bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anorectal manometry for the diagnosis of pelvic floor disorders in patients with hypermobility spectrum disorders and hypermobile Ehlers-Danlos syndrome
Authors: Zhou Wendy , Zikos Thomas A. , Halawi Houssam , Sheth Vipul R. , Gurland Brooke , Nguyen Linda A. , Neshatian Leila 
Published: December 2022

Abstract
Introduction
Functional gastrointestinal disorders (FGID) including impaired rectal evacuation are common in patients with Hypermobility Spectrum Disorder (HSD) or Hypermobile Ehlers-Danlos Syndrome (hEDS). The effect of connective tissue pathologies on pelvic floor function in HSD/hEDS remains unclear. We aimed to compare clinical characteristics and anorectal pressure profile in patients with HSD/hEDS to those of age and sex matched controls.

Methods
We conducted a retrospective review of all FGID patients who underwent high resolution anorectal manometry (HR-ARM) and balloon expulsion test (BET) for evaluation of impaired rectal evacuation. Patients with HSD/hEDS were age and sex matched to a randomly selected cohort of control patients without HSD/hEDS. An abnormal BET was defined as the inability to expel a rectal balloon within 2 minutes. Wilcoxon rank sum test and Fisher’s exact test were used to make comparisons and logistic regression model for predictive factors for abnormal evacuation.

Results
A total of 144 patients (72 with HSD/hEDS and 72 controls) were analyzed. HSD/hEDS patients were more likely to be Caucasian (p < 0.001) and nulliparous. Concurrent psychiatric disorders; depression, and anxiety (p < 0.05), and somatic syndromes; fibromyalgia, migraine and sleep disorders (p < 0.001) were more common in these patients. Rate of abnormal BET were comparable among the groups. HDS/hEDS patients had significantly less anal relaxation and higher residual anal pressures during simulated defecation, resulting in significantly more negative rectoanal pressure gradient. The remaining anorectal pressure profile and sensory levels were comparable between the groups. While diminished rectoanal pressure gradient was the determinant of abnormal balloon evacuation in non HSD/hEDS patients, increased anal resting tone and maximum volume tolerated were independent factors associated with an abnormal BET in HSD/hEDS patients. Review of defecography data from a subset of patients showed no significant differences in structural pathologies between HSD/hEDS and non HSD/hEDS patients.

Conclusions
These results suggest anorectal pressure profile is not compromised by connective tissue pathologies in HSD patients. Whether concurrent psychosomatic disorders or musculoskeletal involvement impact the pelvic floor function in these patients needs further investigation.
What matters and influence resuscitation preference? Development, field testing, and structural validation of items among older patients in the emergency department
Authors: Hanson Stine , Nissen Søren Kabell , Nielsen Dorthe , Lassen Annmarie , Brabrand Mikkel , Forero Roberto , Jensen Jens Søndergaard , Ryg Jesper 
Published: December 2022

AbstractBackgroundDecisions about resuscitation preference is an essential part of patient-centered care but a prerequisite is having an idea about which questions to ask and understand how such questions may be clustered in dimensions. The European Resuscitation Council Guidelines 2021 encourages resuscitation shared decision making in emergency care treatment plans and needs and experiences of people approaching end-of-life have been characterized within the physical, psychological, social, and spiritual dimensions. We aimed to develop, test, and validate the dimensionality of items that may influence resuscitation preference in older Emergency Department (ED) patients.MethodsA 36-item questionnaire was designed based on qualitative interviews exploring what matters and what may influence resuscitation preference and existing literature. Items were organized in physical, psychological, social, and spiritual dimensions. Initial pilot-testing to assess content validity included ten older community-dwelling persons. Field-testing, confirmatory factor analysis and post-hoc bifactor analysis was performed on 269 older ED patients. Several model fit indexes and reliability coefficients (explained common variance (ECV) and omega values) were computed to evaluate structural validity, dimensionality, and model-based reliability.ResultsItems were reduced from 36 to 26 in field testing. Items concerning religious beliefs from the spiritual dimension were misunderstood and deemed unimportant by older ED patients. Remaining items concerned physical functioning in daily living, coping, self-control in life, optimism, overall mood, quality of life and social participation in life. Confirmatory factor analysis displayed poor fit, whereas post-hoc bifactor analysis displayed satisfactory goodness of fit (χ2=562.335 (p<0.001); root mean square error of approximation=0.063 (90% CI [0.055;0.070])). The self-assessed independence may be the bifactor explainingwhat mattersto older ED patients’ resuscitation preference.ConclusionsWe developed a questionnaire and investigated the dimensionality of what matters and may influence resuscitation preference among older ED patients. We could not confirm a spiritual dimension. Also, in bifactor analysis the expected dimensions were overruled by an overall explanatory general factor suggesting independence to be of particular importance for clinicians practicing resuscitation discussions in EDs. Studies to investigate how independence may relate to patients’ choice of resuscitation preference are needed.
Family support in the management of diabetes patients’ perspectives from Limpopo province in South Africa
Authors: Mphasha M. H. , Mothiba T. M. , Skaal L. 
Published: December 2022

AbstractBackgroundFamily support is linked with improved diabetes outcomes, whereas lack thereof is associated with complications. Living together with people in the same household doesn’t guarantee support in diabetes management. Hence it is critical to comprehend patient’s lived experiences regarding family support.ObjectivesTo explore family support in diabetes management.MethodologyQualitative method and phenomenological exploratory descriptive design were used to collect data from 17 patients with 6 months or more living with diabetes and getting treatment in clinics of Senwabarwana, Limpopo province. Purposive sampling was used to select participants. One-on-one interviews were conducted using voice recorders and field notes for non-verbal cues were observed. Unstructured interview guide with principal question which enabled probing was used. Data were analysed using 8 Steps of Tesch’s inductive, descriptive, and open coding technique. Trustworthiness was ensured.ResultsParticipants get support from family members with regards to food, exercise, and collection of medication. Diabetic men with sexual dysfunction also reported getting similar support from their wives whereas, in contrary diabetic women do not get sufficient supports from their husbands. Loss of income among diabetic men has been reported as a source of martial conflicts and unsatisfactory support from wives.ConclusionFamily members of diabetic patients collect medication for patients, including cooking and serving meals to them. Wives of diabetic men outpace husbands of diabetic women in responsiveness to the health needs of their partners, respectively. Diabetic men with impaired sexual function get support from their wives, whilst female patients do not get similar support from their husbands. On the other hand, patients who lost income get inadequate spousal support, which compromises diabetes management and adherence to treatment. This study identifies gender disparities in spousal support as crucial issue requiring an urgent attention, hence the need for gender-biased family-centred diabetes care.
Insulin resistance mediates obesity-related risk of cardiovascular disease: a prospective cohort study
Authors: Tian Xue , Chen Shuohua , Wang Penglian , Xu Qin , Zhang Yijun , Luo Yanxia , Wu Shouling , Wang Anxin 
Published: December 2022

Abstract
Background
The mechanisms linking obesity to cardiovascular disease (CVD) are still not clearly defined. Individuals who are overweight or obese often develop insulin resistance, mediation of the association between obesity and CVD through the insulin resistance seems plausible and has not been investigated. This study aimed to evaluate whether and to what extend the effect of general and central obesity on cardiovascular disease (CVD) is mediated by insulin resistance.

Methods
A total of 94,136 participants without CVD at baseline were recruited from the Kailuan study. Insulin resistance was evaluated by the triglyceride-glucose (TyG) index, calculating as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. Mediation analysis using a new 2-stage regression method for survival data proposed by Valeri and VanderWeele was to explore the mediating effects of the TyG index on the association between obesity and CVD.

Results
During a median follow-up of 13.01 years, we identified 7327 cases of CVD. Mediation analyses showed that 47.81% of the total association (hazard ratio [HR], 1.18; 95% confidence interval [CI], 1.12–1.24) between overweight and CVD was mediated through the TyG index (HR [indirect association], 1.07; 95% CI, 1.07–1.09), and the proportion mediated was 37.94% for general obesity. For central obesity, analysis by waist circumference, waist/hip, and waist/height categories yielded an attenuated proportion mediated of 32.01, 35.02, and 31.06% for obesity, taken normal weight as reference.

Conclusions
The association between obesity and CVD was mediated by TyG index, suggesting proper control of insulin resistance can be effective to reduce the effects of obesity on CVD.
Mathematical calculation of the difference in shortening length after two types of proximal femoral varus and an investigation of their applicable conditions: an own-pair design
Authors: Sun Jian , Cui Yong , Qu Jing , Lian Feng 
Published: December 2022

Abstract
Background
The shortening length of the lower extremity after the proximal femoral osteotomy is an important issue to be considered in preoperative planning of developmental dysplasia of the hip (DDH) in children. There is still a lack of research on shortening the length of the lower extremities in different proximal femoral osteotomy varus styles. We aimed to verify the relationship between the shortening length after “point-to-face” and “face-to-face” varus osteotomy and proposed a formula for calculating the difference in shortening length and verified its feasibility.

Methods
Fifty-five children with unilateral DDH were enrolled. The preoperative hip CT data were imported into mimics 21, 3-Matic 10 (Materialise, Leuven, Belgium) for femoral reconstruction and simulated osteotomy, and the difference (t) was calculated by directly measuring the length of the proximal femur after osteotomy. d* sinθ was measured in a three-dimensional environment to calculate the difference in femoral shortening length between the two osteotomy methods (t').

Results
The results of the direct measurement method and the formula measurement method are shown in the table; the differences in the results of the femoral shortening length difference were not statistically significant (P > 0.05). The limits of agreement (95%) of the difference values using Bland–Altman analysis were between − 0.50 and 0.46 mm, with a mean of − 0.02 mm, indicating a high agreement between the two methods. r = 0.99 (P < 0.05) for the Pearson correlation analysis between the direct measurement method and the calculated method showed that the two methods were significantly correlated.

Conclusions
The derived formula can accurately calculate the difference in the shortening length of the proximal femur after “point-to-face” and “face-to-face” varus osteotomy in children with DDH, which is suitable for clinical application.
Delayed aortic regurgitation after TEVAR procedure: a case report
Authors: Park Soo Jin , Lee Seungwook , Son Jeong A , Hyun Seungji , Kim Do Jung , Lim Sang Hyun , Hong You Sun 
Published: December 2022

Abstract
Background
Acute aortic regurgitation (AR) is uncommon condition and usually results in an emergent situation because the left ventricle does not adapt quickly due to a sudden increase in end-diastolic volume caused by the regurgitant flow. Thoracic endovascular aortic repair (TEVAR) is a procedure that places a stent-graft on the lesion of thoracic aorta through a minimally invasive approach.

Case presentation
Here we report that a catheter-induced aortic valve injury associated with TEVAR can cause delayed AR, exemplified by the case of a patient who developed acute AR 42 months after TEVAR. For this, aortic valve replacement was performed and the patient was discharged without complications.

Conclusion
Our results demonstrate that when a catheter-related procedure is performed around the aortic valve, slight injury of the valve can cause aortic insufficiency even 3 years after surgery. Consequently, when performing a catheter-related procedure around the aortic valve, special attention is always required.
Evaluation of serum CA125-Tn glycoform in peritoneal dissemination and surgical completeness of high-grade serous ovarian cancer
Authors: Jin Xiayu , Du Ming , Wang Yisheng , Wang Yuefei , Lu Yingying , Xu Congjian , Zhang Xiaoyan 
Published: December 2022

Abstract
Background
Peritoneal dissemination is the predominant feature of malignant progression in ovarian cancer and is a major cause of poor surgical outcomes and clinical prognoses. Abnormal glycosylation of carbohydrate antigen 125 (CA125) may be involved in peritoneal implantation and metastasis. Here, we evaluated the clinical relevance of CA125-Tn glycoform in the assessment of high-grade serous ovarian cancer (HGSOC).

Methods
A total of 72 patients diagnosed with HGSOC were included. Pre-treatment serum CA125-Tn levels were measured using an antibody-lectin enzyme-linked immunosorbent assay. The association of CA125-Tn with clinical factors was analyzed in all cases, whereas its association with peritoneal dissemination, residual disease, and progression-free survival was analyzed in stage III–IV cases.

Results
Pre-treatment serum CA125-Tn levels were significantly higher in advanced-stage HGSOC patients than in early-stage patients (P = 0.029). In advanced-stage patients, the pre-treatment CA125-Tn level increased with an increase in Fagotti’s score (P = 0.004) and with the extension of peritoneal dissemination (P = 0.011). The pre-treatment CA125-Tn level increased with the volume of residual disease (P = 0.005). The association between CA125-Tn level and suboptimal surgery remained significant even after adjustment for treatment type and stage. Pre-treatment CA125-Tn levels were also related to disease recurrence.

Conclusion
Serum CA125-Tn level could be a novel biomarker for peritoneal dissemination and a promising predictor of surgical completeness in ovarian cancer. Patients with lower CA125-Tn levels were more likely to have no residual disease. CA125-Tn could help surgeons to adopt optimized treatment strategies for patients with advanced ovarian cancer as a pre-treatment evaluator.
Surgical resection of a massive residual retroperitoneal mass after chemotherapy for a paratesticular rhabdomyosarcoma: a case report
Authors: Chalouati Takoua , Ghalleb Montassar , Jallali Amani , Slimane Maher , Sahraoui Ghada , Ben hassouna Jamal , Chargui Riadh , Rahal Khaled 
Published: December 2022

Abstract
Introduction
Paratesticular rhabdomyosarcoma is a rare and aggressive mesenchymal tumor, accounting for only 7% of all rhabdomyosarcomas. It is mainly encountered in children and adolescents. The standard treatment consists of radical orchidectomy with negative surgical margins. However, chemotherapy is recommended to control retroperitoneal micrometastasis. The place of surgery for progressive retroperitoneal lymph node metastases remains controversial. We present a case of paratesticular rhabdomyosarcoma with progressive retroperitoneal lymph node metastases treated with surgery.

Case report
We report a case of a 17-year-old North African male with no particular medical history who presented with a left scrotal mass that had been evolving for several months. Beta-human chorionic gonadotropin, alpha-fetoprotein, and lactate dehydrogenase were normal. Scrotal ultrasonography revealed the presence of a 6 cm heterogeneous hypoechogenic tissular mass with cystic areas adherent to the left scrotal wall, which was thickened in some places and vascularized by color Doppler. It exerted a mass effect on the homolateral testicle, which was of average volume. The thoracic–abdominal–pelvic computed tomography scan showed the presence of suspicious paraaortic lymph nodes. The most voluminous one measured 16 × 23 mm2. A left orchidectomy was performed. The final pathology report revealed an 8 cm paratesticular rhabdomyosarcoma of the embryonic type that displaced the testicle without invading it. Without going beyond it, it infiltrated the epididymis, the rete testis, and the albuginea. The surgical margin at the level of the spermatic cord was free. The patient had adjuvant chemotherapy (ifosfamide, vincristine, and dactinomycin). The patient had a challenging paraaortic lymph node dissection since the mass enlaced the left ureter and renal vessels. On histological examination, the paraaortic lymph nodes were metastatic.

Conclusion
Rhabdomyosarcoma is an aggressive malignancy with high metastatic potential. Therefore, only an accurate diagnosis and early treatment can ensure better survival. Surgery in expert hands seems to be a good option for progressive retroperitoneal nodes. However, further studies are needed to determine the place of surgery in this setting.
Gut microbial diversity among Yorkshire, Landrace and Duroc boars and its impact on semen quality
Authors: Li Jiawei , Li Yuhang , Cheng Meixia , Ye Fengchun , Li Wen , Wang Cong , Huang Yuxuan , Wu Yan , Xuan Rui , Liu Guanyuan , Huang Jianhua 
Published: December 2022

AbstractThe gut microbiota plays an important role in pig health and performance, particularly in host growth and fecundity. In present study, the characteristics and diversity of gut microbiota in fine purebred boars from three-way crossbred “Duroc×Landrace×Yorkshire” pigs were investigated using 16 S rRNA gene sequencing. The results showed that the three breeds of boars shared similar gut microbiota, yet there remain slight differences at the family/genus level. At the family level, Ruminococcaceae, Streptococcaceae and Lactobacillaceae have the highest abundance in Landrace, while Rikenellaceae and f_p_251_o5 have the highest abundance in Duroc. The abundance of Prevotellaceae, Lachnospiraceae and Spirochaetaceae in intestinal of Yorkshire were higher than that of Landrace and Duroc. In addition, ten and six biomarkers were identified in the microbiota across breeds and months of age, respectively. Moreover, we evaluated the effect of gut microbiota on boar semen quality, revealing that Duroc had the strongest sperm vitality, significantly associated with the genus Rikenellaceae_PC9_gut_group. In addition, the spermatogenesis ability and sperm production improved gradually along with increase of age. In conclusion, this study provides a reference for understanding the gut microbiota composition of purebred boars used for three-way crosses and their impact on semen performance.
Hyperaccumulation of lead using Agrostis tenuis
Authors: Anguilano Lorna , Onwukwe Uchechukwu , Dekhli Aghis , Venditti Susanna , Aryani Danny , Reynolds Alan 
Published: December 2022

AbstractIn recent years the quest for a circular economy approach and the upcycling of secondary raw materials have been pushed in the global political agenda. Increased interest has been taken by the recovery of materials from sludges, brines, contaminated waters and other media, all included in the larger umbrella identified as “low-grade” mineralisation. Contaminated soils have an interesting role in this process, and various methodologies have been developed using chemical, bacteriological and pyrometallurgical cleaning procedures. However, these procedures all involve the movement of high volume of materials and the disruption of the industrial landscape; furthermore, they often require the use of hazardous solvents and high energy processes. This work proposes to identify less impactful methods aimed at the recovery of metals from mining areas while preserving the landscape and avoiding environmental impacts such as the increase of CO2 for transport and increase hazard through use of solvents, this takes particular importance in areas of industrial heritage status. In particular, this work focuses on the use of Agrostis tenuis, an autochthonous species in mining areas of the UK, as a “mining tool” for the removal of lead. The selection of this plant is due to its visually non-invasive nature, as the plant is already present in these areas, it doesn’t grow above 10/15 cm and it also grows very fast and can be easily harvested with existing agricultural equipment. The experiments and results presented in this paper indicate: (1) Agrostis Tenuis shows the ability to adjust to contamination and increase its accumulation capacity; (2) the metal collected by the plant is fully transposed in the aerial part of the plant in a stable compound form and can consequently be harvested and further processed.
Peer assessment in group-oriented classroom contexts: on the effectiveness of peer assessment coupled with scaffolding and group work on speaking skills and vocabulary learning
Authors: Homayouni Mina 
Published: December 2022

AbstractPeer learning, also known as collaborative learning, is based on social constructivism and contends that learning takes place more actively when students interact socially with their peers. This study sought to examine the effects of scaffolded peer assessment in group-oriented classrooms on developing speaking skills and enlarging the vocabulary size of language learners. To accomplish this objective, through cluster sampling, the researchers selected 37 lower-intermediate and 5 intermediate learners of English. Then, 20 lower-intermediate subjects were randomly assigned as the experimental group along with the 5 more proficient learners. In groups of 5, the intermediate learner was assigned the role of the mediator and was responsible for giving feedback to their peers. The rest of the subjects were assigned as the control group and there was no mediator in their group. Four instructional sessions were allocated to scaffolded peer assessment of speaking and four sessions were devoted to scaffolded peer assessment of vocabulary learning. In this randomized pre-test–post-test-delayed post-test trial, an independent sample t test, and a one-way repeated measures ANOVA were carried out. The results of the statistical analyses demonstrated the impact of scaffolded peer assessment on developing both speaking skills and enlarging learners’ vocabulary size with a large effect size. That is, by implementing scaffolded peer assessment in a group-oriented context both speaking skills and vocabulary knowledge can be developed. The pedagogical implication of this study is that language teacher can implement the notions of social constructivism and socio-cultural theory proposed by Vygotsky (Readings on the Development of Children 23:34-41, 1978) to expand and develop learners’ zone of proximal development.