bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vegetarian and vegan diets and the risk of cardiovascular disease, ischemic heart disease and stroke: a systematic review and meta-analysis of prospective cohort studies
Authors: Dybvik Jarle Sæby , Svendsen Mette , Aune Dagfinn 
Published: August 2022

Abstract
Purpose
Vegetarian diets have been associated with reduced risk of ischemic heart disease (IHD). However, results regarding cardiovascular disease (CVD) overall and stroke are less clear. We conducted a systematic review and meta-analysis of prospective cohort studies on CVD, IHD and stroke risk among vegetarians or vegans versus nonvegetarians to clarify these associations.

Methods
PubMed and Ovid Embase databases were searched through August 12, 2021. Prospective cohort studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for incidence or mortality from CVD, IHD and stroke, comparing vegetarians and vegans to nonvegetarians were included. Risk of bias (RoB) was assessed using ROBINS-I and the strength of evidence was assessed using World Cancer Research Fund (WCRF) criteria. Summary RRs (95% CIs) were estimated using a random effects model.

Results
Thirteen cohort studies (844,175 participants, 115,392 CVD, 30,377 IHD, and 14,419 stroke cases) were included. The summary RR for vegetarians vs. nonvegetarians was 0.85 (95% CI: 0.79–0.92, I2 = 68%, n = 8) for CVD, 0.79 (95% CI: 0.71–0.88, I2 = 67%, n = 8) for IHD, 0.90 (95% CI: 0.77–1.05, I2 = 61%, n = 12) for total stroke, and for vegans vs. nonvegetarians was 0.82 (95% CI: 0.68–1.00, I2 = 0%, n = 6) for IHD. RoB was moderate (n = 8) to serious (n = 5). The associations between vegetarian diets and CVD and IHD were considered probably causal using WCRF criteria.

Conclusions
Vegetarian diets are associated with reduced risk of CVD and IHD, but not stroke, but further studies are needed on stroke. These findings should be considered in dietary guidelines.

Review registration
No review protocol registered.
Improving the safety of the Manchester triage system for children with congenital heart disease
Authors: Leeb Franziska , Sharma Ursula , Yeghiazaryan Lusine , Moll Henriëtte A. , Greber-Platzer Susanne 
Published: August 2022

AbstractThis study is a prospective evaluation of the validity of a Manchester triage system (MTS) modification for detecting under-triaged pediatric patients with congenital heart disease (CHD). Children with CHD visiting the emergency unit of the Department of Pediatrics and Adolescent Medicine, University Hospital Vienna in 2014 were included. The MTS modification updated the prioritization of patients with complex syndromic diseases, specific symptoms related to chronic diseases, decreased general condition (DGC), profound language impairment, unknown medical history, or special needs. A four-level outcome severity index based on diagnostic and therapeutic interventions, admission to hospital, and follow-up strategies was defined as a reference standard for the correct clinical classification of the MTS urgency level. Of the 19,264 included children, 940 had CHD. Of this group, 266 fulfilled the inclusion criteria for the modified triage method. The MTS modification was significantly more often applied in under-triaged (65.9%) than correctly or over-triaged (25%) children with CHD (p-value χ2 test < 0.0001, OR 5.848, 95% CI: 3.636–9.6).Conclusion: The MTS urgency level upgrade modification could reduce under-triage in children with CHD. Applying a safety strategy concept to the MTS could mitigate under-triage in such a high-risk patient group.

What is Known:• The Manchester triage system is considered to be valid and reliable but tends to over-triage.• A study by Seiger et al. showed poor performance in children with chronic illnesses, especially in children with cardiovascular diseases.

What is New:• The MTS modification with one urgency level upgrade could decrease under-triage in children with congenital heart disease.• As reference standard a four level outcome severity index (OSI) was established to include diagnostic investigations, medical interventions, hospital admission or follow up visits in the assessment.
Prion strains viewed through the lens of cryo-EM
Authors: Manka Szymon W. , Wenborn Adam , Collinge John , Wadsworth Jonathan D. F. 
Published: August 2022

AbstractMammalian prions are lethal transmissible pathogens that cause fatal neurodegenerative diseases in humans and animals. They consist of fibrils of misfolded, host-encoded prion protein (PrP) which propagate through templated protein polymerisation. Prion strains produce distinct clinicopathological phenotypes in the same host and appear to be encoded by distinct misfolded PrP conformations and assembly states. Despite fundamental advances in our understanding of prion biology, key knowledge gaps remain. These include precise delineation of prion replication mechanisms, detailed explanation of the molecular basis of prion strains and inter-species transmission barriers, and the structural definition of neurotoxic PrP species. Central to addressing these questions is the determination of prion structure. While high-resolution definition of ex vivo prion fibrils once seemed unlikely, recent advances in cryo-electron microscopy (cryo-EM) and computational methods for 3D reconstruction of amyloids have now made this possible. Recently, near-atomic resolution structures of highly infectious, ex vivo prion fibrils from hamster 263K and mouse RML prion strains were reported. The fibrils have a comparable parallel in-register intermolecular β-sheet (PIRIBS) architecture that now provides a structural foundation for understanding prion strain diversity in mammals. Here, we review these new findings and discuss directions for future research.
The Complex Plank Problem, Revisited
Authors: Ortega-Moreno Oscar 
Published: August 2022

AbstractBall’s complex plank theorem states that if $$v_1,\dots ,v_n$$

v
1

,
⋯
,

v
n

are unit vectors in $${\mathbb {C}}^d$$

C

d

, and $$t_1,\dots ,t_n$$

t
1

,
⋯
,

t
n

are non-negative numbers satisfying $$\sum _{k=1}^nt_k^2 = 1$$

∑

k
=
1

n

t
k
2

=
1

, then there exists a unit vector v in $${\mathbb {C}}^d$$

C

d

for which $$|\langle v_k,v \rangle | \ge t_k$$

|

⟨

v
k

,
v
⟩

|
≥

t
k

for every k. Here we present a streamlined version of Ball’s original proof.
RETRACTED ARTICLE: Prediction of gestational diabetes based on explainable deep learning and fog computing
Authors: El-Rashidy Nora , ElSayed Nesma E. , El-Ghamry Amir , Talaat Fatma M. 
Published: August 2022

AbstractGestational diabetes mellitus (GDM) is one of the pregnancy complications that endangers both mothers and babies. GDM is usually diagnosed at 22–26 weeks of gestation. However, early prediction is preferable because it may decrease the risk. The continuous monitoring of the mother’s vital signs helps in predicting any deterioration during pregnancy. The originality of this research is to provide a comprehensive framework for pregnancy women monitoring. The proposed Data Replacement and Prediction Framework consists of three layers, which are: (i) Internet of things (IoT) Layer, (ii) Fog Layer, and (iii) Cloud Layer. The first layer used IoT sensors to aggregate vital signs from pregnancies using invasive and non-invasive sensors. The vital signs are then transmitted to fog nodes to be processed and finally stored in the cloud layer. The main contribution in this research is located in the fog layer producing the GDM module to implement two influential tasks which are as follows: (i) Data Finding Methodology (DFM), and (ii) Explainable Prediction Algorithm (EPM) using DNN. First, the DFM is used to replace the unused data to free up the cache space for new incoming data items. The cache replacement is very important in the case of the healthcare system as the incoming vital signs are frequent and must be replaced continuously. Second, the EPM is used to predict the occurrence of GDM in the second trimester of the pregnancy. To evaluate our model, we extracted data from 16,354 pregnant women from the medical information mart for intensive care (MIMIC III) benchmark dataset. For each woman, vital signs, demographic data, and laboratory tests were aggregated. The results of the prediction model are superior to the state-of-the-art (ACC = 0.957, AUC = 0.942). Regarding explainability, we used Shapley additive explanation (SHAP) framework to provide local and global explanations for the developed models. Overall, the proposed framework is medically intuitive and allows the early prediction of GDM with a cost-effective solution.
Sacroiliac innervation
Authors: Steinke Hanno , Saito Toshiyuki , Kuehner Janne , Reibetanz Uta , Heyde Christoph-Eckhard , Itoh Masahiro , Voelker Anna 
Published: August 2022

Abstract
Purpose
To investigate the innervation pattern of the sacroiliac region, especially with regard to the sacroiliac joint (SIJ). Dorsal SIJ innervation was analyzed and described. Our main hypothesis was that nerves reach the SIJ dorsally, passing ligamental compartments, as this would explain dorsal SIJ pain.

Methods
To examine sacroiliac innervation, we followed the nerves in over 50 specimens over several years. Plastinated slices were evaluated, nerves in the region were stained histologically, and the data were summarized as 3D models.

Results
The Rami communicans and posterior branches of the spinal nerves and their branches that form a dorsal sacral plexus and communicating branches, together with corresponding vessels, were observed to form neurovascular bundles embedded by tiny fatty connectives in gaps and tunnels. Branches of L5-S1 pass the inner sacroiliac ligaments (the interosseous sacroiliac ligament and axial interosseous ligament). The outer sacroiliac ligaments (posterior sacroiliac ligaments, long posterior sacroiliac ligament, sacrotuberal ligament, thoracolumbar fascia) are passed by the S1-S4 branches. However, although the paths of these nerves are in the direction of the SIJ, they do not reach it. It is possible that impingement of the neurovascular bundles may result in pain. Moreover, the gaps and tunnels connect to the open dorsal SIJ.

Conclusion
Our findings suggest that Bogduk’s term “sacroiliac pain” correlates to “sacroiliac innervation”, which consists of “inner-” and “outer sacroiliac ligament innervation”, and to ventral “SIJ pain”. The watery gaps and tunnels observed could play a significant role in innervation and thus in the origins of SIJ pain.

Level of evidence
Individual cross-sectional studies with consistently applied reference standard and blinding.
Finite Element Analysis of Expansive Bedrock Considering Electro-chemo-mechanical Coupling Phenomena in Crystal Layers of Clay Minerals and Internal Structural Degradation
Authors: Hoshi Keitaro , Yamada Shotaro , Kyoya Takashi 
Published: August 2022

AbstractThis research proposes a novel model targeting expansive bedrock by combining an elastoplastic model considering electro-chemo-mechanical phenomena with the Cam-clay model, based on considerations of cementation and its degradation owing to plastic deformation. Additionally, tunnel excavation and swelling analyses are demonstrated by incorporating the proposed model into a finite element analysis code. Specifically, swelling analysis is conducted by decreasing the bedrock ion concentration and by considering the groundwater supply to the tunnel. The simulation results indicate that considerable swelling occurs in a limited area, such as the bottom part of the tunnel, even though changes in ion concentration are uniformly set in the entire analysis area; moreover, swelling phenomena develop instantaneously analogous to the observational records. The simulation reveals that shear stress increases while excavating an area and that softening with plastic expansion occurs in bedrock skeleton owing to decreasing ion concentration. In addition, the yielding of the bedrock skeleton triggers a rapid internal structural degradation and swelling of the clay mineral interlaminar layers based on simulations. Thus, this study clarifies the tunnel swelling deformation mechanism as an interaction problem between coupled electro-chemo-mechanical phenomena occurring in crystal layers and a plastic phenomenon involving the internal structural degradation of the bedrock skeleton.
Surgical safety checklists for dental implant surgeries—a scoping review
Authors: Kupka Johannes Raphael , Sagheb Keyvan , Al-Nawas Bilal , Schiegnitz Eik 
Published: August 2022

Abstract

Objectives
In both elective surgeries and aviation, a reduction of complications can be expected by paying attention to the so-called human factors. Checklists are a well-known way to overcome some of these problems. We aimed to evaluate the current evidence regarding the use of checklists in implant dentistry.

Methods
An electronic literature search was conducted in the following databases: CINHAL, Medline, Web of Science, and Cochrane Library until March 2022. Based on the results and additional literature, a preliminary checklist for surgical implant therapy was designed.

Results
Three publications dealing with dental implants and checklists were identified. One dealt with the use of a checklist in implant dentistry and was described as a quality assessment study. The remaining two studies offered suggestions for checklists based on literature research and expert opinion.

Conclusions
Based on our results, the evidence for the use of checklists in dental implantology is extremely low. Considering the great potential, it can be stated that there is a need to catch up. While creating a new implant checklist, we took care of meeting the criteria for high-quality checklists. Future controlled studies will help to place it on a broad foundation.

Clinical relevance
Checklists are a well-known way to prevent complications. They are especially established in aviation, but many surgical specialties and anesthesia adopt this successful concept. As implantology has become one of the fastest-growing areas of dentistry, it is imperative that checklists become an integral part of it.
Killing pain?: a population-based registry study of the use of prescription analgesics, anxiolytics, and hypnotics among all children, adolescents and young adults in Norway from 2004 to 2019
Authors: Stangeland Helle , Handal Marte , Skurtveit Svetlana Ondrasova , Aakvaag Helene Flood , Dyb Grete , Wentzel-Larsen Tore , Baumann-Larsen Monica , Zwart John Anker , Storheim Kjersti , Stensland Synne Øien 
Published: August 2022

AbstractThe ongoing opioid epidemic has been a global concern for years, increasingly due to its heavy toll on young people’s lives and prospects. Few studies have investigated trends in use of the wider range of drugs prescribed to alleviate pain, psychological distress and insomnia in children, adolescents and young adults. Our aim was to study dispensation as a proxy for use of prescription analgesics, anxiolytics and hypnotics across age groups (0–29 years) and sex over the last 15 years in a large, representative general population. The study used data from a nationwide prescription database, which included information on all drugs dispensed from any pharmacy in Norway from 2004 through 2019. Age-specific trends revealed that the prevalence of use among children and adolescents up to age 14 was consistently low, with the exception of a substantial increase in use of melatonin from age 5. From age 15–29, adolescents and young adults used more prescription drugs with increasing age at all time points, especially analgesics and drugs with higher potential for misuse. Time trends also revealed that children from age 5 were increasingly dispensed melatonin over time, while adolescents from age 15 were increasingly dispensed analgesics, including opioids, gabapentinoids and paracetamol. In contrast, use of benzodiazepines and z-hypnotics slightly declined in young adults over time. Although trends were similar for both sexes, females used more prescription drugs than their male peers overall. The upsurge in use of prescription analgesics, anxiolytics and hypnotics among young people is alarming.Trial registration The study is part of the overarching Killing Pain project. The rationale behind the Killing Pain research was pre-registered through ClinicalTrials.gov on April 7, 2020. Registration number NCT04336605; https://clinicaltrials.gov/ct2/show/record/NCT04336605.
From representations to servomechanisms to oscillators: my journey in the study of cognition
Authors: Cheng Ken 
Published: August 2022

AbstractThe study of comparative cognition bloomed in the 1970s and 1980s with a focus on representations in the heads of animals that undergird what animals can achieve. Even in action-packed domains such as navigation and spatial cognition, a focus on representations prevailed. In the 1990s, I suggested a conception of navigation in terms of navigational servomechanisms. A servomechanism can be said to aim for a goal, with deviations from the goal-directed path registering as an error. The error drives action to reduce the error in a negative-feedback loop. This loop, with the action reducing the very signal that drove action in the first place, is key to defining a servomechanism. Even though actions are crucial components of servomechanisms, my focus was on the representational component that encodes signals and evaluates errors. Recently, I modified and amplified this view in claiming that, in navigation, servomechanisms operate by modulating the performance of oscillators, endogenous units that produce periodic action. The pattern is found from bacteria travelling micrometres to sea turtles travelling thousands of kilometres. This pattern of servomechanisms working with oscillators is found in other realms of cognition and of life. I think that oscillators provide an effective way to organise an organism’s own activities while servomechanisms provide an effective means to adjust to the organism’s environment, including that of its own body.
The value of EEG attenuation in the prediction of outcome in COVID-19 patients
Authors: Marinelli Lucio , Pappalardo Irene , Robba Chiara , Saitta Laura , Cabona Corrado , Battaglini Denise , Casaleggio Monia , Bellini Anna , Ferrari Alessandra , Brunetti Iole , Villani Flavio 
Published: August 2022

Abstract
Introduction

During the COVID-19 pandemic, electroencephalography (EEG) proved to be a useful tool to demonstrate brain involvement. Many studies reported non-reactive generalized slowing as the most frequent pattern and epileptiform activity in a minority of patients.

Objective
To investigate the prevalence of diffuse unreactive background attenuation or suppression and its correlation with outcome in a cohort of COVID-19 patients.

Methods
The EEGs recorded during the first year of the COVID-19 pandemic were retrospectively evaluated to identify the main pattern and focus on the occurrence of a low-voltage background, either attenuated (10–20 μV) or suppressed (< 10 μV). We sought a correlation between in-hospital mortality and low-voltage EEG. In a subsample of patients, biomarkers of inflammation, hypoxemia and organ failure were collected. Brain imaging was also evaluated.

Results
Among 98 EEG performed in 50 consecutive patients, diffuse unreactive slowing was the most prevalent pattern (54%), followed by unreactive attenuation or suppression pattern (26%), being the latter significantly correlated with an unfavourable outcome (p = 0.0004). Survivors showed significantly lower interleukine-6 values compared to non-survivors. Patients with attenuated EEG and non-survivors also showed lower PaO2/FiO2 values. Neuroradiological findings were very heterogeneous with a prevalence of lesions suggestive of a microangiopathic substrate.

Conclusions
EEG attenuation or suppression may be more frequent than previously reported and significantly associated with a poor outcome. SARS-CoV-2 infection may result in encephalopathy and reduced EEG voltage through mechanisms that are still unknown but deserve attention given its negative impact on prognosis.
Long-term oncological outcomes after local excision of T1 rectal cancer
Authors: Leijtens J. W. A. , Smits L. J. H. , Koedam T. W. A. , Orsini R. G. , van Aalten S. M. , Verseveld M. , Doornebosch P. G. , de Graaf E. J. R. , Tuynman J. B. 
Published: August 2022

Abstract
Background
A growing proportion of patients with early rectal cancer is treated by local excision only. The aim of this study was to evaluate long-term oncological outcomes and the impact of local recurrence on overall survival for surgical local excision in pT1 rectal cancer.

Methods
Patients who only underwent local excision for pT1 rectal cancer between 1997 and 2014 in two Dutch tertiary referral hospitals were included in this retrospective cohort study. The primary outcome was the local recurrence rate. Secondary outcomes were distant recurrence, overall survival and the impact of local recurrence on overall survival.

Results
A total of 150 patients (mean age 68.5 ± 10.7 years, 57.3% males) were included in the study. Median length of follow-up was 58.9 months (range 6–176 months). Local recurrence occurred in 22.7% (n = 34) of the patients, with a median time to local recurrence of 11.1 months (range 2.3–82.6 months). The vast majority of local recurrences were located in the lumen. Five-year overall survival was 82.0%, and landmark analyses showed that local recurrence significantly impacted overall survival at 6 and 36 months of follow-up (6 months, p = 0.034, 36 months, p = 0.036).

Conclusions
Local recurrence rates after local excision of early rectal cancer can be substantial and may impact overall survival. Therefore, clinical decision-making should be based on patient- and tumour characteristics and should incorporate patient preferences.
Electrochemical treatment of wastewater to remove contaminants from the production and disposal of plastics: a review
Authors: Malinović Borislav N. , Markelj Jernej , Žgajnar Gotvajn Andreja , Kralj Cigić Irena , Prosen Helena 
Published: August 2022

AbstractWastewater is major source of contaminants originating from the production, usage, and disposal of plastic materials. Due to their poor biodegradability of these contaminants in municipal wastewater treatment plants, additional advanced oxidation processes such as electrochemical treatments have been developed to improve the standard biological treatment. Here we review the applications of electrochemical treatments of wastewater for the removal of the following plastic contaminants: bisphenol A, phthalic acid esters, and benzotriazoles. We present the effectiveness of treatment in terms of contaminant removal and mineralization; the identification of transformation products; toxicity assessment; and process energy requirements. In the present review, we have focused on the applications of electrochemical treatments of wastewater for the removal of three important groups of contaminants originating mainly from plastics: bisphenol A, phthalic acid esters, and benzotriazoles. The review focuses on the research of electrochemical treatments for these contaminants from the last five years. The papers are assessed from the point of i) effectiveness of treatment in terms of contaminant removal and mineralization; ii) identification of transformation products; iii) toxicity assessment; iv) processes’ energy requirements. Electrochemical treatments were confirmed to be a viable option for the removal of selected contaminants from wastewater.