bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatal Presentation of Susac Syndrome in a Congenitally Deaf Patient With a Cochlear Implant
Authors: Richter John E. , Rourk Katelyn S. , Stewart Michael W. , Raymond Mallory J. 
Published: June 2024

Objective
To report a fatal case of Susac syndrome in a congenitally deaf patient with a cochlear implant and a history of migraines, emphasizing the diagnostic challenges in patients with preexisting conditions.

Patient
A 33-year-old male with congenital hearing loss, a cochlear implant, and chronic migraines who presented with mild subacute auditory disturbance and headaches that later progressed to severe encephalopathy.

Intervention
Explantation of a non–magnetic resonance imaging (MRI) compatible cochlear implant followed by MRI, fundoscopy, and the administration of immunosuppressive medications.

Main Outcome Measures
Diagnosis was confirmed by characteristic MRI appearance and the presence of a hemi-retinal artery occlusion.

Results
After weeks of immunosuppressive treatment, the patient died of a global cerebral ischemic event of unknown origin.

Conclusions
For patients with preexisting sensorineural hearing loss and cochlear implants, Susac syndrome poses a diagnostic challenge. Auditory disturbances in the absence of cochlear implant failure should prompt further evaluation for visual disturbances and encephalopathy. MRI and fundoscopy should be performed to detect other features of the disease.
Resonance Frequency Analysis Identifies Implant- and Host-Related Factors Associated With Bone-Anchored Hearing Implant Stability
Authors: Bezdjian Aren , Mikolajewicz Nicholas , Denton Carolyn , Bouchard Alice , Rummler Maximilian , Gludovatz Bernd , Shin Mihee , Zimmermann Elizabeth , Salameh Samer , Daniel Sam J. , Willie Bettina M. 
Published: June 2024

Hypothesis
Resonance frequency analysis (RFA) is a reliable, noninvasive method to assess the stability of bone-anchored hearing implants (BAHIs), although surgical-, implant-, and host-related factors can affect its outcome.

Background
BAHI plays an important role in restoring hearing function. However, implant- and host-related factors contribute to premature implant extrusion. To mitigate this, noninvasive methods to assess implant stability, along with a better understanding of factors contributing to BAHI failure, are needed.

Methods
We evaluated the utility of RFA to quantify implant stability in sawbone (bone mimicking material), 29 human cadaveric samples, and a prospective cohort of 29 pediatric and 27 adult participants, and identified factors associated with implant stability. To validate the use of RFA in BAHI, we compared RFA-derived implant stability quotient (ISQ) estimates to peak loads obtained from mechanical push-out testing.

Results
ISQ and peak loads were significantly correlated (Spearman rho = 0.48, p = 0.0088), and ISQ reliably predicted peak load up to 1 kN. We then showed that in cadaveric samples, abutment length, internal table bone volume, and donor age were significantly associated with implant stability. We validated findings in our prospective patient cohort and showed that minimally invasive Ponto surgery (MIPS; versus linear incision), longer implantation durations (>16 wk), older age (>25 yr), and shorter abutment lengths (≤10 mm) were associated with better implant stability. Finally, we characterized the short-term reproducibility of ISQ measurements in sawbone and patient implants.

Conclusions
Together, our findings support the use of ISQ as a measure of implant stability and emphasize important considerations that impact implant stability, including surgical method, implant duration, age, and abutment lengths.
Immediate Facial Nerve Palsy Secondary to Otological Surgery: A Systematic Review and Narrative Synthesis
Authors: Patel Sanjay , Walters Ben , Kim Valerie , Walijee Hussein 
Published: June 2024

Objectives
Iatrogenic facial nerve palsy following otological surgery is a devastating complication that results in adverse aesthetic and functional outcomes. This study aims to review studies that have reported cases of immediate facial nerve palsy to learn why and where injuries occurred and to assess outcomes following management.

Databases Reviewed
MEDLINE, Embase, Cochrane CENTRAL, and Pubmed up to June 20, 2023.

Methods
Clinical studies of immediate facial nerve palsies following middle ear and cochlear implantation surgery were included. Risk of bias was examined using the Brazzelli risk of bias tool. Due to the inconsistency in reporting of outcomes, we were unable to perform a meta-analysis.

Results
Of 234 studies identified, 11 met the inclusion criteria. The most common causes of injury were excessive drilling, use of sharp hooks to remove disease, or disorientation of the surgeon secondary to bleeding or inflammation. Variable usage of preoperative computed tomography (CT) imaging and intraoperative facial nerve monitoring was reported. The tympanic segment was the most common site of injury. A variety of surgical techniques were employed to approach the facial nerve injury including facial nerve decompression, direct closure, and repair using an autologous nerve graft.

Conclusions
Otological surgeons should consider utilizing preoperative CT imaging to establish a three-dimensional mental image of key landmarks and anatomical variations before embarking on surgery. Intraoperative FN monitoring enables safe practice. Despite these measures, complex disease processes and hostile intraoperative conditions can present difficulty. Multiple treatment options are available to treat the underlying injury.
Parents’ Experiences of Communicating With Children About Their Diagnosis of Nonterminal Cancer and Its Related Issues
Authors: Du Yiran , Huang Xiaoyan , Xie Run , Gu Ying , Zhu Daqian , Wang Hongsheng 
Published: June 2024

Background
Many children experience serious symptoms when they are diagnosed with and treated for cancer. Through appropriate parent-child communication, parents were able to identify children’s physical and psychological problems, adjust their behavior, and help them cope with the disease.

Objective
This study aimed to systematically search for and integrate evidence from qualitative studies on communication between parents and children with nonterminal cancer from parents’ perspectives.

Methods
A thorough systematic review and metasynthesis of qualitative studies were conducted. Articles were searched from PubMed/MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, and PsycArticles from the database inception to November 6, 2022. After screening and quality appraisal, 14 articles were finally included in the metasynthesis.

Results
Three themes and 11 subthemes were identified: (1) communication content, including diagnosis, treatment, health management, health risk, and emotion; (2) factors influencing communication, including ages of children, parents’ experience of communication, parents’ awareness of protection, and culture; and (3) children’s responses, including acceptance and resistance.

Conclusions
This systematic review found that parents were influenced by various factors during the decision-making process of parent-child communication about childhood cancer and its related issues. Parents tended to adjust their communication content and style to protect their children.

Implications for Practice
Future research should be conducted to explore children’s experiences of communicating with their parents and analyze the similarities and differences between the communication needs of parents and children. Healthcare professionals should provide professional communication guidance to facilitate the parent-child relationship and improve the mental health of both children and their parents.
Perinatal Care for Persons with Dissociative Disorders
Authors: Dindinger Rebeccah A. , Manzo Laura L. , Manupule Susannah E. , Harp Solène Lehuédé 
Published: June 2024

Abstract
Caring for persons with mental health diagnoses can be daunting, especially when the conditions are rare, and there is little evidence to guide nursing practice. There is minimal information about caring for persons with dissociative disorders beyond the behavioral health literature, much less as in obstetric context. Women are more likely to experience dissociative disorders and post-traumatic stress disorders than men. Severe maternal morbidity is significantly more common in women with a history of stress and trauma-related conditions, highlighting the importance of providing guidance for clinicians caring for them. It is imperative that nurses caring for women who may dissociate understand the complexities of the disorders and advocate for early, interdisciplinary care. Dissociative disorders, including dissociative identity disorder, post-traumatic stress disorder with dissociation, dissociative amnesia, depersonalization-derealization disorder, other specified dissociative disorders, and the care of pregnant persons with these conditions are presented.
Trends in Gender Authorship of Abstract Presentations at Plastic Surgery the Meeting
Authors: Stewart Sara J. , Jabori Sinan K. , Pandya Shivani , Alawadi Salman , Szewczyk Joanne , Samaha Yasmina , Lessard Anne-Sophie , Singh Devinder , Danker Sara 
Published: June 2024

Abstract
Current literature fails to examine gender differences of authors presenting abstracts at national plastic surgery meetings. This study aims to assess the ratio of female to male abstract presentations at Plastic Surgery The Meeting (PSTM).
The gender of all abstract presenters from PSTM between 2010 and 2020 was recorded. The primary outcome variable was authorship (first, second, or last). Trends in gender authorship were assessed via Cochran-Armitage trend tests. Chi-square was utilized to evaluate the association between author gender and presentation type and author gender and subspecialty.
Between 2010 and 2020, 3653 abstracts were presented (oral = 3035, 83.1%; poster = 618, 16.9%) with 19,328 (5175 females, 26.8%) authors. Of these, 34.5%, 32.0%, and 18.6% of first, second, and last authors were female, respectively. The total proportion of female authors increased from 153 (20.4%) in 2010 to 1065 (33.1%) by 2020. The proportion of female first, second, and last authors increased from 21.8% to 44.8%, 24.0% to 45.3%, and 14.3% to 22.1%, respectively, and demonstrated a positive linear trend (P < 0.001). The proportion of female first authors in aesthetics (23.9%) was lower than that for breast (41.8%), cranio/maxillofacial/head & neck (38.5%), practice management (43.3%), and research/technology (39.4%) (P < 0.001).
Our study demonstrates a significant increase in female representation as first, second, and last authors in abstract presentations at PSTM within the last decade, although the absolute prevalence remains low.
Can Lymph Node Involvement in Unilateral Wilms Tumor be Predicted by Preoperatively known Data in Combination with Intraoperative Findings?
Authors: Meier Clemens-Magnus , Furtwängler Rhoikos , Welter Nils , Mergen Marvin , Wagenpfeil Stefan , von Schweinitz Dietrich , Stein Raimund , Kager Leo , Schenk Jens-Peter , Vokuhl Christian , Kroiss-Benninger Sabine , Melchior Patrick , Warmann Steven W. , Fuchs Jörg , Graf Norbert 
Published: June 2024

Objective:
This study aimed to identify parameters that allow the estimation of tumor-infiltrated lymph nodes (LN) after pretreatment for unilateral Wilms tumor (WT).

Summary Background Data:
Complete tumor resection with removal of regional LN is always necessary. Positive LNs require local irradiation influencing benefits in case of NSS in long-term follow-up. Clinical and tumor-related data available at the time of surgery in combination with intraoperative findings (IAF) were used to estimate the LN status during surgery.

Methods:
Altogether, 2115 patients with unilateral WT were prospectively enrolled in SIOP-93-01 / GPOH and SIOP-2001 / GPOH over a period of 30 years (1993–2023). LN infiltration by tumor was calculated for age, sex, metastases at diagnosis, tumor volume (TV), TV shrinkage, and intraoperative findings (IAF) using logistic regression models.

Results:
Age ≥48 months (P<0.001, OR 2.17, CI 1.57 – 3.00), TV at diagnosis ≥300 (P<0.001, OR 3.72, CI 2.37 – 5.85), metastasis at diagnosis (P<0.001, OR 6.21, CI 4.47 – 8.62) and IAF (>1: P<0.001, OR 3.54, CI 2.13 – 5.88) correlated with positive LNs. TV shrinkage was not predictive of positive LN. Three flow charts were developed based on age, TV at diagnosis, metastasis, and IAF. These flowcharts defined risks between 0% and 41.5% for LN infiltration by tumor.

Conclusions:
The combination of age, TV at diagnosis, and metastasis with IAF allows the estimation of the frequency of positive LNs, which may help surgeons deciding about NSS.
Three distinct conductance states in polycyclic aromatic hydrocarbon derivatives
Authors: Ismael Ali K. , Mohaymen Taha Taha Abdel , Al-Jobory Alaa 
Published: June 2024

Tight-binding model (TBM) and density functional theory (DFT) calculations were employed. Both simulations have demonstrated that the electrical conductance for eight polycyclic aromatic hydrocarbons (PAHs) can be modulated by varying the number of aromatic rings (NAR) within the aromatic derivatives. TBM simulations reveal three distinct conductance states: low, medium and high for the studied PAH derivatives. The three distinct conductance states suggested by TBM are supported by DFT transmission curves, where the low conductance evidenced by
T
(
E
) = 0, for benzene, naphthalene, pyrene and anthracene. While azulene and anthanthrene exhibit a medium conductance as
T
(
E
) = 1, and tetracene and dibenzocoronene possess a high conductance with
T
(
E
) = 2. Low, medium and high values were elucidated according to the energy gap
E
g
and
E
g
gaps are strongly dependent on the NAR in the PAH derivatives. This study also suggests that any PAH molecules are a conductor if
E
g
< 0.20 eV. A linear relationship between the conductance and NAR (
G
∝ NAR) was found and conductance follows the order
G
(benzene, 1 NAR) <
G
(anthanthrene, 4 NAR) <
G
(dibenzocoronene, 9 NAR). The proposed study suggests a relevant step towards the practical application of molecular electronics and future device application.
Barcoded SARS-CoV-2 viruses define the impact of time and route of transmission on the transmission bottleneck in a Syrian hamster model
Authors: Trende Reed , Darling Tamarand L. , Gan Tianyu , Wang David , Boon Adrianus C.M. 
Published: June 2024

ABSTRACTThe transmission bottleneck, defined as the number of viruses that transmit from one host to infect another, is an important determinant of the rate of virus evolution and the level of immunity required to protect against virus transmission. Despite its importance, SARS-CoV-2’s transmission bottleneck remains poorly characterized, in part due to a lack of quantitative measurement tools. To address this, we adapted a SARS-CoV-2 reverse genetics system to generate a pool of >200 isogenic SARS-CoV-2 viruses harboring specific 6-nucleotide barcodes inserted in ORF10, a non-translated ORF. We directly inoculated donor Syrian hamsters intranasally with this barcoded virus pool and exposed a paired naïve contact hamster to each donor. Following exposure, the nasal turbinates, trachea, and lungs were collected, viral titers were measured, and the number of barcodes in each tissue were enumerated to quantify the transmission bottleneck. The duration and route (airborne, direct contact, and fomite) of exposure were varied to assess their impact on the transmission bottleneck. In airborne-exposed hamsters, the transmission bottleneck increased with longer exposure durations. We found that direct contact exposure produced the largest transmission bottleneck (average 27 BCs), followed by airborne exposure (average 16 BCs) then fomite exposure (average 8 BCs). Interestingly, we detected unique BCs in both the upper and lower respiratory tract of contact animals from all routes of exposure, suggesting that SARS-CoV-2 can directly infect hamster lungs. Altogether, these findings highlight the utility of barcoded viruses as tools to rigorously study virus transmission. In the future, barcoded SARS-CoV-2 will strengthen studies of immune factors that influence virus transmission.
Factors Affecting Integration of an Early Warning System for Antimalarial Drug Resistance within a Routine Surveillance System in a Pre-elimination Setting in Sub-Saharan Africa
Authors: Kagoro Frank M. , Allen Elizabeth , Raman Jaishree , Mabuza Aaron , Magagula Ray , Kok Gerdalize , Malatje Gillian , Guerin Philippe J , Dhorda Mehul , Maude Richard J , Barnes Karen I 
Published: June 2024

1.AbstractTo address the current threat of antimalarial resistance, countries need innovative solutions for timely and informed decision-making. Integrating molecular resistance marker surveillance into routine malaria surveillance in pre-elimination contexts offers a potential early warning mechanism to identify resistance signals and target areas for further investigation, including therapeutic efficacy studies. However, there is limited evidence on what influences the performance of such a system in resource-limited settings.From March 2018 to February 2020, a sequential mixed-methods study was conducted in primary healthcare facilities in a South African pre-elimination setting to explore factors influencing the flow, quality and linkage of malaria case notification and antimalarial molecular resistance marker data. Using a process-oriented framework, we undertook monthly and quarterly data linkage and consistency analysis at different levels of the health system, as well as a survey, focus group discussions and interviews to identify potential barriers to, and enhancers of, the roll-out and uptake of this integrated information system.Over two years, 4,787 confirmed malaria cases were notified from 42 primary healthcare facilities in the Nkomazi sub-district, Mpumalanga, South Africa. Of the notified cases, 78.5% (n=3,758) were investigated, and 55.1% (n=2,636) were successfully linked to theirPlasmodium falciparummolecular resistance marker profiles. Five tangible processes—malaria case detection and notification, sample collection, case investigation, analysis and reporting—were identified within the process-oriented logic model. Workload, training, ease of use, supervision, leadership, and resources were recognized as cross-cutting influencers affecting the program’s performance.Approaching malaria elimination, linking molecular markers of antimalarial resistance to routine malaria surveillance is feasible. However, cross-cutting barriers inherent in the healthcare system can determine its success in a resource-limited setting.
Runaway resorption of microcracks contributes to age-related hip-fracture patients
Authors: Gray Marena , Boughton Oliver , Wiles Crispin , Reinhard Christina , Vo Nghia T. , Atwood Robert , Stavri Richard , Cobb Justin P. , Hansen Ulrich , Abel Richard L. 
Published: June 2024

AbstractMicrodefects, including microcracks and resorption trenches, may be important contributors to bone fragility. 3D microdefect morphology was imaged using synchrotron micro-CT to develop a classification system for investigating the relationship with bone mechanics and hip-fractures.Femoral heads from ageing hip-fracture patients (n=5, 74-82 years) were compared to ageing non-fracture controls (n=5, 72-84 years). Two trabecular cores were prepared from the chiasma; one was imaged using synchrotron micro-CT to measure microdefects and one was mechanically tested to measure tensile strength. Morphological and mechanical data were compared and correlated using Mann Whitney U test and Pearson’s rank correlation.Microdefects varied and were classified into four categories based on shape and measurable parameters. Hip-fracture donors exhibited significantly higher density of all microdefects (p<0.05). Microdefect volume was strongly negatively correlated with ultimate tensile strength (p<0.05) and stiffness (p<0.05).Microdefects might contribute to loss of bone strength and fragility fracture via runaway resorption. Microcracks could promote focussed osteoclastic resorption and the formation of resorption pits which create stress risers leading to the re-formation of microcracks under continued load. CT-based classification methods should be used to explore the complex interaction between microdefects, metabolism, and bone fracture mechanics.
Convergent genetic adaptation in human tumors developed under systemic hypoxia and in populations living at high altitudes
Authors: Arenillas Carlota , Ruiz-Cantador José , Celada Lucía , Calsina Bruna , García-Galea Eduardo , Datta Debayan , Fasani Roberta , Moreno-Cárdenas Ana Belén , Alba-Linares Juan José , Miranda Berta , Martínez-Montes Ángel M. , Álvarez-Escolá Cristina , Lecumberri Beatriz , González García Elvira Ana , Flores Shahida K. , Esquivel Emmanuel , Ding Yanli , Regojo Zapata Rita Maria , Pozo-Kreilinger Jose Juan , Iglesias Carmela , Dwight Trisha , Muir Christopher , Alday Amelia Oleaga , Garrido-Lestache Rodríguez-Monte Maria Elvira , Del Cerro Maria Jesús , Martínez-Bendayán Isaac , Lourenço Delmar M. , Pereira Maria Adelaide A. , Burnichon Nelly , Buffet Alexandre , Broberg Craig , Dickson Paxton , Fraga Mario Fernandez , Llorente Pendás José Luis , Soriano Joaquín Rueda , Fuentes Francisco Buendía , Toledo Sergio P.A. , Clifton-Bligh Roderick , Dienstmann Rodrigo , Capdevila Jaume , Gimenez-Roqueplo Anne-Paule , Favier Judith , Weghorn Donate , Nuciforo Paolo , Young William , Opotowsky Alexander R. , Vaidya Anand , Bancos Irina , Robledo Mercedes , Casteràs Anna , Dos-Subirà Laura , Chiara María Dolores , Adameyko Igor , Dahia Patricia L.M. , Toledo Rodrigo A. 
Published: June 2024

AbstractEPAS1HIF2αis the primary gene implicated in systemic hypoxia adaptation. Conversely, aberrantly activatedEPAS1HIF2αacts as a tumor driver against which anti-tumor therapeutics are proven effective. We elucidated connections between adaptation to systemic hypoxia in high-altitude populations, such as Tibetans and Sherpas, and human tumors. Similar to the accelerated adaptability observed in high-altitude populations via genetic introgression, tumors from patients with hypoxia since birth exhibited impaired DNA repair and increased mutation burden. As in high-altitude dwellers,EPAS1HIF2αgenetic variants were positively selected within sympathetic tumors developed under hypoxia, with a consistently high frequency of 90%. Bulk and single-cell RNA sequencing followed byin vitrostudies have shown that hypoxia andEPAS1HIF2αgain-of-function tumor mutations induceCOX4i2expression and impair mitochondrial respiration, indicating that decreased cellular oxygen consumption may confer a proliferative advantage in hypoxia. Analyzing medical data from a patient cohort with hypoxia since birth who developed/did not develop tumors revealed tissue-specific and time-dependent tumorigenic effects of systemic hypoxia, which is limited to oxygen-sensitive and responsive cells, particularly during the postnatal period. This study supports connections between theEPAS1HIF2αgenetic adaptation in human tumors developed under systemic hypoxia to populations living in high altitudes. The genetic adaptations in populations to different stressors can be explored further to understand tumorigenesis and tumor evolution.