bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Glucose-6-Phosphate Dehydrogenase Deficiency in Newborns in Northeast Mexico
Authors: Villarreal-Martínez Laura , Torres-Sánchez Katia A. , Ibarra-Ramírez Marisol , Martínez-Garza Laura E. , Villarreal-Martínez Daniel Z. , Viera Daniel A. G. , Herrera María del C. R. , O.-Castillo Miguel , Bautista-Gómez Andrea J. , Martínez Adrián G. , de la Garza Juan F. M.
Published: August 2022

Objective Glucose-6-phosphate dehydrogenase deficiency (G6PDd) is the most common enzymatic disease worldwide and the prevalence is not well established because of the lack of screening. This study aimed to estimate the prevalence of G6PDd in a Hispanic population from Northeast Mexico.

Study Design In this retrospective study, a database was used to analyze the G6PDd in neonates included in the expanded newborn metabolic screening of inherited metabolic disorders during a period of 4 years through the GSP Neonatal G6 kit (PerkinElmer).

Results Among 96,152 (48,462 male) neonates screened for G6PD enzyme activity, a total of 566 (0.58%) cases were deficient for G6PD. Of those 566 patients, 469 (82.8%) attended the second test and the other 97 (17.2%) patients were lost. Of those 469 who did attend, 384 (81.9%) neonates were deficient in the second test and 85 (18.1%) were normal. With the data collected, 384 neonates were confirmed with G6PDd, 348 (88.6%) were male and 36 (11.4%) patients were female. The calculated prevalence for this population was 0.72 cases per 100 male newborns.

Conclusion The prevalence of G6PDd in the Northeastern Mexican population is high. Since migration is increasing in the United States, pediatricians should be aware of the need to search for G6PDd in newborns and the wide clinical manifestations they can present.

Key Points
Provider Perspectives on Patient- and Provider-Facing High Blood Pressure Clinical Decision Support
Authors: Dorr David A. , Richardson Joshua E. , Bobo Michelle , D'Autremont Christopher , Rope Robert , Dunne MJ , Kassakian Steven Z. , Samal Lipika
Published: August 2022

Background Hypertension, persistent high blood pressures (HBP) leading to chronic physiologic changes, is a common condition that is a major predictor of heart attacks, strokes, and other conditions. Despite strong evidence, care teams and patients are inconsistently adherent to HBP guideline recommendations. Patient-facing clinical decision support (CDS) could help improve recommendation adherence but must also be acceptable to clinicians and patients.

Objective This study aimed to partly address the challenge of developing a patient-facing CDS application, we sought to understand provider variations and rationales related to HBP guideline recommendations and perceptions regarding patient role and use of digital tools.

Methods We engaged hypertension experts and primary care respondents to iteratively develop and implement a pilot survey and a final survey which presented five clinical cases that queried clinicians' attitudes related to actions; variations; prioritization; patient input; importance; and barriers for HBP diagnosis, monitoring, and treatment. Analysis of Likert's scale scores was descriptive with content analysis for free-text answers.

Results Fifteen hypertension experts and 14 providers took the pilot and final version of the surveys, respectively. The majority (>80%) of providers felt the recommendations were important, yet found them difficult to follow-up to 90% of the time. Perceptions of relative amounts of patient input and patient work for effective HBP management ranged from 22 to 100%. Stated reasons for variation included adverse effects of treatment, patient comorbidities, shared decision-making, and health care cost and access issues. Providers were generally positive toward patient use of electronic CDS applications but worried about access to health care, nuance of recommendations, and patient understanding of the tools.

Conclusion At baseline, provider management of HBP is heterogeneous. Providers were accepting of patient-facing CDS but reported preferences for that CDS to capture the complexity and nuance of guideline recommendations.
Autonomic Nervous System in Preterm Very Low Birth Weight Neonates with Intraventricular Hemorrhage
Authors: Shiono Ai , Bonno Motoki , Toyoda Hidemi , Ogawa Masahiro , Tanaka Shigeki , Hirayama Masahiro
Published: August 2022

Objective Heart rate variability (HRV) indicates cardiac autonomic nerve activity and is influenced by brain damage during the neonatal period. We aimed to determine whether a correlation exists between the HRV of extremely preterm neonates and neurodevelopmental test scores.

Study Design Electrocardiogram data of neonates were assessed and HRV patterns in extremely preterm neonates with severe intraventricular hemorrhage (IVH; n = 6) and those with no/mild IVH (n = 28) were compared. We analyzed the relationship between HRV and neurodevelopmental outcomes at 18 months (n = 21) and 3 years (n = 23) in extremely preterm neonates.

Results HRV was significantly associated with IVH severity in extremely preterm neonates (p < 0.05). Neonates with severe IVH exhibited increased HR and decreased mean R-to-R interval (NN) compared with neonates with no/mild IVH. HRV parameters significantly decreased in the severe IVH group, but not in the no/mild IVH group, suggesting that both sympathetic and parasympathetic activities decreased in neonates with severe IVH. Additionally, decreased HR and increased NN were significantly related to impaired neurodevelopmental outcomes in the no/mild IVH group at corrected ages of 18 months and 3 years, respectively (all p < 0.05).

Conclusion HRV was significantly associated with IVH severity and neurodevelopmental outcome in extremely preterm neonates. HRV can distinguish extremely preterm neonates who subsequently had severe IVH from those who had no/low-grade IVH. HRV may identify extremely preterm neonates needing adjuvant neuroprotective interventions. These findings warrant further investigation in a larger population of extremely preterm neonates.

Key Points
Circulating Endothelial Cells are Associated with Thromboembolic Events in Patients with Antiphospholipid Antibodies
Authors: Foret Thomas , Dufrost Virginie , Heymonet Marie , Risse Jessie , Faure Gilbert C. , Louis Huguette , Lagrange Jeremy , Lacolley Patrick , Devreese Katrien , Gibot Sébastien , Regnault Veronique , Zuily Stéphane , Wahl Denis
Published: August 2022

Background Endothelial damage has been described in antiphospholipid antibody (aPL)-positive patients. However, it is uncertain whether circulating endothelial cells (CECs)—which are released when endothelial injury occurs—can be a marker of patients at high risk for thrombosis.

Methods Ninety-seven patients with aPL and/or systemic lupus erythematosus (SLE) were included. CECs were determined by an automated CellSearch system. We also assayed plasma levels of tissue factor-bearing extracellular vesicles (TF+/EVs) and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) as markers of endothelial dysfunction/damage.

Results Patients' mean age was 46.1 ± 13.9 years, 77 were women. Thirty-seven had SLE and 75 patients were suffering from antiphospholipid syndrome. Thirty-seven percent of patients presented a medical history of arterial thrombosis and 46% a history of venous thromboembolism (VTE). Thirteen patients had increased levels of CECs (>20/mL), with a mean CEC level of 48.3 ± 21.3 per mL. In univariate analysis, patients with obesity or medical history of myocardial infarction (MI), VTE, or nephropathy had a significant increased CEC level. In multivariate analysis, obesity (odds ratio [OR] = 6.07, 95% confidence interval [CI]: 1.42–25.94), VTE (OR = 7.59 [95% CI: 1.38–41.66]), and MI (OR = 5.5 [95% CI: 1.1–26.6)] were independently and significantly associated with elevated CECs. We also identified significant correlations between CECs and other markers of endothelial dysfunction: sTREM-1 and TF+/EVs.

Conclusion This study demonstrated that endothelial injury assessed by the levels of CECs was associated with thromboembolic events in patients with aPL and/or autoimmune diseases.
A Case of Prepubertal Ovarian Tissue Cryopreservation in Metachronous Bilateral Mature Ovarian Teratoma Requiring Bilateral Oophorectomy
Authors: Malik Tom , Wheeler Robert , Hall Nigel J. , Gray Juliet
Published: August 2022

Mature ovarian teratoma has the potential to occur metachronously in the contralateral ovary. There are significant implications for fertility as bilateral oophorectomy may be indicated. In prepubertal girls, ovarian tissue cryopreservation (OTC) offers the only possibility of a future biological pregnancy but outcome data are limited. We present a case of prepubertal OTC in a 12-year-old girl undergoing a second oophorectomy for metachronous contralateral mature teratoma. We offer a discussion of the challenges that emerged regarding perioperative decision-making, balancing the need for safe oncological resection with the desire to preserve fertility.
Technologien zur In-vivo-Untersuchung der Biomechanik der Hornhaut: Brillouin-Spektroskopie und Hydratationszustand – quo vadis?
Authors: Heisterkamp Alexander , Wenzel Johannes , Iriarte Christian , Kalies Stefan Klaus Michael , Reiss Stephan , Stachs Oliver , Sperlich Karsten
Published: August 2022

Um die strukturelle Integrität der Kornea zu beurteilen, werden nicht invasive Verfahren für die lokale Messung ihrer mechanischen Eigenschaften benötigt. Neben einer Reihe von etablierten
Verfahren und den damit assoziierten Vor- und Nachteilen ist die Brillouin-Spektroskopie als ein immer noch relativ neues Verfahren in der Lage, den Kompressionsmodul von biologischem
Gewebe, speziell der Kornea, in vivo zu bestimmen. Im vorliegenden Beitrag werden diese verschiedenen existierenden und in der Entwicklung befindlichen Technologien zur Untersuchung der
Biomechanik der Hornhaut diskutiert und zueinander in Korrelation gesetzt.
A Rare Case of Isolated Vesical Mucormycosis in a Patient with COVID-19 Pneumonitis
Authors: Muthe Mridula Manohar , Shirsath Sankalp Dilip , Shirsath Raunaklaxmi Dilip , Firke Vikrant Prabhakar
Published: August 2022

We present the case of a 60-year-old diabetic female who was diagnosed with coronavirus disease 2019 (COVID-19) pneumonitis. After her recovery during follow-up, she presented with recurrent hematuria, burning of micturition and, occasional lower abdominal discomfort, with unsatisfactory response to oral antibiotics. On imaging evaluation, there was mild right hydronephrosis and hydroureter with urothelial thickening involving the right lower ureter and a filling defect in the urinary bladder close to the vesicoureteric junction seen on excretory phase images. Cystoscopy revealed a whitish friable mass-like lesion that was retrieved, histopathology of which revealed fungal elements, and Rhizopus was isolated in culture. Thus, the diagnosis of urinary bladder fungal ball due to mucormycosis infection of the urinary tract was reached. The patient was asymptomatic after 10 weeks of antifungal treatment. The treating physicians, urologist, and radiologists need to have a high index of suspicion of urinary mucormycosis in patients with COVID-19 pneumonia.
Childhood-Onset Neurodegeneration with Cerebellar Atrophy Syndrome: Severe Neuronal Degeneration and Cardiomyopathy with Loss of Tubulin Deglutamylase Cytosolic Carboxypeptidase 1
Authors: Samur Bahadir M. , Ercan-Sencicek Gulhan A. , Caglayan Ahmet Okay , Per Huseyin , Gumus Hakan , Gumus Gulsum , Baykan Ali
Published: August 2022

The cytoskeleton is a dynamic filamentous network with various cellular and developmental functions. The loss of cytosolic carboxypeptidase 1 (CCP1) causes neuronal death. Childhood-onset neurodegeneration with cerebellar atrophy (CONDCA, OMIM no.: 618276) is an extremely rare disease caused by ATP/GTP binding protein 1 (AGTPBP1) gene-related CCP1 dysfunction of microtubules affecting the cerebellum, spinal motor neurons, and peripheral nerves. Also, possible problems are expected in tissues where the cytoskeleton plays a dynamic role, such as cardiomyocytes. In the present study, we report a novel homozygous missense (NM_015239: c.2447A > C, p. Gln816Pro) variant in the AGTPBP1 gene that c.2447A > C variant has never been reported in a homozygous state in the Genome Aggregation (gnomAD; v2.1.1) database, identified by whole-exome sequencing in a patient with a seizure, dystonia, dilated cardiomyopathy (DCM), and accompanying atrophy of caudate nuclei, putamen, and cerebellum. Unlike other cases in the literature, we expand the phenotype associated with AGTPBP1 variants to include dysmorphic features, idiopathic DCM which could be reversed with supportive treatments, seizure patterns, and radiological findings. These findings expanded the spectrum of the AGTPBP1 gene mutations and associated possible manifestations. Our study may help establish appropriate genetic counseling and prenatal diagnosis for undiagnosed neurodegenerative patients.
Role of Diffusion-Weighted Magnetic Resonance Imaging in Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer and Its Molecular Subtypes
Authors: Singh Neetu , Jain Shivi , Verma Ashish , Khanna Seema , Shukla Ram Chandra
Published: August 2022

Purpose The aim of this study was to evaluate the role of apparent diffusion coefficient (ADC) and hence diffusion-weighted imaging in prediction of pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) in locally advanced breast cancer (LABC) and its molecular subtypes.

Methods In this tertiary hospital-based prospective study, 30 patients aged 30 to 65 years, having clinically/cytologically diagnosed LABC, were included. Magnetic resonance imaging (MRI) was done to obtain prechemotherapy ADC (ADCpre), postchemotherapy ADC (ADCpost), change in ADC (ΔADC), and ΔADC% for each tumor and its subtype. Postsurgical pCR was used as the reference standard for determining tumor response. All four ADC parameters were compared between pCR and non-pCR groups.

Results Of the 30 patients, 19 (63.3%) patients showed pCR, while 11 (36.7%) patients did not. The pCR group showed significantly lower mean ADCpre (p <  0.001) and higher mean ADCpost (p <  0.05), ΔADC, and ΔADC% (p = 0.000) than non-pCR group. The best cutoff values to differentiate responders from nonresponders with receiver operating characteristic curve analysis of ADCpre, ADCpost, and ΔADC% were 0.98 × 10−3 mm2/s (68.4% sensitivity, 63.6% specificity), 1.31×10−3 mm2/s (68.4% sensitivity, 63.6% specificity), and 25% (84.2% sensitivity, 90.9% specificity), respectively. Human epidermal growth factor receptor 2 (HER2)-enriched subtype showed significant difference in mean ADCpre (p = 0.045), while triple-negative subtype showed significant differences in mean ADCpost (p = 0.032) and mean ΔADC (p = 0.019) between the two groups.

Conclusion ADCpre, ADCpost, and ΔADC can predict pCR to NACT in LABC. Among molecular subtypes, ADCpre was predictive only in HER2-enriched subtype, while ADCpost and ΔADC were predictive only in triple-negative subtype.
Localized Metastatic Recurrence of HCC following Distal Extremity Trauma: Bone Scintigraphy and Anatomicopathological Correlation
Authors: Zamora Edgar , Rivera Valladares Louisiana , Edema Ukuemi , Freeman Leonard M.
Published: August 2022

Hepatocellular carcinoma (HCC) is the most common type of liver cancer, with a poor median survival when left untreated. Extrahepatic metastases involving musculoskeletal tissues typically present with concomitant nonosseous metastases at the time of diagnosis. A 61-year-old male on 1-year remission, following transarterial chemoembolization of a 2.3-cm hepatic HCC 1 year before, presented with a 2-month history of left wrist pain and swelling after falling on an outstretched hand. Computed tomographic scan revealed diffuse osteolytic lesions localized in left hand and distal forearm, associated with equivocal diffuse activity on bone scan. Subsequent surgical debridement revealed metastatic hepatocellular carcinoma.
Isolated Rectal Metastases from Locally Advanced Carcinoma Prostate Detected by 18F-PSMA-1007 PET/CT
Authors: Singh Shashank Shekhar , Singh Rani Kunti Randhir , Kumar Narvesh , Atrey Harshvardhan
Published: August 2022

Rectal involvement by prostate carcinoma is rare and isolated rectal metastases are even rarer with only a few cases having been reported in the literature. In our knowledge, no case of isolated rectal metastases diagnosed on prostate specific membrane antigen positron emission tomography/computed tomography has been reported to date. We present a case of a 66-year-old patient who presented with rectal bleeding and passage of urine from anal region and was diagnosed with carcinoma prostate infiltrating the rectum along with solitary rectal metastases.
Transanal Mesenteric Resection in Hirschsprung's Disease Using ICG under Concept of NOTES Technique
Authors: Muto Mitsuru , Onishi Shun , Murakami Masakazu , Yano Keisuke , Harumatsu Toshio , Ieiri Satoshi
Published: August 2022

Laparoscopic surgery has been applied for Hirschsprung's disease (HD). We herein report our approach to mesenteric processing for laparoscopic-assisted transanal endorectal pull-through (L-TERPT). Following mucosectomy and entering the abdominal cavity, a vessel sealing system is transanally inserted into the abdominal cavity for mesenteric processing based on concept of Natural Orifice Translumenal Endoscopic Surgery. Since the transanal axis is parallel to the dissected mesentery, it makes easier to operate in comparison to when the procedure is performed through the abdominal working port and can reduce the additional abdominal trocar wound. We also use indocyanine green (ICG) fluorescence navigation. Fluorescing the vessels with ICG allows intraoperative visualization of the blood flow in the retrieved intestine. With these innovative combined techniques, L-TERPT for HD can be safely performed, even in infants with small intraabdominal cavities.
Impact of Deletion on Angelman Syndrome Phenotype Variability: Phenotype–Genotype Correlation in 97 Patients with Motor Developmental Delay
Authors: Belghiti Hanae Daha , Abbassi Meriame , Sayel Hanane , Ahakoud Mohamed , El Makhzen Badr Eddine , Lee Norman , Russo Silvia , Chaouki Sana , Bouguenouch Laila
Published: August 2022

Angelman syndrome (AS) is a rare neurodevelopmental disorder due to genetic defects involving chromosome 15, known by intellectual disability, cognitive and behavioral disorders, ataxia, delayed motor development, and seizures. This study highlights the clinical spectrum and molecular research to establish the genotype–phenotype correlation in the pediatric Moroccan population. Methylation-specific-polymerase chain reaction (MS-PCR) is a primordial technique not only to identify the genetic mechanism of AS but also to characterize the different molecular classes induced in the appearance of the clinical symptoms. Patients with positive methylation profile were additionally studied by fluorescent in situ hybridization. Sequencing analysis of the UBE3A gene was performed for patients with negative MS-PCR. We used Fisher's test to assess differences in the distribution of features frequencies among the deletional and the nondeletional group. Statistical analysis was performed using R project. We identified from 97 patients diagnosed with AS, 14 (2.06%) had a classical AS phenotype, while 70 (84.5%) patients displayed a subset of consistent and frequent criteria. Development delay was shown severe in 63% and moderate in 37%. Nineteen out of 97 of them had MS-PCR positive in which 17 (89.47%) had 15q11-q13 deletion. Deletion patients presented a higher incidence of epileptic seizures (p = 0.04), ataxia (p = 0.0008), and abnormal electroencephalogram (EEG) profile (p = 0.003). We further found out a frameshift deletion located at exon 9 of the UBE3A gene discovered in a 5 years old patient. We report in this study the genotype–phenotype correlation using different molecular testing. Correlation analysis did not reveal any statistical differences in phenotypic dissimilarity between deletion and nondeletion groups for most clinical features, except the correlation was highly significant in the abnormal EEG. According to our findings, we recommend offering MS-PCR analysis to all patients with severe intellectual disability, developmental delay, speech impairment, happy demeanor, and hypopigmentation.
Transfusion Requirements with Hybrid Management of Placenta Accreta Spectrum Incorporating Targeted Embolization and a Selective Use of Delayed Hysterectomy
Authors: Gatta Luke A. , Weber Jeremy M. , Gilner Jennifer B. , Lee Paula S. , Grotegut Chad A. , Herbert Katherine A. , Bashir Mustafa , Pieper Carl F. , Ronald James , Pabon-Ramos Waleska , Habib Ashraf S. , Strickland Kyle C. , Secord Angeles Alvarez , James Andra H.
Published: August 2022

Objective This study compares the number of units of red blood cells (RBCs) transfused in patients with placenta accreta spectrum (PAS) treated with or without a multidisciplinary algorithm that includes placental uterine arterial embolization (P-UAE) and selective use of either immediate or delayed hysterectomy.

Study Design This is a retrospective study of deliveries conducted at a tertiary care hospital from 2001 to 2018 with pathology-confirmed PAS. Those with previable pregnancies or microinvasive histology were excluded. To improve the equity of comparison, analyses were made separately among scheduled and unscheduled cases, therefore patients were assigned to one of four cohorts as follows: (1) scheduled/per-algorithm, (2) scheduled/off-algorithm, (3) unscheduled/per-algorithm, or (4) unscheduled/off-algorithm. Primary outcomes included RBCs transfused and estimated blood loss (EBL). Secondary outcomes included perioperative complications and disposition.

Results Overall, 95 patients were identified, with 87 patients meeting inclusion criteria: 36 treated per-algorithm (30 scheduled and 6 unscheduled) and 51 off-algorithm patients (24 scheduled and 27 unscheduled). Among scheduled deliveries, 9 (30.0%) patients treated per-algorithm received RBCs compared with 20 (83.3%) patients treated off-algorithm (p < 0.01), with a median (interquartile range [IQR]) of 3.0 (2.0, 4.0) and 6.0 (2.5, 7.5) units transfused (p = 0.13), respectively. Among unscheduled deliveries, 5 (83.3%) per-algorithm patients were transfused RBCs compared with 25 (92.6%) off-algorithm patients (p = 0.47) with a median (IQR) of 4.0 (2.0, 6.0) and 8.0 (3.0, 10.0) units transfused (p = 0.47), respectively. Perioperative complications were similar between cohorts.

Conclusion A multidisciplinary algorithm including P-UAE and selective use of delayed hysterectomy is associated with a lower rate of blood transfusion in scheduled but not unscheduled cases.

Key Points
Temporal Trend and Risk Factors for Respiratory Distress Syndrome–Associated Neonatal Mortality in Preterm Infants: A Population-Based Study in a Middle-Income Country
Authors: Marinonio Ana Sílvia Scavacini , Costa-Nobre Daniela Testoni , Sanudo Adriana , Miyoshi Milton Harumi , Areco Kelsy Catherina Nema , Kawakami Mandira Daripa , Xavier Rita de Cassia , Konstantyner Tulio , Bandiera-Paiva Paulo , Freitas Rosa Maria Vieira de , Morais Lilian Cristina Correia , Teixeira Mônica La Porte , Waldvogel Bernadette Cunha , Kiffer Carlos Roberto Veiga , Almeida Maria Fernanda Branco de , Guinsburg Ruth
Published: August 2022

Objective This article aimed to report a temporal series of respiratory distress syndrome (RDS)-associated neonatal mortality rates in preterm live births in São Paulo state, Brazil, and to identify social, maternal, and neonatal characteristics associated with these deaths.

Study Design This is a population-based study of all live births with gestational age (GA) between 22 and 36 weeks, birth weight ≥400 g, without congenital anomalies from mothers living in São Paulo state during 2004 to 2015. RDS-associated neonatal mortality was defined as death up to 27 days after birth with ICD-10 codes P22.0 or P28.0. RDS-associated neonatal mortality rate (annual percent change [APC] with 95% confidence intervals [95% CIs]) was analyzed by Prais–Winsten. Kaplan–Meier estimator identified the time after birth that the RDS-associated neonatal death occurred. Poisson's regression model compared social maternal and neonatal characteristics between preterm live births that survived the neonatal period and those with RDS-associated neonatal deaths, with results expressed in incidence rate ratio and 95% CI.

Results A total of 645,276 preterm live births were included in the study, of which 612,110 survived and 11,078 had RDS-associated neonatal deaths. RDS-associated neonatal mortality rate was 17.17 per thousand preterm live births, with a decreasing annual trend (APC: −6.50%; 95% CI: −9.11 to −3.82%). The median time of these deaths was 48 hours after birth. The following risk factors for RDS-associated neonatal death were identified: maternal schooling ≤7 years (1.18; 1.09–1.29), zero to three prenatal care visits (1.25; 1.18–1.32), multiple pregnancy (1.24; 1.16–1.33), vaginal delivery (1.29; 1.22–1.36), GA 22 to 27 weeks (106.35; 98.36–114.98), GA 28 to 31 weeks (20.12; 18.62–21.73), male sex (1.16; 1.10–1.22), and 5-minute Apgar scores of 0 to 3 (6.74; 6.08–7.47) and 4 to 6 (3.97; 3.72–4.23).

Conclusion During the study period, RDS-associated neonatal mortality rates showed significant reduction. The relationship between RDS-associated neonatal deaths and social, maternal, and neonatal factors suggests the need for perinatal strategies to reduce prematurity and to improve the initial management of preterm infants.

Key Points
Agraphis nutans in Treatment of Chronic Tonsillitis: Randomised, Pragmatic, Equivalence Trial
Authors: Chakraborty Sunanda , Uchat Usha Ghelani , Ghosh Priyanka , Singh Navin Kumar , Koley Munmun , Saha Subhranil
Published: August 2022

Background Agraphis nutans (AN) is a potential homeopathic medicine in the treatment of chronic tonsillitis, but has remained under-researched. This trial attempts to compare the effects of AN with individualised homeopathic medicines (IHMs) in the treatment of chronic tonsillitis in adults.

Methods An open, randomised, pragmatic, equivalence trial was conducted to compare the effects of AN with IHMs. Sixty adults suffering from chronic tonsillitis were randomised to receive either AN (n = 30) or IHMs (n = 30). Three visual analogue scales (VASs) in the sore throat pain model (STPM) – sore throat pain intensity scale (STPIS), difficulty swallowing scale (DSS) and swollen throat scale (swoTS)—were used as the primary outcome while tonsil and adenoid health status instrument (TAHSI) and Glasgow benefit inventory (GBI) as the secondary outcomes; and they were measured after 6 and 12 weeks. Intention-to-treat sample was analysed to detect non-inferiority of AN against IHMs and group differences using two-ways (split-half) repeated measure analysis of variance and unpaired t-tests.

Results Reductions in all three STPM-VASs, TAHSI and GBI total and subscale scores were significant in the IHMs group (all p < 0.001, except TAHSI halitosis and nocturnal breathing subscale scores), but not in the AN group. Still, except GBI, non-inferiority was exhibited by AN against IHMs in rest of the outcomes after 6 and 12 weeks (all p < 0.001). Hepar sulphuris calcareum (n = 11; 36.7%) and Mercurius solubilis (n = 3; 10%) were the most frequently prescribed remedies in the IHMs group.

Conclusion AN performed non-inferior to IHMs in treatment of chronic tonsillitis in adults; however, it may result from suppression of symptoms. Rigorous and larger trials are warranted.

Trial Registration: CTRI/2018/10/016233; UTN: U1111–1221–8221.
Extensive Nonsegmental Pulmonary Perfusion Defects on SPECT/CT as an Early Sign of COVID-19 Infection
Authors: Franceschi Ana M. , Matthews Robert , Ahmed Osama , Mourtzikos Karen , Bajc Marika , Franceschi Dinko
Published: August 2022

We describe a hospitalized patient with confirmed coronavirus disease 2019 in whom the initial chest computed tomography (CT) was negative, while subsequent perfusion single-photon emission computed tomography/computed tomography imaging revealed extensive nonsegmental perfusion defects in addition to newly developing parenchymal densities. Possible reasons for these findings and their relationship to the multisystem severe acute respiratory syndrome coronavirus 2 infection are discussed in this article.
The Use of Acellular Dermal Matrix (Integra Single Layer) for the Correction of Malformative Chest Wall Deformities: First Case Series Reported
Authors: Delgado-Miguel Carlos , Miguel-Ferrero Miriam , Muñoz-Serrano Antonio , Díaz Mercedes , López-Gutiérrez Juan Carlos , Torre Carlos De la
Published: August 2022

Introduction Autologous tissue transfers have been used in chest wall reconstruction for decades, with high morbidity. Recently, acellular dermal matrices (ADMs) have emerged as an alternative. The aim of this article is to report our initial experience in the reconstruction of malformative chest wall deformities with ADM.

Methods A prospective observational study was performed in patients with malformative chest wall deformities, who were reconstructed with ADM at our institution between 2018 and 2020. We analyzed demographic variables, surgical features, postoperative complications, and cosmetic results at 12 months' follow- up.

Results Four male patients were included (median age: 16 years). Two patients had bilateral costal anomalies, one patient had a unilateral chest deformity, and one patient had Poland syndrome. In all patients, blunt dissection of the subcutaneous cellular tissue overlying the defect was performed through 2.5 to 3 cm skin incisions, creating a pouch. Afterwards, several sheets of Integra Single Layer were placed in the pouch, to replace the volume defect. All patients were discharged same-day. No postoperative infections, hematomas, or seromas were observed. Only one patient presented with a partial surgical wound dehiscence. Revisions were performed at 1, 3, 6, and 12 months. All 4 patients were satisfied with the cosmetic outcome (Nuss Questionnaire: median score: 16 points; Q1–Q3: 22–26).

Conclusion The use of ADM in malformative chest wall deformities reconstruction has not been previously described in children. This study demonstrates that the use of ADM is a safe and reliable technique. However, more studies with long-term follow-up are warranted.
COVID-19-Related Intestinal Ischemia in A 7-Year Old Boy
Authors: Fadgyas Balázs , Garai Gábor István , Schnur János , Kiss Viktória Irén , Vass Viktória , Mátyus Enikő , Balázs György , Cserni Tamas
Published: August 2022

Severe abdominal pain and vomiting are common symptoms in children with pediatric multisystem inflammatory syndrome (PIMS). Mesenteric lymphadenitis and aseptic peritonitis are predominantly reported in cases where acute surgical abdomen was suspected and laparotomy was performed at the early stage of the pandemic. These reports generally discouraged surgeons to perform exploration in COVID-19-related cases and medical management was prioritized. Only a few COVID-19-specific surgical cases with intestinal ischemia were published. Here, we report another case of COVID-19-related intestinal ischemia complicated with Meckel's diverticulitis in a non-immunocompromised child who clearly required surgical intervention. In our case, the combination of COVID-19-related vasculitis and low blood pressure episodes may have contributed to this severe outcome.
The Mediastinal Visceral Space: The Central Pathway for the Spread of Mediastinal Disease
Authors: Ponnatapura Janardhana , Oliphant Michael , Holbert John M.
Published: August 2022

The connective tissue of the mediastinal visceral space extends from the neck through the chest and into the abdomen. This connective tissue encases the esophagus and tracheobronchial tree and is bounded by the perivisceral fascia. The continuous longitudinal and axial interconnection of the mediastinal visceral space accounts for commonly observed bidirectional pathways of disease through the chest. Disease patterns that seem counterintuitive when viewed through the lens of gross anatomy are more understandable in view of this knowledge. This article illustrates case examples of the spread of gas, fluid, fat and soft tissue mass through the mediastinal visceral space.
Organizational culture as a mediator of credible leadership influence on work engagement: empirical studies in private hospitals in East Java, Indonesia
Authors: Srimulyani Veronika Agustini , Hermanto Yustinus Budi
Published: August 2022

The success of health services in hospitals depends on the work engagement of medical and non-medical personnel in providing quality services for patients. Engaged employees will be more proactive, take the initiative to collaborate with others, and are committed to achieving high-quality performance. A leader’s ability in an organization is a major factor in building a work ethic in the organization, instilling values, norms, and ethics through organizational culture into employee work behavior, such as work engagement. Credibility leadership is the practice of leading an organization through a positive culture change. Credible leadership can increase work engagement through an organizational culture emphasized by education and organizational leaders. The study aimed to analyze the influence of leadership credibility and organizational culture on work engagement by sampling medical and non-medical personnel at two private hospitals in Madiun City. The hypothesis was tested using structural equation modeling (SEM) and path analysis. The results of hypothesis testing show that: (1) credible leadership has a significant positive influence on organizational culture; (2) organizational culture has a significant positive influence on work engagement; (3) organizational culture is the perfect mediator of credible leadership influences on work engagement. This study’s results confirm that leaders’ role in shaping a positive organizational culture through good credible leadership practices, while organizational culture can increase employee work engagement.
Varying climatic-social-geographical patterns shape the conflict risk at regional and global scales
Authors: Hao Mengmeng , Ding Fangyu , Xie Xiaolan , Fu Jingying , Qian Yushu , Ide Tobias , Maystadt Jean-François , Chen Shuai , Ge Quansheng , Jiang Dong
Published: August 2022

Given that armed conflict has been seriously impeding sustainable development, reducing the frequency and intensity of armed conflicts has become an explicit goal and a common theme of the 2030 Sustainable Development Goals. Determining the factors shaping armed conflict risks in different regions could support formulating region-specific strategies to prevent armed conflicts. A machine learning approach was applied to reveal the drivers of, and especially the impact of climatic conditions on, armed conflict in Sub-Saharan Africa, the Middle East, and South Asia and characterizes their changes over time. The analyses show a rising impact of climatic conditions on armed conflict risk over the past decades, although the influences vary regionally. The overall percentage increases in the contribution of climatic conditions to conflict risks over the last 30 years in Sub-Saharan Africa, the Middle East, and South Asia are 4.25, 4.76, and 10.65 percentage points, respectively. Furthermore, it is found that the Climatic–Social–Geographical (“C–S–G”) patterns that characterize armed conflict risks vary across the three studied regions, while each regional pattern remains relatively stable over time. These findings indicate that when devising defenses against conflicts, it is required to adapt to specific situations in each region to more effectively mitigate the risk of armed conflict and pursue Sustainability Development Goals.
Computational method to create synthetic 3D spider web structures
Authors: Kim Meeri
Published: August 2022

Researchers have developed and applied a computational method based on deep neural networks to model and create complex 3D spider webs.
Improvements to artificial photosynthesis devices
Authors: Johnson-Groh Mara
Published: August 2022

By matching the voltages of photovoltaic modules and electrochemical reactors, researchers improved the energy conversion efficiency in artificial photosynthesis devices.
High speed ultraviolet digital image correlation (UV-DIC) for dynamic strains at extreme temperatures
Authors: Rowley Lindsey J. , Thai Thinh Q. , Dabb Alisa , Hill Benjamin D. , Furman Brandon A. , Berke Ryan B.
Published: August 2022

Digital Image Correlation (DIC) is a camera-based method of measuring full-field displacements and strains from the surface of a deforming object. It can be applied at any length scale (determined by the lenses) and any time scale (determined by the camera), and because it is non-contacting, it can also be used at temperatures much higher than can be withstood by bonded strain gauges. At extreme temperatures, materials emit light in the form of blackbody radiation, which can saturate the camera sensor. It has previously been shown that the emitted light can be effectively screened by using ultraviolet (UV) cameras, lenses, and filters; however, commercially available UV cameras are relatively slow, which limits the speed of combined UV-DIC measurements. In this study, a UV intensifier was paired with a high-speed camera, and its ability to perform UV-DIC at high temperature and high speed was investigated. The system was compared over three different experiments: (A) a quasi-static thermal expansion test at high temperature, (B) a vibration test at room temperature, and (C) the same vibration test repeated at high temperature. The system successfully performed DIC up to at least 1600 °C at frame rates of 5000 fps, which is more than 100 times faster than other examples of UV-DIC in the literature. In all cases, measurements made using the UV intensifier were much noisier than those made without the intensifier, but the intensifier enabled measurements at temperatures well above those which an unfiltered high-speed camera otherwise saturates.
Multispectral time-resolved energy–momentum microscopy using high-harmonic extreme ultraviolet radiation
Authors: Heber Michael , Wind Nils , Kutnyakhov Dmytro , Pressacco Federico , Arion Tiberiu , Roth Friedrich , Eberhardt Wolfgang , Rossnagel Kai
Published: August 2022

A 790-nm-driven high-harmonic generation source with a repetition rate of 6 kHz is combined with a toroidal-grating monochromator and a high-detection-efficiency photoelectron time-of-flight momentum microscope to enable time- and momentum-resolved photoemission spectroscopy over a spectral range of 23.6–45.5 eV with sub-100 fs time resolution. Three-dimensional (3D) Fermi surface mapping is demonstrated on graphene-covered Ir(111) with energy and momentum resolutions of ≲100 meV and ≲0.1 Å−1, respectively. The tabletop experiment sets the stage for measuring the kz-dependent ultrafast dynamics of 3D electronic structure, including band structure, Fermi surface, and carrier dynamics in 3D materials as well as 3D orbital dynamics in molecular layers.
An opto-thermal approach for rotating a trapped core–shell magnetic microparticle with patchy shell
Authors: Bai Wen , Shao Meng , Zhou Jinhua , Zhao Qian , Ji Feng , Zhong Min-Cheng
Published: August 2022

The ability to trap and rotate magnetic particles has important applications in biophysical research and optical micromachines. However, it is difficult to achieve the spin rotation of magnetic particles with optical tweezers due to the limit in transferring spin angular momentum of light. Here, we propose a method to obtain controlled spin rotation of a magnetic microparticle by the phoretic torque, which is originated from inhomogeneous heating of the microparticle’s surface. The microparticle is trapped and rotated nearby the laser focus center. The rotation frequency is several Hertz and can be controlled by adjusting the laser power. Our work provides a method to the study of optical rotation of microscopic magnetic particles, which will push toward both translational and rotational manipulation of the microparticles simultaneously in a single optical trap.
Some insights on the short pulse scattering from a small target. Case study: The PEC sphere revisited
Authors: Zozaya Sahad Alfonso J.
Published: August 2022

In this paper, we revisit the impulse response of a perfectly conducting sphere from a short pulse excitation. From the basics associated with that response, we assess a novel late response turn-on time criterion that we investigate by means of simulation. In this way, we determine a better late response turn-on time criterion compared to the well-established one used in natural resonance estimation algorithms in the literature so far. The results obtained are in agreement with those expected from the theory.
Rapid mechanical property prediction and de novo design of three-dimensional spider webs through graph and GraphPerceiver neural networks
Authors: Lu Wei , Yang Zhenze , Buehler Markus J.
Published: August 2022

Spider webs feature advanced structural performance due to the evolutionary success of over more than 3 × 109 years, including lightweight design and exceptional mechanical properties. Spider webs are appealing for bio-inspired design since web designs serve multiple functions including mechanical protection and prey catching. However, high computational cost and limited quantified web properties render extensive spider web studies challenging in part due to the high structural complexity and randomness of fiber arrangements in 3D webs. Here, we report a computational method to relate spider web graph microstructures to effective mechanical properties, focusing on strength and toughness, and upscaling from the microscopic to the mesoscale level. The new computational framework uses deep neural networks, trained on graph-structured Cyrtophora citricola spider web mechanical data, in order to capture complex cross-scale structural relationships. Three different models are developed and compared. First, two Graph Neural Network (GNN) models, a Graph Convolutional Network, and a Principal Neighborhood Aggregation method. Second, a GraphPerceiver transformer model that is fed similar input data as provided to the GNN approach but within a natural language modeling context using self-attention mechanisms. The GraphPerceiver model can achieve similar performance as the GNN model, offering added flexibility for building deep learning models of diverse hierarchical biological materials. As an application of the model, we propose a computational optimization tool for synthetic web design that is used to generate synthetic, de novo spider web architectures. Finally, multi-objective optimization enables us to discover web structures that meet specific mechanical properties as design objectives.
Taiwan axion search experiment with haloscope: Designs and operations
Authors: Chang Hsin , Chang Jing-Yang , Chang Yi-Chieh , Chang Yu-Han , Chang Yuan-Hann , Chen Chien-Han , Chen Ching-Fang , Chen Kuan-Yu , Chen Yung-Fu , Chiang Wei-Yuan , Chien Wei-Chen , Doan Hien Thi , Hung Wei-Cheng , Kuo Watson , Lai Shou-Bai , Liu Han-Wen , OuYang Min-Wei , Wu Ping-I , Yu Shin-Shan
Published: August 2022

We report on a holoscope axion search experiment near 19.6 µeV from the Taiwan Axion Search Experiment with Haloscope collaboration. This experiment is carried out via a frequency-tunable cavity detector with a volume V = 0.234 liter in a magnetic field B0 = 8 T. With a signal receiver that has a system noise temperature Tsys ≅ 2.2 K and an experiment time of about one month, the search excludes values of the axion–photon coupling constant gaγγ ≳ 8.1 × 10−14 GeV−1, a factor of 11 above the Kim–Shifman–Vainshtein–Zakharov benchmark model, at the 95% confidence level in the mass range of 19.4687–19.8436 µeV. We present the experimental setup and procedures to accomplish this search.
All-day thermoelectric power generation beyond 1 W m−2 regime via radiative heat exchange with space and water-based heat storage
Authors: Alajlan Abdulrahman M. , Almethen Abdurrahman A. , Qasem Hussam
Published: August 2022

While the Sun is a potent energy source, the ultra-cold space has excellent potential for nighttime power generation because of its accessibility at night. Herein, we propose and demonstrate an effective approach that enables all-day energy harvesting using water-based heat storage and radiative thermal emitters across thermometric devices. We experimentally demonstrate all-day power generation with a peak power density of 1.51 W m−2 at daytime and 0.32 W m−2 at nighttime, surpassing the previous experimental records by nearly an order of magnitude. We further develop a theoretical model to validate and predict the power generation performance of the tested system. In addition, we show that the thermoelectric power generation can be enhanced with further optimization. This work opens opportunities to develop scalable, efficient all-day power generation based on thermoelectric devices.
A stable low-symmetry T-phase of MSi2Z4 (M = Mo, W; Z = P, As) nanosheets with promising electronic and photovoltaic properties: Insight from first-principles calculations
Authors: Wang Yanli , Ding Yi
Published: August 2022

The synthesis of MoSi2N4 nanosheets boosts research on the layered MA2Z4 materials, which can be viewed as a MoS2-like MZ2 sheet sandwiched between two AZ surfaces. Most studies focus on the trigonal-prismatic (H-phase) MA2Z4 nanosheets, while the stable octahedral (T-phase) MA2Z4 ones are rarely explored. Here, based on first-principles calculations, we have identified a stable low-symmetry T-phase (Tl-phase) geometry for the MSi2Z4 (M = Mo, W; Z = P, As) materials. Such Tl-MSi2Z4 nanosheets are stabilized by the trimerization of metal atoms, which is distinct from the well-known T′-phase MoS2 system that favors the metal dimerization instead. The investigated Tl-MSi2Z4 nanosheets are all direct-gap semiconductors with moderate gap sizes around 1 eV and hence exhibit a strong absorption capacity to visible lights. High hole mobilities of 104–105 cm2/V s appear in the Tl-MSi2Z4 nanosheets that are dozens to hundreds of times larger than the electron mobilities. Moreover, superior photovoltaic performances are present in these Tl-MSi2Z4 materials, whose power-conversion efficiencies are estimated up to 26.1%–31.8% in a few micrometer thickness. In particular, the photovoltaic efficiency of the Tl-MoSi2P4 system can surpass the Shockley–Queisser limit and reaches 36.9%–39.5% under the concentration of 100–1000 suns illumination. Our study demonstrates that peculiar distorted T-phase geometries can exist in the layered MA2Z4 family, which exhibit promising electronic, transport, and photovoltaic behaviors for nanoelectronics, nano-devices, and green-energy applications.
New exact solutions of nonlinear Schrödinger equation with extended rational sin–cos and sinh–cosh method
Authors: Ahmadi Karchi Nikan , Ghaemi Mohammad Bagher , Vahidi Javad
Published: August 2022

This paper employs the extended rational sin–cos and sinh–cosh method to construct precise solutions to the nonlinear Schrödinger equation. It is illustrated that the proposed technique provides a foremost and effectual mathematical tool for solving numerous types of partial differential equations applied in mathematics, optics, physics, and chemical engineering. We obtain the consequences of periodic, dark, and bright solutions. Furthermore, we can imagine the acquired solutions by drawing two-dimensional and three-dimensional plots.