bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synthetically Important Ring-Opening Acylations of Alkoxybenzenes
Authors: Talukdar Ranadeep 
Published: September 2020

AbstractCyclic ketones, anhydrides, lactams and lactones are a particular class of molecules that are often used in synthesis, wherein their electrophilic properties are leveraged to enable facile Friedel–Crafts ring openings through nucleophilic attack at the carbonyl sp2 centre. The use of electron-rich alkoxybenzenes as nucleophiles has also become important since the discovery of the Friedel–Crafts reaction. As a result, various isomeric alkoxybenzenes are used for preparing starting materials in target-oriented syntheses. This review covers the instances of different alkoxybenzenes that are used as nucleophiles in ring-opening acylations with carbonyl-containing cyclic electrophiles, for the construction of important building blocks for multistep transformations. This review summarizes the ring-opening functionalization of three- to seven-membered molecular rings with alkoxybenzenes in a Friedel–Crafts fashion. Sometimes the rings need subtle or considerable activation by the help of Lewis acid(s), followed by nucleophilic attack. This review is aimed to be a summary of the important acylations of electron-rich alkoxybenzenes by nucleophilic ring-opening of cyclic molecules. The works cited employ a wide range of conditions and differently substituted substrates for target-oriented syntheses.1	Introduction and Scope2	Arenes for Acylative Ring Opening2.1	Three-Membered Rings: Ring Opening of Oxirane-2,3-dione2.2	Four-Membered Rings2.2.1	Ring Opening of Cyclobutanones2.2.2	Ring Opening of β-Lactams2.2.3	Ring Opening of β-Lactone2.3	Five-Membered Rings2.3.1	Ring Opening of Phthalimides2.3.2	Ring Opening of γ-Lactones2.3.3	Ring Opening of Anhydrides2.4	Six-Membered Rings2.5	Seven-Membered Rings3	Conclusion
The Effect of Nano Zinc Oxide Particles on Color Stability of MDX4-4210 Silicone Prostheses
Authors: Charoenkijkajorn Dittaya , Sanohkan Sasiwimol 
Published: September 2020

Abstract
Objective This article aimed to study the effect of different concentrations of nano zinc oxide particles on the color change of MDX4–4210 facial silicone elastomer after artificial aging.
Materials and Methods Silicone specimens (N = 150) were fabricated by incorporating intrinsic pigments and divided into three groups—white, yellow, and red, each group consisting of 50 specimens (n = 50). In each color, specimens were subdivided into five subgroups according to the quantity of zinc oxide nanoparticles (0, 0.5, 1.0, 1.5, and 2.0% weight), where the 0% weight served as the control in each group. All specimens were then subjected to artificial aging using an accelerated aging machine chamber for 12, 24, 48, and 72 hours. L*a*b* values of specimens were noted after a different aging period by a spectrophotometer and ∆E* was calculated.
Statistical Analysis Two-way repeated analysis of variance (ANOVA) was done to examine the effects under test conditions (concentration and aging time) of each color group. Then color, concentration, and the aging period were subjected to three-way repeated ANOVA to investigate the effects of different colors and concentrations on ∆E*. Bonferroni’s test was performed to identify differences between groups. The significant level was at p = 0.05.
Results The control group showed significantly higher ∆E* values than the test groups. The 1.5% test group showed significantly lower ∆E* compared with the others. The 0.5 to 2.0% of nano zinc oxide significantly decreased the color change of the silicone elastomer (p < 0.05), but there were no significant differences among groups.
Conclusions Incorporation of 1.5% of nano zinc oxide can improve the color stability of silicone prosthesis (MDX4–4210).
Noninvasive Cardiac Output Monitoring in Newborn with Hypoplastic Left Heart Syndrome
Authors: Gatelli Italo Francesco , Vitelli Ottavio , Chiesa Gaia , De Rienzo Francesca , Martinelli Stefano 
Published: September 2020

Objective This study aimed to describe the first two cases of electrical cardiometry applied to newborn with hypoplastic left heart syndrome for hemodynamical assessment in the first days of life before surgical correction and see if this can help decision making process in these patients.
Study Design We describe two case series of two full-term newborn with hypoplastic left heart syndrome in the Neonatal Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, between December 2019 and January 2020.
Results Case 1 was persistently hemodynamically stable with prostaglandin E1 infusion at 0.01 mcg/kg/min, showing good capillary refill time, good diuresis, no difference between pre- and postductal values of oxygen saturation or blood pressure. Electrical cardiometry monitoring constantly showed cardiac output values higher than 300 mL/kg/min. Case 2 showed poor clinical condition needing prostaglandin E1 infusion up to 0.05 mcg/kg/min, intubation and septostomy associated with low cardiac output around 190 mL/kg/min. Once cardiac output has begun to rise and reached values constantly over 300 mL/kg/min, clinical condition improved with amelioration in oxygen saturation, diuresis, blood pressure, and blood gas analysis values. She was then extubated and finally clinically stable until surgery with minimal infusion of prostaglandin E1 at 0.01 mcg/kg/min.
Conclusion This case highlights how hemodynamic information provided by electrical cardiometry can be used to supplement the combined data from all monitors and the clinical situation to guide therapy in these newborns waiting surgery.
Key Points
Factors Associated with the Complications of Hysteroscopic Myomectomy
Authors: Lima Mariana Patelli Juliani de Souza , Costa-Paiva Lúcia , Brito Luiz Gustavo Oliveira , Baccaro Luiz Francisco 
Published: September 2020

Abstract
Objective To evaluate the factors associated with complete myomectomy in a single surgical procedure and the aspects related to the early complications.
Methods A cross-sectional study with women with submucous myomas. The dependent variables were the complete myomectomy performed in a single hysteroscopic procedure, and the presence of early complications related to the procedure.
Results We identified 338 women who underwent hysteroscopic myomectomy. In 89.05% of the cases, there was a single fibroid to be treated. According to the classification of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French), most fibroids were of grade 0 (66.96%), followed by grade 1 (20.54%), and grade 2 (12.50%). The myomectomies were complete in 63.31% of the cases, and the factors independently associated with complete myomectomy were the diameter of the largest fibroid (prevalence ratio [PR]: 0.97; 95% confidence interval [95%CI]: 0.96–0.98) and the classification 0 of the fibroid according to the FIGO (PR: 2.04; 95%CI: 1.18–3.52). We observed early complications in 13.01% of the hysteroscopic procedures (4.44% presented excessive bleeding during the procedure, 4.14%, uterine perforation, 2.66%, false route, 1.78%, fluid overload, 0.59%, exploratory laparotomy, and 0.3%, postoperative infection). The only independent factor associated with the occurrence of early complications was incomplete myomectomy (PR: 2.77; 95%CI: 1.43–5.38).
Conclusions Our results show that hysteroscopic myomectomy may result in up to 13% of complications, and the chance of complete resection is greater in small and completely intracavitary fibroids; women with larger fibroids and with a high degree of myometrial penetration have a greater chance of developing complications from hysteroscopic myomectomy.
The Spanish National Network “Grupo Castrillo”: 22 Years of Nationwide Neonatal Infection Surveillance
Authors: Fernandez Colomer Belen , Cernada Badia Maria , Coto Cotallo Daniel , Lopez Sastre Jose ,   Grupo Castrillo Network
Published: September 2020

Objective This study aimed to describe the epidemiology of vertically transmitted sepsis (VS) and nosocomial sepsis (NOS) in very low birth weight (VLBW) neonates (birth weight ≤ 1,500 g) over the past 22 years in Spain.
Study Design This is a retrospective analysis of prospectively collected VS and NOS in neonates from 1996 to 2018 in the 44 neonatal units integrated in the Spanish Neonatal Network Grupo Castrillo.
Results A total of 2,676 episodes of VS were recorded in 2,196,129 live births (LBs; 1.2/1,000 LBs) over the study period (1996–2018). The incidence declined from 2.4 to 1 to 1.2/1,000 LBs (p < 0.0001). Of the 2,676 episodes, 95.7% were early onset (≤72 hours) and 4.3% cases late onset VS. Group B streptococcus (GBS) (33.1%) and E. coli (29.3%) were the most frequently isolated pathogen. The GBS incidence declined significantly from 1.25 to 0.21/1,000 LBs (p < 0.0001). E. coli incidence showed a significant increase trend in VLBW infants (p < 0.05). The global mortality per 1000 LBs decreased from 0.21 to 0.13/1,000. A total of 7,036 episodes of NOS involving 5,493 VLBW infants were registered over 20,935 neonatal admissions (NAs) in the study period (2006–2018). The incidence was 26.2 per 100 NAs. The median postnatal age at onset was 13 days (interquartile range [IQR]: 9–23 days). Around 80% of cases occurred in infants with a central line in place. Gram positive (GP) bacteria accounted for 66.2% with Staphylococcus epidermidis as the most frequently isolated pathogen, gram negative (GN) bacteria entailed 27.4%, and fungi 6.2%. Klebsiella sp. was the most common GN isolated and Candida albicans the most prevalent fungus. The overall mortality was 8.3%.
Conclusion The causative pathogen of neonatal sepsis may change over time and between countries, therefore a national surveillance network based on a consensus definition could be essential to provide accurate information.
Key Points
Impact of COVID-19 on Lung Transplant Activity in Germany—A Cross-Sectional Survey
Authors: Michel Sebastian , Witt Christian , Gottlieb Jens , Aigner Clemens 
Published: September 2020

AbstractThe current COVID-19 pandemia affects health care systems worldwide, however, to a variable extent depending on the caseload in each country. We aimed to provide a cross-sectional overview of current limitations or adaptions in lung transplant programs in Germany in from January to May 2020 due to the COVID-19 pandemia caused by severe acute respiratory syndrome coronavirus 2. A cross-sectional survey assessing various aspects of lung transplant activity was sent to all active lung transplant programs (n = 12) in Germany. Eight centers (66%) responded to the survey within the requested time frame. Four centers (50%) reported their activity is not restricted at all and four centers (50%) reported on moderate general limitations. The overall lung transplant activity in Germany from January to May 2020 contains 128 bilateral and 11 single lung transplantations, which is similar to the same period in the year 2019 (126 bilateral transplantations and 12 single lung transplantations). The results suggest that the influence of the COVID-19 pandemia on lung transplantation activity in Germany has been moderate so far. Nevertheless, adaptions such as extensive testing of donors and recipients were introduced to reduce the likelihood of infections and increase patient safety. Alertness to changes in COVID-19 reproduction rates might be required until effective antiviral therapy or vaccination is available.
Validation of an Instrument for Real-Time Assessment of Neonatal Intubation Skills: A Randomized Controlled Simulation Study
Authors: Kuijpers Lindie J.M.K. , Binkhorst Mathijs , Yamada Nicole K. , Bouwmeester Romy N. , van Heijst Arno F.J. , Halamek Louis P. , Hogeveen Marije 
Published: September 2020

Objective This study aimed to evaluate the construct validity and reliability of real-time assessment of a previously developed neonatal intubation scoring instrument (NISI).
Study Design We performed a randomized controlled simulation study at a simulation-based research and training facility. Twenty-four clinicians experienced in neonatal intubation (“experts”) and 11 medical students (“novices”) performed two identical elective intubations on a neonatal patient simulator. Subjects were randomly assigned to either the intervention group, receiving predefined feedback between the two intubations, or the control group, receiving no feedback. Using the previously developed NISI, all intubations were assessed, both in real time and remotely on video. Construct validity was evaluated by (1) comparing the intubation performances, expressed as percentage scores, with and without feedback, and (2) correlating the intubation performances with the subjects' level of experience. The intrarater reliability, expressed as intraclass correlation coefficient (ICC), of real-time assessment compared with video-based assessment was determined.
Results The intervention group contained 18 subjects, the control group 17. Background characteristics and baseline intubation scores were comparable in both groups. The median (IQR) change in percentage scores between the first and second intubation was significantly different between the intervention and control group (11.6% [4.7–22.8%] vs. 1.4% [0.0–5.7%], respectively; p = 0.013). The 95% CI for this 10.2% difference was 2.2 to 21.4%. The subjects' experience level correlated significantly with their percentage scores (Spearman's R = 0.70; p <0.01). ICC's were 0.95 (95% CI: 0.89–0.97) and 0.94 (95% CI: 0.89–0.97) for the first and second intubation, respectively.
Conclusion Our NISI has construct validity and is reliable for real-time assessment.
Key Points
Bleaching Stained Arrested Caries Lesions: In vivo Clinical Study
Authors: Al-Angari Sarah S. , AlHadlaq Mashael , Abahussain Noor , AlAzzam Njood 
Published: September 2020

Abstract
Objective Conservative approaches to esthetically treat stained arrested caries lesions (s-ACLs) have not been explored in clinical studies. This study aims to investigate the efficacy of in-office dental bleaching agent, as a conservative approach, to esthetically treat s-ACLs.
Materials and Methods Twelve patients (n = 46) presented with s-ACLs were treated with 40% hydrogen peroxide (in-office bleaching protocol; 20 minutes × 3). Color values were measured using a spectrophotometer (CIE L*a*b*), aided with digital photography to assess visual color change clinically. Measurements were taken for each specimen at baseline and immediately after bleaching.
Statistical Analysis The color change calculated before and after bleaching for each dental substrate was analyzed using paired t-test (α = 0.05).
Results The bleached s-ACLs had a significant increase in L* values (p < 0.001), and a significant decrease in both a* (p = 0.001) and b* (p = 0.007) values, indicating lighter color improvement (bleaching efficacy). The baseline mean of L*, a*, and b* values were 61.5, 2, and 15.4, respectively, and after bleaching were 67.7, 1.4, and 13.3, respectively, with a mean increase in ∆E of >7.9, which resulted in a visible clinical stain improvement as orange/light brown stains were removed completely, while gray/black stains improved to a lesser extent.
Conclusion Significant color improvement was observed when the in-office bleaching protocol (40% hydrogen peroxide) was used in orange/brown s-ACLs. However, it showed lesser improvement in gray/black s-ACLs.
Tarsocrural Instability in Cats: Combined Internal Repair and Transarticular External Skeletal Fixation
Authors: Hammer Meike , Irubetagoyena Iban , Grand Jean-Guillaume 
Published: September 2020

Abstract
Objective The aim of this study was to report outcomes after combined internal repair and transarticular external skeletal fixation (TESF) for the treatment of tarsocrural joint instabilities (TCI) in cats.
Materials and Methods Open reduction of the tarsal joint was performed followed by combined (1) internal repair (tibial/ fibular malleolar osteosynthesis or primary ligament suture and/or prosthetic ligament repair) and (2) temporary TESF. Stability of the tarsus was determined at short-term follow-up (4–8 weeks postoperatively). Short-term complications were evaluated and midterm outcome assessed by an owner telephone questionnaire.
Results Fourteen cats were included of which nine had open TCI. Median time for frame removal was 47 days. Eleven patients had satisfactory stability of the tarsus at short-term follow-up. Catastrophic complications occurred in three cats consisting of extensive skin necrosis of the paw with subsequent hindlimb amputation in two and multiple digit amputations in one cat. Major complications occurred in one cat with persistent TCI requiring pantarsal arthrodesis. Nine cat owners indicated a ‘full or acceptable’ outcome at midterm (median, 1.5 years).
Conclusion Close monitoring in the postoperative period until TESF removal is important for early identification of complications. Despite good joint stability at short-term, persistent or recurrent lameness at midterm can occur.
Nurses’ Knowledge on Prevention of Catheter-Associated Urinary Tract Infection in a Selected Hospital of Mangaluru
Authors: Benny Anns M. , Idiculla Anju S. , Kunjumon Annmary , George Anuja , A. Anusha Roseline , Sequera Sonia K.L. 
Published: September 2020

Abstract
Introduction Catheter-associated urinary tract infection (CAUTI) is one of the most common health care–acquired infections encountered in clinical practice. The most important predisposing factor for CAUTI is the insertion and prolonged use of indwelling urinary catheter, which has been performed by unsterile technique, and by not taking adequate measures to maintain cleanliness of the catheter. This study aimed to assess the knowledge on prevention of CAUTI among staff nurses in a selected hospital of Mangaluru.
Materials and Methods Staff nurses working in medical college hospital with National Accreditation Board of Hospitals and Healthcare Providers accreditation were included in this cross-sectional descriptive study. Structured knowledge questionnaire was used to assess nurses’ knowledge on CAUTI. Frequency, percentage, mean, standard deviation, and Chi-square test were used for association.
Results Majority of nurses (80.85%) had average knowledge on prevention of CAUTI, whereas 11.2% nurses had low knowledge and few (7.231%) nurses had high knowledge regarding CAUTI. Association was found between knowledge and age (0.013), educational qualification (0.018), and encounter with patients with CAUTI (0.00) is <0.05, at 0.05 level of significance
Conclusion Pooled results showed that majority of the nurses had average knowledge on prevention of CAUTI.
Putative Clinical Implications of Unilateral Ossified Sacrospinous Ligament
Authors: Siddiqui Abu Ubaida , Gurudiwan Richa , Siddiqui Abu Talha , Gupta Paritosh , Singh Jivtesh 
Published: September 2020

Abstract
Introduction Sacrospinous ligament (SSL) is a thin structure that extends from the ischial spine to the lateral margins of sacrum and coccyx, anterior to the Sacrotuberous ligament (STL). The internal pudendal and inferior gluteal vessels, pudendal nerve, sciatic nerve, and other branches of sacral nerve plexus pass through the greater sciatic foramen (GSF) in close proximity to the ischial spine and SSL.
Objective This study aimed to report a case encountered during the routine osteology tutorial, where one of the pelvises presented with ossified SSL on the right side along with ossification of lumbosacral and the sacroiliac joints.
Case Report The SSL of the right side of the pelvis was completely ossified, extending between the ischial spine and fifth piece of sacrum. The ossification had a broad-based origin from the sacrum and tapered as in proceeded to the ischial spine. It was attached to the ischial spine with a slight enlargement. Moreover, the lumbosacral and the sacroiliac joints also appeared to be ossified.
Conclusion Ossification of the SSL can restrict the lesser sciatic foramen and the greater sciatic foramen, thus causing compression of neurovascular structures traversing these areas. This can be the causative factor in pudendal nerve/sciatic nerve entrapment and can be a cause for undiagnosed chronic perineal pain. Proper anatomical knowledge and radiologic studies can be utilized for accurate diagnosis and treatment of neurovascular compression syndromes and also during reconstructive procedures of the pelvic floor and treatment of uterovaginal prolapse.
Radiation induces dynamic changes to the T cell repertoire in renal cell carcinoma patients
Authors: Chow Jacky , Hoffend Nicholas C. , Abrams Scott I. , Schwaab Thomas , Singh Anurag K. , Muhitch Jason B. 
Published: September 2020

Significance
Strong evidence supports the tumor immune landscape as a determinant of patient responses to immunotherapy. Readily available therapies, including radiation, are being investigated as modifying agents with immune checkpoint blockade. However, little is known regarding radiotherapy’s impact within the tumor microenvironment and intratumoral T cell repertoires of patients, leaving critical gaps in the guided design of clinical protocols. In this study, samples from renal cell carcinoma (RCC) patients underwent high-throughput analysis to reveal transcriptional immune activation and increased clonality in irradiated tumors. Analysis across longitudinal blood samples showed that tumor-enriched clonotypes undergo phases of peripheral expansion and contraction following radiation. Collectively, these findings demonstrate that radiotherapy remodels intratumoral T cell responses and support refined sequencing of combination strategies in RCC.
Highly infectious prions are not directly neurotoxic
Authors: Benilova Iryna , Reilly Madeleine , Terry Cassandra , Wenborn Adam , Schmidt Christian , Marinho Aline T. , Risse Emmanuel , Al-Doujaily Huda , Wiggins De Oliveira Michael , Sandberg Malin K. , Wadsworth Jonathan D. F. , Jat Parmjit S. , Collinge John 
Published: September 2020

Significance
Prions are infectious agents composed of polymers of misfolded prion protein which cause fatal brain diseases such as Creutzfeldt–Jakob disease. These diseases involve progressive loss of neuronal cells, and it has been long assumed that prions are directly toxic to cells as they propagate. However, recent studies have suggested that prion infectivity and neurotoxicity can be uncoupled and involve distinct mechanisms. Using highly purified infectious prions we demonstrate that prions are not directly neurotoxic and that toxicity present in infected brain tissue can be distinguished from infectious prions. This has fundamental implications for understanding of prion diseases and how to treat them and may have wide relevance in other neurodegenerative diseases which involve propagation and spread of proteopathic seeds.
Lifestyle adaptations ofRhizobiumfrom rhizosphere to symbiosis
Authors: Wheatley Rachel M. , Ford Brandon L. , Li Li , Aroney Samuel T. N. , Knights Hayley E. , Ledermann Raphael , East Alison K. , Ramachandran Vinoy K. , Poole Philip S. 
Published: September 2020

SignificanceRhizobia are soil-dwelling bacteria that form symbioses with legumes and provide biologically useable nitrogen as ammonium for the host plant. High-throughput DNA sequencing has led to a rapid expansion in publication of complete genomes for numerous rhizobia, but analysis of gene function increasingly lags gene discovery. Mariner-based transposon insertion sequencing has allowed us to characterize the fitness contribution of bacterial genes and determine those functionally important in aRhizobium–legume symbiosis at multiple stages of development.