bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Clinical Use of the Novacor Left Ventricular Assist Device as a Bridge to Transplantation
Authors: Ramsey James , Frist William H. , Hammon John W. , Merrill Walter H. , Stewart James R. , Bender Harvey W. 
Published: August 2023

The Novacor left ventricular assist device (NLVAD) is an implantable, electrically powered, pulsatile circulatory assist device undergoing clinical investigation. This report reviews the 33-day bridge-to-transplant course of a patient presenting in cardiogenic shock after acute myocardial infarction who could not be weaned from cardiopulmonary bypass following emergency coronary artery revascularization.
Cardiac output was satisfactory during the entire 33-day period: 4.2 ± 0.8 1/min (± SD) during the first week and 6.3 ± 0.9 thereafter. Haptoglobin remained low (30 ± 4 mg%), suggesting mild hemolysis, but plasma hemoglobin remained normal throughout and the patient required only 600 ml of blood after the first two postoperative days. Renal impairment (peak creatinine = 2.9 mg/dl on day three) was attributed to preoperative hypotension and resolved by day seven. The clinical course included pneumonia and hypoxic encephalopathy, both of which resolved. There were no thromboembolic complications or device-related infections. The patient underwent orthotopic cardiac transplantation on day 33.
This case demonstrates the long term clinical efficacy and safety of the NLVAD in the setting of cardiogenic shock after massive myocardial infarction as a bridge-to-transplant support system.
Retrospektive Versorgungsstudie von d-uo zur Therapie des mCRPC mit Radium-223-dichlorid
Authors: Jores Charlotte , König Frank , Hellmis Eva , Grund Christina , Klier Jörg , Zillmann Roger , Eichenauer Rolf , Schönfelder Robert , Johannsen Manfred , Schröder Jörg , Hempel Elke , Doehn Christian 
Published: August 2023

ZusammenfassungIm Rahmen der Phase III-Studie ERA-223 wurde bei Patienten mit einem metastasierten
kastrationsresistenten Prostatakarzinoms (mCRPC) unter einer Kombinationstherapie mit
Radium-223 und Abirateron ein erhöhtes Fraktur- und möglicherweise auch ein erhöhtes
Sterberisiko festgestellt. Dies hat im Jahr 2018 zu einer Änderung des Zulassungstextes
geführt. Radium-223 darf in Deutschland erst in der 3. Therapielinie als Monotherapie neben
der Androgendeprivations-Therapie (ADT) beim mCRPC mit symptomatischen Knochenmetastasen ohne
bekannte viszerale Metastasen oder bei Patienten mit mCRPC, für die keine andere verfügbare
systemische Therapie geeignet ist, eingesetzt werden. Da zur Versorgungrealität in Deutschland
kaum Daten existieren, wurden in der vorliegenden Studie die Mitglieder von d-uo (Deutsche Uro-Onkologen) bezüglich ihres Therapieverhaltens befragt. Es konnten Daten von 123
Patienten analysiert werden, welche zwischen 2014 und 2019 eine Behandlung mit Radium-223
erhielten. Es zeigte sich, dass knapp 50% der mCRPC-Patienten bereits vor der Label-Änderung
Radium-223 erst nach 2 Vortherapien erhalten haben. Etwa die Hälfte der Patienten erhielt
parallel eine der neuen Androgenrezeptor- gerichteten Therapien (Androgen Receptor Targeting
Agents, ARTA). Das führte jedoch im Gegensatz zur ERA-223 nicht zu einer erhöhten Frakturrate.
Allerdings erhielten ein Großteil der Patienten zeitgleich eine Osteoprotektion. Trotz des
späten Einsatzes von Radium-223 zeigten noch knapp die Hälfte der Patienten ein Ansprechen auf
die Therapie.
Zystische Halsläsionen im Schnittbild
Authors: Vogl Thomas J. , Helal Rania 
Published: August 2023

ZusammenfassungZystische Läsionen sind in der Halsbildgebung relativ häufig. Es kommen verschiedene angeborene oder erworbene Veränderungen als Ursache infrage, die primär mit Ultraschall, aber auch mit CT und MRT und ggf. auch bioptisch analysiert werden sollten, um die adäquate Therapie einleiten zu können. In diesem Beitrag werden die bildgebenden Kriterien dieser zystischen Läsionen dargestellt.
Schilddrüse und Schwangerschaft
Authors: Koehler Viktoria Florentine , Auernhammer Christoph , Spitzweg Christine 
Published: August 2023

Zusammenfassung
Physiologische Anpassungen der Schilddrüsenfunktion in der Schwangerschaft Die Schwangerschaft hat umfangreiche physiologische Auswirkungen auf die Schilddrüse und den Schilddrüsenhormonstoffwechsel. Dies muss bei der Beurteilung der Schilddrüsenlaborparameter unter Beachtung trimenonspezifischer Referenzbereiche sowie bei der Indikationsstellung für den Beginn einer Therapie berücksichtigt werden.
Schilddrüsen-Autoantikörper-positive euthyreote Schwangere Die Auswirkungen subklinischer Schilddrüsenfunktionsstörungen und/oder positiver Schilddrüsen-Autoantikörper auf die werdende Mutter sowie den Embryo/Feten werden weiterhin kontrovers diskutiert. Bei euthyreoten Schwangeren mit positiven Schilddrüsen-Autoantikörpern kann eine Levothyroxin (LT4)-Substitution, insbesondere bei Abortrezidiven, diskutiert werden.
Subklinische Hypothyreose Die Kombination aus erhöhten Thyreoperoxidase-Antikörpern (TPO-AK) und einer subklinischen Hypothyreose scheint das Risiko für schwangerschaftsassoziierte Komplikationen zu erhöhen, weshalb bei subklinischer Hypothyreose auch unter Berücksichtigung des TPO-AK-Status individuell, jedoch insgesamt großzügig, die Indikation zur LT4-Substitution gestellt wird. Bei einer Substitutionstherapie sollte aber nach der Schwangerschaft die Situation neu evaluiert werden, da viele Mütter keine dauerhafte Schilddrüsenhormongabe benötigen.
Manifeste Hypothyreose Die manifeste Hypothyreose ist immer eine klare Indikation für eine rasche LT4-Gabe mit dem Ziel, möglichst zügig eine Euthyreose zu erreichen.
Hyperthyreose Die häufig im 1. Trimenon auftretende – physiologische, durch humanes Choriongonadotropin (hCG) vermittelte – passagere Verminderung bis hin zur Suppression des Thyreoidea-stimulierenden Hormons (TSH) stellt keine Indikation für Thyreostatika dar. Bei anderen Formen der manifesten Hyperthyreose muss die Indikation für eine thyreostatische Medikation (Propylthiouracil oder Thionamide) in der Schwangerschaft aufgrund von möglichen teratogenen Effekten sowie der Gefahr der Induktion einer hypothyreoten Stoffwechsellage beim Feten sehr streng sowie trimenonspezifisch gestellt werden und erfordert ein interdisziplinäres Management.
Medulläres Schilddrüsenkarzinom
Authors: Kroiß Matthias , Köhler Viktoria Florentine , Spitzweg Christine 
Published: August 2023

Zusammenfassung
Diagnose und Prognose Calcitonin ist ein sensitiver und spezifischer Tumormarker zur Früherkennung und Verlaufskontrolle des MTC. Daneben kommt dem Ultraschall der Schilddrüse eine entscheidende Rolle zu.
Rolle des RET-Proto-Onkogens Das medulläre Schilddrüsenkarzinom (MTC) nimmt seinen Ursprung aus den parafollikulären calcitoninproduzierenden C-Zellen. Es macht nur ca. 3–8% aller Schilddrüsenkarzinome aus. Aktivierende Mutationen im RET (rearranged during transfection)-Gen liegen bei etwa 25% der Patienten in der Keimbahn vor, werden aber auch beim sporadischen MTC als somatische Mutationen in ca. 60% der Fälle beobachtet. Bei metastasierter Erkrankung findet sich in 90% eine RET-Mutation. RET-Mutationen gelten als Treibermutationen und schließen weitere Treibermutationen weitestgehend aus. Seltener sind somatische Mutationen der RAS-Gene.
Chirurgische Therapie Die chirurgische Resektion ist bis heute der einzige kurative Therapieansatz. Entscheidend für eine frühzeitige Diagnosestellung ist die Bestimmung des Serum-Calcitonins bei Nachweis von Schilddrüsenknoten. Die chirurgische Therapie steht auch bei der Behandlung lokoregionärer Rezidive oder lokal angehbarer Metastasen im Zentrum.
Systemtherapie Bei irresektabel fortgeschrittener und
progredienter Erkrankung mit signifikanter Tumorlast kann eine systemische Therapie
erforderlich werden. Neuerdings ist die Kenntnis einer RET-Mutation im Tumorgewebe
therapeutisch relevant, da mit dem selektiven RET-Inhibitor Selpercatinib eine neue, effektive
und gut verträgliche Systemtherapien zur Verfügung steht. Dieser ist inzwischen wie bisher nur
die Multityrosinkinaseinhibitoren Cabozantinib und Vandetanib als Erstlinientherapie des
fortgeschrittenen MTC zugelassen. Vandetanib darf ebenfalls nur noch bei Patienten mit
RET-Mutation angewendet werden.
Development of a hybrid hydrogel for submucosal injection in endoscopic resection of gastrointestinal neoplasm: From laboratory to clinical trial
Authors: Kang Jui-Wen , Chen Po-Jun , Chen Chiung-Yu , Riley Guillermo , Wang Yao-Sheng , Kuo Hsin-Yu , Chuang Chiao-Hsiung 
Published: August 2023

Abstract
Background and study aims Submucosal injection solution is essential for successful endoscopic resection of the early gastrointestinal tumor. We evaluated a new endoscopic hydrogel for submucosal injection and its clinical feasibility.
Patients and methods A hydrogel (AceGel) containing 0.4% sodium alginate and 2% calcium lactate was developed for ex vivo and animal studies. Subsequently, a prospective, single-arm study was conducted to assess its feasibility and safety in humans. Patients with gastrointestinal neoplasms undergoing endoscopic resection were enrolled. All patients underwent endoscopic surveillance after 4 weeks and outpatient follow-up at week 6. Afterward, they received endoscopic follow-up according to the medical routine.
Results In the ex vivo experiments, the submucosal elevation height of AceGel was equivalent to sodium hyaluronate and superior to saline or glycerol. Animal studies showed that the excised wounds healed well without surrounding tissue damage. Twelve patients participated in the clinical trial, including three, two, and seven patients with esophageal, gastric, and colonic lesions, respectively. The mean neoplasm size and submucosal injection volumes were 24.0±8.6 mm and 22.8±19.9 mL, respectively. All patients had adequate wound healing on 4-week surveillance endoscopy, and none had serious adverse events during 6-week follow-up. Moreover, endoscopic follow-up showed complete wound healing after 6 to 46 months without local mucosal inflammation in all patients.
Conclusions AceGel is good for endoscopic submucosal injection and demonstrated its usefulness in durable mucosal elevation for endoscopic therapy in preclinical tests. This clinical trial shows its safety and feasibility in all participating patients.
Efficacy and safety of cap-assisted endoscopic mucosal resection for superficial duodenal epithelial neoplasia ≤ 10 mm
Authors: Kimoto Yoshiaki , Sawada Rikimaru , Banjoya Susumu , Iida Toshifumi , Kimura Tomoya , Furuta Koichi , Nagae Shinya , Ito Yohei , Yamazaki Hiroshi , Takeuchi Nao , Takayanagi Shunya , Kano Yuki , Sakuno Takashi , Ono Kohei , Negishi Ryoju , Ohno Akiko , Sakai Eiji , Minato Yohei , Chiba Hideyuki , Ohata Ken 
Published: August 2023

Abstract
Background and study aims Endoscopic treatment strategies for small superficial duodenal epithelial neoplasia (SDET) have not been established, and the R0 resection rates of all previously reported endoscopic techniques are somewhat low. Furthermore, no reports of cap-assisted endoscopic mucosal resection (EMRC), which is reportedly associated with a relatively high R0 resection rate, have been evaluated in sufficient numbers of patients. Therefore, we assessed the efficacy and safety of EMRC for SDETs ≤ 10 mm in a retrospective cohort study.
Patients and methods We examined a prospectively maintained database and identified 248 consecutive patients (248 lesions) who had undergone endoscopic resection for SDETs ≤ 10 mm between January 2017 and June 2022. Our treatment strategy was consistent, with EMRC indicated for all SDETs ≤ 10 mm without non-lifting signs. The primary endpoint was the R0 resection rate.
Results Overall, 20 lesions had non-lifting signs and were selected for endoscopic submucosal dissection, while the remaining 228 lesions were treated with EMRC. As a result of EMRC, the median tumor size was 5 mm, and the mean procedure time was 5 minutes. Most of the lesions (89.2%) were located in the descending part. The R0 resection rate was 97.4% (222/228 cases), and the en bloc resection rate was 99.6%. Only seven patients(3.1%) experienced adverse events (6 patients, delayed bleeding; 1 patient, acute pancreatitis), which were successfully managed without surgical intervention. Furthermore, no recurrences were observed.
Conclusions We have demonstrated that EMRC is an effective and safe treatment for SDETs ≤ 10 mm that do not have non-lifting signs.
Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Gram-Negative Bacteria in a Pediatric Intensive Care Unit
Authors: Deniz Melis , Şenol Hande , Erat Tugba , Arı Hatice Feray , Altug Ümit , Kıral Eylem , Parlak Kerim , Özçınar Hadice 
Published: August 2023

AbstractWe aimed to analyze risk factors of ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR), pan-drug-resistant (PDR), and extensively drug-resistant (XDR) gram-negative bacteria (GNB) in a pediatric intensive care unit (PICU). This retrospective study evaluated pediatric patients diagnosed with VAP at a tertiary referral hospital. Of the 46 children in the present study, 40 (86.9%) had VAP caused by MDR-, XDR-, and PDR-GNB. Most patients (60.9%) had spent >28 days in the PICU at the time of diagnosis. Respiratory failure necessitating PICU admission was associated with XDR infection-induced VAP (p = 0.034). High rates of prior broad-spectrum antibiotic use were observed in patients with XDR GNB-induced VAP. VAP induced by MDR-, XDR-, and PDR-GNB occurred more frequently than that caused by drug-susceptible GNB in PICU patients. Long stays for more than 28 days in the PICU and past use of broad-spectrum antibiotics can lead to the development of XDR-GNB-induced VAP. The high antibiotic resistance rates detected in our study highlight the importance of strict infection control measures and antimicrobial stewardship programs in PICUs.
Heritage speakers’ processing of the Spanish subjunctive
Authors: López-Beltrán Priscila , Dussias Paola E. 
Published: August 2023

Abstract
We investigated linguistic knowledge of subjunctive mood in heritage speakers of Spanish who live in a
long-standing English-Spanish bilingual community in Albuquerque, New Mexico. Three experiments examine the constraints on
subjunctive selection. Experiment 1 and Experiment 2 employed pupillometry to investigate heritage speakers’ online sensitivity to
the presence of the subjunctive with non-variable governors (Lexical conditioning) and with negated governors (Structural
conditioning). Experiment 3 employed an elicited production task to examine production of subjunctive in the same contexts. The
findings of the heritage group were compared to those of a group of Spanish-dominant Mexican bilinguals. Results showed that in
comprehension and production, heritage speakers were as sensitive as the Spanish-dominant bilinguals to the lexical and structural
factors that condition mood selection. In comprehension, the two groups experienced an increased pupillary dilation in conditions
where the indicative was used but the subjunctive was expected. In addition, high-frequency governors and irregular subordinate
verbs boosted participants’ sensitivity to the presence of the subjunctive. In production, there were no significant differences
between heritage speakers and Spanish-dominant bilinguals when producing the subjunctive with non-variable and negated
governors.
Inhomogeneous spatial distribution of non radiative recombination centers in GaN/InGaN nanowire heterostructures studied by cathodoluminescence
Authors: Concordel Alexandre , Rochat Névine , Quach Anh My Naht , Rouvière Jean-Luc , Jacopin Gwénolé , Napierala Jérôme , Daudin Bruno 
Published: August 2023

Abstract
In order to elucidate the mechanisms responsible for cathodoluminescence intensity variations at the scale of single InGaN/GaN nanowire heterostructures, a methodology is proposed based on a statistical analysis on ensembles of several hundreds of nanowires exhibiting a diameter of 180, 240 and 280 nm. For 180 nm diameter, we find that intensitiy variations are consistent with incorporation of point defects obeying Poisson’s statistics. For wider diameters, intensity variations at the scale of single NWs are observed and assigned to local growth conditions fluctuations. Finally, for the less luminescent nanowires, a departure from Poisson’s statistics is observed suggesting the possible clustering of non independent point defects.
Analysis of an aligned magnetic nano-Casson fluid flow along with bio-convection based on Stefan's blowing
Authors: Saleem Musharafa , Tufail Muhammad Nazim 
Published: August 2023

Abstract
This theoretical study illustrates the effect of an inclined stretching sheet with bio-mixed convection, aligned magnetohydrodynamics (MHD), porous medium, Joule heating, viscous dissipation, the Buongiorno nanofluid model, and chemical reaction effects. Stefan blowing (SB) and partial slips, as well as our presumptions and laws, like the conservation of mass, momentum, and energy, must all be taken into consideration when solving our partial differential equations (PDEs). Similarity transformations are used in the context of a gyro-tactic motile microorganism flowing through an inclined stretched surface to produce ordinary differential equations (ODEs). The BVP4C method generates numerical results for different parameters through MATLAB programming. Additionally, a numerical and graphical exploration of the effects of numerous developing variables on the velocity, temperature, concentration, and density of motile bacteria is done. To verify the accuracy of the numerical model, the findings of the numerical research are compared to experimental data. Microbial distribution decreases with both negative and positive SB (suction and injection) attitudes, as indicated by the Peclet number and microbe movement coefficient. The mobility of microorganisms increases with higher values of the Lewis number, which governs their motility. The Lewis number and chemical reaction parameters affect the volume fraction transfer during the flow of the nano-Casson fluid in both the suction and injection cases of the SB effect, leading to increased concentration transfer.
Elevated nocturnal respiratory rates in the mitochondria of CAM plants: current knowledge and unanswered questions
Authors: Leverett Alistair , Borland Anne M 
Published: August 2023

AbstractCrassulacean acid metabolism (CAM) is a metabolic adaptation that has evolved convergently in 38 plant families to aid survival in water-limited niches. Whilst primarily considered a photosynthetic adaptation, CAM also has substantial consequences for nocturnal respiratory metabolism. Here, we outline the history, current state and future of nocturnal respiration research in CAM plants, with a particular focus on the energetics of nocturnal respiratory oxygen consumption. Throughout the 20th century, research interest in nocturnal respiration occurred alongside initial discoveries of CAM, although the energetic and mechanistic implications of nocturnal oxygen consumption and links to the operation of the CAM cycle were not fully understood. Recent flux balance analysis (FBA) models have provided new insights into the role that mitochondria play in the CAM cycle. Several FBA models have predicted that CAM requires elevated nocturnal respiratory rates, compared to C3 species, to power vacuolar malic acid accumulation. We provide physiological data, from the genus Clusia, to corroborate these modelling predictions, thereby reinforcing the importance of elevated nocturnal respiratory rates for CAM. Finally, we outline five unanswered questions pertaining to nocturnal respiration which must be addressed if we are to fully understand and utilize CAM plants in a hotter, drier world.
A new approach to an old problem: how to categorize the habit of ferns and lycophytes
Authors: Zotz Gerhard , Armenia Lisa , Einzmann Helena J R 
Published: August 2023

Abstract

Background and Aims
Substrate preferences are often treated as species traits and are used to distinguish different habits, i.e. an epiphytic, lithophytic or terrestrial habit. Such a categorization, however, ignores substantial intraspecific variation. An approach that takes biological variability within a species into account is needed.

Methods
We focused on four large genera of ferns and lycophytes and found relevant information in &gt;500 sources, such as online databases, checklists, floras and species descriptions. Translating textual information into a quantitative index, we quantified the propensity to grow on either substrate as a continuous trait for 1475 species.

Key Results
Only a minority of species exhibited strict substrate fidelity, but a majority of them showed clear habitat preferences. The relative frequencies of intermediates between strict lithophytes, epiphytes and terrestrials does not support the frequent notion of ecological similarity of the lithophytic and epiphytic habitat.

Conclusions
The compiled data are useful immediately for ecological and evolutionary studies with the focal taxa. More importantly, we propose the replacement of the concept of distinct habits with one of gradual differences. This should have a profound impact on any such study with plants in general.
The Role of Calcium Hydroxylapatite (Radiesse) as a Regenerative Aesthetic Treatment: A Narrative Review
Authors: Aguilera Shino Bay , McCarthy Alec , Khalifian Saami , Lorenc Z Paul , Goldie Kate , Chernoff W Gregory 
Published: August 2023

Abstract

For decades, a wide variety of natural and synthetic materials have been used to augment human tissue to improve aesthetic outcomes. Dermal fillers are some of the most widely used aesthetic treatments throughout the body. Initially, the primary function of dermal fillers was to restore depleted volume. As biomaterial research has advanced, however, a variety of biostimulatory fillers have become staples in aesthetic medicine. Such fillers often contain a carrying vehicle and a biostimulatory material that induces de novo synthesis of major structural components of the extracellular matrix. One such filler, Radiesse (Merz Aesthetics, Raleigh, NC), is composed of calcium hydroxylapatite microspheres suspended in a carboxymethylcellulose gel. In addition to immediate volumization, Radiesse treatment results in increases of collagen, elastin, vasculature, proteoglycans, and fibroblast populations via a cell-biomaterial–mediated interaction. When injected, Radiesse acts as a cell scaffold and clinically manifests as immediate restoration of depleted volume, improvements in skin quality and appearance, and regeneration of endogenous extracellular matrices. This narrative review contextualizes Radiesse as a regenerative aesthetic treatment, summarizes its unique use cases, reviews its rheological, material, and regenerative properties, and hypothesizes future combination treatments in the age of regenerative aesthetics.

Level of Evidence: 5