bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Knowledge Regarding Cervical Cancer and Its Screening among Woman in Rural India
Authors: Khanna Divya 
Published: March 2021

AbstractContext Cervical cancer is the most common cancer among rural women of India. However, awareness of cancer of the uterine cervix and its screening coverage among the general population of India remains insufficient.Aims The study aims to assess awareness of cervical cancer and its screening among women attending a rural health care center in northern India and determine factors associated with satisfactory knowledge.Settings and Design A cross-sectional observational study was done among women attending a rural secondary health care center from Uttar Pradesh, India.Materials and Methods A total of 1088 women aged ≥30 years were interviewed using a pretested schedule. Data were collected for biosocial, reproductive, sexual, and personal habits of participants and their partners. Scoring for knowledge related to cervical cancer and its screening was done.Statistical Analysis Used Descriptive statistics were calculated. Chi-square test was applied to detect the significant difference in distribution of bio-socio-demographic variables with knowledge score. Statistically significant variables were subjected to multinomial logistic regression. Unadjusted and adjusted odds ratios with 95% confidence interval were calculated as odds of having poor cervical cancer awareness. p < 0.05 was considered statistically significant.Results Most participants knew about cervical cancer as a type of cancer in women. Very few knew about symptoms, risk factors, and screening of the disease. Illiteracy and multiple sexual contacts were significant predictors of awareness.Conclusions The study demonstrates a lack of awareness in women regarding cervical cancer and its prevention, especially among those women who belonged to weaker sections of the society, because of illiteracy and poor socioeconomic status. Lack of awareness is a potential limiting step for a woman to seek cervical cancer screening. Multipronged strategies are needed to improve the level of cervical cancer awareness among women.
Pediatric Metastatic Crohn's Disease
Authors: Oliveira Amanda Trindade de , Oliveira Raissa Albuquerque Calais de , Meyer Matheus Matta Machado Duque Estrada , Silva Ilson Geraldo da , Massahud Matheus Duarte 
Published: March 2021

AbstractCrohn's disease (CD) is a chronic, relapsing, idiopathic condition, characterized by granulomatous, transmural inflammation of the gastrointestinal tract, which can affect its entire length, from mouth to anus. Metastatic Crohn's disease (MCD) is a rare form of skin involvement and is defined by skin lesions without contiguity with the gastrointestinal tract. A 9-year-old patient presented with gastrointestinal complaints and gross skin lesions in the vulva and perianal region. The diagnosis of Crohn's disease was made when the patient was 11 years old, after being evaluated by the colorectal surgeon. Treatment was started with a “top-down” approach, with a sustained response for four years. Afterwards, there was a relapse of the skin disease in previously normal areas, without overt symptoms. Treatment consisted of steroids and local infiltration of infliximab, without improvement. A year later, there was a rapid progression of the skin lesions, and the drug changed to adalimumab, also without response and worsening of the skin lesions. The patient was admitted to the hospital and intravenous steroids were initiated, along with surgical debridement of the lesions. After some improvement, ustekinumab was initiated with satisfactory response. Pediatric MCD has an important impact on the patient's quality of life, with influences on growth and social development.
Assessment of Quality Indexes in Colonoscopy in the Coloproctology Service of a Tertiary Private Hospital in Southern Brazil
Authors: Pinto Rafael Castilho , Seabra Marcela Krug , Cunha Aline Andrea da , Pagano Cassia Garcia Moraes , Mussnich Heloisa Guedes 
Published: March 2021

Abstract
Background Colorectal cancer (CRC) is the third most common cancer among men, and the second among women worldwide. In Brazil, the incidence and mortality of CRC continues to increase. In colonoscopies, adenoma detection rates (ADRs) higher than 25% are associated linearly with better outcomes and lower rates of interval cancer.
Objective To assess the colonoscopy quality indexes.
Methods This is a cross-sectional retrospective study in which anatomopathological data and data regarding the colonoscopies were collected from the patient records of Hospital Moinhos de Vento, in Southern Brazil. The exams were performed by doctors from the Colorectal Service from June to August 2015.
Results A total of 430 exams were included. Most patients were women (60.9% [262]), with a mean age of 56.96 years. The cecal intubation rate was of 96.7% (416). The quality of the bowel preparation was excellent or good in 92.95% (396) of the cases. The average time of removal of the colonoscope in normal exams was of 6.15 minutes. Polyps were detected in 201 patients (46.7%), and adenomas, in 125 patients (29.1%); 12 patients (2.8%) had advanced adenomas, and 6 (2.3%) had malignant neoplasms. The proximal serrated lesion detection rate (PSLDR) was of 6.7% (29). The prevalence ratio (PR) of adenomas among men was 1.78 times greater than in women (95% confidence interval [95%CI]: 1.16–2.75). The PR of adenomas among people aged 50 years or older was 2.41 times that of those under 50 years of age (95%CI: 1.43–4.06).
Conclusion The data obtained are in line with international quality criteria in colonoscopy. More studies are needed to assess the ADR in the Brazilian population.
Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Middle Fossa Approaches and Anterior Petrosectomy, Surgical Principles, and Illustrative Cases
Authors: Salgado-Lopez Laura , Perry Avital , Graffeo Christopher S. , Carlstrom Lucas P. , Leonel Luciano C.P.C. , Driscoll Colin L.W. , Link Michael J. , Peris-Celda Maria 
Published: March 2021

Abstract
Introduction The middle fossa (MF) approaches encompass a group of versatile surgical accesses to pathologies in the MF, internal auditory canal (IAC), and superomedial aspect of the posterior fossa. Although many descriptions of the MF approaches have been published, a practical surgical guide that allows an easy understanding for Skull Base trainees is needed.
Methods Three formalin-fixed, colored-injected specimens were dissected under microscopic magnification (six sides). A MF craniotomy followed by IAC drilling was performed on three sides, and anterior petrosectomy (AP) was performed in the remaining three sides. The anatomical dissection was documented in stepwise three-dimensional photographic images. Following dissection, representative case applications were reviewed.
Results The MF approach provides direct access to the MF structures and IAC. The AP provides excellent access to the superomedial aspect of the posterior fossa. Key common steps include: positioning and skin incision; scalp and muscle flaps; burr holes; craniotomy flap elevation; dural dissection along the petrous ridge; division of the middle meningeal artery; and exposure of the greater superficial petrosal nerve, tegmen tympani, and V3. Then, to approach the IAC: superior IAC drilling, and longitudinal dura opening. The area drilled in the AP approach forms a pentagon limited by the petrous internal carotid artery, cochlea, IAC, petrous ridge, and lateral border of V3.
Conclusion The MF approaches are challenging. Operatively oriented skull base dissections provide a crucial foundation for learning these techniques. We describe comprehensive step-by-step approaches intended to develop familiarity in the cadaver laboratory and facilitate understanding of their potential for skull base disorders. Basic surgical principles are described to help in the operating room as well as illustrative cases.
Normal Values and Associated Factors in High-resolution Anorectal Manometry in Healthy Vietnamese Adults
Authors: Anh Nguyen Ngoc , Tung Le Dinh , Khoa Ngo Xuan , Cuong Le Manh , Hung Nguyen Xuan , Hang Nguyen Thi Thu , Khanh Pham Phuc , Huy Nguyen Van , Kien Vu Duy 
Published: March 2021

Abstract
Introduction The present study aims to identify normal high-resolution anorectal manometry (HRAM) values and related factors in healthy Vietnamese adults.
Methods The present cross-sectional study was conducted at the Viet Duc hospital, Hanoi, Vietnam, during April and May 2019. Healthy volunteers were recruited to participate in the study. Anorectal measurement values from the digestive tract, including pressure, were recorded.
Results A total of 76 healthy volunteers were recruited. The mean functional anal canal length was 4.2 ± 0.5 cm, while the mean anal high-pressure zone length was 3.4 ± 0.5 cm. The mean defecation index was 1.4 ± 0.8, with values ranging from 0.3 to 5.0. The mean threshold volume to elicit the rectoanal inhibitory reflex (RAIR) was 18.1 mL. The mean rectal sensation values were 32.4 mL, 81.6 mL, and 159 mL for first sensation, desire to defecate, and urge to defecate, respectively. Dyssynergic patterns occurred in ∼ 50% of the study participants and included mainly types I (27.6%) and III (14.6%). There were significant differences between male and female patients in terms of maximum anal squeeze pressure, maximum anal cough pressure, maximum anal strain pressure, maximum rectal cough pressure, and maximum rectal strain pressure (all p < 0.01).
Conclusions The present study establishes normal HRAM values in healthy Vietnamese adults, particularly regarding normal values of anorectal pressure and rectal sensation. Further studies that include larger sample sizes should be conducted to further confirm the constants and their relationships.
The making of “deep language” in the Philippines
Authors: Osborne Dana 
Published: March 2021

Abstract
This analysis interrogates one of the most highly recognizable, but little understood metalinguistic descriptors of
language in the contemporary Philippine linguistic scene: the concept of “deep language.” Here, “deep language” is explored as a complex,
polysemous term generally used to describe homegrown conceptualizations of “pure” forms of Philippine-type languages and speakers. The
contemporary understanding of “deep language” in the Philippines is theorized to have been informed by a complex combination of folk and
academic discourses that have percolated throughout shared ideologies and conceptualizations of language since national independence at mid-20th
century. The metric of “depth” in the analysis of language is shown to function centrally as a conceptual metaphor that enables everyday
speakers to theorize person-types and the passage of time in a folk chronotope reckoned through the sign of language.
Spontaneous classroom engagement facilitating development of L2 pragmatic competence
Authors: Van Dyke Angelina , Acton William R. 
Published: March 2021

AbstractThe question of how to teach toward social, cultural and linguistic L2 pragmatic competence has raised serious challenges (Kasper, 1997). This is more the case for spoken rather than written discourse. As can be expected, the underlying pragmatic implications of spontaneous face-to-face communication naturally constrains the interactional scope and its potential pedagogical application. To address this issue, this naturalistic study explores two key potential contributors to the development of oral pragmatic competence: meta-pragmatic classroom conversational discourse and the course framework supporting that kind of relatively spontaneous interaction. An English for Academic Purposes (EAP) course provided fluency practice protocols, instruction in pragmatic categories, analysis of conversational data and “live” in-class intervention, focusing on meaning and alternate expressions and forms. Those interventions were designed to enhance learners’ ability to self-assess, monitor and expand their interactional repertoires. Part of a larger research project examining principles of pragmatics applied in EAP instruction, this study focuses on data from spontaneous classroom interactions situated within the integrated instructional framework of the course. Results present a range of strategies employed by the instructor consistent with current theoretical models of factors or pedagogical interventions that facilitate development of pragmatic competence.
Models to inform neutralizing antibody therapy strategies during pandemics: the case of SARS-CoV-2
Authors: Guttieres Donovan , Sinskey Anthony J , Springs Stacy L 
Published: March 2021

Abstract

Background
Neutralizing antibodies (nAbs) against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) can play an important role in reducing impacts of the COVID-19 pandemic, complementing ongoing public health efforts such as diagnostics and vaccination. Rapidly designing, manufacturing and distributing nAbs requires significant planning across the product value chain and an understanding of the opportunities, challenges and risks throughout.

Methods
A systems framework comprised of four critical components is presented to aid in developing effective end-to-end nAbs strategies in the context of a pandemic: (1) product design and optimization, (2) epidemiology, (3) demand and (4) supply. Quantitative models are used to estimate product demand using available epidemiological data, simulate biomanufacturing operations from typical bioprocess parameters and calculate antibody production costs to meet clinical needs under various realistic scenarios.

Results
In a US-based case study during the 9-month period from March 15 to December 15, 2020, the projected number of SARS-CoV-2 infections was 15.73 million. The estimated product volume needed to meet therapeutic demand for the maximum number of clinically eligible patients ranged between 6.3 and 31.5 tons for 0.5 and 2.5 g dose sizes, respectively. The relative production scale and cost needed to meet demand are calculated for different centralized and distributed manufacturing scenarios.

Conclusions
Meeting demand for anti-SARS-CoV-2 nAbs requires significant manufacturing capacity and planning for appropriate administration in clinical settings. MIT Center for Biomedical Innovation’s data-driven tools presented can help inform time-critical decisions by providing insight into important operational and policy considerations for making nAbs broadly accessible, while considering time and resource constraints.
Identification of Molecular Alterations Challenging Initial Pathologic Classification in Cases of Clinician-Initiated Next-Generation Sequencing Testing
Authors: Cho Joseph H , Charnot-Katsikas Angela , Segal Jeremy , Pytel Peter 
Published: March 2021

AbstractObjectivesLarge gene panel next-generation sequencing (NGS) is a powerful tool capable of generating predictive data on cancer prognosis and response to specific therapeutic interventions. The utility of large panel NGS data on tumor classification, however, may be underappreciated because of a workflow that often circumvents the surgical pathologist. We sought to describe cases in which NGS data lead to an unanticipated change in tumor classification and to discuss current workflow practices of NGS testing that limit its use as a diagnostic adjunct.MethodsWe performed a retrospective review to identify cases in which NGS testing uncovered data that led to a revision of the initial pathologic diagnosis that an outside or in-house pathologist had made.ResultsNine cases are presented in which NGS data provided insights that led to a revision of the original pathologic diagnosis. Distinctive molecular signatures, mutational signatures, fusions, or identification of viral sequencing provided the critical evidence on which these tumors were reclassified.ConclusionsThe current workflow of NGS testing should always include the surgical pathologist as an active partner to ensure that the molecular results are fully reflected in the final diagnosis. In some instances, active participation by the surgical pathologist may require amendment of previously issued pathology reports.
Pathology Residency Open-House Events: A Novel Marketing Paradigm
Authors: Salah Haneen T , Mirza Kamran M 
Published: March 2021

Abstract

Objectives
Due to the continued impact of coronovirus 2019 (COVID-19), residency programs were advised to offer virtual interviews in place of traditional in-person interviews for the 2021 match recruitment season. As a result, many pathology residency programs offered preinterview virtual open-house events to meet prospective applicants before the interview season. This article aims to understand applicants’ perspective on those events during the residency recruitment season of 2020 to 2021.

Methods
We performed a cross-sectional survey-based study involving 95 pathology residency applicants.

Results
Our results demonstrated that applicants generally have a positive perception of open house events; 91% found virtual open-house events beneficial, 63.2% attended open-house events for programs they were not considering applying to. Considering the high number of offered virtual open house events, 17% of applicants felt overwhelmed by attendance and 30% felt obligated to attend.

Conclusions
This brief report demonstrates the generally positive impact of these events.
Divergence in floral scent and morphology, but not thermogenic traits, associated with pollinator shift in two brood-site-mimicking Typhonium (Araceae) species
Authors: Sayers Thomas D J , Johnson Kim L , Steinbauer Martin J , Farnier Kevin , Miller Rebecca E 
Published: March 2021

Abstract

Background
Flowers which imitate insect oviposition sites probably represent the most widespread form of floral mimicry, exhibit the most diverse floral signals and are visited by two of the most speciose and advanced taxa of insect – beetles and flies. Detailed comparative studies on brood-site mimics pollinated exclusively by each of these insect orders are lacking, limiting our understanding of floral trait adaptation to different pollinator groups in these deceptive systems.

Methods
Two closely related and apparent brood-site mimics, Typhonium angustilobum and T. wilbertii (Araceae) observed to trap these distinct beetle and fly pollinator groups were used to investigate potential divergence in floral signals and traits most likely to occur under pollinator-mediated selection. Trapped pollinators were identified and their relative abundances enumerated, and thermogenic, visual and chemical signals and morphological traits were examined using thermocouples and quantitative reverse transcription–PCR, reflectance, gas chromatography–mass spectrometry, floral measurements and microscopy.

Key Results
Typhonium angustilobum and T. wilbertii were functionally specialized to trap saprophagous Coleoptera and Diptera, respectively. Both species shared similar colour and thermogenic traits, and contained two highly homologous AOX genes (AOX1a and AOX1b) most expressed in the thermogenic tissue and stage (unlike pUCP). Scent during the pistillate stage differed markedly – T. angustilobum emitted a complex blend of sesquiterpenes, and T. wilbertii, a dung mimic, emitted high relative amounts of skatole, p-cresol and irregular terpenes. The species differed significantly in floral morphology related to trapping mechanisms.

Conclusions
Functional specialization and pollinator divergence were not associated with differences in anthesis rhythm and floral thermogenic or visual signals between species, but with significant differences in floral scent and morphological features, suggesting that these floral traits are critical for the attraction and filtering of beetle or fly pollinators in these two brood-site mimics.
Letter to the Editor: Significant mutation enrichment in inverted repeat sites of new SARS-CoV-2 strains
Authors: Bartas Martin , Goswami Pratik , Lexa Matej , Červeň Jiří , Volná Adriana , Fojta Miroslav , Brázda Václav , Pečinka Petr 
Published: March 2021

Abstract
In a recently published paper, we have found that SARS-CoV-2 hot-spot mutations are significantly associated with inverted repeat loci and CG dinucleotides. However, fast-spreading strains with new mutations (so-called mink farm mutations, England mutations and Japan mutations) have been recently described. We used the new datasets to check the positioning of mutation sites in genomes of the new SARS-CoV-2 strains. Using an open-access Palindrome analyzer tool, we found mutations in these new strains to be significantly enriched in inverted repeat loci.
Deep grey matter injury in multiple sclerosis: a NAIMS consensus statement
Authors: Ontaneda Daniel , Raza Praneeta C , Mahajan Kedar R , Arnold Douglas L , Dwyer Michael G , Gauthier Susan A , Greve Douglas N , Harrison Daniel M , Henry Roland G , Li David K B , Mainero Caterina , Moore Wayne , Narayanan Sridar , Oh Jiwon , Patel Raihaan , Pelletier Daniel , Rauscher Alexander , Rooney William D , Sicotte Nancy L , Tam Roger , Reich Daniel S , Azevedo Christina J ,   the North American Imaging in Multiple Sclerosis Cooperative (NAIMS)
Published: March 2021

Abstract
Although multiple sclerosis has traditionally been considered a white matter disease, extensive research documents the presence and importance of grey matter injury including cortical and deep regions. The deep grey matter exhibits a broad range of pathology and is uniquely suited to study the mechanisms and clinical relevance of tissue injury in multiple sclerosis using magnetic resonance techniques. Deep grey matter injury has been associated with clinical and cognitive disability. Recently, MRI characterization of deep grey matter properties, such as thalamic volume, have been tested as potential clinical trial end points associated with neurodegenerative aspects of multiple sclerosis. Given this emerging area of interest and its potential clinical trial relevance, the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative held a workshop and reached consensus on imaging topics related to deep grey matter. Herein, we review current knowledge regarding deep grey matter injury in multiple sclerosis from an imaging perspective, including insights from histopathology, image acquisition and post-processing for deep grey matter. We discuss the clinical relevance of deep grey matter injury and specific regions of interest within the deep grey matter. We highlight unanswered questions and propose future directions, with the aim of focusing research priorities towards better methods, analysis, and interpretation of results.