bluuebunny/crossref_metadata_2025_split huggingface dataset:
Central sensitization and adult attention deficit hyperactivity disorder in medical students with chronic back pain: a cross-sectional study
Authors: Ibrahim Maha E. , Hefny Mohamed A. 
Published: April 2022

Abstract
Background
Chronic back pain is a common health complaint among university students. A subset of chronic back pain patients suffer from increased pain sensitivity, a process termed central sensitization. Chronic pain is also associated with cognitive dysfunction, involving attention, memory, and learning. Those are key features of adult attention deficit hyperactivity disorder. This study aimed to assess the associations between adult attention deficit hyperactivity disorder and central sensitization in students with chronic back pain.

Results
Two hundred twenty-seven students completed the survey, and 90 (39.6%) had back pain for more than 3 months. Students with back pain had significantly higher central sensitization (P<0.01) and higher attention deficit scores (P=0.05). Significant positive correlations were found between scores of the two questionnaires (r= 0.55, P<0.01). Regression analysis adjusted for age and gender showed that higher attention deficit scores were associated with back pain (odd’s ratio:1.025, P=0.05). The odd’s ratio was attenuated after adding central sensitization to the model (odd’s ratio: 0.99, P=0.70).

Conclusions
The findings of this study suggest that attention deficit hyperactivity disorder is associated with elevated central sensitization in patients with chronic back pain. Our results support the hypothesis that central sensitization mediates the effect of attention deficit on back pain.
CYP21A2 Gene Expression in a Humanized 21-Hydroxylase Mouse Model Does Not Affect Adrenocortical Morphology and Function
Authors: Schubert Tina , Reisch Nicole , Naumann Ronald , Reichardt Ilka , Landgraf Dana , Quitter Friederike , Thirumalasetty Shamini Ramkumar , Heninger Anne-Kristin , Sarov Mihail , Peitzsch Mirko , Huebner Angela , Koehler Katrin 
Published: April 2022

Abstract
Steroid 21-hydroxylase is an enzyme of the steroid pathway that is involved in the biosynthesis of cortisol and aldosterone by hydroxylation of 17α-hydroxyprogesterone and progesterone at the C21 position. Mutations in CYP21A2, the gene encoding 21-hydroxylase, cause the most frequent form of the autosomal recessive disorder congenital adrenal hyperplasia (CAH). In this study, we generated a humanized 21-hydroxylase mouse model as the first step to the generation of mutant mice with different CAH-causing mutations. We replaced the mouse Cyp21a1 gene with the human CYP21A2 gene using homologous recombination in combination with CRISPR/Cas9 technique. The aim of this study was to characterize the new humanized mouse model. All results described are related to the homozygous animals in comparison with wild-type mice. We show analogous expression patterns of human 21-hydroxylase by the murine promoter and regulatory elements in comparison to murine 21-hydroxylase in wild-type animals. As expected, no Cyp21a1 transcript was detected in homozygous CYP21A2 adrenal glands. Alterations in adrenal gene expression were observed for Cyp11a1, Star, and Cyb11b1. These differences, however, were not pathological. Outward appearance, viability, growth, and fertility were not affected in the humanized CYP21A2 mice. Plasma steroid levels of corticosterone and aldosterone showed no pathological reduction. In addition, adrenal gland morphology and zonation were similar in both the humanized and the wild-type mice. In conclusion, humanized homozygous CYP21A2 mice developed normally and showed no differences in histological analyses, no reduction in adrenal and gonadal gene expression, or in plasma steroids in comparison with wild-type littermates.
A política e a economia do governo Bolsonaro: uma análise sobre a captura do orçamento
Authors: Silva Marcos Fernandes Gonçalves da , Teixeira Marco Antonio Carvalho 
Published: April 2022

O objetivo deste artigo é analisar o final do governo Bolsonaro do ponto de vista da capacidade de arbitrar o conflito distributivo e de governar. Para tanto, analisa-se o processo orçamentário 2021/2022. A análise é de economia política e de política. Parte-se do suposto de que o orçamento é a expressão dos conflitos distributivos inerentes à sociedade e de que tais conflitos devem ser arbitrados. Do contrário, haverá perda de agenda e descontrole da política fiscal. O artigo descreve como elementos institucionais e estruturais estão por detrás da construção de orçamentos críveis, sustentáveis e efetivos e de seus contrários. Em primeiro lugar, faz-se uma análise de economia política e, por fim, de ciência política. A conclusão é que o processo orçamentário de 2021/2022 é um sintoma da crise de governabilidade, pois há evidências de que não houve arbitragem do conflito distributivo.
Effects of bariatric surgery on renal function and associated factors with bivariate analysis: a cohort study
Authors: Amaro Borborema Bezerra Juliana , Pachu Raia dos Santos Eduardo , Teixeira Brandt Carlos 
Published: April 2022

Background: Obesity is a global pandemic, caused by genetic, biological and social factors, increasing the risk of many chronic diseases, including kidney disease. Bariatric surgery can control associated comorbidities and also improve renal function. Thus, the aim of this study was to evaluate the effect of bariatric surgery on renal function and associated factors, through bivariate analysis. Methods: A cohort, prospective, analytical study was carried out in the Department of surgery and obesity, in Campina Grande - Paraíba, Brazil. Thirty-five obese patients were evaluated in the preoperative period of bariatric surgery and after one year of bariatric surgery. Sociodemographic and anthropometric data were collected, body mass index was calculated, and renal function was estimated through the glomerular filtration rate. Results: Predominantly female (71.4%) and white (77.1%) patients were observed. Regarding the type of bariatric surgery, most patients (65.7%) underwent the sleeve technique. There was no significant difference between the mean levels of cystatin C pre and post bariatric surgery. There was a significant improvement in the mean glomerular filtration rates in the postoperative period (p=0.09). In further analysis of the association between the variables: type of bariatric surgery, diabetes or hypertension outcomes, no association was observed with the outcome improvement in glomerular filtration rate, without statistical significance, respectively (p = 0.312; p =0.217; p = 0.476). Similarly, there was no statistically significant difference between the variable loss of body mass index, under the effect of bariatric surgery, in relation to the outcome of the glomerular filtration rate (p = 0.904). Conclusion: After analyzing the association between outcome of glomerular filtration rate and the studied variables, no association was observed between these variables, under the effect of bariatric surgery, with improvement in glomerular filtration rate. Thus, bariatric surgery is associated with improvement of renal function independently.
The efficacy of adjunctive alpha-blockers on ureteroscopy procedure for ureteral stones: a systematic review and meta-analysis
Authors: Serani Sesari Saras , Atmoko Widi , Birowo Ponco , Rasyid Nur 
Published: April 2022

Background: Urolithiasis cases are a common condition, and the number is still growing today. The prevalence of urinary tract stones globally currently ranges from 2-20% with a recurrence rate of around 50%. The present study aims to investigate the efficacy of adjunctive alpha-blockers in improving the success rate of ureteroscopy (URS) procedure for urolithiasis. Methods: We reviewed articles obtained from MEDLINE, CENTRAL, CINAHL, and Elsevier from 14 August to 9 September 2020, comparing alpha-blockers as adjunctive therapy, versus either a placebo or no drug at all, in post-URS urolithiasis patients. There were no restrictions on the type of URS and alpha-blockers given to patients. The quality of studies included was assessed using Cochrane’s Risk of Bias Assessment for Randomized-Controlled Trials. Results: Forest plot analysis emphasizes the statistically significant difference among the group, where the adjunctive alpha-blocker group had pooled relative risk (RR) of being stone-free, readmitted due to initial URS failure, having an overall complication, having haematuria, getting their ureteral mucous injured, and suffering a colic episode was 1.71 (95% CI, 1.11–1.24), 0.50 (95% CI, 0.25–1.01), 0.41 (95% CI, 0.27–0.61), 0.42 (95% CI, 0.22–0.79), 0.31 (95% CI, 0.13–0.73), and 0.21 (95% CI, 0.06–0.69), respectively. Conclusions: Alpha blockers minimize the frequency and duration of ureteral contractions, allowing smooth stone expulsion. With this knowledge, it is expected to help clinicians decide the importance of adjunctive alpha-blocker administration.
Efficacy and safety of CT-guided percutaneous fine needle aspiration and biopsy for malignant pulmonary lesions
Authors: Rai Santosh , BS Vinay , Acharya Vishak , Kini Jyoti R , Kamath M Madhav , Achappa Basavaprabhu , Mendonca Jane 
Published: April 2022

Background: CT-guided percutaneous transthoracic fine needle aspiration (FNA) and core biopsy (CB) are commonly used to characterise lung lesions. There is conflicting information on which method is superior and wide variation in reported complication rates. Our objectives were to establish the efficacy and safety of percutaneous CT-guided FNA and CB in the diagnosis of malignant lung lesions. Methods: This retrospective study included patients who underwent CT-guided percutaneous FNA and/or CB for lung parenchymal lesions at Kasturba Medical College Mangalore, from January 2013 to December 2020. Ethical clearance was obtained from the Institutional Ethics Committee. Efficacy was determined by the adequacy of samples, sensitivity, specificity and diagnostic accuracy. Safety was assessed using the incidence of complications. Results: A total of 326 patients underwent both FNA and CB, and 49 underwent FNA alone. Adequate samples were obtained in 82.9% of FNA cases and 95.7% of CB cases. Considering biopsy as the gold standard, the sensitivity, specificity and diagnostic accuracy of FNA for malignancy were 95.19%, 80% and 91.27%, respectively. Kappa agreement between the two methods was substantial (0.767). Pneumothorax was the only complication observed, and was seen in 31 patients (8.2%), of which only one required chest tube drainage. The incidence of pneumothorax was significantly higher in patients with pre-existing lung disease such as COPD/emphysema (p value 0.000), patients with smaller lesions (p = 0.009), and deeper lesions from the pleura (p <0.0001). Conclusions: FNA and CB are both safe and effective procedures. In the absence of an onsite cytopathologist, we recommend a combination of both techniques.
The effect of exercise interventions on inflammatory markers in major depressive disorder: protocol for a systematic review and meta-analysis
Authors: Grunberg Diana , Martin Jason A. , Cryan John F. , O’Halloran Ken D. , Kelleher Eric , Dinan Timothy G. , Clarke Gerard 
Published: April 2022

Background: Depression currently affects 4.4% of the global population, and 93.7% of this population suffer from major depressive disorder (MDD) according to 2017 statistics. MDD patients are more likely to suffer from co-morbidities such as cardiovascular disease and high body mass index (BMI), thus contributing to its large cost to society. Throughout the literature, there are known links between inflammation and MDD. Interestingly, while exercise is considered a promising intervention for MDD, the mechanism(s) of action remain unclear, thereby preventing the creation of optimal, cost-saving, exercise “prescriptions” for those with MDD. Thus, the aim of this review and meta-analysis is to summarize and analyse the current literature exploring how quantified exercise interventions modulate inflammatory molecules in MDD patients. Methods: Electronic databases (APA PsycINFO, and PubMed/MEDLINE (EBSCO interface), EMBASE) will be searched using a detailed search strategy comprised of three search term themes: exercise, depression/MDD, and inflammation/inflammatory molecules. Only quantified exercise interventions performed in adult humans with MDD validated via a recognized diagnostic criterion will be included. Studies should also include a MDD control group and explore changes in inflammatory molecules. Examples of these molecules include:include C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1b), tumour necrosis factor-alpha (TNF-a), homocysteine, d-dimer and myeloperoxidase (MPO). After eligible studies are identified, standardized data extraction will be employed and the risk of bias in each study will be appraised using the Cochrane handbook checklists. In the event of two or more homogenous studies exploring exercise effects over a similar period of time, raw mean differences or standardized mean differences will be pooled using random effects analysis. This systematic review and meta-analysis will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Dissemination: This systematic review and meta-analysis will be disseminated in peer-reviewed journals. PROSPERO registration: CRD42020186006 (31/08/2020)
Supporting sustainable long-term residential care in Ireland: a study protocol for the Sustainable Residential Care (SRC) project
Authors: Walsh Brendan , Connolly Sheelah , Wren Maev-Ann , Hill Leonie 
Published: April 2022

The coronavirus disease 2019 (COVID-19) pandemic brought to the fore deficiencies in the long-term residential care (LTRC) sector, including issues of governance, funding and staffing. Many of these issues pre-dated the pandemic and have contributed to concerns around the sustainability of the current model of LTRC in Ireland. The aim of the project detailed in this protocol is to provide an evidence base to help ensure the sustainability of the LTRC sector in Ireland within a new wider model of care for older people. The project includes three key objectives: (i) to describe and analyse the characteristics of LTRC homes across Ireland; (ii) to examine the association between LTRC home characteristics and COVID-19 outbreaks and deaths and (iii) to identify challenges to the sustainability of the LTRC sector within a COVID-19 environment and beyond. Bringing together the findings from these three objectives, the project will identify approaches and strategies which will help ensure the sustainability of LTRC that meets the needs of residents. The proposed research incorporates quantitative analyses and a review. Combining data from a variety of administration sources and using a variety of statistical techniques, the project will include a retrospective observational analysis of COVID-19 in LTRC homes in Ireland. Subsequently, a review will examine the current funding model of LTRC in Ireland, as well as the regulations and governance structure that underlie the system. The review will also examine international practices in these areas. Bringing together the findings from the quantitative analysis and the review and working with the knowledge users on the project, the project will build upon recent work in the area to identify the current challenges to the system of LTRC and possible solutions.
Fitting parametric sets to probability distributions
Authors: Käärik Meelis , Pärna Kalev 
Published: April 2022

We consider the problem of approximation of distributions by sets. Given a probability P on a metric space (S,d) and a class A of subsets of S, find an approximative set A∈ A that minimizes the mean discrepancy of a random point X ∼ P from the set A:
W(A,P) = ∫Sφ(d(x,A))P(dx) → min A∈ A.
We are especially interested in the case of parametric approximative sets, A = {A(Θ) : Θ∈ T }, where the aim is to find a value of the parameter Θ∈ T which minimizes
W(Θ,P) = W(A(Θ,P))→ min Θ∈ T .
Current article is an extension of Käärik and Pärna (2003) to the case where approximating sets A(Θ) are unions of k parametric sets of the same type. We will prove the convergence of optimal values of loss functions and the existence of optimal sets in some functional spaces.
MANOVA with singular variance matrix
Authors: Srivastava Muni S. , Von Rosen Dietrich 
Published: April 2022

Classical multivariate analysis of variance for p response variables is extended to cover high-dimensional data. For example, data often comprise many response variables that may be related. Therefore, inference based on all the response variables may be inefficient. However, the relationship between the response variables is usually not known. This leads to the assumption that the p response variables span a linear space of some fixed dimension, say r<p; equivalently the p×p variance matrix is singular of rank r. We will assume that the rank is given. Following the classical approach of doing inference in linear models, parameters are first estimated and thereafter tests are constructed. Estimators and tests are based on the likelihood method. The present model differs from the classical multivariate analysis of variance model and consists of a deterministic and a random part. It is noticed that the classical approach is a special case of the one which will be considered in this article.
Weak metric approximation properties and nice projections
Authors: Abrahamsen Trond A. 
Published: April 2022

We prove that a Banach space X has the weak MAP (the weak MCAP) [the very weak MCAP] if and only if there exists a norm one projection P on X∗∗ with X⊂P(X∗∗) such that P is in the weak∗-closure of F(X,X) (K(X,X)) [K(X,X∗∗)] in L(X∗∗,X∗∗).
The experience of using ACE inhibitors and Ca channel blockers in the treatment of hypertension in patients with renal cell carcinoma
Authors: Pasichnyk Serhii , Gozhenko Anatolii 
Published: April 2022

Renal cell carcinoma (RCC) is one of widely spread urological cancers. It is known that approximately 26% of patients with a history of kidney cancer (KC) may have concomitant coronary artery disease, hypertension, diabetes mellitus and some other systemic diseases, which may lead to nephrosclerotic changes and the development or progression of the existing CRF.
The aim of the study. To study the renal function effects of ACE inhibitors (perindopril arginine) in patients with RCC, both as monotherapy and in combination with Ca channel blockers when conducting treatment of concomitant hypertension (HT).
Materials and methods. The study enrolled 38 patients with RCC. All patients were diagnosed with RCC for the first time, with their cancer staged according to the TNM International Classification (Т1 N0 M0).
Within a month, the use of combination therapy for kidney cancer complicated by Stage І, Degree ІІ hypertension was leading to increases in serum creatinine by 3 µmol/l and by 7 µmol/l in those patients where combination therapy was not used. In the meantime, during the same period, glomerular filtration rate reduced by 5 ml/min/1.73 m2 in patients of the first group and by 15 ml/min/1.73 m2 in patients of the second group.
Complications after SARS-CoV2 virus infection in the respiratory, cardiovascular, nervous systems and in the kidneys.
Authors: Brzyska Anna , Bogucka Julia , Bojarska Małgorzata , Domańska Natalia , Piecewicz-Szczęsna Halina 
Published: April 2022

Wprowadzenie i cel pracy: Mechanizm w jaki wirus sars-cov-2 atakuje narządy i powoduje ich długotrwałe powikłania nie jest do końca poznany. Wielu pacjentów, którzy przebyli COVID-19 coraz częściej skarży się na różne dolegliwości, a część z nich przyjmowana jest do szpitali trybie pilnym. Celem pracy jest przybliżenie najczęściej występujących komplikacji po infekcji sars-cov-2 w wybranych układach i narządach, a także ich następstw.
Materiał i metoda: W lutym 2022 roku przeszukano bazy danych Medline (PubMed) oraz Google Scholar przy użyciu słów kluczowych: after COVID-19 complications, long-term sequelae of covid-19, mortality after covid-19, post-covid, long covid . Zostały wybrane prace w językach angielskim, francuskim i niemieckim opublikowane w latach 2020-2022.
Opis stanu wiedzy: Zgromadzone statystyki pokazują, że COVID-19 bardzo często pozostawia zmiany zwłóknieniowe w płucach oraz niespecyficzne objawy takie jak duszność, utrzymujący się ból głowy czy utrata smaku i węchu. Często obserwuje się symptomy niewydolności prawej komory serca i zawały serca różnej etiologii, a aktywowany zakażeniem śródbłonek naczyń może prowadzić do zaburzeń zakrzepowych w płucach, mózgu i w obwodowym układzie naczyniowym. Podczas pandemii zanotowano także wzrost ilości przypadków ostrego uszkodzenia nerek.
Podsumowanie: Dotychczasowe doniesienia pozwalają stwierdzić, że proces chorobowy związany z covid-19 nie kończy się w momencie ustąpienia głównych objawów. W organizmie zmiany zapalne mogą toczyć się jeszcze długi czas i prowadzić do nieodwracalnych powikłań, niekiedy katastrofalnych w skutkach.
Słowa klucz: after covid complications; long-term sequelae of covid-19; mortality after covid-19; post-covid; long covid
Knowledge dialogues for better health: complementarities between health innovation studies and health disciplines
Authors: Natera José Miguel , Rojas Soledad , Dutrénit Gabriela , Vera-Cruz Alexandre O. 
Published: April 2022

Health innovation studies and the health disciplines highlight the importance of using knowledge to improve human welfare. However, these disciplines rarely yield discussion about this issue. The objective of this paper is to establish a dialogue between health innovation studies and the health disciplines, and to reveal the complementarities between these approaches. We present a revision of selected models of health knowledge use. From health innovation studies, we consider two models focused on the nature of health innovation, and two others that orient health innovation studies towards addressing inclusive development issues. From the health disciplines, we analyse translational research and knowledge translation models. Using a systemic perspective, we structure our analysis of complementarities on four analytical dimensions:
(i) The actors, proposing the recognition of the public sector, the productive sector, the scientific community, and health services providers. We also define two dynamic actors: knowledge users and knowledge beneficiaries.
(ii) The interactions, considering them as asymmetrical to facilitate knowledge flows.
(iii) The process, based on specific models of healthcare activities and a broad set of validation mechanisms (not only market-related).
(iv) The institutional framework, proposing consideration of formal institutions (e.g. regulations) and informal institutions (e.g. socio-cultural background).
Yb-fiber-pumped high-average-power picosecond optical parametric oscillator tunable across 1.3−1.5 μm
Authors: Nandy Biplob , Chaitanya Kumar S. , Ebrahim-Zadeh M. 
Published: April 2022

We report the generation of high-repetition-rate picosecond pulses in the 1.3-1.5 µm spectral range by internal second harmonic generation (SHG) of an idler-resonant optical parametric oscillator (OPO) based on MgO-doped periodically-poled LiNbO3 (MgO:PPLN), synchronously pumped by ∼20 ps pulses at 80 MHz using an Yb-fiber laser at 1.064 µm. By taking advantage of the high spatial quality of the resonant idler beam in the 2503-3030 nm wavelength range and using a second MgO:PPLN crystal with fanout grating structure for intracavity SHG, we have achieved spectral coverage across 1272-1515 nm with up to 1.23 W average power. The second harmonic output exhibits a power stability of 3% rms over 1 hour in pulses of 8.3 ps with Gaussian beam profile. The described approach overcomes the spectral limitation of 1.064 µm-pumped OPOs based on MgO:PPLN and other oxide-based nonlinear crystals, where signal generation below ∼1.45 µm is precluded by multi-phonon absorption of idler radiation above ∼4 µm.