bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of asymptomatic peptic ulcer disease diagnosed during screening endoscopy in patients with cirrhosis
Authors: Lema Girma Deshimo , Gebeyaw Enguday Demeke 
Published: December 2024

Objective Asymptomatic peptic ulcer disease (PUD) is frequently overlooked in patients with cirrhosis, who are at increased risk for gastrointestinal complications that can lead to increased morbidity and mortality. We aimed to determine the prevalence and associated factors of asymptomatic PUD identified during screening endoscopy in patients with cirrhosis. Methods We conducted a retrospective cross-sectional study among patients with cirrhosis at St. Paul’s Hospital Millennium Medical College in Ethiopia. Data were collected using a structured questionnaire from patients’ medical charts. A logistic regression model was used to identify predictors of peptic ulcer. Results This study included 296 patients, revealing that 19.6% had PUD (95% confidence interval: 13.5–26.4). Significant associations were found between peptic ulcer and Helicobacter pylori infection, moderate and heavy alcohol consumption, and Child–Pugh class C cirrhosis. Conclusion We found that patients with liver cirrhosis are more likely to have asymptomatic peptic ulcers. Asymptomatic PUD was linked to H. pylori infection, greater alcohol consumption, and Child–Pugh class C liver disease, highlighting the need for targeted prevention and management strategies to reduce morbidity in patients with cirrhosis, such as eradication therapy for H. pylori and counseling on alcohol use.
Women with disabilities and the loss of custody of their children: “Carers, but not mothers”
Authors: Rodríguez-Garrido Pía , Herrera Florencia , Yupanqui-Concha Andrea , Rojas Andrea , Hichins-Arismendi Melissa 
Published: December 2024

Historically, the motherhood of women with disabilities has been questioned due to negative representations surrounding it. It is assumed that women with disabilities cannot be mothers and, when they are, their capacity to care for their children is called into doubt. According to international literature, women with disabilities are more susceptible to losing the custody of their children. However, in Chile, there is scant evidence about this. Using the paradigm of situated feminist epistemologies, this paper analyzes the experiences of three Chilean mothers with disabilities who have faced judicial processes regarding their children's custody. Three dimensions emerged from the thematic analysis: (a) The role of carers under tension: “Carers, but not mothers!”; (b) The absence of support and reasonable accommodations: The institutional debt; and (c) The influence of ableism on custody processes. The findings reveal a series of adversities that women with disabilities must overcome to demonstrate their fitness as mothers. Institutional ableism hampers due process in cases about the custody of their children. As long as appropriate support is provided and the disabling view is transformed, mothers with disabilities can provide the care and parenting their children require.
Molybdenum Cofactor Deficiency with a Novel Pathogenic Variant in the Molybdenum Cofactor Synthesis 1 (MOCS1): A Case Report
Authors: MGTW Premadasa , AH Monica , E Emmett , P Rathnayake , PMS Fernando , S Jayasena , S Basnayaka , E Jasinge 
Published: December 2024

Molybdenum cofactor deficiency (MOCOD) is a rare autosomal recessive disorder associated with a high mortality rate. We report a genetically confirmed MOCOD case of a Sri Lankan infant girl born to a consanguineous family, who presented with refractory neonatal seizures, respiratory distress, and the appearance of global cerebral ischemia on the CT brain. Biochemical investigations revealed hypouricemia, hypouricosuria, and increased urinary xanthine. Genetic analysis revealed a homozygous novel pathogenic variant in the MOCS1 gene, consistent with MOCOD.
Diagnostic value of high-frequency ultrasound combined with magnetic resonance in different clinical stages of frozen shoulder: A retrospective cohort study
Authors: Zhang Lei , Chen Hua , Yang Qi , Ding Zhichao , Zhang Laizhi , Gu Yifeng 
Published: December 2024

Background Frozen shoulder (FS) is a common musculoskeletal disease. Imaging plays an active role in the clinical diagnosis and staging of FS. Objective This study is undertaken to assess the application value of high-frequency ultrasound (HFU) combined with magnetic resonance (MR) in clinical staging diagnosis of FS. Methods This was a retrospective cohort study. The medical records of FS patients (from January 2021 to February 2022, n = 100) were collected. Patients were categorized into stage I (n = 30), stage II (n = 35) and stage III (n = 35) groups. The diagnostic value of HFU-related and MR-related indicators was assessed by the receiver operating characteristic (ROC) curve. The correlation between HFU/MR indicator and passive range of motion-related indicators was analyzed by Spearman rank method. Results There were no statistically significant differences in gender, age, height, weight, and affected shoulder (left: right) among the three groups at different stages ( p > 0.05). HFU and MR in combination had a higher diagnostic coincidence rate when compared to their single use (96.00% vs. 91.00% or 93.00%). There was high diagnostic value for inferior capsule thickness (ICT) (area under the curve (AUC) = 0.914, p < 0.001, 95% CI (0.836–0.992)), glenohumeral distance (GHD) (AUC = 0.999, p < 0.001, 95% CI (0.996–1.000)) and articular capsule thickness (ACT) (AUC = 1.000, p < 0.001, 95% CI (0.998–1.000)) in stage I FS, for ICT (AUC = 0.947, p < 0.001, 95% CI (0.885–1.000)) and GHD (AUC = 0.974, p < 0.001, 95% CI (0.949–0.999)) in stage II FS, and for ACT (AUC = 0.989, p < 0.001, 95% CI (0.975–1.000)) in stage III FS. ICT/ACT positively correlated with internal rotation (IR), and negatively correlated with external rotation (ER)/extension (EX)/flexion (FL)/abduction (AB). GHD had a negative correlation with IR, and a positive correlation with ER/EX/FL/AB. Conclusion High-frequency ultrasound combined with magnetic resonance can improve the accuracy in clinical diagnosis of FS, promote better staging of FS, and provide a more reliable basis for clinical diagnosis and treatment of FS.
Efficacy of Wilate Prophylaxis in Reducing Nosebleeds in Patients with Severe VWD – A Post-hoc Analysis of the WIL-31 Study
Authors: Boban Ana , Dubey Leonid , Vilchevska Kateryna V. , Inati Adlette , Khayat Claudia Djambas , Sidonio Robert F. 
Published: December 2024

Background Prophylaxis with a von Willebrand factor (VWF) concentrate is recommended in von Willebrand disease (VWD) patients with a history of frequent and severe bleeds. Despite nosebleeds being a frequent manifestation of VWD, few studies have investigated the efficacy of factor prophylaxis in preventing nosebleeds in patients with severe VWD. Methods This post-hoc analysis of a prospective, 12-month, phase 3 study assessed the efficacy of wilate in the prevention of nosebleeds in 33 patients aged ≥6 years with severe type 1, type 2 or type 3 VWD. All patients previously participated in a 6-month prospective study of on-demand treatment with any VWF concentrate. Prophylactic efficacy was assessed by comparing total and spontaneous annualized bleeding rates for nosebleeds (TABR and SABR, respectively) during prophylaxis with rates during on-demand treatment. Results The mean TABR and SABR for nosebleeds were reduced by 76% and 81% respectively during prophylaxis versus on-demand treatment (2.7 vs 11.0 and 2.1 vs 10.9). During the second 6 months of prophylaxis, mean TABR was 49% lower and mean SABR 57% lower versus the first 6 months. The percentage of patients with zero nosebleeds was 19% during 6 months of on-demand treatment, 55% during the first 6 months of prophylaxis, and 68% during the second 6 months of prophylaxis. The efficacy of wilate in the treatment of breakthrough nosebleeds was rated excellent in 99% of cases. Conclusion This post-hoc analysis demonstrated the efficacy of wilate prophylaxis in the prevention and treatment of nosebleeds in children and adults with severe VWD.
Acute intra ocular inflammation following intravitreal injections of faricimab: A multicentric case series
Authors: Le Hoang Mai , Querques Giuseppe , Guenoun Sacha , El Ghazi Djazia , Haddad Walid M. , Mouallem Alexandra , Semoun Oudy , Souied Eric H. 
Published: December 2024

Purpose To report 8 cases of acute intra ocular inflammation (IOI) following intravitreal injections (IVI) of faricimab in patients with age related macular degeneration (AMD), retinal vein occlusion (RVO) and macular neovascularization associated with chronic central serous retinopathy (CSR). Methods This is a multicentric retrospective observational case-series. Cases of acute IOI that occurred in 5 different institutions in France and Italy between November 2023 and June 2024 were reported. Results 8 eyes of 8 patients presented with acute IOI following IVI of faricimab. Best corrected visual acuity (BCVA) at the time of the IOI event varied between counting fingers and 20/25. 6 patients had neovascular AMD, 1 patient had a macular edema secondary to central RVO and 1 patient had a macular neovascularization associated with chronic CSR. Mean delay between the last IVI of faricimab and the assessment of the IOI event was 10.0 days. Presentation of IOI varied among patients. 6 patients presented with vitritis with varying severity. One of them had an associated papillitis. One patient presented with an anterior uveitis without vitritis. Corticosteroids were used in 5 cases. 2 cases resolved spontaneously. Surgery was needed in 1 case. These 8 cases of IOI occurred out of a total of 1923 IVI of faricimab performed with an estimated frequency of 0.41%. Conclusion Acute IOI may happen after IVI of faricimab. Severity of inflammation varies and treatment should be adjusted according to the clinical presentation.
Identifying 10-year cumulative incidence and risk of revision following total hip arthroplasty in patients with and without a diagnosis of human immunodeficiency virus
Authors: Mahindroo Sonal , Ferraro Samantha , Agarwal Amil , Zhao Amy , Das Avilash , Cohen Jordan S , Thakkar Savyasachi C , Golladay Gregory J 
Published: December 2024

Introduction: Prior studies have shown human immunodeficiency virus (HIV) may be a risk factor for early revision following THA, but little data exists looking at long-term implant survivorship. Therefore, the purpose of this study was to compare the 10-year cumulative incidence rate for revision following THA in patients with and without HIV. Methods: A retrospective cohort analysis of patients with HIV undergoing elective THA was conducted using a national database. Patients were stratified into asymptomatic HIV (AHIV) and acquired immune deficiency syndrome (AIDS) cohorts. These patients were propensity-score matched to a group of elective THA patients without HIV based on age, gender, and Charlson Comorbidity Index (CCI) at a 1:2 ratio. Kaplan-Meier and Cox Proportional Hazards Regression Analyses were used to assess cumulative incidence and risk of revisions within 10-years of the index procedure. Results: In total, 678 patients were at-risk at the 10-year mark. There were no differences in 10-year risk of revision THA, amongst patients with HIV when compared to matched and unmatched controls ( p > 0.05 for all). Patients with HIV did have an increased risk of periprosthetic joint infection (PJI) following THA when compared to the unmatched control ( p = 0.001). Discussion: Surgeons and patients can be reassured of comparable 10-year revision rates in patients with and without HIV. However, as these patients are at increased risk for PJI and PPF, especially those with AIDS, when compared to the general population, surgeons should consider PJI prophylactic modalities in this patient population.
Pregnancy-Related Morphea: A Case Report
Authors: Borna Sedigheh , Zamanpour Zeynab , Shakoei Safoura , Aliasgharpoor Maryam , Hamidi Madani Zahra 
Published: December 2024

Background: Morphea is a skin condition marked by erythematous and hardened inflammatory lesions that can progress to atrophic and sclerotic plaques. In this case report, we present a case of a pregnant woman who showed morphea presentation. Case presentation: A 37-year-old G2P1L1 woman with a gestational age of 32 weeks and 2 days was referred to the hospital with complaints of swelling, pain, and erythema in both legs for the past week, without any obstetric complaints. Upon initial examination at the time of admission, swelling, erythema, warmth in both legs, ecchymotic lesions, and non-pitting edema were observed. Biometry and color Doppler ultrasound for evaluation of fetus growth was normal. Skin examination revealed mild erythema, warmth, and purpura and petechiae in some areas, with an orange peel appearance and firm texture on palpation. Leg lesion skin punch biopsy reported a sclerodermoid reaction pattern and findings more compatible with morphea. The patient was managed for morphea during pregnancy. However, at 38 weeks and 6 days of gestation, due to worsening symptoms and spreading stiffness to the groin area, and the need for initiating pulse corticosteroids and mycophenolate mofetil (CellCept), the patient was re-admitted for cesarean section. In the follow-up assessment, ultrasound findings were normal, IGRA, HIV antibody, HCV antibody, HBC antigen, and HBS antigen were negative, and no edema or inflammation was seen in the patient. Conclusions: In conclusion, although our patient recovered without specific treatment, predicting the recurrence or worsening of morphea in future pregnancies is challenging.
Study on the parameters of steel plate reinforcement rib-deck crack considering local stress disturbances
Authors: Gao Yuqiang , Ji Bohai , Fu Zhongqiu , Fei Jiangbin 
Published: December 2024

Local reinforcement will change the local stiffness distribution of the component, causing perturbation effects on the local stress of the fatigue detail. Only considering the reinforcement effect may lead to excessive strengthening and induce new fatigue-prone points. For the fatigue detail of the rib-deck weld, steel plate reinforcement test and numerical simulations were conducted. The stress changes of the deck weld toe and weld root before and after reinforcement were analyzed. The influence of parameters such as steel plate length, thickness, and width on the reinforcement effect of the weld toe crack and local stress disturbance was discussed, and reasonable parameters were recommended. The results show that after the cracking of the weld toe, the stress concentration locations at the weld toe and weld root of the deck shift from the center of the specimen to the crack tip. Steel plate reinforcement can effectively restrain the crack propagation, but can lead to an increase in the stress at the deck weld root within the reinforced area. A good reinforcement effect can be achieved while the steel plate covers the crack, and further increasing the steel plate length has limited improvement on the reinforcement effect but reduces the adverse effect of steel plate reinforcement on the stress of the deck weld root. Increasing the steel plate width will increase the adverse effect of steel plate reinforcement on the deck weld root stress, and it is recommended to use steel plates with a length greater than 120 mm and a length-to-width ratio greater than 4 for reinforcement. Increasing the width of the steel plate has a relatively small effect on the reinforcement effect and the stress at the deck weld root, and steel plates with the same thickness as the deck are recommended.
Physiologically based pharmacokinetic modeling to predict the effect of risperidone on aripiprazole pharmacokinetics in subjects with different CYP2D6 genotypes and individuals with hepatic impairment
Authors: Mou Fan , Huang Zhiwei , Cheng Yu , Zhao Xue , Sun Xiujia , Li Huafang , Yu Shunying 
Published: December 2024

Background: Aripiprazole and risperidone, widely used atypical antipsychotics, are commonly adjunctively prescribed in clinical practice. When aripiprazole was combined with risperidone, the genotype of drug-metabolizing enzymes and liver impairment may lead to complex pharmacokinetic changes. The Physiologically Based Pharmacokinetic (PBPK) model can predict the influence of these factors on plasma concentration and optimize dosage regimens. Objectives: This study aims to investigate the pharmacokinetic changes of aripiprazole caused by various influencing factors when it was co-administered with risperidone through PBPK models. Design: The PBPK models of aripiprazole and risperidone were developed by gathering physicochemical parameters and drug-specific parameters. Then, by combining the inhibitory parameters, the enzymatic kinetic parameters of CYP2D6 genotypes, and the changes in anatomical and physiological parameters when liver function is damaged, the corresponding PBPK models were further established. Finally, this study put forward dosage optimization recommendations for situations where risks may exist. Methods: The comparison between predicted and observed plasma concentration data, along with the assessment of pharmacokinetic parameters, was utilized to evaluate the fit performance of the models. Results: The simulations of the PBPK model revealed that co-administration of risperidone did not result in significant changes in aripiprazole pharmacokinetics. However, in individuals with mild hepatic impairment and CYP2D6 normal metabolizer, a dose reduction of approximately 11% was advised when aripiprazole was combined with risperidone. When individuals with mild liver damage have CYP2D6 genotypes of intermediate metabolizer (IM) and poor metabolizer (PM), aripiprazole doses should be further reduced to 61% and 51%, respectively. Conclusion: The co-administration of aripiprazole and risperidone is generally considered safe from a pharmacokinetic perspective. However, if individuals have a CYP2D6 genotype of IM or PM and/or if they have mild hepatic impairment, adjusting the dose of aripiprazole is advisable to mitigate potential risks when combining it with risperidone.
Enhanced MRI-based brain tumor segmentation and feature extraction using Berkeley wavelet transform and ETCCNN
Authors: Gokapay Dilip Kumar , Mohanty Sachi Nandan 
Published: December 2024

Objective Brain tumors are abnormal growths of brain cells that are typically diagnosed via magnetic resonance imaging (MRI), which helps to discriminate between malignant and benign tumors. Using MRI image analysis, tumor sites have been identified and classified into four distinct tumor categories: meningioma, glioma, not tumor, and pituitary. If a brain tumor is not detected in its early stages, it could progress to a severe level or cause death. Therefore, to address these issues, the proposed approach uses an efficient classifier based on deep learning for brain tumor detection. Methods This article describes the classification and detection of brain tumor by an efficient two-channel convolutional neural network. The input image is initially rotated during the augmentation stage. Morphological operations, thresholding, and region filling are then used in the pre-processing stage. The output is then segmented using the Berkeley Wavelet Transform. A two-channel convolutional neural network is used to extract features from segmented objects. In the end, the most effective deep neural network is employed to determine the features of brain tumors. The classifier will utilize the Enhanced Serval Optimization Algorithm to determine the optimal gain parameters. MATLAB serves as the platform of choice for implementing the suggested model. Results Several performance metrics are calculated to assess the proposed brain tumor detection method, such as accuracy, F measures, kappa, precision, sensitivity, and specificity. The proposed model has a 98.8% detection accuracy for brain tumors. Conclusion The evaluation shows that the suggested strategy has produced the best results.
Barriers to clinical follow-up visits in multiple sclerosis: A nationwide register-based study
Authors: Beczek Agata , Landt Eskild Morten , Storr Lars Kristian , Beck Malene , Pontieri Luigi , Magyari Melinda , Dahl Morten 
Published: December 2024

Background In Denmark, specialized multiple sclerosis (MS) clinics offer free-of-charge treatment to people with MS. However, not all people with MS attend regular clinical follow-up. Objective To identify people with MS who do not attend Danish MS clinics and identify barriers to treatment. Methods The Danish Multiple Sclerosis Registry was linked to other national Danish registries with follow-up from 2000–2020. We used a time-dependent Cox regression to rank factors associated with low attendance to clinical follow-up visits based on the magnitude of hazard ratios (HRs). Results We included 10,175 adults with MS, of which 3862 (38%) had less than one visit annually. The five top-ranked factors that reduced the risk of visits occurring included never having received diseases modifying treatment (HR: 0.48; 95%CI: 0.46–0.49), been diagnosed with MS before 2009 (0.79; 0.78–0.81), association with MS center in an outer region of Denmark (0.82; 0.80–0.84), having progressive MS type (0.88; 0.86–0.91) and not having received symptomatic treatment at diagnosis (0.91; 0.89–0.93). Conclusion Our results highlight disease-specific and geographic inequalities in the management of people with MS in Denmark. Strategies to prevent this inequality, especially for people with progressive phenotypes and those who need supportive and non-medical treatment and care, should be implemented.
The United States, Europe, and the Global Compacts: Honoring the Right to Remain and the Right to Migrate
Authors: Appleby J. Kevin 
Published: December 2024

Executive Summary The adoption of the Global Compacts on Migration and Refugees in 2019 by the UN General Assembly marked a significant achievement, providing two essential frameworks from which UN Member States could fashion their future immigration and refugee policies. Since their adoption, however, the number of forcibly displaced in the world has increased significantly, prompting receiving nations, such as the United States and the European countries, to rely more on deterrence-based enforcement initiatives to reduce the number of migrants arriving at their borders. At the same time, the number of migrant deaths, both on sea and land, have increased, as desperate migrants, asylum-seekers, and refugees have attempted to find new homes in industrialized nations. This paper analyzes the migration policies adopted by the United States and Europe in the nearly six years since the Global Compacts were adopted and provides an assessment about how these receiving nations have adapted to the rising number of forcibly displaced in the world, and whether, in doing so, their policies have been consistent with the provision of both Compacts. The paper finds that: • Both the US and Europe have instituted enforcement policies that violate the spirit, if not the intent, of the two Compacts, and, in some cases, undermine international human rights standards; • Both the US and Europe have attempted to balance their enforcement-related approaches with the creation of legal avenues and immigrant integration policies, consistent with the two Compacts, but their efforts, to date, have been insufficient to the need; • The US has made significant strides in introducing policies to protect refugee-like populations, but has failed to protect asylum-seekers in need of protection who arrive at the US-Mexico border; • Europe has relied on bilateral agreements and restrictive laws to deter migrants from reaching European shores, while at the same time supported sending and transit countries with development assistance; • Both the US and Europe have a mixed record with regard to preserving the principles of the right to remain and the right to migrate, a record which must be improved in the years ahead.