bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous cholecystocutaneous fistula secondary to xanthogranulomatous cholecystitis: a case report
Authors: Almayouf Abdullah A. , Ahmed Hassan M. , Alzahrani Adel A. , Alashkar Abdulrahman H. 
Published: December 2022

Abstract
Background
Xanthogranulomatous cholecystitis, a rare variant of cholecystitis, may infrequently be complicated by spontaneous cholecystocutaneous fistula.

Case presentation
We report the case of a 75-year-old Saudi Arabian man who presented with “a painful area of redness” (cellulitis) over his right upper abdomen. Abdominal computed tomography revealed multiple collections, which were drained surgically. A discharging sinus was identified, and a fistulogram revealed cholecystocutaneous fistula during his follow-up visit. The patient underwent laparoscopic management and recovered uneventfully. Final histopathological evaluation confirmed acute-on-chronic xanthogranulomatous cholecystitis .

Conclusions
Although rare, surgeons should consider cholecystocutaneous fistula in the differential diagnosis of anterior abdominal wall abscesses, particularly in patients with concurrent or background symptoms of gallbladder disease. We report the first case of laparoscopic management for cholecystocutaneous fistula in Saudi Arabia.
Threatening the 5G core via PFCP DoS attacks: the case of blocking UAV communications
Authors: Amponis George , Radoglou-Grammatikis Panagiotis , Lagkas Thomas , Mallouli Wissam , Cavalli Ana , Klonidis Dimitris , Markakis Evangelos , Sarigiannidis Panagiotis 
Published: December 2022

AbstractThe modern communications landscape requires reliable, high-speed, high-throughput and secure links and sessions between user equipment instances and the data network. The 5G core implements the newly defined 3GPP network architecture enabling faster connectivity, low latency, higher bit rates and network reliability. The full potential of this set of networks will support a set of critical Internet of things (IoT) and industrial use cases. Nevertheless, several components and interfaces of the next-generation radio access network (NG-RAN) have proven to be vulnerable to attacks that can potentially obstruct the network’s capability to provide reliable end-to-end communication services. Various inherent security flaws and protocol-specific weaknesses have also been identified within the 5G core itself. However, little to no research has gone into testing and exposing said core-related weaknesses, contrary to those concerning the NG-RAN. In this paper, we investigate, describe, develop, implement and finally test a set of attacks on the Packet Forwarding Control Protocol (PFCP) inside the 5G core. We find that, by transmitting unauthorised session control packets, we were able to disrupt established 5G tunnels without disrupting subscribers’ connectivity to the NG-RAN, thus hindering the detection of said attacks. We evaluate the identified PFCP attacks in a drone-based scenario involving 5G tunnelling between two swarms.
Analysis of a stochastic predator–prey system with fear effect and Lévy noise
Authors: Xue Renxiu , Shao Yuanfu , Cui Minjuan 
Published: December 2022

AbstractThis paper studies a stochastic predator–prey model with Beddington–DeAngelis functional response, fear effect, and Lévy noise, where the fear is of prey induced by predator. First, we use Itô’s formula to prove the existence and uniqueness of a global positive solution and its moment boundedness. Next, sufficient conditions for the persistence and extinction of both species are given. We further investigate the stability in distribution of our system. Finally, we verify our analytical results by exhaustive numerical simulations.
3D printing of molds for the creation of facsimiles and volumetric reintegrations in wax anatomical sculptures
Authors: Sterp Moga Emanuel , Sánchez-Ortiz Alicia , Hernández-Muñoz Óscar 
Published: December 2022

Abstract
In recent years, 3D printing technologies have had a considerable impact on the field of conservation and restoration of cultural heritage. Professionals in this sector have been provided with exploratory tools for documenting, analyzing, intervening, and preserving objects and works of art that make up our history. This research focuses on finding the most suitable material along with the ideal printing position that could provide molds for the production of anatomical wax facsimiles that guarantee maximum quality and fidelity when compared to its original. These replicas and fragments allow conservator-restorers to volumetrically reintegrate while testing different options before applying direct treatment to the works. The results obtained from testing on different types of printing materials as well as the positives achieved from them are presented.
Εffect of cleansers on the composition and mechanical properties of orthodontic aligners in vitro
Authors: Iliadi Anna , Enzler Vera , Polychronis Georgios , Peltomaki Timo , Zinelis Spiros , Eliades Theodore 
Published: December 2022

Abstract
Background
The aim of the study was to investigate the effect of three aligner cleaners on the composition and mechanical properties of two types of orthodontic aligners.

Materials and methods
The cleaners tested were two alkaline peroxide solutions (Retainer Brite—RB; Retainer Cleaner—RC) and one peroxide-free (Steraligner—ST) and the aligners Clear Aligner (C, polyester) and Invisalign (I, polyester–urethane). The aligners were immersed in the cleaner solutions as instructed every day (15 min for RB, RC; 5 min for ST) for a two-week period. The acidity of the solutions was tested with a pH meter. The changes in the chemical composition of the aligners were studied by attenuated total-reflection Fourier transform infrared spectrometry (ATR-FTIR), while Instrumented Indentation Testing (IIT) was used for assessment of changes in Martens Hardness (HM), modulus (EIT), elastic index (nIT) and relaxation (RIT).

Results
RB and RC were weakly acidic (pH = 6.3), whereas ST was mildly acidic (pH = 4.8). The ATR-FTIR analysis demonstrated evidence of acidic hydrolysis of C in ST and I in RB. The IIT-derived properties of I were not affected by the cleaners. However, for C a significant change was found in HM (all cleaners), nIT (all cleaners) and RIT (RB, ST). Although the chemical changes support a hydrolytic material deterioration, the results of mechanical properties may interfere with the material residual stresses during fabrication.

Conclusions
Caution should be exerted in the selection of aligner cleaners. The mild acidic cleanser was more aggressive to the polyester, whereas an alkaline peroxide to the polyester–urethane aligner.
Effects of cerebellar transcranial direct current stimulation on upper limb motor function after stroke: study protocol for the pilot of a randomized controlled trial
Authors: Yuasa Akiko , Uehara Shintaro , Ushizawa Kazuki , Toyama Takamichi , Gomez-Tames Jose , Hirata Akimasa , Otaka Yohei 
Published: December 2022

Abstract
Background
Transcranial direct current stimulation (tDCS) is a technique that can noninvasively modulate neural states in a targeted brain region. As cerebellar activity levels are associated with upper limb motor improvement after stroke, the cerebellum is a plausible target of tDCS. However, the effect of tDCS remains unclear. Here, we designed a pilot study to assess: (1) the feasibility of a study that aims to examine the effects of cerebellar tDCS combined with an intensive rehabilitation approach based on the concept of constraint-induced movement therapy (CIMT) and (2) the preliminary outcome of the combined approach on upper limb motor function in patients with stroke in the chronic stage.

Methods
This pilot study has a double-blind randomized controlled design. Twenty-four chronic stroke patients with mild to moderate levels of upper limb motor impairment will be randomly assigned to an active or sham tDCS group. The participants will receive 20 min of active or sham tDCS to the contralesional cerebellum at the commencement of 4 h of daily intensive training, repeatedly for 5 days per week for 2 weeks. The primary outcomes are recruitment, enrollment, protocol adherence, and retention rates and measures to evaluate the feasibility of the study. The secondary outcome is upper limb motor function which will be evaluated using the Action Research Arm Test, Fugl-Meyer Assessment, for the upper extremity and the Motor Activity Log. Additionally, neurophysiological and neuroanatomical assessments of the cerebellum will be performed using transcranial magnetic stimulation and magnetic resonance imaging. These assessments will be conducted before, at the middle, and after the 2-week intervention, and finally, 1 month after the intervention. Any adverse events that occur during the study will be recorded.

Discussion
Cerebellar tDCS combined with intensive upper limb training may increase the gains of motor improvement when compared to the sham condition. The present study should provide valuable evidence regarding the feasibility of the design and the efficacy of cerebellar tDCS for upper limb motor function in patients with stroke before a future large trial is conducted.

Trial registration
This study has been registered at the Japan Registry of Clinical Trials (jRCTs042200078). Registered 17 December 2020
Influences of early diagnostic suggestions on clinical reasoning
Authors: Kourtidis Ploutarchos , Nurek Martine , Delaney Brendan , Kostopoulou Olga 
Published: December 2022

AbstractPrevious research has highlighted the importance of physicians’ early hypotheses for their subsequent diagnostic decisions. It has also been shown that diagnostic accuracy improves when physicians are presented with a list of diagnostic suggestions to consider at the start of the clinical encounter. The psychological mechanisms underlying this improvement in accuracy are hypothesised. It is possible that the provision of diagnostic suggestions disrupts physicians’ intuitive thinking and reduces their certainty in their initial diagnostic hypotheses. This may encourage them to seek more information before reaching a diagnostic conclusion, evaluate this information more objectively, and be more open to changing their initial hypotheses. Three online experiments explored the effects of early diagnostic suggestions, provided by a hypothetical decision aid, on different aspects of the diagnostic reasoning process. Family physicians assessed up to two patient scenarios with and without suggestions. We measured effects on certainty about the initial diagnosis, information search and evaluation, and frequency of diagnostic changes. We did not find a clear and consistent effect of suggestions and detected mainly non-significant trends, some in the expected direction. We also detected a potential biasing effect: when the most likely diagnosis was included in the list of suggestions (vs. not included), physicians who gave that diagnosis initially, tended to request less information, evaluate it as more supportive of their diagnosis, become more certain about it, and change it less frequently when encountering new but ambiguous information; in other words, they seemed to validate rather than question their initial hypothesis. We conclude that further research using different methodologies and more realistic experimental situations is required to uncover both the beneficial and biasing effects of early diagnostic suggestions.
COVID19-induced immunosuppression and aggressive progression of primary cranial vault lymphoma presenting as a management challenge, a case report, and a literature review
Authors: Jha Vikas Chandra , Alam Mohammad Shahnawaz 
Published: December 2022

Abstract
Background
We needs to study Primary Large cell Non-Hodgkin’s Lymphoma of the cranial vault, which is rare, and its association with COVID19 has not been reported, which may have an immunosuppressive effect to aggravate its progression.

Patient details
Our patient, a 53-year-old male, noticed fast growth of posterior cranial vault lesion from 2 to 10 cm size in last 6 months after COVID 19 affliction. MRI brain with contrast revealed lesions suggesting meningioma. The whole-body PET scan was normal. Following Subtotal excision of the mass, histopathology revealed large B-cell Non-Hodgkin’s lymphoma (DLBCL). Immunohistochemistry showed positive results for CD10, CD20, CD45 (LCA), ALK, and BCL-VE with a Ki-67 index of 90–95%. Following radiotherapy and chemotherapy patient is disease-free on imaging and doing well at 5 months of follow-up.

Conclusions
Early intervention with excisional biopsy and timely chemo and radiotherapy in favorable immunostaining may add survival benefits even in malignant features induced by immunosuppressing diseases such as COVID19 in diffuse large B-cell lymphoma (DLBCL) of the scalp.
ALSFRS-R-SE: an adapted, annotated, and self-explanatory version of the revised amyotrophic lateral sclerosis functional rating scale
Authors: Maier André , Boentert Matthias , Reilich Peter , Witzel Simon , Petri Susanne , Großkreutz Julian , Metelmann Moritz , Lingor Paul , Cordts Isabell , Dorst Johannes , Zeller Daniel , Günther René , Hagenacker Tim , Grehl Torsten , Spittel Susanne , Schuster Joachim , Ludolph Albert , Meyer Thomas ,   for the MND-NET consensus group
Published: December 2022

Abstract
Background
The ALS Functional Rating Scale in its revised version (ALSFRS-R) is a disease-specific severity score that reflects motor impairment and functional deterioration in people with amyotrophic lateral sclerosis (ALS). It has been widely applied in both clinical practice and ALS research. However, in Germany, several variants of the scale, each differing slightly from the others, have developed over time and are currently in circulation. This lack of uniformity potentially hampers data interpretation and may decrease item validity. Furthermore, shortcomings within the standard ALSFRS-R questions and answer options can limit the quality and conclusiveness of collected data.

Methods
In a multistage consensus-building process, 18 clinical ALS experts from the German ALS/MND network analyzed the ALSFRS-R in its current form and created an adapted, annotated, and revised scale that closely adheres to the well-established standardized English version.

Results
Ten German-language variants of the ALSFRS-R were collected, three of which contained instructions for self-assessment. All of these variants were compiled and a comprehensive linguistic revision was undertaken. A short introduction was added to the resulting scale, comprising general instructions for use and explanations for each of the five reply options per item. This adapted version of the scale, named ALSFRS-R-SE (with the “SE” referring to “self-explanatory”), was carefully reviewed for language and comprehensibility, in both German and English.

Conclusion
An adapted and annotated version of the ALSFRS-R scale was developed through a multistage consensus process. The decision to include brief explanations of specific scale items and reply options was intended to facilitate ALSFRS-R-SE assessments by both healthcare professionals and patients. Further studies are required to investigate the accuracy and utility of the ALSFRS-R-SE in controlled trials and clinical real-world settings.
Genotype by environment interaction analysis for Fusarium head blight response and yield performance of bread wheat (Triticum aestivum L.) in southern Ethiopia
Authors: Mengesha Getachew Gudero , Abebe Shiferaw Mekonnen , Tsakamo Yisahak Tsegaye , Issa Bilal Temmam , Lera Zerhun Tomas , Shertore Misgana Mitku , Fedilu Kedir Bamud , Tadesse Yosef Berihun , Mekonnen Asaminew Amare , Esho Abate Gebremikael , Dojamo Tariku Simion , Halengo Muluneh Mekiso , Mena Gedyon Tamru , Adamo Wondimu Adila , Cheleko Dizgo Chencha , Woldesilassie Agdew Bekele 
Published: December 2022

AbstractFusarium head blight (FHB) is one of the major biotic constraints to wheat due to its direct detrimental effects on yield quality and quantity. To manage the disease, the deployment of resistant genotypes is ideal in terms of effectiveness, eco-friendliness, and sustainability of production. The study was conducted to determine the responses of different wheat genotypes to FHB, and to identify suitable and stable wheat genotype(s) regarding the FHB resistance and yield performance. A field study was carried out using eleven bread wheat genotypes in seven locations in southern Ethiopia during the 2019 main cropping season. A randomized complete block design with three-time replicates was applied in this study. The results showed that the lowest mean FHB severity (11.33%) and highest mean yield (4.54 t/ha) were recorded at Bonke. Conversely, the highest mean FHB severity (83.38%) and the lowest mean yield (0.94 t/ha) were observed at North Ari. It was also showed that maximum mean FHB severity (49.25%) and minimum mean yield (2.95 t/ha) were recorded on the genotype Hidase under crosswise assessment. Across locations, a minimum mean FHB severity (17.54, 18.83, and 21.31%) and maximum mean yield (3.92, 3.96, and 3.93 t/ha) were noted from the Shorima, Bondena, and Wane genotypes, respectively. GGE biplot analysis and various comparison tests for FHB severity revealed a higher percentage of variation concerning FHB resistance reactions due to the environment (47% as an interactive element), followed by genotype by environment interaction (21%). AMMI analysis revealed genotype, environment, and genotype by environment interaction had a total variation of 7.10, 58.20, and 17.90% for yield performance, respectively. The inconsistency between genotype responses to FHB and yield performance demonstrated that the environmental component was responsible for significant variability in FHB reaction, yield performance, and the dominance of cross-over interaction. However, the greatest level of resistance to FHB was comparatively found in the genotypes Shorima, Bondena, Wane, and Huluka across locations. Considering both FHB resistance response and yield stability, in most environments, Shorima, Bondena, Wane, and Huluka genotypes were suggested for consideration of cultivation where they are well-performed under the pressure of FHB. North Ari and Hulbareg were acknowledged as more discriminating environments than the others for test genotypes against FHB. Bonke and Chencha were considered ideal environments for selecting superior genotypes with good yield performance.
Evidence of orthohantavirus and leptospira infections in small mammals in an endemic area of Gampaha district in Sri Lanka
Authors: Sunil-Chandra N. P. , Fahlman Åsa , Waidyarathna Shantha , Näslund Jonas , Jayasundara M. V. M. L. , Wesula Lwande Olivia , Bucht Göran 
Published: December 2022

Abstract
Background
Orthohantaviruses and leptospira are emerging zoonotic pathogens of high public health significance. The epidemiology of orthohantavirus infections and leptospirosis is similar and presents related clinical pictures in humans. However, a paucity of data on actual reservoir hosts for orthohantaviruses and leptospira exists. Therefore, this study aimed at determining the occurrence of orthohantaviruses and leptospira in small mammals captured in an endemic region of Sri Lanka.

Methods
Rodents and shrews were morphologically and/or genetically identified using morphological keys and DNA barcoding techniques targeting the cytochrome oxidase b subunit gene (Cytb). Lung tissues and sera were subsequently analyzed for the presence of orthohantavirus RNA using qRT-PCR. Sera of rats were tested for IgG antibodies against orthohantaviruses and leptospira.

Results
Forty-three (43) small mammals representing: Rattus (R.) rattus (black rat) or R. tanezumi (Asian rat), Suncus murinus (Asian house shrew), R. norvegicus (brown rat) and Mus musculus (house mouse) were investigated. No orthohantavirus RNA was detected from the lung tissue or serum samples of these animals. Elevated levels of IgG antibodies against Puumala orthohantavirus (PUUV) and/or Seoul orthohantavirus (SEOV) antigens were detected in sera of 28 (72%) out of the 39 rats analysed. Interestingly, 36 (92%) of the 39 rats also showed presence of anti leptospira-IgG antibodies in their serum, representing dual infection or dual exposure in 26/39 (66.7%) of examined rats.

Conclusions
This project targets important public health questions concerning the occupational risk of orthohantavirus infections and/or leptospirosis in an endemic region of Sri Lanka. Most rats (72%) in our study displayed antibodies reacting to orthohantavirus NP antigens, related to PUUV and/or SEOV. No correlation between the orthohantavirus and leptospira IgG antibody levels were noticed. Finally, a combination of both morphological and DNA barcoding approaches revealed that several species of rats may play a role in the maintenance and transmission of orthohantavirus and leptospira in Sri Lanka.
Characterization of the gut microbiome and resistome of Galapagos marine iguanas (Amblyrhynchus cristatus) from uninhabited islands
Authors: Vasco Karla , Guevara Nataly , Mosquera Juan , Zapata Sonia , Zhang Lixin 
Published: December 2022

Abstract
Background
Understanding the natural microbiome and resistome of wildlife from remote places is necessary to monitor the human footprint on the environment including antimicrobial use (AU). Marine iguanas are endemic species from the Galapagos Islands where they are highly affected by anthropogenic factors that can alter their microbiota as well as their abundance and diversity of antimicrobial-resistant genes (ARGs). Thus, this study aims to apply culture-independent approaches to characterize the marine iguana’s gut metagenomic composition of samples collected from the uninhabited islands Rabida (n = 8) and Fernandina (Cabo Douglas, n = 30; Punta Espinoza, n = 30). Fresh feces from marine iguanas were analyzed through SmartChip RT-PCR, 16S rRNA, and metagenomic next-generation sequencing (mNGS) to identify their microbiome, microbial-metabolic pathways, resistome, mobilome, and virulome.

Results
The marine iguana’s gut microbiome composition was highly conserved despite differences in ecological niches, where 86% of taxa were shared in the three locations. However, site-specific differences were mainly identified in resistome, mobilome, virulorome, and metabolic pathway composition, highlighting the existence of factors that induce microbial adaptations in each location. Functional gut microbiome analyses revealed its role in the biosynthesis and degradation of vitamins, cofactors, proteinogenic amino acids, carbohydrates, nucleosides and nucleotides, fatty acids, lipids, and other compounds necessary for the marine iguanas. The overall bacterial ARG abundance was relatively low (0.006%); nevertheless, the presence of genes encoding resistance to 22 drug classes was identified in the iguana’s gut metagenome. ARG-carrying contig and co-occurrence network analyses revealed that commensal bacteria are the main hosts of ARGs. Taxa of public health interest such as Salmonella, Vibrio, and Klebsiella also carried multidrug-resistance genes associated with MGEs which can influence the dissemination of ARGs through horizontal gene transfer.

Conclusion
Marine iguanas depend on the gut microbiome for the biosynthesis and degradation of several compounds through a symbiotic relationship. Niche-specific adaptations were evidenced in the pool of microbial accessory genes (i.e., ARGs, MGEs, and virulence) and metabolic pathways, but not in the microbiome composition. Culture-independent approaches outlined the presence of a diverse resistome composition in the Galapagos marine iguanas from remote islands. The presence of AR pathogens in marine iguanas raises concerns about the dispersion of microbial-resistant threats in pristine areas, highlighting wildlife as sentinel species to identify the impact of AU.