bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Personal Biography of a Physiological Misnomer: The Anaerobic Threshold
Authors: Hagberg James 
Published: December 2021

AbstractIn 1973 Wasserman, Whipp, Koyal, and Beaver published a groundbreaking study titled “Anaerobic threshold and respiratory gas analysis during exercise”. At that time, respiratory gas analysis and laboratory computers had evolved such that more advanced respiratory exercise physiology studies were possible. The initial publications from this group on the onset of anaerobic metabolism in cardiac patients, the first breath-by-breath VO2 system, the first description of the anaerobic threshold, and then later new methods to detect the anaerobic threshold have been and continue to be highly cited. In fact, their 1973 anaerobic threshold paper is the sixth and their 1986 paper is the second most cited paper ever published in the Journal of Applied Physiology. The anaerobic threshold concept has also generated>5500 publications with the rates increasing over time. The publication of two papers that help to refute the “anaerobic” explanation for this phenomenon had no effect on the rates of citations of the original anaerobic threshold papers or the number of anaerobic threshold papers published since. Thus, despite now substantial evidence refuting the proposed anaerobic mechanisms underlying this phenomenon, these papers continue to be highly influential in the discipline of exercise physiology and, perhaps even more explicitly, clinical exercise physiology.
Framework for Considering Abnormal Heart Rate Characteristics and Other Signs of Sepsis in Very Low Birth Weight Infants
Authors: Kumar Rupin S. , Otero Noelia Aviles , Abubakar Maryam O. , Elliott Megan R. , Wiggins Jaclyn Y. , Sharif Misky M. , Sullivan Brynne A. , Fairchild Karen D. 
Published: December 2021

Objective A heart rate characteristics index (HeRO score), incorporating low variability and superimposed decelerations, was developed as a sepsis risk indicator for preterm infants in the neonatal intensive care unit (NICU). A rise in the risk score should prompt consideration of other clinical changes that may be signs of sepsis to decide whether a workup and antibiotics are needed. We aimed to develop a framework to systematically consider signs potentially indicating sepsis in very low birth weight (VLBW) infants.
Study Design We developed easy-recall acronyms for 10 signs of sepsis in VLBW infants. Over 12 months in a level IV NICU, neonatology fellows completed a brief survey after each shift to document changes prompting sepsis workups. We analyzed associations between survey data, hourly heart rate characteristic data, and the diagnosis of the workup, grouped as culture-positive sepsis (CXSEP, positive blood or urine culture), clinical sepsis (CLINSEP, negative cultures treated with antibiotics ≥5 days), or sepsis ruled out (SRO, negative cultures and <3 days antibiotics).
Results We analyzed 93 sepsis workups in 48 VLBW infants (35 CXSEP, 20 CLINSEP, and 38 SRO). The most frequently cited changes prompting the workups were heart rate patterns and respiratory deterioration, which were common in all three categories. Low blood pressure and poor perfusion were uncommonly cited but were more likely to be associated with CXSEP than the other signs. A rise in the HeRO score ≥1 from 0 to 12 hours before compared with 12to 72 hours prior the blood culture occurred in 31% of workups diagnosed as CXSEP, 16% CLINSEP, and 31% SRO.
Conclusion The HeRO score can alert clinicians to VLBW infants at high or increasing risk of a sepsis-like illness, but heart rate characteristic patterns are highly variable in individual babies. The easy-recall NeoSEP-10 framework can assist clinicians in considering other clinical changes when making decisions about sepsis workups and the duration of antibiotics.
Key Points
Lumbar Spinous Process–Splitting Technique for Ligamentum Flavum Cyst Removal
Authors: Tomasi Santino Ottavio , Umana Giuseppe Emmanuele , Scalia Gianluca , Raudino Giuseppe , Stevanovic Vlado , Krainz Herbert , Kral Michael , Nicoletti Giovanni Federico , Winkler Peter A. 
Published: December 2021

Abstract
Background Laminotomy for lumbar stenosis is a well-defined procedure and represents a routine in every neurosurgical department. It is a common experience that the uni- or bilateral paraspinal muscle detachment, together with injury of the supra- and interspinous ligaments, can lead to postoperative pain. In the literature, the application of a minimally invasive technique, the lumbar spinous process–splitting (LSPS) technique, has been reported.
Methods In this study, we present a case series of 12 patients who underwent LSPS from September 2019 to April 2020. Two patients had a cyst of the ligamentum flavum, eight a single-level lumbar canal stenosis (LCS), and two a two-level LCS. Moreover, we propose a novel morphological classification of postoperative muscle atrophy and present volumetric analysis of the decompression achieved.
Results There were no complications related to this technique. In all patients, the vertebral canal area was more than doubled by the procedure. The muscle sparing showed grade A, according to our classification.
Conclusion To our knowledge, this is the first description of this surgical technique and the first LSPSL case series in Europe. Furthermore, cases of ligamentum flavum cyst removal using this safe and effective technique have not yet been reported.
Management of DOAC in Patients Undergoing Planned Surgery or Invasive Procedure: Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies (FCSA) Position Paper
Authors: Squizzato Alessandro , Poli Daniela , Barcellona Doris , Ciampa Antonio , Grandone Elvira , Manotti Cesare , Moia Marco , Toschi Vincenzo , Tosetto Alberto , Testa Sophie ,   Scientific Reviewer Committee
Published: December 2021

AbstractPatients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. About a quarter of the anticoagulated patients require temporary cessation of direct oral anticoagulants (DOACs) or vitamin K antagonists for a planned intervention within 2 years from anticoagulation inception. Several clinical issues about DOAC interruption remain unanswered: many questions are tentatively addressed daily by thousands of physicians worldwide through an experience-based balancing of thrombotic and bleeding risks. Among possible valuable answers, the Italian Federation of Centers for the diagnosis of thrombotic disorders and the Surveillance of the Antithrombotic therapies (FCSA) proposes some experience-based suggestions and expert opinions. In particular, FCSA provides practical guidance on the following issues: (1) multiparametric assessment of thrombotic and bleeding risks based on patients' individual and surgical risk factor, (2) testing of prothrombin time, activated partial thromboplastin time, and DOAC plasma levels before surgery or invasive procedure, (3) use of heparin, (4) restarting of full-dose DOAC after high risk bleeding surgery, (5) practical nonpharmacological suggestions to manage patients perioperatively. Finally, FCSA suggests creating a multidisciplinary “anticoagulation team” with the aim to define the optimal perioperative management of anticoagulation.
Artifacts in MRI: Villain or Hero? Using Artifacts for Diagnosing Central Nervous System Diseases
Authors: Morais Gabriela Lopes de , Peruzini Gilmar Filho , Rosa-Júnior Marcos 
Published: December 2021

AbstractAn artifact is a feature present in an image which is not part of the original structure. It can occur as a consequence of several factors. It may be mistaken for pathologic conditions, leading to adverse consequences for the patients. The aim of the present study is to present a selection of the main artifacts described in brain and spinal magnetic resonance images to improve the ability of the physicians to recognize them and to reduce their interference on the final interpretation of a scan. The authors searched the scientific community for artifacts in magnetic resonance imaging (MRI), which were selected to focus on central nervous system (CNS) findings. With the Picture Archiving and Communication System (PACS) database from the center where this study was conducted, the authors designated brain and spine MRI scans with conspicuous artifacts to compose the present study. The artifacts were then classified as those that contribute to the diagnosis and those that must be distinguished from pathologic lesions. Considering the novel classification proposed by the present study, physicians might be stimulated to reevaluate their opinions regarding artifacts, perhaps considering them helpful to evaluate certain conditions even if they cannot be fully corrected, as shown by this distinct approach to artifacts with specific findings concerning differential diagnosis of CNS conditions.
Type A Aortic Dissection Masquerading as an Inferior Myocardial Infarction
Authors: Hussain Azhar , Rossi Alessia , Smith Alexander , Lopez-Marco Ana , Khalil Amina , Roberts Neil 
Published: December 2021

AbstractType A aortic dissection is a life-threatening condition with a wide range of clinical manifestations. Dissection can sometimes mimic an acute myocardial infarction due to similar presenting symptoms and initial clinical investigations. We report the case of a 52-year-old male who presented with an inferior ST-segment elevation myocardial infarction with two drug-eluting stents inserted as a stabilizing intervention prior to surgical repair of an acute aortic dissection.
Single-Stage Off-Pump Hybrid Repair of Kommerell's Diverticulum with Right-Sided Aortic Arch Using a Surgeon-Customized Vascular Prosthesis
Authors: Acharya Metesh , Ahmed Aamer , Deshpande Aparna , Vainas Tryfon , Hadjinikolaou Leonidas , Mariscalco Giovanni 
Published: December 2021

AbstractWe report the successful single-stage hybrid management of Kommerell's diverticulum associated with a right-sided aortic arch in a 63-year-old woman. She underwent total aortic arch debranching utilizing a surgeon-customized vascular prosthesis, without cardiopulmonary bypass or deep hypothermic circulatory arrest, and concomitant zone-0 endovascular stent–graft deployment.
Endovascular Therapy of 103 Aneurysms in the Internal Carotid Artery with Flow Re-Direction Endoluminal Device
Authors: Teixeira Vinicius Fialho , Bastos Albedy Moreira , Santos Rafael Brito 
Published: December 2021

Abstract
Objective Intracranial aneurysms (AIs) are acquired vascular abnormalities that cause sacculations in the arterial wall and are present in ~2 to 5% of the population. Among the treatment options are endovascular interventions with the use of flow-redirecting stents. In the present study, we analyzed the flow re-direction endoluminal device (FRED).
Methods The present study aims to describe the results obtained from treatment with FRED in a series of patients affected by aneurysms in intracranial segments of the internal carotid artery. This is a cross-sectional, epidemiological, and observational study, whose data were obtained from the medical records of 81 patients from July 2018 to July 2019.
Results One hundred and three internal carotid artery aneurysms were observed in 81 patients, with a prevalence of women (91.35%), small (< 10 mm) (89.33%), and located at the C6 level (73.78%) of the internal carotid artery. Of the 81 patients, 16 had multiple aneurysms in the same artery. One hundred and three FRED stents were used in the treatment. These patients underwent angiography 6 months after the surgery, using the O'Kelly-Marotta classification (OKM) to assess the effectiveness of the device, and it was observed that: in 91 of the 103 procedures (88.34%), the FRED was fully open and well positioned, thus restoring the arterial flow and leading to a statistically significant result. In addition, a low complication rate (4.85%) was found, with ischemic stroke being the main complication (1.94%).
Conclusion This device can be an effective option in the treatment of internal carotid aneurysms since the aneurysm occlusion rate is excellent with a low rate of complications.
SYNGAP1 and Methylenetetrahydrofolate in Cerebrospinal Fluid: Cognitive Development after Oral Folate (5-Methyltetrahydrofolate) Supplementation in a 5-Year-Old Girl
Authors: Hess Valentin , Miguel Justine , Bonnemains Chrystèle , Bilbault Claire 
Published: December 2021

AbstractSynaptic Ras GTPase-activating protein 1 (SYNGAP1), also called Ras-GAP 1 or RASA5, is a cerebral protein with a role in brain synaptic function. Its expression affects the development, structure, function, and plasticity of neurons. Mutations in the gene cause a neurodevelopment disorder termed mental retardation-type 5, also called SYNGAP1 syndrome. This syndrome can cause many neurological symptoms including pharmaco-resistant epilepsy, intellectual disability, language delay, and autism spectrum disorder. The syndrome naturally evolves as epileptic encephalopathy with handicap and low intellectual level. A treatment to control epilepsy, limit any decrease in social capacities, and improve intellectual development is really a challenging goal for these patients. The etiologic investigation performed in a 5-year-old girl with early epileptic absence seizures (onset at 6 months) and psychomotor delay (language) revealed a low methylenetetrahydrofolate level in cerebrospinal fluid in a lumbar puncture, confirmed by a second one (35 nmol/L and 50 nmol/L vs. 60–100 nmol/L normal), associated with normal blood and erythrocyte folate levels. Hyperhomocysteinemia, de vivo disease, and other metabolic syndromes were excluded by metabolic analysis. No genetic disorders (like methylenetetrahydrofolate reductase and methenyltetrahydrofolate synthetase) with folate metabolism were found. The physical examination showed only a minor kinetic ataxia. An oral folate (5-methyltetrahydrofolate) supplementation was started with oral vitamin therapy. The child showed good progress in language with this new treatment; epilepsy was well balanced with only one antiepileptic drug. The SYNGAP1 mutation was identified in this patient's genetic analysis. Since the start of folate supplementation/vitamin therapy, the patient's neurologic development has improved. To our knowledge, no association between these two pathologies has been linked and no patient with this SYNGAP1 mutation has ever showed much intellectual progress. Low cerebral methylenetetrahydrofolate levels could be associated with SYNGAP1 mutations. One of the hypotheses is the link of folate metabolism with epigenetic changes including methylation process. One inborn metabolic activity in folate metabolism may be associated with SYNGAP1 disease with epigenetic repercussions. Further studies should assess the link of SYNGAP1 and methyltetrahydrofolate and the evolution of SYNGAP1 patients with oral folate supplementation or vitamin therapy.
Axilla versus Wrist as the Recipient Site in Vascularized Lymph Node Transfer for Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis
Authors: Chocron Yehuda , Azzi Alain J. , Bouhadana Gabriel , Kokosis George , Vorstenbosch Joshua 
Published: December 2021

AbstractBackground Vascularized lymph node transfers (VLNT) are being used with increasing frequency for the treatment of breast cancer-related lymphedema (BCRL). However, there is a lack of consensus in the surgical field as to which recipient site should be utilized. We, therefore, aim to assess the evidence comparing the wrist and axilla as recipient sites for VLNT in BCRL.Methods We conducted a systematic literature review to compare the wrist and axilla as recipient sites for VLNT in BCRL. Demographic data, as well as circumference reduction rate (CRR), excess volume reduction (EVR), postoperative decrease in infections per year, postoperative discontinuation of compression garments, and overall pooled complication rate were extracted from included studies. These were compared through a meta-analysis.Results A total of 37 studies met the inclusion criteria for a total of 689 patients. VLNTs to the wrist and axilla resulted in a decrease in CRR of 42.1 and 51.5%, and a decrease in EVR of 35.6 and 48.8%, respectively. However, our meta-analysis showed no significant differences between CRR or EVR and between wrist and axilla as recipient sites. Similarly, we found no differences in postoperative decrease in infections per year, postoperative discontinuation of compression garments, and overall pooled complication rate.Conclusion These data suggest noninferiority between the wrist and axilla as recipient sites for VLNT in the context of BCRL. In the absence of randomized, prospective data, we hope these results can be used as an evidence-based reference and facilitate future studies.
Comparison of Scoring Systems for Mortality Prediction in Pediatric Multitrauma Patients
Authors: Çelegen Mehmet , Çelegen Kübra 
Published: December 2021

AbstractThe aim of this study was to compare scoring systems for mortality prediction and determine the threshold values of these scoring systems in pediatric multitrauma patients. A total of 57 multitrauma patients referred to the pediatric intensive care unit from January 2020 to August 2021 were included. The pediatric trauma score (PTS), injury severity score (ISS), base deficit (B), international normalized ratio (I), Glasgow coma scale (G) (BIG) score, and pediatric risk of mortality 3 (PRISM 3) score were analyzed for all patients. Of the study group, 35% were female and 65% were male with a mean age of 72 months (interquartile range: 140). All groups' mortality ratio was 12.2%. All risk scores based on mortality prediction were statistically significant. Cutoff value for PTS was 3.5 with 96% sensitivity and 62% specificity; for the ISS, it was 20.5 with 92% sensitivity and 43% specificity; threshold of the BIG score was 17.75 with 85.7% sensitivity and 34% specificity; and 12.5 for PRISM 3 score with 87.6% sensitivity and 28% specificity. PTS, ISS, BIG score, and PRISM 3 score were accurate risk predictors for mortality in pediatric multitrauma patients. ISS was superior to PTS, PRISM 3 score, and BIG score for discrimination between survivors and nonsurvivors.
Encephalitis, a Rare Manifestation of Human Herpesvirus 7 Infection
Authors: de Melo Parente Rita Guilherme Vilhena Pires , Pessoa Tânia Cristina , Moita Paula Cristina Afonso , dos Santos Sandra Cristina Campos , Pereira Ana Cristina Didelet , Castro Sofia Vidal 
Published: December 2021

AbstractHuman herpesvirus 7 (HHV-7) infection typically occurs in childhood and is frequently asymptomatic. Some clinical manifestations include fever and exanthem subitum. There have been rare reports of invasion of HHV-7 into the central nervous system. Here we report a case of encephalitis associated with HHV-7. A 16-year-old girl patient presented with headache, vomiting, disorientation, and psychomotor agitation. Glasgow Coma Scale on arrival was 9. Cerebrospinal fluid tested positive for HHV-7. Electroencephalogram showed intermittent slowing and rare sharp waves in the left frontal region. She recovered well after appropriate treatment for encephalitis.This case added to the few existing reports of encephalitis due to HHV-7. Physicians should be aware of this rare neurological manifestation of HHV-7 for prompt management. Similar cases should be reported to further our knowledge about this virus and its role in neurological disease.
The dynamic state index with moisture and phase changes
Authors: Hittmeir Sabine , Klein Rupert , Müller Annette , Névir Peter 
Published: December 2021

The dynamic state index (DSI) is a scalar field that combines variational information on the total energy and vorticity of a flow field with the second law of thermodynamics. Its magnitude is a combined local measure for non-stationarity, diabaticity, and dissipation in the flow, and it has been shown to provide good qualitative indications for the onset and presence of precipitation and the organization of storms. The index has been derived thus far for ideal fluid models only, however, so that one may expect more detailed insights from a revised definition of the quantity that includes more complex aerothermodynamics. The present paper suggests definitions of DSI-like indicators for flows of moist air with phase changes and precipitation. In this way, the DSI is generalized to signal deviations from a variety of different types of balanced states. A comparison of these indices evaluated with respect to one and the same flow field enables the user to test whether the flow internally balances any combination of the physical processes encoded in the generalized DSI-indices.
A systematic review of experimental research in audiovisual translation 1992–2020
Authors: Wu Zhiwei , Chen Zhuojia 
Published: December 2021

Abstract
This study systematically reviewed 61 experimental studies on audiovisual translation (AVT), published in academic journals between 1992 and 2020. The review examined five aspects of these studies: publication trends, research scopes, research designs, statistical procedures, and reporting practices. Major findings include: (a) there has been a slight concentration of publication outlets for experimental AVT research; (b) the focal studies could be categorized into three themes (product, process, and pedagogy), with the product theme being the most popular and subtitling the dominant AVT modality; (c) the inclusion of a comparison group was the most common design feature, and questionnaires and tests were the most popular research instruments; (d) inferential statistical analysis was favored over descriptive statistical analysis; (e) data normality information and effect sizes were not regularly reported. Based on the systematic review, suggestions are made for the future development of experimental AVT research.
The intrinsic electrochemical behavior of layered Cu2WSe4 nanoparticles
Authors: Li Minyuan M , Ivanov Sergei A 
Published: December 2021

Abstract
Nanoplates of Cu2WSe4 (∼50 nm) were synthesized via a hot-injection method by one-pot selenation of WCl6 and Cu(acac)2. This synthetic route provided another perspective towards the intrinsic electrochemical properties of Cu2MSe4 (M = Mo or W), where their nanoparticles were previously synthesized via a metathesis route. Cations-dependent cathodic events and surface activation anodic events were identified by cyclic voltammetry in acetonitrile.