bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synchronous bilateral testicular cancer with discordant histopathology occurring in a 20-year-old patient: A case report and review of the literature
Authors: Symeonidis Evangelos N , Tsifountoudis Ioannis , Anastasiadis Anastasios , Mutomba Wilbert F , Kotakidou Rodoula , Hatzichristou Dimitrios , Dimitriadis Fotios 
Published: July 2021

Introduction: Bilateral testicular tumors are very rare, accounting for 1%–5% of all testicular germ-cell tumors (TGCTs). The vast majority of primary bilateral TGCTs are metachronous, with synchronous tumors comprising approximately 0.5%–1% of all cases. Those occurring synchronously share mostly the same histological pattern, predominantly seminoma, with synchronous bilateral TGCTs (SBTGCTs) with discordant subtypes being extremely rare. Case presentation: We present the case of a 20-year-old male complaining of a palpable painless right testicular mass incidentally noticed during sexual intercourse. Ultrasonography (US) and magnetic resonance imaging (MRI) of the scrotum demonstrated bilateral testicular lesions, while staging with contrast-enhanced computed tomography (CT) exhibited normal findings. Right radical orchiectomy and left testis-sparing surgery (TSS) with concomitant onco-testicular sperm extraction (onco-TESE) were initially performed. Histology of the right testis revealed a mixed germ-cell tumor, consisting of seminoma and embryonal carcinoma, while that from the left testis disclosed embryonal carcinoma and intratubular germ-cell neoplasia unclassified (IGCNU) infiltrating the surgical margins. Hence, left orchiectomy was subsequently scheduled with histology unveiling IGCNU in the greatest part of the remaining testicular parenchyma. Following adjuvant chemotherapy, with bleomycin, etoposide, and cisplatin (BEP), the patient received testosterone replacement therapy and remained free of recurrence at an 18-month follow-up. Conclusion: This case highlights both the rarity of a bilateral testicular tumor’s synchronous appearance and its extremely infrequent discordant histopathology. A comprehensive review of the major series of SBTGCTs with discordant histology cited in the literature is additionally presented.
Credit Guidance for a Desired Economy: An Original Institutional Economics Critique of Financialization
Authors: McDonagh Naoise 
Published: July 2021

Financialization describes the turn to speculative asset trading that has become increasingly central to economic life in recent decades. Critics argue this has occurred at the expense of the “real economy,” referring to production and trade. Critics further argue that finance’s normal role is to serve the needs of the productive sector. Financialization, which diverts capital from production to speculation, is viewed as a deviant form of capitalist development. Drawing on original institutionalist insights, this article argues that such a juxtaposition of the so-called real economy versus deviant financialization is misleading. Financial speculation is a logical outcome of capitalism’s actual real economy—capital accumulation. Firms within a capitalist economy must continually engage profit-seeking practices, which in turn produces psychological habituation in agents. The latter makes profit-seeking, not production-seeking, the psychological foundation of capitalist agency, such that all legal profit-making activity is an instance of capitalism’s real economy. Prioritizing productive investment is a desired economy, an outcome that requires regulatory intervention. This paper proposes that credit guidance is a regulatory solution to financialization, one that can increase economic welfare. JEL Classification: O38, D91, H11, P10
Matrices, internal groups, and the psychic apparatus. Response to article by Clarisse Vollon and Guy Gimenez ‘A “complementarist” approach to the group as matrix and as psychic apparatus’
Authors: Tubert-Oklander Juan 
Published: July 2021

There is usually more than one theoretical view of a hypercomplex situation, which may be cognitively complementary, but they bring about different results when used to orient our practice, on account of their underlying assumptions, values, and intentions. The authors compare two approaches to work with groups: Foulkes’s group analysis and Kaës’s psychoanalytic approach to groups, exploring their coincidences and differences, through their respective concepts of the matrix and the group psychic apparatus. Psychoanalysis starts from the assumption of an isolated individual subject, and then constructs the additional dimension of relations and collective life. Group analysis takes as its starting point the assumption of the primary and essential relational and social nature of the human being, and the subject is a secondary construction that emerges from the initial participatory existence. The concept of the internal group in Kaës is strictly intrapsychic and abstract, while in Pichon-Rivière it is experiential and introjective. Psychoanalysis and group analysis are based on two different conceptions of human existence, and this is clearly shown by the authors’ clinical vignette. Studies like this contribute to a better understanding among the various traditions and schools of analytic work with groups.
A description of the clinical course of severe benzonatate poisonings reported in the literature and to NPDS: A systematic review supplemented with NPDS cases
Authors: Minhaj FS , Leonard JB 
Published: July 2021

Background: Benzonatate is a commonly prescribed medication that can be lethal in acute overdose of a small number of capsules. Objective: This was a systematic review to describe the course of severe poisoning and deaths from benzonatate supplemented with the National Poison Data System (NPDS) fatalities module. Methods: The NPDS was queried from 2000 to 2018 for benzonatate fatalities. Pubmed, Cochrane, Embase, and Google Scholar were searched for combinations of benzonatate and “poisoning,” “overdose,” and “toxicity.” References of relevant articles were searched for additional publications. Articles were included if they described the clinical course of at least one patient suffering from benzonatate poisoning and available in English. Dual independent review and extraction were performed. Results: Seventeen cases from NPDS and 19 published reports met the inclusion criteria resulting in 36 cases, mostly (28/36) self-harm ingestions. Most patients were young [17 (11–29), median (IQR)] and female (22). Onset of toxicity was rapid at <5 min (9). Most common symptoms included cardiac arrest (29), seizures (24), and dysrhythmias (24). Treatments included intubation (26), cardiopulmonary resuscitation (28), vasopressors (20) and others. Return of spontaneous circulation was achieved in 23/28 patients, but most had significant neurologic deficits or other end organ damage and 5 survived with a good neurologic outcome. Conclusion and relevance: Overdose ingestions of benzonatate can cause significant toxicity with a rapid onset. Interventions performed were generally supportive in nature. Duration of directly toxic effects is short, but dramatic with neurologic devastation and resuscitated patients often still have a poor outcome.
Evaluation of retinal inflammatory biomarkers after intravitreal steroid implant and Ranibizumab injection in diabetic macular edema
Authors: Muftuoglu Ilkay Kilic , Tokuc Ecem Onder , Sümer Fatma , Karabas V Levent 
Published: July 2021

Purpose: To compare the efficacy of intravitreal (IV) ranibizumab (IVR) injection with IV dexamethasone implant (IVDEX) in treatment naive diabetic macular edema (DME) patients with inflammatory component. Materials and methods: Treatment naive DME eyes with subfoveal neurosensorial detachment (SND) and hyperreflective spots (HRS) were treated either three loading doses of IVR (18 eyes) or one dose of IVDEX (19 eyes). Central macular thickness (CMT), height of SND, the number of HRSs scattered on the individual retinal layers and photoreceptor integrity were assessed using spectral domain- optical coherence tomography scans over 3-months follow-up. Results: The mean change in best-corrected visual acuity (BCVA) was −0.11 ± 0.08 logMAR in IVDEX group and −0.04 ± 0.06 logMAR in IVR group at 1-month ( p = 0.011). IVDEX group showed statistically significant more increase in BCVA compared to those receiving IVR injections at 2-months ( p = 0.004) and 3-months ( p = 0.017) visits. Compared to baseline, the number of total HRSs and the number of HRSs at each individual inner retinal layer significantly decreased in both groups at all follow-up visits. However, IVDEX group showed more decrease in the total number of HRSs at 2- and 3-months ( p < 0.001 at 2-months, and p = 0.006 at 3-months) and in the mean number of HRSs located at inner nuclear layer–outer plexiform layer level ( p = 0.016 at 1-month, p < 0.001 at 2-months, and p < 0.001 at 3-months). After treatment, the number of HRSs on the outer nuclear layer showed some non-significant increase in both groups. Conclusion: HRSs tended to migrate from inner retina to the outer retina in DME eyes by treatment. Dexamethasone seemed to be more effective option in such cases with inflammatory component.
Pre-emptive or reactive treatment, angioplasty or stent-graft? The outcome for interventions for venous stenosis in early-cannulation arteriovenous grafts
Authors: Kingsmore David B , Stevenson Karen S , Thomson Peter C , Kasthuri Ram , Knight Stephen , Jackson Andrew , Hussey Keith , Richarz Sabine , Isaak Andrej 
Published: July 2021

Background: Early-cannulation arteriovenous grafts (ecAVG) have good initial patency, but frequent episodes of reintervention for venous stenosis (VS) and thrombosis limit their use. Stent grafts (SG) have shown promise in reducing re-interventions and improving functional patency for dysfunctional ecAVG and recurrent VS. There is little data on the impact of stent grafts as the first elective procedure for VS. The aim of this study was to determine firstly, if treating VS whilst asymptomatic has a better outcome than treating after presentation with thrombosis; and secondly, to determine the best initial treatment for asymptomatic VS: SG or angioplasty. Methods: A retrospective study was performed of 259 ecAVG with a sutured anastomosis. The case-mix and outcomes of 153 who presented with VS was analysed by presentation (elective at surveillance or emergency following thrombosis), and then for only elective patients, by treatment (SG vs angioplasty). Results: There was no significant difference in case-mix and time to presentation by mode of presentation (100 elective and 53 with thrombosis) other than a higher rate of pro-thrombotic disorders in thrombosed ecAVG. Thrombosed ecAVG had poorer outcomes with increased re-intervention rates and thrombosis in the following year, and reduced long-term functional patency. In patients presenting electively, primary SG rather than angioplasty led to significantly reduced thrombosis rates, a longer time to re-intervention in the following year, and superior long-term functional patency. The use of SG was the same in both groups. Both the mode of presentation and the type of intervention performed were independently predictive of a poorer subsequent functional patency. Conclusions: Primary elective stent-grafting may be the optimal strategy to reducing maintenance costs with ecAVG.
Differences between adolescents in secure residential care and non-residential educational facilities
Authors: Pronk Sanne , Germie Van den Berg , Kuiper Chris , Popma Arne , Geert Jan Stams , Mulder Eva 
Published: July 2021

Summary In this cross-sectional study, we examined differences between 351 adolescents allocated to secure residential youth care and the non-residential alternative educational facility School2Care (12–18 years old, 63% boys). Data were collected by means of the official school registration system and standardized questionnaires. Findings Results showed that adolescents in both settings had severe problems. Emergency situations, problems in daily functioning in all life domains, and previous out-of-home placements were found to be associated with allocation to secure residential youth care instead of non-residential alternative education. These three factors may be considered risk factors for secure residential placement of adolescents with complex needs. Applications This study provides input for the prevention of secure residential youth care, because the two dynamic (changeable) risk factors for residential out-of-home placement (i.e., emergency situations and adolescent’s daily life functioning) should be considered as intervention targets in non-residential care, while static factors (i.e., history of out-of-home placement) can be used to improve risk assessment of residential out-of-home placement, with higher risk requiring more intensive treatment according to the risk-need-responsivity model for effective mandated treatment.
Call the Rezadora: Aiding Latino Families at the End of Life
Authors: Larson Kim L. , Jewell Graziella D. , Maldonado Maria Fernanda , Braxton Morgan E. , Johnson Lee Ann 
Published: July 2021

Introduction: The rezadora, a lay spiritual leader, provides support to Latino families as they provide end-of-life (EOL) care for loved ones. The purpose of this study was to learn about the work of the rezadora in Guatemala as a resource for Latinos with serious illness in the United States. Methods: An ethnographic exploratory case study was conducted during summer 2018 in rural Guatemala. We interviewed three rezadoras who resided in two villages. The study yielded two cases, the single case and the paired case, which allowed for a holistic view of how the rezadora serves the community. Results: Content and thematic analysis led to two themes: Essence of being called and Power of prayerful song. Essence of being called was represented by the prominence of the rezadora and their perpetual faith work. Power of prayerful song was characterized through the mission, customs, and the presence of the rezadora. A good death was aided by the rezadora in this context. Conclusions: As the Latino population ages in place, the need for palliative and EOL care services will increase. Lay spiritual leaders could enhance the palliative care teams in these communities and improve the quality of life for Latinos with serious illness.
Current Status Regarding the Safety of Inpatient Versus Outpatient Total Shoulder Arthroplasty: A Systematic Review
Authors: Puzzitiello Richard N. , Moverman Michael A. , Pagani Nicholas R. , Menendez Mariano E. , Salzler Matthew J. 
Published: July 2021

Background: Surgeons have begun to transition total shoulder arthroplasty (TSA) to the outpatient setting in order to contain costs and reallocate resources. Purpose: The purpose of this systematic review was to evaluate the safety and cost of outpatient TSA by assessing associated complication rates, clinical outcomes, and total treatment charges. Methods: The MEDLINE, Embase, and Cochrane Library online databases were queried in March 2020 for studies on outpatient shoulder arthroplasty. Inclusion criteria were (1) a study population undergoing TSA, (2) discharge on the day of surgery, and (3) inclusion of at least 1 reported outcome. Results: Of 20 studies identified that met inclusion criteria, 14 were comparative studies involving an inpatient control group, 2 of which were matched by age and comorbidities. The remaining studies used control groups consisting of inpatient TSAs who were older or more medically infirm according to American Society of Anesthesiologists (ASA) or Charlson Comorbidity Index (CCI) scores. The combined average age of the outpatient and inpatient groups was 66.5 and 70.1 years, respectively. Patients who underwent outpatient TSA had similar rates of readmissions, emergency department visits, and perioperative complications in comparison to inpatients. Patients also reported comparably high levels of satisfaction with outpatient procedures. Four economic analyses demonstrated substantial cost savings with outpatient TSA in comparison to inpatient surgery. Conclusion: In carefully selected patients, outpatient TSA appears to be equally safe but less resource intensive than inpatient arthroplasty. Nonetheless, there remains a need for larger prospective studies to decisively characterize the relative safety of outpatient TSA among patients with similar baseline health.
Efficacy of dural venous sinus stenting in treating idiopathic intracranial hypertension with acute vision loss
Authors: Zehri Aqib H , Lee Katriel E , Kartchner Jeff , Arnel Madison , Martin Timothy , Wolfe Stacey Q , Fargen Kyle M 
Published: July 2021

Introduction Dural venous sinus stenting (VSS) is an effective, durable treatment for patients with idiopathic intracranial hypertension (IIH) due to underlying venous sinus stenosis. However, the use of venous sinus stenting to treat IIH with acute vision loss has rarely been described. Methods A retrospective chart analysis identified patients who received VSS for fulminant IIH, defined as acute (< 8 weeks) visual field loss to within the central 5° and/or a decrease in visual acuity to less than or equal to 20/50 in either eye in the presence of papilledema. Results Ten patients were identified with average patient age of 31.0 years, and all except one were female. Mean body mass index was 41.2 kg/m2. All patients presented with vision loss and some with headache and tinnitus. The average trans-stenotic gradient pre-stenting was 28.7 mmHg (range 9–62 mmHg). All patients had diminished or resolved venous gradients immediately following the procedure. At mean follow-up of 60.5 weeks, 100% had improvements in papilledema, 80.0% had subjective vision improvement, 55.6% had headache improvement and 87.5% had tinnitus improvement. 90.0% had stable or improved visual acuity in both eyes with a mean post-stenting Snellen acuity of 20/30 and an average gain of 3 lines Snellen acuity post-stenting (95% confidence intervals 0.1185–0.4286, p = 0.0018). Two patients (20.0%) required further surgical treatment (cerebrospinal shunting and/or stenting) after their first stenting procedure. Conclusions This series suggests that VSS is feasible in patients presenting with IIH and acute vision loss with a fairly low complication rate and satisfactory clinical outcomes.
Window dressing in the Active Share scores in publicly reported portfolios
Authors: Andreu Laura , Forner Carlos , Sarto José Luis 
Published: July 2021

Using a unique database that includes publicly disclosed fund holdings at the end of the quarter as well as the holdings in all non-publicly disclosed months, we found that some funds could alter their portfolios in publicly disclosed months to artificially increase their Active Share scores and consequently appear more active and take advantage of the positive relationship between Active Share and money flows. We show how, consistent with non-informed trades, these funds erode their future performance. However, these funds reach their objective of increasing future money flows. Moreover, we find that window-dresser funds can be identified by controlling the level of tracking error. The funds with high Active Share scores and low tracking errors have the highest levels of Active Share window dressing and the worst future returns. However, compared with less active funds, they are able to capture higher money flows. JEL CLASSIFICATION G23; G11
Repair of a Complete Radial Tear of the Lateral Meniscus
Authors: Ignozzi Anthony J. , Anderson Greg , Diduch David R. 
Published: July 2021

Background: Recognizing and repairing a lateral meniscus complete radial tear is critical, as this tear pattern makes the meniscus nonfunctional for load sharing of axial forces, and the convex shape of the lateral tibial plateau increases contact pressure. Indications: The diagnosis of a lateral meniscus complete radial tear was supported by joint effusion, lateral joint line tenderness, positive McMurray test, and magnetic resonance imaging findings. Arthroscopy confirmed the complete radial tear. Technique Description: During the procedure, a self-capturing suture passer was used to pass a size 0 high-strength suture through the meniscus. To start the repair, the free ends of the suture were passed from top to bottom on both sides of the tear. These free ends were then crossed on the bottom of the meniscus to create an X configuration and passed from the bottom to top slightly further back from the first suture passes. A spinal needle and a chia were used from outside-in to create a side-to-side suture across the tear to reinforce the repair, and a knot was then tied on the outer capsule. The chia was used once again to shuttle the size 0 sutures to the exterior portion of the knee and the knots were tied on top of the capsule. Results: Postoperatively, patients are 25% weightbearing with a 0° to 90° range of motion restriction for 6 weeks, with no deep squatting for 3 months. With an isolated radial tear repair, the patient can expect to return to sport by 5 months. Radial tear repair outcomes demonstrate reduced lateral meniscus extrusion, complete meniscus healing in 86.4% of patients, and significantly improved International Knee Documentation Committee, Lysholm, and Tegner scores. Discussion/Conclusion: Repairing a complete radial tear of the lateral meniscus restores the function of the meniscus. This surgical technique provides a high rate of complete meniscus healing and excellent patient satisfaction.
Reducing private car demand, fact or fiction? A study mapping changes in accessibility to grocery stores in Norway
Authors: Rokseth Lillian Sve , Heinen Eva , Hauglin Espen Aukrust , Nordström Tobias , Manum Bendik 
Published: July 2021

Abstract
Background
Travel surveys show that the amount of private car driving in Norway has increased significantly since the mid-1980s. Private car driving has for a long time been the main mode of transport for retail and service trips, and grocery shopping trips represent over 60% of the retail and service travels. Despite the growing number of studies addressing accessibility to daily destinations, to the best of the authors’ knowledge there are no studies examining these issues over time.

Methods
This paper aims to investigate changes in accessibility to grocery stores over time and use two counties in Norway as examples. Based on GIS data at a detailed level, distances from dwellings to nearest grocery store has been examined.

Findings
The results from the spatial analyses reveal significant changes from 1980 to 2019: The share of the population living within 500-m from a grocery store has decreased from 55% to 34% in one of the counties examined and from 36% to 19% in the other. This indicates that the share of people living within walking distance to a local grocery store has nearly halved. With such changes in accessibility to grocery stores, increased car driving for grocery shopping should not come as a surprise. Contrary to the frequent statements about sustainable urban development and active transportation, it seems that Norway still is developing as a country that in the future will be more and not less dependent on private cars.
Pneumonia caused by Pseudomonas fluorescens: a case report
Authors: Liu Xiao , Xiang Lei , Yin Yunhong , Li Hao , Ma Dedong , Qu Yiqing 
Published: July 2021

Abstract
Background
Pseudomonas fluorescens (P. fluorescens) has been detected in respiratory samples from patients. However, no previous reports have been published about these P. fluorescens cultures from lung tissues.

Case presentation
Here, we report a case of pneumonia caused by P. fluorescens. P. fluorescens was identified from lung biopsy specimens for the first time in this case. According to the antibiotic susceptibility testing (AST) of P. fluorescens, the patient was given ciprofloxacin treatment. The temperature of the patient then returned to normal. Chest CT examination revealed improvements in pulmonary inflammation.

Conclusions
These findings suggest that the patients with pneumonia caused by P. fluorescens should be treated in a timely manner according to the AST results.