bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intercostobrachial neuralgia—a case of bizzare diagnosis?
Authors: Singh Tejinder , Kumar Parijat 
Published: May 2022

Abstract
Background
Intercostobrachial neuralgia is a rare and bizarre diagnosis usually missed by many clinicians. The rare occurrence and absence of clear diagnostic criteria could be a result of this missed diagnosis. The symptoms could range from debilitating pain in the axilla, medial arm, and forearm at rest and with specific shoulder movements. The symptoms are very distinct from axillary web syndrome in which the patient could have thickening of subcutaneous tissue of axilla with affected shoulder mobility but absence of neural symptoms. The diagnostic and treatment procedure involving breast cancer may cause injury or lesion of the intercostobrachial nerve and is of particular interest to the surgeons, pain physicians, and physical therapists. The diagnosis is reached after excluding all the other possible diagnoses. The treatment of this post-surgical intercostobrachial neuralgia can range from cryoneurolysis, ultrasound-guided nerve block, steroid injection, and paravertebral nerve block. Lidocaine injection and avoiding certain positions like flexion and abduction are helpful in certain patients. Unfortunately, there is not much literature available on possible manual therapy treatments of this diagnosis. Therefore, this case report focuses on potential manual therapies to address this intricate diagnosis.

Case presentation
The patient is a 38-year-old Asian female reported to an outpatient orthopedic physical therapy clinic with left medial arm and forearm pain for the past 5 years. Medical history included left breast lump removal surgery 9 years ago and cervical laminectomy C6–C7 with little success. The quick disability arm and hand scale showed a 36% disability score of function. The manual therapy approach targeted the cervicothoracic junction, second and third costovertebral joint, thoracic spine (T1–T8), and atlantooccipital joint (C0–C1). The patient showed significant improvement in function with a DASH score falling to 0% disability with a hands-on approach.

Conclusion
The intercostobrachial neuralgia is usually undiagnosed by various practitioners, physicians, and surgeons. The clinicians must consider manual treatments to the second and third rib and soft tissue mobilizations around the axillary region. The patient demonstrated significant improvement in symptoms with this approach.
Useful on-site macroscopic quantitative evaluation of EBUS-TBNA samples
Authors: Matias Maria Inês , Caldeira João Nunes , Matos Paulo , de Santis Michele , Fonseca Ana Luísa , Barradas Lurdes 
Published: May 2022

Abstract
Background
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield. Optimal specimen acquisition is of a key importance; however, rapid on-site cytology examination (ROSE) during EBUS-TBNA has limited access. In an attempt to provide immediate feedback to the operator, the intervention pulmonology team started to classify macroscopically every lymph node sample in terms of abundance. The main objective of this study was to clarify whether this on-site macroscopic evaluation of EBUS sample was related to histology results and therefore any helpful for clinical practice.

Results
From a total of 288 lymph node stations sampled, adequate/diagnostic histological results were present in 11.1% of “insufficient” samples, 40.9% “sufficient” samples, 76.4% “good” samples and 88.1% of “excellent” samples. This was statistically significant with p-value under 0.0001. Also, there was a statistical agreement between samples that were macroscopically “insufficient” or “sufficient” with “inadequate” and “dubious” histological results and also between macroscopically “good” and “excellent” samples and histological results that were adequate/diagnostic. And that statistical agreement was of moderate magnitude according to the “Landis and Koch” classification (k = 0.386).

Conclusions
The positive relationship between the on-site macroscopic evaluation of the EBUS sample as “excellent” and the “adequate/diagnostic” histological result is of high clinical importance since it represents a fast, cheap and easy method that provides immediate feedback to the operator influencing his conduct; by obtaining additional passes to achieve an “excellent” will ensure a higher percentage of samples with a diagnosis, accelerating the patients treatment.
Phase II Study of Lorlatinib in Patients With Anaplastic Lymphoma Kinase–Positive Lung Cancer and CNS-Specific Relapse
Authors: Dagogo-Jack Ibiayi , Oxnard Geoffrey R. , Evangelist Makenzi , Digumarthy Subba R. , Lin Jessica J. , Gainor Justin F. , Murphy John F. , Rabin Michael S. , Heist Rebecca S. , Muzikansky Alona , Shaw Alice T. 
Published: May 2022

PURPOSE The CNS is a recurrent site of progression in anaplastic lymphoma kinase (ALK)–rearranged (ALK+) lung cancer. Lorlatinib is a third-generation ALK inhibitor developed to penetrate the CNS and overcome ALK resistance mutations. We conducted a phase II study to evaluate the intracranial activity of lorlatinib in patients with CNS-only progression on second-generation ALK inhibitors. METHODS Patients with ALK+ lung cancer who had intracranial progression on ≥ 1 ALK inhibitor without measurable extracranial disease received lorlatinib 100 mg once daily. The primary end point was intracranial disease control rate at 12 weeks per modified RECIST v1.1. Secondary end points included intracranial progression-free survival, intracranial objective response rate, and safety/tolerability. RESULTS Twenty-three patients were enrolled between November 2016 and January 2019. Fifteen (65%) patients had irradiated CNS metastases, with a median of 20.2 months between radiation and lorlatinib. Control of intracranial disease was observed in 21 (95%) evaluable patients at 12 weeks. The intracranial objective response rate was 59% with six complete and seven partial responses. The median intracranial progression-free survival was 24.6 months (95% CI, 20.2 to not reached). With a median follow-up of 16.8 months, nine patients developed disease progression, including four patients with CNS progression. The most common treatment-related adverse events were hypercholesterolemia (96%), hypertriglyceridemia (87%), edema (65%), cognitive effects (52%), and mood effects (43%). Three patients discontinued treatment because of toxicity, including two patients with fatal respiratory events. CONCLUSION Lorlatinib induced durable intracranial disease control in patients with CNS-only relapse on second-generation ALK inhibitors, suggesting that tumors with CNS-limited progression on brain-penetrant ALK tyrosine kinase inhibitors remain ALK-dependent.
Delta-Aminolevulinic acid dehydratase enzyme activity and susceptibility to lead toxicity in Uganda’s urban children
Authors: mukisa Ambrose , Kasozi Denis , Aguttu Claire , Kyambadde Joseph 
Published: May 2022

Background: Rapid industrialization, urbanization, and population explosion in sub-Saharan Africa escalate environmental lead levels and subsequently blood lead levels in children. Its levels in one’s environment account for their blood lead levels. One’s susceptibility to lead toxicity is governed by nutrition status, age and genetics. This study aimed at expounding susceptibility to lead toxicity by relating blood lead levels, delta-aminolevulinic acid dehydratase (ALAD) enzyme activity, and genetic variations of proteins that code for ALAD in urban children of Uganda. Methods: A total of 198 blood samples were spectrophotometrically analysed for blood lead levels (BLL), hemoglobin (Hb) levels, and ALAD enzyme activity before DNA extraction, polymerase chain reaction, and restriction fragment length digestion for ALAD polymorphism. Results: Up to 99.5% of the total samples analyzed coded for ALAD1 allele compared to 0.05% that coded for ALAD2. There was a significant relationship between BLL, Hb status and ALAD enzyme activity in the three isozymes (ALAD1-1, ALAD1-2 and ALAD2-2) in strength of ALAD1-1 (r = 0.42, p -value = 0.02) ˂ ALAD1-2 (r = 0.62, p -value = ˂ 0.001) ˂ ALAD2-2 (r = 0.67, p -value = ˂ 0.001). Conclusions: Majority of children in Uganda code for the ALAD1 allele, which is important for blood lead ions hoarding during lead toxicity. Hoarding of blood lead not only delays exposure effects but also accumulates its levels in deposit tissues and this poses adverse effects later in their lives
Prediction of the effects of the top 10 nonsynonymous variants from 30229 SARS-CoV-2 strains on their proteins
Authors: Sia Boon Zhan , Boon Wan Xin , Yap Yoke Yee , Kumar Shalini , Ng Chong Han 
Published: May 2022

Background: SARS-CoV-2 virus is a highly transmissible pathogen that causes COVID-19. The outbreak originated in Wuhan, China in December 2019. A number of nonsynonymous mutations located at different SARS-CoV-2 proteins have been reported by multiple studies. However, there are limited computational studies on the biological impacts of these mutations on the structure and function of the proteins.  Methods: In our study nonsynonymous mutations of the SARS-CoV-2 genome and their frequencies were identified from 30,229 sequences. Subsequently, the effects of the top 10 highest frequency nonsynonymous mutations of different SARS-CoV-2 proteins were analyzed using bioinformatics tools including co-mutation analysis, prediction of the protein structure stability and flexibility analysis, and prediction of the protein functions. Results: A total of 231 nonsynonymous mutations were identified from 30,229 SARS-CoV-2 genome sequences. The top 10 nonsynonymous mutations affecting nine amino acid residues were ORF1a nsp5 P108S, ORF1b nsp12 P323L and A423V, S protein N501Y and D614G, ORF3a Q57H, N protein P151L, R203K and G204R. Many nonsynonymous mutations showed a high concurrence ratio, suggesting these mutations may evolve together and interact functionally. Our result showed that ORF1a nsp5 P108S, ORF3a Q57H and N protein P151L mutations may be deleterious to the function of SARS-CoV-2 proteins. In addition, ORF1a nsp5 P108S and S protein D614G may destabilize the protein structures while S protein D614G may have a more open conformation compared to the wild type. Conclusion: The biological consequences of these nonsynonymous mutations of SARS-CoV-2 proteins should be further validated by in vivo and in vitro experimental studies in the future.
Infectious diseases data observatory (IDDO) visceral leishmaniasis library of clinical therapeutic studies: A protocol for a living systematic review of clinical studies
Authors: Singh-Phulgenda Sauman , Rashan Sumayyah , Harriss Eli , Dahal Prabin , Naylor Caitlin , Brack Matthew , Guérin Philippe J. , Maguire Brittany J. 
Published: May 2022

Introduction: Visceral leishmaniasis (VL) is a vector-borne disease caused by protozoan parasites of the genus Leishmania. The disease is endemic in parts of South Asia, East Africa, South America and the Mediterranean region, with an estimated 50,000 to 90,000 cases occurring annually. A living systematic review of existing scientific literature is proposed to identify clinical drug efficacy studies against VL, conducted following the Preferred Reporting Items for Systematic-Reviews and Meta-Analyses (PRISMA) guidelines. Methods and analysis: The proposed living systematic review builds on a previous systematic review first carried out in 2016, and the current protocol is designed to capture any published or registered VL clinical study from Nov-2021 onwards. The following databases will be searched by a medical librarian: PubMed, Ovid Embase, Scopus, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, clinicaltrials.gov, WHO ICTRP, as well as IMEMR, IMSEAR, and LILACS from the WHO Global Index Medicus. The systematic review will consider both randomised and non-randomised interventional studies, including single-armed studies. Ethics and dissemination: A database of eligible studies, including study characteristics, is openly available (https://www.iddo.org/tool/vl-surveyor) and will be continually updated every six months. All findings will be published in a peer-reviewed journal. PROSPERO registration: CRD42021284622 (29/11/2021)
PEMBERDAYAAN EKONOMI MASYARAKAT MELALUI PENGOLAHAN HASIL BUMI LOKAL UNTUK MENINGKATKAN MINAT BERWIRAUSAHA
Authors: Fahmi Syariful , Shinta Faizah Sarah 
Published: May 2022

Artikel ini bertujuan untuk (1) memberikan wawasaanÂ dalam rangka memaksimalkan potensi sumber daya alam lokal yang ada di Dusun Ketos, (2) menciptakan peluang usaha serta meningkatkan minat berwirausaha warga Dusun Ketos, (3) memberikan strategi pemasaran yang kreatif guna mendorong pemasaran dan daya saing produk lokal Dusun Ketos. Adapun artikel ini juga diharapkan dapat memberi manfaat untuk (1) masyarakat dalam rangka meningkatkan perekonomian melalui strategi pengolahan hasil bumi dan pemasaran yang kreatif, (2) untuk pemerintah diharapkan bisa berpartisipasi dalam memberikan dorongan dan stimulan dalam rangka pengembangan ekonomi kreatif bagi masyarakat, (3) Untuk Dinas Pertanian diharapkan memberikan pendampingan dalam peningkatan sumber daya lokal yang menjadi hasil panen pokok masyarakat agar lebih baik, (4) Dinas Perpustakaan dan Arsip Daerah diharapakan dapat menyediakan literatur yang mampu menunjangÂ peningkatan wawasanbagi masyarakat, (5) Dinas Koperasi diharapkan dapat memberikan pengarahan serta pendampingan untuk warga dari hasil pengolahan hingga pemasaran produk.
Ultra-fast detail enhancement for a short-wave infrared image
Authors: Chen Yaohong , Zhang Hui , Zhao Zehao , Wang Zhen , Wang Hao , Kwan Chiman 
Published: May 2022

Image detail enhancement is critical to the performance of short-wave infrared (SWIR) imaging systems, especially to the long-range systems. However, the existing high-performance infrared (IR) image enhancement methods typically have difficulty in meeting the requirements of the imaging system with high resolution and high frame rate. In this paper, we propose an ultra-fast and simple SWIR image detail enhancement method based on the difference of Gaussian (DoG) filter and plateau equalization. Our method consists of efficient edge detail information extraction and histogram equalization. The experimental results demonstrated that the proposed method achieves outstanding enhancement performance with a frame rate around 50 fps for

1280

×

1024

SWIR images.
Analysis of the smoothing characteristics and shape-retaining ability of conformal vibration polishing and suppression strategy for full-spatial frequency errors of optics
Authors: Liu Shiwei , Wang Hongxiang , Hou Jing , Zhang Qinghua , Chen Xianhua , Zhong Bo , Zhang Mingzhuang 
Published: May 2022

Conformal vibration polishing (CVP) employing flexible polishing tools is expected to be an efficient means of optical processing, and all current research on it is limited to planar components. Hence, the smoothing characteristics of the middle spatial frequency (MSF) errors and the ability to maintain the surface shape of different types of optics in CVP are analyzed. A combined processing method based on magnetorheological finishing and CVP for full-spatial frequency errors is proposed and verified by experiment. The peak-to-valley value, MSF errors, and surface roughness of the large-diameter component can reach 75 nm, 1.1 nm, and 0.37 nm after 9 h of processing. The research not only demonstrates the excellent removal characteristics of CVP and the effectiveness of the proposed method but also provides an additional choice for the high-precision manufacturing of optics.
Diverse lineages of pathogenic Leptospira species are widespread in the environment in Puerto Rico, USA
Authors: Stone Nathan E. , Hall Carina M. , Ortiz Marielisa , Hutton Shelby M. , Santana-Propper Ella , Celona Kimberly R. , Williamson Charles H. D. , Bratsch Nicole , Fernandes Luis G. V. , Busch Joseph D. , Pearson Talima , Rivera-Garcia Sarai , Soltero Fred , Galloway Renee , Sahl Jason W. , Nally Jarlath E. , Wagner David M. 
Published: May 2022

Background
Leptospirosis, caused by Leptospira bacteria, is a common zoonosis worldwide, especially in the tropics. Reservoir species and risk factors have been identified but surveys for environmental sources are rare. Furthermore, understanding of environmental Leptospira containing virulence associated genes and possibly capable of causing disease is incomplete, which may convolute leptospirosis diagnosis, prevention, and epidemiology.

Methodology/Principal findings
We collected environmental samples from 22 sites in Puerto Rico during three sampling periods over 14-months (Dec 2018-Feb 2020); 10 water and 10 soil samples were collected at each site. Samples were screened for DNA from potentially pathogenic Leptospira using the lipL32 PCR assay and positive samples were sequenced to assess genetic diversity. One urban site in San Juan was sampled three times over 14 months to assess persistence in soil; live leptospires were obtained during the last sampling period. Isolates were whole genome sequenced and LipL32 expression was assessed in vitro.
We detected pathogenic Leptospira DNA at 15/22 sites; both soil and water were positive at 5/15 sites. We recovered lipL32 sequences from 83/86 positive samples (15/15 positive sites) and secY sequences from 32/86 (10/15 sites); multiple genotypes were identified at 12 sites. These sequences revealed significant diversity across samples, including four novel lipL32 phylogenetic clades within the pathogenic P1 group. Most samples from the serially sampled site were lipL32 positive at each time point. We sequenced the genomes of six saprophytic and two pathogenic Leptospira isolates; the latter represent a novel pathogenic Leptospira species likely belonging to a new serogroup.

Conclusions/Significance
Diverse and novel pathogenic Leptospira are widespread in the environment in Puerto Rico. The disease potential of these lineages is unknown but several were consistently detected for >1 year in soil, which could contaminate water. This work increases understanding of environmental Leptospira diversity and should improve leptospirosis surveillance and diagnostics.
Burden of disease and associated complications of hepatitis a in children and adults in Mexico: A retrospective database study
Authors: Guzman-Holst Adriana , Luna-Casas Gerardo , Burguete Garcia Ana , Madrid-Marina Vicente , Cervantes-Apolinar Maria Yolanda , Andani Anar , Huerta-Garcia Gloria , Sánchez-González Gilberto 
Published: May 2022

Background
Hepatitis A virus (HAV) infection is a leading cause of viral hepatitis in children, yet the HAV vaccine is not included in the national immunization program (NIP) in Mexico. This study addresses an identified evidence gap of the burden of hepatitis A disease, complications, and associated costs in Mexico by analyzing surveillance and healthcare data. Data review included disease morbidity (incidence and hospitalization), mortality, and healthcare resource utilization costs.

Methods
In this observational, retrospective database study, we conducted a systematic screening, extraction, and analysis of outcome data from the national surveillance system in Mexico from January 2000 to December 2019.

Results
During the analysis period (2000–2019), the average incidence rate/year of HAV cases was 14.7 (5.4–21.5) per 100,000 inhabitants. Children 1–9 years of age (YoA) had the highest average incidence rate/year with 47.8 (14.7–74.5). The average hospitalization rate/year due to HAV infection was 5.8% (2.9–9.6%). Although the highest burden of HAV continued to be in children (1–9 YoA), an increase in incidence and hospitalizations (with complications) in older age groups (≥ 10–64 YoA) was observed. The annual average fatality rate was estimated to be 0.44% (0.26–0.83%) of which 28.8% of deaths were concentrated in adults ≥ 65 YoA. The total direct costs of medical attention due to HAV and related complications were estimated at $382 million Mexican pesos.

Conclusion
The overall results suggest an uptrend in HAV infections in adolescents/adults compared to children in Mexico. Therefore, as the overall incidence risk of HAV infection decreases, the mean age of infection increases. This consequently increases the risk of severity and complications in older age groups, thus increasing the demand for healthcare resources. Our findings provide evidence for including the inactivated HAV vaccine in the Mexican NIP.
STEAM-DWI as a robust alternative to EPI-DWI: Evaluation in pediatric brain MRI
Authors: Gräfe Daniel , Päts Anne , Merkenschlager Andreas , Roth Christian , Hirsch Franz Wolfgang , Frahm Jens , Voit Dirk 
Published: May 2022

Purpose
Diffusion-weighted imaging (DWI) is an essential element of almost every brain MRI examination. The most widely applied DWI technique, a single-shot echo-planar imaging DWI (EPI-DWI) sequence, suffers from a high sensitivity to magnetic field inhomogeneities. As an alternative, a single-shot stimulated echo acquisition mode diffusion-weighted MRI (STEAM-DWI) has recently been re-introduced after it became significantly faster. The aim of the study was to investigate the applicability of STEAM-DWI as a substitute to EPI-DWI in a daily routine of pediatric radiology.

Methods
Retrospectively, brain MRI examinations of 208 children with both EPI-DWI and STEAM-DWI were assessed. Visual resolution and diagnostic confidence were evaluated, the extent of susceptibility artifacts was quantified, and contrast-to-noise ratio was calculated in case of diffusion restriction. Furthermore, the correlation of apparent diffusion coefficient values between STEAM-DWI and EPI-DWI was tested.

Results
STEAM-DWI was inferior to EPI-DWI in visual resolution but with higher diagnostic confidence and lower artifact size. The apparent diffusion coefficient values of both sequences demonstrated excellent correlation. The contrast-to-noise ratio of STEAM-DWI was only half of that of EPI-DWI (58% resp. 112%).

Conclusion
STEAM-DWI is a robust alternative to EPI-DWI when increased susceptibility artifacts are to be expected. Drawbacks are a lower contrast-to-noise ratio and poorer visual resolution.
Factors affecting prolonged time to extubation in patients given remimazolam
Authors: Shimamoto Yoko , Sanuki Michiyoshi , Kurita Shigeaki , Ueki Masaya , Kuwahara Yoshie , Matsumoto Ayumu 
Published: May 2022

Purpose
To analyze the cause of prolonged recovery from general anesthesia with remimazolam.

Methods
We studied 65 patients under general anesthesia with remimazolam. According to time to extubation, patients were divided into short period (SP) (n = 34, < 15 min) and long period (LP) (n = 31, ≥ 15 min) groups. Variables affecting time to extubation such as age, sex, height, body weight, body mass index (BMI), plasma albumin concentration, ASA class, duration of surgery, and total duration of general anesthesia, and total dose of remimazolam were compared between SP and LP groups. At the end of remimazolam infusion and upon extubation, predictive remimazolam concentrations were calculated using pharmacokinetic/pharmacodynamic three compartment modeling.

Results
LP group showed significantly higher BMI, older age, and lower plasma albumin concentration compared with those of SP group. Logistic regression analysis showed that the probability of time to extubation of ≥ 15 min was higher in patients with BMI greater than 22.0 kg/m2 (AUC 0.668, 95% CI 0.533‒0.803), ages older than 79.0 years (AUC 0.662, 95% CI 0.526‒0.798), and plasma albumin concentrations lower than 3.60 g/dl (AUC 0.720, 95% CI 0.593‒0.847). LP group showed significantly lower predicted remimazolam concentration than SP group upon extubation despite no difference in concentration between both groups at the end of infusion. Pharmacological analysis estimates that LP group is more sensitive to remimazolam than SP group through amplified responses.

Conclusions
Lower remimazolam doses should be considered for the overweight patients, elderly, and those with lower plasma albumin concentration.