bluuebunny/crossref_metadata_2025 huggingface dataset:
Pr-AKI: Acute Kidney Injury in Pregnancy – Etiology, Diagnostic Workup, Management
Authors: Scurt Florian G. , Morgenroth Ronnie , Bose Katrin , Mertens Peter R. , Chatzikyrkou Christos
Published: March 2022

Despite significant improvements in inpatient and outpatient management, pregnancy-related acute kidney injury (Pr-AKI) remains an important risk factor for early and late maternal and
fetal morbidity and mortality. There is a discrepancy between the incidence of Pr-AKI in developing and in developed countries, with the former experiencing a decrease and the latter an
increase in Pr-AKI in recent decades. Whereas septic and hemorrhagic complications predominated in the past, nowadays hypertensive disorders and thrombotic microangiopathy are the leading
causes of Pr-AKI. Modern lifestyles and the availability and widespread use of in-vitro fertilization techniques in industrialized countries have allowed more women of advanced age to become
pregnant. This has led to a rise in the percentage of high-risk pregnancies due to the disorders and comorbidities inherent to or accompanying aging, such as diabetes, arterial hypertension
and preexisting chronic kidney disease. Last but not least, the heterogeneity of symptoms, the often overlapping clinical and laboratory characteristics and the pathophysiological changes
related to pregnancy make the diagnosis and management of Pr-AKI a difficult and challenging task for the treating physician. In addition to general supportive management strategies such as
volume substitution, blood pressure control, prevention of seizures or immediate delivery, each disease entity requires a specific therapy to reduce maternal and fetal complications. In this
review, we used the current literature to provide a summary of the physiologic and pathophysiologic changes in renal physiology which occur during pregnancy. In the second part, we present
common and rare disorders which lead to Pr-AKI and provide an overview of the available treatment options.
Hypercapnia: An Added Culprit in Gray Matter Injury in Preterm Neonates
Authors: Kasirer Yair , David Eliel Ben , Hammerman Cathy , Shchors Irina , Nun Alona Bin
Published: March 2022

Over the last decade, there has been increased recognition of diverse forms of primary gray matter injury (GMI) in postpreterm neonates. In this study, we aimed to assess whether early neonatal hypercapnia in the preterm infant was associated with GMI on magnetic resonance imaging (MRI) at term equivalent age (TEA). All blood gases taken during the first 2 weeks of life were analyzed for hypercapnia. MRI was performed at TEA postpreterm infants using a unique neonatal MRI 1T scanner. The neonatal MRI scans were assessed using a standardized scoring system, the Kidokoro scoring system, a method used to assess abnormal brain metrics and the presence and severity of brain abnormalities. Subscores are assigned for different regions of the brain. Twenty-nine infants were studied, about half of whom had evidence of some gray matter abnormality. Fifteen of the infants were hypercapnic. The hypercapnic infants had significantly higher deep gray matter abnormality readings as compared with the nonhypercapnic infants (12 [11; 12] vs. 10 [8; 11], respectively; p = 0.0106). Correlations were observed between peak pCO2 over the first 2 weeks of life and the overall gray matter abnormality score (GMAS) at TEA, and between the percentage of hypercapnic blood gases during the first 2 weeks of life and the GMAS. All of the infants in our population who had severe GMI at TEA were hypercapnic in the first 2 weeks of life. In conclusion, our data show a correlation between early hypercapnia in preterm neonates and GMI at TEA.
Das Segelboot kreuzt weiter
Authors: Münst Richard
Published: March 2022

Der Autor Richard Münst arbeitet als katholischer Seelsorger u. a. an der Universitätsklinik für Psychiatrie und Psychotherapie III bei Prof. Spitzer in Ulm. Münst reflektiert seine seelsorgerliche Arbeit mit psychisch erkrankten Menschen. Er sieht das Verhältnis von Psychotherapie und Seelsorge ähnlich der Beziehung von Motorboot und Segelboot. Münst betrachtet den historischen Wandel der institutionellen Verankerung von Seelsorge in der Psychiatrie. Er beschreibt die aktuellen Rahmenbedingungen, unter denen er arbeitet. Der Seelsorger berichtet, was Patienten bei ihm suchen: offenes Gespräch; Rituale; Klärung der Gottesbeziehung; theologischer Austausch. Münst erläutert, wie sich aus seiner Sicht Psychotherapie und Seelsorge unterscheiden bzw. was für ihn Seelsorge bedeutet. Dabei verwendet er den Begriff Lebensdeutung und die Unterscheidung heilend/heilsam. Münst zeigt biblische und theologische Hintergründe seines Handelns und erläutert, wie er von Erkenntnissen aus dem personenzentrierten Ansatz der Psychotherapie bei Carl Rogers profitiert. Die Variable „Präsenz“ bei C. Rogers bildet für ihn eine Brücke zu seinem Tun und Reflektieren als Klinikseelsorger und Meditationsbegleiter.
Einstellungen gegenüber der COVID-19-Impfung im Vergleich zur
Grippeschutzimpfung bei Krankenhauspersonal
Authors: Weigel Angelika , Brehm Thomas Theo , Schulze zur Wiesch Julian , Vogt Birgit , Lohse Ansgar W. , Löwe Bernd
Published: March 2022

Krankenhauspersonal, das eine Grippe- oder COVID-19-Schutzimpfung erhalten oder
eine COVID-19-Schutzimpfung abgelehnt hatte, wurde bezüglich
Einstellungen zur jeweiligen Schutzimpfung, Inanspruchnahme der
Grippeschutzimpfung und Ablehnungsgründen der COVID-19-Schutzimpfung
befragt. COVID-19-Schutzimpfungsablehnende schätzten verglichen mit den
anderen beiden Gruppen das Risiko einer Infektion für sich selbst und
generell sowie die Wirksamkeit der Schutzimpfung am niedrigsten und das Risiko
der Schutzimpfung am höchsten ein. Auch berichteten sie die niedrigste
frühere Inanspruchnahme der Grippeschutzimpfung. Der wahrgenommene Druck
zur Impfung erwies sich als relevante Barriere. Zukünftige Impfkampagnen
sollten eine Balance zwischen Informationen zu Impfstoffen, der Notwendigkeit
der Schutzimpfung und Freiwilligkeit der Inanspruchnahme erhalten.
Aktuelle ERAS-Implementierung in der Thoraxchirurgie an deutschen Kliniken
Authors: Andreas Marco Nicolas , Dziodzio Tomasz , Hillebrandt Karl-Herbert , Elsner Aron , Strauchmann Julia , Aydin Mustafa , Pratschke Johann , Rückert Jens-Carsten , Neudecker Jens
Published: March 2022

Einleitung In den letzten Jahren haben sich zunehmend ERAS-Behandlungspfade in vielen chirurgischen Bereichen etabliert, da sie allgemeine Komplikationen reduzieren und die Genesung
von Patienten erheblich beschleunigen können. Für die Thoraxchirurgie wurden 2019 erstmals ERAS-Guidelines von der ERAS Society in Zusammenarbeit mit der European Society of Thoracic
Surgeons (ESTS) veröffentlicht. Inwieweit sich ERAS-Maßnahmen im klinischen Alltag in der Thoraxchirurgie in Deutschland etabliert haben, wurde anhand eines Online-Fragebogens evaluiert.

Material und Methoden Es wurde eine Onlineumfrage zur aktuellen ERAS-Implementierung an deutschen Kliniken durchgeführt. Zeitraum der Umfrage war vom 12.05.2021 bis zum 01.06.2021.
Im Fragebogen, der 22 Fragen umfasste, wurde die aktuelle Umsetzung verschiedener perioperativer Maßnahmen (u. a. Mobilisation, Thoraxdrainagen-Management, Schmerzmanagement) als wesentliche
Items des ERAS-Pathways erfragt. Anschließend wurden die Resultate zusammengefasst, beschreibend analysiert und in den Kontext der aktuellen Literatur gesetzt.

Ergebnisse Von 155 angeschriebenen leitenden Thoraxchirurgen beantworteten 32 den Fragebogen. Bei 28,1% (n = 9) der Kliniken war ein ERAS-Kernteam etabliert, eine Datenbank zur
Erfassung der ERAS-Items gab es in 15,6% (n = 5). Zudem bekamen die Patienten meist kein ERAS-Tagebuch (96,9%, n = 31) ausgehändigt. Ein präoperatives Carboloading wurde von 15,6% (n = 5)
durchgeführt. Eine PONV-Prophylaxe wurde bei 59,4% (n = 19) der Befragten standardmäßig durchgeführt. In der Regel wurde bei elektiven anatomischen Resektionen eine Thoraxdrainage (84,4%,
n = 27) eingelegt. Bei 3% (n = 1) der Zentren wurden 2 Drainagen eingelegt, bei 12,5% (n = 4) wurde keine Drainage intraoperativ eingebracht. Meist wurden digitale Drainagesysteme verwendet
(90,6%, n = 29). Der am häufigsten angewendete initiale Drainagensog war –10 cm H2O (75%, n = 24). Einen Sog von ≤ 2 cmH2O verwendeten lediglich 2 Befragte. Die
Drainageentfernung erfolgte in 50% (n = 16) der Fälle am 1. oder 2. postoperativen Tag (POD), in 34,4% (n = 11) am 3. und 4. POD und bei 9,4% (n = 3) verblieb die Drainage über den 4. Tag
hinaus. Bei 71,9% (n = 23) der Befragten erfolgte die erste Mobilisation postoperativ noch am OP-Tag.

Diskussion Die Implementierung der ERAS-Guidelines ist in Deutschland interindividuell noch sehr variabel. Bestimmte perioperative Prozesse werden bereits gut abgedeckt, allerdings
ist eine vollständige Umsetzung von ERAS-Items noch nicht gänzlich in der klinischen Praxis angekommen. Erste Schritte in diese Richtung wurden bereits gemacht und legen die Grundlage für
eine weitere zentrumsübergreifende Zusammenarbeit.
Indication Creep of Antenatal Late Preterm Steroids
Authors: McElwee Eliza R. , Wilkinson Kyla , Crowe Rebecca , Newman Jill C. , Alkis Mallory , Wineland Rebecca , Finneran Matthew M.
Published: March 2022

Objective While antenatal corticosteroids (ACS) administered in the late preterm period have been shown to reduce respiratory morbidity, this finding was demonstrated in a well-designed randomized controlled trial (the Antenatal Betamethasone for Women at Risk for Late Preterm Delivery [ALPS]) with strict inclusion/exclusion criteria that may differ from clinical practice. The aim of this study was to investigate whether there has been indication creep since use of late preterm ACS became standard of care.

Study Design Retrospective cohort study of pregnant women who received late preterm ACS between 2016 and 2019 were identified and separated into epochs of 2016 to 2017 and 2018 to 2019 based on year of exposure. The primary outcome was rate of inappropriate ACS exposure, defined as nonadherence to the inclusion/exclusion criteria of the ALPS trial. Secondary outcomes were rates of nonoptimal ACS exposure (delivery >7 days from ACS or term delivery). Logistic regression was used to generate adjusted odds ratios (aORs) between epochs for the primary outcome adjusting for confounders.

Results There were 660 women who received late preterm ACS during the study period with 229 (34.6 %) deemed inappropriate exposures. The most common reason for inappropriate treatment was preterm premature rupture of membrane (PPROM; 29.0%) with exclusionary cervical examination or contraction frequency. No difference was observed in inappropriate ACS exposure between epochs (aOR = 0.83, 95% confidence interval [CI]: 0.59–1.2). However, there was a reduction in nonoptimal exposure over time (aOR = 0.67, 95% CI: 0.47–0.97) . Women receiving inappropriate ACS were more likely to deliver at term if indicated for maternal/fetal status (50.0 vs. 19.5%, p < 0.001) and preterm labor (66.0 vs. 41.9%; p = 0.015). Further, inappropriate exposure in preterm labor had higher rates of exposure latency >7 days (62.3 vs. 39.1%, p = 0.006) with a longer latency to delivery (3 vs. 16 days; p < 0.001).

Conclusion Over one-third of women received late preterm ACS for an indication that could be classified as indication creep. Depending on indication, inappropriate administration is associated with higher rates of nonoptimal exposure.

Key Points
On the Copper-Promoted Backbone Arylation of Histidine-Containing Peptides Using Triarylbismuthines
Authors: Gagnon Alexandre , Chan Hwai-Chien
Published: March 2022

We report herein our detailed investigation on the histidine-directed backbone arylation of histidine-containing peptides using triarylbismuth reagents. The reaction proceeds on the backbone NH of the amino acid that precedes the histidine, the so-called n–1 position. The protocol is applicable to dipeptides where the histidine is located at the C-terminus and to tripeptides where the histidine occupies the central position. The transformation is promoted by copper(II) acetate in the presence of phenanthroline (Phen) and diisopropylethylamine in dichloromethane at 50 °C under oxygen. An excellent scope was observed for the triarylbismuthines. In all cases, the imidazole ring of the histidine is protected with a trityl group to prevent the arylation of the side chain. An ATCUN-like model is proposed to explain the observed results.
Bleeding Complications in Neonates Receiving Extracorporeal Membrane Oxygenation and Controlled Hypothermia
Authors: Joshi Swosti , Cardona Vilmaris Quinones , Poletto Erica , Menkiti Ogechukwu
Published: March 2022

Objective Safety and efficacy data on controlled hypothermia (CH) for neonates with moderate to severe hypoxic ischemic encephalopathy has been extrapolated to a subgroup of these patients who also require extracorporeal membrane oxygenation for refractory persistent pulmonary hypertension of the newborn (PPHN). However, safety data on the concomitant use of CH and extracorporeal membrane oxygenation (ECMO) are lacking.

Methods This is a single-center retrospective study of neonates ≥35 weeks' gestation with refractory PPHN who required ECMO between January 2010 and December 2020. Study groups were divided into those receiving CH/ECMO versus ECMO only. Baseline characteristics, short-term outcomes, and brain magnetic resonance imaging (MRI) data were compared.

Results A total of 36 neonates who received ECMO for refractory PPHN were included. Of these, 44.4% (n = 16) received CH/ECMO and 55.6% (n = 20) received ECMO only. Bleeding complications were more common in CH/ECMO group 50% (n = 8) versus ECMO only 15% (n = 3, p = 0.023). T1 brain MRI severity scores were higher in CH/ECMO group versus ECMO only group, however, there were no statistical difference in T2 and diffusion-weighted image scores. Functional status and survival to discharge were comparable between groups.

Conclusion In our cohort, neonates who received CH/ECMO had higher bleeding complications than ECMO only group with comparable functional status and survival at discharge.

Key Points
Formal Syntheses of Dictyodendrins B, C, and E by a Multi-Substituted Indole Synthesis
Authors: Yamaguchi Junichiro , Kabuki Akira
Published: March 2022

The dictyodendrins are a family of marine alkaloids, which possess a highly substituted pyrrolo[2,3-c]carbazole core. This core structure can be regarded as a multi-substituted indole and aniline moiety. To achieve a concise synthesis of dictyodendrins, we planned to capitalize on our previously developed multi-substituted indole synthesis. By using this method along with two C–H functionalizations, formal syntheses of dictyodendrins B, C, and E were achieved.
The Conceptual Development of a Conjunctive Olefination
Authors: Silvi Mattia , Filippini Dario
Published: March 2022

We recently discovered a functional group tolerant and transition-metal-free conjunctive olefination reaction with applications in late-stage functionalization chemistry. In this Synpacts contribution, we analyze the conceptual background that has stimulated the discovery of this reactivity and reflect on the key aspects of its development.

1 Introduction

2 Conceptual Background

2.1 Photoredox-Mediated Giese Reaction

2.2 Photoredox Radical-Polar Reactivity

3 The Development of the Process

4 Conclusion
Phosphorus(III)-Promoted 1,2-Boronate Migration and Application to Stereoselective gem-C,B-Glycosylation
Authors: He Zhi-Tao
Published: March 2022

Modifications of glycosidic linkers are valuable in medicinal chemistry and natural-product synthesis. Whereas considerable attention has been paid to the development of methods for monoglycosylation, the corresponding geminal diglycosylation has almost been ignored. Little work has focused on exploring new routes for stereoselective gem-diglycosylation, presumably due to challenges in controlling selectivity and activity on a confined quaternary carbon center. Highlighted herein is a recent advance in stereoselective C,B-glycosylation through an unprecedented PPh3-promoted 1,2-boronate-migration process.
Resveratrol Attenuates Hyperoxia Lung Injury in Neonatal Rats by Activating SIRT1/PGC-1α Signaling Pathway
Authors: Yang Kun , Yang Menghan , Shen Yunchuan , Kang Lan , Zhu Xiaodan , Dong Wenbin , Lei Xiaoping
Published: March 2022

Objectives Our previous study showed that resveratrol (Res) attenuates apoptosis and mitochondrial dysfunction in alveolar epithelial cell injury induced by hyperoxia by activating the SIRT1/PGC-1α signaling pathway. In the present study, we investigated whether Res protects against hyperoxia-induced lung injury in neonatal rats by activating SIRT1/PGC-1α signaling pathway.

Methods Naturally delivered neonatal rats were randomly divided into six groups: normoxia + normal saline, normoxia + dimethyl sulfoxide (DMSO), normoxia + Res, hyperoxia + normal saline, hyperoxia + DMSO, and hyperoxia + Res. Lung tissue samples were collected on postnatal days 1, 7, and 14. Hematoxylin and eosin staining was used to evaluate lung development. Dual-immunofluorescence staining, real-time polymerase chain reaction, and western blotting were used to evaluate the levels of silencing information regulator 2-related enzyme 1 (SIRT1), peroxisome proliferator-activated receptor γ co-activator 1α (PGC-1α), nuclear respiratory factor 1 (Nrf1), Nrf2, transcription factor A (TFAM) and citrate synthase, the number of mitochondrial DNA (mtDNA) and mitochondria, the integrity of mtDNA, and the expression of TFAM in mitochondria.

Results We found that hyperoxia insulted lung development, whereas Res attenuated the hyperoxia lung injury. Res significantly upregulated the levels of SIRT1, PGC-1α, Nrf1, Nrf2, TFAM, and citrate synthase; promoted TFAM expression in the mitochondria; and increased the copy number of ND1 and the ratio of ND4/ND1.

Conclusion Our data suggest that Res attenuates hyperoxia-induced lung injury in neonatal rats, and this was achieved, in part, by activating the SIRT1/PGC-1α signaling pathway to promote mitochondrial biogenesis.

Key Points
Characteristics and Outcomes of Pregnant Women with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in New York City: A Matched Cohort Study
Authors: Khoury Rasha S. , Fazzari Melissa , Lambert Calvin , Debolt Chelsea , Stone Joanne , Bianco Angela , Nathan Lisa , Dolan Siobhan M. , Bernstein Peter S.
Published: March 2022

Objective The aim of this study was to examine the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and preterm birth, cesarean birth, and composite severe maternal morbidity by studying women with and without SARS-CoV-2 infection at the time of delivery hospitalization from similar residential catchment areas in New York City.

Study Design This was a retrospective cohort study of pregnant women with laboratory-confirmed or laboratory-denied SARS-CoV-2 on nasopharyngeal swab under universal testing policies at the time of admission who gave birth between March 13 and May 15, 2020, at two New York City medical centers. Demographic and clinical data were collected and follow-up was completed on May 30, 2020. Groups were compared for the primary outcome and preterm birth, in adjusted (for age, race/ethnicity, nulliparity, body mass index) and unadjusted analyses.

Results Among this age-matched cohort, 164 women were positive and 247 were negative for SARS-CoV-2. Of the positive group, 52.4% were asymptomatic and 1.2% had critical coronavirus disease 2019 (COVID-19). The groups did not differ by race and ethnicity, body mass index, or acute or chronic comorbidities. Women with SARS-CoV-2 were more likely to be publicly insured. Preterm birth, cesarean birth, and severe maternal morbidity did not differ between groups. Babies born to women with SARS-CoV-2 were more likely to have complications of prematurity or low birth weight (7.7 vs. 2%, p = 0.01).

Conclusion Preterm and cesarean birth did not differ between women with and without SARS-CoV-2 across disease severity in adjusted and unadjusted analysis among this cohort during the pandemic peak in New York City.
Cord Blood Cell-Free DNA Concentration: A Novel Marker for Neonatal Wellbeing
Authors: Imterat Majdi , Erez Offer , Tirosh Dan , Gelkop Yael Miller , Benshalom-Tirosh Neta , Ben-Tabo Maor , Douvdevani Amos
Published: March 2022

Objective Cord gas values and Apgar scores, currently used as markers for newborn wellbeing and postpartum complications, provide rough estimates, and their use remains elusive. Circulating cell-free DNA (cfDNA) may better represent newborn status at birth and the effect of parturition on the fetus. This pilot study investigates the association between cord blood (CB) cfDNA and neonatal outcomes.

Study Design In a prospective cohort study, cfDNA concentration was measured in immediately following delivery collected CB sera of newborns using our rapid fluorescent assay.

Results During the study period, blood samples from umbilical cords of 100 newborns were collected. Vaginal delivery was associated with a higher median CB cfDNA than cesarean delivery (277 [95% confidence interval [CI] 199–377] vs. 100 [95% CI 43–265] ng/mL, p < 0.01). cfDNA levels were significantly associated with gestational age at delivery (rho = 0.308, p = 0.002) and CB base deficit (BD, r = 0.252, p = 0.017). According to maternal and fetal complications, CB cfDNA was elevated in fetuses with category II of heart rate tracing (p < 0.05), with maternal positive vaginal culture (p < 0.01), and with premature rupture of membranes (PROM, p < 0.001). Logistic regression models of CB cfDNA fourth quartiles demostrate a double odds ratio for elevated BD (>3mmol/L) and for worse heart rate tracing category.

Conclusion Serum CB cfDNA concentration reflects the newborn's status and hazards with an excellent association with CB BD, fetal heart rate category, and maternal risk factors for infection (positive vaginal culture and PROM). This preliminary observation suggests that cfDNA can serve as a point of care biomarker for newborn status at the time of delivery.

Key Points
Is Amniocentesis after CVS Risky?
Authors: Cagino Kristen , Chasen Stephen T.
Published: March 2022

Objective Approximately, 2% of women who undergo chorionic villi sampling (CVS) will subsequently undergo amniocentesis due to placental mosaicism or sampling/laboratory issues. Our objective was to compare obstetric outcomes in women who underwent both procedures with those who had CVS alone.

Study Design Retrospective case-control study of patients with singleton pregnancies undergoing invasive testing from 2010 to 2020 was performed. All women who underwent CVS followed by amniocentesis were compared with a control group who underwent CVS alone matched (2:1) for age and year of pregnancy. Women with pregnancy loss at <16 weeks were excluded from the control group. Pregnancies terminated for genetic abnormalities were excluded. Obstetric outcomes were compared between cases and controls. Student t-test and Fisher's exact test were used for statistical comparison.

Results During the study period 2,539 women underwent CVS, and 66 (2.6%) subsequently underwent amniocentesis. The 66 cases were compared with 132 age-matched controls who underwent CVS alone. Mean maternal age was 36.8 ± 3.4 years, and 43% of women were nulliparous. Amniocentesis was performed due to sampling or laboratory issues in 33% of cases, placental mosaicism in 44%, and further diagnostic testing in 23%. There were no pregnancy losses or stillbirths in either group. Those who had two invasive procedures delivered at similar gestational ages and birthweights and did not have higher rates of adverse outcomes compared with those who underwent CVS alone.

Conclusion Patients considering CVS who are concerned about the possibility that a second invasive procedure could be required should be reassured that this does not appear to be associated with higher rates of adverse outcomes. Due to study size, we cannot exclude the possibility of small differences in uncommon outcomes, such as pregnancy loss or stillbirth.

Key Points
Fetal Growth Biometry as Predictors of Shoulder Dystocia in a Low-Risk Obstetrical Population
Authors: Newman Roger B. , Stevens Danielle R. , Hunt Kelly J. , Grobman William A. , Owen John , Sciscione Anthony , Wapner Ronald J. , Skupski Daniel , Chien Edward K. , Wing Deborah A. , Ranzini Angela C. , Porto Manuel , Grantz Katherine L.
Published: March 2022

Objective This study aimed to evaluate fetal biometrics as predictors of shoulder dystocia (SD) in a low-risk obstetrical population.

Study Design Participants were enrolled as part of a U.S.-based prospective cohort study of fetal growth in low-risk singleton gestations (n = 2,802). Eligible women had liveborn singletons ≥2,500 g delivered vaginally. Sociodemographic, anthropometric, and pregnancy outcome data were abstracted by research staff. The diagnosis of SD was based on the recorded clinical impression of the delivering physician. Simple logistic regression models were used to examine associations between fetal biometrics and SD. Fetal biometric cut points, selected by Youden's J and clinical determination, were identified to optimize predictive capability. A final model for SD prediction was constructed using backward selection. Our dataset was randomly divided into training (60%) and test (40%) datasets for model building and internal validation.

Results A total of 1,691 women (98.7%) had an uncomplicated vaginal delivery, while 23 (1.3%) experienced SD. There were no differences in sociodemographic or maternal anthropometrics between groups. Epidural anesthesia use was significantly more common (100 vs. 82.4%; p = 0.03) among women who experienced SD compared with those who did not. Amniotic fluid maximal vertical pocket was also significantly greater among SD cases (5.8 ± 1.7 vs. 5.1 ± 1.5 cm; odds ratio = 1.32 [95% confidence interval: 1.03,1.69]). Several fetal biometric measures were significantly associated with SD when dichotomized based on clinically selected cut-off points. A final prediction model was internally valid with an area under the curve of 0.90 (95% confidence interval: 0.81, 0.99). At a model probability of 1%, sensitivity (71.4%), specificity (77.5%), positive (3.5%), and negative predictive values (99.6%) did not indicate the ability of the model to predict SD in a clinically meaningful way.

Conclusion Other than epidural anesthesia use, neither sociodemographic nor maternal anthropometrics were significantly associated with SD in this low-risk population. Both individually and in combination, fetal biometrics had limited ability to predict SD and lack clinical usefulness.

Key Points
Social Determinants of Health: The Fifth Vital Sign
Authors: Pardo Christina , McLaren Rodney , Minkoff Howard
Published: March 2022

Introduction Since the last decade, social determinants of health (SDOH) have become a vital component of the liturgy of public health. From that time, the number of articles on SDOH cited in PubMed has increased from approximately 775 to over 4,700.

Issue In obstetrics, social determinants of health have particular resonance in discussions of maternal mortality and health disparities and the number of articles on SDOH in obstetrics has increased sixfold during the same interval. However, while most obstetricians are now aware of SDOH, many are unsure about how to address them within the context of their own practice.

Summary In this piece, we will discuss the importance of SDOH in obstetrics, the reasons why most obstetricians have not engaged with it and suggest steps to help bridge the gap between merely accepting SDOH's importance and implementing strategies to mitigate their effects.

Key Points
Umbilical Artery Cord Gas Abnormalities in the Presence of a Nuchal Cord in Term Singleton Pregnancies: A Cohort Study
Authors: Zahedi-Spung Leilah Deborah , Raghuraman Nandini , Carter Ebony B. , Cahill Alison G. , Rosenbloom Joshua I.
Published: March 2022

Objective The clinical significance of nuchal cord (NC) at the time of delivery is unclear. Studies have found that NC is associated with lower umbilical artery (UA) pH. Since fetal hypercarbia precedes respiratory acidosis, we hypothesize UA pCO2 is elevated in neonates with NC at the time of delivery.

Study design This is a secondary analysis of a prospective cohort study of women with full-term singleton pregnancies admitted in labor or for induction of labor at an institution with a universal umbilical cord gas policy. We compared patients with NC at the time of delivery to those without NC. Women were excluded if they did not have validated UA gases, had a major fetal anomaly, or had an intrauterine fetal demise. The primary outcome of the study was UA pCO2. Secondary outcomes were other components of UA gas and neonatal morbidity composite. Baseline characteristics were compared utilizing chi-square or Fisher's exact test or the Student's t-test. UA gas parameters were compared using the Kruskal–Wallis test. Multivariable logistic regression was utilized to adjust for confounders.

Results Of the 8,580 study participants, 7,608 had validated umbilical cord gases. The incidence of NC in the population was 24.15% (n = 1,837). UA pCO2 was higher in those with NC than without (58 mm Hg [53–64] vs. 55 mm Hg [50–60], p < 0.01). There was a greater odds of hypercarbia in the NC group (pCO2 > 65 mmHg; adjusted odds ratio [aOR]: 1.97, 95% confidence interval [CI]: 1.72–2.25, p < 0.01). Additionally, the NC group was more likely to be mildly acidemic (pH < 7.2, aOR: 1.74, 95% CI: 1.51–2.01, p < 0.01). There was no difference in composite neonatal morbidity between the groups.

Conclusion NC is associated with an increased risk of hypercarbia and acidemia. However, this is not associated with increased risk of neonatal morbidity.

Key Points
Current Advances in Meerwein-type Radical Alkene Functionalizations
Authors: Heinrich Markus R. , Diesendorf Nina
Published: March 2022

Alkene functionalizations via Meerwein arylations are becoming increasingly attractive, especially since a variety of mild and sustainable methods for aryl radical generation are available today. This entails a broad spectrum of substrates and radical scavengers, as well as convenient synthetic routes to relevant precursors for further transformations. The present review focuses on recent advances in Meerwein-type alkene functionalizations and gives insights into the key mechanistic details of the respective reactions.

1 Introduction

2 Hydroarylation and Carboarylation

3 Carboamination, Carbooxygenation, and Carbothiolation

4 Carbohalogenation

5 Conclusion and Outlook
Effect of Surgical Approach on Length of Stay, Cost, and Early Complication Rate in Total Hip Arthroplasty
Authors: Campbell Joshua C. , Rajaee Sean S. , Palosaari Andrew A. , Ju Derek , Moon Charles , Paiement Guy , Penenberg Brad
Published: March 2022

Background Total hip arthroplasty (THA) is a historically popular and successful operation. While many steps of the operation are consistent between practitioners, discussion around which approach constitutes the “best” approach for routine, primary THA remains an open question.

Objective The purpose of this study was to determine the effects of the surgical approach on hospital length of stay (LOS), hospital costs, and complication rates. A multisurgeon review of a single hospital was conducted to evaluate three surgical approaches: superior (SA), posterior (PA), and direct anterior (DAA).

Methods All elective primary THAs performed between July 2013 and July 2016 were reviewed in an administrative database. Two surgeons performed SA, three surgeons performed PA, and two surgeons performed DAA. A total of 1,799 arthroplasties were analyzed: 980 (SA), 685 (PA), and 134 (DAA). Multivariate logistic, Poisson, and linear regression models were used to calculate the effects of each approach on LOS, cost, and per cent discharge home while adjusting for age, severity of illness scores, obesity, and smoking.

Results After adjusting for patient characteristics, mean LOS for SA (1.8 days) was lower than both PA (2.4, p < 0.001) and DAA (2.9, p < 0.001), and PA (2.4) was lower than DAA (2.9, p < 0.001). Mean hospital costs were lower for SA than PA ($738 difference, p < 0.001) and DAA ($2,222 difference, p < 0.001), and PA was lower than DAA ($1,420 difference, p < 0.001). Both SA (88.7%) and PA (86.1%) were associated with a higher rate of discharge to home than DAA (78.4%, p = 0.002, p < 0.001, respectively). SA and PA were associated with a lower 30-day readmission (1.3%) compared with DAA (5.2%, p < 0.001) with no difference in 90-day readmissions seen.

Conclusion When controlling for patient factors, the SA was associated with a decreased LOS, decreased costs, and increased likelihood of discharge home compared with both the PA and DAA with no increase in 90-day readmissions.
Stability with a Constrained Posterior Stabilized Primary Total Knee Arthroplasty Does Not Compromise Durability
Authors: Yohe Nicholas , Vanderbrook Douglas J. , Sherman Alain E. , Papas Paraskevi Vivian , Scuderi Giles R.
Published: March 2022

Total knee arthroplasty (TKA) in cases of complex deformity (e.g., ligamentous laxity, posttraumatic arthritis) may require prostheses with inherent varus–valgus stability greater than that of traditional posterior stabilized or cruciate-retaining implants. Here, we investigate the clinical and radiographic outcomes of TKA using a midlevel constraint (MLC) prosthesis. A retrospective review of 53 patients (62 knees) who underwent primary TKA with an MLC implant was performed. Short tibial stem extensions were utilized in 49 knees, and 13 knees received no stem extension. Mean follow-up time was 31.6 months (standard deviation [SD] = 10.0, range = 24–53). Preoperative and postoperative range of motion (ROM) were assessed. Plain radiographs were reviewed for alignment, radiolucent lines, component loosening, and osteolysis. Patients who developed postoperative arthrofibrosis underwent manipulation under anesthesia (MUA). Failure was defined as instability, component loosening, or need for revision surgery. Mean ROM significantly improved from 114.1 degrees (SD = 19.7 degrees) preoperatively to 123.5 degrees (SD = 12.2 degrees) at final follow-up (t = −3.43, p = 0.001). Thirty-seven knees initially presented with varus deformity (mean = 7.5 degrees, SD = 4.8 degrees), whereas 23 had valgus deformity (mean = 10.6 degrees, SD = 6.5 degrees), and 2 knees had neutral alignment. Following surgery, mean alignment was 4.3 degrees valgus (SD = 1.7 degrees, range = 0–8 degrees), representing a statistically significant improvement (t = 5.29, p < 0.001). Six patients (9.7%) developed arthrofibrosis requiring MUA, which was irrespective of baseline ROM (p = 0.92) and consistent with 12% incidence reported in the literature. There were no significant differences in postoperative ROM (t = 0.38, p = 0.71), alignment (t = −0.22, p = 0.83), or incidence of arthrofibrosis (χ2 = 0.07, p = 0.79) between short-stemmed and nonstemmed implants. There was no radiographic evidence of radiolucent lines, component loosening, or osteolysis in any patients. No patients required revision surgery. Use of an MLC prosthesis with primary femoral component in TKA resulted in satisfactory clinical and radiographic results with no evidence of component loosening, osteolysis, instability, or need for revision at minimum 2-year follow-up.
Survival Analysis of Surgically Resected ypN2 Lung Cancer after Neoadjuvant Therapy
Authors: İşgörücü Özgür , Citak Necati
Published: March 2022

Introduction Surgery is widely accepted today when downstaging of mediastinal lymph nodes after neoadjuvant therapy is achieved. However, the role of surgery in patients with persistent N2 disease is still controversial. This study aims to detail the diagnostic problems, prognostic features, and long-term survival of the persistent N2 non-small cell lung cancer patient group.

Patients and Methods One-hundred fifty patients who received neoadjuvant therapy and subsequently underwent resection, in-between 2003 and 2015, were retrospectively analyzed. In this study, “persistent N2” group refers to patients who received neoadjuvant therapy for clinically or histologically proven N2, who underwent a surgery after having been classified as “downstaged” at restaging, but in whom ypN2 lesions were subsequently confirmed on the operative specimens. Patients with multistation N2 were included in the study. There were 119 patients who met the criteria, whereas persistent ypN2 was detected in 28.5% (n = 34) of all patients.

Results Overall 5-year survival rate was 47.2%, while it was 23.4% for patients with persistent N2. Factors that adversely affected survival were to have nonsquamous cell histological type (p = 0.006), high ypT stage (p = 0.001), persistent N2 (p = 0.02), and recurrence during follow-up (p < 0.001). A trend toward a shorter survival was observed when the ypN2 zone was subcarinal versus other zones, but did not reach statistical significance (p = 0.08). In addition, a trend toward a shorter survival of patients with multiple N2 involvement (p = 0.412) was observed.

Conclusion In the persistent N2 group, when multiple involvement or subcarinal involvement was excluded, relatively good survival was detected.
Psychosoziale Unterstützung in Kliniken: Hilfe für die Helfer
Authors: König Romy
Published: March 2022

Hier ein klinikeigenes Sorgentelefon, dort Lavendelsträuße zur Aufmunterung – all das reicht nicht, um Gesundheitsfachkräfte in Pandemie-Zeiten mental aufzufangen. Psychosoziale Hilfe für Pflegefachkräfte, Ärztinnen und Ärzte muss strukturell aufgezogen werden. Erste Kliniken gehen voran.
The networked researcher, the editorial manager, and the traveller: the profiles of international political scientists and the determinants of internationalisation
Authors: Tronconi Filippo , Engeli Isabelle
Published: March 2022

The concept of internationalisation, when referring to the work of social scientists within academic institutions, takes on different meanings and involves different activities. This contribution aims to shed light on the international activities of political scientists across Europe and to investigate the various meanings and practices of internationalisation. The analysis relies on the PROSEPS survey, involving some 1,800 political scientists across 37 European countries. We identify three distinct profiles of international scholars: the networked researcher, the editorial manager, and the traveller. These profiles differ according to 1) the building of international research networks, 2) the involvement in the activities of the international publishing industry, 3) the research and teaching exchanges with foreign academic institutions. Determinants, such as gender, family status, career stage, availability of institutional and financial support, and geographical location, are considered as potential drivers or inhibitors of internationalisation. Our analysis shows that the internationalisation of academic practices follows contrasting paths according to the type of international profile.
Entangled photon pairs lead to optimized quantum spectroscopy
Authors: Green Leigh Ann
Published: March 2022

Quantum dynamics of molecules and photons used to explore nonlinear interferometric spectroscopy
A representation of the Dunkl oscillator model on curved spaces: Factorization approach
Authors: Najafizade Amene , Panahi Hossein , Chung Won Sang , Hassanabadi Hassan
Published: March 2022

In this paper, we study the Dunkl oscillator model in a generalization of superintegrable Euclidean Hamiltonian systems to the two-dimensional curved ones with a m:n frequency ratio. This defined model of the two-dimensional curved systems depends on a curvature/deformation parameter of the underlying space involving reflection operators. The curved Hamiltonian Hκ admits the separation of variables in both geodesic parallel and polar coordinates, which generalizes the Cartesian coordinates of the plane. Similar to the behavior of the Euclidean case, which is the κ → 0 limit case of the curved space, the superintegrability of a curved Dunkl oscillator is naturally understood from the factorization approach viewpoint in that setting. Therefore, their associated sets of polynomial constants of motion (symmetries) as well as algebraic relations are obtained for each of them separately. The energy spectrum of the Hamiltonian Hκ and the separated eigenfunctions are algebraically given in terms of hypergeometric functions and in the special limit case of null curvature occur in the Laguerre and Jacobi polynomials. Finally, the overlap coefficients between the two bases of the geodesic parallel and polar coordinates are given by hypergeometric polynomials.
Understanding the origins of the basic equations of statistical fibrillatory dynamics
Authors: Jenkins Evan V. , Dharmaprani Dhani , Schopp Madeline , Quah Jing Xian , Tiver Kathryn , Mitchell Lewis , Pope Kenneth , Ganesan Anand N.
Published: March 2022

The mechanisms governing cardiac fibrillation remain unclear; however, it most likely represents a form of spatiotemporal chaos with conservative system dynamics. Renewal theory has recently been suggested as a statistical formulation with governing equations to quantify the formation and destruction of wavelets and rotors in fibrillatory dynamics. In this perspective Review, we aim to explain the origin of the renewal theory paradigm in spatiotemporal chaos. The ergodic nature of pattern formation in spatiotemporal chaos is demonstrated through the use of three chaotic systems: two classical systems and a simulation of cardiac fibrillation. The logistic map and the baker's transformation are used to demonstrate how the apparently random appearance of patterns in classical chaotic systems has macroscopic parameters that are predictable in a statistical sense. We demonstrate that the renewal theory approach developed for cardiac fibrillation statistically predicts pattern formation in these classical chaotic systems. Renewal theory provides governing equations to describe the apparently random formation and destruction of wavelets and rotors in atrial fibrillation (AF) and ventricular fibrillation (VF). This statistical framework for fibrillatory dynamics provides a holistic understanding of observed rotor and wavelet dynamics and is of conceptual significance in informing the clinical and mechanistic research of the rotor and multiple-wavelet mechanisms of AF and VF.
The thrust enhancement for SDBD with nanostructured TiO2 films
Authors: Wang Haitao , Zhang Weidong , Zhang Wei , Hou Zhongyu
Published: March 2022

Design requirements of the structural features, the material properties, and the processing capabilities are hard to be satisfied in nanotechnologies simultaneously. In this paper, TiO2 nanoparticles that are chemically reliable have been processed through the doctor blade method to realize a kind of field enhancement nanostructure, aiming to enhance the dielectric-barrier-discharge plasma actuation performance. It is found that the thrust enhancement rate could be approximately 72% at 13 kV and 8 kHz, compared to the controlled samples. In addition, a threshold phenomenon of the thrust enhancement effect was also found from the experiments, where the applied voltage and frequency lower than specific criteria could both lead to a decrease in the thrust generation and vice versa. It is suggested that the increase in the ionization frequency resulted from the field enhancement effect of the nanostructures is the leading mechanism for the extra thrust generation, which is inconsistent with the experimental examinations of the plasma characteristics and the plasma kinetic simulation. The results suggested that TiO2 nanoparticles could be used to improve the actuation performance in harsh environments with sound substrate compatibility.
Numerical study of the transverse diffusion coefficient for a one component model of plasma
Authors: Valvo Lorenzo , Carati Andrea
Published: March 2022

In this paper, we discuss the results of some molecular dynamics simulations of a magnetized one component plasma, targeted to estimate the diffusion coefficient D⊥ in the plane orthogonal to the magnetic field lines. We find that there exists a threshold with respect to the magnetic field strength |B→|: for weak magnetic field, the diffusion coefficients scale as 1/|B→|2, while a slower decay appears at high field strength. The relation of this transition with the different mixing properties of the microscopic dynamics is investigated by looking at the behavior of the velocity autocorrelation.
Prospects for phase engineering of semi-stable Ga2O3 semiconductor thin films using mist chemical vapor deposition
Authors: Kaneko Kentaro , Uno Kazuyuki , Jinno Riena , Fujita Shizuo
Published: March 2022

Routes to semi-stable phases of Ga2O3 are the subject of extended discussions based on the review of growth methods, growth conditions, and precursors in works that report semi-stable phases other than the thermally stable β phase. The focus here is on mist chemical vapor deposition because it has produced single-phase Ga2O3 of α, γ, and ε (or κ) in terms of the substrate materials, and features of this growth method for phase control are emphasized. Recent reports of phase control by other growth technology give a deeper understanding of how to determine and control the phases, increasing the opportunities to fully utilize the novel and unique properties of Ga2O3.
X-ray zooming microscopy with two Fresnel zone plates
Authors: Wakabayashi Daisuke , Suzuki Yoshio , Shibazaki Yuki , Sugiyama Hiroshi , Hirano Keiichi , Nishimura Ryutaro , Hyodo Kazuyuki , Igarashi Noriyuki , Funamori Nobumasa
Published: March 2022

We propose a variable-magnification full-field x-ray microscope using two Fresnel zone plates (FZPs). By moving the positions of the two FZPs, the magnification can be continuously changed even if the sample and camera positions are fixed. It was demonstrated that the magnification can be changed in the range of 25–150× using a hard x-ray beam at 14.4 keV. Using the first FZP as a convex lens and the second FZP as a concave lens, high magnification can be achieved at a short camera length. Even under the condition of a camera length of about 7 m, a magnification higher than 300× was achieved, and a line and space pattern with a pitch of 40 nm was observed at 10 keV. By inserting a knife edge at an appropriate position in the optical system, a phase-contrast image can be easily obtained, which is useful for soft-tissue observation of biological samples.
Signature of Lifshitz transition in WTe2.08 nanosheets detected through electrical transport measurements
Authors: Majhi Kunjalata , Kakani Vivek , Ganesan R. , Anil Kumar P. S.
Published: March 2022

WTe2, a type-II Weyl semimetal, has recently attracted much attention due to its unique band structure leading to extremely large magnetoresistance and exceedingly high mobility. In this report, we discuss the signature of Lifshitz transition in WTe2.08 nanosheets through electrical transport measurements. We observed a resistivity anomaly (at T = T*) in the resistivity (ρxx) vs temperature (T) curve, which shows significant thickness dependence. The Hall resistance evolves from non-linear to linear with a decrease in thickness. Combining both zero-field resistivity and Hall measurements, we provide evidence substantiating the resistivity anomaly as a direct manifestation of Lifshitz transition.