bluuebunny/crossref_metadata_2025_split huggingface dataset:
Einsatz von künstlicher Intelligenz im Screening auf diabetische Retinopathie an einer diabetologischen Schwerpunktklinik
Authors: Paul Sebastian , Tayar Allam , Morawiec-Kisiel Ewa , Bohl Beathe , Großjohann Rico , Hunfeld Elisabeth , Busch Martin , Pfeil Johanna M. , Dähmcke Merlin , Brauckmann Tara , Eilts Sonja , Bründer Marie-Christine , Grundel Milena , Grundel Bastian , Tost Frank , Kuhn Jana , Reindel Jörg , Kerner Wolfgang , Stahl Andreas 
Published: January 2022

Zusammenfassung
Hintergrund
Seit 2018 ist mit IDx-DR ein Verfahren auf dem Markt, welches den Grad der diabetischen Retinopathie (DR) mittels künstlicher Intelligenz (KI) bestimmt.

Methoden
Wir haben IDx-DR in die Sprechstunde an einer diabetologischen Schwerpunktklinik integriert und berichten über die Übereinstimmung zwischen IDx-DR (IDx Technologies Inc., Coralville, IA, USA) und Funduskopie sowie IDx-DR und ophthalmologischer Bildbeurteilung sowie über den Einfluss unterschiedlicher Kamerasysteme.

Ergebnisse
Mit der Topcon-Kamera (n = 456; NW400, Topcon Medical Systems, Oakland, NJ, USA) konnte im Vergleich zur Zeiss-Kamera (n = 47; Zeiss VISUCAM 500, Carl Zeiss Meditec AG, Jena, Deutschland) häufiger eine ausreichende Bildqualität in Miosis erreicht werden. Insgesamt war bei etwa 60 % der Patienten eine IDx-DR-Analyse in Miosis möglich. Alle Patienten, bei denen keine IDx-DR-Analyse in Miosis möglich war, konnten in Mydriasis funduskopiert werden. Innerhalb der Gruppe der auswertbaren Befunde zeigte sich eine Übereinstimmung zwischen IDx-DR und augenärztlicher Funduoskopie in ca. 55 %, ein Überschätzen des Schweregrads durch IDx-DR in ca. 40 % und ein Unterschätzen in ca. 4 %. Die Sensitivität (Spezifität) für das Erkennen einer schweren, behandlungsbedürftigen Retinopathie lag bei 95,7 % (89,1 %) für Fälle mit auswertbaren Fundusaufnahmen und bei 65,2 % (66,7 %), wenn alle Fälle betrachtet werden (inklusive derjeniger ohne verwertbare Aufnahme in Miosis). Der Kappa-Koeffizient zeigt mit 0,334 (p < 0,001) eine ausreichende Übereinstimmung zwischen IDx-DR und ärztlicher Bildauswertung anhand des Fundusfotos unter Berücksichtigung aller Patienten mit auswertbarer IDx-DR-Analyse. Der Vergleich zwischen IDx-DR mit der ärztlichen Funduskopie ergibt unter denselben Voraussetzungen eine geringe Übereinstimmung mit einem Kappa-Wert von 0,168 (p < 0,001).

Schlussfolgerung
Die vorliegende Studie zeigt Möglichkeiten und Grenzen des KI-gestützten DR-Screenings auf. Eine wesentliche Einschränkung liegt in der Tatsache, dass bei ca. 40 % der Patienten keine ausreichenden Aufnahmen in Miosis gewonnen werden konnten. Wenn ausreichende Aufnahmen vorlagen, stimmten IDx-DR und augenärztliche Diagnose in über 50 % der Fälle überein. Ein Unterschätzen des Schweregrades durch IDx-DR kam selten vor. Für die Integration in augenärztlich unterstützten Sprechstunden erscheint uns das System grundsätzlich geeignet. Die hohe Rate an fehlenden Aufnahmen in Miosis stellt allerdings eine Limitation dar, die einen Einsatz ohne augenärztliche Kontrollmöglichkeit schwierig erscheinen lässt.
Synergistic effect of El Niño and the North Pacific Oscillation on wintertime precipitation over Southeastern China and the East China Sea Kuroshio area
Authors: Sun Yue , Li Jianping 
Published: January 2022

AbstractWintertime precipitation in China is most pronounced over the southeastern area, and the Kuroshio in the East China Sea anchors a prominent precipitation band over the warm side of the sea surface temperature front. Previous studies have suggested that many factors contribute to the interannual variation of the precipitation over southeastern China (SC), whereas less attention has been paid to precipitation variability over the East China Sea Kuroshio (ECSK) area. This study focuses on the interannual variation of wintertime precipitation over the SC and ECSK areas. Empirical orthogonal function analysis reveals a spatially uniform pattern from SC to the ECSK area. Composite analysis shows that an El Niño event intensifies wintertime precipitation over our target region, and this effect is tripled when an El Niño follows a positive North Pacific Oscillation (NPO) event in the previous winter. The positive NPO event in the previous winter intensifies the El Niño event via the Victoria mode ocean bridge and the subsequent Bjerknes feedback. In comparison with single-factor El Niño events, a much weaker Walker cell induced by the joint event induces a much weaker regional Hadley cell through anomalous descending motion over the western tropical Pacific. The weakened regional Hadley circulation over the western Pacific directly enhances the precipitation over the SC and ECSK area. In this study, the synergistic effect of an El Niño event and a positive NPO event indicates that the influence of the El Niño event can be amplified by the positive NPO event in the previous winter.
Association between compliance with enhanced recovery after surgery (ERAS) protocols and postoperative outcome in patients with primary liver cancer undergoing hepatic resection
Authors: Feng Jinhua , Li Ka , Xu Ruihua , Feng Huan , Han Qiang , Ye Hui , Li Fuyu 
Published: January 2022

Abstract
Background
Enhanced recovery after surgery (ERAS) is a multidisciplinary, stress-minimizing approach that is associated with improved postoperative outcomes. However, whether the level of compliance with ERAS protocols impacts the postoperative outcome of patients with primary liver cancer undergoing liver resection is unknown. The study aimed to analyze the association between compliance with ERAS protocols and liver resection outcomes.

Methods
This prospective cohort study consecutively recruited patients with primary liver cancer who were scheduled for elective liver surgery between January 2019 and December 2020 at the Department of Biliary Surgery, West China Hospital of Sichuan University. Twenty individual ERAS items were assessed in all patients. The patients were divided into two groups according to their degree of compliance with the ERAS interventions: an ERAS-compliant (ERAS-C) group of individuals who complied with over 75% of the ERAS components and an ERAS-noncompliant (ERAS-N) group. The primary outcomes were ERAS compliance, occurrence of major complications within 30 days postoperatively, and length of postoperative hospital stay. The secondary outcomes were 30-day readmissions, reoperations and other rehabilitation indicators. The study was registered at www.chictr.org.cn (identity number ChiCTR2000040021).

Results
Overall, 436 patients were enrolled; their mean age was 54 years (interquartile range [IQR], 47–66). Of these patients, 206 were allocated to the ERAS-C group, and the other 230 patients comprised the ERAS-N group. The overall compliance rate was 70% (IQR, 65%-80%). The ERAS-C group had higher compliance rates [80.00% (IQR, 75.00–85.00%)] than the ERAS-N group [65.00% (IQR, 65.00–70.00%)], P < 0.001). The ERAS-C group had significantly fewer major complications (7.77% vs. 15.65%, OR, 0.449, 95% CI, 0.241–0.836, P = 0.012) and shorter postoperative hospital stays (5 days [IQR, 4–6] vs. 6 days [IQR, 5–7], P < 0.001) than the ERAS-N group. Subgroup analysis indicated that compliance rates greater than 80%, between 65 and 80%, and lower than 65% were associated with decreased major complication rates (6.25%, 8.48% and 22.83%, respectively) and shorter postoperative hospital stays. However, the rates of ICU stay, readmission, reoperation and mortality within 30 days after surgery were not different between groups (P > 0.05).

Conclusion
The results of this study suggest that higher compliance with ERAS components is associated with a lower incidence of major postoperative complications and a shorter postoperative hospital stay.
Clinical effects and safety of different transarterial chemoembolization methods for bridging and palliative treatments in hepatocellular carcinoma
Authors: Mohr Isabelle , Vogeler Marie , Pfeiffenberger Jan , Sprengel Simon David , Klauss Miriam , Radeleff Boris , Teufel Andreas , Chang De-Hua , Springfeld Christoph , Longerich Thomas , Merle Uta , Mehrabi Arianeb , Weiss Karl Heinz , Mieth Markus 
Published: January 2022

Abstract
Purpose
We assessed and compared clinical effects and safety endpoints of three methods of transarterial chemoembolization (TACE), conventional (cTACE), with drug-eluting beads (DEB-TACE), and with degradable starch microspheres (DSM-TACE), used in patients with hepatocellular carcinoma (HCC) in the bridging to liver transplant (LT) and the palliative setting.

Methods
In our center, 148 patients with HCC underwent 492 completed TACE procedures between 2008 and 2017 (158 for bridging to LT; 334 for palliative treatment) which we analyzed retrospectively. Of these procedures, 348 were DEB-TACE, 60 cTACE, and 84 DSM-TACE.

Results
The cTACE procedure revealed a significantly longer period of hospitalization (p = 0.02), increased occurrence of nausea (p = 0.025), and rise in alanine transaminase (ALT) levels (p = 0.001), especially in the palliative setting. In the bridging to LT cohort, these clinical endpoints did not reach statistical significance.

Conclusions
The clinical safety of different TACE methods for HCC in both the palliative and the bridging to LT setting was equivalent. In the palliative setting, the cTACE procedure revealed an increased risk for adverse clinical effects such as nausea, elevation of ALT, and a prolonged period of hospitalization what might either be related to the systemic effects of the chemotherapeutic agent or to the differences in both collectives. Thus, further studies must be conducted on a larger number of TACE procedures to effectively explore the clinical side effects of the various TACE variants.
Identification of bacterial lipo-amino acids: origin of regenerated fatty acid carboxylate from dissociation of lipo-glutamate anion
Authors: Hueber Amandine , Gimbert Yves , Langevin Geoffrey , Galano Jean-Marie , Guy Alexandre , Durand Thierry , Cenac Nicolas , Bertrand-Michel Justine , Tabet Jean-Claude 
Published: January 2022

AbstractThe identification of bacterial metabolites produced by the microbiota is a key point to understand its role in human health. Among them, lipo-amino acids (LpAA), which are able to cross the epithelial barrier and to act on the host, are poorly identified. Structural elucidation of few of them was performed by high-resolution tandem mass spectrometry based on electrospray combined with selective ion dissociations reach by collision-induced dissociation (CID). The negative ions were used for their advantages of yielding only few fragment ions sufficient to specify each part of LpAA with sensitivity. To find specific processes that help structural assignment, the negative ion dissociations have been scrutinized for an LpAA: theN-palmitoyl acyl group linked to glutamic acid (C16Glu). The singular behavior of [C16Glu-H]¯ towards CID showed tenth product ions, eight were described by expected fragment ions. In contrast, instead of the expected product ions due to CONH-CH bond cleavage, an abundant complementary dehydrated glutamic acid and fatty acid anion pair were observed. Specific to glutamic moiety, they were formed by a stepwise dissociation via molecular isomerization through ion–dipole formation prior to dissociation. This complex dissociated by partner splitting either directly or after inter-partner proton transfer. By this pathway, surprising regeneration of deprotonated fatty acid takes place. Such regeneration is comparable to that occurred from dissociation to peptides containing acid amino-acid. Modeling allow to confirm the proposed mechanisms explaining the unexpected behavior of this glutamate conjugate.
Cultural biodiversity unpacked, separating discourse from practice
Authors: Mariani Mariagiulia , Cerdan Claire , Peri Iuri 
Published: January 2022

AbstractIn this article, we question to what extent origin-food labels, namely Geographical Indications (GIs) and Slow Food Presidia, may effectively account for cultural biodiversity (CB). Building on Foucault’s discourse theory, we question how the Slow Food movement and GI promoters have developed their own discourse and practice on CB, how these discourses contrast, and how they inform projects. Focusing on the practices to cultivate the microbiological life of three origin labeled cheeses (from France and Italy), we have revealed the gap between these institutional discourses and what happens on the ground. We argue that how actors’ relationships in the marketplace unfold, from public authorities to the collectives of producers to consumers, may threaten the effects that these experiences of alternative food productions may have in the defense of biodiversity, causing, for instance, the loss of diversity of the invisible microbial ecosystems of artisan raw milk cheese. However, we conclude that, despite limitations, the mediatized institutional narrative on CB can amplify the political voice of local actors by fostering community and social relationships between the farmers.
Understanding metabolic alterations and heterogeneity in cancer progression through validated immunodetection of key molecular components: a case of carbonic anhydrase IX
Authors: Takacova Martina , Kajanova Ivana , Kolarcikova Maria , Lapinova Jana , Zatovicova Miriam , Pastorekova Silvia 
Published: January 2022

AbstractCancer metabolic heterogeneity develops in response to both intrinsic factors (mutations leading to activation of oncogenic pathways) and extrinsic factors (physiological and molecular signals from the extracellular milieu). Here we review causes and consequences of metabolic alterations in cancer cells with focus on hypoxia and acidosis, and with particular attention to carbonic anhydrase IX (CA IX). CA IX is a cancer-associated enzyme induced and activated by hypoxia in a broad range of tumor types, where it participates in pH regulation as well as in molecular mechanisms supporting cancer cells’ invasion and metastasis. CA IX catalyzes reversible conversion of carbon dioxide to bicarbonate ion plus proton and cooperates with a spectrum of molecules transporting ions or metabolites across the plasma membrane. Thereby CA IX contributes to extracellular acidosis as well as to buffering intracellular pH, which is essential for cell survival, metabolic performance, and proliferation of cancer cells. Since CA IX expression pattern reflects gradients of oxygen, pH, and other intratumoral factors, we use it as a paradigm to discuss an impact of antibody quality and research material on investigating metabolic reprogramming of tumor tissue. Based on the validation, we propose the most reliable CA IX-specific antibodies and suggest conditions for faithful immunohistochemical analysis of molecules contributing to heterogeneity in cancer progression.
Resveratrol Alleviates Hepatic Fibrosis in Associated with Decreased Endoplasmic Reticulum Stress-Mediated Apoptosis and Inflammation
Authors: Ma Zhenyu , Sheng Lulu , Li Juan , Qian Jianmin , Wu Gang , Wang Zhengxin , Zhang Yi 
Published: January 2022

Abstract—Hepatic fibrosis (HF) is the typical response to chronic liver disease and is characterized by deposition of abundant extracellular matrix. The aim of the present study was to investigate the protective effect of resveratrol (RSV) in a CCl4-induced rat model of HF. We demonstrate that the administration of RSV effectively improves liver function and ameliorates liver fibrosis by reducing collagen deposition and reversing the expression of COL1A1 and PPAR-γ. Treatment efficacy of RSV could be attributed to reversed epithelial-mesenchymal transition progress with upregulated expression of E-cadherin and downregulated N-cadherin, vimentin, and α-SMA. Moreover, RSV significantly decreased the levels of endoplasmic reticulum stress (ERS)-related proteins CHOP; Bip; cleaved caspase-3, caspase-7, and caspase-12; Bax; and Bak while promotes the expression of anti-apoptosis protein Bcl2. The important role of ERS in HF was confirmed by using 4-PBA, an ERS inhibitor, which markedly ameliorated CCl4-induced HF. Further, mechanistic studies demonstrated that RSV significantly decreased CCl4-induced transforming growth factor-β synthesis and inflammatory factor (tumor necrosis factor-α and interleukin-6) expression and reduced the inflammation of hepatic stellate cells by inhibiting the NF-κB pathway in vivo and in vitro. In conclusion, the results suggested that RSV ameliorated HF in associated with decreased ERS-induced apoptosis and inflammation in rats.
Is strategic interaction among governments just a modern phenomenon? Evidence on welfare competition under Britain’s 19th-century Poor Law
Authors: Brueckner Jan K. 
Published: January 2022

AbstractDrawing on data from mid-19th century Britain, this paper studies strategic interaction among local governments in the choice of welfare benefits under the Poor Law, the local welfare system of the time. The paper exploits a national reform that reduced the length of residency required for welfare eligibility, which should have increased the incentive for welfare migration and thus led to both stronger strategic interaction and lower levels of equilibrium spending. The results show evidence of a positive but small degree of baseline interaction, suggesting that modern models of welfare competition may apply even in settings with relatively high migration costs. While the change in post-reform equilibrium spending is negative as predicted, the results show no evidence of stronger interaction after the reform.
Exceptional sequences of 8 line bundles on $$({\mathbb {P}}^1)^3$$
Authors: Altmann Klaus , Altmann Martin 
Published: January 2022

AbstractWe investigate maximal exceptional sequences of line bundles on $$({\mathbb {P}}^1)^r$$

(

P

1

)

r

, i.e., those consisting of $$2^r$$

2
r

elements. For $$r=3$$

r
=
3

we show that they are always full, meaning that they generate the derived category. Everything is done in the discrete setup: Exceptional sequences of line bundles appear as special finite subsets $${s}$$
s
of the Picard group $${\mathbb {Z}}^r$$

Z

r

of $$({\mathbb {P}}^1)^r$$

(

P

1

)

r

, and the question of generation is understood like a process of contamination of the whole $${\mathbb {Z}}^r$$

Z

r

out of an infectious seed $${s}$$
s
.
The Role of Grandparental Sensitivity and Parental Sensitivity in Infant Cognitive Development in China: A Pilot Study
Authors: Li Wei , Emmen Rosanneke , Woudstra Mi-lan , Branger Marjolein , Wang Lamei , Alink Lenneke , Mesman Judi 
Published: January 2022

AbstractGrandparental caregiving is common in China, which can directly impact grandchild development. In addition, grandparents may have an indirect impact on children through their relationship with and support of the parents. However, associations between grandparenting, parenting, and child outcomes are rarely investigated. The current study is a pilot study which includes 42 mothers, fathers, and co-residing grandparents in China, and examines whether grandparental sensitivity relates to parental sensitivity (biological child of the grandparent), and whether grandparental sensitivity and maternal and paternal sensitivity each uniquely contribute to 14-month-old children’s Executive Function (EF). Results did not show a significant relation between parental and grandparental sensitivity or a unique contribution of sensitivity from mothers, fathers, or grandparents to infant EF. Our findings from exploratory analyses showed differences in sensitivity of grandparents and parents towards the third generation but did not confirm a combined effect of multiple caregivers on infant EF development in China.
Impact of catheter contact angle on lesion formation and durability of pulmonary vein isolation
Authors: Ohta Masayuki , Hayashi Kentaro , Sato Hiroyuki , Noto Takahiro , Kawahatsu Kandoh , Katagiri Masaya , Mita Tomohiro , Kazuno Yoshio , Sasaki Shunsuke , Doi Takahiro , Hirokami Mitsugu , Yuda Satoshi 
Published: January 2022

Abstract

Purpose
This study is aimed to evaluate the impact of catheter contact angle on lesion formation and durability of pulmonary vein isolation (PVI).

Methods
Both in vitro experiment and retrospective observational study were conducted. For in vitro experiment, radiofrequency lesions were created on explanted swine hearts in three different catheter contact angles (0°, 45°, and 90°). In the retrospective observational study, we assessed patients who had undergone repeat catheter ablation due to atrial fibrillation recurrence after initial PVI. When pulmonary vein (PV) reconnection was observed, we analyzed the previous ablation points within and without the gap area. The gap areas were where ablation had changed the PV activation sequence or eliminated the PV potential in the repeat session.

Results
In the in vitro experiment, lesion width was the smallest (5.3 ± 0.4 mm) in perpendicular contact compared to 0° (vs 5.8 ± 0.5 mm, p = 0.040) and 45° (vs 6.4 ± 0.4 mm, p < 0.001). In the retrospective observational study, we assessed 666 tags of 16 patients with PV reconnections, and 60 tags were in the gap area. Tags in the gap area had longer interlesion distance (odds ratio [OR] 1.49, p < 0.001), greater contact force variability (OR 1.03, p = 0.008), and higher rate of perpendicular contact (OR 3.26, p < 0.001) on multivariate analysis.

Conclusions
Perpendicular contact was associated with a smaller lesion and higher rate of PV reconnection.
Phosphate Fixation and P Mineralogy on Natural and Ca-Modified Zeolites During Simultaneous Nutrient Removal
Authors: Stocker Kristina , Ellersdorfer Markus 
Published: January 2022

AbstractThe recovery and recycling of nutrients (N&P) from wastewater are one of the major topics to save primary energy and resources, to raise the efficiency of wastewater treatment plants, and to foster a future circular economy. In the present study, the removal of ammonium (NH4+) and phosphate (PO43−) using natural and Ca-treated zeolite is investigated in detail. Special emphasis is put on the simultaneous removal of both species from model solutions followed by elaborate mineralogical analyses (XRD, EPMA, FEG-SEM) for zeolite characterization and in order to determine the type, structure, and crystal sizes of CaP-phases precipitating on the zeolites surface. The effectivity of the phosphate segregation and chemical composition and the crystalline structure of the CaP-phase precipitating on the surface of the zeolite depend on the physico chemical conditions in particular on pH, molar ratio of Ca and P (due to zeolite modification), and the presence of NH4+. Results of simultaneous removal experiments of N&P revealed that Ca pretreatment enhances P segregation and increases the obtainable P-loadings of Ca–zeolites. Maximum P-loadings of 25 mg g−1 Ca–zeolite in binary solutions containing both ammonium and phosphate were obtained. Simultaneous phosphate removal by surface precipitation of CaP-phases does not significantly influence ammonium ion exchange and the type of CaP-precipitates formed on the zeolite surface is assumed to be mainly brushite and apatite.