bluuebunny/crossref_metadata_2025 huggingface dataset:
Microfluidic model with air-walls reveals fibroblasts and keratinocytes modulate melanoma cell phenotype, migration, and metabolism
Authors: Ayuso Jose M. , Sadangi Shreyans , Lares Marcos , Rehman Shujah , Humayun Mouhita , Denecke Kathryn M. , Skala Melissa C. , Beebe David J. , Setaluri Vijayasaradhi
Published: January 2021

Melanoma evolution is a complex process.
Synthesis of 1,3,4-trisubstituted pyrrolidines as meropenem adjuvants targeting New Delhi metallo-β-lactamase
Authors: Jin Wen Bin , Xu Chen , Qi Xiao Lin , Zeng Ping , Gao Wei , Lai Ki Hon , Chiou Jiachi , Chan Edward W. C. , Leung Yun-Chung , Chan Tak Hang , Wong Kwok-Yin , Chen Sheng , Chan Kin-Fai
Published: January 2021

A promising NDM-1 inhibitor was discovered by the construction of pyrrolidine library via boric acid-catalyzed 1,3-dipolar cycloaddition and cell-based screens.
Enhanced effect of CdS on amorphous Mo15S19 for photocatalytic hydrogen evolution
Authors: Quan Yongkang , Wang Guorong , Li Junke , Jin Zhiliang
Published: January 2021

Amorphous Mo15S19 loaded onto the surface of CdS improves the separation efficiency of photogenerated carriers, which reduces the recombination rate of photogenerated electrons and holes.
Zn-rich (GaN)1−x(ZnO)x: a biomedical friend?
Authors: Bagherzadeh Mojtaba , Rabiee Navid , Fatahi Yousef , Dinarvand Rassoul
Published: January 2021

The synthesis of (GaN)1−x(ZnO)x with the assistance of high-gravity using a green approach for the first time, with the application of delivering pCRISPR.
Phase control for indium oxide nanoparticles
Authors: Nielsen Ida Gjerlevsen , Sommer Sanna , Iversen Bo Brummerstedt
Published: January 2021

The indium oxides, c-In2O3, h-In2O3, InOOH and In(OH)3, have been studied by in situ X-ray scattering to determine the formation and transformation mechanisms in this system of important wide band gap semiconductors.
Construction of a double-walled carbon nanoring
Authors: Zhao Chong , Liu Fupin , Feng Lai , Nie Mingzhe , Lu Yuxi , Zhang Jie , Wang Chunru , Wang Taishan
Published: January 2021

The shortest double-walled carbon nanotube of [6]CPP⊂[12]CPP is constructed through the supramolecular assembly, it shows varied electronic structure, high photoconductivity, and self-assembly behavior deduced by host–guest interactions.
Single Mo1(W1, Re1) atoms anchored in pyrrolic-N3doped graphene as efficient electrocatalysts for the nitrogen reduction reaction
Authors: Zhao Wanghui , Chen Lanlan , Zhang Wenhua , Yang Jinlong
Published: January 2021

Mo1(W1and Re1) supported by pyrrolic-N doped graphene (M1/pyrrolic-N3–G) are theoretically predicted as potential electrocatalysts for nitrogen reduction reaction (NRR) with high stability, activity and ammonia selectivity.
Overcoming photovoltage deficitvianatural amino acid passivation for efficient perovskite solar cells and modules
Authors: Hu Jinlong , Xu Xin , Chen Yijun , Wu Shaohang , Wang Zhen , Wang Yousheng , Jiang Xiaofang , Cai Boyuan , Shi Tingting , Brabec Christoph J. , Mai Yaohua , Guo Fei
Published: January 2021

Defect passivation with natural amino acid molecules is reported, resulting in largely enhanced photovoltages in blade-coated MAPbI3perovskite solar cells and modules.
Pulmonary tissue-mimetic hydrogel niches for small cell lung cancer cell culture
Authors: Jung Mijung , Han Yoobin , Woo Changhee , Ki Chang Seok
Published: January 2021

Lung dECM and HA were modified with methacrylic moieties. Small cell lung cancer cells (NCI-H69) were then encapsulated the pulmonary-mimetic hydrogels in the presence of a photoinitiator under UV light irradiation.
Excellent thermoelectric performance achieved in Bi2Te3/Bi2S3@Bi nanocomposites
Authors: Zhang Yi-Xin , Zhu Yu-Ke , Song Dong-Sheng , Feng Jing , Ge Zhen-Hua
Published: January 2021

N-Type Bi2Te3/Bi2S3@Bi nanocomposites with a designed network structure were constructed and achieved an excellent ZT value of 1.2 at 450 K.
Thermal conductivity reduction by nanostructuration in electrodeposited CuNi alloys
Authors: Manzano Cristina V. , Caballero-Calero Olga , Tranchant Maxime , Bertero Enrico , Cervino-Solana Pablo , Martin-Gonzalez Marisol , Philippe Laetitia
Published: January 2021

The thermal conductivity of CuNi alloys grown by pulsed electrodeposition is reduced by the nanostructuration to a value of 9.0 ± 0.9 W m−1K−1due to the incorporation of saccharine in the electrolyte which allowed reduction of the crystallite size.
Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study
Authors: Sun Yongtao , Feng Hai , Zou Ting , Hou Ming , Jin Yanwu , Gu Changping , Wang Yuelan , Li Juan , Liu Mengjie , Zhang Min , Gao Yalei
Published: January 2021

Aim: To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinical prevention of POCD. A total of 88 patients who underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180 days post-surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which included Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ2 or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative day 2 had statistically significant (P<0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (odds ratio (OR) value > 1, P<0.05) are the risk factors for POCD. The incidence of day-21 and -180 POCD was approximately 26.1 and 22.7%, respectively.
ACE2/Ang-(1-7)/Mas1 axis and the vascular system: vasoprotection to COVID-19-associated vascular disease
Authors: Kuriakose Jithin , Montezano Augusto C. , Touyz Rhian M.
Published: January 2021

The two axes of the renin–angiotensin system include the classical ACE/Ang II/AT1 axis and the counter-regulatory ACE2/Ang-(1-7)/Mas1 axis. ACE2 is a multifunctional monocarboxypeptidase responsible for generating Ang-(1-7) from Ang II. ACE2 is important in the vascular system where it is found in arterial and venous endothelial cells and arterial smooth muscle cells in many vascular beds. Among the best characterized functions of ACE2 is its role in regulating vascular tone. ACE2 through its effector peptide Ang-(1-7) and receptor Mas1 induces vasodilation and attenuates Ang II-induced vasoconstriction. In endothelial cells activation of the ACE2/Ang-(1-7)/Mas1 axis increases production of the vasodilator’s nitric oxide and prostacyclin’s and in vascular smooth muscle cells it inhibits pro-contractile and pro-inflammatory signaling. Endothelial ACE2 is cleaved by proteases, shed into the circulation and measured as soluble ACE2. Plasma ACE2 activity is increased in cardiovascular disease and may have prognostic significance in disease severity. In addition to its enzymatic function, ACE2 is the receptor for severe acute respiratory syndrome (SARS)-coronavirus (CoV) and SARS-Cov-2, which cause SARS and coronavirus disease-19 (COVID-19) respectively. ACE-2 is thus a double-edged sword: it promotes cardiovascular health while also facilitating the devastations caused by coronaviruses. COVID-19 is associated with cardiovascular disease as a risk factor and as a complication. Mechanisms linking COVID-19 and cardiovascular disease are unclear, but vascular ACE2 may be important. This review focuses on the vascular biology and (patho)physiology of ACE2 in cardiovascular health and disease and briefly discusses the role of vascular ACE2 as a potential mediator of vascular injury in COVID-19.
Computing the feasible operating region of active distribution networks: Comparison and validation of random sampling and optimal power flow based methods
Authors: Contreras Daniel A. , Rudion Krzysztof
Published: January 2021

The feasible operating region (FOR) indicates the operation points that an active distribution network can achieve at the interconnection point with the transmission grid when operating flexible assets within it; without disturbing the stability of the grid itself. Even though the concept is not new, many novel methods to compute the FOR efficiently have been proposed in recent years, resulting in two main schools of thought: random sampling (RS) and optimal power flow (OPF) methods. Both approaches have their merits, yet no wide‐ranging analysis regarding scenarios in which each method could be best applied has been done so far. This paper focuses on performing such a comparison; however, capability charts of flexibility providing units and grids are usually modelled as irregular convex polygons, requiring some adaptation of the RS‐methods to allow for a proper comparison of the resulting feasible operating region. Correspondingly, new methods to adapt the extraction of random samples from generic capability charts are proposed in the paper. Using models of two radial distribution grids, both OPF‐ and RS‐based methods are compared and validated. Results show that RS methods are adequate for assessing small grids, especially with the proposed improvements, while OPF‐based methods excel in larger grids.
Single‐ and triple‐band bandpass filters using novel perturbed isosceles right‐angled triangular SIW cavities
Authors: Zhang Junjie , Liu Qing , Zhou Dongfang , Zhang Dewei
Published: January 2021

Herein, a rigorous derivation of an isosceles right‐angled triangular (IRT) metallic cavity is analysed. Then, the transverse field components in the IRT substrate‐integrated waveguide (SIW) cavity are derived, and the expression of the resonant frequencies can also be obtained. Then, a novel perturbed IRT SIW cavity is proposed, which is based on the characteristics of resonant modes in IRT SIW cavity and the capacitive‐loading technique. Three prototypes were designed to verify the validity of the derivation and analysis in this study. First, a dual‐mode single passband filter was implemented using the perturbed modes TE102 and TE202. Next, two tri‐mode triple‐band bandpass filters (BPFs) using the perturbed modes TE101, TE102 and TE202 are proposed, synthesised, verified and measured for demonstration, including a second‐order direct‐coupled one which operates at 8.02, 11.44 and 12.52 GHz, and a fourth‐order direct‐coupled one which operates at 7.7, 11.0 and 12.1 GHZ. The measured curves agree well with the simulated ones. Very compact circuit sizes and excellent filtering performances have been achieved for the three prototypes.
Multi‐mode dual‐polarised cavity backed patch antenna array for 5G mobile devices
Authors: Di Paola Carla , Zhao Kun , Pedersen Gert F. , Zhang Shuai
Published: January 2021

This paper proposes a dual‐polarised cavity backed patch antenna for next generation phased arrays for mobile handsets. The antenna exhibits multi‐band performance, allowing to cover the 5G bands n257 (26.5–29.5 GHz), n258 (24.25–27.5 GHz), n261 (27.5–28.35 GHz) and a portion of band n260 (37–40 GHz). Two orthogonal modes are excited in the substrate integrated waveguide (SIW) cavity and show similar impedance matching and symmetric radiation patterns. A parasitic element is introduced on top of the cavity and shifted off‐centre to improve the port‐to‐port isolation and guide the main beam. A parametric study of the antenna dimensions is conducted to verify the multi‐resonance operating mechanism. The design is validated by the measurements of the fabricated four‐element array. The array scanning angle is from −35° to 38° for V‐pol and from −29° to 31° for H‐pol at 28 GHz, where the realised gain raises from 8 to 12 dBi.
The Tully-Fisher relation in dense groups at z ∼ 0.7 in the MAGIC survey
Authors: Abril-Melgarejo Valentina , Epinat Benoît , Mercier Wilfried , Contini Thierry , Boogaard Leindert A. , Brinchmann Jarle , Finley Hayley , Michel-Dansac Léo , Ventou Emmy , Amram Philippe , Krajnović Davor , Mahler Guillaume , Pineda Juan C. B. , Richard Johan
Published: January 2021

Context. Galaxies in dense environments are subject to interactions and mechanisms that directly affect their evolution by lowering their gas fractions and consequently reducing their star-forming capacity earlier than their isolated counterparts.

Aims. The aim of our project is to get new insights into the role of environment in the stellar and baryonic content of galaxies using a kinematic approach, through the study of the Tully-Fisher relation (TFR).

Methods. We study a sample of galaxies in eight groups, over-dense by a factor larger than 25 with respect to the average projected density, spanning a redshift range of 0.5 < z < 0.8 and located in ten pointings of the MAGIC MUSE Guaranteed Time Observations program. We perform a morpho-kinematics analysis of this sample and set up a selection based on galaxy size, [O II]λλ3727,3729 emission line doublet signal-to-noise ratio, bulge-to-disk ratio, and nuclear activity to construct a robust kinematic sample of 67 star-forming galaxies.

Results. We show that this selection considerably reduces the number of outliers in the TFR, which are predominantly dispersion-dominated galaxies. Similar to other studies, we find that including the velocity dispersion in the velocity budget mainly affects galaxies with low rotation velocities, reduces the scatter in the relation, increases its slope, and decreases its zero-point. Including gas masses is more significant for low-mass galaxies due to a larger gas fraction, and thus decreases the slope and increases the zero-point of the relation. Our results suggest a significant offset of the TFR zero-point between galaxies in low- and high-density environments, regardless of the kinematics estimator used. This can be interpreted as a decrease in either stellar mass by ∼0.05 − 0.3 dex or an increase in rotation velocity by ∼0.02 − 0.06 dex for galaxies in groups, depending on the samples used for comparison. We also studied the stellar and baryon mass fractions within stellar disks and found they both increase with stellar mass, the trend being more pronounced for the stellar component alone. These fractions do not exceed 50%. We show that this evolution of the TFR is consistent either with a decrease in star formation or with a contraction of the mass distribution due to the environment. These two effects probably act together, with their relative contribution depending on the mass regime.
Establishing a reliable determination of the final mass for rapidly accreting supermassive stars
Authors: Haemmerlé L.
Published: January 2021

Context. The formation of supermassive black holes possibly takes place via direct collapse, with a supermassive star (SMS) as its progenitor. In this scenario, the SMS accretes at > 0.1 M⊙ yr−1 until it collapses into a massive black hole seed as a result of the general-relativistic (GR) instability. However, the exact mass at which the collapse occurs is not known, as existing numerical simulations give us a divergent range of results.

Aims. Here, we address this problem analytically, which allows for reliable ab initio determination of the onset point of the GR instability, for given hydrostatic structures.

Methods. We applied the relativistic equation of radial pulsations in its general form to the hydrostatic GENEC models already published in the literature.

Results. We show that the mass of spherical SMSs forming in atomically cooled halos cannot exceed 500 000 M⊙, which stands in contrast to previous claims. On the other hand, masses in excess of this limit, possibly up to ∼106 M⊙, could be reached in alternative versions of direct collapse.

Conclusions. Our method can be used to test the consistency of GR hydrodynamical stellar evolution codes.
S3-Leitlinie zur kardiologischen Rehabilitation im deutschsprachigen Raum Europas
Authors: Schwaab Bernhard , Rauch Bernhard
Published: January 2021

Was ist neu?

Indikationen zur kardiologischen Rehabilitation Zur Indikation und Durchführung der kardiologischen Rehabilitation (KardReha) ist erstmals eine evidenzbasierte Leitlinie auf S3-Niveau publiziert worden 1. Neben der federführenden DGPR wurde diese Leitlinie von 6 weiteren deutschen Fachgesellschaften (DGK, DGTHG, DGSP, DKPM, DGRW, BNK) sowie erstmals auch von den kardiologischen Gesellschaften aus Österreich (ÖKG) und der Schweiz (CPRS) konsentiert. Aufgrund der Bedeutung der beruflichen Wiedereingliederung für Patienten mit kardiovaskulären Erkrankungen war zudem die Deutsche Rentenversicherung (DRV) an der Erstellung der Leitlinie beteiligt. Über die Deutsche Herzstiftung wurden ebenfalls erstmals Patientenvertreter im Sinne einer partizipativen Entscheidungsfindung eingebunden. Neben Patienten mit koronarer Herzkrankheit (KHK) und Patienten mit systolischer Herzinsuffizienz (HFrEF) wurden weitere, auch seltenere Reha-Indikationen evaluiert. Hierzu zählen Patienten nach Herztransplantation oder mit Herzunterstützungssystem (VAD), nach Aortendissektion, nach Myokarditis sowie Patienten mit peripherer arterieller Verschlusskrankheit (paVK) und Erwachsene mit angeborenen Herzfehlern (EMAH).

Durchführung der kardiologischen Rehabilitation Für alle Indikationen wird die Evidenz zur Wirksamkeit der multidisziplinären Therapie in der KardReha (medizinische Betreuung, körperliches Training, Lebensstiländerungen, psychosoziale Interventionen und Schulungen) dargestellt. Zudem evaluiert die Leitlinie die etablierten Nachsorgeprogramme nach Durchführung einer KardReha (z. B. ambulante Herzgruppen, IRENA) 1.
Hyponatriämie – Ursachen, Diagnostik und Therapie
Authors: Kettritz Ralph
Published: January 2021

Was ist neu?

Hyponatriämie und klinische Symptome Neuere Untersuchungen veranschaulichen das breite Spektrum der klinischen Hyponatriämie-assoziierten Symptome und weisen auf erhebliche kognitive Einschränkungen bei bereits milder Hyponatriämie hin.

Hyponatriämie und ihre Ursachen Eine genomweite Assoziationsstudie (GWAS) identifizierte bei Patienten mit Thiazid-induzierter Hyponatriämie ADH-unabhängige „loss-of-function“-Mutationen, die zu einer verminderten Aktivität des Prostaglandin-Transporters im Sammelrohr der Nieren führen. Diese genetische Prädisposition verstärkt die Aquaporin-2-Expression und begünstigt die Wasserrückresorption. Auch andere Medikamente wie Fluconazol können ADH-unabhängige Wirkungen auf AQP2 und die Wasserrückresorption entfalten.

Akute vs. chronische Hyponatriämie und Korrekturgeschwindigkeit Etwa 25–50 % der Hyponatriämie-Patienten erfahren eine Überkorrektur mit zu schnellem Anstieg des Serum-Na+. Die Bestimmung von Urin-Osmolarität und freier Wasser-Clearance kann helfen Überkorrekturen zu vermeiden.

Aktuelle Studien Neben etablierten SIADH-Therapien wie Flüssigkeitsrestriktion, hyperosmolaren Salzinfusionen und Harnstoffgabe wird gegenwärtig der Wert von SGLT2-Inhibitoren zur Behandlung von Patienten mit Hyponatriämie untersucht.
Antifibrotische Therapie – neue Indikationen bei Non-IPF-interstitiellen Lungenerkrankungen
Authors: Markart Philipp , Drakopanagiotakis Fotios , Wygrecka Malgorzata
Published: January 2021

Was ist neu?

Nintedanib zur Behandlung der SSc-ILE Nintedanib reduziert den jährlichen Abfall der forcierten Vitalkapazität (FVC) bei Patienten mit interstitieller Lungenerkrankung (ILE) in Assoziation mit einer systemischen Sklerose (SSc) und ist in dieser Indikation neu zugelassen.

Nintedanib zur Behandlung der chronischen progredient fibrosierenden ILE In der INBUILD-Studie wurde Nintedanib bei Patienten mit chronischer progredient fibrosierender ILE (Non-IPF) untersucht. Eingeschlossen waren Patienten mit exogen allergischer Alveolitis (EAA), idiopathischer nichtspezifischer interstitieller Pneumonie (iNSIP), unklassifizierbarer idiopathischer interstitieller Pneumonie, ILE bei rheumatoider Arthritis, SSc-ILE, expositionsassoziierter ILE, ILE bei Mischkollagenose, Sarkoidose und anderen fibrosierenden ILE. Nintedanib führte auch in dieser Patientengruppe zu einer signifikanten Reduktion des jährlichen FVC-Abfalls. Zusätzlich zur Therapie der IPF und der SSc-ILE ist Nintedanib jetzt auch zur Behandlung anderer chronischer progredient fibrosierender ILE zugelassen.

Pirfenidon bei Non-IPF-ILE Pirfenidon wurde ebenfalls bei Patienten mit progredienter Non-IPF-Lungenfibrose untersucht. In der finalen Analyse der RELIEF-Studie konnte ein signifikant positiver Effekt auf den Verlauf der FVC durch die Pirfenidon-Behandlung nachgewiesen werden. Eine Zulassung in dieser Indikation liegt bisher nicht vor. Im Rahmen einer Phase-II-Studie wurde Pirfenidon bei unklassifizierbarer progredienter ILE untersucht. Die Lungenfunktionsmessung im Zentrum (sekundärer Endpunkt) ergab eine signifikante Abschwächung des FVC-Verlusts nach 24 Wochen in der mit Pirfenidon behandelten Gruppe versus Placebo. Eine Zulassung in dieser Indikation liegt bisher ebenfalls nicht vor.
Testosteronmangel im Alter – was ist zu tun?
Authors: Jaschke Nikolai Pirmin , Rachner Tilman D. , Hofbauer Lorenz C.
Published: January 2021

Definition Der Testosteronmangel des alternden Mannes ist nach wie vor nicht präzise definiert. Verschiedene Fachgesellschaften fordern zwar unisono das Vorliegen spezifischer klinischer Symptome in Verbindung mit konsistent erniedrigten morgendlichen Testosteronspiegeln. Allerdings existieren für letztere keine einheitlichen Grenzwerte. Erschwerend kommt hinzu, dass einzelne Symptome des Testosteronmangels bei unterschiedlichen Testosteron-Schwellenwerten auftreten können.

Testosteronersatztherapie – Anti-Aging oder falsche Hoffnung? Während zahlreiche retrospektive und kleinere prospektive Studien mit suboptimalem Design den Nutzen einer Testosteronersatztherapie im Alter nahelegen, existieren nur wenige Placebo-kontrollierte, randomisierte, doppelt verblindete Untersuchungen, die klinisch relevante Endpunkte verlässlich untersucht haben. Zu diesen zählen:
Comparison of Safety Profiles of the New and Old Formulations of Levothyroxine in a First Global Introduction in France
Authors: Lehnert Hendrik , Castello-Bridoux Claire , Channaiah Bushan , Martiniere Karine , Hildemann Steven , Wémeau Jean-Louis
Published: January 2021

Background Levothyroxine sodium marketed in France was reformulated following a French National Agency for Medicines and Health Products Safety request for a more stringent potency specification. Despite previously established purity and bioequivalence of the new and old formulations, reports of adverse events substantially increased following reformulation. This analysis evaluated the nature and relevance of the medically confirmed safety reports.

Methods Spontaneous and solicited individual case safety reports in France were retrieved from 26 March 2015 to 30 June 2016 (old formulation) and 26 March 2017 to 30 June 2018 (new formulation). Rates of reports and adverse events were calculated for the overall patient population and for at-risk subgroups. Adverse events delineated by thyroid-stimulating hormone levels were evaluated.

Results A total of 295 and 42 775 reports for the old formulation and new formulation, respectively, were retrieved, with 149 and 5503 medically confirmed. The most common medically confirmed adverse events were consistent with the known safety profile of levothyroxine, with generally comparable rates between both formulations (range of differences, 1.8–4.1%). Most cases were not serious (old formulation, 65.8%; new formulation, 78.7%). Reporting rates were similar or higher for the old formulation within subgroups of at-risk patients. Nature/distributions of adverse events by thyroid-stimulating hormone levels as determined by both the marketing authorization holder of levothyroxine and the French National Agency for Medicines and Health Products Safety were similar.

Conclusions The new formulation safety profile aligns with the established profile of the old formulation of levothyroxine. The benefit–risk profile is unchanged, such that the benefits of using the new formulation in the approved indications outweigh the risks associated with the treatment.
Prävalenz von SARS-CoV-2 bei Mitarbeitern eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen
Authors: Platten Martin , Cranen Rita , Peters Claudia , Wisplinghoff Hilmar , Nienhaus Albert , Bach Alexander Daniel , Michels Guido
Published: January 2021

Hintergrund Wir erhoben die Prävalenz von SARS-CoV-2 in der Belegschaft eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen im Rahmen einer Querschnittsstudie.

Methode Allen 1363 Mitarbeiter wurden ein nasopharyngealer Abstrich sowie eine Serologie auf SARS-CoV-2 angeboten. Zudem wurde ein Fragebogen zu Vorerkrankungen, Kontakten zu SARS-CoV-2-positiven Personen und COVID-19-typischen Symptomen vorgelegt.

Ergebnisse 1212 MitarbeiterInnen nahmen teil. 19 von 1363 (1,4 %) Mitarbeitern waren PCR-positiv (3 während der Studie, 16 vorher). Bei 40 (3,3 %) bzw. 105 (8,6 %) Mitarbeitern wurde IgG bzw. IgA nachgewiesen, bei 32 (2,6 %) IgG und IgA. Damit wurden insgesamt 47 Mitarbeiter positiv für SARS-CoV-2 getestet. In dieser Gruppe waren die häufigsten Symptome Kopfschmerzen (56 %), Müdigkeit (49 %), Halsschmerzen (49 %) und Husten (46 %), Fieber wurde in 33 % berichtet. Positiv getestete Mitarbeiter gaben häufiger Kontakt zu einem COVID-19-Fall an (60,5 % vs. 37,3 %; p = 0,006). Mitarbeiter mit isoliertem IgA-Nachweis gaben seltener Symptome an.

Schlussfolgerung 3,9 % der Mitarbeiter eines Krankenhauses der Regel-/Schwerpunktversorgung wurden zwischen dem 27.04. und 20.05.2020 positiv auf SARS-CoV-2 getestet. Der Anteil war geringer als erwartet; mögliche Gründe sind die geringe Durchseuchung der Bevölkerung und die umfangreichen, einheitlichen hausinternen Präventionsmaßnahmen.
Artocarpus lacucha Extract and Oxyresveratrol Inhibit Glucose Transporters in Human Intestinal Caco-2 Cells
Authors: Wongon Matusorn , Limpeanchob Nanteetip
Published: January 2021

Reduction of intestinal glucose absorption might result from either delayed carbohydrate digestion or blockage of glucose transporters. Previously, oxyresveratrol was shown to inhibit α-glucosidase, but its effect on glucose transporters has not been explored. The present study aimed to assess oxyresveratrol-induced inhibition of the facilitative glucose transporter 2 and the active sodium-dependent glucose transporter 1. An aqueous extract of Artocarpus lacucha, Puag Haad, which is oxyresveratrol-enriched, was also investigated. Glucose transport was measured by uptake into Caco-2 cells through either glucose transporter 2 or sodium-dependent glucose transporter 1 according to the culture conditions. Oxyresveratrol (40 to 800 µM) dose-dependently reduced glucose transport, which appeared to inhibit both glucose transporter 2 and sodium-dependent glucose transporter 1. Puag Haad at similar concentrations also inhibited these transporters but with greater
efficacy. Oxyresveratrol and Puag Haad could help reduce postprandial hyperglycemic peaks, which are considered to be most damaging in diabetics.
Entwicklung der hausärztlichen Versorgung innerhalb der letzten Jahrzehnte – eine Analyse des Basisdatensatzes der Kassenärztlichen Vereinigung Bayerns
Authors: Schäfer Merle , Donnachie Ewan , Gerlach Roman , Tauscher Martin , Schneider Antonius
Published: January 2021

Ziel der Studie Der Hausärztemangel in Deutschland nimmt weiterhin zu. Durch ein vertieftes Verständnis der Veränderung von hausärztlichen Kennzahlen innerhalb der letzten Jahrzehnte könnten Ansatzpunkte für eine Verbesserung der Versorgungssituation identfiziert werden. Ziel war die Analyse von hausärztlichen Kennzahlen der Kassenärztlichen Vereinigung Bayerns (KVB) im Hinblick auf die Dauer zwischen Staatsexamensabschluss und Selbstständigkeit in Form einer Praxisniederlassung seit den siebziger Jahren, die Entwicklung von Gemeinschaftspraxen und Angestelltenverhältnissen und den Erwerb von Zusatzbezeichnungen.

Methodik Als Datengrundlage für die Analyse des Zeitraums zwischen Staatsexamensabschluss und Niederlassung, Entwicklung von Gemeinschaftspraxen und Zusatzbezeichnungen dienten die Arztregisterdaten der niedergelassenen Ärzte in Bayern, aufbereitet von der KVB. Es wurden deskriptive Analysen durchgeführt.

Ergebnisse Seit den 70er Jahren kam es zu einer erheblichen Zunahme der zeitlichen Dauer von Studienabschluss bis zur Niederlassung in eigener Praxis von durchschnittlich 5 auf 12 Jahre. Es entwickelte sich ein deutlicher Trend hin zur Gemeinschaftspraxis seit den 2000er Jahren. Die Anzahl der Neuniederlassungen in eigener Praxis blieb über die letzten Jahre relativ konstant. Zudem zeichnet sich eine deutliche Tendenz zum Angestelltenverhältnis ab. Der Anteil an Zusatzbezeichnungen nimmt im zeitlichen Verlauf insbesondere im alternativmedizinischen Bereich und Sportmedizin ab.

Schlussfolgerung Es sind weiterhin Initiativen notwendig, um die Facharztweiterbildung inhaltlich und zeitlich effizient zu gestalten. Darüber hinaus müssten kontinuierlich motivationale Anreize zur Niederlassung mit eigenem KV-Sitz erfolgen, wobei gleichzeitig dem ausgeprägten Wunsch nach Anstellungsverhältnissen Rechnung getragen werden sollte.
Perrhenate Esters as Intermediates in Molecular Complexity-Increasing Reactions
Authors: Floreancig Paul E.
Published: January 2021

Allylic alcohols form perrhenate esters upon reaction with Re2O7 or HOReO3. These species undergo nonstereospecific and nonregiospecific alcohol-transposition reactions through cationic intermediates. Sequencing these nonselective processes with reversible trapping by electrophiles results in cyclization reactions where regio- and stereocontrol are dictated by thermodynamics. The cationic intermediates can also be utilized as electrophiles in intra- or intermolecular dehydrative reactions with nucleophiles. These processes serve as the basis for applications in catalytic syntheses of a wide range of heterocyclic and carbocyclic structures that often show considerable increases in molecular complexity. This Account describes a sequence of events that started from a need to solve a problem for the completion of a natural product synthesis and evolved into a central element in the design of numerous new transformations that proceed under mild conditions from readily accessible substrates.

1 Introduction

2 Exploratory Studies

3 Application to Spiroketal Synthesis

4 Reactions with Epoxides as Trapping Agents

5 Development of Dehydrative Cyclizations

6 Bimolecular Reactions

7 Spirocyclic Ether Formation

8 Conclusions
Nickel-Catalyzed Cross-Electrophile Coupling of the Difluoromethyl Group for Fluorinated Cyclopropane Synthesis
Authors: Jarvo Elizabeth R. , Lucas Erika L. , McGinnis Tristan M. , Castro Anthony J.
Published: January 2021

Herein, we report a new strategy for fluorinated cyclopropane synthesis. Photocatalytic olefin difluoromethylation is coupled with a nickel-catalyzed intramolecular cross-electrophile coupling (XEC) reaction between a difluoromethyl moiety and a benzylic ether. To the best of our knowledge, this is the first example of a XEC reaction employing a difluoromethyl group as an electrophile. A plausible mechanism is highlighted, and DFT calculations are included to support the observed stereochemical outcome.
Surgical Treatment Alternatives to Sacral Neuromodulation for Fecal Incontinence: Injectables, Sphincter Repair, and Colostomy
Authors: Ivatury Srinivas Joga , Wilson Lauren R. , Paquette Ian M.
Published: January 2021

Fecal incontinence is a prevalent health problem that affects over 20% of healthy women. Many surgical treatment options exist for fecal incontinence after attempts at non-operative management. In this article, the authors discuss surgical treatment options for fecal incontinence other than sacral neuromodulation.
Cost-Effectiveness of Emergent MRI during Stroke Alert to Diagnose Stroke Mimics: Single-Center Experience
Authors: Kapoor Nidhi , Sharma Rohan , Iser Courtney , Chaudhari Kaustubh , Nalleballe Krishna , Brown Aliza , Veerapaneni Poornachand , Sheng Sen , Elkhider Hisham , Veerapaneni Karthika , Onteddu Sanjeeva , Sidorov Evgeny
Published: January 2021

Objective The aim of this article was to assess the role of emergent magnetic resonance imaging (MRI) for stroke mimics during a stoke alert (within 45 minutes) in reducing direct cost of management and duration of inpatient stay.

Methods We did a retrospective chart review of all the patients who received emergent MRI brain during a stroke alert to help make decision about intravenous tissue-type plasminogen activator (IV tPA) administration from January 2013 to December 2015. Using the patient financial resource data and with the help of billing department, we calculated the approximate money saved in taking care of the patients who may have received IV tPA if emergent MRI brain was not available to diagnose stroke mimics as they presented with acute neurologic deficit within IV tPA time window.

Results Ninety seven out of 1,104 stroke alert patients received emergent MRI. Of these only 17 (17.5%) were diagnosed with acute ischemic stroke (AIS), and 80 (82.5%) as stroke mimics. By doing emergent MRI for suspected stroke mimics, our study showed an approximate total saving of $1,005,720 to $1,384,560, that is, $12,571 to $17,307 per patient in medical expenditure.

Discussion We suggest modification of stroke pathway from current algorithm “CT+CTA≥IV-tPA/neurointervention≥MRI” to “MRI+MRA≥IV-tPA/neurointervention” for possible stroke mimics, which can reduce the cost, radiation exposure, and duration of hospital stay for stroke mimics.

Conclusion Emergent MRI is a cost-effective tool to evaluate IV-tPA eligibility for suspected stroke mimics during a stroke alert.
Role of Cardiac Biomarkers in the Assessment of Acute Cerebrovascular Accident
Authors: Radhakrishnan Srinivasan , Moorthy Swathy , Gadde Sudish , Madhavan Krishnaswamy
Published: January 2021

Background Stroke (cerebrovascular accident) has for long been a global burden in terms of its morbidity and mortality. Serum levels of cardiac enzymes such as creatine kinase-MB (CK-MB) component, troponin T, and brain natriuretic peptide have been found to be elevated among the patients with stroke and also serve to prognosticate these patients. The serum levels of these enzymes correlate directly to the severity of stroke in these patients.

Objective Elevated cardiac enzymes among patients with acute cerebrovascular accidents are not uncommon despite the patients not having any cardiac problems. We aimed to identify the occurrence of elevated cardiac enzymes among patients with acute stroke and their correlation with the severity of stroke.

Materials and Methods Our study included 100 patients of acute stroke with no previous history of cardiac ailments. Serum levels of troponin I and CK-MB were analyzed among these patients using enzyme-linked immunosorbent assay method within the first 2 hours of admission. Patients outcome during the hospital stay were analyzed. Stroke severity was assessed using the National Institute of Health Stroke score (NIHS score) and the modified Rankin Score (mRS). The cardiac enzyme levels were correlated with these scores.

Results Twenty-eight percent of patients had elevated troponin I, while 72% patients had normal levels with the mean values of 10.36 to 106.54 ng/mL and 0.00 to 0.02 ng/mL, respectively. CK-MB levels were found elevated among 14% patients and normal among 86% patients with mean values of 5.8 to 124.36 and 0.0 to 4.3 ng/mL, respectively. Among the six patients who succumbed to death, three patients had increased troponin I and four had elevated CK-MB. NIHS scores of 21.0357±6.79 and 105.277±5.564 were seen in patients with elevated and normal troponin I, whereas NIHS scores of 20.4285±8.658 and 11.8721±9.273 were seen among patients with increased and normal CK-MB, respectively. The mRS scores were 4.3214±0.367, 2.4305±1.374, 4.2143±1.412, and 2.756±1.749 ng/mL among the patients with elevated and normal troponin I and CK-MB, respectively.

Conclusion The mean values of cardiac enzymes troponin I and CK-MB were higher among patients with higher scores of NIHS and mRS. Among them, troponin I was very significant and it may serve as an early biomarker for the severity of stroke and hint on early cardiac evaluation among these patients.
Factors Associated with Poor Antiepileptic Drugs Adherence in Below Poverty Line Persons with Epilepsy: A Cross-Sectional Study
Authors: Govil Nikhil , Chahal Savita , Gupta Nishu , Kaloti Amandeep Singh , Nadda Anuradha , Singh Parmal
Published: January 2021

Background Adherence to antiepileptic drugs (AED) is essential for adequate seizure control in epilepsy. People with low socioeconomic status are more vulnerable to poor adherence to AED. The present study aimed to explore factors associated with poor adherence to antiepileptic drugs in below poverty line (BPL) persons with epilepsy (PWE).

Methods The research had a cross-sectional design with inclusion of persons aged 18 to 65 years and an established diagnosis of epilepsy. Holding a BPL card (Yellow card) was taken as a measure for BPL criteria. Adherence to antiepileptic drugs was assessed using medication adherence rating scale (MARS). Univariate analysis with Chi-square test was used to determine the association between various variables and AED adherence, while the predictors of adherence were identified using multivariate logistic regression analysis.

Results There was a total of 88 BPL PWE. The mean age of male and female patients was 35.0 ± 15.0 & 32.0 ± 10.1 years, respectively. Adherence for drugs were found to be 30.7% and nonadherence to be 44.3%. Low (illiterate or primary) education (OR 0.041 [0.01–0.21]), polytherapy (OR 0.088 [0.02–0.40]), and substance abuse (OR 0.05 [0.01–0.58]) were found to have significant association with nonadherence to AEDs. Age, gender, marital status, family composition, occupation, rural urban background, distance from health care facility, duration of epilepsy, and side effects of AED were not found to have significant association with adherence.

Conclusion There is a need for psychoeducational programs for the people having low education status and polytherapy to form positive beliefs in AEDs. Substance abuse should also be addressed while treating them.
Effects of Long Durations of RF–Magnetron Sputtering Deposition of Hydroxyapatite on Titanium Dental Implants
Authors: Safi Ihab Nabeel , Hussein Basima Mohammed Ali , Aljudy Hikmat J. , Tukmachi Mustafa S.
Published: January 2021

Objectives Dental implant is a revolution in dentistry; some shortages are still a focus of research. This study use long duration of radiofrequency (RF)–magnetron sputtering to coat titanium (Ti) implant with hydroxyapatite (HA) to obtain a uniform, strongly adhered in a few micrometers in thickness.

Materials and Methods Two types of substrates, discs and root form cylinders were prepared using a grade 1 commercially pure (CP) Ti rod. A RF–magnetron sputtering device was used to coat specimens with HA. Magnetron sputtering was set at 150 W for 22 hours at 100°C under continuous argon gas flow and substrate rotation at 10 rpm. Coat properties were evaluated via field emission scanning electron microscopy (FESEM), scanning electron microscopy–energy dispersive X-ray (EDX) analysis, atomic force microscopy, and Vickers hardness (VH). Student’s t-test was used.

Results All FESEM images showed a homogeneous, continuous, and crack-free HA coat with a rough surface. EDX analysis revealed inclusion of HA particles within the substrate surface in a calcium (Ca)/phosphorus (P) ratio (16.58/11.31) close to that of HA. Elemental and EDX analyses showed Ca, Ti, P, and oxygen within Ti. The FESEM views at a cross-section of the substrate showed an average of 7 µm coat thickness. Moreover, these images revealed a dense, compact, and uniform continuous adhesion between the coat layer and the substrate. Roughness result indicated highly significant difference between uncoated Ti and HA coat (p-value < 0.05). A significant improvement in the VH value was observed when coat hardness was compared with the Ti substrate hardness (p-value < 0.05).

Conclusion Prolonged magnetron sputtering successfully coat Ti dental implants with HA in micrometers thickness which is well adhered essentially in excellent osseointegration.
Peripartum Hysterectomies over a Fifteen-year Period
Authors: Dorigon Alessandra , Martins-Costa Sérgio Hofmeister , Ramos José Geraldo Lopes
Published: January 2021

Objective To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure.

Methods A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019.

Results The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age.

Conclusion Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.
Is it Possible to Predict Massive Bleeding in Nulliparous Women with Placenta Previa?
Authors: Orgul Gokcen , Ayhan Sule Goncu , Saracoglu Gulhan Cetinkaya , Yucel Aykan
Published: January 2021

Objective We evaluated risk factors to determine if there were specific risk factors that could predict massive bleeding in nulliparous women with placenta previa.

Methods The participants were classified into two groups. Women with a calculated blood loss ≥ 1,000 mL were included in the massive bleeding group. Women without any signs or symptoms related with hypovolemia or with a calculated bleeding volume < 1,000 mL were categorized into the non-massive bleeding group.

Results There were 28 patients (40.6%) with massive bleeding and 41 cases (59.4%) with non-massive bleeding. The calculated blood loss and number of cases that required red cell transfusions were statistically different between the groups (< 0.005 and 0.002, respectively). There were no statistically significant differences in terms of maternal or fetal factors, placental location, or delivery characteristics between the two groups.

Conclusion We could not determine the predictive features for massive hemorrhage based on clinical features, delivery features, or placental location.
Evaluation of Bone–Implant Interface Stress and Strain Using Heterogeneous Mandibular Bone Properties Based on Different Empirical Correlations
Authors: Hussein Mostafa Omran , Alruthea Mohammed Suliman
Published: January 2021

Objectives The purpose of this study was to compare methods used for calculating heterogeneous patient-specific bone properties used in finite element analysis (FEA), in the field of implant dentistry, with the method based on homogenous bone properties.

Materials and Methods In this study, three-dimensional (3D) computed tomography data of an edentulous patient were processed to create a finite element model, and five identical 3D implant models were created and distributed throughout the dental arch. Based on the calculation methods used for bone material assignment, four groups—groups I to IV—were defined. Groups I to III relied on heterogeneous bone property assignment based on different equations, whereas group IV relied on homogenous bone properties. Finally, 150 N vertical and 60-degree-inclined forces were applied at the top of the implant abutments to calculate the von Mises stress and strain.

Results Groups I and II presented the highest stress and strain values, respectively. Based on the implant location, differences were observed between the stress values of group I, II, and III compared with group IV; however, no clear order was noted. Accordingly, variable von Mises stress and strain reactions at the bone–implant interface were observed among the heterogeneous bone property groups when compared with the homogenous property group results at the same implant positions.

Conclusion Although the use of heterogeneous bone properties as material assignments in FEA studies seem promising for patient-specific analysis, the variations between their results raise doubts about their reliability. The results were influenced by implants’ locations leading to misleading clinical simulations.
Neurological Manifestations of Congenital Cytomegalovirus Infection at a Tertiary Care Centre from Southern India
Authors: Gowda Vykuntaraju K. , Kulhalli Preeti , Vamyanmane Dhananjaya K.
Published: January 2021

Background Cytomegalovirus (CMV) is a ubiquitous herpes virus. It is the most common congenital viral infection. Data on congenital CMV in India are lacking and hence the present study was undertaken.

Objectives The aim of the study is to evaluate the clinical and radiological profile of neurological manifestations of congenital CMV infections in tertiary care hospital.

Methods This is a retrospective chart review of the clinical and laboratory profile of congenital CMV infections presenting from January 2018 to February 2020 to a tertiary care hospital in Southern India. Details of clinical profile, serological and neuroimaging data were obtained and analyzed.

Results A total of 42 cases with female preponderance (57%) were reported during the study period. The mean age of presentation was 2.9 years. Clinical features were developmental delay (81%), microcephaly (93%), seizures (33%), intrauterine growth restriction (19%), neonatal encephalopathy (10%), anemia (9%), jaundice (10%), hepato-splenomegaly (7%), and eye abnormalities (14%). Antenatal maternal fever was reported by 12%. Sensorineural hearing loss was present in 57%. Neuroimaging showed periventricular calcification (79%), cerebral atrophy (69%), ventricular dilatation (55%), malformations (26%), dysmyelination (12%), and temporal lobe cysts (5%). CMV-immunoglobulin-M positivity was seen in 14 cases (33%), urinary polymerase chain reaction for CMV was positive in 21 cases (50%), and clinical diagnosis was done in seven cases (16%).

Conclusion Common findings in congenital CMV are microcephaly, developmental delay, seizures, anemia, and sensorineural hearing loss. Common neuroimaging findings are periventricular calcification, cerebral atrophy, malformation, white matter signal changes, and cysts. CMV can mimic like cerebral palsy, malformations of the brain, demyelinating disorders, and calcified leukoencephalopathies like Aicardi-Goutières syndrome.