bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early outcomes of limb salvage surgery with mega-prosthesis
Authors: Bilal Muhammad , Jilani Syed Rizwan-UL-Ahsan , Rafi Ilyas , Shakeel Osama , Jabeen Wardah 
Published: October 2023

Objective:
To determine the early outcomes of limb salvage surgery with mega prosthesis.

Methods:
This retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) from 1st January 2017 till 31st January 2020. Data like demographics, histopathology, functional and survival outcomes were retrieved from the Hospital Information System. Musculoskeletal Tumor Society (MSTS) score was used to evaluate the functional outcomes after the surgery. For survival analyses, Kaplan-Meier curve was applied. Prosthesis joint infection, amputation rate, metastasis, mortality rate, and recurrence were also recorded.

Results:
This study included 43 patients who underwent limb salvage surgery with endoprosthesis reconstruction at SKMCH&RC. The mean age at the time of diagnosis was (26.5±15.8) years. Patients with distal femoral replacement had the highest MSTS scores (81.45±9.70) while those with proximal humerus replacement has the lowest MSTS scores (56.8±11.2). There was a strong association between site of tumor and MSTS (F=3.30, P=0.017). We also found a correlation between surgical site infection and MSTS scores (r=0.484, P=0.001). Patients with recurrence also had significantly lower MSTS scores (P<0.05). The cumulative survival rate at the end of two-year follow-up was (71.4±17.1)% in proximal femur tumor patients, (88.0±7.8)% in distal femur tumor patients, and (50.0±3.5)% in proximal humerus tumor patients. Besides, patients with Ewing sarcoma had the highest survival rate (97.5±11.0)% while patients with chondrosarcoma had the lowest survival rate (77.8±13.9)%.

Conclusions:
Limb salvage surgery with mega-prosthesis can be performed with satisfactory functional and survival outcomes, but further studies are needed to compare it with other limb salvage methods. This study can be used as a reference for future studies.
Effect of taxifolin on cold-shock damages in spermatozoa in rabbits
Authors: Yılmaz İrfan , Türk Gaffari , Çakır Cihangiroğlu Aslıhan , Acısu Tutku Can , Güngör İbrahim Halil , Arkalı Gözde , Ekmen Edanur Güler 
Published: October 2023

Objective:
To investigate the effect of taxifolin added to rabbit semen on freezing-induced cold-shock damages in spermatozoa.

Methods:
Semen was collected from six adult New Zealand rabbits once a week by artificial vagina. The collected semen was pooled at 38 °C and divided into four equal volumes. They were diluted with 0, 50, 100 and 200 μM taxifolin-containing Tris + egg yolk extender at 38 °C and their temperatures were lowered to 4 °C. Following equilibration, semen drawn into 0.25 mL straws were frozen in an automatic semen freezing device and stored in liquid nitrogen container at -196 °C. Samples were thawed in 38 °C water for 25 s and the analyses of motility, kinematic parameters, morphological deformities, changes in membrane integrity, mitochondrial membrane potential, dead-live ratio, acrosomal damages and as well as oxidative stress analyses were performed in semen.

Results:
Addition of 50 μM taxifolin significantly improved motility (total, progressive, rapid and static), high mitochondrial membrane potential and the ratios of spermatozoa with acrosomal damage compared to the control group. Compared to the control group, malondialdehyde (MDA) levels in the 50 and 100 μM taxifolin groups were significantly lower, while the MDA level was high and viable spermatozoa ratio was low in the 200 μM taxifolin group. There were no significant differences between the groups in terms of kinematic parameters, morphological deformities, membrane integrity and antioxidant levels.

Conclusions:
The low dose of taxifolin (50 μM) has a positive effect and the high dose (200 μM) has a negative effect. Therefore, it is concluded that the addition of low-dose (50 μM) taxifolin to the extenders would be a useful additive in reducing cold-shock damage that occurs during freezing of rabbit semen.
Outcomes of patients admitted to the intensive care unit with community-acquired pneumonia in a tertiary care center in Riyadh, Saudi Arabia
Authors: Oreibi Talal , Alenezi Farhan , Ahmed Amjad M. , Humaid Felwa Bin , Sadat Musharaf , Tamim Hani Mohammed , Baseet Faisal Fouad , Naidu Brintha , Arabi Yaseen M. 
Published: October 2023

Abstract:

BACKGROUND:
Community-acquired pneumonia (CAP) is a leading cause of intensive care unit (ICU) morbidity and mortality. Despite extensive international epidemiological and clinical studies to improve those patients’ outcomes, local statistics in Saudi Arabia are limited. The objective of this study is to describe the clinical characteristics and outcomes of patients admitted to the ICU with the diagnosis of CAP reflecting the experience of a tertiary center over an 18-year period.

METHODS:
A retrospective cohort study included all consecutive adult ICU patients diagnosed with CAP between 1999 and 2017. Baseline demographics, patients’ risk factors, and initial admission laboratory investigations were compared between survivors and nonsurvivors. A multivariate regression model was used to predict mortality.

RESULTS:
During the study period, there were 3438 patients admitted to the ICU with CAP (median age 67 [Quartile 1, 3 (Q1, Q3) 51, 76] years) and 54.4% were males, of whom 1007 (29.2%) died. The survivors compared with nonsurvivors were younger (65 vs. 70 years), less likely to have chronic liver disease (2.4% vs. 10.5%), chronic renal failure (8.1% vs. 14.4%), and be immunocompromised (10.2% vs. 18.2%), and less frequently required mechanical ventilation or vasopressors (46.2% vs. 80.5% and 29.6% vs. 55.9%, respectively). Acute Physiology and Chronic Health Evaluation (APACHE) II score was significantly higher among nonsurvivors (median score 26 vs. 20) with a longer duration of mechanical ventilation and ICU stay. Using a multivariate regression model, age, APACHE II score, bilirubin level, vasopressors, and mechanical ventilation were significantly associated with increased mortality, while diabetes was associated with lower mortality.

CONCLUSION:
Around one-third of patients admitted to the ICU with CAP died. Mortality was significantly associated with age, APACHE II score, vasopressor use, and mechanical ventilation. A comprehensive national registry is needed to enhance epidemiological data and to guide initiatives for improving CAP patients’ outcomes.
Clinicodemographic characteristics and prognostic role of myasthenia gravis in thymoma: Experience from a Saudi population
Authors: Shammari Abdullah Al , Saad Aida , Saif Lama Tareq , Othman Safy A. , Ghosheh Mohammad J. , Khdeir Ghadir M. , Alashgar Omniyah , Abu-Rayya Mohammed A. , Ahmed Mohamed Hussein , AlKattan Khaled , Saleh Waleed 
Published: October 2023

Abstract:

OBJECTIVES:
The objectives of the study were to determine the clinicodemographic characteristics and the prognostic role of myasthenia gravis (MG) in thymoma.

METHODS:
The records of patients who underwent surgical resection of thymoma at King Faisal Specialist Hospital and Research Center in the past 23 years were reviewed. Seventy thymoma patients were finally included and were then categorized based on MG status into the MG group (39 patients) and the non-MG group (31 patients). Collected data included patients’ demographic characteristics, tumor characteristics, and postoperative clinical outcomes. All analyses were conducted using SPSS. The comparison between both groups was tested using the Student t-test and Chi-square test for continuous and categorical variables, respectively. A P = 0.05 or less indicated statistical significance.

RESULTS:
Patients’ age ranged from 11 to 76 years, and female predominance was observed (55.7%). Compared to the non-MG group, no difference in patients’ gender was observed (P = 0.058); however, MG patients had a younger age (39.30 vs. 48.77, P = 0.0095). No difference was noted between both groups based on the World Health Organization classification (P = 0.398), but MG patients tended to present with less-advanced tumors based on the TNM classification (P = 0.039) and lower stage based on the MASAOKA staging system (P = 0.017). No significant change in tumor size (P = 0.077), resectability (P = 0.507), and adjuvant therapy (P = 0.075) were observed. MG was not significantly associated with postoperative complications, morbidity, or mortality. However, it exhibited a prognostic protective role in terms of lower recurrence (2.56% vs. 35.48%, P = 0.0001) and longer survival duration (18.62 vs. 10.21 years, P < 0.001) as compared to non-MG patients.

CONCLUSIONS:
MG occurrence in thymoma patients is more likely to occur at a younger age, higher TNM classification, and advanced MASAOKA stage. Although no significant association was noted between MG and complications and mortality, MG exhibited a protective role in thymoma by providing a lower recurrence rate and longer survival duration.
Do orthodontists aim to decrease the duration of fixed appliance treatment?
Authors: Abid Mushriq F. , Alhuwaizi Akram F. , Al-Attar Ali M. 
Published: October 2023

OBJECTIVES:
The aim of the present study was to investigate the trends in the use of fixed appliance and accelerated orthodontics to decrease the treatment duration. Further, this study aimed to assess the effect of demographic factors on the participant's choice of treatment modality.

METHODS:
This was a cross-sectional study in the form of questionnaire-based online survey especially designed and distributed to 265 orthodontists via email. The questions aimed to collect basic information about the participants and respondents’ choices for decreasing the treatment duration. The data were analyzed according to gender, level of academic education and years of clinical experience using Chi-square test.

RESULTS:
A response rate of 85.2% was reported. Most of the orthodontists aimed to reduce the treatment duration by the biomechanical (66.8%) and surgical approaches (27.4%). The use of sliding mechanics (69.4%) and one-step retraction was more common (66.3%). MBT bracket prescription was more prevalent (51.7%), followed by Roth (41.1%). Conventional brackets were used more than self-ligating brackets, and aesthetic brackets were avoided by one third of the respondents. NiTi wires were the most commonly used wires during the alignment stage (44.2%). However, the effect of gender, years of clinical experience and specialty level of education showed some effects on the use of certain techniques and clinical practice of the respondents.

CONCLUSIONS:
Most of the orthodontists aimed to decrease orthodontic treatment duration by using biomechanical and surgical approaches. Gender and clinical experience to a certain extent affected the participants’ choice during orthodontic treatment.
Sarıcakaya (Eskişehir) Granitoyidindeki Pegmatitlerin Kökeni ve Endüstriyel Hammadde Potansiyeli
Authors: GÜLLÜ Bahattin , BİLGİLİOĞLU Hacer 
Published: October 2023

Eskişehir kuzeyindeki Sarıcakaya Granitoidindeki pegmatitlerin ana mineralojik bileşeni plajiyoklaz, ortoklaz, kuvars, biyotit, ±granat, ±muskovit, ±epidot’tur. Konfokal raman spektroskopi çalışmalarında plajiyoklaz minerallerinin albit-oligoklaz, granatların ise çoğunlukla spessartin bileşimde oldukları görülmektedir. Endüstriyel hammadde olarak kullanılabilme potansiyeline sahip pegmatitler ana kaya ile keskin dokanaklı olup, serizitleşme ve killeşme gösterirler.
Pegmatitlerin A/NK (mol%) oranı 0.96-1,79 (ortalama 1,32), A/CNK (mol%) oranları 0.82-1.55 (ortalama:1,07) arasında değişmekte olup metalümin-peralümin karakteri yansıtmaktadır. Zirkon ve apatit doygunluk sıcaklıkları pegmatitleri oluşturan magmanın ortalama sıcaklığının 678,7-766,7°C aralığında değiştiğini göstermektedir. ORG’ye göre normalize edilen örümcek diyagramlarda kabuksal kirlenmenin etkilerinin gözlendiği pegmatitlerin, Sarıcakaya granitoidini oluşturan magmanın pegmatitik-pnömatolitik evredeki kristallenen magmatik birimleri olduğu düşünülmektedir.
Simposio 4: Fertilización asistida y diabetes mellitus materna
Authors: Geller Marisa 
Published: October 2023

La diabetes mellitus (DM) tipo 1 y 2 se ubican dentro de las enfermedades crónicas más prevalentes en las mujeres en edad reproductiva. A su vez, son pacientes con alteraciones en su fertilidad donde se observa que tienen menor descendencia que sus pares y varias deben hacer tratamientos de fertilidad de alta complejidad.
La hiperglucemia de la DM1 (por el déficit de insulina) y la hiperinsulinemia (por la administración exógena) pueden inducir al hipogonadismo, ovarios de aspecto poliquístico e hiperandrogenismo. En el caso de la DM2, las pacientes pueden presentar síndrome de ovario poliquístico (SOP), obesidad, insulinorresistencia e inflamación crónica, todo esto explica la mayor dificultad para lograr un embarazo.
Impacto de los tratamientos para el control glucémico en la insuficiencia cardíaca
Authors: Sanabria Hugo 
Published: October 2023

La diabetes mellitus (DM) es un factor de riesgo independiente para el desarrollo de insuficiencia cardíaca (IC). El riesgo de desarrollar esta complicación es dos a cuatro veces mayor en hombres y cinco veces superior en mujeres con DM. Ante este escenario es imprescindible conocer el efecto de los diferentes grupos farmacológicos que utilizamos para el control glucémico sobre el riesgo de desarrollar IC, como así también una vez presentado el cuadro clínico, su rol pronóstico.
La metformina está contraindicada en pacientes con IC y filtrado glomerular <30 ml/min debido a un mayor riesgo de desarrollar acidosis láctica. Su uso en pacientes estables no incrementaría este riesgo e incluso estudios caso control evidenciaron cierto efecto beneficioso en esta subpoblación, aunque este impacto no fue demostrado en ensayos clínicos randomizados. Las tiazolidinedionas, agonistas PPARγ, como la pioglitazona y rosiglitazona están claramente asociadas a un riesgo mayor de internaciones por IC. Este riesgo si bien no parece acompañarse de un incremento en la mortalidad, se asocia a un aumento del empleo de diuréticos y de internaciones por lo cual está contraindicado en pacientes con diagnóstico de IC y debe usarse con precaución en pacientes con alto riesgo de desarrollarlo.
Omega 3: ¿Debemos indicarlo en nuestros pacientes?
Authors: Milikowski Marta 
Published: October 2023

Los lípidos se identifican como un componente fundamental de la dieta porque desarrollan funciones muy importantes. Influyen en la modulación de las funciones inmunitarias y en los procesos inflamatorios atribuible a los ácidos grasos poliinsaturados de cadena larga (long chain polyunsaturated fatty acids, LCPUFA).
Los ácidos grasos esenciales (AGE), como el ácido linoleico (AL) y el α-linolénico (AAL), deben incorporarse con la dieta porque el organismo no los sintetiza.
Impacto de la actividad física: ¿cómo prescribirla?
Authors: Minuchín Gabriel 
Published: October 2023

Anualmente la American Diabetes Association (ADA) realiza recomendaciones sobre cuidados y tratamientos de pacientes con diabetes mellitus (DM)1. Sería muy sencillo seguir prolijamente dichas recomendaciones para el beneficio de los individuos con DM o para quienes tienen riesgo de padecerla, sin embargo, no se cumplen, lo que provoca serios perjuicios para la salud.
Existen numerosas barreras para la prescripción adecuada de la actividad física (AF) por parte de los médicos2 y numerosas causas referidas por pacientes para no practicarla3.
Mecanismos independientes del descenso de peso
Authors: Álvarez María 
Published: October 2023

Desde la década de 1930 existen reportes de casos aislados de mejoría de la hiperglucemia luego de cirugías gástricas por cáncer o enfermedad úlcero-péptica.
A partir de la cirugía bariátrica, con el objetivo de la pérdida de peso en pacientes con obesidad severa (del griego baros: peso, iatrikos: tratamiento), se observó la remisión de la diabetes mellitus tipo 2 (DM2) en el posoperatorio inmediato. El hallazgo inesperado de remisión de la DM con la cirugía bariátrica abre el campo de estudio del tubo digestivo como un órgano endocrino poderoso capaz de regular el apetito, el metabolismo energético y el metabolismo de la glucosa.
Simposio 18: Plan de alimentación y actividad física: impacto cardiovascular
Authors: Morejón Andrea 
Published: October 2023

Las intervenciones sobre el estilo de vida, la alimentación y la actividad física constituyen sin lugar a dudas una de las herramientas fundamentales en la prevención y tratamiento de la obesidad, así como de las comorbilidades asociadas al peso. Su adecuada implementación brinda beneficios no solo propios de las intervenciones, alimentación y actividad física, sino también permiten mejorar los resultados con terapias concomitantes para el tratamiento de la obesidad, sus comorbilidades y reducir el riesgo cardiovascular1.
Con respecto al rol de la alimentación, se ha evaluado una diversidad de planes alimentarios, los cuales se diferencian principalmente en cuanto a la proporción y/u origen de los macronutrientes. Por ejemplo, planes de estilo mediterráneo, vegetariano, DASH demostraron mejorar en distinta medida parámetros cardiometabólicos2. Sin embargo, es importante considerar que deben tenerse en cuenta múltiples aspectos individuales y socioculturales al momento de diseñar un plan alimentario y, por lo tanto, no existe un patrón de alimentación saludable único que pueda implementarse de manera universal e invariable para obtener beneficios sobre la salud. De lo que sí se dispone de evidencia en la actualidad, es de la relación perjudicial del consumo habitual de productos ultraprocesados, los cuales incrementan de un 4 a un 9% tanto la enfermedad como la mortalidad cardiovascular3, por lo cualsu consumo debería desalentarse.
Perbandingan Daya Dan Torsi Sepeda Motor Yamaha Byson 150cc Dengan Knalpot Standar Dan Knalpot Free Flow
Authors: Prayogi Yoga , Prasetyo Imam , Valentino Febi 
Published: October 2023

Abstract

The combustion of fuel inside the combustion chamber takes place as an explosion. This process occurs very quickly and makes a very loud or noisy sound. The function of the muffler is as a silencer and regulates the flow direction of combustion gases to flow regularly. The construction of the free flow exhaust is an exhaust without barriers with relatively wasteful fuel consumption, both working on engines with high revs. Previous researchers replaced the exhaust with a size of tenths of a centimeter of a meter, while in this final project used a fifth of a centimeter. The goal to be achieved by the author in writing this final project is to find out the use of free flow exhaust on power and torque on Yamaha Byson 150cc motorcycles. This final project is carried out by the method of taking test data from the dynotest, using the dynotester tool. The test results are the influence of free flow exhaust measuring 25 cm, 30 cm and standard exhaust, resulting in the most optimal increase in power and torque on a 30 cm free flow exhaust with maximum power data of 13.1 HP at 6750 RPM, and maximum torque reaching 15.35 Nm at 4500 RPM, this is due to the influence of silencer length and without any obstacles, namely the catalic converter which makes the vehicle's breath longer so that it can get peak power at engine speed higher ones.

Keywords: α-amylase enzyme; Fennel leaves; Decrease in glucose

Abstrak

A Pembakaran bahan bakar di dalam ruang bakar berlangsung sebagai ledakan. Proses ini terjadi sangat cepat dan menimbulkan suara yang sangat keras atau bising. Fungsi dari knalpot (muffler) adalah sebagai peredam suara dan mengatur arah aliran gas-gas hasil pembakaran agar mengalir dengan teratur. Konstruksi dari knalpot free flow yaitu knalpot tanpa sekat hambatan dengan konsumsi bahan bakar yang relatif boros, baik bekerja pada mesin dengan putaran tinggi. Peneliti terdahulu mengganti knalpot dengan ukuran persepuluh senti meter, sedangkan dalam tugas akhir ini menggunakan perlima sentimeter. Tujuan yang ingin dicapai oleh penulis pada penulisan tugas akhir ini adalah untuk mengetahui penggunaan knalpot free flow terhadap daya dan torsi pada sepeda motor Yamaha Byson 150cc. Tugas akhir ini dilakukan dengan metode pengambilan data uji dari dynotest, menggunakan alat dynotester. Hasil pengujian yaitu pengaruh knalpot free flow ukuran 25 cm, 30 cm dan knalpot standar, menghasilkan peningkatan daya dan torsi paling optimal pada knalpot free flow ukuran 30 cm dengan data daya maksimum sebesar 13,1 HP pada 6750 RPM, dan torsi maksimum mencapai 15,35 Nm pada 4500 RPM, hal ini karena pengaruh panjang silencer dan tanpa adanya hambatan yaitu catalic converter yang membuat nafas kendaraan lebih panjang sehingga mampu mendapatkan puncak daya pada putaran mesin yang lebih tinggi..

Kata kunci: Kata kunci: Knalpot; Torsi; Daya.
Commerce, Food, and Identity in Seventeenth-Century England and France
Authors: Dyk Garritt Van 
Published: October 2023

“Tell me what you eat, and I’ll tell you who you are” was the challenge issued by French gastronomist Jean Brillat-Savarin. Champagne is declared a unique emblem of French sophistication and luxury, linked to the myth of its invention by Dom Pérignon. Across the Channel, a cup of sweet tea is recognized as a quintessentially English icon, simultaneously conjuring images of empire, civility, and relentless rain that demands the sustenance and comfort that only tea can provide. How did these tastes develop in the seventeenth century?
Commerce, Food, and Identity in Seventeenth-Century England and France: Across the Channel offers a compelling historical narrative of the relationship between food, national identity, and political economy in the early modern period. These mutually influential relationships are revealed through comparative and transnational analyses of effervescent wine, spices and cookbooks, the development of coffeehouses and cafés, and the ‘national sweet tooth’ in England and France.
Servants and Servitude in Colonial America
Authors: Lawson Russell M. 
Published: October 2023

Thousands of people arrived in the British-American colonies as indentured servants, transported felons, and kidnapped children forced into bound labor. Others already in America, such as Indians, freedmen, and poor whites, placed themselves into the service of others for food, clothing, shelter, and security; poverty in colonial America was relentless, and servitude was the voluntary and involuntary means by which the poor adapted, or tried to adapt, to miserable conditions. From the 1600s to the 1700s, Blacks, Indians, Europeans, Englishmen, children, and adults alike were indentured, apprenticed, transported as felons, kidnapped, or served as redemptioners.
Though servitude was more multiracial and multicultural than slavery, involving people from numerous racial and ethnic backgrounds, far fewer books have been written about it. This fascinating new study of servitude in colonial America provides the first complete overview of the varied lives of the dispossessed in 17th- and 18th-century America, examining colonial American servitude in all of its forms.
Brewster Buffalo
Authors: Braas Nico 
Published: October 2023

One of the lesser-known fighter aircraft of World War II was the Brewster Buffalo, or, using the U.S. Navy designation system, the F2A. By some historians the Buffalo is regarded as an outright failure, but this is a rating this stubby little fighter did not deserve.
This book presents an overview of the development and operational use of the Buffalo with many photos including a number not published before.