bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment for breast cancer in a patient with erythropoietic protoporphyria and photosensitivity: a case report
Authors: Shimazaki Akiko , Hashimoto Takuma , Kai Masaya , Nakayama Tetsuzo , Yamada Mai , Zaguirre Karen , Tokuda Kentaro , Kubo Makoto , Yamaura Ken , Nakamura Masafumi 
Published: January 2021

Abstract
Background
Erythropoietic protoporphyria (EPP) is a rare disorder of heme synthesis. Patients with EPP mainly show symptoms of photosensitivity, but approximately 20% of EPPs are associated with the liver-related complications. We report a case of breast cancer in a 48-year-old female patient with EPP in whom meticulous perioperative management was required in order to avoid complications resulting from this disease.

Case presentation
The patient was diagnosed with EPP at the age of 33 and had a rich family history of the disease. For right breast cancer initially considered as TisN0M0 (Stage 0), the right mastectomy and sentinel lymph node biopsy were performed, while the final stage was pT1bN0M0, pStage I. In the perioperative period, we limited the drug use and monitored light wavelength measurements. Besides, we covered surgical lights, headlights, and laryngoscope’s light with a special polyimide film that filtered the wavelength of light causing dermal photosensitivity. After the surgery, any emerging complications were closely monitored.

Conclusions
The surgery, internal medicine, anesthesiology, and operation departments undertook all possible measures through close cooperation to ensure a safe surgery for the patient with a rare condition.
Factors Influencing the Association Between Coach and Athlete Rating of Exertion: a Systematic Review and Meta-analysis
Authors: Paul Darren , Read Paul , Farooq Abdulaziz , Jones Luke 
Published: January 2021

Abstract
Background
Subjective monitoring of rate of perceived exertion is common practice in many sports. Typically, the information is used to understand the training load and at times modify forthcoming sessions. Identifying the relationship between the athlete and coach’s interpretation of training would likely further benefit understanding load management. The aim of this systematic review was to evaluate the relationship between coaches’ rating of intended exertion (RIE) and/or rating of observed exertion (ROE) and athletes’ reported rating of perceived exertion (RPE).

Methods
The review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of Medline, Google Scholar, Science Direct, SPORTDiscus, and Web of Science databases. We assessed the correlation between coach-reported RIE and/or ROE and RPE. Assessment for risk of bias was undertaken using the Quality Appraisal for Reliability Studies (QAREL) checklist. Inclusion criteria were (1) male and/or female individuals, (2) individual and/or team sport active participants, and (3) original research article published in the English language.

Results
Data from 19 articles were found to meet the eligibility criteria. A random effect meta-analysis based on 11 studies demonstrated a positive association of player vs. coach rating of RIE (r = 0.62 [95% CI 0.5 to 0.7], p < 0.001). The pooled correlation from 7 studies of player vs. coach rating on ROE was r = 0.64 95% CI (0.5 to 0.7), p < 0.001.

Conclusion
There was a moderate to high association between coach RIE and/or ROE and athlete-reported RPE and this association seems to be influenced by many factors. The suggestions we present in this review are based on imploring practitioners to consider a multi-modal approach and the implications of monitoring when using RPE.

Trial Registration
CRD42020193387
Patients and public are important stakeholders in health technology assessment but the level of involvement is low – a call to action
Authors: Wale Janet L. , Thomas Samuel , Hamerlijnck Dominique , Hollander Ronald 
Published: January 2021

Abstract
Background
Health technology assessment (HTA) agencies have an important role in the evaluation and approval of new technologies. They determine their value within a health system so to promote equitable, quality care with available healthcare resources. Many HTA agencies have some mechanism for involving patients in their processes, but there is great variability and an absence of comprehensive, robust practices for involvement. The accelerating pace of medical innovation creates a need to improve the depth and breadth of patient involvement in the HTA process.

Main body
In this ‘Call to action’, we present ideas from three HTA expert commentaries calling for collaborative learning and to share innovative ideas for changes in HTA. We also draw on examples of HTA agencies creatively pursuing this goal. We propose a ‘Call to action’ for HTA stakeholders to undertake serious dialogue with patient advocates aimed at creating shared goals. HTA agencies can use these goals to ensure meaningful patient involvement at every step of the HTA process. Five elements are explored. In ‘Recognizing the value of shared purpose’, we highlight examples of HTA agencies that have patients working in partnership with medical practitioners and HTA staff. Results include improved processes that instil confidence. ‘Committing to patient involvement as part of HTA culture’ highlights several initiatives aimed at changes in HTA organisational culture to be more inclusive of patients. In ‘Aligning patient and HTA goals’ we cite work in Belgium and New Zealand which places a greater emphasis on quality of life rather than life expectancy and cost-effectiveness. By ‘Integrating patient involvement at every step of the HTA process’ patients can make vital contributions at every stage of the HTA process. We provide two examples of where HTA agencies have successfully involved patients early in the process in order to broaden the scope of evaluations. ‘Developing a common language and working together’ can support transformative dialogue through ‘unified language’.

Conclusion
The authors of this commentary ask that agencies and stakeholders involved in HTA take up this call to work together for visionary and transformative elevation of the voice of patients in HTA worldwide.
Translation and content validity of the Dutch Impact of Vision Impairment questionnaire assessed by Three-Step Test-Interviewing
Authors: Rausch – Koster T. P. , van der Ham A. J. , Terwee C. B. , Verbraak F. D. , van Rens G. H. M. B. , van Nispen R. M. A. 
Published: January 2021

AbstractBackgroundPatients suffering from exsudative retinal diseases may experience severe central vision loss and this might have impact on their daily activities and quality of life. To measure the disabilities these patients may have, the use of the Impact of Vision Impairment Profile questionnaire is recommended. The aim of this study was to translate the original English 28-item Impact of Vision Impairment Profile (IVI) into the Dutch language and evaluate its comprehensibility, comprehensiveness and relevance as evidence of content validity. The translation process was performed using standardized methods. Content validity was assessed by cognitive debriefing using a Three-Step Test-Interview (TSTI) method for participants diagnosed with exudative retinal diseases. Step 1 and 2 focused on assessment of comprehensibility of items, step 3 on comprehensiveness and relevance. Audio-recorded qualitative data was analyzed using Atlas.ti. Data regarding comprehensibility problems was further categorized into item-specific problems and general problems.ResultsFew minor discrepancies in wording were found after translation. After conducting 12 cognitive interviews, data saturation was reached. All participants reported comprehensibility problems resulting from specific items, these were; sentence structure, vocabulary and formulation, influence of conditions or composite items and influence of comorbid disorders. Several general comprehensibility problems resulting from instructions or response categories were detected. The main general comprehensibility problem resulted from the layout of the Dutch-IVI. Most participants considered the included items as relevant and indicated that they covered the problems that occur due to vision impairment.ConclusionsMinor problems in the Dutch translation were detected and adjusted. The layout and instructions of the Dutch-IVI resulted in some comprehensibility problems. The Dutch-IVI appeared to be at risk of being interpreted as a generic patient reported outcome measure, instead of a disease-specific instrument, mainly due to the influence of co-morbidities. Adaptations should improve validity and reliability of the Dutch-IVI, however, cross-cultural comparisons may be at stake.
Endophytic fungi, Beauveria bassiana and Metarhizium anisopliae, confer control of the fall armyworm, Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae), in two tomato varieties
Authors: Mwamburi Lizzy A. 
Published: January 2021

Abstract
Background
The fall armyworm, Spodoptera frugiperda (J. E. Smith) (Lepidoptera: Noctuidae), is an important pest of tomatoes that reduces yield and fruit quality resulting in losses of up to 100%. The pest has developed resistance to chemical insecticides, therefore necessitating alternative control measures. The entomopathogenic fungi (EPF) Beauveria bassiana and Metarhizium anisopliae have been exploited extensively for biological control of the insect pests of economic importance.

Results
The potential of B. bassiana (Bals.) Vuillemin (Hypocreales: Cordycipitaceae) (BbC1) and M. anisopliae (Metchn.) Sorokin (Hypocreales: Clavicipitaceae) (M150) to persist as endophytic EPF in two tomato varieties, Matina and Harzfeuer, which spread within host tissues and protect plants against larval attack of S. frugiperda was evaluated. Tomato seedlings were inoculated by dipping roots in either BbC1 or M150 spore suspensions (108 spores/ ml). The qPCR analyses revealed the presence of both fungi in > 65% of the tested samples. Second-instar larvae of S. frugiperda were introduced onto inoculated plants that revealed the presence of fungal DNA and non-inoculated plants, 14 days after inoculation. Treating tomato plants with the EPF resulted in reducing weights and slowing larval development of Spodoptera. Larvae fed on BbC1 and M150-treated Matina significantly reduced weights than those treated with Harzfeuer tomato plants. The tomato variety Matina conferred enhanced level of resistance to the S. frugiperda larvae, further aggravated by the presence of both fungi through dietary stress resulting in slow development and reduce larval weight.

Conclusion
These results may serve the tomato production systems and the S. frugiperda integrated management programs.
Intra-arterial anaesthetics for pain control in arterial embolisation procedures: a systematic review and meta-analysis
Authors: Shiwani Taha Hanif , Shiwani Hunain 
Published: January 2021

Abstract
Purpose
A systematic review to determine the effectiveness of intra-arterial anaesthetics on post- operative pain and opioid analgesia requirements in arterial embolisation procedures.

Materials and methods
A systematic review of the literature was performed (Embase, PubMed, MEDLINE and the Cochrane Library) from inception to 10th August 2020. Randomised controlled trials (RCTs) and cohort studies that utilised intra-arterial anaesthesia during an embolisation procedure for the purposes of pain control were included. Eligibility was assessed by two investigators independently.

Results
Eight hundred fifty-nine candidate articles were identified, and 9 studies met the inclusion criteria (6 RCTs and 3 retrospective cohort studies). Four studies were of hepatic chemoembolisation and 5 were of uterine artery embolisation.
Five hundred twenty-nine patients were treated in total. All studies used lidocaine as the anaesthetic with doses ranging from 20 to 200 mg, and the anaesthetic was delivered varyingly before, during or after embolisation. Pain intensity was converted to a numeric scale from 0 to 10, and opioid doses were converted to milligram morphine equivalent doses. A random-effects meta-analysis model was used to analyse the results of RCTs, and the results of cohort studies were summarised with a narrative synthesis. The meta-analyses suggested that pain scores were reduced by a mean of 1.02 (95% CI − 2.34 to 0.30; p = 0.13) and opioid doses were reduced by a mean of 7.35 mg (95% CI, − 14.77, 0.06; p = 0.05) in the intervention group however neither finding was statistically significant. No serious adverse events were reported.

Conclusion
Intra-arterial anaesthetic may slightly reduce pain intensity and post-operative opioid consumption following embolisation, however the results are not statistically significant. There is very limited data available on the effect of anaesthetic on length of hospital admission. Whilst no serious adverse events were reported, there are some concerns regarding the effect of lidocaine on the technical success of embolisation procedures that preclude our recommendation for routine use in embolisation procedures.
High quality randomised controlled trials are required to elucidate the dose-response effect of lidocaine on opioid consumption and pain following embolisation, particularly in the first few hours post-operatively, as well as effects on duration of hospital stay.
Susceptibility to the novel coronavirus disease (COVID-19) is associated with ABO and Rh blood groups: a case-control study from Afghanistan
Authors: Saify Khyber , Alborz Mohammad Sarwar , Saadat Mostafa 
Published: January 2021

Abstract
Background
There are preliminary studies about the association between COVID-19 and ABO phenotypes and the results are controversial. There are only two studies which investigated the association of Rh blood groups in addition to ABO with COVID-19; however, in the statistical analysis ABO and Rh blood groups have been considered separately. Therefore, the present case-control study was performed to determine the association of COVID-19 with ABO blood groups considering the Rh blood groups simultaneously. The study was conducted in Kunduz COVID-19 treatment specific center, Spin-Zar Hospital (Kunduz Province, North East Afghanistan). A total of 301 confirmed COVID-19 cases and 1039 healthy blood donors as control group were included in the study.

Results
The Rh− phenotype strongly increased the risk of COVID-19 (OR = 2.97, 95% CI 1.86–3.89, P < 0.001). Although blood group A increased the risk of developing COVID-19, the association did not reach statistical significance. In analysis of the combination phenotypes, the A− blood group remarkably increased the risk of COVID-19 (OR = 7.24, 95% CI 3.62–14.4, P < 0.001). Multivariate analysis revealed that the interaction of Rh and ABO is significant (P < 0.013).

Conclusion
These findings indicate that susceptibility to COVID-19 is strongly associated with A− blood group.
Added value of contrast-enhanced spectral mammography in symptomatic patients with dense breasts
Authors: Mohamed Sara Ahmed Sadek , Moftah Sherine George , Chalabi Nivine Abd El Moneim , Salem Mona Ali Abdel-Wahed 
Published: January 2021

Abstract
Background
Breast cancer is the most common malignancy in females around the world representing 25.1% of all cancers.
The high prevalence and need for early treatment of breast malignancy highlight the importance of early and accurate diagnosis. In order to achieve this target, it is necessary to select the most appropriate modality for investigation.
Early detection of breast cancer by conventional mammography tends to reduce mortality; however, it has a low sensitivity and specificity in young females with dense breasts owing to reduced contrast between a possible tumor and the surrounding breast tissue with superimposition of the glandular tissue obscuring underlying lesions.
Our study included 25 patients with dense breasts presented with different breast symptoms, yet the breast lump was the most common complaint. The aim of our study is to evaluate the supplementary value of contrast-enhanced spectral mammography in the assessment of symptomatic patients with dense breasts.

Results
In our study, the enrolled subjects underwent both contrast-enhanced spectral mammography (CESM) and conventional full-field digital mammography (FFDM). CESM was shown to be better than FFDM in terms of sensitivity, positive predictive value, negative predictive value, and accuracy, measuring 100%, 77.8%, 100%, and 84%, compared to 56%, 75%, 46%, and 60%, respectively, yet both modalities showed low specificity, measuring 63.6% and 66.6% for CESM and FFDM, respectively.
The added value of CESM was assessed in terms of ability to detect and correctly characterize the lesions in correlation to histopathological results where CESM could detect 88% of the lesions included in our study and correctly characterized 84% of the lesions; on the other side, FFDM detected only 20% of the lesions and correctly characterized 60% of the lesions. CESM changed the treatment plan to a more extensive surgery +/− neoadjuvant chemotherapy in 57% out of fourteen cases diagnosed with breast cancer emphasizing the role of CESM in assessing the extent of the disease, multicentricity, and multifocality and consequently tailoring the most appropriate treatment plan suitable for each patient.

Conclusion
Contrast-enhanced spectral mammography is superior to full-field digital mammography in patients with dense breasts with a significant supplementary value in detection, characterization of lesions, and tailoring the appropriate treatment plan.
Hybrid PET/MRI findings in a case of pulmonary and extra-pulmonary tuberculosis associated with motor-neuron disease-like illness—a coincidence or a causation?: a case report
Authors: Peer Sameer , Nagaraj Chandana , Mangalore Sandhya 
Published: January 2021

AbstractBackgroundThe association of tuberculosis and motor neuron disease-like illness has not been described previously. We present a case of co-existent pulmonary and extra-pulmonary tuberculosis in a young man whose clinical presentation was suggestive of a motor neuron disease-like illness and was subsequently diagnosed with tubercular infection. This case provokes our thought as to whether the association between tuberculosis and motor neuron dysfunction was just a co-incidence, given the high prevalence of tuberculosis in our set-up, or does it point towards a possible causative role of infection in motor neuron disease.Case presentationA 31-year-old man presented with progressive thinning of bilateral upper and lower limbs with associated pain and twitching sensation in upper and lower limb muscles. He had a history of loss of appetite and unintentional weight loss. On clinical examination, there was evidence of fasciculations in bilateral quadriceps, bilateral biceps, and paraspinal muscles which was further confirmed with electrophysiology. The work-up for underlying autoimmune, toxic and metabolic aetiology, and paraneoplastic aetiology was found to be negative. CT scan of the chest was suggestive of consolidations in bilateral upper lobes with multiple tree-in-bud nodules in both the lungs. Hybrid 18-Flourine-flourodeoxyglucose positron emission tomography and magnetic resonance imaging (F-18-FDG PET/MRI) imaging was also suggestive of pulmonary and extra-pulmonary tuberculosis. Imaging of the brain revealed atrophy along bilateral motor cortices with reduced tracer uptake. Diagnosis of tubercular infection was confirmed with nucleic acid amplification test and the patient was put on anti-tubercular therapy. On follow-up after 6 months, the patient reported improvement in the symptoms and the muscle power in bilateral upper and lower limbs.ConclusionWe have described a very rare association of pulmonary and extra-pulmonary tuberculosis with motor neuron-like illness. It may be debated that such an association may just be co-incidental; however, given the improvement in the symptoms and signs of the motor neuron disease-like illness on follow-up while the patient was on anti-tubercular therapy, it may point towards a causative relationship between tubercular infection and motor neuron dysfunction. Further epidemiological studies should be sought for in order to reach a conclusive answer.
CT pulmonary angiography in COVID-19 pneumonia: relationship between pulmonary embolism and disease severity
Authors: Yassin Aya , Abdelkader Maryam Ali , Mohammed Rehab M. , Osman Ahmed M. 
Published: January 2021

Abstract
Background
Pulmonary embolism (PE) is one of the known sequels of COVID-19 infection. We aimed to assess the incidence of PE in patients with COVID-19 infection and to evaluate the relationship between the CT severity of the disease and the laboratory indicators. This was a retrospective study conducted on 96 patients with COVID-19 infection proved by positive PCR who underwent CT pulmonary angiography (CTPA) with a calculation of the CT severity of COVID-19 infection. Available patients’ complaint and laboratory data at the time of CTPA were correlated with PE presence and disease severity.

Results
Forty patients (41.7%) showed positive PE with the median time for the incidence of PE which was 12 days after onset of the disease. No significant correlation was found between the incidence of PE and the patients’ age, sex, laboratory results, and the CT severity of COVID-19. A statistically significant relation was found between the incidence of PE and the patients’ desaturation, hemoptysis, and chest pain. A highly significant correlation was found between the incidence of PE and the rising in the D-dimer level as well as the progressive CT findings when compared to the previous one.

Conclusion
CT progression and the rising in D-dimer level are considered the most important parameters suggesting underlying PE in patients with positive COVID-19 infection which is commonly seen during the second week of infection and alert the use of CT pulmonary angiography to exclude or confirm PE. This is may help in improving the management of COVID-19 infection.
Multimodality imaging review of focal renal lesions
Authors: Lyske Jonathan , Mathew Rishi Philip , Hutchinson Christopher , Patel Vimal , Low Gavin 
Published: January 2021

Abstract
Background
Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses.

Main body of the abstract
A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features.

Short conclusion
Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.