bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiatively Driven Clumpy X-Ray Absorbers in the NLS1 Galaxy IRAS 13224-3809
Authors: Midooka Takuya , Mizumoto Misaki , Ebisawa Ken 
Published: August 2023

Abstract
Recent radiation-magnetohydrodynamic simulations of active galactic nuclei predict the presence of the disk winds, which may become unstable and turn into fragmented clumps far from the central black hole. These inner winds and the outer clumps may be observed as ultrafast outflows (UFOs) and partial absorbers, respectively. However, it is challenging to observationally constrain their origins because of the complicated spectral features and variations. To resolve such degeneracies of the clumpy absorbers and other components, we developed a novel spectral-ratio model fitting technique that estimates the variable absorbing parameters from the ratios of the partially absorbed spectra to the non-absorbed one, canceling the complex non-variable spectral features. We applied this method to the narrow-line Seyfert 1 galaxy IRAS 13224-3809 observed by XMM-Newton in 2016 for ∼1.5 Ms. As a result, we found that the soft spectral variation is mostly caused by changes in the partial covering fraction of the mildly ionized clumpy absorbers, whose outflow velocities are similar to those of the UFO (∼0.2–0.3c). Furthermore, the velocities of the clumpy absorbers and UFOs increase similarly with the X-ray fluxes, consistent with the change in the UV-dominant continuum flux. We also discovered a striking correlation between the clump covering fraction and the equivalent width of the UFO absorption lines, which indicates that increasing the outflow in the line of sight leads to more prominent UFOs and more partial absorption. These findings strongly suggest that the clumpy absorbers and the UFO share the same origin, driven by the same UV-dominant continuum radiation.
On the Short-period Eclipsing High-mass X-Ray Binary in NGC 4214
Authors: Lin Zikun , Soria Roberto , Swartz Douglas A. 
Published: August 2023

Abstract
We present the results of our study of the luminous (L
X ≈ 1039 erg s−1) X-ray binary CXOU J121538.2+361921 in NGC 4214, the high-mass X-ray binary with the shortest known orbital period. Using Chandra data, we confirm the ≈13,000 s (3.6 hr) eclipse period, and an eclipse duration of ≈2000 s. From this, we estimate a mass ratio M
2/M
1 ≳ 3 and a stellar density ρ ≈ 6 g cm−3, which implies that the donor must be a Wolf–Rayet or a stripped helium star. The eclipse egress is consistently much slower than the ingress. This can be explained by denser gas located either in front of the compact object (as expected for a bow shock) or trailing the donor star (as expected for a shadow wind, launched from the shaded side of the donor). There is no change in X-ray spectral shape with changing flux during the egress, which suggests either variable partial covering of the X-ray source by opaque clumps or, more likely, a gray opacity dominated by electron scattering in a highly ionized medium. We identify the optical counterpart from Hubble images. Photometry blueward of ∼5500 Å indicates a bright (M

B
≈ −3.6 ± 0.3 mag, for a range of plausible extinctions), hot (T ≈ 90,000 ± 30,000 K) emitter, consistent with the Wolf–Rayet scenario. There is also a bright (M

I
≈ −5.2 mag), cool (T ≈ 2700 ± 300 K) component consistent with an irradiated circumbinary disk or with a chance projection of an unrelated asymptotic giant branch star along the same line of sight.
Striped Jets in Post–Neutron Star Merger Systems
Authors: Kaufman Emma , Christie I. M. , Lalakos A. , Tchekhovskoy A. , Giannios D. 
Published: August 2023

Abstract
Models invoking magnetic reconnection as the particle acceleration mechanism within relativistic jets often adopt a gradual energy dissipation profile within the jet. However, such a profile has yet to be reproduced in first-principles simulations. Here we perform a suite of 3D general relativistic magnetohydrodynamic simulations of post–neutron star merger disks with an initially purely toroidal magnetic field. We explore the variations in both the microphysics (e.g., nuclear recombination, neutrino emission) and system parameters (e.g, disk mass). In all of our simulations, we find the formation of magnetically striped jets. The stripes result from the reversals in the poloidal magnetic flux polarity generated in the accretion disk. The simulations display large variations in the distributions of stripe duration, τ, and power, 〈P
Φ〉. We find that more massive disks produce more powerful stripes, the most powerful of which reaches 〈P
Φ〉 ∼ 1049 erg s−1 at τ ∼ 20 ms. The power and variability that result from the magnetic reconnection of the stripes agree with those inferred in short-duration gamma-ray bursts. We find that the dissipation profile of the cumulative energy is roughly a power law in both radial distance, z, and τ, with a slope in the range of ∼1.7–3; more massive disks display larger slopes.
The Solar Origin of an In Situ Type III Radio Burst Event
Authors: Wang 王 Meiqi 美祺 , Chen 陈 Bin 彬 , Yu 余 Sijie 思捷 , Gary Dale E. , Lee Jeongwoo , Wang Haimin , Cohen Christina 
Published: August 2023

Abstract
Solar type III radio bursts are generated by beams of energetic electrons that travel along open magnetic field lines through the corona and into interplanetary space. However, understanding the source of these electrons and how they escape into interplanetary space remains an outstanding topic. Here we report multi-instrument, multiperspective observations of an interplanetary type III radio burst event shortly after the second perihelion of the Parker Solar Probe (PSP). This event was associated with a solar jet that produced an impulsive microwave burst event recorded by the Expanded Owens Valley Solar Array. The type III burst event also coincided with the detection of enhanced in situ energetic electrons recorded by both PSP at 0.37 au and WIND at 1 au, which were located very closely on the Parker spiral longitudinally. The close timing association and magnetic connectivity suggest that the in situ energetic electrons originated from the jet’s magnetic reconnection region. Intriguingly, microwave imaging spectroscopy results suggest that the escaping energetic electrons were injected into a large opening angle of about 90°, which is at least nine times broader than the apparent width of the jet spire. Our findings provide an interpretation for the previously reported, longitudinally broad spatial distribution of flare locations associated with prompt energetic electron events and have important implications for understanding the origin and distribution of energetic electrons in interplanetary space.
Male Breast Cancer – Experience at a Tertiary Care Center in India
Authors: Dwivedi Surjeet , Lohia Nishant , Nair Lakshmi Geetha , Thakur Nikhil , Kumar Surender , Saha Manish , Anto A. K. Ajin 
Published: August 2023

Introduction:
Male breast cancer (MBC) is a rare affliction accounting for approximately 1% of all breast cancer cases. The treatment guidelines of MBC mirror those of female breast cancer which are derived mostly from data obtained from studies involving female breast cancer patients. Data on MBC are mostly limited to single-institution studies due to the rarity of the disease. This study was undertaken to assess retrospectively the pattern of demographic and clinicopathological factors in MBC treated at our tertiary care center.

Materials and Methods:
Records of MBC treated between January 2019 and December 2020 in our institute were analyzed and data regarding the demographic and clinicopathological profile of patients was recorded. Observational retrospective single centre study.

Results:
A total of 12 patients of MBC were encountered with a median age of 58 years. The painless lump was the most common presentation with the retro-areolar region being the most commonly involved site. The most common American Joint Committee on Cancer anatomical stage group observed was Stage II with the left breast being involved more than the right. None of the patients had a family history of breast carcinoma. Out of the 12 patients, 10 patients were positive for hormonal receptors, whereas only two patients showed human epidermal growth factor receptor 2 amplifications.

Conclusion:
MBC is a rare disease. Further multi-institutional studies involving a larger number of patients are needed for a better understanding and formulation of gender-specific guidelines for the effective management of MBC.
Knowledge, Attitude, and the Practice Study among the Kshar Sutra Practicing Surgeons
Authors: Javed Danish , Dixit Ashish Kumar , Tarique Barkati Md. , Dhama Yudhveer , Chaudhary Praveen 
Published: August 2023

Background:
Kshar Sutra treatment in cases of fistula is quite common in India. We conducted a cross-sectional study among Kshar Sutra practitioners to find out knowledge, attitude, and practicing approach in the present scenario. A total of 192 participants completed this online survey through a self-administered questionnaire.

Materials and Methods:
Two experts assessed the content and face validity of the questionnaire. The tool was pilot-tested to validate the questionnaire and Cronbach’s alpha coefficient was calculated to assess the acceptable internal consistency before the data collection. A total of 32 questions in three domains, knowledge (6), attitude (12), and practice (14), respectively, were asked to participants. We performed linear and logistic regressions to find out the relations with respect to independent variables such as experience, nature of job, qualification, and number of surgeries performed every year by participants.

Results:
Knowledge was found positively related to qualification and experience significantly. Less use of analgesics and antibiotics was positively related to qualification but negatively related to experience. More cosmetic scar in postoperative cases was positively supported by more cases performing surgeons but negatively by private practitioners. Less time required for surgery was positively related to more experienced surgeons. The use of self-prepared Kshar Sutra was seen 2–6 times popular among more qualified and experienced private practitioners. Most of the surgeons were in favor of investigations and indoor admission before surgery.

Conclusion:
Re-orientation programs are required to conduct for Kshar Sutra surgeons and the availability of commercial Kshar Sutras is extremely demanding to fill the gap in current practice.
Vitamin D Supplementation as a Probable Measure to Alleviate Musculoskeletal Pain, Prevent Infection and Enhance Physical Ability among Indian Adults from Urban Low Socioeconomic Backgrounds: An Observational Study
Authors: Mahtani Renu , Bora Pranita , Wikhe Anjali , Garcha Sonia , Mahtani Raunak , Kodali Prakash Babu , Nair Pradeep M. K. 
Published: August 2023

Problem Considered:
Vitamin D deficiency is a global concern that needs significant attention. This observational study reports the impact of Vitamin D supplementation on general body aches, frequency of infection, and energy levels among Indian adults.

Methods:
This study included 508 adults aged 19–89 years old from low socioeconomic backgrounds who were given Vitamin D supplements for 4 months. The severity of musculoskeletal symptoms, frequency of infection or its symptoms, and perceived energy levels of the participants before and after the exposure were measured using a structured questionnaire. Data were analyzed descriptively for the frequencies, and a Chi-square and Wilcoxon signed-rank test was used to analyze the impact of Vitamin D on the variables studied.

Results:
The majority of the participants were female (82.3%) and were never exposed to Vitamin D supplementation earlier (84%). Nearly 65% of the participants were either homemakers, students, unemployed, or retired. Vitamin D supplementation was significantly associated with the reduction in back pain (P < 0.001), fatigue and body pain (P < 0.001), knee pain (P < 0.001), and pain in the hands and legs (P < 0.001). Vitamin D also significantly reduced the frequency of infection and/or its symptoms (P < 0.001) and improved physical work capacity (P < 0.001).

Conclusion:
Vitamin D supplementation for urban low socioeconomic groups may be beneficial as it can reduce the pain, frequency of infection and improve general well-being. The limitations of this study, such as the lack of a nonexposed group and data on the Vitamin D status of the participants, warrant consideration in future studies.
A Cross-sectional Study: Assessment of Optimal Breastfeeding Practices among Tribal Women Having Children 0–23 Months of Age Residing in an Island of Sundarbans, West Bengal
Authors: Reshma A. S. , Bandyopadhyay Lina , Paul Bobby , Jaiswal Aditi Ajit , Das Arpita , Pal Niladri Sekhar 
Published: August 2023

Context:
Tribal population is vulnerable to all inequities of the society and less penetrated by the service providers. Breastfeeding, 0–23 months old children is important for their development and is boon for their health.

Objective:
The objective of this study is to estimate the prevalence of optimal breastfeeding practices (OBFs) and elicit its predictors.

Materials and Methods:
This descriptive cross-sectional study was conducted in the tribal area of Sunderbans, West Bengal, among mothers having children 0–23 months of age, from May 2021 to September 2021. Participants were selected by the cluster sampling technique. OBFs were assessed by initiation of breastfeeding within 1 h of birth, exclusive breastfeeding till 6 months of age, and continuation of breastfeeding along with complementary feed till 23 months of age. Iowa Infant Feeding Attitude Scale was administered to assess attitude toward breastfeeding. Statistical analysis was done using multivariable logistic regression.

Results:
The mean age of the study participants was 24.8 ± 4.1 years. Early initiation of breastfeeding was done by 76.5% of the participants, but continuation beyond 6 months of age by 70.9%. OBFs were shown by 25.5% of the participants, which has a significant association with the knowledge about the breastfeeding practices (adjusted odds ratio [aOR]: 2.14; 95% confidence interval [CI]: 1.52–3.01) and maternal education (aOR: 3.78; 95% CI: 1.17–12.17).

Conclusion:
This study showed that only one-fourth of the participants have OBFs. This situation must be addressed with imparting proper knowledge about the importance of breastfeeding. Support group of women in the community should be formulated to aid mothers in continuation of breastfeeding.
Carcinoma buccal mucosa treated with definitive hypofractionated accelerated radiotherapy: a retrospective analysis of treatment outcomes
Authors: Babu Geethu , Ravikumar Rejnish , Rafi Malu , Sharafuddin Zuzaki , Shankar S Arun , George Preethi Sara , Kainickal Cessal Thommachan , Kunnambath Ramadas 
Published: August 2023

Abstract

Introduction:
Oral cancer is a major public health concern in India. Both conventional and altered fractionation radiotherapy schedules have been used in curative treatment of oral cancer. This study aimed to retrospectively evaluate the clinical profile and treatment outcomes of patients with carcinoma buccal mucosa who underwent treatment with definitive hypofractionated accelerated radiotherapy.

Methods:
A total of 517 patients treated from January 2011 to December 2016 were eligible for the analysis. All patients were treated with definitive hypofractionated accelerated radiotherapy schedule of 5,250 cGy in 15 fractions over 3 weeks. Survival estimates were generated using the Kaplan–Meier method.

Results:
At a median follow-up of 77.4 months, 473 (91.5%) patients attained complete remission with radiation therapy. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 69% and 80.5%, respectively. The 5-year OS for stage I, II, III and IVa tumours was 80.3%, 84.4%, 81.4% and 73.7%, respectively, and the DFS was 75.7%, 73.2%, 69.6% and 60.2%, respectively. Age >50 years was found to be a significant factor affecting DFS (P = 0.026) and OS (P = 0.048) in multivariate analysis. Fifty-three (10.3%) patients developed osteoradionecrosis of the mandible.

Conclusion:
Excellent outcome could be achieved in less-aggressive, low-volume carcinoma of the buccal mucosa with radical accelerated hypofractionated radiotherapy. A radiotherapy schedule over a 3-week period is useful in high-volume centres.
Feasibility of nonoperative treatment of acute appendicitis in children: a prospective cohort study
Authors: Perveen Shazia , Akhtar Jamshed , Ali Sajid , Jabbar Abdul 
Published: August 2023

Abstract

Introduction:
The management of acute appendicitis is a matter of debate even in contemporary era. Non-operative management is proposed as a valid treatment option for acute appendicitis in children.

Methods:
A prospective cohort study was conducted from April 2020 to September 2021 at the National Institute of Child Health, Jinnah Sindh Medical University, Karachi, Pakistan, in children aged ≤ 12 years who were suspected of having acute appendicitis. Children with diffuse peritonitis and complex mass on ultrasonography were excluded. All children were kept nil per oral and started on intravenous fluid hydration and antibiotics. Statistical analyses were performed using IBM SPSS version 20. Chi-square test and Fisher’s exact test were applied to determine the statistical significance.

Results:
A total of 190 patients were admitted with a diagnosis of acute appendicitis. Thirty-two children with advanced disease underwent surgery. The remaining 158 patients were managed with nonoperative treatment. In 138 (87.3%) patients, resolution of symptoms occurred. Twenty (12.7%) patients underwent operation during the same admission (non-responders). Thirteen (9.4%) patients had recurrence of symptoms and underwent appendectomy. A total of 33 (20.9%) patients had appendectomy either at the primary admission or after discharge. Non-operative treatment was more likely to be successful in patients with symptoms of ≤ 24 h duration (P = 0.02), total leucocyte count of <12 × 109 cells/L (P = 0.005) and smaller size of the appendix on ultrasound (P = 0.001).

Conclusion:
Among children with uncomplicated acute appendicitis, a non-operative approach resulted in resolution of symptoms in 87.3% of patients at the initial admission. Failure of non-operative treatment and recurrence of disease after discharge from the hospital occurred in 9.4% of patients after successful initial treatment. Thus, the overall success rate at a mean follow-up of 3 months was about 78%.
Presenting characteristics, histological subtypes and outcomes of adult central nervous system tumours: retrospective review of a surgical cohort
Authors: Lim Mervyn Jun Rui , Zheng Yilong , Eng Sean Wai-Onn , Seah Celest Wen Ting , Fu Shuning , Lam Lucas Zheng Long , Wong Joel Yat Seng , Vellayappan Balamurugan , Wong Andrea Li-Ann , Teo Kejia , Nga Vincent Diong Weng , Lwin Sein , Yeo Tseng Tsai 
Published: August 2023

Abstract

Introduction:
The most recent local study on the incidence of histological subtypes of all brain and spinal tumours treated surgically was published in 2000. In view of the outdated data, we investigated the presenting characteristics, histological subtypes and outcomes of adult patients who underwent surgery for brain or spinal tumours at our institution.

Methods:
A single-centre retrospective review of 501 patients who underwent surgery for brain or spinal tumours from 2016 to 2020 was conducted. The inclusion criteria were (a) patients who had a brain or spinal tumour that was histologically verified and (b) patients who were aged 18 years and above at the time of surgery.

Results:
Four hundred and thirty-five patients (86.8%) had brain tumours and 66 patients (13.2%) had spinal tumours. Patients with brain tumours frequently presented with cranial nerve palsy, headache and weakness, while patients with spinal tumours frequently presented with weakness, numbness and back pain. Overall, the most common histological types of brain and spinal tumours were metastases, meningiomas and tumours of the sellar region. The most common complications after surgery were cerebrospinal fluid leak, diabetes insipidus and urinary tract infection. In addition, 15.2% of the brain tumours and 13.6% of the spinal tumours recurred, while 25.7% of patients with brain tumours and 18.2% of patients with spinal tumours died. High-grade gliomas and metastases had the poorest survival and highest recurrence rates.

Conclusion:
This study serves as a comprehensive update of the epidemiology of brain and spinal tumours and could help guide further studies on brain and spinal tumours.
Treating overactive bladder symptoms after transurethral prostatic surgery for benign prostatic hyperplasia – Which medication to choose?
Authors: Lee Cheng-Ling , Kuo Hann-Chorng 
Published: August 2023

ABSTRACT

Objectives:
Overactive bladder (OAB) symptoms are often encountered in patients after transurethral resection of the prostate (TUR-P) or transurethral incision of the prostate (TUI-P) for benign prostatic obstruction (BPO). Either antimuscarinics or b-3 agonist has been found effective in relieving OAB symptoms. However, urologists usually do not prescribe such medication immediately after TUR-P or TUI-P to avoid an increase in postvoid residual and risk of urinary tract infection. If OAB medication can be used and adverse events (AEs) can be reduced to minimum, patients’ quality of life after bladder outlet obstruction surgery could be improved. This study compared the safety and efficacy between solifenacin and mirabegron in men undergoing TUR-P or TUI-P.

Materials and Methods:
This prospective, randomized trial compared the safety and efficacy of OAB medication on the reduction in Urgency Severity Score (USS), OAB Symptoms Score (OABSS), International Prostate Symptom Score, and urgency urinary incontinence episodes in men with BPO undergoing surgical intervention. All patients could void smoothly after catheter removal and were randomly received daily solifenacin 5 mg, mirabegron 50 mg, or no interventions for 4 weeks. At 2 and 4 weeks postoperatively, participants’ OAB symptoms and AEs were evaluated.

Results:
A total of 57 men were enrolled in this study with a mean age of 70.8 ± 6.1 years. At 2 weeks postoperatively, USS (1.56 ± 1.72 vs. 2.39 ± 1.72 vs. 2.26 ± 1.73, P < 0.011) and OABSS (5.33 ± 3.65 vs. 7.67 ± 4.19 vs. 8.58 ± 4.31, P < 0.000) were significantly reduced in patients taking solifenacin, mirabegron, or control, respectively. Two patients in the solifenacin group developed urinary retention. However, the changes of variables at 4 weeks postoperatively were insignificant among the three groups.

Conclusion:
Solifenacin and mirabegron are two different drug classes both equally effective in treating immediate OAB symptoms after TUR-P or TUI-P. However, OAB symptoms could be relieved at 4 weeks without any medication. Considering AEs, b-3 agonist has a more favorable safety profile than antimuscarinics.