bluuebunny/crossref_metadata_2025 huggingface dataset:
Patientensicherheit bei differenzierter (innerklinischer) Schockraumaktivierung für Schwerverletzte
Authors: Hagel S. , Liedtke K. R. , Bax S. , Wailke S. , Klüter T. , Behrendt P. , Franke G. M. , Seekamp A. , Langguth P. , Balandin A. , Grünewald M. , Schunk D.
Published: January 2023

Hintergrund und Fragestellung

Das Vorhalten einer Schockraumbereitschaft erfordert hohe personelle und instrumentelle Kosten. Das Ziel dieser Studie war es, die Versorgungsressourcen durch die Kategorisierung in einen A‑Schockraum und einen B‑Schockraum als modifiziertes Versorgungskonzept auf seine Sicherheit und Praktikabilität zu prüfen.

Methodik

In einer prospektiven, monozentrischen Studie wurden traumatologische Schockräume im Zeitraum von Mai 2020 bis Januar 2021 anhand der S3 Leitlinien GoR A und B Kriterien und des ABCDE-Schemas in A‑Schockräume (SR-A) oder B‑Schockräume (SR-B) eingeteilt. Die Einteilung der Schockräume erfolgte nach telefonischer Anmeldung bei dem Oberarzt der Notaufnahme. Neben den Vitalparametern bei der Patientenaufnahme wurden die Hospitalisierungsdauer sowie die Mortalität erhoben. Die Gruppenvergleiche erfolgten mittels t-Test, Chi-Quadrat-Test oder Mann-Whitney-U-Test verwendet und ein p < 0,05 als signifikant definiert.

Ergebnis

Im Studienzeitraum wurden 135 Schockräume erfasst. Davon waren 93 Schockraumanmeldungen dem SR-B- und 42 dem SR-A-Team zugeteilt worden. In der Zuweisung zeigte sich, dass bei SR-A-Trauma-Patienten in 80,5 % eine Notarztbegleitung erfolgte, während dies bei dem SR-B-Patienten bei 55,5 % lag. Der Glasgow Coma Scale (GCS) war bei den SR‑B Patienten signifikant höher. In der Notfallsonographie (eFAST) konnte in einem Fall der SR‑A und in vier Fällen des SR‑B ein traumaassoziierter pathologischer Befund festgestellt werden. Eine Übernahme auf die Intensivstation war in 26 % bei SR‑A und 3,2 % bei SR‑B notwendig. Neun SR‑A Patienten und ein SR‑B Patient verstarben innerhalb von 30 Tagen. Der Injury Severity Score (ISS) zeigte eine signifikant größere Verletzungsschwere bei den Patienten im SR‑A zu den Patienten im SR‑B (ISS 28,3 vs. 6,8).

Schlussfolgerung

Die Ergebnisse dieser Studie zeigen, dass die innerklinische Zuordnung in einen A‑ und einen B‑Schockraum nach dem Polytraumameldebild in Verbindung mit dem gemeldeten ABCDE-Status sicher anzuwenden ist. Dabei werden die personellen Schockraumressourcen effizient eingesetzt, ohne dass es einen Hinweis auf eine gesteigerte Patientengefährdung durch diese Form der Zuteilung gibt.

Graphic abstract
Effect of discharge accumulation on wire breakage in WEDM process
Authors: Wang Jun , Sánchez José A. , Izquierdo Borja , Ayesta Izaro
Published: January 2023

In recent years, WEDM has been adopted in precision machining as an important alternative machining method because of its greater flexibility and lower wear cost compared with traditional machining, whereas wire breakage during WEDM is an unignorable problem that influences the machining quality and efficiency. Therefore, it has been a research topic of considerable interest. This work focuses on exploring the reason for the wire breakage. Firstly, by observing the wire after discharges and using the finite element method, a complete thermal model considering both latent heat and flushing efficiency was built. With this model, the simulation of the crater on the wire was finished. Then based on the result gotten from the simulation and experiment, the heat partition ratio to the wire was found as 46.74% by inverse fitting. After that, a wire breakage experiment was done and through locating the position of 50 discharges before wire breakage it is found that 34% of discharges were located within a range of 2 mm, and the minimum area in the wire cross-section only remained 41.88% compared with the original wire. This kind of decrease in the cross-section area made the stress higher than the UTS of the wire and caused the wire breakage. The findings of this work allow for a more in-depth understanding of the effect of discharge accumulation on wire breakage.
Risk Stratification of Patients with Marginal Hepatic Functional Reserve Using the Remnant Hepatocyte Uptake Index in Gadoxetic Acid‐Enhanced Magnetic Resonance Imaging for Safe Liver Surgery
Authors: Akabane Miho , Shindoh Junichi , Kobayashi Yuta , Okubo Satoshi , Matsumura Masaru , Hashimoto Masaji
Published: January 2023

Background

This study aimed to explore the efficacy of gadoxetic acid‐enhanced (Gd‐EOB) magnetic resonance imaging (MRI) in surgical risk estimation among patients with marginal hepatic function estimated by indocyanine green (ICG) clearance test.

Methods

This analysis focused on 120 patients with marginal hepatic functional reserve (ICG clearance rate of future liver remnant [ICG‐Krem] < 0.10). Preoperative Gd‐EOB MRI was retrospectively reviewed, and the remnant hepatocyte uptake index (rHUI) was calculated for quantitative measurement of liver function. The predictive power of rHUI for posthepatectomy liver failure was compared with several clinical measures used in current risk estimation before hepatectomy.

Results

Receiver operating curve analysis showed that rHUI had the best predictive power for posthepatectomy liver failure among the tested variables (ICG‐R15, ICG‐Krem, albumin + bilirubin score, and albumin + ICG‐R15 score). Cross‐validation showed that a threshold of 925 could be the best cut‐off value for estimating the postoperative risk of liver failure with sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 0.689, 0.884, 5.94, and 0.352, respectively.

Conclusion

rHUI could be a sensitive substitute measure for posthepatectomy liver failure risk estimation among patients with marginal hepatic functional reserve.
The Effects of Chronic Steroid Use on Postoperative Complications Following Thyroidectomy
Authors: Koh Elizabeth S. , Chen Frank R. , Chen Sophia , Quan Theodore , Leung Karen L. , Yang Jason
Published: January 2023

Background

Patients undergoing thyroidectomy are sometimes on chronic steroids for underlying disease. This study examined the postoperative risk profile of thyroidectomy patients on chronic steroids.

Methods

Patients in the National Surgical Quality Improvement Program (NSQIP) database who underwent thyroidectomy were sorted by presence or absence of chronic steroid use. Clinicodemographics, comorbidities, and postoperative complications were recorded and compared between the two. Univariate and multivariate analyses compared the groups and calculated odds ratios (OR).

Results

We identified 42,857 patients. 41,903 (97.8%) patients were not on chronic steroids, while 954 (2.2%) were. Most underwent total thyroidectomy (18,748, 43.75%) or total lobectomy (16,323, 38.09%). Following univariate and multivariate analyses, patients on chronic steroids had increased risk of postoperative bleeding and transfusions (OR = 0.375, p = 0.046, 95% CI 0.223–0.988), open wound infection (OR = 0.226, p < 0.001, 95% CI 0.117–0.437), pulmonary embolism (OR = 0.312, p = 0.034, 95% CI 0.106–0.918), and ventilator use > 48 h (OR = 0.401, p < 0.008, 95% CI 0.205–0.785).

Conclusions

Chronic steroid use prior to thyroidectomy is an independent risk factor for multiple postoperative complications, namely postoperative bleeding and transfusions, open wound infection, pulmonary embolism, and ventilator use over 48 h. Patients on chronic steroids should be medically optimized before thyroidectomy to reduce the risk of potentially life‐threatening complications.
Phytotoxic Interference of Culture Filtrates of Endophytic Bacteria Associated with Nerium oleander Leaf Against Seed Germination of the Invasive Noxious Weed Cenchrus echinatus
Authors: Hagaggi Noura Sh. A. , Abdul-Raouf Usama M.
Published: January 2023

Weeds cause destructive agricultural losses, so weed control is an urgent challenge facing agriculture. The extensive use of synthetic chemical herbicides has detrimental environmental impacts and promotes the emergence of resistant species. Therefore, in this study we tried to find a new natural weed control that can ensure biosafety and eco-sustainability. The phytotoxic potential of culture filtrates of the endophytes Bacillus inaquosorum NL1 and Bacillus safensis NL2 isolated from Nerium oleander leaf against the invasive harmful weed species Cenchrus echinatus was evaluated. Culture filtrates of both bacterial species exhibited potent phytotoxic activity, which resulted in 100% germination inhibition of C. echinatus. The chemical analysis of culture filtrates revealed high contents of total phenolics and n-alkanes that have phytotoxic effects against seed germination. According to the findings of this study the endophytic bacteria associated with N. oleander leaf can be used in the future to develop a sustainable bio-herbicide formulation.
Strain-modulated Rashba spin splitting and optical absorption of MoSSe/WSe$$_2$$ heterostructures
Authors: Xuan Wenhua , Yang Ningjing , Luo Jinlong , Wang Rongli , Yang Hai , Jin Guojun
Published: January 2023

Effective modulation of electronic and optical properties for van der Waals heterostructures is beneficial to spintronics and optoelectronic devices. We use first-principle calculations to investigate the effects of intralaminar biaxial strain on the Rashba spin splitting and optical absorption of MoSSe/WSe$$_2$$

2

heterostructures. First, considering the different stacking manners, the most stable configuration is confirmed from six heterostructures. The results show that this is in type II energy band alignment, which effectively reduces the carrier recombination rate. Second, Rashba splitting strength can be effectively modulated by biaxial strain, and splitting occurs at the $$\Gamma $$
Γ
point, in which the tensile and compressive strains can suppress and promote the strength, respectively. Third, we calculate the dielectric constant and optical absorption of the MoSSe/WSe$$_2$$

2

heterostructure and find a higher optical absorption coefficient in visible light scope than two monolayers, and the maximum value can reach 6.11$$\times $$
×
$$10^5$$

10
5

cm$$^{-1}$$

-
1

. The first absorption peak of the heterostructure increases with increasing tensile strain and the absorption edge is red shifted. On the contrary, there is an opposite effect under compressive strain. These results suggest that MoSSe/WSe$$_2$$

2

heterostructures have potential applications in strain-tunable spintronic and optoelectronic devices.
Contribution of cryptochromes and photolyases for insect life under sunlight
Authors: Deppisch Peter , Kirsch Valentina , Helfrich-Förster Charlotte , Senthilan Pingkalai R.
Published: January 2023

The cryptochrome/photolyase (CRY/PL) family is essential for life under sunlight because photolyases repair UV-damaged DNA and cryptochromes are normally part of the circadian clock that controls the activity–sleep cycle within the 24-h day. In this study, we aim to understand how the lineage and habitat of an insect affects its CRY/PL composition. To this end, we searched the large number of annotated protein sequences of 340 insect species already available in databases for CRY/PLs. Using phylogenetic tree and motif analyses, we identified four frequent CRY/PLs in insects: the photolyases 6-4 PL and CPDII PL, as well as the mammalian-type cryptochrome (MCRY) and Drosophila-type cryptochrome (DCRY). Assignment of CRY/PLs to the corresponding insects confirmed that light-exposed insects tend to have more CRY/PLs than insects with little light exposure. Nevertheless, even insects with greatly reduced CRY/PLs still possess MCRY, which can be regarded as the major insect cryptochrome. Only flies of the genus Schizophora, which includes Drosophila melanogaster, lost MCRY. Moreover, we found that MCRY and CPDII PL as well as DCRY and 6-4 PL occur very frequently together, suggesting an interaction between the two pairs.
Modified surgical anchor refixation in older patients with acute proximal hamstring rupture: clinical outcome, patient satisfaction and muscle strength
Authors: Chocholáč Tomáš , Bühl Linda , Nüesch Corina , Bleichner Niklas , Mündermann Annegret , Stoffel Karl
Published: January 2023

Introduction

After conventional surgical refixation of the hamstrings after proximal hamstring rupture, patients frequently experience pain while sitting and deficits in hamstring muscle strength of the operated side. To improve these outcomes, we have modified the surgical anchor placement and have carried out a thorough follow-up examination.

Materials and methods

Thirteen older patients (8 female, 5 males) with a median age of 64.2 (range, 52.1–80.4) years were surgically treated for acute proximal hamstring rupture using modified anchor placement and participated in a follow-up assessment at a median of 46.2 (11.2–75.0) months after surgery. Patients completed the Perth Hamstring Assessment Tool (PHAT), quality of life questionnaire (EQ-5D-5L) and the Lower Extremity Functional Scale (LEFS), and rated their satisfaction level on a scale from 0 to 100%. Local tenderness on the ischial tuberosity and maximum passive hip flexion were measured on both limbs. Maximum isokinetic knee flexor muscle strength was measured bilaterally using a dynamometer.

Results

The median (range) PHAT, EQ-5D-5L and LEFS score were 78.8/100 (54.6–99.8), 0.94/1 (0.83–1) and 88.75/100 (61.25–100). The median satisfaction was 100% (90–100%). Only one patient felt discomfort when the ischial tuberosity was palpated. Neither maximum passive hip flexion nor maximum isokinetic flexor muscle strength differed between the operated and non-operated side (P > 0.58). Clinical scores did not correlate with the leg symmetry index of knee flexor muscle strength (Spearman’s rho < 0.448, P > 0.125). There were no tendon re-ruptures, or postoperative sciatic radiculopathy, at the time of follow-up.

Conclusions

The modified extra-anatomical anchor placement resulted in good clinical and functional outcome of surgical repair of acute proximal hamstring rupture. Especially the absence of postoperative pain while sitting and the comparable muscle strength to the contralateral side is promising.

Clinical trial registration

ClinicalTrials.gov Identifier: NCT04867746, registered.
Neurofilament light (NfL) as biomarker in serum and CSF in status epilepticus
Authors: Margraf Nils G. , Dargvainiene Justina , Theel Emily , Leypoldt Frank , Lieb Wolfgang , Franke Andre , Berger Klaus , Kuhle Jens , Kuhlenbaeumer Gregor
Published: January 2023

Objective

We explored the potential of neurofilament light chain (NfL) in serum and cerebrospinal fluid as a biomarker for neurodestruction in status epilepticus.

Methods

In a retrospective analysis, we measured NfL in serum and cerebrospinal fluid samples of patients with status epilepticus using a highly sensitive single-molecule array technique (Simoa). Status epilepticus was diagnosed according to ILAE criteria. Additionally, we employed an alternative classification with more emphasis on the course of status epilepticus. We used data from three large control groups to compare NfL in status epilepticus versus neurologically healthy controls.

Results

We included 28 patients (mean age: 69.4 years, SD: 15 years) with a median status duration of 44 h (IQR: 80 h). Twenty-one patients (75%) suffered from convulsive status epilepticus and seven (25%) from non-convulsive status epilepticus. Six patients died (21%). Cerebrospinal fluid and serum NfL concentrations showed a high correlation (r = 0.73, p < 0.001, Pearson). The main determinant of NfL concentration was the status duration. NfL concentrations did not differ between convulsive status epilepticus and convulsive status epilepticus classified according to the ILAE or to the alternative classification without and with adjusting for status duration and time between status onset and sampling. We found no association of NfL concentration with death, treatment refractoriness, or prognostic scores.

Conclusion

The results suggest that neurodestruction in status epilepticus measured by NfL is mainly determined by status duration, not status type nor therapy refractoriness. Therefore, our results suggest that regarding neurodestruction convulsive and non-convulsive status epilepticus are both neurological emergencies of comparable urgency.
Impact of intravitreal injection therapy on contrast sensitivity in patients with nAMD and DME
Authors: Dieke Sebastian , Wurche Stefanie , Ruebsam Anne , Wirbelauer Christopher , Joussen Antonia M. , Winterhalter Sibylle
Published: January 2023

Purpose

The study aims to evaluate changes in contrast sensitivity (CS) during therapy with intravitreal vascular endothelial growth factor (VEGF) inhibitors in patients with neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME).

Methods

Prospective, uncontrolled, multicenter study on patients with neovascular AMD or DME who underwent intravitreal injection therapy with Ranibizumab, Aflibercept, or Bevacizumab was conducted. Best corrected visual acuity (BCVA) and CS measured by Mars Letter Contrast Sensitivity Test (MLCS) and Freiburg Visual Acuity and Contrast Test (FrACT) in logCS were evaluated before 3 consecutive VEGF inhibitor injections, which followed the pro renata regimen in treatment-naïve and pretreated eyes with a maximum of 9 injections. Correlation of MLCS and FrACT was calculated by the Spearman’s rank correlation coefficient.

Results

Eighty eyes of 74 patients (mean age 72.7; SD ± 9.96) were included. BCVA improved significantly from 0.44 (SD ± 0.21) logMAR to 0.38 (SD ± 0.23) logMAR by 0.06 (SD ± 0.14) logMAR values (p < 0.001). CS measured by MLCS increased significantly from 1.27 (SD ± 0.25) logCS to 1.39 (SD ± 0.22) logCS (p < 0.001). CS measured by FrACT also improved significantly from 1.22 (SD ± 0.32) logCS to 1.30 (SD ± 0.29) logCS (p = 0.035). A positive correlation between MLCS and FrACT was found (r = 0.389; p < 0.001). Despite statistical significance, results for BCVA, MLCS, and FrACT failed clinical significance. Overall best test results were achieved with MLCS.

Conclusions

Intravitreal injection therapy with VEGF inhibitors led to an improvement of BCVA and CS measured by MLCS and FrACT. MLCS was superior and more sensitive compared to FrACT and even BCVA to evaluate CS in elderly patients with macular pathology.
Developmental and age differences in visuomotor adaptation across the lifespan
Authors: Ruitenberg Marit F. L. , Koppelmans Vincent , Seidler Rachael D. , Schomaker Judith
Published: January 2023

In the present cross-sectional study, we examined age and sex differences in sensorimotor adaptation. We tested 253 individuals at a local science museum (NEMO Science Museum, Amsterdam). Participants spanned a wide age range (8–70 years old; 54% male), allowing us to examine effects of both development and healthy aging within a single study. Participants performed a visuomotor adaptation task in which they had to adapt manual joystick movements to rotated visual feedback. We assessed the rate of adaptation following the introduction of the visual perturbation (both for early and later stages of adaptation), and the rate of de-adaptation following its removal. Results showed reliable adaptation patterns which did not differ by sex. We observed a quadratic relationship between age and both early adaptation and de-adaptation rates, with younger and older adults exhibiting the fasted adaptation rates. Our findings suggest that both younger and older age are associated with poorer strategic, cognitive processes involved in adaptation. We propose that developmental and age differences in cognitive functions and brain properties may underlie these effects on sensorimotor functioning.
Teenagers’ and parental attitudes towards the use of placebo pills
Authors: de Bruijn Clara M.A. , Benninga Marc A. , Vlieger Arine M.
Published: January 2023

The placebo response a significant therapeutic improvement after a placebo intervention — can be high in children. The question arises of how optimal advantages of placebo treatment in pediatric clinical care be achieved. In this era of shared-decision making, it is important to be aware of patients’ and parental attitudes. Therefore, the aim of the current study was to assess teenagers’ and parental views on the use of placebo pills in pediatric clinical care. All patients (aged 12–18 years) and parents of children (aged 0–18 years), visiting the pediatric outpatient clinic between March 2020 through December 2020, were invited to participate in this study multicenter survey study. Of 1644 distributed questionnaires: 200/478 (47%) teenagers and 456/1166 (45%) parents filled out the complete survey. More parents were positive towards prescribing placebo medication than teenagers (80% vs. 71%, p = .019), especially when the clinician disclosed the use of a placebo to parents and teenagers, respectively (76% vs. 55%, p = .019). Increasing age of teenagers was positively associated with the willingness for placebo interventions (OR 0.803, 95%CI 0.659–0.979), as was a higher level of parental education (OR 0.706, 95%CI 0.526–0.949).

  Conclusion: This study emphasizes the willingness of teenagers and parents to receive placebo medication. Placebo medication becoming more acceptable and integrated into daily care may contribute to a decrease in medication use.

What is Known:• A placebo is a treatment without inherent power to produce any therapeutic effect, but can result in significant therapeutic improvement, the so-called placebo response.• Treatment response rates after placebo interventions in children can be high, ranging from 41 to 46% in pediatric trials.

What is New:• Most teenagers (71%) and parents (80%) find it appropriate for healthcare professionals to prescribe placebo medication.• Compared to adult care, pediatrics has a unique feature to disclose placebo treatment to parents while concealing it for the young patient: the majority of teenagers (85%) and parents (91%) agree to disclose placebo treatment to parents exclusively.
Gutted: constipation in children with chronic kidney disease and on dialysis
Authors: Wan Mandy , King Lillian , Baugh Natasha , Arslan Zainab , Snauwaert Evelien , Paglialonga Fabio , Shroff Rukshana
Published: January 2023

Functional constipation is a common problem in otherwise healthy children. Children with chronic kidney disease (CKD) and on dialysis have additional disease-related risk factors including the uremic milieu, fluid and dietary restrictions, and decreased physical activity, as well as treatment-related risk factors such as dialysis therapy and polypharmacy that contribute to and compound the problem. Constipation causes significant distress for children and their caregivers. In children on peritoneal dialysis, severe constipation can impede catheter function and ultrafiltration. Accumulating evidence points to a possible bidirectional relationship between constipation and CKD, potentially mediated by gut dysbiosis with consequent increased generation of gut-derived uremic toxins and disruption of intestinal epithelium integrity leading to translocation of noxious luminal contents into the circulation inducing systemic inflammation. Effective management of constipation is required but there is little published data on the safety and effectiveness of treatments in adults or children with CKD. In this review, we discuss the diagnosis and epidemiology of functional constipation, provide an overview of its pathophysiology, summarize the therapeutic management, and reflect on the challenges in children with CKD.
Importance of temporary and permanent snow for new second homes
Authors: Falk Martin Thomas , Hagsten Eva , Lin Xiang
Published: January 2023

This study investigates empirically how natural snow depth and permanent snow affect the number of new second homes in Norway. One out of four Norwegian municipalities is partly covered by glaciers and permanent snow. In the winter seasons of 1983–2020, there is a decline in snow depth from 50 to 35 cm on average (based on 41 popular second-home areas in the mountains). Results of the fixed effects Poisson estimator with spatial elements show that there is a significant and positive relationship between natural snow depth in the municipality and the number of second homes started. There is also a significant and negative relationship between the number of new second homes in the municipality and a scarcity of snow in the surrounding municipalities. However, the magnitude of both effects is small. Estimates also show a strong positive relationship between the proportion of surface covered by permanent snow or glaciers in the municipality and new second homes. This implies that a decline in permanent snow and glaciers may make these areas less attractive for the location of second homes.
Self-efficacy and coping style in relation to psychological distress and quality of life in informal caregivers of patients with head and neck cancer: a longitudinal study
Authors: van Hof Kira S. , Hoesseini Arta , Verdonck-de Leeuw Irma M. , Jansen Femke , Leemans C. René , Takes Robert P. , Terhaard Chris H. J. , Baatenburg de Jong Robert J. , Sewnaik Aniel , Offerman Marinella P. J.
Published: January 2023

Objective

In order to understand how informal caregivers of head and neck cancer (HNC) patients deal with the consequences of the disease, we investigated their self-efficacy and coping style in relation to symptoms of anxiety and depression (distress) and quality of life (QoL) over time. In addition, factors associated with self-efficacy and coping style were investigated.

Methods

A total of 222 informal caregivers and their related HNC patients were prospectively followed as part from the multicenter cohort NETherlands QUality of life and Biomedical cohort studies In Cancer (NET-QUBIC). Self-efficacy and coping style were measured at baseline, and distress and QoL at baseline and 3, 6, 12, and 24 months after treatment.

Results

Informal caregivers had a high level of self-efficacy comparable with patients. Caregivers used “seeking social support,” “passive reacting,” and “expression of emotions” more often than patients. Factors associated with self-efficacy and coping were higher age and lower education. Higher self-efficacy was related with better QoL and “active tackling” was associated with less depression symptoms. “Passive reacting” and “expression of emotions” were associated with higher psychological distress and reduced QoL.

Conclusion

Among informal caregivers of HNC patients, higher self-efficacy and “active tackling” were associated with better functioning over time, while “passive reacting” and “expression of negative emotions” were associated with worse functioning. Awareness of the differences in self-efficacy skills and coping and their relationship with QoL and psychological distress will help clinicians to identify caregivers that may benefit from additional support that improve self-efficacy and “active tackling” and reduce negative coping styles.
Quality of CAD-CAM inlays placed on aged resin-based composite restorations used as deep margin elevation: a laboratory study
Authors: Theisen Catherine E. R. , Amato Julia , Krastl Gabriel , Attin Thomas , Blatz Markus B. , Weiger Roland , Eggmann Florin
Published: January 2023

Objectives

To assess the impact of the age of resin-based composite (RBC) restorations used for deep margin elevation (DME) on the marginal quality and fracture resistance of inlays.

Materials and methods

Permanent human molars with direct RBC restorations, involving the mesial, occlusal, and distal surface (MOD), were allocated to four groups (each n = 12). Half of the teeth underwent thermomechanical loading including 240,000 occlusal load cycles and 534 thermal cycles (TML, 5 °C/55 °C; 49 N, 1.7 Hz). With RBC left in one proximal box as DME, all teeth received MOD inlays, made from lithium disilicate (LDS) or a polymer-infiltrated ceramic network material (PICN). The restored teeth underwent TML including 1.2 million occlusal cyclic loadings and 2673 thermal cycles. The marginal quality was assessed at baseline and after both runs of TML. Load-to-fracture tests were performed. The statistical analysis comprised multiple linear regressions (α = 0.05).

Results

Simulated aging of RBC restorations had no significant effect on the marginal quality at the interface between the RBC and the tooth and the RBC and the inlay (p ≥ 0.247). Across time points, higher percentages of non-continuous margin were observed between the inlay and the tooth than between the tooth and the RBC (p ≤ 0.039). The age of the DME did not significantly affect the fracture resistance (p ≥ 0.052).

Conclusions

Artificial aging of RBC restorations used for DME had no detrimental effect on the marginal quality and fracture resistance of LDS and PICN inlays.

Clinical relevance

This laboratory study suggests that—in select cases—intact, direct RBC restorations not placed immediately before the delivery of an indirect restoration may be used for DME.
Gemcitabine alters sialic acid binding of the glycocalyx and induces inflammatory cytokine production in cultured endothelial cells
Authors: Gunji Mariko , Sawa Chika , Akiyama Minako , Mukai Shumpei , Takaki Takashi , Kang Dedong , Honda Kazuho
Published: January 2023

Gemcitabine (GEM) is an anticancer drug inhibiting DNA synthesis. Glomerular thrombotic microangiopathy (TMA) has been reported as an adverse effect. However, the precise mechanism of GEM-induced endothelial injury remains unknown. Cultured human umbilical vein endothelial cells (HUVECs) in the confluent phase were exposed to GEM (5–100 μM) for 48 h and evaluated cell viability and morphology, lectin binding concerning sialic acid of endothelial glycocalyx (GCX), and immunofluorescent staining of platelet–endothelial cell adhesion molecule (PECAM) and vascular endothelial growth factor receptor 2 (VEGFR2). The mRNA expression of α2,6-sialyltransferase (ST6Gal1), sialidase (neuraminidase-1: NEU-1), and interleukin (IL)-1β and IL-6 was also evaluated. GEM exposure at 5 μM induced cellular shrinkage and intercellular dissociation, accompanied by slight attenuation of PECAM and VEGFR2 immunostaining, although cell viability was still preserved. At this concentration, lectin binding showed a reduction of terminal sialic acids in endothelial GCX, probably associated with reduced ST6Gal1 mRNA expression. IL-1β and IL-6 mRNA expression was significantly increased after GEM exposure. GEM reduced terminal sialic acids in endothelial GCX through mRNA suppression of ST6Gal1 and induced inflammatory cytokine production in HUVECs. This phenomenon could be associated with the mechanism of GEM-induced TMA.
Applied multivariate statistical analysis as a tool for assessing groundwater reactions in the Niebla-Posadas aquifer, Spain
Authors: Scheiber Laura , Jurado Anna , Pujades Estanislao , Criollo Rotman , Suñé Enric Vázquez
Published: January 2023

In the current context of population growth and climate change, it is essential to effectively manage groundwater resources, to improve their quality, and to determine the behaviour of certain contaminants. Groundwater quality can be worsened most often by anthropogenic factors but can also be altered by natural factors depending on the chemical signatures of water sources (i.e., hydrochemical reactions) as a result of mixing processes. In these cases, the use of mixing calculations and multivariate statistical analysis (MSA) methods is crucial for determining the reactions that occur, the origin and fate of the detected compounds, ions or parameters, and the behaviour of the system. Thus, these methods ascertain processes that affect the chemical composition (i.e., quality) of groundwater bodies, and this information is needed for designing groundwater management strategies that exploit aquifers in a sustainable way. However, these methods are rarely employed, as few investigations that consider them focus on urban aquifers. Here, mixing calculations and other MSA methods that consider major ions and environmental isotopes are utilized in an aquifer located in a rural area associated with the Niebla-Posadas aquifer, Spain, where groundwater quality has deteriorated due to geogenic factors. This study proves the usefulness of these methods for deriving essential information that is needed (1) to properly manage the exploitation of aquifers, (2) to avoid the deterioration of groundwater bodies, and (3) to identify the reasons behind poor groundwater quality.
SARS-CoV-2 infection and SLE: endothelial dysfunction, atherosclerosis, and thrombosis
Authors: Płazak Wojciech , Drabik Leszek
Published: January 2023

An increased risk of atherosclerotic and thrombotic complications characterizes connective tissue diseases. Endothelial dysfunction is the basis for the initiation and progression of atherosclerosis and thrombosis. We present systemic lupus erythematosus (SLE) as a model rheumatic disease with endothelial dysfunction and discuss its mechanisms, factors that influence the early onset and rapid progression of atherosclerosis, and the increased risk of thromboembolic events. We focus on established methods to improve endothelium function, including statins, antiplatelet, and antithrombotic therapy. Hypercoagulable and hypofibrinolitic states and a hyperinflammatory response characterize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Several pathogenic mechanisms are typical for an acute phase of Covid-19 post-Covid syndrome and connective tissue diseases: endothelial dysfunction, elevated antiphospholipid antibody titer, activation of the complement system, and formation of extracellular neutrophil traps (NET). The current review discusses the mechanisms underlying SLE and the COVID-19 in the context of endothelial function, atherosclerosis, and thrombosis (Graphical abstract).

Key Points• The pathophysiology of systemic lupus erythematosus (SLE) and Covid-19 shows some similarities, such as endothelial cell activation and dysfunction, the activation of complementary systems, the presence of antiphospholipid antibodies, and the formation of extracellular neutrophil traps.• Autoimmunity in both diseases creates the basis for hyperinflammatory, hypercoagulable, and hypofibrinolitic states and their thromboembolic complications.• This paper presents our perspective on the mechanisms behind the cardiovascular manifestations of SLE and COVID-19, with a particular emphasis on endothelial dysfunction.

Graphical abstract

Covid-19 and systemic lupus erythematosus—potential similarities in pathophysiology. Figures of the panel illustrate the clinical manifestations of endothelial dysfunction, atherosclerosis, and thromboembolism, including coronary artery disease ([A] coronary angiography with left anterior descending artery stenosis and [B] scintigraphy with reduced perfusion in the myocardial apical segments), stroke ([C] carotid angiography, left carotid artery occlusion) and pulmonary embolism ([D]computed tomography with thrombus in the right pulmonary artery).
Gender-specific outcomes of deep brain stimulation for Parkinson’s disease — results from a single movement disorder center
Authors: Kübler Dorothee , Astalosch Melanie , Gaus Verena , Krause Patricia , de Almeida Marcelino Ana Luísa , Schneider Gerd-Helge , Kühn Andrea
Published: January 2023

Introduction and goal

The
investigation of gender differences in treatment response is crucial for effective personalized therapies. With only 30%, women are underrepresented in trials for deep brain stimulation (DBS) in Parkinson’s disease (PD). It is therefore important to evaluate gender-specific outcomes of DBS in PD in order to improve therapeutic counseling.

Methods

We analyzed clinical outcome parameters of 203 patients with PD that underwent DBS surgery targeting the subthalamic nucleus (STN) at our movement disorder center. A total of 27.6% of patients were female and 72.4% male. Motor and non-motor scores were compared before and 1 year after DBS surgery (1y FU) using Wilcoxon signed-rank tests and gender specific outcomes were analyzed with chi-square tests.

Results

At 1y FU, we found significant improvement in UPDRS II, UPDRS III (35.78 ± 36.14% MedOFF vs. StimON-MedOFF), UPDRS IV, depression (BDI-II), and health-related disability as (ADL) that showed no gender-specific differences. No significant change was revealed for UPDRS I, QUIP, and DemTect for the entire cohort. However, when analyzing both groups separately, only women improved in general cognition (plus 1.26 ± 3.03 DemTect points, p = 0.014*), whereas only men ameliorated in depression (minus 1.97 ± 6.92 BDI-II points, p = 0.002**) and impulsivity (minus 2.80 ± 7.27 QUIP points, p = 0.004**). Chi-square tests, however, revealed no significant differences between genders.

Conclusion and outlook

STN-DBS is a highly effective treatment for motor and non-motor symptoms of PD for both women and men but our study hints towards gender-specific outcomes in non-motor-domains like cognition, depressive symptoms, and impulsivity. To explore this in more detail, larger cohorts need to be investigated in multicenter trials.
Realistic details impact learners independently of split-attention effects
Authors: Skulmowski Alexander
Published: January 2023

Realistic visualizations are considered to introduce the risk of distracting learners from relevant information. In two experiments, the interplay between realism and a known form of distraction, the split-attention effect, were investigated. This effect describes that spatially separating relevant information can have a substantial negative effect on learning. The experiments were conducted using short anatomy learning tasks to test whether a combination of realism and split attention would lead to the worst retention performance or, alternatively, whether realism can counteract the negative effects of split attention. The first experiment (n = 125) revealed that realism attenuated the cognitive load induced by split attention, suggesting a compensatory effect of realism (i.e., realism may have helped learners to deal with the detrimental influence of split attention). However, retention performance was not impacted in a similar way, indicating that this compensatory effect on subjective cognitive load may actually be the result of learners’ illusion that realistic details are helpful. Split attention significantly reduced retention performance. Experiment 2 (n = 152) resulted in negative effects of realism and split attention on retention. In sum, the experiments suggest that realistic details can affect learners independently of other visual design factors as exemplified by the split-attention effect. Thus, the assumption that realism is likely to distract learners is rendered implausible by the experiments, as the distraction of split attention should have amplified any distractive potential of realistic details. However, the results also suggest that the effects of realism on learning are still somewhat unpredictable.
Real-world evidence with magnetic sphincter augmentation for gastroesophageal reflux disease: a scoping review
Authors: Froiio Caterina , Tareq Ahmad , Riggio Valentina , Siboni Stefano , Bonavina Luigi
Published: January 2023

Background

The burden of gastroesophageal reflux disease (GERD) is high, with up to 30% of the Western population reporting reflux-related symptoms with or without hiatal hernia. Magnetic sphincter augmentation (MSA) is a standardized laparoscopic procedure for patients who are dissatisfied with medical therapy and for those with early-stage disease who would not usually be considered ideal candidates for fundoplication. The MSA device is manufactured in different sizes and is designed to augment the physiologic barrier to reflux by magnetic force.

Methods

An extensive scoping review was performed to provide a map of current evidence with respect to MSA, to identify gaps in knowledge, and to make recommendations for future research. All the authors contributed to the literature search in PubMed and Web of Science and contributed to summarizing the evidence.

Results

Magnetic sphincter augmentation, especially in combination with crural repair, is effective in reducing GERD symptoms, proton pump inhibitor use, and esophageal acid exposure, and in improving patients’ quality of life. Safety issues such as device erosion or migration have been rare and not associated with mortality. The MSA device can be removed laparoscopically if necessary, thereby preserving the option of fundoplication or other therapies in the future. Contraindication to scanning in high-power Tesla magnetic resonance systems remains a potential limitation of the MSA procedure. High-resolution manometry and functional lumen imaging probes appear to be promising tools to predict procedural outcomes by improving reflux control and reducing the incidence of dysphagia.

Conclusion

A consensus on acquisition and interpretation of high-resolution manometry and impedance planimetry data is needed to gain better understanding of physiology, to improve patient selection, and to pave the way for a personalized surgical approach in antireflux surgery.
Predictors of the difficulty of transcervical subcarinal lymph node dissection for esophageal cancer
Authors: Furuke Hirotaka , Konishi Hirotaka , Fujiwara Hitoshi , Shiozaki Atsushi , Ohashi Takuma , Shimizu Hiroki , Arita Tomohiro , Yamamoto Yusuke , Morimura Ryo , Kuriu Yoshiaki , Ikoma Hisashi , Kubota Takeshi , Okamoto Kazuma , Otsuji Eigo
Published: January 2023

Background

Transmediastinal radical esophagectomy (TME) is a new minimally invasive approach without thoracotomy. However, the transcervical dissection of subcarinal lymph nodes (SCLN) is challenging. The shape or narrowness of the mediastinal space, particularly around the aortic arch to the tracheal bifurcation, may increase the difficulty of this procedure. The present study aimed to clarify predictors of the difficulty of transcervical SCLN dissection.

Methods

Patients who underwent TME between 2016 and 2019 were included (n = 126). Four indicators, the cervical angle, carina distance, aorta distance, and sternum distance, were defined as indicators of mediastinal narrowness by 3D-CT. The relationships between the difficulty of transcervical SCLN dissection and clinicopathological features, including the above indicators, were investigated.

Results

In a univariate analysis, the cervical angle (p = 0.023), aorta distance (p = 0.002), and middle thoracic tumor (p = 0.040) correlated with difficulty. The median cervical angle and aorta distance were 15° and 33 mm in difficult cases and 19° and 43 mm in easy cases, respectively. In a multivariate analysis, the short aorta distance (odds ratio: 7.96, p = 0.002) and middle thoracic tumor (odds ratio: 3.35, p = 0.042) were independent predictive factors.

Conclusions

The cervical angle, aorta distance, and middle thoracic tumor may predict the difficulty of transcervical SCLN dissection. In difficult cases, a transhiatal approach should be combined for complete SCLN dissection.
Phylogeny and Genetic Diversity of Philippine Native Pigs (Sus scrofa) as Revealed by Mitochondrial DNA Analysis
Authors: Banayo Joy B. , Manese Kathlyn Louise V. , Salces Agapita J. , Yamagata Takahiro
Published: January 2023

Philippine native pigs (PhNP) are small black pigs domesticated in rural communities in the Philippines. They are valued locally for their various sociocultural roles. Recently, considerable literature has accumulated in the field of native pig production and marketing. However, there is limited research on the genetic diversity of PhNP. No previous study has investigated the evolutionary relatedness among native pigs from various islands and provinces in Luzon and the Visayas, Philippines. In addition, a much debated question is whether the PhNP were interbreeding with or even domesticated from endemic wild pigs. This study aims to clarify some of the uncertainties surrounding the identity and classification of PhNP based on mitochondrial DNA (mtDNA) signatures. Native pig samples (n = 157) were collected from 10 provinces in Luzon and the Visayas. Approximately 650 base pairs of the mtDNA D-loop region were sequenced and analyzed together with publicly available sequences. Pairwise-distance analysis showed genetic separation of North and South Luzon (SL) and the clustering of SL with Visayan pigs. Phylogenetic analysis showed that the PhNP clustered within 3 recognized Asian pig domestication centers: D2 (East Asia), D7 (Southeast Asia) and the Cordillera clade (sister to the Lanyu). We identified 19 haplotypes (1–38 samples each), forming 4 haplogroups, i.e., North Luzon, South Luzon and Visayas, Asian mix and the Cordillera cluster. No endemic wild pig mtDNA was detected in the native pig population, but evidence of interspecific hybridization was observed. This study showed that the Philippine native pigs have originated from at least 3 Sus scrofa lineage and that they were not domesticated from the endemic wild pigs of the Philippines.
Assessing the role of tumour-associated macrophage subsets in breast cancer subtypes using digital image analysis
Authors: Zwager Mieke C. , Bense Rico , Waaijer Stijn , Qiu Si-Qi , Timmer-Bosscha Hetty , de Vries Elisabeth G. E. , Schröder Carolien P. , van der Vegt Bert
Published: January 2023

Purpose

The number of M1-like and M2-like tumour-associated macrophages (TAMs) and their ratio can play a role in breast cancer development and progression. Early clinical trials using macrophage targeting compounds are currently ongoing. However, the most optimal detection method of M1-like and M2-like macrophage subsets and their clinical relevance in breast cancer is still unclear. We aimed to optimize the assessment of TAM subsets in different breast cancer subtypes, and therefore related TAM subset numbers and ratio to clinicopathological characteristics and clinical outcome.

Methods

Tissue microarrays of 347 consecutive primary Luminal-A, Luminal-B, HER2-positive and triple-negative tumours of patients with early-stage breast cancer were serially sectioned and immunohistochemically stained for the pan-macrophage marker CD68 and the M2-like macrophage markers CD163, CSF-1R and CD206. TAM numbers were quantified using a digital image analysis algorithm. M1-like macrophage numbers were calculated by subtracting M2-like TAM numbers from the total TAM number.

Results

M2-like markers CD163 and CSF-1R showed a moderate positive association with each other and with CD68 (r ≥ 0.47), but only weakly with CD206 (r ≤ 0.06). CD68 + , CD163 + and CSF-1R + macrophages correlated with tumour grade in Luminal-B tumours (P < 0.001). Total or subset TAM numbers did not correlate with disease outcome in any breast cancer subtype.

Conclusion

In conclusion, macrophages and their subsets can be detected by means of a panel of TAM markers and are related to unfavourable clinicopathological characteristics in Luminal-B breast cancer. However, their impact on outcome remains unclear. Preferably, this should be determined in prospective series.
How credible are Okun coefficients? The gap version of Okun’s law for G7 economies
Authors: Boďa Martin , Považanová Mariana
Published: January 2023

The paper draws attention to the fact that findings that follow from estimation of Okun’s law are extremely sensitive to methodological choices. The argument rests in a case study oriented upon G7 countries for a period 1991/Q1–2021/Q4 and accounts for a possible asymmetry in the output–unemployment relationship. First, business and unemployment fluctuations are estimated by six purely statistical approaches that arise by casting the Hodrick–Prescott filter, the Hamilton filter and the unobserved component model into a univariate or bivariate framework. Second, the gap version of Okun’s law is modelled by means of an auto-regressive distributed lag model or its nonlinear threshold counterpart according as asymmetry is allowed or not. The results indicate huge heterogeneity in Okun coefficients for every country caused by differences even in the basal methodological aspects accounted for in the case study. The diversity of results demonstrates that initial modelling choices may provide economic policy-makers with conflicting insights and advice. This issue follows merely from the absence of general standards that might decide which particular result is more credible.