bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Probiotics and Vitamin D3 Supplementation on Sports Performance Markers in Male Mixed Martial Arts Athletes: A Randomized Trial
Authors: Przewłócka Katarzyna , Kujach Sylwester , Sawicki Piotr , Berezka Paweł , Bytowska Zofia Kinga , Folwarski Marcin , Kowalski Kondrat , Kaczor Jan Jacek 
Published: May 2023

Abstract
Background
Strategies targeted at the intestine microbiome seem to be beneficial for professional athletes. The gut–muscle axis is associated with the inflammatory state, glucose metabolism, mitochondrial function, and central nervous system health. All these mechanisms may affect maximal oxygen uptake, muscle strength, and training adaptation. Moreover, the positive effect of certain bacterial strains may be enhanced by vitamin D. Thus, this study aimed to assess and compare the level of selected markers of sports performance of mixed martial arts (MMA) athletes supplemented with vitamin D3 or probiotics combined with vitamin D3.

Methods
A 4-week randomized double-blind placebo-controlled clinical trial was conducted with 23 MMA male athletes assigned to the vitamin D3 group (Vit D; n = 12) or probiotics + vitamin D3 group (PRO + VitD; n = 11). Repeated measures of the creatine kinase level, lactate utilization ratio, and anaerobic performance were conducted.

Results
After 4 weeks of supplementation, we found lower lactate concentrations 60 min after the acute sprint interval in the PRO + VitD group when compared to the Vit D group (4.73 ± 1.62 and 5.88 ± 1.55 mmol/L; p < 0.05). In addition, the intervention improved the total work (232.00 ± 14.06 and 240.72 ± 13.38 J kg−1; p < 0.05), and mean power following the anaerobic exercise protocol (7.73 ± 0.47 and 8.02 ± 0.45 W kg−1; p < 0.05) only in the PRO + VitD group. Moreover, there was an improvement in the lactate utilization ratio in the PRO + VitD group compared with the Vit D group as shown by the percentage of T60/T3 ratio (73.6 ± 6.9 and 65.1 ± 9.9%, respectively; p < 0.05). We also observed elevated serum 25(OH)D3 concentrations after acute sprint interval exercise in both groups, however, there were no significant differences between the groups.

Conclusion
Four weeks of combined probiotic and vitamin D3 supplementation enhanced lactate utilization and beneficially affected anaerobic performance in MMA athletes.
Extensive anaplastic multi-centric ependymoma in a young adult: case report and literature review
Authors: Aballa Lamya , Chraa Mohamed , Louhab Nissrine , Kissani Najib 
Published: May 2023

Abstract
Background
Ependymoma is a rare adult tumor that originates from ependymal cells of the ventricles and the spinal cord. The diagnosis and management can be very challenging. This study aims to bring out the hypothalamus as an atypical location of ependymoma and to underline the consequences of treatment delay in anaplastic ependymomas through a concrete case.

Case presentation
We present a case of 20 years with no previous medical history, suffering from progressive intracranial hypertension syndrome, tetraparesis, cerebellar ataxia, and a weight loss of 3 kg in 4 months. Cerebral and medullar Magnetic Resonance Imaging showed multiple processes including the temporal region, the cerebellum, the 4th ventricular floor, the interpeduncular cistern, the hypothalamus, and almost the entire spinal cord, in addition to a posterior intradural lesion. The hypothalamic localization was very suggestive of neurohistiocytosis. A stereotactic biopsy and immunohistochemical study confirmed the diagnosis of anaplastic ependymoma. Total resection was impossible and radiotherapy was delayed by inconclusive dosimetric scans. The patient's outcome was unfortunately quickly fatal.

Conclusions
Ependymomas should be evoked whatever the location in the central nervous system. Radiotherapy must be quickly discussed and started when the gross total resection is impossible. The locations, as well as the doses of irradiation, are now well-established and any delay in initiating radiotherapy only darkens the prognosis.
Locally advanced primary breast lymphoma: a rare case report
Authors: Pereira Rafaela , Costa Luísa Amado , Rosa José Eduardo , Duarte Isabel 
Published: May 2023

Abstract
Background
Primary Breast Lymphoma is a rare manifestation of extranodal non-Hodgkin lymphoma and accounts for less than 1% of all breast malignancies. It is defined by localized involvement of the mammary tissue by lymphomatous infiltrate in the absence of prior extramammary lymphoma and concomitant widespread disease.

Case presentation
A 46-year-old melanodermic woman was referred to our hospital due to an extensive ulcerated right breast lesion with signs of infection. Imaging studies revealed a large breast tumor invading the chest wall, with cortical disruption of adjacent ribs and associated pleural thickening. Later, it was complicated with a bronchopleural cutaneous fistula. Biopsy of the mass was performed and the histopathologic diagnosis was consistent with breast infiltration by diffuse large B-cell lymphoma. Concurrent widespread lymphomatous disease and preceding extramammary lymphoma were excluded. Firstly, antibiotic therapy was instituted and surgical debridement was performed in order to control the infection. Afterwards, she underwent chemotherapy and local radiotherapy, with radiologic complete response.

Conclusions
The diagnosis of primary breast lymphoma is challenging because this disease has non-specific symptoms and imaging features. Radio–pathological correlation and exclusion of systemic lymphoma are essential to establish the diagnosis and to minimize potential complications.
Pirtobrutinib in Covalent Bruton Tyrosine Kinase Inhibitor Pretreated Mantle-Cell Lymphoma
Authors: Wang Michael L. , Jurczak Wojciech , Zinzani Pier Luigi , Eyre Toby A. , Cheah Chan Y. , Ujjani Chaitra S. , Koh Youngil , Izutsu Koji , Gerson James N. , Flinn Ian , Tessoulin Benoit , Alencar Alvaro J. , Ma Shuo , Lewis David , Lech-Maranda Ewa , Rhodes Joanna , Patel Krish , Maddocks Kami , Lamanna Nicole , Wang Yucai , Tam Constantine S. , Munir Talha , Nagai Hirokazu , Hernandez-Ilizaliturri Francisco , Kumar Anita , Fenske Timothy S. , Seymour John F. , Zelenetz Andrew D. , Nair Binoj , Tsai Donald E. , Balbas Minna , Walgren Richard A. , Abada Paolo , Wang Chunxiao , Zhao Junjie , Mato Anthony R. , Shah Nirav N. 
Published: May 2023

PURPOSE Pirtobrutinib is a highly selective, noncovalent (reversible) Bruton tyrosine kinase inhibitor (BTKi). We report the safety and efficacy of pirtobrutinib in patients with covalent Bruton tyrosine kinase inhibitor (cBTKi) pretreated mantle-cell lymphoma (MCL), a population with poor prognosis. METHODS Patients with cBTKi pretreated relapsed/refractory (R/R) MCL received pirtobrutinib monotherapy in a multicenter phase I/II trial (BRUIN; ClinicalTrials.gov identifier: NCT03740529 ). Efficacy was assessed in the first 90 consecutively enrolled patients who met criteria for inclusion in the primary efficacy cohort. The primary end point was overall response rate (ORR). Secondary end points included duration of response (DOR) and safety. RESULTS The median patient age was 70 years (range, 46-87), the median prior lines of therapy was 3 (range, 1-8), 82.2% had discontinued a prior cBTKi because of disease progression, and 77.8% had intermediate- or high-risk simplified MCL International Prognostic Index score. The ORR was 57.8% (95% CI, 46.9 to 68.1), including 20.0% complete responses (n = 18). At a median follow-up of 12 months, the median DOR was 21.6 months (95% CI, 7.5 to not reached). The 6- and 12-month estimated DOR rates were 73.6% and 57.1%, respectively. In the MCL safety cohort (n = 164), the most common treatment-emergent adverse events (TEAEs) were fatigue (29.9%), diarrhea (21.3%), and dyspnea (16.5%). Grade ≥3 TEAEs of hemorrhage (3.7%) and atrial fibrillation/flutter (1.2%) were less common. Only 3% of patients discontinued pirtobrutinib because of a treatment-related adverse event. CONCLUSION Pirtobrutinib is a first-in-class novel noncovalent (reversible) BTKi and the first BTKi of any kind to demonstrate durable efficacy after prior cBTKi therapy in heavily pretreated R/R MCL. Pirtobrutinib was well tolerated with low rates of treatment discontinuation because of toxicity.
Safe Prescribing Practices: Clinicians' Views on Prescribing Opioids to Patients With Early-Stage Cancer
Authors: Wood Timothy , Cheung Winson , Ruether Dean , Sinnarajah Aynharan , Tanguay Robert , Tarumi Yoko , Lau Jenny , Cuthbert Colleen Ann 
Published: May 2023

PURPOSE Opioids are often necessary for patients experiencing high-intensity pain. However, side effects exist and some patients may misuse opioids. To better understand how opioids are prescribed to patients with early-stage cancer and how to enhance opioid safety, clinicians' views of opioid prescribing were explored. METHODS This was a qualitative inquiry including any Alberta clinician prescribing opioids to patients with early-stage cancer. Semistructured interviews were conducted with nurse practitioners (NP), medical oncologists (MO), radiation oncologists (RO), surgeons (S), primary care physicians (PCP), and palliative care physicians (PC) between June 2021 and March 2022. Interpretive description was used to analyze the data using two coders (C.C. and T.W.). Debriefing sessions were used to resolve and discrepancies. RESULTS Twenty-four clinicians were interviewed (NP [n = 5], MO [n = 4], RO [n = 4], S [n = 5], PCP [n = 3], and PC [n = 3]). The majority had been in practice at least 10 years. Prescribing practices were related to disciplinary perspective, goals of care, patient condition, and resource availability. Most clinicians did not see opioid misuse as a problem but were aware that specific patient risk factors are present and that long-term use can be problematic. Most clinicians undertake safe prescribing approaches tacitly (eg, screening for past opioid misuse and reviewing number of prescribers) and not all agreed they should be universally applied. Barriers (eg, procedural and time) and facilitators (eg, education) to safe prescribing approaches were identified. CONCLUSION To enhance uptake and cross-disciplinary consistency of safe prescribing approaches, clinician education regarding opioid misuse and benefits of safe prescribing practices, and addressing procedural barriers are necessary.
Correlation between GAL-3, Klotho, Calcium and Phosphorus Metabolism Indexes and Cardiovascular Complications in patients with Chronic Kidney Disease
Authors: Li Zhe , Li Jian-Long , Wang Qian , Fan Xing , Gao Yan , Li Xue-Zhong 
Published: May 2023

Objective: To investigate the correlation between GAL-3, Klotho, calcium and phosphorus indexes and cardiovascular complications in patients with chronic kidney disease (CKD).
Methods: This is a retrospective study. Forty patients with CKD and cardiovascular complications admitted to the Affiliated Hospital of Hebei University from February 20, 2022 to February 20, 2023 were selected as the experimental group, and another 40 patients with CKD without cardiovascular complications were selected as the control group. The differences in serum Ca+2, PO-4, GAL-3 and Klotho levels between the two groups were analyzed, and the correlations between the above indicators levels and creatinine levels were analyzed. The correlation between the above indicators levels and cardiac function classification was analyzed, and analyzed the risk factors of CKD complicated with cardiovascular complications.
Results: The levels of Ca+2, PO-4 and GAL-3 in the experimental group were significantly higher than those in the control group, while the level of Klotho was significantly lower than that in the control group. The levels of Ca+2 and PO-4 were positively correlated with the level of Creatinine (Cr), while the level of Klotho was negatively correlated with the Cr. The levels of Ca+2 and PO-4 were positively correlated with cardiac function classification, while the level of Klotho was negatively correlated with cardiac function classification. Logistic regression analysis showed that hypertension, BMI, Cr, Ca+2, PO-4 and VLDL were risk factors for cardiovascular complications, and Klotho level was a protective factor.
Conclusion: A positive correlation can be seen between the levels of Ca+2, PO-4 and cardiac function classification in patients with CKD. Klotho is a protective factor for cardiovascular diseases.
doi: https://doi.org/10.12669/pjms.39.4.6988
How to cite this: Li Z, Li JL, Wang Q, Fan X, Gao Y, Li XZ. Correlation between GAL-3, Klotho, Calcium and Phosphorus Metabolism Indexes and Cardiovascular Complications in patients with Chronic Kidney Disease. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6988
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Combinatorial Auctions with Interdependent Valuations: SOS to the Rescue
Authors: Eden Alon , Feldman Michal , Fiat Amos , Goldner Kira , Karlin Anna R. 
Published: May 2023

We study combinatorial auctions with interdependent valuations, where each agent i has a private signal si that captures her private information and the valuation function of every agent depends on the entire signal profile, [Formula: see text]. The literature in economics shows that the interdependent model gives rise to strong impossibility results and identifies assumptions under which optimal solutions can be attained. The computer science literature provides approximation results for simple single-parameter settings (mostly single-item auctions or matroid feasibility constraints). Both bodies of literature focus largely on valuations satisfying a technical condition termed single crossing (or variants thereof). We consider the class of submodular over signals (SOS) valuations (without imposing any single crossing-type assumption) and provide the first welfare approximation guarantees for multidimensional combinatorial auctions achieved by universally ex post incentive-compatible, individually rational mechanisms. Our main results are (i) four approximation for any single-parameter downward-closed setting with single-dimensional signals and SOS valuations; (ii) four approximation for any combinatorial auction with multidimensional signals and separable-SOS valuations; and (iii) (k + 3) and (2 log(k) + 4) approximation for any combinatorial auction with single-dimensional signals, with k-sized signal space, for SOS and strong-SOS valuations, respectively. All of our results extend to a parameterized version of SOS, d-approximate SOS, while losing a factor that depends on d. Funding: A. Eden was partially supported by NSF Award IIS-2007887, the European Research Council (ERC) under the European Union's Seventh Framework Programme [FP7/2007-2013]/ERC Grant Agreement 337122, by the Israel Science Foundation [Grant 317/17], and by an Amazon research award. M. Feldman received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program [Grant Agreement 866132], by the Israel Science Foundation [Grant 317/17], by an Amazon research award, and by the NSF-BSF [Grant 2020788]. The work of K. Goldner was supported partially by NSF awards DMS-1903037 and CNS-2228610 and a Shibulal Family Career Development Professorship. A. R. Karlin was supported by the NSF-CCF [Grant 1813135].
A pilot study to investigate the effect of topical microporous polysaccharide haemospheres on outcomes following robot-assisted radical prostatectomy
Authors: Abou Chedid W , Janardanan S , Kavanagh L , Eden C 
Published: May 2023

Introduction Controlling bleeding without disturbing the anatomy and function of the structures in the prostate bed remains a significant challenge during radical prostatectomy (RP). Materials and methods Five grams of powdered microporous polysaccharide haemospheres (MPH) was applied to the prostate bed at the end of robot-assisted RP in 422 consecutive patients. Continence was defined as no pads and potency as the ability to have penetrative sex with or without PDE5 inhibitors in previously potent, non-diabetic men aged <70 years following bilateral intra- or inter-fascial neurovascular bundle (NVB) preservation. Results In total, 95.3% of patients had nerve preservation and the mean operating time and blood loss were 142 minutes and 200ml, respectively. There were no intraoperative complications, and the postoperative transfusion rate was 0.2%. The mean hospital stay was 1.7 nights, and duration of catheterisation was 12 days. Final pathology demonstrated a mean prostate weight of 40.0g and 14.5% replacement by cancer, most commonly Gleason 7. The positive surgical margin rate for pT2 tumours was 10.0%. Biochemical recurrence was 2.1% at a mean follow-up of 18.0 months. Continence and potency rates at 4 weeks and 1 year after surgery were 76.4% and 97.7% and 27.8% and 78.1%, respectively. The trifecta and pentafecta rates 1 year after surgery were 53.1% and 45.8%. Discussion and conclusion Powdered MPH applied to the prostate bed at the end of robot-assisted RP appears to be a safe, easily applied and useful adjunct to conventional haemostasis. The suggestion that it might also improve the functional outcomes of RP merits further investigation in the context of a randomised trial.
Surgeons’ user experience of telemedicine in surgical consultations during the COVID-19 pandemic, with an emphasis on general surgical consultations
Authors: Kumaran NK , Salama Y , Karmakar BK 
Published: May 2023

Background The COVID-19 pandemic and the eventual national lockdown in the UK brought a halt to the face-to-face outpatient appointments at most NHS hospitals. Owing to this, clinicians have had to switch to other means of consultation, to maintain continuity of care. This survey was done to see how surgeons perceive telemedicine as part of their surgical consultations. Methods A questionnaire was piloted and re-designed following which an improved questionnaire was circulated among all users of telemedicine in surgical specialties through social media platforms. The results were analysed using smart survey software. Results Seventy per cent of the respondents had never used telemedicine before the COVID-19 pandemic. Three-quarters of the respondents found difficulty in assessing patients preoperatively. A significant proportion were worried about confidentiality and data security. The other concerns expressed were difficulty in building a rapport and the absence of a legal framework to support the surgeons in the transition. Despite some concerns, most of them were in favour of using telemedicine in the future with some improvements. Conclusion As the pandemic prevented people from attending face-to-face appointments, remote consultations were stepped up to help overcome the difficulties. Screening services were suspended and treatment accumulated. Telemedicine will be a corner-stone service as healthcare systems attempt to tackle this backlog. The already existing software need to be further explored. Future studies must address the use of telemedicine in preoperative consultations. Regulatory bodies must ensure that there is adequate legal framework in place so that clinicians continue to embrace telemedicine.
Titanium miniplate removal after joint orthodontic–orthognathic surgery treatment: a 10-year retrospective hospital-based audit
Authors: Adatia A , Padashi-Fard M , Adali NS , Camilleri AC 
Published: May 2023

Introduction The reported incidence of titanium miniplate removal after orthognathic surgery varies widely, making delivery of risk information to patients problematic. This variation relates to potential biases introduced during the study design, for example, with the pooling of different patient types, creating heterogeneous study samples. This study reduces sampling bias by limiting the cohort to only consecutive orthognathic cases. The primary aim of the study was to identify the incidence of miniplate removal following orthognathic surgery. The secondary aim was to assess the indications and any risk factors for miniplate removal. Methods Data from the clinical records of 907 orthognathic surgery cases treated within a centralised oral and maxillofacial hospital service over a 10-year period were collected by two operators and analysed. Every identified case qualified for inclusion. Patient demographics (age, sex, medical comorbidity, smoking), operations (type of surgery, duration, third molar removal, complications) and the indication, timing and site of miniplate removal were analysed. Results Only 19 patients required postoperative miniplate removal, with the most common indication being infection (63%). There was no significant difference in any of the factors assessed except that significantly more miniplates were removed from female patients (68%) (p<0.001) and from mandibular sites (84.2%) (p=0.003). Conclusions The incidence of miniplate removal for this sample was 2.1%. Female sex and miniplate location in the mandible were the only statistically significant risk factors for miniplate removal.
How to WHO: lessons from aviation in checklists and debriefs
Authors: Guy IA , Kerstein RL , Brennan PA 
Published: May 2023

Introduction The World Health Organization (WHO) surgical safety checklist (SSC) has had an overall positive impact; however, it has not completely prevented adverse events and compliance with the checklist varies. The aviation industry is considered to have better engagement with their safety checklists, reporting not only safety improvements, but also a cultural shift in their checklist philosophy over recent years. Methods We explored the personal attitudes of pilots working in the aviation industry to identify principles of an effective checklist philosophy that could be transposed to the healthcare setting to empower more effective, consistent and ultimately successful implementation of the WHO SSC. A questionnaire was developed by the authors. Three airline pilots were interviewed via telephone, and asked questions regarding the logistics of and attitudes to checklists in the aviation industry. Results Several key factors for successful checklist implementation were identified. These include regular training and education on human factors and the checklist’s purpose, and institution of an atmosphere that is receptive, engaged and welcoming. Much can be learned from the aviation industry, where not only has the incidence of adverse events decreased, but the attitudes of people working in the industry have also transformed. Conclusion The WHO SSC is an invaluable tool used in healthcare settings worldwide. However, it is not a standalone commodity. To be effective, it necessitates steadfast engagement from the team members involved in its implementation. Human and checklist must work in partnership, using each other’s strengths and fallibilities, to optimise outcomes and prevent risks to patient safety.