bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Sensory-Motor Neuropathy Mimicking CIDP as Predominant Presentation of PDH Deficiency
Authors: Croci Carolina , Cataldi Matteo , Baratto Serena , Bruno Claudio , Trucco Federica , Doccini Stefano , Romano Alessandro , Nesti Claudia , Santorelli Filippo Maria , Fiorillo Chiara 
Published: January 2023

Abstract
Introduction Pyruvate dehydrogenase complex (PDH) deficiency (Online Mendelian Inheritance in Man # 312170) is a relatively common mitochondrial disorder, caused by mutations in the X-linked PDHA1 gene and presenting with a variable phenotypic spectrum, ranging from severe infantile encephalopathy to milder chronic neurological disorders.Isolated peripheral neuropathy as predominant clinical presentation is uncommon.
Results We report on a patient, now 21 years old, presenting at the age of 2 years with recurrent symmetric weakness as first symptom of a PDH deficiency. Neurophysiological evaluation proving a sensory-motor polyneuropathy with conduction blocks and presence of elevated cerebrospinal fluid proteins, suggested a chronic inflammatory demyelinating polyneuropathy. The evidence of high serum lactate and the alterations in oxidative metabolism in muscle biopsy pointed toward the final diagnosis. After starting nutritional supplements, no further episodes occurred. A hemizygous mutation in PDHA1 (p.Arg88Cys) was identified. This mutation has been previously described in five patients with a similar phenotype. A three-dimensional reconstruction demonstrated that mutations affecting this arginine destabilize the interactions between the subunits of the E1 complex.
Conclusion We summarize the clinical and genetic characteristics of one patient with PDH deficiency presenting isolated peripheral nervous system involvement. This study highlights that the diagnosis of PDH deficiency should be considered in children with unexplained peripheral neuropathy, even with features suggestive of acquired forms, especially in case of early onset and limited response to treatment. A simple analysis of lactic acid could help to target the diagnosis.In addition, we suggest that the residue Arg88 is the most frequently involved in this specific phenotype of PDH deficiency.
Endoscopic management of gastrointestinal wall defects, fistula closure, and stent fixation using through-the-scope tack and suture system
Authors: Krishnan Arunkumar , Shah-Khan Sardar M. , Hadi Yousaf , Patel Neel , Thakkar Shyam , Singh Shailendra 
Published: January 2023

Background Multiple devices are available for tissue approximation. A new through-the-scope suturing (TTSS) device has recently been introduced; however, data on its scope of use and clinical effectiveness are limited. We aimed to assess the clinical course and effectiveness of this TTSS device.
Methods A retrospective review was performed for consecutive patients who underwent TTSS application. Primary outcomes were technical and clinical success, and secondary outcomes included adverse events and long-term clinical success.
Results 53 patients (mean age 67.8 years; 69.8 % females) were included, with a mean defect size of 32.6 mm (SD 11.9). Technical success was achieved in 51 patients (96.2 %). Clinical success was achieved in 49 patients (92.4 %). Two patients (3.8 %) experienced failed fistula closure after technical success. Long-term follow-up (> 30 days) was available for 45 patients (84.9 %), with a mean follow-up of 7.2 months. One patient (1.9 %) had self-reported bleeding that did not require further intervention.
Conclusions TTTS was an effective and safe method for the closure of large gastrointestinal defects and could be used for fistula closure and stent fixation, making it a valuable addition to the armamentarium of endoscopic closure devices.
Imaging Recommendations for Diagnosis, Staging, and Management of Ovarian and Fallopian Tube Cancers
Authors: Rupa Renganathan , Prema Renganathan , Popat Palak Bhavesh , Manchanda Smita , Venkatesh Kasi , Chandramohan Anuradha , Subbian Anbukkani , Rangarajan Bharath 
Published: January 2023

AbstractOvarian malignancy the third most common gynecological malignancy and is the leading cause of death in women. Non-specific clinical presentation delays the diagnosis, and they often present in the advanced stage of disease. No imaging modality is recommended for screening as there is no significant mortality reduction. Ultrasound (USG) is usually the initial modality in suspected ovarian mass. MRI is recommended for the characterization of indeterminate ovarian or adnexal mass on USG. CT abdomen and pelvis with oral and IV contrast is the recommended imaging modality in staging the disease, predicting the resectability and in selecting the patients who would benefit from neoadjuvant chemotherapy. Early ovarian cancers are staged by post-surgical histology and undergo upfront surgery. Advanced disease benefit by neoadjuvant chemotherapy and less morbidity by interval cytoreduction where image-guided biopsy is performed for histological diagnosis. Follow-up recommendations are based on tumor histology. CT/PET CT is recommended for diagnosing recurrence.
Is It Possible to Eliminate Postoperative Shunt Infections?: Results of a Modified Hydrocephalus Clinical Research Network Protocol
Authors: Elbaroody Mohammad , Ezz Adham , Eldessouky Amr Helmy , Hassan Ahmed A. Aziz N. , Elsharkawy Ahmed Abbas , Ali Khaled Bassim , Refaee Ehab Ahmed El 
Published: January 2023

Abstract
Background Postoperative shunt infection is a nightmare in neurosurgical practice with additional morbidity and mortality. A lot of protocols have contributed to the reduction of ventriculoperitoneal shunt (VPS) infections but not eradication. The aim of the study was to evaluate the rigid application of a modified Hydrocephalus Clinical Research Network (HCRN) protocol in the prevention of postoperative shunt infection.
Methods We retrospectively evaluated children with congenital hydrocephalus who underwent VPS insertion, and in whom the protocol was applied from June 2019 to January 2020. Follow-up ranged from 11 to 24 months.
Results Thirty-seven procedures were performed including 35 primary shunt insertions and two revision surgeries. The median age was 5 months (range, 1–30 months), and 25 patients were males. The most common cause for VPS placement was congenital hydrocephalus without identifiable cause in 28 cases (80%). The endoscope-assisted technique was used in the insertion of the proximal end in six cases (17%). The mean follow-up was 19.4 months (11–24 months). The rate of shunt infection was 0% till the last follow-up.
Conclusion The preliminary results showed an effective method for the prevention of postoperative shunt infections using the modified protocol. These initial findings need to be validated in a large prospective study before widespread application can be recommended.
Postoperative Discomfort Among Laparotomy Patients from a Selected Hospital at Mangaluru: An Observational Study
Authors: Latha S. , Kamath Neetha , Joseph Gincy 
Published: January 2023

Abstract
Background Factors causing postoperative discomfort after laparotomy are numerous and must be explored in depth. The postoperative distress may significantly affect the patient's state of well-being. Hence, the present study aims to assess the factors contributing to discomfort after laparotomy.
Aim The aim was to assess and compare the discomfort between open and laparoscopic abdominal surgery.
Objectives of the Study
1. To analyze the causes of patient's discomfort after abdominal surgery.2. To compare the discomfort between open and laparoscopic abdominal surgery.3. To determine the association between pain and selected variables among open and laparoscopic abdominal surgery.
Materials and Methods An exploratory approach with a prospective observational design was adopted for this study. Using the purposive sampling technique, 100 patients were selected to open and 100 to laparoscopic abdominal surgery groups. Data were collected using demographic and clinical proforma and standardized postoperative discomfort inventory 6 and 24 hours after the surgery. The assessment focused on the study variables such as symptoms after the surgery and the factors contributing to the postoperative discomfort.
Statistical Analysis The collected data were analyzed using descriptive and inferential statistics using the SPSS software version 20.
Results Among 200 participants, most of the open (68%) and laparoscopic abdominal surgeries (42%) belong to 25 to 35 years of age. Also, 54% and 13% were diabetic in open and laparoscopic abdominal surgery groups, respectively. Most samples (56% in open and 68% in laparoscopic surgery) stayed 5 and 10 hours in postoperative ICU. In open and laparoscopic abdominal surgeries, pain is the primary (100%) cause of postoperative discomfort after 6 hours of surgery. Movement restriction is also the reason for significant discomfort both in open (98%) and laparoscopic (100%) abdominal surgeries.In contrast, pain (99% and 100%), movement restriction (92% and 95%), and abdominal distention (61% and 34%) were the major problems contributing to the patient's discomfort after 24 hours of both open and laparoscopic surgeries too. There was a significant difference in causes of patient discomfort between open and laparoscopic abdominal surgery after 6 hours (P < 0.05), except for discomfort related to IV drip (P = 0.852), constipation (P = 0.2), and chills (P = 0.6).
Conclusion Even though pain is the major distressing factor both in open and laparoscopic surgeries, the current study highlights a few other factors that affect postoperative recovery. Nurses' attention to such distressing factors will fasten patients' recovery and quality of life after abdominal surgery.
Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Epicutaneo-Caval Catheter Placement in Neonates
Authors: D'Andrea Vito , Prontera Giorgia , Cota Francesco , Russo Rosellina , Barone Giovanni , Vento Giovanni 
Published: January 2023

Objective Epicutaneo-caval catheters (ECCs) are essential for the care of sick infants who require long-term medical and nutritional management. The aim of this study was to investigate the use of real-time ultrasound as an alternative to X-rays to reduce the incidence of primary malpositions during catheter insertion.
Study Design Data on ECCs were retrospectively collected in a tertiary neonatal intensive care unit. Catheter were analyzed considering the tip location technique (standard chest–abdominal radiograph vs real-time ultrasound)
Results A total of 248 ECCs were analyzed. Of these, 118 catheters had primary malposition (47.6%). The tip of 165 catheters was assessed using standard chest–abdominal X-rays and 107 (64.8%) were found to be in an inappropriate location. In the group of 83 catheters that were placed using real-time ultrasound for tip location, only 11 catheters (13.2%) had primary malposition. The rate of malposition among the two groups showed a statistically significant difference (p < 0.001). Hypothetically, 300 chest X-rays could have been saved if real-time ultrasound had been used to locate the tip, reducing radiation exposure to infants.
Conclusion The use of a real-time ultrasound may be beneficial in reducing primary catheter malpositions compared with conventional radiography. In addition, secondary malpositions and catheter-related complications can be monitored over time.
Key Points
Does Fissureless Videothoracoscopic Lobectomy Help for Postoperative Air Leak?
Authors: Kara Murat , Özkan Berker , Duman Salih , Erdoğdu Eren , Sarıgül Arda , Toker Alper 
Published: January 2023

Abstract
Background Postoperative air leak is a common problem in patients undergoing pulmonary resections. A conventional fissure dissection technique during videothoracoscopic lobectomy, particularly in patients with fused fissures is very likely to result in parenchymal damage and prolonged air leak (PAL). In contrast, fissureless video-assisted thoracoscopic surgery (VATS) lobectomy may have advantages regarding PAL and hospital stay.
Methods We conducted a retrospective study consisting of 103 consecutive patients who underwent a VATS lobectomy either with a conventional or fissureless technique and statistically analyzed the results particularly with respect to PAL, chest tube duration (CTD), and length of hospital stay (LOS).
Results We had 21 (20.4%) cases with PAL. Gender (p = 0.009), histological size of tumor (p = 0.003), and surgical technique (p = 0.009) showed statistically significant differences for PAL in contingency tables. Significant predictors for PAL in univariate analysis were male sex (p = 0.017), histological size of tumor more than 24 mm (p = 0.005), and conventional technique (p = 0.017). Similarly, multivariate analysis revealed male sex (p = 0.036), histological size of tumor more than 24 mm (p = 0.043), and conventional technique (p = 0.029) as significant predictors for PAL. In addition, both the medians of CTD (p = 0.015) and LOS (p = 0.005) were comparably lesser as 3 days, in patients who underwent fissureless videothoracoscopic lobectomy.
Conclusion The fissureless technique helps for PAL in patients undergoing videothoracoscopic lobectomy.
The Impact of Exercise on Motor Recovery after Long Nerve Grafting—Experimental Rat Study
Authors: Camuzard Olivier , Lu Johnny Chuieng-Yi , Abbadi Sam El , Chang Tommy Nai-Jen , Chuang David Chwei-Chin 
Published: January 2023

Abstract
Background Long nerve grafting often results in unsatisfactory functional outcomes. In this study we aim to investigate the effect of swimming exercise on nerve regeneration and functional outcomes after long nerve grafting.
Methods A reversed long nerve graft was interposed between C6 and the musculocutaneous nerve in 40 rats. The rats were divided into four groups with 10 in each based on different postoperative swimming regimes for rehabilitation: group A, continuous exercise; group B, early exercise; group C, late exercise; and group D, no exercise (control group). A grooming test was assessed at 4, 8, 12, and 16 weeks postoperatively. Biceps muscle compound action potential (MCAP), muscle tetanic contraction force (MTCF), and muscle weights were assessed after 16 weeks. Histomorphometric analyses of the musculocutaneous nerves were performed to examine nerve regeneration.
Results The grooming test showed all groups except group D demonstrated a trend of progressive improvement over the whole course of 16 weeks. Biceps MCAP, MTCF, and muscle weights all showed significant better results in the exercise group in comparison to the group D at 16 weeks, which is especially true in groups A and B. Nerve analysis at 16 weeks, however, showed no significant differences between the exercise groups and the control group.
Conclusions Swimming after long nerve grafting can significantly improve muscle functional behavior and volume. The effect is less evident on nerve regeneration. Continuous exercise and early exercise after surgery show more optimal outcomes than late or no exercise. Having a good habit with exercise in the early period is thought as the main reason. Further studies are needed to determine the optimal exercise regimen.
Free Flaps in Sternal Osteomyelitis After Median Sternotomy: A Center's 12-Year Experience
Authors: Georgiou Iakovos , Ioannou Christos I. , Schmidt Jeremias , Eschborn Johannes , Mostofizadeh-Haghighi Giw , Infanger Manfred , Ghods Mojtaba , Kruppa Philipp 
Published: January 2023

Abstract
Background Adequate treatment of deep sternal wound infections (DSWIs) after open thoracic surgery still presents a major challenge. This study retrospectively analyzes the results of a single center's 12-year experience in treating DSWI, with special emphasis on free flap reconstruction.
Methods In this single-center, retrospective study, all patients admitted with the diagnosis of DSWI after open thoracic surgery between 2009 and 2020 were included. A comparative analysis was performed between: (1) pedicled versus free flaps, (2) the center's two workhorse flaps—the pedicled latissimus dorsi (pLD) versus free anterolateral thigh (fALT) flaps, as well as (3) myocutaneous (MC) versus fasciocutaneous (FC) flaps. Primary endpoints were length of hospital stay (LOS) after reconstruction and in-hospital mortality.
Results Of a total of 165 patients included, 152 underwent DSWI defect reconstruction with a total of 12 different reconstruction methods. Although the defect size was larger in patients who underwent free flap coverage, and the risk profile in the fALT and FC flap groups was higher, the LOS after reconstruction (in days) did not differ significantly between the groups (pedicled vs. free flaps: 23 vs. 28, p > 0.05; pLD vs. fALT: 24.5 vs. 26, p > 0.05; MC vs. FC flaps: 23 vs. 26, p > 0.05). Also, no significant differences were found in terms of in-hospital mortality when comparing the groups (pedicled vs. free flaps: 11.2 vs. 17.4%, p > 0.05; pLD vs. fALT: 11.5 vs. 12.5%, p > 0.05; MC vs. FC flaps: 12.9 vs. 12.5%, p > 0.05).
Conclusion With proper patient selection, free tissue transfer is a valuable alternative in the treatment of sternal dehiscence after a DSWI. Furthermore, our data demonstrate that MC flaps are not necessarily superior to FC flaps in the reconstruction of sternal osteomyelitis defects.
Spinal Dysraphism Spectrum: A Novel Protocol-based Approach for Accurate Diagnosis on Imaging
Authors: Rana Abhilasha , Krishnan Venkatram , Jamwal Rupie 
Published: January 2023

AbstractThe spectrum of spinal dysraphism includes various congenital anomalies of the spinal column and spinal cord. Clinical manifestations are varied and range from paraparesis, gastrointestinal, genitourinary, and musculoskeletal anomalies to asymptomatic cases depending on the level and extent of spinal involvement. Magnetic resonance imaging is the gold standard for assessing these complex spinal anomalies. Even for the experienced radiologist, diagnosis can be challenging in complex cases. It is essential to be aware of the normal embryological developmental stages of the spine for an adequate understanding of the complex anatomy, pathogenesis, and cliniconeuroradiological classification of spinal dysraphism, which is necessary for accurately diagnosing each case as a particular pathological entity. In this pictorial essay, we have depicted the stages and process of spinal embryogenesis, cliniconeuroradiological classification, and the imaging spectrum of spinal dysraphism. As the confusing terminologies and the numerous variants can potentially lead to misdiagnosis, we have proposed a step-wise protocol-based imaging approach to analyze each case and arrive at the correct diagnosis systematically. This would be particularly helpful in confusing and difficult cases, as accurate and early diagnosis is crucial for appropriate patient management.
Deviance as an historical artefact: a scoping review of psychological studies of body modification
Authors: Owens Rebecca , Filoromo Steven J. , Landgraf Lauren A. , Lynn Christopher D. , Smetana Michael R. A. 
Published: January 2023

AbstractBody modification is a blanket term for tattooing, piercing, scarring, cutting, and other forms of bodily alteration generally associated with fashion, identity, or cultural markings. Body modifications like tattooing and piercing have become so common in industrialised regions of the world that what were once viewed as marks of abnormality are now considered normal. However, the psychological motivations for body modification practices are still being investigated regarding deviance or risky behaviours, contributing to a sense in the academic literature that body modifications are both normal and deviant. We explored this inconsistency by conducting a scoping review of the psychological literature on body modifications under the assumption that the psychological and psychiatric disciplines set the standard for related research. We searched for articles in available online databases and retained those published in psychology journals or interdisciplinary journals where at least one author is affiliated with a Psychology or Psychiatry programme (N = 94). We coded and tabulated the articles thematically, identifying five categories and ten subcategories. The most common category frames body modifications in general terms of risk, but other categories include health, identity, credibility/employability, and fashion/attractiveness. Trends in psychology studies seem to follow the shifting emphasis in the discipline from a clinical orientation regarding normality and abnormality to more complex social psychological approaches.
Understanding media empowerment: citizen journalism in Palestine
Authors: Horoub Ibrahim 
Published: January 2023

AbstractThis study addresses the nature of citizen journalism in Palestine, with the chief aim of identifying its role in promoting professionalism, ethics, and objectivity, and empowering digital media, information accessibility, and democratization of media production. To this end, this study uses data from different universities across Palestine obtained through surveys that address digital media empowerment and non-professional users in the new media landscape. The study sample used was selected using the stratified sampling method. Upon completion of a pilot test, a total of 300 questionnaires were distributed among undergraduates of 10 universities across Palestine based on their willingness to participate and availability. Our results suggest that official media outlets can benefit from citizen journalism by providing accurate and valid sources of information to citizen journalists to increase engagement among their audiences as a result of enhanced perceptions of independency and credibility. However, our findings also reveal that citizen journalism does not make a significant difference in undermining gatekeeping practices over new media content in Palestine. Moreover, the results show that there is no relationship or correlation between the idea of adopting citizen journalism as a complementary method to traditional journalism and the credibility and reliability of news stories presented by citizen journalists.
Evidence of excited-state lifetime enhancement in dimyristoyl-phosphocholine nanodiscs by ultraviolet absorption spectroscopy
Authors: Kocheril Philip A. , Hiller Miranda I. , Kubicek-Sutherland Jessica Z. 
Published: January 2023

Ultraviolet absorption spectroscopy is an analytical tool that is commonly utilized to determine protein concentrations, primarily due to characteristic absorption of tryptophan and tyrosine at 280 nm. Accurate concentration determination is essential to the accuracy of many biophysical techniques, and ultraviolet absorption provides a convenient and rapid method to assess protein concentration. However, the widespread usage of this method assumes that ultraviolet absorption is the same for individual amino acids in aqueous solution (where the molar extinction coefficient was measured) as for the amino acid in the conformational environment of the protein of interest. We demonstrate that additional considerations may be necessary for the membrane scaffold protein in dimyristoyl-phosphocholine nanodiscs through ultraviolet absorption spectroscopy of nanodiscs, liposomes, the membrane scaffold protein, and a mixture of liposomes and the non-nanodisc-associated protein. The aromatic amino acids of the membrane scaffold protein absorb significantly less light at 280 nm when associated with lipids in a lipoprotein assembly, which we plausibly attribute to an enhancement of chromophore excited-state lifetimes due to reduced intramolecular motion in the nanodisc. We caution that using the molar absorptivity of the membrane scaffold protein alone to determine nanodisc concentrations may not yield accurate results. Instead, the molar absorptivity of each nanodisc formulation should be explored independently to account for the unique conformational environment of each nanodisc.