bluuebunny/crossref_metadata_2025 huggingface dataset:
Generic low-atmosphere signatures of swirled-anemone jets
Authors: Joshi Reetika , Aulanier Guillaume , Radcliffe Alice , Rouppe van der Voort Luc , Pariat Etienne , Nóbrega-Siverio Daniel , Schmieder Brigitte
Published: May 2024

Context.Solar jets are collimated plasma flows moving along magnetic field lines and are accelerated at low altitude following magnetic reconnection. Several of them originate from anemone-shaped low-lying arcades, and the most impulsive ones tend to be relatively wider and display untwisting motions.

Aims.We aim to establish typical behaviours and observational signatures in the low atmosphere that can occur in response to the coronal development of such impulsive jets.

Methods.We analysed an observed solar jet associated with a circular flare ribbon using high-resolution observations from SST coordinated with IRIS and SDO. We related specifically identified features with those developing in a generic 3D line-tied numerical simulation of reconnection-driven jets performed with the ARMS code.

Results.We identified three features in the SST observations: the formation of a hook along the circular ribbon, the gradual widening of the jet through the apparent displacement of its kinked edge towards (and not away) from the presumed reconnection site, and the falling back of some of the jet plasma towards a footpoint offset from that of the jet itself. The 3D numerical simulation naturally accounts for these features, which were not imposed a priori. Our analyses allowed us to interpret them in the context of the 3D geometry of the asymmetric swirled-anemone loops and their sequences of reconnection with ambient coronal loops.

Conclusions.Given the relatively simple conditions in which the observed jet occurred, together with the generic nature of the simulation that comprised minimum assumptions, we predict that the specific features that we identified and interpreted are probably typical of every impulsive jet.
Continuum and spectral-line observations of the OH megamaser galaxy IRAS 01298−0744
Authors: Wu Zhongzu , Sotnikova Yulia , Mufakharov Timur , Shen Zhiqiang , Chen Yongjun , Wang Shouzhi , Wu Jiangfeng
Published: May 2024

We present Very Long Baseline Array observations of radio continuum and OH line emission toward the OH megamaser (OHM) galaxy IRAS 01298−0744. We recover over 82% of the OH line emission seen in single-dish observations, including multiple strong OH line components and the broad shallow line profile spanning over 1000 km s−1. The OH emission spatially has four compact components, as well as diffuse emission, and the 3σ signals are distributed in a rectangular region with size of ∼40 × 30 mas. The spatial-velocity structure is complex and is consistent with that from HCN and HCO+ lines in the literature, indicating that the nuclear region of this source is likely still in the merging process characterized by intense nuclear activities. The multiple strong OH peaks are blue-shifted compared to dense millimetre-wave molecular gas tracers, but similar to optical Na I absorption. This suggests that the compact masers might be in an outflow driven by an active galactic nucleus or starburst. We have detected compact radio continuum emissions adjacent to the maser positions with a brightness temperature of around 3 × 106 K, similar to other OHM galaxies with very-long-baseline interferometry observations in the literature, which is consistent with a starburst origin.
Update Kontraindikationen Peritonealdialyse
Authors: Artunc Ferruh
Published: May 2024

Die Peritonealdialyse (PD) ist eine Form der Nierenersatztherapie, die den betroffenen Patienten eine selbstständige Behandlung im heimischen Umfeld ermöglicht. Trotz guter Ergebnisse ist die PD im Vergleich zur Hämodialyse (HD) weltweit unterrepräsentiert. Einer der Gründe ist, dass in vielen Fällen medizinische Kontraindikationen angeführt werden. Die einzige absolute Kontraindikation für eine PD ist die Unmöglichkeit eines peritonealen Stoffaustauschs durch aktive Prozesse in der Bauchhöhle, eine verringerte Oberfläche oder eine peritoneale Fibrose. Sämtliche weitere Kontraindikationen wie Adhäsionen, Anurie, Adipositas, ungeplanter Start oder Leckagen sind relativ und können potenziell überwunden werden. Dazu ist jedoch die Expertise eines erfahrenen und gut aufgestellten PD-Zentrums erforderlich.
Peritonealdialyse assoziierte Peritonitis
Authors: Kimmel Martin
Published: May 2024

Im Verlauf einer Peritonealdialyse (PD) können infektiöse Komplikationen auftreten, zu denen PD-Katheter assoziierte Infektionen und die PD-assoziierte Peritonitis gezählt werden. In den aktualisierten internationalen Leitlinien der International Society of Peritoneal Dialysis (ISPD) zur PD-assoziierten Peritonitis und zu PD-Katheter assoziierten Infektionen sind alle wichtigen Aspekte in übersichtlichen Algorithmen umfangreich dargestellt. In diesem Beitrag werden einige Aspekte des Managements der PD-assoziierten Peritonitis bezüglich der Prävention, der Präsentation und Diagnosestellung, des praktischen empirischen Vorgehens und der gezielten Antibiotikatherapie zusammengefasst.
Biologika in der dermatologischen Praxis – eine 20-jährige Geschichte
Authors: Jahn Sigbert , Diamanti Evangelia , Wagner Christine , Prestel Julia , Herbst Matthias
Published: May 2024

Immuntherapien mit Biologika (monoklonalen Antikörpern, Fusionsproteinen) haben das dermatologische therapeutische Arsenal in den letzten 20 Jahren enorm erweitert und die Therapie mittelschwerer bis schwerer entzündlicher Dermatosen deutlich effizienter gemacht. Dieses Jubiläum hat uns motiviert, einen Rückblick zu halten auf die Entwicklung der Biologikatherapien in der Dermatologie und diesen mit eigenen Erfahrungen aus der dermatologischen Praxis zu illustrieren.
Effects of Hyperglycemia on Angiogenesis in Human Placental
Endothelial Cells
Authors: Yanik Turkan , Katirci Ertan , Simsek Mehmet , Korgun Emin Turkay , Kipmen-Korgun Dijle
Published: May 2024

The placenta is a temporary organ that provides communication between the mother
and fetus. Maternal diabetes and abnormal placental angiogenesis may be linked.
We investigated the angiogenesis mechanism resulting from VEGF and glucose
stimulation in PECs obtained from human term placenta. Immunohistochemistry was
performed to characterize PECs obtained from human term placenta. D-glucose was
added to the medium containing PECs to establish normoglycemic and hyperglycemic
conditions. The expression levels of VEGF, VEGFR-1 and VEGFR-2 genes and
proteins in PECs from the control and experimental groups were analyzed by
RT-PCR and Western blotting, respectively. With 48-hours incubation, gene
expressions increased due to hyperglycemia, while protein levels increased due
to the combined effect of VEGF and hyperglycemia. While VEGFR-2 gene expression
and protein amounts increased in 24-hours due to the combined effect of VEGF and
hyperglycemia, the effect of VEGF stimulation and glucose level on VEGFR-2
decreased in 48-hour incubation with time. VEGF, VEGFR-1 and VEGFR-2 genes and
proteins were affected by hyperglycemic conditions in PECs. Hyperglycemia
occurring in various conditions such as gestational diabetes mellitus and
diabetes mellitus may affect VEGF, VEGFR-1 and VEGFR-2 genes and proteins of
PECs derived from human term placenta.
Nephrotisches Syndrom nach Infektion eines ventrikuloatrialen Shunts
Authors: Schmorl Philipp , Deicher Robert , Bräsen Jan Hinrich , Martin Stephan
Published: May 2024

Ein männlicher Patient (Mitte/Ende 20 Jahre alt) stellte sich in der Urologie des MZEB mit seit einem Monat blutig tingiertem, zunehmend trübem Urin ohne Dysurie oder Harninkontinenz vor. Mit dem klinischen Bild eines nephrotischen Syndroms erfolgte eine notfallmäßige Krankenhauseinweisung in die medizinische Klinik. Nach umfangreicher internistischer Diagnostik wurde eine Glomerulonephritis festgestellt, welche durch eine Shuntinfektion bedingt war. Nach entsprechender Therapie konnte der Patient in deutlich verbessertem Zustand entlassen werden. Im vorliegenden Fall lässt sich die ungewöhnliche Symptomatik von ursächlichen Problemen insbesondere vor dem Hintergrund schwerer Behinderungen darstellen.
The beauty of pediatric musculoskeletal ultrasound
Authors: Drakonaki Elena E , Adriaensen Miraude , Simoni Paolo , Aparisi Gomez Maria Pilar
Published: May 2024

Ultrasound is a powerful technique in pediatric imaging and musculoskeletal (MSK) imaging in many specific clinical scenarios. This article will feature some common and less common spot diagnoses in pediatric musculoskeletal ultrasound.

Cases were collected by members of the Educational Committee of the ESSR (European Society of musculoSkeletal Radiology) and the Pediatric Subcommittee of the ESSR with expertise in musculoskeletal ultrasound.

Fifteen clinical entities are discussed based on the features that allow diagnosis by ultrasound.

Clinical history, location, and ultrasound appearance are the keys to spot diagnoses when performing pediatric musculoskeletal ultrasound.
BF3·OEt2-Mediated (3+2) Cycloaddition Reactions of Donor-Acceptor Cyclopropanes (DACs) with Cyanamides: Access to Cyclic Amidines
Authors: Goswami Avijit , Gopal Braj , Singh Prasoon Raj , Bhatt Shubham
Published: May 2024

A BF3·OEt2-promoted facile synthesis of cyclic amidines (2-amino-1-pyrrolines) has been developed via the (3+2)-cycloaddition of cyanamides with donor-acceptor cyclopropanes (DACs). In addition to this, the protocol has been successfully extended to construct a dimerized amidine derivative and gram-scale synthesis with great efficiency.
Skeletal Effects of a Prolonged Oral Metformin Treatment in Adult
Wistar Rats
Authors: Wanionok Nahuel E. , Molinuevo María S. , Fernández Juan M. , Lucas Besada , Cortizo Ana M. , Castillo Evelyn J. , Jiron Jessica M. , Claudia Sedlinsky , Leon Schurman , Aguirre José I. , McCarthy Antonio D.
Published: May 2024

Introduction We previously showed that a 3-week oral metformin (MET)
treatment enhances the osteogenic potential of bone marrow stromal cells (BMSCs)
and improves several bone histomorphometric parameters in Wistar rats with
metabolic syndrome (MetS). However, the skeletal effects of extended periods of
MET need to be completely elucidated. Hence, in this study, the impact of a
prolonged (3-month) MET treatment was investigated on bone architecture,
histomorphometric and biomechanics variables, and osteogenic potential of BMSCs
in Wistar rats with or without MetS.

Materials and Methods Young male Wistar rats (n=36) were randomized into
four groups (n=9) that received either 20% fructose (F), MET
(MET), F plus MET treatments (FMET), or drinking water
alone (Veh). Rats were euthanized, blood was collected, and bones were
dissected and processed for peripheral quantitative computed tomography (pQCT)
analysis, static and dynamic histomorphometry, and bone biomechanics. In
addition, BMSCs were isolated to determine their osteogenic potential.

Results MET affected trabecular and cortical bone, altering bone
architecture and biomechanics. Furthermore, MET increased the pro-resorptive
profile of BMSCs. In addition, fructose-induced MetS practically did not affect
the the structural or mechanical variables of the skeleton.

Conclusion A 3-month treatment with MET (with or without MetS) affects
bone architecture and biomechanical variables in Wistar rats.
Novel Eyelid Supraorbital Pretemporal Approach to the Anterior Communicating Artery Complex: A Quantitative Cadaveric Comparative Study
Authors: Zhao Xiaochun , Evans Alexander R. , Shi Helen H. , Pelargos Panayiotis E. , Tan Jeremy , Do Thai , Dunn Ian F. , Graffeo Christopher , Bauer Andrew M.
Published: May 2024

Objectives Access to the anterior communicating artery (ACom) complex may be achieved via the modified orbito-zygomatic (mOZ) or eyelid supraorbital (ES) approaches. Further, the ES approach may improve cosmesis at the cost of decreased exposure and maneuverability. Thus, a novel eyelid supraorbital pretemporal (ESP) approach, a combination of the ES approach with a pretemporal dissection, may optimize the shortcomings of the ES approach.

Design This is a cadaveric study.

Setting Five ES, ESP, and mOZ approaches were performed on cadaveric heads and compared.

Participants Cadaveric specimens were provided under the University of Oklahoma Health Science Center's Willed Body Program.

Main Outcome Measures Quantitative measures of exposure, maneuverability, and angles of attack in horizontal and vertical planes were compared between approaches.

Results The ESP approach was superior in terms of exposure and deep maneuverability when compared with the ES approach (p < 0.01). In addition, this approach demonstrated superior angles of attack in vertical (p < 0.01) and horizontal (p = 0.045) planes. When compared with the mOZ approach, the ESP approach provided significantly greater exposure to the contralateral A2 (p < 0.01) with a less favorable horizontal angle of attack (p < 0.01). The ESP provides exact exposure to complete the pretemporal osteotomy, offering a unique perspective on the ACom complex.

Conclusion When accessing the ACom complex, the ESP approach yields superior exposure and maneuverability compared with the ES approach and is comparable to the mOZ approach, with unique advantages provided by the addition of pretemporal osteotomy and dissection.
Use of Jugular Venous Pressure to Optimize Outcomes of Vestibular Schwannoma Resection: A Review of the Literature and Proof of Concept
Authors: Brakel Benjamin , Wang Jessica , Kam Jeremy , Huttunen Henrik , Dhaliwal Bali , McEwen Jon , Westerberg Brian , Makarenko Serge , Akagami Ryojo
Published: May 2024

Background Surgical resection of vestibular schwannoma (VS) and other benign posterior fossa tumors is often curative if gross total resection is achieved; however, these lesions pose unique challenges due to their intricate location and proximity to critical structures. Approaches for resection often utilize lateral head rotation and neck flexion to optimize the surgical field. However, this may inadvertently occlude cerebral venous drainage, elevating intracranial pressure (ICP) and increasing intraoperative bleeding, potentially increasing the operative risk to patients.

Methods We review relevant literature regarding the effects of head rotation and neck flexion on internal jugular vein (IJV) occlusion and ICP and highlight the notion that head rotation and flexion may occlude the ipsilateral IJV, increasing ICP. Subsequently, we propose a novel technique using continuous, real-time monitoring of jugular bulb pressure (JBP) to detect obstructions in jugular venous flow and guide optimal head positioning prior to VS resection.

Results As proof of concept, we present a single-patient case in which JBP monitoring was employed to optimize head positioning prior to a VS resection, which shows a significant reduction in JBP compared with traditional positioning.

Conclusion This innovative approach offers promise in enhancing the safety and efficacy of intracranial surgery for VS and other neurosurgical procedures.
Discovery of the Lysosome-Inhibiting Function of Acremolactone B
Authors: Wang Shaonan , Wu Yali , Ba Mengyu , Xu Zhou , Gu Guoxing , Whittingham William G. , Liu Cong , Li Ang , He Weiwei
Published: May 2024

Lysosome inhibitors have garnered considerable interest for their utility in lysosome biology research and potential therapeutic applications. We discovered the lysosome-inhibiting function of acremolactone B (1), a scarce azaphilone-type polyketide, leveraging our previous scalable synthesis. This compound significantly reduces lysosomal acidity and impairs the maturation of the lysosomal protease cathepsin D (CTSD) in triple-negative breast cancer cells (MDA-MB-231) and human lung cancer cells (A549). Furthermore, we found that compound 1 suppresses downstream autophagy, as revealed by monitoring autophagic flux and conducting transmission electron microscopy (TEM) analysis. This study unveils the previously unrecognized biological role of 1 and introduces a new scaffold for lysosome inhibitors.
Primary Extraskeletal Falcine Myxoid Chondrosarcoma—A Case Report and Review of Literature
Authors: Narayanan Rajasekhar , Venugopal Renjith T. , L. Suresh Kumar K. , B. Jose P. , Bahuleyan Anjana , P. Reshmi C. , Varghese Thomas , Pillai Marthanda A.
Published: May 2024

Intracranial chondrosarcomas are rare malignant lesions. Both skull base and dural-based extraosseous chondrosarcomas have been reported to occur intracranially. Dural-based chondrosarcomas arising from the falx cerebri are rare lesions with only 19 cases reported till date. Although conventional, mesenchymal, and myxoid variants of chondrosarcomas have been reported intracranially, myxoid variant are the rarest with only 17 cases reported till date, among which only 2 were falcine. We are reporting the third case of falcine myxoid chondrosarcoma in a 32-year-old man who presented with seizures and subtle lower limb weakness. Radiological findings were suggestive of an atypical meningioma in the falcine region. Macroscopically total resection of the tumor was done. Histopathological examination confirmed myxoid chondrosarcoma, grade 1. Postoperative period was uneventful, and the patient remains asymptomatic 34 months after the surgery without the application of any adjuvant therapy. Falcine myxoid chondrosarcomas are extremely rare lesions with variable aggressiveness as suggested by the three cases reported till now including the present case.
The Ability to Detect the COVID-19 Genome Using Saliva Swabs in Comparison with Nasopharyngeal Swabs in Baghdad
Authors: Alkaisi Amera Khalil , Abdulateef Yasir Mufeed , Abdo Salma Burhan
Published: May 2024

Objective Nasopharyngeal swab (NPS) sampling has been recommended by the World Health Organization (WHO) since the start of the COVID-19 pandemic, and real-time reverse transcription polymerase chain reaction (RT–PCR) is used to detect SARS-CoV- 2, the causative agent of COVID-19. This sampling technique is invasive and causes discomfort to the patient. Saliva swabs (SSs) can be used as an alternative noninvasive method; however, there are limited data confirming its suitability for the diagnosis of COVID-19. The aim of this study was to test the ability to detect COVID-19 using SSs in comparison with NPSs in the Baghdad Alkark sector.

Materials and Methods Six hundred and fifty patients were included in this study, and written informed consent was obtained from all the study participants. Paired NPSs and SSs were collected at the same time from each participant between days 3 and 5 after disease initiation. SSs were taken from the sublingual area. An RT‒PCR assay was used to detect the viral ribonucleic acid (RNA) of SARS-CoV-2 for the diagnosis of COVID-19. The chi-squared test was used for data analysis, with p < 0.05 considered significant.

Results Out of 650 participants with suspected COVID-19 (313 males and 145 females), 313 were confirmed to be positive for COVID-19 by quantitative RT–PCR (RT‒qPCR) using both samples. The ages ranged between 12 and 85 years, with a mean/standard deviation (SD) of 45.45 (16.62) years. All the cases with positive results using NPSs were also positive when SSs were used. Statistically, there was no significant difference between the two groups (p = 0.347).

Conclusion RT‒PCR assays conducted on SSs and NPSs performed similarly, indicating that SSs may be a safe, inexpensive diagnostic sampling method and an effective tool for population screening. We recommend more studies to support this finding.
A Cross-Sectional Study on Incidence and Predictors of Self-Reported Dental Anxiety among Nigerian Public Primary Schoolchildren
Authors: Eseadi Chiedu , Surjaningrum Endang R.
Published: May 2024

Objective The presence of dental anxiety in Nigerian public primary schools may be one of the main obstacles preventing schoolchildren from effectively utilizing dental care services. The main objective of this cross-sectional study was to investigate the incidence and factors associated with self-reported dental anxiety among Nigerian public primary school children.

Materials and Methods A cross-sectional, observational design was employed to examine 434 primary schoolchildren (aged 6–9 years) from selected schools in Abia State, Southeastern Nigeria. Data collection was conducted using the Modified Dental Anxiety Scale, which includes 5-point Likert responses, five questions, and demonstrates good internal consistency.

Results The findings indicate that there was no statistically significant difference in the occurrence of dental anxiety between male and female schoolchildren (p = 0.374). In total, 1.9, 8.7, 10.1, 36.4, and 42.9% of the schoolchildren reported experiencing no dental anxiety, mild, moderate, extreme, and severe levels of dental anxiety, respectively. Furthermore, the results reveal that 2.1% of the variance in children's dental anxiety scores could be accounted for by factors such as gender, age, socioeconomic status, and parental education. However, the influence of gender (B = 0.183; p = 0.060; 95% confidence interval [CI]: –0.008 to 0.374), age (B = –0.128; p = 0.187; 95% CI: –0.318 to 0.062), socioeconomic status (B = –0.067; p = 0.124; 95% CI: –0.152 to 0.018), and parental education (B = –0.045; p = 0.420; 95% CI: –0.154 to 0.064) on schoolchildren's dental anxiety was not significant.

Male and female schoolchildren did not have significantly different dental anxiety levels. Gender, age, socioeconomic status, or parent education level did not significantly predict the dental anxiety among schoolchildren.

Conclusion School-based interventions need to be targeted to reduce dental anxiety among male and female primary schoolchildren in the study area. Clinicians should consider providing interventions to manage dental anxiety in children with moderate to severe levels of anxiety.
Sleep Hygiene Intervention Improves Sleep Time and Duration in High School Students
Authors: Corrêa Camila de Castro , Silva Gabryella Nery Teles Nogueira , Viana Giovanna Régis , Lira Amanda Lima e , Macedo Gabriela Duarte , Weber Silke Anna Theresa
Published: May 2024

Objective To evaluate the effects of a sleep hygiene education program for adolescents to address excessive daytime sleepiness, insomnia, and sleep-related behaviors.

Materials and Methods The participants were 98 high school students from the 11th and 12th grades. A day-long health promotion action was conducted at their school science fair to disseminate relevant information about sleep disorders. Social status and sleep perception and habits were evaluated through the following validated questionnaires: the Brazilian Economic Classification Criteria, a questionnaire on sleep habits for adolescents, the Pediatric Daytime Sleepiness Scale, the Insomnia Severity Index, and the Sleep Time-Related Information and Communication Technology questionnaire. The questionnaires were administered before the fair and 12 months after participation, and the results before and after the intervention were compared by means of the Student t-test and the Fisher exact test. For the correlations involving the results, the Pearson correlation was used with the level of significance of p < 0.05.

Results A qualitative reduction in poor bedtime habits was observed after the intervention, such as watching television and leaving a cell phone on with sound. A higher frequency of use of electronic devices can affect school performance and contribute to later bedtime on weekends (p < 0.001). Excessive daytime sleepiness was correlated with the excessive use of electronic devices (p = 0.017).

Conclusion Some habits changed after the awareness intervention. There was an impact of the use of electronic devices on academic performance, on the regularity of bedtimes, and on excessive daytime sleepiness. We emphasize the importance of health education programs with sustainable actions following actual changes in behavior.
Bruxism, Lifestyle, Anxiety, and Sleep Impairment in Dental Students
Authors: Hilgenberg-Sydney Priscila Brenner , Necker Amanda , Kajevski Luiz Felipe , Senff Jordana , Bertoli Fernanda Mara de Paiva , de Souza Juliana Feltrin
Published: May 2024

The aim of this study was to verify the correlation of self-reported sleep and awake bruxism with demographic characteristics, oral behaviors, anxiety, temporomandibular disorder (TMD) signs and symptoms, sleep quality, and orthodontic treatment history in dental students. A total of 104 students of Dentistry located in Paraná (South Brazilian State) answered the following self-administered questionnaires: Oral Behavior Checklist, State Anxiety Inventory, TMD signs and symptoms questionnaire, and the Pittsburgh Sleep Quality Index. Associations between possible awake bruxism (AB) and sleep bruxism (SB) with sleep quality, anxiety, and TMD were analyzed by Poisson Regression with robust variance. The significance level adopted was 5%. The frequency of AB and SB was 76% and 55.8%, respectively. A statistically higher frequency of AB was observed in students who had the following conditions: use of psychotropic medication, physical activity practitioners, moderate or high level of anxiety, more oral behaviors, sleep disorders, and sleep bruxism. Sleep bruxism was diagnosed more frequently in students who presented moderate or high levels of anxiety, oral behaviors, and sleep disorders. The frequency of TMD reported was higher in students with SB, as well as in those with AB. In conclusion, lifestyle, moderate and high anxiety levels, and sleep disorders are associated with a higher prevalence of AB and SB. Furthermore, AB and SB are associated with a higher frequency of TMD reporting.
Profile and Outcomes of COVID-19 Infection in Pediatric Patients with and without Cancer: A Case–Control Study
Authors: Sahi Puneet Kaur , Kumar Varun , Gupta Arpita , Das Mampy , Meena Priyanka , Divyanshi Divyanshi
Published: May 2024

Objectives Pediatric patients with cancer are considered a vulnerable population to the ill effects of coronavirus disease 2019 (COVID-19). We hereby studied the difference between clinical characteristics, lab parameters, and outcomes of COVID-19 among children suffering from cancer and those without cancer. We also analyzed risk factors for the occurrence of moderate-to-severe COVID-19 disease in pediatric cancer patients.

Materials and Methods This retrospective case–control study was carried out using the medical record review method over 6 months in a tertiary-care center in India. All patients below 18 years of age, with reverse-transcriptase polymerase chain reaction (RTPCR) confirmed COVID-19, were screened for enrolment. Patients were split into two groups: Group A comprised of patients with cancer, while group B consisted of patients without any underlying comorbidity. Patients with other comorbidity except cancer and inadequately recorded case sheets were excluded. Details regarding demography, clinical features, investigations, treatment, and outcomes were recorded.

Statistical Analysis Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software, version 25 was used for data analysis. A p-value less than 0.05 was considered significant.

Results Two-hundred-five pediatric inpatients with RTPCR-established COVID-19 infection were screened and final analyses were performed on 97 patients, of which 31 children were classified into group A and 66 into group B. Median age of enrolled children was 5 years with 58.8% males. The prevalence of cancer as a comorbidity in pediatric inpatients with COVID-19 was 15%. Fifty-five percent of cancer patients had hematological malignancies, while 45% had solid tumors. Fever (p = 0.001) and gastrointestinal manifestations (p = 0.0001) were significantly less common among pediatric cancer patients. Children with cancer had significantly more leukopenia (p = 0.003), neutropenia (p = 0.003), and lymphopenia (p = 0.005). The case fatality rate was higher in children with cancer (3.2%) as compared to noncancer patients (1.5%, p = 1.0). Few risk factors for moderate-to-severe COVID-19 among children with cancer included age less than 2 years (p = 0.06), undernutrition (p = 0.33), advanced stage of cancer (p = 0.49), and presence of coinfection (p = 0.35)

Conclusion Cancer is a significant comorbidity among pediatric COVID-19 patients. While children with cancer have less severe COVID-19, their case fatality rate is higher than those without cancer. Younger age, undernutrition, advanced stage of cancer, and presence of coinfections may predispose to the development of moderate-to-severe COVID-19 among pediatric cancer patients.
Achieving Health Equity: Advancing Colorectal Surgery among Racial and Ethnic Minorities in America
Authors: Overstreet Demario S. , Hollis Robert H.
Published: May 2024

Racial inequities in short and long-term outcomes following colorectal surgery continue to persist. Using inflammatory bowel disease and colorectal cancer as disease foci, we review existing racial inequities in surgical outcomes and complications, discuss how social determinants of health and biopsychosocial factors can contribute to these inequities, and highlight potential mechanisms for building interventions to achieve health equity following colorectal surgery for minority populations.
Predictors of Hepatic Decompensation after Yttrium90 Transarterial Radioembolization—Optimizing Patient Selection
Authors: Wong Amelia , Cheng Shirley , Herrera Anthony , Wong Linda
Published: May 2024

Purpose Yttrium 90 (Y90) transarterial radioembolization (TARE) is effective for unresectable hepatocellular carcinoma (HCC) or to bridge/downstage before transplant; however, optimal patient selection is not well-described. This study aims to identify factors that increase risk of liver decompensation resulting in hospital admissions after TARE.

Methods Patients who received Y90 as their first treatment during 2012 to 2022 were identified from a prospectively collected database of 1675 HCC patients. Clinically significant hepatic decompensation was defined as total bilirubin more than or equal to 3 mg/dL or any increase in Model for End-stage Liver Disease (MELD) score resulting in readmission within 60 days or death.

Results Of 137 patients, 7 (5.1%) developed hepatic decompensation requiring admission within 30 days and an additional 8 (10.9%) within 60 days. Two of these patients (1.4%) died and two (1.4%) required urgent transplant within 2 months. Preprocedure albumin less than 3.5 gm/dL (p = 0.0207), international normalized ratio more than 1.2 (p = 0.017), ascites (p = 0.036), elevated MELD (p = 0.012), and Child-Pugh (p = 0.007) scores were significant predictors of decompensation, while creatinine and sodium were not. Patients with Child-Pugh B score were three to four times more likely to decompensate (28 vs. 8%) compared to Child-Pugh A. For every unit increase in Child-Pugh score more than 6, odds of decompensation increased by a factor of 2.15.

Conclusion Y90 TARE is safe and effective; however, 10.9% patients require readmission for worsened liver function. Because ascites is a significant factor in predicting decompensation and all patients require adequate renal function to receive Y90 TARE, Child-Pugh score may be more useful than MELD for patient selection. Further risk stratification may be required for those with a Child-Pugh score more than or equal to 7.
Computerized Surgical Planning for Mandibular Distraction Osteogenesis
Authors: Hu Kevin G. , Aral Ali , Rancu Albert , Alperovich Michael
Published: May 2024

Mandibular distraction osteogenesis is a technically challenging procedure due to complex mandibular anatomy, especially in the treatment of Pierre-Robin Sequence due to variable bone thickness in the infant mandible and the presence of tooth buds. Computerized surgical planning (CSP) simplifies the procedure by preoperatively visualizing critical structures, producing cutting guides, and planning distractor placement. This paper describes the process of using CSP to plan mandibular distraction osteogenesis, including discussion of recent advances in the use of custom distractors.
Cardiac Surgery 2023 Reviewed
Authors: Kirov Hristo , Caldonazo Tulio , Mukharyamov Murat , Toshmatov Sultonbek , Fischer Johannes , Schneider Ulrich , Siemeni Thierry , Doenst Torsten
Published: May 2024

We reviewed the cardiac surgical literature for 2023. PubMed displayed almost 34,000 hits for the search term “cardiac surgery AND 2023.” We used a PRISMA approach for a results-oriented summary. Key manuscripts addressed the mid- and long-term effects of invasive treatment options in patient populations with coronary artery disease (CAD), comparing interventional therapy (percutaneous coronary intervention [PCI]) with surgery (coronary artery bypass graft [CABG]). The literature in 2023 again confirmed the excellent long-term outcomes of CABG compared with PCI in patients with left main stenosis, specifically in anatomically complex chronic CAD, but even in elderly patients, generating further support for an infarct-preventative effect as a prognostic mechanism of CABG. For aortic stenosis, a previous trend of an early advantage for transcatheter (transcatheter aortic valve implantation [TAVI]) and a later advantage for surgical (surgical aortic valve replacement) treatment was also re-confirmed by many studies. Only the Evolut Low Risk trial maintained an early advantage of TAVI over 4 years. In the mitral and tricuspid field, the number of interventional publications increased tremendously. A pattern emerges that clinical benefits are associated with repair quality, making residual regurgitation not irrelevant. While surgery is more invasive, it currently generates the highest repair rates and longest durability. For terminal heart failure treatment, donor pool expansion for transplantation and reducing adverse events in assist device therapy were issues in 2023. Finally, the aortic diameter related to adverse events and technical aspects of surgery dominated in aortic surgery. This article summarizes publications perceived as important by us. It cannot be complete nor free of individual interpretation, but provides up-to-date information for patient-specific decision-making.
Acute Sinister in Stent Thrombosis in Endovascular Stenting in SVC Syndrome Secondary to Fibrosing Mediastinitis: Emergent Catheter-Directed Thrombolysis and Outcome—A Case Report
Authors: Singh Damandeep , Kumar Sanjeev , Nandi Debanjan , Singh Resham
Published: May 2024

A 40-year-old woman presented with a 4-week history of headache, facial swelling, and dyspnea. Computed tomography (CT) scan of the chest showed marked narrowing of the superior vena cava (SVC) with surrounding hypodense soft tissue and prominent collateral circulation in mediastinum, and the diagnosis of fibrosing mediastinitis was made. Biopsy suggested active fungal infection and she was treated with oral antifungal therapy. She reported persistent symptoms even after medical management; hence, she was taken for endovascular treatment with placement of a 16 × 60 mm stent (Optimed sinus-XL) in SVC. The patient complained of aggravation in symptoms immediately the next day, and a diagnostic venogram revealed acute total in-stent thrombosis. On an emergency basis, the patient was taken for catheter-directed thrombolysis (CDT) with tissue plasminogen activator (tPA) infusion. She was followed up with CT after1 year, which showed patent stent and no residual or recurrent thrombosis. She is on follow-up with marked relief in symptoms and improved quality of life. Catheter-directed thrombolysis is an emergent treatment modality with limited albeit growing evidence to treat acute in-stent thrombosis. CDT with tPA can be used to effectively treat acute thrombosis with promising results.
Minor Neurological Dysfunction: A Comparative Study in Pediatrics with Different Types of Focal Epilepsy
Authors: Cam Yagmur , Tekin-Orgun Leman , Soysal-Acar A. Sebnem , Gucuyener Kivilcim , Elbasan Bulent
Published: May 2024

Epilepsy is a disorder that occurs as a result of abnormal neuronal discharges in the brain and affects approximately 1% of children. Sensorimotor function impairments that are related to minor neurological deficits may be seen even in children diagnosed with epilepsy solely. This study aims to determine the type and areas of minor neurological dysfunction (MND) in children with Self-Limited Focal Epilepsy (SeLFE) and to compare the children with Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTS) and SeLFE without SeLECTS. Fifty-six children diagnosed with epilepsy (28 SeLECTS and 28 SeLFE without SeLECTS) were included in the study. Both groups consisted of 13 girls and 15 boys. The mean ages of SeLECTS and SeLFE without SeLECTS groups were 9.68 ± 1.63 and 9.32 ± 1.62, respectively. A Modified Touwen Neurological Examination was performed to determine the type and areas of MND. There were no differences between the groups regarding MND type, coordination, fine manipulation, sensory, and involuntary movement areas (p > 0.05). It should be considered that children with SeLECTS may be neurologically affected as much as children with other types of epilepsy. Long-term problems due to epilepsy may be minimized by short-term neurodevelopmental follow-ups.
Computerized Surgical Planning in Gender Affirming Facial Surgery
Authors: Ihnat Jacqueline M. , Aral Ali , Mukherjee Thayer , Alperovich Michael
Published: May 2024

Computerized Surgical Planning (CSP) is a surgical tool that enables precise bony changes through the creation of custom cutting guides and/or custom plates. CSP has been shown to be a safe and effective tool in gender affirming facial surgery as well, specifically with regard to frontal sinus setback, zygomatic remodeling, genioplasty, and mandibular angle and body reshaping. CSP aids in trainee education, improves symmetry, reduces operative time, and can produce idealized results during complex revisions. Overall, CSP is a valuable tool in the field of gender affirming facial surgery that helps surgeons achieve optimal aesthetic and safety outcomes for patients.
Posterior Skirt Technique with Mitral Valve Replacement for Mitral Annular Calcification
Authors: Sokolowski Caleb , Al-Saghir Tala , Lee Yeonsoo Sara , Ceniza Nicolas , Baciewicz Frank
Published: May 2024

Severe mitral annular calcification (MAC) presents a surgical challenge due to the complexity of disease and the risk of valve replacement. There have been a variety of techniques to combat this risk including edge-to-edge repair, collar-enforced prosthesis, and pericardial patch techniques. This report highlights a case in which a novel reproducible surgical technique was used to prevent perivalvular leak with mitral valve replacement. This technique may add to surgeons' repertoire in addressing patients with MAC concentrated on the posterior annulus.
Outcomes of 881 Consecutive Coronary Artery Bypass Graft Patients Using Heartstring Device
Authors: Amano Kentaro , Takami Yoshiyuki , Maekawa Atsuo , Yamana Koji , Akita Kiyotoshi , Matsuhashi Kazuki , Niwa Wakana , Takagi Yasushi
Published: May 2024

Backgrounds One of the strategies to prevent stroke after coronary artery bypass grafting (CABG) may be the use of a device for proximal anastomosis without partial clamp of the ascending aorta.

Methods We retrospectively investigated early and late outcomes in consecutive 881 patients undergoing isolated CABG using Heartstring for proximal anastomosis from January 2008 to December 2022, to reveal the validity to use it. All patients underwent preoperative imaging workups to evaluate neurovascular atherosclerosis.

Results The mean age of the patients was 68.9 years, 20% were female and 13% had previous history of stroke. CABG was on-pump beating heart (52.2%) or off-pump (47.8%) with a mean number of distal anastomoses of 3.38 ± 0.93, using 1.62 ± 0.53 Heartstring devices under different aortic manipulations. In-hospital mortality was 2.0% and perioperative stroke rate was 0.9%, none of them died during hospital stay. During the follow-up period of 70 ± 47 months, the overall actuarial survival rates were 86 and 66%, and major adverse cardiac and cerebrovascular events (MACCEs)-free rates were 86 and 70% at 5 and 10 years, respectively. On multivariable analysis, risk factors for late death included male, previous history of stroke, postoperative sternomediastinitis, late new-onset stroke, and MACCEs, but did not include the perioperative stroke.

Conclusion Low stroke rate, as low as 0.9%, after CABG using Heartstring for proximal anastomosis, although under a variety of aortic manipulations, may contribute to the improved long-term prognosis.
Critical Organ Dysfunction and Preoperative Mortality in Newborns with Hypoplastic Left Heart Syndrome
Authors: Durbin Matthew D. , Wynn James L. , Chaudhry Paulomi , Posorske Alyx , Voskoboynik Ellen , Park Woo Y. , Lavilla Orlyn , Aziz Khyzer B.
Published: May 2024

Hypoplastic left heart syndrome (HLHS) is fatal without surgical intervention. An important subset of HLHS patients die prior to surgical intervention, but this population is underevaluated. The neonatal sequential organ failure assessment score (nSOFA) is an operational definition of organ dysfunction that can identify those with a high risk of mortality among neonatal intensive care unit (NICU) patients. The utility of the nSOFA to predict preoperative mortality in the unique HLHS population is unknown and could inform care, particularly care provided by neonatology staff. We performed a multicenter retrospective cohort study of HLHS cases across three level IV NICUs from January 1, 2009, to December 3, 2023. Patients were classified as either survived or died prior to surgical intervention. Demographic variables were curated from medical records including the maximum nSOFA (nSOFAmax) before surgical intervention or death. We identified 265 patients with HLHS over the study period. The nSOFAmax was greater in patients who died preoperatively (14/265; 5%) compared with survivors to surgical intervention (median 8 [interquartile range, 6, 12] vs. 2 [0, 4]; p < 0.001). The area under receiver operating characteristics curve for the nSOFAmax to discriminate for mortality was 0.93 (95% confidence interval, 0.88–0.98; p < 0.001). Compared with an nSOFAmax of 0, the likelihood ratio for preoperative death doubled at 2, tripled at 4, and was 10-fold at 9. This is the first demonstration of nSOFA utility in specific to congenital heart disease and HLHS. The nSOFAmax represents a novel, electronic health record-compatible, and generalizable method to identify patient-level organ dysfunction and risk for preoperative mortality in HLHS patients.

Key Points
Party system transformation from below: protests by Jobbik and LMP
Authors: Borbáth Endre , Susánszky Pál
Published: May 2024

Recent changes in European politics—such as the rise of so-called movement parties on both the left and the right—call for a rethinking of the links between protest dynamics and party system transformation. In this paper, we contribute to the theoretical and empirical understanding of the mechanisms that unfold in periods of intensified interactions between protest and electoral politics through a case study of the transformation of the Hungarian party system. We ask what mechanisms drive parties' involvement in protests before and after entering parliament. We focus on two competitors: the radical right Movement for a Better Hungary (Jobbik) and the green party Politics Can Be Different (LMP). Using a dataset of protest events compiled from Hungarian news agency reports and official police records, we map the protest network mobilized by the two parties between 2002 and 2022. We analytically distinguish and empirically identify three different mobilization mechanisms: strengthening the party's profile by protesting its own issue, using protest mobilization to build alliances with other parties and actors, or relying on protest to establish a presence at the local level. The empirical results show that Jobbik relies on protest through a combination of different mechanisms, while LMP uses protest to broaden its issue profile and build alliances with other political parties. Over time, both parties increasingly rely on protest to establish a local presence outside of Budapest.
Urban traffic-parking system dynamics model with macroscopic properties: a comparative study between Shanghai and Zurich
Authors: Mesfin Biruk Gebremedhin , Li Zihao , Sun Daniel , Chen Deming , Xi Yueting
Published: May 2024

Analyzing the dynamics of parking traffic can better represent the real dynamic states of road networks, thereby allowing for a deeper analysis of the parking system’s impact. This paper comparatively investigates the impact of parking policies on two traffic networks with different infrastructure, socio-economic, and policy characteristics. Parking space, average parking duration, and parking fee policies were analyzed as a function of cruising distances and cruising time with indirect effects on traffic emissions. Empirically, the system dynamics model application is tested and validated with the macroscopic data from two central business districts (CBDs) in Shanghai (Xujiahui area) and Zurich (Bahnhofstrasse area). Results showed Bahnhofstrasse CBD is more sensitive against the policy shifts with relatively higher elasticity and indicated greater responsiveness in aggregating traffic emissions when compared with Xujiahui CBD. The findings of this study may provide an overall framework to empirically assess the performance of different traffic conditions and strategies on urban parking systems.
A tale of two paths to vaccine acceptance: self-interest and collective interest effect, mediated by institutional trust, and moderated by gender
Authors: Kol Ofrit , Zimand-Sheiner Dorit , Levy Shalom
Published: May 2024

Coronavirus and other prevailing viruses continue to remain a health threat and challenge the efforts of institutions to promote vaccination acceptance. The current study’s aim is to propose a conceptual framework explaining the role of individual motivators (such as self-interest and collective interest) in shaping attitudes toward vaccination while emphasizing the pivotal role of institutional trust as a mediator and gender as a moderator. Data were collected via an online panel survey among Israelis (N = 464), and SEM statistics were used to test the model empirically. The path analysis model supports the positive direct effect of collective interest and the negative effect of self-interest. Additionally, it shows an indirect effect through the mediation effect of institutional trust and gender moderation. Therefore, institutional trust may significantly influence self-interest people’s attitudes toward vaccines. Furthermore, since females process information more comprehensively, their developed trustworthiness in institutions has an increased impact on vaccine acceptance. Theoretical and practical implications are discussed.
The impact and effectiveness of China’s entrepreneurship policy for back-home migrant workers
Authors: Zhao Xianzhou , Marjerison Rob Kim , Peng Chuanyu
Published: May 2024

This study aims to estimate the net effect of China’s entrepreneurship policy on back-home migrant workers since 2015. Using survey data from the provinces of; Zhejiang, Henan, and Guizhou with propensity score matching to control selection bias, the study indicates that the overall entrepreneurship policy has a significant positive impact on the probability of entrepreneurial entry. The poverty alleviation effect of the overall policy is greater than its industrial development effect, while the employment effect is not significant. The infrastructure policy’s effect on employment, industrial development, and poverty alleviation is greater than the other policies, and the financial policy’s effect on these three aspects is not significant. This study contributes to the existing literature by addressing a well-defined gap regarding the net effect of entrepreneurship policy on entrepreneurship entry and provides well-supported and plausible explanations for the inconsistencies among previous studies on policy effect indicators. As a practical contribution, this study provides China and other developing economies with compelling empirical evidence to support the design and amendment of entrepreneurship policy at the national level.