bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinguishing feature of gut microbiota in Tibetan highland coronary artery disease patients and its link with diet
Authors: Ma Yulan , Zhu Lulu , Ma Zhijun , Gao Zhongshan , Wei Yumiao , Shen Youlu , Li Lin , Liu Xingli , Ren Ming
Published: September 2021

The prevalence of coronary artery disease (CAD) in Tibetan Highlanders is lower than that in plain-living individuals, but the mechanism still unclear. Gut microbiota (GM) disorder is considered one of the potential factors involved in the pathogenesis of CAD, but the GM characteristics of Tibetan Highlanders suffering from CAD are unknown. We sequenced the V3-V4 region of the 16S ribosomal RNA of gut bacteria from fecal samples from Tibetan and Han CAD patients and healthy individuals inhabiting the Qinghai-Tibet Plateau, as well as from Han CAD patients and healthy individuals living at sea level, and we analyzed the GM characteristics of these subjects by bioinformatics analysis. The results showed that Tibetan Highlanders suffering from CAD had higher GM α-diversity, with differently distributed cluster compared with healthy Tibetan Highlanders and Han CAD patients living at high and low altitudes. Genera Catenibacterium, Clostridium_sensu_stricto, Holdemanella, and Ruminococcus 2 were enriched in Tibetan Highlanders suffering from CAD compared with healthy Tibetan Highlanders and Han CAD patients living at high- and low-altitudes. Prevotella was enriched in Tibetan Highlanders suffering from CAD compared with Han CAD patients living at high- and low-altitudes. Moreover, Catenibacterium was positively correlated with Prevotella. Additionally, Catenibacterium, Holdemanella, and Prevotella were positively correlated with fermented dairy product, carbohydrate and fiber intake by the subjects, while Clostridium_sensu_stricto was negatively correlated with protein intake by the subjects. In conclusion, our study indicated that Tibetan Highlanders suffering from CAD showed distinct GM, which was linked to their unique dietary characteristics and might associated with CAD.
Physical insights on transistors based on lateral heterostructures of monolayer and multilayer PtSe2 via Ab initio modelling of interfaces
Authors: Calogero Gaetano , Marian Damiano , Marin Enrique G. , Fiori Gianluca , Iannaccone Giuseppe
Published: September 2021

Lateral heterostructures (LH) of monolayer-multilayer regions of the same noble transition metal dichalcogenide, such as platinum diselenide (PtSe2), are promising options for the fabrication of efficient two-dimensional field-effect transistors (FETs), by exploiting the dependence of the energy gap on the number of layers and the intrinsically high quality of the heterojunctions. Key for future progress in this direction is understanding the effects of the physics of the lateral interfaces on far-from-equilibrium transport properties. In this work, a multi-scale approach to device simulation, capable to include ab-initio modelling of the interfaces in a computationally efficient way, is presented. As an application, p- and n-type monolayer-multilayer PtSe2LH-FETs are investigated, considering design parameters such as channel length, number of layers and junction quality. The simulations suggest that such transistors can provide high performance in terms of subthreshold characteristics and switching behavior, and that a single channel device is not capable, even in the ballistic defectless limit, to satisfy the requirements of the semiconductor roadmap for the next decade, and that stacked channel devices would be required. It is shown how ab-initio modelling of interfaces provides a reliable physical description of charge displacements in their proximity, which can be crucial to correctly predict device transport properties, especially in presence of strong dipoles, mixed stoichiometries or imperfections.
Constructing a passive targeting and long retention therapeutic nanoplatform based on water-soluble, non-toxic and highly-stable core–shell poly(amino acid) nanocomplexes
Authors: Wang Xin , Deng Bingqing , Yu Meng , Zeng Tao , Chen Yuyu , Hu Jianqiang , Wu Qianqing , Li Aiqing
Published: September 2021

A water-soluble, non-toxic, stable, passive kidney targeting, slow-released and long retentive therapeutic nanoplatform of core–shell gefitinib/poly(ethylene glycol)-polytyrosine nanocomplexes (Gef-PY NCs) is designed and constructed.
Metal–organic framework micromotors: perspectives for environmental applications
Authors: Vikrant Kumar , Kim Ki-Hyun
Published: September 2021

Metal–organic framework micromotors possessing a self-propulsion system have been proposed as a new generation of advanced materials for various environmental applications.
Single-molecule magnets within polyoxometalate-based frameworks
Authors: Babaei Zarch Malihe , Mirzaei Masoud , Bazargan Maryam , Gupta Sandeep K. , Meyer Franc , Mague Joel T.
Published: September 2021

Two polyoxometalate-based frameworks containing holmium and terbium are synthesized. Their single-molecule magnet (SMM) properties are investigated, where weak field-induced SMM behaviour is observed at low temperatures in dynamic magnetic studies.
Half-sandwich manganese complexes Cp(CO)2Mn(NHC) as redox-active organometallic fragments
Authors: Brousses Rémy , Maurel Vincent , Mouesca Jean-Marie , César Vincent , Lugan Noël , Valyaev Dmitry A.
Published: September 2021

One-electron oxidation of MnI NHC complexes affords stable 17-electron MnII radical cations. The influence of NHC substituents on spectroscopic properties and conformational behavior within the series of MnI/MnII species was systematically studied.
Magneli-type tungsten oxide nanorods as catalysts for the selective oxidation of organic sulfides
Authors: Dören René , Hartmann Jens , Leibauer Benjamin , Panthöfer Martin , Mondeshki Mihail , Tremel Wolfgang
Published: September 2021

Reduced Magneli-type tungsten oxide WO3−x nanorods selectively catalyze the oxidation of thioethers to the corresponding sulfoxides in an oxidase-like manner, while CeO2 nanocrystals catalyze oxidation to the sulfones.
A method to restore the intrinsic dielectric functions of 2D materials in periodic calculations
Authors: Yang Guang , Gao Shang-Peng
Published: September 2021

A highly feasible method to restore the intrinsic optical properties of 2D materials in supercell calculations was formulated and applied.
The construction of benzimidazo[2,1-a]isoquinolin-6(5H)-ones from N-methacryloyl-2-phenylbenzoimidazoles through radical strategies
Authors: Kang Qing-Qing , Zhang Wei-Kang , Ge Guo-Ping , Zheng Hongxing , Wei Wen-Ting
Published: September 2021

We highlight significant progress in the synthesis of benzimidazo[2,1-a]isoquinolin-6(5H)-ones using C-, S-, P-, and Si-centered radicals, including the selection of the catalytic system, substrate scope, mechanistic understanding, and applications.
Structural revision of the Mcl-1 inhibitor MIM1: synthesis and biological studies on ovarian cancer cells with evaluation of designed analogues
Authors: Paysant Hippolyte , Hedir Siham , Justaud Frédéric , Weiswald Louis Bastien , El Dine Assaad Nasr , Soulieman Ali , Hachem Ali , Elie Nicolas , Brotin Emilie , Denoyelle Christophe , Bignon Jérôme , Roussi Fanny , Jouanne Marie , Tasseau Olivier , Roisnel Thierry , Voisin-Chiret Anne Sophie , Grée René , Levoin Nicolas , Poulain Laurent
Published: September 2021

This paper describes the synthesis and biological evaluation of new inhibitors of anti-apoptotic proteins towards novel anti-cancer agents.
Iron-catalyzed radical cascade cyclization of oxime esters with isocyanides: synthesis of 1-cyanoalkyl isoquinolines and 6-cyanoalkyl phenanthridines
Authors: Xue Dengqi , Liu Rongqi , Zhang Denggao , Li Ning , Xue Yijie , Ge Qianwei , Shao Liming
Published: September 2021

An iron-catalyzed radical cascade cyclization of oxime esters with isocyanides for the synthesis of 1-cyanoalkyl isoquinolines and 6-cyanoalkyl phenanthridines has been developed.
Effect of hydrophilic groups on the bioactivity of antimicrobial polymers
Authors: Pham Phuong , Oliver Susan , Wong Edgar H. H. , Boyer Cyrille
Published: September 2021

Antimicrobial polymers have recently been investigated as potential treatments to combat multidrug-resistant pathogens.
Catalytic asymmetric dearomative [4 + 2] annulation of 2-nitrobenzofurans and 5H-thiazol-4-ones: stereoselective construction of dihydrobenzofuran-bridged polycyclic skeletons
Authors: Zhao Jian-Qiang , Zhou Shun , Wang Zhen-Hua , You Yong , Chen Shuang , Liu Xiong-Li , Zhou Ming-Qiang , Yuan Wei-Cheng
Published: September 2021

An organocatalytic asymmetric dearomative [4 + 2] annulation of 2-nitrobenzofurans and 5H-thiazol-4-ones is developed for the construction of dihydrobenzofuran-bridged polycyclic skeletons with good results.
Phenolate anion-catalyzed direct activation of inert alkyl chlorides driven by visible light
Authors: Wei Delian , Li Xipan , Shen Lei , Ding Yuzhen , Liang Kangjiang , Xia Chengfeng
Published: September 2021

A photochemical activation of inert alkyl chlorides catalyzed by phenolate anions was developed for C–O bond formation, dehalogenation, and cyclization under mild conditions.
A robust and facile method for desulfonation to amines
Authors: Li Chen , Huang Yilei , Cao Sheng , Luo Yunhao , Zhang Ying , Yang Guang
Published: September 2021

In this study, a robust and facile method for desulfonation to achieve secondary amines is demonstrated.
Correction: Neuroinflammatory inhibitors from Gardneria nutans Siebold & Zuccarini
Authors: Si Ying-Ying , Wang Wei-Wei , Feng Qing-Mei , Zhao Zhen-Zhu , Xue Gui-Min , Sun Yan-Jun , Feng Wei-Sheng , Jun Im Young , Wang Xian-Shi
Published: September 2021

Correction for ‘Neuroinflammatory inhibitors from Gardneria nutans Siebold & Zuccarini’ by Ying-Ying Si et al., RSC Adv., 2021, 11, 27085–27091. DOI: 10.1039/D1RA05204G.
Real-time imaging of cell-surface proteins with antibody-based fluorogenic probes
Authors: Wang Wenchao , Zhang Ying , Zhao Hong , Zhuang Xinlei , Wang Haoting , He Kaifeng , Xu Wanting , Kang Yu , Chen Shuqing , Zeng Su , Qian Linghui
Published: September 2021

A modular strategy to convert commercially available antibodies into fluorogenic probes has been developed, enabling selective recognition and wash-free imaging of endogenous membrane proteins.
Direct access to tetrasubstituted cyclopentenyl scaffolds through a diastereoselective isocyanide-based multicomponent reaction
Authors: Fernandes Vitor A. , Lima Rafaely N. , Broterson Yoisel B. , Kawamura Meire Y. , Echemendía Radell , de la Torre Alexander F. , Ferreira Marco A. B. , Rivera Daniel G. , Paixão Marcio W.
Published: September 2021

Simple and available reagents are combined in this new three-component isocyanide-based multicomponent reaction providing an interesting and straightforward way to prepare complex and highly functionalized cyclopentenyl rings.
Mussel-inspired hydrogels as tough, self-adhesive and conductive bioelectronics: a review
Authors: Yu Qin , Zheng Zirong , Dong Xinhao , Cao Rui , Zhang Shuheng , Wu Xiaolin , Zhang Xinya
Published: September 2021

To achieve the goal of robust mechanical properties, long-term adhesion, sensitive electrical conductivity, the wearable sensors were inspired by various mussels on the base of catechol and its analogues.
Natural template derived porous carbon nanoplate architectures with tunable pore configuration for a full-carbon sodium-ion capacitor
Authors: Wang Kunfang , Sun Fei , Su Yanlin , Chen Yingquan , Gao Jihui , Yang Haiping , Zhao Guangbo
Published: September 2021

Porous carbon nanoplates with tailored morphology were fabricated as electrodes of SIC by using natural dolomite as a template and coal tar as a carbon precursor. The full-carbon SIC exhibits high energy and power densities as well as a long cycling lifespan.
Electrospinning nanofibers and nanomembranes for oil/water separation
Authors: Yan Xianhang , Xiao Xiao , Au Christian , Mathur Shaurya , Huang Linjun , Wang Yanxin , Zhang Zhijie , Zhu Zhijun , Kipper Matt J. , Tang Jianguo , Chen Jun
Published: September 2021

This paper gives a current summary of research advances in the field of electrospun nanofibers and nanofiber membranes for oil/water separation. And a discussion about the future field development is given.
A dramatic reduction in the sintering temperature of the refractory sodium β′′-alumina solid electrolyte via cold sintering
Authors: Grady Zane , Ndayishimiye Arnaud , Randall Clive
Published: September 2021

The refractory solid electrolyte, sodium beta alumina, is cold sintered at 375 °C which is over 1000 °C lower than conventional sintering. A relative density above 90% and an ionic conductivity of 10−3 S cm−1 (300 °C) is obtained.
High partial thermal conductivity of luminescence sites: a crucial factor for reducing the heat-induced lowering of the luminescence efficiency
Authors: Luo Ni , Xu Jing , Cheng Xiyue , Li ZhenHua , Huang Yidong , Whangbo Myung-Hwan , Deng Shuiquan , Hong Maochun
Published: September 2021

The high partial thermal conductivity of luminescence sites is associated with the reduction of the heat-induced lowering of the luminescence efficiency of phosphors. This finding may be helpful for screening efficient phosphors.
High-throughput virtual screening for organic electronics: a comparative study of alternative strategies
Authors: Omar Ömer H. , del Cueto Marcos , Nematiaram Tahereh , Troisi Alessandro
Published: September 2021

We review how high throughput virtual screening can been used to navigate the landscape of materials for organic electronics.
Retromer dependent changes in cellular homeostasis and Parkinson's disease
Authors: Yang Zhe , Li Zebin , Teasdale Rohan D.
Published: September 2021

To date, mechanistic treatments targeting the initial cause of Parkinson's disease (PD) are limited due to the underlying biological cause(s) been unclear. Endosomes and their associated cellular homeostasis processes have emerged to have a significant role in the pathophysiology associated with PD. Several variants within retromer complex have been identified and characterised within familial PD patients. The retromer complex represents a key sorting platform within the endosomal system that regulates cargo sorting that maintains cellular homeostasis. In this review, we summarise the current understandings of how PD-associated retromer variants disrupt cellular trafficking and how the retromer complex can interact with other PD-associated genes to contribute to the disease progression.
Stellar structures, molecular gas, and star formation across the PHANGS sample of nearby galaxies
Authors: Querejeta M. , Schinnerer E. , Meidt S. , Sun J. , Leroy A. K. , Emsellem E. , Klessen R. S. , Muñoz-Mateos J. C. , Salo H. , Laurikainen E. , Bešlić I. , Blanc G. A. , Chevance M. , Dale D. A. , Eibensteiner C. , Faesi C. , García-Rodríguez A. , Glover S. C. O. , Grasha K. , Henshaw J. , Herrera C. , Hughes A. , Kreckel K. , Kruijssen J. M. D. , Liu D. , Murphy E. J. , Pan H.-A. , Pety J. , Razza A. , Rosolowsky E. , Saito T. , Schruba A. , Usero A. , Watkins E. J. , Williams T. G.
Published: September 2021

We identify stellar structures in the PHANGS sample of 74 nearby galaxies and construct morphological masks of sub-galactic environments based on Spitzer 3.6 μm images. At the simplest level, we distinguish five environments: centres, bars, spiral arms, interarm regions, and discs without strong spirals. Slightly more sophisticated masks include rings and lenses, which are publicly released but not explicitly used in this paper. We examine trends with environment in the molecular gas content, star formation rate, and depletion time using PHANGS–ALMA CO(2–1) intensity maps and tracers of star formation. The interarm regions and discs without strong spirals clearly dominate in area, whereas molecular gas and star formation are quite evenly distributed among the five basic environments. We reproduce the molecular Kennicutt–Schmidt relation with a slope compatible with unity within the uncertainties and without significant slope differences among environments. In contrast to what has been suggested by early studies, we find that bars are not always deserts devoid of gas and star formation, but instead they show large diversity. Similarly, spiral arms do not account for most of the gas and star formation in disc galaxies, and they do not have shorter depletion times than the interarm regions. Spiral arms accumulate gas and star formation, without systematically boosting the star formation efficiency. Centres harbour remarkably high surface densities and on average shorter depletion times than other environments. Centres of barred galaxies show higher surface densities and wider distributions compared to the outer disc; yet, depletion times are similar to unbarred galaxies, suggesting highly intermittent periods of star formation when bars episodically drive gas inflow, without enhancing the central star formation efficiency permanently. In conclusion, we provide quantitative evidence that stellar structures in galaxies strongly affect the organisation of molecular gas and star formation, but their impact on star formation efficiency is more subtle.
Dynamical effects of the radiative stellar feedback on the H I-to-H2 transition
Authors: Maillard Vincent , Bron Emeric , Le Petit Franck
Published: September 2021

Context. The atomic-to-molecular hydrogen (H/H2) transition has been extensively studied as it controls the fraction of gas in a molecular state in an interstellar cloud. This fraction is linked to star-formation by the Schmidt–Kennicutt law. While theoretical estimates of the column density of the H I layer have been proposed for static photodissociation regions (PDRs), Herschel and well-resolved Atacama Large Millimeter Array observations have revealed dynamical effects in star forming regions, caused by the process of photoevaporation.

Aims. We extend the analytic study of the H/H2 transition to include the effects of the propagation of the ionization front, in particular in the presence of photoevaporation at the walls of blister H II regions, and we find its consequences on the total atomic hydrogen column density at the surface of clouds in the presence of an ultraviolet field, and on the properties of the H/H2 transition.

Methods. We solved semi-analytically the differential equation giving the H2 column density profile by taking into account H2 formation on grains, H2 photodissociation, and the ionization front propagation dynamics modeled as advection of the gas through the ionization front.

Results. Taking this advection into account reduces the width of the atomic region compared to static models. The atomic region may disappear if the ionization front velocity exceeds a certain value, leading the H/H2 transition and the ionization front to merge. For both dissociated and merged configurations, we provide analytical expressions to determine the total H I column density. Our results take the metallicity into account. Finally, we compared our results to observations of PDRs illuminated by O-stars, for which we conclude that the dynamical effects are strong, especially for low-excitation PDRs.
Space Weather research in the Digital Age and across the full data lifecycle: Introduction to the Topical Issue
Authors: McGranaghan Ryan M. , Camporeale Enrico , Georgoulis Manolis , Anastasiadis Anastasios
Published: September 2021

The onset and rapid advance of the Digital Age have brought challenges and opportunities for scientific research characterized by a continuously evolving data landscape reflected in the four V’s of big data: volume, variety, veracity, and velocity. The big data landscape supersedes traditional means of storage, processing, management, and exploration, and requires adaptation and innovation across the full data lifecycle (i.e., collection, storage and processing, analytics, and representation). The Topical Issue, “Space Weather research in the Digital Age and across the full data lifecycle”, collects research from across the full data lifecycle (collection, management, analysis, and communication; collectively “Data Science”) and offers a tractable compendium that illustrates the latest computational and data science trends, tools, and advances for Space Weather research. We introduce the paradigm shift in Space Weather and the articles in the Topical Issue. We create a network view of the research that highlights the contribution to the change of paradigm and reveals the trends that will guide it hereafter.
What Radiologists Should Know About Normal Pressure Hydrocephalus
Authors: Illies Till , Eckert Bernd , Kehler Uwe
Published: September 2021

Background Normal pressure hydrocephalus is a disease in elderly patients and one of the most common causes of treatable dementia. It occurs frequently with microangiopathy and Alzheimer’s disease, so that differential diagnosis plays an important role. This is crucially determined by imaging findings. Therapy consists of cerebrospinal fluid drainage through a shunt, which should be performed as early as possible to improve the chances of success.

Method This report is based on a summary of the relevant literature that has been reviewed in PubMed with reference to epidemiology, symptoms, pathophysiology, diagnostics, and therapy. The results were supplemented by the joint guidelines of the German Society of Neurology and the German Society of Neurosurgery.

Results and Conclusion The understanding of the pathophysiologic changes leading to normal pressure hydrocephalus has expanded significantly in recent years to include concepts explaining relevant comorbidities. Diagnosis is based on radiological and clinical indicators, although accurate differentiation with respect to comorbidities is not always possible. A high response rate to treatment can be achieved by good patient selection. Positive prognostic markers for therapeutic success include Disproportionately Enlarged Subarachnoid Space Hydrocephalus (DESH), short disease duration, predominant gait disturbance, and few comorbidities.

Key Points: 

Citation Format
Colonoscopy quality across Europe: a report of the European Colonoscopy Quality Investigation (ECQI) Group
Authors: Spada Cristiano , Koulaouzidis Anastasios , Hassan Cesare , Amaro Pedro , Agrawal Anurag , Brink Lene , Fischbach Wolfgang , Hünger Matthias , Jover Rodrigo , Kinnunen Urpo , Ono Akiko , Patai Árpad , Pecere Silvia , Petruzziello Lucio , Riemann Jürgen F. , Amlani Bharat , Staines Harry , Stringer Ann L. , Toth Ervin , Antonelli Giulio , Fuccio Lorenzo
Published: September 2021

Background and study aims The European Colonoscopy Quality Investigation (ECQI) Group comprises expert colonoscopists and investigators with the aim of raising colonoscopy standards. We assessed the levels of monitoring and achievement of European Society of Gastrointestinal Endoscopy (ESGE) performance measures (PMs) across Europe using responses to the ECQI questionnaires.

Methods The questionnaire comprises three forms: institution and practitioner questionnaires are completed once; a procedure questionnaire is completed on multiple occasions for individual total colonoscopies. ESGE PMs were approximated as closely as possible from the data collected via the procedure questionnaire. Procedure data could provide rate of adequate bowel preparation, cecal intubation rate (CIR), withdrawal time, polyp detection rate (PDR), and tattooing resection sites.

Results We evaluated ECQI questionnaire data collected between June 2016 and April 2018, comprising 91 practitioner and 52 institution questionnaires. A total of 6445 completed procedure forms were received.

Institution and practitioner responses indicate that routine recording of PMs is not widespread: adenoma detection rate (ADR) is routinely recorded in 29 % of institutions and by 34 % of practitioners; PDR by 42 % and 47 %, CIR by 62 % and 64 %, bowel preparation quality by 56 % and 76 %, respectively.

Procedure data showed a rate of adequate bowel preparation of 84.2 %, CIR 73.4 %, PDR 40.5 %, mean withdrawal time 7.8 minutes and 12.2 % of procedures with possible removal of a non-pedunculated lesion ≥ 20 mm reporting tattooing.

Conclusions Our findings clearly show areas in need of quality improvement and the importance of promoting quality monitoring throughout the colonoscopy procedure.
Feasibility study of endoscopic biliary drainage under direct peroral cholangioscopy by using an ultra-slim upper endoscope (with videos)
Authors: Park Jae Keun , Moon Jong Ho , Lee Yun Nah , Jo Seok jung , Choi Moon Han , Lee Tae Hoon , Cha Sang-Woo , Cho Young Deok , Park Sang-Heum
Published: September 2021

The therapeutic utility of peroral cholangioscopy (POC) is limited. Direct POC using an ultra‑slim upper endoscope expands the therapeutic indications because of its larger working channel, of up to 2.2 mm. We evaluated the feasibility of selective biliary drainage using a plastic stent under direct POC. From April 2015 to March 2019, biliary drainage under endoscopic visualization was performed in the same endoscopic session as direct POC without exchanging the duodenoscope. After guidewire insertion through the stricture or stone, a 5 Fr plastic stent and/or nasobiliary drainage catheter was used for biliary drainage. Selective biliary drainage under direct POC was performed in 32 patients, including 17 with difficult bile duct stones. Biliary drainage was performed with a plastic stent in 29 patients, nasobiliary drainage in one, and combined drainage in two patients. The technical success rate for biliary drainage placement under direct POC was 100 % (32/32). No significant procedure-related complications occurred. In conclusion, biliary drainage with a plastic stent or catheter under direct POC using an ultra-slim upper endoscope is feasible and may be useful for lesions obstructing the bile duct.
Cost comparisons of endoscopic and surgical resection of stage T1 rectal cancer
Authors: Arthursson Victoria , Rosén Roberto , Norlin Jenny M. , Gralén Katarina , Toth Ervin , Syk Ingvar , Thorlacius Henrik , Rönnow Carl-Fredrik
Published: September 2021

Background and study aims Management of T1 rectal cancer is complex and includes several resection methods, making cost comparisons challenging. The aim of this study was to compare costs of endoscopic and surgical resection and to investigate hypothetical cost scenarios for the treatment of T1 rectal cancer.

Patients and methods Retrospective population-based cost minimization study on prospectively collected data on T1 rectal cancer patients treated using endoscopic submucosal dissection (ESD), transanal endoscopic microsurgery (TEM), open, laparoscopic, or robotic resection, in Skåne County, Sweden (2011–2017). The hypothetical cost scenarios were based on the distribution of high-risk features of lymph node metastases in a national cohort (2009–2017).

Results Eighty-five patients with T1 RC undergoing ESD (n = 16), TEM (n = 17), open (n = 35), laparoscopic (n = 9), and robotic (n = 8) resection were included. ESD had a total 1-year cost of 5165 € and was significantly (P < 0.05) less expensive compared to TEM (14871€), open (21 453 €), laparoscopic (22 488 €) and robotic resection (26 562 €). Risk factors for lymph node metastases were seen in 68 % of 779 cases of T1 rectal cancers included in the national cohort. The hypothetical scenario of performing ESD on all T1 RC had the lowest total 1-year per patient cost compared to all other alternatives.

Conclusions This is the first study analyzing total 1-year costs of endoscopic and surgical methods to resect T1 rectal cancer, which showed that the cost of ESD was significantly lower compared to TEM and surgical resection. In fact, based on hypothetical cost scenarios, ESD is still justifiable from a cost perspective even when all high-risk cases are followed by surgery in accordance to guidelines.
Severe COVID-19 and Retina: Are There Any Retinal Manifestations?
Authors: Gündogan Medine , Kiliç Soner , Göktas Sertan , Vural Esra , Sirem Muhammed Rasit , Ünal Sefa , Celik Ilhami
Published: September 2021

Purpose To investigate whether there are retinal lesions associated with severe COVID-19.

Methods We studied 232 symptomatic subjects aged 18 – 65 years who had severe COVID-19 and had received treatment. The evaluations included ophthalmological examinations, optical
coherence tomography (OCT), imaging modalities with near infrared reflectance (NIR), fundus autofluorescence (FAF), and fundus photography (FP).

Results The mean age of the patients was 49 years, and 67.6% of them were men. There were no findings of microhemorrhage, cotton wool spots (CWS), vitritis, or retinitis in the
examination and imaging.

Conclusions This study indicates that retinal involvement as a complication associated with COVID-19 is questionable, although some reports have demonstrated a relationship that may
occur secondary to existing systemic diseases.
Endoscopic ultrasound-guided fine-needle biopsy in patients with unexplained diffuse gastrointestinal wall thickening
Authors: Chavarría Carlos , García-Alonso Francisco J. , de Benito-Sanz Marina , Mata-Romero Pilar , Madrigal Beatriz , Sanchez-Ocaña Ramon , Diez-Redondo Pilar , Núñez Henar , Perez-Miranda Manuel , de la Serna-Higuera Carlos
Published: September 2021

Background and study aims Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is recommended after non-diagnostic biopsy in gastrointestinal wall thickening, although the performance of currently available FNB needles in this setting is unknown. We aimed to assess the diagnostic accuracy and safety of EUS-FNB and to evaluate the "T" wall staging in malignant pathology.

Patients and methods This was a single center retrospective study that included all consecutive patients undergoing EUS-FNB for diffuse gastrointestinal wall thickening with at least one previous negative conventional endoscopic biopsy between January 2016 and November 2019. EUS-FNB was performed using linear-array echoendoscopes with slow-pull/fanning technique. Tissue acquisition was done with 19- or 22-gauge biopsy needles. Samples were included in formalin without rapid on-site evaluation and submitted for histopathological processing. The final diagnosis was based on conclusive histology or absence of evidence of disease progression after follow-up at least 6 months.

Results Twenty-nine patients (21 men), with a median age of 68 (IQR: 56–77), were included. EUS-FNB was technically feasible and the sample quality was adequate for full histological assessment in all patients (100 %). Sensitivity, specificity, positive and negative predictive values, and overall accuracy for diagnosis of malignancy were 95.5 %, 100 %, 100 %, 83.3 %, and 96.3 %, respectively. In patients with malignant disease, the samples obtained allowed detection of signs of deep layer inﬁltration (“histological staging”) in 17 of 21 cases (81 %). No adverse events were noted.

Conclusions The EUS-FNB technique demonstrated excellent diagnostic performance and safety in the study of unexplained diffuse gastrointestinal wall thickening. Histological staging was obtained in a high percentage of samples.
Over-the-scope clip as first-line therapy for ulcers with high-risk bleeding stigmata is efficient compared to standard endoscopic therapy
Authors: Buddam Avanija , Rao Sirish , Koppala Jahnavi , Rangray Rajani , Abdussalam Abdullah , Mukherjee Sandeep , Chandra Subhash
Published: September 2021

Background and study aims Ulcers with high-risk stigmata have significant rebleeding rates despite standard endoscopic therapy. Data on over-the-scope clip (OTSC) for recurrent bleeding is promising but data on first line therapy is lacking. We report comparative outcomes of OTSC as first-line therapy versus standard endoscopic therapy in ulcers with high-risk stigmata.

Patients and methods Consecutive adults who underwent endoscopic therapy for ulcers with high-risk stigmata between July 2019 to September 2020 were included. Patients were grouped into OTSC or standard therapy based on first-line therapy used on index endoscopy. Outcomes measured included: 1) intra-procedural hemostasis based on endoscopic documentation of adequate hemostasis; 2) 7-day rebleeding (> 2 g/dL drop in hemoglobin, hematochezia or hemorrhagic shock); 3) cost of endoscopic interventions; and 4) procedure duration measured as endoscope insertion to removal time. Cost of tools used during the index endoscopy was included.

Results Sixty-eight patients were included, 47 were in standard therapy and 21 in the OTSC group. Hemostasis was achieved in 95.2 % in the OTSC group compared to 83.0 % in the standard therapy group (P = 0.256, number needed to treat [NNT]: 9). Procedure time was shorter in the OTSC group (23 vs. 16 minutes, P = 0.002). Cost of endoscopic interventions were comparable, P = 0.203. Early rebleeding was less often in OTSC group, two (9.5 %) compared to 10 (21.3 %) in standard therapy group, NNT 9.

Conclusions Use of OTSCs as first-line treatment for ulcers bleed probably improves hemostasis and decreases early rebleeding. Use of OTSC as first-line therapy shortened procedure duration without increasing the cost of endoscopic interventions.
Colon capsule endoscopy in clinical practice: lessons from a national 5-year observational prospective cohort
Authors: Benech Nicolas , Vinet Olivier , Gaudin Jean-Louis , Benamouzig Robert , Dray Xavier , Ponchon Thierry , Galmiche Jean-Paul , Sacher-Huvelin Sylvie , Samaha Elia , Saurin Jean-Christophe ,   On Behalf Of The ONECC Study Group
Published: September 2021

Background and study aims Colon capsule endoscopy (CCE) has been proposed as an alternative to colonoscopy for screening patients at average risk of colorectal cancer (CRC). A prospective national cohort was developed to assess relevance of CCE in real-life practice and its short- and long-term impacts on clinical management.

Patients and methods All patients who underwent a CCE in France were prospectively enrolled from January 2011 to May 2016 and reached annually by phone until May 2017. All CCE and colonoscopy reports were systematically collected.

Results During the study period, 689 CCEs were analyzed from 14 medical centers. Median follow-up time was 35 months [IQR: 12–50]. Indication for CCE was mainly for elderly patients (median age: 70 years, IQR: [61–79]) due to anesthetic or colonoscopy contraindication (n = 307; 44.6 %). Only 337 CCEs (48.9 %) were both complete and with adequate bowel preparation. Advanced neoplasia (adenoma with high-grade dysplasia or CRC) was diagnosed following 32 CCEs (4.6 %). Among patients who underwent colonoscopy or therapeutic surgery following CCE, 18.8 % of all advanced neoplasias (6/32) had not been diagnosed by CCE mainly due to technical issues. Performing a colonoscopy in the case of significant polyps or insufficient bowel cleansing or after an incomplete CCE allowed the diagnosis of 96.9 % of all identified advanced neoplasias (31/32).

Conclusions Outside the scope of academic trials, improvement is needed to increase the reliability of CCE as less than half were considered optimal i. e. complete with adequate bowel cleansing. Most of missed colonic advanced neoplasia were due to incomplete CCE with distal neoplasia location.
Evaluation of the ESGE recommendations for COVID-19 pre-endoscopy risk-stratification in a high-volume center in Germany
Authors: Zellmer Stephan , Ebigbo Alanna , Kahn Maria , Muzalyova Anna , Classen Johanna , Grünherz Vivian , Temizel Selin , Dhillon Christine , Messmann Helmut , Römmele Christoph
Published: September 2021

Background and study aims The European Society of Gastrointestinal Endoscopy (ESGE) has defined COVID-19 infection prevention and control strategies within the endoscopy unit. These include pre-endoscopic questionnaire-based risk-stratification as well as pre-procedure viral testing. Real-life data on the effectiveness of these measures are presented here.

Patients and methods Data from the outpatient endoscopic unit of the University Hospital Augsburg between July 1, 2020 and December 31, 2020 including the second pandemic wave were reviewed retrospectively. All patients were assessed with a pre-endoscopic risk-stratification questionnaire as well as viral testing using an antigen point-of-care test (Ag-POCT) in conjunction with a standard polymerase chain reaction (PCR) test. Highly elective procedures were postponed. The theoretically expected number of SARS-CoV-2-positive patients was simulated and compared with the actual number. In addition, endoscopy staff was evaluated with a rapid antibody test to determine the number of infections among the personnel.

Results In total, 1029 procedures, 591 questionnaires, 591 Ag-POCTs, and 529 standard PCR tests were performed in 591 patients. 247 procedures in 142 patients were postponed. One Ag-POCT was positive but with a negative PCR test, while one PCR test was positive but with a negative Ag-POCT. This was lower than the theoretically expected number of COVID-19-positive patients (n = 15). One of 43 employees (2.3 %) in the outpatient endoscopy unit was seropositive.

Conclusions Pre-endoscopic risk management including questionnaire-based risk stratification and viral testing seems to be an effective tool in combination with personal protective equipment for SARS-CoV-2 infection prevention and control within the endoscopy unit even in a high-prevalence setting.
Impact of COVID-19 on gastroenterology fellowship training: a multicenter analysis of endoscopy volumes
Authors: Paleti Swathi , Sobani Zain A. , McCarty Thomas R. , Gutta Aditya , Gremida Anas , Shah Raj , Nutalapati Venkat , Bazerbachi Fateh , Jesudoss Randhir , Amin Shreya , Okwara Chinemerem , Kathi Pradeep Reddy , Ahmed Ali , Gessel Luke , Hung Kenneth , Masoud Amir , Yu Jessica , Mony Shruti , Akshintala Venkata , Jamil Laith , Nasereddin Thayer , Kochhar Gursimran , Vyas Neil , Saligram Shreyas , Garg Rajat , Sandhu Dalbir , Benrajab Karim , Konjeti Rajesh , Agnihotri Abhishek , Trivedi Hirsh , Grunwald Matthew , Mayer Ira , Mohanty Arpan , Rustagi Tarun
Published: September 2021

Background and study aims The COVID-19 pandemic has had a profound impact on gastroenterology training programs. We aimed to objectively evaluate procedural training volume and impact of COVID-19 on gastroenterology fellowship programs in the United States.

Methods This was a retrospective, multicenter study. Procedure volume data on upper and lower endoscopies performed by gastroenterology fellows was abstracted directly from the electronic medical record. The study period was stratified into 2 time periods: Study Period 1, SP1 (03/15/2020 to 06/30/2020) and Study Period 2, SP2 (07/01/2020 to 12/15/2020). Procedure volumes during SP1 and SP2 were compared to Historic Period 1 (HP1) (03/15/2019 to 06/30/2019) and Historic Period 2 (HP2) (07/01/2019 to 12/15/2019) as historical reference.

Results Data from 23 gastroenterology fellowship programs (total procedures = 127,958) with a median of 284 fellows (range 273–289; representing 17.8 % of all trainees in the United States) were collected. Compared to HP1, fellows performed 53.6 % less procedures in SP1 (total volume: 28,808 vs 13,378; mean 105.52 ± 71.94 vs 47.61 ± 41.43 per fellow; P < 0.0001). This reduction was significant across all three training years and for both lower and upper endoscopies (P < 0.0001). However, the reduction in volume was more pronounced for lower endoscopy compared to upper endoscopy [59.03 % (95 % CI: 58.2–59.86) vs 48.75 % (95 % CI: 47.96–49.54); P < 0.0001]. The procedure volume in SP2 returned to near baseline of HP2 (total volume: 42,497 vs 43,275; mean 147.05 ± 96.36 vs 150.78 ± 99.67; P = 0.65).

Conclusions Although there was a significant reduction in fellows’ endoscopy volume in the initial stages of the pandemic, adaptive mechanisms have resulted in a return of procedure volume to near baseline without ongoing impact on endoscopy training.
Effects of the First COVID-19 Lockdown on Ophthalmological Patient Care
Authors: Schuh Anna , Kassumeh Stefan , Schmelter Valerie , Demberg Lilian , Siedlecki Jakob , Anschütz Andreas , Kreutzer Thomas , Mayer Wolfgang J. , Kohnen Thomas , Shajari Mehdi , Priglinger Siegfried
Published: September 2021

Purpose To determine the effect of lockdown on medical care, with the example of ophthalmology.

Methods Patients in a period during the first lockdown were compared to a non-lockdown period, with a total of 12 259 patients included in an observational study. Changes in different areas (elective, emergency, inpatients, surgeries) and eye care subspecialties were compared. Emergency patients were analyzed according to severity and urgency. Patients showing hints requiring treatment for urgent cardiovascular diseases were determined. Differences in patients who would have suffered severe vision loss without treatment were identified and the QALY (quality-adjusted life years) loss was determined accordingly. A model to prioritize patient visits after the end of lockdown or in future lockdown scenarios was developed. Data were collected at the University Eye Hospital LMU Munich and patient files were reviewed individually by ophthalmologists.

Results The average patient number decreased by − 59.4% (p < 0.001), with a significant loss in all areas (elective, emergency, inpatients, surgeries; p < 0.001). There was a decline of − 39.6% for patients at high risk/high severity. Patients with indications of a risk factor of future stroke declined significantly (p = 0.003). QALY loss at the university eye hospital was 171, which was estimated to be 3160 – 24 143 for all of Germany. Working up high losses of outpatients during these 8 weeks of projected lockdown in Germany would take 7 – 23 weeks under normal circumstances, depending on ophthalmologist density. The prioritization model can reduce morbidity by up to 78%.

Conclusion There was marked loss of emergency cases and patients with chronic diseases. Making up for the losses in examinations and treatments will theoretically take weeks to months. To reduce the risk of morbidity, we recommend a prioritization model for rescheduling and future lockdown scenarios.
Itemreduktion zur Verbesserung der Praktikabilität
neonatologischer Schmerzmesssysteme
Authors: Tischler Max , Kappesser Judith , Utsch Boris , Ehrhardt Harald , Hermann Christiane , Zimmer Klaus-Peter , de Laffolie Jan
Published: September 2021

Hintergrund Trotz über 50 psychometrisch validierter
Beobachtungsverfahren gibt es bisher keinen Konsens über das
praktikabelste Schmerzassessment bei Neugeborenen. Die Items von NFCSshort und
PIPP wurden mit der Schmerzeinschätzung der prozedurbeteiligten
Behandler verglichen und es wurde evaluiert, ob eine Itemreduktion zu Gunsten
der Alltagsanwendung möglich wäre.

Material und Methoden 52 Neugeborene wurden in unserer Beobachtungsstudie
einer klinisch indizierten peripheren Venenpunktion unterzogen. Patient und
Monitordaten wurden standardisiert auf Video aufgezeichnet. Die
Schmerzintensität wurden durch sieben unabhängige Untersucher
mittels NFCSshort und PIPP bewertet und hinsichtlich der Variabilität
zwischen den Untersuchern verglichen.

Ergebnisse Nur vier Items des PIPP (Herzfrequenz,
Augenbrauenvorwölbung, zusammengekniffene Augen, betonte
Nasolabialfalte) wiesen einen signifikanten Zusammenhang mit der
geschätzten Schmerzhaftigkeit der Prozedur auf. Die Items 1
(Gestationsalter), 2 (Wachheitsgrad) und 4 (Sauerstoffsättigung) hatten
bei keinem Untersucher Einfluss auf das Schmerzmessergebnis. Die Auswertung des
NFCSshort zeigte bei zwei Untersuchern für das Item 1
(Vorwölbung der Augenbrauen) und bei einem Untersucher für das
Item 2 (zusammengekniffene Augen) keine Einflüsse auf das
Messergebnis.

Diskussion Die Ergebnisse der Studie legen eine Kürzung des PIPP um
drei Items nahe, da diese keinen Einfluss auf das Schmerzmessergebnis zeigten.
Eine Reduktion des PIPP um das Item Gestationsalter erscheint fraglich, da es in
weiteren Studien als bedeutsames Item bewertet wurde. Ein Verzicht auf das Item
Sauerstoffsättigung geht mit einem geringeren Messaufwand einher. Eine
weitere Kürzung der bereits gekürzten Version (NFCSshort) auf
weniger als fünf Items ist auf Basis unserer Ergebnisse nicht zu
empfehlen.
Impact of Psychiatric and Related Somatic Medications on the Duration
and Severity of COVID-19: A Retrospective Explorative Multi-center Study from
the German Metropolitan Ruhr-area
Authors: Bonnet Udo , Claus BenediktBernd , Schaefer Martin , Kuhn Jens , Nyhuis Peter , Scherbaum Norbert , Brüne Martin , Wakili Velat , Juckel Georg
Published: September 2021

Introduction Several psychiatric and somatic medications are assumed to
improve COVID-19-symptoms. These include antidepressants, antipsychotics, and
anticonvulsants as well as anticoagulants, statins, and
renin-angiotensin-aldosterone-system (RAAS)-inhibitors for somatic comorbid
conditions. All these agents may reduce the hyperinflammatory response to
SARS/CoV-2 or the related negative cardio-cerebrovascular outcomes.

Methods In a retrospective longitudinal, multi-center inpatient study, we
sought to explore the influence of psychiatric medications on COVID-19,
comprising the period from diagnosing SARS/CoV-2-infection via PCR
(nasopharyngeal swab) up to the next 21 days. Ninety-six psychiatric inpatients
(mean age [SD] 65.5 (20.1), 54% females) were included. The primary
outcome was the COVID-19-duration. Secondary outcomes included symptom severity
and the presence of residual symptoms.

Results COVID-19-related symptoms emerged in 60 (62.5%) patients,
lasting 6.5 days on average. Six (6.3%) 56–95 years old patients
died from or with COVID-19. COVID-19-duration and residual symptom-presence
(n=22, 18%) were not significantly related to any substance.
Respiratory and neuro-psychiatric symptom-load was significantly and negatively
related to prescription of antidepressants and anticoagulants, respectively.
Fatigue was negatively and positively related to RAAS-inhibitors and
proton-pump-inhibitors, respectively. These significant relationships
disappeared with p-value adjustment owed to multiple testing. The mean total
psychiatric burden was not worsened across the study.

Discussion None of the tested medications was significantly associated
with the COVID-19-duration and -severity up to the end of post-diagnosing week
3. However, there were a few biologically plausible and promising relationships
with antidepressants, anticoagulants, and RAAS-inhibitors before p-value
adjustment. These should encourage larger and prospective studies to re-evaluate
the influence of somatic and psychiatric routine medications on COVID-19-related
health outcomes.
Effectiveness of Moxibustion for Breech Presentation: A Prospective
Study
Authors: Sarsmaz Kemal , Kulah Belkiz Berna , Orgul Gokcen , Tonyalı Nazan Vanlı , Yucel Aykan , Tekin Ozlem Moraloglu
Published: September 2021

Objective To evaluate the moxibustion for turning fetuses from breech to
vertex presentation.

Materials and Methods This was a single-center prospective study. All
pregnant women carrying a fetus in breech presentation between the 32 and 35
gestational weeks were offered moxibustion application. The primary outcomes
were vertex presentation at 37 weeks of gestation, vertex presentation at birth,
and vaginal birth rates. A secondary analysis was performed to understand the
effect of parity, type of breech presentation, body mass index (BMI), placental
location, gender, and fetal birth weight on the presentation at birth.

Results There were 63 cases in the study group and 245 cases in the
control group. The rate of vertex presentation at term was found to be higher in
the moxibustion group compared to controls (66.7 vs. 48.2%,
p=0.022). There were 45 (71.4%) and 131 (53.5%) fetuses
with vertex presentation at birth in the study and control groups, respectively
(p=0.020). Overall, vaginal delivery rate was higher in the study group
(50.8 vs. 37.1%, p=0.048). Multiparity and higher birth weight
were associated with increased rates of vertex presentation in the moxibustion
and control groups.

Conclusion Moxibustion application increased the rate of vertex
presentation at birth and also vaginal delivery rate compared with expectant
management. Offering moxibustion between the 32nd and 36th week of gestation may
provide women with a singleton fetus in breech presentation an opportunity for a
vaginal birth.