bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe aortic stenosis is associated with perioperative mortality in proximal femur fracture patients
Authors: Cronin Patrick K. , Olson Jeffrey J. , Harris Mitchel B. , Weaver Michael J. 
Published: March 2021

Abstract

Objectives:
Evaluate the correlation between aortic stenosis and perioperative mortality in patients following surgical fixation of proximal femur fractures.

Design:
Retrospectively reviewed case series.

Setting:
Two Academic, Level 1 Trauma Centers.

Patients/Participants:
One hundred fifty-eight patients, definitively diagnosed with aortic stenosis by means of echocardiogram, who underwent surgical fixation for an isolated proximal femur fracture (OTA/AO 31-A, 31-B, 32-A, 32-B, and 32-C fractures) between January 2000 and June 2015. The severity of the aortic stenosis was based upon accepted echocardiographic hemodynamic parameters designated by the 2014 American Heart Association guidelines.

Main Outcome Measures:
Post Injury mortality, 30-day mortality, and 1-year mortality.

Secondary Outcome Measures:
Postoperative mortality stratified by severity of aortic stenosis based on aortic valve area (AVA) and ejection fracture (EF) as determined by preoperative echocardiography.

Results:
One hundred fifty-eight patients were available for final analysis. Kaplan–Meier survival analysis revealed a significantly longer time to mortality among Non-severe aortic stenosis patients compared to Severe aortic stenosis patients, P value .006. Twenty-three percent of patients with Severe aortic stenosis and 10% of patients with Non-severe aortic stenosis died within 30 days of surgery. No significant difference was observed in mean survival among AS patients who underwent surgery within 48 hours of injury (34.5 months) and those delayed more than 48 hours after injury (25.0 months), P value .116. Among the commonly measured hemodynamic parameters of aortic stenosis, only AVA and EF were significantly associated with mortality, P value .015, and P value < .001, respectively. There were no significant effects for Aortic Vmax, Peak ΔP, and Mean ΔP. An AVA of 0.8 cm2 or less is associated with a significantly shorter (22 months) postinjury mortality than patients with an AVA > 0.8 cm2. (37 months), P value .009.

Conclusions:
Severe aortic stenosis is associated with a shorter postoperative time to mortality after surgical fixation of hip fractures compared to patients with Non-severe stenosis. Aortic valve area and Ejection Fraction are the only hemodynamic parameters significantly associated with postoperative mortality.

Level of Evidence: Prognostic Level III
Comparison of reamed long and short intramedullary nail constructs in unstable intertrochanteric femur fractures
Authors: Blum Laura E. , Yee Michael A. , Mauffrey Cyril , Goulet James A. , Perdue Aaron M. , Hake Mark E. 
Published: March 2021

Abstract

Objectives:
There is no definitive evidence to guide clinicians in their decision-making for implant choice regarding long or short intramedullary nails for unstable fracture patterns. Historically short nails were associated with higher rates of perisprothetic fractures which seem to have improved with newer designs. Long intramedullary nails have higher blood loss and time under anesthesia. The purpose of this study was to assess stability of long and short intramedullary nail constructs in unstable intertrochanteric fracture patterns to better elucidate if unstable intertrochanteric fractures are amenable to treatment with short intramedullary nails.

Methods:
This study utilized composite model femurs which were assigned to either a comminuted or reverse obliquity fracture pattern, then subsequently assigned to implantation with either a long or short intramedullary nail. All the samples were reamed to the level of the distal femur and instrumented with the appropriate nail. Axial and torsional stiffness as well as axial load to failure values were determined using a servohydraulic loading system.

Results:
Short nail constructs exhibited significantly greater axial stiffness in A1 fractures and torsional stiffness in A3 fractures when compared with long nails. There was no significant difference between axial load to failure between long nails and short nails.

Discussion:
We found no significant difference in axial load to failure values between long and short intramedullary nail fixation in 2 unstable intertrochanteric fracture patterns in a composite femur model. Short nails exhibited greater stiffness in axial loads in the A1 pattern and torsional stiffness in the A3 pattern. This suggests short or long intramedullary nails could be appropriately employed for fixation of unstable intertrochanteric hip fracture patterns.
Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Survey of Medical Directors in the United States*
Authors: Ozment Caroline P. , Scott Briana L. , Bembea Melania M. , Spinella Philip C. ,   For the Pediatric ECMO (PediECMO) subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and the Extracorporeal Life Support Organization (ELSO)
Published: March 2021

OBJECTIVES:
To compare current practices within the United States of anticoagulation management and blood transfusion in neonatal and pediatric extracorporeal membrane oxygenation patients with a 2013 international report.

DESIGN:
Cross-sectional survey distributed between August and December 2019.

SETTING:
Extracorporeal Life Support Organization–registered neonatal and pediatric extracorporeal membrane oxygenation centers in the United States.

PARTICIPANTS:
Extracorporeal membrane oxygenation medical directors.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Eighty-three medical directors at 108 centers responded. After removing four duplicate responses, 79 surveys were analyzed. Seventy-nine percent (n = 62) report a written extracorporeal membrane oxygenation protocol for both anticoagulation and blood product management. Ninety-four percent (n = 74) report unfractionated heparin as their primary anticoagulant; the remaining use the direct thrombin inhibitor, bivalirudin. Ninety percent (n = 71) report measuring antifactor Xa levels. Most centers report using a combination of assays to monitor heparin therapy, either antifactor Xa and activated partial thromboplastin time (54%) or more commonly antifactor Xa and activated clotting time (68%). Forty-one percent use viscoelastic tests to aid management. Goal monitoring levels and interventions generated by out of range values are variable. Fifty-one percent will replace antithrombin. Platelet transfusion thresholds vary by age and center with ranges from 50,000 to 100,000 cells/µL. Eighty-two percent of respondents are willing to participate in a randomized controlled trial comparing anticoagulation strategies for patients receiving extracorporeal membrane oxygenation.

CONCLUSIONS:
Compared with the 2013 pediatric population, extracorporeal membrane oxygenation center anticoagulation and blood transfusion approaches continue to vary widely. Most report continued use of heparin as their primary anticoagulant and follow a combination of monitoring assays with the majority using the antifactor Xa assay in their practices, a significant shift from prior results. Antithrombin activity levels and viscoelastic tests are followed by a growing number of centers. Platelet transfusion thresholds continue to vary widely. Future research is needed to establish optimal anticoagulation and blood transfusion management.
Sensory bedside testing: a simple stratification approach for sensory phenotyping
Authors: Reimer Maren , Forstenpointner Julia , Hartmann Alina , Otto Jan Carl , Vollert Jan , Gierthmühlen Janne , Klein Thomas , Hüllemann Philipp , Baron Ralf 
Published: March 2021

Abstract

Introduction:
Stratification of patients according to the individual sensory phenotype has been suggested a promising method to identify responders for pain treatment. However, many state-of-the-art sensory testing procedures are expensive or time-consuming.

Objectives:
Therefore, this study aimed to present a selection of easy-to-use bedside devices.

Methods:
In total, 73 patients (39 m/34 f) and 20 controls (11 m/9 f) received a standardized laboratory quantitative sensory testing (QST) and a bedside-QST. In addition, 50 patients were tested by a group of nonexperienced investigators to address the impact of training. The sensitivity, specificity, and receiver-operating characteristics were analyzed for each bedside-QST parameter as compared to laboratory QST. Furthermore, the patients' individual sensory phenotype (ie, cluster) was determined using laboratory QST, to select bedside-QST parameters most indicative for a correct cluster allocation.

Results:
The bedside-QST parameters “loss of cold perception to 22°C metal,” “hypersensitivity towards 45°C metal,” “loss of tactile perception to Q-tip and 0.7 mm CMS hair,” as well as “the allodynia sum score” indicated good sensitivity and specificity (ie, ≳70%). Results of interrater variability indicated that training is necessary for individual parameters (ie, CMS 0.7). For the cluster assessment, the respective bedside quantitative sensory testing (QST) parameter combination indicated the following agreements as compared to laboratory QST stratification: excellent for “sensory loss” (area under the curve [AUC] = 0.91), good for “thermal hyperalgesia” (AUC = 0.83), and fair for “mechanical hyperalgesia” (AUC = 0.75).

Conclusion:
This study presents a selection of bedside parameters to identify the individual sensory phenotype as cost and time efficient as possible.
Facial Transplantation
Authors: Santanelli di Pompeo Fabio , Longo Benedetto , Giovanoli Pietro , Plock Jan Alexander , Campanale Antonella , Laporta Rosaria , Sorotos Michail , Paolini Guido , Renzi Luca , Nuccitelli Gloria , Stoppacciaro Antonella , Lagana Bruno , Pribaz Julian J. 
Published: March 2021

Background
The aim of this study was to report the first case of acute facial allograft transplantation (facial allograft transplantation) failure with allograft removal and autologous free-flap reconstruction.

Methods
A 49-year-old female patient affected by neurofibromatosis type 1 with a massive neurofibroma infiltrating the whole left hemiface was planned for FAT for the left hemiface including the auricle, all skin and soft tissues from the temporal region, periorbital and nasal region, and up to the perioral area. The maxillary process of the zygomatic bone, left hemimaxilla, and hemimandible from contralateral parasyphysis to the incisura mandibulae were also included.

Results
Total surgical time was 26 hours. There were 2 intraoperative arterial thromboses that were solved with new anastomoses and sufficient flap perfusion. On postoperative day 2, the allograft became pale with suspected arterial occlusion and the patient returned to the operative room for exploration no flow into the FAT was found. The allograft was removed and the recipient site reconstructed with a skin-grafted composite left latissimus dorsi-serratus anterior flap.

Conclusions
Hyperacute loss of FAT is a very dramatic event, and the activation of a backup surgical plan is crucial to save patient's life, give a reasonable temporary reconstruction, and return on the waiting-list for a second face transplantation.
Fracture dynamics of solid materials: from particles to the globe
Authors: Uenishi Koji 
Published: March 2021

Solid materials have been used extensively for various kinds of structural components in our surroundings. Stability of such solid structures, including not only machinery, architectural and civil structures but also our solid earth, is largely governed by fracture development in the solids. Especially, dynamic fracture, once occurring—quite often unexpectedly—evolves very rapidly and can lead to catastrophic structural failures and disasters like earthquakes. However, contrary to slowly enlarging fractures that can be recognized spatio-temporally in detail, it is extremely difficult to trace dynamically growing fractures even in controlled laboratory experimental conditions, and its physics still remains unexplored. This theme issue introduces and summarizes recent advancements in our understanding of the widespread topics of dynamic fracture of solids from well-assorted perspectives, involving laboratory experiments, simulations and analytical methods as well as field observations, with the common background of mechanics of fracture. Multi-scale subjects range from fracture of metals at atom or particle levels to disastrous rock bursts in deep gold mines and detection of unique signals before devastating fracture such as large, global-scale earthquakes.This article is part of the theme issue ‘Fracture dynamics of solid materials: from particles to the globe'.
Cascadia megathrust earthquake rupture model constrained by geodetic fault locking
Authors: Li Duo , Liu Yajing 
Published: March 2021

Paleo-earthquakes along the Cascadia subduction zone inferred from offshore sediments and Japan coastal tsunami deposits approximated to M9+ and ruptured the entire margin. However, due to the lack of modern megathrust earthquake records and general quiescence of subduction fault seismicity, the potential megathrust rupture scenario and influence of downdip limit of the seismogenic zone are still obscure. In this study, we present a numerical simulation of Cascadia subduction zone earthquake sequences in the laboratory-derived rate-and-state friction framework to investigate the potential influence of the geodetic fault locking on the megathrust sequences. We consider the rate-state friction stability parameter constrained by geodetic fault locking models derived from decadal GPS records, tidal gauge and levelling-derived uplift rate data along the Cascadia margin. We incorporate historical coseismic subsidence inferred from coastal marine sediments to validate our coseismic rupture scenarios. Earthquake rupture pattern is strongly controlled by the downdip width of the seismogenic, velocity-weakening zone and by the earthquake nucleation zone size. In our model, along-strike heterogeneous characteristic slip distance is required to generate margin-wide ruptures that result in reasonable agreement between the synthetic and observed coastal subsidence for the AD 1700 Cascadia Mw∼9.0 megathrust rupture. Our results suggest the geodetically inferred fault locking model can provide a useful constraint on earthquake rupture scenarios in subduction zones.This article is part of the theme issue ‘Fracture dynamics of solid materials: from particles to the globe’.
Pre-P gravity signals from dynamic earthquake rupture: modelling and observations
Authors: Kame Nobuki 
Published: March 2021

Dynamic earthquake rupture is one of the most extensive and devastating fracture phenomena on the Earth. It causes a sudden crustal deformation around a fault and generates seismic waves that induce bulk density variations propagating with them. Both processes constitute rock-mass redistribution, which is expected to induce simultaneous transient gravity perturbations at all distances before the arrival of P-waves. Interest in such pre-P gravity signals has increased both in terms of modelling and observations because of their potential for earthquake early warning. A simple forward model has pioneered the search for the so-called prompt elasto-gravity signals, which led to the first report of a signal from the 2011 Mw9.0 Tohoku-Oki earthquake using a single superconducting gravimeter record. The second report followed using hundreds of broadband seismometers with critical modification of the previous model to consider the pre-P ground acceleration in the measurement of gravity. Post-event analyses have identified prompt elasto-gravity signals from several large earthquakes, and state-of-the-art instruments are now being developed for real-time signal detection. This paper reviews recent progress in the cutting-edge subject of prompt elasto-gravity signals owing to large-scale earthquake rupture.This article is part of the theme issue ‘Fracture dynamics of solid materials: from particles to the globe’.
Dissolved oxygen minimally affects magnetic susceptibility in biologically relevant conditions
Authors: Fortier Véronique , Levesque Ives R. 
Published: March 2021

AbstractPurposeTo investigate the potential of quantitative susceptibility mapping (QSM) with MRI as a biomarker for tissue oxygenation in fat-water mixture. Oxygen molecules (O2) are paramagnetic. This suggests that dissolved O2in tissue should affect the measured magnetic susceptibility. However, direct measurements of dissolved O2in tissues is challenging with QSM as the induced change in susceptibility is below the sensitivity of existing algorithms. QSM in regions that contain fat could be sensitive enough to be used as a marker of tissue oxygenation as oxygen has a larger solubility in fat than in water.MethodsThe relationship between dissolved O2concentration and magnetic susceptibility was investigated based on MRI measurements using phantoms made of fat-water emulsions. Dairy cream was used to approximate fat-containing biological tissues. Phantoms based on dairy cream with 35 % fat were designed with controlled concentrations of dissolved O2. O2was bubbled into the dairy cream to reach O2concentrations above the concentration at atmospheric pressure, while nitrogen was bubbled in cream to obtain O2concentrations below atmospheric pressure. Magnetic susceptibility was expected to increase, becoming more paramagnetic, as O2concentration was increased.ResultsMagnetic susceptibility from MRI-based QSM measurements did not reveal a dependence on O2concentration in fat-water mixture phantoms. The relationship between susceptibility and O2was weak and inconsistent among the various phantom experiments.ConclusionQSM in fat-water mixture appears to be minimally sensitive to dissolved O2based on phantom experiments. This suggests that QSM is not likely to be sensitive enough to be proposed as a marker for tissue oxygenation, as the change in magnetic susceptibility induced by the change in dissolved O2concentration is below the current detection limit, even in the presence of fat.
A Serpin27A-dependent Toll Signaling Underlies Host Genetics of Cancer Resistance inDrosophila
Authors: Singh Reeta , Harsh Sneh , Bajpai Anjali , Pal Subhabrata , Pandey Ravi Kant , Sinha Pradip 
Published: March 2021

AbstractCancer resistance varies amongst individuals, although its host genetic underpinnings remain largely elusive. Remissions of sarcomas were first reported following repeated injections of patients with mixtures of killed bacteria—Coley’s toxins—a phenomenon, which was subsequently causally traced to induction of innate immunity. Here we reveal remission ofDrosophilaepithelial neoplasms by genetically triggered host innate immunity via Toll signaling. These neoplasms display capacities to receive and, in rare instances, induce Toll signaling. A tumor-induced and progressive Toll signaling, however, did not culminate in tumor suppression. By contrast,Drosophilahosts heterozygous forspn27A1mutation, which constitutively produce activated Toll ligand, SpzAct, displayed comprehensive tumor remission via Toll-induced, NF-κB-mediated, tumor cell death. Our results reveal a novel node of host genetic cancer resistance via serpin-dependent Toll signaling.
Selective Corticofugal Modulation on Sound Processing in Auditory Thalamus of Awake Marmosets
Authors: Zhang Yuanqing , Wang Xiaohui , Zhu Lin , Bai Siyi , Li Rui , Sun Hao , Qi Runze , Cai Ruolan , Li Min , Jia Guoqiang , Schriver Kenneth E , Li Xinjian , Gao Lixia 
Published: March 2021

SummaryCortical feedback has long been considered crucial for modulation of sensory processing. In the mammalian auditory system, studies have suggested that corticofugal feedback can have excitatory, inhibitory, or both effects on the response of subcortical neurons, leading to controversies regarding the role of corticothalamic influence. This has been further complicated by studies conducted under different brain states. In the current study, we used cryo-inactivation in the primary auditory cortex (A1) to examine the role of corticothalamic feedback on medial geniculate body (MGB) neurons in awake marmosets. The primary effects of A1 inactivation were a frequency-specific decrease in the auditory response of MGB neurons coupled with an increased spontaneous firing rate, which together resulted in a decrease in the signal-to-noise ratio. In addition, we report for the first-time that A1 robustly modulated the long-lasting sustained response of MGB neurons which changed the frequency tuning after A1 inactivation, e.g., neurons with sharp tuning increased tuning bandwidth whereas those with broad tuning decreased tuning bandwidth. Taken together, our results demonstrate that corticothalamic modulation in awake marmosets serves to enhance sensory processing in a way similar to center-surround models proposed in visual and somatosensory systems, a finding which supports common principles of corticothalamic processing across sensory systems.
Output tracking and feedback stabilization for 6-DoF UAV using an enhanced active disturbance rejection control
Authors: Najm Aws Abdulsalam , Kasim Ibraheem Ibraheem , Humaidi Amjad J. , Azar Ahmad Taher 
Published: March 2021

PurposeThe hybrid control system of the nonlinear PID (NLPID) controller and improved active disturbance rejection control (IADRC) are proposed for stabilization purposes for a 6-degree freedom (DoF) quadrotor system with the existence of exogenous disturbances and system uncertainties.Design/methodology/approachIADRC units are designed for the altitude and attitude systems, while NLPID controllers are designed for the x−y position system on the quadrotor nonlinear model. The proposed controlling scheme is implemented using MATLAB/Simulink environment and is compared with the traditional PID controller and NLPID controller.FindingsDifferent tests have been done, such as step reference tracking, hovering mode, trajectory tracking, exogenous disturbances and system uncertainties. The simulation results showed the demonstrated performance and stability gained by using the proposed scheme as compared with the other two controllers, even when the system was exposed to different disturbances and uncertainties.Originality/valueThe study proposes an NLPID-IADRC scheme to stabilize the motion of the quadrotor system while tracking a specified trajectory in the presence of exogenous disturbances and parameter uncertainties. The proposed multi-objective Output Performance Index (OPI) was used to obtain the optimum integrated time of the absolute error for each subsystem, UAV quadrotor system energy consumption and for minimizing the chattering phenomenon by adding the integrated time absolute of the control signals.