bluuebunny/crossref_metadata_2025_split huggingface dataset:
The young Hobson family: Possible binary parent body and low-velocity dispersal
Authors: Vokrouhlický D. , Brož M. , Novaković B. , Nesvorný D. 
Published: August 2021

Context.Asteroid families with ages younger than 1 Myr offer an interesting possibility of studying the outcomes of asteroid disruptions that are little modified by subsequent evolutionary processes.Aims.We analyze a very young asteroid family associated with (18777) Hobson in the central part of the main belt. We aim at (i) understanding its peculiar size distribution, and (ii) setting an upper limit on the characteristic dispersal velocity at subkilometer sizes corresponding to the smallest visible Hobson members.Methods.We identified the Hobson family using an up-to-date asteroid catalog. A significant increase in the number of its known members allowed us to study their size distribution and compare it with computer simulations of catastrophic disruptions. Backward orbital integrations of the heliocentric orbits allowed us to confirm the previously suggested age of Hobson and helped to estimate limits of the ejection speed.Results.The Hobson family has an unusual size distribution: two nearly equal-size bodies, followed by a population of smaller asteroids, whose distribution takes a characteristic power law. There are two possibilities to explain these data. Either a canonical impact onto a single parent body, requiring fine-tuned impact conditions that have not been studied so far, or an unconventional model for the parent object of the Hobson family, namely a binary with ≃7−9 km primary and a ≃2.5 km secondary. In the latter case, the primary was disrupted, leaving behind the largest remnant (18777) Hobson and a suite of subkilometer asteroids. The second largest asteroid, (57738) 2001 UZ160, is the nearly intact satellite of the parent binary. The excellent convergence of nominal orbits of Hobson members sets an upper limit of ≃(10−20) m s−1for the initial dispersal velocity of the known members, which is consistent with both formation models. The Hobson family provides a so far rare opportunity of studying disruptions of small asteroids in a situation in which both the material strength and reaccumulation efficiency play an important role.
SpyGlass von innen und außen: Welchen Stellenwert hat die moderne Cholangioskopie heute?
Authors: Stahlberg Urte , Bojarski Christian 
Published: August 2021

ZusammenfassungDie modulare Cholangioskopie wird im Rahmen diagnostischer und therapeutischer Endoskopie der Gallengänge im Rahmen einer ERC oder bei Spezialfällen im Rahmen einer PTC eingesetzt.
Diagnostik und Signifikanzbeurteilung bei Verdacht auf sexuelle Gewalt im Kindes- und Jugendalter
Authors: Richter Patrizia , Bartels Marco Baz , Kieslich Matthias 
Published: August 2021

ZUSAMMENFASSUNGHintergrund Sexueller Missbrauch ist bei Kindern schwierig zu diagnostizieren und stellt eine erhebliche Herausforderung für alle beteiligten Fachdisziplinen einer medizinischen Kinderschutzambulanz dar. Die vorliegende Arbeit zeigt Fallkonstellationen und die zu verwendende Diagnostik, um ein Verdachtsmoment zu erhärten oder nachzuweisen.Patienten und Methode Die Studie erfolgte retrospektiv anhand der Patientendokumentation von 210 Kindern und Jugendlichen im Alter zwischen 4 Monaten und 18 Jahren, die mit Verdacht auf sexuellen Missbrauch im Zeitraum von 2010 bis 2015 in der Kinderschutzambulanz Frankfurt am Main vorgestellt wurden. 173 Fälle wurden detaillierter analysiert. Mit Hilfe von standardisierten Erfassungsbögen wurden die Fälle analysiert und die Verdachtsmomente bezüglich ihrer Signifikanz beurteilt.Ergebnisse Insgesamt wurden 173 Kinder und Jugendliche mit Verdacht auf sexuellen Missbrauch detailliert analysiert. Der Großteil dieser Kinder und Jugendlichen war weiblich und unter 10 Jahre alt. Häufig wurde der Vater des Kindes im Rahmen von Trennungssituationen oder Sorgerechtsstreits der Eltern des sexuellen Missbrauchs beschuldigt. Vor allem die eigenanamnestischen Angaben der Patientinnen und Patienten hatten in 60% für die Erhärtung der Verdachtsmomente Bedeutung. Die Einschätzung gelang umso sicherer, wenn der mutmaßliche Täter nicht dem engen Familienkreis angehörte und wenn andere Formen körperlicher Gewalt assoziiert vorlagen.Schlussfolgerung Die Studie zeigt, dass der gynäkologische bzw. anogenitale Untersuchungsbefund relativ wenig Bedeutung für die Erhärtung eines Verdachts auf sexuellen Missbrauch hat. Viel mehr unterstreichen die Ergebnisse den Stellenwert weiterer diagnostischer Maßnahmen, insbesondere die anamnestische und psychologische Evaluation.
Intrahepatic Cholestasis of Pregnancy
Authors: Jurk Stanisław M. , Kremer Andreas E. , Schleussner Ekkehard 
Published: August 2021

AbstractIntrahepatic cholestasis of pregnancy (ICP) is a rare but potentially serious complication of pregnancy, the main symptom of which is intense pruritus with elevated serum levels of bile acids. The elevated serum bile acid concentration is regarded as a predictor for poor perinatal outcome including intrauterine death. Ursodeoxycholic acid (UDCA) has become established as the treatment of choice in clinical management to achieve a significant improvement in symptoms and reduce the cholestasis. Pregnant women with severe intrahepatic cholestasis should always be managed in a perinatal centre with close interdisciplinary monitoring and treatment involving perinatologists and hepatologists to minimise the markedly increased perinatal morbidity and mortality as well as maternal symptoms.
Labour Induction with Misoprostol in German Obstetric Clinics: What Are the Facts on Such Use?
Authors: Kehl Sven , Weiss Christel , Rath Werner , Schneider Michael , Stumpfe Florian , Faschingbauer Florian , Beckmann Matthias W. , Stelzl Patrick 
Published: August 2021

Abstract
Subject While the synthetic prostaglandin E1 analogue misoprostol is the most effect labour induction agent, its use is off-label for the most part. For this reason, and in view of its potential adverse effects and varying approaches to its administration, the drug has recently once again become a focus of critical attention. The objective of this survey was thus to establish a record of labour induction with misoprostol in German clinics and determine the impact of the negative reporting on everyday obstetric practice.
Material and Methods In this cross-sectional study, 635 obstetrics and gynaecology departments in Germany were requested by email to participate in our survey in February/March 2020. Online responses to 19 questions were requested regarding the clinic, use of misoprostol before and after the critical reporting, use of misoprostol (sourcing, method of administration, dosage, monitoring) and other labour induction methods.
Results A total of 262 (41.3%) of the clinics solicited for the survey completed the questionnaire. There were no differences regarding the care level (Perinatal Centre Level I, Perinatal Centre Level II, Clinic with Perinatal Focus or Obstetric/Private Clinic; p = 0.2104) or birth counts (p = 0.1845). In most cases, misoprostol was prepared in the clinicʼs own pharmacy (54%) or imported from another country (46%) and administered orally in tablet form (95%). Misoprostol dosage levels varied (25 µg [48%], 50 µg [83%], 75 µg [6%], 100 µg [47%] and > 100 µg [5%]). Most of the clinics used premanufactured tablets/capsules (59%), although Cytotec tablets were also divided (35%) or dissolved in water (5%). Misoprostol administration intervals were mainly every 4 hours (64%) or every 6 hours (30%). CTG checks were run in most cases before and after administration of a dose of misoprostol (78% and 76%) and before and after administration of a dose of prostaglandin E2
(both 88%). Presence of contractions led to no misoprostol (59%) or no prostaglandin E2 (64%) being administered in most cases. The critical reporting resulted in discontinuation of use of misoprostol in 17% of the clinics – mainly smaller obstetric/private clinics with fewer than 1000 births. Labour cocktails were used mainly in obstetric and private clinics (61%).
Conclusion Misoprostol is an established agent for labour induction in German clinics. The dosing schemes used vary. Improvements of currently common management practices are required, especially in the area of labour induction (CTG checks before and after administration of labour-inducing medication, no administration of prostaglandin if contractions are ongoing). The discussion of use of misoprostol in the media resulted in stoppage of its use mainly in smaller clinics.
De novo Design of SARS-CoV-2 Main Protease Inhibitors
Authors: Vepřek Nynke A. , Peitsinis Zisis , Zhang Yingkai , Trauner Dirk , Fischer Christian , Rühmann Klaus-Peter , Yang Chao , Spradlin Jessica N. , Dovala Dustin , Nomura Daniel K. 
Published: August 2021

AbstractThe COVID-19 pandemic prompted many scientists to investigate remedies against SARS-CoV-2 and related viruses that are likely to appear in the future. As the main protease of the virus, MPro, is highly conserved among coronaviruses, it has emerged as a prime target for developing inhibitors. Using a combination of virtual screening and molecular modeling, we identified small molecules that were easily accessible and could be quickly diversified. Biochemical assays confirmed a class of pyridones as low micromolar noncovalent inhibitors of the viral main protease.
Oncologic Panendoscopy: Description of an Optimized Procedure Based on Our Experience
Authors: Pincet Laurence , Sandre Cécile de , Lang Florian J. W. , Colin Victor 
Published: August 2021

Abstract
Introduction All patients with a new head and neck squamous cell carcinoma (HNSCC) undergo diagnostic panendoscopy as part of the screening for synchronous second primary tumors. It includes a pharyngolaryngoscopy (PLS), a tracheobronchoscopy and esophagoscopy, and a stomatoscopy. Rigid techniques are risky, with long learning curves.
Objective We propose a precise description of the panendoscopy protocol. We include an optimization of the PLS technique that completes the flexible esophagoscopy when rigid esophagoscopy isn't performed.
Methods The present retrospective observational study includes 122 consecutive patients with a new primary HNSCC who underwent traditional panendoscopy and the new PLS technique between January 2014 and December 2016. A two-step procedure using a Macintosh laryngoscope and a 30° telescope first exposes panoramically the larynx, the upper trachea, and the oropharynx; then, in a second step, the hypopharynx is exposed down to the upper esophageal sphincter. Broncho-esophagoscopy is performed with a rigid and flexible scope.
Results In total, 6 (5%) patients presented synchronous tumors (3 in the esophagus, 2 in the oral cavity, and 1 in the larynx 1). Rigid endoscopy was complicated by 2 (1,6%) dental lesions, and had to be completed with a flexible scope in 38 (33%) cases for exposition reasons. The two-step PLS offered a wide-angle view of the larynx, upper trachea, and oro- and hypopharynx down to the sphincter of the upper esophagus. The procedure was easy, reliable, safe, repeatable, and effectively completed the flexible endoscopies.
Conclusion Rigid esophagoscopy remains a difficult procedure. Two-step PLS combined with flexible broncho-esophagoscopy offers good optical control.
Pelvic Venous Congestion Secondary to a Circumaortic Renal Collar in an Adolescent Female: Report of a Case
Authors: Alonso-Arroyo Verónica , Velasco Jose Javier , Pérez-Bertólez Sonia , Molina Maria Elena , Marugan-de-Miguelsanz Jose Manuel , Sanchez-Abuin Alberto , Beltran Oscar Dario Gomez 
Published: August 2021

AbstractWe report a 13-year-old girl who presented with a recurrent abdominal pain that started after her menarche. The abdominal palpation revealed tenderness over the left ovarian point. The laboratory study, ultrasonography, and abdominal X-ray were normal. The computed tomography and magnetic resonance imaging showed a double left renal vein with a retroaortic component, an increased left parauterine circulation, and ipsilateral ovarian vein engorgement. A diagnostic and therapeutic phlebography allowed a selective catheterization of a group of pelvic varicose veins draining to the left ovarian and to the internal iliac veins. There were no complications during the procedure and the symptoms disappeared 2 days later. Circumaortic left renal vein may cause hematuria, proteinuria, pelvic congestion syndrome, and massive hemorrhage during surgery. A conservative treatment is recommended for patients without gynecourological/renal symptoms or with mild hematuria. The endovascular treatment by gonadal venous embolization is safe and effective.
Percutaneous Management of Benign Biliary Strictures
Authors: Fang Adam , Kim Il Kyoon , Ukeh Ifechi , Etezadi Vahid , Kim Hyun S. 
Published: August 2021

AbstractBenign biliary strictures are often due to a variety of etiologies, most of which are iatrogenic. Clinical presentation can vary from asymptomatic disease with elevated liver enzymes to obstructive jaundice and recurrent cholangitis. Diagnostic imaging methods, such as ultrasound, multidetector computed tomography, and magnetic resonance imaging (cholangiopancreatography), are used to identify stricture location, extent, and possible source of biliary obstruction. The management of benign biliary strictures requires a multidisciplinary team approach and include endoscopic, percutaneous, and surgical interventions. Percutaneous biliary interventions provide an alternative diagnostic and therapeutic approach, especially in patients who are not amenable to endoscopic evaluation. This review provides an overview of benign biliary strictures and percutaneous management by interventional radiologists. Diagnostic evaluation with percutaneous transhepatic cholangiography and treatment options, including biliary drainage, balloon dilation, retrievable/biodegradable stents, and other innovative minimally invasive options, are discussed.
Advancements in Endoscopic Biliary Interventions by Gastroenterology
Authors: Almuhaidb Aymen , Olson Dylan , Aadam A. Aziz 
Published: August 2021

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic technique in which a specialized side-viewing endoscope is guided into the duodenum, allowing for instruments to access the biliary and pancreatic ducts. ERCP was initially developed as a diagnostic tool as computed tomography was in its infancy during that time. ERCP has evolved since its inception in the 1960s to becoming not only a valuable diagnostic resource but now an effective therapeutic intervention in the treatment of various biliary disorders. The most common biliary interventions performed by ERCP include the management of biliary obstructions for benign and malignant indications. Additionally, endoscopic ultrasound (EUS) has been increasingly utilized in diagnosing and intervening on pancreaticobiliary lesion. This article will discuss the various methods currently available for various endoscopic biliary interventions and future interventional techniques. For the management of biliary strictures, EUS can be utilized with fine need aspiration, while ERCP can be used for the placement of various stents and diagnostic modalities. Another example is radiofrequency ablation, which can be used for the treatment of hilar strictures. Achieving bile duct access can be challenging in patients with complicated clinical scenarios; other techniques that can be used for bile duct access include EUS-guided rendezvous approach, transluminal approach, Choleodochoduodenostomy, and hepatogastrostomy, along with gaining access in complicated anatomy such as in patients with Rou-en-Y anatomy. Another useful endoscopic tool is nonsurgical drainage of the gallbladder, which can be a suitable option when patients are not optimal surgical candidates. There has also been an increase in outpatient utilization of ERCP, which was previously seen as a predominantly inpatient procedure in the past. Possible future evolutions of biliary interventions include robotic manipulation of a duodenoscope and direct infusion of chemotherapeutic or immunomodulatory agents into the pancreaticobiliary tree. These advancements will depend on parallel advancements in other imaging and laboratory as well as breakthrough technology or techniques by other disciplines including interventional radiology and minimally invasive surgery.
Technique for Adaptation of Konno Aortoventriculoplasty in Patient-Prosthesis Mismatch
Authors: Vural Kerem M. , Sabuncu Timucin 
Published: August 2021

AbstractThe patient-prosthesis mismatch has been reported as an important cause of adverse outcome following aortic valve replacement. The relief of patient-prosthesis mismatch generally requires a reoperation of comprehensive nature, which necessitates an extensive aortic root enlargement. The Konno aortoventriculoplasty represents an efficient treatment option, as this technique provides both extreme root enlargement and relief of the frequently associated subvalvular obstruction. However, the application and conduct of the procedure may somewhat differ from the pediatric Konno procedures. This article describes our surgical technique adaptation in Konno-aortoventriculoplasty for adult patient-prosthesis mismatch cases, highlighting the differing points from the pediatric-Konno.
Cardiovascular Manifestations of COVID-19: Insights into a Single-Center Experience
Authors: Schukraft Sara , Magnin Jean-Luc , Cook Stéphane 
Published: August 2021

Abstract
Background Since December 2019, an emerging outbreak of novel coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2). The aim of the present report is to describe a population with elevated levels of high-sensitive cardiac troponin T (hs-cTnT) and report on their management during the pandemic of COVID-19.
Methods In this retrospective cohort, we collected data from all patients with hs-cTnT levels of >50 ng/mL admitted to Fribourg Hospital between February 15, 2020, and April 15, 2020. The primary diagnosis for troponin elevation was recorded. Echocardiographic, electrocardiographic, and coronary angiographic data were analyzed for signs of myocardial ischemia, infarction, or other cardiomyopathies. In-hospital follow-up was performed for deaths from all causes and for cardiac deaths. Propensity score matching was used in a subgroup analysis to match COVID-19 and non-COVID-19 patients (n = 21 per group).
Results Overall, 215 patients with high hs-cTnT levels were enrolled. The median age was 75 [65–83] years and 30% were women. 21 patients (10%) were diagnosed with COVID-19. Of these, acute myocardial injury related to COVID-19 was the most commonly described cardiovascular manifestation during the pandemic peak. Median troponin values were not different between COVID-19 patients and non-COVID-19 patients (94 vs. 137, p = 0.14). The number of cardiological examinations was globally low (echocardiography 51% and coronary angiography 52%) in the context of the pandemic. Patients in the COVID-19 group underwent significantly less echocardiographic examinations (19 vs. 55%, p ≤ 0.01) and coronary angiographies (5 vs. 58%, p ≤ 0.01) than non-COVID-19 patients. Overall mortality in patient with COVID-19 and elevated troponins was very high, as 38% of patients died during hospitalization including 14% for cardiac death. This trend was confirmed in the propensity score–matched analysis.
Conclusion Interpretation of troponins during the COVID-19 pandemic was complicated due to the low number of cardiovascular investigations in this context. Follow-up of patients with COVID-19 and cardiovascular events is important to assess their prognosis and to improve their care.
Relapse of Immune Thrombotic Thrombocytopenic Purpura Following Vaccination with COVID19 mRNA Vaccine
Authors: Pavenski Katerina 
Published: August 2021

AbstractAn 84 year old male with a previous history of immune thrombotic thrombocytopenic purpura (iTTP) received the first dose of COVID19 mRNA vaccine (Pfizer-Biontech). Seven days later he was diagnosed with iTTP relapse. He received in-patient treatment with therapeutic plasma exchange, high dose steroids and rituximab and subsequently recovered. This case report highlights the need to monitor patients with iTTP following vaccination.
Energy efficiency of voltage waveform tailoring for the generation of excited species in RF plasma jets operated in He/N2 mixtures
Authors: Korolov I , Donkó Z , Hübner G , Liu Y , Mussenbrock T , Schulze J 
Published: August 2021

Abstract
Based on tunable diode laser absorption spectroscopy (TDLAS) measurements of the spatially averaged and peak helium metastable atom densities in a capacitively coupled micro atmospheric pressure plasma jet operated in He/N2 mixtures, the energy efficiency of metastable species (He-I 23S1) generation is compared for three different scenarios: single frequency operation at (i) 13.56 MHz and (ii) 54.12 MHz, and voltage waveform tailoring (VWT) at (iii) ‘valleys’-waveforms synthesized from four consecutive harmonics of 13.56 MHz. For each case, the dissipated power is measured based on a careful calibration procedure of voltage and current measurements. It is shown that the range of powers, at which the jet can be stably operated, is noticeably expanded by VWT. The results are compared to particle-in-cell/Monte Carlo collisions simulation results and very good agreement is found. The computational results show that the choice of the surface coefficients in the simulation is important to reproduce the experimental data correctly. Due to the enhanced control of the spatio-temporal electron power absorption dynamics and, thus, of the electron energy distribution function by VWT, this approach does not only provide better control of the generation of excited and reactive species compared to single frequency excitation, but in case of helium metastables the energy efficiency is also shown to be significantly higher in case of VWT.
Improved ice content, radiation, precipitation and low-level circulation over the tropical pacific from ECMWF ERA-interim to ERA5
Authors: Li Jui-Lin F , Xu Kuan-Man , Richardson Mark , Jiang Jonathan H , Stephens Graeme , Lee Wei-Liang , Fetzer Eric , Yu Jia-Yuh , Wang Yi-Hui , Wang F-J 
Published: August 2021

Abstract
This study evaluates changes in simulated Pacific climate between two ECMWF re-analyses; the ERA Interim (ERAI) and the newest ERA5. Changes in the Integrated Forecasting System (IFS) and possibly sea surface temperature result in greatly reduced discrepancies in ERA5’s ice water path (IWP), radiative fluxes and precipitation relative to satellite-based observational products. IWP shows the largest percentage change, increasing by over 300% from ERAI to ERA5, due to inclusion of falling ice (snow) that impacts radiative calculation. ERAI to ERA5 changes in high-cloud fraction are generally anticorrelated as expected with outgoing longwave radiation, with ERA5 having smaller longwave discrepancies versus CERES observations compared with ERAI. Reflected shortwave discrepancies are similarly reduced from ERAI to ERA5, which appears to be due to changes in both cloud fraction and optical depth. Finally, ERA5 also reduces a longstanding precipitation excess relative to the GPCP observational product in the southern trade winds region between the Southern Pacific and intertropical convergence zones. This appears to be related to cooler prescribed sea surface temperatures, thereby reducing local moisture supply via suppressing net latent heat flux and stronger surface trade-winds. Compared with GPCP and CERES, ERA5 shows similar geographic patterns of discrepancies to ERAI in terms of precipitation and top-of-atmosphere radiation, but their magnitudes are greatly reduced in ERA5.