bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of gut Bifidobacterium population in healthy Japanese infants over the first three years of life: a quantitative assessment
Authors: Nagpal Ravinder , Kurakawa Takashi , Tsuji Hirokazu , Takahashi Takuya , Kawashima Kazunari , Nagata Satoru , Nomoto Koji , Yamashiro Yuichiro
Published: August 2017

Bifidobacteria are important members of human gut microbiota; however, quantitative data on their early-life dynamics is limited. Here, using a sensitive reverse transcription-qPCR approach, we demonstrate the carriage of eight signature infant-associated Bifidobacterium species (B. longum, B. breve, B. bifidum, B. catenulatum group, B. infantis, B. adolescentis, B. angulatum and B. dentium) in 76 healthy full-term vaginally-born infants from first day to three years of life. About 21% babies carry bifidobacteria at first day of life (6.2 ± 1.9 log10 cells/g feces); and this carriage increases to 64% (8.0 ± 2.2), 79% (8.5 ± 2.1), 97% (9.3 ± 1.8), 99% (9.6 ± 1.6), and 100% (9.7 ± 0.9) at age 7 days, 1, 3 and 6 months, and 3 years, respectively. B. longum, B. breve, B. catenulatum group and B. bifidum are among the earliest and abundant bifidobacterial clades. Interestingly, infants starting formula-feed as early as first week of life have higher bifidobacterial carriage compared to exclusively breast-fed counterparts. Bifidobacteria demonstrate an antagonistic correlation with enterobacteria and enterococci. Further analyses also reveal a relatively lower/ delayed bifidobacterial carriage in cesarean-born babies. The study presents a quantitative perspective of the early-life gut Bifidobacterium colonization and shows how factors such as birth and feeding modes could influence this acquisition even in healthy infants.
Monolithically multi-color lasing from an InGaN microdisk on a Si substrate
Authors: Athanasiou M. , Smith R. M. , Pugh J. , Gong Y. , Cryan M. J. , Wang T.
Published: August 2017

An optically pumped multi-color laser has been achieved using an InGaN/GaN based micro-disk with an undercut structure on a silicon substrate. The micro-disk laser has been fabricated by means of a combination of a cost-effective microsphere lithography technique and subsequent dry/wet etching processes. The microdisk laser is approximately 1 μm in diameter. The structure was designed in such a way that the vertical components of the whispering gallery (WG) modes formed can be effectively suppressed. Consequently, three clean lasing peaks at 442 nm, 493 nm and 522 nm have been achieved at room temperature by simply using a continuous-wave diode laser as an optical pumping source. Time–resolved micro photoluminescence (PL) measurements have been performed in order to further confirm the lasing by investigating the excitonic recombination dynamics of these lasing peaks. A three dimensional finite-difference-time-domain (FDTD) simulation has been used for the structure design.
Tracheal reconstruction with a free vascularized myofascial flap: preclinical investigation in a porcine model to human clinical application
Authors: Kim Won Shik , Chang Jae Won , Jang Woo Soon , Seo Young Joon , Kang Mi-Lan , Sung Hak-Joon , Kim Da Hee , Kim Jung Min , Park Jae Hong , Ban Myung Jin , Na Gina , Shin Seung Ho , Byeon Hyung Kwon , Koh Yoon Woo , Kim Se-Heon , Baik Hong Koo , Choi Eun Chang
Published: August 2017

Although there are various methods for tracheal reconstruction, such as a simple approximation with suturing and coverage with adjacent soft tissue or muscle, large defects >50% of the tracheal length still present a clinical challenge. Tissue engineering, a recent promising way to possibly resolve this problem, requires a long preparatory period for stem cell seeding on a scaffold and relatively invasive procedures for stem cell harvesting. As an alternative, we used a vascularized myofascial flap for tracheal reconstruction. In four porcine models, the deep inferior epigastric perforator (DIEP) was used in two and the superior epigastric artery perforator (SEAP) in two. Transformation of the surface of the transplanted myofascial flap was analyzed in the airway environment. The flaps failed in the DIEP group due to venous congestion. At 12 weeks postoperatively, none of SEAP group showed any signs of respiratory distress; the inner surface of the implant exhibited stratified squamous epithelium with sparse cilia. In the clinical setting, a patient who underwent a tracheal reconstruction with a vascularized myofascial flap and 2-year follow-up was in good health with no respiratory distress symptoms.
Effects of twin orientation and spacing on the mechanical properties of Cu nanowires
Authors: Yang Zhenyu , Zheng Lingli , Yue Yonghai , Lu Zixing
Published: August 2017

The role of twin orientation in mechanical behaviors of nanomaterials is drawing increasing attention. In this paper, atomistic simulations on the tensile deformation of twinned Cu nanowires (NWs) are implemented to investigate the twin orientation and spacing effects. The results of numerical simulations reveal that the tensile deformation mechanisms can be divided into three types with the twin orientation varying from 0° to 90°: dislocations slip intersecting with twin boundary (TB), stacking faults formed parallel to the TB and TB migration. Detail analysis about dislocation motion is carried out to illustrate the plastic deformation mechanisms. In addition, with the increasing of the TB spacing, there is a transition from yield with strain hardening to yield with nearly constant flow stress. The peak stress decreases with the increase of TB spacing, which can be attributed to surface roughness caused by crystal reorientation. Our findings also suggest a possible approach to tune the mechanical behaviors of low dimensional nanostructures.
Interferences between breathing, experimental dyspnoea and bodily self-consciousness
Authors: Allard Etienne , Canzoneri Elisa , Adler Dan , Morélot-Panzini Capucine , Bello-Ruiz Javier , Herbelin Bruno , Blanke Olaf , Similowski Thomas
Published: August 2017

Dyspnoea, a subjective experience of breathing discomfort, is a most distressing symptom. It implicates complex cortical networks that partially overlap with those underlying bodily self-consciousness, the experience that the body is one’s own within a given location (self-identification and self-location, respectively). Breathing as an interoceptive signal contributes to bodily self-consciousness: we predicted that inducing experimental dyspnoea would modify or disrupt this contribution. We also predicted that manipulating bodily self-consciousness with respiratory-visual stimulation would possibly attenuate dyspnoea. Twenty-five healthy volunteers were exposed to synchronous and asynchronous respiratory-visual illumination of an avatar during normal breathing and mechanically loaded breathing that elicited dyspnoea. During normal breathing, synchronous respiratory-visual stimulation induced illusory self-identification with the avatar and an illusory location of the subjects’ breathing towards the avatar. This did not occur when respiratory-visual stimulation was performed during dyspnoea-inducing loaded breathing. In this condition, the affective impact of dyspnoea was attenuated by respiratory-visual stimulation, particularly when asynchronous. This study replicates and reinforces previous studies about the integration of interoceptive and exteroceptive signals in the construction of bodily self-consciousness. It confirms the existence of interferences between experimental dyspnoea and cognitive functions. It suggests that respiratory-visual stimulation should be tested as a non-pharmacological approach of dyspnoea treatment.
Magnetic nanoparticle-enhanced surface plasmon resonance biosensor for extracellular vesicle analysis
Authors: Reiner Agnes T. , Ferrer Nicolas-Guillermo , Venugopalan Priyamvada , Lai Ruenn Chai , Lim Sai Kiang , Dostálek Jakub
Published: August 2017

Sensitive analysis of small lipid extracellular vesicles by using a grating-coupled surface plasmon resonance biosensor.
Metal–organic framework enhanced electromembrane extraction – a conceptual study using basic drugs as model substances
Authors: Fakhari Ali Reza , Asadi Sajad , Kosalar Hasan Mohammadi , Sahragard Ali , Hashemzadeh Alireza , Amini Mostafa M.
Published: August 2017

This work aims to use an appealing metal–organic framework (MOF), MIL-101(Cr), for the enhancement of electromembrane extraction efficiency.
A one-pot radioiodination of aryl amines via stable diazonium salts: preparation of 125I-imaging agents
Authors: Sloan Nikki L. , Luthra Sajinder K. , McRobbie Graeme , Pimlott Sally L. , Sutherland Andrew
Published: August 2017

A mild, general and efficient one-pot tandem process that produces radioiodinated SPECT imaging agents from readily available aryl amines via stable diazonium salts has been developed.
The electronic properties of three popular high spin complexes [TM(acac)3, TM = Cr, Mn, and Fe] revisited: an experimental and theoretical study
Authors: Carlotto S. , Floreano L. , Cossaro A. , Dominguez M. , Rancan M. , Sambi M. , Casarin M.
Published: August 2017

The combined use of NEXAFS spectroscopic data and DFT results on TM(acac)3(TM = Cr, Mn, Fe) allowed us to look into the TM–ligand bonding scheme and to rationalize the peculiar electronic and structural properties of the title complexes.
Radicals derived from acetaldehyde and vinyl alcohol
Authors: Estep Marissa L. , Morgan W. James , Winkles Alexander T. , Abbott Adam S. , Villegas-Escobar Nery , Mullinax J. Wayne , Turner Walter E. , Wang Xiao , Turney Justin M. , Schaefer Henry F.
Published: August 2017

We reassign several fundamental modes of radicals implicated in butanol combustion and report values for unobserved fundamentals and absolute energetics.
Computer-aided rational design of Fe(iii)-catalysts for the selective formation of cyclic carbonates from CO2 and internal epoxides
Authors: Sinha Indranil , Lee Yuseop , Bae Choongman , Tussupbayev Samat , Lee Yujin , Seo Min-Seob , Kim Jin , Baik Mu-Hyun , Lee Yunho , Kim Hyunwoo
Published: August 2017

The mechanism of Fe-catalyzed cyclic carbonate formation of CO2 and internal epoxides was studied to identify design strategies for more efficient catalysts.
Merging visible light photocatalysis of dye-sensitized TiO2 with TEMPO: the selective aerobic oxidation of alcohols
Authors: Zhang Yichi , Wang Zhan , Lang Xianjun
Published: August 2017

Efficient visible-light-induced selective aerobic oxidation of alcohols was accomplished by merging the photocatalysis of dye-sensitized TiO2 with TEMPO catalysis.
In situ construction of a heterojunction over the surface of a sandwich structure semiconductor for highly efficient photocatalytic H2 evolution under visible light irradiation
Authors: Lin Zheguan , Lin Jinjin , Huang Lingting , Zhang Xiaoyan , Wang Ying , Zhang Zizhong , Lin Huaxiang , Wang Xuxu
Published: August 2017

Constructing a heterojunction on the MnSb2S4 of a sandwich structure ([SbS]+–[MnS2]2−–[SbS]+) is more favorable to the separation of photogenerated charge to improve photocatalytic activity.
A bifunctional nanomodulator for boosting CpG-mediated cancer immunotherapy
Authors: Wang Zhenzhen , Zhang Yan , Liu Zhen , Dong Kai , Liu Chaoqun , Ran Xiang , Pu Fang , Ju Enguo , Ren Jinsong , Qu Xiaogang
Published: August 2017

We reported a bifunctional nanomodulator that could induce immunogenic cell death and decrease the immunosuppressive microenvironment to boost CpG-mediated cancer immunotherapy.
Synthesis of 4-benzylpyridines via Pd-catalyzed CH3-arylation of 4-picoline
Authors: Wu Jing , Wang Dadian , Chen Xiang , Gui Qingwen , Li Hua , Tan Ze , Huang Genping , Wang Guangwei
Published: August 2017

A highly efficient synthesis of 4-benzylpyridines was developed via Pd-catalyzed C(sp3)–H arylation between 4-picoline and aryl halides. It was found that the best yields were achieved with a simple Pd(PPh3)4 catalyst and Cs2CO3 as the base.
Utilization of chromic polydiacetylene assemblies as a platform to probe specific binding between drug and RNA
Authors: Kamphan Anothai , Gong Changjun , Maiti Krishnagopal , Sur Souvik , Traiphol Rakchart , Arya Dev P.
Published: August 2017

Recognition of nucleic acids remains an important endeavor in biology.
Effect of Ti compositions for efficiency enhancement of CaTiO3:Er3+,Ni2+ broadband-sensitive upconverters
Authors: Luitel Hom Nath , Mizuno Shintaro , Nonaka Takamasa , Tani Toshihiko , Takeda Yasuhiko
Published: August 2017

More than 7-fold increase of UC emission was realized in the CaTiO3:Ni2+,Er3+ broadband-sensitive upconverter compared to that in the previously reported CaZrO3:Ni2+,Er3+.
A new paradigm on the chemical potentials of components in multi-component nano-phases within multi-phase systems
Authors: Kaptay George
Published: August 2017

A new paradigm is offered claiming that the thermodynamic nano-effect in multi-component and multiphase systems is proportional to the increased surface areas of the phases and not to their increased curvatures (as the Kelvin paradigm claims).
Liquid crystal alignment behaviors on capsaicin substituted polystyrene films
Authors: Ju Changha , Kim Taehyung , Kang Hyo
Published: August 2017

The liquid crystal (LC) alignment behavior on plant-based capsaicin substituted polystyrene film was investigated. This can give the basic idea for the design of eco-friendly LC alignment layer based on renewable resource containing polymer film.
Superhydrophobic controlled-release fertilizers coated with bio-based polymers with organosilicon and nano-silica modifications
Authors: Zhang Shugang , Yang Yuechao , Gao Bin , Li Yuncong C. , Liu Zhiguang
Published: August 2017

Although bio-materials for controlled-release fertilizers (CRFs) have been developed rapidly because of their low-cost and green and sustainable properties, the release characteristics of these CRFs still face problems because the coating is often hydrophilic with many micro-holes.
High color rendering index trichromatic white and red LEDs prepared from silane-functionalized carbon dots
Authors: Wang Yunfeng , Wang Kai , Han Zhixia , Yin Zhengmao , Zhou Chuanjian , Du Fanglin , Zhou Shuyun , Chen Ping , Xie Zheng
Published: August 2017

White LEDs with high CRI values can be produced by silane-functionalized carbon dots with green and red emission that have potential to be luminescence and encapsulation layers simultaneously.
Candidate genes responsible for early key events of phenobarbital-promoted mouse hepatocellular tumorigenesis based on differentiation of regulating genes between wild type mice and humanized chimeric mice
Authors: Ohara Ayako , Takahashi Yasuhiko , Kondo Miwa , Okuda Yu , Takeda Shuji , Kushida Masahiko , Kobayashi Kentaro , Sumida Kayo , Yamada Tomoya
Published: August 2017

Integrated analysis of DNA modification and gene expression was conducted in mouse hepatoocellular adenomas promoted by phenobarbital.
Paper‐based capillary actuation of liquid metal
Authors: Moorefield M.R. , Ohta A.T. , Shiroma W.A.
Published: August 2017

A new method of actuating liquid metal using capillary action via paper media is presented. This actuation method uses no electrical power and is capable of moving a liquid‐metal slug up to 3 mm/s. A microstrip transmission line switch was fabricated to demonstrate this new actuation method. This switch has >40 dB isolation and <2 dB insertion loss across a 5‐GHz span.
Design of planar multi‐way differential power division network using double‐sided parallel stripline
Authors: Sun Cheng‐Guang , Li Jia‐Lin
Published: August 2017

In this Letter, we analyse the double‐sided parallel stripline to realise multi‐way differential power division network. The design equations are detailed. For very high frequency/ultra high frequency (VHF/UHF) band applications, a demonstrator centred at 62.5 MHz with ten pairs of differential outputs, utilising the grounded coplanar waveguide as the output interfaces, is developed. Experimental examinations on the fabricated demonstrator match well with numerical simulations, thus verifying the studies network.
Synchronisation method for pulsed pseudolite positioning signal under the pulse scheme without slot‐permutation
Authors: Wang Jianhui , Xu Ying , Luo Ruidan , Zhang Yi , Yuan Hong
Published: August 2017

Ground‐based pseudolite positioning systems are valuable in environments where global positioning system (GPS) is not available. To mitigate near‐far effect, pseudolite positioning systems often use pulsed signals instead of GPS‐like continuous signals. The simple pulse scheme without slot‐permutation cannot preserve the spectrum shape of the original un‐pulsed signal, and this may result in false frequency‐lock in the receiver. Complicated pseudorandom pulse schemes are often used to avoid false frequency‐lock, which increases acquisition and tracking complexity. The synchronisation method presented in this study can acquire and track pulsed signals without false frequency‐lock under the pulse scheme without slot‐permutation, which enables the use of this pulse scheme in pseudolite positioning systems and is useful for reducing complexity of transmitter and receiver. Simulation results show that the presented method can track code phase, carrier phase and Doppler frequency accurately and correctly.
Precipitous Resolution of Type-A Intramural Hematoma with Medical Management in a Patient with Metastatic Stage 4 Renal Cell Carcinoma
Authors: Velasquez Camilo , Bin Mahmood Syed , Zafar Mohammad , Brownstein Adam , Saeyeldin Ayman , Ziganshin Bulat , Elefteriades John
Published: August 2017

Intramural hematoma (IMH) is a variant form of aortic dissection characterized by involvement of the aortic media without the presence of an overt intimal flap. Surgical extirpation is the standard of care for type-A IMH in the Western world. However, a conservative approach with anti-impulse therapy has been advocated especially in Japan as a viable alternative. Here, we report a case of an elderly male patient with a history of metastatic stage 4 renal cell carcinoma who was treated with anti-impulse therapy for an acute type-A IMH. Blood pressure stabilization and continuous monitoring resulted in complete resolution of the IMH within 6 days. This report illustrates how immediate medical management in patients with acute type-A IMH who are not surgical candidates can alleviate the progression or even lead to regression as early as 1 week after initiating anti-impulse therapy.
Sleep Disturbance, Cognitive Decline, and Dementia: A Review
Authors: Wu Mark , Rosenberg Paul , Spira Adam , Wennberg Alexandra
Published: August 2017

Approximately half of older people report sleep disturbances, which are associated with various health conditions, including neurodegenerative disease and dementia. Indeed, 60 to 70% of people with cognitive impairment or dementia have sleep disturbances, which are linked to poorer disease prognosis. Sleep disturbances in people with dementia have long been recognized and studied; however, in the past 10 years, researchers have begun to study disturbed sleep, including sleep fragmentation, abnormal sleep duration, and sleep disorders, as risk factors for dementia. In this review the authors summarize evidence linking sleep disturbance and dementia. They describe how specific aspects of sleep (e.g., quality, duration) and the prevalence of clinical sleep disorders (e.g., sleep-disordered breathing, rapid eye movement sleep behavior disorder) change with age; how sleep parameters and sleep disorders are associated with the risk of dementia; how sleep can be disturbed in dementia; and how disturbed sleep affects dementia prognosis. These findings highlight the potential importance of identifying and treating sleep problems and disorders in middle-aged and older adults as a strategy to prevent cognitive decline and dementia. The authors also review recent evidence linking sleep disturbances to the pathophysiology underlying dementing conditions, and briefly summarize available treatments for sleep disorders in people with dementia.
The Role of Iron in Pediatric Restless Legs Syndrome and Periodic Limb Movements in Sleep
Authors: Felt Barbara , Munzer Tiffany
Published: August 2017

Restless legs syndrome (RLS) is a common and treatable neurologic condition in pediatric patients, with a prevalence as high as 2 to 3%. The diagnosis of RLS is made clinically based on an urge to move the legs accompanied by lower extremity discomfort that occurs during rest usually later in the day and is relieved by movement. Periodic limb movements in sleep (PLMS) can overlap with RLS, although PLMS also exists as a separate entity characterized by stereotyped movements of lower extremities in sleep. Both conditions may be highly debilitating and interfere with daily function notably in the areas of educational attainment and behavioral regulation. Iron deficiency has been implicated in the pathophysiology of both RLS and PLMS. Current evidence suggests that treatment of ferritin levels < 50 µg/L may be beneficial in improving pediatric RLS symptoms and comorbid conditions or daytime dysfunction associated with RLS. Areas for future research include (1) clarifying the ferritin or other iron status measure level which predicts iron treatment will provide symptom improvement in pediatric patients, and (2) randomized clinical trials using iron therapy to determine the degree and duration of treatment.
Emergency Sleep Medicine
Authors: Guay Christian , Ellenbogen Jeffrey
Published: August 2017

Sleep is a tranquil process that contributes substantially to our overall health and well-being. Yet sleep creates certain vulnerabilities. These sometimes require urgent management decisions for prehospital emergency medical services and on-call medical providers alike. Some of these emergencies may be directly due to sleep itself, whereas others may result from sleep disorders or a lack of sleep. And then some medical emergencies may occur during sleep by chance. Yet for some of these emergencies, sleep does not necessarily play a benign role. Sleep can mask the emergency—causing a delay in detection, confusion in the diagnosis, or even impede treatment. Finally, some disorders will mimic sleep and thus elude detection. Understanding these core principles will enable medical practitioners to optimize care for patients in emergency situations.
Supplemental Oxygen Study: A Randomized Controlled Study on the Effect of Maternal Oxygen Supplementation during Planned Cesarean Delivery on Umbilical Cord Gases
Authors: Fong Alex , Nageotte Michael , Simon Valeria
Published: August 2017

Objective The aim was to determine the fetal umbilical blood gas effects of supplemental maternal oxygenation compared with room air (RA) during term planned cesarean delivery.

Methods This is a prospective randomized controlled study of singleton planned cesarean deliveries randomized to receive supplemental oxygen (O2) at 10 L per minute (L/min) via facemask or RA. Umbilical cord gases were collected. The primary outcome was umbilical arterial pH level. Secondary outcomes included umbilical cord values and maternal and neonatal outcomes. Data were expressed as median ± interquartile range (IQR).

Results Seventy subjects in total were enrolled, with 65 subjects available for analysis. The median umbilical arterial pO2 was significantly increased in the supplemental O2 group (18 [13.5–20.5] mm Hg) versus RA group (16 [12–18] mm Hg), p = 0.04). The median umbilical venous pO2 was significantly increased in the supplemental O2 group (32 [26.5–36.0] mm Hg) versus RA group (28.5 [22–34.3] mm Hg), p = 0.04). There were no significant differences with other umbilical blood gas values and composite maternal or neonatal complications.

Conclusion Subjects with term singleton gestations receiving O2 at 10 L/min during cesarean delivery compared with RA demonstrated no significant change in umbilical cord pH values. There was a significant increase in umbilical cord arterial and venous O2 levels in those receiving O2.
Maternal and Neonatal Outcomes of Induction of Labor Compared with Planned Cesarean Delivery in Women with Preeclampsia at 34 Weeks' Gestation or Longer
Authors: Bowers Katherine , Kawakita Tetsuya
Published: August 2017

Objective This study aims to compare outcomes of induction with planned cesarean in women with preeclampsia.

Study Design A retrospective cohort study, including women with singleton pregnancies, preeclampsia (mild, severe, and superimposed), and without previous cesarean at ≥ 34 weeks' gestation was conducted. Outcomes included primary outcome (intensive care unit [ICU] admission, thromboembolism, transfusion, and hysterectomy), composite severe neonatal outcome (asphyxia, arterial cord pH < 7.0, hypoxic–ischemic encephalopathy, and 5-minute Apgar score < 5), neonatal ICU (NICU) admission, transient tachypnea of newborn (TTN), and respiratory distress syndrome (RDS). Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated, controlling for confounders.

Results Of 5,506 women with preeclampsia at ≥ 34 weeks' gestation, 5,104 (92.7%) women underwent induction. Induction compared with planned cesarean was not associated with an increased risk of the primary outcome but was related to increased risks of ICU admission (aOR: 3.29; 95% CI: 1.02–10.64), and linked to decreased risks of composite neonatal outcome (aOR: 0.32; 95% CI: 0.10–0.99), NICU admission (aOR: 0.60; 95% CI: 0.43–0.84), TTN (aOR: 0.38; 95% CI: 0.22–0.64), and RDS (aOR: 0.44; 95% CI: 0.22–0.86).

Conclusion Induction was not associated with an increased risk of the primary outcome but was associated with an increased risk of ICU admission and decreased risks of neonatal outcomes.
Perioperative Antibiotic Choice in Labored versus Unlabored Cesareans and Risk of Postcesarean Infectious Morbidity
Authors: Hopkins Maeve , Dotters-Katz Sarah , Boggess Kim , Heine R. , Smid Marcela
Published: August 2017

Objective This study aims to estimate postcesarean infectious morbidity in women receiving perioperative β-lactam versus non-β-lactam antibiotics.

Methods We conducted a retrospective cohort analysis of the Maternal-Fetal Medicine Unit Cesarean Registry. The exposure was β-lactam perioperative antibiotics versus non-β-lactam regimens at cesarean delivery (CD). We stratified by labored versus unlabored CD. The primary composite outcome included wound infection, seroma, hematoma, endometritis, readmission due to wound complication, or debridement. Multivariable logistic regression estimated odds of wound complication by antibiotic regimen after adjusting for relevant confounders.

Results Our analysis included 43,735 women who delivered via CD, 48% following labor. In both groups, 95% of women received β-lactam antibiotics. In the labored CD group (n = 20,860), there was no significant difference in primary outcome by β-lactam versus non-β-lactam antibiotics (10.5 vs. 9.9%, p = 0.53). In the unlabored CD group (n = 22,875), women receiving non-β-lactam antibiotics were more likely to experience a wound complication compared with those in the β-lactam group (6.2 vs. 4.7%, p = 0.02, adjusted odds ratio: 1.39, 95% confidence interval: 1.08–1.80) after adjustment for clinical confounders.

Conclusion In unlabored CD, non-β-lactam antibiotics have a higher risk of wound complications compared with β-lactam regimens. Further study to optimize antibiotic prophylaxis for β-lactam allergic women undergoing unlabored CD is warranted.
Verletzungen der thorakolumbalen Wirbelsäule im Kindes- und Jugendalter
Authors: Ruf Michael , Pitzen Tobias , Obid Peter
Published: August 2017

Thorakolumbale Wirbelsäulenverletzungen sind bei Kindern deutlicher seltener als bei Erwachsenen. Entsprechend sind Informationen zu diesem Themenkomplex spärlich. In diesem Artikel sollen vier Aspekte zu thorakolumbalen Frakturen der kindlichen Wirbelsäule näher beleuchtet werden:1. die Epidemiologie von kindlichen thorakolumbalen Verletzungen2. Besonderheiten bei pädiatrischen thorakolumbalen Verletzungen3. spezielle Aspekte der Diagnostik4. Therapie der kindlichen thorakolumbalen Verletzungen
Ursachen, Diagnose und Therapie der negativen Dysphotopsie
Authors: Wenzel Martin , Langenbucher Achim , Eppig Timo
Published: August 2017

Die negative Dysphotopsie (ND) ist ein dunkler, manchmal gebogener Schatten im temporalen Gesichtsfeld, der nach einer Kataraktoperation auftritt und die Betroffenen sehr stören kann. Von R. Olson wurde er als „the number one troublesome complaint after uneventful cataract surgery“ bezeichnet. Die Ätiologie ist nicht geklärt und Thema teils kontroverser Diskussionen. Sie liegt wohl in einer geringen Veränderung des Abbildungsmaßstabs durch die neue Linse. Hierdurch kann es zu einer geringfügigen Verschiebung des zum blinden Fleck und zu den zentralen Gefäßen korrespondierenden Objektraums kommen, sodass diese vorübergehend teilweise bemerkt werden. Bis dato wurden keine definitiven Kriterien für die Diagnostik einer ND veröffentlicht. Auf der Basis unserer Erfahrungen der letzten 2 Jahre mit 77 Augen (55 Patienten) von 6031 Kataraktoperationen sind folgende Punkte zur Sicherung der Diagnose wichtig: 1) Störendes dunkles Areal im temporalen Gesichtsfeld nach einer Kataraktoperation mit Linsenimplantation. 2) Fehlen von objektivierbaren Ursachen wie Glaskörpertrübungen, Netzhautschädigungen oder eines verifizierten Gesichtsfelddefekts. 3) Der Schatten wird bei etwa 60 – 90° peripher vermutet. 4) Er lässt sich objektiv zwischen 10 und 25° im temporalen Gesichtsfeld nachweisen. 5) Er ist nicht immer sichtbar: Bei seitlicher Beleuchtung wird er abgeschwächt oder verschwindet. 6) Die ND wird durch den Ausgleich von auch nur geringen Refraktionsfehlern gebessert oder verschwindet ganz. 7) Die ND wird abgeschwächt oder verschwindet durch seitliche „Scheuklappen“, z. B. Hände des Untersuchers. 8) Die ND wird durch Abdecken des Partnerauges abgeschwächt oder sie kann ganz verschwinden. Präoperativ sollte über Dysphotopsien aufgeklärt werden. Als Stufenplan zur Therapie der ND empfehlen wir: 1) Beschwerden ernst nehmen, Patienten aufklären und beruhigen. 2) Bei persistierenden Beschwerden: Tragen einer Brille auch bei kleinsten Refraktionsfehlern so lange, bis die ND verschwunden ist. 3) Wenn die Brille nicht getragen werden will oder nicht zur Besserung der ND führt, half bei 2 unserer Patienten eine mehrwöchige Okklusionstherapie. Eine Revisionsoperation war so nie nötig.
Besonderheiten und Versorgung penetrierender Verletzungen am Beispiel von Schuss- und Explosionsopfern ohne ballistischen Körperschutz in Afghanistan (2009 – 2013)
Authors: Güsgen Christoph , Willms Arnulf , Richardsen Ines , Bieler Dan , Kollig Erwin , Schwab Robert
Published: August 2017

Auch in Deutschland wurden in jüngster Zeit Anschläge mit terroristischem Hintergrund durchgeführt, waren geplant oder konnten nur knapp vereitelt werden. Diese Tatsache führt die Notwendigkeit vor Augen, eine entsprechende Expertise zur Versorgung von Schuss- und Explosionsverletzungen vorzuhalten. Die Daten zur Versorgung von Schuss- und insbesondere aber Explosionsverletzungen stammen häufig aus Krisen- und Kriegsregionen. Eine Vergleichbarkeit mit zivilen Terroranschlagtraumata ist durch den bei Soldaten vorhandenen ballistischen Körperschutz (Schutzwesten, Body Armour) nur schwer möglich.

Methodik Es wurden die Daten der Patienten, die im deutschen Militärhospital Mazar-e Sharif bei Schuss- oder Explosionsverletzungen versorgt wurden, aus den Jahren 2009 – 2013 analysiert. Einschlusskriterien waren penetrierende Verletzungen des Thorax bzw. des Abdomens. Zur besseren Vergleichbarkeit mit zivilen Anschlagsszenarien wurden ausschließlich zivile Patienten ohne ballistischen Körperschutz einbezogen.

Ergebnisse Von den 117 Patienten waren 58 von Schuss- und 59 von Explosionsverletzungen des Thorax oder Abdomens betroffen. 60% der Patienten hatten eine Thorax-, 69% eine Abdominal- und 25,6% eine thorakoabdominelle Verletzung, wobei die Explosionsverletzten signifikant mehr Thoraxverletzungen aufwiesen. Abdominell waren Leber-, Dünndarm- und Kolonverletzungen in der Anzahl führend. Bei den Explosionsverletzten fanden sich sowohl signifikant mehr Verletzungen als auch ein im Mittel mit 29 signifikant höherer Injury Severity Score (ISS). 26% der Schuss- und 41% der Explosionsverletzten wurde durch Damage Control Surgery (DCS) erstversorgt. Schussverletzungen hatten trotz niedrigerem ISS keine geringere Anzahl an Operationen pro Patient. Die mit 25,7% höchste Mortalität wiesen Patienten mit thorakoabdominellen Kombinationsverletzungen auf (vs. 8,3% bei isoliert thorakal und 8,7% isoliert abdominell). Die Gesamtmortalität betrug 13,7% (10,3% nach Schuss-, 16,7% nach Explosionsverletzung). Die verstorbenen Patienten wiesen mit 32,9% einen signifikant erhöhten ISS-Wert auf.

Schlussfolgerung Explosionsverletzte ohne ballistischen Schutz des Torsos weisen vor allem für thorakoabdominelle Verletzungen eine hohe Mortalität auf. Explosionsverletzungen können häufiger zur DCS-Indikation führen. Die Versorgung von Schuss- und Explosionsverletzten setzt die Kenntnis und Kompetenz zur Durchführung von Damage-Control-Prozeduren des Thorax und des Abdomens voraus.
The Value of Partial HPV Genotyping After Conization of Cervical Dysplasias
Authors: Friebe Kristin , Klapdor Rüdiger , Hillemanns Peter , Jentschke Matthias
Published: August 2017

Introduction In this retrospective study partial genotyping of human papilloma viruses (HPV) using the Abbott RealTime HighRisk HPV Test (RealTime) was compared with simple HPV detection (Qiagen Hybrid Capture 2 Test; hc2) for recurrence prediction at the first follow-up examination after conization of cervical intraepithelial neoplasia (CIN).

Methods 144 women who had undergone conization for CIN between January 2007 and December 2013 were included. HPV status was determined preoperatively and at first follow-up using hc2 in 103 women and RealTime in 41 women. Recurrent or persistent CIN was assumed when CIN2+ was confirmed histologically or on comparable cytology findings.

Results Of the 144 women with complete data 12 (8.3%) had a recurrence after conization. HPV persistence at follow-up correlated significantly with recurrence (hc2: p = 0.003; RealTime: p = 0.003) and both sensitivity and specificity were high (hc2 = 100 and 78.4% respectively; RealTime = 75.0 and 83.9%). Whereas isolated HPV testing had a relatively low positive predictive value for recurrence (hc2 16%; RealTime 54.5%), this rose to 80% with HPV 16 detection at follow-up.

Conclusion At follow-up after conization of CIN the combination of high risk HPV detection and partial genotyping of HPV 16 constitutes excellent diagnostic criteria for recurrence/persistence of CIN.
Patientenzufriedenheit nach stereotaktischer Radiotherapie bei exsudativer altersbedingter Makuladegeneration
Authors: Kurz Maximilian , Rudolf Martin , Holzhey Annekatrin , Neubauer Aljoscha S. , Grisanti Salvatore , Ranjbar Mahdy
Published: August 2017

Hintergrund Die stereotaktische Radiotherapie (SRT) ist ein neues adjuvantes Verfahren zu den bisherigen intravitrealen operativen Medikamentengaben (IVOM) bei exsudativer altersbedingter Makuladegeneration (AMD). Ziel unserer Studie war es, die Faktoren zu untersuchen, welche die Zufriedenheit der Patienten 1 Jahr nach Behandlung beeinflussen.

Methoden Ein Fragebogen wurde im Rahmen einer retrospektiven Studie an 35 konsekutiv behandelte Patienten ausgegeben, bei denen zwischen 2014 und 2015 eine SRT mit dem IRay®-System an der Klinik für Augenheilkunde der Universität zu Lübeck durchgeführt worden war. Neben einer rein deskriptiv-statischen Auswertung der Antworten erfolgte eine Korrelationsanalyse sowie eine Subgruppenanalyse entsprechend IVOM-Respondern (jährliche Injektionsrate nach SRT ≤ 3), Visus-Respondern (Visusverbesserung ≥ 0,2 logMAR) und Doppel-Respondern (sowohl jährliche Injektionsrate nach SRT ≤ 3 als auch Visusverbesserung ≥ 0,2 logMAR).

Ergebnisse Die Antwortrate betrug 86%. Die SRT wurde generell gut vertragen. Bei den Erwartungen an die Therapie gaben doppelt so viele Patienten eine Verringerung der IVOM-Frequenz im Vergleich zu einer Verbesserung des Visus an. Erstere waren signifikant zufriedener mit ihren Ergebnissen. IVOM-Responder waren zudem signifikant zufriedener als IVOM-Non-Responder, während Visus-Responder im Vergleich zu Visus-Non-Respondern keine höhere Zufriedenheit angaben.

Schlussfolgerung Die Patientenzufriedenheit scheint stark vom Verständnis bezüglich der Wirkweise der SRT und den vorher definierten Zielen abzuhängen. Eine ausführliche, aber vor allem verständliche Aufklärung mit der Formulierung von realistischen Zielen ist deshalb wichtig.
Interventionelle Therapie der Mitralklappe: MitraClip® – Indikationen und Vorgehen 2017
Authors: Horstkotte Jan , Boekstegers Peter
Published: August 2017

Die interventionelle Behandlung der Mitralklappeninsuffizienz mit dem MitraClip®-Verfahren ist mittlerweile eine etablierte Alternative für Hochrisikopatienten. Neben der Behandlung der sekundären – funktionellen – Mitralklappeninsuffizienz ist der MitraClip durchaus auch bei Patienten mit primärer – degenerativer – Mitralklappeninsuffizienz und erhöhtem Operationsrisiko oder sehr hohem Lebensalter einsetzbar und hat im mittelfristigen Verlauf klinisch überzeugende Behandlungsergebnisse gezeigt. Eine zunehmende Anzahl von Studien belegt, dass das MitraClip-Verfahren auch langfristig vergleichbare Ergebnisse zur operativen Therapie bietet 1, 2. Weiterhin haben sich die Techniken zur Beurteilung des periprozeduralen Ergebnisses verbessert 3. Ob mit der MitraClip-Implantation bei Patienten mit sekundärer Mitralklappeninsuffizienz ein Überlebensvorteil gegenüber einer rein medikamentösen Therapie besteht bzw. ob die MitraClip-Implantation bei der primären oder sekundären Mitralklappeninsuffizienz und hohem OP-Risiko der operativen Therapie überlegen ist, wird aktuell in verschiedenen laufenden randomisierten Studien untersucht (RESHAPE-HF, COAPT-Studie, MATTERHORN).
Chancen und Risiken der Telemedizin in der Orthopädie und Unfallchirurgie
Authors: Holderried Martin , Schlipf Madeleine , Höper Ansgar , Meier Reinhard , Stöckle Ulrich , Kraus Tobias
Published: August 2017

Hintergrund Seit der Jahrtausendwende breitet sich die Internetnutzung und Verwendung elektronischer Medien auch im Gesundheitssektor kontinuierlich aus. Ziel dieser Studie war es, die derzeitigen Herausforderungen der analogen intersektoralen Arzt-Patienten-Kommunikation und mögliche Potenziale von eHealth-Anwendungen zu evaluieren. Auf Grundlage einer quantitativen Befragung von Notaufnahmepatienten sollen Verbesserungsansätze für die Sicherung der Versorgungsqualität für Patientinnen und Patienten der Orthopädie und Unfallchirurgie bedarfsorientiert erarbeitet werden können.

Methoden Ein speziell ausgearbeiteter Fragebogen wurde im Zeitraum von September bis November 2016 an Notfallpatienten ausgehändigt. Als Ausschlusskriterium war lediglich ein bedrohlicher Gesundheitszustand definiert, der die Teilnahme an der Studie nicht ermöglichte.

Ergebnisse Unter den 255 Befragten fanden sich 43,5% Frauen und 56,5% Männer. Die räumliche Entfernung zur Klinik betrug im Mittel 39,86 km. 223 Befragte waren gesetzlich und 32 privat krankenversichert. Neben Onlineshopping und Onlinebanking war die Suche nach Gesundheitsthemen die meistgenannte Internetrecherche. Die Befürchtung eines schlechteren Arzt-Patienten-Verhältnisses über Onlinekommunikation sehen über ⅔ (71,2%) aller Befragten. Als weitere Gefahren einer zunehmenden Digitalisierung wird seitens der Befragten die Sorge um Datenschutz (59,3%) und Datensicherheit (54,3%) angegeben. Der Wunsch nach Zeit- (81,8%) und Wegeersparnis (77,1%) für ärztliche Konsultation geht mit dem Wunsch einer Onlineterminplanung (67,8%) sowie tieferen Integration der Patienten in den Informationsfluss via elektronischem Arztbrief (68,9%) und elektronischer Terminerinnerung (E-Mail 68,8%/SMS 66,5%) einher.

Schlussfolgerung Interessanterweise sind die Befragten generell positiv gegenüber „eHealth“ eingestellt, jedoch werden Onlinechats mit Ärzten und Videotelefonie von den befragten Patienten eher zurückhaltend bewertet. Den größten Zuspruch erhielten Onlineorganisationstools zur einfacheren Terminfindung und -erinnerung für die Patienten. Es zeigt sich ein Trend zum mündigeren Patienten, der besser informiert ist und daher in Diagnosefindung und Behandlungsablauf eingebunden werden will.
Excessive Catecholamine Secretion and the Activation of the Renin-Angiotensin-Aldosterone-System in Patients with Pheochromocytoma: A Single Center Experience and Overview of the Literature
Authors: Haase Matthias , Dringenberg Till , Allelein Stephanie , Willenberg Holger , Schott Matthias
Published: August 2017

Catecholamines stimulate renin-secretion in the juxtaglomerular cells of the kidney and a number of case reports suggest an association between pheochromocytoma and activation of the RAAS. Therefore, it could be asked whether patients suffering from pheochromocytoma with high concentrations of circulating catecholamines present with oversecretion of renin and aldosterone. We identified twelve patients with excessive catecholamine secretion due to pheochromocytoma and compared them to a group of twelve patients with essential hypertension (EH) with regard to the activation of the renin-angiotensin-aldosterone-system (RAAS). The PubMed database was screened for studies that investigate the association between pheochromocytoma and activation of the RAAS. The plasma concentrations of metanephrines (19.9-fold) and normetanephrines (29.5-fold) were significantly higher in the pheochromocytoma group than in the EH group. Renin and aldosterone levels were 1.3-fold and 1.6-fold higher, respectively, as compared to the EH group, whereas the differences were not statistically significant. There was no significant correlation between plasma metanephrine or normetanephrine levels and the plasma renin concentration (rs=0.077, rs=0.049, respectively) in our patients. The data from our institution and from review of literature suggest that an association between pheochromocytoma in the context of high plasma catecholamine levels and activation of the RAAS is present. However, results have not been consistent. Thus, other causes of RAAS-activation should be considered also in the presence of pheochromocytoma or reinvestigation for aldosteronism should be offered to such patients after removal of the catecholamine-producing tumour.
Polarization dependent nanostructuring of silicon with femtosecond vortex pulse
Authors: Rahimian M. G. , Bouchard F. , Al-Khazraji H. , Karimi E. , Corkum P. B. , Bhardwaj V. R.
Published: August 2017

We fabricated conical nanostructures on silicon with a tip dimension of ∼ 70 nm using a single twisted femtosecond light pulse carrying orbital angular momentum (ℓ=±1). The height of the nano-cone, encircled by a smooth rim, increased from ∼ 350 nm to ∼ 1 μm with the pulse energy and number of pulses, whereas the apex angle remained constant. The nano-cone height was independent of the helicity of the twisted light; however, it is reduced for linear polarization compared to circular at higher pulse energies. Fluid dynamics simulations show nano-cones formation when compressive forces arising from the radial inward motion of the molten material push it perpendicular to the surface and undergo re-solidification. Simultaneously, the radial outward motion of the molten material re-solidifies after reaching the cold boundary to form a rim. Overlapping of two irradiated spots conforms to the fluid dynamics model.
Effect of Ga addition on the valence state of Ce and magnetic properties of melt-spun Ce17Fe78-xB6Gax (x = 0-1.0) ribbons
Authors: Jiang Qingzheng , Zhong Minglong , Lei Weikai , Zeng Qingwen , Hu Yongfeng , Quan Qichen , Xu Yaping , Hu Xianjun , Zhang Lili , Liu Renhui , Ma Shengcan , Zhong Zhenchen
Published: August 2017

The Ce17Fe78-xB6Gax (x=0-1.0) ribbons were fabricated by a melt-spinning technique in order to study the mechanism of the valence variation of Ce and their magnetic properties as well as improve the thermal stability of Ce-based rare earth permanent magnets. The systematic investigations of the Ce17Fe78-xB6Gax (x=0-1.0) alloys show that the room-temperature coercivity increases significantly from 352 kA/m at x = 0 to 492 kA/m at x = 1.0. The Curie temperature (Tc) increases monotonically from 424.5 K to 433.6 K, and the temperature coefficients of remanence (α) and coercivity (β) of the ribbons are better off from -0.56 %/K, -0.75 %/K for x = 0 to -0.45 %/K, -0.65 %/K for x = 0.75 in the temperature range of 300–400 K, respectively. The Ce L3-edge X-ray absorption near edge structure (XANES) spectrums reveal that there is more Ce4+ in ribbons under total electron yield than fluorescence yield as Ce has a high affinity with oxygen. The weight of Ce3+ increases while the weight of Ce4+ decreases in Ga-added alloys. The refined grain size and a more uniform microstructure are mainly attributed to the improved magnetic properties and thermal stability with Ga doping. This paper may serve as a reference for further developing the so-called gap magnets and the effective utilization of the rare earth resources.
An evaluation of pipe traps for the capture of small arboreal mammals
Authors: Harrison Lee , Soanes Kylie , van der Ree Rodney
Published: August 2017

Optimal wildlife survey techniques should maximise detectability or capture rates of target species and minimise potential harm to animals. We compared the effectiveness of Elliott and PVC pipe traps for the capture of small arboreal mammals in the Victorian Central Highlands and found that pipe traps were less effective at capturing small arboreal mammals than Elliott traps.
Survival of Upper Piedmont Stream Fishes Implanted with 8‐mm Passive Integrated Transponder Tags
Authors: Cary Joshua B. , Holbrook Jessica L. , Reed Morgan E. , Austin Thomas B. , Steffensen Matthew S. , Kim Seoghyun , Pregler Kasey C. , Kanno Yoichiro
Published: August 2017

We studied weekly and bimonthly survival of select nongame fishes that were implanted with 8‐mm PIT tags in upper Piedmont streams of South Carolina, USA. Weekly survival in stream enclosures was assessed for a total of 350 tagged individuals and 311 control (untagged) fish (39–101 mm TL; median = 65 mm TL) belonging to six species (Bluehead Chub Nocomis leptocephalus, Creek Chub Semotilus atromaculatus, Yellowfin Shiner Notropis lutipinnis, Mottled Sculpin Cottus bairdii, Northern Hog Sucker Hypentelium nigricans, and Striped Jumprock Moxostoma rupiscartes). Weekly survival rates ranged from 93.3% to 100% among species, with Yellowfin Shiners experiencing the lowest survival rate. Only 2 of the 337 surviving tagged individuals lost their tags (0.6% tag loss). Logistic regression indicated that species and body length were statistically significant predictors of survival and tag retention. Odds ratios indicated that tagged fish were 1.718 times less likely to survive than control fish, but the tagging effect was not statistically significant. Bimonthly survival was estimated by conducting a mark–recapture study from September 2015 to May 2016, which involved tagging 1,413 unique individuals of Bluehead Chub (45–75 mm TL) in a 520‐m stream section and 431 individuals of Mottled Sculpin (45–75 mm) in another 740‐m section. Bayesian state–space analysis of Cormack–Jolly–Seber models indicated that apparent survival did not differ between newly tagged and previously tagged (i.e., recaptured) individuals in any sampling interval, suggesting that the acute and chronic effects of tagging did not differ. Mean bimonthly apparent survival rate was 0.76 (95% credible interval = 0.64–0.86) for Bluehead Chub and 0.74 (95% credible interval = 0.59–0.88) for Mottled Sculpin. Our results indicate that PIT tags can be successfully applied to study the ecology and life history of small‐bodied, nongame fish species, although caution should be exercised when selecting the species and body sizes to be tagged.