bluuebunny/crossref_metadata_2025_split huggingface dataset:
Formation of giant plasmoids at the pulsar wind termination shock: A possible origin of the inner-ring knots in the Crab Nebula
Authors: Cerutti Benoît , Giacinti Gwenael 
Published: November 2021

Context. Nearby pulsar wind nebulae exhibit complex morphological features: jets, torus, arcs, and knots. These structures are well captured and understood in the scope of global magnetohydrodynamic models. However, the origin of knots in the inner radius of the Crab Nebula remains elusive.
Aims. In this work, we investigate the dynamics of the shock front and downstream flow with a special emphasis on the reconnecting equatorial current sheet. We examine whether giant plasmoids produced in the reconnection process could be good candidates for the knots.
Methods. To this end, we perform large semi-global three-dimensional particle-in-cell simulations in a spherical geometry. The hierarchical merging plasmoid model is used to extrapolate numerical results to pulsar wind nebula scales.
Results. The shocked material collapses into the midplane, forming and feeding a large-scale, but thin, ring-like current layer. The sheet breaks up into a dynamical chain of merging plasmoids, reminiscent of three-dimensional reconnection. Plasmoids grow to a macroscopic size. The final number of plasmoids predicted is solely governed by the inverse of the dimensionless reconnection rate.
Conclusions. The formation of giant plasmoids is a robust feature of pulsar wind termination shocks. They provide a natural explanation for the inner-ring knots in the Crab Nebula, provided that the nebula is highly magnetized.
TOI-2257 b: A highly eccentric long-period sub-Neptune transiting a nearby M dwarf
Authors: Schanche N. , Pozuelos F. J. , Günther M. N. , Wells R. D. , Burgasser A. J. , Chinchilla P. , Delrez L. , Ducrot E. , Garcia L. J. , Gómez Maqueo Chew Y. , Jofré E. , Rackham B. V. , Sebastian D. , Stassun K. G. , Stern D. , Timmermans M. , Barkaoui K. , Belinski A. , Benkhaldoun Z. , Benz W. , Bieryla A. , Bouchy F. , Burdanov A. , Charbonneau D. , Christiansen J. L. , Collins K. A. , Demory B.-O. , Dévora-Pajares M. , de Wit J. , Dragomir D. , Dransfield G. , Furlan E. , Ghachoui M. , Gillon M. , Gnilka C. , Gómez-Muñoz M. A. , Guerrero N. , Harris M. , Heng K. , Henze C. E. , Hesse K. , Howell S. B. , Jehin E. , Jenkins J. , Jensen E. L. N. , Kunimoto M. , Latham D. W. , Lester K. , McLeod K. K. , Mireles I. , Murray C. A. , Niraula P. , Pedersen P. P. , Queloz D. , Quintana E. V. , Ricker G. , Rudat A. , Sabin L. , Safonov B. , Schroffenegger U. , Scott N. , Seager S. , Strakhov I. , Triaud A. H. M. J. , Vanderspek R. , Vezie M. , Winn J. 
Published: November 2021

Context. Thanks to the relative ease of finding and characterizing small planets around M-dwarf stars, these objects have become cornerstones in the field of exoplanet studies. The current paucity of planets in long-period orbits around M dwarfs makes such objects particularly compelling as they provide clues about the formation and evolution of these systems.
Aims. In this study we present the discovery of TOI-2257 b (TIC 198485881), a long-period (35 d) sub-Neptune orbiting an M3 star at 57.8 pc. Its transit depth is about 0.4%, large enough to be detected with medium-size, ground-based telescopes. The long transit duration suggests the planet is in a highly eccentric orbit (e ~ 0.5), which would make it the most eccentric planet known to be transiting an M-dwarf star.
Methods. We combined TESS and ground-based data obtained with the 1.0-meter SAINT-EX, 0.60-meter TRAPPIST-North, and 1.2-meter FLWO telescopes to find a planetary size of 2.2 R⊕ and an orbital period of 35.19 days. In addition, we make use of archival data, high-resolution imaging, and vetting packages to support our planetary interpretation.
Results. With its long period and high eccentricity, TOI-2257 b falls into a novel slice of parameter space. Despite the planet’s low equilibrium temperature (~256 K), its host star’s small size (R* = 0.311 ± 0.015) and relative infrared brightness (Kmag = 10.7) make it a suitable candidate for atmospheric exploration via transmission spectroscopy.
Effects of the combined use of a scissor-type knife and traction clip on endoscopic submucosal dissection of colorectal tumors: a propensity score-matched analysis
Authors: Inoue Ken , Yoshida Naohisa , Dohi Osamu , Sugino Satoshi , Matsumura Shinya , Kitae Hiroaki , Yasuda Ritsu , Nakano Takahiro , Terasaki Kei , Hirose Ryohei , Naito Yuji , Murakami Takaaki , Inada Yutaka , Ogiso Kiyoshi , Morinaga Yukiko , Kishimoto Mitsuo , Yoshito Itoh 
Published: November 2021

Abstract
Background and study aims This study evaluated the technical aspects of colorectal endoscopic submucosal dissection (ESD) with the Clutch Cutter (CC) (Fujifilm Co., Tokyo, Japan), a scissor-type knife, and the S-O clip (SO) as a traction clip, and compared the safety and efficacy to ESD using a needle-type knife.
Patients and methods This was a single-center retrospective study. In Study 1, we evaluated 125 ESD patients: 60 using the SO and CC (SO group) and 65 using the CC (CC group). In Study 2, we evaluated 185 ESD patients: the CC group (N = 65) and 120 using the Flush knife BT-S (Flush group) (Fujifilm Co., Tokyo, Japan). In both studies, the clinicopathological features and therapeutic outcomes were compared using a propensity score-matched analysis.
Results In 36 pairs of matched patients in Study 1, the rates of en bloc resection, R0 resection, perforation, and postoperative bleeding (POB) were 97.2 %, 88.9 %, 2.8 %, and 0 %, respectively, for the SO group and 100 %, 91.7 %, 0 %, and 0 % for the CC group (not significant). The mean procedure time for the SO group among less-experienced endoscopists was significantly shorter than in the CC group (42 vs. 65 minutes, P = 0.036). In 49 pairs of matched patients in Study 2, the rates of en bloc resection, R0 resection, perforation, and POB were 100 %, 95.8 %, 0 %, and 0 %, respectively, for the CC group and 98.0 %, 95.8 %, 0 %, and 2.0 % for the Flush group (not significant). The mean procedure time in the CC group among less-experienced endoscopists was significantly shorter than in the Flush group (52 vs. 67 minutes, P = 0.038).
Conclusions CC and the combined use of CC and SO reduced colorectal ESD procedure time among less-experienced endoscopists.
Serum Levels of Interleukin-36 Alpha and Interleukin-36 Receptor
Antagonist In Behcet’s Syndrome
Authors: Ünsal Pelin , Çerçi Pamir , Açıkgöz Şükrü Alper , Keskin Göksal , Ölmez Ümit 
Published: November 2021

Abstract
Background Behcet’s syndrome (BS) is a systemic vasculitic
disorder. This study aimed to investigate the levels of serum IL-36α and
IL-36Ra in patients with BS.
Material and Methods A total of 80 subjects (60 BS patients and 20 healthy
controls [HC]) were included.
Results The median IL-36α level was 0.11 ng/ml in
the BS group and 0.09 ng/ml in the HC group (p=0.058).
The mean IL-36Ra level was 13.62 pg/ml in the BS group and
13.26 pg/ml in the HC group (p=0.348). Serum IL-36Ra
levels of the active group were significantly higher (p=0.037). Patients
with oral ulcers and central nervous system involvement had higher serum IL36Ra
levels. In the BS group, a positive correlation was found between serum IL-36Ra
and CRP. In a multivariate analysis, the IL-36Ra level (OR=1.067;
95% CI=1.001–1.137; p=0.045) was independently
associated with disease activity.
Conclusion According to these findings, it is not clear whether such a
slight difference is clinically significant, but they suggest that the IL-36
cytokine family may play a role in the course of the disease.
Management of large polyps in a colorectal cancer screening program with fecal immunochemical test: a community- and population-based observational study
Authors: Denis Bernard , Gendre Isabelle , Perrin Philippe , Tuzin Nicolas , Pioche Mathieu 
Published: November 2021

Abstract
Background and study aims The aim of this study was to analyze presentation, management, and outcomes of large polyps (LPs; ≥ 20 mm) detected in a colorectal cancer (CRC) screening program using a quantitative fecal immunochemical test (FIT).
Patients and methods This was a retrospective community- and population-based observational study of all LPs detected in patients aged 50 to 74 years between 2015 and 2019 during FIT-positive colonoscopies within the screening program organized in Alsace (France).
Results Among 13,633 FIT-positive colonoscopies, 1256 LPs (8.5 % malignant and 51.8 % nonpedunculated) were detected by 102 community gastroenterologists in 1164 patients (one in 12 colonoscopies). The sensitivity of optical diagnosis of malignancy was 54 % for nonpedunculated and 27 % for pedunculated T1 CRCs. The endoscopic resection rate was 82.7 % (95 % confidence interval [CI] 80.3–84.9) for benign LPs (70.2 % [95 % CI 66.4–74.1]) nonpedunculated, 95.2 % [95 % CI 93.4–97.1] pedunculated), varying from 0 to 100 % depending on the endoscopist. It was correlated with cecal intubation (Pearson r = 0.49, P < 0.01) and adenoma detection rates (r = 0.25, P = 0.01). Most endoscopists did not refer patients to more experienced endoscopists, and as a result, 60 % to 90 % of 183 surgeries for benign LPs were unwarranted. Endoscopic resection was curative for 4.3 % (95 % CI 0.9–12.0) of nonpedunculated and 37.8 % (95 % CI 22.5–55.2) of pedunculated T1 CRCs. Overall, 22 endoscopic submucosal dissections had to be performed to avoid one surgery.
Conclusions Compared with current recommendations, there is tremendous room for improvement in community endoscopy practices in the diagnosis and management of LPs. Detection and polypectomy competencies are correlated and highly variable among endoscopists. Endoscopic resection is curative for 83 % of benign LPs and 16 % of T1 CRCs.
Endoscopic submucosal dissection: How to be more efficient?
Authors: Lambin Thomas , Rivory Jérôme , Wallenhorst Timothée , Legros Romain , Monzy Frédéric , Jacques Jérémie , Pioche Mathieu 
Published: November 2021

AbstractEndoscopic submucosal dissection (ESD) allows an “en bloc” resection with safety margins (R0 resection) regardless of the size of the lesion. However, while R0 brings a real benefit for the patient, it is not considered sufficient by many experts to justify the technical difficulties and the longer procedure time compared to piecemeal mucosectomy. The aims of this review are to provide several technical and strategical tips to help you save time and become comfortable during ESD procedures. ESD is divided into several intertwined phases: injection, incision, access to the submucosae, and submucosal dissection itself. During injection there are some mistakes that should not be made: a superficial injection, or on the contrary, a too deep injection. A good needle and good injection technique are mandatory. Some techniques, such as repeated injection or prolonged lifting solution, can help maintain the lift. After this step, mucosal incision can be made, taking care to have a good margin to allow an R0 resection. Starting the mucosal incision from a small point allows calibration of the depth of the incision and then obtaining a nice incision. Trimming is also very important to widen submucosal access. Then comes the submucosal dissection itself. Strategies such as the tunnel strategy or the pocket creation method can help to facilitate dissection, but more importantly, traction systems have become unavoidable, especially in the stomach and colon. Most common complications are bleeding and perforation, and they usually can be managed endoscopically.
Patient characteristics and procedural outcomes of moderate sedation for endoscopic procedures in patients with obesity: A retrospective, propensity score-matched study
Authors: Garg Shashank , Syed Shorabuddin , Perisetti Abhilash , Inamdar Sumant , Vargo John 
Published: November 2021

Abstract
Background Endoscopic procedures are performed commonly with moderate sedation. Obesity can pose a challenge in its safe administration. This study was aimed at assessing outcomes of endoscopy procedures performed with moderate sedation in obese patients.
Patients and methods This was a retrospective study of patients undergoing esophagogastroduodenoscopy (EGD) and/or colonoscopy with moderate sedation from July 17, 2017 to December 31, 2019. Demographics, comorbidities, outpatient medications and procedure-related outcomes (procedure time, recovery time, cardiopulmonary adverse events, 7-day post-procedure hospitalization, cecal intubation time, withdrawal time, tolerance of moderate sedation and sedation medications administered) were compared for patient with and without obesity after propensity score matching. Standard statistical methods were used for analysis.
Results A total of 7601 procedures were performed with moderate sedation for 5746 patients. Propensity score matching identified 1360 and 1740 pairs of EGDs and colonoscopies with moderate sedation for patients with and without obesity. Recovery time was found to be shorter for obese patients undergoing EGD (OR: 0.989, 95 % CI: 0.981–.998; P = 0.01). Obese patients did not differ from non-obese patients in any other procedure-related outcomes for EGDs or colonoscopies.
Conclusions Outcomes for endoscopy procedures performed with moderate sedation were noted to be similar between obese and non-obese patients. These findings suggest that moderate sedation can be used safely for endoscopic procedures in patients with obesity.
Severe acute ischemic colitis: What is the place of endoscopy in the management strategy?
Authors: Lorenzo Diane , Barthet Marc , Serrero Mélanie , Beyer Laura , Berdah Stéphane , Birnbaum David , Vitton Véronique , Gonzalez Jean Michel 
Published: November 2021

Abstract
Background and study aims Ischemic colitis (IC) is potentially lethal. Clinical and biology information and results of computed tomography (CT) scan and/or colonoscopy are used to assess its severity. However, decision-making about therapy remains a challenge.
Patients and methods This was a retrospective, single-center study between 2006 and 2015. Patients with severe IC who underwent endoscopic evaluation were included. The aims were to determine outcomes depending on endoscopic findings and assess the role of endoscopy in the management.
Results A total of 71 patients were included (men = 48 (68%), mean age = 71 ± 13 years). There was hemodynamic instability in 29 patients (41 %) and severity signs on CT scan in 18 (38 %). Twenty-nine patients (41 %) underwent surgery and 24 (34 %) died. The endoscopic grades were: 15 grade 1 (21 %), 32 grade 2 (45 %), and 24 grade 3 (34%). Regarding patients with grade 3 IC, 55 % had hemodynamic instability, 58 % had severity signs on CT scan, 68 % underwent surgery, and 55 % died. The decision to perform surgery was based on hemodynamic status in 62 % of cases, CT scan data in 14 %, endoscopic findings in 10 %, and other in 14 %. Colectomy was more frequent in patients with grade 3 IC (P < 0.05). A mismatch between mucosal aspect (necrosis) and serous (normal) was observed in 13 patients (46 %). Risk factors for colectomy in univariate analysis were aortic aneurysm surgery, hemodynamic instability, no colic enhancement on CT scan, and endoscopic grade 3. Risk factors for mortality in multivariate analysis were hemodynamic instability, colectomy, and Charlson score > 5 (P < 0.05).
Conclusions This study suggests a low impact of endoscopy on surgical decision making. Hemodynamic instability was the first indication for colectomy. A discrepancy between endoscopic mucosal (necrosis) and surgical serous (normal) aspects was frequently noted.
Cricopharyngeal peroral endoscopic myotomy improves oropharyngeal dysphagia in patients with Parkinson’s disease
Authors: Wu Peter I. , Szczesniak Michal M. , Omari Taher , Lam Thomas Y. , Wong Marc , Maclean Julia , Ma Karen K. , Chan Anne Y. , Mok Vincent , Cook Ian J. , Cock Charles , Sung Joseph , Wu Justin , Chiu Philip W. 
Published: November 2021

Abstract
Background and study aims Oropharyngeal dysphagia (OPD) is prevalent in patients with Parkinson’s disease (PD). Upper esophageal sphincter (UES) dysfunction is an important pathophysiological factor for OPD in PD. The cricopharyngeus (CP) is the main component of UES. We assessed the preliminary efficacy of cricopharyngeal peroral endoscopic myotomy (C-POEM) as a treatment for dysphagia due to UES dysfunction in PD.
Patients and methods Consecutive dysphagic PD patients with UES dysfunction underwent C-POEM. Swallow metrics derived using high-resolution pharyngeal impedance manometry (HRPIM) including raised UES integrated relaxation pressure (IRP), raised hypopharyngeal intrabolus pressure (IBP), reduced UES opening caliber and relaxation time defined UES dysfunction. Sydney Swallow Questionnaire (SSQ) and Swallowing Quality of Life Questionnaire (SWAL-QOL) at before and 1 month after C-POEM measured symptomatic improvement in swallow function. HRPIM was repeated at 1-month follow-up.
Results C-POEM was performed without complications in all (n = 8) patients. At 1 month, there was an improvement in both the mean SSQ (from 621.5 to 341.8, mean difference –277.3, 95 %CI [–497.8, –56.7], P = 0.02) and SWAL-QOL (from 54.9 to 68.3, mean difference 9.1, 95 %CI [0.7, 17.5], P = 0.037) scores. Repeat HRPIM confirmed a decrease in both the mean UES IRP (13.7 mm Hg to 3.6 mm Hg, mean difference –10.1 mm Hg, 95 %CI [–16.3, –3.9], P = 0.007) and the mean hypopharyngeal IBP (23.5 mm Hg to 10.4 mm Hg, mean difference –11.3 mm Hg, 95 %CI [–17.2, –5.4], P = 0.003).
Conclusions In dysphagic PD patients with UES dysfunction, C-POEM is feasible and enhances UES relaxation and reduces sphincteric resistance to flow during the swallow, thereby improving dysphagia symptoms.
Endoscopic resection outcomes and predictors of failed en bloc endoscopic mucosal resection of colorectal polyps ≤ 20 mm among advanced endoscopy trainees
Authors: King William W. , Draganov Peter V. , Wang Andrew Y. , Uppal Dushant , Rumman Amir , Kumta Nikhil A. , DiMaio Christopher J. , Trindade Arvind J. , Sejpal Divyesh V. , D’Souza Lionel S. , Bucobo Juan C. , Gomez Victoria , Wallace Michael B. , Pohl Heiko , Yang Dennis 
Published: November 2021

Abstract
Background and study aims En bloc endoscopic mucosal resection (EMR) is preferred over piecemeal resection for polyps ≤ 20 mm. Data on colorectal EMR training are limited. We aimed to evaluate the en bloc EMR rate of polyps ≤ 20 mm among advanced endoscopy trainees and to identify predictors of failed en bloc EMR.
Methods This was a multicenter prospective study evaluating trainee performance in EMR during advanced endoscopy fellowship. A logistic regression model was used to identify the number of procedures and lesion cut-off size associated with an en bloc EMR rate of ≥ 80 %. Multivariate analysis was performed to identify predictors of failed en bloc EMR.
Results Six trainees from six centers performed 189 colorectal EMRs, of which 104 (55 %) were for polyps ≤ 20 mm. Of these, 57.7 % (60/104) were resected en bloc. Trainees with ≥ 30 EMRs (OR 6.80; 95 % CI: 2.80–16.50; P = 0.00001) and lesions ≤ 17 mm (OR 4.56;95 CI:1.23–16.88; P = 0.02) were more likely to be associated with an en bloc EMR rate of ≥ 80 %. Independent predictors of failed en bloc EMR on multivariate analysis included: larger polyp size (OR:6.83;95 % CI:2.55–18.4; P = 0.0001), right colon location (OR:7.15; 95 % CI:1.31–38.9; P = 0.02), increased procedural difficulty (OR 2.99; 95 % CI:1.13–7.91; P = 0.03), and having performed < 30 EMRs (OR: 4.87; 95 %CI: 1.05–22.61; P = 0.04).
Conclusions In this pilot study, we demonstrated that a relatively low proportion of trainees achieved en bloc EMR for polyps ≤ 20 mm and identified procedure volume and lesion size thresholds for successful en bloc EMR and independent predictors for failed en bloc resection. These preliminary results support the need for future efforts to define EMR procedure competence thresholds during training.
Bedeutung der Herzangst für den psychologischen
Betreuungsbedarf und die subjektive Erwerbsprognose – Hinweise aus der
stationären kardiologischen Rehabilitation
Authors: Eilerts Anna-Lisa , Schröer Sarah , Wissen Sarah , Mayer-Berger Wolfgang , Pieper Claudia 
Published: November 2021

Zusammenfassung
Hintergrund In der stationären kardiologischen Rehabilitation
werden Patienten idealerweise nach psychosozialen Risikofaktoren gescreent und
psychologisch betreut. Herzbezogene Ängste bei kardiologischen
Erkrankungen können die Lebensqualität erheblich
beeinträchtigen und sowohl die Prognose des Krankheitsverlaufs als auch
die soziale und berufliche Teilhabe beeinflussen. Aufgrund der Diskrepanz
zwischen der, in der Literatur berichteten, Prävalenz der Herzangst und
dem, durch die Patienten in der Klinik Roderbirken geäußerten
Bedarf an psychologischer Betreuung, vermuteten die Autoren, dass ein Teil der
Patienten diesen Bedarf nicht selbständig äußert. Ziel
der Studie war es, diese Patienten durch ein einfaches Screening-Instrument zu
identifizieren, um ihnen eine adäquate psychologische Betreuung
anzubieten und dadurch die Rehabilitationsziele, darunter den Erhalt der
Erwerbsfähigkeit, zu sichern.
Methode Die vorliegenden Daten wurden in einer monozentrischen
Querschnittsstudie in der Rehabilitationsklinik Roderbirken, Leichlingen, NRW,
erhoben. Die Patienten wurden einmalig mit einem standardisierten Fragebogen,
bestehend aus dem Herzangstfragebogen, der Hospital Anxiety and Depression Scale
und der Skala I des Screening-Instruments Beruf und Arbeit in der Rehabilitation
befragt. Soziodemographische und klinische Daten wurden aus dem Kliniksystem
ergänzt. Die Auswertung der Daten erfolgte mithilfe
deskriptiv-statistischer und regressionsanalytischer Verfahren. Ein Ethikvotum
liegt vor.
Ergebnisse Nach Bereinigung des Datensatzes konnten 507 Patienten in die
Analyse eingeschlossen werden (82,6% Männer, mittleres Alter
gesamt 54,4±7,1 Jahre). Von diesen meldeten 40,0% einen Bedarf
an psychologischer Betreuung an. Bei 15,7% aller Patienten lag eine
Herzangst nach dem Herzangstfragebogen vor, von denen wiederum 59,0%
einen Bedarf an psychologischer Betreuung anmeldeten. Es zeigte sich, dass
insbesondere Patienten mit diagnostizierten psychischen Erkrankungen
Betreuungsbedarf äußerten (57,6 vs. 0,7%;
p<0,05). Die subjektive Erwerbsprognose war mit Herzangst und mit der
Depressionssymptomatik nach Hospital Anxiety and Depression Scale assoziiert (je
p<0,001), des Weiteren mit der Ausbildung und dem beruflichen
Status.
Diskussion Die Ergebnisse der Selbstbeurteilungsfragebögen und die
Betrachtung sozioökonomischer sowie klinischer Patientencharakteristika
geben Hinweise auf ein Bedarfsprofil hinsichtlich des psychologischen
Betreuungsbedarfs und eine negative subjektive Erwerbsprognose.
Schlussfolgerung Ein Screening mit der Hospital Anxiety and Depression
Scale ist geeignet, um die Identifizierung nicht geäußerter
psychologischer Betreuungsbedarfe und damit die Zielerreichung der beruflichen
Reintegration in der kardiologischen Rehabilitation zu unterstützen.
Ultrasound and contrast-enhanced ultrasound (CEUS) in infective liver lesions
Authors: Chaubal Nitin , Thomsen Thomas , Kabaalioglu Adnan , Srivastava David , Rösch Stephanie Simone , Dietrich Christoph F. 
Published: November 2021

ZusammenfassungInfektiöse fokale Leberläsionen (FLL) treten in der klinischen Praxis häufig auf, wobei bakterielle Leberabszesse die Hälfte ausmachen. Eine genaue Diagnose der FLL ist für die Auswahl der am besten geeigneten Therapie und zur Vorbeugung von Komplikationen unerlässlich. Ziel der aktuellen Arbeit ist es, den Nutzen von Ultraschall und kontrastmittelverstärktem Ultraschall (CEUS) zur Erkennung und Charakterisierung infektiöser Leberläsionen zu beschreiben.