bluuebunny/crossref_metadata_2025 huggingface dataset:
The Λ(1405) with one pole
Authors: Klempt Eberhard
Published: September 2020

The Λ(1405)1/2-resonance is discussed and a fit of the Bonn-Gatchina (BnGa) partial-wave- analysis group is presented to data relevant for this resonance. In the Σπ-NKcoupled channel system, no Σ pole and only one Λ pole in the mass range from the Σπthreshold to 1500 MeV is required to get a good description of the data.
Determining dominant partial waves in photoproduction via moment analysis
Authors: Wunderlich Yannick
Published: September 2020

Important insights into the excitation spectra of baryons are provided by measurements of polarization observables in reactions that involve particles with spin. The photoproduction of a single pseudoscalar meson constitutes an example-reaction that has been under intense investigation recently. We present the basic method of moment-analysis for pseudoscalar meson photoproduction, in which just the angular distributions are analyzed. Using this method, the total angular momentum quantum number of the dominant partial waves contributing in the data can be extracted quickly. Furthermore, the Legendre-coeffcients extracted from the angular distributions show interesting composition-patterns in terms of multipoles and allow for instructive comparisons to models. In this contribution, recent results for moment analyses of polarization data for the photoproduction of pions and eta-mesons are shown.
The Inhibitory Effect of Curcumin on Hypoxia Inducer Factors (Hifs)
as a Regulatory Factor in the Growth of Tumor Cells in Breast Cancer Stem-Like
Cells
Authors: Sarighieh Mehrnaz Asadi , Montazeri Vahideh , Shadboorestan Amir , Ghahremani Mohammad Hossein , Ostad Seyed Nasser
Published: September 2020

Hypoxia in the microenvironment is related to chemotherapy resistance, tumor
progression, and metastasis. Curcumin, as a phenolic compound extracted from the
turmeric, has been used as an anti-cancer agent with low toxicity in recent
years. Since curcumin has inhibitory activities against hypoxia-inducible
factors (HIFs) in several cancers, this study was conducted to examine the
effect of curcumin on MCF-7 cells and cancer stem-like cells (CS-LCs) under
hypoxic and normoxic conditions. CS-LCs were isolated from MCF-7 cells using the
magnet activated cell sorting (MACS) method based on CD44
+/ CD24
- surface markers. The effects of curcumin on the viability of MCF-7
cells and CS-LCs were examined in hypoxic and normoxic conditions using the MTT
test. The effects of curcumin on apoptosis and cell cycle of CS-LCs and MCF-7
cells were analyzed using flow cytometry. Moreover, the inhibitory effects of
curcumin on the levels of HIF-1 and HIF-2α protein in CS-LCs were
investigated using the western blot method. Early apoptosis occurred in CSC-LCs
more than MCF-7 cells under hypoxic conditions. Flow cytometry assay showed that
curcumin caused cell cycle arrest of CSC-LCs and MCF-7 at the G2/M phase
under hypoxic conditions while under normoxic conditions, arrest occurred at the
G0/G1 phase in MCF-7 cells and at S and G2/M phases in CS-LCs.
Based on the results, the curcumin inhibited the expression of HIF-1 by
degrading ARNT in CS-LCs.

In conclusion, curcumin has inhibitory effects on MCF- 7 cells and CS- LCs and
thus may be used as an antitumor agent.
Underwater vs conventional endoscopic mucosal resection in the management of colorectal polyps: a systematic review and meta-analysis
Authors: Kamal Faisal , Khan Muhammad Ali , Lee-Smith Wade , Khan Zubair , Sharma Sachit , Tombazzi Claudio , Ahmad Dina , Ismail Mohammad Kashif , Howden Colin W. , Binmoeller Kenneth F.
Published: September 2020

Background Recently, underwater endoscopic mucosal resection (UEMR) has shown promising results in the management of colorectal polyps. Some studies have shown better outcomes compared to conventional endoscopic mucosal resection (EMR). We conducted this systematic review and meta-analysis to compare UEMR and EMR in the management of colorectal polyps.

Methods We searched several databases from inception to November 2019 to identify studies comparing UEMR and EMR. Outcomes assessed included rates of en bloc resection, complete macroscopic resection, recurrent/residual polyps on follow-up colonoscopy, complete resection confirmed by histology and adverse events. Pooled risk ratios (RR) with 95 % confidence interval were calculated using a fixed effect model. Heterogeneity was assessed by I2 statistic. Funnel plots and Egger’s test were used to assess publication bias. We used the Newcastle-Ottawa scale (NOS) for assessment of quality of observational studies, and the Cochrane tool for assessing risk of bias for RCTs

Results Seven studies with 1291 patients were included; two were randomized controlled trials and five were observational. UEMR demonstrated statistically significantly better efficacy in rates of en bloc resection, pooled RR 1.16 (1.08, 1.26), complete macroscopic resection, pooled RR 1.28 (1.18, 1.39), recurrent/residual polyps; pooled RR 0.26 (0.12, 0.56) and complete resection confirmed by histology; pooled RR 0.75 (0.57, 0.98). There was no significant difference in adverse events (AEs); pooled RR 0.68 (0.44, 1.05).

Conclusions This meta-analysis found statistically significantly better rates of en bloc resection, complete macroscopic resection, and lower risk of recurrent/residual polyps with UEMR compared to EMR. We found no significant difference in AEs between the two techniques.
Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis
Authors: Dhindsa Banreet Singh , Saghir Syed Mohsin , Naga Yassin , Dhaliwal Amaninder , Ramai Dayl , Cross Chad , Singh Shailender , Bhat Ishfaq , Adler Douglas G.
Published: September 2020

Background and study aims Transoral outlet reduction (TORe) is an endoscopic procedure used in patients with weight gain post Roux-en-Y gastric bypass (RYGB). We performed a systematic review and meta-analysis to evaluate the efficacy and safety of TORe with a full-thickness suturing device for treating patients with weight regain after RYGB.

Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to March 2020). The primary outcomes assessed were technical success, absolute weight loss (AWL) and percent of total weight loss (% TWL) at 3, 6, and 12 months after the procedure. The secondary outcomes assessed were pooled rate of adverse events (AEs), adverse event subtypes and association of size of gastrojejunal anastomosis (GJA) and percent TWL.

Results Thirteen studies on 850 patients were included. The pooled rate of technical success was 99.89 %. The absolute weight loss (kg) at 3, 6, and 12 months was 6.14, 10.15, and 7.14, respectively. The percent TWL at 3, 6, and 12 months was 6.69, 11.34, and 8.55, respectively. The pooled rate of AE was 11.4 % with abdominal pain being the most common adverse event. The correlation coefficient (r) was –0.11 between post TORe GJA size and weight loss at 12 months.

Conclusion TORe is an endoscopic procedure that is safe and technically feasible for post RYGB with weight gain.
Der digitale Baumzeichentest – Ein kunsttherapeutischer Ansatz für das Demenz-Screening
Authors: Robens Sibylle , Ostermann Thomas
Published: September 2020

Für die Frühdiagnostik von Demenz bestehtder Bedarf an zuverlässigen Screeningverfahren.Der Uhrentest nach Shulman weistlaut S3-Leitlinie „Demenz“ für Patientinnenund Patienten mit leichten kognitiven Einschränkungenkeine ausreichende Sensitivitätauf. Einen neuen Ansatz bietet der digitaleBaumzeichentest, der von einem multidisziplinärenTeam aus Wissenschaftlerinnenund Wissenschaftlern zusammen mit Kunsttherapeutinnenund -therapeuten entwickeltwurde. Das Zeichnen des Baummotivs erfolgthier mithilfe eines Tablets mit digitalemStift und einem einfachen Malprogramm.Durch eine softwaregestützte Berechnungund statistische Analyse wirdanhand bestimmter Zeichenmerkmale derGrad der kognitiven Beeinträchtigung erfasst.Die Forscherinnen und Forscher versprechensich durch das innovative Verfahren, neben einem diagnostischen Mehrwertzur frühen Identifizierung kognitiv eingeschränkterPersonen, eine weniger mitScham und Stress verbundene Testung, diezu einer erhöhten Motivation führt, an einemScreening teilzunehmen.
Full-thickness resection device (FTRD) for treatment of upper gastrointestinal tract lesions: the first international experience
Authors: Khashab Mouen A. , Sharaiha Reem Z. , Hajifathalian Kaveh , Ichkhanian Yervant , Dawod Qais , Meining Alexander , Schmidt Arthur , Glaser Nicholas , Vosoughi Kia , Diehl David L. , Grimm Ian S. , James Theodore , Templeton Adam W. , Samarasena Jason B. , Chehade Nabil El Hage , Lee John G. , Chang Kenneth J. , Mizrahi Meir , Barawi Mohammed , Irani Shayan , Friedland Shai , Korc Paul , Aadam Abdul Aziz , Al-Haddad Mohammad , Kowalski Thomas E. , Smallfield George , Ginsberg Gregory G. , Fukami Norio , Lajin Michael , Kumta Nikhil A. , Tang Shou-jiang , Naga Yehia , Amateau Stuart K. , Kasmin Franklin , Goetz Martin , Seewald Stefan , Kumbhari Vivek , Ngamruengphong Saowanee , Mahdev Srihari , Mukewar Saurabh , Sampath Kartik , Carr-Locke David L.
Published: September 2020

Background and study aims The Full-Thickness Resection Device (FTRD) provides a novel treatment option for lesions not amenable to conventional endoscopic resection techniques. There are limited data on the efficacy and safety of FTRD for resection of upper gastrointestinal tract (GIT) lesions.

Patients and methods This was an international multicenter retrospective study, including patients who had an endoscopic resection of an upper GIT lesion using the FTRD between January 2017 and February 2019.

Results Fifty-six patients from 13 centers were included. The most common lesions were mesenchymal neoplasms (n = 23, 41 %), adenomas (n = 7, 13 %), and hamartomas (n = 6, 11 %). Eighty-four percent of lesions were located in the stomach, and 14 % in the duodenum. The average size of lesions was 14 mm (range 3 to 33 mm). Deployment of the FTRD was technically successful in 93 % of patients (n = 52) leading to complete and partial resection in 43 (77 %) and 9 (16 %) patients, respectively. Overall, the FTRD led to negative histological margins (R0 resection) in 38 (68 %) of patients. A total of 12 (21 %) mild or moderate adverse events (AEs) were reported. Follow-up endoscopy was performed in 31 patients (55 %), on average 88 days after the procedure (IQR 68–138 days). Of these, 30 patients (97 %) did not have any residual or recurrent lesion on endoscopic examination and biopsy, with residual adenoma in one patient (3 %).

Conclusions Our results suggest a high technical success rate and an acceptable histologically complete resection rate, with a low risk of AEs and early recurrence for FTRD resection of upper GIT lesions.
Diagnostic performance of artificial intelligence to identify deeply invasive colorectal cancer on non-magnified plain endoscopic images
Authors: Nakajima Yuki , Zhu Xin , Nemoto Daiki , Li Qin , Guo Zhe , Katsuki Shinichi , Hayashi Yoshikazu , Utano Kenichi , Aizawa Masato , Takezawa Takahito , Sagara Yuichi , Shibukawa Goro , Yamamoto Hironori , Lefor Alan Kawarai , Togashi Kazutomo
Published: September 2020

Background and study aims Colorectal cancers (CRC) with deep submucosal invasion (T1b) could be metastatic lesions. However, endoscopic images of T1b CRC resemble those of mucosal CRCs (Tis) or with superficial invasion (T1a). The aim of this study was to develop an automatic computer-aided diagnosis (CAD) system to identify T1b CRC based on plain endoscopic images.

Patients and methods In two hospitals, 1839 non-magnified plain endoscopic images from 313 CRCs (Tis 134, T1a 46, T1b 56, beyond T1b 37) with sessile morphology were extracted for training. A CAD system was trained with the data augmented by rotation, saturation, resizing and exposure adjustment. Diagnostic performance was assessed using another dataset including 44 CRCs (Tis 23, T1b 21) from a third hospital. CAD generated a probability level for T1b diagnosis for each image, and > 95 % of probability level was defined as T1b. Lesions with at least one image with a probability level > 0.95 were regarded as T1b. Primary outcome is specificity. Six physicians separately read the same testing dataset.

Results Specificity was 87 % (95 % confidence interval: 66–97) for CAD, 100 % (85–100) for Expert 1, 96 % (78–100) for Expert 2, 61 % (39–80) for both gastroenterology trainees, 48 % (27–69) for Novice 1 and 22 % (7–44) for Novice 2. Significant differences were observed between CAD and both novices (P = 0.013, P = 0.0003). Other diagnostic values of CAD were slightly lower than of the two experts.

Conclusions Specificity of CAD was superior to novices and possibly to gastroenterology trainees but slightly inferior to experts.
Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients
Authors: Riegert Monica , Nandwani Monica , Thul Bonny , Chiu Angela Chang , Mathews Simon C. , Khashab Mouen A. , Kalloo Anthony Nicholas
Published: September 2020

Background and study aims The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, solutions are needed to improve this disparity, with non-physician endoscopists being a potential option. However, current literature on the performance of non-physicians in endoscopy is limited. The aim of this study was to assess the quality of colonoscopy performed by three gastrointestinal fellowship-trained nurse practitioners (NPs).

Methods This was a retrospective study performed at a single tertiary academic medical center. Colonoscopies performed by three gastrointestinal-specialized NPs after having completed training of at least 140 supervised colonoscopies were reviewed for analysis. Inclusion criteria were patients undergoing colonoscopy for colorectal cancer screening purposes. Outcomes included colonoscopy quality indicators as defined by the American Society for Gastrointestinal Endoscopy/American College of Gastroenterology Taskforce (ASGE/ACG) Taskforce.

Results The study included 1,012 subjects (mean age 56.2 years, female 51.5 %, African American 73.9 %) who underwent screening colonoscopies by three NPs. Cecal intubation was successful in 997 subjects (98.5 %). Mean adenoma detection rate was 35.6 %. Mean withdrawal time was 18.9 minutes. There were no adverse events including colonic perforations or delayed post-polypectomy bleeding.

Conclusions Three fellowship-trained NPs in colonoscopy in the United States satisfied the quality indicators proposed by the ASGE/ACG Task force, demonstrating that adequately trained NPs can perform colonoscopy safely and effectively. With the demand for colonoscopy exceeding the supply, non-physicians could be part of the solution to meet the demands for CRC screening.
Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?
Authors: Mangiavillano Benedetto , Sosa-Valencia Leonardo , Deprez Pierre , Eisendrath Pierre , Robles-Medranda Carlos , Eusebi Leonardo H. , Di Leo Milena , Auriemma Francesco , Bianchetti Mario , Anderloni Andrea , Carrara Silvia , Repici Alessandro
Published: September 2020

Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.
Bockshornklee (Trigonella foenum-graecum)
Authors: Chrubasik-Hausmann Sigrun
Published: September 2020

Vielversprechende Indizien für Wirksamkeit, aber unzureichend belegt
COVID-19: Eine Formel als Heuristik
Authors: Wildner Manfred
Published: September 2020

Heureka – ich habe es gefunden! Dieser freudige Ausruf anlässlich einer geistigen Erkenntnis ist uns vom griechischen Mathematiker und Naturforscher Archimedes überliefert, der mit diesem Ausruf unbekleidet durch die Straßen von Syrakus gelaufen sein soll, nachdem er in der Badewanne das Prinzip des Auftriebs eines Körpers als proportional zum verdrängten Medium (hier: Wasser) entdeckt haben soll. Im Notizbuch des Mathematikers Gauß findet sich auch 2000 Jahre später noch ein „Heureka!“ neben der Erkenntnis, dass jede positive ganze Zahl als Summe von höchstens 3 Dreieckszahlen ausgedrückt werden kann. Anknüpfend an diese historischen Anekdoten ist eine Heuristik, welche den Wortstamm mit Heureka teilt, verallgemeinernd eine praktische Lösungsstrategie – die Kunst, mit unvollständiger Information und oft unter Zeitdruck ausreichend schnell zu einer praktikablen Lösung zu gelangen, auch wenn diese noch nicht die optimale Lösung darstellt.
Stereoselective 1,4-Addition of Primary Alcohols to γ-Alkoxy-α,β-unsaturated Esters
Authors: Nakamura Seiichi , Inatomi Saki , Takayanagi Yuta , Watanabe Kento , Toita Akinori , Yamakoshi Hiroyuki
Published: September 2020

The scope and limitations of the diastereoselective 1,4-addition reaction of primary alcohols to γ-alkoxy-α,β-unsaturated esters were investigated. We found that a variety of sodium alkoxides, generated from the corresponding primary alcohols with NaH, underwent 1,4-addition reactions with (E)-enoates in CH2Cl2 at –23 °C to give β-alkoxy esters in modest yields with good to excellent syn-selectivity, whereas stereoselectivity was not observed with the use of glycerol derivatives as nucleophiles. Cyclic acetal protection was found to play a pivotal role for the reaction to proceed.
Unexpected Substitution Reaction of 1,1-Dichloro-2,2,2-trifluoroethane (HCFC-123) with Phenolates
Authors: Tang Xiao-Jun , Chen Qing-Yun
Published: September 2020

An unexpected substitution reaction of HCFC-123 with phenolates is reported. During the reaction, fluorine atoms in HCFC-123 are removed one by one in the presence of phenolates.
Tratamento medicamentoso da sarcopenia
Authors: Souza Caio Gonçalves de
Published: September 2020

A sarcopenia vem ganhando cada vez mais importância na literatura científica e nos consultórios médicos. Com o envelhecimento da população, essa condição clínica se torna cada vez mais imprescindível de se conhecer, se prevenir e de se tratar. O objetivo desta revisão é trazer as evidências atuais sobre o diagnóstico dessa patologia, de forma prática, bem como as principais opções atuais de tratamento.
Paralisia obstétrica: Avaliação da técnica Sever-L'Episcopo modificada por Hoffer
Authors: Severo Antonio L. , Carvalho Pedro G. L. , Lemos Marcelo B. , Nunes Marcos C. , Scaranto Marjurie , Barros Fernando K.
Published: September 2020

Avaliar os resultados de uma série de 28 casos de paralisia obstétrica alta tratadas com a técnica Sever-L'Episcopo modificada por Hoffer, entre 2003 e 2016. As crianças (idade média, quatro anos e sete meses) com contratura em adução e rotação interna do ombro sem deformidades ósseas secundárias (Mallet classe II) foram submetidas ao alongamento do músculo peitoral e tenotomia do músculo subescapular associada à transferência do latissimus dorsi e músculo redondo maior para o músculo infraespinhal, movendo-se para a função de rotadores externos e elevadores. O seguimento médio foi de 3 anos e 10 meses. Ao final do estudo, 24 pacientes obtiveram excelentes escores de avaliação funcional, principalmente de abdução e rotação externa, passando de Mallet classe II para classe IV. Quatro pacientes ainda demonstraram algum grau de limitação de movimento global, passando da classe II para a classe III. Independentemente do ganho funcional final, todos os pacientes foram capazes de realizar tarefas que antes eram difíceis. Os dados deste estudo sugerem que a cirurgia de Hoffer é um método eficaz no tratamento das sequelas de paralisia obstétrica alta sem deformidades ósseas secundárias.
Tratamento do Dedo em Gatilho
Authors: Belloti João Carlos , Sato Edson Sasahara , Faloppa Flavio
Published: September 2020

O dedo em gatilho é uma afecção frequente. Não obstante a tenossinovite e a alteração da polia A1 serem identificados como fatores desencadeantes, não há consenso sobre a verdadeira causa na literatura, sendo que a sua verdadeira etiologia permanece desconhecida. O diagnóstico é puramente clínico na maior parte das vezes. Ele depende unicamente da existência do travamento do dedo no decorrer da movimentação flexão ativa. O tratamento do dedo em gatilho geralmente se inicia com intervenções não cirúrgicas que são instituídas por pelo menos 3 meses. Nos pacientes em quem haja apresentação inicial com deformidade em flexão ou incapacidade de flexão do dedo, pode haver indicação mais precoce do tratamento cirúrgico em razão da intensidade do quadro álgico e da incapacidade funcional do paciente.

No presente artigo de revisão, apresentaremos as modalidades e o nosso algoritmo para o tratamento do dedo em gatilho.
The Chimeric Propeller Flap
Authors: Hallock Geoffrey G.
Published: September 2020

A chimeric flap consists of multiple discrete tissues or flaps connected only by a common source vessel. Each component must have an independent source of circulation. Rotation of any included part only about its specific vascular supply, such as done with a propeller flap, would be possible. These characteristics, whereby the chimeric flap concept and propeller flap concept are combined, would result in a chimeric propeller flap. Such a choice will enhance overall flap insetting capabilities and versatility, while often limiting the reconstructive need to but a single donor site!
The Effects of Rheumatoid Arthritis on In-Hospital Lengths of Stay, Complications, and Costs following Primary Total Hip Arthroplasty: A Matched-Control Study
Authors: Vakharia Rushabh M. , Gwam Chukuweike , Luo T. David , Mannino Angelo , Anoushiravani Afshin A. , Plate Johannes F. , Roche Martin W.
Published: September 2020

Studies investigating the relationship of rheumatoid arthritis (RA) in patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to analyze whether RA patients undergoing primary THA have higher rates of: (1) in-hospital lengths of stay (LOS), (2) medical complications, (3) implant-related complications, and (4) costs of care. A query using an administrative claims database was performed identifying patients who underwent primary THA with RA, whereas patients without RA served as controls. Study group patients were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 518,927 patients with (n = 86,507) and without (n = 432,420) RA undergoing primary THA. A p-value of less than 0.002 was considered statistically significant. Patients with RA were found to have significantly longer in-hospital LOS (4 vs. 3 days, p < 0.0001). Additionally, RA patients had significantly higher incidence and odds (odds ratio [OR]) of medical (6.39 vs. 1.18%; OR: 5.71, p < 0.0001) and implant-related complications (7.45 vs. 3.35%; OR: 2.32, p < 0.0001) compared with patients without RA. Furthermore, RA patients were found to have significantly higher day of surgery ($12,422.19 vs. $12,103.08, p < 0.0001) and total global 90-day episode of care costs ($16,560.40 vs. $15,167.67, p < 0.0001). This study of 518,927 patients demonstrates patients with RA undergoing primary THA have significantly longer in-hospital LOS, in addition to higher rates of complications and costs. The study is informative as orthopaedists can adequately counsel and educate RA patients of the potential complications which may occur following their procedure.
Comparison of Precision for Manual versus Robotic-Assisted Total Hip Arthroplasty Performed by Fellows
Authors: Smith Ryan , Borukhov Ilya , Hampp Emily , Thompson Matt , Byrd Zackary O. , Sodhi Nipun , Mont Michael A. , Scholl Laura
Published: September 2020

Although various studies have shown that robotic-assisted total hip arthroplasty (RATHA) is associated with improved component positioning to plan and reduced intraoperative complications, there is still a learning curve for implementation even for experienced surgeons. This study assessed this learning curve for fellows during their training year, by comparing the accuracy and precision of acetabular component positioning, leg length, component offset, and center of rotation between manual THA (MTHA) and RATHA. Six fresh-frozen lower extremity specimens were utilized for surgical procedures performed by two adult reconstruction fellows who were halfway through their training year. The specimens were randomized to undergo one side with manual instrumentation and the contralateral side with RATHA. The final intraoperative surgical plan for rotation, cup orientation, leg length, and offset values were recorded and compared with the actual values measured by computed tomography (CT) scan. Using pre- and postoperative CT scans, the RATHA group was then compared with the MTHA group for accuracy and precision to plan. To assess differences in standard deviations of each measurement, 2-variances testing was performed using α = 0.05. To assess differences in central tendencies of each measurement for each group, Mann–Whitney U tests were performed using α = 0.05. RATHA exhibited significantly (p < 0.05) greater accuracy and precision to plan compared with MTHA in shell version (2.3 ± 1.2° vs. 7.8 ± 4.6°), shell inclination (2.1 ± 1.2° vs. 7.2 ± 3.2), and leg length discrepancy (0.8 ± 0.8 mm vs. 6.4 ± 3.7 mm). Center of head rotation was reported for each anatomical plane. There was no statistical difference in distance from original center of head rotation when considering the superoinferior, mediolateral, and anteroposterior planes as well as when combined as a total deviation in all three planes. The use of CT-guided preoperative planning and intraoperative robotic technology can help surgeons achieve desired implant placement. Results from this study indicate that with limited RATHA experience, surgeons in fellowship training were able to place THA components more accurately and precisely to plan for several important parameters compared with MTHA, namely shell inclination, shell anteversion, and leg length discrepancy.
Parkinson's Disease Is Associated with Increased Complications, Readmission Rates, and Costs of Care after Total Hip Arthroplasty: A Matched-Cohort Analysis
Authors: Katz Simon , Marchand Kevin B. , Vakharia Rushabh M. , Anis Hiba , Sodhi Nipun , Piuzzi Nicolas S. , Mont Michael A. , Roche Martin W.
Published: September 2020

Studies investigating the impact of Parkinson's disease (PD) on patients undergoing primary total hip arthroplasty (THA) are limited. Therefore, the purpose of this study was to investigate whether PD patients undergoing primary THA are at increased risk of: (1) medical complications; (2) implant-related complications; (3) readmissions; and (4) costs. A query was performed using an administrative claims database. Matched non-PD patients undergoing primary THA served as a control group. Non-PD patients undergoing primary THA served as a matching cohort. The query yielded 39,184 patients (PD = 9,796; control = 29,388). Pearson's chi-square tests, logistic regression analyses, and Welch's t-tests were used to test for significance between the cohorts. Patients who have PD were found to have increased odds (4.64 vs. 1.15%; odds ratio [OR]: 4.19, 95% confidence interval [CI]: 3.60–4.87, p < 0.0001) of medical complications compared with the matched cohort. PD patients had greater odds of implant-related complications (7.12 vs. 3.99; OR: 1.84, p < 0.0001). PD patients also had significantly higher odds of 90-day readmission (19.83 vs. 15.29%; OR: 1.37, 95% CI: 1.29–1.45, p < 0.0001) and incurred greater 90-day costs of care ($20,143 vs. $16,905, p < 0.0001). The results of the study demonstrate that PD is an independent risk factor for medical complications, implant-related complications, readmission rates, and increased costs of care following a primary THA. The findings of this study should be used in risk stratification and should inform physician–patient discussion but should not be arbitrarily used to deny access to care.
The History of Propeller Flaps
Authors: Hyakusoku Hiko , Ono Shimpei
Published: September 2020

Several pedicled flaps were developed by Hyakusoku at the Nippon Medical School Hospital, Tokyo, Japan, in the 1980s to treat a large number of patients with postburn contractures. In this setting, the propeller flaps were described for the first time in 1991. The term propeller was used because of the blade shape of the skin island rotating on its axis. In 1989, Koshima introduced the term perforator flaps, whereas Hallock, in 2006, applied the perforator flap concept to the propeller flap. The name perforator pedicled propeller flap followed. Propeller flap had developed to be an important operative technique and a hot topic in the field of reconstructive microsurgery, with the important contribution of Teo. In 2009, the First Tokyo Meeting on Perforator and Propeller Flaps was held, where Pignatti reported the consensus on the definition and classification of propeller flaps that was given by the advisory panel of the meeting. Further evolutions developed since then will be described in this dedicated issue of Seminars of Plastic Surgery.
Ibrutinib Suppresses Early Megakaryopoiesis but Enhances Proplatelet Formation
Authors: Huang Jiansong , Huang Shujuan , Ma Zhixin , Lin Xiangjie , Li Xia , Huang Xin , Wang Jinghan , Ye Wenle , Li Yang , He Daqiang , Yang Min , Pan Jiajia , Ling Qing , Li Fenglin , Mao Shihui , Wang Huafeng , Wang Yungui , Jin Jie
Published: September 2020

Ibrutinib, an irreversible inhibitor of Bruton's tyrosine kinase, has a favorable safety profile in patients with B cell-related malignancies. A primary adverse effect of ibrutinib is thrombocytopenia in the early stages of treatment, but platelet counts increase or recover as treatment continues. Currently, the effects of ibrutinib on megakaryopoiesis remain unclear. In this study, we investigated the mechanism by which ibrutinib induces thrombocytopenia using cord blood CD34+ hematopoietic stem cells (HSCs), a human megakaryoblastic cell line (SET-2), and C57BL/6 mice. We show that treatment with ibrutinib can suppress CD34+ HSC differentiation into megakaryocytes (MKs) and decrease the number of colony-forming unit-MKs (CFU-MKs). The ibrutinib-dependent inhibition of early megakaryopoiesis seems to mainly involve impaired proliferation of progenitor cells without induction of apoptosis. The effects of ibrutinib on late-stage megakaryopoiesis, in contrast to early-stage megakaryopoiesis, include enhanced MK differentiation, ploidy, and proplatelet formation in CD34+ HSC-derived MKs and SET-2 cells. We also demonstrated that MK adhesion and spreading, but not migration, were inhibited by ibrutinib. Furthermore, we revealed that integrin αIIbβ3 outside-in signaling in MKs was inhibited by ibrutinib. Consistent with previous clinical observations, in C57BL/6 mice treated with ibrutinib, platelet counts decreased by days 2 to 7 and recovered to normal levels by day 15. Together, these results reveal the pathogenesis of ibrutinib-induced transient thrombocytopenia. In conclusion, ibrutinib suppresses early megakaryopoiesis, as evidenced by inhibition of MK progenitor cell proliferation and CFU-MK formation. Ibrutinib enhances MK differentiation, ploidy, and proplatelet formation, while it impairs integrin αIIbβ3 outside-in signaling.
Pharmacological Neuroprotection of the Preterm Brain: Current Evidence and Perspectives
Authors: Siahanidou Tania , Spiliopoulou Christina
Published: September 2020

Despite improvements in viability, the long-term neurodevelopmental outcomes of preterm babies remain serious concern as a significant percentage of these infants develop neurological and/or intellectual impairment, and they are also at increased risk of psychiatric illnesses later in life. The current challenge is to develop neuroprotective approaches to improve adverse outcomes in preterm survivors. The purpose of this review was to provide an overview of the current evidence on pharmacological agents targeting the neuroprotection of the preterm brain. Among them, magnesium sulfate, given antenatally to pregnant women with imminent preterm birth before 30 to 34 weeks of gestation, as well as caffeine administered to preterm infants after birth, exhibited neuroprotective effects for human preterm brain. Erythropoietin treatment of preterm infants did not result in neuroprotection at 2 years of age in two out of three published large randomized controlled trials; however, long-term follow-up of these infants is needed to come to definite conclusions. Further studies are also required to assess whether melatonin, neurosteroids, inhaled nitric oxide, allopurinol, or dietary supplements (omega-3 fatty acids, choline, curcumin, etc.) could be implemented as neuroprotectants in clinical practice. Furthermore, other pharmacological agents showing promising signs of neuroprotective efficacy in preclinical studies (growth factors, hyaluronidase inhibitors or treatment, antidiabetic drugs, cannabidiol, histamine-H3 receptor antagonists, etc.), as well as stem cell- or exosomal-based therapies and nanomedicine, may prove useful in the future as potential neuroprotective approaches for human preterm brain.

Key Points
Are Oxinium Femoral Heads Superior to Alternative Bearing Surface Materials? A Systematic Review
Authors: Zou Anthony H. , Feng James E. , Novikov David , O'Connor Casey M. , Anoushiravani Afshin A. , Schwarzkopf Ran , Vigdorchik Jonathan M.
Published: September 2020

Oxidized zirconium (OxZr) femoral heads were developed to emulate the superior wear and scratch properties of ceramics while eliminating their unwanted tendency for brittle fracturing. Studies using OxZr have demonstrated reduced linear and volumetric wear of polyethylene (PE) liners when compared with cobalt chrome, ceramic, and steel femoral heads. The purpose of this systematic review was to determine the difference in revision rates, radiologically determined linear wear rates, and patient-reported outcomes among OxZr and alternative bearing materials. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocols, a systematic review of published literature through April 24, 2018 was conducted. Among the 862 cases included at a mean weighted follow-up of 4.78 years, the revision THA rate and patient-reported outcomes were similar among OxZr and alternative bearing materials. One of the five studies demonstrated significantly lower linear wear rates in the OxZr group when paired with ultrahigh molecular-weight PE (OxZr 0.03 mm/y vs. stainless-steel 0.11 mm/y; p < 0.001) and when paired with highly-crosslinked PE (OxZr 0.02 mm/y vs. stainless-steel 0.04 mm/y; p < 0.001). The remaining four studies found no difference in linear wear rates. OxZr demonstrated similar outcome to that of modern-day ceramic and metal femoral heads for short- and mid-term revision surgery rates and patient-reported outcomes. Longer term studies are needed to evaluate if any long-term wear advantages are seen with the use of OxZr femoral heads and if the use of OxZr is cost effective compared with ceramic or metal alternatives. The level of evidence of the study is level II, systematic review.
Real-time tracking of protein unfolding with time-resolved x-ray solution scattering
Authors: Henry L. , Panman M. R. , Isaksson L. , Claesson E. , Kosheleva I. , Henning R. , Westenhoff S. , Berntsson O.
Published: September 2020

The correct folding of proteins is of paramount importance for their function, and protein misfolding is believed to be the primary cause of a wide range of diseases. Protein folding has been investigated with time-averaged methods and time-resolved spectroscopy, but observing the structural dynamics of the unfolding process in real-time is challenging. Here, we demonstrate an approach to directly reveal the structural changes in the unfolding reaction. We use nano- to millisecond time-resolved x-ray solution scattering to probe the unfolding of apomyoglobin. The unfolding reaction was triggered using a temperature jump, which was induced by a nanosecond laser pulse. We demonstrate a new strategy to interpret time-resolved x-ray solution scattering data, which evaluates ensembles of structures obtained from molecular dynamics simulations. We find that apomyoglobin passes three states when unfolding, which we characterize as native, molten globule, and unfolded. The molten globule dominates the population under the conditions investigated herein, whereas native and unfolded structures primarily contribute before the laser jump and 30 μs after it, respectively. The molten globule retains much of the native structure but shows a dynamic pattern of inter-residue contacts. Our study demonstrates a new strategy to directly observe structural changes over the cause of the unfolding reaction, providing time- and spatially resolved atomic details of the folding mechanism of globular proteins.
Repetitive non-thermal melting as a timing monitor for femtosecond pump/probe X-ray experiments
Authors: Bengtsson Å. U. J. , Ekström J. C. , Wang Xiaocui , Jurgilaitis A. , Pham Van-Thai , Kroon D. , Larsson J.
Published: September 2020

Time-resolved optical pump/X-ray probe experiments are often used to study structural dynamics. To ensure high temporal resolution, it is necessary to monitor the timing between the X-ray pulses and the laser pulses. The transition from a crystalline solid material to a disordered state in a non-thermal melting process can be used as a reliable timing monitor. We have performed a study of the non-thermal melting of InSb in single-shot mode, where we varied the sample temperature in order to determine the conditions required for repetitive melting. We show how experimental conditions affect the feasibility of such a timing tool.
Dioctadecyldimethylammonium bromide, a surfactant model for the cell membrane: Importance of microscopic dynamics
Authors: Sharma V. K. , Srinivasan H. , García Sakai V. , Mitra S.
Published: September 2020

Cationic lipid membranes have recently attracted huge attention both from a fundamental point of view and due to their practical applications in drug delivery and gene therapy. The dynamical behavior of the lipids in the membrane is a key parameter controlling various physiological processes and drug release kinetics. Here, we review the dynamical and thermotropic phase behavior of an archetypal cationic lipid membrane, dioctadecyldimethylammonium bromide (DODAB), as studied using neutron scattering and molecular dynamics simulation techniques. DODAB membranes exhibit interesting phase behavior, specifically showing coagel, gel, and fluid phases in addition to a large hysteresis when comparing heating and cooling cycles. The dynamics of the lipid membrane is strongly dependent on the physical state of the bilayer. Lateral diffusion of the lipids is faster, by an order of magnitude, in the fluid phase than in the ordered phase. It is not only the characteristic times but also the nature of the segmental motions that differ between the ordered and fluid phases. The effect of different membrane active molecules including drugs, stimulants, gemini surfactants, and unsaturated lipids, on the dynamical and thermotropic phase behavior of the DODAB membrane, is also discussed here. Various interesting features such as induced synchronous ordering between polar head groups and tails, sub diffusive behavior, etc., are observed. The results shed light on the interaction between these additives and the membrane, which is found to be a complex interplay between the physical state of the membrane, charge, concentration, molecular architecture of the additives, and their location within the membrane.
Kinetic simulations of anomalous resistivity in high-temperature current carrying plasmas
Authors: Tummel K. , Ellison C. L. , Farmer W. A. , Hammer J. H. , Parker J. B. , LeChien K. R.
Published: September 2020

Anomalous resistivity caused by lower hybrid drift instabilities (LHDIs) has been extensively studied in the literature, and has been invoked to explain the rates of magnetic diffusion and plasma profile evolution in the low-density plasma periphery of theta and screw pinch plasmas. This article presents a fully kinetic simulation study of LHDIs with a realistic mass ratio using the particle-in-cell code Chicago over a large range of drift speeds, 0.5<vdi2/vti2<14.5, plasma β, β≥2×10−5, and temperature ratios, 0.1<Te/Ti<10. The resistivity quantified from the simulations is compared with the analytic estimates from the literature and a generalized resistivity expression is presented, which can be applied over the entire range of plasma environments that were simulated in this study. This expression uses the amplitude of the LHDI fluctuations resulting from instability saturation by electron resonance broadening rather than plateau formation, current relaxation, or ion trapping. The generalized resistivity expression is appropriate for full-scale fluid simulations that encounter a large range of plasma conditions, and has better agreement with the resistivity quantified from kinetic simulations than previous expressions in the literature, particularly at low plasma β. Anomalous resistivity has also been considered as an explanation of the rapid magnetic field dissipation during magnetic reconnection events at large plasma β. At a large β, the magnetic field fluctuations of LHDIs can dominate the electrostatic fluctuations and this article investigates enhanced collisionality due to the nonlinear magnetic force, δJ×δB/c.
Development of a broad band AC power amplifier for real time turbulence feedback control experiment in the Saskatchewan Torus-modified (STOR-M) tokamak
Authors: Basu Debjyoti , Nakajima Masaru , Melnikov A. V. , McColl David , Xiao Chijin , Hirose Akira
Published: September 2020

A gated oscillating power amplifier has been developed for high frequency biasing and real time turbulent feedback experiments in the Saskatchewan Torus-modified tokamak. This oscillator is capable of providing a peak to peak oscillating output voltage of around ±60 V with a current around 30 A within the frequency band 1 kHz–50 kHz without any distortions. The overall output power is amplified by a two-stage metal oxide semiconductor field-effect transistor power op-amp as well as nine identical push–pull amplifiers in the final stages. The power amplifier input signal, collected from the plasma floating potential during the tokamak discharge, is optically isolated from the tokamak vessel ground. The filtered floating potential fluctuations with a band width of 5 kHz–40 kHz were amplified and fed to an electrode inserted into the plasma edge to study the response of the plasma turbulence. We observe that magnetic fluctuations are suppressed due to real time feedback of the floating potential.
Wideband complex-enhanced bidirectional phase chaotic secure communication with time-delay signature concealment
Authors: Lu Tianfeng , Wang Hongxiang , Ji Yuefeng
Published: September 2020

A novel bandwidth-enhanced bidirectional phase chaotic secure communication system with time-delay signature (TDS) concealment is proposed and analyzed by numerical simulation. This bidirectional system based on two mutually coupled electro-optic (MCEO) phase feedback loops is driven by a common all-optical (AO) chaotic source. The AO driving source makes the amplitude and phase terms in the Ikeda-based MCEO equation chaotic. Two mutually coupled optoelectronic delayed feedback loops also greatly increase the complexity of the chaotic carrier. By replacing the semiconductor laser in the existing bidirectional communication scheme with an electro-optic feedback loop, the problems of narrow carrier bandwidth and poor synchronization performance can be compensated. Compared to the single MCEO system, the permutation entropy of the AO-MCEO cascaded system with a bit rate of 10 Gbit/s is improved by 0.13 to 0.98. The TDS of the AO-MCEO system is suppressed 35 times to less than 0.01 to be completely hidden when the EO gain is reduced by half to 2.75. The chaos effective bandwidth is increased by 5 GHz to 32.05 GHz, and the spectrum flatness is reduced by 0.33 dB/Hz to 0.82 dB/Hz. Meanwhile, the security is further enhanced by reducing the cross-correlation coefficient to 0.001 between the AO driving source and the electro-optical chaotic carrier. The results show that the proposed model has potential applications in bandwidth-enhanced bidirectional secure chaotic systems.
Simulation of plasma instabilities artificially induced in the equatorial ionosphere
Authors: Gao Jingfan , Guo Lixin , Xu Zheng-Wen , Zhao Haisheng
Published: September 2020

Based on a proposed high-resolution numerical simulation, a qualified development of ionospheric instability triggered by chemical release is first presented in this paper. First, the upwelling, pinching, penetrating, and bifurcating processes of artificial instability are overall produced with electron density patterns generated by using this model. This high-resolution simulation method is first used in artificial instability rather than similar previous work involving natural cases. The numerical method provides a clearer prospect on the development of artificially induced instability. Second, aside from the morphology, statistical characteristics of the electron density fluctuations are obtained and used to verify the effect of instability. The variance and the power spectral density (PSD) of artificial instability are first analyzed in detail by using data extracted from simulations. The empirical PSD of the generated natural irregularities yields Shkarofsky's spectrum, which is deemed to be the general spectrum of the ionospheric plasma. It is interesting that the PSD of artificially initiated electron density fluctuation is found to be in good agreement with Shkarofsky's spectrum. This consistency indicates the occurrence of irregularities in nonlinear simulation and applicability of the simulations to extended studies. Finally, as the electron density fluctuation shown in simulation varies along the altitude, the multiple phase screen (MPS) method is ready for scintillation calculation of the diagnostic radio propagation. Validity of the scintillation calculation by using the MPS reveals that the electron density predicted by instability simulation could be useful for further studies involving both natural and artificial instabilities in the ionosphere. It is shown that the high-resolution simulation model proposed could be useful for further studies involving both natural and artificial instabilities in the ionosphere.