bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trans-cervical thoracic duct embolization for post-surgical left Chylothorax in a patient with multifocal lymphatic malformations
Authors: Gulaya Karan , Entezari Pouya , Salem Riad , Riaz Ahsun 
Published: October 2021

Abstract
Background
Mediastinal and abdominal lymphatic malformations may not be diagnosed until adulthood. Radiologic and pathologic diagnosis is often challenging due to the rarity of the lesion. Surgical excision of these lesions may be curative but lymphatic leak is a known complication. Lymphatic duct embolization may then be required to treat the leak.

Case presentation
We describe a patient with post-surgical chylothorax where thoracic duct lymphangiography and embolization was performed by catheterizing the thoracic duct at the venous angle where it drains into the subclavian vein.

Conclusion
Lymphatic duct embolization can be challenging in patients with lymphatic malformations. In these patients, if there is adequate visualization on ultrasound or fluoroscopy, terminal aspect of the thoracic duct can be accessed through the subclavian vein to perform the procedure.
Mid-term outcomes of tantalum cup– a single centre study
Authors: Bawale Rajesh , Choudhry Baseem , Samsani Srinivasa 
Published: October 2021

Abstract
Introduction
The cementless acetabular implants are commonly used in primary and revision hip arthroplasty. Reconstruction of acetabulum in case of bone defects can be challenging. The aims of this single center study are to review the mid-term outcomes of porous tantalum cups (TM) and evaluate complications.

Methods
The midterm outcome of a trabecular metal tantalum modular uncemented cup was evaluated in 59 hips in 58 patients. In our group, we had 23 males and 35 females. The mean age was 70.11 years (range, 30 to 87 years). Four patients were lost to follow-up and 13 died during the period without having further surgeries attributed to the hip arthroplasty. The remaining 41 patients (42 revision hip arthroplasties) had complete data available.

Results
The mean follow-up was 87 months, ranging from 24 to 144 months. Standard pelvic anteroposterior (AP) radiographs were used to assess and preoperatively classify acetabular defects as per Paprosky classification. The serial radiographs showed excellent stability, bone opposition and graft incorporation. Four patients had further surgeries. Two of these were due to infection (one superficial and one deep infection). One of the patients had washout and then removal of metal work, the other patient only had a washout and symptoms settled. One patient had vascular compromise and went for surgery to stem the bleeding. One patient had re-revision due to stem loosening and hence required surgery but the revision cup remained stable. We noted a 96% survival at an average of 7.2 years follow-up.

Conclusion
The mid-term results with the trabecular metal cementless cup appeared to be promising in both primary and revision hip arthroplasty, even in the presence of considerable bone loss which requires bone grafting and augments.

Level of evidence
IV.
Nutritional, phytochemical and antioxidant properties of 24 mung bean (Vigna radiate L.) genotypes
Authors: Wang Fuhao , Huang Lu , Yuan Xingxing , Zhang Xiaoyan , Guo Luping , Xue Chenchen , Chen Xin 
Published: October 2021

Abstract
This study aimed to investigate the proximate and phytochemicals present in seeds of 24 mung bean (Vigna radiate L.) genotypes from four provinces of China for estimating their nutritional and antioxidant properties. Proximate analysis of mung bean genotypes revealed that starch, protein, fat, ash and water-soluble polysaccharide ranged from 39.54–60.66, 17.36–24.89, 4.24–12.18, 2.78–3.53 and 1.99–2.96 g/100 g respectively. The five principal fatty acids detected in mung beans were stearic acid, palmitic acid, linoleic acid, oleic acid, and linolenic acid. The contents of insoluble-bound phenolic compounds, soluble phenolic compounds, and flavonoids ranged from 0.78 to 1.5 mg GAE g− 1, 1.78 to 4.10 mg GAE g− 1, and 1.25 to 3.52 mg RE g− 1, respectively. The black seed coat mung bean genotype M13 (Suheilv 1) exhibited highest flavonoid and phenolic contents which showed strong antioxidant activity. Two flavonoids (vitexin and isovitexin) and four phenolic acids (caffeic, syringic acid, p-coumaric, and ferulic acids) were identified by HPLC. Vitexin and isovitexin were the major phenolic compounds in all mung bean genotypes. The content of soluble phenolic compounds had positive correlation with DPPH (r2 = 0.713) and ABTS (r2 = 0.665) radical scavenging activities. Principal component analysis indicated that the first two principal components could reflect most details on mung bean with a cumulative contribution rate of 66.1%. Twenty-four mung bean genotypes were classified into four groups based on their phenolic compounds contents and antioxidant activities. The present study highlights the importance of these mung bean genotypes as a source of nature antioxidant ingredient for the development of functional foods or a source of health promoting food.

Graphical Abstract
Analytical method validation for related substances in sodium valproate oral solution by gas chromatography
Authors: Chandrasekar R. , Sivagami B. , Eswarisai M. , Nandini P. , Pallavi Y. , Sai Dikshitha P. , Shirisha V. , Yamini Y. 
Published: October 2021

Abstract
Background
Sodium Valproate is the sodium salt of valproic acid (VPA). Valproic acid is mainly used for the treatment of epilepsy. The specific aim of the study is to develop and validate an optimized method for the determination of six related substances such as N,N-dimethyl valpronamide, valeric acid, 2-methyl valeric acid, 2-ethyl valeric acid, 2-isopropyl valeric acid and 2-n-butyl valeric acid in Sodium Valproate Oral Solution by Gas Chromatography. Chromatographic separations of these six related substances were achieved on DB-FFAP fused silica capillary column (30 m × 0.53 mm) bonded with a 0.5-µm layer of macrogol 20,000 2-nitroterephthalate materials used as stationary phase. The six related impurities were extracted using heptane and monitored by Gas Chromatography coupled with flame ionization detector. The performance of the developed method was assessed by evaluating system suitability, method precision, specificity, linearity and range, ruggedness, accuracy, robustness.

Results
The correlation coefficient was within the acceptance criteria in the range of 0.9998. The evaluated concentrations for Sodium Valproate were in the ranges of 5.05–25.27 ppm. The average recovery values were in the range of 92.4–100.4%. Solution Stability experiments were performed to evaluate the degradation behavior of SVS.

Conclusion
A novel, precise and sensitive GC method was developed, validated and optimized for the determination of six related substances in sodium Valproate oral solution. The results obtained from the validation experiments demonstrated that the method is accurate, precise, linear, specific, sensitive and robust. Hence, the proposed method can be an alternative method, for the determination of related substances in sodium valproate oral solution drug substance.
Could smell and taste dysfunction in COVID-19 patients be a sign of the clinical course of the disease?
Authors: Bayrak A. F. , Karaca B. , Özkul Y. 
Published: October 2021

Abstract
Background
It could be of great benefit to determine smell and taste dysfunction in COVID-19 patients and to investigate the relationship between these symptoms and clinical characteristics as the determination of points requiring attention during the clinical course of the disease.

Method
Evaluations of patients diagnosed with COVID-19 were made using a questionnaire method. Those with smell and taste dysfunction completed a visual analog scale (VAS) to determine severity. The patients were evaluated at the end of 1 and 2 months.

Results
Evaluation was made of a total of 105 patients with a mean age of 55.9±17.6 years. Smell and taste dysfunction was present in 56 (53.3%) patients with a mean age of 48.7±17.6 years and the 49 (46.7%) patients with no smell and taste dysfunction had a mean age of 64±13.6 years. It was determined that as age increased, the complaints of smell and taste dysfunction decreased. Full recovery was determined in 31 (55%) patients after 1 month, and in 16 (28%) patients, smell and taste dysfunction continued at the end of the second month. The symptoms of smell and taste dysfunction were determined to last longer in patients with no comorbidities, no symptoms of fever or shortness of breath, and those treated as outpatients (p=0.043, p=0.031, p=0.034, p=0.028, respectively). In the older age patient group, the VAS scores were observed to be higher and the time to recovery was shorter (p=0.007, p=0.018, respectively).

Conclusion
Smell and taste dysfunction in COVID-19 patients is seen more as age decreases and recovery takes longer. Smell and taste dysfunction is seen more in patients with symptoms of cough, nasal obstruction, and headache and lasts longer in patients without symptoms of fever and shortness of breath, with no comorbidities and in those treated as outpatients.
Application of cell-free massive MIMO in 5G and beyond 5G wireless networks: a survey
Authors: Obakhena Hope Ikoghene , Imoize Agbotiname Lucky , Anyasi Francis Ifeanyi , Kavitha K. V. N. 
Published: October 2021

AbstractIn recent times, the rapid growth in mobile subscriptions and the associated demand for high data rates fuels the need for a robust wireless network design to meet the required capacity and coverage. Deploying massive numbers of cellular base stations (BSs) over a geographic area to fulfill high-capacity demands and broad network coverage is quite challenging due to inter-cell interference and significant rate variations. Cell-free massive MIMO (CF-mMIMO), a key enabler for 5G and 6G wireless networks, has been identified as an innovative technology to address this problem. In CF-mMIMO, many irregularly scattered single access points (APs) are linked to a central processing unit (CPU) via a backhaul network that coherently serves a limited number of mobile stations (MSs) to achieve high energy efficiency (EE) and spectral gains. This paper presents key areas of applications of CF-mMIMO in the ubiquitous 5G, and the envisioned 6G wireless networks. First, a foundational background on massive MIMO solutions-cellular massive MIMO, network MIMO, and CF-mMIMO is presented, focusing on the application areas and associated challenges. Additionally, CF-mMIMO architectures, design considerations, and system modeling are discussed extensively. Furthermore, the key areas of application of CF-mMIMO such as simultaneous wireless information and power transfer (SWIPT), channel hardening, hardware efficiency, power control, non-orthogonal multiple access (NOMA), spectral efficiency (SE), and EE are discussed exhaustively. Finally, the research directions, open issues, and lessons learned to stimulate cutting-edge research in this emerging domain of wireless communications are highlighted.
Opioid-free anesthesia versus opioid-inclusive anesthesia for breast cancer surgery: a retrospective study
Authors: Di Benedetto Pia , Pelli Massimiliano , Loffredo Chiara , La Regina Rosaria , Policastro Federico , Fiorelli Silvia , De Blasi Roberto Alberto , Coluzzi Flaminia , Rocco Monica 
Published: October 2021

Abstract
Background
Breast cancer surgery is usually managed using opioid-inclusive anesthesia (OIA), although opioids are associated with several adverse events, including nausea, vomiting, and constipation. Multimodal opioid-free anesthesia (OFA) has been introduced to reduce the incidence of these side effects. In this single-center retrospective study, we investigated whether ketamine, combined with magnesium and clonidine, could effectively control postoperative pain in patients undergoing quadrantectomy, while reducing postoperative nausea and vomiting (PONV).

Results
A total of 89 patients submitted to quadrantectomy were included and divided into an OFA group (38 patients) and an OIA group (51 patients) according to the received anesthetic technique. Analgesia in the OIA group was based on an intraoperative infusion of remifentanil, and analgesia in the OFA consisted of an intraoperative infusion of ketamine and magnesium sulfate. Postoperative pain in both groups was managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol. Postoperative pain, assessed with the numeric rating scale (NRS), requirements for additional analgesics, the incidence of PONV, and patient satisfaction evaluated using a QoR-40 questionnaire were compared between the two groups. Levels of pain at 30 min and 6, 12, and 24 h after surgery; number of paracetamol rescue doses; and the incidence of PONV were lower in the OFA group (p <0.05). Patient satisfaction was comparable in the two groups.

Conclusions
A combination of ketamine, magnesium, and clonidine could be more effective than opioid-based analgesia in reducing postoperative pain and lowering PONV occurrence after quadrantectomy for breast cancer.
Predicting Shoulder Force to Prevent Injury: Body Fat Mass Increases Shoulder Stress among Pitchers
Authors: FRIESEN KENZIE B. , OLIVER GRETCHEN D. 
Published: October 2021

ABSTRACT

Purpose
The purpose of this study was to examine the relationship between whole body and throwing arm composition and length with throwing shoulder distraction and anterior force. Literature shows a relationship between shoulder force and pain; therefore, as well as between body mass and pain, it was hypothesized that pitchers with greater body fat mass would display increased throwing shoulder force during the acceleration phase of the softball pitch.

Methods
Thirty-eight high school softball pitchers from southern United States agreed to participate (1.69 ± 0.07 m, 74.71 ± 16.36 kg, 15.2 ± 1.1 yr). All procedures were completed within one visit. Pitchers underwent a dual-energy x-ray absorptiometry scan then threw fastballs at regulation distance while motion was measured using an electromagnetic motion capture system. Data from the three fastest pitches were averaged and analyzed. Peak shoulder distraction and anterior force during the acceleration phase of the softball pitch were extracted and used as dependent variables in two separate regression analyses. Whole body and throwing arm fat mass and lean mass, as well as throwing arm length were entered as independent variables into both regression equations.

Results
The first regression equation was statistically significant (F(5,37) = 13.28, P < 0.001) and explained approximately 62% of the variance in peak shoulder distraction force (R
2 = 0.675, adjusted R
2 = 0.624). Increased whole body fat mass (B = 13.76, SE = 5.39, β = 0.91, t = 2.553, P = 0.016) significantly predicted peak throwing shoulder distraction force. The second regression equation predicting peak anterior force was not significant.

Conclusions
Increased fat mass may exacerbate the high force observed at the throwing shoulder and further increase injury susceptibility to pitchers.
Effect of Concurrent Training on Body Composition and Gut Microbiota in Postmenopausal Women with Overweight or Obesity
Authors: DUPUIT MARINE , RANCE MÉLANIE , MOREL CLAIRE , BOUILLON PATRICE , BOSCARO AUDREY , MARTIN VINCENT , VAZEILLE EMILIE , BARNICH NICOLAS , CHASSAING BENOIT , BOISSEAU NATHALIE 
Published: October 2021

ABSTRACT

Purpose
Menopause tends to be associated with an increased risk of obesity and abdominal fat mass (FM) and is associated with lower intestinal species diversity. The aim of this study was to determine the effects of a high-intensity interval training and resistance training (HIIT + RT) program on body composition and intestinal microbiota composition in overweight or obese postmenopausal women.

Methods
Participants (n = 17) were randomized in two groups: HIIT + RT group (3× per week, 12 wk) and control group without any training. Dual-energy x-ray absorptiometry was used to measure whole-body and abdominal/visceral FM and fat-free mass. Intestinal microbiota composition was determined by 16S rRNA gene sequencing at baseline and at the study end, and the diet was controlled.

Results
Compared with sedentary controls, physical fitness (maximal oxygen consumption, peak power output) increased, total abdominal and visceral FM decreased, and segmental muscle mass increased in the training group. Although the HIIT + RT protocol did not modify α-diversity and taxonomy, it significantly influenced microbiota composition. Moreover, various intestinal microbiota members were correlated with HIIT + RT-induced body composition changes, and baseline microbiota composition predicted the response to the HIIT + RT program.

Conclusions
HIIT + RT is an effective modality to reduce abdominal/visceral FM and improve physical capacity in nondieting overweight or obese postmenopausal women. Training modified intestinal microbiota composition, and the response to training seems to depend on the initial microbiota profile. More studies are needed to determine whether microbiota composition could predict the individual training response.
Are Gait Biomechanics Related to Physical Activity Engagement? An Examination of Adolescents with Autism Spectrum Disorder
Authors: BENNETT HUNTER J. , RINGLEB STACIE I. , BOBZIEN JONNA , HAEGELE JUSTIN A. 
Published: October 2021

ABSTRACT

Purpose
Adolescents with autism spectrum disorder (ASD) rarely meet physical activity (PA) guidelines, thus not reaping associated health benefits. Although many barriers exist, abnormal or inefficient gait biomechanics could negatively impact engagement in PA. This study has two purposes: first, to compare total body mechanical work between adolescents with ASD and neurotypical age-, sex-, and body mass index–matched controls, and second to determine whether gait biomechanics are significantly related to engagement in PA.

Methods
Twenty-five adolescents (age, 13–18 yr) with ASD and 17 neurotypical controls (eight with ASD had no match) participated in the study. Three-dimensional motion capture and force platforms were used to record and analyze gait biomechanics at self-selected speeds and a standardized 1.3 m·s−1. Total body mechanical work (sum of joint works across lower extremity, low back, torso, and shoulders) was compared between groups (n = 17 for each) and speeds using a mixed model analysis of variance. Average daily light PA, moderate to vigorous PA, and total PA was recorded for the entire data set with ASD using triaxial accelerometers worn for 1 wk. Regression analyses were performed between work, stride time variability, speed, and stride length with each PA variable.

Results
Adolescents with ASD generated 9% more work compared with the controls (P = 0.016). Speed and stride length were significant regressors of light PA, moderate to vigorous PA, and total PA, explaining greater than 0.20 variance (P < 0.02 for all regressions).

Conclusions
Although adolescents with ASD walked with significantly greater work, the complex full-body variable is not significantly related to engagement in PA. In agreement with research spanning multiple populations and ages, speed and stride length are indicative of PA engagement in adolescents with ASD.
Identification of thresholds for accuracy comparisons of heart rate and respiratory rate in neonates
Authors: Coleman Jesse , Ginsburg Amy Sarah , Macharia William M. , Ochieng Roseline , Zhou Guohai , Dunsmuir Dustin , Karlen Walter , Ansermino J. Mark 
Published: October 2021

Background: Heart rate (HR) and respiratory rate (RR) can be challenging to measure accurately and reliably in neonates. The introduction of innovative, non-invasive measurement technologies suitable for resource-constrained settings is limited by the lack of appropriate clinical thresholds for accuracy comparison studies. Methods: We collected measurements of photoplethysmography-recorded HR and capnography-recorded exhaled carbon dioxide across multiple 60-second epochs (observations) in enrolled neonates admitted to the neonatal care unit at Aga Khan University Hospital in Nairobi, Kenya. Trained study nurses manually recorded HR, and the study team manually counted individual breaths from capnograms. For comparison, HR and RR also were measured using an automated signal detection algorithm. Clinical measurements were analyzed for repeatability. Results: A total of 297 epochs across 35 neonates were recorded. Manual HR showed a bias of -2.4 (-1.8%) and a spread between the 95% limits of agreement (LOA) of 40.3 (29.6%) compared to the algorithm-derived median HR. Manual RR showed a bias of -3.2 (-6.6%) and a spread between the 95% LOA of 17.9 (37.3%) compared to the algorithm-derived median RR, and a bias of -0.5 (1.1%) and a spread between the 95% LOA of 4.4 (9.1%) compared to the algorithm-derived RR count. Manual HR and RR showed repeatability of 0.6 (interquartile range (IQR) 0.5-0.7), and 0.7 (IQR 0.5-0.8), respectively. Conclusions: Appropriate clinical thresholds should be selected a priori when performing accuracy comparisons for HR and RR. Automated measurement technologies typically use a smoothing or averaging filter, which significantly impacts accuracy. A wider spread between the LOA, as much as 30%, should be considered to account for the observed physiological nuances and within- and between-neonate variability and different averaging methods. Wider adoption of thresholds by data standards organizations and technology developers and manufacturers will increase the robustness of clinical comparison studies.
Factors influencing partograph recording among skilled birth attendants at Mzuzu Central Hospital, Northern Malawi
Authors: Kaunda Prisca , Leshabari Selbada , Mwale Charles Masulani 
Published: October 2021

Background/Aims Malawi has very high maternal and neonatal mortality rates, often resulting from complications during labour and delivery. Complete recording of a partograph during labour monitoring has been associated with a reduction and prompt management of fatal complications. Although the partograph is an essential tool for monitoring women during labour, there is limited evidence on the status of its recording and associated factors among skilled birth attendants in northern Malawi. The aim of this study was to assess partograph recording and explore factors affecting its recording among skilled birth attendants at the Mzuzu Central Hospital in Malawi. Methods The study used a descriptive cross-sectional design with mixed methods. The study involved a retrospective review of 369 patient partographs, using a data extraction sheet to gather quantitative data, which were analysed using descriptive statistics. Qualitative data were collected through individual in-depth interviews with seven skilled birth attendants working at the hospital, using a semi-structured interview guide and analysed by content analysis. Results Of the 369 partographs that were reviewed, recording was complete in only 12.7% of fetal assessments, 13.3% of maternal assessments and 24.7% of sections recording the progress of labour. The most completely recorded parameter was liquor (71.8%), followed by cervical dilatation (70.5%). The least completely recorded parameters were temperature (13.6%) and urine protein (2.2%). Factors that influenced the recording of a partograph included skilled birth attendants' general knowledge on the partograph, the availability of equipment for assessments, supportive supervision, staffing levels, attendance to in-service training and clients' perception of the frequency of assessments. Conclusions Skilled birth attendants at Mzuzu Central Hospital partially complete partographs during labour. Staffing levels, availability of equipment for assessments, in-service training and supportive supervision are all factors that affect complete partograph recording. Therefore, it is essential to implement strategies that can promote complete partograph recording in order to reduce maternal and newborn morbidity and mortality at this health facility.