bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ruptured isolated spinal artery aneurysms: Case series of five patients and a review of the literature on management strategies
Authors: McGuire Laura Stone , Fuentes Angelica , Charbel Fady T , Alaraj Ali , Amin-Hanjani Sepideh 
Published: January 2023

Background Aneurysms of the spinal arteries are rare entities, the majority of which are associated with other vascular lesions, such as spinal vascular malformations. Isolated spinal artery aneurysms (SAAs) are even less frequently encountered, and their incidence is largely unknown, as the literature is limited to case reports and small series. The optimal management strategy for SAAs is not well defined. Objective To review the institutional experience of five patients with isolated SAAs. Methods Five cases of isolated SAAs were identified at our institution, including two cases with multiple simultaneous SAAs. Clinical presentation, imaging, and management strategies for each case were reviewed. A literature review of all SAAs reported between 1950 and 2020 was performed. Results A total of five patients with eight isolated SAAs presented to our institution: one aneurysm was lumbar in location, while the remaining seven were thoracic. Two patients were treated with glue embolization followed by laminectomy for hematoma evacuation; one was treated with only surgery; and the other two, which both had multiple lesions, were managed conservatively with interval complete regression of their aneurysms. All five patients had good neurological outcomes. Literature review found 124 patients with at least 137 isolated SAAs and revealed treatment strategies including conservative management, glue or coil embolization, muslin wrapping, and surgical resection or clipping. Conclusion Multiple management strategies exist for SAAs, and clinical consideration of patient presentation and lesion morphology determine appropriate strategy. Our case series demonstrates three of these treatment paradigms.
Phylogenetic analysis of Prevotella copri from fecal and mucosal microbiota of IBS and IBD patients
Authors: Lo Presti Alessandra , Del Chierico Federica , Altomare Annamaria , Zorzi Francesca , Monteleone Giovanni , Putignani Lorenza , Angeletti Silvia , Cicala Michele , Guarino Michele Pier Luca , Ciccozzi Massimo 
Published: January 2023

Background: Prevotella copri is the most abundant member of the genus Prevotella that inhabits the human large intestines. Evidences correlated the increase in Prevotella abundance to inflammatory disorders, suggesting a pathobiont role. Objectives: The aim of this study was to investigate the phylogenetic dynamics of P. copri in patients with irritable bowel syndrome (IBS), inflammatory bowel diseases (IBDs) and in healthy volunteers (CTRL). Design: A phylogenetic approach was used to characterize 64 P. copri 16S rRNA sequences, selected from a metagenomic database of fecal and mucosal samples from 52 patients affected by IBD, 44 by IBS and 59 healthy. Methods: Phylogenetic reconstructions were carried out using the maximum likelihood (ML) and Bayesian methods. Results: Maximum likelihood phylogenetic tree applied onto reference and data sets, assigned all the reads to P. copri clade, in agreement with the taxonomic classification previously obtained. The longer mean genetic distances were observed for both the couples IBD and CTRL and IBD and IBS, respect to the distance between IBS and CTRL, for fecal samples. The intra-group mean genetic distance increased going from IBS to CTRLs to IBD, indicating elevated genetic variability within IBD of P. copri sequences. None clustering based on the tissue inflammation or on the disease status was evidenced, leading to infer that the variability seemed to not be influenced by concomitant diseases, disease phenotypes or tissue inflammation. Moreover, patients with IBS appeared colonized by different strains of P. copri. In IBS, a correlation between isolates and disease grading was observed. Conclusion: The characterization of P. copri phylogeny is relevant to better understand the interactions between microbiota and pathophysiology of IBD and IBS, especially for future development of therapies based on microbes (e.g. probiotics and synbiotics), to restore the microbiota in these bowel diseases.
Investigation of the relationship between rational drug use and healthy lifestyle behaviours of university students
Authors: Aslan Sinan , Çinar Ercan , Ertürk Nuriye EFE , Baysal Peyda 
Published: January 2023

Aim: the aim of this research is to investigate the relationship between rational drug use and healthy lifestyle behaviours of university students. Method: this descriptive and cross-sectional study consisted of 1115 students from a university in the Southeast-East Anatolia Region in the autumn semester of the 2019–2020 academic year. In the collection of data, ‘Student Introduction Form’, ‘The Rational Drug Use Scale’ and ‘The Health-Promoting Lifestyle Profile II’ were used. Ethical approval was obtained from the Batman University Ethics Committee. In addition, necessary legal permissions were obtained from the institution where the study was conducted and from the students. Descriptive statistics, number, percentage, independent t-test, ANOVA test and Spearman’s rank correlation were used in the Statistical Package for Social Science (SPSS) 22.0 package software to analyse the data. Results: the average age of the students was 21.31 ± 2.37 years, and their monthly drug expenditure was 142.63 ± 157.200 Turkish Lira. Some 28.1% of them were third-year students, 59% had graduated from Anatolian high school, 59.6% were living with their nuclear family, 49.1% had an equal level of income and expenditure, 7.7% had no chronic disease, and 9% had regular medication. Some 57.8% of them had health insurance. The Health-Promoting Lifestyle Profile II scale mean score of the students was 124.12 ± 21.37 and the Rational Drug Use Scale mean score was 33.65 ± 6.75. A statistically significant difference was found between the students’ class, income, and the total mean scores of the health-promoting lifestyle profile II scale ( p < 0.05). A statistically significant difference was found between the school type, family type and income status of the students and the total mean scores of the rational drug use scale ( p < 0.05). Conclusion: a strong positive correlation was found between rational drug use scale and the health-promoting lifestyle profile II scales.
Closing-Wedge Posterior Tibial Slope–Reducing Osteotomy in Complex Revision ACL Reconstruction
Authors: Vivacqua Thiago , Thomassen Stephan , Winkler Philipp W. , Lucidi Gian A. , Rousseau-Saine Alexis , Firth Andrew D. , Heard Mark , Musahl Volker , Getgood Alan M.J. 
Published: January 2023

Background: A posterior tibial slope (PTS) >12° has been shown to correlate with failure of anterior cruciate ligament (ACL) reconstruction (ACLR). PTS-reducing osteotomy has been described to correct the PTS in patients with a deficient ACL, mostly after failure of primary ACLR. Purpose: To report radiologic indices, clinical outcomes, and postoperative complications after PTS-reducing osteotomy performed concurrently with revision ACLR (R-ACLR). Study Design: Case series; Level of evidence, 4. Methods: A review of medical records at 3 institutions was performed of patients who had undergone PTS-reducing osteotomy concurrently with R-ACLR between August 2010 and October 2020. Radiologic parameters recorded included the PTS, patellar height according to the Caton-Deschamps Index (CDI), and anterior tibial translation (ATT). Patient-reported outcomes (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS]), reoperations, and complications were evaluated. Results: Included were 23 patients with a mean follow-up of 26.7 months (range, 6-84 months; median, 22.5 months). Statistically significant differences from preoperative to postoperative values were found in PTS (median [range], 14.0° [12°-18°] vs 4.0° [0°-15°], respectively; P < .001), CDI (median, 1.00 vs 1.10, respectively; P = .04) and ATT (median, 8.5 vs 3.6 mm, respectively; P = .001). At the final follow-up, the IKDC score was 52.4 ± 19.2 and the KOOS subscale scores were 81.5 ± 9.5 (Pain), 74 ± 21.6 (Symptoms), 88.5 ± 8 (Activities of Daily Living); 52.5 ± 21.6 (Sport and Recreation), and 48.8 ± 15.8 (Quality of Life). A traumatic ACL graft failure occurred in 2 patients (8.7%). Reoperations were necessary for 6 patients (26.1%) because of symptomatic hardware, and atraumatic recurrent knee instability was diagnosed in 1 patient (4.3%). Conclusion: Tibial slope–reducing osteotomy resulted in a significant decrease of ATT and can be considered in patients with a preoperative PTS ≥12° and ≥1 ACLR failure. In highly complex patients with multiple prior surgeries, the authors found a reasonably low graft failure rate (8.7%) when utilizing PTS-reducing osteotomy. Surgeons must be aware of potential complications in patients with multiple previous failed ACLRs.
Does social desirability of entrepreneurship matter for early-stage entrepreneurs’ internationalization? The moderating role of economic freedom
Authors: Capelleras Joan-Lluís , Martin-Sanchez Victor , Zhang Chao 
Published: January 2023

Based on an institutional perspective, this study examines the influence of the social desirability of entrepreneurship on early-stage entrepreneurs’ internationalization and the moderating role of home country economic freedom. Using data from 45,454 early-stage entrepreneurs in 48 countries for the period 2005–2016, we find that the social desirability of entrepreneurship negatively affects early-stage entrepreneurs’ internationalization, and that economic freedom positively moderates this relationship. The study contributes to the literature by showing how the home country institutional context affects the level of early-stage entrepreneurs’ internationalization across countries. JEL CLASSIFICATION: F23; L26; O17
SBNO2 is a critical mediator of STAT3-driven hematological malignancies
Authors: Brandstoetter Tania , Schmoellerl Johannes , Grausenburger Reinhard , Kollmann Sebastian , Doma Eszter , Huuhtanen Jani , Klampfl Thorsten , Eder Thomas , Grebien Florian , Hoermann Gregor , Zuber Johannes , Mustjoki Satu , Maurer Barbara , Sexl Veronika 
Published: January 2023

Abstract
Gain-of-function mutations in the signal transducer and activator of transcription 3 (STAT3) gene are recurrently identified in patients with large granular lymphocytic leukemia (LGLL) and in some cases of natural killer (NK)/T-cell and adult T-cell leukemia/lymphoma. To understand the consequences and molecular mechanisms contributing to disease development and oncogenic transformation, we developed murine hematopoietic stem and progenitor cell models that express mutated STAT3Y640F. These cells show accelerated proliferation and enhanced self-renewal potential. We integrated gene expression analyses and chromatin occupancy profiling of STAT3Y640F-transformed cells with data from patients with T-LGLL. This approach uncovered a conserved set of direct transcriptional targets of STAT3Y640F. Among these, strawberry notch homolog 2 (SBNO2) represents an essential transcriptional target, which was identified by a comparative genome-wide CRISPR/Cas9-based loss-of-function screen. The STAT3-SBNO2 axis is also present in NK-cell leukemia, T-cell non-Hodgkin lymphoma, and NPM-ALK-rearranged T-cell anaplastic large cell lymphoma (T-ALCL), which are driven by STAT3-hyperactivation/mutation. In patients with NPM-ALK+ T-ALCL, high SBNO2 expression correlates with shorter relapse-free and overall survival. Our findings identify SBNO2 as a potential therapeutic intervention site for STAT3-driven hematopoietic malignancies.
Lockdown stringency and employment formality: evidence from the COVID-19 pandemic in South Africa
Authors: Köhler Timothy , Bhorat Haroon , Hill Robert , Stanwix Benjamin 
Published: January 2023

AbstractIn response to COVID-19 most governments used some form of lockdown policy to manage the pandemic. This required making iterative policy decisions in a rapidly changing epidemiological environment resulting in varying levels of lockdown stringency over time. While studies estimating the labour market effects of lockdown policies exist in both developed and developing countries, there is limited evidence on the impact of variation in lockdown stringency, particularly in developing countries. Such variation may have large heterogenous effects both on aggregate and between worker groups. In this paper, we estimate the causal effect of lockdown stringency on employment probabilities, adopting a quasi-experimental design on unique labour force panel data from South Africa. South Africa is a useful case study given its upper-middle-income status and relatively small informal sector, thus serving as an example to a variety of developing and developed country economies. We find that the negative employment effects of the country’s lockdown policy were driven by effects on the informal sector. Furthermore, we observe important effect heterogeneity by employment formality as the stringency of the country’s lockdown regulations changed over time. We find that more stringent lockdown levels negatively affected informal, but not formal sector employment, while less stringent levels negatively affected formal, but not informal sector employment. From a policy perspective, evidence of such heterogeneity can inform decisions around the optimal targeting of support as the pandemic progresses and lockdown policies are reconsidered.
Causes of endoscopic misdiagnosis of gastrointestinal cyst as solid lesion
Authors: Gao Fei , Li Huikai , Du Chen , Han Ke , Linghu Enqiang 
Published: January 2023

Abstract
Background
To explore the causes of endoscopic misdiagnosis of gastrointestinal cyst as solid lesion and the diagnostic value and limitations of EUS, guide clinicians to develop appropriate treatment strategies and improve the ability to identify SMT.

Methods
We enrolled patients diagnosed with gastrointestinal SMT between January 2001 and December 2021 who underwent endoscopic resection with postoperative pathological diagnosis of cyst. Age, sex, maximum lesion diameter, judge the texture of lesion, origin and echo are potential factors affecting the diagnostic accuracy of cysts.

Results
The diagnostic accuracy of EUS assessment 39.3% higher than that without EUS assessment (6.7%). The error rate was 60.7%, lower than that without EUS assessment (93.3%), suggesting that preoperative EUS assessment improved the diagnostic accuracy of gastrointestinal cyst (Fisher's accurate test, P = 0.033). The diagnostic accuracy of “judge the texture of lesion” was higher than that of no touch (P = 0.031). When the lesion size increased by 1 cm, the diagnostic accuracy decreased by about 21%. Hypoechoic lesions were less likely to be diagnosed correctly than anechoic lesions (P = 0.003).

Conclusions
The main cause of misdiagnosing gastrointestinal cyst as solid lesion is that no EUS assessment was performed before endoscopic resection or anechoic lesion was judged as hypoechoic lesion by preoperative EUS assessment.
SPATS2 is correlated with cell cycle progression and immune cells infiltration in hepatocellular carcinoma
Authors: Lin Jing , Yan Jia , Deng Xiu ling , Wang Chang shan , Wang Hai sheng 
Published: January 2023

AbstractThe spermatogenesis associated serine rich 2 (SPATS2) is a member of RNA-binding protein in which the abnormal expression is linked with carcinogenesis in serval types of cancer. However, there is no systematic study on the differential expression, prognostic significance, epigenetic regulation, immune infiltration of SPATS2 in hepatocellular carcinoma (HCC). In the present study, we investigated the expression, prognosis, epigenetic regulation, and immune cell infiltration of SPATS2 in HCC. We found that the elevated expression of SPATS2 was unfavorably associated with the clinical pathological stage and prognosis. Functional enrichment analysis revealed that SPATS2 is associated with cell cycle, apoptosis and cancer cell metastasis processes in HCC. Our results confirmed that knockdown of SPATS2 will affect cell cycle, apoptosis and invasion of HCC cell lines. Moreover, the expression of SPATS2 is upregulated by epigenetic regulation, including DNA methylation, m6A and histone modification in HCC. In addition, SPATS2 expression was positively correlated with immune cell infiltration or expression of immune related gene markers in HCC. Taken together, our data demonstrated that SPATS2 is associated with progression and immune infiltration, and could serve as a prognostic biomarker for HCC. In conclusion, these results highlight the potential of SPATS2 to be used as a therapeutic target for HCC.
Short and long-term follow-up and clinical outcomes in patients with celiac disease in a large private practice setting
Authors: Khurana Akash , Leffler Daniel A. , Gomez Kayeromi , Thukral Chandrashekhar 
Published: January 2023

Abstract
Background
Celiac disease (CD) is caused by an immune response to gluten and treatment is adherence to a gluten-free diet. Guidelines from studies in large academic settings recommend registered dietitian (RD) referrals at time of diagnosis and periodic testing for micronutrient deficiencies. There is limited data to guide follow-up parameters in a large, community-based practice. The purpose of this study was to evaluate guideline adherence in this setting.

Methods
This retrospective study conducted in 2019 assessed CD care based on follow-up rates, micronutrient testing, symptoms, and serology results in cohorts with and without RD referrals. Patients in this study were followed at Rockford Gastroenterology Associates (RGA): a large, private GI practice. Patients were included if they had a diagnosis of CD from 1/2014 through 12/2018, based on positive serology and/or duodenal biopsy. Patient data was collected by chart review and analyzed through Microsoft Excel. Fisher’s exact and Chi-square tests were used for the statistical analysis and were calculated through the Statistical Product and Service Solutions (SPSS) software.

Results
320 patients were initially reviewed and a cohort of 126 patients met inclusion criteria. 69.8% had a RD referral. 65.9% had at least one lab test order for any of the 6 micronutrients. Of 63 patients tested for iron, 11 were iron deficient (8 with RD referral). Of 64 patients tested for vitamin D, 21 were deficient (17 with referral). 80.2% attended at least one follow-up appointment, but 34.9% had only one follow-up visit over a mean follow up duration of 5.82 months. 79 patients had follow-up data for symptoms or serology and were separated into 4 categories (with vs. without RD referral): (1) asymptomatic and negative serology (32% vs. 26%), (2) symptomatic and negative serology (28% vs. 16%), (3) asymptomatic and positive serology (27% vs. 32%), (4) symptomatic and positive serology (13% vs. 26%). Category 1 yielded a fisher exact test value of 2.62 (p = 0.466).

Conclusions
RD referral, micronutrient testing, and close follow-up are important parameters that affect outcomes in patients with CD. Rates for dietitian referral, some micronutrient testing and follow-up visits were higher than 50%, though results from this study were not statistically significant. Further standardization of follow-up testing and monitoring for CD will help minimize discrepancies between community-based and large, academic GI practices.
Transradial versus transfemoral approach for TACE: a retrospective study
Authors: You Ke , Guo Tao , Sun Da , Song Hao , Liu Zuojin 
Published: January 2023

Abstract
Objective
Transcatheter arterial chemoembolization (TACE) has been widely applied in the treatment of hepatocellular carcinoma (HCC). Our study aimed to investigate the feasibility and efficacy of transradial access as an alternative to transfemoral access for TACE.

Methods
Patients undergoing TACE were divided into the radial artery (RA) route group or the femoral artery (FA) route group according to the operation approach, namely, transradial or transfemoral access. We retrospectively analysed the clinical characteristics, technical outcomes, clinical efficacy and incidence of adverse events to compare the two technologies for intervention for HCC.

Results
Transradial access was found to achieve superior technical outcomes and clinical efficacy, as the patients in the RA group had a lower rate of hepatic arterial spasm, a higher partial response rate and a lower progression rate than the patients in the FA group according to the mRECIST evaluations. In contrast, the liver function indices and VAS (visual analogue scale) pain scores were consistent across the two groups. Moreover, patients in the RA group had a shorter length of stay than those in the FA group, despite similar hospitalization expenses. The total adverse events were significantly reduced by transradial access for TACE (72.5% vs. 84.1%, P = 0.027).

Conclusion
Our study suggested that transradial access is an effective and feasible alternative to transfemoral access for TACE. Large-scale prospective randomized controlled studies are expected.
Lethality risk markers by sex and age-group for COVID-19 in Mexico: a cross-sectional study based on machine learning approach
Authors: Rojas-García Mariano , Vázquez Blanca , Torres-Poveda Kirvis , Madrid-Marina Vicente 
Published: January 2023

Abstract
Background
Mexico ranks fifth worldwide in the number of deaths due to COVID-19. Identifying risk markers through easily accessible clinical data could help in the initial triage of COVID-19 patients and anticipate a fatal outcome, especially in the most socioeconomically disadvantaged regions. This study aims to identify markers that increase lethality risk in patients diagnosed with COVID-19, based on machine learning (ML) methods. Markers were differentiated by sex and age-group.

Methods
A total of 11,564 cases of COVID-19 in Mexico were extracted from the Epidemiological Surveillance System for Viral Respiratory Disease. Four ML classification methods were trained to predict lethality, and an interpretability approach was used to identify those markers.

Results
Models based on Extreme Gradient Boosting (XGBoost) yielded the best performance in a test set. This model achieved a sensitivity of 0.91, a specificity of 0.69, a positive predictive value of 0.344, and a negative predictive value of 0.965. For female patients, the leading markers are diabetes and arthralgia. For males, the main markers are chronic kidney disease (CKD) and chest pain. Dyspnea, hypertension, and polypnea increased the risk of death in both sexes.

Conclusions
ML-based models using an interpretability approach successfully identified risk markers for lethality by sex and age. Our results indicate that age is the strongest demographic factor for a fatal outcome, while all other markers were consistent with previous clinical trials conducted in a Mexican population. The markers identified here could be used as an initial triage, especially in geographic areas with limited resources.