bluuebunny/crossref_metadata_2025_split huggingface dataset:
The transition from Galactic to extragalactic cosmic rays: The high–energy end of the Galactic spectrum
Authors: Cristofari Pierre 
Published: April 2023

Understanding the transition from Galactic to extragalactic cosmic rays (CRs) is essential to make sense of the Local cosmic ray spectrum. Several models have been proposed to account for this transition in the 0.1 - 10 × 1018 eV range. For instance: ankle models, where the change from a steep Galactic component to a hard extragalactic spectrum occurs in the 4 − 10 × 1018 eV region, dip models, where the interactions of CR protons with the CMB producing electron-positron pairs shape the ankle, or mixed composition models, in which extragalactic CRs are composed of nuclei of various types.
In all these scenarios, the low-energy part of the transition involves the high-energy part of the Galactic component. Therefore, any information on the Galactic component, such as maximum energy, chemical composition, and spectrum after propagation, is crucial to understanding the Galactic-extragalactic transition. We briefly review the high-energy part of the CR spectrum expected from the best potential sources of Galactic CRs.
The Effect of Dry Needling on Suprapatellar Tendonitis:
A Case Report
Authors: Shahbazi Majid 
Published: April 2023

Abstract
Background Patellar tendinitis is common in jumping sports. Pain from
patellar tendinopathy is challenging to manage. Dry needling as a stand-alone
treatment for tendinopathy is supported. To our knowledge, dry needling has
never been used alone. This case report depicts dry needling on the proximal
patellar pole.
Case description A 43-year-old male presented with left suprapatellar
tendinitis. He was injured four months before beginning dry needling while
playing futsal without warming up. The superior pole of the patellar was tender
to palpation and caused moderate pain. At 20 degrees of knee flexion, discomfort
began during double leg squats. The Clarke’s Sign, Eccentric Step, and
Step Up tests showed positive results. The patient received five sessions of DN
at the proximal pole of the patella twice weekly. This study’s primary
outcomes were the numeric pain rating scale (NPRS), the Kujala Anterior Knee
Pain Scale (AKPS), the global rating of change scale (GRC), and the angle of
knee flexion during the squat. The researcher collected data at the five
stages.
Outcomes The patient’s primary outcome measures improved after
three weeks of DN and three months of follow-up. The NPRS showed a reduction in
pain, while the AKPS demonstrated a decrease in disability.
Conclusion The successful treatment of a patient with suprapatellar
tendinopathy utilizing DN is possibly described for the first time in this case
report. This study demonstrated the efficacy of dry needling as a first-line
treatment for managing chronic tendinopathy with a history of trauma.
NextLens—The Next Generation of Surgical Navigation: Proof of Concept of an Augmented Reality System for Surgical Navigation
Authors: Grunert Ronny , Snyderman Carl-Henry , Gardner Paul , Busse Michel , Ahner Lukas , Kropla Fabian , Möbius Robert , Jung Svenja , Scholz Sebastian , Güresir Erdem , Winkler Dirk 
Published: April 2023

Abstract
Objective The aim of this work was the development of an augmented reality system including the functionality of conventional surgical navigation systems.
Methods An application software for the Augmented Reality System HoloLens 2 from Microsoft was developed. It detects the position of the patient as well as position of surgical instruments in real time and displays it within the two-dimensional (2D) magnetic resonance imaging or computed tomography (CT) images. The surgical pointer instrument, including a pattern that is recognized by the HoloLens 2 sensors, was created with three-dimensional (3D) printing. The technical concept was demonstrated at a cadaver skull to identify anatomical landmarks.
Results With the help of the HoloLens 2 and its sensors, the real-time position of the surgical pointer instrument could be shown. The position of the 3D-printed pointer with colored pattern could be recognized within 2D-CT images when stationary and in motion at a cadaver skull. Feasibility could be demonstrated for the clinical application of transsphenoidal pituitary surgery.
Conclusion The HoloLens 2 has a high potential for use as a surgical navigation system. With subsequent studies, a further accuracy evaluation will be performed receiving valid data for comparison with conventional surgical navigation systems. In addition to transsphenoidal pituitary surgery, it could be also applied for other surgical disciplines.
Bluetooth Coupling in Hearing Aids: Effect on Audiovisual Speech Recognition and Quality Rating of Compressed Speech in Older Individuals with Sloping Hearing Loss
Authors: Shetty Hemanth Narayan , Kumar Shubhaganga Dhrruva , Vijayasarathy Srikar 
Published: April 2023

Abstract
Introduction Older individuals often report that they find it difficulty in enjoying watching television since they find it hard to follow the rapid intensity variations, and voice changes from scene to scene.
Objective The present study investigated the effect of coupling the hearing aid with the television via Bluetooth on audiovisual speech recognition and quality rating of compressed speech in older individuals with hearing loss.
Method Twenty participants in the age range of 60 to 75 years who had moderate to moderately severe sloping sensorineural hearing loss were bilaterally fitted with digital receiver in the canal hearing aids. The hearing aid was coupled with a television via Bluetooth using a streamer. The video recorded stimuli were presented at 65 dB SPL at normal rate, 35% compression and 45% compression conditions. Speech recognition scores and quality ratings were obtained for each condition with and without the Bluetooth streamer connected to the hearing aids.
Results Speech recognition scores were significantly better with Bluetooth coupling compared with conventional hearing aid use at 40% compressed speech rate. The quality was also rated higher in almost all parameters across speech rates when Bluetooth was used.
Conclusions The improved clarity and nullification of room reverberation offered by Bluetooth coupling can potentially compensate for the age-related temporal processing deficit contributing to ease of listening.
Patterns of Maxillofacial Injures Caused by Motorcycle Accidents
Authors: Noorali Imad S. , Attyia Marwa A. , Alsunbuli Mudher M. B. 
Published: April 2023

Abstract
Introduction Motorcycles are used as a common means of transportation, and motorcycle accidents are responsible for a major portion of trauma injuries.
Objectives The purpose of this study was to analyze the patterns of facial injuries in motorcyclists, to evaluate the types of injuries, and to investigate if the accident-related factors had any impact on the characteristics of the injuries.
Methods This retrospective observational study included 74 patients with maxillofacial injuries following motorcycle-related accidents. Investigated data were divided into four main categories: sociodemographic, accident-related, injury-related, and treatment-related.
Results All the patients were males with a mean age (±SD) of 25.03 (±9.986) years. Most accidents (n = 44, 59.4%) occurred in the evening. Most of the patients (n = 40, 54%) were traveling on motorcycle models that had maximum speed of over 120 km/h. Furthermore, 15 patients (18.9%) were under the influence of alcohol during the crashes and only one patient was wearing a helmet. Fractures of the maxillofacial bones were observed in 50 (67.5%) crash victims; 24 of them (48%) had middle third fractures, 11 (22%) had mandibular fractures, and 15 patients (30%) presented with a combination of lower, middle, and upper third fractures.
Conclusion Almost all patients were not wearing helmets at the moment of the crash. The most common fractured site was the maxilla. The majority of the patients received surgical treatment. Increased enforcement of safety measures for riders and raising awareness about the dangers of motorcycle crashes are required measures to improve traffic safety and, ultimately, population health.
Nasal Crust-Related Morbidity and Debridement After Endoscopic Skull Base Surgery
Authors: Curran Kent , Adepoju Adedamola , Pinheiro-Neto Carlos , Peris-Celda Maria , Kenning Tyler 
Published: April 2023

Abstract
Introduction: Nasal crust after endoscopic skull base surgery can cause nasal congestion, obstruction, and pain, which can affect quality of life. The use of debridement aims to provide symptomatic relief and improve quality of life. Generally, most adult patients tolerate office-based debridement, except in a few select patients that require further sedation in the operating room for a debridement. The study sought to determine the rate of symptomatic crust-related morbidity and the rate of debridement in both the office and the operating room.
Methods: Premorbid, operative, and postoperative data of adult patients who had endoscopic skull base surgery in our institution from 2014 to 2018 were reviewed retrospectively. The characteristics of nasal symptoms in the postoperative period were determined and the number of debridements in the office and the operating room were analyzed.
Results: Two hundred and thirty-four (234) patients with 244 surgeries were included in the study. The majority, 68.9%, had a sellar lesion and a free mucosa graft (FMG) was the most common skull base reconstruction at 53.5%. One hundred and twenty (49.0%) had crust-related symptoms during the postoperative period and 11 patients (4.5%) required the operating room for debridement. The use of a pedicled flap, anxiety, and preoperative radiotherapy were significantly associated with intolerance to in-office debridement (p-value=0.05).
Conclusions: The use of a pedicled flap or anxiety may predispose patients to require an OR debridement. Previous radiotherapy also influenced the tolerance to the in-office debridement.
Variations of the Nasal Septum in Adult Nigerians: Computed Tomography Study
Authors: Ominde Beryl Shitandi , Ikubor Joyce , Igbigbi Patrick Sunday , Okolugbo Nekwu 
Published: April 2023

AbstractIntroduction The morphological variants of the nasal septum have been implicated in sinus pathology and pose a challenge during endoscopic surgeries.Objective The present study aimed at evaluating the prevalence of nasal septum variants in adult Nigerians.Methods The present study was performed at the Radiology Department of Delta State University Teaching Hospital, Nigeria, following ethical approval. Brain computed tomography (CT) scan images of 336 adults were evaluated for nasal septum variants. The angle of the deviated nasal septum was measured, and the severity was classified. Data were analyzed using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, NY, USA). The angle of deviation was presented in means and standard deviation. Frequencies of the variants were presented in percentages. The Student t-test was used to compare the angle of deviation, while the chi-squared test was used to compare the frequencies in the different groups. A p-value < 0.05 was considered statistically significant.Results The prevalence of straight and deviated nasal septum was 59.5% and 40.5%, respectively. Deviation was predominant in females (46%) and, more frequently, of moderate severity (75%). The angle of deviation was significantly larger in males (12.55 ± 2.99°) than in females (11.13 ± 2.41°; p = 0.003). Nasal spur had a prevalence of 11.9%, and its coexistence with deviated nasal septum was observed in 5.06%. Septal pneumatization was seen in 10 patients (3%).Conclusion Deviation of the nasal septum occurred more in females and toward the left; however, the angle of deviation was significantly higher in males. Nasal septal spur and pneumatization were the least prevalent variants.
Assessment of Pulmonary Metastasis in Differentiated Thyroid Carcinoma: Value of HRCT Correlation with Functional Imaging
Authors: Kalshetty Ashwini , Basu Sandip 
Published: April 2023

AbstractPulmonary metastases in thyroid carcinoma demonstrates varying imaging characteristics and disease biology and the outcome. The valuable complimentary role of high-resolution CT (HRCT) in conjunction with functional imaging such as radioiodine scan has been discussed and illustrated in this review along with the varied clinical and imaging presentations of lung metastases from differentiated thyroid cancer (DTC). A multi-modality patient-specific diagnostic approach and awareness about the atypical presentations helps in early identification as well as effective management of these patients, and especially in certain situations that could need multi-disciplinary management. While HRCT of the lungs as an added tool provides detailed visualization of the lung parenchyma, in the era of hybrid imaging, the routine adoption of SPECT-CT in patients with pulmonary metastases (in diagnostic or post-treatment settings) could provide equivalent or even incremental information from further management viewpoint.
Paranasal Sinus Embryonal Rhabdomyosarcoma Metastasizing to Breast and Ovary on PET/CT—A Case Report with the Review of Literature
Authors: Singh Vijay , Saini Vivek , Ora Manish , Gambhir Sanjay 
Published: April 2023

AbstractRhabdomyosarcoma (RMS) is a malignant soft tissue tumor of skeletal muscle origin. The head and neck, urinary tract, and extremities are the common sites of origin. Embryonal, alveolar, pleomorphic, and spindle/sclerosing are subtypes. It is more common in childhood and rare among adults. The incidence and risk factors for this disease are mainly largely unknown. RMS is sporadic in most instances; however, it is attributed to familial syndromes in some situations—its metastasis to the lungs, bone marrow, and lymph nodes. Breast and ovary involvement is scarce. Diagnostic workup mainly includes contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). However, 18F-fluro-deoxyglucose positron emission tomography (18F-FDG-PET/CT) and PET/MRI are increasing contribution to providing functional insights about tumor biology and improving the diagnostic accuracy of the imaging workup. This report presents a case of the neck's embryonal RMS metastasizing simultaneously to the breast and ovary. PET/CT imaging revealed the unusual pattern, further validated by histopathology.
Comparison of Free Flap Outcomes at a University Hospital versus County Hospital Setting for Head and Neck Reconstruction
Authors: Swanson Mark S. , Gantz Oliver , Zhou Sheng , Fisher Laurel , Kezirian Eric , Tan Michael H. , Zhang Yanchen , Chambers Tamara N. , Sinha Uttam K. , Kokot Niels 
Published: April 2023

Abstract
Introduction Patients at public county hospitals often have poorer access to healthcare with advanced disease on presentation. These factors, along with limited resources at county hospitals, may have an impact on outcomes for patients requiring complex head and neck reconstruction.
Objective To delineate differences in the frequency of complications in two different care settings, a public county hospital and a private university hospital.
Methods Retrospective review of otolaryngology patients at a university hospital compared with a publicly-funded county hospital. The main outcome measure was major complications including total flap loss or unplanned reoperation in 30 days. Secondary outcome measures included medical complications, partial flap loss, and unplanned hospital readmission in 30 days.
Results In the county hospital sample (n = 58) free flap failure or reoperation occurred in 20.7% of the patients, and minor complications, in 36.2% of the patients. In the university hospital sample (n = 65) flap failure or reoperation occurred in 9.2% of the patients, and minor complications, in 12.3% of the patients. Patients at the private hospital who had surgery in the oropharynx were least likely to have minor complications.
Conclusion Patients at the county hospital had a higher but not statistically significant difference in flap failure and reoperation than those at a university hospital, although the county hospital experienced more minor postoperative complications. This is likely multifactorial, and may be related to poorer access to primary care preoperatively, malnutrition, poorly controlled or undiagnosed medical comorbidities, and differences in hospital resources.
The Effect of Tonsillectomy and Adenoidectomy on Upper Airway Obstruction Patterns in Children with Obstructive Sleep Apnea
Authors: Mothersole Kelsey , Ulualp Seckin Omer , Szmuk Peter , Liu Christopher 
Published: April 2023

Abstract
Introduction Alterations in upper airway flow dynamics and sites of airway obstruction immediately after tonsillectomy and adenoidectomy (TA) have not been assessed. Identification of the changes in airway obstruction patterns after TA potentially improves the surgical management of children with obstructive sleep apnea (OSA).
Objective To evaluate the effect of TA on upper airway obstruction patterns detected with drug-induced sleep endoscopy (DISE).
Methods The medical records of patients who underwent pre-TA DISE during the induction of anesthesia and post-TA DISE at the end of TA were reviewed. Data pertaining to polysomnography and DISE findings were analyzed.
Results Twenty-seven patients (15 male and 12 females aged between 2 and 18 years old) were identified. All patients had obstruction at multiple sites of the upper airway. Prior to TA, airway obstruction was at the level of the velum in 27 patients, of the oropharynx/lateral walls in 27, of the tongue in 7, and of the epiglottis in 4. After TA, airway obstruction was at the level of the velum in 24 patients, of the oropharynx/lateral walls in 16, of the tongue in 6, and of the epiglottis in 4. The degree of obstruction at the levels of the velum and oropharynx/lateral walls after TA was significantly decreased.
Conclusions Drug-induced sleep endoscopy performed prior to TA revealed that most of the sites of airway obstruction persisted after TA in OSA children with multiple sites of airway obstruction. Further studies in larger group of children with OSA are needed to establish the value of DISE findings in predicting residual OSA after TA, surgical planning, determining the need for post TA sleep study, and counseling caregivers.
The Effect of Different Stimulation Rates on Brainstem Auditory-Evoked-Potential Responses
Authors: Andrade Kelly Cristina Lira de , Frizzo Ana Cláudia Figueiredo , Oliveira Katielle Menezes de , Pinheiro Natália dos Santos , Marques Maria Cecilia dos Santos , Carnaúba Aline Tenório Lins , Costa Klinger Vagner Teixeira , Menezes Pedro de Lemos 
Published: April 2023

Abstract
Introduction Auditory-evoked potentials are influenced by several factors, including polarity, filter, stimulus intensity and stimulation rate. The presentation of higher rates of stimuli per second enables the collection of a greater number of responses in a given period of time, promoting a shorter testing time; however, the collected recordings are subject to changes related to wave morphology.
Objectives To compare the brainstem auditory-evoked-potential responses with click stimulus with the most commonly used stimulation rates in the clinical practice.
Methods The present cross-sectional analytical study was performed with fifteen participants of both genders and normal hearing thresholds. The brainstem auditory-evoked potential was performed at four different stimulation rates (21.1, 26.7, and 27.7 stimuli/s, and a rate determined based on a mathematical calculation using the a measurement of the transmission frequency of the power grid at the time of the examination).
Results We observed that the rate of 21.1 stimuli/s showed the highest amplitudes for waves I, III, and V when compared with the other rates. The rate of 26.7 stimuli/s, when compared with 27.7 stimuli/s, showed a higher amplitude for wave V. The latency if wave V was significantly lower with the rate of 21.1 stimuli/s than with 27.7 stimuli/s.
Conclusions The stimulation rate interferes with wave latencies and amplitudes; its decrease from 27.7 to 21.1 stimuli/s decreases the latency of wave V and increases the amplitues and improves the morphology of waves I, III and V. In addition, we found evidence that suggests an improvement in the visualization of wave III by adjusting the stimulation rate based on a measurement of the local transmission frequency of the power grid.
Observation of two different temperature-dependent behaviors of the defects in III-nitride micro-LEDs
Authors: Mo Chen , Liu Bangzhi , Xu Jian 
Published: April 2023

As micro-LED pixel sizes shrink, the volume-to-surface ratio increases, so defect-assisted non-radiative recombination becomes more important for LED pixel efficiency degradation. The donor-type defects on the pixel sidewalls are induced by inductively coupled plasma etching, and the carrier leakage through the sidewalls is determined by the density of surface traps. The defects in quantum wells provide places for the non-radiative recombination of electron–hole pairs, and the recombination rate is related to the thermal velocity of carriers and the trapping cross section of defects. The experimental results indicate that the significant improvement of quantum efficiency from sidewall passivation happens at current densities higher than 400 A/cm2 at an environmental temperature of 300 K. When the temperature decreases to 150 K, the sample with sidewall passivation has 10% higher quantum efficiency at all current ranges. Numerical modeling is applied to evaluate the behaviors of two types of defects at different temperatures. Our observation from modeling reveals that the efficiency drop caused by surface defects is hardly affected by temperature changes, whereas results show that the Shockley–Read–Hall nonradiative recombination rate decreases rapidly at low temperature due to longer carrier lifetime and increased difficulty of electron and hole recombination in traps. Therefore, the significant increase in the efficiency at 150 K, especially in the low current density range, is due to the defects within the quantum well.