bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can computed tomography predict nodal metastasis in breast cancer patients?
Authors: Fakhry Sherihan , Abdel Rahman Rasha Wessam , Saied Hend Mahmoud , Saif El-nasr Safaa Ibrahim 
Published: July 2022

Abstract
Background
Axillary lymph node metastasis is considered one of the main prognostic factors clinically used for the evaluation of breast cancer patient. Also, an accurate diagnosis of axillary lymph node metastasis has a significant effect on the tumor staging and treatment planning. Ultrasonography is a noninvasive, available imaging modality that is capable of giving a real-time evaluation of axillary lymph nodes in breast cancer cases. On the other hand, multi-detector-row computed tomography is increasingly preferred by clinicians to preoperatively evaluate regional lymph node status in many cancers. The aim of this study was to compare the diagnostic performance of computed tomography against ultrasound in detecting axillary lymph node status in breast cancer patients.

Results
One hundred and fifty breast cancer patients were included in this prospective study. According to the final pathological results, 79/150 (52.7%) lymph nodes were metastatic, while 71/150 (47.3%) lymph nodes were benign with no evidence of metastases. Ultrasound examination has achieved a sensitivity of 76.4% and a specificity of 60.8% with overall diagnostic accuracy of 68.7%. Computed tomography (CT) examination has achieved a much higher sensitivity of 98.6%, a much lower specificity of 35.4%, and overall diagnostic accuracy of 65.3%. In our study, CT examination was superior on ultrasound in the determination of the level of lymph node affection, and this may be attributed to the dependency of ultrasound examination on the operator’s experience.

Conclusions
CT is not routinely used in the assessment of nodal stage. However, if used in proper clinical setting, it may increase our confidence in excluding nodal metastasis owing to its high sensitivity. Despite its low specificity, it may act as road map for the surgeon, providing the ability to assess all groups of lymph nodes as well as the number of the suspicious lymph nodes.
Impact of repeated patient counseling using different pressurized metered-dose inhalers training devices on inhalation technique, lung function, and asthma control in adult asthmatics
Authors: Sobh Ahmed H. M. , Rabea Hoda , Hamouda Manal Ali , Shawky Farid , Abdelrahim Mohamed E. A. 
Published: July 2022

AbstractBackgroundPressurized metered-dose inhalers (pMDIs) are among the most common devices that asthmatic patients use. The poor pMDI inhalation technique mostly results in poor lung deposition. The present work aimed to compare the impact of introducing two different training devices combined with their related smartphone applications on the proper performance of the inhalation technique and lung function in asthmatic adults.MethodsA total of 316 patients were allocated to 3 groups, 105 in the control group (normal patient education group), 104 in the group using the Clip-Tone device and its smartphone applications, and 107 in the group using the Flo-Tone and its smartphone applications. Each group had three visits. Their number of inhalation technique mistakes was recorded, their forced expiratory volume in the first second (FEV1) was measured, and an asthma control test (ACT) was given. Afterward, they had their allocated training. Differences in medians of outcomes among repeated visits per group and different groups per visit were measured. Finally, correlation statistics between FEV1% of predicted and the correct performance of inhalation technique (as a whole and as separate steps) per visit were conducted to study any associations if existed.ResultsIn the short term (after 2 visits), the Clip-Tone group showed significant superiority (p < 0.01) to both, the control and Flo-Tone groups, in terms of overall proper technique performance, and FEV1% of predicted. In the long term (after 3 visits), both interventions have shown significant superiority to the control in terms of correct inhalation technique performance (p < 0.05) and FEV1% of predicted (p < 0.01). None of them have shown significant superiority to each other. In terms of ACT scores, the Flo-Tone group showed significant improvement to both the control (p < 0.01) and the Clip-Tone (p < 0.05) groups in the second visit. In the third visit, both advancement counseling groups showed significant superiority to the control group (p < 0.01); However, the difference in medians between both Clip-Tone’s and Flo-Tone’s ACT scores disappeared. Weak, yet significant (− 0.146,p < 0.05) negative correlation existed between the number of mistakes in inhalation technique in the third visit and FEV1% of predicted. Correct performance of step 7 in the third visit showed a weak significant positive correlation (0.2,p < 0.01) with FEV1% of predicted.ConclusionIntroducing new training devices to the normal counseling that provides visual and audial feedback has shown that they could further enhance the inhalation technique performance and subsequently the lung function outcomes and asthma control of asthmatic patients. Yet, larger studies might be required to test the superiority of one to another.
New-Onset Atrial Fibrillation in Patients With Type 2 Diabetes Treated With Novel Glucose-Lowering Therapies
Authors: Hsiao Fu-Chih , Yen Kun-Chi , Chao Tze-Fan , Chen Shao-Wei , Chan Yi-Hsin , Chu Pao-Hsien 
Published: July 2022

Abstract

Context
Whether sodium-glucose cotransporter 2 inhibitors (SGLT2is) are associated with lower risk of new-onset atrial fibrillation (AF) compared with glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes was unknown.

Objective
We aimed to determine the comparative risk of new-onset AF with SGLT2is vs GLP-1RAs in Asian patients with type 2 diabetes in a real-world setting.

Methods
We used medical data from a multicenter health care provider in Taiwan and enrolled 16 566 and 2746 patients treated with an SGLT2i and a GLP-1RA, respectively, from January 1, 2016, to December 31, 2018. Propensity score weighting was used to balance the baseline covariates. The patients were followed from the drug index date until the occurrence of new-onset AF or the end of the follow-up period.

Results
In this study, 54%, 45%, and 1% of the SGLT2i group patients were treated with empagliflozin, dapagliflozin, and canagliflozin, respectively, and 65% and 35% of the GLP-1RA group patients were treated with liraglutide and dulaglutide, respectively. SGLT2is were associated with lower risk of new-onset AF compared with GLP-1RAs after inverse probability of treatment weighting (subdistribution hazard ratio: 0.72; 95% CI, 0.54-0.97; P = 0.028). Subgroup analysis revealed that this finding was consistent among the following high-risk subgroups: older patients, female patients, and patients with cardiovascular disease or chronic kidney disease.

Conclusion
SGLT2is were associated with lower risk of new-onset AF compared with GLP-1RAs among patients with type 2 diabetes mellitus in a real-world practice.
Animal Models of Preeclampsia: Mechanistic Insights and Promising Therapeutics
Authors: Taylor Erin B , George Eric M 
Published: July 2022

AbstractPreeclampsia (PE) is a common pregnancy-specific disorder that is a major cause of both maternal and fetal morbidity and mortality. Central to the pathogenesis of PE is the production of antiangiogenic and inflammatory factors by the hypoxic placenta, leading to the downstream manifestations of the disease, including hypertension and end-organ damage. Currently, effective treatments are limited for PE; however, the development of preclinical animal models has helped in the development and evaluation of new therapeutics.In this review, we will summarize some of the more commonly used models of PE and highlight their similarities to the human syndrome, as well as the therapeutics tested in each model.
Development of Regio- and Face-selective [2 + 3] Cycloaddition Reactions of Readily Preparable Oxime-substituted Nitrile Oxides with Silicon-linked Allylic-alcohol Moieties for Intramolecular Reactions
Authors: Umemoto Nao , Imayoshi Ayumi , Tsubaki Kazunori 
Published: July 2022

Abstract
Nitrile oxides are typically prepared in situ from nitroalkanes and converted to 2-isoxazoline heterocycles upon [2 + 3] cycloaddition with alkenes, providing synthetically useful intermediates such as β-hydroxy ketones and γ-amino alcohols. Herein, we prepared oxime-substituted nitrile oxides bound to allylic-alcohol derivatives through a silicon atom and demonstrated their intramolecular cycloaddition reactions. The desired cycloadducts were obtained as single regioisomers in good yields. Furthermore, face-selective cycloaddition reactions were achieved using α-substituted allylic-alcohol derivatives, affording the desired cycloadducts with high diastereoselectivity.
Level of development, foreign direct investment and domestic investment in food manufacturing
Authors: Djokoto Justice Gameli 
Published: July 2022

Background: Whilst the literature on the complementarity and substitutability of foreign direct investment (FDI) on domestic investment (DI) is not uncommon, the facet of food manufacturing is non-existent. This paper fills this void by investigating the effect of FDI on DI in the food manufacturing sector for developing, economies in transition and developed countries. Methods: Using an unbalanced panel data of 49 countries from 1993 to 2016, from FAOSTAT, estimated by the system generalised method of moments (GMM), the Wald statistics for the short and long-run effects of FDI on DI were computed for the development groups. Results: Developed economies experienced a crowd-out effect of FDI on DI in the short run, whilst the others experienced no significant effect. In the case of the long run, the food manufacturing sectors of all three development groups exhibited a crowd-out effect. The effect in the long run for all development groups together is a crowd-in. Analysing all country groups together could mask the results of the various country groups. Conclusions: A review of investment policies to prioritise FDI entry mode that favour domestic investment is needed. Improvement of the investment regulatory and administrative efficiency among others are recommended.
Regional clustering and waves patterns due to COVID-19 by the index virus and the lambda/gamma, and delta/omicron SARS-CoV-2 variants in Peru
Authors: Toyama Melissa , Vargas Lucía , Ticliahuanca Sofía , Quispe Antonio M 
Published: July 2022

Background: Coronavirus disease 2019 (COVID-19) impact varies substantially due to various factors, so it is critical to characterize its main differences to inform decision-makers about where to focus their interventions and differentiate mitigation strategies. Up to this date, little is known about the patterns and regional clustering of COVID-19 waves worldwide. Methods: We assessed the patterns and regional clustering of COVID-19 waves in Peru by using the weekly mortality rates for each of the 25 regions as an outcome of interest. We obtained the death counts from the National Informatics System of Deaths and population estimates from the National Registry of Identification and Civil Status. In addition, we characterized each wave according to its duration, peak, and mortality rates by age group and gender. Additionally, we used polynomial regression models to compare them graphically and performed a cluster analysis to identify regional patterns. Results: We estimated the average mortality rate at the first, second, and third wave at 13.01, 14.12, and 9.82 per 100,000 inhabitants, respectively, with higher mortality rates among elders and men. The patterns of each wave varied substantially in terms of duration, peak, impact, and wave shapes. Based on our clustering analysis, during the first wave caused by the index virus, the 25 regions of Peru presented six different wave patterns. However, the regions were clustered in two different wave patterns during the second and third, caused by alpha/lambda/delta and omicron. Conclusions: The propagation of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) variants behaved in Peru with varying wave patterns and regional clustering. During the COVID-19 pandemic, the weekly mortality rates followed different spatiotemporal patterns with solid clustering, which might help project the impact of future waves of COVID-19.
Eating Disorders and Orthodontics
Authors: Dhadwal Amardeep Singh , Marnell Ben , Patel Anjli 
Published: July 2022

In modern-day practice, there is an expanding population of patients with suspected or confirmed eating disorders. Increased awareness of the presenting features and manifestations of eating disorders is required for recognition of this situation and appropriate management. This article provides an overview of features of common eating disorders that may present in practice. It will draw attention to potential difficulties when orthodontic treatment is required and will make recommendations on how to judiciously manage potential problems. CPD/Clinical Relevance: This article outlines issues of importance for the orthodontic team when encountering patients with known or suspected eating disorders and provides guidance in the appropriate management.
Craniofacial Microsomia: Aetiology, Classification and Clinical Features. Part 1
Authors: Gibson Clara , Mubeen Suhaym , Evans Robert 
Published: July 2022

‘This article gives an overview of craniofacial microsomia (CFM), its diagnostic features and relevant classification systems. Craniofacial microsomia is the most common facial anomaly after cleft lip and palate. It has a wide phenotypic variance and requires a multidisciplinary approach for comprehensive management. We outline both the facial and dental manifestations and orthodontic implications. CPD/Clinical Relevance: CFM patients often require comprehensive dental and orthodontic care and it is necessary for the clinician to be aware of the clinical challenges in treating this cohort of patients. By having a thorough understanding of the aetiology and clinical features, it can help direct appropriate clinical care.
‘Mister Speaker! I therefore have no claim’ – Agda Östlund’s Entrance in the Parliamentary Debate in March 1922 in a Historical and Rhetorical Perspective
Authors: Gustafson Magnus 
Published: July 2022

In March 1922 the Social Democrat Agda Östlund (1870–1942) speaks as the first female member of Swedish Parliament in the Second Chamber due to her own proposal for the state to take responsibility for arranging suitable work for tuberculosis patients when they leave the sanatorium, so that they can complete their convalescence. It may seem that democracy was once and for all established when women were finally included in the Parliament. But that was not the case. The question is how Agda Östlund acts in a formative historical stage after the first democratic election, how she finds a speaking position and how her speech can be understood in relation to the negotiation of the meaning of women’s civil and democratic rights.
This article includes a contextualisation and a text analysis where I go into how the text relates to a rhetorical situation. I see Agda Östlund’s utterances as rhetorical in accordance with the theoretical perspectives established by Lloyd F. Bitzer where the key concepts are rhetorical situation, problem, restrictions and audience. Agda Östlund uses the mother role as a rhetorical strategy, connects the issue of tuberculosis to the home and everyday environment and nursing, which are traditionally female spheres, and highlights class injustice in the possibility of completing convalescence after sanitation. The mother role and the factual and low-key argumentation have two purposes in this speech – partly to adapt to the Parliament order, and partly to present the actual issue. The rhetorical strategy is about using the mother role as a persona to make the class perspective a matter of care, nursing and compassion.
Östlund’s entry into the Parliament debate can be described as a rhetorically fragile situation because she speaks for the very substance of her own motion while at the same time following the committee’s line, in which she herself is a part, and demands a rejection of it.
Progression to arthroplasty surgery among patients with hip and knee osteoarthritis
Authors: Gustafsson Kristin , Kvist Joanna , Zhou Caddie , Eriksson Marit , Rolfson Ola 
Published: July 2022

Aims The aim of this study was to estimate time to arthroplasty among patients with hip and knee osteoarthritis (OA), and to identify factors at enrolment to first-line intervention that are prognostic for progression to surgery. Methods In this longitudinal register-based observational study, we identified 72,069 patients with hip and knee OA in the Better Management of Patients with Osteoarthritis Register (BOA), who were referred for first-line OA intervention, between May 2008 and December 2016. Patients were followed until the first primary arthroplasty surgery before 31 December 2016, stratified into a hip and a knee OA cohort. Data were analyzed with Kaplan-Meier and multivariable-adjusted Cox regression. Results At five years, Kaplan-Meier estimates showed that 46% (95% confidence interval (CI) 44.6 to 46.9) of those with hip OA, and 20% (95% CI 19.7 to 21.0) of those with knee OA, had progressed to arthroplasty. The strongest prognostic factors were desire for surgery (hazard ratio (HR) hip 3.12 (95% CI 2.95 to 3.31), HR knee 2.72 (95% CI 2.55 to 2.90)), walking difficulties (HR hip 2.20 (95% CI 1.97 to 2.46), HR knee 1.95 (95% CI 1.73 to 2.20)), and frequent pain (HR hip 1.56 (95% CI 1.40 to 1.73), HR knee 1.77 (95% CI 1.58 to 2.00)). In hip OA, the probability of progression to surgery was lower among those with comorbidities (e.g. ≥ four conditions; HR 0.64 (95% CI 0.59 to 0.69)), with no detectable effects in the knee OA cohort. Instead, being overweight or obese increased the probability of OA progress in the knee cohort (HR 1.25 (95% CI 1.15 to 1.37)), but not among those with hip OA. Conclusion Patients with hip OA progressed faster and to a greater extent to arthroplasty than patients with knee OA. Progression was strongly influenced by patients’ desire for surgery and by factors related to severity of OA symptoms, but factors not directly related to OA symptoms are also of importance. However, a large proportion of patients with OA do not seem to require surgery within five years, especially among those with knee OA. Cite this article: Bone Joint J 2022;104-B(7):792–800.
Immunomodulatory role of T helper cells in rheumatoid arthritis
Authors: Luo Pan , Wang Peixu , Xu Jiawen , Hou Weikun , Xu Peng , Xu Ke , Liu Lin 
Published: July 2022

Rheumatoid arthritis (RA) is an autoimmune disease that involves T and B cells and their reciprocal immune interactions with proinflammatory cytokines. T cells, an essential part of the immune system, play an important role in RA. T helper 1 (Th1) cells induce interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), and interleukin (IL)-2, which are proinflammatory cytokines, leading to cartilage destruction and bone erosion. Th2 cells primarily secrete IL-4, IL-5, and IL-13, which exert anti-inflammatory and anti-osteoclastogenic effects in inflammatory arthritis models. IL-22 secreted by Th17 cells promotes the proliferation of synovial fibroblasts through induction of the chemokine C-C chemokine ligand 2 (CCL2). T follicular helper (Tfh) cells produce IL-21, which is key for B cell stimulation by the C-X-C chemokine receptor 5 (CXCR5) and coexpression with programmed cell death-1 (PD-1) and/or inducible T cell costimulator (ICOS). PD-1 inhibits T cell proliferation and cytokine production. In addition, there are many immunomodulatory agents that promote or inhibit the immunomodulatory role of T helper cells in RA to alleviate disease progression. These findings help to elucidate the aetiology and treatment of RA and point us toward the next steps.Cite this article: Bone Joint Res 2022;11(7):426–438.
Routine politics of production in post-Fordist manufacturing
Authors: Vidal Matt 
Published: July 2022

This article presents a theory of routine politics of production, which was inductively developed based on a case study of 22 supplier factories in the USA, including in-depth interviews with 31 managers and 52 workers. All factories had implemented lean production. The findings show that (i) some managers prioritise the qualitative upgrading of organisational capabilities over quantitative work intensification, (ii) this includes objective forms of worker empowerment, and (iii) many workers resist or are hesitant about these forms of empowerment (while being committed to their work). The majority of workers from this convenience sample described either no work intensification under lean or ‘positive intensification’, which by their own assessment reduces monotony and/or makes the work more challenging. The first necessary condition for routine politics of production to obtain is that managers prioritise qualitative upgrading over quantitative effort levels. The second necessary condition is worker reticence or resistance toward managerial attempts to change routines.
The article eschews theories of control and consent in favour of a classical Marxist framework emphasising labour process contradictions. Managers face conflicting pressures between deskilling and upskilling labour. Workers develop a contradictory orientation of alienated commitment. They are committed to being productive workers, in an attempt to realise a purpose in response to their alienation. Yet, in another manifestation of their alienation, experiences of bad management result in scepticism toward management. They embrace their work and Fordist conceptions of efficiency, wanting to see their organisation succeed, yet they contest managerial attempts to upgrade routines, which they deem inefficient.
Temporal behavior of air and sea surface temperature in a marine protected area of Cuba
Authors: González-De Zayas Roberto , Matos Pupo Felipe , Lestayo González Julio Antonio , Hernández-Fernández Leslie 
Published: July 2022

The Cuban Archipelago -particularly its coastal zones- is exposed to Global Warming. The rise of air and sea surface temperature value is a good indicator of its consequences to biodiversity. Air temperature was measured using an Automatic Meteorological Station at the Jardines de la Reina National Park between 2016 and 2017. Sea surface temperature was measured using temperature data loggers twice in the years 2000 (January and September) and 2016 (from January to June) in coral, mangrove and seagrass habitats. Air and sea surface temperature satellite data of the same studied sites were analyzed in the period 2003-2017 using in situ measurements. Results showed that all temperature values were similar to those reported in similar studies in Cuba and the Caribbean, and that extreme values were within the tolerance ranges previously reported for the studied habitats. Air temperature did not have a significant trend; however, sea surface temperature had a significant increase (0.01 °C) during the studied period. These results show the great influence of the Caribbean Sea over the marine waters and climate of this area. A combined monitoring system was proposed using in situ data logger measurements and satellite data temperature analysis to watch this important marine reserve of the Caribbean Region
Myelolipoma After Infliximab Treatment for Crohn's Disease
Authors: Cesa Kevin , Puppa Elaine Leonard , Eslami Katayoun , Blanchard Samra M. , Watkins Runa D. 
Published: July 2022

ABSTRACT
A 20-year-old woman with Crohn's disease receiving infliximab therapy presented to the emergency department with lower extremity swelling secondary to compression of the common iliac vein. On magnetic resonance imaging, an enlarging pelvic mass was identified. The pathology of the mass was consistent with myelolipoma. We believe this is the first case of myelolipoma in a patient on immunosuppression with infliximab.