bluuebunny/crossref_metadata_2025 huggingface dataset:
“Giving the gift of life twice”: Understanding the lived experiences of parent donors and non-donors in pediatric haploidentical hematopoietic cell transplantation
Authors: Schaefer Megan , Aguilera Vanessa , Parris Kendra , Long Alanna , Triplett Brandon , Phipps Sean
Published: September 2021

Background: The use of parental donors in pediatric haploidentical
hematopoietic cell transplantation is increasing, but research on the
psychosocial impact of parental donation is currently limited. We
conducted a retrospective, qualitative study to explore parental
perceptions of the donation process and the impact of being a donor (or
non-donor) on parents’ adjustment and coping with their child’s
transplant experience. Methods: Parents/caregivers of children who
underwent transplantation with a parental donor or a matched unrelated
donor (N = 136) participated in interviews and completed an open-ended
questionnaire. Both bereaved parents and parents of survivors were
surveyed. Results: Six themes were identified in the data: level of
understanding and satisfaction; perception of choice; preparation for
donation; perceptions of donation and infusion; benefit-finding; and
psychological impact of transplantation. Most parents were satisfied
with the information they received and reported a good understanding of
transplantation and donation procedures. Parents were divided on
perspectives of choice, but their responses reflect that the necessity
of saving their child’s life does not allow for choice. They described
considerable effort to prepare for transplantation, physically,
emotionally, and logistically. Parents acknowledged the psychological
impact while identifying positive outcomes that resulted from their
child’s transplant journey. Conclusions: Results highlight the unique
experiences of parental donors and non-donors from the anticipation
phase to the completion of their child’s transplant. Additionally,
findings inform supportive care guidance by highlighting the need to
assess parental donors’ emotional functioning, provide support
post-donation, and conduct bereavement follow-up.
SIROLIMUS EFFICACY IN THE TREATMENT OF CRITICALLY- ILL INFANTS WITH CHYLOUS EFFUSIONS
Authors: Agarwal Shreya , Anderson Berkley , Mahajan Priya , Fernandes Caraciolo , Margolin Judith , Iacobas Ionela
Published: September 2021

Background: While rare in children, chylothorax is a significant cause
of respiratory morbidity and can lead to malnutrition and
immunodeficiency. Historically, the traditional pharmacological
treatment has been octreotide. There are several treatments that have
been utilized in the past few years including sirolimus, however data
regarding their efficacy and outcomes is limited. Furthermore, sirolimus
has proven efficacy in complex vascular malformations, and hence, its
utility/efficacy in pediatric chylous effusions warrants further
investigation. Methods: In this retrospective study at Texas Children’s
Hospital, data were extracted for all patients with chylothorax who were
treated with sirolimus between 2009 and 2020. Details regarding
underlying diagnosis, co-morbidities and number of days from sirolimus
initiation to resolution of effusion were collected. Descriptive
statistics were used to analyze the study cohort. Results: Initially a
total of twelve infants were identified. Among them, seven patients had
complete data and were included in the study. The mean duration of
sirolimus treatment needed for chest tube removal was 16 days, with a
median of 19 days and range of 7- 22 days. Chest tube output
corresponded with sirolimus serum trough levels and trended down prior
to chest tube removal. Conclusion: With close monitoring, sirolimus is a
safe and effective therapy for pediatric lymphatic effusions even in
critically-ill infants. The study also demonstrates shorter duration of
chest tube requirement after initiation of sirolimus compared to
previous studies. Our conclusion is based on a small case series due to
the rare incidence of the condition.
Constrictive pericarditis with extensive pericardial calcification: case report and review of literature
Authors: Mahajan Pranav , Naik Anant , Aedma Surya , Ally Saeed , Mehta Sanjay
Published: September 2021

Constrictive pericarditis refers to inflammation of the pericardial sac,
possibly leading to acute heart failure. More than 80% cases are
presumed to be due to recent or remote viral illnesses. Prominent
features include chest pain, dyspnea and electrocardiogram (ECG)
revealing P-R segment depression, diffuse concave ST segment elevation,
and T-wave inversion. Echocardiogram and cardiac magnetic resonance
imaging (MRI) can help establish diagnosis. Over time, the pericardium
can undergo fibrosis or calcification resulting in excessive symptoms.
After medical management with ibuprofen, colchicine or steroids, partial
or complete pericardiectomy is considered. We are presenting a case with
constrictive pericarditis due to extensive pericardial calcification,
and ultimate resolution with pericardiectomy.
Acute Aortic Syndrome in Marfan Syndrome with Chest Pain and Negative Initial Imaging
Authors: Rokui Sorush , Percy Edward , Price Joel
Published: September 2021

A 25-year-old male with Marfan Syndrome and previous aortic root surgery
presented with severe chest and upper back pain. Initial CT angiogram
showed mild aortic dilatation but no acute dissection. Anti-impulse
therapy was initiated. Five days after presentation, follow-up CT
angiography revealed a new pseudoaneurysm of the descending thoracic
aorta. The patient underwent replacement of the mid-descending thoracic
aorta with a collagen-impregnated woven polyester tube graft without
complication. Despite negative initial imaging and relatively small
aortic size, patients with Marfan Syndrome with acute chest pain should
be treated with high suspicion and may benefit from admission and serial
imaging.
Long-term consequences of trans-radial catheterization on the radial artery
Authors: Clarke Nicholas , Jagannathan Geetha , Lawton Jennifer
Published: September 2021

Background: The radial artery (RA) is often utilized for diagnostic
coronary angiography and percutaneous intervention. Recent high-level
evidence supports RA use in preference to saphenous vein as a conduit
for coronary revascularization. Aim: To demonstrate gross and histologic
changes of the RA following transradial access. Methods: We present two
patients who had open RA harvest for coronary bypass surgery after
transradial catheterization. Results: Examination 8 years after
transradial catheterization demonstrated thickened intima and
dissection, and examination 12 years following transradial
catheterization with percutaneous coronary intervention demonstrated
chronic dissection with thickened intima and near occlusion of the
lumen. Conclusion: Transradial access via the RA, even after several
years, is associated significant injury, making it unusable as a conduit
for surgical coronary revascularization. A RA that has been utilized for
catheterization should not be considered for coronary revascularization.
Angioedema severity and impacts on quality of life: chronic histaminergic angioedema versus chronic spontaneous urticaria
Authors: Sabate-Bresco Marina , Rodríguez-Garijo Nuria , AZOFRA JULIÁN , Baeza María L. , Donado Carmen Diaz , Gaig Pere , Guilarte Mar , Herrera-Lasso Valeria , Labrador-Horrillo Moises , Sala-Cunill Anna , Veleiro Beatriz , Gil Pilar , Ferrer Marta
Published: September 2021

Background: Chronic histaminergic angioedema (CHA) is defined
as recurrent episodes of isolated angioedema (without hives) of unknown
cause that respond to the same treatment as chronic spontaneous
urticaria (CSU). Quality of life (QoL) studies have not been performed
for CHA, except those carried out in the context of CSU associated with
angioedema attacks (CSU-AE). Moreover, biomarkers for monitoring disease
activity in CHA have not been identified. We aim to describe the burden
of CHA and impact on patient QoL, compare the findings to those in
CSU-AE patients, and investigate biomarker associations with disease
severity and QoL parameters. Methods: We performed a
prospective multicenter study that included 68 patients with CHA and 63
patients with CSU-AE. Demographic and clinical variables were collected.
Validated patient-reported questionnaires were employed to analyze the
quality of life and disease activity. Blood and serological parameters,
including blood cell count, C-reactive protein, D-dimer and total IgE,
were also analyzed. Results: Angioedema disease activity was
significantly higher in CSU-AE patients (median AAS7, IQR: 1,
[0–1]) than CHA patients (0, [0–1]; p= 0.022). A considerable
impact on QoL was found in both groups, although significantly worse
values were found for CSU-AE (median AEQoL, IQR: 37, [10–65];
p=0.005). CHA patients were older than CSU-AE patients, and female
predominance was not observed. Conclusions: Angioedema severity
and QoL impacts are significantly worse in CSU than in chronic
histaminergic angioedema. Angioedema should be included in severity
urticaria scores (UAS) as well as in specific quality of life urticaria
scales.
The Intestine-lung Trafficking of Memory-like Group 2 Innate Lymphoid Cells Orchestrates Asthma Relapse
Authors: Bao Kaifan , Zhou Yijing , Chen Yanyan , Wang Meiling , Yuan Weiyuan , Yu Xuerui , Zhang Yuheng , Xu Yifan , Shi Liyun , Zheng Jie , Hong Min
Published: September 2021

Background: Recent works imply that immune memory might be
expanded to group 2 innate lymphoid cells (ILC2s), but the cellular and
molecular bases are largely unknown. Here, we investigated the memory
and migrating properties of Lin KLRG1
IL-17RB ILC2s (herein referred as
mILC2s) and their contribution to asthma relapse. Methods:
Clinical asthmatic subjects and HDM-induced mice asthma models were
applied to investigate the memory-like characteristics of mILC2s
including greater effector cytokine-producing potential and in
vivo persistence. Parabiosis pairs of CD45.1 and
CD45.2 mice were employed to determine whether
mILC2s were circulating cells. Adoptive transplantation was performed to
analyze the origin of the mILC2s accumulated in airway upon asthma
relapse. CCR9 and S1P signaling blockade were used to confirm the
migration of mILC2s during different asthma phases by In vivo
imaging. KLRG1 neutralization was utilized to analyze the role of mILC2s
in asthma relapse on Rag1 mice.
Results: mILC2s persisted in vivo and retained the
potency of producing IL-13 and re-inducing allergic responses.
Critically, parabiosis study and in vivo imaging showed that the
vast majority of mILC2s migrated to and resided in small intestine
during asthma remission, and subsequently moved to airway upon
re-encountering antigens, regulated by CCR9 and S1P signaling. Blockade
of S1P signaling markedly limited secondary exposure-induced airway
inflammation. Furthermore, KLRG1 neutralization attenuated asthmatic
responses of Rag1 mice, supporting a
pivotal role for mILC2s in mediating asthma relapse independent of
adaptive immune cells. Conclusion: mILC2s exhibit memory-like
and lung-small intestine migratory properties, which empowers them to
drive asthma relapse.
Impact of the COVID-19 pandemic on surgery for severe endometriosis in the UK: a national database study
Authors: Lewin Jonathan , Saridogan Ertan , Byrne Dominic , Clark T Justin , Vashisht Arvind
Published: September 2021

Objective: To determine the impact of the COVID-19 pandemic on surgery
for severe endometriosis in the UK at a national, regional and
centre-level. Design: Population-based national cohort study.
Population: All women undergoing endometriosis surgery requiring
dissection of the pararectal space in the UK from 2017 to 2020
inclusive. Methods: The British Society for Gynaecological Endoscopy
(BSGE) collects data nationally on all operations for severe
endometriosis which involve dissection of the pararectal space. Annual
audits of this database were obtained from the BSGE. Publicly available
data on COVID-19 deaths and population were obtained from the UK Office
for National Statistics. Main outcome measures: Numbers of annual
BSGE-registered endometriosis operations. Results: A total of 5916
operations were performed. The number of operations decreased by 49.4%
overall between 2019 and 2020. The number of endometriosis centres
remained the same, however the median number of operations per centre
decreased from 21 to 12.5, with a median percentage decrease at each
centre of 51.0% (IQR 29.4% – 75.0%). There was no significant change
in the type of surgery performed. All 11 administrative regions of Great
Britain had reduced numbers of BSGE-registered operations in 2020
compared with the average for 2017-2019, with a median 56.6% decrease
(range 6.13% - 68.62%). Regional reduction in operations was
significantly correlated with COVID-19 death rates (r=0.557, 95% CI of
r 0.048 – 1.00, p=0.037). Conclusions: There has been a dramatic fall
in the number of operations for severe endometriosis in Britain during
the COVID-19 pandemic.
The journey from infertility to uterus transplantation: A mixed-methods study of the perspectives of participants in the Dallas Uterus Transplant Study (DUETS)
Authors: Wall Anji , Johannesson Liza , Sok Monica , Warren Ann Marie , Gordon Elisa , Testa Giuliano
Published: September 2021

Objective: To study the impact of absolute uterine factor infertility
(AUFI) and uterus transplantation (UTx) on women, and UTx recipients’
perceptions of Utx and reproductive autonomy Design: Convergent
mixed-methods study. Setting: UTx program in a large academic medical
centre in the United States. Population/Sample: 20 Utx recipients
Methods: A medical chart review was conducted to collect patient
demographic information, and clinical outcomes. Semi-structured
interviews collected information regarding participants’ experience.
Main Outcome Measure(s): The outcomes of interest were participants’
experience of infertility, experience with UTx, and general perceptions
of UTx. Results: 7 participants were pregnant (one with a second child),
6 had experienced early graft failure and removal, 5 had delivered a
healthy baby, and 4 had a viable graft and were awaiting embryo
transfer. The primary themes identified were: the negative impact of
AUFI diagnosis on psychological wellbeing, relationships, and female
identity; the positive impact of UTx on healing the emotional scars of
AUFI, female identity, and value of research trial participation; and
the perception of UTx as an expansion of reproductive autonomy. All
participants reported Utx was worthwhile, regardless of individual
outcome. On bivariate analysis, disease aetiology, having a child after
uterus transplantation, experiencing graft failure and current pregnancy
were not significantly associated with the impact of AUFI or of UTx on
participants’ identities. Conclusion: AUFI has a negative impact on
women from a young age, affects multiple relationships, and challenges
female identity. UTx helps reverse this impact, transforming women’s
life narrative of infertility and enhancing female identity.
Increased risk of abortion after frozen-thawed embryo transfer in women with polycystic ovary syndrome phenotypes A and D
Authors: Wang Qiumin , Zheng Yanjun , Li Ping , Zhang Guanqun , Gao Shanshan , Wang Ze , Hao Baozhen , Shi Yuhua
Published: September 2021

Abstract Objectives: To investigate pregnancy outcomes after
frozen-thawed embryo transfer (FET) according to polycystic ovary
syndrome (PCOS) phenotypes. Design: Retrospective study. Setting:
University-based centre for reproductive medicine. Participants: 8903
patients who underwent FET between January 2017 and October 2019.
Methods: All patients were divided into PCOS and control groups, with
the former categorised into four phenotype groups (PCOS phenotypes A, B,
C, D) based on Rotterdam criteria. All patient data were retrospectively
collected and evaluated. Main outcome measures: Pregnancy outcomes after
FET consisted of biochemical, clinical and ectopic pregnancies,
abortion, premature delivery and live birth. Results: Women with PCOS
phenotype A experienced an increased incidence of biochemical pregnancy,
clinical pregnancy and premature delivery compared to those with PCOS
phenotype D and in the control group (P < 0.001, P = 0.005, P
= 0.006, respectively), while incidences of ectopic pregnancy and live
birth were comparable between all groups (P > 0.05). We
found significantly higher abortion (P = 0.010) and lower ongoing
pregnancy (P = 0.023) rates for women with PCOS phenotypes A and D
compared to those in the control group. After adjusting for potential
confounders, PCOS phenotypes A and D (vs. control) were associated with
an elevated risk of abortion (adjusted odds ratio [OR], 1.476, 95%
confidence interval [CI], 1.077–2.024, P = 0.016; adjusted OR,
1.348, 95% CI, 1.080–1.682, P = 0.008, respectively). Conclusions: For
the first time, our study demonstrates that women with PCOS phenotypes A
and D show an increased risk of abortion after FET.
MANAGING PLACENTA ACCRETA SPECTRUM IN LOW RESOURCE SETTING USING A NOVEL DISSECTION-FREE AORTA CLAMP: OPERATIVE TECHNIQUE
Authors: Paily Vakkanal , Sidhik Afshana , Raj Raji , Sudhamma Ajithakumari , Joseph Joshy , Usha M.G , George Raymond , Ramakrishnan Soumya , Cheriyan Sara , John Teena , Pradeep Manu
Published: September 2021

A novel over-the-peritoneum aorta clamp enabled a senior obstetrician,
backed by a urologist, to manage 33 women with histopathology-confirmed
Placenta Accreta spectrum, with no maternal mortality, relatively low
incidence of blood transfusion and urological injuries in a limited
resource setting. Easily applied by the obstetricians themselves, this
clamp can be an effective and relatively safer alternative to
intra-aortic balloon occlusion and aortic-cross clamping. We anticipate,
obstetricians in low-resource settings can easily adapt our methods and
contribute further prospective evidence.
Socioeconomic Disparities in Surveillance and Follow-Up of Patients with Thoracic Aortic Aneurysm
Authors: Shang Michael , Weininger Gabe , Mori Makoto , Kahler-Quesada Arianna , Degife Ellelan , Brooks Cornell , Williams Matthew , Assi Roland , Geirsson Arnar , Vallabhajosyula Prashanth
Published: September 2021

Background: Thoracic aortic aneurysm is a significant risk factor for
aortic dissection and rupture. Guidelines recommend referral of patients
to a cardiovascular specialist for periodic surveillance imaging with
surgical intervention determined primarily by aneurysm size. We
investigated the association between socioeconomic status and
surveillance practices in patients with ascending aortic aneurysms.
Methods: We retrospectively reviewed records of 465 consecutive patients
diagnosed between 2013-2016 with ascending aortic aneurysm ≥4cm on
computed tomography scans. Primary outcomes were clinical follow-up with
a cardiovascular specialist and aortic surveillance imaging within 2
years following index scan. We stratified patients into quartiles using
the area deprivation index (ADI), a validated percentile measure of 17
variables characterizing socioeconomic status at the census block group
level. Competing risks analysis was used to determine interquartile
differences in risk of death prior to follow up with a cardiovascular
specialist. Results: Lower socioeconomic status was associated with
significantly lower rates of surveillance imaging and referral to a
cardiovascular specialist. On competing risks regression, the ADI
quartile with lowest socioeconomic status had lower hazard of follow-up
with a cardiologist or cardiac surgeon prior to death (HR 0.46 [0.34,
0.62], p<0.001). Though there were no differences in
aneurysm size at time of surgical repair, patients in the lowest
socioeconomic quartile were more frequently symptomatic at surgery than
other quartiles (92% vs 23-38%, p<0.001). Conclusion:
Patients with lower socioeconomic status receive less timely follow-up
imaging and specialist referral for thoracic aortic aneurysms, resulting
in surgical intervention only when alarming symptoms are already
present.
Risk Factors for Atrial Fibrillation following a Cardiac Surgery
Authors: Marai Ibrahim , Khatib Wiaam , Grosman-Rimon Liza , Carasso Shemy , Sakhnini Ali , Birati Edo , Kachel Erez
Published: September 2021

Background: Atrial fibrillation (AF) following cardiac surgery is common
and has clinical impact on morbidity. The preoperative and
intraoperative risk factors are still not well defined. The objective of
the study was to examine preoperative and intraoperative risk factors
for AF following cardiac surgery. Methods: A retrospective analysis of a
database of cardiac surgeries was performed during 2017-2019 at Poriya
Medical Center. Preoperative factors and intraoperative were recorded.
Results: 208 patients were included in this analysis. Overall AF
following cardiac surgery was detected in 50 (24%) patients. Of 175
patients who did not have history of AF prior to surgery, 27 (15.5%)
had post-operative AF. In the 33 patients with previous AF, AF following
surgery was detected in 23 (70%). Patients with AF following surgery
who were older (66.2±8.0 vs. 60.7± 11.4 years, p=0.002), were treated
more with anti-arrhythmic drugs (18.9% vs 4.5, p<0.001), and
had higher rates of pre-operative AF (46% vs 6.3%, p=0.0001), prior
cerebral vascular accidents (14% vs 4.4%, p=0.019), and prior valve
replacement (10% vs 1.9%, p=0.009) compared to patients without AF
following surgery. In multivariate Cox regression analysis, age (HR
1.04, CI 1.01-1.07, P=0.006) and history of preoperative AF (HR 6.01, CI
3.42-10.57, P<0.001) were predictors of AF following cardiac
surgery. The probability of being free of postsurgical AF was 80% among
patients without history of AF compared to 30% in patients with
previous AF history (p<0.001). Conclusion: Preoperative AF and
age were predictors of AF following cardiac surgery
Transapical ultrasound-guided myectomy in midventricular obstructive hypertrophic cardiomyopathy
Authors: Yokota Yutaka , Hirota Masanori , Suezawa Takanori , Kawabata Takuya , Kuroko Yosuke , Kotani Yasuhiro , Kasahara Shingo
Published: September 2021

In patients with midventricular obstructive hypertrophic cardiomyopathy
(HCM), a transapical approach allows excellent exposure for
midventricular myectomy. Although the ventriculotomy is required on the
antero-lateral left ventricular wall, the minimal ventriculotomy would
be ideal, especially for cases with concomitant apical aneurysm. We
report a case of midventricular obstructive HCM with concomitant apical
aneurysm. Through the minimal ventriculotomy within the aneurysm, the
hypertrophic septum was successfully hollowed out under repeated
ultrasound guidance. Intraoperative ultrasound guidance is useful for
transapical septal myectomy in midventricular obstructive HCM.
Left Atrial Appendage Exclusion in Patients with Atrial Fibrillation: Should it become Standard of Care?
Authors: Magarakis Michael , Sarris-Michopoulos Panagiotis
Published: September 2021

Atrial Fibrillation (AF) is the most common arrhythmia affecting the
general population, with the prevalence projected to reach 12.1 million
cases in 2030. Recently, attention has focused on the role of the Left
Atrial Appendage (LAA) and its association with the most feared
complication of AF: thromboembolism. Common sense indicates that the LAA
should be excluded in all patients with AF; however, procedures to
exclude the LAA have yet to become the standard of care. Recent studies
in the cardiac surgery literature , , indicate a clear benefit of LAA
exclusion amongst patients with AF undergoing cardiac surgery.
Interestingly, this benefit was found to extend well beyond the
postoperative period, in cohorts that were equally anticoagulated and
had similar CHA2DS2-VASC scores. It appears reasonable that our medical
community should strongly consider initiating a prospective randomized
trial in an effort to fully elucidate the need for routine LAA exclusion
in this patient population.
Coronary artery vasculitis in a patient of Behçet’s disease.
Authors: Wei Haiyang , Xu Zhenqiang , Hu Bin , Zou Chengwei , Zhang Gang
Published: September 2021

We report a case of coronary artery vasculitis in Behçet’s disease. The
patient was treated with the off-pump coronary artery bypass grafting.
This case shows the diagnostic value of coronary computed tomography
angiography in coronary artery inflammatory disease.
Florida Sleeve is a Safe and Effective Technique for Valve Salvage in Acute Stanford Type A Aortic Dissection
Authors: Alhussaini Mahmoud , Jeng Eric , Martin Tomas , Filion Amber , Beaver Thomas , Arnaoutakis George
Published: September 2021

Objective: Valve-sparing root replacement is commonly used for
management of aortic root aneurysms in elective setting, but its
technical complexity hinders its broader adoption for acute Type-A
Aortic Dissection (ATAAD). The Florida Sleeve (FS) procedure is a
simplified form of valve sparing aortic root reconstruction that does
not require coronary reimplantation. Here, we present our outcomes of
the Florida Sleeve (FS) repair in patients with dilated roots in the
setting of an ATAAD. Methods: We retrospectively reviewed 24 consecutive
patients (2002-2018) treated with FS procedure for ATAAD. Demographic,
operative, and postoperative outcomes were queried from our
institutional database. Long term follow-up was obtained from clinic
visits for local patients, and with telephone and telehealth measures
otherwise. Results: Mean age was 49 ± 14 years with 19 (79%) males.
Marfan syndrome was present in 4 (16.7%) patients and 14 (58.3) had ≥2+
aortic insufficiency (AI). Nine (37.2%) had preoperative mal-perfusion
or shock. The FS was combined with hemi-arch replacement in 15 (62.5%)
patients and a zone-2 arch replacement in 9 (37.5%) patients. There
were 2 (8.3%) early postoperative mortalities. Median follow-up period
was 46 months (range; 0.3-146). The median survival of the entire cohort
was 143.4 months. One patient (4.2%) required redo aortic valve
replacement for unrelated aortic valve endocarditis at 30 months
postoperatively. Conclusion: FS is simplified and reproducible
valve-sparing root repair. In appropriate patients, it can be applied
safely in acute Stanford type-A aortic dissection with excellent early
and long-term results.
Linear IgA/IgG bullous dermatosis successfully treated with omalizumab: A Case report
Authors: Haulrig Morten Bahrt , Nielsen Signe , Elberling Jesper , Skov Lone
Published: September 2021

Linear IgA/IgG bullous dermatosis (LAGBD) is a rare, autoimmune
blistering skin disease. We report a case of LAGBD in a 70-year-old
woman. All common treatments were discontinued due to side effects or
lack of treatment response. The patient was successfully treated with
omalizumab which cleared her lesions after three months.
Epidural unilateral stimulation with “Adaptive Stim” option in treatment of type II CRPS
Authors: Simonyan Armen Samvelovich , Tyurnikov Vladimir Mikhaylovich , Simonyan Anna Dmitrievna , Gushcha Artem Olegovich
Published: September 2021

CRPS is a type of severe pain syndrome and can be triggered by previous
surgery or trauma. CRPS type II is associated with a confirmed nerve
injury. We want to present to your attention a case report of successful
treatment of CRPS type II using unilateral epidural stimulation.
Deep dorsal penile vein thrombosis in a patient with Covid-19 Infection: A rare complication and the first reported case
Authors: Bagheri Seyed Morteza , Tabrizi Zhale
Published: September 2021

Covid-19 infection may have extrapulmunary manifestations such as blood
hypercoagulability that may causes thrombosis in both arterial and
venous system.Deep dorsal penile vein thrombosis is very rare and the
most common cause is coagulation disorders.It causes penile pain
especially during erection and it is diagnosed by ultrasound.
A case report of open appendectomy in treating acute perforated appendicitis with necrotizing fasciitis of the abdominal wall: a rare complication of a common disease*
Authors: Hosseinzadeh Rezvan , Rakhsha Mohsen , kazemi Kataneh , behnamfar Morteza
Published: September 2021

We present a case of a 37-year-old woman referred to our hospital with a
1-week history of significant weakness, anorexia, and mild abdominal
pain. According to laboratory and radiographic data, the patient was
diagnosed with perforated appendicitis and gangrene.
Pharyngeal-Cervical Brachial Variant of Guillain-Barré syndrome mistaken for a case of Surgical Dysphagia
Authors: Marshal Megan
Published: September 2021

We present the case of a 41 year old gentleman who was admitted to
hospital with a presumed case of surgical dysphagia. A clinical
diagnosis of pharyngeal-cervical-brachial variant of Guillain-Barré
Syndrome was made and he treated with a 5 day course of IVIG resulting
in gradual but signigicant symptomatic relief.
Triple-component Mixed Neuroendocrine-Nonneuroendcocrine Neoplasm of the duodenum: A rare case report
Authors: Khemiri Souhir , Masmoudi Sonda , Yaich Asma , Boudawara Ons , Aloulou Samir , khanfir afef
Published: September 2021

Mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) are an
heterogeneous subgroup of rare neoplasms. Triple componed MiNEN
associating neuroendocrine tumor, adenocarcinoma and squamous cell
carcinoma are rarely described in the literature. Here we present the
unique case of a 56-year-old women with neuroendocrine tumor,
adenocarcinoma and squamous cell carcinoma of the duodenum
A PUZZLING HEPATIC TUMOR: EPITHELIOID ANGIOMYOLIPOMA WITH A MINOR ADIPOCYTIC COMPONENT
Authors: Limaiem F. , BACCOUCH Seifeddine , BOUJELBENE Nadia , ATALLAH Aziz , HAJRI Mohamed , GABSI Sofiene , Farhat Leila Ben , bouraoui saadia
Published: September 2021

Hepatic epithelioid angiomyolipomas are uncommon mesenchymal neoplasms.
They are difficult to diagnose by imaging, especially when the fatty
component is scant or absent. The gold standard for the diagnosis is
histologic examination coupled with an immunohistochemical study.
Positive HMB-45 immunostaining of the myoid cells is a major diagnostic
feature.
Improvement of Depression in a Patient with Hypothyroidism and Deiodinase Polymorphism with LT3 Therapy
Authors: Ahmed Ziyan , Sherin Rinsha , Hoang Thanh , Fonseca Tatiana , Shakir Mohamed
Published: September 2021

We report a 54-year-old man with treatment-resistant depression (TRD)
and hypothyroidism who responded to LT3/LT4 combination, rather than LT4
alone. He was able to discontinue all antidepressant medications
eventually. Interestingly, the patient has a DIO2 polymorphism.
Acute Macular Neuroretinopathy as a Manifestation of Coronavirus Disease 2019: a Case Report
Authors: Masjedi Marjan , Hosseini Nastaran Sadat , Pourazizi Mohsen
Published: September 2021

This is a new case of simultaneous occurrences of AMN and COVID-19 in a
previously healthy woman. The importance of the current report lies in
increasing the awareness of all physicians about the probable
association of COVID-19 with retinal vascular injury and ischemia.
Midfacial development and the wisdom of teeth: A case series
Authors: Singh G. Dave , Lee Sangmin
Published: September 2021

The alignment of third molars has largely been overlooked by
orthodontists. Since difficulties arise during their eruption, a
plethora of surgical procedures is advocated for their management,
including prophylactic extraction. This case series describes the use of
midfacial development in 4 patients and illustrates successful patterns
of third molar eruption.
A Rare Case Report of Deep Vein Thrombocytosis associated with Brucellosis in Iran
Authors: Ghafouri Majid , Danafar Mojtaba , Shokri Azar
Published: September 2021

Brucellosis is among the most prevalent zoonotic diseases that can
involve almost any organ. Here we present a case of deep vein thrombosis
due to human brucellosis. We described a 62 old male farmer with a
history of brucellosis and deep vein thrombosis on his right leg
Besov-Hankel norms in terms of the continuous Bessel wavelet transform
Authors: Pathak Ashish , Kumar Dileep
Published: September 2021

Using the theory of continuous Bessel wavelet transform in $L^2
(\mathbb{R})$-spaces, we established the Parseval and
inversion formulas for the
$L^{p,\sigma}(\mathbb{R}^+)$-
spaces. We investigate continuity and boundedness properties of Bessel
wavelet transform in Besov-Hankel spaces. Our main results: are the
characterization of Besov-Hankel spaces by using continuous Bessel
wavelet coefficient.
Special decompositions and linear superpositions of nonlinear systems: BKP and dispersionless BKP equations
Authors: Hao Xiazhi , Lou Senyue
Published: September 2021

The existence of decomposition solutions of the well-known nonlinear BKP
hierarchy is analyzed. It is shown that these decompositions provide
simple and interesting relationships between classical integrable
systems and the BKP hierarchy. Further, some special decomposition
solutions display a rare property: they can be linearly superposed. With
the emphasis on the case of the fifth BKP equation, the structure
characteristic having linear superposition solutions is analyzed.
Finally, we obtain similar superposed solutions in the dispersionless
BKP hierarchy.
Global existence and asymptotic behavior for a generalized Boussinesq type equation without dissipation
Authors: Liu Guowei , Wang Wei , Xu Qiuju
Published: September 2021

In this paper, we study the Cauchy problem for a generalized Boussinesq
type equation in $\mathbb{R}^n$. We establish a
dispersive estimate for the linear group associated with the generalized
Boussinesq type equation. As applications, the global existence, decay
and scattering of solutions are established for small initial data.
Lie Symmetries, Painlev\’{e} analysis and global dynamics for the temporal equation of radiating stars
Authors: Leon Genly , Govender Megandhren , Andronikos Paliathanasis
Published: September 2021

We study the temporal equation of radiating stars by using three
powerful methods for the analysis of nonlinear differential equations.
Specifically, we investigate the global dynamics for the given master
ordinary differential equation to understand the evolution of solutions
for various initial conditions as also to investigate the existence of
asymptotic solutions. Moreover, with the application of Lie’s theory, we
can reduce the order of the master differential equation, while an exact
similarity solution is determined. Finally, the master equation
possesses the Painlev\’{e} property, which means that
the analytic solution can be expressed in terms of a Laurent expansion.
Early post-induction Augmented therapy improves outcome in children and adolescents with T-cell acute lymphoblastic leukemia
Authors: Shanap Mayada Abu , Aljbour Haytham , Rihani Rawad , Hashem Hasan , Ghosh Amal Abu , Tbakhi Abdelghani , Kamal Nazmi , Sultan Iyad , Madanat Faris
Published: September 2021

Introduction: T-cell acute lymphoblastic leukemia (T-ALL) accounts for
approximately 15% of all newly diagnosed ALL in children and
adolescents and is associated with worse outcomes compared to pre-B ALL.
We aimed to decrease T-ALL relapses by intensifying our regimen.
Methods: Patients with T-ALL were treated using two different regimens;
before September 2014, patients were treated per St. Jude Total XV
protocol; subsequently, a major change was adopted by adding two
intensive blocks: FLAG and Re-Intensification (fludarabine,
dexamethasone, cytarabine, etoposide and asparaginase). Cranial
radiation was limited to patients with WBC >=100k/µl at
diagnosis and/or patients with CNS2/CNS3 status. Results: Between June
2005 and April 2020, a total of 100 patients (76 males) were treated and
followed for a median of 70 months (range, 14-181 months). Median age at
diagnosis was 9 years (range,0.5-17.8 years). Forty-eight patients were
diagnosed after September 2014 and received the augmented regimen; their
median follow up was 46 months (range,14-74 months). The 5-yr-EFS
estimates for patients who received the augmented regimen vs. standard
regimen were 87%±4.9% vs 67%±6.8% (p=0.03); and the 5-yr-OS
estimates were 87%±5.1% vs. 71%±6.3% (p=0.06) respectively.
Treatment related mortality (TRM) were reported in 2 patients treated
using our standard regimen but none for patients who received the
augmented regimen. Conclusions: We implemented a novel approach with
early intensification added to a backbone of modified St. Jude Total-XV
regimen for patients with T-ALL that resulted in improved outcome with
no treatment related mortality.
Community Predictors of COVID-19 Cases and Deaths in Massachusetts: Evaluating Changes Over Time Using Geospatially Refined Data
Authors: Spangler Keith , Patil Prasad , Peng Xiaojing , Levy Jonathan , Lane Kevin , Tieskens Koen , Carnes Fei , Klevens R. Monina , Erdman Elizabeth , Troppy T. , Fabian M. , Leibler Jessica
Published: September 2021

Background: The COVID-19 pandemic has highlighted the need for targeted
local interventions given substantial heterogeneity within cities and
counties. Publicly available case data are typically aggregated to the
city or county level to protect patient privacy, but more granular data
are necessary to identify and act upon community-level risk factors that
can change over time. Methods: Individual COVID-19 case and mortality
data from Massachusetts were geocoded to residential addresses and
aggregated into two time periods: “Phase 1” (March–June 2020) and
“Phase 2” (September 2020–February 2021). Institutional cases
associated with long-term care facilities, prisons, or homeless shelters
were identified using address data and modeled separately. Census tract
sociodemographic and occupational predictors were drawn from the
2015-2019 American Community Survey. We used mixed-effects negative
binomial regression to estimate incidence rate ratios (IRRs), accounting
for town-level spatial autocorrelation. Results: Case incidence was
elevated in census tracts with higher proportions of Black and Latinx
residents, with larger associations in Phase 1 than Phase 2. Case
incidence associated with proportion of essential workers was similarly
elevated in both Phases. Mortality IRRs had differing patterns from case
IRRs, decreasing less substantially between Phases for Black and Latinx
populations and increasing between Phases for proportion of essential
workers. Mortality models excluding institutional cases yielded stronger
associations for age, race/ethnicity, and essential worker status.
Conclusions: Geocoded home address data can allow for nuanced analyses
of community disease patterns, identification of high-risk subgroups,
and exclusion of institutional cases to comprehensively reflect
community risk.
Some results of Watson, Plancherel type integral transforms related to the Hartley, Fourier convolutions and applications
Authors: Trinh Tuan
Published: September 2021

In this work, we study the Watson-type integral transforms for the
convolutions related to the Hartley and Fourier transformations. We
establish necessary and sufficient conditions for these operators to be
unitary in the L 2 (R) space and get their inverse represented in the
conjugate symmetric form. Furthermore, we also formulated the
Plancherel-type theorem for the aforementioned operators and prove a
sequence of functions that converge to the original function in the
defined L 2 (R) norm. Next, we study the boundedness of the operators (T
k ). Besides, showing the obtained results, we demonstrate how to use it
to solve the class of integro-differential equations of Barbashin type,
the differential equations, and the system of differential equations.
And there are numerical examples given to illustrate these.
Validation of notch stress estimation schemes for different constraints, strain gradients and loading conditions on low C-Mn steel
Authors: Jena Shreebanta Kumar , Arora Punit , Gupta Suneel , Chattopadhyay J.
Published: September 2021

The present study is aimed at validation of notch stress/ strain
estimation schemes such as classical Neuber, Hoffmann-Seeger and
recently developed Ince-Glinka method for Nuclear piping material (low
C-Mn steel). The study has considered different constraints, loading
conditions, various hole sizes to accommodate strain gradient variations
and equivalent peak strains. The notch stress field evaluated using
these schemes is compared with corresponding stress using
elastic-plastic Finite Element (FE) analyses. The comparisons have
brought out that the Hoffmann-Seeger scheme results in reasonably
accurate assessment of stress localization nearly for all constraint
geometries, loadings and strain gradients. However, the classical Neuber
scheme is more suitable for low constraint geometries and intermediate
constraint geometries whereas it results in under-estimation of maximum
principal stress for high constraint geometries, thereby leading to
over-prediction of fatigue life. Further, the suitability of energy
equivalence equations of Ince-Glinka model for individual stress
components, has been reviewed.
Pregnancy benefit of acupuncture on in vitro fertilization: A systematic review and meta-analysis
Authors: Yan Shiyan , Liu Xiaoyu , Pu Zhenqing , Lin Yuhan , Xiong Zhiyi , Liu Baoyan , Zhang Haoyan , Liu Cunzhi
Published: September 2021

Background: The evidence of acupuncture for in vitro fertilization (IVF)
remains debatable. Objectives: To evaluate the efficacy of acupuncture
on embryo transfer in women undergoing IVF. Search Strategy: PubMed,
MEDLINE, Web of Science, EMBASE, CENTRAL, Wanfang, Chinese National
Knowledge Infrastructure, VIP were searched up to 6 September 2021.
Selection Criteria: Randomized controlled trials (RCTs) of acupuncture
evaluating IVF’s effects were included. Data Collection and Analysis:
Clinical pregnancy rate (CPR) and live birth rate (LBR) were
quantitatively summarized by the random-effect model. Variations in
pooled estimates were examined by subgroup analyses and I2 was measured
to quantify statistical heterogeneity. Main Results: Forty-nine eligible
RCTs representing 9422 women undergoing IVF for pregnant success were
identified. Pooled CPR and LBR showed a significant difference between
acupuncture and control groups (odds ratio [OR]=1.65, 95%
confidence interval [CI]: 1.45 to 1.88; OR=1.34, 95% CI: 1.08 to
1.66). Subgroup analysis showed a benefit of traditional acupuncture for
women aged < 35 years (CPR: OR=1.57, 95% CI: 1.23 to 2.03;
LBR: OR=1.34, 95% CI:1.23 to 1.48), treatment with  3 sessions (CPR:
OR=2.37, 95% CI: 1.46 to 3.85; LBR: OR=1.99, 95% CI:1.52 to 2.60), and
lower baseline control group rates of CPR (CPR: OR=2.14, 95% CI: 1.22
to 2.13; LBR: OR=2.23, 95% CI:1.07 to 4.62). Heterogeneity across
studies were found (CPR: I2=47.4, p <0.001; LBR: I2=62.9, p
<0.001). Conclusions: Although benefits of acupuncture in CPR
and LBR among IVF women existed, no robust associations were found and
which might be limited by the heterogeneity of current evidence
The Importance of Continental Evaporation for Precipitation in Colombia: A Baseline Combining Observations from Stable Isotopes and Modeling Moisture Trajectories
Authors: Escobar Maritza , Hoyos Isabel , Hoyos Isabel , Villegas Juan Camilo
Published: September 2021

The hydroclimatology of Northern South America responds to
strongly-coupled dynamics of oceanic and terrestrial surface-atmosphere
exchange, as moisture evaporated from these sources interact to produce
continental rainfall. However, the relative contributions of these two
source types through the annual cycle have been described only in
modeling studies, with no observational tools used to corroborate these
predictions. The use of isotopic techniques to study moisture sources
has been common in assessing changes in the water cycle and in climate
dynamics, as isotopes allow tracking the connection between evaporation,
transpiration, and precipitation, as well as the influence of large
scale hydroclimatic phenomena, such as the seasonal Inter Tropical
Convergence Zone migration. We characterize the isotopic composition of
moisture sources becoming precipitation in the Andes and Caribbean
regions of Colombia, using stable isotopes data (δ18O, δ2H) from the
Global Network of Isotopes in Precipitation (1971-2016) and contrasting
it with moisture trajectory tracking from the FLEXPART model, using
input from ERA-Interim reanalysis to compute the relative contribution
of oceanic and terrestrial sources through the annual cycle. Our results
indicate that most precipitation in the region comes from terrestrial
sources including recycling (>30 % for all months),
Orinoco (up to 28 % monthly for April), and the northern Amazon (up to
17 % monthly for June, July, and August); followed by oceanic sources
including the Tropical South Pacific (up to 30 % monthly in October,
November, December) and Tropical North Atlantic (up to 30 % monthly for
January). These outcomes highlight the utility of combining stable
isotopes in precipitation and modeling techniques to discriminate
terrestrial and oceanic sources of precipitation. Further, our results
highlight the need to assess the hydrological consequences of land cover
change in South America, particularly in a country like Colombia where
water, food and energy security all depend directly on precipitation. .
Volumetric remodeling evaluated after frozen elephant trunk by 3D technology in acute type A aortic dissection
Authors: Chen Guangtian , Yan Xinjian , Liang Qiuer , He Jie , Peng Jihai , Wang Chaojie , Fan Xiaoping
Published: September 2021

Background: Three-dimensional reconstruction technology is used to
measure the volume of the descending aorta and to evaluate the
characteristics of the remodeling of the descending aorta with different
lengths after frozen elephant trunk (FET) treatment of acute type A
aortic dissection (ATAAD). Methods: Three-dimensional reconstruction of
the computed tomography angiography (CTA) of 48 cases ATAAD patients
preoperatively and 1-3 months postoperatively was performed to measure
the total volume of the aorta lumen model, descending aorta lumen
volume, abdominal arterial lumen volume, as well as the true lumen (TL)
and false lumen (FL) of each segment. The postoperative volumetric ratio
was subtracted from the preoperative volumetric ratio, and the final
distinction was made according to our remodeling classification
criteria. Result: There were 13 (76.47%) positive remodeling cases, 9
(42.86%) stable remodeling cases, and 2 (20.00%) negative remodeling
cases in the long FET group. In the short FET group, there were 4
(23.53%) positive remodeling cases, 12 (57.14%) stable remodeling
cases, and 8 (80.00%) negative remodeling cases. As shown above, the
data was obtained from the volumetric measurement and the morphological
analysis of the three-dimensional reconstruction model. Conclusion:
According to our classification criteria, long FET can promote the
positive remodeling of the descending aorta, and it is meaningful for
three-dimensional reconstruction to be used in volume measurement and
morphological research.