bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catalytic Asymmetric [3+3] Cycloaddition of Activated Isocyanides with Azomethine Imines
Authors: Qian Linghui , Liao Jia-Yu , Tao Ling-Fei 
Published: July 2022

AbstractCatalytic asymmetric 1,3-dipolar cycloaddition reactions of activated isocyanides with various 2π dipolarophiles have been intensively studied, affording a wide range of enantioenriched five-membered N-heterocycles. In sharp contrast, the catalytic enantioselective higher-order cycloaddition of activated isocyanides has not been achieved yet. We present here our recent work on the development of an unprecedented silver-catalyzed highly diastereo- and enantioselective [3+3] cycloaddition of activated isocyanides with azomethine imines. This method features high efficiency, good to excellent stereocontrol, wide substrate scope, as well as operational simplicity. It is also noteworthy that the same catalytic system was proved to be suitable for not only the late-stage functionalization of complex bioactive molecules but also the kinetic resolution of racemic azomethine imines.1	Introduction2	Results and Discussion3	Summary and Outlook
Gender Influence on Abdominal Aortic Aneurysm Surgery in a Caribbean Population
Authors: Harnarayan Patrick , Budhooram Steve , Harnanan Dave , Ramdass Michael J. , Islam Shariful , Naraynsingh Vijay 
Published: July 2022

AbstractFemale patients with abdominal aortic aneurysms (AAAs) are usually less common and older than their male counterparts. We report on AAA disease in a Caribbean nation with respect to gender and review their outcomes relative to the male population. Data were collected prospectively and analyzed retrospectively for patients with AAAs who underwent surgery from 2001 to 2018. Sixty patients were diagnosed with AAA with 44 going on to have surgical repair of which 35 were males, aged 61 to 89 (mean age 73.4 years). Nine women ages 44 to 74 years (mean age 60.8 years) had surgical intervention, three being between 40 and 49 years. The size of aneurysms in these patients ranged from 4.3 to 11.0 cm in diameter (average 6.95 cm), female patients having an average diameter of 6.7 cm. Of the 44 patients, 43 underwent open and one endovascular repair. Thirty-three were elective cases and 11 were ruptured with 32 aorto-aortic and 13 aorto-iliac repairs. There were nine fatalities, three elective and six ruptured, with only one being female. Women had similar outcomes to men in all age groups with young patients having good results. Female AAA patients are usually older, undergo less surgical procedures especially if endovascular, and have worse outcomes than their male counterparts. Our study showed that the females were younger but had similar outcomes to the male patients. The female Caribbean patients may present at much younger ages than in continental populations and this may be due to genetic, ethnic, or lifestyle factors.
The Clinical Value of Serial Radionuclide Gastric-Emptying Scintigraphy for Objective Evaluation of Gastroparesis in a Patient with Superior Mesenteric Artery Syndrome Post Corrective Surgery
Authors: Javaid Amir , Siraj Qaisar Hussain 
Published: July 2022

AbstractSuperior mesenteric artery syndrome is a rare cause of intestinal obstruction. The condition results from compression of the duodenum between the aorta and the superior mesenteric artery, which causes an impairment of gastric emptying and associated chronic symptoms. There is a need to objectively assess the severity of gastric-emptying disorder in these patients post-treatment to assess the efficacy of the conservative or surgical management. We report here a case of a patient where the radionuclide gastric-emptying study was crucial in monitoring the effectiveness of surgical management of this syndrome.
18F-FDG PET/CT Imaging of Boari Flap Mimicking Urothelial Cancer Recurrence
Authors: Fishberg Sharon E. , Gofrit Ofer N. , Orevi Marina 
Published: July 2022

AbstractA 63-year-old man underwent distal ureterectomy as a treatment for urothelial carcinoma of the ureter. Reconstruction of the urinary system was accomplished by tubularizing part of the bladder roof (Boari flap). A year later, metastatic evaluation with 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) showed high metabolic activity in the reconstructed area. Thorough evaluation confirmed the presence of a bladder diverticulum (the Boari flap) with no evidence of malignancy. We present the first 18F-FDG PET/CT images of a Boari flap in the literature.
68Ga-DOTATATE Uptake in COVID-19 Pneumonia: A Non-Neoplastic False Positive
Authors: Weissman Joshua P. , Bartel Twyla 
Published: July 2022

AbstractIn the detection and characterization of neuroendocrine tumors (NETs), the NETSPOT 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) utilizes a somatostatin analog to capture whole body imaging of somatostatin receptors. Here, we report a rare case of incidental coronavirus disease 2019 (COVID-19) detection using 68Ga-DOTATATE PET/CT for a 48-year-old patient with COVID-19 who presented to our nuclear medicine department for oncologic and neuroendocrine indications. Current maximal intensity project image from 68Ga-DOTATATE PET/CT demonstrated numerous hypermetabolic foci in the upper abdominal lymph nodes, consistent with somatostatin-avid pancreatic islet cell neoplasm. Radiotracer uptake corresponding to the anatomic infiltrates was also seen in the bilateral pneumonia. With the rise of worldwide COVID-19 cases, and the continued use of NETSPOT for somatostatin avid neoplasms, it is imperative that diagnostic measures of this disease are clearly understood. This case highlights the importance of including COVID-19 on the differential diagnosis when radiotracer uptake appears in 68Ga-DOTATATE PET/CT.
Chest Wall Mass as the Dominant Presentation of Low-Grade B-Cell Non-Hodgkin's Lymphoma: A Case Report
Authors: Sonavane Sunita Nitin , Basu Sandip 
Published: July 2022

AbstractLow-grade B cell non-Hodgkin's lymphoma with dominant presentation of chest wall mass is presented in this report. The patient, a 65-year-old woman, presented with pain, rising skin temperature and redness, and swelling on the right lower chest wall. The histopathological examination revealed non-Hodgkin's lymphoma; the staging fluorodeoxyglucose-positron emission tomography/computed tomography demonstrated stage IVE disease, with hypermetabolic active disease in the right anterolateral chest wall in the form of large soft tissue mass and subcutaneous tissue with underlying bony erosion with extension into right anterior cardiophrenic space and superiorly up to right second costosternal region along the right internal mammary vessels. This was along with hypermetabolic active right axillary, right supraclavicular and left inguinal lymphadenopathy, and thickened hypermetabolic posterior right pleura with ametabolic right-sided pleural effusion. Bone marrow biopsy revealed uninvolved bone marrow. On follow-up after eight cycles of R-CHOP chemotherapy, the mass had completely resolved on contrast-enhanced computed tomography.
Two Cases of Quadricuspid Aortic Valve: Aortic Regurgitation and Degeneration
Authors: Federspiel Jan Michael , Tschernig Thomas , Laschke Matthias Werner , Schäfers Hans-Joachim 
Published: July 2022

Abstract
Background Quadricuspid aortic valve is rare and occasionally associated with aortic regurgitation and ascending aortic dilatation. Recent studies suggest an association of aortic regurgitation with ascending aortic medial degeneration.
Case Description Histologic evaluation of ascending aortic tissue of two individuals with regurgitant quadricuspid aortic valve, one dilated, one non-dilated, yielded comparable degeneration in the Media.
Conclusion Regurgitation of quadricuspid aortic valve may lead to the degeneration of Tunica media of the ascending aorta.
Spatial population genetics with fluid flow
Authors: Benzi Roberto , Nelson David R , Shankar Suraj , Toschi Federico , Zhu Xiaojue 
Published: July 2022

Abstract
The growth and evolution of microbial populations is often subjected to advection by fluid flows in spatially extended environments, with immediate consequences for questions of spatial population genetics in marine ecology, planktonic diversity and origin of life scenarios. Here, we review recent progress made in understanding this rich problem in the simplified setting of two competing genetic microbial strains subjected to fluid flows. As a pedagogical example we focus on antagonsim, i.e., two killer microorganism strains, each secreting toxins that impede the growth of their competitors (competitive exclusion), in the presence of stationary fluid flows. By solving two coupled reaction–diffusion equations that include advection by simple steady cellular flows composed of characteristic flow motifs in two dimensions (2D), we show how local flow shear and compressibility effects can interact with selective advantage to have a dramatic influence on genetic competition and fixation in spatially distributed populations. We analyze several 1D and 2D flow geometries including sources, sinks, vortices and saddles, and show how simple analytical models of the dynamics of the genetic interface can be used to shed light on the nucleation, coexistence and flow-driven instabilities of genetic drops. By exploiting an analogy with phase separation with nonconserved order parameters, we uncover how these genetic drops harness fluid flows for novel evolutionary strategies, even in the presence of number fluctuations, as confirmed by agent-based simulations as well.
Compulsory Licences in a Regional Context: An Appraisal of the TRIPS Amendment’s Special Regional Treatment
Authors: Adekola Tolulope Anthony 
Published: July 2022

Abstract
Against the backdrop of the regional mechanism carved out under Art. 31bis(3) of the TRIPS Agreement for issuing compulsory licences, the paper critically appraises the mechanism’s viability or otherwise in addressing the challenge of access to essential medicines in a regional context. The paper finds that the mechanism remains severely restricted. First, it does not exempt an importing country within the regional alliance from issuing a separate compulsory licence where a patent is in force on the pharmaceutical product in question. Second, the logic of the mechanism is counterintuitive in that it is prohibited from being used as an instrument to pursue industrial policy objectives, and in a broad sense, a public-health-related industrial agenda. Using the East African Community (EAC) as a case study, the paper practically reveals how the identified distortions inhibit the use of compulsory licences within a regional coalition. The paper also examines how the potency of the TRIPS transition period, which excludes 80% of EAC member states from granting pharmaceuticals patents until 2034, is being whittled down by the African Regional Intellectual Property Organization’s (ARIPO) obligations and unclear domestic legislation. The paper recommends an overhaul of the TRIPS amendment’s regional mechanism for better effectiveness in driving pharmaceutical access.
Classification of Fermi-LAT unidentified gamma-ray sources using catboost gradient boosting decision trees
Authors: Coronado-Blázquez Javier 
Published: July 2022

ABSTRACT
The latest Fermi-LAT gamma-ray catalogue, 4FGL-DR3, presents a large fraction of sources without clear association to known counterparts, i.e. unidentified sources (unIDs). In this paper, we aim to classify them using machine learning algorithms, which are trained with the spectral characteristics of associated sources to predict the class of the unID population. With the state-of-the-art catboost algorithm, based on gradient boosting decision trees, we are able to reach a 67 per cent accuracy on a 23-class data set. Removing a single of these classes – blazars of uncertain type – increases the accuracy to 81 per cent. If interested only in a binary AGN/pulsar distinction, the model accuracy is boosted up to 99 per cent. Additionally, we perform an unsupervised search among both known and unID population, and try to predict the number of clusters of similar sources, without prior knowledge of their classes. The full code used to perform all calculations is provided as an interactive python notebook.
Physics of nova outbursts: A theoretical model of classical nova outbursts with self-consistent wind mass loss
Authors: Kato Mariko , Saio Hideyuki , Hachisu Izumi 
Published: July 2022

Abstract
We present a model for one cycle of a classical nova outburst based on a self-consistent wind mass loss accelerated by the gradient of radiation pressure, i.e., so-called optically thick winds. Evolution models are calculated by a Henyey code for a 1.0 $M_{\odot }$ white dwarf with a mass-accretion rate of 5 × 10−9 $M_{\odot }$ yr−1. The outermost part of the hydrogen-rich envelope is connected to a steadily moving envelope where optically thick winds occur. We confirm that no internal shock waves occur at thermonuclear runaway. The wind mass-loss rate reaches a peak of 1.4 × 10−4 $M_{\odot }$ yr−1 at the epoch of the maximum photospheric expansion, where the photospheric temperature decreases to log Tph (K) = 3.90. Almost all of the accreted mass is lost in the wind. The nuclear energy generated in hydrogen burning is lost in a form of photon emission (64%), gravitational energy (lifting up the wind matter against gravity, 35%), and the kinetic energy of the wind (0.23%). A classical nova should be very bright in a far-UV (100–300 Å) band for one day just after the onset of thermonuclear runaway (∼ 25 d before the optical maximum). In the decay phase of the nova outburst, the envelope structure is very close to that of a steady-state solution.
Secondary prevention of latex allergy
Authors: Nettis Eustachio , Casella Rossella , Incorvaia Cristoforo , Miniello Andrea 
Published: July 2022

Purpose of review
The present review addresses the secondary prevention in healthcare worker, healthcare setting, and in patients outside the healthcare setting.

Recent findings
There is sufficient knowledge of the broad aetiology of latex allergy for secondary preventive programmes to be widely adopted. Currently, avoidance of latex-containing surgical products is mandatory in the care of sensitized patients. They should also have a list of occult sources of natural rubber latex exposure and cross-reacting fruits. During all health-care procedures latex allergic patients should be treated in a ‘latex-free’ environment. Specific sublingual immunotherapy has been suggested as a suitable therapeutic option. It can be offered, in addition to symptomatic treatment, to selected patients, when avoidance measures are not feasible or effective. The use of omalizumab could also be extended as an adjunct to latex immunotherapy.

Summary
Despite of the progress made in the secondary prevention of latex allergy, the disease still continues to be a global health problem.
Depression Increases Posterior Cervical Decompression and Fusion Revision Rates and Diminishes Neck Disability Index Improvement
Authors: Toci Gregory R. , Lambrechts Mark J. , Karamian Brian A. , Mao Jennifer , Heinle Jeremy , Bhatt Shivang , Harlamova Daria , Canseco Jose A. , Kaye Ian David , Woods Barrett I. , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: July 2022

Study Design.
A retrospective cohort study.

Objective.
To determine if depression and/or anxiety significantly affect patient-reported outcome measures (PROMs) after posterior cervical decompression and fusion (PCDF).

Summary of Background Data.
Mental health diagnoses are receiving increased recognition for their influence of outcomes after spine surgery. The magnitude that mental health disorders contribute to patient-reported outcomes following PCDF requires increased awareness and understanding.

Materials and Methods.
A review of electronic medical records identified patients who underwent a PCDF at a single institution during the years 2013–2020. Patients were placed into either depression/anxiety or nondepression/anxiety group based on their medical history. A delta score (∆) was calculated for all PROMs by subtracting postoperative from preoperative scores. χ2 tests and t tests were utilized to analyze categorical and continuous data, respectively. Regression analysis determined independent predictors of change in PROMs. Alpha was set at 0.05.

Results.
A total of 195 patients met inclusion criteria, with 60 (30.8%) having a prior diagnosis of depression/anxiety. The depression/anxiety group was younger (58.8 vs. 63.0, P=0.012), predominantly female (53.3% vs. 31.9%, P=0.007), and more frequently required revision surgery (11.7% vs. 0.74%, P=0.001). In addition, they had worse baseline mental component (MCS-12) (42.2 vs. 48.6, P<0.001), postoperative MCS-12 (46.5 vs. 52.9, P=0.002), postoperative neck disability index (NDI) (40.7 vs. 28.5, P=0.001), ∆NDI (−1.80 vs. −8.93, P=0.010), NDI minimum clinically important difference improvement (15.0% vs. 29.6%, P=0.046), and postoperative Visual Analog Scale (VAS) Neck scores (3.63 vs. 2.48, P=0.018). Only the nondepression/anxiety group improved in MCS-12 (P=0.002) and NDI (P<0.001) postoperatively. Depression and/or anxiety was an independent predictor of decreased magnitude of NDI improvement on regression analysis (β=7.14, P=0.038).

Conclusion.
Patients with history of depression or anxiety demonstrate less improvement in patient-reported outcomes and a higher revision rate after posterior cervical fusion, highlighting the importance of mental health on clinical outcomes after spine surgery.
Establishment of an Individualized Distal Junctional Kyphosis Risk Index following the Surgical Treatment of Adult Cervical Deformities
Authors: Passias Peter G. , Naessig Sara , Sagoo Navraj , Passfall Lara , Ahmad Waleed , Lafage Renaud , Lafage Virginie , Vira Shaleen , Schoenfeld Andrew J. , Oh Cheongeun , Protopsaltis Themistocles , Kim Han Jo , Daniels Alan , Hart Robert , Burton Douglas , Klineberg Eric O. , Bess Shay , Schwab Frank , Shaffrey Christopher , Ames Christopher P. , Smith Justin S. ,   On Behalf of the International Spine Study Group
Published: July 2022

Study Design.
A retrospective review of a multicenter comprehensive cervical deformity (CD) database.

Objective.
To develop a novel risk index specific to each patient to aid in patient counseling and surgical planning to minimize postop distal junctional kyphosis (DJK) occurrence.

Background.
DJK is a radiographic finding identified after patients undergo instrumented spinal fusions which can result in sagittal spinal deformity, pain and disability, and potentially neurological compromise. DJK is considered multifactorial in nature and there is a lack of consensus on the true etiology of DJK.

Materials and Methods.
CD patients with baseline (BL) and at least one-year postoperative radiographic follow-up were included. A patient-specific DJK score was created through use of unstandardized Beta weights of a multivariate regression model predicting DJK (end of fusion construct to the second distal vertebra change in this angle by <−10° from BL to postop).

Results.
A total of 110 CD patients included (61 yr, 66.4% females, 28.8 kg/m2). In all, 31.8% of these patients developed DJK (16.1% three males, 11.4% six males, 62.9% one-year). At BL, DJK patients were more frail and underwent combined approach more (both P<0.05). Multivariate model regression analysis identified individualized scores through creation of a DJK equation: −0.55+0.009 (BL inclination)−0.078 (preinflection)+5.9×10-5 (BL lowest instrumented vertebra angle) + 0.43 (combine approach)−0.002 (BL TS-CL)−0.002 (BL pelvic tilt)−0.031 (BL C2-C7) + 0.02 (∆T4–T12)+ 0.63 (osteoporosis)−0.03 (anterior approach)−0.036 (frail)−0.032 (3 column osteotomy). This equation has a 77.8% accuracy of predicting DJK. A score ≥81 predicted DJK with an accuracy of 89.3%. The BL reference equation correlated with two year outcomes of Numeric Rating Scales of Back percentage (P=0.003), reoperation (P=0.04), and minimal clinically importance differences for 5-dimension EuroQol questionnaire (P=0.04).

Conclusions.
This study proposes a novel risk index of DJK development that focuses on potentially modifiable surgical factors as well as established patient-related and radiographic determinants. The reference model created demonstrated strong correlations with relevant two-year outcome measures, including axial pain-related symptoms, occurrence of related reoperations, and the achievement of minimal clinically importance differences for 5-dimension EuroQol questionnaire.
Metastasis of a Surgically Excised Melanoma In Situ
Authors: Anderson Jarett , Hamp Austin , Booms Alisha , Stover Kimberly Carlson 
Published: July 2022

ABSTRACT
Melanoma in situ (MIS) is considered a noninvasive precursor to malignant melanoma and is defined as abnormal melanocytes that are confined to the epidermis without evidence of invasion through the basal membrane and into the deeper dermis. It is often referred to as Stage 0 melanoma.
MIS is thought to have no metastatic potential. However, several reports have shown that occult invasive disease may be found upon further testing of pathologically unequivocal MIS. In addition, several risk factors contribute to the upstaging of an MIS.
We present a case of a patient who was diagnosed with MIS who underwent excision of the primary lesion. Although the pathology report of the excision revealed negative margins, he was later found to have metastatic lesions to several lymph nodes, his parotid gland, and his brain. This resulted in extensive medical treatment that the patient did not originally anticipate.
Implementation of an Advanced Practice Registered Nurse–Led Clinic to Improve Follow-up Care for Post–Ischemic Stroke Patients
Authors: Mitchell Erin , Reynolds Staci S. , Mower-Wade Donna , Raser-Schramm Jonathan , Granger Bradi B. 
Published: July 2022

ABSTRACT

BACKGROUND: Ischemic stroke continues to be a leading cause of serious disability within the United States, affecting 795 000 people annually. Approximately 12% to 21% of post–ischemic stroke patients will be readmitted to the hospital within 30 days of discharge. Studies suggest that implementation of a follow-up appointment within 7 to 14 days of discharge improves 30-day readmission rates; however, implementation of these guidelines is uncommon, and follow-up visits within the recommended window are not often achieved. The purpose of this project was to evaluate the impact of an advanced practice registered nurse (APRN)-led stroke clinic on follow-up care for post–ischemic stroke patients. The aims were to improve time to follow-up visit and reduce 30-day unplanned readmissions. METHODS: A pre/post intervention design was used to evaluate the impact of a process to access the APRN-led stroke clinic. The intervention included a scheduling process redesign, and subsequent APRN and scheduler education. RESULTS: The time to clinic follow-up preintervention averaged 116.9 days, which significantly reduced to 33.6 days post intervention, P = .0001. Unplanned readmissions within 30 days declined from 11.5% to 9.9%; however, it was not statistically significant, P = .149. Age was not statistically different between preintervention and postintervention groups, P = .092, and other demographics were similar between the groups. CONCLUSION: An APRN-led clinic can improve follow-up care and may reduce unplanned 30-day readmissions for post–ischemic stroke patients. Further work is needed to determine the impact of alternative approaches such as telehealth.