bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Infection and Revision Surgery following Patellar Tendon and Quadriceps Tendon Repairs: An Analysis of 3,442 Patients
Authors: Lewis Daniel C. , Athoff Alyssa D. , Kamalapathy Pramod , Yarboro Seth R. , Miller Mark D. , Werner Brian C. 
Published: April 2021

AbstractDisruption of the extensor mechanism is debilitating with surgical repair being the accepted treatment. The incidence of infection and reoperation after extensor mechanism repair are not well reported in the literature. Thus, the objective of the current study was to (1) determine the incidence of surgical site infection and reoperation within 1 year of primary extensor mechanism repair and (2) identify independent risk factors for infection and reoperation following patellar and quadriceps tendon repair. A retrospective review of the 100% Medicare Standard Analytic files from 2005 to 2014 was performed to identify patients undergoing isolated patellar tendon repair and quadriceps tendon repair. Diagnosis of infection within 1 year of operative intervention and revision repair were assessed. Extensor mechanism injuries in the setting of total knee arthroplasty and polytrauma were excluded. Multivariate logistic regression analysis was performed to evaluate risk factors for postoperative infection and reoperation within 1 year. Infection occurred in 6.3% of patients undergoing patellar tendon repair and 2.6% of patients undergoing quadriceps tendon repair. Diabetes mellitus (odds ratio [OR] = 1.89, p = 0.005) was found to be an independent risk factor for infection following patellar tendon repair. Reoperation within 1 year occurred in 1.3 and 3.9% following patellar tendon and quadriceps tendon repair, respectively. Age less than 65 years (OR = 2.77, p = 0.024) and obesity (OR = 3.66, p = 0.046) were significant risk factors for reoperation after patellar tendon repair. Hypertension (OR = 2.13, p = 0.034), hypothyroidism (OR = 2.01, p = 0.010), and depression (OR = 2.41, p = 0.005) were significant risk factors for reoperation after quadriceps tendon repair. Diabetes mellitus was identified as a risk factor for infection after patellar tendon repair. Age less than 65 years, peripheral vascular disease, and congestive heart failure were risk factors for infection after quadriceps tendon repair. The current findings can be utilized to counsel patients regarding preoperative risk factors for postoperative complications prior to surgical intervention for extensor mechanism injuries.
Autologous Blood Pleurodesis: What Is the Optimal Time Interval and Amount of Blood?
Authors: Campisi Alessio , Dell'Amore Andrea , Zhang Yonghui , Gu Zhitao , Ciarrocchi Angelo Paolo , Faccioli Eleonora , Bertolaccini Luca , Rea Federico , Stella Franco , Fang Wentao 
Published: April 2021

Abstract
Background Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized.
Methods We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed.
Results After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1–13) after ABPP were also statistically different (p < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis.
Conclusion In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped.
Transcatheter Aortic Valve Implantation in Patients Who Cannot Undergo Transfemoral Access
Authors: Useini Dritan , Beluli Blerta , Christ Hildegard , Schlömicher Markus , Patsalis Polykarpos , Haldenwang Peter , Strauch Justus 
Published: April 2021

Abstract
Introduction Though transfemoral (TF) access has emerged as a gold standard access for patients with aortic stenosis who undergo transcatheter aortic valve implantation (TAVI), there has been no study that has characterized patients who cannot undergo TF access in detail. We aim to evaluate the contraindications for TF access, their incidence, classify them, and provide the outcomes of patients who failed to be TF candidates.
Methods From 925 patients who underwent TAVI between February 2014 and May 2020 at our heart center, 130 patients failed to be TF candidates and underwent transapical-transcatheter aortic valve implantation (TA-TAVI). In this study, we included all those patients who failed to be TF candidates and underwent TA-TAVI using the third-generation balloon expandable valve (Edwards SAPIEN 3 valve [S3]) (116 patients; STS score 6.07 ± 4.4; age 79.4 ± 7).
Results The incidence of patients unsuitable for TF access at our heart center was 14%. We classified this TAVI population into absolute contraindication for TF access n = 84 (72.5%) and increased interventional risk for TF access n = 32 (27.5%). After TA-TAVI of this specific population using S3, the in-hospital mortality and stroke were 1.7 and 1.7%, respectively. The vascular injury rate was 1.7%. We registered no paravalvular leakage ≥2. The pacemaker rate was 7.4%. The mean transvalvular pressure gradient was 8.7 mm Hg.
Conclusion The incidence of patients who cannot undergo TF access or who are at high interventional risk is considerably high. TA-TAVI, supported with sufficient interventional experience and appropriate valve system, represents an excellent alternative for patients with distinct vasculopathy.
CDKL5 Gene: Beyond Rett Syndrome
Authors: Ciccia Lina Maria , Scalia Bruna , Venti Valeria , Pizzo Francesco , Pappalardo Maria Grazia , La Mendola Flavia Maria Consuelo , Falsaperla Raffaele , Praticò Andrea D. 
Published: April 2021

Abstract
CDKL5 is a gene located in the X-chromosome (Xp22) encoding a serine/threonine kinase involved in various signaling pathways, implicated in cell proliferation, axon development, dendrite growth, synapse formation, and maintenance. Mutations occurring in this gene have been associated with drug-resistant early-onset epilepsy, with multiple seizures type, and deep cognitive and motor development delay with poor or absent speech, ataxic gait or inability to walk, hand stereotypies and in a few cases decrement of head growth. Many aspects remain unclear about the CDKL5 deficiency disorders, research will be fundamental to better understand the pathogenesis of neurological damage and consequently developed more targeted and profitable therapies, as there is not, at the present, a gene-based treatment and the seizures are in most of the cases drug resistant. In this article, we summarize the actual knowledge about CDKL5 gene function and mostly the consequence given by its dysfunction, also examining the possible therapeutic approaches.
Astaxanthin Reduces the Severity of Intestinal Damage in a Neonatal Rat Model of Necrotizing Enterocolitis
Authors: Akduman Hasan , Tayman Cuneyt , Korkmaz Veli , Akduman Filiz , Fettah Nurdan D. , Gürsoy Başak K. , Turkmenoglu Tugba T. , Çağlayan Murat 
Published: April 2021

Objective This study aimed to ascertain the effects of astaxanthin (ASX) in an experimental necrotizing enterocolitis (NEC) model using rat pups.
Study Design Forty-two pups born from five Wistar albino rats were randomly divided into three groups as the control group, NEC + placebo (saline), and NEC + ASX. Pups in the NEC + ASX group were given 100 mg/kg/day oral ASX from day 1 to day 4 of the study. Saline of 2 mL/kg was given to the NEC + placebo group. Histopathological, immunohistochemical (caspase-3), and biochemical evaluations including the total antioxidant status (TAS), total oxidant status (TOS), superoxide dismutase (SOD), glutathione (GSH), lipid hydroperoxide (LPO), 8-hydroxydeoxyguanosine (8-OHdG), advanced oxidation protein products (AOPP), myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and nuclear factor erythroid 2–related factor 2 (Nfr-2) activities were all performed.
Results A better survival rate and weight gain were demonstrated in the NEC + ASX group (p < 0.05). In the histopathological evaluation, the severity of intestinal damage was significantly reduced in the NEC + ASX group, as well as decreased apoptosis (enzyme-linked immunosorbent assay [ELISA] for caspase-3; p = 0.001). The biochemical analyses of intestinal tissue TOS, oxidative stress index (OSI; TOS/TAS), IL-1β, LPO, 8-OHdG, AOPP, caspase-3 (p < 0.001 for all), and TNF-α and MPO (p = 0.001 for both parameters) levels were lower in the NEC + ASX group than in the NEC + placebo group. Nrf-2, TAS, GSH, and SOD levels were higher in the NEC + ASX group than in the NEC + placebo group (p = 0.001, 0.001, <0.001, and 0.01, respectively).
Conclusion ASX treatment has been shown to effectively reduce the severity of intestinal damage in NEC due to its antioxidant, anti-inflammatory, and antiapoptotic properties.
Key Points
Use of Single Chimeric Free Flaps or Double Free Flaps for Complex Head and Neck Reconstruction
Authors: Raghuram Anjali C. , Manfro Gabriel , Teixeira Gilberto V. , Cernea Claudio R. , Dias Fernando L. , Marco Mauricio De , Polo Róger , Abu-Ghname Amjed , Maricevich Marco 
Published: April 2021

Abstract
Background Free flaps have become the preferred reconstructive approach to restore form and function for patients presenting with complex head and neck defects. For composite, complex defects for which a regular free flap might not meet all reconstructive demands, adequate coverage can be achieved with either a single chimeric free flap or a double free flap.
Methods We performed a single-center retrospective chart review of patients who underwent either single chimeric free flap or double free flap reconstruction. Indications for reconstruction included defects resultant from head and neck tumor or osteoradionecrosis resections. We extracted the following variables: tumor location, defect, flap(s) performed, and postoperative complications. Unpaired t-tests were performed to evaluate for statistically significant differences in complications encountered between the single chimeric versus the double free flap patient groups.
Results In our series of 44 patients, a total of 55 single chimeric and double free flaps were performed. We found no significant difference in overall complications (p = 0.41) or flap/skin paddle loss (p = 0.45) between the groups. There were three total flap losses; two patients underwent successful salvage procedures and one patient died. The anterolateral thigh (ALT) was the most common free flap (70%) used in our series, and 98% of our patients completed successful reconstruction.
Conclusion As the initial reconstructive effort is critical for achieving favorable long-term outcomes in complex head and neck cases, effective and safe techniques should be employed to ensure optimal delivery of care. We believe that single chimeric and double free flap techniques should be appropriately utilized as part of the armamentarium of head and neck reconstructive microsurgeons.
Redefining the Reconstructive Ladder in Vulvoperineal Reconstruction: The Role of Pedicled Perforator Flaps
Authors: Elia Jhonatan , Do Nicholas T. K. , Chang Tommy N.-J. , Lai Chyong-Huey , Chou Hung-Hsueh , Chang Frank C.-S. , Huang Jung-Ju 
Published: April 2021

AbstractBackground Gynecological reconstruction is difficult, particularly in cases with recurrence and received previous surgeries and/or radiotherapy and necessitate secondary reconstruction. Perforator flaps can preserve other donor sites for potential later reconstruction, and they also can be better tailored to the defect. We hypothesized that the use of perforator-based flaps can better restore the defect with less complications.Methods A retrospective review was conducted of all patients who underwent vulvar–perineum reconstruction between 2011 and 2018 by the senior author, and oncologic and reconstructive outcomes and complications were analyzed.Results Thirty-three patients underwent 55 soft tissue reconstructions for vulvar–perineum defects during the study period. The mean follow-up time was 27.6 ± 28.9 months. Squamous cell carcinoma was the most common cancer (45.5%). For 11 patients (33.3%), the procedures were performed for the treatment of recurrent cancer. The average defect size was 39.8 ± 34.3 cm2. The overall survival rate was 90.3%. Profunda artery perforator flaps were the most commonly applied flap for reconstruction in both the primary and recurrent groups. Poor wound healing was the most common complication which occurred in 10 of the 55 flaps (18.2%). Perforator flaps presented fewer complications than myocutaneous flaps or traditional random flaps. Similarly, Island pedicle flap design also presented fewer complications than traditional rotation flaps. With proper reconstruction, previous surgery or radiotherapy did not contribute to an increase in complications.Conclusion In our experience, perforator flaps can provide satisfactory reconstruction for perineum reconstruction with low postoperative complications while preserving other donor sites in the event of disease recurrence for repeat resection and reconstruction. Previous surgery or radiotherapy did not increase the complications or preclude its usage. A redefined reconstructive ladder was created to help selecting the best state-of-the-art technique for reconstruction to achieve better results.
SCN1B Gene: A Close Relative to SCN1A
Authors: Pasquetti Elisa , Lo Bianco Manuela , Sullo Federica , Patanè Francesca , Sciuto Laura , Polizzi Agata , Praticò Andrea D. , Zanghì Antonio , Falsaperla Raffaele 
Published: April 2021

AbstractOne of the first reported genes associated with epilepsy was SCN1B, which encodes for β-subunit of voltage-gated sodium channel of excitable cells and it is critical for neuronal function in both central and peripheral nervous system. β-subunits modulate the expression levels and functional properties of sodium channels and though their immunoglobulin domains may mediate interactions between channels and other proteins. Traditionally, SCN1B mutations were associated with generalized epilepsy with febrile seizures plus, a familial epilepsy syndrome characterized by heterogeneous phenotypes including febrile seizures (FS), febrile seizures plus (FS + ), mild generalized epilepsies, and severe epileptic encephalopathies. Throughout the years, SCN1B mutations have been also associated with Dravet syndrome and, more recently, with developmental and epileptic encephalopathies, expanding the spectrum associated with this gene mutations to more severe phenotypes.
Antegrade Approach of Percutaneous Coronary Intervention for Chronic Total Occlusion
Authors: Raghu C. , Ghogre Rahul K. , Mandepudi Alekhya 
Published: April 2021

AbstractChronic total occlusion (CTO) is a common challenge accounting for 10% of coronary lesions found on coronary angiography. Patients are frequently referred for bypass surgery because percutaneous coronary intervention is challenging in this subset. Recent advances in the hardware as well as the technical expertise and an algorithm approach have improved the success to more than 90%.Antegrade approach is the cornerstone for managing CTO and has two distinct strategies: antegrade wire escalation, and antegrade dissection and reentry strategy. Step-wise approach to perform these procedures and the use of adjunct imaging are discussed.
A 100 kV, 50 Hz repetitive high-voltage pulse lifetime test platform
Authors: Yu Binxiong , Su Jiancang , Li Rui , Cheng Jie , Zhao Liang , Zhang Yu , Qiu Xudong 
Published: April 2021

The pulse lifetime characteristics of solid materials have been widely concerned in the field of pulse power technology. In this paper, a repetitive high-voltage pulse lifetime test platform for the pulse lifetime test of insulation materials is set up. The platform contains a closed magnetic-core transformer and a sample cavity. The transformer insulated by transformer oil was stably operated at the 100 kV/50 Hz mode with maximum rise time of 45 µs. The sample cavity insulated by SF6 gas includes a gas switch with an amplitude jitter less than 3% at the 50 Hz mode. The platform has advantages of high efficiency and reliability. First, it can generate three kinds of different pulses simultaneously, which satisfied the insulation test requirements under different pulse conditions. The first kind of the generated pulse is a sinusoidal pulse with an amplitude of 100 kV when the gas switch keeps open. The second one is a unipolar microsecond pulse when the gas switch closes. The last one is a nanosecond pulse generated by secondary capacitor discharge. Second, long-time operation of the platform including the pulse transformer is realized. The platform was stably operated for more than 20 × 106 pulses at the 50 Hz/100 kV mode for pulse lifetime tests of solid pulse forming lines and other solid materials.
The impact of identity by descent on fitness and disease in dogs
Authors: Mooney Jazlyn A. , Yohannes Abigail , Lohmueller Kirk E. 
Published: April 2021

Significance
Dogs and humans have coexisted together for thousands of years, but it was not until the Victorian Era that humans practiced selective breeding to produce the modern standards we see today. Strong artificial selection during the breed formation period has simplified the genetic architecture of complex traits and caused an enrichment of identity-by-descent (IBD) segments in the dog genome. This study demonstrates the value of IBD segments and utilizes them to infer the recent demography of canids, predict case-control status for complex traits, locate regions of the genome potentially linked to inbreeding depression, and to identify understudied breeds where there is potential to discover new disease-associated variants.
Learning effective physical laws for generating cosmological hydrodynamics with Lagrangian deep learning
Authors: Dai Biwei , Seljak Uroš 
Published: April 2021

Significance
Hydrodynamical simulations are crucial for accurately predicting cosmological observations, but they are computationally too expensive to simulate in a full survey volume. Gravity-only N-body simulations reduce the computational cost but cannot directly model the observables such as stars and gas. Here we propose a deep-learning approach to generate these observables. The model consists of several layers of Lagrangian displacement field moving the particles. It requires only a handful of parameters to learn, in contrast to neural networks, and can be viewed as learning the effective physical laws. By combining N-body solvers with our model, we are able to generate higher-accuracy hydrodynamic observables with computational costs several orders of magnitude cheaper than the traditional hydrodynamical simulations at the same resolution.
Microbiome reduction and endosymbiont gain from a switch in sea urchin life history
Authors: Carrier Tyler J. , Leigh Brittany A. , Deaker Dione J. , Devens Hannah R. , Wray Gregory A. , Bordenstein Seth R. , Byrne Maria , Reitzel Adam M. 
Published: April 2021

Significance
Microbes have a strong impact on the biology of their host, with those living in the gut being essential to immunity, development, and metabolism. A functional gut, however, has been lost several times during animal evolution. Here, using sister sea urchin species, we report that the loss of a functional gut corresponds with a reduced microbial diversity and abundance. Gut loss also coincides with associating with an endosymbiont that complements host nutrition and potentially impacts host reproduction. Therefore, transitions in developmental life histories in animals can accompany shifts in the microbial community.
Biomechanical trade-offs in the pelvic floor constrain the evolution of the human birth canal
Authors: Stansfield Ekaterina , Kumar Krishna , Mitteroecker Philipp , Grunstra Nicole D. S. 
Published: April 2021

SignificanceThe relatively small human birth canal has arisen from an evolutionary trade-off between multiple antagonistic selective forces. We present evidence that a large pelvic floor is disadvantageous for maintaining continence and supporting the weight of the inner organs and the fetus through multiple finite element analyses of pelvic floor models varying in size and thickness. An increase in pelvic floor size led to a disproportionately large deflection as well as higher tissue stretches and stresses. Increased pelvic floor thickness considerably reduced deflection by increasing stiffness. However, as a side effect, it increases the intra-abdominal pressure necessary for childbirth, thus reflecting another evolutionary trade-off affecting not only the size but also the thickness of the pelvic floor.
Impaired TRPV4-eNOS signaling in trabecular meshwork elevates intraocular pressure in glaucoma
Authors: Patel Pinkal D. , Chen Yen-Lin , Kasetti Ramesh B. , Maddineni Prabhavathi , Mayhew William , Millar J. Cameron , Ellis Dorette Z. , Sonkusare Swapnil K. , Zode Gulab S. 
Published: April 2021

Significance
Primary Open Angle Glaucoma (POAG) is the most common form of glaucoma that leads to irreversible vision loss and blindness worldwide. POAG is often associated with elevated intraocular pressure (IOP). The trabecular meshwork (TM), a molecular sieve-like structure, tightly controls IOP by constantly adjusting the resistance to aqueous humor (AH) outflow. In POAG, there is increased resistance to AH outflow, elevating IOP. Here, we show that mechanically activated TRPV4 channels in TM play a critical role in IOP regulation via calcium-mediated activation of eNOS signaling and production of nitric oxide (NO). Importantly, we show that impaired TRPV4 channel activity results in reduced NO bioavailability and elevated IOP in glaucoma. Our findings support impaired TRPV4-eNOS signaling to the pathogenesis of POAG.
Orphan nuclear receptor ERR-γ regulates hepatic FGF23 production in acute kidney injury
Authors: Radhakrishnan Kamalakannan , Kim Yong-Hoon , Jung Yoon Seok , Kim Don-Kyu , Na Soon-Young , Lim Daejin , Kim Dong Hun , Kim Jina , Kim Hyung-Seok , Choy Hyon E. , Cho Sung Jin , Lee In-Kyu , Ayvaz Şamil , Nittka Stefanie , Fliser Danilo , Schunk Stefan J. , Speer Thimoteus , Dooley Steven , Lee Chul-Ho , Choi Hueng-Sik 
Published: April 2021

Significance
Bone is the main source of fibroblast growth factor 23 (FGF23), which is important for phosphate and vitamin D homeostasis. In acute kidney injury (AKI), high blood levels of FGF23 are positively correlated with disease progression and increased risk of mortality. Reducing adverse plasma FGF23 levels in AKI patients is favorable. We showed here that hepatocytes are the major source of circulating FGF23, and orphan nuclear receptor ERR-γ is a novel transcriptional regulator of hepatic FGF23 production in AKI. Liver-specific depletion of ERR-γ or ERR-γ inverse agonist, GSK5182, significantly reduced plasma levels of FGF23 in AKI. This study reveals liver is the source of FGF23 and a therapeutic strategy to control pathologically adverse plasma FGF23 levels in AKI.