bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initial Experiences with the MitraClip G4: Review of the Novel Device Features
Authors: Ives Christopher W. , Prejean Shane P. , Vardas Panos N. , Von Mering Gregory , Ahmed Mustafa I. 
Published: August 2021

Objective Percutaneous edge-to-edge mitral valve repair is an evolving procedure with increasing indications for use. The MitraClip™ G4 is the newest device with 4 device options, each with distinct characteristics. While the NTR and XTR clips have been in use, the G4 adds 2 new wider clips with additional features, the NTW and XTW. Methods We reviewed 26 cases employing the MitraClip G4 at our institution from November 2019 to March 2020. Results The NTR, XTR, NTW, and XTW clips were used in 3 (11.5%), 0 (0.0%), 16 (61.5%), and 11 (42.3%) cases, respectively. Median mitral regurgitation grade was reduced from 4+ to 1+, though 7 (27%) cases had 2+ residual mitral regurgitation. Conclusions The new G4 device includes simplified instructions for use, the option of a wider clip, controlled gripper actuation, and potential left atrial pressure monitoring. The newest MitraClip G4 device allows for potential improved treatment options for patients with mitral regurgitation.
Impact of COVID-19 on social determinants of health for adults with cystic fibrosis
Authors: Albon Dana , Bruschwein Heather , Soper Morgan , List Rhonda , Jennings Deirdre , Gettle Lucy , Compton Martina , Bailey Molly , Starheim Elissa , Murray Rachel , Kalmanek John , Somerville Lindsay 
Published: August 2021

Introduction: Outcomes in cystic fibrosis are influenced by multiple factors, including social determinants of health. Low socioeconomic status has been shown to be associated with lung function decline, increased exacerbation rates, increased health care utilization, and decreased survival in cystic fibrosis. The COVID-19 pandemic disrupted the US economy, placing people with cystic fibrosis at risk for negative impacts due to changes in social determinants of health. Methods: To characterize the impact of COVID-19-related changes in social determinants of health in the adult cystic fibrosis population, a social determinants of health questionnaire was designed and distributed to patients as part of a quality improvement project. Results: Of 132 patients contacted, 76 (57.6%) responses were received. Of these responses, 22 (28.9%) answered yes to at least one question that indicated an undesired change in social determinants of health. Patients with stable employment prior to COVID-19 were more likely to endorse undesired change in all domains of the questionnaire, and the undesired changes were most likely to be related to employment, insurance security, and access to medications. Patients receiving disability were more likely to report hardship related to utilities and food security compared with patients previously employed or unemployed. Of patients endorsing risk of socioeconomic hardship, 21 (95.5%) were contacted by a social worker and provided resources. Conclusion: Utilizing a social determinants of health questionnaire to screen for social instability in the context of COVID-19 is feasible and beneficial for patients with cystic fibrosis. Identifying social issues early during the pandemic and implementing processes to provide resources may help patients with cystic fibrosis mitigate social hardship and maintain access to health care and medications.
Regenerative technology to restore and preserve erectile function in men following prostate cancer treatment: evidence for penile rehabilitation in the context of prostate cancer survivorship
Authors: Chung Eric 
Published: August 2021

Introduction: Erectile dysfunction (ED) following prostate cancer treatment is not uncommon and penile rehabilitation is considered the standard of care in prostate cancer survivorship (PCS), where both patient and his partner desire to maintain and/or recover pre-treatment erectile function (EF). There is a clinical interest in the role of regenerative therapy to restore EF, since existing ED treatments do not always achieve adequate results. Aim: To review regenerative therapies for the treatment of ED in the context of PCS. Materials and Methods: A review of the existing PubMed literature on low-intensity extracorporeal shockwave therapy (LIESWT), stem cell therapy (SCT), platelet-rich plasma (PRP), gene therapy, and nerve graft/neurorrhaphy in the treatment of ED and penile rehabilitation, was undertaken. Results: IESWT promotes neovascularization and neuroprotection in men with ED. While several systematic reviews and meta-analyses showed positive benefits, there is limited published clinical data in men following radical prostatectomy. Cellular-based technology such as SCT and PRP promotes cellular proliferation and the secretion of various growth factors to repair damaged tissues, especially in preclinical studies. However, longer-term clinical outcomes and concerns regarding bioethical and regulatory frameworks need to be addressed. Data on gene therapy in post-prostatectomy ED men are lacking; further clinical studies are required to investigate the optimal use of growth factors and the safest vector delivery system. Conceptually interpositional cavernous nerve grafting and penile re-innervation technique using a somatic-to-autonomic neurorrhaphy are attractive, but issues relating to surgical technique and potential for neural ‘regeneration’ are questionable. Conclusion: In contrast to the existing treatment regime, regenerative ED technology aspires to promote endothelial revascularization and neuro-regeneration. Nevertheless, there remain considerable issues related to these regenerative technologies and techniques, with limited data on longer-term efficacy and safety records. Further research is necessary to define the role of these alternative therapies in the treatment of ED in the context of penile rehabilitation and PCS.
Comparison between 2D radiographic weight-bearing joint space width and 3D MRI non-weight-bearing cartilage thickness measures in the knee using non-weight-bearing 2D and 3D CT as an intermediary
Authors: Jansen Mylène P. , Mastbergen Simon C. , Eckstein Felix , van Heerwaarden Ronald J. , Spruijt Sander , Lafeber Floris P. J. G. 
Published: August 2021

Background: In knee osteoarthritis, radiographic joint space width (JSW) is frequently used as a surrogate marker for cartilage thickness; however, longitudinal changes in radiographic JSW have shown poor correlations with those of magnetic resonance imaging (MRI) cartilage thickness. There are fundamental differences between the techniques: radiographic JSW represents two-dimensional (2D), weight-bearing, bone-to-bone distance, while on MRI three-dimensional (3D) non-weight-bearing cartilage thickness is measured. In this exploratory study, computed tomography (CT) was included as a third technique, as it can measure bone-to-bone under non-weight-bearing conditions. The objective was to use CT to compare the impact of weight-bearing versus non-weight-bearing, as well as bone-to-bone JSW versus actual cartilage thickness, in the knee. Methods: Osteoarthritis patients ( n = 20) who were treated with knee joint distraction were included. Weight-bearing radiographs, non-weight-bearing MRIs and CTs were acquired before and 2 years after treatment. The mean radiographic JSW and cartilage thickness of the most affected compartment were measured. From CT, the 3D median JSW was calculated and a 2D projectional image was rendered, positioned similarly and measured identically to the radiograph. Pearson correlations between the techniques were derived, both cross-sectionally and longitudinally. Results: Fourteen patients could be analyzed. Cross-sectionally, all comparisons showed moderate to strong significant correlations (R = 0.43–0.81; all p < 0.05). Longitudinal changes over time were small; only the correlations between 2D CT and 3D CT (R = 0.65; p = 0.01) and 3D CT and MRI (R = 0.62; p = 0.02) were statistically significant. Conclusion: The poor correlation between changes in radiographic JSW and MRI cartilage thickness appears primarily to result from the difference in weight-bearing, and less so from measuring bone-to-bone distance versus cartilage thickness.
An evaluation of the efficacy of the locked plate with bone grafting in Sanders type III and IV intra-articular calcaneus fractures
Authors: Varol Ali , Oc Yunus , Kilinc Bekir Eray 
Published: August 2021

Objective: To demonstrate the efficacy of locking plate osteosynthesis performed by an L-shaped lateral approach in patients with Sanders type III and IV intra-articular calcaneal fractures with posterior facet displacement. Methods: Fifty-three patients with Sanders type III or IV unilateral calcaneal fractures treated with locking plates and additional bone grafting were included in the study. Böhler and Gissane angles, and heel height values were measured on the radiological examinations. Clinical results of the patients were evaluated using the American Orthopaedic Foot and Ankle Society and Maryland evaluation criteria. The presence of arthrosis was investigated with Broden’s view. Preoperative and postoperative values were evaluated. Results: The mean Gissane angle was 119.32°, the mean Böhler angle was 9.47° and the mean heel height was 40.82 mm on radiographs at initial presentation of the patients. The mean Gissane angle was 114.63°, the mean Böhler angle was 23.33° and the mean heel height was 47.84 mm on the early postoperative radiographs of the patients. In patients, a mean 4.69° recovery was achieved in the Gissane angle, 13.86° in Böhler angle and 7.02 mm in heel height. On the most recent follow-up, Böhler angle was 21.49°, Gissane was 114.88° and the mean heel height was 46.95 mm. The mean American Orthopaedic Foot and Ankle Society score and Maryland score were 86.91 and 86.53, respectively, on the last follow-up. Conclusion: Internal fixation and grephonage using low-profile locking plates provides good functional results to patients since it facilitates anatomic restoration of the subtalar joint and correction of calcaneal height, width and varus/valgus heel.
Dysregulation of human beta-defensin-3 expression in the peripheral blood of patients with sepsis
Authors: Al Mansour Noura , Al-Kafaji Ghada , Al Mahmeed Ali , Bindayna Khalid M 
Published: August 2021

Objectives: Sepsis is a serious medical condition caused by the body’s systemic inflammatory response to infections. The antimicrobial peptides, human beta-defensins, play a key role in modulating host immune responses, and aberrant expression of human beta-defensins has been implicated in many infections and inflammatory diseases. However, little is known about the expression of human beta-defensin-3 in systemic infectious diseases. Methods: We investigated the gene expression and protein level of human beta-defensin-3 in peripheral whole blood from 107 participants—67 patients with sepsis and 40 healthy controls—and evaluated the feasibility of human beta-defensin-3 as an indicator for sepsis. Total RNA was extracted from peripheral blood samples, and relative mRNA expression of human beta-defensin-3 was determined by reverse transcription-quantitative polymerase chain reaction. Plasma concentration of human beta-defensin-3 was measured by enzyme-linked immunosorbent assay. Pearson’s correlation analysis was performed to assess the relationship between human beta-defensin-3 mRNA and protein levels. Receiver operating characteristic analysis was performed to evaluate the value of human beta-defensin-3 as a biomarker for sepsis. Results: Human beta-defensin-3 mRNA expression was significantly downregulated in sepsis patients compared to controls (p = 0.001). The mean fold change of mRNA expression (±standard error) was 0.82 ± 0.63 in sepsis patients and 1.39 ± 1.09 in controls. Plasma concentration of human beta-defensin-3 (pg/mL) was significantly lower in sepsis patients compared to healthy controls (p = 0.039). The mean protein concentration (±standard error) was 539.6 ± 39.4 in sepsis patients and 715.5 ± 53 in controls. There was a significant correlation between human beta-defensin-3 mRNA expression and the corresponding protein level in sepsis patients (r = 0.358, p = 0.04), but not in healthy controls (r = 0.124, p = 0.51). For discriminating sepsis patients from healthy controls, the area under the receiver operating characteristic curve was 0.722 (95% confidence interval: 0.597–0.847, p = 0.002) for human beta-defensin-3 mRNA and 0.689 (95% confidence interval: 0.557–0.827, p = 0.009) for human beta-defensin-3 protein. Conclusion: This is the first study to show the downregulation of human beta-defensin-3 gene expression and protein level in sepsis, which may contribute to the complex immunological imbalance in sepsis. The significant correlation between human beta-defensin-3 mRNA expression and protein concentration suggests that mRNA expression could be used to predict protein level. Our study also showed a potential role of human beta-defensin-3 as a blood-based biomarker for sepsis. More studies on the clinical significance of human beta-defensin-3 in sepsis could further support a biomarker development.
Design of a Flexible Capture Mechanism Inspired by Sea Anemone for Non-cooperative Targets
Authors: Yang Jiankun , Ren Chengwei , Yang Chenghao , Wang Youyu , Wan Shumin , Kang Rongjie 
Published: August 2021

AbstractRobotic grippers have been used in industry as end-effectors but are usually limited to operations in pre-defined workspace. However, few devices can capture irregularly shaped dynamic targets in space, underwater and other unstructured environments. In this paper, a novel continuum arm group mechanism inspired by the morphology and motions of sea anemones is proposed. It is able to dissipate and absorb the kinetic energy of a fast moving target in omni-direction and utilize multiple arms to wrap and lock the target without accurate positioning control. Wire-driven actuation systems are implemented in the individual continuum arms, achieving both bending motion and stiffness regulation. Through finite element method, the influence of different configurations of the continuum arm group on the capture performance is analyzed. A robotic prototype is constructed and tested, showing the presented arm group mechanism has high adaptability to capture targets with different sizes, shapes, and incident angles.
Design of 3D-printed Cable Driven Humanoid Hand Based on Bidirectional Elastomeric Passive Transmission
Authors: Chen Teru , Zhao Xingwei , Ma Guocai , Tao Bo , Yin Zhouping 
Published: August 2021

AbstractMotion control of the human hand is the most complex part of the human body. It has always been a challenge for a good balance between the cost, weight, responding speed, grasping force, finger extension, and dexterity of prosthetic hand. To solve these issues, a 3D-printed cable driven humanoid hand based on bidirectional elastomeric passive transmission (BEPT) is designed in this paper. A semi-static model of BEPT is investigated based on energy conservation law to analyze the mechanical properties of BEPT and a dynamical simulation of finger grasping is conducted. For a good imitation of human hand and an excellent grasping performance, specific BEPT is selected according to human finger grasping experiments. The advantage of BEPT based humanoid hand is that a good balance between the price and performance of the humanoid hand is achieved. Experiments proved that the designed prosthetic hand’s single fingertip force can reach 33 N and the fastest fingertip grasping speed realized 0.6 s/180°. It also has a good force compliance effect with only 430g’s weight. It can not only grab fragile objects like raw eggs and paper cup, but also achieve strong grasping force to damage metal cans. This humanoid hand has considerable application prospects in artificial prosthesis, human-computer interaction, and robot operation.
Investigation of cortical thickness and volume during spontaneous attacks of migraine without aura: a 3-Tesla MRI study
Authors: Amin Faisal Mohammad , De Icco Roberto , Al-Karagholi Mohammad Al-Mahdi , Raghava Jayachandra M. , Wolfram Frauke , Larsson Henrik B. W. , Ashina Messoud 
Published: August 2021

Abstract
Background
Structural imaging has revealed changes in cortical thickness in migraine patients compared to healthy controls is reported, but presence of dynamic cortical and subcortical changes during migraine attack versus inter-ictal phase is unknown. The aim of the present study was to investigate possible changes in cortical thickness during spontaneous migraine attacks. We hypothesized that pain-related cortical area would be affected during the attack compared to an inter-ictal phase.

Methods
Twenty-five patients with migraine without aura underwent three-dimensional T1-weighted imaging on a 3-Tesla MRI scanner during spontaneous and untreated migraine attacks. Subsequently, 20 patients were scanned in the inter-ictal phase, while 5 patients did not show up for the inter-ictal scan. Four patients were excluded from the analysis because of bilateral migraine pain and another one patient was excluded due to technical error in the imaging. Longitudinal image processing was done using FreeSurfer. Repeated measures ANOVA was used for statistical analysis and to control for multiple comparison the level of significance was set at p = 0.025.

Results
In a total of 15 patients, we found reduced cortical thickness of the precentral (p = 0.023), pericalcarine (p = 0.024), and temporal pole (p = 0.017) cortices during the attack compared to the inter-ictal phase. Cortical volume was reduced in prefrontal (p = 0.018) and pericalcarine (p = 0.017) cortices. Hippocampus volume was increased during attack (p = 0.007). We found no correlations between the pain side or any other clinical parameters and the reduced cortical size.

Conclusion
Spontaneous migraine attacks are accompanied by transient reduced cortical thickness and volume in pain-related areas. The findings constitute a fingerprint of acute pain in migraine patients, which can be used as a possible biomarker to predict antimigraine treatment effect in future studies.

Trial registration
The study was registered at ClinicalTrials.gov (NCT02202486).
iTRAQ-based quantitative proteomic analysis of thoracic aortas from adult rats born to preeclamptic dams
Authors: Yu Bin , Zhu Hong-Dan , Shi Xiao-Liang , Chen Pan-Pan , Sun Xiang-Mei , Xia Gui-Yu , Fang Min , Zhong Yong-Xing , Tang Xiao-Li , Zhang Tao , Pan Hai-Tao 
Published: August 2021

Abstract
Background
Preeclampsia and gestational hypertension can cause vascular function impairment in offspring. In our previous work, we described the protein expression profiles of umbilical artery tissues from patients with preeclampsia.

Methods
To gain insights into the mechanisms of vascular dysfunction in adult rats born to preeclamptic dams, we analyzed thoracic aorta tissues by using iTRAQ isobaric tags and 2D nano LC-MS/MS.

Results
By using the iTRAQ method, we analyzed 1825 proteins, of which 106 showed significantly different expression in the thoracic aortic. Ingenuity pathway analysis (IPA) showed that the majority of differentially expressed proteins (DEPs) were associated with cardiovascular function. Further analysis indicated that glucose-6-phosphate dehydrogenase (G6PD), which is inhibited by miR-423-5p and activated by TP53, had the strongest effect on cardiovascular function. The expression of G6PD was upregulated in thoracic aorta tissues, as confirmed by Western blotting. The expression of two other vascular function-related proteins, cysteine- and glycine-rich protein 2 (CSRP2) and tubulin alpha-4 A (TUBA4A), was upregulated, as demonstrated by mass spectrometry (MS).

Conclusions
Although the results require further functional validation, these data provide novel findings related to vascular function impairment in the adult offspring of preeclamptic mothers.
Pediatric testicular microlithiasis through four clinical case studies: review of the literature and proposal of clinical guidelines
Authors: Chaka Amina , Daassa Amine Fredj , Hamdouni Wadye , Ktari Kamel , Laamiri Rachida , Nouri Abdellatif 
Published: August 2021

Abstract
Background
Testicular microlithiasis in children was defined for the first time in 1961 based on histological criteria. There should be more than 5 calcifications per testicle in order to say that the patient has testicular microlithiasis. It has three different echographic grades depending on the number of calcifications. However, this disease is uncommon, with inaccurate prevalence and no certain information about its evolution or etiology.

Main body
We studied 4 clinical cases of children diagnosed with testicular microlithiasis, in light of the conducted review of the literature, and we defined the characteristics of this disease and proposed a management and monitoring framework based on the clinical observations.

Conclusion
There is a link between testicular microlithiasis and testicular cancer. Therefore, it is recommended to make a regular follow-up of children who present testicular microlithiasis with the presence of risk factors.
Non-conventional learning on sustainable development: achieving the SDGs
Authors: Leal Filho Walter 
Published: August 2021

AbstractLearning has been identified as a critical tool for the achievement of sustainable development. But whereas the literature predominantly focuses on the use of classroom-based teaching methods and approaches, there is a perceived need to shed some light on the potential role which can be played by non-conventional learning. Based on the relevance of addressing this need, this commentary describes the role of non-conventional learning methods in supporting the achievement of the UN Sustainable Development Goals. In particular, it discusses the contribution of non-conventional teaching as a catalyst for a more active participation of learners, and also shows some of the trade-offs.
Three-dimensional hierarchical porous carbon derived from natural resources for highly efficient treatment of polluted water
Authors: Li Jiaxin , Holze Rudolf , Moyo Simbarashe , Wang Song , Li Sanxi , Tang Tao , Chen Xuecheng 
Published: August 2021

Abstract
Background
Dealing with the ever-increasing water pollution has become an urgent global problem, especially the organic containing polluted water. Physical adsorption has become one of the most popular ways for removal of organic dyes from wastewater due to its low cost as well as high efficiency. However, the adsorption performance is still limited by the low specific surface area (SSA) and unsuitable pore size. Hence, it is still a challenge to synthesize active carbon (AC) with high SSA, suitable pore size distribution as well as low cost for polluted water treatment. Here, we report an efficient method to prepare AC with large SSA from jujube for removal of both cationic dye and anionic dye from aqueous solution. The present results demonstrate that biomass-derived hierarchical porous carbon has a real potential application for wastewater treatment.

Results
The as-prepared hierarchical porous structure carbon material (PC-500-6) shows a high specific surface area (3203 m2/g) and pore size distribution in the range 0.8 to 3.0 nm, while exhibiting an enhanced adsorption performance for both methylene blue (MB) and methylene orange (MO) from an aqueous solution. The maximum adsorption capacity even reaches 925.93 mg/g and 1281.39 mg/g for MB and MO, which was calculated from Langmuir model. Through analysis of the adsorption data, it was found that the corresponding adsorption kinetic fits the pseudo-second-order model very well.

Conclusions
It can be concluded that the adsorption of MB has a strong correlation with SSA, pore size distribution as well as the pore volume. The present study paved a practical way for wastewater treatment by using biomass-derived hierarchical porous carbon.