bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID‐19 in childhood: Transmission, clinical presentation, complications and risk factors
Authors: Siebach Melissa K. , Piedimonte Giovanni , Ley Sylvia H.
Published: March 2021

Children less than 18 years of age account for an estimated 2%–5% of reported severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) cases globally. Lower prevalence of coronavirus disease 2019 (COVID‐19) among children, in addition to higher numbers of mild and asymptomatic cases, continues to provide challenges in determining appropriate prevention and treatment courses. Here, we summarize the current evidence on the transmission, clinical presentation, complications and risk factors in regard to SARS‐CoV‐2 in children, and highlight crucial gaps in knowledge going forward. Based on current evidence, children are rarely the primary source of secondary transmission in the household or in child care and school settings and are more likely to contract the virus from an adult household member. Higher transmission rates are observed in older children (10–19 years old) compared with younger children ( <10 years old). While increasing incidence of COVID‐19 in neonates raises the suspicion of vertical transmission, it is unlikely that breast milk is a vehicle for transmission from mother to infant. The vast majority of clinical cases of COVID‐19 in children are mild, but there are rare cases that have developed complications such as multisystem inflammatory syndrome in children, which often presents with severe cardiac symptoms requiring intensive care. Childhood obesity is associated with a higher risk of infection and a more severe clinical presentation. Although immediate mortality rates among children are low, long‐term respiratory, and developmental implications of the disease remain unknown in this young and vulnerable population.
Hospital admission rate in children and adolescents with mild persistent asthma
Authors: Ponte Eduardo Vieira , Mingotti Cintia Fernanda Bertagni , Mamoni Ronei Luciano , Marchi Evaldo , Martinelli José Eduardo , de Menezes Marcelo Bezerra , Vianna Elcio dos Santos Oliveira , Cruz Álvaro Augusto
Published: March 2021

Introduction

The health and financial burden of mild‐persistent asthma has been poorly investigated.

Objective

Our aim was to compare the rate of hospital admissions that have occurred during the preceding year between children and adolescents with current mild‐persistent (MP) and moderate‐severe (MS) asthma.

Methods

We screened children and adolescents with asthma at eight outpatient clinics. The inclusion criteria were asthma diagnosis, age from 6 to 18 years and follow‐up with a physician during the preceding 6 months. Subjects answered standardized questionnaires and underwent spirometry.

Results

We enrolled 220 MP and 102 MS asthmatic subjects. The proportion of subjects with HA during the preceding year was similar between MP and MS asthma groups (7% vs. 7%; p = .89). Symptoms score and the financial values spent by the family in the care of asthma were lower in MP asthma as compared with MS asthma group (asthma control questionnaire score 0.7 [0.3–1.0) vs. 2.0 [1.1–2.5]; p < .01) (asthma expenses in USD 13 [2–43] vs. 28 [10–83]; p < .01). The frequency of subjects using inhaled corticosteroids maintenance therapy was lower in the MP asthma group as compared with the MS asthma group (54% vs. 100%; p < .01).

Conclusion

We conclude that the frequency of hospital admissions that have occurred during the preceding year was similar between subjects with current MP and MS asthma. Symptoms score and the financial values spent by the family in the care of asthma were lower in the MP asthma group.
The effect of Acapella trainer on respiratory function of patients after thoracoscopic lung cancer surgery
Authors: Lu Xinxin , Qiang Yan
Published: March 2021

Objective

To investigate the effect of Acapella training on respiratory function in patients undergoing video‐assisted thoracic surgery (VATS).

Methods

A total of 60 patients undergoing VATS surgery for lung cancer in the department of thoracic Surgery of our hospital from August 2018 to February 2019 were selected as study subjects, and were divided into observation group (n = 30) and control group (n = 30) according to the random number table method. The control group received routine pulmonary rehabilitation exercise after surgery, and the patients in the observation group received postoperative respiratory function exercise with Acapella therapeutic apparatus on the basis of the control group. Respiratory function, including forced vital capacity (FVC), forced expiratory capacity in the first second (FEV1), peak expiratory flow (PEF), and length of hospital stay, were observed and compared between the two groups before and after using Acapell trainer.

Results

There was no significant difference in FEV1, FVC, and PEF between the two groups before treatment with Acapella (P >.05), the difference between the above indicators after treatment and before treatment was statistically significant (P <.05); After Acapella treatment, FEV1, FVC, and PEF were significantly different between the two groups (P = .04, P = .047, P = .047).The postoperative hospital stay in the experimental group was shorter than that in the control group, and the difference was statistically significant (P = .028).

Conclusion

Acapella trainer can improve patients' respiratory function and shorten postoperative hospital stay.
Quantitative systems pharmacology in neuroscience: Novel methodologies and technologies
Authors: Bloomingdale Peter , Karelina Tatiana , Cirit Murat , Muldoon Sarah F. , Baker Justin , McCarty William J. , Geerts Hugo , Macha Sreeraj
Published: March 2021

The development and application of quantitative systems pharmacology models in neuroscience have been modest relative to other fields, such as oncology and immunology, which may reflect the complexity of the brain. Technological and methodological advancements have enhanced the quantitative understanding of brain physiology and pathophysiology and the effects of pharmacological interventions. To maximize the knowledge gained from these novel data types, pharmacometrics modelers may need to expand their toolbox to include additional mathematical and statistical frameworks. A session was held at the 10th annual American Conference on Pharmacometrics (ACoP10) to highlight several recent advancements in quantitative and systems neuroscience. In this mini‐review, we provide a brief overview of technological and methodological advancements in the neuroscience therapeutic area that were discussed during the session and how these can be leveraged with quantitative systems pharmacology modeling to enhance our understanding of neurological diseases. Microphysiological systems using human induced pluripotent stem cells (IPSCs), digital biomarkers, and large‐scale imaging offer more clinically relevant experimental datasets, enhanced granularity, and a plethora of data to potentially improve the preclinical‐to‐clinical translation of therapeutics. Network neuroscience methodologies combined with quantitative systems models of neurodegenerative disease could help bridge the gap between cellular and molecular alterations and clinical end points through the integration of information on neural connectomics. Additional topics, such as the neuroimmune system, microbiome, single‐cell transcriptomic technologies, and digital device biomarkers, are discussed in brief.
Fast uniform generation of random graphs with given degree sequences
Authors: Arman Andrii , Gao Pu , Wormald Nicholas
Published: March 2021

In this paper we provide an algorithm that generates a graph with given degree sequence uniformly at random. Provided that , where is the maximal degree and m is the number of edges, the algorithm runs in expected time O(m). Our algorithm significantly improves the previously most efficient uniform sampler, which runs in expected time for the same family of degree sequences. Our method uses a novel ingredient which progressively relaxes restrictions on an object being generated uniformly at random, and we use this to give fast algorithms for uniform sampling of graphs with other degree sequences as well. Using the same method, we also obtain algorithms with expected run time which is (i) linear for power‐law degree sequences in cases where the previous best was O(n4.081), and (ii) O(nd + d4) for d‐regular graphs when , where the previous best was O(nd3).
Cytosolic Delivery of Thiolated Mn‐cGAMP Nanovaccine to Enhance the Antitumor Immune Responses
Authors: Chen Chengyun , Tong Yuhong , Zheng Youshi , Shi Yingjun , Chen Zhaowei , Li Juan , Liu Xiaolong , Zhang Da , Yang Huanghao
Published: March 2021

As a stimulator of interferon gene (STING), cyclic dinucleotide activates a broad cellular immune response for anti‐cancer immunotherapy (CIT). However, the inherent of instability of 2′ 3′‐cyclic‐GMP‐AMP (cGAMP) with poor cellular targeting, rapid clearance, and inefficient transport to the cytoplasm seriously hinders cGAMP potency. Here, a thiolated and Mn2+ coordinated cyclic dinucleotide nanovaccine (termed as Mn‐cGAMP NVs) to enable direct cytosolic co‐delivery of cGAMP and Mn2+ to potentiate the antitumor immune response is presented. In the NVs, the fixation cGAMP with Mn2+ ions not only improve its stability, but also potentiate the activation of STING. Meanwhile, the presence of polysulfides on the NVs surface allowed direct cytosolic delivery while avoiding degradation. In this way, the production of cytokines for activating T cells immunity is greatly elevated, which in turn suppressed the primary and distal tumors growth through long‐term immune memory and led to long‐term survival of poorly immunogenic B16F10 melanoma mice. Moreover, by further combining with anti‐PD‐L1 monoclonal antibody, synergistic T cells antitumor immune response is elicited. This work offers a promising strategy to enhance the potency of cGAMP, holding a considerable potential for CIT applications.
Intermolecular Interaction Control Enables Co‐optimization of Efficiency, Deformability, Mechanical and Thermal Stability of Stretchable Organic Solar Cells
Authors: Zhu Qinglian , Xue Jingwei , Zhang Lu , Wen Jialun , Lin Baojun , Naveed Hafiz Bilal , Bi Zhaozhao , Xin Jingming , Zhao Heng , Zhao Chao , Zhou Ke , (Frank) Liu Shengzhong , Ma Wei
Published: March 2021

Promoting efficiency, deformability, and life expectancy of stretchable organic solar cells (OSCs) have always been key concerns that researchers are committed to solving. However, how to improve them simultaneously remains challenging, as morphology parameters, such as ordered molecular arrangement, beneficial for highly efficient devices actually limits mechanical stability and deformability. In this study, the unfavorable trade‐off among these properties has been reconciled in an all‐polymer model system utilizing a mechanically deformable guest component. The success of this strategy stems from introducing a highly ductile component without compromising the pristine optimized morphology. Preferable interaction between two donors can maintain the fiber‐like structure while enhancing the photocurrent to improve efficiency. Morphology evolution detected via grazing incidence X‐ray scattering and in situ UV–vis absorption spectra during stretching have verified the critical role of strengthened interaction on stabilizing morphology against external forces. The strengthened interaction also benefits thermal stability, enabling the ternary films with small efficiency degradation after heating 1500 h under 80 °C. This work highlights the effect of morphology evolution on mechanical stability and provides new insights from the view of intermolecular interaction to fabricate highly efficient, stable, and stretchable/wearable OSCs.
Defect‐Induced Self‐Cleaning Solar Absorber with Full‐Spectrum Light Absorption for Efficient Dye Wastewater Purification
Authors: Yuan Baohua , Zhang Chaofan , Liang Ying , Yang Lixia , Yang Huawei , Bai Liangjiu , Wei Donglei , Wang Wenxiang , Wang Qingyao , Chen Hou
Published: March 2021

Solar steam generation is considered a promising approach to provide the solution for water scarcity. To solve the problem of organic pollutions’ enrichment on traditional solar absorbers, herein, a self‐cleaning absorber, which consists of CsXWO3 nanorods‐anchored hydrogenated TiO2−X nanowires based on a flexible Ti mesh (H‐TiO2−X/CsXWO3), is proposed. The well‐designed H‐TiO2−X nanowires grown on Ti mesh contain a rational concentration ratio of surface oxygen vacancies (OV) to bulk OV, and the introduced W5+ and OV in CsXWO3 nanorods are also demonstrated. The defects in H‐TiO2−X/CsXWO3 endow it with a superior photocatalytic activity and light absorption in the full spectrum. Importantly, the enrichment of organic molecules, both on the surface of solar absorbers and in bulk water is carefully studied during solar steam generation. Compared with the spatially separated evaporation device without photocatalytic activity, the multifunctional H‐TiO2−X/CsXWO3 composite can not only accomplish a high evaporation rate of 1.46 kg m−2 h−1, but also prevent the surface enrichment of dye after continuous 12 h evaporation or after 20 cycle tests. Integrating photocatalysis into solar‐driven water evaporation optimizes the performance and broadens the application field.
Flexible Image Sensors with Semiconducting Nanowires for Biomimic Visual Applications
Authors: Lou Zheng , Shen Guozhen
Published: March 2021

Flexible image sensors with good detectivity, high mechanical stability, and excellent flexibility have generated great interest in biomimetic visual applications. Semiconductor nanowires (NWs) with a unique geometric structure, good transparency, and excellent electronic/optoelectronic properties can cater to flexible applications associated with image sensors. Herein, a comprehensive review of flexible image sensors with semiconducting NWs is offered, and the key performance parameters of photodetectors are introduced in detail. The excellent performances of heterostructure and NW array photodetectors, as well as organic–inorganic hybrid devices, are also reviewed. Finally, new concepts of flexible image sensors, including visual memory, infrared image sensing, and biomimetic electronic eye, are examined to showcase future research in this exciting field.
Optimization of Extraction Technology, Structure, and Antioxidant Activity of Polysaccharide from Grifola frondosa
Authors: Zhao Hou‐kuan , Wei Xian‐yong , Xie Yi‐min
Published: March 2021

Using DMSO as solvent, ultrasonic‐assisted extraction of polysaccharides from Grifola frondosa is studied. The effects of different extraction conditions on the yield of polysaccharides are investigated. The optimal extraction conditions are found by a Box‐Behnken design. The results showed that the yield of Grifola frondosa polysaccharide can reach 6.94% under the following conditions: liquid–solid ratio of 33.8 mL g‐1, ultrasonic power of 104.6 W, extraction temperature of 35.6°C, and extraction time of 4.7 h. The structure of the polysaccharides is investigated by infrared spectroscopy, nuclear magnetic resonance, molecular weight, monosaccharide composition, and methylation. The purified polysaccharides are found to have good antioxidant activity in vitro.
Recent progress in thick‐film organic photovoltaic devices: Materials, devices, and processing
Authors: Zhang Difei , Fan Baobing , Ying Lei , Li Ning , Brabec Christoph J. , Huang Fei , Cao Yong
Published: March 2021

A successful transfer of organic photovoltaic technologies from lab to fab has to overcome a range of critical challenges such as developing high‐mobility light‐harvesting materials, minimizing the upscaling losses, designing advanced solar modules, controlling film quality, decreasing overall cost, and extending long‐operation lifetime. To realize large‐area devices toward practical applications, much effort has been devoted to understanding the fundamental mechanism of how molecular structures, device architectures, interfacial engineering, and light management and carrier dynamics affect photovoltaic performance. Such studies addressed various fundamental issues of charge carrier behavior in organic heterojunctions primarily in terms of exciton generation dependence upon light incidence, charge transportation dependence on built‐in electric field, and charge extraction versus recombination. In consideration of high‐throughput roll‐to‐roll process for large‐scale fabrication of organic photovoltaic devices, it is highly appreciable to realize high power conversion efficiencies that are highly tolerable to the film thickness. Herein we summarize the recent progress in developing thick‐film organic photovoltaic devices from the perspective of efficiency‐loss mechanisms, material design, and device optimization strategies, proposing guidelines for designing high‐efficiency thickness‐insensitive devices toward mass production.
Clinoptilolite and iron sorption/desorption under multiple pH conditions: Testing a substrate for passive treatment of acidic, iron‐rich solutions
Authors: Langman Jeff B. , Sandlin Wes R. , Waynant Kris , Traver‐Greene Michael , Moberly James G.
Published: March 2021

Equilibrium sorption and desorption experiments were conducted with clinoptilolite to evaluate the potential sorption/desorption of iron during different pH conditions. Sorption experiments indicated a partitioning of 0% to 17% of the iron in solution given pH of 2 to 4. The pH 2 solution was able to desorb 70% of the iron that was captured from a pH 3 solution. The largest desorption and sorption of iron and corresponding pH represent the end points of iron capture primarily by sorption/exchange. These endpoints are the estimated pHpzcof 2.5 and the initial precipitation point of iron(II) at pH ~3.5. This acidity range is where clinoptilolite is able to capture iron without precipitation or the occurrence of full surface protonation. The inability of the highest acidity to remove all sorbed iron represents the greater bound iron that will not readily desorb with a change in pH. This retained iron creates a metastable state of the clinoptilolite that has a lower sorption capacity but reflects the ability of clinoptilolite to retain a sorbed transition metal with changes in pH. As pH varies, clinoptilolite may evolve in a sequence of metastable states reflective of its ability to capture or retain metals.

Practitioner points

Clinoptilolite is a capable reactive substrate, but its sorption/exchange effectiveness at low and variable pH and ability to retain captured metals was unknown.

Clinoptilolite retains its metal capture properties to a pH of 2.5 where surface protonation and mineral degradation likely occurs.

The ability of clinoptilolite to retain captured iron under greater acidity reflects an evolution of its sorption/retention capacity.
The electroelastic fields inside and outside a piezoelectric parabolic inclusion with uniform eigenstrains and eigenelectric fields
Authors: Wang Xu , Schiavone Peter
Published: March 2021

Using the Stroh octet formalism, we obtain the electroelastic fields in an infinite homogeneous piezoelectric medium containing a parabolic Eshelby inclusion undergoing uniform eigenstrains and eigenelectric fields. We prove that the internal electroelastic field defining stresses, total strains, electric displacements, total electric fields and rigid‐body rotation inside the parabolic inclusion is uniform. The internal uniform electroelastic field is expressed explicitly in terms of the reduced generalized compliances and the imposed eigenstrains and eigenelectric fields. The decaying non‐uniform electroelastic field in the exterior of the parabolic inclusion is also obtained.
Reduced Variable Neighbourhood Search for the Generation of Controlled Circular Data
Authors: Consoli Sergio , Perrotta Domenico , Turchi Marco
Published: March 2021

A number of artificial intelligence and machine learning problems need to be formulated within a directional space, where classical Euclidean geometry does not apply or needs to be readjusted into the circle. This is typical, for example, in computational linguistics and natural language processing, where language models based on Bag-of-Words, Vector Space, or Word Embedding, are largely used for tasks like document classification, information retrieval and recommendation systems, among others. In these contexts, for assessing document clustering and outliers detection applications, it is often necessary to generate data with directional properties and units that follow some model assumptions and possibly form close groups. In the following we propose a Reduced Variable Neighbourhood Search heuristic which is used to generate high-dimensional data controlled by the desired properties aimed at representing several real-world contexts. The whole problem is formulated as a non-linear continuous optimization problem, and it is shown that the proposed Reduced Variable Neighbourhood Search is able to generate high-dimensional solutions to the problem in short computational time. A comparison with the state-of-the-art local search routine used to address this problem shows the greater efficiency of the approach presented here.
Examining axion-like particles with superconducting radio-frequency cavity
Authors: Salnikov Dmitry , Satunin Petr , Kirpichnikov D. V. , Fitkevich Maxim
Published: March 2021

Abstract

We address production of massive axion-like particles by two electromagnetic modes inside a superconducting radio-frequency (SRF) cylindrical cavity. We discuss in detail the choice of pump modes and cavity design. We numerically compute time-averaged energy density of produced axion field for various cavity modes and wide range of axion masses. This allows us to estimate optimal conditions for axion production within a cavity. In addition, we consider photon regeneration process initiated by produced axion field in a screened radio-frequency cavity and derive constraints in parameter space (gaγγ, ma) for different choice of pump modes.
Altered sensory innervation and pain hypersensitivity in a model of young painful arthritic joints: short- and long-term effects
Authors: La Hausse De Lalouviere Luke , Morice Oscar , Fitzgerald Maria
Published: March 2021

Background

Early life experience can cause long-term alterations in the nociceptive processes underlying chronic pain, but the consequences of early life arthritic joint inflammation upon the sensory innervation of the joint is not known. Here, we measure pain sensitivity and sensory innervation in a young, juvenile and adult rodent model of arthritic joints and test the consequences of joint inflammation in young animals upon adult arthritic pain and joint innervation.

Methods

Unilateral ankle joint injections of complete Freund’s adjuvant (CFA) (6−20 µl) were performed in young, postnatal day (P)8, adolescent (P21) and adult (P40) rats. A separate cohort of animals were injected at P8, and again at P40. Hindpaw mechanical sensitivity was assessed using von Frey monofilaments (vF) for 10 days. Nerve fibres were counted in sections through the ankle joint immunostained for calcitonin gene-related peptide (CGRP) and neurofilament 200 kDa (NF200).

Results

Ankle joint CFA injection increased capsular width at all ages. Significant mechanical pain hypersensitivity and increased number of joint CGRP + ve sensory fibres occurred in adolescent and adult, but not young, rats. Despite the lack of acute reaction, joint inflammation at a young age resulted in significantly increased pain hypersensitivity and CGRP+ fibre counts when the rats were re-inflamed as adults.

Conclusions

Joint inflammation increases the sensory nociceptive innervation and induces acute pain hypersensitivity in juvenile and adult, but not in young rats. However, early life joint inflammation ‘primes’ the joint such that adult inflammatory pain behaviour and nociceptive nerve endings in the joint are significantly increased. Early life joint inflammation may be an important factor in the generation and maintenance of chronic arthritic pain.
Politische Kindermedizin
Authors: Popow C. , Püspök R. , Tatzer E. , Gobara S. , Jürgenssen O.
Published: March 2021

Die „Politische Kindermedizin“ ist ein Projekt engagierter KindermedizinerInnen, die Missstände und Fehlentwicklungen in der Kindermedizin analysieren, bewerten und aufzeigen, Lösungsvorschläge erarbeiten und diese an die Politik herantragen. Ziel war und ist es, im Sinne von „patient advocacy“ eine Verbesserung der pädiatrischen Versorgung von Kindern und Jugendlichen zu erreichen. Geschichte und Anliegen der Initiative „Politische Kindermedizin“ werden von 1997 bis heute dargestellt.
Could you hate a robot? And does it matter if you could?
Authors: Ryland Helen
Published: March 2021

This article defends two claims. First, humans could be in relationships characterised by hate with some robots. Second, it matters that humans could hate robots, as this hate could wrong the robots (by leaving them at risk of mistreatment, exploitation, etc.). In defending this second claim, I will thus be accepting that morally considerable robots either currently exist, or will exist in the near future, and so it can matter (morally speaking) how we treat these robots. The arguments presented in this article make an important original contribution to the robo-philosophy literature, and particularly the literature on human–robot relationships (which typically only consider positive relationship types, e.g., love, friendship, etc.). Additionally, as explained at the end of the article, my discussions of robot hate could also have notable consequences for the emerging robot rights movement. Specifically, I argue that understanding human–robot relationships characterised by hate could actually help theorists argue for the rights of robots.
A human stem cell-derived test system for agents modifying neuronal N-methyl-d-aspartate-type glutamate receptor Ca2+-signalling
Authors: Klima Stefanie , Brüll Markus , Spreng Anna-Sophie , Suciu Ilinca , Falt Tjalda , Schwamborn Jens C. , Waldmann Tanja , Karreman Christiaan , Leist Marcel
Published: March 2021

Methods to assess neuronal receptor functions are needed in toxicology and for drug development. Human-based test systems that allow studies on glutamate signalling are still scarce. To address this issue, we developed and characterized pluripotent stem cell (PSC)-based neural cultures capable of forming a functional network. Starting from a stably proliferating neuroepithelial stem cell (NESC) population, we generate “mixed cortical cultures” (MCC) within 24 days. Characterization by immunocytochemistry, gene expression profiling and functional tests (multi-electrode arrays) showed that MCC contain various functional neurotransmitter receptors, and in particular, the N-methyl-d-aspartate subtype of ionotropic glutamate receptors (NMDA-R). As this important receptor is found neither on conventional neural cell lines nor on most stem cell-derived neurons, we focused here on the characterization of rapid glutamate-triggered Ca2+ signalling. Changes of the intracellular free calcium ion concentration ([Ca2+]i) were measured by fluorescent imaging as the main endpoint, and a method to evaluate and quantify signals in hundreds of cells at the same time was developed. We observed responses to glutamate in the low µM range. MCC responded to kainate and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), and a subpopulation of 50% had functional NMDA-R. The receptor was modulated by Mg2+, Zn2+ and Pb2+ in the expected ways, and various toxicologically relevant agonists (quinolinic acid, ibotenic acid, domoic acid) triggered [Ca2+]i responses in MCC. Antagonists, such as phencyclidine, ketamine and dextromethorphan, were also readily identified. Thus, the MCC developed here may fill an important gap in the panel of test systems available to characterize the effects of chemicals on neurotransmitter receptors.
Drain Lipase Levels and Decreased Rate of Drain Amylase Levels as Independent Predictors of Pancreatic Fistula with Nomogram After Pancreaticoduodenectomy
Authors: Suzuki Shuji , Shimoda Mitsugi , Shimazaki Jiro , Oshiro Yukio , Nishida Kiyotaka , Shiihara Masahiro , Izumo Wataru , Yamamoto Masakazu
Published: March 2021

Background

Pancreaticoduodenectomy (PD) has recently been improved due to its increased safety. However, postoperative pancreatic fistula (POPF) remains a lethal complication of PD. Identifying novel clinicophysiological risk factors for POPF during the early post‐PD period would help improve patient morbidity and mortality. Therefore, this retrospective study aimed to evaluate possible risk factors during the early postoperative period after pancreaticoduodenectomy (PD).

Methods

Data from 349 patients who underwent PD between 2007 and 2012 were examined retrospectively. All patients were classified into 2 groups: group A, patients without fistulae or biochemical leaks (288 patients), and group B, those with grade B or C POPF (61 patients). Data on various clinicophysiological parameters, including serum and drain laboratory data, were collected. Univariate and multivariate analyses were performed to evaluate POPF predictors. A predictive nomogram was established for these results.

Results

Univariate analysis showed that various serum and drain‐related factors, such as white blood cell count, C‐reactive protein levels, drain amylase (DAMY) levels, and drain lipase (DLIP) levels, were possible POPF risk factors. Multivariate analysis confirmed that postoperative day (POD) 1 DLIP levels (hazard ratio, 15.393; p = 0.037) and decreased rate (POD3/1) of DAMY levels (hazard ratio, 4.415; p = 0.028) were independent risk factors. Further, POD1 DLIP levels and decreased rate of DAMY levels were significantly lower in group A than in group B. The accuracy of nomogram was 0.810.

Conclusions

POD1 DLIP levels (> 245 U/mL) and decreased rate of DAMY levels (> 0.44) were POPF risk factors, making them possible biomarkers for POPF.
Male Patients may be More Vulnerable to Acute Kidney Injury After Colorectal Surgery in an Enhanced Recovery Program: A Propensity Score Matching Analysis
Authors: Shim Jung‐Woo , Ro Hojun , Lee Chul Seung , Park Jaesik , Lee Hyung Mook , Kim Yong‐Suk , Moon Young Eun , Hong Sang Hyun , Chae Min Suk
Published: March 2021

Background

Although many reports have shown that enhanced recovery after surgery (ERAS) programs improve the perioperative outcomes of patients undergoing colorectal surgery, the prevalence of early acute kidney injury (AKI) after surgery in such patients requires attention. Protective roles of the female sex in terms of chronic kidney disease and progression of ischemic renal injury have been described in many studies. We thus explored whether a sex difference was evident in terms of postoperative AKI in a colorectal ERAS setting.

Methods

From January 2017 to August 2019, 453 patients underwent laparoscopic colorectal cancer resection in an enhanced recovery program. Of these, 217 female patients were propensity score (PS)‐matched with 236 male patients. Then, 215 patients of either sex were compared in terms of postoperative renal function and complications.

Results

Among the PS‐matched patients, the incidence of AKI was significantly higher in male than female patients (24.2% vs. 9.8%, P < 0.001). Male patients also exhibited a greater reduction in the postoperative estimated glomerular filtration rate, compared with female patients. The male sex was associated with an approximately threefold increase in the risk of AKI. The rate of surgical complications was significantly higher in male than female patients.

Conclusions

Caution must be taken to prevent postoperative AKI in patients (particularly males) participating in colorectal ERAS programs. The mechanism underlying the sex difference remains unclear. Additional studies are required to determine whether male patients require perioperative management that differs from that of females, to prevent postoperative AKI.
Usefulness of Serum Anti‐p53 Antibody Measurement in Patients Undergoing Hepatectomy for Colorectal Liver Metastases
Authors: Kojima Kazutaka , Shindoh Junichi , Akabane Miho , Umino Ryosuke , Kobayashi Yuta , Okubo Satoshi , Hashimoto Masaji
Published: March 2021

Background

While anti‐p53 antibody (p53‐Ab) is a potential marker for early detection of colorectal cancer, its clinical utility in patients with advanced colorectal cancer remains unknown.

Methods

The clinical significance of p53‐Ab was investigated by analyzing the data of 206 patients who underwent curative resection for colorectal liver metastases.

Results

Of the 206 patients, 60 (29%) were seropositive and 146 were seronegative for p53‐Ab before the surgery. The preoperative serum p53‐Ab level showed no significant correlation with the serum CEA or serum CA19‐9 levels. The perioperative changes in serum p53‐Ab positivity were significantly correlated with the preoperative serum p53‐Ab levels and multivariate analysis confirmed that a higher preoperative p53‐Ab level was independently associated with a worse recurrence‐free survival (hazard ratio [HR], 1.07; 95% CI, 1.01–1.13; P = 0.033 per + 100 U/mL), even after adjustments for other oncological factors, including the preoperative serum CEA level.

Conclusion

Higher preoperative p53‐Ab levels were associated with a higher risk of recurrence after curative resection of colorectal liver metastases.
Prognostic Value of Inflammatory Biomarkers in 5‐Year Survival After Endovascular Repair of Abdominal Aortic Aneurysms in a Predominantly Male Cohort: Implications for Practice
Authors: Lecumberri E. , Ruiz‐Carmona C. , Mateos E. , Galarza A. , Subirana I. , Clara A.
Published: March 2021

Background

Prognostic factors of long‐term survival can guide selection of patients for endovascular repair of abdominal aortic aneurysms (EVAR). The aim of this study was to evaluate the relationship between the neutrophil‐to‐lymphocyte ratio (NLR), the platelet‐to‐lymphocyte ratio (PLR), the lymphocyte‐to‐monocyte ratio (LMR) and the systemic immune‐inflammation index (SIII) with survival after EVAR and to assess whether the addition of these biomarkers improved the prediction of survival after surgery.

Methods

Retrospective analysis of 284 consecutive patients who underwent an EVAR at a single institution. The association between biomarkers and survival was explored using generalized additive models with penalized smoothing splines and multivariate Cox models. C‐statistics and continuous net reclassification indexes (c‐NRI) were used to assess the improvement in prediction.

Results

Survival rates at 2 and 5 years were 83.9% and 66.2%, respectively. The predictive score of survival included hemoglobin (HR = 0.849, p = 0.004), statin intake (HR = 0.538, p = 0.004), atrial fibrillation (HR = 2.515, p < 0.001), heart failure (HR = 2.542, p = 0.017) and the non‐revascularized coronary artery disease (HR = 2.163, p = 0.004). Spline analyses showed a linear relationship between survival and NLR, PLR, LMR and SII. After adjusting for the predictive score, there was an independent relationship between survival and NLR (HR = 1.072, p = 0.006), PLR (HR = 1.002, p = 0.014) and SII (HR = 1.000, p = 0.043). However, only the addition of NLR improved moderately the c‐NRI. A NLR ≥ 3 was independently associated with lower survival rates at 2‐years (HR 1.98; 95% CI 1.07–3.66) and 5‐years (HR 1.84, 95% CI 1.22–2.78) of follow‐up.

Conclusions

Most inflammatory biomarkers are linear and independently associated with survival after EVAR, but only the NLR improved moderately the prediction of a survival score. Therefore, a NLR ≥ 3 may be used to identify patients with a low survival rate and help in decision‐making.
Illustrations of Hernia Surgery in the Early Period of the Ottoman Empire by Şerefeddin Sabuncuoğlu
Authors: Doğan Fatih , Tutak Fatma Nilay
Published: March 2021

Background

Imperial Surgery (Cerrahiyyetü’l‐ Haniyye), penned by Şerefeddin Sabuncuoğlu (C.E. 1385–1468), is an impressive medical book that was written in Turkish using the Arabic alphabet, containing color miniature drawings and human figures, depicted in a fantastic style. The purpose of this report is to present this unique contribution to the literature on the known history of hernia surgery.

Methods

Imperial Surgery is divided into three chapters, each of which is divided into sections that, in general, present patients and diseases in the form of case reports. Some sections detail the procedures to be performed on a patient, the surgical instruments used and the positioning of the patient, which are described in detail with color miniature drawings.

Conclusions

Şerefeddin Sabuncuoğlu was a great surgeon in Turkish medical history. Given all of the hernia‐related information in literature, the treatise written by Sabuncuoğlu in fifteenth century and its suggested approaches to hernias show clearly the place that he should hold in the history of the art of healing. Hernia surgery is described step‐by‐step under four headings in two chapters, supported by four miniature drawings, including surgical tools.
A retrospective comparison of respiratory events with JAK inhibitors or rituximab for rheumatoid arthritis in patients with pulmonary disease
Authors: Cronin Owen , McKnight Olivia , Keir Lindsay , Ralston Stuart H. , Hirani Nikhil , Harris Helen
Published: March 2021

Janus kinase inhibitors (JAKi) are an exciting option for the treatment of rheumatoid arthritis (RA) but little is known about their safety and tolerability in patients with existing respiratory disorders. The objective was to compare pulmonary safety of JAKi versus rituximab in patients with concurrent interstitial lung disease (ILD) or bronchiectasis. We performed a retrospective electronic patient record review of patients with known ILD or bronchiectasis commencing JAKi or rituximab for the treatment of RA. Patients initiating treatment from January 2016 to February 2020 were included. Respiratory events (hospitalization or death from a respiratory cause) were compared using Kaplan–Meier survival analysis. We analysed patients who received JAKi (n = 28) and rituximab (n = 19) for a mean (SD) of 1.1 (0.62) and 2.14 (1) years respectively. Patients were predominantly female (68%), anti-CCP antibody positive (94%) and non-smoking (89%) with a median (IQR) percentage predicted FVC at baseline of 100% (82–115%) and percentage predicted TLCO of 62% (54.5–68%). Respiratory events occurred in five patients treated with JAKi (18%; 5 hospitalizations, 2 deaths) and in four patients treated with rituximab (21%; 3 hospitalizations, 1 death). Respiratory event rates did not differ between groups (Cox-regression proportional hazard ratio = 1.38, 95% CI 0.36–5.28; p = 0.64). In this retrospective study, JAKi for the treatment of RA with existing ILD or bronchiectasis did not increase the rate of hospitalization or death due to respiratory causes compared to those treated with rituximab. JAK inhibition may provide a relatively safe option for RA in such patients.
Long-time experimental investigation of turbulent superstructures in Rayleigh–Bénard convection by noninvasive simultaneous measurements of temperature and velocity fields
Authors: Moller Sebastian , Resagk Christian , Cierpka Christian
Published: March 2021

Large-scale mean patterns in Rayleigh–Bénard convection, also referred to as turbulent superstructures, have mainly been studied by means of numerical simulations so far, but experimental investigations are still rare. However, the analysis of turbulent superstructures, which are of great importance due to their effect on the local transport of heat and momentum, require both numerical and experimental data. Therefore, within the scope of this study measurements were performed in the horizontal mid plane and in a horizontal plane closer to the top of a Rayleigh–Bénard cell with an aspect ratio of $$\varGamma =l/h=25$$

Γ
=
l
/
h
=
25

, thereby showing the initial formation of turbulent superstructures and their long-time rearrangement. The turbulent superstructures are investigated experimentally by noninvasive simultaneous measurements of temperature and velocity fields, using the color signal of thermochromic liquid crystals (TLCs) for the evaluation of the temperature and their temporal displacement for the determination of all three velocity components in the measurement planes via stereoscopic particle image velocimetry (stereo-PIV). Applying this measuring technique it is demonstrated that the time-averaging of instantaneous temperature and velocity fields uncovers the turbulent superstructures in both fields. Furthermore, the combination of the temperature and velocity data is used to characterize the local heat flux quantified by the local Nusselt number, which confirms that the turbulent superstructures strongly enhance the heat transfer in Rayleigh–Bénard convection.

Graphic abstract
Frozen-section examination in the management of paediatric testicular lesions
Authors: O’Connor E. , Roy C. , Annavarapu S. , Gabra H. O.
Published: March 2021

Purpose

Paediatric testicular and para-testicular lesions have traditionally been managed according to adult protocols. Testis-sparing surgery (TSS) has gained popularity as it has become apparent benign lesions predominate in childhood. Frozen-section examination (FSE) for intra-operative diagnosis has been extensively utilised in adults, though its use in paediatric practice remains limited. We reviewed our experience of FSE in paediatric patients with an aim to identify the utility and efficacy of this tool in the management of testicular and para-testicular pathology.

Methods

A retrospective, single-centre review of paediatric patients who underwent intra-operative FSE for a range of testicular and para-testicular lesions was performed. FSE results were compared to final pathology. TSS was performed if appropriate, and was utilised in adolescent patients, and in lesions with a diameter greater than 20 mm.

Results

Nine males underwent FSE from 2013 to 2020. Median age at surgery was 9 years (range 1–15). Eight (89%) patients had benign pathology. FSE result correlated with the final pathological examination in 100% of cases. FSE facilitated TSS in 7/9 cases.

Conclusion

FSE has 100% diagnostic accuracy for paediatric testicular and para-testicular pathology. We would recommend all lesions be evaluated by FSE to guide intra-operative decision making and facilitate TSS in appropriate cases.
A DARPin targeting activated Mac-1 is a novel diagnostic tool and potential anti-inflammatory agent in myocarditis, sepsis and myocardial infarction
Authors: Siegel Patrick M. , Bojti István , Bassler Nicole , Holien Jessica , Flierl Ulrike , Wang Xiaowei , Waggershauser Philipp , Tonnar Xavier , Vedecnik Christopher , Lamprecht Constanze , Stankova Ivana , Li Tian , Helbing Thomas , Wolf Dennis , Anto-Michel Nathaly , Mitre Lucia Sol , Ehrlich Julia , Orlean Lukas , Bender Ileana , Przewosnik Anne , Mauler Maximilian , Hollederer Laura , Moser Martin , Bode Christoph , Parker Michael W. , Peter Karlheinz , Diehl Philipp
Published: March 2021

The monocyte β2-integrin Mac-1 is crucial for leukocyte–endothelium interaction, rendering it an attractive therapeutic target for acute and chronic inflammation. Using phage display, a Designed-Ankyrin-Repeat-Protein (DARPin) was selected as a novel binding protein targeting and blocking the αMI-domain, an activation-specific epitope of Mac-1. This DARPin, named F7, specifically binds to activated Mac-1 on mouse and human monocytes as determined by flow cytometry. Homology modelling and docking studies defined distinct interaction sites which were verified by mutagenesis. Intravital microscopy showed reduced leukocyte–endothelium adhesion in mice treated with this DARPin. Using mouse models of sepsis, myocarditis and ischaemia/reperfusion injury, we demonstrate therapeutic anti-inflammatory effects. Finally, the activated Mac-1-specific DARPin is established as a tool to detect monocyte activation in patients receiving extra-corporeal membrane oxygenation, as well as suffering from sepsis and ST-elevation myocardial infarction. The activated Mac-1-specific DARPin F7 binds preferentially to activated monocytes, detects inflammation in critically ill patients, and inhibits monocyte and neutrophil function as an efficient new anti-inflammatory agent.
Correction to: Impact of tourniquet during knee arthroplasty: a bayesian network meta‑analysis of peri‑operative outcomes
Authors: Migliorini Filippo , Maffulli Nicola , Aretini Paolo , Trivellas Andromahi , Tingart Markus , Eschweiler Jörg , Baroncini Alice
Published: March 2021

A correction to this paper has been published: https://doi.org/10.1007/s00402-021-03844-w
UV light-based reprocessing of flexible endoscopes without working channel in Oto-Rhino-Laryngology: an effective method?
Authors: Rudhart Stefan A. , Günther Frank , Dapper Laura , Thangavelu Kruthika , Geisthoff Urban W. , Stankovic Petar , Wilhelm Thomas , Stuck Boris A. , Hoch Stephan
Published: March 2021

Background

Reprocessing of flexible endoscopes (FEs) is often expensive, time consuming, and becomes increasingly complex, due to rising demands of hygiene. After beneficial results in reprocessing of rigid endoscopes using Impelux™ UV-C light technology, we tested the same method for reprocessing of FEs without working channel.

Materials and methods

Testing was performed on FEs without working channel after routine clinical use (transnasal flexible endoscopy). Disinfection consisted of mechanical precleaning and 60 s exposure to Impelux™ UV-C light technology. Bacterial contamination was tested on 50 FEs before and after disinfection. Further 50 FEs regarding protein residuals. The absolute effectiveness of the D60 was tested on 50 test bodies (RAMS) with a standardized contamination of 107 colony-forming units (CFU) of Enterococcus faecium.

Results

The FEs were contaminated with a high average value of 916.7 CFU (± 1057 CFU) after clinical usage. After reprocessing, an average contamination of 2.8 CFU (± 1.6) on 14% (n = 7) of the FEs was detected consisting of non-pathogenic species, the remaining FE were sterile. After reprocessing, all FEs were protein-free (< 1 μg). The artificially contaminated test bodies showed no remaining bacterial contamination after disinfection, resulting in an average absolute germ reduction of about 107 CFU.

Conclusion

Impelux™ UV-C light technology efficiently reduces bacterial contamination of FEs and might be useful in daily practice.