bluuebunny/crossref_metadata_2025_split huggingface dataset:
A multicenter survey on endoscopic retrograde cholangiopancreatography during the COVID-19 pandemic in northern and central Italy
Authors: Donato Giulio , Forti Edoardo , Mutignani Massimiliano , Laterra Maria Antonella , Arese Daniele , Coppola Franco , Zaccari Piera , Mariani Alberto , Arcidiacono Paolo Giorgio , Pigò Flavia , Conigliaro Rita , Costa Deborah , Tringali Alberto , Lavagna Alessandro , Rocca Rodolfo , Gabbiadini Roberto , Fugazza Alessandro , Repici Alessandro , Fava Giammarco , Marini Francesco , Mosca Piergiorgio , Urban Flavia , Monica Fabio , Crinò Stefano Francesco , Gabbrielli Armando , Blois Matteo , Binda Cecilia , Sbrancia Monica , Fabbri Carlo , Frego Roberto , Dinelli Marco , Imbesi Venerina , Gambitta Pietro , Balzarini Marco , Segato Sergio , Grazioli Leonardo Minelli , Spada Cristiano , Amato Arnaldo , Venezia Giovanna , Aragona Giovanni , Rosa Cesare , Alvisi Costanza , Devani Massimo , Manes Gianpiero , Dell’Amico Iginio , Gemme Carlo , Reati Raffaella , Auriemma Francesco , Mangiavillano Benedetto , Rodi Marcello , Bertani Helga , Mazzucco Dario , Armellini Elia , Cantù Paolo , Penagini Roberto , Occhipinti Pietro 
Published: April 2021

Abstract
Background and study aims COVID-19 has dramatically impacted endoscopy practice because upper endoscopy procedures can be aerosol-generating. Most elective procedures have been rescheduled. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently performed in emergency or urgent settings in which rescheduling is not possible. We evaluated the impact of the COVID-19 pandemic on ERCP in Italy during the SARS-CoV-2 lockdown, in areas with high incidence of COVID-19.
Patients and methods We performed a retrospective survey of centers performing ERCP in high COVID-19 prevalence areas in Italy to collect information regarding clinical data from patients undergoing ERCP, staff, case-volume and organization of endoscopy units from March 8, 2020 to April 30, 2020.
Results We collected data from 31 centers and 804 patients. All centers adopted a triage and/or screening protocol for SARS-CoV-2 and performed follow-up of patients 2 weeks after the procedure. ERCP case-volume was reduced by 44.1 % compared to the respective 2019 timeframe. Of the 804 patients undergoing ERCP, 22 (2.7 %) were positive for COVID-19. Adverse events occurred at a similar rate to previously published data. Of the patients, endoscopists, and nurses, 1.6 %, 11.7 %, and 4.9 %, respectively, tested positive for SARS-CoV-2 at follow up. Only 38.7 % of centers had access to a negative-pressure room for ERCP.
Conclusion The case-volume reduction for ERCP during lockdown was lower than for other gastrointestinal endoscopy procedures. No definitive conclusions can be drawn about the percentage of SARS-CoV-2-positive patients and healthcare workers observed after ERCP. Appropriate triage and screening of patients and adherence to society recommendations are paramount.
Evidenz von Trainingsempfehlungen für ein Hypertrophietraining
Authors: Gavanda Simon , Isenmann Eduard 
Published: April 2021

ZusammenfassungDer Abbau der Skelettmuskulatur steigt mit zunehmendem Alter und wird in der heutigen Gesellschaft aufgrund geringerer körperlicher Aktivität zusätzlich beschleunigt. Die Skelettmuskulatur ist vor allem für die Übertragung von Kräften und somit für unsere alltäglichen Bewegungen verantwortlich. Mit der Reduzierung der Muskelmasse wird die Durchführung von Alltagsbewegungen kontinuierlich erschwert, und die Lebensqualität kann dadurch deutlich sinken. Mit Kraft- bzw. Hypertrophietraining kann jedoch einer Muskelatrophie entgegengewirkt werden, indem Abbauprozesse verlangsamt werden und die Skelettmuskulatur wieder aufgebaut wird. Trainingsempfehlungen für ein Hypertrophietraining variieren jedoch erheblich. Dieser Artikel soll vor allem den aktuellen Forschungstand zusammenfassen und praxisrelevante Empfehlungen aussprechen.Der entscheidendste Aspekt beim Hypertrophietraining scheint lediglich das Setzen von regelmäßigen progressiven und erschöpfenden Belastungsreizen zu sein, die mindestens einen Wirkungsmechanismus aktivieren, der für hypertrophe Effekte verantwortlich ist. Vor allem die Variation der mechano-biologischen Deskriptoren (Trainingswiderstand, Anzahl Wiederholungen und Sätze, Pause etc.) könnte helfen, langfristig effektive Reize zu gestalten. Dabei kann nahezu auf unbegrenzte Kombinationsmöglichkeiten zurückgegriffen werden, welche jedoch dem Leistungsniveau und der Belastbarkeit der trainierenden Person sowie der Umsetzbarkeit im Alltag angepasst werden müssen. Nach dem Motto „viele Wege führen nach Rom“ gibt es dabei nicht nur eine konkrete Lösung bei der Planung und Durchführung eines Hypertrophietrainings. Es ist eher von essenzieller Bedeutung, dass kontinuierliche Belastungsreize in unterschiedlichen Variationen durchgeführt werden, um einen Hypertrophieeffekt zu erzeugen und folglich dem Abbau der Skelettmuskulatur entgegenzuwirken.
Factor XI as a Target for New Anticoagulants
Authors: Fredenburgh James C. , Weitz Jeffrey I. 
Published: April 2021

AbstractDespite advances in anticoagulant therapy, thrombosis remains the leading cause of morbidity and mortality worldwide. Heparin and vitamin K antagonists (VKAs), the first anticoagulants to be used successfully for the prevention and treatment of thrombosis, are associated with a risk of bleeding. These agents target multiple coagulation factors. Thus, by activating antithrombin, heparin mainly inhibits factor Xa and thrombin, whereas VKAs lower the levels of the vitamin K–dependent clotting factors. Direct oral anticoagulants, which have replaced VKAs for many indications, inhibit only factor Xa or thrombin. Although the direct oral anticoagulants are associated with less bleeding than VKAs, bleeding remains their major side effect. Epidemiological and animal studies have identified factor XI as a target for potentially safer anticoagulant drugs because factor XI deficiency or inhibition protects against thrombosis and is associated with little or no bleeding. Several factor XI–directed strategies are currently under investigation. This article (1) reviews the rationale for the development of factor XI inhibitors, (2) identifies the agents in most advanced stages of development, (3) describes the results of completed clinical trials and provides a summary of those underway, and (4) highlights the opportunities and challenges for this next generation of anticoagulants.
Propulsive Force of Upper Limbs and its Relationship to Swim Velocity
in the Butterfly Stroke
Authors: Morais Jorge , Barbosa Tiago M. , Lopes Vitor P. , Marques Mario C , Marinho Daniel Almeida 
Published: April 2021

AbstractThe aims of this study were to: (1) verify the sex effect; (2) assess upper
limb asymmetry in anthropometrics and propulsive force variables; and (3)
identify the main determinants of butterfly swim velocity based on a set of
anthropometrics, kinematics, and propulsive force variables. Twenty swimmers
(10 males: 15.40±0.30 years; 10 females: 14.43±0.23 years)
at the national level were recruited for analysis. A set of anthropometrics,
kinematics, and propulsive force variables were measured. Overall, a
significant sex effect was verified (p≤0.05). Non-significant
differences between upper-limbs were noted for males and females in all
variables, except for the dF in males (t=−2.66,
p=0.026, d=0.66). Stroke frequency presented the highest
contribution, where a one unit increase in the stroke frequency imposed an
increase of 0.375 m·s-1 (95CI: 0.105;0.645, p=0.010)
in the swim velocity. The swim velocity was predicted by the mean propulsive
force, intra-cyclic variation of the swim velocity, and stroke frequency.
Overall, swimmers exhibit non-significant differences in the variables
assessed. Swim velocity in the butterfly stroke was determined by an
interaction of propulsive force and kinematic variables in young
swimmers.
Anticoagulation in Critically Ill Adults during Extracorporeal Circulation
Authors: Buchtele Nina , Staudinger Thomas , Schäfer Anne-Kristin , Bögl Magdalena Sophie , Schoergenhofer Christian , Schwameis Michael 
Published: April 2021

AbstractExtracorporeal circuits including renal replacement therapy, extracorporeal membrane oxygenation, and ventricular assist devices are increasingly used in critically ill patients. The need for anticoagulation to provide circuit patency and avoid thrombosis remains a challenging task for treating physicians. In the presence of overall low scientific evidence concerning the optimal anticoagulants, monitoring tests, and therapeutic target ranges, recommendations are largely expert opinions and most centers use individual “in-house” anticoagulation protocols. This review gives a practical view on current concepts of anticoagulation strategies in patients with extracorporeal assist devices.
Endoscopic ultrasound-guided gastroenterostomy using an oroenteric catheter-assisted technique: a retrospective analysis
Authors: Nguyen Nam Q. , Hamerski Christopher M. , Nett Andrew , Watson Rabindra R. , Rigopoulos Morgan , Binmoeller Kenneth F. 
Published: April 2021

Abstract
Background This study evaluated an oroenteric catheter (OEC)-assisted technique to distend the enteric loop for endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in patients with gastric outlet obstruction (GOO).
Methods Patient outcomes were reviewed. Proximal enteric loops were filled with water via an OEC (7 Fr or 8 Fr), providing a target for EUS-GE using a lumen-apposing metal stent (15-mm caliber). Clinical success was defined as toleration of a non-liquid diet by Day 3.
Results 42 patients (mean age 73.1 [SEM 2.8] years; 23 male) underwent EUS-GE for malignant (n = 37) and benign (n = 5) duodenal strictures. EUS-GE creation was successful in 41/42 (98 %), with mean procedure time of 36 (SEM 3) minutes and no serious complications. Clinical success was achieved in 39/42 (93 %) at 5.7 (SEM 2.6) months’ follow-up. Of 14 patients who died, 13 (93 %) maintained oral intake until death. EUS-GE provided good symptom relief in all 28 surviving patients until follow-up.
Conclusions OEC-assisted EUS-GE provided satisfactory relief of GOO symptoms, with high technical success (98 %) and no serious complications.
Management of Disseminated Intravascular Coagulation in Acute Leukemias
Authors: ten Cate Hugo , Leader Avi 
Published: April 2021

AbstractDisseminated intravascular coagulation (DIC) is characterized by the intravascular activation of coagulation with loss of localization arising from different causes, and is diagnosed using scoring systems which rely upon the presence of an underlying disorder compatible with DIC alongside hemostatic derangements such as low platelet count, prolonged prothrombin time, and elevated fibrinogen degradation products. DIC is common in patients with acute leukemia, with prevalence ranging from 17 to 100% in acute promyelocytic leukemia (APL) and 8.5 to 25% in acute lymphoblastic leukemia (ALL) and non-APL acute myeloid leukemia (AML). The pathophysiology is complex and varies between the leukemia subtypes, and is not fully reflected by the laboratory markers currently used to classify DIC. Similarly, the clinical consequence of DIC in acute leukemia also varies across the types of leukemia. DIC is primarily associated with bleeding in APL, while thrombosis is the dominant phenotype in ALL and non-APL AML. The cornerstone of managing DIC is the treatment of the underlying disease, as exemplified by the important role of early administration of all-trans retinoic acid in APL. Other aspects of management focus on supportive care aimed at minimizing the risk of bleeding, via transfusion of blood products. The use of blood products is more liberal in APL, due to the hemorrhagic phenotype and unacceptably high rates of early hemorrhagic death. This review will focus on the pathophysiology, risk factors, clinical implications, and the management of DIC in patients across the spectrum of acute leukemias.
Early double-guidewire versus repeated single-guidewire technique to facilitate selective bile duct cannulation: a randomized controlled trial
Authors: Laquière Arthur , Privat Jocelyn , Jacques Jeremie , Legros Romain , Urena-Campos Romina , Belkhodja Hichem , Subtil Clément , Kanafi Leïla , Lecomte Laurence , Boustière Christian , Katsogiannou Maria , Karsenti David 
Published: April 2021

Abstract
Background During endoscopic retrograde cholangiopancreatography (ERCP), access to the common bile duct (CBD) can be problematic after unintentional insertion of the guidewire into the pancreatic duct. We conducted a prospective, randomized study in order to compare biliary cannulation success rates of early double-guidewire (EDG) and repeated single-guidewire (RSG) techniques in patients with inadvertent passage of the guidewire into the pancreatic duct.
Methods Patients with a native papilla were randomly assigned to either the EDG or RSG groups after unintentional insertion of the guidewire into the pancreatic duct. The primary outcome was successful selective CBD cannulation within 10 minutes. The secondary outcomes were successful final selective bile duct cannulation, time to bile duct cannulation, and frequency of post-ERCP pancreatitis (PEP).
Results 142 patients were randomized and selective bile duct cannulation was achieved in 57/68 patients (84 %) in the EDG group and in 37/74 patients (50 %) in the RSG group within 10 minutes (relative risk 1.34; 95 % confidence interval 1.08–6.18; P < 0.001). The overall final selective bile duct cannulation rate was 99.3 %. The time to access the CBD was shorter using the EDG technique (6.0 vs. 10.4 minutes; P = 0.002). Mild PEP was not observed more frequently in the EDG group than in the RSG group.
Conclusion The EDG technique significantly increased the success rate of biliary duct cannulation within 10 minutes compared with an RSG approach.
Genetic Variability of the Paired Box Transcription Factor; PAX8 Gene: Guidance Towards Treatment Strategies in a Cohort of Congenital Hypothyroidism
Authors: El-Ella Sohier S. Abou , Khattab Essam Shawky A.E.H. , Beddah Rehab K. , Barseem Naglaa Fathy 
Published: April 2021

AbstractThe contribution of PAX8 genetic variants to congenital hypothyroidism (CH) is not well understood. We aimed to study the genetic variability of exons 3 and 5 of PAX8 gene among a cohort of children with congenital hypothyroidism in correspondence to their clinical aspect. Blood samples were collected from 117 children (63 girls and 54 boys) with CH and enrolled as cases (Group I). All cases underwent biochemical confirmation with low FT4 and high TSH levels and thyroid gland imaging, along with equal number of matched apparently healthy individuals who served as controls (Group II). Genomic materials for exons 3 and 5 of PAX8 gene were extracted, amplified by PCR, detected by electrophoresis, purified, and sequenced by the Sanger technique through the application of ABI 3730x1 DNA Sequencer. Out of 117 cases, eight different effective PAX8 mutations were detected in exon 3 (G23D, V35I, I34T, Q40P, p.R31C, p.R31H, p.R31A, and p.I47T) in 14 patients with their sonographic findings ranged from normal, hypoplastic to thyroid agenesis. Besides the reported mutations, one novel mutation; R31A was detected in 1 euotopic case. Exon 5 analysis revealed no detected mutations elsewhere. In contrast, all healthy control children showed no mutation and normal sonographic findings. Mutations in exon 3 of PAX8 gene, implies its important role in thyroid development and function, as a first estimate of PA8 mutation rate in Egyptian patients with CH having normal and dysgenetic gland. Using ultrasound is mandatory for diagnosis and guiding the treatment of children with CH.
Individual calculation of perfusion activity based on ventilation efficiency for V/P-SPECT
Authors: Bärenfänger Felix , Block Andreas , Schmelz Detlef , Hamami-Arlinghaus Monia 
Published: April 2021

Abstract
Aim Implementation of the individual calculation of perfusion activity to ensure the guideline-compliant ratio of perfusion to ventilation (P/V-ratio) of ≥ 3 in the diagnosis of acute pulmonary embolism (PE) using V/P-SPECT.
Material and Methods 50 consecutive V/P-SPECT examinations, in which a standard activity of 160 MBq was applied for perfusion imaging, are evaluated retrospectively. Based on this patient group an activity factor is determined, which provides a correlation between the applied perfusion activity and the expected perfusion counts of the gamma camera. Using the mean activity factor, the perfusion activity required for a P/V-ratio of four is calculated using the previously acquired ventilation count rate. This is applied prospectively to the 100 subsequent examinations.
Results The mean perfusion activity factor is (54.56 ± 10.13) cps/MBq. The individually calculated perfusion activities range from 80 MBq to 200 MBq with an average value of (146.9 ± 35.3) MBq and a median of 140 MBq. The individual activity calculation thus reduced the mean perfusion activity by 8.2 % and the median by 12.5 %. In addition, the individual calculation reduced the proportion of P/V ratios < 3 from 14 % to 0 % and the proportion of P/V ratios > 5 from 24 % to 19 %.
Conclusion The presented method for the individual calculation of perfusion activity offers a simple way to ensure a guideline-compliant P/V-ratio. Furthermore, unnecessarily high perfusion activity as a result of inadequate ventilation can be avoided.
Withanolides from Withania somnifera Ameliorate Neutrophil Infiltration in Endotoxin-Induced Peritonitis by Regulating Oxidative Stress and Inflammatory Cytokines
Authors: Solleti Siva Kumar , Singh Hoshiyar , Balkrishna Acharya , Sharma Niti , Varshney Anurag 
Published: April 2021

AbstractIdentification of novel anti-inflammatory strategies are needed to avoid the side effects associated with the currently available therapies. Use of anti-inflammatory herbal remedies is gaining attention. The purpose of the present investigation was to evaluate the pharmacological potential of the withanolide-rich root extracts of the medical plant Withania somnifera (L.) Dunal using in vivo and in vitro models of endotoxin-induced inflammation and oxidative stress. The pharmacological effects of W. somnifera root extracts were evaluated using a mouse model of endotoxin (lipopolysaccharide)-induced peritonitis and various relevant human cell lines. HPLC analysis of the W. somnifera root extracts identified the presence of various bioactive withanolides. In vivo challenge of mice with endotoxin resulted in the infiltration of various leukocytes, specifically neutrophils, along with monocytes and lymphocytes into the peritoneal
cavity. Importantly, prophylactic treatment with W. somnifera inhibited the migration of neutrophils, lymphocytes, and monocytes and decreased the release of interleukin-1β, TNF-α, and interleukin-6 cytokines into the peritoneal cavity as identified by ELISA. Liver (glutathione peroxidase, glutathione, glutathione disulfide, superoxide dismutase, malondialdehyde, myeloperoxidase) and peritoneal fluid (nitrite) biochemical analysis revealed the antioxidant profile of W. somnifera. Similarly, in human HepG2 cells, W. somnifera significantly modulated the antioxidant levels. In THP-1 cells, W. somnifera decreased the secretion of interleukin-6 and TNF-α. In HEK-Blue reporter cells, W. somnifera inhibited TNF-α-induced nuclear factor-κB/activator protein 1 transcriptional activity. Our findings suggest the pharmacological effects of root extracts of W. somnifera rich in withanolides
inhibit neutrophil infiltration, oxidative hepatic damage, and cytokine secretion via modulating the nuclear factor-κB/activator protein 1 pathway.
Enhanced Skin Permeation of Punicalagin after Topical Application of Pluronic Micelles or Vesicles Loaded with Lafoensia pacari Extract
Authors: Garcia Sandra Alves de Sousa , da Rocha Priscila Bianca Rodrigues , Souza Bruno dos Santos , Paz Andressa Tuane Santana , Negris Ana Luiza Caetano , Marreto Ricardo Neves , da Conceição Edemilson Cardoso , Bara Maria Teresa Freitas , Taveira Stephânia Fleury 
Published: April 2021

AbstractPunicalagin, the principal ellagitannin of Lafoensia pacari leaves, has proven antioxidant activity, and standardized extracts of L. pacari can be topically used for skin aging management. We hypothesized that Pluronic nanomicelles or vesicles could solubilize sufficiently large amounts of the standardized extracts of L. pacari and provide chemical stability to punicalagin. The standardized extracts of L. pacari were obtained with an optimized extraction procedure, and the antioxidant activity was characterized. Formulations containing Pluronic at 25% and 35% were obtained with or without Span 80. They were characterized by average diameter, polydispersity index, punicalagin content, physicochemical stability, and rheology. A release and skin permeation study was carried out in vertical diffusion cells. The extraction procedure allowed quantifying high punicalagin content (i.e., 141.61 ± 3.87 mg/g). The standardized extracts of
L. pacari showed antioxidant activity for all evaluated methods. Pluronic at 25 and Pluronic at 35 with standardized extracts of L. pacari showed an average diameter of about 25 nm. The addition of Span 80 significantly increased the mean diameter by 15-fold (p < 0.05), indicating the spontaneous formation of vesicles. Pluronic formulations significantly protected punicalagin from chemical degradation (p < 0.05). Pluronic at 25 formulations presented as free-flowing liquid-like systems, while Pluronic at 35 resulted in an increase of about 44-fold in |ƞ*|. The addition of Span 80 significantly reduced the Pluronic sol-gel transition temperature (p < 0.05), indicating the formation of vesicles. Formulations with Span 80 significantly enhanced punicalagin skin permeation compared to formulations without Span 80 (p < 0.05). Formulations with Span 80 were demonstrated to be the most promising formulations, as they allowed significant permeation of
punicalagin (about 80 to 315 µg/cm2), which has been shown to have antioxidant activity.
Synthesis of Bempedoic Acid through Electrochemical Decarboxylation of Dialkylated Malonic Acid
Authors: Tian Lifang , Wang Yahui , Xu Zhimin , Zheng Yue 
Published: April 2021

AbstractBempedoic acid is a small-molecule inhibitor of adenosine triphosphate-citrate lyase (ACL) that is effective in the treatment of hypercholesterolemia and hypertension. In this paper, a new, six-step synthesis of bempedoic acid with 42% overall yield is reported. Ketone formation by electrochemical decarboxylation of dialkylated malonic acid is introduced as the key step of this process. This method uses mild conditions and its high efficiency makes it potentially suitable for industrial production.
Nickel-Catalyzed Decarbonylative Thioetherification of Acyl Fluorides via C–F Bond Activation
Authors: Nishihara Yasushi , You Jingwen , Chen Qiang 
Published: April 2021

AbstractNickel-catalyzed decarbonylative thioetherification of acyl fluorides has been developed. This transformation allows an array of acyl fluorides to react with thiophenols. A wide range of functional groups are well tolerated and the corresponding sulfides can be obtained in good to excellent yields. This protocol provides the formation of diverse carbon–sulfur bonds via a highly efficient decarbonylative process.
Organoiodine-Catalyzed Enantioselective Intramolecular Oxy­aminations of Alkenes with N-(Fluorosulfonyl)carbamate
Authors: Hashimoto Takuya , Wata Chisato 
Published: April 2021

AbstractOrganoiodine-catalyzed enantioselective intramolecular oxyaminations were realized by the use of benzyl N-(fluorosulfonyl)carbamate as the exogenous nitrogen source. The method allows access to enantioenriched lactones and oxazolines, starting from γ,δ- and δ,ε-unsaturated esters and N-allyl amides, respectively.