bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic Endonasal Transpterygoid Approach: Technical Lessons
Authors: Finger Guilherme , Gun Ramazan , Wu Kyle C. , Carrau Ricardo L. , Prevedello Daniel M. 
Published: June 2023

INDICATIONS: CORRIDOR AND LIMITS OF EXPOSURE
The endoscopic endonasal transpterygoid approach (EETPA) provides direct access to the petrous apex, lateral clivus, inferior cavernous sinus compartment, jugular foramen, and infratemporal fossa.
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In the coronal plane, it provides exposure far beyond a traditional sphenoidotomy.

ANATOMIC ESSENTIALS: NEED FOR PREOPERATIVE PLANNING AND ASSESSMENT
The pterygoid process of the sphenoid bone forms the junction between the body and greater sphenoid wing before bifurcating because it descends into medial and lateral plates. The key to this exposure lies in the region's bony foramina: the palatovaginal canal, vidian canal, and foramen rotundum.
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ESSENTIALS STEPS OF THE PROCEDURE
After performing a maxillary antrostomy, stepwise exposure of these foramina leads to the pterygopalatine fossa. The sphenopalatine artery is cauterized as it becomes the posterior septal artery at the sphenopalatine foramen, and the maxillary sinus' posterior wall is opened to expose the pterygopalatine fossa. After mobilizing and retracting the contents of the pterygopalatine fossa, the pterygoid process is removed, improving access in the coronal plane.
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PITFALLS/AVOIDANCE OF COMPLICATIONS
Vidian neurectomy causes decreased or absent lacrimation. Injury to the maxillary nerve or its branches results in facial, palatal, or odontogenic anesthesia or neuralgia. In addition, the EEPTA precludes the ability to raise an ipsilateral nasal septal flap, making it crucial to plan reconstruction preoperatively.
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VARIANTS AND INDICATIONS FOR THEIR USE
There are 5 variants of the EEPTA: extended pterygopalatine fossa, lateral recess of the sphenoid sinus, petrous apex, infratemporal fossa and petrous carotid artery, and middle and posterior skull base.
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The patient consented to the procedure.
Images in the video used with permission as follows: images at 0:33 and 1:15 reused from Bozkurt et al,
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© Georg Thieme Verlag KG; image at 0:39 from Prosser et al,
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© John Wiley and Sons; images at 0:54, 9:03, and 9:38 from Kasemsiri et al,
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© John Wiley and Sons; images at 1:07 and 9:44 from Falcon et al,
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© John Wiley and Sons; image at 1:15 from Sandu et al,
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© Springer Nature.
Percutaneous Vertebroplasty and Upper Instrumented Vertebra Cement Augmentation Reducing Early Proximal Junctional Kyphosis and Failure Rate in Adult Spinal Deformity: Case Series and Literature Review
Authors: Gassie Kelly , Pressman Elliot , Vicente Angel Chinea , Flores-Milan Gabriel , Gordon Jonah , Alayli Adam , Lockard Gavin , Alikhani Puya 
Published: June 2023

BACKGROUND AND OBJECTIVES:
One of the risks involved after long-segment fusions includes proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). There are reported modalities to help prevent this, including 2-level prophylactic vertebroplasty. In this study, our goal was to report the largest series of prophylactic cement augmentation with upper instrumented vertebra (UIV) + 1 vertebroplasty and a literature review.

METHODS:
We retrospectively reviewed our long-segment fusions for adult spinal deformity from 2018 to 2022. The primary outcome measures included the incidence of PJK and PJF. Secondary outcomes included preoperative and postoperative Oswestry Disability Index, visual analog scale back and leg scores, surgical site infection, and plastic surgery closure assistance. In addition, we performed a literature review searching PubMed with a combination of the following words: “cement augmentation,” “UIV + 1 vertebroplasty,” “adjacent segment disease,” and “prophylactic vertebroplasty.” We found a total of 8 articles including 4 retrospective reviews, 2 prospective reviews, and 2 systematic reviews. The largest cohort of these articles included 39 patients with a PJK/PJF incidence of 28%/5%.

RESULTS:
Overall, we found 72 long-segment thoracolumbar fusion cases with prophylactic UIV cement augmentation with UIV + 1 vertebroplasty. The mean follow-up time was 17.25 months. Of these cases, 8 (11.1%) developed radiographic PJK and 3 (4.2%) required reoperation for PJF. Of the remaining 5 patients with radiographic PJK, 3 were clinically asymptomatic and treated conservatively and 2 had distal fractured rods that required only rod replacement.

CONCLUSION:
In this study, we report the largest series of patients with prophylactic percutaneous vertebroplasty and UIV cement augmentation with a low PJK and PJF incidence of 11.1% and 4.2%, respectively, compared with previously reported literature. Surgeons who regularly perform long-segment fusions for adult spinal deformity can consider this in their armamentarium when using methods to prevent adjacent segment disease because it is an effective modality in reducing early PJK and PJF that can often result in revision surgery.
Endoscopic Endonasal Optic Nerve Decompression in Idiopathic Intracranial Hypertension: When to Implement Optic Nerve Sheath Fenestration
Authors: Ahmedov Merdin Lyutviev , Tahmazoglu Burak , Aydin Seckin , Kartum Tufan Agah , Mergen Burak , Yildirim Senihe Rengin , Kemerdere Rahşan , Tanriover Necmettin 
Published: June 2023

BACKGROUND AND OBJECTIVE:
Idiopathic intracranial hypertension (IIH) is a syndrome characterized with increased intracranial pressure and normal cerebrospinal fluid (CSF) composition. Treatment is mainly conservative, whereas CSF diversion surgery is the most frequently used surgical intervention. Endoscopic endonasal optic nerve decompression (EOND) is a newer surgical treatment of this patient group. This study presents a single clinic's case series with comparative results of unilateral an bilateral EOND with or without optic nerve fenestration.

METHODS:
Sixteen patients with IIH syndrome who underwent 18 EOND procedures by a single neurosurgeon were evaluated with MRI and digitally subtracted angiography preoperatively. Both preoperative and postoperative visual acuity and perimetry and fundoscopy examinations were routinely performed. All patients underwent sphenoidotomy using the endoscopic binostril approach; however, unilateral or bilateral optic nerve decompression and accompanying optic sheath fenestration was determined on a case-by-case basis, after which all patients were also evaluated for the outcome of headaches.

RESULTS:
Most of the patients were female, and the mean age was 30.28 ± 9.78 years. CSF pressure was increased in all patients (406.43 ± 112.91 mm of H2O), and the follow-up period was 61.72 ± 21.67 months. In patients with unilateral EOND, visual fields improved in 83%, visual acuity in 70%, headache in 75%, and papilledema in 27% of cases. In patients with bilateral EOND, perimetry improved in 86%, visual acuity in 43%, headache in 50%, and papilledema in 57% of cases.

CONCLUSION:
EOND is an effective surgical option in the treatment of IIH. Bilateral decompression is preferable in patients with bilateral visual involvement, and optic nerve fenestration may prove to be helpful in patients with IIH whose primary complaint is headache.
Large field-of-view thermal imaging via all-silicon meta-optics
Authors: Wirth-Singh Anna , Fröch Johannes E. , Han Zheyi , Huang Luocheng , Mukherjee Saswata , Zhou Zhihao , Coppens Zachary , Böhringer Karl F. , Majumdar Arka 
Published: June 2023

A broad range of imaging and sensing technologies in the infrared require large field-of-view (FoV) operation. To achieve this, traditional refractive systems often employ multiple elements to compensate for aberrations, which leads to excess size, weight, and cost. For many applications, including night vision eye-wear, air-borne surveillance, and autonomous navigation for unmanned aerial vehicles, size and weight are highly constrained. Sub-wavelength diffractive optics, also known as meta-optics, can dramatically reduce the size, weight, and cost of these imaging systems, as meta-optics are significantly thinner and lighter than traditional refractive lenses. Here, we demonstrate 80° FoV thermal imaging in the long-wavelength infrared regime (8–12 µm) using an all-silicon meta-optic with an entrance aperture and lens focal length of 1 cm.
Propagation characteristics of the Kummer beam in turbulence with an anisotropic tilt angle
Authors: Yu Zhou , Wang Wenhai , Yang Donghui , Hu Zhengda , Zhu Yun 
Published: June 2023

Different from prevailing assumptions, turbulence cells display anisotropic tilt angles, rendering the environment in optical communication significantly more complex. In light of this, we develop expressions for the spatial coherence radius and the detection probability of the orbital angular momentum (OAM) states of the Kummer beam in turbulence with an anisotropic tilt angle. Through our investigation into the impact of various angles on optical communication, we identify suitable angles for mitigating the effects of atmospheric turbulence. Our findings indicate that when the zenith angle is equal to the anisotropic tilt angle and the azimuth angle is π, the disturbance of turbulence on the detection probability of OAM states is relatively weak. In slant paths, the variability in turbulence cells’ scales with altitude, particularly the inner scale, cannot be ignored. Consequently, a peak value emerges in the OAM detection probability owing to the variation of inner scales with altitude. Furthermore, the exponent of the amplitude factor and the logarithmic axicon parameter of the Kummer beam exhibit a significant impact on the received signal, especially at short propagation distances. We also investigate some other parameters of the turbulence and Kummer beam to enhance our comprehension of the propagation characteristics of a Kummer beam in a slant path. Overall, our results have practical implications in wireless optical communication systems such as remote sensing and radar communications.
ELISA F29 –A therapeutic efficacy biomarker in Chagas disease: Evaluation in pediatric patients treated with nifurtimox and followed for 4 years post-treatment
Authors: Rivero Rocio , Esteva Mónica Inés , Huang Erya , Colmegna Leylen , Altcheh Jaime , Grossmann Ulrike , Ruiz Andrés Mariano ,   on behalf of the CHICO and CHICO SECURE Study Groups
Published: June 2023

Background
Measurement of the success of antitrypanosomal treatment for Chagas disease is difficult, particularly in the chronic phase of the disease, because anti-Trypanosoma cruzi antibodies persist in serum for prolonged periods. We studied the effects of nifurtimox administered by two different treatment regimens on the T. cruzi calcium-binding flagellar protein F29 in children diagnosed with Chagas disease measured using an enzyme-linked immunosorbent assay (ELISA) technique (ELISA F29).

Methods and principal findings
In a phase 3, randomized, double-blind, parallel-group, historically controlled study (ClinicalTrials.gov NCT02625974), blood samples obtained from children diagnosed with Chagas disease and treated with nifurtimox for either 60 days or 30 days were analyzed using an ELISA with an F29 recombinant protein as the antigen, as well as conventional serological tests (recombinant ELISA and indirect hemagglutination assay). In an exploratory approach, serological response to nifurtimox treatment was evaluated for 4 years post-treatment. In both treatment groups, the number of patients with negative ELISA F29 values increased over the period of observation. The incidence rate of negative seroconversion using ELISA F29 was 22.94% (95% CI: 19.65%, 26.63%) in the 60-day treatment group and 21.64% (95% CI: 17.21%, 26.86%) in the 30-day treatment group. In the subpopulation of patients who tested seropositive for F29 before nifurtimox treatment, 88 patients (67.7%) in the 60-day regimen and 39 patients (59.1%) in the 30-day regimen were F29 seronegative at 4 years post-treatment. All patients who had a positive ELISA F29 test at baseline and seroconverted to negative measured by conventional serology reached seronegativity in ELISA F29 earlier than in conventional serology.

Conclusions
The results demonstrate a serological response to treatment with nifurtimox measured by the ELISA F29 test in children diagnosed with Chagas disease. The F29-based ELISA can be considered a potential early marker of response to antitrypanosomal therapy for Chagas disease.

Trial registration
ClinicalTrials.gov NCT02625974.
Mendelian randomization study on the causal relationship between leukocyte telomere length and prostate cancer
Authors: Wan Bangbei , Lu Likui , Lv Cai 
Published: June 2023

Background
Leukocyte telomere length (LTL) is related to prostate cancer (PCa). However, the causal relationship between them remains unknown. This study was aimed at identifying the causal direction between LTL and PCa with Mendelian randomization (MR).

Methods
Single-nucleotide polymorphisms associated with LTL were identified from a genome-wide association study (GWAS) involving 472,174 individuals. Summary-level data of PCa-related GWAS were extracted from four cohorts comprising 456,717 individuals. An inverse-variance-weighted (IVW) algorithm was used for MR. Sensitivity analyses were performed with MR-Egger regression, IVW regression, leave-one-out test, and MR-Pleiotropy Residual Sum and Outlier analyses. A meta-analysis was also performed to compute the average genetically determined effect of LTL on PCa.

Results
A long LTL was associated with an increased risk of PCa in all cohorts, with odds ratios of 1.368 (95% confidence interval [CI]: 1.247 to 1.500, P = 2.84×10−11), 1.503 (95% CI: 1.243 to 1.816, P = 2.57×10−5), 1.722 (95% CI: 1.427 to 2.077, P = 1.48×10−8), and 1.358 (95% CI: 1.242 to 1.484, P = 1.73×10−11) in the IVW analysis. Sensitivity analyses showed that the genetically determined effect of LTL on PCa was stable and reliable. The meta-analysis showed that the genetically determined per 1-standard deviation rise in LTL correlated significantly with an average 40.6% increase in the PCa risk, with an average odds ratio of 1.406 (95% CI: 1.327 to 1.489, P < 0.001).

Conclusion
The results of this study supported the causal hypothesis that the genetically determined longer LTL was associated with a higher risk of PCa. This finding could serve as a basis for therapeutic strategies for PCa.
Sleep in neurointensive care patients, and patients after brain tumor surgery
Authors: Nyholm Lena , Zetterling Maria , Elf Kristin 
Published: June 2023

Background
Severely brain injured patients treated in the neuro intensive care unit (NICU) are usually sedated. Sedation may affect not only the ability to sleep, but also the EEG rhythms used to identify sleep.

Aim
The aims were:

To study if sleep patterns could be identified in the severely brain injured and sedated patients in the NICU
To study if sleep patterns could be identified in patients the night after brain tumor surgery in the neurointermediate care unit (NIMCU)
To search for risk factors for not being able to sleep after brain tumor surgery

Study design
Two populations were included; one with patients affected by severe brain injury and one with patients who had undergone planned brain tumor surgery. This was a quantitative observational study using EEG. Eligible neurointensive care patients for this study had to be suffering from a neurosurgical condition (for example subarachnoid haemorrhage, acute subdural hematoma, intracerebral haemorrhage and meningitis), have affected consciousness and age over 18 years. Thirty-seven patients were included from NICU. Ninety-eight patients, with a suspected glioma (WHO grade II-IV) planned for surgery were also included.

Results
Neuro intensive care patients, sedated and treated in ventilator, showed no EEG sleep patterns at all. After brain tumor surgery, sleep occurred in 74% of the patients, despite frequent wake-up tests. The patients with sleep patterns were on average 8 years younger, p = 0.03.

Conclusions
Patients with severe brain injury are at risk of having no sleep when treated at the NICU, whereas after brain tumor surgery, sleep occurs in three-fourths of the patients. Further studies and new methods are warranted to identify sleep and investigate how the loss of sleep affects these patients and how sleep disturbances can be managed.
Muslim women’s knowledge, views, and attitudes towards sexually transmitted infections in Saudi Arabia: A qualitative study
Authors: Alomair Noura , Alageel Samah , Davies Nathan , Bailey Julia V. 
Published: June 2023

Background
The cultural sensitivity surrounding sexuality in Islamic communities has an impact on awareness and prevention of sexually transmitted infections (STIs). This study explores Muslim women’s knowledge, views, and attitudes towards STIs and people living with HIV/AIDs in Saudi Arabia.

Methods
We conducted qualitative semi-structured interviews with Muslim women from Saudi Arabia. Interviews took place in a public hospital in Riyadh, Saudi Arabia in 2019. Data were transcribed, coded, and analysed using a reflexive thematic analysis.

Results
Twenty-eight women were interviewed, the majority were college educated and employed. Participants lacked knowledge about STIs, and there were significant misconceptions. The majority of women expressed extremely negative attitudes towards STIs, particularly towards people living with HIV/AIDS. Participants believed that judgemental attitudes and stigmatisation of people with HIV/AIDS were justified if an infection was transmitted through extramarital sex. Men were believed to be the source of STIs, and STIs were viewed as punishment from God for extramarital sexual relations that are forbidden in Islam. Protection against STIs was believed to be achieved by strengthening religious beliefs.

Conclusion
Attitudes towards people with STIs, HIV/AIDS in particular, were highly influenced by religious views towards extramarital sex, as well as lack of knowledge and misconceptions. There is an urgent need for accurate information and improved awareness of sexual health including STIs among Muslims in Saudi Arabia. Public health efforts should be directed towards reducing stigma and discrimination against people living with HIV/AIDS in Saudi Arabia and other Islamic communities.
Cost analysis of an intrapartum quality improvement package for improving preterm survival and reinforcing best practices in Kenya and Uganda
Authors: Smith Hughes Carolyn , Butrick Elizabeth , Namutundu Juliana , Olwanda Easter , Otieno Phelgona , Waiswa Peter , Walker Dilys , Kahn James G. 
Published: June 2023

Introduction
Preterm birth is a leading cause of under-5 mortality, with the greatest burden in lower-resource settings. Strategies to improve preterm survival have been tested, but strategy costs are less understood. We estimate costs of a highly effective Preterm Birth Initiative (PTBi) intrapartum intervention package (data strengthening, WHO Safe Childbirth Checklist, simulation and team training, quality improvement collaboratives) and active control (data strengthening, Safe Childbirth Checklist).

Methods
In our analysis, we estimated costs incremental to current cost of intrapartum care (in 2020 $US) for the PTBi intervention package and active control in Kenya and Uganda. We costed the intervention package and control in two scenarios: 1) non-research implementation costs as observed in the PTBi study (Scenario 1, mix of public and private inputs), and 2) hypothetical costs for a model of implementation into Ministry of Health programming (Scenario 2, mostly public inputs). Using a healthcare system perspective, we employed micro-costing of personnel, supplies, physical space, and travel, including 3 sequential phases: program planning/adaptation (9 months); high-intensity implementation (15 months); lower-intensity maintenance (annual). One-way sensitivity analyses explored the effects of uncertainty in Scenario 2.

Results
Scenario 1 PTBi package total costs were $1.11M in Kenya ($48.13/birth) and $0.74M in Uganda ($17.19/birtth). Scenario 2 total costs were $0.86M in Kenya ($23.91/birth) and $0.28M in Uganda ($5.47/birth); annual maintenance phase costs per birth were $16.36 in Kenya and $3.47 in Uganda. In each scenario and country, personnel made up at least 72% of total PTBi package costs. Total Scenario 2 costs in Uganda were consistently one-third those of Kenya, largely driven by differences in facility delivery volume and personnel salaries.

Conclusions
If taken up and implemented, the PTBi package has the potential to save preterm lives, with potential steady-state (maintenance) costs that would be roughly 5–15% of total per-birth healthcare costs in Uganda and Kenya.
A compassion-based program to reduce psychological distress in medical students: A pilot randomized clinical trial
Authors: Rojas Blanca , Catalan Elena , Diez Gustavo , Roca Pablo 
Published: June 2023

ObjectivesPhysicians and medical students are subject to higher levels of psychological distress than the general population. These challenges have a negative impact in medical practice, leading to uncompassionate care. This pilot study aims to examine the feasibility of Compassion Cultivation Training (CCT) to reduce psychological distress and improve the well-being of medical students. We hypothesize that the CCT program, as compared to a waitlist control group, will reduce psychological distress (i.e., stress, anxiety, and depression) and burnout symptoms, while improving compassion, empathy, mindfulness, resilience, psychological well-being, and emotion-regulation strategies after the intervention. Furthermore, we hypothesize that these improvements will be maintained at a two-month follow-up.MethodsMedical students were randomly assigned to an 8-week CCT or a Waitlist control group (WL). They completed self-report assessments at pre-intervention, post-intervention, and a 2-month follow-up. The outcomes measured were compassion, empathy, mindfulness, well-being, resilience, emotional regulation, psychological distress, burnout, and COVID-19 concern. Mixed-effects models and Reliable Change Index were computed.ResultsCompared with WL, CCT showed significant improvements in self-compassion, mindfulness, and emotion regulation, as well as a significant decrease in stress, anxiety, and emotional exhaustion component of burnout. Furthermore, some of these effects persisted at follow-up. No adverse effects of meditation practices were found.ConclusionsCCT enhanced compassion skills while reducing psychological distress in medical students, this being critical to preserving the mental health of physicians while promoting compassionate care for patients. The need for institutions to include this type of training is also discussed.