bluuebunny/crossref_metadata_2025 huggingface dataset:
CAD-based data augmentation and transfer learning empowers part classification in manufacturing
Authors: Ruediger-Flore Patrick , Glatt Moritz , Hussong Marco , Aurich Jan C.
Published: February 2023

Especially in manufacturing systems with small batches or customized products, as well as in remanufacturing and recycling facilities, there is a wide variety of part types that may be previously unseen. It is crucial to accurately identify these parts based on their type for traceability or sorting purposes. One approach that has shown promising results for this task is deep learning–based image classification, which can classify a part based on its visual appearance in camera images. However, this approach relies on large labeled datasets of real-world images, which can be challenging to obtain, especially for parts manufactured for the first time or whose appearance is unknown. To overcome this challenge, we propose generating highly realistic synthetic images based on photo-realistically rendered computer-aided design (CAD) data. Using this commonly available source, we aim to reduce the manual effort required for data generation and preparation and improve the classification performance of deep learning models using transfer learning. In this approach, we demonstrate the creation of a parametric rendering pipeline and show how it can be used to train models for a 30-class classification problem with typical engineering parts in an industrial use case. We also demonstrate how our method’s entropy gain improves the classification performance in various deep image classification models.
Emergence of mass spectrometry detergents for membrane proteomics
Authors: Behnke Jan-Simon , Urner Leonhard H.
Published: February 2023

Detergents enable the investigation of membrane proteins by mass spectrometry. Detergent designers aim to improve underlying methodologies and are confronted with the challenge to design detergents with optimal solution and gas-phase properties. Herein, we review literature related to the optimization of detergent chemistry and handling and identify an emerging research direction: the optimization of mass spectrometry detergents for individual applications in mass spectrometry–based membrane proteomics. We provide an overview about qualitative design aspects including their relevance for the optimization of detergents in bottom-up proteomics, top-down proteomics, native mass spectrometry, and Nativeomics. In addition to established design aspects, such as charge, concentration, degradability, detergent removal, and detergent exchange, it becomes apparent that detergent heterogeneity is a promising key driver for innovation. We anticipate that rationalizing the role of detergent structures in membrane proteomics will serve as an enabling step for the analysis of challenging biological systems.
Gamma radiation coupled ADP-ribosyl transferase activity of Pseudomonas aeruginosa PE24 moiety
Authors: Morgan Radwa N. , Saleh Sarra E. , Farrag Hala A. , Aboshanab Khaled M.
Published: February 2023

The ADP-ribosyl transferase activity of P. aeruginosa PE24 moiety expressed by E. coli BL21 (DE3) was assessed on nitrobenzylidene aminoguanidine (NBAG) and in vitro cultured cancer cell lines. Gene encoding PE24 was isolated from P. aeruginosa isolates, cloned into pET22b( +) plasmid, and expressed in E. coli BL21 (DE3) under IPTG induction. Genetic recombination was confirmed by colony PCR, the appearance of insert post digestion of engineered construct, and protein electrophoresis using sodium dodecyl-sulfate polyacrylamide gel (SDS-PAGE). The chemical compound NBAG has been used to confirm PE24 extract ADP-ribosyl transferase action through UV spectroscopy, FTIR, c13-NMR, and HPLC before and after low-dose gamma irradiation (5, 10, 15, 24 Gy). The cytotoxicity of PE24 extract alone and in combination with paclitaxel and low-dose gamma radiation (both 5 Gy and one shot 24 Gy) was assessed on adherent cell lines HEPG2, MCF-7, A375, OEC, and Kasumi-1 cell suspension. Expressed PE24 moiety ADP-ribosylated NBAG as revealed by structural changes depicted by FTIR and NMR, and the surge of new peaks at different retention times from NBAG in HPLC chromatograms. Irradiating recombinant PE24 moiety was associated with a reduction in ADP-ribosylating activity. The PE24 extract IC50 values were < 10 μg/ml with an acceptable R2 value on cancer cell lines and acceptable cell viability at 10 μg/ml on normal OEC. Overall, the synergistic effects were observed upon combining PE24 extract with low-dose paclitaxel demonstrated by the reduction in IC50 whereas antagonistic effects and a rise in IC50 values were recorded after irradiation by low-dose gamma rays.

Key points

• Recombinant PE24 moiety was successfully expressed and biochemically analyzed.

• Low-dose gamma radiation and metal ions decreased the recombinant PE24 cytotoxic activity.

• Synergism was observed upon combining recombinant PE24 with low-dose paclitaxel.
Prevalence of celiac artery compression by median arcuate ligament in patients with splanchnic artery aneurysms/pseudoaneurysms submitted to endovascular embolization
Authors: Borges Ana Paula , Antunes Célia , Donato Paulo
Published: February 2023

Purpose

To study the association between median arcuate ligament compression (MALC) of celiac artery (CA) and splanchnic artery aneurysms/pseudoaneurysms (SAAPs) submitted to endovascular embolization.

Methods

Single center retrospective study of embolized SAAPs between 2010 and 2021, to evaluate the prevalence of MALC, and compare demographic data and clinical outcomes between patients with and without MALC. As a secondary objective, patient characteristics and outcomes were compared between patients with different causes of CA stenosis.

Results

MALC was found in 12.3% of 57 patients. SAAPs were more prevalent in the pancreaticoduodenal arcades (PDAs) in patients with MALC, compared to those without MALC (57.1% vs. 10%, P = .009). Patients with MALC had a greater proportion of aneurysms (71.4% vs. 24%, P = .020), as opposed to pseudoaneurysms. Rupture was the main indication for embolization in both groups (71.4% and 54% of patients with and without MALC, respectively). Embolization was successful in most cases (85.7% and 90%), with 5 immediate (28.6% and 6%) and 14 non-immediate (28.6% and 24%) post-procedure complications. Thirty and 90-day mortality rate were 0% in patients with MALC, and 14% and 24% in patients without MALC. Atherosclerosis was the only other cause of CA stenosis, in 3 cases.

Conclusions

In patients with SAAPs submitted to endovascular embolization, the prevalence of CA compression by MAL is not uncommon. The most frequent location for aneurysms in patients with MALC is in the PDAs. Endovascular management of SAAPs is very effective in patients with MALC, with low complications, even in ruptured aneurysms.

Graphical Abstract
Pediatric Trauma in The Netherlands: Incidence, Mechanism of Injury and In‐Hospital Mortality
Authors: Fylli Christina , Schipper Inger B. , Krijnen Pieta
Published: February 2023

Background

In the Netherlands, there are no specialized or certified pediatric trauma centers, especially for severely injured children. National and regional agreements on centralization of pediatric trauma care are scarce. This study aims to describe the incidence, injury mechanism and in‐hospital mortality of pediatric trauma in the Netherlands, as a prelude to the further organization of pediatric trauma care.

Methods

A retrospective cohort analysis of data from the Dutch National Trauma Registry in 2009–2018, concerning all children (0–16 years) hospitalized due to injury in the Netherlands.

Results

The annual number of admitted injured children increased from 8666 in 2009 to 13,367 in 2018. Domestic accidents were the most common cause of non‐fatal injury (67.9%), especially in children aged 0–5 years (89.2%). Severe injury (injury severity score ≥  16) accounted for 2.5% and 74% of these patients were treated in level‐1 trauma centers. In both deceased and surviving patients with severe injuries, head injuries were the most common (72.1% and 64.3%, respectively). In‐hospital mortality after severe injury was 8.2%. Road‐traffic accidents (RTAs) were the leading cause of death (46.5%).

Conclusions

Domestic accidents are the most common cause of injury, especially in younger children, whereas RTAs are the lead cause of fatal injury. Severe pediatric trauma in the Netherlands is predominantly managed in level‐1 trauma centers, where a multidisciplinary team of experts is available. Improving the numbers of severely injured patients primarily brought to level‐1 trauma centers may help to further reduce mortality.
Postoperative Timing of Chemoprophylaxis and Its Impact on Thromboembolism and Bleeding Following Major Abdominal Surgery: A Multicenter Cohort Study
Authors:   PROTECTinG investigators,   VERITAS Collaborative
Published: February 2023

Background

Major abdominal surgery is associated with bleeding and venous thromboembolism (VTE) risks. Chemoprophylaxis prevents VTE but increases bleeding risk. When compared with pre‐ and intra‐operative chemoprophylaxis, recent evidence suggests that starting chemoprophylaxis postoperatively lowers the risk of bleeding without compromising VTE protection. This study investigates whether an optimal window exists in the postoperative period for initiating chemoprophylaxis in patients undergoing major abdominal surgery.

Methods

Analysis of pooled data from four multicenter PROTECTinG studies, which investigated the timing of perioperative chemoprophylaxis on bleeding and VTE outcomes following major abdominal surgery. Patients that commenced chemoprophylaxis postoperatively were separated into quartiles based on timing of administration within the first 24 h post‐surgery.

Results

Overall, 4729 (Abdominal visceral resection N = 668, cholecystectomies N = 573, major ventral hernia repair N = 1701, antireflux surgery N = 1787) consecutive patients had chemoprophylaxis commenced within 24 h following elective surgery. Baseline characteristics were comparable between quartiles. Across quartiles and within each procedural type, the timing of starting chemoprophylaxis was not associated with bleeding (2.6, 1.7, 2.7 and 3.2%, p = 0.130) or clinical VTE (0.8, 0.2, 0.8 and 0.5%, p = 0.131), and did not predict their occurrences on multivariate analysis.

Conclusion

Chemoprophylaxis can be safely started at any time within 24 h post‐skin closure in major abdominal surgery, without affecting bleeding or VTE risks. This finding encourages the standardization of chemoprophylaxis timing in the postoperative period to pre‐defined times during the day to improve workflow efficiency and chemoprophylaxis compliance.
Fall‐Related Injuries in Malawi: Outcomes and Trends Over Time
Authors: An Selena J. , Ngwira Natasha , Davis Dylane , Gallaher Jared , Charles Anthony
Published: February 2023

Background

Fall‐related injury (FRI) is a leading cause of injuries worldwide. Data on injury patterns and trends over time are lacking in resource‐limited settings.

Methods

We performed a retrospective analysis of FRI at Kamuzu Central Hospital in Malawi from 2009 to 2021. Outcomes were compared between patients presenting with FRI and those with other injury mechanisms. Bivariate and multivariate regressions were used to determine predictors of presentation following falls and mortality. We also analyzed time trends.

Results

A total of 166,047 patients were included, of which 41,695 were patients presenting after falls (25.7%). Most FRI patients were between 5 and 45 (67.2%) and male (66.9%). Most falls occurred at home (67.3%) and resulted in extremity injuries (51.6%). The predicted probability of hospital presentation after falling is highest for children ≤  5 years and adults >  60 years and decreases over time. On multivariate analysis, patients between 5 and 15 [adjusted odds ratio (AOR) 1.70, 95% confidence interval (CI) 1.63–1.77] and > 60 (AOR 1.14, 95% CI 1.07–1.22) and women (AOR 1.13, 95% CI 1.10–1.16) are more likely to present with FRI. Compared to patients with non‐FRI, those with FRI were more likely to have been injured at school (AOR 2.16, 95% CI 2.01–2.32) and during sports and recreation (AOR 4.53, 95% CI 4.24–4.85).

Conclusion

FRI is the most common injury presentation after motor vehicle injury in this low‐resource setting. This study provides essential information about FRI in Malawi over time. Our findings can help inform resource allocation and injury prevention initiatives.
Frequency of anterolateral ligament tears and ramp lesions in patients with anterior cruciate ligament tears and associated injuries indicative for these lesions—a retrospective MRI analysis
Authors: Stranger Nikolaus , Kaulfersch Christian , Mattiassich Georg , Mandl Jürgen , Hausbrandt Peter A. , Szolar Dieter , Schöllnast Helmut , Tillich Manfred
Published: February 2023

Objectives

To assess the frequency of anterolateral ligament (ALL) tears and ramp lesions (RL) detected with MRI in patients with anterior cruciate ligament (ACL) tears and to describe associated injuries indicative for these lesions.

Methods

In this retrospective study, 164 patients with surgically verified ACL tears were included. Preoperative MRI scans were reviewed for ALL tears and different types of RL. All coexisting meniscal tears, tears of the medial (MCL) and lateral collateral band (LCL), and posterior-medial tibial bone marrow edema (BME) were recorded. The frequency of ALL tears and RL was assessed and coexisting injuries were correlated using Pearson’s chi-square test. A p < 0.05 was defined as statistically significant. In cases of multiple testing, Bonferroni’s correction was applied.

Results

ALL tears and RL combined were detected in 28 patients (17.1%), ALL tears in 48 patients (29.3%), and RL in 54 patients (32.9%) which were significantly associated to each other. ALL tears were significantly associated with tears of the posterior horn of the lateral meniscus (PHLM), BME, and with tears of the LCL and MCL. RL were significantly associated with tears of the posterior horn of the medial (PHMM) and PHLM, with BME, and with tears of the LCL.

Conclusions

ACL tears are associated with RL or ALL tears in about one-third of cases and with both lesions combined in about one-fifth of cases. ALL tears and RL are significantly associated with additional posttraumatic injuries, which can thus be indicative of these lesions.

Key Points

• ACL tears were associated with ramp lesions or ALL tears in about one-third of the cases.

• Ramp lesions and ALL tears were significantly associated with each other, tear in the PHLM, tear in the LCL, and BME.

• ALL tears were more frequently associated with instable classified ramp lesion type 4b and type 5.
CT colonography: can we achieve an adequate bowel preparation without diet restriction?
Authors: Rengo Marco , Tiberia Filippo , Vicini Simone , Bellini Davide , Celestre Michela , Trionfera Gianfranco , Laghi Andrea , Carbone Iacopo
Published: February 2023

Objective

To evaluate if an adequate bowel preparation for CT colonography, can be achieved without diet restriction, using a reduced amount of cathartic agent and fecal tagging. To investigate the influence of patients’ characteristics on bowel preparation and the impact on patients’ compliance.

Methods

In total, 1446 outpatients scheduled for elective CT colonography were prospectively enrolled. All patients had the same bowel preparation based on a reduced amount of cathartic agent (120 g of macrogol in 1.5 l of water) the day before the exam and a fecal tagging agent (60 ml of hyperosmolar oral iodinated agent) the day of the exam. No dietary restrictions were imposed before the exam. The bowel preparation was evaluated using a qualitative and quantitative score. Patients were grouped by age, gender, and presence of diverticula in both scores. Patients’ compliance has been evaluated with a questionnaire after the end of the exam and with a phone-calling interview the day after the exam.

Results

According to the qualitative score, adequate bowel preparation was achieved in 1349 patients (93.29%) and no statistical differences were observed among the subgroups of patients. Quantitative scores demonstrated that colon distension was significantly better in younger patients and without diverticula. A good patients’ compliance was observed and most patients (96.5%) were willing to repeat it.

Conclusions

The lack of diet restriction does not affect the quality of CTC preparation and good patient’s compliance could potentially increase the participation rate in CRC screening programs.

Key Points

• An adequate quality bowel preparation for CT colonography can be achieved without diet restriction, using a reduced amount of cathartic agent (120 g of macrogol in 1.5 l of water) and fecal tagging (60 ml of hyperosmolar oral iodinated agent).

• A bowel preparation based on the combination of a reduced amount of cathartic agent and fecal tagging, without diet restriction, allows obtaining good quality in more than 90% of patients.

• The bowel preparation scheme proposed reduces the distress and discomfort experienced by the patients improving adherence to CTC.
Evaluation of a deep learning-based reconstruction method for denoising and image enhancement of shoulder MRI in patients with shoulder pain
Authors: Feuerriegel Georg C. , Weiss Kilian , Kronthaler Sophia , Leonhardt Yannik , Neumann Jan , Wurm Markus , Lenhart Nicolas S. , Makowski Marcus R. , Schwaiger Benedikt J. , Woertler Klaus , Karampinos Dimitrios C. , Gersing Alexandra S.
Published: February 2023

Objectives

To evaluate the diagnostic performance of an automated reconstruction algorithm combining MR imaging acquired using compressed SENSE (CS) with deep learning (DL) in order to reconstruct denoised high-quality images from undersampled MR images in patients with shoulder pain.

Methods

Prospectively, thirty-eight patients (14 women, mean age 40.0 ± 15.2 years) with shoulder pain underwent morphological MRI using a pseudo-random, density-weighted k-space scheme with an acceleration factor of 2.5 using CS only. An automated DL-based algorithm (CS DL) was used to create reconstructions of the same k-space data as used for CS reconstructions. Images were analyzed by two radiologists and assessed for pathologies, image quality, and visibility of anatomical landmarks using a 4-point Likert scale.

Results

Overall agreement for the detection of pathologies between the CS DL reconstructions and CS images was substantial to almost perfect (κ 0.95 (95% confidence interval 0.82–1.00)). Image quality and the visibility of the rotator cuff, articular cartilage, and axillary recess were overall rated significantly higher for CS DL images compared to CS (p < 0.03). Contrast-to-noise ratios were significantly higher for cartilage/fluid (CS DL 198 ± 24.3, CS 130 ± 32.2, p = 0.02) and ligament/fluid (CS DL 184 ± 17.3, CS 141 ± 23.5, p = 0.03) and SNR values were significantly higher for ligaments and muscle of the CS DL reconstructions (p < 0.04).

Conclusion

Evaluation of shoulder pathologies was feasible using a DL-based algorithm for MRI reconstruction and denoising. In clinical routine, CS DL may be beneficial in particular for reducing image noise and may be useful for the detection and better discrimination of discrete pathologies.

Summary statement

Assessment of shoulder pathologies was feasible with improved image quality as well as higher SNR using a compressed sensing deep learning–based framework for image reconstructions and denoising.

Key Points

• Automated deep learning–based reconstructions showed a significant increase in signal-to-noise ratio and contrast-to-noise ratio (p < 0.04) with only a slight increase of reconstruction time of 40 s compared to CS.

• All pathologies were accurately detected with no loss of diagnostic information or prolongation of the scan time.

• Significant improvements of the image quality as well as the visibility of the rotator cuff, articular cartilage, and axillary recess were detected.
Taylor expansion of the correlation metric for an individual forecast evaluation and its application to East Asian sub-seasonal forecasts
Authors: Oh Seol-Hee , Ham Yoo-Geun
Published: February 2023

This study develops a skill evaluation metric for an individual forecast by applying a Taylor expansion to the commonly-used temporal correlation skill. In contrast to other individual forecast evaluation metrics, which depend on the amplitude of forecasted and observed anomalies, the so-called “association strength (AS) skill” is less affected by the anomaly amplitude and mainly depends on the degree of similarity between the forecasted and the observed values. Based on this newly developed index, the forecast skill is evaluated for an individual case, then, a group is categorized with respect to the AS skill. The cases with the highest AS skill exhibit the highest correlation skill than any group randomly selected, indicating that the AS skill is a powerful metric to evaluate the non-dimensionalized forecast skill. This strategy is adopted for the subseasonal East Asian summer precipitation forecasts produced by the UK Met Office’s ensemble Global Seasonal forecast system version 5 (GloSea5). In the group with the highest AS skill of the East Asian summer precipitation index (i.e., highest AS cases), the geopotential height anomalies showed quasi-stationary Rossby waves from the North Atlantic to East Asia. The spatial distribution of the dominant subseasonal anomalies for cases with the highest AS is distinct from the cases or groups with the lowest AS skill. Furthermore, the dominant pattern with the highest AS is not solely explained by any well-known typical subseasonal climate patterns, such as the Madden–Julian Oscillation, circumglobal teleconnection pattern, Pacific-Japan pattern, or the Summer North Atlantic Oscillation. This implies that the excitation of well-known climate patterns only partly contributes to increasing the mid-latitude climate predictability in the GloSea5.
Quantitative attribution of vertical motions responsible for the early spring drought conditions over southeastern China
Authors: Yin Zejiang , Yang Song , Wei Wei
Published: February 2023

The interannual variability and long-term trend of the drought conditions over southeastern China during early spring (from February to April) are investigated by analyzing the standardized precipitation evapotranspiration index in 1979–2020. Results from an attribution analysis show that precipitation deficiency and atmospheric water demand contributes about 96.5 and 6.7% to the drought conditions on interannual time scale, and about 72.8 and 22.3% to the long-term trend, respectively. The precipitation deficiency is primarily contributed by moisture divergence via the descending anomalies throughout the troposphere over southeastern China. A further diagnosis with the omega equation reveals that the descending anomalies are dominated by the strong negative zonal vorticity advection in the upper troposphere and the enhanced meridional cold advection throughout the troposphere. They are controlled by a barotropic anomalous anticyclone over the eastern Tibetan Plateau and an anomalous cyclone over the western North Pacific. Non-negligibly, the contribution of potential evapotranspiration to the drying trend in early spring over southeastern China is about four times larger than that to the interannual variability. Given that potential evapotranspiration may increase in a warming climate, it may be critical for the change in drought conditions in future. This study serves as a basis for fully understanding the severity of recent droughts and for model simulation of the drought conditions over southeastern China.
Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature
Authors: Escolino Maria , Kalfa Nicolas , Castagnetti Marco , Caione Paolo , Esposito Giovanni , Florio Luisa , Esposito Ciro
Published: February 2023

In the last 20 years, endoscopic injection (EI) has affirmed as a valid alternative to open surgery for management of pediatric vesicoureteral reflux (VUR). This study aimed to investigate and discuss some debated aspects such as indications, bulking agents and comparison, techniques of injection and comparison, predictive factors of success, use in specific situations. EI is minimally invasive, well accepted by patients and families, with short learning curve and low-morbidity profile. It provides reflux resolution rates approaching those of open reimplantation, ranging from 69 to 100%. Obviously, the success rate may be influenced by several factors. Recently, it is adopted as first-line therapy also in high grade reflux or complex anatomy such as duplex, bladder diverticula, ectopic ureters. The two most used materials for injection are Deflux and Vantris. The first is absorbable, easier to inject, has lower risk of obstruction, but can lose efficacy over time. The second is non-absorbable, more difficult to inject, has higher risk of obstruction, but it is potentially more durable. The two main techniques are STING and HIT. To date, the ideal material and technique of injection has not yet clearly established, but the choice remains dependent on surgeon’s preference and experience.
Total hip arthroplasty through the direct anterior approach for sequelae of Legg–Calvé–Perthes disease
Authors: Hasler Julian , Flury Andreas , Hoch Armando , Cornaz Frédéric , Zingg Patrick O. , Rahm Stefan
Published: February 2023

Introduction

Due to multiplanar deformities of the hip, total hip arthroplasty (THA) for sequelae of Legg–Calvé–Perthes disease (LCPD) is often technically demanding. This study aimed to compare the clinical and radiographic outcomes of patients with sequelae of LCPD undergoing THA through the direct anterior approach (DAA) and non-anterior approaches to the hip.

Methods

All patients with sequelae of LCPD who underwent primary THA between 2004 and 2018 (minimum follow-up: 2 years) were evaluated and separated into two groups: THA through the DAA (Group AA), or THA through non-anterior approaches to the hip (Group non-AA). Furthermore, a consecutive control group of patients undergoing unilateral THA through the DAA for primary hip osteoarthritis (Group CC) was retrospectively reviewed for comparison.

Results

Group AA comprises 14 hips, group non-AA 17 hips and group CC 30 hips. Mean follow-up was 8.6 (± 5.2; 2–15), 9.0 (± 4.6; 3–17) and 8.1 (± 2.2; 5–12) years, respectively. At latest follow-up, Harris Hip Score was 90 (± 20; 26–100), 84 (± 15; 57–100), and 95 (± 9; 63–100) points, respectively. Overall, 6 patients treated for LCPD (each 3 patient in the AA and non-AA group) developed postoperative sciatic nerve palsy, of which only one was permanent. Complication-related revision rate at the latest follow-up was 15% in the AA-group and 25% in the non-AA group, respectively.

Conclusion

THA through the DAA might be a credible option for the treatment of sequelae of LCPD with comparable complication rates and functional outcomes to non-anterior approaches.
Primary ossiculoplasties provide better hearing results than revisions: a retrospective cohort study
Authors: Kálmán Judit , Horváth Tamás , Dános Kornél , Tamás László , Polony Gábor
Published: February 2023

Purpose

To evaluate the efficacy of ossicular chain reconstruction (OCR) in primary and revision surgeries, and to investigate the impact of the number of previous surgeries on hearing outcomes.

Methods

Retrospective analysis of cases with OCR due to chronic otitis in a tertiary center between January 2018 and September 2021.

Results

Altogether, 147 cases of ossicle involvement were assessed. In 91.83% (n = 135) OCR was performed, 96.26% of them with titanium TORP/PORP (n = 130), two cases with autologous prosthesis and three with piston. Mean follow-up was 8.8 months. The ABG significantly improved in the total group (TORP/PORP) from a mean (SD) of 30.94 (15.55) to 19.76 (13.36) dB (p < 0.0001) with 60.86% success. The best results were achieved in primary OCR with PORP implantation without cholesteatoma (89.47%). Primary cases have a significantly higher success rate in contrary to revision surgeries (72.27%, vs. 52.00%, p = 0.032). The only relevant predictive factor proved to be the fact of revision (p = 0.029). A statistically significant correlation between the number of previous surgeries and hearing results could not be proved. There was no difference in hearing outcomes between patients with only one or more than one previous surgeries in the revision groups. Neither the presence of cholesteatoma, nor the type of OCR (TOPR/PORP) and the indication of revision had an impact on postoperative ABG.

Conclusions

Titanium prostheses are effective in OCR both in primary and revision cases. It is not the number of previous surgeries, but the fact of revision that influences postoperative hearing results.
Esophageal rupture through extreme sadomasochistic practice
Authors: Koelzer Sarah C. , Bunzel Lena M. , Holz Franziska , Birngruber Christoph G. , Verhoff Marcel A.
Published: February 2023

We report the case of a woman in her thirties who suffered an esophageal rupture while participating in extreme sadomasochistic practices. After herself seeking help in a hospital for complaints alleged to be from a fall, she was initially diagnosed with several broken ribs and a pneumothorax. The cause of the pneumothorax was later discovered to be an esophageal rupture. When confronted with this atypical injury for a fall, the woman admitted to have accidentally swallowed an inflatable gag, which her partner had afterwards inflated. In addition to the esophageal rupture, the patient also had numerous other externally visible injuries of various ages, reportedly also from sadomasochistic acts. Although an in-depth police investigation was conducted and a “slave contract” was found, the woman’s consent to the extreme sexual practices performed by her life partner could not be substantiated conclusively. The man was convicted for intentional infliction of serious as well as dangerous bodily injury and sentenced to a long term in prison.
Levodopa–carbidopa intestinal gel in advanced Parkinson’s disease: long-term results from COSMOS
Authors: Fasano Alfonso , García-Ramos Rocío , Gurevich Tanya , Jech Robert , Bergmann Lars , Sanchez-Soliño Olga , Parra Juan Carlos , Simu Mihaela
Published: February 2023

Background

While immediate benefits of levodopa–carbidopa intestinal gel (LCIG) are evident in patients with Parkinson’s disease (PD), long-term LCIG effects require further study.

Objectives

We explored long-term LCIG on motor symptoms, nonmotor symptoms (NMS), and LCIG treatment settings in patients with advanced PD (APD).

Methods

Data were obtained (medical records and patient visit) from COSMOS, a multinational, retrospective, cross-sectional post-marketing observational study in patients with APD. Patients were stratified into 5 groups based on LCIG treatment duration at the patient visit, from 1–2 to > 5 years LCIG. Between-group differences were assessed for changes from baseline in LCIG settings, motor symptoms, NMS, add-on medications, and safety.

Results

Out of 387 patients, the number of patients per LCIG group was: > 1– ≤ 2 years LCIG (n = 156); > 2– ≤ 3 years LCIG (n = 80); > 3– ≤ 4 years LCIG (n = 61); > 4– ≤ 5 years LCIG (n = 30); > 5 years LCIG (n = 60). Baseline values were similar; data reported are changes from the baseline. There were reductions in “off” time, dyskinesia duration, and severity across LCIG groups. Prevalence, severity, and frequency of many individual motor symptoms and some NMS were reduced amongst all LCIG groups, with few differences between groups. Doses for LCIG, LEDD and LEDD for add-on medications were similar across groups both at LCIG initiation and patient visit. Adverse events were similar across all LCIG groups and consistent with the established safety profile of LCIG.

Conclusions

LCIG may provide sustained, long-term symptom control, while potentially avoiding increases in add-on medication dosages.

Trial registration

ClinicalTrials.gov Identifier: NCT03362879. Number and date: P16-831, November 30, 2017.
Neurofilament light chain levels indicate acute axonal damage under bortezomib treatment
Authors: Cebulla Nadine , Schirmer Daniel , Runau Eva , Flamm Leon , Gommersbach Sonja , Stengel Helena , Zhou Xiang , Einsele Hermann , Reinhold Ann-Kristin , Rogalla von Bieberstein Bruno , Zeller Daniel , Rittner Heike , Kortüm K. Martin , Sommer Claudia
Published: February 2023

Introduction

Bortezomib (BTZ) is a selective and reversible proteasome inhibitor and first line treatment for multiple myeloma (MM). One of the side effects is BTZ-induced peripheral neuropathy (BIPN). Until now there is no biomarker which can predict this side effect and its severity. Neurofilament light chain (NfL) is a neuron specific cytoskeletal protein, of which higher levels can be detected in peripheral blood in case of axon damage. In this study, we aimed to evaluate the relationship between NfL serum levels and characteristics of BIPN.

Methods

We performed a first interim analysis of a monocentric, non-randomized, observational clinical trial including 70 patients (DRKS00025422) diagnosed with MM in the inclusion period of June 2021 until March 2022. Two groups of patients—one with ongoing BTZ treatment at the time of recruiting, and one with BTZ treatment in the past—were compared to controls. NfL in serum was analyzed via the ELLA™ device.

Results

Both patients with previous and ongoing BTZ treatment had higher serum NfL levels than controls, and patients with ongoing BTZ treatment had higher NfL levels than patients with BTZ treatment in the past. Serum NfL levels correlated with electrophysiological measures of axonal damage in the group with ongoing BTZ treatment.

Conclusion

Elevated NfL levels indicate acute axonal damage under BTZ in MM patients.
Increased physical workload in home care service is associated with reduced recovery from work
Authors: Mänttäri Satu , Säynäjäkangas Pihla , Selander Kirsikka , Laitinen Jaana
Published: February 2023

Objective

This study investigated the physical workload of home care service workers and determined whether the different intensities of physical work strain experienced by home care nurses have different impacts on their recovery from work.

Methods

Physical workload and recovery were measured among 95 home care nurses based on heart rate (HR) and heart rate variability (HRV) recordings during one work shift and the following night. Differences in the physical work strain were compared between younger (≤ 44-year-old) and older (≥ 45-year-old) employees and between morning and evening shifts. To determine the effects of occupational physical activity on recovery, HRV at all time points (during the workday, when awake and asleep, and whole measurement) in relation to the amount of occupational physical activity was examined.

Results

The average physiological strain during the work shift, measured as metabolic equivalent (MET), was 1.8 ± 0.5. Moreover, the occupational physical demands in relation to maximal capacity were higher for the older employees. The results of the study showed that a higher occupational physical workload reduced the HRV of home care workers during the workday, leisure time, and sleep.

Conclusions

These data indicate that increased occupational physical workload is associated with reduced recovery among home care workers. Therefore, decreasing occupational strain and ensuring sufficient recovery is recommended.
Epidemiology and outcomes of traumatic chest injuries in children: a nationwide study in the Netherlands
Authors: Sweet Arthur A. R. , de Bruin Ivar G. J. , Peek Jesse , IJpma Frank F. A. , van Baal Mark C. P. M. , Leenen Luke P. H. , Houwert Roderick M.
Published: February 2023

Thoracic injuries are infrequent among children, but still represent one of the leading causes of pediatric mortality. Studies on pediatric chest trauma are dated, and little is known of outcomes in different age categories. This study aims to provide an overview of the incidence, injury patterns, and in-hospital outcomes of children with chest injuries. A nationwide retrospective cohort study was performed on children with chest injuries, using data from the Dutch Trauma Registry. All patients admitted to a Dutch hospital between January 2015 and December 2019, with an abbreviated injury scale score of the thorax between 2 and 6, or at least one rib fracture, were included. Incidence rates of chest injuries were calculated with demographic data from the Dutch Population Register. Injury patterns and in-hospital outcomes were assessed in children in four different age groups. A total of 66,751 children were admitted to a hospital in the Netherlands after a trauma between January 2015 and December 2019, of whom 733 (1.1%) sustained chest injuries accounting for an incidence rate of 4.9 per 100,000 person-years. The median age was 10.9 (interquartile range (IQR) 5.7–14.2) years and 62.6% were male. In a quarter of all children, the mechanisms were not further specified or unknown. Most prevalent injuries were lung contusions (40.5%) and rib fractures (27.6%). The median hospital length of stay was 3 (IQR 2–8) days, with 43.4% being admitted to the intensive care unit. The 30-day mortality rate was 6.8%.

Conclusion: Pediatric chest trauma still results in substantial adverse outcomes, such as disability and mortality. Lung contusions may be inflicted without fracturing the ribs. This contrasting injury pattern compared to adults underlines the importance of evaluating children with chest injuries with additional caution.

What is Known:• Chest injuries are rare among children, but represent one of the leading causes of pediatric mortality.• Children show distinct injury patterns in which pulmonary contusions are more prevalent than rib fractures.

What is New:• The proportion of chest injuries among pediatric trauma patients is currently lower than reported in previous literature, but still leads to substantial adverse outcomes, such as disabilities and death.• The incidence of rib fractures gradually increases with age and in particular around puberty when ossification of the ribs becomes completed. The incidence of rib fractures among infants is remarkably high, which is strongly suggestive for nonaccidental trauma.
Competing risk nomogram for predicting prognosis of patients with spinal and pelvic chordoma: A SEER-based retrospective study
Authors: Li Junhong , Ma Cong , Yuan Xuhui , Li Na , Xu Yong , Guo Jianfeng , Liao Hui
Published: February 2023

Purpose

Recently, competing risk nomograms were widely applied to predict prognosis in numerous tumors other than chordoma. Here, we aimed to construct and validate a competing-risk-based prognostic nomogram to predict 3- and 5-year cancer-specific death (CSD) in patients with spinal and pelvic chordoma.

Methods

All chordoma patient data were abstracted from the Surveillance, Epidemiology, and End Results (SEER) resource, and a total of 485 chordoma patients were eventually included in this study. Multivariate competing risk model and multivariate Cox model were used to determine independent prognostic factors, respectively, and the results of the two models were compared. Nomogram was employed to visualize the competing risk model. The discrimination, calibration, and clinical utility of this model were evaluated by Harrell concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Ten-fold cross-validation was further utilized to validate the prognostic nomogram.

Results

Significant prognostic factors affecting CSD were age (P = 0.016), localized involvement (P < 0.0001), and radical resection (P < 0.001) in the multivariate competing risk model. C-indexes were 0.799 and 0.76, and AUC were 0.812 and 0.778 for 3- and 5-year CSD. Calibration plots demonstrated the nomogram was well-fitted, and DCA indicated good clinical utility. The nomogram showed good performance in the 10-fold cross-validation.

Conclusion

We successfully built the first competing-risk-based nomogram to predict clinical outcomes in patients with spinal and pelvic chordoma. This well-established nomogram hopes to help clinicians with precise prognostic assessment and thus improve clinical outcomes.
Modified lanthanide-doped carbon dots as a novel nanochemosensor for efficient detection of water in toluene and its potential application in lubricant base oils
Authors: Chimeno-Trinchet Christian , Pacheco Maria Emilia , Fernández-González Alfonso , Badía-Laíño Rosana
Published: February 2023

A fast and efficient method was developed for obtaining europium(III)-doped surface-modified carbon dots with a hydrophobic coating. This surface functionalization improved the dispersibility of the nanoparticles in non-polar media, as well as modified the accessibility of water molecules to the europium ions. These two features allowed studying the application of doped carbon dots as moisture nanochemosensor, demonstrating high stability over time of both the photoluminescent signal intensity and the stability of the dispersions. The developed nanochemosensor was used to determine water in toluene with a detection limit of 8.5 × 10−4 M and a quantification limit of 2.4 × 10−3 M. The proposed system matches and even improves other methodologies for water determination in organic solvents; it has a low detection limit and a fast response time (almost instantaneous) and requires neither expensive material nor trained personnel. The results suggest a promising future for the development of a new sensing phase for moisture determination in lubricant base oil.

Graphical Abstract
Microbead-based extracorporeal immuno-affinity virus capture: a feasibility study to address the SARS-CoV-2 pandemic
Authors: Jarvas Gabor , Szerenyi Dora , Jankovics Hajnalka , Vonderviszt Ferenc , Tovari Jozsef , Takacs Laszlo , Foldes Fanni , Somogyi Balazs , Jakab Ferenc , Guttman Andras
Published: February 2023

In this paper, we report on the utilization of micro-technology based tools to fight viral infections. Inspired by various hemoperfusion and immune-affinity capture systems, a blood virus depletion device has been developed that offers highly efficient capture and removal of the targeted virus from the circulation, thus decreasing virus load. Single-domain antibodies against the Wuhan (VHH-72) virus strain produced by recombinant DNA technology were immobilized on the surface of glass micro-beads, which were then utilized as stationary phase. For feasibility testing, the virus suspension was flown through the prototype immune-affinity device that captured the viruses and the filtered media left the column. The feasibility test of the proposed technology was performed in a Biosafety Level 4 classified laboratory using the Wuhan SARS-CoV-2 strain. The laboratory scale device actually captured 120,000 virus particles from the culture media circulation proving the feasibility of the suggested technology. This performance has an estimated capture ability of 15 million virus particles by using the therapeutic size column design, representing three times over-engineering with the assumption of 5 million genomic virus copies in an average viremic patient. Our results suggested that this new therapeutic virus capture device could significantly lower virus load thus preventing the development of more severe COVID-19 cases and consequently reducing mortality rate.

Graphical Abstract
Neurobiological correlates and attenuated positive social intention attribution during laughter perception associated with degree of autistic traits
Authors: Martinelli Anne , Hoffmann Elgin , Brück Carolin , Kreifelts Benjamin , Ethofer Thomas , Wildgruber Dirk
Published: February 2023

Laughter plays an important role in group formation, signaling social belongingness by indicating a positive or negative social intention towards the receiver. In adults without autism, the intention of laughter can be correctly differentiated without further contextual information. In autism spectrum disorder (ASD), however, differences in the perception and interpretation of social cues represent a key characteristic of the disorder. Studies suggest that these differences are associated with hypoactivation and altered connectivity among key nodes of the social perception network. How laughter, as a multimodal nonverbal social cue, is perceived and processed neurobiologically in association with autistic traits has not been assessed previously. We investigated differences in social intention attribution, neurobiological activation, and connectivity during audiovisual laughter perception in association with the degree of autistic traits in adults [N = 31, Mage (SD) = 30.7 (10.0) years, nfemale = 14]. An attenuated tendency to attribute positive social intention to laughter was found with increasing autistic traits. Neurobiologically, autistic trait scores were associated with decreased activation in the right inferior frontal cortex during laughter perception and with attenuated connectivity between the bilateral fusiform face area with bilateral inferior and lateral frontal, superior temporal, mid-cingulate and inferior parietal cortices. Results support hypoactivity and hypoconnectivity during social cue processing with increasing ASD symptoms between socioemotional face processing nodes and higher-order multimodal processing regions related to emotion identification and attribution of social intention. Furthermore, results reflect the importance of specifically including signals of positive social intention in future studies in ASD.
Differential analysis of culturable and unculturable subgingival target microorganisms according to the stages of periodontitis
Authors: Lafaurie Gloria Inés , Castillo Diana Marcela , Iniesta Margarita , Sanz Mariano , Gómez Luz Amparo , Castillo Yormaris , Pianeta Roquelina , Delgadillo Nathaly Andrea , Neuta Yineth , Diaz-Báez David , Herrera David
Published: February 2023

Objectives

Culturable and unculturable microorganisms have been associated with periodontitis. Their differential proportions and composition have not been evaluated by their severity and complexity defined by stages in the 2018 AAP-EEP classification.

Methods

One hundred eighty subgingival biofilm samples were collected in Spain and Colombia from subjects categorized as health/gingivitis: periodontitis stages I/II periodontitis stages III/IV. Target culturable microorganisms (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Treponema denticola, and Eubacterium nodatum) and target unculturable microorganisms (Filifactor alocis, Eubacterium saphenum, Eubacterium brachy, Desulfobulbus oralis) were evaluated by quantitative PCR analysis. In addition, their differences and association with periodontal status were analyzed by ANCOVA and logistic regression models once adjusted to age, current smoking, and country.

Results

P. gingivalis was significantly associated with periodontitis stages I/II, OR 2.44 (CI 95% 1.08–5.47) and stages III/V, OR 6.43 (CI 95% 2.43–16.9). T forsythia, OR 7.53 (CI 95% 2.07–27.4); D. oralis, OR 5.99 (CI 95% 2.71–13.23); F. alocis, OR 10.9 (CI 95% 4.56–23.2); E. brachy, 3.57 (CI 95% 1.40–9.11); and E. saphenum, 4.85 (CI 95% 1.99–11.7) were significantly associated only with stages III/IV periodontitis. P. gingivalis evidenced significant differences with the increase in the severity of the periodontal lesion: 2.97 colony forming unit (CFU)/μL (CI 95% 2.32–3.54) health/gingivitis, and 4.66 CFU/μL (CI 95% 4.03–5.30) and 5.90 CFU/μL (CI 95% 5.20–6.48) in stages I/II and III/IV respectively (p < 0.0001). Unculturable microorganisms only evidenced differences in concentration in stages III/IV compared with health-gingivitis (p ≤ 0.001).

Conclusion

Culturable and unculturable are strongly associated with stages III/IV periodontitis. Classic culturable microorganisms are more sensitive to differentiate between stages of periodontitis in the quantitative analysis.

Clinical relevance

Future interventional studies of periodontal disease should include Filifactor alocis, Eubacterium saphenum, Eubacterium brachy, and Desulfobulbus oralis as possible markers of therapy response and as indicators of progressive disease.