bluuebunny/crossref_metadata_2025 huggingface dataset:
A perspective on developing solid-phase extraction technologies for industrial-scale critical materials recovery
Authors: Brewer Aaron , Florek Justyna , Kleitz Freddy
Published: March 2022

Solid-phase extraction offers numerous advantages for critical materials recovery, and research in the field would benefit from increased focus on environmental impact, techno-economic assessments, and process scalability with real-world resources.
Nanostructuring determines poisoning: tailoring CO adsorption on PtCu bimetallic nanoparticles
Authors: Vega Lorena , Garcia-Cardona Julia , Viñes Francesc , Cabot Pere L. , Neyman Konstantin M.
Published: March 2022

A combination of CO stripping voltammograms on diverse PtCu nanoparticles fuel cell electrocatalysts and density functional calculations show that surface chemical ordering and certain defects presence explain the CO tolerance vs. poisoning.
A microkinetic description of electrocatalytic reactions: the role of self-organized phenomena
Authors: Calderón-Cárdenas Alfredo , Paredes-Salazar Enrique A. , Varela Hamilton
Published: March 2022

A microkinetic model can be constructed through a phenomenological approach by following the schematically represented workflow. The model parameters are fitted by comparison between the empirical and simulated kinetic responses.
Bimetallic sulfide NiCo2S4 yolk–shell nanospheres as high-performance cathode materials for rechargeable magnesium batteries
Authors: Ma Yiming , Zhang Yujie , Wang Fan , Xie Haijiao , Wang Jin
Published: March 2022

A yolk–shell structured NiCo2S4 is constructed to improve the cycling stability of rechargeable Mg batteries using a bimetallic synergistic effect.
Application of a novel heterogeneous sulfite activation with copper(i) sulfide (Cu2S) for efficient iohexol abatement
Authors: Wu Ying , Xing Danying , Zhang Linna , Suo Hualiang , Zhao Xiaodan
Published: March 2022

The Cu2S/sulfite process achieves efficient iohexol abatement, in which reductive sulfur species prominently accelerate Cu species' redox cycle and radical generation.
Enantioselective [1,2]-Stevens rearrangement of thiosulfonates to construct dithio-substituted quaternary carbon centers
Authors: Hu Linfeng , Li Jinzhao , Zhang Yongyan , Feng Xiaoming , Liu Xiaohua
Published: March 2022

An asymmetric [1,2] Stevens rearrangement was realized via chiral guanidine and copper(i) complexes. A series of novel chiral dithioketal derivatives were obtained with good yields (up to 90% yield) and enantioselectivities (up to 96 : 4 er).
A highly efficient and stable perovskite cathode with in situ exsolved NiFe alloy nanoparticles for CO2 electrolysis
Authors: Wang Mengmeng , Li Naizhi , Shen Qing , Zhan Zhongliang , Chen Chusheng
Published: March 2022

This study aims at improving the CO2 electrolysis performance of the lanthanum chromium ferrite cathode through modification with in situ exsolved metal nanoparticle catalysts.
Spectrum of DNA mismatch repair failures viewed through the lens of cancer genomics and implications for therapy
Authors: Mas-Ponte David , McCullough Marcel , Supek Fran
Published: March 2022

Genome sequencing can be used to detect DNA repair failures in tumors and learn about underlying mechanisms. Here, we synthesize findings from genomic studies that examined deficiencies of the DNA mismatch repair (MMR) pathway. The impairment of MMR results in genome-wide hypermutation and in the ‘microsatellite instability’ (MSI) phenotype—occurrence of indel mutations at short tandem repeat (microsatellite) loci. The MSI status of tumors was traditionally assessed by molecular testing of a selected set of MS loci or by measuring MMR protein expression levels. Today, genomic data can provide a more complete picture of the consequences on genomic instability. Multiple computational studies examined somatic mutation distributions that result from failed DNA repair pathways in tumors. These include analyzing the commonly studied trinucleotide mutational spectra of single-nucleotide variants (SNVs), as well as of other features such as indels, structural variants, mutation clusters and regional mutation rate redistribution. The identified mutation patterns can be used to rigorously measure prevalence of MMR failures across cancer types, and potentially to subcategorize the MMR deficiencies. Diverse data sources, genomic and pre-genomic, from human and from experimental models, suggest there are different ways in which MMR can fail, and/or that the cell-type or genetic background may result in different types of MMR mutational patterns. The spectrum of MMR failures may direct cancer evolution, generating particular sets of driver mutations. Moreover, MMR affects outcomes of therapy by DNA damaging drugs, antimetabolites, nonsense-mediated mRNA decay (NMD) inhibitors, and immunotherapy by promoting either resistance or sensitivity, depending on the type of therapy.
Soft open points based load restoration for the urban integrated energy system under extreme weather events
Authors: Wang Xinyue , Li Xue , Li Xiaojing , Parisio Alessandra , Wang Changrong , Jiang Tao
Published: March 2022

With frequent occurrences of extreme natural disasters such as typhoons in urban integrated energy systems (UIES), it is of great significance to cope with different kinds of disturbances. This paper proposes a load restoration method under typhoon weather for urban distribution and natural gas networks based on soft open points (SOP). Firstly, the typhoon wind speed model is introduced and the line fault rates of distribution networks under typhoons are calculated. Secondly, the gas turbine and electric‐driven compressor are considered as the coupling units of the integrated electric–gas energy system, and related models are constructed. The fault analysis method of the natural gas network is proposed considering the faults in the distribution network lead by typhoons. Thirdly, SOP installed in the distribution network with the V/f control mode is applied to restore electrical loads and provide voltage support for the loads on the fault side. After that, the loads of the gas network could also be restored because of the restoration of the coupling units. Optimal energy flow is applied to determine the output of the power and gas sources, coupling units and also the loads to be restored. Finally, the fault rate of each line under typhoon disaster is analysed and the correctness and effectiveness of the resilience improving method based on SOP are verified with test systems UIES E33‐G14 and UIES E123‐G48.
Évaluation de différents procédés d’extraction des composés phénoliques d’une plante médicinale : Verbena officinalis
Authors: Falleh Hanen , Hafsi Chokri , Mohsni Ichrak , Ksouri Riadh
Published: March 2022

Depuis la nuit des temps, les plantes ont été la source principale de molécules bioactives, tels les composés phénoliques, capables de remédier à diverses maladies. Cependant, le contenu et l’activité des polyphénols dépendent d’un certain nombre de facteurs intrinsèques et extrinsèques. Dans le but d’optimiser les procédés d’obtention des principes actifs de la verveine (Verbena officinalis), les effets de la provenance de la plante, du solvant et de la méthode d’extraction ont été évalués. Ainsi, la partie aérienne de V. officinalis a été collectée dans deux régions différentes de la Tunisie (Bizerte et Ain Draham). L’extraction a été réalisée par macération, décoction et par l’appareil de Soxhlet tantôt avec de l’eau tantôt avec de l’éthanol pur. Une variabilité significative des teneurs en composés phénoliques ainsi que des capacités antioxydantes et antimicrobiennes des extraits a été observée en fonction des facteurs étudiés. De manière générale, les extraits éthanoliques sont plus riches en composés phénoliques et présentent des activités antioxydantes plus fortes que les extraits aqueux. Cependant, vis-à-vis de différentes souches pathogènes, les extraits aqueux sont souvent au moins aussi puissants que les extraits éthanoliques pour inhiber la croissance bactérienne in vitro. De plus des différences notables sont observées selon que V. officinalis provient de la région de Bizerte ou d’Ain Draham. Ces résultats montrent que la prise en compte de plusieurs paramètres est nécessaire pour optimiser l’efficacité des procédures d’extraction des molécules bioactives de V. officinalis.
Growth mechanism of Al-Ti-O inclusions in steelmaking process
Authors: Chu Rensheng , Li Zhanjun , Malfliet Annelies , Blanpain Bart , Guo Muxing
Published: March 2022

In the present work, the formation and growth of Al-Ti-O complex inclusions in the steel after SiMn and Ti deoxidation is systematically investigated. The evolution with time of the size, composition and morphology of the Al-Ti-O complex inclusions were studied. After adding 70TiFe alloy, the inclusion composition changed from Si-Mn-Al to Ti-Al-O-N. The growth of the inclusions after a deoxidation time of 30 s is mainly controlled by turbulent collisions. The three-dimensional morphology and shape factor of the inclusions is determined to research the growth pattern of Al-Ti inclusions.
Serum CYR61 Levels are Associated with Graves’ Ophthalmopathy
and Smoking in Patients with Graves’ Disease
Authors: Cerri Perparim , Shahida Bushra , Lantz Mikael , Planck Tereza
Published: March 2022

Smoking is a well-known risk factor for Graves’ ophthalmopathy (GO) in
patients suffering from Graves’ disease (GD). Cysteine-rich angiogenic
inducer 61 (CYR61), which has multiple physiological functions, has been shown
to be associated with GD and GO. In this study, we aimed to investigate the
association between smoking and CYR61 concentrations in GD patients with and
without GO. Serum CYR61 was measured by ELISA. The association between CYR61
concentration and GO was assessed with binary logistic regression in all
patients and in subgroups of smokers and nonsmokers. The Spearman correlation
coefficient was used to determine the correlations between CYR61 concentration
and clinical parameters. CYR61 levels were significantly higher in GD patients
with GO than in patients without GO, in smokers than in nonsmokers and in
individuals older than 50 years than in those younger than 50 years. The
subgroup of “GO smokers” had the highest CYR61 levels [median
(IQR), 119 pg/ml (129.8)], compared with “GO
nonsmokers” [84.2 pg/ml (90.8), p=0.04],
“no GO smokers” [88.9 pg/ml (109.8),
p=0.01] and “no GO nonsmokers”
[79.4 pg/ml (129.89), p=0.003]. For each unit increase
in CYR61 concentration, the odds of having GO in smokers significantly and
independently increased by 1% (OR=1.010; 95% CI:
1.002–1.018, p=0.012). In conclusion, our results indicate that
smoking and age increase serum CYR61 levels in patients with GD and GO. The role
of CYR61 as a predictor of GO in patients with GD should be evaluated in
prospective studies.
Prognostic Value of Long Noncoding RNA SNHG11 in Patients with
Prostate Cancer
Authors: Li Ying , Pan Bin , Guo Xiuqin , Meng Xiaomin , Tian Xiaojing
Published: March 2022

The present study was aimed to explore the prognostic value of long noncoding RNA
SNHG11 in prostate cancer, study its expression, and assess its effect on tumor
progression. One hundred and twenty prostate cancer patients and 45 cases of
benign prostate hyperplasia (BPH) patients were collected. RT-qPCR was used to
test the expression of SNHG11 in prostate cancer and BPH tissues, as well as in
cell lines. Kaplan-Meier survival analysis and Cox regression assays were
introduced to evaluate the prognostic meaning of SNHG11 in prostate cancer. The
CCK-8 assays were performed to explore the effect of SNHG11 on prostate cancer
cell proliferation, and a Transwell assay was conducted to access the influence
of SNHG11 on prostate cancer cell migration and invasion. SNHG11 expression
level was upregulated both in prostate cancer tissues and cell lines.
Overexpression of SNHG11 was significantly associated with Gleason score,
clinical T stage, surgical margin status, and lymph node metastasis. Patients
with high SNHG11 expression levels led to a shorter overall survival time and
biochemical recurrence-free survival when compared with those of low expression
levels. Multivariate Cox regression results suggested that SNHG11 has the
potential to act as a prognostic marker for prostate cancer patients. Knockdown
of SNHG11 suppressed 22RV1 cell proliferation, migration, and invasion. In
conclusion, SNHG11 is upregulated in prostate cancer patients and predicts an
unfavorable prognosis for prostate cancer patients. Its knockdown can weaken
prostate cancer cell metastasis and growth in vitro.
Anti-Mullerian Hormone Levels Increase After Bariatric Surgery in
Obese Female Patients With and Without Polycystic Ovary Syndrome
Authors: Buyukkaba Mitat , Turgut Seda , Ilhan Mahmut Muzaffer , Ekinci Iskender , Yaylım İlhan , Zeybek Sakir Umit , Turan Saime , Tasan Ertugrul , Karaman Ozcan
Published: March 2022

This study was aimed to investigate the effect of weight loss by bariatric
surgery on the level of anti-Mullerian hormone (AMH) in morbidly obese female
patients with or without polycystic ovary syndrome (PCOS). This prospective
study includes 70 females, obese, and fertile patients of reproductive age. All
patients were evaluated to determine the changes in weight, body mass index
(BMI), serum AMH, and other biochemical parameters at the end of six months. The
mean levels of the preop and postop AMH were
1.66±0.87 ng/ml and
5.99±1.39 ng/ml in the PCOS group;
1.35±0.76 ng/ml and
6.23±1.47 ng/ml in the non-PCOS group, respectively. The
postop AMH levels were significantly higher than the preop levels for both
groups (p<0.001). There were significant differences in the level of
glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL),
triglyceride, total cholesterol, hemoglobin A1c, HOMA-IR, insulin between preop
and postop 6th month. A negative correlation was found between postop AMH and
body weight in all patients (r=–0.337, p=0.031). Postop
AMH levels were negatively correlated with postop BMI levels in the non-PCOS
patient group (r=–0.408, p=0.043). No significant
difference was observed between the PCOS and non-PCOS groups in terms of all the
parameters examined. In conclusion, our study suggests that the significantly
increased AMH levels by losing weight with bariatric surgery in patients with
morbid obesity with and without PCOS may indicate the improvement of
fertilization potential. It could be considered when evaluating fertility in
patients with morbid obesity.
Chiral Ammonium Salt Catalyzed Asymmetric Alkylation of Unactivated Amides
Authors: Xu Changming , Yang Xinshuang
Published: March 2022

A chiral spirocyclic quaternary ammonium salt catalyzed asymmetric alkylation of unactivated amides under homogeneous conditions has been developed, giving the target products with up to 60% ee. This novel methodology provides a general and concise protocol for asymmetric α-functionalization of unactivated amides.
Microwave-Assisted Hydrogen-Free Reductive Deiodination of Iodoarenes with Silicon-Nanoarray Palladium-Nanoparticle Catalyst
Authors: Yamada Yoichi M. A. , Matsukawa Yuta
Published: March 2022

The hydrogenolysis of iodoarenes using a silicon nanoarray palladium catalyst under microwave irradiation was investigated. When triethanolamine was used as the sacrificial reductant, the reaction proceeded via reductive deiodination under an aerobic atmosphere even without the presence of the explosive hydrogen gas, affording the corresponding hydrogen-substituted arenes in high yields. No reaction occurred in the absence of microwaves, indicating a noticeable microwave effect.
Correlação entre posicionamento do implante das artroplastias parciais de recobrimento do ombro e os resultados funcionais
Authors: Luz Gilberto Daniel , Cavalcanti Amanda S. , Ferreira Júlio , Godoy Eduardo , Amaral Marcus Vinicius Galvão , Motta Filho Geraldo da R.
Published: March 2022

Objetivo O objetivo do presente estudo é correlacionar os resultados funcionais de uma série de casos de artroplastias parciais de recobrimento do ombro com o posicionamento do implante.

Métodos Um total de 25 pacientes foram avaliados em relação à amplitude de movimentos, à avaliação funcional pelo escore de Universidade da Califórnia Los Angeles (UCLA) e por análise radiográfica. Os dados pré- e pós-operatórios foram comparados. Adicionalmente, os pacientes foram agrupados quanto ao ângulo cérvico-diafisário (ACD) avaliado na radiografia em anteroposterior e quanto ao ângulo de retroversão (ARV) avaliado na radiografia em posição axilar. Foi considerado como posicionamento ideal (padrão anatômico) um ACD entre 130° e 140° e um ARV entre 20° e 40°. Os dados foram analisados pelo teste pareado de Wilcoxon, pela análise de variância (ANOVA, na sigla em inglês) seguida pelo pós-teste de Kruskal-Wallis ou pelo teste de Mann-Whitney, quando apropriado.

Resultados O seguimento médio foi de 48,3 meses (12 a 67 meses). A avaliação funcional pós-operatória (31,5) foi melhor do que a pré-operatória (15,5) (p < 0,001). Seis pacientes apresentaram posicionamento anatômico do implante, enquanto 19 pacientes foram considerados “fora do padrão.” Sete pacientes apresentaram um ACD < 130°, quatorze apresentaram um ACD entre 130° e 140°, e quatro apresentaram um ACD >140°. Quinze pacientes apresentaram um ARV ≤ 20°, e 10 entre 20° e 40°. Utilizando esses critérios para agrupar os pacientes, a comparação dos parâmetros da avaliação clínico-funcional pós-operatória não foi estatisticamente diferente (p > 0,05).

Conclusão A artroplastia parcial de recobrimento do ombro oferece significativa recuperação funcional pós-operatória em pacientes com doenças degenerativas articulares. Entretanto, o posicionamento do implante avaliado pelos ACD e ARV não se correlaciona com o resultado clínico-funcional, sendo, portanto, uma medida imprecisa de sucesso da cirurgia.

Nível de Evidência IV, Série de Casos.
Estudo epidemiológico das lesões multiligamentares do joelho
Authors: Pinheiro Igor Natário , Pedrinha Igor Stefano Menescal , Maia Phelippe Augusto Valente , Cortes André Rodrigues de Oliveira , Albuquerque Rodrigo Pires e , Barretto João Maurício
Published: March 2022

Objetivo Descrever e associar as características das lesões multiligamentares de joelho com o perfil do paciente e mecanismo de trauma.

Métodos Trata-se de um estudo transversal que avaliou 82 pacientes com lesões multiligamentares do joelho de setembro de 2016 até setembro de 2018. As variáveis coletadas foram idade, gênero, eixo mecânico, lateralidade, arco de movimento, mecanismo do trauma, lesões associadas, ligamentos afetados e afastamento do trabalho.

Resultados A amostra incluiu pacientes de 16 a 58 anos, com média de 29,7 anos, e os homens foram os mais afetados, correspondendo a 92,7% dos casos. O mecanismo de trauma mais comum foi acidente motociclístico (45,1%). O ligamento mais lesado foi o ligamento cruzado anterior (80,5%), seguido do ligamento cruzado posterior (77,1%), do canto posterolateral (61,0%) e do ligamento colateral tibial (26,8%). O tipo de luxação mais frequente era o KD IIIL (30,4%). Apenas 1 paciente apresentou lesão vascular, e 13 (15,9%) apresentaram lesões neurológicas. A maioria das vítimas foi afastada do trabalho (52,4%).

Conclusão Há grande diferença entre os pacientes que apresentam lesão multiligamentar no Brasil em relação ao encontrado nos estudos internacionais. Desta forma, convém realizar mais estudos específicos sobre o tema com a nossa população, de modo a aperfeiçoar o tratamento destes pacientes.
Reconstrução microcirúrgica em um hospital ortopédico: Indicações e desfechos em adultos
Authors: Iamaguchi Raquel Bernardelli , Macedo Lucas Sousa , Cho Alvaro Baik , Rezende Marcelo Rosa de , Mattar Rames , Wei Teng Hsiang
Published: March 2022

Objetivo Os avanços da microcirurgia reconstrutiva na cirurgia ortopédica proporcionaram melhores resultados funcionais e estéticos, evitando as muitas indicações de amputação. Nos hospitais de ortopedia e traumatologia com um grande volume de atendimento, a reconstrução microcirúrgica é essencial, a fim de reduzir os custos e as complicações destes complexos defeitos ortopédicos. Descrevemos uma abordagem microcirúrgica para feridas traumáticas, ressecção tumoral, defeitos ósseos e transferência muscular livre realizada por uma unidade ortopédica especializada em microcirurgia. O objetivo do presente estudo é avaliar os fatores preditivos de resultados dos retalhos microcirúrgicos na reconstrução dos membros, fornecendo uma análise descritiva dos retalhos microcirúrgicos para as indicações ortopédicas.

Métodos Estudo prospectivo transversal, que incluiu todos os casos consecutivos de retalhos microcirúrgicos com indicação ortopédica de 2014 a 2020. Foram coletados os dados do histórico clínico pessoal, procedimentos microcirúrgicos intraoperatórios e exames laboratoriais. As complicações e os desfechos de retalho livre foram estudados mediante uma análise descritiva e estatística.

Resultados Avaliamos 171 retalhos em 168 pacientes. A indicação mais frequente para a realização de um retalho microcirúrgico foi a traumática, em 66% dos pacientes. Foram observadas complicações cirúrgicas em 51 retalhos, conforme a classificação de Clavien-Dindo do tipo III. A taxa de êxito global dos retalhos microcirúrgicos foi de 88,3%. Na análise multivariada, foram identificados como fatores de risco para complicações tempo de isquemia ≥ 2 horas (p = 0,032) e obesidade (p = 0,007). A perda parcial do retalho foi mais comum em pacientes com trombocitose, com contagem de plaquetas pré-operatória (p = 0,001).

Conclusão Os fatores de risco independentes para complicações de retalhos microcirúrgicos para a reconstrução de membro são obesidade e tempo de isquemia do retalho ≥ 2 horas, e a presença de trombocitose como fator de risco para perda parcial do retalho.
Histomorfometria da microarquitetura óssea em ratas tratadas com vitamina D e bisfosfonato no manejo da osteoporose
Authors: Queiroz Júnior José Reginaldo Alves de , Cartaxo Marina Falcão de Souza , Paz Silvania Tavares , Tenório Fernanda das Chagas Ângelo Mendes , Lemos Ana Janaína Jeanine Martins de , Maia Carina Scanoni
Published: March 2022

Objetivo Verificar como a administração conjunta de alendronato de sódio (ALN) e vitamina D3 (VD) atua na microarquitetura óssea em ratas com osteoporose induzida por glicocorticoide.

Métodos O experimento utilizou 32 ratas da linhagem Wistar, com peso médio de 300 a 400g, com 90 dias de vida. A indução da osteoporose consistiu na administração de dexametasona na dose de 7,5 mg/kg de peso corporal, por via intramuscular, 1 vez por semana durante 5 semanas, à exceção dos animais do grupo controle. Os animais foram distribuídos nos seguintes grupos: G1 (grupo controle sem osteoporose), G2 (grupo controle com osteoporose sem tratamento), G3 (grupo com osteoporose tratado com ALN 0,2 mg/kg), G4 (grupo com osteoporose tratado com VD 10.000UI/500μL) e G5 (grupo com osteoporose tratado com ALN + VD). Os fêmures direitos das ratas foram fixados em formol a 10% tamponado, descalcificados e processados para inclusão em parafina. Os cortes histológicos foram corados com hematoxilina-eosina para análise histomorfométrica. A espessura cortical e a cavidade medular foram medidas em cortes transversais.

Resultados Houve diferença estatística (p < 0,05) entre os grupos G3 e G5 em relação ao grupo controle positivo (G2), tanto em relação à medida da espessura cortical quanto em relação ao diâmetro total do osso. Na avaliação da área medular, apenas o grupo G3 se mostrou estatisticamente diferente do grupo G2.

Conclusão O tratamento concomitante com ALN diário e VD semanal é eficaz para prevenir a perda óssea induzida por glicocorticoide. No entanto, não houve diferença entre esta terapia testada e o tratamento apenas com o ALN.
Factors Affecting Ophthalmology Trainees to Pursue Vitreoretinal Surgery Fellowship
Authors: O'Fee John R. , Rayess Nadim , Pan Carolyn K. , Toy Brian C.
Published: March 2022

Objective The aim of this study was to understand the factors that ophthalmology trainees consider in pursuing vitreoretinal surgery (VRS) fellowship training.

Methods This is a prospective observational survey study. Survey invitations were disseminated to postgraduate year 4 (PGY)-4 ophthalmology residents at Accreditation Council for Graduate Medical Education-accredited residency programs and surgical retina fellows at Association of University Professors of Ophthalmology Fellowship Compliance Committee-compliant fellowship programs in the United States. Survey questions on factors related to VRS were administered employing a 5-point Likert scale. Responses from ophthalmology residents pursuing surgical retina were combined with surgical retina fellows' responses and compared with responses from PGY-4 residents not pursuing vitreoretinal surgery.

Results Eighty-one resident surveys were completed. Forty-three fellow surveys were completed. Fifty-seven out of eighty-one (70.4%) residents were not pursuing surgical retina, and a total of 67 trainees (24 residents, 43 fellows) were pursuing surgical retina. The following factors were associated with pursuing VRS training: male gender (p = 0.031); having performed retina research during residency (p ≤ 0.001); enjoying surgical retina procedures (p ≤ 0.001), enjoying surgical retina patient outcomes (p ≤ 0.001), and working with vitreoretinal surgeons (p ≤ 0.001); finding surgical retina prestigious (p ≤ 0.001); perceiving their residency having a strong record of matching surgical retina (p = 0.039); liking the potential financial income from surgical retina (p ≤ 0.001); and having vitreoretinal mentors during residency (p = 0.014). A majority of trainees (31/57, 54.4%) not pursuing surgical retina disagreed or strongly disagreed with enjoying the patient outcomes in surgical retina. A third of female residents not pursuing surgical retina felt having a female surgical retina mentor would have made them more likely to pursue the field.

Conclusion Longer retina rotations, encouraging resident participation in retina research, and increasing mentorship opportunities of female trainees from female retina specialists may increase resident interest in pursuing surgical retina fellowship.
Battery Ingestion with Colonic Perforation after Colostomy Closure in a Toddler
Authors: Lukish Annamarie C. , Pat Vivien , Apte Anisha , Levitt Marc A.
Published: March 2022

Disc and button battery ingestion in children is common. In fact, data reports a dramatic increase in battery ingestion during the coronavirus disease 2019 pandemic likely as a result of increased household population density and electronic product utilization. These batteries often remain lodged in the esophagus causing potentially devastating complications if they are not removed urgently. Batteries that are passed beyond the esophagus usually do not cause any complications. We present the case of a 15-month-old male who underwent a colostomy takedown 2 months following a posterior sagittal anorectoplasty for imperforate anus. He recovered quickly, was advanced on his diet, and was discharged to home on postoperative day 3. On postoperative day 5 following the stoma closure, he presented with an acute abdomen, pneumoperitoneum and an abdominal X-ray that revealed a 21 mm disc battery in the left lower quadrant. He underwent exploration and the battery was found perforating the anastomosis. There was significant fibropurulent exudate and inflammation. The battery was removed, the anastomosis was excised, and a colostomy with Hartman's pouch was performed. The toddler recovered uneventfully.

This case offers an opportunity to discuss the concerns of battery ingestion and postoperative care following intestinal surgery in children. We could find no other similar reports in the world's literature of a disrupted colonic anastomosis due to battery ingestion.
Hindgut Duplication in an Infant with Omphalocele–Exstrophy–Imperforate Anus–Spinal Defects (OEIS) Complex
Authors: Tirrell Timothy F. , Demehri Farokh R. , Lillehei Craig W. , Borer Joseph G. , Warf Benjamin C. , Dickie Belinda H.
Published: March 2022

Introduction The congenital anomaly of omphalocele, cloacal exstrophy, imperforate anus, and spinal abnormalities (OEIS complex) is rare but well recognized. Hindgut duplications are also uncommon and are not known to be associated with OEIS. We describe a neonate with OEIS who was found to have fully duplicated blind-ending hindguts.

Case Report A premature infant boy with OEIS underwent first-stage closure on day of life 6, which included excision of the omphalocele sac, separation of the cecal plate and bladder halves, tubularization of the cecal plate, hindgut rescue with end colostomy, and joining of the bladder halves. Cecal plate inspection revealed two hindgut structures that descended distally, one descended midline into the pelvis along the sacrum and the second laterally along the left border of the sacrum. Both lumens connected to the cecal plate and had separate mesenteries. In an effort to maximize the colonic mucosal surface area, the hindgut segments were unified through a side-to-side anastomosis, creating a larger caliber hindgut. The cecal plate was tubularized and an end colostomy was created. Bowel function returned and he was discharged home on full enteral feeds.

Discussion This case represents a cooccurrence of two extremely rare and complex congenital anomalies. The decision to unify the distinct hindguts into a single lumen was made in an effort to combine the goals of management for both OEIS and alimentary duplications. The hindgut is abnormal in OEIS and should be assessed carefully during repair.
Artificial Egg Activation Using Calcium Ionophore
Authors: Attia Ahmed , Nicholson Cara , Martins da Silva Sarah J.
Published: March 2022

Artificial oocyte activation, most commonly using calcium ionophore, is a treatment add-on utilized to avoid recurrence of abnormally low or total failed fertilization following in vitro fertilization/intracytoplasmic sperm injection. It aims to modify defective physiological processes, specifically calcium-mediated cell signaling that are critical to events required for fertilization. Routine application of artificial oocyte activation is neither required nor recommended; however, it represents an invaluable intervention for a subgroup of patients affected by sperm-related oocyte activation deficiency.
Tubular Duplication of the Esophagus in a Newborn, Treated by Thoracoscopy
Authors: Khvorostov Igor , Gusev Alexey , Alkhasov Abdumanap , Yatsyk Sergey , D'yakonova Elena
Published: March 2022

We present a case of tubular esophageal duplication in a 3-day-old female newborn (38 weeks, 2,500 g) without concomitant abnormal development. Esophageal duplication was diagnosed based on the clinical picture, direct laryngoscopy, esophagography and computed tomography. The duplicated esophagus was resected by thoracoscopy leaving the orthotopic esophagus in place. Isolation from the pharynx was performed via a separate cervical incision. After a follow-up period of 20 months, the child returned to normal growth and development.
Conceitos de alinhamento sagital e parâmetros espinopélvicos
Authors: Menezes Cristiano Magalhães , Lacerda Gabriel Carvalho , Lamarca Santiago
Published: March 2022

A cirurgia da coluna continua a expandir seus horizontes para cuidar dos pacientes incapacitados com dor e deformidades. Desde a última década, nosso conhecimento sobre o alinhamento espinal, do crânio à pelve, aumentou consideravelmente. Portanto, faz-se necessária a expansão de tal conhecimento para o ortopedista geral, para que possamos proporcionar melhores cuidados para essa população.

O alinhamento espinal global é um conceito crítico no entendimento do impacto ocasionado pela condição patológica (doença degenerativa, trauma, deformidade) e mesmo do seu tratamento, como na instrumentação e artrodese da coluna. O tratamento de qualquer doença na coluna deve incluir o entendimento da complexidade do alinhamento espinopélvico.

A princípio, todos os parâmetros parecem puramente matemáticos e pouco aplicáveis à realidade do leitor mais desatento. Mas, aos poucos, fica claro que, como tudo em ortopedia, a biomecânica faz parte essencial do conhecimento do sistema musculoesquelético, tornando mais claras as lógicas da fisiologia do movimento.

O conhecimento dos conceitos de alinhamento sagital e dos parâmetros espinopélvicos proporcionam uma melhor compreensão dos esqueletos axial e apendicular, além de um melhor entendimento dos processos fisiológicos e adaptativos da coluna frente ao processo degenerativo crescente que ocorre ao longo da vida.
Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women
Authors: Miranda Larissa Antunes , de Moura Anna Caroline Ribeiro , Kasawara Karina Tamy , Surita Fernanda Garanhani , Moreira Mayle Andrade , do Nascimento Simony Lira
Published: March 2022

Objective To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women.

Methods A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%.

Results Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81 ± 81.84 METs), followed by work-related activities (40.77 ± 84.71 METs). Only 19.3% women exercised during pregnancy (4.76 ± 12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR = 29.8; 95% CI 4.9–117.8). Nulliparity (OR = 3.1; 95% CI 1.0–9.1), low levels of anxiety (OR = 3.6; 95% CI 1.2–10.7), and unemployment (OR = 4.8; 95% CI 1.1–19.6) were associated with the practice of exercise during pregnancy.

Conclusion Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.
A Case of Minimal Change Disease after SARS-CoV-2 Vaccination under the Age of 18
Authors: Alhosaini Mohamad Nour
Published: March 2022

This is a care report of a 16-year-old-male who developed de novo minimal change disease following the second dose of the Pfizer vaccine. The patient developed sudden onset edema and 10 kg weight gain. He had nephrotic range proteinuria with normal renal function. Kidney biopsy with adequate sample confirmed minimal change disease. The patient improved after 1 week of starting prednisone. This is the first case of minimal change disease after the Pfizer vaccine in the teenager population since expanding the age groups to allow younger subjects to receive the vaccine. Reporting cases at different age groups will help in trying to clarify whether the increasing reports of nephrotic syndrome following the vaccination are accidental or cause–effect relationship.
COVID-19: The Impact on Internal Medicine Resident Training
Authors: Garcia Odalys Estefania Lara , Sawalha Khalid , Al-Akchar Mohammad
Published: March 2022

The novel coronavirus disease 2019 (COVID-19) pandemic has impacted the lives of physicians at all levels. The workloads and working hours have increased tremendously which affected the time spent on administrative and academic duties. The COVID-19 pandemic imposed a lot of challenges on academic institutions in term of providing quality of care to patients and maintaining the quality of education for trainee. Herein, we discuss the challenges and impact of the pandemic on residents training.
Geographic Trends in the Ophthalmology Residency Match: Influence of Program and Applicant Characteristics
Authors: Cohen Samuel A. , Pershing Suzann
Published: March 2022

Introduction The ophthalmology residency match remains competitive. Several prior studies have examined various factors that contribute to a successful match into an ophthalmology residency program; however, the role of geographic location in the ophthalmology residency match process is unclear. The purpose of our study was to evaluate geographic trends in the ophthalmology residency match and to determine whether geographic trends vary based on program level factors such as program rank or funding source and/or applicant factors such as year of training, gender, and medical degree earned. Specifically, we assessed associations with residents training at the residency program affiliated with their medical school and/or within the same geographic region as their medical school, using data obtained through publicly available sources and residency program surveys.

Methods We used the American Medical Association's Fellowship and Residency Electronic Interactive Database database to identify accredited ophthalmology residency programs. Residency program Web sites and email inquiries were used to collect demographic and geographic information for residents in the graduating classes of 2021 to 2023. Statistical analysis included χ2 testing and multivariate logistic regression.

Results In total, 1,378 residents were included from 110 ophthalmology residency programs and 218 medical schools. Residents who matched at the residency program affiliated with their medical school (18%) were evenly distributed among the Midwest, Northeast, South, and West regions (p = 0.2236). Residency programs in the West (31.7%) matched fewer regional medical students compared with programs in the South (61.2%), Midwest (57.4%), and Northeast (58.4%) (p < 0.0001). Attending a publicly funded medical school was associated with higher odds of matching into a regional residency program (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.10–1.90; p = 0.0001) and attending a privately funded medical school was associated with higher odds of matching into a top-ranked residency program (OR, 1.53, 95% CI, 1.34–1.82; p = 0.0002).

Conclusions The majority of current ophthalmology residents trained at programs in the same geographic region as their medical schools, with nearly 20% of residents training at their medical school-affiliated program. Geographic differences in match results were observed based on resident gender, medical school characteristics, and residency program region.
An Investigation of Pulse Oximetry Levels During Swallowing in Healthy Adults and in Individuals with Severe and Very Severe Chronic Obstructive Pulmonary Disease
Authors: Alani Salim S. , Stierwalt Julie A.G. , LaPointe Leonard L. , Morris Richard J. , Jeong Allan C. , Filson Moses Jennifer , Upton Thomas D.
Published: March 2022

To compare pulse oximetry (PO) levels during swallowing in healthy adults and adults with severe chronic obstructive pulmonary disease (COPD). Participants included two groups of 60 healthy adults, balanced for gender. The young group ranged from 18 to 38 years, and the older group from 60 to 87 years. In addition, there were 11 participants with COPD aged 43 to 82 years. PO levels were collected as each participant swallowed 10 mL of water, 10 mL of applesauce, and a piece of diced pear (three trials each). Analyses for the healthy groups revealed neither statistically significant main effects for bolus type nor interactions between gender and age. For between-subject effects, there was no main effect for gender, but there was a large main effect for age, and a gender and age interaction. In the group with COPD, there were no significant differences across bolus types; however, PO measures were consistently lower than the healthy groups for all bolus types. Healthy adults exhibited stable PO levels across bolus types. Adults with COPD, although exhibiting significantly lower PO levels, also remained stable. For clinicians who monitor PO measures, these results offer a more comprehensive understanding of the nature of these measures during swallowing in these groups.
Telemedicine Curriculum in an Ophthalmology Residency Program
Authors: Aziz Kanza , Sherif Noha A. , Meshkin Ryan S. , Lorch Alice C. , Armstrong Grayson W.
Published: March 2022

Background The COVID-19 pandemic has accelerated the adoption of telemedicine in the field of ophthalmology. Despite the increasing utilization of telemedicine, there is a lack of formal training in ophthalmology residency programs to ensure ophthalmologists are prepared to conduct virtual eye exams.

Objective This article aims to assess the impact of an ophthalmic telemedicine curriculum on ophthalmology residents' self-reported knowledge acquisition in conducting telemedicine eye exams, perceived ability to diagnose, manage, and triage common eye diseases, and evaluate their attitudes toward the current and future use of teleophthalmology.

Methods This single-center study at Massachusetts Eye and Ear used a nonvalidated pre- and postcurriculum survey conducted during the 2020 to 2021 academic year among ophthalmology residents. Participants engaged in an ophthalmic telemedicine curriculum that consisted of interactive didactic lectures and electronic postdidactic assessments.

Results Twenty-four residents (100%) completed a precurriculum survey, while 23 of 24 (95.8%) residents completed both the telemedicine curriculum and a postcurriculum survey. On a five-point Likert scale, the median interquartile range (IQR) scores for confidence with setup/logistics, history taking, examination, documentation, and education increased from 2.5 (2.0–4.0) to 4.0 (3.5–4.5) (p = 0.001), 3.0 (3.0–4.0) to 5.0 (4.0–5.0) (p < 0.001), 2.0 (1.8–2.0) to 4.0 (3.5–4.0) (p < 0.001), 2.0 (1.0–2.0) to 4.0 (3.0–4.0) (p < 0.001), and 2.5 (2.0–3.0) to 4.0 (4.0–4.0) (p < 0.001), respectively. The median (IQR) scores for comfort with ethics/professionalism, disparities and conducting patient triage, diagnosis, and management increased from 2.0 (2.0–2.3) to 4.0 (3.0–4.0) (p < 0.001), 2.0 (2.0–2.0) to 3.0 (3.0–4.0) (p < 0.001) and 3.0 (2.0–3.0) to 4.0 (3.0–4.0) (p = 0.001), 2.0 (2.0–3.0) to 3.0 (3.0–4.0) (p < 0.001), and 3.0 (2.0–3.0) to 3.0 (3.0–4.0) (p = 0.008), respectively.

Conclusion The implementation of an ophthalmic telemedicine curriculum increased resident confidence and self-reported knowledge across all logistical and clinical components of virtual ophthalmic care. Formal telehealth curricula can address an unmet educational need of resident trainees in an era of rapid uptake and utilization of telehealth services.
Lateral Collateral Ligament and Biceps Femoris Tendon Fixation with a Suture Anchor to the Tibial Metaphysis after Proximal Fibula En Bloc Resections Preserve Lateral Knee Stability
Authors: Buyukdogan Kadir , Işık Samet , Ayık Gökhan , Tokgözoğlu Mazhar , Ayvaz Mehmet
Published: March 2022

This study aims to analyze the functional outcomes and lateral knee stability of patients who underwent lateral collateral ligament (LCL) and biceps femoris tendon reconstruction with suture anchors after proximal fibula en bloc resection for bone tumors. Patients who underwent proximal fibular en bloc resection between 2007 and 2018 were retrospectively viewed. Patients were invited to visit the clinic, and their functional scores were evaluated using the Musculoskeletal Tumor Society Scoring (MSTS) system. Lateral knee stability was evaluated by varus stress radiographs obtained at 20 degrees of flexion, and the range of motion (ROM) of the bilateral knee was assessed. Side-to-side differences were graded according to the International Knee Documentation Committee (IKDC) criteria and compared between types I and II resections. A total of 17 patients (4 males and 13 females) with a mean age of 31.1 ± 17.1 (range: 13–65) years at the time of surgery were available for radiological and clinical examination at a mean follow-up of 68.6 ± 36.4 (range: 22–124) months after surgery. In terms of ROM measurements, IKDC grades and side-to-side differences in both flexion and extension were not significantly different between the groups. On varus stress radiographs, lateral knee gapping was measured to be 0.93 ± 0.91 mm in type-I resections and 1.83 ± 0.45 mm in type-II resections, and statistically significant differences were detected among the groups (p = 0.039). When the values were graded according to IKDC criteria, none of the knees were classified as abnormal, and no difference was observed between the groups. Mean MSTS score of patients with type-I resections was significantly higher than those of patients with type-II resections (92.7 vs. 84.4%, p = 0.021). In the subscale analysis, a significant difference was observed in the support scores (type I = 94.5%, type II = 70%; p = 0.001). The reattachment of LCL and biceps femoris tendon to the tibial metaphysis with a suture anchor is a simple and effective method to prevent lateral knee instability after proximal fibula resections.
Polarization and US foreign policy: key debates and new findings
Authors: Friedrichs Gordon M. , Tama Jordan
Published: March 2022

Polarization in the USA has been on the rise for several decades. In this context, few observers expect politics today to stop “at the water’s edge,” as the old cliché goes. But key questions about the relationship between polarization and US foreign policy remain to be fully answered. To what extent are American ideas about foreign policy now polarized along partisan lines? How is polarization changing the foreign policy behavior of the US Congress and President? And how is polarization altering the effectiveness of US foreign policy and influencing America’s role in the world? In this introductory article to our special issue “Domestic Polarization and US Foreign Policy: Ideas, Institutions, and Policy Implications,” we provide an overview of key debates and existing knowledge about these questions, highlight important new findings from the contributions to the special issue, and suggest avenues for further research on this increasingly important topic.
Characterization of the stability and dynamics of a laser-produced plasma expanding across a strong magnetic field
Authors: Yao Weipeng , Capitaine Julien , Khiar Benjamin , Vinci Tommaso , Burdonov Konstantin , Béard Jérôme , Fuchs Julien , Ciardi Andrea
Published: March 2022

Magnetized laser-produced plasmas are central to many studies in laboratory astrophysics, in inertial confinement fusion, and in industrial applications. Here, we present the results of large-scale three-dimensional magnetohydrodynamic simulations of the dynamics of a laser-produced plasma expanding into a transverse magnetic field with a strength of tens of teslas. The simulations show the plasma being confined by the strong magnetic field into a slender slab structured by the magnetized Rayleigh–Taylor instability that develops at the plasma–vacuum interface. We find that when the initial velocity of the plume is perturbed, the slab can develop kink-like motions that disrupt its propagation.