bluuebunny/crossref_metadata_2025_split huggingface dataset:
A distractions capture tool for cardiac surgery and lung transplantation: impact on outcomes
Authors: Arkley James , Ong Lay Ping , Gunaratnam Niranjan , Butt Tanveer , Clark Stephen Charles 
Published: January 2023

Abstract
Objectives
Surgical distractions are associated with worse patient outcomes. Lung transplantation and cardiac surgery’s multi-disciplinary nature, and their inherent complexities render them more vulnerable to distractions. We aim to use a novel distractions capture tool to evaluate the severity of distractions during cardiac surgery (CS) and lung transplantation (LTx) and assess its impact on post-operative complications.

Methods
A prospective ‘blinded’ study was undertaken by direct observation of distractions during CS and LTx. Events were identified using the Imperial College Error Capture tool (ICECAP). Number and severity of distractions were correlated with post-operative outcomes (ICU & hospital stay, bleeding and anastomotic complications).

Results
In LTx, we observed 2059 distractions within 287 h across 41 surgeries. In CS, we observed 1089 distractions within 192 h across 62 surgeries. Surgeons were consciously aware of 19.2% (LTx) and 21.3% (CS) of recorded events. Distractions consisted of procedure-independent pressures (61% LTx vs 56% CS), equipment problems (15% LTx vs 23%CS), communication (12% LTx vs 12% CS), technical problems or patient safety concerns (12% LTx vs 9% CS). In CS, 91% of procedure-independent pressures were non-operative distractions whilst LTx recorded 83%. Staff absences at a critical moment of surgery were recorded at 9% (LTx) and 7% (CS). The number and severity of distractions correlated with bleeding (CS p < 0.001, LTx p < 0.01), prolonged ICU stay (CS p = 0.002, LTx p = 0.002), hospital stay (CS p < 0.001) and anastomotic complications(LTx p < 0.03).

Conclusions
ICECAP as a novel surgical distractions capture tool was effective & applicable to both elective cardiac and urgent transplant surgeries. Surgeons were unaware of a large number of distractions & interruptions. Distractions were associated with longer ICU stay and higher rate of bleeding.
T7Max transcription system
Authors: Deich Christopher , Cash Brock , Sato Wakana , Sharon Judee , Aufdembrink Lauren , Gaut Nathaniel J. , Heili Joseph , Stokes Kaitlin , Engelhart Aaron E. , Adamala Katarzyna P. 
Published: January 2023

Abstract
Background
Efficient cell-free protein expression from linear DNA templates has remained a challenge primarily due to template degradation. In addition, the yields of transcription in cell-free systems lag behind transcriptional efficiency of live cells. Most commonly used in vitro translation systems utilize T7 RNA polymerase, which is also the enzyme included in many commercial kits.

Results
Here we present characterization of a variant of T7 RNA polymerase promoter that acts to significantly increase the yields of gene expression within in vitro systems. We have demonstrated that T7Max increases the yield of translation in many types of commonly used in vitro protein expression systems. We also demonstrated increased protein expression yields from linear templates, allowing the use of T7Max driven expression from linear templates.

Conclusions
The modified promoter, termed T7Max, recruits standard T7 RNA polymerase, so no protein engineering is needed to take advantage of this method. This technique could be used with any T7 RNA polymerase- based in vitro protein expression system.
Cytokine hemoadsorption with CytoSorb® in post-cardiac arrest syndrome, a pilot randomized controlled trial
Authors: Monard Céline , Bianchi Nathan , Poli Elettra , Altarelli Marco , Debonneville Anne , Oddo Mauro , Liaudet Lucas , Schneider Antoine 
Published: January 2023

Abstract
Background
Hemoadsorption (HA) might mitigate the systemic inflammatory response associated with post-cardiac arrest syndrome (PCAS) and improve outcomes. Here, we investigated the feasibility, safety and efficacy of HA with CytoSorb® in cardiac arrest (CA) survivors at risk of PCAS.

Methods
In this pilot randomized controlled trial, we included patients admitted to our intensive care unit following CA and likely to develop PCAS: required norepinephrine (> 0.2 µg/kg/min), and/or had serum lactate > 6 mmol/l and/or a time-to-return of spontaneous circulation (ROSC) > 25 min. Those requiring ECMO or renal replacement therapy were excluded. Eligible patients were randomly allocated to either receive standard of care (SOC) or SOC plus HA. Hemoadsorption was performed as stand-alone therapy for 24 h, using CytoSorb® and regional heparin–protamine anticoagulation. We collected feasibility, safety and clinical data as well as serial plasma cytokines levels within 72 h of randomization.

Results
We enrolled 21 patients, of whom 16 (76%) had out-of-hospital CA. Median (IQR) time-to-ROSC was 30 (20, 45) minutes. Ten were assigned to the HA group and 11 to the SOC group. Hemoadsorption was initiated in all patients allocated to the HA group within 18 (11, 23) h of ICU admission and conducted for a median duration of 21 (14, 24) h. The intervention was well tolerated except for a trend for a higher rate of aPTT elevation (5 (50%) vs 2 (18%) p = 0.18) and mild (100–150 G/L) thrombocytopenia at day 1 (5 (50%) vs 2 (18%) p = 0.18). Interleukin (IL)-6 plasma levels at randomization were low (< 100 pg/mL) in 10 (48%) patients and elevated (> 1000 pg/mL) in 6 (29%). The median relative reduction in IL-6 at 48 h was 75% (60, 94) in the HA group versus 5% (− 47, 70) in the SOC group (p = 0.06).

Conclusions
In CA survivors at risk of PCAS, HA was feasible, safe and was associated with a nonsignificant reduction in cytokine plasma levels. Future trials are needed to further define the role of HA after CA. Those studies should include cytokine assessment to enrich the study population.
Trial registration: NCT03523039, registered 14 May 2018.
Ventriculus terminalis cyst in an infant: a case report
Authors: Menezes Arnold H. , Sato Yutaka , Dlouhy Brian J. , Jones Karra A. , Moore Steven A. 
Published: January 2023

Abstract
Background
Filar cysts are frequently found on neonatal ultrasound and are physiologically involuting structures with natural resolution. Hence, there has been no previous histologic correlation. Ventriculus terminalis is a focal central canal dilation in the conus medullaris and usually not clinically significant. Extra-axial cyst at the conus–filum junction connected to ventriculus terminalis is extremely rare, especially when associated with tethered lipomatous filum terminale and with progressive cyst enlargement.

Case presentation
A Caucasian female neonate with abnormal gluteal cleft had ventriculus terminalis cyst with an extra-axial cyst at the conus–filar junction and taut lipomatous filum on ultrasound examination and magnetic resonance imaging. This persisted at 6-month follow up imaging. In light of the nonresolving extra-axial mass and thick taut lipomatous filum, the child underwent L1–L3 osteoplastic laminectomies. The extra-axial cyst expanded after bony decompression and furthermore on dural opening; visualized on ultrasound. It communicated with the central canal and was documented with intraoperative photomicrographs. It was excised and filum sectioned. Histological immunostaining of the cyst wall showed neuroglial and axonal elements. The child did well without deficits at 4-year follow up with normal urodynamics.

Conclusion
Progression dilation of ventriculus terminalis and extra-axial conofilar cyst with tethered lipomatous filum will likely progress to clinical significance and require surgical intervention. The embryologic basis for this pathology is discussed, with literature review.
Biopreservative efficacy of Enterococcus faecium-immobilised film and its enterocin against Salmonella enterica
Authors: Rashid Muzamil , Sharma Sunil , Kaur Arvinder , Kaur Amarjeet , Kaur Sukhraj 
Published: January 2023

AbstractThe growing awareness about the adverse health effects of artificial synthetic preservatives has led to a rapid increase in the demand for safe food preservation techniques and bio preservatives. Thus, in this study, the biopreservatives efficacy of enterocin-producing Enterococcus faecium Smr18 and its enterocin, ESmr18 was evaluated against Salmonella enterica contamination in chicken samples. E. faecium Smr18 is susceptible to the antibiotics penicillin-G, ampicillin, vancomycin, and erythromycin, thereby indicating that it is a nonpathogenic strain. Further, the enterocin ESmr18 was purified and characterised as a 3.8 kDa peptide. It possessed broad spectrum antibacterial activity against both Gram-positive and Gram-negative pathogens including S. enterica serotypes Typhi and Typhimurium. Purified ESmr18 disrupted the cell membrane permeability of the target cell thereby causing rapid efflux of potassium ions from L. monocytogenes and S. enterica. Chicken samples inoculated with S. enterica and packaged in alginate films containing immobilised viable E. faecium resulted in 3 log10 colony forming units (CFU) reduction in the counts of S. enterica after 34 days of storage at 7–8 °C. The crude preparation of ESmr18 also significantly (p < 0.05) reduced the CFU counts of salmonella-inoculated chicken meat model. Purified ESmr18 at the concentration upto 4.98 µg/ml had no cytolytic effect against human red blood cells. Crude preparation of ESmr18 when orally administered in fish did not cause any significant (p < 0.05) change in the biochemical parameters of sera samples. Nonsignificant changes in the parameters of comet and micronucleus assays were observed between the treated and untreated groups of fishes that further indicated the safety profile of the enterocin ESmr18.
Robotic-assisted revision total knee arthroplasty: a novel surgical technique
Authors: Ngim Hui-Ling Joanne , Van Bavel Dirk , De Steiger Richard , Tang Andrew W. W. 
Published: January 2023

Abstract
Background
Revision total knee arthroplasty is a challenging procedure. The robotic-assisted system has been shown to enhance the accuracy of preoperative planning and improve reproducibility in primary arthroplasty surgeries. The aim of this paper was to describe the surgical technique for robotic-assisted revision total knee arthroplasty and the potential benefits of this technique.

Method
This single-centre retrospective study included a total of 19 patients recruited from April 1, 2021 to April 30, 2022. Inclusion criteria were patients who had Mako™ robotic-assisted revision total knee arthroplasty done within the study period with a more than 6 months follow-up. Statistical analysis was done using Microsoft Excel 16.0.

Results
All 19 patients were followed up for 6 to 18 months. All patients in this study had uneventful recoveries without needing any re-revision surgery when reviewed to date.

Conclusion
With the development of dedicated revision total knee software, robot-assisted revision TKA can be a promising technique that may improve surgical outcomes by increasing the accuracy of implant placement, and soft tissue protection and achieving a better well-balanced knee.
Follicular fluid biomarkers for prediction of human IVF outcome in women with poor ovarian response
Authors: Barroso-Villa Gerardo , Valdespin-Fierro Carlos , Weiser-Smeke Ariane-Estrella , Machargo-Gordillo Ana-Paula , Flores-Pliego Arturo , Palma-Lara Icela , Oehninger Sergio 
Published: January 2023

Abstract
Background
The aim of controlled ovarian stimulation is to achieve an optimal number of mature oocytes to obtain good-quality embryos. High follicular fluid (FF) concentrations of FSH, hCG, and LH promote oocyte maturation and are associated with a higher probability of fertilization. LH concentrations in FF are consistently higher in follicles that will lead to a successful IVF outcome. The levels of some of these FF biomarkers may vary among different ovarian stimulation schemes; however, the effects of corifollitropin alfa, recombinant FSH (rFSH), LH (rLH), and highly purified urinary menotropins uhMG on these biomarkers are still unknown. The objective of this study was to characterize the profile of FF biomarkers (leptin, vascular endothelial growth factor (VEGF), metalloproteinases (MMPs), and NO2−/NO3−) according to three different protocols of controlled ovarian stimulation (COS) in poor ovarian responders (POR) and to evaluate the association between these profiles and clinical outcomes. Three groups of POR patients were examined according to the protocols used.

Results
Group C showed significant higher levels in all biomarkers (p < 0001). FF samples from Group B had the lowest levels of VEGF and Pro-MMP-9. Group A showed the lowest concentration of pro-MMP-2. The VEGF level and number of captured oocytes were positively correlated in Group C (r = 0.534, p = 0.01). MMP-9 and fertilization rate were negatively correlated in Group C (r = −0.476, p = 0.02). We found negative correlations between proMMP-2 and serum estradiol levels on the day of rhCG administration.

Conclusion
We found significant variations in the biomarker concentrations between the different controlled ovarian stimulation schemes used in POR patients. These differences can be potentially explained by the nature and composition of the gonadotropins. Our results support the hypothesis that some of these molecules should be thoroughly investigated as noninvasive predictors of egg quality.
Unresolving cyclic pelvic pain in young women due to rare structural uterine anomalies: a case series
Authors: Kandasamy Vignesh , Reghunath Anjuna , Gupta Swarna , Sharma Anuradha , Ghasi Rohini Gupta 
Published: January 2023

Abstract
Background
There are many causes for cyclic pelvic pain unresponsive to anti-spasmodic medications in young women. An uncommon, although significant, association in patients presenting with such symptoms is structural uterine anomalies with rudimentary functional cavities. Ultrasound is the first-line modality for the investigation of dysmenorrhea, and the radiologist may be the first person to identify such an underlying condition in the patient. However, transabdominal ultrasound may provide only limited information. Magnetic resonance imaging (MRI) is the imaging modality of choice in such situations due to its high soft tissue resolution and multiplanar capability. This case series is unique in that it primarily highlights the MR imaging of rare structural uterine anomalies in three young females suffering from severe dysmenorrhea, along with an imaging approach.

Case presentation
We present three cases of unresolving cyclic pain in young nulliparous females who were radiologically diagnosed with three rare uterine structural anomalies—accessory and cavitated uterine mass, Mayer–Rokitansky–Küster–Hauser syndrome, and functional non-communicating rudimentary horn in a hemiuterus or unicornuate uterus, which were treated with resection leading to symptom relief.

Conclusion
In young women with recurrent cyclic pelvic pain, uterine structural abnormalities with functioning cavities should be considered as an etiology and evaluated with MRI. Owing to the non-specific nature of causes of dysmenorrhea, a schematic approach to imaging is essential for identifying the various underlying gynecological conditions, thus aiding in the prompt management of the patient.
Comparative study between blind and ultrasound-guided steroid injection for carpal tunnel syndrome
Authors: Farfour Hesham , Hegab Sherif , El-Sherif Sherine , Abdel-Kerim Amr 
Published: January 2023

Abstract
Background
Carpal tunnel syndrome is the most common entrapment neuropathy. Local injections of corticosteroids have proven to be an effective treatment option. Injections are either blind (non-guided) or guided by ultrasound. The current study aimed to compare the efficiency of both approaches and determine which one yields better results.

Method
This study involved 30 patients (8 males, 22 females, aged 36–58 years, mean age 48.3 years) with 30 affected hands with mild or moderate carpal tunnel syndrome. Patients were randomly divided into two equal groups. Steroid injections were performed blindly in group 1 and ultrasound-guided in group 2. A mixture of 2 ml of triamcinolone and lidocaine was administered at both groups. Follow-up (using the Boston Carpal Tunnel Questionnaire and ultrasound assessment) was performed 4 weeks after the injection.

Results
The symptom severity scale, functional status scale, cross-sectional area, and flattening ratio were significantly reduced in both groups at 4 weeks after the procedure. The ultrasound-guided group showed a statistically significant improvement compared to the blindly injected group.

Conclusions
Local steroid injection is an effective method in the management of both idiopathic and secondary carpal tunnel syndrome. Although clinical and sonographic improvement was achieved with blind and guided steroid injections, better results were obtained when ultrasound was used.
A multi-agent-based symbiotic organism search algorithm for DG coordination in electrical distribution networks
Authors: Kawambwa Shamte , Mnyanghwalo Daudi 
Published: January 2023

AbstractMetaheuristic algorithms have become popular in solving engineering optimization problems due to their advantages of simple implementation and the ability to find near-optimal solutions for complex and large-scale problems. However, most applications of metaheuristic algorithms consider centralized design, assuming that all possible solutions are available in one machine or controller. In some applications, such as power systems, especially DG coordination, centralized design may not be efficient. This work integrates a multi-agent system (MAS) into a metaheuristic algorithm for enhanced performance. In a proposed multi-agent framework, the agent implements a metaheuristic algorithm and uses shared information with neighbours as input to optimize the solutions. In this study, a new distributed Symbiotic Organism Search (SOS) algorithm has been proposed and tested in the proposed multi-agent framework. The proposed algorithm is termed a multi-agent-based symbiotic organism search algorithm (MASOS). The MASOS has been tested and compared with other proficient algorithms through statistical analysis using benchmark functions. The results show that the proposed MASOS solves the considered benchmark functions efficiently. Then MASOS was tested for DGs coordination considering load variations in the Tanzanian electrical distribution network. The results show that the coordination of DG using the proposed algorithm reduces power loss and improves the voltage profiles of the power system.
Prevalence and pattern of isolated fungi from bronchoalveolar lavage among patients with lung cancer: a prospective cross-sectional study
Authors: El-Badrawy Mohammad Khairy , Elsaied Amany Ragab , Ibrahim Asmaa Adel Metwally , Eladl Ahmed Elsayed , Elmorsey Rehab Ahmad 
Published: January 2023

Abstract
Background
Fungal colonization or infection has recently been reported in patients with lung cancer, and it is possible that it has a role in the pathogenesis of lung cancer or having an effect on treatment and outcome. Aim of work was to assess the prevalence and pattern of isolated fungi from patients with lung cancer at the time of diagnosis. In this prospective cross-sectional observational study, patients with suspected lung tumors were subjected to fiberoptic bronchoscopy (FOB) for biopsy, bronchoalveolar lavage (BAL) with its culture for fungal growth. After a pathological diagnosis, 100 cases of confirmed lung cancer were entered into the study analysis. The prevalence and type of isolated fungi have been determined and compared to the characteristics of the participants and cell types of lung cancer.

Results
Fungi were isolated from 68% of the studied lung cancer cases. The most common isolated fungi were Candida albicans (32%), Aspergillus niger (28%), and Aspergillus fumigatus (8%). Fungi were isolated with a higher frequency in lung cancer cases with the following characteristics: males (p = 0.008), current or ex-smokers (p = 0.002), and chronic obstructive pulmonary disease (COPD) association (p = 0.01). In comparison to lung cancer cases with negative fungal culture, detection of fungal colonization was more associated with increasing severity of clinical presentation: higher grades of dyspnea (grade 1 vs. grade 2, p 0.001), a higher cough score (score 1 versus score 3, p 0.001), a higher chest pain score (score 0 versus score 1, p 0.001), and higher scores of hemoptysis (score 0 versus score 3, p 0.001). Otherwise, no difference was detected regarding age, frequency of comorbidities, chest computed tomography (CT) findings, lung cancer cell type, and staging in lung cancer patients with fungal colonization (p > 0.05).

Conclusion
Fungi were isolated in more than two thirds of lung cancer cases at the time of diagnosis with higher frequency among males, smokers, and those having associated COPD. This may negatively affect the response to treatment and prognosis of lung cancer. ClinicalTrials.gov (NCT 05575388).
As low as diagnostically acceptable dose imaging in maxillofacial trauma: a reference quality approach
Authors: Widmann Gerlig , Schönthaler Hannes , Tartarotti Alexander , Degenhart Gerald , Hörmann Romed , Feuchtner Gudrun , Jacobs Reinhilde , Pauwels Ruben 
Published: January 2023

Objectives: As-low-as-diagnostically-acceptable (ALADA) doses are substantially lower than current diagnostic reference levels. To improve dose management, a reference quality approach was tested in which phantom quality metrics of a clinical ALADA dose reference protocol were used to benchmark potential ALADA dose protocols for various scanner models. Methods: Spatial resolution, contrast resolution, contrast-to-noise ratio (CNR) and subjective noise and sharpness were evaluated for a clinical ALADA dose reference protocol at 80 kV and 40 mA (CTDIvol 2.66 mGy) and compared with test protocols of two CT scanners at 100 kV and 35 mA (3.08–3.44 mGy), 80 kV and 54–61 mA (2.65 mGy), 80 kV and 40 mA (1.73–1.92 mGy), and 80 kV and 21–23 mA (1.00–1.03 mGy) using different kernels, filtered backprojection and iterative reconstructions. The test protocols with the lowest dose showing quality metrics non-inferior to the reference protocol were verified in a cadaver study by determining the diagnostic accuracy of detection of maxillofacial fractures and CNR of the optical nerve and rectus inferior muscle. Results: 36 different image series were analysed in the phantom study. Based on the phantom quality metrics, potential ALADA dose protocols at 1.73–1.92 mGy were selected. Compared with the reference images, the selected protocols showed non-inferiority in the detection and classification of maxillofacial fractures and non-inferior CNR of orbital soft tissues in the cadaver study. Conclusions: Reference quality metrics from clinical ALADA dose protocols may be used to guide selection of potential ALADA dose protocols of different CT scanners.
Ψήγματα κριτικής, 4–10
Authors: Jordan David 
Published: January 2023

Critical Trifles, 4–10 [continuation of «Ψήγματα κριτικής», Eulimene 1 (2000) 127–31].
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