bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for Low Anterior Resection Syndrome (LARS) in patients undergoing laparoscopic surgery for rectal cancer
Authors: Nicotera Antonella , Falletto Ezio , Arezzo Alberto , Mistrangelo Massimiliano , Passera Roberto , Morino Mario 
Published: February 2022

AbstractBackgroundTotal mesorectal excision (TME) represents the “gold standard” of rectal cancer surgery. In locally advanced lesions neoadjuvant treatments (e.g. radiotherapy-nRT, radio chemotherapy-cnRT) have been shown to improve TME oncological results, reducing local recurrences rate. Nevertheless, these treatments have significant functional consequences impacting patients’ quality of life (QoL). The resulting syndrome is known as Low Anterior Resection Syndrome (LARS). The purpose of this work was to evaluate the association between risk factors and the development of LARS in a prospective series of laparoscopic sphincter-saving TME.MethodsThe study was conducted as a retrospective observational epidemiological study of a prospective database, including all patients undergoing laparoscopic anterior resection surgery for rectal cancer at our Unit from 1st January 2013 to 31st May 2018. The diagnosis of LARS was performed using the LARS Score. We classified risk factors in patient-related, pre-, intra- and post-operative factors.ResultsThe sample included 153 consecutive patients. Forty-one were affected by “low” rectal cancer, 74 by “middle” rectal cancer, 38 by “high” rectal cancer. The prevalence of overall LARS (major LARS + minor LARS) in our series was 35.9% (55/153 cases). Association between nRT and overall/major LARS was significant (respectivelyp = 0.03 and 0.02). Distal localization of tumor was also significantly associated with LARS [overall LARS (p = 0.03), major LARS (p = 0.014)].ConclusionsIn our study, neoadjuvant radiotherapy and tumor localization resulted independent risk factors for LARS after laparoscopic sphincter-saving TME. Tumor localization in the “middle” and “high” rectum resulted a protective factor compared to the localization in “low” rectum.
The effect of inlet flow profile and nozzle diameter on drug delivery to the maxillary sinus
Authors: Pourmehran Oveis , Cazzolato Benjamin , Tian Zhao , Arjomandi Maziar 
Published: February 2022

AbstractIn this paper, the effect of the turbulence and swirling of the inlet flow and the diameter of the nozzle on the flow characteristics and the particles' transport/deposition patterns in a realistic combination of the nasal cavity (NC) and the maxillary sinus (MS) were examined. A computational fluid dynamics (CFD) model was developed in ANSYS® Fluent using a hybrid Reynolds averaged Navier–Stokes–large-eddy simulation algorithm. For the validation of the CFD model, the pressure distribution in the NC was compared with the experimental data available in the literature. An Eulerian–Lagrangian approach was employed for the prediction of the particle trajectories using a discrete phase model. Different inlet flow conditions were investigated, with turbulence intensities of 0.15 and 0.3, and swirl numbers of 0.6 and 0.9 applied to the inlet flow at a flow rate of 7 L/min. Monodispersed particles with a diameter of 5 µm were released into the nostril for various nozzle diameters. The results demonstrate that the nasal valve plays a key role in nasal resistance, which damps the turbulence and swirl intensities of the inlet flow. Moreover, it was found that the effect of turbulence at the inlet of the NC on drug delivery to the MS is negligible. It was also demonstrated that increasing the flow swirl at the inlet and decreasing the nozzle diameter improves the total particle deposition more than threefold due to the generation of the centrifugal force, which acts on the particles in the nostril and vestibule. The results also suggest that the drug delivery efficiency to the MS can be increased by using a swirling flow with a moderate swirl number of 0.6. It was found that decreasing the nozzle diameter can increase drug delivery to the proximity of the ostium in the middle meatus by more than 45%, which subsequently increases the drug delivery to the MS. The results can help engineers design a nebulizer to improve the efficiency of drug delivery to the maxillary sinuses.
Autonomous Learning in a Pseudo-Episodic Physical Environment
Authors: Haughn Kevin P. T. , Inman Daniel J. 
Published: February 2022

AbstractForpractical considerations reinforcement learning has proven to be a difficult task outside of simulation when applied to a physical experiment. Here we derive an optional approach to model free reinforcement learning, achieved entirely online, through careful experimental design and algorithmic decision making. We design a reinforcement learning scheme to implement traditionally episodic algorithms for an unstable 1-dimensional mechanical environment. The training scheme is completely autonomous, requiring no human to be present throughout the learning process. We show that the pseudo-episodic technique allows for additional learning updates with off-policy actor-critic and experience replay methods. We show that including these additional updates between periods of traditional training episodes can improve speed and consistency of learning. Furthermore, we validate the procedure in experimental hardware. In the physical environment, several algorithm variants learned rapidly, each surpassing baseline maximum reward. The algorithms in this research are model free and use only information obtained by an onboard sensor during training.
Radiological investigation of natural carbonated spring waters from Eastern Carpathians, Romania
Authors: Begy R.-Cs. , Savin C.-F. , Süle D.-K. , Nuhanovic M. , Giagias E. , Kovács T. 
Published: February 2022

AbstractThe current study presents a radiological water-quality assessment on 64 spring water samples from four Romanian counties. The study area is abundant in CO2-rich spring waters consumed by locals and tourists. Gross alpha activities ranged between 21 ± 2 and 7530 ± 658 mBq L−1, with 27% of the samples exceeding the WHO threshold. Gross beta values ranged from 40 ± 2 to 5520 ± 430 mBq L−1, with 29% exceeding the recommended values. Radionuclide activities fluctuated between 0.6 ± 0.08 and 81 ± 6 Bq L−1 for 222Rn, 15 ± 2 to 1154 ± 112 mBq L−1 for 226Ra, and from 18 ± 2 to 64 ± 5 mBq L−1 for 210Po. The annual effective doses attributed to radium varied between 0.002 and 0.23 mSv yr−1.
Max Power: Implementing the Capabilities Approach to Identify Thresholds and Ceilings in Energy Justice
Authors: Baard Patrik , Melin Anders 
Published: February 2022

AbstractIn this paper, we apply the capabilities approach—with the addition of capability ceilings—to energy justice. We argue that, to ensure energy justice, energy policies and scenarios should consider enabling not only minimal capability thresholds but also maximum capability ceilings. It is permissible, perhaps even morally required, to limit the capabilities of those above the threshold if it is necessary for enabling those below the threshold to reach the level required by justice. We make a distinction between tragic and non-tragic conflicts of capabilities: tragic conflicts are instances when one cannot raise an agent’s capabilities above the threshold that justice requires without pushing someone else below the threshold or restricting someone from reaching the threshold. In contrast, a non-tragic choice is when increasing someone above the threshold required by justice does not entail pushing someone else’s capabilities below the threshold. We utilise this framework to discuss energy justice and emissions of greenhouse gases. Drawing on the relation between points on the human development index and levels of energy consumption, we conclude that non-tragic mitigation policies now are highly preferable to tragic policies later.
Novel Neurorights: From Nonsense to Substance
Authors: Bublitz Jan Christoph 
Published: February 2022

AbstractThis paper analyses recent calls for so called “neurorights”, suggested novel human rights whose adoption is allegedly required because of advances in neuroscience, exemplified by a proposal of the Neurorights Initiative. Advances in neuroscience and technology are indeed impressive and pose a range of challenges for the law, and some novel applications give grounds for human rights concerns. But whether addressing these concerns requires adopting novel human rights, and whether the proposed neurorights are suitable candidates, are a different matter. This paper argues that the proposed rights, as individuals and a class, should not be adopted and lobbying on their behalf should stop. The proposal tends to promote rights inflationism, is tainted by neuroexceptionalism and neuroessentialism, and lacks grounding in relevant scholarship. None of the proposed individual rights passes quality criteria debated in the field. While understandable from a moral perspective, the proposal is fundamentally flawed from a legal perspective. Rather than conjuring up novel human rights, existing rights should be further developed in face of changing societal circumstances and technological possibilities.
The current state of research of word-of-mouth in the health care sector
Authors: Pauli Gerlinde , Martin Sebastian , Greiling Dorothea 
Published: February 2022

AbstractHealth information plays a significant role in the health behavior of individuals. Word-of-mouth (WOM) is essential in this context. In recent years, new forms of online communication have greatly expanded the possibilities for seeking information and, in consequence, significantly changed communication behavior. Similarly, the doctor-patient relationship has gradually evolved and the traditional asymmetry of medical knowledge is increasingly being corrected as today’s health care consumers are becoming more well-informed. A key source of information is either in-person or online WOM. A research gap exists in terms of analyzing the current state of research of WOM in health care. Although various studies highlight the influence of WOM on health behavior, to the best of our knowledge there exists no systematic literature review that summarizes the current state of research on WOM in health care. Therefore, this paper presents a comprehensive systematic literature review on WOM in health care. The literature review investigates existing WOM studies in the health care sector based on a systematic search for articles in a twenty-year timeframe from January 2000 to December 2019. The resulting total of 34 articles constitutes the basis of this paper. These studies are analyzed using a model of WOM in health care and – based on the theory of cognitive dissonance, the theory of the strength of weak ties, and the theory of perceived risk – clustered into the creation, spread, and impact of WOM. The investigated studies emphasize the importance of the staff in the service process. Furthermore, negative reviews have a stronger impact than positive ones, with service quality representing the main reason for negative WOM. In addition, the importance of electronic word-of-mouth (eWOM) is underlined, as online reviews are gaining popularity for patient decision-making processes. Although some studies have addressed WOM in health care, research gaps remain. For example, there are few studies on eWOM and some medical disciplines in private practice are neglected in WOM research. By systematically presenting and analyzing the literature on WOM in health care, this paper represents an important starting point for future research and also provides insights into the role of WOM in health care practice.
Large net forest loss in Cambodia’s Tonle Sap Lake protected areas during 1992–2019
Authors: Chen Aifang , Chen Anping , Varis Olli , Chen Deliang 
Published: February 2022

AbstractHistorical land-use practices have caused forest loss in Cambodia’s Tonle Sap Lake area (TSLA), the largest freshwater lake in Southeast Asia. However, it remains unclear if this deforestation trend had continued since 2001 when the land was designated as protected areas. Using satellite imagery, we investigated forest conversion flows and fragmentation patterns in the TSLA for 1992–2001, 2001–2010, and 2010–2019, respectively. Results show substantial forest losses and fragmentations occurring at the lower floodplain where the protected areas are located until 2010, with some forest regain during 2010–2019. The land conversions indicated that forest clearing and agricultural farming were the primary causes for observed extensive forest loss during 1992–2010. Hence, despite the creating of protected areas in 2001, our findings reveal the persistence of alarming forest loss in the TSLA until 2010. On the other hand, while net forest loss has stopped after 2010, forest regain during 2010–2019 is way too small to restore the region’s total forest area to even the level when the protected areas were established. Thus, more effective planning and implementations of forest management and restoration policies are needed for the TSLA.
A participatory ecodesign framework to address both environmental and economic dimensions in viticulture at farm scale
Authors: Perrin Aurélie , Czyrnek-Delêtre Magdalena , Ben Jaballah Maha , Rouault Anthony , van der Werf Hayo M. G. , Ghali Mohamed , Sigwalt Annie , Renaud-Gentié Christel 
Published: February 2022

AbstractThere is an urgent need for agriculture in general, and for viticulture in particular, to reduce their impacts on the environment. Doing so requires an approach that supports transitioning to more environmentally friendly practices. Involving farmers and agricultural advisors is key to lifting technical, economic, and social barriers to this transition. Participatory methods can help to consider specific contexts and concerns, but few suitable tools are available. We developed a methodological framework to address both environmental and economic dimensions at the field and farm scales in three participatory ecodesign workshops with winegrowers. We applied our framework to the ecodesign of pathways of technical operations in the Middle Loire Valley, France. The first two workshops focused on the field scale, and group interactions were facilitated using a serious game and a “live” assessment of the environmental performance of the ecodesigned system. The third workshop focused on implementation at farm level. The aggregated environmental impact of the ecodesigned farm decreased by 4%, while the economic performance of its four pathways of technical operations improved. We showed that combining environmental and economic assessment tools, suitable for use in participatory workshops, addresses most mechanisms for and barriers to changing practices at the farm scale. The typology of activities at the farm scale allows farm characteristics and the diversity of production systems to be represented in the ecodesign without over-complicating the process. The use of farm maps takes advantage of the collective expertise of the group and increases participant involvement. This process highlighted the need to continue to extend the scope and criteria of ecodesign to decrease environmental impacts even more. Here, we show for the first time the need to quantify the influence of a farm’s environmental practices on its economic performance to reduce the perception of risk and facilitate adoption of these practices.
Phonological working memory is adversely affected in adults with anorexia nervosa: a systematic literature review
Authors: Dahlén Amelia D. , Gaudio Santino , Schiöth Helgi B. , Brooks Samantha J. 
Published: February 2022

Abstract
Purpose
Cognitive restraint has potentiating and deleterious effects on working memory (WM) in anorexia nervosa (AN). Conflicting evidence may be due to heterogeneity of tasks examining different WM components (e.g., verbal/auditory versus visuospatial), and differences in adolescent versus adult AN. Additionally, differential cognitive profiles of restricting versus binge/purging subtypes, comorbid psychiatric disorders and psychotropic medication use may confound findings.

Methods
To address these conflicts, 25 studies, published between 2016 and 2021, investigating WM in children, adolescents and adults with AN were systematically reviewed using PRISMA guidelines.

Results
In 71% of WM tasks, no difference in performance between AN patients and age-matched controls was reported, while 29% of WM tasks showed worse performance. Adults with AN displayed deficits in 44% of the verbal/auditory tasks, while performance remained unaffected in 86% of visuospatial tasks.

Conclusion
Examining age groups and WM subsystems separately revealed novel findings of differentially affected WM components in AN. Comorbidities and psychotropic medications were common among AN participants and should be regarded as critical confounding factors for WM measures. Future studies examining different components of WM, acknowledging these confounding factors, may reveal specific deficits in AN to aid treatment improvement strategies.

Level of evidence
I, systematic review.
A hybrid model integrating FMEA and HFACS to assess the risk of inter-city bus accidents
Authors: Liou James J. H. , Liu Perry C. Y. , Luo Shiaw-Shyan , Lo Huai-Wei , Wu Yu-Zeng 
Published: February 2022

AbstractThe incidence of inter-city bus accidents receives a lot of attention from the public because they often cause heavy casualties. The Human Factors Analysis and Classification System (HFACS) is the prevailing tool used for traffic accident risk assessment. However, it has several shortcomings, for example: (1) it can only identify the potential failure modes, but lacks the capability for quantitative risk assessment; (2) it neglects the severity, occurrence and detection of different failure modes; (3) it is unable to identify the degree of risk and priorities of the failure modes. This study proposes a novel hybrid model to overcome these problems. First, the HFACS is applied to enumerate the failure modes of inter-city bus operation. Second, the Z-number-based best–worst method is used to determine the weights of the risk factors based on the failure mode and effects analysis results. Then, a Z-number-based weighted aggregated sum product Assessment is utilized to calculate the degree of risk of the failure modes and the priorities for improvement. The results of this study determine the top three ranking failure modes, which are personal readiness from pre-conditions for unsafe behavior, human resources from organizational influence, and driver decision-making error from unsafe behavior. Finally, data for inter-city buses in Taiwan in a case study to illustrate the usefulness and effectiveness of the proposed model. In addition, some management implications are provided.
Differential Size Distribution and Estrogen Receptor Cargo of Oviductal Extracellular Vesicles at Various Stages of Estrous Cycle in Mice
Authors: Yi Chenchen , Ni Ya , Sun Peibei , Gao Tian , Li Kun 
Published: February 2022

AbstractOviductal extracellular vesicles (OEVs) play an important role in fertilization and embryo development. However, it remains largely unknown whether the size and protein cargo of OEVs change during the estrous cycle in mice. This study analyzed the changes in the size distribution and protein cargo of OEVs at four stages of the estrous cycle in mice. The distribution widths of OEVs according to the estrous cycle stage were as follows: proestrus, 20–690 nm in diameter, with two peaks at 50 and 250 nm; estrus, 22–420 nm in diameter, with two peaks at 40 and 200 nm; metestrus, 30–70 nm diameter, with a single peak at 40 nm; and diestrus, 10–26 nm diameter, with a single peak at 20 nm. The estrogen receptor (ER) level in OEVs at the proestrus stage differed significantly from that at estrus (P = 0.013) and diestrus (P = 0.005). The levels of CD9 and Hsc70 fluctuated across the four stages, although with no significant differences. Furthermore, OEVs were observed among the cilia and microvilli of epithelial cells at the proestrus, estrus, and diestrus stages, but not at the metestrus stage. The number of observed OEVs was the highest at the proestrus stage, followed by the estrus, and the diestrus stage. Endosomes were also observed at the estrus and diestrus stages. The change of the OEV size and ER cargo is associated with the estrous cycle in mice. Our findings increase the understanding of the physiological characteristics of OEVs, which may have clinical applications.
Subjective perception of spinal deformity after selective versus non-selective fusion of Lenke 1C curves
Authors: Bizzoca Davide , Piazzolla Andrea , Solarino Giuseppe , Moretti Lorenzo , Moretti Biagio 
Published: February 2022

AbstractPurposeTo assess the self-image perception and the Quality-of-Life (QoL) in female adolescents, with Lenke 1C scoliosis curves, treated with selective versus non-selective posterior spinal instrumentation and fusion (PSF).MethodsPatients undergoing PSF for idiopathic adolescent scoliosis (AIS) were recruited and divided into two groups: patients managed with selective thoracic fusion (STF) were included in Group A, whereas patients treated with non-selective fusion (N-STF) in Group B. Each patient completed the Italian version of the Scoliosis Research Society-22R questionnaire (SRS-22R), the Quality-of-Life Profile for Spinal Deformities questionnaire (QLPSD) and the Spinal Appearance Questionnaire (SAQ), before surgery and at 24-month follow-up.ResultsOne hundred and fifty seven female patients (mean age 16.38) were included in this study. 80 patients underwent STF, while 77 patients received N-STF. At 24-month follow-up, patients managed with N-STF showed better SRS-22R self-image mean score (p = .012), SRS-22R satisfaction mean score (p = .033), QLPSD body image mean score (p = .005), but worse SRS-22 function mean score (p = .006) and QLPSD back flexibility mean score (p = .007), compared with patients who underwent STF. In terms of self-image perception, patients undergoing STF showed significantly worse SAQ total mean score (p = .002), SAQ appearance mean score (p = .001) and SAQ expectation (p = .001). We found a significant correlation between SAQ appearance mean score and SRS-22R self-image (R = − 0.721), SRS-22 mental health (R = − 0.8), QLPSD psychosocial functioning (R = 0.7) and QLPSD back flexibility (R = 0.8).ConclusionAlthough the STF of Lenke 1C curves provides better functional outcomes, in the present study, female patients receiving STF revealed a worse perceived body image, compared with patients treated with N-STF, at 24-month follow-up. Particular attention should be addressed to the preoperative patient’s mental health and body image perception, when choosing between STF and N-STF.