bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric anesthesia and achalasia: 10 years’ experience in peroral endoscopy myotomy management
Authors: Sbaraglia Fabio , Familiari Pietro , Maiellare Federica , Mecarello Marco , Scarano Annamaria , Del Prete Demetrio , Lamacchia Rosa , Antonicelli Federica , Rossi Marco 
Published: June 2022

Abstract
Background
Endoscopic treatment for achalasia (POEM) is a recently introduced technique that incorporates the concepts of natural orifice transluminal surgery. Although pediatric achalasia is rare, POEM has been episodically used in children since 2012. Despite this procedure entails many implications for airway management and mechanical ventilation, evidences about anesthesiologic management are very poor. We conducted this retrospective study to pay attention on the clinical challenge for pediatric anesthesiologists. We put special emphasis on the risk in intubation maneuvers and in ventilation settings.

Results
We retrieved data on children 18 years old and younger who underwent POEM in a single tertiary referral endoscopic center between 2012 and 2021. Demographics, clinical history, fasting status, anesthesia induction, airway management, anesthesia maintenance, timing of anesthesia and procedure, PONV, and pain treatment and adverse events were retrieved from the original database.
Thirty-one patients (3–18 years) undergoing POEM for achalasia were analyzed. In 30 of the 31 patients, rapid sequence induction was performed. All patients manifested consequences of endoscopic CO2 insufflation and most of them required a new ventilator approach. No life-threatening adverse events have been detected.

Conclusions
POEM procedure seems to be characterized by a low-risk profile, but specials precaution must be taken. The inhalation risk is actually due to the high rate of full esophagus patients, even if the Rapid Sequence Induction was effective in preventing ab ingestis pneumonia. Mechanical ventilation may be difficult during the tunnelization step. Future prospective trials will be necessary to individuate the better choices in such a special setting.
Impact of COVID-19 in Cervical and Breast Cancer Screening and Systemic Treatment in São Paulo, Brazil: An Interrupted Time Series Analysis
Authors: Duarte Mateus B.O. , Argenton Juliana L.P. , Carvalheira José B.C. 
Published: June 2022

PURPOSE COVID-19 caused a disruption in cancer management around the world, resulting in an estimated excess burden secondary to screening disruption and excess lag time for treatment initiation. METHODS We gathered information from primary reimbursement data sets of the public health system of São Paulo, Brazil, from April 2020 to November 2021, and compared these data with those of the pre–COVID-19 period. We used an interrupted time series model to estimate the effect of the COVID-19 pandemic on the rate of key procedures of breast and cervical cancer health care chain. RESULTS We estimated that 1,149,727, 2,693, and 713,616 pap smears, conizations, and mammograms, respectively, were missed or delayed during the COVID-19 pandemic, compared with those in the years immediately before the COVID-19 stay-at-home restrictions. Specifically, we observed an acute decrease of procedures after the COVID-19 stay-at-home restrictions, with a trend to recovery in the long term. Regarding the systemic treatment analysis, we observed a 25% reduction in the rate of initiation of adjuvant systemic treatment for early breast cancer (stage I/II). However, we did not find a clear effect on the other settings of systemic treatment for breast cancer. We estimated an excess of 156 patients starting palliative care for cervical cancer after the COVID-19 stay-at-home restrictions. CONCLUSION The COVID-19 pandemic significantly reduced the performance rate of pap smears, conizations, and mammograms. The initiation of adjuvant treatment for early-stage breast cancer was most susceptible to COVID-19's health system disruption. Furthermore, the downward trend of treatment of advanced cervical cancer was interrupted. Therefore, public health policies are urgently needed to decrease the incidence of advanced cervical and breast cancers caused by delayed diagnosis and treatment initiation. The COVID-19 control policies resulted in reduction of cancer patients' delivery of care. This study evaluated the pandemic's influence in key procedures of breast and cervical cancer chain of care in São Paulo, Brazil. We observed a substantial reduction in the number of mammograms, pap smears, and conizations performed since the onset of the COVID-19 pandemic. In addition, stage I and II breast cancer adjuvant treatment presented a reduced realization rate, whereas palliative treatment delivered for advanced cervical cancer increased. Our results support the need for public health policies focused on mitigating the long-term effects of COVID-19 in cancer-related mortality.
Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline
Authors: Korytkowski Mary T , Muniyappa Ranganath , Antinori-Lent Kellie , Donihi Amy C , Drincic Andjela T , Hirsch Irl B , Luger Anton , McDonnell Marie E , Murad M Hassan , Nielsen Craig , Pegg Claire , Rushakoff Robert J , Santesso Nancy , Umpierrez Guillermo E 
Published: June 2022

AbstractBackgroundAdult patients with diabetes or newly recognized hyperglycemia account for over 30% of noncritically ill hospitalized patients. These patients are at increased risk for adverse clinical outcomes in the absence of defined approaches to glycemic management.ObjectiveTo review and update the 2012 Management of Hyperglycemia in Hospitalized Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline and to address emerging areas specific to the target population of noncritically ill hospitalized patients with diabetes or newly recognized or stress-induced hyperglycemia.MethodsA multidisciplinary panel of clinician experts, together with a patient representative and experts in systematic reviews and guideline development, identified and prioritized 10 clinical questions related to inpatient management of patients with diabetes and/or hyperglycemia. The systematic reviews queried electronic databases for studies relevant to the selected questions. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the certainty of evidence and make recommendations.ResultsThe panel agreed on 10 frequently encountered areas specific to glycemic management in the hospital for which 15 recommendations were made. The guideline includes conditional recommendations for hospital use of emerging diabetes technologies including continuous glucose monitoring and insulin pump therapy; insulin regimens for prandial insulin dosing, glucocorticoid, and enteral nutrition–associated hyperglycemia; and use of noninsulin therapies. Recommendations were also made for issues relating to preoperative glycemic measures, appropriate use of correctional insulin, and diabetes self-management education in the hospital. A conditional recommendation was made against preoperative use of caloric beverages in patients with diabetes.ConclusionThe recommendations are based on the consideration of important outcomes, practicality, feasibility, and patient values and preferences. These recommendations can be used to inform system improvement and clinical practice for this frequently encountered inpatient population.
Enhancing the Trustworthiness of the Endocrine Society’s Clinical Practice Guidelines
Authors: McCartney Christopher R , Corrigan Maureen D , Drake Matthew T , El-Hajj Fuleihan Ghada , Korytkowski Mary T , Lash Robert W , Lieb David C , McCall Anthony L , Muniyappa Ranganath , Piggott Thomas , Santesso Nancy , Schünemann Holger J , Wiercioch Wojtek , McDonnell Marie E , Murad M Hassan 
Published: June 2022

Abstract
In an effort to enhance the trustworthiness of its clinical practice guidelines, the Endocrine Society has recently adopted new policies and more rigorous methodologies for its guideline program. In this Clinical Practice Guideline Communication, we describe these recent enhancements—many of which reflect greater adherence to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to guideline development—in addition to the rationale for such changes. Improvements to the Society’s guideline development practices include, but are not limited to, enhanced inclusion of nonendocrinologist experts, including patient representatives, on guideline development panels; implementation of a more rigorous conflict/duality of interest policy; a requirement that all formal recommendations must be demonstrably underpinned by systematic evidence review; the explicit use of GRADE Evidence-to-Decision frameworks; greater use and explanation of standardized guideline language; and a more intentional approach to guideline updating. Lastly, we describe some of the experiential differences our guideline readers are most likely to notice.
Yttrium-90 Selective Internal Radiation Therapy Plus Cryoablation for Recurrent Adrenocortical Carcinoma With Liver Metastases
Authors: Lin Tung-Yen , Lin Kuan-Yu , Kuo Hung-Yang , Huang Kuo-How , Wang Chih-Yuan , Lin Yu-Lin , Shih Shyang-Rong , Liang Po-Chin 
Published: June 2022

Abstract
Advanced adrenocortical carcinoma (ACC) has a poor prognosis and is often resistant to the conventional regimens of mitotane administration and systemic chemotherapy. In addition to surgery, local therapeutic measures can be valuable. Here, we present the case of a 33-year-old woman who developed left retroperitoneal local recurrent ACC with hepatic and pulmonary metastases 1 year after radical adrenalectomy. The tumors progressed under chemotherapy and mitotane treatments. She was treated with yttrium-90 selective internal radiation therapy (90Y SIRT) for hepatic metastases and cryoablation of the local recurrent tumor, after which significant tumor shrinkage was observed. She then received radiofrequency ablation for the residual hepatic metastases and radiotherapy to the residual local recurrent tumor. Complete remission was achieved and maintained at least until the data cutoff day (15.8 months after the last treatment). This is the first published report of cryoablation in a patient with ACC and the third report of 90Y SIRT use for hepatic metastasis of ACC. Cryoablation and 90Y SIRT are local treatment choices for ACC that are worthy of further study.
Introduction
Authors: Facer Keri , Newfield Christopher 
Published: June 2022

Abstract
The authors organized a conference, “Global Higher Education in 2050: Imagining Universities for Sustainable Societies,” at the University of California, Santa Barbara, March 4–6, 2020, right before the campus was closed for eighteen months in response to the COVID-19 pandemic. The event's premise was that the futures of higher education will be plural, must be responsive to large international divergences, and must be actively created by global majorities rather than policy elites. This introduction describes the papers' common project of identifying the key elements in the higher education status quo and features that might lead toward unexpected futures. We summarize the three horizons methodology that guided some of the work. We also outline the activities of the third day, the workshop that sought a means of linking the present to the future. This work continues beyond the horizons of the papers published here.
Assessment of heavy metals in food and drug packaging materials
Authors: Mukhi Senna , Rukmini M S , Ajay Manjrekar Poornima , Iyyaswami Reghupathi , Sindhu H 
Published: June 2022

Background: Food and drug packaging materials are an integral part of our everyday life. Noxious elements can inadvertently be included in packaging materials in various stages of their production. Adulterants, adhesives, colorants and heavy metal interference are the common sources of contamination in food packaging materials. Heavy metal toxicity has far-reaching ill effects on living organisms. The present study aimed at qualitatively and quantitatively analysing heavy metal contamination of various materials that are used for food and drug packaging in India. Methods: The qualitative detection was done by rapid assay and heavy metals were quantified with the help of inductively coupled plasma-optical emission spectrometry (ICP-OES). A total of 13 types of food and drug packaging materials were procured from local market and analysed for four heavy metals viz. arsenic (As), vanadium (V), mercury (Hg) and cadmium (Cd). The concentration of each heavy metal in the samples was compared with permitted values published by the European Council. Results: Of the 13 samples, heavy metals were qualitatively detected in 10 samples. ICP­-OES values for quantitative estimation showed presence of heavy metal above permissible range in 10 of the studied samples for vanadium, all samples for arsenic, two samples for mercury and one sample for cadmium. Arsenic was found to be the commonest heavy metal contaminant, present in 13 samples above permissible limit. Conclusions: The significantly higher concentration of heavy metal poses a potential health risk to the consumer and affects the quality of the food.
eXNVerify: coverage analysis for long and short-read sequencing data in clinical context
Authors: Porębski Sebastian , Stokowy Tomasz 
Published: June 2022

Accurate identification of genetic variants to a large extent is based on the type of experimental technology, quality of the material and coverage of sequencing data obtained. The latter, coverage quality, highly influences variant calling accuracy and final diagnosis. Our motivation was to create a tool that will evaluate genome coverage and accelerate the introduction of long-read sequencing to medical diagnostics and clinical practice. The implementation was guided by the ease of use of the tool by users who are not proficient in using complex software. A Docker container is perfect for this purpose. Using Docker’s advantages (flexibility, mobility and ease of use of the proposed tools), we created eXNVerify. This is a tool for inspection of clinical data in the context of pathogenic variants search. The tool calculates clinical depth coverage (CDC) – a measure of coverage which we introduce to evaluate loci with pathogenic germline and somatic variants reported in ClinVar. The tool additionally provides visualization options for user-defined genes of interest. Finally, we present examples of BRCA1, TP53, CFTR application and results of a test conducted in the Extensive Sequence Dataset of Gold-Standard Samples for Benchmarking and Development. eXNVerify improves the diagnostic process of patients related to important genetic diseases and facilitates the assessment of genetic samples by diagnosticians. The use of Docker allows to run an analysis package and does not require any special technical preparation. Detailed examples are included in the GitHub project documentation and the package can be downloaded directly from DockerHub using the command: docker pull porebskis/exnverify:1.0.
Consumers’ behavior in conversational commerce marketing based on messenger chatbots
Authors: Mehta Reena , Verghese Jose , Mahajan Shriya , Barykin Sergey , Bozhuk Svetlana , Kozlova Nelli , Vasilievna Kapustina Irina , Mikhaylov Alexey , Naumova Elena , Dedyukhina Natalia 
Published: June 2022

Background: The increasing penetration of smartphones and the Internet in developing countries caused the rise of e-retail. Conversational commerce is highly increasing via interaction through messengers. To extract the benefits of both trends, companies have adopted messenger chatbots. These chatbots use Artificial intelligence and natural language processing to give live responses to the customer and assist online shopping on the messenger interface. This research aims to discover the factors that affect the use of messenger chatbots and their influence on attitude and behavior intention. Methods: The research methodology includes the Technology Acceptance Model (TAM) with the variables of perceived usefulness, perceived ease of use, consumer trust, and anthropomorphism. The authors used an online survey for collecting the responses from 192 respondents and analyzed structural equation modelling. Results: Customer trust has shown the most decisive influence on customer attitude followed by Perceived Usefulness, Perceived Ease of Use. Also, the use of chatbots to make online shopping faster significantly affects the use of messenger chatbots for online shopping in the future. The authors explore various factors resulting in consumers’ favor of accepting chatbots as an interface for m-commerce. Conclusions: The findings indicate that organizations should design strategies to improve interaction with the customer by developing messenger chatbots for more trusting conversations. Further research could include a theoretical digital marketing approach to conversational commerce based on anthropomorphic digital technologies.
Impact of pathogenic mutations of the GLUT1 glucose transporter on solute carrier dynamics using ComDYN enhanced sampling
Authors: Mouhib Halima , Higuchi Akiko , Abeln Sanne , Yura Kei , Feenstra K. Anton 
Published: June 2022

Background: The solute carrier (SLC) family of membrane proteins is a large class of transporters for many small molecules that are vital for cellular function. Several pathogenic mutations are reported in the glucose transporter subfamily SLC2, causing Glut1-deficiency syndrome (GLUT1DS1, GLUT1DS2), epilepsy (EIG2) and cryohydrocytosis with neurological defects (Dystonia-9). Understanding the link between these mutations and transporter dynamics is crucial to elucidate their role in the dysfunction of the underlying transport mechanism, which we investigate using molecular dynamics simulations. Methods: We studied pathogenic and non-pathogenic mutations, using a newly developed coarse-grained simulation approach ‘ComDYN’, which captures the ‘COMmon constraints DYNamics’ between both states of the solute carrier protein. To guarantee the sampling of large conformational changes, we only include common constraints of the elastic network introduced upon coarse-graining, which showed similar reference distances between both conformational states (≤1 Å difference). Results: ComDYN is computationally efficient and sufficiently sensitive to capture effects of different mutations. Our results clearly indicate that the pathogenic mutation in GLUT1, G91D, situated at the highly conserved RXGRR motif between helices 2 and 3, has a strong impact on transporter function, as it blocks the protein from sampling both conformational states. In comparison, predictions from SIFT and PolyPhen only provided an impression of the impact upon mutation in the highly conserved RXGRR motifs, but yielded no clear differentiation between pathogenic and non-pathogenic mutations. Conclusions: Using our approach, we can explain the pathogenicity of the mutation G91D and some of the effects of other known pathogenic mutations, when we observe the configurations of the transmembrane helices, suggesting that their relative position is crucial for the correct functioning of the GLUT1 protein. To fully understand the impact of other mutations in the future, it is necessary to consider the effect of ligands, e.g., glucose, within the transport mechanism.
Barriers and enablers to sustaining self-management behaviours after attending a self-management support intervention for type 2 diabetes: a protocol for a systematic review and qualitative evidence synthesis
Authors: Carvalho Márcia , Dunne Pauline , Kwasnicka Dominika , Byrne Molly , McSharry Jenny 
Published: June 2022

Background: Attendance at self-management support interventions is associated with improved outcomes for people with type 2 diabetes. However, initial improvements are often not sustained beyond one year, which may be a result of difficulties in sustaining positive changes made to self-management behaviours. The aim of this systematic review is to synthesise qualitative research on the barriers and enablers to sustaining self-management behaviours following attendance at a self-management support intervention for type 2 diabetes. Methods: The review will use the “best fit” framework synthesis method to develop a new conceptual model of sustained behaviour change in type 2 diabetes. MEDLINE (Ovid), EMBASE (Elsevier), CINAHL (EBSCO), PsycINFO (Ovid), SCOPUS, ProQuest Dissertations and Theses, WorldCat and Open Grey will be searched to identify primary qualitative studies. A parallel search will be conducted in Google Scholar to identify relevant theories for the development of an a priori framework to synthesise findings across studies. Methodological limitations of included studies will be assessed using an adapted version of the Critical Appraisal Skills Programme tool for Qualitative Studies. A sensitivity analysis will be conducted to examine the impact of studies with methodological limitations on synthesis findings. Confidence in the synthesis findings will be assessed using the GRADE-CERQual tool. Screening, data extraction, methodological limitation assessment, synthesis and GRADE-CERQual assessment will be conducted by one author with a second author independently verifying a randomly selected 20% sample. Discussion: This review will develop a new model of sustained behaviour change in type 2 diabetes self-management. The findings can be used to inform the development of new interventions or revision of existing interventions to better support sustained engagement in type 2 diabetes self-management behaviours.
Much research, but little learned to date: A scoping review of the methodological quality of research on mental health of healthcare professionals in low- and lower-middle income countries
Authors: Lohmann Julia , John Denny , Dzay Aso 
Published: June 2022

Background: SARS-CoV-2 has resulted in widespread awareness of health workers’ work realities and their mental health impacts, and corresponding unprecedented research effort. Reviews of the quantitative literature on mental health of clinical skilled healthcare personnel in low- and lower-middle income countries (LLMIC), however, point at quality issues in the pre-pandemic literature. We used the evidence generated in the context of one pre-pandemic review to understand methodological strengths and weaknesses in detail, with the aim of distilling recommendations for future research. Methods: Our study used the literature identified in a systematic search up to the end of 2020, in English or French language, in MEDLINE, EMBASE, PsychINFO, Global Health, and CAIRN. Following a scoping review approach, we extracted and charted data on key study characteristics as well as on study quality. In regard to the latter, we developed nine quality criteria on the basis of existing quality checklists, but expanding on issues of particular relevance to the measurement and interpretation of levels of mental health or illness. We collated the charted data in descriptive fashion. Results: We included data from 152 studies, assessing a range of mental health outcomes, with a focus on burnout. Most studies were conducted in India, Nigeria, Pakistan, or Egypt, in urban secondary- and tertiary-care settings. We judged only 20% of studies as of high quality due to shortcomings particularly regarding sample representativeness, context-specific measurement tool validity, and reporting of methodological detail. Conclusion: We conclude that despite its impressive size, we can learn comparatively little from the body of literature up to the end of 2020 due to limitations in quality. Based on our findings, we outline areas for expansion, methodological improvement, and standardization of reporting in future research. PROSPERO Registration: CRD42019140036.