bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pathological post-obstructive diuresis following obstructive uropathy due to constipation in the post-partum period: a case report
Authors: Rishard Mohamed , Kossinna Thalagala Kossinnage Maheeka , Latiff Mohamed Nazar , De Silva Susantha , Asmath Mohamed Hilmy Mohamed 
Published: November 2021

Abstract
Background
Constipation during pregnancy is not uncommon. Usually, this does not warrant extensive evaluation and settles with minor interventions or lifestyle modifications. Severe fecal impaction in chronically constipated patients can rarely lead to obstructive uropathy. Relief of obstruction can result in a diuretic phase which may be self-limiting or pathological. However, occurrence of pathological post-obstructive diuresis as a result of severe constipation is an extremely rare complication during pregnancy and puerperium which can even be fatal if not promptly diagnosed and adequately monitored and timely intervened. We describe the management of a pathological post-obstructive diuresis which occurred in the immediate postpartum period after treatment of severe constipation and obstructive uropathy.

Case presentation
A woman who had undergone an emergency caesarean section due to deep transverse arrest 1 week ago, presented with fecal impaction and anuria. On relief of urinary obstruction which had developed secondary to fecal impaction, she developed pathological post-obstructive diuresis. Careful and timely monitoring with exact fluid replacement, correction of electrolyte imbalances and multidisciplinary care ensured complete recovery of the patient.

Conclusions
Despite obstructive uropathy being uncommon in obstetric practice, clinicians need to have a high index of suspicion to monitor and promptly manage the potentially life-threatening condition of post-obstructive diuresis in pregnant and puerperal women undergoing urinary tract decompression. Due to unreliability of laboratory cutoff values in pregnancy and puerperium, a more vigilant and multidisciplinary approach with lower threshold for intervention is more prudent in the management of these patients.
A neural network for glomerulus classification based on histological images of kidney biopsy
Authors: Cascarano Giacomo Donato , Debitonto Francesco Saverio , Lemma Ruggero , Brunetti Antonio , Buongiorno Domenico , De Feudis Irio , Guerriero Andrea , Venere Umberto , Matino Silvia , Rocchetti Maria Teresa , Rossini Michele , Pesce Francesco , Gesualdo Loreto , Bevilacqua Vitoantonio 
Published: November 2021

Abstract
Background
Computer-aided diagnosis (CAD) systems based on medical images could support physicians in the decision-making process. During the last decades, researchers have proposed CAD systems in several medical domains achieving promising results.

CAD systems play an important role in digital pathology supporting pathologists in analyzing biopsy slides by means of standardized and objective workflows. In the proposed work, we designed and tested a novel CAD system module based on image processing techniques and machine learning, whose objective was to classify the condition affecting renal corpuscles (glomeruli) between sclerotic and non-sclerotic. Such discrimination is useful for the biopsy slides evaluation performed by pathologists.

Results
We collected 26 digital slides taken from the kidneys of 19 donors with Periodic Acid-Schiff staining. Expert pathologists have conducted the slides preparation, digital acquisition and glomeruli annotations. Before setting the classifiers, we evaluated several feature extraction techniques from the annotated regions. Then, a feature reduction procedure followed by a shallow artificial neural network allowed discriminating between the glomeruli classes.

We evaluated the workflow considering an independent dataset (i.e., processing images not used in the training procedure). Ten independent runs of the training algorithm, and evaluation, allowed achieving MCC and Accuracy of 0.95 (± 0.01) and 0.99 (standard deviation < 0.00), respectively. We also obtained good precision (0.9844 ± 0.0111) and recall (0.9310 ± 0.0153).

Conclusions
Results on the test set confirm that the proposed workflow is consistent and reliable for the investigated domain, and it can support the clinical practice of discriminating the two classes of glomeruli. Analyses on misclassifications show that the involved images are usually affected by staining artefacts or present partial sections due to slice preparation and staining processes. In clinical practice, however, pathologists discard images showing such artefacts.
How staff characteristics influence residential care facility staff’s attitude toward person-centered care and informal care
Authors: Boumans Jogé , van Boekel Leonieke , Kools Nathalie , Scheffelaar Aukelien , Baan Caroline , Luijkx Katrien 
Published: November 2021

Abstract
Background
Staff members, and their attitudes, are crucial for providing person-centered care in residential care facilities for people with dementia. However, the literature on the attitudes of nursing staff regarding person-centered care is limited. The objective of this study is to explore the association between staff characteristics (age, education level, years of work experience and function, i.e., care or welfare) and staff attitudes toward perceived person-centered care provision and including informal caregivers in the caregiving process in residential care facilities.

Methods
A convenience sample of 68 care staff – nurses and nurse assistants - welfare staff members – activity counselors, hostesses, and living room caretakers - of two residential care facilities filled out a questionnaire. Staff attitudes regarding perceived person-centered care were measured with the Person-centered Care Assessment Tool (P-CAT). Staff attitudes regarding informal care provision were measured with the Attitudes Toward Families Checklist (AFC). Multiple linear regression analysis explored the association between variables age, work experience, education, and function (care or welfare).

Results
A higher age of staff was associated with a more negative attitude toward perceived person-centered care and informal care provision. Welfare staff had a more negative attitude toward the inclusion of informal caregivers than care staff. The perceived person-centered care provision of the care and welfare staff was both positive. Work experience and education were not associated with perceived person-centered care provision or informal care provision.

Conclusion
This study is one of the first to provide insight into the association between staff characteristics and their attitude toward their perceived person-centered care provision and informal care provision. A higher age of both the care and welfare staff was associated with a more negative attitude toward their perceived person-centered care and informal care provision. Welfare staff had a less positive attitude toward informal care provision. Additionally, future studies, also observational studies and interview studies, are necessary to collect evidence on the reasons for negative attitudes of older staff members towards PCC and informal care giving, to be able to adequately target these reasons by implementing interventions that eliminate or reduce these negative attitudes.
Safety and effectiveness of switching to Abacavir/Lamivudine plus rilpivirine for maintenance therapy in virologically suppressed HIV-1 individuals in Singapore (SEALS)
Authors: Lim Z. C. , Hoo G. S. , Ang J. H. , Teng C. B. , Ang L. W. , Lee C. C. , Leo Y. S. , Law H. L. , Ng O. T. , Wong C. S. 
Published: November 2021

Abstract
Background
The efficacy and tolerability of an antiretroviral regimen are important considerations for selection of HIV-1 infection maintenance therapy. Abacavir/lamivudine plus rilpivirine (ABC/3TC + RPV) has been shown in international studies to be effective and well-tolerated in virologically suppressed individuals. This study evaluated the effectiveness and safety of switching to ABC/3TC + RPV as maintenance therapy in virologically suppressed HIV-1 infected individuals in Singapore.

Methods
In this retrospective, single-centre study, we included individuals who were prescribed ABC/3TC + RPV, had HIV-1 viral load (VL) < 50 copies/ml immediately pre-switch, and had no documented history of resistance mutations or virologic failure to any of the components. The follow-up period was 48 ± 12 weeks. The primary outcome was the proportion of individuals who maintained virologic suppression of HIV-1 VL < 50 copies/ml at the end of follow-up period based on on-treatment analysis. The secondary outcomes were the resistance profiles associated with virologic failure, changes in immunologic and metabolic parameters, and the safety profile of ABC/3TC + RPV.

Results
A total of 222 individuals were included in the study. The primary outcome was achieved in 197 individuals [88.8%, 95% confidence interval: 83.7–92.4%]. There were 21 individuals (9.5%) who discontinued treatment for non-virologic reasons. The remaining 4 individuals experienced virologic failure, of whom, 3 of these individuals had developed emergent antiretroviral resistance and had HIV-1 VL > 500 copies/ml at the end of the 48 ± 12 weeks follow-up period. The remaining individual experienced sustained low level viremia and subsequently achieved viral suppression without undergoing resistance testing. A total of 49 adverse events were observed in 31 out of 222 individuals (14.0%), which led to 13 individuals discontinuing therapy. Neuropsychiatric adverse events were most commonly observed (53.1%). A statistically significant increase in CD4 was observed (p < 0.01), with a median absolute change of 31 cells/uL (interquartile range: − 31.50 to 140.75). No significant changes in lipid profiles were detected.

Conclusion
ABC/3TC + RPV is a safe and effective switch option for maintenance therapy in virologically suppressed HIV-1 individuals with in Singapore.
Assessment of the learning curve of video-assisted thoracoscopic sympathectomy in a single neurosurgical trainee: a cumulative summation analysis
Authors: Alkosha Hazem M. , Elkiran Yasser M. 
Published: November 2021

Abstract
Background
Video-assisted thoracoscopic sympathectomy (VATS) is a common procedure unusually practiced by neurosurgeons due to lack of training.

Objective
To evaluate the learning curve for VATS in a young neurosurgeon with no previous experience in open sympathectomy techniques or extracranial endoscopic procedures.

Methods
This is a retrospective review and analysis of prospectively collected data in 50 consecutive cases admitted to our facility with the diagnosis of essential palmar and axillary hyperhidrosis operated by a neurosurgical trainee under strict supervision of 2 experienced mentors. After an initial training phase, cumulative sum mation (CUSUM) analysis was used to evaluate the surgical performance of the trainee in terms of operating time, blood loss, hospital stay and failures.

Results
Improvement in operating time was noticed after the first 20 cases with significant affection by changes in OR team. The blood loss was significantly improved after the first 10 cases with less sensitivity to changes in OR team. Hospital stay and failures were steady and within expected values throughout the study.

Conclusion
An average of 20 cases may be enough for a neurosurgeon with basal knowledge to attain technical competence in VATS sympathectomy. Mentored surgical training on VATS sympathectomy is a safe and effective training method with failures within expected limits. The experience of the OR team plays an important role in the rapid improvement and consistency of performance.
The use of GnRH analogs in preserving ovarian function during chemotherapy
Authors: Odeh Omar M. , Awwad Johnny , Khalife Dalia , Ghunaim Suleiman 
Published: November 2021

Abstract
Background
The literature has always been controversial on the use of gonadotropin-releasing hormone agonists in preserving fertility in women of childbearing age after chemotherapy; thereby, in this article, we will be discussing its use in preserving fertility.

Main body of abstract
When it comes to preserving fertility, it is crucial to consider all available options in this topic due to its very sensitive nature, thereby we have found that while a lot of trials favor the use of gonadotropin-releasing hormone agonists, the lack of proper follow-up and long-term trials renders its use highly debatable, and since the longest follow-up trial showed non-significant results, it also opens the floor for debate on whether this short-term benefit is worth adding another drug to the regimen or not.

Short conclusion
As described in this review, while the use of gonadotropin-releasing hormone agonists is beneficial in a lot of studies, the lack of long-term reports still makes its use debatable, thereby more trials should be done.
Reviewing cancer’s biology: an eclectic approach
Authors: Diori Karidio Ibrahim , Sanlier Senay Hamarat 
Published: November 2021

Abstract
Background
Cancer refers to a group of some of the worldwide most diagnosed and deadliest pathophysiological conditions that conquered researchers’ attention for decades and yet begs for more questions for a full comprehension of its complex cellular and molecular pathology.

Main body
The disease conditions are commonly characterized by unrestricted cell proliferation and dysfunctional replicative senescence pathways. In fact, the cell cycle operates under the rigorous control of complex signaling pathways involving cyclins and cyclin-dependent kinases assumed to be specific to each phase of the cycle. At each of these checkpoints, the cell is checked essentially for its DNA integrity. Genetic defects observed in these molecules (i.e., cyclins, cyclin-dependent kinases) are common features of cancer cells. Nevertheless, each cancer is different concerning its molecular and cellular etiology. These could range from the genetic defects mechanisms and/or the environmental conditions favoring epigenetically harbored homeostasis driving tumorigenesis alongside with the intratumoral heterogeneity with respect to the model that the tumor follows.

Conclusions
This review is not meant to be an exhaustive interpretation of carcinogenesis but to summarize some basic features of the molecular etiology of cancer and the intratumoral heterogeneity models that eventually bolster anticancer drug resistance for a more efficient design of drug targeting the pitfalls of the models.
Realization of the key aspects of the right to adequate housing in affordable housing programs in Egypt
Authors: Hafez Nahla Mahmoud , Kamel Rowaida Reda , Elsherif Doaa Mahmoud , Nasreldin Rania Ibrahim 
Published: November 2021

AbstractThe realization of the right to adequate housing is a critical issue that countries seek to achieve through affordable housing projects. However, there is a discrepancy in fulfilling the right to adequate housing between countries, which has surfaced the dilemma of defining adequate housing. In this respect, scanning relevant literature figured out seven key aspects to meet the right to adequate housing. Using a questionnaire launched to experts in the field, they figured out to what extent the seven aspects have been realized in the affordable housing programs in Egypt. The results showed a significant percentage of realization of the seven key aspects of the right to adequate housing. The findings showed an apparent variation in the completion of the seven key aspects, which decision-makers can improve at different scales with the progression of the programs. Future research can build on this direction to consider aspects like accessibility and cultural adequacy of these programs.
Industrial symbiosis platforms for synergy identification and their most important data points: a systematic review
Authors: Akrivou Chrysanthi , Łȩkawska-Andrinopoulou Lucyna , Tsimiklis Georgios , Amditis Angelos 
Published: November 2021

Background: Industrial symbiosis (IS) primarily involves interfirm utilization of industrial residual resources. An important factor determining the success of IS is the identification and matching of cooperation opportunities. Digital tools, including IS platforms, are considered facilitators of this process. This systematic literature review addresses the research question: ‘Which are the most important data points of an IS platform and how can they be used for the promotion of IS?’. Methods: The review is based on scientific publications from the following academic research databases: ScienceDirect, Scopus, SpringerLink, Wiley Online Library, AISel and IEEE (via Google Scholar), and grey literature obtained through a customized Google search technique, last performed on 9/3/2021. Records were included according to their scientific content, namely if the document: i) examined the identification of synergies utilizing ICT tools, ii) data requirements or platform related information were presented or iii) the impact of a digital tool in promoting IS was discussed. Exclusion criteria were: articles not written in English, not peer-reviewed, published before 2016 or document type other than scientific article, conference paper or EU project deliverable. Two independent reviewers performed title scanning and abstract reading of the documents to reduce the risk of bias. Results: The total number of records included after abstract and full text reading was 32. The main results of this review suggest that two significant types of data points are encountered in IS platforms; i) data required for synergy identification and ii) platform related information. Conclusions: A possible limitation of the study is a minor risk of bias due to one reviewer performing full text reading and synthesis of results; however, they reported to and consulted with the supervising reviewer. Overall, the results indicate that several types of data points are required for effective matching and successful promotion of IS through digital tools.
Peer assessment after clinical exposure (PACE): an evaluation of structured peer support for staff in emergency care
Authors: Sillitoe Kristina , Kimbya Nikki , Milliken Jackie , Bennett Paula 
Published: November 2021

Background: There is an increasing body of evidence that identifies psychological stressors associated with working in emergency medicine. Peer Assessment After Clinical Exposure (PACE) is a structured programme designed to support staff following traumatic or chronic work-related stressful exposure. The first author of this study created the PACE programme and implemented it in one emergency department (ED). Aim: A service evaluation designed to explore the thoughts and experiences of the staff who accessed the PACE support service. Method: Participants were selected by a non-probability convenience strategy to represent the ED staff population. The study cohort ranged from junior staff nurse level to emergency consultant. Data were collected using a semi-structured interview and examined by the method of interpretative phenomenological analysis. Findings: This study confirmed the findings of previous research that current pressures within the ED include crowding, time pressure and working within an uncontrollable environment. Eight participants identified an absence of previous emotional support resulting in dissociation and avoidance behaviours following traumatic exposure. Overall, the PACE service was well received by the majority of staff (11/12). There was a positive association with the one-to-one element and the educational component helped to reduce the stigma associated with stress reactions after work-related exposure. Conclusion: PACE received a positive response from staff. This service presently does not exist elsewhere in the NHS so further research will be needed to evaluate its long-term impact and effectiveness on a wider scale.
Facial reconstruction with extended supraclavicular flap after necrotizing fasciitis: Case report
Authors: Danilo Leite da Silva Rocha Kaio , Hugo Melo Carvalho Victor , Ivo Martins Cidade Pedro , Sávio Soares Macedo Allan , Fernandes Peixoto Furtado Maria Isabel , Carvalho Bezerra de Brito Vieira Lívia , Felippe de Araújo Rolim Francisco 
Published: November 2021

Este relato de caso descreve um caso clínico de fasceíte necrotizante de face submetida a tratamento cirúrgico para reconstrução facial utilizando retalho supraclavicular estendido. Uma das abordagens para reconstrução facial é a utilização de retalho expandido, autonomizado. Realizou-se o controle infeccioso da lesão com antibioticoterapia ampla e desbridamentos cirúrgicos de todo tecido necrótico, procede-se a cirurgia reparadora, primeiramente com preparo do retalho e posterior transferência de pele supraclavicular estendida para o local afetado. Este relato evidencia um caso raro e enfatiza a importância do diagnóstico precoce, da abordagem cirúrgica realizada com brevidade e do sucesso com reparação utilizando o retalho supraclavicular autonomizado. O retalho supraclavicular expandido é uma excelente opção para reconstrução da face em pacientes em que foram removidas extensas áreas de pele, pois apresentaram boa vascularização e aspecto estético adequado no pós-operatório.

Palavras-chave: Retalhos autonomizados, reconstrução facial, retalho supraclavicular, cirurgia reconstrutiva, retalho cirúrgico.
A Lei 131/2009 e o Impacto sobre o Controle Social através do Aumento da Transparência: Uma Análise do Cumprimento da Lei no Município de Araripina – PE / The Complimentary Law Number 131 of 2009 and the Impact on Social Control Through Increased Transparency: An Analysis of the Compliance of The Law in the Municipality of Araripina - PE
Authors: Lopes Maria Izabela Gomes , Lacerda Rodrigo De Souza 
Published: November 2021

Resumo: A administração pública pode ser entendida como a forma de atuação do Governo, onde para que esta atue de maneira eficiente, é necessário que ela arrecade os tributos da sociedade. Por tratar de erário público, a administração pública necessita possuir o máximo de transparência possível. É nesse contexto que a lei complementar nº 131/09, instituída no dia 27 de maio de 2009, também conhecida como Lei da Transparência, onde alterou o artigo 48 da Lei Complementar nº 101/2000 conhecida como a Lei de Responsabilidade Fiscal (LRF), incluindo dispositivos que expandem a transparência de toda a gestão dos recursos públicos. Sendo assim, o objetivo geral deste estudo é entender qual a relevância da Lei 131/2009 no aumento do controle social verificando se o município de Araripina-PE cumpre com os requisitos tratados nessa lei. Diante disso, foi necessário abordar acerca da Administração e seus principais tipos, dando continuidade através da conceituação da receita e despesa pública e por fim, contextualizar sobre a importância da transparência na gestão pública através das leis instituídas que garantem essa transparência, com a Lei de Responsabilidade Fiscal e a Lei da Transparência. Para isso, primeiramente foi utilizada a pesquisa bibliográfica para embasar o estudo, utilizando livros e legislação específica e posteriormente, foi realizado um estudo de caso analisando o Portal da Transparência da cidade de Araripina-PE para identificar se o município segue o que institui a Lei 131/2009. Diante disso, foi possível concluir que o município cumpre com a Lei de transparência, uma vez que no Portal são divulgados todos os atos da gestão pública, como as receitas previstas e arrecadadas, assim como as despesas fixadas e pagas, além de que também são disponibilizados planos, balanços orçamentários e outras informações de cunho público que garante uma maior participação social.