bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redefining the role of surgery in early small-cell lung cancer
Authors: Doerr Fabian , Stange Sebastian , Michel Maximilian , Schlachtenberger Georg , Menghesha Hruy , Wahlers Thorsten , Hekmat Khosro , Heldwein Matthias B. 
Published: August 2022

Abstract
Purpose
Resection is guideline recommended in stage I small-cell lung cancer (SCLC) but not in stage II. In this stage, patients are treated with a non-surgical approach. The aim of this meta-analysis was to assess the role of surgery in both SCLC stages. Surgically treated patients were compared to non-surgical controls. Five-year survival rates were analysed.

Methods
A systematic literature search was performed on December 01, 2021 in Medline, Embase and Cochrane Library. Studies published since 2004 on the effect of surgery in SCLC were considered and assessed using ROBINS-I. We preformed I2-tests, Q-statistics, DerSimonian-Laird tests and Egger-regression. The meta-analysis was conducted according to PRISMA.

Results
Out of 6826 records, we identified seven original studies with a total of 15,170 patients that met our inclusion criteria. We found heterogeneity between these studies and ruled out any publication bias. Patient characteristics did not significantly differ between the two groups (p-value > 0.05). The 5-year survival rates in stage I were 47.4 ± 11.6% for the ‘surgery group’ and 21.7 ± 11.3% for the ‘non-surgery group’ (p-value = 0.0006). Our analysis of stage II SCLC revealed a significant survival benefit after surgery (40.2 ± 21.6% versus 21.2 ± 17.3%; p-value = 0.0474).

Conclusion
Based on our data, the role of surgery in stage I and II SCLC is robust, since it improves the long-term survival in both stages significantly. Hence, feasibility of surgery as a priority treatment should always be evaluated not only in stage I SCLC but also in stage II, for which guideline recommendations might have to be reassessed.
Molecular subtyping of gastroesophageal dysplasia heterogeneity according to TCGA/ACRG classes
Authors: Angerilli Valentina , Pennelli Gianmaria , Galuppini Francesca , Realdon Stefano , Fantin Alberto , Savarino Edoardo , Farinati Fabio , Mastracci Luca , Luchini Claudio , Fassan Matteo 
Published: August 2022

AbstractGastric adenocarcinoma has recently been classified into several subtypes on the basis of molecular profiling, which has been successfully reproduced by immunohistochemistry (IHC) and in situ hybridization (ISH). A series of 73 gastroesophageal dysplastic lesions (37 gastric dysplasia and 36 Barrett dysplasia; 44 low-grade dysplasia and 29 high-grade dysplasia) was investigated for mismatch repair proteins, E-cadherin, p53, and EBER status, to reproduce The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG) molecular clustering. Overall, the dysplastic lesions were classified as follows: according to TCGA classification, EBV, 0/73 (0%), MSI, 6/73 (8.2%), GS, 4/73 (5.5%), CIN, 63/73 (86.3%); according to ACRG molecular subtyping, MSI, 6/73 (8.2%), MSS/EMT, 4/73 (5.5%), MSS/TP53−, 33/73 (45.2%), MSS/TP53+, 30/73 (41.1%). A positive association was found between MSS/TP53− and Barrett dysplasia (p = 0.0004), between MSS/TP53+ and LG dysplasia (p = 0.001) and between MSS/TP53+ and gastric dysplasia (p = 0.0018). Gastroesophageal dysplastic lesions proved to be heterogenous in terms of TCGA/ACRG classes, but with a different distribution from that of cancers, with no EBV-positive cases, an increasing presence of mismatch repair deficiency from low grade to high grade lesions, and a prevalence of p53 aberrations in Barrett dysplasia. The present study further demonstrated that gastroesophageal dysplastic lesions may be characterized by alterations in predictive/prognostic biomarkers, and this should be considered in routine diagnostic.
Prediction of laparoscopic skills: objective learning curve analysis
Authors: Rahimi A. Masie , Hardon Sem F. , Uluç Ezgi , Bonjer H. Jaap , Daams Freek 
Published: August 2022

Abstract
Introduction
Prediction of proficiency of laparoscopic skills is essential to establish personalized training programs. Objective assessment of laparoscopic skills has been validated in a laparoscopic box trainer with force, motion and time recognition. The aim of this study is to investigate whether acquiring proficiency of laparoscopic skills can be predicted based on performance in such a training box.

Methods
Surgical residents in their first year of training performed six different tasks in the Lapron box trainer. Force, motion and time data, three objective measures of tissue manipulation and instrument handling, were collected and analyzed for the six different tasks. Linear regression tests were used to predict the learning curve and the number of repetitions required to reach proficiency.

Results
A total of 6010 practice sessions performed by 42 trainees from 13 Dutch hospitals were assessed and included for analysis. Proficiency level was determined as a mean result of seven experts performing 42 trials. Learning curve graphs and prediction models for each task were calculated. A significant relationship between force, motion and time during six different tasks and prediction of proficiency was present in 17 out of 18 analyses.

Conclusion
The learning curve of proficiency of laparoscopic skills can accurately be predicted after three repetitions of six tasks in a training box with force, path length and time recognition. This will facilitate personalized training programs in laparoscopic surgery.
Konzeptionen von Simulationen mit Simulationspersonen für die Medizinethik-Lehre
Authors: Seifart Carola , Schönbauer Andrea , Monteverde Settimio , Krones Tanja 
Published: August 2022

ZusammenfassungSimulationen mit Simulationspersonen (Schauspieler*innen) gehören in der medizinischen Lehre zum Ausbildungs-Standard. In der medizinethischen Lehre ist dies bisher nicht in gleichem Umfang der Fall. Für ihren Einsatz, insbesondere in der klinischen Ethik, können gute Gründe angeführt werden, wie beispielsweise die Möglichkeit konkreter Erfahrungen als Lehrelement und die situationsspezifische Verbindung von Wissen, Können und Haltungen in einem Lernprozess. Die Konzeption von Simulationen mit Simulationspersonen in der medizinethischen Lehre ist jedoch voraussetzungsreich. Es müssen die mehrdimensionalen Lernziele und die Anforderungen an die medizinethische Lehre berücksichtigt werden. Der Beitrag möchte anhand eines konkreten Beispiels einen Überblick über die Entwicklung und Konzeption von Drehbüchern bzw. Rollen-Skripten für Simulationen mit Simulationspersonen für die Lehre in der klinischen Ethik als wichtigem Teilbereich der Medizinethik geben. Dabei wird auf die besonderen Voraussetzungen und Spezifika dieser Simulationen eingegangen. Abschließend wird kritisch diskutiert, welchen Stellenwert das Training von kommunikativen Fertigkeiten in der medizinethischen Theorie und klinisch-ethischen Praxis haben kann und soll. Der Beitrag schließt mit der Überlegung, ob nicht auch in der Fortbildung von klinischen Ethiker*innen Simulationspersonen zum Einsatz kommen sollten.
A confirmatory factorial analysis of the Chatbot Usability Scale: a multilanguage validation
Authors: Borsci Simone , Schmettow Martin , Malizia Alessio , Chamberlain Alan , van der Velde Frank 
Published: August 2022

Abstract
The Bot Usability Scale (BUS) is a standardised tool to assess and compare the satisfaction of users after interacting with chatbots to support the development of usable conversational systems. The English version of the 15-item BUS scale (BUS-15) was the result of an exploratory factorial analysis; a confirmatory factorial analysis tests the replicability of the initial model and further explores the properties of the scale aiming to optimise this tool seeking for the stability of the original model, the potential reduction of items, and testing multiple language versions of the scale. BUS-15 and the usability metrics for user experience (UMUX-LITE), used here for convergent validity purposes, were translated from English to Spanish, German, and Dutch. A total of 1292 questionnaires were completed in multiple languages; these were collected from 209 participants interacting with an overall pool of 26 chatbots. BUS-15 was acceptably reliable; however, a shorter and more reliable solution with 11 items (BUS-11) emerged from the data. The satisfaction ratings obtained with the translated version of BUS-11 were not significantly different from the original version in English, suggesting that the BUS-11 could be used in multiple languages. The results also suggested that the age of participants seems to affect the evaluation when using the scale, with older participants significantly rating the chatbots as less satisfactory, when compared to younger participants. In line with the expectations, based on reliability, BUS-11 positively correlates with UMUX-LITE scale. The new version of the scale (BUS-11) aims to facilitate the evaluation with chatbots, and its diffusion could help practitioners to compare the performances and benchmark chatbots during the product assessment stage. This tool could be a way to harmonise and enable comparability in the field of human and conversational agent interaction.
Imbalance of Th17, Treg, and helper innate lymphoid cell in the peripheral blood of patients with rheumatoid arthritis
Authors: Wang Ting , Rui Jinbing , Shan Wenqi , Xue Fei , Feng Dingqi , Dong Liyang , Mao Jiahui , Shu Yang , Mao Chaoming , Wang Xuefeng 
Published: August 2022

Abstract
Introduction
Rheumatoid arthritis (RA) is a chronic inflammatory disease involving a variety of immune cells, including adaptive T and B cells and innate lymphoid cells (ILCs). Understanding the pathogenic role of these immune cells in RA provides new insights into the intervention and treatment of RA.

Methods
A total of 86 patients with RA (RA group) and 50 healthy controls (HC) were included in the study. The immune cells of CD4+, CD19+ B, NK, Th17, Treg, ILCs, and their subsets (i.e., ILC1s, ILC2s, and ILC3s) were characterized in peripheral blood mononuclear cells by flow cytometry. Cytokines (i.e., IFN-γ, IL-4, IL-10, IL-17A, IL-22, and IL-33) in sera were detected using ELISA. The above immune cells and cytokines were analyzed in patients with different disease activity status and positive ( +) or negative ( −) rheumatoid factor (RF)/anti-citrullinated protein antibodies (ACPA).

Results
Patients with RA had higher percentages of CD4+ T, CD19+ B, Th17, ILC2s, and ILC3s and lower percentages of Treg and ILC1s than HC. Patients with RA had elevated levels of IFN-γ, IL-4, IL-17A, and IL-22 and decreased level of IL-10. Compared with HC, patients with high disease activity had higher percentages of Th17, ILC2s, and ILC3s; lower percentages of ILC1s; and lower level of IL-10. The percentage of Treg cells in remission, low, moderate, and high disease activities decreased, whereas the level of IL-17A increased compared with HC. Furthermore, RF+ or ACPA+ patients exhibited elevated percentages of CD19+ B, ILC2s, and ILC3s and had decreased percentage of ILC1s and Treg cells than HC. The percentage of Th17 cells increased in RF−/ACPA− and RF+/ACPA+ patients. However, the above immune cells between RF or ACPA positive and negative patients were not significantly different.

Conclusion
Th17, Treg, and ILC subset dysregulations are present in patients with RA but may not be associated with conventionally defined seropositive RF and ACPA.

Key Points• Th17, Treg, and ILC subset dysregulations are present in patients with RA but may reflect inflammation rather than specific diseases and stages.• No difference for the distribution of Th17, Treg, and ILC subsets between RF+and RF− patients and between ACPA+and ACPA− patients. The screening spectrum of RF and ACPA serology should be expanded to elucidate the role of immune cells in RA pathogenesis.
Analysis of control strategies for VIVA OpenHBM with active reflexive neck muscles
Authors: Putra I Putu A. , Thomson Robert 
Published: August 2022

AbstractModeling muscle activity in the neck muscles of a finite element (FE) human body model can be based on two biological reflex systems. One approach is to approximate the Vestibulocollic reflex (VCR) function, which maintains the head orientation relative to a fixed reference in space. The second system tries to maintain the head posture relative to the torso, similar to the Cervicocolic reflex (CCR). Strategies to combine these two neck muscle controller approaches in a single head-neck FE model were tested, optimized, and compared to rear-impact volunteer data. The first approach, Combined-Control, assumed that both controllers simultaneously controlled all neck muscle activations. In the second approach, Distributed-Control, one controller was used to regulate activation of the superficial muscles while a different controller acted on deep neck muscles. The results showed that any muscle controller that combined the two approaches was less effective than only using one of VCR- or CCR-based systems on its own. A passive model had the best objective rating for cervical spine kinematics, but the addition of a single active controller provided the best response for both head and cervical spine kinematics. The present study demonstrates the difficulty in completely capturing representative head and cervical spine responses to rear-impact loading and identified a controller capturing the VCR reflex as the best candidate to investigate whiplash injury mechanisms through FE modeling.
Stochastic modelling and simulation of PTEN regulatory networks with miRNAs and ceRNAs
Authors: Carletti Margherita , Spaletta Giulia 
Published: August 2022

AbstractIn this work, three genetic regulatory networks are considered, that model the post–transcriptional regulation of the PTEN onco–suppressor gene, mediated by microRNAs and competitive endogenous RNAs, in glioblastoma multiforme, the most severe of brain tumours. We simulate solutions of the resulting stochastic differential systems and discuss the effects of this miRNA–fashioned regulation on PTEN expression.
Economies of Scale: The Rationale Behind the Multinationality-Performance Enigma
Authors: Eckert Stefan , Koppe Max , Burkatzki Eckhard , Eichentopf Simon , Scharf Constantin 
Published: August 2022

AbstractIn a widely acclaimed contribution to Management International Review, Hennart (2007) challenged one of the mainstream theories of International Business, the S-curve relationship between multinationality and performance, by arguing that there is no positive impact on performance aside from the scale enhancing effect resulting from increasing multinationality. We examine his arguments by analyzing 3876 firms from Canada, Germany, Japan, the UK and the US over the period from 2002 to 2016. We find that the empirical evidence for a direct positive impact of multinationality on performance is not convincing. However, increasing multinationality leads to a significantly higher firm performance via the economies of scale-channel. Multinationality seems to be more important as a means to increase scale for firms from small home markets compared to firms from large domestic markets. Intangible assets appear to amplify the impact of scale on performance much more than the impact of multinationality on performance. In the end, it's size that matters.
Travel in the Time of COVID: A Review of International Travel Health in a Global Pandemic
Authors: Flaherty Gerard T. , Hamer Davidson H. , Chen Lin H. 
Published: August 2022

Abstract
Purpose of Review
This review critically considers the impact of the COVID-19 pandemic on global travel and the practice of travel medicine, highlights key innovations that have facilitated the resumption of travel, and anticipates how travel medicine providers should prepare for the future of international travel.

Recent Findings
Since asymptomatic transmission of the virus was first recognized in March 2020, extensive efforts have been made to characterize the pattern and dynamics of SARS-CoV-2 transmission aboard commercial aircraft, cruise ships, rail and bus transport, and in mass gatherings and quarantine facilities. Despite the negative impact of further waves of COVID-19 driven by the more transmissible Omicron variant, rapid increases of international tourist arrivals are occurring and modeling anticipates further growth. Mitigation of spread requires an integrated approach that combines masking, physical distancing, improving ventilation, testing, and quarantine. Vaccines and therapeutics have played a significant role in reopening society and accelerating the resumption of travel and further therapeutic innovation is likely.

Summary
COVID-19 is likely to persist as an endemic infection, and surveillance will assume an even more important role. The pandemic has provided an impetus to advance technology for telemedicine, to adopt mobile devices and GPS in contact tracing, and to apply digital applications in research. The future of travel medicine should continue to harness these novel platforms in the clinical, research, and educational arenas.
Design of scalable metalens array for optical addressing
Authors: Hu Tie , Feng Xing , Yang Zhenyu , Zhao Ming 
Published: August 2022

AbstractLarge-scale trapped-ion quantum computers hold great promise to outperform classical computers and are crucially desirable for finance, pharmaceutical industry, fundamental chemistry and other fields. Currently, a big challenge for trapped-ion quantum computers is the poor scalability mainly brought by the optical elements that are used for optical addressing. Metasurfaces provide a promising solution due to their excellent flexibility and integration ability. Here, we propose and numerically demonstrate a scalable off-axis metalens array for optical addressing working at the wavelength of 350 nm. Metalens arrays designed forxlinearly polarized and left circularly polarized light respectively can focus the collimated addressing beam array into a compact focused spot array with spot spacing of 5 μm, featuring crosstalk below 0.82%.Graphical Abstract
To CT or not to CT: Questioning the Cost-Effectiveness of CT Thorax in Head and Neck Cancers
Authors: Usman Nawaz , Shetty Preethi S. , Dikhit Punit Singh , Dinker Diksha , Kumar Naveena A. N. , Palod Akhil , Prakashini Koteshwara , Sankaran Priya P. , Somu G. 
Published: August 2022

Abstract
Computed tomography (CT) scan has been an integral part of the diagnostic workup for patients with head and neck squamous cell carcinoma. Our study was designed to find out the incidence of distant metastasis and second primary tumor and to correlate the cost-effectiveness of CT thorax in detecting the same. This study was conducted among 326 cancer patients who visited our center with curative intent in the year 2021, with lesions in various head and neck subsites. Data were collected based on their pathological TNM staging and the presence of distant metastasis as evident on their CT thorax imaging with various variables related to the disease. Incremental cost-effectiveness ratio (ICER) was calculated for detecting a single metastatic deposit and second primary tumor in terms of Indian currency and was correlated to each subsite and stage of disease at presentation. Out of these 326 patients, 281 patients were included in our study after considering the inclusion criteria, and among these 281 patients, 235 of them underwent CT thorax for metastatic workup. No patient was found to have a second primary. Metastases were found in 12 patients. The site of primary lesion and clinical tumor (cT) staging were found to be significantly influencing the incidence of metastasis on CT thorax. ICER was least for larynx, pharynx, and paranasal sinuses and was highest for oral cavity primaries and early-stage disease. As per our observations and results of ICER, CT thorax is indeed a valuable modality but should be used judiciously when it comes to initial diagnostic workup.
Relay intercropping can efficiently support weed management in cereal-based cropping systems when appropriate legume species are chosen
Authors: Leoni Federico , Lazzaro Mariateresa , Ruggeri Matteo , Carlesi Stefano , Meriggi Pierluigi , Moonen Anna Camilla 
Published: August 2022

AbstractRelay intercropping of subsidiary legumes with durum wheat (living mulch) can be a viable option to support ecological weed control and optimize nutrient cycling in cereal-based cropping systems. However, the lack of knowledge on suitable legume species is often identified as the main bottleneck for the successful application of legume living mulches. This study aimed to evaluate the suitability of 12 different legumes for relay intercropping with wheat in two contrasting Mediterranean cereal-based cropping systems respectively characterized by low-input and integrated management. Each legume was monitored from the undersowing in wheat until the following spring and we compared direct drilling to broadcast sowing of legumes. None of the undersown legumes showed a negative effect on the wheat grain yield. Relay intercropping of legumes proved to be an effective solution to control weeds before and after the wheat harvest, provided suitable legumes species are chosen. Suitable legumes reduced the weed biomass up to the 90% during the intercropping and up to 94% in the following spring. On the contrary, legumes such as Trifoliumresupinatum, Viciavillosa, Medicagotruncatula, and Medicagoscutellata boosted weed growth in the following spring in comparison with the control. According to the performance of legumes, Medicagosativa, Trifoliumrepens and Medicagolupulina had the most suitable characteristics for relay intercropping with durum wheat at the Ravenna site, in a highly productive region whereas Medicagosativa, Hedysarumcoronarium and Trifoliumsubterraneum performed better in the low-input system near Pisa, where yields are generally lower. This is the first time that such a diversity in legumes species is tested in the same experiment for relay intercropping under diversified environmental and management conditions. The results of this study can support farmers in selecting the most appropriated legume species for their specific cropping systems and local conditions.
The methodology wars and outdoor and environmental education: Feminism, positivism, and causation
Authors: Reed Jack 
Published: August 2022

AbstractHow causation is approached has, for some time now, been a central debate within the archives of educational research. Despite rich discussion in broader literature, the influence of what has been described as the ‘methodology wars’ has rarely featured within the field(s) of outdoor and environmental education (OEE). This paper explores causation in this context, employing a feminist paradigmatic approach to investigate the role of causation in OEE research. A positivist approach is also considered in parallel, asking whether and how research in OEE navigates causation, and the potential influences of this upon competing audiences (e.g., policy makers and funders). Drawing on a conceptual causal pluralist approach to causation within the feminist paradigm, four key touchstones are presented that stand ready to facilitate inclusive, equitable, and reflexive research for OEE post-pandemic. The paper reflects on the general position of OEE presently, and responds to increasing sociocultural complexity as it is lived and felt within the profession and beyond.