bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exceptional lymph node recurrence of an unusual ovarian tumor 16 years later: a case report
Authors: Sakhri Saida , Slimane Maher , Bouaziz Hanen , Khessairi Nayssem , Boujelbene Nadia , Ben Dhiab Tarek 
Published: April 2024

Abstract
Background
Sex cord-stromal tumors with annular tubules are a rare tumor accounting for less than 1% of all ovarian malignancies. However, they are characterized by very late recurrence, which can be as late as 30 years after diagnosis and treatment.

Case presentation
A 16-year-old female Caucasian patient was treated in our department for a stage IA ovarian sex cord-stromal tumors with annular tubules. She underwent a left salpingo-oophorectomy and ipsilateral pelvic node biopsy with no adjuvant treatment. She was seen for amenorrhea after being lost to follow up for 16 years. The diagnosis of recurrence was made by radiology and the elevation of serum inhibin B level. The patient underwent resection of the tumor, left segmental colectomy, and paraaortic lymphadenectomy because the mass was massively adherent to the left mesocolon. Histology confirmed the diagnosis with no metastatic lymph nodes. No adjuvant therapy was indicated. The patient was lost to follow-up again for 4 years and re-presented for amenorrhea. Serum inhibin B level was high. A second recurrence was suggested, and the patient underwent a laparoscopic surgery. We performed left pelvic and paraaortic lymphadenectomy, and 3 months after surgery the patient was pregnant.

Conclusion
Sex cord-stromal tumors with annular tubules is a slow-growing ovarian tumor with a high potential for recurrence and metastasis. Surgery is the mainstay of treatment. Due to the rarity of these tumors, they are often unsuspected and thus incompletely staged before primary surgery; the diagnosis is made by histological examination. The prognosis of these patients is unknown, and they require long-term follow-up.
Characterization of vitamin D3 biotransformation by the cell lysate of Actinomyces hyovaginalis CCASU-A11-2
Authors: Abbas Ahmad M. , Elkhatib Walid F. , Aboulwafa Mohammad M. , Hassouna Nadia A. , Aboshanab Khaled M. 
Published: April 2024

AbstractA former work conducted in our Lab, lead to in a effective scale up of vitamin D3 bioconversion into calcitriol by Actinomyces (A.) hyovaginalis isolate CCASU-A11-2 in Lab fermenter (14 L) resulting in 32.8 µg/100 mL of calcitriol. However, the time needed for such a bioconversion process was up to 5 days. Therefore, the objective of this study was to shorten the bioconversion time by using cell-free lysate and studying different factors influencing bioconversion. The crude cell lysate was prepared, freeze-dried, and primarily fractionated into nine fractions, of which, only three fractions, 50, 100, and 150 mM NaCl elution buffers showed 22, 12, and 2 µg/10 mL, calcitriol production, respectively. Ammonium sulfate was used for protein precipitation, and it did not affect the bioconversion process except at a concentration of 10%w/v. Secondary fractionation was carried out using 80 mL of the 50 mM NaCl elution buffer and the results showed the 80 mL eluent volume was enough for the complete elution of the active protein. The pH 7.8, temperature 28 °C, and 6 h reaction time were optimum for maximum calcitriol production (31 µg/10 mL). In conclusion, the transformation of vitamin D3 into calcitriol was successfully carried out within 6 h and at pH 7.8 and 28 °C using fractionated cell lysate. This process resulted in a 10-fold increase in calcitriol as compared to that produced in our previous study using a 14 L fermenter (32.8 µg/100 mL). Therefore, cell-free lysate should be considered for industrial and scaling up vitamin D3 bioconversion into calcitriol.
Pfizer COVID19 vaccine is not associated with acute cardiovascular events excluding myocarditis– a national self-controlled case series study
Authors: Boker Lital Keinan , Fluss Ronen , Dichtiar Rita , Rosenberg Alina , Ben-Lassan Maya , Huppert Amit 
Published: April 2024

Abstract
Background
Despite publications assuring no increased risk for acute cardiovascular events (excluding myocarditis) and sudden death following administration of COVID19 vaccines, these issues still stir much public ado. We assessed the risk for acute cardiovascular events that require hospitalization (excluding myocarditis) and for mortality in the short-term following administration of the second dose of the Pfizer COVID19 vaccine in Israel.

Methods
Using a self-controlled case series (SCCS) study design and national databases, all second-dose vaccinees, who had not been diagnosed with COVID19 and who had an acute cardiovascular event (acute myocardial infarction/acute stroke/acute thromboembolic event) that required hospitalization in the 60 days following vaccine administration between Jan 11th, 2021 and Oct 31st 2021, were included. A similar analysis was carried out for mortality. The first 30 days following vaccination were defined as risk period while the next 30 days were defined as control period. The probability for an event between these periods was compared using a conditional logistic regression model, accounting for sex, age group, background morbidity and seasonal risk.

Results
Out of 5,700,112 second dose vaccinees, 4,163 had an acute cardiovascular event in the 60 days following vaccine administration. Following exclusion of 106 due to technical considerations, 1,979 events occurred during the risk period and 2,078 during the control period: Odds ratio, OR = 0.95, 95% confidence interval, CI 0.90–1.01, p = 0.12. Adjusted OR was similar (OR = 0.88, 95%CI 0.72–1.08). Stratifying by age showed no increased risk in any age group. Mortality assessment indicated low number of events in both periods. These results were consistent in sensitivity analyses.

Conclusions
There was no increased risk for acute cardiovascular events (excluding myocarditis) in the risk period compared to the control period following administration of the second dose of Pfizer COVID19 vaccine. Mortality data raised no concerns either, but may have been biased.
Exploring the power of pure attention mechanisms in blind room parameter estimation
Authors: Wang Chunxi , Jia Maoshen , Li Meiran , Bao Changchun , Jin Wenyu 
Published: April 2024

AbstractDynamic parameterization of acoustic environments has drawn widespread attention in the field of audio processing. Precise representation of local room acoustic characteristics is crucial when designing audio filters for various audio rendering applications. Key parameters in this context include reverberation time (RT$$_{60}$$60) and geometric room volume. In recent years, neural networks have been extensively applied in the task of blind room parameter estimation. However, there remains a question of whether pure attention mechanisms can achieve superior performance in this task. To address this issue, this study employs blind room parameter estimation based on monaural noisy speech signals. Various model architectures are investigated, including a proposed attention-based model. This model is a convolution-free Audio Spectrogram Transformer, utilizing patch splitting, attention mechanisms, and cross-modality transfer learning from a pretrained Vision Transformer. Experimental results suggest that the proposed attention mechanism-based model, relying purely on attention mechanisms without using convolution, exhibits significantly improved performance across various room parameter estimation tasks, especially with the help of dedicated pretraining and data augmentation schemes. Additionally, the model demonstrates more advantageous adaptability and robustness when handling variable-length audio inputs compared to existing methods.
The lived experiences of operating room nurses from the surgery on COVID-19 patients: a phenomenological study
Authors: Imani Behzad , Mostafayi Mehrnush , Zandi Shirdel 
Published: April 2024

Abstract
Background
During the COVID-19 pandemic, some patients who were transported to the operating room for emergency surgery had COVID-19; operating room nurses should be in direct contact with these patients in a small and closed space of the operating room. This can lead to unpleasant experiences for these people. Accordingly, this study was conducted to understand the experience of operating room nurses during the surgery of COVID-19 patients.

Methods
This qualitative study is a descriptive phenomenological study. Sampling was done purposefully and participants were selected based on the inclusion and exclusion criteria. The data of this study was obtained through semi-structured interviews with 12 participants and analyzed using the Colaizzi method.

Results
Four main themes and 13 sub-themes were presented in this study: (1) feeling heroic (being a savior, self-sacrificing). (2) Exacerbating burnout (emotional exhaustion, feeling of incompetence, physical overtiredness). (3) Psychiatric crisis (destructive anxiety, horror of death, worrying about being a carrier, drastic feeling of pity). (4) Feeling the need for support (need for professional support, need for emotional support, need for social support).

Conclusion
The results of this study show that operating room nurses experienced conflicting feelings during surgery on patients with COVID-19. So the feeling of being a hero was a heartwarming experience, but the aggravation of job burnout and mental crisis was unpleasant for them. Also, these people have experienced the need to be supported in various aspects.
Consumers preferences and social sustainability: a discrete choice experiment on ‘Quality Agricultural Work’ ethical label in the Italian fruit sector
Authors: Rossi Eleonora Sofia , Cacchiarelli Luca , Severini Simone , Sorrentino Alessandro 
Published: April 2024

AbstractThe Italian legislator has adopted several instruments to discourage undeclared work and exploitative labour in agriculture, mostly of a penal-repressive nature. Among the direct and indirect policy measures, the ‘Quality Agricultural Work Network’ represents an interesting approach to producing a ‘whitelist’ of farmers compliant with labour regulations. A law proposal intends to establish the ‘Quality Agricultural Work’ (QAW) ethical label to incentivise farmers to join the network, to which a limited percentage of farms have signed up. This study aims to investigate consumer preferences for the QAW label in the Italian fruit sector. We conducted a choice experiment on a sample of 324 consumers. Willingness to pay for ethical labels was estimated before and after information treatment was administered to evaluate the prospective effects of promotional and information campaigns. The information treatment conveyed a clear and concise message about the QAW project and its ethical label. The results show that consumers would pay a high price premium for fruit produced under fair working conditions, indicating that there may be a market space for the QAW label. Moreover, consumers perceive environmental and social sustainability claims as complementary contexts where both dimensions of sustainability are relevant.
Graphical abstract
GEN1 as a risk factor for human congenital anomalies of the kidney and urinary tract
Authors: Du Xuanjin , Wang Chunyan , Liu Jialu , Yu Minghui , Ju Haixin , Xue Shanshan , Li Yaxin , Liu Jiaojiao , Dai Rufeng , Chen Jing , Zhai Yihui , Rao Jia , Wang Xiang , Sun Yubo , Sun Lei , Wu Xiaohui , Xu Hong , Shen Qian 
Published: April 2024

Abstract
Background
Congenital anomalies of the kidney and urinary tract (CAKUT) are prevalent birth defects. Although pathogenic CAKUT genes are known, they are insufficient to reveal the causes for all patients. Our previous studies indicated GEN1 as a pathogenic gene of CAKUT in mice, and this study further investigated the correlation between GEN1 and human CAKUT.

Methods
In this study, DNA from 910 individuals with CAKUT was collected; 26 GEN1 rare variants were identified, and two GEN1 (missense) variants in a non-CAKUT group were found. Mainly due to the stability results of the predicted mutant on the website, in vitro, 10 variants (eight CAKUT, two non-CAKUT) were selected to verify mutant protein stability. In addition, mainly based on the division of the mutation site located in the functional region of the GEN1 protein, 8 variants (six CAKUT, two non-CAKUT) were selected to verify enzymatic hydrolysis, and the splice variant GEN1 (c.1071 + 3(IVS10) A > G) was selected to verify shear ability. Based on the results of in vitro experiments and higher frequency, three sites with the most significant functional change were selected to build mouse models.

Results
Protein stability changed in six variants in the CAKUT group. Based on electrophoretic mobility shift assay of eight variants (six CAKUT, two non-CAKUT), the enzymatic hydrolysis and DNA-binding abilities of mutant proteins were impaired in the CAKUT group. The most serious functional damage was observed in the Gen1 variant that produced a truncated protein. A mini-gene splicing assay showed that the variant GEN1 (c.1071 + 3(IVS10) A > G) in the CAKUT group significantly affected splicing function. An abnormal exon10 was detected in the mini-gene splicing assay. Point-mutant mouse strains were constructed (Gen1: c.1068 + 3 A > G, p.R400X, and p.T105R) based on the variant frequency in the CAKUT group and functional impairment in vitro study and CAKUT phenotypes were replicated in each.

Conclusion
Overall, our findings indicated GEN1 as a risk factor for human CAKUT.
The immediate impacts of TV programs on preschoolers' executive functions and attention: a systematic review
Authors: Namazi Sara Arian , Sadeghi Saeid 
Published: April 2024

Abstract
Background
Previous research has presented varying perspectives on the potential effect of screen media use among preschoolers. In this study, we systematically reviewed experimental studies that investigated how pacing and fantasy features of TV programs affect children's attention and executive functions (EFs).

Methods
A systematic search was conducted across eight online databases to identify pertinent studies published until August 2023. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines.

Results
Fifteen papers involving 1855 participants aged 2–7 years fulfilled all the inclusion criteria for this review and were entered into the narrative synthesis. Despite the challenge of reaching general conclusions and encountering conflicting outcomes, a nuanced analysis reveals distinct patterns within various subgroups. The impact of pacing on attention is discernible, particularly in bottom-up attention processes, although the nature of this effect remains contradictory. Conversely, consistent findings emerge regarding top-down attention, suggesting any impact. Moreover, a subgroup analysis of different EF components yields valuable insights, highlighting the negative effect of fantasy on inhibitory control within the EF framework.

Conclusion
The complexity of these outcomes highlights the need for further research, considering factors such as content, child-specific characteristics, environmental factors, and methodological approaches. These findings collectively emphasize the necessity of conducting more comprehensive and detailed research, especially in terms of the underlying mechanisms and their impact on brain function.
A case of phyllodes tumor with rapid growth during pregnancy and lactation period: a case report
Authors: Tohyama Shiori , Horimoto Yoshiya , Ushiyama Yumiko , Semba Ryoko , Hotchi Shiori , Sugano Naomi , Ogura Kanako , Murakami Fumi 
Published: April 2024

Abstract
Background
The age of onset of the phyllodes tumor is generally in the late 40 s, and diagnosis and treatment during pregnancy and lactation are rare. We herein present a case of a phyllodes tumor that rapidly increased in size during the pregnancy and lactation period.

Case presentation
A 39-year-old woman was referred to our hospital with a mass in the right breast that increased in size during the pregnancy and lactation period. On ultrasound (5 week postpartum), a well-defined lobulated mass with internal septations and fluid retention was observed. Magnetic resonance imaging of the breast at 8 week postpartum revealed a 70-mm-sized smooth-margin mass with multilocular cystic components. Marked proliferation of stromal cells with high cell density was observed in a biopsy specimen taken at the previous hospital. We diagnosed the mass as a phyllodes tumor of borderline malignancy and excised it at 13 week postpartum. The excised tumor was 85 mm in diameter and its interior was filled with a milk-like substance. Histologically, there was only a mild increase in stromal cell density but fibrosis with associated degeneration was prominent. The final diagnosis was benign phyllodes tumor with degeneration.

Conclusions
We report a case of a phyllodes tumor that rapidly increased in size during pregnancy and the lactation period. The accumulation of a milk-like substance was thought to be responsible for the rapid growth of the tumor.
Tumor lysis syndrome following letrozole for locally advanced breast cancer: a case report
Authors: Kikuchi Masayuki , Miyabe Rika , Matsushima Hirokazu , Kita Hidenori , Kobayashi Junko , Ando Takashi , Atsuta Koji , Shintani Tsunehiro 
Published: April 2024

Abstract
Background
Letrozole, an aromatase inhibitor, is used to treat breast cancer in postmenopausal women. Tumor lysis syndrome (TLS) is a complication that can trigger multiple organ failure caused by the release of intracellular nucleic acids, phosphate, and potassium into the blood due to rapid tumor cell disintegration induced by drug therapy. TLS is uncommon in solid tumors and occurs primarily in patients receiving chemotherapy. Herein, we report a rare occurrence of TLS that developed in a patient with locally advanced breast cancer following treatment with letrozole.

Case presentation
An 80-year-old woman with increased bleeding from a fist-sized left-sided breast mass presented to our hospital. Histological examination led to a diagnosis of invasive ductal carcinoma of the luminal type. The patient refused chemotherapy and was administered hormonal therapy with letrozole. Seven days after letrozole initiation, she complained of anorexia and diarrhea. Blood test results revealed elevated blood urea nitrogen (BUN) and creatinine (Cr) levels, and she was admitted to our hospital for intravenous infusions. On the second day after admission, marked elevations of LDH, BUN, Cr, potassium, calcium, and uric acid levels were observed. Furthermore, metabolic acidosis and prolonged coagulation capacity were observed. We suspected TLS and discontinued letrozole, and the patient was treated with hydration, febuxostat, and maintenance hemodialysis. On the third day after admission, her respiratory status worsened because of acute respiratory distress syndrome associated with hypercytokinemia, and she was intubated. On the fourth day after admission, her general condition did not improve, and she died.

Conclusions
Although TLS typically occurs after chemotherapy initiation, the findings from the present case confirm that this syndrome can also occur after hormonal therapy initiation and should be treated with caution.
Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal
Authors: Gloeckl Rainer , Zwick Ralf H. , Fürlinger Ulrich , Schneeberger Tessa , Leitl Daniela , Jarosch Inga , Behrends Uta , Scheibenbogen Carmen , Koczulla Andreas Rembert 
Published: April 2024

AbstractPeople with long COVID may suffer from a wide range of ongoing symptoms including fatigue, exertional dyspnea, reduced exercise performance, and others. In particular, impaired exercise performance is a condition that can be recovered in many people through an individualized physical exercise training program. However, clinical experience has shown that the presence of post-exertional malaise (PEM) is a significant barrier to physical exercise training in people with long COVID. Currently, there is no guideline or consensus available on how to apply exercise training in this cohort. Therefore, we conducted a literature review in the PubMed library using the following search terms: “COVID”, “post-COVID”, “long COVID” and “exercise” searching for studies from January 2020 to January 2024. Data from 46 trials were included. Exercise training regimes were very heterogeneous and none of these studies reported on the management of PEM in the context of an exercise training program. Based on the feedback from an additional survey that was answered by 14 international experts in the field of exercise training in long COVID, combined with the authors´ own extensive practical experience, a best practice proposal for exercise training recommendations has been developed. This proposal differentiates exercise procedures according to the presence of no, mild/moderate or severe PEM in people with long COVID. These recommendations may guide allied healthcare professionals worldwide in initiating and adjusting exercise training programs for people with long COVID, stratified according to the presence and severity of PEM.
Determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia: an unmatched case-control study
Authors: Seboka Keraj , Gurara Abenet Menene , Bekele Nardos Tilahun , Belachwe Yohanes Abera , Getahun Mihiret Shawel , Negussie Yohannes Mekuria 
Published: April 2024

Abstract
Background
Puerperal sepsis, is a significant factor in maternal morbidity and mortality, especially in regions with lower income levels where maternal mortality rates are highest. However, it can be largely avoided if detected in time. Recognizing and dealing with the root causes early is essential in addressing this problem. Therefore, this study aimed to identify the determinants of puerperal sepsis among postpartum women at a tertiary care hospital in Ethiopia.

Methods
An institutional-based unmatched case-control study was conducted among 266 postpartum women (88 cases and 178 controls) from October 1, 2023 to November 30, 2023. For each case, two controls were chosen using a systematic random sampling approach. Data were collected using an interviewer-administered, structured questionnaire and medical record review. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 27. Binary logistic regression analysis was used to model the association between puerperal sepsis and independent variables. variables that had a crude association in the bivariable analysis (p < 0.25) were entered and analyzed by a multivariable binary logistic regression model to identify statistically significant factors. In the final model, Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. Statistical significance was declared at p < 0.05.

Result
Rural residence (AOR = 6.9; 95% CI:2.77–17.10), having no formal education (AOR = 3.8; 95% CI: 2.55, 10.76), cesarean section delivery (AOR: 5.1; 95% CI: 1.30, 11.00) and complication during pregnancy (AOR: 4.6, 95% CI: 1.96, 11.10) were independent determinants of puerperal sepsis.

Conclusion
Place of residence, maternal education level, mode of delivery, and complication during pregnancy were determinants of puerperal sepsis. It is crucial to implement education and awareness initiatives aimed at mothers, ensure universal access to healthcare services, advocate for evidence-based delivery protocols, and conduct comprehensive antenatal screenings.