bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kurative Klauenpflege zur mechanischen Entlastung von Sohlengeschwüren – eine Ex-vivo-Studie
Authors: Fischer Daniela , Grund Sarah , Pesenhofer Robert , Friebel Luise , Mülling Christoph K.W. 
Published: May 2021

Zusammenfassung
Gegenstand und Ziel Hohe Druckbelastungen der Rinderklauen führen regelmäßig zu Schäden an den Klauengeweben und nachfolgend zu therapiebedürftigen Rusterholz’schen Sohlengeschwüren (RSG). Ein komplizierter Verlauf der RSG kann durch fachgerechte Klauenpflege verhindert werden. In dieser Studie wurde untersucht, wie sich ein an der Außenklaue der Hintergliedmaße vorgenommener stufenloser und keilförmiger Entlastungsschnitt vom Ballen bis zur Sohlenspitze auf die Druckverteilung unter den Klauen der Beckengliedmaße auswirkt und ob eine Veränderung der Druckverteilung zur Lederhautentlastung im Bereich des Defekts führt.
Material und Methode Neunzehn isolierte distale Rindergliedmaßen vom Schlachthof (A: unbearbeiteter Zustand) wurden schrittweise bearbeitet (B: funktionelle Klauenpflege, Schritt 1–3; C: Erweiterung der Hohlkehlung und kreisrunde Bohrung zur Simulation eines RSG an der Außenklaue; D: keilförmiger Entlastungsschnitt vom Ballen bis zur Hälfte der Sohlenfläche in Richtung Sohlenspitze; E: keilförmige Erweiterung des Entlastungsschnittes über die gesamte Sohlenfläche bis kurz vor die Sohlenspitze). Zwischen den einzelnen Bearbeitungsschritten wurden die Gliedmaßen mit 200 kg belastet. Die Druckverteilung unter den Klauen wurde mit Drucksensoren gemessen. Außerdem wurden die Klauen auf einer Glasplatte positioniert, was die Beurteilung der Vorwölbung der Lederhaut bzw. des Fettpolsters anhand des Bohrlochs ermöglichte.
Ergebnisse In Zustand A lasteten durchschnittlich 63 %, bei Zustand E 30 % der gesamten Kraft auf der Außenklaue. Mit zunehmender Bearbeitung der Klauen verlagerten sich die Druckmaxima vom Ballen- in den Sohlenspitzenbereich. Die relative Belastungsfläche der Innenklaue nahm mit fortschreitender Bearbeitung um bis zu 18,4 % zu. In Zustand E ergab sich im Vergleich zu C eine signifikante Reduzierung der Lederhautvorwölbung im Bereich des künstlichen Sohlendefekts.
Schlussfolgerung Der keilförmige Entlastungsschnitt (E) führte an den isolierten Rindergliedmaßen zu einer Außenklauen- und Ballenentlastung und stellt eine Methode zur Defekt- und Lederhautentlastung dar.
Klinische Relevanz Der Entlastungsschnitt könnte auch am lebenden Tier eine Druckentlastung der Außenklaue bewirken und so den Krankheitsverlauf von RSG positiv beeinflussen.
Ältere, einsame Männer mit Alkoholabhängigkeit: Systematische Literaturrecherche zum aktuellen Stand der alters- und geschlechtsspezifischen Interventionen
Authors: Klein Michael , Kemper Nicole , Lich Katharina , Winter-Wilms Felix 
Published: May 2021

ZusammenfassungDer Kenntnisstand zu Prävalenzen und Krankheitsverläufen älterer, einsamer Männer, die an Alkoholstörungen leiden, ist immer noch sehr gering und damit auch das Hilfeangebot. Die vorliegende systematische Literaturrecherche identifiziert die Risikofaktoren dieser Zielgruppe, den aktuellen Wissensstand über Alkoholkonsum bei älteren, einsamen Männern sowie den aktuellen Interventionsstand. Hierfür wurden nach einem umfangreichen Suchlauf 43 einschlägige Literaturquellen zum Thema Alkohol im Alter, Einsamkeit und Interventionen einbezogen. Eindeutiges Ergebnis ist, dass es wenige alters- oder geschlechtsspezifische Suchthilfeprogramme für Männer insgesamt gibt und keines, welches sich spezifisch auf ältere und einsame Männer ausrichtet. Einsamkeit wird in den Studien zwar hin und wieder als Problem bei Suchtkranken beschrieben, aber nicht explizit untersucht. Es wurde daher ein innovatives Interventionskonzept, das auf diese Gruppe zugeschnitten ist, entwickelt. Das Programm „Viktor“ bezieht sich auf diese Problematik und bietet ein spezifisches Angebot für Männer ab 55 Jahren mit einer Alkohol- und Einsamkeitsproblematik an.
Monitored needle acceleration in endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses improves sample quality and diagnostic accuracy: a randomized trial
Authors: Ciocîrlan Mihai , Gheorghiu Anca , Bilous Dana , Cruceru Miruna , Mănăilă Georgiana , Tianu Elena , Vlăduţ Cătălina 
Published: May 2021

Background Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is recommended for the diagnosis of solid pancreatic masses. We aimed to evaluate whether a high needle movement acceleration value during puncture increases diagnostic accuracy.
Methods EUS-FNA needle acceleration was measured using a PocketLab accelerometer connected by Bluetooth to a smartphone. Two passes (fast and slow, with higher and lower than 1g [9.8 m/s2] needle acceleration values, respectively) were performed in a random order. The sample cellularity and quality were measured using semiquantitative scales.
Results 51 patients were included (32 women; mean age 63). The mean (standard deviation [SD]) acceleration values were 1.59g (0.66g) for the fast pass and 0.32g (0.19g) for the slow pass (P < 0.001). The fast pass yielded significantly higher levels of EUS-FNA accuracy (84.3 % vs. 68.6 %; P = 0.02) and adequate quality scores (94.1 % vs. 76.5 %; P = 0.007). High cellularity scores were seen with similar frequencies (15.7 % vs. 11.8 %; P = 0.32).
Conclusions A higher than 1g EUS-FNA needle acceleration may increase the diagnostic accuracy and specimen quality from solid pancreatic lesions.
A Posterior Communicating Segment Aneurysm of the Supraclinoid Internal Carotid Artery Treated with an Extracranial to Intracranial Bypass and Trapping
Authors: Ozaydin Burak , Baykal Duygu , Ezgu Mehmet C. , Baskaya Mustafa K. 
Published: May 2021

AbstractSurgical treatment of giant aneurysms often poses significant challenges. Endovascular techniques have evolved exponentially over the last decades, and most of these complex aneurysms can be treated with flow-diverting techniques; however, successful obliteration of all giant aneurysms is not always possible with endovascular flow-diverting techniques. Although the need for microsurgical intervention has undoubtedly diminished, a versatile-thinking surgeon should keep in mind that obliteration of these aneurysms combined with revascularizing the distal circulation via extracranial–intracranial bypass techniques can provide a potentially life-long durable solution. The key to curing these pathologies is to utilize interdisciplinary decision making with a robust knowledge of the pros and cons of different treatment approaches. Herein, we present a case of a giant posterior communicating segment aneurysm of the left supraclinoid internal carotid artery (ICA), which was treated by obliteration (Fig. 1). Extradural anterior clinoidectomy was used to provide exposure of the supraclinoidal ICA proximal to the aneurysm, and revascularization of the distal circulation was achieved with a common carotid artery to M2-superior trunk bypass using a radial artery interposition graft (Fig. 2). The patient was a 62-year-old female who presented with vision loss in her left eye but was otherwise neurologically intact. She had a history of two unsuccessful flow-diverting stent placement attempts 2 months prior to this surgery. Postoperatively, the patient woke up without any deficits, with her left eye vision partially recovered and ultimately returning to normal at 1-year follow-up. Computed tomography (CT) angiography at a 1-year follow-up showed complete obliteration of the aneurysm and successful revascularization of the distal circulation.The link to the video can be found at: https://youtu.be/DsIuIJJj1l4.
Anatomical Basis of the Zygomatic-Transmandibular Approach: Operative Video
Authors: Guinto Gerardo , Hernandez Eli , Gallardo-Ceja David , Gallegos-Hernandez Francisco , Arechiga Norma , Guinto-Nishimura Gerardo 
Published: May 2021

AbstractTumor growth in infratemporal fossa (ITF) and parapharyngeal space (PPS) is generally slow and generates very few clinical manifestations, so it is not uncommon for tumors to reach large dimensions at the time of diagnosis, making necessary to perform ample approaches. In zygomatic-transmandibular approach (ZTMA), the access of the ITF and PPS is obtained by a combination of a pterional craniotomy plus a zygomatic-mandibular osteotomy. Tumor excision is achieved by its initial dissection from all of the neurovascular structures of the middle fossa by the neurosurgical team and the final resection by the head and neck team from below. In the first part of this video, we present a brief anatomical–surgical description of the ITF and PPS and in the second part, we show case of a trigeminal schwannoma that could be successfully removed through a ZTMA. Using this approach, an ample and safe exposure of the ITF and PPS is achieved, without affecting the chewing or facial nerve function and with excellent cosmetic results, so it can be considered as a reliable surgical option, particularly in cases of giant tumors that affect these regions (Figs. 1 and 2).The link to the video can be found at: https://youtu.be/oxVFhzT8HsQ.
Incidence of Hypertensive Disorders of Pregnancy in Women with COVID-19
Authors: Chornock Rebecca , Iqbal Sara N. , Wang Tiffany , Kodama Samantha , Kawakita Tetsuya , Fries Melissa 
Published: May 2021

Objective The study aimed to examine the incidence of hypertensive disorders of pregnancy in women diagnosed with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2, also known as COVID-19).
Study Design This was a retrospective cohort study of all women who delivered at MedStar Washington Hospital Center in Washington, DC from April 8, 2020 to July 31, 2020. Starting April 8, 2020, universal testing for COVID-19 infection was initiated for all women admitted to labor and delivery. Women who declined universal testing were excluded. Hypertensive disorders of pregnancy were diagnosed based on American College of Obstetricians and Gynecologists Task Force definitions.1 Maternal demographics, clinical characteristics, and labor and delivery outcomes were examined. Neonatal outcomes were also collected. Laboratory values from admission were evaluated. Our primary outcome was the incidence of hypertensive disorders of pregnancy among women who tested positive for COVID-19. The incidence of hypertensive disorders of pregnancy was compared between women who tested positive for COVID-19 and women who tested negative.
Results Of the 1,008 women included in the analysis, 73 (7.2%) women tested positive for COVID-19, of which 12 (16.4%) were symptomatic at the time of admission. The incidence of hypertensive disorders of pregnancy was 34.2% among women who tested positive for COVID-19 and 22.9% women who tested negative for COVID-19 (p = 0.03). After adjusting for race, antenatal aspirin use, chronic hypertension, and body mass index >30, the risk of developing any hypertensive disorder of pregnancy was not statistically significant (odds ratio: 1.58 [0.91–2.76]).
Conclusion After adjusting for potential confounders, the risk of developing a hypertensive disorder of pregnancy in women who tested positive for COVID-19 compared with women who tested negative for COVID-19 was not significantly different.
Key Points
Caring for Overweight Children and Adolescents at a Reference Clinic in Nutrology: Habits and Attendance
Authors: Moro Valeria , Del Ciampo Luiz Antonio 
Published: May 2021

Abstract
Introduction The global obesity epidemic has mobilized health services to offer care at all levels, with reference outpatient clinics playing a prominent role in cases of greater complexity.
Objectives The present study aimed to identify soft drinks consumption and physical activity habits among children and adolescents diagnosed with overweight and obesity during the first visit at a secondary level nutrology outpatient clinic, and to verify attendance at follow-up visits in a 2-year period from the first visit.
Materials and Methods This is a retrospective, descriptive study based on data collection from medical records of overweighted or obese patients receiving first care at the Nutrology Clinic of the Municipal Health Secretariat from Ribeirão Preto, São Paulo, Brazil. The study population included children and adolescents aged between 2 and 18 years old cared for from January 2, 2013 to December 30, 2017. Age, weight, height, soft drinks consumption, physical activity, and attendance in scheduled follow-up visits during a 2-year period were analyzed.
Results During the study period, 316 patients were registered, including 302 (95.5%) diagnosed with obesity. Of these, 112 (35.4%) were children and 204 (64.6%) were adolescents. Only 2.0% of the children and adolescents did not consume soft drinks, while 23.5 and 26.2% of the children and adolescents, respectively, consumed them daily. Physical inactivity was reported by 31.8% of the children and by 35.8% of the adolescents. Among those who practiced some type of physical activity, 81.3% of the children and 78.2% of the adolescents did not meet the recommendation of moderate to vigorous activity for 60 minutes per day. Dropout rates within the 1st year were of 41.9% for children and of 34.3% for adolescents, increasing to 76.9% and 73.8%, respectively, within the 2nd year.
Conclusion There was a high consumption of soft drinks and low adherence to physical activity among patients who started outpatient follow-up. A small adherence to the follow-up program was also identified, with high dropout rates within the 2-year period following the first visit.
Vitamin D Deficiency in Brazil: Questions about Potential Causes and Clinical Characteristics*
Authors: Vieira Fabrícia Belloni dos Santos , Ferreira Ana Paula Morguete , Giacomelli Felipe Rezende , Lima Lívia Gonçalves de , Hirose Thiago Santos , Zorzo Renato Augusto 
Published: May 2021

AbstractVitamin D is a micronutrient essential to various systems from the human body, and it is not restricted to the classical function of bone mineralization. Its synthesis is mainly related to ultraviolet B (UVB) radiation exposure. Although Brazil is a tropical country with high levels of UVB radiation, counter-intuitively, a large number of Brazilians present vitamin D deficiency, which is also a worldwide issue. This review aims to approach clinical features and explore potential causes for this apparent contradiction through questions that could explain vitamin D deficiency in the Brazilian population.
Metformin Exposure and Risk of Hypertensive Disorders of Pregnancy in Patients with Type 2 Diabetes
Authors: Racine Jenna L. , Adams Jacquelyn H. , Antony Kathleen M. , Hoppe Kara K. , Iruretagoyena Jesus I. , Stewart Katharina S. , Eddy April , Rhoades Janine S. 
Published: May 2021

Objective Metformin has been found to have a role in promoting vascular remodeling and angiogenesis which may reduce the risk of developing preeclampsia. Prior studies have shown a decrease in the incidence of hypertensive disorders of pregnancy in patients with type 2 and gestational diabetes taking metformin. We hypothesize metformin exposure decreases the risk of developing hypertension in patients with type 2 diabetes.
Study Design Retrospective cohort study from 2009 to 2019 of singleton pregnancies was complicated by type 2 diabetes. We compared patients who received metformin throughout pregnancy to those with no metformin exposure. The primary outcome was a hypertension composite defined as gestational hypertension, preeclampsia with or without severe features, HELLP syndrome, or eclampsia. Individual hypertensive outcomes and neonatal outcomes were secondarily evaluated. Logistic regression was used to adjust for confounding variables.
Results A total of 254 pregnancies were included. Women exposed to metformin were significantly less likely to develop hypertension composite compared with nonexposed women (22.7 vs. 33.1%, aOR 0.53, 95% CI 0.29–0.96). The incidence of preeclampsia with severe features was also significantly lower in those who received metformin compared with those who did not (12.1 vs. 20.7%, aOR 0.38, 95% CI 0.18–0.81). There were no differences in preterm birth prior to 34 or 37 weeks, fetal growth restriction, or birth weight between the study groups. A subgroup analysis of women without chronic hypertension also had a significantly lower risk of developing preeclampsia with severe features (7.6 vs. 17.8%, aOR 0.35, 95% CI 0.13–0.94).
Conclusion Metformin exposure was associated with a decreased risk of composite hypertensive disorders of pregnancy in patients with pregestational type 2 diabetes. These data suggest that there may be benefit to metformin administration beyond glycemic control in this patient population.
Key Points
The Impact of Maternal Preeclampsia and Hyperglycemia on the Cardiovascular Health of the Offspring: A Systematic Review and Meta-analysis
Authors: Hoodbhoy Zahra , Mohammed Nuruddin , Nathani Karim Rizwan , Sattar Saima , Chowdhury Devyani , Maskatia Shiraz , Tierney Seda , Hasan Babar , Das Jai K. 
Published: May 2021

Objectives The objective of this review was to assess the impact of maternal preeclampsia or hyperglycemia on the body composition and cardiovascular health in the offspring.
Study Design We conducted a systematic review utilizing PubMed, EBSCO, CINAHLPlus, Cochrane Library, and Web of Science to include all studies assessing the impact of preeclampsia/eclampsia and/or gestational/pregestational diabetes mellitus on the health of the offspring (children <10 years of age). The health measures included anthropometry, cardiac dimensions and function, and vascular function. We performed a meta-analysis using Review Manager software and computed net risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and mean difference (MD) with 95% CI for continuous data.
Results There were 6,376 studies in total, of which 45 were included in the review and 40 in the meta-analysis. The results demonstrated higher birth weight (MD: 0.12 kg; 95% CI: 0.06–0.18) and systolic and diastolic blood pressure (BP; MD: 5.98 mm Hg; 95% CI: 5.64–6.32 and MD: 3.27 mm Hg; 95% CI: 0.65–5.89, respectively) in the offspring of mothers with gestational diabetes compared to controls. In contrast, the offspring of mothers with preeclampsia had lower birth weight (MD: −0.41 kg; 95% CI: −0.7 to −0.11); however, they had increased systolic (MD: 2.2 mm Hg; 95% CI: 1.28–3.12) and diastolic BP (MD: 1.41 mm Hg; 95% CI: 0.3–2.52) compared to controls. There is lack of data to conduct a meta-analysis of cardiac morphology, functional, and vascular imaging parameters.
Conclusion These findings suggest that the in-utero milieu can have a permanent impact on the body composition and vascular health of the offspring. Future work warrants multicenter prospective studies to understand the mechanism and the actual effect of exposure to maternal hyperglycemia and high BP on the cardiovascular health of the offspring and long-term outcomes.
Key Points
Combination of Fundal Height and Ultrasound to Predict Small for Gestational Age at Birth
Authors: Grantz Katherine L. , Ortega-Villa Ana M. , Pugh Sarah J. , Bever Alaina , Grobman William , Newman Roger B. , Owen John , Wing Deborah A. , Albert Paul S. 
Published: May 2021

Objective The objective of the study was to determine whether adding longitudinal measures of fundal height (FH) to the standard cross-sectional FH to trigger third trimester ultrasound estimated fetal weight (EFW) would improve small for gestational age (SGA) prediction.
Study Design We developed a longitudinal FH calculator in a secondary analysis of a prospective cohort study of 1,939 nonobese pregnant women who underwent serial FH evaluations at 12 U.S. clinical sites. We evaluated cross-sectional FH measurement ≤ –3 cm at visit 3 (mean: 32.0 ± 1.6 weeks) versus the addition of longitudinal FH up to and including visit 3 to trigger an ultrasound to diagnose SGA defined as birth weight <10th percentile. If the FH cut points were not met, the SGA screen was classified as negative. If FH cut points were met and EFW was <10th percentile, the SGA screen was considered positive. If EFW was ≥10th percentile, the SGA screen was also considered negative. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were computed.
Results In a comparison of methods, 5.8% of women were classified as at risk of SGA by both cross-sectional and longitudinal classification methods; cross-sectional FH identified an additional 4.0%, and longitudinal fundal height identified a separate, additional 4.5%.Using cross-sectional FH as an ultrasound trigger, EFW had a PPV and NPV for SGA of 69 and 92%, respectively. After adding longitudinal FH, PPV increased to 74%, whereas NPV of 92% remained unchanged; however, the number of women who underwent triggered EFW decreased from 9.7 to 5.7%.
Conclusion An innovative approach for calculating longitudinal FH to the standard cross-sectional FH improved identification of SGA birth weight, while simultaneously reducing the number of triggered ultrasounds. As an essentially free-of-charge screening test, our novel method has potential to decrease costs as well as perinatal morbidity and mortality (through better prediction of SGA).
Key Points
Toroidal soft x-ray array on the EXL-50 spherical tokamak
Authors: Huang X. L. , Zhang Y. P. , Zhu Y. B. , Li X. , He L. , Li Y. X. , Zhou J. , Cheng S. K. , Yang Y. M. , Bai R. H. , Zhao X. , Tao R. Y. , Chen B. , Dai L. L. , Zeng G. Q. , Liu Y. , Liu M. S. 
Published: May 2021

A toroidal soft x-ray array system for spectrum and intensity measurements on the EXL-50 spherical tokamak is described. Silicon drift detectors and digital multichannel analyzers are adopted for all 21 channels of the array, and an average energy resolution of 147 eV at 5.89 keV has been achieved at count rates over 500 kcps. In total, 20 channels of the array are symmetrically observed in both co- and counter-current directions on the EXL-50 mid-plane with a spatial resolution of around 10 cm, and the remaining one serves as a background reference channel. Tungsten emissions from tungsten coating of the limiters on the central post are observed. The influence of hard x rays on measured soft x-ray spectra and system operation is discussed.
Design and operation of a transportable 87Rb atomic fountain clock
Authors: Cheng He-nan , Zhang Zhen , Deng Siminda , Ji Jing-wei , Ren Wei , Xiang Jing-feng , Zhao Jian-bo , Zhao Xin , Ye Mei-feng , Li Lin , Li Tang , Qu Qiu-zhi , Chen Weiliang , Liu Kun , Dai Shaoyang , Fang Fang , Li Tianchu , Liu Liang , Lü De-sheng 
Published: May 2021

A transportable fountain clock with high reliability is important for high-precision time-frequency measurements. Because of its relatively small cold atoms’ collision frequency shift and ease of attaining high quantum state preparation efficiency, the rubidium atomic fountain clock has an indicated higher stability and reliability. This paper reports the design and operation of a transportable rubidium atomic fountain clock developed by the Shanghai Institute of Optical and Fine Mechanics, Chinese Academy of Science. After being transported more than 1000 km from Shanghai to the Changping Campus of the National Institute of Metrology, China, the optical platform and other hardware of the fountain clock did not need to be adjusted. The rubidium fountain clock maintained a stability of 4.0 × 10−13τ1/2, reaching 5.0 × 10−16 at 300 000 s. After transportation, the rubidium fountain clock and a cesium fountain clock (NIM5) were operated together against the reference frequency of a hydrogen maser. In three separate operating periods, over a total of nearly three months, the average frequency repeatability of the rubidium fountain was less than 3.8 × 10−15.