bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and Efficacy of Current Sclera Fixation Methods for Intraocular Lenses and Literature Overview
Authors: Muth Daniel Rudolf , Wolf Armin , Kreutzer Thomas , Shajari Mehdi , Vounotrypidis Efstathios , Priglinger Siegfried , Mayer Wolfgang J. 
Published: April 2021

Abstract
Background Evaluation of the three currently most common techniques for intraocular lens (IOL) sclera fixation: (1) Prolene suture with Hoffman sclera pocket (2) four-point GoreTex suture technique (3) sutureless flanged intrascleral IOL fixation with double-needle (“Yamane”) technique.
Material and Methods Retrospective, clinical case series (chart review) at the Department of Ophthalmology, Ludwig-Maximilians-University (LMU), Munich, Germany. Enrolled in the study were 51 patients with 55 eyes. Best-corrected visual acuity (BCVA); manifest refraction (OR); corneal tomography (central corneal thickness, CCT); biometry; central macular thickness (CMT) by optical coherence tomography (OCT); intraocular pressure (IOP); and IOL type and IOL power were recorded and compared prior to and 3 – 12 months post IOL sclera fixation surgery. Pre- and postsurgery difference analysis was performed by Wilcoxon rank sum testing (z).
Results Intrascleral fixation by GoreTex suture was performed in 14 (25.5%) eyes, by Prolene suture in 19 (34.5%,) and by Yamane technique in 22 (40.0%) eyes. Within the 3 – 12 months follow-up post scleral fixation, a total of 2 (14.3%) eyes from the GoreTex, 3 (15.8%) from the Prolene and 1 (4.5%) eye from the Yamane group required refixation. Pre- and post-surgery analysis revealed a statistically significant difference in the total patient population BCVA (exact Wilcoxon test: z = − 3.202; p = 0.001; n = 55) and the Yamane subgroup (exact Wilcoxon test: z = − 2.068; p = 0.001; n = 22). The GoreTex (n = 14) and Prolene (n = 19) subgroups revealed no statistically significant differences versus preoperative baseline. Across groups, there was no statistically significant difference in IOP, CMT, and CCT. No retinal complications were observed, neither intraoperatively nor during follow-up.
Conclusion The volume of IOL revision surgery is increasing. Often, the only option left for visual rehabilitation is scleral IOL fixation. All three scleral fixation techniques studied demonstrated a good safety profile with no statistically significant impact on IOP, CMT, CCT, but with a notable revision rate. Visual rehabilitation to preoperative baseline levels (GoreTex [n = 14] and Prolene [n = 19]) and a statistically significant increase in visual acuity (total cohort [n = 55] and Yamane [n = 22]) seems possible. Unlike iris fixation, scleral fixation is surgically more complex and the surgeon must master a steeper learning curve.
Aktueller Stand bei den endoskopischen Therapieverfahren der GERD (Endoplikation): GERDX, MUSE, EsophyX
Authors: Tschoner Andreas 
Published: April 2021

ZusammenfassungDie gastroösophageale Refluxerkrankung (GERD) beeinträchtigt durch ihre Symptome die Lebensqualität betroffener Patienten teils beträchtlich. Im Laufe der letzten Jahrzehnte zeigt die GERD eine zunehmende Prävalenz weltweit. Zugrunde liegt der GERD meist ein insuffizientes, weil strukturell defektes Ventil zwischen Magen und Speiseröhre. Zur Behandlung von GERD haben sich bis heute die Medikamentengruppe der Protonenpumpenhemmer (PPI) als konservative, rein symptomatische Therapie und die laparoskopische Fundoplikation (LF) in ihren Ausführungsvarianten zur Behebung der Ursache etabliert. In den letzten 2 Jahrzehnten wurden zunehmend neue Verfahren als Therapieoption entwickelt. Die Endoskopie verfolgt hierbei unterschiedliche Ansätze: Augmentierung mittels Injektionsverfahren, Stabilisierung des unteren Ösophagussphinkters mittels Radiofrequenzablation (RFA, Stretta-Prozedur) und Mukosaresektion (ARMS) bzw. Rekonstruktion des Ventilapparates mit Klammernahtgeräten (GERDX, MUSE, EsophyX). Abgesehen von der RFA haben sich vor allem die Klammerverfahren durchgesetzt. Die kurzfristigen Ergebnisse sind vielversprechend, Langzeitresultate jedoch noch kaum verfügbar. Auch randomisierte Vergleichsstudien zur LF sind rar.
Epicondylopathia humeri radialis
Authors: Leschinger Tim , Tischer Thomas , Doepfer Anna Katharina , Glanzmann Michael , Hackl Michael , Lehmann Lars , Müller Lars , Reuter Sven , Siebenlist Sebastian , Theermann Ralf , Wörtler Klaus , Banerjee Marc 
Published: April 2021

AbstractBackground Lateral epicondylitis is a common orthopaedic condition often massively restricting the quality of life of the affected patients. There are a wide variety of treatment options – with varying levels of evidence.Method The following statements and recommendations are based on the current German S2k guideline Epicondylopathia radialis humeri (AWMF registry number: 033 – 2019). All major German specialist societies participated in this guideline, which is based on a systematic review of the literature and a structured consensus-building process.Outcomes Lateral epicondylitis should be diagnosed clinically and can be confirmed by imaging modalities. The Guidelines Commission issues recommendations on clinical and radiological diagnostic workup. The clinical condition results from the accumulated effect of mechanical overload, neurologic irritation and metabolic changes. Differentiating between acute and chronic disorder is helpful. Prognosis of non-surgical regimens is favourable in most cases. Most cases spontaneously resolve within 12 months. In case of unsuccessful attempted non-surgical management for at least six months, surgery may be considered as an alternative, if there is a corresponding structural morphology and clinical manifestation. At present, it is not possible to recommend a specific surgical procedure.Conclusion This paper provides a summary of the guideline with extracts of the recommendations and statements of its authors regarding the pathogenesis, prevention, diagnostic workup as well as non-surgical and surgical management.
Kosmetische Laser- und Elektrokautertherapie ohne rechtswirksame Aufklärung
Authors: Elsner P. , Meyer J. 
Published: April 2021

ZusammenfassungBei einer Patientin erfolgte als Selbstzahlerleistung bei einem Hautarzt die Therapie eines Spider-Naevus elektrokaustisch sowie dermaler Naevuszellnaevi mittels Erbiumlaser. Die Patientin war mit dem Behandlungsergebnis unzufrieden und bemängelte bei der zuständigen Schlichtungsstelle die Behandlung; die Laserbehandlung im Gesicht sei fehlerhaft durchgeführt worden. Die Behandlung sei nur für eine Hautveränderung abgesprochen gewesen; während des Eingriffs seien durch den behandelnden Arzt jedoch weitere Bereiche gelasert worden. Erst nach der Behandlung seien ihr mittels Spiegel ärztlicherseits die gelaserten Areale gezeigt worden.Die Schlichtungsstelle verneinte ebenso wie der konsultierte dermatologische Gutachter einen Behandlungsfehler; sowohl die Elektrokaustik als auch die Lasertherapie seien lege artis erfolgt. Die geltend gemachten Ansprüche waren aus Sicht der Schlichtungsstelle jedoch unter dem Gesichtspunkt der mangelhaften Aufklärung begründet. In den Patientenunterlagen des Hautarztes fand sich lediglich ein kursorischer Hinweis über die Möglichkeit der Entfernung der Hautveränderungen mit dem Elektrokauter und dem Erbiumlaser und über den Verlauf und die möglichen Komplikationen. Derartige Hinweise genügten nach Einschätzung der Schlichtungsstelle für die Dokumentation über die geplanten kosmetischen Behandlungsmaßnahmen und in der Folge für die rechtswirksame Einwilligung der Patientin nicht.Auch bei nach Facharztstandard korrekt durchgeführten kosmetischen Eingriffen ist auf eine rechtzeitige, umfassende Aufklärung als Voraussetzung für eine rechtswirksame Einwilligung des Patienten in den Eingriff höchsten Wert zu legen. Ohne Aufklärung und rechtswirksame Einwilligung ist der Eingriff rechtswidrig; unvermeidliche verbleibende kosmetische Beeinträchtigungen nach einem solchen Eingriff sind dann als Gesundheitsschaden zu bewerten und schadensersatzpflichtig. Neben den zivil- und möglicherweise strafrechtlichen Konsequenzen muss der Arzt auch mit berufsrechtlichen Disziplinarmaßnahmen rechnen.
Linking the Presence of Macular Oedema to Structural and Functional Alterations in Retinitis Pigmentosa
Authors: Friesacher Anna , Lopez Torres Lisette T. , Valmaggia Christophe , Rüesch Reinhard , Todorova Margarita G. 
Published: April 2021

Abstract
Objective To investigate the association between the central retinal thickness (CRT), the retinal nerve fibre layer thickness (RNFL), and the functional alterations in retinitis pigmentosa (RP) patients.
Methods Forty-three patients with typical RP and nineteen age-matched controls, who underwent SD-OCT (macular and optic disc OCT protocols) and electrophysiology, were included. The RP group was divided into two subgroups: with clinical appearance of macular oedema (ME-RP; 30 eyes) and without macular oedema (no-ME; 44 eyes). Central retinal thickness OCT data were averaged in three zones (zone 1 [0°–3°], zone 2 [3°–8°], and zone 3 [8°–15°]) and were evaluated in relation to the RNFL thickness and electrophysiological data.
Results The ME-RP group showed increased CRT (zone 1) and RNFL thickness compared to the controls and no-ME-RP (p ≤ 0.002). The no-ME-RP group had reduced CRT thickness (all zones; p ≤ 0.018) compared to the controls and ME-RP, whereas the RNFL thickness in the no-ME-RP group was reduced only compared to the ME-RP group (p < 0.001). The ME-RP group showed significantly more attenuated functional responses than the no-ME-RP patients. A significant positive interaction was found between the CRT (zones 1 and 2) and the RNFL thickness within ME-RP (p ≤ 0.010). Significant negative interactions were found between CRT, RNFL thickness, and functional findings within ME-RP (p ≤ 0.049).
Conclusion The presence of macular oedema correlated well with increased RNFL thickness and residual function in RP patients. Such association provides evidence of an underlying transneuronal mechanism of retinal degeneration. Simultaneous monitoring of CRT and RNFL thickness may help in the future to evaluate the progression of the disease and the efficacy of treatments in RP patients.
A Withanolide-rich Fraction of Athenaea velutina Induces Apoptosis and Cell Cycle Arrest in Melanoma B16F10 Cells
Authors: Almeida Alisson A. , Lima Graziela D. A. , Eiterer Marinês , Rodrigues Laís A. , A. do Vale Juliana A. , Zanatta Ana C. , Bressan Gustavo C. , de Oliveira Leandro L. , Leite João P. V. 
Published: April 2021

Abstract
Athenaea velutina is a promising Brazilian shrub with cytotoxic and antimigratory properties against cancer cells. However, the mechanism of induction of cancer cell death and the compounds involved remain unknown. To ascertain these bioactive compounds, bioassay-guided fractionation was performed, alongside the appropriate in vitro tests. A withanolide-rich fraction (FAv_5) from the dichloromethane extract increased cytotoxic activity by 1.5-fold (IC50 = 2.1 µg/mL). Fourteen withanolide steroids were tentatively identified for the first time for this species by mass spectrometry coupled to liquid chromatography (LC MS/MS), including withanolide A, aurelianolide A, and aurelianolide B. FAv_5 significantly decreased cell proliferation, migration, and invasion with a selectivity index greater than 8 for B16F10 cells. Furthermore, flow cytometry with annexin V fluorescein isothiocyanate/propidium iodide (V-FITC/PI) staining showed
FAv_5 to promote cell cycle arrest at the G0/G1-phase as well as apoptotic cell death. Overall, these findings highlight A. velutina as a source of withanolide-steroids that inhibit cancer cell proliferation through apoptosis and cell cycle blockade mechanisms. Details on the geographic distribution of A. velutina and species conservation strategies have also been highlighted.
Hygiene bei der HNO-Untersuchung: Fluoreszenzstudie mit Übersicht der aktuellen Empfehlungen
Authors: Rohrmeier Christian , Schneider-Brachert Wulf , Kühnel Thomas , Hitzenbichler Florian , Holzmann Thomas , Bohr Christopher 
Published: April 2021

ZusammenfassungSteigende normative Ansprüche an Patientensicherheit und Maßnahmen der Qualitätssicherung, aber auch die Problematik multiresistenter Keime und von Erregern mit hohem Ansteckungspotenzial, verstärken die Notwendigkeit hygienisch korrekten Arbeitens.In dieser Studie sollten hygienisch relevante potenzielle Kontaminationsquellen bei
der HNO-Untersuchung identifiziert und mögliche Verbesserungsstrategien untersucht
werden.Von 5 Untersuchern mit unterschiedlicher Berufserfahrung, deren Handschuhe vor der
Untersuchung mit Fluoreszenzlotion benetzt wurden, wurde eine komplette HNO-Untersuchung
durchgeführt. Kontaminierungen insbesondere an der Untersuchungseinheit und am
Instrumentarium wurden identifiziert. Das potenzielle Risiko einer Übertragung von
Erregern auf Folgepatienten wurde mittels eines eigens entwickelten Scores bewertet.
Verschiedene Strategien zur Reduzierung identifizierter Kontaminationsmöglichkeiten
wurden erarbeitet und gedanklich durchgespielt.Der Score der Untersucher war mit im Mittel 87,4 Punkten (±3,6) sehr hoch. Die
Umsetzung von einzelnen Hygienemaßnahmen im Untersuchungsablauf würde zu einer
deutlichen Erniedrigung des Scores und damit einer Verbesserung der Hygiene führen: kein
Händeschütteln (81,8), zusätzlich Patientenstuhldesinfektion (79,8), Desinfektion
wichtiger Flächen (69,8), Bereitstellen von Standardinstrumenten (60,2) oder aller
Instrumente (32,2), Desinfektion aller relevanten Flächen und Bereitstellen aller
Instrumente (7,4).Die Ergebnisse zeigen sehr deutlich, dass eine HNO-Untersuchung aus Sicht der Hygiene
einen komplexen Vorgang darstellt. Für einen verlässlichen Schutz vor möglichen
Übertragungsereignissen ist deshalb eine strukturierte Bündelung von Hygienemaßnahmen
notwendig.
Advances in Transition-Metal-Catalyzed C–H Bond Oxygenation of Amides
Authors: Punji Benudhar , Vijaykumar Muniyappa 
Published: April 2021

AbstractC–O bond formation represents a fundamental chemical transformation in organic synthesis to develop valuably oxygenated (hetero)arenes. Particularly, the direct and regioselective C–H bond oxygenation of privileged amides, using a transition metal catalyst and a mild oxygenating source, is a step-economy and attractive approach. During the last decade, considerable progress has been realized in the direct C–H oxygenation of primary, secondary, and tertiary amides. This Short Review compiles the advances in transition-metal-catalyzed oxygenation of C(sp2)–H and C(sp3)–H bonds on various amides with diverse oxygenation sources. The review is categorized into two different major sections: (i) C(sp2)–H oxygenation and (ii) C(sp3)–H oxygenation. Each section is discussed based on the directing group (monodentate and bidentate) attached to the amide derivatives.1	Introduction2	C(sp2)–H Oxygenation2.1	Monodentate Directed2.2	Bidentate Directed3	C(sp3)–H Oxygenation3.1	Monodentate Directed3.2	Bidentate Directed4	Conclusion and Outlook
Role of Membrane Lipid Rafts in MRP4 (ABCC4) Dependent Regulation of the cAMP Pathway in Blood Platelets
Authors: Belleville-Rolland Tiphaine , Leuci Alexandre , Mansour Alexandre , Decouture Benoit , Martin Fanny , Poirault-Chassac Sonia , Rouaud Margot , Guerineau Hippolyte , Dizier Blandine , Pidard Dominique , Gaussem Pascale , Bachelot-Loza Christilla 
Published: April 2021

Abstract
Background Platelet cytosolic cyclic adenosine monophosphate (cAMP) levels are balanced by synthesis, degradation, and efflux. Efflux can occur via multidrug resistant protein-4 (MRP4; ABCC4) present on dense granule and/or plasma membranes. As lipid rafts have been shown to interfere on cAMP homeostasis, we evaluated the relationships between the distribution and activity of MRP4 in lipid rafts and cAMP efflux.
Methods Platelet activation and cAMP homeostasis were analyzed in human and wild-type or MRP4-deleted mouse platelets in the presence of methyl-β-cyclodextrin (MßCD) to disrupt lipid rafts, and of activators of the cAMP signalling pathways. Human platelet MRP4 and effector proteins of the cAMP pathway were analyzed by immunoblots in lipid rafts isolated by differential centrifugation.
Results MßCD dose dependently inhibited human and mouse platelet aggregation without affecting per se cAMP levels. An additive inhibitory effect existed between the adenylate cyclase (AC) activator forskolin and MßCD that was accompanied by an overincrease of cAMP, and which was significantly enhanced upon MRP4 deletion. Finally, an efflux of cAMP out of resting platelets incubated with prostaglandin E1 (PGE1) was observed that was partly dependent on MRP4. Lipid rafts contained a small fraction (≈15%) of MRP4 and most of the inhibitory G-protein Gi, whereas Gs protein, AC3, and phosphodiesterases PDE2 and PDE3A were all present as only trace amounts.
Conclusion Our results are in favour of part of MRP4 present at the platelet surface, including in lipid rafts. Lipid raft integrity is necessary for cAMP signalling regulation, although MRP4 and most players of cAMP homeostasis are essentially located outside rafts.
Acquired FXIII Deficiency is Associated with High Morbidity
Authors: Duque Patricia , Chasco-Ganuza Maite , Ortuzar Ariana , Almaraz Carolina , Terradillos Estrella , Perez-Rus Gloria , Pascual Cristina 
Published: April 2021

Abstract
Background A factor XIII (FXIII) level >30% is considered necessary to prevent spontaneous bleeding. Bleeding is also a risk in patients with acquired FXIII deficiency, but the hemostatic level of FXIII in this context remains to be determined.
Methods We retrospectively analyzed all patients diagnosed with acquired FXIII deficiency at a large hospital over 3 years (study ID NCT04416594, http://www.clinicaltrials.gov) and assessed clinical data to identify the best cut-off point for FXIII activity to distinguish between low and high risk of major bleeding in a mixed medical and surgical population.
Results Of the 97 patients who experienced bleeding despite a normal coagulation test, 43.2% had FXIII activity <70%. FXIII activity was significantly lower in surgical patients and patients admitted to the intensive care unit (ICU). Low FXIII activity was significantly associated with long ICU stays and a high incidence of major bleeding.
Conclusion Acquired FXIII deficiency is associated with high morbidity. The hemostatic level of FXIII in the setting of acquired FXIII deficiency might be above 30%.
Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): Targeting Pathomechanisms with Bruton Tyrosine Kinase Inhibitors
Authors: von Hundelshausen Philipp , Lorenz Reinhard , Siess Wolfgang , Weber Christian 
Published: April 2021

AbstractA series of cases with rare thromboembolic incidents including cerebral sinus vein thrombosis (some of them fatal) and concomitant thrombocytopenia occurring shortly after vaccination with the coronavirus disease 2019 (COVID-19) vaccine AZD1222 (Vaxzevria) have caused significant concern and led to its temporary suspension in many countries. Immediate laboratory efforts in four of these patients have identified a tentative pathomechanism underlying this syndrome termed initially vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) and renamed recently vaccine-induced immune thrombotic thrombocytopenia (VITT). It encompasses the presence of platelet-activating antibodies to platelet factor-4/heparin complexes, possibly emulated by polyanionic constituents of AZD1222, and thus resembles heparin-induced thrombocytopenia (HIT). Because these immune complexes bind and activate platelets via Fcγ receptor IIA (FcγRIIA), high-dose intravenous immunoglobulin G has been suggested for treatment of VITT in addition to non-heparin anticoagulants. Here we propose inhibitors of Bruton tyrosine kinase (Btk) approved for B cell malignancies (e.g., ibrutinib) as another therapeutic option in VITT, as they are expected to pleiotropically target multiple pathways downstream of FcγRIIA-mediated Btk activation, for example, as demonstrated for the effective inhibition of platelet aggregation, dense granule secretion, P-selectin expression and platelet-neutrophil aggregate formation stimulated by FcγRIIA cross-linking. Moreover, C-type lectin-like receptor CLEC-2- and GPIb-mediated platelet activation, the interactions and activation of monocytes and the release of neutrophil extracellular traps, as encountered in HIT, could be attenuated by Btk inhibitors. As a paradigm for emergency repurposing of approved drugs in COVID-19, off-label use of Btk inhibitors in a low-dose range not affecting haemostatic functions could thus be considered a sufficiently safe option to treat VITT.
Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
Authors: Bhardwaj Ajit , Satapathy Ganesh C. , Garg Arpit , Chawla Vikas , Jangra Kiran 
Published: April 2021

Abstract
Background Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We retrospectively analyzed the incidence of PSH in TBI using PSH-assessment measure (PSH-AM) scale.
Methods This single-center retrospective cohort study was conducted in traumatic head injury patients admitted in the intensive care unit from January 1, 2016 to December 31, 2019 in a tertiary care center. The data was collected from the hospital database after obtaining approval from the hospital ethics committee.
Results A total of 287 patients (18–65 years of age) were admitted to intensive care unit (ICU) with TBI out of which 227 patients were analyzed who had ICU stay for more than 14 days. PSH was diagnosed in 70 (30.8%) patients. Mean age of PSH positive patients was 40 ± 18 and 49 ± 11 years for PSH negative patients (p < 0.001). The age group between 40 and 50 years had a higher incidence of PSH. The age and Glasgow coma score (GCS) were significantly associated with the occurrence of PSH. The GCS score demonstrated good accuracy for predicting the occurrence of PSH with AUC 0.83, 95% CI of 0.775 to 0.886, and a p-value of 0.001.
Conclusion We observed that the incidence of PSH was 30.8% in the patients with TBI. Age and GCS were found to have a significant association for predicting the occurrence of PSH. The patients who developed PSH had a longer length of hospital stay in ICU.
Homozygous UBA5 Variant Leads to Hypomyelination with Thalamic Involvement and Axonal Neuropathy
Authors: Al-Saady Murtadha L. , Kaiser Charlotte S. , Wakasuqui Felipe , Korenke G. Christoph , Waisfisz Quinten , Polstra Abeltje , Pouwels Petra J. W. , Bugiani Marianna , van der Knaap Marjo S. , Lunsing Roelineke J. , Liebau Eva , Wolf Nicole I. 
Published: April 2021

AbstractThe enzyme ubiquitin-like modifier activating enzyme 5 (UBA5) plays an important role in activating ubiquitin-fold modifier 1 (UFM1) and its associated cascade. UFM1 is widely expressed and known to facilitate the post-translational modification of proteins. Variants in UBA5 and UFM1 are involved in neurodevelopmental disorders with early-onset epileptic encephalopathy as a frequently seen disease manifestation. Using whole exome sequencing, we detected a homozygous UBA5 variant (c.895C > T p. [Pro299Ser]) in a patient with severe global developmental delay and epilepsy, the latter from the age of 4 years. Magnetic resonance imaging showed hypomyelination with atrophy and T2 hyperintensity of the thalamus. Histology of the sural nerve showed axonal neuropathy with decreased myelin. Functional analyses confirmed the effect of the Pro299Ser variant on UBA5 protein function, showing 58% residual protein activity. Our findings indicate that the epilepsy currently associated with UBA5 variants may present later in life than previously thought, and that radiological signs include hypomyelination and thalamic involvement. The data also reinforce recently reported associations between UBA5 variants and peripheral neuropathy.