bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abelchia: inability to belch/burp—a new disorder? Retrograde cricopharyngeal dysfunction (RCPD)
Authors: Karagama Yakubu 
Published: April 2021

Abstract
Case series
This is retrospective case series involving 72 patients who presented with symptoms associated with inability to burp. The following symptoms was described by almost all the patients; retrosternal pain after eating or drinking, bloating feeling in the stomach, gurgling noise in the throat, excessive flatulence. These symptoms are worse with fizzy/carbonated drinks and beer. A full clinical history and examination plus endoscopic and in some cases barium a swallow radiological investigation was done.

Procedure
The surgery was performed under a general anaesthesia for all cases. Suspension pharyngoscopy in supine position using a Weerda diverticuloscope to identify the cricopharyngeal bar muscle. High dose of botulinum toxin A (botox) 100 iu was injected into the cricopharynxgeus muscle under a general anaesthesia.

Results
A total of 72 patients were diagnosed and undergone surgery between November 2016 and December 2020. There were 50 male and 22 female patients. Their average age was 30 (range 18–68 years old). All patients were able to burp again within first 4 weeks of the injection. This persisted even after the Botox worn off beyond the 3 months in 96% of cases. The average follow-up was 24 months post injection with longest follow-up 48 months (range 1–48 months).

Conclusion
The author reported a new condition of inability to burp due to failure of the cricopharyngeal sphincter to relax spontaneously and outcome of treatment using botulinum toxin A injection into the cricopharyngeus muscle. It is expected that the paralysing action of botulinum toxin injection last approximately 3 months. However, this group of patients seem to be cured even after the effect of the botox is worn off. The author therefore postulated that there might me some neural dysfunction that inhibits the brain to send signals to the cricopharyngeal sphincter to initiate burping. Once burping is re-established with the help of botox injection, spontaneous burping seems to occur and sustained even after the botox is worn off.
Re-evaluation of single nucleotide variants and identification of structural variants in a cohort of 45 sudden unexplained death cases
Authors: Neubauer Jacqueline , Wang Shouyu , Russo Giancarlo , Haas Cordula 
Published: April 2021

AbstractSudden unexplained death (SUD) takes up a considerable part in overall sudden death cases, especially in adolescents and young adults. During the past decade, many channelopathy- and cardiomyopathy-associated single nucleotide variants (SNVs) have been identified in SUD studies by means of postmortem molecular autopsy, yet the number of cases that remain inconclusive is still high. Recent studies had suggested that structural variants (SVs) might play an important role in SUD, but there is no consensus on the impact of SVs on inherited cardiac diseases. In this study, we searched for potentially pathogenic SVs in 244 genes associated with cardiac diseases. Whole-exome sequencing and appropriate data analysis were performed in 45 SUD cases. Re-analysis of the exome data according to the current ACMG guidelines identified 14 pathogenic or likely pathogenic variants in 10 (22.2%) out of the 45 SUD cases, whereof 2 (4.4%) individuals had variants with likely functional effects in the channelopathy-associated genes SCN5A and TRDN and 1 (2.2%) individual in the cardiomyopathy-associated gene DTNA. In addition, 18 structural variants (SVs) were identified in 15 out of the 45 individuals. Two SVs with likely functional impairment were found in the coding regions of PDSS2 and TRPM4 in 2 SUD cases (4.4%). Both were identified as heterozygous deletions, which were confirmed by multiplex ligation-dependent probe amplification. In conclusion, our findings support that SVs could contribute to the pathology of the sudden death event in some of the cases and therefore should be investigated on a routine basis in suspected SUD cases.
Age-dependent decrease in dental pulp cavity volume as a feature for age assessment: a comparative in vitro study using 9.4-T UTE-MRI and CBCT 3D imaging
Authors: Timme Maximilian , Borkert Jens , Nagelmann Nina , Streeter Adam , Karch André , Schmeling Andreas 
Published: April 2021

AbstractEvaluation of secondary dentin formation is generally suitable for age assessment. We investigated the potential of modern magnetic resonance imaging (MRI) technology to visualize the dental pulp in direct comparison with cone beam computed tomography (CBCT). To this end, we examined 32 extracted human teeth (teeth 11–48 [FDI]) using 9.4-T ultrashort echo time (UTE)-MRI and CBCT (methods). 3D reconstruction was performed via both manual and semi-automatic segmentation (settings) for both methods in two runs by one examiner. Nine teeth were also examined by a second examiner. We evaluated the agreement between examiners, scan methods, and settings. CBCT was able to determine the pulp volume for all teeth. This was not possible for two teeth on MRI due to MRI artifacts. The mean pulp volume estimated by CBCT was consistently higher (~ 43%) with greater variability. With lower variability in its measurements, evaluation of pulp volume using the MRI method exhibited greater sensitivity to differences between settings (p = 0.016) and between examiners (p = 0.009). The interactions of single-rooted teeth and multi-rooted teeth and method or setting were not found to be significant. For examiner agreement, the mean pulp volumes were similar with overlapping measurements (ICC > 0.995). Suitable for use in age assessment is 9.4-T UTE-MRI with good reliability and lower variation than CBCT. For MRI, manual segmentation is necessary due to a more detailed representation of the interior of the pulp cavity. Since determination of pulp volume is expected to be systematically larger using CBCT, method-specific reference values are indispensable for practical age assessment procedures. The results should be verified under in vivo conditions in the future.
Physiological responses and cycle characteristics during double-poling versus diagonal-stride roller-skiing in junior cross-country skiers
Authors: Andersson Erik P. , Hämberg Irina , Do Nascimento Salvador Paulo Cesar , McGawley Kerry 
Published: April 2021

Abstract
Purpose
This study aimed to compare physiological factors and cycle characteristics during cross-country (XC) roller-skiing at matched inclines and speeds using the double-poling (DP) and diagonal-stride (DS) sub-techniques in junior female and male XC skiers.

Methods
Twenty-three well-trained junior XC skiers (11 women, 12 men; age 18.2 ± 1.2 yr.) completed two treadmill roller-skiing tests in a randomized order using either DP or DS. The exercise protocols were identical and included a 5 min warm-up, 4 × 5 min submaximal stages, and an incremental test to exhaustion, all performed at a 5° incline.

Results
No significant three-way interactions were observed between sex, submaximal exercise intensity, and sub-technique. For the pooled sample, higher values were observed for DP versus DS during submaximal exercise for the mean oxygen uptake kinetics response time (33%), energy cost (18%), heart rate (HR) (9%), blood lactate concentration (5.1 versus 2.1 mmol·L−1), rating of perceived exertion (12%), and cycle rate (25%), while cycle length was lower (19%) (all P < 0.001). During the time-to-exhaustion (TTE) test, peak oxygen uptake ($$\dot{V}$$

V
˙

O2peak), peak HR, and peak oxygen pulse were 8%, 2%, and 6% lower, respectively, for DP than DS, with a 29% shorter TTE during DP (pooled data, all P < 0.001).

Conclusion
In well-trained junior XC skiers, DP was found to exert a greater physiological load than DS during uphill XC roller-skiing at submaximal intensities. During the TTE test, both female and male athletes were able to ski for longer and reached markedly higher $$\dot{V}$$

V
˙

O2peak values when using DS compared to DP.
Myostatin regulates the production of fibroblast growth factor 23 (FGF23) in UMR106 osteoblast–like cells
Authors: Ewendt Franz , Feger Martina , Föller Michael 
Published: April 2021

AbstractMyostatin is a signaling molecule produced by skeletal muscle cells (myokine) that inhibits muscle hypertrophy and has further paracrine and endocrine effects in other organs including bone. Myostatin binds to activin receptor type 2B which forms a complex with transforming growth factor-β type I receptor (TGF-βRI) and induces intracellular p38MAPK and NFκB signaling. Fibroblast growth factor 23 (FGF23) is a paracrine and endocrine mediator produced by bone cells and regulates phosphate and vitamin D metabolism in the kidney. P38MAPK and NFκB-dependent store-operated Ca2+ entry (SOCE) are positive regulators of FGF23 production. Here, we explored whether myostatin influences the synthesis of FGF23. Fgf23 gene expression was determined by qRT-PCR and FGF23 protein by ELISA in UMR106 osteoblast–like cells. UMR106 cells expressed activin receptor type 2A and B. Myostatin upregulated Fgf23 gene expression and protein production. The myostatin effect on Fgf23 was significantly attenuated by TGF-βRI inhibitor SB431542, p38MAPK inhibitor SB202190, and NFκB inhibitor withaferin A. Moreover, SOCE inhibitor 2-APB blunted the myostatin effect on Fgf23. Taken together, myostatin is a stimulator of Fgf23 expression in UMR106 cells, an effect at least partially mediated by downstream TGF-βRI/p38MAPK signaling as well as NFκB-dependent SOCE.
Influence of layer separation on the determination of stomach smooth muscle properties
Authors: Borsdorf Mischa , Böl Markus , Siebert Tobias 
Published: April 2021

AbstractUniaxial tensile experiments are a standard method to determine the contractile properties of smooth muscles. Smooth muscle strips from organs of the urogenital and gastrointestinal tract contain multiple muscle layers with different muscle fiber orientations, which are frequently not separated for the experiments. During strip activation, these muscle fibers contract in deviant orientations from the force-measuring axis, affecting the biomechanical characteristics of the tissue strips. This study aimed to investigate the influence of muscle layer separation on the determination of smooth muscle properties. Smooth muscle strips, consisting of longitudinal and circumferential muscle layers (whole-muscle strips [WMS]), and smooth muscle strips, consisting of only the circumferential muscle layer (separated layer strips [SLS]), have been prepared from the fundus of the porcine stomach. Strips were mounted with muscle fibers of the circumferential layer inline with the force-measuring axis of the uniaxial testing setup. The force–length (FLR) and force–velocity relationships (FVR) were determined through a series of isometric and isotonic contractions, respectively. Muscle layer separation revealed no changes in the FLR. However, the SLS exhibited a higher maximal shortening velocity and a lower curvature factor than WMS. During WMS activation, the transversally oriented muscle fibers of the longitudinal layer shortened, resulting in a narrowing of this layer. Expecting volume constancy of muscle tissue, this narrowing leads to a lengthening of the longitudinal layer, which counteracted the shortening of the circumferential layer during isotonic contractions. Consequently, the shortening velocities of the WMS were decreased significantly. This effect was stronger at high shortening velocities.
Fluctuations of extreme eigenvalues of sparse Erdős–Rényi graphs
Authors: He Yukun , Knowles Antti 
Published: April 2021

AbstractWe consider a class of sparse random matrices which includes the adjacency matrix of the Erdős–Rényi graph $${{\mathcal {G}}}(N,p)$$

G
(
N
,
p
)

. We show that if $$N^{\varepsilon } \leqslant Np \leqslant N^{1/3-\varepsilon }$$

N
ε

⩽
N
p
⩽

N

1
/
3
-
ε

then all nontrivial eigenvalues away from 0 have asymptotically Gaussian fluctuations. These fluctuations are governed by a single random variable, which has the interpretation of the total degree of the graph. This extends the result (Huang et al. in Ann Prob 48:916–962, 2020) on the fluctuations of the extreme eigenvalues from $$Np \geqslant N^{2/9 + \varepsilon }$$

N
p
⩾

N

2
/
9
+
ε

down to the optimal scale $$Np \geqslant N^{\varepsilon }$$

N
p
⩾

N
ε

. The main technical achievement of our proof is a rigidity bound of accuracy $$N^{-1/2-\varepsilon } (Np)^{-1/2}$$

N

-
1
/
2
-
ε

(
N
p
)

-
1
/
2

for the extreme eigenvalues, which avoids the $$(Np)^{-1}$$

(
N
p
)

-
1

-expansions from Erdős et al. (Ann Prob 41:2279–2375, 2013), Huang et al. (2020) and Lee and Schnelli (Prob Theor Rel Fields 171:543–616, 2018). Our result is the last missing piece, added to Erdős et al. (Commun Math Phys 314:587–640, 2012), He (Bulk eigenvalue fluctuations of sparse random matrices. arXiv:1904.07140), Huang et al. (2020) and Lee and Schnelli (2018), of a complete description of the eigenvalue fluctuations of sparse random matrices for $$Np \geqslant N^{\varepsilon }$$

N
p
⩾

N
ε

.
ALE formulation for thermomechanical inelastic material models applied to tire forming and curing simulations
Authors: Zreid Imadeddin , Behnke Ronny , Kaliske Michael 
Published: April 2021

AbstractForming of tires during production is a challenging process for Lagrangian solid mechanics due to large changes in the geometry and material properties of the rubber layers. This paper extends the Arbitrary Lagrangian–Eulerian (ALE) formulation to thermomechanical inelastic material models with special consideration of rubber. The ALE approach based on tracking the material and spatial meshes is used, and an operator-split is employed which splits up the solution within a time step into a mesh smoothing step, a history remapping step and a Lagrangian step. Mesh distortion is reduced in the smoothing step by solving a boundary value problem. History variables are subsequently remapped to the new mesh with a particle tracking scheme. Within the Lagrangian steps, a fully coupled thermomechanical problem is solved. An advanced two-phase rubber model is incorporated into the ALE approach, which can describe green rubber, cured rubber and the transition process. Several numerical examples demonstrate the superior behavior of the developed formulation in comparison to purely Lagrangian finite elements.
Local radon flux maxima in the quaternary sediments of Schleswig–Holstein (Germany)
Authors: Albert Johannes , Schärf Maximilian , Enzmann Frieder , Waltl Martin , Sirocko Frank 
Published: April 2021

AbstractThis paper presents radon flux profiles from four regions in Schleswig–Holstein (Northern Germany). Three of these regions are located over deep-rooted tectonic faults or salt diapirs and one is in an area without any tectonic or halokinetic activity, but with steep topography. Contrary to recently published studies on spatial patterns of soil radon gas concentration we measured flux of radon from soil into the atmosphere. All radon devices of each profile were deployed simultaneously to avoid inconsistencies due to strong diurnal variations of radon exhalation. To compare data from different seasons, values had to be normalized. Observed radon flux patterns are apparently related to the mineralogical composition of the Quaternary strata (particularly to the abundance of reddish granite and porphyry), and its grain size (with a flux maximum in well-sorted sand/silt). Minimum radon flux occurs above non-permeable, clay-rich soil layers. Small amounts of water content in the pore space increase radon flux, whereas excessive water content lessens it. Peak flux values, however, are observed over a deep-rooted fault system on the eastern side of Lake Plön, i.e., at the boundary of the Eastholstein Platform and the Eastholstein Trough. Furthermore, high radon flux values are observed in two regions associated with salt diapirism and near-surface halokinetic faults. These regions show frequent local radon flux maxima, which indicate that the uppermost strata above salt diapirs are very inhomogeneous. Deep-rooted increased permeability (effective radon flux depth) or just the boundaries between permeable and impermeable strata appear to concentrate radon flux. In summary, our radon flux profiles are in accordance with the published evidence of low radon concentrations in the “normal” soils of Schleswig–Holstein. However, very high values of radon flux are likely to occur at distinct locations near salt diapirism at depth, boundaries between permeable and impermeable strata, and finally at the tectonically active flanks of the North German Basin.
Surgical nuances and construct patterns influence construct stiffness in C1-2 stabilizations: a biomechanical study of C1-2 gapping and advanced C1-2 fixation
Authors: Koller Heiko , Hartmann Sebastian , Raphael Gmeiner , Schmölz Werner , Orban Christoph , Thome Claudius 
Published: April 2021

Abstract
Purpose
Stabilization of C1-2 using a Harms–Goel construct with 3.5 mm titanium (Ti) rods has been established as a standard of reference (SOR). A reduction in craniocervical deformities can indicate increased construct stiffness at C1-2. A reduction in C1-2 can result in C1-2 joint gapping. Therefore, the authors sought to study the biomechanical consequences of C1-2 gapping on construct stiffness using different instrumentations, including a novel 6-screw/3-rod (6S3R) construct, to compare the results to the SOR. We hypothesized that different instrument pattern will reveal significant differences in reduction in ROM among constructs tested.

Methods
The range of motion (ROM) of instrumented C1-2 polyamide models was analyzed in a six-degree-of-freedom spine tester. The models were loaded with pure moments (2.0 Nm) in axial rotation (AR), flexion extension (FE), and lateral bending (LB). Comparisons of C1-2 construct stiffness among the constructs included variations in rod diameter (3.5 mm vs. 4.0 mm), rod material (Ti. vs. CoCr) and a cross-link (CLX). Construct stiffness was tested with C1-2 facets in contact (Contact Group) and in a 2 mm distracted position (Gapping Group). The ROM (°) was recorded and reported as a percentage of ROM (%ROM) normalized to the SOR. A difference > 30% between the SOR and the %ROM among the constructs was defined as significant.

Results
Among all constructs, an increase in construct stiffness up to 50% was achieved with the addition of CLX, particularly with a 6S3R construct. These differences showed the greatest effect for the CLX in AR testing and for the 6S3R construct in FE and AR testing. Among all constructs, C1-2 gapping resulted in a significant loss of construct stiffness. A protective effect was shown for the CLX, particularly using a 6S3R construct in AR and FE testing. The selection of rod diameter (3.5 mm vs. 4.0 mm) and rod material (Ti vs. CoCr) did show a constant trend but did not yield significance.

Conclusion
This study is the first to show the loss of construct stiffness at C1-2 with gapping and increased restoration of stability using CLX and 6S3R constructs. In the correction of a craniocervical deformity, nuances in the surgical technique and advanced instrumentation may positively impact construct stability.
Cold atmospheric plasma coupled with air abrasion in liquid medium for the treatment of peri-implantitis model grown with a complex human biofilm: an in vitro study
Authors: Hui Wang Lai , Perrotti Vittoria , Piattelli Adriano , Ostrikov Kostya , Fang Zhi , Quaranta Alessandro 
Published: April 2021

Abstract
Objective
Treatment of implants with peri-implantitis is often unsuccessful due to residual microbial biofilm hindering re-osseointegration. The aim of this study was to treat biofilm-grown titanium (Ti) implants with different modalities involving air abrasion (AA) and cold atmospheric plasma (CAP) to compare the effectiveness in surface decontamination and the alteration/preservation of surface topography.

Materials and methods
Saliva collected from a peri-implantitis patient was used to in vitro develop human biofilm over 35 implants with moderately rough surface. The implants were then mounted onto standardized acrylic blocks simulating peri-implantitis defects and treated with AA (erythritol powder), CAP in a liquid medium, or a combination (COM) of both modalities. The remaining biofilm was measured by crystal violet (CV). Surface features and roughness before and after treatment were assessed by scanning electron microscope (SEM). The data were statistically analyzed using Kruskal-Wallis followed by Tukey’s multiple comparison test.

Results
In the present peri-implantitis model, the human complex biofilm growth was successful as indicated by the statistical significance between the negative and positive controls. All the treatment groups resulted in a remarkable implant surface decontamination, with values very close to the negative control for AA and COM. Indeed, statistically significant differences in the comparison between the positive control vs. all the treatment groups were found. SEM analysis showed no post-treatment alterations on the implant surface in all the groups.

Conclusions
Decontamination with AA delivering erythritol with or without CAP in liquid medium demonstrated compelling efficacy in the removal of biofilm from implants. All the tested treatments did not cause qualitative alterations to the Ti surface features. No specific effects of the CAP were observed, although further studies are necessary to assess its potential as monotherapy with different settings or in combination with other decontamination procedures.

Clinical relevance
CAP is a promising option in the treatment of peri-implantitis because it has potential to improve the elimination of bacterial plaque from implant surfaces, in inaccessible pockets or during open-flap debridement, and should stimulate the process of the re-osseointegration of affected dental implants by not altering surface features and roughness.
Characteristics of person, place, and activity that trigger failure to speak in children with selective mutism
Authors: Schwenck Christina , Gensthaler Angelika , Vogel Felix , Pfeffermann Anke , Laerum Sabine , Stahl Julia 
Published: April 2021

AbstractSelective Mutism (SM) is an anxiety disorder with predictable and circumscribed situations in which children remain silent while they speak unaffectedly in others. However, core features of anxiety inducing stimuli have rarely been studied so far. Parents of children with elevated SM symptomatology participated in an online-based study and answered open ended questions about specific characteristics of a person, place, and activity that elicit failure to speak in their child. The final sample consisted of n = 91 parents with children aged between 3 and 17 years (M = 8.02 years, SD = 3.94). Answers were analyzed by qualitative content analysis. Characteristics of a person were assigned to five categories with lack of distance as the most frequently reported feature. With respect to a place, the majority of parents mentioned unknown places as a silence trigger. The most frequently mentioned feature of an activity that was designated to be associated to silence was new activity. There were only few associations between the designation of these features, age, and gender. For the first time, anxiety inducing triggers related to person, place, and activity were comprehensively assessed in children with SM. This allows a differentiated and deeper understanding of an understudied disorder. The majority of characteristics can be associated with proposed etiological factors such as increased behavioral inhibition, conditioning processes, social anxiety, and a strong need for control. Implications for effective treatments are discussed.