bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personalised high tibial osteotomy has mechanical safety equivalent to generic device in a case–control in silico clinical trial
Authors: MacLeod Alisdair R. , Peckham Nicholas , Serrancolí Gil , Rombach Ines , Hourigan Patrick , Mandalia Vipul I. , Toms Andrew D. , Fregly Benjamin J. , Gill Harinderjit S. 
Published: June 2021

Abstract
Background
Despite favourable outcomes relatively few surgeons offer high tibial osteotomy (HTO) as a treatment option for early knee osteoarthritis, mainly due to the difficulty of achieving planned correction and reported soft tissue irritation around the plate used to stablise the osteotomy. To compare the mechanical safety of a new personalised 3D printed high tibial osteotomy (HTO) device, created to overcome these issues, with an existing generic device, a case-control in silico virtual clinical trial was conducted.

Methods
Twenty-eight knee osteoarthritis patients underwent computed tomography (CT) scanning to create a virtual cohort; the cohort was duplicated to form two arms, Generic and Personalised, on which virtual HTO was performed. Finite element analysis was performed to calculate the stresses in the plates arising from simulated physiological activities at three healing stages. The odds ratio indicative of the relative risk of fatigue failure of the HTO plates between the personalised and generic arms was obtained from a multi-level logistic model.

Results
Here we show, at 12 weeks post-surgery, the odds ratio indicative of the relative risk of fatigue failure was 0.14 (95%CI 0.01 to 2.73, p = 0.20).

Conclusions
This novel (to the best of our knowledge) in silico trial, comparing the mechanical safety of a new personalised 3D printed high tibial osteotomy device with an existing generic device, shows that there is no increased risk of failure for the new personalised design compared to the existing generic commonly used device. Personalised high tibial osteotomy can overcome the main technical barriers for this type of surgery, our findings support the case for using this technology for treating early knee osteoarthritis.
Recent progress in the total synthesis of pyrrole-containing natural products (2011–2020)
Authors: Singh Nidhi , Singh Snigdha , Kohli Sahil , Singh Aarushi , Asiki Hannah , Rathee Garima , Chandra Ramesh , Anderson Edward A. 
Published: June 2021

This review discusses total syntheses of pyrrole-containing natural products over the last ten years, highlighting recent advances in the chemistry of pyrroles in the context of their innate reactivity, and their preparation in complex settings.
Caregivers' Experiences of Infant Feeding Problems: The Role of Self-Compassion and Stress Management
Authors: Mahurin-Smith Jamie , Beck Ann 
Published: June 2021

Introduction
Infant feeding problems are strongly associated with caregiver stress, which in turn is linked to poorer outcomes for children. Self-compassion is a modifiable trait strongly associated with improved mental health and greater resilience. The purpose of this study was to investigate the relationships among self-compassion, stress management practices, and caregiver stress in a sample of parents who identified feeding problems in their infants.

Method
Parents who identified feeding problems in their infants completed an online survey. They described the feeding problems, completed the Self-Compassion Scale and the Perceived Stress Scale, and detailed their stress management practices.

Results
Higher self-compassion was strongly associated with lower overall stress and more modestly associated with lower feeding-related distress. More severe feeding problems were significantly more stressful for caregivers. Participants reported a wide variety of stress management approaches.

Discussion
These findings indicate that higher self-compassion is associated with lower caregiver stress for parents whose infants experience feeding problems. Implications for service providers are reviewed.

Supplemental Material

https://doi.org/10.23641/asha.14831028
First Solar Orbiter observation of the Alfvénic slow wind and identification of its solar source
Authors: D’Amicis R. , Bruno R. , Panasenco O. , Telloni D. , Perrone D. , Marcucci M. F. , Woodham L. , Velli M. , De Marco R. , Jagarlamudi V. , Coco I. , Owen C. , Louarn P. , Livi S. , Horbury T. , André N. , Angelini V. , Evans V. , Fedorov A. , Genot V. , Lavraud B. , Matteini L. , Müller D. , O’Brien H. , Pezzi O. , Rouillard A. P. , Sorriso-Valvo L. , Tenerani A. , Verscharen D. , Zouganelis I. 
Published: June 2021

Context.Turbulence dominated by large-amplitude, nonlinear Alfvén-like fluctuations mainly propagating away from the Sun is ubiquitous in high-speed solar wind streams. Recent studies have demontrated that slow wind streams may also show strong Alfvénic signatures, especially in the inner heliosphere.Aims.The present study focuses on the characterisation of an Alfvénic slow solar wind interval observed by Solar Orbiter between 14 and 18 July 2020 at a heliocentric distance of 0.64 AU.Methods.Our analysis is based on plasma moments and magnetic field measurements from the Solar Wind Analyser (SWA) and Magnetometer (MAG) instruments, respectively. We compared the behaviour of different parameters to characterise the stream in terms of the Alfvénic content and magnetic properties. We also performed a spectral analysis to highlight spectral features and waves signature using power spectral density and magnetic helicity spectrograms, respectively. Moreover, we reconstruct the Solar Orbiter magnetic connectivity to the solar sources both via a ballistic and a potential field source surface (PFSS) model.Results.The Alfvénic slow wind stream described in this paper resembles, in many respects, a fast wind stream. Indeed, at large scales, the time series of the speed profile shows a compression region, a main portion of the stream, and a rarefaction region, characterised by different features. Moreover, before the rarefaction region, we pinpoint several structures at different scales recalling the spaghetti-like flux-tube texture of the interplanetary magnetic field. Finally, we identify the connections between Solar Orbiter in situ measurements, tracing them down to coronal streamer and pseudostreamer configurations.Conclusions.The characterisation of the Alfvénic slow wind stream observed by Solar Orbiter and the identification of its solar source are extremely important aspects for improving the understanding of future observations of the same solar wind regime, especially as solar activity is increasing toward a maximum, where a higher incidence of this solar wind regime is expected.
Status quo palliativmedizinischer Tageskliniken und Tageshospize in Deutschland: Ergebnisse einer gemischt-methodischen Studie
Authors: Apolinarski Beate , Herbst Franziska A. , Röwer Hanna A. A. , Schneider Nils , Stiel Stephanie 
Published: June 2021

ZusammenfassungZiel der Studie Der Bestand von Tageshospizen und palliativmedizinischen Tageskliniken in Deutschland soll erstmals systematisch erhoben und analysiert werden.Methodik In dieser gemischt-methodischen Studie wurden Einrichtungsleitungen in leitfadengestützten Interviews (06.–07.2020) und standardisierter Fragebogenerhebung (08.–10.2020) zu einrichtungsbezogenen Kriterien befragt. Interviewdaten wurden qualitativ inhaltsanalytisch, quantitative Daten deskriptiv ausgewertet.Ergebnisse Die Interviews (n = 7) liefern einen Überblick über Organisation und Versorgungsangebot hospizlich-palliativer Tageseinrichtungen. Von 28 standardisiert befragten Einrichtungen waren 13 bereits in Betrieb. Die zumeist an andere Versorger angebundenen Einrichtungen bieten in der Regel zwischen 2 und 8 Tagesplätze an.Schlussfolgerung Aufgrund der gezeigten Entstehungsdynamik scheint eine systematische Integration der neuen Strukturen in die bestehende Hospiz- und Palliativversorgung sinnvoll.
Evaluating the Green Credentials of Flow Chemistry towards Industrial Applications
Authors: Baumann Marcus , Smyth Megan , Moody Thomas S. , Wharry Scott 
Published: June 2021

AbstractContinuous flow chemistry is becoming an established technology platform that finds frequent application in industrial chemical manufacture with support and endorsements by the FDA for pharmaceuticals. Amongst the various advantages that are commonly cited for flow chemistry over batch processing, sustainability continues to require further advances and joint efforts by chemists and chemical engineers in both academia and industry. This short review highlights developments between 2015 and early 2021 that positively impact on the green credentials associated with flow chemistry, specifically when applied to the preparation of pharmaceuticals. An industrial perspective on current challenges is provided to whet discussion and stimulate further investment towards achieving greener modern synthetic technologies.1	Introduction2	Subject Areas and Relevant Case Studies3	Industrial Outlook on Future Sustainability Driven through	Continuous Manufacturing Approaches4	Conclusions and Outlook
Efficacy and Safety of Antifibrinolytic Drugs in Pediatric Surgery: A Systematic Review
Authors: Hovgesen Nadia Thrane , Larsen Julie Brogaard , Fenger-Eriksen Christian , Hansen Anne Kirkeby , Hvas Anne-Mette 
Published: June 2021

AbstractAntifibrinolytic drugs are used to reduce blood loss and subsequent transfusions during surgery and following trauma, but the optimal dosing regimen in the pediatric population is still unresolved. The aim of this systematic review was to evaluate efficacy and safety of antifibrinolytic drugs in pediatric surgery and trauma to determine the optimal dosing regimen. A literature search was performed in PubMed, Embase, Cochrane, and Web of Science on May 3, 2020. We included randomized controlled studies investigating the effect of tranexamic acid (TXA), aprotinin, and epsilon-aminocaproic acid, in terms of reducing blood loss, blood transfusions, reoperations, and rebleeds in pediatric patients aged 0 to 18 years undergoing cardiac surgery, noncardiac surgery, or trauma. Fifty randomized controlled trials (RCTs) were included; 28 RCTs investigated cardiac surgery and 22 investigated noncardiac surgery. No RCTs regarding trauma met the inclusion criteria. All antifibrinolytic drugs reduced postoperative blood loss and transfusions when used in pediatric surgery. The dosing regimen varied between studies, but similar effect sizes were found in terms of reduced blood loss regardless of the cumulative dose used. Few studies found adverse events, and no difference in incidence or type of adverse events was seen between the antifibrinolytic and the placebo group. In conclusion, use of antifibrinolytics is efficient and safe in children undergoing surgery. We propose TXA as the drug of choice based on its level of evidence and safety profile; we recommend a dosing regimen composed of a loading dose of 10 to 15 mg/kg prior to surgery followed by 1 to 5 mg/kg/h as continuous infusion throughout surgery.
New Classification of Gastric Varices: A Twenty-Year Experience
Authors: Singh Akash , Verma Nipun , Rathi Sahaj , Kumari Sunita , Chandel Shivani , Singh Virendra 
Published: June 2021

Abstract
Objectives Gastric varices (GV) have been classified by the Sarin classification for over two decades. However, a subset of these varices does not fit into this classification. We share our experience on GV in past 20 years and propose a modification.
Materials and Methods Consecutive patients with portal hypertension (PHT) posted for esophagogastroduodenoscopy were screened for GV between 1996 and 2016 at a tertiary-care hospital. GV were categorized as gastroesophageal varices (GOV1, GOV2) and isolated gastric varices (IGV1, IGV2) by Sarin’s classification. Patients with varices in esophagogastric region as well as distally in the stomach or duodenum, thus having efferent drainage into the superior as well as inferior vena cava simultaneously, remain unclassified and were coined as GOV3.
Statistical Analysis Descriptive data was represented as mean (standard deviation) or median (interquartile range) or number (percentage). Chi-squared test, t-test, and logistic regression were done to compare groups and identify outcomes of interest.
Results GV were recognized in 400 (11.5%) of 3,476 patients with PHT. Underlying disease was cirrhosis in 301 (75.2%), extrahepatic portal venous obstruction in 78 (19.5%), noncirrhotic portal fibrosis in 18 (4.5%) and Budd–Chiari syndrome in 3 (0.75%) patients with GV. GOV1, GOV2, IGV1, IGV2, and combined GOV1 with GOV2 were seen in 170 (42.5%), 154 (38.5%), 17 (4.3%), 5 (1.3%), and 12 (3.0%) patients; respectively. GOV3 were identified in 42 (10.5%) patients. Ninety-three patients with GV presented with gastrointestinal bleed and frequency of GOV2 was higher and GOV1 and GOV3 were lower among bleeders than non-bleeders.
Conclusions A significant proportion of patients with GV remain uncategorized by current classification among PHT patients. Addition of GOV3 in Sarin’s classification will make it more comprehensive, uniform, and reproducible for future studies.
Hypomyelination and Congenital Cataract: Clinical, Imaging, and Genetic Findings in Three Tunisian Families and Literature Review
Authors: Bouyacoub Yosra , Drissi Cyrine , Kraoua Ichraf , Chargui Mariem , Rebai Ibtihel , Chebil Ahmed , Klaa Hédia , Benrhouma Hanene , Hassen Aida , Gouider-Khouja Neziha , Abdelhak Sonia , Boespflug-Tanguy Odile , Youssef-Turki Ilhem Ben , Dorboz Imen 
Published: June 2021

AbstractHypomyelination and congenital cataract (HCC) is characterized by congenital cataract, progressive neurologic impairment, and diffuse myelin deficiency. This autosomal recessive disorder is caused by homozygous variant in the FAM126A gene. Five consanguineous Tunisian patients, belonging to three unrelated families, underwent routine blood tests, electroneuromyography, and magnetic resonance imaging of the brain. The direct sequencing of FAM126A exons was performed for the patients and their relatives. We summarized the 30 previously published HCC cases. All of our patients were carriers of a previously reported c.414 + 1G > T (IVS5 + 1G > T) variant, but the clinical spectrum was variable. Despite the absence of a phenotype–genotype correlation in HCC disease, screening of this splice site variant should be performed in family members at risk.
Iatrogenic Intracranial Hypotension after Surgery of Adolescent Idiopathic Scoliosis due to a Misplaced Screw within the Thoracic Thecal Sac
Authors: Heiler Ute , Pitzen Tobias , Ruf Michael 
Published: June 2021

AbstractWe present the case of a postoperative intracranial hypotension due to a misplaced intrathecal screw. Although typical symptoms such as orthostatic headache were present immediately after surgery, diagnosis was hidden until 20 years later, resulting in a disastrous clinical course.
Versatile Usage of the Modified Lateral Mass Screw as an Alternative to Cervical Pedicle Screw Fixation
Authors: Kim Moon-Kyu , Lee Jung-Jae , Cho Su-Hee , Kwak Dai-Soon 
Published: June 2021

AbstractObjective Posterior subaxial cervical screw fixation is commonly performed using the cervical pedicle screws (CPS) and lateral mass screws (LMS); however, their compatibility is low. Modified lateral mass screws (mLMS, also called paravertebral foramen screw) fixation was introduced as a salvage technique for LMS fixation and has features of both LMS and CPS techniques. In the present study, the use of mLMS as an alternative to CPS was analyzed based on clinical results.Methods Seventy-eight screws (38 CPSs and 40 mLMSs) were inserted into 12 patients. The misplacement of the screws was evaluated by computed tomography (CT). The failure of instrumentation and instability were evaluated using plain radiographs.Results The total number of CPS misplacements was 3 (10.5%); however, neurologic complications were not observed. mLMSs were used in the middle segments of the fusion in 10 patients and 2 patients had mLMS fixation for single-level fusion. An additional bridging implant was not required for connecting both CPSs and mLMSs. Instability was not observed during the observation period (4–51 months). Complete fusion was seen in 10 patients.Conclusions The alternative mLMS fixation can decrease the risk of screw misplacement compared with CPS fixation alone and achieves adequate stability leading to fusion.
Role of Covering Ileostomy in Causation of Anastomotic Strictures in Low Anterior Resections for Rectum Carcinoma
Authors: Khan Mudassir Ahmad , Wani Rauf A. , Mehraj Asif , Baba Arshad , Laway Mushtaq , Chowdri Nisar A. , Parray Fazl Q. 
Published: June 2021

Abstract
Background Colorectal resection anastomosis is the commonest cause of rectal strictures. Anastomotic site ischemia, incomplete doughnuts from stapled anastomosis and pelvic infection, are some of the risk factors that play a role in the development of postoperative rectal strictures. However, the role of diverting stoma in the development of rectal strictures has not been studied extensively.
Objectives To study the difference in the occurrence of anastomotic strictures (AS) in patients submitted to low anterior resection (LAR) with covering ileostomy (CI), and to LAR without CI for carcinoma rectum.
Methods This was a prospective, comparative case control study carried out at a tertiary care referral center. Low anterior resection with covering ileostomy was performed in patients with rectum carcinoma in the study group, while LAR without covering ileostomy was performed in the control group. The study group had 29 patients, while the control group had 33 patients with rectum carcinoma.
Results During the mean follow-up period of 9.1months, 8 (28%) patients in the study group and 2 (6%) patients in the control group developed AS (p =0.019). Out of these 8 patients with AS in the study group, 50% had Grade-I AS, 25% had Grade-II AS, while 25% of the patients had Grade-III (severe) AS. However, both patients who developed AS in the control group had a mild type (Grade I) of AS.
Conclusion Covering ileostomy increases the chances of AS formation after LAR for rectum carcinoma. Also, the SKIMS Clinical Grading of Rectal Strictures is a simple and handy tool available for every surgeon to grade, classify and monitor the postoperative rectal strictures.
Peristomal Dermatitis: Treatment with Green Banana Peel (Musa sapientum) Powder
Authors: da Silva Ana Cristina , Simões Isabella Stephanie , Salomé Geraldo Magela , Atzingen Dênia Amélia Novato Castelli von , Mendonça Adriana Rodrigues dos Anjos 
Published: June 2021

Abstract
Objective To develop green banana peel (Musa sapientum) powder for the treatment of peristomal dermatitis, and to evaluate its effectiveness and healing time.
Methods A clinical, analytical and longitudinal study. In total, 44 volunteers of both genders, aged > 18 years, with intestinal ostomy, who presented peristomal dermatitis, participated in the research. The sample was divided into two groups: the study group used a powder containing 10% of green banana peel, and the control group used ostomy powder. The research was approved by the Ethics in Research Committees (Comitês de Ética em Pesquisa, CEP, in Portuguese) under opinion n° 2.381.904.
Results The healing time of the study group was shorter than that of the control group (p = 0.022). To analyze the results, we used the two-sample t-test (mean days until healing for both study groups).
Conclusion The powder containing 10% of green banana peel was developed, and effective healing of the peristomal dermatitis was observed. Compared to the ostomy powder, it presented a shorter healing time.
Ovarian Metastasis from Colorectal Adenocarcinoma
Authors: Fillmann Lúcio Sarubbi , Fillmann Henrique Sarubbi , Fillmann Laura Pinho , Tubiana Ana Paula Reginatto , Ribeiro Raquel , Coelho Mariana 
Published: June 2021

Abstract
Introduction Ovarian metastases of gastrointestinal origin, also called Krukenberg tumors, have a guarded prognosis. Physicians need to look for alternatives in diagnosis and treatment for this clinical condition in order to improve the outcome of the patients.
Objectives To report the experience of the authors in the treatment of these patients, and to perform a review of the literature on the epidemiology, clinical presentation, diagnosis, treatment, and prognosis for ovarian metastases from colorectal cancer.
Methods We collected clinical information regarding the patients treated for ovarian metastasis from colorectal adenocarcinoma at our coloproctology service, and performed a search on the PubMed database using the terms colorectal cancer, ovarian metastasis, Krukenberg tumor and surgery.
Conclusion Large abdominal tumors are the most frequent presentation of ovarian metastasis from colorectal cancer. The diagnosis is based on a histopathological analysis, levels of carcinoembryonic antigen (CEA) and cancer antigen 125 (CA-125), and immunohistochemical studies for the cytokeratin 20 (CK20), caudal-type homeobox 2 (CDX2) and vilina markers. Citoreductive surgical procedures are the most promising approach to treatment, with the highest impact on overall survival. The prognosis is negatively influenced by the extent of the metastasis, by citoreductive surgical procedures with persistence of macro- or microscopic foci of the disease, and by low scores on the general well-being index of the patient.
Obstructive Jaundice Following Transarterial Chemoembolization for Hepatocellular Carcinoma with Bile Duct Invasion
Authors: Matsushita Kazuki , Kageyama Ken , Kameda Natsuhiko , Koizumi Yurina , Yamamoto Akira 
Published: June 2021

AbstractHepatocellular carcinoma (HCC) with bile duct invasion is considered rare. A case in which a fragment of intraductal tumor dropped into the common bile duct after transarterial chemoembolization (TACE) and caused abdominal pain, and obstructive jaundice secondary to biliary obstruction is presented. This case was successfully managed by emergent endoscopic sphincterotomy. Physicians should recognize one of the complications due to TACE for HCC with intraductal tumor invasion.
Management of Neurological Emergencies in Children: An Updated Overview
Authors: Mastrangelo Mario , Baglioni Valentina 
Published: June 2021

AbstractNeurological emergencies account for about one-third of the highest severity codes attributed in emergency pediatric departments. About 75% of children with acute neurological symptoms presents with seizures, headache, or other paroxysmal events. Life-threatening conditions involve a minor proportion of patients (e.g., less than 15% of children with headache and less than 5% of children with febrile seizures). This review highlights updated insights about clinical features, diagnostic workup, and therapeutic management of pediatric neurological emergencies. Particularly, details will be provided about the most recent insights about headache, febrile seizures, status epilepticus, altered levels of consciousness, acute motor impairment, acute movement disorders, and functional disorders, as well as the role of diagnostic tools (e.g., neuroimaging, lumbar puncture, and electroencephalography), in the emergency setting. Moreover, the impact of the current novel coronavirus disease2019 (COVID-19) pandemic on the evaluation of pediatric neurologic emergencies will also be analyzed.