bluuebunny/crossref_metadata_2025 huggingface dataset:
Komplette Okklusion der Arteria radialis durch einen kardiogenen Embolus bei infektiöser Endokarditis
Authors: Bugariu Marios , Tilkorn Daniel , Hauser Joerg , Bienek Markus
Published: April 2022

Wir präsentieren den Fall einer septischen Thrombosierung der rechtsseitigen Arteria radialis durch einen kardiogenen Embolus auf Grundlager einer infektiösen Endokarditis. Nach initialem Verdacht einer beugeseitigen Unterarmphlegmone bei bestehender Tenosynovitis zeigte sich intraoperativ eine langstreckige Thrombosierung der Arteria radialis. Wir führten die Resektion des thrombosierten Gefäßabschnittes sowie die Rekonstruktion mittels Veneninterponat durch. Im Rahmen der Fokussuche fanden sich echokardiografisch Vegetationen am vorderen Mitralklappensegel. Im Zuge dessen erfolgte die operative Mitralklappensegelrekonstruktion mittels Mitralklappenanuloplastik.
Lipoabdominoplastik in der postbariatrischen Chirurgie: eine relevante Alternative zur Fleur-de-Lis-Abdominoplastik?
Authors: Motamedi Melodi , Almeida Jessica , Allert Sixtus
Published: April 2022

Hintergrund Die Anzahl an bariatrischen Operationen und somit auch die Anzahl an postbariatrischen Eingriffen ist in den letzten Jahren dramatisch gestiegen. Obwohl in der postbariatrischen Chirurgie lange Narbenverläufe zu Gunsten einer Körperformrekonstruktion üblich sind, beobachten wir neben dem Wunsch der Körperkonturierung zunehmend den nach ästhetisch ansprechenderen Ergebnissen. Insbesondere die Fleur-de-Lis-Abdominoplastik wird aufgrund der sichtbaren vertikalen Narbe von jungen Patientinnen nach massivem Gewichtsverlust kritisch gesehen. Häufig stören sich auch Operateure sowohl am ästhetischen Outcome wie auch an der höheren Komplikationsrate.

Methoden Retrospektive Analyse von 20 Patientinnen nach massivem Gewichtsverlust nach bariatrischer Operation, die im Zeitraum von Januar 2020 bis Januar 2021 statt einer Fleur-de-Lis Abdominoplastik eine Lipoabdominoplastik erhalten haben. Die Datenanalyse erfolgte anhand des präoperativen vertikalen und horizontalen Hautüberschüsse (Pittsburgh Rating Scale), anhand des Body-Mass-Index, der operativen Technik und des Endresultats.

Ergebnisse 20 Patientinnen mit einer Indikation zur Durchführung einer FdL-Abdominoplastik unterzogen sich einer kombinierten radikalen Liposuktion des Bauches mit traditioneller Abdominoplastik. Das Ursprungsgewicht vor der massiven Gewichtsreduktion rangierte zwischen 100–168 kg. Die durchschnittliche Gewichtsreduktion lag bei 56,5 kg. Im Mittel betrug der BMI 27,3 kg/m². Das Durchschnittsalter unserer Studiengruppe betrug 40 Jahre. Bei einer Patientin (5 %) konnte eine Major-Komplikation verzeichnet werden. Es handelte sich um ein infiziertes Serom, welches konservativ behandelt werden konnte. Eine Patientin (5 %) wünschte eine Nachstraffung in FDL-Technik im weiteren Verlauf.

Fazit Die Durchführung einer Lipoabdominoplastik ist auch bei postbariatrischen Patienten gut und sicher durchführbar. Es zeigen sich gute Körperkonturierungen ohne vertikale Schnittführung mit einem hohen Maß an Patientenzufriedenheit. Die Anzahl an Patienten, die sich einer FdL-Abdominoplastik unterziehen müssten, kann mit dieser Technik erfolgreich gesenkt werden.
Direct percutaneous endoscopic jejunostomy (DPEJ) and percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) technical success and outcomes: Systematic review and meta-analysis
Authors: Deliwala Smit S. , Chandan Saurabh , Kumar Anand , Mohan Babu , Ponnapalli Anoosha , Hussain Murtaza S. , Kaushal Sunil , Novak Joshua , Chawla Saurabh
Published: April 2022

Background and study aims Endoscopic methods of delivering uninterrupted feeding to the jejunum include direct percutaneous endoscopic jejunostomy (DPEJ) or PEG with jejunal extension (PEG-J), validated from small individual studies. We aim to perform a meta-analysis to assess their effectiveness and safety in a variety of clinical scenarios.

Methods Major databases were searched until June 2021. Efficacy outcomes included technical and clinical success, while safety outcomes included adverse events (AEs) and malfunction rates. We assessed heterogeneity using I2
and classic fail-safe to assess bias.

Results 29 studies included 1874 patients (983 males and 809 females); mean age of 60 ± 19 years. Pooled technical and clinical success rates with DPEJ were 86.6 % (CI, 82.1–90.1, I2
73.1) and 96.9 % (CI, 95.0–98.0, I2
12.7). The pooled incidence of malfunction, major and minor AEs with DPEJ were 11 %, 5 %, and 15 %. Pooled technical and clinical success for PEG-J were 94.4 % (CI, 85.5–97.9, I2
33) and 98.7 % (CI, 95.5–99.6, I2
 < 0.001). The pooled incidence of malfunction, major and minor AEs with DPEJ were 24 %, 1 %, and 25 %. Device-assisted DPEJ performed better in altered gastrointestinal anatomy. First and second attempts were 87.6 % and 90.2 %.

Conclusions DPEJ and PEG-J are safe and effective procedures placed with high fidelity with comparable outcomes. DPEJ was associated with fewer tube malfunction and failure rates; however, it is technically more complex and not standardized, while PEG-J had higher placement rates. The use of balloon enteroscopy was found to enhance DPEJ performance.
Endoscopic diagnosis of gastric intestinal metaplasia in patients with autoimmune gastritis using narrow-band imaging: does pseudopyloric metaplasia muddy the waters?
Authors: Dilaghi Emanuele , Esposito Gianluca , Pivetta Giulia , Galli Gloria , Pilozzi Emanuela , Annibale Bruno , Lahner Edith
Published: April 2022

Background and study aims In autoimmune atrophic gastritis (AAG), associated with intestinal (IM) and/or pseudopyloric metaplasia (PPM), endoscopic surveillance is recommended for gastric cancer risk mainly linked to IM. Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) reliably identifies IM, but has not been assessed in AAG. We aimed to assess the performance of EGGIM (index test) versus histology (reference test) of corpus IM in AAG.

Patients and methods This was a cross-sectional study of 210 AAG patients undergoing surveillance gastroscopy with narrow-band imaging (NBI): corpus IM scored according to EGGIM, histology according to updated Sydney system, and morphological criteria.

Results NBI identified corpus IM in 88.6 % of AAG patients: EGGIM were 0, 1, 2, 3, 4 in 11.4 %, 0.5 %, 33.3 %, 1.9 %, and 52.9 %, respectively. Histology identified corpus IM in 78.1 % and PPM in 79.5 % of patients. PPM was present with IM in 57.6 % and without IM in 21.9 % patients, 20.5 % had IM without PPM. EGGIM, compared to histology, correctly classified 76.2 % of patients, showing high sensitivity (91.5 %, 95 %CI 86.1–95.3). EGGIM correctly classified 93 % of patients with IM without PPM, 90.9 % with both metaplasias, and 21.7 % with PPM without IM yielding low specificity (21.7 %, 95 %CI 10.9–36.4).

Conclusions In AAG, EGGIM showed high accuracy and sensitivity identifying > 90 % of patients with histological corpus IM. EGGIM overestimated IM when PPM without IM was present, yielding low specificity. These findings raise the question of whether in AAG, PPM and IM may display similar endoscopic features on NBI.
Safety and efficacy of dual emission endoscopic laser treatment in patients with upper or lower gastrointestinal vascular lesions causing chronic anemia: results from the first multicenter cohort study
Authors: Tontini Gian Eugenio , Dioscoridi Lorenzo , Rimondi Alessandro , Cantù Paolo , Cavallaro Flaminia , Giannetti Aurora , Elli Luca , Pastorelli Luca , Pugliese Francesco , Mutignani Massimiliano , Vecchi Maurizio
Published: April 2022

Objectives and study aims Recent pilot studies have assessed the feasibility of a novel 1.9-/1.5-μm dual emission endoscopic laser treatment (1.9-/1.5-μmDEELT) for endoscopic hemostasis, ablation and resection. In this study, we investigated the safety and efficacy of 1.9-/1.5-μmDEELT in patients with chronic anemia due to gastrointestinal vascular lesions in a real-life multicenter cohort setting.

Patients and methods Consecutive patients with moderate/severe iron-deficiency anemia undergoing 1.9-/1.5-μmDEELT for upper and lower gastrointestinal bleeding due to vascular lesions were enrolled in three academic referral centers. Safety and successful ablation of vascular lesions were the primary outcomes. Long-term hemoglobin level, blood transfusion requirements, endoscopic severity scores of complex vascular disorders and technical lasing parameters were also assessed. Long-term hemoglobin variations have been further assessed, with repeated measure analysis of variance and univariate analyses.

Results Fifty patients (median age 74; range 47 to 91 years) with gastric antral vascular ectasia (GAVE) (22), angioectasia (22) and radiation proctopathy (6) underwent 58 1.9-/1.5-μmDEELT between 2016 and 2020. All procedures were technically feasible leading to successful ablation of the targeted lesion/s, with no incident or adverse event potentially related to the 1.9-/1.5-μmDEELT technique. Within a 6-month follow-up, hemoglobin values significantly rose (+ 1.77 at 1 month and + 1.70 g/dL at 6 months, P < 0.01), the blood supply requirement decreased (at least one transfusion in 32 versus 13 patients, P < 0.01), and GAVE lesions showed a clear endoscopic improvement (from 5 points to 1 points, P < 0.01).

Conclusions The 1.9-/1.5-μm laser system is a safe and effective endoscopic tool for haemostatic ablation of bleeding vascular lesions within the gastrointestinal tract in tertiary referral centers.
Endoscopic or surgical treatment for necrotizing pancreatitis: Comprehensive systematic review and meta-analysis
Authors: Mohamadnejad Mehdi , Anushiravani Amir , Kasaeian Amir , Sorouri Majid , Djalalinia Shirin , Kazemzadeh Houjaghan Amirmasoud , Gaidhane Monica , Kahaleh Michel
Published: April 2022

Background and study aims Treatment of necrotizing pancreatitis is changed over the past two decades with the availability of endoscopic, and minimally invasive surgical approaches. The aim of this systematic review was to assess outcomes of endoscopic drainage, and different types of surgical drainage approaches in necrotizing pancreatitis.

Methods Medline, Embase, Scopus, and Web of Science were searched from 1998 to 2020 to assess outcomes in endoscopic drainage and various surgical drainage procedures. The assessed variables consisted of mortality, development of pancreatic or enteric fistula, new onset diabetes mellitus, and exocrine pancreatic insufficiency.

Results One hundred seventy studies comprising 11,807 patients were included in the final analysis. The pooled mortality rate was 22 % (95 % confidence interval [CI]: 19%–26 %) in the open surgery (OS), 8 % (95 %CI:5 %–11 %) in minimally invasive surgery (MIS), 13 % (95 %CI: 9 %–18 %) in step-up approach, and 3 % (95 %CI:2 %–4 %) in the endoscopic drainage (ED). The pooled rate of fistula formation was 35 % (95 %CI:28 %–41 %) in the OS, 17 % (95 %CI: 12%–23 %) in MIS, 17 % (95 %CI: 9 %–27 %) in step-up approach, and 2 % (95 %CI: 0 %–4 %) in ED. There were 17 comparative studies comparing various surgical drainage methods with ED. The mortality rate was significantly lower in ED compared to OS (risk ratio [RR]: 30; 95 %CI: 0.20–0.45), and compared to MIS (RR: 0.40; 95 %CI: 0.26–0.6). Also, the rate of fistula formation was lower in ED compared to all other surgical drainage approaches.

Conclusions This systematic review demonstrated lower rate of fistula formation with ED compared to various surgical drainage methods. A lower rate of mortality with ED was also observed in observational studies. PROSPERO Identifier: CRD42020139354
Endoscopic stenting for malignant biliary obstruction is technically successful in patients with preexisting duodenal stents
Authors: Simoes Priya K. , Schattner Mark A. , Gerdes Hans , Shah Pari M. , Kurtz Robert C. , Mendelsohn Robin B.
Published: April 2022

Background and study aims There are limited data on the success of endoscopic retrograde cholangiopancreatography (ERCP) in patients with malignant biliary and duodenal obstruction with a preexisting duodenal stent. The aim of this study was to evaluate patient and procedural outcomes of a cohort of patients with preexisting duodenal stents who underwent an attempt at ERCP for malignant biliary obstruction (MBO).

Patients and methods This was a single-center retrospective study on consecutive patients with a preexisting duodenal stent who underwent attempted ERCP for MBO. Technical success was defined as successful cannulation of the common bile duct, with successful dilation and/or deployment of a biliary stent under fluoroscopy. Clinical success was defined as number of patients in the entire group who underwent ERCP successfully with resolution of symptoms.

Results We identified 64 patients (73 % men, 74 % white, median age 62 years) with a preexisting duodenal stent who underwent 85 attempts at ERCP. ERCP was technically successful in 50 of 85 procedures (59 %). Overall ERCP was successful in 41 of 85 patients (48 %). ERCP was more likely to be successful in patients with Type 1 and 3 duodenal strictures than with Type 2 strictures (83 % and 92 % vs. 42 %, P < 0.01), in patients with a preexisting sphincterotomy (79% vs. 20 %, P = 0.01) or preexisting biliary stent (66 % vs. 34 %, P = 0.04). Adverse events included bleeding (n = 3), post-procedure fever (n = 3) and abdominal pain (n = 1).

Conclusions Although biliary stenting via ERCP is often technically challenging in patients with a prior duodenal stent, it is a safe and effective method of biliary drainage. ERCP should be attempted in patients with Type 1 and 3 duodenal strictures, a prior sphincterotomy or an indwelling biliary stent.
Effect of a polyp detection poster on detection of sessile serrated lesions: a prospective controlled study
Authors: Shaukat Aasma , Rex Douglas K. , Shyne Michael , Church Timothy R. , Moscatelli Joseph P. , Colton Joshua B.
Published: April 2022

Background and study aims Colonoscopy is effective in reducing the incidence of colorectal cancer, but interval cancers remain a concern and their occurrence mainly is thought to be due to poor detection of sessile serrated lesions (SSLs) and advanced neoplasia (AN). Currently there are no low-cost, easy-to-implement tools to improve detection of difficult-to-detect polyps. Our aims were to compare the detection rate for SSLs and AN between two groups of endoscopists at a large community practice, one of which received an intervention of a polyp detection poster displayed over the monitor in their endoscopy suite for 6 months. We compared preintervention and post-intervention detection rates in the intervention and control groups.

Methods This was a convenience case control quality improvement project. For 6 months, a 2’ × 3’ poster of pictures of SSLs and advanced neoplasia was displayed over the monitor for 44 endoscopist in a large community gastroenterology practice in the Minneapolis/St.Paul area, while another 44 physicians performed colonoscopy in the usual fashion without the poster. The endpoints were improvement in detection rates for SSLs and AN preintervention and post-intervention between the control and intervention groups.

Results During the study, 88 endoscopists performed 54,861 colonoscopies. At least one adenoma was detected in 41.3 % of patients, one or more SSLs in 11.4 %, and AN in 10.6 %. During the intervention period, the SSL detection rates were 10.9 % and 12.3 % for the control and intervention groups and for AN, the detection rates were 10.4 % and 10.75 % for the two groups, respectively. Exposure to the polyp detection poster significantly changed SSL detection for the intervention group relative to the control group (likelihood ratio test P < 0.001). No significant effect of the intervention was observed for detection of AN, right-sided AN or left-sided AN, or adenoma detection rate.

Conclusions Placement of a polyp detection poster above the endoscopy video monitor increased detection of SSL but not AN.
Rapid development of accurate artificial intelligence scoring for colitis disease activity using applied data science techniques
Authors: Patel Mehul , Gulati Shraddha , Iqbal Fareed , Hayee Bu'Hussain
Published: April 2022

Background and study aims Scoring endoscopic disease activity in colitis represents a complex task for artificial intelligence (AI), but is seen as a worthwhile goal for clinical and research use cases. To date, development attempts have relied on large datasets, achieving reasonable results when comparing normal to active inflammation, but not when generating subscores for the Mayo Endoscopic Score (MES) or ulcerative colitis endoscopic index of severity (UCEIS).

Patients and methods Using a multi-task learning framework, with frame-by-frame analysis, we developed a machine-learning algorithm (MLA) for UCEIS trained on just 38,124 frames (73 patients with biopsy-proven ulcerative colitis). Scores generated by the MLA were compared to consensus scores from three independent human reviewers.

Results Accuracy and agreement (kappa) were calculated for the following differentiation tasks: (1) normal mucosa vs active inflammation (UCEIS 0 vs ≥ 1; accuracy 0.90, κ = 0.90); (2) mild inflammation vs moderate-severe (UCEIS 0–3 vs ≥ 4; accuracy 0.98, κ = 0.96); (3) generating total UCEIS score (κ = 0.92). Agreement for UCEIS subdomains was also high (κ = 0.80, 0.83 and 0.88 for vascular pattern, bleeding and erosions respectively).

Conclusions We have demonstrated that, using modified data science techniques and a relatively smaller datasets, it is possible to achieve high levels of accuracy and agreement with human reviewers (in some cases near-perfect), for AI in colitis scoring. Further work will focus on refining this technique, but we hope that it can be used in other tasks to facilitate faster development.
Study on the Action Mechanism of Dkk-1, TGF-β1 and TNF-α Expression Levels in Dupuytren’s Contracture
Authors: Niu Kecheng , Dai Guangming , Jiang Wei , Zhang Ian , Zhang Peiguang , Tan Yunyan , Feng Bo
Published: April 2022

Background The biological mechanism of Dupuytren’s contracture needs to be further studied in order to minimize postoperative recurrence and provide a pathological basis for the development of new therapeutic targets.

Methods HE staining, immunohistochemistry, PCR and western blotting were performed in pathological palmar aponeurosis specimens and normal palmar aponeurosis tissues for comparative study.

Results (1) TNF-α expression was up-regulated: TNF-α mRNA was more highly expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (2) Dkk-1 expression was down-regulated: Dkk-1 mRNA was lower expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (3) TGF-β1 expression was up-regulated: TGF-β1 mRNA was higher expressed in the pathological tissues of DD patients than in the CT group, P < 0.05, and the difference between the two groups was statistically significant; (4) Pearson correlation analysis suggested that TNF-α expression was positively correlated with TGF-β1 expression, TNF-α expression was negatively correlated with DKK-1 expression, and TGF-β1 expression was negatively correlated with DKK-1 expression.

Conclusion TNF-α, DKK-1 and TGF-β1 may play a role in the pathogenesis of palmar aponeurosis contracture, and there is a relationship between them. The study of the relationship between the three and their related signaling pathways provides a therapeutic target and a basis for the prevention and early treatment of palmar aponeurotic contracture.
A Direct Method for Synthesis of Fluorinated Quinazolinones and Quinoxalines Using Fluorinated Acids without Metals or Additives
Authors: Ma Chen , Li Shichen , Lv Xueyan , Ren Jianing , Feng Lei
Published: April 2022

The trifluoromethyl group only exists in synthetic compounds. Owing to the unique bioactivities of this group, the trifluoromethylation of alkanes, arenes, unsaturated compounds like olefins, aldehydes­, and ketones, and heterocycles has been studied constantly in recent decades. Herein, a direct method using trifluoroacetic acid as a CF3 source for the synthesis of 2-(trifluoromethyl)quinazolin-4-ones and 4-(trifluoromethyl)pyrrolo/indolo[1,2-a]quinoxalines without any catalysts or additives is reported; a wide range of fluorinated compounds were obtained in 52%–94% yield.
Investigation of the Relationship Between Autoimmune and Nodular
Goiter in Patients with Euthyroid Polycystic Ovary Syndrome and Their
Phenotypes
Authors: Altuntaş Seher Çetinkaya , Güneş Mutlu
Published: April 2022

Polycystic ovary syndrome (PCOS) is an endocrine disorder that frequently affects
women of reproductive age. In PCOS, the incidence of thyroid diseases has
increased in addition to reproductive and metabolic problems. To compare thyroid
nodule, volume, autoimmunity, and thyroid function tests of euthyroid PCOS and
its phenotypes. The files of 178 patients with PCOS aged 18–45 years and
92 patients with no disease who were matched for body mass index were
retrospectively scanned. Women with PCOS were divided into four phenotypes,
ABCD. Anti-TPO titer and prevalence, fT3, and thyroid volume were higher in the
PCOS group compared with the control group in terms of anti-Tg levels, presence
of nodules, and the number of nodules. There was no statistical difference
between the PCOS group and the healthy controls. The number of nodules of
1 cm and above was found to be higher only in patients with PCOS
compared with the control group. When the phenotypes were examined, thyroid
dysfunction features were found in phenotype A, which was the most prominent.
Thyroid autoimmunity, thyroid volume, and the number of nodules larger than
1 cm increased in patients with PCOS compared with controls. This
situation is thought to be caused by the reproductive and metabolic properties
of PCOS because thyroid dysfunction was detected more in phenotype A, which is
called the full phenotype. Therefore, all patients with PCOS, especially
phenotype A, should be evaluated for the presence of nodules with autoimmunity
using USG, even if there are no symptoms, and thyroid functions.
Organic Nitrating Reagents
Authors: Patra Subrata , Mosiagin Ivan , Katayev Dmitry , Giri Rahul
Published: April 2022

Nitro compounds are vital raw chemicals that are widely used in academic laboratories and industries for the preparation of various drugs, agrochemicals, and materials. Thus, nitrating reactions are of great importance for chemists and are even taught in schools as one of the fundamental transformations in organic synthesis. Since the discovery of the first nitrating reactions in the 19th century, progress in this field has been constant. Yet, for many years the classical electrophilic nitration approach using a mixture of strong mineral acids dominated the field. However, in recent decades, the attention of researchers has focused on new reactivity and new reagents that can provide access to nitro compounds in a practical and straightforward way under mild reaction conditions. Organic nitrating reagents have played a special role in this field since they have enhanced reactivity. They also allow nitration to be carried out in an ecofriendly and sustainable manner. This review examines the development and application of organic nitrating reagents.

1 Introduction

2 Organic Nitrating Reagents

2.1 Alkyl Nitrites

2.2 Nitroalkanes

2.3 Alkyl Nitrates

2.4 N-Nitroamides

2.5 N-Nitropyrazole

2.6 N-Nitropyridinium Salts

3 Organic Nitrating Reagents Generated In Situ

3.1 Acyl Nitrates

3.2 Trimethylsilyl Nitrate

3.3 Nitro Onium Salts

4 Organic Nitronium Salts

5 Organic Nitrates and Nitrites

5.1 Ammonium Nitrates

5.2 Heteroarylium Nitrates

5.3 Other Organic Nitrates

5.4 Organic Nitrites

6 Conclusion and Outlook
Anatomy of the Mesentery
Authors: Bunni John
Published: April 2022

It is clear that despite the importance of multimodal therapy, the most impactful weapon in the arsenal of treatment in a patient with colorectal cancer is high-quality surgery. This has been shown time and time again and surgery remains the bedrock in the management of visceral, and particularly colorectal, cancer. The reason for this is an anatomical one, based upon embryological planes. One cannot truly understand and perform high-quality surgery without an appreciation of the fascial and mesenteric anatomy of the abdomen and pelvis.

R. J. (“Bill”) Heald greatly advanced the management of rectal cancer with his description of the anatomical foundation of total mesorectal excision. He popularized usage of the term “mesorectum” and was an early pioneer in the commitment to mesenteric-based surgery. This concept has been extended by Werner Hohenberger to mesocolic excision for colon cancer surgery.

These all rely on the principle that, in general, cancer tends to remain within its embryological compartment of origin, making it amenable to dissecting out as an oncological surgical envelope or package. There have been some theories put forth as to why, but it remains the fact that, far more often than not, an excision within the mesenteric plane affords better outcomes than the one that breaches it.

Thus an understanding of the anatomy of the mesentery is important and is the scientific foundation of the art that is cancer surgery.

Herein the author outlines the history of the development of our understanding of mesenteric anatomy and where we are today.
Intriguing Role of the Mesentery in Ileocolic Crohn's Disease
Authors: Turri Giulia , Carvello Michele , Ben David Nadav , Spinelli Antonino
Published: April 2022

Crohn's disease (CD) is a chronic relapsing inflammatory bowel disease with unknown etiology. Up to 80% of patients will eventually require surgery throughout their lifetime, and often repeated resections are required for disease recurrence. Observations of “creeping fat” surrounding the diseased intestine renewed interest in the mesentery, recently defined as an organ with endocrine and immune functions. According to the inside-out model, the mesentery may be primarily affected in CD and subsequent cause alterations in the mucosa. Recently, lower surgical recurrence rates have been reported with en-bloc excision of the mesentery adjoining the diseased intestine. Results of ongoing randomized controlled trials may clarify the role of the mesentery in CD and possibly lead to its adoption as standard during surgery for Crohn's disease.
Utility of Axillary Reverse Mapping (ARM) and Incidence of Metastasis in Arm Draining Lymph Nodes in Patients with Breast Cancer
Authors: Kumar Pramit , Singh Parneet , Veerwal Hardik , Ravi Bina , Narayan Manishi L.
Published: April 2022

Objective Lymphedema of the upper limb is the most common complication in patients with breast cancer, who require axillary lymph node (LN) dissection. Proposition of identifying upper limb draining LN and preserving it, during axillary dissection can reduce significant postoperative morbidity, but it has the risk of inadequate oncological resection. This study was planned to find out metastatic rate in axillary reverse mapping (ARM) nodes in our population.

Materials and Methods Lymphoscintigraphy (LSG) was performed using intradermal injection of 99mTc Sulfur Colloid into ipsilateral second and third interdigital web spaces of hand in patients with breast cancer. Planar, single-photon emission computed tomography-computed tomography images were acquired followed by intraoperative localization of arm draining LNs using Gamma Probe. All identified ARM nodes were dissected and sent for histopathological examination to confirm metastatic involvement.

Results Twenty eligible patients were prospectively analyzed. The identification rate of arm draining LN with LSG was 90% (18/20). Among 14 eligible patients included in the study, ARM node metastasis was seen in two patients. A total of 64 ARM nodes were dissected from 14 patients, 4/64 nodes (2 patients) were positive for metastases (6.25%). Of the six patients excluded from the study, in 1 patient ARM node could not be identified on Gamma Probe, in two cases, it could not be retrieved surgically, in next two cases ARM could not be identified on LSG and remaining one case was removed because of previous surgical intervention.

Conclusion In the current study, LSG showed the identification rate of 90% for ARM nodes in patients with carcinoma breast and metastatic involvement was seen in 6.25% (4/64) of these nodes in 2/14 (14.2%) patients, which is in agreement with previously published data. Oncological safety of preserving ARM nodes needs to be evaluated in the larger population.
Granulicatella adiacens as an Unusual Cause of Empyema: A Case Report and Review of Literature
Authors: Purohit Geetarani , Mishra Baijayantimala , Sahoo Satyajeet , Mahapatra Ashoka
Published: April 2022

Granulicatella adiacens, a nutritionally variant Streptococcus (NVS), is part of the normal commensal flora of human mouth, genital, and intestinal tracts and rarely causes disease. It has been mostly reported from bacteremia and endocarditis cases, but rarely can cause vertebral osteomyelitis, pancreatic abscess, otitis media, and endovascular, central nervous system, ocular, oral, bone and joint, and genitourinary infections. Due to requirement of fastidious culture conditions and non-specific colony morphology, serious diagnostic difficulties may arise in cases of NVS infections. Here, we are reporting a rare fatal infection of G. adiacens presented with empyema complicated to sepsis and necrotizing fasciitis.

Clinicians should be aware of the pathogenic potential of Granulicatella adiacens (a normal commensal flora of human mouth, genital and intestinal tracts). Appropriate supplemented media and a reliable detection system should be used to identify these fastidious organisms. We present this rare case to bring awareness among clinicians regarding such a rare but potentially fatal infection.
The Question of Phonetic Balance in Word Recognition Testing
Authors: Martin Frederick N. , Champlin Craig A. , Perez Desirée D.
Published: April 2022

Twenty subjects with normal hearing and 15 subjects with mild-to-moderate sensorineural hearing losses were tested with eight lists of words using monosyllabic pronunciation to determine word recognition scores. Four of the lists were taken from Northwestern University Test No. 6 and four were simply made up by randomly selecting words from a dictionary. All of the word lists were used to determine performance-intensity functions. No clinically meaningful differences were observed among the lists.

Abbreviations: ANOVA = analysis of variance, NU-6 = Northwestern University Auditory Test No. 6, PB = phonemically/phonetically balanced, SRT = speech recognition threshold, WRS = word recognition score
Independent trajectory mixed quantum-classical approaches based on the exact factorization
Authors: Ha Jong-Kwon , Min Seung Kyu
Published: April 2022

Mixed quantum-classical dynamics based on the exact factorization exploits the “derived” electron-nuclear correlation (ENC) term, aiming for the description of quantum coherences. The ENC contains interactions between the phase of electronic states and nuclear quantum momenta, which depend on the spatial shape of the nuclear density. The original surface hopping based on the exact factorization (SHXF) [Ha et al., J. Phys. Chem. Lett. 9, 1097 (2018)] exploits frozen Gaussian functions to construct the nuclear density in the ENC term, while the phase of electronic states is approximated as a fictitious nuclear momentum change. However, in reality, the width of nuclear wave packets varies in time depending on the shape of potential energy surfaces. In this work, we present a modified SHXF approach and a newly developed Ehrenfest dynamics based on the exact factorization (EhXF) with time-dependent Gaussian functions and phases by enforcing total energy conservation. We perform numerical tests for various one-dimensional two-state model Hamiltonians. Overall, the time-dependent width of Gaussian functions and the energy conserving phase show a reliable decoherence compared to the original frozen Gaussian-based SHXF and the exact quantum mechanical calculation. In particular, the energy conserving phase is crucial for EhXF to reproduce the correct quantum dynamics.
Reformulation of thermally assisted-occupation density functional theory in the Kohn–Sham framework
Authors: Yeh Shu-Hao , Yang Weitao , Hsu Chao-Ping
Published: April 2022

We reformulate the thermally assisted-occupation density functional theory (TAO-DFT) into the Kohn–Sham single-determinant framework and construct two new post-self-consistent field (post-SCF) static correlation correction schemes, named rTAO and rTAO-1. In contrast to the original TAO-DFT with the density in an ensemble form, in which each orbital density is weighted with a fractional occupation number, the ground-state density is given by a single-determinant wavefunction, a regular Kohn–Sham (KS) density, and total ground state energy is expressed in the normal KS form with a static correlation energy formulated in terms of the KS orbitals. In post-SCF calculations with rTAO functionals, an efficient energy scanning to quantitatively determine θ is also proposed. The rTAOs provide a promising method to simulate systems with strong static correlation as original TAO, but simpler and more efficient. We show that both rTAO and rTAO-1 is capable of reproducing most results from TAO-DFT without the additional functional Eθ used in TAO-DFT. Furthermore, our numerical results support that, without the functional Eθ, both rTAO and rTAO-1 can capture correct static correlation profiles in various systems.
Selected configuration interaction wave functions in phaseless auxiliary field quantum Monte Carlo
Authors: Mahajan Ankit , Lee Joonho , Sharma Sandeep
Published: April 2022

We present efficient algorithms for using selected configuration interaction (sCI) trial wave functions in phaseless auxiliary field quantum Monte Carlo (ph-AFQMC). These advances, geared toward optimizing computational performance for longer configuration interaction expansions, allow us to use up to a million configurations in the trial state for ph-AFQMC. In one example, we found the cost of ph-AFQMC per sample to increase only by a factor of about 3 for a calculation with 104 configurations compared to that with a single one, demonstrating the tiny computational overhead due to a longer expansion. This favorable scaling allows us to study the systematic convergence of the phaseless bias in auxiliary field quantum Monte Carlo calculations with an increasing number of configurations and provides a means to gauge the accuracy of ph-AFQMC with other trial states. We also show how the scalability issues of sCI trial states for large system sizes could be mitigated by restricting them to a moderately sized orbital active space and leveraging the near-cancellation of out of active space phaseless errors.
Safety and Efficacy of a Digital Therapeutic for Substance use Disorder: Secondary Analysis of Data from a NIDA Clinical Trials Network Study
Authors: Maricich Yuri A. , Nunes Edward V. , Campbell Aimee N. C. , Botbyl Jeffrey D. , Luderer Hilary F.
Published: April 2022

Background: Traditional treatments for substance use disorders (SUDs) rely heavily on face-to-face interactions, which pose substantial limitations for patients. A clinical trial of a digital therapeutic (DT), delivering behavioral therapy demonstrated safety and efficacy in a population including patients with opioid use disorder (OUD) not treated with buprenorphine, which is not a guideline-recommended approach. This study re-analyzed the data excluding patients with OUD to more closely approximate real-world patient populations. Methods: Secondary analysis of patients with substance use disorders related to alcohol, cannabis, cocaine, or other stimulants ( n = 399, patients with OUD excluded) from a previously-published randomized controlled trial. Patients received 12-weeks of outpatient treatment-as-usual (TAU; n = 193) or TAU with reduced counseling plus a DT ( n = 206) providing computerized cognitive behavioral therapy and contingency management. Primary outcomes were abstinence in weeks 9–12 and retention in treatment. Results: The 399 patients in this analysis (206 in the DT group and 193 in the TAU group) reported substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (e.g., methamphetamines). Demographic and baseline characteristics including age, sex, race, education, and reported primary substance use disorder were balanced between treatment groups. Abstinence was significantly higher in the DT group compared to TAU (40.3 vs. 17.6%; p < 0.001) as was retention in therapy (76.2 vs. 63.2%, p = 0.004). Intergroup adverse event rates were not significantly different ( p = 0.68). Conclusions: The results demonstrate that use of a DT safely increased abstinence (reduced substance use) and retention in treatment among patients with substance use disorders related to alcohol, cannabis, cocaine, or other stimulants (including methamphetamines).
Using Data Science to Improve Outcomes for Persons with Opioid use Disorder
Authors: Hayes Corey J. , Cucciare Michael A. , Martin Bradley C. , Hudson Teresa J. , Bush Keith , Lo-Ciganic Weihsuan , Yu Hong , Charron Elizabeth , Gordon Adam J.
Published: April 2022

Medication treatment for opioid use disorder (MOUD) is an effective evidence-based therapy for decreasing opioid-related adverse outcomes. Effective strategies for retaining persons on MOUD, an essential step to improving outcomes, are needed as roughly half of all persons initiating MOUD discontinue within a year. Data science may be valuable and promising for improving MOUD retention by using “big data” (e.g., electronic health record data, claims data mobile/sensor data, social media data) and specific machine learning techniques (e.g., predictive modeling, natural language processing, reinforcement learning) to individualize patient care. Maximizing the utility of data science to improve MOUD retention requires a three-pronged approach: (1) increasing funding for data science research for OUD, (2) integrating data from multiple sources including treatment for OUD and general medical care as well as data not specific to medical care (e.g., mobile, sensor, and social media data), and (3) applying multiple data science approaches with integrated big data to provide insights and optimize advances in the OUD and overall addiction fields.
Medications for Opioid use Disorder in State Prisons: Perspectives of Formerly Incarcerated Persons
Authors: Treitler Peter C. , Enich Michael , Reeves Donald , Crystal Stephen
Published: April 2022

Background : Opioid use disorder (OUD) is common among incarcerated persons and risk of overdose and other adverse drug-related consequences is high after release. Recognizing their potential to reduce these risks, some correctional systems are expanding access to medication for opioid use disorder (MOUD). This study explored the experiences and perspectives of formerly incarcerated individuals on MOUD use while incarcerated and after release. Methods : We interviewed 53 individuals with self-reported OUD who were released from New Jersey state prisons. Interviews explored motivations to use MOUD while incarcerated and after release, and experiences with prison-based MOUD and transition to community-based care. We performed cross-case analysis to examine common and divergent perspectives across participants. Results : A common reason for accepting prerelease MOUD was recognition of its effectiveness in preventing drug use, overdose, and other drug-related consequences. Participants who chose not to use MOUD often were focused on being completely medication-free or saw themselves as having relatively low-risk of substance use after a prolonged period without opioid use. A few participants reported challenges related to prison-based MOUD, including logistical barriers, stigma, and once-daily buprenorphine dosing. Most participants effectively transitioned to community-based care, but challenges included insurance lapses and difficulty locating providers. Conclusions : Many formerly incarcerated persons with OUD recognize the value of MOUD in supporting recovery, but some hold negative views of MOUD or underestimate the likelihood that they will return to drug use. Patient education on risks of post-release overdose, the role of MOUD in mitigating risk, and MOUD options available to them could increase engagement. Participants’ generally positive experiences with MOUD support the expansion of correctional MOUD programs.
EP3 enhances adhesion and cytotoxicity of NK cells toward hepatic stellate cells in a murine liver fibrosis model
Authors: Tao Xixi , Zhang Rui , Du Ronglu , Yu Tingting , Yang Hui , Li Jiwen , Wang Yuhong , Liu Qian , Zuo Shengkai , Wang Xi , Lazarus Michael , Zhou Lu , Wang Bangmao , Yu Ying , Shen Yujun
Published: April 2022

Natural killer (NK) cells exhibit antifibrotic properties in liver fibrosis (LF) by suppressing activated hepatic stellate cell (HSC) populations. Prostaglandin E2 (PGE2) plays a dual role in innate and adaptive immunity. Here, we found that E-prostanoid 3 receptor (EP3) was markedly downregulated in NK cells from liver fibrosis mice and patients with liver cirrhosis. NK cell–specific deletion of EP3 aggravated hepatic fibrogenesis in mouse models of LF. Loss of EP3 selectively reduced the cytotoxicity of the CD27+CD11b+ double positive (DP) NK subset against activated HSCs. Mechanistically, deletion of EP3 impaired the adhesion and cytotoxicity of DP NK cells toward HSCs through modulation of Itga4-VCAM1 binding. EP3 upregulated Itga4 expression in NK cells through promoting Spic nuclear translocation via PKC-mediated phosphorylation of Spic at T191. Activation of EP3 by sulprostone alleviated CCL4-induced liver fibrosis in mice. Thus, EP3 is required for adhesion and cytotoxicity of NK cells toward HSCs and may serve as a therapeutic target for the management of LF.
Design of hollow metasurfaces for absorption sensors and surface enhanced infrared absorption
Authors: Vasić Borislav
Published: April 2022

Absorption sensors detect variations in the imaginary part of refractive index with selectivity in sensing since analytes can be distinguished according to their characteristic absorption bands. In this study we combine the theoretical analysis based on temporal coupled mode theory and numerical calculations in order to derive design principles of optimal metasurfaces aimed for absorption sensing and surface enhanced infrared absorption (SEIRA). We consider hollow metal–insulator-metal metasurfaces with an empty space between two metallic layers. This space acts as a channel for the infiltration of fluid analytes in the region with the maximal electric field enhancement, which provides high sensitivity. We demonstrate that optimal metasurfaces operate in overcoupled regime where radiative decay rate of the resonant mode is larger than non-radiative decay rate. The operation in this regime is adjusted by choosing appropriate channel thickness (the vertical distance between two metallic layers), which should be around three times larger than the channel thickness at the critical coupling point, associated with equal decay rates and zero reflectance. Metasurface period should be as large as possible, whereas the operating frequency should be equal to the resonant frequency of metasurfaces. The same conclusions hold for hollow metasurfaces aimed for SEIRA, while in addition, their resonant frequency should match the vibrational frequency of an analyte under investigation. The absorption sensitivity (reflectance change divided by the change in the imaginary part of refractive index) of an optimal metasurface is larger than

10
 

R
I

U

−
1

, which provides detection of the imaginary part of refractive index below

10

−
3

.
Topological insulators on the square–hexagon lattice driven by next-nearest-neighbor hopping
Authors: Wang Guo Xiang , Zhang Ying Zheng , Wei Jun Hong
Published: April 2022

We investigate the topological phase transition of the square–hexagon lattice driven by the next-nearest-neighbor (NNN) hopping. By means of the Fukui–Hatsugai method, the topological invariant Z
2 can be determined. The phase diagrams in the (t
1, t
2) plane for different filling fractions are displayed, together with the size of the bulk band gap. We find the competition between t
1 and t
2 can drive the system into topological nontrivial phase, with Z
2 = 1. Interestingly, for 2/5 and 3/5 filling fractions, topological nontrivial phase can be easily realized when the NNN hoppings are turned on. Besides, the phase diagrams in the plane of t
2 and λ

so2 (t
1 and λ

so1) are also investigated. By numerically diagonalizing the Hamiltonian, the bulk band structures are calculated. And the topological trivial and nontrivial phase are also distinguished in terms of helical edge state. In experiments, these topological phase transitions may be realized by shaking optical lattice.
The role of surface charge and its decay in surface dielectric barrier discharges
Authors: Li Ting , Yan Hui-Jie , Li Jia-Qi , Schulze J , Yu Si-Qi , Song Jian , Zhang Quan-Zhi
Published: April 2022

The charge accumulation and decay in surface dielectric barrier discharges (SDBDs) driven by a sine AC voltage waveform (4 kHz) in combination with a nanosecond positive voltage pulse (300 ns, 20 Hz) is experimentally investigated based on a combination of the electro-optical Pockels effect and a high-speed camera. It is found that the accumulation of positive surface charge on the dielectric promotes the discharge in the negative half cycle of the applied AC voltage, whereas it inhibits the development of following new positive charge filaments. The decay of a single positive charge filament on the surface is a result of the neutralization by negative charges that originate either from the migration of negative surface charge (electrons) or the drift of free electrons from the volume above the surface towards the surface. This work aims to contribute to a better understanding of the evolution of surface charge and its effects in SDBDs.
Dynamic crossover across the peak effect in Ba

1−x

K
x
Fe2As2 superconductor for H

||c

-axis and H

||ab

-plane
Authors: Pissas M , Stamopoulos D , Wang Chunlei , Ma Yanwei
Published: April 2022

The vortex matter properties of a Ba

1
−
x

K
x
Fe2As2 single crystal (

T
c

=
38.2

K) were studied, by employing both isofield and isothermal ac-susceptibility measurements,

χ
n

(
f
,

H
0

)
=

χ
n

′

(
f
,

H
0

)
−
i

χ
n

′
′

(
f
,

H
0

)

, in a wide range of frequencies and amplitudes of the applied ac magnetic field. The irreversibility line (

H

irr

(
T
,
θ
)

), formally defined by the onset of the third harmonic, is recorded for both

H
∥
c

-axis and

H
∥
a
b

-plane. It can be reproduced from the empirical equation,

H

irr

(
T
)
=

H
0

(
1
−
T

/

T
c

)
n

, with

n
c

=

n

a
b

=
1.24

and

μ
0

H
0
c

=
210

Tesla,

μ
0

H
0

a
b

=
540

Tesla. The isofield measurements of the first harmonic revealed a narrow diamagnetic peak, related to a local peak of the critical current below the irreversibility line for both

H
∥
c

-axis and

H
∥
a
b

-plane. The local peak for

μ
0

H
<
0.2

Tesla is transformed to a sudden drop before it completely disappears. Detailed ac-susceptibility measurements were conducted for frequencies ranging within f = 0.1–10 kHz. From these data, the pinning potential, U, is deduced both as function of temperature and dc magnetic field. These results revealed that the ac response of vortex matter exhibits three distinct dynamic behaviors. By employing a model proposed by Mikitik and Brandt (2001 Phys. Rev. B 64 184514), that is based on a Lindemann type criterion and the collective pinning theory, we reproduced the experimentally recorded vortex matter phase diagram by taking into account both thermal fluctuations and random point disorder. To this effect, we adopted a

δ

T
c

pinning mechanism,

c

L

=
0.25

,

D
0

/

c

L

= 1.1–1.5 and a Ginzburg number

G
i
=

10

−
3

.