bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demographics, clinical characteristics, and real-world treatment patterns among patients with beta-thalassemia: a retrospective medical record abstraction study
Authors: Cappellini Maria Domenica , Glassberg Mrudula B. , Meyers Juliana , Jimenez Maria , Nham Tram , Bueno Luciana , Sieluk Jan , Yucel Aylin , Alashkar Ferras 
Published: December 2024

Background: Beta-thalassemias (BTs) are characterized by deficient or absent synthesis of the beta-globin subunit, leading to anemia. Patient characteristics and treatment patterns in these patients may vary. Objective: This retrospective study evaluated demographics, clinical characteristics, and treatment patterns in patients with transfusion-dependent BT (TDT) and non-transfusion-dependent BT (NTDT). Methods: Medical records of adults with TDT or NTDT in the United Kingdom, France, Germany, Spain, and Canada with ⩾5 years of history within the practice were evaluated. Results: Among patients with TDT ( N = 118), mean (standard deviation (SD)) age was 36.1 (11.9) years, and 28.8% were female; among patients with NTDT ( N = 96), mean (SD) age was 36.6 (9.8) years, and 38.5% were female. Among patients with TDT, 21.2% received transfusions every 2 weeks or more frequently, 28.8% every 3 weeks, 26.3% every 4 weeks, and 21.2% less frequently than 4 weeks. Patients with TDT had a mean (SD) of 2.4 (0.6) units of blood transfused per transfusion, with a pretransfusion hemoglobin (Hb) level of 6.9 (1.3). In total, 84.4% of patients with NTDT had at least one transfusion, and the mean (SD) number of transfusions among patients with NTDT was 15.9 (15.9). Among patients with NTDT, the mean (SD) units of blood per transfusion were 2.2 (0.6) units, and the mean (SD) Hb level prior to transfusion was 7.4 (1.2) g/dL. Iron chelation therapy was received by 70.3% of TDT patients and 45.8% of NTDT patients. Conclusion: This study found that both patients with NTDT and TDT have low pretransfusion Hb levels. A high number of patients, especially patients with TDT, were not treated according to the current recommendations on target hemoglobin level, thereby highlighting the importance of national reference centers for improving long-term outcomes and quality of life in these patients.
On the fracture of aluminum plates perforated by rigid flat-nosed projectiles
Authors: Rosenberg Zvi , Vayig Yaniv 
Published: December 2024

We present a series of 2D numerical simulations for the perforation process of aluminum plates impacted by rigid steel cylinders. The simulations accounted for the residual velocities of these projectiles as a function of their impact velocities, as obtained recently by several workers. The aluminum plates in these works were made of the quasi-brittle 2024-T351 and 7075-T651 alloys, and the more ductile 6061-T651 alloy. The material properties of these alloys, for their strength and failure parameters, were taken from published works. We find that the ductility/brittleness property of these alloys is related to the different values of their corresponding strains to failure at shear states. Our simulations for the two quasi-brittle alloys resulted in good agreement with the measured data. On the other hand, the simulations for the 6061-T651 alloy agreed with the corresponding data only when we used a relatively low value of the Taylor-Quinney coefficient for this alloy. We also highlight various problems with the issue of mesh sensitivity in simulating the perforation of metallic plates by rigid cylinders. Particularly, we found that these simulations do not converge to definite values for the residual velocities even when the mesh size is reduced to 0.025 mm. Moreover, we found that the experimental data for the residual velocities can be accounted for by different failure curves, depending on the mesh size of the simulation. Thus, a given failure criterion cannot be validated by such simulations.
Topical high concentration oxygen with hyaluronic acid: A safe and effective treatment for vaginal atrophy and sexual function improvement
Authors: Lami Alessandra , Manta Andra Catalina , Amati Veronica , Alvisi Stefania , Baldassarre Maurizio , Carli Alessia , Lucchetta Giada , Seracchioli Renato , Meriggiola Maria Cristina 
Published: December 2024

Background Genitourinary syndrome of menopause (GSM) is a condition affecting many postmenopausal women. Among the available treatments, the vaginal natural oxygenation device (VNOD) is a new promising option. Aim To evaluate the safety and the effectiveness of vaginal high concentration (HC) oxygen (O2) and hyaluronic acid (HA) in postmenopausal women with vaginal atrophy (VA). Methods Study 1: Ten subjects received HA and O2 at a concentration of 21% (sham group) and ten at 95% (treatment group). All subjects completed five sessions of VNOD. Evaluations and questionnaires were completed at baseline, before each session and at one-month follow-up: Visual Analogue Scale, Vaginal Health Index (VHI), Vaginal Maturation Value (VMV), Menopause Quality Of Life (MeNQoL), Female sexual function index (FSFI) and Female sexual distress scale (FSDS). Study 2: 52 postmenopausal women with VA completed the same protocol of study 1 with HC O2 and HA. Results Treatment was well-tolerated. In study 1, in the treatment group we recorded significant improvements in VHI score ( p-value 0.001), VMV ( p-value 0.005) and in the psychosocial, physical and sexual domains of the MeNQoL compared to sham group. In study 2, all women experienced a significant improvement in VHI ( p-value <0.001), FSFI total score ( p-value 0.007), desire ( p-value 0.004), lubrication ( p-value 0.006), satisfaction ( p-value 0.042), pain ( p-value 0.001) domains, FSDS score ( p-value 0.003) and MeNQoL sexual domain ( p-value <0.001). Conclusion The preliminary results of this study suggest that VNOD is a safe and effective treatment for VA in postmenopausal women, and improves sexual function.
Reconstruction of a body wall defect using diaphragm lateralisation and advancement, latissimus dorsi, and internal and external abdominal oblique muscle flaps in a cat
Authors: Kooner Kiren , Rubiños Carlos 
Published: December 2024

Case summary A cat aged 12 years and 7 months was referred to a multidisciplinary hospital for investigation of feline injection site sarcoma (FISS) on the left thoracolumbar region. A CT examination of the mass revealed a multi-lobulated mass affecting the body wall, extending from the level of lumbar vertebrae L2 to L4. The mass was excised with 5 cm lateral margins, including resection of the 13th left rib, the caudal edge of the latissimus dorsi (LD) muscle, full-thickness abdominal wall and sections of the lumbar epaxial muscles. To reconstruct the defect, a combination of muscle flaps was used. This included diaphragmatic advancement and lateralisation, rotation of the LD, and creation of transposition flaps from the internal abdominal oblique and external abdominal oblique muscles, ensuring closure without tension. Skin closure required mobilising an inguinal flank fold flap. The cat was discharged from hospital 3 days postoperatively. Histopathology confirmed a diagnosis of FISS with clean wide margins. A gradual return to normal activity and complete healing of the surgical site was reported on follow-up, with one minor complication related to the skin flap (bruising at the base of the inguinal flank fold flap). Relevance and novel information This report describes the use of the aforementioned combination of muscle flaps to close a major abdominal wall defect in a cat with an excellent outcome. Practitioners can consider this technique when planning tissue reconstruction after FISS resection.
Nasal telangiectatic osteosarcoma with direct extension to the brain in a domestic shorthair cat
Authors: Silva Anahi Souza , Sousa Ana Lívia Vasconcelos de , Diniz Nanci Sousa Nilo Bahia , Macêdo Isabel Luana de , Costa Júnior Jair Duarte da , Martins Christine Souza , Melo Cristiano Barros de , Castro Márcio Botelho de 
Published: December 2024

Case summary This case report describes the clinical and pathological features of telangiectatic osteosarcoma (TOS) with brain invasion in a 4-year-old female domestic shorthair cat. The cat presented with respiratory distress, epistaxis, anorexia and significant nasal obstruction. A rhinoscopy revealed an amorphous white neoformation in the left nasal cavity. Despite treatment, the cat’s condition deteriorated and it succumbed to the disease. Necropsy and histopathologic examination revealed an infiltrative malignant neoplasm with osteoid matrix and sarcomatous cells surrounding blood-filled non-vascular spaces. Immunohistochemistry showed positive staining for bone cell markers and vimentin, while endothelial markers were negative, confirming TOS. Relevance and novel information Nasal diseases in cats present significant diagnostic challenges due to similar clinical signs, such as respiratory distress and nasal discharge. Nasal osteosarcomas are rare, and TOS is the rarest subtype, characterized by blood-filled spaces within an aggressive osteolytic lesion. This case highlights the diagnostic complexities and poor prognosis associated with TOS in cats, emphasizing the need for advanced imaging and immunohistochemical tests for accurate diagnosis. Given the aggressive nature and rapid progression of TOS, it should be considered in differential diagnoses of feline nasal obstructive lesions.
Amyloidosis and the Syncopal Enigma
Authors: Strelow Brittany , Middleton Hayden , Young Kathleen A. , Olson Nicole , Boucher Lauren , Cera Alanna , Boswell Christopher L. 
Published: December 2024

Background: Syncope is a common presenting complaint in the outpatient setting and requires a thoughtful and meticulous approach to history-taking skills. This is crucial in discerning cardiac versus non-cardiac etiologies, underscoring the pivotal role of healthcare professionals in the diagnostic process. Case Report: This is a case of a 76-year-old male who presented to the primary care clinic following an episode of syncope with abrupt loss of consciousness. Given the presentation, there was a high suspicion of cardiac etiology, and further testing was pursued. An electrocardiogram (ECG) demonstrated normal sinus rhythm with a pre-existing first-degree atrioventricular (AV) block. The Holter monitor was without sustained arrhythmias. A dobutamine stress echocardiogram was negative for myocardial ischemia, though a resting transthoracic echocardiogram demonstrated findings consistent with cardiac amyloidosis. Further evaluation with cardiology confirmed the diagnosis of transthyretin (ATTR) cardiac amyloidosis. He was initiated on appropriate treatment and underwent a dual chamber implantable cardioverter defibrillator (ICD) given his presentation. The patient ultimately succumbed to his disease 5 years after his diagnosis. Conclusion: If the cardiac etiology of syncope is suspected, further cardiac structural evaluation is necessary. Cardiac amyloidosis, although rare, is a cause of cardiogenic syncope that should not be overlooked. It should be considered in the differential diagnosis in the appropriate clinical setting, highlighting the need for a broad and comprehensive approach to diagnosis.
Does Position of Pedicle Screws Correlate With Adjacent Segment Degeneration? An Average 6-Year Follow-Up Retrospective Study
Authors: Latallade Valentino , Pereira Duarte Matías , Huespe Iván A. , Kido Gonzalo , Petracchi Matías , Gruenberg Marcelo 
Published: December 2024

Study Design Retrospective case serie. Objectives Assess the correlation between pedicle screw (PS) position of the first instrumented vertebra (FIV) with proximal adjacent segment degeneration (ASD) development or progression. Methods Patients ≥55 years who have undergone lumbar fusion with a minimum 2-year follow-up were included. Radiographic PS position was assessed by the angle between the first PS and the upper vertebral endplate (VE) and by the PS tip-VE distance. Radiographic parameters of ASD included: disc height, disc angle, and vertebral listhesis. ASD magnetic resonance imaging (MRI) parameters included: disc degeneration and lumbar stenosis. ROC curve analysis was performed to identify the best cut-off points in correlation with lumbar stenosis. Results Forty-eight patients were included with an average follow-up of 6 years. All 48 included patients developed some degree of ASD whether on radiographic or MRI parameters. PS tip-VE distance and PS-VE angle were both positively correlated with: (1) Delta (Δ) lumbar stenosis; (2) Δ Disc degeneration; and (3) Δ Disc height. ROC curve analysis correlating PS tip-VE distance and PS-VE angle with an increase in the canal stenosis severity ≥2° resulted in a cut-off point of 36% and 9.5°, respectively. Conclusions The cranial orientation (PS-VE angle) of the pedicle screw in the first instrumented vertebra, along with a shorter pedicle screw tip-vertebral endplate distance (PS tip-VE), positively correlated with ASD progression at an average 6-year follow-up. Protective values against lumbar stenosis were identified as a PS tip-VE distance ≥36% of the first instrumented vertebra height and a PS-VE angle ≤9.5° relative to the upper vertebral endplate.
Joint Effusion at 3 Months After Anterior Cruciate Ligament Reconstruction: Its Risk Factors and Association With Subsequent Muscle Strength and Graft Remodeling
Authors: Kikuchi Naoya , Kanamori Akihiro , Arai Norihito , Okuno Kosuke , Yamazaki Masashi 
Published: December 2024

Background: Joint effusion at 3 months after anterior cruciate ligament (ACL) reconstruction is a risk factor for ACL reinjury. However, factors associated with joint effusion at 3 months postoperatively and the effect of joint effusion on subsequent quadriceps muscle strength and graft remodeling remain unknown. Purposes: To identify factors associated with joint effusion and investigate the association between joint effusion and quadriceps muscle strength and graft remodeling in the postoperative period. Study Design: Case-control study; Level of evidence, 3. Methods: In this retrospective multicenter study, the medical records of patients who underwent single-bundle ACL reconstruction between 2015 and 2021 were reviewed. The study included the data of 174 patients (mean age, 23.5 ± 10.6 years). Demographic data, including sex, age at surgery, time from injury to surgery in months, body mass index, preinjury Tegner activity score, presence of meniscus, and chondral injuries, were collected. Magnetic resonance imaging was performed 3 months postoperatively. Joint effusion was defined as grade 3 (range of grades, 0-3) according to the ACL Osteoarthritis Score. Isokinetic strength testing was performed at 60 deg/s, while the limb symmetry index (LSI) of quadriceps strength was evaluated at 6 months postoperatively. Moreover, graft remodeling was evaluated using magnetic resonance imaging-derived signal intensity ratio (SIR) measures at 1 year postoperatively. The authors used multivariate logistic and linear regression analyses to identify the factors influencing joint effusion at 3 months and those associated with postoperative quadriceps strength LSI and SIR values, respectively. Results: Greater preinjury Tegner activity scores (odds ratio, 1.59; 95% CI, 1.08 to 2.34; P = .02) increased the odds of joint effusion at 3 months postoperatively. Multivariable linear regression analysis revealed that joint effusion (β = −23.8; 95% CI, −36.0 to −11.7; P < .001) was an independent factor associated with LSI of the quadriceps. Furthermore, joint effusion (β = 1.33; 95% CI, 0.53 to 2.14; P = .001) was associated with a higher SIR value of the reconstructed graft. Conclusion: The preinjury Tegner activity score was a factor associated with joint effusion at 3 months postoperatively, and joint effusion was associated with subsequent muscle weakness and delayed graft remodeling.
‘What else can we do to create an inclusive environment?’ Human resources specialists about dyslexic and neurodivergent employees
Authors: Černickaja Karin , Sokolová Lenka 
Published: December 2024

Although symptoms of dyslexia tend to restrict it to the school environment, it is a lifelong condition. Research has focused primarily on prevention and intervention within educational spaces; however, studies indicate that dyslexic individuals continue to face challenges and barriers also in workplaces. This study aims to explore the reflections of human resources specialists on their knowledge and beliefs about dyslexic employees and on their attitudes and practices toward dyslexic employees. Themes were developed through reflexive thematic analysis. Human resources specialists have some basic knowledge about dyslexia and its impact on employees. However, their beliefs are based on their assumptions and experience encountering dyslexic employees, which are rather rare. In general, they are open to help building more inclusive workplaces, but for now these steps to equality are based on individual approaches, which requires disclosure from the employee. Dyslexic employees may not feel psychological safety at work, leading to non-disclosure. Lay abstract Research has been focused primarily on prevention and intervention within educational spaces; however, studies indicate that dyslexic individuals continue to face challenges and barriers also in workplaces. This study aimed to explore human resources specialists’ reflections on their knowledge and beliefs about dyslexic employees and on their attitudes and practices toward dyslexic employees. Human resources specialists have some basic knowledge about dyslexia and its impact on employees. However, their beliefs are based on their assumptions and experience encountering dyslexic employees, which are rather rare. In general, they are open to help building more inclusive workplaces, but for now these steps to equality are based on individual approaches, which requires disclosure from the employee. To build more inclusive environments, we must raise awareness not only between human resources specialists, but also other employees (colleagues), and importantly between dyslexic employees, who might not know about their rights and possibilities provided by their companies.
Cognitive benefits of folic acid supplementation during pregnancy track with epigenetic changes at an imprint regulator
Authors: Hilman L. , Ondičová M. , Caffrey A. , Clements M. , Conway C. , Ward M. , Pentieva K. , Irwin R. E. , McNulty H. , Walsh C. P. 
Published: December 2024

Abstract
Background
The human ZFP57 gene is a major regulator of imprinted genes, maintaining DNA methylation marks that distinguish parent-of-origin-specific alleles. DNA methylation of the gene itself has shown sensitivity to environmental stimuli, particularly folate status. However, the role of DNA methylation in ZFP57’s own regulation has not been fully investigated.

Methods
We used samples and data from our previously described randomised controlled trial (RCT) in pregnancy called Folic Acid Supplementation in the Second and Third Trimester (FASSTT), including follow-up of the children at age 11. Biometric and blood biochemistry results were examined for mothers and children. Methylation of ZFP57 was analysed by EPIC arrays, pyrosequencing and clonal analysis, and transcription assessed by PCR-based methods. Functional consequences of altered methylation were examined in cultured cells with mutations or by inhibition of the main DNA methyltransferases. DNA variants were examined using pyrosequencing and Sanger sequencing, with results compared to published studies using bioinformatic approaches. Cognitive outcomes were assessed using the Wechsler Intelligence Scale for Children 4th UK Edition (WISC-IV), with neural activity during language tasks quantified using magnetoencephalography (MEG).

Results
Here we show that methylation at an alternative upstream promoter of ZFP57 is controlled in part by a quantitative trait locus (QTL). By altering DNA methylation levels, we demonstrate that this in turn controls the expression of the ZFP57 isoforms. Methylation at this region is also sensitive to folate levels, as we have previously shown in this cohort. Fully methylated alleles were associated with poorer performance in the Symbol Search and Cancellation subtests of WISC-IV in the children at age 11 years. There were also differences in neural activity during language tasks, as measured by MEG. Analysis of published genome-wide studies indicated other SNPs in linkage disequilibrium with the mQTL were also associated with neurodevelopmental outcomes.

Conclusions
While numbers in the current RCT were small and require further validation in larger cohorts, the results nevertheless suggest a molecular mechanism by which maternal folic acid supplementation during pregnancy may help to counteract the effects of folate depletion and positively influence cognitive development in the offspring.
Reasons for unsafe abortion in Iran after pronatalist policy changes: a qualitative study
Authors: Haseli Arezoo , Rahnejat Nasrin , Rasoal Dara 
Published: December 2024

Abstract
Background
In Iran, restrictive abortion laws have led to widespread unsafe abortions, posing significant health risks. The 2021 Family and Youth Protection Law further restricted access to reproductive health services in an effort to boost birth rates. The purpose of this qualitative study is to explore the reasons women sought abortions in an illegal context, based on their own experiences.

Methods
This exploratory qualitative study involved in-depth interviews with 46 women in Kermanshah, Iran, between April and August 2024. All participants had experienced incomplete abortions after undergoing unsafe procedures. Data were analyzed using conventional content analysis and thematic analysis with MAXQDA 10 software to identify key themes in the women's experiences. To ensure the study's rigor, we applied Guba and Lincoln’s criteria, including credibility, dependability, confirmability, and transferability.

Results
Five main themes emerged from the interviews: economic hardship, pursuit of a prosperous life, unstable marital relationships, health and fertility issues, and cultural factors. Economic challenges, such as unemployment and lack of basic necessities, were the most frequently cited reasons for seeking unsafe abortions. Health issues, including unplanned pregnancies and fear of fetal anomalies, also played a significant role, alongside cultural stigmas related to age, illegitimacy, and gender preferences.

Conclusion
This study sheds light on the multifaceted factors driving unsafe abortions in Iran following pronatalist policy changes. A holistic approach is recommended to address the interconnected economic, social, and cultural challenges that contribute to this issue. By implementing such comprehensive strategies, policymakers and stakeholders can work to reduce the prevalence of unsafe abortion practices and foster improved health and well-being for women.