bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of viral load non-suppression among HIV-positive children and adolescents attending care and treatment clinics in Tabora region, Tanzania
Authors: Mchomvu Ruth Daniel , Hussein Ally Kassim , Matee Mecky 
Published: November 2022

Abstract
Background
In Africa, data on viral suppression among human immunodeficiency virus (HIV)-positive children and adolescents on antiretroviral (ART) are scarce. This study aimed to determine determinants of HIV viral load (VL) non-suppression among HIV-positive children and adolescents (< 20 years old) who attend care and treatment clinics (CTCs) in Tabora region from January 2018 to April 2022. Data were abstracted from CTCs’ database and patient records including socio-demographic, ART drug regimen, clinical, virological and immunological features, for a maximum of 52 months. Viral non-suppression was defined as plasma VL ≥ 1000 copies/mil after 6 months on ART, during the follow-up period. Cox proportional hazards regression model and hazard ratios (HRs) were used in estimating the determinants of viral non-suppression.

Results
A total of 378 HIV-positive children (0–9 years) and adolescents (10–19 years) were enrolled, of whom 124 (32.8%) had virological non-suppression. The overall rate of VL non-suppression was 1.38 (95% CI 1.15, 1.64) per 100 person-months of observation. After adjusting for other factors, determinants of viral non-suppression were poor ART adherence level at initiation of ART (HR = 3.3; 95% CI 2.16, 4.91), low CD4 count at ART initiation (HR = 1.66; 95% CI 1.20, 2.30), nevirapine (NVP)-based regimen (HR = 2.64; 95% CI 1.32, 5.26), efavirenz (EFV)-based regime (HR = 2.08; 95% CI 1.03, 4.18), lopinavir/ritonavir (LPV/r)-based regimen (HR = 2.21; 95% CI 1.13, 4.32) and being on second-line regimen (HR = 6.11; 95% CI 2.50, 14.96).

Conclusions
HIV viral non-suppression among children and adolescents on ART in central Tanzania in the Tabora region is high (32.8%) and is associated with poor ART adherence level, low CD4 count, NVP-, EFV-, and LPV/r-based regimen. Early initiation of ART and intensified monitoring are required to improve viral suppression rates of HIV-infected children to attain the third goal of the UNAIDS 95-95-95.
Metabolic syndrome as independent risk factor among sample of Egyptian women with breast cancer
Authors: Mahmoud Walaa S. , Azmy Osama M. , Abu-Elghait Mohammed , Gomaa Mohammed Mohammed Mohammed , El Sayed Ibrahim El Tantawy , Hammad Doaa Y. , Kamel Mahmoud M. , Abdelqader Eslam M. , Yousef Walaa 
Published: November 2022

Abstract
Background
Metabolic syndrome (MetS) and breast cancer (BC) are closely related and need more clarification. In clinical practice, the early diagnosis of BC is the most crucial issue. The current study aimed to investigate the incidence of metabolic syndrome among Egyptian women with breast cancer as independent risk factor, and the relationships between anthropometric indices (BMI, waist, hip, middle upper arm circumferences) and breast cancer risk.

Results
MetS rate was significantly higher among women with breast cancer (n = 89, 65%) women; compared to CG: 43.5%, (37) women therefore metabolic syndrome was strongly associated with breast cancer. More than half of BC cases (n = 85, 62%) were obese (BMI > 29.9), and 37 women (27%) were overweight (BMI 25–29.9). Additionally, the BC group had greater levels of fasting blood sugar than the control group (109.72 ± 51.31, 78.49 ± 22.79 mg/dL, respectively). Waist circumference, hip circumference, and WHtR values in BC women showed highly significant difference (p value = 0.000) compared to control group.

Conclusion
In our study, the metabolic syndrome and its elements were significantly correlated among Egyptian women with breast cancer. Anthropometric indices were linked to an increased risk of breast cancer.
The targeted delivery of chitosan nanoparticles to treat indoxacarb: induced lung fibrosis in rats
Authors: Ali Naglaa A. , Kishta Mohamed S. , Fekry Mohamed , Mohamed Safaa H. 
Published: November 2022

Abstract
Background
This study evaluated the effects of chitosan nanoparticles (Ch-NPs) on indoxacarb (INDOX)-induced pulmonary fibrosis in in vivo and in vitro models. In in vivo studies, 40 male albino rats were randomly divided into four groups (10 rats/group): Group 1, normal control; Group 2, INDOX (600 mg/kg b.w.); Group 3, Ch-NPs (2 mg/kg b.w.); and Group 4, Ch-NPs + INDOX. Characterization of Ch-NPs was done measuring dynamic light scattering, zeta potential, Fourier-transform infrared spectroscopy, transmission electron microscopy, and antioxidant activity studies after various Ch-NPs treatments. From in vitro studies, the impact of Ch-NPs on A549 lung carcinoma cell proliferation was also examined.

Results
Our data indicated that INDOX provoked considerable lung damage as indicated by decreased antioxidant enzyme levels of superoxide dismutase and glutathione peroxidase, increased production of nitric oxide and malondialdehyde serum levels, elevated myeloperoxidase activity, increased hydroxyproline and cytokeratin-19 serum levels, and significantly upregulated matrix metallopeptidase-9 and microRNA-101 gene expression levels when compared with controls. Furthermore, histopathological and immunohistochemical investigations of cyclooxygenase-2 in the lung tissue revealed marked inflammation, severe fibrosis, and neutrophil infiltration. Critically, Ch-NPs treatment significantly reversed INDOX-induced changes in lung biochemical, histopathological, and immunohistochemical outcomes.

Conclusion
Therefore, Ch-NPs may function as potential therapeutic drugs for lung fibrosis owing to their antioxidant, anti-inflammatory, and antifibrotic activities with neutrophil infiltration.
Prescribed fire in longleaf pine ecosystems: fire managers’ perspectives on priorities, constraints, and future prospects
Authors: Kupfer John A. , Lackstrom Kirsten , Grego John M. , Dow Kirstin , Terando Adam J. , Hiers J. Kevin 
Published: November 2022

Abstract
Background
Projected trajectories of climate and land use change over the remainder of the twenty-first century may result in conditions and situations that require flexible approaches to conservation planning and practices. For example, prescribed burning is a widely used management tool for promoting longer-term resilience and sustainability in longleaf pine ecosystems of the southeastern United States, but regional stressors such as climatic warming, changing fire conditions, and an expanding wildland-urban interface may challenge its application. To facilitate the development of fire management strategies that account for such changes, we surveyed nearly 300 fire managers to elicit information on the criteria used for prioritizing burn sites, current burning practices and constraints, and expectations for changes in burning opportunities, including those pertaining to climate change and urban growth.

Results
Respondents noted that their most common criteria for selecting longleaf pine stands for burning were fire history, ecosystem health, and fuel reduction, with the presence of threatened and endangered species also given priority by public land managers. Many respondents (38%) cited recent burn frequencies that fall short of historic burn intervals. Barriers to burning included legal, institutional, and managerial constraints, such as proximity to human developments, public concerns, and risk aversion, as well as environmental and resource constraints, including weather, air quality restrictions, and lack of personnel, equipment, or funding. Roughly half of all respondents expect that opportunities to burn will be reduced over the next 30 years, particularly during the growing season. Fire manager perceptions of factors that will limit prescribed burning in the future include a similar suite of constraints, many of which will be affected by projected regional changes in land use and climate.

Conclusions
On an organizational level, burn window availability and resource limitations constrain prescribed burning practices. More broadly, policy and legal frameworks coupled with trends in urbanization and climate change are expected to interact with operational constraints to challenge managers’ abilities to implement landscape-scale burning strategies and achieve restoration goals. Additional research and engagement with fire managers are needed to investigate opportunities for introducing policy flexibility, leveraging shared management interests, and developing creative solutions to expand burning opportunities.
Development of nanoemulsion of antiviral drug for brain targeting in the treatment of neuro-AIDS
Authors: Nemade S. M. , Kakad S. P. , Kshirsagar S. J. , Padole T. R. 
Published: November 2022

Abstract
Background
Delivery of drugs via the nasal route directly to the brain utilizing the olfactory pathway is purportedly known to be a more efficient method to deliver neuro-therapeutics to the brain by circumventing the BBB, thereby increasing the bioavailability of these drugs in the brain. The main objective of the project work is to improve the bioavailability of the antiretroviral drug and to minimize the side effects of this therapy which are observed at the higher side in the chronic HIV treatment. The advantage of nasal drug delivery is its noninvasiveness and self-administration. Nanoformulation provides fast onset of action and helps to achieve site-specific delivery. In the current work, nanoemulsion formulation was developed with a ternary phase system. In vitro characterization of nanoemulsion was performed.

Result
Optimized batch B2 had a zeta potential of − 18.7 mV showing a stable emulsion system and a particle size of 156.2 nmin desirable size range. Batch B2 has the least variation in globule size with PDI 0.463. Results from ex vivo studies revealed that developed nanoemulsion (B2) possessed a higher rate of drug release compared to other formulations.

Conclusion
Phase diagrams indicated more width of the nanoemulsion region with an increase in surfactant ratio. Stable nanoemulsion was prepared with a combination of surfactant and co-surfactants. Nanoemulsions could prove one of the best alternatives for brain delivery of potent medications.

Graphical Abstract
Light cupula phenomenon: a systematic review
Authors: Bal Nilüfer , Altun Melike , Kuru Elif , Basoz Behmen Meliha , Gedik Toker Ozge 
Published: November 2022

AbstractGeotropic direction-changing positional nystagmus (DCPN) is transient in lateral semicircular canal (LSSK) canalolithiasis; it usually cuts off within a minute and fatigues. However, a “light cupula” mechanism has been described for patients with positional vertigo who exhibit a persistent geotropic DCPN without delay or fatigue. When the cupula becomes lighter than the surrounding endolymph, deflection may occur in the cupula under the influence of gravity. The person experiences dizziness and persistent positional nystagmus can be observed while remaining in that position.In this review, studies investigating the “light cupula phenomenon,” which is a newly defined phenomenon in the literature, were compiled. A systematic literature search was conducted on the light cupula phenomenon in PubMed and Google Scholar databases to illuminate the clinical side of this new phenomenon and reveal its distinctive features. Turkish and English articles published between 2010 and 2021 were scanned; the thesis, reviews, and books were excluded from the study. Forty-eight articles were included in the study.Mechanisms underlying light cupula has been explained as the “heavier endolymph hypothesis” with increased endolymph specific gravity due to an acute attack such as labyrinth hemorrhage, insufficient inner ear perfusion, or inflammation in the inner ear; “lighter cupula hypothesis” based on alcohol acting on the cupula earlier and making it lighter than the endolymph; “light particle hypothesis” due to the buoyancy of light debris, which are degenerative, swollen, and inflammatory cells in the endolymph adhering to the cupula and the “altered endolymph/perilymph density ratio hypothesis” that the difference in density between perilymph and endolymph causes light cupula. The pathophysiology of the light cupula phenomenon is still unclear, but it can be thought that all the different hypotheses may be effective in this phenomenon. Therefore, nystagmus characteristics and clinical course should be considered in patients for a more effective diagnosis and treatment process. In addition, the results of the studies show that light cupula may not be an uncommon disease and that some patients with geotropic DCPN can often be misdiagnosed as canalolithiasis LSCC-BPPV.
Outcomes of coblation tonsillectomy versus bipolar electrocautery tonsillectomy in pediatric population
Authors: Eltelety Ahmad M. , Swelam Mohamed E. , Dewidar Hazem M. , El Batawi Ahmed M. 
Published: November 2022

Abstract
Background
Bipolar electrocautery tonsillectomy has been the preferred technique for many otolaryngologists, yet coblation tonsillectomy is gaining popularity in the current practice. This study aims at comparing both techniques in terms of pain, bleeding, and healing.

Results
A total of 120 patients were randomly divided into two equal groups. Overall mean pain score associated with coblation tonsillectomy was statistically less than that caused by bipolar electrocautery throughout the follow-up period (p < 0.001). The difference in pain duration was statistically longer for the bipolar group. The incidence of postoperative hemorrhage—both reactionary and secondary—was statistically higher in the bipolar group. Coblation tonsillectomy showed statistically shorter duration of healing (p < 0.001).

Conclusions
Coblation tonsillectomy is associated with less pain severity and shorter pain duration, fewer bleeding incidents, and more prompt healing.
Idiopathic acquired dacryocystocele in an adult: case report of a rare entity
Authors: Kothandaraman Kirubakaran , Gupta Rijuneeta 
Published: November 2022

Abstract
Background
Idiopathic acquired dacryocystocele in adults is a rare disorder of the lacrimal drainage pathway. Only 20 cases have been reported in the literature. It presents with a triad of epiphora, medial canthal swelling, and recurrent dacryocystitis. Patients presenting without recurrent dacryocystitis is quite uncommon. This presentation can be confused with secondary nasolacrimal duct obstruction and other non-inflammatory pathologies. Dacryocystorhinostomy with stenting is the treatment employed in most reported cases.

Case presentation
A 24-year-old male presented with epiphora and medial canthal swelling for 3 years. Examination revealed features of left nasolacrimal duct obstruction. Imaging was suggestive of a cystic, homogenous, non-enhancing lesion in the left lacrimal sac region without bone destruction. Findings were suggestive of dacryocystocele. Patient underwent endoscopic dacryocystorhinostomy without stenting. Postoperatively, the swelling and epiphora resolved. Patient is symptom-free on follow-up.

Conclusion
Idiopathic dacryocystocele must be considered in evaluation of a medial canthal mass with epiphora without dacryocystitis. Conservative treatment is ineffective. Endoscopic dacryocystorhinostomy is safe and effective.
Exploring the Role of the Inhibitor of Apoptosis BIRC6 in Breast Cancer: A Database Analysis
Authors: Gómez Bergna Santiago M. , Marchesini Abril , Amorós Morales Leslie C. , Arrías Paula N. , Farina Hernán G. , Romanowski Víctor , Gottardo M. Florencia , Pidre Matias L. 
Published: December 2022

PURPOSE The aim of the present work was to investigate the role of apoptosis inhibitor BIRC6 (baculoviral IAP repeat-containing protein 6) in breast cancer (BC), focusing particularly on its involvement in the metastatic cascade. METHODS We analyzed BIRC6 mRNA expression levels and copy number variations in three BC databases from The Cancer Genome Atlas comparing clinical and molecular attributes. Genomic analysis was performed using the cBioPortal platform, whereas transcriptomic studies (mRNA expression levels, correlation heatmaps, survival plots, and gene ontology) were performed using USC Xena and R. Statistical significance was set at P < .05. RESULTS Our bioinformatic analyses showed that there was a differential expression of BIRC6 in cancer samples when compared with normal samples. Copy number variations that involve amplification and gain of BIRC6 gene were correlated with negative hormone receptor tumors, higher prognostic indexes, younger age at diagnosis, and both chemotherapy and radiotherapy administration. Transcriptomic and gene ontology analyses showed that, under conditions of high BIRC6 mRNA levels, there are differential expression patterns in apoptotic, proliferation, and metastatic pathways. CONCLUSION In summary, our in silico data suggest that BIRC6 plays an antiapoptotic, pro-proliferative, and apparent prometastatic role and could be a relevant molecular target for treatment of BC tumors.
Brain Vasculature Color-Labeling Using the Triple-Injection Method in Cadaveric Heads: A Technical Note for Improved Teaching and Research in Neurovascular Anatomy
Authors: Smith Kathleen , Ventre Giancarlo J. , Palmisciano Paolo , Hussein Ahmed E. , Hoz Samer S. , Forbes Jonathan A. , Lowrie Donald J. , Zuccarello Mario , Andaluz Norberto , Prestigiacomo Charles J. 
Published: December 2022

BACKGROUND:
Color-labeling injections of cadaveric heads have revolutionized education and teaching of neurovascular anatomy. Silicone-based and latex-based coloring techniques are currently used, but limitations exist because of the viscosity of solutions used.

OBJECTIVE:
To describe a novel “triple-injection method” for cadaveric cranial vasculature and perform qualitative and semiquantitative evaluations of colored solution penetration into the vasculature.

METHODS:
After catheter preparation, vessel cannulation, and water irrigation of embalmed cadaveric heads, food coloring, gelatin, and silicone solutions were injected in sequential order into bilateral internal carotid and vertebral arteries (red-colored) and internal jugular veins (blue-colored). In total, 6 triple-injected embalmed cadaveric heads and 4 silicone-based “control” embalmed cadaveric heads were prepared. A qualitative analysis was performed to compare the vessel coloring of 6 triple-injected heads with that of 4 “control” heads. A semiquantitative evaluation was completed to appraise sizes of the smallest color-filled vessels.

RESULTS:
Naked-eye and microscope evaluations of embalmed experimental and control cadaveric heads revealed higher intensity and more distal color-labeling following the “triple-injection method” compared with the silicone-based method in both the intracranial and extracranial vasculature. Microscope assessment of 1-mm-thick coronal slices of triple-injected brains demonstrated color-filling of distal vessels with minimum diameters of 119 μm for triple-injected heads and 773 μm for silicone-based injected heads.

CONCLUSION:
Our “triple-injection method” showed superior color-filling of small-sized vessels as compared with the silicone-based injection method, resulting in more distal penetration of smaller caliber vessels.
Functional Outcome Following Proximal Tibial Osteosarcoma Resection and Reconstruction by Modular Endoprosthesis
Authors: Ebeid Walid Atef , Hassan Mohammad Hassan Abd-Ellatif 
Published: November 2022

Abstract
Purpose
The proximal tibia is a common location for osteosarcoma. Modular endoprosthesis is a popular reconstructive option, yet it has been associated with many complications. Our study aimed to evaluate the functional outcome and complications of proximal tibial osteosarcoma patients treated by limb salvage using modular endoprosthesis.

Methods
A retrospective study of a prospective database was performed during the period between January 2000 and July 2017. Fifty-five patients with proximal tibial osteosarcoma underwent resection and modular endoprosthetic reconstruction. The functional outcome was evaluated using the Musculoskeletal tumor society scoring system and knee range of motion. Postoperative complications were classified according to Henderson classification; Type 1 (soft tissue failure), Type 2 (aseptic loosening), Type 3 (structural failure), Type 4 (infection) and Type 5 (local tumor progression).

Results
The mean follow-up period was 71.69 ± 49.76 months. The mean musculoskeletal tumor society score was 26.5 ± 2.22; the mean range of motion was 72.63 ± 25.07, and the mean extension lag was 15.09 ± 15.38. Type 1, type 2, type 3, type 4, and type 5 complications occurred in 7.3%, 14.5%, 21.8%, 23.6%, and 5.5%, respectively. Chest metastasis developed in 10 patients (18.2%). The estimated 5-year and 10-year survival rates for the treated patients were 83.6% and 79.9%.

Conclusions
Proximal tibial osteosarcoma reconstruction with a modular endoprosthesis is a reliable treatment option for retaining limb function. Most complications are manageable.
Clinical effect of minimally invasive technique of internal fixation device removal in patients with healed long tubular bone fractures
Authors: Li Chaoyi , Lin Wei , Wu Guozhi , Zhang Linkang , Zhang Pijun 
Published: December 2022

Objective: To investigate the clinical effect of minimally invasive technique applied to internal fixation removal in patients with healed long tubular bone fractures.
Methods: The records of patients with internal fixation of long tubular bone fracture who underwent the removal of the internal fixation device after fracture healing in The Second Affiliated Hospital of Hainan Medical College from May 2020 to December 2021 were reviewed. According to the different operation methods of taking out the internal fixation device, patients were divided into minimally invasive group (n=40) and traditional group (n=45). The perioperative indexes, levels of inflammatory factors tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), Karnofsky Performance Score (KPS), visual analog scale (VAS) pain score and complications were compared between the two groups.
Results: The drainage volume, bleeding volume, incision length and hospital stay in the minimally invasive group were significantly lower than those in the traditional group (P<0.05). The KPS score of minimally invasive group was significantly higher than that of traditional group at one week and one month after the operation, and the VAS score of minimally invasive group was significantly lower than that of traditional group at one day and one week after the operation (P<0.05). The levels of TNF-α and CRP in the observation group were significantly lower than those in the control group(P<0.05). There was one case of infection in the minimally invasive group, one case of secondary fracture and two cases of infection in the traditional group(P>0.05).
Conclusions: Minimally invasive surgery for the removal of the internal fixation device in patients with healed long tubular bone fractures with internal fixation is associated with significantly improved clinical effect, relieved symptoms, reduced inflammatory response, and improved functional recovery of patients.
doi: https://doi.org/10.12669/pjms.39.1.6967
How to cite this: Li C, Lin W, Wu G, Zhang L, Zhang P. Clinical effect of minimally invasive technique of internal fixation device removal in patients with healed long tubular bone fractures. Pak J Med Sci. 2023;39(1):91-95. doi: https://doi.org/10.12669/pjms.39.1.6967
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.