bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of local infiltration of tranexamic acid in subcutaneous surgery: A protocol from a single medical center
Authors: Chang Yao-Jen , Lin Yu-Hsien , Wang Pao-Lo , Lin Hwang-Chi 
Published: September 2023

Background:
The purpose of this study was to explore efficacy of locally injected tranexamic acid (TXA) at a concentration of 1 mg/mL for reduction perioperative bleeding and postoperative complications in subcutaneous tumor excisions. We present the protocol and also compare results between the group of use antithrombotic group and not used.

Methods:
This is a retrospective study. Fifty-three patients were divided into 3 groups. Group 1 (n = 14): using antithrombotic drugs (antiplatelet or anticoagulants) with locally injected TXA. Group 2 (n = 17): using antithrombotic drugs without locally injected TXA. Group 3 (n = 22): not using antithrombotic drugs but with locally injected TXA. TXA was diluted to 1 mg/mL for use based on our experience. All patients were operated by 1 surgeon in 1 single medical center in Taipei from March 1st, 2020, to March 31st 2022. Outcomes such as the quality of perioperative surgical field and postoperative surgical complications were evaluated and compared. The quality of field was intraoperatively recorded by an assessment and photos from the surgeon. The statistical relationships between the complication rates were analyzed using χ2 test and a 1-way ANOVA by SPSS 25.

Results:
From Groups 1 and 3, a total of 36 patients, 29 patients had a clear surgical field during procedure. When comparing Groups 1 and 2, use of locally injected TXA had greater positive advantage in terms of a clearer vision whilst surgery (P = .031). Group 2 had more minor complications such as hematoma, severe ecchymosis, wound dehiscence, wound infection. By postoperatively reducing hematomas for 24 hours, it significantly reduce the incidence of abovementioned minor complications (P = .036). With the help of locally injected TXA, shorter time was required to remove drain, hence reducing duration of in-hospital stay.

Conclusion:
The use of locally injected TXA whilst performing subcutaneous surgery on patients taking antithrombotic drugs is cost-effective. It could reduce bleeding and provide a more effective surgical field. In our study, favorable results were obtained from the use of diluted tranexamic acid (1 mg/mL) mixed with lidocaine, namely in clearing the surgical field as well as reducing postoperative surgical complications.
Small intestinal obstruction due to a giant gallstone: a rare case report from Syria
Authors: Suleiman Farah , Suleiman Ghazal , Shbani Abdulrahman , Hasan Ahmad , Hussein Al-janabi Moatasem 
Published: September 2023

Introduction and importance:
Gallstone ileus is a rare and potentially life-threatening condition characterized by the obstruction of the small intestine due to a gallstone. It occurs as a complication of gallstone disease, where a large gallstone erodes through the gallbladder into the gastrointestinal tract, creating a fistula.

Case presentation:
A type 2 diabetic woman in her 50s presented to the emergency department complaining of abdominal pain and vomiting. She has not emptied her bowels since 3 days ago. A clinical examination showed tenderness in the abdomen associated with fecal vomiting. A computed tomography (CT) scan was performed and showed a dilated gallbladder with gas. A giant gallstone in a small intestinal loop was observed. The diagnosis was a small intestinal obstruction due to a giant gallstone and a duodenal-biliary fistula.

Clinical discussion:
Gallstone ileus is an occasional complication of cholelithiasis, occurring in less than 0.5% of patients. Gallstone ileus frequently occurs in the terminal ileum and the ileocecal valve. Regarding the clinical presentation, abdominal pain is the most common symptom, followed by vomiting and constipation. CT scan is the gold standard utilized to diagnose gallstone ileus. Surgical intervention is the mainstay treatment for giant gallstone ileus, with enterolithotomy being the most commonly performed procedure.

Conclusion:
Gallstone ileus is an uncommon but potentially life-threatening condition that can emerge in elderly patients with a history of cholelithiasis. It is crucial for clinicians to maintain a high index of suspicion when encountering older patients with risk factors for cholelithiasis and intestinal obstruction.
Unraveling recurrent urinary tract infection in adulthood: a rare case report of unilateral partial duplex collecting system with ureterocele
Authors: Katwal Shailendra , Ghimire Aastha , Shrestha Kusum , Kansakar Rochak , Amatya Suban 
Published: September 2023

Introduction:
Duplication of the renal collecting system, known as the duplex collecting system, is a common congenital anomaly of the urinary tract. It can be partial or complete and affects 0.7–4% of the population, with a higher incidence in females. Ureteroceles are cystic dilations of the distal ureter and are often asymptomatic, particularly in adults.

Case presentation:
The authors present a case of a newly diagnosed partial duplex collecting system of the left kidney and left intravesical ureterocele, which was diagnosed for the first time at the age of 47 years, along with a history of symptoms suggestive of recurrent urinary tract infection and a urethral calculus which was surgically managed 5 years ago.

Clinical discussion:
The presence of a duplex collecting system can be observed even in males, with the possibility of recurrent urinary tract infection and the rare occurrence of an intravesical ureterocele. While ureteroceles are typically considered a congenital condition, they can also be diagnosed in adults.

Conclusion:
A partial duplex collecting system of the left kidney with left intravesical ureterocele in the age of 47 years in a male is a rare occurrence. Diagnosis and management of such urological cases can be challenging especially in a resource limited setting, which can be mitigated by awareness of unusual presentations, proper antenatal care, and access to proper diagnostic tools.
Interprofessional Team Collaboration as a Mediator Between Workplace Social Capital and Patient Safety Climate: A Cross-Sectional Study
Authors: Kida Ryohei , Suzuki Risa , Fujitani Katsumi , Ichikawa Kaori , Matsushita Hironobu 
Published: August 2023

Background and Objectives:
Patient-safety climate is one of the most important organizational factors contributing to health care quality. We hypothesized that a patient safety climate is fostered by the willingness to collaborate and trust among members as well as by daily collaborative practices. This study aimed to clarify the effect of workplace social capital on patient safety climate. We also sought to investigate the mediating effect of interprofessional team collaboration on the relationship between workplace social capital and patient safety climate.

Methods:
This cross-sectional survey was conducted from November 2021 to January 2022 using anonymous web-based questionnaires. The survey was distributed to 1495 employees working in a hospital in Tokyo, Japan. The questionnaire included the patient safety climate scale, workplace social capital scale, Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II-J), and demographic items. Structural equation modeling was performed to verify the associations among the 3 variables. In addition, a significance test for indirect effects was conducted using the bootstrap method to confirm the mediating effect of AITCS-II-J.

Results:
A total of 725 employees participated in this survey, and 632 data items were analyzed. Nurses were the highest number of respondents (68.2%), followed by physicians (13.3%). Workplace social capital and patient safety were directly and significantly associated (β = .309, P < .01). Furthermore, the partially indirect effect of the AITCS-II-J on the association between workplace social capital and patient safety climate was also significant (β = .430, P < .01).

Conclusions:
Workplace social capital was significantly and directly related to patient safety climate and was also significantly related to patient safety climate partially mediated by interprofessional team collaboration. Our findings suggest the importance of workplace social capital and routine multidisciplinary collaboration for a patient safety climate to manage health care quality.
Prostate Adenocarcinoma Metastasis to the Rectal Submucosa and Mesorectal Lymph Node on 18F-PSMA PET/CT
Authors: Segal Eric , Dababo Nour , Bhalla Deepali , Bucklan Daniel 
Published: September 2023

Abstract
We report a case of biopsy-proven prostate cancer metastasis to the rectum and presumed metastasis to a mesorectal lymph node, identified as radiotracer-avid lesions on prostate-specific membrane antigen PET/CT during workup for biochemically recurrent prostate cancer. This case adds to a growing number of atypical sites of metastatic prostate cancer being reported since the approval of prostate-specific membrane antigen PET/CT for staging of prostate cancer.
Goals of care and end-of-life communication needs of persons with chronic respiratory disease
Authors: Reinke Lynn F. , Fasolino Tracy , Sullivan Donald R. 
Published: September 2023

Purpose of the review
To highlight recent advances in effective communication among persons with chronic respiratory diseases. The authors focus on communication science related to goals of care (GOC) discussions, medical devices, and life-sustaining invasive treatments. The authors discuss important considerations when working with individuals with low literacy and rurality. Communication handoffs between respiratory clinicians and/or palliative care to hospice clinicians are summarized to ensure effective person-centered and caregiver-centered care.

Recent findings
Studies suggest the following communication approaches: (1) clarify differences between palliative and end of life; (2) conduct conversations early and gradual throughout the illness trajectory; (3) distinguish types of GOC discussions as they relate to treatment preferences; (4) for patients from rural communities, include family members and spiritual leaders; (5) assess literacy and employ supportive strategies; (6) apply time-limited-trial framework for life-sustaining treatment (LST) decisions; and (7) standardize processes for communication handoffs to hospice clinicians to improve communication fidelity.

Summary
Effective communication tools for clinicians to engage in GOC discussions for persons with chronic respiratory diseases are grounded in a patient-centered framework. A trained clinician should lead these conversations and include interdisciplinary team members throughout the disease trajectory including at the end of life. These approaches may enable patients to express their values and care preferences as they evolve over time.
Rapid advancements in diagnostic technology during the COVID pandemic: Important and Difficult Tasks for Medical Laboratory Professionals
Authors: Khadka Ram Bahadur , Karki Khimdhoj , Pandey Jitendra , Chaudhary Gautam Prasad , Gupta Santosh Kumar , Dhakal Ganesh , Pant Dhakaraj 
Published: September 2023

The acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes the illness COVID-19 first emerged throughout China in December 2019 and subsequently spread throughout the globe after the World Health Organization designated it a global outbreak in March 2020.We used the terms COVID-19, SARS-COV-2, Medical Laboratory Professionals,Diagnostic, and Importance, difficulties to search the databases of PubMed and Google Scholar for previously published material. Many molecular based diagnostic tests are applied in corona virus detection like Reverse Transcription Polymerase Chain Reaction, Multiplex Polymerase Chain Reaction, Droplet Digital polymerase Chain reaction, Loop-mediated Isothermal Amplification Test and more. Due to lack of availability of molecular and serologic tests that have been clinically validated or authorized by national or international regulatory bodies, Clinical laboratory experts are tackling threats to our global defense and wellness, including infectious diseases. The opportunity to express gratitude to the unsung medical laboratory heroes and COVID0-19 pandemic allies is now greater than ever. Each year, Medical Laboratory Professionals Week should honors those who contribute key diagnostic data that help save lives. This review article explore overall summary on testing methods including Important and Difficult Tasks for Medical Laboratories which will provide good message for better public health matter.
The Association of Alzheimer’s Disease-related Blood-based Biomarkers with Cognitive Screening Test Performance in the Congolese Population in Kinshasa
Authors: Schwinne Megan , Alonso Alvaro , Roberts Blaine R. , Hickle Sabrina , Verberk Inge MW , Epenge Emmanuel , Gikelekele Guy , Tsengele Nathan , Kavugho Immaculee , Mampunza Samuel , Yarasheski Kevin E. , Teunissen Charlotte E. , Stringer Anthony , Levey Allan , Ikanga Jean 
Published: September 2023

AbstractBackgroundAlzheimer’s Disease (AD), the most common cause of dementia, poses a significant global burden. Diagnosis typically involves invasive and costly methods like neuroimaging or cerebrospinal fluid (CSF) biomarker testing of phosphorylated tau (p-tau) and amyloid-β42/40(Aβ42/40). Such procedures are especially impractical in resource-constrained regions, such as the Democratic Republic of Congo (DRC). Blood-based biomarker testing may provide a more accessible screening opportunity.ObjectiveThis study aims to examine if AD-related blood-based biomarkers are associated with cognitive test performance in the Congolese population, where limited research has been conducted.MethodsIn this cross-sectional study of 81 Congolese individuals, cognitive assessments (Alzheimer’s Questionnaire (AQ) and Community Screening Interview for Dementia (CSID)) distinguished dementia cases from controls. Blood draws were taken to assess p-tau 181 and Aβ42/40biomarkers. Relationships between the biomarkers and cognitive performance were analyzed using multiple linear regression models.ResultsLower plasma Aβ42/40was significantly associated with lower CSID scores and higher AQ scores, indicative of AD (p<0.001). These relationships were observed in healthy controls (CSID p=0.01, AQ p=0.03), but not in dementia cases. However, p-tau 181 did not exhibit significant associations with either measure. Factors such as age, sex, education, presence of APOE e4 allele, did not alter these relationships.ConclusionUnderstanding relationships between AD-related screening tests and blood-biomarkers is a step towards utilization of blood-based biomarker tests as a screening tool for AD, especially in resource-limited regions. Further research should be conducted to evaluate blood biomarker test efficacy in larger samples and other populations.
Can long-term COVID-19 vaccination be improved by serological surveillance?: a modeling study for Mozambique
Authors: Liu Carol Y , Shioda Kayoko , Kraay Alicia NM , Massora Sergio , de Jesus Áuria , Massinga Arsénia , Monjane Celso , Omer Saad B , Jenness Samuel M , Nelson Kristin , Flasche Stefan , Mandomando Inacio , Lopman Benjamin A 
Published: September 2023

AbstractSeroprevalence provides an estimate of the population-level susceptibility to infection. In this study, we used a transmission model to examine the potential of using serological surveillance to inform the timing of COVID-19 boosters in Mozambique. We simulated using population-level seroprevalence thresholds as an estimate of the risk of outbreaks to trigger the timing of re-vaccination campaigns among older adults. We compare this approach to a strategy of re-vaccination at fixed time intervals. Vaccinating older adults each time the seroprevalence among older adults falls below 50% and 80% resulted in medians of 20% and 71% reduction in deaths, respectively, and number-needed-to-vaccinate to avert one death (NNT) of 1,499 (2.5th-97.5thcentile:1,252-1,905) and 3,151 (2,943-3,429), respectively. In comparison, biennial and annual re-vaccination of older adults resulted in medians of 35% and 52% deaths averted, respectively, and NNTs of 1,443 (1,223-1,733) and 1,941 (1,805-2,112), respectively. We conducted sensitivity analysis over a range of antibody waning rates and epidemic scenarios and found that re-vaccination trigger thresholds of 50-60% seroprevalence are most likely to be efficient compared to fixed-time strategies. However, given marginal gains in efficiency even in the best-case scenarios, our results favor the use of simpler fixed-time strategies for long-term control of SARS-CoV-2.
PVN microglia via P2Y12transmit hemodynamic signal to promote sympathetic excitation in hypertension
Authors: Wei Bo , Cheng Guo , Li Li , Sun Qihang , Bi Qianqian , Lu Cheng , Yin Chunyou , Chen Ningting , Hu Miner , Lu Haoran , Hu Zhechun , Mao Genxiang , Gu Yan , Wan Shu , Liu Xiaoli , Shen Xiao Z. , Shi Peng 
Published: September 2023

ABSTRACTHypertension is usually accompanied with an elevated sympathetic tonicity, but how sympathetic hyperactivity is triggered is not fully understood. Recent advances reveal that microglia-centered neuroinflammation contributes to sympathetic excitation in hypertension. In this study, we performed a temporospatial analysis of microglia at both morphological and transcriptomic levels, and found that microglia in the hypothalamic paraventricular nucleus (PVN) were early responders to hypertensive challenges. PVN is the central hub for maintaining cardiovascular function via regulation of fluid balance and sympathetic outflow. Comprehensive vasculature analyses unveiled that PVN was characterized by high capillary density, thin vessel diameter, and complex vascular topology among brain regions. As such, PVN is susceptible to the penetration of ATP released from the vasculature in response to hemodynamic disturbance after blood pressure increase. ATP ligation to microglial P2Y12receptor is responsible for the microglial accumulation and activation in the PVN. Furthermore, either pharmacological blockade or genetic ablation of microglial P2Y12could substantially restrain blood pressure increase under hypertensive challenge. Together, these findings disclose that a unique vasculature pattern results in the vulnerability of PVN pre-sympathetic neurons to hypertension-associated insults, which is mediated by microglia.
PRDM6 promotes medulloblastoma by repressing chromatin accessibility and altering gene expression
Authors: Schmidt Christin , Cohen Sarah , Gudenas Brian L. , Husain Sarah , Carlson Annika , Westelman Samantha , Wang Linyu , Phillips Joanna J. , Northcott Paul A. , Weiss William A. , Schwer Bjoern 
Published: September 2023

ABSTRACTSNCAIPduplication may promote Group 4 medulloblastomaviainduction of PRDM6, a poorly characterized member of thePRDF1 and RIZ1 homology domain-containing(PRDM) family of transcription factors. Here, we investigated the function of PRDM6 in human hindbrain neuroepithelial stem cells and tested PRDM6 as a driver of Group 4 medulloblastoma. We report that human PRDM6 localizes predominantly to the nucleus, where it causes widespread repression of chromatin accessibility and complex alterations of gene expression patterns. Genome-wide mapping of PRDM6 binding reveals that PRDM6 binds to chromatin regions marked by histone H3 lysine 27 trimethylation that are located within, or proximal to, genes. Moreover, we show that PRDM6 expression in neuroepithelial stem cells promotes medulloblastoma. Surprisingly, medulloblastomas derived from PRDM6-expressing neuroepithelial stem cells match human Group 3, but not Group 4, medulloblastoma. We conclude that PRDM6 expression has oncogenic potential but is insufficient to drive Group 4 medulloblastoma from neuroepithelial stem cells. We propose that both PRDM6 and additional factors, such as specific cell-of-origin features, are required for Group 4 medulloblastoma. Given the lack of PRDM6 expression in normal tissues and its oncogenic potential shown here, we suggest that PRDM6 inhibition may have therapeutic value in PRDM6-expressing medulloblastomas.
A microfluidic model of colonocyte-microbiota interaction mimicking the colorectal cancer microenvironment
Authors: Penarete-Acosta Daniel , Stading Rachel , Emerson Laura , Horn Mitchell , Chakraborty Sanjukta , Han Arum , Jayaraman Arul 
Published: September 2023

AbstractChanges in the abundance of certain bacterial species within the colorectal microbiota correlate with colorectal cancer development. While carcinogenic mechanisms of single pathogenic bacteria have been characterizedin vitro, limited tools are available to investigate interactions between pathogenic bacteria and both commensal microbiota and colonocytes in a physiologically relevant tumor microenvironment. To address this, we developed a microfluidic device that can be used to co-culture colonocytes and colorectal microbiota. The device was used to explore the effect ofFusobacterium nucleatum, an opportunistic pathogen associated with colorectal cancer development in humans, on colonocyte gene expression and microbiota composition.F. nucleatumaltered the transcription of genes involved in cytokine production, epithelial-to-mesenchymal transition, and proliferation in colonocytes in a contact-independent manner; however, most of these effects were diminished by the presence of fecal microbiota. Interestingly,F. nucleatumsignificantly altered the abundance of multiple bacterial clades associated with mucosal immune responses and cancer development in the colon. Our results highlight the importance of evaluating the potential carcinogenic activity of pathogens in the context of a commensal microbiota, and the potential to discover novel inter-species microbial interactions in the colorectal cancer microenvironment.
Effects of visual feedback on corticostriatal activity during continuousde novomotor skill learning
Authors: Park Sungbeen , Kim Junghyun , Kim Sungshin 
Published: September 2023

AbstractA corticostriatal network plays a pivotal role in visuomotor learning. However, it is unclear to what extent visual feedback for motor learning impacts corticostriatal activity. To address this, we conducted an fMRI experiment in which participants acquired a complex motor skill using either online or offline visual cursor feedback. We found a highly selective response in the entire striatum to visual performance feedback in both conditions and a relatively higher response in the caudate nucleus for the offline feedback. However, the ventromedial prefrontal cortex (vmPFC) response was significant only for online feedback. Furthermore, we also found functional distinctions of the striatal subregions in random versus goal-directed motor control. These findings collectively underscore the substantial impact of such simple visual feedback, as designed in our study, in eliciting corticostriatal responses, thereby elucidating its significance in reinforcement-based motor learning.