bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical impact of changes in mitral regurgitation severity after medical therapy optimization in heart failure
Authors: Pagnesi Matteo , Adamo Marianna , Sama Iziah E. , Anker Stefan D. , Cleland John G. , Dickstein Kenneth , Filippatos Gerasimos S. , Inciardi Riccardo M. , Lang Chim C. , Lombardi Carlo M. , Ng Leong L. , Ponikowski Piotr , Samani Nilesh J. , Zannad Faiez , van Veldhuisen Dirk J. , Voors Adriaan A. , Metra Marco 
Published: March 2022

Abstract
Background
Few data are available regarding changes in mitral regurgitation (MR) severity with guideline-recommended medical therapy (GRMT) in heart failure (HF). Our aim was to evaluate the evolution and impact of MR after GRMT in the Biology study to Tailored treatment in chronic heart failure (BIOSTAT-CHF).

Methods
A retrospective post-hoc analysis was performed on HF patients from BIOSTAT-CHF with available data on MR status at baseline and at 9-month follow-up after GRMT optimization. The primary endpoint was a composite of all-cause death or HF hospitalization.

Results
Among 1022 patients with data at both time-points, 462 (45.2%) had moderate-severe MR at baseline and 360 (35.2%) had it at 9-month follow-up. Regression of moderate-severe MR from baseline to 9 months occurred in 192/462 patients (41.6%) and worsening from baseline to moderate-severe MR at 9 months occurred in 90/560 patients (16.1%). The presence of moderate-severe MR at 9 months, independent from baseline severity, was associated with an increased risk of the primary endpoint (unadjusted hazard ratio [HR], 2.03; 95% confidence interval [CI], 1.57–2.63; p < 0.001), also after adjusting for the BIOSTAT-CHF risk-prediction model (adjusted HR, 1.85; 95% CI 1.43–2.39; p < 0.001). Younger age, LVEF ≥ 50% and treatment with higher ACEi/ARB doses were associated with a lower likelihood of persistence of moderate-severe MR at 9 months, whereas older age was the only predictor of worsening MR.

Conclusions
Among patients with HF undergoing GRMT optimization, ACEi/ARB up-titration and HFpEF were associated with MR improvement, and the presence of moderate-severe MR after GRMT was associated with worse outcome.

Graphical abstract
Pediatric morphometric study to guide the optimized implantation of the Osia® 2 implant system
Authors: Posta Balint , Perenyi Adam , Szabo Linda , Nagy Roland , Katona Gabor , Csakanyi Zsuzsanna , Rovo Laszlo , Bere Zsofia 
Published: March 2022

Abstract
Purpose
Continuous technological advances result in the availability of new bone conduction hearing implants, of which their suitability for pediatric patients is of major concern. The CochlearTMOsia® 2 is a new active osseointegrated steady-state implant system that uses digital piezoelectric stimulation to treat hearing loss. The implant in the United States was approved for patients aged 12 years and above, whereas the CE mark is independent of age, the only requirement is body weight of at least 7 kg. Therefore, further clinical studies are required to assess device characteristics in younger patients. The aim of our study was to perform a morphometric study among 5–12-year-old children, and to develop a surgical protocol for Osia 2 system implantation based on these findings.

Methods
We examined retrospectively cranial CT scans of 5–12-year-old patients from our clinical database. We measured the bone and soft-tissue thickness in the region of interest, and the position of the sigmoid sinus. 3D printed temporal bones were also used for planning.

Results
Soft-tissue thickness varied between 3.2 ± 0.5 mm and 3.6 ± 0.6 mm and bone thickness varied between 3.5 ± 1.1 mm and 4.7 ± 0.3 mm. The sigmoid sinus was located 1.3 ± 0.2 cm posterior to the ear canal, and the anterior distance was 4.8 ± 0.9 to 7.1 ± 1.1 mm.

Conclusions
Our morphometric studies showed that patients aged 5–12 have different anatomical dimensions compared to adults, but that implantation of the Osia 2 system is feasible in these patients using an altered implant positioning recommended by our data. The Cochlear™ Osia® 2 is, therefore, an option for hearing rehabilitation in younger pediatrics.
Reported thresholds of self-motion perception are influenced by testing paradigm
Authors: Pleshkov M. , Rondas N. , Lucieer F. , van Stiphout L. , Janssen M. , Guinand N. , Perez-Fornos A. , Demkin V. , van Rompaey V. , Kingma H. , van de Berg R. 
Published: March 2022

Abstract
Background/objective
Different testing paradigms have been proposed to investigate perceptual self-motion thresholds. They can differ regarding the amount of possible motions that patients have to choose from. Objective of this study was to compare the two-option paradigm and twelve-option paradigm, to investigate whether reducing the choice options significantly influences the reported thresholds of self-motion perception of healthy subjects.

Methods
Thirty-three volunteers with no prior vestibular complaints were included and sequentially tested with both paradigms at a random sequence. Perceptual self-motion thresholds were measured using a hydraulic motion platform in the absence of external visual and auditory cues. The platform delivered twelve different movements: six translations and six rotations. Each subject had to report the correct type and direction of movements. Thresholds were determined by a double confirmation of the lowest threshold, in combination with a double rejection of the one-step lower stimulus. Perceptual self-motion thresholds of both paradigms were compared using the mixed model analysis.

Results
The twelve-option paradigm showed significantly higher reported thresholds for yaw rotations and translations left, right and down (p < 0.001), compared to the two-option paradigm. No statistical difference was found for rolls and translations up. No significant gender effect, learning effect and carry-over effect were present in any of the applied motion directions.

Conclusion
Reported thresholds of self-motion perception of healthy subjects are influenced by the testing paradigm. The twelve-option paradigm showed significantly higher thresholds than the two-option paradigm. Results obtained with each testing paradigm should, therefore, be compared to paradigm-specific normative data.
The Cologne-Mecklenburg-Vorpommern DMEK Donor Study (COMEDOS) — design and review of the influence of donor characteristics on Descemet membrane endothelial keratoplasty (DMEK) outcome
Authors: Schrittenlocher Silvia , Matthaei Mario , Bachmann Björn , Cursiefen Claus 
Published: March 2022

Abstract

Background
Posterior lamellar keratoplasty and especially Descemet membrane endothelial keratoplasty (DMEK) are gaining interest worldwide. Little is known about the influence of donor factors on DMEK outcome. Here we provide an overview of the existing peer-reviewed literature on this topic and present the design of the upcoming cooperation study COMEDOS (Cologne-Mecklenburg-Vorpommern DMEK Donor Study).

Methods
A literature search of PubMed and MEDLINE was conducted to retrieve articles published between September 2013 and May 2021. Seventeen peer-reviewed articles were selected. Design and concept of the prospective COMEDOS are outlined.

Results
Main interest parameters were the donor diabetes mellitus status, age, and lens status. There is a large heterogeneity regarding the sample size, study design, and investigated parameters. There seems to be a consensus that younger donors are associated with tighter rolls, a more difficult preparation, and unfolding setting. Diabetic donors seem to increase the risk of tissue tearing due to adherences and result more frequently in preparation failure. The COMEDOS aims not only to analyze the diabetes status of the donor, but also to correlate all donor systemic comorbidities and their ophthalmologic history to the DMEK clinical outcome. Furthermore, a correlation of Descemet membrane lamella preparation and surgery outcome is planned.

Conclusion
Currently, there is a lack of knowledge regarding the effect and impact of donor tissue characteristics on DMEK outcome and complications. An in-depth investigation is planned by the upcoming COMEDOS to close this knowledge gap.
Risk factors for shoulder disorders among French workers: prospective cohort study
Authors: Bodin Julie , Garlantézec Ronan , Descatha Alexis , Evanoff Bradley , Thomas Thierry , Roquelaure Yves 
Published: March 2022

Abstract
Objectives
Shoulder disorders are common in the working population. This longitudinal study aimed to explore the relationships between personal factors and occupational organisational, psychosocial, and biomechanical factors and the incidence of shoulder disorders.

Methods
A total of 3710 workers in the Pays de la Loire region (Loire Valley area, France) were randomly included by their occupational physician in the Cosali cohort between 2002 and 2005. All workers completed a self-administered questionnaire about personal factors and work exposure, and using a standardised physical examination, occupational physicians diagnosed shoulder disorders. Between 2007 and 2010, 1611 workers were re-examined by their occupational physician. The 1,320 workers free of shoulder disorders at baseline were studied. A conceptual model was developed in which relationships between organisational, psychosocial, biomechanical, and personal factors at baseline and the incidence of shoulder disorders were assumed. Structural equation modelling was used to test the model.

Results
Shoulder disorders were directly associated with biomechanical factors and age but not with psychosocial factors. However, skill discretion and psychological demand influenced shoulder disorders indirectly through biomechanical factors. Exposure to a work pace dependent on an automatic rate and to a work pace dependent on customers’ demands were associated with biomechanical and psychosocial factors, but not directly to shoulder disorders.

Conclusions
This study identified the complex direct and indirect relationships between occupational factors and shoulder disorders. Our data confirmed our conceptual causation model: organisational and psychosocial factors were associated with biomechanical factors, while biomechanical factors were associated with the incidence of shoulder disorders.
Sudden neonatal death in individuals with medium-chain acyl-coenzyme A dehydrogenase deficiency: limit of newborn screening
Authors: Mütze Ulrike , Nennstiel Uta , Odenwald Birgit , Haase Claudia , Ceglarek Uta , Janzen Nils , Garbade Sven F. , Hoffmann Georg F. , Kölker Stefan , Haas Dorothea 
Published: March 2022

AbstractMedium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency is the most common disorder of mitochondrial β-oxidation of fatty acids resulting in hypoketotic hypoglycemia, hepatopathy, and often fatal outcome in undiagnosed children. Introduction of tandem mass spectrometry–based newborn screening programs in the late 1990s has significantly reduced morbidity and mortality in MCAD deficiency; however, neonatal death in individuals with early disease manifestation and severe hypoglycemia may still occur. We describe the fatal disease course in eight newborns with MCAD deficiency, aiming to raise awareness for early clinical symptoms and the life-saving treatment, and promote systematic post-mortem protocols for biochemical and genetic testing, necessary for correct diagnosis and counselling of the family if unexpected death occurred in the neonatal period.Conclusion: Early newborn screening and awareness for clinical symptoms is lifesaving in MCAD deficiency, which may present with fatal neonatal crisis. Systematic post-mortem diagnostic protocols are needed for sudden neonatal deaths.

What is Known:• Medium-chain acyl-coenzyme A dehydrogenase (MCAD) deficiency identified by newborn screening has an excellent outcome.• Fatal neonatal crises occur in the first days prior to screening.

What is New:• Poor feeding, no monitoring of blood glucose, and homozygosity of the common gene variant (c.985A > G) are major risk factors for fatal neonatal crisis in MCAD deficiency.• Post-mortem diagnostic protocols are indispensable for correct diagnosis and counselling of the family if unexpected death occurred in the neonatal period.
Variability in Swallowing Biomechanics in Infants with Feeding Difficulties: A Videofluoroscopic Analysis
Authors: Fuller Laura , Miles Anna , Dharmarathna Isuru , Allen Jacqui 
Published: March 2022

AbstractClinicians performing feeding evaluations in infants often report swallow variability or inconsistency as concerning. However, little is known about whether this represents pathological incoordination or normal physiologic variance in a developing child. Our retrospective study explored quantitative videofluoroscopic measures in 50 bottle-fed infants (0–9 months) referred with feeding concerns. Our research questions were as follows: Is it possible to assess swallow to swallow variability in an infant with feeding concerns, is there variability in pharyngeal timing and displacement in infants referred for videofluoroscopy, and is variability associated with aspiration risk? Measures were taken from a mid-feed, 20-s loop recorded at 30 frames per second. Each swallow within the 20-s loop (n = 349 swallows) was analysed using quantitative digital measures of timing, displacement and coordination (Swallowtail™). Two blinded raters measured all swallows with strong inter-rater reliability (ICC .78). Swallow frequency, suck-swallow ratio, residue and aspiration were also rated. Variability in timing and displacement was identified across all infants but did not correlate with aspiration (p > .05). Sixteen infants (32%) aspirated. Across the cohort, swallow frequency varied from 1 to 15 within the 20-s loops; suck-swallow ratios varied from 1:1 to 6:1. Within-infant variability in suck-swallow ratios was associated with higher penetration-aspiration scores (p < .001). In conclusion, pharyngeal timing and displacement variability is present in infants referred with feeding difficulties but does not correlate with aspiration. Suck-swallow ratio variability, however, is an important risk factor for aspiration that can be observed at bedside without radiation. These objective measures provide insight into infant swallowing biomechanics and deserve further exploration for their clinical applicability.
Exercise in allogeneic bone marrow transplantation: a qualitative representation of the patient perspective
Authors: Abo Shaza , Parry Selina M. , Ritchie David , Sgro Gabriella , Truong Dominic , Denehy Linda , Granger Catherine L. 
Published: March 2022

Abstract
Purpose
Exercise is emerging as a vital aspect of care to alleviate the physical and psychosocial symptom burden associated with allogeneic bone marrow transplantation (BMT). Understanding the patient perspective regarding exercise is important to move towards implementation. This study aimed to characterise experiences and views regarding participation in an exercise program in adults receiving treatment for haematological disease with allogeneic BMT.

Methods
Individual semi-structured interviews were conducted with 35 participants from either an early- or late-commencing supervised group-based exercise program. Using an inductive, conventional approach to qualitative content analysis data were independently analysed by two researchers.

Results
Six major themes and 33 sub-themes were identified: this encompassed motivation, physical opportunity and capability to exercise; psychosocial effects of group-based exercise; experienced impact of participation in an exercise program; and intervention design considerations. Key barriers to exercise included symptom severity and fluctuating health and distance or difficult access to an exercise facility or equipment, whilst facilitators included encouragement from staff; peer support in the group-based setting; flexibility; education; and ability to measure change.

Conclusion
This study highlights the importance of a flexible approach to exercise with consideration of individual symptoms and preferences. The perceived psychological impact of exercise should not be underestimated; future exercise programs should be designed in partnership with patients, with consideration of group-based activities to reduce social isolation if this is feasible in the treatment context. Intervention design should also acknowledge the individual’s physical and psychological capability, opportunity and automatic and reflective motivation to direct and sustain exercise behaviours following BMT.
Experimentelle Untersuchung des Abwälzverhaltens von Beveloidverzahnungen mit lokal angepassten Verzahnungsdaten entlang der Zahnbreite
Authors: Marino Daniel , Bachmann Matthias , Binz Hansgeorg 
Published: March 2022

ZusammenfassungZur Übertragung von Drehmoment und Drehzahl in beliebiger Achsanordnung eignen sich bei kleinem Achswinkel bis 30° Beveloidverzahnungen. Besonders die windschiefe Achslage bietet dabei Potenzial, Bauraum und Gewicht aufgrund eines möglichst direkten Leistungsfluss zu realisieren. Beveloidradpaarungen in nicht paralleler Achslage haben jedoch den Nachteil, dass aufgrund der geneigten Grundzylinder nur ein punktförmiger Kontakt vorliegt. Der auftretende Ease-Off kann ausschließlich durch komplexe Zahnflankenmodifikationen kompensiert werden, um so das Übertragungsverhalten zu verbessern. Zum Überprüfen der Wirksamkeit solcher Modifikation sind simulative Zahnkontaktanalysen unumgänglich. Zusätzlich sind Abwälzversuche erforderlich, um die simulativen Ergebnisse abzusichern. Durch Beveloidverzahnungen mit lokal angepassten Verzahnungsdaten entlang der Zahnbreite kann ein konjugierter Eingriff angenähert werden, was ein voll ausgebildetes Tragbild mit geringem Drehfehler in Kontaktsimulationen zeigt. In diesem Bericht sollen die vielversprechenden Ergebnisse der Kontaktsimulationen in Abwälzversuchen validiert werden. Zunächst wird mithilfe des Versuchskonzepts das Vorgehen definiert, um die Prüfstandsversuche durchzuführen und die erzielten Ergebnisse am Prüfstand mit den Simulationsergebnissen abzugleichen. Die exemplarisch ausgelegte Prüfverzahnung wird mittels Fünf-Achs-Fräsen gefertigt und kann mit drei Mikrogeometrien am Umfang verteilt ausgeführt werden. Zwei Ansätze zur Definition der Mikrogeometrien werden vorgestellt, mit denen ausgehend vom konjugierten Eingriff eine gezielte Positionierung und Skalierung des Tragbilds möglich ist. Die tatsächliche Zahnflankengeometrie wird topografisch vermessen und kann in Kontaktsimulationen untersucht werden. Der Vergleich zwischen diesen Simulationsergebnissen und den am Prüfstand ermittelten Ergebnissen zeigt beim Tragbild und lastfreien Drehfehlerverlauf eine hohe Übereinstimmung. Der Vergleich zwischen den Prüfstands- und Simulationsergebnissen validiert die analytische Berechnungsmethode zur Auslegung und Optimierung von Beveloidverzahnungen mit lokal angepassten Verzahnungsdaten entlang der Zahnbreite.
Downstream Modification of Mercury in Diverse River Systems Underscores the Role of Local Conditions in Fish Bioaccumulation
Authors: Emmerton Craig A. , Drevnick Paul E. , Serbu Jessica A. , Cooke Colin A. , Graydon Jennifer A. , Reichert Megan , Evans Marlene S. , McMaster Mark E. 
Published: March 2022

AbstractFish consumption advisories for mercury (Hg) are common in rivers, highlighting connections between landscape sources of Hg and downstream fluvial ecosystems. Though watershed conditions can influence concentrations of Hg in smaller streams, how Hg changes downstream through larger rivers and how these changes associate with Hg concentrations in fish is not well understood. Here we present a continuum of concentrations and yields of total mercury (THg) and methylmercury (MeHg) from small tributary systems draining diverse western Canadian headwater landscapes through to major transboundary rivers. We associate these downstream patterns with THg concentrations in tissues of resident fish in major rivers. Mean concentrations and yields of unfiltered THg from over 80 monitored tributaries and major rivers were highly variable in space ranging from 0.28 to 120 ng L−1 and 0.39 to 170 µg ha−1 d−1, respectively. Using spatial data and a hierarchical cluster analysis, we identified three broad categories of tributary catchment conditions. Linear mixed modeling analysis with water quality variables revealed significantly lower THg concentrations in tributaries draining cordillera-foothills (geometric mean: 0.76 ng L−1) regions relative to those draining forested (1.5 ng L−1) and agriculturalized landscapes (2.4 ng L−1), suggesting that sources and mobility of THg in soils and surface waters were different between landscapes. However, these concentration differences were not sustained downstream in major rivers as local sources and sinks of THg in river channels smoothed differences between landscape types. Extensive fish tissue monitoring in major rivers and ANCOVA analysis found that site-specific, river water THg and MeHg concentrations and local catchment conditions were stronger associates of THg concentrations in fish than broader trends in rivers within and across landscape classes. Consequently, site-specific, targeted monitoring of THg and MeHg concentrations in water and fish is a preferred study design when assessing regional-level patterns in fish tissue concentrations.
Looking into the black box of “Medical Innovation”: rising health expenditures by illness type
Authors: Breyer Friedrich , Lorenz Normann , Pruckner Gerald J. , Schober Thomas 
Published: March 2022

AbstractThere is agreement among health economists that on the whole medical innovation causes health care expenditures (HCE) to rise. This paper analyzes for which diagnoses HCE per patient have grown significantly faster than average HCE. We distinguish decedents (patients in their last 4 years of life) from survivors and use a unique dataset comprising detailed HCE of all members of a regional health insurance fund in Upper Austria for the period 2005–2018. Our results indicate that among decedents in particular, the expenditures for treatment of neoplasms have exceeded the general trend in HCE. This confirms that medical innovation for this group of diseases has been particularly strong over the last 15 years. For survivors, we find a noticeable growth in cases and cost per case for pregnancies and childbirth, and also for treatment of mental and behavioral disorders. We discuss whether these findings contradict the widespread interpretation of cost-increasing innovations as “medical progress” and offer some policy recommendations.
SDP-based bounds for graph partition via extended ADMM
Authors: Wiegele Angelika , Zhao Shudian 
Published: March 2022

AbstractWe study two NP-complete graph partition problems, k-equipartition problems and graph partition problems with knapsack constraints (GPKC). We introduce tight SDP relaxations with nonnegativity constraints to get lower bounds, the SDP relaxations are solved by an extended alternating direction method of multipliers (ADMM). In this way, we obtain high quality lower bounds for k-equipartition on large instances up to $$n =1000$$

n
=
1000

vertices within as few as 5 min and for GPKC problems up to $$n=500$$

n
=
500

vertices within as little as 1 h. On the other hand, interior point methods fail to solve instances from $$n=300$$

n
=
300

due to memory requirements. We also design heuristics to generate upper bounds from the SDP solutions, giving us tighter upper bounds than other methods proposed in the literature with low computational expense.