bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypicality index: avoiding false reassurance in prenatal screening
Authors: Kristensen S. E. , Gadsbøll K. , Nicolaides K. H. , Vogel I. , Pedersen L. H. , Wright A. , Petersen O. B. , Wright D. 
Published: December 2022

ABSTRACTObjectiveTo demonstrate the application of the atypicality index as an adjunct to first‐trimester risk assessment for major trisomies by the combined test.MethodsThis was a study of 123 998 Danish women with a singleton pregnancy who underwent routine first‐trimester screening, including risk assessment for major trisomies. An atypicality index, which is a measure of the degree to which a profile is atypical, was produced for measurements of fetal nuchal translucency thickness and maternal serum free β‐human chorionic gonadotropin and pregnancy‐associated plasma protein‐A. The incidence of adverse pregnancy outcome, including miscarriage, intrauterine death and termination of pregnancy, was tabulated according to the screening result and atypicality index.ResultsIn pregnancies with low risk and those with high risk for major trisomies according to the combined screening test, the incidence of adverse pregnancy outcome increased with increasing atypicality index. In pregnancies with a low risk for trisomies and atypicality index of ≥ 99%, the incidence of adverse outcome was 5.1 (95% CI, 3.4–7.6) times higher compared with that in low‐risk pregnancies with a typical measurement profile, reflected by an atypicality index of < 80%. Similarly, in high‐risk pregnancies, the incidence of adverse outcome was 7.9 (95% CI, 4.4–14.5) times higher in those with an atypicality index of ≥ 99% compared to those with an atypicality index of < 80%. Using individual profile plots, we were able to demonstrate a transparent and intuitive method for visualization of multiple variables, which can help interpret the individual combination of measurements and level of atypicality.ConclusionsIn pregnancies undergoing first‐trimester combined screening and classified as being at low risk for major trisomies, profiles that are typical of pregnancies with normal outcome provide additional reassurance, whereas those with an atypical profile may warrant further investigation. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Six complex microbial inoculants for removing ammonia nitrogen from waters
Authors: Sun Chunmeng , Li Cong , Zhang Kai , Ma Xingmao , Zhang Yunshu 
Published: December 2022

AbstractTo determine the effect of microbial inoculants on the removal of ammonia nitrogen (NH4+‐N), six different complex microbial inoculants were studied. In this study, their effectiveness on NH4+‐N removal was compared, and their microbial community composition was determined. High‐throughput sequencing results showed that Proteobacteria and Firmicutes were the dominant phyla in six samples. Before the reaction, Bacillus, Cyanobacteria, and Mitochondria genera were the dominant genera. The dominant genera were significantly different after the reaction with the addition of bacterial agents. The six water samples were Massilia, Escherichia‐Shigella, Brevibacillus, Mitsuaria, Bacillus, and Ralstonia. Among the six complex microbial inoculants, “Gandu nitrifying bacteria (NR4)” have the best removal effect on NH4+‐N. In addition, the removal effect of six different bacterial agents on chemical oxygen demand (COD) was compared. The results showed that “Bilaiqing ammonia nitrogen removal bacteria agent (NR5)” has the best removal effect on COD. Single‐factor experiments suggested that the optimal conditions for NR4 bacteria were pH 7, 30°C, 1.0 g/L of bacterial agent dosage and a wide range of NH4+‐N from 30 to 300 mg/L.Practitioner Points

The nitrogen removal effects of six different microbial agents were compared.
High‐throughput sequencing provides important insights into the study of ammonia nitrogen removal by microbial communities.
Analysis of six different complex bacterial agents by high‐throughput sequencing.
The relative abundance of microorganisms is not proportional to the ability to remove NH4+‐N
Good application effect in urban landscape water body.
Resiliente kritische und sensible Infrastrukturen im Kontext moderner Kommunikationssysteme
Authors: Börner Kai , Kroushkov Dimitar , Malchow Jan-Ole 
Published: December 2022

ZusammenfassungModerne Informations- und Kommunikationstechnologien (IKT) sind das zentrale Nervensystem weltweiter Wirtschaftskreisläufe, des gesellschaftlichen Zusammenlebens und staatlichen Han-delns. Sie sind einerseits eine Errungenschaft, ohne die wir unser Leben nicht so führen könnten, wie wir es kennen. Andererseits können schon kleinste Störungen in den unzähligen mit IKT hoch-gradig vernetzten Systemen ernsthafte Probleme bereiten. Wie also lassen sich vernetzte Systeme, bei deren Ausfall die Gefahr von Versorgungsengpässen oder Störungen der öffentlichen Sicherheit bestehen, resilient machen?
Die Energiewende als Sprungbrett in ein resilientes Energiesystem
Authors: Korzynietz Roman , Bierau-Delpont Frauke , Moorfeld Rainer 
Published: December 2022

ZusammenfassungEnergiesysteme sind essenziell für Sicherheit und Wohlstand und zählen zu Recht zu den kritischen Infrastrukturen in Deutschland. Gegenwärtig erzwingt die Energiewende ihren auf vielfältige Weise herausfordernden Umbau – verbunden unter anderem mit einer starken Kopplung der Teilsysteme, beherrschbar nur auf Basis umfassender Digitalisierung. Aber trotz dieser absehbar gewaltigen Komplexität künftiger Systeme darf die Versorgungssicherheit nicht leiden. So sollen die Energiesysteme sich an immer neue Anforderungen automatisch anpassen und auch hohen Belastungen standhalten können bzw. nach Versagen schnell wiederherstellbar sein. Mit einem Wort: Sie sollen resilient sein.
Auf dem Weg zu resilienten Pflegesettings: Soziotechnische Faktoren digitaler Transformationsprozesse
Authors: Lutze Maxie , Schmietow Bettina , Müller Marius 
Published: December 2022

ZusammenfassungUm bessere Arbeitsbedingungen in der Pflege zu schaffen, bietet die Digitalisierung eine Fülle neuer Chancen. Bei der Einführung digitaler Technologien, die Resilienz in der Pflege stärken können, gilt es jedoch zu vermeiden, dass deren Anwendung zu einer zusätzlichen Belastungsquelle für das Pflegepersonal wird. Eine Analyse der komplexen Beziehungen in der Pflege verdeutlicht das Ausmaß der Herausforderung, eine pflegespezifische Resilienz zu verwirklichen. Denn der bisherige Fokus, der auf die Ausbildung individueller Resilienz liegt, ist unzureichend und muss um organisationale und systemische Aspekte ergänzen werden.
Open Public Data, Medienkompetenz und die Resilienz der Gemeinschaft vor Ort
Authors: Lehning Lukas , Schweigel Henry , Creemers Niklas 
Published: December 2022

ZusammenfassungÖffentliche Diskurse finden zunehmend in digitalen Medien statt. Häufig entfalten sie hier Dynamiken, die einer gemeinsamen Willensbildung, der Verlässlichkeit geteilter kommunikativer Praktiken und nicht zuletzt der Wahrheitsfindung abträglich sind. In der Folge leidet die Fähigkeit lokaler Gemeinschaften, gemeinsam Lösungen etwa für die Bewältigung von Krisen und disruptiven Entwicklungen zu finden. Diskursive Resilienz wird somit zu einem notwendigen Faktor von Gemeinschaftsresilienz. Der Beitrag diskutiert diese Zusammenhänge und zeigt auf, wie die Resilienz von Gemeinschaften – insbesondere mit Blick auf Fragen einer diskursiven Resilienz – gestärkt werden kann. Im Fokus stehen dabei partizipative Verfahren und innovative Maßnahmen auf Basis von Open Public Data (OPD). So adressiert dieses Kapitel die Potenziale und Herausforderungen, welche die Verfügbarkeit und Nutzung dieser Daten für lokale Kontexte bereithalten. Dabei betont der Beitrag Daten- und Medienkompetenz als Voraussetzungen für eine zielführende Verwendung von OPD zur Stärkung von Gemeinschaftsresilienz.
Die Resilienz von Unternehmen und Wirtschaft in Zeiten externer Schocks
Authors: Busch-Heizmann Anne , Krabel Stefan , Wangler Leo 
Published: December 2022

ZusammenfassungEine weltweite Finanz- und Wirtschaftskrise gegen Ende der 2000er Jahre, wenige Jahre später die Corona-Pandemie und aktuell kaum zu kalkulierende Auswirkungen eines Krieges auf dem europäischen Kontinent: drei markante Beispiele für externe Schocks, die auf Unternehmen und Wirtschaft einwirken und denen sie standhalten müssen. Da ist es hilfreich, einen Blick auf Theorien, Modelle und Operationalisierungen von Resilienz zu werfen – sowohl aus arbeits- und organisationssoziologischer als auch aus betriebswirtschaftlicher und innovationspolitischer Perspektive.
On the Stability of Steady-State Solutions to the Navier–Stokes Equations in the Whole Space
Authors: Galdi Giovanni P. , Maremonti P. 
Published: December 2022

AbstractWe prove asymptotic stability of steady-state solutions to the Navier–Stokes equations in the whole space. One of the novelties of this work consists in considering perturbations that show a distinct pointwise behavior (in space and time) and correspond to initial data only belonging to suitable weighted Lebesgue spaces.
Augmentierte Primärnaht „internal bracing“ nach ligamentärer Ellenbogenluxation
Authors: Rausch Valentin , Königshausen Matthias , Schildhauer Thomas A. , Geßmann Jan 
Published: December 2022

Zusammenfassung
Operationsziel
Ziel der operativen Versorgung ist die primäre Stabilisierung des instabilen Ellenbogens nach ligamentärer Ellenbogenluxation.

Indikationen
Ligamentäre Ellenbogenluxationen werden von unterschiedlichen Verletzungen der umgebenden Muskulatur sowie der Kollateralbänder begleitet. Die operative Versorgung ist bei Versagen der konservativen Therapie indiziert, d. h. wenn eine Dezentrierung oder Reluxation nur durch Ruhigstellung in > 90° Beugung und Pronation verhindert werden kann oder das Gelenk durch aktive muskuläre Führung nach 5 bis 7 Tagen nicht zentriert werden kann.

Kontraindikationen
Kontraindikationen für eine alleinige augmentierte Primärnaht bestehen in der Regel bei begleitenden knöchernen Verletzungen im Rahmen der Luxation, bei ausgedehnten Weichteilverletzungen sowie im Falle eines Infektes am Ellenbogen.

Operationstechnik
Die Versorgung mittels augmentierter Primärnaht des Ellenbogens erfolgt kombiniert über einen lateralen (Kocher) und medialen (FCU-Split) Zugang zum Ellenbogen. Nach Reposition des Ellenbogens werden jeweils zuerst die Kollateralbänder mit hochfesten Polyethylenfäden augmentiert und gemeinsam mit einem weiteren hochfesten Polyethylenfaden im Humerus verankert. Darüber werden die Extensoren bzw. Flexoren ebenfalls fadenaugmentiert am Epicondylus lateralis bzw. medialis refixiert.

Weiterbehandlung
Ziel der Weiterbehandlung ist die frühfunktionelle Beübung des Ellenbogens, die in einer Bewegungsorthese unter Vermeidung von Varus- und Valgusbelastung erfolgt.

Ergebnisse
Im Zeitraum zwischen August 2018 und Januar 2020 wurden insgesamt 12 Patienten mit einer augmentieren Primärnaht nach instabiler rein ligamentärer Ellenbogenluxation versorgt. Nach einem mittleren Nachverfolgungszeitraum von 14 ± 12,7 Monaten zeigte sich ein Mayo-Elbow Performance Score von im Mittel 98,5 Punkten bei mittlerem funktionellem Bogen von 115°. Keiner der Patienten gab ein verbleibendes Instabilitätsgefühl des Ellenbogens an.
EANM practice guideline for quantitative SPECT-CT
Authors: Dickson John C. , Armstrong Ian S. , Gabiña Pablo Minguez , Denis-Bacelar Ana M. , Krizsan Aron K. , Gear Jonathan M. , Van den Wyngaert Tim , de Geus-Oei Lioe-Fee , Herrmann Ken 
Published: December 2022

Abstract PurposeQuantitative SPECT-CT is a modality of growing importance with initial developments in post radionuclide therapy dosimetry, and more recent expansion into bone, cardiac and brain imaging together with the concept of theranostics more generally. The aim of this document is to provide guidelines for nuclear medicine departments setting up and developing their quantitative SPECT-CT service with guidance on protocols, harmonisation and clinical use cases.MethodsThese practice guidelines were written by members of the European Association of Nuclear Medicine Physics, Dosimetry, Oncology and Bone committees representing the current major stakeholders in Quantitative SPECT-CT. The guidelines have also been reviewed and approved by all EANM committees and have been endorsed by the European Association of Nuclear Medicine.ConclusionThe present practice guidelines will help practitioners, scientists and researchers perform high-quality quantitative SPECT-CT and will provide a framework for the continuing development of quantitative SPECT-CT as an established modality.
Multidisciplinary tumor board analysis: validation study of a central tool in tumor centers
Authors: Frank Benedikt , Ihorst Gabriele , Herget Georg , Schäfer Henning , Neubauer Jakob , Calba Marc-Antoine , Textor Daniel , Möller Mandy-Deborah , Wenger Sina , Jung Johannes , Waldschmidt Johannes , Miething Cornelius , Rassner Michael , Greil Christine , Wäsch Ralph , Engelhardt Monika 
Published: December 2022

Abstract

The established standard to ensure state-of-the-art cancer treatment is through multidisciplinary tumor boards (TBs), although resource- and time-intensive. In this validation study, the multiple myeloma (MM)-TB was reexamined, aiming to validate our previous (2012–2014) results, now using the TB data from March 2020 to February 2021. We assessed MM-TB protocols, physicians’ documentation, patient, disease, remission status, progression-free survival (PFS), and overall survival (OS) as left-truncated survival times. Moreover, TB-adherence, level of evidence according to grade criteria, time requirements, study inclusion rates, and referral satisfaction were determined. Within a 1-year period, 312 discussed patients were documented in 439 TB protocols. Patient and disease characteristics were typical for comprehensive cancer centers. The percentages of patients discussed at initial diagnosis (ID), with disease recurrence or in need of interdisciplinary advice, were 39%, 28%, and 33%, respectively. Reasons for the MM-TB presentation were therapeutic challenges in 80% or staging/ID-defining questions in 20%. The numbers of presentations were mostly one in 73%, two in 20%, and three or more in 7%. The TB adherence rate was 93%. Reasons for non-adherence were related to patients’ decisions or challenging inclusion criteria for clinical trials. Additionally, we demonstrate that with the initiation of TBs, that the number of interdisciplinarily discussed patients increased, that TB-questions involve advice on the best treatment, and that levels of compliance and evidence can be as high as ≥ 90%. Advantages of TBs are that they may also improve patients’, referrers’, and physicians’ satisfaction, inclusion into clinical trials, and advance interdisciplinary projects, thereby encouraging cancer specialists to engage in them.
Classifications of posterior malleolar fractures: a systematic literature review
Authors: Terstegen Julia , Weel Hanneke , Frosch Karl-Heinz , Rolvien Tim , Schlickewei Carsten , Mueller Elena 
Published: December 2022

Abstract
Introduction
Complex ankle fractures frequently involve the posterior malleolus. Many classifications describing posterior malleolar fractures (PMF) exist. The aim of this study was to provide a systematic literature review to outline existing PMF classifications and estimate their accuracy.

Methods
The databases PubMed and Scopus were searched without time limits. Only specific PMF classifications were included; general ankle and/or pilon fracture classifications were excluded. Selection and data extraction was performed by three independent observers. The systematic literature search was performed according to the current criteria of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The methodological quality of the included studies was quantified using the modified Coleman score.

Results
A total of 110 studies with a total of 12.614 patients were included. Four main classifications were identified: Those describing the size of the posterior malleolar fracture (n = 66), Haraguchi (n = 44), Bartoníček/Rammelt (n = 21) and Mason (n = 12). The quality of the studies was moderate to good with a median Coleman-score of 43.5 (14–79) and a weighted median Coleman-score of 42.5 points. All classifications achieved a substantial to perfect score regarding the inter- and intraobserver reliability, with Mason scoring the lowest in comparison.

Conclusions
None of the reviewed PMF classifications has been able to establish itself decisively in the literature. Most of the classifications are insufficient in terms of a derivable treatment algorithm or a prognosis with regard to outcome. However, as the Bartoníček/Rammelt classification has the greatest potential due to its treatment algorithm, its reliability in combination with consistent predictive values, its usage in clinical practice and research appears advisable.
Neural correlates of digital measures shown by structural MRI: a post-hoc analysis of a smartphone-based remote assessment feasibility study in multiple sclerosis
Authors: Ganzetti Marco , Graves Jennifer S. , Holm Sven P. , Dondelinger Frank , Midaglia Luciana , Gaetano Laura , Craveiro Licinio , Lipsmeier Florian , Bernasconi Corrado , Montalban Xavier , Hauser Stephen L. , Lindemann Michael 
Published: December 2022

Abstract
Background
A study was undertaken to evaluate remote monitoring via smartphone sensor-based tests in people with multiple sclerosis (PwMS). This analysis aimed to explore regional neural correlates of digital measures derived from these tests.

Methods
In a 24-week, non-randomized, interventional, feasibility study (NCT02952911), sensor-based tests on the Floodlight Proof-of-Concept app were used to assess cognition (smartphone-based electronic Symbol Digit Modalities Test), upper extremity function (Draw a Shape Test, Pinching Test), and gait and balance (Static Balance Test, Two-Minute Walk Test, U-Turn Test). In this post-hoc analysis, digital measures and standard clinical measures (e.g., Nine-Hole Peg Test [9HPT]) were correlated against regional structural magnetic resonance imaging outcomes. Seventy-six PwMS aged 18–55 years with an Expanded Disability Status Scale score of 0.0–5.5 were enrolled from two different sites (USA and Spain). Sixty-two PwMS were included in this analysis.

Results
Worse performance on digital and clinical measures was associated with smaller regional brain volumes and larger ventricular volumes. Whereas digital and clinical measures had many neural correlates in common (e.g., putamen, globus pallidus, caudate nucleus, lateral occipital cortex), some were observed only for digital measures. For example, Draw a Shape Test and Pinching Test measures, but not 9HPT score, correlated with volume of the hippocampus (r = 0.37 [drawing accuracy over time on the Draw a Shape Test]/ − 0.45 [touching asynchrony on the Pinching Test]), thalamus (r = 0.38/ − 0.41), and pons (r = 0.35/ − 0.35).

Conclusions
Multiple neural correlates were identified for the digital measures in a cohort of people with early MS. Digital measures showed associations with brain regions that clinical measures were unable to demonstrate, thus providing potential novel information on functional ability compared with standard clinical assessments.
Community engaged research to measure the impact of COVID-19 on vulnerable community member’s well-being and health
Authors: Barwise Amelia K. , Egginton Jason , Pacheco-Spann Laura , Clift Kristin , Albertie Monica , Johnson Matthew , Batbold Sarah , Phelan Sean , Allyse Megan 
Published: December 2022

Summary
Background
The COVID-19 pandemic has exacerbated existing income inequality and health disparities in the United States (US). The objective of this study was to conduct timely, community-engaged research to understand the disproportionate impact of the COVID-19 pandemic on historically under-resourced communities with the goal of improving health equity. The initiative focused on priorities identified by Community Health Needs Assessments (CHNA) conducted every 3 years per Federal funding requirements. These were access to healthcare, maternal/child health, obesity/food insecurity/physical activity, and mental health/addiction.

Methods
In the first three quarters of 2021, we developed and employed mixed methods in three simultaneous phases of data collection. In phase 1, we used purposive sampling to identify key informants from multiple stakeholder groups and conducted semi-structured interviews. In phase 2, we held focus groups with community members from historically marginalized demographics. In phase 3, we developed a survey using validated scales and distributed it to diverse communities residing in the geographic areas of our healthcare system across four states.

Conclusion
Healthcare systems may use the methodology outlined in this paper to conduct responsive community engagement during periods of instability and/or crisis and to address health equity issues. The results can inform sustainable approaches to collaborate with communities to build resilience and prepare for future crises.
Dynamic nomogram for predicting generalized conversion in adult-onset ocular myasthenia gravis
Authors: Bi Zhuajin , Cao Yayun , Gui Mengcui , Lin Jing , Zhang Qing , Li Yue , Ji Suqiong , Bu Bitao 
Published: December 2022

Abstract
Purpose
To explore the factors and risk mapping model of progression from ocular myasthenia gravis (OMG) to generalized myasthenia gravis (GMG) in adult-onset patients.

Methods
A retrospective, observational cohort study was performed for 435 OMG patients with onset age older than 14 years old. Multivariate Cox regression was used to identify the independent factors affecting generalized conversions that then were incorporated into the construction of the nomogram.

Results
Two hundred thirty-seven patients (54.5%) had transformed into GMG after a median of 1.1 years (range 0.1-–9.1 years). The 6-, 12-, and 24-month generalized conversion rates were 31.7%, 49.8%, and 65.4%, respectively. Multivariable analysis showed that the early-onset age, male sex, concomitant autoimmune diseases (AID), positive results of anti-acetylcholine receptor antibodies, repetitive nerve stimulation abnormalities, the presence of thymoma, and prednisone treatment were significantly associated with the generalized conversions (hazard ratio [HR] = 0.598, 0.686, 1.554, 1.541, 2.020, 2.510, and 0.556, respectively). A nomogram was established to predict the possibility of generalization-free survival (GFS) in adult-onset OMG patients, and the model demonstrated good predictive performance with a C-index of 0.736 (95% confidence interval 0.703 ~ 0.769). Moreover, subgroup analyses were performed based on the presence or absence of prednisone therapy, and the results indicated that prednisone therapy has better prevention of generalized conversions in male, non-thymoma patients, and patients without other AID.

Conclusion
A new predictive nomograph and web-based survival calculator we developed show favorable applicability and accuracy in predicting long-term GFS in adult-onset OMG patients.