bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges in Diagnosing Intrahepatic Cholangiolithiasis in a 39-Year-Old Patient
Authors: Guseva A. K. , Sergeyeva O. N. , Nekrasova T. P. , Imaraliev O. T. , Okhlobystin A. V. , Shirokova Y. N. , Ostrovskaya A. S. , Zharkova M. S. , Cherenda A. S. , Ivashkin V. T. 
Published: December 2024

Aim: to highlight the challenges of diagnosing and treating a patient with severe intrahepatic cholangiolithiasis.Key points. Primary sclerosing cholangitis is a chronic progressive liver disease characterized by destructive inflammation and fibrosis in the bile ducts, leading to biliary strictures, secondary biliary cirrhosis, portal hypertension and liver failure. Cholangiolithiasis occurs in more than half of cases of primary sclerosing cholangitis and can be both a complication and a cause of secondary sclerosing cholangitis, maintaining inflammation in the ducts and facilitating stone formation. Genetic mutations are known to contribute to the development of gallstones in young patients, including low phospholipid-associated cholelithiasis. Despite the wide range of modern methods of radiological and endoscopic diagnostics, there are still difficulties in differential diagnostics of bile duct diseases. This article presents a clinical case of a 39-year-old male patient with primary sclerosing cholangitis, dyslipidemia and multiple cholangioliths in the gallbladder, intraand extrahepatic bile ducts.Conclusion. The presented clinical case demonstrates the difficulties in assessing pathogenesis, choosing diagnostic and therapeutic approaches in patients with severe intrahepatic lithiasis that may mimic hepatic neoplasm. Combination of non-invasive and endoscopic methods, such as magnetic resonance imaging, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and cholangioscopy, appears to be the most effective both diagnostically and therapeutically.
Diagnosis and Treatment of Gastroesophageal Reflux Disease (Clinical Guidelines of the Russian Gastroenterological Association, Russian Scientific Medical Society of Internal Medicine, Russian Society for the Prevention of Noncommunicable Diseases, Scientific Community for Human Microbiome Research)
Authors: Ivashkin V. T. , Trukhmanov A. S. , Maev I. V. , Drapkina O. M. , Livzan M. A. , Martynov A. I. , Lapina T. L. , Paraskevova A. V. , Andreev D. N. , Alexeeva O. P. , Alekseenko S. A. , Baranovsky A. Yu. , Zayratyants O. V. , Zolnikova O. Yu. , Dronova O. B. , Kliaritskaia I. L. , Korochanskaya N. V. , Kucheryavyy Yu. A. , Mammaev S. N. , Osipenko M. F. , Pirogov S. S. , Poluektova E. A. , Rumyantseva D. E. , Sayfutdinov R. G. , Storonova O. A. , Uspenskiy Yu. P. , Khlynov I. B. , Tsukanov V. V. , Sheptulin A. A. 
Published: December 2024

Aim. These recommendations are developed for practitioners in order to familiarize them with modern diagnostic methods, management features and pharmacotherapy of patients with gastroesophageal reflux disease (GERD).General provisions. GERD is the most common reason for patients to visit clinics. There are esophageal and extraesophageal manifestations of GERD. Patients' complaints of heartburn and regurgitation remain the most sensitive and specific clinical manifestations of GERD. The diagnosis of GERD is established on the basis of anamnestic data, instrumental examination (detection of reflux esophagitis during upper gastrointestinal endoscopy, detection of pathological gastroesophageal reflux with 24-hour pH-metry or/and 24-hour pH-impedance monitoring). Patients with suspected GERD and the absence of erosive and ulcerative changes in the mucous membrane of the esophagus or the presence of erosive esophagitis of Grade A according to Los Angeles Classification of Gastroesophageal Reflux Disease are recommended to conduct 24-hour pH-metry on PPI off to exclude or confirm the diagnosis of GERD. Patients with extraesophageal manifestations of GERD without classic symptoms (heartburn, regurgitation) are recommended to undergo 24-hour pH-impedance monitoring with discontinuation of proton pump inhibitor therapy. When deciding on surgical treatment, all patients need to perform high-resolution esophageal manometry and 24-hour pH-impedance monitoring. Complications of GERD include bleeding, strictures, Barrett’s esophagus and esophageal adenocarcinoma. The main groups of medications used in the treatment of GERD are proton pump inhibitors (PPIs), potassium-competitive acid blockers (P-CABs), alginates, antacids, and prokinetics. PPIs are the drugs of choice in the treatment of both symptoms of gastroesophageal reflux disease and existing erosive esophagitis. Combination therapy Rebamipide with PPIs increases the effectiveness of relief of GERD symptoms, as well as reduces the frequency of relapses.Conclusion. These clinical recommendations will improve the quality of medical care for patients with GERD.
Genetics of Inflammatory Bowel Disease: Current Understanding and Future Directions
Authors: Chandra Sekar P. K. , Veerabathiran R. 
Published: December 2024

Aim: to present literature data on the genetic underpinnings of inflammatory bowel disease (IBD), focusing on key genetic variants such as NOD2, ATG16L1, and IL23R; The objective of this was to understand how these genetic factors contribute to immune dysregulation, epithelial barrier dysfunction, and mucosal homeostasis in IBD.Key points. IBD, encompassing Crohn's disease and ulcerative colitis, is intricately shaped by a nexus of genetic and environmental factors, and its global prevalence is increasing. Genetic research has identified pivotal variants — NOD2, ATG16L1, and IL23R — linked to IBD, influencing key pathways, such as autophagy, interleukin signaling, and bacterial management. These genetic variants, integral to IBD's etiology of IBD, have functional significance because they perturb immune regulation, compromise epithelial barrier integrity, and disrupt mucosal homeostasis, collectively contributing to intestinal inflammation through diverse mechanisms. Early detection of IBD is paramount for arresting disease progression and underscoring the importance of prognostic testing and genetic screening, especially in cases with familial predispositions or very early onset IBD. Additionally, the use of certain IBD medications, such as corticosteroids, azathioprine, and infliximab, may have implications for male fertility, necessitating a nuanced understanding of these potential effects for informed decision-making in IBD management. This comprehensive understanding of the genetic landscape, functional implications, and diagnostic strategies is vital for advancing personalized treatments and improving outcomes in individuals with IBD.Conclusion. IBD is a complex gastrointestinal disorder influenced by a combination of genetic and environmental factors. Genetic variants, including NOD2, ATG16L1, and IL23R, contribute to dysregulation of immune responses, epithelial barrier function, and mucosal homeostasis. While progress has been made in understanding the genetic landscape of IBD, ongoing research is needed to elucidate the functional consequences of these variants, identify causal genes, and explore gene-environment interactions. This deeper understanding holds the potential for more precise diagnostics and personalized treatments, ultimately improving outcomes in individuals living with IBD.
Hyperparathyroidism in Patients with End-Stage Chronic Liver Disease (Clinical Observations)
Authors: Lavreniuk A. A. , Gorbacheva A. N. , Bibik E. E. , Eremkina A. K. , Tikhonov I. N. , Mokrysheva N. G. 
Published: December 2024

Aim: to present disorders of mineral and bone metabolism in patients with chronic liver diseases through clinical observations.Key points. The liver plays an important role in mineral metabolism: metabolic activation of vitamin D, synthesis of vitamin D-binding protein and albumin, metabolism of parathyroid hormone, etc. However, data on the development of mineral metabolism disorders, particularly hyperparathyroidism, in this population are very limited. Bone diseases such as osteoporosis and osteomalacia are quite common in chronic liver disease, especially in cirrhosis and cholestatic diseases; however, the pathogenesis of these disorders and their relationship with mineral metabolism remain poorly understood. The article presents cases of severe primary hyperparathyroidism (PHPT) in patients with chronic liver disease. In one patient with a long history of viral hepatitis C and cirrhosis, PHPT manifested with severe bone complications, including multiple vertebral compression fractures and a subsequent femoral neck fracture. Imaging studies revealed lesions of all four parathyroid glands, and the removal of the largest lesion did not result in disease remission. In the second case described, PHPT was diagnosed in a patient with bone pain and osteoporosis following orthotopic liver transplantation for Budd — Chiari syndrome with cirrhosis. One year after the initial surgical treatment for PHPT, the patient experienced a recurrence of the disease, with confirmed multiglandular lesion.Conclusion. In patients with chronic liver diseases, disorders of mineral and bone metabolism remain a significant yet not fully understood problem. Further studies are needed to develop therapeutic approaches for this group of patients to prevent the onset of late, disabling complications.
Intensive Glucose Lowering and Its Effects on Vascular Events and Death According to Age at Diagnosis and Duration of Diabetes: The ADVANCE Trial
Authors: Ohkuma Toshiaki , Harris Katie , Woodward Mark , Hamet Pavel , Harrap Stephen , Mancia Giuseppe , Marre Michel , Poulter Neil , Chalmers John , Zoungas Sophia ,   ADVANCE Collaborative Group
Published: December 2024

OBJECTIVE
To compare the vascular effects of pursuing more versus less glucose lowering in patients with younger or older age at diabetes diagnosis, and with shorter or longer diabetes duration.

RESEARCH DESIGN AND METHODS
We studied 11,138 participants from the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial, classified into subgroups defined by age at diabetes diagnosis (≤50, &gt;50–60, and &gt;60 years) and diabetes duration (≤5, &gt;5–10, and &gt;10 years).

RESULTS
Intensive glucose lowering significantly lowered the risk of the primary composite outcome of major macrovascular and microvascular events (hazard ratio 0.90, 95% CI 0.82–0.98) with no evidence of heterogeneity in the proportional effects across subgroups defined by age at diagnosis or diabetes duration (P for heterogeneity = 0.86 and 0.47, respectively). Similar consistent treatment effects were also observed for all-cause death, cardiovascular death, and the components of major vascular events.

CONCLUSIONS
Intensive glucose lowering may be recommended irrespective of age at diagnosis or diabetes duration.
Mujeres afrentadas a partir de los pleitos del Archivo de la Universidad de Valladolid (1596-1600)
Authors: Bertolini Crespo Sandra 
Published: December 2024

Este trabajo analiza todos los pleitos del siglo XVI conservados en el Archivo de la Universidad de Valladolid en los que una mujer denunció ante el tribunal del rector la afrenta y las acciones violentas que sufrió por parte de uno o varios estudiantes. A partir del análisis material de los pleitos, se ha estudiado el contenido de las querellas, analizando así sus causas – los delitos– y su desarrollo. También se examina la función y significado de los términos empleados en las descripciones de las mujeres a lo largo del proceso legal, así como la figura de los estudiantes acusados.
Obstáculos formativos a la inclusión educativa
Authors: Dopico Rodríguez Eduardo , Menéndez Suarez Covadonga 
Published: December 2024

Ofrecer una educación inclusiva requiere de una adecuada formación del profesorado en diversidad, equidad e inclusión, temáticas sobre las que se han podido documentar carencias y sobreentendidos que afectan a las culturas docentes, a las micropolíticas desarrolladas en los centros y a las prácticas de aula. Investigando sobre las ideas y la formación percibida por el profesorado, tanto generalista como especialista en respuesta a la diversidad, sobre inclusión y equidad y sus competencias para desarrollar una verdadera educación inclusiva, a través de debates colaborativos y preguntas-clave, hemos encontrado resultados que nos alertan de la presencia de fisuras en la formación permanente del profesorado que exigen replantear las políticas educativas en inclusión y programar oportunidades de formación en este ámbito a todo el profesorado. Se sugiere combinar acciones en los propios centros para reflexionar sobre la inclusión, sin olvidar la importancia de considerar el compromiso personal de cada docente con su propia formación continua.
Desafíos del acogimiento residencial en España: pasado, presente y futuro de las leyes de infancia.
Authors: Cantos-Egea Alison , Tierno-García Juana-María , Camarero Figuerola Marta 
Published: December 2024

El sistema de acogimiento residencial y la atención a la infancia y adolescencia han experimentado diversas modificaciones y adaptaciones a lo largo del tiempo, ajustándose a los cambios en los contextos sociopolíticos y culturales. En la actualidad, en España existen 22 leyes de infancia (3 de ámbito estatal y 19 autonómicas) que regulan el marco organizativo y legal para garantizar la protección de los derechos de las personas menores de edad. Esta investigación, a través de una scooping review, tiene como objetivo analizar, por un lado, cómo se organiza el acogimiento residencial en las distintas comunidades autónomas y, por otro, cómo se estructura el marco regulador referente a las competencias de liderazgo, el perfil profesional y la práctica de los profesionales que intervienen de forma socioeducativa y psicosocial en la protección de los derechos de la infancia. Los resultados muestran la necesidad de establecer criterios normativos estandarizados para todas las comunidades autónomas, con el fin de garantizar una protección integral de la infancia y la adolescencia a nivel nacional. Además, se destaca la importancia de contar con un sistema de información estandarizado que evalúe el impacto de las medidas adoptadas en el sistema de protección infantil. También se evidencia la falta de unificación en los perfiles y funciones de los profesionales, así como la necesidad de debatir nuevos modelos de atención integral que prioricen la calidad de vida y la justicia social de la infancia y adolescencia en situación de protección en España.
Predicting blood loss volume in a canine model of hemorrhagic shock using arterial waveform machine learning analysis
Authors: Edwards Thomas , Gonzalez Jose M. , Hernandez-Torres Sofia , Venn Emilee , Ford Rebekah , Ewer Nicole , Hoareau Guillaume L. , Holland Lawrence , Convertino Victor A. , Snider Eric 
Published: December 2024

Abstract

OBJECTIVE
To determine if the compensatory reserve algorithm validated in humans can be applied to canines. Our secondary objective was to determine if a simpler waveform analysis could predict the percentage of blood loss volume.

METHODS
6 purpose-bred, anesthetized dogs underwent 5 rounds of controlled hemorrhage and resuscitation while continuously recording invasive arterial blood pressure waveforms in this prospective, experimental study. We calculated human compensatory reserve using deep learning (hCRM-DL) and machine learning (hCRM-ML) models previously developed with human data. We trained a metric to track blood loss volume using features extracted from canine (c) arterial waveforms as an input.

RESULTS
When applied to the 6 dogs, the hCRM-DL model (R2 = 0.38) more poorly fit a linear regression model against mean arterial pressure and had lower area under the receiver operating characteristic (AUROC; 0.60) compared to the hCRM-ML model (R2 = 0.61; AUROC, 0.73). Conversely, the arterial waveform analysis for canine blood loss volume metric (cBLVM) predicted blood loss in dogs experiencing controlled hemorrhagic shock more accurately (R2 = 0.74). The cBLVM model for predicting blood loss volume had the highest AUROC score (0.81) and was the earliest indicator of hemorrhage onset.

CONCLUSIONS
The hCRM-ML and hCRM-DL algorithms did not translate to accurate prediction of the onset of hemorrhagic shock in dogs. However, the arterial waveform feature analysis–derived cBLVM might provide decision support to resuscitate dogs with hemorrhagic shock.

CLINICAL RELEVANCE
Canine BLVM may be useful in estimating blood loss in dogs, which can guide resuscitation strategies for these patients.
Does current forest management affect the ecologic and esthetic assets of the landscape in Poland?
Authors: Słupska Alicja , Zawadzka Anna 
Published: December 2024

Abstract
Forestry in Poland finds itself currently at a crossroads. On the one hand, there is powerful social pressure and concern for sustainable development and landscape assets of forests, while on the other hand, the output function is still important. Forest complexes are a crucial element contributing to the esthetic value of landscapes.
The esthetic and landscape assets of forests at a regional or local level are determined by numerous elements. Examples of measures at the regional level are afforestation programs, while at the local level, one of the most important factors influencing the landscape is the extent of clear-cut areas or the increase in the proportion/use of natural regeneration.
Forest management must take into account the multifaceted role of forests, in which the landscape function is extremely important. Allowing for a variety of ecosystem services that forests supply can contribute to minimizing the risk of potential conflicts whilst maximizing the benefits derived from forest ecosystems by different stakeholder groups. The aim of this paper is to present the results of a literature review relating to the impact of forest management (with its tools) on ecologic and esthetic landscape values at both regional and local levels.
Innovation and adaptation in public–private partnerships in the military domain under broad-spectrum influencing: Towards a competence-based strategic approach
Authors: Häyhtiö Markus , Eklund Amanda , Palokangas Marko 
Published: December 2024

Abstract
The purpose of this research is to conduct two instrumental case studies, one from Finland and the other from Israel. These case studies explain ‘why’ and ‘how’ clear and significant differences exist between these two nations in the area of military innovation and adaptation. Research strategy is not to conduct a comparative case study, but results make it possible to find and evaluate operating methods suitable for building and safeguarding Finnish society in cooperation between private and public actors. The operating methods being studied focus on the early stages in the life cycle of developing military capability. This study utilises the inductive approach, in which data guide the research process. As the research progresses, new information is built on top of the acquired data, and the overall picture of the topic is constructed in an iterative manner. Contribution of the research are propositions that the Finnish Defence Forces would benefit from a competence-based strategic approach to partially replace the resource-based approach. A separate sub-strategy with its foundation in competence-based strategy is proposed for innovation activities. Results indicate that the excellence-based approach chosen by Israel that emerged in the case study and literature review has specifically produced results in the area of developing innovation activities.
First isolation of Aerococcus viridans from clinical specimens collected on a pig farm in Poland
Authors: Cybulski Piotr , Kondratiuk Radosław , Spiekermeier Ines , Woźniakowski Grzegorz 
Published: December 2024

Abstract

Introduction
Successful retrieval of Aerococcus viridans from porcine clinical specimens has been rarely described, and data has only been obtained from a few swine-producing countries. Therefore, the aim of this study was the isolation of A. viridans recovered from a specimen originating from a commercial pig farm located in Poland.

Material and Methods
Seven dead 12-week-old pigs weighing 24–26 kg with joint swelling of the hind legs were selected on a modern farrow-to-nursery farm in Poland in October 2023. The research material was joint swabs from one affected limb amputated through the proximal part of the femur. Bacteria were isolated using matrix-assisted laser desorption/ionisation–time-of-flight mass spectrometry. Antimicrobial susceptibility testing of isolates of Staphylococcus aureus, A. viridans and Trueperella pyogenes was performed by disc diffusion and also by minimal inhibitory concentration evaluation in the case of A. viridans. Two pooled samples were screened by PCR for Streptococcus suis, Actinobacillus pleuropneumoniae, Actinobacillus suis, Mycoplasma hyorhinis, M. hyosynoviae and Glaesserella parasuis.

Results
Five samples were positive for bacteria by culture and five isolates were recovered. Staphylococcus aureus was identified in three samples and T. pyogenes and A. viridans in one each. Pooled samples were G. parasuis-, M. hyorhinis-, M. hyosynoviae-, Actinobacillus pleuropneumoniae-, Actinobacillus suis- and S. suis-negative in the PCR. The A. viridans isolated was susceptible to beta-lactams and gentamicin. Ten representative nucleotide contigs from the 500 obtained showed similarity as high as 97.5% to GenBank reference strains.

Conclusion
To the best of our knowledge, this is the first identification of A. viridans in clinically affected Polish pigs. It elevates the importance of uncommon pathogens, including A. viridans, in the development of lameness in pigs. This research emphasises the role of modern diagnostic tools for accurate identification of swine pathogens. Further research would prove beneficial to elucidate the mechanisms of A. viridans infection, its prevalence, pathogenicity and virulence factors.
Percutaneous Transulnar Arterial Approach for Coronary Interventions
Authors: Kaul Neelam , Kaul Suresh 
Published: December 2024

Objectives:
Coronary diagnostics and interventions have come a long way. For decades the femoral artery has been the access of choice , until radial artery was found to be a viable alternative for coronary and non coronary interventions. We present here our experiences and an analytical review of our transulnar journey, spanning nearly a decade of inhibitions and tentativeness of using it as an alternative , to an upfront route of choice based on arterial dominance.

Materials and Methods:
We did a retrospective analysis based on interventions done through the transulnar route between Jan 2015 and Dec 2023. Both the operators in the study were experts in transradial procedures with an experience of more than 5000 each radial procedures.

Results:
Arterial dominance was assessed by palpation , and was defined as the more intensely palpable pulse at the wrist. Ulnar dominance was seen in 57.6 percent of the cases. Spasm was encountered in the ulnar artery in just a single case, and 4 cases (2.6%) had loops and tortuosities. The mean fluoroscopy time for coronary angiography was 1.5 mins.

Conclusion:
Transulnar route is a safe and effective alternative to radial approach in coronary diagnostic and interventional procedures. The principle of arterial dominance at the wrist is a good way for selection of access routes.