bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrence of perforation and overall patient survival after penetrating keratoplasty versus amniotic membrane transplantation in corneal perforation
Authors: Elhardt Carolin , Schweikert Romina , Kamnig Rupert , Vounotrypidis Efstathios , Wolf Armin , Wertheimer Christian M. 
Published: January 2023

Abstract
Purpose
The following is a comparative analysis on the treatment outcomes of corneal perforations using amniotic membrane transplantation (AMT) or penetrating keratoplasty (PK).

Methods
This monocentric retrospective study was performed at the Department of Ophthalmology, University Hospital Ulm, Germany. A total of 78 eyes of 78 patients were included. Thirty-nine eyes received an AMT, and 39 patients were treated with a PK. Primary outcome was recurrence of perforation. Secondary outcomes were patient mortality and visual acuity.

Results
No statistically significant difference was observed with regard to a recurrence of perforation between the two groups (26% in AMT vs 23% in PK, p > 0.99). The time of recurrences was within the first two years and did not differ statistically (p = 0.97). In addition, a proportional hazards model with cox regression regarding recurrent perforation showed no significant differences (p = 0.5). After AMT, 41% and after KP, 28% of the patients died during follow-up (p = 0.2), respectively. The Charlson Comorbidity Index (p < 0.0001) and the age at the time of surgery (p = 0.0002) were statistically significantly higher in those who were deceased. A mean follow-up of 485 ± 517 days was recorded.

Conclusion
Both surgical methods show good results and no statistically significant difference regarding recurrent perforation rate. About a third of the patients died during the follow-up period. The decision regarding the appropriate method should therefore be based on a combination of all factors.
Oligometastatic disease and visceral resections in advanced malignant melanoma: a propensity-matched analysis
Authors: Urbanski Alexander , Minnemann Julia , Mauch Cornelia , Schmidt Thomas , Kreuzberg Nicole , Schlaak Max , Bruns Christiane J. , Stippel Dirk L. , Wahba Roger 
Published: January 2023

Abstract
Purpose

Malignant melanoma is among the tumours with the highest increase in incidence of solid tumours in Germany. While most patients are diagnosed at an early stage and show a good prognosis, advanced stages of malignant melanoma are accompanied with a poor prognosis and limited treatment options. Comparable to other tumour entities, the resection of visceral metastases could lead to a better prognosis. Supplementary, the subgroup of oligometastatic patients might benefit from surgical therapy to a greater extent.

Methods
This retrospective study analysed 351 patients treated between 2006 and 2017 at the University Hospital of Cologne. A total of 121 patients showed visceral metastases, with which we compared patients with a diffuse tumour spread to patients in an oligometastatic state. Furthermore, we evaluated the effect of visceral resection of oligometastatic, malignant melanoma.

Results
Our analysis showed that patients with an oligometastatic malignant melanoma had a significantly better prognosis than patients with a diffuse pattern of metastases, if they showed visceral metastases. Furthermore, the resection of visceral metastases leads to a significant gain in median overall survival time (13.6 vs. 34.2 months) and in progression-free survival (9.6 vs. 3.8 months).

Conclusion
The resection of visceral metastases is a rational treatment option in advanced malignant melanoma. Although our study is limited by a small cohort of patients (n = 18), we believe that the resection of visceral metastases will be fundamental in the treatment of malignant melanoma. In particular, patients in an oligometastatic stage could be an eligible group for surgical treatment.
Nitrogen-mediated metabolic patterns of susceptibility to Botrytis cinerea infection in tomato (Solanum lycopersicum) stems
Authors: Lacrampe Nathalie , Colombié Sophie , Dumont Doriane , Nicot Philippe , Lecompte François , Lugan Raphaël 
Published: January 2023

Abstract
Main conclusion
Severe N stress allows an accumulation of C-based compounds but impedes that of N-based compounds required to lower the susceptibility of tomato stem toBotrytis cinerea.

Abstract
Botrytis cinerea, a necrotrophic filamentous fungus, forms potentially lethal lesions on the stems of infected plants. Contrasted levels of susceptibility to B. cinerea were obtained in a tomato cultivar grown on a range of nitrate concentration: low N supply resulted in high susceptibility while high N supply conferred a strong resistance. Metabolic deviations and physiological traits resulting from both infection and nitrogen limitation were investigated in the symptomless stem tissue surrounding the necrotic lesion. Prior to infection, nitrogen-deficient plants showed reduced levels of nitrogen-based compounds such as amino acids, proteins, and glutathione and elevated levels of carbon-based and defence compounds such as α-tomatine and chlorogenic acid. After B. cinerea inoculation, all plants displayed a few common responses, mainly alanine accumulation and galactinol depletion. The metabolome of resistant plants grown under high N supply showed no significant change after inoculation. On the contrary, the metabolome of susceptible plants grown under low N supply showed massive metabolic adjustments, including changes in central metabolism around glutamate and respiratory pathways, suggesting active resource mobilization and production of energy and reducing power. Redox and defence metabolisms were also stimulated by the infection in plants grown under low N supply; glutathione and chlorogenic acid accumulated, as well as metabolites with more controversial defensive roles, such as polyamines, GABA, branched-chain amino acids and phytosterols. Taken together, the results showed that nitrogen deficiency, although leading to an increase in secondary metabolites even before the pathogen attack, must have compromised the constitutive levels of defence proteins and delayed or attenuated the induced responses. The involvement of galactinol, alanine, cycloartenol and citramalate in the tomato stem response to B. cinerea is reported here for the first time.
Translating evidence in a priority setting partnership: knowledge gaps between healthcare providers and oesophageal cancer patients
Authors: McDonnell Sarah , Breslin Tara , Mascan Bianca , Shahruddin Nur Shuhada , Elnour Mawaheb , Fanning Michelle , Galvin Anthony , Moore Jennifer , Ravi Narayansamy , Reynolds John V. , Donohoe Claire L. 
Published: January 2023

Abstract

Introduction

Despite the fact that health information is now more accessible than ever, knowledge gaps remain between patients and healthcare providers (HCPs). To date, the patients’ need for information following a diagnosis of oesophageal cancer has not been adequately met.

Purpose
The purpose of this study was to identify why knowledge gaps exist between oesophageal cancer patients and HCPs and how to address them.

Methods
Purposive sampling of a group of people living with and after oesophageal cancer who had participated in a priority-setting partnership where 45% of questions from patients had existing evidence-based answers. A 7-set question series was developed for use in a patient/HCP focus group in addition to 11 individual phone interviews with survivors of oesophageal cancer. Qualitative semistructured interviews were conducted to explore oesophageal cancer patients’ access to information. The data was analysed thematically, which involved coding all patient transcripts before identifying and reviewing key themes.

Results
The three primary themes that emerged were as follows: opportunity (HCP team factors and relationship development), ability (patient factors) and priority (pacing of information delivery).

Conclusion
Effective communication between patients and HCPs was identified as an integral component of the enhancement of patient knowledge. HCPs should continue to refine and improve methods of information delivery and encourage conversations regarding information preferences.
High patient satisfaction and increased physical activity following a remote multidisciplinary team multiple myeloma clinic
Authors: Lecat Catherine S. Y. , Fisher Abigail , Atta Maria , Camilleri Marquita , McCourt Orla , Land Joanne , Worthington Sarah , Hart Alyse , Daniel Angela , Uddin Inayah , Roche Charlotte , Auner Holger W. , Yong Kwee 
Published: January 2023

AbstractPurposePatients with multiple myeloma suffer from disease-related complications such as bone destruction, toxicities from repeated therapies and age-related co-morbidities. With improved treatment options, patients are living longer and have specific survivorship needs such as low exercise levels that need to be addressed. In this study, we designed, implemented and evaluated a multidisciplinary team (MDT) myeloma clinic that provided participants with tailored exercise and lifestyle advice.MethodsThe Promoting Individualised Self-Management and Survivorship (PrISMS) clinic was set up in two UK myeloma centres. This remote MDT clinic comprised of a doctor, a nurse specialist and a physiotherapist. Patients were required to complete blood tests and a questionnaire about their symptoms and concerns before each consultation. Patient-reported outcome measures were captured using validated questionnaires. Patient feedback was collected using a specially designed survey and structured telephone interviews.ResultsSixty-one patients were enrolled in the pilot clinic with 210 consultations held during the study period. Nine patients had disease progression and were referred safely back to face-to-face clinics. There was a significant improvement in patients’ exercise score (p = 0.02) after PrISMS clinic. Patient satisfaction was high, with 83% feeling more confident in self-managing myeloma after PrISMS clinic.ConclusionPrISMS clinic is safe and feasible, with high patient compliant and acceptability. It empowers patients to self-manage their condition and encourages physical activity, which is associated with improved quality of life and fatigue level. Future randomised controlled trials will help to confirm its benefits on patient clinical outcomes and cost-effectiveness.
Prognostic factors associated with outcome following an epidural steroid injection for disc-related sciatica: a systematic review and narrative synthesis
Authors: Nagington Alan , Foster Nadine E. , Snell Kym , Konstantinou Kika , Stynes Siobhán 
Published: January 2023

Abstract
Purpose
Clinical guidelines recommend epidural steroid injection (ESI) as a treatment option for severe disc-related sciatica, but there is considerable uncertainty about its effectiveness. Currently, we know very little about factors that might be associated with good or poor outcomes from ESI. The aim of this systematic review was to synthesise and appraise the evidence investigating prognostic factors associated with outcomes following ESI for patients with imaging confirmed disc-related sciatica.

Methods
The search strategy involved the electronic databases Medline, Embase, CINAHL Plus, PsycINFO and reference lists of eligible studies. Selected papers were quality appraised independently by two reviewers using the Quality in Prognosis Studies tool. Between-study heterogeneity precluded statistical pooling of results.

Results
3094 citations were identified; 15 studies were eligible. Overall study quality was low with all judged to have moderate or high risk of bias. Forty-two prognostic factors were identified but were measured inconsistently. The most commonly assessed prognostic factors were related to pain and function (n = 10 studies), imaging features (n = 8 studies), patient socio-demographics (n = 7 studies), health and lifestyle (n = 6 studies), clinical assessment findings (n = 4 studies) and injection level (n = 4 studies). No prognostic factor was found to be consistently associated with outcomes following ESI. Most studies found no association or results that conflicted with other studies.

Conclusions
There is little, and low quality, evidence to guide practice in terms of factors that predict outcomes in patients following ESI for disc-related sciatica. The results can help inform some of the decisions about potential prognostic factors that should be assessed in future well-designed prospective cohort studies.
The two-network framework of number processing: a step towards a better understanding of the neural origins of developmental dyscalculia
Authors: Klein Elise , Knops André 
Published: January 2023

AbstractDevelopmental dyscalculia is a specific learning disorder that persists over lifetime and can have an enormous impact on personal, health-related, and professional aspects of life. Despite its central importance, the origin both at the cognitive and neural level is not yet well understood. Several classification schemas of dyscalculia have been proposed, sometimes together with an associated deficit at the neural level. However, these explanations are (a) not providing an exhaustive framework that is at levels with the observed complexity of developmental dyscalculia at the behavioral level and (b) are largely mono-causal approaches focusing on gray matter deficits. We suggest that number processing is instead the result of context-dependent interaction of two anatomically largely separate, distributed but overlapping networks that function/cooperate in a closely integrated fashion. The proposed two-network framework (TNF) is the result of a series of studies in adults on the neural correlates underlying magnitude processing and arithmetic fact retrieval, which comprised neurofunctional imaging of various numerical tasks, the application of probabilistic fiber tracking to obtain well-defined connections, and the validation and modification of these results using disconnectome mapping in acute stroke patients. Emerged from data in adults, it represents the endpoint of the acquisition and use of mathematical competencies in adults. Yet, we argue that its main characteristics should already emerge earlier during development. Based on this TNF, we develop a classification schema of phenomenological subtypes and their underlying neural origin that we evaluate against existing propositions and the available empirical data.
Praxis der präklinischen Schlaganfallversorgung im deutschsprachigen Raum
Authors: Lier Martin , Euler Maximilian , Roessler Markus , Liman Jan , Goericke Meike Bettina , Baubin Michael , Mueller Stefan Matthias , Kunze-Szikszay Nils 
Published: January 2023

Zusammenfassung
Hintergrund
Eine leitlinienadhärente rettungsdienstliche Versorgung kann die Prognose von Schlaganfallpatienten positiv beeinflussen.

Ziel der Arbeit
Durchführung einer Bestandsaufnahme der Organisation der präklinischen Schlaganfallversorgung im Hinblick auf die Empfehlungen aktueller Versorgungsleitlinien.

Material und Methoden
Die ärztlichen Leitungen Rettungsdienst (ÄLRD) in Deutschland (n = 178), Österreich (n = 9) und der Schweiz (n = 32) wurden zu einer Onlinebefragung (unipark.com, Tivian XI GmbH, Köln, Deutschland) eingeladen. Die Umfrage war über 10 Wochen (22.04. bis 30.06.2020) erreichbar, erfolgte anonym und schloss Angaben zu Strukturdaten, zur klinischen Versorgung und zur Alarmierungs- bzw. Versorgungsstrategie ein.

Ergebnisse
Die Umfrage wurde 69-mal beendet und 65 Datensätze in die Auswertung einbezogen (4-mal kein ÄLRD). Die Merheit von 73,8 % (n = 48) waren ÄLRD in Deutschland, 15,4 % (n = 10) in der Schweiz und 10,8 % (n = 7) in Österreich. Es ergaben sich wesentliche Unterschiede in der infrastrukturellen Ausstattung der RD-Bereiche: 93,3 % (n = 61) der Befragten gaben an, eine SOP zur allgemeinen Schlaganfallversorgung zu nutzen, 37 % (n = 24) unterschieden zwischen Schlaganfällen mit leichter und schwerer Symptomatik und 15,4 % (n = 10) nutzten einen spezifischen Score zur Vorhersage von proximalen Gefäßverschlüssen mit hoher Thrombektomiewahrscheinlichkeit.

Diskussion
Die präklinische Schlaganfallversorgung ist sehr heterogen organisiert. In Hinblick auf Leitlinienadhärenz und die Einschätzung der Thrombektomiewahrscheinlichkeit besteht, unter anderem durch einheitliche Nutzung präklinischer Vorhersagescores, ein erhebliches Optimierungspotenzial.

Graphic abstract
Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers
Authors: Campos-Madueno Edgar I. , Moradi Melika , Eddoubaji Yasmine , Shahi Fatemeh , Moradi Sina , Bernasconi Odette J. , Moser Aline I. , Endimiani Andrea 
Published: January 2023

Abstract
The clinical impact of infections due to extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing Enterobacterales (Ent) has reached dramatic levels worldwide. Infections due to these multidrug-resistant (MDR) pathogens—especially Escherichia coli and Klebsiella pneumoniae—may originate from a prior asymptomatic intestinal colonization that could also favor transmission to other subjects. It is therefore desirable that gut carriers are rapidly identified to try preventing both the occurrence of serious endogenous infections and potential transmission. Together with the infection prevention and control countermeasures, any strategy capable of effectively eradicating the MDR-Ent from the intestinal tract would be desirable. In this narrative review, we present a summary of the different aspects linked to the intestinal colonization due to MDR-Ent. In particular, culture- and molecular-based screening techniques to identify carriers, data on prevalence and risk factors in different populations, clinical impact, length of colonization, and contribution to transmission in various settings will be overviewed. We will also discuss the standard strategies (selective digestive decontamination, fecal microbiota transplant) and those still in development (bacteriophages, probiotics, microcins, and CRISPR-Cas-based) that might be used to decolonize MDR-Ent carriers.
Differential instructional effectiveness: overcoming the challenge of learning to solve trigonometry problems that involved algebraic transformation skills
Authors: Ngu Bing Hiong , Phan Huy P. 
Published: January 2023

AbstractThe design principles of cognitive load theory and learning by analogy has independently contributed to our understanding why an instruction will or will not work. In an experimental study involving 97 Year 9 Australian students conducted in regular classrooms, we evaluated the effect of the unguided problem-solving approach, worked examples approach and analogy approach on learning to solve two types of trigonometry problem. These trigonometry problems (sin40° = $$\frac{x}{6}$$

x
6

vs. cos50° = $$\frac{14}{x}$$

14
x

) exhibited two levels of complexity owing to the location of the pronumeral (numerator vs. denominator). The solution procedure of worked examples provided guidance, whereas the unguided problem-solving was without any guidance. Analogical learning placed emphasis on comparing a pair of isomorphic examples to facilitate transfer. Across the three approaches, solving practice problems contributed towards performance on the post-test. However, the worked examples approach and analogy approach were more efficient than the unguided problem-solving approach for acquiring skills to solve practice problems regardless of their complexity. Therefore, the worked examples approach and analogy approach that emphasizes algebraic transformation skills have the potential to reform instructional efficiency for learning to solve trigonometry problems.
Properties and Stability of Mining-Induced Meromixis in Two Small Boreal Lakes in Eastern Finland
Authors: Kehusmaa Karoliina , Kauppila Tommi , Österholm Peter , Juntunen Janne , Saarni Saija 
Published: January 2023

AbstractMine waters are a significant point source stressor for aquatic environments, not only due to their acidity and high metal concentrations, but also because of their high electrolyte concentrations. Ion-rich mine waters can disturb the seasonal mixing of lake waters, even leading to permanent stratification, i.e. meromixis. In this study, we investigated two small natural lakes receiving waters from closed Ni-Cu mines. To characterize the present chemical and physical conditions of these two boreal lakes, we collected water samples and in-situ water column measurements seasonally in 2017 and 2018. We modelled the stability of meromixis in the lakes under varying physico-chemical and meteorological conditions with the MATLAB-based open-source model code, MyLake. Chemical analyses and water column measurements show that both lakes are currently meromictic with a chemocline separating the circulating, well-oxygenated upper water from the non-circulating, hypoxic bottom water. The main anion was SO4 in both lakes, while the main cations were Ca, Mg, Na, and K. Elevated concentrations of conservative elements flowing from the mine areas are crucial in maintaining the meromixis. Modelling scenarios suggest that the meromixis would be sustained for several decades even if the external load ceased completely. Lake morphology and sheltered surroundings also seem to contribute to maintaining the meromixis in these lakes. Consequently, our results indicate that small headwaters are sensitive to persistent meromixis even when external loading is mild.
Clinician educators’ conceptions of assessment in medical education
Authors: Sims D. A. , Cilliers F. J. 
Published: January 2023

AbstractIn pursuing assessment excellence, clinician-educators who design and implement assessment are pivotal. The influence of their assessment practice in university-run licensure exams on student learning has direct implications for future patient care. While teaching practice has been shown to parallel conceptions of teaching, we know too little about conceptions of assessment in medical education to know if this is the case for assessment practice and conceptions of assessment. To explore clinician-educators’ conceptions of assessment, a phenomenographic study was undertaken. Phenomenography explores conceptions, the qualitatively different ways of understanding a phenomenon. Data analysis identifies a range of hierarchically inclusive categories of understanding, from simple to more complex, and the dimensions that distinguish each category or conception. Thirty-one clerkship convenors in three diverse Southern settings were interviewed in three cycles of iterative data collection and analysis. Four conceptions of assessment were identified: passive operator, awakening enquirer, active owner and scholarly assessor. Six dimensions were elucidated to describe and distinguish each conception: purpose of assessment; temporal perspective; role and responsibility; accountability; reflexivity and emotional valence. Additionally, three characteristics that appeared to track the progressive nature of the conceptions were identified: professional identity, assessment literacy and self-efficacy. These conceptions encompass and extend previously described conceptions across different educational levels, disciplines and contexts, suggesting applicability to other settings. There is some evidence of a relationship between conceptions and practice, suggesting, together with the hierarchical nature of these conceptions, that targeting conceptions during faculty development may be an effective approach to enhance assessment practice.