bluuebunny/crossref_metadata_2025 huggingface dataset:
Vulvovaginal Candidosis (Excluding Mucocutaneous Candidosis): Guideline of the German (DGGG), Austrian (OEGGG) and Swiss (SGGG) Society of Gynecology and Obstetrics (S2k-Level, AWMF Registry Number 015/072, September 2020)
Authors: Farr Alex , Effendy Isaak , Tirri Brigitte Frey , Hof Herbert , Mayser Peter , Petricevic Ljubomir , Ruhnke Markus , Schaller Martin , Schäfer Axel P. A. , Willinger Birgit , Mendling Werner
Published: April 2021

Aim The aim of this official guideline, published and coordinated by the German (DGGG), Austrian (OEGGG) and Swiss (SGGG) Societies of Gynecology and Obstetrics in collaboration with the DMykG, DDG and AGII societies, was to provide consensus-based recommendations obtained by evaluating the relevant literature for the diagnosis, treatment and management of women with vulvovaginal candidosis.

Methods This S2k guideline represents the structured consensus of a representative panel of experts with a range of different professional backgrounds commissioned by the Guideline Committee of the above-mentioned societies.

Recommendations This guideline gives recommendations for the diagnosis, management, counseling, prophylaxis and screening of vulvovaginal candidosis.
Ergebnisse der Re-Evaluation von Patienten aus der Intensivpflege in einem lokalen Weaning-Zentrum
Authors: Heine A. , Hustig-Kittler V. , Schröder M. , Desole S. , Boesche M. , Obst A. , Stubbe B. , Ewert R.
Published: April 2021

Aktuell werden in deutschen Weaning-Zentren ungeachtet des enormen personellen und materiellen Ressourceneinsatzes etwa 20 % der Patienten nicht erfolgreich von der mechanischen Beatmung entwöhnt und in die außerklinische Beatmung überführt.

Wir haben im Rahmen eines Pilotprojektes 33 Patienten (48 % weiblich; mittleres Alter 68 ± 11 Jahre bei Aufnahme) zwischen 03/2015 bis 11/2019 zur Re-Evaluation einer möglichen Entwöhnung von der invasiven Beatmung stationär aufgenommen. Zu diesem Zeitpunkt waren die Patienten seit Entlassung aus der Akutklinik bereits 475 ± 775 Tage invasiv beatmet. Die mittlere Liegedauer der Patienten auf der Weaning-Station betrug 26 ± 19 Tage, wobei wir 24/33 (73,53 %) erfolgreich entwöhnen konnten. Von diesen erfolgreich entwöhnten Patienten wurden 11/24 (44 %) mit einer nicht-invasiven Beatmung (NIV) entlassen. Die komplett entwöhnten Patienten zeigten ein 3- bzw. 12-Monats-Überleben von 92 % bzw. 77 %. Bei den Patienten mit einer NIV lagen die Daten bei 91 % bzw. 81 % und bei den invasiv beatmeten Patienten bei 86 % bzw. 71 %.

Die vorgelegten Ergebnisse zeigen die Möglichkeit einer erfolgreichen Entwöhnung auch nach langer invasiver außerklinischer Beatmung. Somit erscheinen aus unserer Sicht regelhafte Re-Evaluationen zur Frage einer Entwöhnung der Patienten mit einer bestehenden Beatmungsnotwendigkeit im ambulanten Bereich sinnvoll.
Methotrexat-Intoxikation nach Therapie einer Psoriasis inversa bei chronischer Niereninsuffizienz
Authors: Elsner P.
Published: April 2021

Bei einer pflegebedürftigen Patientin mit chronischer Niereninsuffizienz und Psoriasis vulgaris wurde durch ihre Hautärztin eine Therapie mit Methotrexat verordnet. Die Laborkontrollen sollten über die Hausärztin erfolgen; diese wurden jedoch erst für einen Monat später vereinbart. In der Zwischenzeit hatte der Pflegedienst bereits die erste Methotrexat-Injektion durchgeführt, wonach es zu einer Verschlechterung des Hautzustandes und Schleimhautbeschwerden bei der Patientin kam. Die Hautärztin wies die Patientin daraufhin in eine dermatologische Klinik ein; vorher wurde vom Pflegedienst jedoch eine zweite Methotrexat-Dosis verabreicht. In der Hautklinik wurde aufgrund des Befundes einer erosiven Stomatitis und Vulvitis, einer ausgeprägten Leukopenie und Thrombozytopenie und des Verdachtes auf akutes Nierenversagen eine Methotrexat-Intoxikation diagnostiziert. Die Patientin verstarb wenige Tage später an einem Multiorganversagen.

Methotrexat ist zur Induktionstherapie bei mittelschwerer bis schwerer Psoriasis vulgaris zugelassen. Zu den Gegenanzeigen einer Methotrexat-Therapie zählt nach Leitlinie und Fachinformation eine Niereninsuffizienz; ferner sind Laborkontrollen individualisiert vor der Behandlung, nach einer Woche und nach 6 Wochen und danach alle 6–12 Wochen durchzuführen. Unter arzthaftungsrechtlichen Aspekten dürfte der Einsatz von Methotrexat zur Behandlung einer Psoriasis inversa bei einer betagten Patientin mit Niereninsuffizienz als grober Behandlungsfehler zu bewerten sein; die Nichtdurchführung empfohlener Laborkontrollen ist als Befunderhebungsfehler zu werten. Die Fehleranalyse zeigt allerdings, dass der tragische Verlauf der Methotrexatintoxikation bei besserer Kommunikation zwischen den beteiligten Ärzten und Pflegenden möglicherweise hätte verhindert werden können.
Resilienz
Authors: Marshall Robert Percy , Best Norman
Published: April 2021

Es ist so eine Sache mit der Resilienz. Viele verstehen darin die
Möglichkeit, sich gegen äußere Stressoren abzugrenzen und an
sich abprallen zu lassen. Das ist aber nur die halbe Wahrheit. Am ehesten beschreibt
dies die intrinsische Abwehr gegen schädliche externe Einflüsse.
Resilienz bedeutet, so kann man es sinngemäß in Wikipedia nachlesen,
die Möglichkeiten eines Systems auf Anforderungen zu reagieren und diese so
zu verarbeiten, dass es nicht zu einer Überforderung kommt.
Epidemiology of Childhood Uveitis in a Tertiary Care Center: A 20-Year Study
Authors: Hoogewoud Florence , Cohen Judith , Rossi Daniele , Koryllou Aikaterini , Guex-Crosier Catherine , Ezziat Sakina , Hofer Michael , Guex-Crosier Yan
Published: April 2021

Purpose To investigate demographics and causes of pediatric uveitis in a Swiss tertiary reference center over a 20-year period.

Materials and Methods Retrospective cohort study on patients with uveitis aged less than 16 years seen at Jules-Gonin Eye Hospital between 1 January 2000 and 31 December 2019.

Results Out of 2846 patients with uveitis seen in the Jules-Gonin Eye Hospital Ocular Immune-Infectiology Department, 317 (11.1%) were under 16 years of age and were included in this study. Median age at onset of the uveitis was 8.9 years (range 0 – 16). Anterior uveitis was the most frequent presentation (45.1%) followed by posterior uveitis in 26.2%, intermediate uveitis in 23.3%, and panuveitis in 5.4%. The inflammation was most frequently bilateral and non-granulomatous. A systemic inflammatory disease was found in 34% of the cases and an infectious cause in 24%.

Conclusion The repartition of the location of the uveitis was similar to previous reports from Western countries. Uveitis in juvenile idiopathic arthritis is the most frequent etiology related to a systemic disease in children. An infectious cause was found in 24% of our patients, which is a greater proportion than in adult cohorts.
Systemische Ozontherapie bei Autoimmunerkrankungen
Authors: Feldhaus Simon
Published: April 2021

Autoimmunerkrankungen stellen eine Herausforderung für den therapeutischen Alltag dar. Durch die multifaktoriellen Ursachen dieser Erkrankungen ist eine integrative, ganzheitliche Behandlung notwendig. Durch eine individuelle Therapie, die auf die jeweiligen Ursachen eingeht, erhöhen sich die Chancen nachhaltig, die Entzündungsreaktion zu stoppen. Die Ozontherapie stellt dabei einen wesentlichen Pfeiler dar und zeigt eindrückliche klinische Erfolge.
Passive Bewegung belastet Hüft-TEP deutlich weniger – Wissenschaft nachgefragt
Authors: Veit Katrin
Published: April 2021

Physiotherapeut Manuel Mattes räumt in seiner Bachelorarbeit mit dem alten mechanischen Bild von Belastung auf. Mit In-vivo-Belastungsmessungen am Hüftgelenk untersuchte er, wie sich passive von aktiven Bewegungen hinsichtlich intraartikulärer Belastungen unterscheiden und ob die Werte kritisch bezüglich der Implantatstabilität sind. Sein Fazit: Die Belastung bei passiven Bewegungen liegt deutlich unter der durch Alltagsaktivitäten.
„Die Diagnose lautet Leben“ – Interview mit Christoph Keller
Authors: Huber Martin
Published: April 2021

„Jeder Krüppel ein Superheld“ – so lautet der Titel des neuen Buches von Schriftsteller Christoph Keller. Mit 14 erkrankt der Schweizer an spinaler Muskelatrophie, mit 25 bekommt er seinen ersten Rollstuhl. physiopraxis-Themenscout Martin Huber hat mit ihm über sein Buch, über Barrieren, die im Kopf beginnen, und über Inklusion gesprochen.
Entlastungshelfer – Wie Schulterabduktionskissen wirken
Authors: Ketterer Claudia , Heimbring Lisa
Published: April 2021

Impingement-Syndrom, Schulterluxation, Oberarmkopffraktur – Diagnosen, bei denen in der Nachbehandlung häufig das Schulterabduktionskissen eingesetzt wird. Eine bessere Durchblutung der Sehne und reduzierte Zugkräfte begründen die Indikation. Ob es jedoch wirklich immer indiziert ist, ist noch längst nicht geklärt.
Clinical Profile and Mutations Associated with Multiple Endocrine Neoplasia-Type1 (MEN1) and Their First-Degree Relatives at Risk of Developing MEN1: A Prospective Study
Authors: Shyamasunder Asha Hesarghatta , Pai Rekha , Ramamoorthy Hemalatha , Sakhti Dhananjayan , Manipadam Marie Therese , Kapoor Nitin , Paul Thomas Vizhalil , Jebasingh Felix , Thomas Nihal , Abraham Deepak Thomas , Paul Mazhuvanchary Jacob , Chacko Ari George , Prabhu Krishna , Rajaratnam Simon
Published: April 2021

Multiple Endocrine Neoplasia type-1 (MEN1) is an autosomal dominant disorder
with a combined occurrence of tumours of parathyroid glands, pancreatic
islets, and anterior pituitary. About 90% of these patients carry
mutations in the MEN1 gene, though the spectrum is not well defined in
India. Forty clinically suspected cases of MEN1 were enrolled prospectively
over six years; 32 patients (23 index-cases and nine affected relatives)
with≥2 classical endocrine tumours of MEN1 were considered definite,
and eight were categorised as ‘MEN1-like’. Details of their
clinical presentation, treatment and mutational analysis including MEN1
gene, 3′ and 5′ untranslated regions (UTR) of MEN1, CDKN1B,
and CaSR genes were collated. Asymptomatic first-degree relatives were also
screened. Among the 32 definite MEN1 patients, all had primary
hyperparathyroidism, 22 (68.7%) had gastroentero-pancreatic
neuroendocrine tumours, and 21 (66%) had pituitary adenoma. Of the
23 definite index-cases, 13 (56.5%) carried mutations in the MEN1
gene. Five of nine affected first-degree relatives (55.5%), and four
of 10 asymptomatic relatives (40%) also had MEN1 mutations. Seven of
10 MEN1 mutation-negative definite index-cases harboured p.V109G
polymorphism in the CDKN1B gene. All eight MEN1-like cases were negative for
mutations and large deletions in MEN1, mutations in 3′ and
5′ UTR of MEN1, CaSR and CDKN1B genes. The study has helped to
clearly document the pattern of mutations among Indian MEN1 patients.
However, the absence of MEN1 mutation in ~44% of cases and
the presence of p.V109G polymorphism in CDKN1B gene raise the question
whether such polymorphisms could independently contribute to
pathogenesis.
Netzimplantation bei der Chirurgie der Hiatushernie und bei der Anti-Reflux-Chirurgie – Kontra-Statement
Authors: Kuvendjiska Jasmina , Höppner Jens
Published: April 2021

Bei der chirurgischen Behandlung der gastroösophagealen Refluxerkrankung und der operativen Behandlung von Hiatushernien ist die hohe Rezidivrate der Hiatushernie ein zentrales Problem. Vor diesem Hintergrund werden zur Augmentation des Nahtverschlusses am Hiatus oesophageus verschiedene alloplastische Netze eingesetzt. Es wurden in der Vergangenheit sehr unterschiedliche Ergebnisse berichtet und der Einsatz von Netzen bei der Hiatusrekonstruktion wurde kontrovers diskutiert. Im Vordergrund stehen neben der Rezidivhäufigkeit auch immer wieder Berichte über Komplikationen der Hiatusaugmentation durch alloplastische Netze. Die heutige Datenlage zeigt auf der Grundlage von mehreren prospektiv randomisierten, doppelt verblindeten Vergleichsstudien und von Metaanalysen (Klasse-Ia- und -Ib-Evidenz) keine Vorteile der netzaugmentierten Hiatoplastik für die Verhinderung des Hiatushernienrezidivs. Sie beschreibt gleichzeitig mehr langfristige postoperative Komplikationen – vor
allem von Dysphagie – beim Einsatz von Netzen für die Hiatusrekonstruktion. Vom routinemäßigen Einsatz der Netzaugmentation bei der Hiatusrekonstruktion muss daher aktuell abgeraten werden.
Synthesis of Spiro Pyrazolone-Oxindole and Bicyclic Pyrazolone Derivatives via Solvent-Dependent Regioselective Aza-1,4/1,6-Michael and Intramolecular Cycloaddition under Catalyst-Free Conditions
Authors: Kashinath Dhurke , Sathish Kota , Nagaraju Sakkani
Published: April 2021

A solvent-dependent, highly regioselective [3+2]-cyclo­addition reaction of isoxazole-styrenes and azomethine imines under catalyst-free conditions is reported, furnishing a library of pyrazolone–spirooxindole hybrids. Good regioselectivity for the isomeric structures was achieved by the reaction of isoxazole-styrene and azomethine imine in different solvents and temperatures. The developed method was extended for the synthesis of tri-substituted dinitrogen-fused pyrazolones by using a 1,6-Michael addition reaction. Furthermore, the isoxazole moiety was converted into a carboxylic acid as a model study via ring opening.
Dual Roles of TBHP-Enabled Regioselective Hydroetherification of (Trifluoromethyl)alkenes with Boronic Acids: Access to α-Trifluoromethyl β-Aryloxy Tertiary Alcohols
Authors: Zhu Chuanle , Li Hengyuan
Published: April 2021

The three-starting materials four-component reaction of (trifluoromethyl)alkenes, TBHP, and boronic acids is reported, delivering various useful α-trifluoromethyl-β-aryloxy tertiary alcohols in high yields and in an exclusively regioselective hydroetherification manner. TBHP serves as both the oxidant and nucleophile in this reaction, as well as the O-source of the products.
Generation of Aryllithium Reagents from N-Arylpyrroles Using Lithium
Authors: Yorimitsu Hideki , Ozaki Tomoya , Kaga Atsushi , Saito Hayate
Published: April 2021

Treatment of 1-aryl-2,5-diphenylpyrroles with lithium powder in tetrahydrofuran at 0 °C results in the generation of the corresponding aryllithium reagents through reductive C–N bond cleavage.
Site-Selective Late-Stage C–H Functionalization via Thianthrenium Salts
Authors: Ritter Tobias , Berger Florian
Published: April 2021

The high abundance of C–H bonds in organic molecules makes C–H functionalization a powerful approach to quickly increase the complexity of an organic molecule. However, the high abundance of C–H bonds also provides a challenge to C–H functionalization reactions: selectivity. While most C–H functionalization reactions produce mixtures of different products for most substrates, we have developed a highly selective method for aromatic C–H functionalization via sulfonium salts. The reaction does not require a certain directing group to be selective. The introduced functional group is a sulfonium group, which participates in various follow-up reactions such as palladium-catalyzed cross-coupling reactions and photoredox catalysis. Here we discuss our pathway to develop the reaction as well as its scope and utility.

1 Introduction

2 Site-Selective Synthesis of Sulfonium Salts

3 Sulfonium Salts in Palladium-Catalyzed Cross-Coupling

4 Sulfonium Salts in Photoredox Catalysis

5 Sulfur(IV) Reductive Elimination

6 Cine Substitution

7 Conclusion
Antimonium Tartaricum as a Possible Homeopathic Prophylactic Remedy in the COVID-19 Epidemic
Authors: Fujino Fernanda Maria Simões da Costa , Olandim Ana Amélia Campos Claro , Lemonica Renata , Coggan Jennifer Anne , Takeyama Eduardo Nishimiya , Sant'Ana Soraya Cristina , Cervezão Priscila de Oliveira Neto , Benites Nilson Roberti , Mollo Sylvio Antonio , Barnabé Vagner Doja
Published: April 2021

The current COVID-19 (coronavirus disease 2019) epidemic has proved challenging due to its high impact on physical and mental health. According to Hahnemann, the founder of homeopathy, in an epidemic the most severe symptoms of the clinical condition presented by the population in question should be the basis for selecting the medication that is as similar as possible to them, and which should be administered to individuals who have been exposed to the disease but have not yet developed it. This medicine is called the genus epidemicus. This study aims to demonstrate the reasoning used to propose the homeopathic medicine Antimonium tartaricum (Ant-t) as a genus epidemicus in the COVID-19 epidemic. It was decided to develop the reasoning based on the respiratory symptoms described in the epidemiological bulletins presented by the Health Surveillance Secretariat of the Ministry of Health of Brazil, as these symptoms are the most serious of the disease. After repertorization, it was confirmed in the Materia Medica that Ant-t has a high degree of similarity with these respiratory symptoms, including the most serious situations, of COVID-19. Homeopathic Ant-t is thus a possible prophylactic genus epidemicus in the COVID-19 epidemic; further studies are needed to test this conclusion.
Internal Carotid Artery Blister Aneurysm: Review of Endovascular Techniques
Authors: Gupta Vipul , Londhe Shrikant , Parthasarathy Rajsrinivas
Published: April 2021

Cerebral blister aneurysms are very difficult vascular lesions in terms of accurate diagnosis as well as proper management strategy for vascular neurosurgeons and neurointerventionists. Histopathological analysis has revealed their nature to be more akin to pseudoaneurysms in comparison to the typical berry aneurysms. This explains their fragile nature, with high probability of rerupture and regrowth during the follow-up if not addressed properly. Even though surgical approaches have evolved over the years to minimize intraprocedural rupture and recurrence, they still have relatively high morbidity as well as mortality in comparison to endovascular treatment. Over the last few years, endovascular treatment has evolved significantly, with introduction of new devices and techniques. Focus of the endovascular management has shifted from the deconstructive techniques to reconstructive ones with parent artery preservation. Recent introduction of flow diverter technology has enabled neurointerventionists to manage these difficult lesions with more confidence in terms of avoiding rerupture and recurrence. Flow diverter (FD) use in blister aneurysm resulted in high-technical success, complete aneurysm occlusion, and less complications in comparison to other reconstructive techniques like simple coiling, stent assisted coiling, and overlapping/monotherapy stent placement. Few debatable issues like use of dual antiplatelets in the setting of acute subarachnoid hemorrhage (SAH), timing of drugs in relation to procedures, single/overlapping devices, and concerns during cerebral vasospasm phase need further detailed analysis and standardized protocols. In this article, we have done a review of different endovascular treatment options in the management of internal carotid artery blister aneurysms with special focus on FD and issues related to it.
Delirium in Cardiac and Cardiovascular Surgical Intensive Care Units
Authors: Breit Hannah , Bleck Thomas P. , Koffman Lauren
Published: April 2021

Delirium is a common occurrence in cardiac and cardiovascular surgical intensive care units. Due to multiple confounding factors, this diagnosis remains challenging for medical professionals. Multiple theories exist regarding the pathophysiology of delirium, which include disruption of neurotransmitters as well as inflammation. Delirium has been associated with prolonged hospitalizations and an increase in mortality. Although there are widely used screening tools for delirium, none have been validated in this particular patient population. Limited treatments exist for delirium, so: both pharmacologic and nonpharmacologic preventative measures should be employed in this patient population.
Neurological Complications in Patients with Heart Transplantation
Authors: Sakusic Amra , Rabinstein Alejandro A.
Published: April 2021

Neurological complications after heart transplantation are common and include cerebrovascular events (ischemic strokes, hemorrhagic strokes, and transient ischemic attacks), seizures, encephalopathy, central nervous system (CNS) infections, malignancies, and peripheral nervous system complications. Although most neurological complications are transient, strokes and CNS infections can result in high mortality and morbidity. Early recognition and timely management of these serious complications are crucial to improve survival and recovery. Diagnosing CNS infections can be challenging because their clinical presentation can be subtle in the setting of immunosuppression. Immunosuppressive medications themselves can cause a broad spectrum of neurological complications including seizures and posterior reversible encephalopathy syndrome. This article provides a review of the diagnosis and management of neurological complications after cardiac transplantation.
Cerebrovascular Complication and Valve Surgery in Infective Endocarditis
Authors: Rice Cory J. , Kovi Shivakrishna , Wisco Dolora R.
Published: April 2021

Infective endocarditis (IE) with neurologic complications is common in patients with active IE. The most common and feared neurological complication of left-sided IE is cerebrovascular, from septic emboli causing ischemic stroke, intracranial hemorrhage (ICH), or an infectious intracranial aneurysm with or without rupture. In patients with cerebrovascular complications, valve replacement surgery is often delayed for concern of further neurological worsening. However, in circumstances when an indication for valve surgery to treat IE is present, the benefits of early surgical treatment may outweigh the potential neurologic deterioration. Furthermore, valve surgery has been associated with lower in-hospital mortality than medical therapy with intravenous antibiotics alone. Early valve surgery can be performed within 7 days of transient ischemic attack or asymptomatic stroke when medically indicated. Timing of valve surgery for IE after symptomatic medium or large symptomatic ischemic stroke or ICH remains challenging, and current data in the literature are conflicting about the risks and benefits. A delay of 2 to 4 weeks from the time of the cerebrovascular event is often recommended, balancing the risks and benefits of surgery. The range of timing of valve surgery varies depending on the clinical scenario, and is best determined by a multidisciplinary decision between cardiothoracic surgeons, cardiologists, infectious disease experts, and vascular neurologists in an experienced referral center.
A Comprehensive Review of Risk Factor, Mechanism, and Management of Left Ventricular Assist Device–Associated Stroke
Authors: Cho Sung-Min , Tahsili-Fahadan Pouya , Kilic Ahmet , Choi Chun Woo , Starling Randall C. , Uchino Ken
Published: April 2021

The use of left ventricular assist devices (LVADs) has been increasing in the last decade, along with the number of patients with advanced heart failure refractory to medical therapy. Ischemic stroke and intracranial hemorrhage remain the leading causes of morbidity and mortality in LVAD patients. Despite the common occurrence and the significant outcome impact, underlying mechanisms and management strategies of stroke in LVAD patients are controversial. In this article, we review our current knowledge on pathophysiology and risk factors of LVAD-associated stroke, outline the diagnostic approach, and discuss treatment strategies.
Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management
Authors: Boyanpally Anusha , Cutting Shawna , Furie Karen
Published: April 2021

Acute ischemic stroke (AIS) and acute myocardial infarction (AMI) may co-occur simultaneously or in close temporal succession, with occurrence of one ischemic vascular event increasing a patient's risk for the other. Both employ time-sensitive treatments, and both benefit from expert consultation. Patients are at increased risk of stroke for up to 3 months following AMI, and aggressive treatment of AMI, including use of reperfusion therapy, decreases the risk of AIS. For patients presenting with AIS in the setting of a recent MI, treatment with alteplase, an intravenous tissue plasminogen activator, can be given, provided anterior wall myocardial involvement has been carefully evaluated. It is important for clinicians to recognize that troponin elevations can occur in the setting of AIS as well as other clinical scenarios and that this may have implications for short- and long-term mortality.
A Novel Technique for Radiographic Diagnosis of Sarcopenia that Accurately Predicts Postoperative Complications in Lower Extremity Free Flap Patients
Authors: Maddox Suma S. , Palines Patrick A. , Hoffman Ryan D. , Danos Denise M. , Womac Daniel J. , Tuggle Charles T. , Stalder Mark W.
Published: April 2021

Background Sarcopenia is linked to poor outcomes throughout the surgical literature and can be assessed on preoperative imaging to potentially aid in risk stratification. This study examined the effects of sarcopenia on surgical morbidity following lower extremity (LE) reconstruction, and also compared two methods of assessment, one of which is novel (“ellipse method”).

Methods A retrospective cohort study of 50 patients receiving free flap-based reconstruction of the LE was performed. Bilateral psoas density and area were quantified at L4 through tracing (“traditional method”) and encircling (“ellipse method”) to calculate Hounsfield unit average calculation (HUAC). Logistic regression and receiving operator curve analysis for the primary outcome of any postoperative complication was used to determine HUAC cutoffs (≤ 20.7 vs. ≤ 20.6) for sarcopenia. Risk of complications associated with sarcopenia was evaluated using Fisher's exact tests.

Results Twelve patients (24%) met criteria for sarcopenia via the traditional method and 16 (32%) via the ellipse method. By both methods, sarcopenic patients were older and more often female and diabetic. These patients also had higher American Society of Anesthesiologists scores and lower serum prealbumin levels. The ellipse method was found to be more accurate, sensitive, and specific than the traditional method in predicting postoperative morbidity (p = 0.009). Via the ellipse method, sarcopenic patients were at higher risk for any complication (p = 0.002) and were at a higher risk for a deep vein thrombus or pulmonary embolism via the traditional method (p = 0.047).

Conclusion Sarcopenia is associated with greater pre- and postoperative morbidity in LE reconstruction. The novel ellipse method is a simplified and accurate method of assessing sarcopenia that can be easily performed in the clinical setting.
Flexor Carpi Radialis Brevis Resection for Treatment of a Distal Radius Fracture: A Case Report
Authors: Werntz Ryan L. , Hadeed Andrew J. , Cappelleti Giacomo L. , Orbay Jorge L.
Published: April 2021

The flexor carpi radialis brevis (FCRB) is an anomalous muscle of the forearm that is only present in 3.5 to 8.6% of the population. In the case of volar plating of distal radius fractures, the FCRB inhibits proper fracture exposure and thus hinders proper reduction. A 78-year-old female presented with right distal radius fracture which necessitated internal fixation. Following mobilization and retraction of the flexor carpi radialis tendon, an anomalous muscle belly was identified as the FCRB. With continued difficulty in exposure and fracture site reduction, resection of the FCRB was performed. The patient was able to return to her activities of daily living without pain and demonstrated no appreciable functional deficit. This case report demonstrates a distal radius fracture where FCRB resection was used, resulting in no detrimental clinical outcomes.
Efficacy of Adductor Canal Blocks in Total Knee Arthroplasty
Authors: Johns Nicholas , Noye Nicholas , Wall Chris , Martin Glen , Loch Alan
Published: April 2021

Total knee arthroplasty (TKA) is associated with significant postoperative pain. The population receiving TKA is generally elderly and often have multiple comorbidities that can present a challenge to postoperative management. Safe and effective multimodal pain management has led to improved outcomes while minimizing complications and side effects. The objective of this study was to investigate the efficacy of adductor canal blocks (ACB) in patients receiving TKA within a regional Queensland population. We performed a retrospective comparative cohort analysis of 458 patients who received TKA at a regional private hospital between January 2016 and December 2018. Inclusion criteria included body mass index (BMI) <50 kg/m2 and unilateral TKA. Using the patients' hospital records, age, gender, American Society of Anesthesiologists' score (ASA), BMI, diabetic status, length of stay (LOS), opioid requirement on discharge, range of motion (ROM) on discharge, return to theater, and readmission within 12 months were recorded. One hundred and thirty-eight patients received ACB and 263 did not. The two groups were comparable for age, gender, diabetic status, and ASA. Patients who received an ACB had an 18-hour longer LOS (p < 0.0001), but were discharged on lower dosages of opioids equivalent to 7.9 oral morphine milligram equivalent (MME; p < 0.0001). Patients who had an ACB had a similar ROM on discharge and did not have an increased rate of readmission or return to theater. This study demonstrates that ACB are efficacious when used as part of a multimodal analgesia regime for TKA.
The Spectrum of DEPDC5-Related Epilepsy
Authors: Salomone Giulia , Comella Mattia , Portale Anna , Pecora Giulia , Costanza Giuseppe , Lo Bianco Manuela , Sciuto Sarah , Praticò Elena R. , Falsaperla Raffaele
Published: April 2021

Disheveled EGL-10 and pleckstrin domain-containing protein 5 (DEPDC5) is a key member of the GAP activity toward rags complex 1 complex, which inhibits the mammalian target of rapamycin complex 1 (mTORC1) pathway. DEPDC5 loss-of-function mutations lead to an aberrant activation of the mTOR signaling. At neuronal level, the increased mTOR cascade causes the generation of epileptogenic dysplastic neuronal circuits and it is often associated with malformation of cortical development. The DEPDC5 phenotypic spectrum ranges from sporadic early-onset epilepsies with poor neurodevelopmental outcomes to familial focal epilepsies and sudden unexpected death in epilepsy; a high rate of inter- and intrafamilial variability has been reported. To date, clear genotype–phenotype correlations have not been proven. More studies are required to elucidate the significance of likely pathogenic/variants of uncertain significance. The pursuit of a molecular targeted antiepileptic therapy is a future challenge.
The PAP Flap Breast Reconstruction: A Practical Option for Slim Patients
Authors: Jo Taehee , Jeon Dong Nyeok , Han Hyun Ho
Published: April 2021

Background The posterior thigh-based profunda artery perforator (PAP) flap has been an emerging option as a secondary choice in breast reconstructions. However, whether a PAP flap could consistently serve as the secondary option in slim patients has not been investigated.

Methods Records of immediate unilateral breast reconstructions performed from May 2017 to June 2019 were reviewed. PAP flap breast reconstructions were compared with standard deep inferior epigastric perforator (DIEP) flap breast reconstructions, and were grouped into single or stacked PAP flaps for further analysis.

Results Overall, 43 PAP flaps were performed to reconstruct 32 breasts. Eleven patients underwent stacked PAP flap reconstruction, while 17 patients underwent 21 single PAP flap reconstruction. The average body mass index (BMI) of the patients was 22.2 ± 0.5 kg/m2. The results were as follows: no total loss, one case of venous congestion (2.3%), two donor site wound dehiscence cases (4.7%), and one case of fat necrosis from partial flap loss (2.3%). When compared with 192 DIEP flap reconstructions, the final DIEP flap supplied 98.1 ± 1.7% of mastectomy weight, while the final PAP flap supplied 114.1 ± 6.2% of mastectomy weight (p < 0.005), demonstrating that PAP flaps can successfully supply final reconstruction volume. In a separate analysis, single PAP flaps successfully supplied 104.2% (84.2-144.4%) of mastectomy weights, while stacked PAP flaps supplied 103.7% (98.8-115.2%) of mastectomy weights.

Conclusion In our series of PAP flap reconstructions performed in low-to-normal BMI patients, we found that PAP flaps, as single or stacked flaps, provide sufficient volume to reconstruct mastectomy defects.
SLC25A22 and Its Related Epileptic Encephalopathies
Authors: Patanè Francesca , Pasquetti Elisa , Sullo Federica , Tosto Monica , Sciuto Laura , Garozzo Maria Teresa , Praticò Elena R. , Falsaperla Raffaele
Published: April 2021

Epileptic encephalopathy is a condition in which seizures, electroencephalographic epileptiform abnormalities lead to a progressive deterioration of brain functions causing a significant psychomotor delay. One of the typical features of this heterogeneous and large group of severe disorders is the extremely early onset of seizures. The main causes of the epileptic encephalopathies include structural brain defects, inherited metabolic disorders; in this aspect, more than 100 genetic defects, including mutations in the solute carrier family 25 (SLC25A22) gene which encodes a mitochondrial glutamate carrier. To date, the main clinical phenotypes related to mutations of this gene are Ohtahara syndrome (or early infantile epileptic encephalopathy), early myoclonic encephalopathy and migrating partial seizures in infancy. In all the cases, prognosis is poor and no disease-modifying treatment is available in the present days.
Endovascular Stenting for Malignant Obstruction of Superior Vena Cava: A Single-Center Experience Using the Body Floss Technique
Authors: Lingegowda Dayananda , Gupta Bharat , Gehani Anisha , Ghosh Priya , Mukhopadhyay Sumit
Published: April 2021

Purpose Endovascular stenting is the treatment of choice for malignant obstruction of the superior vena cava (SVC) when rapid symptomatic relief is desired. Body floss technique is not routinely used during SVC stenting but has few advantages over single-access technique. We report our experience with stenting for malignant obstruction of the SVC using the body floss technique.

Materials and Methods Between March 2015 and March 2020, 25 patients (20 men, 5 women; median age, 65 years) with malignant SVC obstruction underwent endovascular stenting of the SVC. We retrospectively evaluated these patients for clinical and technical success rates, complications, recurrence-free survival, and overall survival.

Results Stent placement was successful in 24/25 patients (technical success: 96%). Clinical success was achieved in 23/25 (92%) patients. A mortality rate of 4% (1/25) was noted due to SVC rupture. Partial stent migration was noted in two patients (8%) and was treated by placing an additional overlapping stent. Incidental early stent thrombosis was seen in two patients within 8 hours of stent placement, but these patients showed symptom relief with anticoagulation. Follow-up imaging confirmed stent patency in all patients. Late stent occlusion due to tumor progression was seen in one patient. The primary patency rate was 88% (22/25). Overall median survival of 133 days was observed (range: 1–847 days).

Conclusion Endovascular stenting of the SVC for malignant obstruction using the body floss technique is associated with high technical and clinical success, and low rate of complications.
A novel CMOS hexaferrite circulator with 25 GHz operating frequency
Authors: Zhang Guangjun , Jiang Yanfeng
Published: April 2021

A novel CMOS hexaferrite circulator with a Y-junction structure is designed and fabricated, which is compatible with standard CMOS technology. The spin-coating approach is adopted during the fabrication, in which the photoresist is mixed with nano-hexaferrite powder for preparation of a magnetic thin film in the device. Compared with the traditional circulator with an external permanent magnet for operation, the novel circulator can utilize the spin-coating magnetic film and is compatible with CMOS technology. The remanent magnetization of the adopted hexaferrite thin film can provide the required magnetic field for reciprocity properties. The optimization of impedance matching and the improvements in the related parameters are demonstrated on the novel CMOS circulator. The CMOS circulator exhibits the merits of small volume and easy integration while keeping its promising non-reciprocity properties. The fabrication is conducted based on the standard 180-nm CMOS technology. S-parameter measurements on the circulator show that the device has an isolation of 20 dB over 520 MHz bandwidth at 26.2 GHz. The minimum insertion loss is 1.81 dB. The novel CMOS-compatible circulator has potential application in 5G wireless communication systems.
Flow visualization and density measurement of the supersonic molecular beam for fusion plasma fueling
Authors: Xiao Guoliang , Yin Jiao , Chen Chengyuan , Feng Beibin , Zhong Wulyu , Zhang Yipo , Li Bingli , Wang Tianbo , Xiao Weiwen , Xu Min , Duan Xuru
Published: April 2021

The supersonic molecular beam injection (SMBI) technique is widely used in magnetic fusion devices for plasma fueling and active control of particles. The beam flow formed by the SMBI system is directly visualized by a newly established schlieren diagnostic system on the SMBI testing platform. This schlieren system could provide a 2D density distribution of the beam with the sub-mm spatial resolution by detecting the change in the refractive index of the medium caused by the SMBI in the low-pressure vacuum chamber. The structure and the divergence angle of the supersonic molecular beam for fusion plasma fueling are first measured. Additionally, the density profile of the supersonic molecular beam is reconstructed from the measured light intensity by the schlieren system. The experimental comparison between the standard nozzle and the optimized nozzle of the SMBI system shows the great potential of the diagnostic system in optimizing the beam characteristics.
Particle-in-cell Monte Carlo-collision modeling of non-ideal effects in wave-heated dense microplasmas
Authors: Solmaz Evrim , Levko Dmitry , Raja Laxminarayan L.
Published: April 2021

A computational model for non-ideal plasma effects during the time evolution of a second-stage laser-heated discharge at high pressures is presented. The model extends a classical one-dimensional particle-in-cell Monte Carlo-collision (PIC-MCC) approach coupled with Maxwell's equations for the laser-heating process of a xenon plasma at 300 K temperature and 10–100 bar pressure. Plasma non-ideality resulting from Coulomb coupling at high plasma densities is manifested as a depression in the effective ionization potential of atoms and enhanced collision cross sections. These non-ideal effects are represented using the Ecker–Kröll model in the context of the PIC-MCC approach. We find that full ionization of the plasma is obtained on the picosecond timescale, starting from the skin layer and quickly expanding throughout the domain through an anomalous extension of the skin depth. More critically, we show that the inclusion of the non-ideal plasma effects results in more rapid ionization compared to an ideal plasma, especially at higher pressures. The ionization delay reduction is of the order of a fraction of a picosecond, corresponding to a 16% decrease at 100 bar. As the amplitude of the wave field is lowered, the ionization rate is lowered, making the plasma non-ideality effects more prominent.
Targeted survey for the eastern quoll (
Authors: Hope Ben , Bilney Rohan J. , Peterie Jess
Published: April 2021

Following the report of a photograph of an eastern quoll in 2013 from the Nungatta area, near Eden in southern New South Wales, we investigated whether the species may persist in the area. This involved reviewing existing wildlife records, speaking to landholders and ecologists who have recently surveyed the area, and performing a targeted survey totalling 1893 camera-nights across 59 sites in May–July 2019 in the general vicinity of the sighting. We were not able to independently verify the presence of a wild population as no additional record of an eastern quoll was obtained.
Cholestenone functions as an antibiotic against
Helicobacter pylori
by inhibiting biosynthesis of the cell wall component CGL
Authors: Kobayashi Junichi , Kawakubo Masatomo , Fujii Chifumi , Arisaka Nobuhiko , Miyashita Masaki , Sato Yoshiko , Komura Hitomi , Matoba Hisanori , Nakayama Jun
Published: April 2021

Significance

Cholesteryl-α-D-glucopyranoside (CGL) is a cell wall constituent of
Helicobacter pylori
. It is synthesized by cholesterol α-glucosyltransferase, which transfers glucose from UDP-glucose to a carbon atom at the third position of cholesterol with an α1,3-linkage. We previously discovered that αGlcNAc contained in gastric gland mucins serves as antibiotic against
H. pylori
by inhibiting CGL biosynthesis. Here, we reveal that cholestenone exhibits antibiotic activity against
H. pylori
including a clarithromycin-resistant
H. pylori
strain by suppressing CGL biosynthesis in vitro. Strikingly, oral administration of cholestenone alone successfully eradicated
H. pylori
infection in C57BL/6 mice. Given its safety, cholestenone therapy could be promising to eradicate
H. pylori
, including antibiotic-resistant strains.
Optical vector field rotation and switching with near-unity transmission by fully developed chiral photonic crystals
Authors: Chen Chun-Wei , Khoo Iam Choon
Published: April 2021

Significance

We demonstrate by theory and experiments that a liquid crystal–based chiral photonic crystal (CPC), fabricated with a field-assisted molecular self-assembly technique to an unprecedented number (
N
> 1,000) of unit cells, will achieve the full potentials of an ideal (
N
→ ∞) CPC. Such high-
N
CPCs possess large optical rotatory power with near-unity transmission, work equally well on lasers of simple or complex vector fields, and allow dynamic polarization switching and control by virtue of field-induced index/birefringence changing mechanisms at modest or ultrafast speeds. They are highly promising alternatives to current state-of-the-art polarization manipulation optics that exhibit giant optical rotatory power but are generally passive and beset with large optical loss.
Idioscopus clypealis (mango leafhopper).
Authors: Ganeswaran R
Published: April 2021

Mango leafhoppers are major pests in the Indian subcontinent. The major damage caused is at the flowering stage and several studies have highlighted the reduction of yield which may be between 20 and 100% depending on population size. Verghese and Rao (1987) examined the critical infestation stages of I. clypealis in Uttar Pradesh, India. The mean density of cicadellids was 0.54-20.64 per panicle in 1983 and 0-6.03 per panicle in 1984. In both years, the peak population occurred when the fruit was pea sized. At the post-bloom stage a population of two adults per panicle was sufficient to cause yield reduction. It is suggested that the critical infestation stages are at post-bloom, when the fruit is marble sized, and 1 month before harvest, with corresponding critical population levels of two adults, 6-21 nymphs and 4-11 hoppers per panicle. In the Philippines, Corey et al. (1989) found that the economic injury levels for I. clypealis on two croppings of mangoes averaged 4.21, 4.30, 4.45 and 4.55 adults per panicle at 2, 10, 18 and 26 days, respectively, after flower bud break for the first cropping, and 4.79, 4.88, 5.06 and 5.18 adults per panicle for the second cropping.
Entada gigas (sea-bean).
Authors: Dube Shruti
Published: April 2021

A datasheet on Entada gigas covering, as an economically important tree, its taxonomy, importance, silviculture, distribution, biology and ecology, uses, products and pests.
Haematoxylum campechianum (logwood).
Authors: Rojas-Sandoval Julissa , Acevedo-Rodríguez Pedro
Published: April 2021

A datasheet on Haematoxylum campechianum covering, as an economically important tree, its taxonomy, importance, silviculture, distribution, biology and ecology, uses, products and pests.
Amorpha fruticosa (false indigo-bush).
Authors: Iamonico Duilio
Published: April 2021

A datasheet on Amorpha fruticosa covering, as an economically important tree, its taxonomy, importance, silviculture, distribution, biology and ecology, uses, products and pests.
Adonidia merrillii (Christmas palm).
Authors: Rojas-Sandoval Julissa
Published: April 2021

A datasheet on Adonidia merrillii covering, as an economically important tree, its taxonomy, importance, silviculture, distribution, biology and ecology, uses, products and pests.
Bocconia frutescens (plume poppy).
Authors: Chimera Charles G.
Published: April 2021

A datasheet on Bocconia frutescens covering, as an economically important tree, its taxonomy, importance, silviculture, distribution, biology and ecology, uses, products and pests.
Chilling or Learning?
Authors: Dyevre Arthur , Lampach Nicolas , Glavina Monika
Published: April 2021

We exploit the nonhierarchical nature of the European Union legal system to investigate the effect of negative feedback on intercourt cooperation. We argue that, in the context of a nonhierarchical referral system, formal dismissals expose shirking, which the principal, the referral court, has no formal power to curb. Yet we find that when referring courts have experienced a formal dismissal, they are not only more likely to resubmit but also more likely to see their references accepted. This effect increases with the number of formal dismissals previously experienced. Our findings suggest that referring courts expect significant benefits from cooperation that the referral court is able to leverage to ameliorate the quality of the referring judges’ work.
Bulk plasmon polariton based structured illumination microscopy by utilizing hyperbolic metamaterials
Authors: Liu Xiangzhi , Kong Weijie , Wang Changtao , Pu Mingbo , Li Zhenyan , Li Xiong , Ma Xiaoliang , Luo Xiangang
Published: April 2021

Because structured illumination microscopy (SIM) has the advantages of wide-field, rapid imaging, and biocompatibility, it is widely used for super-resolution imaging of living cells. Here, we demonstrate a new super-resolution imaging method—bulk plasmon polariton based SIM (BPPSIM), which combines the SIM with the hyperbolic metamaterials (HMMs). By utilizing an HMM composed of a multilayer metal/dielectric film, a deep subwavelength bulk plasmon polariton is obtained. The imaging resolution of BPPSIM can be improved by the uniform and wide-field structured illumination pattern with high spatial frequency, benefiting from the filtering effect of HMM for the spatial frequency spectrum. The resolution of the recovered images by BPPSIM has been increased to 1/8 of the fluorescence wavelength, which is 2.7-fold enhancement in resolution compared with traditional fluorescence microscopy. This proposed approach demonstrates the operability and flexibility of the structured illumination pattern and can be used in a simple, wide-field and super-resolution fluorescence microscope.