bluuebunny/crossref_metadata_2025 huggingface dataset:
Luft nach oben
Authors: Noschinski Dirk-Rüdiger
Published: October 2021

Die Volkskrankheit COPD wird hauptsächlich durch Rauchen, aber auch Luftschadstoffe und Alpha-1-Antitrypsin-Mangel verursacht und zeigt sich in Studien immer stärker als eine durch immunologische Sensibilisierung ausgelöste Autoimmunerkrankung. Zu den bewährten und im Artikel beschriebenen osteopathischen Mobilisationstechniken zählen Psoas-Release, Leberpumpe, Mobilisation des Zwerchfells und der 1. Rippe, Kompression des Sternums und Scapula-Release. In Kombination mit anderen Verfahren kann die Osteopathie durch Lösung von Blockaden und Adhäsionen wesentlich zu einer Verbesserung der Lebensqualität beitragen.
Orale Antikoagulation bei Erwachsenen mit angeborenen Herzfehlern
Authors: La Rosée Karl , Klingenheben Thomas
Published: October 2021

Patienten mit angeborenen Herzfehlern weisen ein erhöhtes Risiko für das Auftreten
thrombembolischer Ereignisse auf. Je nach zugrunde liegender Anatomie/operativer Korrektur ist
dieses Risiko jedoch individuell sehr unterschiedlich und lässt sich weder hinsichtlich
Embolierisiko noch hinsichtlich Blutungsrisiko durch die gängigen Risikoscores (z. B.
CHA2DS2-VASc oder HAS-BLED) verlässlich abbilden. Neben der Frage der
Indikationsstellung zur oralen Antikoagulation ist die Frage nach der Möglichkeit des
Einsatzes neuer oraler Antikoagulanzien (NOAK) anstelle der Standardtherapie mit
Vitamin-K-Antagonisten (VKA) eine immer drängendere, sofern kein mechanischer Klappenersatz
und keine schwergradige Mitralstenose vorliegt. Bei atrialen Arrhythmien/Vorhofflimmern können
nach momentaner Datenlage Patienten mit als „leicht“ klassifizierbaren Vitien mit NOAK
behandelt werden, während Patienten mit mittelgradigen oder schweren/komplexen Herzfehlern
eher mit VKA behandelt werden sollten.
Vaginales Mikrobiom und Darmmikrobiom – ein Crosstalk
Authors: Mendling Werner
Published: October 2021

In der Vagina der gesunden prämenopausalen Frau wurden bisher 561 verschiedene Bakterien-Arten identifiziert, darunter > 30 von 261 bekannten Laktobazillus-Arten, von denen Lactobacillus (L.) crispatus, L. gasseri, L. jensenii und L. iners signifikant unterschiedlich je nach Ethnie und Individuum diverse Communitiy State Types (CST) mit unterschiedlichen pH-Werten dominieren. Die häufigsten Bakterien sind von den Stämmen (Phyla) Firmicutes (z. B. Lactobacillus oder Streptococcus), Proteobacteria (z. B. Escherichia oder Pseudomonas), Actinobacteria (z. B. Bifidobacterium) und Bacteroidetes, (z. B. Prevotella oder Bacteroides). Die wichtigsten Gattungen sind neben Laktobazillen Gardnerella (mit 4 Arten und 13 Subspezies), Atopobium, Prevotella, Streptococcus, Corynebacterium, Gemella, Dialister, Snethia, Megasphera, Mobiluncus, Ureaplasma, Mycoplasma u. a. In etwa 70 % werden auch Candida (C.)-Arten, meist C. albicans, gefunden. Tampons beeinflussen die vaginale Mikrobiota nicht wesentlich. Das menstruelle Toxic-Schock-Syndrom kommt mit und ohne Tampons und auch bei Menstruationstassen vor.

Im Rektosigmoid sind > 90 % Firmicutes und Bacteroidetes, von denen neben Laktobazillen viele Gattungen und Arten in Vagina und Rektum gemeinsam vorkommen können. Im Darm bilden diese Bakterien je nach (u. a.) „Lifestyle“ kurzkettige Fettsäuren, die elementare Bedeutung für die Eubiose, Hemmung von proinflammatorischen Zytokinen und die Gesundheit haben.

Die praktische und empfohlene Diagnostik gynäkologischer Infektionen und der sexuell übertragbaren Dysbiose Bakterielle Vaginose (BV) ist nicht die bakteriologische Kultur, sondern das Nativpräparat aus dem Fluor mit 400-facher Phasenkontrastmikroskopie. Die „klassischen“ sexuell übertragbaren Genitalinfektionen können heute mit Nuklearamplifikations-Techniken nicht-kulturell identifiziert werden. Die BV kann auch mit solchen Techniken anhand typischer Konstellationen von bestimmten Laktobazillen und typischen Anaerobiern zueinander diagnostiziert werden. Der häufige kulturelle Nachweis von z. B. G. vaginalis, Kolibakterien, Ureaplasmen, B-Streptokokken usw. ist klinisch ohne Wert und sollte unterlassen werden.
Sportmedizinische Aspekte bei EMAH-Patienten
Authors: Hock Julia , Hager Alfred
Published: October 2021

Immer mehr Patienten mit angeborenem Herzfehler erreichen das Erwachsenenalter. Neben der
allgemeinen medizinischen Untersuchung (Elektrokardiogramm, Echokardiografie, Laborparameter
etc.) findet auch die Funktionsdiagnostik immer mehr an Bedeutung. Zu dieser zählen sowohl die
Lungenfunktion (Spirometrie, Bodyplethysmografie) als auch die Bestimmung der
Leistungsfähigkeit (6-Minuten-Gehtest, Spiroergometrie). Wann jedoch eine solche Untersuchung
sinnvoll ist, scheint oftmals unklar. Dieser Artikel soll sowohl das standardisierte Vorgehen
dieser Untersuchungen aufzeigen als auch die Vor- und Nachteile unterschiedlicher
Untersuchungen je nach Fragestellung aufzeigen.

Wichtig hierbei ist, dass eine vollständige sportmedizinische Untersuchung bei Patienten
mit angeborenem Herzfehler immer zusammen mit einer kardiologischen Untersuchung stattfinden
muss. Nur dann kann eine sichere Untersuchung durch das geschulte Personal gewährleistet
werden.
Mandibular Fractures: Diagnosis and Management
Authors: Panesar Kanvar , Susarla Srinivas M.
Published: October 2021

Accurate evaluation, diagnosis, and management of mandibular fractures is essential to effectively restore an individual's facial esthetics and function. Understanding of surgical anatomy, fracture fixation principles, and the nuances of specific fractures with respect to various patient populations can aid in adequately avoiding complications such as malocclusion, non-union, paresthesia, and revision procedures. This article reviews comprehensive mandibular fracture assessment, mandibular surgical anatomy, fracture fixation principles, management considerations, and commonly encountered complications. In addition, this article reviews emerging literature examining 3-dimensional printing and intraoperative imaging.
Numerical characterization of quasi-steady thermal load for thin crystal at cryogenic temperature with nondiffusive heat transfer
Authors: Qu Zhengxian , Ma Yanbao , Zhou Guanqun , Wu Juhao
Published: October 2021

With dramatically improved brightness and repetition rate, the thermal load for crystal optics in x-ray free-electron laser applications has also significantly increased. To mitigate the thermal load, one effective method is cryogenic cooling. However, the emerging nondiffusive heat transfer phenomenon at cryogenic temperature may cause design failure if overlooked. To evaluate the optical performance of thin crystal optics under thermal load at cryogenic temperature, an integrated numerical tool is presented and applied to characterize the thermal load on thin crystals with nondiffusive phenomena accounted. Significant thermally induced distortion of the rocking curve is observed from numerical simulation, leading to potential seed power reduction in hard x-ray self-seeding application. Cryogenic cooling is confirmed necessary by simulation to handle the thermal load at high repetition rate operation.
Bayesian and non-Bayesian regression analysis applied on wind speed data
Authors: Tanoe Vincent , Henderson Saul , Shahirinia Amir , Bina Mohammad Tavakoli
Published: October 2021

Statistical methods are widely used to analyze the relationship between several independent variables (predictors) and a dependent variable. As wind energy rapidly becomes an important source of renewable energy, it is prudent to deeply evaluate any potential existing relationships among the data. This paper aims to apply the frequentist statistical approach, namely, non-Bayesian and the Bayesian approach, to multiple linear regression to wind speed data to investigate the differences between the two methodologies. This study uses the NREL wind speed data from fifteen different wind farms. In the proposed study, a correlation matrix was implemented to select the significantly correlated variables among all and use it as the dependent variable. This method is followed by a Random Forest machine learning technique for feature selection and considering the most important features that will be used for the Bayesian and non-Bayesian regression models. We first run a multiple linear regression (non-Bayesian regression model) in which we apply the variance inflation factor to detect any multicollinearity problem to get the fitted model. We then apply the Bayesian approach to the fitted model to analyze the relationship between the dependent and independent variables. The results from both non-Bayesian and the Bayesian approaches show close coefficients and parameters estimations. Moreover, using different wind speed data sample sizes of hourly, daily, and weekly data, we found that the daily data provide a strong coefficient estimator and the highest R-squared compared to the hourly and weekly data.
Local hybrid functionals augmented by a strong-correlation model
Authors: Wodyński Artur , Arbuznikov Alexei V. , Kaupp Martin
Published: October 2021

The strong-correlation factor of the recent KP16/B13 exchange–correlation functional has been adapted and applied to the framework of local hybrid (LH) functionals. The expression identifiable as nondynamical (NDC) and dynamical (DC) correlations in LHs is modified by inserting a position-dependent KP16/B13-style strong-correlation factor qAC(r) based on a local version of the adiabatic connection. Different ways of deriving this factor are evaluated for a simple one-parameter LH based on the local density approximation. While the direct derivation from the LH NDC term fails due to known deficiencies, hybrid approaches, where the factor is determined from the B13 NDC term as in KP16/B13 itself, provide remarkable improvements. In particular, a modified B13 NDC expression using Patra’s exchange-hole curvature showed promising results. When applied to the simple LH as a first attempt, it reduces atomic fractional-spin errors and deficiencies of spin-restricted bond dissociation curves to a similar extent as the KP16/B13 functional itself while maintaining the good accuracy of the underlying LH for atomization energies and reaction barriers in weakly correlated situations. The performance of different NDC expressions in deriving strong-correlation corrections is analyzed, and areas for further improvements of strong-correlation corrected LHs and related approaches are identified. All the approaches evaluated in this work have been implemented self-consistently into a developers’ version of the Turbomole program.
Adaptive partitioning molecular dynamics using an extended Hamiltonian approach
Authors: Bachmann Jim , Doltsinis Nikos L.
Published: October 2021

A recently proposed extended Hamiltonian approach to switching interaction potentials is generalized to enable adaptive partitioning molecular dynamics simulations. Switching is performed along a fictitious classical degree of freedom whose value determines the mixing ratio of the two potentials on a time scale determined by its associated mass. We propose to choose this associated fictitious mass adaptively so as to ensure a constant time scale for all switching processes. For different model systems, including a harmonic oscillator and a Lennard-Jones fluid, we investigate the window of switching time scales that guarantees the conservation of the extended Hamiltonian for a large number of switching events. The methodology is first applied in the microcanonical ensemble and then generalized to the canonical ensemble using a Nosé–Hoover chain thermostat. It is shown that the method is stable for thousands of consecutive switching events during a single simulation, with constant temperature and a conserved extended Hamiltonian. A slight modification of the original Hamiltonian is introduced to avoid accumulation of small numerical errors incurred after each switching process.
Critical currents in conventional Josephson junctions with grain boundaries
Authors: Sulangi Miguel Antonio , Bettmann Laetitia , Weingartner T. A. , Pokhrel N. , Patrick E. , Law M. , Kreisel A. , Hirschfeld P. J.
Published: October 2021

It has been hypothesized that the variation of the critical currents in Nb/Al–AlOx/Nb junctions is due to, among other effects, the presence of grain boundaries in the system. Motivated by this, we examine the effect of grain boundaries on the critical current of a Josephson junction. We assume that the hopping amplitudes are dependent on the interatomic distance and derive a physically realistic model of distance-dependent hopping amplitudes. We find that the presence of a grain boundary and associated disorder is responsible for a very large drop in the critical current relative to a clean system. We also find that when a tunnel barrier is present, grain boundaries cause substantial variations in the critical currents due to the disordered hoppings near the tunnel barrier. We discuss the applicability of these results to Josephson junctions presently intended for use in superconducting electronics applications.
Ultrahigh-speed multiplex coherent anti-Stokes Raman scattering microspectroscopy using scanning elliptical focal spot
Authors: Kizawa Shun , Hashimoto Mamoru
Published: October 2021

We present a beam-scanning multiplex coherent anti-Stokes Raman scattering (CARS) microspectroscopy system using parallel excitation and parallel detection schemes based on an elliptical focal spot, which enables highly efficient signal acquisition even for short exposures. The elliptical focal spot was used to simultaneously observe the CARS signals of an enlarged region and reduce the peak irradiance. The developed system realized an acquisition rate of 34 139 spectra/s and enabled ultrahigh-speed acquisition of a vibrational spectroscopic image, covering the fingerprint region of 930–1 830 cm−1 with 256(x) × 256(y) × 512(spectrum) pixels in 1.92 s or with 128(x) × 128(y) × 256(spectrum) pixels in 0.54 s. We demonstrated ultrahigh-speed hyperspectral imaging of a mixture of polymer beads in liquid linoleic acid and living adipocytes using the developed system. All of the present demonstrations were performed with a low-peak irradiance excitation of ∼19 GW/cm2, which has been reported in previous studies to cause less photodamage to living cells. The label-free and ultrahigh-speed identification and visualization of various molecules made possible by the present system will accelerate the development of practical live-cell investigation.
Super-resolved Raman microscopy using random structured light illumination: Concept and feasibility
Authors: Lee Hongki , Yoo Hajun , Moon Gwiyeong , Toh Kar-Ann , Mochizuki Kentaro , Fujita Katsumasa , Kim Donghyun
Published: October 2021

In this article, we report the use of randomly structured light illumination for chemical imaging of molecular distribution based on Raman microscopy with improved image resolution. Random structured basis images generated from temporal and spectral characteristics of the measured Raman signatures were superposed to perform structured illumination microscopy (SIM) with the blind-SIM algorithm. For experimental validation, Raman signatures corresponding to Rhodamine 6G (R6G) in the waveband of 730–760 nm and Raman shift in the range of 1096–1634 cm−1 were extracted and reconstructed to build images of R6G. The results confirm improved image resolution using the concept and hints at super-resolution by almost twice better than the diffraction-limit.
Interaction between dilute water vapor and dodecane thiol ligated Au nanoparticles: Hydrated structure and pair potential of mean force
Authors: Martinez Michael N. , Smith Alex G. , Nowack Linsey M. , Lin Binhua , Rice Stuart A.
Published: October 2021

The interaction between two ligated nanoparticles depends on whether they are isolated or immersed in a liquid solvent. However, very little is known about the influence of solvent vapor on the interaction between two ligated nanoparticles. Recent experiments yield the surprising result that the cyclic exposure of solvent free suspended monolayers of dodecane thiol ligated gold nanoparticles (AuNPs) to water vapor and dry nitrogen generates reversible cyclic decreases and increases in Young’s modulus of the monolayer, implying corresponding cyclic changes in the AuNP–AuNP interaction. We examine how water vapor interacts with an isolated dodecane thiol dressed AuNP and how water vapor affects the interaction between a pair of nanoparticles, using all-atom molecular-dynamics simulations. We find that there is condensation of water molecules onto the ligand shell of an AuNP in the form of clusters of 100–2000 molecules that partially cover the shell, with most of the water in a few large clusters. A water cluster bridges the AuNPs, with a sensibly constant number of water molecules for AuNP–AuNP separations from the edge-to-edge contact up to center-to-center separations of 100 Å. The wet AuNP–AuNP interaction has a slightly deeper and wider asymmetric well than does the dry interaction, a change that is qualitatively consistent with that implied by the observed water vapor induced change in Young’s modulus of a monolayer of these AuNPs. We find that macroscopic analyses of water drop–deformable surface interactions and dynamics provide both guidance to understanding and qualitatively correct predictions of the phenomena observed in our simulations.
Continuous microwave-to-optical transduction with atomic beam fluorescence
Authors: Li Chao , Sun Fuyu , Liu Jie , Li Xiaofeng , Hou Dong , Zhang Shougang
Published: October 2021

We present a method for performing microwave (MW)-to-optical transduction based on atomic beam magnetic resonance spectroscopy, where laser-induced beam fluorescence bridges two electromagnetic waves with significantly different frequencies. We experimentally demonstrate the real-time demodulation of an infrasonic wave signal encoded in a MW carrier by driving Cs beam Rabi (Ramsey) transition with a single (two separated) MW magnetic field(s), thus validating this method. A high signal-to-noise ratio (SNR) of above 90 dB was achieved for near-full modulation, and a MW field variation as small as 0.02% was detectable with a SNR > 10 dB by utilizing either of the transduction configurations. Our sensitive and continuous atomic beam MW transducers offer a promising platform for atomic communication and MW sensing.
Molecular dynamics study of six-dimensional hard hypersphere crystals
Authors: Lue Leo , Bishop Marvin , Whitlock Paula A.
Published: October 2021

Six-dimensional hard hypersphere systems in the A6, D6, and E6 crystalline phases have been studied using event-driven molecular dynamics simulations in periodic, skew cells that reflect the underlying lattices. In all the simulations, the systems had sufficient numbers of hyperspheres to capture the first coordination shells, and the larger simulations also included the complete second coordination shell. The equations of state, for densities spanning the fluid, metastable fluid, and solid regimes, were determined. Using molecular dynamics simulations with the hyperspheres tethered to lattice sites allowed the computation of the free energy for each of the crystal lattices relative to the fluid phase. From these free energies, the fluid–crystal coexistence region was determined for the E6, D6, and A6 lattices. Pair correlation functions for all the examined states were computed. Interestingly, for all the states examined, the pair correlation functions displayed neither a split second peak nor a shoulder in the second peak. These behaviors have been previously used as a signature of the freezing of the fluid phase for hard hyperspheres in two to five dimensions.
Applying phraseological complexity measures to L2 French
Authors: Vandeweerd Nathan , Housen Alex , Paquot Magali
Published: October 2021

This study partially replicates Paquot’s (2018, 2019) study of phraseological complexity in L2 English by investigating how phraseological complexity
compares across proficiency levels as well as how phraseological complexity measures relate to lexical, syntactic and
morphological complexity measures in a corpus of L2 French argumentative essays. Phraseological complexity is operationalized as
the diversity (root type-token ratio; RTTR) and sophistication (pointwise mutual information; PMI) of three
types of grammatical dependencies: adjectival modifiers, adverbial modifiers and direct objects. Results reveal a significant
increase in the mean PMI of direct objects and the RTTR of adjectival modifiers across proficiency levels. In
addition to phraseological sophistication, important predictors of proficiency include measures of lexical diversity, lexical
sophistication, syntactic (phrasal) complexity and morphological complexity. The results provide cross-linguistic validation for
the results of Paquot (2018, 2019) and
further highlight the importance of including phraseological measures in the current repertoire of L2 complexity measures.
fsca
Authors: Vandeweerd Nathan
Published: October 2021

This article reports on an open-source R package for the extraction of syntactic units from dependency-parsed
French texts. To evaluate the reliability of the package, syntactic units were extracted from a corpus of L2 French and were
compared to units extracted manually from the same corpus. The f-score of the extracted units ranged from 0.53–0.97. Although
units were not always identical between the two methods, manual and automatically-derived syntactic complexity measures were
strongly and significantly correlated (ρ = 0.62–0.97, p < 0.001), suggesting that this
package may be a suitable replacement for manual annotation in some cases where manual annotation is not possible but that care
should be used in interpreting the measures based on these units.
Living in turbulent times
Authors: Li Heng
Published: October 2021

Spoken metaphors such as “unstable situation” document a conceptual association between physical instability and difficult situations. Drawing on research in embodied cognition and conceptual metaphor, the present research examined whether people’s somatic experience can influence their attitudes toward the current COVID-19 pandemic. The hypothesis is that inducing a sensorimotor state such as physical instability can activate the associated abstract concepts such as the feelings of instability during a public health crisis. In Experiment 1, participants who sat at a wobbly table and chair believed more in and had greater concern about the coronavirus disease than participants in a stable workstation. Using a different manipulation of physical instability and a more diverse sample, Experiment 2 found that participants who stood on one foot rather than two were more likely to worry about the pandemic. Experiment 3 examined consequential behavior that might follow from respondents’ COVID-19-related attitudes. The results showed that participants who adopted a single-leg stance rather than a double-leg stance donated more money to the coronavirus treatment acceleration program aiming to stabilize the virus situation. Taken together, these findings indicate that seemingly irrelevant physical experiences can skew people’s opinions on the COVID-19 pandemic, exerting potential downstream effects on their actual behavior.
High-sensitivity Bloch surface wave sensor with Fano resonance in grating-coupled multilayer structures
Authors: Ge Daohan , Zhou Yujie , Lv Mengcheng , Shi Jiakang , Babangida Abubakar A. , Zhang Liqiang , Zhu Shining
Published: October 2021

A new type of device consisting of a lithium niobate film coupled with a distributed Bragg reflector (DBR) was theoretically proposed to explore and release Bloch surface waves for applications in sensing and detection. The film and grating made of lithium niobate (LiNbO3) were placed on both sides of the DBR and a concentrated electromagnetic field was formed at the film layer. By adjusting the spatial incidence angle of the incident light, two detection and analysis modes were obtained, including surface diffraction detection and guided Bloch detection. Surface diffraction detection was used to detect the gas molecule concentrations, while guided Bloch detection was applied for the concentration detection of biomolecule-modulated biological solutions. According to the drift of the Fano curve, the average sensor sensitivities from the analysis of the two modes were 1560 °/RIU and 1161 °/RIU, and the maximum detection sensitivity reached 2320 °/RIU and 2200 °/RIU, respectively. This study revealed the potential application of LiNbO3 as a tunable material when combined with DBR to construct a new type of biosensor, which offered broad application prospects in Bloch surface wave biosensors.
Shakespeare inThe Wilds: Experimenting withThe Tempest
Authors: Wald Christina
Published: October 2021

This article discusses the TV series The Wilds (Amazon Prime, 2020) as an adaptational experiment with Shakespeare’s The Tempest in several respects: as one of the latest complex TV shows to engage with the Shakespearean legacy, it experiments with the serialization of Shakespeare’s plot. Further, being an ‘unmarked’ adaptation that never directly refers to Shakespeare, it tests the limits as to what is ‘Shakespeare’ and what is ‘not Shakespeare’ or ‘no longer Shakespeare’ in the adaptational rhizome created by The Tempest and its reworkings, among which Lord of the Flies, Brave New World, and the TV series Lost are of particular importance for The Wilds. Changing Shakespeare’s character constellation to an all-female group of teenage castaways overseen by a female social scientist modelled on Prospero who seeks to overcome master narratives of fraternal power struggles, colonial exploitation, and patriarchal sexual oppression, The Wilds tests which changes the Shakespeare material can and perhaps needs to undergo to continue to have cultural meaning today. As part of this radical re-gendering, the series multiplies and collates Miranda, Ariel, and Caliban to interrogate contemporary girlhood and the future of intersectional feminism. The article concludes by assessing how the series appeals to differently knowing viewers, some of whom will feel invited to partake in the Tempest experiment, while others will lose Shakespeare’s tracks in The Wilds.
Outcomes of nontuberculous mycobacteria isolation among lung transplant recipients: A matched case-control with retrospective cohort study
Authors: Grimes Razelle , Cherrier Lauren , Nasar Aasya , Nailor Michael D , Walia Rajat , Goodlet Kellie J
Published: October 2021

Purpose

Lung transplant recipients are at increased risk for acquiring nontuberculous mycobacteria (NTM), but the clinical significance of NTM isolation, particularly among patients not meeting guideline-endorsed diagnostic criteria for NTM pulmonary disease, is unclear.

Methods

A case-control study of lung transplant recipients culture-positive for NTM at a large transplant center during a 7-year period (2013-2019) was performed.

Results

Twenty-nine cases were matched 1:2 to non-NTM controls. The median time to NTM isolation was 10.7 months post transplant. Only 34.5% of all cases, and half of treated cases, met diagnostic criteria for NTM pulmonary infection. All-cause mortality at 12 months was numerically higher among NTM cases versus controls (20.7% vs 8.6%, P = 0.169); however, no deaths were attributed to NTM. No increase in the 12-month rate of acute rejection was observed (27.6% vs 36.2%, P = 0.477). Recent augmented immunosuppression was associated with increased odds of NTM isolation, while azithromycin prophylaxis was associated with reduced odds of NTM isolation and was not associated with macrolide resistance. Both adverse events and actual or potential drug-drug interactions occurred in more than 90% of treated cases; these events included ocular toxicity, hearing loss, and supratherapeutic calcineurin inhibitor concentrations. Eight of the 14 treated cases (57.1%) required early antibiotic discontinuation due to adverse events or drug-drug interactions.

Conclusion

Among lung transplant recipients, most patients with NTM isolation did not meet guideline criteria for infection and had outcomes similar to non‒NTM-infected patients, which may reflect transient lung colonization by NTM rather than true disease. As adverse events are common with NTM therapy, limiting unnecessary antibiotic treatment represents an area for future antimicrobial stewardship efforts.
Aesthetic Surgery Practice Resumption in the United Kingdom During the COVID-19 Pandemic
Authors: Joji Nikita , Patel Nakul , Nugent Nora , Patel Nian , Mair Manish , Vadodaria Shailesh , Waterhouse Norman , Ramakrishnan Venkat , Sankar Thangasamy K
Published: October 2021

Background

The global COVID-19 pandemic has significantly impacted all aspects of healthcare, including the delivery of elective aesthetic surgery practice. A national, prospective data collection was carried out of the first aesthetic plastic surgery procedures performed during the COVID-19 pandemic in the United Kingdom.

Objectives

The aim of this study was to explore the challenges aesthetic practice is facing and to identify if any problems or complications arose from carrying out aesthetic procedures during the COVID-19 pandemic.

Methods

Over a 6-week period from June 15 to August 2, 2020, data were collected by means of a proforma for aesthetic plastic surgery cases. All patients had outcomes recorded for an audit period of 14 days postsurgery.

Results

The results demonstrated that none of the 371 patients audited who underwent aesthetic surgical procedures developed any symptoms of COVID-19–related illness and none required treatment for any subsequent respiratory illness.

Conclusions

No COVID-19–related cases or complications were found in a cohort of patients who underwent elective aesthetic procedures under strict screening and infection control protocols in the early resumption of elective service.
SGNNMD: signed graph neural network for predicting deregulation types of miRNA-disease associations
Authors: Zhang Guangzhan , Li Menglu , Deng Huan , Xu Xinran , Liu Xuan , Zhang Wen
Published: October 2021

MiRNAs are a class of small non-coding RNA molecules that play an important role in many biological processes, and determining miRNA-disease associations can benefit drug development and clinical diagnosis. Although great efforts have been made to develop miRNA-disease association prediction methods, few attention has been paid to in-depth classification of miRNA-disease associations, e.g. up/down-regulation of miRNAs in diseases. In this paper, we regard known miRNA-disease associations as a signed bipartite network, which has miRNA nodes, disease nodes and two types of edges representing up/down-regulation of miRNAs in diseases, and propose a signed graph neural network method (SGNNMD) for predicting deregulation types of miRNA-disease associations. SGNNMD extracts subgraphs around miRNA-disease pairs from the signed bipartite network and learns structural features of subgraphs via a labeling algorithm and a neural network, and then combines them with biological features (i.e. miRNA–miRNA functional similarity and disease–disease semantic similarity) to build the prediction model. In the computational experiments, SGNNMD achieves highly competitive performance when compared with several baselines, including the signed graph link prediction methods, multi-relation prediction methods and one existing deregulation type prediction method. Moreover, SGNNMD has good inductive capability and can generalize to miRNAs/diseases unseen during the training.
Neoadjuvant therapy versus direct to surgery for T4 colon cancer: meta-analysis
Authors: Jung Flora , Lee Michael , Doshi Sachin , Zhao Grace , Lam Tin Cheung Kimberley , Chesney Tyler , Guidolin Keegan , Englesakis Marina , Lukovic Jelena , O’Kane Grainne , Quereshy Fayez A , Chadi Sami A
Published: October 2021

Background

Despite persistently poor oncological outcomes, approaches to the management of T4 colonic cancer remain variable, with the role of neoadjuvant therapy unclear. The aim of this review was to compare oncological outcomes between direct-to-surgery and neoadjuvant therapy approaches to T4 colon cancer.

Methods

A librarian-led systematic search of MEDLINE, Embase, the Cochrane Library, Web of Science, and CINAHL up to 11 February 2020 was performed. Inclusion criteria were primary research articles comparing oncological outcomes between neoadjuvant therapies or direct to surgery for primary T4 colonic cancer. Based on PRISMA guidelines, screening and data abstraction were undertaken in duplicate. Quality assessment was carried out using Cochrane risk-of-bias tools. Random-effects models were used to pool effect estimates. This study compared pathological resection margins, postoperative morbidity, and oncological outcomes of cancer recurrence and overall survival.

Results

Four studies with a total of 43 063 patients met the inclusion criteria. Compared with direct to surgery, neoadjuvant therapy was associated with increased rates of margin-negative resection (odds ratio (OR) 2.60, 95 per cent c.i. 1.12 to 6.02; n = 15 487) and 5-year overall survival (pooled hazard ratio 1.42, 1.10 to 1.82, I2 = 0 per cent; n = 15 338). No difference was observed in rates of cancer recurrence (OR 0.42, 0.15 to 1.22; n = 131), 30-day minor (OR 1.12, 0.68 to 1.84; n = 15 488) or major (OR 0.62, 0.27 to 1.44; n = 15 488) morbidity, or rates of treatment-related adverse effects.

Conclusion

Compared with direct to surgery, neoadjuvant therapy improves margin-negative resection rates and overall survival.
Effects of structured intraoperative briefings on patient outcomes: multicentre before-and-after study
Authors: Tschan Franziska , Keller Sandra , Semmer Norbert K , Timm-Holzer Eliane , Zimmermann Jasmin , Huber Simon A , Wrann Simon , Hübner Martin , Banz Vanessa , Prevost Gian Andrea , Marschall Jonas , Candinas Daniel , Demartines Nicolas , Weber Markus , Beldi Guido
Published: October 2021

Background

Operations require collaboration between surgeons, anaesthetia professionals, and nurses. The aim of this study was to determine whether intraoperative briefings influence patient outcomes.

Methods

In a before-and-after controlled trial (9 months baseline; 9 months intervention), intraoperative briefings were introduced in four general surgery centres between 2015 and 2018. During the operation, the responsible surgeon (most senior surgeon present) briefed the surgical team using the StOP? protocol about: progress of the operation (Status), next steps (Objectives), possible problems (Problems), and encouraged asking questions (?). Differences between baseline and intervention were analysed regarding surgical-site infections (primary outcome), mortality, unplanned reoperations, and duration of hospital stay (secondary outcomes), using inverse probability of treatment (IPT) weighting based on propensity scores.

Results

In total, 8256 patients underwent surgery in the study. Endpoint data were available for 7745 patients (93.8 per cent). IPT-weighted and adjusted intention-to-treat analyses showed no differences in surgical-site infections between baseline and intervention (9.8 versus 9.6 per cent respectively; adjusted difference (AD) –0.15 (95 per cent c.i. −1.45 to 1.14) per cent; odds ratio (OR) 0.92, 95 per cent c.i. 0.83 to 1.15; P = 0.797), but there were reductions in mortality (1.6 versus 1.1 per cent; AD –0.54 (−1.04 to −0.03) per cent; OR 0.60, 0.39 to 0.92; P = 0.018), unplanned reoperations (6.4 versus 4.8 per cent; AD –1.66 (−2.69 to −0.62) per cent; OR 0.72, 0.59 to 0.89; P = 0.002), and fewer prolonged hospital stays (21.6 versus 19.8 per cent; AD –1.82 (−3.48 to −0.15) per cent; OR 0.87, 0.77 to 0.98; P = 0.024).

Conclusion

Short intraoperative briefings improve patient outcomes and should be performed routinely.
Equal cerebral perfusion during extended aortic coarctation repair
Authors: Rüffer André , Knieling Ferdinand , Cesnjevar Robert , Regensburger Adrian , Purbojo Ariawan , Dittrich Sven , Münch Frank , Wölfle Joachim , Jüngert Jörg
Published: October 2021

OBJECTIVES

Aortic coarctation with distal aortic arch hypoplasia can be effectively addressed by coarctation resection with extended end-to-end-anastomosis (REEEA). Particularly, when unilateral cerebral perfusion (UCP) is established by clamping of left-sided supra-aortic vessels, the extent of cerebral blood flow distribution during repair remains undetermined, so far. Transfontanellar contrast-enhanced ultrasound (T-CEUS) can be utilized for real-time visualization and quantitative evaluation of cerebral blood flow. This study quantitatively evaluates cerebral perfusion during REEEA by using intraoperative T-CEUS.

METHODS

In a prospective study, 9 infants with open fontanelle undergoing REEEA [median age: 13 days (range 1–34) and median weight 3.1 kg (range 2.2–4.4)] were intraoperatively examined with T-CEUS at 3 consecutive time-points: before skin incision, during UCP and after skin suture. A software-based analysis of 11 parameters was used for data evaluation. Absolute and relative blood flow in contralateral hemispheres was measured in side-by-side comparison, and referenced to baseline measurements.

RESULTS

No side-depend absolute or relative cerebral perfusion differences were found during REEEA, except for an increased relative ‘wash-out-rate’ (P = 0.0013) in favour of the right hemisphere after surgery. Compared to ipsilateral baseline levels, ‘rise time’ was transiently increased in right (P = 0.0277) and ‘time-to-peak’ in both hemispheres (right: P = 0.0403 and left: P = 0.0286), all during UCP.

CONCLUSIONS

The use of T-CEUS provided evidence for homogenous distribution of contrast agent in both hemispheres during UCP. T-CEUS can be utilized for the postprocedural evaluation of cerebral perfusion during congenital cardiac surgery.

Clinical Trial Registration

URL: http://www.clinicaltrials.gov Unique, Identifier: NCT03215628.
Impact of the initial site of recurrence on prognosis after curative surgery for primary lung cancer
Authors: Isaka Tetsuya , Ito Hiroyuki , Nakayama Haruhiko , Yokose Tomoyuki , Saito Haruhiro , Masuda Munetaka
Published: October 2021

OBJECTIVES

This retrospective study aimed to elucidate the impact of the initial site of recurrence on relapse-free survival and post-recurrence survival (PRS) after the curative resection of primary lung cancer.

METHODS

We enrolled 325 patients who developed recurrence after curative resection of pathological stage I–IIIA primary lung cancer between January 2006 and December 2018 at the Kanagawa Cancer Center. Cases were classified as follows based on the initial site of recurrence: cervicothoracic lymph node (n = 144), lung (n = 121), pleural dissemination (n = 52), bone (n = 59), brain and meningeal dissemination (n = 50) and abdominal organ (n = 34) cases. The relapse-free survival and PRS of patients with and without recurrence at each site were compared using the log-rank test. The impact of the initial site of recurrence on PRS was analysed using the Cox proportional hazards model.

RESULTS

Relapse-free survival was significantly poorer in patients with abdominal organ recurrence than in patients without abdominal organ recurrence (11.5 vs 17.6 months, P = 0.024). The PRS of patients with bone and abdominal organ recurrences was worse than that of patients without bone (18.4 vs 31.1 months, P < 0.001) or abdominal organ (13.8 vs 30.6 months, P < 0.001) recurrence. Multiple recurrence sites were observed more frequently in patients with bone and abdominal organ recurrences. Bone [hazard ratio (HR) 2.13; P < 0.001] and abdominal organ metastasis (HR 1.71; P = 0.026) were independent poor prognostic factors for PRS.

CONCLUSIONS

This study suggests surveillance for abdominal organ recurrence in the early postoperative period. Patients with bone and abdominal organ recurrence should receive multimodality treatment to improve their prognosis.
Long COVID: long-term effects?
Authors: Di Toro Alessandro , Bozzani Antonio , Tavazzi Guido , Urtis Mario , Giuliani Lorenzo , Pizzoccheri Roberto , Aliberti Flaminia , Fergnani Viola , Arbustini Eloisa
Published: October 2021

The term Long COVID (or Post COVID) describes a condition characterized by persistence of symptoms for at least 12 weeks after the onset of COVID-19. It may last several months but the duration is still matter of observation. The symptoms and the clinical manifestations are clinically heterogeneous and suggesting involvement of multi-organs/systems, including the cardiovascular system. The general recurrent symptoms include fatigue, breathlessness, myalgia, headache, loss of memory, and impaired concentration. Patients report loss of their previous psychophysical performance. Cardiovascular involvement manifests with common symptoms such as palpitations and chest pain, and, less commonly, with events such as late arterial and venous thromboembolisms, heart failure episodes, strokes or transient ischaemic attack, ‘myo-pericarditis’. The diagnostic criteria are mainly based on the narrative of the patients. Measurable biomarkers or instrumental findings or clinical events are not yet framed in a shared diagnostic framework. The open question for clinicians and researchers is whether biomarkers, electrocardiogram, non-invasive imaging, and clinical monitoring should be included in a shared diagnostic protocol aimed at defining the diagnostic path and protecting patients at risk of unexpected events.
Ablation of ventricular tachycardia in 2021
Authors: Bianchi Stefano , Cauti Filippo Maria
Published: October 2021

Nowadays, ablation of ventricular tachycardia (VT) in structural heart disease is an increasingly used procedure. In fact, it is the most effective strategy in controlling arrhythmic burden in VT patients. The ablative approaches are the result of the last 10 years of technological advances (Catheters, 3D mapping systems) and the constant study of the pathophysiological mechanisms underlying arrhythmic circuits. This presentation seeks to revisit the state of the art in the ablative treatment of VT.
Prevention of chemotherapy-induced left ventricular dysfunction
Authors: Bisceglia Irma , Canale Maria Laura , Cartoni Domenico , Matera Sabrina , Petrolati Sandro
Published: October 2021

Prevention of left ventricular dysfunction predominantly induced by anthracyclines and/or trastuzumab still represents a challenge for cardio-oncology today. Indeed, this complication threatens to limit the significant gain in cancer survival achieved to date. Oncology strategies with cumulative dose limitation, continuous infusion, dexrazoxane, and liposomal formulations have been shown to decrease the risk of anthracycline cardiotoxicity. The preventive use of ace inhibitors, sartans, and/or beta-blockers has not yet provided convincing evidence and the positive effect on left ventricular ejection fraction decline appears poor without a clear clinical relevance. Assessment of the cardiovascular risk profile is a key aspect of the baseline evaluation of any patient scheduled for cancer therapy. Control and/or correction of modifiable cardiovascular risk factors is the first form of primary prevention of cardiotoxicity. It will be necessary to select populations at higher risk of developing cardiac dysfunction, identify patients genetically predisposed to develop cardiotoxicity in order to build the most appropriate strategies to correctly and timely target cardioprotective therapies.
Coagulopathy and COVID-19
Authors: Lorini Ferdinando Luca , Di Matteo Maria , Gritti Paolo , Grazioli Lorenzo , Benigni Alberto , Zacchetti Lucia , Bianchi Isabella , Fabretti Fabrizio , Longhi Luca
Published: October 2021

SARS-CoV-2 infection is associated with frequent thrombotic events, at the micro and macro-vascular level, due to the perpetuation of a state of hypercoagulability. The so-called ‘COVID-19 associated coagulopathy’ (CAC) represents a key aspect in the genesis of organ damage from SARS-CoV-2. The main coagulative alterations described in the literature are represented by high levels of D-dimer and fibrinogen. Although CAC has some common features with disseminated intravascular coagulation and sepsis-induced coagulopathy, there are important differences between these clinical pictures and the phenotype of CAC is unique. The pathogenesis of CAC is complex and is affected by the strong interconnection between the inflammatory system and coagulation, in the phenomenon of immunothrombosis and thrombo-inflammation. Several mechanisms come into play, such as inflammatory cytokines, neutrophils, the complement system as well as an alteration of the fibrinolytic system. Finally, an altered platelet function and especially endothelial dysfunction also play a central role in the pathophysiology of CAC. Heparin has several potential effects in CAC, in fact in addition to the anticoagulant effect, it could have a direct antiviral effect and anti-inflammatory properties. The high incidence of thrombo-embolic phenomena despite the use of antithrombotic prophylaxis have led some experts to recommend the use of anticoagulant doses of heparin, but at present the optimal anticoagulant regimen remains to be determined.
How to reduce uncommon but severe transcatheter aortic valve implantation complications: stroke, thrombosis, endocarditis, cognitive decline?
Authors: Saia Francesco , Orzalkiewicz Mateusz
Published: October 2021

Transcatheter aortic valve implantation has become a valid alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis, regardless of baseline surgical risk. The incidence of periprocedural complications has steadily declined over the years, thanks to technical advancement of transcatheter heart valves, delivery systems, and increased operators’ experience. Beyond the most common periprocedural complications, there are a few uncommon but potentially severe complications that more often occur during follow-up, although they may also arise in the periprocedural phase. Stroke, infective endocarditis, valve thrombosis, and cognitive decline are among them. In this brief review, we describe the incidence, predictive factors, and potential preventive measures for those events.
Renal arteries denervation: from the treatment of resistant hypertension to the treatment of atrial fibrillation
Authors: Versaci Francesco , Sciarretta Sebastiano , Scappaticci Massimiliano , Di Pietro Riccardo , Calcagno Simone , Del Prete Armando , Gaspardone Carlo , Biondi Zoccai Giuseppe
Published: October 2021

Renal denervation (RDN) is a therapeutic strategy for patients with uncontrolled arterial hypertension characterized by considerable fluctuations during its progression. After initial strong enthusiasm, the procedure came to an abrupt halt following the publication of the Symplicity HTN-3 study results. The results of recently published studies highlight the reduction in blood pressure values after RDN and justify the inclusion in the Guidelines of new recommendations for the use of RDN in clinical practice, in selected patients. Additionally, RDN findings are summarized in view of other potential indications such as atrial fibrillation. Six prospective, randomized studies are presented that evaluated RDN as an adjunct therapy to pulmonary vein isolation for the treatment of atrial fibrillation. In five studies, patients had uncontrolled hypertension despite therapy with three antihypertensive drugs. The analysis of these studies showed that RDN reduced the recurrence of atrial fibrillation (AF) by 57% compared to patients with pulmonary vein isolation (PVI) only. Modulation of the autonomic nervous system by RDN has been shown not only to reduce blood pressure but also to have an antiarrhythmic effect in symptomatic AF patients when the strategy is combined with PVI, thus opening up new therapeutic scenarios.