bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Primate Cultural Significance Index: applications with Popoluca Indigenous people at Los Tuxtlas Biosphere Reserve
Authors: Pinto-Marroquin Marianna , Aristizabal John F. , García-Del Valle Yasminda , Ruan-Soto Felipe , Serio-Silva Juan Carlos 
Published: October 2021

Abstract
Background
The study of the cultural significance (CS) of biodiversity provides key information to develop conservation strategies consistent with traditions and perceptions of human communities. In Los Tuxtlas Biosphere Reserve (TBR) in Mexico, the mantled howler monkeys (Alouatta palliata mexicana) and the black-handed spider monkeys (Ateles geoffroyi vellerosus) have historically coexisted with Popoluca Indigenous Peoples. This study sought to determine how the presence of a natural protected area (TBR location) and a range of sociodemographic factors (gender, age, origin, language proficiency, education level, religion) relate to the CS held by the Popoluca Indigenous People in relation to these two endangered primate species.

Methods
The first Primate Cultural Significance Index (PCSI) was designed as a composed index of 11 cultural variables (sub-indices) and was applied randomly to a representative size sample of people over 15 years old in two Popolucas communities, one within the TBR (Piedra Labrada = 81 people) and another outside (Los Mangos = 91). U Mann–Whitney tests were used to compare the PCSI between communities and Generalized Linear Models (GLM) to evaluate the sociodemographic factors of participants that influenced the sub-indices in the PCSI.

Results
The cultural significance of spider monkeys held by the Popolucas was higher for the community within the TBR than for the community outside, while for howler monkeys it was higher outside. For both primate species across the two communities, the most relevant sub-indices were (1) interest in conservation and (2) touristic significance of primates. Sociodemographic factors of participants influenced nine sub-indices of cultural significance out of the possible 10 sub-indices applied for each primate species. The demographic factors that most influenced each sub-index for both species were location and gender.

Conclusions
The main differences found between communities may be linked to the conservation and sustainable development programs promoted by the reserve, as well as the greater persistence of Popolucan ancestral traditions within the boundaries of the reserve. We recommend that conservation efforts should focus on people less interested about primate conservation (women, non-natives and residents outside the reserve), and turn to the leadership of people more interested (native men who reside inside the reserve).
Breastfeeding experiences of Latina migrants living in Spain: a qualitative descriptive study
Authors: Iglesias-Rosado Blanca , Leon-Larios Fatima 
Published: October 2021

Abstract
Background
The migratory flows in Spain have changed due to the arrival of a diverse migrant population. Among the new migrants the Latino collective predominate with more than half being women of childbearing age. There are no previous studies exploring breastfeeding experiences of migrants in a country where their mother tongue is spoken. This study aimed to explore Latina migrants’ breastfeeding experiences in a Spanish-speaking country.

Methods
A descriptive qualitative study was carried out in the main province in southern Andalusia between November 2019 and June 2020. The study used intentional sampling. The study participants were contacted by video calls and data were collected through a semi-structured in-depth interview (n = 19). The interviews were transcribed and analysed by thematic analysis.

Results
The nineteen participants were aged between 22 and 43 years old and came from six different countries in Latin America. The two main categories that emerged were breastfeeding facilitators and barriers, divided into ten interrelated sub-categories: working conditions; precarious socioeconomic conditions; lack of support (health professionals, family and society); physiological changes, pain and fatigue; ignorance and wrong beliefs; support networks (partner, health professionals and family); host country versus home country; religious practices/worship; appropriate attitude, knowledge and experience; and breastfeeding support groups. Most of the study participants stated that their breastfeeding experiences were influenced by barriers such as work and by facilitators such as peer support.

Conclusions
More support from caregivers and more sensitivity to cultural diversity were demanded by the women and well-trained professionals are needed to enable breastfeeding for a longer time. This paper provides caregivers, such as nurses, more knowledge about the care demanded by migrant women to ensure a longer breastfeeding experience.
The intractable problems with brain death and possible solutions
Authors: Joffe Ari R. , Khaira Gurpreet , de Caen Allan R. 
Published: October 2021

AbstractBrain death has been accepted worldwide medically and legally as the biological state of death of the organism. Nevertheless, the literature has described persistent problems with this acceptance ever since brain death was described. Many of these problems are not widely known or properly understood by much of the medical community. Here we aim to clarify these issues, based on the two intractable problems in the brain death debates. First, the metaphysical problem: there is no reason that withstands critical scrutiny to believe that BD is the state of biological death of the human organism. Second, the epistemic problem: there is no way currently to diagnose the state of BD, the irreversible loss of all brain functions, using clinical tests and ancillary tests, given potential confounders to testing. We discuss these problems and their main objections and conclude that these problems are intractable in that there has been no acceptable solution offered other than bare assertions of an ‘operational definition’ of death. We present possible ways to move forward that accept both the metaphysical problem - that BD is not biological death of the human organism - and the epistemic problem - that as currently diagnosed, BD is a devastating neurological state where recovery of sentience is very unlikely, but not a confirmed state of irreversible loss of all [critical] brain functions. We argue that the best solution is to abandon the dead donor rule, thus allowing vital organ donation from patients currently diagnosed as BD, assuming appropriate changes are made to the consent process and to laws about killing.
Radiographic optimization of the lateral position of the knee joint aided by CT images and the maximum intensity projection technique
Authors: Wang Shiming , Xiao Zhibo , Lu Yunfeng , Zhang Zhiwei , Lv Fajin 
Published: October 2021

Abstract
Background
Standard lateral knee-joint X-ray images are crucial for the accurate diagnosis and treatment of many knee-joint-related conditions. However, it is difficult to obtain standard lateral knee-joint X-ray images in the current knee-joint lateral radiography position.

Purpose
To optimize the lateral position of knee joint for radiography aided by computed tomography (CT) images and the maximum intensity projection technique.

Materials and methods
One hundred cases of anteroposterior and lateral radiographs of knee joints were included. Of these, 50 cases were for lateral radiography in conventional position, and the other 50 cases were for lateral radiography in optimized position. The optimized position was acquired by a retrospective analysis of one hundred cases of knee-joint CT images. The quality of the X-ray images in optimized group was compared with those in conventional group. The data were statistically analyzed using the Mann–Whitney U test.

Results
There were differences in the optimized position between males and females. The posterior condyles of the femoral epiphysis in optimized group were in perfect superimposition for most patients. However, the ones in conventional group were not. The average quality score of the lateral knee-joint X-ray images in optimized position was 3.76 ± 0.98, which is much higher than the 1.84 ± 1.15 score in conventional position. Moreover, the difference in the average quality score was statistically significant (P < 0.05).

Conclusion
Optimization of the lateral position of knee joint for radiography is possible with the aid of CT images and the maximum intensity projection technique.
Left atrial geometry in an ovine ischemic mitral regurgitation model: implications for transcatheter mitral valve replacement devices with a left atrial anchoring mechanism
Authors: Imai Akito , Khamooshian Arash , Okamoto Keitaro , Saito Yoshiaki , Wijdh-den Hamer Inez J. , Mariani Massimo A. , Gillespie Matthew J. , Gorman Robert C. , Gorman Joseph H. , Bouma Wobbe 
Published: October 2021

Abstract
Background
Transcatheter mitral valve replacement (TMVR) is a challenging, but promising minimally invasive treatment option for patients with mitral valve disease. Depending on the anchoring mechanism, complications such as mitral leaflet or chordal disruption, aortic valve disruption or left ventricular outflow tract obstruction may occur. Supra-annular devices only anchor at the left atrial (LA) level with a low risk of these complications. For development of transcatheter valves based on LA anchoring, animal feasibility studies are required. In this study we sought to describe LA systolic and diastolic geometry in an ovine ischemic mitral regurgitation (IMR) model using magnetic resonance imaging (MRI) and echocardiography in order to facilitate future research focusing on TMVR device development for (I)MR with LA anchoring mechanisms.

Methods
A group of 10 adult male Dorsett sheep underwent a left lateral thoracotomy. Posterolateral myocardial infarction was created by ligation of the left circumflex coronary artery, the obtuse marginal and diagonal branches. MRI and echocardiography were performed at baseline and 8 weeks after myocardial infarction (MI).

Results
Six animals survived to 8 weeks follow-up. All animals had grade 2 + or higher IMR 8 weeks post-MI. All LA geometric parameters did not change significantly 8 weeks post-MI compared to baseline. Diastolic and systolic interpapillary muscle distance increased significantly 8 weeks post-MI.

Conclusions
Systolic and diastolic LA geometry do not change significantly in the presence of grade 2 + or higher IMR 8 weeks post-MI. These findings help facilitate future tailored TMVR device development with LA anchoring mechanisms.
A rare cause of chronic dysphagia: pulmonary inflammatory myofibroblastic tumor with distal esophagus invasion
Authors: Gu Yi-Min , Chen Long-Qi 
Published: October 2021

Abstract
Background
Inflammatory myofibroblastic tumor (IMT) is rare intermediate tumor, which happens mostly in children and young adults.

Case presentation
Reported is the successful treatment of a 29-year-old man presented with progressively dysphagia and weight loss. No other abnormal symptoms were observed. The contrast enhanced computed tomography (CT) revealed a dumbbell-shaped lesion between lung and esophagus. Finally, it was pathologically diagnosed as pulmonary IMT invading to the distal esophagus after operation. The patient underwent partial esophagectomy and left lower lobectomy, and was discharged on 10th postoperative day.

Conclusions
IMT is a rare lesion that usually occurs in the lung, but pulmonary IMT with distal esophagus invasion has not been described previously. Discriminating untypical symptom, completed resection, pathological expertise and closed follow-up will reach the successful diagnosis and treatment.
Prognostic factors of esophageal perforation and rupture leading to mortality: a retrospective study
Authors: Kim Jong Duk 
Published: October 2021

Abstract
Background
Esophageal perforation and rupture (EPR) is a serious, potentially life-threatening condition. However, no treatment methods have been established, and data concerning factors affecting mortality are limited. This report presents the prognostic factors of mortality in EPR based on experience in the management of such patients.

Methods
For this retrospective analysis, 79 patients diagnosed as having EPR between 2006 and 2016 and managed at Gyeongsang National University Hospital were examined. The management method was determined in accordance with the location and size of the EPR, laboratory findings, and radiological findings. Thirty-nine patients were treated with surgery; and 40, with nonsurgical management.

Results
The most common cause of EPR was foreign body (fish bone or meat bone), followed by vomiting, iatrogenic causes, and trauma. Thirty-nine patients underwent primary repair of EPR, of whom 4 patients died. Forty patients underwent nonsurgical management, of whom 3 patients died. The remaining patients were discharged. Mortality correlated with the size of the EPR (> 25 mm) and the segmented neutrophil count percentage (> 86.5%) in the white blood cell test and differential.

Conclusions
The mortality risk was increased when the EPR size and the segmented neutrophil count percentage in the white blood cell test and differential was high. Delayed diagnosis, which was considered an important predictive factor in previous investigations, was not statistically significant in this study.
Trial registration: Not applicable.
Diagnostic utility of next-generation sequencing-based panel testing in 543 patients with suspected skeletal dysplasia
Authors: Scocchia Alicia , Kangas-Kontio Tiia , Irving Melita , Hero Matti , Saarinen Inka , Pelttari Liisa , Gall Kimberly , Valo Satu , Huusko Johanna M. , Tallila Jonna , Sistonen Johanna , Koskenvuo Juha , Alastalo Tero-Pekka 
Published: October 2021

Abstract
Background
Skeletal dysplasia is typically diagnosed using a combination of radiographic imaging, clinical examinations, and molecular testing. Identifying a molecular diagnosis for an individual with a skeletal dysplasia can lead to improved clinical care, guide future medical management and treatment, and inform assessment of risk for familial recurrence. The molecular diagnostic utility of multi-gene panel testing using next-generation sequencing (NGS) has not yet been characterized for an unselected population of individuals with suspected skeletal dysplasia. In this study, we retrospectively reviewed patient reports to assess the diagnostic yield, reported variant characteristics, impact of copy number variation, and performance in prenatal diagnostics of panel tests for variants in genes associated with skeletal dysplasia and growth disorders.

Results
Clinical reports of consecutive patients with a clinical indication of suspected skeletal dysplasia who underwent panel testing were examined. The 543 patients included in the study submitted samples for diagnostic genetic testing with an indication of suspected skeletal dysplasia or growth disorder and received one of three nested panel tests. A molecular diagnosis was established in 42.0% of patients (n = 228/543). Diagnostic variants were identified in 71 genes, nearly half of which (n = 35, 49.3%) contributed uniquely to a molecular diagnosis for a single patient in this cohort. Diagnostic yield was significantly higher among fetal samples (59.0%, n = 52/88) than postnatal samples (38.7%, n = 176/455; z = 3.55, p < 0.001). Diagnostic variants in fetal cases were identified across 18 genes. Thirteen diagnostic CNVs were reported, representing 5.7% of diagnostic findings and ranging in size from 241-bp to whole chromosome aneuploidy. Additionally, 11.4% (36/315) of non-diagnostic patient reports had suspicious variants of unknown significance (VUS), in which additional family studies that provide segregation data and/or functional characterization may result in reclassification to likely pathogenic.

Conclusions
These findings demonstrate the utility of panel testing for individuals with a suspected skeletal dysplasia or growth disorder, with a particularly high diagnostic yield seen in prenatal cases. Pursuing comprehensive panel testing with high-resolution CNV analysis can provide a diagnostic benefit, given the considerable phenotype overlap amongst skeletal dysplasia conditions.
Genetic spectrum and clinical characteristics of 3β-hydroxy-Δ5-C27-steroid oxidoreductase (HSD3B7) deficiency in China
Authors: Zhao Jing , Setchell Kenneth D. R. , Gong Ying , Sun Yinghua , Zhang Ping , Heubi James E. , Fang Lingjuan , Lu Yi , Xie Xinbao , Gong Jingyu , Wang Jian-She 
Published: October 2021

Abstract
Background
Biallelic variants in HSD3B7 cause 3β-hydroxy-Δ5-C27-steroid oxidoreductase (HSD3B7) deficiency, a life-threatening but treatable liver disease. The goal of this study was to obtain detailed information on the correlation between the genotype and phenotype of HSD3B7 deficiency and to report on responses to primary bile acid therapy.

Methods
The medical records of a cohort of 39 unrelated patients with genetically and biochemically confirmed HSD3B7 deficiency were examined to determine whether there exist genotype-phenotype relationships in this bile acid synthesis disorder.

Results
In all, 34 of the 44 variants identified in HSD3B7 were novel. A total of 32 patients presented early with neonatal cholestasis, and 7 presented after 1-year of age with liver failure (n = 1), liver cirrhosis (n = 3), cholestasis (n = 1), renal cysts and abnormal liver biochemistries (n = 1), and coagulopathy from vitamin K1 deficiency and abnormal liver biochemistries (n = 1). Renal lesions, including renal cysts, renal stones, calcium deposition and renal enlargement were observed in 10 of 35 patients. Thirty-three patients were treated with oral chenodeoxycholic acid (CDCA) resulting in normalization of liver biochemistries in 24, while 2 showed a significant clinical improvement, and 7 underwent liver transplantation or died. Remarkably, renal lesions in 6 patients resolved after CDCA treatment, or liver transplantation. There were no significant correlations between genotype and clinical outcomes.

Conclusions
In what is the largest cohort of patients with HSD3B7 deficiency thus far studied, renal lesions were a notable clinical feature of HSD3B7 deficiency and these were resolved with suppression of atypical bile acids by oral CDCA administration.
Severe deforming dermatitis in a kitten caused by Caryospora bigenetica
Authors: Saari Seppo , Schildt Kirsti , Malkamäki Sanna , Andersin Ulla , Sukura Antti 
Published: October 2021

AbstractBackgroundCaryospora bigeneticais an intracellular protozoan parasite, which in its primary hosts, typically snakes, is found it the intestine. Extraintestinal multiplication with the development of tissue cysts takes place in secondary hosts, which are normally prey for snakes. Natural infection in domestic animals has been reported only in dogs; this is the first report ofC. bigeneticainfection in a cat.Case presentationA stray kitten developed nodular dermatitis after being adopted by a shelter. Firm swelling, nodules, and crusts were present mainly on the nasal bridge, eyelids, and pinnae. Histopathology and cytology revealed severe pyogranulomatous inflammation with abundant intracellular organisms suggestive of apicomplexan protozoa. Treatment with clindamycin 13 mg/kg twice daily was initiated, but the cat was euthanized because of the worsening condition. Transmission electron microscopy confirmed parasite’s apicomplexan origin postmortem, and the causative agent was identified asC. bigeneticaby polymerase chain reaction and DNA sequencing.ConclusionsWe present the first case of a naturally occurring infection withC. bigeneticain a cat. Although the definitive etiological diagnosis relied on molecular identification, the abundance of unsporulated oocysts and caryocysts and the parasite's effective reproduction within macrophages and in several other cell types might have enabled differentiation from other protozoal infections and allowed a presumptive diagnosis through cytology and histopathology.
Management of asymptomatic hypoglycemia with 40% oral dextrose gel in near term at-risk infants to reduce intensive care need and promote breastfeeding
Authors: Meneghin Fabio , Manzalini Martina , Acunzo Miriam , Daniele Irene , Bastrenta Petrina , Castoldi Francesca , Cavigioli Francesco , Zuccotti Gian Vincenzo , Lista Gianluca 
Published: October 2021

AbstractBackgroundNeonatal hypoglycemia is a common disorder especially in at-risk infants and it can be associated with poor long-term neurological outcomes. Several therapeutic interventions are suggested, from the implementation of breastfeeding to the glucose intravenous administration. Oral dextrose gel massaged into the infant’s inner cheek is a recent treatment option of asymptomatic hypoglycemia, after which oral feeding is encouraged. This approach seems to reduce the admission of infants to neonatal intensive care unit (NICU) so favouring maternal bonding and breastfeeding success at discharge.MethodsIn our ward, we prospectively compared a group of near-term neonates, (Gr2,n = 308) at risk for hypoglycemia, treated with an innovative protocol based on the addition of 40% oral dextrose gel (Destrogel, Orsana®,Italy) administered by massaging gums and cheek with historical matching newborns (Gr1,n = 389) treated with a formerly used protocol, as control group. The primary outcome was occurrence of NICU admission and the requirement of intravenous glucose administration; while discharge with full breastfeeding was the secondary outcome.ResultsIn Gr1, 39/389 (10%) infants presented with asymptomatic hypoglycemia, 19/39 were transferred to the NICU, and 14/39 required intravenous glucose treatment. In Gr2, among the 30/308 infants with asymptomatic hypoglycemia managed according to the new protocol, 3/30 were transferred to the NICU and received intravenous glucose infusion. The mean duration of hospitalization respectively was 6.43 (± 6.36) and 3.73 ± 1.53 days (p <  0.001). At discharge, 7.7% of the infants in Gr1 and 30% of the infants in Gr2 were exclusively breastfed (p = 0.02). Considering Gr1 vs Gr2, the number of patients that were transferred to NICU was 19 (48.7%) vs 3 (10%) (p = 0.001) and the number of infants that needed intravenous glucose infusion was 14 (35.9%) vs 3 (10%) (p = 0.01), respectively.ConclusionsIn our population of near term infants, the introduction of 40% oral dextrose gel to the protocol, helped in the safe management of asymptomatic hypoglycemia and, at the same time, implemented breastfeeding.