bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting anesthetic infusion events using machine learning
Authors: Miyaguchi Naoki , Takeuchi Koh , Kashima Hisashi , Morita Mizuki , Morimatsu Hiroshi
Published: December 2021

Recently, research has been conducted to automatically control anesthesia using machine learning, with the aim of alleviating the shortage of anesthesiologists. In this study, we address the problem of predicting decisions made by anesthesiologists during surgery using machine learning; specifically, we formulate a decision making problem by increasing the flow rate at each time point in the continuous administration of analgesic remifentanil as a supervised binary classification problem. The experiments were conducted to evaluate the prediction performance using six machine learning models: logistic regression, support vector machine, random forest, LightGBM, artificial neural network, and long short-term memory (LSTM), using 210 case data collected during actual surgeries. The results demonstrated that when predicting the future increase in flow rate of remifentanil after 1 min, the model using LSTM was able to predict with scores of 0.659 for sensitivity, 0.732 for specificity, and 0.753 for ROC-AUC; this demonstrates the potential to predict the decisions made by anesthesiologists using machine learning. Furthermore, we examined the importance and contribution of the features of each model using Shapley additive explanations—a method for interpreting predictions made by machine learning models. The trends indicated by the results were partially consistent with known clinical findings.
A population-based study of TyG index distribution and its relationship to cardiometabolic risk factors in children and adolescents
Authors: Yoon Jong Seo , Shim Young Suk , Lee Hae Sang , Hwang Il Tae , Hwang Jin Soon
Published: December 2021

The purpose of this study was to present age- and sex-specific distributions of the triglyceride-glucose (TyG) index and to evaluate their relationship with cardiometabolic risk factors in children and adolescents. A total of 7404 participants aged 10–18 years from the Korean National Health and Nutrition Survey were included as the reference population. The TyG index was calculated as ln(fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The percentile of the TyG index exhibited a steady linear relationship with age for both sexes. TyG index significantly correlated with waist circumference (WC) standard deviation score (SDS; r = 0.110, p < 0.001), systolic blood pressure (SBP; r = 0.104, p < 0.001), diastolic blood pressure (DBP; r = 0.083, p < 0.001), glucose (r = 0.220, p < 0.001), high-density lipoprotein cholesterol (HDL-C; r = − 0.325, p < 0.001), and triglycerides (TG; r = 0.926, p < 0.001). Multiple linear regression analysis revealed that the TyG index was significantly associated with WC SDS (β = 0.116, p < 0.001), SBP (β = 2.009, p < 0.001), DBP (β = 1.464, p < 0.001), glucose (β = 3.376, p < 0.001), HDL-C (β =  − 6.431, p < 0.001), and TG (β = 85.518, p < 0.001). Our results suggest that the TyG index has a steady linear distribution for sex and age in children and adolescents and constitutes an indicator for predicting metabolic disorders that could lead to cardiovascular disease later in life.
Survival impact of treatment for chronic obstructive pulmonary disease in patients with advanced non-small-cell lung cancer
Authors: Ajimizu Hitomi , Ozasa Hiroaki , Sato Susumu , Funazo Tomoko , Sakamori Yuichi , Nomizo Takashi , Kuninaga Kiyomitsu , Ogimoto Tatsuya , Hosoya Kazutaka , Yamazoe Masatoshi , Tsuji Takahiro , Yoshida Hironori , Itotani Ryo , Ueno Kentaro , Kim Young Hak , Muro Shigeo , Hirai Toyohiro
Published: December 2021

Chronic obstructive pulmonary disease (COPD) may coexist with lung cancer, but the impact on prognosis is uncertain. Moreover, it is unclear whether pharmacological treatment for COPD improves the patient’s prognosis. We retrospectively investigated patients with advanced non-small-cell lung cancer (NSCLC) who had received chemotherapy at Kyoto University Hospital. Coexisting COPD was diagnosed by spirometry, and the association between pharmacological treatment for COPD and overall survival (OS) was assessed. Of the 550 patients who underwent chemotherapy for advanced NSCLC between 2007 and 2014, 347 patients who underwent spirometry were analyzed. Coexisting COPD was revealed in 103 patients (COPD group). The median OS was shorter in the COPD group than the non-COPD group (10.6 vs. 16.8 months). Thirty-seven patients had received COPD treatment, and they had a significantly longer median OS than those without treatment (16.7 vs. 8.2 months). Multivariate Cox regression analysis confirmed the positive prognostic impact of COPD treatment. Additional validation analysis revealed similar results in patients treated with immune checkpoint inhibitors (ICIs). Coexisting COPD had a significant association with poor prognosis in advanced NSCLC patients if they did not have pharmacological treatment for COPD. Treatment for coexisting COPD has the potential to salvage the prognosis.
Likelihood of unprecedented drought and fire weather during Australia’s 2019 megafires
Authors: Squire Dougal T. , Richardson Doug , Risbey James S. , Black Amanda S. , Kitsios Vassili , Matear Richard J. , Monselesan Didier , Moore Thomas S. , Tozer Carly R.
Published: December 2021

Between June 2019 and March 2020, thousands of wildfires spread devastation across Australia at the tragic cost of many lives, vast areas of burnt forest, and estimated economic losses upward of AU$100 billion. Exceptionally hot and dry weather conditions, and preceding years of severe drought across Australia, contributed to the severity of the wildfires. Here we present analysis of a very large ensemble of initialized climate simulations to assess the likelihood of the concurrent drought and fire-weather conditions experienced at that time. We focus on a large region in southeast Australia where these fires were most widespread and define two indices to quantify the susceptibility to fire from drought and fire weather. Both indices were unprecedented in the observed record in 2019. We find that the likelihood of experiencing such extreme susceptibility to fire in the current climate was 0.5%, equivalent to a 200 year return period. The conditional probability is many times higher than this when we account for the states of key climate modes that impact Australian weather and climate. Drought and fire-weather conditions more extreme than those experienced in 2019 are also possible in the current climate.
Passive detection of COVID-19 with wearable sensors and explainable machine learning algorithms
Authors: Gadaleta Matteo , Radin Jennifer M. , Baca-Motes Katie , Ramos Edward , Kheterpal Vik , Topol Eric J. , Steinhubl Steven R. , Quer Giorgio
Published: December 2021

Individual smartwatch or fitness band sensor data in the setting of COVID-19 has shown promise to identify symptomatic and pre-symptomatic infection or the need for hospitalization, correlations between peripheral temperature and self-reported fever, and an association between changes in heart-rate-variability and infection. In our study, a total of 38,911 individuals (61% female, 15% over 65) have been enrolled between March 25, 2020 and April 3, 2021, with 1118 reported testing positive and 7032 negative for COVID-19 by nasopharyngeal PCR swab test. We propose an explainable gradient boosting prediction model based on decision trees for the detection of COVID-19 infection that can adapt to the absence of self-reported symptoms and to the available sensor data, and that can explain the importance of each feature and the post-test-behavior for the individuals. We tested it in a cohort of symptomatic individuals who exhibited an AUC of 0.83 [0.81–0.85], or AUC = 0.78 [0.75–0.80] when considering only data before the test date, outperforming state-of-the-art algorithm in these conditions. The analysis of all individuals (including asymptomatic and pre-symptomatic) when self-reported symptoms were excluded provided an AUC of 0.78 [0.76–0.79], or AUC of 0.70 [0.69–0.72] when considering only data before the test date. Extending the use of predictive algorithms for detection of COVID-19 infection based only on passively monitored data from any device, we showed that it is possible to scale up this platform and apply the algorithm in other settings where self-reported symptoms can not be collected.
Forecasting adverse surgical events using self-supervised transfer learning for physiological signals
Authors: Chen Hugh , Lundberg Scott M. , Erion Gabriel , Kim Jerry H. , Lee Su-In
Published: December 2021

Hundreds of millions of surgical procedures take place annually across the world, which generate a prevalent type of electronic health record (EHR) data comprising time series physiological signals. Here, we present a transferable embedding method (i.e., a method to transform time series signals into input features for predictive machine learning models) named PHASE (PHysiologicAl Signal Embeddings) that enables us to more accurately forecast adverse surgical outcomes based on physiological signals. We evaluate PHASE on minute-by-minute EHR data of more than 50,000 surgeries from two operating room (OR) datasets and patient stays in an intensive care unit (ICU) dataset. PHASE outperforms other state-of-the-art approaches, such as long-short term memory networks trained on raw data and gradient boosted trees trained on handcrafted features, in predicting six distinct outcomes: hypoxemia, hypocapnia, hypotension, hypertension, phenylephrine, and epinephrine. In a transfer learning setting where we train embedding models in one dataset then embed signals and predict adverse events in unseen data, PHASE achieves significantly higher prediction accuracy at lower computational cost compared to conventional approaches. Finally, given the importance of understanding models in clinical applications we demonstrate that PHASE is explainable and validate our predictive models using local feature attribution methods.
Loss of peptidase D binding restores the tumor suppressor functions of oncogenic p53 mutants
Authors: Yang Lu , Li Yun , Bhattacharya Arup , Zhang Yuesheng
Published: December 2021

Tumor suppressor p53, a critical regulator of cell fate, is frequently mutated in cancer. Mutation of p53 abolishes its tumor-suppressing functions or endows oncogenic functions. We recently found that p53 binds via its proline-rich domain to peptidase D (PEPD) and is activated when the binding is disrupted. The proline-rich domain in p53 is rarely mutated. Here, we show that oncogenic p53 mutants closely resemble p53 in PEPD binding but are transformed into tumor suppressors, rather than activated as oncoproteins, when their binding to PEPD is disrupted by PEPD knockdown. Once freed from PEPD, p53 mutants undergo multiple posttranslational modifications, especially lysine 373 acetylation, which cause them to refold and regain tumor suppressor activities that are typically displayed by p53. The reactivated p53 mutants strongly inhibit cancer cell growth in vitro and in vivo. Our study identifies a cellular mechanism for reactivation of the tumor suppressor functions of oncogenic p53 mutants.
Advancing the science of dynamic airborne nanosized particles using Nano-DIHM
Authors: Pal Devendra , Nazarenko Yevgen , Preston Thomas C. , Ariya Parisa A.
Published: December 2021

In situ and real-time characterization of aerosols is vital to several fundamental and applied research domains including atmospheric chemistry, air quality monitoring, or climate change studies. To date, digital holographic microscopy is commonly used to characterize dynamic nanosized particles, but optical traps are required. In this study, a novel integrated digital in-line holographic microscope coupled with a flow tube (Nano-DIHM) is demonstrated to characterize particle phase, shape, morphology, 4D dynamic trajectories, and 3D dimensions of airborne particles ranging from the nanoscale to the microscale. We demonstrate the application of Nano-DIHM for nanosized particles (≤200 nm) in dynamic systems without optical traps. The Nano-DIHM allows observation of moving particles in 3D space and simultaneous measurement of each particle’s three dimensions. As a proof of concept, we report the real-time observation of 100 nm and 200 nm particles, i.e. polystyrene latex spheres and the mixture of metal oxide nanoparticles, in air and aqueous/solid/heterogeneous phases in stationary and dynamic modes. Our observations are validated by high-resolution scanning/transmission electron microscopy and aerosol sizers. The complete automation of software (Octopus/Stingray) with Nano-DIHM permits the reconstruction of thousands of holograms within an hour with 62.5 millisecond time resolution for each hologram, allowing to explore the complex physical and chemical processes of aerosols.
Specific ablation of PDGFRβ-overexpressing pericytes with antibody-drug conjugate potently inhibits pathologic ocular neovascularization in mouse models
Authors: Lee Seok Jae , Kim Soohyun , Jo Dong Hyun , Cho Chang Sik , Kim Su Ree , Kang Dongmin , Chae Jisu , Yoo Duck Kyun , Ha Suji , Chung Junho , Kim Jeong Hun
Published: December 2021

Background

Crosstalk between pericytes and endothelial cells is critical for ocular neovascularization. Endothelial cells secrete platelet-derived growth factor (PDGF)-BB and recruit PDGF receptor β (PDGFRβ)–overexpressing pericytes, which in turn cover and stabilize neovessels, independent of vascular endothelial growth factor (VEGF). Therapeutic agents inhibiting PDGF-BB/PDGFRβ signaling were tested in clinical trials but failed to provide additional benefits over anti-VEGF agents. We tested whether an antibody-drug conjugate (ADC) – an engineered monoclonal antibody linked to a cytotoxic agent - could selectively ablate pericytes and suppress retinal and choroidal neovascularization.

Methods

Immunoblotting, flow cytometry, cell viability test, and confocal microscopy were conducted to assess the internalization and cytotoxic effect of ADC targeting mPDGFRβ in an in vitro setting. Immunofluorescence staining of whole-mount retinas and retinal pigment epithelium-choroid-scleral complexes, electroretinography, and OptoMotry test were used to evaluate the effect and safety of ADC targeting mPDGFRβ in the mouse models of pathologic ocular neovascularization.

Results

ADC targeting mPDGFRβ is effectively internalized into mouse brain vascular pericytes and showed significant cytotoxicity compared with the control ADC. We also show that specific ablation of PDGFRβ-overexpressing pericytes using an ADC potently inhibits pathologic ocular neovascularization in mouse models of oxygen-induced retinopathy and laser-induced choroidal neovascularization, while not provoking generalized retinal toxicity.

Conclusion

Our results suggest that removing PDGFRβ-expressing pericytes by an ADC targeting PDGFRβ could be a potential therapeutic strategy for pathologic ocular neovascularization.
Highly luminescent gold nanocluster assemblies for bioimaging in living organisms
Authors: Yu Fanfan , Cao Zheng , He Shiyu , Xiang Hui , Zhao Gan , Yang Lina , Liu Honglin
Published: December 2021

Fabrication of highly luminescent and functionalized gold cluster nano-assembled structures for low-background and high-sensitivity sensing and imaging of the GSH molecule in cells and living organisms.
Tuning fast excited-state decay by ligand attachment in isolated chlorophyll a
Authors: Gruber Elisabeth , Teiwes Ricky , Kjær Christina , Brøndsted Nielsen Steen , Andersen Lars H.
Published: December 2021

Excited-state dynamics plays a key role for light harvesting and energy transport in photosynthetic proteins. Here we study the intrinsic dynamics of two chlorophyll a complexes by performing fs-pump-probe measurements in vacuo.
Valley polarization transition driven by biaxial strain in Janus GdClF monolayer
Authors: Guo San-Dong , Guo Xiao-Shu , Cai Xiu-Xia , Liu Bang-Gui
Published: December 2021

The valley degree of freedom of carriers in crystals is useful to process information and perform logic operations, and it is a key factor for valley application to realize valley polarization, which can be achieved by strain.
Porphyrinoids, a unique platform for exploring excited-state aromaticity
Authors: Kim Jinseok , Oh Juwon , Osuka Atsuhiro , Kim Dongho
Published: December 2021

Recently, Baird (anti)aromaticity has been referred to as a description of excited-state (anti)aromaticity.
Micron-sized biogenic and synthetic hollow mineral spheres occlude additives within single crystals
Authors: Marzec Bartosz , Walker Jessica , Jhons Yasmeen , Meldrum Fiona C. , Shaver Michael , Nudelman Fabio
Published: December 2021

Occlusion of micron-sized algae cells and calcitic hollow spheres within calcite single crystals, mediated by the positively charged polymer poly(allylamine hydrochloride). Both objects are used to transport functional additives to the host lattice.
Hipster microcarriers: exploring geometrical and topographical cues of non-spherical microcarriers in biomedical applications
Authors: Bjørge Isabel M. , Correia Clara R. , Mano João F.
Published: December 2021

Microcarriers presenting biophysical cues regulate cell fateviacell–substrate interactions and activation of mechanotransduction pathways.
Janus monolayer HfSO with improved optical properties as a novel material for photovoltaic and photocatalyst applications
Authors: Dat Vo D. , Vu Tuan V.
Published: December 2021

First principles calculations were performed to investigate the photocatalytic behavior of 2D Janus monolayer HfSO at equilibrium and under the influence of strains and external electric fields.
Cu-catalyzed [2 + 2 + 1] cascade annulation of vinyl iodonium salts with elemental sulfur/selenium for the modular synthesis of thiophenes and selenophenes
Authors: Wu Yaxing , Wu Chao , Wang Fei , Chen Chao
Published: December 2021

The Cu-catalyzed [2 + 2 + 1] regioselective synthesis of thiophenes/selenophenes was realized from aryl-vinyl iodonium salts and elemental sulfur/selenium.
The reaction mechanism of acetylene hydrochlorination on defective carbon supported ruthenium catalysts identified by DFT calculations and experimental approaches
Authors: Wang Xiaolong , Fan Dong , Lan Guojun , Cheng Zaizhe , Sun Xiucheng , Qiu Yiyang , Han Wenfeng , Tang Haodong , Liu Huazhang , Zhu Yihan , Hu Xiaojun , Li Ying
Published: December 2021

The electron density of ruthenium ions in RuCl3/AC-D catalyst increases, which reduces the energy barrier of the main reaction and inhibits the side reactions.
Iron covalent doping in WB2 to boost its hydrogen evolution activity
Authors: Jin Meng , Liu Yanyan , Wang Jialu , Zhang Xian , Han Miaomiao , Zhang Yunxia , Wang Guozhong , Zhang Haimin
Published: December 2021

An iron covalent-doped WB2 was fabricated, as an electrocatalyst by effectively manipulating its electronic structure for high-efficiency hydrogen evolution reaction, combining experimental with theoretical results to unveil its intrinsic mechanism.
Synthesis of the C50 diastereomers of the C33–C51 fragment of stambomycin D
Authors: Wang Yongchen , Chintalapudi Venkaiah , Gudmundsson Haraldur G. , Challis Gregory L. , Anderson Edward A.
Published: December 2021

The preparation of two C50 diastereomers of the C33–C51 region of stambomycin D is described. In addition to excellent correlation with the natural product, this synthesis establishes conditions for eventual global deprotection.
One-pot synthesis of α-aminophosphonates by yttrium-catalyzed Birum–Oleksyszyn reaction
Authors: Ceradini Davide , Shubin Kirill
Published: December 2021

For the first time, yttrium triflate was used as an efficient green catalyst for the synthesis of α-aminophosphonates through a one-pot three-component Birum–Oleksyszyn reaction.
Nature of electronic excitations in small non-stoichiometric quantum dots
Authors: Bhati Manav , Ivanov Sergei A. , Senftle Thomas P. , Tretiak Sergei , Ghosh Dibyajyoti
Published: December 2021

Low-energy electronic excitations in non-stoichiometric quantum dots (QDs) have a unique charge transfer (CT) character: surface-to-core in anion-rich and core-to-surface in cation-rich QDs.
A QCM study of strong carbohydrate–carbohydrate interactions of glycopolymers carrying mannosides on substrates
Authors: Oh Takahiro , Uemura Takeshi , Nagao Masanori , Hoshino Yu , Miura Yoshiko
Published: December 2021

The carbohydrate–carbohydrate interaction was demonstrated by glyco-cluster with glycopolymers and could be measured quantitatively.
ALMA-IMF
Authors: Ginsburg A. , Csengeri T. , Galván-Madrid R. , Cunningham N. , Álvarez-Gutiérrez R. H. , Baug T. , Bonfand M. , Bontemps S. , Busquet G. , Díaz-González D. J. , Fernández-López M. , Guzmán A. , Herpin F. , Liu H. , López-Sepulcre A. , Louvet F. , Maud L. , Motte F. , Nakamura F. , Nony T. , Olguin F. A. , Pouteau Y. , Sanhueza P. , Stutz A. M. , Towner A. P. M. ,   The ALMA-IMF Consortium, Armante M. , Battersby C. , Bronfman L. , Braine J. , Brouillet N. , Chapillon E. , Di Francesco J. , Gusdorf A. , Izumi N. , Joncour I. , Walker Lu X. , Men’shchikov A. , Menten K. M. , Moraux E. , Molet J. , Mundy L. , Nguyen Luong Q. , Reyes-Reyes S. D. , Robitaille J. , Rosolowsky E. , Sandoval-Garrido N. A. , Svoboda B. , Tatematsu K. , Walker D. L. , Whitworth A. , Wu B. , Wyrowski F.
Published: December 2021

We present the first data release of the ALMA-IMF Large Program, which covers the 12m-array continuum calibration and imaging. The ALMA-IMF Large Program is a survey of fifteen dense molecular cloud regions spanning a range of evolutionary stages that aims to measure the core mass function. We describe the data acquisition and calibration done by the Atacama Large Millimeter/submillimeter Array (ALMA) observatory and the subsequent calibration and imaging we performed. The image products are combinations of multiple 12 m array configurations created from a selection of the observed bandwidth using multi-term, multi-frequency synthesis imaging and deconvolution. The data products are self-calibrated and exhibit substantial noise improvements over the images produced from the delivered data. We compare different choices of continuum selection, calibration parameters, and image weighting parameters, demonstrating the utility and necessity of our additional processing work. Two variants of continuum selection are used and will be distributed: the “best-sensitivity” (bsens) data, which include the full bandwidth, including bright emission lines that contaminate the continuum, and “cleanest” (cleanest), which select portions of the spectrum that are unaffected by line emission. We present a preliminary analysis of the spectral indices of the continuum data, showing that the ALMA products are able to clearly distinguish free-free emission from dust emission, and that in some cases we are able to identify optically thick emission sources. The data products are made public with this release.
Dynamical interplay of disc thickness and interstellar gas: Implication for the longevity of spiral density waves
Authors: Ghosh Soumavo , Jog Chanda J.
Published: December 2021

A typical galactic disc has a finite thickness. In addition to stars, it also contains a finite amount of interstellar gas. Here, we investigate the physical impact of the finite thickness of a galactic disc on the disc stability against the non-axisymmetric perturbations and on the longevity of the spiral density waves, with and without the presence of gas. The longevity is quantified via the group velocity of density wavepackets. The galactic disc is first modelled as a collisionless stellar disc with finite height and then more realistically as a gravitationally coupled stars plus gas system (with a different thickness for stars and gas). For each case, we derive the appropriate dispersion relation in the Wentzel-Kramers-Brillouin approximation and study the dynamical effect of the disc thickness on the life-time of spiral density waves via a parametric approach. We find the generic trend that the effective reduction in disc self-gravity due to disc thickness makes it more stable against the non-axisymmetric perturbations and shortens the life-span of the spiral density waves. Furthermore, interstellar gas and disc thickness are shown to have a mutually opposite dynamical effect on the disc stability as well as on the longevity of the spiral density waves. While the gas supports the non-axisymmetric features for a longer time, the disc thickness has an opposite, quenching effect. Consequently, the net change is set by the relative dominance of the opposite effects of the interstellar gas and the disc thickness.
Photovoltaic / thermal systems and its importance in domestic use
Authors: Mosalam Heba A.
Published: December 2021

Hybrid photovoltaic thermal solar system becomes one of the potential to play a significant role in the renewable energy sector. The validation of the photovoltaic/ thermal solar system is not valid in Egypt with proven efficiency of both electrical and thermal system. This paper presents a Comparison between Thermal and PVT performance values for the same area with number of 18 units PVT and 14 units’ thermal units and other parameters to be discussed during the compression in domestic application, see the parameters and boundaries of selected system, and evaluate the performance of each system.
Influence of different abiotic factors on lipid production by microalgae – a review
Authors: Gaignard Clément , Zissis George , Buso David
Published: December 2021

Research on lipid production in microalgae, especially to target biofuels, has been widely published in recent decades. This literature is mostly focused on the optimization of culture conditions, metabolic engineering, biorefinery and downstream processes. At the lab scale, lipid production is very promising concerning biofuels production based on microalgae due to their high lipid content. However, the accumulation of knowledge associated with the development of processes and technologies for the production of biomass and associated lipids has so far not achieved the hoped-for commercial success due to still too expensive operating costs compared to fossil fuels. This review aims to present the influence of various abiotic factors on the accumulation of lipids and lipid profile in microalgae, such as the depletion of the culture medium, temperature and light, but also most innovative like the induction by hormones. Other optimization procedures and the use of wastewater to improve the cost-viability are discussed in perspective.
Habiter les restes (Résider dans les résidus)
Authors: Jeanjean Agnès
Published: December 2021

Ce texte propose une réflexion sur les restes déchus et plus particulièrement lorsque ceux-ci contribuent à donner prise sur le monde, à le rendre « habitable » non seulement parce que leur présence est ressource (économique, matérielle) mais parce qu’elle permet d’élaborer des significations « autres ». La réflexion prend appuie sur deux enquêtes de terrain. L’une menée en France dans les cuisines d’ateliers de services techniques; l’autre au Maroc auprès de collecteurs de moules informels vivants dans un bidonville sur la frange côtière de Temara.
Enjeux actuels de la connaissance anthropologique en milieu urbain
Authors: Selim Monique
Published: December 2021

Les anthropologues ont mené des recherches dans les villes depuis de nombreuses décennies, dans la perspective de s’inscrire dans la ville plutôt que de faire de la ville un objet spécifique. Leur méthodologie singulière fondée sur l’immersion du chercheur dans un groupe social précis –dont l’interconnaissance est à la fois concrète et numérique désormais – a-t-elle été à même de produire des connaissances originales en milieu urbain et relève-t-elle ce défi aujourd’hui ? Comment l’anthropologie dite urbaine a-t-elle évolué avec la transformation des villes ? Cette dénomination a-t-elle encore un sens dans la période actuelle qui voit les anthropologues multiplier leurs terrains et faire muter leur démarche à l’aune des bouleversements profonds que connaissent les sociétés, toutes marquées par la financiarisation et l’algorithmisation du capitalisme ? Cet article tente de répondre à ces questions en revenant sur quelques dates-clés.
Diagnosis and Therapy of Female Genital Malformations (Part 1). Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/052, May 2019)
Authors: Oppelt Peter , Binder Helge , Birraux Jacques , Brucker Sara , Dingeldein Irene , Draths Ruth , Eckoldt Felicitas , Füllers Ulrich , Hiort Olaf , Hoffmann Dorit , Hoopmann Markus , Hucke Jürgen , Korell Matthias , Kühnert Maritta , Ludwikowski Barbara , Mentzel Hans-Joachim , mon OʼDey Dan , Rall Katharina , Riccabona Michael , Rimbach Stefan , Schäffeler Norbert , Shavit Sandra , Stein Raimund , Utsch Boris , Wenzl Rene , Wieacker Peter , Zeino Mazen
Published: December 2021

Objectives Female genital malformations may take the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and adnexa, the clinical picture of malformations may vary greatly. Depending on the extent of the malformation, organs of the urinary system or associated malformations may also be involved.

Methods This S2k-guideline was developed by representative members from different medical specialties and professions as part of the guidelines program of the DGGG, SGGG and OEGGG. The recommendations and statements were developed using a structured consensus process with neutral moderation and voted on.

Recommendations The guideline is the first comprehensive presentation of the symptoms, diagnosis and treatment options for female genital malformations. Additional chapters on classifications and transition were included.
Diagnosis and Therapy of Female Genital Malformations (Part 2). Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/052, May 2019)
Authors: Oppelt Peter , Binder Helge , Birraux Jacques , Brucker Sara , Dingeldein Irene , Draths Ruth , Eckoldt Felicitas , Füllers Ulrich , Hiort Olaf , Hoffmann Dorit , Hoopmann Markus , Hucke Jürgen , Korell Matthias , Kühnert Maritta , Ludwikowski Barbara , Mentzel Hans-Joachim , mon OʼDey Dan , Rall Katharina , Riccabona Michael , Rimbach Stefan , Schäffeler Norbert , Shavit Sandra , Stein Raimund , Utsch Boris , Wenzl Rene , Wieacker Peter , Zeino Mazen
Published: December 2021

Objectives Female genital malformations may be present in the form of individual entities, they may involve neighboring organs or they may occur in the context of complex syndromes. Given the anatomical structures of the vulva, vagina, uterus and uterine appendages, the clinical picture of malformations varies greatly.

Methods This S2k-guideline was developed by representative members from different medical specialties and professions as part of the guidelines program of the DGGG, SGGG and OEGGG. The recommendations and statements were developed and voted on using a structured consensus process with neutral moderation.

Recommendations This guideline is the first comprehensive summary of female genital malformations from infancy to adulthood which covers clinical examinations, diagnostic workups and treatment options. Additional chapters have been included on complex urogenital malformations, vascular malformations, psychosomatic care, and tumor risk.
Mangel- und Unterernährung
Authors: Löser Christian , Jordan Angela , Wegner Ellen
Published: December 2021

Wie kann einer Unterernährung entgegengewirkt werden, wenn nach Operationen, Krankheit oder im Alter Essen nur eingeschränkt möglich ist. Mit diesem Thema befasst sich das Buch des Ernährungsteams um Prof. Löser, Arzt für Innere Medizin und Ernährungsmedizin, der seit 2003 die „Modellklinik Ernährungsmedizin“ am Roten Kreuz Krankenhaus in Kassel leitet.
Strahlenschutz in der Zahnmedizin und Kieferorthopädie unter besonderer Berücksichtigung von Kindern und Jugendlichen
Authors: Weiss Veronika , Krasser Andreas , Stücklschweiger Georg , Kirnbauer Barbara , Sorantin Erich
Published: December 2021

Bildgebende Verfahren sind mittlerweile insbesondere für die individualisierte Medizin ein essenzieller Bestandteil in fast allen medizinischen Fachgebieten.

Mittels verschiedener invasiver und nichtinvasiver Apparate werden meist 2- oder 3-dimensionale Bildinformationen zur Diagnostik unverzichtbar, gegebenenfalls in Kombination mit funktionellen Parametern.

In der Zahnmedizin und Kieferorthopädie kommt zu den 2-dimensionalen speziell röntgenbasierten Abbildungsverfahren mit zunehmender Häufigkeit die Schnittbilddiagnostik hinzu, hier im Vordergrund die „Digitale Volumentomografie (DVT)“ (englisch „Cone Beam Computed Tomography“ – CBCT).

Der Großteil der kieferorthopädischen Patientinnen und Patienten ist im Kindesalter, hier gilt der Leitsatz „Kinder sind allerdings keine kleinen Erwachsenen“ 1. Insbesondere die anatomischen, metabolischen und funktionellen Gegebenheiten unterscheiden sich bei Kindern z. T. vehement von Erwachsenen, wodurch sich eine deutlich höhere Strahlenempfindlichkeit bei ihnen zeigt.

Dieser Artikel zeigt die Grundlagen der Strahlenwirkung auf den Menschen und umfasst die unterschiedliche Dosisbelastung typischer zahnmedizinischer bzw. kieferorthopädischer Bildgebungsmethoden sowie deren erforderliche Strahlenschutzmaßnahmen, unter besonderer Berücksichtigung von Kindern.
A Personal Biography of a Physiological Misnomer: The Anaerobic Threshold
Authors: Hagberg James
Published: December 2021

In 1973 Wasserman, Whipp, Koyal, and Beaver published a groundbreaking study titled “Anaerobic threshold and respiratory gas analysis during exercise”. At that time, respiratory gas analysis and laboratory computers had evolved such that more advanced respiratory exercise physiology studies were possible. The initial publications from this group on the onset of anaerobic metabolism in cardiac patients, the first breath-by-breath VO2 system, the first description of the anaerobic threshold, and then later new methods to detect the anaerobic threshold have been and continue to be highly cited. In fact, their 1973 anaerobic threshold paper is the sixth and their 1986 paper is the second most cited paper ever published in the Journal of Applied Physiology. The anaerobic threshold concept has also generated>5500 publications with the rates increasing over time. The publication of two papers that help to refute the “anaerobic” explanation for this phenomenon had no effect on the rates of citations of the original anaerobic threshold papers or the number of anaerobic threshold papers published since. Thus, despite now substantial evidence refuting the proposed anaerobic mechanisms underlying this phenomenon, these papers continue to be highly influential in the discipline of exercise physiology and, perhaps even more explicitly, clinical exercise physiology.
Framework for Considering Abnormal Heart Rate Characteristics and Other Signs of Sepsis in Very Low Birth Weight Infants
Authors: Kumar Rupin S. , Otero Noelia Aviles , Abubakar Maryam O. , Elliott Megan R. , Wiggins Jaclyn Y. , Sharif Misky M. , Sullivan Brynne A. , Fairchild Karen D.
Published: December 2021

Objective A heart rate characteristics index (HeRO score), incorporating low variability and superimposed decelerations, was developed as a sepsis risk indicator for preterm infants in the neonatal intensive care unit (NICU). A rise in the risk score should prompt consideration of other clinical changes that may be signs of sepsis to decide whether a workup and antibiotics are needed. We aimed to develop a framework to systematically consider signs potentially indicating sepsis in very low birth weight (VLBW) infants.

Study Design We developed easy-recall acronyms for 10 signs of sepsis in VLBW infants. Over 12 months in a level IV NICU, neonatology fellows completed a brief survey after each shift to document changes prompting sepsis workups. We analyzed associations between survey data, hourly heart rate characteristic data, and the diagnosis of the workup, grouped as culture-positive sepsis (CXSEP, positive blood or urine culture), clinical sepsis (CLINSEP, negative cultures treated with antibiotics ≥5 days), or sepsis ruled out (SRO, negative cultures and <3 days antibiotics).

Results We analyzed 93 sepsis workups in 48 VLBW infants (35 CXSEP, 20 CLINSEP, and 38 SRO). The most frequently cited changes prompting the workups were heart rate patterns and respiratory deterioration, which were common in all three categories. Low blood pressure and poor perfusion were uncommonly cited but were more likely to be associated with CXSEP than the other signs. A rise in the HeRO score ≥1 from 0 to 12 hours before compared with 12to 72 hours prior the blood culture occurred in 31% of workups diagnosed as CXSEP, 16% CLINSEP, and 31% SRO.

Conclusion The HeRO score can alert clinicians to VLBW infants at high or increasing risk of a sepsis-like illness, but heart rate characteristic patterns are highly variable in individual babies. The easy-recall NeoSEP-10 framework can assist clinicians in considering other clinical changes when making decisions about sepsis workups and the duration of antibiotics.

Key Points
Lumbar Spinous Process–Splitting Technique for Ligamentum Flavum Cyst Removal
Authors: Tomasi Santino Ottavio , Umana Giuseppe Emmanuele , Scalia Gianluca , Raudino Giuseppe , Stevanovic Vlado , Krainz Herbert , Kral Michael , Nicoletti Giovanni Federico , Winkler Peter A.
Published: December 2021

Background Laminotomy for lumbar stenosis is a well-defined procedure and represents a routine in every neurosurgical department. It is a common experience that the uni- or bilateral paraspinal muscle detachment, together with injury of the supra- and interspinous ligaments, can lead to postoperative pain. In the literature, the application of a minimally invasive technique, the lumbar spinous process–splitting (LSPS) technique, has been reported.

Methods In this study, we present a case series of 12 patients who underwent LSPS from September 2019 to April 2020. Two patients had a cyst of the ligamentum flavum, eight a single-level lumbar canal stenosis (LCS), and two a two-level LCS. Moreover, we propose a novel morphological classification of postoperative muscle atrophy and present volumetric analysis of the decompression achieved.

Results There were no complications related to this technique. In all patients, the vertebral canal area was more than doubled by the procedure. The muscle sparing showed grade A, according to our classification.

Conclusion To our knowledge, this is the first description of this surgical technique and the first LSPSL case series in Europe. Furthermore, cases of ligamentum flavum cyst removal using this safe and effective technique have not yet been reported.
Management of DOAC in Patients Undergoing Planned Surgery or Invasive Procedure: Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies (FCSA) Position Paper
Authors: Squizzato Alessandro , Poli Daniela , Barcellona Doris , Ciampa Antonio , Grandone Elvira , Manotti Cesare , Moia Marco , Toschi Vincenzo , Tosetto Alberto , Testa Sophie ,   Scientific Reviewer Committee
Published: December 2021

Patients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. About a quarter of the anticoagulated patients require temporary cessation of direct oral anticoagulants (DOACs) or vitamin K antagonists for a planned intervention within 2 years from anticoagulation inception. Several clinical issues about DOAC interruption remain unanswered: many questions are tentatively addressed daily by thousands of physicians worldwide through an experience-based balancing of thrombotic and bleeding risks. Among possible valuable answers, the Italian Federation of Centers for the diagnosis of thrombotic disorders and the Surveillance of the Antithrombotic therapies (FCSA) proposes some experience-based suggestions and expert opinions. In particular, FCSA provides practical guidance on the following issues: (1) multiparametric assessment of thrombotic and bleeding risks based on patients' individual and surgical risk factor, (2) testing of prothrombin time, activated partial thromboplastin time, and DOAC plasma levels before surgery or invasive procedure, (3) use of heparin, (4) restarting of full-dose DOAC after high risk bleeding surgery, (5) practical nonpharmacological suggestions to manage patients perioperatively. Finally, FCSA suggests creating a multidisciplinary “anticoagulation team” with the aim to define the optimal perioperative management of anticoagulation.
Artifacts in MRI: Villain or Hero? Using Artifacts for Diagnosing Central Nervous System Diseases
Authors: Morais Gabriela Lopes de , Peruzini Gilmar Filho , Rosa-Júnior Marcos
Published: December 2021

An artifact is a feature present in an image which is not part of the original structure. It can occur as a consequence of several factors. It may be mistaken for pathologic conditions, leading to adverse consequences for the patients. The aim of the present study is to present a selection of the main artifacts described in brain and spinal magnetic resonance images to improve the ability of the physicians to recognize them and to reduce their interference on the final interpretation of a scan. The authors searched the scientific community for artifacts in magnetic resonance imaging (MRI), which were selected to focus on central nervous system (CNS) findings. With the Picture Archiving and Communication System (PACS) database from the center where this study was conducted, the authors designated brain and spine MRI scans with conspicuous artifacts to compose the present study. The artifacts were then classified as those that contribute to the diagnosis and those that must be distinguished from pathologic lesions. Considering the novel classification proposed by the present study, physicians might be stimulated to reevaluate their opinions regarding artifacts, perhaps considering them helpful to evaluate certain conditions even if they cannot be fully corrected, as shown by this distinct approach to artifacts with specific findings concerning differential diagnosis of CNS conditions.
Type A Aortic Dissection Masquerading as an Inferior Myocardial Infarction
Authors: Hussain Azhar , Rossi Alessia , Smith Alexander , Lopez-Marco Ana , Khalil Amina , Roberts Neil
Published: December 2021

Type A aortic dissection is a life-threatening condition with a wide range of clinical manifestations. Dissection can sometimes mimic an acute myocardial infarction due to similar presenting symptoms and initial clinical investigations. We report the case of a 52-year-old male who presented with an inferior ST-segment elevation myocardial infarction with two drug-eluting stents inserted as a stabilizing intervention prior to surgical repair of an acute aortic dissection.
Single-Stage Off-Pump Hybrid Repair of Kommerell's Diverticulum with Right-Sided Aortic Arch Using a Surgeon-Customized Vascular Prosthesis
Authors: Acharya Metesh , Ahmed Aamer , Deshpande Aparna , Vainas Tryfon , Hadjinikolaou Leonidas , Mariscalco Giovanni
Published: December 2021

We report the successful single-stage hybrid management of Kommerell's diverticulum associated with a right-sided aortic arch in a 63-year-old woman. She underwent total aortic arch debranching utilizing a surgeon-customized vascular prosthesis, without cardiopulmonary bypass or deep hypothermic circulatory arrest, and concomitant zone-0 endovascular stent–graft deployment.
Endovascular Therapy of 103 Aneurysms in the Internal Carotid Artery with Flow Re-Direction Endoluminal Device
Authors: Teixeira Vinicius Fialho , Bastos Albedy Moreira , Santos Rafael Brito
Published: December 2021

Objective Intracranial aneurysms (AIs) are acquired vascular abnormalities that cause sacculations in the arterial wall and are present in ~2 to 5% of the population. Among the treatment options are endovascular interventions with the use of flow-redirecting stents. In the present study, we analyzed the flow re-direction endoluminal device (FRED).

Methods The present study aims to describe the results obtained from treatment with FRED in a series of patients affected by aneurysms in intracranial segments of the internal carotid artery. This is a cross-sectional, epidemiological, and observational study, whose data were obtained from the medical records of 81 patients from July 2018 to July 2019.

Results One hundred and three internal carotid artery aneurysms were observed in 81 patients, with a prevalence of women (91.35%), small (< 10 mm) (89.33%), and located at the C6 level (73.78%) of the internal carotid artery. Of the 81 patients, 16 had multiple aneurysms in the same artery. One hundred and three FRED stents were used in the treatment. These patients underwent angiography 6 months after the surgery, using the O'Kelly-Marotta classification (OKM) to assess the effectiveness of the device, and it was observed that: in 91 of the 103 procedures (88.34%), the FRED was fully open and well positioned, thus restoring the arterial flow and leading to a statistically significant result. In addition, a low complication rate (4.85%) was found, with ischemic stroke being the main complication (1.94%).

Conclusion This device can be an effective option in the treatment of internal carotid aneurysms since the aneurysm occlusion rate is excellent with a low rate of complications.
SYNGAP1 and Methylenetetrahydrofolate in Cerebrospinal Fluid: Cognitive Development after Oral Folate (5-Methyltetrahydrofolate) Supplementation in a 5-Year-Old Girl
Authors: Hess Valentin , Miguel Justine , Bonnemains Chrystèle , Bilbault Claire
Published: December 2021

Synaptic Ras GTPase-activating protein 1 (SYNGAP1), also called Ras-GAP 1 or RASA5, is a cerebral protein with a role in brain synaptic function. Its expression affects the development, structure, function, and plasticity of neurons. Mutations in the gene cause a neurodevelopment disorder termed mental retardation-type 5, also called SYNGAP1 syndrome. This syndrome can cause many neurological symptoms including pharmaco-resistant epilepsy, intellectual disability, language delay, and autism spectrum disorder. The syndrome naturally evolves as epileptic encephalopathy with handicap and low intellectual level. A treatment to control epilepsy, limit any decrease in social capacities, and improve intellectual development is really a challenging goal for these patients. The etiologic investigation performed in a 5-year-old girl with early epileptic absence seizures (onset at 6 months) and psychomotor delay (language) revealed a low methylenetetrahydrofolate level in cerebrospinal fluid in a lumbar puncture, confirmed by a second one (35 nmol/L and 50 nmol/L vs. 60–100 nmol/L normal), associated with normal blood and erythrocyte folate levels. Hyperhomocysteinemia, de vivo disease, and other metabolic syndromes were excluded by metabolic analysis. No genetic disorders (like methylenetetrahydrofolate reductase and methenyltetrahydrofolate synthetase) with folate metabolism were found. The physical examination showed only a minor kinetic ataxia. An oral folate (5-methyltetrahydrofolate) supplementation was started with oral vitamin therapy. The child showed good progress in language with this new treatment; epilepsy was well balanced with only one antiepileptic drug. The SYNGAP1 mutation was identified in this patient's genetic analysis. Since the start of folate supplementation/vitamin therapy, the patient's neurologic development has improved. To our knowledge, no association between these two pathologies has been linked and no patient with this SYNGAP1 mutation has ever showed much intellectual progress. Low cerebral methylenetetrahydrofolate levels could be associated with SYNGAP1 mutations. One of the hypotheses is the link of folate metabolism with epigenetic changes including methylation process. One inborn metabolic activity in folate metabolism may be associated with SYNGAP1 disease with epigenetic repercussions. Further studies should assess the link of SYNGAP1 and methyltetrahydrofolate and the evolution of SYNGAP1 patients with oral folate supplementation or vitamin therapy.