bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of diabetes and its predictors in the Greater Beirut Area: a five-year longitudinal study
Authors: Nasrallah Mona P. , Elbejjani Martine , Nasreddine Lara , Chami Hassan , Ismaeel Hussein , Fleifel Mohamad , Al Zahraa Chokor Fatima , Tamim Hani 
Published: May 2022

AbstractBackgroundType 2 Diabetes (T2D) remains a world epidemic. Obtaining accurate estimates of its incidence and their predictors will aid in targeting preventive measures, allocating resources, and strategizing its management. The Middle East North Africa region has high T2D prevalence and rates of rise. Few incidence studies exist for the region, and none from Lebanon. The current study objective was to determine diabetes incidence and diabetes predictors in a community-based Lebanese sample. A secondary objective was to describe the metabolic control over time in adults with preexisting diabetes.MethodsThis is a five-year (2014–2019) follow-up study on a random sample of 501 residents of the Greater Beirut area. Out of 478 people eligible to participate in the follow-up study, 198 returned (response rate 39.5%). Assessment included medical history, anthropometric measures, food frequency, sleep, and lifestyle questionnaires. Laboratory data included glycemic indices (fasting glucose and HbA1C) and other biological markers. The diagnosis of probable diabetes (PD) was based on one abnormal test for either fasting glucose ≥ 126 mg/dL or HbA1C ≥ 6.5% or having history of diabetes.ResultsThe incidence of diabetes was 17.2 (95% CI 9.6–28.7) per 1000 person-years. Cardiometabolic risk factors independently associated with diabetes were: older age, higher BMI, family history of diabetes, metabolic syndrome, higher CRP and triglyceride level; whereas an independent predictor of diabetes was previous BMI.In addition, the 42 participants with preexisting diabetes had worsening of their metabolic profile over a five-year period.ConclusionsThe incidence of diabetes was high as compared to some reported world rates, and in line with the high prevalence in the MENA region. The risk was highest in those with positive family history and the presence of the metabolic syndrome or its components. Preventive measures should particularly target participants with that specific risk profile. This becomes particularly important when observing that metabolic control gets worse over time in individuals with diabetes.
Emotional competences in vocational education and training: state of the art and guidelines for interventions
Authors: Sauli Florinda , Wenger Matilde , Fiori Marina 
Published: May 2022

AbstractInterventions in emotional competences and scientific studies of emotional competence are flourishing in the educational context. However, we find very few programs in Europe involving emotional interventions in vocational education and training (VET) and a dearth of scientific contributions. Our purpose with this paper is twofold: a) we provide the state of the art on existing international scientific publications about emotional training interventions in VET and a summary of existing programs at the European level; b) by relying on the analysis of relevant cases in the educational literature, we provide guidelines about how scientifically-based interventions in emotional competences in VET could be developed. Ultimately, our goal is to open a discussion of emotional training as a novel domain of research for VET scholars and practitioners, and of how emotional competences could be introduced in a vocational curriculum.
Left thoracoscopic approach in the supine position for torsion of the residual esophagus after esophagectomy: a case report
Authors: Yamaguchi Kazuya , Haruki Shigeo , Sakano Masayoshi , Suzuki Kunihito , Miura Akinori 
Published: May 2022

Abstract
Background
Anastomotic stenosis can occur after esophagectomy and gastric tube reconstruction. The effective surgical treatment for refractory anastomotic stenosis, which seems difficult to resolve with endoscopic treatment, has not been established. We report a case of refractory stenosis due to esophageal torsion in which reconstructive surgery was possible using a left thoracoscopic approach in the supine position.

Case presentation
A 72-year-old man who underwent thoracoscopic subtotal esophagectomy and retrosternal gastric tube reconstruction for esophageal cancer 6 months previously presented to us. Postoperative endoscopy revealed that the residual esophagus was twisted approximately 360°, just above the anastomotic site. Conservative endoscopic treatment failed to improve the condition due to severe passage obstruction, and reconstructive surgery was repeated. Surgery was performed in the supine position using a left thoracoscopic approach. The entire circumferences of the gastric tube and residual esophagus were dissected from the inferior mediastinum to the top of the sternum, with focus on preserving the right gastroepiploic vein and gastric-tube wall. Subsequently, laparoscopic surgery was performed to remove the gastric tube from the thoracoabdominal junction. After separating the esophagus on the oral side of the torsion from the left cervical wound, the abdomen was opened, the gastric tube was pulled out through the abdominal wound, and adhesions in the abdominal cavity were peeled off to raise the gastric tube cranially via the retrosternal route. An end-to-side anastomosis was performed using a circular stapler, and the esophageal torsion and previous anastomosis were resected. Oral intake was resumed on the 7th postoperative day, and the patient was discharged on the 38th day.

Conclusions
After subtotal esophagectomy and retrosternal gastric tube reconstruction, the left thoracoscopic approach is one of the most minimally invasive approaches and is especially useful for preserving the right gastroepiploic artery and veins and for mobilizing the gastric tube wall.
The EORTC QLU-C10D discrete choice experiment for cancer patients: a first step towards patient utility weights
Authors: Gamper Eva-Maria , King Madeleine T. , Norman Richard , Loth Fanny L. C. , Holzner Bernhard , Kemmler Georg ,   the EORTC Quality of Life Group^
Published: May 2022

AbstractBackgroundThe European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility-Core 10 Dimensions (QLU-C10D) is a novel cancer-specific preference-based measure (PBM) for which value sets are being developed for an increasing number of countries. This is done by obtaining health preferences from the respective general population. There is an ongoing discussion if instead patients suffering from the disease in question should be asked for their preferences. We used the QLU-C10D valuation survey, originally designed for use in the general population, in a sample of cancer patients in Austria to assess the methodology’s acceptability and applicability in this target group before obtaining QLU-C10D patient preferences.MethodsThe core of the QLU-C10D valuation survey is a discrete choice experiment in which respondents are asked to give preferences for certain health states (described by a relatively large number of 10 quality of life domains) and an associated survival time. They therewith are asked to trade off quality of life against life time. As this might be a very burdensome task for cancer patients undergoing treatment, a cognitive interview was conducted in a pilot sample to assess burden and potential additional needs for explanation in order to be able to use the DCE for the development of QLU-C10D patient preferences. In addition, responses to general feedback questions on the survey were compared against responses from a matched control group from the already completed Austrian general population valuation survey.ResultsWe included 48 patients (mean age 59.9 years; 46% female). In the cognitive interview, the majority indicated that their experience with the survey was positive (85%) and overall clarity as good (90%). In response to the general feedback questions, patients rated the presentation of the health states less clear than matched controls (p = 0.008). There was no difference between patients and the general population concerning the difficulty in choosing between the health states (p = 0.344).ConclusionDespite the relatively large number of DCE domains the survey was manageable for patients and allows going on with the QLU-C10D patient valuation study.
Behavioral symptoms among children and adolescents with attention deficit hyperactivity disorder during COVID-19 outbreak: a retrospective prospective cohort study
Authors: Abdel Fattah Nelly R. , Yousef Amira Mohamed , Mohamed Amany Elshabrawy , Amin Shimaa Ibrahim 
Published: May 2022

Abstract
Background
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental conditions in children, and with the coronavirus pandemic, ADHD children now pose obvious challenges. This retrospective prospective cohort study was conducted on 150 ADHD children and adolescents that had previously attended the child unit of the Psychiatry Department, Zagazig University Hospitals, Sharkia, Egypt, and diagnosed as ADHD patients using the research diagnostic criteria of DSM-5 which administrated by experienced psychiatrists and evaluated by The Arabic version of Conner’s Parent Rating Scale Revised-short version (CPRS-48) before the onset of COVID-19 pandemic. We collected the other data of the study by applying an Arabic language questionnaire which included the data related to the COVID -19 pandemic and the Arabic version of CPRS-48 by which we reevaluated the behavioral symptoms of the subjects who participated in the study during COVID-19 pandemic. This research aimed to evaluate the behavioral symptoms among ADHD children and adolescents and detect the change in these symptoms during the COVID-19 pandemic by comparing them before and during the pandemic.

Results
One hundred fifty ADHD children were included in the study with a mean age of 10 years old. The male gender was predominant and represented 76.7% of the sample. Ninety percent were living in urban areas with more low social class (50%), 84.7% of parents were married, 60% of the family member of our subjects had COVID-19 while 12% lost one or more of their relative by the pandemic (64.7%). The fathers continued working as normal, while 40.7% of the mothers stopped working because of COVID-19. 62.7% of the parents were verbally and physically abusive to their children. Unfortunately, 100% of the subjects stopped attending their behavioral therapy center, 96.0% stopped their Follow up with a psychiatrist, and 55% stopped complying with their medications. As we presumed, we found a statistically significant change in the behavioral and psychological symptoms measured by Conner’s Parent Rating Scale Revised-short version (CPRS-48) during the COVID-19 pandemic compared to the period before. The worsening of the symptoms was associated with age, sex, residency, social class, father and mother present working and couple status, having positive cases or losses of COVID-19 among family members, and patient maltreatment.

Conclusions
To conclude, this study suggests that the lockdown caused by the COVID-19 pandemic has worsened symptoms in a significant number of children and adolescents with ADHD, which needs clinical attention. Moreover, the patients’ psychiatric follow-up and compliance with their medications were markedly affected. Additionally, the lockdown has also led to an increase in the abusive behavior of the parents towards their children.
Left ventricular pseudoaneurysm repair utilizing P2 segment of mitral valve: a case report
Authors: Tien Lillie , Drevets Peter , Ward Alison , Lee Richard 
Published: May 2022

Abstract
Background
Left ventricular (LV) pseudoaneurysms are a rare occurrence typically seen after myocardial infarction (MI) or in patients with prior cardiac surgery and are associated with a significant risk of rupture and mortality. Management includes primary repair, epicardial patching, or percutaneous repair with occlusive devices.

Case presentation
This case report describes a 46-year-old male with a large LV pseudoaneurysm that was surgically patched with a segment of his mitral valve. To our knowledge, there has not been a documented repair utilizing a segment of the mitral valve.

Conclusions
The applicability of this technique is limited to cases with posteriorly located pseudoaneurysms near the mitral valve, thus allowing the P2 segment to be used as a patch. This is a novel approach to LV pseudoaneurysm repair, though careful consideration towards patient selection is warranted, as comorbid conditions may contribute to morbidity and mortality.
Stauffer syndrome: a comprehensive review of the disease and diagnostic plan proposal
Authors: Elseidy Sheref A. , Awad Ahmed K. , Mandal Debvarsha , Elbadawy Merihan A. , Iqbal Amir 
Published: May 2022

AbstractStauffer syndrome, first described by Herbert Stauffer in 1961, is a hepatic paraneoplastic syndrome characterized by multiple extrahepatic malignancies, most commonly renal cell carcinoma. The syndrome manifests a wide range of symptoms caused by various pathophysiological mechanisms and presents with abnormalities in liver function tests in either cholestatic or non-cholestatic patterns.Stauffer’s syndrome is classified into two types: classical and jaundice variants. Some crossovers continue to occur, complicating the diagnosis of such a rare and frequently missed syndrome, which can be the only diagnostic clue for the retrograde detection of a hidden malignancy.To bridge the gap regarding such an important, but still unrecognized, syndrome, not only did we thoroughly cover what had previously been proposed in the literature, but we also proposed a diagnostic protocol based on multicenter experience with such a rare disease.
Posterior ethmoid sinus: a computed tomography analysis and classification
Authors: El-Anwar Mohammad Waheed , Elsayed Atef Hussein , Eldib Diaa Bakry , Almolla Rania Mostafa , Khazbak Alaa Omar 
Published: May 2022

Abstract
Background
The CT details of the dimensions of the posterior ethmoid sinus are not fully covered in the literature, so building up for a base for the CT measurements and description of that area is important. Preoperative details of the posterior ethmoid sinuses are mandatory before any approach or procedure involving this area.

Objective
To determine the different dimensions, measurements, and grading of the posterior ethmoid sinus by computed tomography (CT) that were not previously published.

Methods
Two hundred paranasal CT scans (400 sides) were included in the study. Axial images were acquired with multiplanar reformats to obtain delicate details in coronal and sagittal planes for all subjects.

Results
Within 200 CTs (400 sides), the mean anteroposterior dimension of the posterior ethmoid was 13.62± 1.75 mm (range= 9.5–19.5), the mean posterior ethmoid transverse diameter was 12.15+1.6 mm (range= 8–16.2) and the mean posterior ethmoid height was 44.64±3.83 mm (range= 35.8–56) without reported significant differences between both sides in all posterior ethmoid dimensions. The mean width of the posterior ethmoid sinus and its height from the orbital roof and nasal floor was significantly more in males than in females. There was significantly lower fovea ethmoidalis in males than females as we go posterior.

Conclusion
This study improves surgeons’ awareness and orientation of posterior ethmoid sinus variations in the endoscopic sinus surgery and can be of help to residents in training.
Role of elective neck dissection with salvage laryngectomy
Authors: Anwar Mohamed , Dewidar Hazem , Hareedy Amal , Gebril Note-Elfateh , Nassar Ahmed 
Published: May 2022

Abstract
Background
Elective neck dissection with salvage laryngectomy was associated with decreased quality of life, increased operative time, and increased incidence of complications; some surgeons prefer wait-and-see observation policy. However, lymph nodes recurrence after salvage total laryngectomy during follow-up period carry very poor quality of life and very poor survival rate.
The aim of this study is to investigate the risk of nodal metastases in patients undergoing salvage laryngectomy and to search for predictors of occult metastases in this group of patients. Our study included 30 patients presented with recurrent laryngeal cancer after failure of organ preservation protocol. All selected patients were without detected lymph nodes both clinically and radiologically, classified as N0 according to The TNM classification.
All patients were candidate for salvage total laryngectomy and had elective neck dissection performed during surgery to detect the possible occult cervical lymph node metastasis.

Results
The positive nodal metastasis incidence was 14% in glottic, 29% in supraglottic, and 57% in trans-glottic tumors of all positive patients. The previously indicated results showed statistically significantly increased incidence of positive LN in the supraglottic tumor site and increased incidence of negative LN in the glottic site.
Regarding the recurrence T stage in our study, lymph nodes were negative for metastasis in one patient with rT1 representing 4%, 6 patients with rT2 representing 26%, and for rT3 and rT4 were 65% and 4%, respectively. The nodal metastasis was positive in 3 patients with rT3 representing 43% and 4 patients with rT4 representing 57%. No patients with rT1 or rT2 showed nodal metastasis.

Conclusions
Our findings demonstrated that patients with advanced local disease at recurrence undergoing salvage total laryngectomy may benefit from an elective neck dissection.
Hematological markers and ultrasound 7-joint inflammation score as add-on tools in the assessment of inflammation in rheumatoid arthritis patients
Authors: Gaballah Abd Elatif Ahmed , Elsawy Noha Abdelhalim , El Gendy Wessam Mohamed , Afifi Ahmed Hafez , Hanafi Maha Saeid Mahmoud 
Published: May 2022

AbstractBackgroundRheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and joint destruction that eventually induces severe disability. Inflammation is the key determinant and primary underlying mechanism leading to disability and increased mortality in patients with RA. This study aimed to correlate the hematological markers and ultrasound 7-joint inflammation score to disease activity in rheumatoid arthritis patients.ResultsThe current study involved 54 RA patients diagnosed according to the 2010 ACR/EULAR classification criteria for RA and thirty healthy control subjects. There were 48 females (88.9%) and 6 males (11.1%). The age of patients ranged from 32 to 60 years, with a mean of 46.04 ± 5.65 years. Using disease activity score 28-ESR, total white blood cell count and absolute lymphocytic count were significantly lower in RA patients with high disease activity. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, ESR, and CRP were significantly higher in patients with high disease activity using disease activity score 28 CRP. Also, a statistically significant positive correlation was detected between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and both clinical disease activity scores. Red cell distribution width but not platelet distribution width was significantly higher in RA patients but both parameters had no association or correlation with clinical disease activity scores. Neutrophil-to-lymphocyte ratio was found to have a statistically significant positive correlation with the tenosynovitis score by powered Doppler ultrasound. There were statistically significant positive correlations between disease activity score 28 ESR and CRP and synovitis and tenosynovitis scores by greyscale and powered Doppler ultrasound using the ultrasound 7 score.ConclusionNeutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume could be potential inflammatory markers for follow-up of disease activity in RA patients. The ultrasound 7 score is a simple and practical scoring system for use in the detection of inflammation, even subclinically in RA patients, which may help the physician in his clinical decisions. The combined use of both hematological markers and the ultrasound 7 score may be of great value.
Evan syndrome as initial presentation of COVID-19 infection
Authors: Mohammadien Hamdy A. , Abudab Lotfy H. , Ahmad Azza M. 
Published: May 2022

Abstract
Background
Evans’ syndrome (ES) is a rare and chronic autoimmune disease characterized by the concomitant or sequential association of auto-immune hemolytic anemia (AIHA) with immune thrombocytopenia (ITP), and less frequently autoimmune neutropenia with a positive direct anti-human globulin test. ES represents up to 7% of AIHA and around 2% of ITP. Studies have found that coronavirus disease 2019 (COVID-19) may be associated with various hematological complications, i.e., coagulopathies; however, finding of Evans syndrome is a novel case.

Case report
A 54-year-old diabetic man complaining of fever (high grade), arthralgia and myalgia, fatigue, and dark color of urine. He was admitted to isolation sector at Sohag General Hospital on day 6 because of fever with cough, dyspnea, and progressive fatigue, and at admission, he was tachypneic, tachycardiac, jaundiced, febrile (38 °C), and hypoxemic (O2 saturations on room air was 80%). Laboratory studies showed hemoglobin (Hb) 5.43 g/dL, high reticulocyte (12.5%), ↓ed platelet count (54 × 103/μl), hyperbilirubinemia and elevated C-reactive protein (CRP), D-dimer, ferritin, and lactate dehydrogenase. Markers of autoimmune diseases and screening for malignant diseases were negative. HRCT chest showed bilateral small-sized peripheral ground glass opacities in both lungs, with positive reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 RNA in the nasopharyngeal swab. Direct Coombs test was positive for immunoglobulin (IgG) and C3d. Evans syndrome secondary to COVID-19 was diagnosed and treatment with packed red cell (PRC) transfusions, favipiravir, dexamethasone, prednisone, ceftriaxone, enoxaparin, oral hypoglycemic, and oxygen using face mask, and then Hb value increased to 10.3 g/dL and he was discharged home without any complications.

Conclusion
There are few reports of patients with concurrent COVID-19 and Evans syndrome. So, SARS-CoV-2 infection should be considered in any patient presenting with new-onset ES of unclear etiology.