bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left atrial myxoma with cardiogenic shock following a myocardial infarction: a case report
Authors: Lancaster Ian , Hrobowski-Blackman Tara , Patel Deep , Chatoor Lubna , Simon Joshini , Willinger Andrew 
Published: March 2024

Abstract
Background
Myxomas are the most common primary cardiac tumor and typically originate in the left atrium. Atrial myxomas may present following complications of obstruction and emboli. If an atrial myxoma goes untreated, complications such as congestive heart failure, embolic stroke, and sudden death can occur.

Case presentation
A 58-year-old Caucasian male presented following a cardiac arrest. He was taken emergently to the cardiac catheterization lab and received two drug eluting stents. Following the procedure, he was found to have a left atrial mass that was intermittently obstructing the mitral valve on echocardiography. After leaving the cardiac catheterization lab, he was hypotensive and placed on multiple intravenous medications for hemodynamic support as well as an Impella device. Following medical optimization, he underwent one vessel coronary artery bypass graft as well as surgical excision of the left atrial mass, which pathology had shown to be an atrial myxoma.

Conclusion
This patient’s case of cardiogenic shock following revascularization was complicated by the identification of an atrial myxoma, which, when large enough, can obstruct blood flow through the mitral valve leading to acute mitral dynamic stenosis. This condition results in circulatory collapse due to obstruction of the left ventricle in diastole as the myxoma occludes the mitral valve.
Volatile organic compounds emitted by Megaplatypus mutatus associated fungi: chemical identification and temperature-modulated responses by the ambrosial beetle
Authors: Ceriani-Nakamurakare Esteban D. , Slodowicz Mariel , Carmarán Cecilia , Gonzalez-Audino Paola 
Published: March 2024

Abstract
Background
In ambrosia and bark beetles–fungi interaction, volatile organic compounds (VOCs) play a central role in mediating various aspects of community dynamics of beetles and/or fungi. These functions include facilitating beetle habitat location, mate identification, and fungal partner differentiation. However, the understanding on this context remains limited, especially in the globally distributed subfamily Platypodinae, which comprises predominantly ambrosia beetles. There is a lack of chemical data on ambrosia fungi from native South American species. This study addresses this gap by characterizing VOCs from twelve fungal species associated with Megaplatypusmutatus and assessing species-specific behavioral responses during dispersal.

Methods
Fungal VOCs were collected by gas chromatography–mass spectrometry combined with solid-phase microextraction and Y-olfactometry assays of males and females were performed at dispersal stage. Statistical analyses involved: non-metric multidimensional scaling multivariate plot and PERMANOVA test, a cluster analysis through unweighted pair group method with Jaccard index, and finally, a chi-square goodness-of-fit test for beetle behavioral assays.

Results
We identified 72 VOCs from the fungal species isolated from M.mutatus galleries, exocuticle, and gut. The olfactory behavior of M.mutatus demonstrated its capacity to discriminate between volatile profiles, showing a preference for either the fungus or the control source. Our results also enhance the understanding in a chemotaxonomic context and in the behavioral responses of M.mutatus revealing the beetle's remarkable low temperature tolerance and its capability to maintain mobility and orientation toward volatile sources even after zero-degree Celsius exposure.

Conclusion
This study presents a comprehensive insight into fungal VOC profiles, emphasizing the sources of isolation within pest associated fungi, as well as its symbiotic species from the Raffaelea genus. In conclusion, our findings suggest that Megaplatypusmutatus exhibits a general aversion to its fungal VOCs symbiont. However, a notable exception arises when the beetles are pre-exposed for 48 h to freezing conditions, highlighting the beetles' ability to withstand freezing conditions as adults and to exhibit altered responses to their fungal associates under these circumstances.
Why failed asylum seekers should have a conditional right to stay: an ethical guideline for policy debates
Authors: Hadj Abdou Leila , Kollar Eszter 
Published: March 2024

AbstractThis article aims to reconcile the moral rights of failed asylum seekers with the integrity of the asylum system. Can the state grant failed asylum seekers a right to stay without undermining the core purpose of the refugee system? Can the state sometimes return those whose asylum claim has failed without violating their moral rights? The article argues that restricting the rights of asylum seekers and reducing the length of the asylum process raise ethical concerns and practical problems. It emphasizes that liberal states should charitably interpret the norms of international protection. It proposes to extend the right to stay on social membership grounds qualified by a good faith condition, and limit returns to those that have lodged their claim in bad faith. Engaging with the good/bad faith distinction the article aims to counteract a culture of suspicion towards asylum seekers by clarifying what it really means to launch a claim in bad faith and to realign its scope in a morally appropriate way.
Barriers and enablers to engagement in exercise and physical activity in non-English speaking South Asian people with chronic musculoskeletal disease
Authors: Maricar Nasimah , Yeowell Gillian , David Trixy , Khan Behram , Barton Anne , Hyrich Kimme L , Hartley Sandra E 
Published: March 2024

Abstract
Background
Exercise and physical activity (EPA) are recommended for people with chronic musculoskeletal disease; however, lower levels of engagement with EPA has been consistently reported in people from the South Asian community across a range of diseases. As language can pose a significant barrier in healthcare, this study aimed to understand the enablers and barriers to the acceptance of EPA among non-English speaking South Asian people who attended rheumatology clinics.

Methods
12 non-English speaking individuals from the South Asian community who had chronic musculoskeletal disease with significant pain scores were interviewed via telephone or face-to-face in their spoken languages. The audio recordings of the interviews were translated into English and transcribed verbatim. Data was analysed using thematic analysis implemented in the NVivo 12 Pro software program.

Results
The mean age was 52 years (9 women and 2 men). One main theme was identified: ‘Enablers and barriers to exercise and physical activity’. Enablers to EPA were having knowledge about the benefits of EPA, being given resources in a language that they understood, and supportive environments such as having access to community facilities for those who could not undertake EPA in their houses. Barriers included physical health such as pain and fatigue, lack of time, difficulties with transportation to exercise venues, dislike of group exercises and lack of understanding of what and how to do exercise and be physically active. Participants’ beliefs about EPA and whether they impacted their physical health seemed to influence whether they were undertaken or not. There was a perception that their culture shaped their compatriots’ beliefs about EPA, and it was not normal practice for people from their country of birth to engage in it.

Conclusions
This is the first qualitative study to explore the barriers and enablers to engagement in EPA in non-English speaking South Asian people with chronic musculoskeletal disease. Modifiable factors such as addressing the level of knowledge on the benefits of EPA in the management of chronic joint and muscle pain; aiding the development of the skills required to exercise safely and confidently despite chronic pain and providing information and services in the native language could promote the EPA engagement of non-English speaking South Asian individuals with chronic musculoskeletal disease. The findings may inform improvements within clinical services to promote the benefits, impact and self-efficacy of engagement with EPA as part of chronic musculoskeletal disease management.

Ethics approval
The West Midlands-Edgbaston Research Ethics Committee (reference:20/WM/0305).
Mechanical shunt failure in hydrocephalus: a common but remediable complication with technical nuances
Authors: Fayaz Mohsin , Khalid Azhar , Wani Abrar Ahad , Arif Sajad Hussain 
Published: March 2024

Abstract
Background
A ventriculoperitoneal (VP) shunt is a cerebral shunt that diverts excess cerebrospinal fluid (CSF).Obstruction in the normal outflow or decreased absorption of the fluid is the usual cause. Hydrocephalus is treated by cerebral shunts.In paediatric patients, untreated hydrocephalus can be lethal and leads to many adverse effects including increase irritabilities, chronic headaches, learning difficulties, visual disturbances, and, in more advanced cases, severe mental retardation. Malfunction of the shunt with excess CSF accumulated can increase the intracranial pressure resulting in cerebral oedema and ultimately herniation.

Objective
To study and evaluate the mechanical causes of shunt failure and their surgical remedies and reduce the preventable morbidity, cost and mortality associated with shunt failure.

Methods
We conducted a prospective observational study including 70 patients who developed pure mechanical shunt failure for the first time from 2017 to 2020 in the Department of Neurosurgery Sher-i-kashmir Institute of Medical Sciences. Patients with previous shunt surgeries which include VP shunting and shunt revision or failure and shunt infections were excluded. Identity of all the patients has been kept anonymus. Written informed consent was obtained from all patients or their guardians in case of minors. Shunt malfunction was in the form of catheter misplacement, kinking, displacement from the ventricle or peritoneal cavity, disconnection, migration,inadvertent suturing of the catheter, air in shunt bulb.

Results
We found kinking at the proximal end in 25 (35%) patients as the most common cause of shunt failure. It was mostly as a result of inadequate and less spacious tunnelling made for the reservoir. Inadvertant suturing of shunt while closing abdomen in 7 (10%), shunt disconnection in 6 (8.5%), air in shunt bulb in 2 (2.8%), wrong placement at ventricular end in 10 (14.2%), shunt migration into the brain parenchyma in 5 (7.1%), shunt migration through the anal canal in 1(1.4%), pseudomeningocele around catheter valve in 3 (4.2%), placement of lower end into the preperitoneal space in 4 (5.7%) patients.

Conclusions
Shunt surgery is seemingly a straightforward operation for neurosurgeons. But considering the incidence of shunt failure and its associated morbidity and mortality, it should always be done with trepidation and extreme caution. Exclusive mechanical shunt malfunction is a major concern and leads to great deal of morbidity in the shunt operations. However, there are trivial remedies and technical nuances which needs to be followed during surgery to avoid these complications.
Coil embolization of a giant pseudoaneurysm associated with a disrupted axillary artery: a case report
Authors: Oka Naoki , Kuriyama Akira , Ishisaka Yukio 
Published: March 2024

Abstract
Background
Stent-graft placement is generally used to treat pseudoaneurysm (PSA) of the axillary artery (AA) trunk to maintain the patency of peripheral vessels. Coil embolization of a PSA associated with a disrupted AA trunk has rarely been reported.

Case presentation
A 54-year-old woman presented with swelling of her right shoulder. She had had a right proximal humeral fracture 12 years earlier. Contrast-enhanced computed tomography (CECT) and subsequent angiograms revealed a giant PSA at the disrupted, distal right AA. There were collateral flows to the brachial artery from the proximal to the right AA. To preserve collateral flows to the brachial artery, selective embolization of the inflow artery that derived from the distal AA was performed with hydrogel-coated coils. The post-embolization arteriogram showed no flow into the PSA, but collateral flows to the brachial artery we preserved. The post-embolization course was uneventful. The patient regained warmth in her right arm and hand on post-embolization day 4. Repeat CECT on post-embolization day 9 confirmed blood-flow to her right radial artery.

Conclusions
While a stent-graft should be used if the AA trunk can be preserved, coil embolization should be considered for PSA if the AA trunk is disrupted but collaterals are preserved.
Dual drug-loaded cubosome nanoparticles for hepatocellular carcinoma: a design of experiment approach for optimization and in vitro evaluation
Authors: Badiger Poorvika , Mannur V. S. , Koli Rahul 
Published: March 2024

Abstract
Background
Liver cancer, a formidable and complex disease, poses a significant global health threat, stemming from various causes, including chronic infections like hepatitis B and C, cirrhosis, and lifestyle factors. In liver cancer treatment, targeted delivery revolutionizes precision therapy, minimizing side effects by directing drugs specifically to cancer cells. This study aims to develop and statistically optimize cubosomal formulations containing piperine and quercetin with the goal of augmenting their activity against hepatocellular carcinoma.

Results
Employing a central-composite design, we utilized Design-Expert® software to guide the experiment. The key formulation variables were the concentration of glyceryl monooleate (GMO) and Poloxamer-407, while the dependent responses were particle size (PS) and entrapment efficiency (EE%). The optimized cubosomal formulation was validated through the utilization of high-resolution transmission electron microscopy (HR-TEM), in vitro release studies, and an in vitro cell proliferation assay conducted on the HepG2 cell line. High-performance liquid chromatography was employed for the determination of piperine and quercetin in the optimized cubosomal nanoparticle. The optimized formulation had a composition of 2.5 (w/w%) GMO and 0.5 (w/w%) Poloxamer 407. The predicted values for PS and EE% were 102.34 and 75.11%, respectively. The cytotoxicity of the optimized cubosomal formulation exhibited enhanced efficacy on the HepG2 cancer cell line, even at lower concentrations, when compared to the standard. Notably, it demonstrated a superior cytotoxic effect on the liver cancer cell line.

Conclusion
The findings of the study indicated that cubosomes exhibit promise as an effective carrier for delivering piperine and quercetin, addressing hepatocellular carcinoma effectively.

Graphical abstract
Racial and Ethnic Differences in Psychosocial Care Use Among Adults With Metastatic Breast Cancer: A Retrospective Analysis Across Six New York City Health Systems
Authors: Pinheiro Laura C. , An Anjile , Zeng Caroline , Walker Desiree , Mercurio Anne Marie , Hershman Dawn L. , Rosenberg Shoshana M. 
Published: March 2024

PURPOSE A metastatic breast cancer (mBC) diagnosis can affect physical and emotional well-being. However, racial and ethnic differences in receipt of outpatient psychosocial care and supportive care medications in adults with mBC are not well described. METHODS Adults with mBC were identified in the INSIGHT-Clinical Research Network, a database inclusive of >12 million patients receiving care across six New York City health systems. Outpatient psychosocial care was operationalized using Common Procedure Terminology codes for outpatient psychotherapy or counseling. Psychosocial/supportive care medications were defined using Rx Concept Unique Identifier codes. Associations between race/ethnicity and outpatient care and medication use were evaluated using logistic regression. RESULTS Among 5,429 adults in the analytic cohort, mean age was 61 years and <1% were male; 53.6% were non-Hispanic White (NHW), 21.4% non-Hispanic Black (NHB), 15.9% Hispanic, 6.1% Asian/Native Hawaiian/Pacific Islander (A/NH/PI), and 3% other or unknown. Overall, 4.1% had ≥one outpatient psychosocial care visit and 63.4% were prescribed ≥one medication. Adjusted for age, compared with NHW, Hispanic patients were more likely (odds ratio [OR], 2.14 [95% CI, 1.55 to 2.92]) and A/NH/PI patients less likely (OR, 0.35 [95% CI, 0.12 to 0.78]) to have an outpatient visit. NHB (OR, 0.59 [95% CI, 0.51 to 0.68]) and Asian (OR, 0.36 [95% CI, 0.29 to 0.46]) patients were less likely to be prescribed medications. CONCLUSION Despite the prevalence of depression, anxiety, and distress among patients with mBC, we observed low utilization of psychosocial outpatient care. Supportive medication use was more prevalent, although differences observed by race/ethnicity suggest that unmet needs exist.
Machine learning models reveal distinct disease subgroups and improve diagnostic and prognostic accuracy for individuals with pathogenic SCN8A gain-of-function variants
Authors: Hack Joshua B. , Watkins Joseph C. , Hammer Michael F. 
Published: March 2024

ABSTRACT
Distinguishing clinical subgroups for patients suffering with diseases characterized by a wide phenotypic spectrum is essential for developing precision therapies. Patients with gain-of-function (GOF) variants in the SCN8A gene exhibit substantial clinical heterogeneity, viewed historically as a linear spectrum ranging from mild to severe. To test for hidden clinical subgroups, we applied two machine-learning algorithms to analyze a dataset of patient features collected by the International SCN8A Patient Registry. We used two research methodologies: a supervised approach that incorporated feature severity cutoffs based on clinical conventions, and an unsupervised approach employing an entirely data-driven strategy. Both approaches found statistical support for three distinct subgroups and were validated by correlation analyses using external variables. However, distinguishing features of the three subgroups within each approach were not concordant, suggesting a more complex phenotypic landscape. The unsupervised approach yielded strong support for a model involving three partially ordered subgroups rather than a linear spectrum. Application of these machine-learning approaches may lead to improved prognosis and clinical management of individuals with SCN8A GOF variants and provide insights into the underlying mechanisms of the disease.
The Dynamics of Locomotor Neuromuscular Fatigue during Ramp-Incremental Cycling to Intolerance
Authors: Baldwin Molly M. , Chadwick Matthew R. , Benson Alan P. , Rossiter Harry B. , Ferguson Carrie 
Published: March 2024

ABSTRACT

Introduction
Traditional neuromuscular fatigue assessments are not task-specific and are unable to characterize neuromuscular performance decline during dynamic whole-body exercise. This study used interleaved maximal isokinetic cycling efforts to characterize the dynamics of the decline in neuromuscular performance during ramp-incremental (RI) cycle ergometry exercise to intolerance.

Methods
Eleven young healthy participants (10 male/1 female) performed two RI cycle ergometry exercise tests to intolerance: [1] RI-exercise with peak isokinetic power (Piso) at 80 rev·min-1 measured at baseline and immediately at intolerance from a maximal ~6 s effort; [2] RI-exercise where additional Piso measurements were interleaved every 90 s to characterize the decline in neuromuscular performance during the RI-test. Muscle excitation was measured using EMG during all Piso assessments, and pulmonary gas exchange was measured throughout.

Results
Baseline Piso was 832 ± 140 W and RI-exercise reduced Piso to 349 ± 96 W at intolerance (p = 0.001), which was not different from flywheel power at intolerance (303 ± 96 W; p = 0.292). There was no reduction in Piso between baseline cycling and gas exchange threshold (GET; baseline Piso vs. mean Piso below GET: 828 ± 146 vs. 815 ± 149 W; p = 1.00). Piso fell progressively above GET until intolerance (Piso every 90 s above GET: 759 ± 139; 684 ± 141; 535 ± 144; 374 ± 117 W; each p < 0.05 vs. baseline and mean Piso below GET). Peak muscle excitation (EMG) was also reduced only above GET (73 ± 14 % of baseline, at intolerance; p < 0.05). However, the reduction in peak Piso preceded the reduction in peak muscle excitation.

Conclusions
The dynamics of the decline in neuromuscular performance (reduction in Piso and EMG) during RI-exercise are consistent with known intensity-dependent metabolic and traditional pre-post neuromuscular fatigue responses to discrete bouts of constant-power exercise.
Conhecimento e percepção de autoeficácia e eficácia coletiva de professores sobre o Guia Alimentar
Authors: Almeida Ramine Mirelle Mendes Pereira , Pereira Mariana Mendes , Cunha Anne Caroline , Silveira Marise Fagundes , Brito Maria Fernanda Santos Figueiredo , Lopes Wanessa Casteluber , Pinho Lucinéia de 
Published: March 2024

Introdução: No processo de educação em saúde para que o indivíduo mude seus hábitos de saúde, é necessário que tenha conhecimentos, apresente crenças de autoeficácia positivas e compartilhe a eficácia coletiva. Objetivo: Avaliar o conhecimento e a percepção de autoeficácia e eficácia coletiva de professores sobre o Guia Alimentar para a População Brasileira. Método: Realizou-se estudo transversal no período de dezembro de 2019 a dezembro de 2020. A população do estudo foi composta por 1.491 professores da Educação Básica da rede pública municipal de ensino de Montes Claros, Minas Gerais. Para a amostra, estimou-se o tamanho mínimo de 511 professores e foi utilizado um questionário on-line para coleta de dados. Quanto a avaliação do conhecimento, percepção de autoeficácia e eficácia coletivados professores sobre o Guia Alimentar, utilizaram-se escalas autoadministradas e previamente validadas. Os dados coletados foram categorizados e processados eletronicamente através do software Statistical Package for the Social Science (SPSS), versão 22.0. Resultados: Na análise do desempenho dos professores quanto ao Guia Alimentar, observou-se que 79,7% (474) dos profissionais apresentaram baixo conhecimento; 70,4% (419), baixa autoeficácia; e 69,1% (411), baixa eficácia coletiva. O alto conhecimento entre os docentes foi associado à maior renda percapita (p= 0,004). A alta autoeficácia foi associada ao maior grau de escolaridade (p= 0,031). A alta autoeficácia coletiva foi associada às variáveis renda (p=0,035) e escolaridade (p=0,004). Conclusão: Os professores do presente estudo demonstraram baixo conhecimento e baixa percepção de autoeficácia e eficácia coletiva sobre o Guia Alimentar.