bluuebunny/crossref_metadata_2025_split huggingface dataset:
Constraining the LyC escape fraction from LEGUS star clusters with SIGNALS H ii region observations: a pilot study of NGC 628
Authors: Teh Jia Wei , Grasha Kathryn , Krumholz Mark R , Battisti Andrew J , Calzetti Daniela , Rousseau-Nepton Laurie , Rhea Carter , Adamo Angela , Kennicutt Robert C , Grebel Eva K , Cook David O , Combes Francoise , Messa Matteo , Linden Sean T , Klessen Ralf S , Vilchez José M , Fumagalli Michele , McLeod Anna , Smith Linda J , Chemin Laurent , Wang Junfeng , Sabbi Elena , Sacchi Elena , Petric Andreea , Bruna Lorenza Della , Boselli Alessandro 
Published: June 2023

ABSTRACT
The ionizing radiation of young and massive stars is a crucial form of stellar feedback. Most ionizing (Lyman-continuum; LyC, λ &lt; 912Å) photons are absorbed close to the stars that produce them, forming compact H ii regions, but some escape into the wider galaxy. Quantifying the fraction of LyC photons that escape is an open problem. In this work, we present a seminovel method to estimate the escape fraction by combining broadband photometry of star clusters from the Legacy ExtraGalactic UV Survey (LEGUS) with H ii regions observed by the Star formation, Ionized gas, and Nebular Abundances Legacy Survey (SIGNALS) in the nearby spiral galaxy NGC 628. We first assess the completeness of the combined catalogue, and find that 49 per cent of H ii regions lack corresponding star clusters as a result of a difference in the sensitivities of the LEGUS and SIGNALS surveys. For H ii regions that do have matching clusters, we infer the escape fraction from the difference between the ionizing power required to produce the observed H ii luminosity and the predicted ionizing photon output of their host star clusters; the latter is computed using a combination of LEGUS photometric observations and a stochastic stellar population synthesis code slug (Stochastically Lighting Up Galaxies). Overall, we find an escape fraction of ${f}_{\textrm {esc}}= 0.09^{+0.06}_{-0.06}$ across our sample of 42 H ii regions; in particular, we find H ii regions with high fesc are predominantly regions with low $\operatorname{H\alpha }$-luminosity. We also report possible correlation between fesc and the emission lines $\rm [O\, \rm {\small II}]/[N\, \rm {\small II}]$ and $\rm [O\, \rm {\small II}]/H\beta$.
Magnetically activated accretion outbursts of pre-main-sequence discs
Authors: Cleaver Jacob , Hartmann Lee , Bae Jaehan 
Published: June 2023

ABSTRACT
We investigate whether triggering of the magnetorotational instability (MRI) in protoplanetary discs can account for the wide diversity of observed accretion outbursts. We show that short-lived, relatively low accretion rate events probably result from triggering in the inner disc and can occur at low surface densities, comparable to or smaller than the minimum mass solar nebula, and thus are very unlikely to result from MRI triggering by gravitational instability. We develop time-dependent accretion disc models using an α-viscosity approach and calculate light curves to compare with observations. Our modelling indicates that the lag time between infrared and optical bursts seen in Gaia 17bpi can be explained with an outside-in propagation with an α ∼ 0.1 in the MRI-active region, consistent with other estimates. While outbursts in inner discs can show time delays of a few yr between infrared and optical light curves, our models indicate that large, FU Ori-like bursts can exhibit infrared precursors decades before optical bursts. Detecting such precursors could enable analysis of the central star before it is overwhelmed by the rapid accreting material, as well as constraining outburst physics. Our results emphasize the importance of near-infrared monitoring of young stellar objects in addition to optical surveys. In addition, our findings emphasize the need for more sophisticated, three-dimensional, non-ideal magnetohydrodynamic simulations to fully exploit observational results.
Tax competition and state aid
Authors: Mason Ruth 
Published: June 2023

Abstract
At the inception of a new and potentially transformative type of tax enforcement, this article reviews the goals underlying the prohibition on state aid, and, in particular, whether those goals properly encompass limitations on tax competition. To explore this question, this article examines treaty text and structure, doctrine, and policy arguments for and against using state aid to curb tax competition. It concludes that the European Commission’s expansion of state-aid doctrine to limit tax competition improperly constrains Member State tax autonomy, arrogates tax policy power to the unelected Commission, and increases legal uncertainty. This article urges the Court of Justice of the European Union to clarify that preventing tax competition is not an independent goal of state-aid enforcement, although limits on tax competition may arise instrumentally via a free-trade interpretation of the prohibition of state aid.
Decision-making Algorithm for the Surgical Treatment of Degenerative Lumbar Spondylolisthesis of L4/L5
Authors: Schönnagel Lukas , Caffard Thomas , Zhu Jiaqi , Tani Soji , Camino-Willhuber Gaston , Amini Dominik A. , Haffer Henryk , Muellner Maximilian , Guven Ali E. , Chiapparelli Erika , Arzani Artine , Amoroso Krizia , Shue Jennifer , Duculan Roland , Zippelius Timo , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Mancuso Carol A. , Hughes Alexander P. 
Published: June 2023

Study Design.
A retrospective analysis of prospectively collected data.

Objective.
To report the decision-making process for DA and DF at a tertiary orthopedic center and compare the operative outcomes between both groups.

Background.
Controversy exists around the optimal operative treatment for DLS, either with decompression and fusion (DF) or decompression alone (DA). Although previous studies tried to establish specific indications, clinical decision-making algorithms are needed.

Methods.
Patients undergoing spinal surgery for DLS at L4/5 were retrospectively analyzed. A survey of spine surgeons was performed to identify factors influencing surgical decision-making, and their association with the surgical procedure was tested in the clinical dataset. We then developed a clinical score based on the statistical analysis and survey results. The predictive capability of the score was tested in the clinical dataset with a ROC analysis. To evaluate the clinical outcome, two years follow-up postoperative Oswestry Disability Index (ODI), postoperative low back pain (LBP) (NAS), and patient satisfaction were compared between the DF and DA groups.

Results.
124 patients were included in the analysis; 66 received DF (53.2%) and 58 DA (46.8%). Both groups showed no significant differences in postoperative ODI, LBP, or satisfaction. The degree of spondylolisthesis, facet joint diastasis and effusion, sagittal disbalance, and severity of LBP were identified as the most important factors for deciding on DA or DF. The AUC of the decision-making score was 0.84. At a cut-off of 3 points indicating DF, the accuracy was 80.6%.

Conclusion.
The 2-year follow-up data showed that both groups showed similar improvement in ODI after both procedures, validating the respective decision. The developed score shows excellent predictive capabilities for the decision processes of different spine surgeons at a single tertiary center and highlights relevant clinical and radiographic parameters. Further studies are needed to assess the external applicability of these findings.
Open vs Robotic Radical Cystectomy Outcomes at a Single Institution: A Retrospective Review of 152 Patients
Authors: Gonzalez Ashley N. , Zhao Lee C. , Steinberg Gary D. , Corcoran Anthony , Wysock James S. , Huang William C. 
Published: June 2023

Introduction:
Robotic radical cystectomy is becoming increasingly used over the traditional open approach; however, the potential advantages remain an area of active investigation, with several studies to date finding overall comparable outcomes. We sought to add to the existing body of work by performing a retrospective review of open vs robotic radical cystectomies performed at our institution.

Methods:
All patients who underwent radical cystectomy for urothelial cancer with curative intent at New York University (Manhattan and Long Island sites) were included. Surgical dates spanned between October 2017 and March 2022. Individual patient charts were reviewed in Epic for data extraction.

Results:
A total of 152 patients were included in the final analysis including 71 robotic and 81 open radical cystectomies. Estimated blood loss and the number of perioperative blood transfusions were significantly lower in the robotic cohort, whereas operative times were significantly longer. The median length of stay was 5 days in the robotic cohort vs 6 days in the open cohort; this only reached statistical significance for the ileal conduit subgroup. However, 90-day mortality, return to emergency department, readmissions, and complication rates were not significantly different. Oncologic outcomes were also similar, aside from an increase in lymph node count among the robotic cohort.

Conclusions:
In the hands of experienced surgeons, a robotic surgical approach did not confer major benefits in perioperative morbidity and mortality, although it did achieve similar oncologic efficacy, led to fewer blood transfusions, and led to a shorter length of stay in patients who underwent ileal conduits diversions.
Protective Effects of Infliximab Against Kanamycin-Induced Ototoxicity in Rats
Authors: Koçdor Pelin , Özkan Esra , Akpunar Fatmanur , Hızal Evren , Özdemir Yasemin Gürsoy 
Published: June 2023

Hypothesis
To examine the protective effects of infliximab (INF) against kanamycin (KM)-induced hearing loss.

Background
Tumor necrosis factor α blockers can reduce cellular inflammatory reactions and decrease cell death.

Methods
Thirty-six rats with normal hearing were randomly divided into six groups. The first group was injected with 400 mg/kg KM intramuscularly (IM), the second group with 7 mg/kg INF intraperitoneally (IP) and 400 mg/kg KM IM, the third group with 7 mg/kg INF IP and 200 mg/kg KM IM, and the fourth group with 1 mg/kg 6-methylprednisolone (MP) IP and 400 mg/kg KM IM. Group 5 was injected with 1 mg/kg MP IP and 200 mg/kg KM IM, and group 6 with saline IP once. Auditory brain-stem response (ABR) for hearing thresholds was performed on days 7 and 14. From the frozen sections of the cochlea, the area of the stria vascularis, the number of neurons in the spiral ganglion, the fluorescence intensity of hair cells (FIHC), postsynaptic density (PSD), and presynaptic ribbons (PSRs) were calculated.

Results
The KM-induced increase in hearing thresholds was detected on the 14th day. Hearing was only preserved in the group treated with INF after low-dose KM exposure but not in the groups that received high-dose KM. The FIHC, excitatory PSD, and PSR were preserved only in the INF-treated group after half-dose KM exposure. In MP groups, FIHC, excitatory PSD, and PSR were significantly lower than in the control group.

Conclusions
Our results support that tumor necrosis factor–based inflammation may play a role in the ototoxicity mechanism.
Expanding Understanding of Electrocochleography in Cochlear Implantation: Auditory Neuropathy Spectrum Disorder With Normal Pure Tone Average
Authors: Buhle Anna C. , McCrary Hilary C. , Gordon Steven A. , Johnson Kathryn M. , Babajanian Eric E. , Patel Neil S. 
Published: June 2023

Objective:
Describe the preoperative decision-making, intraoperative electrocochleographic (ECoG) findings, and outcome of cochlear implantation (CI) in a patient with auditory neuropathy spectrum disorder (ANSD) and normal pure-tone thresholds.

Patients:
A 19-year-old with a history of hypoxic ischemic encephalopathy and seizures was referred for hearing rehabilitation in the setting of typical hearing by pure tone audiometry but poor speech understanding. A diagnosis of ANSD was made based on acoustic brainstem response (ABR), distortion product otoacoustic emission, and acoustic reflex testing. Imaging revealed no central cause of hearing impairment.

Interventions:
Right-sided CI.

Main Outcome Measures:
Preoperative and postoperative audiometric data. Intraoperative ECoG.

Results:
Preoperatively the patient underwent comprehensive audiologic testing with behavioral audiometry, ABR testing, and CI candidacy evaluation. In the right ear, the pure tone average (PTA) was 15 dB and word recognition score was 36%. ABR confirmed ANSD. Preoperative CNC and AzBio in quiet were 8% and 0%, respectively. Intraoperative ECoG amplitudes and audiometry showed responses in the 100 uV range and estimated PTA of 42 dB HL. Postoperative testing at 1-month post-initial activation revealed PTA of 45 dB HL and unchanged word and sentence scores. However, the patient cites an improved ability to communicate and increased confidence and averages over 14 hours of device use daily.

Conclusions:
To our knowledge, this is the first reported case of CI in an ear with normal PTA. Given that nearly all presently available ECoG data comes from patients with greater degrees of hearing loss, this unique case adds to our understanding of hearing preservation in CI.
Anatomic Variations of the Lateral Branch of the Supraorbital Nerve Observed in Endoscopic Forehead Surgery
Authors: Kim Sung-Eun , Jung Jaemin 
Published: June 2023

Surgeons dissect carefully in the medial third of the supraorbital rim to preserve the supraorbital nerve (SON) during surgical forehead rejuvenation. However, the anatomic variations of SON exit from the frontal bone have been researched in cadaver or imaging studies. In this study, we report a variation in the lateral branch of SON observed in an endoscopic view during forehead lifts. A retrospective review of 462 patients who underwent endoscopy-assisted forehead lifts between January 2013 and April 2020 was performed. Data, including the location, number, and form of the exit point and thickness of SON and its lateral branch variant, were recorded and reviewed intraoperatively, utilizing high-definition endoscopic assistance. Thirty-nine patients and 51 sides were included, and all patients were female, with a mean age of 44.53 (18–75) years. This nerve exited a foramen in the frontal bone ~8.82 ± 2.79 cm lateral to SON and ~1.89 ± 1.34 cm from the supraorbital margin vertically. Observed thickness variations of the lateral branch of SON included 20 small, 25 medium, and 6 large nerves. This study revealed various positional and morphologic variations of the lateral branch of SON in an endoscopic view. Thus, surgeons can be alerted of the anatomic variations of SON and establish careful dissection during procedures. In addition, the findings of this study will be useful in planning nerve blocks, filler injections, and migraine treatments in the supraorbital region.
Intraorbital Wooden Foreign Body in a Soldier
Authors: Hwang Kun , Park Chan Yong 
Published: June 2023

The authors report a case of an intraorbital wooden foreign body that was misinterpreted as a radiolucent area of retained air on a computed tomography (CT) scan. A 20-year-old soldier presented to an outpatient clinic following an impingement with a bough while cutting down a tree. He had a 1-cm-deep laceration on the inner canthal area of his right eye. A military surgeon explored the wound and suspected a foreign body, but could not find or extract anything. Thereafter, the wound was sutured and the patient was transferred. An examination revealed an acutely ill-looking man with distressing pain in the medial canthal and supraorbital area associated with ipsilateral ptosis and periorbital edema. A CT scan showed a radiolucent area suspected to be retained air in the medial periorbital area. The wound was explored. Upon removal of the stitch, yellowish pus was drained. An intraorbital piece of wood measuring 1.5 cm×0.7 cm was extracted. The patient’s hospital course was uneventful. Pus culture revealed growth of Staphylococcus epidermidis. Wood has a density similar to air and fat and can be difficult to distinguish from soft tissue both on plain x-ray films and CT. In this case, the CT scan showed a radiolucent area resembling retained air. Magnetic resonance imaging is a better method of investigation in cases of a suspected organic intraorbital foreign body. Clinicians should be aware of the possibility of retention of an intraorbital foreign body in patients presenting with periorbital trauma, especially those with even a small open wound.
The Influence of Bolus of Methylprednisolone on Postorthognathic Surgery Symptoms: A Controlled Clinical Trial
Authors: Amodeo Giulia , Cerbelli Edoardo , Pisano Annalinda , Minieri Luciana , Scopelliti Domenico 
Published: June 2023

Objective:Despite improvements in maxillary and mandibular osteotomy, complications still result in around 20%. Post and intraoperative standard therapies, based on the use of betamethasone and tranexamic acid, could help to minimize the onset of side effects. The aim of the study was to compare the role of a supplementary bolus of methylprednisolone rather than the standard therapy in the onset of postoperative symptoms.Methods:The authors enrolled 10 patients, affected by class 2 and 3 Dentoskeletal, submitted to the institution for maxillomandibular repositioning osteotomy between October 2020 and April 2021. Patients were divided into 2 groups as follows: 5 patients (groupA) received standard therapy consisting of the administration of 4 mg of betamethasone, intraoperatively, and 1 g of tranexamic acid in 2 administrations. The remaining 5 patients (groupB) received a supplementary bolus of 20 mg methylprednisolone before the end of the surgery.All patients received, in the postoperative period, 4 mg of betamethasone every 12 hours, for 3 days. Postoperative outcomes were evaluated with a questionnaire evaluating speaking discomfort, pain when swallowing, feeding discomfort, drinking discomfort, swelling, and ache. Each parameter was associated with a numeric rating scale ranging from 0 to 5.Results:The authors observed that patients treated with a supplementary bolus of methylprednisolone (groupB) had a statistically significant reduction of all postoperative symptoms as compared with patients of groupA(*P< 0.05, **P<0.01 Fig. 1).Conclusion:The study highlighted that the additional bolus of methylprednisolone improved all of the 6 parameters investigated by the questionnaire submitted to patients, resulting in a faster recovery and improvement of the patient’s compliance with surgery. Further studies with a larger population are needed to confirm preliminary results.
A Randomized Controlled Trial to Assess the Impact of Enhanced Recovery After Surgery on Patients Undergoing Elective Spine Surgery
Authors: Ali Zarina S. , Albayar Ahmed , Nguyen Jessica , Gallagher Ryan S. , Borja Austin J. , Kallan Michael J. , Maloney Eileen , Marcotte Paul J. , DeMatteo Ronald P. , Malhotra Neil R. 
Published: June 2023

Objective:
To conduct a prospective, randomized controlled trial (RCT) of an enhanced recovery after surgery (ERAS) protocol in an elective spine surgery population.

Summary Background Data:
Surgical outcomes such as length of stay (LOS), discharge disposition, and opioid utilization greatly contribute to patient satisfaction and societal healthcare costs. ERAS protocols are multimodal, patient-centered care pathways shown to reduce postoperative opioid use, reduced LOS, and improved ambulation; however, prospective ERAS data is limited in spine surgery.

Methods :
This single-center, IRB-approved, prospective RCT enrolled adult patients undergoing elective spine surgery between March 2019 and October 2020. Primary outcomes were peri-operative and 1-month postoperative opioid use. Patients were randomized to ERAS (n=142) or standard of care (SOC; n=142) based on power analyses to detect a difference in postoperative opioid use.

Results:
Opioid use during hospitalization and the first postoperative month was not significantly different between groups (ERAS 112.2 vs. SOC 117.6 MME, P=0.76; ERAS 38.7% vs. SOC 39.4%, P=1.00 respectively). However, patients randomized to ERAS were less likely to use opioids at 6 months postoperatively (ERAS 11.4% vs. SOC 20.6%, P=0.046) and more likely to be discharged to home after surgery (ERAS 91.5% vs. SOC 81.0%, P=0.015).

Conclusion:
Here, we present a novel ERAS prospective RCT in the elective spine surgery population. While we do not detect a difference in the primary outcome of short-term opioid use, we observe significantly reduced opioid use at 6-month follow-up as well as an increased likelihood of home disposition after surgery in the ERAS group.
Body Mass Index is Associated with Pediatric Complicated Appendicitis and Postoperative Complications
Authors: Hebballi Nutan B. , DeSantis Stacia , Brown Eric L. , Markham Christine , Tsao KuoJen 
Published: June 2023

Objective:
To investigate the association between body mass index (BMI) spectrum and complicated appendicitis and postoperative complications in pediatric patients.

Summary Background Data:
Despite the impact of being overweight and obese on complicated appendicitis and postoperative complications, the implications of underweight are unknown.

Methods:
A retrospective review of pediatric patients was conducted using NSQIP (2016–2020) data. Patient’s BMI percentiles were categorized into underweight, normal weight, overweight, and obese. The 30-day postoperative complications were grouped into minor, major, and any. Univariate and multivariable logistic regression models were performed.

Results:
Among 23,153 patients, the odds of complicated appendicitis were 66% higher in underweight patients (OR=1.66; 95% CI: 1.06-2.59) and 28% lower in overweight patients (OR=0.72; 95% CI: 0.54-0.95) than normal-weight patients. A statistically significant interaction between overweight and preoperative white blood cells (WBC) increased the odds of complicated appendicitis (OR=1.02; 95% CI: 1.00-1.03). Compared to normal-weight patients, obese patients had 52% higher odds of minor (OR=1.52; 95% CI: 1.18-1.96) and underweight patients had three times the odds of major (OR=2.77; 95% CI: 1.22-6.27) and any (OR=2.82; 95% CI: 1.31-6.10) complications. A statistically significant interaction between underweight and preoperative WBC lowered the odds of major (OR=0.94; 95% CI: 0.89-0.99) and any complications (OR=0.94; 95% CI: 0.89-0.98).

Conclusions:
Underweight, overweight, and interaction between overweight and preoperative WBC were associated with complicated appendicitis. Obesity, underweight and interaction between underweight and preoperative WBC were associated with minor, major, and any complications. Thus, personalized clinical pathways and parental education targeting at-risk patients can minimize postoperative complications.
Scalablein-vitroimmunostimulation of human blood for in-depth profiling of acute immune response effects
Authors: Reitzner Stefan Markus , Brodin Petter , Mikeš Jaromír 
Published: June 2023

SummaryIn-vitro immune stimulation of whole blood has great analytic potential for exploring the immune system function. However, logistical and biological constraints might limit the extent to which such investigations can be performed. Flexible and often even low-tech mobile applicability can increase the diversity of conditions that can be investigated. To this end, we developed and optimized a medium that enables prolongedin-vitrostimulation and enables highly functional immune responses within 24 hours of incubation. In addition, we also developed and optimized a low-tech water-based mobile incubator to enable logistical flexibility. Finally, we describe the implementation of both systems using a practical example of sample collection at a sampling site with no access to laboratory equipment outside of a research lab.