bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transseptal coronary artery—a pictorial review
Authors: Maller Vijetha V , Johnson Jason N. , Boston Umar , Knott-Craig Christopher 
Published: April 2024

AbstractA transseptal coronary artery course, also known as a transconal course, is an anomalous course of the left main coronary artery (LMCA) or the left anterior descending artery (LAD) through the conal septal myocardium. The conal septal myocardium is the posterior wall of the right ventricular outflow tract (RVOT), acting as a dividing myocardial wall between the subaortic and subpulmonary outflow tracts. The initial segment of a transseptal coronary artery has an extraconal course between the aorta and the RVOT cranial to the true intramyocardial segment. The transseptal coronary artery then emerges out of the conal septal myocardium at the epicardial surface on the lateral aspect of the RVOT. Many consider the transseptal coronary artery to be a benign entity. However, there are few case reports of severe cardiac symptoms such as myocardial ischemia, arrhythmia, and even sudden cardiac deaths due to potential coronary artery compression in the systolic phase.​ In this article, we seek to describe the imaging findings of transseptal coronary artery course on coronary computed tomography angiography (CTA), discuss their clinical analysis, and briefly discuss the management of these lesions.
Graphical abstract
Gn protein expressed in plants for diagnosis of severe fever with thrombocytopenia syndrome virus
Authors: Chang Yu-Chih , Shimoda Hiroshi , Jiang Min-chao , Hsu Yau-Heiu , Maeda Ken , Yamada Yumiko , Hsu Wei-Li 
Published: April 2024

Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) causes the highly fatal disease in humans. To facilitate diagnosis, the native form of subunit glycoprotein (Gn), a prime target for potential vaccines and therapies, was produced in Nicotiana benthamiana using a Bamboo mosaic virus-based vector system. By fusion with secretory signal tags, SSExt, derived from the extension protein, and the (SP)10 motif, the yield of the recombinant Gn (rGn) was remarkably increased to approximately 7 mg/kg infiltrated leaves. Ultimately, an rGn-based ELISA was successfully established for the detection of SFTSV-specific antibodies in serum samples from naturally infected monkeys. As validated with the reference method, the specificity and sensitivity of rGn-ELISA were 94% and 96%, respectively. In conclusion, utilizing well-suited fusion tags facilitates rGn production and purification in substantial quantities while preserving its antigenic properties. The rGn-ELISA, characterized by its commendable sensitivity and specificity could serve as a viable alternative diagnostic method for assessing SFTSV seroprevalence.

Key points
• SFTSV Gn, fused with secretory signal tags, was expressed by the BaMV-based vector.
• The plant fusion tags increased expression levels and eased the purification of rGn.
• The rGn-ELISA was established and validated; its specificity and sensitivity > 94%.
Intravenous Opioid Medication with Piritramide Reduces the Risk of Pneumothorax During CT-Guided Percutaneous Core Biopsy of the Lung
Authors: Goetz Andrea , Poschenrieder Florian , Steer Frederike Georgine , Zeman Florian , Lange Tobias J. , Thurn Sylvia , Greiner Barbara , Stroszczynski Christian , Uller Wibke , Hamer Okka , Hammer Simone 
Published: April 2024

Abstract
Purpose
CT-guided percutaneous core biopsy of the lung is usually performed under local anesthesia, but can also be conducted under additional systemic opioid medication. The purpose of this retrospective study was to assess the effect of intravenous piritramide application on the pneumothorax rate and to identify risk factors for post-biopsy pneumothorax.

Materials and Methods
One hundred and seventy-one core biopsies of the lung were included in this retrospective single center study. The incidence of pneumothorax and chest tube placement was evaluated. Patient-, procedure- and target-related variables were analyzed by univariate and multivariable logistic regression analysis.

Results
The overall incidence of pneumothorax was 39.2% (67/171). The pneumothorax rate was 31.5% (29/92) in patients who received intravenous piritramide and 48.1% (38/79) in patients who did not receive piritramide. In multivariable logistic regression analysis periinterventional piritramide application proved to be the only independent factor to reduce the risk of pneumothorax (odds ratio 0.46, 95%-confidence interval 0.24, 0.88; p = 0.018). Two or more pleura passages (odds ratio 3.38, 95%-confidence interval: 1.15, 9.87; p = 0.026) and prone position of the patient (odds ratio 2.27, 95%-confidence interval: 1.04, 4.94; p = 0.039) were independent risk factors for a higher pneumothorax rate.

Conclusion
Procedural opioid medication with piritramide proved to be a previously undisclosed factor decreasing the risk of pneumothorax associated with CT-guided percutaneous core biopsy of the lung.

Level of Evidence 4
small study cohort.

Graphic Abstract
Comparison of Clinical and Radiological Outcomes Between Different (Balloon) Guide Catheter With and Without Inflated Balloon in Acute Ischemic Stroke Patients: A MaSQ-Registry Study
Authors: Knapen R. R. M. M. , Celen M. , Pinckaers F. M. E. , Wagemans B. A. J. M. , van Zwam W. H. , van Oostenbrugge R. J. , van der Leij C. 
Published: April 2024

Abstract
Purpose
Balloon guide catheters (BGCs) are used in endovascular treatment (EVT) for ischemic stroke. Previous literature did not distinguish between BGC use with and without inflated balloon. This study aims to compare outcomes between non-BCG and BGC use with and without inflated balloon during EVT.

Methods
Patients who underwent EVT for anterior circulation ischemic stroke between September 2020 and February 2023 were analyzed. Patients were divided into three groups: non-BGC, BGC with inflated balloon, or BGC without inflated balloon. The primary outcome was the ordinal modified Rankin Scale (mRS) at 90-day follow-up. Secondary outcomes included expanded Thrombolysis In Cerebral Ischemia score (eTICI) and periprocedural complications. Regression analyses with BGC with inflated balloon as comparator were performed with adjustments. Subgroup analyses were conducted based on first-line thrombectomy technique.

Results
Out of 511 patients, 428 patients were included. Compared to BCG with inflated balloon, the mRS at 90 days did not differ in the group without inflated balloon (adjusted common [ac]OR: 1.07, 95%CI 0.67–1.73) or non-BGC (acOR: 1.42, 95%CI 0.83–2.42). Compared to patients treated with a BGC with inflated balloon, those treated with BGC without inflated balloon had lower eTICI scores (acOR: 0.59, 95%CI 0.37–0.94), and patients treated with non-BGC had lower chances of periprocedural complications (aOR: 0.41, 95%CI 0.20–0.86).

Conclusions
This study shows no clinical differences in ischemic stroke patients treated with BGC with inflated balloon compared to non-BGC and BGC without inflated balloon, despite lower periprocedural complication rates in the non-BGC group and lower eTICI scores in the BGC without inflated balloon group.

Level of Evidence
Level 3, non-controlled retrospective cohort study.

Graphical Abstract
Einfluss des Verhältnisses von Transplantatgröße zu Hornhautgröße auf Immunreaktion, Re-Bubbling-Rate und postoperativen Endothelzellverlust bei 457 Augen nach Descemet-Membrane-Endothelial-Keratoplastik (DMEK)
Authors: Reinert Ursula , Seitz Berthold , Munteanu Cristian , Daas Loay 
Published: April 2024

Zusammenfassung
Hintergrund
Ziel dieser Studie war es, den Einfluss des Verhältnisses von Transplantatgröße zu Hornhautgröße auf postoperative Komplikationen (endotheliale Immunreaktion [IR], Re-Bubbling-Rate und Endothelzellverlust [ECL]) nach Descemet-Membrane-Endothelial-Keratoplastik (DMEK) zu untersuchen.

Patienten und Methoden
Retrospektiv eingeschlossen wurden 457 Patientenaugen mit den Diagnosen Fuchs-Endotheldystrophie (n = 431), pseudophake bullöse Keratopathie (n = 9) und andere Diagnosen (n = 17), welche zwischen 2016 und 2019 in der Klinik für Augenheilkunde am Universitätsklinikum des Saarlandes (UKS) in Homburg/Saar mittels DMEK (n = 270) bzw. Triple-DMEK (n = 187) operiert wurden. Der Nachbeobachtungszeitraum erstreckte sich bis Ende 2020. Die untersuchten Zielgrößen waren: Auftreten einer endothelialen IR, eines Re-Bubblings und die Größe des postoperativen ECL (6 Wochen, 6 Monate, 1 Jahr) in Abhängigkeit des Verhältnisses von Transplantat- zu Hornhautgröße (VTH).

Ergebnisse
Das VTH in dieser Studie schwankte von 0,35 bis 0,62 (0,46 ± 0,04). Es traten 33 (7,2 %) postoperative IR auf (DMEK n = 25; Triple-DMEK n = 8). Das durchschnittliche VTH war ohne IR (0,46 ± 0,04) signifikant (p = 0,038) kleiner als in der Gruppe mit IR (0,47 ± 0,05). Ein Re-Bubbling war bei 159 von 457 Patientenaugen nötig (34,8 %). Das VTH der Augen mit Re-Bubbling (0,47 ± 0,04) war signifikant (p = 0,014) größer als das VTH der Augen ohne Re-Bubbling (0,45 ± 0,04). Die durchschnittliche präoperative Endothelzellzahl (ECD) betrug 2603 ± 251 Zellen/mm2 (Min: 2161, Max: 3500 Zellen/mm2). Ein größerer VTH hatte keinen positiven Einfluss auf den Endothelzellverlust (r = 0,001; p = 0,974).

Schlussfolgerung
Unsere Ergebnisse deuten an, dass ein größerer Transplantatdurchmesser im Vergleich zu Hornhautgröße mit einer erhöhten Rate von IR und Re-Bubblings nach DMEK einhergeht. Dagegen hatte das VTH keinen Einfluss auf den Endothelzellverlust nach DMEK. Aus diesem Grund sollte der Transplantatdurchmesser für DMEK gerade bei der Fuchs-Dystrophie nicht unnötig groß gewählt werden.
On a Class of Elliptic Orthogonal Polynomials and their Integrability
Authors: Desiraju Harini , Latimer Tomas Lasic , Roffelsen Pieter 
Published: April 2024

AbstractBuilding upon the recent works of Bertola; Fasondini, Olver and Xu, we define a class of orthogonal polynomials on elliptic curves and establish a corresponding Riemann–Hilbert framework. We then focus on the special case, defined by a constant weight function, and use the Riemann–Hilbert problem to derive recurrence relations and differential equations for the orthogonal polynomials. We further show that the sub-class of even polynomials is associated to the elliptic form of Painlevé VI, with the tau function given by the Hankel determinant of even moments, up to a scaling factor. The first iteration of these even polynomials relates to the special case of Painlevé VI studied by Hitchin in relation to self-dual Einstein metrics.
Assessment of olfactory recovery after COVID-19: cross-sectional study
Authors: Zaid Ehab Abou , Eltelety Ahmad Mohamed , Azooz Khaled Omar , Ragab Gouda , Nassar Ahmed Amin 
Published: April 2024

Abstract
Objective
This study aimed to evaluate recovery patterns of olfactory dysfunction among recovered COVID-19 patients, both subjective and objective, and correlate this recovery to the severity of the disease.

Methods
The study recruited 200 patients and assigned them to two equal groups, one of them was a control group. The olfactory function of the study group was assessed via subjective and objective methods at baseline and then monthly for three months, with changes in smell function reported at each visit. These patients underwent chemosensory testing using the Sniffin’ Sticks test and completed the validated Arabic version of the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS).

Results
Olfactory dysfunction occurred on the first day of COVID-19 symptoms in 37% of participants. Subjective reports suggested smell recovery in 55% after 3 months, but Sniffin' Sticks showed only 1% with normal function, indicating persistent deficits in others. This study revealed smell recovery for 93% of participants (median 14 days), with most (58%) recovering within 2 weeks. No significant links were found between demographics, COVID-smell loss timing, and recovery speed.

Conclusion
Three months after COVID-19, many patients perceive smell recovery, but objective tests reveal shockingly high rates of persistent dysfunction. Further follow-up with objective tests is vital to assess the true burden and potential long-term effects of smell loss.
Search engine optimization and its association with readability and accessibility of diabetic retinopathy websites
Authors: Lam Matthew R. , Manion Garrett N. , Young Benjamin K. 
Published: April 2024

Abstract
Purpose
This study investigated whether websites regarding diabetic retinopathy are readable for patients, and adequately designed to be found by search engines.

Methods
The term “diabetic retinopathy” was queried in the Google search engine. Patient-oriented websites from the first 10 pages were categorized by search result page number and website organization type. Metrics of search engine optimization (SEO) and readability were then calculated.

Results
Among the 71 sites meeting inclusion criteria, informational and organizational sites were best optimized for search engines, and informational sites were the most visited. Better optimization as measured by authority score was correlated with lower Flesch Kincaid Grade Level (r = 0.267, P = 0.024). There was a significant increase in Flesch Kincaid Grade Level with successive search result pages (r = 0.275, P = 0.020). Only 2 sites met the 6th grade reading level AMA recommendation by Flesch Kincaid Grade Level; the average reading level was 10.5. There was no significant difference in readability between website categories.

Conclusion
While the readability of diabetic retinopathy patient information was poor, better readability was correlated to better SEO metrics. While we cannot assess causality, we recommend websites improve their readability, which may increase uptake of their resources.
Child participation during outpatient consultations: a mixed methods study
Authors: Koenis Maud M. , Vroman Heleen , Brand Paul L. P. , van Woerden Christiaan S. 
Published: April 2024

AbstractAlthough children wish to be included in their own healthcare, they recognize a gap between their right to be heard and their ability to become involved. Despite adaptation of medical consultation styles which suit a more patient-centered approach, data on the current state of child participation in clinical encounters are missing. We aimed to assess actual child participation in a Dutch pediatric clinic. Children aged 4–18 years visiting a pediatric outpatient clinic for consultation after general practitioner’s referral were included. Sixteen consultations of six pediatricians were recorded and transcribed verbatim. Quantitative measurement included word count and speech turn; conversation analysis with qualitative appraisal provided data on participatory behavior. Quantitative child participation equaled parent participation in turns (28% vs 29%, respectively), but remained limited in words (relative contribution 11% for child, 23% for parent and 66% for pediatrician). Children spoke on average six words per speech turn. Child age correlated positively with participation in words (p = 0.022, r = 0.566) and turns (p =  < 0.001, r = 0.746). Children were mostly involved during social history taking, introduction, and physical examination but did not actively speak during the decision-making process. Children took an active role by instigating talks. Qualitative facilitators included appropriate language and verbal or non-verbal child allocated turns. Adults involved children by asking them questions and verifying their opinions or plans with the child. Teenagers participated most during the entire consultation, while younger children were more likely to lose their focus by the end of the conversation.Conclusion: Despite increased turn taking, children’s verbal participation remains low in pediatric consultations. If pediatricians and parents maintain a triadic conversation style throughout every stage of the medical encounter, child participation may increase.

What is Known:• Verbal child participation varies between 4 and 17%, measured in turns, words, speech time, or utterances.• Child participation is limited to social talk, laughter, and providing medical information.

What is New:• Child speech turns equal parental speech turns (28%), but average relative word count remains low (11%).• Three percent of the children’s turns are defined a “contributing in decision making, giving their opinion or give consent,” which equals three turns per consultation.
Clozapintherapie bei Wirkverlust einer antipsychotischen Einstellung nach Lebertransplantation
Authors: Sommer Lea , Weber Sabine , Listabarth Stephan , Trojer Armin , Groemer Magdalena , König Daniel 
Published: April 2024

ZusammenfassungNach schrittweiser Umstellung der psychopharmakologischen Therapie konnte bei einem Patienten mit vorbekannter paranoider Schizophrenie Clozapin etabliert werden, nachdem es bei St. p. Lebertransplantation und laufender Immunsuppression mit Tacrolimus zu einer Exazerbation psychotischer Symptomatik gekommen war. Bisherige Therapieversuche mit Risperidon, Paliperidon, Quetiapin und Olanzapin hatten zu keiner wesentlichen Besserung geführt. In dem hier beschriebenen Zeitraum von ca. 20 Wochen fanden wöchentliche Termine und Blutbildkontrollen statt sowie regelmäßige Laborkontrollen der Leber- und Nierenfunktionsparameter, metabolischen Parameter und Medikamentenspiegel. Schwankungen im Clozapinspiegel waren wahrscheinlich auf starke Änderungen des Nikotinkonsums zurückzuführen. Nach der Etablierung von Clozapin kam es insgesamt zu einer deutlichen Verbesserung des Allgemeinzustandes des Patienten.Die Verschlechterung des psychopathologischen Zustandes nach Transplantation könnte rückblickend mit möglichen unerwünschten neuropsychiatrischen Effekten von Tacrolimus in Zusammenhang stehen. Zwischenzeitlich traten Bewegungsstörungen auf, welche am ehesten auf den antipsychotischen Therapieversuch mit Paliperidon zurückgeführt wurden und mit Biperiden akut und erfolgreich behandelt werden konnten. Es kam im weiteren Verlauf nach Clozapinetablierung zu einer Hypersalivation, was von dem Patienten allerdings im Rahmen des gebesserten Allgemeinzustandes toleriert wurde. Die Fortsetzung regelmäßiger multidisziplinärer Kontrollen inklusive entsprechender Laboruntersuchungen waren weiterhin vorgesehen.
Effect of material composition and thickness of orthodontic aligners on the transmission and distribution of forces: an in vitro study
Authors: Elshazly Tarek M. , Bourauel Christoph , Ismail Ahmed , Ghoraba Omar , Aldesoki Mostafa , Salvatori Damiano , Elattar Hanaa , Alhotan Abdulaziz , Alkabani Yasmine 
Published: April 2024

Abstract
Objectives
To investigate the effects of material type and thickness on force generation and distribution by aligners.

Materials and methods
Sixty aligners were divided into six groups (n = 10): one group with a thickness of 0.89 mm using Zendura Viva (Multi-layer), four groups with a thickness of 0.75 mm using Zendura FLX (Multi-layer), CA Pro (Multi-layer), Zendura (Single-layer), and Duran (Single-layer) sheets, and one group with a thickness of 0.50 mm using Duran sheets. Force measurements were conducted using Fuji® pressure-sensitive films.

Results
The lowest force values, both active and passive, were recorded for the multi-layered sheets: CA Pro (83.1 N, 50.5 N), Zendura FLX (88.9 N, 60.7 N), and Zendura Viva (92.5 N, 68.5 N). Conversely, the highest values were recorded for the single-layered sheets: Duran (131.9 N, 71.8 N) and Zendura (149.7 N, 89.8 N). The highest force was recorded at the middle third of the aligner, followed by the incisal third, and then the cervical third. The net force between the incisal and cervical thirds (FI-FC) showed insignificant difference across different materials. However, when comparing the incisal and middle thirds, the net force (FI-FM) was higher with single-layered materials. Both overall force and net force (FI-FM) were significantly higher with 0.75 mm compared to those with a thickness of 0.50 mm.

Conclusions
Multi-layered aligner materials exert lower forces compared to their single-layered counterparts. Additionally, increased thickness in aligners results in enhanced retention and greater force generation. For effective bodily tooth movement, thicker and single-layered rigid materials are preferred.

Clinical relevance
This research provides valuable insights into the biomechanics of orthodontic aligners, which could have significant clinical implications for orthodontists. Orthodontists might use this information to more effectively tailor aligner treatments, considering the specific tooth movement required for each individual patient. In light of these findings, an exchangeable protocol for aligner treatment is suggested, which however needs to be proven clinically. This protocol proposes alternating between multi-layered and single-layered materials within the same treatment phase. This strategy is suggested to optimize treatment outcomes, particularly when planning for a bodily tooth movement.
Assessing the progress of internal instability of fill dam material in South Korea through long-term seepage tests
Authors: Lee Hee-Jun , Kim Inhyun , Chung Choong-Ki 
Published: April 2024

AbstractSeveral studies investigating the internal instability of well-graded soils have suggested that well-graded soils show characteristics and developments different from those of gap-graded soils. Moreover, the cause and progression of long-term internal instability in well-graded soils have not yet been established. This study aimed to address this knowledge gap by conducting long-term seepage tests to analyze the progress and cause of the internal instability of well-graded soils generally utilized in fill dams in South Korea. The test results revealed that well-graded soils in internally stable conditions exhibited clogging due to fine particles, reducing overall permeability. A similar phenomenon was identified under internally unstable conditions. The subsequent unclogging process resulted in a rapid increase in permeability and erosion rate with the collapse of the soil structure. Consequently, the internal instabilities of well-graded soils progress through suffosion. Based on the test results, the mechanism of internal instability and its progression in well-graded soils were proposed.
Volumetric segmentation in the context of posterior fossa-related pathologies: a systematic review
Authors: Kobets Andrew J. , Alavi Seyed Ahmad Naseri , Ahmad Samuel Jack , Castillo Ashley , Young Dejauwne , Minuti Aurelia , Altschul David J. , Zhu Michael , Abbott Rick 
Published: April 2024

Abstract
Background
Segmentation tools continue to advance, evolving from manual contouring to deep learning. Researchers have utilized segmentation to study a myriad of posterior fossa-related conditions, such as Chiari malformation, trigeminal neuralgia, post-operative pediatric cerebellar mutism syndrome, and Crouzon syndrome. Herein, we present a summary of the current literature on segmentation of the posterior fossa. The review highlights the various segmentation techniques, and their respective strengths and weaknesses, employed along with objectives and outcomes of the various studies reported in the literature.

Methods
A literature search was conducted in PubMed, Embase, Cochrane, and Web of Science up to November 2023 for articles on segmentation techniques of posterior fossa. The two senior authors searched through databases based on the keywords of the article separately and then enrolled joint articles that met the inclusion and exclusion criteria.

Results
The initial search identified 2205 articles. After applying inclusion and exclusion criteria, 77 articles were selected for full-text review after screening of titles/abstracts. 52 articles were ultimately included in the review. Segmentation techniques included manual, semi-automated, and fully automated (atlas-based, convolutional neural networks). The most common pathology investigated was Chiari malformation.

Conclusions
Various forms of segmentation techniques have been used to assess posterior fossa volumes/pathologies and each has its advantages and disadvantages. We discuss these nuances and summarize the current state of literature in the context of posterior fossa-associated pathologies.