bluuebunny/crossref_metadata_2025 huggingface dataset:
Inadvertent irreversible closure of arterial duct following therapeutic use of transplacental indomethacin in a fetus with severe Ebstein's anomaly and circular shunt
Authors: Gill K. , Arbic N. , Seed M. , Honjo O. , Ryan G. , Jaeggi E.
Published: August 2021

We report on a fetal case of Ebstein's anomaly with severe tricuspid regurgitation, functional pulmonary atresia and progressive circular shunting (CS) across a widely patent ductus arteriosus (DA) and regurgitant pulmonary valve, contributing to significant systemic hypoperfusion. To mitigate the extent of CS and allow the pregnancy to continue, maternal non‐steroidal anti‐inflammatory drug (NSAID) therapy with indomethacin was started at 33 + 5 weeks to induce DA constriction. Rather than achieving the desired narrowing of the DA, the treatment led to its complete closure and only minimal antegrade flow across the pulmonary valve. While closure of the DA resulted in the anticipated improvement in fetal hemodynamics, at birth, the child was at risk of severe hypoxemia and its consequences due to the lack of adequate pulmonary perfusion. Reduction and eventual discontinuation of the NSAID treatment did not result in DA reopening. Our experience illustrates the risk of unintended irreversible DA closure when NSAIDs are used to treat CS. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Applied anatomy of the skull in the Arabian horse: A computed tomographic, cross‐sectional, volumetric and morphometric study
Authors: Goodarzi Nader , Zehtabvar Omid , Tohidifar Mohsen
Published: August 2021

This study was conducted to present a comprehensive and integrative computed tomography (CT) – anatomical cross sections atlas of skull, volumetric properties of the paranasal sinuses, and morphometric values for surface cranial nerves in the adult Arabian horse. Ten heads of Arabian horse breed were used. The different structures in the nasal, oral and cranial cavities were determined and labelled in the anatomical sections and their corresponding CT scan images. Three paranasal sinuses namely maxillary, conchofrontal and sphenopalatine sinuses were identified in the CT scan images. The caudal maxillary sinus was the largest paranasal sinus with 131.93 ± 7.67 cm3 volume and the sphenopalatine sinus 13.3 ± 1.2 cm3 volume was the smallest one. The infraorbital foramen was located 4.16 ± 0.18 cm and 4.70 ± 0.35 cm far away from the most rostral point of the facial crest and alveolar root, respectively. The mean distance between the mental foramen and most lateral incisive tooth was 3.12 ± 0.29 cm. These results including present CT scan‐cross‐sectional atlas, paranasal sinuses volume and morphometric properties would be applicable in practice for more precise diagnosis of head lesions and blocking the surface terminal branches of the cranial nerves during surgical operations in this valuable horse's breed.
Coupled inversion of hydraulic and self‐potential data from transient outflow experiments to estimate soil petrophysical properties
Authors: Xie Jing , Cui Yian , Niu Qifei
Published: August 2021

Hydraulicproperties of soils could play an important role in affecting the partitioning of precipitation in the critical zone. In addition to traditional approaches, in the last two decades, many geophysical methods have been used to aid the hydrologic characterization and measurement of geological materials. In particular, the self‐potential (SP) method shows great potential in these hydrogeophysical applications. The objective of this study is to evaluate whether the addition of SP data can improve the estimation of hydraulic properties of soils in an outflow experiment. A stochastic, coupled hydrogeophysical inversion was developed, in which the governing equations were solved using the finite volume method and the parameter estimation was conducted using a Bayesian approach associated with the Markov chain Monte Carlo technique. The results show that the addition of SP data in the inversion could reduce the uncertainty related to the estimated hydraulic parameters of soils and the length of the associated 95% confidence interval can be shortened by ∼1/3. It is also shown that the electrical properties of soils at saturated and unsaturated conditions may also be estimated from the outflow experiment when SP data are available. Compared with hydraulic parameters, the accuracy of the estimated electrical properties is slightly lower. Among them, the saturated streaming potential coupling coefficientCsathas the highest accuracy and lowest uncertainty sinceCsatdirectly influences the magnitude of SP signals. The accuracy of other electrical parameters is lower than that ofCsat(and hydraulic parameters), and the associated uncertainty can be one order of magnitude larger.
Investigations on the Solubility of Sn4‐Cluster Compounds in Liquid Ammonia
Authors: Klein Wilhelm , Benda Christian B. , Henneberger Thomas , Witzel Benedikt J. L. , Fässler Thomas F.
Published: August 2021

By using different transition metal containing precursors and liquid ammonia as solvent, single crystals of Sn44‐ cluster containing ammoniates were grown, and three new compounds have been characterized by single crystal structure determination. K4Sn4 ⋅ 8 NH3 (1) (P63, a=13.0370(6) Å and c=39.0889(11) Å) has been obtained by dissolving a precursor with the nominal composition “KRuSn4” in liquid ammonia, and Rb2Na2Sn4 ⋅ 4.8 NH3 (2) (Pc, a=9.4005(3) Å, b=15.3663(6) Å, c=12.7312(6) Å, β=94.675(3)°) from a similar solution of “Rb9Na9Co16Sn24“. 1 represents the last missing ammoniate of the A4Sn4 compounds with heavier alkali metal cations. K6[OH]2[Sn4] ⋅ 5 NH3 (3) was crystallized from solutions of the binary Zintl phase K12Sn17 in presence of AuPPh3Cl and cryptand[2.2.2] (P21/c, a=10.3655(1) Å, b=12.7489(2) Å, c=16.9137(3) Å, β=103.212(2)°), and is the Sn44‐ cluster compound that appears to be stable in presence of the highest amount of hydroxide so far.
Introduction
Authors: Villiger Daniel
Published: August 2021

In August 2017, the Swiss Federal Railways (SBB) was launching a campaign by means of which passengers should gain more attention for additional trains during rush hour. Between 6 a.m. and 8 a.m. employees dressed with a fox tail and fox ears had to walk around on platforms with posters that indicated when and where the additional trains leave. The idea of the SBB was that passengers who use these additional trains are sly foxes and vixens because these trains are less crowded than the normal ones.
Defining Different Forms of Discrimination
Authors: Villiger Daniel
Published: August 2021

As we have seen in the introduction, when we talk about discrimination, we normally talk about a certain kind of behaviour. If we treat a person or group differently compared to another person or group, this means that we behave differently depending on who our counterpart is. Therefore, dissecting discrimination implies dissecting the ways we behave in. The tool of analysis used in this dissertation in order to investigate and explain behaviour is decision theory.
Where Does Taste-Based Discrimination Come From?
Authors: Villiger Daniel
Published: August 2021

As the last chapter has revealed, the reason why a decision-maker makes use of statistical discrimination is easily comprehensible. If a decision situation underlies uncertainty, he has to assess the probabilities of possible scenarios with some degree of vagueness. In this process, group memberships of providers can serve as a proxy for these probabilities.
How Do We Get Our Beliefs for Statistical Discrimination?
Authors: Villiger Daniel
Published: August 2021

From a decision theoretical perspective, there is one major question that the concept of statistical discrimination raises: When is it rational to have a certain belief and use it for statistical discrimination and when not? By definition, the correctness of a statistical difference between two or more groups regarding some characteristic is not a requirement for statistical discrimination (Lippert-Rasmussen, 2014). You also discriminate statistically if the difference and / or its relevance does not actually exist but you believe it to exist. But what defines the boundary between a rational and an irrational belief then?
Reassembling Discrimination
Authors: Villiger Daniel
Published: August 2021

In the last three parts of the dissertation, we have dissected discrimination. First of all, we said that two requirements have to be fulfilled in order that an act is discriminatory: (1) In the decision situation, there has to be a differentiation between two or more things/people. (2) At least one of these things/people has to be treated in a systematically different way compared to the other things/people.
Conclusion
Authors: Villiger Daniel
Published: August 2021

This dissertation provided a descriptive analysis of the phenomenon of discrimination. We first dissected discrimination by means of decision theory. In so doing, we started with a broad definition of discrimination and then identified more and more distinctive manifestations of it. First of all, we separated social from non-social discrimination.
Monodromy methods for torus conformal blocks and entanglement entropy at large central charge
Authors: Gerbershagen Marius
Published: August 2021

Abstract

We compute the entanglement entropy in a two dimensional conformal field theory at finite size and finite temperature in the large central charge limit via the replica trick. We first generalize the known monodromy method for the calculation of conformal blocks on the plane to the torus. Then, we derive a monodromy method for the zero-point conformal blocks of the replica partition function. We explain the differences between the two monodromy methods before applying them to the calculation of the entanglement entropy. We find that the contribution of the vacuum exchange dominates the entanglement entropy for a large class of CFTs, leading to universal results in agreement with holographic predictions from the RT formula. Moreover, we determine in which regime the replica partition function agrees with a correlation function of local twist operators on the torus.
Higgs-boson production in top-quark fragmentation
Authors: Brancaccio Colomba , Czakon Michał , Generet Terry , Krämer Michael
Published: August 2021

Abstract

We compute the fragmentation functions for the production of a Higgs boson at $$ \mathcal{O} $$
O
($$ {y}_t^2 $$

y
t
2

αs). As part of this calculation, the relevant splitting functions are also derived at the same perturbative order. Our results can be used to compute differential cross sections with arbitrary top-quark and Higgs-boson masses from massless calculations. They can also be used to resum logarithms of the form ln(pT/m) at large transverse momentum pT to next-to-leading-logarithmic accuracy by solving the DGLAP equations.
Shifted quiver Yangians and representations from BPS crystals
Authors: Galakhov Dmitry , Li Wei , Yamazaki Masahito
Published: August 2021

Abstract

We introduce a class of new algebras, the shifted quiver Yangians, as the BPS algebras for type IIA string theory on general toric Calabi-Yau three-folds. We construct representations of the shifted quiver Yangian from general subcrystals of the canonical crystal. We derive our results via equivariant localization for supersymmetric quiver quantum mechanics for various framed quivers, where the framings are determined by the shape of the subcrystals.

Our results unify many known BPS state counting problems, including open BPS counting, non-compact D4-branes, and wall crossing phenomena, simply as different representations of the shifted quiver Yangians. Furthermore, most of our representations seem to be new, and this suggests the existence of a zoo of BPS state counting problems yet to be studied in detail.
Spectral walls in multifield kink dynamics
Authors: Adam C. , Oles K. , Romanczukiewicz T. , Wereszczynski A. , Zakrzewski W. J.
Published: August 2021

Abstract

We show that spectral walls are common phenomena in the dynamics of kinks in (1+1) dimensions. They occur in models based on two or more scalar fields with a nonempty Bogomol’nyi-Prasad-Sommerfield (BPS) sector, hosting two zero modes, where they are one of the main factors governing the soliton dynamics. We also show that spectral walls appear as singularities of the dynamical vibrational moduli space.
Symmetry breaking at high temperatures in large N gauge theories
Authors: Chaudhuri Soumyadeep , Rabinovici Eliezer
Published: August 2021

Abstract

Considering marginally relevant and relevant deformations of the weakly coupled (3 + 1)-dimensional large N conformal gauge theories introduced in [1], we study the patterns of phase transitions in these systems that lead to a symmetry-broken phase in the high temperature limit. These deformations involve only the scalar fields in the models. The marginally relevant deformations are obtained by varying certain double trace quartic couplings between the scalar fields. The relevant deformations, on the other hand, are obtained by adding masses to the scalar fields while keeping all the couplings frozen at their fixed point values. At the N → ∞ limit, the RG flows triggered by these deformations approach the aforementioned weakly coupled CFTs in the UV regime. These UV fixed points lie on a conformal manifold with the shape of a circle in the space of couplings. As shown in [1], in certain parameter regimes a subset of points on this manifold exhibits thermal order characterized by the spontaneous breaking of a global ℤ2 or U(1) symmetry and Higgsing of a subset of gauge bosons at all nonzero temperatures. We show that the RG flows triggered by the marginally relevant deformations lead to a weakly coupled IR fixed point which lacks the thermal order. Thus, the systems defined by these RG flows undergo a transition from a disordered phase at low temperatures to an ordered phase at high temperatures. This provides examples of both inverse symmetry breaking and symmetry nonrestoration. For the relevant deformations, we demonstrate that a variety of phase transitions are possible depending on the signs and magnitudes of the squares of the masses added to the scalar fields. Using thermal perturbation theory, we derive the approximate values of the critical temperatures for all these phase transitions. All the results are obtained at the N → ∞ limit. Most of them are found in a reliable weak coupling regime and for others we present qualitative arguments.
Lonely Planets and Lightweight Asteroids: A Statistical Mechanics Model for the Planetary Problem
Authors: Pinzari Gabriella , Scoppola Benedetto , Troiani Alessio
Published: August 2021

In this paper we propose a notion of stability, which we call $$\varepsilon -N$$

ε
-
N

-stability, for systems of particles interacting via Newton’s gravitational potential, and orbiting a much bigger object. For these systems the usual thermodynamical stability condition, ensuring the possibility to perform the thermodynamical limit, fails, but one can use as relevant parameter the maximum number of particles N that guarantees the $$\varepsilon -N$$

ε
-
N

-stability. With some judicious but not particularly optimized estimates, borrowed from the classical theory of equilibrium statistical mechanics, we show that our model has a good fit with the data observed in the Solar System, and it gives a reasonable interpretation of some of its global properties.
Long-time behavior of solutions to a fourth-order nonlinear Schrödinger equation with critical nonlinearity
Authors: Okamoto Mamoru , Uriya Kota
Published: August 2021

We consider the long-time behavior of solutions to a fourth-order nonlinear Schrödinger (NLS) equation with a derivative nonlinearity. By using the method of testing by wave packets, we construct an approximate solution and show that the solution for the fourth-order NLS has the same decay estimate for linear solutions. We prove that the self-similar solution is the leading part of the asymptotic behavior.
Evolution of a hydrothermal ore-forming system recorded by sulfide mineral chemistry: a case study from the Plaka Pb–Zn–Ag Deposit, Lavrion, Greece
Authors: Frenzel Max , Voudouris Panagiotis , Cook Nigel J. , Ciobanu Cristiana L. , Gilbert Sarah , Wade Benjamin P.
Published: August 2021

Laser ablation-inductively coupled plasma-mass spectrometry and electron-probe microanalysis were used to investigate the trace-element contents of sphalerite, chalcopyrite and pyrite from the Plaka Pb–Zn–Ag deposit. Using petrographic observations, the analytical results could be linked to the temporal evolution of the Plaka ore-forming system. Sphalerite chemistry reliably records the temperature andfS2evolution of the system, with estimated formation temperatures reproducing the microthermometric results from previous fluid-inclusion studies. Chalcopyrite chemistry also shows systematic variations over time, particularly for Cd, Co, Ge, In, Sn and Zn concentrations. Measurable pyrite was only found in association with early high-temperature mineralisation, and no clear trends could therefore be identified. We note, however, that As and Se contents in pyrite are consistent with formation temperatures estimated from co-existing sphalerite. Statistical analysis of the sphalerite data allowed us to identify the dominant geological controls on its trace-element content. The three investigated factors temperature,fS2, and sample location account for > 80% of the observed variance in Mn, Fe, Co, Ga, Ge, In, Sb and Hg concentrations, and > 60% of the observed variance in Cd and Sn concentrations. Only for Cu and Ag concentrations is the explained variance < 50%. A similarly detailed analysis was not possible for chalcopyrite and pyrite. Nevertheless, comparison of the results for all three investigated minerals indicates that there are some systematic variations across the deposit which may be explained by local differences in fluid composition.
Automatic high fidelity foot contact location and timing for elite sprinting
Authors: Evans Murray , Colyer Steffi , Salo Aki , Cosker Darren
Published: August 2021

Making accurate measurements of human body motions using only passive, non-interfering sensors such as video is a difficult task with a wide range of applications throughout biomechanics, health, sports and entertainment. The rise of machine learning-based human pose estimation has allowed for impressive performance gains, but machine learning-based systems require large datasets which might not be practical for niche applications. As such, it may be necessary to adapt systems trained for more general-purpose goals, but this might require a sacrifice in accuracy when compared with systems specifically developed for the application. This paper proposes two approaches to measuring a sprinter’s foot-ground contact locations and timing (step length and step frequency), a task which requires high accuracy. The first approach is a learning-free system based on occupancy maps. The second approach is a multi-camera 3D fusion of a state-of-the-art machine learning-based human pose estimation model. Both systems use the same underlying multi-camera system. The experiments show the learning-free computer vision algorithm to provide foot timing to better than 1 frame at 180 fps, and step length accurate to 7 mm, while the system based on pose estimation achieves timing better than 1.5 frames at 180 fps, and step length estimates accurate to 20 mm.
Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament
Authors: Arrigoni Paolo , Cucchi Davide , Luceri Francesco , Zagarella Andrea , Catapano Michele , Menon Alessandra , Bruno Valentina , Gallazzi Mauro , Randelli Pietro Simone
Published: August 2021

Purpose

The lateral elbow musculature conveys a dynamic valgus moment to the elbow, increasing joint stability. Muscular or tendinous lesions to the anterior half of the common extensor origin (CEO) may provoke a deficiency in the elbow dynamic stabilizers, regardless of their traumatic, degenerative, or iatrogenic aetiology. Furthermore, a role for the radial band of the lateral collateral ligament (R-LCL) has been postulated in the aetiology of lateral elbow pain. This study aimed to evaluate the effects of sequential lateral releases with dynamic ultrasound, evaluating its capability to detect lesions of the CEO and of the R-LCL.

Methods

Ultrasound investigation of the lateral compartment of the elbow was performed on nine cadaveric specimens with a 10 MHz linear probe in basal conditions, after the release of the anterior half of the CEO and after complete R-LCL release. The lateral joint line widening (λ) was the primary outcome parameter, measured as the linear distance between the humeral and radial articular surfaces.

Results

The release of the anterior half of the CEO significantly increased λ by 200% compared to the starting position (p = 0.0008) and the previously loaded position (p = 0.0015). Conversely, further release of the R-LCL caused only a marginal, non-significant increase in λ.

Conclusions

Ultrasound evaluation can detect changes related to tendon tears or muscular avulsions of the CEO and can depict lateral elbow compartmental patholaxity by assessing articular space widening while scanning under dynamic stress. However, it cannot reliably define if the R-LCL is injured. Iatrogenic damage to the CEO should be carefully avoided, since it causes a massive increase in compartmental laxity.
The effectiveness of group-based pelvic floor muscle training in preventing and treating urinary incontinence for antenatal and postnatal women: a systematic review
Authors: Yang Xiaowei , Zhang Aixia , Sayer Lynn , Bassett Sam , Woodward Sue
Published: August 2021

Introduction and hypothesis

Urinary incontinence (UI) is prevalent in antenatal and postnatal women. Pelvic floor muscle training (PFMT) is the first-line treatment for UI. Group-based PFMT provides a way for professionals to deliver this intervention to more women who need to prevent and/or treat UI. This review aims to (1) assess the effectiveness of group-based PFMT in preventing and treating UI in antenatal and postnatal women and (2) explore the characteristics of group-based intervention and factors which had an impact on the success of group-based PFMT.

Methods

Randomized controlled trials (RCTs) were included in this review. A comprehensive search was conducted in PubMed, Embase, Medline, PsycINFO, Maternity and Infant Care Database, CINAHL, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database and Wanfang Database. The overall quality was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). RCTs which included pregnant and/or postnatal women with or without UI investigating the effectiveness of group-based PFMT were included.

Results

Five RCTs were included in this review. The overall quality of the results of the included studies was low. Delivering group-based PFMT during pregnancy significantly reduced the prevalence of UI in both the pregnant period [risk ratio (RR) = 0.67, 95% confidence interval (CI) 0.57 to 0.80, P < 0.00001] and the postnatal period [RR = 0.66, 95% CI 0.52 to 0.84, P = 0.0008]. Only one RCT delivered group-based PFMT during the postnatal period.

Conclusion

Evidence of weak quality supports the effectiveness of undertaking group-based PFMT in pregnancy to prevent UI during pregnancy and the postnatal period. No evidence showed the effectiveness of undertaking group-based PFMT in the postnatal period.
Cytotoxicity, metabolism, and isozyme mapping of the synthetic cannabinoids JWH-200, A-796260, and 5F-EMB-PINACA studied by means of in vitro systems
Authors: Gampfer Tanja M. , Wagmann Lea , Belkacemi Anouar , Flockerzi Veit , Meyer Markus R.
Published: August 2021

Intake of synthetic cannabinoids (SC), one of the largest classes of new psychoactive substances, was reported to be associated with acute liver damage but information about their hepatotoxic potential is limited. The current study aimed to analyze the hepatotoxicity including the metabolism-related impact of JWH-200, A-796260, and 5F-EMB-PINACA in HepG2 cells allowing a tentative assessment of different SC subclasses. A formerly adopted high-content screening assay (HCSA) was optimized using a fully automated epifluorescence microscope. Metabolism-mediated effects in the HCSA were additionally investigated using the broad CYP inhibitor 1-aminobenzotriazole. Furthermore, phase I metabolites and isozymes involved were identified by in vitro assays and liquid chromatography–high-resolution tandem mass spectrometry. A strong cytotoxic potential was observed for the naphthoylindole SC JWH-200 and the tetramethylcyclopropanoylindole compound A-796260, whereas the indazole carboxamide SC 5F-EMB-PINACA showed moderate effects. Numerous metabolites, which can serve as analytical targets in urine screening procedures, were identified in pooled human liver microsomes. Most abundant metabolites of JWH-200 were formed by N-dealkylation, oxidative morpholine cleavage, and oxidative morpholine opening. In case of A-796260, most abundant metabolites included an oxidative morpholine cleavage, oxidative morpholine opening, hydroxylation, and dihydroxylation followed by dehydrogenation. Most abundant 5F-EMB-PINACA metabolites were generated by ester hydrolysis plus additional steps such as oxidative defluorination and hydroxylation. To conclude, the data showed that a hepatotoxicity of the investigated SC cannot be excluded, that metabolism seems to play a minor role in the observed effects, and that the extensive phase I metabolism is mediated by several isozymes making interaction unlikely.
18F-FDG texture analysis predicts the pathological Fuhrman nuclear grade of clear cell renal cell carcinoma
Authors: Zhang Linhan , Zhao Hongyue , Jiang Huijie , Zhao Hong , Han Wei , Wang Mengjiao , Fu Peng
Published: August 2021

Purpose

This article analyzes the image heterogeneity of clear cell renal cell carcinoma (ccRCC) based on positron emission tomography (PET) and positron emission tomography-computed tomography (PET/CT) texture parameters, and provides a new objective quantitative parameter for predicting pathological Fuhrman nuclear grading before surgery.

Methods

A retrospective analysis was performed on preoperative PET/CT images of 49 patients whose surgical pathology was ccRCC, 27 of whom were low grade (Fuhrman I/II) and 22 of whom were high grade (Fuhrman III/IV). Radiological parameters and standard uptake value (SUV) indicators on PET and computed tomography (CT) images were extracted by using the LIFEx software package. The discriminative ability of each texture parameter was evaluated through receiver operating curve (ROC). Binary logistic regression analysis was used to screen the texture parameters with distinguishing and diagnostic capabilities and whose area under curve (AUC) > 0.5. DeLong's test was used to compare the AUCs of PET texture parameter model and PET/CT texture parameter model with traditional maximum standardized uptake value (SUVmax) model and the ratio of tumor SUVmax to liver SUVmean (SUL)model. In addition, the models with the larger AUCs among the SUV models and texture models were prospectively internally verified.

Results

In the ROC curve analysis, the AUCs of SUVmax model, SUL model, PET texture parameter model, and PET/CT texture parameter model were 0.803, 0.819, 0.873, and 0.926, respectively. The prediction ability of PET texture parameter model or PET/CT texture parameter model was significantly better than SUVmax model (P = 0.017, P = 0.02), but it was not better than SUL model (P = 0.269, P = 0.053). In the prospective validation cohort, both the SUL model and the PET/CT texture parameter model had good predictive ability, and the AUCs of them were 0.727 and 0.792, respectively.

Conclusion

PET and PET/CT texture parameter models can improve the prediction ability of ccRCC Fuhrman nuclear grade; SUL model may be the more accurate and easiest way to predict ccRCC Fuhrman nuclear grade.

Graphic abstract
Sutures ultrasound: useful diagnostic screening for posterior plagiocephaly
Authors: Marino Silvia , Ruggieri Martino , Marino Lidia , Falsaperla Raffaele
Published: August 2021

Purpose

Posterior plagiocephaly (PP) is a common clinical condition in pediatric age. There are two main causes of PP: postural plagiocephaly and craniosynostosis. Early diagnosis is important, as it prevents neurological complications and emergencies. Diagnosis in the past was often made late and with imaging tests that subjected the infant to a high radiation load. Suture ultrasound does not use ionizing radiation; it is easy to perform, allows an early diagnosis, and directs toward the execution of the cranial 3D-CT scan, neurosurgical consultation, and possible intervention. The aim of the study is to describe the high sensitivity and specificity of suture ultrasound for the differential diagnosis between plagiocephaly and craniosynostosis.

Methods

We reported our prospective experience and compared it with the data in the literature through a systematic review. The systematic review was conducted on electronic medical databases (PubMed, Embase, Cochrane Library, Scopus, and Web of Science) evaluating the published literature up to November 2020. According to Preferred Reporting Items for Systematic Reviews and Meta-ANALYSES (PRISMA statement), we identified 2 eligible studies. Additionally, according to AMSTAR 2, all included reviews have been critically rated as high quality. A total of 120 infants with abnormal skull shape were examined in NICU. All underwent clinical and ultrasound examination.

Results

Of the total, 105 (87.5%) had plagiocephaly and 15 dolichocephaly/scaphocephaly (12.5%). None of these had associated other types of malformations and/or neurological disorders. The synostotic suture was identified ultrasonographically in 1 infant and subsequently confirmed by 3D CT scan (100%).

Conclusion

Cranial sutures ultrasonography can be considered in infants a selective, excellent screening method for the evaluation of skull shape deformities as first technique before the 3D CT scan exam and subsequent neurosurgical evaluation. Cranial suture ultrasonography should be considered part of clinical practice especially for pediatricians.
Management of colorectal anastomotic leakage using endoscopic negative pressure therapy with or without protective ostomy: a retrospective study
Authors: Şandra-Petrescu Flavius , Tzatzarakis Emmanouil , Kähler Georg , Reissfelder Christoph , Herrle Florian
Published: August 2021

Purpose

Management of colorectal anastomotic leakage (AL) is patient-oriented and requires an interdisciplinary approach. We analyzed the management of AL according to its severity and presence of ostomy and proposed a therapy algorithm.

Methods

We identified all patients who underwent colorectal surgery and developed an AL in our clinic between 2012 and 2017. The management of AL was retrospectively analyzed according to the severity grade: asymptomatic (A), requesting interventional or antibiotic therapy (B), undergoing re-operation (C). The groups were compared according to the leakage characteristics, presence of ostomy, and patient clinical conditions.

Results

We identified 784 consecutive patients meeting the inclusion criteria. Of these, 10.8% experienced an AL (A = 18%, B = 48%, and C = 34%). The rate of successful ostomy closure was 100% (A), 68% (B), and 62% (C), respectively. Within group B, 91% of the patients were treated solely by endoscopic negative pressure therapy (ENPT), whereas 37% of the patients within group C required ENPT in addition to surgery. Seven cases within group B (17%) required no protective ostomy (nOB) during ENPT which was itself shorter and required less cycles in comparison to group B with ostomy (OB) (p = 0.017 and 0.111, respectively). Moreover, the leakage distance to anal verge was higher in the OB subgroup (p < 0.001).

Conclusion

ENPT for the treatment of colorectal AL is efficient in combination with operative revision or protective ostomy. In selected patients, it is feasible also in the absence of a protective ostomy.
Intestinal anastomotic healing models during experimental colitis
Authors: Miltschitzky J. R. E. , Clees Z. , Weber M.-C. , Vieregge V. , Walter R. L. , Friess H. , Reischl S. , Neumann P.-A.
Published: August 2021

Background

Anastomotic leakage represents a major complication following resections in colorectal surgery. Among others, intestinal inflammation such as in inflammatory bowel disease is a significant risk factor for disturbed anastomotic healing. Despite technical advancements and several decades of focused research, the underlying mechanisms remain incompletely understood. Animal experiments will remain the backbone of this research in the near future. Here, instructions on a standardized and reproducible murine model of preoperative colitis and colorectal anastomosis formation are provided to amplify research on anastomotic healing during inflammatory disease.

Methods

We demonstrate the combination of experimental colitis and colorectal anastomosis formation in a mouse model. The model allows for monitoring of anastomotic healing during inflammatory disease through functional outcomes, clinical scores, and endoscopy and histopathological examination, as well as molecular analysis.

Discussion

Postoperative weight loss is used as a parameter to monitor general recovery. Functional stability can be measured by recording bursting pressure and location. Anastomotic healing can be evaluated macroscopically from the luminal side by endoscopic scoring and from the extraluminal side by assessing adhesion and abscess formation or presence of dehiscence. Histologic examination allows for detailed evaluation of the healing process.

Conclusion

The murine model presented in this paper combines adjustable levels of experimental colitis with a standardized method for colorectal anastomosis formation. Extensive options for sample analysis and evaluation of clinical outcomes allow for detailed research of the mechanisms behind defective anastomotic healing.
Coronary artery bypass grafting versus stent implantation in patients with chronic coronary syndrome and left main disease: insights from a register throughout Germany
Authors: Stachon Peter , Kaier Klaus , Hehn Philip , Peikert Alexander , Wolf Dennis , Oettinger Vera , Staudacher Dawid , Duerschmied Daniel , Zirlik Andreas , Zehender Manfred , Bode Christoph , von zur Mühlen Constantin
Published: August 2021

Background

Recent randomized controlled trials have sparked debate about the optimal treatment of patients suffering from left main coronary artery disease. The present study analyzes outcomes of left main stenting versus coronary bypass grafting (CABG) in a nationwide registry in patients with chronic coronary syndrome (CCS).

Methods

All cases suffering from CCS and left main coronary artery disease treated either with CABG or stent, were identified within the database of the German bureau of statistics. Logistic or linear regression models were used with 20 baseline patient characteristics as potential confounders to compare both regimens.

Results

In 2018, 1318 cases with left main stenosis were treated with CABG and 8,920 with stent. Patients assigned for stenting were older (72.58 ± 9.87 vs. 68.63 ± 9.40, p < 0.001) and at higher operative risk, as assessed by logistic EuroSCORE (8.77 ± 8.45 vs. 4.85 ± 4.65, p < 0.001). After risk adjustment, no marked differences in outcomes were found for in-hospital mortality and stroke (risk adjusted odds ratio (aOR) for stent instead of CABG: aOR mortality: 1.08 [95% CI 0.66; 1.78], p = 0.748; aOR stroke: 0.59 [0.27; 1.32], p = 0.199). Stent implantation was associated with a reduced risk of relevant bleeding (aOR 0.38 [0.24; 0.61], p < 0.001), reduced prolonged ventilation time (aOR 0.54 [0.37 0.79], p = 0.002), and postoperative delirium (aOR 0.16 [0.11; 0.22], p < 0.001). Furthermore, stent implantation was associated with shorter hospital stay (− 6.78 days [− 5.86; − 7.71], p < 0.001) and lower costs (− €10,035 [− €11,500; − €8570], p < 0.001).

Conclusion

Left main stenting is a safe and effective treatment option for CCS-patients suffering from left main coronary artery disease at reasonable economic cost.

Graphic abstract
Apolipoprotein E regulates lipid metabolism and α-synuclein pathology in human iPSC-derived cerebral organoids
Authors: Zhao Jing , Lu Wenyan , Ren Yingxue , Fu Yuan , Martens Yuka A. , Shue Francis , Davis Mary D. , Wang Xue , Chen Kai , Li Fuyao , Liu Chia-Chen , Graff-Radford Neill R. , Wszolek Zbigniew K. , Younkin Steven G. , Brafman David A. , Ertekin-Taner Nilüfer , Asmann Yan W. , Dickson Dennis W. , Xu Ziying , Pan Meixia , Han Xianlin , Kanekiyo Takahisa , Bu Guojun
Published: August 2021

APOE4 is a strong genetic risk factor for Alzheimer’s disease and Dementia with Lewy bodies; however, how its expression impacts pathogenic pathways in a human-relevant system is not clear. Here using human iPSC-derived cerebral organoid models, we find that APOE deletion increases α-synuclein (αSyn) accumulation accompanied with synaptic loss, reduction of GBA levels, lipid droplet accumulation and dysregulation of intracellular organelles. These phenotypes are partially rescued by exogenous apoE2 and apoE3, but not apoE4. Lipidomics analysis detects the increased fatty acid utilization and cholesterol ester accumulation in apoE-deficient cerebral organoids. Furthermore, APOE4 cerebral organoids have increased αSyn accumulation compared to those with APOE3. Carrying APOE4 also increases apoE association with Lewy bodies in postmortem brains from patients with Lewy body disease. Our findings reveal the predominant role of apoE in lipid metabolism and αSyn pathology in iPSC-derived cerebral organoids, providing mechanistic insights into how APOE4 drives the risk for synucleinopathies.
Retrospective analysis of secondary resection of the cervical stump after subtotal hysterectomy: why and when?
Authors: Neis Felix , Reisenauer Christl , Kraemer Bernhard , Wagner Philipp , Brucker Sara
Published: August 2021

Purpose

The rates of hysterectomy are falling worldwide, and the surgical approach is undergoing a major change. To avoid abdominal hysterectomy, a minimally invasive approach has been implemented. Due to the increasing rates of subtotal hysterectomy, we are faced with the following questions: how often does the cervical stump have to be removed secondarily, and what are the indications?

Methods

This was a retrospective, single-centre analysis of secondary resection of the cervical stump conducted from 2004 to 2018.

Results

Secondary resection of the cervical stump was performed in 137 women. Seventy-four percent of the previous subtotal hysterectomy procedures were performed in our hospital, and 26% were performed in an external hospital. During the study period, 5209 subtotal hysterectomy procedures were performed at our hospital. The three main indications for secondary resection of the cervical stump were prolapse (31.4%), spotting (19.0%) and cervical dysplasia (18.2%). Unexpected histological findings (premalignant and malignant) after subtotal hysterectomy resulted in immediate (median time, 1 month) secondary resection of the cervical stump in 11 cases. In four patients, the indication was a secondary malignant gynaecological disease that occurred more than 5 years after subtotal hysterectomy. The median time between subtotal hysterectomy and secondary resection of the cervical stump was 40 months. Secondary resection of the cervical stump was performed vaginally in 75.2% of cases, laparoscopically in 20.4% of cases and abdominally in 4.4% of cases. The overall complication rate was 5%.

Conclusion

Secondary resection of the cervical stump is a rare surgery with a low complication rate and can be performed via the vaginal or laparoscopic approach in most cases. The most common indications are prolapse, spotting and cervical dysplasia. If a secondary resection of the cervical stump is necessary due to symptoms, 66.6% will be performed within the first 6 years after subtotal hysterectomy.
Lenvatinib plus TACE with or without pembrolizumab for the treatment of initially unresectable hepatocellular carcinoma harbouring PD-L1 expression: a retrospective study
Authors: Chen Song , Wu Zhiqiang , Shi Feng , Mai Qicong , Wang Liguang , Wang Fan , Zhuang Wenquan , Chen Xiaoming , Chen Huanwei , Xu Bo , Lai Jiaming , Guo Wenbo
Published: August 2021

Purpose

The aim of this retrospective study was to compare the clinical outcomes of pembrolizumab-lenvatinib-transarterial chemoembolization (TACE) versus lenvatinib-TACE sequential therapy in selected populations of Chinese patients with initially unresectable hepatocellular carcinoma (uHCC) harbouring programmed cell death ligand-1 (PD-L1) expression.

Methods

Consecutive patients with initial PD-L1-positive uHCC who received pembrolizumab-lenvatinib-TACE or lenvatinib-TACE sequential therapy were retrospectively identified from three medical institutions during 2016–2020. The primary endpoints included the rate of conversion therapy, defined as converting initially uHCC to hepatectomy, overall survival (OS), and progression-free survival (PFS); secondary endpoint was the frequency of key adverse events (AEs).

Results

In total, 220 consecutively recruited patients were retrospectively reviewed, 78 of whom were ineligible according to the current criteria, leaving 142 patients [pembrolizumab-lenvatinib-TACE: n = 70, median age 58 years (range 36–69) and lenvatinib-TACE: n = 72, 57 years (35–68)] who were eligible for the study. The median duration of follow-up was 27 months [95% confidence interval (CI), 26.3–28.7 months]. At the last follow-up, the rate of conversion therapy was 25.7% in the pembrolizumab-lenvatinib-TACE group and 11.1% in the lenvatinib-TACE group (p = 0.025). The median OS was 18.1 months (95% CI 16.5–20.7) in the pembrolizumab-lenvatinib-TACE group versus 14.1 months (95% CI 12.2–16.9) in the lenvatinib-TACE group [hazard ratio (HR) 0.56, 95% CI 0.38–0.83; p = 0.004]. A distinct difference in the median PFS interval between the groups was detected [9.2 months (95% CI 7.1–10.4) in the pembrolizumab-lenvatinib-TACE group vs. 5.5 months (95% CI 3.9–6.6) in the lenvatinib-TACE group (HR 0.60; 95% CI 0.39–0.91; p = 0.006)]. The rates of the key AEs assessed, which were hypertension, nausea, and rash, were higher in the pembrolizumab-lenvatinib-TACE group than in the lenvatinib-TACE group (all p < 0.05).

Conclusion

Among the selected populations of patients with initial PD-L1-positive uHCC, pembrolizumab-lenvatinib-TACE sequential therapy may have promising antitumour activity, with an acceptable conversion rate and a well-characterized safety profile.
Parietal epithelial cell dysfunction in crescentic glomerulonephritis
Authors: Wong Milagros N. , Tharaux Pierre-Louis , Grahammer Florian , Puelles Victor G.
Published: August 2021

Crescentic glomerulonephritis represents a group of kidney diseases characterized by rapid loss of kidney function and the formation of glomerular crescents. While the role of the immune system has been extensively studied in relation to the development of crescents, recent findings show that parietal epithelial cells play a key role in the pathophysiology of crescent formation, even in the absence of immune modulation. This review highlights our current understanding of parietal epithelial cell biology and the reported physiological and pathological roles that these cells play in glomerular lesion formation, especially in the context of crescentic glomerulonephritis.
Low-congestion shortcut and graph parameters
Authors: Kitamura Naoki , Kitagawa Hirotaka , Otachi Yota , Izumi Taisuke
Published: August 2021

Distributed graph algorithms in the standard CONGEST model often exhibit the time-complexity lower bound of $${\tilde{\Omega }}(\sqrt{n} + D)$$

Ω
~

(

n

+
D
)

rounds for several global problems, where n denotes the number of nodes and D the diameter of the input graph. Because such a lower bound is derived from special “hard-core” instances, it does not necessarily apply to specific popular graph classes such as planar graphs. The concept of low-congestion shortcuts was initiated by Ghaffari and Haeupler [SODA2016] for addressing the design of CONGEST algorithms running fast in restricted network topologies. In particular, given a graph class $${\mathcal {C}}$$
C
, an f-round algorithm for constructing shortcuts of quality q for any instance in $${\mathcal {C}}$$
C
results in $${\tilde{O}}(q + f)$$

O
~

(
q
+
f
)

-round algorithms for solving several fundamental graph problems such as minimum spanning tree and minimum cut, for $${\mathcal {C}}$$
C
. The main interest on this line is to identify the graph classes allowing the shortcuts that are efficient in the sense of breaking $${\tilde{O}}(\sqrt{n}+D)$$

O
~

(

n

+
D
)

-round general lower bounds. In this study, we consider the relationship between the quality of low-congestion shortcuts and the following four major graph parameters: doubling dimension, chordality, diameter, and clique-width. The key ingredient of the upper-bound side is a novel shortcut construction technique known as short-hop extension, which might be of independent interest.
Runtime Analyses of the Population-Based Univariate Estimation of Distribution Algorithms on LeadingOnes
Authors: Lehre Per Kristian , Nguyen Phan Trung Hai
Published: August 2021

We perform rigorous runtime analyses for the univariate marginal distribution algorithm (UMDA) and the population-based incremental learning (PBIL) Algorithm on LeadingOnes. For the UMDA, the currently known expected runtime on the function is $${\mathcal {O}}\left( n\lambda \log \lambda +n^2\right)$$

O

n
λ
log
λ
+

n
2

under an offspring population size $$\lambda =\Omega (\log n)$$

λ
=
Ω
(
log
n
)

and a parent population size $$\mu \le \lambda /(e(1+\delta ))$$

μ
≤
λ
/
(
e
(
1
+
δ
)
)

for any constant $$\delta >0$$

δ
>
0

(Dang and Lehre, GECCO 2015). There is no lower bound on the expected runtime under the same parameter settings. It also remains unknown whether the algorithm can still optimise the LeadingOnes function within a polynomial runtime when $$\mu \ge \lambda /(e(1+\delta ))$$

μ
≥
λ
/
(
e
(
1
+
δ
)
)

. In case of the PBIL, an expected runtime of $${\mathcal {O}}(n^{2+c})$$

O
(

n

2
+
c

)

holds for some constant $$c \in (0,1)$$

c
∈
(
0
,
1
)

(Wu, Kolonko and Möhring, IEEE TEVC 2017). Despite being a generalisation of the UMDA, this upper bound is significantly asymptotically looser than the upper bound of $${\mathcal {O}}\left( n^2\right)$$

O

n
2

of the UMDA for $$\lambda =\Omega (\log n)\cap {\mathcal {O}}\left( n/\log n\right)$$

λ
=
Ω

(
log
n
)

∩
O

n
/
log
n

. Furthermore, the required population size is very large, i.e., $$\lambda =\Omega (n^{1+c})$$

λ
=
Ω
(

n

1
+
c

)

. Our contributions are then threefold: (1) we show that the UMDA with $$\mu =\Omega (\log n)$$

μ
=
Ω
(
log
n
)

and $$\lambda \le \mu e^{1-\varepsilon }/(1+\delta )$$

λ
≤
μ

e

1
-
ε

/

(
1
+
δ
)

for any constants $$\varepsilon \in (0,1)$$

ε
∈
(
0
,
1
)

and $$0<\delta \le e^{1-\varepsilon }-1$$

0
<
δ
≤

e

1
-
ε

-
1

requires an expected runtime of $$e^{\Omega (\mu )}$$

e

Ω
(
μ
)

on LeadingOnes, (2) an upper bound of $${\mathcal {O}}\left( n\lambda \log \lambda +n^2\right)$$

O

n
λ
log
λ
+

n
2

is shown for the PBIL, which improves the current bound $${\mathcal {O}}\left( n^{2+c}\right)$$

O

n

2
+
c

by a significant factor of $$\Theta (n^{c})$$

Θ
(

n
c

)

, and (3) we for the first time consider the two algorithms on the LeadingOnes function in a noisy environment and obtain an expected runtime of $${\mathcal {O}}\left( n^2\right)$$

O

n
2

for appropriate parameter settings. Our results emphasise that despite the independence assumption in the probabilistic models, the UMDA and the PBIL with fine-tuned parameter choices can still cope very well with variable interactions.