bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Chronic Liver Disease (CLD) Based on Esophageal Varices in Children
Authors: Roy Urmi , Mondal Aniruddha , Rukunuzzaman Md. 
Published: November 2023

Background: Chronic Liver Disease (CLD) is a complex and often debilitating condition that affects individuals of all ages, including children. Within pediatric CLD, one critical aspect that demands careful evaluation is the presence and severity of esophageal varices. If left untreated, these enlarged, fragile blood vessels in the esophagus can lead to life-threatening bleeding. The assessment of esophageal varices plays a pivotal role in managing and prognosis of children with CLD.
Aim of the Study: The study aims to measure laboratory parameters and calculate serum liver fibrosis scores in CLD children.
Methods: This retrospective study analyzed 24 pediatric patients diagnosed with esophageal varices in Chronic Liver Disease (CLD) at the Department of Pediatric Gastroenterology & Nutrition, BSMMU, Dhaka, Bangladesh, over two years from April 2019 to October 2021. Ethical standards were adhered to with informed consent and ethical committee approval.
Results: According to the diagnoses, 50% of the patients were identified as having Wilson's disease. Notably, 16.7% of the patients presented with Grade 4 esophageal varices. In terms of laboratory parameters, the median hemoglobin level was 10.2 gm/dl, the total leukocyte count was 6300/mm3, the platelet count had a median of 90000/µL, the bilirubin level had a median of 2.7 gm/dl, ALT had a median of 57 U/L, AST had a median of 134.5 U/L, GGT had a median of 132 U/L, INR had a median of 1.6, albumin had a median of 25 gm/dl, and cholesterol had a median of 105 mg/dl. Lastly, the median liver stiffness was recorded as 13.1 kPa, with an interquartile range (IQR) spanning from 10.3 to 21.
Conclusion: This study highlights the importance of early detection and management of esophageal varices in children with CLD, as they are crucial prognostic indicators for underlying liver conditions. By integrating these clinical tools and parameters, healthcare providers can make informed decisions regarding the management and treatment of children with CLD. Early identification of esophageal varices and a comprehensive assessment of the liver's functional status are essential in improving the overall care and outcomes for pediatric patients with chronic liver disease, ensuring timely intervention and support to enhance their quality of life.
Fetal and Neonatal Alloimmune Thrombocytopenia: A Concise Review
Authors: Ojedokun Samson , Oloyede Taiwo , Alabi Ayobami , Oke Oluwaseyi , Akinbola Abraham , Kofoworade Olawumi , Oladibu Olanike 
Published: November 2023

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare disease resulting from the effect of maternal alloantibodies on fetal human platelet antigens HPAs which could lead to severe haemorrhage. An antibody from mother reacting against a defined platelet alloantigen has been identified as the aetiology of platelet destruction in an infant with this condition and several other platelet-specific antigens were implicated to be capable of initiating maternal immunization during pregnancy leading to fetal platelet destruction. However, in most cases of maternal sensitizations the exposure to fetal blood usually occur during delivery, resulting to thrombocytopenia in the newborn. Current management of fetal and neonatal alloimmune thrombocytopenia in the next pregnancy involves administration of intravenous immune globulin and steroids during antenatal for mothers with previous history or those at risk. Some advances has been suggested in the line of management and these include testing of cell-free fetal DNA obtained from maternal blood to determine the fetal human platelet antigen genotype, the creation of a prophylactic product; a platelet equivalent of Rhesus immune globulin and the development of neonatal Fc receptor inhibitors to replace the current medical therapy administered to pregnant women with an affected fetus.
FNAIT is a devastating complication of pregnancy that can present with difficult diagnostic and treatment challenges. Hence, a need for surveillance.
Killing Two Birds in One Stone-Percutaneous Treatment of a Large ASD and Pulmonary Stenosis in the Same Setting in an Adult Patient-a Case Report.
Authors: Munde Kalyan S. , Jalkote Shrishail Kumar , Niari Jayakrishna 
Published: November 2023

Pulmonary stenosis (PS) associated with a huge ostium secundum Atrial septal defect (ASD) is relatively uncommon. In such condition, a significant left-to-right shunt across ASD is prevented by significant obstruction at pulmonary valve level and hence it protects the pulmonary bed until adulthood. Transcatheter intervention is the treatment of choice when they occur separately but when they occur together, ideal treatment option is not clear. As per literature, percutaneous transcatheter pulmonary valvuloplasty was performed first, followed by transcatheter closure of the secundum atrial septal defect. We report a case of combined ASD (Atrial septal defect) with moderate PS (Pulmonary stenosis), where we performed percutaneous BPV.
(Balloon Pulmonary Valvuloplasty) with Inoue balloon first followed by transcatheter ASD device closure in the same setting.
Climate Change in Kenya: Understanding Major Threats and Government Policies for Resilience
Authors: Mushitsi Patrick , San Nay Min , Nsabimana Aurore Shania 
Published: November 2023

This article aims to describe and highlight major climate threats found in Kenya and climate change policy implemented by the government of Kenya from 2010 to 2022. Climate change poses a severe threat to the living conditions of citizens and wildlife worldwide. Numerous studies have demonstrated that in the absence of implemented policies, living conditions can be further deteriorated.
While Africa may not contribute significantly to air pollution, there are other human activities that pollute the environment and need to be eliminated, as African people are already suffering from the impacts of climate change. African countries must take necessary steps to initiate sustainable development policies that ensure a better life for their citizens.
In the case of Kenya, droughts and floods have resulted in the loss of human and animal lives and have negatively impacted the country's economy. Consequently, the government has implemented necessary measures since 2010 to address the issue of climate change.
Various policies such as the National Climate Change Response Strategy (2010), the National Environment Policy (2013), Kenya National Adaptation Plan 2015-2030, Climate Change Bill (2014), National Climate Change Action Plan (NCCAP 2013-2017), National Climate Change Action Plan (2018-2022), and National Drought Management Authority (2016) have been enacted in response to climate change. These policies demonstrate the government's genuine concern for climate change issues. Overall, this study aims to contribute to the understanding of climate change policy in Kenya and raise awareness about the global threat posed by climate change.
Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up
Authors: Suárez-García I. , Gutierrez Félix , Pérez-Molina José A. , Moreno Santiago , Aldamiz Teresa , Valencia Ortega Eulalia , Curran Adrián , Gutiérrez González Sara , Asensi Víctor , Amador Prous Concha , Jarrin Inma , Rava Marta ,   CoRIS
Published: November 2023

Abstract
Purpose
Our aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors.

Methods
We included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004–2021). We estimated mortality rates and standardised mortality ratios (SMRs). We used cause-specific Cox models to identify risk factors.

Results
Among 17,978 PLWH, NADC caused 21% of all deaths observed during the follow-up. Mortality rate due to NADC was 1.58 (95%CI 1.36, 1.83) × 1000 person-years and lung and liver were the most frequent cancer-related causes of death. PLWH had 79% excess NADC mortality risk compared to the general population with the highest SMR found for Hodgkin lymphoma, anal and liver cancers. The SMRs decreased with age and were the highest in age groups under 50 years. The most important prognostic factor was low CD4 count, followed by smoking, viral hepatitis and HIV transmission through heterosexual contact or injection drug use.

Conclusion
Non-AIDS cancers are an important cause of death among PLWH. The excess mortality related to certain malignancies and the association with immunodeficiency, smoking, and coinfections highlights the need for early detection and treatment of cancer in this population.
Comparison of intra-operative outcomes following internal fixation with trochanteric stabilisation plate or intramedullary nail in intertrochanteric fractures
Authors: Geetala Rahul , Wakefield Edward , Bradshaw Florence , Zhang James , Krkovic Matija 
Published: November 2023

Abstract
Purpose
Intertrochanteric fractures can be classified as stable (AO-OTA 31-A1) or unstable (AO-OTA 31-A2/3). For A3 fractures there is no recommended treatment, often fixed with either an intramedullary nail (IMN) or a dynamic hip screw and trochanteric stabilisation plate (DHS/TSP). This study retrospectively reviews peri-operative outcomes of patients treated with either fixator.

Methods
Pre-operative demographics, operative information and patient outcome data from 213 patients who suffered intertrochanteric fractures and were treated with either DHS/TSP or IMN at a major trauma centre from 01/2015 to 01/2022 was collected. Unpaired T tests were performed to assess levels of significance between peri-operative outcomes.

Results
The mean age for DHS/TSP-treated patients was 2.63 years greater than IMN-treated (P = 0.039). There were no other significant differences in pre-operative characteristics. We found a significantly shorter mean operative time in the DHS/TSP group (88.05 min, 95% CI: 82.1–94.0) compared to IMN counterparts (100.8 min, 95% CI: 92.7–109.0, P = 0.012), but no statistically significant difference in length of hospital stay or patient mortality, blood transfusion, re-operation or complication rates. When A3 fractures were analysed, a statistically significant greater proportion of IMN patients required blood transfusions (DHS/TSP: 35.90%, IMN: 65.00%, P = 0.0093). All other factors were found to have no significant differences.

Conclusion
This study provides evidence to support the national guidelines regarding A1 fractures and suggests that DHS/TSP is a valid alternative to the IMN in A3 intertrochanteric fractures, with reduced blood loss. With the flexibility to add the TSP intraoperatively to prevent femoral head medialisation, and cheaper implant costs, the DHS/TSP may become the preferred method of internal fixation.
Unveiling the anticancer potentiality of single cell oils produced by marine oleaginous Paradendryphiella sp. under optimized economic growth conditions
Authors: El-Shall Hadeel , Abu‑Serie Marwa , Abu-Elreesh Gadallah , Eltarahony Marwa 
Published: November 2023

AbstractBioprospecting about new marine oleaginous fungi that produce advantageous bioproducts in a green sustainable process is the key of blue bioeconomy. Herein, the marine Paradendryphiella sp. was utilized for single cell oils (SCOs) production economically, via central composite design, the lipid content enhanced 2.2-fold by 5.5 g/L lipid yeild on seawater-based media supplemented with molasses concentration 50 g/L, yeast extract, 2.25 g/L at initial pH value (5.3) and 8 days of static incubation. Subsequently, the fatty acid methyl esters profiles of SCOs produced on optimized media under different abiotic conditions were determined; signifying qualitative and quantitative variations. Interestingly, the psychrophilic-prolonged incubation increased the unsaturation level of fatty acids to 59.34%, while ω-6 and ω-3 contents representing 23.53% and 0.67% respectively. Remarkably, it exhibited the highest EC100 dose by 677.03 µg/mL on normal human lung fibroblast Wi-38 cells. Meanwhile, it showed the highest inhibiting proliferation potential on cancer cell lines of A549, MDA-MB 231 and HepG-2 cells by 372.37, 417.48 and 365.00 µg/mL, respectively. Besides, it elevated the oxidative stress, the expression of key apoptotic genes and suppressed the expression of key oncogenes (NF-κB, BCL2 and cyclin D); implying its promising efficacy in cancer treatment as adjuvant drug. This study denoted the lipogenesis capacity of Paradendryphiella sp. under acidic/alkaline and psychrophilic/mesophilic conditions. Hereby attaining efficient and economic process under seasonal variation with different Egyptian marine sources to fill the gap of freshwater crisis and simultaneously preserve energy.
A rat study on the PTEN expression in ovarian tissue in PCOS and folliculogenesis
Authors: Namlı Kalem Muberra , Anadol Elvan , Kalem Ziya , Sezginer Perihan Yalçınkaya , Elmas Cigdem , Yılmaz Canan , Bakirarar Batuhan 
Published: November 2023

AbstractThe objective of this investigation was to examine alterations in PTEN expression within ovarian tissue in a rat model of polycystic ovary syndrome (PCOS). The analysis also encompassed the examination of PTEN alterations in the ovarian tissue throughout the process of folliculogenesis in rats with normal ovulatory cycles. The study involved 12 adult female Sprague‒Dawley rats randomly assigned to the letrozole-induced polycystic ovary syndrome (PCOS) group as part of an animal-based research endeavour. The sections derived from the ovaries were subjected to immunohistochemical staining for PTEN. The evaluation of PTEN staining levels in ovarian tissues was conducted using electron microscopy. Follicle counts, as well as hormonal and biochemical analyses (serum luteinising hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), testosterone, oestradiol levels and serum glucose, triglyceride, HDL and LDL-cholesterol levels), were conducted to provide evidence of the manifestation of polycystic ovary syndrome (PCOS) in rats. The number of primordial and Graafian follicles in the PCOS group decreased significantly, and the number of primary, secondary and antral follicles increased significantly. PTEN expression was found to be significantly higher in the PCOS group than in the control group in the primordial follicle oocyte cytoplasm, primordial follicle granulosa cells, primary follicle oocyte cytoplasm, primary follicle granulosa cells, antral follicle oocyte cytoplasm, antral follicle granulosa cells, and corpus luteum (p = 0.007, p = 0.001, p = 0.001, p = 0.001, p = 0.001, p = 0.002, and p = 0.018, respectively). In the non-PCOS group, a time-dependent comparison of the amount of oocyte cytoplasm and PTEN staining in granulosa cells of the oocytes at different stages of development was performed. While the follicles were developing from the primordial follicle to the primary and antral follicle, the amount of PTEN staining in the oocyte cytoplasm decreased, whereas the PTEN activity in the granulosa cells increased as the oocyte developed (p = 0.001 and p = 0.001, respectively). The current investigation demonstrated changes in PTEN expression in ovarian tissue throughout the course of normal folliculogenesis, as well as in instances of disrupted folliculogenesis, with a focus on rats with PCOS.
Revised emission factors for estimating direct nitrous oxide emissions from nitrogen inputs in Australia’s agricultural production systems: a meta-analysis
Authors: Grace Peter , De Rosa Daniele , Shcherbak Iurii , Strazzabosco Alice , Rowlings David , Scheer Clemens , Barton Louise , Wang Weijin , Schwenke Graeme , Armstrong Roger , Porter Ian , Bell Michael 
Published: November 2023

Context Agricultural soils are a major source of emissions of the greenhouse gas nitrous oxide (N2O). Aim Quantify direct N2O emissions from Australian agricultural production systems receiving nitrogen (N) inputs from synthetic and organic fertilisers, crop residues, urine and dung. Method A meta-analysis of N2O emissions from Australian agriculture (2003–2021) identified 394 valid emission factors (EFs), including 102 EFs with enhanced efficiency fertilisers (EEFs). Key results The average EF from all N sources (excluding EEFs) was 0.57%. Industry-based EFs for synthetic N fertiliser (excluding EEFs) ranged from 0.17% (non-irrigated pasture) to 1.77% (sugar cane), with an average Australia-wide EF of 0.70%. Emission factors were independent of topsoil organic carbon content, bulk density and pH. The revised EF for the non-irrigated cropping (grains) industry is now 0.41%; however, geographically-defined EFs are recommended. Urea was the most common N source with an average EF of 0.72% compared to urine (0.20%), dung (0.06%) and organo-mineral mixtures (0.26%). The EF for synthetic N fertilisers in rainfed environments increased by 0.16% for every 100 mm over 300 mm mean annual rainfall. For each additional 50 kg N ha−1 of synthetic fertiliser, EFs increased by 0.13%, 0.31% and 0.38% for the horticulture, irrigated and high rainfall non-irrigated cropping industries, respectively. The use of 3,4 dimethylpyrazole-phosphate (DMPP) produced significant reductions in EFs of 55%, 80% and 84% for the horticulture, non-irrigated and irrigated cropping industries, respectively. Conclusions and implications Incorporation of the revised EFs into the 2020 National Greenhouse Accounts (NGA) produced a 12% increase in direct N2O emissions from the application of synthetic N fertilisers. The lack of country-specific crop residue decomposition data is a major deficiency in the NGA.
Supporting Dialogue: Using Self-Selected Material Objects to Explore Spirituality, Mental Distress and the Social Worker Role
Authors: Carlisle Patricia 
Published: November 2023

Abstract
This article is based upon a qualitative doctoral study about the role, if any, of spirituality in the lives of mental health service users, and how the subject is engaged with mental health social workers in Northern Ireland (NI). One-to-one interviews with twelve mental health service users and twelve mental health social workers were conducted with participants invited to bring an object. The object was used to assist dialogue with participants regarding their experience of spirituality, and its application in practice. International research proposes that spirituality plays a supportive role for some people experiencing mental health problems. The acknowledgement of spirituality in mental health social work practice in NI is, however, challenging due to various factors. Of particular significance is NI’s history of violent political conflict, shaped in part by the contested role of religion in the creation of the NI state. This article considers how the selection, presence and absence of the object were used to support participants in exploring a subject that can be challenging to communicate. This article proposes the use of objects within mental health social work practice and research as useful aides to explore culturally sensitive and personal topics.
Treatment of right-sided aortic arch aneurysms with aberrant left subclavian artery with Kommerell’s diverticulum using the frozen elephant trunk technique
Authors: Juraszek Andrzej , Berger Tim , Kreibich Maximilian , Tsagakis Konstantinos , Sioris Thanos , Berkarda Zeynep , Rylski Bartosz , Siepe Matthias , Czerny Martin 
Published: November 2023

Abstract

OBJECTIVES
The ideal treatment for aneuryms of aberrant left subclavian arteries with Kommerell's diverticulum arising from right aortic arches remains open.

METHODS
Between January 2015 and December 2020, 5 patients with aneurysms from a right-sided aortic arch with aberrant left subclavian artery and Kommerell’s diverticulum underwent repair by using the frozen elephant trunk technique in 3 aortic centres. Patients’ characteristics were retrospectively reviewed and the surgical procedure and outcomes are presented.

RESULTS
The median age of the 2 male and 3 female patients was 59 (range from 49 to 63) years. The median operative times were as follows: surgery 405 min (range from 335 to 534), cardiopulmonary bypass time 244 min (range from 208 to 280) and aortic clamp time 120 min (from 71 to 184). The mean core temperature was 25.94°C (from 24 to 28). The intensive care unit stay was 4 days (range from 1 to 8) and the in-hospital stay 21 days (from 16 to 34). All patients were discharged and we observed no stroke or spinal cord ischaemia postoperatively. During the median follow-up time of 1003 days (range from 450 to 2306), 3 patients required subsequent thoracic endovascular distal stent graft extension.

CONCLUSIONS
The frozen elephant trunk technique is a good treatment option for patients with aneuryms of an aberrant left subclavian artery with Kommerell's diverticulum arising from right aortic arches. Secondary stent graft extension is a frequently needed component of the treatment concept.
Perceptions and Prevalence of Cannabis Use in Women With Inflammatory Bowel Disease of Reproductive Age: A Cross-Sectional Study
Authors: Hossein-Javaheri Nariman , O’Connor Katie , Steinhart Hillary , Deshpande Amol , Maxwell Cynthia , Huang Vivian , Tandon Parul 
Published: November 2023

Abstract

Background
Many patients with inflammatory bowel disease (IBD) may use cannabis for relief of symptoms. During pregnancy, however, cannabis exposure may be associated with adverse pregnancy outcomes. We aimed to determine the prevalence and perceptions of cannabis use in women with IBD.

Methods
Through recruitment at Mount Sinai Hospital and online platforms such as Twitter, women with IBD (age 18–45) were asked to complete anonymous surveys on demographics, cannabis use, perception of use during pregnancy, and discussing its use with healthcare providers (HCP). Categorical variables were reported as frequencies and compared across groups with the chi-square test.

Results
One-hundred and two pregnant patients with IBD were included in this study, 19 (18.6%) reported using cannabis. Current users were more likely to report constant pain in the last 12 months and discuss its use with their HCP. Fifty-three (52.0%) women were unsure of the specific risks associated with cannabis use during pregnancy, and only 15 (14.7%) had ever discussed its use with their HCP. Those who had discussed cannabis use with their HCP were more likely to have prior IBD-related surgery, perceive its use unsafe during pregnancy, and be more likely to be using cannabis.

Conclusion
Many women with IBD report uncertainty of the risks of cannabis use during pregnancy and the majority have never discussed cannabis use with their providers. With the increasing legalization of cannabis in many jurisdictions, it is imperative patients and healthcare providers discuss the risks and benefits of its use, particularly during vulnerable times such as pregnancy.