bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thoracoscopic esophageal drainage for tracheal compression due to mucocele after esophagogastric bypass: a case report
Authors: Yamashita Takeshi , Otsuka Koji , Goto Satoru , Ariyoshi Tomotake , Motegi Kentaro , Kohmoto Masahiro , Saito Akira , Fujimasa Koichiro , Sato Yoshihito , Kato Rei , Sawatani Tetsuo , Murakami Masahiko 
Published: June 2023

Abstract
Background
Esophagogastric bypass is performed for esophageal strictures. Mucus retention, known as mucocele, sometimes occurs at the stricture oral side of the remnant esophagus. It is often asymptomatic and is expected to be naturally decompressed, but it may cause respiratory failure depending on the case. Herein, we report a case in which we successfully performed thoracoscopic esophageal drainage as emergency airway management due to tracheal compression by a mucocele after esophagogastric bypass for unresectable esophageal cancer with esophagobronchial fistula.

Case presentation
A 56-year-old man underwent esophageal bypass surgery for an unresectable esophageal carcinoma with an esophagobronchial fistula following chemotherapy and radiation therapy. Nine months after bypass surgery, he experienced severe dyspnea due to tracheal compression caused by mucus retention on the oral side of the esophageal tumor. We planned thoracoscopic surgery for mucus retention drainage through the right thoracic cavity to secure the airway as an emergency procedure under general anesthesia. Intubation can be performed safely by guiding bronchoscopy in the semi-supine position. Upper esophageal dilation was observed on the cranial side of the azygos arch. We dissected the mediastinal pleura of the upper thoracic esophagus and exposed its wall. A 12-Fr silicone drain was placed in the esophagus through the right chest wall and 120 ml of white fluid was aspirated. He was discharged 9 days after surgery without complications and resumed treatment with an immune checkpoint inhibitor 23 days after surgery. Thereafter, he continued chemotherapy for esophageal cancer, but died of tumor progression and lung metastasis 35 months after bypass surgery and 25 months after thoracoscopic surgery.

Conclusions
Thoracoscopic esophageal drainage could be performed safely as emergency airway management, shorten the period of discontinuance, and allow cancer treatment to be resumed promptly. We believe that this thoracoscopic procedure is an effective and less invasive method if the percutaneous approach is difficult.
The feasibility of a randomized controlled crossover trial to assess the effect of probiotic and prebiotic supplementation on the health of elite wheelchair athletes
Authors: Hertig-Godeschalk Anneke , Glisic Marija , Ruettimann Belinda , Valido Ezra , Capossela Simona , Stoyanov Jivko , Flueck Joelle L. 
Published: June 2023

Abstract
Background
Gastrointestinal (GI) problems represent a health burden in Para athletes and can ultimately reduce athletic performance. This study aimed to evaluate the feasibility of a randomized controlled crossover trial (RCCT) assessing the effects of probiotic and prebiotic supplementation on the health of Swiss elite wheelchair athletes.

Methods
The RCCT was conducted between March 2021 and October 2021. Athletes were randomized to receive either a daily probiotic (3 g of probiotic preparation, including eight bacterial strains), or a daily prebiotic (5 g of oat bran) supplementation first. After the first supplementation phase (4 weeks), a washout period (4 weeks) and the second crossover supplementation phase (4 weeks) followed. Data were collected at four study visits (every 4 weeks) and included 3-day training and nutrition diaries, the Gastrointestinal Quality of Life Index (GIQLI) questionnaire, stool samples, and fasting blood samples. The study assessed the feasibility criteria such as recruitment rate, retention rate, success of data collection, adherence to the protocol, willingness to participate, and safety.

Results
This pilot study met the majority of the predefined minimum requirements for the feasibility criteria. Out of 43 invited elite wheelchair athletes, 14 (33%) consented (mean (standard deviation) age: 34 (9) years, eight females, 11 with a spinal cord injury). The desired sample size was not reached, but the achieved recruitment rate was modest, especially considering the population studied. All participating athletes completed the study. With the exception of one missing stool sample and two missing diaries, data were successfully collected for all athletes at all four visits. Most athletes adhered to the daily intake protocol for at least 80% of the days, both for probiotics (n = 12, 86%) and prebiotics (n = 11, 79%). Ten (71%) athletes would be willing to participate in a similar study again. No serious adverse events occurred.

Conclusion
Despite the limited number of elite wheelchair athletes in Switzerland and the modest recruitment rate, the implementation of a RCCT in elite wheelchair athletes is feasible. The data collected in this study provide essential information for the design of the subsequent study which will include a larger cohort of physically active wheelchair users.

Trial registration
Swiss Ethics Committee for Northwest/Central Switzerland (EKNZ), 2020–02337). ClinicalTrials.gov, NCT04659408.
Challenges of managing hypertension in Pakistan - a review
Authors: Elahi Adil , Ali Arzina Aziz , Khan Aamir Hameed , Samad Zainab , Shahab Hunaina , Aziz Namra , Almas Aysha 
Published: June 2023

Abstract
Background
This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension.

Methods
A comprehensive literature search was conducted electronically using PubMed and Google Scholar. Using specific screening methodology, 55 articles were selected to be included.

Results
We found from this extensive review that several small studies report high prevalence of hypertension but there is a lack of population based prevalence of hypertension in Pakistan. Lifestyle risk factors such as obesity, unhealthy diet, decreased physical activity, low socioeconomic status, and lack of access to care were the main associated factors with hypertension. Lack of blood pressure monitoring practices and medication non-adherence were also linked to uncontrolled hypertension in Pakistan and were more evident in primary care setups. The evidence presented is essential for delineating the burden of the disease, hence allowing for better management of this underserved population.

Conclusion
There is a need for updated surveys to depict the true prevalence and management of hypertension in Pakistan. Cost-effective implementation strategies and policies at the national level are needed for both prevention and control of hypertension.
Interactional effects of depressive symptoms and physical function on daily physical activity in ambulatory patients receiving hemodialysis
Authors: Matsunaga Yusuke , Suzuki Yuta , Yamamoto Shohei , Imamura Keigo , Yoshikoshi Shun , Harada Manae , Kutsuna Toshiki , Kamiya Kentaro , Yoshida Atsushi , Ichikura Kanako , Fukase Yuko , Murayama Norio , Tagaya Hirokuni , Matsunaga Atsuhiko 
Published: June 2023

Abstract
Background
Clarification of the factors associated with decreased physical activity is crucial for effective disease management in patients undergoing hemodialysis. Although evidence suggests that physical activity may be associated with physical function or depressive symptoms, limited studies have demonstrated these factors to be independently associated with the former in patients undergoing hemodialysis. This study aimed to examine whether physical function and depressive symptoms were independently or interactively associated with daily physical activity in patients undergoing hemodialysis.

Methods
This cross-sectional study analyzed 157 clinically stable outpatients (median age: 68 years) receiving hemodialysis. Physical activity (steps/day) was measured using an accelerometer for four consecutive non-dialysis days. Physical function was evaluated by calculating usual walking speed along a 10-m walkway. The 10-item version of the Center for Epidemiologic Studies for Depression Scale was used to assess depressive symptoms.

Results
The hierarchical multiple regression model (Model 2), constructed by adding physical function to Model 1 (clinical characteristics), showed a significant increase in coefficient of determination (R2), compared to Model 1 (ΔR2 = 0.15, P < 0.01). There was no significant increase in R2 between Models 2 and 3, where depressive symptoms were added to Model 2. The interaction term of physical function with depressive symptoms in Model 4 indicated an increase in R2 (ΔR2 = 0.01, P = 0.03), compared with Model 3. The simple slope analysis demonstrated that the difference in physical activity between patients with or without depressive symptoms at higher levels of physical function was greater than that at its lower levels.

Conclusions
Physical function was a strong and independent factor associated with physical activity, but no independent relationship between depressive symptoms and the physical activity was observed in patients undergoing hemodialysis. In contrast, physical function and depressive symptoms were interactively associated with daily physical activity in patients undergoing hemodialysis who were capable of walking independently. Our findings suggested that a two-step screening, primarily based on physical function and then depressive symptoms, can be useful to identify factors associated with physical inactivity in hemodialysis patients.
Aging and leukemic evolution of hematopoietic stem cells under various stress conditions
Authors: Kurosawa Shuhei , Iwama Atsushi 
Published: June 2023

AbstractHematopoietic stem cells (HSCs) have self-renewal capacity and differentiation potential into all lineages of blood cells throughout the lifetime of an organism. The function of HSCs gradually changes during aging. To date, various stress factors influencing HSC aging have been identified. The increased production of reactive oxygen species and DNA damage responses are causatively attributed to HSC aging. The increased apolarity is a prominent feature of aged HSCs, whereas it is less obvious in young HSCs. The bone marrow (BM) microenvironment niche is a crucial factor for HSC aging. Mesenchymal stem cells show skewed differentiation during aging, which leads to decreased bone formation and increased adipogenesis. The accumulation of adipocytes confers negative effects on hematopoiesis. Loss of sympathetic nerve fibers or adrenoreceptor β3 signaling induces premature HSC and niche aging. Epigenetic regulators such as polycomb group proteins and the sirtuin family of proteins act to prevent premature aging. Targeting these factors, several rejuvenation strategies for aged HSCs have been employed in mice. However, we still do not know whether these strategies can be extrapolated to human HSCs. Aging is frequently accompanied by the development of clonal hematopoiesis, which is called age-related clonal hematopoiesis (ARCH) or clonal hematopoiesis of indeterminate potential (CHIP). Most ARCH/CHIP mutations occur in genes encoding epigenetic regulators including DNMT3A, TET2, and ASXL1, which suggests the relevance of epigenetic drift during the aging process. ARCH/CHIP is a strong risk factor for subsequent hematologic cancer. Notably, it also has an impact on the development of non-malignant disorders such as coronary heart disease. Further studies are warranted to decipher the complete picture of molecular crosstalk that regulates HSC aging.
Lupus and antiphospholipid syndrome diagnosis in a young female presenting with multiple non-specific symptoms
Authors: Jnani Jack 
Published: June 2023

AbstractA female in her 30s with no known past medical conditions presented to North Shore University Hospital with three weeks of intermittent fevers, fatigue, and malaise. She also reports generalized body pain, myalgias, ear pain, throat pain, and joint pain. She denies rash. She also reports nausea, vomiting, and diarrhea and a 10-pound weight loss in one week. She had a miscarriage at 16 weeks of gestation. She met systemic inflammatory syndrome criteria on admission as she was febrile to 102.9 Fahrenheit, tachycardic to 120 beats per minute, tachypneic to 22 breaths/minute, and had leukopenia with white blood cell count of 2,470 per cubic milliliter. Labs were significant for pancytopenia, elevated transaminases, low C3 complement level, double stranded DNA > 1000 IU/mL, anti-nuclear factor positive 1:1280, and positive antiphospholipid serology. She was treated with steroids and hydroxychloroquine and was started on warfarin.
Collaborative care model versus usual care for people with musculoskeletal conditions and co-existing anxiety and depression: protocol for a feasibility mixed-methods randomised controlled trial
Authors: Teixeira Maria Joao Cardoso , Tehrany Rokhsaneh , Jaggi Anju , Ahmed Refah , Dove Lucy , Ramanuj Parashar 
Published: June 2023

Background
In the UK 17.8 million people have musculoskeletal pathophysiology, which becomes universal with age. Levels of discomfort and incapability correlate with symptoms of anxiety and depression. People with sufficient symptoms who seek care can benefit from collaborative diagnosis and treatment of mental and physical health organised by a case manager. This paper presents the protocol for a feasibility trial of collaborative care in an orthopaedic setting.

Aims
To determine the feasibility and acceptability of providing collaborative care for patients with musculoskeletal conditions and co-existing symptoms of anxiety and depression identified on a screening tool in a physical and occupational therapy out-patient setting.

Method
A two-arm parallel-group randomised controlled trial will recruit 40 adult out-patients with at least moderate anxiety and depression, who have been referred for physiotherapy and occupational therapy. Participants will be allocated on a 1:1 ratio to collaborative care or to usual care. Co-primary outcomes will be key feasibility indicators collected at baseline and at 6 months. A qualitative study will be conducted post-intervention to explore the acceptability and potential improvements to the collaborative care model.

Results
This study will investigate the use of the collaborative care model for patients with musculoskeletal and co-existing moderate or severe levels of anxiety or depression.

Conclusions
The results will provide important evidence to determine a future trial.
The Modern, the Untimely, and the Planetary
Authors: Banerjee Prathama 
Published: June 2023

Abstract
This essay is a critical homage to Ranajit Guha, who passed away recently in his hundredth year. Through a rereading of Guha's bilingual oeuvre—including his later writings in Bengali—the essay explores Guha's rethinking of time as he started with Marxism, moved to a critique of historicism, then to a disavowal of history, on to postcolonial criticism, and ultimately to a cosmopolitical stance. It suggests that Guha's most important contribution to global critical theory is not his historiographical achievements but his unique phenomenology of time. Mobilizing both modern and nonmodern semiotic, grammatological, and aesthetic traditions, Guha reconceived time as a function of the limits and possibilities of human language and argued that common lives and subaltern subjects could not be accessed without admitting to the heterogenous temporal constitution—“time-knots” as he would call them—of the contemporary. Thinking with Guha helps us make the general argument that emancipatory politics demands a radical reopening of the question of time and a stepping aside of the framework of modernity—an argument that other erstwhile Subaltern Studies authors such as Dipesh Chakrabarty and Partha Chatterjee have recently made. The essay understands Guha's century-long political and intellectual journey as a metonym for our times, marked by an agonistic and unpredictable interplay of multiple pasts, losses, emergences, and futures.
The dynamics behind diversity in suboscine songs
Authors: Amador Ana , Mindlin Gabriel B. 
Published: June 2023

ABSTRACT
Vocal behavior plays a crucial evolutionary role. In the case of birds, song is critically important in courtship, male–male competition and other key behaviors linked to reproduction. However, under natural conditions, a variety of avian species live in close proximity and share an ‘acoustic landscape’. Therefore, they need to be able to differentiate their calls or songs from those of other species and also from those of other individuals of the same species. To do this efficiently, birds display a remarkable diversity of sounds. For example, in the case of vocal learners, such as oscine passerines (i.e. songbirds), complex sequences and subtle acoustic effects are produced through the generation of complex neuromuscular instructions driving the vocal organ, which is remarkably conserved across approximately 4000 oscine species. By contrast, the majority of the sister clade of oscines, the suboscine passerines, are thought not to be vocal learners. Despite this, different suboscine species can generate a rich variety of songs and quite subtle acoustic effects. In the last few years, different suboscine species have been shown to possess morphological adaptations that allow them to produce a diversity of acoustic characteristics. Here, we briefly review the mechanisms of sound production in birds, before considering three suboscine species in more detail. The examples discussed in this Review, integrating biological experiments and biomechanical modeling using non-linear dynamical systems, illustrate how a morphological adaptation can produce complex acoustic properties without the need for complex neuromuscular control.
Maternal and neonatal outcomes in women with twin pregnancies based on gestational weight gain: An updated systematic review and meta-analysis
Authors: Wang Xiaoyin , Yan Mei , Xu Zhou , Zhuang Lin 
Published: June 2023

Objective: This updated systematic review and meta-analysis aimed to assess maternal and fetal outcomes of pregnancies based on the Institute of Medicine (IOM) guidelines of gestational weight gain (GWG).
Methods: PubMED, SCOPUS, EMBASE and Web of Science were searched up to 30th July 2022. All studies evaluating maternal and/or neonatal outcomes of twin pregnancies based on the IOM guidelines of gestational weight gain were included.
Results: Twenty two studies were included. Mothers with twin pregnancies experiencing inadequate GWG showed higher incidence of gestational diabetes with the risk ratio (RR) 1.22 95% CI (0.95,1.57), p=0.0005, i2= 69% and premature rupture of membrane (PROM) with RR 1.14 95% CI (0.99, 1.30), p=0.07; i2=0% that coincided with higher rates of preterm birth, low birth weight, small for gestational age (SGA) and admission to NICU in neonates. Mothers with excessive GWG had higher risk of developing gestational hypertension with RR 1.59 95% CI (1.22, 2.07), p=0.0006, i2=75% and extremely preterm delivery (<32 weeks).
Conclusion: Within the limitations of this review, GWG was found to be a predictable risk factor for adverse maternal and neonatal outcomes of twin pregnancies.
doi: https://doi.org/10.12669/pjms.39.4.7529
How to cite this: Wang X, Yan M, Xu Z, Zhuang L. Maternal and neonatal outcomes in women with twin pregnancies based on gestational weight gain: An updated systematic review and meta-analysis. Pak J Med Sci. 2023;39(4):1166-1177. doi: https://doi.org/10.12669/pjms.39.4.7529
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.
SECAI – Sustainable Heating through Edge-Cloud-based AI Systems
Authors: Kortum Henrik , Hagen Simon , Eleks Marian , Rebstadt Jonas , Remark Florian , Lowin Maximilian , Wilson Cristina Mihale , Eberhardt Birgid , Roß Andree , Maihöfner Dominik , Hinz Oliver , Thomas Oliver 
Published: June 2023

ZusammenfassungEtwa 18 % der CO2-Emissionen in Deutschland entstehen durch die Beheizung, Kühlung und Warmwasserbereitstellung von Gebäuden, wobei mehr als 75 % der deutschen Haushalte fossile Brennstoffe wie Erdgas und Erdöl nutzen. Der in dieser Arbeit vorgestellte SECAI (Sustainable heating through Edge-Cloud-based Artificial Intelligence Systems)-Ansatz verfolgt das Ziel, die Heizungssteuerung in Mehrfamilienhäusern und damit den CO2-Verbrauch durch den Einsatz von Informationstechnologien zu reduzieren.Der SECAI-Ansatz betrachtet dabei das gesamte Ökosystem bestehend aus Sensoren, Einzelraumregelungen, Zentralheizung, Mietenden und Vermietenden. Dabei wird der Heizbedarf von Privatwohnungen KI-basiert analysiert, um darauf aufbauend optimierte und abgestimmte Heizpläne für Gebäudekomplexe und Wohnungen zu erstellen, die in der Lage sind, durch Edge-Cloud-Technologien, Sensorik und Federated Learning ad hoc und datenschutzkonform auf Änderungen im Nutzungsverhalten zu reagieren. Diese Informationen werden zudem für die KI-basierte Steuerung der zentralen Heizanlagen im Gebäude verwendet, in denen Wärme und Warmwasser für alle Wohnungen erzeugt wird. Hierfür betrachtet SECAI vier Ebenen. Diese reichen von Sensoren und Aktoren (Nano), über die Wohnung (Mikro) und das Gebäude (Meso) bis zu Gebäudekomplexen und gleicharten Gebäuden (Makro) und stehen bei der Beheizung in starker Abhängigkeit zueinander. Rund um die SECAI-Lösung entsteht dabei ein komplexes Ökosystem in dem Mietende, die Wohnungswirtschaft, Heizungshersteller und Anbieter von IoT-Lösungen mit Produkten und Diensten in Interaktion treten.