bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term patterns of cave-exiting activity of hibernating bats in western North America
Authors: Whiting Jericho C. , Doering Bill , Aho Ken , Rich Jason
Published: April 2021

Understanding frequency and variation of cave-exiting activity after arousal from torpor of hibernating bats is important for bat ecology and conservation, especially considering white-nose syndrome. In winter from 2011 to 2018, we acoustically monitored, and counted in hibernacula, two species of conservation concern—western small-footed myotis (Myotis ciliolabrum) and Townsend’s big-eared bats (Corynorhinus townsendii)—in 9 caves located in important habitat for these species in western North America. We investigated if cave-exiting activity differed by species, cave, number of hibernating bats, moon phase, and weather variables. Both species exited hibernacula during all winter months, but most activity occurred in March followed by November. Although we counted almost 15 times more Townsend’s big-eared bats during hibernacula surveys, we documented western small-footed myotis exiting caves 3 times more than Townsend’s big-eared bats. Cave-exiting activity increased with increasing number of hibernating bats, but more so for western small-footed myotis. Both species of bats were active during warm weather and low wind speeds. Western small-footed myotis were more active during colder temperatures, higher wind speeds, and greater change in barometric pressure than Townsend’s big-eared bats. Our results provide a long-term dataset of cave-exiting activity after arousal from torpor during hibernation for these species before the arrival of white-nose syndrome.
Adrenergic inhibition facilitates normalization of extracellular potassium after cortical spreading depolarization
Authors: Monai Hiromu , Koketsu Shinnosuke , Shinohara Yoshiaki , Ueki Takatoshi , Kusk Peter , Hauglund Natalie L. , Samson Andrew J. , Nedergaard Maiken , Hirase Hajime
Published: April 2021

Cortical spreading depolarization (CSD) is a propagating wave of tissue depolarization characterized by a large increase of extracellular potassium concentration and prolonged subsequent electrical silencing of neurons. Waves of CSD arise spontaneously in various acute neurological settings, including migraine aura and ischemic stroke. Recently, we have reported that pan-inhibition of adrenergic receptors (AdRs) facilitates the normalization of extracellular potassium after acute photothrombotic stroke in mice. Here, we have extended that mechanistic study to ask whether AdR antagonists also modify the dynamics of KCl-induced CSD and post-CSD recovery in vivo. Spontaneous neural activity and KCl-induced CSD were visualized by cortex-wide transcranial Ca2+ imaging in G-CaMP7 transgenic mice. AdR antagonism decreased the recurrence of CSD waves and accelerated the post-CSD recovery of neural activity. Two-photon imaging revealed that astrocytes exhibited aberrant Ca2+ signaling after passage of the CSD wave. This astrocytic Ca2+ activity was diminished by the AdR antagonists. Furthermore, AdR pan-antagonism facilitated the normalization of the extracellular potassium level after CSD, which paralleled the recovery of neural activity. These observations add support to the proposal that neuroprotective effects of AdR pan-antagonism arise from accelerated normalization of extracellular K+ levels in the setting of acute brain injury.
Influence of physical activity before and during pregnancy on infant’s sleep and neurodevelopment at 1-year-old
Authors: Nakahara Kazushige , Michikawa Takehiro , Morokuma Seiichi , Ogawa Masanobu , Kato Kiyoko , Sanefuji Masafumi , Shibata Eiji , Tsuji Mayumi , Shimono Masayuki , Kawamoto Toshihiro , Ohga Shouichi , Kusuhara Koichi ,   the Japan Environment and Children’s Study Group, Kamijima Michihiro , Yamazaki Shin , Ohya Yukihiro , Kishi Reiko , Yaegashi Nobuo , Hashimoto Koichi , Mori Chisato , Ito Shuichi , Yamagata Zentaro , Inadera Hidekuni , Nakayama Takeo , Iso Hiroyasu , Shima Masayuki , Kurozawa Youichi , Suganuma Narufumi , Katoh Takahiko
Published: April 2021

The aim of this study was to investigate the association between maternal physical activity (PA) before and during pregnancy and sleep and developmental problems in 1-year-old infants. We used data from a nationwide cohort study in Japan that registered 103,062 pregnancies between 2011 and 2014. Participants were asked about their PA before and during pregnancy, and the sleep and development of their children at the age of 1 year. Maternal PA was estimated using the International Physical Activity Questionnaire and was expressed in METs per week. We defined scores below the cut-off points of the Ages and Stages Questionnaire (ASQ) as abnormal for infant development. Based on the levels of PA before or during pregnancy, the participants were divided into five groups. In mothers with higher PA levels, the risk ratio for bedtime after 22:00 or abnormal ASQ scores in their 1-years-old infants were lower. These associations were observed for PA before and during pregnancy. Higher levels of maternal PA, both before and during pregnancy, may reduce sleep and developmental problems in infants.
Diabetes is associated with greater leg pain and worse patient-reported outcomes at 1 year after lumbar spine surgery
Authors: Nagata Kosei , Nakamoto Hideki , Sumitani Masahiko , Kato So , Yoshida Yuichi , Kawamura Naohiro , Tozawa Keiichiro , Takeshita Yujiro , Nakarai Hiroyuki , Higashikawa Akiro , Iizuka Masaaki , Ono Takashi , Fukushima Masayoshi , Sasaki Katsuyuki , Okazaki Rentaro , Ito Yusuke , Hara Nobuhiro , Doi Toru , Taniguchi Yuki , Matsubayashi Yoshitaka , Tanaka Sakae , Oshima Yasushi
Published: April 2021

Although patients with diabetes reportedly have more back pain and worse patient-reported outcomes than those without diabetes after lumbar spine surgery, the impact of diabetes on postoperative recovery in pain or numbness in other regions is not well characterized. In this study, the authors aimed to elucidate the impact of diabetes on postoperative recovery in pain/numbness in four areas (back, buttock, leg, and sole) after lumbar spine surgery. The authors retrospectively reviewed 993 patients (152 with diabetes and 841 without) who underwent decompression and/or fixation within three levels of the lumbar spine at eight hospitals during April 2017–June 2018. Preoperative Numerical Rating Scale (NRS) scores in all four areas, Oswestry Disability Index (ODI), and Euro quality of life 5-dimension (EQ-5D) were comparable between the groups. The diabetic group showed worse ODI/EQ-5D and greater NRS scores for leg pain 1 year after surgery than the non-diabetic group. Although other postoperative NRS scores tended to be higher in the diabetic group, the between-group differences were not significant. Diabetic neuropathy caused by microvascular changes may induce irreversible nerve damage especially in leg area. Providers can use this information when counseling patients with diabetes about the expected outcomes of spine surgery.
Data suggest COVID-19 affected numbers greatly exceeded detected numbers, in four European countries, as per a delayed SEIQR model
Authors: Tiwari Sankalp , Vyasarayani C. P. , Chatterjee Anindya
Published: April 2021

People in many countries are now infected with COVID-19. By now, it is clear that the number of people infected is much greater than the number of reported cases. To estimate the infected but undetected/unreported cases using a mathematical model, we can use a parameter called the probability of quarantining an infected individual. This parameter exists in the time-delayed SEIQR model (Scientific Reports, article number: 3505). Here, two limiting cases of a network of such models are used to estimate the undetected population. The first limit corresponds to the network collapsing onto a single node and is referred to as the mean-$$\beta$$
β
model. In the second case, the number of nodes in the network is infinite and results in a continuum model wherein the infectivity is statistically distributed. We use a generalized Pareto distribution to model the infectivity. This distribution has a fat tail and models the presence of super-spreaders that contribute to the disease progression. While both models capture the detected numbers well, the predictions of affected numbers from the continuum model are more realistic. Our results suggest that affected people outnumber detected people by one to two orders of magnitude in Spain, the UK, Italy, and Germany. Our results are consistent with corresponding trends obtained from published serological studies in Spain, the UK and Italy. The match with limited studies in Germany is poor, possibly because Germany’s partial lockdown approach requires different modeling.
Development of a novel heterologous gene expression system using earthworms
Authors: Akazawa Shin-ichi , Machida Yu , Takeuchi Aya , Wakatsuki Yuka , Kanda Naoki , Kashima Norito , Murayama Hayato
Published: April 2021

In recent years, animals and plants have received increasing attention as potential next-generation protein production systems, especially for biopharmaceuticals and animal proteins. The aim of the present study was to develop the earthworms Eisenia fetida Waki and Eisenia andrei Sagami as next-generation animal protein production hosts. These earthworms have been approved as model animals for acute toxicity tests by the Organization for Economic Co-operation and Development, and they have post-translational modification systems. However, so far, none of the studies have used earthworm transfection techniques. Thus, we developed a transfection method for E. fetida and E. andrei using microinjection and electroporation systems. The maximum survival rates and transfection efficiencies were 79.2% and 29.2% for E. fetida, and 95.8% and 50.0% for E. andrei, respectively. Furthermore, human erythropoietin was detected in the transformed earthworm tail fragments using an enzyme-linked immunosorbent assay. These results contribute to the development of a potential earthworm-based novel animal protein production system.
Rifted margins classification and forcing parameters
Authors: Sapin F. , Ringenbach J.-C. , Clerc C.
Published: April 2021

Rifted margins are the result of the successful process of thinning and breakup of the continental lithosphere leading to the formation of new oceanic lithosphere. Observations on rifted margins are now integrating an increasing amount of multi-channel seismic data and drilling of several Continent-Ocean Transitions. Based on large scale geometries and domains observed on high-quality multi-channel seismic data, this article proposes a classification reflecting the mechanical behavior of the crust from localized to diffuse deformation (strong/coupled to weak/decoupled mechanical behaviors) and magmatic intensity leading to breakup from magma-rich to magma-poor margins. We illustrate a simple classification based on mechanical behavior and magmatic production with examples of rifted margins. We propose a non-exhaustive list of forcing parameters that can control the initial rifting conditions but also their evolution through time. Therefore, rifted margins are not divided into opposing types, but described as a combination and continuum that can evolve through time and space.
Author Correction: The dynamics of plant nutation
Authors: Raja Vicente , Silva Paula L. , Holghoomi Roghaieh , Calvo Paco
Published: April 2021

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Performance of a cardiac lipid panel compared to four prognostic scores in chronic heart failure
Authors: McGranaghan Peter , Saxena Anshul , Düngen Hans-Dirk , Rubens Muni , Appunni Sandeep , Salami Joseph , Veledar Emir , Lacour Philipp , Blaschke Florian , Obradovic Danilo , Loncar Goran , Tahirovic Elvis , Edelmann Frank , Pieske Burkert , Trippel Tobias Daniel
Published: April 2021

The cardiac lipid panel (CLP) is a novel panel of metabolomic biomarkers that has previously shown to improve the diagnostic and prognostic value for CHF patients. Several prognostic scores have been developed for cardiovascular disease risk, but their use is limited to specific populations and precision is still inadequate. We compared a risk score using the CLP plus NT-proBNP to four commonly used risk scores: The Seattle Heart Failure Model (SHFM), Framingham risk score (FRS), Barcelona bio-HF (BCN Bio-HF) and Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score. We included 280 elderly CHF patients from the Cardiac Insufficiency Bisoprolol Study in Elderly trial. Cox Regression and hierarchical cluster analysis was performed. Integrated area under the curves (IAUC) was used as criterium for comparison. The mean (SD) follow-up period was 81 (33) months, and 95 (34%) subjects met the primary endpoint. The IAUC for FRS was 0.53, SHFM 0.61, BCN Bio-HF 0.72, MAGGIC 0.68, and CLP 0.78. Subjects were partitioned into three risk clusters: low, moderate, high with the CLP score showing the best ability to group patients into their respective risk cluster. A risk score composed of a novel panel of metabolite biomarkers plus NT-proBNP outperformed other common prognostic scores in predicting 10-year cardiovascular death in elderly ambulatory CHF patients. This approach could improve the clinical risk assessment of CHF patients.
Computational analysis of macrolides as SARS-CoV-2 main protease inhibitors: a pattern recognition study based on molecular topology and validated by molecular docking
Authors: Zanni Riccardo , Galvez-Llompart Maria , Galvez Jorge
Published: April 2021

Macrolides share the same chemo-mathematical pattern as SARS-CoV-2 protease inhibitors.
Green synthesis of starch-capped Cu2O nanocubes and their application in the direct electrochemical detection of glucose
Authors: Jiménez-Rodríguez Antonio , Sotelo Eduardo , Martínez Lidia , Huttel Yves , González María Ujué , Mayoral Alvaro , García-Martín José Miguel , Videa Marcelo , Cholula-Díaz Jorge L.
Published: April 2021

Starch-capped Cu2O nanocubes were used as an active electrochemical element to directly detect glucose.
A hairpin probe-mediated DNA circuit for the detection of themecAgene ofStaphylococcus aureusbased on exonuclease III and DNAzyme-mediated signal amplification
Authors: Pan Jiafeng , Bao Dongqin , Bao Enhu , Chen Junhua
Published: April 2021

A hairpin probe-mediated DNA circuit for the detection of themecAgene ofStaphylococcus aureuswith high sensitivity and selectivity based on exonuclease III and DNAzyme-mediated signal amplification.
Covalent triazine frameworks constructed via benzyl halide monomers showing high photocatalytic activity in biomass reforming
Authors: Guan Lijiang , Cheng Guang , Tan Bien , Jin Shangbin
Published: April 2021

Covalent triazine frameworks were efficiently synthesized from benzyl halide derived monomers, and showed high activity in photocatalytic biomass reforming.
Persistent 2c–3e σ-bonded heteronuclear radical cations centered on S/Se and P/As atoms
Authors: Yang Wenbang , Wang Wenqing , Zhang Leran , Zhang Li , Ruan Huapeng , Feng Zhongtao , Fang Yong , Wang Xinping
Published: April 2021

The synthesis and characterization of persistent radical cations featuring heteronuclear 2c–3e σ-bonds between chalcogen and pnicogen atoms.
Surface free energy of diamond nanocrystals – a molecular dynamics study of its size dependence
Authors: Skrobas Kazimierz , Stefanska-Skrobas Kamila , Stelmakh Svitlana , Gierlotka Stanislaw , Palosz Bogdan
Published: April 2021

The surface free energy value of nanoparticles is not constant – it depends on particle shape and varies with particle size.
In situ construction of a 2D/2D heterostructured ZnIn2S4/Bi2MoO6Z-scheme system for boosting the photoreduction activity of Cr(vi)
Authors: Lin Jie , He Jiale , Hu Jianqiang , Dong Jiaqi , Liu Anyu , Yang Yong , Tang Lanqin , Li Liang , Zhou Yong , Zou Zhigang
Published: April 2021

The direct 2D/2D Z-scheme heterostructures of ZnIn2S4/Bi2MoO6 were rationally constructed, exhibiting obviously enhanced photocatalytic activity for Cr(vi) reduction under visible light (λ ≥ 420 nm) irradiation.
Enhancing the chemical flexibility of hybrid perovskites by introducing divalent ligands
Authors: Burley Lydia G. , Beecham-Lonsdale James H. , Srivastava Anant Kumar , Collings Ines E. , Saines Paul J.
Published: April 2021

Incorporating divalent ligands allows for solely A+ and B3+ cations in hybrid perovskites observed to have anisotropic thermal expansion.
Skipped dienes in natural product synthesis
Authors: Petruncio Greg , Shellnutt Zachary , Elahi-Mohassel Synah , Alishetty Suman , Paige Mikell
Published: April 2021

The 1,4-diene motif, also known as a skipped diene, is widespread across various classes of natural products including alkaloids, fatty acids, terpenoids, and polyketides as part of either the finalized structure or a biosynthetic intermediate.
Hot off the press
Authors: Hill Robert A. , Sutherland Andrew
Published: April 2021

A personal selection of 32 recent papers is presented covering various aspects of current developments in bioorganic chemistry and novel natural products such as eurysoloid A from Eurysolen gracilis.
Biofabricated silver nanoparticles exhibit broad-spectrum antibiofilm and antiquorum sensing activity against Gram-negative bacteria
Authors: Qais Faizan Abul , Ahmad Iqbal , Altaf Mohammad , Manoharadas Salim , Al-Rayes Basel F. , Ali Abuhasil Mohammed Saeed , Almaroai Yaser Ayesh
Published: April 2021

Green synthesized silver nanoparticles inhibit the quorum sensing and biofilm development of Gram-negative pathogenic bacteria
Multifunctional peptide-assembled micelles for simultaneously reducing amyloid-β and reactive oxygen species
Authors: Lei Li , Zou Zhifeng , Liu Jin , Xu Zhiai , Fu Ying , Tian Yang , Zhang Wen
Published: April 2021

Multifunctional micelles based on a peptide–polymer for simultaneously targeting Aβ degradation and ROS scavenging for AD therapy.
Oxygen vacancy enriched NiMoO4 nanorods via microwave heating: a promising highly stable electrocatalyst for total water splitting
Authors: Karmakar Arun , Karthick Kannimuthu , Sankar Selvasundarasekar Sam , Kumaravel Sangeetha , Ragunath Madhu , Kundu Subrata
Published: April 2021

Vacancy enriched NiMoO4(Vo) nanorods have been synthesized by utilizing microwave heating. The oxygen vacancy has bought an excellent OER/HER activity and to reach 10 mA cm−2, NiMoO4(Vo) as anode and cathode just required 360 mV as overpotential.
Ancient and present surface evolution processes in the Ash region of comet 67P/Churyumov-Gerasimenko
Authors: Bouquety A. , Jorda L. , Groussin O. , Sejourné A. , Bouley S. , Costard F.
Published: April 2021

Aims. The Rosetta mission provided us with detailed data of the surface of the nucleus of comet 67P/Churyumov-Gerasimenko. In order to better understand the physical processes associated with the comet activity and the surface evolution of its nucleus, we performed a detailed comparative morphometrical analysis of two depressions located in the Ash region.

Methods. To detect morphological temporal changes, we compared pre- and post-perihelion high-resolution (pixel scale of 0.07–1.75 m) OSIRIS images of the two depressions. We quantified the changes using the dynamic heights and the gravitational slopes calculated from the digital terrain model of the studied area. In particular, we measured seven geometric parameters associated with the two depressions (length, three width values, height, area, and volume) using the ArcGIS software before and after perihelion.

Results. Our comparative morphometrical analysis allowed us to detect and quantify the temporal changes that occurred in two depressions of the Ash region during the last perihelion passage. We find that the two depressions grew by several meters. The area of the smallest depression (structure I) increased by 90 ± 20%, with two preferential growths: one close to the cliff associated with the apparition of new boulders at its foot, and a second one on the opposite side of the cliff. The largest depression (structure II) grew in all directions, increasing in area by 20 ± 5%, and no new deposits have been detected. We interpreted these two depression changes as being driven by the sublimation of ices, which explains their global growth and which can also trigger landslides. The deposits associated with depression II reveal a stair-like topography, indicating that they have accumulated during several successive landslides from different perihelion passages. Overall, these observations bring additional evidence of complex active processes and reshaping events occurring on short timescales (months to years), such as depression growth and landslides, and on longer timescales (decades to millenniums), such as cliff retreat.
In vitro and in vivo antileishmanial activity of β-acetyl-digitoxin, a cardenolide of Digitalis lanata potentially useful to treat visceral leishmaniasis
Authors: Freitas Camila S. , Lage Daniela P. , Oliveira-da-Silva João A. , Costa Rafaella R. , Mendonça Débora V.C. , Martins Vívian T. , Reis Thiago A.R. , Antinarelli Luciana M.R. , Machado Amanda S. , Tavares Grasiele S.V. , Ramos Fernanda F. , Brito Rory C.F. , Ludolf Fernanda , Chávez-Fumagalli Miguel A. , Roatt Bruno M. , Ramos Gabriela S. , Munkert Jennifer , Ottoni Flaviano M. , Campana Priscilla R.V. , Duarte Mariana C. , Gonçalves Denise U. , Coimbra Elaine S. , Braga Fernão C. , Pádua Rodrigo M. , Coelho Eduardo A.F.
Published: April 2021

Current treatments of visceral leishmaniasis face limitations due to drug side effects and/or high cost, along with the emergence of parasite resistance. Novel and low-cost antileishmanial agents are therefore required. We report herein the antileishmanial activity of β-acetyl-digitoxin (b-AD), a cardenolide isolated from Digitalis lanata leaves, assayed in vitro and in vivo against Leishmania infantum. Results showed direct action of b-AD against parasites, as well as efficacy for the treatment of Leishmania-infected macrophages. In vivo experiments using b-AD-containing Pluronic® F127 polymeric micelles (b-AD/Mic) to treat L. infantum-infected mice showed that this composition reduced the parasite load in distinct organs in more significant levels. It also induced the development of anti-parasite Th1-type immunity, attested by high levels of IFN-γ, IL-12, TNF-α, GM-CSF, nitrite and specific IgG2a antibodies, in addition to low IL-4 and IL-10 contents, along with higher IFN-γ-producing CD4+ and CD8+ T-cell frequency. Furthermore, low toxicity was found in the organs of the treated animals. Comparing the therapeutic effect between the treatments, b-AD/Mic was the most effective in protecting animals against infection, when compared to the other groups including miltefosine used as a drug control. Data found 15 days after treatment were similar to those obtained one day post-therapy. In conclusion, the results obtained suggest that b-AD/Mic is a promising antileishmanial agent and deserves further studies to investigate its potential to treat visceral leishmaniasis.
Assessment of Retinal Neurodegeneration and Choroidal Thickness in COVID-19 Patients Using Swept-Source OCT Technology
Authors: Cetinkaya Tugba , Kurt Muhammed M. , Akpolat Cetin
Published: April 2021

Purpose To analyze the central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), and choroidal thickness (ChT) measurements in patients with coronavirus disease 2019 (COVID-19).

Methods The study was conducted cross-sectionally 4 weeks after the completed treatment of COVID-19. The diagnosis of COVID-19 was based on the polymerase chain reaction test and/or clinical and radiological findings. The patients with treated COVID-19 were enrolled in the COVID-19 group; age- and sex-matched healthy participants served as the control group. All patients in the COVID-19 group were hospitalized and treated with favipiravir, moxifloxacin, and heparin without the requirement for intubation. The measurements of CMT, RNFLT (in four quadrants), GCLT (in six sectors of two different boundaries), and ChT (in five locations) were performed by swept-source optical coherence tomography (SS-OCT).

Results Similar visual acuity (p = 0.582) and intraocular pressure (p = 0.766) values were observed between the COVID-19 and control groups. Regarding SS-OCT measurements, all mean CMT, RNFLT (in four quadrants), GCLT (in six sectors of two different boundaries), and ChT (in five locations) values were similar in the COVID-19 and control groups (p > 0.05 for all). In the COVID-19 group, a statistically significant negative correlation was noted between the mean ferritin level and temporal RNFLT (r = − 0.378, p = 0.014) and a positive correlation was observed between the mean ferritin level and nasal RNFLT (r = + 0.371, p = 0.016).

Conclusion SS-OCT measurements showed no retinal neurodegenerative and choroidal thickness alterations in COVID-19 patients. Nonsignificant results might be due to the examination of the patients in the early period of the COVID-19 after the treatment. Therefore, late period OCT measurements should be reviewed with new studies in the future.
Zwanzig-Nagel-Dystrophie der Kindheit
Authors: Makris N. , Megahed M.
Published: April 2021

Zwanzig-Nagel-Dystrophie (ZND) der Kindheit ist eine seltene gutartige Nagelkrankheit, bei der alle 20 Nägel betroffen sind. Sie tritt normalerweise idiopathisch auf, kann sich aber mit einer Vielzahl von dermatologischen und nicht dermatologischen Erkrankungen entwickeln. Histopathologisch handelt es sich u. a. um eine Entzündung der Matrix der Nägel, deren Ausmaß zu dem Schweregrad des klinischen Bilds beiträgt. ZND der Kindheit ist i. d. R. eine selbstlimitierende Erkrankung, sodass die Beratung und Beruhigung des Kindes und der Eltern als vernünftige Behandlungsmöglichkeiten gelten. Wir berichten über einen Fall eines 7-jährigen Jungen mit einer 1-jährigen Vorgeschichte von 20-Nagel-Dystrophie ohne eigene Krankheiten oder Haut- oder Nagelerkrankungen in der Familienanamnese.
The fate of paratesticular masses: 13 years’ experience in a tertiary referral centre
Authors: Demirel Huseyin Cihan , Tokuç Emre , Eryilmaz Ozlem Ton , Aykanli Emre , Yavuzsan Abdullah Hizir , Ozagari Ayse Aysim , Kirecci Sinan Levent , Horasanli Kaya
Published: April 2021

Objective Paratesticular neoplasms exhibit different behaviours, depending on the embryological tissue of origin. Treatment modalities can depend on the differential diagnosis. The aim of this study is to present the clinical, morphological and histopathological features of patients with paratesticular masses and their follow-ups and is intended to increase awareness of the issues.

Methodology We included 31 excisions of paratesticular masses, after radiological diagnosis as paratesticular mass in our hospital between 2007–2020. Information on treatment modalities, tumour recurrence, metastasis, and survival rates were obtained from hospital archives. All patients were evaluated by taking patients’ history, physical examination, scrotal ultrasound, chest radiography, and serum tumour markers. Treatment modality was selected according to intraoperative findings. Haematoxylin-eosin sections were examined, and immunohistochemical analyses were performed for smooth muscle actin, desmin, Ki67, CD34, S100, and myogenin. Ten high-power fields were counted to document Ki67 and p53 nuclear positivity rates.

Results A total of 31 operations were performed with recurrence in three patients. Histomorphological and immunohistochemical examination revealed eleven malignant masses; eight rhabdomyosarcomas, a leiomyosarcoma, a liposarcoma and a large B cell lymphoma. Other excised masses were benign and infective lesions.

Conclusion Paratesticular masses are heterogeneous tumours that follow different clinical courses. Clinicians must be aware of this histological diversity in order to plan a treatment pathway. This study is one of the largest published series, with a long follow-up period. It shows that the most critical features in determining prognosis are histopathological subtype and tumour grade.
Beinvenenthrombose und Lungenembolie nach Varizensklerosierung
Authors: Elsner P. , Meyer J.
Published: April 2021

Bei einer Patientin erfolgte unter der klinischen Diagnose „Venektasien Oberschenkel- und Unterschenkelbereich“ eine Schaumsklerosierungsbehandlung mittels Äthoxysklerolschaum. 5 Tage später stellte sich die Patientin mit starken Schmerzen im Wadenbereich und starker Behinderung beim Auftreten wieder vor, wobei nach klinischer Befunderhebung mit diskretem Rötungsnachweis der Verdacht auf eine Thrombophlebitis geäußert wurde. Die Behandlung erfolgte mit Ibuprofen. Ein Termin zu einer duplexsonografischen Untersuchung 11 Tage später wurde vereinbart, von der Patientin allerdings erst nach 16 Tagen wahrgenommen, wobei eine Phlebografie erfolgte, die eine tiefe Venenthrombose zeigte. Eine folgende stationäre Behandlung ergab zusätzlich eine Lungenarterienembolie.

Die Patientin bemängelte ihre Behandlung in der Hautarztpraxis. Durch eine fehlerhafte Verödungsbehandlung bzw. Nachkontrolle sei eine tiefe Thrombose mit nachfolgender Lungenembolie nicht erkannt worden und durch Verkennung offenkundiger Symptome eine Falschbehandlung erfolgt.

Von einem hinzugezogenen dermatologischen Gutachter und der Schlichtungsstelle wurde ein Behandlungsfehler bestätigt. Die Verödungstherapie stellte zwar eine anerkannte Behandlungsmethode der Varikosis nach Facharztstandard dar. Eine tiefe Venenthrombose nach Sklerosierungstherapie ist zwar sehr selten, jedoch wären nach Wiedervorstellung der Patientin wegen erheblicher Beschwerden weiterführende diagnostische Maßnahmen, insbesondere eine duplexsonografische Abklärung, ohne wesentliche Zeitverzögerung indiziert gewesen. Es handelte sich um einen Befunderhebungsmangel, der im konkreten Fall zu einer Beweislastumkehr hinsichtlich der Kausalität des Behandlungsfehlers für den eingetretenen Schaden führte.

Nach endovenösen Eingriffen bei Varikosis sind tiefe Venenthrombosen mit dem Risiko einer Lungenembolie seltene, aber typische Komplikationen. Bei nach einer Schaumsklerosierung auftretenden Extremitätenschmerzen sollte eine tiefe Venenthrombose differenzialdiagnostisch erwogen und unverzüglich durch eine Duplexsonografie und Bestimmung der D-Dimere bestätigt oder ausgeschlossen und ggf. leitliniengerecht therapiert werden. Die Verzögerung eines indizierten Thromboseausschlusses kann als schuldhafter Befunderhebungsfehler mit der Folge der Beweislastumkehr gewertet werden.
Clinical efficacy and safety of magnetic sphincter augmentation (MSA) and transoral incisionless fundoplication (TIF2) in refractory gastroesophageal reflux disease (GERD): a systematic review and meta-analysis
Authors: Chandan Saurabh , Mohan Babu P. , Khan Shahab R. , Jha Lokesh K. , Dhaliwal Amaninder J. , Bilal Mohammad , Aziz Muhammad , Canakis Andrew , Arora Sumant , Malik Sarah , Kassab Lena L. , Ponnada Suresh , Bhat Ishfaq , Hewlett Alexander T. , Sharma Neil , McDonough Stephanie , Adler Douglas G.
Published: April 2021

Background and study aims Proton pump inhibitors (PPI) are effective medical therapy options for gastro-esophageal reflux disease (GERD). However, 20 % to 40 % of patients report symptoms despite taking daily PPI. Transoral incisionless fundoplication (TIF2) and magnetic sphincter augmentation (MSA) are less invasive options for the treatment of refractory GERD and are increasingly gaining popularity.

Methods We conducted a comprehensive search of several databases to identify relevant studies. Our primary aim was to compare the efficacy of both interventions reported as improvement in Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) score, overall patient satisfaction, improvement in post-procedure regurgitation, and fraction of patients completely off PPI therapy at follow up.

Results Twenty-four studies with 1942 patients were included in the final analysis. Both MSA and TIF2 had comparable technical success and clinical success based on improvement in GERD-HRQL scores i. e. 98.8 % (CI 95.6,99.7) vs 98.5 % (CI 95.7,99.5) and 80.4 % (CI 66,89.6) vs 77.7 % (CI 64.1,87.2), respectively. A significantly greater proportion of patients reported improvement in regurgitation, i. e. 91.1 % (CI 83.8,95.3) vs 73.1 % (CI 62.5,81.7) and were able to completely discontinue PPI therapy with MSA compared to TIF2 i. e. 91.3 % (CI 81.5,96.2) vs 63.8 % (CI 51.6,74.4). Patients’ BMI and presence of a hiatal hernia did not have any effect on procedural outcomes.

Conclusion Both procedures performed at par when comparing clinical success in terms of improvement in GERD-HRQL scores. In terms of overall patient satisfaction, post procedure regurgitation and cumulative number of patients off PPI therapy, MSA outperforms TIF2.
Effect of music on pediatric endoscopic examinations: a randomized controlled trial
Authors: Bay Constanza , Henriquez Romina , Villarroel Luis , Gana Juan Cristóbal
Published: April 2021

Background and study aims The primary objective was to measure the effect of music as an adjunct to sedation in patient anxiety levels during pediatric endoscopic examinations.

Patients and methods We performed a single-blind randomized controlled trial comparing music with no music in children aged 2 to 18 years. Anxiety was measured using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Visual Analog Anxiety Scale (VAS-anxiety). Patient perception of pain was evaluated with the Wong-Baker Faces Pain Rating Scale (WBFPRS). Patient experience, family satisfaction, and endoscopist perception of difficulty were evaluated. Sedative doses were recorded.

Results A total of 51 children were randomized to the experimental group and 49 children to the control group. The mean ages were 10.5 years and 12.3 years, respectively. There were 63 % female subjects with no differences between groups. Overall, there were 85 upper endoscopies and 15 colonoscopies. In the recovery unit, the experimental group had lower average m-YPAS scores (mean score 27.7 vs 34.7; P < 0.001), a higher proportion of them had low m-YPAS scores (80 % vs 49 % P < 0.001), had lower VAS-anxiety scores [mean score 0.55 vs 1.57 (P = 0.003)], and had lower WBFPRS scores [mean score 2.7 vs 1.3 (P = 0.001)]. There were no statistically significant differences found in the amount of standard sedation given to the groups, nor in additional sedation administered. In the experimental group, the patient-reported experience was significantly better.

Conclusions The study results show that music reduces anxiety and pain associated with endoscopic procedures in children. It also facilitates these procedures and improves patient satisfaction.
Alternative operative Verfahren zur Behandlung der gastroösophagealen Refluxerkrankung
Authors: Schoppmann Sebastian F.
Published: April 2021

Das Versagen der medikamentösen Therapie bei mehr als 30% der Patienten mit gastroösophagealer Refluxerkrankung (GERD) wie auch zunehmende Bedenken bez. einer säurehemmenden Dauertherapie haben zu einer neuen Fokussierung auf chirurgische Antirefluxtherapien geführt. Unter den Sphinkteraugmentationsverfahren haben die beiden laparoskopischen Verfahren, die magnetische (LINX) und die elektrische (EndoStim), eine breitere Anwendung gefunden. Die magnetische Sphinkteraugmentation stellte eine sehr sichere (Komplikationsrate 0,1% und Reoperationsrate 3,4%) Methode dar, die sowohl zu signifikanten Verbesserungen der subjektiven (GERD-HRQL-Verbesserung 19,9 auf 4,1; p = 0,001) als auch objektiven GERD-Erfolgsparameter (79% PPI-Freiheit und 89% Normalisierung der Säureexposition im distalen Ösophagus) führt. Die elektrische Sphinkteraugmentation hat erste vielversprechende Kurzzeitergebnisse in geringen Patientenanzahlen gezeigt (92% subjektive Beschwerdeverbesserung). Ein Vergleich zum operativen Goldstandard der laparoskopischen Fundoplikation ist bei beiden Methoden ausständig. Alternative, laparoskopische Antirefluxmethoden stellen eine potenzielle Alternative zur laparoskopischen Fundoplikation dar.
The Prevention of Positioning Injuries During Gynecologic Surgery. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/077, October 2020)
Authors: Fleisch Markus C. , Bader Werner , Balzer Kai , Bennefeld Luisa , Boeing Carsten , Bremerich Dorothee , Gass Paul , Geissbuehler Verena , Koch Martin C. , Nothacker Monika J. , Pietzner Klaus , Renner Stefan P. , Römer Thomas , Roth Stephan , Schütz Florian , Schulte-Mattler Wilhelm , Sehouli Jalid , Lippach Kristina , Tamussino Karl , Teichmann Alexander , Tempfer Clemens , Thill Marc , Tinneberg Hans-Rudolf , Zarras Konstantinos
Published: April 2021

Purpose Positioning injuries are relatively common, forensically highly relevant complications of gynecologic surgery. The aim of this official AWMF S2k-guideline is to provide statements and recommendations on how to prevent positioning injuries using the currently available literature. The literature was evaluated by an interdisciplinary group of experts from professional medical societies. The consensus on recommendations and statements was achieved in a structured consensus process.

Method The current guideline is based on the expired S1-guideline, which was updated by a systematic search of the literature and a review of relevant publications issued between February 2014 and March 2019. Statements were compiled and voted on by a panel of experts.

Recommendations The guideline provides general and specific recommendations on the prevention, diagnosis and treatment of positioning injuries.
The Efficacy of Ab Externo Canaloplasty by Using a Nonabsorbable Suture and No Viscoelastics; IOP Results, Intraoperative and Early Complication Rates within 6-Month Follow-Up Period
Authors: Vastardis Iraklis , Fili Sofia , Perdikakis Georgios , Kontopoulou Kalliopi , Gatzioufas Zisis , Kohlhaas Markus
Published: April 2021

Background To report the efficacy of ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification in terms of mean intraocular pressure (IOP), medication reduction, and intra- and postoperative complication rates as well as additional glaucoma surgery.

Patients and Methods Forty-eight patients with primary open-angle glaucoma (POAG) and 50 eyes were divided into two groups according to the operation performed (Group A canaloplasty, n = 34 and Group B canaloplasty combined with phaco, n = 16), respectively. The success criteria were evaluated between three IOP ranges: a) IOP ≤ 16 mmHg, b) ≤ 18 mmHg, and c) ≤ 21 mmHg. Complete success was considered the percentage of eyes reaching these goals with no medication and qualified success with or without medication. Groups A and B were compared with the Kaplan-Meier test. Mean IOP and medication reduction as well as additional glaucoma surgery were also evaluated. The follow-up time was 6 months. Statistical importance was given at p < 0.05.

Results Fail rate and intraoperative conversion of canaloplasty to other surgery (trabeculotomy due to extensive cheese-wiring) accounted for 12% (6 eyes), while a mandatory usage of the iTrack 250A microcatheter to successfully overcome intracanalicular bridging of the Schlemmʼs canal accounted for 20% (10 eyes). The most common early postoperative complications in both groups were hyphema, cheese wiring, and transient IOP rising. The mean IOP in Group A reduced from 23.67 ± 6.06 mmHg to 13.35 ± 4.23 mmHg and in Group B, it reduced from 23.55 ± 6.19 mmHg to 12.75 ± 1.5 mmHg at 6 months (p < 0.001). Group Aʼs absolute success rates accounted for a) 44%, b) 47.1%, and c) 52.9% in comparison to Group B [a) 50%, b) 50%, and c) 56.3%] at 6 months (p < 0.05). Qualified success with or without medication showed no statistical differences between the groups. The mean medication reduction was significantly lower (p < 0.001) in both groups (Group A from baseline
3.2 ± 1.23 to 0.95 ± 1.35 and Group B from 3.12 ± 0.88 to 1.12 ± 0.75 at 6 months, respectively). Five eyes (10%) required additional glaucoma surgery.

Conclusions Ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification seems to lower the mean IOP and medication sufficiently. However, they pose a greater surgical challenge and intraoperative complication rate. Additional glaucoma surgery or medication following both procedures may be necessary to achieve an optimal target IOP.
Optic Disc Features in Familial Retinal Arteriolar Tortuosity
Authors: Sinner Veronika , Heckmann Jan , Sturm Veit , Valmaggia Christophe , Todorova Margarita G.
Published: April 2021

Purpose Describing optic disc appearance in familial retinal arteriolar tortuosity (fRAT) using multimodal imaging and raising awareness of peripapillary arterial changes due to this disorder.

Methods A cross-sectional study was performed in four consecutive patients of two non-related families. Detailed ophthalmological examination was performed and supported by medical and family history and multimodal imaging.

Results In all subjects, increased tortuosity of second- and third-order retinal arteries in superior and deeper vascular plexus was documented. Furthermore, tortuosity in the peripapillary circle of Zinn-Haller was found. In addition, retinal vessel oximetry confirmed tortuosity only of the arterial vessels.

Conclusion The present data suggests that a blurry bordered, hyperemic optic disc in the presence of abnormally tortuous arteriolar vessels and asymptomatically or oligosymptomatically spontaneously resolved hemorrhages could be associated with a fRAT. This finding could be linked to peripapillary arterial vessel tortuosity.
Generation „Social Media“ – Nutzung moderner Medien zum Informationsgewinn bezüglich Sportverletzungen
Authors: Enz Andreas , Schöffl Volker , Simon Michael , Back David Alexander , Tischer Thomas , Lutter Christoph
Published: April 2021

Hintergrund Die Nutzung digitaler Medien ist in nahezu allen Bereich des täglichen Lebens zur Normalität geworden. Ziel dieser Arbeit war es zu analysieren, inwieweit verletzte Sportler Online-Medien nutzen, um Informationen über Sportverletzungen oder deren Prävention zu erhalten.

Material und Methoden Zwischen 07/2017 und 12/2019 wurden im Klettersport sowohl Freizeit- als auch Wettkampfsportler nach ihrer Nutzung verschiedener Medien mit Hinblick auf die Bereiche Sportmedizin und Prävention befragt.

Ergebnisse 488 Athleten wurden in die Studie eingeschlossen (70,9 % männlich, 29,1 % weiblich, 33,2 ± 10,3 (13–71) Jahre). 69,9 % der Athleten nutzen online verfügbare medizinische Inhalte, wobei die Videoplattform YouTube am häufigsten zur spezifischen Suche verwendet wird (24,4 %). Jüngere Athleten (< 30 Jahre) nutzen Videoplattformen deutlich häufiger als ältere Athleten (p = 0,011). Sportspezifische Literatur wird von der Altersgruppe 30.–50. Lebensjahr am häufigsten verwendet (37,4 %). Die Altersgruppe > 50 Jahre nutzt dieses Medium signifikant seltener (18,8 %; p = 0,013). Wettkampfathleten nutzen signifikant häufiger webbasierte medizinische Inhalte als Freizeitathleten (p = 0,005). Das generelle Interesse an Verletzungsprophylaxe ist groß, wobei Wettkampfathleten häufiger entsprechende Inhalte nutzen. Fast 9 % aller befragten Patienten begaben sich aufgrund ihrer Online-Recherchearbeit in eine entsprechende sportorthopädische Einrichtung.

Zusammenfassung Internetbasierte medizinische Informationen werden von 69,9 % der Athleten genutzt, die Videoplattform YouTube wird am häufigsten verwendet. Videoplattformen und sportspezifische Literatur werden von jüngeren Athleten deutlich häufiger als von älteren Athleten genutzt. Webbasierte medizinische Inhalte werden von Wettkampfathleten signifikant häufiger aufgerufen als von Freizeitathleten. Das generelle Interesse an Verletzungsprophylaxe ist groß, wobei Wettkampfathleten häufiger entsprechende Inhalte nutzen bzw. suchen.
Warten auf bundesweite Lösung – Schulgeldfreiheit
Authors: Wagner Pascal
Published: April 2021

Nach wie vor sind hohe Ausbildungskosten in der Physiotherapie ein Thema. Zwar sind viele Bundesländer inzwischen schulgeldfrei, einige warten allerdings immer noch auf eine deutschlandweite Lösung der Bundesregierung. Eine Übersicht über die aktuelle Situation.
Establishment of Early Pregnancy Related Thyroid Hormone Models and Reference Intervals for Pregnant Women in China Based on Real World Data
Authors: Ma Chaochao , Li Xiaoqi , Liu Lixin , Cheng Xinqi , Xue Fang , Wu Jie , Xia Liangyu , Yin Yicong , Wang Danchen , Zou Yutong , Qiu Ling , Liu Juntao
Published: April 2021

Thyroid hormone reference intervals are crucial for diagnosing and monitoring thyroid dysfunction during early pregnancy, and the dynamic change trend of thyroid hormones during pregnancy can assist clinicians to assess the thyroid function of pregnant women. This study aims to establish early pregnancy related thyroid hormones models and reference intervals for pregnant women. We established two derived databases: derived database* and derived database#. Reference individuals in database* were used to establish gestational age-specific reference intervals for thyroid hormones and early pregnancy related thyroid hormones models for pregnant women. Individuals in database# were apparently healthy non-pregnant women. The thyroid hormones levels of individuals in database# were compared with that of individuals in database* using nonparametric methods and the comparative confidence interval method. The differences in thyroid stimulating hormone and free thyroxine between early pregnant and non-pregnant women were statistically significant (p<0.0001). The reference intervals of thyroid stimulating hormone, free thyroxine and free triiodothyronine for early pregnant women were 0.052–3.393 μIU/ml, 1.01–1.54 ng/dl, and 2.51–3.66 pg/ml, respectively. Results concerning thyroid stimulating hormone and free thyroxine reference intervals of early pregnancy are comparable with those from other studies using the same detection platform. Early pregnancy related thyroid hormones models showed various change patterns with gestational age for thyroid hormones. Early pregnancy related thyroid hormones models and reference intervals for pregnant women were established, so as to provide accurate and reliable reference basis for the diagnosing and monitoring of maternal thyroid disfunction in early pregnancy.
Kollision mit Folgen – Fallbeispiel Schleudertrauma
Authors: Martina Aegerter Andrea , Luomajoki Hannu
Published: April 2021

Die 35-jährige Richterin Johanna Müller entwickelt eine Woche nach einem Autounfall Kopf- und Nackenschmerzen, Schwindel, massive Konzentrationsstörungen und Augenprobleme. Nach einem ausführlichen Befund konzentriert sich ihr Physiotherapeut auf Edukation und Hands-off-Therapien – mit Erfolg.
Mental Comorbidity in Rheumatic Diseases
Authors: Seifert Olga , Baerwald Christoph
Published: April 2021

In this review, we summarise the most relevant studies in a PubMed Search term
“mental disorders and rheumatic disease” in the last 15 years.
Mental disorders such as depression and anxiety are common in people with
rheumatic diseases. Treating these comorbidities can improve the patientʼs
quality of life. The high prevalence of symptoms of psychiatric disorders is a
challenge for rheumatologists, especially with regard to the differentiation of
possible psychiatric components in rheumatological diseases. Screening for
psychiatric problems in patients with rheumatic diseases should be evaluated as
soon as possible, as these can have a major influence on the perception of pain
and physical functioning status from the outset. Mental health disorders are
seen as a risk factor for poor patient outcomes, as patients may not adhere to
medical treatments. The potential side effects of biological agents can increase
patient anxiety and affect adherence to therapy. Therefore, interdisciplinary
care would be of great advantage in the treatment of rheumatic patients with
psychological comorbidities.