bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrapancreatic autologous stem cell therapy for type 1 diabetes – an experimental study
Authors: Jawale Sagar 
Published: September 2023

Introduction:
Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes, is a chronic autoimmune condition in which the pancreas makes little or no insulin leading to resultant hyperglycemia. The incidence of type 1 diabetes in India is 0.26 per 1000 children.

Materials and methods:
The author treated 25 patients with type 1 diabetes with autologous intrapancreatic stem cell therapy in the last 5 years. A group of 26 patients of type 1 diabetes with conventional treatment of insulin injections was put as a control group in the same period.

Results:
The results of the therapy group were substantially superior to the control group, which came statistically highly significant. The variable compared were weight gain, the daily requirement of insulin and its drop after therapy, the rise of C-peptide levels and drop in anti-glutamic acid decarboxylase antibody, drop in HbA1c levels, and drop in fasting and postprandial blood sugar.

Discussion:
When stem cells are given intravenously, the majority are engulfed by the lungs and only a small fraction is delivered to the pancreas. When injected into the pancreas, through its arterial blood supply, due to the larger size and irregular shape of stem cells, they are retained in tissue spaces and do not escape from the venous side, thus achieving far higher concentration in the pancreas compared to the intravenous route.

Conclusions:
Intrapancreatic stem cell therapy for type 1 diabetes is safe, affordable, and effective. It has the potential to become a viable treatment option for type 1 diabetes patients.
Sociodemographic disparities associated with advanced stages and distant metastatic breast cancers at diagnosis in Indonesia: a cross-sectional study
Authors: Setyawan IG Budhi , Kurnia Dian , Setiaji Kunta , Anwar Sumadi Lukman , Purwanto Deni J. , Azhar Yohana , Budijitno Selamat , Suprabawati Desak Gede Agung , Priyono Sasongko Hadi , Siregar Bintang Abadi , Indriawan Ramses , Tripriadi Effif Syofra , Umar Mulawan , Pieter John SLA , Yarso Kristanto Yuli , Hermansyah Dedy , Wibisana IGN Gunawan , Harahap Wirsma Arif , Gautama Walta , Achmad Dimyati 
Published: September 2023

Background:
The global health burden of breast cancer is increasing with 5-year survival rates being much shorter in low-income and middle-income countries. Sociodemographic and clinical disparities in early cancer detection affect long-term outcome.

Methods:
The authors compared social, demographic, and pathological characteristics associated with metastatic and late stages of breast cancer diagnosis using data collected from a special registry developed by Perhimpunan Bedah Onkologi Indonesia (PERABOI) in 2015.

Results:
Of 4959 patients recruited in this study, 995 women (20.1%) were diagnosed with metastatic breast cancer. Lower education status and living in rural areas were significantly associated with Stage IV at diagnosis [odds ratio (OR)=1.256, 95% CI=1.093–1.445, P=0.001; and OR=1.197, 95% CI=1.042–1.377, P=0.012; respectively). Main complaints other than lump (ulceration, breast pain, and discharge) and occupation as a housewife were also associated with the presentation of metastatic diseases (OR=2.598, 95% CI=2.538–3.448, P<0.001 and OR=1.264, 95% CI=1.056–1.567, P=0.030, respectively). Having lower education and living outside Java and Bali islands were associated with the diagnosis of late-stage breast cancers (OR=1.908, 95% CI=1.629–2.232, P<0.001 and OR=3.039, 95% CI=2.238–4.126, P<0.001; respectively). A higher proportion of breast cancer patients were relatively younger with bigger tumour size, positive axillary nodal involvement, and more frequent Human epidermal growth factor receptor 2 overexpression.

Conclusion:
The authors identified sociodemographic disparities in the metastatic and late-stage diagnosis of breast cancers among Indonesian women. The subsequent action is required to reduce disparities faced by women with lower social and educational levels for early diagnosis and better healthcare access.
Impacts of COVID-19 pandemic on pediatric fractures: a 4-year evaluation of epidemiology and delayed treatment from prepandemic to pandemic period at a tertiary referral hospital
Authors: Muhammad Hilmi , Magetsari Rahadyan , Rukmoyo Tedjo , Hasan Meirizal , Hidayat Luthfi , Triangga Aditya F.R. , Putro Yuni A.P. , Lanodiyu Zikrina A. , Rahayu Bernadeta F.P. , Kartika Andrea , Sakti Yudha M. 
Published: September 2023

Background:
Definitive fracture surgery should be performed as soon as the patient’s condition allows. However, there may be some delays in the treatment during a pandemic.

Objective:
This study aimed to investigate and compare the epidemiology and delays in pediatric fracture management during the pandemic and prepandemic periods in terms of how many cases were delayed, how long were the delays, and the causes for the delays of fracture treatment.

Methods:
This comparative-retrospective study was conducted in a tertiary referral hospital in Yogyakarta, Indonesia. The authors included all patients who presented to the hospital from 1 December 2019 to 30 November 2021 (pandemic group period) and from 1 December 2017 to 30 November 2019 (prepandemic group period). The collected data included: patients’ age and sex, fractured bone, fracture type, concurrent fracture, hospital stay duration, treatment, need for multidisciplinary treatment, interval from arrival to treatment, and reasons for delayed surgical treatment. The data were obtained from the patients’ medical records.

Results:
Results showed a decrease in the pediatric fracture cases during the 2 years pandemic period compared to the prepandemic period (75 vs. 135 cases). There was no significant difference in the evaluated parameters of demographic, fractured bone and type, hospital stay duration, treatment, other department involvement, and delayed surgical treatment for the fracture. The most common reason for the definitive surgical management delay was the need for medical condition improvements (n=63, 79.7%) and it was significantly associated with the need for multidisciplinary treatment approach (22.83 in isolated orthopedic cases vs. 87.5% in multidisciplinary cases; P=0.000).

Conclusion:
There was a decrease in the pediatric fracture cases during the 2-year pandemic period compared to the prepandemic period. The delay in definitive surgical management was mainly due to the need for the medical condition improvements and it was associated with the need for a multidisciplinary treatment approach.
Endovenous laser ablation versus conventional surgery (ligation and stripping) for primary great saphenous varicose vein: a systematic review and meta-analysis
Authors: Shrestha Oshan , Basukala Sunil , Thapa Niranjan , Karki Sagun , Pant Prashant , Paudel Sushanta 
Published: September 2023

Background:The great saphenous varicose vein was managed with high ligation and stripping conventionally, but with the development of minimally invasive surgical techniques like endovascular laser ablation (EVLA), they have become popular. This systematic review and meta-analysis of randomized controlled trials aim to compare the short-term and long-term outcomes of these two modalities on headings like procedural time, technical success, recovery time, recurrences, cost-effectiveness, and complications.Materials and methods:The protocol followed in this study was registered prospectively in the Registry of Systematic Reviews/Meta-analyses. Electronic databases were searched with appropriate search terms for relevant studies, and after their screening, data was extracted. The odds ratio was used for dichotomous data, and the mean difference or standardized mean difference was used for continuous variables.Results:This study identified 18 publications (10 randomized controlled trials) with a total of 1936 patients. There was no difference in procedural time, recovery time, recurrences at 1, 2, and 5 years, or clinical severity score. The surgery group had 4.35 times higher statistically significant odds of being technically successful at 2 years, while pooling data on bruising, hematoma, sensory disturbance, infection, and phlebitis showed that the EVLA group was less likely to develop postoperative complications.Conclusion:Technical failures were more common in the EVLA, whereas postoperative complications were more common in the surgery group. Both have comparable clinical effectiveness, and neither modality has clear superiority over the other. Parameters like cost-effectiveness must be assessed at the hospital level before choosing the right procedure for the patients.
Avascular necrosis of femoral head following COVID-19 infection
Authors: Assad Saywan K. , Sabah Mohammed , Kakamad Fahmi H. , Salih Abdulwahid M. , Salih Rawezh Q. , Mohammed Shvan H. , Ali Razhan K. , Abdalla Berun A. , Hassan Marwan N. 
Published: September 2023

Introduction:
It is crucial to be aware of post-COVID-19 non-pulmonary complications. Avascular necrosis (AVN) is one of these complications. It should be noted that the risk of AVN persists in individuals who have recovered from the COVID-19 infection. The current study aims to report several cases of AVN after being infected with SARS-CoV-2.

Materials and methods:
This is a single-centre retrospective case series conducted over a 2-year period (January 2021–December 2022) involving individuals who developed AVN after being infected with COVID-19.

Result:
The study included a total of 17 patients. The mean age of patients was 38.65±6.1 years. Twelve of them were male (70.6%) and five were female (29.4%), with a ratio of 3:1. The mean BMI of the patients was 28.3±2.4 kg/m2. Eleven (64.7%) patients reported administering steroid injections throughout the infection course. The mean interval between COVID-19 infection and presentation to the clinic was 6.53 months. The majority of patients (82.3%) complained of bilateral hip pain. Limping was observed in 47% of the cases. MRI showed AVN in all cases. Bilateral core decompression was performed in five cases (29.4%), total hip replacement in three cases (17.6%), and conservative treatment in nine cases (53%).

Conclusion:
The ongoing pandemic may have many long-term sequelae. There is a risk of developing AVN after COVID-19.
Giant condyloma acuminatum surgical management: a case report and literature review
Authors: Al-Ghamdi Ahmed M. , Alfalah Seba , Anwer Khurshid , Alzaher Ibrahim , Alsuhaimi Ahmed A. , Aldhafeeri Sahar M. 
Published: September 2023

Introduction and importance:
Condyloma acuminatum (CA) or genital warts, represents a rare sexually transmitted disease caused by the human papillomavirus. Infection occurs when host basal cells are exposed to viral infection through a damaged epithelial barrier, during sexual intercourse, or due to other minor skin abrasions. Giant condyloma acuminatum (GCA) has a higher rate of malignant transformation than CA.

Case presentation:
We are presenting a 44-year-old single gentleman known as a smoker, hepatitis B positive, vitiligo, and hypercholesteromia. He was an alcoholic and had multiple heterosexual relationships abroad. Referred from the dermatology clinic, complaining of genital warts that had increased in size for 10 years.

Clinical discussion:
CA management includes local applications like imiquimod and podophyllotoxin and clinician-administered treatments such as cryotherapy, surgical excision, electrosurgery, and CO2 laser therapy. Other options, such as interferon, radiotherapy, or chemotherapy, are available. The selection of therapy should be individualized and based upon consideration of the extent of the disease, patient preference, cost, adverse effects, treatment availability, and the response to previous treatments. Complete surgical excision is the treatment of choice for GCA.

Conclusion:
We present a patient with GCA in the perianal area that was surgically treated with an excellent outcome.
Prevalence and impact of diabetes mellitus in hospitalized COVID-19 patients in a Tunisian Center: a cross-sectional study
Authors: Rouis Sana , Chebil Dhekra , Debbabi Wided , Hannachi Hajer , Sakly Hela , Chermiti Sondes , Marzouk Hajer , Kharrat Issam , Samet Slim , Merzougui Latifa 
Published: September 2023

Background:
The outbreak of the coronavirus disease 2019 (COVID-19) has become an evolving worldwide health crisis. With the rising prevalence of diabetes mellitus has come an increasing awareness of their impacts on infectious diseases, and the risk for postinfection complications and mortality from critical infections.

Objective:
The objective of this study was to evaluate the prevalence and impact of diabetes mellitus on the severity and mortality of COVID-19.

Methods:
Data of laboratory-confirmed hospitalized patients at the COVID-19 unit between September 2020 and August 2021 were analyzed, in a cross-sectional study. The population was classified into two groups: COVID-19 patients with and without diabetes. Primary outcomes were the overall length of hospital stay, the admission to the ICU, and death. The association between diabetes and death was assessed in a Cox proportional hazards model.

Results:
A total of 866 patients were included. There were 270 (31.2%) patients with diabetes. Diabetic patients were more likely to have hypertension (58.1 vs. 33.4%), cardiovascular disease (18.5 vs. 10.4%), and dyslipidaemia (17.8 vs. 7.2). Overall, 263 patients died, among them only 86 in the diabetic group (P=0.523). Patients with diabetes had a higher risk of developing complications (P<0.001). Multivariate Cox regression analysis showed that diabetes was not significantly associated with death [HR (95% CI): 1.253 (0.963–1.631)].

Conclusion:
Diabetes was associated with a greater risk of complications in patients with COVID-19. Special attention to diabetic patients during treatment must be given to avoid these complications.
Digital Collateral Information Through Electronic and Social Media in Psychotherapy: Comparing Clinician-reported Trends Before and During the COVID-19 Pandemic
Authors: Vahia Ipsit V. , Sava Rachel N. , Cray Hailey V. , Kim Heejung J. , Dickinson Rebecca A. , Ressler Kerry J. , Trueba Ana F. 
Published: September 2023

Background:
Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to virtual care had an impact on therapists’ use of patients’ electronic and social media to augment clinical information that may inform psychotherapy.

Methods:
In 2018, we conducted a survey of a cohort of psychotherapists affiliated with McLean Hospital. We then reapproached the same cohort of providers for the current study, gathering survey responses from August 10, 2020, to September 1, 2020, for this analysis. We asked clinicians whether they viewed patients’ electronic and social media in the context of their psychotherapeutic relationship, what they viewed, how much they viewed it, and their attitudes about doing so.

Results:
Of the 99 respondents, 64 (64.6%) had viewed at least 1 patient’s social media and 8 (8.1%) had viewed a patient’s electronic media. Of those who reported viewing patients’ media, 70 (97.2%) indicated they believed this information helped them provide more effective treatment. Compared with the 2018 prepandemic data, there were significantly more clinicians with>10 years of experience reporting media use in therapy. There was also a significant increase during the pandemic in the viewing of media of adult patients and a trend toward an increase in viewing of media of older adult patients.

Conclusions:
Review of patients’ electronic and social media in therapy became more common among clinicians at a large psychiatric teaching hospital during the COVID-19 pandemic. These findings support continuing research about how reviewing patients’ media can inform and improve clinical care.
Acute Treatment of Adolescent Cannabinoid Hyperemesis Syndrome With Haloperidol, Lorazepam, and/or Capsaicin: A Single Institution Case Series
Authors: Brown Jerry M. , Wilsey Michael J. , Dhana Leila , Lonsdale Hannah 
Published: September 2023

Cannabinoid hyperemesis syndrome (CHS), an under-recognized and seemingly paradoxical condition, arises in some adolescents and adults who chronically use cannabis. It presents acutely with intractable nausea, vomiting, and abdominal pain but standard antiemetic therapy leads to improvement for only a minority of patients. Randomized controlled trial evidence in adults indicates the superiority of haloperidol over ondansetron in alleviating the acute symptoms of CHS, but safe and effective treatment for adolescents with the disorder is currently unknown. The successful use of topical capsaicin has also been reported. We report a case series of 6 adolescent patients with CHS who presented to Johns Hopkins All Children’s Hospital and were treated with haloperidol, lorazepam, and/or capsaicin. Four patients given 5 mg intravenous (IV) haloperidol and 2 mg IV lorazepam and 1 patient treated with 5 mg IV haloperidol and peri-umbilical topical capsaicin (0.025%) experienced full acute symptomatic relief. One patient, treated only with topical capsaicin, reported improvement of symptoms with some persistent nausea. Haloperidol/lorazepam, haloperidol/capsaicin, and topical capsaicin alone appear safe and effective in adolescents, but larger studies are required to confirm our findings.
The Triple “S” Impact of COVID-19: Nationwide Evidence of the Impact of the Stress Associated With Restrictive Measures on Substance Use, Sleep, and Social Connectedness in Qatar
Authors: Abed Alah Muna , Abdeen Sami , Kehyayan Vahe , Bougmiza Iheb 
Published: September 2023

Objectives:
Countries worldwide implemented social and movement restrictions to contain the spread of coronavirus disease 2019 (COVID-19). Unfortunately, such restrictions have adversely impacted people’s lifestyles. The goal of this study was to assess the impact of COVID-19-related restrictive measures on substance use, sleep, and social connectedness in Qatar’s population.

Methods:
A web-based survey was conducted between January 2021 and February 2021 targeting adults ≥18 years of age who were residing in Qatar between March and August 2020.

Results:
A total of 1408 participants completed the survey. Of tobacco users in our sample, 36% reported increased tobacco use since the start of home confinement, while 41.6% of alcohol users reported decreased alcohol use. Concerning sleep, 46.1% reported an increase in average sleep duration per day (0.77 h mean increase, 95% CI: 0.66-0.88, P<0.001), and a third of participants reported poorer sleep quality. Of the participants, 39.6% felt socially disconnected. Perceived stress was found to be an independent predictor for increased use of tobacco, deterioration in sleep quality, and increased sleep duration during home confinement.

Conclusions:
Restrictive measures related to COVID-19 resulted in both positive and negative impacts on the lifestyle of Qatar’s population. Emphasis should be placed on encouraging people to adopt healthy strategies for coping with various stressors that arise during future home confinement measures. It is also necessary to address the persistence of adverse consequences in the postpandemic era.
Survival After Simultaneous Heart-kidney Transplant in Recipients With a Durable LVAD and Chronic Kidney Disease: Effect of the 2018 Heart Allocation Policy Change
Authors: Fraser Meg , Agdamag Arianne C. , Riad Samy , Nzemenoh Bellony N. , Jackson Scott , Money Joel , Knoper Ryan , Martin Cindy M. , Alexy Tamas 
Published: September 2023

Background.
Heart transplantation remains the most definitive therapy for qualified candidates with end-stage heart failure. Concomitant kidney disease is common in this population prompting an increase in simultaneous heart-kidney (SHK) transplantation in recent years. The goal of our study was to explore the effects of the 2018 heart allocation policy (HAP) change on candidate listing characteristics and compare survival rates at 1 y in patients that were supported with a left ventricular assist device (LVAD) pretransplant and underwent SHK or heart alone transplant (HAT).

Methods.
We used data from the Scientific Registry of Transplant Recipients and identified all adults who underwent primary SHK or HAT between January 2010 and March 2022. Recipients supported with a durable LVAD and estimated glomerular filtration rate <60 mL/min/1.73 m2 were selected (n = 309 SHK; 217 pre- and 92 post-HAP and n = 3,324 HAT; 2738 pre- and 586 post-HAP).

Results.
Difference in survival at 1 y did not reach statistical significance. Comparing the 1-y survival of SHK and HAT recipients who were bridged with LVAD pre-HAP, we found no significant difference (P = 0.694). Adjusting for the same covariates in a multivariable model did not affect the results (SHK versus HAT hazard ratio 0.84 [0.51, 1.37]; P = 0.48). In contrast, SHK recipients supported with an LVAD who were listed and transplanted post-HAP change had significantly lower 1-y survival, when compared with HAT (P = 0.037).

Conclusions.
Our findings suggest that the HAP change had a potentially negative impact on the survival of select patients undergoing SHK transplant. Further research is warranted in this area.
The role of sphingosine-1-phosphate receptor 2 in mouse retina light responses
Authors: Shrestha Abhishek P , Stiles Megan , Grambergs Richard C. , Boff Johane M. , Madireddy Saivikram , Mondal Koushik , Rajmanna Rhea , Porter Hunter , Sherry David , Proia Richard L. , Vaithianathan Thirumalini , Mandal Nawajes 
Published: September 2023

AbstractThe bioactive sphingolipid sphingosine-1-phosphate (S1P) acts as a ligand for a family of G protein-coupled S1P receptors (S1PR1-5) to participate in a variety of signaling pathways. However, their specific roles in the neural retina remain unclear. We previously showed that S1P receptor subtype 2 (S1PR2) is expressed in murine retinas, primarily in photoreceptors and bipolar cells, and its expression is altered by retinal stress. This study aims to elucidate the role of S1PR2 in the mouse retina. We examined light responses by electroretinography (ERG), structural differences by optical coherence tomography (OCT), and protein levels by immunohistochemistry (IHC) in wild-type (WT) and S1PR2 knockout (KO) mice at various ages between 3 and 6 months. We found that a- and b-wave responses significantly increased at flash intensities between 400∼2000 and 4∼2,000 cd.s/m2respectively, in S1PR2 KO mice relative to those of WT controls at baseline. S1PR2 KO mice also exhibited significantly increased retinal nerve fiber layer (RNFL) and outer plexiform layer (OPL) thickness by OCT relative to the WT. Finally, in S1PR2 KO mice, we observed differential labeling of synaptic markers by immunohistochemistry (IHC) and quantitative reverse transcription polymerase chain reaction (RT-qPCR). These results suggest a specific involvement of S1PR2 in the structure and synaptic organization of the retina and a potential role in light-mediated functioning of the retina.