bluuebunny/crossref_metadata_2025 huggingface dataset:
Ionic liquid-assisted chemiluminescent immunoassay of prostate specific antigen using nanoceria as an alkaline phosphatase-like nanozyme label
Authors: Huang Ting , Hu Xilu , Wang Min , Wu Yuxin , Hu Lianzhe , Xia Zhining
Published: February 2021

An alkaline phosphatase mimicking nanozyme was applied for a chemiluminescent immunoassay for the first time.
Introduction to Nanomaterials Applied to Life Sciences
Authors: Espinosa A. , Teran F. J. , Ortega D.
Published: February 2021

A. Espinosa, F. J. Teran and D. Ortega introduce the Nanoscale Advances themed collection on Nanomaterials Applied to Life Sciences.
Short‐term railway passenger demand forecast using improved Wasserstein generative adversarial nets and web search terms
Authors: Feng Fenling , Zhang Jiaqi , Liu Chengguang , Li Wan , Jiang Qiwei
Published: February 2021

Accurately predicting railway passenger demand is conducive for managers to quickly adjust strategies. It is time‐consuming and expensive to collect large‐scale traffic data. With the digitization of railway tickets, a large amount of user data has been accumulated. We propose a method to predict railway passenger demand using web search terms data. In order to improve the prediction accuracy, we improved Wasserstein Generative Adversarial Nets (WGAN), which were good at generating and identifying data, by adding a predictor and supervised learning adversarial training to predict railway passenger demand. The improved WGAN could generate virtual data to expand real data, and use parallel data to predict railway passenger demand. We used search times of web search terms on different devices as training data to predict railway passenger demand in Beijing. The results show that the change in demand for railway passenger lags behind the change in the data of web search terms by one month. It is suitable for forecasting in advance. Compared with other forecasting methods, the improved WGAN performance is better, and the mean absolute percentage error is 1.98%. Because it can use mixed data for training and prediction, it has stronger adaptability when data scale decreases.
Time‐domain characterisation of epoxy‐based barium titanate nanocomposites
Authors: Zafar Romana , Gupta Nandini
Published: February 2021

In this article, the dielectric response of epoxy resin and epoxy‐based barium titanate (BaTiO3) nanocomposites is characterised in the time‐domain, based on polarisation and depolarisation current measurements. The aim of this article is to understand the dominant polarisation mechanisms in neat epoxy and its nanocomposites and validate the findings in frequency‐domain spectroscopy (FDS). The effect of various parameters on the dielectric response of the material is investigated to this end, namely, polarisation–depolarisation time, electrode material, electric field and specimen thickness. The effect of pre‐processing the nano‐particles before use is also studied. In order to validate the findings of FDS, time‐domain spectroscopy (TDS) of neat epoxy and its nanocomposites is performed.
Differenzialdiagnostik der pulmonalen Hypertonie am Beispiel der Kollagenose assoziierten PAH im Kontext chronischer Lungen- und Linksherzerkrankungen
Authors: Leuchte H. H. , Halank M. , Held M. , Borst M. , Ewert R. , Klose H. , Lange T. J. , Meyer F. J. , Skowasch D. , Wilkens H. , Seyfarth H.-J.
Published: February 2021

Die pulmonale Hypertonie (PH) ist eine regelmäßige Komplikation von Kollagenosen und wird zudem im Zusammenhang mit Lungen- und Linksherzerkrankungen diagnostiziert.

Die korrekte Differenzierung und Klassifikation der PH ist essenziell, um Therapien möglichst zielgerichtet einsetzen zu können und ein Vorenthalten von wichtigen Therapien ebenso zu vermeiden wie eine Übertherapie.

Bei den Kollagenosen umfasst die Differenzialdiagnostik und Klassifikation die Differenzierung innerhalb der assoziierten pulmonalarteriellen Hypertonie (APAH) Gruppe 1, aber auch, Klassifikationsgruppen übergreifend, die Gruppe 2 (mit führender linkskardialer Beteiligung), Gruppe 3 (mit führender parenchymatöser Lungenerkrankung), Gruppe 4 (chronisch thromboembolische PH) und letztlich die Gruppe 5 (z. B. bei terminaler Niereninsuffizienz und Dialysepflicht).

Ähnliches trifft auch auf die zunehmend älteren Patienten zu, die mit einer PAH diagnostiziert werden und Komorbiditäten aufweisen, die entweder selbst eine PH hervorrufen können oder als Komorbiditäten einer echten PAH auftreten.

Die abnehmende Trennschärfe zwischen den einzelnen PH-Gruppen erschwert die korrekte Klassifikation und stellt eine große klinische Herausforderung dar.

Auf dem Boden unterschiedlicher klinischer Szenarien wird im vorliegenden Artikel die Differenzialdiagnostik der PH sowohl bei Kollagenosen als auch bei chronischen Linksherz- und Lungenerkrankungen aufgearbeitet und objektive Kriterien vorgestellt, die diese Differenzierung erleichtern.
Is Mental Stress the Primary Cause of Glaucoma?
Authors: Sabel Bernhard A. , Lehnigk Luisa
Published: February 2021

The prognosis of going blind is very stressful for patients diagnosed with “glaucoma”. Worries and fear of losing independence is a constant mental burden, with secondary risks of depression and social isolation. But stress is not only a result of glaucoma but also a possible cause (risk factor). This should not be surprising, given that chronic stress can trigger “psychosomatic” organ dysfunctions anywhere in the body. Why should the organ “eye” be an exception? Indeed, glaucoma patients often suspect that severe emotional stress caused their visual field loss or “foggy vision”. The hypothesis that stress is a possible cause of glaucoma is supported by different observations: (i) acute and chronic stress increases intraocular pressure and (ii) long-term stress can lead to vascular dysregulation of the microcirculation in the eye and brain (“Flammerʼs syndrome”), leading to partial hypoxia and hypoglycaemia (hypo-metabolism). Even if nerve cells do not die, they may then
become inactive (“silent” neurons). (iii) Degenerative changes have been reported in the brain of glaucoma patients, affecting not only anterograde or transsynaptic areas of the central visual pathway, but degeneration is also found (iv) in brain areas involved in emotional appraisal and the physiological regulation of stress hormones. There are also psychological hints indicating that stress is a cause of glaucoma: (v) Glaucoma patients with Flammerʼs syndrome show typical personality traits that are associated with low stress resilience: they often have cold hands or feet, are ambitious (professionally successful), perfectionistic, obsessive, brooding and worrying a lot. (vi) If stress hormone levels and inflammation parameters are reduced in glaucoma patients by relaxation with meditation, this correlates with normalisation of intraocular pressure, and yet another clue is that (vii) visual field improvements after non-invasive current stimulation therapy, that are
known to improve circulation and neuronal synchronisation, are much most effective in patients with stress resilient personalities. An appreciation of stress as a “cause” of glaucoma suggests that in addition to standard therapy (i) stress reduction through relaxation techniques should be recommended (e.g. meditation), and (ii) self-medication compliance should not be induced by kindling anxiety and worries with negative communication (“You will go blind!”), but communication should be positive (“The prognosis is optimistic”).
Screening for upper gastrointestinal cancers with magnetically controlled capsule gastroscopy: a feasibility study
Authors: Li Zhen , Liu Jing , Ji Chao-Ran , Chen Fei-Xue , Liu Fu-Guo , Ge Jian , Chen Yong , Sun Xue-Guo , Lu Yan-Yan , Cheng Gui-Hua , Zhang Jie , Li Peng , Liu Ji-Yong , Yang Chong-Mei , Zuo Xiu-Li , Li Yan-Qing
Published: February 2021

Background The medical consortium is an intensive and disease-specific association that integrates tertiary public hospitals and medical examination centers in China. We aimed to evaluate the feasibility of the medical consortium for screening upper gastrointestinal (GI) cancers (MCSC) by magnetically controlled capsule gastroscopy (MCCG).

Methods 6627 asymptomatic subjects underwent MCCG as part of health check-ups in the MCSC between March and November 2018. Relevant clinical data were collected and analyzed.

Results The MCSC detected 32 patients with upper GI cancer (0.48 %) confirmed by pathology. The detection rate of early gastric cancer was 16.67 % (4 /24). Gastric polyps, ulcers, and submucosal tumors were found in 15.54 %, 3.76 %, and 3.17 % of subjects, respectively. The whole GI preparation and operation process were well tolerated.

Conclusions The MCSC was a feasible model for upper GI cancer screening, especially for asymptomatic subjects. Further prospective studies with better operational quality control are warranted.
Insulinbedarf und Glukosehomöostase bei Menschen nach partieller und totaler Pankreatektomie im Vergleich zu Menschen mit anderen Diabetesformen
Authors: Quast Daniel Robert , Breuer Thomas Georg Karl , Nauck Michael Albrecht , Janot-Matuschek Monika , Uhl Waldemar , Meier Juris Jendrik
Published: February 2021

Einleitung Pankreasresektionen werden bei schwerwiegenden Pankreaserkrankungen durchgeführt. Bei Komplikationen einer chronischen Pankreatitis, teilweise jedoch auch bei Raumforderungen, kann eine Pankreasteilresektion sinnvoll sein. Eine totale Pankreatektomie führt zum absoluten Insulinmangel und der Notwendigkeit einer Insulintherapie. Bei Teilresektionen (partielle Pankreatektomie) werden weniger gravierende Konsequenzen für den Glukosemetabolismus erwartet. Es ist das Ziel der vorliegenden Arbeit, die Insulinregime nach Pankreatektomie mit denen anderer Diabetesformen zu vergleichen.

Material und Methodik Es wurden Patientencharakteristika und Details der postoperativen Insulintherapie von pankreasoperierten Patienten einer spezialisierten Universitätsklinik für Viszeralchirurgie ausgewertet. Diese Daten wurden mit Kohorten nicht operierter Patienten mit Typ-1-Diabetes (T1DM; absoluter Insulinmangel) bzw. Typ-2-Diabetes (T2DM; Insulinresistenz und relativer Insulinmangel), jeweils unter Insulintherapie, verglichen. Ergänzt wurde diese Datenanalyse durch eine Literaturrecherche zu den Stichworten „pancreatogenic diabetes“, „type 3c diabetes“ und „pancreatectomy diabetes“.

Ergebnisse Daten von 32 (68,8 % Frauenanteil) bzw. 41 (43,9 % Frauenanteil) Patienten nach totaler bzw. partieller Pankreatektomie wurden analysiert. Vor der totalen Pankreatektomie hatten 56,3 % der Patienten einen Diabetes mellitus, postoperativ bestand bei allen Patienten eine Insulinpflichtigkeit. Dabei waren die Insulindosierungen im Vergleich mit Patienten mit T1DM (unter intensivierter Insulintherapie) signifikant niedriger (p < 0,0001). Die Dosierungen von Basal- (48,6 % weniger) und Mahlzeiteninsulin (38,1 % weniger) waren gleichermaßen betroffen. Eine partielle Pankreatektomie führte deutlich seltener zu einem Diabetes mellitus, und eine Insulintherapie war nur bei 26,8 % der Patienten erforderlich.

Diskussion Der basale und prandiale Insulinbedarf nach Pankreatektomie ist niedriger als bei einem T1DM und einem T2DM. Dies sollte bei der Blutzuckereinstellung nach Pankreatektomie berücksichtigt werden.
Hyperurikämie, Gicht und Herz – eine kritische Diskussion im Licht der aktuellen Literatur
Authors: Christoph Marian , Schön Steffen , Wunderlich Carsten
Published: February 2021

Zahlreiche Untersuchungen zeigen, dass Patienten mit Hyperurikämie und insbesondere mit symptomatischer Hyperurikämie, einer Gicht, kardiovaskuläre Risikopatienten sind. Bei symptomatischer Hyperurikämie sollte nach aktuellen Leitlinien eine harnsäuresenkende Therapie mit Zielwert-Erreichung eingeleitet werden. Darüber hinaus sind die Diagnose und optimale Therapie der klassischen kardiovaskulären Risikofaktoren von besonderer Bedeutung.
Endovascular Treatment in the Subclavian Steal Syndrome: Series of 29 Patients
Authors: Gatto Luana Antunes Maranha , Seabra Diego do Monte Rodrigues , Zenatti Gabriel Angelo Garute , Frose Letícia , Koppe Gelson Luis , Demartini Zeferino
Published: February 2021

Subclavian steal syndrome is a group of symptoms resulting from retrograde flow in the vertebral artery, “stealing” blood from the posterior intracranial circulation and other territories, caused by stenosis or occlusion of the subclavian artery proximal to the origin of the same vertebral artery, or even of the brachiocephalic trunk. Most of the time, it is an incidental finding in patients with other conditions or cerebrovascular risk factors. We report a series of 29 patients with an angiographic diagnosis, in which 7 received treatment (all endovascular), all with symptoms directly related to this condition. Advanced age, systemic arterial hypertension, diabetes mellitus, smoking and stroke were comorbidities frequently related. Six patients improved completely after the procedure and one remained with vertigo.
Pedicle Subtraction Osteotomy for Deformity Correction in the Upper Cervical Spine: A Technical Note
Authors: Al Barim Bilal , Müther Michael , Schipmann Stephanie , Stummer Walter , Schwake Michael
Published: February 2021

Background Kyphosis is the most common deformity of the cervical spine leading to development of severe disabilities. In case of fused kyphosis, surgical treatment can be demanding and often requires multiple-step procedures for adequate correction. We present a technique of single-stage pedicle subtraction osteotomy (PSO) of C3 to treat a patient with fused kyphosis of C2 and C3 causing spinal stenosis with subsequent myelopathy.

Methods A 53-year-old man presented with progressive myelopathy not able to walk with 6/18 points on the modified Japanese Orthopedic Association scale. Horizontal gaze was lost due to cervical kyphosis. Magnetic resonance imaging (MRI) revealed a cervical kyphosis causing stenosis, cord compression, and kinking; computed tomography (CT) showed substantial anterior and posterior fusion of C2 and C3.

Results Surgery included decompression via laminectomy of C2 to C6 in combination with PSO of C3 and additional dorsal instrumentation of C2 to C6. Cervical spinal alignment was corrected, as the C2–C4 Cobb angle was reduced from 48.9 to 20.6 degrees. Horizontal gaze was restored. Postoperative MRI demonstrated full decompression of the cord without kinking of the vertebral arteries. No complications were noted. The patient recovered well with restoration of his ability to walk.

Conclusion Single-stage pedicle subtraction closing wedge osteotomy in the upper cervical spine, although a demanding surgical procedure, is an alternative treatment option in selected cases of fused and severe cervical kyphosis. In contrast to multiple-step approaches, the single-stage procedure could reduce operating time and may thus decrease complications.
Predictors of Intraoperative Aneurysm Rupture, Aneurysm Remnant, and Brain Ischemia following Microsurgical Clipping of Intracranial Aneurysms: Single-Center, Retrospective Cohort Study
Authors: Świątnicki Wojciech , Szymański Jarosław , Szymańska Anna , Komuński Piotr
Published: February 2021

Background and Study Aims Complete microsurgical clip occlusion of an aneurysm is one of the most important challenges in cerebrovascular surgery. Incorrect position of clip blades as well as intraoperative aneurysm rupture can expose the patient to serious complications such as rebleeding in case of aneurysm remnant and cerebral ischemia in case of occlusion of branching arteries or perforators. The aim of this study was to identify independent predictors of surgery-derived complications (aneurysm remnant and brain ischemia) as well as intraoperative aneurysm rupture in an institutional series of patients.

Material and Methods This is a single-institution, retrospective cohort study including 147 patients with 162 aneurysms that were selected for microsurgical clipping due to intracranial aneurysm in a 5-year period. Bivariate and multivariate analyses were performed to identify independent predictors among demographic, clinical, and radiographic factors.

Results Increasing aneurysm size with a cutoff value at 9 mm (p = 0.009; odds ratio [OR]: 0.644) and irregular dome shape (p = 0.003; OR: 4.242) were independently associated with brain ischemia and aneurysm remnants that occurred in 13.6 and 17.3% of patients in our group, respectively. Intraoperative rupture was encountered in 27% of patients and its predictors were patient's age (p = 0.002; OR: 1.073) and increasing aneurysm size with a cutoff value at 7 mm (p = 0.003; OR: 1.205).

Conclusion Aneurysm size, patient's age, and irregular dome shape were the most important risk factors of aneurysm remnant, brain ischemia, and intraoperative aneurysm rupture in our series of patients. We were not able to define a cutoff value for patient's age, but our results showed that with increasing age the risk of intraoperative aneurysm rupture increased.
Distribution of Underlying Causative Organisms, Patient Age, and Survival in Spontaneous spondylodiscitis with Special Focus on Elderly Patients
Authors: Lackermair Stephan , Egermann Hannes , Müller Adolf
Published: February 2021

Background and Objective spondylodiscitis is becoming a more frequently encountered diagnosis in our clinical practice. Multimorbid and especially older patients build up a relevant portion of cases. The goal of our study was to evaluate our clinical data and to reveal specifics concerning elderly patients with spontaneous spondylodiscitis.

Patients and Methods We retrospectively analyzed clinical data for the years from 2012 to 2014. The search was conducted on the basis of the International Classification of Diseases, 10th Revision (ICD-10) diagnoses for spondylodiscitis. Postoperative infections were not included in this study. All cases were evaluated in terms of infectious agents (in blood culture and/or computerized tomography [CT]-guided or surgical biopsy), age, and overall survival.

Results Fifty-one patients with spontaneous spondylodiscitis were identified. The most frequent pathogen was methicillin-sensitive Staphylococcus aureus (MSSA; n = 21; 41.17%). Escherichia coli and S. epidermidis were each found in four patients each (7.84%). Methicillin-resistant S. aureus (MRSA), Pseudomonas aeruginosa, and S. hominis were found in three cases (5.88%). Other bacteria were found in one case (each 1.96 %). In 12 cases, there was no bacteria growth (23.53%). One of these patients revealed to have a tuberculosis infection, diagnosed after the study period (in 2015). Two-thirds of the patients were ≥65 years old (n = 34). All three patients with MRSA were >65 years old. Three of seven patients <50 years had IV drug abuse (42.86%). In these patients, rather rare infectious agents for spondylodiscitis were found (P. aeruginosa, S. hominis, Citrobacter). Mortality was 7.84% (n = 4). All of these patients were ≥67 years old, three of four (75%) were ≥75 years old.

Conclusion Our study of spontaneous spondylodiscitis showed a stronger representation of older patients (>65 years). Lethal outcome exclusively concerned the older age group. S. aureus was the most frequent pathogen as shown previously. MRSA infections might be more common in the older age group. Rare causative organisms mainly occurred in patients with iv drug abuse. Further evaluation through randomized multicenter studies focusing on the different subgroups and comorbidities in larger populations and correlation with appropriate treatment options is necessary.
A Supplemental Technique for Preoperative Evaluation of Giant Intracranial Aneurysm
Authors: Wang Hua-wei , Wu Chen , Xue Zhe , Shu Xu-jun , Sun Zheng-hui
Published: February 2021

Background Preoperative planning mainly relies on digital subtraction angiography (DSA) and computed tomography angiography. However, neither technique can reveal thrombi in giant intracranial aneurysms (GIAs). In this study, we aimed to reconstruct the circulating and noncirculating parts of GIAs with the time-of-flight (TOF) and motion-sensitized driven-equilibrium (MSDE) sequences with 3D Slicer to reveal an integrated presentation of GIAs, compare its accuracy, and validate the usefulness for preoperative planning.

Material and Methods Patients with GIAs who were treated with microsurgery in our department were included in this study. Both the TOF and MSDE sequence data for each patient were loaded into 3D Slicer for reconstruction and segmentation. The parameters measured by 3D Slicer were compared with those measured by DSA.

Results The mean diameter for all GIAs was 28.7 ± 1.5 mm (range, 25.9–31.9 mm). The mean diameter for all GIAs measured by DSA and 3D Slicer was 24.46 ± 5.25 and 28.66 ± 1.48 mm, respectively (t = 4.948, p < 0.01). When only the nonthrombotic GIAs were included, the mean diameter measured by DSA and 3D Slicer was 28.69 ± 2.03 and 28.97 ± 1.79 mm, respectively (t = 1.023, p = 0.323). The mean aneurysmal volume was 8,292.6 ± 1,175.1 mm3 and the mean thrombotic volume was 3,590.0 ± 1,003.7 mm3.

Conclusion The MSDE sequence brings diagnostic benefits as a comparison to other MRI sequences. Reconstruction of GIAs with 3D Slicer is a low-cost, dependable, and useful supplemental technique for surgical planning.
Expectant Management of Severe COVID-19 Pneumonia in Late Preterm Pregnancy and Subsequent Cholecystitis: Lessons Learned
Authors: Mokhtari Neggin B. , Drassinower Daphnie , Orr Lindsey A. , Cobb Nathan K. , Mims Oscar L. , Landy Helain J.
Published: February 2021

Introduction Since the emergence of coronavirus disease 2019 (COVID-19) as a pandemic in March 2020, research and guidance have been published with regard to the management of infection and considerations in pregnancy, but much is still unknown. Pregnant women with COVID-19 infection are more likely to be hospitalized and are at increased risk for intensive care unit admissions and intubation than nonpregnant women with COVID-19 infection. The optimal timing of delivery among pregnant women with COVID-19 infection has not been established at this time, especially when the infection arises in late preterm and early term gestation. It is suggested that COVID-19 infection should not be considered a sole indication for delivery. The risks and benefits of prolonging pregnancy versus delivery should be taken into consideration at any given gestational age in a patient with COVID-19 infection.

Case Report We report a case of a patient in the late third trimester of pregnancy that presented with severe COVID-19 infection and was managed expectantly through her disease course with improvement of respiratory status without necessitating delivery. We also discuss the unique development of cholecystitis in her hospitalization that may represent another clinical association to COVID-19 infection.

Conclusion This case illustrates that delaying delivery is an option even in later gestational ages for maternal stabilization. A multidisciplinary approach and teamwork is needed to manage pregnant women with COVID-19 infection for optimal outcomes for both mother and fetus.

Key Points
A Brief Review of Brain's Blood Flow–Metabolism Coupling and Pressure Autoregulation
Authors: Papasilekas Themistoklis , Themistoklis Konstantinos Michail , Melanis Konstantinos , Patrikelis Panayiotis , Spartalis Eleftherios , Korfias Stefanos , Sakas Damianos
Published: February 2021

Background The human brain, depending on aerobic glycolysis to cover its metabolic needs and having no energy reserves whatsoever, relies on a constant and closely regulated blood supply to maintain its structural and functional integrity. Cerebral autoregulation, that is, the brain's intrinsic ability to regulate its own blood flow independently from the systemic blood pressure and cardiac output, is an important physiological mechanism that offers protection from hypoperfusion injury.

Discussion Two major independent mechanisms are known to be involved in cerebral autoregulation: (1) flow–metabolism coupling and (2) myogenic responses of cerebral blood vessels to changes in transmural/arterial pressure. A third, less prominent component of cerebral autoregulation comes in the form of neurogenic influences on cerebral vasculature.

Conclusion Although fragmentation of cerebral autoregulation in separate and distinct from each other mechanisms is somewhat arbitrary, such a scheme is useful for reasons of simplification and to better understand their overall effect. Comprehension of cerebral autoregulation is imperative for clinicians in order for them to mitigate consequences of its impairment in the context of traumatic brain injury, subarachnoid hemorrhage, stroke, or other pathological conditions.
Double-Bundle Posterior Cruciate Ligament Reconstruction
Authors: Stannard James P. , Temperato Joseph , Stannard James T.
Published: February 2021

The optimal surgical technique for posterior cruciate ligament (PCL) reconstruction is a topic of debate among knee surgeons. There are many variables to consider including graft selection, graft fixation method, and single- versus double-bundle reconstruction. While there is a need for ongoing research to elucidate which technique yields the best results, this article discusses recent literature on the topic of single- versus double-bundle PCL reconstruction as well as the senior author's preferred reconstruction method.
Lumbar Puncture Opening Pressure in Patients with Spinal Muscular Atrophy
Authors: Becker Lena-Luise , Weiß Claudia , Tietze Anna , Martiny Viktoria , Kaindl Angela M.
Published: February 2021

The announcement of a hydrocephalus as a possible side effect in patients with spinal muscular atrophy (SMA) receiving the drug nusinersen, promoted major concern and warrants further evaluation. In this retrospective monocentric study, we analyzed clinical data, lumbar puncture opening pressure (LOP) measurement, and ophthalmologic and neuroimaging results in 34 patients with SMA types 1 to 3 undergoing treatment with nusinersen. None of the patients reported symptoms indicative of increased intracranial pressure. In our cohort, the LOP was >20 cm H2O in 25 patients (70.5%), and within this group ≥28 cm H2O in 12 patients (35.3%), in two patients, it was increased prior to treatment initiation. Signs of increased intracranial pressure in ophthalmological assessments or brain imaging were only seen in one patient. We did not identify a correlation between increased LOP and SMA type, scoliosis, or age of the patients; however, it was slightly higher in patients receiving sedation. Our results raise the question whether the LOP is generally increased in SMA as part of the underlying disease, if so, what the etiology is, and whether the increased LOP needs to be treated.
Transtibial Posterior Cruciate Ligament Reconstruction
Authors: Fanelli Gregory C.
Published: February 2021

The keys to successful posterior cruciate ligament (PCL) reconstruction are to identify and treat all pathology, utilize strong graft material, accurately place tunnels in anatomic insertion sites, minimize graft bending, mechanical graft tensioning, secure graft fixation, and the appropriate postoperative rehabilitation program. Adherence to these technical principles results in successful single- and double-bundle arthroscopic transtibial tunnel PCL reconstruction based upon stress radiography, arthrometer, knee ligament rating scales, and patient satisfaction measurements. The purpose of this manuscript is to describe the arthroscopic transtibial tunnel posterior cruciate ligament reconstruction surgical technique.
TSC1 as a Novel Gene for Sleep-Related Hypermotor Epilepsy: A Child with a Mild Phenotype of Tuberous Sclerosis
Authors: Mastrangelo Mario , Commone Chiara , Greco Carlo , Leuzzi Vincenzo
Published: February 2021

Sleep-related hypermotor epilepsy (SHE) is a rare syndrome that presents with hyperkinetic asymmetric tonic/dystonic seizures with vegetative signs, vocalization, and emotional facial expression, mainly during light non-rapid eye movement sleep stages. The role of various genes (CHRNA4, CHRNB2, CHRNA2, KCNT1, DEPDC5, NPRL2, NPRL3, and PRIMA1) has previously been reported, though genetic etiology is assessed in less than 10% of cases. We report the case of a 5-year-old female carrying the TSC1 variant c.843del p.(Ser282Glnfs*36) who presented with a mild phenotype of tuberous sclerosis, including carbamazepine-responsive SHE, normal neurocognitive functioning, hypomelanotic macules, no abnormalities outside the central nervous system, and tubers at neuroimaging. The presented case extends the list of SHE-related genes to include TSC1, thus suggesting a central pathogenic role of mammalian target of rapamycin (mTOR) cascade dysfunction in SHE and introducing a possible use of mTOR inhibitors in this epileptic syndrome.
Scalp and Forehead Injury: Management of Acute and Secondary Defects
Authors: Namin Arya W. , Tassone Patrick T. , Galloway Tabitha L.I. , Renner Gregory J. , Chang C.W. David
Published: February 2021

The primary challenges in scalp reconstruction are the relative inelasticity of native scalp tissue and the convex shape of the calvarium. All rungs of the reconstructive ladder can be applied to scalp reconstruction, albeit in a nuanced fashion due to the unique anatomy and vascular supply to the scalp. Important defect variables to incorporate into the reconstructive decision include site, potential hairline distortion, size, depth, concomitant infection, prior radiation therapy, planned adjuvant therapy, medical comorbidities, patient desires, and potential calvarium and dura defects.
Clinical Analysis of En Bloc Resection for Advanced Temporal Bone Squamous Cell Carcinoma
Authors: Komune Noritaka , Kuga Daisuke , Matsuo Satoshi , Miyazaki Masaru , Noda Teppei , Sato Kuniaki , Hongo Takahiro , Koike Kensuke , Uchi Ryutaro , Kogo Ryunosuke , Tsuchihashi Nana Akagi , Masuda Shogo , Nakagawa Takashi
Published: February 2021

Objective En bloc and margin-negative surgical resection seems to offer the best prognosis for patients with temporal bone squamous cell carcinoma (TB-SCC). In this study, we summarize the outcomes of surgical cases of advanced TB-SCC (T3–T4) that were managed in two institutions, with an accompanying description of the surgical procedure that was utilized: modified subtotal temporal bone resection (STBR), which involves the en bloc removal of the temporal bone including or transecting the otic capsule.

Design This is a case series study with chart review.

Setting The study was conducted at two academic tertiary care medical centers.

Participants Chart information was collected for all patients who underwent surgical resection of advanced TB-SCC between July 1998 and February 2019. The resulting dataset contained 43 patients with advanced TB-SCC who underwent en bloc resection during the review period. Tumor staging followed the modified Pittsburgh classification. Disease-specific survival (DSS) rates were calculated according to the Kaplan–Meier method.

Main Outcome Measure This study shows disease-specific 5-year DSS rate.

Results The 5-year DSS rate of the cases who underwent en bloc resection was 79.7%. En bloc lateral temporal bone resection was employed in a total of 25 cases (DSS: 79.0%). En bloc modified STBR was utilized in 18 cases (DSS: 81.7%).

Conclusion En bloc margin-negative resection is a reliable treatment strategy for advanced TB-SCC. Modified STBR can be a treatment option for TB-SCC without marked posterior extension.
Repair of Bronchial Anastomosis Following Lung Transplantation
Authors: Chamogeorgakis Themistokles , Moquin Kenneth , Simoff Michael , Nemeh Hassan
Published: February 2021

Background Bronchial anastomotic complications are reported in 2 to 18% of patients after lung transplantation. The majority of complications can be managed with bronchoscopic intervention. When extensive dehiscence is present, surgical intervention can be entertained.

Materials and Methods Between March 1, 2006, and December 31, 2019, our program performed 244 lung transplantations. We conducted a retrospective review of our patient cohort and identified patients who suffered from significant anastomotic complications that required surgical interventions.

Results Twenty-eight and 216 patients underwent single and bilateral lung transplantations, respectively. Eighteen patients developed airway complications (7.4%). The incidence of anastomotic complications was 5.2% (24 complications for a total of 460 bronchial anastomoses). Four patients were managed conservatively. The majority of the bronchial anastomotic complications were managed endoscopically (eight patients). Four patients with associated massive air leak underwent repair of the bronchial anastomosis and two patients were retransplanted because they developed severe distal airway stenosis.

Conclusion Bronchial anastomotic complications are a major cause of morbidity in lung transplantation. The majority of cases can be managed bronchoscopically. In more severe cases associated with massive air leak or imminent massive hemoptysis from bronchopulmonary arterial fistula, surgical intervention is necessary. Aortic homograft interposition along with vascularized pedicle wrapping may be a viable option to re-establish airway continuity when tension-free bronchial anastomotic revision is not possible. In cases with smaller bronchial defects, primary repair with utilization of a vascularized flap can be effective as treatment option.
Clinical Phenotype in an Early-Onset French Pediatric Population: Charcot–Marie–Tooth's Disease Type 2A
Authors: Majorel-Beraud C. , Baudou E. , Walther-Louvier U. , Espil-Taris C. , Beze-Beyrie P. , Cintas P. , Rivier F. , Cances C.
Published: February 2021

Charcot–Marie–Tooth's disease type 2A (MCT2A), induced by mutation of the mitofusin 2 (MFN2) gene represents the main cause of MCT2. The aim of this study is to provide details of the clinical and electromyographic phenotype of MCT2A in a pediatric population. We conducted a French multicenter retrospective study, including all children with a genetic diagnosis of MCT2A. Thirteen MCT2A children were included with a beginning of symptoms before the age of 10 years (“early-onset group”). We report two new mutations: c.1070 A → T (p.Lys357.Met) and c.280 C → G (p.Arg94Gly). The evolution of the disease is marked by a fast worsening for three patients with loss of motor autonomy, while the evolution is relatively stable for eight patients. The group of early-onset MCT2A seems more heterogeneous than previously described, with a nonconstant severe phenotype.
Magnetic Resonance Imaging and Cone Beam CT Image Registration for Osseous and Soft Tissue Abnormalities of Temporomandibular Joint: A Systematic Review
Authors: Nagi Ravleen , Nagaraju Rakesh , Naidu Giridhar S. , Reddy Prashanthi , Bibra Ajay , Makkad Ramanpal Singh
Published: February 2021

Introduction Proper diagnosis of temporomandibular disorders (TMDs) is paramount for proper management. Cone beam computed tomography (CBCT) provides additional information about osseous components of TMJ, but diagnosis of soft tissue abnormalities is still a challenging issue for the clinicians. To overcome this, magnetic resonance imaging (MRI) and CBCT registration has shown to be a new promising technique that combines key features of both images into one single fusion image. The purpose of this systematic review was to compile available literature regarding the usefulness of CBCT and MRI-CBCT fusion imaging in proper diagnosis of temporomandibular joint (TMJ) abnormalities.

Materials and Methods Computerized literature search from January 2010 to 2020 using five databases: PubMed (MEDLINE) database (National Library of Medicine, NCBI), Cochrane Database, Scopus, Embase, and Science Direct was conducted by use of medical specific headings (MeSH) keywords.

Results Only 10 articles met the inclusion criteria. Eight articles showed that CBCT accurately detected osseous components of TMJ but has low reliability in diagnosing soft tissue articular disc disorders. Relationship between hard and soft tissues were clearly visualized in fused images.

Conclusion MRI-CBCT image registration is a reliable diagnostic tool for simultaneous evaluation of osseous and soft tissue abnormalities of TMJ and in future more studies should be encouraged to validate its accuracy for TMJ analysis.
Etiological and Clinical Profile of Acute Nonbacterial Encephalitis in Children: A Single-Center Prospective Study
Authors: Cengiz Ali Bülent , Günbey Ceren , Ceyhan Mehmet , Korukluoğlu Gülay , Tanır Başaranoğlu Sevgen , Eroğlu Ertuğrul Nesibe Gevher , Coşgun Yasemin , Konuşkan Bahadır , Özsürekci Yasemin , Anlar Banu
Published: February 2021

Encephalitis is a serious neurological syndrome caused by inflammation of the brain. The diagnosis can be challenging and etiology remains unidentified in about half of the pediatric cases. We aimed to investigate demographic, clinical, laboratory, electroencephalographic and neuroimaging findings, and outcome of acute encephalitis of nonbacterial etiology. This prospective study included children hospitalized with the diagnosis of acute encephalitis between 2017 and 2019. Microbiological investigations of the cerebrospinal fluid (CSF) were recorded. All CSF specimens were tested for anti-N methyl D-aspartate receptor (NMDAR) antibodies. In total, 31 children aged 10 months to 17 years (median = 6 years) were included. Pathogens were confirmed in CSF in three patients (9.7%): varicella zoster virus, herpes simplex virus type 1 (HSV-1), and both HSV-1 and NMDAR antibodies. Presenting features included encephalopathy (100%), fever (80.6%), seizure (45.2%), focal neurological signs (29%), and ataxia (19.4%). On clinical follow-up of median 9 (6–24) months, six patients showed neurological deficits: together with two patients who died in hospital, total eight (25.8%) patients were considered to have unfavorable outcome. Need for intubation, receiving immunomodulatory treatment, prolonged hospitalization, and high erythrocyte sedimentation rate at admission were associated with unfavorable outcome. The etiology of encephalitis remains unexplained in the majority of children. HSV-1 is the most frequently detected virus, consistent with the literature. The fact that anti-NMDAR encephalitis was detected in one child suggests autoimmune encephalitis not being rare in our center. The outcome is favorable in the majority while about one-fifth of cases suffer from sequelae.
a-axis YBa2Cu3O7−x/PrBa2Cu3O7−x/YBa2Cu3O7−x trilayers with subnanometer rms roughness
Authors: Suyolcu Y. Eren , Sun Jiaxin , Goodge Berit H. , Park Jisung , Schubert Jürgen , Kourkoutis Lena F. , Schlom Darrell G.
Published: February 2021

We demonstrate a-axis YBa2Cu3O7−x/PrBa2Cu3O7−x/YBa2Cu3O7−x trilayers grown on (100) LaAlO3 substrates with improved interface smoothness. The trilayers are synthesized by ozone-assisted molecular-beam epitaxy. The thickness of the PrBa2Cu3O7−x layer is held constant at 8 nm, and the thickness of the YBa2Cu3O7−x layers is varied from 24 nm to 100 nm. X-ray diffraction measurements show all trilayers to have >97% a-axis content. The rms roughness of the thinnest trilayer is <0.7 nm, and this roughness increases with the thickness of the YBa2Cu3O7−x layers. The thickness of the YBa2Cu3O7−x layers also affects the transport properties: while all samples exhibit an onset of the superconducting transition at and above 85 K, the thinner samples show wider transition widths, ΔTc. High-resolution scanning transmission electron microscopy reveals coherent and chemically sharp interfaces and that growth begins with a cubic (Y,Ba)CuO3−x perovskite phase that transforms into a-axis oriented YBa2Cu3O7−x as the substrate temperature is ramped up.
The pulsatile flow of thermally developed non-Newtonian Casson fluid in a channel with constricted walls
Authors: Bukhari Zainab , Ali Amjad , Abbas Zaheer , Farooq Hamayun
Published: February 2021

This article presents a numerical investigation of the pulsatile flow of non-Newtonian Casson fluid through a rectangular channel with symmetrical local constriction on the walls. The objective is to study the heat transfer characteristics of the said fluid flow under an applied magnetic field and thermal radiation. Such a study may find its application in devising treatments for stenosis in blood arteries, designing biomechanical devices, and controlling industrial processes with flow pulsation. Using the finite difference approach, the mathematical model is solved and is converted into the vorticity-stream function form. The impacts of the Hartman number, Strouhal number, Casson fluid parameter, porosity parameter, Prandtl number, and thermal radiation parameter on the flow profiles are argued. The effects on the axial velocity and temperature profiles are observed and argued. Some plots of the streamlines, vorticity, and temperature distribution are also shown. On increasing the values of the magnetic field parameter, the axial flow velocity increases, whereas the temperature decreases. The flow profiles for the Casson fluid parameter have a similar trend, and the profiles for the porosity parameter have an opposite trend to the flow profiles for the magnetic field parameter. The temperature decreases with an increase in the Prandtl number. The temperature increases with an increase in the thermal radiation parameter. The profile patterns are not perfectly uniform downstream of the constriction.
Effect of Schottky barrier height lowering on resistance degradation of Fe-doped SrTiO3 thin-film capacitor
Authors: Xue Feng
Published: February 2021

It is generally believed that the resistance degradation behavior of bulk and thin-film oxide capacitors arises from the oxygen vacancy migration within the oxide and/or the charge injection at the oxide/electrode interface. The magnitude of the degradation in the resistance has been theoretically studied in the literature by solving the electrochemical transport equations while assuming constant Schottky barrier height. The treatment of constant Schottky barrier height in existing models has led to significant underestimation of the resistance degradation. In this work, I incorporated the dependence of Schottky barrier height on the oxygen vacancy concentration at the interface into the existing model to simulate the degradation process in thin-film oxide capacitors. With the consideration of Schottky barrier height lowering from the interface dipole arising from the accumulation of oxygen vacancies at the cathode interface, I found that the leakage current can be increased by more than one order of magnitude, which is more consistent with experimental observations in comparison to the prediction from existing models.
Lupus manifestations in children with primary immunodeficiency diseases: Comprehensive phenotypic and genetic features and outcome
Authors: Al-Mayouf Sulaiman M , Alreefi Hajar A , Alsinan Tuqa A , AlSalmi Ghada , AlRowais Abdulaziz , Al-Herz Waleed , Alazami Anas M , Alsonbul Abdullah , Al-Mousa Hamoud
Published: February 2021

Objectives

To report the phenotypic, genetic findings and outcome of children with lupus manifestations associated with primary immunodeficiency diseases (PIDs).

Methods

Data are retrospectively collected on patients with lupus manifestations and PIDs seen between 1998 and 2019. Data comprised the clinical findings and genetic testing, the response to treatment and the accrual damage related to SLE.

Results

A total of 39 patients (22 female) were reviewed. Thirty-four patients had lupus manifestations and six patients with SLE-like manifestations. Genetic analysis was performed in 25 patients. Complement deficiency was the most frequent PIDs; 26 patients were C1q deficient, three patients had C3 deficiency, two patients had C4 deficiency and one patient with heterozygous C8b variant. The other seven patients had different PIDs genetic defects that include SCID caused by PNP deficiency, CGD, CVID (PIK3CD), IL-2RB mutation, DNase II deficiency, STAT1 mutation, ISG15 mutation and Griscelli syndrome type 3. Mucocutaneous lesions, arthritis and lung involvement were the main clinical features. 84.1% experienced recurrent infections. The mean accrual damage was 2.7 ± 2.2. There were five deaths because of infection.

Conclusion

This study suggests that patients with lupus manifestations and early onset disease, family history of SLE or recurrent infections should undergo immunological work-up and genetic testing to rule out PIDs.
Treatment practices and costs among patients with psoriatic arthritis: A Japanese hospital claims database analysis
Authors: Inui Kentaro , Sato Masayo , Esterberg Elizabeth , Parikh Rohan C , Kimura Shuichi , Torisu-Itakura Hitoe
Published: February 2021

Objective

Assess patient characteristics, real-world treatment patterns, and health care resource utilization (HCRU) among patients with psoriatic arthritis (PsA) in Japan.

Methods

Patients diagnosed with PsA from April 2009 through July 2017 were identified from the Medical Data Vision database. Patient characteristics, treatment patterns, and HCRU were evaluated for these patients.

Results

A total of 639 patients met inclusion criteria and were included in the analysis for patients with a PsA diagnosis. Over 12 months following diagnosis, patients received oral NSAIDs (61.7%), conventional synthetic disease-modifying antirheumatic drugs (DMARDs) (55.1%), corticosteroids (35.1%), topical NSAIDs (34.0%), adalimumab (14.7%), infliximab (9.7%), secukinumab (5.0%), ustekinumab (4.5%), ixekizumab (1.6%), and golimumab (1.6%). A total of 227 (35.5%) patients initiated biologic DMARDs (bDMARDs) over the median 25.2 months of study follow-up. Compared with the overall group of patients diagnosed with PsA, patients who initiated bDMARDs had higher median total per-patient health care costs ($27,772 vs. $11,316), lower median per-patient hospitalization costs ($31,164 vs. $39,359), and fewer median hospital days per admission (8.0 vs. 12.0 days).

Conclusion

This study presents knowledge of the current state of patient characteristics, treatment patterns, HCRU, and costs among patients with PsA in Japan. Considering the relatively recent guideline recommendations, the preliminary treatment patterns suggest physicians may be following treatment guidelines.
Examining the Influence of Mental Health on Self-Stigma in a Mexican Prison
Authors: Pérez-Ramírez Berenice , Barthelemy Juan J. , Gearing Robin E. , Olson Lindamarie , Giraldo-Santiago Natalia , Torres Luis R.
Published: February 2021

Prisons in Mexico, like other countries, struggle to house and effectively treat individuals with mental illness. This study on 194 male Mexican prisoners managing mental disorders aims to 1) explore what mental health symptomology is associated with self-stigma and 2) identify what mental health symptomology predicts increased self-stigma. Results found that depression, mania, and anger significantly predicted harm to self-esteem scores, and education and mania significantly predicted agreement and application subscales. Given the increased number of imprisoned individuals with mental illness in Mexico and minimal treatment available, these findings support the importance of implementing self-stigma interventions within prisons.
Deterministic force-free resonant activation
Authors: Capała Karol , Dybiec Bartłomiej
Published: February 2021

The combined action of noise and deterministic force in dynamical systems can induce resonant effects. Here, we demonstrate a minimal, deterministic force-free setup allowing for the occurrence of resonant, noise-induced effects. We show that in the archetypal problem of escape from finite intervals driven by α-stale noise with a periodically modulated stability index, depending on the initial direction of the modulation, resonant-activation-like or noise-enhanced-stability-like phenomena can be observed. Consequently, in comparison to traditional Lévy flights, Lévy flights with a time-dependent jump length exponent are capable of facilitating or slowing down the escape from finite intervals in an analogous way, such as the modulation of the potential in the resonant activation setup.