bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic Artery Embolization for Palliation of Symptomatic Hypoglycemia in Patients With Hepatic Insulinoma Metastases
Authors: Linch Forrest , Thompson Scott , Fleming Chad , Vella Adrian , Andrews James 
Published: October 2021

Abstract

Context
Insulinoma is a pancreatic neuroendocrine tumor that causes hyperinsulinemic hypoglycemia. Symptomatic hypoglycemia related to hepatic insulinoma metastases may be addressed with liver-directed therapies such as hepatic artery embolization.

Objective
This work aimed to determine the safety and effectiveness of bland hepatic artery embolization (HAE) for palliation of symptomatic hypoglycemia in patients with hepatic insulinoma metastases refractory to medical management.

Methods
An institutional review board–approved retrospective review was undertaken of all patients with a tissue (n = 18) or imaging (n = 2) diagnosis of hepatic insulinoma metastases and symptomatic hyperinsulinemic hypoglycemia refractory to medical management who underwent bland HAE at a single center between January 1, 1998 and November 1, 2020. Twenty patients (10 women, 10 men; mean age, 56 years; range, 18-84 years) were identified who individually underwent 1 (n = 7), 2 (n = 5), 3 (n = 5), 4 (n = 2), or 5 (n = 1) HAEs, for an overall total of 45 HAEs. Post-HAE hypoglycemia recurrence was defined as onset of adrenergic symptoms (eg, sweating, weakness, tremor), neuroglycopenic symptoms (eg, confusion, loss of consciousness), and/or documented serum glucose of less than 50 mg/dL, in the absence of an alternative explanation. Median time to first hypoglycemia recurrence, hypoglycemia-free survival (HFS), and overall survival (OS) were calculated using Kaplan-Meier method.

Results
Before HAE, all patients experienced adrenergic or neuroglycopenic symptoms alleviated by glucose intake, and 60% (n = 12) of patients had documented serum glucose of less than 50 mg/dL within 1 week of the first treatment. Median post-HAE follow-up was 9.4 months (mean, 26 months; range, 0.1-190 months). Postprocedural hypoglycemic symptom relief after the first HAE was reported in 100% (n = 20) of patients before discharge or at follow-up. Post-HAE hypoglycemia recurrence occurred in 60% (n = 12) of patients with a median time to first hypoglycemia recurrence of 2 months (mean, 14 months; range, 0.2-60 months). After the first HAE, median HFS was 14.5 months, and median OS was 16 months. One patient experienced labile postprocedure blood glucose levels requiring intensive care unit admission for intravenous dextrose. Otherwise, no major procedure-related complications occurred.

Conclusion
Bland HAE is a safe, effective, and repeatable procedure for palliation of symptomatic hypoglycemia in patients with hepatic insulinoma metastases refractory to medical management.
Oncoplastic Breast-Conserving Surgery for Synchronous Multicentric and Multifocal Tumors: Is It Oncologically Safe? A Retrospective Matched-Cohort Analysis
Authors: De Lorenzi Francesca , Borelli Francesco , Pagan Eleonora , Bagnardi Vincenzo , Peradze Nickolas , Jereczek-Fossa Barbara Alicia , Leonardi Cristina , Mazzarol Giovanni , Favia Giorgio , Corso Giovanni , Montagna Emilia , Rietjens Mario , Veronesi Paolo 
Published: October 2021

Abstract
Background
Oncoplastic surgery is a well-established approach that combines breast-conserving treatment for breast cancer and plastic surgery techniques. Although this approach already has been described for multicentric and multifocal tumors, no long-term oncologic follow-up evaluation and no comparison with patients undergoing mastectomy have been published. This study aimed to evaluate whether oncoplastic surgery is a safe and reliable treatment for managing invasive primary multicentric and multifocal breast cancer.

Methods
The study compared a consecutive series of 100 patients with multicentric or multifocal tumors who had undergone oncoplastic surgery (study group) with 100 patients who had multicentric or multifocal tumors and had undergone mastectomy (control group) during a prolonged period. The end points evaluated were disease-free survival (DFS), overall survival (OS), cumulative incidence of local recurrence (CI-L), regional recurrence (CI-R), and distant recurrence (CI-D), all measured from the date of surgery.

Results
The OS and DFS were similar between the two groups. The incidence of local events was higher in the oncoplastic group, whereas the incidence of regional events was slightly higher in the mastectomy group. These differences were not statistically significant. The cumulative incidence of distant events was similar between the two groups.

Conclusions
To the authors’ knowledge, the current study provides the best available evidence suggesting that the oncoplastic approach is a safe and reliable treatment for managing invasive multifocal and multicentric breast cancers.
Spectrum of MR imaging findings of sinonasal mucormycosis in post COVID-19 patients
Authors: Kondapavuluri Sushen Kumar , Anchala Varun Kumar reddy , Bandlapalli Shohyle , Gorantla Rajani , Danaboyina Ankamma Rao , Kondapavuluri Benod Kumar , Mandalapu Satyanarayana 
Published: October 2021

During rapid spread of coronavirus disease (COVID-19) globally, ever since WHO declared COVID-19 as pandemic, there have been various patterns of disease in terms of diagnosis, management and complications. Secondary infections are reportedly common in hospitalized and severely ill COVID-19 patients among which fungal being 10 times more common. Mucormycosis is amongst the most lethal form of Zygormycosis occurring in post COVID-19 patients. A varied patterns of disease involvement and spectrum of imaging features are observed in patients with mucormycosis in post COVID-19 patients. MRI has better efficacy than CT in detecting early invasion of mucormycosis. The goal of this review is to familiarize radiologists about the MR imaging spectrum of mucormycosis in post COVID-19 patients with potential diagnostic pitfalls in CT. Advances in knowledge: Radiological findings of mucormycosis in post COVID-19 patients show varied patterns of disease involvement and spectrum of imaging features. One should not solely rely on CT imaging to detect the extent of disease. MRI helps in early and accurate detection of invasion into adjacent structures and so helpful in early intervention.
Reaction and Learning Evaluation of a Non-immersive Virtual Reality Application for Children with Autism Spectrum Disorder
Authors: Rosli Muhamad Irfan , Embi Zarina , Abdullah Junaidi , Samsudin Mohd Ali , Zainal Abidin Mohamad Izani , Abdullah Norra 
Published: October 2021

Background: Autism Spectrum Disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech, and nonverbal communication, in addition to repetitive or restrictive behaviours. For decades, children with ASD have been familiarising themselves with information and communication technologies (ICT) in their training and diagnosis. One of the ICT areas, namely non-immersive virtual reality (NIVR), has become a noticeable tool to help ASD children in their social training. It provides extensive virtual interaction, a safe environment, and is affordable. An NIVR application is developed to assist the intervention on ASD children. However, the whole experiences of the training need to be validated to conclude its effectiveness. Methods: A case study was employed as the research method. An evaluation of NIVR application using multiple sources of evidence was guided by Kirkpatrick Model of Evaluation (KME) which was executed via questionnaires, pre- and post-test. The main objectives of this research were to evaluate level 1 and 2 of KME. The target for Level 1 is to assess the reactions to the NIVR application. Level 2 is to gauge the knowledge, confidence, or mindset of participants. Level 2 covers the evaluation prior to the training (pre-test) and after the training (post-test). Results: On average the ASD children had good experiences and were able to improve their social skills with the NIVR application. Therefore, the combination of serious game, analytics and specific VR type provides good data assessment, facilitate comfortable training, and can be an effective intervention for children with ASD. Conclusion: The positive trend on both levels shows that the application has a good potential to be used in ASD training. The results could be improved in a higher number of participants. Currently, only a limited number of research participants could be obtained due to the COVID-19 pandemic.
Lived Lives at Fort Dunree: a rural Irish community perspective
Authors: Cleary Eimear , Malone Kevin M. , Corry Collete , Sheridan Anne , Kelleher Cecily C. , Lane Abbie , McGuiness Seamus 
Published: October 2021

Background: Elevated suicide rates have alarmed policy makers and communities. In these circumstances, the value of understanding more about communities and their potential role in suicide intervention is becoming more apparent. This study involved evaluating feedback from individuals with and without previous suicidal thinking who participated in an arts-science rural community-based intervention project around suicide in County Donegal, Ireland (Lived Lives at Fort Dunree). Methods: A combined quantitative and qualitative questionnaire was used to evaluate individual and community responses to the Lived Lives project. Results: Participants (n = 83), with and without a mental health history and previous suicidal ideation, reported they believed Lived Lives could have potential to help suicide-bereaved families, people with mental illness and people with suicidal thinking. Qualitative results suggested its’ suitability for specific groups affected by suicide. Discussion: The evaluation of the Lived Lives project indicated that supervised, “safe-space” community intervention projects around suicide have inherent value with positive impacts for bereaved individuals and communities, including those who have experienced suicidal feelings. Future research should explore the transferability of these findings to other communities, and at-risk groups.
Stop codon readthrough contexts influence reporter expression differentially depending on the presence of an IRES
Authors: Yordanova Martina M. , Loughran Gary , Atkins John F. , Baranov Pavel V. 
Published: October 2021

Background: Previously we reported the discovery of stop codon readthrough in AMD1 mRNA followed by ribosome stalling at the end of a conserved Open Reading Frame (ORF) that we termed AMD1. To explain the severe suppression of reporters fused to AMD1 tail we proposed a mechanism invoking ribosome queueing. To test this hypothesis, we placed the reporter stop codon in the context of readthrough permissive sequences in a dual reporter vector with downstream reporter expression driven by the EMCV IRES. In accordance with our hypothesis, we observed a striking disproportional reduction of upstream reporter activity in response to increased readthrough levels. Methods: We employ dual luciferase assays, western blotting and RT-qPCR to explore the effects of test sequences downstream to the reporter stop codon on its expression in dual and monocistronic reporter vectors. Results: With the dual reporter system, the disproportionate reduction of upstream reporter activity is not specific to AMD1 tail and occurs as long as the readthrough stop codon context is present at the end of the reporter’s ORF. In a monocistronic vector without an IRES, the test sequences had distinct effects which were reflective of their properties e.g. AMD1 tail inhibitory effect. We further show with RT-qPCR that the EMCV IRES driven expression of a reporter is an accurate proxy of reporter RNA levels. Conclusions: While our findings provide little new information regarding the functional role of AMD1 tail, they raise caution for the use of viral IRES elements in expression vectors for studying mechanisms of mRNA translation. These findings may also be pertinent to the natural properties of read through permissive sequences and of IRES elements, though these require a separate investigation.
Date of introduction and epidemiologic patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Mogadishu, Somalia: estimates from transmission modelling of satellite-based excess mortality data in 2020
Authors: Koltai Mihaly , Warsame Abdihamid , Bashiir Farah , Freemantle Terri , Reeve Chris , Williams Chris , Jit Mark , Flasche Stefan , Davies Nicholas G. ,   CMMID COVID-19 working group, Aweis Ahmed , Ahmed Mohamed , Dalmar Abdirisak , Checchi Francesco 
Published: October 2021

Background: In countries with weak surveillance systems, confirmed coronavirus disease 2019 (COVID-19) deaths are likely to underestimate the pandemic’s death toll. Many countries also have incomplete vital registration systems, hampering excess mortality estimation. Here, we fitted a dynamic transmission model to satellite imagery data of cemeteries in Mogadishu, Somalia during 2020 to estimate the date of introduction and other epidemiologic parameters of the early spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in this low-income, crisis-affected setting. Methods: We performed Markov chain Monte Carlo (MCMC) fitting with an age-structured compartmental COVID-19 model to provide median estimates and credible intervals for the date of introduction, the basic reproduction number (R0) and the effect of non-pharmaceutical interventions (NPIs) up to August 2020. Results: Under the assumption that excess deaths in Mogadishu March-August 2020 were attributable to SARS-CoV-2 infections, we arrived at median estimates of November-December 2019 for the date of introduction and low R0 estimates (1.4-1.7) reflecting the slow and early rise and long plateau of excess deaths. The date of introduction, the amount of external seeding, the infection fatality rate (IFR) and the effectiveness of NPIs are correlated parameters and not separately identifiable in a narrow range from deaths data. Nevertheless, to obtain introduction dates no earlier than November 2019 a higher population-wide IFR (≥0.7%) had to be assumed than obtained by applying age-specific IFRs from high-income countries to Somalia’s age structure. Conclusions: Model fitting of excess mortality data across a range of plausible values of the IFR and the amount of external seeding suggests an early SARS-CoV-2 introduction event may have occurred in Somalia in November-December 2019. Transmissibility in the first epidemic wave was estimated to be lower than in European settings. Alternatively, there was another, unidentified source of sustained excess mortality in Mogadishu from March to August 2020.
Pilot study to investigate differences in middle molecules, oxidative stress and markers of peripheral vascular disease in patients treated by high flux haemodialysis and haemodiafiltration
Authors: Nongnuch Arkom , Kitiyakara Chagriya , Sappadungsuk Supawadee , Sathirapongsasuti Nuankanya , Vipattawat Kotcharat , Zhang Pin , Davies Nathan , Davenport Andrew 
Published: October 2021

Background
Dialysis patients have an increased risk of mortality. Recently treatment with haemodiafiltration (HDF) has been reported to reduce mortality, particularly cardiovascular mortality, compared to standard high-flux haemodialysis (HD). However, why HDF may offer a survival advantage remains to be determined. So, we conducted a pilot study to explore differences in middle-molecules, inflammation and markers of vascular disease in patients treated by HD and HDF.

Methods
Observational cross-sectional study measuring serum β2-microglobulin (β2M), Advanced Glycosylation End Products (AGEs) by skin autofluorescence (SAF), oxidative stress with ischaemia modified albumin ratio (IMAR) and peripheral vascular disease assessment using Ankle-Brachial Index (ABI), and arterial stiffness using Cardio-Ankle Vascular Index (CAVI).

Results
We studied 196 patients, mean age 69.1 ± 12.4 years, 172 (87.8%) treated by HD and 24 (12.2%) by HDF. Age, body mass index, co-morbidity and dialysis vintage were not different between HD and HDF groups. Middle molecules; β2M (31±9.9 vs 31.2±10 ug/mL) and SAF (2.99±0.72 vs 3.0±0.84 AU), ABI (1.06±0.05 vs 1.07±0.10) and CAVI (9.34±1.55 vs 9.35±1.23) were not different, but IMAR was higher in the HD patients (38.4±14.8 vs 31.3 ± 17.4, P = 0.035)

Conclusions
In this pilot observational study, we found patients treated by HDF had lower oxidative stress as measured by IMAR, with no differences in middle molecules. Lower oxidative stress would be expected to have diverse protective effects on the cardiovascular system Although we found no differences in ABI and CAVI, future studies are required to determine whether reduced oxidative stress translates into clinically relevant differences over time.
Quality of life among germ-cell testicular cancer survivors: The effect of time since cancer diagnosis
Authors: Jovanovski Aleksandar , Zugna Daniela , Di Cuonzo Daniela , Lista Patrizia , Ciuffreda Libero , Merletti Franco , Rosato Rosalba , Richiardi Lorenzo 
Published: October 2021

Introduction
Testicular cancer is one of the most treatable cancers, with a 10-year survival of more than 95%. Many patients will be long-term survivors and this disease strikes men in an important phase of their lives, therefore the quality of life (QoL) among these patients is an area of particular interest. We aimed to study whether QoL in testicular cancer survivors depends on the time since cancer diagnosis.

Methods
Data were collected from the EPSAM (Esposizioni postnatali e salute maschile) study, a case-control study on patients with testicular cancer, diagnosed between 1997 and 2008 in the province of Turin, Northern Italy, and interviewed between 2008 and 2010 (response rate among cases 57%). Patients were contacted through their oncologist at the San Giovanni Batista Hospital in Turin or through their general practitioner (GP) in the rest of the Province of Turin. QoL was assessed cross-sectionally using the short form 12 (SF-12) questionnaire, a generic short-form health survey that produces two summary scores, PCS (physical component score) and MCS (mental component score), to evaluate physical and mental health, respectively.

Results
Out of 234 study patients, 125 cases were seminomas and 109 cases were nonseminomas. The mean age at diagnosis was 34.5 years. After adjusting for age, time since diagnosis was not associated with PCS and MCS scores. Among nonseminomas, the median PCS slightly increased (adjusted OR (odds ratio) for 5+ vs < 2 years since cancer diagnosis: 1.78 (1.17–2.73), p = 0.008) and MCS slightly decreased (adjusted OR per 1-year increase since cancer diagnosis: 0.92, 95% CI: 0.82–1.05, p = 0.23) with time. Similar findings of no association between time since diagnosis and PCS and MCS were found when the analyses were restricted to the subgroup of cancer patients contacted through their oncologist, whose response proportion was 82%.

Conclusion
In a study of testicular cancer patients interviewed cross-sectionally at 1 to more than 10 years since diagnosis, time since cancer diagnosis was not associated with QoL when we considered all germ-cell testicular cancer patients together. When stratified by histology type, we found certain evidence that nonseminoma cases report higher PCS over time since cancer diagnosis.
Comprehensive evaluation of COVID-19 patient short- and long-term outcomes: Disparities in healthcare utilization and post-hospitalization outcomes
Authors: Salerno Stephen , Sun Yuming , Morris Emily L. , He Xinwei , Li Yajing , Pan Ziyang , Han Peisong , Kang Jian , Sjoding Michael W. , Li Yi 
Published: October 2021

BackgroundUnderstanding risk factors for short- and long-term COVID-19 outcomes have implications for current guidelines and practice. We study whether early identified risk factors for COVID-19 persist one year later and through varying disease progression trajectories.MethodsThis was a retrospective study of 6,731 COVID-19 patients presenting to Michigan Medicine between March 10, 2020 and March 10, 2021. We describe disease progression trajectories from diagnosis to potential hospital admission, discharge, readmission, or death. Outcomes pertained to all patients: rate of medical encounters, hospitalization-free survival, and overall survival, and hospitalized patients: discharge versus in-hospital death and readmission. Risk factors included patient age, sex, race, body mass index, and 29 comorbidity conditions.ResultsYounger, non-Black patients utilized healthcare resources at higher rates, while older, male, and Black patients had higher rates of hospitalization and mortality. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss anemia were risk factors for these outcomes. Diabetes with complications, coagulopathy, fluid and electrolyte disorders, and blood loss were associated with lower discharge and higher inpatient mortality rates.ConclusionsThis study found differences in healthcare utilization and adverse COVID-19 outcomes, as well as differing risk factors for short- and long-term outcomes throughout disease progression. These findings may inform providers in emergency departments or critical care settings of treatment priorities, empower healthcare stakeholders with effective disease management strategies, and aid health policy makers in optimizing allocations of medical resources.
Determination of Urinary Gluten Immunogenic Peptides to Assess Adherence to the Gluten-Free Diet: A Randomized, Double-Blind, Controlled Study
Authors: Monachesi Chiara , Verma Anil K. , Catassi Giulia N. , Franceschini Elisa , Gatti Simona , Gesuita Rosaria , Lionetti Elena , Catassi Carlo 
Published: October 2021

INTRODUCTION:
The adherence to a gluten-free diet (GFD) is a trending topic in the management of celiac disease. The aim of our study was to evaluate the diagnostic performance of urinary gluten immunogenic peptides (GIP) determination to detect gluten contamination of the GFD.

METHODS:
In study A, 25 healthy adults on a standard GFD performed 6 gluten challenges (0, 10, 50, 100, 500, and 1,000 mg) with quantification of urinary GIP before (T0) and during the following 24 hours. In study B, 12 participants on a gluten contamination elimination diet underwent urinary GIP determination at T0 and after challenge with 5 or 10 mg gluten. Urine GIP concentration was determined by an immunochromatographic assay.

RESULTS:
In study A, 51 of 150 baseline urine samples were GIP+ on GFD and 7 of 17 were GIP+ after the zero-gluten challenge, whereas only 55 of 81 were GIP+ after the 10–1,000 mg gluten challenges. There was no significant change in the 24-hour urinary GIP when increasing gluten from 10 to 1,000 mg. In study B, 24 of 24 baseline urine samples were GIP−, whereas 8 of 24 were GIP+ after 5 or 10 mg of gluten.

DISCUSSION:
Traces of gluten in the standard GFD may cause positivity of urinary GIP determination, whereas a false negativity is common after a gluten intake of 10–1,000 mg. Owing to the impossibility of standardizing the test in normal conditions, it seems unlikely that urinary GIP determination may represent a reliable tool to assess the compliance to the GFD of patients with celiac disease or other gluten-related disorders.
Weichenstellerinnen – ein Blick hinter die Kulissen der Fachdisziplin Vorgeschichte zwischen 1918–1939
Authors: Schöbel Gunter 
Published: October 2021

Zusammenfassung
Der Beitrag thematisiert die Bedeutung dreier Frauen, die im Umfeld bedeutender vor- und frühgeschichtlicher Archäologen der Universitäten Tübingen und Berlin im Zeitraum zwischen 1918 und 1939 ihren Einfluss ausübten und forschungsgeschichtliche Entwicklungen in neuem Lichte erscheinen lassen.