bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eight-and-a-half syndrome as the first presentation of multiple sclerosis in an Asian male: a case report
Authors: Lim Xin Ying , Wai Yong Zheng , Yong Yun Xiu , Lim Lik Thai 
Published: March 2023

Abstract
Background
Multiple sclerosis is a diffuse chronic demyelinating disease of the central nervous system. It is relatively uncommon in the Asian population and even more so in males. Despite the usual involvement of the brainstem, eight-and-a-half syndrome remains a rare first presentation in multiple sclerosis. Only a few cases have been reported previously, but none involving the Asian population. Eight-and-a-half syndrome, a neuro-ophthalmological condition, is characterized by one-and-a-half syndrome with ipsilateral lower facial nerve palsy, which localizes lesions to the pontine tegmentum. This case report demonstrates the first case of eight-and-a-half syndrome as the first presentation of multiple sclerosis in an Asian male.

Case presentation
A healthy 23-year-old Asian man presented with sudden onset of diplopia followed by left-sided facial asymmetry for 3 days. Assessment of extraocular movement revealed left conjugate horizontal gaze palsy. On right gaze, there was limited left eye adduction and horizontal nystagmus of the right eye. These findings were consistent with a left-sided one-and-a-half syndrome. Prism cover test revealed left esotropia of 30 prism diopters. Cranial nerve examination showed left lower motor neuron facial nerve palsy, while other neurological examination was normal. Magnetic resonance imaging brain showed multifocal T2 fluid attenuated inversion recovery hyperintense lesions, involving bilateral periventricular, juxtacortical, and infratentorial regions. A focal gadolinium contrast-enhanced lesion with open ring sign on T1 sequence was seen at the left frontal juxtacortical region. Multiple sclerosis was diagnosed on the basis of the clinical and radiological evidence, which fulfilled the 2017 McDonald criteria. Positive oligoclonal bands in cerebrospinal fluid analysis further confirmed our diagnosis. He had a complete resolution of symptoms 1 month after a course of pulsed corticosteroid therapy, and was subsequently placed on maintenance therapy with interferon beta-1a.

Conclusion
This case illustrates eight-and-a-half syndrome as the first presentation of a diffuse central nervous system pathology. A wide range of differential diagnoses needs to be considered in such a presentation as based on the patient’s demographics and risk factors.
Vasculitis presenting as carpal tunnel syndrome: a case report
Authors: Rahbar Mohammad , Dolatkhah Neda 
Published: March 2023

Abstract
Background
Carpal tunnel syndrome is the most common focal mononeuropathy which presents with pain in the wrist and hand, paresthesia, loss of sensation in the distribution of the median nerve, and in more severe cases, weakness and atrophy of the thenar muscles. Meanwhile, carpal tunnel syndrome can present as an initial manifestation of underlying systemic vasculitis disorder and result in severe physical disabilities.

Case presentation
A 27-year-old Iranian man was referred to our electrodiagnosis center with a clinical diagnosis of carpal tunnel syndrome in April 2020. Surgical intervention had been taken into account for him because of unsuccessful conservative therapies. On admission, thenar eminence was reduced. Electrodiagnostic findings were not compatible with median nerve entrapment at the wrist. All sensory modalities in the distribution of the right median nerve were decreased. Additionally, a mild increase in erythrocyte sedimentation rate was noted in laboratory tests. Because of the high vasculitis suspicion, we recommended the nerve biopsy and/or starting a high-dose corticosteroid. However, the surgery release was performed. After 6 months, the patient was referred for progressive weakness and numbness in the upper and lower limbs. After documentation of vasculitis neuropathy by biopsy, a diagnosis of non-systemic vasculitic neuropathy was confirmed. A rehabilitation program started immediately. Rehabilitation led to gradual improvement and recovery of function and muscle strength, and no complications remained, except mild leg paralysis.

Conclusions
Physicians should be suspicious of the median nerve vasculitis mononeuropathy in a patient with carpal tunnel syndrome-like symptoms. Median nerve vasculitis mononeuropathy as an initial presenting feature of vasculitis neuropathy can further result in severe physical impairments and disabilities.
Prevalence of pineal gland calcification: systematic review and meta-analysis
Authors: Belay Daniel Gashaneh , Worku Misganaw Gebrie 
Published: March 2023

Abstract
Background
Pineal gland calcification is the formation of corpora arenacea predominantly composed of calcium and phosphorus. It plays an important role in regulating the light/dark circadian changes to synchronize their daily physiological activities like feeding, metabolism, reproduction, and sleep through the secretion of melatonin. Therefore, this study aimed to assess the pooled prevalence of pineal gland calcification.

Methods
A systematic review was done using published research articles from different electronic databases. Cross-sectional studies were included for systematic review and only studies conducted on the human population were included for quantitative analysis. Published articles were selected by assessing the title and abstract for relevance to the review objectives. Finally, the full text was retrieved for further assessment.

Results
The pooled prevalence of pineal gland calcification was 61.65% [95% CI: 52.81, 70.49], with a heterogeneity of I2 = 97.7%, P ≤ 0.001. According to the qualitative analysis, an increase in age, male sex, and white ethnicity are the major socio-demographic characteristics that increase the prevalence of pineal gland calcification.

Conclusion
The pooled prevalence of pineal gland calcification was higher compared with reports from previous studies. Different studies reported pineal gland calcification was most prevalent in the adult population compared with the pediatric age groups. According to the qualitative analysis, an increase in age, male sex, and white ethnicity are the major socio-demographic characteristics that increase the prevalence of pineal gland calcification.
Experimental Study of the Shear Behavior of RC Beams Strengthened with High-Performance Fiber-Reinforced Concrete
Authors: Gerges Najib , Issa Camille A. , Sleiman Elias , Najjar Melissa , Kattouf Ali 
Published: March 2023

AbstractIn this study, the efficacy of strengthening of reinforced concrete (RC) beams in shear by utilizing high-performance fiber-reinforced concrete (HPFRC) was explored. The shear strengthening was achieved by epoxy bonding of prefabricated HPFRC strips or plates onto the beams. The beams were strengthened utilizing two different strengthening schemes: (i) plates side strengthening (ii) vertical strips applied at shear critical sections. The behavior of the two configurations was compared to the behavior of non-shear reinforced and shear-reinforced RC beams. The high-performance concrete (HPC) utilized contains 1.5% of steel fibers per volume of HPC mortar and is known as HPFRC. Parameters determined were the flexural strength and compressive strength of HPFRC mortar. The obtained results revealed that HPFRC realized a 28-day flexural strength of 20 MPa and a compressive strength of 108 MPa. Moreover, HPFRC strengthened RC beams experienced an increased in strength capacity of about 50% for plates and 36% for vertical strips compared to the RC beams with no stirrups. The results for HPFRC strengthened beams with plates were superior compared to those of the stirrup-reinforced beams, whereas the results of HPFRC strips strengthened beams were almost identical to the stirrup-reinforced beams. Also observed, was an improvement in the ductility of the beams with the best results achieved when employing HPFRC plates and strips.
Age-related accumulation of B-1 cell progenitors in mice reflects changes in miR15a/16-1 expression and radioresistance capacity
Authors: Souza Olívia F , de Oliveira Vivian C , Rodrigues Gabriel J. F. , Costa Lucas V. S. , Corado Fernanda , Popi Ana F. 
Published: March 2023

AbstractHyperproliferative diseases such as Chronic Lymphocytic Leukemia (CLL) and Systemic Lupus Erythematosus (SLE) are potentially related to some disturbance in the apoptosis pathway, specifically in B-1a cells (CD5+). Accumulation of B-1a cells in lymphoid organs, bone marrow or periphery is observed in some leukemia experimental murine models along aging. It is known that aging also increases the healthy B-1 cell population. However, it is not yet clear if it happens due to self-renewal of mature cells or proliferation of progenitor cells. Herein we demonstrated that the B-1 cell precursor population (B-1p) from bone marrow of middle-aged mice is higher than from young mice. Also, these aged cells are more resistant to irradiation and have downregulation of microRNA15a/16. Alterations in these microRNAs expression and in Bcl-2 regulation were already described in human hematological malignancies and new therapeutically approaches focus on that axis. This finding could explain the early events related to cell transformation during aging and correlate with beginning of symptoms in hyperproliferative diseases. Moreover, studies have already reported these pro-B-1 as a contributor to the origin of other leukemia (Acute Myeloid Leukemia - AML). Our results point to a possible relation between B-1 cell precursors and hyperproliferation during aging. We hypothesized that this population could be maintained until the mature status of the cell or reveal changes that result in re-activation of precursor in adult bone marrow, culminating in accumulation of B-1 cells later. Based on this, B-1 cell progenitor could represent an origin for B cell malignancies and a new candidate target to diagnose and treatments in the future.
Double-chambered left ventricle: diagnosis by CMR and review of the literature
Authors: Saadia Sheema , Nasir Aiysha , Sultan Fateh Ali Tipoo 
Published: March 2023

Abstract
Background
A double-chambered left ventricle (DCLV) is an extremely rare congenital malformation. The exact prevalence of DCLV is not known, although studies have reported prevalence of 0.04–0.42%. This abnormality is characterized by the sub-division of left ventricle into two chambers, the main left ventricular chamber (MLVC) and the accessory chamber (AC) by a septum or muscle band.

Case presentation
We are reporting two cases of DCLV, one in an adult male and an infant, who were referred for undergoing cardiac magnetic resonance (CMR) imaging. The adult patient was asymptomatic, whereas the infant had the diagnosis of left ventricular aneurysm on fetal echocardiography. On CMR, we confirmed the diagnosis of DCLV in both patients, as well as moderate aortic insufficiency in the adult patient. Both patients were lost to follow-up.

Conclusions
The double-chambered left ventricle (DCLV) is commonly detected in infancy or childhood. Although echocardiography can help detect double-chambered ventricles, MRI provides a better knowledge of this problem and can also be used to diagnose other related heart disorders.
Echocardiography-directed management of hemodynamically unstable neonates in tertiary care hospitals
Authors: Shokr Ahmed Abd-Elaziz Salem , Tomerak Rania Hosny , Agha Hala Mounir , ElKaffas Rania Mohamad Helmy , Ali Samia Bekhtte Ibrahem 
Published: March 2023

Abstract
Background
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being, and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion. A bedside point-of-care echocardiography can provide real-time hemodynamic information by assessing cardiac function, loading conditions (preload and afterload), and cardiac output, which makes it an ideal tool for monitoring hemodynamic assessment in neonates and children.

Methods
A prospective cross-section study was carried out on all neonates admitted to the NICU of Cairo University Children’s Hospital (CUCH) during the period from September 2017 through August 2018 in whom manifestations of hemodynamic instability were elected regardless of gestational age, weight, gender, or type of disease.

Results
There is a positive correlation between EF, FS, LVOT, RVOT, LVTI, RVTI, MAPSE, and TAPSE with birth weight. There is a negative correlation between birth weight and either LVO or RVO. In neonates weighted > 1500 g, there is a significant correlation between decreases in longitudinal systolic function of the heart (TAPSE and MAPSE) and either hemodynamic instability or need for echo-directed management, but there is no significant correlation between both in neonates weighted ≤ 1500 g. There is a significant relationship between birth weight and survival “the more the births weight the better survival chance and between complete compliance with ECDM protocol and achieving normal hemodynamic state.”

Conclusions
Decreases in EF, FS, TAPSE, and MAPSE in low birth weight neonates’ ≤ 1500 g are late signs of hemodynamic instability. TAPSE and MAPSE are the earliest parameters noticed to be decreased in hemodynamically unstable neonates > 1500 g even before EF and FS but return to normal values latterly. There is a significant relationship between complete compliance with ECDM protocol and achieving normal hemodynamics. Birth weight of ≤ 1500 g was an independent predictor of mortality regardless of the degree of compliance with the protocol.
Magnetic resonance imaging in the workup of patients with perianal fistulas
Authors: Madany Asmaa Hagagy , Murad Amr Farouk , Kabbash Mansour Mohammed , Ahmed Hala Maher 
Published: March 2023

Abstract
Background
Perianal sepsis and fistulas are common lesions. Fistula-in-ano is a tedious problem because of high recurrence rates and severe unexpected complications postoperatively. Many imaging modalities are used to evaluate this area. Magnetic resonance imaging (MRI) has been considered the gold standard procedure for perianal fistula assessment, i.e., it provides the surgeon with an accurate roadmap to select the best surgical approach, determines the extent of sphincter division, and estimates the risk of postoperative incontinence. We carried out a prospective diagnostic accuracy study involving 50 patients (mean age, 42.44 years) with perianal fistulas who underwent pelvic MRI with a 1.5 Tesla scanner using multiple sequences, including diffusion and post-contrast series that were either local or systemic. This study aimed to evaluate the diagnostic validity of pelvic MRI/MR fistulogram in perianal fistula assessment, identify perianal fistula-associated findings by MRI, and optimize the MRI technique with maximum technical safety.

Results
Intersphincteric fistulas were the most common type of perianal fistula observed based on Parks’ classification. Intersphincteric, trans-sphincteric, extrasphincteric, and suprasphincteric fistulas were found in 30 (60%), 12 (24%), 4 (8%), and 4 (8%) patients, respectively. According to St. James’ classification, 21 (42%), 9 (18%), 8 (16%), 4 (8%), and 8 (16%) patients had perianal fistula grades I, II, III, IV, and V, respectively. The combination of variable MR sequences and MR fistulogram increased the diagnostic validity of MRI examinations. Our results correlated with surgical results (reference standard) with perfect interobserver reliability.

Conclusions
Of all imaging modalities, MRI has become a prerequisite for a successful surgery of a perianal fistula. MRI can identify: (a) fistula morphological details, (b) the relationship between the fistulous tract and the anal sphincter, (c) fistula wound healing, (d) an active versus chronic scarred fistula, (e) postoperative stigmata, and (f) a perianal fistula from its mimics. MRI with variable sequences and MRI fistulogram are successful combinations that increase diagnostic efficiency with technical safety by avoiding both ionizing radiation and systemic gadolinium.
Comparison of an online adaptation of the Autism Diagnostic Observation Schedule-2 with its in-person version in an adult autism diagnostic service
Authors: Blackmore Charlotte E. , Nolan Alexandra , Stoencheva Vladimira , Greenwood Natalie , Liu-Thwaites Natasha , Maltezos Stefanos , McAlonan Grainne M. 
Published: March 2023

Background
Restrictions on in-person assessments during the COVID-19 pandemic were a challenge for an adult autism diagnostic service receiving over 600 referrals annually. The service sought to adapt the Autism Diagnostic Observation Schedule (ADOS-2) for online administration.

Aims
To investigate whether an online adaptation of the ADOS-2 performed comparably to the in-person ADOS-2. To obtain qualitative feedback from patients and clinicians regarding experiences of the online alternative.

Method
Online ADOS-2 assessments were completed for 163 referred individuals. A matched-comparison group comprised 198 individuals seen for an in-person ADOS-2 assessment prior to COVID-19 restrictions. A two-way analysis of variance (ANOVA) was run to explore any effect of assessment type (online or in-person ADOS-2) and gender on total ADOS score. Qualitative feedback was collected from 46 patients and 8 clinicians involved in diagnostic decision-making after the online ADOS-2 assessment.

Results
A two-way ANOVA found no significant effect of assessment type or gender and no assessment type × gender interaction effect on total ADOS score. Qualitative feedback suggested that only 27% of patients would have preferred an in-person assessment. Nearly all clinicians reported gains from offering an online alternative.

Conclusions
This is the first study to examine an online adaptation of ADOS-2 within an adult autism diagnostic service. It performed comparably to the in-person ADOS-2, making it a viable alternative when in-person assessments are not possible. As this clinic group has high rates of comorbid mental health difficulties, we encourage further work to determine whether online assessment approaches generalise to other services to increase options for patients and efficiencies for service delivery.
Equivalence between time series predictability and Bayes error rate
Authors: Xu En , Zhou Tao , Yu Zhiwen , Sun Zhuo , Guo Bin 
Published: March 2023

Abstract
Predictability is an emerging metric that quantifies the highest possible prediction accuracy for a given time series, being widely utilized in assessing known prediction algorithms and characterizing intrinsic regularities in human behaviors. Lately, increasing criticisms aim at the inaccuracy of the estimated predictability, caused by the original entropy-based method. In this paper, we strictly prove that the time series predictability is equivalent to a seemingly unrelated metric called Bayes error rate that explores the lowest error rate unavoidable in classification. This proof bridges two independently developed fields, and thus each can immediately benefit from the other. For example, based on three theoretical models with known and controllable upper bounds of prediction accuracy, we show that the estimation based on Bayes error rate can largely solve the inaccuracy problem of predictability.
The influence of plant odours on sexual readiness in an insectivorous songbird
Authors: Caro Samuel P. , Delaitre Ségolène , Buatois Bruno , Bonadonna Francesco , Graham Jessica L. 
Published: March 2023

ABSTRACTMany organisms rely on environmental cues to predict and anticipate the annual optimal timing of reproduction. In insectivorous birds, preparation for breeding often coincides with the time vegetation starts to develop in spring. Whether there is a direct relationship between the two, and through which mechanisms this link could come about, has rarely been investigated. Plants release herbivore-induced plant volatiles (HIPVs) when they are attacked by insects, and recent studies have shown that birds can detect and orient to those odours when searching for food. Whether those volatiles also stimulate sexual reproductive development and timing of reproduction remains to be discovered. We tested this hypothesis by monitoring gonadal growth in pairs of blue tits (Cyanistes caeruleus) exposed to air from caterpillar-infested oak trees or from a control, in spring. We found that while males and females grew their gonads over time, gonads grew at the same rate in both odour treatments. More exploratory (i.e. a proxy of personality) females did, however, have larger ovarian follicle sizes when exposed to the HIPVs than to the control air, which is consistent with earlier results showing that fast explorers have larger gonads in spring and are more sensitive to HIPVs. If HIPVs constitute powerful attractants in foraging birds, their influence on gonadal development prior to breeding appears to be relatively subtle and to only enhance reproductive readiness in some individuals. These results are nevertheless important as they set olfaction as a new player in the seasonal timing of reproduction in birds.
Language Training of Military Specialists in the Context of Professional Communication
Authors: Kostikova L. , Shevchenko B. , Chernyavskaya E. 
Published: March 2023

Introduction. The expansion of contacts and interaction with foreign states on security and stability issues increases the requirements for the professional language training of military specialists, their ability to professional communication in a foreign language. The focus on international cooperation obliges military personnel to constantly improve their knowledge, independently master new information related to new types of weapons and military equipment. It is assumed that the language training of military specialists will be effective if it is focused on professional communication.
The purpose of the study is to identify the attitude of future military specialists to professional communication in the process of language training at a military university.
Methods and materials. The methodological orientation of this study is integrated approach to teaching foreign languages. During the study, a questionnaire survey of cadets of 3-4 courses of the Ryazan Guards Higher Airborne Command School was conducted. The total number of respondents is 64 people, aged 19-22 years, young men.
Study results. On the basis of an integrated approach, military terminology is included in the content of foreign language classes, the need to consider the experience of Russian military personnel in military operations, international conflicts and peacekeeping missions is emphasized.
Scientific novelty. It has been proven that the use of pedagogical technologies for activating and intensifying the activities of students contributes to improving their preparation for professional communication. It is determined that the participation of cadets in project technologies, role-playing games and in the analysis of specific situations focused on the disclosure of their creative potential and the development of the desire for cognitive activity requires them to be more independent and self-organization.
Conclusion. In the context of escalation of international conflicts, issues of readiness of military specialists for professional communication become more and more urgent. The results of the study can be used to develop individual training trajectories for military specialists.