bluuebunny/crossref_metadata_2025_split huggingface dataset:
µPIV measurements of the phase-averaged velocity distribution within wavy films
Authors: Metzmacher Andreas , Burgmann Sebastian , Janoske Uwe 
Published: April 2023

AbstractThin-film flows are frequently used in process engineering and are therefore of great interest in research. In most cases, waves occur which have a positive effect on the material and heat transport and significantly influence the dynamics of the film flow. A combination of µ-particle image velocimetry and confocal chromatic distance measurement is used to measure phase-averaged flow velocities in naturally developed film waves. A trigger signal is sent to the PIV system and a recording starts when a wave reaches the wave crest threshold. This makes it possible to trigger the µPIV system depending on the film thickness. The focus of this work is on the triggering of the wave crest. The functionality and quality of the measurements depend on the correct positioning of the confocal chromatic sensor, with the light spot at the level of the camera section. Simultaneously, the minimum, average, and maximum film thickness, as well as the wave amplitude and wave frequency, are recorded. Film flow is investigated on a glass plate at various angles (5°, 10°, 15°) of inclination, Reynolds numbers (30-200), and measurement positions. The results are compared with the theoretical solutions according to Nusselt. In addition, the influence of the tilt angle and the measuring position is explained. The measuring position, in particular, has a non-negligible influence since the characteristics of the film flow are largely dependent on the streamwise measuring position. Compared to the theoretical solutions according to Nusselt, the velocities and film thicknesses are significantly greater due to the presence of the waves. With increasing inclination angle and streamwise measuring position, the measured mean and maximum velocities of the film flow increase. They almost double when the inclination angle increases from 5° to 15°. When comparing the velocities depending on the measuring position (300–500 mm), it is noticeable that the velocities increase between 5 and 15%, depending on the angle, due to wave development and gravity.
MELD-score for risk stratification in cardiac surgery
Authors: Pathare Presheet , Elbayomi Mohamed , Weyand Michael , Griesbach Colin , Harig Frank 
Published: April 2023

AbstractThe outcome of the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) is also influenced by the renal and hepatic organ functions. Risk stratification, using scores such as EURO Score II or STS Short-Term Risk Calculator for patients undergoing cardiac surgery with cardiopulmonary bypass, ignores the quantitative renal and hepatic function; therefore, MELD-Score was applied in these cases. We retrospectively examined patient data using the MELD score as a predictor of mortality. To perform a univariate analysis of the data, patients were classified into three groups based on the MELD Score: MELD < 10 (Group 1), MELD 10 to 19 (Group 2), and MELD ≥ 20 (Group 3). A total of 11,477 participants were included in the study, though several patients with either missing MELD scores or lack of creatinine, bilirubin, or INR levels were dropped from the original cohort. Eventually, 10,882 patients were included in the analysis. The primary outcome was defined as postoperative, in-hospital mortality. Secondary outcomes such as postoperative bleeding, including the requirement for repeat thoracotomy, postoperative neurological complications, and assessment of catecholamines on weaning from cardiopulmonary bypass/ requirement of mechanical circulatory support were examined. A higher MELD score was associated with increased postoperative mortality. Patients with MELD > 20 experienced a 31.2% postoperative mortality, compared to Group 1 (4.6%) and Group 2 (17.5%). The highest rates of postoperative bleeding (13.8%) and, repeat thoracotomy (13.2%) & postoperative pneumonia (17.4%) were seen in Group 3 (threefold increase when compared to Group 1, renal failure requiring dialysis (N = 235, 2.7% in Group 1 v/s N = 78, 22.9% in Group 3) or requiring high dose catecholamines post-operatively or mechanical circulatory support (IABP/ECLS). Incidentally, an increased MELD Score was not associated with a significant increase in the postoperative incidence of stroke/TIA or the presence of sternal wound infections/complications. A higher mortality was observed in patients with reduced liver and renal function, with a significant increase in patients with a MELD score > 20. As the current risk stratification scores do not consider this, we recommend applying the MELD score before considering patients for cardiac surgery.
Improved forecast of 2015/16 El Niño event in an experimental coupled seasonal ensemble forecasting system
Authors: Ray Sulagna , Stefanova Lydia , Fu Bing , Guan Hong , Wang Jiande , Meixner Jessica , Mehra Avichal , Zhu Yuejian 
Published: April 2023

AbstractTo improve NOAA’s seasonal forecasting capabilities, a new coupled system within the Unified Forecast System (UFS) framework is being developed through a community-wide effort led by NOAA’s Environmental Modeling Center targeting the configuration of a future operational Seasonal Forecast System (SFS v1). An experimental version of this ensemble seasonal forecasting system is tested on forecasting the strong El Niño of 2015/16. The then-operational systems and NCEP real-time seasonal forecasts (CFSv2) underestimated its strength towards the end of 2015 and beginning of 2016. In addition to perturbing the atmospheric initial conditions, run-time stochastic physics-based perturbations are applied in both atmosphere and ocean components of this new coupled system to represent the model uncertainties. The UFS ensembles are initialized on June 1st, 2015 and run through a 9-month period. Compared to CFSv2, the forecast of Niño 3.4 SST and intra-seasonal zonal windstress for the 2015/16 El Niño in the UFS system are improved, as is the ensemble spread. A cold SST forecast error develops in the central equatorial Pacific, likely from excess evaporative cooling, shallower thermocline, and an excessively strong vertical current shear driven cooling. Near the eastern equatorial Pacific coast, on the other hand, warm surface and cool subsurface errors persist from initialization until the end of the forecast. The results suggest that further improvement in the seasonal forecast may be achieved by a combination of factors, including, but not limited to, improving the coupled system initialization, along with the atmospheric physics.
Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis
Authors: Al Smady Montaser Nabeeh , Hendi Salama Bin , AlJeboury Sarah , Al Mazrooei Hessa , Naji Hussein 
Published: April 2023

Abstract
Background
Ladd’s Procedure has been the surgical intervention of choice in the management of congenital intestinal malrotation for the past century. Historically, the procedure included performing an appendectomy to prevent future misdiagnosis of appendicitis, since the location of the appendix will be shifted to the left side of the abdomen. This study consists of two parts. A review of the available literature on appendectomy as part of Ladd’s procedure and then a survey sent to pediatric surgeons about their approach (to remove the appendix or not) while performing a Ladd’s procedure and the clinical reasoning behind their approach.

Methods
The study consists of 2 parts: (1) a systematic review was performed to extract articles that fulfill the inclusion criteria; (2) a short online survey was designed and sent by email to 168 pediatric surgeons. The questions in the survey were centered on whether a surgeon performs an appendectomy as part of the Ladd’s procedure or not, as well as their reasoning behind either choice.

Results
The literature search yielded five articles, the data from the available literature are inconsistent with performing appendectomy as part of Ladd's procedure. The challenge of leaving the appendix in place has been briefly described with minimal to no focus on the clinical reasoning. The survey demonstrated that 102 responses were received (60% response rate). Ninety pediatric surgeons stated performing an appendectomy as part of the procedure (88%). Only 12% of pediatric surgeons are not performing appendectomy during Ladd’s procedure.

Conclusion
It is difficult to implement a modification in a successful procedure like Ladd’s procedure. The majority of pediatric surgeons perform an appendectomy as part of its original description. This study has identified gaps in the literature pertaining to analyze the outcomes of performing Ladd's procedure without an appendectomy which should be explored in future research.
The corticocancellous press fit iliac crest bone dowel for recalcitrant scaphoid nonunion: analysis of union rate and clinical outcome
Authors: Schäfer Ruth Christine , Nusche Andreas , Einzmann Anna , Illg Claudius , Daigeler Adrien , Rachunek Katarzyna 
Published: April 2023

Abstract
Introduction
Scaphoid nonunion after failed primary treatment remains challenging particularly when entailed by bone loss, avascular necrosis or deformity. We describe a scaphoid augmentation and fixation technique for cases of recalcitrant nonunion after screw placement by autologous press fit corticocancellous dowel. This study aims to provide reliable data on clinical and radiological outcomes and to contextualize in the face of other treatment options.

Material and methods
The study included 16 patients with recalcitrant nonunion of the scaphoid. All patients received screw removal and scaphoid reconstruction by a dowel shaped non-vascularized corticocancellous bone graft from the iliac crest facilitating packing of the screw channel. Bone union, the scapholunate, radiolunate and intrascaphoidal angles were evaluated on X-ray and CT images, range of motion noted. Additionally grip strength, DASH and Green O’Brien scores were obtained from eight patients.

Results
A union rate of 73% was noted after mean follow-up of 54 months. After revisional reconstruction of the scaphoid an extension–flexion rate of 84% of the healthy side was noted while pronation-supination reached 101%. DASH score averaged at 2.9, rest pain on a numeric rating scale was 0.43 with 99% peak grip force of the healthy side.

Conclusion
In complex cases of revisional scaphoid nonunion after screw placement, the corticocancellous iliac crest pressfit dowel is an option for augmentation and stabilization of the scaphoid by preserving the articular surface.

Level of evidence
IV, retrospective case series.
Effect of different surgical routes on pregnancy outcome of history-indicated cervical cerclage
Authors: Qin Feng , Yang Yong , Zhou Wei , Chi Yugang , Liu Bao , Chen Gongli 
Published: April 2023

Abstract
Objective
To study the guiding significance of medical history on laparoscopic and vaginal cervical cerclage in the treatment of cervical incompetence and its influence on pregnancy outcome.

Methods
A total of 53 cases by laparoscopic abdominal cervical cerclage (LAC group) before pregnancy and 73 cases by transvaginal cervix cerclage (TVC group) at 12–14 weeks of pregnancy were collected. Multivariate logistic regression analysis was performed on the influencing factors of delivery gestational weeks. Furthermore, the gestational weeks after cervical cerclage were compared between the two groups with high- and low-risk grades.

Results
The number of previous uterine cavity operations in LAC group was more than that TVC group, and the costs of operation were more than TVC group. At the same time, the hospitalization days and operation time were longer than those in TVC group, and the delivery rate of cesarean section was higher than TVC group, but the total hospitalization times were less than TVC group (P < 0.05). The rate of delivery before 34 weeks of pregnancy and the incidence of premature rupture of membranes or premature labor in LAC group were lower than those in TVC group (P < 0.05). In TVC group, the increased number of prior PTB or STL and the history of cervical cerclage failure would increase the risk of premature delivery before 34 weeks of pregnancy. There was no increased risk of preterm delivery before 34 weeks of pregnancy in LAC group (P > 0.05). According to the risk level, in the high-risk group, the delivery rate of LAC group at gestational weeks < 37 weeks, < 34 weeks and < 28 weeks was lower than that of TVC group.

Conclusion
Laparoscopic cervical cerclage might be more effective in preventing premature delivery before 34 weeks of gestation, and its influence on delivery gestational weeks was not affected by related medical history. For high-risk patients with the history of prior PTB or STL and failed cerclage, laparoscopic cervical cerclage might be more effective than vaginal cervical cerclage in preventing extremely preterm before 28 weeks, premature delivery before 34 weeks and premature delivery before 37 weeks. Therefore, our limited experience suggested that LAC can be a recommended option for patients with high-risk history.
Translocator protein (TSPO)-PET as diagnostic and monitoring tool in COVID-19 related MRI-negative brainstem encephalitis: a case report
Authors: Wischmann Johannes , Bartos Laura M. , Brendel Matthias , Albert Nathalie L. , Forbrig Robert , Straube Andreas , Masouris Ilias 
Published: April 2023

Abstract
Background
Encephalitis and myelitis have been linked to both COVID-19 vaccination and infection, causing symptoms such as reduced consciousness, mental state alterations and seizures. Remarkably, most cases do not show significant structural alterations on MRI scans, which poses a diagnostic challenge.

Methods
We present the diagnostic workup and clinical course of a patient who developed a progressive brainstem syndrome two weeks after COVID-19 vaccination and subsequent infection. We used translocator protein (TSPO)-PET scans for the first time to investigate COVID-related neuroinflammation.

Results
The patient developed oculomotor disorder, dysarthria, paresthesia in all distal limbs and spastic-atactic gait. CSF analysis revealed mild lymphocytic pleocytosis with normal protein levels. Brain and spinal cord MRI scans were negative, but TSPO/PET scans showed increased microglia activity in the brainstem, which correlated with the clinical course. Steroid treatment led to clinical improvement, but relapse occurred during prednisone taper after four weeks. Plasmapheresis had no significant effect; however, complete remission was achieved with cyclophosphamide and methotrexate, with normal TSPO signal ten months after onset.

Conclusions
TSPO-PET can be a valuable tool in the diagnostic and therapeutic monitoring of COVID-19-related encephalitis, particularly in cases where MRI scans are negative. Aggressive immunosuppressive therapy can lead to sustained remission.
Predictors for selective flexure mobilization during robotic anterior resection for rectal cancer: a prospective cohort analysis
Authors: Meyer Jeremy , van der Schelling George , Wijsman Jan , Ris Frédéric , Crolla Rogier 
Published: April 2023

Abstract
Introduction
Splenic flexure mobilization (SFM) may be indicated during anterior resection to provide a tension-free anastomosis. However, to date, no score allows identifying patients who may benefit from SFM.

Methods
Patients who underwent robotic anterior resection for rectal cancer were identified from a prospective register. Demographic and cancer-related variables were extracted, and predictors of SFM were identified using regression models. Thereafter, 20 patients with SFM and 20 patients without SFM were randomly selected and their pre-operative CTscan were reviewed. The radiological index was defined as 1/(sigmoid length/pelvis depth). The optimal cut-off value for predicting SFM was identified using ROC curve analysis.

Results
Five hundred and twenty-four patients were included. SFM was performed in 121 patients (27.8%) and increased operative time by 21.8 min (95% CI: 11.3 to 32.4, p < 0.001). The incidence of postoperative complications did not differ between patient with or without SFM. Realization of an anastomosis was the main predictor for SFM (OR: 42.4, 95% CI: 5.8 to 308.5, p < 0.001). In patients with colorectal anastomosis, both sigmoid length (15 ± 5.1 cm versus 24.2 ± 80.9 cm, p < 0.001) and radiological index (1 ± 0.3 versus 0.6 ± 0.2, p < 0.001) differed between patients who had SFM and patients who did not. ROC curve analysis of the radiological index indicated an optimal cut-off value of 0.8 (sensitivity: 75%, specificity: 90%).

Conclusion
SFM was performed in 27.8% of patients who underwent robotic anterior resection, and increased operative time by 21.8 min. For optimal surgical planning, patients requiring SFM can be identified based on pre-operative CT using the index 1/(sigmoid length/pelvis depth) with a cut-off value set at 0.8.
A Meso/Macroscale Theoretical Model for Investigating the Large Deformation of Soft Rock Tunnels Considering Creep and Anisotropic Effects
Authors: Xia Chang , Liu Zhen , Zhou Cuiying , Zhang Lihai 
Published: April 2023

AbstractThe rheological deformation of soft rock resulting from tunnel excavation can lead to significant construction and safety challenges. In this study, a multiphase numerical model was developed to simulate the rheological deformation of soft rock surrounding a tunnel after excavation. The developed model considers the coupled meso/macroscale creep and damage processes of the rock using the coupled discrete element method–finite element method (DEM–FEM). In particular, the damage and deformation accumulation at the mesoscale (i.e., initial phase before excavation, loading phase due to the disturbance of the excavation and creep-induced damage phase leading to large deformation) were incorporated into the model. The model predictions were validated using field monitoring data. By incorporating the coupled meso/macroscale deformation process of the rock into the model, the predicted time-dependent displacements of the tunnel face agree reasonably well with the monitoring data. In addition, the results demonstrate that tunnel brittle damage accumulated in mineral clusters severely leads to instantaneous deformation, which becomes less important in the creep evolution stage. Furthermore, the results indicate that the final deformation is characterized by a high sensitivity to the value of mesoscale modeling parameters.
Early-Time Shut-In for Plane-Strain Hydraulic Fractures
Authors: Liu Dong 
Published: April 2023

AbstractOne investigates the post-shut-in growth of a plane-strain hydraulic fracture in an impermeable medium while accounting for the possible presence of a fluid lag. After the stop of fluid injection, the fracture may present three distinct propagation patterns: an immediate arrest, a temporary arrest with delayed propagation, and a continuous fracture growth. These three patterns are all followed by a final fracture arrest yet the fracture behaviour prior to that results from the interplay between the dimensionless toughness $$\mathcal {K}_m$$

K
m

, the shut-in time $$t_s/t_{om}$$

t
s

/

t

om

, and the propagation time $$t/t_s$$

t
/

t
s

. $$\mathcal {K}_m$$

K
m

characterizes the energy dissipation ratio between fracture surface creation and viscous fluid flow under constant rate injection. $$t_s$$

t
s

and $$t_{om}$$

t

om

represent respectively the timescale of shut-in and the coalescence of the fluid and fracture fronts. The immediate arrest occurs when the fracture toughness dominates the fracture growth at the stop of injection ($$\mathcal {K}_m \gtrapprox 4.3$$

K
m

⪆
4.3

). It may also occur upon an early shut-in at low dimensionless toughness associated with an overshoot of fracture extension and a significant fluid lag. For intermediate values of $$\mathcal {K}_m$$

K
m

and $$t_s/t_{om}$$

t
s

/

t

om

, the fracture may experience a temporary arrest followed by a restart of fracture propagation. The period of the temporary arrest becomes shorter with higher dimensionless toughness and later shut-in until it drops to zero. The fracture behaviour after shut-in then transitions from temporary arrest to continuous propagation. These propagation patterns result in different evolution of fracture dimensions which possibly explains the various emplacement scaling relations reported in magmatic dikes.
Clinical usefulness of metagenomic next-generation sequencing for Rickettsia and Coxiella burnetii diagnosis
Authors: Zhang Xuan , Chen Huixin , Han Dongsheng , Wu Wei 
Published: April 2023

AbstractRickettsia and Coxiella burnetii are zoonotic tick-borne pathogens that cause febrile illnesses in humans. Metagenomic next-generation sequencing (mNGS) is a new technology used to diagnose infectious diseases. However, clinical experience with applying the test to rickettsioses and Q fever is relatively limited. Therefore, this study aimed to explore the diagnostic performance of mNGS in detecting Rickettsia and C. burnetii. We retrospectively studied patients with rickettsioses or Q fever between August 2021 and July 2022. Peripheral blood mNGS and polymerase chain reaction (PCR) were performed for all patients. Clinical data were retrieved for analysis. Thirteen patients were included in this study (eleven confirmed cases and two suspected cases). Signs and symptoms included fever (13, 100%), rash (7, 53.8%), muscle soreness (5, 38.5%), headache (4, 30.8%), skin eschar (3, 23.1%), and disturbance of consciousness (2, 15.4%). In addition, eight patients (61.6%) had thrombocytopenia, ten (76.9%) had liver function impairment, and two (15.4%) had renal function impairment. The results of mNGS revealed seven patients with R. japonica (53.8%), five with C. burneti (38.5%), two with R. heilongjiangensis (15.4%), and one with R. honei (7.7%). PCR results were positive in 11 patients (84.6%). After receiving doxycycline-based treatment, 12 (92.3%) patients returned to a normal temperature within 72 h. All patients were discharged in better health. Therefore, mNGS can help diagnose Rickettsia and C. burnetii and shorten the diagnosis time, especially for patients with atypical clinical manifestations and unclear epidemiologic evidence of a tick bite or exposure.