bluuebunny/crossref_metadata_2025_split huggingface dataset:
Giant Pancreatic Lymphangioma Herniating Above the Diaphragm
Authors: Zeineddin Suhail , Feng Winnie A. , Mazraani Maurice , Del Prado Paul 
Published: February 2023

Lymphangiomas of pancreatic origin are rare and can often be found with abdominal symptoms or incidentally on imaging. A 46-years-old female presented with epigastric abdominal pain and vomiting, and twenty-pound weight loss over 3 months. Computed tomography of the abdomen showed a septated mass of the distal pancreas measuring 25.4 cm in largest diameter and extending superiorly into the mediastinum via a hiatal hernia. Endoscopic ultrasound demonstrated abutment but no invasion of the esophagus and stomach. She underwent an exploratory laparotomy with retroperitoneal mass excision, distal pancreatectomy, splenectomy, and hiatal hernia repair with Dor fundoplication. Pathology was consistent with a cystic lymphangioma. Patient was discharged on postoperative day 3 and remained recurrence free for over a year.
The Far-Right Takeover in Brazil: Effects on the Health Agenda
Authors: Fedatto Maíra S. 
Published: February 2023

On October 28, 2018, the far-right populist Jair Bolsonaro won Brazilian elections against the Partido dos Trabalhadores (Workers’ Party—PT) candidate Fernando Haddad after a vigorous social-media campaign reinforced by fake news. In a context of economic crisis, escalating violence, and corruption scandals and a polarized population, Bolsonaro’s authoritarian inclinations and reactionary rhetoric were concerns from several perspectives, mainly regarding the environment, education, human rights, health, and even the young Brazilian democracy. In particular, the Mais Médicos program, the national drug policy, and the HIV/AIDS Department have all been negatively influenced by his anticommunist rhetoric and the alarming escalation of evangelical conservatism. The militarization of his supporters in terms of moral values challenges the future of the secular state and therefore its substantial gains in international cooperation for health. With his approval rate falling and an international health crisis under way, Bolsonaro may not have an easy path ahead of him, and neither will the Brazilian population. No dia 28 de outubro de 2018, o populista da extrema direita, Jair Bolsonaro, ganhou as eleições contra o candidato do Partido dos Trabalhadores (PT), Fernando Haddad, depois uma campanha enérgica baseada em redes sociais e reforçada por notícias falsas. Num âmbito que inclui uma crise econômica, uma escalada de violência, escândalos de corrupção e uma população polarizada, as tendências autoritárias e retórica reacionária de Bolsonaro apresentam desafios com respeito a muitos temas como o meio ambiente, a educação, direitos humanos, a saúde, e mesmo a democracia jovem do Brasil. O programa Mais Médicos, a política antidrogas e o Departamento de VIH/Sida, em particular, foram negativamente influenciados pela retórica anticomunista e pela alarmante expansão do conservadorismo evangélico. A militarização dos seguidores de Bolsonaro em termos de valores morais ameaça o futuro do estado secular e, por conseguinte, seus ganhos significativos na área de cooperação internacional com relação à saúde. Com sua índice de aprovação em declínio e uma crise internacional de saúde que está atualmente em curso, não podendo ser fácil para Bolsonaro e nem para a população brasileira nos anos a seguir.
Clues of incomplete reversal of heparin in cardiac surgery
Authors: Tiquet Bérénice , Pihan Franck , Thomasset Philippe , Denizou Michel , Tifrea Marius , Tifrea Andreaa , Orsel Isabelle , Marsaud Jean Philippe , Jouan Jérome , Vandroux David 
Published: February 2023

Objectives In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these sudden hemostasis abnormalities and to evaluate the performances of point of care coagulation testing. Methods In this prospective and descriptive study, we included 33 consecutive patients undergoing elective cardiac surgery for 1 month. Heparin-induced anticoagulation and calculation of the protamine dose were tested by the Hemostasis Management System Plus device (Medtronic, Minneapolis, MN, USA). Fifteen minutes after the end of the protamine infusion, activated clotting time (ACT), activated partial thromboplastin time and anti Xa activity were measured. In case of unusual clinical bleeding, a Quantra analysis (Stago, HemoSonics LLC, Charlottesville, VA) was added. Results Residual antiXa activity >0.2 IU/mL after neutralization was present in 44% of patients. Our investigation concluded incomplete heparin reversal. There was no association between cellular reinfusate and the presence of heparin. The unusual rate of hemostasis abnormalities was explained by a less efficient protamine reversal of heparin. ACT and Clot Time Ratio (CTR, Quantra system) correlated with AntiXa with Spearman's coefficients of 0.85 ( p < .0001) and 0.95 ( p = .0012), respectively. About ACT, a threshold of 150 seconds had a sensitivity of 85% [58–97] and a specificity of 85% [58–97%] for detection of AntiXa>0.2. For CTR, a threshold of 1.4 had a sensitivity of 67% [30–94] and a specificity of 100% [18–100]. Conclusion The use of point of care coagulation testing is effective in detecting incomplete reversal of heparin.
The Minimal Clinically Important Difference Changes Greatly Based on the Different Calculation Methods
Authors: Franceschini Marco , Boffa Angelo , Pignotti Elettra , Andriolo Luca , Zaffagnini Stefano , Filardo Giuseppe 
Published: February 2023

Background: The minimal clinically important difference (MCID) for patient-reported outcome measures (PROMs) expresses both the extent of the improvement and the value that patients place on it. MCID use is becoming increasingly widespread to understand the clinical efficacy of a given treatment, define guidelines for clinical practice, and properly interpret trial results. However, there is still large heterogeneity in the different calculation methods. Purpose: To calculate and compare the MCID threshold values of a PROM by applying various methods and analyzing their effect on the study results interpretation. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: The data set used to investigate the different MCID calculation approaches was based on a database of 312 patients affected by knee osteoarthritis and treated with intra-articular platelet-rich plasma. MCID values were calculated on the International Knee Documentation Committee (IKDC) subjective score at 6 months using 2 approaches: 9 methodologies referred to an anchor-based approach and 8 methodologies to a distribution-based approach. The obtained threshold values were applied to the same series of patients to understand the effect of using different MCID methods in evaluating patient response to treatment. Results: The different methods employed led to MCID values ranging from 1.8 to 25.9 points. The anchor-based methods ranged from 6.3 to 25.9, while the distribution-based ones were from 1.8 to 13.8 points, showing a 4.1× variation of the MCID values within the anchor-based methods and a 7.6× variation within the distribution-based methods. The percentage of patients who reached the MCID for the IKDC subjective score changed based on the specific calculation method used. Among the anchor-based methods, this value varied from 24.0% to 66.0%, while among the distribution-based methods, the percentage of patients reaching the MCID varied from 44.6% to 75.9%. Conclusion: This study proved that different MCID calculation methods lead to highly heterogeneous values, which significantly affect the percentage of patients achieving the MCID in a given population. The wide-ranging thresholds obtained with the different methodologies make it difficult to evaluate the real effectiveness of a given treatment questioning the usefulness of MCID, as currently available, in the clinical research.
Prospective Randomized Trial of Biologic Augmentation With Bone Marrow Aspirate Concentrate in Patients Undergoing Arthroscopic Rotator Cuff Repair
Authors: Cole Brian J. , Kaiser Joshua T. , Wagner Kyle R. , Sivasundaram Lakshmanan , Otte R. Stephen , Tauro Tracy M. , White Gregory M. , Ralls Michael L. , Yanke Adam B. , Forsythe Brian , Romeo Anthony A. , Verma Nikhil N. 
Published: February 2023

Background: Although initial studies have demonstrated that concentrated bone marrow aspirate (cBMA) injections promote rotator cuff repair (RCR) healing, there are no randomized prospective studies investigating clinical efficacy. Hypothesis/Purpose: To compare outcomes after arthroscopic RCR (aRCR) with and without cBMA augmentation. It was hypothesized that cBMA augmentation would result in statistically significant improvements in clinical outcomes and rotator cuff structural integrity. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients indicated for aRCR of isolated 1- to 3-cm supraspinatus tendon tears were randomized to receive adjunctive cBMA injection or sham incision. Bone marrow was aspirated from the iliac crest, concentrated using a commercially available system, and injected at the aRCR site after repair. Patients were assessed preoperatively and serially until 2 years postoperatively via the following functional indices: American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Simple Shoulder Test, 12-Item Short Form Health Survey, and Veterans RAND 12-Item Health Survey. Magnetic resonance imaging (MRI) was performed at 1 year to assess rotator cuff structural integrity according to Sugaya classification. Treatment failure was defined as decreased 1- or 2-year ASES or SANE scores as compared with preoperative baseline, the need for revision RCR, or conversion to total shoulder arthroplasty. Results: An overall 91 patients were enrolled (control, n = 45; cBMA, n = 46): 82 (90%) completed 2-year clinical follow-up and 75 (82%) completed 1-year MRI. Functional indices significantly improved in both groups by 6 months and were sustained at 1 and 2 years (all P < .05). The control group showed significantly greater evidence of rotator cuff retear according to Sugaya classification on 1-year MRI (57% vs 18%; P < .001). Treatment failed for 7 patients in each group (control, 16%; cBMA, 15%). Conclusion: cBMA-augmented aRCR of isolated supraspinatus tendon tears may result in a structurally superior repair but largely fails to significantly improve treatment failure rates and patient-reported clinical outcomes when compared with aRCR alone. Additional study is warranted to investigate the long-term benefits of improved repair quality on clinical outcomes and repair failure rates. Registration: NCT02484950 (ClinicalTrials.gov identifier).
A Deep Insight into the Correlation Between Gut Dysbiosis and Alzheimer’s Amyloidopathy
Authors: Kondaveeti Sreenivasulu Naidu , Thekkekkara Dithu , T Lakshmi Narayanan , Manjula S. N. , Tausif Y Mohammed , Babu Amrita , Meheronnisha SK 
Published: February 2023

Recent research has shown a strong correlation between gut dysbiosis and Alzheimer’s disease (AD). The purpose of this review is to investigate the relationship between gut dysbiosis, immune system activation, and the onset of AD and to examine current breakthroughs in microbiota-targeted AD therapeutics. A review of scientific literature was conducted to assess the correlation between gut dysbiosis and AD and the various factors associated. Gut dysbiosis produces an increase in harmful substances, such as bacterial amyloids, which makes the gut barrier and blood-brain barrier more permeable. This leads to the stimulation of immunological responses and an increase in cytokines such as interleukin-1β (IL-1β). As a result, gut dysbiosis accelerates the progression of AD. The review highlights the connection between gut dysbiosis and AD and the potential for microbiota-targeted therapies in AD treatment. Pictorial Abstract
Sleep Quality and Associated Factors Among Adult Cancer Patients on Treatments at Tikur Anbessa Specialized Hospital Oncology Unit, Addis Ababa, Ethiopia, 2021
Authors: Abebe Eshetu , Giru Berhanu Wordofa , Boka Abdissa 
Published: February 2023

Background Patients with cancer frequently reported sleep problems during their treatments which can affect their sleep quality have an impact on patients’ quality of life (QOL). Objective to assess the prevalence of sleep quality and associated factors in adult cancer patients on treatment in the Oncology unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2021 Methods institutional-based cross-sectional study design was used and data was collected by using face-to-face structured interview questionnaires from March 1 to April 1, 2021. Sleep Quality Index (PSQI) consisted of 19 items, the social support scale (OSS-3) consisted of 3 items, and the Hospital Anxiety and Depression Scale (HADS) consisted of 14 items were applied. Logistic regression including bivariate and multivariate analysis was done to examine the association between dependent and independent variables, and P< 0.05 was considered the level of significance for associations. Results A total of 264 sampled adult cancer patients on treatments were included in this study, with a response rate of 93.61%. About 26.5% of the participants’ age distribution was between 40 to 49 years, and 68.6% were female. 59.8% of the study participants were married. Concerning education, about 48.9% of participants attended primary and secondary school and 45% of participants were unemployed. Overall, 53.79% of individuals had poor sleep quality. Low income ((AOR=5.36 CI 95% (2.23, 12.90), fatigue (AOR=2.89 CI 95(1.32, 6.33), pain (AOR 3.82 C I95 % (1.84, 7.93), poor of social support (AOR =3.20 CI 95% (1.43, 6.74), anxiety (AOR=3.48 CI 95% (1.44, 8.38) and depression (AOR 2.87 CI 95 % (1.05-7.391) were all associated with poor sleep quality. Conclusion This study revealed a high prevalence of poor sleep quality, which was significantly associated with factors like low income, fatigue, pain, poor social support, anxiety, and depression among cancer patients on treatments.
Design and efficiency evaluation of a new wearable device for multi-degree suppression of hand pathological tremor
Authors: Yousef Mo’ath , Hafizh Muhammad , Sassi Sadok , Muthalif Asan G.A 
Published: February 2023

Sufferers of onset upper limb tremors find difficulty performing daily tasks due to rapid involuntary movements. Traditional treatments being offered help alleviate symptoms but are costly and can be invasive. Wearable technology advancements have introduced the applications of tremor suppression devices. A low-cost wearable bracelet was developed for sufferers of Parkinson’s disease and essential tremors to target rest and active tremors. Real-life measured tremor spectrums were used as input signals to design a dynamic vibration absorber. An innovative multiple-slot design allowed for multiple frequency suppression in the range of 3–8 Hz. A finite element analysis simulated the response of the upper limb with and without the bracelet. The results showed an overall suppression decreased tremors by up to 68% and targeted suppression decreased tremors by up to 98.2%.
Sleep Structure in Untreated Adults With ADHD: A Retrospective Study
Authors: Kato Takao , Ozone Motohiro , Kotorii Nozomu , Ohshima Hayato , Hyoudou Yuki , Mori Hiroyuki , Wasano Kenjirou , Hiejima Hiroshi , Habukawa Mitunari , Uchimura Naohisa 
Published: February 2023

Objective: Polysomnographic findings in neurodevelopmental disorders have been reported, but previous studies have had several limitations. The purpose of this study was to characterize sleep structure in untreated adults diagnosed with ADHD, excluding ADHD-related sleep disorders as determined by polysomnography and multiple sleep latency testing. Methods: This study included 55 patients aged 18 years or older who visited the Kurume University Hospital Sleep Clinic between April 2015 and March 2020. The diagnosis of ADHD was determined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (ADHD group, n = 28; non-ADHD, n = 27). Results: The ADHD group had significantly longer slow wave sleep (SWS) duration than the non-ADHD group (ADHD: 68.3 ± 31.0 minutes vs. non-ADHD: 43.4 ± 36.6 minutes; p = .0127). Conclusions: The increased SWS volume observed in drug-naïve adult patients with ADHD may be related to the pathogenesis of this disorder.
Well-Differentiated Neuroendocrine Tumors of the Appendix in Children and Adolescents: A Clinicopathologic Study
Authors: Simon Caroline T. , Ehrlich Peter , Hryhorczuk Anastasia , Rabah Raja , Sedig Laura , Stoll Tammy , Heider Amer 
Published: February 2023

Background and Aims: Pediatric neuroendocrine tumors (NET) of the GI tract are rare and appendiceal NET are typically incidental. Few studies have been done in the pediatric population and practice guidelines are mainly based on adult data. There are currently no diagnostic studies specific for NET. Our study aimed to identify clinical, radiological, and pathological findings in pediatric appendiceal NET, test criteria for follow up surgical treatment, review potential prognostic pathological findings, and possible pre-operative diagnostic radiological studies. Materials and Methods: A retrospective data search was conducted for well-differentiated NET of the appendix in patients ≤21 years between 1/1/2003 and 7/1/2022. Available clinical, radiologic, pathological, and follow-up information was recorded. Results: Thirty-seven patients with appendiceal NET were identified. No masses were reported in the patients who underwent presurgical imaging. Appendectomy samples showed NET (0.2–>4 cm), most located in the tip. Most cases were WHO G1 (34/37), with negative margins (n = 25). Sixteen cases extended to the subserosa/mesoappendix (pT3). Lymphovascular (6), perineural (2), and both lymphovascular and perineural invasion were also noted (2). The specified tumor stages were pT1 (10/37), pT3 (16/37), and pT4 (4/37). Patients who underwent laboratory testing for chromogranin A (20) and urine 5HIAA (11) had normal limits. Subsequent surgical resection was recommended in 13 cases and performed in 11. To date, all patients have no recurrent or additional metastatic disease. Conclusions: Our study showed that all pediatric well-differentiated appendiceal NET were incidentally found as part of acute appendicitis management. Most NET were localized with low-grade histology. Our small cohort support the previously suggested management guidelines with follow up resection in certain cases. Our radiologic review didn’t identify a best modality for NET. Comparing cases with and without metastatic disease, no tumors under 1 cm had metastasis, but serosal and perineural invasion along with G2 status were associated with metastasis in our limited study.
Descemet membrane endothelial keratoplasty graft detachments in superior versus temporal approach
Authors: Coco Giulia , Romano Davide , Borgia Alfredo , Kaye Stephen B , Romano Vito 
Published: February 2023

Purpose To evaluate the difference in Descemet Membrane Endothelial Keratoplasty (DMEK) graft detachment rate comparing superior versus temporal main incision approach. Methods Retrospective comparative study on patients who underwent DMEK surgery for Fuchs endothelial dystrophy or bullous keratopathy with main wound incision performed at either 90° in the superior approach, or at 180°/0° in the temporal approach. All main incisions were secured with a single 10–0 nylon suture at the end of surgery. Data collected were donor age and gender, endothelial cell counts, graft diameter, recipient age and gender, indication for transplant, surgeon grade, re-bubbling rate, air fill in the anterior chamber (AC) at day one and intra- and early postoperative complications. Results 187 eyes were included in the study. 99 eyes had DMEK surgery with superior approach, while 88 eyes had temporal approach. The two groups had no differences in donor age and sex, endothelial cell counts, graft diameter, recipient age and sex, indication for transplant, surgeon grade, and air fill in the anterior chamber at day one. Re-bubbling rate was 38.4% for surgeries performed with superior access and 29.5% for those with temporal access(p = 0.186). After exclusion of patients with intraoperative and/or postoperative complication, the difference in re-bubbling rate was higher, although non-significant (37.5% and 25% for superior and temporal approach respectively, p = 0.098). Conclusion The temporal approach in DMEK showed a trend towards a clinically significant lower rate of post-operative re-bubbling compared to the superior approach, however, no statistically significant difference was noted comparing the two approaches, which both remain feasible options in DMEK surgery.
Grammatical gender agreement in production: The case of heritage Russian
Authors: Vorobyeva Tamara , Bel Aurora , Voeikova Maria 
Published: February 2023

Aims and objectives/purpose/research questions: The primary goal of this study was to investigate the knowledge of Russian gender in young heritage speakers through different agreement constructions. Design/methodology/approach: Participants were 30 Russian–Spanish–Catalan multilinguals from Spain aged 7–11 years, divided into two proficiency groups, and a baseline group of 24 age-matched Russian monolinguals residing in Russia. All participants completed four experiments using an oral elicited production task addressing different linguistic conditions. Data and analysis: The accuracy scores were compared between the two proficiency groups and between the heritage and monolingual speakers to document any changes as a function of the type of agreement construction, gender value, noun form transparency, and crosslinguistic congruency. Findings/conclusions: The results demonstrated a hierarchy of gender values; masculine being the easiest gender value, neuter the most difficult, and feminine in between the two. The crosslinguistic influence was yelled under vulnerable conditions: when (1) the proficiency in heritage language is low, (2) in opaque and (or) incongruent nouns, and (3) in agreement construction which is absent in Spanish and Catalan. The results also suggest that the heritage language from the high-proficiency group can attain monolingual-like gender agreement knowledge. Originality: We documented gender agreement production in trilingual speakers, which is an under-explored topic. The study employs a new method of analysing gender in several constructions, including adjectival and verbal agreement at Noun Phrase and sentence levels. Significance/implications: The study provides insights into heritage language development during the early years of exposure to the two majority languages. The results may offer a greater understanding of the characteristics of heritage language/L2 development in trilingual children.