bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discriminative Capacity of CT Volumetry to Identify Autonomous Cortisol Secretion in Incidental Adrenal Adenomas
Authors: Olmos Roberto , Mertens Nicolás , Vaidya Anand , Uslar Thomas , Fernandez Paula , Guarda Francisco J , Zúñiga Álvaro , San Francisco Ignacio , Huete Alvaro , Baudrand René 
Published: January 2022

Abstract

Context
Incidentally discovered adrenal adenomas are common. Assessment for possible autonomous cortisol excess (ACS) is warranted for all adrenal adenomas, given the association with increased cardiometabolic disease.

Objective
To evaluate the discriminatory capacity of 3-dimensional volumetry on computed tomography (CT) to identify ACS.

Methods
Two radiologists, blinded to hormonal levels, prospectively analyzed CT images of 149 adult patients with unilateral, incidentally discovered, adrenal adenomas. Diameter and volumetry of the adenoma, volumetry of the contralateral adrenal gland, and the adenoma volume-to-contralateral gland volume (AV/CV) ratio were measured. ACS was defined as cortisol ≥ 1.8 mcg/dL after 1-mg dexamethasone suppression test (DST) and a morning ACTH ≤ 15. pg/mL.

Results
We observed that ACS was diagnosed in 35 (23.4%) patients. Cortisol post-DST was positively correlated with adenoma diameter and volume, and inversely correlated with contralateral adrenal gland volume. Cortisol post-DST was positively correlated with the AV/CV ratio (r = 0.46, P &lt; 0.001) and ACTH was inversely correlated (r = −0.28, P &lt; 0.001). The AV/CV ratio displayed the highest odds ratio (1.40; 95% CI, 1.18-1.65) and area under curve (0.91; 95% CI, 0.86-0.96) for predicting ACS. An AV/CV ratio ≥ 1 (48% of the cohort) had a sensitivity of 97% and a specificity of 70% to identify ACS.

Conclusion
CT volumetry of adrenal adenomas and contralateral adrenal glands has a high discriminatory capacity to identify ACS. The combination of this simple and low-cost radiological phenotyping can supplement biochemical testing to substantially improve the identification of ACS.
Varying Dosages of Subcutaneous Unfractionated Heparin and Activated Partial Thromboplastin Time in Hospitalized Antepartum Patients: A Retrospective Cohort Analysis
Authors: Elmofty Dalia H. , Tucker Andrew , Wuenstel Andrew M. , Cheng Paul K. , Fox Edward , Knoebel Randall , Liao Chuanghong , Scavone Barbara 
Published: January 2022

BACKGROUND:
Venous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality in the United States. Subcutanous unfractionated heparin (UFH) has been used for decades for VTE prophylaxis and under many obstetric quality of care initiatives, hospitalized antepartum patients now receive doses as high as 10,000 units every 12 hours. This practice increases the likelihood of UFH administration around the time that epidural labor analgesia is requested or neuraxial analgesia for cesarean delivery is needed. To clarify the effect of UFH on coagulation, we reviewed the care of hospitalized antepartum patients receiving VTE prophylaxis with UFH to determine the incidence of concurrent abnormal activated partial thromboplastin time (aPTT) values and associated risk factors.

METHODS:
This retrospective cohort study used data from the University of Chicago Pharmacy database to identify hospitalized antepartum patients receiving subcutaneous UFH from June 1, 2016 to July 1, 2019. Our institutional protocol states that all patients hospitalized for antepartum conditions should receive pharmacologic prophylaxis empirically unless contraindicated. For patients receiving UFH, dosing was based on gestational age: 5000 units every 12 hours for first trimester antepartum patients, 7500 units every 12 hours for second trimester patients, and 10,000 units every 12 hours for patients in the third trimester. As per protocol, aPTT values were obtained 2 hours after the third dose of heparin, and platelet counts after 4 days. Data collection included demographics, comorbidities, heparin doses, aPTT values, platelet counts, creatinine if available, and anesthetic type and complications. Logistic regression was performed to determine the association between elevated aPTT >40 seconds and study variables.

RESULTS:
Of the 321 antepartum patients who received subcutaneous UFH, 33 (10.3%) had an aPTT >40 seconds, 4 of those 33 patients (12.1%) received 5000 units every 12 hours, 14 (42.2%) received 7500 units every 12 hours, and 15 (45.5%) received 10,000 units every 12 hours. The likelihood of a patient having aPTT >40 seconds was 2.8% with 5000 units every 12 hours, 18.9% with 7500 units every 12 hours, and 14.6% with 10,000 units every 12 hours.

CONCLUSIONS:
Elevated aPTT values are likely with total daily doses of 15,000 or 20,000 units subcutaneous UFH in hospitalized antepartum patients.
The Association of Laryngeal Position on Videolaryngoscopy and Time Taken to Intubate Using Spatial Point Pattern Analysis of Prospectively Collected Quality Assurance Data
Authors: Miller Matthew R. , Gemal Hugo , Ware Sandra , Hayes-Bradley Clare 
Published: January 2022

BACKGROUND:
During videolaryngoscopy (VL), the larynx appears within the defined area of the video screen, and its location can be measured as a point within this space. Spatial statistics offer methods to explore the relationship between location data and associated variables of interest. The aims of this study were to use spatial point pattern analysis to explore if the position of the larynx on VL is associated with longer times to intubate, increased risk of a needing >1 intubation attempt, or percentage of glottic opening.

METHODS:
Quality assurance data and clinical notes from all prehospital intubations using C-MAC Pocket Monitor with CMAC-4 blade (Karl Storz) from January 1, 2018, to July 31, 2020, were reviewed. We extracted 6 measurements corresponding to the time taken to obtain the initial and then best laryngeal view, time to manipulate a bougie, and time to place the endotracheal tube, as well a percentage of glottic opening and a number of intubation attempts. Larynx location was the middle of the base of glottis, in cm from the left and bottom on the C-MAC screen. Two plots were produced to summarize the base of glottis location and time to perform each time component of intubation. Next, a cross mark function and a maximum absolute deviation hypothesis test were performed to assess the null hypotheses that the spatial distributions were random. The association between glottis location and >1 intubation attempt was assessed by a spatial relative risk plot.

RESULTS:
Of 619 eligible intubations, 385 had a video for analysis. The following time variables had a nonrandom spatial distribution with a tendency for longer times when the larynx was off-center to the top or right of the screen: laryngoscope passing from teeth to glottis, glottis first view to best view of the larynx, time from bougie appearing to being placed in the cords, and overall time from teeth to endotracheal tube passing through cords. There was no increased relative risk for >1 intubation attempt.

CONCLUSIONS:
Spatial point pattern analysis identified a relationship between the position of the larynx during VL and prolonged intubation times. We did not find a relationship between larynx location and >1 attempt. Whether the location of the larynx on the screen is a marker for difficult VL or if optimizing the larynx position to the center of the screen improves intubation times would require further prospective studies.
Myotonic dystrophy type 1 embryonic stem cells show decreased myogenic potential, increased CpG methylation at the DMPK locus and RNA mis-splicing
Authors: Franck Silvie , Couvreu De Deckersberg Edouard , Bubenik Jodi L. , Markouli Christina , Barbé Lise , Allemeersch Joke , Hilven Pierre , Duqué Geoffrey , Swanson Maurice S. , Gheldof Alexander , Spits Claudia , Sermon Karen D. 
Published: January 2022

ABSTRACT
Skeletal muscle tissue is severely affected in myotonic dystrophy type 1 (DM1) patients, characterised by muscle weakness, myotonia and muscle immaturity in the most severe congenital form of the disease. Previously, it was not known at what stage during myogenesis the DM1 phenotype appears. In this study we differentiated healthy and DM1 human embryonic stem cells to myoblasts and myotubes and compared their differentiation potential using a comprehensive multi-omics approach. We found myogenesis in DM1 cells to be abnormal with altered myotube generation compared to healthy cells. We did not find differentially expressed genes between DM1 and non-DM1 cell lines within the same developmental stage. However, during differentiation we observed an aberrant inflammatory response and increased CpG methylation upstream of the CTG repeat at the myoblast level and RNA mis-splicing at the myotube stage. We show that early myogenesis modelled in hESC reiterates the early developmental manifestation of DM1.
Non-Aqueous Liquid Phase Synthesis of Acetic Acid via Ionic Liquid Promoted Homogeneous Carbonylation of Methanol over Ir(III) Catalysts
Authors: Zhang Qiang , He Anbang , Xiao Wen , Du Jun , Liu Zuohua , Tao Changyuan 
Published: January 2022

Abstract
Carbonylation of methanol to acetic acid is an aqueous homogeneous catalytic process widely used in industry. In the existing methanol carbonylation industry, a large amount of water (14–15 wt.%) is required in the Monsanto process to inhibit catalyst deactivation, which also consumes a lot of energy to separate the water from the acetic acid product. Here, non-aqueous liquid phase synthesis of acetic acid was carried out by ionic liquid promoted homogeneous carbonylation of methanol over Ir(III) catalysts. It was found that 1-butyl-3-methylimidazolium bis(trifluoromethanesulfonyl)imide ([Bmim]Tf2N) and N-butyl pyridinium bis(trifluoromethanesulfonyl)imide ([BPy]Tf2N) could promote the acetic acid selectivity (&gt;98%) and methanol conversion (&gt;99%) under a relatively mild reaction condition of 160 °C and 3.0 MPa. In the reaction, Tf2N− formed an Ir*[Tf2N] complex with Ir to promote the stability of Ir and enhance the activation of CO. From DFT calculation results, the CO insertion was a rate controlling step on the Ir-base catalyst in the reaction cycle, determining the conversion and selectivity of the reaction. The oxygen and nitrogen groups from Tf2N− interacted with Ir to form an Ir*[Tf2N] complex, which could effectively reduce the energy barrier of the CO insertion step, enhancing the selectivity of HAc. Moreover, the catalyst system could be easily recycled and reused with the methanol conversion of 89.66% after five cycles. The methanol carbonylation based on the ionic liquid promoted catalyst is a promising non-aqueous liquid-phase sustainable process.
Sport-Related Concussion Preceding Adrenal Insufficiency and Hypopituitarism
Authors: Northam Weston T. , Alexander Andrew , Carneiro Kevin A. 
Published: January 2022

Abstract
A 49-year-old woman with a history of daily inhaled corticosteroid use for asthma presented to a concussion clinic 7 wk after sport-related head injury with headache, visual blurring, dizziness, nausea, fatigue, polydipsia, and polyuria. Examination revealed difficulty with vestibulo-occulomotor testing due to nausea and visual straining. Cranial CT/MR imaging was unremarkable. Laboratory testing revealed critically low serum cortisol, hypernatremia, and urine studies suggesting diabetes insipidus. The patient was referred to the emergency department. Intravenous fluid resuscitation, corticosteroids, and desmopressin led to significant symptomatic relief. She was maintained on oral hydrocortisone after cosyntropin test revealed adrenal insufficiency. Her clinical picture suggested chronic subclinical adrenal suppression from inhaled corticosteroids, which was exacerbated by hypopituitarism possibly from concussion combined with diabetes insipidus. Adrenal insufficiency should be considered in athletes with history of corticosteroid use and endocrine-related symptoms after concussion, because this can create significant morbidity and can mimic traditional symptoms of concussion.
Novel antifungal agents in clinical trials
Authors: Jacobs Samantha E. , Zagaliotis Panagiotis , Walsh Thomas J. 
Published: January 2022

Invasive fungal diseases due to resistant yeasts and molds are an important and increasing public health threat, likely due to a growing population of immunosuppressed hosts, increases in antifungal resistance, and improvements in laboratory diagnostics. The significant morbidity and mortality associated with these pathogens bespeaks the urgent need for novel safe and effective therapeutics. This review highlights promising investigational antifungal agents in clinical phases of development: fosmanogepix, ibrexafungerp, rezafungin, encochleated amphotericin B, oteseconazole (VT-1161), VT-1598, PC945, and olorofim. We discuss three first-in-class members of three novel antifungal classes, as well as new agents within existing antifungal classes with improved safety and tolerability profiles due to enhanced pharmacokinetic and pharmacodynamic properties.
Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study
Authors: Barakat Muna , A. AlSalamat Husam , Jirjees Feras , Al-Obaidi Hala , k. Hussain Zainab , El Hadidi Seif , Mansour Sara , Malaeb Diana , Hosseini Hassan 
Published: January 2022

Background and objective: Stroke is the second leading cause of death in Jordan and over the world. Knowledge and awareness towards stroke play a crucial role in the management and prevention of its complications. This study aims to assess the knowledge and awareness about stroke among the Jordanian population and determine factors associated with stroke awareness. Methods: This cross-sectional study through a web-based anonymous questionnaire that needed 10 minutes to be completed. It examined sociodemographic characteristics and recognition of the risk factors, warning signs, stroke consequences, and early response to stroke symptoms. Logistic regression analysis identified the factors associated with poor knowledge of stroke. Results: A total of 573 Jordanian adults participated in this study. The participant's ability to identify at least one early symptom of stroke and the proper response to the symptoms were significantly correlated with the educational level (OR of 3.4 and 2.5, respectively). At least one consequence of stroke was significantly associated with different demographic factors such as gender, socioeconomic income, females versus males and those with medium income versus low income had significantly higher odds (OR of 6.6 and 4.1, respectively). Conclusion: This study revealed a good knowledge and awareness level about stroke among Jordanians correlated mainly with their educational level. Therefore, new strategies should be considered to decrease the prevalence of stroke in Jordan, including the need for engagement in enhanced awareness campaigns.
Sub-chronic effects of Baccharis dracunculifolia treatment on biochemical, oxidative, and histopathological parameters in diabetic rats
Authors: Pereira Ricardo Aparecido , Hey Albimara , de Carli Alexandre Lustoza , Sanches Camila Garcia Salvador , Bordion Jardel Cristiano , Iurckevicz Genice , Wouk Jessica , Almeida Pablo , da Silva Luiz Augusto , Penteado Rozilda , Prasniewski Anaclara , Oldoni Tatiane Luiza Cadorin , Dangui Anayana Zago , Malfatti Carlos Ricardo Maneck 
Published: January 2022

Background: Oxidative stress and the mild inflammatory process present in diabetes play a critical role in the pathogenesis of the disease and its comorbidities. This understanding has opened new avenues and targets for developing improved treatments since the risk factors associated with diabetes may be reduced through non-pharmacological interventions. In this sense, plant extracts could be efficient in preventing or assisting these pathological conditions treatment. Methods: Diabetes mellitus was induced in 24 rats, which were allocated in 4 groups: Control (CT), Control+Baccharis (CT-B), Diabetes (DB), and Diabetes+Baccharis (DB-B). For 28 days, the animals of CT-B and DB-B groups were treated, via gavage, with B. dracunculifolia extract at 50 mg.kg-1. Results: The DB group presented higher values than the DB-B group on parameters such as creatinine (26.42%), urea (31.42%), and triglycerides (60.80%). Creatinine and triglycerides values of DB-B group (0.39±0.01 e 75.0±8.4, receptively) were equivalent to the values of CT group (0.32±0.01 e 71.7±5.4) and of CT-B group (0.39±0.01, and 58.8±4.5). The treatment with B. dracunculifolia improved the levels of fasting glucose and response of glucose tolerance (32%), insulin (52,17%) and lipid peroxidation (liver 33.33%, kidney 38.77%) when compared to the DB group. Conclusions: The phenolic compounds and the anti-inflammatory activity of the extract of Baccharis dracunculifolia may be responsible for the hypoglycemic effect observed in the study.
Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education
Authors: Rafi Aisha , Anwar Muhammad Idrees , Younas Ayesha , Manzoor Shamaila 
Published: January 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed the world’s economy, health and education in a blink of an eye. Almost 1 billion learners have been affected across the globe. This has resulted in a paradigm shift to blended learning. Therefore, it was felt necessary to provide practical guidelines for the development of blended curriculum in medical education. It would help to overcome the challenges faced due to unprecedented transformation of medical education on account of pandemic. Methods: Guidelines based on personal experience of the authors and literature search were developed using the complex adapted blended learning system (CALBS) framework. Seven experts developed these guidelines using the nominal group technique. The consent form and literature for CABLS framework was shared with experts. The experts developed the guidelines independently during phase one of the technique. After a given time, phase 2 started with moderator mediated discussion about the individual guidelines developed by the experts. After discussion and mutual consensus four types of guideline ideas were developed. During the third phase the experts ranked the guideline ideas on a scale of 1 to 5. The guideline idea that ranked highest was selected as a final guideline for developing a blended learning curriculum. Results: The group consensus resulted in developing seven guidelines for a blended course or curriculum in medical education. These guidelines are based on a conceptual framework supplemented by expert’s own personal experience and current evidence from literature. Conclusions: These guidelines would provide a comprehensive and systematic approach to develop a blended learning curriculum in medical education.
FORMATION OF MORAL CONSCIOUSNESS PRIMARY SCHOOL CHILDREN BASED ON COMPETENCE APPROACH
Authors: Vyalikova Galina , Finikova Julia , Hackalo Snezhana 
Published: January 2022

The article examines some aspects of the formation of the moral consciousness of modern schoolchildren on the basis of one of the leading methodological principles - the competence-based approach.
Large-scale changes taking place in various spheres of society, new social and economic reality, developing market relations, digitalization, modernization of Russian education require a revision of the strategy and tactics of educating the younger generation in terms of solving the problems of forming high moral qualities of the personality of students, including primary school age. But is a modern teacher competent enough to successfully cope with the multitasking of real pedagogical reality, including the moral education of schoolchildren?
The study of the problem under consideration in theory and in practice shows that moral education is significant, first of all, because it permeates all aspects of education: mental, aesthetic, physical, labor, environmental, etc. Hence, its backbone nature is obvious. Any human action presupposes a moral aspect, including the regulatory function of morality.
All of the above served as the basis for choosing the topic of the article. According to the authors, the results and conclusion of this article can, to a certain extent, actualize the problem of the formation of the moral consciousness of primary schoolchildren from the standpoint of the competence-based approach and outline ways to solve it.
Incidence and predictors of anemia among adults on HIV care at South Gondar Zone Public General Hospital Northwest Ethiopia, 2020; retrospective cohort study
Authors: Tigabu Agimasie , Beyene Yeshiwork , Getaneh Temesgen , Chekole Bogale , Gebremaryam Tigist , Sisay Chanie Ermias , Selomom Nigusie , Alene Tamiru , Aragie Getachew , Legas Getasew , Dessie Getnet 
Published: January 2022

BackgroundAnemia is a major public health problem worldwide which accounts 24.8% of the population. Subsequently, anemia is a leading killer of people living with human immunodeficiency virus and many of these deaths occur in developing countries including Ethiopia. Cross sectional studies have done on anemia and human immunodeficiency virus. However, there is limited study on incidence of anemia and its predictors among adults on HIV care, especially no survival study has been conducted in the study area.ObjectiveTo assess incidence and predictors of anemia among adults on Human immunodeficiency virus care.MethodsAn institution-based retrospective cohort study was conducted among 434 adults on HIV care from January 1st2015 to December 30th2019 at Debre Tabor Referral Hospital. A computer-generated simple random sampling technique was employed to select the study participants. Ethical clearance was obtained from the Institutional Review Board of Bahir Dar University, and also, we got implied consent to review charts from the concerned bodies in the hospital. Data were entered using Epi-data version 3.1 and analyzed by using STATA version 14.0. A Kaplan Meier survival curve was utilized to estimate anemia free survival time. Bivariable and Multivariable Cox proportional hazards model were fitted to identify predictors of anemia.ResultsThe overall incidence density rate of anemia was 6.27 (95% CI: 0.051, 0.077) per 100 person years. Clinical stage III/IV (AHR = 1.04; 95% CI = 1.02, 1.06), Body Mass Index less than 18.5 kg/m2 (AHR = 3.11; 95% CI = 1.56, 6.22), serum creatinine greater than 1.1 IU/L(AHR = 2.07; 95% CI = 1.12, 3.81) and fair/poor level of adherence(AHR = 1.05; 95% CI = 1.03, 1.07) were statistically significant predictors of anemia while increased anti-retroviral treatment duration (AHR = 0.98; 95% CI = 0.97, 0.99) decrease the risk of anemia at 95% confidence level.ConclusionThe overall incidence density rate of anemia was high. Patients with clinical stage III/IV, body mass index < 18.5 kg/m2, serum creatinine greater than 1.1 IU/L and fair/poor level of adherence were significant predictors of anemia while increased antiretroviral treatment duration had decreased the risk of anemia.RecommendationEven if the overall incidence rate of anemia was lower as compared to previous studies in Ethiopia, still the incidence of anemia was high. So, prevention measures should be taken beside with HIV care especially within 6-months ART initiation.