bluuebunny/crossref_metadata_2025 huggingface dataset:
Target volume delineation for radiotherapy of meningiomas: an ANOCEF consensus guideline
Authors: Martz Nicolas , Salleron Julia , Dhermain Frédéric , Vogin Guillaume , Daisne Jean-François , Mouttet-Audouard Raphaelle , Tanguy Ronan , Noel Georges , Peyre Matthieu , Lecouillard Isabelle , Jacob Julian , Attal Justine , Charissoux Marie , Veresezan Ovidiu , Hanzen Chantal , Huchet Aymeri , Latorzeff Igor , Coutte Alexandre , Doyen Jérôme , Stefan Dinu , Feuvret Loic , Garcia Gabriel C. T. E. , Royer Philippe
Published: July 2023

Purpose

Radiotherapy is, with surgery, one of the main therapeutic treatment strategies for meningiomas. No prospective study has defined a consensus for the delineation of target volumes for meningioma radiotherapy. Therefore, target volume definition is mainly based on information from retrospective studies that include heterogeneous patient populations. The aim is to describe delineation guidelines for meningioma radiotherapy as an adjuvant or definitive treatment with intensity-modulated radiation therapy and stereotactic radiation therapy techniques. This guideline is based on a consensus endorsed by a multidisciplinary group of brain tumor experts, members of the Association of French-speaking Neuro-oncologists (ANOCEF).

Materials and methods

A 3-step procedure was used. First, the steering group carried out a comprehensive review to identify divergent issues on meningiomas target volume delineation. Second, an 84-item web-questionnaire has been developed to precisely define meningioma target volume delineation in the most common clinical situations. Third, experts members of the ANOCEF were requested to answer. The first two rounds were completed online. A third round was carried out by videoconference to allow experts to debate and discuss the remaining uncertain questions. All questions remained in a consensus.

Results

Limits of the target volume were defined using visible landmarks on computed tomography and magnetic resonance imaging, considering the pathways of tumor extension. The purpose was to develop clear and precise recommendations on meningiomas target volumes.

Conclusion

New recommendations for meningiomas delineation based on simple anatomic boundaries are proposed by the ANOCEF. Improvement in uniformity in target volume definition is expected.
Extended prone positioning for intubated ARDS: a review
Authors: Walter Thaïs , Ricard Jean-Damien
Published: July 2023

During the COVID-19 pandemic, several centers had independently reported extending prone positioning beyond 24 h. Most of these centers reported maintaining patients in prone position until significant clinical improvement was achieved. One center reported extending prone positioning for organizational reasons relying on a predetermined fixed duration. A recent study argued that a clinically driven extension of prone positioning beyond 24 h could be associated with reduced mortality. On a patient level, the main benefit of extending prone positioning beyond 24 h is to maintain a more homogenous distribution of the gas–tissue ratio, thus delaying the increase in overdistention observed when patients are returned to the supine position. On an organizational level, extending prone positioning reduces the workload for both doctors and nurses, which might significantly enhance the quality of care in an epidemic. It might also reduce the incidence of accidental catheter and tracheal tube removal, thereby convincing intensive care units with low incidence of ARDS to prone patients more systematically. The main risk associated with extended prone positioning is an increased incidence of pressure injuries. Up until now, retrospective studies are reassuring, but prospective evaluation is needed.

Graphical Abstract
A new reservoir-based CPAP with low oxygen consumption: the Bag-CPAP
Authors: de Beaufort Eloïse , Carteaux Guillaume , Morin François , Lesimple Arnaud , Haudebourg Anne-Fleur , Fresnel Emeline , Duval Damien , Broc Alexandre , Mercat Alain , Brochard Laurent , Savary Dominique , Beloncle François , Mekontso Dessap Armand , Richard Jean-Christophe
Published: July 2023

Background

Several noninvasive ventilatory supports rely in their design on high oxygen consumption which may precipitate oxygen shortage, as experienced during the COVID-19 pandemic. In this bench-to-bedside study, we assessed the performance of a new continuous positive airway pressure (CPAP) device integrating a large reservoir (“Bag-CPAP”) designed to minimize oxygen consumption, and compared it with other CPAP devices.

Methods

First, a bench study compared the performances of Bag-CPAP and four CPAP devices with an intensive care unit ventilator. Two FiO2 targets (40–60% and 80–100%) at a predefined positive end expiratory pressure (PEEP) level between 5 and 10 cm H2O were tested and fraction of inspired oxygen (FiO2) and oxygen consumption were measured. Device-imposed work of breathing (WOB) was also evaluated. Second, an observational clinical study evaluated the new CPAP in 20 adult patients with acute respiratory failure in two hospitals in France. Actual FiO2, PEEP, peripheral oxygen saturation, respiratory rate, and dyspnea score were assessed.

Results

All six systems tested in the bench study reached the minimal FiO2 target of 40% and four reached at least 80% FiO2 while maintaining PEEP in the predefined range. Device-delivered FiO2/consumed oxygen ratio was the highest with the new reservoir-based CPAP irrespective of FiO2 target. WOB induced by the device was higher with Bag-CPAP. In the clinical study, Bag-CPAP was well tolerated and could reach high (> 90%) and moderate (> 50%) FiO2 with an oxygen flow rate of 15 [15–16] and 8 [7–9] L/min, respectively. Dyspnea score improved significantly after introduction of Bag-CPAP, and SpO2 increased.

Conclusions

In vitro, Bag-CPAP exhibited the highest oxygen saving properties albeit had increased WOB. It was well accepted clinically and reduced dyspnea. Bag-CPAP may be useful to treat patients with acute respiratory failure in the field, especially when facing constraints in oxygen delivery.
Why is it so hard to identify (consistent) predictors of treatment outcome in psychotherapy? – clinical and research perspectives
Authors: Eilertsen Silje Elisabeth Hasmo , Eilertsen Thomas Hasmo
Published: July 2023

Background

Anxiety and depression are two of the most debilitating psychological disorders worldwide today. Fortunately, effective treatments exist. However, a large proportion of patients do not recover from treatment, and many still have symptoms after completing treatment. Numerous studies have tried to identify predictors of treatment outcome. So far, researchers have found few or no consistent predictors applicable to allocate patients to relevant treatment.

Methods

We set out to investigate why it is so hard to identify (consistent) predictors of treatment outcome for psychotherapy in anxiety and depression by reviewing relevant literature.

Results

Four challenges stand out; a) the complexity of human lives, b) sample size and statistical power, c) the complexity of therapist-patient relationships, and d) the lack of consistency in study designs. Together these challenges imply there are a countless number of possible predictors. We also consider ethical implications of predictor research in psychotherapy. Finally, we consider possible solutions, including the use of machine learning, larger samples and more realistic complex predictor models.

Conclusions

Our paper sheds light on why it is so hard to identify consistent predictors of treatment outcome in psychotherapy and suggest ethical implications as well as possible solutions to this problem.
Are inner nuclear layer ischemic lesions hidden indicators of retinal vein occlusion risk? A case-control study
Authors: Nourinia Ramin , Mashhadi Seyed Mohammadjavad , Abtahi Seyed-Hossein , Nouri Hosein
Published: July 2023

Purpose

To investigate the association between retinal vein occlusion (RVO) and evidence of previous, unnoticed inner nuclear layer (INL) infarction in the fellow eye.

Methods

This prospective case-control study compared the prevalence of INL lesions in the fellow eye of consecutive people with hypertension (PwHTN) with unilateral RVO versus a randomly chosen eye of an age-matched control group of PwHTN without RVO. En face slabs above the outer plexiform layer (OPL) were generated from 6 × 6 fovea-centered optical coherence tomography scans. Cross-sectional scans and en face slabs were surveyed for evidence of active/resolved ischemic INL lesions.

Results

69 PwHTN were included and assigned to two groups, i.e., the RVO group (n = 37; 22 BRVO and 15 CRVO) and the control group (n = 32). There was no inter-group difference regarding age, gender distribution, and background diseases. Resolved INL lesions were more frequent in the RVO group (n = 26) than in the control group (n = 4) (70.3% vs. 12.5%, p < 0.001). BRVO and CRVO cases had similar prevalence of INL lesions in their fellow eyes. Unlike diabetes, ischemic heart disease, and gender, INL lesions were associated with RVO (in the fellow eye) with an odds ratio of 15.7 (95%CI: 4.17–76.73, p < 0.001).

Conclusion

We identified a substantially higher prevalence of INL lesions in PwHTN with RVO compared to PwHTN without RVO. The atrophic appearance of lesions suggests they may serve as early markers of increased RVO risk in individuals with systemic or cardiovascular predisposing factors.
Differences in prevalence and management of chronic kidney disease among T2DM inpatients at the grassroots in Beijing and Taiyuan: a retrospective study
Authors: An Lingwang , Wang Dandan , Shi Xiaorong , He Yali , Lee Yaujiunn , Lu Juming
Published: July 2023

Purpose

Chronic kidney disease (CKD) has been one of the most common complications in type 2 diabetes mellitus (T2DM) patients. This retrospective study aimed to investigate the regional differences in the prevalence and management of CKD in T2DM inpatients from two grassroots hospitals in Beijing and Taiyuan.

Methods

The sociodemographic status, health history, lifestyle information, biochemical parameters and drug choices of the patients were collected from the Diabetes Care Information System using a retrospective cross-sectional analysis. The presence of CKD was defined as albuminuria (urine albumin-to-creatinine ratio of ≥ 30 mg/g) and/or as a reduced estimated glomerular filtration rate (< 60 ml/min/1.73 m2).

Results

858 patients with T2DM in Beijing and 1,085 patients with T2DM in Taiyuan were included, with a median age of 61.0 and 61.9 years, respectively. The duration of diabetes was 10.5 and 10.3 years, respectively. The prevalence of CKD in Beijing (39.2%) was significantly higher than in Taiyuan (22.4%). The overall ABC control (A = haemoglobin A1c; B = blood pressure; C = cholesterol) in both the Beijing and Taiyuan groups were not ideal. Patients with CKD tended to use insulin, renin–angiotensin–aldosterone system (RAAS) inhibitors, sodium-glucose cotransporter-2 inhibitors (SGLT-2i) and dyslipidaemia therapy in Taiyuan than in Beijing. The actual proportion of carbohydrate, fat and protein in calories was 49.6%:35.4%:14.4% in Beijing and 61.5%:27.8%:10.8% in Taiyuan.

Conclusions

The higher prescription rates of RAAS inhibitors, SGLT-2i and dyslipidaemia therapy may underlie the fluctuations in the prevalence of CKD in Beijing or Taiyuan. Intensive insulin therapy and personal nutritional guidance, along with the extensive use of RAAS inhibitors, SGLT-2i and dyslipidaemia therapy during follow-up, can all play a positive role in the management of CKD in patients with T2DM in both Beijing and Taiyuan.
Development and content validity assessment of the Dry Eye Disease Questionnaire in patients with dry eye disease, meibomian gland dysfunction, and Sjögren’s syndrome dry eye disease
Authors: Sloesen Brigitte , Young Alyson , Forde Katie , Hodson Nicola , Bentley Sarah , Walsh Oonagh , Naujoks Christel , O’Brien Paul , Sharma Garima
Published: July 2023

Background

Dry eye disease (DED), Meibomian gland dysfunction (MGD), and Sjögren’s syndrome dry eye disease (SS-DED) are eye dryness conditions that show significant overlap in various symptoms of ocular discomfort. The aim of this study was to qualitatively explore the patient experience and evaluate content validity of the newly developed Dry Eye Disease Questionnaire (DED-Q).

Methods

Semi-structured interviews were conducted with 61 US adults who reported experiencing ocular symptoms due to their physician-confirmed primary diagnosis of DED (n = 21), MGD (n = 20), or SS-DED (n = 20). The open-ended concept-elicitation phase was followed by cognitive debriefing (CD) of the DED-Q to evaluate participants’ understanding and relevance of the instructions, items, response options, and recall periods. Interviews were also conducted with eight specialist healthcare professionals to assess clinical relevance of the concepts included. Verbatim interview transcripts were analyzed using thematic analysis in ATLAS.ti v8 software.

Results

A total of 29 symptoms and 14 impacts on quality of life were reported across participant interviews. Primary ocular symptoms reported included eye dryness (n = 61/61; 100%), eye irritation (n = 55/61; 90%), eye itch (n = 54/61; 89%), burning sensation (n = 52/61; 85%), and foreign body sensation (n = 51/61; 84%). The most impacted aspects of daily life were using digital screens (n = 46/61; 75%), driving (n = 45/61; 74%), working (n = 39/61; 64%), and reading (n = 37/61; 61%). CD findings showed most participants had good understanding of DED-Q items and confirmed most concepts were relevant to the lived experience of their condition. Aside from few minor changes to the items and examples to facilitate more accurate interpretation, the proposed instruction wording was modified for various symptom and impact modules to encourage participants to focus only on dry eye vision problems.

Conclusions

This research identified multiple prevalent symptoms and impacts of DED, MGD, and SS-DED, most of which were similar across the conditions. The DED-Q was confirmed to be a content-valid PRO measure suitable for use in clinical studies to assess the patient experience of DED, MGD, and SS-DED. Future work will focus on evaluating the psychometric properties of the DED-Q for use as an efficacy endpoint in clinical trials.
Interval between two-stage exchanges: what is optimal and how do you know?
Authors: Sousa Ricardo , Carvalho André , Soares Daniel , Abreu Miguel Araújo
Published: July 2023

Background

Two-stage exchange arthroplasty remains the most popular option for the treatment of chronic periprosthetic joint infection (PJI). Determining infection eradication and optimal timing of reimplantation can be challenging. Information to allow for a truly informed evidence-based decision is scarce.

Methods

We conducted a critical review of available evidence on the presently available tests to help determine timing of reimplantation.

Results

Serology is traditionally used to follow up patients after the first stage. Despite tradition mandates waiting for normal inflammatory markers, there is actually no evidence that they correlate with persistent infection. The role of synovial fluid investigation between stages is also explored. Cultures lack sensitivity and neither differential leukocyte counts nor alternative biomarkers have proven to be accurate in identifying persistent infection with a spacer in situ. We also examined the evidence regarding the optimal time interval between resection and reimplantation and whether there is evidence to support the implementation of a two week “antibiotic holiday” prior to proceeding with reimplantation. Finally, wound healing and other important factors in this setting will be discussed.

Conclusion

Currently there are no accurate metrics to aid in the decision on the optimal timing for reimplantation. Decision must therefore rely on the resolution of clinical signs and down trending serological and synovial markers.
Advances in mass transfer and fluid flows in non-thermal food processing industry – a review
Authors: Al-Najjar Shahad Z. , Al-Sharify Zainab T. , Onyeaka Helen , Miri Taghi , Obileke KeChrist , Anumudu Christian K.
Published: July 2023

All around the world, food processing techniques make use of various kinds of treatments to improve the shelf-life of foods. The commonly used thermal treatments are likely to result in deteriorating the sensory as well as nutritional qualities of foods. However, consumers are now demanding for safer and cleaner food without needing to compromise on the quality. Owing to the evolving nature of consumer demands, food technologists and others in the agro-food chain have devised processes to meet these changing demands by considering new non-thermal food processing techniques, which achieve microbiological inactivation in food materials without the application of heat directly. This review provides an appraisal on certain non-thermal food processing technologies with a focus on their operational mechanisms and success in the preservation of numerous kinds of food and offers an outline on the developments in non-thermal food processing techniques used in the food industry to enhance mass transfers. Increase in mass transfer is of industrial interest owing to a reduction in operation time. Use of a faster mass transfer velocity in the process produces multiple benefits, such as an increase in productivity, the preservation of physiological and nutritional value of food components, and a reduction in economic costs. The review demonstrates that techniques such as Pulsed Electric Field, Ultrasonication and Supercritical technology are viable treatments for enhancing mass transfer in the food processing industries.

Graphical Abstract
Satisfaction of cardiac surgery trainees with the residency training program in Saudi Arabia: a survey-based study
Authors: Abdulrahman Osama Abdullah , Baaqeel Rahaf Ghassan , Bahakeem Reem Faisal , Alotaibi Naif Fahad , Almarjan Asayil Yousef , Alsulami Marah Meshal , Babgi Mohammad Fawzi , Ahmed Elnazeer Osman
Published: July 2023

Background

There is a direct relationship between the degree of trainees’ satisfaction and their productivity. The Saudi Board of Cardiac Surgery is a new training program established by the Saudi Commission for Health Specialties. As a result, we aimed to provide helpful information and data in order to improve the overall quality of the local cardiac training program. This is the first study to look at how satisfied residents are with the Saudi cardiac surgery training program.

Results

The study included 55.3% central region residents (N = 26), 31.9% western region residents (N = 15), and others from other regions, resulting in a total of 47 participants out of 60 with a 78.3% response rate. Only 42.6% of all residents were satisfied with their training in the Saudi Board of Cardiac Surgery program, 23.4% were neutral, and 34.0% were dissatisfied with the program. The most essential area for improvement was operative experience (63.8%), followed by workplace climate (8.5%) and mentorship (6.4%), whereas the area least in need of improvement was research opportunities (2.1%).

Conclusions

Our results indicate a decline in satisfaction level with the training program. In reference to our findings, implementing simulation-based surgical learnings and providing more frequent exposure to Boot Camp experience in cardiac surgery is recommended. Adequate and constant mentoring, and constructive feedback, represent a valuable resource for improvement theoretically and surgically.
Evaluation of surgical approaches to infratemporal and pterygopalatine fossae
Authors: Behairy Essam A. , Barsem Neveen G. , Eldemerdash Ashraf A.
Published: July 2023

Background

Tumors in the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) are still challenging to surgeons because of their deep location and proximity to various arteries and cranial nerves. This study aimed to evaluate the access to infratemporal fossa and pterygopalatine fossa through anterior transmaxillary, modified endoscopic transnasal transmaxillary approaches. The study was a prospective comparative study conducted on 20 patients having a mass in pterygopalatine or infratemporal fossa. History, examination, computed tomography, and magnetic resonance imaging were performed for all patients. Nine patients were operated with anterior transmaxillary approach and eleven patients were operated with endoscopic transnasal transmaxillary approach. The operative duration, intraoperative blood loss, and operative difficulty were assessed. Patients were assessed 1 week postoperatively using a nasal surgical questionnaire for postoperative nasal symptoms. Endoscopic assessment of the nose was done 1 week postoperative to assess the degree of crusting and 4 weeks postoperative to assess nasal adhesions. Postoperative complications were assessed for both groups.

Results

There was a significant difference between the two groups regarding operative duration and blood loss favoring the endoscopic group. There was a non-significant difference between the two groups regarding operative difficulty. There was a significant difference between the two groups regarding nasal obstruction, crustation, bleeding, sneezing, secretion, and nasal pain. There was a significant difference between the two groups regarding the endoscopic assessment for nasal crusting and adhesions. Facial swelling and numbness of the face were significantly more in the open group compared with the endoscopic group.

Conclusion

Endoscopic endonasal transmaxillary approach had less trauma and lower complication rate while anterior transmaxillary was technically feasible and offered excellent surgical access with easy lateral expansion toward the infratemporal fossa. Both approaches had comparable operative difficulty and acceptable postoperative quality of life.
Individual and joint associations of anxiety disorder and depression with cardiovascular disease: A UK Biobank prospective cohort study
Authors: Nakada Shinya , Ho Frederick K. , Celis-Morales Carlos , Jackson Caroline A. , Pell Jill P.
Published: July 2023

Background

Growing evidence suggests that individuals with anxiety disorder have an elevated risk of cardiovascular disease (CVD) but few studies have assessed this association independently of or jointly with depression.

Methods

We conducted a prospective cohort study using UK Biobank. Diagnoses of anxiety disorder, depression, and CVDs were ascertained through linked hospital admission and mortality data. Individual and joint associations between anxiety disorder and depression and CVD overall, as well as each of myocardial infarction, stroke/transient ischemic attack, and heart failure, were analyzed using Cox proportional hazard models and interaction tests.

Results

Among the 431,973 participants, the risk of CVD was higher among those who had been diagnosed with anxiety disorder only (hazard ratio [HR] 1.72; 95% confidence interval [CI] 1.32–2.24), depression only (HR 2.07; 95% CI 1.79–2.40), and both conditions (HR 2.89; 95% CI 2.03–4.11) compared to those without these conditions, respectively. There was very little evidence of multiplicative or additive interaction. Results were similar for myocardial infarction, stroke/transient ischemic attack, and heart failure.

Conclusions

Having anxiety is associated with the same magnitude of increased risk of CVD among people who do not have depression and those who do. Anxiety disorder should be considered for inclusion in CVD risk prediction and stratification, in addition to depression.
Quest for a universal cluster preformation formula: A new paradigm for estimating the cluster formation energy
Authors: Majekodunmi Joshua T. , Kumar Raj , Bhuyan M.
Published: July 2023

This study presents a holistic picture of the preformation of nuclear clusters with credence to the kinematics of their emissions. Besides the fitting of the preformation formula to reproduce the experimental half-lives, we have investigated the interrelationship between the parameters involved in the cluster decay process for medium, heavy and superheavy nuclei. Based on the established conceptual findings, we propose a new cluster preformation probability (P
0) formula that incorporates all influential parameters of the cluster radioactivity and thus has an edge over the existing formulae in the literature. Further, we hypothesize that a fraction of the decay energy is needed for cluster formation within the parent nucleus. The proposed formula opens a new paradigm to separately estimate the energy contributed during the cluster formation from its emission and thus shows that the contribution of the Q-value splits into three major parts accounting for the energy contributed during the cluster preformation, its emission and recoil of the daughter nucleus. Moreover, the expression P
0 is adept at accommodating the theorized concept of heavy particle radioactivity (HPR). The result reveals that, like α-decay, a proper estimation of the P
0- and Q-value in the cluster studies is enriched with qualitative information about the nuclear structure. However, from the analysis, the Geiger-Nuttall law is not the best compromise in the clustering due to the non-linearity between log10 T
1/2 and

, unlike in α-decay. We have demonstrated that with the inclusion of the proposed formula, the half-life predictions from both microscopic R3Y and phenomenological M3Y NN potentials closely agree with the available experimental data and that the slight variation can be traced to their peculiar barrier characteristics.
Hemoglobin Levels Improve Fracture Risk Prediction in Addition to FRAX Clinical Risk Factors and Bone Mineral Density
Authors: Jaiswal Raju , Johansson Helena , Axelsson Kristian F , Magnusson Per , Harvey Nicholas C , Vandenput Liesbeth , McCloskey Eugene , Kanis John A , Litsne Henrik , Johansson Lisa , Lorentzon Mattias
Published: July 2023

Context

Anemia and decreasing levels of hemoglobin (Hb) have previously been linked to increased fracture risk, but the added value to FRAX, the most utilized fracture prediction tool worldwide, is unknown.

Objective

To investigate the association between anemia, Hb levels, bone microstructure, and risk of incident fracture and to evaluate whether Hb levels improve fracture risk prediction in addition to FRAX clinical risk factors (CRFs).

Methods

A total of 2778 community-dwelling women, aged 75-80 years, and part of a prospective population-based cohort study in Sweden were included. At baseline, information on anthropometrics, CRFs, and falls was gathered, blood samples were collected, and skeletal characteristics were investigated using dual-energy x-ray absorptiometry and high-resolution peripheral quantitative computed tomography. At the end of follow-up, incident fractures were retrieved from a regional x-ray archive.

Results

The median follow-up time was 6.4 years. Low Hb was associated with worse total hip and femoral neck bone mineral density (BMD), and lower tibia cortical and total volumetric BMD, and anemia was associated with increased risk of major osteoporotic fracture (MOF; hazard ratio 2.04; 95% CI 1.58-2.64). Similar results were obtained for hip fracture and any fracture, also when adjusting for CRFs. The ratio between 10-year fracture probabilities of MOF assessed in models with Hb levels included and not included ranged from 1.2 to 0.7 at the 10th and 90th percentile of Hb, respectively.

Conclusion

Anemia and decreasing levels of Hb are associated with lower cortical BMD and incident fracture in older women. Considering Hb levels may improve the clinical evaluation of patients with osteoporosis and the assessment of fracture risk.
Pheochromocytomas Most Commonly Present As Adrenal Incidentalomas: A Large Tertiary Center Experience
Authors: Aggarwal Sunil , Prete Alessandro , Chortis Vasileios , Asia Miriam , Sutcliffe Robert P , Arlt Wiebke , Ronchi Cristina L , Karavitaki Niki , Ayuk John , Elhassan Yasir S
Published: July 2023

Context

Pheochromocytomas are increasingly diagnosed in incidentally detected adrenal masses. However, the characteristics of incidental pheochromocytomas are unclear.

Objective

We aimed to assess the proportion and clinical, biochemical, radiological, genetic, histopathological, and follow-up characteristics of incidental pheochromocytomas.

Methods

A retrospective review was conducted of patients with pheochromocytoma seen between January 2010 and October 2022 at a large UK tertiary care center. The diagnosis was confirmed histologically or by the combined presence of increased plasma and/or urinary metanephrines (MN), indeterminate adrenal mass on cross-sectional imaging, and metaiodobenzylguanidine avidity.

Results

We identified 167 patients with pheochromocytoma; 144 (86.2%) underwent adrenalectomy, for 23 (13.8%) surgery was either awaited, deemed unsuitable due to frailty or other metastatic malignancy, or declined by the patients. Excluding pheochromocytomas diagnosed via screening genetically predisposed individuals (N = 20), 37 of 132 (28.0%) presented with adrenergic symptoms and/or uncontrolled hypertension, while 91 of 132 (69.0%) patients presented with an incidentally detected adrenal mass. Incidentally detected patients were older (median age 62 years) than those detected due to clinical suspicion (aged 42 years) or after genetic screening (aged 33 years) (all P < .05). Incidentally detected pheochromocytomas were smaller (median 42 mm) than tumors detected due to adrenergic symptoms/uncontrolled hypertension (60 mm), but larger than tumors identified by genetic screening (30 mm) (all P < .05). Increased MN excretion showed a similar pattern (symptomatic/uncontrolled hypertension > incidental > genetic screening) (all P < .05). Hereditary predisposition was detected in 20.4% of patients (incidental, 15.3%; symptomatic/uncontrolled hypertension, 42.9%).

Conclusion

The majority of pheochromocytomas are diagnosed incidentally and have distinct clinical, radiological, biochemical, and genetic features. Their detection at older age but smaller size may point to a different underlying tumor biology.
It’s a Balancing Act! Menopausal Symptoms in Competitive Weightlifters
Authors: Huebner Marianne , Ma Wenjuan
Published: July 2023

Introduction

Athletes may be unprepared for the onset and duration of menopausal symptoms and how they affect training and competition goals. There are inconsistent results about physical activity and menopausal symptoms, and guidance for athletes is lacking.

Purpose

We aimed to study the reciprocal association of performance and weekly hours of weightlifting training with menopausal symptoms.

Methods

Women reported the frequency of weightlifting training and additional physical activities, heaviest weight lifted, and menopausal symptoms using the validated Menopausal Rating Scale. An online survey was distributed by national governing bodies in 30 countries to female master weightlifters (ages 30 to 79 yr) in May 2022. Simultaneous equation models were used to provide reliable estimates in the presence of contemporaneous effects.

Results

Participants included 868 women, 178 postmenopausal. The proportions of moderate or more severe somato-vegetative symptoms and psychological symptoms were 25.7% and 46.5%, respectively. Better performance, defined as weight lifted relative to age and body weight, was associated with a lower score of menopausal symptoms (−0.51, P < 0.001); worse menopausal symptoms were associated with lower performance (−1.22 for somato-vegetative, −2.19 for psychological; P < 0.001). More hours of weightlifting training were associated with worse menopausal symptoms, whereas more hours of other physical activities were associated with worse somato-vegetative but not with psychological symptoms. Instrumental variables in the model were joint pain and protein tracking. The majority tracked their daily protein intake (62.8%) with a median of 1.9 g·kg−1 body mass.

Conclusion

Somato-vegetative symptoms were less prevalent in weightlifters than in the general population. There is simultaneous feedback between sport performance and severity of menopausal symptoms. Athletes must balance training intensity and menopausal symptoms to achieve training goals.
Variants of Amyotrophic lateral sclerosis and rehabilitation: an overview
Authors: Iluț Silvina , Stan Adina , Rahovan Imelda , Hapca Elian , Strilciuc Stefan , Muresanu Dafin
Published: July 2023

Amyotrophic lateral sclerosis (ALS) represents a progressive neurodegenerative disease that affects motor neurons in the brain and spinal cord leading to the impairment of volun-tary muscle control and eventually death. It accounts for about 80%-90% of all motor neu-ron diseases, and is characterized by a marked variability in terms of clinical forms, gene-tics, survival rate and diagnostic particularities. A diagnosis of ALS or one of the variants comes with a great burden for the patient and patient’s family because of the high morbidi-ty and mortality rate of this disorder. As a consequence, it is mandatory to optimize the ac-curacy of the diagnostic process of ALS spectrum for providing the best clinical manage-ment and quality of life for patients and avoiding diagnostic mistakes. Our review focuses on the general and particular aspects of ALS and its variants in an effort to improve the process of diagnosis, therapy and exclusion of mimics of this group of diseases and to pro-vide the latest findings in this field.
The effect of the gel with tricolor violet extract on the activity of the antioxidant defense system in rats with a model of parodontitis
Authors: Novytska Iryna , Gorbatovska Natalya , Nikolaeva Ganna , Tretyakova Olena , Gushcha Sergey
Published: July 2023

The authors investigated the antioxidant properties of the gel with tricolor violet extract when used in rats with an experimental pаrodontitis model. To simulate periodontal pa-thology, white laboratory rats were given a solution of ethylenediaminetetraacetic acid (2%) daily with drinking water and three times a week; the drug "Warfarin Orion" was administered per os for 30 days. Animals were randomly divided into four equal groups of 10 each. Group 1 - intact rats; group 2 - rats with a model of pаrodontitis; group 3 - rats with a model and applications on the mucous membrane of the alveolar process gel "Pla-cebo". Group 4 - rats with a pаrodontitis model and applications on the mucous mem-brane of the alveolar process of the gel with the violet extract. In periodontal tissues and blood serum, we studied the level of inflammation markers - malondialdehyde (MDA) and diene conjugation. The state of the antioxidant defense system (AODS) was also assessed by the activity of glutathione peroxidase (GP), glutathione reductase (GR), glucose-6-phosphate dehydrogenase (G-6-PD), superoxide dismutase (SOD), and catalase. The pаro-dontitis model in rats of the 2nd group was characterized by the development of inflam-matory processes in periodontal tissues and blood, which is confirmed by changes in the pro- and antioxidant protection system. In rats of the 4th group, the content of MDA was restored in periodontal tissues. The state of the AOP system was normalized (decrease in the activity of SOD and catalase to the values of group 1), the tension in the glutathione-antioxidant defense system disappeared (the activity of GP decreased, and the activity of GR and G-6-PDH increased to the level control). In the blood serum, the content of MDA significantly reduced, and the level of DC remained higher than in group 1.In contrast, sta-bilization of the activity of marker enzymes of glutathione-antioxidant protection in blood serum (GP, GR, G-6-PDH) was noted with significant activation of the activity of SOD and catalase, with stabilization of SOD and catalase.
Conclusion. The periodontal protective effectiveness of the gel with tricolor violet was es-tablished, as evidenced by the restoration of the state of protective antioxidant systems and the inhibition of lipid peroxidation processes both directly in the periodontal tissues and at the system level.
Gender identity, embodiment and liminality in women΄s experience of mastectomy
Authors: Ziliaskopoulou Despoina , Avdi Evrinomy
Published: July 2023

In addition to a potentially life-threatening illness, women with breast cancer also face several challenges related to the effects of medical treatment on their bodies and their embodied identity. Mastectomy, as a highly invasive treatment, has significant impact on women's lives. This study aims to investigate the experience of mastectomy and the subjective meanings that it holds for women, in relation to their identity and relationships. The research questions were explored through a phenomenological approach in order to better understand the role of the body in this experience, and a gender perspective was adopted in order to critically examine the socio-cultural background that shapes women’s experience. Seventeen women, aged between 26-57, who had undergone mastectomy following a breast cancer diagnosis, participated in the study. The research material was collected through semi-structured interviews and analyzed using phenomenological analysis. The analysis also drew upon a gender perspective, given a focus of the study on the gendered dimension of embodied identity.  Findings indicate that a core element of the experience of mastectomy concerns the alteration of embodied identity and a sense of liminality, an unresolved state of being in between the previous normal life and life post-diagnosis. The analysis highlighted the need to expand the concept of liminality in psycho-oncology, to include the ambiguity associated with women’s self-identification as ‘normal women’, in relation to embodied experience and the socio-cultural constructions of the female breast. Interestingly, liminality in relation to gender identity characterizes many women’s experience, despite the use of silicone pads and/or plastic reconstructive surgery to manage the altered body. The findings enrich our theoretical understanding of the experience of mastectomy, broaden the concept of liminality, highlight the gendered dimensions of identity and the role of the socio-cultural context in shaping the experience of mastectomy. Moreover, they point to useful directions for the design and delivery of individualized support to women who have undergone mastectomy.
Intersectionality as researchers’ and participants’ resource: A commentary on the contributions to the Special Issue
Authors: Figgou Lia
Published: July 2023

The aim of this commentary is to relate the papers contributing to this special issue to the broader directions and orientations of psychological research on intersectionality.  It is argued that, in common with existing psychological research, the contributions to the current issue either explore how social actors stereotype others in light of their intersecting social identities or focus on the potential psychological and social implications of holding intersecting subordinate identities (including gender). It is also maintained that while intersectionality has mainly constituted the researcher’s concern and analytic lens, a future research agenda, as it is indicated by some of the contributions, should involve the study of intersectionality as participants’ concern and resource and the investigation of the (proximal and distal) implications of its use in different social and rhetorical contexts.
The discourse of resistance against spoken sexism
Authors: Flouli Anastasia , Athanasiades Christina
Published: July 2023

Spoken sexism, which remains up to this day a heavily understudied phenomenon, contributes incessantly to the preservation of patriarchy while reinforcing misogyny and sex-based oppression. The present paper focuses on how women discursively construct sexist comments as a cause for reaction, drawing upon a discourse of resistance, while sculpting a combative subject position. The 30 women who participated in the study took part voluntarily in individual semi-structured interviews, in order to share their views and experiences in relation to spoken sexism. For the analyses of the material, post-structuralism was taken as epistemological approach, while a Foucauldian discourse analysis (FDA) was used for the portrayal of the discourses. Due to the gendered nature of the subject under discussion and in acknowledgement that spoken sexism is discursively constructed within patriarchal structures of power, a feminist perspective was upheld in relation to the interpretation and discussion of the results. The findings reveal not only the resilient nature of sex-based oppression but also an increase in awareness as well as responsibility regarding the issue of spoken sexism.
Do sociodemographic factors impact in the use of cash in retail transactions?
Authors: Kawamoto Carlos
Published: July 2023

This paper presents the result of a study that assessed the use of cash in retail transactions in the city of São Paulo and the influence of individuals´ sociodemographic condition and transaction value on the likelihood of paying with banknotes. Respondents were selected by quota sampling process based on their sociodemographic profiles. The analyses were carried out using Pearson´s chi-squared test, as well as estimates from probit models. The results indicated that 56% of the respondents´ last purchases were settled in cash, and that both the transaction value and the buyer´s sociodemographic condition influence the likelihood of using banknotes.
Entrepreneurial competencies of accounting services firm owners
Authors: Lizote Suzete Antonieta , Teston Sayonara de Fátima , Zawadzki Patrick , Chaudhuri Manodip Ray
Published: July 2023

This study aimed to recognize the entrepreneurial competencies of owners of accounting services companies. The research, descriptive in nature, had a quantitative approach, applying a self-completion questionnaire based on the McClelland model (1973), which highlights the entrepreneurial competencies in the sets of achievement, planning, and Power. The respondents were 364 owners of accounting service companies located in the State of Santa Catarina. The results showed that the search for opportunity competence was the one that stood out the most in the achievement set. In the planning set, systematic planning and monitoring predominated. Finally, in the power set, the competence with the highest average was persuasion and networking.
Networks of nonprofit organizations and power relations
Authors: Amaoka Bernardino Raphaela , De Souza Conte Pedro Paulo , De Souza Dutra Ivan , De Lima Carlos Eduardo
Published: July 2023

This study aims to understand how power relations between the most central actors of a Social Network of Non-Profit Organizations in Londrina – PR influence access to its resources. A quantitative and qualitative approach research was adopted, and data collection was done using survey, interviews and document analysis. Findings show that the most central organizations possess and exchange in their relations resources considered scarce in the Third Sector (such as inspection and credibility), and thus, the impact of the two categories of centrality (Degree and Proximity) can be confirmed.
Educação empreendedora no ensino superior
Authors: Silva Carla Patrícia de Sousa , Pereira Etnny Coelho de Sa , Guimarães Jairo de Carvalho
Published: July 2023

Compreender sobre em que condições o espírito empreendedor se sobressai, remete a aspectos relacionados à Educação Empreendedora. A adoção de modelos pedagógicos que tornem o ensino de empreendedorismo atraente para os graduandos representa um procedimento necessário visando à sua formação e ao estímulo ao empreendedorismo na academia. O objetivo do estudo é descrever como os estudantes de Administração percebem e avaliam a Educação Empreendedora no processo de formação acadêmica. A pesquisa tem abordagem quantitativa, natureza descritiva e utilizou o survey. Foi possível identificar que os estudantes têm perfil empreendedor e reconhecem a importância da Educação Empreendedora na formação acadêmico-profissional.
Práticas de desenvolvimento sustentável em Unidades de Conservação
Authors: Santos Marianne Corrêa dos , Pinto Francisco Roberto , Silva Felipe Roberto
Published: July 2023

Este estudo busca identificar se os meios de hospedagem de Barra Grande e Jericoacoara têm adotado práticas de sustentabilidade sob a ótica das quatro dimensões, visto que estão inseridos em Unidades de Conservação. Como estratégia da pesquisa, fez-se uso de amostragem por casos múltiplos e os dados foram analisados pela técnica de análise de conteúdo de Bardin (2011). Os achados evidenciam que, das dimensões de sustentabilidade implementadas nos meios de hospedagem, a dimensão ambiental é a que se encontra mais estruturada, na maioria deles, pois apresenta práticas de redução do consumo de energia e água e preservação do meio ambiente.
Formação de diretores de escolas no Brasil
Authors: Mariano Sandra R. H.
Published: July 2023

Este estudo explorou a política pública implementada pelo governo federal brasileiro para formação de diretores de escola, em cooperação com os sistemas de educação estaduais e municipais, a fim de melhorar os resultados da aprendizagem escolar, desenvolvida no âmbito do Programa Nacional Escola de Gestores da Educação Básica Pública (PNGEB). O artigo investigou os conteúdos da pós-graduação lato sensu Gestão Escolar, na perspectiva da base de conhecimento contemporâneo sobre administração da educação tal como apresentado na literatura internacional. Os conteúdos contemplados na formação pouco compartilham da sólida base de conhecimento internacional desenvolvida no campo da administração educacional, especialmente aquelas relacionadas às práticas de liderança para o aprimoramento escolar, como um conjunto de orientações e práticas para o fazer pedagógico. Os resultados mostram que a política de desenvolvimento de diretores de escolas no Brasil pouco aproveitou a contribuição das pesquisas sobre liderança educacional em todo o mundo, apesar das evidências de pesquisas mostrarem que as práticas de liderança compartilham muito mais semelhanças do que diferenças entre diferentes contextos.
Value addition in horticulture in the liquid modernity
Authors: Lima da Silva Ana Paula , Bertolini Geysler Rogis , Da Silva Elizandra
Published: July 2023

This paper analyzed the perception of family farmers about the ways of adding value to horticultural products in the liquid modernity. For this, it was used the exploratory-descriptive research of phenomenological approach, with qualitative nature. It was concluded that farmers are not clear about what value addition is, despite the fact that they use some variables. It was found that they receive little or no technical assistance, that they have not received orientation about management, and observed that they do not seek information about the market. This shows that farmers are not prepared to face the challenges contained in liquid modernity, which is fluid, and has as its main characteristic the speed of change, including in commercial relations.
Epistemologia dos saberes docentes
Authors: Rodrigues Zabolotny Simone , Quintana Alexandre Costa , Capuano da Cruz Ana Paula
Published: July 2023

O objetivo do estudo foi compreender como ocorre o processo de construção dos saberes mobilizados pelos docentes dos Programas de Pós-Graduação stricto sensu em Ciências Contábeis. Em termos metodológicos, na primeira etapa, ocorreu uma pesquisa de levantamento, e na segunda, entrevistas semiestruturadas com docentes. Os resultados apontaram que os saberes mais mobilizados foram os profissionais, indicando uma lacuna na formação pedagógica dos professores investigados. Já em relação a construção dos saberes, os achados da pesquisa revelaram que estes foram construídos durante as suas trajetórias antes de ingressar na carreira docente, no ambiente da Pós-Graduação stricto-sensu, na vivência com seus mestres.