Accounts of Chemical Research最新文献

{"title":"Dibenzothiophenium Salts: Practical Alternatives to Hypervalent I(III)-Based Reagents","authors":"Manuel Alcarazo*,&nbsp;","doi":"10.1021/acs.accounts.4c0080410.1021/acs.accounts.4c00804","DOIUrl":"https://doi.org/10.1021/acs.accounts.4c00804https://doi.org/10.1021/acs.accounts.4c00804","url":null,"abstract":"<p >During the past few years, the interest among organic synthesis practitioners in the use of sulfonium salts has exponentially growth. This can arguably be attributed to a series of specific factors: (a) The recent development of more direct and efficient protocols for the synthesis of these species, which make sulfonium reagents of a wide structural variety easily available in multigram scale. (b) The recognition that the reactivity of these salts resembles that of hypervalent iodine compounds, and therefore, they can be used as effective replacement of such species in most of their applications. (c) Their intrinsic thermal stability and tolerance to air and moisture, which clearly surpass that of I(III)-reagents of analogue reactivity, and facilitate their purification, isolation as well-defined species, storage, and safely handling on larger scale. (d) Finally, the possibility to further functionalize sulfonium salts once the sulfur-containing platform has been incorporated. Specifically, this last synthetic approach is not trivial when working with hypervalent I(III)-species and facilitates the access to sulfonium salts with no counterpart in the I(III) realm.</p><p >This renewed interest in sulfonium salts has led to the improvement of already existing transformations as well as to the discovery of unprecedented ones; in particular, by the development of protocols that incorporate sulfonium salts as partners in traditional cross-coupling and C–H activation steps or combine them with more modern technologies such as photocatalysis or electrosynthesis. In this Account, the reactivity of a series of sulfonium salts originally prepared in our laboratory will be outlined and compared to their I(III)-counterparts. Some of these reagents are now commercially available, and their use has started to spread widely across the synthetic chemistry community, helping to speed the process of identification of potentially bioactive products or new functionaliced materials. However, challenges still remain. The development of sulfonium reagents characterized by an optimal balance between reactivity and site-selectivity, or showing broader compatibility toward sensitive functional groups is still a need. In addition, the intrinsic stability of sulfonium salts often makes necessary the use of (sophisticated) catalysts that activate the latent reactivity hidden in their structures. Although <i>a priori</i> one can see this fact as a disadvantage, it might actually be decisive to harvest the full synthetic potential of sulfonium salts because their thermal stability will surely facilitate the preparation of operational reagents with no counterpart in the context of I(III)-chemistry. If this becomes true, sulfonium salts may contribute to the expediting of retrosynthetic disconnections that, to date, are impossible.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":"58 4","pages":"635–646 635–646"},"PeriodicalIF":16.4,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://pubs.acs.org/doi/epdf/10.1021/acs.accounts.4c00804","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Negative Parental Influences and Criminal Thinking in Juvenile Offending Behaviors.","authors":"Branna Humphrey, Bradley D Edwards, Jennifer Pealer","doi":"10.1177/0306624X221132998","DOIUrl":"10.1177/0306624X221132998","url":null,"abstract":"<p><p>Previous research has established that juveniles who experience negative parental influence are more likely to engage in problem and offending behavior. Less attention has been given to the possibility that criminal thinking styles might partially explain this relationship. This study examined the negative parental influences and criminal thinking styles of 1,354 juvenile offenders to establish that both negative parental influences and criminal thinking are significantly associated with juvenile problem and offending behavior. Further, the analysis showed that juvenile criminal thinking (proactive, reactive, and general) might mediate the relationship between negative parental influences and problem behavior. Implications for such findings are discussed.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"170-183"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive neurally adjusted ventilatory assist (NAVA) in the pediatric ICU: assessing optimal Edi compliance.","authors":"Riwaaj Lamsal, Gwenyth Fischer, Michael Shyne, Arif Somani","doi":"10.23736/S2724-5276.21.06431-4","DOIUrl":"10.23736/S2724-5276.21.06431-4","url":null,"abstract":"<p><strong>Background: </strong>Bronchiolitis patients are supported with non-invasive conventional modalities (HFNC, CPAP and BiPAP). Neurally adjusted ventilatory assist (NAVA) is a newer mode which supports based on electrical activity of the diaphragm (Edi). It is unclear if non-invasive NAVA is used within optimal operational parameters. The study aim was to evaluate Edi compliance.</p><p><strong>Methods: </strong>A retrospective chart review of bronchiolitis patients admitted to the PICU from January 2015 to January 2018 was undertaken. NAVA compliance within optimal parameters (defined as Edi peak values between 5-15 µV and Edi min <1µV) was assessed as the primary outcome. Secondary outcomes included PICU length of stay (LOS), duration to minimal respiratory support (defined as 4 L/min or less on HFNC) and intubation rate in the conventional (non-NAVA) and non-invasive NAVA.</p><p><strong>Results: </strong>Sixty-three patients with a mean age of 6.89 months with 30 on NAVA and 33 on non-NAVA support were analyzed. Compliance with optimal Edi peak and Edi min was 50.4% (±37.5%) and 33.8% (±26.2%) respectively. Regression models for PICU LOS with minimal respiratory support and for 1 L/kg of HFNC showed adjusted R²=0.96 and 0.92, respectively. The mean PICU stay for NAVA was 146.00 hrs. (±66.26) versus 69.58 hrs. (±57.69) for the non-NAVA group (P<0.001). Duration to minimal respiratory support was 125.40 hrs, (±54.90) for NAVA versus 58.03 hrs, (±58.97) for non-NAVA group (P<0.001). A higher intubation rate was found in the NAVA group (13.33% versus 3.03%, P=0.296).</p><p><strong>Conclusions: </strong>We found suboptimal compliance with operational parameters with non-invasive NAVA support. There was longer PICU LOS, time to minimal respiratory support in the NAVA compared to the non-NAVA support.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"45-53"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39264382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis C virus-specific markers in pediatric patients with chronic hepatitis C.","authors":"Lyudmila Nikolaeva, Elena Leybman, Evgeniy Samokhvalov, Karen Kyuregyan, Vera Kichatova, Olga Isaeva, Victor Kuprianov","doi":"10.23736/S2724-5276.21.06564-2","DOIUrl":"10.23736/S2724-5276.21.06564-2","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to investigate hepatitis C virus (HCV) specific markers in chronically infected children. The main objective was to explore the patterns of marker variability.</p><p><strong>Methods: </strong>HCV RNA, core antigen, anti-HCV IgM, and antibodies to individual viral proteins were detected using commercially available assays or experimental ELISA. RNA genotyping and recombination were performed by sequencing.</p><p><strong>Results: </strong>HCV RNA and core antigen were detected in serum samples of all children (N.=100). Anti-HCV IgM, anti-NS4AB IgG, and anti-NS5A IgG were revealed less often than antibodies to core and NS3 proteins. To elucidate the cause of this finding, all subjects were divided into 4 groups differing in hepatitis duration. It was anti-NS4AB only whose detection depended on the infection duration. A trend was established that the longer the hepatitis duration, the more frequently anti-HCV IgM was observed. No significant impact of HCV RNA load and NS4A/NS4B amino acid substitutions on anti-NS4AB IgG detection was found. The increase HCV genotype 3 was observed among children infected after 2000. The earliest case of infection caused by HCV intergenotype recombinant RF1_2k/1b was identified in a child vertically infected in 1997.</p><p><strong>Conclusions: </strong>HCV genotypes and subtypes were found to be variable virus specific markers in children infected in 1997-2015. Over the period, there has been a trend to change the dominant HCV subtype and appearance of recombinant RF1_2k/1b in children. Among humoral markers, anti-NS4AB revealing is depended on chronic hepatitis C duration, while for anti-HCV IgM, only a trend was established. The detection of anti-NS4AB can be helpful in assessing the duration of chronic hepatitis C.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"54-61"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39687969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurosurgical shunt treatment of pediatric hydrocephalus: epidemiology and influencing factors on revision surgeries: a single-center retrospective analysis of 131 patients.","authors":"Jasmin Nagl, Frank P Schwarm, Michael Bender, Aylin Gencer, Harald Ehrhardt, Andreas Hahn, Bernd A Neubauer, Malgorzata A Kolodziej","doi":"10.23736/S2724-5276.22.06816-1","DOIUrl":"10.23736/S2724-5276.22.06816-1","url":null,"abstract":"<p><strong>Background: </strong>Pediatric hydrocephalus is a result of a dysfunction of cerebrospinal fluid circulation, and it has diverse pathogeneses. This study investigates the epidemiology of pediatric hydrocephalus, as well as the influences of primary etiology and implant type on treatment complications and the development of new therapeutic approaches and strategies.</p><p><strong>Methods: </strong>Between 2013 and 2018, a retrospective analysis of 131 children, who were suffering from hydrocephalus, was conducted. Medical charts, operative reports and clinical follow-up visits were reviewed. Statistical analysis was performed using t-test/ANOVA and Kruskal-Wallis Test/Mann-Whitney U Test.</p><p><strong>Results: </strong>The most common pathogeneses of hydrocephalus among our patients were meningomyelocele-associated and posthemorrhagic. The majority of patients received a programmable differential pressure valve (PPV, 77.8%) or a fixed differential pressure valve with a gravitational unit (FPgV, 14.8%). Among 333 shunt-associated surgeries, 66% of surgeries were revision surgeries and were performed because of mechanical shunt dysfunction (61%), infection (12%), or other reasons (27%). The median rate of revisions within one year for each patient was 0.15 (IQR^25-75: 0.00-0.68) and was influenced by etiology (P=0.045) and valve type (P=0.029). The highest rates were seen in patients with posthemorrhagic hydrocephalus and in those with FPgVs; the lowest rates were seen in patients with meningomyelocele-associated hydrocephalus and PPVs. The occurrence of mechanical dysfunctions was correlated with FPgV patients (P=0.014). Furthermore, the median time interval between initial shunt surgery and onset of infection was shorter than that between initial surgery and mechanical dysfunction (P=0.033).</p><p><strong>Conclusions: </strong>Based on this research, we can state several factors that influence revision surgeries in pediatric shunt patients. With the assessment of patients' risk profiles, physicians can classify pediatric shunt patients and thus avoid unnecessary examinations or invasive procedures. Furthermore, medical providers can prevent revision surgeries if they choose shunt material in accordance with a patient's associated shunt complications.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"18-27"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40669363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Huge unrepaired myelocystocele, progressive sac enlargement in later stages of life: a case report.","authors":"Hosein Safari, Armin Jahangiri Babadi, Pooyan Alizadeh, Reza Ajudani, Soroor Hamidi","doi":"10.1080/02688697.2022.2118235","DOIUrl":"10.1080/02688697.2022.2118235","url":null,"abstract":"<p><strong>Background: </strong>Spinal dysraphism is characterized by failure of fusion at dorsal midline structures through the embryonic developmental stages. A terminal myelocystocele consists of a skin-covered lumbosacral spina bifida and meningocele that directly continuous with the spinal subarachnoid space.</p><p><strong>Observation: </strong>A 43-year-old woman who was diagnosed at birth with myelocystocele in the lower segments of the lumbar spine. She was not operated in the early stages of life. At the 43th years of her old, during 9-months, the sac began to progressively increase in size. In our initial examination before surgery, an extremely large skin-covered myelocystocele sac was observed in the thoracolumbar with a diameter of approximately 60 * 70 * 40 cm. patient operated and sac repaired. More than 20 liter of cerebrospinal fluid drainaged from cyst during surgery.</p><p><strong>Lessons: </strong>The mechanism of cyst enlargement is not well understood. Progressive and severe increase in size of unrepaired myelocystocele sac is possible in old ages even without cerebral hydrocephalus.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"84-87"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33449707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of aggressive pituitary neuroendocrine tumour with extremely rapid progression: possible diagnostic value of <i>TERT</i> promoter methylation.","authors":"Masamichi Endo, Jun-Ichi Adachi, Chiaki Murakami, Chie Inomoto, Miyu Komatsu, Shunya Hanakita, Ken-Ichi Oyama, Akira Matsuno, Ryo Nishikawa, Soichi Oya","doi":"10.1080/02688697.2022.2151564","DOIUrl":"10.1080/02688697.2022.2151564","url":null,"abstract":"<p><p>Most pituitary adenoma/neuroendocrine tumours (PitNET) are histologically benign and grow slowly; however, a subset of these tumours exhibit a more aggressive clinical course characterized by local invasiveness and early recurrence. These high-risk PitNETs often require multiple surgeries and radiation over several years and may eventually acquire carcinomatous characteristics, such as metastasis in some cases. Herein, we report a rare case of PitNET causing oculomotor paresis with extremely rapid recurrence only 3 months after initial surgery, followed by lethal liver metastasis. Preoperative magnetic resonance imaging and intraoperative findings were consistent with typical PitNETs, other than moderate invasion of the cavernous sinus. Pathological examination of the specimen obtained from the initial transsphenoidal surgery revealed increased mitosis and elevated rates of cells positive for Ki-67 and p53. Based on the immunohistochemical assessment for transcription factors and pituitary hormones, the diagnosis was determined to be a silent sparsely granulated corticotroph PitNET with focal malignant transformation. Aggressive features represented by Ki-67 and p53 positivity were more robust in recurrent and metastatic specimens, but hormone immunostaining was decreased. Epigenetic analysis revealed methylation of the telomerase reverse transcriptase (<i>TERT</i>) promoter in the tumour, resulting in TERT upregulation. Despite extensive research, markers for distinguishing extremely aggressive PitNETs have not been determined. Although further analysis is needed, our case demonstrates the possible usefulness of assessing <i>TERT</i> promoter methylation status in the stratification of recurrence risk in extremely high-risk variants of PitNET.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"93-99"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35348694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dropped head syndrome in a patient with Parkinson's disease and inflammatory myopathy, treated with sternocleidomastoid release and circumferential cervical fusion.","authors":"Yingda Li, Gregory Basil, Steven Vanni","doi":"10.1080/02688697.2022.2123892","DOIUrl":"10.1080/02688697.2022.2123892","url":null,"abstract":"<p><strong>Background: </strong>Dropped head syndrome (DHS) is a recently recognised cause of cervical spinal deformity and disability. The combination of Parkinson's disease (PD) and inflammatory myopathy in the genesis of DHS has not been previously reported. Furthermore, the optimal surgical treatment of progressive DHS remains undefined.</p><p><strong>Case description: </strong>We report the case of a 64-year-old patient with severe DHS and coronal plane deformity secondary to underlying PD, precipitated by a focal paraspinal myositis, successfully corrected using asymmetric sternocleidomastoid (SCM) release and circumferential cervical fusion. The nuances of decision-making in this challenging patient population are highlighted, including the benefits of intraoperative traction, anterior column reconstruction and bicortical screw fixation. Postoperatively, significant reductions in pain and disability were achieved, along with restoration of cervical lordosis (CL), C2-7 sagittal vertical axis (CSVA) and chin-brow vertical angle (CBVA).</p><p><strong>Conclusions: </strong>Circumferential cervical fusion with concomitant SCM release is a useful option in the treatment of recalcitrant DHS with biplanar deformity, addressing the unique biomechanical and endocrinological challenges posed by patients with underlying PD.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"104-109"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40360223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of lymphocele following anterior lumbar interbody fusion, case report and review of literature.","authors":"Madhav R Patel, Kevin C Jacob, Timothy J Hartman, James W Nie, Jonathan A Myers","doi":"10.1080/02688697.2022.2120962","DOIUrl":"10.1080/02688697.2022.2120962","url":null,"abstract":"<p><p>While anterior lumbar interbody fusion (ALIF) is known as an established and safe procedure for treatment of degenerative disc disease, albeit rare, the development of postoperative intra-abdominal or retroperitoneal collection of lymph warrants timely diagnosis and management. This study presents the case of a 62-year-old male who underwent L4-L5 and L5-S1 ALIF and developed a persistent left-sided fluid collection, resulting in a symptomatic retroperitoneal lymphocele confirmed by computed tomography (CT). After percutaneous drainage by interventional radiology (IR), output remained high at 1 liter (L) per day, necessitating sclerotherapy with doxycycline and ethanol. In the absence of improvement, a lymphangiogram demonstrating a persistent lymph leak and glue embolization was performed. Due to refractory symptoms, retroperitoneal exploration with methylene blue dye was utilized for lymphatic mapping, and a lymphatic capillary leak in proximity to the left iliac artery was identified and successfully ligated with resolution of symptoms. With suspected fluid collections following ALIF, confirmation with CT or ultrasound (US) imaging followed by percutaneous drainage and testing of fluid is necessary. In mild cases, drainage alone or nonsurgical chemical sclerotherapy may suffice. In symptomatic refractory cases, localization of the site with lymphangiogram or US-guided injection of methylene blue dye allows for easier identification and definitive management with either transabdominal laparoscopic fenestration or retroperitoneal surgical exploration and ligation.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"88-92"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical validation of functional magnetic resonance urography in the study of ureteral anomalies distal to the uretero-pelvic junction in a pediatric cohort.","authors":"Fiammetta Sertorio, Lorenza Delfino, Michela C Wong, Federico Palo, Marcello Carlucci, Venusia Fiorenza, Luca Basso, Lorenzo Anfigeno, Giorgio Piaggio, Maria B Damasio, Girolamo Mattioli","doi":"10.23736/S2724-5276.22.06462-X","DOIUrl":"10.23736/S2724-5276.22.06462-X","url":null,"abstract":"<p><strong>Background: </strong>Ureteral anomalies distal to the uretero-pelvic junction (UPJ) belong to the wide spectrum of congenital anomalies of the kidney and urinary tract (CAKUT). They can cause severe obstruction requiring a detailed anatomical depiction to define the surgical approach. Up to date, ultrasonography, voiding cystourethrography and scintigraphy are considered the gold-standard diagnostic tools to study obstructive anomalies of the urinary tract; however, they do not provide accurate ureteral anatomical details. The aim of our study was to evaluate the concordance between functional magnetic resonance urography (fMRU) and intraoperative findings to define ureteral anomalies distal to UPJ.</p><p><strong>Methods: </strong>Pediatric patients with ureteral anomalies distal to the UPJ who underwent surgery after performing fMRU were retrospectively collected. Surgical data were compared with radiological results. The concordance was assessed considering both pathological and non-pathological urinary tracts and was calculated by means of the Cohen's kappa coefficient. fMRU diagnostic accuracy was defined by sensitivity, specificity, and binomial exact confidence intervals.</p><p><strong>Results: </strong>We included 46 patients. The sensitivity and specificity of fMRU were 98.0% and 83.3%; positive predictive value 90.4%, negative predictive value 96.2%. The concordance between surgical findings and fMRU was 92.3%, with a Cohen's k coefficient of 0.83 (excellent).</p><p><strong>Conclusions: </strong>Our study demonstrates the excellent agreement between fMRU and surgical findings in the definition of ureteral anomalies distal to the UPJ in children. Thus, it could be considered a valid imaging technique in the preoperative planning as it provides the surgeon with important information regarding the etiology and site of the obstruction.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":" ","pages":"28-35"},"PeriodicalIF":16.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39863547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}