bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Intraoperative Dorsal Tangential View and the Radial Groove View of the Distal Radius to Detect Dorsal Screw Protrusion in Volar Plating: Teaching Effect and Value in Clinical Practise
Authors: Fässler D , Pozzi L , Doert A , Schläppi M , Meier C 
Published: June 2023

Abstract

Background
Dorsal screw tip protrusion (DSTP) with extensor tendon injury is a well-known complication of volar plating for distal radius fractures. The dorsal tangential view (DTV) and the radial groove view (RGV) have been recommended to detect DSTP. The value of these views depends on their quality and reproducibility.

Aims
It was the aim of this study to investigate the quality of these views before and after teaching of the involved surgeons.

Methods
All adult patients treated with volar plating for distal radius fractures between 10/2019 and 10/2020 were included. Prior to their first case in the study period, all involved surgeons were instructed in a standardized manner how to perform technically correct DTV and RGV. Patients from an earlier period served as controls. Image quality was rated independently by two investigators. Detection of DSTP based on fluoroscopy was documented and protruding screws were exchanged. The impact of teaching was assessed. Furthermore, reliability of DTV and RGV to detect DSTP was compared to postoperative ultrasound.

Results
A total of 124 patients were included in the study group, 125 patients served as controls. Interobserver agreement for the image quality was 97% for DTV and 98% for RGV. Image quality significantly improved with teaching (p&lt;0.001). Correct images were observed in 81% vs. 58% for DTV and 81% vs. 53% for RGV. From a total of 571 evaluated screws intraoperative fluoroscopy identified 24 DSTP (4.2%) in 23 patients (18.5%). Postoperative ultrasound revealed 4 DSTP (0.8-1.2mm; 0.7%) in 4 patients (3.2%).

Conclusions
Teaching surgeons how to perform technically good DTV and RGV leads to a significant improvement of image quality. DTV and RGV are reliable tools to detect DSTP. However, despite correct views, some minor dorsal cortex penetrations may be missed. Thus, early further investigations are recommended in patients with extensor tendon irritation.
Carpal Tunnel Syndrome and Trigger Digit: An Early Symptom of Cardial Amyloidosis
Authors: Kallenbach B , Höfflinghaus T , Höller S , Dietrich M , Sproedt J 
Published: June 2023

Abstract

Background
Amyloidosis is a disease with misfolded protein deposits. The subform transthyretin amyloidosis (ATTR) presents with heart failure, atrial fibrillation and bundle branch block, often requiring pacing. Soft tissue deposits may occur, causing trigger digit (TD) and carpal tunnel syndrome (CTS). These may be an initial symptom of systemic amyloidosis with cardiac manifestation, they precede cardiac amyloidosis on average 5-9 years. Studies showed positivity of up to 22.5% for ATTR in tenosynovial biopsies in CTS-patients identified by a screening algorithm. ATTR is found in around 25% of autopsies at 80 years and older, with underestimated prevalence in the general population.

Aims
Early detection is crucial in treating systemic amyloidosis. Therefore, biopsies taken during carpal tunnel release (CTR) and trigger release (TR) can contribute significantly to its diagnosis.

Methods
Patients admitted in 2022 to our hospital were examined prospectively and biopsied if macroscopic intraoperative synovial hyperplasia was present. Histologic examination was done with Congo red staining and immunohistologic examination for ATTR. Patients tested positive for ATTR were offered a cardiologic follow-up.

Results
118 patients (63 CTS, 55 TD) were included in the study, 40 (34%) underwent partial synovectomy. Of these, 3 patients (7.5%) were positive for ATTR. 1 patient had an unremarkable cardiologic examination, 1 patient declined, 1 patient is pending.

Conclusions
Early detection of amyloidosis by CTR and TR is a topic of increasing relevance. In our study, the positivity rate was lower than in others. However, there was different patient selection, e.g., according to macroscopic findings instead of a screening algorithm. The observation period is insufficient to record any cardiac results; a follow-up in 5-10 years would be appropriate. Current therapy for amyloidosis aims to delay the disease progress by preventing deposit formation, with no therapy degrading pre-existing deposits. Thus, early detection is crucial for disease outcome and justifies additional screening cost.
Improving the Early Outcome of Digital Replantation: Technical Tricks Learned in a US Fellowship
Authors: Früh F , Safa B , Watt A , Pridgen B , Lin W , Buntic R , Buncke G 
Published: June 2023

Abstract

Background
Despite stable numbers of upper limb amputations there is a decline in replantation in Europe. This results in lacking experience, decreasing success rates, and fewer attempts. Training in high-volume centers is crucial for hand surgeons performing upper extremity replantation.

Aims
This abstract highlights the experience in a US microsurgery fellowship.

Methods
Upper extremity revascularization and replantation cases during a 10 month - period were retrospectively reviewed. Overall, the fellow was exposed to 29 cases: 2 hand, 5 thumb and 9 digitial replantations as well as 13 thumb and digital revascularizations. Primary outcome was the survival of the injured body part. Secondary outcomes were total case time, number of repaired arteries/veins, the use of vein grafts, and early free flap coverage. Whenever possible, all microsurgical steps including vessel debridement and anastomosis were performed under tourniquet.

Results
Success rate was 21/29 (72%). Failure was limited to avulsion or crush injuries. Mean surgery time for revascularization was 92 min (range, 45-134 min) per digit. Mean surgery time for thumb and single digit replantation was 133 min (range, 62-270 min) and for the two hand replantations 180 min and 300 min, respectively. Routinely, only 1 dominant artery was repaired. Forearm or saphenous vein grafts were used in 14/29 cases. Only in 3/23 cases &gt; 1 vein was repaired and in 3 cases interpositional vein grafts were used for dorsal vein reconstruction. One venous flow-through flap was used and a dorsal hand soft tissue defect was covered with a fascio-cutaneous free flap 5 days after replantation.

Conclusions
Replantation remains a challenge for hand surgeons. The thoughtful use of a tourniquet with vessel debridement in a bloodless field is key to maximize the efficiency of replantation. Furthermore, the liberate use of vein grafts and venous flow-through flaps helps moving outside the trauma zone, thus increasing the likelihood of upper limb salvage.
Mid- to Long-Term Clinical and Radiological Outcome after Perilunate Injuries
Authors: Riederer J , Kellenberger C , Häfeli M , Cordier T , Wirtz C , Schibli S , Felsbourg J 
Published: June 2023

Abstract

Background
Perilunate dislocations (PLD) and perilunate fracture dislocations (PLFD) are rare but severe injuries to the wrist, usually resulting from a high-energy trauma occurring in sports injuries, motor vehicle accidents, falls or machine related accidents. Treatment of choice is early reduction with carpal transfixation, fracture fixation and refixation of the injured ligaments.

Aims
As reports on mid- to long-term outcome are scarce, we aimed to investigate clinical and radiological outcome of open treatment after a minimal follow-up of 2 years.

Methods
Patients treated for PLD and PLFD in our institution were identified back to 2008. Inclusion criteria were PLD and PLFD who underwent open surgery, had a minimal follow-up of 2 years and were available for a follow-up. Clinical examination included ROM and grip strength. PRWE, quick DASH, SF-12 and the single assessment numeric evaluation (SANE) score were used as PROMs. Dorso-palmar and lateral X-rays were done and assessed for carpal height, inter- and radio-carpal angles and degenerative changes.

Results
Of 54 identified patients, 29 patients could be located and contacted. By the date of abstract submission 15 patients after PLFD and 9 after PLD had been followed-up in our clinic. Mean follow-up was 93 months (24-170). Mean F/E was 43/0/51° for the affected and 68/0/66° for the healthy wrist, P/S 77/0/73° and 79/0/79°, R/U 24/0/34° and 27/0/44°. Mean grip strength was 41kp and 61kp. Mean score for PRWE was 13.2, qDASH 14.2%, SF-12 physical score 50.9, mental score 55.1 and SANE 86%. 11 patients showed slight to moderate degenerative changes. Carpal height (Nattrass Index) showed a mean of 1.45.

Conclusions
Although the affected wrists showed reduced ROM and SANE scores, patients were mostly satisfied with the outcome and only exhibited little pain. Open reduction and fixation of PLD and PLFD reliably lead to satisfactory results even in the long-term.
Training with a Novel Digitally Enhanced Hands-On Surgical Training (DEHST) Enhances the Performance During Intramedullary Nail Distal Interlocking
Authors: Pastor T , Cattaneo E , Gueorguiev B , Windolf M , Buschbaum J 
Published: June 2023

Abstract

Background
Freehand distal interlocking of intramedullary nails remains a challenging task. This surgical step is the most difficult part performed at the end of the operation and may have a catastrophic influence on patients’ outcome of not performed precisely. Recently, the AO Research Institute developed a new training device for Digitally Enhanced Hands-on Surgical Training (DEHST), potentially improving surgical skills needed for this surgical step. The device already yielded high scores in terms of face and construct validity in the first step of the validation cascade.

Aims
To evaluate weather training with DEHST enhances the performance of novices without surgical experience in free-hand distal nail interlocking compared to a non-trained group of novices.

Methods
20 novices were assigned in two groups and performed distal interlocking of a tibia nail in an artificial bone model under a real C-arm. Group 1: DEHST trained novices (virtual locking of five nail holes during one hour of training). Group 2: untrained novices without DEHST training. Time, number of x-rays, nail hole roundness, critical events and success rates were compared between the groups.

Results
Time to complete the task (sec) and x-ray exposure (µGcm2) were significantly lower in Group1 414.7 (290–615) and 17.8 (9.8–26.4) compared to Group2 623.4 (339–1215) and 32.6 (16.1–55.3); p=0.041 and 0.003. Perfect circle roundness (%) was 95.0 (91.1–98.0) in Group 1 and 80.8 (70.1–88.9) in Group 2; p&lt;0.001. In Group 1 90% of the participants achieved successful completion of the task (hit the nail with the drill), whereas only 60% of the participants in group 2 achieved this; p=0.121.

Conclusions
Training with DEHST significantly enhances the performance of novices without surgical experience in distal interlocking of intramedullary nails. Besides radiation exposure and operation time the complication rate during the operation can be significantly reduced.
Clearing of Polytrauma Patients for Early Definitive Fracture Fixation: A Systematic Literature Review
Authors: Roman R , Klingebiel F K L , Halvachizadeh S , Kalbas Y , Pape H C 
Published: June 2023

Abstract

Background
Early patient assessment is important for surgical decision making in severely injured patients. Moreover it is known that early fracture fixation is beneficial, such as those in stable condition or those who respond well to resuscitation.

Aims
The aim of this systematic review is to identify parameters that indicate risk factors for an unfavorable outcome and early complications. In addition, we aim to improve decision making and separate patients who would benefit from early versus staged definitive surgical fixation.

Methods
A systematic review was performed of peer-reviewed articles in English or German published between January 1, 2000, and May 15 2022 (PUBMED) according to PRISMA guidelines. The primary outcome was the pathophysiologic response to polytrauma, including coagulopathy, shock/hemorrhage, hypothermia, and soft tissue injury to determine the treatment strategy with the least number of complications. Articles that had used quantitative parameters to distinguish between stable and unstable patients were combined.

Results
The initial systematic search for MeSH criteria yielded 1550 publications deemed relevant to the following topics (coagulopathy (n = 37), hemorrhage/shock (n = 7), hypothermia (n = 11), soft tissue injury (n = 24)). Thresholds for stable, borderline, unstable, and in extremis conditions were defined according to the existing literature as follows: Coagulopathy; International Normalized Ratio (INR) and viscoelastic methods (VEM)/blood/shock; lactate, systolic blood pressure and hemoglobin, hypothermia; thresholds in degrees Celsius/soft tissue trauma: traumatic brain injury, thoracic and abdominal trauma, and musculoskeletal trauma.

Conclusions
In this systematic literature review, we summarize the publications by focusing on the different pathways that stimulate pathophysiologic cascades and distant organ damage. We propose that these parameters can be used for clinical decision making within the concept of safe definitive surgery (SDS) in the treatment of severely injured patients.
The Questionable Burden of AB0 Incompatible Kidney Transplantation
Authors: Berchtold C , Huebel K , Roessler F , Graf N , Dutkowski P , Mueller T , Lehmann K , de Rougemont O 
Published: June 2023

Abstract

Background
AB0 incompatible kidney transplantation has become a genuine treatment for end-stage renal disease. Non-inferiority in long term graft function compared to AB0 compatible transplantation has been shown. However, the assumed burden due to complications owing to increased immunosuppression inherent to AB0 incompatible transplantation has not yet been quantified.

Aims
The aim of the study was to determine if AB0 incompatible recipients have additional morbidity and whether this burden is justified or whether kidney paired donation programs should be advocated.

Methods
From January 2000 to March 2020 46 AB0 incompatible living kidney transplantations were performed. Patients were matched with AB0 compatible recipients according to sex, age, underlying disease, year of transplantation, and duration of dialysis. Number and duration of readmissions, surgical complication rates according to Clavien-Dindo and its comprehensive complication index (CCI), kidney function, occurrence of new onset diabetes, as well as tumor incidence were analyzed.

Results
Readmission rate was not higher in AB0 incompatible recipients. The median difference in length of hospital stay for readmissions, CCI during primary hospital stay, and CCI for readmissions at 3, 6, 12 and &gt;12 months after transplantation were comparable. Incidence of tumor and new onset diabetes after transplantation was not increased in incompatible recipients.

Conclusions
AB0 incompatible recipients do not suffer from a higher burden compared to AB0 compatible recipients. We currently recommend not delaying transplantation in AB0 incompatible pairs.
Clinical considerations in early-onset cerebral amyloid angiopathy
Authors: Banerjee Gargi , Collinge John , Fox Nick C , Lashley Tammaryn , Mead Simon , Schott Jonathan M , Werring David J , Ryan Natalie S 
Published: June 2023

AbstractCerebral amyloid angiopathy (CAA) is an important cerebral small vessel disease associated with brain haemorrhage and cognitive change. The commonest form, sporadic amyloid-β CAA, usually affects people in mid- to later life. However, early-onset forms, though uncommon, are increasingly recognized and may result from genetic or iatrogenic causes that warrant specific and focused investigation and management.In this review, we firstly describe the causes of early-onset CAA, including monogenic causes of amyloid-β CAA (APP missense mutations and copy number variants; mutations of PSEN1 and PSEN2) and non-amyloid-β CAA (associated with ITM2B, CST3, GSN, PRNP and TTR mutations), and other unusual sporadic and acquired causes including the newly-recognized iatrogenic subtype. We then provide a structured approach for investigating early-onset CAA, and highlight important management considerations.Improving awareness of these unusual forms of CAA amongst healthcare professionals is essential for facilitating their prompt diagnosis, and an understanding of their underlying pathophysiology may have implications for more common, late-onset, forms of the disease.
Combined Wee1 and EGFR inhibition reveals synergistic antitumor effect in esophageal squamous cell carcinoma
Authors: Chen Dongshao , Hong Ruoxi , Cao Youjun , Wu Qingnan , Wang Yan , Chen Jie , Li Jinting , Zhang Weimin , Zhan Qimin 
Published: June 2023

AbstractEpidermal growth factor receptor (EGFR) is one of the most common amplified and overexpressed oncogenes in esophageal squamous cell carcinoma (ESCC), while the clinical efficacy of EGFR-targeted therapy in ESCC is dismal. Here, we evaluated the efficacy of dual blockage using monoclonal antibody against EGFR (Nimotuzumab) and an Wee1 inhibitor (AZD1775) in ESCC. We found that the mRNA and protein expression of EGFR and Wee1 were positively correlated in ESCC. Nimotuzumab-AZD1775 co-treatment inhibited tumor growth in PDX models with different drug susceptibility. Transcriptome sequencing and mass spectrometry analysis indicated that higher sensitive models showed enrichment of the PI3K/Akt or MAPK signaling pathway in Nimotuzumab-AZD1775 group compared with control group. In vitro experiments showed that the combination further inhibit PI3K/Akt and MAPK pathways compared to their monotherapy as indicated by downregulation of pAKT, pS6, pMEK, pErk and p-p38 MAPK. Furthermore, AZD1775 potentiated Nimotuzumab’s antitumor effect through inducing apoptosis. Meanwhile, the bioinformatics analysis suggests the POLR2A might be candidate molecule of EGFR/Wee1 downstream. In conclusion, our work uncovers that EGFR-mAb Nimotuzumab combined with Wee1 inhibitor AZD1775 elicited potentiated anticancer activity against ESCC cell line and PDXs partially through PI3K/Akt and MAPK pathways blockade. These preclinical data raise the promising that ESCC patients may benefit from dual target EGFR and Wee1.
Simple shape feature computation across modalities: convergence and divergence between the ventral and dorsal visual streams
Authors: Tian Shuang , Chen Yuankun , Fu Ze , Wang Xiaoying , Bi Yanchao 
Published: June 2023

Abstract
Shape processing, whether by seeing or touching, is pivotal to object recognition and manipulation. Although the low-level signals are initially processed by different modality-specific neural circuits, multimodal responses to object shapes have been reported along both ventral and dorsal visual pathways. To understand this transitional process, we conducted visual and haptic shape perception fMRI experiments to test basic shape features (i.e. curvature and rectilinear) across the visual pathways. Using a combination of region-of-interest-based support vector machine decoding analysis and voxel selection method, we found that the top visual-discriminative voxels in the left occipital cortex (OC) could also classify haptic shape features, and the top haptic-discriminative voxels in the left posterior parietal cortex (PPC) could also classify visual shape features. Furthermore, these voxels could decode shape features in a cross-modal manner, suggesting shared neural computation across visual and haptic modalities. In the univariate analysis, the top haptic-discriminative voxels in the left PPC showed haptic rectilinear feature preference, whereas the top visual-discriminative voxels in the left OC showed no significant shape feature preference in either of the two modalities. Together, these results suggest that mid-level shape features are represented in a modality-independent manner in both the ventral and dorsal streams.
Cerebral blood flow velocity and oxygenation in neonatal aortic arch repair at two perfusion temperatures
Authors: Finnigan Lucy E M , Lotto Robyn , Jones Helen , Lotto Attilio 
Published: June 2023

Abstract

OBJECTIVES
(i) To monitor cerebral blood flow velocity (CBFv) throughout aortic arch repair surgery and during the recovery period. (ii) To examine the relationship between transcranial doppler ultrasound (TCD) and near-infrared spectroscopy (NIRS) during cardiac surgery. (iii) To examine CBFv in patients cooled to 20°C and 25°C.

METHODS
During aortic arch repair and after surgery, measurements of TCD, NIRS, blood pH, pO2, pCO2, HCO3, lactate, Hb, haematocrit (%) and temperature (core and rectal) were recorded in 24 neonates. General linear mixed models were used to examine differences over time and between two cooling temperatures. Repeated measures correlations were used to determine the relationship between TCD and NIRS.

RESULTS
CBFv changed during arch repair (main effect of time: P = 0.001). During cooling, CBFv increased by 10.0 cm/s (5.97, 17.7) compared to normothermia (P = 0.019). Once recovering in paediatric intensive care unit (PICU), CBFv had increased from the preoperative measurement by 6.2 cm/s (0.21, 13.4; P = 0.045). CBFv changes were similar between patients cooled to 20°C and 25°C (main effect of temperature: P = 0.22). Repeated measures correlations (rmcorr) identified a statistically significant but weak positive correlation between CBFv and NIRS (r = 0.25, P≤0.001).

CONCLUSIONS
Our data suggested that CBFv changed throughout aortic arch repair and was higher during the cooling period. A weak relationship was found between NIRS and TCD. Overall, these findings could provide clinicians with information on how to optimise long-term cerebrovascular health.
Porewater constituents inhibit microbially mediated greenhouse gas production (GHG) and regulate the response of soil organic matter decomposition to warming in anoxic peat from a Sphagnum-dominated bog
Authors: Song Tianze , Liu Yutong , Kolton Max , Wilson Rachel M , Keller Jason K , Rolando Jose L , Chanton Jeffrey P , Kostka Joel E 
Published: June 2023

Abstract
Northern peatlands store approximately one-third of terrestrial soil carbon. Climate warming is expected to stimulate the microbially mediated degradation of peat soil organic matter (SOM), leading to increasing greenhouse gas (GHG; carbon dioxide, CO2; methane, CH4) production and emission. Porewater dissolved organic matter (DOM) plays a key role in SOM decomposition; however, the mechanisms controlling SOM decomposition and its response to warming remain unclear. The temperature dependence of GHG production and microbial community dynamics were investigated in anoxic peat from a Sphagnum-dominated peatland. In this study, peat decomposition, which was quantified by GHG production and carbon substrate utilization is limited by terminal electron acceptors (TEA) and DOM, and these controls of microbially mediated SOM degradation are temperature-dependent. Elevated temperature led to a slight decrease in microbial diversity, and stimulated the growth of specific methanotrophic and syntrophic taxa. These results confirm that DOM is a major driver of decomposition in peatland soils contains inhibitory compounds, but the inhibitory effect is alleviated by warming.