bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroprevalence of anti‐SARS‐CoV‐2 antibodies in Africa: A systematic review and meta‐analysis
Authors: Chisale Master R. O. , Ramazanu Sheena , Mwale Saul Eric , Kumwenda Pizga , Chipeta Mep , Kaminga Atipatsa C. , Nkhata Obed , Nyambalo Billy , Chavura Elton , Mbakaya Balwani C.
Published: July 2021

We estimated the seroprevalence of anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) antibodies in residents of African countries and explored its associated factors. We searched PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases for peer reviewed articles and pre‐prints that reported anti‐SARS‐CoV‐2 antibody seroprevalence of general or specific human populations resident in Africa. The eligible studies were evaluated using Joana Briggs Institute prevalence critical appraisal tool. Twenty‐three studies involving 27,735 individuals were included in our paper. The pooled seroprevalence of anti‐SARS‐CoV‐2 antibodies in Africa was 22% (95%CI: 14–31) with very high heterogeneity (I2 = 100%, p < 0.001). Seroprevalence was highest in studies conducted in Central Africa compared to Southern Africa, West Africa, North Africa and East Africa respectively. The number of days between the first reported coronavirus disease 2019 case in each country and when a seroprevalence study was conducted was a significant moderator of seroprevalence. Seropositivity was numerically influenced by gender and age of the participants with males and those aged below 50 years being most affected with SARS‐CoV‐2 infection. The highest pooled seroprevalence in Africa reported in this review should be interpreted cautiously due to high heterogeneity between studies. Continued seroprevalence surveillance is warranted to establish Africa's transition towards herd immunity.
Deep depth profiling using gas cluster secondary ion mass spectrometry: Micrometer topography development and effects on depth resolution
Authors: Muramoto Shin , Graham Daniel J.
Published: July 2021

Secondary ion mass spectrometry using the argon cluster primary ion beam enables molecular compositional depth profiling of organic thin films with minimal loss of chemical information or changes in sputter rate. However, for depth profiles of thicker organic films (>10 μm of sputtered depth), we have observed the rapid formation of micron‐scale topography in the shape of pillars that significantly affect both the linearity of the sputter yield and depth resolution. To minimize distortions in the 3D reconstruction of the sample due to this topography, a stepwise, staggered sample rotation was employed. By using polymer spheres embedded in an organic film, it was possible to measure the depth resolution at the film‐sphere interface as a function of sputtered depth and observe when possible distortions in the 3D image occurred. In this way, it was possible to quantitatively measure the effect of micron‐scale topography and sample rotation on the quality of the depth profile.
Interfacial Defects Change the Correlation between Photoluminescence, Ideality Factor, and Open‐Circuit Voltage in Perovskite Solar Cells
Authors: Kim Sohyeon , Jang Jun Hyeok , Wu Ziang , Lee Mi Jung , Woo Han Young , Hwang Inchan
Published: July 2021

The ideality factor (nid) and photoluminescence (PL) analyses assess charge recombination characteristics in perovskite solar cells (PeSCs). However, their correlations with open‐circuit voltage (Voc) are often found to be complicated depending on the recombination types in the devices. Herein, the correlation of nid, PL characteristics and Voc is elucidated depending on the interfacial crystal quality in triple‐cation mixed‐halide perovskite, Cs0.05(MA0.17FA0.83)0.95Pb(I0.83Br0.17)3, deposited on different hole transport layers (HTLs). In the devices with low quality interfacial crystals, Voc increases together with nid, which originates from the light intensity‐dependence of majority carrier at the interface. Meanwhile, a negative correlation between Voc and nid is observed for devices with high quality interfacial crystals. The authors discuss the cases that PL enhancement by the improvement of overall crystal quality can fail to correlate with a Voc increase if interfacial crystal quality becomes worse. The study highlights that interfacial crystal quality evaluation can help to understand charge recombination via nid and PL measurements, and more importantly provide information of which defect engineering between at the interface and in the bulk would be more effective for device optimization.
Defect‐Engineered Nanozyme‐Linked Receptors
Authors: Wu Yu , Wen Jing , Xu Weiqing , Huang Jiajia , Jiao Lei , Tang Yinjun , Chen Yifeng , Yan Hongye , Cao Shiyu , Zheng Lirong , Gu Wenling , Hu Liuyong , Zhang Lizhi , Zhu Chengzhou
Published: July 2021

Though nanozymes are successfully applied in various areas, the increasing demands facilitate the exploitation of nanozymes possessing higher activity and more functions. Natural enzyme‐linked receptors (ELRs) are critical components for signal transductions in vivo by expressing activity variations after binding with ligands. Inspired by this, the defect‐engineered carbon nitrides (DCN) are reported to serve as nanozyme‐linked receptors (NLRs). For one thing, cyano defects increase the enzyme‐like activity by a factor of 109.5. For another, DCN‐based NLRs are constructed by employing cyano groups as receptors, and variable outputs are ensued upon the addition of ion ligands. Significantly, both the cascade effect and electronic effect are demonstrated to contribute to this phenomenon. Finally, NLRs are used for pattern recognition of metal ions, indicating the signal transduction ability of NLRs as well. This work not only provides great promise of defect engineering in nanozymes, but also contributes to the design of artificial ELRs.
“I Don’t Even Know Why This is a Monument”: Exploring Multimodal Making in Early Childhood
Authors: Price‐Dennis Detra , Mapes Noelle
Published: July 2021

In this article, we offer insights into the literacy practices that supported students’ inquiry and critical media making about the role of monuments in our society. We learned that multimodal making with print‐based and digital tools provided an opportunity for the students to engage in critical historical analysis of the monuments in NYC. Specifically, this work revealed that 1) technologies functioned as tools for process and production; 2) students constructed monuments to honor collective action for humanity; and 3) students developed fluid and interconnected literacy practices.
Canine disseminated peritoneal angiomatosis with arterial differentiation in a 10‐month‐old Rhodesian Ridgeback
Authors: Bacon Jessica , Berman Katherine Gray , Gosling Mark , Jardim Gomes Barbara , Giannasi Chiara
Published: July 2021

A 10‐month‐old, male entire Rhodesian Ridgeback was presented with a 1‐week history of vomiting, small and large intestinal diarrhoea, hyporexia and weight loss. Physical examination revealed a palpable abdominal mass. Abdominal ultrasonography and contrast computed tomography demonstrated multiple cystic masses of varied size and wall thickness with no appreciable origin. An exploratory laparotomy revealed multiple mass lesions throughout the mesentery, located adjacent to blood vessels and varying in size from approximately 2 mm up to 13 cm in diameter. In histologic sections, the nodular structures resembled thick‐walled arteries. Immunohistochemistry confirmed positive cytoplasmic immunoreactivity for von Willebrand factor, CD31 and smooth muscle actin. This is, to the authors’ knowledge, the first case of disseminated peritoneal angiomatosis with arterial differentiation in the dog. The dog was euthanased due to the progressive nature of the mass lesions.
Social networks research in ex situ populations: Patterns, trends, and future directions for conservation‐focused behavioral research
Authors: Lewton Jack , Rose Paul E.
Published: July 2021

Social networks research using non‐human animals has grown over the past decade, utilizing a wide range of species to answer an array of pure and applied questions. Network approaches have relevance to conservation, evaluating social influences on fecundity, health, fitness and longevity. While the application of network approaches to in situ populations with conservation concern appears in published literature, the degree to which ex situ and zoo‐housed populations are the focus of “social networks for conservation research” is limited. Captive environments provide scientists with an ability to understand the social behavior of species that may be hard to observe consistently in the wild. This paper evaluates the scope of network research involving ex situ populations, analyzing output from 2010 to 2019 to determine trends in questions and subjects using ex situ populations. We show that only 8.2% of ex situ social network analysis (SNA) implications are of conservation‐focus, apparent in papers relating to birds, carnivores, bats, primates, reptiles, and ungulates. Husbandry and welfare questions predominate in ex situ network research, but over half of these papers have nonpractical application (basic science). The chance of a citation for a basic science paper was 95.4% more than for a conservation‐based paper. For taxonomic groups, primate‐focused papers had the most citations. The focus of ex situ conservation‐based networks research may be driven by the needs of conservation programs (e.g., population recovery outcomes) or by a need to evaluate the efficacy of ex situ conservation goals. We evaluate our findings considering the IUCN's One Plan Approach to conservation to show how in situ and ex situ network research is applicable to global conservation efforts. We have identified that there is a lack of application and evaluation of SNA to wildlife conservation. We highlight future areas of research in zoos and hope to stimulate discussion and collaboration between relevant parties.
NNLO QCD study of polarised W+W− production at the LHC
Authors: Poncelet Rene , Popescu Andrei
Published: July 2021

Abstract

Longitudinal polarisation of the weak bosons is a direct consequence of Electroweak symmetry breaking mechanism providing an insight into its nature, and is instrumental in searches for physics beyond the Standard Model. We perform a polarisation study of the diboson production in the pp →$$ {\mathrm{e}}^{+}{v}_{\mathrm{e}}{\mu}^{-}{\overline{v}}_{\mu } $$

e
+

v
e

μ
−

v
¯

μ

process at NNLO QCD in the fiducial setup inspired by experimental measurements at ATLAS. This is the first polarisation study at NNLO. We employ the double-pole approximation framework for the polarised calculation, and investigate NNLO effects arising in differential distributions.
Friction behavior of the wire material Gummetal®
Authors: Kopsahilis Isabel Eri , Drescher Dieter
Published: July 2021

Objectives

Gummetal® (Maruemu Works, Osaka, Japan), a new orthodontic wire material successfully used in clinical applications since 2006, is biocompatible and exhibits exceptionally high elasticity, nonlinear elastic behavior, plasticity and strength. Systematic comparisons of friction behavior are lacking; thus, the friction of Gummetal® in the binding modus was compared to commonly used low friction wires.

Materials and methods

In vivo tests were run with Gummetal®, CoCr (cobalt-chromium Elgiloy®, Rocky Mountain Orthodontics, Denver, CO, USA), β‑Ti (β-Titanium TMA®, Ormco, Orange, CA, USA), NiTi (nickel–titanium, NiTi-SE, Dentalline, Birkenfeld, Germany), and stainless steel (SS; Ref. 251-925, 3M Unitek, Monrovia, CA, USA) [dimensions: 0.014 inch (0.35 mm), 0.016 inch (0.40 mm), 0.016 × 0.022 inch (0.40 × 0.56 mm), and 0.019 × 0.025 inch (0.48 × 0.64 mm)—β-Ti not available in the dimension 0.014 inch]. These were combined with Discovery® (Dentaurum, Ispringen, Germany), Micro Sprint® (Forestadent, Pforzheim, Germany), Clarity™ (3M Unitek), and Inspire Ice™ (Ormco) and slots in the dimension 0.022 inch (0.56 mm) and, except for the 0.019 × 0.025 inch wires, in the dimension 0.018 inch (0.46 mm). They were ligated with a 0.010 inch (0.25 mm) steel ligature (Smile Dental, Ratingen, Germany). Brackets were angulated by applying a moment of force of 10 Nmm against the wire, which was pulled through the slot at 0.2 mm/s.

Results

In 660 tests using 132 bracket–wire combinations, friction loss for Gummetal® was comparable to and, in a few combinations with Micro Sprint®, significantly lower (p < 0.05) than SS and CoCr. The friction for Gummetal® was significantly lower (p < 0.05) than NiTi, and β‑Ti. In some bracket–wire combinations, lower friction was found with round wires compared to rectangular wires, except for the combination with Inspire Ice™, which was higher but not significant. Slot size did not have a significant effect on friction in most combinations.

Conclusion

The low friction associated with Gummetal® wires during arch-guided tooth movement will be a valuable addition to the armamentarium of orthodontists.
Eine retrospektive Untersuchung zu differenzialdiagnostischen Überlegungen in vermeintlichen Kinderschutzfällen
Authors: Röding Stefanie , Dittmann-Wolf Aline , Lackner Denise , Blume Christian , Hasse Anette , Mützel Elisabeth , Wolf Gerhard K.
Published: July 2021

Hintergrund

Die Diagnosestellung einer Kindesmisshandlung kann mit Irrtümern in beide Richtungen verbunden sein; einerseits können Misshandlungen unentdeckt bleiben oder aber Misshandlungen fälschlicherweise als Ursache für Verletzungen angenommen werden. Derartige diagnostische Irrtümer können dazu führen, dass Kinder dem misshandelnden Umfeld weiterhin ausgesetzt werden oder aber Kinder zu Unrecht in Obhut genommen und von ihrer Familie getrennt werden.

Methoden

Kinderschutzfälle aus den letzten 10 Jahren wurden retrospektiv anhand der elektronischen Krankenakte auf falsch-positive Fälle untersucht. Ein positives Ethikvotum der LMU München zur Publikation liegt vor.

Ergebnisse

Die als falsch-positiv identifizierten Fälle hatten als Ursache für vermeintliche nichtakzidentelle Verletzungsmuster eine genetisch gesicherte Osteogenesis imperfecta Typ 6, einen Lichen sclerosus und eine Hämophilie B. In allen Fällen wurde das Jugendamt miteinbezogen, in allen Fällen kam es zu einer Belastung für Eltern und Kinder, in einem Fall kam es zu einer, im Nachhinein ungerechtfertigten, temporären Inobhutnahme.

Diskussion

Eine interdisziplinär und multiprofessionell besetzte Kinderschutzgruppe an der Kinderklinik kann notwendige Differenzialdiagnosen ins Gespräch bringen und die Koordination mit dem Jugendamt und der Polizei erleichtern. Die Inobhutnahme durch das Jugendamt ist einerseits eine wichtige Maßnahme, um Kinder und Jugendliche vor weiteren Gefährdungen zu schützen, andererseits sollten ungerechtfertigte Inobhutnahmen vermieden werden, weil die daraus resultierende Trennung von Eltern und Kind zu erheblichen Belastungen führen kann. Die Konsultation der Rechtsmedizin ist hilfreich, um die Diagnose entsprechend einzugrenzen oder aber um alternative, medizinische Diagnosen anzubieten.
White matter deficits correlate with visual motion perception impairments in dyslexic carriers of the DCDC2 genetic risk variant
Authors: Perani Daniela , Scifo Paola , Cicchini Guido M. , Rosa Pasquale Della , Banfi Chiara , Mascheretti Sara , Falini Andrea , Marino Cecilia , Morrone Maria Concetta
Published: July 2021

Motion perception deficits in dyslexia show a large intersubjective variability, partly reflecting genetic factors influencing brain architecture development. In previous work, we have demonstrated that dyslexic carriers of a mutation of the DCDC2 gene have a very strong impairment in motion perception. In the present study, we investigated structural white matter alterations associated with the poor motion perception in a cohort of twenty dyslexics with a subgroup carrying the DCDC2 gene deletion (DCDC2d+) and a subgroup without the risk variant (DCDC2d–). We observed significant deficits in motion contrast sensitivity and in motion direction discrimination accuracy at high contrast, stronger in the DCDC2d+ group. Both motion perception impairments correlated significantly with the fractional anisotropy in posterior ventral and dorsal tracts, including early visual pathways both along the optic radiation and in proximity of occipital cortex, MT and VWFA. However, the DCDC2d+ group showed stronger correlations between FA and motion perception impairments than the DCDC2d– group in early visual white matter bundles, including the optic radiations, and in ventral pathways located in the left inferior temporal cortex. Our results suggest that the DCDC2d+ group experiences higher vulnerability in visual motion processing even at early stages of visual analysis, which might represent a specific feature associated with the genotype and provide further neurobiological support to the visual-motion deficit account of dyslexia in a specific subpopulation.
Habitat selection and 3D space use partitioning of resident juvenile hawksbill sea turtles in a small Caribbean bay
Authors: Matley J. K. , Johansen L. K. , Klinard N. V. , Eanes S. T. , Jobsis P. D.
Published: July 2021

Understanding how aquatic animals select and partition resources provides relevant information about community dynamics that can be used to help manage conservation efforts. The critically endangered hawksbill sea turtle (Eretmochelys imbricata) spends an extended part of its juvenile development in coastal waters. A strong proclivity to remain resident in small areas, often in high density, raises questions about how juveniles partition resources including selection of habitat and spatial overlap among conspecifics. Using between 36 and 41 acoustic receivers in the 1.5 km2 study site, this study quantified day-and-night habitat selection, as well as 2D and 3D space use of 23 juvenile hawksbills within two adjacent Caribbean foraging grounds—Brewers Bay and Hawksbill Cove, St. Thomas, US Virgin Islands—between 2015 and 2018. We found that coral reef, rock, and the artificial dolosse forming an airport runway, were the most strongly selected habitats based on resource selection indices. Individual activity spaces in 2D and 3D were both larger during the day compared to night, although the same parts of the bay were used by each individual during both periods. The 3D approach also showed deeper space use during the day. Weekly comparisons of activity space between individuals showed limited overlap (mean 95% UD overlap; day: 0.15 (2D) and 0.07 (3D), night: 0.11 (2D) and 0.03 (3D)), suggesting some degree of resource partitioning or territoriality. Results from this study provide relevant space use information for resource management of juvenile hawksbills, in which many populations are facing habitat degradation and population declines.
Superior Ophthalmic Vein Embolism Following Forehead Augmentation with Autologous Fat Injection
Authors: Putthirangsiwong Bunyada , Vongsilpavattana Varan , Leelawongs Sasikant , Chanthanaphak Ekachat , Tunlayadechanont Padcha , Chokthaweesak Weerawan
Published: July 2021

Background

Facial rejuvenation and reconstruction with autologous fat injection are a common and effective procedure used worldwide. Most surgeons and patients are satisfied with the favorable outcomes. However, catastrophic complications from arterial and venous occlusion resulting in visual loss and stroke may occur.

Case presentation

We herein report a case of isolated venous occlusion from fat embolism. The patient developed acute painful proptosis and blurred vision of her right eye while undergoing an esthetic autologous fat injection into her forehead. Based on her clinical manifestations and radiologic findings, the patient was diagnosed with superior ophthalmic vein occlusion. Symptomatic and supportive treatments were given. Spontaneous clinical improvement occurred without secondary complications. Therefore, the initially planned endovascular therapy with transfemoral transvenous embolectomy of the right superior ophthalmic vein was canceled.

Conclusions

Facial augmentation with autologous fat injection can cause superior ophthalmic vein embolism. Surgeons should therefore perform this procedure very cautiously. Prompt ophthalmological evaluation and proper management are important for improving clinical outcomes.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
The Right to Data Portability: conception, status quo, and future directions
Authors: Kuebler-Wachendorff Sophie , Luzsa Robert , Kranz Johann , Mager Stefan , Syrmoudis Emmanuel , Mayr Susanne , Grossklags Jens
Published: July 2021

For almost three years, the General Data Protection Regulation (GDPR) has been granting citizens of the European Union the right to obtain personal data from companies and to transfer these data to another company. The so-called Right to Data Portability (RtDP) promises to significantly reduce switching costs for consumers in digital service markets, provided that its potential is effectively translated into reality. Thus, of all the consumer rights in the GDPR, the RtDP has the potential to be the one with the most significant implications for digital markets and privacy. However, our research shows that the RtDP is barely known among consumers and can currently only be implemented in a fragmented manner—especially with regard to the direct transfer of data between online service providers. We discuss several ways to improve the implementation of this right in the present article.
Intraokularer Druckanstieg nach Vitrektomie – Applanationstonometrie nach Goldmann misst niedriger als dynamische Konturtonometrie
Authors: Bäurle Sebastian , Viestenz Anja , Seitz Berthold , Viestenz Arne
Published: July 2021

Hintergrund

Das dynamische Konturtonometer PASCAL (DCT) ist ein digitales, der natürlichen Hornhautgeometrie angepasstes Kontakttonometer. Verglichen wurde das DCT mit dem Goldmann-Applanationstonometer (GAT).

Methodik

In einer prospektiven Querschnittstudie wurden 100 Augen vor und nach Pars-plana-Vitrektomie (ppV) vergleichend mit dem GAT und DCT gemessen. Verwendete Endotamponaden waren verschiedene Gase und Silikonöle. Erfasst wurden der präoperative intraokulare Druck (IOD), postoperative Druckveränderungen und die Intertonometerdifferenz.

Ergebnisse

Präoperativ lag der mittlere IOD mit dem GAT gemessen bei 15,8 ± 5,2 mm Hg und dem DCT bei 17,5 ± 5,9 mm Hg. Am ersten postoperativen Tag stieg bei Augen, die mit Gas versorgt wurden, der Druck im Mittel um 2,5 mm Hg (p = 0,035) an. Das DCT erfasste 18 Augen (19,1 %) mit einem postoperativen IOD von ≥ 25 mm Hg. Postoperativ maß das GAT den IOD im Schnitt 2,5 mm Hg niedriger und bei expansiver Gasendotamponade im Mittel um 3,0 mm Hg niedriger als das DCT. Bei IOD-Werten von postoperativ über 20 mm Hg lag das GAT im Mittel 4,7 mm Hg unter dem DCT. Zehn von 18 Augen mit IOD ≥ 25 mm Hg wurden mit dem GAT nicht als hypertensiv (≥ 25 mm Hg) erkannt. Bei 13 % maß das DCT am 1. postoperativen Tag einen um mindestens 6 mm Hg höheren IOD als das GAT. In einem Extremfall wurde der IOD mit dem GAT bei Gasendotamponade um 12 mm Hg unterschätzt.

Schlussfolgerung

Postoperative Druckanstiege nach ppV sind gefürchtete Komplikationen und können zu irreversiblem Visusverlust führen. Abhängig von der verwendeten Endotamponade misst das GAT den IOD niedriger als das DCT – besonders bei Druckspitzen durch expansive Gase. Die postoperative IOD-Messung nach ppV ist bedeutend und die Messwerte von GAT und DCT können abweichen.
Roberts’ weak welfarism theorem: a minor correction
Authors: Hammond Peter J.
Published: July 2021

Roberts’ “weak neutrality” or “weak welfarism” theorem concerns Sen social welfare functionals which are defined on an unrestricted domain of utility function profiles and satisfy independence of irrelevant alternatives, the Pareto condition, and a form of weak continuity. Roberts (Rev Econ Stud 47(2):421–439, 1980) claimed that the induced welfare ordering on social states has a one-way representation by a continuous, monotonic real-valued welfare function defined on the Euclidean space of interpersonal utility vectors—that is, an increase in this welfare function is sufficient, but may not be necessary, for social strict preference. A counter-example shows that weak continuity is insufficient; a minor strengthening to pairwise continuity is proposed instead and its sufficiency demonstrated.
Sedimentology of a coastal shelf sector characterised by multiple bedload boundaries: Plettenberg Bay, inner Agulhas Bank, South Africa
Authors: Flemming Burg , Martin Keith
Published: July 2021

The study deals with a large sand body (spit-bar) attached to the eastern tip of the Robberg Peninsula, Plettenberg Bay, South Africa. To date, the bar has prograded about 8 km beyond the tip of the peninsula. The bar top is predominantly composed of medium sand, the upper slope of fine sand, and the lower slope of fine muddy sand. Stratigraphically, the sedimentology thus documents an upward coarsening, calcareous quartz-arenitic depositional sequence. The spit-bar as a whole forms the eastern end of a sediment compartment that is clearly distinguishable from neighbouring compartments on the basis of its geomorphology, the textural characteristics of the sediment, and the distribution of sediment thicknesses. Aeolian overpass across the peninsula appears to have formed a fan-like sand deposit in its rear, which is perched upon the upper shoreface of the bay as suggested by the bathymetry to the north of the peninsula. It forms an integral part of the sediment body defining the spit-bar. The estimated volume of sand stored in the spit-bar amounts to 5.815 km3, of which 0.22 km3is contributed by the aeolian overpass sand. The sediment sources of the spit-bar are located up to 100 km to the west, where a number of small rivers supply limited amounts of sediment to the sea and numerous coastal aeolianite ridges in the Wilderness embayment have been subject to erosion after becoming drowned in the course of the postglacial sea-level rise since about 12 ky BP. By contrast, the sediment volume in the adjacent compartment B to the north (Plettenberg Bay), which has been supplied by local rivers, amounts to only 0.127 km3. In a geological context, large sand bodies such as the Robberg spit-bar are excellent exploration models for hydrocarbons (oil and gas).
Novel minimally invasive tape suture osteosynthesis for instabilities of the pubic symphysis: a biomechanical study
Authors: Cavalcanti Kußmaul Adrian , Schwaabe Fanny , Kistler Manuel , Gennen Clara , Andreß Sebastian , Becker Christopher A. , Böcker Wolfgang , Greiner Axel
Published: July 2021

Introduction

Open book fractures are challenging injuries oftentimes requiring surgical treatment. The current treatment of choice is symphyseal plating, which requires extensive surgery and entirely limits physiological movement of the symphyseal joint, frequently resulting in implant failure. Therefore, we investigated the biomechanical properties of a semi-rigid implant (modified SpeedBridge™) as a minimally invasive tape suture construct for the treatment of open book fractures and evaluated the superiority of two techniques of implementation: criss-cross vs. triangle technique.

Materials and methods

Nine synthetic symphyseal joints were dissected creating an open book fracture. The different osteosynthesis methods (plating, modified SpeedBridge™ in criss-cross/triangle technique) were then applied. All constructs underwent horizontal and vertical loading, simulating biomechanical forces while sitting, standing and walking. For statistical analysis, dislocation (mm) and stiffness (N/mm) were calculated.

Results

Symphyseal plating for the treatment of open book fractures proved to be a rigid osteosynthesis significantly limiting the physiological mobility of the symphyseal joint (dislocation: 0.08 ± 0.01 mm) compared to the tape sutures (dislocation: triangle technique 0.27 ± 0.07 mm, criss-cross technique 0.23 ± 0.05 mm) regarding horizontal tension (p < 0.01). Both modified SpeedBridge™ techniques showed sufficient biomechanical stability without one being superior to the other (p > 0.05 in all directions).

Considering vertical loading, no statistical difference was found between all osteosynthesis methods (caudal: p = 0.41; cranial: p = 0.61).

Conclusions

Symphyseal plating proved to be the osteosynthesis method with the highest rigidity. The modified SpeedBridge™ as a semi-rigid suture construct provided statistically sufficient biomechanical stability while maintaining a minimum of symphyseal movement, consequently allowing ligamental healing of the injured joint without iatrogenic arthrodesis. Furthermore, both the criss-cross and the triangle technique displayed significant biomechanical stability without one method being superior.
Subacromial impingement syndrome: association of multiple magnetic resonance imaging parameters with shoulder function and pain
Authors: Jäschke Malte , Köhler Hans-Christian , Weber Marc-André , Tischer Thomas , Hacke Claudia , Schulze Christoph
Published: July 2021

Introduction

Shoulder pain is one of the most common complaints in orthopaedics. This study focusses on the relationship between shoulder function in subacromial impingement syndrome and imaging criteria in magnetic resonance imaging (MRI).

Materials and methods

This prospective clinical trial included 69 patients treated for subacromial impingement syndrome. Shoulder function (Constant Score, range of abduction, abduction force) and pain were correlated with the following MRI parameters: tendinosis of the rotator cuff, “halo-sign” around the biceps tendon, subacromial distance, critical shoulder angle, size of subacromial osteophytic spurs and maximum width of subacromial and subdeltoid bursa. Statistical analyses included Pearson’s and Spearman’s coefficients of correlation, multiple regression analysis and Student’s t-test.

Results

The Constant Score was correlated positively with the critical shoulder angle (r = 0.313; p = 0.009) and inversely with a “halo-sign” around the biceps tendon (rho =  −0.384; p = 0.001). There was no significant correlation between spur size and shoulder function, but the size of the subacromial and subdeltoid bursae was positively correlated with the subacromial spur’s size (subacromial bursa: coronal plane: r = 0.327; p = 0.006; sagittal view: r = 0.305; p = 0.011; subdeltoid bursa coronal view: r = 0.333 p = 0.005). The width of the subdeltoid bursa in coronal plane was positively correlated with shoulder pain (r = 0.248; p = 0.004) and negatively with the range of abduction (r =  −0.270; p = 0.025), as well as the mean (r =  −0.332; p = 0.005) and maximum (r =  −0.334; p = 0.005) abduction force.

Conclusions

Shoulder function and pain in subacromial impingement are best predicted by the width of the subdeltoid bursa measured in the coronal MRI plane as an indicator of bursitis as well as the presence of a “halo-sign” around the biceps tendon indicating glenohumeral joint effusion. Presence of a subacromial spur could lead to subacromial and subdeltoid bursitis, which impairs shoulder function. Shoulder function seems not to be compromised by the presence of a subacromial spur in absence of bursitis.

This study was registered at the German Clinical Trials Register on 08 February 2013 (ID: DRKS00011548).
Tortures alleged by migrants in Italy: compatibility and other medicolegal challenges
Authors: Bianchi Ilenia , Focardi Martina , Bugelli Valentina , Pradella Francesco , Giolli Carlo , Friani Francesca , Pinchi Vilma
Published: July 2021

Background

Illegal immigration to Europe is a well-known phenomenon whose numbers are being steadily increasing in recent years. Most of the immigrants in Italy come from war zones, and many of them submit an asylum application supported by the complaint to have been victims of persecutory acts in their home countries.

Material and methods

One hundred ninety-six medicolegal reports are analyzed considering the different country of origin, the type of the lesions claimed, tools used, evidenced effects, location of the perpetration of the physical abuses, and the possible motivation of the alleged torture.

Results

Greater than 80% of the assessed asylum seekers are over 18-year males coming from African countries. Fifty-eight percent of migrants were tortured or abused in countries of transit, 95% in Libya. Economic, familial, politic, and ethnic reasons prevail in some countries of origin, while tortures or abuses perpetrated in transit countries are mainly linked to forced labor and detention. In the 42.2% of cases, no physical evidence of tortures was detected. The Istanbul Protocol resulted to have been only partly applicable and about 40% of the medicolegal reports are “inconclusive” about the compatibility of physical evidence with the alleged tortures.

Conclusions

The medicolegal and forensic experts involved in torture and ill-treatment cases should seek specific education and training to lower the risks of underestimation and the rate of inconclusive reports. More extensive implementation of the Istanbul Protocol in daily practice should be pursued by the authorities in charge of asylum or protection releasement.
Mucoepidermoid carcinoma of the salivary glands revisited with special reference to histologic grading and CRTC1/3-MAML2 genotyping
Authors: Fehr André , Werenicz Sarah , Trocchi Pietro , Falk Markus , Friedrich Reinhard E. , Stammler Angelika , Stang Andreas , Oesterling Florian , Khil Laura , Stenman Göran , Böcker Werner , Tiemann Katharina , Löning Thomas
Published: July 2021

Mucoepidermoid carcinoma (MEC) is the most common carcinoma of the salivary glands. Here, we have used two large patient cohorts with MECs comprising 551 tumors to study clinical, histological, and molecular predictors of survival. One cohort (n = 167), with known CRCT1/3-MAML2 fusion status, was derived from the Hamburg Reference Centre (HRC; graded with the AFIP and Brandwein systems) and the other (n = 384) was derived from the population-based Cancer Registry of North Rhine-Westphalia (LKR-NRW; graded with the AFIP system). The reliability of both the AFIP and Brandwein grading systems was excellent (n = 155). The weighted kappa for inter-rater agreement was 0.81 (95% CI 0.65–0.97) and 0.83 (95% CI 0.71–0.96) for the AFIP and Brandwein systems, respectively. The 5-year relative survival was 79.7% (95% CI 73.2–86.2%). Although the Brandwein system resulted in a higher rate of G3-MECs, survival in G3-tumors (AFIP or Brandwein grading) was markedly worse than in G1/G2-tumors. Survival in > T2 tumors was markedly worse than in those with lower T-stage. Also, fusion-negative MECs had a worse 5-year progression-free survival. The frequency of fusion-positive MECs in the HRC cohort was 78.4%, of which the majority (86.7%) was G1/G2-tumors. In conclusion, the AFIP and Brandwein systems are useful in estimating prognosis and to guide therapy for G3-MECs. However, their significance regarding young age (≤ 30 years) and location-dependent heterogeneity of in particular G2-tumors is more questionable. We conclude that CRTC1/3-MAML2 testing is a useful adjunct to histologic scoring of MECs and for pinpointing tumors with poor prognosis with higher precision, thus avoiding overtreatment.
Complementary and alternative medicine (CAM) supplements in cancer outpatients: analyses of usage and of interaction risks with cancer treatment
Authors: Wolf Clemens P. J. G. , Rachow Tobias , Ernst Thomas , Hochhaus Andreas , Zomorodbakhsch Bijan , Foller Susan , Rengsberger Matthias , Hartmann Michael , Huebner Jutta
Published: July 2021

Purpose

The aim of our study was to analyze the use of complementary and alternative medicine (CAM) supplements, identify possible predictors, and analyze and compile potential interactions of CAM supplements with conventional cancer therapy.

Methods

We included outpatient cancer patients treated at a German university hospital in March or April 2020. Information was obtained from questionnaires and patient records. CAM–drug interactions were identified based on literature research for each active ingredient of the supplements consumed by the patients.

Results

37.4% of a total of 115 patients consumed CAM supplements. Potential interactions with conventional cancer treatment were identified in 51.2% of these patients. All types of CAM supplements were revealed to be a potential source for interactions: vitamins, minerals, food and plant extracts, and other processed CAM substances. Younger age (< 62 years) (p = 0.020, φc = 0.229) and duration of individual cancer history of more than 1 year (p = 0.006, φc = 0.264) were associated with increased likelihood of CAM supplement use. A wide range of different CAM supplement interactions were reviewed: effects of antioxidants, cytochrome (CYP) interactions, and specific agonistic or antagonistic effects with cancer treatment.

Conclusion

The interaction risks of conventional cancer therapy with over-the-counter CAM supplements seem to be underestimated. Supplements without medical indication, as well as overdoses, should be avoided, especially in cancer patients. To increase patient safety, physicians should address the risks of interactions in physician–patient communication, document the use of CAM supplements in patient records, and check for interactions.
Linking Numbers in Three-Manifolds
Authors: Cahn Patricia , Kjuchukova Alexandra
Published: July 2021

Let M be a connected, closed, oriented three-manifold and K, L two rationally null-homologous oriented simple closed curves in M. We give an explicit algorithm for computing the linking number between K and L in terms of a presentation of M as an irregular dihedral three-fold cover of $$S^3$$

S
3

branched along a knot $$\alpha \subset S^3$$

α
⊂

S
3

. Since every closed, oriented three-manifold admits such a presentation, our results apply to all (well-defined) linking numbers in all three-manifolds. Furthermore, ribbon obstructions for a knot $$\alpha $$
α
can be derived from dihedral covers of $$\alpha $$
α
. The linking numbers we compute are necessary for evaluating one such obstruction. This work is a step toward testing potential counter-examples to the Slice-Ribbon Conjecture, among other applications.
Effects of Soil Abiotic and Biotic Factors on Tree Seedling Regeneration Following a Boreal Forest Wildfire
Authors: Ibáñez Theresa S. , Wardle David A. , Gundale Michael J. , Nilsson Marie-Charlotte
Published: July 2021

Wildfire disturbance is important for tree regeneration in boreal ecosystems. A considerable amount of literature has been published on how wildfires affect boreal forest regeneration. However, we lack understanding about how soil-mediated effects of fire disturbance on seedlings occur via soil abiotic properties versus soil biota. We collected soil from stands with three different severities of burning (high, low and unburned) and conducted two greenhouse experiments to explore how seedlings of tree species (Betula pendula, Pinus sylvestris and Picea abies) performed in live soils and in sterilized soil inoculated by live soil from each of the three burning severities. Seedlings grown in live soil grew best in unburned soil. When sterilized soils were reinoculated with live soil, seedlings of P. abies and P. sylvestris grew better in soil from low burn severity stands than soil from either high severity or unburned stands, demonstrating that fire disturbance may favor post-fire regeneration of conifers in part due to the presence of soil biota that persists when fire severity is low or recovers quickly post-fire. Betula pendula did not respond to soil biota and was instead driven by changes in abiotic soil properties following fire. Our study provides strong evidence that high fire severity creates soil conditions that are adverse for seedling regeneration, but that low burn severity promotes soil biota that stimulates growth and potential regeneration of conifers. It also shows that species-specific responses to abiotic and biotic soil characteristics are altered by variation in fire severity. This has important implications for tree regeneration because it points to the role of plant–soil–microbial feedbacks in promoting successful establishment, and potentially successional trajectories and species dominance in boreal forests in the future as fire regimes become increasingly severe through climate change.
A matter of frailty: the modified Subdural Hematoma in the Elderly (mSHE) score
Authors: Hernández-Durán Silvia , Behme Daniel , Rohde Veit , von der Brelie Christian
Published: July 2021

The Subdural Hematoma in the Elderly (SHE) score was developed as a model to predict 30-day mortality from acute, chronic, and mixed subdural hematoma in the elderly population after minor or no trauma. Emerging evidence suggests frailty to be predictive of mortality and morbidity in the elderly. In this study, we aim to externally validate the SHE for chronic subdural hematoma (CSDH) alone, and we hypothesize that the incorporation of frailty into the SHE may increase its predictive power. A retrospective cohort of elderly patients with CSDH after minor or no trauma being treated at our institution was evaluated with the SHE. Thirty-day mortality and outcome were documented. Patients were assessed with the Clinical Frailty Scale (CFS), which was incorporated into a modified SHE (mSHE). Both the SHE and the mSHE were then assessed in their predictive powers through receiver operating characteristic statistics. We included 168 patients. Most (n = 124, 74%) had a favorable outcome at 30 days. Mortality was low at n = 7, 4%. The SHE failed to predict mortality (AUC = .564, p = .565). Contrarily, the mSHE performed well in both mortality (AUC = .749, p = .026) and outcome (AUC = .862, p < .001). A threshold of mSHE = 3 is predictive of mortality with a sensitivity of 50% and a specificity of 75% and of poor outcome with a sensitivity of 88% and a specificity of 64%. Frailty should be routinely evaluated in elderly individuals, as it can predict outcome and mortality, providing the possibility for medical, surgical, nutritional, cognitive, and physical exercise interventions.
Diagnostic utility of a novel magnifying endoscopic classification system for superficial Barrett’s esophagus-related neoplasms: a nationwide multicenter study
Authors: Goda Kenichi , Takeuchi Manabu , Ishihara Ryu , Fujisaki Junko , Takahashi Akiko , Takaki Yasuhiro , Hirasawa Dai , Momma Kumiko , Amano Yuji , Yagi Kazuyoshi , Furuhashi Hiroto , Hashimoto Satoru , Kanesaka Takashi , Shimizu Tomoki , Ono Yoichiro , Yamagata Taku , Fujiwara Junko , Azumi Takane , Watanabe Gen , Ohkura Yasuo , Nishikawa Masako , Oyama Tsuneo
Published: July 2021

Background

Currently, no classification system using magnification endoscopy for the diagnosis of superficial Barrett’s esophagus (BE)-related neoplasia has been widely accepted. This nationwide multicenter study aimed to validate the diagnostic accuracy and reproducibility of the magnification endoscopy classification system, including the diagnostic flowchart developed by the Japan Esophageal Society—Barrett’s esophagus working group (JES-BE) for superficial Barrett’s esophagus-related neoplasms.

Methods

The JES-BE acquired high-definition magnification narrow-band imaging (HM-NBI) images of non-dysplastic and dysplastic BE from 10 domestic institutions. A total of 186 high-quality HM-NBI images were selected. Thirty images were used for the training phase and 156 for the validation (test) phase. We invited five non-experts and five expert reviewers. In the training phase, the reviewers discussed how to correctly predict the histology based on the JES-BE criteria. In the validation phase, they evaluated whether the criteria accurately predicted the histology results according to the diagnostic flowchart. The validation phase was performed immediately after the training phase and at 6 weeks thereafter.

Results

The sensitivity and specificity for all reviewers were 87% and 97%, respectively. Overall accuracy, positive predictive value, and negative predictive value were 91%, 98%, and 83%, respectively. The overall strength of inter-observer and intra-observer agreements for dysplastic histology prediction was κ = 0.77 and κ = 0.83, respectively. No significant difference in diagnostic accuracy and reproducibility between experts and non-experts was found.

Conclusion

The JES-BE classification system, including the diagnostic flowchart for predicting dysplastic BE, is acceptable and reliable, regardless of the clinician’s experience level.
Peri-anastomotic microdialysis lactate assessment after esophagectomy
Authors: Hedberg Jakob , Linder Gustav , Sundbom Magnus
Published: July 2021

Background

Esophagectomy is the cornerstone in curative treatment for esophageal and gastroesophageal junctional cancer. Esophageal resection is an advanced procedure with many complications, whereof anastomotic leak is the most dreaded. This study aimed to monitor the microcirculation with microdialysis analysis of local lactate levels in real-time on both sides of the esophagogastric anastomosis in totally minimally invasive Ivor-Lewis esophagectomy.

Materials and Methods

Twenty-five patients planned for esophageal resection with gastric conduit reconstruction and intrathoracic anastomosis were recruited. A sampling device, the OnZurf® Probe, along with the CliniSenz® Analyser (Senzime AB, Uppsala Sweden) was utilized for measurements. Lactate levels from both sides of the anastomosis were analysed in real time, on site, by a transportable analyser device. Measurements were made every 30 min during the first 24 h, and thereafter every 2 hours for up to 4 days.

Results

All probes could be positioned as planned and on the third postoperative day 19/25 and 15/25 of the esophageal and gastric probes, respectively, continued to deliver measurements. In total, 89.6% (1539/1718) and 72.4% (1098/1516) of the measurements were deemed successful. The average lactate level on the esophageal side of the anastomosis and the gastric conduit ranged between 1.1–11.5 and 0.8–7.0 mM, respectively. Two anastomotic leaks occurred, one of which had persisting high lactate levels on the gastric side of the anastomosis.

Conclusion

Application and use of the novel CliniSenz® analyser system, in combination with the OnZurf® Probe was feasible and safe. Continuous monitoring of analytes from the perianastomotic area has the potential to improve care after esophageal resection.