bluuebunny/crossref_metadata_2025_split huggingface dataset:
Online information on medical cannabis is not always aligned with scientific evidence and may raise unrealistic expectations
Authors: Macedo Arthur Cassa , de Faria André Oliveira Vilela , Bizzi Isabella , Moreira Fabrício A. , Colasanti Alessandro , Ghezzi Pietro 
Published: July 2022

Abstract
Background
There is a growing literature on the potential medical uses of Cannabis sativa and cannabinoid compounds. Although these have only been approved by regulatory agencies for a few indications, there is a hype about their possible benefits in a variety of conditions and a large market in the wellness industry. As in many cases patients search for information on cannabis products online, we have analyzed the information on medical cannabis available on the Internet. Therefore, this study aims at assessing the quality of the information available online on medical cannabis.

Methods
We searched “medical cannabis” on June 2019 using google.com and downloaded the first 243 websites. After excluding dead links or websites with no information about cannabis, 176 websites were included. They were then classified for their typology (e.g., commercial, government, news outlets). As an indicator of trustworthiness, we used the Journal of American Medical Association (JAMA) score, which assesses the indication of date, author, ownership of the website, and the presence of references. We also considered if a website is certified by Health-On-the-Net (HON), an independent organization, by displaying a HONCode symbol. Subsequently, we performed a content analysis to assess both the medical cannabis indications mentioned by webpages and the completeness of the information provided (whether they mentioned potential side effects and legal/regulatory issues or not).

Results
Analyzing 176 webpages returned by a search engine, we found that 52% of them were news websites. Pain, epilepsy, and multiple sclerosis were the most frequently mentioned therapeutic areas (cited in 92, 84 and 80 webpages, respectively), which did not always match those for which there is regulatory approval. Information was also incomplete, with only 22% of the webpages mentioning potential side effects. Health portal websites provided the most complete information, with all of them (n = 7) reporting side effects. On average, 80% of webpages had a neutral stance on the potential benefits of medical cannabis, with commercial websites having more frequently a positive stance (67%).

Conclusions
We conclude that the information that can be found online is not always aligned in terms of the therapeutic areas for which science-based evidence is often still weak.
Revisiting some overlooked registered Thai traditional medicine preparations: an alert to a regulatory affair
Authors: Vimolmangkang Sornkanok , Rani Dolly , Prestwong Naruemon , Sutcharitchan Chayanis , Pakdeesattayapong Duangkamol 
Published: July 2022

Abstract
Objective
This study evaluated the heavy metal identity and content of registered Thai Traditional medicine (TTM) preparations in Thailand to ensure consumer safety.

Methods
Both qualitative and quantitative information about the elemental composition of the heavy metal content in each TTM crude drug and the heavy metal content in some registered TTM preparations in Thailand was performed. Seven kinds of mineral-based TTM crude drugs, namely realgar, orpiment, Chinese powder, Sen, vermilion, natural vermilion, and cinnabar, were analyzed with X-ray diffraction and scanning electron microscopy and energy-dispersive spectroscopy techniques to determine the type of metal and elemental composition to confirm their chemical formulas. Furthermore, the number of heavy metals, such as arsenic (As), lead (Pb), and mercury (Hg), was in three samples of realgar-containing preparations; one sample of Sen-containing preparation, and eight samples of cinnabar-containing preparations. Heavy metals were determined with inductively coupled plasma-optical emission spectrometry.

Results
It was observed that realgar and orpiment consisted of arsenic sulfide (AsS) and arsenic trisulfide (As2S3), respectively. Both crude drugs contained approximately 50% of As. Vermilion, natural vermilion, and cinnabar consisted of mercuric sulfide (HgS), with Hg accounting for approximately 66%. Sen consisted of Pb (II, IV) oxide (Pb3O4) with an approximate Pb percentage of 80%. However, Pb was absent in Chinese powder and consisted mainly of calcium carbonate (CaCO3). A traditional detoxification procedure can reduce the amount of As and Hg in processed crude drugs by at least 20%.

Conclusions
Pb was higher in some TTM preparations, and no CaCO3 was detected in Chinese powder. Our results raise concerns on both safety and efficacy to consumers and alert public health policymakers that they should implement regulations so that the quality (authenticity) and quantity of elemental medicine used in traditional medicine are correctly labeled and within permissible limits to prevent threats to consumers.
“Hiding beaver tail liver”: a rare case report of a beaver tail liver lookalike variant located medially to the spleen, mimicking a perisplenic hematoma
Authors: Arkoudis Nikolaos-Achilleas , Stamelos Konstantinos , Tsochatzis Athanasios , Moschovaki-Zeiger Ornella , Spiliopoulos Stavros 
Published: July 2022

Abstract
Background
Liver lobe anatomic variations are uncommon and may often cause clinical difficulties. We present a trauma patient with a previously unreported (to our knowledge) hepatic morphology, which was initially misdiagnosed as a possible perisplenic hematoma, leading to unnecessary further investigations.

Case presentation
A 32-year-old male patient was brought to our hospital’s emergency department following a low-energy motor vehicle accident. The patient was ambulatory, had a GCS of 15/15, and appeared hemodynamically stable with normal hematocrit (Hct)/hemoglobin (Hb) blood counts. No clinical signs/symptoms of bleeding were noted, and no significant complaints were documented, besides minor left flank tenderness with overlying abrasions. The patient's past medical history was insignificant. FAST (Focused Assessment with Sonography for Trauma) scan performed gave the impression of a crescent-shaped hypoechoic lesion/collection medially to the spleen, raising suspicion of a perisplenic hematoma. Subsequent computed tomography (CT) scan displayed no trauma-related findings, while the suspected hematoma was seen to correspond to variant left hepatic lobe morphology.

Conclusion
The “hiding beaver tail liver” (HBTL) is a hepatic morphology variant encountered when the lateral part of the left liver lobe (beaver’s tail) extends across the midline and lies medially to the visceral surface of the spleen, following an acute angulation (in hiding). As it can mimic true pathology, familiarity with this morphology is crucial to avoid false diagnosis and unnecessary investigations.
Use of Herbal Medicine Is Associated With Late-Stage Presentation in Tanzanian Patients With Cancer: A Survey to Assess the Utilization of and Reasons for the Use of Herbal Medicine
Authors: Henke Oliver , Bruchhausen Walter , Massawe Anna 
Published: July 2022

PURPOSE In Tanzania, patients with cancer present late with advanced stages. Among other reasons, the use of herbal medicine (HM) might contribute to delay in diagnosis and treatment. This study aims to understand the utilization of HM and the reasons for its' use. METHODS A semistructured 30-item questionnaire with closed- and open-ended questions was applied to a cohort of patients with cancer at Kilimanjaro Christian Medical Centre. Content analysis was performed for answers to open-ended questions. RESULTS Three hundred two patients were interviewed, 50.9% males and 49.1% females. The mean age was 64 years. 71.6% were in stages III/IV. 70.5% patients used HM and 67.1% started conventional medicine after stopping HM, 7.5% started HM after conventional medicine, and 24.9% combined both. Stage IV patients used HM as first line significantly more often in comparison: stage I 55.6%; II 58.1%; III 57.2%; and IV 70.6%. 77.5% did not tell their doctors about the use of HM. Commonest reasons to use HM were belief in cure, hope of symptom relief, lack of cancer services, and tradition. CONCLUSION The majority of patients used HM before consulting a doctor, which contributes to stage IV presentation. Use of HM alongside with chemotherapy is mostly not known to the treating physician and may lead to interactions. These findings must alert health care workers and health policymakers to further foster health education about cancer and its treatment. Further research is needed to understand the wide use of HM among Tanzanian patients with cancer and the role that traditional and spiritual healers play in the field of cancer care.
Long-Term Benefits of Tagraxofusp for Patients With Blastic Plasmacytoid Dendritic Cell Neoplasm
Authors: Pemmaraju Naveen , Sweet Kendra L. , Stein Anthony S. , Wang Eunice S. , Rizzieri David A. , Vasu Sumithira , Rosenblat Todd L. , Brooks Christopher L. , Habboubi Nassir , Mughal Tariq I. , Kantarjian Hagop , Konopleva Marina , Lane Andrew A. 
Published: July 2022

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an aggressive myeloid malignancy. We report long-term results, including data from the continued access phase, of the largest prospective BPDCN trial evaluating the CD123-targeted therapy tagraxofusp (TAG) in adults with treatment-naive and relapsed/refractory BPDCN. The primary outcome was complete response (CR) + clinical CR (CRc: CR with residual skin abnormality not indicative of active disease). Eighty-four (65 treatment-naive and 19 relapsed/refractory) of 89 patients received TAG 12 μg/kg once daily; the median follow-up was 34.0 months. For treatment-naive patients, the overall response rate was 75%; 57% achieved CR + CRc. The median time to remission was 39 (range, 14-131) days, and the median CR + CRc duration was 24.9 (95% CI, 3.8 to not reached) months. Nineteen patients (51%) with CR + CRc were bridged to stem-cell transplant, with a median CR + CRc duration of 22.2 (range, 1.5-57.4) months. Most common adverse events were increased alanine (64%) or aspartate (60%) aminotransferase and hypoalbuminemia (51%); most occurred in cycle 1 and were transient. Capillary leak syndrome occurred in 21% of patients (grade ≥ 3: 7%). In first-line patients with BPDCN, TAG monotherapy resulted in high and durable responses, allowing many to bridge to stem-cell transplant. TAG was generally well-tolerated with a predictable and manageable safety profile.
Diffraction-induced entanglement loss of high-dimensional orbital angular-momentum states
Authors: Zhu Kuntuo , Ye Zhangdong 
Published: July 2022

Abstract
The entanglement loss of high-dimensional entangled orbital angular-momentum states in far-field diffraction by a circular aperture was studied theoretically. A general expression for high-dimensional entanglement decay is provided. The results show that the loss depends on both the parity and the magnitude of the orbital angular-momentum index, and it is not affected by a small misalignment error of the aperture.
Facial Nerve Massage for the Treatment of Hemifacial Spasm Refractory to Microvascular Decompression: Outcomes and Complications
Authors: Patel Kevin P. , Eubanks Komal , Wecht Daniel A. , Sekula Raymond F. 
Published: July 2022

BACKGROUND:
After microvascular decompression (MVD) for hemifacial spasm (HFS), a minority of patients realize little to no relief of spasms. In some patients, the absence of relief of spasms results from incomplete or inadequate decompression of vascular compression of the facial nerve, and these patients represent excellent candidates for repeat MVD. However, in other patients, repeat MVD is not appropriate because adequate decompression and resolution of neurovascular compression, as determined by postoperative high-resolution MRI, was achieved with the initial operation.

OBJECTIVE:
To present a cohort of patients with a history of HFS refractory to MVD, with no evidence of neurovascular compression on postoperative MRI, who underwent facial nerve massage (FNM) in the posterior fossa in an attempt to relieve spasms.

METHODS:
Thirteen patients with a history of incomplete relief of spasms after technically adequate MVD surgery for hemifacial spasm underwent FNM. Immediate and long-term degree of spasm relief and complications after FNM were documented through in-person or telemedicine interview.

RESULTS:
At follow-up after FNM, 7 of 12 patients (58.3%) reported complete spasm relief (grade I), 2 of 12 patients (16.7%) reported >75% spasm relief (grade II), 0 patient (0%) reported >50% spasm relief (grade III), 3 of 12 (25.0%) patients reported <50% spasm relief (grade IV), and 1 patient was lost to follow-up. One patient experienced a delayed facial paresis, and another patient experienced high-frequency hearing loss.

CONCLUSION:
After FNM, durable and, at least, partial relief of spasms with a relatively low complication rate was observed in most patients with HFS with incomplete relief of spasms after technically adequate prior MVD.
Pharmacological intervention of the FGF–PTH axis as a potential therapeutic for craniofacial ciliopathies
Authors: Bonatto Paese Christian Louis , Chang Ching-Fang , Kristeková Daniela , Brugmann Samantha A. 
Published: July 2022

ABSTRACT
Ciliopathies represent a disease class characterized by a broad range of phenotypes including polycystic kidneys and skeletal anomalies. Ciliopathic skeletal phenotypes are among the most common and most difficult to treat due to a poor understanding of the pathological mechanisms leading to disease. Using an avian model (talpid2) for a human ciliopathy with both kidney and skeletal anomalies (orofaciodigital syndrome 14), we identified disruptions in the FGF23–PTH axis that resulted in reduced calcium uptake in the developing mandible and subsequent micrognathia. Although pharmacological intervention with the U.S. Food and Drug Administration (FDA)-approved pan-FGFR inhibitor AZD4547 alone rescued expression of the FGF target SPRY2, it did not significantly rescue micrognathia. In contrast, treatment with a cocktail of AZD4547 and teriparatide acetate, a PTH agonist and FDA-approved treatment for osteoporosis, resulted in molecular, cellular and phenotypic rescue of ciliopathic micrognathia in talpid2 mutants. Together, these data provide novel insight into pathological molecular mechanisms associated with ciliopathic skeletal phenotypes and a potential therapeutic strategy for a pleiotropic disease class with limited to no treatment options.
Empirical estimation of skin resistance to water loss in amphibians: agar evaluation as a non-resistance model to evaporation
Authors: Senzano Luis M. , Bovo Rafael P. , Andrade Denis V. 
Published: July 2022

ABSTRACT
Total resistance (rt) to evaporative water loss (EWL) in amphibians is given by the sum of the boundary layer (rb) and the skin resistance (rs). Thus, rs can be determined if the rb component is defined (rs=rt−rb). The use of agar models has become the standard technique to estimate rb under the assumption that the agar surface imposes no barrier to evaporation (rs=0). We evaluated this assumption by determining EWL rates and rb values from exposed surfaces of free water, a physiological solution mimicking the osmotic properties of a generalized amphibian, and agar gels prepared at various concentrations using either water or physiological solution as diluent. Water evaporation was affected by both the presence of solutes and agar concentration. Models prepared with agar at 5% concentration in water provided the most practical and appropriate proxy for the estimation of rb.
Differentiation of multiple myelomas from osteolytic bone metastases: Diagnostic value of tumor homogeneity on Contrast-Enhanced CT
Authors: Huh Yeon Jong , Lee So-Yeon , Kim Sanghee , Lee Seung Eun , Jung Joon-Yong 
Published: July 2022

Objectives: To investigate the diagnostic value of tumor homogeneity on contrast-enhanced (CE) computed tomography (CT) to differentiate multiple myeloma (MM) from osteolytic bone metastases (Mets). Methods: This retrospective study included patients who were diagnosed with MM or Mets and had multiple (≥2) osteolytic bone tumors on pre-treatment CE-CT. Intratumoral homogeneity was assessed by coefficient of variation (CV, ratio of standard deviation to mean) of the density of a single lesion (CV-lesion). Intertumoral homogeneity was assessed as the CV of the densities of multiple lesions in one patient (CV-patient). A classification model was built from CT parameters using classification and regression tree (CART) analysis. Diagnostic performance of the model was evaluated using C-statistics. Results: A total of 272 lesions (81 MM and 191 Mets) of 105 patients were analyzed. The mean CV-lesion and CV-patient of MM were significantly lower than those of Mets: 0.17 vs 0.26 for CV-lesion (p = 0.005) and 0.16 vs 0.23 for CV-patient (p = 0.013). Thickened struts were more common in MM than in Mets (49.1% vs 12.8%, p ≤ 0.001). In CART analysis, CV-lesion was the first partitioning predictor, followed by thickened struts and by CV patient. The CART model could distinguish MM from Mets in both the model development cohort (C-statistic: 0.843) and the temporal validation cohort (0.721, 0.686, and 0.686 for three reviewers, respectively). Conclusions: MM showed intratumoral and intertumoral homogeneity compared with Mets on CE-CT. The combination of CV-lesion and CV-patient can be helpful to radiologists in differentiation of MM from Mets. Advances in knowledge: Our study showed that MM had intratumoral and intertumoral homogeneity compared with Mets on contrast-enhanced CT.
Nomograms predicting recurrence in patients with triple negative breast cancer based on ultrasound and clinicopathological features
Authors: Zhang Lei , Zhang Xudong , Han Peng , Zhao Dantong , Hu Nana , Fan Wei , Wang Panting , Zuo Xiaoxuan , Kong Hanqing , Peng Fuhui , Tian Jiawei , Cui Hao 
Published: July 2022

Objectives:
The clinicopathological and ultrasound features associated with recurrence in patients with triple negative breast cancer (TNBC) were used to develop a nomogram to predict the prognosis of TNBC.

Methods:
Clinicopathological data of 300 patients with TNBC treated between July 2012 and September 2014 were retrospectively reviewed. The endpoint was progression-free survival (PFS). Prognostic factors were screened by multivariate COX regression to develop nomograms. The C-index and calibration curves were used to evaluate the predictive accuracy and discriminatory ability of nomograms.

Results:
Of 300 patients with TNBC followed-up for 5 years, 80 (26.7%) had PFS events. Five informative prognostic factors (large size, vertical orientation, posterior acoustic enhancement, lymph node involvement, and high pathological stage) were screened and used to construct a nomogram for PFS. The C-index of the PFS nomogram was 0.88 (p &lt; 0.01, 95% confidence interval, 0.85–0.90), indicating good predictive accuracy.

Conclusions:
We developed and validated a nomogram for predicting PFS in TNBC. Vertical orientation and posterior acoustic enhancement in ultrasound images of TNBC were associated with worse outcomes.

Advances in knowledge:
Patients with TNBC have a very poor prognosis and patients have a high risk of recurrence, and our study developed a nomogram based on ultrasound and clinicopathological features for TNBC patients to improve the accuracy of individualized prediction of recurrence and provide help for clinical treatment.
Assessment of cardiorespiratory fitness among medical students: a prospective study
Authors: Sharma Abhishek , Sah Shiva Pratik , Rajak Ashik , BC Ayush , Sah Aashutosh , Dhakal Rabindra , Maskey Nawanit , Bajracharya Samyak , Mishra Aavash , Jha Goody 
Published: July 2022

Background: Physical activity and fitness level of fitness decline mostly between adolescence and early adulthood. This leads to risks of non-communicable diseases in the future. Medical students, assumed to have an extensive understanding of physical exercise and its benefits, are less active than they were before attending graduate school. This study aimed to assess changes in physical fitness and physical activity of students over-time. Methods: This was a prospective study undertaken at Basic Science Complex of Kathmandu Medical College Teaching Hospital in Nepal. In total, 72 medical students were put through a modified Harvard step test during their first year and then three years later during their third year at medical school. Maximum aerobic capacity (VO2 max) was calculated subsequently by plotting the average pulse rate on the Astrand-Rhyming Nomogram. Results: The mean value of relative maximum aerobic capacity (VO2 max) decreased from first year to the third year. When the mean values of body mass index and relative maximum aerobic capacity were compared between first year and third year, the difference was found to be statistically significant (p-value=0.000). The physical fitness index and relative maximum aerobic capacity in both years were positively correlated r (70) = +.59, p<0.001(first year); r (70) = +.47, p<0.001(third year). Meanwhile, body mass index and relative maximum aerobic capacity in the third year were negatively correlated and statistically significant with r (70) = -0.23, p=.045. Conclusions: Cardiorespiratory fitness of the students steadily declined as they progressed through their academic years. Positive correlation between cardiorespiratory fitness and physical fitness index was established along with negative correlation between body mass index and cardiorespiratory fitness. The findings in this study expose the lack of fitness in youth as they focus more on academics, giving the impression that they forget to implement a fitness routine in their lifestyle.