bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis and outcomes of wrong site thyroid surgery
Authors: Dionigi Gianlorenzo , Raffaelli Marco , Bellantone Rocco , De Crea Carmela , Ambrosini Carlo Enrico , Miccoli Paolo , Materazzi Gabriele , Ieni Antonio , Caruso Ettore , Zhang Daqi , Dralle Henning 
Published: June 2021

Abstract
Background
In thyroid surgery, wrong-site surgery (WSS) is considered a rare event and seldom reported in the literature.

Case presentation
This report presents 5 WSS cases following thyroid surgery in a 20-year period. We stratified the subtypes of WSS in wrong target, wrong side, wrong procedure and wrong patient. Only planned and elective thyroid surgeries present WSS cases. The interventions were performed in low-volume hospitals, and subsequently, the patients were referred to our centres. Four cases of wrong-target procedures (thymectomies [n = 3] and lymph node excision [n = 1] performed instead of thyroidectomies) and one case of wrong-side procedure were observed in this study. Two wrong target cases resulting additionally in wrong procedure were noted. Wrong patient cases were not detected in the review. Patients experienced benign, malignant, or suspicious pathology and underwent traditional surgery (no endoscopic or robotic surgery). 40% of WSS led to legal action against the surgeon or a monetary settlement.

Conclusion
WSS is also observed in thyroid surgery. Considering that reports regarding the serious complications of WSS are not yet available, these complications should be discussed with the surgical community. Etiologic causes, outcomes, preventive strategies of WSS and expert opinion are presented.
A strangulated internal hernia beneath the left external iliac artery after radical hysterectomy with laparoscopic pelvic lymphadenectomy: a case report and literature review
Authors: Zhang Zhenxing , Hu Gengyuan , Ye Minfeng , Zhang Yu , Tao Feng 
Published: June 2021

Abstract
Background
Ileum obstruction due to internal hernia beneath external iliac artery after pelvic lymph node dissection (PLND) is extremely rare. We reported a case of acute strangulated internal hernia between the left external iliac artery and psoas major as late complication of laparoscopic hysterectomy with pelvic lymphadenectomy.

Case presentation
A 46-year-old woman, who with histories of laparoscopic hysterectomy, bilateral salpingo-oophorectomy and PLND 9 years ago for the cervical malignant tumor, open appendectomy 18 years ago, visited our hospital complaining of aggravated left lower abdominal pain, bloating, nausea and vomiting from few hours ago. Left abdomen distention, tympanitic with rebound tenderness and muscular tension was detected during physical examinations. Accompanying with elevated inflammatory markers and mild intestinal dilatation showed in lab results and contrast-enhanced computed tomography (CT) respectively. After carefully reading the CT images, a small bowel was found between the left external iliac artery (EIA) and the psoas major, combined with the patient's surgical history, we suspected it might be internal hernia. Eventually, the emergency laparoscopic laparotomy confirmed our conjecture, the gap between the iliac vessels and the psoas major was closed with an absorbable suture, the patient was discharged on the fourth postoperative day.

Conclusion
Primary closure of peritoneal fissue maybe an effective measure to potentially prevent internal hernia. The choice of surgical approach for pelvic tumors still needs further exploration but faster diagnosis and immediate laparotomy might promise a better prognosis.
Iranian superwomen's career experiences: a qualitative study
Authors: Nosrati Beigzadeh Maryam , Ghamari Givi Hossein , Rezaei Sharif Ali , Sheykholeslami Ali , Reisy Leila , Hassankhani Hadi 
Published: June 2021

Abstract
Background
Superwoman refers to the identity of a woman who performs several important roles simultaneously and full-time, such as being a wife, mother, and homemaker while holding a job. This study aims to examine the career experiences of Iranian superwomen who maintained their mental health while holding multiple roles.

Methods
Data for this qualitative study were collected via semi-structured interview and analyzed using conventional content analysis. The study participants were 12 multi-role women from different occupations in Tabriz, North West of Iran selected through purposive and theoretical sampling. The women’s mental health status was assessed using Mental Health Continuum-Short Form questionnaire before participating in the research.

Results
The results were classified into three main categories. The first category included Underlying Factors of Job Experience with six subcategories, including Limited job opportunities for women, Educational context (mindset shaped in the parental home), Commitment or freedom in obtaining a job and its continuation, Personality traits, and Non-cognitive skills (emotional intelligence and spiritual intelligence); the second category included the adopted strategies to solve career problems with two subcategories: effective strategies, including the benefits of having a mindset of abundance and having a vision and strategic planning, and ineffective strategies, including the benefits of having a mindset of scarcity; and the third category included Perceived Consequences of employment with two subcategories: psychological consequences and social consequences, with both subcategories including some positive and negative further subcategories. Moreover, a conceptual relationship between the main categories and the subcategories was evident.

Conclusions
The content obtained not only supports the findings about the experiences of multi-role women in cultures outside Iran, but also points to the unique aspects of Iranian superwomen's life experiences and narratives. The findings of this study can help us perceive the real career experiences from the perspective of Iranian professional women with multiple roles.
Final-year medical students’ competence profiles according to the modified requirement tracking questionnaire
Authors: Zelesniack Elena , Oubaid Viktor , Harendza Sigrid 
Published: June 2021

AbstractBackgroundUndergraduate medical education is supposed to equip medical students with basic competences to select any specialty of their choice for postgraduate training. Medical specialties are characterized by a great diversity of their daily work routines and require different sets of competence facets. This study examines the self-assessed competence profiles of final-year undergraduate medical students and their specialty choice for postgraduate training. Students’ profiles, who wish to choose anaesthesiology, internal medicine, or paediatrics, are compared with the physicians’ competence profiles from these three disciplines.MethodsIn this study, 148 volunteer final-year undergraduate medical students completed the modified requirement-tracking (R-Track) questionnaire for self-assessment of their competence profiles. The R-Track questionnaire contains 63 competence facets assigned to six areas of competence: “Mental abilities”, “Sensory abilities”, “Psychomotor & multitasking abilities”, “Social interactive competences”, “Motivation”, and “Personality traits”. The expression of the different competence facets had to be assessed on a 5-point Likert scale (1: “very low” to 5: “very high”). Additionally, socio-demographic data and the participants’ first choice of a medical speciality for postgraduate education were collected. We used analysis of variance (ANOVA) for mean score comparison of subgroups and least significant difference (LSD) tests for post hoc analysis.ResultsThe competence area with the highest rating was “Motivation” (3.70 ± 0.47) while “Psychomotor & multitasking abilities” received the lowest rating (3.34 ± 0.68). Individual facets of competence ranked from “In need of harmony” (4.36 ± 0.72), followed by “Tactfulness” (4.26 ± 0.64), and “Cooperation/Agreeableness” (4.24 ± 0.53) to “Risk orientation” (2.90 ± 0.92), “Mathematical reasoning” (2.87 ± 1.25), and “Sanctioning” (2.26 ± 0.93). The students’ competence profiles showed 100 % congruence with physicians’ competence profiles of the postgraduate specialty of their choice for internal medicine, 33.3 % for paediatrics, and 0 % for anaesthesiology.ConclusionsUndergraduate medical students could define their competence profiles with the modified R-Track questionnaire and compare them with the profile of their desired specialty for postgraduate training to discover possible learning gaps or to detect good specialty matches. A combination of students’ competence self-assessment with an external assessment of students’ facets of competence could provide curricular planners with useful information how to design learning opportunities for specific facets of competence.
Cultural competency and sensitivity in the curriculum for palliative care professionals: a survey in Switzerland
Authors: Weber Orest , Semlali Imane , Gamondi Claudia , Singy Pascal 
Published: June 2021

Abstract
Background
Cultural and linguistic diversity in patients and their relatives represents a challenge for clinical practice in palliative care around the world. Cross-cultural training for palliative care professionals is still scarce, and research can help determine and support the implementation of appropriate training. In Switzerland, health policies address diversity and equity issues, and there is a need for educational research on cross-cultural training in palliative care. The aim of this study was to investigate the clinical challenges faced by Swiss palliative care professionals when working with migrant patients and their relatives. We also documented professionals’ interests in cross-cultural training.

Methods
A web survey of professionals working in specialized palliative care in the French- and Italian-speaking areas of Switzerland investigated clinical challenges with migrant populations and interests in various training opportunities.

Results
A total of 204 individuals responded to the survey, 48.5 % of whom were nurses. The major difficulties they reported were communication impediments associated with patients’ linguistic and/or cultural backgrounds. In relation to educational needs, they expressed a particular interest in communication techniques that would allow them to deal with these issues autonomously. The professionals expressed less interest in training on collaborating with other professionals and examining one’s own stereotypes.

Conclusions
Palliative care professionals’ post-graduate and continuing education must address communication techniques for sensitive palliative and end-of-life topics in cross-cultural contexts. Beginning with their pre-graduate studies, health professionals should assimilate the importance of collaborating with other professionals in complex cross-cultural situations and learn to reflect on their stereotypes and pre-conceptions in clinical practice.
What factors predict physicians' utilization behavior of contrast-enhanced ultrasound? Evidence from the integration of the Theory of Planned Behavior and Technology Acceptance Model using a structural equation modeling approach
Authors: Deng Qingwen , Zheng Yuhang , Lu Junhong , Zeng Zhichao , Liu Wenbin 
Published: June 2021

AbstractBackgroundThe promotion of early diagnosis is undoubtedly effective in reducing the burden of disease. Contrast-enhanced ultrasound (CEUS) is a diagnostic technology for liver cancer, but its implementation faces some challenges. Understanding the influencing factors of CEUS utilization is crucial for its successful implementation. However, such research is rare. The aims of this study were to investigate the status of CEUS utilization and its predictors in China.MethodsThrough multistage random sampling, a cross-sectional study design was conducted among physicians in charge of direct use of CEUS working at liver disease-related departments of sampled health institutions. To access the potential influencing factors of physicians' CEUS utilization, a structured questionnaire was developed based on the theoretical model, which was developed by integration of the Theory of Planned Behavior (TPB) and Technology Acceptance Model (TAM). Structural equation modeling was used to verify the proposed hypotheses, and analyze the relationship and mechanism between the factors.ResultsA total of 309 physicians were enrolled. The mean score of utilization behavior was 2.04 (SD = 1.07), and 37.22% above the mean. The favorable fitting results demonstrated that the integration of TAM and TPB was an acceptable model. SEM results also identified physicians’ intentions to use CEUS was directly associated with utilization behavior (β = 0.287,P < 0.001). Attitude (β = 0.272,P < 0.001), subjective norm (β = 0.172,P = 0.013), perceived behavioral control (β = 0.491,P < 0.001) and perceived usefulness (β = 0.108,P = 0.027) significantly influenced physicians’ intentions. Besides, subjective norm (β = 0.065,P = 0.021), perceived behavioral control (β = 0.141,P = 0.003), and perceived ease of use (β = 0.022,P = 0.033) indirectly affected physicians’ CEUS utilization.ConclusionsThe findings provide a reference for understanding the factors associated with physicians' utilization of CEUS. Additionally, the proposed measures such as building innovative and incentive environment, providing high quality and adequate training, etc., will help promote the utilization of CEUS, thereby increasing the detection rate of liver cancer, and improving the survival rate and the quality of life for liver cancer patients.
Clinical features of bacterial meningitis among hospitalised children in Kenya
Authors: Obiero Christina W. , Mturi Neema , Mwarumba Salim , Ngari Moses , Newton Charles R. , van Hensbroek Michaël Boele , Berkley James A. 
Published: June 2021

AbstractBackgroundDiagnosing bacterial meningitis is essential to optimise the type and duration of antimicrobial therapy to limit mortality and sequelae. In sub-Saharan Africa, many public hospitals lack laboratory capacity, relying on clinical features to empirically treat or not treat meningitis. We investigated whether clinical features of bacterial meningitis identified prior to the introduction of conjugate vaccines still discriminate meningitis in children aged ≥60 days.MethodsWe conducted a retrospective cohort study to validate seven clinical features identified in 2002 (KCH-2002): bulging fontanel, neck stiffness, cyanosis, seizures outside the febrile convulsion age range, focal seizures, impaired consciousness, or fever without malaria parasitaemia and Integrated Management of Childhood Illness (IMCI) signs: neck stiffness, lethargy, impaired consciousness or seizures, and assessed at admission in discriminating bacterial meningitis after the introduction of conjugate vaccines. Children aged ≥60 days hospitalised between 2012 and 2016 at Kilifi County Hospital were included in this analysis. Meningitis was defined as positive cerebrospinal fluid (CSF) culture, organism observed on CSF microscopy, positive CSF antigen test, leukocytes ≥50/μL, or CSF to blood glucose ratio <0.1.ResultsAmong 12,837 admissions, 98 (0.8%) had meningitis. The presence ofKCH-2002signs had a sensitivity of 86% (95% CI 77–92) and specificity of 38% (95% CI 37–38). Exclusion of ‘fever without malaria parasitaemia’ reduced sensitivity to 58% (95% CI 48–68) and increased specificity to 80% (95% CI 79–80). IMCI signs had a sensitivity of 80% (95% CI 70–87) and specificity of 62% (95% CI 61–63).ConclusionsA lower prevalence of bacterial meningitis and less typical signs than in 2002 meant the lower performance ofKCH-2002signs. Clinicians and policymakers should be aware of the number of lumbar punctures (LPs) or empirical treatments needed for each case of meningitis. Establishing basic capacity for CSF analysis is essential to exclude bacterial meningitis in children with potential signs.
Roles of lysine-specific demethylase 1 (LSD1) in homeostasis and diseases
Authors: Kim Dongha , Kim Keun Il , Baek Sung Hee 
Published: June 2021

AbstractLysine-specific demethylase 1 (LSD1) targets mono- or di-methylated histone H3K4 and H3K9 as well as non-histone substrates and functions in the regulation of gene expression as a transcriptional repressor or activator. This enzyme plays a pivotal role in various physiological processes, including development, differentiation, inflammation, thermogenesis, neuronal and cerebral physiology, and the maintenance of stemness in stem cells. LSD1 also participates in pathological processes, including cancer as the most representative disease. It promotes oncogenesis by facilitating the survival of cancer cells and by generating a pro-cancer microenvironment. In this review, we discuss the role of LSD1 in several aspects of cancer, such as hypoxia, epithelial-to-mesenchymal transition, stemness versus differentiation of cancer stem cells, as well as anti-tumor immunity. Additionally, the current understanding of the involvement of LSD1 in various other pathological processes is discussed.
Prevention of re-establishment of malaria
Authors: Schapira Allan , Kondrashin Anatoly 
Published: June 2021

AbstractThe current consensus on prevention of re-establishment of malaria is based on the following principles: (1) Fundamental role of general health services; (2) Surveillance; (3) Vector control; (4) Border actions; (5) Intersectoral collaboration. These principles are critically reviewed, and it is pointed out that alertness of the general health services to suspected malaria (vigilance) needs to be maintained everywhere, while health education is rational only if targeting high-risk sub-populations. It is argued that prevention of re-establishment of malaria transmission should be integrated with prevention of malaria mortality in cases of imported malaria, and that this requires collaboration with entities dealing with travellers’ health and the availability of chemoprophylaxis and other measures for travellers to malaria endemic countries.
Autophagy deficiency exacerbates acute lung injury induced by copper oxide nanoparticles
Authors: Xiao Junting , Tu Baijie , Zhou Xin , Jiang Xuejun , Xu Ge , Zhang Jun , Qin Xia , Sumayyah Golamaully , Fan Jingchuan , Wang Bin , Chen Chengzhi , Zou Zhen 
Published: June 2021

AbstractCopper oxide nanoparticles (CuONPs) are one of the widely used metal nanoparticles in the industrial and commercial fields. Autophagy is an intracellular degradation system that delivers cytoplasmic constituents to the lysosome and has been linked to nanoparticles-induced toxicity. In particular, the roles of autophagy in response to CuONPs have been explored in vitro, although the conclusions are controversial. To clarify the role of autophagy in CuONPs-induced acute lung injury, microtubule-associated protein 1 light chain 3 beta (Map1lc3b or lc3b) knockout mice and their corresponding wild type mice are applied. Our results showed that single-dose intratracheal instillation of CuONPs with dosages of 1.25, 2.5 or 5 mg/kg caused acute lung injury 3 days after treatment in a dose-dependent manner, as evidenced by deteriorative lung histopathology, more infiltration of macrophage cells, increased oxidative stress and copper ions. Loss of lc3b resulted in aggravated lung injury induced by CuONPs, which was probably due to the blockade of mitophagy and consequently the accumulation of aberrant mitochondria with overloaded copper ions. Our study provides the first in vivo evidence that autophagy deficiency exacerbates CuONPs-induced acute lung injury, and highlights that targeting autophagy is a meaningful strategy against CuONPs-associated respiratory toxicity.
Ecotoxicity evaluation of polymeric nanoparticles loaded with ascorbic acid for fish nutrition in aquaculture
Authors: Luis Angélica I. S. , Campos Estefânia V. R. , Oliveira Jhones L. , Vallim José Henrique , Proença Patrícia L. F. , Castanha Rodrigo F. , de Castro Vera L. S. S. , Fraceto Leonardo F. 
Published: June 2021

AbstractBackgroundAscorbic acid (AA) is a micronutrient essential for the mechanisms of reproduction, growth, and defense in fish. However, the biosynthesis of this micronutrient does not occur in fish, so it must be supplied with food. A difficulty is that plain AA is unstable, due to the effects of light, high temperature, and oxygen, among others. The use of nanoencapsulation may provide protection and preserve the physicochemical characteristics of AA for extended periods of time, decreasing losses due to environmental factors.MethodThis study evaluated the protective effect of nanoencapsulation in polymeric nanoparticles (chitosan and polycaprolactone) against AA degradation. Evaluation was made of the physicochemical stability of the nanoformulations over time, as well as the toxicological effects in zebrafish (Danio rerio), considering behavior, development, and enzymatic activity. For the statistical tests, ANOVA (two-way, significance of p < 0.05) was used.ResultsBoth nanoparticle formulations showed high encapsulation efficiency and good physicochemical stability during 90 days. Chitosan (CS) and polycaprolactone (PCL) nanoparticles loaded with AA had mean diameters of 314 and 303 nm and polydispersity indexes of 0.36 and 0.28, respectively. Both nanosystems provided protection against degradation of AA exposed to an oxidizing agent, compared to plain AA. Total degradation of AA was observed after 7, 20, and 480 min for plain AA, the CS nanoparticle formulation, and the PCL nanoparticle formulation, respectively. For zebrafish larvae, the LC50values were 330.7, 57.4, and 179.6 mg/L for plain AA, the CS nanoparticle formulation, and the PCL nanoparticle formulation, respectively. In toxicity assays using AA at a concentration of 50 mg/L, both types of nanoparticles loaded with AA showed lower toxicity towards the development of the zebrafish, compared to plain AA at the same concentration. Although decreased activity of the enzyme acetylcholinesterase (AChE) did not affect the swimming behavior of zebrafish larvae in the groups evaluated, it may have been associated with the observed morphometric changes, such as curvature of the tail.ConclusionsThis study showed that the use of nanosystems is promising for fish nutritional supplementation in aquaculture. In particular, PCL nanoparticles loaded with AA seemed to be most promising, due to higher protection against AA degradation, as well as lower toxicity to zebrafish, compared to the chitosan nanoparticles. The use of nanotechnology opens new perspectives for aquaculture, enabling the reduction of feed nutrient losses, leading to faster fish growth and improved sustainability of this activity.Graphic Abstract