bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cause of Death in Patients in Radiation Oncology
Authors: Domschikowski Justus , Koch Karoline , Schmalz Claudia 
Published: October 2021

BackgroundThe accurate attribution of death in oncologic patients is a difficult task. The patient’s death is often attributed to his or her underlying cancer and therefore judged as cancer-related. We hypothesized that even though our patient’s cancers were either advanced or metastatic, not all patients had died simply because of their cancer.MethodsA total of 105 patients were included in this retrospective analysis. Patient data were collected from digital and paper-based records. Cause of death was assessed from death certificate and compared to the medical autopsy reports. Discrepancies between premortem and postmortem diagnoses were classified as class I and II discrepancies.ResultsOf 105 patients included, autopsy consent was obtained in 56 cases (53%). Among them, 32 of 56 were palliatively sedated, and 42/56 patients died cancer-related as confirmed by autopsy. The most common cause of death by autopsy report was multiorgan failure followed by a combination of tumor and infection, predominantly lung cancer with pneumonia. Here, 21/56 cases (37%) showed major missed diagnoses: seven cases showed class I, 10 class II, and both discrepancies. The most commonly missed diagnoses in both categories were infections, again mainly pneumonia.ConclusionsCancer was the leading cause of death in our study population. A quarter of the patients, however, did not die due to their advanced or metastatic cancers but of potentially curable causes. We therefore conclude that it is important to consider competing causes of death when treating palliative cancer patients. In a palliative setting, the treatment of a potentially curable complication should be discussed with the patients and their families in a shared decision-making process. From our experience, many patients will decline treatment or even further diagnostics when given the option of best supportive care.
The Impact of Mutations in Wolframin on Psychiatric Disorders
Authors: Munshani Saira , Ibrahim Eiman Y. , Domenicano Ilaria , Ehrlich Barbara E. 
Published: October 2021

Wolfram Syndrome is a rare autosomal recessive disease characterized by early-onset diabetes mellitus, neurodegeneration, and psychological disorders. Mutations in the gene WFS1, coding for the protein wolframin, cause Wolfram Syndrome and are associated with bipolar disorder and schizophrenia. This report aims to connect WFS1 mutations to their impact on protein expression and structure, which ultimately translates to altered cell function and behavioral alterations of an individual.Methods: Published data were used to compile WFS1 mutations associated with psychiatric symptoms, both in homozygous patients and heterozygous carriers of WFS1 mutations. These mutations were evaluated in silico using SNAP2, PolyPhen-2, and PROVEAN to predict the effects of sequence variants. Statistical analysis was performed to assess the correlation between the locations of the mutations and the damage prediction scores.Results: Several mutations, clustering in the center and C-terminus of the WFS1 polypeptide, such as A559T and R558C, are found in individuals with psychiatric diseases and appear particularly impactful on protein structure. Our analysis showed that mutations in all regions of wolframin were present in patients with schizophrenia whereas only cytoplasmic and ER luminal mutations were reported in patients with manic episodes and bipolar disorders. According to Poly-Phen-2 predictions, 82.4% of the ER lumen mutations and 85.7% of the membrane mutations are damaging.Conclusion: We propose mood disorders in Wolfram Syndrome and heterozygous carriers of WFS1 mutations are the consequence of specific mutations in WFS1 that alter the structure of wolframin, resulting in intracellular calcium dysregulations and impaired cell signaling, Understanding the effect of WFS1 mutations on bipolar disorder and schizoprenia is integral to designing clinically targeted treatments for both diseases, which need more specialized treatments.
Spondylodiscitis in Children: A Retrospective Study and Comparison With Non-vertebral Osteomyelitis
Authors: Roversi Marco , Mirra Gianluca , Musolino Antonio , Barbuti Domenico , Lancella Laura , Deriu Daniele , Iorio Carlo , Villani Alberto , Crostelli Marco , Mazza Osvaldo , Krzysztofiak Andrzej 
Published: October 2021

Objectives: The aim of this study is to provide new data on pediatrics spondylodiscitis for an optimal clinical management of this site-specific osteomyelitis.Methods: We reported 48 cases of pediatric spondylodiscitis and made three comparisons between: (1) tubercular and non-tubercular cases; (2) patients aged more or less than 5 years; (3) children with spondylodiscitis and 62 controls with non-vertebral osteomyelitis.Results: A higher rate of sequelae was reported in patients with tubercular spondylodiscitis, but no significant differences were noted at the cut-off of 5 years of age. Compared to non-vertebral osteomyelitis, pediatric spondylodiscitis affects younger children of both genders, usually presenting with afebrile back pain, and requiring longer time to admission, hospitalization, and antibiotic therapy.Conclusion: Pediatric spondylodiscitis is an insidious disease with a non-specific presentation in childhood and peculiarities of its own. However, when clinical remission is obtained by an early start of broad-spectrum antibiotics, prolonging the therapy does not improve, nor worsens, the outcome. Surgical management is mandatory in case of vertebral instability and neurological signs but can be avoided when the infection is promptly treated with antibiotic therapy.
Red Blood Cell Metabolism in Pyruvate Kinase Deficient Patients
Authors: Roy Micaela K. , Cendali Francesca , Ooyama Gabrielle , Gamboni Fabia , Morton Holmes , D’Alessandro Angelo 
Published: October 2021

Background: Pyruvate kinase deficiency (PKD) is the most frequent congenital enzymatic defect of glycolysis, and one of the most common causes of hereditary non spherocytic hemolytic anemia. Therapeutic interventions are limited, in part because of the incomplete understanding of the molecular mechanisms that compensate for the metabolic defect.Methods: Mass spectrometry-based metabolomics analyses were performed on red blood cells (RBCs) from healthy controls (n=10) and PKD patients (n=5).Results: In PKD patients, decreases in late glycolysis were accompanied by accumulation of pentose phosphate pathway (PPP) metabolites, as a function of oxidant stress to purines (increased breakdown and deamination). Markers of oxidant stress included increased levels of sulfur-containing compounds (methionine and taurine), polyamines (spermidine and spermine). Markers of hypoxia such as succinate, sphingosine 1-phosphate (S1P), and hypoxanthine were all elevated in PKD subjects. Membrane lipid oxidation and remodeling was observed in RBCs from PKD patients, as determined by increases in the levels of free (poly-/highly-unsaturated) fatty acids and acyl-carnitines.Conclusion: In conclusion, in the present study, we provide the first overview of RBC metabolism in patients with PKD. Though limited in scope, the study addresses the need for basic science to investigate pathologies targeting underrepresented minorities (Amish population in this study), with the ultimate goal to target treatments to health disparities.
Mindfulness Awareness Is Associated With a Lower Risk of Anxiety and Depressive Symptoms in Older Adults With Neurocognitive Disorders
Authors: Lam Linda Chiu Wa , Lee Allen T. C. , Cheng Sheung Tak , Yip Benjamin H. K. , Chan Wai Chi , Fung Ada W. T. , Ma Suk Ling , Cheng Calvin P. W. , Kong Ryan , Chiu Henry T. S. , Lai Frank H. Y. , Wong Samuel Yeung Shan 
Published: October 2021

Background: Apart from depressive disorders, there are great interests in adopting mindfulness based interventions (MBIs) for other mental health conditions. Depression and anxiety are common in people with neurocognitive disorders (NCD). The potential of MBIs as an adjuvant treatment in this cognitively at-risk group should be further explored.Objectives: The current study explored the association between depression and anxiety symptoms with dispositional mindfulness in older adults, and if same association stays in the context of cognitive impairment.Methods: The Hong Kong Mental Morbidity Survey for Older People (MMSOP) is an ongoing epidemiology study of the prevalence of neurocognitive and mental disorders in adults aged 60 years or over in Hong Kong. MMSOP evaluated cognitive function, psychiatric symptoms (Clinical Interview Schedule-revised, CIS-R), chronic physical disease burden, psychosocial support, and resilience factors, including dispositional mindfulness as measured by the Mindful Attention Awareness Scale (MAAS). We analyzed the impact of MAAS on CIS-R and potential moderation effects of mindfulness.Results: In March 2021, 1,218 community dwelling participants completed assessments. The mean age of the sample is 69.0 (SD 6.9) years. Eight hundred and two participants (65.7%) were not demented (CDR 0) and 391 (32%) and 25 (2%) were categorized as having mild NCD (CDR 0.5) and major NCD (CDR 1 or more), respectively. One hundred forty-three (11.7%) satisfied ICD-10 criteria for anxiety or depressive disorder as measured by CIS-R. Linear regression analysis showed that female gender, CIRS, and MAAS scores were significant factors associated with CIS-R scores. MAAS scores moderated and attenuated the impact CIRS on CIS-R (adjusted R2 = 0.447, p &lt; 0.001). MAAS scores remained as significant moderator for CIRS in patients with NCD (CDR ≥ 0.5) (adjusted R2 = 0.33, p &lt; 0.001).Conclusion: Interim findings of the MMSOP suggested that dispositional mindfulness is associated with lower level of mood symptoms in community dwelling older adults in Hong Kong. The interaction effects further suggested that high mindful awareness may reduce the adverse effects of chronic physical morbidity on mental health. The observation stayed in the participants with cognitive impairment. We should further explore MBIs as a non-pharmacological treatment for in older adults at-risk of physical morbidity and cognitive decline.
Sex-Specific Effect of Serum Lipids and Body Mass Index on Psychotic Symptoms, a Cross-Sectional Study of First-Episode Psychosis Patients
Authors: Gjerde Priyanthi B. , Simonsen Carmen E. , Lagerberg Trine V. , Steen Nils Eiel , Andreassen Ole A. , Steen Vidar M. , Melle Ingrid 
Published: October 2021

Background: Schizophrenia is a disorder with considerable heterogeneity in course and outcomes, which is in part related to the patients' sex. Studies report a link between serum lipids, body mass index (BMI), and therapeutic response. However, the role of sex in these relationships is poorly understood. In a cross-sectional sample of first-episode psychosis (FEP) patients, we investigated if the relationship between serum lipid levels (total cholesterol, HDL-C, LDL-C, and triglycerides), BMI, and symptoms differs between the sexes.Methods: We included 435 FEP patients (males: N = 283, 65%) from the ongoing Thematically Organized Psychosis (TOP) study. Data on clinical status, antipsychotics, lifestyle, serum lipid levels, and BMI were obtained. The Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to assess psychotic and depressive symptoms. General linear models were employed to examine the relationship between metabolic variables and symptomatology.Results: We observed a female-specific association between serum HDL-C levels and negative symptoms (B = −2.24, p = 0.03) and between triglycerides levels (B = 1.48, p = 0.04) and BMI (B = 0.27, p = 0.001) with depressive symptoms. When controlling for BMI, only the association between serum HDL-C levels and negative symptoms remained significant. Moreover, the HDL-C and BMI associations remained significant after controlling for demography, lifestyle, and illness-related factors.Conclusion: We found a relationship between metabolic factors and psychiatric symptoms in FEP patients that was sex-dependent.
Primary Sleeve Gastrectomy and Leaks: The Impact of Fundus-Wall Thickness and Staple Heights on Leakage—An Observational Study of 500 Patients
Authors: Boeker Clara , Schneider Barbara , Markov Valentin , Mall Julian , Reetz Christian , Wilkens Ludwig , Hakami Ibrahim , Stroh Christine , Köhler Hinrich 
Published: October 2021

Introduction: The most feared complication of laparoscopic sleeve gastrectomy (LSG) is staple-line leakage. Staple height and fundus-wall thickness might influence such leakage, and this study examined their possible impact on leak incidence. Factors including gender, age, comorbidities, and reinforcement of the staple line were also investigated.Methods: A total of 500 patients between 17 and 71 years of age who were scheduled for LSG were selected to participate in the study. For technical reasons, 53 were excluded. The fundus-wall thickness of 447 patients after LSG was investigated. The impact of staple height, fundus-wall thickness, demographic and medical factors on leak incidence were investigated. Most of our patients (309) were female (69%), while 138 were male (31%).Results: The mean thickness of the proximal fundus wall was 2,904 μm, 3,172 μm in men and 2,784 μm in women. The leak rate was 4.9%. Age, fundus-wall thickness, and BMI showed a strong influence on leak risk, but this effect was significant only for age (p = 0.01). Patient gender and staple size showed no significant influence on the correlation between fundus-wall thickness and leak risk. Gender displayed a small effect of influence on this correlation, with η2 = 0.05.Discussion: Because older age had a significant effect on increasing the risk of staple-line leakage, there is a need for a more specific focus on these patients. Thinner fundus wall and female gender might predispose patients to staple-line leaks, but a significant value could not be reached. Therefore, staple size should remain the surgeon's choice based on clinical experience.
Attitudes and Perspectives of People Living With Human Immunodeficiency Virus: Findings From the Positive Perspectives Survey in Slovakia
Authors: Sojak Lubomir , Simekova Katarina , Piesecka Lubica , Wiesinger Milos , Jarcuska Pavol 
Published: October 2021

Objectives: To investigate the perspectives and attitudes of people living with human immunodeficiency virus (PLHIV) in Slovakia.Methods: A cross-sectional, computer-assisted web survey on health status, emotional support, stigmatisation, communication with physician, treatment, perception, decision-making, concerns, and treatment history. A representative sample of &gt;10% of all PLHIV (N = 895) in Slovakia was invited to participate.Results: Mean age of the 117 respondents was 35.4 (±8.9) years, 52.8% had higher education, and 67.0% were in full-time employment. Most (89.4%) were receiving antiretroviral therapy (ART), and 81.8% had undetectable viral load. Most (85.1%) were satisfied with their ART, and side effects were the primary reason for switching therapies. Most (60.8%) had informed only close friends or relatives about their HIV status, only 3 (2.9%) spoke openly about it, and 60.0% hid their ART from others. Of the 31 respondents (31.6%) who experienced stigmatisation, it was primarily from dentists and other physicians who refused to treat them.Conclusion: In general, PLHIV in Slovakia receive ART and are satisfied with it. They do not speak openly about their HIV status, and some have experienced discrimination.
The Flow of Blood-Based Hybrid Nanofluids with Couple Stresses by the Convergent and Divergent Channel for the Applications of Drug Delivery
Authors: Saeed Anwar , Khan Niqab , Gul Taza , Kumam Wiyada , Alghamdi Wajdi , Kumam Poom 
Published: October 2021

This research work aims to scrutinize the mathematical model for the hybrid nanofluid flow in a converging and diverging channel. Titanium dioxide and silver TiO2 and Ag are considered as solid nanoparticles while blood is considered a base solvent. The couple-stress fluid model is essentially use to describe the blood flow. Therefore, the couple-stress term was used in the recent study with the existence of a magnetic field and a Darcy–Forchheiner porous medium. The heat absorption/omission and radiation terms were also included in the energy equation for the sustainability of drug delivery. An endeavor was made to link the recent study with the applications of drug delivery. It has already been revealed by the available literature that the combination of TiO2 with any other metal can destroy cancer cells more effectively than TiO2 separately. Both the walls are stretchable/shrinkable, whereas flow is caused by a source or sink with α as a converging/diverging parameter. Governing equations were altered into the system of non-linear coupled equations by using the similarity variables. The homotopy analysis method (HAM) was applied to obtain the preferred solution. The influences of the modeled parameters have been calculated and displayed. The confrontation of wall shear stress and hybrid nanofluid flow increased as the couple stress parameter rose, which indicates an improvement in the stability of the base fluid (blood). The percentage (%) increase in the heat transfer rate with the variation of nanoparticle volume fraction was also calculated numerically and discussed theoretically.
The Event Ontology of Nature
Authors: Mikki Said 
Published: October 2021

We propose a new event ontology of the world, which is part of a general approach to philosophy based on combining ideas from science, ontology, and the philosophy of nature. While the position advocated here is grounded in science and philosophy, it attempts to move beyond each of them by devising and exploring a series of technical (naturalized or naturalistic) ontological concepts such as Interconnectedness, the Whole, the Global, Chaos, the event assemblage, and Nonspace. A central theme in our event ontology is the mapping out of a fundamental critique of the theory of the organism and organization, especially when the latter two are viewed as processes in spacetime. In particular, and following earlier leads, we criticize the spacetime doctrine by arguing that it is not ontologically fundamental, where we suggest its replacement by more primordial naturalized ontological concepts of space such as ontospace and Nonspace. The event ontology of nature can be considered a radical alternative attitude toward the relation between the human and nature, an attitude, in fact, that has been repeatedly explored, though under very different headings, by numerous scattered thinkers throughout the history of ideas. We examine some of the past thinkers who contributed to this general but still incoherent body of thought, including Leibniz, Heidegger, Simondon, Ruyer, Deleuze, Whitehead, and Guattari. The goal of this article is to provide a condensed high-level view on this very complex and still evolving subject intended for a large audience, not necessarily only philosophers, but also scientists, mathematicians, technologists, theologians, sociologists, artists, and psychologists.
De Novo Central Vein Stenosis in Hemodialysis Patients Following Initial Tunneled Central Vein Catheter Placement
Authors: Al-Balas Alian , Almehmi Ammar , Varma Rakesh , Al-Balas Hassan , Allon Michael 
Published: October 2021

Background
Central vein stenosis (CVS) is a common complication in hemodialysis patients following tunneled central venous catheter (CVC) insertion. Little is known about its incidence, association with patient characteristics, or relationship with duration of CVC placement. We systematically evaluated central vein stenosis in hemodialysis patients receiving their first CVC exchange at a large medical center.

Methods
All new hemodialysis patients underwent an ultrasound before their internal jugular tunneled CVC placement, to exclude venous stenosis or thrombosis. After the initial CVC insertion, if the patients were referred for CVC exchange due to dysfunction, a catheterogram/venogram was performed to assess for hemodynamically significant (≥50%) central vein stenosis. During a 5-year period (January 2016 to January 2021), we quantified the incidence of CVS in patients undergoing CVC exchange. We also evaluated the association of central vein stenosis with patient demographics, comorbidities, and duration of CVC dependence before exchange.

Results
During the study period, 273 patients underwent exchange of a tunneled internal jugular vein CVC preceded by a catheterogram/venogram. Hemodynamically significant CVS was observed in 36 patients (13%). CVS was not associated with patient age, sex, race, diabetes, hypertension, coronary artery disease, peripheral artery disease, or CVC laterality. However, the frequency of CVS was associated with the duration of CVC dependence (26% versus 11% for CVC duration ≥6 versus <6 months: odds ratio (95% CI), 3.17 (1.45 to 6.97), P=0.003).

Conclusions
Among incident hemodialysis patients receiving their first tunneled internal jugular CVC exchange, the overall incidence of de novo hemodynamically significant central vein stenosis was 13%. The likelihood of CVS was substantially greater in patients with at least 6 months of CVC dependence.
STUDY THE ANTIMICROBIAL AND ANTIADHESIVE ACTIVITY OF PURIFIED BIOSURFACTANT PRODUCED FROM LACTOBACILLUS PLANTARUM AGAINST PATHOGENIC BACTERIA
Authors: Jameel A . A. , Haider N. H. 
Published: October 2021

This study was aimed to purification the biosurfactant that produced from Lactobacillus plantarum isolated from clinical samples of iraqi healthy women by column chromatography through silica gel column (3.5 × 30 cm) using solvent system (chloroform : methanol, 2:1) and characterization the purified product by Thin layer chromatography (TLC), Fourier Transform Infrared Red spectroscopy (FTIR) and Gas chromatography (GC) mass then evaluated its antibacterial and anti-adhesive activity. The results shown the higher emulsification activity (E24%= 63) and lower the surface tension to 23 mN/m in synthetic MSM, while the natural media gave (E24% =71) and lower surface tension to 19 mN/m. The using TLC technique indicated presence of lipopeptide in the biosurfactant with Rf value = 0.82. Antibacterial and antiadhesion activities were evaluated against some pathogenic bacteria, including Pseudomonas aureginosa and Staphylococcus aureus. The results showed a higher inhibitory effect of biosurfactant at concentration 200 mg/ml on S. aureus and P. aeruginosa with the inhibition zone 27 mm and 33 mm respectively in BCDFTM media. While purified biosurfactant with concentration 200 mg/ml produced in MSM media had an effect on S. aureus and P. aeruginosa with the inhibition zone 21 mm, and 18 mm respectively. The anti-adhesion activity of purified biosurfactant against p.aeruginosa ranging from (34.70 ± 5.256) to (11.7 ± 9.7) produced from natural media BCDFTM and was higher than the anti-adhesion activity of purified biosurfactant against the same pathogen ranging from (46.95 ± 7.37) to (20.15 ± 2.805) produced in MSM.