bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevated retinal artery vascular resistance determined by novel visualized technique of laser speckle flowgraphy in branch retinal vein occlusion
Authors: Tomita Ryo , Iwase Takeshi , Fukami Marie , Goto Kensuke , Ra Eimei , Terasaki Hiroko 
Published: October 2021

AbstractWe aimed to investigate the increase in resistivity of the retinal artery in the branch retinal vein occlusion (BRVO)-affected area, and to visualize it. Thirty-two eyes of 32 patients with BRVO were measured by laser speckle flowgraphy (LSFG). The retinal artery and vein running to the BRVO-affected area and vertically symmetrical vessels in the unaffected area were examined. We applied the LSFG parameter beat strength over mean blur rate (BOM), calculated using a similar method to the pulsatility index used in Doppler flowmetry to evaluate resistivity of the vessels. Our results showed that the BOM map could clearly visualize the increase of resistivity in the retinal artery as a two-dimensional map. The BOM of the arteries in the affected area was significantly higher than that of the unaffected area (P = 0.001). Multiple regression analysis showed that the ratio of BOM in retinal arteries of the affected area to the unaffected was significantly associated with the extent of retinal hemorrhage (β = 0.447, P = 0.009). In conclusion, the index of resistivity of the retinal artery in the BRVO-affected area was higher and could be visualized in a two-dimensional map. These findings and techniques would contribute to elucidate the pathophysiology of BRVO.
MMPs and TIMPs levels are correlated with anthropometric parameters, blood pressure, and endothelial function in obesity
Authors: Boumiza Soumaya , Chahed Karim , Tabka Zouhair , Jacob Marie-Paule , Norel Xavier , Ozen Gulsev 
Published: October 2021

AbstractThe association between matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinases (TIMPs) and obesity as well as obesity-related disease including metabolic syndrome is not fully explored. Our aims are that: (i) to evaluate the plasma levels of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, TIMP-2 and their ratios in non-obese people, overweight and obese people with or without metabolic syndrome, (ii) to investigate correlations between MMPs or TIMPs levels and several anthropometric parameters, blood pressure, endothelial function. Anthropometric and biochemical parameters were determined in 479 randomly selected participants, subdividing according to body mass index (BMI) and metabolic syndrome status. Plasma MMPs and TIMPs levels were measured. The assessment of endothelial function was characterized in people with obesity, overweight and non-obese, using laser Doppler Flowmetry. Obese people have elevated MMP-1, MMP-2, TIMP-1, TIMP-2 levels and decreased MMP-3/TIMP-1 and MMP-9/TIMP-1 ratios compared with non-obese people. MMP-1 levels and MMP-1/TIMP-1 ratio were positively correlated with BMI and waist circumference (WC) while MMP-2 levels were negatively correlated with BMI and WC values in obese people. MMP-3 levels and MMP-3/TIMP-1 ratio were positively correlated with systolic blood pressure (SBP) or diastolic blood pressure (DBP) in obese and metabolic syndrome people. Additionally, MMP-9 levels and MMP-9/TIMP-1 ratio were negatively correlated with endothelium-dependent response in obese and metabolic syndrome people. MMP-1, MMP-2, TIMP-1, TIMP-2 levels were increased in obese subjects. Significant correlations between anthropometric parameters and MMP-1 as well as MMP-1/TIMP-1 ratio supported these results. MMP-3 and -9 levels as well as their ratios with TIMP-1 were associated with blood pressure and endothelial-dependent response, respectively. In conclusion, our results demonstrated that MMP-1, MMP-3 and MMP-9 levels were correlated with several obesity-related parameters including BMI, WC, blood pressure and endothelial-dependent response. Our findings will hopefully provide new aspects for the use of MMPs and TIMPs as clinical biomarkers in obesity-related cardiovascular diseases such as metabolic syndrome and hypertension. The lack of measure of MMPs activity in plasma and relevant organs/tissues in obesity and metabolic syndrome is considered as a limitation in this report.
Effect of non-ionizing reaction rate (assumed to be controllable) on the plasma generation mechanism and communication around RAMC vehicle during atmospheric reentry
Authors: Ouyang Wenchong , Liu Qi , Zhang Zheng , Jin Tao , Wu Zhengwei 
Published: October 2021

AbstractRadio frequency (RF) blackout occurs during radio attenuation measurement C (RAMC) vehicle reentry due to the attenuation effect of the plasma sheath on the communication signal. In recent years, the mitigation mechanism of chemical reaction for RF blackout problem has gradually been studied numerically and experimentally. However, the effect of non-ionization reaction rate has been ignored because it does not directly involve the generation of electrons. In the present study, the influence of non-ionizing reaction rate on the plasma generation mechanism and EM wave attenuation was numerically solved by the plasma flow and multilayer transmission model. According to the simulation results, only the reaction rate of $$NO \rightleftharpoons N + O$$

N
O
⇌
N
+
O

has a significant effect on the electron number density in all non-ionizing reactions, and the degree of influence is less than the ionization reaction rate. The EM wave attenuation decreases with the decrease of the reaction rate of $$NO \rightleftharpoons N + O$$

N
O
⇌
N
+
O

. When the reaction rate is reduced by 25 times, the maximum attenuation of electromagnetic wave can be reduced by 12 dB. Finally, a potential scheme by reducing the reaction rate of $$NO \rightleftharpoons N + O$$

N
O
⇌
N
+
O

was proposed to mitigate the RF blackout problem.
Diagnosing thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance cytology with the deep convolutional neural network
Authors: Youn Inyoung , Lee Eunjung , Yoon Jung Hyun , Lee Hye Sun , Kwon Mi-Ri , Moon Juhee , Kang Sunyoung , Kwon Seul Ki , Jung Kyong Yeun , Park Young Joo , Park Do Joon , Cho Sun Wook , Kwak Jin Young 
Published: October 2021

AbstractTo compare the diagnostic performances of physicians and a deep convolutional neural network (CNN) predicting malignancy with ultrasonography images of thyroid nodules with atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) results on fine-needle aspiration (FNA). This study included 202 patients with 202 nodules ≥ 1 cm AUS/FLUS on FNA, and underwent surgery in one of 3 different institutions. Diagnostic performances were compared between 8 physicians (4 radiologists, 4 endocrinologists) with varying experience levels and CNN, and AUS/FLUS subgroups were analyzed. Interobserver variability was assessed among the 8 physicians. Of the 202 nodules, 158 were AUS, and 44 were FLUS; 86 were benign, and 116 were malignant. The area under the curves (AUCs) of the 8 physicians and CNN were 0.680–0.722 and 0.666, without significant differences (P > 0.05). In the subgroup analysis, the AUCs for the 8 physicians and CNN were 0.657–0.768 and 0.652 for AUS, 0.469–0.674 and 0.622 for FLUS. Interobserver agreements were moderate (k = 0.543), substantial (k = 0.652), and moderate (k = 0.455) among the 8 physicians, 4 radiologists, and 4 endocrinologists. For thyroid nodules with AUS/FLUS cytology, the diagnostic performance of CNN to differentiate malignancy with US images was comparable to that of physicians with variable experience levels.
Feasibility, safety, and economic consequences of using minimal flow anaesthesia by Maquet FLOW-i equipped with automated gas control
Authors: Colak Yusuf Z. , Toprak Hüseyin I. 
Published: October 2021

AbstractLow fresh gas flow rates are recommended because of their benefits, however, its use is limited due to associated risks. The main purpose of this study was to investigate whether 300 mL of fresh gas flow that practised with automated gas control mode is applicable and safe. The second aim is to show that automated mode can provide economic benefits. Sixty hepatectomy cases who suitable criterias were included to cohort study in three groups as prospective, sequential, observational. An operating room were allocated only for this study. 300 mL fresh gas flow with automated mode (groupA3), 600 mL fresh gas flow with automated mode (groupA6) and, 600 mL fresh gas flow with manually (groupM6) was applied. Patients’ respiratory, hemodynamic parameters (safety), number of setting changes, O2concentration in the flowmeter that maintained FiO2:0.4 during the low flow anaesthesia (feasibility) and comsumption data of anaesthetic agent and CO2absorber (economical) were collected and compared. p < 0.05 was accepted as statistical significance level. No significant differences were detected between the groups in terms of demographic data and duration of operation. Safety datas (hemodynamic, respiratory, and tissue perfusion parameters) were within normal limits in all patients. O2concentration in the flowmeter that maintained FiO2:0.4 was statistically higher in groupA3 (92%) than other groups (p < 0.001) but it was still within applicable limits (below the 100%). Number of setting changes was statistically higher in groupM6 than other groups (p < 0.001). The anaesthetic agent consumption was statistically less in groupA3 (p = 0.018). We performed fresh gas flow of 300 mL by automated mode without deviating from the safety limits and reduced the consumption of anaesthetic agent. We were able to maintain FiO2:0.4 in hepatectomies without much setting changes, and we think that the automated mode is better in terms of ease of practise.
Mortality risk factors of COVID-19 infection in kidney transplantation recipients: a systematic review and meta-analysis of cohorts and clinical registries
Authors: Udomkarnjananun Suwasin , Kerr Stephen J. , Townamchai Natavudh , Susantitaphong Paweena , Tulvatana Wasee , Praditpornsilpa Kearkiat , Eiam-Ong Somchai , Avihingsanon Yingyos 
Published: October 2021

AbstractKidney transplantation recipients (KTR) with coronavirus disease 2019 (COVID-19) are at higher risk of death than general population. However, mortality risk factors in KTR are still not clearly identified. Our objective was to systematically analyze published evidence for risk factors associated with mortality in COVID-19 KTR. Electronic databases were searched for eligible studies on 1 August 2021. All prospective and retrospective studies of COVID-19 in KTR were considered eligible without language restriction. Since data in case reports and series could potentially be subsets of larger studies, only studies with ≥ 50 patients were included. Random-effects model meta-analysis was used to calculate weighted mean difference (WMD) and pooled odds ratio (OR) of factors associated with mortality. From a total 1,137 articles retrieved, 13 were included in the systematic review and meta-analysis comprising 4,440 KTR. Compared with survivors, non-survivors were significantly older (WMD 10.5 years, 95% CI 9.3–11.8). KTR of deceased donor were at higher risk of death (OR 1.73, 95% CI 1.10–2.74). Comorbidities including diabetes mellitus, cardiovascular disease, and active cancer significantly increased mortality risk. KTR with dyspnea (OR 5.68, 95% CI 2.11–15.33) and pneumonia (OR 10.64, 95% CI 3.37–33.55) at presentation were at higher mortality risk, while diarrhea decreased the risk (OR 0.61, 95% CI 0.47–0.78). Acute kidney injury was associated with mortality (OR 3.24, 95% CI 1.36–7.70). Inflammatory markers were significantly higher in the non-survivors, including C-reactive protein, procalcitonin, and interleukine-6. A number of COVID-19 mortality risk factors were identified from KTR patient characteristics, presenting symptoms, and laboratory investigations. KTR with these risk factors should receive more intensive monitoring and early therapeutic interventions to optimize health outcomes.
Fault tolerant control of a three‐phase PMSM by limiting the heat of an inter‐turn fault
Authors: Foitzik Simon , Doppelbauer Martin 
Published: October 2021

AbstractInter‐turn faults are most commonly the initial stator winding fault in power trains with Voltage Source Inverters. Without counteractions, these faults can propagate and cause catastrophic failures in safety critical applications like all‐electric aircraft. The propagation of an inter‐turn fault can be reduced, by limiting the local temperature at the fault. In this article, a fault tolerant control scheme is designed and validated, which reduces the heat of an inter‐turn fault by a controlled adaption of the operating point. The control strategy utilizes the hyperbolas of constant torque and the controller design is based on a linear time‐invariant system description. A machine learning regression is used for the online heat estimation and a 3D lumped‐parameter model to evaluate the thermal effectiveness. To test the control scheme, an inter‐turn fault is actively switched, which generates the local heat equal to of the overall stator copper losses. The control scheme adopts the operating point within 30 electric periods, which reduces the generated heat of the inter‐turn fault by . This causes a temperature reduction at the fault locally from °C to °C, which extends the approximated insulation life from  s to  h.
Fallbeispiel: Die Darmbarriere stabilisieren
Authors: Hinze Susanne 
Published: October 2021

SummaryAbdomen-Beschwerden und wiederkehrende Nasennebenhöhlenentzündungen werden häufig nicht zusammengebracht. Eine erhöhte Infektanfälligkeit kann aber mit einem sogenannten Leaky-Gut-Syndrom zusammenhängen. Dieser Fallbericht zeigt die Behandlung einer Patientin mit einem Pflanzenpräparat, das die Darmbarriere stärkt.
Abrechnung Naturheilkunde mit GOÄ
Authors: Stör Wolfram 
Published: October 2021

SummaryÄrztliche Leistungen müssen sich zwingend an der Gebührenordnung für Ärzte (GOÄ) orientieren. Die beratungs- und zeitintensiven Leistungen im Bereich der Komplementärmedizin werden in der GOÄ nicht berücksichtigt. Der Artikel bietet Lösungsansätze für eine adäquate Abrechnung der komplementärmedizinischen Leistungen.
Das Hufeland-Leistungsverzeichnis – Integrative Medizin
Authors: Krebs Johannes , Fischer Sabine 
Published: October 2021

SummaryDas Hufeland-Leistungsverzeichnis stellt seit mehr als 25 Jahren die Basis für eine rechtssichere Abrechnung im Bereich der Naturheilverfahren und Komplementären Medizin dar. Eine grundlegende Überarbeitung steht an, allerdings muss die Entscheidung über die Einführung der neuen Gebührenordnung für Ärzte abgewartet werden.
Abrechnungsempfehlung Applied Kinesiology
Authors: Garten Hans 
Published: October 2021

SummaryApplied Kinesiology (AK) ist eine Methode, die als primäre diagnostische Werkzeuge den manuellen Muskeltest und sensorische diagnostische Provokationen (Challenges) benutzt. Ein einfach verständliches Grundprinzip ist die neurophysiologische Tatsache, dass Noziaktivität Muskeln hemmt. Dabei ist Noziaktivität als Aktivierung von Schmerzrezeptoren zu verstehen, die nur bei Versagen der segmentalen und suprasegmentalen Schmerzhemmmechanismen als Schmerz wahrgenommen wird. Mechanorezeptoren-Aktivierung (als diagnostische Provokation) hemmt Noziafferenzen bereits segmental auf der Ebenen des Hinterhorns.
Komplementärmedizin in der Kassenpraxis
Authors: Bücker Susanne 
Published: October 2021

SummaryNaturheilverfahren und Komplementärmedizin sollten genuiner Bestandteil jeder ärztlichen Behandlung sein und allen Patienten zugutekommen. Dies jedoch wirtschaftlich in eine Kassenpraxis zu integrieren, ist momentan eine Herausforderung. Berufspolitische Überzeugungsarbeit ist daher ebenfalls eine wichtige Aufgabe.
Reoperative Aortic Arch Surgery under Mild Systemic Hypothermia: Two-Center Experience
Authors: Risteski Petar , Radacki Isabel , Zierer Andreas , Lenos Aris , Moritz Anton , Urbanski Paul P. 
Published: October 2021

Abstract
Background The aim of the study was to assess the indications, surgical strategies, and outcomes after reoperative aortic arch surgery performed generally under mild hypothermia.
Methods Ninety consecutive patients (60 males, mean age, 55 ± 16 years) underwent open reoperative aortic arch surgery after previous cardiac aortic surgery. The indications included chronic-progressive arch aneurysm (55.5%), chronic aortic dissection (17.8%), contained arch rupture (16.7%), and graft infection (10%). The reoperation was performed through a repeat sternotomy (96%) or clamshell thoracotomy (4%) using antegrade cerebral perfusion under mild systemic hypothermia (28.9 ± 2.5°C) in all except three patients.
Results The surgery comprised hemiarch or total arch replacement in 41 (46%) and 49 (54%) patients, respectively. The distal extension included classic or frozen elephant trunk technique, each in 12 patients, and total descending aorta replacement in 4 patients. Operative mortality was 6 (6.7%) among all patients, with age identified as the only independent predictor of operative mortality (p = 0.05). Permanent and transient neurologic deficits occurred in 1% and 9% of the patients, respectively. Estimated survival at 8 years was 59 ± 8% with advanced heart failure predictive for late mortality (p = 0.014). Freedom from second reoperation or intervention on the aorta was 78 ± 6% at 8 years, with most of these events occurring downstream in patients with chronic degenerative aneurysms.
Conclusion Aortic arch reoperations performed using antegrade cerebral perfusion under mild systemic hypothermia offer favorable operative outcomes with an exceptionally low rate of neurologic morbidity without any difference between hemiarch and complex arch procedures.
Preservation of the Aortic Root During Type A Aortic Dissection Surgery: An Effective Strategy?
Authors: Baufreton Christophe , Fouquet Olivier , Dang Van Simon , Laribi Jihed , Pinaud Frédéric , Binuani Patrice , Willoteaux Serge 
Published: October 2021

Abstract
Background Management of the aortic root during acute Type A aortic dissection (TAAD) repair remains controversial in term of long-term evolution and reoperation. The aim of this study was to assess the long-term outcomes of the aortic root after conservative management during primary surgery.
Methods One hundred sixty-four consecutive patients were included in this monocentric retrospective study. The primary endpoint was reoperation on the aortic root during long-term follow-up. Forty-six patients had aortic root replacement (ARR) and 118 had supracoronary aortic replacement (SCR). The 10-year survival, occurrence of significant aortic regurgitation, and radiologic aortic root dilatation in each group were assessed during follow-up.
Results Patients from ARR group were younger than those from SCR group (p < 0.0001). Median follow-ups of ARR group and SCR group are 4.4 (interquartile range [IR]: 2.6–8.3) and 6.15 (IR: 2.8–10.53) years, respectively. Reoperation of the aortic root during long-term follow-up was similar in both groups (ARR group: 5.1%, SCR group: 3.3%, p = 0.636). The 10-year survivals of ARR and SCR groups were 64.8 ± 12.3% and 46.3 ± 5.8% (p = 0.012), respectively. Long-term significant aortic regurgitation occurred in one patient (1.7%) and seven patients (7.6%) of the ARR and SCR groups (p = 0.176), respectively. Radiologic aortic root diameters in the SCR group were similar between postoperative period and follow-up studies (p = 0.58). Reoperation on the distal aorta (p = 0.012) and patent radiologic false lumen of the descending aorta (p = 0.043) were independent risk factors of late death.
Conclusion SCR is an effective technique for primary TAAD surgery and does not increase the rate of late reoperation on the aortic root.
Custom-Made Bifurcated Prosthetic Graft for Aortoiliac Aneurysm Repair
Authors: Papadoulas Spyros , Kakkos Stavros K. , Ntouvas Ioannis , Nikolakopoulos Konstantinos , Tsantrizos Polyzois , Papageorgopoulou Chrysanthi , Kouri Natasa 
Published: October 2021

AbstractRevascularization of the internal iliac artery during open repair of aortoiliac aneurysms can be challenging, especially if there is a significant distance between the orifices of the internal and external iliac arteries owing to common iliac aneurysmal dilatation. We describe a technique involving insertion of an 18-mm tube graft between the proximal aortic neck and aneurysmal common iliac artery bifurcation. Revascularization of the contralateral external iliac artery is accomplished through an 8-mm side arm graft.
Hemodynamic Patterns of Spinal Cord Perfusion in Thoracoabdominal Aortic Aneurysm Repair
Authors: Rescigno Giuseppe , Banfi Carlo , Rossella Claudio , Nazari Stefano 
Published: October 2021

AbstractParaplegia in aortic surgery is due to its impact on spinal cord perfusion whose hemodynamic patterns (SCPHP) are not clearly defined. Detailed morphological analysis of vascular network and collateral network modifications within Monro–Kellie postulate due to the fixed theca confines was performed to identify SCPHP. SCPHP may begin with intraspinal “backflow” (I-BF), that is, hemorrhage from anterior and posterior spinal arteries, backward via the connected anterior and posterior radicular medullary arteries, through the increasing diameter and decreasing resistance of segmental arteries (SAs), off their aortic orifices outside vascular network at 0 operative field pressure. The I-BF blood bypasses both intra- and extraspinal capillary networks and causes depressurization (0 diastolic pressure) and full ischemia of dependent spinal cord. When the occlusion of those SAs orifices arrests I-BF, the hemodynamic pattern of intraspinal “steal” (I-S) may take place. The formerly I-BF blood, in fact, is now variably shared between the fraction maintained in its physiological intraspinal network and that keeping flowing as I-S through the extraspinal capillary network. I-S is, however, counteracted by the extraspinal “steal” from the connected mammary/paraspinous-independent extraspinal feeders, all physically competing for the same room left by the missed physiological SA direct aortic blood inflow. Steal phenomenon evolves within the 120-hour time frame of CNm, whose intraspinal anatomical changes may offer the physical basis within the Monro–Kelly postulate, respectively of the intraoperative and postoperative paraplegia. The current procedures could not prevent the unphysiological SCPHP but awareness of details of their various features may offer the basis for improvements tailored, to the adopted intra- and postoperative procedures.
Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation: Challenging Pathology Awaiting Specialized Devices
Authors: El-Gamel Adam 
Published: October 2021

AbstractPatients with aortic incompetence frequently present with anatomical and pathological challenges such as elliptical dilated annulus, dilated aortic root, dilated ascending aorta, and with no calcification in the aortic cusps or annulus. Patients are commonly in graver clinical condition as a result of a long silent clinical course before overt congestive heart failure. All of the above make transcatheter therapies for native aortic valve regurgitation more challenging with poorer outcomes, escalating the risk of insufficient anchoring, prosthesis migration, and residual paravalvular leak compared with current transcatheter aortic valve replacement (TAVR) outcomes for aortic stenosis. There is a need for specialized TAVR devices to address this complex pathology. Surgical aortic valve replacement is the current treatment option and the gold standard for patients with aortic incompetence (AR). Currently, the specific off-label indication for TAVR in pure native AR could be a feasible and reasonable option, as a compassionate treatment is limited to inoperable patients and agreed on by the heart team.