bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infiltration of thyroid papillary cancer tissue with myeloid leukemic cells: a case report
Authors: Sözen Mehmet , Vural Çiğdem , Selek Alev , Kiraz Umay , Cantürk Zeynep , Çetinarslan Berrin , Gezer Emre , Köksalan Damla 
Published: July 2021

Abstract
Background
Extramedullary leukemia, also known as myeloid sarcoma, is a rare form of acute myeloid leukemia and often accompanies bone marrow involvement. Myeloid infiltration of the thyroid gland is extremely rare. Here, a unique case in which thyroid cancer tissue was infiltrated with myeloid cells is presented.

Case presentation
We present a case of thyroid papillary cancer infiltrated by blastic cells and bilateral breast and axillary myeloid sarcoma in a 30-year-old Caucasian female patient with a history of osteosarcoma and MDS-RAEB2. The patient firstly received 6 cycles of chemotherapy for osteosarcoma, and allogeneic hematopoietic stem cell transplantation was performed after anthracycline-based chemotherapy due to MDS-RAEB2. The patient remained in remission on follow-up in terms of both osteosarcoma and MDS-RAEB2. Malignant features (Bethesda VI) were observed in the fine needle aspiration biopsy performed from a newly developed firm, fixed thyroid nodule approximately 4–5 cm in length in the left thyroid lobe. Because of the Bethesda VI thyroid nodule, the patient underwent total thyroidectomy. In the pathological evaluation, CD34-, CD117-, MPO-, and HLA-DR-positive blastic cells which infiltrated into follicular variant papillary thyroid carcinoma were detected. In the evaluation performed due to blastic cell infiltration, multiple lesions showing increased 18-fluorodeoxyglucose activity in bilateral breast and axillae were detected. Myeloid sarcoma was found as a result of tru-cut biopsy from these lesions. A fungal cystic lesion was detected in the frontal region of the patient who developed altered consciousness after the second cycle of treatment of myeloid sarcoma. During her follow-up in the intensive care unit, she died of cranial septic embolism and acute infarction.

Conclusions
Here, we present a very interesting case that is the first. A staged approach to diagnosis with methods including immunohistochemical staining, radiological imaging methods, and cytogenetic and molecular analyses can help make the definitive diagnosis.
Burnout and work-life balance among physicians: the role of migration background
Authors: Hussenoeder Felix S. , Bodendieck Erik , Conrad Ines , Jung Franziska , Riedel-Heller Steffi G. 
Published: July 2021

Abstract
Background
We want to analyze the effect of migration background (MB) on physician burnout and work-life balance.

Methods
In September 2019, physicians from various specialties answered a questionnaire on work and health. We analyzed a subsample of 526 physicians that were working full time in a hospital, 14% with an MB and 47.9% were female.

Results
Multivariate analysis showed that physicians with an MB exhibit significantly less favorable scores on all three burnout dimensions, and this effect persisted in the regression analysis after adding age, gender, and marital status as control variables. There were no differences with regard to work-life balance.

Conclusions
To our knowledge, our study is the first one to suggest that MB plays a significant role in physician mental health. Future research will benefit from identifying the factors behind that connection, e.g., problems related to acculturation, communication and social integration, which can then be addressed by policymakers in order to maintain and improve the medical infrastructure.
Arterial abnormalities in the hands of workers with vibration white fingers – a magnetic resonance angiography case series
Authors: Vihlborg Per , Makdoumi Karim , Gavlovská Hana , Wikström Sverre , Graff Pål 
Published: July 2021

AbstractVibration white finger (VWF) is a complication from exposure to hand-arm vibrations. Poor knowledge of the pathophysiology of VWF means that making an accurate prognosis is difficult. Thus, a better understanding of VWF’s pathophysiology is of importance.The purpose of this study was to investigate whether there were arterial abnormalities in the hands in patients with VWF and a positive Allen’s test, using ultrasound and MRA imaging.This was a case series where arterial abnormalities in the hands were investigated in ten participants with VWF and using prolonged Allen’s test (> 5 s). The participants had an average vibration exposure of 22 years and underwent Doppler ultrasound and Magnetic Resonance Angiography (MRA) to check for arterial abnormalities.The participants had VWF classified as 1–3 on the Stockholm workshop scale. Ultrasound and MRA identified vascular abnormalities in all participants, the predominant finding was missing or incomplete superficial arch. Also, stenosis was identified in four participants.This study reveals a high proportion of arterial stenosis and abnormalities in patients with VWF and a prolonged Allen’s test.
COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial
Authors: Dupuy Emma Gabrielle , Besnier Florent , Gagnon Christine , Vincent Thomas , Grégoire Catherine-Alexandra , Blanchette Caroll-Ann , Saillant Kathia , Bouabdallaoui Nadia , Iglesies-Grau Josep , Payer Marie , Marin Marie-France , Belleville Sylvie , Juneau Martin , Vitali Paolo , Gayda Mathieu , Nigam Anil , Bherer Louis 
Published: July 2021

Abstract
Background
In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults’ cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older.

Methods
One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews’ questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey).

Discussion
This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited.

Trial registration
Clinical trial Identifier NCT04635462. COVEPIC was retrospectively registered on November 19, 2020.
Efficacy of afoxolaner (NexGard®) in preventing the transmission of Leishmania infantum and Dirofilaria immitis to sheltered dogs in a highly endemic area
Authors: Panarese Rossella , Iatta Roberta , Mendoza-Roldan Jairo Alfonso , Zatelli Andrea , Beugnet Frederic , Otranto Domenico 
Published: July 2021

Abstract
Background
Leishmania infantum and Dirofilaria immitis are among the most important canine vector-borne pathogens (CVBPs) of zoonotic concern in Europe. In endemic areas for both of these CVBPs, the use of systemic ectoparasiticides, such as afoxolaner (NexGard®; Boehringer Ingelheim Animal Health), may have the potential for controlling these infections. The aim of this study was to assess, for the first time, the insecticidal efficacy of NexGard® in decreasing the transmission of D. immitis and L. infantum to sheltered dogs living in a hyperendemic area, compared to the year before treatment, as well as its impact on the abundance of mosquito and sand fly populations.

Methods
All dogs (n = 179) enrolled in the study were divided into two groups based on their infection status at enrollment: a non-infected group (G1) and an infected group (G2; infected with D. immitis, L. infantum or both). The study was conducted from March 2020 to March 2021. In order to exclude all animals infected with L. infantum and D. immitis before March 2020 (sampling time: T0), dogs in G1 were sampled in June (T1; i.e. T0 + 90 days) and in October 2020 (T2; i.e. T0 + 210 days). From March to September 2020, all animals (G1 and G2) were weighed and treated monthly with NexGard®. Animals in G1 were tested for the last time in March 2021 (T3; i.e. T0 + 330 days) for assessing post-treatment incidence rate of infection and prevention efficacy.

Results
The post-treatment incidence of D. immitis was 3.7% (1/27; 95% confidence interval [CI]: 0.2–18.1) and that of L. infantum was 3.6% (3/83; 95% CI: 1.0–10.1). Considering the annual incidence in 2019 and 2020, the protective efficacy against D. immitis and L. infantum infections was 94.2 and 64%, respectively. Of the female mosquitoes collected (n = 146), only one pool out of 50 tested positive for D. immitis DNA, whereas out of 1252 female Sergentomya minuta specimens collected, only four tested positive for L. infantum (0.3%).

Conclusions
Afoxolaner is efficacious in decreasing the rate of transmission of both D. immitis and L. infantum; however, comparison of the pre- and post-treatment period demonstrated that there was a significant difference only in the seasonal incidences of D. immitis infection. Preventive measures are recommended throughout the year in endemic areas to reduce the risk of pathogen transmission to animals and humans.

Graphical abstract
Melanosis coli in a peritoneal dialysis patient: a case report
Authors: Zakaria Nor Fadhlina , Ahmad Nurul Izah , Mokhtar Elmina , Zukiman Wan Zul Haikal Hafiz Wan , Shah Anim Md 
Published: July 2021

Abstract
Background
Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion.

Case presentation
We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously.

Conclusions
The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.
IOT security privacy protection mechanism and mechanical structure design simulation optimization
Authors: Guo Caiping , Li Daqing 
Published: July 2021

AbstractOnce the Internet of Things was proposed, it has received great attention from all walks of life and has become one of the top ten technologies that change the world. Therefore, more and more people are engaged in the research of the Internet of Things, after the unremitting efforts of all seniors. Now the Internet of Things has been applied to every aspect of our lives. However, in the application process of the Internet of Things, the protection of personal privacy will undoubtedly be involved. If this problem is not effectively resolved, it will become a major obstacle to the development of the Internet of Things. At present, the research of fully homomorphic technology has attracted great attention from the cryptography community. You can directly calculate the encrypted text encryption to obtain the output and decrypt the output. The result is the same as the output of the unencrypted plain text. This article first comprehensively describes the solution to the privacy protection problem in the existing Internet of Things, and then proposes to apply the fully homomorphic technology to the Internet of Things to make the services provided by the network more secure. Through the analysis of the basic composition and architecture of the existing Internet of Things system, a privacy protection interaction model for the Internet of Things is established, which uses a completely homomorphic technology. On this basis, the algorithm for implementing simple homomorphic encryption is improved, and general homomorphic encryption theory is proposed for some security issues. After using this method to encrypt privacy, the success rate of cracking dropped by 24%.
Burden of non-communicable diseases in Cyprus, 1990–2017: findings from the Global Burden of Disease 2017 study
Authors: Charalampous Periklis , Pallari Elena , Tyrovolas Stefanos , Middleton Nicos , Economou Mary , Devleesschauwer Brecht , Haagsma Juanita A. 
Published: July 2021

Abstract
Background
Non-communicable diseases (NCDs) accounted for over 90% of all deaths in the Cypriot population, in 2018. However, a detailed and comprehensive overview of the impact of NCDs on population health of Cyprus over the period of 1990 to 2017, expressed in disability-adjusted life years (DALYs), is currently not available. Knowledge about the drivers of changes in NCD DALYs over time is paramount to identify priorities for the prevention of NCDs in Cyprus and guide evidence-based decision making. The objectives of this paper were to: 1) assess the burden of NCDs in terms of years of life lost (YLLs), years lived with disability (YLDs), and DALYs in Cyprus in 2017, and 2) identify changes in the burden of NCDs in Cyprus over the 28-year period and assess the main drivers of these changes.

Methods
We performed a secondary database descriptive study using the Global Burden of Disease (GBD) 2017 results on NCDs for Cyprus from 1990 to 2017. We calculated the percentage change of age-standardized DALY rates between 1990 and 2017 and decomposed these time trends to assess the causes of death and disability that were the main drivers of change.

Results
In Cyprus in 2017, 83% (15,129 DALYs per 100,000; 12,809 to 17,707 95%UI) of total DALYs were due to NCDs. The major contributors to NCD DALYs were cardiovascular diseases (16.5%), neoplasms (16.3%), and musculoskeletal disorders (15.6%). Between 1990 and 2017, age-standardized NCD DALY rates decreased by 23%. For both males and females, the largest decreases in DALY rates were observed in ischemic heart disease and stroke. For Cypriot males, the largest increases in DALY rates were observed for pancreatic cancer, drug use disorders, and acne vulgaris, whereas for Cypriot females these were for acne vulgaris, psoriasis and eating disorders.

Conclusion
Despite a decrease in the burden of NCDs over the period from 1990 to 2017, NCDs are still a major public health challenge. Implementation of interventions and early detection screening programmes of modifiable NCD risk factors are needed to reduce occurrence and exacerbation of leading causes of NCDs in the Cypriot population.
Accuracy of digital impressions versus conventional impressions for 2 implants: an in vitro study evaluating the effect of implant angulation
Authors: Abduo Jaafar , Palamara Joseph E. A. 
Published: July 2021

Abstract
Background
Accurate implant impression is an essential requirement for the fabrication of implant prosthesis. This in vitro study evaluated the accuracy of digital impressions by intraoral scanner (IOS) systems in comparison to conventional impressions for recording the position of 2 parallel implants and 2 divergent implants.

Materials and methods
In vitro 3-unit prosthesis master models with 2 tissue level implants were fabricated; one model had parallel implants, and the other model had one 15° tilted implant. The conventional open-tray impressions were obtained with non-splinted (NSP) and splinted (SP) impression copings. Trios 4 (TS), Medit i500 (MT), and True Definition (TD) were used to make digital impressions with scan bodies. A total of 10 impressions were obtained with every technique. The virtual test images of the conventional and digital impressions were converted to 2 virtual implant images. For each group, trueness, precision, inter-implant distance deviation, and angle deviation were measured.

Results
There was a general tendency for digital impressions to provide a more accurate outcome for trueness, precision, and angle deviation. The 2 conventional impressions showed similar accuracy, except for the angle deviation, where the NSP was significantly inferior than SP (p < 0.01) for the divergent implants model. The TD was generally the least accurate among all the IOS systems, especially for the inter-implant distance deviation (p < 0.05).

Conclusions
Within the limitations of the laboratory set-up of the present study and the limited clinical resemblance, the digital impressions appeared to have sufficient accuracy for 2 implants and were least affected by the presence of angle between implants. The most inferior outcome was observed for the NSP technique.
Incorporating microgrids coupling with utilization of flexible switching to enhance self-healing ability of electric distribution systems
Authors: Mousavizadeh Saeed , Alahyari Arman , Ghodsinya Seyed Reza Movahhed , Haghifam Mahmoud-Reza 
Published: July 2021

AbstractElectric distribution networks have to deal with issues caused by natural disasters. These problems possess unique characteristics, and their severity can make load restoration methods impotent. One solution that can help in alleviating the aftermath is the use of microgrids (MGs). Employing the cumulative capacity of the generation resources through MG coupling facilitates the self-healing capability and leads to better-coordinated energy management during the restoration period, while the switching capability of the system should also be considered. In this paper, to form and schedule dynamic MGs in distribution systems, a novel model based on mixed-integer linear programming (MILP) is proposed. This approach employs graph-related theories to formulate the optimal formation of the networked MGs and management of their proper participation in the load recovery process. In addition, the Benders decomposition technique is applied to alleviate computability issues of the optimization problem. The validity and applicability of the proposed model are evaluated by several simulation studies.
Knowledge, attitudes, and impact of COVID-19 pandemic among neurology patients in Jordan: a cross-sectional study
Authors: Athamneh Mohammad , Sa’di Qais , Aldabbour Belal , Khader Yousef , Batayha Waleed 
Published: July 2021

Abstract
Background
The impacts of the COVID-19 pandemic on health services offered to patients with non-communicable diseases, including chronic neurological illnesses, are diverse and universal. We used a self-reported questionnaire to investigate these impacts on neurology patients in Jordan and assess their knowledge and attitudes towards the pandemic.

Results
Most respondents had positive attitudes towards the COVID-19 pandemic, with 96% reporting they believed in the seriousness of the pandemic and adhered to prevention measures. Nearly 97% resorted to the internet and media outlets for medical information about the pandemic. About one in five clinic visitors had their appointments delayed due to interruption of health services. A similar portion of patients with MS, epilepsy, and migraine or tension headache reported medication interruptions during the pandemic. One in two patients reported new events or worsening illness since the start of the pandemic, and sleep disturbances were reported by nearly one in three patients who had epilepsy or headache.

Conclusion
The COVID-19 pandemic’s impacts on patients with neurological illnesses in Jordan were deep and diverse. Meanwhile, the majority of surveyed neurology patients demonstrated a positive attitude towards the pandemic.
Exploring the factors associated with coronaphobia among physicians during the COVID-19 outbreak in Egypt
Authors: Abdelghani Mohamed , Hassan Mervat S. , Elgohary Hayam M. , Fouad Eman 
Published: July 2021

Abstract
Background
Coronaphobia refers to intensified and persistent fears of contracting COVID-19 virus infection. This study aimed to evaluate the newly termed phenomenon, coronaphobia, and address its associated correlates among Egyptian physicians during the outbreak. A cross-sectional study, including a total of 426 Egyptian physicians working during COVID-19 outbreak, was conducted between March 1st and May 1st, 2020. The Fear of COVID-19 Scale (FCV-19S) and Hospital Anxiety and Depression Scale (HADS) were utilized for assessment of coronaphobia, and comorbid anxiety and depressive symptoms among physicians, respectively during the outbreak.

Results
Moderate-to-severe symptoms of anxiety and depression were reported by 28% and 30% of physicians, respectively. Physicians experiencing higher levels of coronaphobia were more likely to be females, nonsmokers, having death wishes and/or self-harming thoughts, receiving insufficient training, dissatisfied with their personal protective equipment (PPE), and had colleagues infected with COVID-19 virus infection. Coronaphobia was positively correlated with anxiety (r = 0.59, P < 0.001) and depressive symptoms (r = 0.47, P < 0.001).

Conclusions
Egyptian physicians experienced higher levels of coronaphobia, anxiety, and depressive symptoms during the COVID-19 outbreak. Yet, frontline physicians did not differ from their second-line counterparts regarding the aforementioned symptoms. Routine mental and physical assessment measures of medical staff should be implemented.