bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does greenwashing obstruct sustainable environmental technologies and green financing from promoting environmental sustainability? Analytical evidence from the Indian economy
Authors: Das Narasingha , Gangopadhyay Partha , Alam Mohammad Mahtab , Mahmood Haider , Bera Pinki , Khudoykulov Khurshid , Dey Labani , Hossain Md. Emran 
Published: August 2023

AbstractThis study aims at assessing the impacts of green growth, in the form of adopting sustainable energy technologies and financing green projects, on environmental conditions in India. Thus, this study is important from the point of view of India's efforts in formulating strategies linked with achieving the environmental development targets enlisted under United Nations SDG‐13 declaration. In this regard, it is assumed that strategies targeted at establishing green growth in India can fail in the presence of greenwashing. To test this hypothesis, a newly introduced econometric technique, namely the Augmented‐ARDL techniques of estimation is used. Accordingly, the results obtained firstly suggest the existence of long‐run and cointegrated relationship exists between the variables of choice. Secondly, it is very much striking to find out that the the there is an inverse relationship between use of sustainable environmental technologies and environmental sustainability across India. Hence, this particular finding points to the possibility of stimulating geenwashing in the context of technology adoption in order to improve the state of the environment in India. Lastly, financing of green projects is seen to promote environmental sustainability which, in turn, affirms the absence of greenwashing in the context of green financing initiatives.
Artificial rabbit optimization‐based ANFIS model development for predicting the compressive strength of GGBFS‐based concrete
Authors: Sun Qingmei 
Published: August 2023

AbstractThe carbon dioxide emissions associated with the production of conventional Portland cement may be mitigated through the utilization of ground granulated blast furnace slag (GGBFS). The consideration of compressive strength () is essential in the design and construction of concrete structures, as it is an essential demand in concrete mixtures. The primary objective of this study is to establish an effective approach for conducting a comprehensive evaluation of machine learning algorithms in predicting the of concrete that incorporates GGBFS. The work focuses on using the adaptive neuro‐fuzzy inference system (ANFIS) to create predictive models for . The of the collected datasets ranged from 6.3 to 101.3 MPa. The study included the artificial rabbit optimization (ARO) and Bald Eagle search algorithm (BES) to improve the effectiveness of the ANFIS approaches. The novelty of this study is attributed to several factors, including the utilization of the ARO and BES methodologies, the incorporation of GGBFS in the evaluation of , the comparison with previous research findings, and the utilization of a substantial dataset encompassing multiple input variables. These factors offer a novel method for improving the effectiveness of prediction models and advance our understanding of forecasting the mechanical characteristics of concrete. The integrated ANF‐AR and ANF‐BA systems showed good estimating skills, according to the findings, which showed R2 values of 0.9961 and 0.9967 for the ANF‐AR's training and testing components and 0.9916 and 0.9946 for the ANF‐BA, respectively. Overall, the ANFIS optimized with ARO model is recognized as the outperformed system for prediction purposes.
Digitale Transformation deutscher Gesundheitseinrichtungen
Authors: Petzold Thomas , Steidle Oliver 
Published: August 2023

Zusammenfassung
Einleitung
Die digitale Transformation umfasst u. a. die Projektierung und Implementierung digitaler Anwendungen, Technologien und Maßnahmen und stellt inzwischen das Tagesgeschäft aller Organisationen und Einrichtungen im Gesundheitswesen dar. Im vorliegenden Beitrag werden die aktuellen Tätigkeitsinhalte der digitalen Transformation in Gesundheitseinrichtungen aus Sicht des Qualitätsmanagements dargestellt.

Methoden
Es erfolgte eine deutschlandweite Befragung von 141 Mitgliedern der Gesellschaft für Qualitätsmanagement in der Gesundheitsversorgung (niedergelassene Ärztinnen und Ärzte, Vertretende von Krankenhäusern, Krankenkassen sowie weiteren Einrichtungen des Gesundheitswesens) über alle Felder der digitalen Transformation, bestehende Projekte und in der Implementierung befindliche digitale Technologien. Anhand von 6 Themenblöcken bewerteten die Teilnehmenden die zeitliche Abfolge und inhaltliche Relevanz für deren Organisation.

Ergebnisse
82 % der Befragten gaben an, dass die digitale Transformation den Arbeitsalltag beeinflusst bzw. verändert. Die häufigsten Projekte umfassen Themen aus dem Prozess- und Schnittstellenmanagement (53 %) sowie zur Verbesserung der Patientensicherheit (52 %). Häufigste konkrete Vorhaben stellen die elektronische Patientenakte und Themen, die im Zuge des Krankenhauszukunftsgesetzes beauftragt wurden, dar.

Diskussion
Laut Aussage der Befragten verändert die digitale Transformation Strukturen und Prozesse von Gesundheitseinrichtungen und macht zusätzliche Kompetenzen erforderlich, damit digitale Technologien zielführend und nachhaltig implementiert werden können. Eine strukturierte Koordination der Kompetenzen aller Professionen einer Gesundheitseinrichtung ist erforderlich, um digitale Technologien im Alltag von Gesundheitseinrichtungen zu verankern.
Pädiatrische Versorgungstrukturen bei Adipositas 2023 – Wo stehen wir?
Authors: Torbahn Gabriel , Lischka Julia , Joisten Christine , Weghuber Daniel 
Published: August 2023

ZusammenfassungAdipositas ist eine chronisch-rezidivierende Erkrankung, verbunden mit einer Vielzahl kardiometabolischer, orthopädischer und psychischer Komorbiditäten und hohen Belastungen für die jeweiligen Gesundheitssysteme. Bereits im Kindes- und im Jugendalter sind in Österreich und Deutschland 15–25 % von Übergewicht oder Adipositas betroffen. Daher ist eine frühzeitige, interdisziplinäre, multimodale und patientenorientierte Behandlung, bestehend aus einer Basistherapie mit Lebensstilmodifikation sowie medizinischer und psychosozialer Betreuung, dringend erforderlich. Obwohl aktuell leitliniengerechte Konzepte vorliegen, existieren nur wenige spezialisierte zertifizierte Versorgungszentren, und für leitliniengerechte Therapieprogramme erfolgt keine flächendeckende Kostenübernahme. Um insbesondere nach der COVID-19-Pandemie eine adäquate flächendeckende und durch die Sozialversicherungen finanzierte Versorgung zu gewährleisten, sind gesundheitspolitische Entscheidungsträger*innen mehr denn je aufgefordert, im Sinne der Patient*innen Lösungen zu entwickeln. Diese Maßnahmen dienen einerseits der Gesundheitsförderung und langfristigen Entlastung der Gesundheitssysteme, v. a. aber der Behandlung betroffener Kinder und Jugendlicher. Ziele dieser Arbeit sind daher, aktuelle Versorgungsempfehlungen und -strukturen bei pädiatrischer Adipositas in Österreich und Deutschland zusammenzufassen sowie rezente Fortschritte und Handlungsempfehlungen für Politik und Gesellschaft darzustellen.
Anti-predator behavior in two brown frogs: differences in the mean behaviors and in the structure of animal personality variation
Authors: Castellano Sergio , Falbo Luca , Seglie Daniele , Friard Olivier 
Published: August 2023

AbstractPredation is a major source of selection and prey are known to modify their behavior depending on their past experiences and the current perceived risk. Within a species, variation in experience and in the response to perceived risk combine to explain variation in personality and individual plasticity. Between species, variation in personality and plasticity might also be the evolutionary consequence of different selective regimes. In this study, we describe the anti-predator behavior of two closely related brown frogs,Rana dalmatinaandRana latastei, and compare their structures of personality variation. We raised tadpoles in a common garden experiment with either fish, dragonfly larvae, or no predators. Tadpoles were then repeatedly tested in the presence of the three acute stimuli and their behavioral variation was described in terms of quantity and quality of movements and of path sinuosity. In these tests, tadpoles of both species and ontogenetic treatments responded flexibly to predators by moving less, faster, and with more tortuous movements, and tadpoles raised with predators tended to move even faster. Independent of the acute treatment,R. dalmatinamoved more and faster thanR. latasteiand the differences were larger without than with predators, demonstrating its higher plasticity. At the individual level, the two species showed qualitatively similar but quantitatively different structures of personality variation.R. dalmatina, more active, faster, and more plastic thanR. latastei, showed also higher repeatability and a larger behavioral variation both among and within individuals.Significance statementPredators are a major source of selection and preys have evolved the ability to flexibly respond to them. These responses often vary among species, because of their different evolutionary histories, and among individuals, because of their different experiences. We analyzed both these sources of behavioral variation in two closely related brown frogs,Rana dalmatinaandR. latastei. We raised tadpoles either with or without predators and tested them in open field trials both with and without predators. The effects of the raising environment were similar in the two species, whereas the effects of the testing arena differed. Both species decreased activity and increased speed and sinuosity with predators, butR. dalmatinamoved always more and faster thanR. latasteiand it showed higher plasticity, larger variation among and within individuals, and relatively higher values in repeatability.
Noninvasive prediction of insufficient biochemical response after ursodeoxycholic acid treatment in patients with primary biliary cholangitis based on pretreatment nonenhanced MRI
Authors: Zhang Yun , Fan Xiaoli , Song Bin , Liu Yifeng , Chen Yidi , Zheng Tianying , Guo Yuxin , Duan Ting , Huang Zixing , Yang Li 
Published: August 2023

Abstract
Objectives
To explore the feasibility of pretreatment nonenhanced magnetic resonance imaging (MRI) in predicting insufficient biochemical response to ursodeoxycholic acid (UDCA) in patients with primary biliary cholangitis (PBC).

Methods
From January 2009 to April 2022, consecutive PBC patients who were treated with UDCA and underwent nonenhanced MRI within 30 days before treatment were retrospectively enrolled. All MR images were independently evaluated by two blinded radiologists. Uni- and multivariable logistic regression analyses were performed to develop a predictive model for 12-month insufficient biochemical response. Model performances were evaluated by computing the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity.

Results
A total of 74 patients (50.6 ± 11.9 years; 62 females) were included. Three pretreatment MRI features, including hepatomegaly (odds ratio [OR]: 4.580; p = 0.011), periportal hyperintensity on T2-weighted imaging (T2WI) (OR: 4.795, p = 0.008), and narrowing of the bile ducts (OR: 3.491; p = 0.027) were associated with 12-month insufficient biochemical response in the multivariable analysis. A predictive model based on the above indicators had an AUC of 0.781, sensitivity of 85.4%, and specificity of 61.5% for predicting insufficient biochemical response.

Conclusions
A noninvasive model based on three pretreatment MRI features could accurately predict 12-month insufficient biochemical response to UDCA in patients with PBC. Early identification of PBC patients at increased risk for insufficient response can facilitate the timely initiation of additional treatment.

Clinical relevance statement
A noninvasive predictive model constructed by incorporating three pretreatment MRI features may help identify patients with primary biliary cholangitis at high risk of insufficient biochemical response to ursodeoxycholic acid and facilitate the timely initiation of additional treatment.

Key Points
• Noninvasive imaging features based on nonenhanced pretreatment MRI may predict an insufficient biochemical response to UDCA in PBC patients.
• A combined model based on three MRI features (hepatomegaly, periportal hyperintensity on T2-weighted imaging, and narrowing of the bile ducts) further improved the predictive efficacy for an insufficient biochemical response to UDCA in PBC patients, with high sensitivity and specificity.
• The nomogram of the combined model showed good calibration and predictive efficacy for an insufficient biochemical response to UDCA in PBC patients. In particular, the calibration curve visualised the clinical applicability of the prediction model.
Cortical atrophy on baseline computed tomography imaging predicts clinical outcome in patients undergoing endovascular treatment for acute ischemic stroke
Authors: Brugnara Gianluca , Engel Adrian , Jesser Jessica , Ringleb Peter Arthur , Purrucker Jan , Möhlenbruch Markus A. , Bendszus Martin , Neuberger Ulf 
Published: August 2023

Abstract
Objective
Multiple variables beyond the extent of recanalization can impact the clinical outcome after acute ischemic stroke due to large vessel occlusions. Here, we assessed the influence of small vessel disease and cortical atrophy on clinical outcome using native cranial computed tomography (NCCT) in a large single-center cohort.

Methods
A total of 1103 consecutive patients who underwent endovascular treatment (EVT) due to occlusion of the middle cerebral artery territory were included. NCCT data were visually assessed for established markers of age-related white matter changes (ARWMC) and brain atrophy. All images were evaluated separately by two readers to assess the inter-observer variability. Regression and machine learning models were built to determine the predictive relevance of ARWMC and atrophy in the presence of important baseline clinical and imaging metrics.

Results
Patients with favorable outcome presented lower values for all measured metrics of pre-existing brain deterioration (p < 0.001). Both ARWMC (p < 0.05) and cortical atrophy (p < 0.001) were independent predictors of clinical outcome at 90 days when controlled for confounders in both regression analyses and led to a minor improvement of prediction accuracy in machine learning models (p < 0.001), with atrophy among the top-5 predictors.

Conclusion
NCCT-based cortical atrophy and ARWMC scores on NCCT were strong and independent predictors of clinical outcome after EVT.

Clinical relevance statement
Visual assessment of cortical atrophy and age-related white matter changes on CT could improve the prediction of clinical outcome after thrombectomy in machine learning models which may be integrated into existing clinical routines and facilitate patient selection.

Key Points
• Cortical atrophy and age-related white matter changes were quantified using CT-based visual scores.
• Atrophy and age-related white matter change scores independently predicted clinical outcome after mechanical thrombectomy and improved machine learning–based prediction models.
• Both scores could easily be integrated into existing clinical routines and prediction models.
Prognostic impact of cancer history in patients undergoing transcatheter mitral valve repair
Authors: Kalkan Alev , Metze Clemens , Iliadis Christos , Körber Maria I. , Baldus Stephan , Pfister Roman 
Published: August 2023

Abstract
Background
History of cancer is common in patients undergoing transcatheter mitral valve repair (TMVR).

Objectives
Aim was to examine the impact of cancer history on outcomes after TMVR.

Methods
In patients of a monocentric prospective registry of TMVR history of cancer was retrospectively assessed from records. Associations with 6-week functional outcomes and clinical outcomes during a median follow-up period of 594 days were examined.

Results
Of 661 patients (mean age 79 years; age-range 37–101 years; 56.1% men), 21.6% had a history of cancer with active disease in 4.1%. Compared with non-cancer patients, cancer patients had a similar procedural success rate (reduction of mitral regurgitation to grade 2 or lower 91.6% vs. 88%; p = 0.517) and similar relevant improvement in 6-min walking distance, NYHA class, Minnesota Living with Heart Failure Questionnaire score and Short Form 36 scores. 1-year survival (83% vs. 82%; p = 0.813) and 1-year survival free of heart failure decompensation (75% vs. 76%; p = 0.871) were comparable between cancer and non-cancer patients. Patients with an active cancer disease showed significantly higher mortality compared with patients having a history of cancer (hazard ratio 2.05 [95% CI 1.11–3.82; p = 0.023]) but similar mortality at landmark analysis of 1 year.

Conclusion
TMVR can be performed with equal efficacy in patients with and without cancer and symptomatic mitral regurgitation. Cancer patients show comparable clinical outcome and short-term functional improvement as non-cancer patients. However, longterm mortality was increased in patients with active cancer underlining the importance of patient selection within the heart-team evaluation.

Graphical abstract
High- and low-dose cyclophosphamide in Egyptian lupus nephritis patients: a multicenter retrospective analysis
Authors: Elaziz Mohamed Momtaz A. , Gamal Sherif M. , Fayed Ahmed , Abu-Zaid Mohammed Hassan , Ghoniem Shada A. , Teleb Doaa A. 
Published: August 2023

Abstract
Background
Lupus nephritis (LN) is a common serious presentation of systemic lupus erythematosus. Cyclophosphamide (CYC) and mycophenolate mofetil (MMF) are listed as the first-line drugs in induction therapy for LN.

Objective
This study aimed to compare high- and low-dose CYC in a cohort of Egyptian LN patients.

Patients and methods
The data of 547 patients with class III/IV active LN who received CYC as induction therapy were retrospectively analyzed. Whereas 399 patients received 6‑monthly 0.5–1 g/m2 CYC doses, 148 patients received six biweekly 500 mg CYC doses. Demographic data, laboratory test results, and disease activity index were recorded and compared at presentation and at 6, 12, 18, 24, and 48 months of follow-up.

Results
After 48 months, the proportion of patients maintaining normal creatinine levels was higher in the group receiving induction therapy with high-dose CYC (67.9%, 60.4%, p = 0.029), and these patients also had higher proteinuria remission at 36 (26.6%, 14.8%, p = 0.014) and 48 months (24.3%, 12.8%, p = 0.006). Comparison of patient outcomes according to both induction and maintenance therapy showed the best results in patients who received high-dose CYC and continued MMF as maintenance therapy.

Conclusion
High- and low-dose CYC are comparable in early phases of treatment. However, after a longer duration of follow-up, high-dose CYC was associated with higher remission rates in the current cohort.
The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis
Authors: Uijterwijk Bas A. , Kasai Meidai , Lemmers Daniel H. L. , Chinnusamy Palanivelu , van Hilst Jony , Ielpo Benedetto , Wei Kongyuan , Song Ki Byung , Kim Song C. , Klompmaker Sjors , Jang Jin-Young , Herremans Kelly M. , Bencini Lapo , Coratti Andrea , Mazzola Michele , Menon Krishna V. , Goh Brian K. P. , Qin Renyi , Besselink Marc G. , Abu Hilal Mohammed ,   for the International Study Group on non-pancreatic periAmpullary CAncer (ISGACA), Hakeem Abdul , Burdio Fernando , Senthilnathan Palanisamy , Sánchez Patricia , Kim Hyeong Seok , Hughes Steven J. , Giani Alessandro 
Published: August 2023

Abstract
Background
Most studies on minimally invasive pancreatoduodenectomy (MIPD) combine patients with pancreatic and periampullary cancers even though there is substantial heterogeneity between these tumors. Therefore, this study aimed to evaluate the role of MIPD compared to open pancreatoduodenectomy (OPD) in patients with non-pancreatic periampullary cancer (NPPC).

Methods
A systematic review of Pubmed, Embase, and Cochrane databases was performed by two independent reviewers to identify studies comparing MIPD and OPD for NPPC (ampullary, distal cholangio, and duodenal adenocarcinoma) (01/2015–12/2021). Individual patient data were required from all identified studies. Primary outcomes were (90-day) mortality, and major morbidity (Clavien-Dindo 3a-5). Secondary outcomes were postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), blood-loss, length of hospital stay (LOS), and overall survival (OS).

Results
Overall, 16 studies with 1949 patients were included, combining 928 patients with ampullary, 526 with distal cholangio, and 461 with duodenal cancer. In total, 902 (46.3%) patients underwent MIPD, and 1047 (53.7%) patients underwent OPD. The rates of 90-day mortality, major morbidity, POPF, DGE, PPH, blood-loss, and length of hospital stay did not differ between MIPD and OPD. Operation time was 67 min longer in the MIPD group (P = 0.009). A decrease in DFS for ampullary (HR 2.27, P = 0.019) and distal cholangio (HR 1.84, P = 0.025) cancer, as well as a decrease in OS for distal cholangio (HR 1.71, P = 0.045) and duodenal cancer (HR 4.59, P < 0.001) was found in the MIPD group.

Conclusions
This individual patient data meta-analysis of MIPD versus OPD in patients with NPPC suggests that MIPD is not inferior in terms of short-term morbidity and mortality. Several major limitations in long-term data highlight a research gap that should be studied in prospective maintained international registries or randomized studies for ampullary, distal cholangio, and duodenum cancer separately.

Protocol registration
PROSPERO (CRD42021277495) on the 25th of October 2021.