bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of malignant pleural effusion in Italian clinical practice: a nationwide survey
Authors: Mei Federico , Tamburrini Mario , Gonnelli Francesca , Morandi Luca , Bonifazi Martina , Sediari Michele , Berardino Alessandro di Marco , Barisione Emanuela , Failla Giuseppe , Zuccatosta Lina , Papi Alberto , Gasparini Stefano , Marchetti Giampietro 
Published: July 2023

Abstract
Background
Pleural disease (PD), particularly malignant pleural effusion (MPE), is a common cause of hospital admission and its prevalence is rising worldwide. Recent advances in diagnostic and therapeutic options, such as Indwelling Pleural Catheters (IPCs), have simplified PD treatment, allowing an effective outpatients management. Therefore, dedicated pleural services can improve PD care, guaranteeing specialized management and optimizing time and cost. We aimed to provide an overview on MPE management in Italy, mainly focused on distribution and characteristics of pleural services and IPCs use.

Methods
A nationwide survey, endorsed by the Italian Thoracic Society, was distributed by email to members of selected subgroups in 2021.

Results
Ninety (23%) members replied, most of whom being pulmonologists (91%). MPE resulted the most common cause of pleural effusion and was managed with heterogenous approaches, including talc pleurodesis via slurry (43%), talc poudrage (31%), repeated thoracentesis (22%) and IPCs insertion (2%). The setting of IPC insertion was inpatient care in 48% of cases, with a predominance of draining frequency every other day. IPC management mainly relied on caregivers (42%). The presence of a pleural service was reported by 37% of respondents.

Conclusions
The present study provides an extensive overview of MPE management in Italy, showing a highly heterogeneous approach, a scarce prevalence of out-patient pleural services, and a still limited adoption of IPCs, mainly due to lack of dedicated community care systems. This survey emphasizes the need of promoting a higher spreading of pleural services and an innovative healthcare delivery with more favourable cost-benefit ratio.
Influence of the shape of the first metatarsal cuneiform joint on the development of hallux valgus deformity
Authors: Sovilj Mirko , Baljozović Andreja , Pilipović Filip , Banjac Maja Sovilj , Baščarević Zoran 
Published: July 2023

Abstract
Objective
To examine the presence of certain shapes of the first metatarsal-cuneiform joint (MTC) joint in feet with hallux valgus (HV) deformity. To determine whether the anatomical orientation of this joint affects the size of the hallux valgus angle (HVA) and the first intermetatarsal angle (IMA) and whether it contributes to the dynamics of the developmental course of HV deformity.

Methods
The shape of the first MTC joint was determined on a sample of 315 feet with HV deformity. The influence of the shape of this joint on the values of HVA and IMA was explored. The relation between the position of the tibial sesamoid and the size of HVA and IMA as well as the dynamics of the development of this deformity depending on the shape of the first MTC joint, was examined.

Results
The oblique shape of the first MTC joint was found in 165 (52.4%) feet, the transverse in 145 (46%), and the convex shape was registered in five feet (1.6%). In the oblique shape of this joint, a moderate and severe degree of HV deformity is predominant, while in the transverse shape a mild degree dominates. A statistically significant dependence of HVA on the shape of the first MTC joint was found (Sig. = 0.010), while the dependence of IMA did not show statistical significance (Sig. = 0.105). HVA values follow the position of the tibial sesamoid in both shapes of the MTC joint while the size of the IMA in the transverse shape does not follow the change of the position of this sesamoid.

Conclusion
The oblique shape of the first MTC joint is associated with the more severe form of HV deformity and its faster developmental course. In the analyzed sample, it was shown that HVA is higher in the oblique shape of the MTC joint and significantly depends on the anatomical orientation of this joint. Furthermore, IMA has a higher value in the oblique shape compared to transverse but this dependence is not statistically significant. The analysis showed that the oblique shape of the first MTC joint contributes to the development of HV deformity.
The effect of foot posture on static balance, ankle and knee proprioception in 18-to-25-year-old female student: a cross-sectional study
Authors: Ghorbani Maryam , Yaali Rasoul , Sadeghi Hassan , Luczak Tony 
Published: July 2023

AbstractBackground & purposeAfferent input from the sole affects postural stability. Cutaneous reflexes from the foot are important to posture and gait. Lower-limb afferents alone provide enough information to maintain upright stance and are critical in perceiving postural sway. Altered feedback from propreoceptive receptors alters gait and patterns of muscle activation. The position and posture of the foot and ankle may also play an important role in proprioceptive input.Therefore, the current research aims to compare static balance and ankle and knee proprioception in people with and without flexible flatfeet.Methodology91 female students between the ages of 18 and 25 voluntarily participated in this study, of which 24 were in the flexible flatfoot group and 67 were in the regular foot group after evaluating the longitudinal arch of the foot. The position sense of ankle and knee joints were measured using the active reconstruction test of the ankle and knee angle; Static balance was measured using the Sharpened Romberg test. Data were non-normally distributed. Accordingly, non-parametric tests were applied. The Kruskal-Wallis test was applied to compare differences between groups in variables.ResultKruskal-Wallis test showed a significant difference between two groups of flat feet and normal feet in the variables of static balance and position sense of ankle plantarflexion, ankle dorsiflexion, and knee flexion (p ≤ 0.05). A significant correlation was found between static balance and sense of ankle and knee position in the group with normal feet. The analysis of the regression line also showed that ankle and knee position sense could predict the static balance score in the regular foot group (ankle dorsiflexion position sense 17% (R2 = 0.17), ankle plantarflexion position sense 17% (R2 = 0.17) and knee flexion position sense 46% (R2 = 0.46) explain of changes in static balance).Discussion & conclusionFlexible flatfoot soles can cause loss of balance and sense of joint position; therefore, according to this preliminary study, clinicians must be aware and should take into account this possible deficit in the management of these patients.
Influence of weight-bearing on the 3D movement of lumbar facet joints in the sitting position
Authors: Han Ye , Wang Xiaodong , Wang Jianzhong , Sun Shaosong , Xia Xi , Wang Jing , Miao Jun 
Published: July 2023

Abstract
Objective
To analyze the motion characteristics of lumbar facet joints and to observe the effect of weight-bearing on lumbar facet joints in the sitting position.

Methods
Ten normal subjects (5 males and 5 females) were recruited and scanned by CT, and their lumbar 3D models were reconstructed by software. The images of flexion and extension of lumbar facet joints in the sitting position were collected without weight-bearing and weight-bearing 10 kg, and the 2D model was constructed by software. The 2D-3D model was matched to restore the flexion and extension motion changes of the subjects’ lumbar spine in the sitting position. Coordinates were established in the middle of the vertebral body and copied to the facet joints. Measure and record the lumbar facet joint movement distance through coordinate system. The relevant data of facet joints were collected.

Results
In the L3/4 segment, after weight loading, the displacement of the left facet joint in the X axis became larger, while that in the Y axis and Z axis decreased. The displacement of the right facet joint in the X axis and Y axis increased, and the Z axis displacement decreased. The rotation angle of the bilateral facet joints also decreased. In the L4/5 segment, after loading, the displacements of the X, Y, and Z axis displacements of both sides increase, while the rotation angles of α and β increase, while the rotation angle of γ decreases. In the L5/S1 segment, the displacements of the X, Y, and Z axes on the left side decrease. The displacement of the X and Y axes on the right side decreases, while the displacement on the Z axis increases. The rotation angles of α and γ increase, and the rotation angle of the β axis decreases.

Conclusion
When sitting, the flexion and extension distance and rotational displacement of lumbar facet joints are not affected by weight-bearing. In addition, there is asymmetry in the movement of the left and right facet joints, and weight bearing has no effect on the asymmetry of the motion.
Applicability of drug-related problem (DRP) classification system for classifying severe medication errors
Authors: Linden-Lahti Carita , Takala Anna , Holmström Anna-Riia , Airaksinen Marja 
Published: July 2023

Abstract
Background
Several classification systems for medication errors (MEs) have been established over time, but none of them apply optimally for classifying severe MEs. In severe MEs, recognizing the causes of the error is essential for error prevention and risk management. Therefore, this study focuses on exploring the applicability of a cause-based DRP classification system for classifying severe MEs and their causes.

Methods
This was a retrospective document analysis study on medication-related complaints and authoritative statements investigated by the Finnish National Supervisory Authority for Welfare and Health (Valvira) in 2013–2017. The data was classified by applying a previously developed aggregated DRP classification system by Basger et al. Error setting and harm to the patient were identified using qualitative content analysis to describe the characteristics of the MEs in the data. The systems approach to human error, error prevention, and risk management was used as a theoretical framework.

Results
Fifty-eight of the complaints and authoritative statements concerned MEs, which had occurred in a wide range of social and healthcare settings. More than half of the ME cases (52%, n = 30) had caused the patient’s death or severe harm. In total, 100 MEs were identified from the ME case reports. In 53% (n = 31) of the cases, more than one ME was identified, and the mean number of MEs identified was 1.7 per case. It was possible to classify all MEs according to aggregated DRP system, and only a small proportion (8%, n = 8) were classified in the category “Other,” indicating that the cause of the ME could not be classified to specific cause-based category. MEs in the “Other” category included dispensing errors, documenting errors, prescribing error, and a near miss.

Conclusions
Our study provides promising preliminary results for using DRP classification system for classifying and analyzing especially severe MEs. With Basger et al.’s aggregated DRP classification system, we were able to categorize both the ME and its cause. More research is encouraged with other ME incident data from different reporting systems to confirm our results.
High-throughput characterization of cortical microtubule arrays response to anisotropic tensile stress
Authors: Demes Elsa , Verger Stéphane 
Published: July 2023

AbstractBackgroundPlants can perceive and respond to mechanical signals. For instance, cortical microtubule (CMT) arrays usually reorganize following the predicted maximal tensile stress orientation at the cell and tissue level. While research in the last few years has started to uncover some of the mechanisms mediating these responses, much remains to be discovered, including in most cases the actual nature of the mechanosensors. Such discovery is hampered by the absence of adequate quantification tools that allow the accurate and sensitive detection of phenotypes, along with high throughput and automated handling of large datasets that can be generated with recent imaging devices.ResultsHere we describe an image processing workflow specifically designed to quantify CMT arrays response to tensile stress in time-lapse datasets following an ablation in the epidermis — a simple and robust method to change mechanical stress pattern. Our Fiji-based workflow puts together several plugins and algorithms under the form of user-friendly macros that automate the analysis process and remove user bias in the quantification. One of the key aspects is also the implementation of a simple geometry-based proxy to estimate stress patterns around the ablation site and compare it with the actual CMT arrays orientation. Testing our workflow on well-established reporter lines and mutants revealed subtle differences in the response over time, as well as the possibility to uncouple the anisotropic and orientational response.ConclusionThis new workflow opens the way to dissect with unprecedented detail the mechanisms controlling microtubule arrays re-organization, and potentially uncover the still largely elusive plant mechanosensors.
YWHAH, a member of 14-3-3 family proteins, and PSME2, the proteasome activator subunit 2, are key host factors of Japanese encephalitis virus infection
Authors: Liu Chaoyue , Yang Yanhong , Li Qianqian , Hu Weimin , Chang Jinxia , Chen Rong , Zhu Hong , Xu Mingfei 
Published: July 2023

Abstract
Background
Host response to virus infection is key to the effective control and eventual elimination of viruses or infected cells; however, the underlying mechanism of Japanese encephalitis virus (JEV) infection remains unclear.

Methods
In the present study, short time-series expression was analyzed by R software to obtain two groups of differentially expressed genes (DEGs) [upregulated/downregulated] during the entire process of JEV infection based on the data in the Gene Expression Omnibus database. GO enrichment and KEGG pathway, protein interactions and hub genes selection were analyzed by DAVID, STRING and Cytoscape respectively. Interactions of the JEV and host proteins, and the microRNAs that target Tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activating protein Eta (YWHAH) and Proteasome activator subunit 2(PSME2) were predicted by P-hipster and ENCORI, respectively. Expression levels of YWHAH and PSME2 were analyzed using the HPA database and RT-qPCR assay.

Results
Two groups of continuously changed DEGs during entire process of JEV infection were obtained. Continuously upregulated cluster was mainly related to regulation of transcription, immune response and inflammatory response; and the continuous downregulated group mainly including intracellular protein transport and signal transduction, several proteolysis pathways. As targets of several microRNAs, the downregulated-YWHAH and the upregulated-PSME2 were related to host and JEV proteins to affect several pathways after JEV infection.

Conclusions
YWHAH and PSME2 are key host factors of JEV infection based on their continuously differentially expressed pattern, interactions with multiple JEV proteins, and as members of the hub genes. Our results provide valuable information for further studies on the interactions between viruses and host.
Information and support to patients when the waiting time guarantee cannot be fulfilled: a qualitative study
Authors: Casales Morici Belén , Augustsson Hanna , Hasson Henna , Ebbevi David 
Published: July 2023

Abstract
Background
Long waiting times for health care services are a prominent health policy issue. Waiting time guarantees may limit time to assessment and treatment.

Methods
This study aims to investigate the information and support given to patients when the waiting time guarantee cannot be fulfilled from a care provider and administrative management perspective. Semi-structured interviews (N = 28) were conducted with administrative management and care providers (clinic staff and clinic line managers) in specialized clinics in the Stockholm Region, Sweden. Clinics were purposefully sampled for maximum variation in ownership (private, public), complexity of care, geographical location, volume of production, and waiting times. Thematic analysis was applied.

Results
Care providers reported that patients received inconsistent information and support with regard to the waiting time guarantee and that information was not adapted to health literacy or individual patient needs. Contrary to local law, they made some patients responsible for finding a new care provider or arranging a new referral. Furthermore, financial interests affected whether patients were referred to other providers. Administrative management steered care providers’ informing practices at specific time points (upon establishment of a new unit and after six months of operation). A specific regional support function, Region Stockholm’s Care Guarantee Office, helped patients change care providers when long waiting times occurred. However, administrative management perceived that there was no established routine to assist care providers in informing patients.

Conclusions
Care providers did not consider patients’ health literacy when informing them about the waiting time guarantee. Administrative management’s attempts to provide information and support to care providers are not producing the results they expect. Soft-law regulations and care contracts seem insufficient, and economic mechanisms undermine care providers’ willingness to inform patients. The described actions are unable to mitigate the inequality in health care that arises from differences in care-seeking behavior.
Association between triglyceride-glucose index and low-density lipoprotein particle size in korean obese adults
Authors: Kim Sanghoon , Lee Ji-Won , Lee Yaeji , Song Youhyun , Linton John A 
Published: July 2023

AbstractBackgroundSmall dense low-density lipoprotein cholesterol (sdLDL-C) is the lipoprotein marker among the various lipoproteins that is most strongly related to atherosclerosis. Insulin resistance (IR) can alter lipid metabolism, and sdLDL-C is characteristic of diabetic dyslipidemia. Therefore, this study sought to inspect the relationship between the triglyceride-glucose (TyG) index and mean low-density lipoprotein (LDL) particle size.MethodsIn this study, a total of 128 adults participated. The correlation coefficients between various lipoproteins and the TyG index were compared using Steiger’s Z test and the Spearman correlation. The independent link between the TyG index and mean LDL particle size was demonstrated by multiple linear regression analysis. To identify the TyG index cutoff value for the predominance of sdLDL particles, receiver operating characteristic curves were plotted.ResultsMean LDL particle size correlated more strongly with the TyG index than did very low-density lipoprotein, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Regression analysis demonstrated that mean LDL particle size had a strong association with the TyG index (β coefficient = -0.038,P-value < 0.001). The TyG index optimal cutoff value for sdLDL particle predominance and the corresponding area under the curve (standard error: 0.028, 95% confidence interval: 0.842–0.952) were 8.72 and 0.897, respectively, which were close to the cutoff value of diabetes risk in Koreans.ConclusionsMean LDL particle size is more strongly correlated with the TyG index than do other lipid parameters. After correcting for confounding variables, mean LDL particle size is independently linked with the TyG index. The study indicates that the TyG index is strongly related to atherogenic sdLDL particles predominance.
Short-term safety and cosmetic outcomes of endoscopic direct-to-implant breast reconstruction and simultaneous contralateral breast augmentation for breast cancer: a prospective analysis of 33 patients
Authors: Qiu Mengxue , Yang Huanzuo , Zhou Jiao , Feng Yu , Liu Xinran , Zhang Qing , Du Zhenggui 
Published: July 2023

Abstract
Background
For patients with small breasts, breast-conserving surgery (BCS) and unilateral nipple-/skin-sparing mastectomy (N/SSM) with breast reconstruction may result in visible breast deformities or asymmetry, and contralateral breast augmentation often require a two-staged operation. We propose a novel endoscopic technique, direct-to-implant breast reconstruction and simultaneous contralateral breast augmentation (DTI-BR-SCBA), and report its short-term safety and cosmetic outcomes.

Methods
In this prospective study, patients with early breast cancer who underwent endoscopic DTI-BR-SCBA between November 2020 and August 2022 were followed for more than 3 months to analysed short-term postoperative safety (complications and oncological safety) and cosmetic outcomes (doctor-assessed results by Ueda scale and patient-reported results by Breast-Q scale).

Results
A total of 33 patients, including 30 treated with endoscopic prepectoral DTI-BR-SCBA, 1 with endoscopic dual-plane DTI-BR-SCBA and 2 with endoscopic subpectoral DTI-BR-SCBA, were analysed. The mean age was 39.7 ± 6.7 years. The mean operation time was 165.1 ± 36.1 min. The overall surgical complication rate was 18.2%. All complications were minor, including haemorrhage (3.0%), cured by compression haemostasis, surgical site infection (9.1%), cured by oral antibiotics, and self-healing nipple-areolar complex ischaemia (6.1%). Furthermore, rippling and implant edge visibility occurred in 6.2% of them. The outcome was graded as “Excellent” and “Good” in 87.9% and 12.1% of patients in the doctor cosmetic assessment, respectively, and patient satisfaction with breasts was significantly improved (55.0 ± 9.5 vs. 58.8 ± 7.9, P = 0.046).

Conclusions
The novel endoscopic DTI-BR-SCBA method may be an ideal alternative for patients with small breasts because it can improve cosmetic results with a relatively low complications rate, which makes it worthy of clinical promotion.
A new era for the negative symptoms of schizophrenia
Authors: Fernandez-Egea Emilio , Mucci Armida , Lee Jimmy , Kirkpatrick Brian 
Published: July 2023

SummaryNegative symptoms remain one of the major unmet needs for people with schizophrenia, and the past decade has witnessed a surge in interest in negative symptoms. In this themed issue, we present new concepts of negative symptoms and recent findings on their epidemiology and pathophysiology and on therapeutic options for their management.