bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mid-term clinical outcomes of totally endoscopic repair for mitral regurgitation in Barlow’s disease
Authors: Zhang Lin , Cui Huimin , Shen Hong , Li Dong , Li Lianggang , Shen Hua , Jiang Shengli 
Published: April 2024

Abstract
Objective
This study aimed to confirm the safety and feasibility of totally endoscopic repair for mitral regurgitation (MR) in Barlow’s disease.

Methods
From June 2018 to December 2022, 21 consecutive Barlow’s disease patients (aged 33 ± 12 years; 57.1% male) underwent totally endoscopic mitral valve (MV) repair with leaflets folding, multiple artificial chordae implantation and ring annuloplasty. The safety and feasibility of this technique was evaluated by its mid-term clinical outcomes.

Results
There was no operative death or complications. The mean cardiopulmonary bypass (CPB) time was 190 ± 41 (128–267) min, and the aortic cross-clamp time was 145 ± 32 (66–200) min. The average number of artificial chordae implantation was 2.9 ± 0.7 (1–4) pairs. The mean MV coaptation length was 1.4 ± 0.3 (0.8–1.8) cm, and the median transvalvular gradient was 1 [interquartile range (IQR), 1–2] mmHg. During a median follow-up time of 24 (IQR, 10–38) months, all patients showed persistent effective valve function with no significant MR or systolic anterior motion.

Conclusions
Totally endoscopic repair was a safe, effective, and reproducible procedure with satisfied mid-term clinical outcomes for MR in Barlow’s disease. However, further randomized and long-term follow-up studies were warranted to determine its clinical effects.
Sex-related differences in outcome of thoracic aortic surgery
Authors: Jiang Hongxue , Xu Hongjie , Xu Zhiyun 
Published: April 2024

Abstract
Background
Sex-related dissimilarities’ influence on outcomes following thoracic aortic surgery is poorly understood. Our aim is to examine sex-related disparities in patients undergoing thoracic aortic aneurysm (TAA).

Methods
A total of 455 cases undergoing thoracic aortic aneurysm (TAA) surgery were consecutively enrolled between December 2009 and December 2015 in a Chinese hospital. Primary outcomes, including overall mortality and related risk factors, were evaluated. Cox regression is utilized to recognize the independent risk factor of these consequences.

Results
Females, compared to males, had greater indexed aortic diameters and higher aortic transvalvular pressure differences. For the location of aortic aneurysms, females had a higher rate of aortic arch involvement, while males had a higher rate of root involvement. Females underwent less frequent complex proximal aortic operations compared with males (29.5% versus 46.9%; p < 0.001). Women and men both had a lower rate of aortic transvalvular pressure difference and LV volume index 7 days after thoracic aortic surgery. The overall mortality for the women’s groups (11%) was suggestively greater compared to 4.9% for the men’s groups (p = 0.026). Renal failure and aortic arch involvement were the main risk factors associated with males’ survival, while maximum indexed aortic diameter and cross-clamp time were the risk factors associated with females’ survival.

Conclusions
The outcome after TAA surgery was less favorable in women with significantly increased overall mortality. It highlights the need to focus on implementing personalized surgery strategies and gender-specific guidelines in treating female patients following TAA surgery.
Repair of a fistula between the aorta and right ventricular outflow tract secondary to infective endocarditis of a unicuspid aortic valve and previously repaired ventricular septal defect
Authors: Karsan Rickesh B. , O’Sullivan Katie E. , Lockhart Christopher J. , Austin Christopher 
Published: April 2024

Abstract
Background
Infective endocarditis of the aortic valve can result in a wide range of destructive pathology beyond the valve leaflets and annulus which require careful surgical planning to provide appropriate debridement and reconstruction. Failure to do so can result in a failure of surgical treatment, recurrent infection and cardiac failure with concomitant high morbidity and mortality.

Case report
We describe the case of a 45-year-old male with previous patch repair of a ventricular septal defect, who was diagnosed with sub-acute bacterial endocarditis of the native aortic valve and developed a new fistula from the aorta to the right ventricular outflow tract which. This was managed surgically.

Conclusion
This unique case highlights another spectrum of infective endocarditis with a unique approach to repair and management.
Evaluation of network-guided random forest for disease gene discovery
Authors: Hu Jianchang , Szymczak Silke 
Published: April 2024

Abstract
Background
Gene network information is believed to be beneficial for disease module and pathway identification, but has not been explicitly utilized in the standard random forest (RF) algorithm for gene expression data analysis. We investigate the performance of a network-guided RF where the network information is summarized into a sampling probability of predictor variables which is further used in the construction of the RF.

Results
Our simulation results suggest that network-guided RF does not provide better disease prediction than the standard RF. In terms of disease gene discovery, if disease genes form module(s), network-guided RF identifies them more accurately. In addition, when disease status is independent from genes in the given network, spurious gene selection results can occur when using network information, especially on hub genes. Our empirical analysis on two balanced microarray and RNA-Seq breast cancer datasets from The Cancer Genome Atlas (TCGA) for classification of progesterone receptor (PR) status also demonstrates that network-guided RF can identify genes from PGR-related pathways, which leads to a better connected module of identified genes.

Conclusions
Gene networks can provide additional information to aid the gene expression analysis for disease module and pathway identification. But they need to be used with caution and validation on the results need to be carried out to guard against spurious gene selection. More robust approaches to incorporate such information into RF construction also warrant further study.
Impact of SGLT-2 inhibitors on modifiable cardiovascular risk factors in Romanian patients with type 2 diabetes mellitus
Authors: Gherbon Adriana , Frandes Mirela , Dîrpeş Darius , Timar Romulus , Timar Bogdan 
Published: April 2024

Abstract
Background
Modifiable cardiovascular risk factors are high blood pressure, smoking, diabetes, sedentary lifestyle, obesity, and hypercholesterolemia.

Aim
To investigate the impact of sodium-glucose 2 co-transporter inhibitors (SGLT-2i) on modifiable cardiovascular risk factors in Romanian patients diagnosed with type 2 diabetes mellitus (T2DM).

Method
A retrospective study was conducted on 200 Romanian patients with T2DM who were being treated with SGLT-2i, either Dapagliflozin or Empagliflozin. Collected data included demographic characteristics, such as weight, body mass index (BMI), fasting blood glucose (FBG), creatinine, glycated hemoglobin (HbA1c), abdominal circumference (AC), urine albumin-to‐creatinine ratio (UACR), systolic blood pressure (SBP), diastolic blood pressure (DBP), C-reactive protein (CRP) and N-terminal pro b-type natriuretic peptide (NT-proBNP). The patients were observed for one year after being treated with SGLT-2i.

Results
The mean value of FBG decreased from 180.00 mg% (IQR: 154.50–207.00) to 130.00 mg% (IQR: 117.50–150.00) (p < 0.001), and the mean of HbA1c values decreased from 8.40% (IQR: 7.98-9.15%) to 7.30% (IQR: 6.90-7.95%) (p < 0.001). We also obtained significant positive effects on body weight, i.e., the weight decreased from 90.50 kg (82.00-106.50) to 89.00 kg (77.50–100.00) (p = 0.018), BMI from 32.87 kg/m2 (29.24–36.45) to 31.00 kg/m2 (27.74–34.71) (p < 0.001) and AC from 107.05 (± 16.39) to 102.50 (± 15.11) (p = 0.042). The UACR decreased from 23.98 mg/g (19.76–36.85) to 19.39 mg/g (1.30-24.29) (p < 0.001). Initially, the median value for SBP was 140.00mmgHg (130.00-160.00), and for DBP was 80.00 mmgHg (72.00–90.00), and one year after treatment, the medium value was 120.00 mmgHg (115.50–130.00) for SBP (p < 0.001), and 72.00 mmgHg (70.00–78.00) for DBP (p < 0.001) The mean CRP values decreased from 68.00 mg/dL (56.25–80.25) to 34.00 mg/dL (28.12–40.12) (p < 0.001), and the mean NT-proBNP decreased from 146.00pg/mL (122.50-170.50) to 136.00 pg/mL (112.50-160.50) (p = 0.005).

Conclusion
Treatment with SGLT-2i in Romanian patients with T2DM has beneficial effects on modifiable cardiovascular risk factors.
Can resistance training improve throwing performance in handball players? A Systematic review and meta-analysis
Authors: Hadjisavvas Stelios , Efstathiou Michalis A. , Themistocleous Irene-Chrysovalanto , Daskalaki Katerina , Malliou Paraskevi , Lewis Jeremy , Stefanakis Manos 
Published: April 2024

Abstract
Background
Throwing is one of the most important movement in handball. Throwing performance is crucial for success in handball.

Objective
Τo investigate the level of evidence for the effect of resistance training (RT) on throwing performance in handball players.

Methods
Systematic searches of Pubmed, Medline complete, Cinahl, Sport Discus and Scopus were undertaken for peer reviewed articles published between 18 March 1995 to 18 March 2023. Randomized, controlled, clinical studies, written in English, aiming to investigate the effect at least one modality of RT on throwing performance (velocity or/and accuracy) in handball players were considered for inclusion in the study. The eligible studies were assessed for methodological quality using the Physical Therapy Evidence Database (PEDRO) scale. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results. Furthermore, the random-effects model was used for the meta-analysis and the Q-statistic was used to test the null hypothesis that all studies in the analysis share a common effect size.

Results
One hundred ninety-eight studies were identified, of which 30 were included. A total of 727 handball players (males = 388, females = 292) were included. 28 of the 30 studies were rated as high methodological quality studies (PEDRO score > 70%) while the rest of the studies were rated as moderate methodological quality studies (PEDRO score ≤ 60%). The mean effect size for the effectiveness of resistance training (RT) in improving jumping throw, running throw, and standing throw velocity were 1.128 (95% CI 0.457 – 1.798), 1.756 (95% CI 1.111 – 2.400), and 1.098 (95% CI 0.689 – 1.507) correspondingly. Traditional weight training using barbells in mostly compound lifts yielded the most significant and robust results. Other RT modalities such as elastic bands, medicine balls, core training and ballistic training showed no significant results or positive effects due to the limited number of the studies.

Conclusion
Strong evidence exists only for the effectiveness of RT using barbells in increasing throwing velocity. In contrast, the remaining RT modalities, while yielding positive results, have limited support due to limited number of studies and the high heterogeneity between studies. Furthermore, there is insufficient evidence to support various forms of RT in increasing throw distance. Finally, medicine ball training and elastic band training demonstrated no benefits in improving throwing accuracy.

Trial registration
PROSPERO ID: CRD42023393574.
Healers that hurt: a scoping review of media reports of cases of rape in healthcare settings
Authors: Okonji Adaobi Margaret , Ishola Adeyinka G. , Ayamolowo Love Bukola , Femi-Akinlosotu Omowumi M. , Mapayi Boladale , Folayan Morenike Oluwatoyin 
Published: April 2024

Abstract
Background
Sexual assault occurring within healthcare settings represents a significant breach of public trust. This scoping review aimed to highlight the profile of people raped, those who committed the rape within the health facilities, and the legal actions taken to resolved cases.

Methods
Media-reported data on incidents of rape in healthcare settings were collected. The search was conducted in May and June 2023, focusing on English-language publications with accessible full texts. Reports that lacked information on the survivors or incidents that occurred outside of healthcare settings were excluded. Descriptive statistics were used to summarize the categories of the collected publications, and graphical representations were employed for visualization purposes.

Results
A total of 62 cases were retrieved, originating from Africa (n = 17; 27.4%), Europe (n = 14; 22.6%), Southeast Asia (n = 14; 22.6%), the Americas (n = 11; 17.7%), the Western Pacific Region (n = 5; 8.1%) and Eastern Mediterranean region (n = 1; 1.6%). In addition, 69 individuals were implicated in 59 cases. They were 31 doctors (44.9%), 17 (24.6%) nurses, four (5.8%) nurse/healthcare assistants, three (4.3%) cleaners/ward boy, two (2.9%) traditional medical doctors, and two (2.9%) security guards. Others included six (8.7%) staff members without designations and one (1.4%) ambulance driver. All perpetrators were male, ranging in age from 22 to 67 years. There were 66 victims identified in the 62 cases with age ranging from 2 to 92 years. Except for one case, all victims were female, and all but one case were patients. Most assaults occurred in consulting rooms/clinics (n = 21; 31.8%), 16 (24.2%) happened under sedation, and six (9.1%) were repeatedly raped, Survivors typically reported the cases the police (n = 12; 19.4%), family/friends (n = 11; 17.7%) or to hospital authorities (n = 10; 16.1%). Out of the 69 perpetrators, 19 (30.6%) were imprisoned with sentences ranging from 12 months to an indefinite period and one (1.6%) received a death sentence.

Conclusion
The raping of patients by healthcare providers within healthcare settings calls for urgent and extensive measures. Stakeholders in healthcare management need to prioritize raising awareness about the problem, implement robust prevention and reporting strategies, and create healthcare environments that are safe, respectful, and supportive for all individuals seeking care.
Controlling factors of latitudinal distribution of dissolved organic matter in the upper layers of the Indian Ocean
Authors: Shigemitsu M. , Sasaoka K. , Wakita M. , Yokokawa T. , Hashioka T. , Arulananthan K. , Murata A. 
Published: April 2024

AbstractWe studied chromophoric (CDOM) and fluorescent (FDOM) dissolved organic matter (DOM) and dissolved organic carbon in surface waters to determine the factors controlling the geographical distribution of DOM along two meridional transects in the Indian Ocean. For CDOM, we calculated the absorption coefficients, spectral slope, and absorption coefficient ratio from the observed absorption spectra. For FDOM, we calculated the biological (BIX) and humification (HIX) indices from the excitation emission matrices (EEMs); parallel factor analysis of the EEMs identified three fluorescent components, i.e., two humic-like and one protein-like. Using these DOM parameters, a factor analysis extracted fewer latent variables than the observed variables to account for the geographical distributions. We obtained three factors (F1, F2, and F3), which explained ~ 84% of the variance in the observed data. From the factor loadings, F1, F2, and F3 were interpreted as the effects of net primary production-derived DOM and its horizontal transport, photodegradation, and vertical transport by physical processes. We characterized seven marine biogeochemical provinces by factor scores. F1 scores gradually decreased from the northernmost to the Antarctic province, with a small maximum around the subtropical front. F2 scores were highest in the subtropical province and decreased in both the northward and southward directions. F3 scores were high in the Antarctic and northernmost provinces, and lowest in the subtropical province. Only BIX was insufficiently explained by these factors. BIX was highest in the northern part of the subtropical province, where photodegradation of DOM was the most intense. This suggests that the possible interaction between photodegradation, autochthonous production, and reworking by heterotrophic bacteria of DOM occurs in the subtropical province.
Bundle branch reentrant ventricular tachycardia in a patient with Fabry disease
Authors: Beladel Wassim , Abdelali Mehdi , Cheikhna Oussama , Hasni Karim , El Minaoui Mohamed 
Published: April 2024

Abstract
Background
Bundle branch reentrant ventricular tachycardia is a unique type of VT that employs both bundles and the ventricular septum as integral components of a re-entrant circuit. It is usually observed in dilated cardiomyopathy, and its circuit depends exclusively on the specialized conduction system.

Case presentation
A 67-year-old man with a history of Fabry disease, and atrial fibrillation ablation, was admitted for a wide QRS tachycardia at 150 bpm, with an LBBB. Pharmacological therapy failed to stop the arrhythmia. Intracardiac recordings confirm the diagnosis. His Bundle recordings are essential, and Atrioventricular (AV) dissociation is typically present. The method used to induce left BBRVT is right ventricle apex stimulation. An electrophysiological study showed an AV dissociation a long HV sequence and a similar QRS morphology between VT and sinus rhythm. An overdrive stopped it. The same arrhythmia reappears and is restored to sinus rhythm by electrical cardioversion. We decided to implant an Implantable Cardiac defibrillator (ICD) with a backup pacing for secondary prevention and to ablate the right bundle branch.

Conclusion
BBRVT is a rare entity that is underreported. Pharmacological therapy is usually inefficient. An ICD is recommended for secondary prevention and can provide backup pacing, frequently required after catheter ablation to prevent the development of AV block or an excessive prolonged HV interval. Catheter ablation of the bundle branch is the first-line therapy.
Clinical and laboratory spectrum of hereditary angioedema in a group of Egyptian children: a cross sectional study
Authors: Almalky Mohamed , El Shabrawy Reham M. , Gheetah Najeeb Ali Mohammed , Elkady Hossam Moustafa , Osman Naglaa S. , Shoman Walaa , Baz Eman Gamal 
Published: April 2024

Abstract
Background
Hereditary angioedema (HAE) is a hereditary illness represented by repeated bouts of submucosal or subcutaneous edema. Types of HAE includes; HAE with deficient C1-inhibitor (type 1), HAE with dysfunctional C1-inhibitor (type 2), and HAE with normal C1-inhibitor. Data on the epidemiology of HAE in Egypt are limited. Therefore, we aimed to characterize HAE in Egyptian children, identify the morbidity, and clarify HAE's different clinical and laboratory presentations.

Methods
In this cross-sectional study, we enrolled pediatric patients diagnosed with HAE according to the international hereditary angioedema WAO/EAACI guidelines. We gathered laboratory data on patients' mean serum C1 esterase inhibitor (C1-INH) level and activity, C4, and IgE levels.

Results
We included 18 HAE patients (14 females and 4 males). They were between the ages of 6 and 18 years. The mean age upon confirmation of diagnosis was 8.4 ± 2.4 years. The mean time required to correctly diagnose HAE was 3.2 ± 1.8 years. We detected type I in 15 cases and type II in three cases. Eleven patients had a family member with HAE. In terms of previous misdiagnoses, 50% of patients were diagnosed with allergic angioedema. The median annual frequency of episodes was 17. The mean HAE attack time was 2.9 ± 1.5 days. Edema was most typically found in the face and abdomen. Trauma was the main triggering factor. We detected a significant direct relationship between severity of attack and C1-INH activity level.

Conclusions
This research adds a considerable clinical information about children with HAE. According to current results, there is a considerable underdiagnosis of HAE in Egypt. The detection and management of HAE can be improved by screening the relatives of HAE patients.
Cannonball Pulmonary Metastases as Initial Presentation of Hepatocellular Carcinoma: A Case Report and Literature Review
Authors: Ibarra-Sifuentes Héctor Raúl , Canales-Azcona Gustavo Abraham , Gómez-Arredondo Jaqueline Isabel , Rodríguez-Álvarez Carlos Javier 
Published: April 2024

Abstract
Background
Hepatocellular carcinoma is a major public health problem, as is considered the fastest growing cause of cancer-related death. Cannonball metastases as an initial finding in hepatocellular carcinoma are considered a rare phenomenon.

Case Presentation
A 59-year-old man presented to the outpatient clinic for subacute cough, asthenia, and involuntary weight loss. Chest X-ray showed multiple, round, bilateral pulmonary solid lesions. Contrast-enhanced computed tomography of the chest and abdomen revealed multiple bilateral, contrast-enhanced pulmonary nodules known as "cannonball" lesions and a heterogeneous lesion located in the right lobe of the liver with retroperitoneal lymphadenopathy. A biopsy was performed, and the histopathological result was compatible with metastatic poorly differentiated hepatocellular carcinoma. Due to the advanced stage of the disease, the patient received palliative care and expired two months later.

Conclusion
Cannonball metastases in hepatocellular carcinoma are considered a rare finding and represents a poor prognosis. It is important to awaken the interest of clinicians in a timely diagnosis, as well as a possible suspicion of hepatocellular carcinoma in patients with this radiographic pattern.
Museu como espaço não formal para o ensino de ciências: uma revisão integrativa
Authors: Silva de Melo Charlline Vládia , Sales Gilvandenys Leite , Junior Antônio de Lisboa Coutinho , Morano Domingos Antônio Clemente Maria Silvio , Cerqueira Gilberto Santos 
Published: April 2024

Locais não formais de educação são espaços nos quais diversas práticas de ensino têm a oportunidade de ocorrer. Neste estudo, exploramos o uso de museus como ferramentas de ensino de ciências, com um foco específico na anatomia humana. Nosso objetivo foi avaliar o potencial pedagógico dos museus para o ensino e determinar se eles permitem a criação de experiências significativas e multidisciplinares. Utilizamos uma metodologia de Revisão Integrativa (RI) que abrange o período de 2012 a 2022. Durante esse processo, buscamos identificar artigos científicos em Língua Portuguesa disponíveis em repositórios digitais, a fim de descrever as abordagens adotadas. Os resultados dessa pesquisa revelaram um total de 392 artigos, no entanto apenas 15 deles foram considerados elegíveis. Essa seleção foi baseada na capacidade dos artigos de apresentar uma interconexão sólida entre teoria e prática no contexto da relação entre museus, ensino de ciências e anatomia. Constatamos que há uma escassez de estudos que se aprofundem nesse modelo pedagógico de ensino por meio de exposições ou objetos expositivos em museus de ciências. Essa abordagem ainda é predominantemente limitada a contextos universitários, em que, muitas vezes, apresenta-se de maneira passiva na integração com o ensino básico e com a comunidade em geral. Como conclusão, destacamos a necessidade de uma maior exploração e desenvolvimento desse potencial pedagógico.