bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Financialization of Health and Education and Inequality in Twenty-first Century Brazil
Authors: Bação Pedro , Mazeron Diogo , Simões Marta 
Published: November 2023

Brazil is often cited for its high levels of inequality. Despite some success in reducing this inequality during the Partido dos Trabalhadores (Workers’ Party—PT) period, the rise of Jair Bolsonaro as Brazil’s president threatened to reverse this trend as he actively sought to promote policies that would lead to greater financialization of the Brazilian economy. In recent years, several studies have shown that the financialization of the economy as a whole can lead to a rise in inequality, but the financialization of the health and education sectors has not been of particular interest to researchers and government officials. An empirical analysis of the pattern of income inequality in twenty-first-century Brazil paying particular attention to the potential impact of the financialization of health and education sectors on this process shows a correlation between greater financialization (especially in the health sector) and an increase in income inequality. O Brasil é frequentemente destacado pelos seus níveis elevados de desigualdade. Apesar de algum progresso na redução da desigualdade durante o período de governação do PT, a tomada de posse como presidente de Jair Bolsonaro ameaça reverter esta trajetória, nomeadamente via o apoio a uma maior financeirização da economia. Nos últimos anos, vários estudos mostraram que a financeirização da economia como um todo pode conduzir ao aumento da desigualdade. Porém, a financeirização dos setores da saúde e da educação não tem sido alvo de interesse particular. Uma análise empírica do comportamento da desigualdade no Brasil no séc. XXI salientando o potencial impacto da financeirização da saúde e da educação, sugere que uma maior financeirização, em particular do setor da saúde, está associada a um aumento da desigualdade na repartição do rendimento no Brasil.
Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country
Authors: Basiri Abbas , Zahir Mazyar , Soleimani Mohammad , Khoshdel Ali Reza , Tabibi Ali , Imen Mohammad Sajjad , Soheilipour Alireza , Golshan Shabnam , Balafkan Masoumeh , Parvin Mahmoud , Shariat Shahrokh F 
Published: November 2023

Objectives: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. Patients and methods: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. Results and limitations: In total 187 patients were identified—orthotopic neobladder (ONB) ( N = 75), ileal conduit (IC) ( N = 57), and cutaneous ureterostomy (CU) ( N = 55)—and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning ( p = 0.003, 0.011, 0.045) as well as better body image ( p < 0.001), lower short- and long-term financial burden ( p = 0.034 and <0.001, respectively), marginally lower complication rate ( p = 0.049), and better 5-year overall survival ( p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. Conclusions: In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.
Percutaneous treatment of stone containing calyceal diverticula: Strategies and outcomes from a University teaching hospital in a developing country
Authors: Chawla Arun , Singh Anshuman , Pai Vivek , KR Surag , Choudhary Anupam , Reddy Bommireddy V , Gali Kasi Viswanath , Shah Abhijit 
Published: November 2023

Introduction: There is a dearth of research available on the outcomes, complications, and recurrence rates of the modalities employed in treatment of diverticula after stone clearance by PCNL. We present our experience of various approaches employed in our institute for treatment of caliceal diverticulum after stone clearance by PCNL. We aimed to review the outcomes, complications, and recurrence rates of these procedures which can provide valuable insights into the effectiveness of these techniques in the treatment of stone containing caliceal diverticulum. Methods: A retrospective analysis of a prospectively maintained database of patients diagnosed with caliceal diverticular stone was conducted. The primary outcome was the stone-free rate (SFR) at the time of hospital discharge, determined by a combined nephroscopic/fluoroscopic assessment, and the obliteration of the diverticular sac. Secondary outcomes included the evaluation of operative time, duration of hospital stay and postoperative complications. Results: A total of 53 patients were evaluated. The mean diverticulum size was 23.2 mm, most common location was the superior calyx (30 (56.7%)). Group 1 (diverticular neck treatment + DJ stent) included 27 patients, group 2 (diverticular wall fulguration + PCN) included 18 patients and group 3 (PCN alone) included 8 patients. Mean operating time was highest in group 1 (80 min). Stone clearance was 100% in group 1, 91% in group 2 and 88% in group 3. Obliteration of caliceal diverticulum was highest in group 1 (90%). Mean duration of hospital stay was lowest in group 1 (3.2 days). Overall complications were lowest in group 2 (3/18). Conclusion: PCNL followed by combination of diverticular wall fulguration and PCN or treatment of diverticular neck and DJ stenting is safe and effective in causing diverticular obliteration. Placement of nephrostomy tube alone was not found to be effective in causing diverticular obliteration in our study.
Virologic outcomes of antiretroviral therapy in patients with HIV-1 following bariatric surgery: A case series and review of the literature
Authors: Badowski Melissa , Kassem Sally , Labedz Malgorzata , Taylor Christopher , Bunnell Kristen , Hall Ashley , Darnell Hannah , Huesgen Emily 
Published: November 2023

Background Selection of an antiretroviral regimen for people living with HIV (PLWH) involves various clinical considerations, such as comorbidities, archived drug resistance mutations, concomitant medications, and potential drug interactions and side effects. Alterations in the surface area and pH of the gastrointestinal tract following bariatric surgery may alter absorption, antiretroviral pharmacokinetics and viral suppression. Data on the efficacy of antiretroviral (ARV) therapy in PLWH who have undergone bariatric surgery are limited or lacking for new antiretrovirals, such as dolutegravir and bictegravir. Methods This case series reports virologic outcomes and side effects in eight cases of PLWH receiving ARV therapy who underwent bariatric surgery. A systematic literature review was performed to review the available literature on the efficacy and safety of antiretroviral regimens in PLWH who have undergone bariatric surgery. Results Virologic suppression was not impacted for obese PLWH who underwent bariatric surgery following failure of life-style modifications and pharmacological therapy. Conclusions There were no deleterious effects on HIV progression for PLWH that underwent bariatric surgery. More prospective research is required to validate the effects of bariatric surgery on immunologic and virologic function outcomes. Close involvement of HIV and surgical specialists is recommended to manage ARV therapy in patients undergoing bariatric surgery.
Fanconi Syndrome in Patients With Human Immunodeficiency Virus Treated With Tenofovir-Based Antiretroviral Therapy: A Systematic Literature Review
Authors: Joshi Mrinmayee , Clark Brendan , Lee Todd A. 
Published: November 2023

Objective: Several cases of Fanconi syndrome (FS), a severe form of nephrotoxicity, have been reported in patients with HIV on tenofovir-containing antiretroviral therapy. A systematic review of the published literature on tenofovir-related FS in patients with HIV was conducted. Data Sources: PubMed and Embase were queried to identify articles in English published between January 2005 and June 2023, reporting tenofovir-related FS in adults with HIV. Preclinical studies, conference/poster abstracts, commentaries and responses, and review papers were excluded. Study Selection and Data Extraction: Of the 256 articles screened, 57 met the inclusion criteria. These comprised 37 case reports, 11 case series, 1 cross-sectional study, 1 case-control study, 4 cohort studies, 1 single-arm open-label clinical trial, 1 sub-analysis of clinical trials, and 1 pooled analysis of clinical trials. Data Synthesis: Among 56 cases on which information was abstracted, median age at FS diagnosis was 50 years, 51.8% were men, and duration of tenofovir use ranged from 6 weeks to 11 years. Ritonavir was co-prescribed in almost half the cases. In observational and interventional studies, incidence of FS was low. Many studies reported resolution of FS symptoms after tenofovir discontinuation. All FS occurrences were identified in those on tenofovir disoproxil fumarate (TDF), except for one patient on tenofovir alafenamide (TAF). Relevance to Patient Care and Clinical Practice: Continuous monitoring of signs and symptoms of renal and bone toxicity is essential for patients with HIV on tenofovir-containing therapy. Conclusions: Occurrence of FS is low in patients with HIV treated with tenofovir-based regimens. Concomitant use of ritonavir may increase risk of FS. TAF may be a safer alternative than TDF in terms of nephrotoxicity.
Non-steroidal intravitreal injection for noninfectious uveitic cystoid macular edema: Systematic review and meta-analysis
Authors: Kianersi Farzan , Rezaeian-Ramsheh Abdolreza , Rahimi Alireza , Akhlaghi Mohammadreza , Dehghani Alireza , Farajzadegan Ziba , Pourazizi Mohsen 
Published: November 2023

Purpose To systematically review the published manuscripts on the non-steroidal intravitreal injection for treatment of noninfectious uveitic cystoid macular edema (CME). Methods The PubMed, Scopus, and Web of Science, Science Direct, ProQuest, Cochrane Library, ProQuest, Embase, Clinical Key, and Springer were searched for relevant articles published until May 2022. The random-effects models were used to estimate the mean difference (MD) and 95% confidence interval (CI) for postoperative central macular thickness (CMT) and visual acuity (VA) changes. VA was transformed into the logarithm of the minimum angle of resolution (LogMAR). Meta-regression was conducted for adjusting the effects of potential confounders. Results A total of 17 relevant studies (258 eyes) were included in this meta-analysis. A significant improvement was observed in CMT in the last follow up (350.89 ± 108.43) compared to the baseline (452.3 ± 112.67) (Log MD = 1.82, 95% CI = 1.62, 2.02; I2 = 57.7%; P = 0.002). Additionally, VA also significantly improved in the last follow up (0.56 ± 0.29) compared to the baseline (0.75 ± 0.3) (Exponential MD = 0.82, 95% CI = 0.69, 0.95; I2 = 0.0%; P = 0.98). The subgroups analyzed included ten studies on anti-vascular endothelial growth factors (VEGF), three studies on infliximab, two studies on methotrexate (MTX), and two studies on diclofenac. All subgroups showed a significant improvement in both CMT and VA at the last follow-up (P < 0.05). Conclusion Non-steroidal intravitreal injection including bevacizumab, ranibizumab, infliximab, MTX and diclofenac appears to be an effective treatment option for noninfectious uveitic CME.
Acetabular erosion after bipolar hip hemiarthroplasty for femoral neck fracture in elderly patients: a retrospective study
Authors: Macheras George A , Pallis Dimitrios , Tsivelekas Konstantinos , Ampadiotaki Margarita M , Lepetsos Panagiotis , Tzefronis Dimitrios , Kateros Konstantinos , Papadakis Stamatios A 
Published: November 2023

Background: The choice between total hip arthroplasty (THA) and hemiarthroplasty (HA) to treat displaced femoral neck fractures, particularly among the elderly, is still controversial. Acetabular erosion consists of a late multifactorial process that may happen after hip HA resulting in significant postoperative burden. This study aims to investigate the impact of acetabular erosion progress after hip HA in patients over 70 years old. Materials and methods: This is a 5-year (2013–2018) retrospective study including consecutive series of patients >70 years who were treated with bipolar hip HA for femoral neck fractures. Patients were categorised into 3 groups for analysis (A = 70–75 years, B = 75–80 years, C = >80 years). The study enrolled a total number of 813 patients who met the inclusion criteria. We assessed acetabular erosion through radiological examinations and measured functional deterioration using the modified Harris Hip Score (mHHS) at 6 and 12 months follow-up. Our comprehensive investigation extended over a maximum period of 5 years. The correlation of patients’ characteristics and HA features on erosion progress was assessed. Results: There were no significant differences in sex distribution, injury side, BMI, ASA score, bipolar head diameter, mHHS and leg-length discrepancy among the groups ( p > 0.05). During the follow-up period, acetabular erosion with consequential conversion to THA was observed in 6.13%, 4.22% and 1.96% for Groups A, B and C respectively ( p = 0.009). A statistically significant difference of acetabular erosion was observed in Group A compared to patients of Group C. Conclusions: Age constitutes a significant factor of acetabular wear after HA in the elderly. The higher rate of acetabular wear in patients <75 years suggests that THA is a more viable option, as HA is for patients >80 years old.
Cerebral Vasomotor Reactivity Testing in the Middle Cerebral Artery Using Transcranial Doppler to Assess Brain Dysregulation in Long-haul COVID Patients
Authors: Mohiuddin Musharaf , Alexander Thomas H. , Holcomb Amanda , Alexander Kaitlyn , Plotkin George , Cook Alan 
Published: November 2023

Introduction: COVID-19 has wide-ranging physiological effects, with many patients complaining of persistent asthenia following recovery from the acute phase of the infection. The frequent term for this is “Long-Haul COVID.” While we have tools to measure effects on general physiology in human subjects, a metric for cerebral dysregulation is lacking. Cerebral blood flow is closely regulated in a healthy young person. Cerebral vasomotor reactivity (CVR) was used as a tool to assess this dysregulation. Methods: A transcranial Doppler (TCD) study for CVR was performed under the influence of Carbogen gas. A questionnaire collected prior to the procedure provided additional details on subjects’ demographics and COVID history. Cases and controls were recruited using the self-reported questionnaire. Statistics involved assessing the reproducibility of the test, as well as discovering differences between cases and control groups. Results: Cerebral vasomotor reactivity was assessed in 26 subjects (10 cases and 16 controls). Mean flow velocity in the left middle cerebral artery was analyzed at baseline, at peak Carbogen gas exposure, and in the hypercapnic phase. The reproducibility of the test was established within the longitudinal repeated measures data. The case and control groups were insignificant in difference at the base level but significant when controlled for confounders. Cerebral vasomotor reactivity was found to increase by 3.8 units in cases compared to controls. Confounders like body mass index, gender, and age were found significantly different between cases and controls. The number of COVID episodes and symptom severity was significant for CVR. Conclusion: This simple TCD bedside test was found to be effective in assessing CVR among all the subjects and was homogenous in its effect irrespective of baseline subject differences. As a preliminary test, the test showed differences among cases and control groups. The sample for the test lacked sufficient power and observations. A bigger sample size and a subsequent longitudinal follow-up may help better understand the use of CVR to screen high-risk populations for cerebrovascular anomalies.
Minimally Invasive Surgical Versus Transcatheter Aortic Valve Replacement: A Retrospective Observational Single-Center Study in Japan
Authors: Yamamoto Hiroyuki , Nakayama Taisuke , Ishii Naoki , Nakamura Yoshitsugu 
Published: November 2023

Objective: This study aimed to compare the outcomes of minimally invasive aortic valve replacement (MICS-AVR) versus transfemoral transcatheter aortic valve replacement (TF-TAVR) in Asian patients. Methods: We conducted a retrospective, observational, single-center study in Japan, including cases of MICS-AVR ( n = 202) and TF-TAVR ( n = 248) between 2014 and 2021. In a total of 450 cases, propensity score matching was performed at a ratio of 1:1, resulting in 96 pairs. Furthermore, we performed competing-risk regression and mediation analyses to determine the treatment effect on outcomes of interests, considering death as a competing risk, and to evaluate the mediation effect of paravalvular leak (PVL) severity. Results: There were similar incidences of all-cause death, cardiac death, stroke and cerebral hemorrhage, and aortic valve reintervention between the 2 groups. However, the TF-TAVR cohort had a longer hospital length of stay and higher rates of significant PVL compared with the MICS-AVR cohort. Multivariable-adjusted Cox regression analyses revealed that heart failure hospitalization (hazard ratio [HR] = 0.129, 95% confidence interval [CI]: 0.038 to 0.445, p = 0.001) and permanent pacemaker implantation (HR = 0.050, 95% CI: 0.006 to 0.409, p = 0.005) favored MICS-AVR. Competing-risk regression analyses confirmed similar findings. All outcomes were unrelated to PVL severity. Conclusions: To our knowledge, this is the first comparative study of clinical outcomes in Asian patients undergoing MICS-AVR versus TF-TAVR, revealing that MICS-AVR could be a feasible and efficient alternative to TF-TAVR. Future larger-scale randomized controlled trials are needed to validate the present results.
Parathyroid carcinoma: Imaging features of initial presentation and recurrence. A single center experience
Authors: Eldaya Rami W , Calle Susana , Wong Franklin C , Learned Kim O , Wintermark Max 
Published: November 2023

Background and purpose Parathyroid carcinoma is the rarest endocrine neoplasm with very few published data discussing its imaging appearance with primary focus on ultrasound imaging features. We present our 23 years institutional experience to highlight multimodality imaging evaluation at presentation and at recurrence. Material and Methods Retrospective chart review of clinical and pathological diagnosis of parathyroid carcinoma patients presented for initial or recurrent disease management at M.D. Anderson Cancer Center between the period of January 2000 and February 2023 was performed. Imaging findings on US, CT, PET/CT, and technetium-99m sestamibi were analyzed for initial and local recurrent parathyroid carcinoma. We further assess patterns of distant recurrence and its location. Results Twenty three patients with pathological and clinical diagnosis of initial (14 patients) or recurrent parathyroid carcinoma (14 patients) were included in this study. US findings of parathyroid carcinoma were larger lesions, increased/irregular vascularity, and non-circumscribed margins. Multiphasic CT findings of parathyroid carcinoma included an arterially enhancing lesion that is hypoenhancing relative to the thyroid and demonstrates no washout on delayed imaging. Highly suggestive findings for recurrent disease included a hypoechoic solid nodule (91.67%) with increased vascularity on ultrasound (81.8%) with corresponding enhancement on CT. Conclusion Parathyroid carcinoma is a rare malignancy often diagnosed after surgical resection. We provided CT and US imaging features that are helpful in suggesting the diagnosis of parathyroid carcinoma and detection of early local recurrence.
GCN5L1 regulates pulmonary surfactant production by modulating lamellar body biogenesis and trafficking in mouse alveolar epithelial cells
Authors: Xu Wenqin , Ma Xiaocui , Wang Qing , Ye Jingjing , Wang Nengqian , Ye Zhenzhen , Chen Tianbing 
Published: November 2023

AbstractBackgroundThe pulmonary surfactant that lines the air–liquid surface within alveoli is a protein–lipid mixture essential for gas exchange. Surfactant lipids and proteins are synthesized and stored in the lamellar body (LB) before being secreted from alveolar type II (AT2) cells. The molecular and cellular mechanisms that regulate these processes are incompletely understood. We previously identified an essential role of general control of amino acid synthesis 5 like 1 (GCN5L1) and the biogenesis of lysosome-related organelle complex 1 subunit 1 (BLOS1) in surfactant system development in zebrafish. Here, we explored the role of GCN5L1 in pulmonary surfactant regulation.MethodGCN5L1 knockout cell lines were generated with the CRISPR/Cas9 system. Cell viability was analyzed by MTT assay. Released surfactant proteins were measured by ELISA. Released surfactant lipids were measured based on coupled enzymatic reactions. Gene overexpression was mediated through lentivirus. The RNA levels were detected through RNA-sequencing (RNA-seq) and quantitative reverse transcription (qRT)- polymerase chain reaction (PCR). The protein levels were detected through western blotting. The cellular localization was analyzed by immunofluorescence. Morphology of the lamellar body was analyzed through transmission electron microscopy (TEM), Lysotracker staining, and BODIPY phosphatidylcholine labeling.ResultsKnocking out GCN5L1 in MLE-12 significantly decreased the release of surfactant proteins and lipids. We detected the downregulation of some surfactant-related genes and misregulation of the ROS–Erk–Foxo1–Cebpα axis in mutant cells. Modulating the activity of the axis or reconstructing the mitochondrial expression of GCN5L1 could partially restore the expression of these surfactant-related genes. We further showed that MLE-12 cells contained many LB-like organelles that were lipid enriched and positive for multiple LB markers. These organelles were smaller in size and accumulated in the absence of GCN5L1, indicating both biogenesis and trafficking defects. Accumulated endogenous surfactant protein (SP)-B or exogenously expressed SP-B/SP-C in adenosine triphosphate-binding cassette transporterA3 (ABCA3)-positive organelles was detected in mutant cells. GCN5L1 localized to the mitochondria and LBs. Reconstruction of mitochondrial GCN5L1 expression rescued the organelle morphology but failed to restore the trafficking defect and surfactant release, indicating specific roles associated with different subcellular localizations.ConclusionsIn summary, our study identified GCN5L1 as a new regulator of pulmonary surfactant that plays a role in the biogenesis and positioning/trafficking of surfactant-containing LBs.