bluuebunny/crossref_metadata_2025_split huggingface dataset:
Locking Compression Plate as an External Fixator for the Treatment of Tibia Infected Bone Defects
Authors: Xiao Hong , Wang Shulin , Wang Feibo , Dong Sun , Shen Jie , Xie Zhao 
Published: September 2021

Abstract
Purpose This study was designed to observe the medium-term efficacy of an induced membrane technique combined with a locking compression plate as an external fixator for the
treatment of tibia infected bone defects.
Methods Patients with a tibial infection were admitted to our department between January 2013 and November 2014. All patients were treated with the induced membrane technique. In the
first stage, polymethyl methacrylate (PMMA) cement was implanted in the defects after debridement and then fixed with a locking compression plate (LCP) as an external fixator. In the second
stage, bone grafts were implanted to rebuild the defects. The external plates were replaced with nails in 57 patients (internal group), and the remaining 30 patients were not exchanged with
fixation (external group). The infection control rate, bone union rate, and complications of the two groups were compared.
Results Eighty-seven patients were enrolled in this study, and all patients had a minimum follow-up of 5 years (average 62.8 months) after grafting. Eighty-three patients (95.4%)
achieved bone union, and the average union time was 6.77 months. Five patients (5.7%) experienced recurrence of infection. Complications included pin tract infection, fixation loosening,
deformity connection, and limitation of joint range of motion (ROM). No significant differences in the infection control rate or bone defect union rate were noted between the two groups. The
overall rate of complications in the external group was 50%, which was greater than that noted in the internal group (21.1%).
Conclusions Locking compression plates are external fixators with smaller sizes that are easier to operate than conventional annular fixators or assembled external fixators. The use
of locking compression plates in combination with the induced membrane technique in the treatment of tibia infected bone defects can achieve good clinical efficacy after medium-term
follow-up.
Is Lumbar Puncture Needed? – Noninvasive Assessment of ICP Facilitates Decision Making in Patients with Suspected Idiopathic Intracranial Hypertension
Authors: Schmidt Bernhard , Czosnyka Marek , Cardim Danilo , Czosnyka Zofia , Rosengarten Bernhard 
Published: September 2021

Abstract
Purpose Idiopathic intracranial hypertension (IIH) usually occurs in obese women of childbearing age. Typical symptoms are headache and sight impairment. Lumbar puncture (LP) is routinely used for both diagnosis and therapy (via cerebrospinal fluid drainage) of IIH. In this study, noninvasively assessed intracranial pressure (nICP) was compared to LP pressure (LPP) in order to clarify its feasibility for the diagnosis of IIH.
Materials and Methods nICP was calculated using continuous signals of arterial blood pressure and cerebral blood flow velocity in the middle cerebral artery, a method which has been introduced recently. In 26 patients (f = 24, m = 2; age: 33 ± 11 years), nICP was assessed one hour prior to LPP. If LPP was > 20 cmH2O, lumbar drainage was performed, LPP was measured again, and also nICP was reassessed.
Results In total, LPP and nICP correlated with R = 0.85 (p < 0.001; N = 38). The mean difference of nICP-LPP was 0.45 ± 4.93 cmH2O. The capability of nICP to diagnose increased LPP (LPP > 20 cmH2O) was assessed by ROC analysis. The optimal cutoff for nICP was close to 20 cmH2O with both a sensitivity and specificity of 0.92. Presuming 20 cmH2O as a critical threshold for the indication of lumbar drainage, the clinical implications would coincide in both methods in 35 of 38 cases.
Conclusion The TCD-based nICP assessment seems to be suitable for a pre-diagnosis of increased LPP and might eliminated the need for painful lumbar puncture if low nICP is detected.
Outcomes of endoscopic resection for superficial duodenal tumors: 10 years’ experience in 18 Japanese high volume centers
Authors: Kato Motohiko , Takeuchi Yoji , Hoteya Shu , Oyama Tsuneo , Nonaka Satoru , Yoshimizu Shoichi , Kakushima Naomi , Ohata Ken , Yamamoto Hironori , Hara Yuko , Doyama Hisashi , Dohi Osamu , Yamasaki Yasushi , Ueyama Hiroya , Takimoto Kengo , Kurahara Koichi , Tashima Tomoaki , Abe Nobutsugu , Nakayama Atsushi , Oda Ichiro , Yahagi Naohisa 
Published: September 2021

Abstract
Background Data on endoscopic resection (ER) for superficial duodenal epithelial tumors (SDETs) are insufficient owing to their rarity. There are two main ER techniques for SDETs: endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). In addition, modified EMR techniques, such as underwater EMR (UEMR) and cold polypectomy, are becoming popular. We conducted a large-scale retrospective multicenter study to clarify the detailed outcomes of duodenal ER.
Methods Patients with SDETs who underwent ER at 18 institutions from January 2008 to December 2018 were included. The rates of en bloc resection and delayed adverse events (AEs; defined as delayed bleeding or perforation) were analyzed. Local recurrence was analyzed using the Kaplan–Meier method.
Results In total, 3107 patients (including 1017 undergoing ESD) were included. En bloc resection rates were 79.1 %, 78.6 %, 86.8 %, and 94.8 %, and delayed AE rates were 0.5 %, 2.2 %, 2.8 %, and 6.8 % for cold polypectomy, UEMR, EMR and ESD, respectively. The delayed AE rate was significantly higher in the ESD group than in non-ESD groups for lesions < 19 mm (7.4 % vs. 1.9 %; P < 0.001), but not for lesions > 20 mm (6.1 % vs. 7.1 %; P = 0.64). The local recurrence rate was significantly lower in the ESD group than in the non-ESD groups (P < 0.001). Furthermore, for lesions > 30 mm, the cumulative local recurrence rate at 2 years was 22.6 % in the non-ESD groups compared with only 1.6 % in the ESD group (P < 0.001).
Conclusions ER outcomes for SDETs were generally acceptable. ESD by highly experienced endoscopists might be an option for very large SDETs.
Pregnancy Outcomes in Refractory Epilepsy Patients with Vagus Nerve Stimulation: Long-Term Single-Center Experience
Authors: Chrastina Jan , Dolezalova Irena , Novak Zdenek , Pešlová Eva , Brazdil Milan 
Published: September 2021

Abstract
Background and Study Aims Vagus nerve stimulation (VNS) has been employed worldwide as an adjunctive therapy in drug-resistant epilepsy patients. However, the mechanisms of VNS action potentially increase the risk of obstetric complications. The study presents the long-term single-center experience with pregnancies and childbirth in women with VNS for refractory epilepsy based on prospectively collected epileptologic data and a retrospective analysis of pregnancy, childbirth, and data about long-term child development.
Material and Methods From a group of patients with VNS implanted for refractory epilepsy between October 1999 and January 2018, all the women of childbearing age (younger than 40 years) were identified. After checking their hospital records for data about any pregnancies, the women with confirmed childbirth during active VNS stimulation and their general practitioners were interviewed based on a prepared questionnaire regarding their gynecologic history, the course of pregnancy and childbirth, gestational week, birth weight and length, any congenital anomalies of the child, and the child's psychomotor development, school performance, and somatic health problems.
Results From the group of 257 patients implanted with VNS for refractory epilepsy, 4 women (1.5%) became pregnant and gave birth (all on polypharmacotherapy). The mean interval from VNS implantation to birth was 44.3 months. Slight seizure worsening during the last trimester was reported in one woman. In one patient, acute caesarean section was required due to placental separation. Planned birth induction and caesarean section were used in the other two women because of their seizure disorder. No malfunction of the stimulation system was detected during pregnancy or after birth. No congenital malformations were observed. The two children who were of school age at the time of this study require special schooling.
Conclusions The study results confirmed a high rate of obstetric interventions in patients with VNS. Although no teratogenic effect of VNS has been proven, the higher incidence of children exposed to VNS needing special education requires attention.
An Immunoassay for Human Chorionic Gonadotropin in Cerebrospinal Fluid: Validation of a Modified-Approved Method for Accreditation by the College of American Pathologists
Authors: Hu Yao , Ni Jiajin , Zhang Huating , Wu Wenqing , Chen Yanwen , Guan Ming 
Published: September 2021

Abstract
Background Human chorionic gonadotropin (hCG) detection in cerebrospinal fluid (CSF) can provide additional value in the diagnosis of germinoma. However, matrix effects can influence the results when alternative sample types are used. Therefore, modified-cleared/approved methods, which are standard methods used outside their intended scope, are of interest. The aim of the present study was to establish a model to validate modified-approved methods in agreement with the College of American Pathologists (CAP) accreditation requirements.
Methods Concentrations of hCG in CSF were determined by means of electrochemiluminescence immunoassay using a Roche Cobas e 602 immunoassay analyzer. Based on the intended use, the following performance characteristics were evaluated: precision, the limit of quantitation (LoQ), and the analytical measurement range (AMR). The reference interval (RI) was also established. For the clinical application study, CSF and serum hCG were measured in 10 patients diagnosed with germinoma.
Results The intra- and inter-assay precisions at two levels (10, 250 IU/L) were 0.64 and 0.57% and 4.26 and 3.54%, respectively. The LoQ for hCG was determined to be 0.25 IU/L. The AMR was set from 0.2 to 1,200 IU/L. The RI for hCG in CSF was below 0.40 IU/L. The CSF hCG levels of 10 patients were all above 0.4 IU/L before therapy.
Conclusion Modified-approved methods were validated and showed that the quality specifications of the medical laboratory have a positive value in the clinical context. The illustration of quantification of hCG in CSF resulted in compliance with the CAP accreditation requirements.
A Framework for Systematic Assessment of Clinical Trial Population Representativeness Using Electronic Health Records Data
Authors: Sun Yingcheng , Butler Alex , Diallo Ibrahim , Kim Jae Hyun , Ta Casey , Rogers James R. , Liu Hao , Weng Chunhua 
Published: September 2021

Abstract
Background Clinical trials are the gold standard for generating robust medical evidence, but clinical trial results often raise generalizability concerns, which can be attributed to the lack of population representativeness. The electronic health records (EHRs) data are useful for estimating the population representativeness of clinical trial study population.
Objectives This research aims to estimate the population representativeness of clinical trials systematically using EHR data during the early design stage.
Methods We present an end-to-end analytical framework for transforming free-text clinical trial eligibility criteria into executable database queries conformant with the Observational Medical Outcomes Partnership Common Data Model and for systematically quantifying the population representativeness for each clinical trial.
Results We calculated the population representativeness of 782 novel coronavirus disease 2019 (COVID-19) trials and 3,827 type 2 diabetes mellitus (T2DM) trials in the United States respectively using this framework. With the use of overly restrictive eligibility criteria, 85.7% of the COVID-19 trials and 30.1% of T2DM trials had poor population representativeness.
Conclusion This research demonstrates the potential of using the EHR data to assess the clinical trials population representativeness, providing data-driven metrics to inform the selection and optimization of eligibility criteria.
Uterine Myometrial Preischemia: Yet Another Physiological Change of Pregnancy!
Authors: Jashnani Kusum , Palve Meherrituja 
Published: September 2021

Abstract
Background The uterus shows tremendous increase in size during pregnancy to nurture the fetus within it. It may show a spectrum of physiological changes or pathological lesions that may affect the pregnancy favorably or adversely. The main purpose of our study was to analyze the physiological changes in the uterus during pregnancy and the postpartum period, thereby gaining deeper knowledge.
Materials and Methods We studied a total of 152 uterine specimens obtained from obstetric hysterectomies and maternal autopsies for the presence or absence of normal physiological changes. As a control group, an equal number of surgical uterine specimens received for abnormal uterine bleeding were studied.
Results Decidual change was observed from 6 weeks of gestation to 16 days postpartum. It was partially deficient to absent in four cases of placenta accreta. Myometrial hypertrophy was seen in 150 cases (98.68%) from 8 weeks of gestation till 30 days postpartum period. Vascular remodeling was partially deficient to absent in eight cases of pregnancy-induced hypertension. Preischemia of myometrial fibers was an unexpected finding noticed from 20 weeks of gestation to 16 days postpartum in 131 cases (86.18%). Cervical wall hemorrhages were seen in 84.84% cases of vaginal delivery and in only 17.64% cases of lower segment cesarean section.
Conclusion Ours is the first study to describe the duration of the routine physiological uterine changes during pregnancy. The relationship between cervical wall hemorrhages and vaginal delivery as well as between myometrial preischemia and gestational age, both being normal physiologic findings, was found to be statistically significant.
Quantitative model for impact of behavioral biases on asset allocation decisions: a case study of investors in UAE
Authors: Pradhan Ashutosh 
Published: September 2021

AbstractIndividuals are expected to be rational and follow the approach prescribed under different traditional finance theories while constructing portfolios. In reality, studies from different parts of the world show that individuals do not act rationally due to cognitive limitations and influence of emotions and feelings. Additionally, in quite a few countries, religion plays an important role in decision-making. As a result, individuals make suboptimal decisions, like holding poorly diversified portfolios, excessive or minimal trading, and taking excessive or too little risk with their portfolios. The analysis of impact of behavioral biases and religiosity has not been done in the context of individual investors living in UAE, which this paper addresses. A survey questionnaire was administered to Arab nationals living in UAE. Data of 129 individuals were analyzed. The findings showed that these investors were influenced by emotional and cognitive biases, had good knowledge of religiosity, & placed them as important. This behavior is consistent with investor behavior observed in the rest of the world. Subsequent to these empirical findings, the paper has developed a quantitative model to predict the impact of behavioral biases and religiosity on asset allocation decisions. The research approach used for developing the quantitative model can be replicated by researchers from across the world tailored to their own regions.
Implementation of a non-communicable disease clinic in rural Sierra Leone: early experiences and lessons learned
Authors: Kachimanga Chiyembekezo , Dibba Yusupha , Patiño Marta , Gassimu Joseph S. , Lavallie Daniel , Sesay Santigie , Lado Marta , Kulinkina Alexandra V. 
Published: September 2021

AbstractThis study is an evaluation of the first cohort of patients enrolled in an outpatient non-communicable disease clinic in Kono, Sierra Leone. In the first year, the clinic enrolled 916 patients. Eight months after the enrollment of the last patient, 53% were still active in care, 43% had been lost to follow-up (LTFU) and 4% had defaulted. Of the LTFU patients, 47% only came for the initial enrollment visit and never returned. Treatment outcomes of three patient groups [HTN only (n = 720), DM only (n = 51), and HTN/DM (n = 96)] were analyzed through a retrospective chart review. On average, all groups experienced reductions in blood pressure and/or blood glucose of approximately 10% and 20%, respectively. The proportions of patients with their condition controlled also increased. As NCDs remain underfunded and under-prioritized in low-income countries, the integrated program in Kono demonstrates the possibility of improving outpatient NCD care in Sierra Leone and similar settings.
Toward a ‘New Normal’? Tourist Preferences Impact on Hospitality Industry Competitiveness
Authors: Cuomo Maria Teresa , Tortora Debora , Danovi Alessandro , Festa Giuseppe , Metallo Gerardino 
Published: September 2021

AbstractThe recent outbreak of novel coronavirus (Covid-19) has led to a global panic due to its fatal nature which has harshly impacted the tourist sector and on the place reputation in general. This study aims to compare the factors that develop tourist preferences in terms of (i) what drives the favorability of tourist preferences? (ii) what relationship exists between tourist expectations, proximity, and favorable reputation? and (iii) what are the main influences of tourist preferences on hospitality system competitiveness pre and post Covid-19? By employing structural equation modeling, this study advances knowledge into the research variables’ relationships and advances reputation and marketing performance and practices in the hospitality industry.
A compact high-power microwave TM01-TE01 mode converter
Authors: Hu Yong-jun , Xu Liang , Zhang Qiang , Yuan Cheng-wei , Liu Jin-liang , Sun Yun-fei 
Published: September 2021

In circular waveguides, the TE01 mode has the lowest transmission loss, which is very suitable for long-distance transmission of high-power microwaves (HPMs). The output mode of HPM sources is mainly the TM01 mode; however, there are few research studies on mode converters of TM01-TE01. In this paper, a high efficiency HPM TM01-TE01 mode converter is designed; compared with the traditional TM01-TE01 mode converters, the structure of the mode converter is compact and easier to process. It is mainly composed of an input circular waveguide, a tapered rectangular waveguide, a 90° bent rectangular waveguide, and an output circular waveguide. A prototype with a center frequency of 2.4 GHz is fabricated and HPM experiments are carried out. The transmission efficiency of this device reaches 99.8% in the simulation, and the measured transmission efficiency is more than 98%. Additionally, the measured power handling capacity is more than 1 GW, which is consistent with simulation. This design has important reference significance for the design of long-distance power transmission devices and HPM mode converters.
Two-color, intracavity pump–probe, cavity ringdown spectroscopy
Authors: Jiang Jun , McCartt A. Daniel 
Published: September 2021

We report a proof-of-principle demonstration of intracavity pump–probe, cavity ringdown (CRD) detection in a three-mirror, traveling-wave cavity. With cavity-enhanced pump power and probe absorption path length, the technique is a generally applicable, high-sensitivity, high-selectivity detection method. In our experiments, the pump radiation is switched off during every other probe ringdown, which allows uncorrelated measurements of analyte and background cavity decay rates. The net, two-color signal from the difference between the pump-on and pump-off decay rates is immune to empty-CRD drifts and spectral overlaps from non-target molecular transitions. The immunity to the ringdown drifts allows longer signal-averaging and, thus, higher detection sensitivity. The ability to compensate for the background absorption enhances the detection selectivity in spectrally congested regions. Our technique is well-suited for trace-detection in the mid-IR region, where pump–probe schemes based on strong rovibrational transitions can be applied. In this work, two-color CRD detection is implemented on a ladder-type, three-level system based on the N2O, ν3 = 1 ← 0, P(19) (pump) and ν3 = 2 ← 1, R(18) (probe), rovibrational transitions. By frequency-locking two-quantum cascade lasers to the p-polarization (pump, Finesse = 5280) and s-polarization (probe, Finesse = 67 700) cavity modes, we achieve high intracavity pump power (36 W) and high probe ringdown rates (&gt;2 kHz). The observed two-color spectra are simulated by a density-matrix, three-level system model that is solved under the constraints of the cavity resonance conditions. In addition to its background compensation capability, experimental flexibility in the selection of pump–probe schemes and signal insensitivity to intracavity laser power are further features that enhance the utility of our technique for mid-IR trace-detection.
Water molecules in CNT–Si3N4 membrane: Properties and the separation effect for water–alcohol solution
Authors: Winarto  , Yamamoto Eiji , Yasuoka Kenji 
Published: September 2021

Water confined in carbon nanotubes (CNTs) has been intensively studied because of its unique properties and potential for various applications and is often embedded in silicon nitride (Si3N4) membranes. However, the understanding of the influence of Si3N4 on the properties of water in CNTs lacks clarity. In this study, we performed molecular dynamics simulations to investigate the effect of the Si3N4 membrane on water molecules inside CNTs. The internal electric field generated in the CNTs by the point charges of the Si3N4 membrane changes the structure and dynamical properties of water in the nanotubes, causing it to attain a disordered structure. The Si3N4 membrane decreases the diffusivity of water in the CNTs; this is because the Coulomb potential energy (i.e., electrostatic interaction) of water decreases owing to the presence of Si3N4, whereas the Lennard-Jones potential energy (i.e., van der Waals interaction) does not change significantly. Furthermore, electrostatic interactions make the water structure more stable in the CNTs. As a result, the Si3N4 membrane enhances the separation effect of the water–methanol mixture with CNTs in the presence of an external electric field. Furthermore, the threshold of the external electric field strength to induce water–methanol separation with CNTs is reduced owing to the presence of a silicon nitride membrane.
A novel Ka-band coaxial transit time oscillator with internal extraction
Authors: Gao Xingfu , Song Lili , Zhang Haoran , Wang Lei , Ling Junpu , He Juntao 
Published: September 2021

In this paper, a Ka-band coaxial transit time oscillator (TTO) with internal extraction is proposed. Particle-in-cell simulation of this oscillator is performed to obtain results as follows: under the conditions of a diode voltage of 459 kV, current of 3.9 kA, and guiding magnetic field of 0.5 T, microwaves with an output power of 0.75 GW and a frequency of 31.4 GHz can be achieved with an efficiency of 42% and a saturation time of nearly 25 ns. Moreover, the asymmetric mode competition is suppressed in the preliminary experiments. The study of a Ka-band TTO aims to extend the working frequency of high power microwave sources to a higher level. Such a device has three merits. First, it implements high power and high efficiency. Second, the internal extraction of the microwave output decreases the over-mode ratio in the microwave extraction region. Third, the over-mode ratio of the internal extraction is smaller compared with the external extraction, which can effectively suppress asymmetric mode competition.