bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management strategies and root causes of missed iatrogenic intraoperative ureteral injuries with delayed diagnosis: a retrospective cohort study of 40 cases
Authors: Zaghbib Selim , Saadi Ahmed , Boussaffa Hamza , Ayed Haroun , Slama Mohamed Riadh Ben 
Published: July 2023

Abstract
Background
Intraoperative iatrogenic ureteral injuries represent rare technical surgical complications with the potential for adverse patient outcomes, particularly when the diagnosis is delayed. Ideally, these technical complications are recognized and repaired intraoperatively. This study was designed to investigate the root causes and outcomes of missed intraoperative ureteral injuries at a tertiary urology referral centre in Tunisia.

Methods
This is a retrospective cohort study in a tertiary urology referral centre in Tunis from January 1st, 2015, to December 31st, 2020, including all patients with iatrogenic ureteral injury, not diagnosed intraoperatively. The factors associated with the success of endoscopic treatment and those associated with the unfavourable evolution were investigated.

Results
A total of 40 iatrogenic ureteral injuries were included. Gynaecological surgery was responsible for 85% of ureteral injuries, mainly during hysterectomies (55%). The symptoms were dominated by low back pain (37.5%) and pyelonephritis (25%). Endoscopic treatment was attempted in 22 cases, it was sufficient in 12 cases. Ureteral injury required surgical treatment in 24 cases, and ureteroneocystostomy was performed in 16 cases. Nephrectomy was performed in eight cases, representing 20% of injuries, including three cases as the first treatment for late-diagnosed cases with a destroyed kidney. In the analytical study, endoscopic treatment was sufficient in 50% in case of ureteral fistula versus 27% in case of ureteral stenosis (p = 0.04). Nephrectomy was performed in 10% of cases when ureteral injury was diagnosed within the first month postoperatively compared to 60% of cases when this delay exceeded one month (p = 0.004).

Conclusion
Iatrogenic ureteral injuries discovered postoperatively are mostly secondary to gynaecologic surgery. Although endoscopic treatment is usually performed as a first treatment, a more aggressive surgical is often necessary, with a nephrectomy rate of 20%.
Changes in the production materials of Burmese textiles in the nineteenth century—dyes, mordants and fibres of Karen garments from the British Museum’s collection
Authors: Tamburini Diego , Dyer Joanne , Cartwright Caroline , Green Alexandra 
Published: July 2023

Abstract
The materials of six Karen textiles from the British Museum’s collection were investigated with the main aim of studying the production changes over the course of the nineteenth century and how these changes related to local and colonial trade networks. The textiles span chronologically from the 1830s to the early 1900s according to their attribution dates, and include traditional garments such as tunics and skirts, in addition to representing a broad colour palette and different dyeing and weaving techniques. The investigation was conducted non-invasively by using digital microscopy, broadband multispectral imaging (MSI) and fibre optic reflectance spectroscopy (FORS). The results guided a sampling campaign during which samples were taken and investigated by optical microscopy (OM), scanning electron microscopy energy dispersive X-ray spectrometry (SEM–EDX) and high-performance liquid chromatography coupled to diode array detector and tandem mass spectrometry (HPLC–DAD-MS/MS). Local natural dyes, such as red and yellow from Morinda citrifolia, lac dye (Kerria lacca), gamboge (Garcinia sp.), turmeric (Curcuma longa), indigo and tannins were found in the older textiles, supporting a possible early production, whereas mixtures of natural and synthetic dyes, including synthetic alizarin (CI 58000), rhodamine B (CI 45170), orange I (CI 14600), diamond green B (CI 42000), diamond green G (CI 42040), auramine O (CI 41000), naphthol yellow S (CI 10316), chrysamine G (CI 22250), crystal violet (CI 42555) and Pigment Red 53:1 (CI 15585:1) were identified in the later textiles. Observations on mordants revealed the use of aluminium, tin and chrome, whereas fibre characterisation highlighted the use not only of cotton (Gossypium sp.) but also of felted wool imported from Europe and Chinese silk dyed with the Chinese cork tree (Phellodendron chinense) yellow dye. The results draw an interesting picture of the introduction of new dyeing materials and techniques in Myanmar over the nineteenth century, and how these impacted the production of traditional Karen textiles.
Exploration of a crucial mechanical property of gap-filling materials for restoration of deformed bronze and tentative application of carbon fiber reinforced composites
Authors: Shen Yijia 
Published: July 2023

Abstract
The fracture of a bronze object is usually accompanied by localized deformation. The deformed part often tends to spring back at an unpredictable moment after its shape is corrected. The reconstruction of the area adjacent to the damage should be sufficiently resistant to the stress derived from springback so that the whole structure can remain stable. However, the choice of gap-filling materials for bronze objects is typically based on personal experience, and there are few available studies on their pertinent properties. The present study focused on a typical situation of deformation, took the flexural modulus as a crucial parameter and explored the development of a protocol for selecting a gap-filling material for bronze restoration in terms of its mechanical property. The flexural modulus was measured for the main classes of materials in use, and the factors related to preparation that influenced performance were studied. Among the various materials tested, carbon fiber reinforced (CFR) materials exhibited an advantageous value of the modulus and notable operational convenience. Further tests were conducted to assess their chemical safety for application in a museum context, as well as their surface workability. After obtaining overall encouraging results, composites reinforced with CF cloth and chopped CF were applied to the reconstruction of different parts of an archaeological bronze vessel. Indications for future improvement in the experimental setup and some practical notes regarding the use of CFR materials were also provided in this paper.
FDG-PET/CT for lymph node staging prior to radical cystectomy
Authors: Pihl Vilhelm , Markus Maria , Abrahamsson Johan , Bläckberg Mats , Hagberg Oskar , Kollberg Petter , Simoulis Athanasios , Trägårdh Elin , Liedberg Fredrik 
Published: July 2023

AbstractBackground18F-Fluorodeoxyglucose positron emission combined with computed tomography (FDG-PET/CT) has been proposed to improve preoperative staging in patients with bladder cancer subjected to radical cystectomy (RC).ObjectiveOur aim was to assess the accuracy of FDG-PET/CT for lymph node staging ascertained at the multidisciplinary tumour board compared to lymph node status in the surgical lymphadenectomy specimen obtained at RC, and to explore potential factors associated with false-positive FDG-PET/CT results.Design, setting and participantsConsecutive patients with bladder cancer undergoing RC with extended lymph node dissection between 2011 and 2019 without preoperative chemotherapy in a tertial referral cystectomy unit were included in the study.Outcome measurements and statistical analysesSensitivity, specificity, positive and negative predictive values and likelihood ratios were calculated. Potential factors investigated for association with false-positive FDG-PET/CT were; bacteriuria within four weeks prior to FDG-PET/CT, Bacillus Calmette–Guerin (BCG) treatment within 12 months prior to FDG-PET/CT and transurethral resection of bladder tumour (TURB) within four weeks prior to FDG-PET/CT.ResultsAmong 157 patients included for analysis, 44 (28%) were clinically node positive according to FDG-PET/CT. The sensitivity and specificity for detection of lymph node metastasis were 50% and 84%, respectively, and the corresponding positive predictive and negative predictive values were 61% and 76%. Positive and negative likelihood ratios were 3.0 and 0.6, respectively. No association was found between bacteriuria, previous BCG treatment or TURB within 28 days and false-positive FDG-PET/CT results.ConclusionsPreoperative FDG-PET/CT prior to RC had a clinically meaningful high specificity (84%) but lower sensitivity (50%) for detection of lymph node metastases compared to lymph node status in an extended pelvic lymphadenectomy template. We could not identify any factors associated with false-positive FDG-PET/CT outcomes.
Severity of waterborne diseases in developing countries and the effectiveness of ceramic filters for improving water quality
Authors: Shayo Godfrey Michael , Elimbinzi Elianaso , Shao Godlisten N. , Fabian Christina 
Published: July 2023

Abstract
Background
It is anticipated that three (3) billion people will experience water stress by 2025 due to limited access to clean water. Water-related diseases and fatalities affect both industrialized and developing countries. Waterborne diseases are challenging worldwide, especially in developing countries. This article evaluates strategies used by various countries, particularly developing countries, to combat waterborne diseases. These strategies have been largely successful in reducing the prevalence of water-related diseases in developing countries.

Main body of the abstract
The effectiveness of these strategies is evaluated in terms of their ability to remove water contaminants such as bacteria, viruses, and chemicals. Different strategies can be used, including traditional water treatment techniques such as boiling, chlorination, flocculation, solar disinfection and ceramic-based water filtration systems. These methods can help improve water quality and safety. The choice of strategy depends on the specific contaminants in the water and the desired outcome. Proper implementation of these strategies is key to ensuring safe drinking water.

Short conclusion
It was revealed that in developing countries, multiple water treatment techniques are used. This has led to the reduction in waterborne diseases from 50 to 90%. Ceramic-based water purification systems are reportedly the modern and least expensive technique, since they are highly efficient and can be made locally. Thus, ceramic water filtration systems are widely used due to their affordability and easy maintenance.
Mortality in a Moroccan psychiatric hospital
Authors: Khlil Chouaib , Attouche Nadia , Choujaa Hafsa , Alami Khadija Mchichi 
Published: July 2023

Abstract
Background and objectives
Even though the statistics have shown that patients with severe mental disorders such as schizophrenia and bipolar disorder are most likely to die 10 to 20 years earlier than the general population, the information on mortality in the Moroccan psychiatric setting is significantly limited. In the course of this study, we aim to describe the clinical characteristics and death-related data of the 18 patients who died over 10 years.

Methods
It is a retrospective and descriptive study of deceased inpatients within the Department of Psychiatry of the University Hospital Center, Ibn Rochd. The study extended over a period of 10 years, from January 1, 2011, to January 1, 2021.

Results
The study identified the death cases of 18 patients over 10 years, with a mortality rate of 1.99/1000, in which the average age of death is around 46,4 years. Men represented 55.6% of the deceased patients. 44.4% were diagnosed with schizophrenia, and 39% had medical comorbidity. The most common causes of death were cardiac causes (22.2%), followed by neuroleptic malignant syndrome (16.7%). Suicide, sudden death, and digestive diseases accounted for 11.1% of all causes.

Conclusion
People with mental disorders experience a high mortality rate. In this study, cardiovascular diseases and the neuroleptic malignant syndrome were the main causes of death, which requires close monitoring of high-risk psychiatric patients with comorbid cardiac problems.
Emergence of a New Glucoregulatory Mechanism for Glycemic Control With Dapagliflozin/Exenatide Therapy in Type 2 Diabetes
Authors: Cersosimo Eugenio , Alatrach Mariam , Solis-Herrera Carolina , Baskoy Gozde , Adams John , Hansis-Diarte Andrea , Gastaldelli Amalia , Chavez Alberto , Triplitt Curtis , DeFronzo Ralph A 
Published: July 2023

Abstract

Context
This study addresses the development of a new glucoregulatory mechanism in type 2 diabetes (T2D) patients treated with SGLT-2 inhibitors, which is independent of glucose, insulin and glucagon. The data suggest the presence of a potential trigger factor (s) arising in the kidney that stimulates endogenous glucose production (EGP) during sustained glycosuria.

Objective
To investigate effects of SGLT-2 inhibitor therapy together with GLP-1 receptor agonist on EGP and glucose kinetics in patients with T2D. Our hypothesis was that increased EGP in response to SGLT2i-induced glycosuria persists for a long period and is not abolished by GLP-1 RA stimulation of insulin secretion and glucagon suppression.

Methods
Seventy-five patients received a 5-hour dual-tracer oral glucose tolerance test (OGTT) (intravenous 3-(3H)-glucose oral (1-14C)-glucose): (1) before/after 1 of dapagliflozin (DAPA); exenatide (EXE), or both, DAPA/EXE (acute study), and (2) after 1 and 4 months of therapy with each drug.

Results
In the acute study, during the OGTT plasma glucose (PG) elevation was lower in EXE (Δ = 42 ± 1 mg/dL) than DAPA (Δ = 72 ± 3), and lower in DAPA/EXE (Δ = 11 ± 3) than EXE and DAPA. EGP decrease was lower in DAPA (Δ = −0.65 ± 0.03 mg/kg/min) than EXE (Δ = −0.96 ± 0.07); in DAPA/EXE (Δ = −0.84 ± 0.05) it was lower than EXE, higher than DAPA. At 1 month, similar PG elevations (EXE, Δ = 26 ± 1 mg/dL; DAPA, Δ = 62 ± 2, DAPA/EXE, Δ = 27 ± 1) and EGP decreases (DAPA, Δ = −0.60 ± 0.05 mg/kg/min; EXE, Δ = −0.77 ± 0.04; DAPA/EXE, Δ = −0.72 ± 0.03) were observed. At 4 months, PG elevations (EXE, Δ = 55 ± 2 mg/dL; DAPA, Δ = 65 ± 6; DAPA/EXE, Δ = 46 ± 2) and lower EGP decrease in DAPA (Δ = −0.66 ± 0.04 mg/kg/min) vs EXE (Δ = −0.84 ± 0.05) were also comparable; in DAPA/EXE (Δ = −0.65 ± 0.03) it was equal to DAPA and lower than EXE. Changes in plasma insulin/glucagon could not explain higher EGP in DAPA/EXE vs EXE mg/kg/min.

Conclusion
Our findings provide strong evidence for the emergence of a new long-lasting, glucose-independent, insulin/glucagon-independent, glucoregulatory mechanism via which SGLT2i-induced glycosuria stimulates EGP in patients with T2D. SGLT2i plus GLP-1 receptor agonist combination therapy is accompanied by superior glycemic control vs monotherapy.
Endovascular Thrombectomy for the Treatment of Large Ischemic Stroke: A Systematic Review and Meta-Analysis of Randomized Control Trials
Authors: Atchley Travis J. , Estevez-Ordonez Dagoberto , Laskay Nicholas M. B. , Tabibian Borna E. , Harrigan Mark R. 
Published: July 2023

BACKGROUND AND OBJECTIVES:Endovascular thrombectomy has previously been reserved for patients with small to medium acute ischemic strokes. Three recent randomized control trials have demonstrated functional benefit and risk profiles for thrombectomy in large-volume ischemic strokes. The primary objective of the meta-analysis was to determine the combined benefit of endovascular thrombectomy in patients with large-volume ischemic strokes and to determine the risk of adverse events after treatment.METHODS:We systematically searched Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Scopus, the Cochrane Central Register, and Google Scholar for randomized trials published between January 1, 2010, and February 19, 2023. We included trials specifically comparing endovascular thrombectomy with medical therapy in adults with acute ischemic stroke with large-volume infarctions (defined by Alberta Stroke Program Early Computed Tomography Score 3-5 or a calculated infarct volume of >50 mL). Data were extracted based on prespecified variables on study methods and design, participant characteristics, analysis approach, and efficacy/safety outcomes. Results were combined using a restricted maximum-likelihood estimation random-effects model. Studies were assessed for potential bias and quality of evidence. The primary outcome was an overall ordinal shift across modified Rankin scale scores toward a better outcome at 90 days after either treatment arm.RESULTS:Three thousand forty-four studies were screened, and 29 underwent full-text review. Three randomized trials (N = 1011) were included in the analysis. The pooled random-effects model for the primary outcome favored endovascular thrombectomy over medical management, with a generalized odds ratio of 1.55 (95% CI 1.25-1.91, I2= 42.84%). There was a trend toward increased risk of symptomatic intracranial hemorrhage in the thrombectomy group, with a relative risk of 1.85 (95% CI 0.94-3.63, I2= 0.00%).CONCLUSION:In patients with large-volume ischemic strokes, endovascular thrombectomy has a clear functional benefit and does not confer increased risk of significant complications compared with medical management alone.
Fast Synthesis of CHA-type Zeolite Using Dealuminated Amorphous Aluminosilicates with High Reactivity
Authors: Sada Yuki , Miyagi Shoko , Yoshioka Masato , Ishikawa Tomoya , Naraki Yusuke , Sano Tsuneji , Okubo Tatsuya , Wakihara Toru 
Published: July 2023

Abstract
Use of dealuminated amorphous aluminosilicates (deAl-Amor) achieved faster synthesis of CHA-type zeolites compared with using conventional amorphous aluminosilicates (Amor). The deAl-Amor also expanded the synthesis window of reactant compositions. Moreover, there was a large difference in morphologies of solid products obtained during the crystallization process between deAl-Amor and Amor, suggesting the time gap in supplying aluminosilicate species contributing to the CHA crystal growth. These results indicate the high potential of deAl-Amor as starting materials for zeolite synthesis.
Clinical benefit of range uncertainty reduction in proton treatment planning based on dual-energy CT for neuro-oncological patients
Authors: Taasti Vicki Trier , Decabooter Esther , Eekers Daniëlle , Compter Inge , Rinaldi Ilaria , Bogowicz Marta , van der Maas Tim , Kneepkens Esther , Schiffelers Jacqueline , Stultiens Cissy , Hendrix Nicole , Pijls Mirthe , Emmah Rik , Fonseca Gabriel Paiva , Unipan Mirko , van Elmpt Wouter 
Published: July 2023

Objective:
Several studies have shown that dual-energy CT (DECT) can lead to improved accuracy for proton range estimation. This study investigated the clinical benefit of reduced range uncertainty, enabled by DECT, in robust optimisation for neuro-oncological patients.

Methods:
DECT scans for 27 neuro-oncological patients were included. Commercial software was applied to create stopping-power ratio (SPR) maps based on the DECT scan. Two plans were robustly optimised on the SPR map, keeping the beam and plan settings identical to the clinical plan. One plan was robustly optimised and evaluated with a range uncertainty of 3% (as used clinically; denoted 3%-plan); the second plan applied a range uncertainty of 2% (2%-plan). Both plans were clinical acceptable and optimal. The dose–volume histogram parameters were compared between the two plans. Two experienced neuro-radiation oncologists determined the relevant dose difference for each organ-at-risk (OAR). Moreover, the OAR toxicity levels were assessed.

Results:
For 24 patients, a dose reduction &gt;0.5/1 Gy (relevant dose difference depending on the OAR) was seen in one or more OARs for the 2%-plan; e.g. for brainstem D0.03cc in 10 patients, and hippocampus D40% in 6 patients. Furthermore, 12 patients had a reduction in toxicity level for one or two OARs, showing a clear benefit for the patient.

Conclusion:
Robust optimisation with reduced range uncertainty allows for reduction of OAR toxicity, providing a rationale for clinical implementation. Based on these results, we have clinically introduced DECT-based proton treatment planning for neuro-oncological patients, accompanied with a reduced range uncertainty of 2%.

Advances in knowledge:
This study shows the clinical benefit of range uncertainty reduction from 3% to 2% in robustly optimised proton plans. A dose reduction to one or more OARs was seen for 89% of the patients, and 44% of the patients had an expected toxicity level decrease.
Racial disparities in major cardiovascular and cerebrovascular adverse events in breast cancer survivors: A nationwide analysis
Authors: Jain Akhil , Desai Rupak , Ahmed Ibrahim , Amakye Kingsley , Raval Maharshi , Patel Sagar , Uttam Chandani Kanishka , Majmundar Vidit , Agrawal Siddharth Pravin , Sanghvi Labdhi , Garg Monika , Patel Darsh , Hamza Mohammad , Bonita Raphael , Dhar Sunil 
Published: July 2023

Background: Improved survival outcomes in breast cancer has brought attention to major cardiovascular and cerebrovascular adverse events (MACCE). Racial disparities in these events among breast cancer survivors are understudied. Methods: Using National Inpatient Sample datasets (October 2015-December 2017, ICD-10-CM), we investigated racial disparities in the hospitalized breast cancer survivors for MACCE. They were further sub-categorized on the basis of prior chemotherapy or radiation therapy (CT/RT). Results: Of 1,301,320 breast cancer survivor women, 75.8% were White, 11.3% were Black, and 16.1% had prior CT/RT. All-cause in-hospital mortality was highest in Asian or Pacific Islanders (3.2%) in the whole breast cancer survivor population; and in Native Americans (4.7%) in CT/RT subgroup. Native Americans (4.1%) had the highest incidence of acute myocardial infarction (AMI) in the overall population, whereas White patients (2.9%) predominated in CT/RT subgroup. White patients (29.6%) had the highest prevalence of arrhythmia, regardless of the prior CT/RT. For strokes, Asian or Pacific Islanders (3.9%) and Black patients (3.8%) had a higher prevalence. All-cause mortality, AMI, arrhythmia, and stroke had the highest adjusted odds in Asian or Pacific Islanders (1.19), Native Americans (1.31), White patients (1), and Black patients (1.12) respectively. Black patients had the lowest quartile income and a longer median stay. White patients had the highest transfer to nursing facilities, whereas Asian or Pacific Islanders had the highest mean hospital expenditures. Conclusions: Racial disparities exist in MACCE among breast cancer survivors. Further research, especially pooling and analyzing real-world data is needed on the prevalence of MACCE in breast cancer survivors, particularly in subgroups with different cancer-related treatments.