bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultrasound diagnosis of syndromic cases with vascular malformations and soft tissue overgrowth: A rare case of CLOVES syndrome
Authors: Rana Abhilasha , Sethy Abhilash , Krishnan Venkatram , Aggarwal Archana 
Published: May 2022

Introduction: Syndromes associated with vascular malformation and soft tissue overgrowth in the paediatric population present with multiple soft tissue swellings. Ultrasound is the initial investigation of choice for paediatric soft tissue swellings. Ultrasound evaluation can accurately assess the nature of vascular malformations and pattern of lipomatous hypertrophy in areas of soft tissue overgrowth to facilitate early diagnosis of such syndromes. Case Report: Here, we report a case of CLOVES (congenital lipomatous overgrowth (CLO), vascular malformations (V), epidermal nevi (E), and spinal/skeletal anomalies/scoliosis (S)) syndrome in a 6-year-old girl referred for evaluation of soft tissue swellings. CLOVES syndrome is a rare overgrowth syndrome in the paediatric population which presents with multiple soft tissue swellings. The ultrasound and clinical features of the syndrome have been illustrated to help radiologists accurately diagnose this rare syndrome based on detailed ultrasound and clinical evaluation. Discussion: Radiological features of CLOVES syndrome and differentiating ultrasound features of other such syndromes have been described in detail. A systematic stepwise approach to diagnosing complex syndromic associations of vascular malformations with lipomatous overgrowth has been proposed. Role of ultrasound in the management, Wilms tumour screening and follow-up of CLOVES syndrome have also been discussed. Conclusion: Ultrasound plays a crucial role in the early diagnosis and management of complex syndromes presenting with soft tissue swelling in the paediatric population. It also aids in the differentiation of such syndromes, tumour screening, guided sclerotherapy and follow-up of vascular lesions encountered in such syndromes.
Complicated appendicitis in an adult patient
Authors: Babington Emmanuel Abiola 
Published: May 2022

Introduction: Appendicitis is a common cause for emergency operations in the western part of the world, mostly affecting children and young adults. Ultrasound in well-trained hands is an effective imaging tool in making this diagnosis; however, this does not come without its challenges and potential complications. Case report: This is a case of a 19-year-old male with one-day history of severe pain in the right iliac fossa; blood results showed raised inflammatory markers. Ultrasound revealed a large abnormal loop of bowel containing heterogeneously echogenic contents, and two large appendicoliths at the base and fundus, with the presence of free fluid in the right iliac fossa and oedema in the adjacent mesentery. Laparoscopic appendectomy confirmed the presence of severe appendicitis with generalised peritonitis and appendicolith. Histology revealed gangrenous appendicitis with perforation in two places. Discussion: This case demonstrates that making a diagnosis of an inflamed appendix alone on ultrasound is not enough, and conducting a detailed assessment of the inflamed appendix and its surrounding anatomy is essential so that all the associated findings can be reported to aid in the patient management, reduce hospital stay and improve overall diagnosis and prognosis.
(Extra) ordinary parenting: Parents of children with disabilities in the context of disability stigma and pride
Authors: Niedbalski Jakub 
Published: May 2022

Introduction/background The research focuses primarily on how parents construct images of themselves and their children that diverge from the narrative of disability as a life tragedy and focus on emphasizing dignity and self-esteem. Methods The research was qualitative. A technique of an unstructured interview conducted with parents of people with intellectual disabilities was used to collect data. The analysis and interpretation were based on the procedures of the grounded theory. Results and conclusion Parents talk about their children as a source of pride, pointing to positive social experiences, social relationships and interactions in the public sphere. At the same time, parents emphasized the painful and exhausting experience of dealing with various types of institutions, thus highlighting the negative role of stigma in their lives and those of their children. Parents resisted framing their children’s 'deficits' and their own lives in terms of mere tragedy or misfortune.
Real-world outcomes of adjuvant gemcitabine versus gemcitabine plus capecitabine for resected pancreatic ductal adenocarcinoma
Authors: Kang Sora , Yoo Changhoon , Lee So Heun , Oh Dongwook , Song Tae Jun , Lee Sang Soo , Jeong Jae Ho , Park Do Hyun , Seo Dong Wan , Park Jin-hong , Hwang Dae Wook , Song Ki Byung , Lee Jae Hoon , Lee Woohyung , Kwak Bong Jun , Hong Sarang , Chang Heung-Moon , Ryoo Baek-Yeol , Kim Kyu-pyo , Kim Song Cheol 
Published: May 2022

Background: Adjuvant chemotherapy is the standard treatment after curative-intent surgery for pancreatic ductal adenocarcinoma (PDAC). The phase-3 ESPAC-4 trial demonstrated significantly improved overall survival (OS) with Gemcitabine plus capecitabine (GemCap) over Gemcitabine (Gem) in Europe. We conducted a retrospective efficacy and safety evaluation of GemCap versus Gem in an Asian population. Methods: This retrospective analysis included 292 patients with PDAC who received adjuvant Gem or GemCap after curative resection between January 2017 and December 2020 at Asan Medical Center, Seoul, Korea. Results: Adjuvant Gem and GemCap were administered to 161 (55.1%) and 131 (44.8%) patients, respectively. The Gem group had significantly older patients (median 66 versus 63 years, p = 0.001); otherwise, the groups had similar baseline characteristics. With median follow-up durations of 39.4 [95% confidence interval (CI), 36.9–45.0] and 39.4 (95% CI, 34.7–41.6) months in the Gem and GemCap groups, the median OS was 36.8 (95% CI, 29.7–43.5) and 46.1 (95% CI, 31.5–not reached) months in the Gem and GemCap groups, respectively [unadjusted hazard ratio (HR) = 0.7; 95% CI, 0.5–1.0; p = 0.07). The median recurrence-free survival was 14.3 (95% CI, 12.9–17.7) and 17.0 (95% CI, 13.3–28.2) months, respectively ( p = 0.5). Hand-foot skin reactions (any grade, 15.3% versus 0.6%; p < 0.001), neutropenia (78.6% versus 67.7%, p = 0.04) and thrombocytopenia (30.5% versus 20.5%, p = 0.04) were more common in the GemCap group. Multivariate analysis revealed adjuvant GemCap – compared with Gem – to be significantly associated with better OS (adjusted HR = 0.6; 95% CI, 0.4–0.9; p = 0.01). Otherwise, moderate or poor histological grade, lymph node positivity, positive resection margin, and elevated CA 19-9 (>median) were significantly associated with worse OS. Conclusions: Adjuvant GemCap showed the consistent clinical outcomes with the ESPAC-4 trial. As mFOLFIRINOX is the new standard treatment for medically fit patients with resected PDAC, further evaluation of optimal adjuvant chemotherapy in daily practice is warranted.
In Vivo Study of the Inflammatory Tissue Response Surrounding a Novel Extended-Wear Kink-Resistant Insulin Infusion Set Prototype Compared With a Commercial Control Over Two Weeks of Wear Time
Authors: Kastner Jasmin R. , Eisler Gabriella , Torjman Marc C. , Khalf Abdurizzagh , Diaz David , Dinesen Alek R. , Loeum Channy , Strasma Paul J. , Joseph Jeffrey I 
Published: May 2022

Background: Infusion set function remains the limiting factor of insulin pump therapy due to nonmetabolic complications. Here, we tested an investigational extended-wear infusion set prototype with a soft, angled, wire-reinforced cannula with three additional side holes, and compared failure mechanisms and tissue response with a commercial Teflon control. Methods: A total of 48 Teflon and 48 prototype infusion sets were inserted subcutaneously every other day for 14 days in 12 swine and infused with dilute insulin. After two weeks, tissue around cannulas was excised, and occlusions, leaks, and kinks were determined. Tissue was processed and stained to assess the total area of inflammation (TAI) and the inflammatory layer thickness (ILT) around the cannulas. Data were analyzed using Fisher’s exact, analysis of variance-general linear model, Kruskal-Wallis, and post hoc tests. Results: On average, the TAI surrounding the investigational cannula was 52.6% smaller than around the commercial control. The ILT was 66.3% smaller around investigational cannulas. Kinks occurred in 2.1% (investigational) vs 32.4% (commercial) cannulas ( P < .001). There was no difference in occlusion alarms and leaks onto skin. Conclusions: The data suggest that the infusion set prototype elicits less inflammation over an extended wear time and is resistant to kinking, compared with a commercial Teflon device. This is consistent with previously published data on the impact of cannula material/angle on the inflammatory tissue response. We highlight the following important aspects of infusion set design: (1) secure skin adhesion, (2) reliable cannula insertion, (3) automatic removal of the stylet, (4) cannula material/design that resists kinking, and (5) minimization of local tissue inflammation.
Effectiveness of Telemedicine in Managing Diabetes in Pregnancy: A Systematic Review and Meta-Analysis
Authors: Laursen Sisse H. , Boel Lise , Udsen Flemming W. , Secher Pernille H. , Andersen Jonas D. , Vestergaard Peter , Hejlesen Ole K. , Hangaard Stine 
Published: May 2022

Background: Strict monitoring of blood glucose during pregnancy is essential for ensuring optimal maternal and neonatal outcomes. Telemedicine could be a promising solution for supporting diabetes management; however, an updated meta-analysis is warranted. This study assesses the effects of telemedicine solutions for managing gestational and pregestational diabetes. Methods: PubMed, EMBASE, Cochrane Library Central Register of Controlled Trials, and CINAHL were searched up to October 14, 2020. All randomized trials assessing the effects of telemedicine in managing diabetes in pregnancy relative to any comparator without the use of telemedicine were included. The primary outcome was infant birth weight. A meta-analysis comparing the mean difference (MD) in birth weight across studies was applied, and subgroup and sensitivity analyses were performed. The revised Cochrane tool was applied to assess the risk of bias, and the certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results: From a total of 18 studies, ten (totaling 899 participants) were used to calculate the effect on infant birth weight. The results nonsignificantly favored the control (MD of 19.34 g; [95% confidence interval, CI −47.8; 86.47]), with moderate effect certainty. Heterogeneity was moderate ( I2 = 37.39%). Statistically significant secondary outcomes included differences in two-hour glucose tolerance postpartum (gestational diabetes; two studies: standardized mean difference 9.62 mg/dL [95% CI: 1.95; 17.28]) that favored the control (GRADE level, very low) and risk of shoulder dystocia (four studies: log odds −1.34 [95% CI: −2.61; −0.08]) that favored telemedicine (GRADE, low). Conclusions: No evidence was found to support telemedicine as an alternative to usual care when considering maternal and fetal outcomes. However, further research is needed, including economic evaluations.
The Influence of Real-Time Continuous Glucose Monitoring on Psychosocial Outcomes in Insulin-Using Type 2 Diabetes
Authors: Soriano Emily C. , Polonsky William H. 
Published: May 2022

Background: To examine the impact of real-time continuous glucose monitoring (rtCGM) on psychosocial outcomes in adults with insulin-using type 2 diabetes (T2D). Methods: A total of 174 insulin-using adults with T2D completed questionnaires assessing diabetes distress, hypoglycemic confidence, hypoglycemic fear, device-related emotional burden, and device-related trust before and after a six-month trial of rtCGM. Hemoglobin A1c (HbA1c) was assessed at the same time points; impaired hypoglycemic awareness (IAH) was assessed at baseline. Change in psychosocial outcomes was examined with t tests, then modeled as a function of baseline HbA1c and IAH and simultaneous change in HbA1c in multiple regression analyses. Results: Respondents were predominantly male (57.5%) and non-Hispanic white (67.8%). Significant improvement over the trial was observed in hypoglycemic fear ( P = .031), hypoglycemic confidence ( P < .001), diabetes distress ( P < .001), and device-related emotional burden ( P < .001). Impaired hypoglycemic awareness at baseline predicted greater improvement in hypoglycemic fear ( P = .002), hypoglycemic confidence ( P = .003), diabetes distress ( P = .013), and device-related emotional burden ( P < .001). Higher baseline HbA1c was linked with greater improvement in hypoglycemic fear ( P = .030); HbA1c change over the trial was positively associated with change in diabetes distress ( P = .010) and device-related emotional burden ( P = .003). Conclusions: Introduction of rtCGM in adults with insulin-using T2D was associated with significant improvements in diabetes-related psychosocial outcomes over six months. Gains were significantly greater among participants reporting IAH and those with higher HbA1c at baseline, thus providing the first evidence regarding which users might more likely benefit.
People With Diabetes and Caregivers Prefer Rescue Glucagon Treatment With a Wider Storage Temperature Range and a Nasal Administration, When Efficacy is Similar: A Discrete Choice Experiment in Spain
Authors: Mitchell Beth D. , Rentz Anne M. , Kummer Shannon , Yan Yu , Heidenreich Sebastian , Krucien Nicolas , Artime Esther , Osumili Beatrice , Rubio Miriam , Gelhorn Heather L. 
Published: May 2022

Background: Conventional injectable glucagon (IG) and nasal glucagon (NG), both having similar efficacy, are two options for the emergency treatment of severe hypoglycemia in Spain. This study elicited the effect of changes in key attributes on preferences for NG and IG medication profiles of people with diabetes and caregivers in Spain. Methods: The relative attribute importance (RAI) that participants placed on glucagon preparation, preparation and administration time, delivery method, recovery time, device size, storage temperature, and headache risk was estimated from an online discrete choice experiment. In addition, patients and caregivers were presented with NG and IG profiles that included rates of successful administration; the proportion of participants choosing each profile was summarized. Results: The analysis included 276 adults with diabetes (65% type 1) and 270 caregivers (49% type 1). Overall mean age was 40 years; 51% were female. The most important attributes were storage temperature (RAI [95% confidence interval] = 27.3% [22.9-32.2]) and delivery method (17.4% [13.1-21.9]). Headache risk (16.2% [11.8-20.7]), time to prepare and administer (14.5% [10.1-18.8]), glucagon preparation (11.4% [6.8-15.8]), recovery time (8.9% [4.3-13.3]), and device size (4.3% [0.3-8.8]) were also relevant. When comparing medication profiles, significantly more participants (78%) preferred NG over IG profiles ( P < .001). Conclusion: Adults with diabetes and caregivers prefer a glucagon treatment with a higher rate of successful administration, wider storage temperature, and nasal delivery method, when efficacy is similar. Participants favored NG over conventional IG as a rescue medication for severe hypoglycemia. This information may help decision-making by payers and treatment discussions between health care professionals and patients.
Intimal hyperplasia detection after aneurysm treatment by flow diversion using magnetic resonance vessel wall imaging
Authors: Russo Riccardo , Mistretta Francesco , Bergui Mauro , Morana Giovanni 
Published: May 2022

In-stent caliber reduction due to neo-intimal hyperplasia (NIH) is an underestimated event that may follow flow diverter stent (FDS) implantation. Although mostly asymptomatic, this vascular reaction is a well-known risk factor for delayed ischemic strokes. Here we report on the contribution of magnetic resonance vessel wall imaging (MR-VWI), performed on a 1.5 T scanner, to detect in-stent stenosis and mural inflammation in a 40-year-old woman with cerebral aneurysm previously treated with FDS and presenting with motor disturbances on follow-up. Digital subtraction angiography and cone-beam CT confirmed 1.5 T MRVWI findings, highlighting the potential value of this non-invasive imaging technique in investigating and detecting NIH.
Association of dynamic susceptibility contrast- and dynamic contrast-enhanced magnetic resonance imaging parameters with molecular marker status in lower-grade gliomas: A retrospective study
Authors: Ahn Sung Hee , Ahn Sung Soo , Park Yae Won , Park Chae Jung , Lee Seung-Koo 
Published: May 2022

Purpose Molecular marker status is clinically relevant for treatment planning and predicting the prognosis of gliomas. This study aimed to assess whether quantitative imaging parameters from dynamic susceptibility contrast- (DSC-) and dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) can predict the molecular marker status of lower-grade gliomas (LGGs). Materials and methods Overall, 132 patients with LGGs who underwent DSC- and DCE-MRI were retrospectively enrolled. Statuses of relevant molecular markers including isocitrate dehydrogenase isoenzyme (IDH), 1p19q codeletion, epidermal growth factor receptor (EGFR), O6-methylguanine-DNA methyltransferase (MGMT), and telomerase reverse transcriptase (TERT) were collected. For each molecular marker, age, tumor diameter and location, and DSC- and DCE-MRI parameters, including the normalized cerebral blood volume (nCBV), volume transfer constant (Ktrans), rate transfer coefficient (Kep), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp), were compared. Multivariable logistic regression analyses were performed. Results The nCBV was significantly lower in LGGs with IDH mutation ( p = .001) and TERT mutation ( p = .027) than those without these mutations. Ktrans ( p = .034), Ve ( p = .023), and Vp ( p = .044) values were significantly lower in MGMT methylated LGGs than in MGMT unmethylated LGGs. Perfusion parameters were not significantly associated with EGFR amplification and 1p19q codeletion. Young age ( p < .001) and small diameter ( p = .001) were significantly associated with IDH mutation. The nCBV was independently associated with IDH status (AUC, 0.817; 95% CI: 0.739–0.894). Conclusions DSC- and DCE-MRI parameters demonstrated correlations with molecular markers of LGGs. Especially, the nCBV can be helpful in predicting the IDH mutation status.
Negative pressure wound therapy over two ipsilateral external skeletal fixators for management of high grade open fractures in a cat
Authors: Karpozilou Athina , Frykfors von Hekkel Anna , Phillips Andrew 
Published: May 2022

Case summary A 7-month-old female neutered Bengal cat was referred to the Queen Mother Hospital for Animals following unknown trauma. Clinical and radiographic examination revealed a grade IIIB open, comminuted, mid-diaphyseal fracture of the left tibia and fibula, and grade IIIB open mid-diaphyseal fractures of the left metatarsals II–V. The fractures were stabilised with tibial and metatarsal external skeletal fixators. The open wounds were initially debrided surgically using conventional dressings, resulting in a small amount of circumferential granulation tissue formation by 10 days postoperatively. Following this 10-day period of conventional wound management, negative pressure wound therapy (NPWT) was applied over the external skeletal fixators and wounds. After 8 days of NPWT complete granulation tissue coverage was achieved in the tibial wound, and only small areas of two metatarsals remained exposed. The tibial wound was left to heal by second intention; a free meshed skin graft was applied to the pedal wound. Twenty weeks postoperatively, all wounds had completely healed and revision surgery with internal fixation was performed to treat a non-union of the tibia. Thirty weeks after the initial surgery, radiographic union of the tibia and metatarsals II–IV was confirmed. Relevance and novel information This is the first report of NPWT application over external fixation for the management of wounds associated with open fractures in veterinary medicine. This case was presented to introduce a novel, well-tolerated and simple technique for the management of tissue loss over an open fracture immobilised with external fixation.
Exploring the effect of an eHealth intervention on women's physical activity: Design and rationale for a randomized controlled trial
Authors: Black Melissa , Brunet Jennifer 
Published: May 2022

Objective This manuscript reports on the protocol for a three-arm randomized controlled trial aiming to assess the effect a self-determination theory-based eHealth intervention on physical activity among insufficiently active women who are overweight or obese. Methods The intervention-of-interest provided (A) six weekly behavioural support emails, (B) a wearable activity tracker, and (C) a copy and verbal explanation of the Canadian physical activity guidelines, and was compared to an intervention that provided (B + C) and another that provided (C). Women from a local community were invited to participate in this study. Participants were recruited between September 2018 and March 2019. Data were collected using self-report and direct measures three times: at baseline (week 0), post-intervention (week 7), and at follow-up (week 21). The primary outcome was self-reported total metabolic equivalent minutes of physical activity per week (MET-m/week); exploratory outcomes included number of days of strength training per week, self-determination theory constructs (i.e. motivational regulations, basic psychological needs satisfaction and thwarting), and well-being indicators (i.e. affect, vitality, depression). Conclusion Findings will provide insight into which combination of intervention components may be more effective at promoting physical activity among insufficiently active women who are overweight or obese, and thus inform the design of future interventions aiming to promote physical activity.
Podcasting and Education: Reflections on the Case of FreshEd
Authors: Brehm Will 
Published: May 2022

Highlights New media formats such as podcasts are revolutionizing the production and dissemination of knowledge in and outside of higher education. One danger is the rise of EdTech companies that have used the pandemic as an opportunity to increase profits as more individuals and systems of higher education rely on digital platforms and products. This report explores the revolutionary potential of podcasts as an education technology that does not necessarily further the privatization of education. The case of the FreshEd podcast is highlighted. The concept of “infrastructuralism” is used to show how an ethos of Open Science can challenge many exploitative academic conventions and social relations. The main problem of a digital infrastructure that does not use the profit motive, however, is sustainable financing.