bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preservation of the ovarian reserve and hemostasis during laparoscopic ovarian cystectomy by a hemostatic agent versus suturing for patients with ovarian endometriosis: study protocol for randomized controlled, non-inferiority trial (PRAHA-2 trial)
Authors: Lim Hyunji , Park Soo Jin , Paik Haerin , Mun Jaehee , Lee Eun Ji , Lee Seungmee , Lim Whasun , Song Gwonhwa , Shim Seung-Hyuk , Lee Chae Hyeong , Yim Ga Won , Kim Hee Seung ,   PRAHA Study Group
Published: July 2021

Abstract
Background
Endometriosis (EMS) can be implanted everywhere, especially in pelvic organs. EMS can be asymptomatic, but it can result in pelvic pain and infertility by inducing local inflammation and pelvic adhesion. The prevalence of EMS is about 10% in reproductive-age women and higher in women with pelvic pain or infertility. For young patients with ovarian EMS, laparoscopic ovarian cystectomy is effective in relieving pelvic pain and preventing local recurrence. However, there is a concern that the ovarian reserve would decrease after the operation because of the removal of a part of the normal ovarian tissue and thermal damage during hemostasis, which depends on the types of hemostasis such as bipolar electrocoagulation, suturing, and the use of a hemostatic agent. In this study, we aim to evaluate the protective effect for the ovarian reserve and hemostasis between a hemostatic agent and suturing during laparoscopic ovarian cystectomy for patients with ovarian EMS.

Methods
This study is a randomized controlled, non-inferiority trial, where a total of 90 patients with ovarian EMS will be randomly assigned to the experimental (hemostatic agent) and control (suturing) groups. In the control group, a barbed suture will be applied for hemostasis, whereas a hemostatic agent will be applied in the experimental group. If two methods are insufficient, bipolar electrocoagulation will be applied for complete hemostasis. As the primary endpoint, the reduction rate of serum anti- Müllerian hormone (AMH) levels reflecting the ovarian reserve will be compared between the two groups 12 weeks after surgery. As secondary endpoints, we will compare the reduction rate of AMH level 48 weeks after surgery, the time required to complete hemostasis, the success rate of hemostasis within 10 min, and adverse events associated with operation.

Discussion
We expect that the protective effect for the ovarian reserve and hemostasis may be comparable between the two methods, suggesting that a hemostatic agent may be preferred considering that it is easy to use during laparoscopic ovarian cystectomy.

Trial registration
ClinicalTrials.govNCT04643106. Registered on 22 November 2020
Community-based intervention for prevention and management of chronic obstructive pulmonary disease in Nepal (COBIN-P trial): study protocol for a cluster-randomized controlled trial
Authors: Adhikari Tara Ballav , Neupane Dinesh , Karki Arjun , Drews Arne , Cooper Brendan , Högman Marieann , Sigsgaard Torben , Kallestrup Per 
Published: July 2021

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide and the commonest of non-communicable diseases (NCDs) in Nepal. Risk factors like indoor and outdoor air pollution, a high prevalence of smoking, and the lack of awareness of COPD make it a serious public health concern. However, no attempt has been made in Nepal to estimate its burden and address the disease at the community level.

Method
This study aims to evaluate the effect of a community-based health educational intervention administered by Female Community Health Volunteers (FCHVs) on the prevention and management of COPD. An open-label, two-group, community-based, cluster-randomized controlled trial will be implemented in the semi-urban area of Pokhara Metropolitan city (former Lekhnath Municipality) located in the Kaski district of Nepal. The estimated sample size of the intervention will be 1143. The unit of randomization is the ward (administrative unit) of the study area. The follow-up survey will be conducted immediately after 12 months of FCHVs-led interventions. The difference in the rate of decline of forced expiratory volume in 1 s (FEV1) and FEV1/FVC (forced vital capacity) ratio are the primary outcomes and the change in the proportion of modifiable risk factors of COPD, health-related quality of life scores, and change in knowledge of COPD will be secondary outcomes.

Discussion
This study will estimate the burden of COPD, the magnitude of risk factors and generate evidence to mobilize community health workers for COPD prevention and management at the community level in Nepal.

Trial registration
ClinicalTrials.gov NCT03797768. Registered on January 9, 2019.
Phlebotomine sand fly survey in the Republic of Moldova: species composition, distribution and host preferences
Authors: Șuleșco Tatiana , Erisoz Kasap Ozge , Halada Petr , Oğuz Gizem , Rusnac Dimian , Gresova Marketa , Alten Bulent , Volf Petr , Dvorak Vit 
Published: July 2021

Abstract
Background
Phlebotomine sand flies (Diptera: Psychodiae) in the Republic of Moldova have been understudied for decades. Our study provides a first update on their occurrence, species composition and bloodmeal sources after 50 years.

Methods
During 5 seasons (2013–2017), 58 localities from 20 regions were surveyed for presence of sand flies using CDC light traps and manual aspirators. Species identification was done by a combination of morphological and molecular approaches (DNA barcoding, MALDI-TOF MS protein profiling). In engorged females, host blood was identified by three molecular techniques (RFLP, cytb sequencing and MALDI-TOF peptide mass mapping). Population structure of most abundant species was studied by cox1 haplotyping; phylogenetic analyses of ITS2 and cox1 genetic markers were used to resolve relationships of other detected species.

Results
In total, 793 sand flies were collected at 30 (51.7%) localities from 12 regions of Moldova. Three species were identified by an integrative morphological and molecular approach: Phlebotomus papatasi, P. perfiliewi and Phlebotomus sp. (Adlerius), the first being the most abundant and widespread, markedly anthropophilic based on bloodmeal analyses, occurring also indoors and showing low population structure with only five haplotypes of cox1 detected. Distinct morphological and molecular characters of Phlebotomus sp. (Adlerius) specimens suggest the presence of a yet undescribed species.

Conclusions
Our study revealed the presence of stable sand fly populations of three species in Moldova that represent a biting nuisance as well as a potential threat of pathogen transmission and shall be further studied.

Graphical abstract
Altered circulating CCR6+and CXCR3+ T cell subsets are associated with poor renal prognosis in MPO-ANCA-associated vasculitis
Authors: Liao Zhonghua , Tang Jiale , Luo Liying , Deng Shuanglinzi , Luo Lisa , Wang Fangyuan , Yuan Xiangning , Hu Xinyue , Feng Juntao , Li Xiaozhao 
Published: July 2021

AbstractBackgroundEffector memory T cells are pivotal effectors of adaptive immunity with enhanced migration characteristics and are involved in the pathogenesis of ANCA-associated vasculitis (AAV). The diversity of effector memory T cells in chemokine receptor expression has been well studied in proteinase 3 (PR3)-AAV. However, few studies have been conducted in myeloperoxidase (MPO)-AAV. Here, we characterized chemokine receptor expression on effector memory T cells from patients with active MPO-AAV.MethodsClinical data from newly diagnosed MPO-AAV patients and healthy subjects were collected and analyzed. Human peripheral blood mononuclear cells (PBMCs) isolated from patients with active MPO-AAV were analyzed by flow cytometry. The production of effector memory T cell-related chemokines in serum was assessed by ELISA.ResultsWe observed decreased percentages of CD4+and CD8+T cells in the peripheral blood, accompanied by a significant decrease in CCR6-expressing T cells but an increase in CXCR3+T cells, in active MPO-AAV. Furthermore, the decrease in CCR6 and increase in CXCR3 expression were mainly limited to effector memory T cells. Consistent with this finding, the serum level of CCL20 was increased. In addition, a decreasing trend in the TEM17 cell frequency, with concomitant increases in the frequencies of CD4+TEM1 and CD4+TEM17.1 cells, was observed when T cell functional subsets were defined by chemokine receptor expression. Moreover, the proportions of peripheral CD8+T cells and CD4+TEMsubsets were correlated with renal prognosis and inflammatory markers.ConclusionsOur data indicate that dysregulated chemokine receptor expression on CD4+and CD8+effector memory T cells and aberrant distribution of functional CD4+T cell subsets in patients with active MPO-AAV have critical roles related to kidney survival.
Clinical characteristics, imaging phenotypes and events free survival in Takayasu arteritis patients with hypertension
Authors: Ying Sun , Sifan Wu , Yujiao Wang , Rongyi Chen , Qingrong Huang , Lili Ma , Huiyong Chen , Lindi Jiang 
Published: July 2021

Abstract
Background
Hypertension occurred in 30–80% of Takayasu arteritis (TAK) patients around the world and the occurrence of hypertension might worsen the disease prognosis. This study aimed to investigate the clinical characteristics and imaging phenotypes, as well as their associations with events free survival (EFS) in Chinese TAK patients with hypertension.

Methods
This current research was based on a prospectively ongoing observational cohort-the East China Takayasu Arteritis (ECTA) cohort, centered in Zhongshan Hospital, Fudan University. Totally, 204 TAK patients with hypertension were enrolled between January 2013 and December 2019. Clinical characteristics and imaging phenotypes of each case were evaluated and their associations with the EFS by the end of August 30, 2020, were analyzed.

Results
Severe hypertension accounted for 46.1% of the entire population. Three specific imaging phenotypes were identified: Cluster 1: involvement of the abdominal aorta and/or renal artery (27.5%); Cluster 2: involvement of the ascending aorta, thoracic aorta, the aortic arch, and/or its branches (18.6%); and Cluster 3: combined involvement of Cluster 1 and 2 (53.9%). Clinical characteristics, especially hypertensive severity, differed greatly among the three imaging clusters. In all, 187 patients were followed up for a median of 46 (9–102) months; 72 events were observed in 60 patients (1–3 per person). The overall blood pressure control rate was 50.8%, and the EFS was 67.9% by the end of the follow-up. Multivariate Cox regression indicated that controlled blood pressure (HR = 2.13, 95% CI 1.32–3.74), Cluster 1 (HR = 0.69, 95% CI 0.48–0.92) and Cluster 3 (HR = 0.72, 95% CI 0.43–0.94) imaging phenotype was associated with the EFS. Kaplan–Meier curves showed that patients with controlled blood pressure showed better EFS (p = 0.043). Furthermore, using cases with Cluster 1 imaging phenotype and controlled blood pressure as reference, better EFS was observed in patients with Cluster 2 phenotype and controlled blood pressure (HR = 2.21, 95%CI 1.47–4.32), while the case with Cluster 1 phenotype plus uncontrolled blood pressure (HR = 0.64, 95%CI 0.52–0.89) and those with Cluster 3 phenotype and uncontrolled blood pressure (HR = 0.83, 95%CI 0.76–0.92) suffered worse EFS.

Conclusion
Blood pressure control status and imaging phenotypes showed significant effects on the EFS for TAK patients with hypertension.
Modeling organizational intelligence, learning, forgetting and agility using structural equation model approaches in Shiraz University of Medical Sciences Hospitals
Authors: Kavosi Zahra , Delavari Sajad , Kiani Mohammad Mehdi , Bastani Peivand , Vali Mohebat , Salehi Marzieh 
Published: July 2021

Abstract
Objectives
Strengthening the organizational agility of the hospital can lead to decreased production costs and increased market share, better serving to patients' needs, introduction of new services and increased competitiveness; therefore, this study aimed to investigate the agility of Shiraz public teaching hospitals.

Results
The results showed that organizational intelligence had a positive and significant effect on organizational agility with a path coefficient of 0.172. Organizational forgetting and organizational learning also played a mediating role between organizational intelligence and organizational agility. This means that organizational intelligence had positive effect on organizational forgetting with path coefficient of 0.482, organizational forgetting on organizational learning with path coefficient of 0.40 and subsequently organizational learning on organizational agility with path factor of 0.07. Organizational forgetting also played a mediating role between organizational intelligence and organizational learning.
Retrospective analysis of the clinical presentation and imaging of eight primary benign mediastinal schwannomas
Authors: Sandoval-Macias Ramiro , Ortiz-Sanchez Irving Daniel , Remirez-Castellanos Ana Lilia , Mora-Hernandez Luis , Cordova-Uscanga Candelaria , Mantilla-Morales Alejandra , Galindo-Garcia Tania Alejandra , Gamboa-Dominguez Armando , Candanedo-Gonzalez Fernando 
Published: July 2021

Abstract
Objective
Mediastinal schwannomas are sometimes confused with other neoplasms during initial radiological studies, especially when there is a history of cancer in another area. In these cases, a more accurate analysis using computed tomography (CT) or even magnetic resonance (MRI) is required. Our study aimed to perform a retrospective analysis of the clinical and imaging features for a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry.

Results
We found eight patients, five men and three women, with an average age of 51 years for this study. The main signs and symptoms at diagnosis were chest pain, dyspnea, cough, and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors > 10 cm were more heterogeneous and showed cystic changes. All patients underwent posterolateral thoracotomy, and radiological follow-up showed no evidence of recurrence. Histological analysis was considered the gold standard to confirm diagnosis, along with at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. According to CT, schwannomas > 10 cm show cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.
Adult-onset perianal Langerhans cell histiocytosis presenting as pruritus ani: a case report and review of the literature
Authors: Hamdan Marah , Qiao Jesse C. , Fikfak Vid 
Published: July 2021

Abstract
Background
Langerhans cells belong to the histiocytic system and give rise to two tumors: Langerhans cell histiocytosis and Langerhans cell sarcoma. Clinical aggressiveness and degree of atypia distinguish the two neoplasms. Langerhans cell histiocytosis can infiltrate a single or multiple organ systems and particularly affects bone, skin, and lymph nodes. Perianal cutaneous Langerhans cell histiocytosis is a rare condition in adults, with 15 cases reported in the literature.

Case
We present the case of a 50-year-old hispanic man who presented with a 9-month history of pruritus ani and a personal history of diabetes insipidus. Punch biopsy confirmed a lesion of Langerhans cells origin but could not exclude Langerhans cell sarcoma because of limited sample size. An additional biopsy was planned as well as a positron emission tomography scan to determine the extent of disease spread. While the patient failed to follow up for repeat biopsy, the positron emission tomography scan was performed and was negative for metastatic disease. A stable perianal lesion of Langerhans cell histiocytosis with benign clinical features in a 50-year-old male despite lack of treatment is extremely rare and has not been described in the literature so far. Here, we review the presentation and workup of patients with Langerhans cell histiocytosis, review the relevant literature, and discuss treatment planning.

Conclusion
Perianal Langerhans cell histiocytosis is rare, and there should be a high index of suspicion with chronic or new perianal lesions, especially in a patient with a history of diabetes insipidus. It is also important to consider the patient’s full clinical course when it is not possible to reach a definitive pathological diagnosis before management.
Asymptomatic meningitis diagnosed by positron emission tomography in a patient with syndrome of inappropriate antidiuretic hormone secretion: a case report
Authors: Hasebe Masanori , Shirakawa Jun , Miyashita Daisuke , Kunishita Rieko , Kyohara Mayu , Okuyama Tomoko , Togashi Yu , Terauchi Yasuo 
Published: July 2021

Abstract
Background
Syndrome of inappropriate antidiuretic hormone secretion can be caused by arginine-vasopressin-producing tumors or enhanced arginine vasopressin secretion from the posterior pituitary gland due to central nervous system disorders and intrathoracic diseases.

Case presentation
A 53-year-old Asian man was hospitalized with complaints of tremor and hiccups. Laboratory examination revealed findings suggestive of hypotonic hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion. The patient did not complain of headache or photophobia, and showed no signs of meningeal irritation. Positron emission tomography–computed tomography revealed 18F-fluoro-deoxy-glucose accumulation along the cervical spinal cord, based on which the patient was diagnosed as having aseptic meningitis. The hyponatremia was treated successfully by fluid restriction, and optimum plasma sodium concentration was maintained by tolvaptan administration.

Conclusions
This case underscores the need to consider the possibility of mild meningitis as the cause of syndrome of inappropriate antidiuretic hormone secretion in patients without other identifiable cause.
Study on new integral operators defined using confluent hypergeometric function
Authors: Oros Georgia Irina 
Published: July 2021

AbstractTwo new integral operators are defined in this paper using the classical Bernardi and Libera integral operators and the confluent (or Kummer) hypergeometric function. It is proved that the new operators preserve certain classes of univalent functions, such as classes of starlike and convex functions, and that they extend starlikeness of order $\frac{1}{2}$

1

2

and convexity of order $\frac{1}{2}$

1

2

to starlikeness and convexity, respectively. For obtaining the original results, the method of admissible functions is used, and the results are also written as differential inequalities and interpreted using inclusion properties for certain subsets of the complex plane. The example provided shows an application of the original results.
A study on multiterm hybrid multi-order fractional boundary value problem coupled with its stability analysis of Ulam–Hyers type
Authors: Nouara Ahmed , Amara Abdelkader , Kaslik Eva , Etemad Sina , Rezapour Shahram , Martinez Francisco , Kaabar Mohammed K. A. 
Published: July 2021

AbstractIn this research work, a newly-proposed multiterm hybrid multi-order fractional boundary value problem is studied. The existence results for the supposed hybrid fractional differential equation that involves Riemann–Liouville fractional derivatives and integrals of multi-orders type are derived using Dhage’s technique, which deals with a composition of three operators. After that, its stability analysis of Ulam–Hyers type and the relevant generalizations are checked. Some illustrative numerical examples are provided at the end to illustrate and validate our obtained results.
Clinical characteristics and risk factors for mortality in COVID-19 inpatients in Birjand, Iran: a single-center retrospective study
Authors: Azarkar Ghodsiyeh , Osmani Freshteh 
Published: July 2021

Abstract
Background
The coronavirus disease 2019(COVID-19) has affected mortality worldwide. The Cox proportional hazard (CPH) model is becoming more popular in time-to-event data analysis. This study aimed to evaluate the clinical characteristics in COVID-19 inpatients including (survivor and non-survivor); thus helping clinicians give the right treatment and assess prognosis and guide the treatment.

Methods
This single-center study was conducted at Hospital for COVID-19 patients in Birjand. Inpatients with confirmed COVID-19 were included. Patients were classified as the discharged or survivor group and the death or non-survivor group based on their outcome (improvement or death). Clinical, epidemiological characteristics, as well as laboratory parameters, were extracted from electronic medical records. Independent sample T test and the Chi-square test or Fisher’s exact test were used to evaluate the association of interested variables. The CPH model was used for survival analysis in the COVID-19 death patients. Significant level was set as 0.05 in all analyses.

Results
The results showed that the mortality rate was about (17.4%). So that, 62(17%) patients had died due to COVID-19, and 298 (83.6%) patients had recovered and discharged. Clinical parameters and comorbidities such as oxygen saturation, lymphocyte and platelet counts, hemoglobin levels, C-reactive protein, and liver and kidney function, were statistically significant between both studied groups. The results of the CPH model showed that comorbidities, hypertension, lymphocyte counts, platelet count, and C-reactive protein level, may increase the risk of death due to the COVID-19 as risk factors in inpatients cases.

Conclusions
Patients with, lower lymphocyte counts in hemogram, platelet count and serum albumin, and high C-reactive protein level, and also patients with comorbidities may have more risk for death. So, it should be given more attention to risk management in the progression of COVID-19 disease.