bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular mechanism of Fast Endophilin-Mediated Endocytosis
Authors: Casamento Alessandra , Boucrot Emmanuel
Published: June 2020

Endocytosis mediates the cellular uptake of micronutrients and cell surface proteins. Clathrin-mediated endocytosis (CME) is the housekeeping pathway in resting cells but additional Clathrin-independent endocytic (CIE) routes, including Fast Endophilin-Mediated Endocytosis (FEME), internalize specific cargoes and support diverse cellular functions. FEME is part of the Dynamin-dependent subgroup of CIE pathways. Here, we review our current understanding of the molecular mechanism of FEME. Key steps are: (i) priming, (ii) cargo selection, (iii) membrane curvature and carrier formation, (iv) membrane scission and (v) cytosolic transport. All steps are controlled by regulatory mechanisms mediated by phosphoinositides and by kinases such as Src, LRRK2, Cdk5 and GSK3β. A key feature of FEME is that it is not constitutively active but triggered upon the stimulation of selected cell surface receptors by their ligands. In resting cells, there is a priming cycle that concentrates Endophilin into clusters on discrete locations of the plasma membrane. In the absence of receptor activation, the patches quickly abort and new cycles are initiated nearby, constantly priming the plasma membrane for FEME. Upon activation, receptors are swiftly sorted into pre-existing Endophilin clusters, which then bud to form FEME carriers within 10 s. We summarize the hallmarks of FEME and the techniques and assays required to identify it. Next, we review similarities and differences with other CIE pathways and proposed cargoes that may use FEME to enter cells. Finally, we submit pending questions and future milestones and discuss the exciting perspectives that targeting FEME may boost treatments against cancer and neurodegenerative diseases.
Assessing Functional Language in School-Aged Children Using Language Sample Analysis
Authors: Heilmann John , Tucci Alexander , Plante Elena , Miller Jon F.
Published: June 2020

Purpose

The goal of this clinical focus article is to illustrate how speech-language pathologists can document the functional language of school-age children using language sample analysis (LSA). Advances in computer hardware and software are detailed making LSA more accessible for clinical use.

Method

This clinical focus article illustrates how documenting school-age student's communicative functioning is central to comprehensive assessment and how using LSA can meet multiple needs within this assessment. LSA can document students' meaningful participation in their daily life through assessment of their language used during everyday tasks. The many advances in computerized LSA are detailed with a primary focus on the Systematic Analysis of Language Transcripts (Miller & Iglesias, 2019). The LSA process is reviewed detailing the steps necessary for computers to calculate word, morpheme, utterance, and discourse features of functional language.

Conclusion

These advances in computer technology and software development have made LSA clinically feasible through standardized elicitation and transcription methods that improve accuracy and repeatability. In addition to improved accuracy, validity, and reliability of LSA, databases of typical speakers to document status and automated report writing more than justify the time required. Software now provides many innovations that make LSA simpler and more accessible for clinical use.

Supplemental Material

https://doi.org/10.23641/asha.12456719
Preflare very long-periodic pulsations observed in Hα emission before the onset of a solar flare
Authors: Li Dong , Feng Song , Su Wei , Huang Yu
Published: June 2020

Context. Very long-periodic pulsations during preflare phases (preflare-VLPs) have been detected in the full-disk solar soft X-ray (SXR) flux. They may be regarded as precursors to solar flares and may help us better understand the trigger mechanism of solar flares.

Aims. In this Letter, we report a preflare-VLP event prior to the onset of an M1.1 circular-ribbon flare on 2015 October 16. It was simultaneously observed in Hα, SXR, and extreme ultraviolet (EUV) wavelengths.

Methods. The SXR fluxes in 1−8 Å and 1−70 Å were recorded by the Geostationary Operational Environmental Satellite (GOES) and Extreme Ultraviolet Variability Experiment, respectively; the light curves in Hα and EUV 211 Å were integrated over a small local region, which were measured by the 1 m New Vacuum Solar Telescope and the Atmospheric Imaging Assembly (AIA), respectively. The preflare-VLP is identified as the repeat and quasi-periodic pulses in light curves during preflare phase. The quasi-periodicity can be determined from the Fourier power spectrum with Markov chain Monte Carlo-based Bayesian.

Results. Seven well-developed pulses are found before the onset of an M1.1 circular-ribbon flare. They are firstly seen in the local light curve in Hα emission and then discovered in full-disk SXR fluxes in GOES 1−8 Å and ESP 1−70 Å, as well as the local light curve in AIA 211 Å. These well-developed pulses can be regarded as the preflare-VLP, which might be modulated by LRC-circuit oscillation in the current-carrying plasma loop. The quasi-period is estimated to be ∼9.3 min.

Conclusions. We present the first report of a preflare-VLP event in the local Hα line and EUV wavelength, which could be considered a precursor of a solar flare. This finding should therefore prove useful for the prediction of solar flares, especially for powerful flares.
Plazentalokalisationen in aufeinanderfolgenden Schwangerschaften – eine retrospektive Kohortenstudie
Authors: Egli Corina , Kimmich Nina , Zimmermann Roland , Kreft Martina
Published: June 2020

Einführung Die Plazentalokalisation ist mit Risiken
während einer Schwangerschaft (SS) und Geburt assoziiert. Kenntnisse
über die Lage der Plazenta ermöglichen eine auf Risikofaktoren
angepasste weitere Betreuung der SS. Verschiedene Studien beschreiben ein
höheres Risiko für eine wiederholte Plazenta prävia,
gleichartige Daten zu anderen Plazentalokalisationen fehlen. Ziel dieser Studie
war es, die Häufigkeitsverteilung der verschiedenen
Plazentalokalisationen zu evaluieren und Korrelationen zwischen
Plazentalokalisationen in aufeinanderfolgenden SS zu analysieren.

Material und Methodik In einer retrospektiven Kohortenstudie wurden
Frauen mit Einlings-SS ≥ 24+0 Schwangerschaftswochen (SSW),
mindestens 1 Ultraschalluntersuchung zur Identifikation der Plazentalokalisation
sowie Geburt ihres Erstgeborenen und mindestens eines direkt
aufeinanderfolgenden Kindes in unserer Klinik zwischen 2007 und 2016 analysiert.
Ausschlusskriterien waren Mehrlingsschwangerschaften,
Aborte/intrauteriner Fruchttod/Frühgeburten
<24+0 SSW.

Resultate Unter 1657 Frauen befand sich die Plazenta am
häufigsten anterior gefolgt von posterior, fundal, lateral und dann als
prävia. Es zeigten sich keine statistisch signifikanten Korrelationen
bezüglich der Plazentalokalisationen in aufeinanderfolgenden SS und kein
signifikanter Einfluss einer vorangegangen Curettage oder Sectio.

Konklusion Die Plazentalokalisation scheint nicht durch den Plazentasitz
in der vorherigen Schwangerschaft beeinflusst zu werden. Daher kann keine
Prognose hinsichtlich der Plazentalokalisation in aufeinanderfolgenden
Schwangerschaften gestellt werden.
Mean Platelet Volume is Affected in Term Fetuses with Intrauterine
Growth Restriction
Authors: Buyuk Gul Nihal , Oskovi-Kaplan Z.Asli , Oksuzoglu Aysegul , Keskin H.Levent
Published: June 2020

Objectives The aim of our study was to analyze the mean platelet volume
levels as a potential marker of altered placentation in intrauterine growth
restriction (IUGR) cases.

Methods A total of 126 term singleton pregnant women with IUGR fetuses
and 345 healthy pregnant controls were recruited and compared.

Results The mean platelet volume was significantly higher in the IUGR
group (10.8±0.9 fl) than the control group (9.9±1.1 fl)
(p=0.03). The mean hemoglobin was lower in IUGR group (11.3
(8.3–14.5) g/dl) than the control group (11.9 (8.2–13.0)
g/dl) (p=0.04). The optimal cut-off MPV for prediction of IUGR
was ≥10.55 fl, with a sensitivity of 59% and a specificity of
75%.

Conclusion Increased MPV levels in term pregnant women may be
particularly helpful for discrimination and prediction of high-risk fetuses when
IUGR is suspected.
Gross Motor Skills in Children with Cerebral Palsy and Intellectual
Disability
Authors: Djuric-Zdravkovic Aleksandra , Perovic Dijana , Milanovic-Dobrota Biljana , Japundza-Milisavljevic Mirjana
Published: June 2020

Objectives The aim of this study is to determine the connection of gross
motor skills (locomotor skills and object control) and the degree of associated
intellectual disability (ID) in children with cerebral palsy (CP).

Participants and methods The study sample included 54 children with CP
and associated ID age 5 years to 6 years and 11 months. For the assessment of
tested skills, The Gross Motor Function Classification System-Expanded and
Revised (GMFCS-E&R), Wechsler Preschool and Primary Scale of
Intelligence-Fourth Edition (WPPSI-IV) and Test of Gross Motor Development
Second Edition (TGMD-2) were used.

Results The results of this study indicate better quality of locomotor
skills than object control skills in children with CP and associated ID.
Children with CP and mild ID have better quality of locomotor skills and object
control, than children with CP and moderate ID. Differences between these 2
groups of children are presented relative to GMFCS-E&R levels.

Conclusion This study has determined significant interconnection of the
quality of gross motor functions and intellectual capacity in preschool children
with CP. This should be considered when creating more detailed individual
developmental rehabilitation plan in children with CP and associated ID and
predict adequate measures of developmental stimulation.
DETERMINATION OF SALIVARY URIC ACID LEVELS IN PERIODONTITIS AND HEALTH: A CASE CONTROL STUDY
Authors: Shetty Mamatha , Talaviya Dipen
Published: June 2020

The aim of this case-control study was to determine whether periodontitis was associated with impaired salivary antioxidant uric acid level. Sixty patients attending a routine dental check-up at department of periodontics AB Shetty memorial institute of dental science were recruited for the study. Thirty patients with periodontitis (case) and 30 patients with healthy periodontium (control) were included in the study. Periodontitis was defined as clinical attachment loss (CAL) ≥ 3mm in 30% of total sites examined (AAP-1999). CAL was measured from cemento-enamel junction to the base of pocket depth in mm using William's graduated probe. The teeth that was examined are (Ramfjord index teeth) 16, 21, 24, 36, 41, 44. l-2ml saliva was collected from patient in sterile glass vial and send for estimation of uric acid immediately. The uric acid level was measured in spectrophotometer. The result was statistically analyzed by student's t test. The mean value of uric acid level in periodontitis was 4.449 mg/dl.The mean value of uric acid level in healthy patient was 4.878 mg/dl. The study concluded that the level of uric acid in periodontitis patients was comparatively less than the normal patients. However, this difference was not statistically significant (p > 0.05)
PATTERN OF MINI OUTBREAKS OF MUMPS AT SOUTH KASHMIR, PULWAMA, INDIA 2007-2011
Authors: H. Arshad Syed Andrabi , Shamila Hamid , Khan Imran , Hamdani Zahoor Ahamad
Published: June 2020

Background prior to design: Limited outbreaks of mumps do occur in schools and crèches and other public places throughout the globe especially in developing countries like India, despite the introduction of MMR vaccine in 1967-1968. Same is the case with South Kashmir where almost every year mini-epidemics of Mumps do occur which however remain unnoticed, unreported and unnotified.

Design: It was a Hospital based Observational study, carried out from the year 2007 to 2011.

Objective: To find the epidemiologic pattern and clinical presentation of mumps in patients attending a tropical medical unit of Multispecialty hospital(DHP) at South Kashmir, Pulwama, India.

Material & Methods: All Children fulfilling the criteria for diagnosis of Mumps were recruited in this study from 2007-2011.Their characteristics, the pattern of clinical features were noted besides information regarding history, place, season, month and year of occurrence of disease was collected from the parents of affected children. All these parameters were noted down by a senior internist and infectionlogist of the department,using well-structured proforma. The data so collected was subjected to biostatistical analysis using Fisher exact test and SPSS version 12.

Results: A total of 55 patients were included in the study. All the children had h/o contact with, raw/ semiripened walnuts. Males were 36 and female were 19 in number. None had received any form of mumps/MMR vaccination. All the patients presented in hot summer and in the month of august showing a seasonal trend annually. Bilateral parotitis, a hallmark of mumps was present in all patients. Rural patients usually presented with mild fever.Earache was mainly present in younger age - groups These findings were statistically significant (P< 0.05). Out of 55 children, orchitis was seen only in one child. CONCLUSION: Mini-epidemics of mumps occur more frequently in south Kashmir and effect our school children and hamper work output.It can be best prevented by inclusion of mumps/MMR vaccine in national immunization schedule.
AN UNUSUAL CYTOLOGICAL EXPERIENCE OF VIRILISING OVARIAN SERTOU-LEYDIG CELL TUMOR - A RARE CASE REPORT
Authors: Permi Harish S. , Padma Shetty K. , Rai Supriya , Manjeera Lakshmi , Poojary Neetha , S. Teerthanath
Published: June 2020

Sertoli-Leydig cell tumor of ovary is a gonadal tumour of the sex cord-stromal type. It is a rare tumor comprising 0.1 to 0.5% of all ovarian tumours. Peritoneal cytology has been well established as a diagnostic and staging tool in the management of the common epithelial tumours of ovary. Germ cell, mesenchymal, and sex-cord stromal tumours are much less frequently encountered in peritoneal specimens, often with cytologic features that may pose diagnostic difficulty and dilemma. We report a case of peritoneal fluid cytology of sertoli leydig cell tumor of ovary in a 20 year old female who presented with virilising symptoms. On removal of ovarian tumor, her virilising symptoms regressed, with regaining of menstruation.
XERODERMA PIGMENTOSA WITH MULTIPLE CUTANEOUS MALIGNANCIES– A RARE CASE REPORT AND REVIEW OF LITERATURE
Authors: Shetty Rohan , S. Girish B. , Ballal Rajesh , Permi Harish S. , Makannavar Pramodh , Alva Vinay
Published: June 2020

Xeroderma pigmentosa is a rare autosomal recessive disorder, characterized by photosensitivity, pigmentary changes, premature skin aging, and marked increase in risk of developing malignant neoplasms of the skin and eyes. Here we present a 13 year old girl with xeroderma pigmentosa who developed multiple cutaneous malignancies in the face and upper limb.
LASER - A RAY OF HOPE IN PERIODONTICS - A REVIEW ARTICLE
Authors: Ramesh Amitha , Bhandary Rahul , Thomas Biju , Dsouza Sheehan R.
Published: June 2020

Lasers have revolutionised dental treatment since three and a half decades of the twentieth century. Theodore maiman in 1960 invented the ruby laser, since then laser is one of the most captivating technologies in dental practice. Lasers have been used in initial periodontal therapy, surgery, and also in implant treatment. Further research is necessary so that laser can become a part of the dental armamentarium. This paper gives an insight to laser in Periodontics
COMPARATIVE EVALUATION OF ANTIMICROBIAL SUSCEPTIBILITY PATTERN AND VIRULENCE FACTORS AMONG ESBL AND NONESBL PRODUCING ESCHERICHIA COLI
Authors: Shenoy Shilpa , K. Sumathi , Shetty A. Veena
Published: June 2020

Objectives: The present study was carried out to compare the antimicrobial susceptibility pattern and phenotypic characteristics in ESBL and non-ESBL producing clinically isolated E.coli.

Material and Methods: A total of 100 non-duplicate consecutive isolates of E.coli were collected from various clinical specimens obtained from K.S. Hegde Charitable Hospital, Mangalore. All the isolates were studied for antimicrobial susceptibility pattern using modified Kirby-Bauer method. ESBL production was screened phenotypically by an initial screening test, which was followed by confirmatory Double disk synergy test. These isolates were screened for virulence factors such as Biofilm assay, hemolysin production and Congo red agar to detect the invasiveness of the isolates.

Results: Out of the 100 E.coli isolates, 45(45%) isolates exhibited ESBL production. Among the ESBL producing isolates 62% were haemolytic, 77% exhibited Congo red uptake, and these two factors were statistically significant as compare non ESBL producing isolates, while 47%, 35% and 18% of the isolates exhibited high, moderate and low biofilm forming ability, respectively. The ESBL producing isolates were multi-drug resistant. There was statistical significance among the ESBL production and expression of virulence factors

Conclusion: The present investigation revealed, a high prevalence of multiple virulence factors among the ESBL in addition to multidrug resistance when compared with non - ESBL isolates. This indicates a dire need for effective ESBL surveillance and control in the hospitals and judicious use of antibiotics among the general public.
A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE ON BREAST CANCER AND UTILIZATION OF MAMMOGRAM AMONG WOMEN IN SELECTED VILLAGES OF UDUPI DISTRICT, KARNATAKA
Authors: Shadap Arkierupaia , Pais Maria , Prabhu Anusuya
Published: June 2020

Breast cancer was considered to be one amongst the most commonly cancer disease in the world. Now it is considered to be the second cancer disease among women in India, with most of the affected population is in the urban areas. Breast cancer is seen mostly after the age of 40 years. According to the Cancer fact 2012, breast cancer is now seen to be among women aged from 35 years above.

Materials and methods: The study was a descriptive survey study to assess the knowledge on breast cancer, awareness and utilization of mammogram among 320 married and unmarried women who were willing to participate in the study. After the consent, a questionnaire prepared by the investigator was given to them.

Results: Majority 46.6% had low knowledge for breast cancer. There was an association between knowledge and age, marital status, education and source of information about breast cancer and it was found to be significant (p< Mammogram is underutilized among participants, from the total number of population i.e; n = 320, only 19.1% (61) were aware of mammogram. Out of 19.1% (61) who were aware of mammogram, did not utilise it.

Conclusion: The study concluded that women have low knowledge on breast cancer and very less population was aware of mammogram which is one of the screening tests for breast cancer. Their low knowledge on breast cancer and unaware of the screening test is the main reason for not utilising mammogram even those who are aware of it. So, nurses as health care members play an important role in providing information and educating the community people.
A STUDY ON KNOWLEDGE OF PRIMI MOTHERS ON SELF MANAGEMENT OF MINOR DISCOMFORTS OF PREGNANCY
Authors: Vincent Sharon , Nayak Sabitha , Paul Shiney
Published: June 2020

'A study on knowledge of primi mothers on self-management of minor discomfort of pregnancy with a view to develop information' was carried out in Justice K.S Hegde Charitable hospital on 100 primi-gravida mothers by using purposive sampling technique. The findings of the study showed that 87% of the primi mothers were in the age group of 21-30 years, 37% of the women had high school education, 70% of the subjects were Hindus, 77% belonged to joint families and 53% were in the gestational age group of 29-40 weeks.

Most 59% of the Primigravida mothers had poor knowledge, 29% had average knowledge, and 12% had good knowledge regarding minor discomforts of pregnancy and its self-management.

Area wise knowledge of Primigravida mothers reveals deficiency in most of the areas, but the lowest mean percentage of score is 28.25% with a standard deviation of 1.74 in the area of knowledge related to Circulatory and Nervous system, which indicated that the maximum knowledge deficit is in this area.

There was significant association between knowledge of Primigravida mothers and age, educational qualification. The calculated ?2 values were 3.953 and 12.603 respectively which are more than the table value 3.84 and 7.82 at 0.05% level of significance. Hence, the research hypothesis was accepted.

The result of the study proved that Primigravida mothers had poor knowledge regarding minor discomforts of pregnancy and its selfmanagement. The findings of the study showed that there was a need to educate all women on preparation towards motherhood. Providing an information booklet on minor discomforts of pregnancy and its management, an uneventful antenatal period can be expected from the mother.
How Do the Locking Screws Lock? A Micro-CT Study of 3.5-mm Locking Screw Mechanism
Authors: Kaczmarek Jakub , Bartkowiak Tomasz , Paczos Piotr , Gapinski Bartosz , Jader Hanna , Unger Martin
Published: June 2020

Objective To quantify the amount of the screw head thread and the plate hole thread connection in two 3.5 mm locking plates: Locking Compression Plate (LCP) and Polyaxial Locking System (PLS).

Materials and Methods A micro - CT scan of a screw head - plate hole connection was performed pre- and post destructive tests. Tests were performed on bone surrogates in a fracture gap model. The 3.5 LCP and 3.5 PLS plates, with 3 perpendicular screws per segment were used in a destructive static test. The 3.5 PLS plates with mono- and polyaxial screws were compared in a cyclic fatigue tests in two orthogonal directions. Pre - and post - test scan datasets were compared. Each dataset was converted into serial images depicting sections cut orthogonally to locking screw axis. The amount of engagement was detected through automated image postprocessing.

Results The mean amount of the thread connection for the LCP was 28.85% before and 18.55% after destructive static test. The mean amount of the connection for the PLS was 16.20% before and 14.55% after destructive static test. When inserted monoaxially, the mean amount of the connection for the PLS screws was 14.4% before and 19.24% after destructive cyclic test. The mean amount of the connection for the polyaxial inserted PLS screws when loaded against plate thickness was 2.99% before and 2.08% after destructive cyclic test. The mean amount of the connection for the polyaxial inserted PLS screws when loaded against plate width was 3.36% before and 3.93% after destructive cyclic test. The 3D visualization of the thread connection showed that the initial interface points between screw head and plate hole are different for both LCP and PLS after the destructive testing. Depending on the type of applied force, there was either loss or increase of the contact.

Clinical Relevance Micro-CT offers news possibilities in locking implant investigation. It might be helpful in better understanding the nature of locking mechanism and prediction of possible mode of failure in different systems.
Long-Term Radiologic Evaluation of Microaspirations among Patients after Esophagectomy
Authors: Pines Guy , Jacobson Francine , Zheng Yifan , Magali Pham , Lerut Toni , Bueno Raphael
Published: June 2020

Objectives Aspirations are common after esophagectomy. Data are lacking regarding its long-term radiological manifestations. The purpose of this study is to determine the incidence and radiological patterns of aspirations among long-term survivors and evaluate their clinical significance.

Methods The records of all patients who underwent esophagectomy between October 2003 and December 2011 and survived more than 3 years were reviewed. Preoperative, first routine postoperative, and latest chest computed tomography (CT)scans were reviewed. Imaging studies were reviewed for radiological signs suspicious of aspirations, conduit location, anastomotic site, and maximal intrathoracic diameter. Data regarding patients' complaints during clinic visits were also collected.

Results A total of 578 patients underwent esophagectomy during the study period. One-hundred twenty patients met the inclusion criteria. Median follow-up was 83.5 months. Cervical and intrathoracic anastomoses were performed in 103 and 17 patients, respectively. A higher rate of CT findings was found in postoperative imaging (n = 51 [42.5%] vs. n = 13 [10.8%] respectively, p < 0.05). Most of these were found in the lower lobes (61%). A higher rate of lesions was found among patients in whom the conduit was bulging to the right hemithorax compared with totally mediastinal or completely in the right hemithorax (54.5 vs. 35.2% and 34.6%, respectively, p < 0.05). No correlation was found with conduit diameter or anastomotic site. These lesions were more prevalent among patients who complained of reflux or cough during meals (NS).

Conclusions A significantly higher rate of new CT findings was found in postoperative imaging of this post-esophagectomy cohort, suggesting a high incidence of aspirations. The locations of the conduit, rather than anastomosis site, seem to play a role in the development of these findings. Further research is needed to evaluate the clinical significance of these findings.
Periprocedural Direct Oral Anticoagulant Management: The RA-ACOD Prospective, Multicenter Real-World Registry
Authors: Ferrandis Raquel , Llau Juan V. , Sanz Javier F. , Cassinello Concepción M. , González-Larrocha Óscar , Matoses Salomé M. , Suárez Vanessa , Guilabert Patricia , Torres Luís-Miguel , Fernández-Bañuls Esperanza , García-Cebrián Consuelo , Sierra Pilar , Barquero Marta , Montón Nuria , Martínez-Escribano Cristina , Llácer Manuel , Gómez-Luque Aurelio , Martín Julia , Hidalgo Francisco , Yanes Gabriel , Rodríguez Rubén , Castaño Beatriz , Duro Elena , Tapia Blanca , Pérez Antoni , Villanueva Ángeles M. , Álvarez Juan-Carlos , Sabaté Sergi ,   for the RA-ACOD investigators
Published: June 2020

Introduction There is scarce real-world experience regarding direct oral anticoagulants (DOACs) perioperative management. No study before has linked bridging therapy or DOAC-free time (pre-plus postoperative time without DOAC) with outcome. The aim of this study was to investigate real-world management and outcomes.

Methods RA-ACOD is a prospective, observational, multicenter registry of adult patients on DOAC treatment requiring surgery. Primary outcomes were thrombotic and hemorrhagic complications. Follow-up was immediate postoperative (24–48 hours) and 30 days. Statistics were performed using a univariate and multivariate analysis. Data are presented as odds ratios (ORs [95% confidence interval]).

Results From 26 Spanish hospitals, 901 patients were analyzed (53.5% major surgeries): 322 on apixaban, 304 on rivaroxaban, 267 on dabigatran, 8 on edoxaban. Fourteen (1.6%) patients suffered a thrombotic event, related to preoperative DOAC withdrawal (OR: 1.57 [1.03–2.4]) and DOAC-free time longer than 6 days (OR: 5.42 [1.18–26]). Minor bleeding events were described in 76 (8.4%) patients, with higher incidence for dabigatran (12.7%) versus other DOACs (6.6%). Major bleeding events occurred in 17 (1.9%) patients. Bridging therapy was used in 315 (35%) patients. It was associated with minor (OR: 2.57 [1.3–5.07]) and major (OR: 4.2 [1.4–12.3]) bleeding events, without decreasing thrombotic events.

Conclusion This study offers real-world data on perioperative DOAC management and outcomes in a large prospective sample size to date with a high percentage of major surgery. Short-term preprocedural DOAC interruption depending on the drug, hemorrhagic risk, and renal function, without bridging therapy and a reduced DOAC-free time, seems the safest practice.
Cardiac Sarcoidosis
Authors: Birnie David H.
Published: June 2020

Approximately 5% of patients with sarcoidosis will have clinically manifest cardiac involvement presenting with one or more of ventricular arrhythmias, conduction abnormalities, and heart failure. It is estimated that another 20 to 25% of pulmonary/systemic sarcoidosis patients have asymptomatic cardiac involvement (clinically silent disease). Cardiac presentations can be the first (and/or an unrecognized) manifestation of sarcoidosis in a variety of circumstances. Immunosuppression therapy (usually with corticosteroids) has been suggested for the treatment of clinically manifest cardiac sarcoidosis (CS) despite minimal data supporting it. Positron emission tomography imaging is often used to detect active disease and guide immunosuppression. Patients with clinically manifest disease often need device therapy, typically with implantable cardioverter defibrillators (ICDs). The extent of left ventricular dysfunction seems to be the most important predictor of prognosis among patients with clinically manifest CS. In the current era of earlier diagnosis, modern heart failure treatment, and use of ICD therapy, the prognosis from CS is much improved. In a recent Finnish nationwide study, 10-year cardiac survival was 92.5% in 102 patients.
Cutaneous Sarcoidosis
Authors: Caplan Avrom , Rosenbach Misha , Imadojemu Sotonye
Published: June 2020

Sarcoidosis is a chronic, multisystem, inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas that impair normal organ functioning. Sarcoidosis predominantly affects the lungs, but the skin is often cited as the second most frequently involved organ. Cutaneous manifestations of sarcoidosis are highly variable and ongoing research seeks to better understand the relationship between clinical morphology and disease prognosis. Skin findings in patients with sarcoidosis can be “specific,” in which sarcoidal granulomas infiltrate the skin, or they can represent a “nonspecific” reactive inflammatory process, as is seen in calcinosis cutis and erythema nodosum. Cutaneous sarcoidosis can be the initial presenting sign or develop later in the course of the disease. In some patients, the skin will be the most involved and impactful organ system and will drive therapy. In other cases, the skin will be an incidental or minor finding, but may be easily accessible for biopsy to confirm the diagnosis. There are many potential therapies for sarcoidosis, though no one therapy is universally effective.
The Importance of the Occlusal Plane in Predicting Better Facial Soft Tissue in Class II Malocclusion in Ethnic Javanese
Authors: Ardani I. Gusti Aju Wahju , Dinata Floretta Charlene , Triwardhani Ari
Published: June 2020

Objectives Class II malocclusion is largely due to a retrognathic mandible. Mandibular rotation is closely related to changes in the occlusal plane during growth. The problems in the occlusal plane could cause disadvantages in the soft tissue profile in Class II malocclusion, presenting treatment challenges for an orthodontist. This study aimed to investigate the importance of the occlusal plane for a better soft tissue profile in Class II malocclusion for Javanese patients.

Materials and Methods The total number of cephalogram softcopies of patients with skeletal Class II malocclusion were selected based on ANB values (> 4 degrees), no agenesis teeth except the third molar, and all permanent teeth. The cephalograms were calculated using digital tracing by Morpheus 3D imaging. The points and areas to be analyzed on the cephalogram were predetermined. The examination was performed in a span of 1 month and performed via a statistical test using Pearson’s test and multiple regression analysis (p < 0.05).

Results There were significant correlation values between the angles produced by the occlusal plane to sella national, Frankfurt horizontal, mandibular plane, and Z-angle (p < 0.05).

Conclusion Patients with skeletal Class II malocclusion have a significant correlation between the occlusal plane and the vertical plane, thereby affecting the shape of the soft tissue profile, which causes a facial imbalance. By improving mandibular movement, the soft tissue profile can also be corrected.
Health-Related Quality of Life and Psychosocial Morbidity in Anorectal Malformation and Hirschsprung's Disease
Authors: Feng Xiaoyan , Lacher Martin , Quitmann Julia , Witt Stefanie , Witvliet Marieke J. , Mayer Steffi
Published: June 2020

Anorectal malformation (ARM) and Hirschsprung's disease (HD) are the most common congenital colorectal anomalies. Despite advances in surgical techniques and improvements in postoperative clinical care, short- and long-term physical and psychosocial morbidity of these patients remains high. This review outlines the current literature on the physical and psychosocial aspects of health-related quality of life (HrQoL) and its confounders in patients with ARM/HD. Moreover, important coping strategies are summarized to further improve HrQoL of ARM/HD patients and their families.
Cardiac Surgery 2019 Reviewed
Authors: Doenst Torsten , Bargenda Steffen , Kirov Hristo , Moschovas Alexandros , Tkebuchava Sophie , Safarov Rauf , Velichkov Ilia , Diab Mahmoud
Published: June 2020

For the year 2019, almost 25,000 published references can be found in PubMed when entering the search term “cardiac surgery.” We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach for article selection and reviewed the main fields of adult cardiac surgery (i.e., coronary, valve, aortic, and heart failure surgery). The past decade has experienced an enormous development of interventional techniques that compete more and more with classic surgery. This contest was broadly visible in 2019. It peaked over the interpretation of the EXCEL trial data, where percutaneous coronary intervention and coronary artery bypass grafting (CABG) for left main disease were compared. A novel pathomechanism for CABG was proposed, potentially answering open questions in the field. In aortic valve surgery, two low-risk trials comparing transcatheter aortic valve implantation (TAVI) to classic aortic valve replacement (surgical aortic valve replacement) received attention for showing equal or superior short-term outcomes for TAVI. Longer follow-up information from recent trials became available presenting results emphasizing the need for joint decision making. While publications addressing surgery on the aorta and the mitral and tricuspid valves were less abundant, there was substantial activity regarding left ventricular assist device support and heart transplantation. This article attempts to summarize the most pertinent publications. It does not expect to be complete and cannot be free of individual interpretation. We aimed to provide a condensed summary of 2019s publications with a stimulus for in-depth reading and a basis supporting patient information.
Distribution of Cytokeratin 17 in the Parenchymal Elements of Rat’s Submandibular Glands Subjected to Fractionated Radiotherapy
Authors: Hassan Sherif S. , Attia Mahmoud A. , Attia Alaa M. , Nofal Reda A. , Fathi Adel
Published: June 2020

Objectives The aim of this research was to study the intensity of cytokeratin 17 (CK17) in the parenchymal elements of rat’s submandibular salivary glands subjected to fractionated radiotherapy regimen that used for treatment of head and neck malignancy.

Materials and Methods Twenty male albino rats were divided into two equal groups (normal and irradiated). The irradiated group received a radiation dose of 5 Grays daily for 5 days using therapeutic X-ray beam. Six months later, submandibular gland was dissected out and prepared for both histological and immunohistochemical studies.

Results Submandibular gland of irradiated group showed two different types of histological alterations. The first alteration showed severe gland atrophy replaced by either fibrous or fatty tissues. In some sections, the gland exhibited proliferating activity in the form of profuse amounts of mitotic figures. Immunohistochemical examination of control glands displayed a mild cytoplasmic expression of CK17 of duct cells as well as serous acini. The staining pattern was either diffused or concentrated at the basal part of the cell with negative expression at its apical part.

Statistical Analysis Expression of CK17 in submandibular gland of irradiated group displayed a highly significant differences (P < 0.001) in both intercalated and striated ducts. Many serous acini displayed a highly significant differences (P < 0.001) whereas, mucous acini were negatively stained.

Conclusions The intensity and diffusion of CK17 expression in our results foretell the pathological effect of radiotherapy on the intermediate filaments of salivary gland parenchyma that interfered with production and/or secretion of saliva leading to xerostomia.
Krylov–Bogolyubov averaging
Authors: Jian W. , Kuksin S. B. , Wu Y.
Published: June 2020

A modified approach to the classical Krylov– Bogolyubov averaging method is presented. It was developed recently for studying partial differential equations, enables one to treat Lipschitz perturbations of linear systems with purely imaginary spectrum, and may be generalized to the case of systems of PDEs with small non-linearities.

Bibliography: 10 titles.
On inversion of the Lagrange–Dirichlet theorem and instability of conservative systems
Authors: Palamodov V. P.
Published: June 2020

Problems related to instability of equilibria of natural systems in mechanics and inversions of the Lagrange–Dirichlet theorem are discussed.

Bibliography: 42 titles.
Motion-flow-guided recurrent network for respiratory signal estimation of x-ray angiographic image sequences
Authors: Fang Huihui , Li Heng , Song Shuang , Pang Kun , Ai Danni , Fan Jingfan , Song Hong , Yu Yang , Yang Jian
Published: June 2020

Motion compensation can eliminate inconsistencies of respiratory movement during image acquisitions for precise vascular reconstruction in the clinical diagnosis of vascular disease from x-ray angiographic image sequences. In x-ray-based vascular interventional therapy, motion modeling can simulate the process of organ deformation driven by motion signals to display a dynamic organ on angiograms without contrast agent injection. Automatic respiratory signal estimation from x-ray angiographic image sequences is essential for motion compensation and modeling. The effects of respiratory motion, cardiac impulses, and tremors on structures in the chest and abdomen bring difficulty in extracting accurate respiratory signals individually. In this study, an end-to-end deep learning framework based on a motion-flow-guided recurrent network is proposed to address the aforementioned problem. The proposed method utilizes a convolutional neural network to learn the spatial features of every single frame, and a recurrent neural network to learn the temporal features of the entire sequence. The combination of the two networks can effectively analyze the image sequence to realize respiratory signal estimation. In addition, the motion-flow between consecutive frames is introduced to provide a dynamic constraint of spatial features, which enables the recurrent network to learn better temporal features from dynamic spatial features than from static spatial features. We demonstrate the advantages of our approach on designed datasets which contain coronary and hepatic angiographic sequences with diaphragm structures, and coronary angiographic sequences without diaphragm structures. Our method improves over state-of-the-art manifold-learning-based methods by 85.7%, 81.5% and 75.3% in respiratory signal accuracy metric on these datasets. The results demonstrate that the proposed method can effectively estimate respiratory signals from multiple motion patterns.
Characterization of a preclinical PET insert in a 7 tesla MRI scanner: beyond NEMA testing
Authors: Gsell Willy , Molinos Cesar , Correcher Carlos , Belderbos Sarah , Wouters Jens , Junge Sven , Heidenreich Michael , Velde Greetje Vande , Rezaei Ahmadreza , Nuyts Johan , Cawthorne Christopher , Cleeren Frederik , Nannan Lise , Deroose Christophe M , Himmelreich Uwe , Gonzalez Antonio J
Published: June 2020

This study evaluates the performance of the Bruker positron emission tomograph (PET) insert combined with a BioSpec 70/30 USR magnetic resonance imaging (MRI) scanner using the manufacturer acceptance protocol and the NEMA NU 4–2008 for small animal PET. The PET insert is made of 3 rings of 8 monolithic LYSO crystals (50 × 50 × 10 mm3) coupled to silicon photomultipliers (SiPM) arrays, conferring an axial and transaxial FOV of 15 cm and 8 cm. The MRI performance was evaluated with and without the insert for the following radiofrequency noise, magnetic field homogeneity and image quality. For the PET performance, we extended the NEMA protocol featuring system sensitivity, count rates, spatial resolution and image quality to homogeneity and accuracy for quantification using several MRI sequences (RARE, FLASH, EPI and UTE). The PET insert does not show any adverse effect on the MRI performances. The MR field homogeneity is well preserved (Diameter Spherical Volume, for 20 mm of 1.98 ± 4.78 without and −0.96 ± 5.16 Hz with the PET insert). The PET insert has no major effect on the radiofrequency field. The signal-to-noise ratio measurements also do not show major differences. Image ghosting is well within the manufacturer specifications (<2.5%) and no RF noise is visible. Maximum sensitivity of the PET insert is 11.0% at the center of the FOV even with simultaneous acquisition of EPI and RARE. PET MLEM resolution is 0.87 mm (FWHM) at 5 mm off-center of the FOV and 0.97 mm at 25 mm radial offset. The peaks for true/noise equivalent count rates are 410/240 and 628/486 kcps for the rat and mouse phantoms, and are reached at 30.34/22.85 and 27.94/22.58 MBq. PET image quality is minimally altered by the different MRI sequences. The Bruker PET insert shows no adverse effect on the MRI performance and demonstrated a high sensitivity, sub-millimeter resolution and good image quality even during simultaneous MRI acquisition.
Lightning network: a second path towards centralisation of the Bitcoin economy*
Authors: Lin Jian-Hong , Primicerio Kevin , Squartini Tiziano , Decker Christian , Tessone Claudio J
Published: June 2020

The Bitcoin lightning network (BLN), a so-called ‘second layer’ payment protocol, was launched in 2018 to scale up the number of transactions between Bitcoin owners. In this paper, we analyse the structure of the BLN over a period of 18 months, ranging from 12th January 2018 to 17th July 2019, at the end of which the network has reached 8.216 users, 122.517 active channels and 2.732,5 transacted Bitcoins. Here, we consider three representations of the BLN: the daily snapshot one, the weekly snapshot one and the daily-block snapshot one. By studying the topological properties of the binary and weighted versions of the three representations above, we find that the total volume of transacted Bitcoins approximately grows as the square of the network size; however, despite the huge activity characterising the BLN, the Bitcoins distribution is very unequal: the average Gini coefficient of the node strengths (computed across the entire history of the Bitcoin lightning network) is, in fact, ≃0.88 causing the 10% (50%) of the nodes to hold the 80% (99%) of the Bitcoins at stake in the BLN (on average, across the entire period). This concentration brings up the question of which minimalist network model allows us to explain the network topological structure. Like for other economic systems, we hypothesise that local properties of nodes, like the degree, ultimately determine part of its characteristics. Therefore, we have tested the goodness of the undirected binary configuration model (UBCM) in reproducing the structural features of the BLN: the UBCM recovers the disassortative and the hierarchical character of the BLN but underestimates the centrality of nodes; this suggests that the BLN is becoming an increasingly centralised network, more and more compatible with a core-periphery structure. Further inspection of the resilience of the BLN shows that removing hubs leads to the collapse of the network into many components, an evidence suggesting that this network may be a target for the so-called split attacks.
Discovery of an unconventional charge modulation on the surface of charge-density-wave material TaTe4
Authors: Sun Haigen , Shao Zhibin , Luo Tianchuang , Gu Qiangqiang , Zhang Zongyuan , Li Shaojian , Liu Lijun , Gedeon Habakubaho , Zhang Xin , Bian Qi , Feng Ji , Wang Jian , Pan Minghu
Published: June 2020

Electronic systems with quasi-one-dimensional (Q1D) Fermi surface tend to form either a charge-density-wave (CDW) or a spin-density-wave ground state at low temperatures due to one-dimensional instabilities. Among various CDW states, surface CDWs are different from that within the bulk due to the reduced dimensionality. Here we report the systematic investigation of charge density modulation on the surface of in situ cleaved TaTe4 crystal by means of low temperature scanning tunneling microscopy/spectroscopy, corroborated with density functional theory calculation. Well-defined Q1D modulation (4a, 6c) accompanied with a periodic lattice distortion is clearly observed on the (010) cleaved surface, distinct from that of its bulk CDW (2a × 2a × 3c). Tunneling spectroscopic measurements reveal a partially-opened energy gap about 23 meV around Fermi level. Such gap shows similar spatial variation with the periodicity of surface modulation and diminishes subsequently as temperature rises, which indicates a novel surface-related CDW gap states. The surface modulation vectors fit well with the Fermi surface nesting vectors, derived from the calculated Fermi surfaces. Surprisingly, such surface modulation can be suppressed greatly by applying vertical magnetic field and a critical field about 9.05 T can be estimated from field-dependent data. Our results demonstrate that this unique CDW modulation is strongly related to Fermi surface nesting mediated electron–electron coupling due to the reduced dimensionality of the surface, and can be readily tuned by relatively small magnetic field.
Assessment of Malaysian E-Passport PKI based on ISO 27000 Series International Standards
Authors: Suhaimi Ahmad Iqbal Hakim bin , Noordin Nurulhuda , Ya’kub Mohd Faizul bin
Published: June 2020

Malaysia was the 1st country in the world to issue biometric passports (e-Passport) in 1998. Recent years, a number of vulnerabilities in e-Passport have been identified in the first and second generation of e-Passports. These vulnerabilities can lead to crucial security issues. Due to lack of case studies conducted to review the Malaysian e-Passport, the objectives of this study are to identify the security risk in Malaysian e-Passport PKI and to recommend the feasible solution for future enhancement. A qualitative method was used in this study where a set of interview questions prepared and interviews been conducted to four participants. The data been analyzed using Thematic Analysis and presented based on risk assessment methodology in ISO 27000 series International Standards. The risk assessment consists of two approaches; risk analysis and risk evaluation. The risk analysis identified resource identification and valuation, risk identification and risk measurement of Malaysian e-Passport PKI. While in risk evaluation, it focuses on risk mitigation and prioritizing protection activities for future enhancement. The results reveal that the Cloning, Man in the Middle, Spoofing and server related issues are the risk of Malaysian e-Passport. For recommendation, the result is to implement Password Authenticated Connection Establishment (PACE) and follow ICAO standards. The significance of this research will help policy-makers to make better decision on the future direction of Malaysian e-Passport in order to ensure Malaysian citizens having secured e-Passport.