bluuebunny/crossref_metadata_2025 huggingface dataset:
Objet a et manie
Authors: de Portzamparc Renaud
Published: December 2019

Cet article aborde la clinique de la manie en se penchant sur les « Mémoires d’un névropathe » de Daniel Paul Schreber. Lors d’une des phases de sa maladie, celui-ci décrit une phase maniaque où il se voit dans une euphorie légère, un doux sommeil morphinique, qui contraste avec la tonalité mélancolique de son état précédent. Freud évoque le même phénomène du basculement de la mélancolie dans l’état maniaque. Binswanger, de son côté, s’est intéressé à la manie dans une perspective phénoménologique qui inspirera Henri Ey pour sa théorie psychodynamique : la déstructuration du champ de conscience libère des énergies et des pulsions qui sont à l’état normal sous contrôle. Le rapport à l’objet, en tant que petit autre, abordé par Freud à propos du deuil, sera repris par Lacan pour préciser cette libération : dans la manie, le sujet n’est plus « lesté » par l’objet a, conçu comme l’objet-cause du désir. Tout alors devient marqué du sceau de l’Idéal. La libération du désir n’est plus limitée par le signifiant phallique et se voit remplacée par une quête de jouissance infinie. La voracité insatiable du maniaque laisse ainsi entrevoir la figure archaïque de la mère dans sa version de surmoi féminin cruel et tout-puissant.
Antikoagulation und/oder Plättchenhemmungbei CKD und Dialysepatienten
Authors: Brandenburg Vincent
Published: December 2019

Maßnahmen zur Blutverdünnung (orale Antikoagulation (OAK) und/oder Anti-Plättchen-Therapie (APT)) tragen in erheblichem Maße zur Anämie bei unseren Patienten mit chronischer Niereninsuffizienz (CKD) bei. Erkrankungen mit einer Indikation zur OAK (z. B. VHF: Vorhofflimmern) oder APT (z. B. KHK: koronare Herzerkrankung) steigen in Inzidenz und Prävalenz mit Verschlechterung der CKD an. Gleichzeitig sind CKD und Dialysepatienten besonders blutungsgefährdet. Die nicht-Vitamin-K-abhängigen oralen Antikoagulanzien (NOAK) zeigen generell eine geringere Neigung zu schweren, lebensbedrohlichen Blutungen als die Vitamin-K-Antagonisten (VKA). Allerdings wurden in den NOAK-Zulassungsstudien Patienten mit einer Kreatinin-Clearance (Krea-Cl) von weniger als 30 ml/min meist nicht inkludiert. Noch unübersichtlicher ist die Datenlage zum Einsatz einer OAK gegen VHF bei dialysepflichtigen Patienten. Es ist in diesem Kollektiv unklar, ob Patienten überhaupt von einer OAK profitieren und welches hierfür eine sichere und effektive Substanz ist. Weder die NOAKs noch der VKA Marcumar® (Phenprocoumon) sind für Dialysepatienten in Deutschland überhaupt zugelassen. Etwas anders ist die Situation hinsichtlich einer APT: Generell sollten Patienten auch mit schwerer CKD oder Dialysepflichtigkeit die APT nach allgemeiner kardiologischer Empfehlung erhalten. Auf dem Boden des erhöhten Blutungsrisikos in diesem Kollektiv erscheinen moderne Kombinationen aus NOAK und einer einzelnen APT-Substanz als Ersatz für das alte Triple-Regime besonders interessant.
Effect of Dietary Fiber on Serum Leptin Level: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Hassanzadeh-Rostami Zahra , Faghih Shiva
Published: December 2019

Background Dietary fibers may induce satiety through affecting gastro-intestinal and peripheral appetite regulating hormones. Thus, we aimed to investigate the effect of dietary fiber consumption on serum leptin level compared to control diet, in short- and long- term trials, through a systematic review and meta-analysis.

Methods We searched PubMed, web of science, Scopus, ProQuest, EMBASE, and Cochrane Library to find randomized controlled clinical trials that evaluated effect of any type of dietary fiber on serum leptin level compared to control diet, until April 2019. Both short-term (1–4 days) and long-term (longer than 2 weeks) studies were selected. Mean differences (MD) of changes in serum leptin level and 95% confidence intervals were extracted from eligible studies, and random effects model was used to analyze data.

Results Thirteen studies included the systematic review and 11 entered in the meta-analysis. No significant change was seen in serum leptin level in short-term (MD=0.02, 95% CI; −0.15, 0.20, Tau2=0.0) and long-term studies (MD=−0.10, 95% CI; −0.28, 0.08, Tau2=0.0), followed by fiber consumption. However, this effect was statistically significant in obese participants (MD=−0.36, 95% CI; −0.71, −0.02, Tau2=0.0) in long-term studies. Moreover, we found no significant results in subgroups of baseline serum leptin level, intervention duration, fiber dose, and fiber type.

Conclusions This meta-analysis found that taking dietary fiber for long term could lower serum leptin level, just in obese persons. However, further clinical trials are needed in this field to clarify this issue.
Nusinersen – Erste Erfahrungswerte aus der klinischen Anwendung bei Patienten mit spinaler Muskelatrophie
Authors: Kappes Claudia , Bernhard Matthias K. , Merkenschlager Andreas
Published: December 2019

Nusinersen (Spinraza® ) ist das einzige bislang zugelassene Medikament zur Therapie der spinalen Muskelatrophien (SMA). In der EU besteht die Zulassung als Orphan Drug seit Anfang 2016 und gilt für alle Formen der spinalen Muskelatrophien. Dieser Artikel gibt einen Überblick über Wirkmechanismus und Anwendung des Medikaments sowie erste klinische Erfahrungswerte nach 3 Jahren der Behandlung von Patienten mit SMA an der Universitätsklinik für Kinder- und Jugendmedizin Leipzig.
Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy
Authors: Lee Youn Joo , Kim Sung Hun , Kang Bong Joo , Kim Yun Ju
Published: December 2019

Purpose To evaluate the time-intensity curve (TIC) parameters on contrast-enhanced ultrasound (CEUS) for early prediction of the response of breast cancer to neoadjuvant chemotherapy (NAC).

Materials and Methods This prospective study included 41 patients with breast cancer. CEUS was performed before and after the first cycle of NAC. TIC parameters were analyzed for different regions of interest (ROIs). ROI 1 targeted the hotspot area of greatest enhancement, ROI 2 delineated the area of hyperenhancement, ROI 3 included the entire tumor on grayscale ultrasound, and ROI 4 encircled the normal parenchyma. The TIC perfusion values for ROI 1, 2, and 3 were divided by the ROI 4 value.

Results 11 (26.8 %) of the 41 patients showed a good response (Miller-Payne score 4 or 5) and 30 (73.2 %) showed a minor response (Miller-Payne score 1, 2, or 3). There were significant differences in the wash-out area under the curve, the wash-in and wash-out areas under the curve on ROI 1/4 after the first cycle of NAC, pre-NAC mean transit time local (mTTl) on ROI 2/4, and pre-NAC mTTl on ROI 3/4 between good and minor responders (area under the receiver-operating characteristic curve > 0.70, p < 0.05).

Conclusion Some TIC parameters obtained by CEUS may allow prediction of the response of breast cancer to NAC at a very early time point.
Total Synthesis of Asperchalasine A
Authors: Deng Jun , Long Xianwen , Ding Yiming , Wu Hai
Published: December 2019

Here we briefly reviewed recent synthetic progress toward cytochalasan trimer, asperchalasine A by Tang, Trauner and our group. This process features a highly stereoselective intermolecular Diels–Alder reaction and a HWE or RCM macrocyclization to establish the key monomer aspochalasin B. A late-stage biomimetic oxidative dearomatization of triphenol and subsequent [5+2] cycloaddition cascade furnished asperchalasine A. We anticipate that this key reaction could also be used for the synthesis of other merocytochalasans, and provide some insight into the biosynthetic connections of merocytochalasans. 1 Introduction2 Total Synthesis of Aspochalasin B 3 Total Synthesis of Asperchalasine A 4 Conclusions
Mitomycin C in the Endoscopic Treatment of Laryngotracheal Stenosis: Systematic Review and Proportional Meta-Analysis
Authors: Queiroga Thereza L. O. , Cataneo Daniele C. , Martins Regina H. G. , Reis Tarcisio A. , Cataneo Antônio J. M.
Published: December 2019

Introduction Mitomycin C is a natural antibiotic that has been used to inhibit the proliferation of fibroblasts in scar tissue.

Objective To evaluate the effectiveness and safety of topical Mitomycin C as an adjuvant in the endoscopic treatment of laryngotracheal stenoses.

Data synthesis A systematic review of experimental or observational studies that have evaluated the treatment of laryngotracheal stenoses with the use of topical Mitomycin C was performed. Databases researched: LILACS, PubMed, Embase, Cochrane and Web of Science. Outcomes: resolution (symptom-free time ≥ one year), number of procedures required, and complications resulting from the procedure. A total of 15 studies (involving 387 patients) were selected. Mitomycin C was administered to every patient in 11 studies, and in 4 other studies, the patients were separated into 2 groups, 1 receiving mitomycin C, and the other not. The resolution of the stenosis evaluated in 12 studies in which the patients received mitomycin C was of 69% (95% confidence interval [95%CI]: 61–76%; I2 = 17.3%). A total of 52% of the patients (95%CI: 39–64%, 11 studies; I2 = 64.7%) were submitted to a single endoscopic procedure, and 48% (95%CI: 36–61%, 11 studies; I2 = 64.7%) were submitted to more than 1 procedure. Complications (mediastinal and subcutaneous emphysema, dysphonia, laceration or vocal fold paralysis and acute light obstruction) were reported in 9% of the patients (95%CI: 3–18%, 9 studies; I2 = 79.8%).

Conclusions The evidence suggests that mitomycin C is an effective and safe option in the endoscopic treatment of laryngotracheal stenosis.
Cortical Auditory Evoked Potentials in 2-Year-Old Subjects
Authors: Costa Inaê , D'Agostini Ayra Renata , Sousa Jennifer Alves , Souza Ana Paula Ramos de , Biaggio Eliara Pinto Vieira
Published: December 2019

Introduction Cortical auditory evoked potentials (CAEPs) can be used to evaluate both peripheral and cortical components of auditory function, and contribute to the assessment of functional sensitivity and auditory thresholds, especially in neonates and infants. Auditory evoked potentials reflect auditory maturity and precede the acquisition of more complex auditory and cognitive skills, and are therefore crucial for speech and language development.

Objective The aim of the present study was to determine the presence, latency and amplitude of CAEP components in response to verbal stimuli in children aged 2 years old.

Methods The sample consisted of 19 subjects, 10 of whom were male while 9 were female. All of the participants were 24 months old at the time of assessment.

Results A total of 17 of the participants displayed all components of the CAEP. Additionally, no significant differences were observed between genders or ears in the present sample. The presence of all components of the CAEP in subjects aged 2 years old confirms the existence of a critical period for the maturation of auditory pathways in the first 2 years of life.

Conclusion In the present study, in addition to the P1/N1 components, it was possible to observe the presence of the CAEP P2/N2 components in individuals aged 24 months, confirming the existence of a critical period for the maturation of the auditory pathways in the first 2 years of life.
Asclepias curassavica—A Multicentric, Randomised, Double-Blind Homoeopathic Pathogenetic Trial
Authors: Rajpal Rajpal , Singh Vinay Kr. , Siddiqui V.A. , Nayak C. , Majumder A.K. , Sarkar D.B. , Sivadas P.S. , Banoth K.
Published: December 2019

Objective To elicit the pathogenetic response of the drug Asclepias curassavica in homoeopathic potencies on healthy human beings.

Methodology Drug Asclepias curassavica was proved by the Central Council for Research in Homoeopathy through randomised, double-blind, placebo-controlled method. The study was conducted at four centres. The drug was proved in two potencies (6C and 30C) on 67 apparently healthy volunteers who were selected after conducting pre-trial medical examination by the medical specialists and routine laboratory investigations. In the first phase, volunteers were given 56 doses (04 doses per day for 14 days) of placebo. In the next two phases, 56 doses (04 doses per day for 14 days) of each potency or placebo were consumed. The symptoms generated during the trial period were noted by the volunteers and elaborated by the Proving Masters. The data obtained from all the four centres was compiled at proving-cum-data processing cell at CCRH headquarters after de-coding.

Observations Out of the 44 provers who were on actual drug trial, 21 manifested symptoms. Drug was able to produce symptoms in both the potencies more or less related to every part of the body.

Conclusion The pathogenetic responses elicited during the proving trial expands the scope of use of the drug Asclepias curassavica and will benefit the research scholars and clinicians. These symptoms will carry more value when verified clinically.
Cardiomyocyte-Specific JunD Overexpression Increases Infarct Size following Ischemia/Reperfusion Cardiac Injury by Downregulating Sirt3
Authors: Akhmedov Alexander , Montecucco Fabrizio , Costantino Sarah , Vdovenko Daria , Schaub Clerigué Ariane , Gaul Daniel S. , Burger Fabienne , Roth Aline , Carbone Federico , Liberale Luca , Amrollahi-Sharifabadi Mohammad , Vellone Valerio Gaetano , Eriksson Urs , Matter Christian M. , Crowe Lindsey A. , Vallée Jean-Paul , Paneni Francesco , Vanhoutte Paul M. , Camici Giovanni G. , Mach François , Lüscher Thomas F.
Published: December 2019

Ischemia/reperfusion (I/R) injury in acute myocardial infarction activates several deleterious molecular mechanisms. The transcription factor JunD regulates pathways involved in oxidative stress as well as in cellular proliferation, differentiation, and death. The present study investigated the potential role of JunD as a modulator of myocardial injury pathways in a mouse model of cardiac I/R injury. Infarct size, systemic and local inflammation, and production of reactive oxygen species, as well as cytosolic and mitochondrial apoptotic pathways were investigated in adult males after myocardial I/R. In wild-type (WT) mice, 30 minutes after ischemia and up to 24 hours following reperfusion, cardiac JunD messenger ribonucleic acid expression was reduced while JunB increased. Cardiac-specific JunD overexpressing mice (JunDTg/0
) displayed larger infarcts compared with WT. However, postischemic inflammatory or oxidative responses did not differ. JunD overexpression reduced Sirt3 transcription by binding to its promoter, thus leading to mitochondrial dysfunction, myocardial cell death, and increased infarct size. On the other hand, JunD silencing reduced, while Sirt3 silencing increased infarct size. In human myocardial autopsy specimens, JunD-positive areas within the infarcted left ventricle staining corresponded to undetectable Sirt3 areas in consecutive sections of the same heart. Cardiac-specific JunD overexpression increases myocardial infarct size following I/R. These effects are mediated via Sirt3 transcriptional repression, mitochondrial swelling, and increased apoptosis, suggesting that JunD is a key regulator of myocardial I/R injury. The present data set the stage for further investigation of the potential role of Sirt3 activation as a novel target for the treatment of acute myocardial infarction.
Particulate Shiga Toxin 2 in Blood is Associated to the Development of Hemolytic Uremic Syndrome in Children
Authors: Brigotti Maurizio , He Xiaohua , Carnicelli Domenica , Arfilli Valentina , Porcellini Elisa , Galassi Elisabetta , Tazzari Pier Luigi , Ricci Francesca , Patfield Stephanie A. , Testa Sara , Paglialonga Fabio , Picicco Damiano , Caprioli Alfredo , Scavia Gaia , Morabito Stefano , Ardissino Gianluigi
Published: December 2019

Hemolytic uremic syndrome (HUS), the leading cause of acute renal failure in children (< 3 years), is mainly related to Shiga toxins (Stx)-producing Escherichia coli (STEC) infections. STEC are confined to the gut resulting in hemorrhagic colitis, whereas Stx are delivered in blood to target kidney and brain, with unclear mechanisms, triggering HUS in 5 to 15% of infected children. Stx were found on circulating cells, free in sera (soluble Stx) or in blood cell-derived microvesicles (particulate Stx), whereby the relationship between these forms of circulating toxins is unclear. Here, we have examined 2,846 children with bloody diarrhea and found evidence of STEC infection in 5%. Twenty patients were enrolled to study the natural course of STEC infections before the onset of HUS. In patients, Stx were found to be associated to circulating cells and/or free and functionally active in sera. In most children, Stx were bound to neutrophils when high amounts of toxins were found in feces. Time-course analysis showed that Stx increased transiently in patients' sera while the decrease of toxin amount on leukocytes was observed. Notably, patients who recovered (85%) displayed different settings than those who developed HUS (15%). The distinctive feature of the latter group was the presence in blood of particulate Stx2 (Stx2 sedimented at g-forces corresponding to 1 μm microvesicles) the day before diagnosis of HUS, during the release phase of toxins from circulating cells. This observation strongly suggests the involvement of blood cell-derived particulate Stx2 in the transition from hemorrhagic colitis to HUS.
Hypoxia Modulates Platelet Purinergic Signalling Pathways
Authors: Paterson Gordon G. , Young Jason M. , Willson Joseph A. , Graham Christopher J. , Dru Rebecca C. , Lee Eleanor W. , Torpey Greig S. , Walmsley Sarah R. , Chan Melissa V. , Warner Timothy D. , Baillie John Kenneth , Thompson Alfred Arthur Roger
Published: December 2019

Background Hypoxia resulting from ascent to high-altitude or pathological states at sea level is known to increase platelet reactivity. Previous work from our group has suggested that this may be adenosine diphosphate (ADP)-specific. Given the clinical importance of drugs targeting ADP pathways, research into the impact of hypoxia on platelet ADP pathways is highly important.

Methods Optimul aggregometry was performed on plasma from 29 lowland residents ascending to 4,700 m, allowing systematic assessment of platelet reactivity in response to several platelet agonists. Aggregometry was also performed in response to ADP in the presence of inhibitors of the two main ADP receptors, P2Y1 and P2Y12 (MRS2500 and cangrelor, respectively). Phosphorylation of vasodilator-stimulated phosphoprotein (VASP), a key determinant of platelet aggregation, was analysed using the VASPFix assay.

Results Hypobaric hypoxia significantly reduced the ability of a fixed concentration of cangrelor to inhibit ADP-induced aggregation and increased basal VASP phosphorylation. However, in the absence of P2Y receptor inhibitors, we did not find evidence of increased platelet sensitivity to any of the agonists tested and found reduced sensitivity to thrombin receptor-activating peptide-6 amide.

Conclusion Our results provide evidence of increased P2Y1 receptor activity at high altitude and suggest down-regulation of the P2Y12 pathway through increased VASP phosphorylation. These changes in ADP pathway activity are of potential therapeutic significance to high-altitude sojourners and hypoxic sea level patients prescribed platelet inhibitors and warrant further investigation.
Medial Patellofemoral Ligament Reconstruction and Nonanatomic Stabilization Techniques in Skeletally Immature Patients
Authors: Pilone Carola , Bonasia Davide Edoardo , Rosso Federica , Cottino Umberto , Mazzola Claudio , Blonna Davide , Rossi Roberto ,   Sigascot Knee Committee
Published: December 2019

Patellar instability is a common cause of knee disability in children and adolescent, with a high recurrence rate. When conservative treatment fails, surgical options should be considered. The femoral insertion of the medial patellofemoral ligament (MPFL) is in close proximity to the distal femoral growth plate and precautions should be taken to avoid injuries to the physis. Anatomical features of the MPFL complex, with focus on the relationship between femoral MPFL attachment and femoral physis, are discussed together with surgical tips to avoid injuries to the growth plates. The aim of this article is to review the recent literature regarding MPFL reconstruction and other stabilization techniques for patellofemoral instability in skeletally immature patients, focusing on the different surgical options available. These can be classified as anatomical versus nonanatomical, proximal versus distal realignments, or based on the graft used: free graft and pedicled graft (quadriceps, patellar tendon, hamstring, and adductor magnus).
Mini Bone Block Distraction Subtalar Arthrodesis (SAMBB) in the Management of Acquired Adult Flatfoot with Subtalar Arthritis: A Modification to the Grice–Green Procedure
Authors: Mosca Massimiliano , Caravelli Silvio , Vannini Francesca , Pungetti Camilla , Catanese Giuseppe , Massimi Simone , Fuiano Mario , Faldini Cesare , Giannini Sandro
Published: December 2019

Adult acquired flatfoot encompasses a wide range of deformities. The goal of surgical treatment of adult acquired flatfoot is to achieve proper alignment of the hindfoot and maintain as much flexibility as possible in the foot and ankle complex; nevertheless, if subtalar arthritis is present, subtalar arthrodesis is usually mandatory. A lateral approach over the sinus tarsi is performed and subtalar joint is prepared removing remaining cartilage, reduced up to 5 degrees of heel valgus, and stabilized with a Kirschner wire. The site of insertion of the corticocancellous bone graft, harvested from the ipsilateral proximal tibia, is prepared carving a vertical groove into the talar and calcaneal edges. Additional autologous cancellous chips, harvested from the proximal tibia, can be positioned and pressed with a beater into the sinus tarsi to enhance fusion. The technique described is a modification of the extra-articular arthrodesis originally proposed by Grice. mini bone block distraction subtalar arthrodesis is a simple and effective technique which permits a subtalar fusion with a restored orientation of the hindfoot and ankle alignment in acquired flatfoot with subtalar arthritis.
Maternal Hypothyroidism during Pregnancy and the Risk for Infectious Morbidity of the Offspring
Authors: Beharier Ofer , Walfisch Asnat , Wainstock Tamar , Szaingurten-Solodkin Irit , Landau Daniela , Sheiner Eyal
Published: December 2019

Objective Animal studies indicate a possible intrauterine immunological imprinting in pregnancies complicated by hypothyroidism. We aimed to evaluate whether exposure to maternal hypothyroidism during pregnancy increases the risk of long-term infectious morbidity of the offspring.

Study Design A retrospective cohort study compared the long-term risk of hospitalization associated with infectious morbidity in children exposed and unexposed in utero to maternal hypothyroidism. Outcome measures included infectious diagnoses obtained during any hospitalization of the offspring (up to the age of 18 years).

Results The study included 224,950 deliveries. Of them, 1.1% (n = 2,481) were diagnosed with maternal hypothyroidism. Children exposed to maternal hypothyroidism had a significantly higher rate of hospitalizations related to infectious morbidity (13.2 vs. 11.2% for control; odds ratio: 1.2; 95% confidence interval: 1.08–1.36; p = 0.002). Specifically, incidences of ear, nose, and throat; respiratory; and ophthalmic infections were significantly higher among the exposed group. The Kaplan–Meier curve indicated that children exposed to maternal hypothyroidism had higher cumulative rates of long-term infectious morbidity. In the Cox proportional hazards model, maternal hypothyroidism remained independently associated with an increased risk of infectious morbidity in the offspring while adjusting for confounders.

Conclusion Maternal hypothyroidism during pregnancy is associated with significant pediatric infectious morbidity of the offspring.
Is Nasal Septum–Tragus Length Measurement Appropriate for Endotracheal Tube Intubation Depth in Neonates? A Randomized Controlled Study
Authors: Uygur Özgün , Öncel Mehmet Yekta , Şimşek Gülsüm Kadıoğlu , Okur Nilüfer , Çelik Kıymet , Bozkurt Özlem , Yücesoy Ebru , Terek Demet , Arslan Meltem Koyuncu , Pekçevik Yeliz , Akar Melek , Köroğlu Özge Altun , Oğuz Suna , Kültürsay Nilgün
Published: December 2019

Objective Endotracheal intubation is a frequent procedure performed in neonates with respiratory distress. Clinicians use different methods to estimate the intubation insertion depth, but, unfortunately, the improper insertion results are very high. In this study, we aimed to compare the two different methods (Tochen's formula = weight in kilograms + 6 cm; and nasal septum–tragus length [NTL] + 1 cm) used to determine the endotracheal tube (ETT) insertion depth.

Study Design Infants who had intubation indications were enrolled in this study. The intubation tube was fixed using the Tochen formula (Tochen group) or the NTL + 1 cm formula (NTL group). After intubation, the chest radiograph was evaluated (above T1, proper place, and below T2).

Results A total of 167 infants (22–42 weeks of gestational age) were included in the study. The proper tube placement rate in both groups was similar (32.4 vs. 30.4% for infants < 34 weeks of gestational age and 56.8 vs. 45.0% in infants > 34 weeks of gestational age). The ETT was frequently placed below T2 at a higher rate in infants with a gestational age of <34 weeks, especially in the NTL group (46% in the Tochen group and 60.7% in the NTL group).

Conclusion The NTL + 1 cm formula led to a higher rate of ETT placement below T2, especially in infants with a birth weight of <1,500 g. Therefore, more studies are needed to determine the optimal ETT insertion depth.
References Values of Fetal Heart Myocardial Volume by Three-Dimensional Ultrasound using Spatiotemporal Image Correlation and Virtual Organ Computer-Aided Analysis Methods and Their Applicability in Pregestational Diabetic Women
Authors: Melo Júnior José Francisco , Bravo-valenzuela Nathalie Jeanne , Nardozza Luciano Marcondes Machado , Peixoto Alberto Borges , Mattar Rosiane , Martins Wellington P. , Pares David Baptista da Silva , Araujo Júnior Edward
Published: December 2019

Objective To determine reference values for myocardial volume of the fetal heart using three-dimensional ultrasound with spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) and to assess their applicability in women with pregestational diabetes.

Study Design This retrospective cross-sectional study included 177 normal pregnant women with fetuses between 200/7 and 336/7 weeks of age. Fetal cardiac volumes were collected using the STIC method, and myocardial volume was obtained by subtraction of the intracavitary volumes using the VOCAL 30-degree method. Intra- and interobserver reproducibility values were determined using the concordance correlation coefficient (CCC). Sixteen women with pregestational diabetes mellitus were evaluated for validation.

Results There was a strong correlation between fetal myocardial volume and gestational age (R
2 = 0.82). Intra- and interobserver reproducibility values were excellent and moderate, respectively, with CCCs of 0.99 and 0.83, respectively. There was no significant difference in mean fetal myocardial volume between normal pregnant women and those with pregestational diabetes (p = 0.64).

Conclusion Reference values for myocardial volume of the fetal heart were determined in normal pregnant women and were not statistically different from those in women with pregestational diabetes mellitus.
Piezosurgery in Hallux Valgus Correction: Distal Linear Osteotomy Operative Technique Using Piezoelectric Tools
Authors: Russo Alessandro , Caravelli Silvio , Mosca Massimiliano , Girolami Mauro , Ortolani Alessandro , Massimi Simone , Fuiano Mario , Zaffagnini Stefano
Published: December 2019

Purpose Piezoelectric and ultrasonic vibrations have been used to cut tissues for three decades, in particular, in periodontics. The increasing use of piezosurgery is based on its clinical advantages such as selective cutting, precision, and low-temperature work rates. The authors applied this concept to a new operative field, the foot and ankle pathology and surgery, such as hallux valgus corrective distal linear osteotomy.

Methods The osteotome equipped was the Surgysonic Moto-II model (Esacrom, Imola, Italy), a system recently developed for cutting bone withmicrovibrations. Tips used in author’s case series were a high-efficiency five teeth piezoelectric saw and a high-efficiency flat scalpel shaped on three edges. Operative technique is described.

Discussion and Conclusion Piezoelectric techniques were developed in response to the need for great precision and safety in bone surgery that was availavle with other manual and rmotorised instruments. Piezo-technology allows minimally-invasive and percutaneous surgery, with reduced trauma on periostium, bone, and soft tissues, reduced healing time of the osteotomy due to the absence of bony necrosis and debris formation and major precision.
Changes in isometric quadriceps strength after the application of ultrasound-guided percutaneous neuromodulation. A case study
Authors: O. Carvajal-Fernández , D. Álvarez Prats , N. Pérez Mallada
Published: December 2019

Background Ultrasound-guided percutaneous neuromodulation (US-guided PNM) is an invasive physiotherapy technique which is employed for neurofunctional improvement and treatment of pain. To date, no study has related this technique with muscle stimulation and dynamometry changes. Within the functional assessment tools, dynamometry tests were performed with devices which enable the calculation of variables related with isometric and isokinetic movement.

Aim To assess the changes in maximum isometric strength after the application of US-guided PNM.

Material and Methods A retrospective case study comprising 13 subjects (26 lower limbs) receiving US-guided PNM, with pre and post-intervention measurements.

The inclusion criteria comprised subjects without pain at the time of study, with coefficients of variation (COV) below 15% and in the process of improving loading work. We excluded subjects with pathology provoking pain at the time of the measurements and with contraindications for dynamometry or US-guided PNM. An isometricmeasurement was performed using the KINEO dynamometry system with 90° hip flexion and 45° knee extension, without strapping and with manual grips in lateral supports of the system. The lever arm was placed at 2 cm of the malleoli in the ventral aspect without strapping the ankle and a pre-intervention measurement was performed of the maximum isometric strength based on a mean of 3 repetitions (3 seconds' contraction and 6 seconds' relaxation). Subsequently, the US-guided PNM technique was performed on the femoral nerve, using the Physio Invasiva device and the PES modality (10 Hz frequency, 240 μs pulse width). Ten maximal and pain free stimulations were performed lasting 10 seconds each, with a 10 second rest between each contraction. After the intervention, a post intervention measurement was performed, in the same manner as the previous measurement.

Results In total, 13 volunteer subjects participated in the study, aged between 27 and 59 years, of which, 2 were women and 11 were men. After the application of US-guided PNM on the femoral nerve, changes were observed in the maximum mean isometric strength of the quadriceps, which increased from 26.75 kg in the pre-intervention mean with a standard deviation of 7.42 kg to 30.05 kg for the post-intervention mean, with a standard deviation of 9.23 kg. The results were statistically significant with p < 0.000.

Conclusion US-guided PNM applied to the femoral nerve is able to produce changes in maximum isometric strength measured using dynamometry.
Novel treatment with percutaneus electrolysis in cervical whiplash syndrome
Authors: JR García Naranjo
Published: December 2019

Introduction and Aims Cervical whiplash syndrome (CWS) commonly occurs because of the rear impact of motor vehicle collisions, producing a forced passive extension of the neck, followed by a rapid flexion in the form of a whip. This violent flexion can lead to an enthesopathy of the levator scapulae muscle (LS). The aim of this study was to evaluate the effectiveness of the percutaneous needle electrolysis (PNE) technique on the enthesopathy of the LS after a CWS and to compare this with a conventional physical therapy protocol.

Material and Methods In a physical therapy center specialized in traffic accidents, we arranged to interview a sample of 100 voluntary patients, providing subjects with the inclusion-exclusion criteria and an informed consent form. Participants recruited to the study had their pain quantified using the visual analog scale (VAS) for pain, the validated neck pain questionnaire (NPQ), and an algometer. Two groups were created. One received the PNE technique and the other received the conventional physiotherapy protocol. Once treatments were completed, pain was quantified once again and the results were obtained.

Results The most important findings are highlighted, regarding the comparison of variables of pain quantification in both groups and regarding the cost per treatment session.

Conclusions

1. The conventional physiotherapy protocol used is effective for the reduction of pain in the SLC in the enthesopathy of the LS.

2. Treatment with the PNE technique is effective for the reduction of pain in the CWS for LS enthesopathy.

3. Physiotherapy treatment which includes the PNE technique is more effective in the algometry variable than treatment performed with conventional physiotherapy techniques by 16.8%.

3. The PNE technique is superior to the protocol of conventional physiotherapy in the cost/effectiveness relationship by 85%.

4. The PNE technique, without combining the same with any other physiotherapy technique, is effective for the reduction of pain in cases of enthesopathy.
Invasive techniques in physical therapy: A literature review
Authors: L. Baraja-Vegas , M. Troyano Ruiz , E. Martí Rubio , J. Galvéz García
Published: December 2019

Background Invasive techniques in physical therapy is a term used to refer to a group of techniques in which the physical agent used for the treatment of different pathologies crosses the skin barrier. The aim of this study was to examine the scientific evidence on the invasive techniques that are most used in physical therapy, by reviewing the literature available on this subject.

Material and Methods A literature search was performed on the EBSCOhost, PubMed, Web of Science (WOS), PEDro and TRIP databases. The selected studies were: randomized clinical trials (RCTs), systematic reviews of RCTs and meta-analyses of RCTs. Studies had to be published between 2008 and 2018, conducted on men and women over the age of 18 and in English or Spanish.

Results In total, 64 studies were retrieved, which were read and scrutinized to confirm whether they were relevant for the present study. Finally, after the various screening processes, a sample of 21 articles was obtained. The level of evidence was analyzed as well as the level of recommendation according to the Oxford scale, together with an impact index according to the Journal Citation Reports (JCR). Seventeen of the studies were meta-analyses and systematic reviews of RCTs, and one systematic review of cohort studies was included.

Conclusion After the analysis of the selected articles and the conclusions, invasive techniques in physical therapy are confirmed to be relatively safe and effective for different pathologies, especially when performed in depth and when the local twitch response (LTR) is sought.
Clinical criteria for the application of dry needling in myofascial pain Syndrome: An expert consensus document and a cross-sectional study among physical therapists
Authors: Secorro Nicolas , Guerra Rafael , Labraca Xavi , Lari Marc , Pecos Daniel , Torres Bárbara , Calvo Sandra
Published: December 2019

Presently, there is no clear consensus on the essential and confirmatory criteria which should govern the application of dry needling (DN) in the treatment of myofascial trigger points. The aim of this study was to generate a consensus on these criteria, via a panel discussion with DN experts which took place at the International Conference of Invasive Physical Therapy held in 2018, including the opinion of the attendees who participated in a live survey on the subject at the conference via an app. The results obtained reveal discrepancies regarding confirmatory criteria such as the elicitation of referred pain; nonetheless, consensus exists on the suitability of the application of individualized and personalized DN treatment and the combination of treatment with other intervention approaches in physical therapy, with the use of ultrasound when required to support a safer clinical practice.
Containing misinformation spreading in temporal social networks
Authors: Wang Wei , Ma Yuanhui , Wu Tao , Dai Yang , Chen Xingshu , Braunstein Lidia A.
Published: December 2019

Many researchers from a variety of fields, including computer science, network science, and mathematics, have focused on how to contain the outbreaks of Internet misinformation that threaten social systems and undermine societal health. Most research on this topic treats the connections among individuals as static, but these connections change in time, and thus social networks are also temporal networks. Currently, there is no theoretical approach to the problem of containing misinformation outbreaks in temporal networks. We thus propose a misinformation spreading model for temporal networks and describe it using a new theoretical approach. We propose a heuristic-containing (HC) strategy based on optimizing the final outbreak size that outperforms simplified strategies such as those that are random-containing and targeted-containing. We verify the effectiveness of our HC strategy on both artificial and real-world networks by performing extensive numerical simulations and theoretical analyses. We find that the HC strategy dramatically increases the outbreak threshold and decreases the final outbreak threshold.
Memory effects on binary choices with impulsive agents: Bistability and a new BCB structure
Authors: Gardini L. , Dal Forno A. , Merlone U.
Published: December 2019

After the seminal works by Schelling, several authors have considered models representing binary choices by different kinds of agents or groups of people. The role of the memory in these models is still an open research argument, on which scholars are investigating. The dynamics of binary choices with impulsive agents has been represented, in the recent literature, by a one-dimensional piecewise smooth map. Following a similar way of modeling, we assume a memory effect which leads the next output to depend on the present and the last state. This results in a two-dimensional piecewise smooth map with a limiting case given by a piecewise linear discontinuous map, whose dynamics and bifurcations are investigated. The map has a particular structure, leading to trajectories belonging only to a pair of straight lines. The system can have, in general, only attracting cycles, but the related periods and periodicity regions are organized in a complex structure of the parameter space. We show that the period adding structure, characteristic for the one-dimensional case, also persists in the two-dimensional one. The considered cycles have a symbolic sequence which is obtained by the concatenation of the symbolic sequences of cycles, which play the role of basic cycles in the bifurcation structure. Moreover, differently from the one-dimensional case, the coexistence of two attracting cycles is now possible. The bistability regions in the parameter space are investigated, evidencing the role of different kinds of codimension-two bifurcation points, as well as in the phase space and the related basins of attraction are described.
Dynamic structure factor of a lipid bilayer in the presence of a high electric field
Authors: Zakhvataev V. E.
Published: December 2019

The influence of a high average electric field (∼1 V/nm) in the hydrophobic interior of a bilayer lipid membrane on short-wavelength in-plane phononic motions of lipid chains is considered. The average electric field is assumed to be nearly constant on a picosecond time scale and a nanometer length scale. This field may be induced, for instance, by externally applied subnanosecond electric pulses or the membrane dipole potential. Using a generalized hydrodynamic approach, we derive a corresponding electrohydrodynamic model generalized to high wave numbers. In the considered approximation, all electric field effects are reduced only to a constant contribution to the generalized isothermal compressibility modulus. The corresponding dynamic structure factor for a lipid bilayer is derived. We show that due to polarization effects, the high field can critically impact the dynamics of longitudinal acousticlike modes at wave numbers near the major peak of the static structure factor. We estimate quantitatively that for typical lipid bilayers, transverse high electric fields can cause strong phonon energy softening, enhancement of phonon population, and formation of a gap in the dispersion of excitation frequency. The results obtained agree with simulations of the initiation of lipid bilayer electropores, suggesting that the proposed model reproduces the essential features of the field’s impact on atomic density fluctuations. The proposed mechanism may have significant implications for the understanding of electroporation, passive molecular transport, and spontaneous pore formation in lipid bilayers.
Strain control of magnetic phase transition and perpendicular magnetic anisotropy in Ta/FeRh/MgO(001) heterostructure
Authors: Odkhuu Dorj
Published: December 2019

Employing first-principles calculations, we reveal tremendous strain effects on the magnetic order and magnetic anisotropy energy (MAE) of Ta-capped FeRh films on MgO(001). It is found that the tensile strain can lead to the magnetic phase transition from a ferromagnetic to an antiferromagnetic state at the FeRh/MgO and Ta/FeRh interfaces. Furthermore, we demonstrate that magnetization direction of Ta/FeRh/MgO(001) can reverse from perpendicular to in-plane orientation by tuning the strain, in contrast to the strain-independent perpendicular magnetization in FeRh/MgO(001). The underlying mechanism is discussed in connection with the strain-induced interfacial magnetic phase transition and changes in Fe 3d-Ta 5d hybridization at the interface. These findings open interesting prospects for exploiting stain manipulation of magnetization switching across the magnetic phase transition of FeRh layers for the next generation of antiferromagnetic memory devices.
Wide-aperture dense plasma fluxes production based on ECR discharge in a single solenoid magnetic field
Authors: Skalyga V. A. , Golubev S. V. , Izotov I. V. , Shaposhnikov R. A. , Razin S. V. , Sidorov A. V. , Bokhanov A. F. , Kazakov M. Yu. , Lapin R. L. , Vybin S. S.
Published: December 2019

Results of experimental investigation of the ECR discharge in a single coil magnetic field as an alternative to rf and helicon discharges for wide-aperture dense plasma fluxes production are presented. A possibility of obtaining wide-aperture high density hydrogen plasma fluxes with homogeneous transverse distribution was demonstrated in such a system. The prospects of using this system for obtaining high current ion beams are discussed.
Synchronous patterns and intermittency in a network induced by the rewiring of connections and coupling
Authors: Budzinski R. C. , Boaretto B. R. R. , Prado T. L. , Viana R. L. , Lopes S. R.
Published: December 2019

The connection architecture plays an important role in the synchronization of networks, where the presence of local and nonlocal connection structures are found in many systems, such as the neural ones. Here, we consider a network composed of chaotic bursting oscillators coupled through a Watts-Strogatz-small-world topology. The influence of coupling strength and rewiring of connections is studied when the network topology is varied from regular to small-world to random. In this scenario, we show two distinct nonstationary transitions to phase synchronization: one induced by the increase in coupling strength and another resulting from the change from local connections to nonlocal ones. Besides this, there are regions in the parameter space where the network depicts a coexistence of different bursting frequencies where nonstationary zig-zag fronts are observed. Regarding the analyses, we consider two distinct methodological approaches: one based on the phase association to the bursting activity where the Kuramoto order parameter is used and another based on recurrence quantification analysis where just a time series of the network mean field is required.
Voltage-controlled superconducting magnetic memory
Authors: Kenawy Ahmed , Magnus Wim , Milošević Milorad V. , Sorée Bart
Published: December 2019

Over the past few decades, superconducting circuits have been used to realize various novel electronic devices such as quantum bits, SQUIDs, parametric amplifiers, etc. One domain, however, where superconducting circuits fall short is information storage. Superconducting memories are based on the quantization of magnetic flux in superconducting loops. Standard implementations store information as magnetic flux quanta in a superconducting loop interrupted by two Josephson junctions (i.e., a SQUID). However, due to the large inductance required, the size of the SQUID loop cannot be scaled below several micrometers, resulting in low-density memory chips. Here, we propose a scalable memory consisting of a voltage-biased superconducting ring threaded by a half-quantum flux bias. By numerically solving the time-dependent Ginzburg-Landau equations, we show that applying a time-dependent bias voltage in the microwave range constitutes a writing mechanism to change the number of stored flux quanta within the ring. Since the proposed device does not require a large loop inductance, it can be scaled down, enabling a high-density memory technology.
Technique improves solid-state nanopores
Authors: Kish Stacy W.
Published: December 2019

Researchers developed a scalable, inexpensive technique capable of creating tiny, nanoscale-sized holes in synthetic membranes, offering new opportunities for biological applications.