bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perimortem changes in clinical parameters in patients undergoing maintenance hemodialysis
Authors: Yoshida Tadashi , Morimoto Kohkichi , Nakayama Takashin , Torimitsu Takuto , Kosugi Shotaro , Oshida Takuma , Yamaguchi Nobuko , Oya Mototsugu 
Published: December 2021

Abstract
Background
End-of-life medical care for patients receiving maintenance hemodialysis (HD) therapy has become an increasingly important issue worldwide. Thus far, no clear indicators and/or biomarkers exist regarding the timing of HD therapy withdrawal.

Methods
To clarify the perimortem circumstances, we examined temporal changes in multiple clinical parameters during the last 10 serial HD sessions of 65 terminal patients with end-stage renal disease who had undergone maintenance HD and died in our hospital.

Results
The results showed that, while most of the laboratory data were unaltered, the physical parameters, such as systolic blood pressure and consciousness levels, gradually and significantly deteriorated toward the last HD session prior to death. The frequency of the use of vasopressors and O2 inhalation tended to increase. The accumulation of such severe conditions was observed at the last HD session. Of interest, the accumulation of severe conditions at the last HD session in patients with malignancies was significantly less than those with cardiovascular diseases or infectious diseases. The accumulation of severe conditions at the last HD session did not differ between patients who withdrew HD versus those who continued HD.

Conclusion
The results of the present study suggest that predicting the timing of maintenance HD therapy withdrawal is likely to be difficult and that the timing of maintenance HD therapy termination may differ among patient groups with distinct comorbid conditions.
Atypical bilateral ventilation/perfusion mismatches in an asymptomatic patient suffering from metastatic thyroid cancer
Authors: Kersting David , Rischpler Christoph , Plönes Till , Aigner Clemens , Umutlu Lale , Herrmann Ken , Hautzel Hubertus 
Published: December 2021

Abstract
Background
Pulmonary embolism is indicated by ventilation/perfusion (V/P) mismatches in ventilation/perfusion scintigraphy. However, other pathologies may also evoke segmental or lobar mismatches. Thus, diagnosis can be difficult in asymptomatic patients with equivocal clinical presentation.

Case presentation
We present a case of multiple bilateral pulmonary ventilation/perfusion mismatches in a poorly differentiated thyroid cancer patient. Exact diagnosis was difficult, as the patient was asymptomatic and pulmonary embolism is commonly unilateral in tumour patients and not typical for thyroid cancer. External pulmonary artery compression by aortic aneurysm, multiple metastases or additional bronchopulmonary malignancies were considered as differential diagnosis. After unilateral pulmonary and hilar metastasectomy, perfusion normalised on the operated side. Pulmonary perfusion defects due to pulmonary artery compression by hilar metastases were finally diagnosed. Pulmonary embolism was deemed unlikely due to the left-sided post-operative normalisation, persistence of right-sided V/P mismatches, and the lack of clinical symptoms.

Conclusion
Pulmonary artery compression may mimic pulmonary artery embolism in lung perfusion scintigraphy and should be considered in bronchopulmonary tumour patients with hilar metastases and unilateral ventilation/perfusion mismatches affecting a complete lobe or even lung. Following the presented case, also bilateral segmental and subsegmental mismatches in patients with hilar metastases from non-bronchopulmonary cancer entities should be carefully evaluated.
The effectiveness of e-learning in patient education delivered to patients with rheumatoid arthritis: The WebRA study—protocol for a pragmatic randomised controlled trial
Authors: Raunsbæk Knudsen Line , Lomborg Kirsten , Ndosi Mwidimi , Hauge Ellen-Margrethe , de Thurah Annette 
Published: December 2021

AbstractBackgroundPatient education is integral to the treatment and care of patients with rheumatoid arthritis. Change is taking place in the organisation of healthcare systems because of a demographic shift towards ageing populations, an increasing use of technology and advancements in digital technologies, allowing for new interventions. This study will aim to evaluate the effectiveness of a newly developed e-learning patient education programme based on self-management that targets patients with rheumatoid arthritis.MethodsA pragmatic multi-centre randomised controlled trial is planned. We intend to recruit approximately 200 patients with a new diagnosis (< 3 months) of rheumatoid arthritis. Participants will be randomised 1:1 to web-based patient education delivered through an e-learning programme at home or standard face-to-face patient education provided at the hospital. The primary outcome is self-efficacy. Secondary outcomes are improved knowledge of rheumatoid arthritis, adherence to medication, health literacy level and quality of life. Outcomes will be measured at baseline and follow-up occurring 1, 3, 6 and 12 months after enrolment. Furthermore, data on healthcare utilisation and utilisation of the e-learning programme will be assessed at the 12-month follow-up. Statistical analysis, including differences between groups, will be evaluated using the chi-square and Kruskal–Wallis tests. Statistical analysis will follow the intention-to-treat principle, and analysis of variance will be used to evaluate the within- and between-groups differences testing the hypothesis of the ‘superiority’ of web-based patient education over standard face-to-face education provided at the hospital. Per protocol analysis will be used to assess the impact of missing data. Enrolment started in February 2021 and will end in June 2022.DiscussionThe study is expected to contribute to the evidence on the effectiveness of web-based patient education within rheumatic diseases. If the e-learning programme is effective, it will be incorporated into existing services to improve the self-management of patients with rheumatoid arthritis. Further, this mode of providing patient education may impact the organisation of health care for both rheumatic diseases and other chronic diseases by offering different modes of delivering patient education based on the needs and preferences of patients.Trial registration: ClinicalTrials.gov identifier NCT04669340. Registered on November 27, 2020.https://www.clinicaltrials.gov/ct2/show/NCT04669340?term=e-learning&cond=Rheumatoid+Arthritis&draw=2&rank=1. See Additional file 1 for detailed information on the dataset according to the World Health Organization Trial Registration Data Set.
An aborted case suspected to CHARGE Syndrome; A rare case with cardiac, intestinal and kidney abnormalities
Authors: Ahmadpour Shahriar , Foghi Khadijeh , Rezaei Faezeh 
Published: December 2021

Abstract
Background
CHARGE syndrome is a life-threatening congenital anomaly. The syndrome associations consist of coloboma, heart disease, atresia of the choanae, retarded growth and development, genital hypoplasia/genitourinary anomalies, and ear anomalies and or hearing loss. The aim of this paper is to describe and discuss a rare case of CHARGE syndrome.

Case presentation
During the routine dissection, atrial septal defect, overriding aorta from both ventricles, patent ductus arteriosus, duodenal anomaly, absent pancreas, right side descending and sigmoid, intestinal herniation in lesser sac, and left kidney anomaly were observed.

Conclusions
This rare case is of importance in re-considering the criteria of CHARGE and understanding the importance of the orchestrated morphologic driving forces of embryonic development.
Psychological factors affecting COVID-19 vaccine acceptance in Indonesia
Authors: Yanto Theo Audi , Octavius Gilbert Sterling , Heriyanto Rivaldo Steven , Ienawi Catherine , Nisa Haviza , Pasai H. Emildan 
Published: December 2021

Abstract
Introduction
Increasing the rate of vaccination is crucial in combating the COVID-19 pandemic. However, a survey of 112,888 Indonesians found that only 64.8% Indonesians were willing to be vaccinated, with 7.6% refusing all vaccines and 27.6% are unsure. Several factors were related to this vaccine hesitancy and refusal, such as cognitive reflection, trust in authoritative figures, and personality traits. This study aims to identify psychological determinants and other factors associated with vaccine hesitancy and vaccine refusal. This was a cross-sectional study with data collection done in March 2021 using a questionnaire. We collected demographic data, respondents' stance on vaccination, as well as their psychology measurement. IBM SPSS 26.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA) was used for statistical analysis.

Results
The data of 190 respondents were collected for this study. There are 165 respondents (86.8%) who belong to “vaccine acceptance”, while 25 are “vaccine hesitance” or “vaccine resistance.” Multivariate analysis shows that frequency of COVID-19 tests (p = 0.03), smoking status (p = 0.035), agreeableness trait (p = 0.001), trust in government (p = 0.04) and trust in scientist (p = 0.049) are significantly associated with the two population.

Conclusion
Several demographic and psychological factors affect the COVID-19 vaccine acceptance. The government and other related parties should consider these factors when adjusting for future policies controlling the COVID-19 pandemic and increasing the vaccination rate.
Preliminary sub-acute toxicological assessment of methanol leaves extract of Culcasia angolensis (Araceae) in Wistar rats
Authors: Abraham Idagu Godwin , Ahmad Mubarak Hussaini 
Published: December 2021

Abstract
Background
The plant Culcasia angolensis (Araceae) has diverse ethnomedicinal uses, including the management of rheumatic pain, healing of cuts, dislocations, and bruises. Despite its potential therapeutic uses, the toxicity profile of Culcasia angolensis has not been evaluated. This study assessed the sub-acute toxicity effects of Culcasia angolensis leaves extract (CAE). The phytochemical determination of the CAE was conducted as per the standard protocols. The median lethal dose (LD50) was determined using the Organization for Economic Cooperation and Development (OECD) 423 guideline. Besides, the sub-acute toxic effects of the CAE (125, 250, and 500 mg/kg) were investigated following administration of the CAE daily for 28 consecutive days as per the OECD 407 guideline. The weekly body weights were recorded. The animals were euthanized on the 29th day, and blood samples were obtained for haematological and biochemical investigations. The heart, kidney, liver, and lungs were collected for histological examinations. Besides, the relative organ weights (ROW) were determined.

Results
The CAE contains cardiac glycosides, alkaloids, tannins, flavonoids, steroids, saponins, and terpenoids. The oral LD50 was above 5 g/kg. There was a remarkable decline in the weekly body weight at all the CAE doses. The CAE increased the lymphocytes, aspartate transaminase, and urea. However, the levels of alanine transaminase and alkaline phosphatase were elevated remarkably. The histological studies did not reveal any serious organs abnormalities.

Conclusion
The CAE is relatively safe on acute administration. However, it may be slightly toxic on sub-acute administration, especially to the liver and kidney.
Impact of zinc oxide, benzoic acid and probiotics on the performance and cecal microbiota of piglets
Authors: da Silva Caio Abercio , Bentin Leonardo Aparecido Teixeira , Dias Cleandro Pazinato , Callegari Marco Aurélio , Facina Vitor Barbosa , Dias Francine Taniguchi Falleiros , Passos Adsos , da Silva Martins Cláudia Cassimira , Costa Marcio Carvalho 
Published: December 2021

Abstract
Background
Intestinal health remains a key factor in animal production because it is essential for digestion, absorption and bacterial fermentation. Feed additives have been used to attenuate the weaning stress such as Zinc Oxide (ZnO) and benzoic acid (C7H6O2). The objective of this study was to evaluate the impact of of benzoic acid and probiotics (BA + P) on performance, diarrhea and cecal microbiota of piglets in the nursery phase (23 to 65 days).

Results
One hundred and sixty weaned piglets with an initial weight of 6.335 ± 0.698 kg and 23 days of age were submitted to four treatments: supplementation with 2500 ppm of Zinc oxide (ZnO), supplementation with a commercial blend of benzoic acid and probiotics (Bacillus licheniformis, Bacillus subtilis and Enterococcus faecium NCIMB 10415; Vevogut P®) (BA + P), supplementation with Zinc oxide plus benzoic acid and probiotics (ZnO + BA + P), and controls receiving only the basal diet without any supplementation. At 65 days of age, 32 piglets (n = 8 per treatment) were slaughtered for the evaluation of the cecal microbiota. Supplementation with ZnO and BA + P were associated with better feed conversion (P < 0.05) in the early stage (23 to 49 days) and with an improvement in all performance parameters over the entire experimental period. The occurrence of diarrhea was lower (P < 0.05) in the BA + P group. The 4 most abundant phyla along with unclassified bacteria represented 93% of all sequences. Firmicutes dominated the cecal microbiota of all groups, followed by Bacteroidetes. Richness represented by the observed number of genera and by the Chao index were statistically lower in ZnO and ZnO + BA + P supplemented animals compared to controls. The beta diversity analysis that compares similarities between bacterial communities demonstrated formation of two distinct clusters containing samples with and without supplementation with ZnO, confirming a strong influence of ZnO on the intestinal microbiota.

Conclusion
The use of Benzoic acid with probiotics yields similar performance results with lower impact on the gut microbiota compared to ZnO, and it should be considered as a potential alternative in swine production.
Sotrovimab: is it effective in early treatment of mild and moderate COVID-19 infections? A retrospective study
Authors: Elesdoudy Ahmed 
Published: December 2021

Abstract
Background
The monoclonal antibody sotrovimab is manufactured to antagonize many types of coronaviruses including the SARS-CoV-2. It is used mainly to treat mild and moderate COVID-19 infection and to prevent the progression of the disease from critical disease to severe.

Objectives
To assess the effectiveness of sotrovimab in the early treatment of mild and moderate COVID-19 infections and prevention of disease progression to severe and critical disease.

Methods
This study was performed on 220 outpatients who have already received sotrovimab in Obaidullah Hospital, United Arab Emirates. All patients underwent the following before receiving sotrovimab: routine laboratory studies (CBC, liver function tests, and kidney function tests) and other laboratory tests (C reactive protein (CRP), D dimer, and chest x-ray). All patients received sotrovimab in a dose of 500 mg once intravenous infusion over 30 min. All laboratory studies and CXR are repeated after 1 week of receiving the dose of sotrovimab.

Results
The outcome was 43 patients deteriorated (19.5%) and 177 patients improved (80.5%). The progress of patients’ symptoms after receiving sotrovimab where the shortness of breath (SOB) deteriorated in 43 patients (19.5%) and improved in 177 patients (80.5%). The cough symptom deteriorated in 43 patients (19.5%), improved in 177 patients (80.5%). The progress of patients' radiology (chest x-ray) where it is deteriorated in 43 patients (19.5%) and improved in 177 patients (80.5%). The rate of hospitalization after receiving sotrovimab where 41 patients were hospitalized (18.6%) and 179 patients were not hospitalized (81.4%). There was a statistically significant difference before and after using sotrovimab in vital signs, inflammatory markers, kidney function tests, electrolytes, endocrine functions, and hepatic profile.

Conclusion
Among adults with mild and moderate COVID-19, the use of sotrovimab significantly improved resolution of symptoms, outcome, radiology, or laboratory marker and decreased hospitalization. The findings support using sotrovimab in the early treatment of mild and moderate COVID-19. Wide-scale studies may be required for clarifying the effects of sotrovimab in the treatment of mild and moderate COVID-19 infections.
Brenner tumors
Authors: Costeira Filipa de Sousa , Félix Ana , Cunha Teresa Margarida 
Published: December 2021

Brenner tumors are rare ovarian neoplasms composed of ovarian transition cells surrounded by dense fibrous tissue. Most of them are small tumors (&lt;2 cm), detected incidentally in asymptomatic women. Its predominantly fibrous content results in relatively low signal on T 2 weighted images, establishing differential diagnosis with ovarian fibroma and thecoma. Their imaging features are very similar, the differentiation is based on secondary characteristics, such as signs or symptoms of estrogen excess and the presence of a second ovarian neoplasm, which has been reported in up to 30% of patients with Brenner tumor. Although originally thought to be universally benign, there have been scattered reports in the past decades of borderline and malignant forms of Brenner tumors.
Bringing Lived Lives to Swift’s Asylum: a psychiatric hospital perspective
Authors: Malone Kevin M. , Cleary Eimear , Kelleher Cecily C. , Jefferies Janis , Lane Abbie , Lucey James V. , McGuiness Seamus 
Published: December 2021

Background: Few “interventions” around suicide and stigma have reached into psychiatric institutions. Lived Lives is a science-arts approach to addressing suicide and stigma, informed by a psychobiographical and visual arts autopsy. The resulting artworks and mediated exhibition ( Lived Lives), has facilitated dialogue, response and public action around stigma-reduction, consistent with a community intervention. Recent evidence from Lived Lives moved us to consider how it may situate within a psychiatric hospital. Methods: Lived Lives manifested in St. Patrick’s University Hospital (Ireland’s oldest and largest psychiatric hospital) in November 2017. A mixed-methods approach was used to evaluate the exhibition as a potential intervention to address stigma around suicide, with quantitative and qualitative data collected via written questionnaire and oral data collected via video documentation. Bereavement support was available. A Clinician and an artist also provided independent evaluation. Results: 86 participants engaged with the exhibition, with 68 completing questionnaire data. Audiences included service users, policy makers, health professionals, senior hospital administrators and members of the public. 62% of participants who completed questionnaires were suicide-bereaved; 46% had experienced a mental health difficulty, and 35% had been suicidal in the past. 91% thought Lived Lives could be of benefit in the aftermath of a suicide death. Half of participants thought Lived Lives could help reduce suicidal feelings, whereas 88% thought it could benefit those with Mental Health difficulties. The emotional response was of a visceral nature, including fear, anger, sadness, disgust and anxiety. Conclusions: Lived Lives sits comfortably in discomfort, unafraid to call out the home-truths about stigma and its pervasive and pernicious impact, and with restoring identity at its core. Lived Lives can operate within a psychiatric hospital, as well as in community. The challenge is to move it forward for greater exposure and impacts in at-risk communities.
Kraasna nominal derivation
Authors: Ernits Enn 
Published: December 2021

This article examines the derivation of Kraasna nominals using suffixes. Despite limited documentation, it was possible to find a large number of nominal derivatives using 18 derivational suffixes formed from 20 primary suffixes and 21 suffixes formed from 21 secondary suffixes. Kraasna suffixes mostly resemble those of Seto. Only the compound suffixes (-i)s-to, -la-s, and -ži-ne, which derive just a few words (kaklas, laanist, soomist, ammuužine) are not characteristic of Seto. The suffixes *-ek and *eš occur as the assimilated form -eh in Kraasna, but as -eh and -eq in Seto. In oblique cases, the derivational suffix -eh still occurs in a mid-19th century folk song but had been lost by the early 20th century. The Kraasna dialect is surprisingly similar to Seto, from which it separated 300 years before its documentation in the early 20th century. It would be interesting to know to what extent later connections with Setomaa harmonised both dialects.
Kokkuvõte. Enn Ernits: Kraasna noomenituletus. Vaatamata talletatud sõnavara piiratusele ilmneb Kraasna murrakus rohkesti käändsõnatuletisi. Need on moodustatud 20 primaarsufiksist tekkinud 18 liite ja 21 sekundaarsufiksist kujunenud sama arvu liidete abil. Kraasna sufiksid sarnanevad seto omadega. Ainult liitliited (-i)s-to, -la-s ja -ži-ne, mis tuletavad vaid üksikuid sõnu (kaklas, laanisto, soomisto, ammuužine), pole seto murrakutele omased. Viimatimainitud sufiks esineb ka Hargla, leivu ja lutsi murrakutes. Kraasna murrakule oli iseloomulik liidete *-ek ja *eš sarnastunud kuju -eh, seevastu seto murrakutes võivad need esineda paralleelselt -eh ja -eq kujul. Obliikvakäändes derivatiivsufiks -eh esines XIX sajandi keskpaiku veel ühe rahvalaulu sõnas *valgõ-hõ-ta, XX sajandi alguseks oli taandunud, vrd *valgõt. Kraasna murrakus kasutati rohkesti deminutiivliidet -kanõ. Enamikul Kraasna käändsõnatuletistel on vasted seto murrakutes, üksnes vähestel juhtudel see puudub, sh kipõküüdzüs ‘kurivaim’, mako ‘magamine’, tukim ‘tugi’ ja vadõridzõq ‘vaderid’. Teadaolevalt ainult Kraasna murrakus esinevad sõnad laudadzõq ~ laadadzõq ‘lehmakahi’ ja puzanõ ‘mõrkjas’. Kraasna murrak, mis irdus setost XX sajandi alguse kirjapanekutega võrreldes 300 aastat varem, on viimasega üllatuslikult sarnane. Tuleks uurida, kuivõrd suutsid murrakuid ühtlustada hilisemad seosed Setomaaga.
Harmonization of the Russian Federation Legislation with Current International Recommendations
Authors: Kochetkov O. , Klochkov V. , Samoylov A. , Shandala N. 
Published: December 2021

Purpose: Harmonization of the Russian Federation legislation with current international recommendations
Results: The concept of the radiation safety system has been significantly modified by recommendations of ICRP (2007) and IAEA (2014). An analysis of existing international regulatory framework for radiation safety allowed to identify the main provisions to be implemented in the Russian legal and regulatory framework. It’s showed that the current Federal Law of 09.01.1996 No. 3-FZ «On Radiation Safety of Population» must be ultimately revised to be harmonized with international documents. General approaches to legal regulation of radiation safety should be essentially modified to create a strong relationship between this law and other regulatory and legal documents in force in the Russian Federation.
Conclusion: An article-by-article analysis of the current Federal Law of 09.01.1996 No. 3-FZ «On Radiation Safety of Population « showed the need to modify 22 existing articles and add 12 new articles in order to harmonize it with international documents. Given such a large volume of modification it is advisable to pass a new law with simultaneous abolition of the current federal law. A new name has been proposed: Federal Law of the Russian Federation «On Radiation Safety in the Russian Federation».
The enactment of the Federal Law of the Russian Federation «On Radiation Safety in the Russian Federation» with the main by-laws approved by the Russian Federation Government – «Radiation Safety Standards» and «Basic Rules for Ensuring Radiation Safety» – will allow to establish an actual regulatory framework for ensuring radiation safety of personnel and population in Russia.