bluuebunny/crossref_metadata_2025 huggingface dataset:
„Ich finde, das ist halt in vielen Punkten im Leben
wichtig“ – Subjektive Vorstellungen junger Erwachsener von
Teilhabe
Authors: Cytera Chirine , Thyen Ute
Published: May 2021

Ziel Die Studie untersucht die subjektiven Vorstellungen junger
Erwachsener von Teilhabe. Im Fokus stehen dabei deren Verständnis von
Teilhabe sowie Lebensbereiche, in denen diese von der Zielgruppe als bedeutsam
erlebt wird.

Methodik In leitfadengestützten Gruppeninterviews (N=6)
wurden 20 junge Erwachsene mit und ohne Beeinträchtigung zu ihren
Vorstellungen von Teilhabe befragt. Um auch schwerer beeinträchtigte
Personen indirekt einzuschließen, wurden zusätzlich deren
Stellvertreter in Einzelinterviews (N=3) befragt. Das Material wurde
mittels qualitativer Inhaltsanalyse nach Mayring ausgewertet.

Ergebnisse Teilhabe wird vielseitig und individuell unterschiedlich
verstanden. Sechs Aspekte einer Begriffsbestimmung konnten ermittelt werden:
Miteinander; soziale Einbindung/Teilnahme an der Gesellschaft;
Aufgeschlossenheit/Unvoreingenommenheit/Interesse; gleiche
Möglichkeiten/ Gleichbehandlung;
Entscheidungsfreiheit/Autonomie; Mitbestimmung/Mitsprache.
Teilhabe ist für die Befragten in sieben Lebensbereichen bedeutsam:
soziales Umfeld; Arbeit/Bildung; Freizeit; Medien; Mobilität;
Politik; Finanzen/Selbstverwaltung.

Schlussfolgerung In den komplexen Vorstellungen junger Erwachsener von
Teilhabe sind insbesondere soziale Aspekte sowie Gleichberechtigung und
Selbstbestimmung von Bedeutung. Teilhabe im Bereich Sexualität und neue
Medien wird ein entscheidender Wert beigemessen, weshalb diese vermehrt
Beachtung finden sollten. Die Lebensbereiche, in denen Teilhabe als relevant
beschrieben wird, können je nach Interessen des Individuums variieren,
was auf den subjektiven Charakter des Konzeptes hinweist und die Bedeutsamkeit
aufzeigt, die jeweiligen Vorstellungen und Präferenzen einer Person oder
Personengruppe zu berücksichtigen.
Prognostische Einflussfaktoren auf den Erfolg der Sialendoskopie bei Sialolithiasis
Authors: Giotakis Aris I , Fischlechner Rene , Dejaco Daniel , Gottfried Timo , Riechelmann Herbert
Published: May 2021

Hintergrund Der Erfolg der Sialendoskopie hängt von mehreren Faktoren ab. Im Jahr 2008 wurde die Lithiasis-Stenosis-Dilatation (LSD) -Klassifikation zur genaueren Beschreibung des Stein-Gang-Verhältnisses eingeführt. Neben dem Nutzen der LSD-Klassifikation untersuchten wir weitere prä- und intraoperativ erhobene Einflussfaktoren auf den Erfolg der Sialendoskopie bei Sialolithiasis.

Methode PatientInnen mit Sialolithiasis der Glandula submandibularis und Glandula parotis, die zwischen September 2018 und März 2020 eine primäre Sialendoskopie erhielten, wurden retrospektiv untersucht. Die Steingröße, Steinlokalisation und LSD-Klassifikation wurden unter anderem als prognostische Einflussfaktoren untersucht.

Ergebnisse Insgesamt wurden 37 PatientInnen retrospektiv untersucht. Eine erfolgreiche Steinextraktion wurde bei 12/37 (32 %) PatientInnen durchgeführt. Bei Erfolg betrug die mediane Steingröße 3,7 mm, verglichen mit 10 mm bei Misserfolg (Mann-Whitney-Test; p < 0,0001). Bei Erfolg waren 11/12 Steine distal lokalisiert, verglichen mit 13/25 proximal lokalisierten Steinen bei Misserfolg (Pearson-Chi-Quadrat-Test; p = 0,010). Bei Erfolg wurden 10/12 Steine als L1S0D0 klassifiziert, während 15/25 bei Misserfolg als L3aS0D0-Steine klassifiziert wurden (Pearson-Chi-Quadrat-Test; p = 0,001). Für distal lokalisierte Steine, die kleiner als 5 mm waren, lag die Erfolgsrate bei 100 %. Für proximal lokalisierte Steine, die größer als 4 mm waren, lag die Erfolgsrate bei 0 %. Für die als L1S0D0 klassifizierten Steine betrug die Erfolgsrate 60–100 %.

Schlussfolgerung Distal lokalisierte Steine und Steine kleiner als 5 mm in einem ansonsten unauffälligen Gangsystem können als prognostisch günstige Faktoren angesehen werden. Zukünftige Studien sollten anhand größerer Datenmengen die LSD-Klassifikation, das Volumen der Steine und deren Gangorientierung bzw. deren Abstand von der Papille untersuchen.
Green Aerobic Oxidation of Thiols to Disulfides by Flavin–Iodine Coupled Organocatalysis
Authors: Iida Hiroki , Oka Marina , Kozako Ryo
Published: May 2021

Coupled catalysis using a riboflavin-derived organocatalyst and molecular iodine successfully promoted the aerobic oxidation of thiols to disulfides under metal-free mild conditions. The activation of molecular oxygen occurred smoothly at room temperature through the transfer of electrons from the iodine catalyst to the biomimetic flavin catalyst, forming the basis for a green oxidative synthesis of disulfides from thiols.
Clinical Efficacy of the Multilayered Skull Base Reconstruction Using In Situ Bone Flap in Endoscopic Endonasal Approach for Craniopharyngioma
Authors: Zhou Yuefei , Hei Yue , Soto Jose M. , Jin Tao , Jiang Xiaofan , Feng Dongxia , Liu Weiping , Gao Dakuan
Published: May 2021

Objective The aim of the study is to summarize and analyze the efficacy of the multilayered skull base reconstruction using in situ bone flap in endoscopic endonasal approach (EEA) for craniopharyngiomas.

Methods A retrospective review of 65 patients who underwent resection of their histopathology confirmed craniopharyngiomas performed at a single institution. Based on the team's understanding and mastery of skull base reconstruction techniques, patients were divided into two groups according to the methods of reconstruction in two periods. First (March 2015 through August 2016), osseous reconstruction was not adopted and served as the control group (34 cases). Second (September 2016 through July 2019), in situ bone flap repair of the skull base (complete osseous reconstruction) served as observation group (31 cases). The length of hospitalization and nasal exudation, bed rest time of hospital discharge, the incidence of cerebrospinal fluid leaks, lumbar drainage, and intracranial/pulmonary infections were collected and compared.

Results Compared with the control group, patients in the observation group had obviously less lumbar drainage and CSF leakage (p < 0.05), but had no significant difference in cases of re-operation, meningitis, and pulmonary infection. At the meantime, cases of nasal exudation, bed rest, and hospitalization of the observation group were significantly reduced (p < 0.05) in the observation group.

Conclusion The multilayered reconstruction technique (especially using in situ bone flap, combined with vascularized pedicled nasoseptal flap) is a safe and effective method in achieving watertight closure after EEEA, and can significantly reduce the incidence of cerebrospinal fluid leaks, and facilitate rehabilitation in skull base reconstruction of craniopharyngiomas.
Racial and Ethnic Disparities in Adverse Perinatal Outcomes at Term
Authors: Parchem Jacqueline G. , Rice Madeline Murguia , Grobman William A. , Bailit Jennifer L. , Wapner Ronald J. , Debbink Michelle P. , Thorp Jr John M. , Caritis Steve N. , Prasad Mona , Tita Alan T.N. , Saade George R. , Sorokin Yoram , Rouse Dwight J. , Tolosa Jorge E. ,   for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network
Published: May 2021

Objective This study aimed to evaluate whether racial and ethnic disparities in adverse perinatal outcomes exist at term.

Study Design We performed a secondary analysis of a multicenter observational study of 115,502 pregnant patients and their neonates (2008–2011). Singleton, nonanomalous pregnancies delivered from 37 to 41 weeks were included. Race and ethnicity were abstracted from the medical record and categorized as non-Hispanic White (White; referent), non-Hispanic Black (Black), non-Hispanic Asian (Asian), or Hispanic. The primary outcome was an adverse perinatal composite defined as perinatal death, Apgar score < 4 at 5 minutes, ventilator support, hypoxic–ischemic encephalopathy, subgaleal hemorrhage, skeletal fracture, infant stay greater than maternal stay (by ≥ 3 days), brachial plexus palsy, or facial nerve palsy.

Results Of the 72,117 patients included, 48% were White, 20% Black, 5% Asian, and 26% Hispanic. The unadjusted risk of the primary outcome was highest for neonates of Black patients (3.1%, unadjusted relative risk [uRR] = 1.16, 95% confidence interval [CI]: 1.04–1.30), lowest for neonates of Hispanic patients (2.1%, uRR = 0.80, 95% CI: 0.71–0.89), and no different for neonates of Asian (2.6%), compared with those of White patients (2.7%). In the adjusted model including age, body mass index (BMI), smoking, obstetric history, and high-risk pregnancy, differences in risk for the primary outcome were no longer observed for neonates of Black (adjusted relative risk [aRR] = 1.06, 95% CI: 0.94–1.19) and Hispanic (aRR = 0.92, 95% CI: 0.81–1.04) patients. Adding insurance to the model lowered the risk for both groups (aRR = 0.85, 95% CI: 0.75–0.96 for Black; aRR = 0.68, 95% CI: 0.59–0.78 for Hispanic).

Conclusion Although neonates of Black patients have the highest frequency of adverse perinatal outcomes at term, after adjustment for sociodemographic factors, this higher risk is no longer observed, suggesting the importance of developing strategies that address social determinants of health to lessen extant health disparities.

Key Points
The Caudal Septum Pivot Technique for Short Nose Correction
Authors: Marianetti Tito M. , Vellone Valentino , De Angelis Francesca , Ramieri Valerio
Published: May 2021

The short nose represents one of the greatest challenges in rhinoplasty. It is characterized by a reduced distance from the nasal radix to the tip-defining points, often associated with inadequate tip projection. Several techniques have been described for correction of short nose with the common objective of replacing and rebuilding the osteocartilaginous framework. One of the most effective method to correct the short nose is the septal extension graft. The authors describe the caudal septum pivot (CSP) technique, a simple method to elongate short noses by using a graft inserted in the dorsal septum after its division using as pivot the caudal portion, without detaching it from its natural anchorage to the anterior nasal spine. A retrospective analysis was performed reviewing the clinical charts and the operative records of 315 patients who underwent revision rhinoplasty from January 2015 to June 2019; among this group, 34 were considered eligible for the study. The patients (8 men, 26 women; mean age: 25.4 years; age range: 22–53 years) were divided into two groups: in 12 patients (Group 1) the CSP technique was performed, while Group 2 was composed of 22 patients who received a more classic treatment with a septal extension graft. To evaluate the outcomes, nasal length, tip projection, and tip rotation were measured pre- and 1 year postoperatively on digital photographs of each patient. Nasal anthropometric measurements revealed, at 12-month visit follow-up, an improvement in nasal length, tip projection, and nasolabial angle was achieved in all the patients. The comparison of the pre- and postoperative values showed a statistically significant reduction in the nasolabial angle (p < 0.05) and an increase in the tip projection (p < 0.05) and in the nasal lengthening (p < 0.05) in both groups. In authors' experience, the CSP technique could be considered a safe, reliable, and effective alternative technique in selected patients.
kma-Umfrage: Was bringt ihr Klinikum auf dem Weg zum „Smart Hospital“ stärker voran – Corona oder das KHZG?
Authors: Orth Anne
Published: May 2021

Mit dem Krankenhauszukunftsgesetz fließen in den nächsten Jahren 4,3 Milliarden Euro in die digitale Transformation der Krankenhäuser. Doch auch die Corona-Pandemie hat die Digitalisierung beschleunigt. kma hat bei Klinikchefs und IT-Verantwortlichen nachgefragt, wovon sie sich stärkere Impulse erwarten und wie weit ihre Häuser auf dem Weg zum „Smart Hospital“ sind.
Private oder konfessionelle Trager als Arbeitgeber?: „Es war nicht gewollt, dass der Geschäftsführer strategisch arbeitet“
Authors: Köhn Andrea , Faber Svenja , Engelbrecht Christoph
Published: May 2021

Weniger Renditedruck, mehr strategische Verantwortung – wenn Klinikgeschäftsführerinnen und -geschäftsführer von privaten zu konfessionellen Trägern wechseln, sind die Erwartungen hoch. Doch finden die „Seitenwechsler“ so wirklich das ersehnte Arbeitsumfeld? Für eine Studie haben zehn von ihnen ihre Erfahrungen geschildert – und dabei ungeschminkt bilanziert.
Aptamer-Facilitated Design of Gold Nanoparticle-Based Logic Gates for Cyromazine and Melamine Detection in Milk
Authors: Xing Haibo , Fei Xuelian , Zheng Bowen , Zheng Xiyin , Dang Xu , Zhang Hongbo , Tian Fuxiang , Mei Xiang , Hu Xiaojun
Published: May 2021

In this paper, we developed a simply designed detection method for logic gates by using aptamers, cetyltrimethyl ammonium bromide, together with melamine and cyromazine to control the aggregation and dispersion of gold nanoparticles (AuNPs). First, either melamine or cyromazine can induce the aggregation of AuNPs, supporting an OR gate to detect whether they were present or not. Second, based on the fact that aptamer T31 can specifically bind with melamine, preventing the aggregation of AuNPs, an improved INHIBIT gate was also fabricated to find whether there was melamine. It has a detection limit of 0.12 ppm by the naked eye for the detection of melamine, and the limit of detection (LOD) by spectrophotometer is 2.2 ppb. Third, with the adsorption of aptamer Tcy1 on AuNPs and the strong coordination of Tcy1 with cyromazine, the addition of cyromazine and CTAB immediately resulted in the aggregation of AuNPs, giving rise to an AND gate. This gate has a detection limit of 0.17 ppm by the naked eye and the limit of detection (LOD) is 9.0 ppb by spectrophotometer. The system provided a good platform for the development of functional logic systems.
The cosmic dispersion measure in the EAGLE simulations
Authors: Batten Adam J , Duffy Alan R , Wijers Nastasha A , Gupta Vivek , Flynn Chris , Schaye Joop , Ryan-Weber Emma
Published: May 2021

The dispersion measure (DM) of fast radio bursts (FRBs) provides a unique way to probe ionized baryons in the intergalactic medium (IGM). Cosmological models with different parameters lead to different DM–redshift (DM–z) relations. Additionally, the over/underdense regions in the IGM and the circumgalactic medium of intervening galaxies lead to scatter around the mean DM–z relations. We have used the Evolution and Assembly of GaLaxies and their Environments (EAGLE) simulations to measure the mean DM–z relation and the scatter around it using over 1 billion lines of sight at redshifts 0 < z < 3. We investigated two techniques to estimate line-of-sight DM: pixel scrambling and box transformations. We find that using box transformations (a technique from the literature) causes strong correlations due to repeated replication of structure. Comparing a linear and a non-linear model, we find that the non-linear model with a dependence on cosmological parameters provides a better fit to the DM–z relation. The differences between these models are the most significant at low redshifts (z < 0.5). The scatter around the DM–z relation is highly asymmetric, especially at low redshift (z < 0.5), and becomes more Gaussiana as redshift approaches z = 3, the limit of this study. The increase in Gaussianity with redshift is indicative of the large-scale structure that is better sampled with longer lines of sight. The DM–z relation measured in EAGLE is available with an easy-to-use python interface in the open-source FRB redshift estimation package fruitbat.
The H i–halo mass relation at redshift z ∼ 1 from the Minkowski functionals of 21-cm intensity maps
Authors: Spina Benedetta , Porciani Cristiano , Schimd Carlo
Published: May 2021

The mean and the scatter of the H i content of a dark matter halo as a function of the halo mass are useful statistics that can be used to test models of structure and galaxy formation. We investigate the possibility of constraining this H i–halo mass relation (HIHMR) from intensity maps of the redshifted 21-cm line. In particular, we use the geometry and topology of the brightness-temperature isocontours in a single frequency channel as quantified by the Minkowski functionals. First, we generate mock maps from a large N-body simulation considering the impact of thermal noise and foreground removal. We then use the Fisher information formalism to forecast constraints on a parametric model for the HIHMR. We consider a 20  000 deg2 survey (originally proposed for dark energy science) conducted with the Square Kilometre Array Phase 1 (SKA-1) MID observatory operating in single-dish mode. For a channel bandwidth of 2 MHz, we show that an integration time of a few$\, \times \, 10^4$ s per pointing is sufficient to image the smoothed H i distribution at redshift z ≃ 1 and to measure the HIHMR in a nearly optimal way from the Minkowski functionals. Tighter constraints on some of the parameters can be obtained by using also an independent measurement of the mean H i density. Combining the results from different frequency channels provides exquisite constraints on the evolution of the HIHMR, especially in the central frequency range of the data cube.
Linking zonal winds and gravity – II. Explaining the equatorially antisymmetric gravity moments of Jupiter
Authors: Dietrich Wieland , Wulff Paula , Wicht Johannes , Christensen Ulrich R
Published: May 2021

The recent gravity field measurements of Jupiter (Juno) and Saturn (Cassini) confirm the existence of deep zonal flows reaching to a depth of 5 per cent and 15 per cent of the respective radius. Relating the zonal wind-induced density perturbations to the gravity moments has become a major tool to characterize the interior dynamics of gas giants. Previous studies differ with respect to the assumptions made on how the wind velocity relates to density anomalies, on the functional form of its decay with depth, and on the continuity of antisymmetric winds across the equatorial plane. For the case of Jupiter, most of the suggested vertical structures exhibit a rather smooth radial decay of the zonal wind, which seems at odds with the observed secular variation of the magnetic field and the prevailing barotropy of the zonal winds. Moreover, the results relied on modifications of the surface zonal flows, an artificial equatorial regularization or ignored the equatorial discontinuity altogether. We favour an alternative structure, where the equatorially antisymmetric zonal wind in an equatorial latitude belt between ±21° remains so shallow that it does not contribute to the gravity signal. The winds at higher latitudes suffice to convincingly explain the measured gravity moments. Our results indicate that the winds are barotropic, i.e. constant along cylinders, in the outer $3000$ km and decay rapidly below. The preferred wind structure is 50 per cent deeper than previously thought, agrees with the measured odd gravity moments, is compliant with the requirement of an adiabatic atmosphere and unbiased by the treatment of the equatorial discontinuity. We discuss possible implications for the interpretation of the secular variation of Jupiter’s magnetic field.
Planets around young active solar-type stars: assessing detection capabilities from a non-stabilized spectrograph
Authors: Heitzmann A , Marsden S C , Petit P , Mengel M W , Wright D , Clerte M , Millburn I , Folsom C P , Addison B C , Wittenmyer R A , Waite I A
Published: May 2021

Short-orbit gas giant planet formation/evolution mechanisms are still not well understood. One promising pathway to discriminate between mechanisms is to constrain the occurrence rate of these peculiar exoplanets at the earliest stage of the system’s life. However, a major limitation when studying newly born stars is stellar activity. This cocktail of phenomena triggered by fast rotation, strong magnetic fields, and complex internal dynamics, especially present in very young stars, compromises our ability to detect exoplanets. In this paper, we investigated the limitations of such detections in the context of already acquired data solely using radial velocity data acquired with a non-stabilized spectrograph. We employed two strategies: Doppler Imaging and Gaussian Processes and could confidently detect hot Jupiters with a semi-amplitude of 100 m s−1 buried in the stellar activity. We also showed the advantages of the Gaussian Process approach in this case. This study serves as a proof of concept to identify potential candidates for follow-up observations or even discover such planets in legacy data sets available to the community.
Latinos understanding the need for adherence in diabetes (LUNA-D): a randomized controlled trial of an integrated team-based care intervention among Latinos with diabetes
Authors: Talavera Gregory A , Castañeda Sheila F , Mendoza Paulina M , Lopez-Gurrola Maria , Roesch Scott , Pichardo Margaret S , Garcia Melawhy L , Muñoz Fatima , Gallo Linda C
Published: May 2021

We developed and tested a culturally appropriate, team-based, integrated primary care and behavioral health intervention in low income, Spanish-speaking Latinos with type 2 diabetes, at a federally qualified health center. This pragmatic randomized controlled trial included 456 Latino adults, 23–80 years, 63.7% female, with diabetes [recruitment glycosylated hemoglobin (HbA1c) ≥ 7.0%/53.01 mmol/mol)]. The Special Intervention occurred over 6 months and targeted improvement of HbA1c, blood pressure, and lipids. The intervention included: (i) four, same-day integrated medical and behavioral co-located visits; (ii) six group diabetes self-management education sessions addressing the cultural dimensions of diabetes and lifestyle messages; (iii) and care coordination. Usual Care participants received primary care provider led standard diabetes care, with referrals to health education and behavioral health as needed. HbA1c and lipids were obtained through electronic health records abstraction. Blood pressure was measured by trained research staff. Multi-level models showed a significant group by time interaction effect (B = −0.32, p < .01, 95% CI −0.49, −0.15), indicating statistically greater improvement in HbA1c level over 6 months in the Special Intervention group (ΔHbA1c = −0.35, p = <.01) versus Usual Care (ΔHbA1c = −0.02, p = .72). Marginally significant group by time interactions were also found for total cholesterol and diastolic blood pressure, with significant improvements in the Special Intervention group (p < .05). This culturally appropriate model of highly integrated care offers strategies that can assist with self-management goals and disease management for Latinos with diabetes in a federally qualified health center setting.
Placebo Analgesia Does Not Reduce Empathy for Naturalistic Depictions of Others’ Pain in a Somatosensory Specific Way
Authors: Hartmann Helena , Riva Federica , Rütgen Markus , Lamm Claus
Published: May 2021

The shared representations account postulates that sharing another’s pain recruits underlying brain functions also engaged during first-hand pain. Critically, direct causal evidence for this was mainly shown for affective pain processing, while the contribution of somatosensory processes to empathy remains controversial. This controversy may be explained, however, by experimental paradigms that did not direct attention towards a specific body part, or that did not employ naturalistic depictions of others’ pain. In this preregistered functional magnetic resonance imaging study, we aimed to test whether causal manipulation of first-hand pain affects empathy for naturalistic depictions of pain in a somatosensory-matched manner. Forty-five participants underwent a placebo analgesia induction in their right hand and observed pictures of other people’s right and left hands in pain. We found neither behavioral nor neural evidence for somatosensory-specific modulation of pain empathy. However, exploratory analyses revealed a general effect of the placebo on empathy, and higher brain activity in bilateral anterior insula when viewing others’ right hands in pain (i.e., corresponding to one’s own placebo hand). These results refine our knowledge regarding the neural mechanisms of pain empathy, and imply that the sharing of somatosensory representations seems to play less of a causal role than the one of affective representations.
Designing and Implementing a Skin Care Protocol for Infants With Neonatal Abstinence Syndrome to Decrease Rates of Diaper Dermatitis
Authors: Glashan Courtney
Published: May 2021

Background:

Infants with neonatal abstinence syndrome (NAS) are at an increased risk for diaper dermatitis, which can cause skin breakdown and lead to significant pain and potential infection exposure. Skin care protocols in the neonatal intensive care unit (NICU) setting seldom specifically address the needs of this at-risk population, leading to inconsistent skin care management.

Purpose:

The goal was to support a decrease in the rate of diaper dermatitis for infants with NAS by designing and implementing an evidence-based skin care protocol.

Methods:

A retrospective medical record review was used to examine outcomes of 25 infants preintervention and 8 infants postintervention. The skin care protocol was a bundle of 5 evidence-based interventions: (1) a specific diaper dermatitis assessment tool; (2) frequent diaper changes with superabsorbent diapers; (3) application of petroleum jelly and alcohol-free wipes; (4) infant bathing in pH neutral soap; and (5) application of zinc oxide barrier cream for erythema.

Results:

There was an overall 80.5% decrease in diaper dermatitis from pre- to postimplementation (P ≤ .01) as noted when comparing positive cases of diaper dermatitis with negative cases from pre- to postintervention.

Implications for Practice:

Expanding the skin care protocol to all neonates in the NICU and nursery could aid in maintaining skin integrity and decreasing diaper dermatitis in the NICU. More research is needed following this study for the data to be generalizable to other NICUs. This study offers key takeaways including using a specific diaper dermatitis assessment tool and consistently using the bundle of interventions.

Video Abstract Available at:

https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=47.
Preoperative Lower Extremity Motor Weakness Affects Deep Vein Thrombosis During the Perioperative Period of Lumbar Surgery
Authors: Imuro Takashi , Saito Mitsuru
Published: May 2021

Study Design.

Prospective cohort study.

Objective.

The aim of this study was to assess preoperative factors in the development/exacerbation of deep vein thrombosis (DVT) in lumbar surgery and selectively perform lower-extremity venous ultrasonography (US) in patients at risk of perioperative deep vein thrombosis (DVT).

Summary of Background Data.

DVT is often present before lumbar surgery and also can develop or is exacerbated postoperatively. An elevated d-dimer level is predictive of DVT but not in all patients or during every operative period. The level of the thrombogenic marker soluble fibrin monomer complex (SFMC) peaks early postoperatively.

Methods.

The study enrolled 698 patients (396 males; 12– 91 years [346 patients aged ≥70 years] at surgery) undergoing surgery for lumbar degenerative diseases. Patients with d-dimer levels ≥0.5 μg/mL or with a lower-extremity manual muscle test (MMT) < grade 3 underwent preoperative US. All preoperative DVT-positive patients and patients with SFMC levels ≥20 μg/mL on postoperative day 1 (POD1) underwent US. Patients with pre- and postoperative femoral-vein DVT underwent screening for pulmonary embolism (PE).

Results.

There were 251 patients with preoperative d-dimer levels ≥ 0.5 μg/mL, including 226 with MMT ≥ grade 3, 38 (16.8%) of whom were DVT-positive on US. In 48 patients with MMT <grade 3, DVT was detected in 16 of 25 patients with d-dimer levels ≥ 0.5 μg/mL (64.0%) and 10 of 23 with d-dimer levels <0.5 μg/mL (43.5%). Postoperatively, 26 of 64 preoperative DVT-positive patients (40.6%) had postoperative exacerbation of DVT; PE occurred in three. Among 100 of 634 preoperative DVT-negative patients, US revealed new DVT in 14 (2.2%) and PE in one. Preoperative DVT and new postoperative DVT were significantly more common in patients aged ≥70 years; postoperative DVT exacerbation was significantly more common in patients aged <70 years. A significantly higher proportion of patients with motor weakness had preoperative DVTs and postoperative exacerbated or new DVTs.

Conclusion.

Preoperative DVT screening by US is advisable for patients with elevated d-dimer levels, lower extremities with MMT < grade 3, or DVT positivity. Postoperative US is advisable for patients with elevated SFMC levels on POD1.

Level of Evidence: 3
Induction of T helper 17 cell response by interleukin-7 in patients with primary cutaneous melanoma
Authors: He Hongxia , Qiao Binjun , Guo Shuping , Cui Hongzhou , Li Ning , Liu Hongye , Qin Junxia , He Jinghong , Yang Xiaofeng , Xue Wenli , Wang Yanzhen
Published: May 2021

Interleukin (IL)-7 plays a vital role in proliferation and activation of T cells, however, its signaling through CD127 is impaired in T cells in cancers and chronic infections. The mechanisms underlying T helper 17 (Th17) cell responses by IL-7 in melanoma remain not fully understood. The aim of this study was to assess the effect of IL-7 signaling on Th17 responses in patients with primary cutaneous melanoma. Healthy and primary cutaneous melanoma donors were selected for this study of Th17 cell function. IL-17+CD4+ Th17 cells and CD127 expression on Th17 cells were determined by flow cytometry. Cytokine level was measured by ELISA. Peripheral and tissue-infiltrating CD4+ T cells were isolated using magnetic beads, and then stimulated with IL-7 and/or signal transducer and activator of transcription 5 inhibitor. Activated signaling molecules were analyzed by flow cytometry. Peripheral and tumor-infiltrating Th17 cells percentage was decreased, while peripheral IL-7 level was also reduced in melanoma patients. There was no significant difference of CD127 expression on Th17 cells between melanoma patients and controls. Antiapoptotic protein Bcl-2 was downregulated, whereas proapoptotic protein-activated caspase-3 was upregulated in peripheral and tissue-infiltrating Th17 cells in melanoma patients. Higher concentration of IL-7 (10 ng/mL), but not lower IL-7 concentration (1 ng/mL), promoted Bcl-2 expression and decreased caspase-3 expression in Th17 cells in melanoma patients. Inhibition of signal transducer and activator of transcription 5 resulted in the downregulation of Bcl-2 while upregulation of caspase-3 in Th17 cells. The present data suggested that reduced IL-7 responsiveness might be insufficient for Th17 activation in patients with primary cutaneous melanoma.
Effectiveness of Progressive Muscle Relaxation and Deep Breathing Exercise on Pain, Disability, and Sleep Among Patients With Chronic Tension-Type Headache
Authors: Gopichandran Lakshmanan , Srivastsava Achal Kumar , Vanamail P. , Kanniammal C. , Valli G. , Mahendra Jaideep , Dhandapani Manju
Published: May 2021

A randomized control trial was conducted to assess the effectiveness of progressive muscle relaxation and deep breathing exercises on pain, disability, and sleep quality among patients with chronic tension-type headache. Of the 169 randomly selected patients, 84 performed the intervention and reported less pain severity and disability and better sleep quality after 12 weeks.
New insights in statins affecting atheromatous plaque macrophages
Authors: Härdtner Carmen , Ehlert Carolin A. , Hilgendorf Ingo
Published: May 2021

Purpose of review

Macrophages are key protagonists of atherosclerotic plaque development and hence represent targets of therapeutic intervention. Statins are the most potent widely used atheroprotective drugs. Therefore, whether and how statins influence atheromatous plaque macrophages has remained at the center of cardiovascular research for decades.

Recent findings

Because statins are capable of regulating macrophage functions in cell culture, largely independent of their cholesterol-lowering effect, it was assumed that these pleiotropic effects operate in vivo as well. Recent experimental data, in line with clinical observations, indicate, however, that statins do not interact with macrophages in atherosclerotic plaques, directly, and instead control their functions and assembly indirectly via changes to circulating lipid levels and endothelial activation.

Statin-mediated lipid lowering induces plaque regression which is characterized by a decline in plaque macrophage content. Understanding how statins provoke this protective phenotype may inspire conceptually new therapeutic approaches in cardiovascular medicine.
Adrenocortical Function in Children With Brain Tumors and Pediatric Hematopoietic Cell Transplantation Recipients
Authors: Shah Koral , Boyd Jennifer W. , Broussard Julia R. , Ginn Kevin , Rahmetulla Rukhsana , Hurst Kristy , Goyal Rakesh K.
Published: May 2021

Adrenocortical insufficiency (AI) is a clinical condition defined by deficient production of glucocorticoids that can result in life-threatening complications. We examined the prevalence of AI in children with brain tumors and those undergoing hematopoietic cell transplantation. Adrenocorticotropic hormone stimulation (stim) testing was used for the assessment of adrenocortical function. On the basis of 155 stim tests in 117 patients, AI was diagnosed in 27.4% of patients with brain tumors and in 21% of hematopoietic cell transplantation recipients. A number of risk factors associated with AI were identified. Adrenocorticotropic hormone stim testing led to a definitive diagnosis of AI or recovery of adrenal function and unambiguous medical management.
A Metastatic Neuroblastic Tumor in a 28-Month-old Boy: Unusual Spontaneous Regression From Neuroblastoma to Ganglioneuroma?
Authors: Yamada Ai , Kinoshita Mariko , Kamimura Sachiyo , Nakame Kazuhiko , Moritake Hiroshi
Published: May 2021

Neuroblastoma with bone metastasis is well known to have an extremely poor prognosis. We experienced the case of a patient with adrenal ganglioneuroblastoma (GNB) with metastases of subcutaneous nodules, a lymph node, and multiple bones. A pathologic examination of tumors from different sites revealed both GNB and ganglioneuroma. A genetic comparison between these tumors identified the same molecular signatures, suggesting the possibility of spontaneous differentiation in the remaining GNB. The patient has been healthy without aggressive chemotherapy, and the patient’s pathologic urinary catecholamines normalized. Even if unusual, we have to recognize probable spontaneous differentiation from neuroblastoma to GNB and then to ganglioneuroma, even in sites of bone metastasis.
Klotho Level as a Marker of Low Bone Mineral Density in Egyptian Sickle Cell Disease Patients
Authors: Hamdy Mona , Shaheen Iman , Seif El Din Hadeel , Ali Basma , Abdel Dayem Omnia
Published: May 2021

Bone involvement of sickle cell disease (SCD) patients varies from acute clinical manifestations of painful vaso-occlusive crises or osteomyelitis to more chronic affection of bone mineral density (BMD) and debilitating osteonecrosis and osteoporosis. Secreted klotho protein is involved in calcium (Ca) reabsorption in the kidney. This study aimed to measure serum klotho levels in children with SCD to determine the possibility of using it as a marker of low BMD in children with SCD in correlation with a dual-energy radiograph absorptiometry scan. This study included 60 sickle disease patients and 30 age-matched and sex-matched control participants without SCD. A highly statistically significant difference was found between patients with normal BMD and those with low BMD, with serum Ca and klotho levels being lower in the latter group. Klotho serum level correlated positively with both serum Ca and BMD. Serum klotho level showed 94.9% sensitivity and 95.2% specificity in the detection of low BMD. Both serum Ca and klotho serum levels may be useful markers for detection of low BMD related to SCD with high sensitivity and specificity; however, klotho may be a better indicator as it is less affected by the nutritional and endocrinal status of patients or by intake of Ca supplements.
A Retrospective Analysis of Treatment Outcomes Following Guided Bone Regeneration at Sites Exhibiting Severe Alveolar Ridge Atrophy
Authors: Di Carlo Stefano , Ciolfi Alessandro , Grasso Elena , Pranno Nicola , De Angelis Francesca , Di Gioia Cira , Jedliński Maciej , Tornese Andrea , Lomelo Paolo , Brauner Edoardo
Published: May 2021

Severely atrophic alveolar ridges represent a great challenge for implant-prosthetic rehabilitations. The aim of this study was to clinically and histologically evaluate horizontal and vertical bone gain, as well as implant survival/success rate after guided bone regeneration (GBR) for the reconstruction of large bone defects. Fourteen subjects (7 males and 7 females; mean age: 48.9 ± 14.1) were enrolled in the study. They were selected according to specific inclusion criteria and all patients required GBR procedures for placing implants in severe atrophic jaws (bone height ≤6 mm). Guided bone regeneration was performed using dense polytetrafluoroethylene nonresorbable titanium-reinforced membranes associated with particulate heterologous bone grafts. Implant placement was performed 6 months after surgery at the same time as the removal of the membrane. Furthermore, a biopsy sample from the grafted sites was collected to conduct a histological analysis of the regenerated bone. Forty-seven dental implants were placed and followed up after prosthetic loading. Seventeen sites, 8 in the maxilla and 9 in the mandible, were suitable for the GBR procedure. The healing period was uneventful in 13 sites. The average value of vertical bone regeneration was 5.88 ± 1.17 mm. Postloading follow-up ranged from 24 to 59 months. During the follow-up, clinical and radiographic exams showed no significant bone resorption and, in each case, the criteria for implants’ survival were respected with no signs of any complications. Histological analysis of the bone biopsy samples revealed residual graft particulate in close contact with newly formed bone. Guided bone regeneration is a reliable technique for reconstruction of severe atrophic ridges. Larger long-term follow-up studies are needed to evaluate the condition of the bone grafted over time and its ability to support functional loading of the implants.
A Comparison of Weight Gain Following Mandibular Distraction Osteogenesis and Tongue-Lip Adhesion in the Treatment of Robin Sequence
Authors: van Nunen Daan P.F. , Griot J. Peter W. Don , Kruisinga Frea , Broers Chantal J.M. , Breugem Corstiaan C.
Published: May 2021

Obstructive respiratory stress and feeding difficulties in infants with Robin sequence (RS) may result in poor weight gain or loss. Following failure of conservative treatment, surgical options include mandibular distraction osteogenesis (MDO) and tongue-lip adhesion (TLA). Whilst both techniques have demonstrated to improve airway patency and feeding behavior, an advantage of either in restoring weight growth remains unknown. This study aimed to improve procedural selection by examining weight gain following MDO and TLA. A retrospective chart review was performed for 17 RS patients that had undergone MDO and 25 that had received TLA. The mean body weight in both groups was below the 50th population percentile at birth and fell further in the period before surgery. A mixed model analysis demonstrated that postoperative weight gain depended on the progression of time and preoperative weight. Conversely, biological sex, congenital comorbidities, method of feeding, the respective cleft team, and the type of surgery did not significantly influence the evolution of postoperative body weight. In conclusion, both MDO and TLA were able to restore weight growth in infants affected by RS, though a clear superiority of either technique could not be established.
Using Buccal Mucosa and Auricular Cartilage With a Local Flap for Full-Thickness Defect of Lower Eyelid
Authors: Jin Ming-Jia , Gao Yang
Published: May 2021

Reconstruction of full-thickness eyelid wounds is challenging. In this case, using buccal mucosa to repair the conjunctival surface of the lower eyelid defect maintain the function of the conjunctival surface, reduce the damage to the original ocular surface environment. Using autologous auricular cartilage as the skeleton of the eyelid defect, provided better support for the flap, and the site had a good esthetic appearance after surgery. Using skin flap to repair the skin surface of the lower eyelid defect, the eyelid defect can be repaired and good clinical results can be obtained.
Increased circulating IL-18 levels in severe mental disorders indicate systemic inflammasome activation
Authors: Szabo Attila , O’Connell Kevin S. , Ueland Thor , Sheikh Mashhood A. , Agartz Ingrid , Andreou Dimitrios , Aukrust Pål , Boye Birgitte , Bøen Erlend , Drange Ole Kristian , Elvsåshagen Torbjørn , Engh John Abel , Hope Sigrun , Høegh Margrethe Collier , Joa Inge , Johnsen Erik , Kroken Rune Andreas , Lagerberg Trine Vik , Lekva Tove , Malt Ulrik Fredrik , Melle Ingrid , Morken Gunnar , Nærland Terje , Steen Vidar Martin , Sørensen Kjetil , Wedervang-Resell Kirsten , Weibell Melissa Auten , Westlye Lars T. , Steen Nils Eiel , Andreassen Ole , Djurovic Srdjan
Published: May 2021

Background

Schizophrenia (SCZ) and bipolar disorder (BD) are severe mental illnesses (SMI) that are part of a psychosis continuum, and dysregulated innate immune responses have been suggested to be involved in their pathophysiology. However, disease-specific immune mechanisms in SMI are not known yet. Recently, dyslipidemia has been linked to systemic inflammasome activation, and elevated atherogenic lipid ratios have been shown to correlate with circulating levels of inflammatory biomarkers in SMI. It is, however, not yet known if increased systemic cholesterol load leads to inflammasome activation in these patients.

Methods

We tested the hypothesis that patients with SCZ and BD display higher circulating levels compared to healthy individuals of key members of the IL-18 system using a large patient cohort (n=1632; including 737 SCZ and 895 BD), and healthy controls (CTRL; n=1070). In addition, we assessed associations with coronary artery disease risk factors in SMI, focusing on relevant inflammasome-related, neuroendocrine, and lipid markers.

Results

We report higher baseline levels of circulating IL-18 system components (IL-18, IL-18BPA) as well as increased expression of inflammasome-related genes (NLRP3 and NLRC4) in the blood of patients relative to CTRL. We demonstrate a cholesterol dyslipidemia pattern in psychotic disorders, and report correlations between levels of blood cholesterol species and the expression of inflammasome system elements in SMI.

Conclusions

Based on these results, we suggest a link between systemic inflammasome activation/dysregulation and cholesterol load in SMI. Our findings further the understanding of possible underlying inflammatory and metabolic mechanisms and may expose important therapeutic targets in SMI.
Landscape of microenvironment in Randall’s plaque by single-cell sequencing
Authors: Liu Zezhen , Duan Xiaolu , Sun Xinyuan , Zhong Jiehui , Zhong Wen , Yu Bangxian , Zhao Zhijian , Mai Zanlin , Liu Hongxing , Li Shujue , Wu Wenqi , Zeng Guohua
Published: May 2021

Randall’s plaque is significantly associated with the occurrence of nephrolithiasis. However, the microenvironment of Randall’s plaque is poorly characterized. To investigate the microenvironment of Randall’s plaque, we analyzed single-cell RNA data of 3 Randall’s plaque and 3 normal renal papillae tissue and identified 11 different cell types. We screened differentially expressed genes among all cell types between Randall’s plaque and normal renal papillae. The microenvironment showed two cell types with multiple stone formation-associated transcriptomic programs. Contrary to previous studies, we did not observe macrophage M1/M2 imbalance. Notably, we detected ossification-associated macrophage is enriched in Randall’s plaque and validated GPNMB and ACP5 were potential biomarkers on the ossification-associated macrophage. We also identified an endothelial subset harboring active communication (COL15A1+ PCDH17+ endothelial, DPECs) with other cells. Together with Immunofluorescence, we validated ossification-associated macrophage and DPECs are enriched in Randall’s plaque tissue. Finally, cell-to-cell communication revealed that Loop of Henle, DPECs, and osteoblasts-associated macrophages was the main source of SPP1 signaling. Our work will further the understanding of the microenvironment among Randall’s plaque tissues and provide deep insight into immune modulation.
Impact of actuators backlash on the helicopter control during landing on the moving vessel deck
Authors: Topczewski Sebastian , Żugaj Marcin , Bibik Przemyslaw
Published: May 2021

Purpose

The purpose of this paper is to test the performance of the control system developed for the helicopter automatic approach and landing on the moving vessel deck, when different values of backlashes are applied to the four control actuators.

Design/methodology/approach

The system consists of automatic control algorithm based on the linear quadratic regulator and the vessel motion prediction algorithm based on autoregressive method with parameters calculated using Burg’s method. Necessary navigation data is provided by on-board inertial navigation system/Global Positioning System. Calculated control commands are executed by four electromechanical actuators. Performance of the mission, which is based on selected procedure of approach and landing of the helicopter on the moving vessel deck, is analyzed taking into account different values of backlashes applied to the actuators.

Findings

In this paper, a description of the control system dedicated for automatic approach and landing of the helicopter on the moving vessel deck is shown. Necessary information about helicopter dynamic model, control system and vessel motion model is included. Tests showing influence of actuator backlashes on the mission performance are presented.

Practical implications

The developed control methodology can be adapted for selected helicopter and used in prospective development of an automatic flight control system (AFCS) or in a simulator. The system can be used to define in which conditions helicopter can perform safe and successful automatic approach and landing on a moving vessel deck.

Originality/value

In this paper, an integrated control system is presented; influence of the control actuator backlashes on the mission performance is analyzed.
High-quality factor multipath differential fractal inductor for wireless applications
Authors: Tumma Sunil Kumar , Nistala Bheema Rao
Published: May 2021

Purpose

The purpose of this study is to develop a high-quality factor fractal inductor for wireless applications such as satellite, WLAN, Bluetooth, microwave, radar and cellular phone.

Design/methodology/approach

The Hilbert fractal curve is used in the implementation of the proposed inductor. In the proposed inductor, the metal width has split into multiple paths based on the skin depth of the metal. The simulations of the proposed inductor are performed in 180 nm CMOS technology using the Advanced Design System EM simulator.

Findings

The multipath technique reduces the skin effects and proximity effects, which, in turn, decreases the series resistance of the inductor and attains high-quality factor over conventional fractal inductor for the equal on-chip area.

Research limitations/implications

The width of the path has chosen higher than the skin depth of the metal for a required operating frequency. Due to cost constraints, the manufacturing of the proposed fractal inductor is limited to a single layer.

Practical implications

The proposed inductor will be useful for the implementation of critical building blocks of radio frequency integrated circuits and monolithic microwave integrated circuits such as low-noise amplifiers, voltage-controlled oscillators, mixers, filters and power amplifiers.

Originality/value

This paper presents for the first time the use of a multipath technique for the fractal inductors to enhance the quality factor.