bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drain Lipase Levels and Decreased Rate of Drain Amylase Levels as Independent Predictors of Pancreatic Fistula with Nomogram After Pancreaticoduodenectomy
Authors: Suzuki Shuji , Shimoda Mitsugi , Shimazaki Jiro , Oshiro Yukio , Nishida Kiyotaka , Shiihara Masahiro , Izumo Wataru , Yamamoto Masakazu 
Published: March 2021

AbstractBackgroundPancreaticoduodenectomy (PD) has recently been improved due to its increased safety. However, postoperative pancreatic fistula (POPF) remains a lethal complication of PD. Identifying novel clinicophysiological risk factors for POPF during the early post‐PD period would help improve patient morbidity and mortality. Therefore, this retrospective study aimed to evaluate possible risk factors during the early postoperative period after pancreaticoduodenectomy (PD).MethodsData from 349 patients who underwent PD between 2007 and 2012 were examined retrospectively. All patients were classified into 2 groups: group A, patients without fistulae or biochemical leaks (288 patients), and group B, those with grade B or C POPF (61 patients). Data on various clinicophysiological parameters, including serum and drain laboratory data, were collected. Univariate and multivariate analyses were performed to evaluate POPF predictors. A predictive nomogram was established for these results.ResultsUnivariate analysis showed that various serum and drain‐related factors, such as white blood cell count, C‐reactive protein levels, drain amylase (DAMY) levels, and drain lipase (DLIP) levels, were possible POPF risk factors. Multivariate analysis confirmed that postoperative day (POD) 1 DLIP levels (hazard ratio, 15.393; p = 0.037) and decreased rate (POD3/1) of DAMY levels (hazard ratio, 4.415; p = 0.028) were independent risk factors. Further, POD1 DLIP levels and decreased rate of DAMY levels were significantly lower in group A than in group B. The accuracy of nomogram was 0.810.ConclusionsPOD1 DLIP levels (> 245 U/mL) and decreased rate of DAMY levels (> 0.44) were POPF risk factors, making them possible biomarkers for POPF.
Male Patients may be More Vulnerable to Acute Kidney Injury After Colorectal Surgery in an Enhanced Recovery Program: A Propensity Score Matching Analysis
Authors: Shim Jung‐Woo , Ro Hojun , Lee Chul Seung , Park Jaesik , Lee Hyung Mook , Kim Yong‐Suk , Moon Young Eun , Hong Sang Hyun , Chae Min Suk 
Published: March 2021

AbstractBackgroundAlthough many reports have shown that enhanced recovery after surgery (ERAS) programs improve the perioperative outcomes of patients undergoing colorectal surgery, the prevalence of early acute kidney injury (AKI) after surgery in such patients requires attention. Protective roles of the female sex in terms of chronic kidney disease and progression of ischemic renal injury have been described in many studies. We thus explored whether a sex difference was evident in terms of postoperative AKI in a colorectal ERAS setting.MethodsFrom January 2017 to August 2019, 453 patients underwent laparoscopic colorectal cancer resection in an enhanced recovery program. Of these, 217 female patients were propensity score (PS)‐matched with 236 male patients. Then, 215 patients of either sex were compared in terms of postoperative renal function and complications.ResultsAmong the PS‐matched patients, the incidence of AKI was significantly higher in male than female patients (24.2% vs. 9.8%, P < 0.001). Male patients also exhibited a greater reduction in the postoperative estimated glomerular filtration rate, compared with female patients. The male sex was associated with an approximately threefold increase in the risk of AKI. The rate of surgical complications was significantly higher in male than female patients.ConclusionsCaution must be taken to prevent postoperative AKI in patients (particularly males) participating in colorectal ERAS programs. The mechanism underlying the sex difference remains unclear. Additional studies are required to determine whether male patients require perioperative management that differs from that of females, to prevent postoperative AKI.
Usefulness of Serum Anti‐p53 Antibody Measurement in Patients Undergoing Hepatectomy for Colorectal Liver Metastases
Authors: Kojima Kazutaka , Shindoh Junichi , Akabane Miho , Umino Ryosuke , Kobayashi Yuta , Okubo Satoshi , Hashimoto Masaji 
Published: March 2021

AbstractBackgroundWhile anti‐p53 antibody (p53‐Ab) is a potential marker for early detection of colorectal cancer, its clinical utility in patients with advanced colorectal cancer remains unknown.MethodsThe clinical significance of p53‐Ab was investigated by analyzing the data of 206 patients who underwent curative resection for colorectal liver metastases.ResultsOf the 206 patients, 60 (29%) were seropositive and 146 were seronegative for p53‐Ab before the surgery. The preoperative serum p53‐Ab level showed no significant correlation with the serum CEA or serum CA19‐9 levels. The perioperative changes in serum p53‐Ab positivity were significantly correlated with the preoperative serum p53‐Ab levels and multivariate analysis confirmed that a higher preoperative p53‐Ab level was independently associated with a worse recurrence‐free survival (hazard ratio [HR], 1.07; 95% CI, 1.01–1.13; P = 0.033 per + 100 U/mL), even after adjustments for other oncological factors, including the preoperative serum CEA level.ConclusionHigher preoperative p53‐Ab levels were associated with a higher risk of recurrence after curative resection of colorectal liver metastases.
Prognostic Value of Inflammatory Biomarkers in 5‐Year Survival After Endovascular Repair of Abdominal Aortic Aneurysms in a Predominantly Male Cohort: Implications for Practice
Authors: Lecumberri E. , Ruiz‐Carmona C. , Mateos E. , Galarza A. , Subirana I. , Clara A. 
Published: March 2021

AbstractBackgroundPrognostic factors of long‐term survival can guide selection of patients for endovascular repair of abdominal aortic aneurysms (EVAR). The aim of this study was to evaluate the relationship between the neutrophil‐to‐lymphocyte ratio (NLR), the platelet‐to‐lymphocyte ratio (PLR), the lymphocyte‐to‐monocyte ratio (LMR) and the systemic immune‐inflammation index (SIII) with survival after EVAR and to assess whether the addition of these biomarkers improved the prediction of survival after surgery.MethodsRetrospective analysis of 284 consecutive patients who underwent an EVAR at a single institution. The association between biomarkers and survival was explored using generalized additive models with penalized smoothing splines and multivariate Cox models. C‐statistics and continuous net reclassification indexes (c‐NRI) were used to assess the improvement in prediction.ResultsSurvival rates at 2 and 5 years were 83.9% and 66.2%, respectively. The predictive score of survival included hemoglobin (HR = 0.849, p = 0.004), statin intake (HR = 0.538, p = 0.004), atrial fibrillation (HR = 2.515, p < 0.001), heart failure (HR = 2.542, p = 0.017) and the non‐revascularized coronary artery disease (HR = 2.163, p = 0.004). Spline analyses showed a linear relationship between survival and NLR, PLR, LMR and SII. After adjusting for the predictive score, there was an independent relationship between survival and NLR (HR = 1.072, p = 0.006), PLR (HR = 1.002, p = 0.014) and SII (HR = 1.000, p = 0.043). However, only the addition of NLR improved moderately the c‐NRI. A NLR ≥ 3 was independently associated with lower survival rates at 2‐years (HR 1.98; 95% CI 1.07–3.66) and 5‐years (HR 1.84, 95% CI 1.22–2.78) of follow‐up.ConclusionsMost inflammatory biomarkers are linear and independently associated with survival after EVAR, but only the NLR improved moderately the prediction of a survival score. Therefore, a NLR ≥ 3 may be used to identify patients with a low survival rate and help in decision‐making.
Illustrations of Hernia Surgery in the Early Period of the Ottoman Empire by Şerefeddin Sabuncuoğlu
Authors: Doğan Fatih , Tutak Fatma Nilay 
Published: March 2021

AbstractBackgroundImperial Surgery (Cerrahiyyetü’l‐ Haniyye), penned by Şerefeddin Sabuncuoğlu (C.E. 1385–1468), is an impressive medical book that was written in Turkish using the Arabic alphabet, containing color miniature drawings and human figures, depicted in a fantastic style. The purpose of this report is to present this unique contribution to the literature on the known history of hernia surgery.MethodsImperial Surgery is divided into three chapters, each of which is divided into sections that, in general, present patients and diseases in the form of case reports. Some sections detail the procedures to be performed on a patient, the surgical instruments used and the positioning of the patient, which are described in detail with color miniature drawings.ConclusionsŞerefeddin Sabuncuoğlu was a great surgeon in Turkish medical history. Given all of the hernia‐related information in literature, the treatise written by Sabuncuoğlu in fifteenth century and its suggested approaches to hernias show clearly the place that he should hold in the history of the art of healing. Hernia surgery is described step‐by‐step under four headings in two chapters, supported by four miniature drawings, including surgical tools.
A retrospective comparison of respiratory events with JAK inhibitors or rituximab for rheumatoid arthritis in patients with pulmonary disease
Authors: Cronin Owen , McKnight Olivia , Keir Lindsay , Ralston Stuart H. , Hirani Nikhil , Harris Helen 
Published: March 2021

AbstractJanus kinase inhibitors (JAKi) are an exciting option for the treatment of rheumatoid arthritis (RA) but little is known about their safety and tolerability in patients with existing respiratory disorders. The objective was to compare pulmonary safety of JAKi versus rituximab in patients with concurrent interstitial lung disease (ILD) or bronchiectasis. We performed a retrospective electronic patient record review of patients with known ILD or bronchiectasis commencing JAKi or rituximab for the treatment of RA. Patients initiating treatment from January 2016 to February 2020 were included. Respiratory events (hospitalization or death from a respiratory cause) were compared using Kaplan–Meier survival analysis. We analysed patients who received JAKi (n = 28) and rituximab (n = 19) for a mean (SD) of 1.1 (0.62) and 2.14 (1) years respectively. Patients were predominantly female (68%), anti-CCP antibody positive (94%) and non-smoking (89%) with a median (IQR) percentage predicted FVC at baseline of 100% (82–115%) and percentage predicted TLCO of 62% (54.5–68%). Respiratory events occurred in five patients treated with JAKi (18%; 5 hospitalizations, 2 deaths) and in four patients treated with rituximab (21%; 3 hospitalizations, 1 death). Respiratory event rates did not differ between groups (Cox-regression proportional hazard ratio = 1.38, 95% CI 0.36–5.28; p = 0.64). In this retrospective study, JAKi for the treatment of RA with existing ILD or bronchiectasis did not increase the rate of hospitalization or death due to respiratory causes compared to those treated with rituximab. JAK inhibition may provide a relatively safe option for RA in such patients.
Long-time experimental investigation of turbulent superstructures in Rayleigh–Bénard convection by noninvasive simultaneous measurements of temperature and velocity fields
Authors: Moller Sebastian , Resagk Christian , Cierpka Christian 
Published: March 2021

Abstract
Large-scale mean patterns in Rayleigh–Bénard convection, also referred to as turbulent superstructures, have mainly been studied by means of numerical simulations so far, but experimental investigations are still rare. However, the analysis of turbulent superstructures, which are of great importance due to their effect on the local transport of heat and momentum, require both numerical and experimental data. Therefore, within the scope of this study measurements were performed in the horizontal mid plane and in a horizontal plane closer to the top of a Rayleigh–Bénard cell with an aspect ratio of $$\varGamma =l/h=25$$

Γ
=
l
/
h
=
25

, thereby showing the initial formation of turbulent superstructures and their long-time rearrangement. The turbulent superstructures are investigated experimentally by noninvasive simultaneous measurements of temperature and velocity fields, using the color signal of thermochromic liquid crystals (TLCs) for the evaluation of the temperature and their temporal displacement for the determination of all three velocity components in the measurement planes via stereoscopic particle image velocimetry (stereo-PIV). Applying this measuring technique it is demonstrated that the time-averaging of instantaneous temperature and velocity fields uncovers the turbulent superstructures in both fields. Furthermore, the combination of the temperature and velocity data is used to characterize the local heat flux quantified by the local Nusselt number, which confirms that the turbulent superstructures strongly enhance the heat transfer in Rayleigh–Bénard convection.

Graphic abstract
Frozen-section examination in the management of paediatric testicular lesions
Authors: O’Connor E. , Roy C. , Annavarapu S. , Gabra H. O. 
Published: March 2021

Abstract
Purpose
Paediatric testicular and para-testicular lesions have traditionally been managed according to adult protocols. Testis-sparing surgery (TSS) has gained popularity as it has become apparent benign lesions predominate in childhood. Frozen-section examination (FSE) for intra-operative diagnosis has been extensively utilised in adults, though its use in paediatric practice remains limited. We reviewed our experience of FSE in paediatric patients with an aim to identify the utility and efficacy of this tool in the management of testicular and para-testicular pathology.

Methods
A retrospective, single-centre review of paediatric patients who underwent intra-operative FSE for a range of testicular and para-testicular lesions was performed. FSE results were compared to final pathology. TSS was performed if appropriate, and was utilised in adolescent patients, and in lesions with a diameter greater than 20 mm.

Results
Nine males underwent FSE from 2013 to 2020. Median age at surgery was 9 years (range 1–15). Eight (89%) patients had benign pathology. FSE result correlated with the final pathological examination in 100% of cases. FSE facilitated TSS in 7/9 cases.

Conclusion
FSE has 100% diagnostic accuracy for paediatric testicular and para-testicular pathology. We would recommend all lesions be evaluated by FSE to guide intra-operative decision making and facilitate TSS in appropriate cases.
A DARPin targeting activated Mac-1 is a novel diagnostic tool and potential anti-inflammatory agent in myocarditis, sepsis and myocardial infarction
Authors: Siegel Patrick M. , Bojti István , Bassler Nicole , Holien Jessica , Flierl Ulrike , Wang Xiaowei , Waggershauser Philipp , Tonnar Xavier , Vedecnik Christopher , Lamprecht Constanze , Stankova Ivana , Li Tian , Helbing Thomas , Wolf Dennis , Anto-Michel Nathaly , Mitre Lucia Sol , Ehrlich Julia , Orlean Lukas , Bender Ileana , Przewosnik Anne , Mauler Maximilian , Hollederer Laura , Moser Martin , Bode Christoph , Parker Michael W. , Peter Karlheinz , Diehl Philipp 
Published: March 2021

AbstractThe monocyte β2-integrin Mac-1 is crucial for leukocyte–endothelium interaction, rendering it an attractive therapeutic target for acute and chronic inflammation. Using phage display, a Designed-Ankyrin-Repeat-Protein (DARPin) was selected as a novel binding protein targeting and blocking the αMI-domain, an activation-specific epitope of Mac-1. This DARPin, named F7, specifically binds to activated Mac-1 on mouse and human monocytes as determined by flow cytometry. Homology modelling and docking studies defined distinct interaction sites which were verified by mutagenesis. Intravital microscopy showed reduced leukocyte–endothelium adhesion in mice treated with this DARPin. Using mouse models of sepsis, myocarditis and ischaemia/reperfusion injury, we demonstrate therapeutic anti-inflammatory effects. Finally, the activated Mac-1-specific DARPin is established as a tool to detect monocyte activation in patients receiving extra-corporeal membrane oxygenation, as well as suffering from sepsis and ST-elevation myocardial infarction. The activated Mac-1-specific DARPin F7 binds preferentially to activated monocytes, detects inflammation in critically ill patients, and inhibits monocyte and neutrophil function as an efficient new anti-inflammatory agent.
UV light-based reprocessing of flexible endoscopes without working channel in Oto-Rhino-Laryngology: an effective method?
Authors: Rudhart Stefan A. , Günther Frank , Dapper Laura , Thangavelu Kruthika , Geisthoff Urban W. , Stankovic Petar , Wilhelm Thomas , Stuck Boris A. , Hoch Stephan 
Published: March 2021

Abstract
Background
Reprocessing of flexible endoscopes (FEs) is often expensive, time consuming, and becomes increasingly complex, due to rising demands of hygiene. After beneficial results in reprocessing of rigid endoscopes using Impelux™ UV-C light technology, we tested the same method for reprocessing of FEs without working channel.

Materials and methods
Testing was performed on FEs without working channel after routine clinical use (transnasal flexible endoscopy). Disinfection consisted of mechanical precleaning and 60 s exposure to Impelux™ UV-C light technology. Bacterial contamination was tested on 50 FEs before and after disinfection. Further 50 FEs regarding protein residuals. The absolute effectiveness of the D60 was tested on 50 test bodies (RAMS) with a standardized contamination of 107 colony-forming units (CFU) of Enterococcus faecium.

Results
The FEs were contaminated with a high average value of 916.7 CFU (± 1057 CFU) after clinical usage. After reprocessing, an average contamination of 2.8 CFU (± 1.6) on 14% (n = 7) of the FEs was detected consisting of non-pathogenic species, the remaining FE were sterile. After reprocessing, all FEs were protein-free (< 1 μg). The artificially contaminated test bodies showed no remaining bacterial contamination after disinfection, resulting in an average absolute germ reduction of about 107 CFU.

Conclusion
Impelux™ UV-C light technology efficiently reduces bacterial contamination of FEs and might be useful in daily practice.
Fall prediction in neurological gait disorders: differential contributions from clinical assessment, gait analysis, and daily-life mobility monitoring
Authors: Schniepp Roman , Huppert Anna , Decker Julian , Schenkel Fabian , Schlick Cornelia , Rasoul Atal , Dieterich Marianne , Brandt Thomas , Jahn Klaus , Wuehr Max 
Published: March 2021

Abstract
Objective
To evaluate the predictive validity of multimodal clinical assessment outcomes and quantitative measures of in- and off-laboratory mobility for fall-risk estimation in patients with different forms of neurological gait disorders.

Methods
The occurrence, severity, and consequences of falls were prospectively assessed for 6 months in 333 patients with early stage gait disorders due to vestibular, cerebellar, hypokinetic, vascular, functional, or other neurological diseases and 63 healthy controls. At inclusion, participants completed a comprehensive multimodal clinical and functional fall-risk assessment, an in-laboratory gait examination, and an inertial-sensor-based daily mobility monitoring for 14 days. Multivariate logistic regression analyses were performed to identify explanatory characteristics for predicting the (1) the fall status (non-faller vs. faller), (2) the fall frequency (occasional vs. frequent falls), and (3) the fall severity (benign vs. injurious fall) of patients.

Results
40% of patients experienced one or frequent falls and 21% severe fall-related injuries during prospective fall assessment. Fall status and frequency could be reliably predicted (accuracy of 78 and 91%, respectively) primarily based on patients' retrospective fall status. Instrumented-based gait and mobility measures further improved prediction and provided independent, unique information for predicting the severity of fall-related consequences.

Interpretation
Falls- and fall-related injuries are a relevant health problem already in early stage neurological gait disorders. Multivariate regression analysis encourages a stepwise approach for fall assessment in these patients: fall history taking readily informs the clinician about patients' general fall risk. In patients at risk of falling, instrument-based measures of gait and mobility provide critical information on the likelihood of severe fall-related injuries.
Impact of residual stress evoked by pyramidal embossing on the magnetic material properties of non-oriented electrical steel
Authors: Gilch Ines , Neuwirth Tobias , Schauerte Benedikt , Leuning Nora , Sebold Simon , Hameyer Kay , Schulz Michael , Volk Wolfram 
Published: March 2021

AbstractTargeted magnetic flux guidance in the rotor cross section of rotational electrical machines is crucial for the machine’s efficiency. Cutouts in the electrical steel sheets are integrated in the rotor sheets for magnetic flux guidance. These cutouts create thin structures in the rotor sheets which limit the maximum achievable rotational speed under centrifugal forces and the maximum energy density of the rotating electrical machine. In this paper, embossing-induced residual stress, employing the magneto-mechanical Villari effect, is studied as an innovative and alternative flux barrier design with negligible mechanical material deterioration. The overall objective is to replace cutouts by embossings, increasing the mechanical strength of the rotor. The identification of suitable embossing geometries, distributions and methodologies for the local introduction of residual stress is a major challenge. This paper examines finely distributed pyramidal embossings and their effect on the magnetic material behavior. The study is based on simulation and measurements of specimen with a single line of twenty embossing points performed with different punch forces. The magnetic material behavior is analyzed using neutron grating interferometry and a single sheet tester. Numerical examinations using finite element analysis and microhardness measurements provide a more detailed understanding of the interaction of residual stress distribution and magnetic material properties. The results reveal that residual stress induced by embossing affects magnetic material properties. Process parameters can be applied to adjust the magnetic material deterioration and the effect of magnetic flux guidance.
Begriffe und Modelle der Überflutungsanalyse
Authors: Maier Roman , Reinstaller Stefan , Muschalla Dirk 
Published: March 2021

ZusammenfassungNiederschlagsinduzierte Überflutungen auf einer lokalen Skala erfahren in den letzten Jahren eine vermehrte Aufmerksamkeit. Vor allem im urbanen Raum ist in den letzten Jahren eine Vielzahl von Ereignissen mit erheblichen Schadenssummen aufgetreten. In der Fachdiskussion wird durch Klimawandel und Urbanisierung eine weitere Zunahme bezüglich Häufigkeit und Ausmaß dieser Ereignisse prognostiziert. Im deutschsprachigen Raum werden unterschiedliche Begriffe, teilweise in Abhängigkeit von den beteiligten Prozessen, benutzt. Neben der kurzen Darstellung der geläufigsten Fachbegriffe wird eine mögliche Klassifizierung vorgeschlagen. Für eine Überflutungsanalyse steht mittlerweile eine Vielzahl an ausgereiften Werkzeugen zur Verfügung. Eine hierarchische Darstellung der Modellansätze erlaubt eine der jeweiligen Aufgabe und dem jeweiligen Untersuchungsgebiet angepasste Auswahl der Modellansätze und eventuelle Kombination dieser. Dabei wird auf GIS-basierte Methoden zur Bestimmung der Fließwege an der Oberfläche, Zelluläre Automaten zur Bestimmung von Überflutungsflächen, 1D-hydrodynamische Kanalnetzmodelle, 2D-hydrodynamische Oberflächenabflussmodelle und gekoppelte 1D-2D-Überflutungsmodelle eingegangen.