bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metastatic breast tumors from extramammary malignancies: a case series
Authors: Semba Ryoko , Horimoto Yoshiya , Arakawa Atsushi , Saito Mitsue 
Published: June 2021

Abstract
Background
Metastatic breast tumors from extramammary malignancies are quite rare. Characteristics of such tumors are unclear due to small number of reported cases. During 2012–2019, approximately 3,500 malignant breast tumors were diagnosed with needle biopsy at our hospital and we experienced three cases (0.09%) of metastatic extramammary malignancies. We herein report these cases focused on imaging and pathological findings.

Case presentation
The first case was a 59-year-old woman who underwent curative surgery for thyroid cancer. After developing lung and ovarian metastases, she visited our department with a mass in her right breast. Ultrasound revealed a 7 mm-sized oval mass. With high depth–width ratio and abundant blood flow, primary breast cancer was suspected. Core needle biopsy revealed atypical cells with nuclear grooves proliferating in papillary formation. With immunohistochemical examination, her final diagnosis was metastatic thyroid cancer. The second case was a 74-year-old woman with metastatic spinal tumors and referred to our department for searching primary tumor. She was diagnosed with gastric cancer at the age of 41. Ultrasound revealed a hypoechoic area including cysts and the internal echo level was uneven. Contrast-enhanced magnetic resonance imaging showed a non-mass lesion with heterogeneous internal enhancement pattern, suggesting ductal carcinoma in situ. Core needle biopsy showed alveolar lesion with predominant signet cell-like morphology. We histologically diagnosed her disease as metastatic gastric cancer. The last case was 33-year woman with Stage IV clear cell sarcoma of the left foot. She came to our department after she felt a lump on her right breast. Ultrasound revealed a 45 mm-sized mass. Her disease was confirmed as metastatic clear cell sarcoma by needle biopsy.

Conclusions
Imaging suggested malignancies, but it was difficult to distinguish them from primary breast cancer. Our cases indicate that metastatic tumors to the breast might have imaging patterns specific to primary organs, although more cases should be accumulated to establish such patterns on imaging. The first two cases shared some similar pathological findings with breast cancer, but also had some histological characteristics of the primary tumors. Hence, it was possible to diagnose these cases as metastatic tumors with careful observation.
Ethnobotanical survey of medicinal plant species used by communities around Mabira and Mpanga Central Forest Reserves, Uganda
Authors: Asiimwe Savina , Namukobe Jane , Byamukama Robert , Imalingat Betty 
Published: June 2021

Abstract
Background
Medicinal plants form an integral part of many health care systems in Uganda. This study aimed at documenting the therapeutic importance of plant species used in primary health care among communities living adjacent to Mabira and Mpanga forest reserves in Central Uganda.

Methods
An ethnobotanical study was conducted between April and June 2018 in 7 villages adjacent to Mpanga and 6 villages adjacent to Mabira central forest reserves. Information was obtained from 28 respondents identified using snowball and purposive sampling techniques and interviewed using semi-structured questionnaires. Descriptive statistics were used to present the data. The quantitative analysis of data was done using fidelity level, informant consensus factor, and percent respondent knowledge indices.

Results
A total of 136 medicinal plants were recorded. The plant species classified into 55 families were grouped under 14 medical categories with the highest number of plant species being used for digestive disorders (44%), followed by respiratory (38%) and dermatological disorders (36%). Hoslundia opposita Vahl was mentioned by 71% of the respondents for treating 22 disease conditions. Plant Family Fabaceae was the most represented with 16 species. Informant consensus agreement was high (0.7) for respiratory disorders. The fidelity level was 100% for Bidens pilosa L. and Callistemon citrinus Skeels for treating wounds and cough, respectively. Plant remedies were mainly prepared by decoction (31%) and administered orally (36%). A large number of plants (61%) were harvested from wild habitats. Herbs (50%) and leaves (50%) contributed the highest percentage of plant biological forms and parts used in remedy preparation.

Conclusion
This study recorded plant species with the potential to treat a wide range of illnesses. This is reflected in the high diversity of the recorded species used for medicinal purposes. Pharmacological studies on the plants with high percentage use values and fidelity levels are needed to validate their uses in the management of the said therapeutic applications. Further research on the isolation and characterization of the plant active compounds could lead to the discovery of new potential drugs.
Serum BDNF and suicidal ideation in drug-naïve and drug-treated MDD patients: a case–control study
Authors: Yousef Amira Mohamed , El-Deen Ghada Mohamed Salah , Ibrahim Abdallah Saad , Mohamed Amany Elshabrawy 
Published: June 2021

Abstract
Background
Disturbances in structural and synaptic plasticity have been linked to depression and suicidal ideation. One of the major neurotrophic factors, the brain-derived neurotrophic factor (BDNF), is involved in the maintenance and survival of neurons and synaptic plasticity. This case–control study assesses the serum BDNF and suicidal ideation among drug-naïve and drug-treated MDD patients attending university hospitals and comparing them to healthy control. A simple random sample of 57 MDD patients and 57 age- and sex-comparable controls were enrolled. The researchers conducted a semi-structured interview to collect the demographic characteristics and disease history. Structured Clinical Interview for DSM-5 (SCID-5), Hamilton Depression Rating Scale (HDRS), and Beck Scale for Suicidal Ideation (BSS) were applied to the participants. Blood samples were collected to measure plasma BDNF level.

Results
The MDD group had lower BDNF than the control group. Within the MDD group, drug-naïve patients had significantly lower BDNF than drug-treated patients. Female patients had lower BDNF than male patients. Positive family history of MDD was associated with low BDNF. Severe and moderate cases had lower BDNF than mild cases. High BSS (≥24) was associated with low BDNF. A statistically significant positive correlation was found between BDNF and age, disease duration, duration of the current episode, and the number of previous episodes.
On the other hand, a statistically significant negative correlation was found between BDNF and age of MDD onset, HDRS, and BSS. A regression model was highly statistically significant in the prediction of HDRS. BDNF and disease duration were negatively correlated with HDRS. On the other hand, depression treatment status was not significantly associated with the HDRS prediction model.

Conclusion
Our findings extend the neurotrophic concept of depression by identifying the decreased BDNF levels as a peripheral biomarker of MDD. Our assessment of depression and suicidal ideation (SI) and their relationship to decreased BDNF levels shed light on the etiopathology of MDD and its related suicidality. They should be more studied to understand better the mechanisms by which they develop. To further explore the effect of BDNF in suicide, larger study sizes and a range of psychiatric diagnoses associated with suicide attempts are required.
What is the diagnostic value of dual-energy computed tomography in patients with clinical diagnosis of gout?
Authors: Lee Jung Sun , Seo Wook Jang 
Published: June 2021

Abstract
Objectives
To investigate the frequency of monosodium urate (MSU) crystal deposits on dual-energy computed tomography (DECT) in patients with clinical diagnosis of gout and the factors associated MSU crystal positivity.

Methods
This study was conducted in patients with clinical diagnosis of gout who underwent DECT. Clinical features were compared between patients with positive and those with negative DECT results. A logistic regression analysis was performed to determine the factors associated with MSU crystal positivity on DECT.

Results
A total of 148 patients with clinical diagnosis of gout were included, and MSU crystal deposition on DECT was observed in 64 patients (43.3%). The patients with positive DECT results were more likely to have renal insufficiency, longer disease duration, and higher serum urate level than those with negative. In the multivariable analysis, first gout attack (odds ratio 0.462; 95% confidence interval 0.229–0.931, p = 0.031) was associated with a less likely MSU crystal deposit-positive DECT result. In the subgroup analysis of patients with first attack, serum urate level > 8 mg/dL was associated with DECT positivity.

Conclusion
Of the patients with clinical diagnosis of gout, those with renal insufficiency, longer disease duration, and high serum urate level were more likely to be positive of gout on DECT. First gout attack was associated with less likely to be positive for MSU crystal on DECT. Thus, performing DECT scan in the selected patients who had characteristics that highly probability of DECT positivity could increase positive predictive value.
Pragmatic approaches to analyzing qualitative data for implementation science: an introduction
Authors: Ramanadhan Shoba , Revette Anna C. , Lee Rebekka M. , Aveling Emma L. 
Published: June 2021

AbstractQualitative methods are critical for implementation science as they generate opportunities to examine complexity and include a diversity of perspectives. However, it can be a challenge to identify the approach that will provide the best fit for achieving a given set of practice-driven research needs. After all, implementation scientists must find a balance between speed and rigor, reliance on existing frameworks and new discoveries, and inclusion of insider and outsider perspectives. This paper offers guidance on taking a pragmatic approach to analysis, which entails strategically combining and borrowing from established qualitative approaches to meet a study’s needs, typically with guidance from an existing framework and with explicit research and practice change goals.Section 1 offers a series of practical questions to guide the development of a pragmatic analytic approach. These include examining the balance of inductive and deductive procedures, the extent to which insider or outsider perspectives are privileged, study requirements related to data and products that support scientific advancement and practice change, and strategic resource allocation. This is followed by an introduction to three approaches commonly considered for implementation science projects: grounded theory, framework analysis, and interpretive phenomenological analysis, highlighting core analytic procedures that may be borrowed for a pragmatic approach. Section 2 addresses opportunities to ensure and communicate rigor of pragmatic analytic approaches. Section 3 provides an illustrative example from the team’s work, highlighting how a pragmatic analytic approach was designed and executed and the diversity of research and practice products generated.As qualitative inquiry gains prominence in implementation science, it is critical to take advantage of qualitative methods’ diversity and flexibility. This paper furthers the conversation regarding how to strategically mix and match components of established qualitative approaches to meet the analytic needs of implementation science projects, thereby supporting high-impact research and improved opportunities to create practice change.
Artificial Intelligence–Assisted Electrocardiography for Early Diagnosis of Thyrotoxic Periodic Paralysis
Authors: Lin Chin , Lin Chin-Sheng , Lee Ding-Jie , Lee Chia-Cheng , Chen Sy-Jou , Tsai Shi-Hung , Kuo Feng-Chih , Chau Tom , Lin Shih-Hua 
Published: June 2021

Abstract

Context
Thyrotoxic periodic paralysis (TPP) characterized by acute weakness, hypokalemia, and hyperthyroidism is a medical emergency with a great challenge in early diagnosis since most TPP patients do not have overt symptoms.

Objective
This work aims to assess artificial intelligence (AI)-assisted electrocardiography (ECG) combined with routine laboratory data in the early diagnosis of TPP.

Methods
A deep learning model (DLM) based on ECG12Net, an 82-layer convolutional neural network, was constructed to detect hypokalemia and hyperthyroidism. The development cohort consisted of 39 ECGs from patients with TPP and 502 ECGs of hypokalemic controls; the validation cohort consisted of 11 ECGs of TPP patients and 36 ECGs of non-TPP individuals with weakness. The AI-ECG–based TPP diagnostic process was then consecutively evaluated in 22 male patients with TTP-like features.

Results
In the validation cohort, the DLM-based ECG system detected all cases of hypokalemia in TPP patients with a mean absolute error of 0.26 mEq/L and diagnosed TPP with an area under curve (AUC) of approximately 80%, surpassing the best standard ECG parameter (AUC = 0.7285 for the QR interval). Combining the AI predictions with the estimated glomerular filtration rate and serum chloride boosted the diagnostic accuracy of the algorithm to AUC 0.986. In the prospective study, the integrated AI and routine laboratory diagnostic system had a PPV of 100% and F-measure of 87.5%.

Conclusion
An AI-ECG system reliably identifies hypokalemia in patients with paralysis, and integration with routine blood chemistries provides valuable decision support for the early diagnosis of TPP.
Exercise to Prevent Anthracycline-Based Cardiotoxicity (EXACT): A Feasibility Study
Authors: Heinze-Milne Stefan D. , Keats Melanie R. , Blanchard Chris , Giacomantonio Nicholas , MacDonald David , Rajda Miroslaw , Younis Tallal , Grandy Scott A. 
Published: June 2021

ABSTRACT
This study aimed to determine the feasibility and potential efficacy of a 12-wk aerobic exercise intervention to mitigate cardiotoxicity in those with breast and hematological cancer receiving anthracycline (AC) treatment. Individuals with breast or hematological cancer that were within 8 wk of initiating AC treatment attended a 12-wk biweekly exercise program. Participants performed aerobic exercise (35%–85% heart rate reserve) on treadmills for 20–45 min per session under the supervision of research staff. Feasibility was evaluated through participant accrual and retention, program adherence, and safety. Aerobic fitness, physical activity, quality of life, and fatigue were assessed along with AC-related serum cytokines (interleukin-1β, interleukin-6, tumor necrosis factor-α, and VEGF) to explore intervention efficacy. Over 12 months, 169 participants (115 breast cancer, 54 hematological) were screened for eligibility. Forty-nine were eligible (28 breast and 21 hematological) and 15 consented (31% accrual). Ten participants completed the study and five withdrew (67% retention). Average exercise session adherence was 73% with no exercise-related adverse events. Cardiopulmonary fitness, physical activity levels, quality of life, fatigue, and serum cytokines did not change over the course of the intervention. Participant accrual and retention, program adherence, and safety statistics in this trial were within the range of similar exercise trials involving individuals with cancer. Study findings showed no postintervention change in measures of quality of life, aerobic fitness, and inflammatory cytokines, suggesting that exercise may mitigate detrimental changes in these parameters while on AC. Overall, the exercise program was feasible, and the results warrant further investigation using a randomized controlled trial approach to investigate whether aerobic exercise therapy can mitigate cardiotoxicity and improve related health and fitness outcomes for individuals receiving AC treatment.
Impact evaluation of soft drink taxes as part of nutrition policies in Gulf Cooperation Council countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates
Authors: Al-Jawaldeh Ayoub , Megally Rania 
Published: June 2021

Background: Prevalence of overweight and obesity is high in the Eastern Mediterranean Region, and there are higher rates in Gulf Cooperation Council (GCC) countries. This had led GCC countries to impose policies that aim to decrease obesity, overweight, and diabetes rates. The objective of this research is to measure the impact of such implemented policy to reduce obesity, namely taxes applied to sugar-sweetened beverages (SSB) in GCC. Methods: The impact of SSB taxes has been measured using a panel data set that covers sales volumes of soft drinks in GCC countries from 2010 to 2020. Results: annual growth in soft drink sales volumes decreased; from 5.44% to 1.33% in Saudi Arabia, 7.37% to 5.93% in United Arab Emirates, and 5.25% to 5.09% in Bahrain from 2016 to 2017. In Qatar, a tax was implemented in 2019, and a reduction in sales volume growth was observed between 2019 and 2020 (3.78% to 2.45%), and in Oman a reduction was observed between 2018 and 2019 (3.60% to 2.99%). Kuwait was the last GCC country to implement taxes in 2020, and the growth in sales volumes decreased from 6.31% to 5.47% from 2019 to 2020. Conclusions: The introduction of health-related taxes on soft drinks has been followed by a drop in the growth rates of sales in GCC countries. This, in turn, can be expected to contribute to a reduction in the prevalence of overweight and obesity, especially when combined with complementary public health policies and interventions. Hence, awareness campaigns should promote the reduction of the consumption sales of SSB and substitute with more consumption of fresh juices. These recommendations align with the recommended priority actions by the World Health Organization Strategy on nutrition for the Eastern Mediterranean Region 2020-2030 adopted by the countries of the Region in October 2019.
A pilot study of red complex and three genera subgingival microbiome in periodontitis subjects with and without diabetes, evaluated by MinION platform
Authors: Bachtiar Boy M. , Theodorea Citra F. , Tahapary Dicky L. , Astrella Cindy , - Natalina , Bachtiar Endang W. 
Published: June 2021

Background: Subgingival niche is one biofilm habitat containing rich microbiota, which plays an active role in maintaining the health of periodontal tissue and determining host response. As such, a study of changing subgingival biofilms is important for understanding the effect of a systemic condition. In this study, we compared the occurrence of six bacteria cohabiting in the subgingival area of periodontitis subjects, with (DP, n = 8) and without (NDP, n = 4) diabetes. Methods: The six genus and species of targeted bacteria were confirmed by 16S rRNA amplicon sequencing on MinION nanopore platform. Descriptive statistic was used to describe the obtained data. Results: We found that the six genus and species of targeted bacteria were detected but in different quantities in either group's periodontal pocket. Our data showed that Tannerella forsythia was the most abundant species in subgingival biofilms of the DP group of the red complex bacteria. In contrast, Aggregatibacter sp., which belongs to the phylum of proteobacteria, was present at a relatively lower level. In contrast, Fusobacterium sp., which belongs to orange complex bacteria, showed relative similarities in subgingival biofilms of both groups tested, while Veillonella sp., were abundant in the DP groups. Conclusions: Our data show that the diversity of classic periodontopathogens increased in the subgingival niche of periodontitis subjects with diabetes. It is the first study in Indonesia to apply MinION-based, full-length 16S rRNA amplicon sequencing in periodontitis patients with and without diabetes.
Use of remdesivir in the treatment of coronavirus disease 2019 (COVID-19) infection among Sudanese patients: a case series
Authors: Yousif Maysoun , Abd El-Raheem Ghada , Mohamed Doaa 
Published: June 2021

Introduction: The coronavirus disease 2019 (COVID-19) pandemic is affecting populations worldwide. Remdesivir is an anti-retroviral agent, with a broad spectrum of usage. Remdesivir usage against COVID-19 had been studied both in vitro and in vivo but is still considered a new treatment for COVID-19 and is not available in all countries. The aim of our study was to report several cases of the use of remdesivir in Sudanese patients and report the adverse events related to the course of treatment. Methods: A case series study was conducted in Imperial Hospital, Khartoum, Sudan reporting two cases who received remdesivir for treating COVID-19 besides other treatments such as steroids and supportive therapy in December 2020. Cases were males aged over 65 years. Cases presentation: Both patients were severe cases of COVID-19 admitted to the intensive care unit (ICU), who received remdesivir for treating COVID-19 infection. Several side effects were reported: the first case had increased liver enzymes and then unexpectedly died from severe resistant hypotension; and hypoalbuminemia was noticed in the second case. Conclusions: Remdesivir use among patients in Sudan must be studied extensively in order to determine the unexpected fatal event and assess the association of this event to remdesivir use, as well as to report the frequency of the side effects.
The Manifestation of Aggressiveness in Students of Technical University
Authors: Nikandrova Natal'ya , Veselkova Elena 
Published: June 2021

This article examines the current student problem of our time – ways to implement intrapersonal conflict in aggressive forms of behavior, mechanisms of manifestation, gender characteristics of aggressiveness in the student environment. The theoretical part of the research defines the main concepts and modern concepts that the authors adhere to. Practical research is based on the identification and study of groups in the University student environment that are most prone to aggression; on the selection in groups of students who are prone to various types of aggression in the form of deviant behavior.
The main tools of the research were methods and techniques: the Express survey developed by the authors; the A. bass-A. darky aggression questionnaire (BD); methods for diagnosing the tendency to deviate behavior (SOP); observation; Spearman's rank correlation coefficient method.
In the course of the study, the following reliable conclusions were obtained. The girls were found to have weak volitional control of the emotional sphere in the manifestation of verbal, physical, indirect aggression, as well as irritability and suspicion. In young men, weakness of volitional control is correlated with irritability, indirect aggression, negativism, and resentment. Delinquent behavior is typical only for young men. Propensity to aggression and violence in the female sample of the risk group is associated with verbal, physical and indirect aggression as a way of detente. Female aggressiveness can manifest itself in a willingness to display negative reactions and an oppositional manner in behavior. In the male sample of the "risk" group, the propensity to aggression and violence have less pronounced correlations with negativism, and the most specific way to solve the situation is physical aggression.
The authors suggest ways to conduct psychological and pedagogical work in higher education with students who have various forms of aggression.