bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends and associated maternal characteristics of antidiabetic medication use among pregnant women in South Korea
Authors: Noh Yunha , Choe Seung-Ah , Shin Ju-Young 
Published: February 2021

AbstractThe prevalence of diabetes during pregnancy and the need for the treatment are increasing. We aimed to investigate antidiabetic medications (ADM) use among pregnant women and their characteristics. Using Korea’s nationwide healthcare database, we included women aged 15–49 years with births during 2004–2013. The prevalence and secular trend of ADM use were assessed in 3 periods: pre-conception period, first trimester, and second/third trimesters. To compare maternal characteristics between pregnancies with and without ADM prescription, we used the χ2 or Fisher’s exact test and Cochran-Armitage trend test. The prescription patterns analyzed by calendar year, age, insurance type, income, area, and medical institution. Of 81,559 pregnancies, 222 (0.27%) and 305 (0.37%) were exposed ADM during pre-conception and pregnancy periods, respectively. ADM prescriptions increased significantly by an 11.3-fold in second/third trimesters, while a 2.9-fold in first trimester. ADM use is more prevalent in women aged older and living in urban areas. Metformin was most used in the pre-conception period, while insulins were most during pregnancy. About 0.4% of women received ADM during pregnancy; a rate was lower than that in western countries. Non-recommended medications were more common in first trimester, which warrants pregnancy screening for women taking ADM.
New Single‐Switch quadratic boost DC/DC converter with Low voltage stress for renewable energy applications
Authors: Hasanpour Sara , Siwakoti Yam , Blaabjerg Frede 
Published: February 2021

In this paper, a novel non‐isolated Single‐Switch Quadratic Boost Coupled‐Inductor (SSQBCI) DC/DC converter with continuous input current and low voltage stress on the switching component is presented. The suggested structure is based on the traditional quadratic boost converter. In this new topology, to achieve an ultra‐high voltage gain without large duty cycle, a Coupled‐Inductor (CI) along with a Voltage Multiplier (VM) are employed. The magnetic energy stored in the leakage inductor of the CI is recycled by a regenerative passive clamp capacitor that is connected with the switch in parallel, which helps to limit the maximum voltage across the switch. Therefore, to reduce the switch conduction loss and improve the efficiency, a switch with the low static drain‐to‐source ON‐resistance can be used. Moreover, the low voltage stress on the output side diode alleviates the reverse recovery loss. The steady‐state operating principle, comparisons with other related topologies and also design considerations in Continuous Conduction Mode (CCM) will be analyzed in detail. Finally, the performance of the proposed SSQBCI is verified by experimental results using a prototype with 30V input and 200V ‐ 160 W output operation at a constant switching frequency 50 kHz.
Step-clipping method can improve the detectability of the target lesion in colonic diverticular bleeding
Authors: Aoyama Taiki , Takemoto Hiroki , Takeuchi Yukari , Shigita Kenjiro , Asayama Naoki , Fukumoto Akira , Mukai Shinichi , Nagata Shinji 
Published: February 2021

Abstract
Background and study aims Despite the information regarding extravasation from contrast-enhanced computed tomography (CECT), the detectability of the target diverticulum by colonoscopy remains unsatisfactory in colonic diverticular bleeding (CDB). The lack of common signs recognizable on CT and endoscopic images makes it difficult to set a region of interest; however, this can be overcome with the “step-clipping” method, a strategic marking technique for revealing the target. We aimed to investigate the clinical performance of the step-clipping method in patients with CDB.
Patients and methods Eighty-seven patients diagnosed with CDB with extravasation using CECT who underwent colonoscopy between August 2007 and February 2020 were included. Patients were divided into two categories: the traditional group (those who underwent colonoscopy from August 2007 to May 2017, n = 54) and the step-clipping group (those who underwent colonoscopy from June 2017 to February 2020, n = 33).
Results The detection rate for the responsible diverticulum was significantly higher in the step-clipping group than in the traditional group (94 % vs 63 %; P = .0013). The step-clipping group had a shorter average search time during colonoscopy (9.6 vs 40.5 minutes; P < .0001) and lower re-bleeding rate after the initial colonoscopy (6 % vs 26 %; P = .02) than the traditional group, which facilitated earlier hospital discharge (5.4 vs 6.8 days; P = .027).
Conclusions Colonoscopy using the step-clipping method can improve the detectability of the target lesion within a shorter time, thus leading to lower re-bleeding rates and earlier hospital discharge.
Erfolgreiche Lösungen für Arthrose, Schmerz und Muskeln
Authors: Mosetter Kurt 
Published: February 2021

ZusammenfassungArthrose und Osteoporose sind keine degenerativen Prozesse, sondern eine Reaktion des Körpers auf zu geringe und falsche Belastungen („form follows function“). Schmerzen machen sich meist erst nach langer Zeit in der neuromuskulären Dekompensation bemerkbar. Gelenkentzündungen entstehen nicht von selbst, sondern meist gehen Magen-Darm-Beschwerden verschiedenster Formen voraus. Langlebigkeit und Remodeling der Knochen werden durch den Stoffwechsel sowie einen stabilen Hormonhaushalt koordiniert und erhalten. Mineralstoffe, D + Galaktose in Kombination mit Glukosamin und Omega-3-Fettsäuren sind wichtige Parameter einer erhaltenden Knochennahrung – denn nicht nur die Anspannung der Muskulatur beansprucht Energie, sondern ebenso die Entspannung. Diese Energie wird durch Glukose und Adenosintriphosphat bereitgestellt. Allerdings führt der Verbrauch von Adenosintriphosphat zur Entstehung von Ammoniak, was leistungsmindernd und toxisch wirkt. Daher gilt: Für gute knöcherne Strukturen ist eine stabile Energiebilanz erforderlich.
Naturheilkundliche Ansätze bei Gonarthrose
Authors: von Busch Beate , Langhorst Jost 
Published: February 2021

ZusammenfassungFür die Behandlung der Gonarthrose steht im Klinikum am Bruderwald in Bamberg in der Abteilung für Integrative Medizin und Naturheilkunde ein multimodales Behandlungskonzept zur Verfügung, das im Wesentlichen aus den sieben Komponenten Ernährungstherapie, Bewegungstherapie, Hydrotherapie, Phytotherapie, Neuraltherapie, Akupunktur und Blutegeltherapie besteht. Ziel aller Maßnahmen ist eine Reduktion der proinflammatorischen Mediatoren in der Kniegelenksflüssigkeit, die eine Schmerzreaktion, eine Destruktion des Gelenkknorpels und eine Einschränkung der Beweglichkeit verursachen. Selbst schwere radiologische Verlaufsformen können mit den geschilderten Methoden erfolgreich therapiert werden. Gleichzeitig wird den Patienten durch selbstwirksames Handeln ein aktiver Umgang mit ihrer Erkrankung ermöglicht. Ein Zugewinn an Lebensqualität ist in vielen Fällen noch Monate nach den Interventionen nachweisbar.
Thrombotic Thrombocytopenic Purpura: When Basic Science Meets Clinical Research
Authors: Bécel Gaëlle , Faict Sylvia , Picod Adrien , Bouzid Raïda , Veyradier Agnès , Coppo Paul 
Published: February 2021

AbstractThe therapeutic landscape of thrombotic thrombocytopenic purpura (TTP) is rapidly changing with the recent availability of new targeted therapies. This progressive shift from empiricism to pathophysiology-based treatments reflects an intensive interaction between the continuous findings in the field of basic science and an efficient collaborative clinical research and represents a convincing example of the strength of translational medicine. Despite the rarity of TTP, national and international efforts could circumvent this limitation and shed light on the epidemiology, clinical presentation, prognosis, and long-term outcome of this disease. Importantly, they also provided high-quality results and practice changing studies for the benefit of patients. We report here the most recent therapeutic findings that allowed progressively improving the prognostic of TTP, both at the acute phase and through long-term outcome.
Endoscopic ‘suction room’ to treat complex enteral stump leaks after upper gastrointestinal surgery
Authors: Mutignani Massimiliano , Dioscoridi Lorenzo , Venezia Ludovica , Larghi Alberto , Pugliese Francesco , Cintolo Marcello , Bonato Giulia , Forti Edoardo 
Published: February 2021

AbstractLeaks/dehiscence of the enteral stump associated with infected peri-enteric collections after upper gastrointestinal surgery are a life-threatening adverse event, not usually endoscopically treatable.We describe a new endoscopic approach to treat complex entero-cutaneous fistulas (CECF) by creating a “suction room” through placement of multiple stents (enteral, biliary and/or pancreatic) and a large nose-enteral suction tube inside the enteral stent maintained on a continuous negative aspiration suction.Between January 2016 and December 2019, six consecutive patients referred to our unit with CECF of the enteral stump after failed redo surgeries underwent creation of a “suction room.” In five patients, enteral, biliary and pancreatic stents were positioned before a nose-to-stent or nose-to-collection large 18 Fr tube placement. In one patient, a pancreatic stent was not placed. Technical and clinical success were achieved in all patients. Mean and median times of aspiration were 49 and 27 days, respectively, with a mean hospital stay of 56 days after the endoscopic procedure. Stents were successfully removed. Mean post-procedural follow-up was 17.3 months.Endoscopic creation of the “suction room” offers the unique possibility of treating complex entero-cutaneous fistulas in surgically altered sites, which are difficult to manage with standard endoscopic methods.
Clinical evaluation of physician-controlled guidewire manipulation during endoscopic ultrasound-guided hepaticogastrostomy (with video)
Authors: Nishiguchi Kyohei , Ogura Takeshi , Nishioka Nobu , Ueno Saori , Okuda Atsushi , Yamada Tadahiro , Yamada Masanori , Ueshima Kazuya , Higuchi Kazuhide 
Published: February 2021

Abstract
Background and study aims Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) may be most complex because of the EUS-guided biliary drainage procedure and variations in the course of the intrahepatic bile duct compared with the common bile duct (CBD). Appropriate guidewire insertion is essential. Physician-controlled guidewire manipulation (PCGW) might improve technical success rates of bile duct cannulation. The present study aimed to determine the technical feasibility and safety of PCGW during EUS-HGS.
Patients and methods A total of 122 consecutive patients who were scheduled to undergo EUS-HGS between October 2017 and April 2019 were prospectively registered. The primary endpoint was the technical success rate of guidewire insertion into the CBD or hepatic hilum. Guidewire insertion was considered to have failed if the HGS assistant failed to achieve manipulation.
Results The intrahepatic bile duct was successfully punctured in 120 of 122 patients. During guidewire insertion by the HGS assistant, guidewire fracture was observed in one patient. The guidewire was successfully inserted into the biliary tract and manipulated by the HGS assistant in 96 patients. PCGW was thus attempted for the remaining 23 patients. The guidewire was inserted by PCGW in all 23 patients, improving the technical success rate for guidewire insertion from 80 % to 100 %. After tract dilation, we deployed covered metal stents and plastic stents in 117 and two patients, respectively. The overall technical success rate for EUS-HGS was 97.5 % (119/122). Adverse events comprising bile peritonitis or leakage developed in five patients.
Conclusion PCGW might contribute to improving the success rate of EUS-HGS.
Prevalence of and risk factors for stent migration-induced duodenal perforation
Authors: Stassen Pauline M.C. , de Jong David M. , Poley Jan-Werner , Bruno Marco J. , de Jonge Pieter J.F. 
Published: February 2021

AbstractBackground and study aims The safety of transpapillary biliary drainage by stent placement through endoscopic retrograde cholangiography (ERC) may be compromised by the occurrence of stent migration-induced perforation of the duodenal wall (SMDP). We aimed to assess the prevalence rate, risk factors and clinical course of SMDP.Patients and methods This retrospective cohort study included all patients who underwent an ERC with biliary plastic stent placement, between January 2014 and December 2018. Patients with an SMDP were identified from our endoscopy complication registry.Results 1227 patients underwent an ERC, of whom 629 patients (51 %) with biliary plastic stent placement; in 304 patients (25 %) stents were placed for perihilar strictures. Thirteen patients with SMDP were identified. The prevalence was 2.1 % for patients with biliary plastic stent placement and 4.3 % for patients stented for a perihilar stricture. All SMDPs occurred in patients with a perihilar stricture and with stents ≥ 12 cm (range 12–20 cm). Another potential risk factor was stent insertion into the left liver lobe, which was present in 10 of 13 patients. In 10 of 13 patients, SMDP was clinically suspected. Three of 13 patients were asymptomatic and diagnosed at elective stent retrieval. Eight patients could be endoscopically treated with an over-the-scope clip. Four patients died due to abdominal sepsis despite repeated interventions.Conclusion SMDP is a rare but potentially life-threatening complication of ERC after transpapillary drainage for perihilar biliary strictures. Stents ≥ 12 cm and stent insertion into the left liver lobe may be associated risk factors.
Antivirale Eigenschaften des Extrakts aus Cistus × incanus L. Pandalis bei SARS-CoV-2 in vitro nachgewiesen
Authors: Träder Jens-Martin 
Published: February 2021

ZusammenfassungDa es noch keine zuverlässige Therapie gegen SARS-CoV-2 gibt, konzentriert sich die Forschung darauf, vielversprechende Substanzen zu finden, die bereits verfügbar sind. In dieser Studie soll untersucht werden, ob das pflanzliche Präparat Cystus Pandalis® in vitro antivirale Eigenschaften gegen SARS-CoV-2 aufweist, da es sich bereits gegen mehrere andere Viren als wirksam erwiesen hat. Am Fraunhofer Institut für Zelltherapie und Immunologie (IZI) wurden Zellkulturen unter Anwendung des Extrakts mit SARS-CoV-2 infiziert. Die Reduktion des Viruswachstums wurde durch den Vergleich von fokusbildenden Einheiten bewertet. Eine fast vollständige Hemmung des Viruswachstums durch den Extrakt wurde bei Konzentrationen von mehr als 15,6 µg/ml mit einer berechneten EC50 (mittlere effektive Konzentration) von 1,94 µg/ml beobachtet. Der Mechanismus dieses Extrakts beruht wahrscheinlich auf einer Wirkung der hochpolymeren Polyphenole. Man vermutet, dass der Extrakt bestimmte virale Strukturen umhüllt, wodurch diese Substanz als Eintrittsinhibitor wirkt. Aufgrund der hohen In-vitro-Aktivität erscheint es sinnvoll, den Extrakt als Prophylaxe gegen Infektionen mit SARS-CoV-2 einzusetzen.
Olfactory Performance among Hospital Residents
Authors: Rezende Gustavo Lara , Sarmet Max , Sousa Gabrielle Everton , Krier Felipe Carneiro , Parreira Diderot Rodrigues , Kuckelhaus Selma Aparecida 
Published: February 2021

Abstract
Introduction Smell plays an important role in the maintenance of health and quality of life of the general population. Health workers with olfactory impairment may not be able to help diagnose certain diseases, and subsequently increase the risk of hazardous events and mortality among those affected. ‘Odor learning’ requires repeated experiences with different smells to develop a discriminatory ability, and this is a process that takes years. Because of that, physicians of certain medical specialities have better odor detection than others.
Objective To study the olfactory performance and associated factors of otorhinolaryngology residents compared with residents of different medical specialities in a representative sample of a tertiary hospital.
Methods The University of Pennsylvania Smell Identification Test (UPSIT) was used to compare olfactory performance. Clinical and epidemiological data were collected among 42 hospital residents.
Results Otorhinolaryngology residents presented an average UPSIT score of 35.0, and the other residents, a score of 32.8 (p = 0.02) Of all the residents, 40.5% showed some grade of olfactory impairment. Half of the females students in the first year of residency showed olfactory dysfunction. The multivariate analyses found age (p = 0.03; 95% confidence interval for β = 0.33) to be an independent predictor of the UPSIT score.
Conclusion The present study demonstrated that otorhinolaryngology residents have greater olfactory capacity compared with other residents. Future studies should explore the relevant factors of olfactory impairment and its impact on quality of life in this population.
Análise de elementos finitos de um dispositivo de dinamização controlada para fixação circular externa
Authors: Faria Fernando Ferraz , Gruhl Carlos Eduardo Miers , Ferro Rafaela Rebonato , Rached Rodrigo Nunes , Soni Jamil Faissal , Trevilatto Paula 
Published: February 2021

Resumo
Objetivo Construir um protótipo virtual de um dispositivo de fixação circular externa para fraturas em ossos longos com dinamização controlada a partir de dois materiais diferentes e prever seu comportamento mecânico por meio da análise de elementos finitos AEF).
Método Modelos tridimensionais compostos de duas peças metálicas unidas por uma junta deslizante em rabo de andorinha e um amortecedor de silicone de alta densidade foram criados em um software. Análises de elementos finitos distintas foram simuladas considerando dois materiais (aço inoxidável ou titânio), modos (bloqueado ou dinamizado) e condições de carregamento (estático/pontual ou dinâmico/0,5 segundo) diferentes com carga axial uniforme de 150 kg na porção superior do dispositivo.
Resultados O modelo de elementos finitos (EFs) apresentou 81.872 nós e 45.922 elementos. Com aço inoxidável, o pico de tensão máxima (140,98 MPa) foi alcançado com o dispositivo bloqueado e sob carga estática, enquanto o maior deslocamento (2.415 × 10−3 mm) foi obtido com o dispositivo bloqueado e sob carga dinâmica. Com titânio, o pico de tensão máxima (141,45 MPa) ocorreu com o dispositivo bloqueado e sob carga estática, enquanto o maior deslocamento (3.975 × 10−3 mm) foi observado com o dispositivo bloqueado e sob carga dinâmica.
Conclusão O protótipo do dispositivo desempenhou o papel de suporte de tensão com deformação aceitável nos dois modos, bloqueado ou dinamizado, e pode ser fabricado com aço inoxidável ou titânio.
“Wings of a Butterfly” Technique in Modified Bentall's Procedure
Authors: Lee Seok In , Choi Chang Hyu , Park Kook Yang , Park Chul-Hyun 
Published: February 2021

AbstractMany surgeons have modified the technique to reduce bleeding from anastomosis line since Bentall and De Bono introduced aortic root replacement using a composite graft. We present a new composite, butterfly wing–shaped, valve graft fixated using hand-made double sewing cuff. The “wings of a butterfly” technique is a method of reinforcement suturing between an added sewing cuff and residual aortic wall at the proximal stump and helps to reduce bleeding after the modified Bentall's procedure.
Managing Status Epilepticus in a Child with Dravet Syndrome: How Difficult It Could Be?
Authors: Badv Reza Shervin , Ghamari Azin , Ashrafi Mahmoud Reza , Mohammadi Mahmoud , Azizi Malamiri Reza , Heidari Morteza 
Published: February 2021

AbstractPreviously known as severe myoclonic epilepsy of infancy, Dravet syndrome is characterized by febrile or afebrile prolonged hemiconvulsive seizures or generalized status epilepticus in an infant with previously normal development. Immediate management of status epilepticus is critical in these patients. Early control of status epilepticus prevents further brain damage; however, there is no consensus regarding the management of status epilepticus in children with Dravet syndrome, as many conventional antiseizure medications that are recommended in the management of status epilepticus worsen the seizures in these patients. A 2.5-year-old girl child patient was referred due to status epilepticus which was refractory to antiseizure medications. Sodium valproate, nitrazepam, ketogenic diet, intravenous phenytoin, and midazolam continuous infusion were administered. After controlling status epilepticus, the probable diagnosis of Dravet syndrome was proposed and confirmed by a mutation in SCN1A. As previously stated in numerous case reports, phenytoin worsens seizures in patients with Dravet syndrome. Therefore, it seems logical that in every infant with status epilepticus and probable Dravet syndrome, the practicing physician considers administering intravenous valproate or even midazolam continuous infusion instead of intravenous phenytoin.
CYP2D6 rs35742686 and rs3892097 Gene Polymorphisms and Childhood Acute Lymphoblastic Leukemia: Relation to Disease Susceptibility in Kashmiri Children
Authors: Shapoo Nidha Sadiq , Masood Akbar , Bhat Javid R. , Bhatia A. S. , Shah Idrees A. , Ganai Bashir A. 
Published: February 2021

AbstractCYP2D6 is one of the most widely investigated CYPs in relation to gene polymorphism. This study analyzed the relationship between CYP2D6 rs35742686 and rs3892097 single-nucleotide polymorphisms (SNPs) and potential risk factors in the development of acute lymphoblastic leukemia (ALL) in Kashmiri children. We recruited 300 cases and 600 controls for genotyping and risk factors assessment. Genotypes of rs35742686 and rs3892097 were analyzed by polymerase chain reaction-restriction fragment length polymorphism method. CYP2D6 expression analysis was done by quantitative reverse transcription polymerase chain reaction in ALL cases. Conditional logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI). High risk of ALL was observed in cases who carried the mutant genotypes of rs35742686 (OR = 18.15; 95% CI = 4.13–79.66, p < 0.0001) or rs3892097 (OR = 24.06; 95% CI = 10.23–56.53, p < 0.0001). Significant interaction was observed between rs35742686 and rs3892097 SNPs (P interaction = 0.001). The risk associated with the variant genotypes of rs35742686 and rs3892097 was retained in the cases whose fathers were smokers or had maternal X-ray exposure (p < 0.001). Relative messenger ribonucleic acid expression across genotypes was significantly decreased in cases carrying rs357426863 (*3/*3) (n-fold = 0.37 ± 0.156, p < 0.0079) and rs3892097 SNPs (*4/*4) (n-fold = 0.02 ± 0.0075, p < 0.0001) suggesting these two events are independent in ALL cases. The study concluded that rs35742686 and rs3892097 SNPs are significantly associated with ALL risk in Kashmiri children.