bluuebunny/crossref_metadata_2025_split huggingface dataset:
Screening to prevent osteoporotic fractures in Egypt: a position statement of the Egyptian Academy of Bone Health
Authors: El Miedany Yasser , El Gaafary Maha , Gadallah Naglaa , Mahran Safaa , Abu-Zaid Mohamed Hassan , Hassan Waleed , Elwakil Walaa 
Published: February 2024

Abstract
Background
By 2030, approximately 22.6 million individuals in Egypt will be older than 50 years and prone to develop osteoporosis and are at risk of sustaining a fragility fracture. Osteoporotic fragility fractures, and in particular hip fractures, are associated with enduring pain, physical disability, poor quality of life, and loss of independence. Mortality rates are also high in this cohort of patients. Over the coming years, the potential preventable burden is likely to surge, particularly with the aging of the Egyptian population. The aim of this work was to determine the age onset of screening for risk of fragility fracture among Egyptians.

Results
A convincing evidence was found that fracture risk assessments are accurate and can be applicable in standard practice to identify individuals at high/very high risk of developing fragility fractures. A tremendous increase in the risk of fragility fracture at the age of 60 (RR = 33.5 for men and 20.2 for women). As interventions to either treat osteoporosis or to modify behavioral risk factors in terms of healthy eating and physical exercise would take years to change this risk, it was recommended to start screening for fragility fracture at the age of 50 for both men and women.

Conclusion
All Egyptian men and postmenopausal women 50 years of age or older should be evaluated/screened for their risk of sustaining a fragility fracture risk. The consequences of failing to identify and treat women and men who are prone to sustain a fragility fracture are considerable. In contrast to DXA scanning, screening with FRAX is cost-effective (time and effort required by patients and the health care system).
Epidemiology of suspected rabies cases in Ethiopia: 2018–2022
Authors: Asfaw Gashaw Beyene , Abagero Abdulnasir , Addissie Adamu , Yalew Alemayehu Worku , Watere Shambel Habebe , Desta Getahun Bahiru , Alemu Mikias Alayu , Merga Hunde , Amenu Yismashewa Wogayehu , Wakene Wubshet Zewdie , Deressa Sisay Getachew 
Published: February 2024

AbstractRabies is a zoonotic disease affecting both public health and the livestock industry in Ethiopia. However, there is limited national-level information on the extent of the disease. Therefore, we studied the national burden and distribution of Rabies on both humans and animals. We conducted a retrospective descriptive study on rabies by obtaining five years (2018–2022) data from the Ethiopian Public Health Institute (EPHI) and the Ministry of Agriculture. We analyzed the incidence, mortalities, temporal and spatial patterns. Microsoft Excel and ArcGIS version 10.2 were used for descriptive and spatial analysis respectively. A total of 37,989 Rabies suspected human exposure cases and 297 deaths were reported with a mean annual number of 7,598 human exposure cases and 59 deaths. The exposure case and mortality incidence rates were 6 and 0.05 per 100,000 populations respectively. Suspected human exposure cases significantly increased from 5,217 (2018) to 11,298 (2022) at a rate of 2.2. In the same period, 2,094 animal suspected rabies cases and 1,682 deaths were reported predominantly in dogs (71.2%), followed by cattle (27.8%) and other domestic animals (1%). There is high rabies suspected human exposure cases at national level. Suspected rabid dogs were the major source of infection in humans. There were gaps in the reporting of animal cases and low dog vaccination coverage. Hence, it is important to strengthen One Health collaboration to enhance surveillance, information sharing, and diagnostic capacity and improve mass dog vaccination coverage.
Single-Agent Trabectedin Versus Physician's Choice Chemotherapy in Patients With Recurrent Ovarian Cancer With BRCA-Mutated and/or BRCAness Phenotype: A Randomized Phase III Trial
Authors: Lorusso Domenica , Raspagliesi Francesco , Ronzulli Dominique , Valabrega Giorgio , Colombo Nicoletta , Pisano Carmela , Cassani Chiara , Tognon Germana , Tamberi Stefano , Mangili Giorgia , Mammoliti Serafina , De Giorgi Ugo , Greco Filippo , Mosconi Anna Maria , Breda Enrico , Artioli Grazia , Andreetta Claudia , Casanova Claudia , Ceccherini Rita , Frassoldati Antonio , Salutari Vanda , Giolitto Serena , Scambia Giovanni 
Published: February 2024

PURPOSE Literature evidence suggests that trabectedin monotherapy is effective in patients with recurrent ovarian cancer (OC) presenting BRCA mutation and/or BRCAness phenotype. METHODS A prospective, open-label, randomized phase III MITO-23 trial evaluated the activity and safety of trabectedin 1.3 mg/m2 given once every 3 weeks (arm A) in BRCA 1/2 mutation carriers or patients with BRCAness phenotype (ie, patients who responded to ≥two previous platinum-based treatments) with recurrent OC, primary peritoneal carcinoma, or fallopian tube cancer in comparison with physician's choice chemotherapy in the control arm (arm B; pegylated liposomal doxorubicin, topotecan, gemcitabine, once-weekly paclitaxel, or carboplatin). The primary end point was overall survival (OS) evaluated in the intention-to-treat population. RESULTS Overall, 244 patients from 21 MITO centers were randomly assigned (arm A = 122/arm B = 122). More than 70% of patients received ≥three previous chemotherapy lines and 35.7% had received a poly (ADP-ribose) polymerase inhibitor (PARPi) before enrollment. Median OS was not significantly different between the arms: arm A: 15.8 versus arm B: 17.9 months ( P = .304). Median progression-free survival was 4.9 months in arm A versus 4.4 months in arm B ( P = .897). Among 208 patients evaluable for efficacy, the objective response rate was 17.1% in arm A and 21.4% in arm B, with comparable median duration of response (5.62 v 5.66 months, respectively). No superior effect was observed for trabectedin in the prespecified subgroup analyses according to BRCA mutational status, chemotherapy type, and pretreatment with a PARPi and/or platinum-free interval. Trabectedin showed a higher frequency of grade ≥3 adverse events (AEs), serious AEs, and serious adverse drug reactions compared with control chemotherapy. CONCLUSION Trabectedin did not improve median OS and showed a worse safety profile in comparison with physician's choice control chemotherapy.
Sertoli-Leydig Cell Tumor as a Cause of Elevated 17-OH Progesterone
Authors: Chong Ya Yuan Nicole , Wong Jing Lin Jeslyn , Ang Xiao Hong Joella , Lim Yuan Ling Amanda 
Published: February 2024

Abstract
Virilizing ovarian tumors are rare but a clinically important diagnosis in a patient presenting with hyperandrogenism. Workup of hyperandrogenism is challenging with a broad range of differentials, including adrenal and ovarian pathology, tumoral or nontumoral in nature. Baseline follicular-phase 17-hydroxyprogesterone (17OHP) measurement is part of the investigation algorithm, and elevated levels are often associated with nonclassic congenital adrenal hyperplasia (NCCAH), which can have its first presentation in adolescence or adulthood. This case describes a young adult woman of reproductive age presenting with menstrual irregularity, raised testosterone, and 17OHP. After extensive workup and serial follow-up, she was found to have a Sertoli-Leydig cell tumor of the left ovary and underwent successful laparoscopic salpingo-oophorectomy with normalization of her menstrual irregularity and biochemical resolution of her testosterone and 17OHP levels.
Effects of Oxygenation Targets on Mortality in Critically Ill Patients in Intensive Care Units: A Systematic Review and Meta-Analysis
Authors: Cao Lei , Chen Qi , Xiang Ying-ying , Xiao Cheng , Tan Yu-ting , Li Hong 
Published: February 2024

BACKGROUND:
The effects of oxygenation targets (partial pressure of arterial oxygen [Pao
2], arterial oxygen saturation [Sao
2]/peripheral oxygen saturation [Spo
2], or inspiratory oxygen concentration [Fio
2] on clinical outcomes in critically ill patients remains controversial. We reviewed the existing literature to assess the effects of lower and higher oxygenation targets on the mortality rates of critically ill intensive care unit (ICU) patients.

METHODS:
MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched from their dates of inception to December 31, 2022, for randomized controlled trials (RCTs) comparing lower and higher oxygenation targets for critically ill patients ≥18 years of age undergoing mechanical ventilation, nasal cannula, oxygen mask, or high-flow oxygen therapy in the ICU. Data extraction was conducted independently, and RoB 2.0 software was used to evaluate the quality of each RCT. A random-effects model was used for the meta-analysis to calculate the relative risk (RR). We used the I2 statistic as a measure of statistical heterogeneity. Certainty of evidence was assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines.

RESULTS:
We included 12 studies with a total of 7416 patients participating in RCTs. Oxygenation targets were extremely heterogeneous between studies. The meta-analysis found no differences in mortality between lower and higher oxygenation targets for critically ill ICU patients (relative risk [RR], 1.00; 95% confidence interval [CI], 0.93–1.09; moderate certainty). The incidence of serious adverse events (RR, 0.93; 95% CI, 0.85–1.00; high certainty), mechanical ventilation-free days through day 28 (mean difference [MD], −0.05; 95%CI, −1.23 to 1.13; low certainty), the number of patients requiring renal replacement therapy (RRT) (RR, 0.96; 95% CI, 0.84–1.10; low certainty), and ICU length of stay (MD, 1.05; 95% CI, −0.04 to 2.13; very low certainty) also did not differ among patients with lower or higher oxygenation targets.

CONCLUSIONS:
Critically ill ICU patients ≥18 years of age managed with lower and higher oxygenation targets did not differ in terms of mortality, RRT need, mechanical ventilation-free days through day 28, or ICU length of stay. However, due to considerable heterogeneity between specific targets in individual studies, no conclusion can be drawn regarding the effect of oxygenation targets on ICU outcomes.
Efficacy of Single-Bolus Administration of Remimazolam During Induction of Anesthesia in Patients Undergoing Cardiac Surgery: A Prospective, Single-Center, Randomized Controlled Study
Authors: Lee Sou-Hyun , Nam Jae-Sik , Choi Dae-Kee , Chin Ji-Hyun , Choi In-Cheol , Kim Kyungmi 
Published: February 2024

BACKGROUND:
Remimazolam is a recently marketed ultrashort-acting benzodiazepine. This drug is considered safe and effective during general anesthesia; however, limited information is available about its effects on patients undergoing cardiac surgery. Therefore, the present study was conducted to evaluate the efficacy and hemodynamic stability of a bolus administration of remimazolam during anesthesia induction in patients undergoing cardiac surgery.

METHODS:
Patients undergoing elective cardiac surgery were randomly assigned to any 1 of the following 3 groups: anesthesia induction with a continuous infusion of remimazolam 6 mg/kg/h (continuous group), a single-bolus injection of remimazolam 0.1 mg/kg (bolus 0.1 group), or a single-bolus injection of remimazolam 0.2 mg/kg (bolus 0.2 group). Time to loss of responsiveness, defined as modified Observer’s Assessment of Alertness/Sedation Scale <3, and changes in hemodynamic status during anesthetic induction were measured.

RESULTS:
Times to loss of responsiveness were 137 ± 20, 71 ± 35, and 48 ± 9 seconds in the continuous, bolus 0.1, and bolus 0.2 groups, respectively. The greatest mean difference was observed between the continuous and bolus 0.2 groups (89.0, 95% confidence interval [CI], 79.1–98.9), followed by the continuous and bolus 0.1 groups (65.8, 95% CI, 46.9–84.7), and lastly between the bolus 0.2 and bolus 0.1 groups (23.2, 95% CI, 6.6–39.8). No significant differences were found in terms of arterial blood pressures and heart rates of the patients.

CONCLUSIONS:
A single-bolus injection of remimazolam provided efficient anesthetic induction in patients undergoing cardiac surgery. A 0.2 mg/kg bolus injection of remimazolam resulted in the shortest time to loss of responsiveness among the 3 groups, without significantly altering the hemodynamic parameters. Therefore, this dosing can be considered a favorable anesthetic induction method for patients undergoing cardiac surgery.
Neuronavigation-Specific Parameters for Selective Access of Trigeminal Rootlets in Radiofrequency Lesioning: A Cadaveric Morphometric Study
Authors: Kaye Joel , Ramanathan Vishan , Sheehy John P. , Andaluz Norberto , Tew John , Forbes Jonathan A. 
Published: February 2024

BACKGROUND AND OBJECTIVE:
Radiofrequency lesioning (RFL) is a safe and effective treatment for medically refractory trigeminal neuralgia. Despite gaining mainstream neurosurgical acceptance in the 1970s, the technique has remained relatively unchanged, with the majority of series using lateral fluoroscopy over neuronavigation for cannula guidance. To date, there are no studies describing neuronavigation-specific parameters to help neurosurgeons selectively target individual trigeminal rootlets. In this cadaveric study, we sought to provide a neuronavigation-specific morphometric roadmap for selective targeting of individual trigeminal rootlets.

METHODS:
Embalmed cadaveric specimens were registered to cranial neuronavigation. Frontotemporal craniotomies were then performed to facilitate direct visualization of the Gasserian ganglion. A 19-gauge cannula was retrofit to a navigation probe, permitting real-time tracking. Using preplanned trajectories, the cannula was advanced through foramen ovale (FO) to the navigated posterior clival line (nPCL). A curved electrode was inserted to the nPCL and oriented inferolaterally for V3 and superomedially for V2. For V1, the cannula was advanced 5 mm distal to the nPCL and the curved electrode was reoriented inferomedially. A surgical microscope was used to determine successful contact. Morphometric data from the neuronavigation unit were recorded.

RESULTS:
Twenty RFL procedures were performed (10R, 10L). Successful contact with V3, V2, and V1 was made in 95%, 90%, and 85% of attempts, respectively. Mean distances from the entry point to FO and from FO to the clival line were 7.61 cm and 1.26 cm, respectively.

CONCLUSION:
In this proof-of-concept study, we found that reliable access to V1–3 could be obtained with the neuronavigation-specific algorithm described above. Neuronavigation for RFL warrants further investigation as a potential tool to improve anatomic selectivity, operative efficiency, and ultimately patient outcomes.
Robotic Approach for Perihilar Cholangiocarcinoma IIIA Type: Step-by-Step Procedure
Authors: Ielpo Benedetto , Rosso Edoardo , d’Addetta Maria Vittoria , Abad Mayra , Vellalta Gemma , Sanchez-Velazquez Patricia , Burdio Fernando 
Published: February 2024

Abstract
Background
Perihilar cholangiocarcinoma is a challenging technique to be performed by minimally invasive approach being the type III among the most complex procedure. Nowadays, the robotic approach is gaining increasing interest among the surgical community, and more and more series describing robotic liver resection have been reported. However, few cases of minimally invasive Bismuth type IIIA cholangiocarcinoma have been reported. Robotic approach allows for a better dissection and suture thanks to the flexible and precise instruments movements, overcoming some of the limitations of the laparoscopic technique. Therefore, robotic technique can facilitate some of the critical steps of a technically demanding procedure, such as the extended right hepatectomy for perihilar cholangiocarcinoma Bismuth IIIA type.

Methods
In this multimedia video we describe, for the first time in the literature, a full robotic surgical step-by-step technique with some tips and tricks for treating a perihilar cholangiocarcinoma Bismuth IIIA type, performing a radical extended right hemihepatectomy, including segment I combined with regional lymphadenectomy anf left bile duct reconstruction. A 55-year-old woman with obstructive jaundice (10 mg/dl) was referred to our center. The endobiliary brushing confirmed adenocarcinoma, and MRI/CT showed a focal perihilar lesion of 2 cm, including the main biliary duct bifurcation and extending up to the right duct (Bismuth Type IIIA hilar cholangiocarcinoma). After endoscopic biliary stents placement and 6 weeks after right portal vein embolization, the future liver remnant, including segments II and III, reached an enough hypertrophy volume with a ratio of 30%. A right hemihepatectomy with caudate lobe, including standard standard lymphadenectomy and left biliary duct reconstruction was performed.

Results
The operation lasted 670 min with an estimated blood loss of 350 ml. Postoperative pathological examination revealed a moderately differentiated adenocarcinoma pT1N0 with 15 retrieved nodes and free margins. The patient experienced a type A biliary fistula and was discharged on the 21st postoperative day without abdominal drainage.

Conclusions
Through the tips and tricks presented in this multimedia article, we show the advantages of the robotic approach for performing correctly one of the most complex surgeries.1-7
Legg-Calvé-Perthes Disease: Diagnosis, Decision Making, and Outcome
Authors: Ng Tammy , Liu Ruikang , Kulkarni Vedant A. 
Published: February 2024

Abstract
Legg-Calvé-Perthes disease (LCPD), or idiopathic avascular necrosis of the proximal capital femoral epiphysis in children, has a variable presentation and can result in significant femoral head deformity that can lead to long-term functional deficits. Plain radiographic imaging is crucial in diagnosing LCPD and guiding treatment. Although the etiology of LCPD remains unknown, the evolution of the disease has been well characterized to include the phases of ischemia, revascularization, and reossification. The mechanical weakening during these phases of healing place the femoral head at high risk of deformity. Treatment of LCPD, therefore, focuses on minimizing deformity through operative and nonoperative strategies to reduce the risk of premature osteoarthritis. Advanced imaging using perfusion MRI may refine surgical decision making in the future, and biological treatments to improve femoral head healing are on the horizon.
What Motivates Secondary School Teachers to Continue to Use Classroom-Based Physical Activity? A Self-Determination Theory Approach
Authors: Reinboth Michael Sæther , Schmidt Sabrina , Jonskaas Cathrine , Grønningsæter Hilde , Karlsen Maria Louise , Bottolfs Marthe , Bratland-Sanda Solfrid 
Published: February 2024

ABSTRACT

Purpose
This study aimed to examine the motivational regulations of secondary school teachers to use classroom-based physical activity (CBPA).

Methods
A total of 148 secondary school teachers (response rate, 34%) completed a survey including the Behavioral Regulation in Exercise Questionnaire (α = 0.79–0.92), the Intrinsic Motivation Inventory perceived competence (α = 0.85) and perceived autonomy (α = 0.86) subscales, and the perceived relatedness with students scale (α = 0.93).

Results
English, Norwegian, and mathematics CBPA were used by 13%, 26%, and 22% of respondents, respectively. Thirty-seven percent of the teachers reported using in-class physically active breaks one to four times a week or daily. There was a positive correlation between teachers’ perception of autonomy, competence, relatedness with students, and self-determined regulations for applying CBPA. A stepwise regression analysis showed that identified regulation for CBPA and perceived competence explained 31% of the likelihood of using CBPA in future teaching.

Conclusion
To improve rates of teachers using CBPA on a regular basis in secondary school, implementers need to focus on strengthening teachers’ personal held values about and perceived competence for using CBPA.
Impact of probiotics on inflammatory bowel disease - a systematic review
Authors: Fijałkowska Justyna , Pełka Maciej , Kania Anna , Ciulkiewicz Łukasz 
Published: February 2024

Introduction: Inflammatory bowel disease (IBD) is a chronic nonspecific inflammatory disease of the gastrointestinal tract that includes ulcerative colitis (UC) and Crohn's disease (CD). Both disease entities have many features in common, such as a basis of chronic inflammation, similar clinical symptoms as well as periods of remission and relapse. The difference between them lies in the lesions location. Treatment of IBD is primarily based on reducing inflammation and maintaining as long a remission time as possible. Increasing evidence is being attributed to the therapeutic potential of probiotics in IBD.
Purpose: This review aims to present the preventive and therapeutic effects of probiotic use in IBS through an analysis of recent studies.
Methods: A review of recent literature was conducted to investigate the impact of probiotic use on the treatment of IBD.
Results: In studies, probiotics help induce and maintain remission in patients with mild to moderate ulcerative colitis, especially when used in combination therapy. In contrast, the usage of probiotics in Crohn's disease does not provide due benefit: it does not induce or prolong remission.
Conclusions: In conclusion, the effect of probiotics on IBD is inconclusive. Some probiotics, particularly the VSL#3 probiotic blend, have shown decent effects on induction and remission in patients with mild to moderate UC. However, no therapeutic effect has been demonstrated in patients with Crohn's Disease. Therefore studies under more restrictive and standardized conditions are required.
AGROTÓXICOS, PESTICIDAS E DEFENSIVOS AGRÍCOLAS: QUAL A NOMENCLATURA ADEQUADA CONFORME A LEGISLAÇÃO CONSUMERISTA?
Authors: Fernandes Alessandro 
Published: February 2024

A Lei Federal n.º 7.802/1989 dispõem sobre a pesquisa, a experimentação, a produção, a embalagem e rotulagem, o transporte, o armazenamento, a comercialização, a propaganda comercial, a utilização, a importação, a exportação, o destino final dos resíduos e embalagens, o registro, a classificação, o controle, a inspeção e a fiscalização de agrotóxicos, seus componentes e demais temas afins, servindo como legislação base para o tema. Uma das discussões levantadas durante a tramitação de proposta de reforma legal refere-se a nomenclatura “agrotóxicos”, propondo sua alteração para pesticidas ou defensivos agrícolas. Este estudo pretende realizar a discussão desta alteração de nomenclatura com base no disposto no Código de Defesa do Consumidor (CDC), verificando qual seria o vocábulo mais adequado. Para tanto conduzimos uma pesquisa qualitativa exploratória composta por desk research em livros, revistas científicas e web e uma análise da Lei Federal 7.082/1989 e das propostas legislativas que propõem sua revisão, em especial o Projeto de Lei (PL) 6.299/2002, sob um prisma consumerista. Percebe-se que a alteração da nomenclatura “agrotóxicos, atende ao um defeso de uma parcela da sociedade de apagar uma memória discursiva negativa acerca do primeiro termo, atentando contra princípios básicos que estruturam a relação consumerista. As eventuais alterações na legislação que pretende reformar a Lei dos Agrotóxicos não podem omitir a nocividade e perigos à saúde dos agrotóxicos através de uma mudança de nomenclatura, sob pena de infringir não só o CDC como também a própria Constituição Federal.