bluuebunny/crossref_metadata_2025_split huggingface dataset:
Methaemoglobinemia: a diagnosis of surprise with recent literature review and management
Authors: Shabnam Sabaha , Nair Venugopal Achuthan , Gladston Divya V. , Ranjith J Siva 
Published: October 2022

Abstract
Background
Methaemoglobinemia (MetHb) is a rare entity in clinical practice which often goes undiagnosed and keeps both the anaesthesiologist and attending surgeon under tension during surgery on seeing dark or chocolate-coloured blood in the surgical field. A low oxygen saturation (SpO2) will further panic us to search for a cause but may end futile. To add further, SpO2 may not rise significantly with adequate oxygenation and may not reach 100 with a fraction of inspired oxygen (FiO2) of 1 which keeps us searching further for a cause. An arterial blood gas (ABG) finally clinches our diagnosis. It is often missed in the pre-anaesthetic evaluation due to its rarity and the patient being asymptomatic most of the time.

Case presentation
We present a case of a 61-year-old man, a reformed smoker and hypertensive on regular medication was evaluated for laparoscopic partial nephrectomy for right renal cell carcinoma. MetHb was diagnosed preoperatively in the midst of the COVID pandemic when we had all our patients’ room air SpO2 recorded and thus helped us in the smooth and hassle-free management with vitamin C preoperatively for 5 days and an uneventful perioperative period.

Conclusions
MetHb is an uncommon and potentially reversible cause of hypoxia. A simple bedside SpO2 evaluation may give a hint to the diagnosis along with a high haematocrit which urges us to order for an ABG when no other cause is attributable. A preoperative diagnosis can lead to an effective and simple management with vitamin C which often reduces methaemoglobin to significantly low levels and to have a favourable outcome. According to the literature, any level of less than 20% does not have much clinical significance in asymptomatic patients and surgery need not be deferred.
Serum MMP-9, SP-D, and VEGF levels reflect the severity of connective tissue disease-associated interstitial lung diseases
Authors: Lv Chengna , Zhang Qipan , Tang Pan , Guo Lun , Ding Qunli 
Published: October 2022

Abstract
Background
Interstitial lung disease (ILD) is a common pulmonary complication of connective tissue disease (CTD). This study aims to evaluate the clinical diagnostic value of matrix metalloproteinase-9 (MMP-9), surfactant protein-D (SP-D), and vascular endothelial growth factor (VEGF) as potential biomarkers for CTD-ILD.

Methods
This research included 33 CTD-ILD patients, 31 CTD patients without ILD, and 24 healthy control subjects. Then, the value of biomarkers for the diagnosis and evaluation of CTD-ILD was assessed through high-resolution computed tomography (HRCT) findings and pulmonary function test (PFT) parameters.

Results
The serum MMP-9, SP-D, and VEGF levels in the CTD-ILD group were higher than those in the CTD-NILD group and healthy group. The ROC curve indicates that VEGF has good to excellent diagnostic performance in diagnosing CTD-ILD, the cut-off that best optimizes sensitivity and specificity in diagnosing CTD-ILD is 277.60 pg/ml (sensitivity, 87.9%; specificity, 83.6%), with an area under the curve (AUC) of 0.905 (95% confidence interval (CI) 0.842–0.968); The ROC curve for MMP-9 suggests this biomarker is fair for diagnosis of CTD-ILD(sensitivity, 81.8%; specificity, 81.8%), with an AUC of 0.867 (95% CI 0.784–0.950), but SP-D only provided lower specificity with higher sensitivity in diagnosing CTD-ILD(sensitivity, 90.9%; specificity, 40.0%). The different serum biomarkers are more specific and sensitive when combined to diagnose ILD. The semiquantitative score for the degree of ILD severity on HRCT was positively correlated with SP-D and VEGF levels (r = 0.461, P = 0.007; r = 0.362, P = 0.039), and serum MMP-9 levels were elevated in the UIP subgroup compared to the non-UIP subgroup. The percentage of diffusing capacity of the lung for carbon monoxide (DLco) (% predicted) had a negative correlation with the SP-D level (r = − 0.407, P = 0.044) and a statistically negative correlation between MMP-9 and the forced vital capacity (FVC) (r = − 0.451, P = 0.024).

Conclusions
Serum MMP-9, SP-D, and VEGF levels may have clinical value in screening and evaluating the severity of CTD-ILD.
Predictors of relapse in granulomatosis with polyangiitis: a multi-center study
Authors: Safari Sara , Alesaeidi Samira , Pakzad Bahram , Abbaspour Sina 
Published: October 2022

Abstract
Background
Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis. Its severity ranges from indolent disease to fulminant that may cause death. With treatment, remission is seen in more than 80% of cases, although relapse is still common. There have been studies showing that there may be factors to predict relapse in GPA. Based on relapses, the decision to start treatment and/or to monitor the patients more closely is made. Therefore, predicting the relapse of GPA can be effective in controlling the disease. Our aim was to investigate possible factors for relapse in GPA.
We recruited 254 patients diagnosed with GPA who were under treatment at Alzahra hospital affiliated to Isfahan University of Medical Sciences (from 2013 to 2020) and Amir Alam Hospital affiliated to Tehran University of Medical Sciences (from 2020 to 2022) to plan a retrospective study. Chi-squared or Fisher’s exact tests were performed to compare categorical variables, while the Mann–Whitney U test was used to compare continuous variables.

Results
Analysis of our patients (aged 20–80,122 females) showed that 147 patients (57.9%) experienced relapse. Mean age in relapse group was 43.8 ± 16.6 and in no-relapse group was 45.6 ± 15.1 (P > 0.05). Among many potential predictors, we observed in multivariate analysis that positive PR3-ANCA (proteinase 3-antineutrophilic cytoplasmic antibodies) (P = 0.007, OR:2.62,CI:1.29–5.31),nose manifestations (P = 0.004, OR 3.00, CI 1.43–6.26), mucosal membranes involvement (P = 0.009, OR 4.21, CI 1.43–12.38), and gastrointestinal tract (GI) complications (P = 0.03, OR 5.64, CI 1.14–27.90) were significant predictors of GPA relapse.

Conclusion
Among clinical and laboratory features we studied, positive PR3-ANCA, nose manifestations, mucosal membranes involvement, and GI complications were independent predictors of relapse in patients with GPA.
Non-invasive predictors of ICU admission and mortality in initially asymptomatic COVID-19 patients
Authors: Raafat Riham Hazem , Alboraie Mohamed , Elkhadry Sally Waheed , Abdelnasier Mostafa , Hashish Mohamed Ahmed , Almansoury Yahya Ahmed , Yousef Noha , Elshaarawy Omar , Madkour Ahmad 
Published: October 2022

Abstract
Background
Coronavirus disease 2019 (COVID-19) can present with pulmonary and non-pulmonary manifestations, or it may be asymptomatic. Asymptomatic patients have a major impact on transmission of the disease, and prediction of their outcome and prognosis is challenging. We aim to identify the predictors of intensive care unit (ICU) admission and mortality in hospitalized COVID-19 patients with initially asymptomatic presentation.

Methods
This was a prospective multicenter study using cohort data that included all admitted patients aged 21 years and above, with different clinical presentations other (than pulmonary manifestation) and were discovered to have COVID-19. Demographic data, clinical data and progression were reported. Univariate analysis and logistic regression analysis were performed to predict ICU admission and mortality during hospitalization.

Results
One hundred forty-nine consecutive patients, 92 (61.7% males) were included in our study, Median age (IQR) was 59.00 (43–69]. Only 1 patient (0.7%) had a contact with a confirmed case of COVID-19. 58 patients (39%) were admitted to ICU and 22 patients (14.8%) have died. High ferritin level (more than 422.5), low oxygen saturation (less than 93%), and in need of non-invasive ventilation (NIV) have 3.148, 8.159 and 26.456 times likelihood to be admitted to ICU, respectively. Patients with high CO-RADS, low oxygen saturation (less than 92.5%), and in need for mechanical ventilation (MV) have 82.8, 15.9, and 240.77 times likelihood to die, respectively.

Conclusion
Initially asymptomatic hospitalized patients with COVID-19 have a great impact on health system with high ICU admission and mortality rate. We identified the predictors that may help in early management and improving prognosis.

Trial registration
Trial was registered in Clinicaltrials.gov, registration number is NCT05298852, 26 March 2022, retrospectively registered.
Comparative theoretical study of x-ray magnetic circularly polarized emission from ferromagnetic Fe, Co, and Ni
Authors: Kobayashi H. , Koide A. , Nomura T. , Inami T. 
Published: October 2022

Abstract
X-ray magnetic circularly polarized emission (XMCPE) is a novel magneto-optical phenomenon in which characteristic x-rays emitted from a magnetized material are circularly polarized. In this letter, we report a comparative theoretical study of XMCPE spectra of the K
α emission from ferromagnetic Fe, Co, and Ni. Calculated XMCPE spectra have characteristic tail structures on the low-energy side of the K
α emission peaks. Comparison of the spectra shows that Fe, Co, and Ni have broad, intermediate, and narrow tail structures, respectively. Since these tail structures originate from electron excitations in the 3d conduction bands, this difference in tail structure width can be explained by the difference in the spin-polarized 3d electron states among the three metals.
Solitary waves explore the quantum-to-classical transition
Authors: Sreedharan A. , Kuriyattil S. , Choudhury S. , Mukherjee R. , Streltsov A. , Wüster S. 
Published: October 2022

Abstract
How the classical appearance of our environment arises from the underlying quantum many-body theory is an open fundamental question. We propose that phenomena involved in the quantum-to-classical transition can be probed in collisions of bright solitary waves in Bose-Einstein condensates, where thousands of atoms form a large compound object at ultra cold temperatures. For the experimentally most relevant quasi-1D regime, where integrability is broken through effective three-body interactions, we find that ensembles of solitary waves exhibit complex interplay between phase coherence and entanglement generation in beyond mean-field simulations using the truncated Wigner method: An initial state of two solitons with a well-defined relative phase looses that phase coherence in the ensemble, with its single-particle two-mode density matrix exhibiting similar dynamics as a decohering two-mode superposition. This apparent decoherence is a prerequisite for the formation of entangled superpositions of different atom numbers in a subsequent soliton collision. The necessity for the solitons to first decohere is explained based on the underlying phase-space of the quintic mean-field equation. We show elsewhere that superpositions of different atom numbers later further evolve into spatially entangled solitons. Loss of ensemble phase coherence followed by system internal entanglement generation appear in an unusual order in this closed system, compared to a typical open quantum system.
Quantum symmetries and conserved charges of the cosmological Friedmann-Robertson-Walker model
Authors: Chauhan B. 
Published: October 2022

AbstractWe discuss both the off-shell nilpotent Becchi-Rouet-Stora-Tyutin (BRST) and anti-BRST symmetry transformations for the cosmological Friedmann-Robertson-Walker (FRW) model with a differential gauge condition in the extended phase space. In this discussion, the presence of anti-BRST symmetry provides the complete geometrical description of BRST within the ambit of the supervariable approach. We derive the conserved (anti-)BRST charges for the FRW model using the celebrated Noether theorem and show the nilpotency and absolute anti-commutativity properties of these conserved charges within the realm of BRST formalism. Finally, we prove the sanctity of (anti-)BRST symmetries through the derivation of these symmetry transformations within the framework of the (anti-)chiral supervariable approach (ACSA) to BRST formalism.
Pituitary Infiltration by Lymphoma
Authors: Tovar-Méndez Víctor Hugo , Cuenca Dalia , Gómez-Pérez Francisco J , Cuevas-Ramos Daniel 
Published: October 2022

AbstractLymphoma infiltration to the pituitary is rare. It represents less than 0.5% of all reported pituitary metastases (PMs). Here we present a case series of 3 patients with PMs from a systemic lymphoma. Also, we performed a literature review of the cases reported. We identified additional 31 cases in which non-Hodgkin lymphoma (NHL) was the most common (n = 28, 90%), with large B-cell NHL the most frequent histological subtype (n = 14, 45%). Central hypothyroidism (n = 21, 67%) was the most frequent pituitary deficiency followed by adrenal insufficiency (n = 19, 61%) and diabetes insipidus (DI; n = 18, 58%). Full endocrine recovery was found in only 12% (n = 4) of patients after treatment, and magnetic resonance imaging showed tumor regression in 22% of them. In our series, 2 patients were diagnosed with diffuse large B-cell lymphoma, and 1 had mixed cellularity of classic Hodgkin lymphoma. The mean age was 54 ± 6.92 years. Hypopituitarism and DI were present in all of them, with 100% of mortality because of advanced systemic disease.
Evaluation of PD-L1 expression in vulvar cancer
Authors: Sahraoui Ghada , Manai Marwa , Yaïche Rahma , Charfi Lamia , Ghalleb Montassar , Douik Hayet , Mrad Karima , Doghri Raoudha 
Published: October 2022

Background: The PD-1/PD-L1 inhibitory immune checkpoint seems to have a significant prognostic impact in the evolution of certain cancers such as bronchopulmonary cancer, breast cancer, lymphomas etc. Indeed, it has been suggested that PD-L1 expression was associated with a worse prognosis due to its immunosuppressive activity within tumor tissue. Currently, the evaluation of the expression of these biomarkers is of increasing interest in gynecological cancers. Hence, we proposed to study the expression of PDL1 in vulvar cancer. Our aims were to study the expression profile of PD-L1 in vulvar cancer by immunohistochemistry and to correlate its expression with overall and relapse-free survival rates. Methods: This is a retrospective study conducted at the pathological anatomy and cytology department of the Saleh Azaiez Institute, Tunis, Tunisia involving 55 patients followed for vulvar cancer over a period of 13 years from 2008 to 2021. Clinicopathologic data was collected from medical records and pathology reports. Results: PD-L1 expression in vulvar squamous cell carcinoma was observed in 44% of cases. This expression was noted in 33% of cases in tumor cells and in 11% of cases in lymphocytes. The median follow-up period was 40 months. During this period, 30% of patients relapsed. For all recurrence cases, 77% were during the first two years. The overall survival rate was 68.4% at two years and 50.3% at five years. The recurrence-free survival rate was 63.8% at five years. Overall survival as well as recurrence-free survival were more reduced in the case of PD-L1 expression. However, this difference was not significant (p=0.07). Conclusions: These results, although insufficient, emphasize the prognostic value that PDL1 could play in vulvar cancer as described in the literature. Despite the low numbers and the unavailability of data for some cases, our results encourage carrying out this work on larger populations.
Comparison of percentage excess weight loss and body composition after Roux-en-Y gastric bypass versus sleeve gastrectomy: A prospective study
Authors: Sapwarobol Suwimol , Aiam-O-Ran Juntagan , Astina Junaida 
Published: October 2022

Background: The aim of the present study was to evaluate the efficacy of Roux-en-Y gastric bypass (RYGB) vs. sleeve gastrectomy (SG) on glycemic control and blood lipid profile at preoperative (baseline), three and six months after surgery. Methods: In a prospective non-randomized design, 32 participants, SG (n = 11) and RYGB (n = 21) completed the study. Results: Results showed that fasting blood glucose (FBG) and Hemoglobin A1C (HbA1C) were significantly reduced from 113.55±30.18 mg/dL at baseline to 93.6±14.81 mg/dL at three months post operation following SG (p = 0.006). In addition, HbA1C decreased significantly in both groups at baseline, three- and six-months post operation (SG 6.41± 0.96, 5.4±0.36 and 5.28±0.57 % (p = 0.022) and RYGB 5.91± 0.94, 5.11± 0.57 and 4.96± 0.55% (p<0.001) respectively). Levels of high-density lipoprotein (HDL) were restored significantly in both groups at 6 months compared to three months post-surgery (SG 41.2± 9.99, 38.67±4.85 and 45.36± 6.22 (p = 0.023) and RYGB 42.67± 9.97, 36.58± 6.06 and 43.03± 6.66 (p =0.003) respectively), whereas there is no significant different in low-density lipoprotein and total cholesterol. Conclusions: Both bariatric surgery (SG and RYGB) improved glycemic control and blood lipid profile. Trial registration: The trial is registered with Thai Clinical Trials Registry (TCTR20210429004) April 29, 2021.
Antibacterial activity of Betadine (Jatropha multifida L.) stem extract on Pseudomonas aeruginosa growth in vitro
Authors: Rusdy Hendry , Damanik Diah HI 
Published: October 2022

Background: Today, people use plants to treat various types of diseases and improve human health. One of the medicinal plants is the Betadine plant (Jatropha multifida L.). Betadine plants have many functions, especially the sap, leaves, fruit and seeds. The compound contents in Betadine stem sap, which is efficacious as an antimicrobial, are saponins, tannins, flavonoids and labaditin. One of the bacteria that cause infection is Pseudomonas aeruginosa. These bacteria can cause opportunistic and nosocomial infections. Methods: This study was a true experimental laboratory with a post-test only control group design. This study used Betadine stem sap extract with concentrations of 25%, 50%, 75%, 100%, gentamicin cream 10% as positive control, and dimethyl sulfoxide (DMSO) solution as negative control. This study used the Kirby-Bauer diffusion method and the bacterium Pseudomonas aeruginosa was grown on nutrient agar media, then incubated for 24 hours and calculated using calipers. Research data were analyzed using one-way ANOVA test. Results: The highest inhibition zone was group 50% (12.725 ± 0.2500 mm) while the lowest inhibition zone was group 100% (8.675 ± 0.5620 mm). Conclusions: Betadine stem extract had antibacterial activity in inhibiting the growth of Pseudomonas aeruginosa bacteria, with the 50% concentration being the most effective in inhibiting the growth of Pseudomonas aeruginosa bacteria.
Relation between delivery mode and maternal mental status one month after delivery at a perinatal center in Japan: A cross-sectional study
Authors: Suzuki Shunji 
Published: October 2022

Background: Maternal mental status has been thought to be affected by the delivery modes. We examined the relation between delivery modes and the mental status of women who delivered at our institute in Japan. Methods: Data were collected from the medical charts of 643 primiparous women without a history of mental disorders who delivered singleton babies and underwent a 1-month postpartum check-up at our institute from September 2018 to June 2019. The maternal mental status was examined based on the scores of the Edinburgh Postnatal Depression Scale (EPDS) and the Mother-Infant Bonding Scale (MIBS). Results: The rate of high scores of the EPDS and the MIBS in women choosing elective cesarean section were higher than in women with vaginal delivery and emergency cesarean section. Conclusion: Mental health care may be necessary for women choosing elective cesarean section.
Medical student perceptions of reflective practice in the undergraduate curriculum
Authors: Gishen Faye , Chakrabarti Rima 
Published: October 2022

Introduction: Reflective practice (RP) forms a core component of medical professionalism but, despite its benefits, it remains largely undervalued among medical students. The aim of this study was to explore medical students’ attitudes and barriers to engagement with RP in the undergraduate programme at a UK based medical school. Methods: This was a qualitative study based on the methodology of phenomenology. All penultimate year medical students at University College London Medical School (n=361) were approached for this study and altogether thirteen participants were recruited, with data collected through two focus group discussions. Thematic analysis was used to generate the coding framework. Results: Five key themes emerged around student attitudes to RP, which were grouped into three domains: ‘value of RP’, ‘barriers to engagement’, and ‘strategies for enabling RP’. ‘Value of RP’ centred on the themes of humanising medicine and developing empathy, developing professionalism and RP as a tool for sense-making. ‘Barriers to engagement’ centred on the purpose and tokenism of RP and in the third domain, ‘strategies for enabling RP’, the theme of student agency in RP emerged strongly. Conclusion: Overall, the value of RP was not fully appreciated until students began their clinical placements. Potential strategies identified by participants for optimising engagement included student co-design and positioning RP within a broader pastoral role early in the undergraduate curriculum.
Supporting oral communication in language learning through the fictitious identity technique
Authors: Saar Katrin , Loogus Terje , Uibu Krista 
Published: October 2022

Kui keeleliste osaoskuste õpetamine võõrkeeletunnis tavaliselt probleeme ei valmista, siis õpetajatele teeb muret õpilaste vähene suhtlusvalmidus. Probleemi aitavad vähendada suhtlussõbralik ja õppijaid motiveeriv keskkond, samuti loovust nõudvad õppijakesksed ning sihtkeele kultuuriruumi vastu huvi tekitavad ülesanded. Seda võimaldab simulatsioon fiktiivse identiteedi kasutamisega. Siinse sekkumisuuringu eesmärk oli välja selgitada, kuidas toetab fiktiivse identiteedi kui keeleõppemeetodi kasutamine üliõpilaste suhtlusvalmidust saksa keeles rääkimisel. Tulemustest järeldub, et meetod toetab üliõpilaste suhtlusvalmidust vaid osaliselt. Positiivsete külgedena märgiti, et fiktiivne identiteet aitab olla rohkem avatum ja spontaansem oma tegelaskujust rääkimisel. Ühtlasi paneb see otsima uusi väljendeid ja sõnu ning kiirendab sisseelamist saksakeelsesse maailma. Samas võivad selle meetodi ülesanded põhjustada rahulolematust. Osa üliõpilasi arvas, et ilma fiktiivse identiteedita oleksid nad tundides suhelnud sama palju. Negatiivset mõju avaldavate teguritena nimetati segadust erinevate identiteetide kasutamisel ja vähest huvi uue tegelaskuju väljamõtlemisel. Meetodis nähti eelkõige võimalust,kuidas keeleoskust aktiivselt arendada.
Summary