bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time Required for Gross Examination of Routine Second and Third Trimester Singleton Placentas by Pathologists’ Assistants
Authors: Horn Christopher , Engel Nicole , Drouin Dominique , Haley John , Holder Cameron , Hung Lina , Royall Lorraine , McInnis Patricia , de Koning Lawrence , Chan Elaine S. 
Published: September 2023

Introduction: In both Canada and the United States, workload measurement for anatomic pathology is mainly based on complexity and clinical significance of specimens, with gross examination being a considerable contributor. While Pathologists’ Assistants (PAs) play an increasing role in gross examination, there is little known regarding the time required for PAs to complete grossing tasks. This information is essential for effective staffing and workload management in pathology laboratories. The objective of our study was to determine the time required for PAs to gross second and third trimester singleton placentas in a large tertiary hospital with a significant perinatal pathology service. Materials and Methods: For our study, 7 certified PAs each grossed a minimum of 10 second and third trimester singleton placentas using a standard placental grossing protocol, an electronic laboratory information system, and voice recognition dictation software. Placental specimens requiring photography, sampling for ancillary studies, or immediate pathologist’s consultation were excluded. We calculated average and standard deviation of grossing times for each PA, overall average grossing time, and 95% confidence interval using a mixed linear regression model. We analyzed the impact of PA job experience, degree obtained, and number of blocks prepared on overall average in a multivariate analysis. Results: The mean grossing times for each PA ranged from 11.0 (standard deviation [sd] = 2.0) to 17.8 (sd = 4.5) minutes. The overall average grossing time was 14.5 minutes, with a 95% confidence interval of 11.7 to 17.3 minutes. In multivariate analysis, an increase in the number of blocks prepared was significantly associated with longer overall average grossing time. If 4 blocks were prepared consistently, the model predicted a slightly lower overall average of 13.3 minutes, with a 95% confidence interval of 10.9 to 15.7 minutes. Discussion: To our knowledge, our study is the first to objectively report time required for PAs to perform gross examinations of routine second and third trimester singleton placentas. The methodology of our study is replicable and can be applied to other specimen types and laboratory settings. Previously, estimated grossing times for specimens were primarily based on retrospective surveys, which were susceptible to recall errors and subjectivity. However, our study demonstrates objective data collection is achievable. Furthermore, the data collected from this study offer valuable insights into the accuracy of previous and current pathology workload models for second and third trimester singleton placentas.
Aqueous misdirection syndrome post silicone oil removal in a vitrectomized eye – a case report
Authors: Sindal Manavi D , Mohankumar Arthi , Gondhale Harshal , CK Nagesha , Srinivasan Kavitha 
Published: September 2023

Puropse Aqueous misdirection syndrome (AMS) is an aggressive post-operative glaucoma unresponsive to conventional measures with grave outcomes. In this report, we describe a rare case of AMS following silicon oil removal in a vitrectomized eye. Methods A diabetic patient with tractional retinal detachment underwent pars plana vitrectomy with silicon oil injection. Following retinal reattachment, silicon oil removal was performed at three months. Post oil removal she developed increased intraocular pressure with shallowing of both the peripheral and central anterior chamber suggestive of AMS. Results Initial medical management with anti-glaucoma medications and cycloplegics was not beneficial. A pars plana lensectomy with complete anterior hyaloidectomy along with a surgical peripheral iridectomy helped relieve the aqueous misdirection. Conclusion AMS can rarely occur following vitrectomy and is likely secondary to intact anterior hyaloid. Lensectomy along with zonulo-hyaloido-iridectomy is essential. This report highlights the occurrence of this rare complication and its effective management.
Computer-assisted drug discovery of potential natural inhibitors of the SARS-CoV-2 RNA-dependent RNA polymerase through a multi-phase in silico approach
Authors: Elkaeed Eslam B , Alsfouk Bshra A , Ibrahim Tuqa H , Arafa Reem K , Elkady Hazem , Ibrahim Ibrahim M , Eissa Ibrahim H , Metwaly Ahmed M 
Published: September 2023

Background The COVID-19 pandemic has led to significant loss of life and economic disruption worldwide. Currently, there are limited effective treatments available for this disease. SARS-CoV-2 RNA-dependent RNA polymerase (SARS-CoV-2 RdRp) has been identified as a potential target for drug development against COVID-19. Natural products have been shown to possess antiviral properties, making them a promising source for developing drugs against SARS-CoV-2. Objectives The objective of this study is to identify the most effective natural inhibitors of SARS-CoV-2 RdRp among a set of 4924 African natural products using a multi-phase in silico approach. Methods The study utilized remdesivir (RTP), the co-crystallized ligand of RdRp, as a starting point to select compounds that have the most similar chemical structures among the examined set of compounds. Molecular fingerprints and structure similarity studies were carried out in the first part of the study. The second part of the study included molecular docking against SARS-CoV-2 RdRp (PDB ID: 7BV2) and Molecular Dynamics (MD) simulations including the calculation of RMSD, RMSF, Rg, SASA, hydrogen bonding, and PLIP. Moreover, the calculations of Molecular mechanics with generalised Born and surface area solvation (MM-GBSA) Lennard-Jones and Columbic electrostatic interaction energies have been conducted. Additionally, in silico ADMET and toxicity studies were performed to examine the drug likeness degrees of the selected compounds. Results Eight compounds were identified as the most effective natural inhibitors of SARS-CoV-2 RdRp. These compounds are kaempferol 3-galactoside, kaempferol 3- O- β-D-glucopyranoside, mangiferin methyl ether, luteolin 7- O- β-D-glucopyranoside, quercetin- O- β-D-3-glucopyranoside, 1-methoxy-3-indolylmethyl glucosinolate, naringenin, and asphodelin A 4’- O- β-D-glucopyranoside. Conclusion The results of this study provide valuable information for the development of natural product-based drugs against COVID-19. However, the elected compounds should be further studied in vitro and in vivo to confirm their efficacy in treating COVID-19.
Machine learning based prediction of length of stay in acute ischaemic stroke of the anterior circulation in patients treated with thrombectomy
Authors: Feyen Ludger , Pinz-Bogesits Jan , Blockhaus Christian , Katoh Marcus , Haage Patrick , Nitsch Louisa , Schaub Christina 
Published: September 2023

Background Length of stay is an important factor for managing the limited resources of a hospital. The early, accurate prediction of hospital length of stay leads to the optimized disposition of resources particularly in complex stroke treatment. Objective In the present study we evaluated different machine learning techniques in their ability to predict the length of stay of patients with stroke of the anterior circulation who were treated with thrombectomy. Material and methods This retrospective study evaluated four algorithms (support vector machine, generalized linear model, K-nearest neighbour and Random Forest) to predict the length of hospitalization of 113 patients with acute stroke who were treated with thrombectomy. Input variables encompassed baseline data at admission, as well as periprocedural and imaging data. Ten-fold cross-validation was used to estimate accuracy. The accuracy of the algorithms was checked with a test dataset. In addition to regression analysis, we performed a binary classification analysis to identify patients that stayed longer than the mean length of stay. Results Mean length of stay was 10.7 days (median 10, interquartile range 6–15). The sensitivity of the best-performing Random Forest model was 0.8, the specificity was 0.68 and the area under the curve was 0.73 in the classification analysis. The mean absolute error of the best-performing Random Forest Model was 4.6 days in the test dataset in the regression analysis. Conclusion Machine learning has potential use to estimate the length of stay of patients with acute ischaemic stroke that were treated with thrombectomy.
Virtual reality simulation training in stroke thrombectomy centers with limited patient volume—Simulator performance and patient outcome
Authors: Søvik Olav , Tveiten Arnstein , Øygarden Halvor , Stokkeland Pål Johan , Hetland Hanne Brit , Schneider Magnus Sundgot , Sandve Knut Olav , Altmann Marianne , Hykkerud Dan Levi , Ospel Johanna , Goyal Mayank , Ersdal Hege Langli , Kurz Martin Wilhelm , Hyldmo Per Kristian 
Published: September 2023

Background Virtual reality simulation training may improve the technical skills of interventional radiologists when establishing endovascular thrombectomy at limited-volume stroke centers. The aim of this study was to investigate whether the technical thrombectomy performance of interventional radiologists improved after a defined virtual reality simulator training period. As part of the quality surveillance of clinical practice, we also assessed patient outcomes and thrombectomy quality indicators at the participating centers. Methods Interventional radiologists and radiology residents from three thrombectomy-capable stroke centers participated in a five months thrombectomy skill-training curriculum on a virtual reality simulator. The simulator automatically registered procedure time, the number of predefined steps that were correctly executed, handling errors, contrast volume, fluoroscopy time, and radiation dose exposure. The design was a before-after study. Two simulated thrombectomy cases were used as pretest and posttest cases, while seven other cases were used for training. Utilizing the Norwegian Stroke Register, we investigated clinical results in thrombectomy during the study period. Results Nineteen interventional radiologists and radiology residents participated in the study. The improvement between pretest and posttest cases was statistically significant for all outcome measures in both simulated cases, except for the contrast volume used in one case. Clinical patient outcomes in all three centers were well within the recommendations from multi-society consensus guidelines. Conclusion Performance on the virtual reality simulator improved after training. Virtual reality simulation may improve the learning curve for interventional radiologists in limited-volume thrombectomy centers. No correlation alleged, the clinical data indicates that the centers studied performed thrombectomy in accordance with guideline-recommended standards.
Socio-Clinical factors associated with Parkinson's disease–related specific self-management behaviours
Authors: Kafri Michal , Abu Taieh Maram , Duvdevani Michal , Schlesinger Ilana , Nassar Maria , Erich Ilana , Hadad Rafi , Yogev-Seligmann Galit 
Published: September 2023

Objective To test associations between socio-clinical factors, self-management and patient activation among patients with Parkinson's disease (PD), and to explore the use of regression tree to find the cut-off levels of socio-clinical factors which associate with lower or higher self-management behaviours and patient's activation. Methods A cross-sectional study of patients with PD ( n = 62) who underwent assessment of their socio-clinical factors including age, gender, cognitive status, comorbidities, disease severity (motor and non-motor symptoms) and social support. The associations of these factors to specific aspects of self-management behaviours including utilization of rehabilitative treatments, physical activity and patient activation were tested. Results Most patients did not utilize rehabilitative treatments. Non-motor symptoms and cognitive status were significantly associated with physical activity ( R2 = 0.35, F(3, 58) = 10.50, p < 0.001). Non-motor symptoms were significantly associated with patient activation ( R2 = 0.30, F(1, 30) = 25.88, p < 0.001). Patients with Mini-Mental State Exam score ≤24 performed less physical activity, relative to those with a higher score. Patients with ≤5 non-motor symptoms showed higher activation relative to those with >5. Conclusion In PD, disease-specific clinical characteristics overshadow other personal factors as determinants of self-management behaviours. The role of non-motor symptoms in reduced self-management behaviours and activation is highlighted.
The association of aspartate transaminase-to-alanine transaminase ratio and metabolic syndrome among HIV patients in Sidama Region, South Ethiopia
Authors: Abera Wondwossen , Wube Temesgen Bizuayehu , Alemayehu Tsegaye 
Published: September 2023

Objective: Studies on the association of the aspartate transaminase-to-alanine transaminase ratio with the metabolic syndrome and its components among HIV patients were scarce. This study aims to determine the association between the aspartate transaminase-to-alanine transaminase ratio and the metabolic syndrome and its components in adult HIV patients on highly active antiretroviral therapy. Methods: This was a cross-sectional study conducted on 302 HIV patients from January 15 to June 30, 2021. Sociodemographic, clinical, and anthropometric data were collected using a structured questionnaire. The patient’s medical records were reviewed. Biochemical analysis was performed after 5 ml of venous blood was collected from each study participant. Metabolic syndrome was defined by the third report of the national cholesterol education program-adult treatment panel. Logistic regression was done to assess the association of MetS with the independent variables, and correlation analysis was performed to see the correlation of MetS components with the aspartate aminotransferase-to-alanine aminotransferase ratio. Result: 302 HIV—positive patients on highly active antiretroviral therapy were included in this study, and 54.6% were female. The median and interquartile range of the age of the study participants were 41 (35–50) years. The prevalence of metabolic syndrome was 29.5% (confidence interval = 24.5–35.1). Chronic illness (Adjusted odds ratio = 4.8, confidence interval = 2.2–10.9) and aspartate aminotransferase-to-alanine aminotransferase ratio (adjusted odds ratio = 2.5, confidence interval = 1.4–4.4) were significantly associated with Metabolic syndrome among the study participants. The aspartate aminotransferase-to-alanine aminotransferase ratio was significantly correlated with blood pressure. Conclusion: This study found the existence of a significant association between the aspartate aminotransferase-to-alanine aminotransferase ratio and metabolic syndrome among HIV patients.
Tiger Parenting Beyond Cultural Essentialism: Discourses of Class, Culture, and Competition in Hong Kong
Authors: Kobakhidze Magda Nutsa , Ma (马莹) Ying , Tsaloukidis Alexandros 
Published: September 2023

Purpose This study explores a nuanced understanding of tiger parenting by moving beyond cultural essentialist perspectives and an East (Chinese)-versus-West binary framework. Design/Approach/Methods The study draws on data from 80 parents in Hong Kong SAR, an example of a culturally-hybrid East Asian metropolis. We applied maximum variation sampling to recruit participants with diverse school choices encompassing different education levels, occupations, social classes, and ethnicities. We used semi-structured interviews to investigate parental beliefs, practices, and understandings of tiger parenting. Findings The findings suggest that tiger parenting is a cross-class and cross-culture phenomenon that would be more fruitfully analyzed by considering parental mindsets, educational structures, peer pressure, generational influences, cultural roots, class preferences, and global aspirations. We posit that tiger parenting and similar parenting practices are increasingly necessitated by fiercely competitive education systems, and becoming globalized across ethnic groups and social class spectrums. Originality/Value This study contributes to the discussion on tiger parenting by highlighting previously understudied factors underpinning the concept. We argue that our analytical approach avoids the previous narrow and cultural essentialist understanding of tiger parenting, and advances the theoretical cogency of the concept.
Humeral Head Reconstruction With Osteochondral Allograft: Bone Plug Optimization for Hill-Sachs Lesions Using CT-Based Computer Modeling Analysis
Authors: Ganokroj Phob , Hollenbeck Justin , Peebles Annalise M. , Brown Justin R. , Hanson Jared A. , Whalen Ryan J. , Golijanin Petar , Provencher CAPT Matthew T. 
Published: September 2023

Background: Engaging Hill-Sachs lesions (HSLs) pose a significant risk for failure of surgical repair of recurrent anterior shoulder instability. Reconstruction with fresh osteochondral allograft (OCA) has been proposed as a treatment for large HSLs. Purpose: To determine the optimal characteristics of talus OCA bone plugs in a computer-simulated HSL model. Study Design: Descriptive laboratory study; Level of evidence, 6 Methods: Included were 132 patients with recurrent anterior instability with visible HSLs; patients who had multidirectional instability or previous shoulder surgery were excluded. Three-dimensional computed tomography models were constructed, and a custom computer optimization algorithm was generated to maximize bone plug surface area at the most superior apex (superiorization) and minimize its position relative to the most medial margin of the HSL defect (medialization). The optimal number, diameter, medialization, and superiorization of the bone plug(s) were reported. Percentages of restored glenoid track width and conversion from off- to on-track HSLs after bone plug optimization were calculated. Results: A total of 86 patients were included in the final analysis. Off-track lesions made up 19.7% of HSLs and, of these, the mean bone plug size was 9.9 ± 1.4 mm, with 2.2 mm ± 1.7 mm of medialization and 3.3 mm ± 2.9 mm of superiorization. The optimization identified 21% of HSLs requiring 1 bone plug, 65% requiring 2 plugs, and 14% requiring 3 plugs, with a mean overall coverage of 60%. The mean width of the restored HSLs was 68%, and all off-track HSLs (n = 17) were restored to on-track. A Jenks natural-breaks analysis calculated 3 ideal bone plug diameters of 8 mm (small), 10.4 mm (medium), and 12 mm (large) in order to convert this group of HSLs to on-track. Conclusion: Using a custom computer algorithm, we have demonstrated the optimal talus OCA bone plug diameters for reconstructing HSLs to successfully restore the HSL track and, on average, 60% of the HSL surface area and 68% of the HSL width. Clinical Relevance: Reconstructing HSLs with talus OCA is a promising treatment option with excellent fit and restoration of HSLs. This study will help guide surgeons to optimize OCA bone plugs from the humeral head, femoral head, and talus for varying sizes of HSLs.
Deucravacitinib: A Novel TYK2 Inhibitor for the Treatment of Moderate-to-Severe Psoriasis
Authors: Kingston Paige , Blauvelt Andrew , Strober Bruce , Armstrong April W. 
Published: September 2023

Background Deucravacitinib is a first-in-class tyrosine kinase 2 (TYK2) inhibitor recently approved for the treatment of adults with moderate-to-severe plaque psoriasis. Objective To discuss the mechanism of action, efficacy, safety, and real-world applications of deucravacitinib for the treatment of psoriasis. Methods Literature on the mechanism of action of deucravacitinib is reviewed. The pivotal clinical studies and long-term extension studies for deucravacitinib are also examined. Results Deucravacitinib is a novel oral TYK2 inhibitor that binds to the regulatory domain of TYK2, a Janus kinase. By inhibiting TYK2, deucravacitinib interferes with signaling of IL-23, IL-12, and type I interferons, cytokines believed to play important roles in psoriasis pathogenesis. Nearly 60% of patients achieve PASI 75 at 16 weeks of treatment; efficacy improves over 24 weeks and is maintained through 2 years of continuous treatment. In a head-to-head comparison, deucravacitinib efficacy was superior to apremilast, an older yet commonly used oral PDE4 inhibitor approved for the treatment of psoriasis. Of note, patients with moderate-to-severe plaque psoriasis with concomitant involvement of the scalp, nails, and/or palms/soles demonstrated good improvement in these high impact areas. Deucravacitinib has an acceptable safety profile and is generally well-tolerated. Small increases in reactivation of herpesvirus infections, including herpes simplex outbreaks, have been reported. Tuberculosis evaluation, but no other blood tests, is recommended prior to initiation of deucravacitinib. Monitoring of triglyceride levels should be conducted for high-risk patients according to local guidelines. Conclusion Deucravacitinib is an effective, safe, and well-tolerated novel oral medication for adults with moderate-to-severe plaque psoriasis.
Acupoint Transcutaneous Electrical Nerve Stimulation in Hospitalized COPD Patients with Severe Dyspnoea: A Randomized Controlled Trial
Authors: Fernández-Jané Carles , Vilaró Jordi , Costa-Tutusaus Lluís 
Published: September 2023

Objective To evaluate the effect of acupuncture transcutaneous electrical nerve stimulation (acuTENS) on the reduction of dyspnoea during acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A multicentric randomized control trial with masked patients and evaluators was carried out. During hospitalization, AECOPD patients received 45 min of acuTENS (experimental group) or sham acuTENS (controls) daily on 5 consecutive days. The trial was conducted at the Hospital del Mar, Barcelona, and Hospital Sant Joan de Déu, Manresa (both in Spain). Dyspnoea and peak expiratory flow were measured daily from the first to fifth days. Length of stay, readmissions at 3 months and adverse events were also analysed. Results Finally, 19 patients with moderately to severely exacerbated COPD were included. Although some tendencies in dyspnoea during day 1 and length of hospital stay were found favouring acupuncture, no significant differences were shown between groups. Conclusions The acuTENS intervention was feasible#well tolerated in AECOPD patients and no important side effects were reported.