bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early correction of base deficit decreases late mortality in polytrauma
Authors: van Wessem Karlijn J. P. , Hietbrink Falco , Leenen Luke P. H. 
Published: November 2022

Abstract
Introduction
Physiology-driven resuscitation has become the standard of care in severely injured patients. This has resulted in a decrease in acute deaths by hemorrhagic shock. With increased survival from hemorrhage, focus shifts towards death later during hospital stay. This population based cohort study investigated the association of initial physiology derangement correction and (late) mortality.

Methods
Consecutive polytrauma patients aged > 15 years with deranged physiology who were admitted to a level-1 trauma center intensive care unit (ICU) from 2015 to 2021, and requiring surgical intervention < 24 h were included. Patients who acutely (< 48 h) died were excluded. Demographics, treatment, and outcome parameters were analyzed. Physiology was monitored by serial base deficits (BD) during the first 48 h. Correction of physiology was defined as BD return to normal values. Area under the curve (AUC) of BD in time was used as measurement for the correction of physiological derangement and related to mortality 3–6 days (early), and > 7 days (late).

Results
Two hundred thirty-five patients were included with a median age of 44 years (70% male), and Injury Severity Score (ISS) of 33. Mortality rate was 16% (71% due to traumatic brain injury (TBI)). Median time to death was 11 (6–17) days; 71% died > 7 days after injury. There was no difference between the single base deficit measurements in the emergency department(ED), operating room (OR), nor ICU between patients who died and those who did not. However, patients who later died were more acidotic at 24 and 48 h after arrival, and had a higher AUC of BD in time. This was independent of time and cause of death.

Conclusion
Early physiological restoration based on serial BD measurements in the first 48 h after injury decreases late mortality.
Postprimäre frühelektive Totalprothetik bei schweren Frakturen des oberen Sprunggelenks
Authors: Pflüger Patrick , Schlickewei Carsten , Barg Alexej , Valderrabano Victor 
Published: November 2022

ZusammenfassungDie Versorgung des oberen Sprunggelenks (OSG) mithilfe einer Totalprothese (TP) ist heutzutage eine etablierte und sichere operative Therapie der Arthrose am OSG. Moderne Implantate haben geringe Revisionsraten und sind der Arthrodese des Sprunggelenks hinsichtlich des von Patienten berichteten Ergebnisses überlegen. Der Stellenwert der primären endoprothetischen Versorgung von Frakturen am OSG ist unklar. Aktuell finden sich diesbezüglich in der Literatur keine Studien. In Anbetracht der steigenden Fallzahlen instabiler Sprunggelenkfrakturen, insbesondere bei älteren Patienten und aufgrund wachsender funktioneller Ansprüche auch bis ins hohe Lebensalter, gilt es zukünftig beim Management dieser Frakturen auch eine endoprothetische Versorgung zu berücksichtigen. Klinische Studien sind notwendig, um die Versorgung von Frakturen des OSG mithilfe einer TP zu evaluieren.
Multimodale Therapiekonzepte lokaler Verfahren mit der Immuntherapie
Authors: Eckert Franziska 
Published: November 2022

ZusammenfassungImmuntherapien haben sich in der Behandlung onkologischer Erkrankungen i. Allg. sowie in der Uroonkologie etabliert. Die Rationale, diese Therapien mit Bestrahlung zu kombinieren, basieren auf den biologischen Effekten von Tumorbestrahlung, die weit über ein „physikalisches“ Abtöten von Tumorzellen hinausgeht. Abhängig von Dosis und Fraktionierung der Bestrahlung sowie dem verwendeten Tumormodell oder der Tumorentität können immunaktivierende und immunsupprimierende Effekte ausgelöst werden. Da eine Antitumorimmunantwort nicht lokal im Tumor sondern systemisch erfolgt, kann eine erfolgreich ausgelöste Antitumorimmunität in einer bestrahlten Metastase zu einem systemischen Ansprechen führen (abskopaler Effekt). In klinischen Studien werden Kombinationsschemata für lokal fortgeschrittene Tumorerkrankungen in der kurativen Situation zur Erhöhung der Heilungsraten sowie in der metastasierten Situation zur Verlängerung des Überlebens in der palliativen Situation eingesetzt. Ein weiteres Einsatzgebiet ist die lokale Behandlung von Oligometastasen oder in der Oligoprogression unter laufender Systemtherapie.
Combination of GNSS orbits using least-squares variance component estimation
Authors: Mansur Gustavo , Sakic Pierre , Brack Andreas , Männel Benjamin , Schuh Harald 
Published: November 2022

AbstractOver the past years, the International GNSS Service (IGS) has been putting efforts into extending its service by setting up and running the Multi-GNSS experiment and pilot project (MGEX). Several MGEX analysis centers (ACs) contribute by providing solutions containing not only GPS and GLONASS but also Galileo, BeiDou, and QZSS. As the current IGS combination software can only handle the orbits of one constellation at a time, it requires substantial modifications to obtain a consistent MGEX orbit product. In this contribution, we present a least-squares framework for a Multi-GNSS orbit combination, where the weights used to combine the ACs’ orbits are determined by least-squares variance component estimation. We introduce and compare two weighting strategies, where either AC-specific weights or AC and constellation-specific weights are used. An automated Z-score test is implemented yielding a common set of core satellites that are used to determine the weights. Both strategies are tested using MGEX orbit solutions for a period of two and a half years. They yield similar results with an agreement with the ACs’ orbits at the one centimeter level for GPS and up to a few centimeters for the other constellations. The 3D-RMS is generally slightly better with the AC and constellation weighting. A comparison of our combination approach with the official IGS combination using three years of GPS and GLONASS orbits shows an agreement of better than 5 mm and 12 mm for GPS and GLONASS, respectively, while the agreement of the official IGS combination with the ACs’ GPS solutions is only around $$15\,\textrm{mm}$$

15

mm

. An external validation using satellite laser ranging shows that the mean residuals of our combined products are around $$-3\,\textrm{mm}$$

-
3

mm

for Galileo, $$6\,\textrm{mm}$$

6

mm

for GLONASS, $$-8\,\textrm{mm}$$

-
8

mm

for BeiDou, and $$-31\,\textrm{mm}$$

-
31

mm

for QZSS.
Oxidation processes and thermal stability of actinolite
Authors: Rösche Constanze , Waeselmann Naemi , Petrova Nadia , Malcherek Thomas , Schlüter Jochen , Mihailova Boriana 
Published: November 2022

AbstractUnderstanding the thermal behaviour of iron-containing amphiboles (AB2C5T8O22W2, C5 = M(1)2 M(2)2 M(3)) at atomic-level scale may have important implications in several fields, including metamorphic petrology, geophysics, and environmental sciences. Here, the thermally induced oxidation and decomposition of actinolite are studied by in situ high-temperature Raman spectroscopy and complementary thermogravimetric/mass-spectrometry analyses as well as X-ray diffraction of the products of amphibole decomposition. The effect of CFe2+ on dehydrogenation/dehydroxylation is followed by comparing the results on actinolite with those for tremolite. We show that mobile charge carriers, namely polarons (conduction electrons coupled to FeO6 phonons) and H+ cations, exist in actinolite at elevated temperatures ~ 1150–1250 K. The temperature-induced actinolite breakdown is a multistep process, involving (i) delocalization of e− from CFe2+ as well as of H+ from hydroxyl groups shared by Fe-containing M(1)M(1)M(3) species, which, however, remain in the crystal bulk; (ii) dehydrogenation and ejection of e− between 1250 and 1350 K, where actinolite can be considered as “oxo-actinolite”, as H+ also from hydroxyl groups next to M(1,3)(MgMgMg) configurations become delocalized and mostly remain in the crystal bulk; (iii) complete dehydroxylation and consequent structure collapse above 1350 K, forming an Fe3+-bearing defect-rich augitic pyroxene. The dehydrogenation of tremolite occurs at 1400 K, triggering immediately a disintegration of the silicate double-chain into single SiO4-chains and followed by a rearrangement of the amphibole octahedral strips and BCa2+ cations into pyroxene-type octahedral sheets at 1450 K. The result of tremolite decomposition is also a single-phase defect-rich clinopyroxene with an intermediate composition on the diopside–clinoenstatite join.
Mental illness rates among employees with fixed-term versus permanent employment contracts: a Danish cohort study
Authors: Hannerz Harald , Burr Hermann , Nielsen Martin Lindhardt , Garde Anne Helene , Flyvholm Mari-Ann 
Published: November 2022

Abstract
Purpose
It has been hypothesized that employment in a fixed-term instead of permanent contract position is associated with an increased risk of development of mental health problems. The present study aimed at estimating rate ratios between fixed-term and permanent employees in the Danish labor force, for use of psychotropic drugs and psychiatric hospital treatment due to mood, anxiety or stress-related disorders, respectively.

Methods
Employment data were drawn from the Danish Labor Force Survey of 2001–2013, which is a part of the European Labor Force Survey. Full-time employed survey participants without mental illness at the baseline interview (N = 106,501) were followed in national health registers for up to 5 years. Poisson regressions were used to estimate rate ratios for redeemed prescriptions of psychotropic drugs and psychiatric hospital treatments due to mood, anxiety or stress-related disease. The analyses were controlled for age, gender, industrial sector, nighttime work, level of education, calendar year, disposable family income and social transfer payments within 1 year prior to the baseline interview.

Results
The rate ratio for hospital diagnosed mood, anxiety or stress-related disorders among employees with fixed-term vs. permanent employment contracts was estimated at 1.39 (99.5% CI 1.04–1.86), while the corresponding rate ratio for redeemed prescriptions of psychotropic drugs was estimated at 1.12 (99.5% CI 1.01–1.24).

Conclusion
The present study supports the hypothesis that employment in a fixed-term rather than permanent contract position is associated with an increased risk of developing mental health problems.

International registered report identifier (IRRID)
DERR2-10.2196/24392.
Counting mitoses in gastrointestinal stromal tumours (GISTs): variable practices in the real-world setting and their clinical implications
Authors: Campora Michela , Paudice Michele , Gambella Alessandro , Comandini Danila , Parente Paola , Sbaraglia Marta , Dei Tos Angelo Paolo , Grillo Federica , Mastracci Luca 
Published: November 2022

AbstractMitotic count (MC) is an important prognostic indicator in gastrointestinal stromal tumours (GISTs). Though MC evaluation was initially proposed in 50 HPFs, recent international guidelines recommend that MC be performed on 5 mm2 because HPFs may have different areas depending on the ocular field number (FN) of the utilized light microscope. Performing MC on different areas leads to a non-standardized evaluation and erroneous risk stratification. The aim of the study was to audit real-life MC practices with special emphasis on possible risk stratification errors. A survey was administered to Italian pathologists to evaluate the following: method used for MC (5 mm2 versus 50 HPF); FN of the light microscope; prognostic scheme for risk stratification. Based on the results of the survey, 100 GISTs (25/risk class using Miettinen prognostic scheme) were retrieved and MC performed using 5 mm2 versus the corresponding mm2 area sizes of 50 HPFs with variable FNs (18, 20, 22). The survey demonstrated that the majority of pathologists (64.5%) use 50 HPFs with various FNs leading to excessive area size. The most frequently used prognostic scheme is that by Miettinen. Using this prognostic scheme and counting mitoses in 5 mm2 versus 50 HPFs with FNs 18, 20 and 22, a change in risk class was identified ranging from 10 to 41%, depending on FN. In conclusion, this study demonstrates that MC is still frequently performed on 50 HPF, with area sizes exceeding the specified 5 mm2 by far.
Deformation of planar ring mesh under static in-plane tensile loads
Authors: Dries Fabian W. , Wallmersperger Thomas , Kessler Jörg 
Published: November 2022

AbstractA ring mesh is a large-scale manufacturable structure with versatile applications in architecture and for protective systems. However, the static and dynamic numerical simulation of a large-scale ring mesh is a resource-intensive task due to the many nonlinear contact points between the individual rings. To characterize the rigid body behavior of the ring mesh, in this paper, a representative volume element is loaded under different in-plane directions. The Green-Lagrangian strain tensor components are obtained as a result. An implicit one-step algorithm is used for this dynamic relaxation issue, modified by the use of stiff springs. Static convergence positions of a representative volume element are determined in several multiaxial tensile directions. The obtained deformation parameters can be used to simulate large deformations of large-scaled ring meshes.
The Roles of the Moss Layer in Mediating Tree Seedling Environmental Stress, Mercury Exposure, and Regeneration in High-Elevation Conifer Forests
Authors: Berdugo Monica B. , Dovciak Martin , Kimmerer Robin W. , Driscoll Charles T. 
Published: November 2022

AbstractThe persistence of future forests depends on the success of tree seedlings which are experiencing increasing physiological stress from changing climate and air pollution. Although the moss layer can serve as an important substrate for tree seedlings, its potential for reducing environmental stress and enhancing the establishment of seedlings remains poorly understood. We tested if the moss layer decreased environmental stress and increased the abundance of balsam fir seedlings dominant in high-elevation forests of northeastern United States that are sensitive to changing climate and mercury deposition. We surveyed balsam fir seedling density by substrate (moss, litter, other) on 120 quadrats (1 × 1 m) in two contrasting canopy environments (in gaps and under canopies), measured seedling stress, and quantified mercury content in seedlings and substrates. We observed that, in both canopy environments, tree seedlings established on moss exhibited (i) increased density, (ii) decreased physiological stress, and (iii) higher potential to recruit into larger size classes, compared to seedlings established in litter. Regardless of canopy environment, seedling foliar mercury levels did not correspond to substrate mercury despite large differences in substrate mercury concentrations (relative to moss, litter concentrations were ~ 4-times greater and soil concentrations were ~ 6-times greater), likely reflecting the dominance of foliar over root uptake of mercury. Because the moss layer appeared to mitigate seedling drought stress, and to increase seedling establishment and recruitment compared to other substrates, these microsite effects should be considered in models predicting forest regeneration and dynamics under increased drought stress associated with the ongoing climate warming.
Cyber risk management for autonomous passenger ships using threat-informed defense-in-depth
Authors: Amro Ahmed , Gkioulos Vasileios 
Published: November 2022

AbstractRecent innovations in the smart city domain have led to the proposition of a new mode of transportation utilizing Autonomous Passenger Ships (APS) or ferries in inland waterways. The novelty of the APS concept influenced the cyber risk paradigm and led to different considerations regarding attack objectives, techniques as well as risk management approaches. The main factor that has led to this is the autoremote operational mode, which refers to autonomous operations and remote supervision and control in case of emergency. The autoremote operational mode influences the risk of cyber attacks due to the increased connectivity and reliance on technology for automating navigational functions. On the other hand, the presence of passengers without crew members imposes a safety risk factor in cyber attacks. In this paper, we propose a new cyber risk management approach for managing the cyber risks against cyber physical systems in general and Autonomous Passenger Ships in particular. Our proposed approach aims to improve the Defense-in-Depth risk management strategy with additional components from the Threat-Informed Defense strategy allowing for more evolved cyber risk management capabilities. Moreover, we have utilized the proposed cyber risk management approach for the proposition of a cybersecurity architecture for managing the cyber risks against an APS use case named milliAmpere2. Additionally, we present our results after conducting a Systematic Literature Review (SLR) in cybersecurity evaluation in the maritime domain. Then, the findings of the SLR were utilized for a suitable evaluation of the proposed risk management approach. Our findings suggest that our proposed risk management approach named Threat-Informed Defense-in-Depth is capable of enriching several risk management activities across different stages in the system development life cycle. Additionally, a comprehensive evaluation of the cybersecurity posture of milliAmpere2 has been conducted using several approaches including risk evaluation, simulation, checklist, and adversary emulation. Our evaluation has uncovered several limitations in the current cybersecurity posture and proposed actions for improvement.
Utilizing a Digital Swarm Intelligence Platform to Improve Consensus Among Radiologists and Exploring Its Applications
Authors: Shah Rutwik , Astuto Arouche Nunes Bruno , Gleason Tyler , Fletcher Will , Banaga Justin , Sweetwood Kevin , Ye Allen , Patel Rina , McGill Kevin , Link Thomas , Crane Jason , Pedoia Valentina , Majumdar Sharmila 
Published: November 2022

AbstractRadiologists today play a central role in making diagnostic decisions and labeling images for training and benchmarking artificial intelligence (AI) algorithms. A key concern is low inter-reader reliability (IRR) seen between experts when interpreting challenging cases. While team-based decisions are known to outperform individual decisions, inter-personal biases often creep up in group interactions which limit nondominant participants from expressing true opinions. To overcome the dual problems of low consensus and interpersonal bias, we explored a solution modeled on bee swarms. Two separate cohorts, three board-certified radiologists, (cohort 1), and five radiology residents (cohort 2) collaborated on a digital swarm platform in real time and in a blinded fashion, grading meniscal lesions on knee MR exams. These consensus votes were benchmarked against clinical (arthroscopy) and radiological (senior-most radiologist) standards of reference using Cohen’s kappa. The IRR of the consensus votes was then compared to the IRR of the majority and most confident votes of the two cohorts. IRR was also calculated for predictions from a meniscal lesion detecting AI algorithm. The attending cohort saw an improvement of 23% in IRR of swarm votes (k= 0.34) over majority vote (k= 0.11). Similar improvement of 23% in IRR (k= 0.25) in 3-resident swarm votes over majority vote (k= 0.02) was observed. The 5-resident swarm had an even higher improvement of 30% in IRR (k= 0.37) over majority vote (k= 0.07). The swarm consensus votes outperformed individual and majority vote decision in both the radiologists and resident cohorts. The attending and resident swarms also outperformed predictions from a state-of-the-art AI algorithm.
Cognitive changes are associated with increased blood-brain barrier leakage in non-brain metastases lung cancer patients
Authors: Zhang Da-Fu , Li Zhen-Hui , Zhang Zhi-Ping , He Yin-Fu , Shang Bin-Li , Xu Xiu-Feng , Ding Ying-Ying , Cheng Yu-Qi 
Published: November 2022

AbstractTo explore the relationship between cognitive function and blood–brain barrier leakage in non-brain metastasis lung cancer and healthy controls. 75 lung cancers without brain metastasis and 29 healthy controls matched with age, sex, and education were evaluated by cognitive assessment, and the Patlak pharmacokinetic model was used to calculate the average leakage in each brain region according to the automated anatomical labeling atlas. After that, the relationships between cognitive and blood–brain barrier leakage were evaluated. Compared with healthy controls, the leakage of bilateral temporal gyrus and whole brain gyrus were higher in patients with lung cancers (P < 0.05), mainly in patients with advanced lung cancer (P < 0.05), but not in patients with early lung cancer (P > 0.05). The cognitive impairment of advanced lung cancers was mainly reflected in the damage of visuospatial/executive, and delayed recall. The left temporal gyrus with increased blood–brain barrier leakage showed negative correlations with delayed recall (r = -0.201, P = 0.042). An increase in blood–brain barrier leakage was found in non-brain metastases advanced lung cancers that corresponded to decreased delayed recall. With progression in lung cancer staging, blood–brain barrier shows higher leakage and may lead to brain metastases and lower cognitive development.
Anisotropic Continuum-Molecular Models: A Unified Framework Based on Pair Potentials for Elasticity, Fracture and Diffusion-Type Problems
Authors: Diana Vito 
Published: November 2022

AbstractThis paper presents a unified framework for continuum-molecular modeling of anisotropic elasticity, fracture and diffusion-based problems within a generalized two-dimensional peridynamic theory. A variational procedure is proposed to derive the governing equations of the model, that postulates oriented material points interacting through pair potentials from which pairwise generalized actions are computed as energy conjugates to properly defined pairwise measures of primary field variables. While mass is considered as continuous function of volume, we define constitutive laws for long-range interactions such that the overall anisotropic behavior of the material is the result of the assigned elastic, conductive and failure micro-interaction properties. The non-central force assumption in elasticity, together with the definition of specific orientation-dependent micromoduli functions respecting material symmetries, allow to obtain a fully anisotropic non-local continuum using a purely pairwise description of deformation and constitutive properties. A general and consistent micro-macro moduli correspondence principle is also established, based on the formal analogy with the classic elastic and conductivity tensors. The main concepts presented in this work can be used for further developments of anisotropic continuum-molecular formulations to include other mechanical behaviors and coupled phenomena involving different physics.