bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perinatales Outcome bei Frauen mit Gestationsdiabetes unter besonderer Berücksichtigung eines Migrationshintergrundes – Ergebnisse einer prospektiven Studie in Berlin
Authors: Stupin Jens H. , Henrich Wolfgang , David Matthias , Schlembach Dietmar , Razum Oliver , Borde Theda , Breckenkamp Jürgen 
Published: June 2021

Zusammenfassung
Hintergrund Etwa 25 % der Bevölkerung Deutschlands haben einen Migrationshintergrund (MH), der mit einem schlechteren perinatalen Outcome einhergehen kann. Der Gestationsdiabetes (GDM) gehört zu den häufigsten Schwangerschaftserkrankungen; von ihm sind Frauen mit MH in höherem Maße betroffen. Bisher liegen keine systematisch erhobenen Daten zur Betreuung von Migrantinnen mit GDM vor.
Fragestellung Ziel der Studie war es, Auswirkungen eines MH auf Schwangerschaften von Frauen mit GDM zu evaluieren: Haben Immigrantinnen und ihre Nachkommen ein schlechteres perinatales Outcome als Frauen ohne MH in den Parametern Geburtseinleitung, Sectio, Makrosomie, Apgar, Nabelschnur-pH-Wert, Verlegung auf eine neonatologische Intensivstation, Frühgeburt und prä-/postpartale Hb-Differenz? Beeinflusst ein MH außerdem den Zeitpunkt der ersten Schwangerenvorsorge sowie die Zahl der Vorsorgeuntersuchungen?
Methoden Datenerhebung an drei Berliner Geburtskliniken 2011/2012 unmittelbar in der Kreißsaalaufnahme über 12 Monate anhand standardisierter Interviews (Fragebogenset) in deutscher, türkischer und anderen Sprachen. Fragen zu soziodemografischen Aspekten, Schwangerenvorsorge sowie ggf. Migration und Akkulturation. Verknüpfung der Befragungsdaten mit Mutterpass- und klinischen Perinataldaten. Adjustierung für Alter, BMI, Parität und sozioökonomischen Status erfolgte in Regressionsmodellen.
Ergebnisse Die Daten von n = 2878 Frauen mit MH (GDM: 4,7 %) und n = 2785 Frauen ohne MH (GDM: 4,8 %) konnten verglichen werden. Eine multiple Regressionsanalyse zeigte keine Unterschiede in den Chancen der beiden Gruppen mit GDM hinsichtlich Sectio, Makrosomie, Apgar, Nabelschnur-pH-Werten, Verlegungen auf eine neonatologische Intensivstation sowie Zeitpunkt der ersten Schwangerenvorsorge ≥ 12 SSW und Zahl der Vorsorgeuntersuchungen < 10. Sowohl für Frauen mit GDM und MH (OR 1,57; 95 %-KI 1,08–2,27) als auch für solche mit GDM ohne MH (OR 1,47; 95 %-KI 1,01–2,14) bestand eine signifikant höhere Chance der Geburtseinleitung.
Schlussfolgerung Frauen mit GDM und MH zeigen ein ähnlich gutes Schwangerschaftsergebnis wie solche mit GDM und ohne MH, was auf eine hohe Qualität der peripartalen Betreuung und Versorgung hinweist. Im Vergleich zu Frauen ohne GDM wird bedingt durch diesen und den höheren BMI unabhängig vom MH vermehrt eingeleitet. Die Ergebnisse für Frauen mit GDM lassen unabhängig vom MH auf einen ähnlichen Standard der Inanspruchnahme von Vorsorgeuntersuchungen in der Schwangerschaft schließen.
Extracorporeal Membrane Oxygenation Induces Early Alterations in Coagulation and Fibrinolysis Profiles in COVID-19 Patients with Acute Respiratory Distress Syndrome
Authors: Hékimian Guillaume , Masi Paul , Lejeune Manon , Lebreton Guillaume , Chommeloux Juliette , Desnos Cyrielle , Pineton De Chambrun Marc , Martin-Toutain Isabelle , Nieszkowska Ania , Bréchot Nicolas , Schmidt Matthieu , Leprince Pascal , Luyt Charles-Edouard , Combes Alain , Frere Corinne 
Published: June 2021

AbstractHemostatic changes induced by extracorporeal membrane oxygenation (ECMO) support have been yet poorly documented in coronavirus-19 (COVID-19) patients who have a baseline complex hypercoagulable state. In this prospective monocentric study of patients with severe acute respiratory distress syndrome (ARDS) rescued by ECMO, we performed longitudinal measurements of coagulation and fibrinolysis markers throughout the course of ECMO support in 20 COVID-19 and 10 non-COVID-19 patients. Blood was sampled before and then 24 hours, 7, and 14 days after ECMO implantation. Clinical outcomes were prospectively assessed until discharge from the intensive care unit or death. The median age of participants was 47 (35–56) years, with a median body mass index of 30 (27–35) kg/m2, and a Sepsis-related Organ Failure Assessment score of 12 (8–16). Baseline levels of von Willebrand factor, fibrinogen, factor VIII, prothrombin F1 + 2, thrombin–antithrombin, D-dimer, and plasminogen activator inhibitor-1 (PAI-1) were elevated in both COVID-19 and non-COVID-19 ARDS patients, indicating that endothelial activation, endogenous thrombin generation, and fibrinolysis shutdown occur in all ARDS patients before ECMO implantation. From baseline to day 7, thrombin generation (prothrombin F1 + 2, p < 0.01) and fibrin formation markers (fibrin monomers, p < 0.001) significantly increased, further resulting in significant decreases in platelet count (p < 0.0001) and fibrinogen level (p < 0.001). PAI-1 levels significantly decreased from baseline to day 7 (p < 0.0001) in all ARDS patients. These changes were more marked in COVID-19 patients, resulting in 14 nonfatal and 3 fatal bleeding. Additional studies are warranted to determine whether monitoring of thrombin generation and fibrinolysis markers might help to early predict bleeding complications in COVID-19 patients supported by ECMO.
The Cost of Care Associated with Microvascular Free Tissue Transfer by Anatomical Region: A Time-Driven Activity-Based Model
Authors: Lindell Jackson S. , Blaschke Breanna L. , Only Arthur J. , Parikh Harsh R. , Gorman Tiffany L. , Vang Sandy X. , Mahajan Ashish Y. , Cunningham Brian P. 
Published: June 2021

Abstract
Background Microvascular free tissue transfer (FTT) is a reliable method for reconstruction of complex soft tissue defects. The goal of this study was to utilize time-driven activity-based cost (TDABC) accounting to measure the total cost of care of FTT and identify modifiable cost drivers.
Methods A retrospective review was performed on patients requiring FTT at a single, level-I academic trauma center from 2013 to 2019. Patient and surgical characteristics were collected, and six prospective FTT cases were observed via TDABC to collect direct and indirect costs of care.
Results When stratified by postoperative stay at intensive care units (ICUs), the average cost of care was $21,840.22, while cases without ICU stay averaged $6,646.61. The most costly category was ICU stay, averaging $8,310.99 (40.9% of nonstratified overall cost). Indirect costs were the second most costly category, averaging $4,388.07 (21.6% of nonstratified overall cost). Overall, 13 of 100 reviewed cases required some form of revision free-flap, increasing cumulative costs to $7,961.34 for cases with non-ICU stay and $22,233.85 for cases with ICU stay, averaging up to $44,074.07 for patients who stayed in the ICU for both procedures. An increase in cumulative cost was also observed within the timeframe of the investigation, with average costs of $8,484.00 in 2013 compared to $45,128 for 2019.
Conclusion Primary drivers for cost in this study were ICU stay and revision/reoperation. Better understanding the cost of FTT allows for cost reduction through the development of new protocols that drive intraoperative efficiency, reduce ICU stays, and optimize outcomes.
Successful Microsurgical Reconstruction for Limb Salvage in a COVID-19-Positive Patient: A Case Report
Authors: Fleury Christopher M. , Chang Brian L. , Slamin Robert P. , Schwitzer Jonathan A. , Kanuri Arjun , Masden Derek L. 
Published: June 2021

Abstract
Background Although the novel 2019 coronavirus (COVID-19) pandemic delayed elective microsurgical reconstruction cases, traumatic injuries requiring microsurgical reconstruction for limb salvage still presented to our hospital. Recent data suggests a link between COVID-19 and increased venous and arterial thromboembolic events, theoretically increasing the risk of microvascular anastomotic thrombosis and flap failure.
Methods We provide a single case report of microsurgical limb salvage in a COVID-19-positive patient with a Gustilo IIIb open tibial-fibular fracture.
Results A free latissimus dorsi muscle flap was used to successfully cover a Gustilo IIIb open tibial-fibular fracture with exposed orthopedic hardware and large soft tissue defect, with 5-month follow-up demonstrating a well-healed flap allowing for preserved ambulation.
Conclusion Although there is a theoretical increased incidence of venous and arterial thrombotic microvascular failure in COVID-19-positive patients, microsurgical reconstruction is occasionally the lone option for salvage. Microsurgical reconstruction in this population must be carefully considered, meticulously executed, and closely monitored.
Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study
Authors: Tsantes Andreas G. , Sokou Rozeta , Konstantinidi Aikaterini , Ioakeimidis Georgios , Lampridou Maria , Parastatidou Stavroula , Theodoraki Martha , Piovani Daniele , Iliodromiti Zoe , Boutsikou Theodora , Iacovidou Nicoletta , Douramani Panagiota , Poulis Aristarchos , Kokoris Styliani , Kriebardis Anastasios G. , Bonovas Stefanos , Tsantes Argirios E. 
Published: June 2021

AbstractThe aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014–February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Neonatal illness severity scores (Modified NEOMOD [Neonatal Multiple Organ Dysfunction] and SNAPPE [Score for Neonatal Acute Physiology with Perinatal Extension]) were calculated at the same time as ROTEM analysis. Mortality during in-hospital stay was the main outcome measure. Multivariable analyses showed that a 10 mm decrease in EXTEM clot amplitude recorded at 10 minutes (A10) is significantly associated with a higher mortality (odds ratio [OR] = 1.69, 95% confidence interval [CI]: 1.33–2.08). Higher modified NEOMOD (OR = 1.36, 95% CI: 1.26–1.47) and higher SNAPPE scores (OR = 1.06, 95% CI: 1.04–1.08) were also associated with increased mortality. The CT and A10 variables demonstrated the best prognostic performance among the EXTEM parameters for mortality (area under the curve [AUC] = 0.78; 95% CI: 0.69–0.86 and AUC = 0.76; 95% CI: 0.66–0.85, respectively), showing an optimal cut-off CT ≥63 seconds and A10 ≤37 mm. Using optimal cut-off values of the EXTEM parameters for prediction of mortality, neonates with CT ≥63 seconds were 7.4 times more likely to die (OR = 7.40, 95% CI: 3.50–15.65), while neonates with A10 ≤37 mm were 5.8 times more likely to die (OR = 5.88, 95% CI: 2.94–12.50). An EXTEM hypocoagulable profile on disease onset was shown to be an independent risk factor for in-hospital mortality in neonatal critical illness.
Evaluation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and C-Reactive Protein in Tension-Type Headache Patients
Authors: Özdemir Hasan Hüseyin , Dönder Ahmet 
Published: June 2021

Abstract

Objectives A tension headache is the most common type of headache, and its causes are multifactorial. A relationship has been shown between migraine headaches and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP). In this study, we investigated the NLR, PLR, and serum CRP levels in frequent episodic tension-type headache (FETTH) and chronic tension-type headache (CTTH) patients.

Materials and Methods This retrospective study included 64 patients with FETTH, 80 patients with CTTH, and 60 healthy controls who were followed up in the neurology clinic. Hematological parameters were compared between the patient and control groups.

Results In CTTH patients, platelets, NLR, PLR, and CRP values were statistically higher than in FETTH patients and patients in the control group. In FETTH patients, the PLR value was higher than in patients in the control group, but there was no statistically significant difference in NLR and CRP values between FETTH patients and patients in the control group. Also, there was no correlation between these values and age and gender.

Conclusion Increase platelet count might have an effect on tension-type headache pathophysiology. Systemic inflammation parameters were shown to be significantly higher in CTTH patients. More comprehensive studies are needed to evaluate the effect of systemic inflammation on the chronicity of tension headaches.
Isolated CNS Relapse in Acute Lymphoblastic Leukemia (ALL): An Experience from a Tertiary Care Center
Authors: Tevatia Manvir Singh , Sharma Isha , Jadhav Toyaja , Somasundaram Venkatesan , Sharma Sanjeevan 
Published: June 2021

Abstract
Aims and Objectives In this study the various parameters of acute lymphoblastic leukemia (ALL), including the clinical features, peripheral blood and bone marrow (BM) findings, immunophenotypic and cytogenetic details in ALL cases who had isolated relapse involving the central nervous system (CNS), were studied.
Patients/Materials and Methods Duration of the study is from 2015 to 2019 in which 5 ALL cases were presented to this tertiary care center. The presenting symptoms varied from headache, fever, and distension of abdomen. These cases were either on therapy or post completion of chemotherapy. The diagnosis of CNS relapse followed after the examination of cerebrospinal fluid (CSF). Patients also underwent BM examination to rule out systemic relapse.
Results Age of patients ranged from 7 months to 42 years. There were three female patients. Two patients had isolated CNS relapse 3.5 years after completing therapy and succumbed to their illness. Two patients had t(9;22) while one patient had t(1;14) cytogenetic abnormality at diagnosis. One patient was diagnosed as T-ALL. Treatment offered was German Multicentre ALL protocol for induction along with 10 cycles of maintenance.
Conclusion The most common hematolymphoid malignancy in children namely ALL accounts for 75% of childhood leukemias. Complete remission rates reach up to 70 to 80%. CNS involvement is known to occur in these cases. CNS relapse may occur alone or with systemic relapse. Advances in therapeutic protocols along with CNS prophylaxis have drastically brought down the rates of CNS relapse. It is essential to maintain a high degree of suspicion so that these cases of isolated CNS relapse can be identified at the earliest and definitive therapy can be offered.
Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives
Authors: Su Yung-Yeh , Li Chia-Chen , Lin Yih-Jyh , Hsu Chiun 
Published: June 2021

AbstractAdvancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based combination regimens, has transformed the treatment landscape for patients with advanced hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides new opportunities of reducing recurrence after curative therapy through adjuvant therapy or improving resectability through neoadjuvant therapy. Improved recurrence-free survival by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types. In this article, developments of systemic therapy in adjuvant and neoadjuvant settings for HCC were reviewed. The design of adjuvant and neoadjuvant therapy using ICI-based regimens and potential challenges of trial conduct and result analysis was discussed. Results from these trials may extend the therapeutic benefit of ICI-based systemic therapy beyond the advanced-stage disease and lead to a new era of multidisciplinary management for HCC.
Cue-Based Feeding as Intervention to Achieve Full Oral Feeding in Preterm Infants Primarily Managed with Bubble CPAP
Authors: Mohamed Mohamed A. , Teumer Kirsten K. , Leone Mariana , Akram Nabi , Rahamn Mohamed H. , Abdelatif Dinan , Condie Kimberly 
Published: June 2021

Objective Cue-based feeding aims at matching introduction of per oral (PO) feeding with physiological readiness of preterm infants to facilitate PO intake and avoid oral aversion. It was claimed that cue-based feeding may lead to delay in the initiation or achieving full PO feeding in clinical setting primarily using bubble nasal continuous positive airway pressure (CPAP). The study aimed to examine the association of cue-based feeding with time of introduction and completing oral feeding in infants primarily managed with bubble CPAP.
Study Design A retrospective analysis where outcomes of preterm infants ≤32 weeks' gestational age (GA) and ≤2,000 g birth weight (BW) were compared after a practice change from volume-based feeding advancement to cue-based feeding. Continuous variables were compared by using t-test and multilinear regression analysis to control for confounding variables.
Results Of the 311 preterm infants who met inclusion and exclusion criteria, 194 were in the cue-based feeding group and 117 were in the volume-based advancement historical comparison group. There were no differences between groups regarding demographic or clinical variables. Postmenstrual age (PMA) of initial feeding assessment was less in the cue-based feeding group. Age of first PO feeding and when some PO was achieved every feed was mildly delayed in the cue-based feeding compared with comparison group, 34 (±1.3) versus 33.7 (±1.2) weeks, and 36.2 (±2.3) versus 36.0 (±2.4) weeks, (p < 0.01) respectively. However, the age of achieving full PO did not differ between groups, 36.8 (±2.2) versus 36.4 (±2.4) weeks (p = 0.13). There was no difference between groups regarding growth parameters at 36 weeks' PMA or at discharge. Similar results were obtained when examining subcategories of infants ≤1,000 g and 1,001 to 2,000 g.
Conclusion Cue-based feeding may not be associated with a delay in achieving full oral feeding or prolongation of the length of stay in preterm infants managed with CPAP.
Key Points
A high-dynamic-range digital RF-over-fiber link for MRI receive coils using delta–sigma modulation
Authors: Fan Mingdong , Brown Robert W. , Gao Xi , Mandal Soumyajit , Petropoulos Labros , Yang Xiaoyu , Handa Shinya , Fujita Hiroyuki 
Published: June 2021

Coaxial cables commonly used to connect radio-frequency (RF) coil arrays with the control console of an MRI scanner are susceptible to electromagnetic coupling. As the number of RF channels increases, such coupling could result in severe heating and pose a safety concern. Non-conductive transmission solutions based on fiber-optic cables are considered to be one of the alternatives but are limited by the high dynamic range (&gt;80 dB) of typical MRI signals. A new digital fiber-optic transmission system based on delta–sigma modulation (DSM) is developed to address this problem. A DSM-based optical link is prototyped using off-the-shelf components and bench-tested at different signal oversampling rates (OSRs). An end-to-end dynamic range (DR) of 81 dB, which is sufficient for typical MRI signals, is obtained over a bandwidth of 200 kHz, which corresponds to OSR = 50. A fully integrated custom fourth-order continuous-time DSM is designed in 180 nm CMOS technology to enable transmission of full-bandwidth MRI signals (up to 1 MHz) with an adequate DR. Initial electrical test results from this custom chip are also presented.
Numerical analysis of drag reduction characteristics of biomimetic puffer skin: Effect of spinal arrangement
Authors: Feng Xiaoming , Jia Changfeng , Fan Dongliang , Hu Yushen , Tian Guizhong 
Published: June 2021

In this paper, biomimetic spines on puffer skin were taken as the study object, and numerical simulation was used to study the effect of the spinal arrangement on drag reduction characteristics. The results showed that the drag reduction decreased with the increasing arrangement position (AP) and inflow angle (β), and the drag reduction of the average arrangement was obviously better than that of the staggered arrangement. Moreover, drag reduction increased gradually as the arrangement quantity-R/T (AQR/AQT) increased. The drag reduction increased first and then decreased with the increasing arrangement spacing-R (ASR), and the drag reduction increased as the arrangement spacing-T (AST) increased. In short, the greater the spinal quantity and spacing, the better the drag reduction effect; however, it was affected by the arrangement position, which made the drag reduction effect reduce. More notably, the optimal drag reduction reached 23.1% when the arrangement parameters were the average arrangement, β = 0°, AP = 0 mm, AQR = 11, AQT = 5, ASR = 6.5 mm, and AST = 3.5 mm. Overall, the spinal arrangement parameters can be effectively regulated until the optimal drag reduction was realized, and this work provides a valuable reference for future studies on drag reduction for engineering applications.
Mapping wave packet bifurcation at a conical intersection in CH3I by attosecond XUV transient absorption spectroscopy
Authors: Chang Kristina F. , Wang Han , Poullain Sonia M. , Prendergast David , Neumark Daniel M. , Leone Stephen R. 
Published: June 2021

Extreme ultraviolet (XUV) transient absorption spectroscopy has emerged as a sensitive tool for mapping the real-time structural and electronic evolution of molecules. Here, attosecond XUV transient absorption is used to track dynamics in the A-band of methyl iodide (CH3I). Gaseous CH3I molecules are excited to the A-band by a UV pump (277 nm, ∼20 fs) and probed by attosecond XUV pulses targeting iodine I(4d) core-to-valence transitions. Owing to the excellent temporal resolution of the technique, passage through a conical intersection is mapped through spectral signatures of nonadiabatic wave packet bifurcation observed to occur at 15 ± 4 fs following UV photoexcitation. The observed XUV signatures and time dynamics are in agreement with previous simulations [H. Wang, M. Odelius, and D. Prendergast, J. Chem. Phys. 151, 124106 (2019)]. Due to the short duration of the UV pump pulse, coherent vibrational motion in the CH3I ground state along the C–I stretch mode (538 ± 7 cm−1) launched by resonant impulsive stimulated Raman scattering and dynamics in multiphoton excited states of CH3I are also detected.
Estimating genetic nurture with summary statistics of multigenerational genome-wide association studies
Authors: Wu Yuchang , Zhong Xiaoyuan , Lin Yunong , Zhao Zijie , Chen Jiawen , Zheng Boyan , Li James J. , Fletcher Jason M. , Lu Qiongshi 
Published: June 2021

Significance
It has been shown that human genomes can affect phenotype both directly (through inherited genetic variants) and indirectly (through parents and the family environment they create). Due to the correlation between parental and offspring genotypes, a standard genome-wide association study (GWAS) captures both the direct and indirect genetic effects. In this study, we introduce a statistical framework named DONUTS to estimate direct and indirect effects using summary statistics from GWAS conducted on own and offspring phenotypes. It requires only GWAS summary statistics as input, allows differential paternal and maternal effects, and accounts for sample overlap and assortative mating. DONUTS provides deeper etiological insights for complex traits and has practical guidance on future study designs.