bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing balloon-expandable and self-expanding transfemoral transcatheter aortic valve replacement based on subgroups in Germany 2019/2020
Authors: Oettinger Vera , Hilgendorf Ingo , Wolf Dennis , Rilinger Jonathan , Maier Alexander , Zehender Manfred , Westermann Dirk , Kaier Klaus , von zur Mühlen Constantin 
Published: November 2023

Abstract
Background
Previously, overall comparable outcomes were seen for balloon-expandable (BE) or self-expanding (SE) transfemoral transcatheter aortic valve replacement (TAVR). However, subgroup analyses based on large case numbers are still needed.

Methods
German national data of all BE and SE transfemoral TAVR treating aortic valve stenosis in 2019 and 2020 were analysed. We then compared different outcomes and performed a subgroup analysis for the endpoint in-hospital mortality.

Results
Overall, 46,243 TAVR were analysed, 19,910 BE, and 26,333 SE. Patients in the SE group had a significantly higher logistic EuroSCORE (13.61 vs 12.66%, p < 0.001), age (81.55 vs 79.99a, p < 0.001), and proportion of women (54.82 vs 40.06%, p < 0.001). Both groups showed a similar in-hospital mortality with 2.37% in BE and 2.35% in SE (p = 0.916). In-hospital mortality also did not differ significantly after risk adjustment (OR = 0.98 [0.86, 1.13], p = 0.799). Patients in the SE group had a significantly lower risk of major bleeding (OR = 0.83 [0.73, 0.95], p = 0.006), but a significantly higher risk of stroke (OR = 1.38 [1.19, 1.59], p < 0.001), delirium (OR = 1.15 [1.06, 1.24], p = 0.001), and permanent pacemaker implantation (OR = 1.29 [1.21, 1.37], p < 0.001). In the subgroup analysis of in-hospital mortality, there were no significant differences in any of the observed subgroups (age < 75/75–79/80–84/ ≥ 85a, logistic EuroSCORE < 4/4– < 9/ ≥ 9, gender, NYHA III/IV, previous CABG, peripheral vascular disease, COPD, pulmonary hypertension, renal disease GFR < 30 ml/min, and diabetes mellitus).

Conclusion
In the direct comparison of balloon-expandable and self-expanding TAVR, there are no differences for in-hospital mortality in subgroups.

Graphical abstract
Coronary microvascular dysfunction in Takotsubo syndrome: an analysis using angiography-derived index of microcirculatory resistance
Authors: Schweiger Victor , Gilhofer Thomas , Fang Rick , Candreva Alessandro , Seifert Burkhardt , Di Vece Davide , Wuerdinger Michael , Koleva Iva , Rajman Katja , Cieslik Maciej , Gotschy Alexander , Michel Jonathan , Stehli Julia , Niederseer David , Ryberg Linn , Ghadri Jelena , Ruschitzka Frank , Stähli Barbara , Cammann Victoria Lucia , Templin Christian 
Published: November 2023

Abstract
Background
Coronary microvascular dysfunction (CMD) has been proposed as a crucial factor in the pathophysiology of Takotsubo syndrome (TTS). The angiography-derived index of microcirculatory resistance (caIMR) offers an alternative to conventional hyperemic wire-based IMR to assess CMD. We aimed to evaluate CMD’s prevalence, transience, and impact on in-hospital outcomes in TTS.

Methods
All three coronary arteries of 96 patients with TTS were assessed for their coronary angiography derived Index of microcirculatory Resistance (caIMR) and compared to non-obstructed vessels of matched patients with ST-elevation myocardial infarction. Further, the association between caIMR and the TTS-specific combined in-hospital endpoint of death, cardiac arrest, ventricular arrhythmogenic events and cardiogenic shock was investigated.

Results
Elevated IMR was present in all TTS patients, with significantly elevated caIMR values in all coronary arteries compared to controls. CaIMR did not differ between apical and midventricular TTS types. CaIMR normalized in TTS patients with follow-up angiographies performed at a median of 28 months (median caIMR at event vs follow-up: LAD 34.8 [29.9–41.1] vs 20.3 [16.0–25.3], p < 0.001; LCX: 38.7 [32.9–50.1] vs 23.7 [19.4–30.5], p < 0.001; RCA: 31.7 [25.0–39.1] vs 19.6 [17.1–24.0], p < 0.001). The extent of caIMR elevation significantly correlated with the combined in-hospital endpoint (p = 0.036).

Conclusion
TTS patients had evidence of elevated caIMR in at least one coronary artery with a trend towards higher LAD caIMR in apical type TTS and normalization after recovery. Furthermore, extent of caIMR elevation was associated with increased risk of in-hospital MACE of TTS patients.

Graphical abstract
The impact of COVID-19 infection, the pandemic and its associated control measures on patients with Pompe disease
Authors: Theunissen Maudy T. M. , van den Elsen Renee M. , House Tiffany L. , Crittenden Brad , van Doorn Pieter A. , van der Ploeg Ans T. , Kruijshaar Michelle E. , van der Beek Nadine A. M. E. 
Published: November 2023

Abstract
Background
Patients with Pompe disease, a rare metabolic myopathy, were thought to be at increased risk of severe COVID-19 disease during the pandemic. In addition, the lockdown may have affected their regular treatment.

Objective
To assess the perceived effect of COVID-19 infection and of the pandemic on the treatment, and physical and mental health of patients with Pompe disease.

Methods
Patients with Pompe disease over 16 years of age participated in an international, cross-sectional, online survey (September 20, 2022–November 7, 2022). The questionnaire, available in eight languages, consisted of 89 questions divided into 3 parts: (A) severity of Pompe disease, (B) COVID-19 precautions and infection(s) and (C) effects of the COVID-19 pandemic.

Results
Among 342 respondents, originating from 25 different countries, 47.6% experienced one or more COVID-19 infections. While most recovered within 4 weeks (69.7%) and only eight patients needed to be admitted to the hospital, 42.2% of patients experienced an impact of the infection on their overall condition, respiratory status and/or mobility status. More severely affected patients took more stringent control measures. The pandemic additionally caused interruptions in medical care in many patients (56.0%) and 17.2% of patients experienced interruptions of enzyme replacement therapy. The pandemic also affected many patients’ disease severity (27.7%), mental health (55.4%) and feeling of loneliness (43.4%).

Conclusion
COVID-19 infection(s) and the pandemic affected the treatment, physical health and mental health of patients with Pompe disease, emphasizing the importance of continued patient centered care during a difficult time such as the COVID-19 pandemic.
Graph neural network-based breast cancer diagnosis using ultrasound images with optimized graph construction integrating the medically significant features
Authors: Chowa Sadia Sultana , Azam Sami , Montaha Sidratul , Payel Israt Jahan , Bhuiyan Md Rahad Islam , Hasan Md. Zahid , Jonkman Mirjam 
Published: November 2023

Abstract
Purpose
An automated computerized approach can aid radiologists in the early diagnosis of breast cancer. In this study, a novel method is proposed for classifying breast tumors into benign and malignant, based on the ultrasound images through a Graph Neural Network (GNN) model utilizing clinically significant features.

Method
Ten informative features are extracted from the region of interest (ROI), based on the radiologists’ diagnosis markers. The significance of the features is evaluated using density plot and T test statistical analysis method. A feature table is generated where each row represents individual image, considered as node, and the edges between the nodes are denoted by calculating the Spearman correlation coefficient. A graph dataset is generated and fed into the GNN model. The model is configured through ablation study and Bayesian optimization. The optimized model is then evaluated with different correlation thresholds for getting the highest performance with a shallow graph. The performance consistency is validated with k-fold cross validation. The impact of utilizing ROIs and handcrafted features for breast tumor classification is evaluated by comparing the model’s performance with Histogram of Oriented Gradients (HOG) descriptor features from the entire ultrasound image. Lastly, a clustering-based analysis is performed to generate a new filtered graph, considering weak and strong relationships of the nodes, based on the similarities.

Results
The results indicate that with a threshold value of 0.95, the GNN model achieves the highest test accuracy of 99.48%, precision and recall of 100%, and F1 score of 99.28%, reducing the number of edges by 85.5%. The GNN model’s performance is 86.91%, considering no threshold value for the graph generated from HOG descriptor features. Different threshold values for the Spearman’s correlation score are experimented with and the performance is compared. No significant differences are observed between the previous graph and the filtered graph.

Conclusion
The proposed approach might aid the radiologists in effective diagnosing and learning tumor pattern of breast cancer.
Iterative magnitude pruning-based light-version of AlexNet for skin cancer classification
Authors: Medhat Sara , Abdel-Galil Hala , Aboutabl Amal Elsayed , Saleh Hassan 
Published: November 2023

AbstractConvolutional Neural Networks (CNN) with different architectures have shown promising results in skin cancer diagnosis. However, CNN has a high computational cost, which makes the need for a light version of CNN a desirable step. This version can be used on small devices, such as mobile phones or tablets. A light version can be created using pruning techniques. In this study, iterative magnitude pruning (IMP) is utilized. This method depends on pruning the network iteratively. The IMP method is applied on AlexNet with transfer learning (TL) and data augmentation. The proposed IMP AlexNet with TL is applied on three different skin cancer datasets which are PAD-UFES-20, MED-NODE, and PH2 dataset. The datasets used are a combination of smartphone, dermoscopic, and non-dermoscopic images. Different CNN versions are applied on the same datasets for comparison with IMP AlexNet. The CNNs used are VGG-16, ShuffleNet, SqueezNet, DarkNet-19, DarkNet-53, and Inception-v3. The proposed IMP AlexNet achieved accuracies of 97.62%, 96.79%, and 96.75%, with accuracy losses of 1.53%, 2.3%, and 2.2%, respectively, compared to the original AlexNet. In addition, the proposed IMP AlexNet requires less running time and memory usage than the traditional AlexNet. The average running time for IMP AlexNet is 0.45 min, 0.28 min, and 0.3 min, for PAD-UFES-20, MED-NODE, and PH2 datasets, respectively. The average RAM usage with IMP AlexNet is 1.8 GB, 1.6 GB, and 1.7 GB, respectively. IMP AlexNet accelerates the average running time by approximately 15 times that of the traditional AlexNet and reduces the average RAM used by 40%.
Energy scaling laws for microstructures: from helimagnets to martensites
Authors: Ginster Janusz , Zwicknagl Barbara 
Published: November 2023

AbstractWe consider scalar-valued variational models for pattern formation in helimagnetic compounds and in shape memory alloys. Precisely, we consider a non-convex multi-well bulk energy term on the unit square, which favors four gradients $$({\pm }\,\alpha ,{\pm }\,\beta )$$

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, regularized by a singular perturbation in terms of the total variation of the second derivative. We derive scaling laws for the minimal energy in the case of incompatible affine boundary conditions in terms of the singular perturbation parameter as well as the ratio $$\alpha /\beta $$

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and the incompatibility of the boundary condition. We discuss how well-studied models for martensitic microstructures in shape-memory alloys arise as a limiting case, and relations between the different models in terms of scaling laws. In particular, we show that scaling regimes arise in which an interpolation between the rather different branching-type constructions in the spirit of Kohn and Müller (Commun Pure Appl Math 47(4):405–435, 1994) and Ginster and Zwicknagl (J Nonlinear Sci 33:20, 2023), respectively, occurs. A particular technical difficulty in the lower bounds arises from the fact that the energy scalings involve various logarithmic terms that we capture in matching upper and lower scaling bounds.
Harnack inequality for solutions of the p(x)-Laplace equation under the precise non-logarithmic Zhikov’s conditions
Authors: Skrypnik Igor , Yevgenieva Yevgeniia 
Published: November 2023

AbstractWe prove continuity and Harnack’s inequality for bounded solutions to the equation $$\begin{aligned} \textrm{div}\big (\mid \nabla u\mid ^{p(x)-2}\,\nabla u \big )&=0, \quad p(x)= {\bar{p}} + L\frac{\log \log \frac{1}{\mid x-x_{0}\mid }}{\log \frac{1}{\mid x-x_{0}\mid }}, \\ {\bar{p}}&>1, \quad L>0, \end{aligned}$$

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Linear inverse problems with Hessian–Schatten total variation
Authors: Ambrosio Luigi , Aziznejad Shayan , Brena Camillo , Unser Michael 
Published: November 2023

AbstractIn this paper, we characterize the class of extremal points of the unit ball of the Hessian–Schatten total variation (HTV) functional. The underlying motivation for our work stems from a general representer theorem that characterizes the solution set of regularized linear inverse problems in terms of the extremal points of the regularization ball. Our analysis is mainly based on studying the class of continuous and piecewise linear (CPWL) functions. In particular, we show that in dimension$$d=2$$d=2, CPWL functions are dense in the unit ball of the HTV functional. Moreover, we prove that a CPWL function is extremal if and only if its Hessian is minimally supported. For the converse, we prove that the density result (which we have only proven for dimension$$d=2$$d=2) implies that the closure of the CPWL extreme points contains all extremal points.
Elective implant removal in the upper extremity: only symptomatic patients benefit
Authors: Hambrecht Jan , Canal Claudio , Klingebiel Felix , Pfammatter Cyrill , Teuben Michel , Neuhaus Valentin , Pape Hans-Christoph , Kalbas Yannik , Hierholzer Christian 
Published: November 2023

Abstract
Purpose
Elective implant removal (IR) in the upper extremity remains controversial. Implants in the olecranon and clavicle are commonly removed for prominence, unlike in the distal radius. Patient-reported symptomatic cannot be verified, and nonspecific discomfort remains unquantified. In this study, indications and outcomes of IR at the clavicle, olecranon and distal radius were evaluated, with a focus on postoperative patient satisfaction.

Materials and methods
In this retrospective, single-center cohort study, patients, who received elective IR of the clavicle, olecranon and distal radius were included. Patients were followed up at least six weeks after IR. Outcomes included patient satisfaction, symptom resolution, and complications.

Results
One hundred and eighty-nine patients were included. Unspecific symptoms of discomfort were the most prevalent indication for IR (48.7%), followed by pain (29.6%) and objective limited range of motion (ROM) (7%). Pain and limited ROM combined was observed in 13.8%. Subjective benefit following IR was described in 54%. Patients with limited ROM (OR 4.7, p < 0.001) or pain (OR 4.1, p < 0.001) were more likely to experience alleviation of complaints. Patients with unspecific symptoms of discomfort, often did not report improvement. Major complications occurred in 2%. Refractures were detected at the clavicle (3.7%) and at the olecranon (2.5%). Minor complication rate was 5%.

Conclusion
IR is a safe procedure in the upper extremity. Indications based on unspecific symptoms of discomfort have a significant lower rate of patient satisfaction postoperatively. Elective IR should be considered cautiously, if it is driven primarily by unspecific symptoms of discomfort. Patient education is relevant to prevent dissatisfying outcome.
Die Arbeit von Elementarpädagog:innen in Zeiten der Covid-19-Pandemie
Authors: Schmidt Sophie , Steger Andrea , Spiel Christiane 
Published: November 2023

ZusammenfassungDer Ausbruch der Coronapandemie im Jahre 2020 führte zu massiven Einschränkungen des gesellschaftlichen Lebens weltweit. In der Folge kam es zur Schließung von Bildungsinstitutionen wie Kindergärten, Schulen und Universitäten. Eine online Fragebogenstudie aus dem Frühjahr 2021 beschäftigte sich mit den Arbeitsbedingungen von Elementarpädagog:innen in Zeiten der Krise in Österreich. Im Fokus standen dabei die Belastungen, Herausforderungen und Lernerfolge der Pädagog:innen. Insgesamt wurden die Daten von N = 541 überwiegend weiblichen Elementarpädagog:innen (97,6 % weiblich) analysiert. 84,1 % der Befragten berichteten von einer beruflichen Gratifikationskrise, also einem negativen Ungleichgewicht zwischen hohen beruflichen Anforderungen und einer niedrigen berufsbezogenen Anerkennung. Die allgemeine Arbeitszufriedenheit erwies sich als moderat (M = 4,28, SD = 1,18). Als herausfordernd wurden allen voran Rahmenbedingungen, wie uneinheitliche, fehlende und schwer umsetzbare COVID-19-Maßnahmen und der Personalmangel erlebt. Als Lerngewinn wurden unter anderem verschiedene Aspekte des pädagogischen Arbeitens, wie beispielsweise eine verstärkte Bedürfnisorientierung aufgrund kleinerer Gruppen genannt. Auch der Zugewinn an Flexibilität und eine erhöhte Stressresistenz wurden als positiv erlebt. Es zeigte sich, dass die Pandemie bereits existierende Missstände in der elementarpädagogischen Arbeit verstärkt. Um eine qualitativ hochwertige Betreuung von Kindern in elementarpädagogischen Einrichtungen weiterhin gewährleisten zu können, bedarf es einer Verbesserung der Arbeits- und Rahmenbedingungen in der frühkindlichen Bildung und Betreuung.
Efficacy and safety of mycophenolate mofetil in patients with immune thrombocytopenic purpura: a systematic review and meta-analysis
Authors: Abdelwahab Omar Ahmed , Mechi Ahmed , Gahlan Shereen , Hamadein Fatima-Elzahraa , Kadhim Hallas , Ismail Doaa , Soliman Youssef , El‑Samahy Mohamed 
Published: November 2023

Abstract
Background
Immune thrombocytopenic purpura (ITP) is a challenging disease in its presentation and management as it may cause life-threatening hemorrhaging in vital organs and may resist several lines of treatment. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of mycophenolate mofetil (MMF) in treating patients with ITP.

Methods
We systematically searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) from inception until 10 October 2022. We included all clinical trials, either controlled or single arm, and prospective and retrospective observational studies that evaluate the efficacy and safety of MMF in patients with ITP. We assessed the risk of bias using three tools (ROBINS-I, Cochrane ROB-2, and NIH), each for eligible study design.

Results
Nine studies were included in this meta-analysis, with a total of 411 patients with ITP. We found that MMF demonstrated an overall response rate of (62.09%; 95% CI = [43.29 to 77.84]) and the complete response rate was (46.75%; 95% CI = [24.84 to 69.99]). The overall proportion of adverse events was (12%; 95% CI = [6 to 24]). After the sensitivity analysis, the overall response rate became 50%; 95% CI = [38 to 63]) and the complete response rate became (32%; 95% CI = [24 to 42]). However, MMF did not appear to affect white blood cell counts or hemoglobin levels significantly.

Conclusion
This systematic review and meta-analysis demonstrate that MMF appears to be an effective and relatively safe treatment option for patients with ITP when combined with steroids and even in those who have not responded to standard therapies (steroid-resistant cases). Further research with well-designed studies is warranted to better understand the factors influencing treatment response and to refine the use of MMF in the management of ITP. An interactive version of our analysis can be accessed from here: https://databoard.shinyapps.io/mycophenolate_meta/

Graphical abstract
How to manage massive spatiotemporal dataset from stationary and non-stationary sensors in commercial DBMS?
Authors: Vitale Vincenzo Norman , Martino Sergio Di , Peron Adriano , Russo Massimiliano , Battista Ermanno 
Published: November 2023

AbstractThe growing diffusion of the latest information and communication technologies in different contexts allowed the constitution of enormous sensing networks that form the underlying texture of smart environments. The amount and the speed at which these environments produce and consume data are starting to challenge current spatial data management technologies. In this work, we report on our experience handling real-world spatiotemporal datasets: a stationary dataset referring to the parking monitoring system and a non-stationary dataset referring to a train-mounted railway monitoring system. In particular, we present the results of an empirical comparison of the retrieval performances achieved by three different off-the-shelf settings to manage spatiotemporal data, namely the well-established combination of PostgreSQL + PostGIS with standard indexing, a clustered version of the same setup, and then a combination of the basic setup with Timescale, a storage extension specialized in handling temporal data. Since the non-stationary dataset has put much pressure on the configurations above, we furtherly investigated the advantages achievable by combining the TSMS setup with state-of-the-art indexing techniques. Results showed that the standard indexing is by far outperformed by the other solutions, which have different trade-offs. This experience may help researchers and practitioners facing similar problems managing these types of data.
How Culture Displaced Structural Reform: Problem Definition, Marketization, and Neoliberal Myths in Bank Regulation
Authors: Mikes Anette , Power Michael 
Published: November 2023

AbstractWe use content analysis to show that the diagnosis of the financial crisis of 2007–2009 shifted significantly from a focus on the need for structural change in the banking industry to an emphasis on culture and reform at the organizational level. We consider four overlapping subsystems in which this shift in problem–solution clusters played out—political, regulatory, legal, and consulting—and show that the “structural reform agenda,” which was initially strong and publicly prominent in the political arena, lost attention. Over time it was displaced by a neoliberal managerialist turn, which watered down or abandoned structural solutions and instead played up a new “culture and conduct reform agenda.” We explain this shift in terms of the marketization of regulation, which—following Mautner (Language and the market society, 1st ed. Routledge, 2010)’s model of interdiscursive alignment—we detect in the shifting language of financial-services reform across the four subsystems in scope. We argue that a neoliberal turn took place with a discursive closure that made the structural reform alternative gradually unsayable and, in the end, unthinkable. At the same time, the discourse turned to embrace the neoliberal agenda, built on the myth of self-regulating actors and markets, manifest in the culture problematic. This managerialist turn was able to mobilise, and be operationalised by, an industry of consultants, whereas structural change came to be seen by regulators as too risky to implement. We claim that these dynamics reveal how a form of “collective strategic ignorance,” based on powerful institutional myths, was systematically oriented to ignore and reject structural sources of crisis. Finally, we suggest that the observed pattern of displacement—whereby initial calls for structural change become later displaced by managerial and procedural solutions—is common to other social issues, such as audit reform and corporate social responsibility.