bluuebunny/crossref_metadata_2025_split huggingface dataset:
Melatonin-induced symptomatic bradycardia in an otherwise healthy male: a case report
Authors: Alawad Asim , Sati Wala , Ahmed Sara M I , Elgassim Moayed , Elgassim Mohamad , Balal Abderahman 
Published: August 2024

Abstract
Melatonin, a pineal gland hormone closely associated with the circadian rhythm, has been trending over the past years as an over-the-counter medication to aid with sleep disturbances. Although generally believed to be safe, recent studies show negative inotropic and chronotropic effects on the heart rate and blood pressure in humans. Several studies suggested that melatonin induces cardiac vagal tone and affects heart rate and mean arterial pressure. Limited literature is currently available on the effects of melatonin beyond its sleep function. We present a case of a healthy 22-year-old male who visited the emergency department reporting palpitations and dizziness following the ingestion of 20 mg of melatonin. Subsequent examinations revealed marked bradycardia. Fortunately, the patient experienced spontaneous resolution of the bradycardia without necessitating intervention after a few hours of observation, and he was observed and discharged.
Feeding limestone buffer to limit-fed dairy steers fed a high inclusion rate of distiller grains
Authors: Olagunju Lydia K , Casper David P 
Published: August 2024

Abstract
The study objective was to evaluate dietary limestone buffer inclusion rates for impacting nutrient digestibility and excretion when growing dairy cattle are fed high distiller grains with solubles (DDGS) limit-fed ration. The hypothesis was that feeding more limestone buffer would offset a low rumen pH when feeding a high DDGS inclusion rate. Five ruminally cannulated Holstein and Brown Swiss steers were used in a crossover design having 2-wk periods to evaluate high and low buffer inclusion rates when limit-fed. Treatments were similar in ingredient composition being: 1) 40% DDGS at 0.80% high CaCO3 buffer inclusion (HIGH) and 2) 40% DDGS with 0.25% low CaCO3 buffer inclusion (LOW) with the remaining ration consisting of grass hay with minerals and vitamins. Rations were limit-fed at 2.50% of body weight (BW) using Calan feeding doors with steers being weighed every 2 wk with ration amounts adjusted accordingly. Rumen fluid was collected via the ruminal cannula at the start and end of each period for pH, ammonia-n, and volatile fatty acid (VFA)s. Fecal grab samples were collected at the end of each period for measurement of total-tract nutrient digestibility. There were no treatment-by-period interactions (P &gt; 0.10) for any of the growth parameters measured. Gains in frame growth parameters were similar (P &gt; 0.10) for steers fed both rations. BWs and gains were similar (P &gt; 0.10) for steers fed both rations. Steers fed the LOW ration demonstrated a numeric improvement in average daily gain combined with a tendency (P &lt; 0.06) for lower dry matter intake resulting in an improved (P &lt; 0.01) feed efficiency (gain:feed) compared with steers fed the HIGH ration. Steers fed HIGH demonstrated greater (P &lt; 0.01) ruminal ammonia-N and isovalerate concentrations compared with steers fed the LOW buffer ration. Steers fed both buffer inclusion rates were similar (P &gt; 0.10) for ruminal pH and remaining VFAs concentrations. Steers fed both buffer inclusion rates were similar (P &gt; 0.10) in DM and organic matter digestibilities. Limit-feeding a high DDGS inclusion rate ratio combined with a low buffer inclusion rate improved feed efficiency while maintaining growth performance. The study hypothesis was rejected in that feed efficiency can be enhanced when feeding a high DDGS ration by feeding a low calcium carbonate buffer.
Febrile seizures
Authors: Eiseman Melissa 
Published: August 2024

ABSTRACT
Febrile seizures are the most common seizure disorder in childhood. Most febrile seizures have a benign course and children have a good prognosis. However, febrile seizures are traumatizing events for a child's family or caregiver to witness. Appropriate caregiver education is crucial to ease anxiety. This article reviews the risk factors, clinical presentation, diagnostics, treatment, and prevention of febrile seizures in addition to providing a guideline for effective caregiver education and support.
Exploring opportunities beyond clinical practice
Authors: Bolander Sarah , Herrick Amber 
Published: August 2024

ABSTRACT
Opportunities outside patient care are expanding for physician associates/assistants (PAs). Exploring new roles beyond clinical practice has the potential for improved career fulfillment as clinicians experience increasing levels of burnout and declining satisfaction with patient care. The decision to shift to a nonclinical role may be overwhelming without knowing what positions PAs are qualified to consider. PAs are increasingly found in the fields of healthcare consulting (as medical science liaisons), medical writing, healthcare insurance, research, and academia. With the rapid growth in PA programs, the need for educators is critical and this transition creates an interesting dynamic in which a proficient clinician becomes a novice educator. This article delves into these expectations and provides guidance on making the transition.
One- versus Three-- Level Fusion in Patients Undergoing Multilevel Lumbar Decompression
Authors: Ratnasamy Philip P , Gouzoulis Michael J , Jabbouri Sahir S , Rubio Daniel R , Grauer Jonathan N 
Published: August 2024

Study Design.
Retrospective cohort study

Objective.
To assess relative odds of perioperative complications, readmissions, and five-year survival to reoperation for three-level lumbar decompression patients who undergo three-level fusion relative to one-level fusion.

Background.
Patients undergoing multilevel lumbar decompression may be indicated for fusion at one or more levels. The question of fusing only one level with indications such as spondylolisthesis or fusing all levels decompressed is of clinical interest in both the short and longer term.

Methods.
Patients undergoing three-level lumbar decompression were extracted from the PearlDiver M165Orto database. The subset of these patients undergoing concomitant three-level and one-level lumbar fusion were identified and matched 1:1 based on patient age, sex, and Elixhauser Comorbidity Index (ECI) scores. The incidence and odds of 90-day postoperative adverse events were compared between the two groups by multivariable analysis, and comparative five-year survival to lumbar spinal reoperation was determined.

Results.
After matching, 28,276 patients were identified as undergoing three-level lumbar decompression with three-level fusion and the same for those undergoing three-level decompression with one-level fusion. Controlling for patient age, sex, and ECI, three-level fusion patients had significantly greater odds ratio (OR) of many 90-day adverse events and aggregated any (OR 1.42), serious (OR 1.44), and minor (OR 1.42) adverse events, as well as readmissions (OR 1.51) (P<0.0001 for all). Five-year survival to reoperation was significantly lower for those undergoing three-level decompression with three-level fusion (P<0.0001).

Conclusions.
Three-level lumbar decompression patients who underwent three-level fusion were found to be at significantly greater odds of 90-day postoperative adverse events, readmissions, and five-year reoperations relative to those undergoing one-level fusion. The current data support the concept of limiting fusion to the levels with specific indications in the setting of multi-level lumbar decompressions and not needing to match the decompression and fusion levels.
Novel Technique for Ulnar Nerve Transposition at the Elbow: The Neocubital Tunnel
Authors: Bakhach Joseph , Saba Salim C. , Bakhach Dimitri , Doghman Jana , Gnaedinger Anika G. , Hammoudeh Diya’ S. 
Published: August 2024

Background:
Many standard surgical procedures for cubital tunnel syndrome rely on ulnar nerve transposition at the elbow. Placing the ulnar nerve anterior to the axis of motion decreases compression during flexion. Subcutaneous, subfascial, and submuscular positioning of the ulnar nerve may predispose to nerve irritation, instability, and compression in the two first scenarios, and requires invasive dissection in the third one. With no single procedure demonstrating clear advantages and outcomes, this study reports the results of a novel technique using the epitrochleo-olecranon ligament to create a neo-tunnel, anatomically stabilizing the ulnar nerve.

Methods:
Nine consecutive patients were enrolled. Patients were evaluated qualitatively for symptomatic improvements using physical examination. The Wilson and Krout, modified McGowan, and PRUNE grading scores were used for quantitative measurement.

Results:
Postoperatively, all patients reported subjective improvement in symptoms and functional improvement. There were no intraoperative or postoperative complications. Baseline severity of disease was evaluated using the McGowan scale (modified by Goldberg): eight (89%) grade IIA patients and one (11%) grade III patient. Postoperatively, seven (78%) patients were reduced to grade 0, and two (22%) patients to grade 1 (P < 0.001). Using the Wilson and Krout criteria, outcomes were as follows: six (67%) excellent, two (22%) good, and one (11%) fair. The mean postoperative PRUNE survey score was 19.3 (SD ± 24.4).

Conclusions:
The neocubital tunnel technique is a relatively noninvasive, safe surgical alternative that may be considered when an anterior transposition of the ulnar nerve is indicated for surgical decompression of the cubital tunnel.
Renal cell carcinoma: an overview of the epidemiology, presentation, histopathological characteristics, and surgical treatment variation between old and new era – a cross-sectional study
Authors: Al Azab Rami S. , Al-Zubi Mohammad T. , Aladaileh Mohammad A. A. , Darwazeh Hashem , Alshboul Mahdi , Khader Yousef S. , Ghalayini Ibrahim F. , Mustafa Ali Mahmoud A. , Al Demour Saddam 
Published: August 2024

Introduction:
The landscape of renal cell carcinoma (RCC) diagnosis, staging, and treatment has evolved over the last decades. Our study to report our experience in this evolution over a 30-years’ time.

Methodology:
A database of patients who underwent nephrectomy for RCC was collected and compared between new era (2017–2021) and old era (1992–2001).

Results:
One hundred thirty-six patients collected in new era compared to 132 in old era, results showed that more patients diagnosed at earlier stage and grade with smaller size of tumor at diagnosis in new era compared to old era.

Conclusion:
The new era showed significant changes in the RCC landscape regarding demographic distribution, presentation, and tumor characteristics.
Sigmoid volvulus as a rare cause of intestinal obstruction in the pediatric population: case series and literature review
Authors: Brito Rojas Isabel C. , Hernández Peñuela Mayra A. , Medina Gaviria Vanessa , La Rotta Martin , Escobar Echeverri John M. 
Published: August 2024

Introduction:
Sigmoid volvulus is an uncommon cause of intestinal obstruction in the pediatric population. This pathology is associated with intestinal malrotation and sometimes with the presence of internal hernias. The clinical presentation includes pain, abdominal distension, and emesis; however, sometimes patients report nonspecific chronic symptoms. Among the diagnostic tools commonly used in children are radiography and abdominal tomography. There are multiple treatment strategies ranging from endoscopic to surgical procedures including resection with stoma creation. Timely diagnosis is crucial given the increased morbidity and mortality resulting from intestinal ischemia and perforation.

Methods:
A review of the medical records of the patients with a diagnosis of sigmoid volvulus treated by pediatric surgeons of the institution and led to devolvulation and subsequent sigmoidectomy presented below was carried out. Likewise, a literature search was carried out in electronic databases, using two equations using terms selected from ‘Medical Subject Heading’ (MeSH) and ‘Descriptors in Health Sciences’ (DeCS). The quality of the studies was evaluated with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) tool for the construction of the manuscript.

Results:
Upon continuation, the experience of six patients between the ages of 5 and 17 with a diagnosis of sigmoid volvulus between the years 2021 and 2023 is presented. These patients were taken to initial decompression by different approaches and in a second surgical stage to sigmoidectomy, most of them with anastomosis. All patients had an adequate postoperative evolution without complications.

Conclusion:
Sigmoid volvulus is a rare condition in pediatrics with a variable and sometimes nonspecific clinical presentation; however, given the increased morbidity and mortality resulting from a delay in diagnosis, it is important to consider the clinical, paraclinical, and radiological findings that allow early identification as a cause of intestinal obstruction.
Characterizing Cochlear Implant Trans-Impedance Matrix Heatmaps in Patients With Abnormal Anatomy
Authors: Cottrell Justin , Winchester Arianna , Friedmann David , Jethanamest Daniel , Spitzer Emily , Svirsky Mario , Waltzman Susan B. , Shapiro William H. , McMenomey Sean , Roland J. Thomas 
Published: August 2024

ObjectiveTo characterize transimpedance matrix (TIM) heatmap patterns in patients at risk of labyrinthine abnormality to better understand accuracy and possible TIM limitations.Study DesignRetrospective review of TIM patterns, preoperative, and postoperative imaging.SettingTertiary referral center.PatientsPatients undergoing cochlear implantation with risk of labyrinthine abnormality.InterventionNone.ResultsSeventy-seven patients were evaluated. Twenty-five percent (n = 19) of patients had a TIM pattern variant identified. These variants were separated into 10 novel categories. Overall, 9% (n = 6) of electrodes were malpositioned on intraoperative x-ray, of which 50% (n = 3) were underinserted, 17% (n = 1) were overinserted, 17% (n = 1) had a tip foldover, and 17% (n = 1) had a coiled electrode. The number of patients with a variant TIM pattern and normal x-ray was 18% (n = 14), and the number of patients with normal TIM pattern and malposition noted on x-ray was 3% (n = 2; both were electrode underinsertions that were recognized due to open circuits and surgical visualization).A newly defined skip heat pattern was identified in patients with IP2/Mondini malformation and interscalar septum width <0.5 mm at the cochlear pars ascendens of the basal turn.ConclusionsThis study defines novel patterns for TIM heatmap characterization to facilitate collaborative and comparative research moving forward. In doing so, it highlights a new pattern termed skip heat, which corresponds with a deficient interscalar septum of the cochlea pars ascendens of the basal turn in patients with IP2 malformation. Overall, the data assist the surgeon in better understanding the implications and limitations of TIM patterns within groups of patients with risk of labyrinthine abnormalities.
The Effect of Mindfulness and Emotional Regulation on Self-care Competence Among Cancer Patients Undergoing Chemotherapy
Authors: Son Seri , Lee Sunhee 
Published: August 2024

Background
Many cancer patients require long-term self-care, both during and after treatment, and need to have self-care competence. Mindfulness and emotional regulation can enhance self-care competence among cancer patients.

Objective
To examine the effect of mindfulness and emotional regulation on self-care competence among cancer patients undergoing chemotherapy.

Methods
The data were completed by 106 cancer patients who were hospitalized at 3 long-term nursing hospitals. The instruments were the Mindfulness Scale, Korean Version of the Difficulties in Emotion Regulation Scale, and Self-As-Care Inventory Scale.

Result
Self-care competence was significantly correlated with mindfulness among cancer patients undergoing chemotherapy. Also, the relationship between mindfulness and emotional regulation was significant. However, emotional regulation did not significantly affect self-care competence.

Conclusions
It is important for cancer patients to focus on the present moment and maintain a balanced approach that keeps a distance from excessive worry. Development and application of interventions aimed at enhancing self-care competence among cancer patients should focus on a high level of mindfulness.

Implications for Practice
It is necessary to support cancer patients in taking time out for mindfulness practice through meditation programs and to help them seamlessly incorporate this habit into their daily lives. Nurses can effectively assist cancer patients by being well-versed in mindfulness techniques and providing adept guidance. Offering personalized mindfulness guidance based on the patient’s condition and needs is also beneficial. By developing programs that incorporate feedback from both patients and healthcare providers, nurses can help patients continuously apply mindfulness practices.
Project SIGNAL: A Dashboard for Supporting Community Confidence in Making Data-Driven Decisions
Authors: Krieger Maxwell , Bessey Sam , Abadin Salma , Akhtar Wajiha , Bowman Sarah , DiVincenzo Sheila , Duong Ellen , House JoAnna , Lai Evelyn , Latham Jennifer , Park Carolyn , Pratty Claire , Rein Blaise , Amand Katie St , Gray Jesse Yedinak , Wilson Michelle , Goedel William 
Published: August 2024

Context:
Data dashboards have emerged as critical tools for surveillance and informing resource allocation. Despite their utility and popularity during COVID-19, there is a growing need to understand what tools and training are tailored to nonprofit community-based organizations that may partner with public health officials.

Program:
In June 2021, the Rhode Island Department of Health and Brown University partnered to create Project SIGNAL (Spatiotemporal Insights to Guide Nuanced Actions Locally), which utilizes spatiotemporal analytics to identify Rhode Island’s largest disparities in COVID-19-related outcomes (eg, testing, diagnosis, vaccinations) at the neighborhood level. Results were hosted in an interactive online dashboard (signal-ri.org) designed using principles of the CDC Clear Communication Index. The target audience included a network of 15 geographic areas called Health Equity Zones, funded by the health department to provide critical grassroots public health programs to address social, health, and economic outcomes in their communities.

Implementation:
To disseminate the dashboard, a 6-hour virtual workshop series was created to train leaders to use the dashboard and increase their confidence in understanding common public health data terminology and concepts and better prepare attendees for rapid decision making during future public health emergencies.

Evaluation:
The Project SIGNAL dashboard was launched in August 2022 and has been accessed over 7500 times. A total of 84 community leaders were trained to use this dashboard, increasing their confidence in applying common public health metrics to make decisions about their COVID-19-related activities.

Discussion:
While several studies have outlined best practices for data dashboards, this is among the first to examine incorporating these practices into a spatiotemporal decision tool designed specifically for community organizations. Project SIGNAL demonstrates that by incorporating design best practices and pairing data dashboards with hands-on training, we can empower community leaders to utilize advanced spatiotemporal methods to identify health disparities and take localized action.
68Ga-Trivehexin PET/CT in Metastatic Non–Small Cell Lung Cancer to the Brain
Authors: Marafi Fahad , Esmail Abdulredha A. , Alfeeli Mahmoud A. , Sadeq Alyaa 
Published: August 2024

Abstract
In the era of molecular imaging and eager to study tumor tissues’ microenvironment with noninvasive means, the search and development of new radiotracer targeted molecule continue. αvβ6-Integrin is a heterodimeric glycoprotein transmembrane receptor that is unique in that it is expressed exclusively in epithelial cells. It is upregulated in varieties of carcinomas such of the lung, breast, and colon. It plays a role in facilitating invasion, inhibiting apoptosis, regulating expression of matrix metalloproteases, and activating TGF-β in carcinoma. Expression of αvβ6 indicates poor prognosis and can help in development of targeted therapy. 68Ga-Trivehexin has affinity of 85%–88% of this integrin.
Canonical Wnt signalling from the Area Opaca induces and maintains the Marginal Zone in pre-primitive-streak stage chick embryos
Authors: Fadaili Yara , Lu Hui-Chun , Lee Hyung Chul , Ryazapova Amra , Stern Claudio D. 
Published: August 2024

AbstractIn chick embryos prior to primitive streak formation, the outermost extraembryonic region, known as the area opaca (AO), was generally thought to act only by providing nutrients and mechanical support to the embryo. Just internal to the AO is a ring of epiblast called the marginal zone (MZ), separating the former from the inner, area pellucida epiblast. The MZ does not contribute cells to any part of the embryo but is involved in determining the position of primitive streak formation from the inner epiblast. Recently it was discovered that the AO can induce a MZ from area pellucida epiblast. Here we explore the nature of this inductive signal. We find that Wnt8c is highly expressed in the AO, whereas canonical Wnt pathway targets are enriched in the MZ, along with strong nuclear β-catenin localization. Using isolation and recombination experiments combined with gain- and loss-of-function by exogenous chemical modulators of the pathway, we reveal that Wnt signalling is essential for induction and maintenance of the MZ, as well as sufficient to induce MZ properties in area pellucida epiblast. We propose that canonical Wnt signalling is responsible for induction of the marginal zone by the area opaca.
A Bioinformatician, Computer Scientist, and Geneticist lead bioinformatic tool development - which one is better?
Authors: Gardner Paul P. 
Published: August 2024

AbstractThe development of accurate bioinformatic software tools is crucial for the effective analysis of complex biological data. This study examines the relationship between the academic department affiliations of authors and the accuracy of the bioinformatic tools they develop. By analyzing a corpus of previously benchmarked bioinformatic software tools, we mapped bioinformatic tools to the academic fields of the corresponding authors and evaluated tool accuracy by field. Our results suggest that “Medical Informatics” outperforms all other fields in bioinformatic software accuracy, with a mean proportion of wins in accuracy rankings exceeding the null expectation. In contrast, tools developed by authors affiliated with “Bioinformatics” and “Engineering” fields tend to be less accurate. However, after correcting for multiple testing, no result is statistically significant (p >0.05). Our findings reveal no strong association between academic field and bioinformatic software accuracy. These findings suggest that the development of interdisciplinary software applications can be effectively undertaken by any department with sufficient resources and training.