calculated. The results showed that none of the categories analyzed could reach a good interrater reliability (ĸ > 0.8) for both methods. The study results highlighted variation and disagreement in the interpretation of the sample among raters and in the subsequent stages and standards allocation. In conclusion, the results of this study highlight that expertise does influence the reliability of the most utilized methods of age estimation of living individuals and stress the importance of proper training and practice, which could greatly increase the accuracy of age assessments.
Psychosocial functioning in adolescents growing up with chronic disease: The Dutch HBSC study
Authors: Berkelbach van der Sprenkel Emma E. , Nijhof Sanne L. , Dalmeijer Geertje W. , Onland-Moret N. Charlotte , de Roos Simone A. , Lesscher Heidi M. B. , van de Putte Elise M. , van der Ent Cornelis K. , Finkenauer Catrin , Stevens Gonneke W. J. M. 
Published: September 2021

AbstractMany adolescents worldwide (indirectly) grow up with a chronic disease, which may impact their functioning and wellbeing. The objective of this study is to assess whether adolescents with a (family member with a) chronic disease differ from their healthy counterparts in terms of psychosocial functioning. Data from the Dutch 2013 HBSC-survey were used, including 7168 adolescents (Meanage = 13.7, SD = 1.57, 50.5% female). Participants indicated whether they or one of their family members had a long-term (> 3 months) disease or disability (mental/physical) and were categorized into four groups based on disease presence (none, other, self, both). Psychosocial functioning was assessed in terms of life satisfaction, self-rated health, psychosomatic health, mental health problems, support, substance use, physical exercise, screen time, and school liking. Chronically diseased adolescents (n = 162) reported lower life satisfaction, self-rated and psychosomatic health, more mental health problems, lower peer support, more substance use, and less physical exercise compared to healthy peers. Chronically diseased adolescents who also had a family member with a chronic disease (n = 74) showed comparable outcomes on these life domains, although they did not differ from their healthy peers regarding peer support, substance use, and physical activity. Healthy adolescents with a chronically diseased family member (n = 737) reported significantly lower life satisfaction, self-rated and psychosomatic health, more mental health problems, and less family support compared to healthy peers who grew up in healthy families; however, they reported more positive outcomes than adolescents who had a chronic disease themselves.Conclusion: Having a (family member with a) chronic disease is associated with impaired psychosocial functioning on various life domains. Our findings aid in understanding the psychosocial associates of chronic disease and imply that caregivers should be observant of psychosocial problems among vulnerable adolescents to provide appropriate guidance.

What is Known:• Adolescents who grow up with a (family member with a) chronic disease encounter numerous challenges that may be related to poorer developmental outcomes on the long term.

What is New:• This study adds a comprehensive overview of the psychosocial functioning of adolescents with a (family member with a) chronic disease, as compared to healthy counterparts that grow up in a healthy family.
Health care quality in nonparametric efficiency studies: a review
Authors: Sommersguter-Reichmann Margit 
Published: September 2021

AbstractScientists are increasingly considering quality in nonparametric frontier efficiency studies in health care. There are many ways to include quality in efficiency analyses. These approaches differ, among other things, in the underlying assumptions about the influence of quality on the attainable efficiency frontier and the distribution of inefficiency scores. The aim is to provide an overview of how scholars have taken quality into account in nonparametric frontier efficiency studies and, at the same time, to address the underlying assumptions on the relationship between efficiency and quality. To this end, we categorized empirical efficiency studies according to the methodological approaches and quality dimensions and collected the quality indicators used. We performed a Web of Science search for studies published in journals covered by the Science Citation Index Expanded, the Social Sciences Citation Index, and the Emerging Sources Citation Index between 1980 and 2020. Of the 126 studies covered in this review, 78 are one-stage studies that incorporate quality directly into the efficiency model and thus assume that quality impacts the attainable efficiency frontier. Forty-four articles are two-stage studies that consider quality in the first and the second stage or the second stage only. Four studies do not assume a priori a specific association between efficiency and quality. Instead, they test for this relationship empirically. Outcome quality is by far the most frequently incorporated quality dimension. While most studies consider structural quality as an environmental variable in the second stage, they include outcome quality predominantly directly in the efficiency model. Process quality is less common.
Characterization and Modeling of Thermostable GH50 Agarases from Microbulbifer elongatus PORT2
Authors: Anggraeni Santi Rukminita , Ansorge-Schumacher Marion B. 
Published: September 2021

AbstractViewing the considerable potential of marine agar as a source for the sustainable production of energy as well as nature-derived pharmaceutics, this work investigated the catalytic activity of three novel GH50 agarases from the mesophilic marine bacterium Microbulbifer elongatus PORT2 isolated from Indonesian coastal seawaters. The GH50 agarases AgaA50, AgaB50, and AgaC50 were identified through genome analysis; the corresponding genes were cloned and expressed in Escherichia coli BL21 (DE3). All recombinant agarases hydrolyzed β-p-nitrophenyl galactopyranoside, indicating β-glycosidase characteristics. AgaA50 and AgaB50 were able to cleave diverse natural agar species derived from Indonesian agarophytes, indicating a promising tolerance of these enzymes for substrate modifications. All three GH50 agarases degraded agarose, albeit with remarkable diversity in their catalytic activity and mode of action. AgaA50 and AgaC50 exerted exolytic activity releasing differently sized neoagarobioses, while AgaB50 showed additional endolytic activity in dependence on the substrate size. Surprisingly, AgaA50 and AgaB50 revealed considerable thermostability, retaining over 75% activity after 1-h incubation at 50 °C. Considering the thermal properties of agar, this makes these enzymes promising candidates for industrial processing.
Autonomic modulation of ventricular electrical activity: recent developments and clinical implications
Authors: van Weperen Valerie Y. H. , Vos Marc A. , Ajijola Olujimi A. 
Published: September 2021

AbstractPurposeThis review aimed to provide a complete overview of the current stance and recent developments in antiarrhythmic neuromodulatory interventions, focusing on lifethreatening vetricular arrhythmias.MethodsBoth preclinical studies and clinical studies were assessed to highlight the gaps in knowledge that remain to be answered and the necessary steps required to properly translate these strategies to the clinical setting.ResultsCardiac autonomic imbalance, characterized by chronic sympathoexcitation and parasympathetic withdrawal, destabilizes cardiac electrophysiology and promotes ventricular arrhythmogenesis. Therefore, neuromodulatory interventions that target the sympatho-vagal imbalance have emerged as promising antiarrhythmic strategies. These strategies are aimed at different parts of the cardiac neuraxis and directly or indirectly restore cardiac autonomic tone. These interventions include pharmacological blockade of sympathetic neurotransmitters and neuropeptides, cardiac sympathetic denervation, thoracic epidural anesthesia, and spinal cord and vagal nerve stimulation.ConclusionNeuromodulatory strategies have repeatedly been demonstrated to be highly effective and very promising anti-arrhythmic therapies. Nevertheless, there is still much room to gain in our understanding of neurocardiac physiology, refining the current neuromodulatory strategic options and elucidating the chronic effects of many of these strategic options.
Genetic diversity of seeds from four German Douglas fir (Pseudotsuga menziesii) seed orchards
Authors: Pakull Birte , Eusemann Pascal , Wojacki Janine , Ahnert Diana , Liesebach Heike 
Published: September 2021

AbstractIn Germany, Douglas fir (Pseudotsuga menziesiiFranco) is seen as a valuable species for future cultivation in times of climate change. Local seed production in seed stands and seed orchards may secure that local adaptation is transferred to the next generation, but small population sizes could lower genetic diversity and thus future adaptability. Here we analyse the transfer of genetic diversity from parent to offspring generation in four older German seed orchards. We detected low pollen contamination rates due to high levels of spatial isolation. Even with a relatively low number of 40 clones, seed orchard design with randomized and repeated planting of clones led to low selfing rates, and despite uneven parental contributions, the number of successful parents and the level of genetic intermixture were high enough to allow the transfer of an adequate part of the genetic diversity to the next generation. Larger numbers, however, might be needed to reliably conserve the entire genetic diversity over succeeding generations. Conclusions on the establishment of future seed orchards and regarding areas requiring further research are drawn at the end of the paper.
Long-term ecology and conservation of the Kungur forest-steppe (pre-Urals, Russia): case study Spasskaya Gora
Authors: Shumilovskikh Lyudmila , Sannikov Pavel , Efimik Elena , Shestakov Igor , Mingalev Vitaliy V. 
Published: September 2021

AbstractThe Kungur forest-steppe is the northernmost outpost of European forest-steppe, located in the western pre-Urals within the boreal climatic zone. The co-existence of boreal, nemoral and steppe species with relicts and endemics results in a high plant diversity, making it an important biodiversity hotspot. Under current climate change and strong agricultural impacts, the Kungur forest-steppe is rapidly degrading. In order to develop sustainable management strategies, we studied the vegetation history over the last 3500 years in the natural reserve area Spasskaya Gora. Palynological data indicate that the territory of Spasskaya Gora was largely covered by hemiboreal forests with high proportion of elm during the late Holocene. An opening of the vegetation strongly correlates with erosion, both indicating anthropogenic activities such as lumbering, agriculture, grazing and hay making. The modernPinusandBetuladominated forests combined with large areas dominated by grasses and herbs appear in the last 300 years and caused by human activity. The data support the ‘anthropogenic’ hypothesis of the Kungur forest-steppe development, suggesting that Pleistocene steppe was replaced by hemiboreal forests during the Holocene. Steppe elements survived on exposed rocks. The recent forest-steppe landscapes dominated by pioneer birch and poplar were formed due to anthropogenic deforestation. With respect to nature conservation, our data demonstrate that prohibition of any anthropogenic activities at Spasskaya Gora will lead to loss of diversity of steppe assemblages over the mid-term. We emphasize that conservation of the high plant diversity of the Kungur forest-steppe must include disturbance factors in the form of selective lumbering, prescribed burning, moderate grazing or traditional mowing.
Evolutionary algorithms for designing reversible cellular automata
Authors: Mariot Luca , Picek Stjepan , Jakobovic Domagoj , Leporati Alberto 
Published: September 2021

AbstractReversible Cellular Automata (RCA) are a particular kind of shift-invariant transformations characterized by dynamics composed only of disjoint cycles. They have many applications in the simulation of physical systems, cryptography, and reversible computing. In this work, we formulate the search of a specific class of RCA – namely, those whose local update rules are defined by conserved landscapes – as an optimization problem to be tackled with Genetic Algorithms (GA) and Genetic Programming (GP). In particular, our experimental investigation revolves around three different research questions, which we address through a single-objective, a multi-objective, and a lexicographic approach. In the single-objective approach, we observe that GP can already find an optimal solution in the initial population. This indicates that evolutionary algorithms are not needed when evolving only the reversibility of such CA, and a more efficient method is to generate at random syntactic trees that define the local update rule. On the other hand, GA and GP proved to be quite effective in the multi-objective and lexicographic approach to (1) discover a trade-off between the reversibility and the Hamming weight of conserved landscape rules, and (2) observe that conserved landscape CA cannot be used in symmetric cryptography because their Hamming weight (and thus their nonlinearity) is too low.
Strategic investment decisions in multi-stage contests with heterogeneous players
Authors: Deutscher Christian , Sahm Marco , Schneemann Sandra , Sonnabend Hendrik 
Published: September 2021

AbstractWhen heterogeneous players make strategic investment decisions in multi-stage contests, they might conserve resources in a current contest to spend more in a subsequent contest, if the degree of heterogeneity in the current (subsequent) contest is sufficiently large (small). We confirm these predictions using data from German professional soccer, in which players are subject to a one-match ban if they accumulate five yellow cards. Players with four yellow cards facing the risk of being suspended for the next match are (i) less likely to be fielded when the heterogeneity in the current match increases and (ii) more likely to receive a fifth yellow card in the current match when heterogeneity in the next match increases or heterogeneity in the next match but one (when they return from their ban) decreases.
Non-invasive sampling of bats reflects their potential as ecological indicators of elemental exposure in a diamond mining area, northern Limpopo Province, South Africa
Authors: Cory-Toussaint Dawn , Taylor Peter J. , Barnhoorn Irene E. J. 
Published: September 2021

AbstractBats have been proposed as reliable bioindicators for monitoring bioaccumulation of elements and chemicals in natural and transformed ecosystems. Non-invasive methods are becoming more popular as research moves away from destructive methodologies. We present the first concentrations of 23 elements in Mops condylurus and Tadarida aegyptiaca (Molossidae) fur and blood from an opencast diamond mine and reference area using inductively coupled plasma mass spectrometry (ICP-MS). Concentrations of B, K, Rb and Cd in the bats’ fur were significantly higher in the mining footprint compared to the reference area (P < 0.05). Other elements such as Zn and Hg were significantly higher in the blood of bats from the mining footprint than the reference area (P < 0.05), whereas Mn was significantly higher in the blood of bats from the reference area than from the mining footprint (P < 0.05). Sixteen of the 22 elements above the limit of detection, with the exception of Ba, were significantly higher in the fur samples than in the blood due to elements being incorporated over time into the fur as it grows, whereas blood reveals short-term exposure to elements. Concentrations of most of the elements were reasonably low except Al, Fe and Zn. In general, the element concentrations particularly in the fur samples were comparable with other international studies reporting elemental fur concentrations from anthropogenically impacted and natural areas. Fur and blood have the potential to be viable indicators of environmental toxicity, but research is required on toxic thresholds and physiological and ecological unknowns around element concentrations in bat tissues and organs.
Associations between ambient air pollutants and hospital admissions: more needs to be done
Authors: Belch Jill JF , Fitton Catherine , Cox Bianca , Chalmers James D 
Published: September 2021

AbstractDeaths from air pollution in the UK are higher by a factor of 10 than from car crashes, 7 for drug-related deaths and 52 for murders, and yet awareness seems to be lacking in local government. We conducted an 18-year retrospective cohort study using routinely collected health care records from Ninewells Hospital, Dundee, and Perth Royal Infirmary, in Tayside, Scotland, UK, from 2000 to 2017. Hospitalisation events and deaths were linked to daily nitric oxides (NOX, NO, NO2), and particulate matter 10 (PM10) levels extracted from publicly available data over this same time period. Distributed lag models were used to estimate risk ratios for hospitalisation and mortality, adjusting for temperature, humidity, day of the week, month and public holiday. Nitric oxides and PM10 were associated with an increased risk of all hospital admissions and cardiovascular (CV) admissions on day of exposure to pollutant. This study shows a significant increase in all cause and CV hospital admissions, on high pollution days in Tayside, Scotland.