bluuebunny/crossref_metadata_2025 huggingface dataset:
Sulfur Betaines from S-Propargyl Xanthates. Unusual Chemistry from a Simple Functional Group
Authors: Zard Samir
Published: January 2019

S-Propargyl xanthates undergo upon heating a [3,3] sigmatropic rearrangement followed by a reversible ring closure into a novel betaine. This betaine can be implicated in carbon–carbon bond forming processes, in the synthesis of esters, in the inversion of secondary alcohols, in the formation of alkenes, for the generation of rigid, cisoid dienes that are highly reactive in both inter- and intra-molecular Diels–Alder cycloadditions, and in various other synthetically useful transformations.

1 Introduction

2 An Unexpected Transformation

3 Evidence for the Betaine Intermediate

4 A Method for the Synthesis of Esters and for the Inversion of Secondary Alcohols

5 A General Alkylation Process

6 The Case of Carbon Acids

7 A Synthesis of Alkenes

8 Further Trapping Experiments. Concerted or Not Concerted?

9 Rigid Cisoid Dienes

10 Propargyl Radicals

11 Concluding Remarks
A Short, Efficient, and Stereoselective Synthesis of Piperine and its Analogues
Authors: Bauer Adriano , Nam Jun-Hyun , Maulide Nuno
Published: January 2019

A quantitative synthesis of piperine from commercially available starting material is presented. The synthesis relies on a stereoselective nucleophilic attack of an in situ generated cuprate onto a cyclobutene lactone. The so-formed aryl-substituted cyclobutene spontaneously undergoes a conrotatory 4π-electrocyclic ring opening to form the 4-aryl pentadienoic acid as a single diastereoisomer. The high-yielding synthesis can be easily modulated on the aryl and on the amide moiety for the synthesis of a wide range of piperine analogues.
Air-Stable Secondary Phosphine Oxides for Nickel-Catalyzed Cross-Couplings of Aryl Ethers by C–O Activation
Authors: Ghorai Debasish , Loup Joachim , Zanoni Giuseppe , Ackermann Lutz
Published: January 2019

Air- and moisture-stable secondary phosphine oxides (SPOs) enabled nickel-catalyzed Kumada–Corriu cross-couplings of various arylmethyl ethers at room temperature by challenging C–O activation.
Lewis Acid-Catalyzed Rearrangement of Fluoroalkylated Propargylic Alcohols: An Alternative Approach to β-Fluoroalkyl-α,β-enones
Authors: Ramasamy Manickavasakam , Lin Hui-Chang , Kuo Sheng-Chu , Hsieh Min-Tsang
Published: January 2019

A practical Lewis acid-catalyzed Meyer–Schuster rearrangement of fluoroalkylated propargylic alcohols, leading to a series of β-fluoroalkyl-α,β-enones, is developed. The methodology reported herein features moderate to high yields and high stereoselectivity in the synthesis of β-alkyl-β-fluoroalkyl-α,β-enones.
Copper-Catalyzed Synthesis of Dibenzo[b,f]imidazo[1,2-d][1,4]oxazepine Derivatives via a Double Ullmann Coupling Reaction
Authors: Liu Jian-Quan , Wang Xiang-Shan , Chen Xin-Yi , Li Zhuo-Huan
Published: January 2019

A double Ullmann coupling reaction successfully takes place between 4,5-diaryl-2-(2-bromophenyl)-1H-imidazoles and 2-bromophenols in the presence of Cs2CO3. This procedure is catalyzed by copper(I) iodide and o-phenanthroline and provides an efficient method for the synthesis of dibenzo[b,f]imidazo[1,2-d][1,4]oxazepine derivatives in good yields.
Synthesis of 5-Aryl-5H-pyrido[2',1':2,3]imidazo[4,5-b]indoles by Domino Pd- and Cu-Catalyzed C–N Coupling Reactions
Authors: Hung Tran , Quan Nguyen , Van Dong Hoang , Nguyen Trinh , Anh Hoang , Hung Trieu , Van Tuyen Nguyen , Thuan Ngo , Dang Tuan , Langer Peter
Published: January 2019

A series of 5-aryl-5H-pyrido[2',1':2,3]imidazo[4,5-b]indoles was successfully prepared in good yields by a practical four-step strategy. In this procedure, the key step was demonstrated to be the domino Pd-and Cu-catalyzed C–N coupling reactions of 3-bromo-2-(2-bromophenyl)imidazo[1,2-a]pyridine with amines.
Formation of COOH-Ylides, and Their Reactivities and Selectivities in Wittig Reactions
Authors: Suganuma Yuta , Kobayashi Yuichi
Published: January 2019

Whereas two equivalents of base are typically required to prepare carboxylate (CO2
–) ylides [Ph3P+C–(H)-alk-CO2
–] (alk = alkanediyl) from carboxy (CO2H) phosphonium salts [(Ph3PCH2-alk-CO2H)+] X–, we reveal, for the first time, that carboxy ylides [Ph3P+C–(H)-alk-CO2H] can be generated with one equivalent of NaHMDS at 0 °C, and that the Wittig reaction of simple aliphatic aldehydes (1 equiv) with these carboxy ylides (1.5–2 equiv) in THF at –95 to –90 °C for one hour, then at warming temperatures to 0 °C over two hours affords (Z)-alkenoic acids. Phosphonium salts containing (CH2)
n
alkanediyl chains (n = 2–5) showed adequate reactivity and high Z-selectivity, whereas shorter or longer alkanediyl chains resulted in a low Z-selectivity and/or a low yield. On the basis of these results with different (CH2)
n
chains and that obtained with a rigid methylene group, we propose that a rapid equilibrium between Ph3PCH
2-alk-CO2
– and Ph3P+C–(H)-alk-CO2
H, through an intramolecular hydrogen exchange, accounts for the success of the Wittig reaction.
Dehydrative Allylation of Amine with Allyl Alcohol by Titanium Oxide Supported Molybdenum Oxide Catalyst
Authors: Kon Yoshihiro , Nakashima Takuya , Fujitani Tadahiro , Murayama Toru , Ueda Wataru
Published: January 2019

The dehydrative allylation from allyl alcohol with amines to generate various allyl amines by MoO3/TiO2 solid catalyst is described. The catalyst can be reused at least three times without a decrease of activity.
Truven Health Analytics MarketScan Databases for Clinical Research in Colon and Rectal Surgery
Authors: Schaefer Eric , Messaris Evangelos , Hollenbeak Christopher , Kulaylat Audrey
Published: January 2019

The MarketScan databases are a family of administrative claims databases that contain data on inpatient and outpatient claims, outpatient prescription claims, clinical utilization records, and healthcare expenditures. The three main databases available for use are each composed of a convenience sample for one of the following patient populations: (1) patients with employer-based health insurance from contributing employers, (2) Medicare beneficiaries who possess supplemental insurance paid by their employers, and (3) patients with Medicaid in one of eleven participating states. Eleven supplemental databases are available, which are utilized to overcome the limited clinical data available in the core MarketScan databases. There are several limitations to this database, primarily related to the fact that individuals or their family members within two of the core databases mandatorily possess some form of employer-based health insurance, which prevents the dataset from being nationally representative. Nonetheless, this database provides detailed and rigorously maintained claims data to identify healthcare utilization patterns among this cohort of patients.
Electronic Health Record–Based Registries: Clinical Research Using Registries in Colon and Rectal Surgery
Authors: Carlson Jacob , Laryea Jonathan
Published: January 2019

Electronic health records (EHRs) or electronic medical records (EMRs) contain a vast amount of clinical data that can be useful for multiple purposes including research. Disease registries are collections of data in predefined formats for population management, research, and other purposes. There are differences between EHRs and registries in the data structure, data standards, and protocols. Proprietary EHR systems use different coding systems and data standards, which are usually kept secret. For EHR data to flow seamlessly into registries, there is the need for interoperability between EHR systems and between EHRs and registries. The levels of interoperability required include functional, structural, and semantic interoperability. EHR data can be manually mapped to registry data, but that is a tedious, resource-intensive endeavor. The development of data standards that can be used as building blocks for both EHRs and registries will help overcome the problem of interoperability.
Role of Endothelial Cells in Acute and Chronic Thrombosis
Authors: Bochenek Magdalena L. , Schäfer Katrin
Published: January 2019

Haemostasis encompasses a set of strictly regulated actions, such as vasoconstriction, platelet activation and blood coagulation. Endothelial cells play a crucial role in all of these processes and are an integral part of the vascular response to injury resulting in thrombus formation. Healthy endothelium expresses mediators to prevent platelet activation, including prostacyclin and nitric oxide, and to inhibit coagulation, such as thrombomodulin or RNase1. Upon activation, endothelial cells expose von Willebrand factor, integrins and other receptors to interact with activated platelets, erythrocytes and coagulation factors, respectively, resulting in blood clot formation. The endothelial cell response to cytokines and growth factors released from activated platelets and immune cells abundantly present in arterial and venous thrombi also plays an important role for thrombus resolution, whereas failure to completely resolve thrombi may initiate fibrotic remodelling and chronic vascular occlusion both in the arterial and venous tree. Therefore, endothelial cells are increasingly recognized as potential target to prevent thrombotic events and to accelerate thrombus resolution. Here, we discuss recent publications from our group in the context of other studies on the role of the endothelium during acute and chronic thrombotic events.
Technical Repeatability and Reproducibility of the Stress Radiographs Performed with the Vezzoni-Modified Badertscher Hip Distension Device
Authors: De Rycke Lieve , Vezzoni Aldo , Polis Ingeborgh , Saunders Jimmy , Broeckx Bart , Bertal Mileva
Published: January 2019

Objective The aim of this study was to evaluate the repeatability and reproducibility of the radiographical stress technique using the Vezzoni-modified Badertscher distension device (VMBDD).

Materials and Methods Stress radiographs of 10 dogs obtained with the VMBDD were performed consecutively by two different operators and then measured twice by a third veterinarian. The technical repeatability was first assessed individually for the two operators who took the stress radiographs, followed by the technical reproducibility. The obtained variances were used to calculate the 95% limits of agreement for the measurement repeatability, the technical repeatability and the technical reproducibility.

Results Both the technical repeatability and reproducibility of the VMBDD technique were good, with the 95% limits of agreement of the measurement repeatability and technical repeatability equalling ± 0.07 overall, and the 95% limits of agreement of the technical reproducibility being ± 0.09.

Clinical Significance These results, in combination with the previous results for the measurement of the laxity index, support the use of the VMBDD as a reliable in-house evaluation method to assess the hip joint by trained clinicians. For screening purposes, however, we suggest to limit the number of evaluators, to limit the variability.
A Pharmacogenomics Clinical Decision Support Service Based on FHIR and CDS Hooks
Authors: Dolin R.H. , Boxwala A. , Shalaby J.
Published: January 2019

Objectives Pharmacogenomics (PGx) is often considered a low-hanging fruit for genomics–electronic health record (EHR) integrations, and many have expressed the notion that drug–gene interaction checking might one day become as much a commodity in EHRs as drug–drug and drug–allergy checking. In addition, the U.S. Office of the National Coordinator has recognized the trend toward storing complete sequencing data outside the EHR in a Genomic Archiving and Communication System (GACS) and has emphasized the need for “pilots that test Fast Healthcare Interoperability Resources (FHIR) Genomics for GACS integration with EHRs.” We sought to develop a PGx clinical decision support (CDS) service, leveraging the emerging FHIR and CDS Hooks standards, and based on an assumption that pharmacogene sequencing data would be stored alongside the EHR in a GACS.

Methods We developed a PGx CDS service as a functional prototype. The service is triggered by a medication order in the EHR. When evoked, the service looks for relevant genetic data in a GACS and returns corresponding recommendations back to the ordering clinician. Where the patient has no genetic data on file, the service can recommend pretreatment genetic testing where applicable.

Results Overall, we were able to meet our objectives and deploy a functional prototype, interfaced with a commercial EHR. We identified several areas where FHIR or CDS Hooks lacked necessary semantics or have implementation ambiguity. Primary FHIR challenges included multiple ways to say the same thing, which exacerbated the complexity of variant to allele conversion and lack of representation of deoxyribonucleic acid region(s) studied. Primary CDS Hooks challenges included the complexity of executing an authenticated query against one system (GACS) upon being triggered by a different system (the EHR), and limitations in the types of actionable recommendations that can be returned to the EHR.

Conclusions In conclusion, we have found that PGx CDS based on FHIR and CDS Hooks appears to represent a promising means of genomics–EHR integration. More real-world testing along with a set of use-case driven GACS interface requirements will push us closer to the U.S. National Human Genome Research Institute vision of a plug-in PGx app.
Rigid Bronchoscopy
Authors: Peralta A. , Debiane Labib , Simoff Michael , Diaz-Mendoza Javier
Published: January 2019

Rigid bronchoscopy is one of the oldest medical techniques used in the respiratory and thoracic fields. Even though its use declined after the development of flexible bronchoscopy, it has again gained importance with the growth of interventional pulmonology, becoming a critical technique taught as part of the training in this subspecialty. The therapeutic advantages compared to other approaches of thoracic pathologies makes rigid bronchoscopy a primary component in the present and future of interventional pulmonary medicine.
Physical Therapy Management of Adults with Mild Traumatic Brain Injury
Authors: Diaz Deborah , Moore Carolyn , Kane Ashley
Published: January 2019

Rehabilitation for individuals after mild traumatic brain injury (mTBI) or concussion requires emphasis on both cognitive and physical rest, with a gradual return to activity including sports. As the client becomes more active, the rehabilitation professional should pay close attention to symptoms associated with mTBI, such as headache, dizziness, nausea, and difficulty concentrating. The systematic approach to return to play provided by the Berlin Consensus Statement on Concussion in Sport can apply to adults with mTBI. This protocol calls for gradually increasing the intensity of physical activity while attending to postconcussion symptoms. During the incident that led to an mTBI, the injured individual may incur injuries to the vestibular and balance system that are best addressed by professionals with specific training in vestibular rehabilitation, most commonly physical therapists. Benign paroxysmal positional vertigo is a condition in which otoconia particles in the inner ear dislodge into the semicircular canals, resulting in severe vertigo and imbalance. This condition frequently resolves in a few sessions with a vestibular physical therapist. In conditions such as gaze instability, motion sensitivity, impaired postural control, and cervicogenic dizziness, improvement is more gradual and requires longer follow-up with a physical therapist and a home exercise program. In all of the above-stated conditions, it is essential to consider that a patient with protracted symptoms of mTBI or postconcussion syndrome will recover more slowly than others and should be monitored for symptoms throughout the intervention.
True Colours – Heterogenität des Fettgewebes
Authors: Fischer-Posovszky P. , Tews D.
Published: January 2019

Das Fettgewebe ist ein dynamisches endokrines Organ. Es spiegelt die Energiehomöostase des Körpers wider und steht über seine Sekretionsprodukte in ständigem Informationsaustausch mit anderen Organsystemen. Das Fettgewebe zeichnet sich durch eine beachtliche anatomische, zelluläre und funktionelle Heterogenität aus, welche sich in einer Vielzahl unterschiedlicher Typen von Fettzellen ausdrückt. Dieser Übersichtsartikel stellt die verschiedenen „Farbnuancen” des Fettgewebes vor und diskutiert ihre funktionelle Relevanz im Organismus.
Cochlear Implantation in Sporadic Vestibular Schwannoma: A Systematic Literature Review
Authors: Bartindale Matthew Robert , Tadokoro Kent Sean , Kircher Matthew Lowell
Published: January 2019

Objective This study was aimed to perform a systematic literature review by examining outcomes in patients with sporadic vestibular schwannoma (VS) undergoing ipsilateral cochlear implant (CI).

Data Sources PubMed-NCBI (National Center for Biotechnology Information) and Scopus databases were searched through October 2017.

Study Selection Studies reporting auditory outcomes for each patient when a CI was placed with an ipsilateral sporadic VS were included.

Main Outcome Measures Demographic variables, VS characteristics, preoperative hearing metrics, duration of deafness, CI type, approach to tumor resection, postoperative auditory outcomes, and postoperative tinnitus outcomes were reported for each eligible patient within studies. Each study was evaluated for quality and bias.

Results Fifteen studies and 45 patients met inclusion criteria. Mean speech discrimination score (SDS) improved from 30.0 to 56.4% after CI placement. The majority when reported had an improvement in tinnitus. Preoperative ipsilateral SDS was a negative predictor of postoperative SDS, while neither tumor resection status, tumor location, duration of deafness, ipsilateral pure tone average, nor timing of CI placement had a significant effect on patient outcome.

Conclusions Notwithstanding the challenges inherent with surveillance magnetic resonance imaging (MRI) in the setting of a cochlear implant magnet, select sporadic vestibular schwannoma patients can be considered for cochlear implantation.
Bronchoscopic Lung Volume Reduction in Patients with Severe Emphysema
Authors: Labarca Gonzalo , Herth Felix , Fernandez-Bussy Sebastian
Published: January 2019

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive procedure for patients with symptomatic severe emphysema who may not be candidates for surgical lung volume reduction. BLVR has been shown to improve both functional and clinical outcomes with a relatively low risk of severe complications. Any potential candidate to BLVR should be on optimal pharmacological and nonpharmacological treatment. Radiographic and pulmonary function testing provide key data to help identify potential BLVR candidates. A variety of BLVR techniques have been published with different associated benefits and risks. Current strategies include either blocking procedures such as endobronchial valves and intrabronchial valves or nonblocking procedures such as endobronchial coils and bronchoscopic thermal vapor ablation. The aim of this review is to describe current options of BLVR including their efficacy and safety based on available data.
Child–Pugh Classification: Time to Abandon?
Authors: Kok Beverley , Abraldes Juan
Published: January 2019

The Child–Pugh classification is one of the commonest and oldest bedside tools utilized in estimating prognosis in patients with cirrhosis. However, its usage as a risk prediction tool or indeed a decision-making tool should be revisited. In this review, we discuss some inherent issues with the Child–Pugh classification and present a few contexts in which the current usage of Child–Pugh warrants reassessment, elaborating on its utility in acute variceal bleeding, specifically its role in decision-making on early transjugular intrahepatic portosystemic shunt, as well as its use in the context of hepatocellular carcinoma and drug development and dose adjustment.
Apolipoprotein C-III Strongly Correlates with Activated Factor VII–Anti-Thrombin Complex: An Additional Link between Plasma Lipids and Coagulation
Authors: Martinelli Nicola , Baroni Marcello , Castagna Annalisa , Lunghi Barbara , Stefanoni Filippo , Tosi Federica , Croce Jacopo , Udali Silvia , Woodhams Barry , Girelli Domenico , Bernardi Francesco , Olivieri Oliviero
Published: January 2019

Activated factor VII–anti-thrombin (FVIIa-AT) complex is a potential biomarker of pro-thrombotic diathesis reflecting FVIIa–tissue factor (TF) interaction and has been associated with mortality in patients with coronary artery disease (CAD). Previous data indicated plasma lipids as predictors of FVIIa-AT variability, and plasma lipoproteins as potential stimulators of the coagulation cascade. Our aim was to evaluate the relationships between FVIIa-AT plasma concentration and a broad apolipoprotein profile (including ApoA-I, ApoB, ApoC-III and ApoE). Within the framework of the observational Verona Heart Study, we selected 666 subjects (131 CAD-free and 535 CAD, 75.4% males, mean age: 61.1 ± 10.9 years) not taking anticoagulant drugs and for whom plasma samples were available for both FVIIa-AT assay and a complete lipid profile. Plasma concentration of FVIIa-AT levels significantly and directly correlated with total and high-density lipoprotein cholesterol, triglycerides, ApoA-I, ApoC-III and ApoE levels. ApoC-III showed the strongest correlation (R = 0.235, p = 7.7 × 10−10), confirmed in all the sub-group analyses (males/females and CAD/CAD-free). Only ApoC-III remained associated with FVIIa-AT plasma concentration, even after adjustment for sex, age, CAD diagnosis, body mass index, renal function, smoking status, lipid-lowering therapies and FVIIa levels. The APOC3 gene locus-tagging polymorphism rs964184, previously linked with cardiovascular risk and plasma lipids by genome-wide association studies, was associated with both ApoC-III and FVIIa-AT plasma concentration. Our results indicate a strong association between ApoC-III and FVIIa-AT levels, thereby suggesting that an increased ApoC-III concentration may identify subjects with a pro-thrombotic diathesis characterized by an enhanced TF-FVIIa interaction and activity.
Thoracoscopy: Advances and Increasing Role for Interventional Pulmonologists
Authors: Lee Pyng , Folch Erik
Published: January 2019

Thoracoscopy is an increasingly common procedure that provides significant clinical information and therapeutic applications. The procedure allows the physician to biopsy the parietal pleura under direct visualization with high accuracy. In addition, one can drain pleural fluid, place a chest tube in a precise location, and perform poudrage pleurodesis. Medical thoracoscopy (MT) is carried out in the operating room or procedure suite under moderate sedation with spontaneous ventilation. In comparison, video-assisted thoracoscopic surgery (VATS) is performed under general anesthesia with single lung ventilation and through multiple ports in the operating room. MT is less invasive, has a comparable diagnostic yield, and may be better tolerated in high-risk patients. The indications, complications, and advances in thoracoscopy will be discussed in this article. In the era of rapidly evolving therapeutics for lung cancer, immune-modulation and ever-increasing risks of immunosuppression, MT will evolve and continue to play a pivotal role in the evaluation and research of pleuropulmonary diseases.
Ultrasound-Guided versus Conventional Caudal Block in Children: A Prospective Randomized Study
Authors: Karaca Omer , Pinar Huseyin Ulas , Gokmen Zeynel , Dogan Rafi
Published: January 2019

Background Injection to the accurate area without any complications is the main factor for the efficiencies of caudal block. The aim of this study was to compare success and the complications of conventional and ultrasound method for caudal block in children.

Materials and Methods Two-hundred sixty-six American Society of Anesthesiologists (ASA) category 1 children aged between 6 months and 6 years undergoing hypospadias, circumcision, or both surgeries were randomly allocated two groups (Group C or Group H, n = 133). About 0.25% bupivacaine with 1/200000 adrenaline (total volume: 0.5 mL/kg) was injected after the needle was inserted into the sacral canal in Group C, or right after the needle pierced the sacrococcygeal ligament under longitudinal ultrasound view in Group H. Success rate of block, block performing time, number of needle puncture, success at first puncture, complication rate, age and weight of the patients encountering these complications were recorded.

Results The success rate of block was similar between two groups (94.7% in Group C vs 96.2% in Group U, p > 0.05). Success at first puncture was higher in Group U than in Group C (90.2 vs 66.2%, respectively; p < 0.001). Number of needle puncture, blood aspiration, subcutaneous bulging, and bone contact was higher in Group C but none in Group U (p < 0.001) and these complications were occurred in children weighing < 16 kg and less younger than 6 years old.

Conclusion We observed that the complications were not encountered, number of needle puncture was lesser, and the success rate of first puncture was higher under ultrasound with longitudinal view.
Epidermoid Cyst in the Cerebellopontine Angle: Technical Description Video
Authors: de Morais Marcus Vinicius , Mota Romulo Almino de Alencar Arrais , Marques Thais Aparecida , Loduca Rafael Duarte de Souza , Melo Paulo Mácio de Porto
Published: January 2019

Objectives To describe the operative technique for treatment of epidermoid cysts in the cerebellopontine angle (CPA).

Design The present video is a case report.

Setting Patient is positioned in three-quarters prone. Retrosigmoid approach should be made under neurological monitoring and with neuronavegation to help achieve maximal safe resection. The skin incision is vertical, slightly curved, 5 mm medial to the mastoid notch. Craniectomy is superiorly limited by the transverse sinus and laterally limited by the sigmoid sinus. A C-shaped durotomy is made with its base protecting the sigmoid sinus. The lesion is removed in piecemeal fashion (Fig. 1). The neurological monitoring helps.

Results The patient was discharged 2 days later without neurological deficits.

Conclusions The surgical treatment associated with neurological monitoring and neuronavegation is a safe procedure to treat epidermoid cysts in the CPA.

The link to the video can be found at: https://youtu.be/sEuFyq9c2sw.
Endogenous Procoagulant Activity in Trauma Patients and Its Relationship to Trauma Severity
Authors: Prior Shannon , Park Myung , Mann Kenneth , Butenas Saulius
Published: January 2019

Background It has been observed that trauma patients have elevated plasma procoagulant activity that could be assigned to an elevated concentration of tissue factor (TF). However, in many instances there is a discrepancy between the levels of TF and the procoagulant activity observed. We hypothesized that factor XIa (FXIa) could be responsible for this additional activity and that the presence and levels of both proteins could correlate with trauma severity.

Methods Citrate plasma from 98 trauma patients (47 blunt, 17 penetrating, and 34 thermal) were evaluated in clotting assays for the presence of FXIa and TF activity using respective inhibitory antibodies.

Results When the three trauma patient groups were divided into two cohorts (Injury Severity Score [ISS] > 25 and ISS ≤ 25), higher frequencies and concentrations of both TF and FXIa were observed for all the more severe injury subgroups.

Conclusions The majority of trauma patients have active FXIa in their plasma, with a significant fraction having active TF as well. Additionally, both TF and FXIa frequency and concentration directly relate to trauma severity. These data suggest the use of these two proteins as potential markers for the stratification of trauma patients.
Neutrophil Extracellular Traps in Arterial and Venous Thrombosis
Authors: Laridan Elodie , Martinod Kimberly , De Meyer Simon
Published: January 2019

Thrombotic complications are still a major health risk worldwide. Our view on the pathophysiology of thrombosis has significantly changed since the discovery of neutrophil extracellular traps (NETs) and their prothrombotic characteristics. Generated by neutrophils that release their decondensed chromatin as a network of extracellular fibers, NETs promote thrombus formation by serving as a scaffold that activates platelets and coagulation. The thrombogenic involvement of NETs has been described in various settings of thrombosis, including stroke, myocardial infarction, and deep vein thrombosis. The aim of this review is to summarize existing evidence showing the presence of NETs in human thrombus material. Following an introduction on NETs and their role in thrombus formation, the authors address studies showing the presence of NETs in arterial or venous thrombi. In addition, they focus on potential novel therapeutic opportunities to resolve or prevent thrombosis by targeting NETs.
The Elusive Diagnosis of Disseminated Intravascular Coagulation: Does a Diagnosis of DIC Exist Anymore?
Authors: Thachil Jecko
Published: January 2019

Disseminated intravascular coagulation (DIC) is an intermediary mechanism of disease known to develop as a complication in other conditions like sepsis, trauma, cancer, or obstetrical disorders. Patients with DIC may present to different specialists depending on symptomology and as such a good understanding of the pathophysiological process is necessary to ensure best management. However, more recently, controversy has risen where experts doubt whether DIC really exists in many of the historically well-established diagnoses. This has led to confusion among both basic science researchers and clinical practitioners about when to consider DIC diagnosis. In this review, the various issues which have led to this uncertainty are addressed, including the problem with different terminologies, simpler explanation of current DIC diagnostic criteria, and reasons behind why the diagnosis may be overlooked or not considered at all, along with their possible solutions. It is hoped that the diagnostic aspects of DIC will come full circle, wherein the recent research can build up on what history had taught us and not refute its existence.
Blood reference intervals for rabbits (Oryctolagus cuniculus) from routine diagnostic samples
Authors: Leineweber Christoph , Müller Elisabeth , Marschang Rachel E.
Published: January 2019

Objective: The goal of this study was to establish reference intervals for blood parameters in rabbits based on data from routine diagnostic samples. Materials and methods: Data sets from 1679–2039 values for clinical chemistry and 937–1559 values for hematological parameters were evaluated using the statistical program Reference Limit Estimator 20151017. Results: The following reference intervals were calculated for hematology: erythrocytes 4.37–7.43 × 1012 cells/l; hematocrit 0.28–0.48 l/l; hemoglobin 89.63–153.82 g/l; leucocytes 2.71–12.23 × 109 cells/l; neutrophils 0.87–7.82 × 109 cells/l; lymphocytes 0.36–6.58 × 109 cells/l; monocytes 0.08–1.71 × 109 cells/l; eosi nophils 0.07–0.19 × 109 cells/l; basophils 0.06–1.1 × 109 cells/l; thrombocytes 225.45–905.3 × 109 cells/l. Calculated intervals for clinical chemistries were: alkaline phosphatase 9.05–94.68 U/l; aspartataminotransferase 3.75–32.44 U/l; creatine kinase 1.63–559.53 U/l; γ-glutamyltransferase 2.5–14.46 U/l; glutamatdehydrogenase 0.68–14.78 U/l; fructosamin 248.08–501.43 µmol/l; bile acid 0.76–19.63 μmol/l; total protein 48.66–73.64 g/l; urea 2.63–10.28 mmol/l; creatinine 51.38–154.35 µmol/l; calcium 3.02–4.3 mmol/l; magnesium 0.66–1.51 mmol/l; phosphorus 0.54–2.18 mmol/l; sodium 132.61– 154.0 mmol/l and potassium 3.52–6.04 mmol/l. Conclusion and clinical relevance: The calculation of intervals based on a large number of routine diagnostic samples allows the establishment of labora tory specific reference intervals without the use of experimental animals.
The Use of Noninvasive Ventilation with High Frequency in Newborns—A Single-Center Experience
Authors: Łoniewska Beata , Tousty Joanna , Michalczyk Barbara , Kordek Agnieszka , Jankowska Agata
Published: January 2019

Objective The aim of the study is to evaluate the efficacy of noninvasive high-frequency ventilation (nHFV) in respiratory-deficient infants.

Study Design Retrospective analysis of 32 cases of nHFV in 30 term (n = 4) and preterm (n = 26) newborns using a noninvasive ventilation (NIV) device. nHFV avoided intubation of children performed with NIV and reintubation after long-term mechanical ventilation (MV). Patients were divided into three groups: Group 1: NIV from birth (n = 18, mean birth weight [BW]: 1,987 g, gestational age [GA]: 33.1 weeks); Group 2: MV, also used temporarily, and NIV (n = 10, BW: 1,074 g, GA: 28.2 weeks); and Group 3: two cases with nHFV avoided reintubation after long-term MV (BW: 725 g, GA: 24.5 weeks).

Results From 32 episodes of nHFV application, positive effect was achieved 26 times (81%) (24 of 30 children). All newborns had a significant increase in pH (7.23–7.27) and reduction in partial pressure of CO2 (66.7–58.9 mm Hg, over 1–2 hours). Failures in application of nHFV reported only in Group 1 (6/18, 33%) (failures primarily due to increasing demand for oxygen). There were two reports of pneumothorax in preterm infants with congenital pneumonia. No other nHFV-related complications were noted.

Conclusion nHFV is a promising NIV mode which can be also used with NIV devices.
Urinary N-telopeptide: The New Diagnostic Test for Osteoporosis
Authors: Ganesan Ganesan , Vijayaraghavan Phagal
Published: January 2019

Context Osteoporosis is a silent disease until it is complicated by trivial fall fractures. There is an increasing interest within the orthopaedic community in the noninvasive cost-effective measurement of the bone mineral density.

Aims The aim of the study is to assess whether urinary N-telopeptide level can be a new diagnostic tool in diagnosing osteoporosis.

Methods and Material This prospective study was done at Sri Ramachandra Medical Centre (SRMC) hospital from October 2015 to October 2017. The study was conducted among patients who comes to SRMC as inpatient or outpatient with suspected osteoporosis and underwent dual-energy X-ray absorptiometry (DXA) scan and urinary N-telopeptide. The inclusion criteria were women aged 65 or older, women aged less than 65 with risk factors, younger postmenopausal women with one or more risk factors, men aged 70 or older, men less than 70 with risk factors, and any above group patients who comes within 24 hours following trivial fall fractures. The exclusion criteria were pathological fracture, history of any illness affecting bone metabolism. The results from DXA scan were taken as gold standard against urinary N-telopeptide. Then the patients were divided into two groups control and study. The control group contains patients who had normal DXA, while study group contains patients having either osteopenia or osteoporosis. Based on our inclusion and exclusion criteria, 110 persons were included in the study. We had 60 study and 50 controls patients. We had 88 females and 22 males. The results obtained were statistically analyzed.

Statistical Analysis Used The collected data were analyzed with IBM SPSS statistics software 23.0 version. To describe about the data descriptive statistics frequency analysis, percentage analysis was used for categorical variables and the mean and standard deviation were used for continuous variables. To find the significant difference between the bivariate samples in independent groups, the unpaired sample t-test was used. To find the significance in categorical data, chi-square test was used. In both the earlier statistical tools, the probability value of 0.05 is considered as significant level.

Results In our study, we had 18.2% osteopenic and 36.4% osteoporotic patients. The mean value of urinary N-telopeptide in control was 49.8 and in case was 182.5. The standard deviation of urinary N-telopeptide value in case was 159.9.

Conclusion Urinary N-telopeptide can give reproducible results and be able to assist in the evaluation of the quantity as well as the quality and be a good judge of someone's risk of fracture. Hence, urinary N-telopeptide can be used as a diagnostic tool for diagnosing osteoporosis.
Metal-Backed Tibial Components Do Not Reduce Risk of Early Aseptic Loosening in Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis
Authors: Costa Giuseppe Gianluca , Lo Presti Mirco , Grassi Alberto , Agrò Giuseppe , Cialdella Sergio , Mosca Massimiliano , Caravelli Silvio , Zaffagnini Stefano
Published: January 2019

Long-term results of unicompartmental knee arthroplasty (UKA) have shown a slightly higher revision rate than total knee arthroplasty (TKA), and implant fixation geometry seems to affect prosthetic survivorship. Whether metal-backed tibial component leads to superior performance over the all-polyethylene design is unclear, and a lack of evidence exists in literature. Our purpose was to demonstrate which implant design of UKA (all-polyethylene or metal-backed tibial component) is clinically superior regarding revision rates and clinical functioning, and investigate the role of potential factors that could affect the revision rate. A systematic review was conducted for clinical studies comparing all-polyethylene and metal-backed tibial components used in primary UKAs in terms of revision rates and clinical scores. Meta-regression techniques were used to explore factors modifying the observed effect. All causes of revision were extracted and analyzed, to find statistically significant differences between the two groups. Our research strategy generated a systematic review of nine studies comprising 1,101 UKAs in 1,088 patients with 87 revisions for any reason. Meta-analysis showed a higher, but not statistically significant, risk of aseptic revision in the all-polyethylene group. Studies with a smaller sample size and higher percentage of female patients were correlated to a higher relative risk of revision in favor of all-polyethylene UKAs. Differently, patients' age and duration of follow-up did not influence the risk ratio. The main cause for revision was aseptic loosening in both implants' component, with no statistically differences in the two groups examined. Our results do not show a superiority of the metal-backed tibial component in UKAs in terms of survivorship, although extreme care must be given for patients with high risk of early failure, such as female patients. However, surgical experience, in combination with careful patient selection, remains paramount and may lead to better long-term outcomes in patients requiring UKA. This is a Level III, therapeutic study.
Radiographs Detect Dorsal Scaphoid Translation in Scapholunate Dissociation
Authors: Chan Kevin , Vutescu Emil S. , Wolfe Scott W. , Lee Steve K.
Published: January 2019

Background Dorsal translation of the proximal scaphoid pole onto the rim of the distal radius is a late finding associated with chronic scapholunate instability. Dorsal scaphoid translation (DST) has been identified by magnetic resonance imaging in patients with scapholunate dissociation (SLD).

Purpose The authors proposed to determine whether DST can be reliably detected on radiographs using two different measurement techniques.

Patients and Methods Lateral radiographs of 20 patients with operatively confirmed SLD were compared with 20 uninjured patients in blinded assessment. DST was assessed using the concentric circle and dorsal tangential line methods. Reliability was calculated using intraclass correlation (ICC) values.

Results Using both techniques, the scaphoid demonstrated increased dorsal translation in patients with SLD. Inter-rater reliabilities for the concentric circles and dorsal tangential line method on radiographs had ICCs > 0.80. Similarly, intra-rater reliabilities had ICCs > 0.90.

Conclusions Both the concentric circles and dorsal tangential line techniques had excellent reliabilities, but the dorsal tangential line method is clinically more practical.

Type of Study/Level of Evidence This is a Level III, diagnostic study.
The Effect of Endoscopic Endonasal Transsphenoidal Skull Base Surgery on Cochlear Function
Authors: Ates Murat Samet , Benzer Murat , Kaya Isa , Biceroglu Huseyin , Ozgiray Erkin , Midilli Rasit , Karci Halil Bulent , Gode Sercan
Published: January 2019

Endoscopic transsphenoidal skull base surgery (ETSS) has become a standard approach in the treatment of sellar and clival lesions, such as pituitary adenoma and chordoma. Due to the close proximity of the clivus and the sella turcica to the inner ear, it is thought that bone drilling in the surgery may have effects on hearing. The aim of this study was to assess the effect of bone drilling in ETSS procedure on cochlear function. This study was performed on 18 patients who underwent ETSS procedure between December 2016 and May 2017. The study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of surgery, type of surgery, preoperative pure-tone audiometry, and preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. Of the DPOAE measurements of the patients who were operated for pituitary adenoma, there was a statistically significant difference between the signal-to-noise ratio (SNR) measurements at 0.5, 1, 2 and 4 kHz (p < 0.05). Additionally, there were no significant differences in preoperative and postoperative SNR measurements of six patients who were selected for clivus chordoma. When the preoperative and postoperative tonal audiometric tests of the patients were compared, no statistically significant difference was found (p > 0.05). In conclusion, it is found that bone drilling in ETSS procedure has a negative effect on cochlear function in the early period. This is the first study to evaluate the degree of noise-induced cochlear damage in patients who were gone under ETSS procedure.
Delta-shocks and vacuums in the relativistic Euler equations for isothermal fluids with the flux approximation
Authors: Zhang Yu , Zhang Yanyan
Published: January 2019

We demonstrate the flux-approximation problem of the isothermal relativistic Euler equations describing a perfect fluid flow in special relativity. First, the Riemann problem of the isothermal relativistic Euler equations under flux perturbation is discussed, and four kinds of solutions are obtained. Second, we rigorously prove that, as the flux perturbation vanishes, any two-shock Riemann solution tends to a delta-shock solution to the pressureless relativistic Euler equations and the intermediate density between the two shocks tends to a weighted δ-measure which forms a delta shock wave. Correspondingly, any two-rarefaction Riemann solution tends to a two-contact-discontinuity solution to the pressureless relativistic Euler equations and the nonvacuum intermediate state in between tends to a vacuum state.
Macdonald denominators for affine root systems, orthogonal theta functions, and elliptic determinantal point processes
Authors: Katori Makoto
Published: January 2019

Rosengren and Schlosser introduced notions of RN-theta functions for the seven types of irreducible reduced affine root systems, RN = AN−1, BN, BN∨, CN, CN∨, BCN, DN, N∈N, and gave the Macdonald denominator formulas. We prove that if the variables of the RN-theta functions are properly scaled with N, they construct seven sets of biorthogonal functions, each of which has a continuous parameter t ∈ (0, t*) with given 0 < t* < ∞. Following the standard method in random matrix theory, we introduce seven types of one-parameter (t ∈ (0, t*)) families of determinantal point processes in one dimension, in which the correlation kernels are expressed by the biorthogonal theta functions. We demonstrate that they are elliptic extensions of the classical determinantal point processes whose correlation kernels are expressed by trigonometric and rational functions. In the scaling limits associated with N → ∞, we obtain four types of elliptic determinantal point processes with an infinite number of points and parameter t ∈ (0, t*). We give new expressions for the Macdonald denominators using the Karlin–McGregor–Lindström–Gessel–Viennot determinants for noncolliding Brownian paths and show the realization of the associated elliptic determinantal point processes as noncolliding Brownian brides with a time duration t*, which are specified by the pinned configurations at time t = 0 and t = t*.
Influence of non-Markovian dynamics in equilibrium uncertainty-relations
Authors: Pachón Leonardo A. , Triana Johan F. , Zueco David , Brumer Paul
Published: January 2019

Contrary to the conventional wisdom that deviations from standard thermodynamics originate from the strong coupling to the bath, it is shown that in quantum mechanics, these deviations originate from the uncertainty principle and are supported by the non-Markovian character of the dynamics. Specifically, it is shown that the lower bound of the dispersion of the total energy of the system, imposed by the uncertainty principle, is dominated by the bath power spectrum; therefore, quantum mechanics inhibits the system thermal-equilibrium-state from being described by the canonical Boltzmann’s distribution. We show for a wide class of systems, systems interacting via central forces with pairwise-self-interacting environments; this general observation is in sharp contrast to the classical case, for which the thermal equilibrium distribution, irrespective of the interaction strength, is exactly characterized by the canonical Boltzmann distribution; therefore, no dependence on the bath power spectrum is present. We define an effective coupling to the environment that depends on all energy scales in the system and reservoir interaction. Sample computations in regimes predicted by this effective coupling are demonstrated. For example, for the case of strong effective coupling, deviations from standard thermodynamics are present and for the case of weak effective coupling, quantum features such as stationary entanglement are possible at high temperatures.
Improvement of focused ultrasonic beam generated by laser phased array: Theoretical analysis
Authors: Chang Ying , Yang Dexing , Guo Yuning
Published: January 2019

To improve the focused ultrasonic beam induced by laser phased array (LPA), the superiority of an improved LPA distribution with conjunction of geometric attenuation and directivity functions of the stimulated ultrasonic beams are investigated theoretically instead of only considering the directivity function. Numerical simulations for the generation of focused longitudinal waves in the thermoelastic regime were implemented to reveal the advantages of the improved LPA design. It is shown that the amplitude of the focused beam increased by 42.1%, and the rise time reduced by 25.0%, as well as spatial sizes narrowed by 50.6% and 41.9% in longitudinal and transverse directions, respectively. In addition, the thermal expansion superposition caused by adjacent laser pulses, which deteriorates the focusing features of the focused beam, should be avoided by setting proper spacing of LPA.