bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “Shiny and Thick High Heel Sign”
Authors: Schacht Hannes , König Inke Regina , Hensler Johannes , Schramm Peter , Küchler Jan , Ditz Claudia , Neumann Alexander 
Published: June 2021

Abstract
Purpose
Together with the foramen ovale, the middle meningeal artery (MMA) looks like a high heel shoe print on axial time-of-flight magnetic resonance angiography (TOF-MRA) images, with the MMA resembling the heel. Cranial dural arteriovenous fistulas (DAVF) are often fed by the MMA, which can lead to an increase of signal intensity and diameter of this vessel, resulting in a more “shiny” and “thick” high heel print appearance than on the contralateral side. We describe this finding as a novel radiologic sign and provide cut-off values for the ratios of MMA signal intensities and diameters for predicting the presence of a DAVF.

Methods
A total of 84 TOF-MRA examinations of 44 patients with DAVFs (40 with unilateral MMA feeders, 4 with bilateral feeders) and of 40 patients without DAVFs were included. Diameters and signal intensities of both MMAs were measured by two raters and evaluated using receiver operating characteristic analysis.

Results
The diameters of feeding and non-feeding MMAs differed significantly, as did the ratios of signal intensities and of diameters of DAVF and control patients (P < 0.0001). Cut-off values were 1.25 for average signal intensity ratio (shiny high heel sign) and 1.21 for diameter ratio (thick high heel sign). The combination of the “shiny” and the “thick” high heel sign resulted in the highest sensitivity (92.5%) and positive predictive value (95%).

Conclusion
The described sign seems promising for the detection of DAVFs with noncontrast-enhanced MRI. The TOF-MRA source images should be reviewed with special attention to the MMA.
Spinal fluid IgG antibodies from patients with demyelinating diseases bind multiple sclerosis-associated bacteria
Authors: Eckman Emily , Laman Jon D. , Fischer Kael F. , Lopansri Bert , Martins Tom B. , Hill Harry R. , Kriesel John D. 
Published: June 2021

Abstract
A panel of 10 IgG enzyme-linked immunosorbent assays (ELISAs) were developed for the detection of anti-microbial immune responses in the cerebrospinal fluid (CSF) of patients with demyelinating diseases (DD). The anti-microbial ELISA assays follow on prior human brain tissue RNA sequencing studies that established multiple sclerosis (MS) microbial candidates. Lysates included in the ELISA panel were derived from Akkermansia muciniphila, Atopobium vaginae, Bacteroides fragilis, Lactobacillus paracasei, Odoribacter splanchnicus, Pseudomonas aeruginosa, Cutibacterium (Propionibacterium) acnes, Fusobacterium necrophorum, Porphyromonas gingivalis, and Streptococcus mutans. CSF responses from patients with demyelinating diseases (DD, N = 14) were compared to those with other neurological diseases (OND, N = 8) and controls (N = 13). Commercial positive and negative control CSF specimens were run with each assay. ELISA index values were derived for each specimen against each of the 10 bacterial lysates. CSF reactivity was significantly higher in the DD group compared to the controls against Akkermansia, Atopobium, Bacteroides, Lactobacillus, Odoribacter, and Fusobacterium. Four of the 11 tested DD group subjects had elevated antibody indexes against at least one of the 10 bacterial species, suggesting intrathecal antibody production. This CSF serological study supports the hypothesis that several of the previously identified MS candidate microbes contribute to demyelination in some patients.

Key messages

A panel of 10 IgG enzyme-linked immunosorbent assays (ELISAs) were developed for the detection of anti-microbial immune responses in the cerebrospinal fluid (CSF) of patients with demyelinating diseases, including multiple sclerosis and acute disseminated encephalomyelitis.

CSF reactivity was significantly higher in the demyelination group compared to the controls against the bacteria Akkermansia, Atopobium, Bacteroides, Lactobacillus, Odoribacter, and Fusobacterium.

Several of the demyelination subjects had elevated antibody indexes against at least one of the 10 antigens, suggesting at least limited intrathecal production of anti-bacterial antibodies.

This CSF serological study supports the hypothesis that several of the previously identified MS candidate microbes contribute to demyelination in some patients.
Fallbasiertes Lernen kann die Lehrqualität im unfallchirurgischen Unterricht verbessern
Authors: Strobel Friedemann , Histing Tina , Pohlemann Tim , Pizanis Antonius , Braun Benedikt Johannes , Orth Marcel , Fritz Tobias 
Published: June 2021

Zusammenfassung
Hintergrund
Medizinische Lehre ist seit jeher eine Herausforderung für Studierende und Dozenten. Die Förderung des Zusammenhangswissens und ein Wissenstransfer von der Theorie auf die Praxis gewinnen in den letzten Jahren an Bedeutung. Um dieses Ziel zu erreichen, werden zunehmend studierendenzentrierte Lehrkonzepte in der Literatur eingesetzt.

Fragestellung
Kann durch ein fallbasiertes Lehrkonzept das unfallchirurgische Seminar verbessert werden?

Material und Methoden
Den Studierenden und Dozenten wurden standardisierte Fallbeispiele und dazugehörige Unterrichtsmaterialien wie Klassifikationshilfen und Versorgungsstrategien zur Verfügung gestellt. Durch eine zweizeitige Evaluation konnten die Auswirkungen dieser Modifikationen des Lehrdesigns erfasst und statistisch ausgewertet werden.

Ergebnisse
Das Seminar wurde als prüfungsrelevanter empfunden. Die Lehre durch die Dozenten wurde als kompetenter und motivierter empfunden. Insgesamt wurde das Seminar durch die Studierenden besser bewertet.

Schlussfolgerungen
Ein fallbasiertes Lehrkonzept kann daher, richtig und gezielt eingesetzt, die unfallchirurgische Lehre signifikant verbessern.
School closures and mental health during the COVID-19 pandemic in Japan
Authors: Yamamura Eiji , Tsustsui Yoshiro 
Published: June 2021

AbstractThe spread of the novel coronavirus disease caused schools in Japan to close to cope with the pandemic. In response to the school closures, parents of students were obliged to care for their children during the daytime, when children usually were at school. Did the increase in the burden of childcare influence parents’ mental health? Based on short panel data from mid-March to mid-April 2020, we explore how school closures influenced the mental health of parents with school-aged children. Using a fixed-effects model, we find that school closures led to mothers of students suffering from worse mental health compared to other females, while the fathers’ mental health did not differ from that of other males. This tendency is only observed for less-educated mothers who had children attending primary school, not for those with children attending junior high school nor for more-educated mothers. The contribution of this paper is showing that school closures increased the inequality of mental health between genders and parents with different educational backgrounds.
Stability of a Point Charge for the Vlasov–Poisson System: The Radial Case
Authors: Pausader Benoit , Widmayer Klaus 
Published: June 2021

AbstractWe consider the Vlasov–Poisson system with repulsive interactions. For initial data a small, radial, absolutely continuous perturbation of a point charge, we show that the solution is global and disperses to infinity via a modified scattering along trajectories of the linearized flow. This is done by an exact integration of the linearized equation, followed by the analysis of the perturbed Hamiltonian equation in action-angle coordinates.
Electrophysiological aftereffects of high-frequency transcranial random noise stimulation (hf-tRNS): an EEG investigation
Authors: Ghin Filippo , O’Hare Louise , Pavan Andrea 
Published: June 2021

AbstractThere is evidence that high-frequency transcranial random noise stimulation (hf-tRNS) is effective in improving behavioural performance in several visual tasks. However, so far there has been limited research into the spatial and temporal characteristics of hf-tRNS-induced facilitatory effects. In the present study, electroencephalogram (EEG) was used to investigate the spatial and temporal dynamics of cortical activity modulated by offline hf-tRNS on performance on a motion direction discrimination task. We used EEG to measure the amplitude of motion-related VEPs over the parieto-occipital cortex, as well as oscillatory power spectral density (PSD) at rest. A time–frequency decomposition analysis was also performed to investigate the shift in event-related spectral perturbation (ERSP) in response to the motion stimuli between the pre- and post-stimulation period. The results showed that the accuracy of the motion direction discrimination task was not modulated by offline hf-tRNS. Although the motion task was able to elicit motion-dependent VEP components (P1, N2, and P2), none of them showed any significant change between pre- and post-stimulation. We also found a time-dependent increase of the PSD in alpha and beta bands regardless of the stimulation protocol. Finally, time–frequency analysis showed a modulation of ERSP power in the hf-tRNS condition for gamma activity when compared to pre-stimulation periods and Sham stimulation. Overall, these results show that offline hf-tRNS may induce moderate aftereffects in brain oscillatory activity.
Convergence of Non-autonomous Attractors for Subquintic Weakly Damped Wave Equation
Authors: Banaśkiewicz Jakub , Kalita Piotr 
Published: June 2021

AbstractWe study the non-autonomous weakly damped wave equation with subquintic growth condition on the nonlinearity. Our main focus is the class of Shatah–Struwe solutions, which satisfy the Strichartz estimates and coincide with the class of solutions obtained by the Galerkin method. For this class we show the existence and smoothness of pullback, uniform, and cocycle attractors and the relations between them. We also prove that these non-autonomous attractors converge upper-semicontinuously to the global attractor for the limit autonomous problem if the time-dependent nonlinearity tends to a time independent function in an appropriate way.
Neonatal donation: are newborns too young to be recognized?
Authors: Vileito Alicija , Hulzebos Christian V. , Toet Mona C. , Baptist Dyvonne H. , Verhagen Eduard A. A. , Siebelink Marion J. 
Published: June 2021

AbstractNeonatal organ and tissue donation is not common practice in the Netherlands. At the same time, there is a transplant waiting list for small size-matched organs and tissues. Multiple factors may contribute to low neonatal donation rates, including a lack of awareness of this option. This study provides insight into potential neonatal organ and tissue donors and reports on how many donors were actually reported to the procurement organization. We performed a retrospective analysis of the mortality database and medical records of two largest neonatal intensive care units (NICUs) in the Netherlands. This study reviewed records of neonates with a gestational age >37 weeks and weight >3000g who died in the period from January 1, 2005 through December 31, 2016. During the study period, 259 term-born neonates died in the two NICUs. In total, 132 neonates with general contra-indications for donation were excluded. The medical records of 127 neonates were examined for donation suitability. We identified five neonates with documented brain death who were not recognized as potential organ and/or tissue donors. Of the remaining neonates, 27 were found suitable for tissue donation. One potential tissue donor had been reported to the procurement organization. In three cases, the possibility of donation was brought up by parents.Conclusion: A low proportion (2%) of neonates who died in the NICUs were found suitable for organ donation, and a higher proportion (12%) were found suitable for tissue donation. We suggest that increased awareness concerning the possibility of neonatal donation would likely increase the identification of potential neonatal donors.

What is Known:• There is an urgent need for very small organs and tissues from neonatal donorsWhat is New:• A number of neonates who died in the NICU were suitable organ or/and tissue donors but were not recognized as donors.• Knowledge on neonatal donation possibilities is also important for proper counseling of parents who sometimes inquire for the possibility of organ and tissue donation.
An eye-tracking based robotic scrub nurse: proof of concept
Authors: Ezzat Ahmed , Kogkas Alexandros , Holt Josephine , Thakkar Rudrik , Darzi Ara , Mylonas George 
Published: June 2021

Abstract
Background
Within surgery, assistive robotic devices (ARD) have reported improved patient outcomes. ARD can offer the surgical team a “third hand” to perform wider tasks and more degrees of motion in comparison with conventional laparoscopy. We test an eye-tracking based robotic scrub nurse (RSN) in a simulated operating room based on a novel real-time framework for theatre-wide 3D gaze localization in a mobile fashion.

Methods
Surgeons performed segmental resection of pig colon and handsewn end-to-end anastomosis while wearing eye-tracking glasses (ETG) assisted by distributed RGB-D motion sensors. To select instruments, surgeons (ST) fixed their gaze on a screen, initiating the RSN to pick up and transfer the item. Comparison was made between the task with the assistance of a human scrub nurse (HSNt) versus the task with the assistance of robotic and human scrub nurse (R&HSNt). Task load (NASA-TLX), technology acceptance (Van der Laan’s), metric data on performance and team communication were measured.

Results
Overall, 10 ST participated. NASA-TLX feedback for ST on HSNt vs R&HSNt usage revealed no significant difference in mental, physical or temporal demands and no change in task performance. ST reported significantly higher frustration score with R&HSNt. Van der Laan’s scores showed positive usefulness and satisfaction scores in using the RSN. No significant difference in operating time was observed.

Conclusions
We report initial findings of our eye-tracking based RSN. This enables mobile, unrestricted hands-free human–robot interaction intra-operatively. Importantly, this platform is deemed non-inferior to HSNt and accepted by ST and HSN test users.
Antimicrobial prophylaxis and post-chemotherapy neutropenic fever in patients with leukemia: comparisons of C-reactive protein, procalcitonin and immediate fever outcome measures between those with and without prophylaxis, and the implications for practice
Authors: Chan Choi Wan , Molassiotis Alex , Lee Harold K. K. 
Published: June 2021

Abstract
Purpose
The efficacy of prophylactic antimicrobial treatment renders challenges in patients with leukemias receiving chemotherapy. The study aimed to compare differences in C-reactive protein (CRP) and procalcitonin (PCT) at presentation and the immediate outcome measures of post-chemotherapy NF between patients with and without antimicrobial prophylaxis.

Methods
A 5-year observational study included 282 NF episodes in 133 leukemia patients requiring hospital care from January 2014 to May 2019. We collected demographic characteristics, laboratory data of blood cell counts and inflammatory biomarkers, and immediate outcome measures of NF, including microbiologically diagnosed infections, presence of predominant pathogens, required modification of antibiotics during NF, adverse medical complications, total fever duration, and deaths. We evaluated data between patients with and without prophylaxis.

Results
Of patients, 77.3%, 68.4%, and 20.6% had antibiotic prophylaxis, antifungal prophylaxis, and no prophylaxis, respectively. There were totally 15 deaths—13 with antibiotic prophylaxis and 10 with antifungal prophylaxis. CRP, PCT, and immediate outcome measures of NF did not show significant differences between those with and without antimicrobial prophylaxis. Although between-group differences showed no statistical significance, higher median fever duration, CRP and PTC values, and higher proportions of NF requiring modification of antibiotics were found more frequently in those with antimicrobial prophylaxis than in those without.

Conclusion
The benefits of using antimicrobial prophylaxis were less supported. Enhancing diagnostic laboratory and medical complication surveillance and periodic evaluation of institutional data during post-chemotherapy neutropenia and NF in relation to antimicrobial prophylaxis is promising in providing insights to redefine the risk–benefit accounts of using prophylaxis.
Psychosomatik und Interaktion
Authors: Dunitz-Scheer Marguerite , Scheer Peter 
Published: June 2021

ZusammenfassungIn diesem kleinen Beitrag versuchen die Autoren, beide aus dem Bereich der pädiatrischen Psychosomatik kommend, ihre Erlebnisse bezüglich der Medizin, die sie bei einer Weltreise 2019 hatten, darzustellen. Dabei geht es um den Maismenschen ebenso wie um die Kraft der Göttin des Vulkans.Die Anwendung auf unseren Erlebniskreis ist schwierig und wird hier ansatzweise versucht.
A mixed-method feasibility study of a novel transitional regime of incremental haemodialysis: study design and protocol
Authors: Hazara Adil M. , Allgar Victoria , Twiddy Maureen , Bhandari Sunil 
Published: June 2021

AbstractBackgroundIncremental haemodialysis/haemodiafiltration (HD) may help reduce early mortality rates in patients starting HD. This mixed-method feasibility study aims to test the acceptability, tolerance and safety of a novel incremental HD regime, and to study its impact on parameters of patient wellbeing.MethodWe aim to enrol 20 patients who will commence HD twice-weekly with progressive increases in duration and frequency, achieving conventional treatment times over 15 weeks (incremental group). Participants will be followed-up for 6 months and will undergo regular tests including urine collections, bio-impedance analyses and quality-of-life questionnaires. Semi-structured interviews will be conducted to explore patients’ prior expectations from HD, their motivations for participation and experiences of receiving incremental HD. For comparison of safety and indicators of dialysis adequacy, a cohort of 40 matched patients who previously received conventional HD will be constructed from local dialysis records (historical controls).ResultsData will be recorded on the numbers screened and proportions consented and completing the study (primary outcome). Incremental and conventional groups will be compared in terms of differences in blood pressure control, interdialytic weight changes, indicators of dialysis adequacy and differences in adverse and serious adverse events. In analyses restricted to incremental group, measurements of RRF, fluid load and quality-of-life during follow-up will be compared with baseline values. From patient interviews, a narrative description of key themes along with anonymised quotes will be presented.ConclusionResults from this study will address a significant knowledge gap in the prescription HD therapy and inform the development novel future therapy regimens.
Einfluss einer Mund-Nase-Maske auf die objektive körperliche Leistungsfähigkeit sowie das subjektive Belastungsempfinden bei gut-trainierten, gesunden Jungen
Authors: Schulte-Körne Benedikt , Hollmann Wildor , Vassiliadis Argiris , Predel Hans-Georg 
Published: June 2021

ZusammenfassungMit dieser Studie wurden die Effekte chirurgischer MNS auf die körperliche Leistungsfähigkeit sowie das subjektive Belastungsempfinden bei trainierten elfjährigen Jungen untersucht.Im aeroben und aerob-anaeroben Übergangsbereich fand sich keine Verminderung der objektiven Leistungsparameter. Allerdings zeigte sich auf der maximalen Belastungsstufe mit MNS eine signifikante Verminderung der Laufzeit sowie eine signifikante Erhöhung des subjektiven Belastungsempfindens bei ansonsten unveränderten Leistungsparametern. Zusammenfassend beeinflusst die Verwendung chirurgischer „Alltags“-MNS bei Kindern die sportlichen Aktivitäten nicht, solange die Belastungen primär im aeroben Intensitätsbereich durchgeführt werden.
Evaluation of optimal FVDs for inter-storey isolation systems based on surrogate performance models
Authors: Donà Marco , Bernardi Enrico , Zonta Alberto , Tan Ping , Zhou Fulin 
Published: June 2021

AbstractInter-storey seismic isolation is increasingly gaining attention. One of the main related issues is the need to limit the relative displacement between substructure and superstructure, while maintaining a good seismic performance of the superstructure. As shown in some studies, fluid viscous dampers (FVDs) mounted in isolation systems are effective in reducing isolator deflection but can be harmful by amplifying inter-storey drifts and floor accelerations. Additionally, the effectiveness of FVDs for inter-storey applications was investigated only recently, and specific approaches for their optimisation and performance evaluation are missing. Therefore, this paper proposes a method for the optimal multi-objective design of FVDs, based on the definition of appropriate surrogate response models, which allows for rationally comparing the FVD effects for a wide range of dampers and structures. In particular, the optimal FVD parameters are provided in a dimensionless form, so that they can be predicted by design equations of general validity within the range of the structures analysed. This method is applied to a stock of regular structures with various vibration periods of superstructure, isolation and substructure, examining a linear and a non-linear isolation system and a set of natural records, in order to comprehensively assess the effects of FVDs and their non-linearity on the seismic performance of these structures. Finally, prediction models of optimal FVD parameters are provided based on the results obtained and are applied to three case studies as an example.
Specific Dystrophins Selectively Associate with Inhibitory and Excitatory Synapses of the Mouse Cerebellum and their Loss Alters Expression of P2X7 Purinoceptors and Pro-Inflammatory Mediators
Authors: Jackson Torquil , Seifi Mohsen , Górecki Dariusz C. , Swinny Jerome D. 
Published: June 2021

AbstractDuchenne muscular dystrophy (DMD) patients, having mutations of the DMD gene, present with a range of neuropsychiatric disorders, in addition to the quintessential muscle pathology. The neurobiological basis remains poorly understood because the contributions of different DMD gene products (dystrophins) to the different neural networks underlying such symptoms are yet to be fully characterised. While full-length dystrophin clusters in inhibitory synapses, with inhibitory neurotransmitter receptors, the precise subcellular expression of truncated DMD gene products with excitatory synapses remains unresolved. Furthermore, inflammation, involving P2X purinoceptor 7 (P2RX7) accompanies DMD muscle pathology, yet any association with brain dystrophins is yet to be established. The aim of this study was to investigate the comparative expression of different dystrophins, alongside ionotropic glutamate receptors and P2RX7s, within the cerebellar circuitry known to express different dystrophin isoforms. Immunoreactivity for truncated DMD gene products was targeted to Purkinje cell (PC) distal dendrites adjacent to, or overlapping with, signal for GluA1, GluA4, GluN2A, and GluD2 receptor subunits. P2X7R immunoreactivity was located in Bergmann glia profiles adjacent to PC-dystrophin immunoreactivity. Ablation of all DMD gene products coincided with decreased mRNA expression for Gria2, Gria3,and Grin2aand increased GluD2 immunoreactivity. Finally, dystrophin-null mice showed decreased brain mRNA expression ofP2rx7and several inflammatory mediators. The data suggest that PCs target different dystrophin isoforms to molecularly and functionally distinct populations of synapses. In contrast to muscle, dystrophinopathy in brain leads to the dampening of the local immune system.