bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of training pathway to reach expert performance levels based on proficiency-based progression in robotic-assisted minimally invasive esophagectomy (RAMIE)
Authors: Müller Dolores T. , Brunner Stefanie , Straatman Jennifer , Babic Benjamin , Eckhoff Jennifer A. , Reisewitz Alissa , Storms Christian , Schiffmann Lars M. , Schmidt Thomas , Schröder Wolfgang , Bruns Christiane J. , Fuchs Hans F. 
Published: August 2023

Abstract
Background
Robotic-assisted minimally invasive esophagectomy (RAMIE) was first introduced in 2003 and has since then shown to significantly improve the postoperative course. Previous studies have shown that a structured training pathway based on proficiency-based progression using individual skill levels as measures of reach of competence can enhance surgical performance. The aim of this study was to evaluate and help understand our pathway to reach surgical expert levels using a proficiency-based approach introducing RAMIE at our German high-volume center.

Methods
All patients undergoing RAMIE performed by two experienced surgeons for esophageal cancer since the introduction of the robotic technique in 2017 was included in this analysis. Intraoperative outcomes and postoperative outcomes were included in the analysis. The cumulative sum method was used to analyze how many cases are needed to reach expert levels for different performance characteristics and skill sets during robotic-assisted minimally invasive esophagectomy.

Results
From 06/2017 to 03/2022, a total of 154 patients underwent RAMIE at our facility and were included in the analysis. An advancement in performance level was observed for total operating time after 70 cases and for thoracic operative time after 79 cases. Lymph node yield showed an increase up until case 60 in the CUSUM analysis. Length of hospital stay stabilized after case 55. The CCI score inflection point was at case 55 in both CUSUM and regression analyses. Anastomotic leak rate stabilized at case 38 and showed another inflection point after case 83.

Conclusion
Our data and analysis showed the progression from proficient to expert performance levels during the implementation of RAMIE at a European high-volume center. Further analysis of surgeons, especially with a different training status has yet to reveal if the caseloads found in this study are universally applicable. However, skill acquisition and respective measures of such are diverse and as a great range of number of cases was observed, we believe that the learning curve and ascent in performance levels cannot be defined by one parameter alone.
Limb position affects intraoperative assessment of condylar width
Authors: Tucker Douglass W. , Chen Michael J. , Reddy Akhil , Carney John J. , Gardner Michael J. , Marecek Geoffrey S. 
Published: August 2023

Abstract
Purpose
We sought to define how changes in position and rotation of fluoroscopic imaging may affect the assessment of condylar widening intraoperatively.

Methods
Thirty-three patients with tibial plateau fractures were prospectively identified and included in this study. Fluoroscopic images of the uninjured tibial plateau were obtained in (1) full extension and (2) slight flexion on foam ramp. Beginning with a plateau view, additional views of the tibial plateau were then obtained by rotating the fluoroscope around the knee in 5 degree increments up to 15 degrees in both internal and external rotation. Measurements of distal femoral condylar width (DFW), distal femoral articular width (FAW), proximal tibial articular width (TAW) and lateral plateau width (LPW) were performed.

Results
LPW was decreased in flexion compared to extension at all degrees of rotation (p = 0.04–0.00001). There was a trend toward increasing LPW with increasing degrees of internal rotation which reached significance at 15˚ of internal rotation when the knee was flexed. On ANOVA, there was a significant difference of LPW with increasing degree of internal rotation when the knee was in flexion (p = 0.008), but not in extension. There were no differences in DFW, FAW, TAW and DFW/TAW at any point though LPW was decreased in flexion at all degrees of rotation. The FAW/TAW ratio was increased in flexion at all degrees of rotation.

Discussion
The knee in flexion will underestimate the measurement of condylar width compared to the knee in full extension, by ~ 2 mm. Rotation of the knee, in comparison, did not have a significant effect on condylar width assessment.

Level of evidence
Diagnostic II.
Diagnostic Value of MRI Features in Dual-phenotype Hepatocellular Carcinoma: A Preliminary Study
Authors: Gu Hong-Xian , Huang Xiao-Shan , Xu Jian-Xia , Zhu Ping , Xu Jian-Feng , Fan Shu-Feng 
Published: August 2023

AbstractThis study aimed to explore the magnetic resonance imaging (MRI) features of dual-phenotype hepatocellular carcinoma (DPHCC) and their diagnostic value.The data of 208 patients with primary liver cancer were retrospectively analysed between January 2016 and June 2021. Based on the pathological diagnostic criteria, 27 patients were classified into the DPHCC group, 113 patients into the noncholangiocyte-phenotype hepatocellular carcinoma (NCPHCC) group, and 68 patients with intrahepatic cholangiocarcinoma (ICC) were classified into the ICC group. Two abdominal radiologists reviewed the preoperative MRI features by a double-blind method. The MRI features and key laboratory and clinical indicators were compared between the groups. The potentially valuable MRI features and key laboratory and clinical characteristics for predicting DPHCC were identified by univariate and multivariate analyses, and the odds ratios (ORs) were recorded. In multivariate analysis, tumour without capsule (P = 0.046, OR = 9.777), dynamic persistent enhancement (P = 0.006, OR = 46.941), and targetoid appearance on diffusion-weighted imaging (DWI) (P = 0.021, OR = 30.566) were independently significant factors in the detection of DPHCC compared to NCPHCC. Serum alpha-fetoprotein (AFP) > 20 µg/L (P = 0.036, OR = 67.097) and prevalence of hepatitis B virus (HBV) infection (P = 0.020, OR = 153.633) were independent significant factors in predicting DPHCC compared to ICC. The differences in other tumour marker levels and imaging features between the groups were not significant. In MR enhanced and diffusion imaging, tumour without capsule, persistent enhancement and DWI targetoid findings, combined with AFP > 20 µg/L and HBV infection-positive laboratory results, can help to diagnose DPHCC and differentiate it from NCPHCC and ICC. These results suggest that clinical, laboratory and MRI features should be integrated to construct an AI diagnostic model for DPHCC.
US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events
Authors: Wong Nathan D. , Karthikeyan Hridhay , Fan Wenjun 
Published: August 2023

Abstract

Background
Semaglutide 2.4 mg benefits weight loss and reduction of cardiovascular disease (CVD) risk factors in adults with obesity. We estimated the US population eligibility for semaglutide 2.4 mg (based on the weight management indication) and the impact on obesity and CVD events.

Methods
We applied STEP 1 trial eligibility criteria to US adults aged ≥ 18 years in the US National Health and Nutrition Examination Survey (NHANES) 2015-2018 to estimate the US eligible population. Semaglutide weight changes in STEP 1 were applied to estimate the population impact on weight changes and obesity prevalence. We also estimated 10-year CVD risks utilizing the BMI-based Framingham CVD risk scores. The difference in estimated risks with and without semaglutide “treatment” multiplied by the eligible NHANES weighted population represented the estimated “preventable” CVD events.

Results
We identified 3999 US adults weighted to an estimated population size of 93.0 million [M] (38% of US adults) who fit STEP 1 eligibility criteria. Applying STEP 1 treatment effects on weight loss resulted in an estimated 69.1% (64.3 M) and 50.5% (47.0 M) showing ≥ 10% and ≥ 15% weight reductions, respectively, translating to a 46.1% (43.0 M) reduction in obesity (BMI ≥ 30 kg/m2) prevalence. Among those without CVD, estimated 10-year CVD risks were 10.15% “before” and 8.34% “after” semaglutide “treatment” reflecting a 1.81% absolute (and 17.8% relative) risk reduction translating to 1.50 million preventable CVD events over 10 years.

Conclusion
Semaglutide treatment in eligible US adults may substantially reduce obesity prevalence and CVD events, which may dramatically impact associated healthcare costs.
ProCrackPlast: a finite element tool to simulate 3D fatigue crack growth under large plastic deformations
Authors: Ganesh Rahul , Dude Durga Prasanth , Kuna Meinhard , Kiefer Bjoern 
Published: August 2023

AbstractMany structural components and devices in combustion and automotive engineering undergo highly intensive cyclic thermal and mechanical loading during their operation, which leads to low cycle (LCF) or thermomechanical (TMF) fatigue crack growth. This behavior is often characterized by large scale plastic deformations and creep around the crack, so that concepts of linear-elastic fracture mechanics fail. The finite element softwareProCrackPlast has been developed at TU Bergakademie Freiberg for the automated simulation of fatigue crack growth in arbitrarily loaded three-dimensional components with large scale plastic deformations, in particular under cyclic thermomechanical loading.ProCrackPlast consists of a bundle of Python routines, which manage finite element pre-processing, crack analysis, and post-processing in combination with the commercial softwareAbaqus .ProCrackPlast is based on a crack growth procedure which adaptively updates the crack size in finite increments. Crack growth is controlled by the cyclic crack tip opening displacement$$\varDelta $$ΔCTOD, which is considered as the appropriate fracture-mechanical parameter in case of large scale yielding. The three-dimensional$$\varDelta $$ΔCTOD concept and its effective numerical calculation by means of special crack-tip elements are introduced at first. Next, the program structure, the underlying numerical algorithms and calculation schemes ofProCrackPlast are outlined in detail, which capture the plastic deformation history along with the moving crack. In all simulations, a viscoplastic cyclic material law is used within a large strain setting. The numerical performance of this software is studied for a single edge notch tension (SENT) specimen under isothermal cyclic loading and compared to common finite element techniques for fatigue crack simulation. The capability of this software is featured in two application examples showing crack growth under mixed-mode LCF and TMF in a typical austenite cast steel, Ni-Resist. In combination with a crack growth law identified in terms of$$\varDelta $$ΔCTOD for a specific material, the toolProCrackPlast is able to predict the crack evolution in a 3D component for a given thermomechanical loading scenario.
Does Dyadic Gratitude Make Sense? The Lived Experience and Conceptual Delineation of Gratitude in Absence of a Benefactor
Authors: Hebbink Nick , Schinkel Anders , de Ruyter Doret 
Published: August 2023

AbstractIn this paper we defend the idea that dyadic gratitude — i.e. gratitude in absence of a benefactor — is a coherent concept. Some authors claim that ‘gratitude’ is by definition a triadic concept involving a beneficiary who is grateful for a benefit to a benefactor. These authors state that people who use the term gratitude in absence of a benefactor do so inappropriately, e.g. by using it as an interchangeable term for ‘appreciation’ or ‘being glad’. We believe that the conceptual analyses which underlie such statements are too strongly focused on language and pay insufficient attention to the lived experience of gratitude. Thus, we have conducted a phenomenological analysis of several experiences in which people report feeling gratitude in absence of a benefactor. Informed by our phenomenological findings, we argue that dyadic gratitude is a coherent concept that shares certain core experiential elements with triadic gratitude. Gratitude is an appreciative response that construes its object as a gratuitous good and as a (metaphorical) gift; it is characterised by a receptive-appreciative attitude, an awareness that we are in some sense dependent on something other than ourselves, and a motivational impetus to promote, celebrate and/or radiate goodness. Finally, we argue that dyadic gratitude is a useful concept because it enables us to think and communicate effectively about a set of experiences. Moreover, it is also a scientifically and philosophically relevant concept, since it seems to be associated with various positive psychosocial effects and might even be developed as a virtuous disposition.
Quantifying the Structural Stability of Simplicial Homology
Authors: Guglielmi Nicola , Savostianov Anton , Tudisco Francesco 
Published: August 2023

AbstractSimplicial complexes are generalizations of classical graphs. Their homology groups are widely used to characterize the structure and the topology of data in e.g. chemistry, neuroscience, and transportation networks. In this work we assume we are given a simplicial complex and that we can act on its underlying graph, formed by the set of 1-simplices, and we investigate the stability of its homology with respect to perturbations of the edges in such graph. Precisely, exploiting the isomorphism between the homology groups and the higher-order Laplacian operators, we propose a numerical method to compute the smallest graph perturbation sufficient to change the dimension of the simplex’s Hodge homology. Our approach is based on a matrix nearness problem formulated as a matrix differential equation, which requires an appropriate weighting and normalizing procedure for the boundary operators acting on the Hodge algebra’s homology groups. We develop a bilevel optimization procedure suitable for the formulated matrix nearness problem and illustrate the method’s performance on a variety of synthetic quasi-triangulation datasets and real-world transportation networks.
Suchthilfe und -prävention für Menschen mit geistiger Behinderung: Ergebnisse einer bundesweiten Online-Befragung von Fachkräften des Suchthilfesystems
Authors: Schote Caroline , Rathmann Katharina 
Published: August 2023

Zusammenfassung
Hintergrund
Durch die fortschreitende Inklusion und die Möglichkeiten stärkerer Teilhabe von Menschen mit (geistiger) Behinderung kommt dieser Personenkreis zunehmend auch in Kontakt mit Suchtmitteln. Dabei ist das Risiko, eine Abhängigkeit bzw. Sucht zu entwickeln, ähnlich hoch wie bei Menschen ohne Behinderung, allerdings bestehen noch immer Ungleichheiten im Zugang zu geeigneten Angeboten der Suchthilfe und -prävention. Ziel des Beitrags ist daher 1) den Kenntnisstand sowie das Angebot zielgruppenspezifischer Programme und Maßnahmen der Suchthilfe und -prävention zu erfassen, 2) die Vernetzung zwischen Sucht- und Behindertenhilfe zu erfassen, 3) den Zusammenhang zwischen der Vernetzung und den zielgruppenspezifischen Angeboten der Suchthilfe und -prävention zu analysieren und 4) den Unterstützungsbedarf von Fachkräften des Suchthilfesystems zu ermitteln, um die Teilhabechancen von Menschen mit geistiger Behinderung an den Suchthilfestrukturen zukünftig zu verbessern.

Material und Methoden
Datenbasis stellt eine Primärerhebung (online) bei Fachkräften des Suchthilfesystems in Deutschland dar. Der Feldzugang erfolgte per E‑Mail über insgesamt 1677 Einrichtungen. An der Befragung nahmen n = 533 Fachkräfte teil. Die Daten wurden mittels uni- und bivariater Analysen ausgewertet.

Ergebnisse
Insgesamt gaben 62 % der befragten Fachkräfte an, keine suchtspezifischen Angebote für Menschen mit geistiger Behinderung zu kennen, 87 % bieten keine Angebote für diese Zielgruppe an. Gut die Hälfte der Befragten (52 %) arbeitet mit Einrichtungen der Behindertenhilfe zusammen. Die bivariaten Auswertungen verdeutlichen, dass mit der Behindertenhilfe vernetzte Einrichtungen häufiger suchtspezifische Angebote für Menschen mit geistiger Behinderung bereitstellen als nicht vernetzte Einrichtungen. Großer bis sehr großer Unterstützungsbedarf für Fachkräfte des Suchthilfesystems besteht in Bezug auf Weiterbildungsangebote, Handlungsempfehlungen, Leitfäden und Arbeitshilfen, um eine zielgruppenadäquate Beratung, Behandlung und Prävention anbieten zu können.

Schlussfolgerung
Um den Zugang für Menschen mit geistiger Behinderung zu Angeboten der Suchthilfe und -prävention zu verbessern, sollten entsprechende Angebote (weiter-)entwickelt werden und in der Suchthilfe Anwendung finden. Wichtige Voraussetzungen hierfür sind die stärkere Vernetzung zwischen Sucht- und Behindertenhilfe, eine wirksame Öffentlichkeitsarbeit sowie Qualifizierungsangebote und Informationen.
Maintaining long-term physical activity after cancer: a conceptual framework to inform intervention development
Authors: Grimmett Chloe , Corbett Teresa , Bradbury Katherine , Morton Kate , May Carl R. , Pinto Bernardine M. , Foster Claire 
Published: August 2023

Abstract
Purpose
This paper describes a conceptual framework of maintenance of physical activity (PA) and its application to future intervention design.

Methods
Evidence from systematic literature reviews and in-depth (N = 27) qualitative interviews with individuals with cancer were used to develop a conceptual framework of long-term physical activity behaviour. Determinants of long-term PA were listed and linked with domains of the Theoretical Domains Framework which in turn were linked to associated behaviour change techniques (BCTs) and finally to proposed mechanisms of action (MoA).

Results
The conceptual framework is presented within the context of non-modifiable contextual factors (such as demographic and material resources) and in the presence of learnt and adapted behavioural determinants of skills, competence and autonomous motivation that must be established as part of the initiation of physical activity behaviour. An inventory of 8 determinants of engagement in long-term PA after cancer was developed. Clusters of BCTs are presented along with proposed MoA which can be tested using mediation analysis in future trials.

Conclusion
Understanding the processes of PA maintenance after cancer and presentation of implementable and testable intervention components and mechanisms of action to promote continued PA can inform future intervention development.

Implications for Cancer Survivors
This resource can act as a starting point for selection of intervention components for those developing future interventions. This will facilitate effective support of individuals affected by cancer to maintain PA for the long term.
Role of the Peripheral Nervous System in Skeletal Development and Regeneration: Controversies and Clinical Implications
Authors: Hassan Mohamed G. , Horenberg Allison L. , Coler-Reilly Ariella , Grayson Warren L. , Scheller Erica L. 
Published: August 2023

AbstractPurpose of ReviewThis review examines the diverse functional relationships that exist between the peripheral nervous system (PNS) and bone, including key advances over the past century that inform our efforts to translate these discoveries for skeletal repair.Recent FindingsThe innervation of the bone during development, homeostasis, and regeneration is highly patterned. Consistent with this, there have been nearly 100 studies over the past century that have used denervation approaches to isolate the effects of the different branches of the PNS on the bone. Overall, a common theme of balance emerges whereby an orchestration of both local and systemic neural functions must align to promote optimal skeletal repair while limiting negative consequences such as pain.SummaryAn improved understanding of the functional bidirectional pathways linking the PNS and bone has important implications for skeletal development and regeneration. Clinical advances over the next century will necessitate a rigorous identification of the mechanisms underlying these effects that is cautious not to oversimplify the in vivo condition in diverse states of health and disease.
Avoiding the Political Resource Curse: Evidence from a Most-Likely Case
Authors: Schmoll Moritz , Swenson Geoffrey 
Published: August 2023

AbstractWhy do some countries escape the political resource curse while others do not? Most scholars argue that avoiding the claimed anti-democratic effects of natural resources, especially oil, largely depends on the quality of pre-existing political institutions and/or the effectiveness of contemporary resource management institutions. Drawing on the most-likely case of Timor-Leste, one of the world’s most oil-dependent countries that nevertheless successfully consolidated democracy, we challenge these dominant theories and highlight new important factors to consider. We show that Timor-Leste did not avoid the curse because of good pre-existing political institutions, good natural resource governance institutions, or an otherwise favorable environment for democracy. Instead, we find that the ideological beliefs of major political actors, their strong popular legitimacy, the absence of a hegemonic actor among them, as well as the approaches of external actors, have produced a consolidated democracy despite strong incentives for the development of authoritarianism. These findings highlight the importance of ideology and agency, of the composition of independence movements, and of constructive international engagement, in particular at critical historical junctures. In short, even countries facing serious political and economic challenges can avoid the political resource curse, and both scholars and policymakers should consider a broader approach to the phenomenon.
Motivation is not enough: how career planning and effort regulation predict academic achievement
Authors: Floris Marcella , Paganin Giulia , Guglielmi Dina , Mazzetti Greta 
Published: August 2023

AbstractItaly is among the EU countries with the lowest rates of college graduates. Preventing dropout rates, promoting better educational achievement and improving adult population well-being can all be accomplished by discovering factors that promote higher academic success. Thus, the current study’s goal is to investigate personal factors that may have an impact on academic achievement (in terms of grade point average [GPA] and number of exams passed). We assume that identified academic motivation will indirectly affect academic achievement via students’ perceived competence in career planning and through their capacity to regulate effort in learning. The present study was conducted at the Department of Agri-Alimentar Science and Technology of a huge university in northern Italy. A sample of 348 students (40.5% male; Mage=21.13 years; SDage= 2.14) voluntarily filled an online questionnaire. Analysis on collected data were performed using structural equation modelling using the Mplus software. The obtained results provided support to the hypothesized association between identified motivation and GPA, via the serial mediation of confidence in career planning and significant learning effort regulation (β = 0.10, SE = 0.03, p = .006), and between identified motivation and exams passed through the serial mediation of confidence in career planning and learning effort regulation (β = 0.10, SE = 0.02, p = .009). Our study extended the body of research on the association between identified academic motivation and academic achievement, by investigating the presence of some elements that mediate this relationship. The findings have several practical implications: in particular, they may be used to design specific actions to promote the educational success of university students – for example, the provision of specific training regarding learning effort management, without neglecting the importance of students’ looking toward their own professional future.