bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bleeding Disorder of Unknown Cause: A Diagnosis of Exclusion
Authors: Mehic Dino , Gebhart Johanna , Pabinger Ingrid 
Published: February 2024

AbstractPatients with an unexplained mild to moderate bleeding tendency are diagnosed with bleeding disorder of unknown cause (BDUC), a classification reached after ruling out other mild to moderate bleeding disorders (MBD) including von Willebrand disease (VWD), platelet function defects (PFDs), coagulation factor deficiencies (CFDs), and non-hemostatic causes for bleeding. This review outlines our diagnostic approach to BDUC, a diagnosis of exclusion, drawing on current guidelines and insights from the Vienna Bleeding Biobank (VIBB). According to guidelines, we diagnose VWD based on VWF antigen and/or activity levels ≤50 IU/dL, with repeated VWF testing if VWF levels are <80 IU/dL. This has been introduced in our clinical routine after our findings of diagnostically relevant fluctuations of VWF levels in a high proportion of MBD patients. PFDs are identified through repeated abnormalities in light transmission aggregometry (LTA), flow cytometric mepacrine fluorescence, and glycoprotein expression analysis. Nevertheless, we experience diagnostic challenges with regard to reproducibility and unspecific alterations of LTA. For factor (F) VIII and FIX deficiency, a cutoff of 50% is utilized to ensure detection of mild hemophilia A or B. We apply established cutoffs for other rare CFD being aware that these do not clearly reflect the causal role of the bleeding tendency. Investigations into very rare bleeding disorders due to hyperfibrinolysis or increase in natural anticoagulants are limited to cases with a notable family history or distinct bleeding phenotypes considering cost-effectiveness. While the pathogenesis of BDUC remains unknown, further explorations of this intriguing area may reveal new mechanisms and therapeutic targets.
Minimally Invasive Correction of Failed Percutaneous Atrial Septal Closure with Device Embolization
Authors: Costa Vlander , Caldonazo Tulio , Montanhesi Paola , Fischer Johannes , Mukharyamov Murat , Kirov Hristo , Doenst Torsten 
Published: February 2024

AbstractWe present the case of a minimally invasive surgical correction for failed percutaneous atrial septal defect (ASD) closure in a 57-year-old female patient with residual ASD, tricuspid regurgitation, atrial fibrillation, and embolization of one of two occluders to the superior mesenteric artery. Our surgical approach consisted of anterolateral minithoracotomy, aortic and femoral vein cannulation, cryoablation, cardiac device removal, closure of ASD with autologous pericardium, and tricuspid repair. The procedure was uneventful and patient was discharged home on postoperative day 4.
Social Determinants of Health and Patient-reported Outcomes Following Autologous Breast Reconstruction, Using Insurance as a Proxy
Authors: Plotsker Ethan L. , Graziano Francis D. , Kim Minji , Boe Lillian A. , Tadros Audree B. , Matros Evan , Azoury Said C. , Nelson Jonas A. 
Published: February 2024

Abstract
Background Insurance type can serve as a surrogate marker for social determinants of health and can influence many aspects of the breast reconstruction experience. We aimed to examine the impact of insurance coverage on patients reported outcomes with the BREAST-Q (patient reported outcome measure for breast reconstruction patients, in patients receiving) in patients receiving deep inferior epigastric artery perforator (DIEP) flap breast reconstruction.
Methods We retrospectively examined patients who received DIEP flaps at our institution from 2010 to 2019. Patients were divided into categories by insurance: commercial, Medicaid, or Medicare. Demographic factors, surgical factors, and complication data were recorded. Descriptive statistics, Fisher's exact, Kruskal–Wallis rank sum tests, and generalized estimating equations were performed to identify associations between insurance status and five domains of the BREAST-Q Reconstructive module.
Results A total of 1,285 patients were included, of which 1,011 (78.7%) had commercial, 89 (6.9%) had Medicaid, and 185 (14.4%) had Medicare insurances. Total flap loss rates were significantly higher in the Medicare and Medicaid patients as compared to commercial patients; however, commercial patients had a higher rate of wound dehiscence as compared to Medicare patients. With all other factors controlled for, patients with Medicare had lower Physical Well-being of the Chest (PWBC) than patients with commercial insurance (β = − 3.1, 95% confidence interval (CI): −5.0, −1.2, p = 0.002). There were no significant associations between insurance classification and other domains of the BREAST-Q.
Conclusion Patients with government-issued insurance had lower success rates of autologous breast reconstruction. Further, patients with Medicare had lower PWBC than patients with commercial insurance regardless of other factors, while other BREAST-Q metrics did not differ. Further investigation as to the causes of such variation is warranted in larger, more diverse cohorts.
Challenges in the Monitoring of Therapeutic Plasma Exchange during Acute Heparin-Induced Thrombocytopenia in Adults under ECMO
Authors: Cavalie Candice , Gendron Nicolas , Kantor Elie , Provenchère Sophie , Sonneville Romain , Gkalea Vasiliki , Bourrienne Marie-Charlotte , Faille Dorothée , Ajzenberg Nadine 
Published: February 2024

AbstractTherapeutic plasma exchange (TPE) has been proposed to remove heparin-induced thrombocytopenia (HIT) antibodies before planned thoracic surgery in patients with acute HIT and to allow brief re-exposure to heparin during surgery. In patients on extracorporeal membrane oxygenation (ECMO), simultaneous administration of TPE and alternative nonheparin anticoagulant therapies is challenging.We report 2 patients on ECMO with acute HIT who underwent repeated TPE to enable cardiothoracic surgery with the use of heparin. In both cases, serial monitoring of HIT antibody titer and heparin-induced platelet activation assay (HIPA) was performed. The effect of adding exogenous platelet factor 4 (PF4) in the HIPA was also tested.Negative anti-PF4/H IgG levels were achieved after 5 and 3 TPE sessions, respectively and patients could beneficiate from surgery with brief heparin re-exposure without any thrombotic complication. Negative HIPA results were obtained before negative anti-PF4/H IgG in one patient but remained positive in the other despite very low antibody titers. The addition of PF4 in HIPA led to more contrasted results for the two patients.Serial HIT screening including immunological and functional assays is necessary to closely monitor TPE in acute HIT patients on ECMO who require surgery. The addition of PF4 in HIPA could help detect clinically relevant platelet-activating antibodies and guide re-exposure to heparin.
Cluster Preface: Biomimetic Synthesis
Authors: Deng Jun , Tang Yefeng 
Published: February 2024

Jun Deng (left) received his B.Sc. from Lanzhou University and his Ph.D. from the Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences (2014) with Professor Ang Li. After a short period of postdoctoral research in the lab of Professor Andrew Myers at Harvard University (2014–2016), he was appointed a Pioneer ‘Hundred Talents Program’ Researcher at Kunming Institute of Botany, Chinese Academy of Sciences in 2017. In December 2020, he moved to Nankai University where he is a professor at the College of Chemistry. He received the Thieme Journals Award (2020). His research focuses on natural product total synthesis and medicinal chemistry.
Yefeng Tang (right) earned his B.S. from Lanzhou University (1995–1999) and his M.S. from the Institute of Materia Medica, Chinese Academy of Medical Science (1999–2002). From 2003 to 2006, he pursued his Ph.D. under the guidance of Professor Zhen Yang and Professor Jiahua Chen at Peking University. Subsequently, he conducted postdoctoral research with Prof. K. C. Nicolaou at The Scripps Research Institute between 2006 and 2009. In 2010, he commenced his independent career at the School of Pharmaceutical Sciences, Tsinghua University, where he is now a tenured professor. His primary research interests encompass the total synthesis of natural products, the development of synthetic methodologies, and the discovery of antiviral and anti-aging drugs.
Hybrid Lymphovenous Anastomosis Surgery Guided by Intraoperative Mesenteric Intranodal Lymphangiography for Refractory Nontraumatic Chylous Ascites: A Case Report
Authors: Woo Soo Jin , Hur Saebeom , Kim Hee Seung , Chang Hak , Kim Ji-Young , Park Soo Jin , Jin Ung Sik 
Published: February 2024

AbstractRefractory chylous ascites can cause significant nutritional and immunologic morbidity, but no clear treatment has been established. This article introduces a case of a 22-year-old female patient with an underlying lymphatic anomaly who presented with refractory chylous ascites after laparoscopic adnexectomy for ovarian teratoma which aggravated after thoracic duct embolization. Ascites (>3,000 mL/d) had to be drained via a percutaneous catheter to relieve abdominal distention and consequent dyspnea, leading to significant cachexia and weight loss. Two sessions of hybrid lymphovenous anastomosis (LVA) surgery with intraoperative mesenteric lymphangiography guidance were performed to decompress the lymphatics. The first LVA was done between inferior mesenteric vein and left para-aortic enlarged lymphatics in a side-to-side manner. The daily drainage of chylous ascites significantly decreased to 130 mL/day immediately following surgery but increased 6 days later. An additional LVA was performed between right ovarian vein and enlarged lymphatics in aortocaval area in side-to-side and end-to-side manner. The chylous ascites resolved subsequently without any complications, and the patient was discharged after 2 weeks. The patient regained weight without ascites recurrence after 22 months of follow-up. This case shares a successful experience of treating refractory chylous ascites with lymphatic anomaly through LVA, reversing the patient's life-threatening weight loss. LVA was applied with a multidisciplinary approach using intraoperative mesenteric lipiodol, and results showed the possibility of expanding its use to challenging problems in the intraperitoneal cavity.
Prediction Pressure Ulcers in High Care Unit Patients: Evaluating Risk Factors and Predictive Scale Using a Prospective Cross-Sectional Study
Authors: Indraswari Anies Dewi Wirati , Aisyiyah Umi , Kurniawan Kurniawan , Surboyo Meircurius Dwi Condro 
Published: February 2024

Abstract
Background The incidence of ulcer pressure in the high care unit (HCU) was relatively high and could be reliably predicted using tools such as the Norton and Jackson/Cubbin scales. However, other risk factors, such as age, gender, consciousness, systemic condition, duration of treatment, and use of restraint, may contribute to the occurrence of ulcer pressure. This study was conducted to analyze the relationship of various risk factors for pressure ulcers and prediction of ulcer pressure, using Norton and Jackson/Cubbin scale, to incident pressure ulcers in HCU patient.
Methods This study utilized a prospective cross-sectional study design to analyze various risk factors for ulcer pressure development in a patient admitted to the HCU, including age, gender, blood profile, consciousness, duration of treatment, and use of restraint. The Norton and Jackson/Cubbin scale was employed to predict pressure ulcers. The relationship between the risk factors and the prediction of pressure ulcer incidents was evaluated using multiple logistic binary regression analysis.
Result Both the Norton and Jackson/Cubbin scales predicted a lower risk of pressure ulcer development (60.98 and 99.02%, respectively). This prediction is consistent with the low incidence of pressure injuries found, which is only 4.39%. Furthermore, the relationship between the identified risk factor (gender, duration of treatment in HCU and use of restraint) and the prediction and incident of pressure ulcer was not significant (p > 0.05). Thus, it is suggested that these risk factors may not strong predictors of pressure ulcer development.
Conclusion This study's result indicated no significant relationship exists between possible identified risk factors and the development of pressure ulcers in HCU patients. However, the Norton and Jackson/Cubbin scales were reliable predictors of pressure ulcer occurrence, with both scales predicting a lower risk of pressure ulcer development.
Does Steal Phenomenon Exist in Multiple Neurotization?—An Experimental Rat Study
Authors: Lu Johnny Chuieng-Yi , Lin Jerry Tsung-Kai , Chuang David Chwei-Chin 
Published: February 2024

Abstract
Background Nerve transfers from one common donor nerve to recipient nerves with multiple target branches can yield slower and unpredictable recovery in the target nerves. Our hypothesis is that steal phenomenon exists when multiple nerve neurotization comes from one donor nerve.
Methods In 30 Sprague-Dawley rats, the left ulnar nerve (UN) was selected as the donor nerve, and the musculocutaneous nerve (MCN) and median nerve (MN) as the recipient target nerves. The rats were separated into three groups (10 rats in each): group A, UN-to-MCN (one-target); group B, UN-to-MN (one-target); and group C, UN-to-MCN and MN (two-target). The right upper limbs were nonoperative as the control group. Outcome obtained at 20 weeks after surgery included grooming test, muscle weight, compound muscle action potential, tetanic muscle contraction force, axon counts, and retrograde labeling of the involved donor and target nerves.
Results At 20 weeks after surgery, muscles innervated by neurotization resulted in significant worse outcomes than the control side. This was especially true in two-target neurotization in the parameter of muscle weight and forearm flexor muscle contraction force outcome when compared to one-target neurotization. Steal phenomenon does exist because flexor muscle contraction force was significantly worse during two-target neurotization.
Conclusion This study proves the existence of steal phenomenon in multiple target neurotization but does not significantly affect the functional results. Postoperative rehabilitative measures (including electrical stimulation, induction exercise) and patient compliance (ambition and persistence) are other crucial factors that hold equivalent importance to long-term successful recovery.
Das bietet Ihnen der VPT 2024
Authors: Pintarelli-Rauschenbach Manuela 
Published: February 2024

ZusammenfassungNeues Jahr – neue Preise: Mit dieser guten Nachricht konnten wir nach erfolgreichen Verhandlungen mit den Vertragspartnern ins neue Jahr starten. Ein guter Anfang. Für 2024 haben wir uns noch eine Menge mehr vorgenommen.
Implementing the debt-for-nature swaps for marine protected areas: case studies from Seychelles and Belize
Authors: Jiang Xiaoyi , Cao Hao 
Published: February 2024

AbstractAs a financing method providing financial support for environmental protection, debt-for-nature swaps (DFNS) have been implemented for nearly forty years. DFNS have covered marine protected areas (MPAs) in four countries since 2015. Although extensive literature discusses the various issues surrounding DFNS, only some researchers have connected the topics of DFNS and MPAs to evaluate the performance of implementing DFNS for financing MPAs. This paper contributes to filling this gap by analyzing the performance of the DFNS for financing MPAs from economic, legal, and environmental aspects by case studies from Seychelles and Belize. It aims to find an answer to the research question of whether the implementation of DFNS is a viable option for financing MPAs by exploring the current performance and discussing the future development of implementing the DFNS for MPAs. The DFNS has played a positive role in establishing MPAs in Seychelles and Belize by providing stable financial support for MPAs and improving the debt sustainability of debtor countries to some extent. However, there are various barriers from a legal perspective in reaching a swap agreement, ensuring the effective implementation of the agreement, and improving the transparency construction. With the trend of increasing scale and amount of debt relief and funding, the DFNS is expected to play an important role in promoting the establishment of MPAs, realizing the economic benefits, and having a satisfactory performance by legal measures. It concludes that with the transparency construction of information disclosure, special legislation on DFNS, an appropriate scale of debt for conversion determined by considering the debt sustainability, an adaptation to the innovation of the contractual approach of sovereign debt restructuring, and complementary assistance from different levels, the implementation of DFNS can be a viable option for financing MPAs.
Nanocomposite thin films containing Pt nanoparticles dispersed in an α-Fe2O3 matrix by RF sputtering
Authors: Abe Seishi 
Published: February 2024

The preparation of nanocomposite thin films that phase-separate Pt and α-Fe2O3 was investigated. These films were prepared on water-cooled glass substrates by radio frequency sputtering in an Ar atmosphere. X-ray diffraction patterns reveal that iron oxide forms Fe3O4 in the as-deposited state and undergoes a phase transition to α-Fe2O3 after heat treatment in the air. Pt is phase-separated from iron oxides in the as-deposited state and during heat treatment in the air, with a crystallite size of less than 2 nm in the as-deposited state, which varies between 2 and 15 nm after heat treatment in the air, estimated from the x-ray diffraction peaks. High-resolution transmission electron microscopy of the sample after heat treatment in the air reveals that spherical particles with a relatively uniform size are dispersed, which are assigned to Pt from fast Fourier transform analysis, while the surrounding area is assigned to α-Fe2O3. Thus, the thin film forms a nanocomposite thin film in which Pt nanoparticles are dispersed in α-Fe2O3.
Irregularity of instantaneous gamma frequency in the motor control network characterize visuomotor and proprioceptive information processing
Authors: Ryu Jihye , Choi Jeong Woo , Niketeghad Soroush , Torres Elizabeth B , Pouratian Nader 
Published: February 2024

Abstract

Objective. The study aims to characterize movements with different sensory goals, by contrasting the neural activity involved in processing proprioceptive and visuo-motor information. To accomplish this, we have developed a new methodology that utilizes the irregularity of the instantaneous gamma frequency parameter for characterization. Approach. In this study, eight essential tremor patients undergoing an awake deep brain stimulation implantation surgery repetitively touched the clinician’s finger (forward visually-guided/FV movement) and then one’s own chin (backward proprioceptively-guided/BP movement). Neural electrocorticographic recordings from the motor (M1), somatosensory (S1), and posterior parietal cortex (PPC) were obtained and band-pass filtered in the gamma range (30–80 Hz). The irregularity of the inter-event intervals (IEI; inverse of instantaneous gamma frequency) were examined as: (1) auto-information of the IEI time series and (2) correlation between the amplitude and its proceeding IEI. We further explored the network connectivity after segmenting the FV and BP movements by periods of accelerating and decelerating forces, and applying the IEI parameter to transfer entropy methods. Main results. Conceptualizing that the irregularity in IEI reflects active new information processing, we found the highest irregularity in M1 during BP movement, highest in PPC during FV movement, and the lowest during rest at all sites. Also, connectivity was the strongest from S1 to M1 and from S1 to PPC during FV movement with accelerating force and weakest during rest. Significance. We introduce a novel methodology that utilize the instantaneous gamma frequency (i.e. IEI) parameter in characterizing goal-oriented movements with different sensory goals, and demonstrate its use to inform the directional connectivity within the motor cortical network. This method successfully characterizes different movement types, while providing interpretations to the sensory-motor integration processes.
Icariin regulates RANKL-induced osteoclast differentiation via the ERα/c-Src/RANK signaling
Authors: Yang Shaolin , Zhang Xiaocui , Liao Xiaofei , Ding Yi , Gan Juwen 
Published: February 2024

Abstract
Osteoporosis (OP) is a common metabolic bone disease. Excessive osteoclastic activity significantly contributes to the development of OP. Icariin (ICA) is a flavonol glycoside derived from herbal plants and possesses curative effects on postmenopausal OP and bone fracture. This study aimed to investigate the effects of ICA on osteoclast differentiation induced by receptor activator of nuclear factor kappa B (RANK) ligand (RANKL) and the involvement of estrogen receptor α (ERα) and RANK signaling cascade in this process. RANKL was used to induce the differentiation of RAW264.7 cells to into osteoclasts. Small interfering RNA technique was used to knockdown ERα in cells. Cell counting kit-8 assay was performed to determine the cytotoxicity of ICA. The number of tartrate-resistant acid phosphatase (TRAP)-positive cells was quantified by TRAP staining. RANKL induced the differentiation of RAW264.7 cells into osteoclasts, while ICA abolished the pro-osteoporotic effect of RANKL. Moreover, ERα knockdown abolished the effects of ICA on RANKL-induced osteoclastogenesis. Further exploration revealed that ICA inhibited the phosphorylation of c-Src in osteoclasts via regulating ERα, while inactivation of c-Src reversed ERα knockdown-promoted osteoclastogenesis. Lastly, ICA inhibited the activation of the mitogen-activated protein kinase signaling pathway and downregulated the expressions of target osteoclastogenic proteins in RANKL-treated RAW 264.7 cells, while ERα knockdown almost completely diminished the effects of ICA. ICA inhibited RANKL-induced osteoclast differentiation via regulating the ERα/c-Src/RANK signaling. These findings elucidated a novel mechanism by which ICA exerts an anti-osteoporotic effect.
Superintegrability and deformed oscillator realizations of quantum TTW Hamiltonians on constant-curvature manifolds and with reflections in a plane
Authors: Marquette Ian , Parr Anthony 
Published: February 2024

Abstract
We extend the method for constructing symmetry operators of higher order for two-dimensional quantum Hamiltonians by Kalnins et al (2010 J. Phys. A: Math. Theor.
43 265205). This expansion method expresses the integral in a finite power series in terms of lower degree integrals so as to exhibit it as a first-order differential operators. One advantage of this approach is that it does not require the a priori knowledge of the explicit eigenfunctions of the Hamiltonian nor the action of their raising and lowering operators as in their recurrence approach (Kalnins et al 2011 SIGMA
7 031). We obtain insight into the two-dimensional Hamiltonians of radial oscillator type with general second-order differential operators for the angular variable. We then re-examine the Hamiltonian of Tremblay et al (2009 J. Phys. A: Math. Theor.
42 242001) as well as a deformation discovered by Post et al (2011 J. Phys. A: Math. Theor.
44 505201) which possesses reflection operators. We will extend the analysis to spaces of constant curvature. We present explicit formulas for the integrals and the symmetry algebra, the Casimir invariant and oscillator realizations with finite-dimensional irreps which fill a gap in the literature.