bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finite element analysis of medial closing and lateral opening wedge osteotomies of the distal femur in relation to hinge fractures
Authors: Meisterhans Michel , Flury Andreas , Zindel Christoph , Zimmermann Stefan M. , Vlachopoulos Lazaros , Snedeker Jess G. , Fucentese Sandro F. 
Published: March 2023

AbstractPurposeIntraoperative hinge fractures in distal femur osteotomies represent a risk factor for loss of alignment and non‐union. Using finite element analysis, the goal of this study was to investigate the influence of different hinge widths and osteotomy corrections on hinge fractures in medial closed‐wedge and lateral open‐wedge distal femur osteotomies.MethodsThe hinge was located at the proximal margin of adductor tubercle for biplanar lateral open‐wedge and at the upper border of the lateral femoral condyle for biplanar medial closed‐wedge distal femur osteotomies, corresponding to optimal hinge positions described in literature. Different hinge widths (5, 7.5, 10 mm) were created and the osteotomy correction was opened/closed by 5, 7.5 and 10 mm. Tensile and compressive strain of the hinge was determined in a finite element analysis and compared to the ultimate strain of cortical bone to assess the hinge fracture risk.ResultsDoubling the correction from 5 to 10 mm increased mean tensile and compressive strain by 50% for lateral open‐wedge and 48% for medial closed‐wedge osteotomies. A hinge width of 10 mm versus 5 mm showed increased strain in the hinge region of 61% for lateral open‐wedge and 32% for medial closed‐wedge osteotomies. Medial closed‐wedge recorded a higher fracture risk compared to lateral open‐wedge osteotomies due to a larger hinge cross‐section area (60–67%) for all tested configurations. In case of a 5 mm hinge, medial closed‐wedge recorded 71% higher strain in the hinge region compared to lateral open‐wedge osteotomies.ConclusionDue to morphological features of the medial femoral condyle, finite element analysis suggests that lateral‐open wedge osteotomies are the preferable option if larger corrections are intended, as a thicker hinge can remain without an increased hinge fracture risk.
Clinical characteristics of Guillain–Barre syndrome in COVID-19: a systematic review and meta-analysis of observational studies
Authors: Yusari I Gusti Agung Ayu Andra , Sudira Putu Gede , Samatra Dewa Putu Gde Purwa 
Published: March 2023

Abstract
Background
Guillain–Barre syndrome (GBS) is a complication that occurs in patients with Coronavirus Disease (COVID-19) infection. The spectrum of symptoms varies from mild to severe symptoms, even death. The study aimed to compare the clinical manifestations in GBS patients with and without COVID-19 comorbidity.

Results
A systematic review and meta-analysis of cohort and cross-sectional studies was conducted comparing the characteristics and course of GBS disease in the COVID-19 positive and COVID-19 negative groups. Four articles were selected with a total sample of 61 COVID-19 positive and 110 COVID-19 negative GBS patients. Based on clinical manifestations, COVID-19 infection increased the likelihood of tetraparesis (OR: 2.54; 95% CI 1.12–5.74; p = 0.03) and the presence of facial nerve involvement (OR: 2.34; 95% CI 1.00–5.47; p = 0.05). Demyelinating type GBS or AIDP was more common in the COVID-19 positive group (OR: 2.32; 95% CI 1.16–4.61; p = 0.02). COVID-19 in GBS significantly increased the need for intensive care (OR: 3.32; 95% CI 1.48–7.46; p = 0.004) and the use of mechanical ventilation (OR: 2.42; 95% CI 1.00–5.86; p = 0.05).

Conclusions
GBS following COVID-19 infection showed more severe variations in clinical characteristics compared to the group of GBS patients without COVID-19. Early detection of GBS, especially the typical manifestations post COVID-19 infection, is very important to carry out intensive monitoring and early management before the patient's condition worsens.
Diffuse refractory coronary artery spasm after off-pump coronary artery bypass grafting: a case series
Authors: Abraham Benson , Nair Kannan Ramachandran , Sulaiman Sajith 
Published: March 2023

Abstract

Background
Diffuse coronary artery spasm after coronary artery bypass grafting may cause disastrous circulatory collapse and death if not detected and managed promptly.

Case presentation
Four out of 387 patients who underwent uneventful off-pump coronary artery bypass grafting between January 2019 and December 2021 at our centre developed unexplained arrhythmias and hypotension within 2 to 6 h of the postoperative period. Coronary angiogram showed diffuse coronary vasospasm involving both grafted and ungrafted native coronary arteries. Vasospasm was refractory to intracoronary vasodilators in all these cases. All of the patients recovered completely with the use of intravenous verapamil infusion and intraaortic balloon pump support.

Conclusions
Coronary artery spasm should remain in the differential diagnosis in patients developing unexplained arrhythmias and haemodynamic instability following coronary artery bypass grafting. Prompt diagnosis with coronary angiogram and proper management strategy using calcium channel blockers and intraaortic balloon pump can revert this deadly complication. Surgical intervention may delay precious time needed for therapeutic intervention.
A randomized controlled study to compare oropharyngeal leak pressure between I-gel™ and laryngeal mask airway supreme™ in children in lateral position under general anesthesia
Authors: Kundal Raksha , Puri Kriti , Agrawal Garima , Singh Ranju , Pandey Maitree 
Published: March 2023

Abstract
Background
Supraglottic airway devices (SADs) are the mainstay for airway management in pediatric ambulatory surgeries and may often be a suitable alternative to endotracheal intubation due to their favorable profile. Optimal oropharyngeal leak pressure of SAD is essential for adequate ventilation and prevention of aspiration. Occasionally, lateral position is required for administration of regional block or for the surgery itself.
We aim to compare the oropharyngeal leak pressure of igel™ and LMA Supreme™ in children in lateral position.
A prospective, randomized study was performed on eighty children of either sex, weighing 5–10 kg, belonging to ASA grade I and II undergoing elective surgery requiring lateral position. The primary objective was comparison of Oropharyngeal leak pressure of both devices in lateral position. Secondary objectives included assessment of insertion success rate, number of insertion attempts and manipulations, time and ease of insertion; and comparison of fiberoptic view of the larynx, fractional volume loss, and displacement with respect to both devices in supine and lateral position.

Results
Oropharyngeal leak pressure of i-gel™ was higher than that of LMA Supreme™ in both supine (25.4 ± 1.4 cm H2O Vs 22.9 ± 1.5 cm H2O) and lateral position (23.9 ± 1.6 vs 21.5 ± 1.5 cm H2O) and was statistically significant (p < 0.001). The success rate of insertion of i-gel™ and LMA Supreme™ was similar (95% and 97.5% respectively). The ease of insertion for both devices was statistically similar (p = 0.593). The mean time for insertion was longer for i-gel™ (15.4 ± 1.72 s vs 12.4 ± 1.73 s) as compared to LMA Supreme™ (p < 0.001). Ventilatory parameters for both devices decreased in the lateral position, which was statistically significant. The fractional volume loss after change of position was 0.123 vs 0.478 for i-gel™ and LMA Supreme™ respectively. In both groups, fiberoptic views worsened with a change of position.

Conclusions
Oropharyngeal leak pressure of both devices reduced in lateral position as compared to supine position. I-gel™ yielded higher leak pressures in supine as well as in lateral position as compared to LMA Supreme™.

Implications
The above findings offer valuable insight for decision-making in pediatric daycare surgeries requiring lateral position where GA is warranted.

Trial registration
CTRI NUMBER (CTRI/2021/01/030442)—the trial was registered with the Clinical Trial Registry of India on 13 January 2021.
The expression level of ARF and p53 in AML patients, and their relation to patients' outcome
Authors: Nabil Reem , Elshazly Samar S. , Hassan Naglaa M. , Nooh Hend A. 
Published: March 2023

Abstract
Background
Acute myeloid leukemia (AML) is a cancer of hematopoietic progenitors characterized by gene mutations. The most popular deregulations are mutation and altered expression in the p53 gene, which is considered the guardian of the genome. Its activity is controlled by regulatory genes, e.g., alternate open reading frame (ARF), whose defects could affect p53 activity.

Aim
To study the effect of altered expression of p53 and ARF genes in de novo AML patients and correlate the results to the patients’ characteristics and outcomes.

Methods
Expression levels of p53 and ARF were assessed in 96 AML adult patients compared to 20 healthy controls using quantitative reverse-transcription PCR (RT-qPCR).

Results
There was significant up-regulation of p53 [77.6 (3.8–9528.3)] compared to controls [1.031 (0.210–9.051)], p < 0.001]. The expression level of ARF was significantly upregulated [6.2 (0.5–964.0)] compared to controls [0.854 (0.357–2.519), p < 0.001]. All of the low ARF expressers had low p53 overexpression, 61.1% of patients with high ARF expression had high p53 over-expression, and 38.9% with high ARF expression had low p53 over-expression (p < 0.001). ARF expression shows a trend of association with FLT3 mutation, as 89.3% with FLT3 mutation have high ARF expression (p = 0.080). Low p53 over-expression was seen in 77% of APL patients, while high p53 expression was associated with non-APL (p = 0.040). The median DFS of mutant NPM1 patients was higher than wild NPM1 (46.15 vs. 5.89 days, p = 0.045). Patients aged ≤ 50 years had better OS and DFS than those > 50 (p = 0.05, p = 0.035, respectively).There were no significant statistical associations between DFS and p53, ARF, and FLT3 mutations.

Conclusion
The p53 and ARF genes are overexpressed in de novo AML patients and they are interrelated. low p53 overexpression is associated with APL phenotype and t(15;17) and patients with t(15;17) had slightly better survival than patients with negative t(15;17) (p = 0.061). AML patients with mutated NPM1 had better DFS than wild NPM1 (p = 0.045). p53 pathway regulation can occur by many alternative ways rather than gene mutation.
Post algebras and ternary adders
Authors: Etiemble Daniel 
Published: March 2023

AbstractExcept for qubits for which the different possible values are unordered, the different values of m-valued circuits either with voltage levels, current levels or charge levels are totally ordered. Either at the Math level (Post algebras) or at the circuit level, it means that each multiple valued level must be decomposed into binary levels, processed with binary computation and finally converted into a multiple valued level. Using ternary adders as example, we show that the ternary-to-binary decoding and binary encoding should be applied to the whole adder or to restricted parts of the adder. The second approach using multiplexers leads to the most efficient ternary adders. However, a comparison with binary adders shows that the ternary-to-binary and binary-to-ternary conversions is the reason for which the binary adders are more efficient.
Scour depth downstream sharp-crested weir
Authors: Obaida Arwa A. Mala , Khattab Noor I. , Mohammed Ahmed Y. 
Published: March 2023

AbstractWeirs are hydraulic obstructions constructed across an open-channel flow causing a rise in water which is useful to convert water to the channels upstream as well as using these structures as a measuring device. There are different types, and a sharp-crested weir is one of them. Local scour downstream hydraulic structures are one of the most critical problems affecting their safety and stability. Many studies conducted to prevent these facilities from collapsing, but the effect of adding a solid apron downstream weir still need deep studies. The current study included a survey of scour reduction downstream sharp-crested weir using a solid apron consisting of three different lengths, four different discharges, and sand bed material to calculate the maximum depth and length of scour hole when using an apron solid. The results proved that the depth and length of the scour hole are reduced to 19.3% and 27.7%, respectively, when an apron solid is used. Two empirical equations were found to determine the maximum depth and length of the hole with a coefficient of determination are 0.892 and 0.804, respectively.
Assessing the priority of human rights and mental health: the PHRAME approach
Authors: Gronholm Petra C. , Gill Neeraj , Carter Grace , Watson Danielle , Helmchen Hanfried , Thornicroft Graham , Sartorius Norman 
Published: March 2023

BackgroundProtecting all human rights of people with mental health conditions is globally important. However, to facilitate practical implementation of rights, it is often necessary to decide which of these rights should be given priority, especially when they conflict with each other.AimsThe aim of the Priorities of Human Rights and Mental Health (PHRAME) project is to develop a replicable approach to establish a proposed set of high-priority human rights of people with mental health conditions, to facilitate practical decision-making and implementation of such rights.MethodA two-stage Delphi-style study with stakeholders was conducted to generate a list of key rights of people with mental health conditions, and rank priorities among these rights in terms of feasibility, urgency and overall importance.ResultsThe stakeholders in this study consistently ranked three rights as top priorities: (a) the right to freedom from torture, cruel inhuman treatment and punishment; (b) the right to health and access to services/treatment; and (c) the right to protection and safety in emergency situations.ConclusionsInsights from PHRAME can support decision-making about the priority to be given to human rights, to guide practical action. This approach can also be used to assess how human rights are prioritised in different settings and by different stakeholders. This study identifies the clear need for a central voice for people with lived experience in research and implementation of decisions about the priority of human rights, ensuring that action respects the opinion of people whose rights are directly affected.
Permissive ureter specification by TBX18-mediated repression of metanephric gene expression
Authors: Weiss Anna-Carina , Blank Eva , Bohnenpoll Tobias , Kleppa Marc-Jens , Rivera-Reyes Reginaldo , Taketo Makoto Mark , Trowe Mark-Oliver , Kispert Andreas 
Published: March 2023

ABSTRACTThe murine kidney and ureter develop in a regionalized fashion from the ureteric bud and its surrounding mesenchyme. Whereas the factors that establish the metanephric cell lineages have been well characterized, much less is known about the molecular cues that specify the ureter. Here, we have identified a crucial patterning function in this process for Tbx18, a T-box transcription factor gene specifically expressed in the mesenchymal primordium of the ureter. Using misexpression and loss-of-function mice combined with molecular profiling approaches, we show that Tbx18 is required and sufficient to repress metanephric mesenchymal gene programs. We identify Wt1 as a functional target of TBX18. Our work suggests that TBX18 acts as a permissive factor in ureter specification by generating a mesenchymal domain around the distal ureteric bud where SHH and BMP4 signaling can occur.
The importance of comparative physiology: mechanisms, diversity and adaptation in skeletal muscle physiology and mechanics
Authors: Mendoza E. , Moen D. S. , Holt N. C. 
Published: March 2023

ABSTRACTSkeletal muscle powers animal movement, making it an important determinant of fitness. The classic excitation–contraction coupling, sliding-filament and crossbridge theories are thought to describe the processes of muscle activation and the generation of force, work and power. Here, we review how the comparative, realistic muscle physiology typified by Journal of Experimental Biology over the last 100 years has supported and refuted these theories. We examine variation in the contraction rates and force–length and force–velocity relationships predicted by these theories across diverse muscles, and explore what has been learnt from the use of workloop and force-controlled techniques that attempt to replicate aspects of in vivo muscle function. We suggest inclusion of features of muscle contraction not explained by classic theories in our routine characterization of muscles, and the use of phylogenetic comparative methods to allow exploration of the effects of factors such as evolutionary history, ecology, behavior and size on muscle physiology and mechanics. We hope that these future directions will improve our understanding of the mechanisms of muscle contraction, allow us to better characterize the variation in muscle performance possible, and enable us to infer adaptation.
Association between gestational blood lipids and TSH levels and pregnancy outcome of patients with subclinical hypothyroidism
Authors: Zhang Jiajia , Chen Hao , Dou Xiaobing , Huang Wei , Zeng Haixia 
Published: March 2023

Objective: To investigate the association between gestational blood lipids and thyroid stimulating hormone (TSH) levels and pregnancy outcomes of patients with subclinical hypothyroidism (SCH).
Methods: In this retrospective observational study, we analyzed the clinical data of 82 patients (case group) with gestational SCH treated in our hospital from January 2021 to January 2022 at gestational weeks 25-33 and grouped them according to whether SCH was well controlled by treatment (case Group-A: well controlled, n=55; case Group-B: poorly controlled, n=27), and the clinical data of 41 pregnant women (control group) undergoing physical examination during the same period. After comparing the blood lipids and TSH levels of the three groups, we compared their adverse pregnancy outcomes to assess the possible correlations between blood lipids and TSH levels and pregnancy outcomes.
Results: The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and TSH in the case Group-B were significantly higher than those in the case Group-A and the control group (P<0.05). Compared with case Group-B and the control group, the incidence of premature delivery, abortion and neonatal growth restriction was higher in case Group-A (P<0.05). Among 82 patients in the case group 42 presented adverse pregnancy outcomes. The levels of TC, TG, LDL-C and TSH in mothers and infants in the adverse outcome group were significantly higher than those in the favorable outcome group (P<0.05). Our Pearson analysis results showed that the levels of TC, TG and LDL-C were positively correlated with the TSH levels and the pregnancy outcomes, and that TSH was positively correlated with pregnancy outcomes (P<0.05).
Conclusion: The levels of TC, TG, LDL-C and TSH in patients with poorly controlled SCH were increased during pregnancy, and were associated with the pregnancy outcomes and positively correlated with each other.
doi: https://doi.org/10.12669/pjms.39.3.7150
How to cite this: Zhang J, Chen H, Dou X, Huang W, Zeng H. Association between gestational blood lipids and TSH levels and pregnancy outcome of patients with subclinical hypothyroidism. Pak J Med Sci. 2023;39(3):721-725. doi: https://doi.org/10.12669/pjms.39.3.7150
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis
Authors: He Xufeng , Liu Yang 
Published: March 2023

Objective: To investigate the effects of arteriovenous fistulas (AVFs) and central venous catheters (CVCs) on the left ventricular function (LVF) and prognosis of maintenance hemodialysis (MHD) patients.
Methods: This retrospective cohort study included 270 patients (139 with AVF and 131 with CVC) undergoing dialysis with newly established vascular access in the blood purification center of Nanhua hospital, University of South China, from January 2019 to April 2021. Dialysis efficiencies, LVF indexes, and one-year prognoses were compared.
Results: At six and twelve months after the establishment of vascular access, the mean urea clearances (Kt/V) and urea reduction ratio (URR) between the AVF- and the CVC-group were similar (P>0.05). The mean LVF values between the two groups were also similar before the establishment of vascular access (P>0.05), but the mean values of left ventricular end diastolic diameter (LVEDd), interventricular septal thickness (IVSTd), and left ventricular posterior wall thickness (LVPWT) in the AVF-group were higher than those in the CVC-group one year later, and mean early (E) and late (A) diastolic mitral velocities, E/A, and ejection fraction (EF) were lower than those in the CVC-group (P<0.05). The incidence of left ventricular hypertrophy and systolic dysfunction in the AVF-group was higher than that in the CVC-group (P<0.05). The hospitalization rate of AVF-group (23.02%) was lower than that of the CVC-group (49.61%) (P<0.05).
Conclusion: Both AVF and CVC can achieve appropriate dialysis effects in MHD patients. AVF has a negative impact on cardiac function while CVC has a high hospitalization rate.
doi: https://doi.org/10.12669/pjms.39.3.7151
How to cite this: He X, Liu Y. Effects of arteriovenous fistulas and central venous catheters on the cardiac function and prognosis of patients on maintenance hemodialysis. Pak J Med Sci. 2023;39(3):780-784. doi: https://doi.org/10.12669/pjms.39.3.7151
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Simulation of self-modulated laser wakefield acceleration using few TW in downramp injection and ionization injection regimes
Authors: Maldonado Edison Puig , Samad Ricardo Elgul , Zuffi Armando Valter Felicio , Vieira Nilson Dias 
Published: March 2023

Simulations of transitional self-modulated laser wakefield acceleration
driven by laser pulses of a few terawatts are discussed, comparing a
downramp-based injection regime with an ionization injection regime.
We demonstrate that a configuration using an N2 gas target and a laser pulse of ∼75mJ with ∼2TW peak power is a good alternative as a
high repetition rate system that produces electrons of many tens of
MeV, pC charge, and emittance of the order of 1 mm mrad.