bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seroepidemiology of Toxoplasma gondii infection in blood donors in a population from the northwestern region of São Paulo state, Brazil
Authors: Assoni Letícia Carolina Paraboli , Nakashima Fabiana , de Sousa Valquíria Pardo , Paduan Natália Juliana , Andreasse Isabela Rufino , Anghinoni Thelma Helena , de Faria Junior Geraldo Magela , Ricci Junior Octávio , Castiglioni Lilian , Brandão Cinara Cássia , de Mattos Luiz Carlos , Ayo Christiane Maria 
Published: August 2023

ABSTRACT

Background
Toxoplasmosis is one of the most common parasitic infections worldwide with varying prevalence between human populations. These variations are mainly associated with human exposure to risk factors. In this article, the seroprevalence of Toxoplasma gondii infection and the risk factors associated with infection in 1729 blood donors from São José do Rio Preto, São Paulo, Brazil were analysed.

Methods
The serological tests for detecting immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-T. gondii were used. The risk factors associated with the infection were identified through the application of an epidemiological questionnaire.

Results
The prevalence of T. gondii infection was 48.0%. The following factors were identified in the final model after multiple logistic regression analysis: drinking raw milk (p=0.003; odds ratio [OR] 1.364 [confidence interval {CI} 1.1 to 1.7]), residing in a rural area (p&lt;0.0001; OR 2.764 [CI 1.7 to 4.6]) and receiving a blood transfusion (p=0.015; OR 1.856 [CI 1.1 to 3.0]).

Conclusions
The data obtained in this study showed that the blood donor population is exposed to risk factors related to infection by T. gondii. These data allow the establishment of control programs to contribute to public health in northwestern São Paulo state.
20-year Clinical Outcomes of Cervical Disk Arthroplasty
Authors: Sasso Willa R. , Ye Jason , Foley David P. , Vinayek Sheetal , Sasso Rick C. 
Published: August 2023

Study Design.
Prospective, randomized, controlled trial.

Objective.
To compare clinical outcomes of anterior cervical discectomy and fusion (ACDF) and cervical disk arthroplasty (CDA) at 20 years.

Summary of Background Data.
Concern for adjacent-level disease after ACDF prompted the development of CDA.

Materials and Methods.
Forty-seven patients with single-level cervical radiculopathy were randomized to either BRYAN CDA or ACDF for a Food and Drug Administration Investigational Device Exemption trial. At 20 years, patient-reported outcomes, including visual analog scales (VAS) for neck and arm pain, neck disability index (NDI), and reoperation rates, were analyzed.

Results.
Follow-up rate was 91.3%. Both groups showed significantly better NDI, VAS arm pain, and VAS neck pain scores at 20 years versus preoperative scores. Comparing CDA versus ACDF, there was no difference at 20 years in mean scores for NDI [11.1 (SD 14.1) vs. 19.9 (SD 17.2), P=0.087], mean VAS arm pain [0.9 (SD 2.4) vs. 2.3 (SD 2.8), P=0.095], or mean VAS neck pain [1.2 (SD 2.5) vs. 2.9 (3.3), P=0.073]. There was a significant difference between CDA versus ACDF groups in the change in VAS neck pain score between 10 and 20 years [respectively, −0.4 (SD 2.5) vs. 1.5 (SD 2.5), P=0.030]. Reoperations were reported in 41.7% of ACDF patients and 10.0% of CDA patients (P=0.039).

Conclusions.
Both CDA and ACDF are effective in treating cervical radiculopathy with sustained improvement in NDI, VAS neck and VAS arm pain at 20 years. CDA demonstrates lower reoperation rates than ACDF. There were no failures of the arthroplasty device requiring reoperation at the index level. The symptomatic nonunion rate of ACDF was 4.2% at 20 years. Despite a higher reoperation rate in the CDA group versus ACDF group, there was no difference in the 20-year NDI, VAS Neck, and VAS arm pain scores.
Applications of Near-Infrared Fluorescence Imaging and Angiography of Inferior Vesical Artery in Laparoscopic Lateral Lymph Node Dissection: A Prospective Non-randomized Controlled Study
Authors: Tang Bin , Zhou Sicheng , He Kunshan , Mei Shiwen , Qiu Wenlong , Guan Xu , Liu Fucheng , Chi Chongwei , Wang Xishan , Tian Jie , Liu Qian , Tang Jianqiang 
Published: August 2023

BACKGROUND:
Near-infrared imaging with indocyanine green has been used to guide lateral lymph node dissection, yet its efficacy and benefits need further investigation.

OBJECTIVE:
To investigate the efficacy and feasibility of near-infrared fluorescence imaging and angiography of inferior vesical artery in laparoscopic lateral lymph node dissection.

DESIGN:
A prospective non-randomized controlled study.

SETTINGS:
Single center study

PATIENTS:
Patients with lower rectal cancer who underwent total mesorectal excision plus lateral lymph node dissection.

MAIN OUTCOME MEASURES:
A cohort of 108 patients was enrolled. After propensity score matching, 29 patients in near-infrared group and 50 patients in non-near-infrared group were matched. The total number of harvested lateral lymph nodes, positive lateral lymph nodes, inferior vesical artery preservation, and postoperative urinary function were compared.

RESULTS:
After propensity score matching, the baseline characteristics were similar in both groups. The total number of harvested lateral lymph nodes in the near-infrared group was significantly higher (12 vs 9, p = 0.013), but positive lateral lymph nodes were similar between the two groups (1 vs. 1, p = 0.439). The ratio of inferior vesical artery preservation was significantly increased with the aid of indocyanine green angiography (93.1% vs. 56.0%, p < 0.001). The non-near-infrared group required more days for urinary catheter removal than the near-infrared group (5 vs. 4, p = 0.046). Urinary recatheterization tended to occur more frequently in the non-near-infrared group, with a marginally significant trend (16% vs. 0%, p = 0.059). The non-near-infrared group tended to have more cases with residual urine volume ≥50 ml than that of the near-infrared group (20.0% vs. 3.4%, p = 0.087), especially in the bilateral dissection subgroup (41.2% vs. 0%, p = 0.041).

LIMITATIONS:
Small sample size.

CONCLUSIONS:
Near-infrared imaging increased the number of harvested lateral lymph nodes, while real-time indocyanine green fluorescence angiography ensured the preservation of inferior vesical artery and tended to improve postoperative urinary function.
Calcification of an intraocular lens designed for sutureless scleral fixation in a patient with band keratopathy
Authors: Bundogji Nour , Filios Achilleas , Hawn Vivian S. , Crafoord Sven , Werner Liliana 
Published: August 2023

Introduction:
A case of a calcified Carlevale intraocular lens (IOL), which was explanted or exchanged and underwent laboratory analyses, is reported.

Patient and Clinical Findings:
A 74-year-old pseudophakic man with a history of type 2 diabetes presented with progressive vision changes 2 years after undergoing vitrectomy and implantation of a Carlevale IOL in the right eye due to previous subluxation of a 3-piece lens. Slitlamp examination was significant for mild band keratopathy and a diffusely opacified Carlevale IOL.

Diagnosis, Intervention, and Outcomes:
The opacified IOL was explanted and exchanged for an Artisan IOL, with posterior enclavation. Grossly, the explanted IOL exhibited extensive and diffuse deposits/crusts throughout its surface, causing opacification. Scanning electron microscopy coupled with surface analysis confirmed that the deposits/crusts were composed of calcium/phosphate.

Conclusions:
To the authors' knowledge, this is the first reported case of an opacified Carlevale IOL that underwent laboratory analysis confirming calcification. Alteration in calcium homeostasis that may accompany the diabetic state may represent a contributing factor to the band keratopathy and IOL calcification in this case.
The Experiences of Black Students in Physical Therapy Education in Texas: A Qualitative Study
Authors: Bakouetila-Martin Mercia , Duke Brittney , Pantoja-Aming Andrea , Alfaro Sarah , Williams Stephanie , Mbah Nkechi , Marie Lucero-Schoenfeld Amy , Ossai Uchenna , Hale Jennifer 
Published: August 2023

Introduction.
Racial or ethnic minorities are underrepresented in many health care professions, including physical therapy. Understanding the experiences of minority students in graduate education provides insight into how physical therapy educational programs can promote diversity, equity, and inclusion, which are factors that have been shown to improve patient outcomes. The purpose of this study is to qualitatively analyze and describe the lived experiences of Black student physical therapists (PT) in Texas.

Review of Literature.
Currently, there is a lack of qualitative research that investigates the experiences of Black students in physical therapy education in the United States.

Subjects.
Nineteen Doctor of Physical Therapy students from 8 different physical therapy educational programs in Texas.

Methods.
This qualitative study was conducted using a phenomenological approach. All participants took part in a focus group regarding their academic experiences. Students' dialogues were recorded and transcribed, and the researchers identified recurrent themes.

Results.
After the analysis of focus group content, it was determined that the following 5 themes characterized the students’ experiences: 1) Barriers to enrollment, 2) underrepresentation, 3) implicit and explicit racism, 4) code-switching, and 5) desired image.

Discussion and Conclusion.
There is evidence to suggest that Black or African American students are subject to unique pressures that negatively affect their experiences during their PT education. Efforts need to be made by higher education institutions and individuals to provide a more inclusive environment to best support those students. By gaining awareness of the results of this study, educators and students can begin dialogues on how to foster inclusivity and cultural understanding in physical therapy education. Ultimately, understanding the experiences of others can improve how individuals coexist in an increasingly diverse society, and how clinicians provide patient-centered, culturally aware care to patients and clients.
A Continuous Quality Improvement Framework for Sustainable Action and Advancement of Diversity, Equity, Inclusion, and Belonging in Physical Therapy
Authors: Kiami Sheri R. , Hayward Lorna , Goodgold Shelley 
Published: August 2023

Background and Purpose.
To address racial and ethnic disparities, physical therapy organizations, educational institutions, and clinical practices seek to advance diversity, equity, inclusion (DEI), and social justice in health care. Although our professional organizations have crafted proclamations, resource lists, developed new accreditation standards, and strategic plans, we lack a unifying framework and action tools for substantial and sustained progress. In addition, the DEI acronym is missing the essential element of belonging (B), that is, sharing a sense of purpose and feeling safe to contribute opinions as a valued member of an organization. Therefore, the purpose of this position paper is to propose the utilization of a continuous quality-improvement (CQI) framework using Plan-Do-Study-Act (PDSA) cycles to advance DEI-B in physical therapy education and practice.

Position and Rationale.
The CQI framework and PDSA cycles are data-driven, iterative approaches for identifying areas for improvement, implementing interventions, collecting data, analyzing outcomes, and taking evidence-based next action steps. Application of this framework can enhance sustainability of DEI-B goals and foster progress toward the proposed accreditation criteria of the Commission on Accreditation in Physical Therapy Education in this critical area. Tenants for PDSA team success are presented, and PDSA cycles are described.

Discussion and Conclusion.
Addressing racism and advancing DEI-B efforts in the physical therapy profession requires bold, sustained, and intentional action that incorporates standards, strategies, and methods for measuring change. Examples of PDSA DEI-B initiatives, interventions, and outcomes are provided to illustrate how this approach can be implemented within a physical therapy education program. Using this CQI framework provides our profession with a DEI-B roadmap for advancing incremental and sustained progress.
Upper Gastrointestinal Neoplasia and Worrisome Thyroid Nodules are Common in Colonic Polyposis of Unknown Etiology (CPUE)
Authors: Hajj Ali Adel , Burke Carol A. , O’Malley Margaret , LaGuardia Lisa , Liska David , Macaron Carole 
Published: August 2023

Background:
Colonic polyposis of unknown etiology (CPUE) is defined as ≥10 cumulative colonic adenomas without a detectable germline pathogenic variant. Surveillance for patients with >100 adenomas is recommended, similar to patients with familial adenomatous polyposis. The utility of extra-colonic screening in patients with 10 to <100 adenomas is not well established.

Methods:
All CPUE patients seen at our center between 2003 and 2022 were included. Patients were categorized based on the range of cumulative colorectal adenoma count: 10 to 19, 20 to 99, and ≥100.

Results:
In all, 150 patients were identified of which 20(13.3%) had 10 to 19 cumulative adenomas, 79(52.7%) had 20 to 99 adenomas, and 51(34.0%) had ≥100 adenomas. Compared with patients with 10 to 19 and 20 to 99, patients with ≥100 adenomas were younger (mean 51 vs. 52 vs. 42 y, respectively). Of patients who underwent esophagogastroduodenoscopy, duodenal adenomas were found in 33.3%, 10.1%, and 38% in the 3 groups, respectively, P=0.002. Ampullary adenomas were significantly more common in the ≥100 adenoma group (14.8%, P=0.019) compared with 8.3% and 2.9% in the 10 to 19 and 20 to 99 groups, respectively. Thyroid nodules ≥1 cm were not detected in patients with 10 to 19 adenomas but were found in 23.3% and 14.3% of patients with 20 to 99 and ≥100 adenomas, respectively (P=0.254).

Conclusion:
In our cohort, duodenal and gastric adenomas occurred in CPUE patients with adenoma count 10 to ≥100 at a relatively high proportion. We recommend a baseline esophagogastroduodenoscopy in all patients with CPUE. While clinically significant thyroid nodules were not detected in patients with 10 to 19 adenomas, they occurred in about one-fifth of the patients with ≥20 adenomas, indicating that thyroid ultrasound is prudent.
Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions
Authors: Chambers Tom , Bamber Harry , Singh Nanak 
Published: August 2023

Purpose of review
Obstructive sleep apnoea (OSA) is an increasingly common pathology that all those involved in perioperative care will come across. Patients with the condition present a challenge at many stages along the perioperative journey, not least because many patients living with OSA are unaware of their diagnosis.
Key interventions can be made pre, intra-, and postoperatively to improve outcomes. Knowledge of screening tools, diagnostic tests, and the raft of treatment options are important for anyone caring for these patients.

Recent findings
Recent literature has highlighted the increasing complexity of surgical patients and significant underdiagnosis of OSA in this patient population. Work has demonstrated how and why patients with OSA are at a higher perioperative risk and that effective positive airways pressure (PAP) therapy can reduce these risks, alongside evidencing how best to optimise adherence to therapy, a key issue in OSA.

Summary
OSA, and particularly undiagnosed OSA, presents a huge problem in the perioperative period. Perioperative PAP reduces the risk of postoperative complications but adherence remains an issue. Bespoke perioperative pathways should be developed to identify and optimise high risk patients, although at present evidence on how best to achieve this is lacking.
Efficacy of 3rd generation TKI in patients with EGFR mutation lung adenocarcinoma with bone metastases: A review of 3 case reports and literature
Authors: Guo Qiang , Feng Weiqiang , Hu Sheng , Ye Jiayue , Wang Silin , Su Lang , Zhang Yang , Zhang Deyuan , Zhang Wenxiong , Xu Jianjun , Wei Yiping 
Published: August 2023

Rationale:
With the advancement of targeted therapies, epidermal growth factor receptor tyrosine kinase inhibitors have become the preferred initial treatment for patients with advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer. Osimertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor, is effective against exon 19 and 21 mutations as well as the T790M mutation. It has been approved by both the food and drug administration and European Medicines Agency for the treatment of non-small cell lung cancer patients with locally advanced or metastatic EGFR-mutated tumors, including those who have acquired T790M mutations.

Patient concerns:
To evaluate the effectiveness of osimertinib in treating patients with EGFR-mutated advanced lung adenocarcinoma and bone metastases, we present the treatment outcomes of 3 patients with EGFR 19 deletion-mutated advanced lung adenocarcinoma and bone metastases who received osimertinib treatment in recent years. All 3 cases involved elderly female patients, aged 62, 62, and 54, respectively.

Diagnoses:
All 3 cases exhibited a diagnosis of pulmonary adenocarcinoma accompanied by osseous metastases, with genetic testing revealing the presence of an EGFR 19del mutation.

Interventions:
In the first case, following 17 months of gefitinib therapy, disease progression prompted a switch to osimertinib treatment. In the second case, bone metastases were detected after 20 months of pemetrexed-carboplatin chemotherapy, leading to a transition to osimertinib therapy. In the third case, after 11 months of erlotinib treatment, bone metastases were identified. Subsequent interventions, including radiation therapy, pemetrexed-carboplatin chemotherapy, pemetrexed-bevacizumab maintenance therapy, and docetaxel chemotherapy, failed to arrest the progression of bone metastases. As a result, a combination of osimertinib and anlotinib targeted therapy was administered.

Outcomes:
All 3 patients experienced relatively good and favorable survival outcomes, with a progression-free survival of 22.7 months, 12 months, and 17.7 months, respectively.

Lessons:
These cases suggest that osimertinib is a promising treatment option for patients with EGFR 19 deletion-mutated lung adenocarcinoma and bone metastases, although further clinical studies are needed to confirm its efficacy.
Identification of the key mechanisms of action of Si-Ni-San in uveitis using bioinformatics and network pharmacology
Authors: Zhang Dandan , Hong Liu , Zhang Rui Su , Zhang Qian , Yao Jing , Wang Jiadi , Zhang Ning 
Published: August 2023

Background:
Uveitis is an eye disease with a high rate of blindness, whose pathogenesis is not completely understood. Si-Ni-San (SNS) has been used as a traditional medicine to treat uveitis in China. However, its mechanism of action remains unclear. This study explored the potential mechanisms of SNS in the treatment of uveitis through network pharmacology and bioinformatics.

Methods:
Using R language and Perl software, the active components and predicted targets of SNS, as well as the related gene targets of uveitis, were mined through the Traditional Chinese Medicine Systems Pharmacology, Therapeutic Target, Gene Expression Omnibus, GeneCards, and DrugBank databases. The network diagram of active components and intersection targets was constructed using Cytoscape software and the String database. The CytoNCA plug-in was used to conduct topological analysis on the network diagram and screen out the core compounds and key targets. The genes were analyzed for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment. Chemoffice, Pymol, AutoDock, and Vina were used to analyze the molecular docking of key targets and core compounds of diseases through the PubChem database.

Results:
JUN, RELA, and MAPK may play important roles in the treatment of uveitis by SNS. Kyoto encyclopedia of genes and genomes pathway enrichment analysis showed that core genes were mainly concentrated in MAPK, toll-like receptor, tumor necrosis factor, and nucleotide oligomerization domain-like receptor signaling pathways. In addition, molecular docking results showed that the bioactive compounds (kaempferol, luteolin, naringin, and quercetin) exhibited good binding ability to JUN, RELA, and MAPK.

Conclusion:
Based on these findings, SNS exhibits multi-component and multi-target synergistic action in the treatment of uveitis, and its mechanism may be related to anti-inflammatory and immune regulation.
Expression and prognostic value of AIM1L in esophageal squamous cell carcinoma
Authors: Zhou Lu , Gan Lanlan , Liu Zongwen 
Published: August 2023

Background:
Absent in melanoma 1-like (AIM1L), also known as crystalline beta gamma domain containing 2. The relationship between AIM1L and tumors has not been fully investigated, and the biological function of AIM1L in different tumors is unknown, so we bioinformatically explored a possible relationship between AIM1L and esophageal squamous cell carcinoma (ESCC).

Methods:
AIM1L mRNA expression was detected by the Gene Expression Omnibus database (GSE20347, GSE161533, and GSE53625), and protein level expression was detected by immunohistochemistry. The correlation between AIM1L expression and clinical pathological characteristics was evaluated by the Wilcoxon signed rank test or chi-square test. Kaplan–Meier analysis and Cox proportional risk regression model were used to determine the prognostic value of AIM1L in ESCC patients and establish and verify a nomogram. Find genes highly related to the expression of AIM1L, conduct GO and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis, and conduct GSEA analysis on the gene set. The “CIBERSORT” R package was used to explore the relationship between AIM1L and immune infiltration, and the “OncoPredict” R package was used to explore the relationship between AIM1L and drug sensitivity.

Results:
Compared with the matched adjacent non-cancer tissues, the expression of AIM1L was down-regulated in ESCC tissues, and correlated with tumor grade. Kaplan–Meier survival analysis and Cox analysis showed that the low expression of AIM1L was related to the poor prognosis of ESCC patients. Enrichment analysis explained the possible function of AIM1L, GSEA determined the highly correlated signal pathway of AIM1L low expression phenotype, immune infiltration analysis determined that AIM1L was related to activated NK cells and macrophage M2, and drug sensitivity analysis determined that the low expression of AIM1L might be related to EGFR targeted drug resistance.

Conclusion:
AIM1L may be a candidate tumor suppressor gene for ESCC and an independent molecular biomarker for the prognosis of ESCC patients.