bluuebunny/crossref_metadata_2025_split huggingface dataset:
A level set-based topology optimization approach for thermally radiating structures
Authors: Cohen Brian S. , March Andrew I. , Willcox Karen E. , Miller David W. 
Published: May 2022

AbstractThe need for efficient thermally radiating structures is apparent in many aerospace system designs including satellites, launch vehicles, and hypersonic aircraft. This paper presents a novel level set-based topology optimization approach for designing thermally efficient radiating structures. In this paper, we derive a shape sensitivity of the thermal heat power radiated objective function using the adjoint method. This sensitivity is a necessary ingredient for our gradient-based algorithm. We apply an augmented Lagrangian method to solve an example 2D problem where the goal is to maximize heat power rejected subject to a material volume constraint. The radiating surface is kept fixed during the optimization to maintain a design-independent boundary condition, while the conducting region is optimized. Several solutions are illustrated with varying initial conditions. We also present a case study indicating that maximizing the thermal compliance functional is not sufficient for solving this class of problems.
Posterior cruciate ligament reconstruction with independent internal brace reinforcement: surgical technique and clinical outcomes with a minimum two year follow-up
Authors: Zhao Xin , Duan Ming Yi , Chen Si Qi , Wang Junyuan , Li Wenxuan , Lv Yuhang , Zhang Hang Zhou 
Published: May 2022

Abstract
Purpose
We developed an augmentation technique for PCL reconstruction with independent internal brace reinforcement and evaluated the functional outcome after PCL reconstruction employing autologous hamstrings augmented with an internal brace system for patients with isolated or combined grade 3 posterior instability who were treated with this technique.

Methods
From January 2016 to January 2018, patients with isolated or combined grade 3 PCL tears who underwent single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces were studied. The function of the operated knee was evaluated according to the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity score. The patients were asked the level of returned to their previous sport. Posterior knee laxity was examined with a KT-1000 arthrometer, and data on range of motion (ROM), re-operation, and other complications were collected.

Results
A total of 33 consecutive patients who received single-bundle PCL reconstruction using autologous hamstrings augmented with independent internal braces with a minimum two years follow-up were included in this study. Two patients had undergone this procedure during the study period and were not included in this study (one had combined bone fractures, and one patient had previous meniscus surgery). Thirty-one patients were available for final analysis. The mean follow-up was 45.35 ± 10.88 months (range 29–66 months). The average IKDC subjective knee evaluation scores from 51.65 ± 12.35 to 84.52 ± 6.42, the Lysholm score from 53.90 ± 11.86 to 85.68 ± 4.99, and the Tegner score from 2.81 ± 0.79 to 6.71 ± 1.83 (P < 0.05 for all). The mean total posterior side-to-side difference in knee laxity, assessed using a KT-1000 arthrometer, decreased from 12.13 ± 2.66 mm pre-operatively to 1.87 ± 0.56 mm post-operatively at 70° (P < 0.05). Most patients (29/31) had normal or near normal knee ROM post-operatively; two patients revealed a 6–15° loss of knee flexion compared with the contralateral knee. Twenty-nine patients (93.55%) returned to a normal daily exercise level. Twenty-three patients (74.19%) returned to competitive sports with high-level sports (Tegner score of 6 or above; eleven patients (35.48%) reported to be on the same level as well as the Tegner level); six patients (19.35%) returned to recreational sports (Tegner score of 4 or 5). Two patients had Tegner scores of 2 and 3, indicating poor function level. No patient needed PCL revision surgery during the follow-up period.

Conclusion
Single-bundle PCL reconstruction with internal brace augmentation for PCL injury exhibited satisfactory posterior stability and clinical outcomes in patients with isolated or combined grade 3 PCL injuries at a minimum two year follow-up.
A New Risk Factor for Cervical Anastomotic Leakage‐Role of The Relative Gastric Length in the Surgical Treatment of Esophageal Cancer
Authors: Yao Peng , Zhang Ying , Li Gang , Zhuo Ze‐Guo , Xu Zhi‐Jie , Alai Gu‐Ha , Lin Yi‐Dan 
Published: May 2022

AbstractBackgroundBlood supply is especially weak near the gastric fundus. Making the anastomosis in this area would increase the risk of anastomotic leakage (AL). In cervical anastomosis, the gastric conduit needs to travel through the thorax. Therefore, the relative length between the stomach and the thorax is an essential factor in deciding if the poorly supplied area could be removed. This study was to explore if a small relative gastric length was a risk of cervical AL. If all other conditions are equal, could intrathoracic anastomosis be a better choice?MethodsPatients who underwent esophagectomy with a preoperative barium swallow in West China Hospital between 2014 and 2017 were included. The length of the greater curvature and the thorax were obtained from the barium esophagogram. The ratio between the length of the greater curvature and the thorax was the relative gastric length calculated from the greater curvature (RGL‐G).ResultsA total of 782 patients were enrolled in the final analysis. The cervical AL group had a significantly higher ratio of patients with an RGL‐G less than 1.3 (26.7% vs. 8.9%, p = 0.003). The multivariate logistic regression proved that RGL‐G less than 1.3 was a risk factor for cervical anastomotic leakage (p = 0.012). Correspondingly, RGL‐G less than 1.3 was not a risk factor (6.3% vs. 14.3%, p = 0.289) in the intrathoracic anastomosis group.ConclusionsRGL‐G less than 1.3 was a new risk factor for cervical AL, but it would not be a problem for intrathoracic anastomosis.
The Effects of Methylene Blue and Carbon Nanoparticles on Transplanted Lymph Node Survival, Reconstructed Lymphatic Function, and Changes in Inflammatory and Fibrosis Factors
Authors: Wang Heng , Dong Dong , Liu Chi , Yuan Mingjie , Chen Liang , Liu Tianyi 
Published: May 2022

AbstractBackground and objectivesMethylene blue (MB) and carbon nanoparticles (CNs) can be used as a simple method for reverse lymphatic mapping. We investigated whether the two tracers had an impact on the survival of lymph nodes and the function of reconstructed lymph vessels after transplantation, as well as the changes in surrounding related factors.MethodsThe stained lymph nodes were non‐vascularized transplanted into the contralateral popliteal fossa in mice. After 4 weeks, the lymphatic recanalization was detected. The samples were harvested for pathological detection and PCR. In addition, the transport ability of the recanalized lymphatics to tumor cells was also explored.ResultsCompared with the control group, there was no significant difference of the MB and CNs groups in the drainage function of recanalized lymphatic vessels, the survival of lymph nodes, or the transport capacity to tumor cells. TNF‐α and IL‐6 were significantly higher in the two tracer groups (**p < 0.01). Besides, the α‐SMA was significantly increased in the CNs group (*p < 0.05).ConclusionsTwo tracers have no effect on the survival of transplanted lymph nodes, nor do they affect the drainage ability or tumor cell capture ability of the reconstructed lymphatics, despite improving TNF‐α and IL‐6 levels and the deposition of CNs.
Study Protocol: Adjuvant Holmium-166 Radioembolization After Radiofrequency Ablation in Early-Stage Hepatocellular Carcinoma Patients—A Dose-Finding Study (HORA EST HCC Trial)
Authors: Hendriks Pim , Rietbergen Daphne D. D. , van Erkel Arian R. , Coenraad Minneke J. , Arntz Mark J. , Bennink Roel J. , Braat Andries E. , Crobach A. Stijn L. P. , van Delden Otto M. , van der Hulle Tom , Klümpen Heinz-Josef , van der Meer Rutger W. , Nijsen J. Frank W. , van Rijswijk Carla S. P. , Roosen Joey , Ruijter Bastian N. , Smit Frits , Stam Mette K. , Takkenberg R. Bart , Tushuizen Maarten E. , van Velden Floris H. P. , de Geus-Oei Lioe-Fee , Burgmans Mark C. ,   Dutch Hepatocellular Cholangiocarcinoma Group
Published: May 2022

Abstract
Purpose
To investigate the biodistribution of holmium-166 microspheres (166Ho-MS) when administered after radiofrequency ablation (RFA) of early-stage hepatocellular carcinoma (HCC). The aim is to establish a perfused liver administration dose that results in a tumoricidal dose of holmium-166 on the hyperaemic zone around the ablation necrosis (i.e. target volume).

Materials and Methods
This is a multicentre, prospective, dose-escalation study in HCC patients with a solitary lesion 2–5 cm, or a maximum of 3 lesions of ≤ 3 cm each. The day after RFA patients undergo angiography and cone-beam CT (CBCT) with (super)selective infusion of technetium-99 m labelled microalbumin aggregates (99mTc-MAA). The perfused liver volume is segmented from the CBCT and 166Ho-MS is administered to this treatment volume 5–10 days later. The dose of holmium-166 is escalated in a maximum of 3 patient cohorts (60 Gy, 90 Gy and 120 Gy) until the endpoint is reached. SPECT/CT is used to determine the biodistribution of holmium-166. The endpoint is met when a dose of ≥ 120 Gy has been reached on the target volume in 9/10 patients of a cohort. Secondary endpoints include toxicity, local recurrence, disease-free and overall survival.

Discussion
This study aims to find the optimal administration dose of adjuvant radioembolization with 166Ho-MS after RFA. Ultimately, the goal is to bring the efficacy of thermal ablation up to par with surgical resection for early-stage HCC patients.

Trial registration
Clinicaltrials.gov identifier: NCT03437382.
Machine learning for optimized individual survival prediction in resectable upper gastrointestinal cancer
Authors: Jung Jin-On , Crnovrsanin Nerma , Wirsik Naita Maren , Nienhüser Henrik , Peters Leila , Popp Felix , Schulze André , Wagner Martin , Müller-Stich Beat Peter , Büchler Markus Wolfgang , Schmidt Thomas 
Published: May 2022

Abstract
Purpose
Surgical oncologists are frequently confronted with the question of expected long-term prognosis. The aim of this study was to apply machine learning algorithms to optimize survival prediction after oncological resection of gastroesophageal cancers.

Methods
Eligible patients underwent oncological resection of gastric or distal esophageal cancer between 2001 and 2020 at Heidelberg University Hospital, Department of General Surgery. Machine learning methods such as multi-task logistic regression and survival forests were compared with usual algorithms to establish an individual estimation.

Results
The study included 117 variables with a total of 1360 patients. The overall missingness was 1.3%. Out of eight machine learning algorithms, the random survival forest (RSF) performed best with a concordance index of 0.736 and an integrated Brier score of 0.166. The RSF demonstrated a mean area under the curve (AUC) of 0.814 over a time period of 10 years after diagnosis. The most important long-term outcome predictor was lymph node ratio with a mean AUC of 0.730. A numeric risk score was calculated by the RSF for each patient and three risk groups were defined accordingly. Median survival time was 18.8 months in the high-risk group, 44.6 months in the medium-risk group and above 10 years in the low-risk group.

Conclusion
The results of this study suggest that RSF is most appropriate to accurately answer the question of long-term prognosis. Furthermore, we could establish a compact risk score model with 20 input parameters and thus provide a clinical tool to improve prediction of oncological outcome after upper gastrointestinal surgery.
Internalizing problems before and during the COVID-19 pandemic in independent samples of Dutch children and adolescents with and without pre-existing mental health problems
Authors: Fischer Karen , Tieskens Jacintha M. , Luijten Michiel A. J. , Zijlmans Josjan , van Oers Hedy A. , de Groot Rowdy , van der Doelen Daniël , van Ewijk Hanneke , Klip Helen , van der Lans Rikkert M. , De Meyer Ronald , van der Mheen Malindi , van Muilekom Maud M. , Hyun Ruisch I. , Teela Lorynn , van den Berg Germie , Bruining Hilgo , van der Rijken Rachel , Buitelaar Jan , Hoekstra Pieter J. , Lindauer Ramón , Oostrom Kim J. , Staal Wouter , Vermeiren Robert , Cornet Ronald , Haverman Lotte , Bartels Meike , Polderman Tinca J. C. , Popma Arne 
Published: May 2022

AbstractThe aim of the study was to assess internalizing problems before and during the pandemic with data from Dutch consortium Child and adolescent mental health and wellbeing in times of the COVID-19 pandemic, consisting of two Dutch general population samples (GS) and two clinical samples (CS) referred to youth/psychiatric care. Measures of internalizing problems were obtained from ongoing data collections pre-pandemic (NGS = 35,357; NCS = 4487) and twice during the pandemic, in Apr–May 2020 (NGS = 3938; clinical: NCS = 1008) and in Nov–Dec 2020 (NGS = 1489; NCS = 1536), in children and adolescents (8–18 years) with parent (Brief Problem Monitor) and/or child reports (Patient-Reported Outcomes Measurement Information System®). Results show that, in the general population, internalizing problems were higher during the first peak of the pandemic compared to pre-pandemic based on both child and parent reports. Yet, over the course of the pandemic, on both child and parent reports, similar or lower levels of internalizing problems were observed. Children in the clinical population reported more internalizing symptoms over the course of the pandemic while parents did not report differences in internalizing symptoms from pre-pandemic to the first peak of the pandemic nor over the course of the pandemic. Overall, the findings indicate that children and adolescents of both the general and clinical population were affected negatively by the pandemic in terms of their internalizing problems. Attention is therefore warranted to investigate long-term effects and to monitor if internalizing problems return to pre-pandemic levels or if they remain elevated post-pandemic.
Older adults’ participation in artistic activities: a scoping review
Authors: Chacur Karima , Serrat Rodrigo , Villar Feliciano 
Published: May 2022

AbstractThis scoping review analyses existing literature on older adults’ participation in artistic activities. It identifies gaps in this research topic and suggests new directions for research. We followed the five-step process defined by Arksey and O’Malley (2005) and extended by Levac et al. (2010). Four electronic databases were searched, and 129 peer-reviewed articles were included in the scoping review. Research into older adults’ participation in artistic activities has grown in the last ten years. However, empirical papers tend to focus on the outcomes of older people’s participation in artistic activities, in particular the benefits. Most papers centred on facilitators to examine the antecedents of this type of participation among people in late life. Research about experiences, potentially negative consequences or barriers to older adults’ participation in artistic activities have been largely overlooked. We identified several gaps in the literature, which we classified as: related to the artistic activities that were considered; the potential costs and barriers for older adults’ participation in artistic activities; older adults’ voices and their diversity; the life course perspective; and a contextual view of research on the topic. These gaps suggest challenges that future research on older adults’ participation in artistic activities should consider.
Deconstructing Ecosystem Service Conflicts through the Prisms of Political Ecology and Game Theory in a North-Western Mediterranean River Basin
Authors: Garau Enrica , Pueyo-Ros Josep , Vila-Subiros Josep , Palom Anna Ribas 
Published: May 2022

AbstractPower relationships, access and control, (in)equity, and (in)justice are key modulators of conflicts arising from ecosystem services between multiple stakeholders. A greater knowledge of stakeholder value systems and behaviors is crucial for understanding socioecological dynamics. We propose an analytical framework that combines political ecology and game theory to analyze water ecosystem services. This integrated framework was used to reinterpret concepts such as common goods, (a)symmetric flows, and (un)fair trade-offs in the context of ecosystem services. The purpose was to gain a better understanding of behaviors and (a)symmetries in power relationships between multiple stakeholders. We studied the case of a north-western Mediterranean river basin using data obtained from stakeholder interviews and newspaper articles. Our findings uncovered different types of stakeholder relationships, ranging from mutual support and cooperation to conflict. The proposed analytical framework shows how social mechanisms can affect ecosystem services flows, potentially facilitating or hindering the development of more equitable management models for natural resources.
Self-harm and Suicidality Experiences of Middle-Age and Older Adults With vs. Without High Autistic Traits
Authors: Stewart Gavin R. , Corbett Anne , Ballard Clive , Creese Byron , Aarsland Dag , Hampshire Adam , Charlton Rebecca A. , Happé Francesca 
Published: May 2022

AbstractSuicide has been identified as a leading cause of premature death in autistic populations. Elevated autistic traits have also been associated with higher rates of self-harm, suicidal ideation, and suicidal self-harm in the general population, but this has yet to be examined in older age. Using baseline cross-sectional data from the PROTECT study, middle-age and older adults with high autistic traits (n = 276) had significantly higher rates of suicidal ideation, deliberate self-harm, and suicidal self-harm than an age/sex-matched comparison group (n = 10,495). These differences represented a 5- to 6-fold increase in likelihood for self-harming and suicidality. These findings, which remained when controlling for depression symptoms, suggest that middle-age and older adults with high autistic traits may be particularly at risk of self-harm and suicidal behaviours.
Personal identity, possible worlds, and medical ethics
Authors: Wagner Nils-Frederic 
Published: May 2022

AbstractThought experiments that concoct bizarre possible world modalities are standard fare in debates on personal identity. Appealing to intuitions raised by such evocations is often taken to settle differences between conflicting theoretical views that, albeit, have practical implications for ethical controversies of personal identity in health care. Employing thought experiments that way is inadequate, I argue, since personhood is intrinsically linked to constraining facts about the actual world. I defend a moderate modal skepticism according to which intuiting across conceptually incongruent worlds constitutes ‘invalid intuition-inferences’—i.e., carrying over intuitions gathered from facts about possible worlds that are at odds with facts about the actual world, for the purpose of making claims about real-life persons and their identity, leads to conceptual incongruences. Such a methodological fallout precludes accurate, informative judgments about personal identity in the actual world, calling into question the adequacy of thought experimental considerations for potential real-world applications in medical ethics.
Bodily obsessions: intrusiveness of organs in somatic obsessive–compulsive disorder
Authors: Puranen Joni P. 
Published: May 2022

AbstractIn this paper, I will provide a phenomenological analysis of somatic obsessions at times present in obsessive–compulsive disorder. I will compare two different types of bodily obsessions, which have a different neurological-physiological underpinning: anguishing awareness of one’s own heartbeat and of one’s own breathing. In addition, I will contrast these two with how one experiences one’s own liver. I will use the concepts "tactility obsessions” and "motility obsessions”, which I have coined for the purpose of this comparison. In other words, these are obsessions concerning the felt sense of one’s autonomous organs and obsessions concerning one’s ability to voluntarily move. Ultimately, I claim that the core lived experience in somatic obsessive–compulsive disorder should not only be understood as having to do with intruding and "distorted thoughts” concerning bodily processes, but could also be understood as having to do with a felt sense of our organs interrupting and intruding our daily lives.
Distribution of the geochemical signature caused by the 2011 Tohoku-oki tsunami in Misawa harbor, northern Japan
Authors: Frenken Mike , Bellanova Piero , Nishimura Yuichi , Reicherter Klaus , Schwarzbauer Jan 
Published: May 2022

AbstractThe 2011 Tohoku-oki tsunami left a characteristic geochemical signature in the sediments of the Misawa harbor on the Aomori coastline (northern Japan), not only in vertical stratigraphy but also in lateral distribution. Suitable indicator compounds for the tsunami impact were used to identify and characterize the distribution of geochemical patterns within the harbor area. Specific compounds are illustrating the different emission sources and distribution during the 2011 tsunami. Petrogenic-derived markers, such as hopanes and polycyclic aromatic hydrocarbons, provide information about the tsunami-related destruction of facilities and technical material and the subsequent release of, for instance, oil and grease. Linear alkylbenzenes and diisopropylnaphthalene are used to identify sewage-derived contaminants released by the tsunami. Old burden markers such as dichlorodiphenyltrichloroethane and its metabolites or polychlorinated biphenyl signal erosion and rearrangement of contaminants present in the sediments prior to the tsunami. Distribution of the analyzed pollutant groups indicate the tsunami-related release through various emission sources and their potential origin. While petrogenic-derived pollutants revealed a significant local spread with hotspot formation near the release, sewage-derived compounds were widely distributed and originated from a diffuse source not necessarily located in the harbor area. In contrast to freshly released contaminants, old burden markers are characterized by erosion of contaminated pre-tsunami sediment, the remobilization of pollutants and subsequent deposition of these sediment-bound contaminants in the tsunami layer. The correlation between all pollutant groups by their preferred accumulation reveals that source-specific compounds show different emission sources but reveal also a topographical control of the pollutant distribution by the 2011 tsunami.