bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute severe aortic insufficiency during cardiopulmonary bypass in a bicuspid aortic valve with unrecognized annular displacement and fibrous strands: a case report
Authors: Saito Tetsuya , Kawamura Masashi , Murakami Takashi , Sakaki Masayuki 
Published: September 2023

Abstract

Background
Bicuspid aortic valve (BAV) with displacement of the attachment of the conjoined aortic leaflet and fibrous strands is a rare cardiac malformation. We report a case of BAV that presented as acute massive aortic regurgitation during cardiopulmonary bypass for a planned non-valve–related procedure and was successfully treated by emergency aortic valve replacement.

Case summary
A 70-year-old man with triple vessel coronary disease and severe left ventricular systolic dysfunction underwent coronary bypass grafting and graft replacement of the ascending aorta. Acute aortic regurgitation occurred during ventricular fibrillation and after de-clamping of the aortic graft. Intra-operative findings included a fused BAV (right–left cusp fusion), very asymmetrical leaflet (commissure angle of the non-fused leaflet 135°), three aortic sinuses, and conjoined leaflets originating from the myocardium in the inter-ventricular septum. The aortic leaflets were resected and replaced with a prosthetic aortic valve at the attachment site of the conjoined leaflets. Post-operatively, no peri-valvular leaks were observed, and left ventricular function was improved.

Discussion
Intra-operative acute massive aortic regurgitation may be caused by a morphologically abnormal aortic leaflet and root complex in patients with a BAV. The dilated aortic root, asymmetrical leaflet, and abnormal aortic leaflet insertion, with thick septal myocardium of the coronary aortic sinus, might have caused unstable leaflet co-aptation, leading to deformation of the aortic leaflets influenced by the change in myocardial tone and intra-operative change in the sinotubular junction. Familiarity with the classification of congenital BAV, and the anatomy of the normal and abnormal aortic root complex, is important.
Micro-foundations of the Quest for Status: Testing Self-Status Perception and the Multilateral Use of Force
Authors: Masumura Yuji , Tago Atsushi 
Published: September 2023

Abstract
Research on status in international relations has expanded in the last few decades. The key empirical studies suggest that status concern generates an incentive for initiating international conflicts since unilateral military engagement is believed to increase the status of a country. We concur with this argument. However, a further study should be conducted to find whether “multilateral” military engagement can change status perceptions and therefore be related to international politics over status. The test is important since the multilateral use of force is distinct from the unilateral use of force in its theoretical background and its connotation in world politics. In our experiment conducted in Japan, we treat the information on the multilateral use of force, and examine whether variations of the treatment information change people’s self-perception over their country’s international status. The results show that participation in a multilateral use of force increases and an early departure from the multilateral mission out of casualty concerns decreases their country’s self-status perception. Also, we successfully identify that the people who have a high social dominance orientation trait are more susceptible to such information.
Epigenetic Aging and Rheumatoid Arthritis
Authors: Mukherjee Nandini , Harrison Tracie C 
Published: September 2023

Abstract
This is the first known comparative assessment of the associations of epigenetic age estimates with the prevalence of rheumatoid arthritis (RA). We used data available in Gene Expression Omnibus (GSE42861) from the Swedish Epidemiological Investigation of Rheumatoid Arthritis study. Information regarding RA diagnosis and 450K DNA methylation (DNAm) of 18- to 70-year-old participants was available. Utilizing Horvath’s online DNAm Age Calculator, we determined the DNAm estimate of Telomere length (DNAmTL), Hannum’s epigenetic age, Horvath’s 2013 and 2018 epigenetic ages, PhenoAge, GrimAge, and the respective age-acceleration measures. The association of RA prevalence with epigenetic age measures was assessed using linear regression, adjusting for sex and smoking status. The p values were corrected for multiple testing using a false discovery rate. We identified statistically significant associations of RA with Horvath 2013 age acceleration (estimate: −1.34; FDR p value: 1.0 × 10−2), Horvath 2018 age acceleration (estimate: −1.32; FDR p value: 4.0 × 10−5), extrinsic age acceleration (estimate: 1.34; FDR p value: 1.0 × 10−2), PhenoAge acceleration (estimate: 2.31; FDR p value: 1.1 × 10−5), GrimAge (estimate: 2.54; FDR p value: 1.0 × 10−2), and GrimAge acceleration (estimate: 3.15; FDR p-value: 1.7 × 10−17). Of note, the raw and age-adjusted GrimAge surrogate DNAm protein components were significantly higher in RA cases than controls. Interestingly, the first-generation measures were associated only with women. No sex-specific effects were identified for PhenoAge or GrimAge accelerations. In this cross-sectional assessment, the second-generation clocks show promise as markers of biological aging, with higher epigenetic age acceleration observed in RA cases compared with healthy controls.
Misunderstanding the margin? The reception of the ECtHR’s margin of appreciation at the national level
Authors: Brems Eva 
Published: September 2023

Abstract
This exploratory article focuses on the receiving end of the margin of appreciation doctrine of the European Court of Human Rights (ECtHR), that is to say, the response of national-level legislators and courts to ECtHR case law involving other states parties, that grants national authorities a wide margin of appreciation. The paper explores the risk that national authorities might misinterpret the margin of appreciation in such cases as a marker of human rights clearance of a rights-restrictive practice as such or as a prompt for domestic courts toward deference in their relationship with the legislative and executive powers. The paper finds anecdotal evidence of such misinterpretation by domestic legislators in the reception of SAS v. France. In addition, an examination of recent fundamental rights case law of the Belgian Constitutional Court illustrates the existence of a problem of misunderstanding the margin of appreciation at the level of domestic courts.
Who misunderstands the margin of appreciation? A reply to Eva Brems
Authors: Iglesias Vila Marisa 
Published: September 2023

Abstract
This reply offers some critical reflections that tie into the assumptions of Eva Brem’s interesting study of the risk of national authorities’ misunderstandings of the margin of appreciation conceded by the European Court of Human Rights (ECtHR). Taking on board a cooperative conception of the principle of subsidiarity, this reply first questions the adequacy of the distinction between a systemic and a normative dimension of the margin of appreciation as the proper basis for assessing the risk of domestic misunderstanding of the margin of appreciation. Next, it raises some objections to the analysis that Brems makes of the ECtHR judgment in S.A.S. v. France, particularly her application of the normative dimension of the margin of appreciation to this example of possible misunderstanding. The reply argues that Brems’s assumption that the ECtHR conducted a procedural rationality review of the French burqa ban minimizes Strasbourg’s own contribution to the risk that other states, in similar cases, may misunderstand how human rights are to be applied to avoid misinterpreting their national margin of appreciation.
Desalkylgidazepam blood concentrations in 63 forensic investigation cases
Authors: Mérette Sandrine A M , Kim Subin , Davis Michael D , Shapiro Aaron M 
Published: September 2023

Abstract
Desalkylgidazepam, also known as bromonordiazepam, is the latest designer benzodiazepine to appear in postmortem blood samples in British Columbia. Our laboratory was first alerted to the presence of desalkylgidazepam in seized drug samples in May 2022, and the analyte was added to an in-house library shortly thereafter. Previously acquired spectra from routine death investigation cases were reprocessed using the updated library with the first presumptive identification of desalkylgidazepam occurring in a sample received in April 2022. A standard addition method for the quantitation of desalkylgidazepam in blood samples (from femoral, iliac, jugular and subclavian veins) was validated and consequently used to confirm presence and concentrations of the drug in 63 cases, with an average concentration of 42.2 ± 44.0 ng/mL (median concentration: 24.5 ng/mL; range: 3.7–220.6 ng/mL). Similar to detections of other novel benzodiazepines, co-occurrence of desalkylgidazepam with opioids and/or stimulants was common. To our knowledge, this paper is the first to report desalkylgidazepam concentrations in postmortem blood samples.
A 10-Year Single-Burn Center Review of Free Tissue Transfer for Burn-Related Injuries
Authors: Alessandri Bonetti Mario , Jeong Tiffany , Stofman Guy M , Egro Francesco M 
Published: September 2023

Abstract
Skin grafting is the mainstay treatment in burn patients. However, in the scenario of soft tissue deficit along with exposure of critical structures, free flap is the only reconstructive option to provide adequate coverage. The aim of the study is to review indications and surgical outcomes of burn patients requiring free tissue transfer. A retrospective cohort study was conducted to review all patients who underwent free tissue transfer for burn-related injuries between March 2012 and June 2023. A total of 13 patients required a free flap for their reconstruction. Eleven flaps were performed during the acute care and 2 were performed for delayed reconstruction. Patients were 69% males and 31% females, with a mean age of 45.5 ± 16 years and a mean BMI of 25.4 ± 6.5. The mean follow-up was 13.5 ± 13.9 months. Indications for free tissue transfer were bone exposure (92%) and severe neck burn contracture (8%). Overall complications rate was 54%. Complications included free flap loss (15%), hematoma (15%), vein thrombosis of the anastomosis (15%), infection (8%), amputation (8%), and wound healing issues (23%). Overall, 38% of the patients required re-operations including venous anastomosis revision, hematoma evacuation, debridement, skin grafting, and debulking. Although sometimes free flap remains the only reconstructive option in severe burn-related injuries, it is only rarely used. However, they carry a high risk of complications and should be considered only as the last resort for limb or life-threatening situations.
Outcomes in Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis Patients Treated With a Medicine-Led Multidisciplinary Approach
Authors: Lewcun Joseph A , Vagonis Alex , Kontzias Christina , Newsom Megan , Drake Mack , Feldman Michael J 
Published: September 2023

Abstract
Patients with Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have traditionally been treated in burn centers. Our burn center’s approach differs by admitting these patients to a medicine service, with support from the burn team. The aim of this study was to determine whether SJS/TEN patients cared for with our system, with burn involvement but not burn admission, demonstrate equivalent outcomes. We conducted a retrospective review of all SJS/TEN patients admitted to the medicine service at a single academic medical center from 2009 to 2021. Outcome measures such as mortality, length of ICU stay, and total length of hospitalization were collected. The Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) was used to calculate expected mortality rates within the cohort. The observed mortality rates were then compared to the expected mortality rates. One hundred and twenty-six patients who were admitted for SJS/TEN were included (70 SJS, 40 SJS/TEN overlap, 16 TEN). The mortality rate for the entire cohort was 10.32% as compared to a 22.33% expected mortality rate (P = .010). The observed and expected mortality rates for SJS, SJS/TEN overlap, and TEN subgroups were 1.43% observed versus 10.22% expected (P = .029), 20.00% observed versus 35.83% expected (P = .133), and 25.00% observed version 44.06% expected (P = .264), respectively. Mortality rates in SJS/TEN patients admitted to medicine units are equivalent or decreased as compared to SCORTEN-predicted mortality rates. Admission of SJS/TEN patients to a medicine unit is appropriate providing there is burn team involvement in their care.
Access to Certified Burn Centers in the United States: The Geospatial and Transport Cost of Transfer
Authors: Edwards Shelley R , Chamoun Gabrielle , Hecox Emily , Brown Madyson I , Hoppe Ian C , Arnold Peter B , Humphries Laura S 
Published: September 2023

Abstract
Specialized burn centers are critical to minimizing burn-associated morbidity and mortality. However, American Burn Association-verified burn centers are unequally distributed across the United States, and fewer centers are available for pediatric patients relative to adults. The economic burden of transporting patients to these centers contributes significantly to the high cost of burn care. This study quantifies inequitable burn care access in the contiguous United States due to age group and location as a function of physical proximity to a verified burn center and transportation cost. County-level distances to the nearest verified adult or pediatric burn center were determined and mapped. Distance calculations for each population were combined with transport cost data (2022 CMS Ambulance Fee Schedules) to estimate transportation costs for each population (adult vs pediatric, urban vs rural). Pediatric patients reside 30.5 miles further than adults from the nearest center, significantly increasing transportation costs. Ground and air transport costs also increased for rural versus urban patients. Notably, rural patients face almost double the cost of air transport. While physical proximity to burn care appears to differ only modestly across age and region, this marginal increase in distance is associated with significant economic impact. This study highlights physical and economic barriers to burn care access faced by rural and pediatric patients and underscores the critical need to improve equity in burn care access. Future studies should expand on this report’s findings to more fully characterize the additional costs associated with inequitable burn care access.
In-situ shearing process observation system for soft materials via transmission electron microscopy
Authors: Miyata Tomohiro , Wang Hsiao-Fang , Watanabe Daisuke , Kawagoe Yoshiaki , Okabe Tomonaga , Jinnai Hiroshi 
Published: September 2023

Abstract
We developed an in-situ shear test system suitable for transmission electron microscopy (TEM) observations, which enabled us to examine the shear deformation behaviours inside soft materials at nanoscale resolutions. This study was conducted on a nanoparticle-filled rubber to investigate its nanoscale deformation behaviour under a large shear strain. First, the shear deformation process of a large area in the specimen was accurately examined and proven to exhibit an almost perfect simple shear. At the nanoscale, voids grew along the maximum principal strain during shear deformation. In addition, the nanoscale regions with rubber and silica aggregates exhibited deformation behaviours similar to the global shear deformation of the specimen. Although the silica aggregates exhibited displacement along the shearing directions, rotational motions were also observed owing to the torque generated by the local shear stress. This in-situ shear deformation system for TEM enabled us to understand the nanoscale origins of the mechanical properties of soft materials, particularly polymer composites.
Graphical Abstract
Effect of chronic disease on racial difference in COVID-19–associated hospitalization among cancer patients
Authors: Wu Xiao-Cheng , Yu Qingzhao , Yi Yong , Maniscalco Lauren S , Hsieh Mei-Chin , Gruber DeAnn , Mendoza Lee , Subbiah Suki , Sokol Theresa , Shrestha Pratibha , Chen Vivien W , Mederos Eileen T , Ochoa Augusto 
Published: September 2023

Abstract

Background
Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19–associated hospitalization among cancer patients.

Methods
We linked Louisiana Tumor Registry’s data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19–associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases.

Results
Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19–associated hospitalization (27.2% vs 17.2%). The odds of COVID-19–associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19–associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively.

Conclusion
Chronic diseases played a substantial role in the racial disparity in COVID-19–associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.
The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in esophagogastric cancer patients
Authors: Yamaguchi Hisashi , Fukumitsu Nobuyoshi , Numajiri Haruko , Ogino Hiroyuki , Katoh Norio , Okimoto Tomoaki , Suzuki Motohisa , Sakurai Hideyuki 
Published: September 2023

Abstract
A nationwide multicenter cohort study on particle therapy was launched by the Japanese Society for Radiation Oncology in Japan in May 2016. We analyzed the outcome of proton beam therapy (PBT) for liver oligometastasis of esophagogastric cancers. Cases in which PBT was performed at all PBT facilities in Japan between May 2016 and February 2019 were enrolled. The patients were selected based on the following criteria: controlled primary cancer, liver recurrence without extrahepatic tumors and no more than three liver lesions. Twenty-two males and two females with a median age of 69 (range, 52–80) years and 35 lesions were included. This study included 6 patients with esophageal and 18 patients with gastric cancer. The median lesion size, fraction size and biological effective dose (BED)10 were 32 (7–104) mm, 3.8 gray (relative biological effect)/fractions (Gy (RBE)/fr) (2–8 Gy (RBE)/fr) and 96.9 (88.8–115.2) Gy, respectively. The median follow-up period was 18 (4–47) months. The 1-, 2- and 3-year overall survival (OS) rates were 75, 51.8 and 45.3%, respectively, and the median OS was 25.3 months. The 1-, 2- and 3-year cumulative local recurrence (LR) rates were 3, 6 and 6%, respectively. Patients’ age (P &lt; 0.01), performance status (P = 0.017) and tumor size (P = 0.024) were significant OS-related factors. No Grade 3 or higher adverse events (AEs) were observed. Owing to the low incidence of AEs and the low LR cumulative incidence, PBT is a feasible option for liver oligometastasis of esophagogastric cancers.
Supernumerary intranasal tooth: case report and review of the literature
Authors: Elgamri Alya Isam , Siddig Omer Elfatih Haj , Jobran Afnan W M 
Published: September 2023

Abstract
The supernumerary intranasal teeth are unusual phenomena. They may be asymptomatic or present with different signs and symptoms such as epistaxis, infection, and nasal obstruction. We report a case of a supernumerary intranasal tooth that erupted more than 2 years ago and was treated with surgical removal under local analgesia.
Ruʾūs al-Jibāl Arabic in Context: A Proposal for an Expanded Typology of Southeastern Arabian Dialects
Authors: Shockley Mark Daniel 
Published: September 2023

Abstract
This paper seeks to clearly outline the features that distinguish Ruʾūs al-Jibāl Arabic (also called Šiḥḥī Arabic, Musandam Arabic) spoken on the Omani peninsula from surrounding dialects. Comparison with nearby Arabic varieties yields a few areal features (in segmental phonology) that establish a dialect continuum from the coasts of northern Oman to Musandam. A large number of phonological similarities between Ruʾūs al-Jibāl Arabic and Dhofari Arabic are then documented here for the first time. This robust but discontinuous link re-frames many of the peculiarities of Ruʾūs al-Jibāl Arabic as vestiges of a coastal southern Arabian dialect group. This finding fits a wellknown ancient pattern of northward population movements out of south Arabia, and allows for a more effective delineation of innovations unique to Ruʾūs al-Jibāl . It also offers a direction forward for an expanded framework for the classification of the Arabic dialects of southeastern Arabia, incorporating Oman's peripheries at Dhofar and Musandam.
Joint Imputation of General Data
Authors: Robbins Michael W 
Published: September 2023

Abstract
High-dimensional complex survey data of general structures (e.g., containing continuous, binary, categorical, and ordinal variables), such as the US Department of Defense’s Health-Related Behaviors Survey (HRBS), often confound procedures designed to impute any missing survey data. Imputation by fully conditional specification (FCS) is often considered the state of the art for such datasets due to its generality and flexibility. However, FCS procedures contain a theoretical flaw that is exposed by HRBS data—HRBS imputations created with FCS are shown to diverge across iterations of Markov Chain Monte Carlo. Imputation by joint modeling lacks this flaw; however, current joint modeling procedures are neither general nor flexible enough to handle HRBS data. As such, we introduce an algorithm that efficiently and flexibly applies multiple imputation by joint modeling in data of general structures. This procedure draws imputations from a latent joint multivariate normal model that underpins the generally structured data and models the latent data via a sequence of conditional linear models, the predictors of which can be specified by the user. We perform rigorous evaluations of HRBS imputations created with the new algorithm and show that they are convergent and of high quality. Lastly, simulations verify that the proposed method performs well compared to existing algorithms including FCS.