bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracheal Narrowing and Its Impact on Anesthesia Care in Patients With Morquio A (Mucopolysaccharidosis Type IVA): An Observational Study
Authors: Theroux Mary C. , DiCindio Sabina , Averill Lauren W. , Pizarro Christian , Oommen Abraham , Bober Michael B. , Ditro Colleen , Campbell Jeffrey , Duker Angela L. , Jones Taylor , Passi Vandna , Barth Patrick , Schmidt Richard J. , Little Mary , Mackenzie Stuart , Tomatsu Shunji , Mackenzie William G. 
Published: May 2023

BACKGROUND:
Recently, tracheal narrowing has been recognized as a significant comorbid condition in patients with Morquio A, also known as mucopolysaccharidosis IVA. We studied a large cohort of patients with Morquio A to describe the extent of their tracheal narrowing and its relationship to airway management during anesthesia care.

METHODS:
This is an observational study, collecting data retrospectively, of a cohort of patients with Morquio A. Ninety-two patients with Morquio A syndrome were enrolled, among whom 44 patients had their airway evaluated by computed tomography angiography and had undergone an anesthetic within a year of the evaluation. Our hypothesis was that the tracheal narrowing as evaluated by computed tomography angiography increases with age in patients with Morquio A. The primary aim of the study was to examine the degree of tracheal narrowing in patients with Morquio A and describe the difficulties encountered during airway management, thus increasing awareness of both the tracheal narrowing and airway management difficulties in this patient population. In addition, the degree of tracheal narrowing was evaluated for its association with age or spirometry parameters using Spearman’s rank correlation. Analysis of variance followed by the Bonferroni test was used to further examine the age-based differences in tracheal narrowing for the 3 age groups: 1 to 10 years, 11 to 20 years, and >21 years.

RESULTS:
Patient age showed a positive correlation with tracheal narrowing (r

s

= 0.415; 95% confidence interval [95% CI], 0.138–0.691; P = .005) with older patients having greater narrowing of the trachea. Among spirometry parameters, FEF25%–75% showed an inverse correlation with tracheal narrowing as follows: FEF25%–75% versus tracheal narrowing: (r

s
= −0.467; 95% CI, −0.877 to −0.057; P = .007). During anesthetic care, significant airway management difficulties were encountered, including cancelation of surgical procedures, awake intubation using flexible bronchoscope, and failed video laryngoscopy attempts.

CONCLUSIONS:
Clinically significant tracheal narrowing was present in patients with Morquio A, and the degree of such narrowing likely contributed to the difficulty with airway management during their anesthetic care. Tracheal narrowing worsens with age, but the progression appears to slow down after 20 years of age. In addition to tracheal narrowing, spirometry values of FEF25%–75% may be helpful in the overall evaluation of the airway in patients with Morquio A.
Anterior-To-Psoas Approach Measurements, Feasibility, Non-Neurological Structures at Risk and Influencing Factors: A Bilateral Analysis From L1-L5 Using Computed Tomography Imaging
Authors: Razzouk Jacob , Ramos Omar , Mehta Shaurya , Harianja Gideon , Wycliffe Nathaniel , Danisa Olumide , Cheng Wayne 
Published: May 2023

BACKGROUND AND OBJECTIVES:
Spinal fusion through the anterior-to-psoas (ATP) technique harbors several approach-related risks. We used abdominal computed tomography imaging to analyze the L1-L5 ATP fusion approach measurements, feasibility, degree of obstruction by non-neurological structures, and the influence of patient characteristics on ATP approach dimensions.

METHODS:
The vascular window, psoas window, safe window, and incision line anterior and posterior margins for the ATP approach were measured on abdominal computed tomography imaging. The feasibility of approach and the presence of kidneys, ribs, liver, spleen, and iliac crests within the ATP approach were also measured. Correlation and regression models among radiographic measurements and patient age, height, weight, and body mass index (BMI) were analyzed as well as differences in approach measurements based on sex.

RESULTS:
Safe window and incision line measurements were more accommodating for the left-sided vs right-sided ATP approach. At L4-5, the ATP approach was not feasible 18% of the time on the left side vs 60% of the time on the right side. The spleen was present 22%, 10%, and 3% of the time from L1-4, while the liver was present 56%, 30%, and 9% of the time. The iliac crests were not observed within ATP parameters. Patient age, height, weight, and BMI did not strongly correlate with approach measurements, although ATP dimensions did differ based on sex.

CONCLUSION:
This study reports characteristics of the ATP approach including approach measurements, feasibility, non-neurological structures at risk, and influencing factors to approach measurements. While incision line measurements are larger for male patients compared with female patients at the lower lumbar levels, safe window sizes are similar across all levels L1-L5. The kidneys, ribs, spleen, and liver are potential at-risk structures during the ATP approach, although the iliac crests pose limited concern for ATP technique. Patient characteristics such as age, height, weight, and BMI do not markedly affect ATP approach considerations.
Endoscopic Placement of Intracystic Catheters: A Technical Note
Authors: Peto Ivo , Reynolds Rebecca A. , Hartnett-Wright Sara , Rodriguez Luis F. , Jallo George I. , Smyth Matthew D. , Akbari S. Hassan A. 
Published: May 2023

BACKGROUND:
Intraventricular neuroendoscopic surgery for tumor resection, biopsy, or cyst fenestration frequently requires precise placement of an intraventricular or intracystic catheter. Placement under direct visualization is not feasible because of small bore of working channel of the standard small ventriculoscope. Various techniques have been reported using a separate transcortical trajectory, endoluminal endoscope, or endovascular guide wire.

OBJECTIVE:
To describe a technique allowing precise placement of intraventricular/intracystic catheter using a small bore working ventriculoscope, without need for additional equipment.

METHODS:
Description of the technique including intraoperative photographs, video, and illustrative cases are provided.

RESULTS:
The peel-away sheath is peeled off approximately 1 to 2 cm to allow for the shaft of the endoscope to pass past its tip. Ventricular access is gained using the peel-away sheath. After the stylet is removed, the peel-away sheath is not peeled further or stapled to the skin. The endoscope is introduced into the ventricle through the peel-away sheath. After the required intraventricular work is performed, the endoscope is maneuvered into the location of the desired catheter position. The peel-away sheath is slowly advanced over the stationary endoscope past its tip. While the peel-away sheath is being held in place, the endoscope is removed. After the catheter has been introduced into the peel-away sheath to a premeasured depth, the peel-away sheath is peeled and removed. The catheter is then connected to collection system, reservoir or shunt system.

CONCLUSION:
The current technique allows for the precise placement of intraventricular/intracystic catheters without the need for additional equipment or a separate transcortical trajectory.
Ventral Subaxial Cervical Access Using Tailored Access Osteotomies, A Cadaveric Study
Authors: Scullen Tyler , Ng Christina , Mathkour Mansour , Iwanaga Jo , Glennon Steve , Tubbs R. Shane , Dumont Aaron , Kalyvas James 
Published: May 2023

BACKGROUND:
Ventral lesions of the subaxial cervical spine are challenging because approaches must circumvent endodermal and neurovascular structures.

OBJECTIVE:
To use cadaveric study to describe 4 posterolateral approaches to the ventral subaxial cervical spine with various facilitating techniques and osteotomies.

METHODS:
Three cadaveric specimens of the cervical spine were sequentially subjected to multilevel laminectomy (Type 1), transfacet (Type 2), transpedicular (Type 3), and extreme lateral transforaminal (Type 4) approaches. Approach working angles and proportion of visualized zones were compared, the former calculated using trigonometric methods.

RESULTS:
There was a significant stepwise increase in working angle in the ventral space, associated with increasing osteotomy type, from an average of 3.7° in single-level type 1 to 19.47° in the type 4 osteotomy. Regarding anatomic zones, proportional partial and total visualization achieved with Type 2 to 4 approaches were significantly greater than with Type 1. Complex osteotomies allowed superior access to be obtained to contributing and adjacent vessels of the ventral spinal axis.

CONCLUSION:
Ventral subaxial cervical lesions are difficult to access. We report increased working angles using quantified cadaveric data in increasingly complex posterior and posterolateral approaches graded as type 1 through 4. We advocate continued translational research in such approaches to lesions often considered to lie in surgically inaccessible locations.
Lateral Transorbital Approach for Repair of Lateral Sphenoid Sinus Meningoencephaloceles in Proximity to Foramen Rotundum: Cadaveric Study and Case Report
Authors: Mathios Dimitrios , Bobeff Ernest J. , Longo Davide , Tabaee Abtin , Anand Vijay K. , Godfrey Kyle J. , Schwartz Theodore H. 
Published: May 2023

BACKGROUND:
The repair of lateral sphenoid sinus cerebrospinal fluid leaks is routinely accomplished through the use of the endonasal endoscopic approach (EEA) with a transpterygoidal extension. This approach can incur sinus morbidity, damage to the vidian, palatine and trigeminal nerves, and the contents of the pterygopalatine fossa, particularly if the encephalocele is lateral to the foramen rotundum (FR) and V2.

OBJECTIVE:
To investigate the use of the lateral transorbital approach (LTOA) as an alternative approach for repair of lateral sphenoid sinus encephaloceles that avoids the potential morbidity of EEA.

METHODS:
We performed cadaveric dissections of 2 specimens (4 sides) and present one of the first cases of a lateral sphenoid sinus encephalocele repair lateral to the FR in a patient through an ipsilateral LTOA.

RESULTS:
We find that the LTOA provides a shorter distance to target compared with the EEA (56 vs 89.5 mm, P = .002). The LTOA field of view also affords excellent visualization of both the medial and lateral aspects of V2, whereas the EEA is less effective at exposing lateral to V2, even after sacrifice of the vidian nerve and maximal pterygopalatine fossa content retraction. We report a case of LTOA to repair a meningoencephalocele lateral to V2 in the sphenoid sinus.

CONCLUSION:
The LTOA to the foramen rotundum is a more direct approach that minimizes the morbidity associated with EEA to repair meningoencephaloceles both medial and lateral to foramen rotundum.
Risk Factors for Adjacent Segment Disease in Short Segment Lumbar Interbody Fusion—A Case Series
Authors: Flores-Milan Gabriel , Cuello César Carballo , Pressman Elliot , Marek Jenna , Krafft Paul R. , McBride Paul , Gassie Kelly , Hayman Erik , Alikhani Puya 
Published: May 2023

BACKGROUND:
Adjacent segment disease (ASD) is a common problem after lumbar spinal fusions. Ways to reduce the rates of ASD are highly sought after to reduce the need for reoperation.

OBJECTIVE:
To find predisposing factors of ASD after lumbar interbody fusions, especially in mismatch of pelvic incidence and lumbar lordosis (PI-LL).

METHODS:
We conducted a retrospective cohort study of all patients undergoing lumbar interbody fusions of less than 4 levels from June 2015 to July 2020 with at least 1 year of follow-up and in those who had obtained postoperative standing X-rays.

RESULTS:
We found 243 patients who fit inclusion and exclusion criteria. Fourteen patients (5.8%) developed ASD, at a median of 24 months. Postoperative lumbar lordosis was significantly higher in the non-ASD cohort (median 46.4° ± 1.4° vs 36.9° ± 3.6°, P < .001), pelvic tilt was significantly lower in the non-ASD cohort (16.0° ± 0.66° vs 20.3° ± 2.4°, P = .002), PI-LL mismatch was significantly lower in the non-ASD cohort (5.28° ± 1.0° vs 17.1° ± 2.0°, P < .001), and age-appropriate PI-LL mismatch was less common in the non-ASD cohort (34 patients [14.8%] vs 13 [92.9%] of patients with high mismatch, P < .001). Using multivariate analysis, greater PI-LL mismatch was predictive of ASD (95% odds ratio CI = 1.393-2.458, P < .001) and age-appropriate PI-LL mismatch was predictive of ASD (95% odds ratio CI = 10.8-970.4, P < .001).

CONCLUSION:
Higher PI-LL mismatch, both age-independent and when adjusted for age, after lumbar interbody fusion was predictive for developing ASD. In lumbar degenerative disease, correction of spinopelvic parameters should be a main goal of surgical correction.
The role of angiotensin receptor blocker (losartan) on decreasing fibrotic process of corpora cavernosa in priapism model of wistar rats
Authors: Siregar Safendra , Rulianov Rulianov , Ksatriapraja Rangga Adhazi , Stefanus Dicky 
Published: May 2023

Background: Priapism induces regulation of Transforming Growth Factor-β1 (TGF-β1) expression and collagen-type-1 deposition. This will replace the normal corpora cavernosa with fibrotic tissue which eventually resulted in erectile dysfunction. It is also known that the fibrosis process of corpora cavernosa is related to Renin-Angiotensin II System (RAS). Angiotensin II receptor blockers (ARB), especially losartan, inhibit the inflammation process and fibrotic tissue formation. This study evaluated the effect of losartan in reducing fibrosis in priapism by evaluating TGF-β1 and collagen-type-1 in cavernous tissue and determined the effect of losartan in preventing fibrosis in priapism model of Wistar rats assessed by the metavir score. Methods: A total of eighteen male Wistar rats mean were divided into five groups. For the priapism models, we applied negative pressure on the penis to make an artificial erection to mimic the priapism process. The control groups were observed and the treatment groups were orally given losartan 15 mg/kg/day. Corpora cavernosa was harvested for TGF-β1 and collagen-type-1 measurement using an enzyme-linked immunosorbent assay (ELISA). The fibrotic tissue of each rat was then collected and assessed histopathologically with the metavir scoring system. Results: Penile TGF-β1 concentration in the losartan-treated group was not significantly different on day 10 and day 28 of observation (p10=0,30; p28=0,17). Meanwhile, collagen-type-1 concentration was significantly lower compared to control group (p10=0,002; p28=0,01). There was a significant difference in metavir scores in rats that received losartan and those who did not (p<0,05). Conclusion: Losartan could suppress the fibrosis process in the priapism model. It could decrease the collagen type 1 deposition during corpora cavernosa tissue regeneration. Based on the metavir score, the group receiving losartan therapy was better than the control group.
Assessment of quality of life in patients with surgically treated maxillofacial fractures
Authors: Nayak Sunil S , Gadicherla Srikant , Roy Sreea , Chichra Muskaan , Dhaundiyal Shriya , Nayak Vanishri S , Kamath Vinayak 
Published: May 2023

Background: The complex nature of maxillofacial injuries can affect the surgical treatment outcomes and general well-being of the patient. To evaluate the efficiency of the surgical treatment, assessment of the quality of life (QOL) of the patients is of vital importance. Due to the absence of an exclusive QOL assessment tool for maxillofacial fractures, we introduce the ‘Twenty-point quality of life assessment in facial trauma patients in Indian population'. The aim of this study was to assess and evaluate the QOL following surgical management of maxillofacial trauma patients based on the severity of the injury. Methods: The study consisted of 182 subjects divided into two groups of 91 each (Group A: severe facial injury and Group B: mild to moderate facial injury). The Facial Injury Severity Scale (FISS) was used to determine the severity of facial fractures and injuries. The twenty–point quality of life assessment tool includes Zone 1 (Psychosocial impact) and Zone 2 (Functional and aesthetic impact), with ten domains each to assess QOL. Results: In Zone 1, the mean scores for Group A and Group B were 38.6 and 39.26, respectively. In Zone 2, Group B (44.56) had higher mean scores compared to Group A (32.92) (p< 0.001). Group B (83.8) had higher mean scores compared to Group A (71.58) when the total of both Zone 1 and Zone 2 were taken into consideration (p<0,001). In Group A, 9 out of 91 patients had a total score of 81- 100 compared to 68 in the same range in Group B. Conclusions: Proper surgical management with adequate care to the hard and soft tissues can improve the QOL by reducing postoperative psychosocial and functional complications. Aesthetic outcomes play an important role in determining the QOL. Mild/ Moderate injuries show better QOL compared to severe maxillofacial injuries.
Morphometry of pyramidalis muscle and its role in reconstructive surgeries: A cadaveric study
Authors: Sumalatha Suhani , Rao Sharanya , Ankolekar Vrinda Hari 
Published: May 2023

Background: The pyramidalis muscle is a tiny triangular-shaped muscle that is located in the anterior abdominal wall, which originates from the body of the pubis and pubic symphysis and is inserted into linea alba. This study aimed to measure the different parameters of the pyramidalis muscle in adult cadavers. Methods: This study was carried out on 31 adults (26 males and five females) 10% formalin embalmed cadavers of both sexes from the Department of Anatomy at Kasturba Medical College, Manipal. Results: The mean length of the right pyramidalis muscle was 64.44 ± 12.52 mm and the left pyramidalis muscle was 64.73 ± 12.81 mm. The mean width of the muscle was 15 ± 4.18 mm and 15.03 ± 3.52 mm on the right and left sides, respectively. The mean thickness of the muscle was 1.32 ± 0.55 mm and 1.4 ± 0.80 mm on the right and left sides, respectively. The distance between the umbilicus to pubic symphysis ranged from 130–192 mm and their mean was calculated to be 159.77 ± 15.36. The distance between the umbilicus and the apex of the muscle ranged from 72–123 mm. Conclusions: The measured parameters like length, width and thickness may help the surgeons to locate the muscle during infra umbilical surgeries.
The balancing act: A qualitative study on remote work and childcare during the COVID-19 lockdown in South Africa
Authors: Scholtz Salome 
Published: May 2023

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many employees' world by forcing some to remote work while caring for children. Methods: This study explored the remote working experiences of child caregivers in balancing work and childcare during the South African COVID-19 lockdown period (from 26 March 2020 to 31 December 2020). A qualitative descriptive design was employed to collect data through an online qualitative questionnaire with semi-structured questions. A final sample of 22 participants was included using purposive and snowball sampling. Results: Findings indicate that White South African employees experienced difficulty balancing work and childcare, which prompted them to use personal and organisational resources to restore work-life balance. These resources included people, spaces and time. Conclusions: This study provides insight for employers and healthcare workers into how remote workers balance work and childcare and can promote conversations or interventions on improving employee remote work experiences - especially in the unique South African context.
All-plasmonic optical leaky-wave antenna with a low sidelobe level
Authors: Zhou Guang Zhu , Chen Bao-Jie , Wu Geng-Bo , Qu Shi-Wei , Chan Chi Hou 
Published: May 2023

Optical antennas have received considerable attention in recent years due to their unique ability to convert localized energy to freely propagating radiation and vice versa. Sidelobe level (SLL) is one of the most crucial parameters in antenna design. A low SLL is beneficial to minimize the antenna interference with other optical components. Here a plasmonic optical leaky-wave antenna with low SLL is reported. Shifting spatial frequency by periodically modulating the electric-field amplitude in a plasmonic gap waveguide enables a free-space coupled wave out of the antenna. At the same time, precise control of the aperture fields by the modulation depth allows for reducing SLL. Simulation results indicate that the proposed design can achieve a high directivity of 15.8 dB and a low SLL of −20  dB at the wavelength of 1550 nm. A low SLL below −15  dB is experimentally demonstrated within the wavelength range from 1527 to 1570 nm. In addition, the low-SLL property is further verified by comparing it with a uniformly modulated antenna. By modulating the guided waves in the plasmonic gap waveguide in different forms, the aperture fields can be flexibly arranged to achieve arbitrary wavefront shaping. It bridges the gap between guided and free-space waves and empowers plasmonic integrated devices to control free-space light, thus enabling various free-space functions.
Maternal diet quality and associations with body composition and diet quality of preschool children: A longitudinal study
Authors: de Bona Coradi Fernanda , Anele Carolina Ribeiro , Goldani Marcelo Zubaran , da Silva Clécio Homrich , Bernardi Juliana Rombaldi 
Published: May 2023

Background
Nutrition, associated with nutritional status, influences the growth of children. This study aimed to identify the association between maternal diet quality and the diet and body composition of their children.

Methods
This is a prospective longitudinal study with mother-child pairs. To assess diet quality, nutritional status, and socioeconomic data, two interviews in the children’s first and third months of life (2011–2016) and one interview when children were of preschool age (2017–2019) were performed. Diet quality was assessed based on daily food consumption and frequency, considering: 1) food groups, based on the Brazilian food pyramid; 2) level of processing, according to the NOVA classification (unprocessed and/or minimally processed foods, processed foods and ultra-processed foods). One-way ANOVA with Tukey post hoc and Kruskal-Wallis with Dunn’s post hoc tests were used to evaluate the influence of factors on children’s diet quality. Pearson and Spearman’s correlations were used to evaluate the relationship between maternal and children’s diet quality, maternal schooling level, and child age. Along with the nutritional assessment of children, multiple linear regression models assessed the impact of covariables on maternal and children’s diet quality.

Results
Eighty-three mother-child pairs participated in this study. The more frequent the maternal consumption of unprocessed and/or minimally processed foods, the higher the consumption of these foods by children (r = +0.30; p = 0.006) and the lower their subscapular skinfold (SSF) thickness (p = 0.011; β = -0.278). On the other hand, the higher the maternal consumption of ultra-processed foods, the higher the children’s tricipital skinfold (TSF) thickness (p = 0.010; β = +0.274) and SSF (p = 0.043; β = +0.222).

Conclusion
Maternal diet quality was associated with the diet and body composition of children.
Cornélio Nepos. Vidas de Epaminondas, Catão e Ático. Fragmentos
Authors: Oliveira Francisco de 
Published: May 2023

O presente volume é dedicado à obra de Cornélio Nepos, Vidas de Varões Ilustres. Contém uma introdução geral sobre o autor; uma súmula de cada vida não traduzida e uma tradução das biografias de Epaminondas, Catão e Ático (com comentário e anotação desenvolvida). É também apresentada a tradução e notas dos fragmentos. O texto constitui uma fonte importante para o estudo do género biográfico e da história da antiguidade clássica, desde a Grécia clássica até aos finais da República Romana e inícios do Principado e seus contactos com outras civilizações.