bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prävalenz von Schleimhautläsionen bei Durchführung der transnasalen endoskopischen Dysphagiediagnostik und angelegter Nasogastralsonde
Authors: Heise Kira-Milena , Miller Simone , Ptok Martin , Jungheim Michael 
Published: October 2023

Zusammenfassung
Hintergrund
Zur Einschätzung des Penetrations- oder Aspirationsrisikos bei Dysphagien hat sich unter anderem die flexible endoskopische Evaluation des Schluckakts (FEES) etabliert. Sie gilt als komplikationsarmes Verfahren, ist jedoch bei angelegter Nasogastralsonde (NGS) erschwert durchführbar und könnte mit einer höheren Rate akzidenteller Schleimhautläsionen einhergehen.

Zielsetzung
In dieser Studie sollte ermittelt werden, ob eine erhöhte Prävalenz von Schleimhautläsionen vorliegt, wenn die FEES bei liegender NGS und damit unter erschwerten Untersuchungsbedingungen durchgeführt wird. Präexistente Läsionen sollten ebenfalls erfasst werden.

Methodik
In einer retrospektiven, monozentrischen Studie wurden insgesamt 918 videodokumentierte FEES-Untersuchungen, die zu diagnostischen Zwecken bei stationären Patient*innen mit angelegter Nasogastralsonde von Januar 2014 bis März 2019 an einer Universitätsklinik durchgeführt wurden, ausgewertet. Erfasst wurden Anzahl und Ausprägungen von Schleimhautläsionen.

Ergebnisse
In keinem der hier analysierten Fälle trat eine endoskopiebedingte Verletzung auf. Bei 48,6 % der analysierten Endoskopien konnten jedoch präexistente Läsionen in Nase und/oder Nasopharynx festgestellt werden, die häufig als Mehrfachverletzungen vorlagen.

Schlussfolgerung
Die Ergebnisse der Studie zeigen, dass die FEES hinsichtlich der Gefahr einer akzidentellen Schleimhautverletzung auch bei in situ befindlicher NGS eine sichere und risikoarme Untersuchungsmethode ist. Bemerkenswert ist jedoch die sehr hohe Zahl präexistenter Schleimhautläsionen, die mit hoher Wahrscheinlichkeit in Zusammenhang mit dem zuvor erfolgten Legen einer NGS stehen. Die Häufigkeit präexistenter Läsionen lässt es ratsam erscheinen, Strategien zur Verletzungsminimierung beim Legen von Nasogastralsonden zu entwickeln.
Characterisation of HNF1A variants in paediatric diabetes in Norway using functional and clinical investigations to unmask phenotype and monogenic diabetes
Authors: Svalastoga Pernille , Kaci Alba , Molnes Janne , Solheim Marie H. , Johansson Bente B. , Krogvold Lars , Skrivarhaug Torild , Valen Eivind , Johansson Stefan , Molven Anders , Sagen Jørn V. , Søfteland Eirik , Bjørkhaug Lise , Tjora Erling , Aukrust Ingvild , Njølstad Pål R. 
Published: October 2023

Abstract
Aims/hypothesis
Correctly diagnosing MODY is important, as individuals with this diagnosis can discontinue insulin injections; however, many people are misdiagnosed. We aimed to develop a robust approach for determining the pathogenicity of variants of uncertain significance in hepatocyte nuclear factor-1 alpha (HNF1A)-MODY and to obtain an accurate estimate of the prevalence of HNF1A-MODY in paediatric cases of diabetes.

Methods
We extended our previous screening of the Norwegian Childhood Diabetes Registry by 830 additional samples and comprehensively genotyped HNF1A variants in autoantibody-negative participants using next-generation sequencing. Carriers of pathogenic variants were treated by local healthcare providers, and participants with novel likely pathogenic variants and variants of uncertain significance were enrolled in an investigator-initiated, non-randomised, open-label pilot study (ClinicalTrials.gov registration no. NCT04239586). To identify variants associated with HNF1A-MODY, we functionally characterised their pathogenicity and assessed the carriers’ phenotype and treatment response to sulfonylurea.

Results
In total, 615 autoantibody-negative participants among 4712 cases of paediatric diabetes underwent genetic sequencing, revealing 19 with HNF1A variants. We identified nine carriers with novel variants classified as variants of uncertain significance or likely to be pathogenic, while the remaining ten participants carried five pathogenic variants previously reported. Of the nine carriers with novel variants, six responded favourably to sulfonylurea. Functional investigations revealed their variants to be dysfunctional and demonstrated a correlation with the resulting phenotype, providing evidence for reclassifying these variants as pathogenic.

Conclusions/interpretation
Based on this robust classification, we estimate that the prevalence of HNF1A-MODY is 0.3% in paediatric diabetes. Clinical phenotyping is challenging and functional investigations provide a strong complementary line of evidence. We demonstrate here that combining clinical phenotyping with functional protein studies provides a powerful tool to obtain a precise diagnosis of HNF1A-MODY.

Graphical Abstract
Optimal conspicuity of pancreatic ductal adenocarcinoma in virtual monochromatic imaging reconstructions on a photon-counting detector CT: comparison to conventional MDCT
Authors: Decker Josua A. , Becker Judith , Härting Mark , Jehs Bertram , Risch Franka , Canalini Luca , Wollny Claudia , Scheurig-Muenkler Christian , Kroencke Thomas , Schwarz Florian , Bette Stefanie 
Published: October 2023

Abstract
Purpose
To analyze the conspicuity of pancreatic ductal adenocarcinoma (PDAC) in virtual monoenergetic images (VMI) on a novel photon-counting detector CT (PCD-CT) in comparison to energy-integrating CT (EID-CT).

Methods
Inclusion criteria comprised initial diagnosis of PDAC (reference standard: histopathological analysis) and standardized contrast-enhanced CT imaging either on an EID-CT or a PCD-CT. Patients were excluded due to different histopathological diagnosis or missing tumor delineation on CT. On the PCD-CT, 40–190 keV VMI reconstructions were generated. Image noise, tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) were analyzed by ROI-based measurements in arterial and portal venous contrast phase. Two board-certified radiologist evaluated image quality and tumor delineation at both, EID-CT and PCD-CT (40 and 70 keV).

Results
Thirty-eight patients (mean age 70.4 years ± 10.3 [range 45–91], 27 males; PCD-CT: n=19, EID-CT: n=19) were retrospectively included. On the PCD-CT, tumor conspicuity (reflected by low TPR and high CNR) was significantly improved at low-energy VMI series (≤ 70 keV compared to > 70 keV), both in arterial and in portal venous contrast phase (P < 0.001), reaching the maximum at 40 keV. Comparison between PCD-CT and EID-CT showed significantly higher CNR on the PCD-CT in portal venous contrast phase at < 70 keV (P < 0.016). On the PCD-CT, tumor conspicuity was improved in portal venous contrast phase compared to arterial contrast phase especially at the lower end of the VMI spectrum (≤ 70 keV). Qualitative analysis revealed that tumor delineation is improved in 40 keV reconstructions compared to 70 keV reconstructions on a PCD-CT.

Conclusion
PCD-CT VMI reconstructions (≤ 70 keV) showed significantly improved conspicuity of PDAC in quantitative and qualitative analysis in both, arterial and portal venous contrast phase, compared to EID-CT, which may be important for early detection of tumor tissue in clinical routine. Tumor delineation was superior in portal venous contrast phase compared to arterial contrast phase.
Heisenberg Spin Exchange Between Nitroxide Probes Diffusing in a Percolation Network
Authors: Lawton Jamie S. , Budil David E. 
Published: October 2023

AbstractHeisenberg spin exchange between nitroxide (Tempone) spin probes has been measured as a function of concentration in the aqueous phase of the hydrated ion exchange membrane Nafion 117. The observed fast-motional electron paramagnetic resonance spectra were analyzed in terms of the stochastic Liouville equation lineshape calculation of Freed and coworkers and the “new paradigm” for interpreting spin exchange effects proposed by Salikhov. Differences between the effective spin exchange measured from the spectrum by these methods are presented and compared, and indicate that dipolar interactions make a significant contribution to spin exchange in this system. In acidic Nafion membranes, the spin probes are deactivated over time, allowing simultaneous measurement of the decay kinetics and spin exchange as a function of paramagnetic probe concentration. Both these processes deviate from the behavior that would be expected from classical chemical kinetics in isotropic media. The results are discussed in terms of currently available models for diffusion and reaction in a percolation network.
Locating $$\gamma$$-ray sources on the celestial sphere via modal clustering
Authors: Montin Anna , Brazzale Alessandra R. , Menardi Giovanna , Sottosanti Andrea 
Published: October 2023

AbstractSky surveys represent the fundamental data basis for detecting and locating as yet undiscovered celestial objects. Since 2008, the Fermi LAT Collaboration has catalogued thousands of $$\gamma$$
γ
-ray sources with the aim of extending our knowledge of the highly energetic physical mechanisms and processes that lie at the core of our Universe. In this article, we present a nonparametric clustering algorithm which identifies high-energy astronomical sources using the spatial information of the $$\gamma$$
γ
-ray photons detected by the large area telescope onboard the Fermi spacecraft. In particular, the sources are identified using a von Mises–Fisher kernel estimate of the photon count density on the unit sphere via an adjustment of the mean-shift algorithm which accounts for the directional nature of the collected data and the need of local smoothing. This choice entails a number of desirable benefits. It allows us to bypass the difficulties inherent on the borders of any projection of the photon directions onto a 2-dimensional plane, while guaranteeing high flexibility. The smoothing parameter is chosen adaptively, by combining scientific input with optimal selection guidelines, as known from the literature. Using statistical tools from hypothesis testing and classification, we furthermore present an automatic way to skim off sound candidate sources from the $$\gamma$$
γ
-ray emitting diffuse background and to quantify their significance. We calibrate and test our algorithm on simulated count maps provided by the Fermi LAT Collaboration.
Stiffness influence on particle separation in polydimethylsiloxane-based deterministic lateral displacement devices
Authors: Marhenke Julius , Dirnecker Tobias , Vogel Nicolas , Rommel Mathias 
Published: October 2023

AbstractPolydimethylsiloxane (PDMS) is a popular material to rapidly manufacture microfluidic deterministic lateral displacement (DLD) devices for particle separation. However, manufacturing and operation challenges are encountered with decreasing device dimensions required to separate submicron particles. The smaller dimensions, notably, cause high hydraulic resistance, resulting in significant pressure even at relatively low throughputs. This high pressure can lead to PDMS deformation, which, in turn, influences the device performance. These effects may often be overlooked in the design and operation of devices but provide a systematic source of error and inaccuracies. This study focuses in detail on these effects and investigates pillar deformation in detail. Subsequently, we discuss a potential solution to this deformation using thermal annealing to stiffen the PDMS. We evaluate the influence of stiffness on the separation performance at elevated sample flow rates with submicron particles (0.45 and 0.97 µm diameter). An excellent separation performance at high throughput is successfully maintained in stiffer PDMS-based DLD devices, while the conventional devices showed decreased separation performance. However, the increased propensity for delamination constrains the maximal applicable throughput in stiffer devices. PDMS deformation measurements and numerical simulations are combined to derive an iterative model for calculating pressure distribution and PDMS deformation. Finally, the observed separation characteristics and encountered throughput constraints are explained with the iterative model. The results in this study underline the importance of considering pressure-induced effects for PDMS-based DLD devices, provide a potential mitigation of this effect, and introduce an approach for estimating pressure-induced deformation.
Conservation genomics of Dioon holmgrenii (Zamiaceae) reveals a history of range expansion, fragmentation, and isolation of populations
Authors: Dorsey Brian L. , Salas-Morales Silva H. , Gregory Timothy J. 
Published: October 2023

AbstractMany Cycad species may not survive the current extinction crisis, despite belonging to the oldest living seed plant lineage. Conservation of endangered and threatened species will require a combination of in situ and ex situ programs, both of which will benefit from better knowledge of species’ population genetic structure, as will assessments of threatened status. Here we develop a cost-effective method of obtaining population-level genomic data from across the range of the Mexican cycad, Dioon holmgreni, and use these data to characterize the genetic structure and diversity of the species. We also reconstruct aspects of the demographic history of the species and evaluate the taxonomic cohesion of populations across the range using genomic and morphological data. We find that D. holmgrenii harbors moderate genetic diversity across genetically and geographically isolated populations that each possess a substantial percentage of private alleles. We further find that the history of this species likely includes a widespread range expansion followed by fragmentation due to population contraction. These results argue for conservation of all populations and their unique alleles but also suggest an unexpected ability of this species to maintain genetic diversity despite dramatic reductions in population size.
Phase 1/1b open-label, dose-escalation study of fruquintinib in patients with advanced solid tumors in the United States
Authors: Wang-Gillam Andrea , Schelman William , Ukrainskyj Stacey , Chien Caly , Gonzalez Martha , Yang Zhao , Kania Marek , Yeckes-Rodin Heather 
Published: October 2023

SummaryThis open-label, phase 1/1b study was conducted to evaluate the safety, tolerability, and pharmacokinetics (PK) of fruquintinib in United States (U.S.) patients to confirm the recommended phase 2 dose (RP2D) established in China. Patients with advanced solid tumors who had progressed on approved systemic therapy, were enrolled into 2 successive dose escalation cohorts, fruquintinib 3 mg (n = 7) or 5 mg (n = 7), orally, once daily (QD), 3 weeks on and 1 week off (3/1) with a 3 + 3 design followed by a dose expansion cohort at the RP2D 5 mg dose (n = 6). PK samples were collected on Days 1, 14, and 21 (Cycle 1). One of 6 dose-limiting toxicity (DLT)-evaluable patients in the 3 mg cohort had a DLT of grade 4 hypertension; there were no DLTs in the 5 mg cohort. The RP2D was confirmed to be 5 mg QD 3/1. All 20 patients experienced a treatment-emergent adverse event; grade ≥ 3 in 5 (71.4%; 3 mg dose) and 12 (92.3%; 5 mg dose) patients. Two patients had a confirmed partial response. After single and multiple doses, median peak plasma concentrations occurred at 2 h post-dose. Steady-state was achieved after 14 days of QD dosing with systemic exposure four-fold higher than that after a single dose. Fruquintinib was well tolerated, and the safety and PK profile at the 5 mg RP2D in U.S. patients with advanced solid tumors was consistent with dose-finding studies in China. Preliminary anticancer activity was observed. This study is registered at Clinicaltrials.gov NCT03251378.
Design of a future scenarios toolkit for an ethical implementation of artificial intelligence in education
Authors: Mouta Ana , Torrecilla-Sánchez Eva María , Pinto-Llorente Ana María 
Published: October 2023

AbstractIn the 1970s, research on artificial intelligence in education emerged with the aim of acknowledging and accommodating the psychological aspects of the learning process. Since then, its applications have evolved and it is now used for student learning and assessment, teachers’ pedagogical practice, management of educational institutions, and lifelong learning. Nevertheless, the ethical challenges of educational programmes using these systems have not been thoroughly studied. Anchored on the theoretical frame of dialogic ethics, this paper presents a section of a participatory futures research project. The goal of the research is to develop a toolkit that educators can use to ensure a smooth and ethical transition to artificial intelligence-based education while preserving the interests of educational development. This paper emphasises the need for an informed and participatory process that involves all stakeholders and begins with an expert consultation through the Delphi method, the results of which allowed the construction of eight hypothetical futures scenarios. These scenarios provide evidence that examining the ethics of using artificial intelligence systems presents an opportunity to reflect on the ethics of education as a whole. They highlight the challenge of balancing the benefits and drawbacks of such systems, especially concerning educational goals and the interplay between diverse educational actors and personal development in educational settings. The study outcomes are intended to encourage discussions on the integration of ethical artificial intelligence in education and facilitate the continuing professional development of teachers by equipping them with scenarios that can be used as a resource for training purposes.
Competition of Rhyzopertha dominica and Sitophilus oryzae on six sorghum varieties
Authors: Agrafioti Paraskevi , Arthur Frank H. , Athanassiou Christos G. 
Published: October 2023

AbstractWe tested the effect of simultaneous infestation by adults of the lesser grain borer, Rhyzopertha dominica (F.) and the rice weevil, Sitophilus oryzae (L.) on six sorghum varieties. For this purpose, vials containing sorghum and either each species alone or both species were placed at 30 °C and 65% relative humidity. After ten days, all parental adults were removed and the vials were returned to the same conditions. Five weeks later the vials were emptied, to record adult emergence, the percentage of insect damaged kernels (IDK), and frass weight. Our results indicated that progeny production capacity for both species was not affected by the simultaneous presence of R. dominica and S. oryzae, and that adult emergence was more of a variety- mediated parameter. Both species had previously shown similar preferences towards specific sorghum varieties. IDK and frass were higher in vials containing R. dominica alone rather than S. oryzae alone, but these indicators were not always related to progeny production. Specifically, the most and the least frass production was noted on Sumac and PE sorghum varieties for both species, respectively. When the two species were placed together in the same vial, the most frass production was noted in the Non-Waxy Burgundy and Sumac varieties. Our results suggest that varietal resistance in sorghum could be utilized to help reduce post-harvest infestations by S. oryzae and R. dominica.
Barriers and Facilitators to Behavioral Healthcare for Women Veterans: a Mixed-Methods Analysis of the Current Landscape
Authors: Fitzke Reagan E. , Bouskill Kathryn E. , Sedano Angeles , Tran Denise D. , Saba Shaddy K. , Buch Keegan , Hummer Justin F. , Davis Jordan P. , Pedersen Eric R. 
Published: October 2023

AbstractWomen veterans have historically faced barriers to behavioral health treatment, particularly through the VA. In conjunction, there have been changes in behavioral healthcare delivery resulting from efforts to improve care for women veterans and the COVID-19 pandemic (e.g., widespread telehealth implementation). The current study draws on a quantitative and qualitative study centering current perspectives of women veterans in their choices to seek or not seek behavioral healthcare in VA and non-VA settings through interviewing 18 women recruited from a larger survey study on veteran behavioral health (n = 83 women, n = 882 men) on their experiences with behavioral health care access and satisfaction, including barriers and facilitators to seeking care. Quantitative findings are descriptively reported from the larger study, which outlined screening for behavioral health problems, behavioral health utilization, treatment modality preferences, and barriers/facilitators to care. While women in the survey sample screened for various behavioral health disorders, rates of treatment seeking remained relatively low. Women reported positive and negative experiences with telehealth and endorsed many barriers to treatment seeking in interviews not captured by survey findings, including lack of women-specific care (e.g., care for military sexual trauma, women-only groups), reports of stranger harassment at the VA, and lack of female providers. Women veterans continue to face barriers to behavioral healthcare; however, ongoing efforts to improve care access and quality, including the implementation of telehealth, show promise in reducing these obstacles. Continued efforts are needed to ensure diverse treatment modalities continue to reach women veterans as this population grows.
From “Local Control” to “Dependency”: Transitions to Single-Vendor Integrated Electronic Health Record Systems and Their Implications for the EHR Workforce
Authors: Brunner Julian , Anderson Ekaterina , Mohr David C. , Cohen-Bearak Adena , Rinne Seppo T. 
Published: October 2023

Abstract
Background
Healthcare systems that previously used either a single legacy electronic health record (EHR) system or a “best-of-breed” combination of products from multiple vendors are increasingly adopting integrated, single-vendor EHR systems. Though healthcare leaders are beginning to recognize the dramatic collateral consequences of these transitions, their impact on the EHR workforce — internal actors most closely involved in governing and supporting the EHR — is poorly understood.

Objective
Identify perceived impacts of adopting single-vendor, integrated EHR systems on the institutional EHR workforce.

Design
In this qualitative study, we conducted semi-structured phone interviews in four healthcare systems in the USA that had adopted an integrated EHR within the previous five years.

Participants
Forty-two staff members of four geographically and organizationally diverse healthcare systems, including 22 individuals with formal informatics roles.

Approach
Transcribed interviews were coded and analyzed using qualitative content analysis methods.

Key Results
Across organizations, participants described a loss of autonomy by the EHR workforce at the individual and institutional level following the adoption of an integrated EHR. We also identified references to transformations in four key professional functions of the EHR workforce: communication, governance, optimization, and education.

Conclusions
Transitions to integrated EHR systems can have important implications for the autonomy and professional functions of the EHR workforce. These findings may help institutions embarking on similar transitions better anticipate and prepare for these changes through such practices as revising job descriptions, strengthening EHR governance structures, and reinforcing pathways to engage frontline clinicians in supporting the EHR. Findings may also help institutions structure vendor contracts in a way that anticipates and mitigates loss of autonomy.