bluuebunny/crossref_metadata_2025_split huggingface dataset:
High neutrophil counts before endovascular treatment for acute basilar artery occlusion predict worse outcomes
Authors: Liao Maofan , Li Fengli , Hu Jinrong , Yang Jie , Wu Deping , Xie Dongjing , Song Jiaxing , Huang Jiacheng , Tian Yan , Luo Weidong , Yue Chengsong , Liu Shuai , Kong Weilin , Huang Li , Zi Wenjie , Li Fangfei 
Published: September 2022

Background and purposeIschemic stroke is related to inflammation. We investigated leukocyte counts, neutrophil counts, and NLR (neutrophil-to-lymphocyte ratio) to explore their prognostic potential and determine if high neutrophil counts before endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO) are associated with worse outcomes at 90 days post-EVT.MethodsLeukocyte and neutrophil counts and NLR were determined in eligible patients from the Acute Basilar Artery Occlusion Study (BASILAR). Patients were divided into four groups according to leukocyte and neutrophil counts and NLR quartiles. The primary outcome was a favorable outcome based on the modified Rankin Scale (mRS: 0–3). The secondary outcome was functional independence (mRS 0–2). The safety outcome was mortality, and an unfavorable outcome was mRS 4–6. Successful reperfusion was mTICI (modified Thrombolysis in Cerebral Infarction) of 2b or 3. All the data were collected within 90 days after EVT.ResultsWe enrolled 586 patients in the study. The leukocyte and neutrophil counts and NLR were significantly associated with clinical outcomes in all patients though no effects were seen in some intervals. Of these three parameters, the neutrophil count had the most significant impact, negatively affecting the outcome. The findings were similar in patients who were successfully recanalized.ConclusionHigher neutrophil counts predicted worse clinical outcomes 90 days after EVT. This finding supports the deleterious role of inflammation in patients with acute BAO despite EVT or successful recanalization.
Central nervous system infection caused by Mycobacterium houstonense: A case report
Authors: Wang LiXia , Wang FaPing , Yang Chuan , Luo FengMing 
Published: September 2022

BackgroundMycobacterium houstonense is a rapidly growing mycobacterium (RGM) that belongs to the unnamed third biovariant complex of the Mycobacterium fortuitum group, which is rarely responsible for human infection. Approximately 76% of infections caused by the M. fortuitum group occur after open fractures or skin, soft tissue, bone, or puncture wounds. To date, only a few cases of human infectious disease caused by M. houstonense have been reported worldwide.Case presentationWe present a case of a 26-year-old man with a central nervous system (CNS) infection caused by M. houstonense. The patient was transferred to our hospital because of headaches and muscle strength changes. One month prior to presentation at our hospital, the patient was diagnosed with tuberculous meningitis at the other two hospitals, but his condition did not improve after anti-tuberculous treatment, antibiotics, and anti-viral treatment before admission to our hospital. Lumbar puncture was performed at both previous hospitals, as well as at our hospital; the results consistently indicated high cerebrospinal fluid (CSF) opening pressure. M. houstonense was detected in the CSF of the second hospital's lumbar puncture by metagenomic next-generation sequencing (mNGS) but was not identified at our hospital. The patient was discharged from our hospital after receiving non-tuberculous mycobacterium (NTM) treatment for 1 month according to the Chinese NTM guidelines. However, the patient died 20 days after discharge.ConclusionSince it is difficult to identify M. houstonense, this is the first case of human CNS infection caused by M. houstonense in China. This case may be considered by neurologists and infectious physicians when CNS infection does not respond to conventional treatment, especially in the uncommon type of NTM.
Image-guided LINAC radiosurgery in hypothalamic hamartomas
Authors: Romanelli Pantaleo , Tuniz Francesco , Fabbro Sara , Beltramo Giancarlo , Conti Alfredo 
Published: September 2022

IntroductionHypothalamic hamartomas (HH) are developmental malformations that are associated with mild to severe drug-refractory epilepsy. Stereotactic radiosurgery (SRS) is an emerging non-invasive option for the treatment of small and medium-sized HH, providing good seizure outcomes without neurological complications. Here, we report our experience treating HH with frameless LINAC SRS.Materials and methodsWe retrospectively collected clinical and neuroradiological data of ten subjects with HH-related epilepsy that underwent frameless image-guided SRS.ResultsAll patients underwent single-fraction SRS using a mean prescribed dose of 16.27 Gy (range 16–18 Gy). The median prescription isodose was 79% (range 65–81 Gy). The mean target volume was 0.64 cc (range 0.26–1.16 cc). Eight patients experienced complete or near complete seizure freedom (Engel class I and II). Five patients achieved complete seizure control within 4 to 18 months after the treatment. Four patients achieved Engel class II outcome, with stable results. One patient had a reduction of seizure burden superior to 50% (Engel class III). One patient had no benefit at all (Engel class IV) and refused further treatments. Overall, at the last follow-up, three patients experience class I, five class II, one class III and one class IV outcome. No neurological complications were reported.ConclusionsFrameless LINAC SRS provides good seizure and long-term neuropsychosocial outcome, without the risks of neurological complications inherently associated with microsurgical resection.
Transcutaneous auricular vagus nerve immediate stimulation treatment for treatment-resistant depression: A functional magnetic resonance imaging study
Authors: Ma Yue , Wang Zhi , He Jiakai , Sun Jifei , Guo Chunlei , Du Zhongming , Chen Limei , Luo Yi , Gao Deqiang , Hong Yang , Zhang Lei , Liu Yong , Fang Jiliang 
Published: September 2022

ObjectiveTranscutaneous auricular vagus nerve stimulation (taVNS) is effective for treatment-resistant depression (TRD). In the current study, we observed the immediate modulating brain effect of taVNS in patients with TRD using rest-state functional magnetic resonance imaging (rs-fMRI).MethodForty patients with TRD and forty healthy controls (HCs) were recruited. Rs-fMRI was performed before and after 30 min of taVNS at baseline. The brain regions that presented significantly different the Regional Homogeneity (ReHo) between the TRD patients and HCs were selected as the ROI to calculate the functional connectivity (FC) of full brain. The correlations were estimated between the clinical scales' score and the functional brain changes.ResultsFollowing taVNS stimulation treatment, TRD patients showed significantly reduced ReHo in the medial orbital frontal cortex (mOFC) (F = 18.06, P &lt; 0.0001), ANCOVA of the mOFC-Based FC images revealed a significant interaction effect on the left inferior parietal gyrus (IPG) and left superior marginal gyrus (SMG) (F = 11.6615, P&lt;0.001,F = 16.7520, P&lt;0.0001). Among these regions, the HAMD and HAMA scores and ReHo/FC changes were not correlated.ConclusionThis study applied rs-fMRI technology to examine the effect of taVNS stimulation treatment on the brain activity of TRD. These results suggest that the brain response of TRD patients to taVNS treatment may be associated with the functional modulation of cortical regions including the medial orbital frontal cortex, the left inferior parietal gyrus, and the left superior marginal regions. Changes in these neuroimaging indices may represent the neural mechanisms underlying taVNS Immediate Stimulation treatment in TRD.
Associations between socioeconomic status and physical activity: A cross-sectional analysis of Chinese children and adolescents
Authors: Ke Youzhi , Shi Lijuan , Peng Lingqun , Chen Sitong , Hong Jintao , Liu Yang 
Published: September 2022

ObjectivesAlthough socioeconomic status (SES) has been shown to be an important determinant of physical activity (PA) in adults, the association in children and adolescents remains less consistent based on evidence from western developed countries. The purpose of this study, therefore, is to investigate associations between SES and PA among Chinese children and adolescents.MethodsA cross-sectional study was conducted with a self-reported questionnaire in China. The multi-stage stratified cluster sampling method was used, and 2,955 children and adolescents (8–17 years old, 53.4% girls) were enrolled in this study. SES was assessed by measuring parental education levels, perceived family wealth, and Family Affluence Scale II (FAS II). PA was assessed by reliable and valid items from the Health Behavior School-aged Children Surveillance questionnaires. Descriptive statistics were used to report sample characteristics, including demographic characteristics, levels of PA, and SES. The Chi-square test was applied to analyze the differences of PA in gender and school period. Binary logistic regression was used to analyze the association between SES and PA among children and adolescents.ResultsOverall, 10.4% of children and adolescents accumulated moderate-to-vigorous physical activity (MVPA) at least 60 min per day. Boys were more physically active than girls (14.1% vs. 7.2%, p &lt; 0.001). Higher socioeconomic status was positively associated with higher physical activity levels among children and adolescents, especially using FAS and mother education level as SES measures. The association between SES and PA varied by gender and grade group, and the effects of SES are also different on weekdays and weekends.ConclusionThis study found socioeconomic disparities in PA among Chinese children and adolescents, and showed the importance of targeting children and adolescents with low SES intervention priority. Based on these research findings, it is suggested that SES, especially for FAS and mother education level, should be considered when designing and implementing the promotion of regular PA in children and adolescents. Health policymakers may use this information to develop interventions to reduce health inequalities among children and adolescents in the future.
Cardiotoxicidade induzida por Osimertinibe e Ramucirumabe em paciente com Câncer de pulmão em estadio avançado – relato de caso clínico
Authors: Vieira Isabela Pedroza , Hartmann Andréa Regina Baréa , Sanfelice Elise Nara 
Published: September 2022

Introdução: O Osimertinibe é um inibidor de tirosina-quinase de terceira geração usado no tratamento de neoplasia de pulmão não pequenas células. O ramucirumabe é um anticorpo monoclonal (IgG1), um antagonista direto do VEGFR2, inibidor da angiogênese tumoral mediada por VEGF. A cardiotoxicidade relacionada à terapia do câncer é definida como uma redução na fração de ejeção do ventrículo esquerdo (FEVE) ≥ 10% para um valor abaixo do limite inferior da normalidade (FEVE < 50%). Relato de caso: Paciente do sexo feminino, 75 anos, diagnosticada com adenocarcinoma pulmonar estágio IV, com metástases pleurais e derrame pleural neoplásico em 2014. Foi identificada mutação no gene EGFR e iniciada terapia com Erlotinibe, mantida por 15 meses, quando evoluiu para carcinomatose peritoneal. Uma nova biópsia confirmou metástase, com mutação de resistência no gene EGFR T790M. Fez quimioterapia com Carboplatina e Pemetrexede. Em 2016, iniciou o uso de Osimertinibe (AZD9291), mantido até março de 2019. A paciente em questão foi a primeira do país a fazer uso do medicamento. Em abril de 2019, foi iniciado um novo ciclo de quimioterapia com Carboplatina e Pemetrexede. Apresentou piora clínica em junho de 2019, sendo mantido apenas Pemetrexede a partir de julho de 2019. Em outubro de 2019, apresentou piora clínica e observou-se progressão da doença. O esquema terapêutico foi alterado para Docetaxel e Ramucirumabe. O primeiro ecocardiograma, em março de 2016, mostrou hipertrofia concêntrica leve do ventrículo esquerdo (VE) e FEVE de 73%. Um novo ecocardiograma de 2019, pouco após a suspensão do Osimertinibe, mostrou hipertrofia concêntrica importante do VE e FEVE de 52%. A hipótese da causa era hipertensão de longa data, pois os relatos de possível cardiotoxicidade começaram a ser descritos apenas mais tarde. Em outubro de 2019, foi internada na UTI por sangramento retal, 10 dias após receber 1 ciclo de Docetaxel e Ramucirumabe. Realizou novo ecocardiograma que mostrou queda da FEVE para 35% devido à hipocinesia difusa e hipertrofia excêntrica do VE. A mesma não tinha sintomas de insuficiência cardíaca, mas apresentou instabilidade hemodinâmica devido ao sangramento. Evoluiu insuficiência respiratória e necessidade de intubação orotraqueal após possível broncoaspiração. Evoluiu a óbito algumas horas depois. Conclusão: Ao escolher um agente antineoplásico para o tratamento do câncer de pulmão, o risco basal do paciente para eventos cardiovasculares deve ser levado em consideração. Protocolos de monitoramento devem ser seguidos para detecção precoce de possível cardiotoxicidade.
Perfil das pacientes com doença Trofoblástica Gestacional atendidas em centros de saúde suplementar da Amazônia
Authors: Cabral Aylla Ferraz , Gomes Camila Soares , Fernandes Milena Cecilia Barroso , Maestá Izildinha , Viana José Fernandes de Souza , Paolino Bruno Monção 
Published: September 2022

A Doença Trofoblástica Gestacional (DTG) é uma complicação rara na gravidez que divide-se em dois grupos: Mola Hidatiforme (MH) e Neoplasia Trofoblástica Gestacional (NTG). O objetivo da pesquisa foi calcular a frequência de DTG em pacientes atendidas em dois centros de referência oncológica de saúde suplementar da cidade de Manaus de 2011 até dezembro de 2019, especificamente, descrever dados sociodemográficos e clínicos, calcular a evolução para NTG classificando as mesmas em alto e baixo risco, assim como descrever formas de tratamento e calcular mortalidade. Trata-se de um estudo observacional retrospectivo, que incluiu pacientes com diagnóstico de DTG que foram atendidas em dois centros suplementares de Manaus de 2011 até dezembro de 2019. Os dados foram obtidos através de entrevistas e preenchimento de protocolo do estudo, após a assinatura do TCLE, depois foram tabulados e analisados estatisticamente. A frequência de DTG foi de cinco pacientes, a idade média foi 32,2 anos. Em sua maioria eram brancas (80%) e possuíam ensino superior completo (80%). A frequência de NTG foi de três pacientes (60%), 100% de baixo risco, 33% apresentaram metástase pulmonar e 100% realizaram monoterapia com Metotrexato. Não ocorreram óbitos nas pacientes da cauística, ficando abaixo da média brasileira de 4% 5.
Description of strategy used to redirect practices in primary care, integrating Leprosy and Tuberculosis actions - Pernambuco, Brazil
Authors: Da Silva José Alexandre Menezes , Medeiros Aymee da Rocha , Da Silva Bárbara Morgana , Mendonça Eline Ferreira 
Published: September 2022

Objective: To describe and analyze a strategy carried out in Pernambuco, which has as its theoretical axis the integrality between surveillance and assistance for the control of leprosy and tuberculosis. Methods: Quantitative, descriptive-exploratory longitudinal study, in the periods: 2012-2014 and 2015-2018, in priority municipalities for tuberculosis and leprosy. The periods were compared considering the methods, results and operational indicators in each phase of the strategy. Results: In 2012-2014, there was a positive increase in the indicators of the components: Assistance, Surveillance and Management. In 2015-2018, an improvement was observed in the indicators of the components: Management and Primary Care. There was no improvement in operational indicators (Cure, Abandonment, examined contacts and Mortality) for both diseases. Conclusion: The strategy was important in supporting decisions for disease control. Not only on an evaluative side, but also on the educational (training) aspect which allowed what was encouraged by the programs. In addition to strengthening the state technical team, the experiment also enabled the evaluation of the municipal management sphere.
Impactos da pandemia da COVID-19 em pacientes portadores de demências e seus cuidadores
Authors: Almeida Isadora Morais , Freitas João Victor Nunes , Santos Júlia Libarino Pontes Pimentel , Correia Rafaela Andrade , Barreto Rafaela Ferreira Schittini , Merelles Saulo Leal 
Published: September 2022

Introdução: Demência é uma síndrome clínica decorrente do comprometimento da função cognitiva, cuja incidência e prevalência são acrescidas com a idade, sendo uma das principais causas de perda da independência e autonomia do idoso. Durante a pandemia, idosos com demência formaram grupo de grande vulnerabilidade, sofrendo extenso impacto no manejo clínico de sua doença, gerando consequências em toda conjuntura familiar, principalmente em seus cuidadores. Metodologia: Revisão de literatura integrativa através da busca bibliográfica nas bases: Scielo, Lilacs e BVS . Descritores utilizados: “demência”, “pandemia” e “COVID-19”. Foram encontrados 112 artigos, 82 destes foram descartados por não se relacionarem diretamente com a temática ou não possuírem textos disponibilizados na íntegra . Incluídos nesse estudo artigos que abordassem eixos temáticos das demências e da pandemia e artigos com menos de 10 anos que tratassem do conceito das demências. Resultados: Estudos mostram que a pandemia trouxe limitações em diferentes âmbitos para pacientes com demência e seus cuidadores. A dificuldade no acesso ou conhecimento da tecnologia e a falta de acompanhamento integral geraram redução de confiança no diagnóstico. Além disso, mostraram que o isolamento social pode comprometer o acesso à estimulação cognitiva e sobrecarregar as famílias no cuidado com esse paciente. Conclusão: Dado o exposto, pacientes com demência e seus cuidadores são populações vulneráveis que foram notadamente afetadas durante a pandemia. Esse estudo mostra a necessidade de intervenções em saúde, o manejo de sintomas psicológicos e comportamentais nesses pacientes e a importância de uma rede de apoio aos seus cuidadores.
The Manifestations of Violence and Sectarianism the Novel "Ya Maryam" by Sinan Antoon
Authors: Mahmoud Jamil Mohammad Hanan 
Published: September 2022

This study aims to shed light on the novel "Ya Maryam" by the Iraqi novelist Sinan Antoon, and to discuss the manifestations of violence and Sectarianism that the novel portrays. Noting that Iraq has faced and is still facing Sectarianism in its most gruesome forms for over a decade, which in turn particularly affects the minorities - including Christians - in that sect. This study aims to discuss the narrative style and plot in tackling these themes, and the techniques the author used to deliver his message on several axes, namely: First - the title. Second - the sequence of events, and manifestations of violence: - Summary of the novel. - The characters: spanning over two generations, pictures of yesterday's Iraq and today's Iraq, and the gap between both caused by the American occupation in 2003. Third - Symbolism.
The Impact of the United States on Military Spending in the Arab Gulf States During the Reign of Donald Trump: 2017-2020
Authors: Torki Bani Salameh Mohammed , Mohammed Alsmadi Laith 
Published: September 2022

This study aimed to demonstrate the impact of the US policy on military spending in the Arab Gulf States during the reign of Donald Trump extending from the 2017 to 2020,
and to clarify the nature of military spending and the indications of this spending. The study relied on the historical system analysis and descriptive analysis approaches to describe the nature and size of military spending in the Arab Gulf States, and the amount of change that occurred in its size during the reign of US president Donald Trump. The study showed that the US foreign policy towards the region during the tenure of US President Donald Trump was based on the principle of paying for protection, and that non-payment nullifies the alliance with it and its defense. As a result, most of the Arab Gulf states concluded many military deals with the United States, as well as pledged to finance American military operations in the region, as military deals were concluded between the United States and Saudi Arabia estimated at about $ 110 billion, and a contract between Qatar and the United States in an aircraft deal of about 20 billion dollars. The size of the military spending of the Arab Gulf States during the period (2016-2019) reached (326.5 billion dollars). The average expenditure of GDP reached (33%) of GDP during that period, and it increased in 2019 to (40%). The Sultanate of Oman topped the total percentage of military spending during the period (2011 -2019), reaching (91.50%).
The Reality of the Role of Emirati Universities to Develop Cultural Diversity Acceptance among their Students’ from their Perspectives
Authors: A .Y Almusa Ebar , Amin Al-Qudah Mohammad 
Published: September 2022

Objectives: This study aims to identify the reality of the role of Emirate universities to develop cultural diversity acceptance among their students’ from their perspectives.
Methods: The quantitative descriptive approach was employed; the required data was collected through a questionnaire consisting of (59) items, which was applied to a sample of (595) male and female undergraduate students for the academic year (2020/2021).
Results: The results showed that the degree of students’ awareness of the role of Emirati universities in developing acceptance of cultural diversity was high, and there were no statistically significant differences at (α = 0.05) in students’ perception of this role due to the variables (sex, college, academic year, and cumulative average), nor to the variable of nationality in the two fields of students’ perception of cultural diversity in Emirate universities and their understanding of the importance of accepting cultural diversity", while the results showed statistically significant differences attributed to the variable of nationality in the field of “the role of Emirate universities in developing the acceptance of cultural diversity among their students” and in favor of Arab nationality.
Conclusions: The need for universities to focus on accepting and developing cultural diversity among students through including its concepts and dimensions in academic curricula; moreover, enhancing the university environment to achieve more cultural and social adaptation amongst students.