bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parotid Lipomas: Case Series and Literature Review – A Case Report
Authors: Unar Ambreen Abdullah , Akhtar Soubia , Iftikhar Haissan , Ikram Mubasher , Akhtar Shabbir 
Published: April 2024

Background: Lipomas are the most frequent neoplasm of mesenchymal origin in the head-and-neck region. Around 15% of lipomas are found in the head-and-neck region. The usual site where lipomas can be found in the head-and-neck region is in the posterior triangle of the neck but they can also be found in the anterior neck, infratemporal fossa, submandibular space, larynx, pharynx, and parotid gland. The incidence of parotid lipoma ranges from 0.6% to 4.4% of all parotid neoplasms. There are two histological variants, focal lipoma and diffuse infiltrating variant. We describe two cases of rare focal lipoma of the parotid gland, therefore, must be reported. As rare as it may appear, existing relevant literature suggest management to includes definitive radiological investigations such as magnetic resonance imaging (MRI) and complete removal of lipoma with or without a cuff of parotid tissue. Case Report: Two cases were identified with a parotid lipoma on final histology. Case 1 is a 57-year-old male with a history of painless left parotid swelling for 2 years, reported to be 5 cm × 4 cm size on ultrasound, therefore, underwent superficial parotidectomy. Case 2 is a 67-year-old male who presented with right parotid swelling for 15 years, reported on ultrasound to be 5 cm × 5 cm, and underwent excision of intraparotid tumor. He later went on to develop breast carcinoma. The facial nerve was intact of both patients. Conclusion: Parotid lipomas are rare entities that should be a differential for clinically soft parotid swellings. Management includes definitive radiological investigations such as MRI and complete removal of lipoma with or without a cuff of parotid tissue instead of regular ultrasound followed by fine-needle aspiration cytology. Although our cases were managed on the same regular outlines, but reporting these cases would suffice the potential role of MRI and computed tomography scan for parotid swelling as per existing literature.
A Rare Case of Pial Arteriovenous Fistula in an Infant – A Case Report
Authors: Kumar Savith , Menon Gayathri S. , Urs Prashanth S. , Itihas Anup 
Published: April 2024

Introduction: Pial arteriovenous fistula (PAVF) is a rare intracranial vascular malformation with diverse clinical presentations. Early diagnosis and intervention are crucial due to its poor natural history. Endovascular treatment has emerged as a preferred option with promising results. Case Report: We report a case of an 8-month-old infant who presented with recurrent focal seizures and acute intraparenchymal hematoma. Further investigation with magnetic resonance angiography and digital subtraction angiography confirmed the presence of a PAVF. Results: Endovascular embolization successfully obliterated the PAVF with no postprocedural complications. Clinical follow-up demonstrated a favorable outcome. Conclusion: This case highlights the significance of early detection through suitable imaging modalities and timely intervention in preventing life-threatening complications associated with PAVFs. Endovascular embolization offers an effective and safe treatment option for pediatric PAVFs, leading to positive outcomes in this rare entity.
Accessory Ostium of the Maxillary Sinus and Its Impact on Sinusitis
Authors: Swain Santosh Kumar 
Published: April 2024

Background: One of the anatomical variations in the maxillary sinus is the accessory ostium (AO). In the nasal cavity, the lateral wall’s vertical plane is parallel to the form of the AO, which is round or oval in appearance. During a nasal endoscopic examination, AO may be seen in contrast to the normal ostium of the maxillary sinus, which is hidden behind the uncinate process. Methods: The search for recent research articles on AO of the maxillary sinus was done with databases Scopus, PubMed, Medline, and Google Scholar. This review article discusses the prevalence, development, endoscopic examination, clinical significance, surgical importance, relationship with chronic sinusitis, and its management. Results: AO may interfere with ventilation and drainage of the maxillary sinus. Hence, it is important to evaluate the anatomical features of the AO for its relationship with sinus pathology. The development of maxillary sinusitis may be significantly impacted by the anatomical variance known as AO of the maxillary sinus. The middle meatus’s posterior nasal fontanelle is where AO is most frequently observed. The possible mechanism for the formation of AO is obstruction of the natural ostium of the maxillary sinus by sinusitis or due to anatomical and pathological factors in the middle meatus leading to rupture of membranous regions such as fontanelle. Conclusion: Clinicians must have adequate knowledge regarding the anatomical variations of the AO. It frequently appears in the fontanelle, the membranous portion of the middle meatus’ lateral nasal wall that is between the uncinate process and inferior meatus.
Presence of endometriosis and chronic overlapping pain conditions negatively impacts the pain experience in women with chronic pelvic–abdominal pain: A cross-sectional survey
Authors: Bartley Emily J , Alappattu Meryl J , Manko Kelsey , Lewis Hannah , Vasilopoulos Terrie , Lamvu Georgine 
Published: April 2024

Background: Evidence of overlap between endometriosis and chronic pain conditions is emerging; however, little is known about how the pain experience differs based on the presence or absence of endometriosis. Objectives: In a sample of women reporting chronic pelvic–abdominal pain (CPP), the aim of this study was to characterize differences in pain symptomatology between women with and without endometriosis and to examine the influence of chronic overlapping pain conditions (COPCs) on pain among these two groups. Design: This was a cross-sectional study, based on an online survey. Methods: Participants (aged 18+ years) completed a survey collecting pain diagnoses and symptoms assessing pelvic pain severity, pain interference, and pain impact. Independent sample t-tests, chi-square, and multiple linear regression models were employed to analyze group differences in pain symptomatology and COPCs. Results: Of the 525 respondents with CPP, 25% (n = 133) reported having endometriosis. Women with endometriosis were younger at the onset of pelvic pain, relative to women without endometriosis ( p = 0.04). There were no differences in age, race, ethnicity, or duration of pelvic pain between women with and without endometriosis. Women with endometriosis reported higher pelvic pain severity (+0.8, 95% CI = 0.4–1.1), pain interference (+5.9, 95% CI = 2.4–9.3), and pain impact (+1.9, 95% CI = 0.8–2.9). Endometriosis was associated with a higher number of COPCs ( p = 0.003), with 25% (n = 33) of women reporting ⩾3 overlapping pain conditions compared with 12% (n = 45) of those without endometriosis. Women with endometriosis had a higher frequency of fibromyalgia ( p < 0.001), chronic fatigue syndrome ( p < 0.001), and temporomandibular disorder ( p = 0.001). The number of COPCs was associated with higher pain severity, interference, and impact, independently of endometriosis. Conclusion: Women with endometriosis experienced higher levels of pain-related burden and COPCs compared with those without endometriosis. Pain intensity, interference, and impact increased with a higher number of pain conditions regardless of endometriosis presence.
Supervised and Unsupervised Approaches for the Real-Time Detection of Undesired Insulin Suspension Caused by Malfunctions
Authors: Idi Elena , Facchinetti Andrea , Sparacino Giovanni , Del Favero Simone 
Published: April 2024

Background: Automated insulin delivery (AID) systems, permit improved treatment of type 1 diabetes (T1D). Unfortunately, malfunctioning in the insulin pump or in the infusion set can prevent insulin from being administered, reducing the AID efficacy and posing the patient at risk. Different data-driven methods available in the literature can be used to deal with the problem of automatically detecting complete insulin suspension in real-time. This article investigates both supervised and unsupervised strategies and proposes a fair comparison under either population or personalized settings. Methods: Several algorithms are compared using data generated through the UVA/Padova T1D simulator, a computer simulator widely used to test control strategies in silico and accepted by the Food and Drugs Administration (FDA) as a substitute to animal pre-clinical trials. Two synthetic data sets, each consisting of 100 virtual subjects monitored for 1 month, were generated. Occasional faults of the insulin pump are simulated as complete occlusions by suspending the therapy administration. Personalized algorithms are investigated with unsupervised approaches only, since personalized labels are hardly available. Results: In the population scenario, the supervised approach outperforms the unsupervised strategy. In particular, logistic regression and random forest achieves a recall of 72% and 82%, with 0.12 and 0.21 false positives (FP) per day, respectively. In the personalized setting scenario, the unsupervised algorithms are tailored on each patient and outperform the population ones, in particular isolation forest achieves a recall 80% and 0.06 FPs per day. Conclusions: This article suggests that unsupervised personalized approach, by addressing the large variability in glucose response among individuals with T1D, is superior to other one-fits-all approaches in detecting insulin suspensions caused by malfunctioning. Population methodologies can be effectively used while waiting to collect sufficient patient data, when the system is installed on a new patient.
Breathing Uneasily: Employees’ Stories of Coping With Poor Indoor Air Quality in the Workplace
Authors: Loraas Dawn Marie 
Published: April 2024

Objectives: This phenomenological study aimed to elucidate the lived experiences of employees suffering from poor indoor air quality (IAQ) in their university workplace. It addresses gaps in understanding IAQ’s personal impacts from occupants’ perspectives. Background: Prior research on sick building syndrome and indoor air pollution utilized quantitative methods to assess physical health outcomes. However, few studies have adopted qualitative approaches to uncover the meanings ascribed to adverse IAQ experiences and their influences on psychosocial well-being. Methods: In-depth semi-structured interviews were conducted with five university employees who attributed their chronic illnesses to poor IAQ in their 60-year-old office building with a history of IAQ concerns. Verbatim transcripts were analyzed using qualitative techniques including thematic coding to extract key themes conveying shared experiences. Results: Employees depicted the building itself as fundamentally “sick” and stigmatized, compelling complex coping behaviors hindering productivity. Communication breakdowns, mistrust in leadership, and strained workplace relationships were prevalent. A sense of betrayal, powerlessness, and a sense of detachment from the workplace emerged with home as a refuge. Conclusions: Although technically adequate, poor IAQ profoundly damaged perceived health, quality of life, relationships, and satisfaction. The accounts emphasize IAQ’s psychosocial dimensions, advancing theoretical links between indoor environments and well-being. Supportive policies, transparency, communication, participatory processes, and human-centered strategies emerge as ways to nurture productivity, well-being, and organizational health.
Bond Integrity and Microleakage of Orthodontic Bands Cemented by Glass Ionomer Cements Stored in Static Magnetic Field
Authors: Al Qassar Sarmad S. Salih , Alkhayat Zainab I. , Al Mallah Mahmood R. 
Published: April 2024

Aim: Improving the band-tooth bond integrity by glass ionomer cement (GIC) is essential in orthodontic treatments. As, microleakage under bands induced enamel demineralization. Storing the dental material to updated magnets improved their mechanical properties. This research aimed to assess the microleakage of GIC after storing in a static magnetic field (SMF). Material and Methods: Forty premolars and their suitable bands were randomly classified into two main groups according to the types of GIC tested in this research; resin-modified GIC (RMGIC) and conventional GIC (CGIC). Each group was subdivided according to the exposure to SMF before polymerization into two subgroups. CGIC not exposed to SMF (CC), CGIC exposed to SMF (CM), RMGIC not exposed to SMF (LC) and RMGIC exposed to SMF (LM). SMF intensity performed was 0.225 Tesla, exposed for 48 hours at room temperature. The entire tube of RMGIC was inserted in SMF, where the powder of CGIC was stored in SMF. The microleakage under the band was evaluated under a 20× stereomicroscope by dye penetration technique at the cement band interface. Wilcoxon signed-rank test was used for data analysis, p ≤ .05. Results: The main (SD) microleakage of GIC reduced significantly ( p = .043) after being exposed to SMF from 3.1950 (0.632) mm to 1.7095 (0.1176) mm and from 0.8745 (0.1104) mm to 0.6430(0.094) mm for CGIC and RMGIC, respectively. Conclusion: Storing the CGIC powder in (0.225 T) SMF improves band-tooth bond integrity. Additionally, the preservation of RMGIC in SMF minimized the microleakage under orthodontic bands.
Integrative analysis of the metabolome and transcriptome provides insights into the mechanisms of lignan biosynthesis in Herpetospermum pedunculosum (Cucurbitaceae)
Authors: Zhu Ziwei , Chen Daihan , Sun Min , Xiao Maotao , Huang Peng , Ren Dongsheng , Yang Yixi , Zhang Zhen , Zhao Qi , Li Rui 
Published: April 2024

Abstract
Background
Herpetospermum pedunculosum (Ser.) C. B. Clarke is a traditional Chinese herbal medicine that heavily relies on the lignans found in its dried ripe seeds (Herpetospermum caudigerum), which have antioxidant and hepatoprotective functions. However, little is known regarding the lignan biosynthesis in H. pedunculosum. In this study, we used metabolomic (non-targeted UHPLC-MS/MS) and transcriptome (RNA-Seq) analyses to identify key metabolites and genes (both structural and regulatory) associated with lignan production during the green mature (GM) and yellow mature (YM) stages of H. pedunculosum.

Results
The contents of 26 lignan-related metabolites and the expression of 30 genes involved in the lignan pathway differed considerably between the GM and YM stages; most of them were more highly expressed in YM than in GM. UPLC-Q-TOF/MS confirmed that three Herpetospermum-specific lignans (including herpetrione, herpetotriol, and herpetin) were found in YM, but were not detected in GM. In addition, we proposed a lignan biosynthesis pathway for H. pedunculosum based on the fundamental principles of chemistry and biosynthesis. An integrated study of the transcriptome and metabolome identified several transcription factors, including HpGAF1, HpHSFB3, and HpWOX1, that were highly correlated with the metabolism of lignan compounds during seed ripening. Furthermore, functional validation assays revealed that the enzyme 4-Coumarate: CoA ligase (4CL) catalyzes the synthesis of hydroxycinnamate CoA esters.

Conclusion
These results will deepen our understanding of seed lignan biosynthesis and establish a theoretical basis for molecular breeding of H. pedunculosum.
Is a randomised controlled trial of take home naloxone distributed in emergency settings likely to be feasible and acceptable? Findings from a UK qualitative study exploring perspectives of people who use opioids and emergency services staff
Authors: Sampson FC , Hughes J , Long J , Buykx P , Goodacre SW , Snooks H , Edwards A , Evans Bridie , Jones Jenna , Moore Chris , Johnston Sasha 
Published: April 2024

Abstract
Objective
Distribution of take-home naloxone (THN) by emergency services may increase access to THN and reduce deaths and morbidity from opioid overdose. As part of a feasibility study for a randomised controlled trial (RCT) of distribution of THN kits and education within ambulance services and Emergency Departments (EDs), we used qualitative methods to explore key stakeholders’ perceptions of feasibility and acceptability of delivering the trial.

Methods
We undertook semi-structured interviews and focus groups with 26 people who use opioids and with 20 paramedics and ED staff from two intervention sites between 2019 and 2021. Interviews and focus groups were recorded, transcribed verbatim and analysed using Framework Analysis.

Results
People using opioids reported high awareness of overdose management, including personal experience of THN use. Staff perceived emergency service provision of THN as a low-cost, low-risk intervention with potential to reduce mortality, morbidity and health service use. Staff understood the trial aims and considered it compatible with their work. All participants supported widening access to THN but reported limited trial recruitment opportunities partly due to difficulties in consenting patients during overdose. Procedural problems, restrictive recruitment protocols, limited staff buy-in and patients already owning THN limited trial recruitment. Determining trial effectiveness was challenging due to high levels of alternative community provision of THN.

Conclusions
Distribution of THN in emergency settings was considered feasible and acceptable for stakeholders but an RCT to establish the effectiveness of THN delivery is unlikely to generate further useful evidence due to difficulties in recruiting patients and assessing benefits.
Secondary analyses of sex differences in attention improvements across three clinical trials of a digital therapeutic in children, adolescents, and adults with ADHD
Authors: Flannery Jessica E. , Hinshaw Stephen P. , Kollins Scott H. , Stamatis Caitlin A. 
Published: April 2024

Abstract
Background
Attention-deficit/hyperactivity disorder (ADHD) remains underdiagnosed and undertreated in girls. Inattentive symptoms, often predominant in girls with ADHD, represent a key driver of impairment and often persist into adulthood. AKL-T01 is a regulated digital therapeutic targeting inattention. We examined potential sex differences in the efficacy of AKL-T01 in three separate trials for 1) children, 2) adolescents, and 3) adults.

Methods
We conducted secondary analyses of clinical outcomes by sex in three AKL-T01 randomized clinical trials in ADHD (n1 = 180 children 30.6% female, M(SD) age = 9.71 (1.32); n2 = 146 adolescents; 41.1% female, M(SD) age = 14.34 (1.26); n3 = 153 adults; 69.9% female, M(SD) age = 39.86 (12.84)). Active treatment participants used AKL-T01 for 25 min/day over 4–6 weeks. Primary outcomes included change in attention on the Test of Variables of Attention (TOVA) and symptom change on the clinician-rated ADHD Rating Scale (ADHD-RS). To evaluate study hypotheses, we conducted a series of robust linear regressions of TOVA and ADHD-RS change scores by sex, adjusting for baseline scores.

Results
In children, girls demonstrated greater improvement in objective attention relative to boys following AKL-T01 (TOVA Attentional Composite Score; Cohen’s d = .36 and Reaction Time Mean Half; Cohen’s d = .54), but no significant sex differences in ADHD rating scale change. We did not observe significant sex differences in outcomes in the adolescent or adult trials. Limitations include binary sex categorization and slight study design variation across the three samples.

Conclusion
AKL-T01 might notably improve attentional functioning in girls with ADHD relative to boys. Objective attention measures may be particularly important in the assessment of attentional improvement in childhood, given known gender biases in ADHD symptom reporting. We emphasize the importance of considering sex and gender-specific factors in ADHD treatment evaluation.

Trial registrations
STARS ADHD CHILD: ClinicalTrials.gov ID NCT03649074;
STARS ADHD ADOLESCENT: ClinicalTrials.gov ID NCT04897074;
STARS ADHD ADULT: ClinicalTrials.gov ID NCT05183919.
A qualitative study of the barriers to commissioning social and therapeutic horticulture in mental health care
Authors: Wood Carly J. , Morton Georgina , Rossiter Kathryn , Baumber Becs , Bragg Rachel E. 
Published: April 2024

Abstract
Background
Social and Therapeutic Horticulture (STH) is a process where trained practitioners work with plants and people to improve an individual’s physical and psychological health, communication and thinking skills. Evidence suggests that STH can support individuals with mental ill-health, however, current commissioning of STH within mental health care is limited. This study aimed to understand the barriers to commissioning STH in mental health care and to identify potential solutions to barriers, to support more widespread availability of services.

Methods
Individuals with a role in mental health care commissioning from across the UK were invited to take part in semi-structured interviews via zoom. Interviews explored factors influencing the mental health services they commission or refer to, their perception of the role of STH in mental health care and the barriers to commissioning STH, together with potential solutions to any barriers identified.

Results
Commissioners identified a lack of knowledge of STH and evidence of its effectiveness, and a culture which prioritises traditional medical models, as barriers to commissioning. Challenges for STH providers in responding to large-scale commissioning requirements were also highlighted as a barrier.

Conclusions
To upscale commissioning of STH in mental health care, STH interventions need to be embedded within NHS priorities and information on STH services and their effectiveness needs to be easily accessible to practitioners. The sector should also be supported in working collaboratively to enable commissioning of services at scale.
Effect of Salvadora persica on resin-dentin bond stability
Authors: Abu-Nawareg Manar M. , Abouelseoud Hanan K. , Zidan Ahmed Z. 
Published: April 2024

Abstract
Background
The stability of resin–dentin interfaces is still highly questionable. The aim of this study was to evaluate the effect of Salvadora persica on resin–dentin bond durability.

Materials and methods
Extracted human third molars were used to provide mid-coronal dentin, which was treated with 20% Salvadora persica extract for 1 min after acid-etching. Microtensile bond strength and interfacial nanoleakage were evaluated after 24 h and 6 months. A three-point flexure test was used to measure the stiffness of completely demineralized dentin sticks before and after treatment with Salvadora persica extract. The hydroxyproline release test was also used to measure collagen degradation by endogenous dentin proteases. Statistical analysis was performed using two-way ANOVA followed by post hoc Bonferroni test and unpaired t-test. P-values < 0.05 were considered statistically significant.

Results
The use of Salvadora persica as an additional primer with etch-and-rinse adhesive did not affect the immediate bond strengths and nanoleakage (p > 0.05). After 6 months, the bond strength of the control group decreased (p = 0.007), and nanoleakage increased (p = 0.006), while Salvadora persica group showed no significant difference in bond strength and nanoleakage compared to their 24 h groups (p > 0.05). Salvadora persica increased dentin stiffness and decreased collagen degradation (p < 0.001) compared to their controls.

Conclusion
Salvadora persica extract pretreatment of acid-etched dentin preserved resin–dentin bonded interface for 6 months.

Clinical significance
Durability of resin-dentin bonded interfaces is still highly questionable. Endogenous dentinal matrix metalloproteinases play an important role in degradation of dentinal collagen within such interfaces. Salvadora persica may preserve resin-dentin interfaces for longer periods of time contributing to greater clinical success and longevity of resin composite restorations.