bluuebunny/crossref_metadata_2025 huggingface dataset:
Liver hydatid diseases of the pregnancy: Management approaches and outcomes
Authors: Noori Ibrahim Falih
Published: February 2021

ABSTRACT

Background:

Although hepatic hydatid disease is infrequent during pregnancy, it could be hazardous for both the mother and the fetus. Most cases of hydatid cysts during pregnancy are asymptomatic and discovered accidentally during prenatal care. The diagnosis of hepatic hydatid disease is easy and straightforward but the management is difficult and problematic.

Objective& method:

We present 12 pregnant patients of various gestational age discovered to have hepatic hydatid disease during antenatal period or for investigation for non-specific symptoms. Their representations, diagnosis and treatments options and outcomes were studied and assessed.

Results:

A retrospective cohort study in which 12 consecutive pregnant patients of different gestational ages diagnosed incidentally or due to non-specific symptoms to have hydatid liver diseases. The age ranges from 18 to 42 year (mean 31.5 years). The size of the cysts measured by ultrasound ranges between 3 cm and 8.5 cm (average 4.8 cm). Four asymptomatic patients were managed by expectant observation and close follow-up, tow patients were managed by anthelminthic drug (Albendazole), four symptomatic large (>5 cm) and palpable cysts underwent PAIR procedure and the last two patients were submitted to surgery in form of pericystectomy due to their acute symptomatic presentation. No mortality occurred and all neonates were healthy with no congenital anomalies.

Conclusions:

Up to now there is no consensus of the management of hydatid disease during pregnancy and each case should be individualized. Observations with close follow up, medical treatment using anthelminthic drugs such as albendazole, percutaneous aspiration and surgery are treatment options.

Highlights
Role of CTSA institutes and academic medical centers in facilitating preapproval access to investigational agents and devices during the COVID-19 pandemic
Authors: Gravelin Misty , Wright Jeanne , Holbein M.E. Blair , Berro Marlene , Brown Jennifer S. , Mashour George A. , Weatherwax Kevin J.
Published: February 2021

Introduction:

With no approved treatments for COVID-19 initially available, the Food and Drug Administration utilized multiple preapproval pathways to provide access to investigational agents and/or medical devices: Expanded Access, Emergency Use Authorizations, and Clinical Trials. Regulatory units within an Academic Medical Center (AMC), including those part of the Clinical and Translational Science Award (CTSA) consortium, have provided support for clinicians in navigating these options prior to the pandemic. As such, they were positioned to be a resource for accessing therapies during the COVID-19 public health emergency.

Methods:

A small survey and a follow-on poll of the national Investigational New Drug (IND)/Investigational Device Exemption (IDE) Workgroup were conducted in October and December 2020 to determine whether CTSA regulatory units assisted in facilitating access to COVID-19 therapies and the extent of pandemic-related challenges these units faced.

Results:

Fifteen survey and 21 poll responses were received, which provided insights into the demands placed on these regulatory support units due to the pandemic and the changes required to provide critical support during this and future crises. Key changes and lessons learned included the importance of regulatory knowledge to support the institutional response, the critical need for electronic submission capacity for Food and Drug Administration (FDA) documents, and the nimble reallocation of regulatory and legal resources to support patient access to investigational agents and/or medical devices during the pandemic.

Conclusion:

AMC- and CTSA-based regulatory units played a meaningful role in the COVID-19 pandemic but further unit modifications are needed for enabling more robust regulatory support in the future.
THE EXTERMINATION OF THE ANCIENT RUSSIAN CITY OF YAROSLAVL AT THE BEGINNING OF THE 13TH CENTURY: THE LONG JOURNEY TO EXACT DATING
Authors: Engovatova Asya V , Cherkinsky Alexander , Zaiseva Ganna I
Published: February 2021

This paper raises methodological issues of radiocarbon (14C) dating of historical events based on data obtained during the excavations of the Russian medieval city of Yaroslavl. The city is of special interest to our study because of the precise time of its destruction by troops of Batu Khan mentioned in chronicles—the winter of 1238. To date in Yaroslavl, researchers have discovered 9 mass burials of citizens and domestic animals buried sometime after the massacre by the Mongols. Mass burials of people alongside animals in a common grave and outside of the cemetery, in violation of Christian traditions, are not typical of medieval Russia and are a sign of a military catastrophe. To test this hypothesis, we dated a total of 65 samples representing all 9 mass burials. A Bayesian chronological model of the accelerator mass spectrometry (AMS) dates narrowed the interval to the range of 1197–1280 cal AD, with the mean age of 1239 AD, consistent with the hypothesis that the studied mass burials of citizens and livestock are related to the capture of the city by the army of Batu Khan.
Democratization in the Shadow of Globalization
Authors: Gao Jacque
Published: February 2021

In this article I develop a new theory of how globalization in the form of increasing potential foreign direct investment (FDI) inflows affects democratization. As the level of potential FDI inflows increases, workers become more willing to support democratization because of the large wage benefits from liberalizing FDI under democracy, while capitalists become less willing to support democratization because of their increasing need for protection from the dictator in the form of FDI restrictions. Increased demand for protection allows dictators to extract larger share of rents from capitalists. The effect of increasing potential FDI on democratization is ambiguous because it increases both workers’ incentive to revolt and dictators’ resistance to democratization.
Effect of protein level and grain source on milk production, nutrient digestibility and ruminal fermentation in primiparous Holstein cows
Authors: Mirzaei-Alamouti H. , Mohammad A. , Vazirigohar M. , Rezamand P. , Mansouryar M.
Published: February 2021

This study investigated whether the interaction of protein level and grain type can affect milk production, nutrient digestibility and rumen fermentation in primiparous Holstein cows. Four dietary treatments were used: high-protein with barley as the only grain source, HP-B; (2) high-protein with an equal mix of barley and maize, HP-BM; (3) low-protein with barley as the only grain source, LP-B and (4) low-protein with equal proportions of barley and maize, LP-BM. High-protein diets showed no improvement in milk or protein yield compared with low-protein, but barley and maize mix diets increased energy-corrected milk yield and fat yield compared with barley-only diets. The highest total apparent digestibility of dry matter, organic matter and neutral detergent fibre was observed for LP-BM whereas HP-BM showed the greatest crude protein digestibility. Treatment had no effect on total volatile fatty acid concentrations, molar proportion of acetate and propionate and acetate to propionate ratio. The lowest ruminal pH was observed for LP-B. High-protein diets resulted in greater concentrations of ammonia nitrogen (N), urinary N, blood and milk urea nitrogen compared with low-protein diets, whereas low-protein diets showed better nitrogen utilization efficiency. This study showed that primiparous lactating cows do not benefit from high-protein diets with different fermentation rates of grain sources, but barley and maize diets may improve milk production performance, ruminal fermentation and pH under the present dietary conditions. The current results on milk production performance should be interpreted with caution due to the small number of cows used (eight in each treatment).
An unusual case of ear mould impression material as a foreign body in the middle ear: case report
Authors: Manjunath D , Vadlamani S , Gaur S K , Dutt S N
Published: February 2021

Background

The occurrence of retained ear mould impression material is rare and can lead to complications. The current case report describes one such complication, where the silicone impression material used to take the impression of the ear canal flowed into the middle ear through the pre-existing tympanic membrane perforation. Five days later, the patient presented with worsened hearing and blood-tinged discharge from the ear. Ear microscopy revealed a greenish foreign body in the middle ear.

Case report

The foreign body was removed by tympanotomy and the perforation repaired using a temporalis fascia graft. A hearing aid was prescribed after ensuring that the perforation had healed.

Conclusion

It is essential that the audiologist perform a basic otological examination before prescribing a hearing aid and preparing an ear mould. A clinical approach algorithm for audiologists, for prior to taking an impression, is suggested.
Endoscopic laryngeal findings in patients undergoing thyroid and parathyroid surgery
Authors: Burckardt E S , Baird B J , Van Stan J H , Burns J A
Published: February 2021

Objectives

This study aimed to report the pre- and post-operative laryngeal endoscopic findings in patients referred by non-otolaryngologists who are undergoing thyroid and/or parathyroid surgery, and to determine the number and nature of referrals before and after the release of the clinical practice guideline for improving voice outcomes after thyroid surgery.

Methods

This retrospective cohort study, conducted at a tertiary care academic hospital, comprised adult patients referred by the endocrine surgery service for laryngoscopy from 2007 to 2018 (n = 166). Data regarding patient demographics, reason for referral and endoscopic findings were recorded.

Results

The number of referrals increased significantly after the release of the practice guideline. The most common indication for referral pre- and post-operatively was voice change. The most common finding during laryngoscopy was normal examination findings (pre-operatively) and unilateral vocal fold immobility (post-operatively).

Conclusion

Peri-operative thyroid and/or parathyroid patients have laryngoscopic findings other than vocal fold immobility. Laryngoscopy to detect structural and functional pathology is warranted.
Opsanus beta (Goode & Bean, 1880) (Acanthopterygii: Batrachoididae), a non-indigenous toadfish in Sepetiba Bay, south-eastern Brazil
Authors: Andrade-Tubino Magda F. , Salgado Fernando Luiz K. , Uehara Wagner , Utsunomia Ricardo , Araújo Francisco Gerson
Published: February 2021

The introduction of non-native predator fish is thought to have important negative effects on native prey populations. Opsanus beta is a non-native toadfish that was originally described in the Gulf of Mexico, between the west coast of Florida and Belize. In the present study, we describe, for the first time, the occurrence of O. beta in Sepetiba Bay (22°55′S), south-eastern Brazil, probably brought into the bay through ships' ballast water. Thirteen specimens were recorded in this area near to Sepetiba Port. Similarly, three other records of this species in the Brazilian coast were also reported near to port areas at Rio de Janeiro (22°49′S), Santos (23°59′S) and Paranaguá (25°33′S) ports. To confirm the species identity, we employed DNA barcoding and compared our samples with sequences deposited on public databases, which indicated that our samples are highly similar (>99.9% of genetic similarity) to O. beta samples collected near its type locality. Several individuals were found in the capable spawning phase, according to histological analysis of the reproductive cell stages. The environmental plasticity of this species and the favourable local environmental conditions probably enabled the establishment of O. beta in this region. This raises concerns of potential high invasion impact due to this species' diet and reproductive capacity.
Dynamical and arithmetic degrees for random iterations of maps on projective space
Authors: HINDES WADE
Published: February 2021

We show that the dynamical degree of an (i.i.d) random sequence of dominant, rational self-maps on projective space is almost surely constant. We then apply this result to height growth and height counting problems in random orbits.
Toward a Multilingual Victorian Transatlanticism
Authors: Reeder Jessie
Published: February 2021

This essay argues that scholarship being done under the sign of transatlantic studies, and Victorian transatlantic studies in particular, is problematically focused on the anglophone northern Atlantic region. Challenging both the essentialness and the disciplinary primacy of the “special relationship” between Britain and the United States, I argue instead that the entire nineteenth-century Atlantic world was a geographically and linguistically permeable space. Paying attention to crossings from north to south and vice versa is both methodologically and ethically necessary. From a methodological perspective, it can help us produce much more thorough answers to the questions transatlantic studies purports to ask about identity and community. But reading beyond anglophone British and U.S. American texts can also help us decolonize our reading and thinking. Of course, work like this requires scholars to read in second and third languages; as such, this essay discusses and denaturalizes the institutional barriers to multilingual English studies. It also offers a case study—a brief reading of a novel by Argentine writer Vicente Fidel López—demonstrating the insights that can be gained by expanding both our geographic perspective and our methodological toolbox.
Austrian behavioral economics
Authors: Whitman Glen
Published: February 2021

This paper explores the potential for gains from trade between Austrian and behavioral economics, with a focus on how the two schools of thoughts can constructively critique each other. Among other things, the Austrian critique of behavioral economics would urge it to jettison its restrictive and axiomatic definition of rationality, and to treat humans as active agents rather than passive recipients of environmental and cognitive influences. Meanwhile, the behavioral critique of Austrian economics would push it to take more seriously the fundamental question of how individuals arrive at choices and to analyze how such choices can interact with ‘micro-institutional’ choice environments.
Seabed Boundaries in the Northern Bay of Bengal: The Unclear Role of the Commission on the Limits of the Continental Shelf in Paving the Way to Resource Exploitation
Authors: SERDY Andrew
Published: February 2021

Even before Bangladesh's submission on the outer limits of its continental shelf beyond 200 miles from its baseline reaches the head of the queue awaiting the attention of the Commission on the Limits of the Continental Shelf, the maritime boundary delimitations with Myanmar (2012) and India (2014) have produced a unique situation, in which Bangladesh's seabed boundaries have been fully delimited with both neighbours, creating a single continuous outer limit landward of the one submitted to the Commission. This may mean that there is no need to await the Commission's reaction to Bangladesh's submission, as there is nothing to stop Bangladesh simply beginning to exploit areas on its side of the two boundaries. This paper examines whether the position is really that simple, and whether any other state might have grounds for objecting if Bangladesh does so, together with deficits of co-operation that may confound early moves to exploitation.
Introducing the New Editor in Chief of JGR: Oceans
Authors: Beal Lisa
Published: February 2021

Find out about the person taking the helm of Journal of Geophysical Research: Oceans and her vision for the coming years.
Nrf2 epigenetic derepression induced by running exercise protects against osteoporosis
Authors: Chen Xingren , Zhu Xiaobo , Wei Ai , Chen Fang , Gao Qi , Lu Ke , Jiang Qing , Cao Wangsen
Published: February 2021

Osteoporosis (OP) is a common skeletal disease involving low bone mineral density (BMD) that often leads to fragility fracture, and its development is affected by multiple cellular pathologies and associated with marked epigenetic alterations of osteogenic genes. Proper physical exercise is beneficial for bone health and OP and reportedly possesses epigenetic modulating capacities; however, whether the protective effects of exercise on OP involve epigenetic mechanisms is unclear. Here, we report that epigenetic derepression of nuclear factor erythroid derived 2-related factor-2 (Nrf2), a master regulator of oxidative stress critically involved in the pathogenesis of OP, mediates the significant osteoprotective effects of running exercise (RE) in a mouse model of OP induced by ovariectomy. We showed that Nrf2 gene knockout (Nfe2l2−/−) ovariectomized mice displayed a worse BMD reduction than the controls, identifying Nrf2 as a critical antiosteoporotic factor. Further, femoral Nrf2 was markedly repressed with concomitant DNA methyltransferase (Dnmt) 1/Dnmt3a/Dnmt3b elevations and Nrf2 promoter hypermethylation in both patients with OP and ovariectomized mice. However, daily 1-h treadmill RE significantly corrected epigenetic alterations, recovered Nrf2 loss and improved the femur bone mass and trabecular microstructure. Consistently, RE also normalized the adverse expression of major osteogenic factors, including osteoblast/osteoclast markers, Nrf2 downstream antioxidant enzymes and proinflammatory cytokines. More importantly, the RE-conferred osteoprotective effects observed in the wild-type control mice were largely abolished in the Nfe2l2−/− mice. Thus, Nrf2 repression due to aberrant Dnmt elevation and subsequent Nrf2 promoter hypermethylation is likely an important epigenetic feature of the pathogenesis of OP, and Nrf2 derepression is essential for the antiosteoporotic effects of RE.
The impact of creativity on functional outcome in schizophrenia: a mediational model
Authors: Sampedro Agurne , Peña Javier , Sánchez Pedro , Ibarretxe-Bilbao Naroa , Iriarte-Yoller Nagore , Pavón Cristóbal , Hervella Isabel , Tous-Espelosin Mikel , Ojeda Natalia
Published: February 2021

Functional impairment remains one of the most challenging issues for treatment in schizophrenia. However, previous studies have mainly focused on the negative impact of symptoms excluding variables that could positively impact functional outcome, such as creativity, which is considered an adaptive capacity for real-life problem-solving. This study analyzed the predictive role of creativity on functional outcome in 96 patients with schizophrenia through a mediational model, including sociodemographic, clinical, neurocognitive, and social cognitive variables. Path analysis revealed that creativity significantly mediated the relationship between neurocognition and functional outcome, and that creativity mediated between negative symptoms and functional outcome. Additionally, neurocognition was directly associated with functional outcome and social functioning was associated with creativity. The involvement of creativity in functional outcome could have relevant implications for the development of new interventions. These findings open up a new field of research on additional personal resources as possible factors of functional outcome in schizophrenia and other diseases.
Author Correction: Transcriptome and translatome profiles of Streptomyces species in different growth phases
Authors: Kim Woori , Hwang Soonkyu , Lee Namil , Lee Yongjae , Cho Suhyung , Palsson Bernhard , Cho Byung-Kwan
Published: February 2021

A Correction to this paper has been published: https://doi.org/10.1038/s41597-021-00858-2.
Integration of relative metabolomics and transcriptomics time-course data in a metabolic model pinpoints effects of ribosome biogenesis defects on Arabidopsis thaliana metabolism
Authors: Pries Christopher , Razaghi-Moghadam Zahra , Kopka Joachim , Nikoloski Zoran
Published: February 2021

Ribosome biogenesis is tightly associated to plant metabolism due to the usage of ribosomes in the synthesis of proteins necessary to drive metabolic pathways. Given the central role of ribosome biogenesis in cell physiology, it is important to characterize the impact of different components involved in this process on plant metabolism. Double mutants of theArabidopsis thalianacytosolic 60S maturation factorsREIL1andREIL2do not resume growth after shift to moderate 10 $$^{\circ }\hbox {C}$$∘Cchilling conditions. To gain mechanistic insights into the metabolic effects of this ribosome biogenesis defect on metabolism, we developed TC-iReMet2, a constraint-based modelling approach that integrates relative metabolomics and transcriptomics time-course data to predict differential fluxes on a genome-scale level. We employed TC-iReMet2 with metabolomics and transcriptomics data from theArabidopsisColumbia 0 wild type and thereil1-1 reil2-1double mutant before and after cold shift. We identified reactions and pathways that are highly altered in a mutant relative to the wild type. These pathways include the Calvin–Benson cycle, photorespiration, gluconeogenesis, and glycolysis. Our findings also indicated differential NAD(P)/NAD(P)H ratios after cold shift. TC-iReMet2 allows for mechanistic hypothesis generation and interpretation of system biology experiments related to metabolic fluxes on a genome-scale level.
Fluocinolone acetonide vitreous insert for chronic diabetic macular oedema: a systematic review with meta-analysis of real-world experience
Authors: Fallico Matteo , Maugeri Andrea , Lotery Andrew , Longo Antonio , Bonfiglio Vincenza , Russo Andrea , Avitabile Teresio , Furino Claudio , Cennamo Gilda , Barchitta Martina , Agodi Antonella , Marolo Paola , Ventre Luca , Caselgrandi Paolo , Reibaldi Michele
Published: February 2021

We conducted a meta-analysis of real-world studies on the 0.19 mg Fluocinolone Acetonide (FAc) intravitreal implant for chronic diabetic macular oedema (DMO), comparing these findings with the Fluocinolone Acetonide for Diabetic Macular Edema (FAME) study. The primary outcome was mean change of best corrected visual acuity (BCVA) at 24 months. Secondary outcomes were 36-month mean BCVA, mean central macular thickness (CMT) change, rates of eyes receiving supplementary intravitreal therapy, cataract surgery, intraocular pressure (IOP)-lowering drops and glaucoma surgery. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Nine real-world studies were included. The FAc implant yielded a significantly improved BCVA at 24 and 36 months (24-month MD = 4.52; 95% CI 2.56–6.48; 36-month MD = 8.10; 95% CI 6.34–9.86). These findings were comparable with the FAME study. The FAc implant yielded significantly reduced 24- and 36-month CMT. Pooled proportions of cataract surgery, IOP-lowering drops and glaucoma surgery were 39%, 27% and 3%, respectively, all lower than the FAME study. Pooled estimate of supplementary intravitreal therapy was 39%, higher than the 15.2% of the FAME study. This meta-analysis of real-world studies confirms favorable visual and anatomical outcomes following FAc insert for chronic DMO. In real-life studies more than one third of patients received supplementary intravitreal therapy, an issue that needs to be further explored.
Disruption of mitochondrial redox homeostasis by enzymatic activation of a trialkylphosphine probe
Authors: Nguyen Jade , Tirla Alina , Rivera-Fuentes Pablo
Published: February 2021

The release of tributylphosphine in mitochondria induces morphological changes and upregulates specific genes from the integrated stress response, such as CHAC1.
Ring-fused dimethoxybenzimidazole-benzimidazolequinone (DMBBQ): tunable halogenation and quinone formation using NaX/Oxone
Authors: Conboy Darren , Kielty Patrick , Bear Joseph C. , Cockcroft Jeremy K. , Farràs Pau , McArdle Patrick , Singer Richard J. , Smith Dennis A. , Aldabbagh Fawaz
Published: February 2021

A new one-pot electrophilic chlorination and bromination with oxidative demethylation uses harmless and inexpensive sodium chloride and sodium bromide with Oxone to yield alicyclic ring-fused bis-benzimidazolequinones.
Lipidomic alteration of plasma in cured COVID-19 patients using ultra high-performance liquid chromatography with high-resolution mass spectrometry
Authors: Bai Yunpeng , Huang Wendong , Li Yaocai , Lai Changchun , Huang Sumei , Wang Guangwen , He Yuemei , Hu Linhui , Chen Chunbo
Published: February 2021

Background: The pandemic of novel coronavirus disease 2019 (COVID-19) has become a serious public health crisis worldwide. The symptoms of COVID-19 vary from mild to severe among different age groups, but the physiological changes related to COVID-19 are barely understood.

Methods: In the present study, a high-resolution mass spectrometry (HRMS)-based lipidomic strategy was used to characterize the endogenous plasma lipids for cured COVID-19 patients with different ages and symptoms. These patients were further divided into two groups: those with severe symptoms or who were elderly and relatively young patients with mild symptoms. In addition, automated lipidomic identification and alignment was conducted by LipidSearch software. Multivariate and univariate analyses were used for differential comparison.

Results: Nearly 500 lipid compounds were identified in each cured COVID-19 group through LipidSearch software. At the level of lipid subclasses, patients with severe symptoms or elderly patients displayed dramatic changes in plasma lipidomic alterations, such as increased triglycerides and decreased cholesteryl esters (ChE). Some of these differential lipids might also have essential biological functions. Furthermore, the differential analysis of plasma lipids among groups was performed to provide potential prognostic indicators, and the change in signaling pathways.

Conclusions: Dyslipidemia was observed in cured COVID-19 patients due to the viral infection and medical treatment, and the discharged patients should continue to undergo consolidation therapy. This work provides valuable knowledge about plasma lipid markers and potential therapeutic targets of COVID-19 and essential resources for further research on the pathogenesis of COVID-19.
Stochastic homogenization of deterministic control problems
Authors: Van-Brunt Alexander
Published: February 2021

In this paper we study homogenization of a class of control problems in a stationary and ergodic random environment. This problem has been mostly studied in the calculus of variations setting in connection to the homogenization of the Hamilton–Jacobi equation. We extend the result to control problems with more general state dynamics and macroscopically inhomogeneous Lagrangians. Moreover, our approach proves homogenization under weaker growth assumptions on the Lagrangian, even in the well-studied calculus of variations setting.
Cone beam « low dose » et orthodontie : une nouvelle modalité d’imagerie…
Authors: Foucart Jean-Michel , Papelard Nicolas , Petitpas Laurent , Bourriau Jérôme
Published: February 2021

En 20 ans, les indications du cone beam se sont multipliées dans tous les champs de la médecine bucco-dentaire, et plus particulièrement en orthopédie dento-faciale.

Jusqu’à présent, au regard de l’irradiation induite, le cone beam, de manière analogue à l’imagerie tomodensitométrique, était considéré comme un examen de seconde intention, réalisé en complément d’un examen 2D traditionnel insuffisamment informatif.

Avec l’apparition des techniques dites « low dose » qui autorisent, sur certains systèmes d’imagerie, à réaliser des acquisitions 3D dont l’irradiation induite est susceptible d’être largement inférieure à celle induite par un panoramique dentaire, il est désormais nécessaire de revoir cette assertion héritée du passé.

En effet, le principe « ALADA », qui se substitue au traditionnel principe « ALARA », impose désormais d’utiliser directement la technique d’imagerie et la séquence d’acquisition la moins irradiante permettant d’obtenir le diagnostic recherché, y compris si cela conduit à diminuer la définition de l’image obtenue.

Dans ce cadre, il est nécessaire de connaître parfaitement les techniques « low dose » afin de discuter de ses indications, plus particulièrement en orthodontie, et de les intégrer dans les arbres décisionnels qui conduisent au choix d’une technique radiographique pour un individu donné dans un but diagnostic précis. Désormais, le cone beam, et plus particulièrement le cone beam « low dose », n’est plus un examen complémentaire, mais un examen radiologique à part entière, dans le cadre d’une pratique orthodontique éminemment consciente des principes de radioprotection.
Akute tubulointerstitielle Nephritis bei Kindern und Jugendlichen
Authors: Wente-Schulz Sarah
Published: February 2021

Die akute tubulointerstitiellen Nephritis (TIN) stellt eine wichtige Ursache des akuten Nierenversagens bei Erwachsenen und Kindern dar. Auslöser der TIN sind eine Vielzahl von Medikamenten, systemische Erkrankungen und Infektionen. Weiterhin existieren idiopathische Fälle ohne identifizierbare Ursache. Eine Sonderform der Erkrankung ist die tubulointerstitielle Nephritis mit Uveitis (TINU), die bei Kindern und Jugendlichen häufiger als bei Erwachsenen vorkommt. Klinische Symptomatik und Laborbefunde der TIN sind häufig unspezifisch, sodass die definitive Diagnose nur bioptisch gesichert werden kann. Die Entfernung der auslösenden Substanz bzw. die Behandlung der Grunderkrankung sind essenziell für die Therapie der TIN. Der Nutzen der Glukokortikoidtherapie wurde bisher nicht durch randomisierte, kontrollierte Studien belegt.
Diagnostik des vesikoureterorenalen Refluxes – MUS vs. MCU
Authors: Mentzel Hans-Joachim
Published: February 2021

Zur Diagnose eines vesikoureterorenalen Reflux existieren verschiedene bildgebende Verfahren. Ziel des Beitrages ist es, das Vorgehen bei der Miktionsurosonografie (MUS) und der Miktionszysturethrografie (MCU) aufzuzeigen und ihre jeweiligen Vor- bzw. Nachteile beim Einsatz im Kindes- und Jugendalter darzulegen.
Im Falle des Einsatzes eines Calcineurininhibitorsbei komplizierten Verläufen des nephrotischen Syndroms im Kindesalter
Authors: Ehren Rasmus , Weber Lutz T.
Published: February 2021

Oft wird zur Behandlung eines kompliziert verlaufenden nephrotischen Syndroms des Kindesalters eine immunsuppressive Dauertherapie eingesetzt. Als first-line-Therapie beim kompliziert verlaufenden steroidsensiblen nephrotischen Syndrom hat sich in Deutschland in den letzten Jahren Mycophenlatmofetil etabliert. Muss aber ein Calcineurininhibitor eingesetzt werden, kann zwischen Ciclosporin A und Tacrolimus gewählt werden. In dieser Übersichtsarbeit werden die Vor- und Nachteile beider Therapien beleuchtet, die Indikationsstellung bei den unterschiedlichen Verlaufsformen des nephrotischen Syndroms erläutert und mögliche Entscheidungshilfen bei der Wahl des Calcineurininhibitors gegeben.
Kopfschmerz im Kindes- und Jugendalter
Authors: Wöber-Bingöl Çiçek
Published: February 2021

Wiederkehrende Kopfschmerzen zählen bei Kindern und Jugendlichen zu den häufigsten Beschwerden und manifestieren sich am häufigsten als Migräne und Spannungskopfschmerz. In diesem Artikel werden die Epidemiologie, Differenzialdiagnose, das klinische Bild, Auslöser, Begleiterkrankungen und Therapie mit Schwerpunkt auf Migräne vermittelt und geschlechtsspezifische Unterschiede wie auch altersspezifische Besonderheiten dargestellt.
Künstliche Intelligenz und Next Generation Sequencing
Authors: Haas Rainer , Jäger Paul S.
Published: February 2021

Mit diesem Artikel möchten wir dem Leser verdeutlichen, wie in den letzten Jahrzehnten dank der Fortschritte in der Molekularbiologie neue medizinisch relevante Erkenntnisse bei myeloischen Neoplasien gewonnen wurden. Das wachsende Verständnis der zugrundeliegenden Pathophysiologie ist auf die Identifizierung spezifischer genomischer Veränderungen zurückzuführen und liefert uns sehr empfindliche Werkzeuge für die Diagnostik, Prognoseabschätzung und das Therapiemonitoring. Zusätzlich ebnet uns die Identifizierung bestimmter molekularer Zielstrukturen den Weg zu einer individualisierten oder personalisierten Therapie. Insbesondere die rasche Entwicklung neuer Sequenzierungstechniken für das menschliche Genom wie Next Generation Sequencing hat zu diesem Fortschritt beigetragen. Einhergehend mit diesem Fortschritt, stehen wir jedoch auch vor neuen Herausforderungen hinsichtlich der Interpretation der gewonnenen Daten. In jüngster Zeit haben uns neue Auswertungsverfahren, die sich unter anderem bei Methoden aus dem Gebiet der künstlichen Intelligenz bedienen, Werkzeuge zur Verfügung gestellt, um die komplexen Wechselwirkungen von genomischen Veränderungen, Krankheitsverlauf und weiteren Faktoren genauer analysieren zu können und welche in Zukunft für den Kliniker an Relevanz gewinnen können.
6-jähriges Mädchen mit suprapatellarer, medial betonter Knieschwellung
Authors: Weise J. , Weller-Heinemann F.
Published: February 2021

In unserem Fall wurde die venöse Malformation trotz ihrer Seltenheit rasch festgestellt. Wegweisend für die Diagnose waren die suprapatellare Lokalisation der Schwellung mit medialer Betonung, fehlende Entzündungsparameter im Blut, sowie die Sonografie. Mit dem Kontrastmittel-MRT konnte der Verdacht einer vaskulären Malformation bestätigt und auf eine juxtaartikuläre venöse Malformation präzisiert werden.
KRAS-G12C-Inhibition beim NSCLC
Authors: Krome Susanne
Published: February 2021

KRAS-Mutationen stellen eine zentrale Schaltstelle für die Proliferation, das Wachstum und die Differenzierung von Tumorzellen dar. Obwohl das Onkogen bereits 1982 entdeckt wurde, galt es bislang als ungeeignetes Target für die Behandlung solider Tumoren. In der CodeBreaK100-Studie hemmte Sotorasib die KRAS-Mutation G12C und war insbesondere bei Patienten mit nicht-kleinzelligen Bronchialkarzinomen (NSCLC) effektiv und vergleichsweise sicher.
Großzelliges B-Zell-Lymphom
Authors: Schmale Ine
Published: February 2021

Die innovativen Therapien mit CAR-T-Zellen zeigten eine vielversprechende Wirksamkeit und Sicherheit bei Patienten mit großzelligem B-Zell-Lymphom. Auf dem ASH 2020 wurden jetzt in Ermangelung von Head-to-Head-Studien 2 MAIC-Analysen – separate paarweise-gematchte adjustierte indirekt-vergleichende Analysen – vorgestellt.
HR-positives Mammakarzinom
Authors: Arnheim Katharina
Published: February 2021

CDK4/6-Inhibitoren sind aus der Behandlung des metastasierten Hormonrezeptor- (HR) positiven Mammakarzinoms nicht mehr wegzudenken. Studien zur adjuvanten Therapie mit diesem neuen Wirkprinzip liefern jedoch widersprüchliche Ergebnisse.
Glioblastome
Authors: Kretzschmar Alexander
Published: February 2021

Rund 50–60 % der Patienten mit Glioblastom erleiden epileptische Anfälle entweder zu Beginn oder im Verlauf der Erkrankung. Eine Erlanger Arbeitsgruppe beschäftigte sich jetzt in einer retrospektiven Studie mit der Frage, welche molekularen Marker mit dem Auftreten von epileptischen Anfällen bei Glioblastom-Patienten korrelieren.
Metformin Attenuates the Metabolic Disturbance and Depression-like Behaviors Induced by Corticosterone and Mediates the Glucose Metabolism Pathway
Authors: Hao Yong , Tong Yingpeng , Guo Yanhong , Lang Xiaoe , Huang Xinxin , Xie Xiaoxian , Guan Yangtai , Li Zezhi
Published: February 2021

Background Metabolism disturbances are common in patients with depression. The drug metformin has been reported to exhibit antidepressant activity. The purpose of this study was to investigate metabolism disturbances induced by corticosterone (CORT) and determine if metformin can reverse these effects and their accompanying depression-like behaviors.

Methods Rats were exposed to corticosterone with or without metformin administration. Depression-like behaviors were tested. Gene expression was confirmed by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot analysis. In addition, the metabolites were quantified by LC-MS/MS analysis.

Results Metformin attenuated the depression-like behaviors induced by CORT. Furthermore, metformin reversed disturbances in body weight, serum glucose, and triglyceride levels, as well as hepatic TG levels induced by CORT. Metformin normalized the alterations in the expression of glucose metabolism-related genes (PGC-1α, G6pc, Pepck, Gck, PYGL, Gys2, PKLR, GLUT4) and insulin resistance-related genes (AdipoR1, AdipoR2) in the muscles and livers of rats induced by CORT. Metabolomic analysis showed that metformin reversed the effects of CORT on 11 metabolites involved in the pathways of the tricarboxylic acid cycle, glycolysis, and gluconeogenesis (3-phospho-D-glycerate, β-D-fructose 6-phosphate, D-glucose 6-phosphate, and pyruvate).

Conclusion Our findings suggest that metformin can attenuate metabolism disturbances and depression-like behaviors induced by CORT mediating the glucose metabolism pathway.
Melanom mit BRAF-Mutation
Authors: Schmale Ine
Published: February 2021

Ob in der Erstlinientherapie des fortgeschrittenen Melanoms – bei Vorliegen einer BRAF-Mutation – lieber eine Immuntherapie oder eine zielgerichtete Therapie eingesetzt werden sollte, wird kontrovers diskutiert. Beim 30. Deutschen Hautkrebskongress wurde Ende 2020 die Datenlage zu diesen Themen aufgegriffen und Argumente für die einzelnen Vorgehensweisen ausgetauscht.
Aspekte der medikamentösen Therapie der Osteoporose bei rheumatoider Arthritis
Authors: Bühring Björn , Thomasius Friederike , Maus Uwe
Published: February 2021

Entzündlich rheumatische Erkrankungen wie die rheumatoide Arthritis, die ankylosierende Spondylitis und der systemische Lupus erythematodes führen zu einem erhöhten Risiko für eine Osteoporose und osteoporotische Frakturen. Das Risiko wird durch die Krankheitsaktivität, die körperlichen Einschränkungen, die medikamentöse Therapie und den Einsatz von Glukokortikoiden wesentlich beeinflusst. Eine möglichst frühe Therapie mit einer effektiven Kontrolle der Entzündungsaktivität ist daher zur Verminderung des Frakturrisikos wesentlich. Die Gabe von Glukokortikoiden sollte soweit möglich reduziert werden. Das Risiko für eine Osteoporose sollte durch eine möglichst frühzeitige Diagnostik analysiert und bei entsprechender Indikation eine osteologische Medikation eingeleitet werden. Die Wahl des Medikamentes erfolgt auf der Basis des jeweiligen Risikos und der jeweiligen Indikation. Die Grundlage jeder Osteoporosetherapie ist eine ausreichende Zufuhr von Vitamin D und Kalzium und eine angepasste körperliche Aktivität.
Renal replacement therapy as bridging-to-recovery in refractory hepatorenal syndrome
Authors: Luedemann Christoph , Plota Jessica , Nattermann Jacob , Strassburg Christian P. , Lutz Philipp , Goeser Felix
Published: February 2021

A 50-year-old female patient with cirrhosis due to alcoholic steatohepatitis was referred to our department because of recurrent hepatorenal syndrome (HRS) and hepatic hydrothorax. Clinically, severe anasarca was the leading problem. In contrast to previous episodes, HRS did not respond to standard treatment including terlipressin.

Given the severe, refractory hyperhydration, we finally initiated renal replacement therapy (RRT). Subsequently, RRT was performed without severe side effects for more than 100 days. In the meantime, liver function remarkably improved, most probably due to the prolonged abstinence from alcohol. Finally, RRT could be stopped. Since then, our patient has remained in good clinical condition for more than 6 months, with well-compensated Child-Pugh stage A cirrhosis and only mild chronic kidney disease stage III.

In conclusion, this case highlights that RRT may be considered in individual cases as bridging therapy in refractory HRS until the liver regenerates due to the absence of damaging mechanisms.
Chologene Diarrhö, Stiefkind der chronischen Diarrhö – Prävalenz, Diagnostik und Therapie. Update 2021
Authors: Storr Martin , Gross Manfred , Madisch Ahmed , von Arnim Ulrike , Mönnikes Hubert , Walters Julian , Krammer Heiner , Keller Jutta
Published: February 2021

Die chologene Diarrhö ist eine der häufigsten nicht diagnostizierten Ursachen der chronischen Diarrhö. Zahlreiche verschiedene Pathophysiologien können einer chronischen Diarrhö zugrunde liegen. Auch nach Ausschlussdiagnostik der häufigeren Ursachen verbleiben bis zu 5 % der Bevölkerung von einer ungeklärten chronischen Diarrhö betroffen. In diesem Kollektiv findet sich in bis zu 50 % als Ursache eine chologene Diarrhö.

Die verschiedenen Pathophysiologien, die zu einer chologenen Diarrhö führen, sind gut charakterisiert. Danach lässt sich die chologene Diarrhö in einen primären, einen sekundären und einen tertiären Subtyp unterteilen. Allen Ursachen gemein sind die erhöhte Menge an Gallensäuren im Kolon und im Fäzes und die dadurch bedingte sekretorisch-osmotische Diarrhö, bei schwereren Formen in Kombination mit einer Steatorrhö. Die Diagnostik der chologenen Diarrhö folgt einem klaren Algorithmus, der neben der Ursachensuche und dem diagnostischen Therapieversuch den 75SeHCAT-Test als Referenzverfahren für den Nachweis eines Gallensäurenverlusts angibt. Aufgrund der Chronizität der Beschwerden und der Notwendigkeit einer dauerhaften, lebenslangen Therapie scheint eine einmalige sichere Diagnosestellung prinzipiell sinnvoll; der Test ist allerdings derzeit nur an wenigen Zentren verfügbar. Die Therapie umfasst neben der Behandlung identifizierbarer Grundkrankheiten den Einsatz von Gallensäuren bindenden Arzneimitteln, Ernährungsempfehlungen und Vitaminsubstitutionen.

Der vorliegende Übersichtsartikel fasst Pathophysiologie und Stellenwert der chologenen Diarrhö zusammen und diskutiert die aktuelle Diagnostik und Therapie.
Superconducting properties of GdxPb1−xMo6S8 (x = 0.5, 0.7, 0.9) compounds
Authors: Terekhov A. V. , Bashlakov D. L. , Zolochevskii I. V. , Khristenko E. V. , Zaleski A. , Khlybov E. P. , Lachenkov S. A.
Published: February 2021

For the first time, the temperature dependences of the electrical resistivity ρ(T) were studied in GdxPb1−xMo6S8 (x = 0.5, 0.7, 0.9) compounds in the temperature range 4–18 K and magnetic fields up to 14 T. It is shown that the superconducting transition temperature values Tc decrease from 14.6 K for a compound with x = 0.5 to 11.8 K for x = 0.9. Experimental dependences Hc2(T) were plotted and it was found that the theoretical dependence Hc2(T) within the microscopic theory of Werthamer-Helfand-Hohenberg poorly describes the experimental data for the Gd0.9Pb0.1Mo6S8 compound. At the same time, the fit of Hc2(T) within the Ginzburg-Landau theory is in good agreement with the experimental results for all the studied samples. An explanation of the dependence Hc2(T) of the studied samples from the gadolinium concentration was proposed. The differential resistance for the Gd0.5Pb0.5Mo6S8–Ag heterocontact with resistance RPC ≈ 2.6 Ω was obtained for 2.6 K using point-contact Andreev reflection spectroscopy. As a result, the superconducting gap for Gd0.5Pb0.5Mo6S8 was estimated for the first time to be Δ ≈ 1.95 meV at 2.6 K. The resulting ratio was 2Δ/kTc ≈ 3.02, which is lower than the Bardeen–Cooper–Schrieffer value of 3.52 for conventional weakly coupled superconductors.
Generation of wave packets and breathers by oscillating kinks in the sine-Gordon system
Authors: Bogdan M. M. , Charkina O. V.
Published: February 2021

Evolution of the nonequilibrium inhomogeneities and topological defects is studied in terms of complex kink solutions of the sine–Gordon equation. The weakly damped oscillation of the sine–Gordon kink, named as the kink quasimode, is described explicitly. It is shown that the oscillatory kink behavior and the wave packet generation depend significantly on the initial nonequilibrium kink profile. In order to specify conditions of the generation of wobbling kinks with a multibreather structure we reformulate the direct scattering problem associated with the sine-Gordon equation as the spectral problem of the Schrödinger operator. We obtain the dependence of the radiation energy, which is emitted during formation of the multi-frequency wobbling kink, on the effective dimension of its initial profile.
Short notes: Effect of hydrostatic pressure up to 12 kbar on the electrical resistance of Y0.77Pr0.23Ba2Cu3O7−δ single crystals
Authors: Khadzhai G. , Matsepulin A. , Vovk R.
Published: February 2021

The effect of high hydrostatic pressure up to 12 kbar on the electrical resistivity in the basal ab plane of an optimally doped Y0.77Pr0.23Ba2Cu3O7−δ single crystal was studied. An inhomogeneity of the sample is found that does not depend on the applied pressure, P. The Tc(P) dependence increases nonlinearly with increasing P, and the value of the baric derivative, dTc/dP, decreases. Possible mechanisms of the effect of high pressure on Tc are discussed, taking into account the presence of features in the electronic spectrum of charge carriers.
Low-temperature photoluminescence of C60 single crystals intercaled with nitrogen molecules in the wide range of temperatures
Authors: Zinoviev P. V. , Zoryansky V. N.
Published: February 2021

The optical properties of C60 single crystals, intercalated with nitrogen molecules, were studied by the spectral-luminescence method at a temperature T = 30 K and excitation by the He–Ne laser (Eexc = 1.96 eV). Intercalation was carried out at a pressure of 30 atm in a temperature range of 200–550 °C. It was found that at sorption temperatures up to 400 °C, the bands of the low-temperature luminescence spectrum of the C60–N2 solutions are broadened without significant energy shift. As a rule, this situation is typical for the case of an increased contribution of the luminescence of “deep X-traps.” The concentration of such exciton emission centers is determined by the degree of occupation of the octahedral cavities of the fullerite fcc lattice by intercalated molecules. This indicates the formation of an equilibrium C60–N2 interstitial solution as a result of physisorption. At sorption temperatures above 400 °C, a significant shift of the luminescence spectrum towards low energies with a considerable inhomogeneous broadening of spectral bands was found for the first time. The shift and significant nonuniform broadening of the luminescence bands are explained by the emergence of a chemical interaction (chemisorption) of nitrogen with fullerene molecules, with the formation of a new nitrogen-containing substance in this case.
A persistent homology method with modified filtration to characterize the phase trajectory of a turbulent wake flow
Authors: Wu Huixuan , Tao Xingtian , Zheng Zhongquan Charlie
Published: February 2021

The topological features of recurrent phase trajectories of a turbulent wake are studied using a modified persistent homology method. In the general persistent homology computation, the input data are considered as isolated points in a high-dimensional space. Networks with various spatial resolutions are constructed based on these points. When the resolution is low, many edges among neighboring points are created as they satisfy the distance threshold. However, most of these edges do not reflect new topology other than the phase trajectory itself. Therefore, our modified method discards the duplicated edges in the network. Only the phase trajectory and the essential topological connections, which have a local minimum distance in the network, are used to represent the topological structure of a phase trajectory. The homology of the recurrent loop reflects the topology complexity of a trajectory in the phase space, and the first Betti number can be used to classify the trajectories according to the number of self-crossings, which characterizes the trajectory complexity. A significant number of trajectories have only one or a few self-crossings. There are also complex trajectories that contain more than 100 self-crossings. The topological distribution classified using the first Betti number follows a power law.