bluuebunny/crossref_metadata_2025_split huggingface dataset:
Augmented reality-assisted systematic mapping of anterolateral thigh perforators
Authors: Tang Yifu , Guo Qiang , Li Xiaoning , Huang Yuzhao , Kuang Wei , Luo Ling 
Published: December 2022

Abstract
Purpose
In soft tissue reconstructive surgery, perforator localization and flap harvesting have always been critical challenges, but augmented reality (AR) has become a dominant technology to help map perforators.

Methods
The lateral circumflex femoral artery (LCFA) and its perforators were reconstructed by CTA in consecutive patients (N = 14). Then, the anterolateral thigh perforators and the points from which the perforators emerged from the deep fascia were marked and projected onto the skin surface. As the virtual images were projected onto patients according to bony markers, the courses of the LCFA and its perforators were depicted on the skin surface for intraoperative guidance. Finally, the locations of the emergence points were verified by intraoperative findings and compared to those determined by handheld Doppler ultrasound.

Results
The sources, locations, and numbers of perforators were determined by CTA. The perforators and their emergence points were accurately mapped on the skin surface by a portable projector to harvest the anterolateral thigh perforator flap. During the operation, the accuracy of the CTA & AR method was 90.2% (37/41), and the sensitivity reached 97.4% (37/38), which were much higher than the corresponding values of Doppler ultrasound. Additionally, the differences between the AR-marked points and the intraoperative findings were much smaller than those seen with Doppler ultrasound (P < 0.001). Consequently, all of the flaps were well designed and survived, and only one complication occurred.

Conclusion
Augmented reality, namely, CTA combined with projection in this study, plays a vital and reliable role in locating the perforator emergence points and guiding the procedure to harvest flaps and has fewer potential risks.
An elderly patient with 17α-hydroxylase deficiency misdiagnosed as primary aldosteronism: a case report
Authors: Ishinoda Yuki , Uto Asuka , Yamada Yoshifumi , Okazaki Maki , Asada Hidetomo , Wakamatsu Seina , Kurihara Isao , Shibata Hironori , Ishii Tomohiro , Hasegawa Tomonobu , Kumagai Hiroo , Kasuga Akira 
Published: December 2022

Abstract
Background
17α-hydroxylase deficiency (17OHD) is a rare autosomal recessive disorder. Aldosterone levels are usually low in patients with 17OHD. However, among the approximately 150 cases of 17OHD reported to date, aldosterone levels were not low in all cases. Therefore, some 17OHD cases may have been misdiagnosed as primary aldosteronism (PA) cases. Often before puberty, 17OHD is diagnosed because of abnormal genital morphology and menstrual irregularities. However, we report a very rare case of 17OHD in an elderly patient with a high aldosterone/renin ratio (ARR) similar to that in PA.

Case presentation
A 63-year-old Japanese woman was transferred to our medical facility for the evaluation of bilateral adrenal hypertrophy, which was incidentally discovered during an abdominal examination after cholecystectomy. The patient had hypokalemia and a high aldosterone/renin ratio. Her medical history included hypertension and right intracerebral capsular hemorrhage at the age of 30 years. Additional testing revealed low cortisol, high adrenocorticotropic hormone, and low testosterone and dehydroepiandrosterone sulfate, indicating congenital adrenal hyperplasia. Genetic analysis revealed a mutation in the CYP17A1 gene and a karyotype of 46, XY; hence, she was diagnosed with 17OHD.

Conclusion
17OHD can resemble PA. The combination of a high ARR and low cortisol level should trigger the consideration of 17OHD.
Presuppositions, cost–benefit, collaboration, and competency impacts palliative care referral in paediatric oncology: a qualitative study
Authors: Salins Naveen , Hughes Sean , Preston Nancy 
Published: December 2022

AbstractBackgroundAlthough a significant proportion of children with cancer need palliative care, few are referred or referred late, with oncologists and haematologists gatekeeping the referral process. We aimed to explore the facilitators and barriers to palliative care referral.MethodsTwenty-two paediatric oncologists and haematologists were purposively recruited and interviewed. Data were analysed using reflexive thematic analysis. Findings were interpreted using the critical realist paradigm.ResultsFour themes were generated. 1) Oncologists expressed concern about the competency of palliative care teams. Palliative care often symbolised therapeutic failure and abandonment, which hindered referral. Trustworthy palliative care providers had clinical competence, benevolence, and knowledge of oncology and paediatrics. 2) Making a palliative care referral was associated with stigma, navigating illness-related factors, negative family attitudes and limited resources, impeding palliative care referral. 3) There were benefits to palliative care referral, including symptom management and psychosocial support for patients. However, some could see interactions with the palliative care team as interference hindering future referrals. 4) Suggested strategies for developing an integrated palliative care model include evident collaboration between oncology and palliative care, early referral, rebranding palliative care as symptom control and an accessible, knowledgeable, and proactive palliative care team.ConclusionPresuppositions about palliative care, the task of making a referral, and its cost-benefits influenced referral behaviour. Early association with an efficient rebranded palliative care team might enhance integration.
Relationships between biological age, distance from aquatic habitats and pyrethroid resistance status of Anopheles funestus mosquitoes in south-eastern Tanzania
Authors: Pinda Polius G. , Msaky Dickson S. , Muyaga Letus L. , Mshani Issa H. , Njalambaha Rukiyah M. , Kihonda Japhet , Bwanaly Hamis , Ngowo Halfan S. , Kaindoa Emmanuel W. , Koekemoer Lizette L. , Okumu Fredros O. 
Published: December 2022

Abstract
Background
Malaria transmission can be highly heterogeneous between and within localities, and is influenced by factors such as survival and biting frequencies of Anopheles mosquitoes. This study investigated the relationships between the biological age, distance from aquatic habitats and pyrethroid resistance status of Anopheles funestus mosquitoes, which currently dominate malaria transmission in south-east Tanzania. The study also examined how such relationships may influence malaria transmission and control.

Methods
Female An. funestus were collected in houses located 50–100 m, 150–200 m or over 200 m from the nearest known aquatic habitats. The mosquitoes were exposed to 1×, 5× and 10× the diagnostic doses of deltamethrin or permethrin, or to the synergist, piperonyl butoxide (PBO) followed by the pyrethroids, then monitored for 24 h-mortality. Ovaries of exposed and non-exposed mosquitoes were dissected to assess parity as a proxy for biological age. Adults emerging from larval collections in the same villages were tested against the same insecticides at 3–5, 8–11 or 17–20 days old.

Findings
Mosquitoes collected nearest to the aquatic habitats (50-100 m) had the lowest mortalities compared to other distances, with a maximum of 51% mortality at 10× permethrin. For the age-synchronized mosquitoes collected as larvae, the insecticide-induced mortality assessed at both the diagnostic and multiplicative doses (1×, 5× and 10×) increased with mosquito age. The highest mortalities at 1× doses were observed among the oldest mosquitoes (17–20 days). At 10× doses, mortalities were 99% (permethrin) and 76% (deltamethrin) among 8–11 day-olds compared to 80% (permethrin) and 58% (deltamethrin) among 3–5 day-olds. Pre-exposure to PBO increased the potency of both pyrethroids. The proportion of parous females was highest among mosquitoes collected farthest from the habitats.

Conclusion
In this specific setting, older An. funestus and those collected farthest from the aquatic habitats (near the centre of the village) were more susceptible to pyrethroids than the younger ones and those caught nearest to the habitats. These findings suggest that pyrethroid-based interventions may remain at least moderately effective despite widespread pyrethroid-resistance, by killing the older, less-resistant and potentially-infective mosquitoes. Further studies should investigate how and whether these observations could be exploited to optimize malaria control in different settings.
18F-FET PET radiomics-based survival prediction in glioblastoma patients receiving radio(chemo)therapy
Authors: Wiltgen Tun , Fleischmann Daniel F. , Kaiser Lena , Holzgreve Adrien , Corradini Stefanie , Landry Guillaume , Ingrisch Michael , Popp Ilinca , Grosu Anca L. , Unterrainer Marcus , Bartenstein Peter , Parodi Katia , Belka Claus , Albert Nathalie , Niyazi Maximilian , Riboldi Marco 
Published: December 2022

Abstract
Background
Quantitative image analysis based on radiomic feature extraction is an emerging field for survival prediction in oncological patients. 18F-Fluorethyltyrosine positron emission tomography (18F-FET PET) provides important diagnostic and grading information for brain tumors, but data on its use in survival prediction is scarce. In this study, we aim at investigating survival prediction based on multiple radiomic features in glioblastoma patients undergoing radio(chemo)therapy.

Methods
A dataset of 37 patients with glioblastoma (WHO grade 4) receiving radio(chemo)therapy was analyzed. Radiomic features were extracted from pre-treatment 18F-FET PET images, following intensity rebinning with a fixed bin width. Principal component analysis (PCA) was applied for variable selection, aiming at the identification of the most relevant features in survival prediction. Random forest classification and prediction algorithms were optimized on an initial set of 25 patients. Testing of the implemented algorithms was carried out in different scenarios, which included additional 12 patients whose images were acquired with a different scanner to check the reproducibility in prediction results.

Results
First order intensity variations and shape features were predominant in the selection of most important radiomic signatures for survival prediction in the available dataset. The major axis length of the 18F-FET-PET volume at tumor to background ratio (TBR) 1.4 and 1.6 correlated significantly with reduced probability of survival. Additional radiomic features were identified as potential survival predictors in the PTV region, showing 76% accuracy in independent testing for both classification and regression.

Conclusions
18F-FET PET prior to radiation provides relevant information for survival prediction in glioblastoma patients. Based on our preliminary analysis, radiomic features in the PTV can be considered a robust dataset for survival prediction.
The effectiveness of using virtual reality technology for perioperative anxiety among adults undergoing elective surgery: a randomised controlled trial protocol
Authors: Asiri Salihah , Guilhermino Michelle , Duff Jed 
Published: December 2022

AbstractBackgroundMore than 2.5 million people are admitted for surgery in Australia each year, and between 40 to 80% will experience moderate to high preoperative anxiety. Elevated levels of preoperative anxiety can increase the risk of postoperative complications such as pain, delayed wound healing, infection, prolonged recovery, and longer hospitalisation. Limited previous research on Virtual Reality (VR) indicates a positive impact on surgery-related anxiety and suggests that the intervention potentially leads to reduce postoperative complications.ObjectiveTo evaluate the effectiveness of using VR technology for perioperative anxiety among adults undergoing elective surgery.MethodA two-group parallel randomised controlled trial (RCT) will be conducted, including 150 adult patients (aged 18 years and over) undergoing elective surgery and requiring an overnight stay at a major metropolitan hospital. Eligible participants will be screened for anxiety via the Amsterdam Preoperative Anxiety and Information score (APAIS). Those with moderate to severe anxiety will be randomly allocated to receive the VR session or usual care, in the preoperative holding area. Intervention participants will use a head-mounted VR device to watch and listen to a nature scene for 10 minutes.Study outcomesThe primary outcome is perioperative anxiety measured using the visual analogue scale for anxiety (VAS-A). Secondary outcomes include stress levels (measured by saliva cortisol level and heart rate), postoperative pain, patient satisfaction with perioperative care, hospital length of stay, and VR-associated adverse events.ConclusionThis study will help evaluate if a brief preoperative VR session can reduce perioperative anxiety for adult elective surgical patients.Trial registrationAustralia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001350910.
Treatment of pregnant and early postpartum women with severe and critical COVID-19: experience at a tertiary center
Authors: Barbosa Rodrigo Nacif , Braga Maria Aparecida , Costa Bárbara Braga , Peret Frederico José Amedee 
Published: December 2022

AbstractBackgroundThe management of acute respiratory failure during pregnancy is a poorly defined issue in the literature, especially regarding the use of the prone position and the appropriate time for delivery. This study describes our experience in treating pregnant and postpartum women with severe or critical coronavirus disease 2019 (COVID-19).Materials and methodsThis descriptive retrospective study included 25 pregnant and 4 postpartum women admitted to an ICU due to respiratory complications from COVID-19 from June 2020 to August 2021.ResultsThe mean maternal age was 33.6 years, and the median gestational age (GA) at admission was 33 weeks. Obesity was the most common comorbidity. The median time between symptom onset and ICU admission was 10 days, while the median length of ICU stay was 14 days. Invasive mechanical ventilation (IMV) was required in 16 (55.2%) patients for a median time of 16.5 days. Prone positioning (PP) was performed in 68.7% of the patients on IMV, and resulted in an expressive increase in arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio). Eleven (44%) pregnant women delivered during their ICU stay for obstetric or fetal reasons: of these, 2 (18%) developed postpartum hemorrhagic shock and 1 (9%) developed abdominal wall infection. None of the 25 pregnant women underwent delivery due to acute respiratory failure or in an attempt to avoid intubation. There were 2 fetal deaths, but no maternal or neonatal deaths.ConclusionWe observed favorable outcomes in pregnant and postpartum women with severe and critical COVID-19 admitted to our institution. This finding reinforces the effectiveness of PP in the treatment of hypoxemic respiratory failure secondary to COVID-19 in pregnant women undergoing IMV, and suggests that gestation should only be interrupted in cases of obstetric and fetal complications, provided the patient is stable, or when hypoxemia is refractory to PP.
Exposure assessment and risk characterization of aflatoxins intake through consumption of maize (Zea mays) in different age populations in the Volta Region of Ghana
Authors: Kortei Nii Korley , Annan Theophilus , Dzikunoo John , Agbetiameh Daniel 
Published: December 2022

AbstractAflatoxin contamination in foods is a vital health challenge for low and middle-income countries in subtropical regions. Maize (Zea mays L.), a staple food most widely grown in Africa including Ghana, and extensively consumed as much as three times per day, is a source of aflatoxin contamination owing to its susceptibility to fungal infection. Aflatoxin levels were checked against international (European Commission, EC) and local (Ghana Standards Authority, GSA) standards, and health risks associated with maize sampled from the Volta Region (Hohoe, Ho, Battor Dugame, and Keta) of Ghana were determined. Total aflatoxins (totalAFs) and the constituent aflatoxins (AFB1, AFB2, AFG1, and AFG2) were measured with High-Performance Liquid Chromatography (HPLC) with a Fluorescence Detector (FLD). Intake and Risk assessments were also conducted using deterministic models prescribed by the Joint FAO/WHO Expert Committee on Additives (JECFA). The degree of occurrence of aflatoxins was observed to be in decreasing order of AFG2 < AFG1 < AFB2 < AFB1 and were within the ranges of 0.78 ± 0.04 $$-$$
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234.73 ± 3.8 µg/kg, 0.47 ± 0.03 $$-$$
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21.6 ± 0.33 µg/kg, 1.01 ± 0.05 $$-$$
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13.75 ± 1.2 µg/kg and 0.66 ± 0.06 $$-$$
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5.51 ± 0.26 µg/kg respectively. Out of the 100 samples analyzed for total aflatoxins (totalAFs), 68 (68%) exceeded the limits of EC and were of range 4.98 ± 0.6 $$-$$
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445.01 ± 8.9 µg/kg whereas 58 (58%) and ranged between 12.12 ± 1.4 $$-$$
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445.01 ± 8.9 µg/kg exceeded GSA limits. Intake and risk assessments of total aflatoxins (totalAFs) for infants, toddlers, children, adolescents, and adults in the Volta Region were; 0.037–1.14 µg/kg bw/day, 0.35–10.81, and 1.47 -45.14 cases/10,000 person/yr respectively for Estimated Daily Intake (EDI), Margin of Exposure (MOE), and Cancer Risks. It was inferred that the consumption of maize posed potential adverse health effects on all age categories studied because all calculated MOE values were less than 10,000.
The Resistance Exercise in Already Active Diabetic Individuals (READI) Randomized Clinical Trial
Authors: Sigal Ronald J , Yardley Jane E , Perkins Bruce A , Riddell Michael C , Goldfield Gary S , Donovan Lois , Malcolm Janine , Hadjiyannakis Stasia , Edwards Alun L , Gougeon Réjeanne , Wells George A , Pacaud Danièle , Woo Vincent , Ford Gordon T , Coyle Doug , Phillips Penny , Doucette Steve , Khandwala Farah , Kenny Glen P ,   the READI Trial Investigators, Phillips Penny , Mitchell Diana , Richardson Janet , Gilchrist Colleen , Rouatt Sharon , Orszag Andrej , Baughan Lynn , Clearwaters Mary Ann , Ilnyckyj Maria , Pockett Sheri , Berard Lori , Hind Krista , Wein Marta , Robertson Kimberly , Phillips Kelley , Hanlon Brittany , Santilli Antonio , Potter Dave , Jarvis Chris , Jarvie Ian , Petrie Alison , Ori Elaine , Wood Blake , Despielgelaere Marc , Murphy Ann , Gillam Melanie , Zarn Dayna , Janzen Laela 
Published: December 2022

AbstractContextResistance exercise training (strength training) and aerobic exercise training are both recommended for people with type 1 diabetes, but it is unknown whether adding resistance exercise provides incremental benefits in people with this condition who already perform aerobic exercise regularly.ObjectiveThis work aimed to evaluate the incremental effect of resistance training on glycated hemoglobin A1c (HbA1c), fitness, body composition, and cardiometabolic risk factors in aerobically active people with type 1 diabetes.MethodsThe Resistance Exercise in Already-active Diabetic Individuals (READI) trial (NCT00410436) was a 4-center, randomized, parallel-group trial. After a 5-week run-in period with diabetes management optimization, 131 aerobically active individuals with type 1 diabetes were randomly assigned to resistance exercise (n = 71, intervention—INT) or control (n = 60, CON) for 22 additional weeks. Both groups maintained their aerobic activities and were provided dietary counseling throughout. Exercise training was 3 times per week at community-based facilities. The primary outcome was HbA1c, and secondary outcomes included fitness (peak oxygen consumption, muscle strength), body composition (anthropometrics, dual-energy x-ray absorptiometry, computed tomography), and cardiometabolic risk markers (lipids, apolipoproteins). Assessors were blinded to group allocation.ResultsThere were no significant differences in HbA1c change between INT and CON. Declines in HbA1c (INT: 7.75 ± 0.10% [61.2 ± 1.1 mmol/mol] to 7.55 ± 0.10% [59 ± 1.1 mmol/mol]; CON: 7.70 ± 0.11% [60.7 ± 1.2 mmol/mol] to 7.57 ± 0.11% [59.6 ± 1.3 mmol/mol]; intergroup difference in change −0.07 [95% CI, −0.31 to 0.18]). Waist circumference decreased more in INT than CON after 6 months (P = .02). Muscular strength increased more in INT than in CON (P &lt; .001). There were no intergroup differences in hypoglycemia or any other variables.ConclusionAdding resistance training did not affect glycemia, but it increased strength and reduced waist circumference, in aerobically active individuals with type 1 diabetes.
Glucagon-like Peptide-2 Acutely Enhances Chylomicron Secretion in Humans Without Mobilizing Cytoplasmic Lipid Droplets
Authors: Syed-Abdul Majid Mufaqam , Stahel Priska , Zembroski Alyssa , Tian Lili , Xiao Changting , Nahmias Avital , Bookman Ian , Buhman Kimberly K , Lewis Gary F 
Published: December 2022

AbstractContextA portion of ingested fats are retained in the intestine for many hours before they are mobilized and secreted in chylomicron (CM) particles. Factors such as glucagon-like peptide-2 (GLP-2) and glucose can mobilize these stored intestinal lipids and enhance CM secretion. We have recently demonstrated in rodents that GLP-2 acutely enhances CM secretion by mechanisms that do not involve the canonical CM synthetic assembly and secretory pathways.ObjectiveTo further investigate the mechanism of GLP-2's potent intestinal lipid mobilizing effect, we examined intracellular cytoplasmic lipid droplets (CLDs) in intestinal biopsies of humans administered GLP-2 or placebo.Design, setting, patients, and interventionsA single dose of placebo or GLP-2 was administered subcutaneously 5 hours after ingesting a high-fat bolus. In 1 subset of participants, plasma samples were collected to quantify lipid and lipoprotein concentrations for 3 hours after placebo or GLP-2. In another subset, a duodenal biopsy was obtained 1-hour after placebo or GLP-2 administration for transmission electron microscopy and proteomic analysis.ResultsGLP-2 significantly increased plasma triglycerides by 46% (P = 0.009), mainly in CM-sized particles by 133% (P = 0.003), without reducing duodenal CLD size or number. Several proteins of interest were identified that require further investigation to elucidate their potential role in GLP-2-mediated CM secretion.ConclusionsUnlike glucose that mobilizes enterocyte CLDs and enhances CM secretion, GLP-2 acutely increased plasma CMs without significant mobilization of CLDs, supporting our previous findings that GLP-2 does not act directly on enterocytes to enhance CM secretion and most likely mobilizes secreted CMs in the lamina propria and lymphatics.