bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cerebrovascular Complication and Valve Surgery in Infective Endocarditis
Authors: Rice Cory J. , Kovi Shivakrishna , Wisco Dolora R. 
Published: April 2021

AbstractInfective endocarditis (IE) with neurologic complications is common in patients with active IE. The most common and feared neurological complication of left-sided IE is cerebrovascular, from septic emboli causing ischemic stroke, intracranial hemorrhage (ICH), or an infectious intracranial aneurysm with or without rupture. In patients with cerebrovascular complications, valve replacement surgery is often delayed for concern of further neurological worsening. However, in circumstances when an indication for valve surgery to treat IE is present, the benefits of early surgical treatment may outweigh the potential neurologic deterioration. Furthermore, valve surgery has been associated with lower in-hospital mortality than medical therapy with intravenous antibiotics alone. Early valve surgery can be performed within 7 days of transient ischemic attack or asymptomatic stroke when medically indicated. Timing of valve surgery for IE after symptomatic medium or large symptomatic ischemic stroke or ICH remains challenging, and current data in the literature are conflicting about the risks and benefits. A delay of 2 to 4 weeks from the time of the cerebrovascular event is often recommended, balancing the risks and benefits of surgery. The range of timing of valve surgery varies depending on the clinical scenario, and is best determined by a multidisciplinary decision between cardiothoracic surgeons, cardiologists, infectious disease experts, and vascular neurologists in an experienced referral center.
A Comprehensive Review of Risk Factor, Mechanism, and Management of Left Ventricular Assist Device–Associated Stroke
Authors: Cho Sung-Min , Tahsili-Fahadan Pouya , Kilic Ahmet , Choi Chun Woo , Starling Randall C. , Uchino Ken 
Published: April 2021

AbstractThe use of left ventricular assist devices (LVADs) has been increasing in the last decade, along with the number of patients with advanced heart failure refractory to medical therapy. Ischemic stroke and intracranial hemorrhage remain the leading causes of morbidity and mortality in LVAD patients. Despite the common occurrence and the significant outcome impact, underlying mechanisms and management strategies of stroke in LVAD patients are controversial. In this article, we review our current knowledge on pathophysiology and risk factors of LVAD-associated stroke, outline the diagnostic approach, and discuss treatment strategies.
Acute Ischemic Stroke Associated with Myocardial Infarction: Challenges and Management
Authors: Boyanpally Anusha , Cutting Shawna , Furie Karen 
Published: April 2021

AbstractAcute ischemic stroke (AIS) and acute myocardial infarction (AMI) may co-occur simultaneously or in close temporal succession, with occurrence of one ischemic vascular event increasing a patient's risk for the other. Both employ time-sensitive treatments, and both benefit from expert consultation. Patients are at increased risk of stroke for up to 3 months following AMI, and aggressive treatment of AMI, including use of reperfusion therapy, decreases the risk of AIS. For patients presenting with AIS in the setting of a recent MI, treatment with alteplase, an intravenous tissue plasminogen activator, can be given, provided anterior wall myocardial involvement has been carefully evaluated. It is important for clinicians to recognize that troponin elevations can occur in the setting of AIS as well as other clinical scenarios and that this may have implications for short- and long-term mortality.
A Novel Technique for Radiographic Diagnosis of Sarcopenia that Accurately Predicts Postoperative Complications in Lower Extremity Free Flap Patients
Authors: Maddox Suma S. , Palines Patrick A. , Hoffman Ryan D. , Danos Denise M. , Womac Daniel J. , Tuggle Charles T. , Stalder Mark W. 
Published: April 2021

Abstract
Background Sarcopenia is linked to poor outcomes throughout the surgical literature and can be assessed on preoperative imaging to potentially aid in risk stratification. This study examined the effects of sarcopenia on surgical morbidity following lower extremity (LE) reconstruction, and also compared two methods of assessment, one of which is novel (“ellipse method”).
Methods A retrospective cohort study of 50 patients receiving free flap-based reconstruction of the LE was performed. Bilateral psoas density and area were quantified at L4 through tracing (“traditional method”) and encircling (“ellipse method”) to calculate Hounsfield unit average calculation (HUAC). Logistic regression and receiving operator curve analysis for the primary outcome of any postoperative complication was used to determine HUAC cutoffs (≤ 20.7 vs. ≤ 20.6) for sarcopenia. Risk of complications associated with sarcopenia was evaluated using Fisher's exact tests.
Results Twelve patients (24%) met criteria for sarcopenia via the traditional method and 16 (32%) via the ellipse method. By both methods, sarcopenic patients were older and more often female and diabetic. These patients also had higher American Society of Anesthesiologists scores and lower serum prealbumin levels. The ellipse method was found to be more accurate, sensitive, and specific than the traditional method in predicting postoperative morbidity (p = 0.009). Via the ellipse method, sarcopenic patients were at higher risk for any complication (p = 0.002) and were at a higher risk for a deep vein thrombus or pulmonary embolism via the traditional method (p = 0.047).
Conclusion Sarcopenia is associated with greater pre- and postoperative morbidity in LE reconstruction. The novel ellipse method is a simplified and accurate method of assessing sarcopenia that can be easily performed in the clinical setting.
Flexor Carpi Radialis Brevis Resection for Treatment of a Distal Radius Fracture: A Case Report
Authors: Werntz Ryan L. , Hadeed Andrew J. , Cappelleti Giacomo L. , Orbay Jorge L. 
Published: April 2021

AbstractThe flexor carpi radialis brevis (FCRB) is an anomalous muscle of the forearm that is only present in 3.5 to 8.6% of the population. In the case of volar plating of distal radius fractures, the FCRB inhibits proper fracture exposure and thus hinders proper reduction. A 78-year-old female presented with right distal radius fracture which necessitated internal fixation. Following mobilization and retraction of the flexor carpi radialis tendon, an anomalous muscle belly was identified as the FCRB. With continued difficulty in exposure and fracture site reduction, resection of the FCRB was performed. The patient was able to return to her activities of daily living without pain and demonstrated no appreciable functional deficit. This case report demonstrates a distal radius fracture where FCRB resection was used, resulting in no detrimental clinical outcomes.
Efficacy of Adductor Canal Blocks in Total Knee Arthroplasty
Authors: Johns Nicholas , Noye Nicholas , Wall Chris , Martin Glen , Loch Alan 
Published: April 2021

AbstractTotal knee arthroplasty (TKA) is associated with significant postoperative pain. The population receiving TKA is generally elderly and often have multiple comorbidities that can present a challenge to postoperative management. Safe and effective multimodal pain management has led to improved outcomes while minimizing complications and side effects. The objective of this study was to investigate the efficacy of adductor canal blocks (ACB) in patients receiving TKA within a regional Queensland population. We performed a retrospective comparative cohort analysis of 458 patients who received TKA at a regional private hospital between January 2016 and December 2018. Inclusion criteria included body mass index (BMI) <50 kg/m2 and unilateral TKA. Using the patients' hospital records, age, gender, American Society of Anesthesiologists' score (ASA), BMI, diabetic status, length of stay (LOS), opioid requirement on discharge, range of motion (ROM) on discharge, return to theater, and readmission within 12 months were recorded. One hundred and thirty-eight patients received ACB and 263 did not. The two groups were comparable for age, gender, diabetic status, and ASA. Patients who received an ACB had an 18-hour longer LOS (p < 0.0001), but were discharged on lower dosages of opioids equivalent to 7.9 oral morphine milligram equivalent (MME; p < 0.0001). Patients who had an ACB had a similar ROM on discharge and did not have an increased rate of readmission or return to theater. This study demonstrates that ACB are efficacious when used as part of a multimodal analgesia regime for TKA.
The Spectrum of DEPDC5-Related Epilepsy
Authors: Salomone Giulia , Comella Mattia , Portale Anna , Pecora Giulia , Costanza Giuseppe , Lo Bianco Manuela , Sciuto Sarah , Praticò Elena R. , Falsaperla Raffaele 
Published: April 2021

AbstractDisheveled EGL-10 and pleckstrin domain-containing protein 5 (DEPDC5) is a key member of the GAP activity toward rags complex 1 complex, which inhibits the mammalian target of rapamycin complex 1 (mTORC1) pathway. DEPDC5 loss-of-function mutations lead to an aberrant activation of the mTOR signaling. At neuronal level, the increased mTOR cascade causes the generation of epileptogenic dysplastic neuronal circuits and it is often associated with malformation of cortical development. The DEPDC5 phenotypic spectrum ranges from sporadic early-onset epilepsies with poor neurodevelopmental outcomes to familial focal epilepsies and sudden unexpected death in epilepsy; a high rate of inter- and intrafamilial variability has been reported. To date, clear genotype–phenotype correlations have not been proven. More studies are required to elucidate the significance of likely pathogenic/variants of uncertain significance. The pursuit of a molecular targeted antiepileptic therapy is a future challenge.
The PAP Flap Breast Reconstruction: A Practical Option for Slim Patients
Authors: Jo Taehee , Jeon Dong Nyeok , Han Hyun Ho 
Published: April 2021

Abstract
Background The posterior thigh-based profunda artery perforator (PAP) flap has been an emerging option as a secondary choice in breast reconstructions. However, whether a PAP flap could consistently serve as the secondary option in slim patients has not been investigated.
Methods Records of immediate unilateral breast reconstructions performed from May 2017 to June 2019 were reviewed. PAP flap breast reconstructions were compared with standard deep inferior epigastric perforator (DIEP) flap breast reconstructions, and were grouped into single or stacked PAP flaps for further analysis.
Results Overall, 43 PAP flaps were performed to reconstruct 32 breasts. Eleven patients underwent stacked PAP flap reconstruction, while 17 patients underwent 21 single PAP flap reconstruction. The average body mass index (BMI) of the patients was 22.2 ± 0.5 kg/m2. The results were as follows: no total loss, one case of venous congestion (2.3%), two donor site wound dehiscence cases (4.7%), and one case of fat necrosis from partial flap loss (2.3%). When compared with 192 DIEP flap reconstructions, the final DIEP flap supplied 98.1 ± 1.7% of mastectomy weight, while the final PAP flap supplied 114.1 ± 6.2% of mastectomy weight (p < 0.005), demonstrating that PAP flaps can successfully supply final reconstruction volume. In a separate analysis, single PAP flaps successfully supplied 104.2% (84.2-144.4%) of mastectomy weights, while stacked PAP flaps supplied 103.7% (98.8-115.2%) of mastectomy weights.
Conclusion In our series of PAP flap reconstructions performed in low-to-normal BMI patients, we found that PAP flaps, as single or stacked flaps, provide sufficient volume to reconstruct mastectomy defects.
SLC25A22 and Its Related Epileptic Encephalopathies
Authors: Patanè Francesca , Pasquetti Elisa , Sullo Federica , Tosto Monica , Sciuto Laura , Garozzo Maria Teresa , Praticò Elena R. , Falsaperla Raffaele 
Published: April 2021

AbstractEpileptic encephalopathy is a condition in which seizures, electroencephalographic epileptiform abnormalities lead to a progressive deterioration of brain functions causing a significant psychomotor delay. One of the typical features of this heterogeneous and large group of severe disorders is the extremely early onset of seizures. The main causes of the epileptic encephalopathies include structural brain defects, inherited metabolic disorders; in this aspect, more than 100 genetic defects, including mutations in the solute carrier family 25 (SLC25A22) gene which encodes a mitochondrial glutamate carrier. To date, the main clinical phenotypes related to mutations of this gene are Ohtahara syndrome (or early infantile epileptic encephalopathy), early myoclonic encephalopathy and migrating partial seizures in infancy. In all the cases, prognosis is poor and no disease-modifying treatment is available in the present days.
Endovascular Stenting for Malignant Obstruction of Superior Vena Cava: A Single-Center Experience Using the Body Floss Technique
Authors: Lingegowda Dayananda , Gupta Bharat , Gehani Anisha , Ghosh Priya , Mukhopadhyay Sumit 
Published: April 2021

Abstract
Purpose Endovascular stenting is the treatment of choice for malignant obstruction of the superior vena cava (SVC) when rapid symptomatic relief is desired. Body floss technique is not routinely used during SVC stenting but has few advantages over single-access technique. We report our experience with stenting for malignant obstruction of the SVC using the body floss technique.
Materials and Methods Between March 2015 and March 2020, 25 patients (20 men, 5 women; median age, 65 years) with malignant SVC obstruction underwent endovascular stenting of the SVC. We retrospectively evaluated these patients for clinical and technical success rates, complications, recurrence-free survival, and overall survival.
Results Stent placement was successful in 24/25 patients (technical success: 96%). Clinical success was achieved in 23/25 (92%) patients. A mortality rate of 4% (1/25) was noted due to SVC rupture. Partial stent migration was noted in two patients (8%) and was treated by placing an additional overlapping stent. Incidental early stent thrombosis was seen in two patients within 8 hours of stent placement, but these patients showed symptom relief with anticoagulation. Follow-up imaging confirmed stent patency in all patients. Late stent occlusion due to tumor progression was seen in one patient. The primary patency rate was 88% (22/25). Overall median survival of 133 days was observed (range: 1–847 days).
Conclusion Endovascular stenting of the SVC for malignant obstruction using the body floss technique is associated with high technical and clinical success, and low rate of complications.
A novel CMOS hexaferrite circulator with 25 GHz operating frequency
Authors: Zhang Guangjun , Jiang Yanfeng 
Published: April 2021

A novel CMOS hexaferrite circulator with a Y-junction structure is designed and fabricated, which is compatible with standard CMOS technology. The spin-coating approach is adopted during the fabrication, in which the photoresist is mixed with nano-hexaferrite powder for preparation of a magnetic thin film in the device. Compared with the traditional circulator with an external permanent magnet for operation, the novel circulator can utilize the spin-coating magnetic film and is compatible with CMOS technology. The remanent magnetization of the adopted hexaferrite thin film can provide the required magnetic field for reciprocity properties. The optimization of impedance matching and the improvements in the related parameters are demonstrated on the novel CMOS circulator. The CMOS circulator exhibits the merits of small volume and easy integration while keeping its promising non-reciprocity properties. The fabrication is conducted based on the standard 180-nm CMOS technology. S-parameter measurements on the circulator show that the device has an isolation of 20 dB over 520 MHz bandwidth at 26.2 GHz. The minimum insertion loss is 1.81 dB. The novel CMOS-compatible circulator has potential application in 5G wireless communication systems.
Idioscopus clypealis (mango leafhopper).
Authors: Ganeswaran R 
Published: April 2021

Abstract

Mango leafhoppers are major pests in the Indian subcontinent. The major damage caused is at the flowering stage and several studies have highlighted the reduction of yield which may be between 20 and 100% depending on population size. Verghese and Rao (1987) examined the critical infestation stages of I. clypealis in Uttar Pradesh, India. The mean density of cicadellids was 0.54-20.64 per panicle in 1983 and 0-6.03 per panicle in 1984. In both years, the peak population occurred when the fruit was pea sized. At the post-bloom stage a population of two adults per panicle was sufficient to cause yield reduction. It is suggested that the critical infestation stages are at post-bloom, when the fruit is marble sized, and 1 month before harvest, with corresponding critical population levels of two adults, 6-21 nymphs and 4-11 hoppers per panicle. In the Philippines, Corey et al. (1989) found that the economic injury levels for I. clypealis on two croppings of mangoes averaged 4.21, 4.30, 4.45 and 4.55 adults per panicle at 2, 10, 18 and 26 days, respectively, after flower bud break for the first cropping, and 4.79, 4.88, 5.06 and 5.18 adults per panicle for the second cropping.
Chilling or Learning?
Authors: Dyevre Arthur , Lampach Nicolas , Glavina Monika 
Published: April 2021

AbstractWe exploit the nonhierarchical nature of the European Union legal system to investigate the effect of negative feedback on intercourt cooperation. We argue that, in the context of a nonhierarchical referral system, formal dismissals expose shirking, which the principal, the referral court, has no formal power to curb. Yet we find that when referring courts have experienced a formal dismissal, they are not only more likely to resubmit but also more likely to see their references accepted. This effect increases with the number of formal dismissals previously experienced. Our findings suggest that referring courts expect significant benefits from cooperation that the referral court is able to leverage to ameliorate the quality of the referring judges’ work.
Bulk plasmon polariton based structured illumination microscopy by utilizing hyperbolic metamaterials
Authors: Liu Xiangzhi , Kong Weijie , Wang Changtao , Pu Mingbo , Li Zhenyan , Li Xiong , Ma Xiaoliang , Luo Xiangang 
Published: April 2021

Abstract
Because structured illumination microscopy (SIM) has the advantages of wide-field, rapid imaging, and biocompatibility, it is widely used for super-resolution imaging of living cells. Here, we demonstrate a new super-resolution imaging method—bulk plasmon polariton based SIM (BPPSIM), which combines the SIM with the hyperbolic metamaterials (HMMs). By utilizing an HMM composed of a multilayer metal/dielectric film, a deep subwavelength bulk plasmon polariton is obtained. The imaging resolution of BPPSIM can be improved by the uniform and wide-field structured illumination pattern with high spatial frequency, benefiting from the filtering effect of HMM for the spatial frequency spectrum. The resolution of the recovered images by BPPSIM has been increased to 1/8 of the fluorescence wavelength, which is 2.7-fold enhancement in resolution compared with traditional fluorescence microscopy. This proposed approach demonstrates the operability and flexibility of the structured illumination pattern and can be used in a simple, wide-field and super-resolution fluorescence microscope.
Microstructural features, spectroscopic study and thermal analysis of potassium permanganate filled PVA–PVP blend films
Authors: Veena G , Lobo Blaise 
Published: April 2021

AbstractPotassium permanganate (KMnO4) filled polyvinyl alcohol (PVA)–polyvinylpyrrolidone (PVP) polymeric blend films have been prepared by solution casting technique, with filler levels (FL) varying from 0.01 up to 4.70 mass%. The microstructural features, thermal properties and spectroscopic properties of these films have been studied using powder XRD, AFM, Fe-SEM, DSC, TG and FTIR. FTIR spectra for filled samples indicated a major molecular structural modification, involving conversion of the hydroxyl (OH) group into ketones at higher FLs. The bands showed a clear distortion in the wide OH band especially at higher FLs of 3.80 mass% and 4.70 mass%. This is confirmed from the TG scans, whose thermal degradation signature reveals multiple stages of degradation for FL of 2.8 mass%, 3.8 mass% and 4.7 mass%. The DSC, TG and DTA curves revealed that value ofTgwas found to decrease on addition of filler in the PVA–PVP blend, whereas the thermal stability of the filled samples was found to increase. The XRD results revealed that the incorporation of KMnO4in PVA–PVP blend made the sample more amorphous. At low FLs, AFM and SEM micrographs show evidence for formation of nano-particles in the host polymeric material only at the lowest FL of 0.01 mass% with uniform dispersion of nano-structures, whereas at moderate FLs, there are micro-structures in the polymeric host, followed by agglomeration of filler induced chemical species as the FL increases beyond 2.8 mass%. Therefore, KMnO4filled PVA–PVP blend films show desirable properties expected from a good solid polymeric electrolyte, for FLs below 1.5 mass%.
Thermodynamic cyclic voltammograms: peak positions and shapes
Authors: Hörmann Nicolas Georg , Reuter Karsten 
Published: April 2021

Abstract
Based on a mean-field description of thermodynamic cyclic voltammograms (CVs), we analyze here in full generality, how CV peak positions and shapes are related to the underlying interface energetics, in particular when also including electrostatic double layer (DL) effects. We show in particular, how non-Nernstian behaviour is related to capacitive DL charging, and how this relates to common adsorbate-centered interpretations such as a changed adsorption energetics due to dipole-field interactions and the electrosorption valency – the number of exchanged electrons upon electrosorption per adsorbate. Using Ag(111) in halide-containing solutions as test case, we demonstrate that DL effects can introduce peak shifts that are already explained by rationalizing the interaction of isolated adsorbates with the interfacial fields, while alterations of the peak shape are mainly driven by the coverage-dependence of the adsorbate dipoles. In addition, we analyze in detail how changing the experimental conditions such as the ion concentrations in the solvent but also of the background electrolyte can affect the CV peaks via their impact on the potential drop in the DL and the DL capacitance, respectively. These results suggest new routes to analyze experimental CVs and use of those for a detailed assessment of the accuracy of atomistic models of electrified interfaces e.g. with and without explicitly treated interfacial solvent and/or approximate implicit solvent models.