bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regionale und geschlechtsspezifische Unterschiede bei Appendektomien
Authors: Leeser Lea , Neukirch Benno , Drösler Saskia E. 
Published: April 2022

Zusammenfassung
Hintergrund
Frühere Analysen kleinräumiger Appendektomieraten zeigen erheblich höhere regionale Unterschiede der Operationshäufigkeiten bei Frauen als bei Männern.

Ziel
Die Arbeit identifiziert valide Messgrößen zur Darstellung regionaler Unterschiede und analysiert geschlechtsspezifische Veränderungen der Appendektomieraten auf Landkreisebene in der Zeitreihe.

Material und Methoden
Datengrundlage sind die der DRG-Statistik entnommenen Appendektomiehäufigkeiten für 2014, 2016 sowie 2018 nach Geschlecht auf Landkreisebene. Die regionalen Unterschiede werden mittels der „systematic component of variation“ (SCV) berechnet und beurteilt. Die SCV ist im Vergleich zu Extrem-Ratio und Variationskoeffizient robuster gegenüber stark schwankender Nennerpopulationen. SCV-Werte über 5 geben einen Hinweis auf hohe Variationen und größer 10 auf sehr hohe Variationen.

Ergebnisse
Bei der männlichen Population lassen sich nur geringe regionale Unterschiede der Operationsraten feststellen, die im Zeitverlauf stabil bleiben (SCV2014 = 2,1, SCV2016 = 1,8 und SCV2018 = 2,0). Bei Frauen hingegen liegt die SCV in den Jahren 2014 sowie 2016 (SCV2014 = 6,1, SCV2016 = 5,3) über 5 und sinkt 2018 auf 4,5 ab. Darstellungen als Funnel-Plot berücksichtigen höhere Streuungen der Operationsraten in Landkreisen mit niedrigen Einwohnerzahlen.

Diskussion
Bei Frauen ist ein rückläufiger Trend in den Appendektomiehäufigkeiten zu erkennen. Unklar ist, ob dieser Trend auf einer Veränderung der Indikationsstellung oder auf einem geänderten allgemeinen Behandlungsmanagement bei einem Appendizitisverdacht beruht. Durch robuste Variationsmaße und der graphischen Aufbereitung als Funnel-Plots ist es möglich, systematisch bedingte regionale Versorgungsunterschiede von Zufallseffekten zu unterscheiden.
Patientenorientierung
Authors: Mihaljevic André L. , Michalski Christoph , Kaisers Udo , Strunk Guido 
Published: April 2022

Zusammenfassung
Hintergrund
Patientenorientierung entwickelt sich politisch und gesellschaftlich zum entscheidenden Leitbild unseres Gesundheitssystems, doch in der praktischen Umsetzung zeigen sich Probleme durch konfligierende Ziele und Interessen.

Ziel der Arbeit
Darstellung des Begriffs Patientenorientierung sowie möglicher Messmethoden mit besonderem Fokus auf den deutschen Sprachraum.

Material und Methoden
Narrative Übersichtsarbeit durch Literatursuche in Medline, der Cochrane Library, PsyINfo und CINHAL. Aus den Ergebnissen wird das Konzept von „Patient-Reported Experience Measures“ (PREMs) und ein PREM-System entwickelt.

Ergebnisse
Die Patientenorientierung ist kein abgeschlossenes theoretisches Konstrukt. Aktuell werden 16 Dimensionen der Patientenorientierung unterschieden. Die am weitesten verbreitete Messmethode zur Erfassung der Patientenorientierung sind PREMs. Anders als in anderen Ländern gibt es im Deutschen nur eine begrenzte Anzahl von PREMs, deren methodologische Messungsqualität häufig unklar ist. Wesentliche chirurgische Aspekte der Patientenversorgung werden durch vorliegende deutschsprachige PREMs nicht erfasst. Es wird ein PREM-System in deutscher Sprache entwickelt und der Forschungsbedarf aufgezeigt.

Diskussion
Anders als in anderen Ländern gibt es in deutscher Sprache kein zusammenhängendes PREM-System. Die systematische Erfassung der Patientenorientierung ist daher insbesondere in der Chirurgie aktuell nicht adäquat möglich. Wesentliche methodologische, organisatorische, regulatorische und finanzielle Aspekte müssen bewältigt werden, bevor die Patientenorientierung als fundiertes Konstrukt im klinischen Alltag implementiert werden kann.
Efficacy and safety of 177Lu‑DOTATATE in patients with advanced pancreatic neuroendocrine tumours: data from the NETTER-R international, retrospective study
Authors: Clement Dominique , Navalkissoor Shaunak , Srirajaskanthan Rajaventhan , Courbon Frédéric , Dierickx Lawrence , Eccles Amy , Lewington Valerie , Mitjavila Mercedes , Percovich Juan Carlos , Lequoy Benoît , He Beilei , Folitar Ilya , Ramage John 
Published: April 2022

Abstract

Purpose
NETTER-R aimed to determine the efficacy, safety and tolerability of 177Lu-DOTATATE in patients with progressive, advanced pancreatic neuroendocrine tumours (panNETs) using retrospective real-world data from multiple sites.

Methods
This international study retrospectively included patients with panNETs treated with 177Lu-DOTATATE. The primary endpoint was progression-free survival (PFS) by Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1). Secondary endpoints included overall survival (OS), safety and tumour response.

Results
In total, 110 patients with panNETs were studied; 65.5% received a cumulative dose of 177Lu-DOTATATE 29.6 GBq ± 10% (median: 7.4 GBq). In 62 patients with available RECIST v1.1 tumour response, the median PFS was 24.8 months (95% confidence interval [CI]: 17.5–34.5), and the objective response rate was 40.3% (95% CI: 28.1–53.6); all responses were partial. With a median follow up of 24.5 months (range: 2.0–123.4 months) after the first cycle of 177Lu-DOTATATE, the median OS in the full analysis set (n = 110) was 41.4 months (95% CI: 28.6–50.2). PFS (hazard ratio [HR]: 3.672; p = 0.0009) and OS (HR: 3.360; p < 0.0001) were longer in patients who received no chemotherapy prior to 177Lu-DOTATATE than those who did. No treatment-emergent adverse events (TEAEs) led to treatment discontinuation. Grade 3 anaemia, lymphopenia and thrombocytopenia occurred in 0.9%, 5.4% and 0.9% of patients, respectively. No acute leukaemia or myelodysplastic syndrome was reported. Six patients (5.5%) had renal TEAEs. All renal grade ≥ 3 events were transient and did not lead to treatment modification.

Conclusions
These results reinforce the role of 177Lu-DOTATATE for the treatment of patients with advanced, somatostatin receptor-positive panNETs.
Correction of the pelvic incidence using a bilateral extending pelvic osteotomy: a proof of concept study
Authors: Ochtman A. E. A. , Bleys R. L. A. W. , Cunningham J. E. , Öner F. C. , van Gaalen S. M. 
Published: April 2022

Abstract
Introduction
The aim of this proof of concept human cadaver study was to quantify the effect of a bilateral extending pelvic osteotomy (BEPO) on pelvic incidence (PI) as a potential alternative for a pedicle subtraction osteotomy (PSO) in patients with severe spinal sagittal malalignment.

Materials and methods
10 fresh frozen human cadavers were treated with the BEPO technique. CT images were made before and after the osteotomy and pure sagittal images were created on which PI was measured.

Results
The mean pre-osteotomy PI was 47.9° (range 36.4–63.9) and the mean post-osteotomy PI was 36.5° (range 22.1–54.4). The mean correction was − 10.4° with a range of − 8.4° to − 17.3° (p = 0.03), which resulted in a mean decrease of 23% in the PI (range 16–42).

Conclusions
There was a feasible and effective correction of PI using the BEPO technique on the os ilium. This was a preliminary cadaveric study. No conclusions could be made on global sagittal alignment. We postulate that an extending osteotomy of the ilium could be a potential alternative for a PSO reducing the complexity of spine surgery in patients with severe spinal sagittal malalignment.
On the dynamic stability of delaminated composite beams under free vibration
Authors: Szekrényes András , Máté Péter , Hauck Bence 
Published: April 2022

AbstractThis work deals with the analysis of the free vibration problem of elastic delaminated composite beams. The work mainly consists of a model development and improvement stage based on the first-order shear deformable beam theory. A general model is developed taking the bending-extensional coupling into account. The specified problem is a built-in beam with free end, and one of the novelties of this work is the consideration of the fact that a built-in beam cannot be fixed rigidly in reality. Thus, a Winkler-type elastic foundation is applied along the built-in length. The total potential energy and the governing equations of the delaminated and intact parts of the beam are also captured. The problem is solved in two ways: analytically and numerically by using the finite element method, respectively. Applying the developed models the natural frequencies, mode shapes as well as the stress resultants are determined. The comparison of natural frequencies to those measured experimentally shows that the built-in length resting on Winkler-type elastic foundation influences significantly the agreement between model and experiment. In the final stage, the parametric excitation phenomenon taking place in the delaminated part is analyzed using a local model and the harmonic balance method. The dynamic buckling is characterized by some stability diagrams, and it is shown that the applied model is very sensitive to the frequency leading to somewhat controversial critical amplitudes compared to measurements.
Disruption in the space–time continuum: why digital ethnography matters
Authors: Cleland Jennifer , MacLeod Anna 
Published: April 2022

AbstractThere is increasing interest in the use of ethnography as a qualitative research approach to explore, in depth, issues of culture in health professions education (HPE). Our specific focus in this article is incorporating the digital into ethnography. Digital technologies are pervasively and increasingly shaping the way we interact, behave, think, and communicate as health professions educators and learners. Understanding the contemporary culture(s) of HPE thus means paying attention to what goes on in digital spaces. In this paper, we critically consider some of the potential issues when the field of ethnography exists outside the space time continuum, including the need to engage with theory in research about technology and digital spaces in HPE. After a very brief review of the few HPE studies that have used digital ethnography, we scrutinize what can be gained when ethnography encompasses the digital world, particularly in relation to untangling sociomaterial aspects of HPE. We chart the shifts inherent in conducting ethnographic research within the digital landscape, specifically those related to research field, the role of the researcher and ethical issues. We then use two examples to illustrate possible HPE research questions and potential strategies for using digital ethnography to answer those questions: using digital tools in the conduct of an ethnographic study and how to conduct an ethnography of a digital space. We conclude that acknowledging the pervasiveness of technologies in the design, delivery and experiences of HPE opens up new research questions which can be addressed by embracing the digital in ethnography.
Agroecology in the North: Centering Indigenous food sovereignty and land stewardship in agriculture “frontiers”
Authors: Price Mindy Jewell , Latta Alex , Spring Andrew , Temmer Jennifer , Johnston Carla , Chicot Lloyd , Jumbo Jessica , Leishman Margaret 
Published: April 2022

AbstractWarming temperatures in the circumpolar north have led to new discussions around climate-driven frontiers for agriculture. In this paper, we situate northern food systems in Canada within the corporate food regime and settler colonialism, and contend that an expansion of the conventional, industrial agriculture paradigm into the Canadian North would have significant socio-cultural and ecological consequences. We propose agroecology as an alternative framework uniquely accordant with northern contexts. In particular, we suggest that there are elements of agroecology that are already being practiced in northern Indigenous communities as part of traditional hunter-gatherer food systems. We present a framework for agroecology in the North and discuss its components of environmental stewardship, economies, knowledge, social dimensions and governance using examples from the Dehcho region, Northwest Territories, Canada. Finally, we discuss several challenges and cautions in creating policy around agroecology in the North and encourage community-based research in developing and testing this framework moving forward.
Philanthropy and the Making of a New Moral Order: A History of Developing Community
Authors: Kumar Arun 
Published: April 2022

AbstractCommunity development, or the socio-economic transformation of local communities, has been a significant focus of organizational ethics. Such community development programmes—whether led by state, civil society, or businesses—are animated by modernization and have involved, I argue, the production of a new moral order. As part of which, communities were imagined in particular ways, historically. Drawing on a periodization of history of philanthropy of the Tata Group (India’s leading multinational conglomerate) from the 1860s onwards, I outline the four stages involved in the production of this new moral order—each with a distinct formulation of community—as part of India’s development. The shifts in imaginaries of community, I conclude, were justified and legitimized by the elites as part of the wider nation-building efforts.
Subscribing to big data at scale
Authors: Wang Xikui , Carey Michael J. , Tsotras Vassilis J. 
Published: April 2022

AbstractToday, data is being actively generated by a variety of devices, services, and applications. Such data is important not only for the information that it contains, but also for its relationships to other data and to interested users. Most existing Big Data systems focus on passively answering queries from users, rather than actively collecting data, processing it, and serving it to users. To satisfy both passive and active requests at scale, application developers need either to heavily customize an existing passive Big Data system or to glue one together with systems like Streaming Engines and Pub-sub services. Either choice requires significant effort and incurs additional overhead. In this paper, we present the BAD (Big Active Data) system as an end-to-end, out-of-the-box solution for this challenge. It is designed to preserve the merits of passive Big Data systems and introduces new features for actively serving Big Data to users at scale. We show the design and implementation of the BAD system, demonstrate how BAD facilitates providing both passive and active data services, investigate the BAD system’s performance at scale, and illustrate the complexities that would result from instead providing BAD-like services with a “glued” system.
Competing feedback in an idealized tide-influenced delta network
Authors: Ragno Niccolò , Tambroni Nicoletta , Bolla Pittaluga Michele 
Published: April 2022

AbstractThe morphodynamic evolution of river deltas is intimately tied to flow and sediment partitioning at bifurcations. In this work, the long-term equilibrium configuration of a simple delta network is investigated by means of an analytical model, which accounts for the effect of small tidal oscillations. Differently from individual bifurcations where tidal action is always a stabilizing factor, in the case of a tree-like delta with multiple bifurcations a dual response emerges. Specifically, depending on the values of four reference parameters functions of tidal amplitude, upstream flow conditions, and channels geometry, tides can either promote or discourage an unbalanced discharge distribution. This behavior primarily concerns the apex bifurcation, which is affected by the variations of the relative tidal amplitude at the internal nodes. In turn these variations depend on how flow and sediment are diverted upstream. The stability of steady-state solutions is found to be governed by the sign and magnitude of the slope asymmetry between channels. This work provides a basic modeling framework for the interpretation of the autogenic response of multiple coupled micro-tidal bifurcations, which can potentially be extended to include in a unified scheme erosional and depositional processes typical of fluvio-deltaic systems.
Physical activity and cardiometabolic risk factors in individuals with spinal cord injury: a systematic review and meta-analysis
Authors: Itodo Oche Adam , Flueck Joelle Leonie , Raguindin Peter Francis , Stojic Stevan , Brach Mirjam , Perret Claudio , Minder Beatrice , Franco Oscar H. , Muka Taulant , Stucki Gerold , Stoyanov Jivko , Glisic Marija 
Published: April 2022

AbstractPhysical inactivity in individuals with spinal cord injury (SCI) has been suggested to be an important determinant of increased cardiometabolic disease (CMD) risk. However, it remains unclear whether physically active SCI individuals as compared to inactive or less active individuals have truly better cardiometabolic risk profile. We aimed to systematically review and quantify the association between engagement in regular physical activity and/or exercise interventions and CMD risk factors in individuals with SCI. Four medical databases were searched and studies were included if they were clinical trials or observational studies conducted in adult individuals with SCI and provided information of interest. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to rate the certainty of evidence. Of 5816 unique citations, 11 randomized clinical trials, 3 non-randomized trial and 32 cross-sectional studies comprising more than 5500 SCI individuals were included in the systematic review. In meta-analysis of RCTs and based on evidence of moderate certainty, physical activity in comparison to control intervention was associated with: (i) better glucose homeostasis profile [WMD of glucose, insulin and Assessment of Insulin Resistance (HOMA-IR) were − 3.26 mg/dl (95% CI − 5.12 to − 1.39), − 3.19 μU/ml (95% CI − 3.96 to − 2.43)] and − 0.47 (95% CI − 0.60 to − 0.35), respectively], and (ii) improved cardiorespiratory fitness [WMD of relative and absolute oxygen uptake relative (VO2) were 4.53 ml/kg/min (95% CI 3.11, 5.96) and 0.26 L/min (95% CI 0.21, 0.32) respectively]. No differences were observed in blood pressure, heart rate and lipids (based on evidence of low/moderate certainty). In meta-analysis of cross-sectional studies and based on the evidence of very low to low certainty, glucose [WMD − 3.25 mg/dl (95% CI − 5.36, − 1.14)], insulin [− 2.12 μU/ml (95% CI − 4.21 to − 0.03)] and total cholesterol [WMD − 6.72 mg/dl (95% CI − 13.09, − 0.34)] were lower and HDL [WMD 3.86 mg/dl (95% CI 0.66, 7.05)] and catalase [0.07 UgHb-1 (95% CI 0.03, 0.11)] were higher in physically active SCI individuals in comparison to reference groups. Based on limited number of cross-sectional studies, better parameters of systolic and diastolic cardiac function and lower carotid intima media thickness were found in physically active groups. Methodologically sound clinical trials and prospective observational studies are required to further elaborate the impact of different physical activity prescriptions alone or in combination with other life-style interventions on CMD risk factors in SCI individuals.
Algorithmic decision-making employing profiling: will trade secrecy protection render the right to explanation toothless?
Authors: de Laat Paul B. 
Published: April 2022

AbstractAlgorithmic decision-making based on profiling may significantly affect people’s destinies. As a rule, however, explanations for such decisions are lacking. What are the chances for a “right to explanation” to be realized soon? After an exploration of the regulatory efforts that are currently pushing for such a right it is concluded that, at the moment, the GDPR stands out as the main force to be reckoned with. In cases of profiling, data subjects are granted the right to receive meaningful information about the functionality of the system in use; for fully automated profiling decisions even an explanation has to be given. However, the trade secrets and intellectual property rights (IPRs) involved must be respected as well. These conflicting rights must be balanced against each other; what will be the outcome? Looking back to 1995, when a similar kind of balancing had been decreed in Europe concerning the right of access (DPD), Wachter et al. (2017) find that according to judicial opinion only generalities of the algorithm had to be disclosed, not specific details. This hardly augurs well for a future right of access let alone to explanation. Thereupon the landscape of IPRs for machine learning (ML) is analysed. Spurred by new USPTO guidelines that clarify when inventions are eligible to be patented, the number of patent applications in the US related to ML in general, and to “predictive analytics” in particular, has soared since 2010—and Europe has followed. I conjecture that in such a climate of intensified protection of intellectual property, companies may legitimately claim that the more their application combines several ML assets that, in addition, are useful in multiple sectors, the more value is at stake when confronted with a call for explanation by data subjects. Consequently, the right to explanation may be severely crippled.
Relative explainability and double standards in medical decision-making
Authors: Kempt Hendrik , Heilinger Jan-Christoph , Nagel Saskia K. 
Published: April 2022

AbstractThe increased presence of medical AI in clinical use raises the ethical question which standard of explainability is required for an acceptable and responsible implementation of AI-based applications in medical contexts. In this paper, we elaborate on the emerging debate surrounding the standards of explainability for medical AI. For this, we first distinguish several goods explainability is usually considered to contribute to the use of AI in general, and medical AI in specific. Second, we propose to understand the value of explainability relative to other available norms of explainable decision-making. Third, in pointing out that we usually accept heuristics and uses of bounded rationality for medical decision-making by physicians, we argue that the explainability of medical decisions should not be measured against an idealized diagnostic process, but according to practical considerations. We conclude, fourth, to resolve the issue of explainability-standards by relocating the issue to the AI’s certifiability and interpretability.
A computational method for rapid orthographic photography of lake sediment cores
Authors: Ankor Martin James , Tyler Jonathan James 
Published: April 2022

AbstractPhotographs of sediment cores are an important dataset, often containing visual evidence for environmental change via sediment composition and structure. These photographs may be used to stratigraphically correlate adjacent cores or for automated image analysis, and can facilitate collaboration amongst researchers through sharing and annotation of the image files. Here we describe the use of computational photogrammetry (also known as Structure from Motion–Multi-View Stereo) to generate orthographic imagery of sediment cores. Computational photogrammetry is a rapid and economical technique, typically requiring only a few minutes for each metre of core, using consumer-grade digital camera equipment. The photogrammetric methodology corrects for topographic distortion caused by sediment surfaces that are not perfectly flat, and can also record features of the scene surrounding the core, such as notes, colour reference cards and measurement tapes or rulers. As the photogrammetric process also generates a three-dimensional reconstruction of the sediment core, spatial-based analysis can be used to identify damaged or non-representative sections of the core that are to be avoided during image analysis. Using an intermittently laminated sediment core from Lake Surprise, Australia, we tested 22 scenarios using control points in a variety of configurations, as well as calibrated and uncalibrated cameras, to identify techniques that can reconstruct the core accurately and generate orthophotos. Multiple techniques were able to achieve suitable accuracy. In particular, targets placed on the table alongside the core, combined with a calibrated camera, achieved high accuracy and enabled a simple, rapid, and repeatable method for generating high-quality sediment core images.