bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychiatric, cognitive functioning and socio-cultural views of menstrual psychosis in Oman: an idiographic approach
Authors: Al-Sibani Nasser , Al-Maqbali Mandhar , Mahadevan Sangeetha , Al-Huseini Salim , Al-Muzeni Muna , Al-Adawi Samir 
Published: September 2020

Abstract
Background
Most documented cases of menstrual psychosis have been from Euro-American populations with reports from cross-cultural populations being only a few. A primary aim was to determine whether the cyclical/episodic nature of menstrual psychosis among case series observed at a tertiary care unit in Oman fulfills the diagnostic criteria of the International Classification of Diseases (ICD-10) and diverge into Brockington’s sub-types (World Psychiatry. 2005;4(1):9–17). Related aims were to solicit measures of psychometric functioning of those with menstrual psychosis and associated idioms of distress.

Methods
A series of consecutive patients seeking psychiatric consultation from January 2016 to December 2017 were screened via structured interview—Composite-International Diagnostic Interview (CIDI) and Brockington’s sub-types. The identified patients (n = 4) also underwent psychometric evaluation including examination of affective functioning, intellectual capacity and neuropsychological functioning (i.e.attention and concentration, learning and remembering, executive function, processing speed and speech and language). The analysis of outcome measures was via an idiographic approach.

Results
The spectrum of distress among people with menstrual psychosis does not fit existing psychiatric nosology. Evaluations revealed that a majority of the participants displayed something akin to morbid phenomena relating to manic and psychotic symptoms. In the parlance of traditional Omani society, this would be termed “spirit possession”. In terms of classification by timing within the menstrual cycle as expounded by Brockington, the present case series in Oman fulfilled the definition of catamenial psychosis and paramenstrual psychosis. With regard to psychometric function, all participants performed adequately on indices of intellectual functioning but appeared to have impairments in neuropsychological functioning, including the dimensions of processing speed, episodic memory, and executive functioning. Within the given society, the periodicity of mind alteration has been attributed to spirit possession.

Conclusions
This is one of the first case series of its kind in the country elucidating whether the manifestation of menstrual psychosis among individuals in Oman fulfills the subtypes postulated by Brockington. The present case series suggests that menstrual psychosis is marked with neuropsychological impairments that were previously observed in other phasic manic episodes or brief psychotic disorders.
Hydroalcoholic extract and seed of Foeniculum vulgare improve folliculogenesis and total antioxidant capacity level in F1 female mice offspring
Authors: Pourjafari Fahimeh , Haghpanah Tahereh , Nematollahi-Mahani Seyed Noreddin , Pourjafari Fariba , Ezzatabadipour Massood 
Published: September 2020

Abstract
Background
Foeniculum vulgare (fennel) is traditionally suggested for the fertility improvement in Iranian lore due to its antioxidant and phytoestrogen compounds. The present study aimed to investigate the effects of fennel seed and its hydroalcoholic extract on the serum total antioxidant capacity (TAC) and folliculogenesis in offspring exposed to either of the treatments in utero and 56 days after birth (PND 56).

Methods
Pregnant NMRI mice were randomly divided into 5 groups of 7: extract-treated groups received 500 and 1000 mg/kg/day fennel extract (FE), seed-treated groups received 500 and 1000 mg/kg/day fennel seed (FS), and the control group (CTL) received no treatment. The treatments started from pregnancy day 1 and continued until PND 56. Body and right ovary weights and ovary dimensions were recorded. Hematoxylin and eosin stained ovary sections were prepared to calculate the proportion of different follicles. The level of TAC in the serums was also measured by fluorescence recovery after photo bleaching.

Results
A marked rise in the body and ovary weights of treated mice was observed compared to the CTL group. The mean number of primordial, primary, pre-antral, and pre-ovulatory follicles as well as corpus luteum size in the treated offspring was significantly higher compared to those of CTL offspring. The atretic follicle number was nonsignificantly lower in either of the treatment groups compared with that in the CTL. However, treatment of animals with 500 mg/kg FE showed a more pronounced effect. Animals in FS500, FE500 and FE1000 groups had a significantly higher level of serum TAC compared to the CTL group.

Conclusions
Fennel extract and seed administration in pregnancy and lactation period improve offspring’s folliculogenesis. Higher level of TAC in the serum of offspring might have positively altered the folliculogenesis milieu.
Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan
Authors: Lu Shu-Ju , Kao Hsiu-O , Chang Bao-Lin , Gong Shu-Ing , Liu Shu-Mei , Ku Shih-Chi , Jerng Jih-Shuin 
Published: September 2020

Abstract
Background
Assessing patients’ expectations and perceptions of health service delivery is challenging. To understand the service quality in intensive care units (ICUs), we investigated the expected and perceived service quality of ICU care.

Methods
We conducted this study at an ICU of a university-affiliated medical center in Taiwan from April to September 2019. Admitted patients or their family members responded to a questionnaire survey adopted from the SERVQUAL instrument consisting of 22 items in five dimensions. The questionnaire was provided on ICU admission for expectation and before ICU discharge for perception. We analyzed the quality gaps between the surveys and applied important-performance analysis (IPA).

Results
A total of 117 patients were included (62.4% males, average age: 65.9 years, average length of stay: 10.1 days, and 76.9% survival to ICU discharge). The overall weighted mean scores for the surveys were similar (4.57 ± 0.81 and 4.58 ± 0.52, respectively). The ‘tangibles’ dimension had a higher perception than expectation (3.99 ± 0.55 and 4.31 ± 0.63 for expectation and perception, respectively, p < 0.001). IPA showed that most of the items in ‘reliability,’ ‘responsiveness’ and ‘assurance’ were located in the quadrant of high expectation and high perception, whereas most of the items in ‘tangibles’ and ‘empathy’ were located in the quadrant of low expectation and low perception. One item (item 1 for ‘tangibles’) was found in the quadrant of high expectation and low perception.

Conclusions
The SERVQUAL approach and IPA might provide useful information regarding the feedback by patients and their families for ICU service quality. In most aspects, the performance of the ICU satisfactorily matched the needs perceived by the patients and their families.
Development and psychometric evaluation of the women shift workers’ reproductive health questionnaire: a sequential exploratory mixed-method study
Authors: Nikpour Maryam , Tirgar Aram , Ghaffari Fatemeh , Ebadi Abbas , Sharif Nia Hamid , Nasiri-Amiri Fatemeh 
Published: September 2020

Abstract
Background
There is no standard and comprehensive questionnaire for reproductive health assessment among women shift workers. This study aimed at the development and psychometric evaluation of the Women Shift Workers’ Reproductive Health Questionnaire.

Methods
This sequential exploratory mixed-method study was conducted in a qualitative (item generation) and a quantitative (psychometric evaluation) phase. In the qualitative phase, the primary item pool of the questionnaire was generated based on the findings of the qualitative content analysis of 21 interviews held with 21 women shift workers as well as the findings of a literature review. In the quantitative phase, the face, content, construct, convergent, and discriminant validity and the reliability of the questionnaire were assessed. For construct validity assessment through exploratory and confirmatory factor analyses, 620 women shift workers were conveniently selected to fill out the questionnaire. Reliability assessment was done through assessing internal consistency, stability, and composite reliability.

Results
The primary item pool contained 88 items. During face and content validity, item number was reduced to 55. Construct validity assessment through factor analysis revealed that 56.50% of the total variance was explained by five factors with 34 items. The factors were named motherhood, general health, sexual relationships, menstruation, and delivery. Confirmatory factor analysis confirmed the fit of the five-factor model. The Cronbach’s alpha and the composite reliability value of the questionnaire were more than 0.7.

Conclusion
The Women Shift Workers’ Reproductive Health Questionnaire is a valid and reliable instrument and can be used for reproductive health assessment among women shift workers.
Efficacy and safety of CyberKnife radiosurgery in elderly patients with brain metastases: a retrospective clinical evaluation
Authors: Acker Gueliz , Hashemi Seyed-Morteza , Fuellhase Josch , Kluge Anne , Conti Alfredo , Kufeld Markus , Kreimeier Anita , Loebel Franziska , Kord Melina , Sladek Diana , Stromberger Carmen , Budach Volker , Vajkoczy Peter , Senger Carolin 
Published: September 2020

Abstract
Background
Stereotactic radiosurgery (SRS) has been increasingly applied for up to 10 brain metastases instead of whole brain radiation therapy (WBRT) to achieve local tumor control while reducing neurotoxicity. Furthermore, brain-metastasis incidence is rising due to the increasing survival of patients with cancer. Our aim was to analyze the efficacy and safety of CyberKnife (CK) radiosurgery for elderly patients.

Methods
We retrospectively identified all patients with brain metastases ≥ 65 years old treated with CK-SRS at our institution since 2011 and analyzed data of primary diseases, multimodality treatments, and local therapy effect based on imaging follow-up and treatment safety. Kaplan–Meier analysis for local progression-free interval and overall survival were performed.

Results
We identified 97 patients (233 lesions) fulfilling the criteria at the first CK-SRS. The mean age was 73.2 ± 5.8 (range: 65.0–87.0) years. Overall, 13.4% of the patients were > 80 years old. The three most frequent primary cancers were lung (40.2%), kidney (22.7%), and malignant melanoma (15.5%). In 38.5% (47/122 treatments) multiple brain metastases were treated with the CK-SRS, with up to eight lesions in one session. The median planning target volume (PTV) was 1.05 (range: 0.01–19.80) cm3. A single fraction was applied in 92.3% of the lesions with a median prescription dose of 19 (range: 12–21) Gy. The estimated overall survivals at 3-, 6-, and 12 months after SRS were 79, 55, and 23%, respectively. The estimated local tumor progression-free intervals at 6-, 12-, 24-, 36-, and 72 months after SRS were 99.2, 89.0, 67.2, 64.6, and 64.6%, respectively. Older age and female sex were predictive factors of local progression. The Karnofsky performance score remained stable in 97.9% of the patients; only one patient developed a neurological deficit after SRS of a cerebellar lesion (ataxia, CTCAE Grade 2).

Conclusions
SRS is a safe and efficient option for the treatment of elderly patients with brain metastases with good local control rates without the side effects of WBRT. Older age and female sex seem to be predictive factors of local progression. Prospective studies are warranted to clarify the role of SRS treatment for elderly patients.
Fanconi–Bickel syndrome in a Ugandan child – diagnostic challenges in resource-limited settings: a case report
Authors: Piloya Thereza , Ssematala Hawa , Dramani Lydia Paparu , Nalikka Oliva , Baluka Miriam , Musiime Victor 
Published: September 2020

Abstract
Background
Fanconi–Bickel syndrome is an autosomal recessive disorder of glucose metabolism. It is an extremely rare disorder. Most cases have been reported in consanguineous communities. None of the cases have been reported in Black Africans in sub-Saharan Africa. This case was diagnosed 3 years after initial presentation due to diagnostic challenges and limited awareness of similar metabolic syndromes in our setting.

Case presentation
We report the case of a 4-year-old boy, born to non-consanguineous Black African parents, who presented with failure to thrive and rachitic features in infancy. Clinical, laboratory, and radiological features were indicative of Fanconi–Bickel syndrome. No genetic testing was done. The diagnosis was made 3 years after the initial presentation due to diagnostic challenges. He showed clinical improvement with the institution of a galactose-free diet.

Conclusion
Fanconi–Bickel syndrome occurs even in non-consanguineous Black African populations. Therefore, clinicians in resource-poor settings should raise their index of suspicion for such metabolic disorders in settings with a high prevalence of failure to thrive among children.
Phloretin ameliorates hepatic steatosis through regulation of lipogenesis and Sirt1/AMPK signaling in obese mice
Authors: Liou Chian-Jiun , Wu Shu-Ju , Shen Szu-Chuan , Chen Li-Chen , Chen Ya-Ling , Huang Wen-Chung 
Published: September 2020

AbstractBackgroundPhloretin is isolated from apple trees and could increase lipolysis in 3T3-L1 adipocytes. Previous studies have found that phloretin could prevent obesity in mice. In this study, we investigated whether phloretin ameliorates non-alcoholic fatty liver disease (NAFLD) in high-fat diet (HFD)-induced obese mice, and evaluated the regulation of lipid metabolism in hepatocytes.MethodsHepG2 cells were treated with 0.5 mM oleic acid to induce lipid accumulation, and then treated with phloretin to evaluate the molecular mechanism of lipogenesis. In another experiment, male C57BL/6 mice were fed normal diet or HFD (60% fat, w/w) for 16 weeks. After the fourth week, mice were treated with or without phloretin by intraperitoneal injection for 12 weeks.ResultsPhloretin significantly reduced excessive lipid accumulation and decreased sterol regulatory element-binding protein 1c, blocking the expression of fatty acid synthase in oleic acid-induced HepG2 cells. Phloretin increased Sirt1, and phosphorylation of AMP activated protein kinase to suppress acetyl-CoA carboxylase expression, reducing fatty acid synthesis in hepatocytes. Phloretin also reduced body weight and fat weight compared to untreated HFD-fed mice. Phloretin also reduced liver weight and liver lipid accumulation and improved hepatocyte steatosis in obese mice. In liver tissue from obese mice, phloretin suppressed transcription factors of lipogenesis and fatty acid synthase, and increased lipolysis and fatty acid β-oxidation. Furthermore, phloretin regulated serum leptin, adiponectin, triglyceride, low-density lipoprotein, and free fatty acid levels in obese mice.ConclusionsThese findings suggest that phloretin improves hepatic steatosis by regulating lipogenesis and the Sirt-1/AMPK pathway in the liver.
Physiological effects of adding ECCO2R to invasive mechanical ventilation for COPD exacerbations
Authors: Diehl J.-L. , Piquilloud L. , Vimpere D. , Aissaoui N. , Guerot E. , Augy J. L. , Pierrot M. , Hourton D. , Arnoux A. , Richard C. , Mancebo J. , Mercat A. 
Published: September 2020

Abstract
Background
Extracorporeal CO2 removal (ECCO2R) could be a valuable additional modality for invasive mechanical ventilation (IMV) in COPD patients suffering from severe acute exacerbation (AE). We aimed to evaluate in such patients the effects of a low-to-middle extracorporeal blood flow device on both gas exchanges and dynamic hyperinflation, as well as on work of breathing (WOB) during the IMV weaning process.

Study design and methods
Open prospective interventional study in 12 deeply sedated IMV AE-COPD patients studied before and after ECCO2R initiation. Gas exchange and dynamic hyperinflation were compared after stabilization without and with ECCO2R (Hemolung, Alung, Pittsburgh, USA) combined with a specific adjustment algorithm of the respiratory rate (RR) designed to improve arterial pH. When possible, WOB with and without ECCO2R was measured at the end of the weaning process. Due to study size, results are expressed as median (IQR) and a non-parametric approach was adopted.

Results
An improvement in PaCO2, from 68 (63; 76) to 49 (46; 55) mmHg, p = 0.0005, and in pH, from 7.25 (7.23; 7.29) to 7.35 (7.32; 7.40), p = 0.0005, was observed after ECCO2R initiation and adjustment of respiratory rate, while intrinsic PEEP and Functional Residual Capacity remained unchanged, from 9.0 (7.0; 10.0) to 8.0 (5.0; 9.0) cmH2O and from 3604 (2631; 4850) to 3338 (2633; 4848) mL, p = 0.1191 and p = 0.3013, respectively. WOB measurements were possible in 5 patients, indicating near-significant higher values after stopping ECCO2R: 11.7 (7.5; 15.0) versus 22.6 (13.9; 34.7) Joules/min., p = 0.0625 and 1.1 (0.8; 1.4) versus 1.5 (0.9; 2.8) Joules/L, p = 0.0625. Three patients died in-ICU. Other patients were successfully hospital-discharged.

Conclusions
Using a formalized protocol of RR adjustment, ECCO2R permitted to effectively improve pH and diminish PaCO2 at the early phase of IMV in 12 AE-COPD patients, but not to diminish dynamic hyperinflation in the whole group. A trend toward a decrease in WOB was also observed during the weaning process.
Trial registration ClinicalTrials.gov: Identifier: NCT02586948.
An exact expression of positive periodic solution for a first-order singular equation
Authors: Xin Yun , Cui Xiaoxiao , Liu Jie 
Published: September 2020

AbstractThe main purpose of this paper is to obtain an exact expression of the positive periodic solution for a first-order differential equation with attractive and repulsive singularities. Moreover, we prove the existence of at least one positive periodic solution for this equation with an indefinite singularity by applications of topological degree theorem, and give the upper and lower bounds of the positive periodic solution.
Adenocarcinoma originating from long-segment Barrett's esophagus over 15 cm: a series of 3 cases
Authors: Kuwayama Naoki , Hoshino Isamu , Gunji Hisashi , Tonooka Toru , Soda Hiroaki , Eto Ryotaro , Takiguchi Nobuhiro , Nabeya Yoshihiro 
Published: September 2020

Abstract
Background
Barrett's esophagus (BE) is characterized by presence of columnar epithelium in the lower esophageal mucosa, which originally comprises stratified squamous epithelium. Gastroesophageal reflux disease causes BE and BE adenocarcinoma (BEAC); further, the incidence of BEAC is increasing, especially in developed countries. Long-segment BE (LSBE) has a particularly high carcinogenic potential and necessitates treatment, surveillance, and prevention.

Case presentation
Herein, we report three cases of BEAC originating from LSBE larger than 15 cm. All three patients underwent surgery for the diagnosis of BEAC. A 66-year-old man with advanced esophageal cancer underwent neoadjuvant chemotherapy and subsequent subtotal esophagectomy. The postoperative pathological diagnosis was of poorly differentiated adenocarcinoma with lymph node metastasis (pT3 pN3 pM0 pStage III based on the Union for International Cancer Control TNM Classification 8th edition). Two years after the operation, the patient was diagnosed with recurrence around the celiac artery and underwent chemotherapy. An 83-year-old woman with advanced esophageal cancer underwent subtotal esophagectomy. The postoperative pathological diagnosis was of well-differentiated adenocarcinoma with supraclavicular lymph node metastasis (pT3 pN3 pM1 pStage IV). Two months after the operation, the patient was diagnosed with recurrence in the neck lymph nodes and underwent chemotherapy; however, she died. A 66-year-old man with early-stage esophageal cancer underwent subtotal esophagectomy. A superficial early cancerous lesion was seen over BE. The postoperative pathological diagnosis was of well-differentiated adenocarcinoma without lymph node metastasis (pT1a pN0 pM0 pStage 0). The patient was found to be alive and recurrence-free 3 months after the operation.

Conclusions
BEAC might show good prognosis if detected and treated early. Extremely LSBE is associated with a high incidence of BEAC; therefore, early detection and treatment with close surveillance is essential.
Combined resection of the hepatic artery without reconstruction in pancreaticoduodenectomy: a case report of pancreatic cancer with an aberrant hepatic artery
Authors: Kuribara Tadao , Ichikawa Tatsuo , Osa Kiyoshi , Inoue Takeshi , Ono Satoshi , Asanuma Kozo , Kaneko Shiori , Sano Takayuki , Shigeyoshi Itaru , Matsubara Kouta , Irie Naoko , Iai Akira , Shinobi Tetsuya , Ishizu Hideki , Miura Katsuhiro 
Published: September 2020

Abstract
Background
Pancreaticoduodenectomy (PD) is rarely performed for pancreatic cancer with hepatic arterial invasion owing to its poor prognosis and high surgical risks. Although there has been a recent increase in the reports of PD combined with hepatic arterial resection due to improvements in disease prognosis and operative safety, PD with major arterial resection and reconstruction is still considered a challenging treatment.

Case presentation
A 61-year-old man with back pain was diagnosed with pancreatic head and body cancer. Although distant metastasis was not confirmed, the tumor had extensively invaded the hepatic artery; therefore, we diagnosed the patient with locally advanced unresectable pancreatic cancer. After gemcitabine plus nab-paclitaxel (GnP) therapy, the tumor considerably decreased in size from 35 to 20 mm. Magnetic resonance imaging revealed a gap between the tumor and the hepatic artery. Tumor marker levels returned to their normal range, and we decided to perform conversion surgery. In this case, an artery of liver segment 2 (A2) had branched from the left gastric artery; therefore, we decided to preserve A2 and perform PD combined with hepatic arterial resection without reconstruction. After four cycles of GnP therapy, we performed hepatic arterial embolization to prevent postoperative ischemic complications prior to surgery. Immediately after embolization, collateral arterial blood flow to the liver was observed. Operation was performed 19 days after embolization. Although there was a temporary increase in liver enzyme levels and an ischemic region was found near the surface of segment 8 of the liver after surgery, no liver abscess developed. The postoperative course was uneventful, and S-1 was administered for a year as adjuvant chemotherapy. The patient is currently alive without any ischemic liver events and cholangitis and has not experienced recurrence in the past 4 years since the surgery.

Conclusions
In PD for pancreatic cancer with hepatic arterial invasion, if a part of the hepatic artery is aberrant and can be preserved, combined resection of the common and proper hepatic artery without reconstruction might be feasible for both curability and safety.