bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘I just don’t want them to be my patient again’: an exploratory mixed-methods study examining provider home safety concerns for adolescents with acquired brain injuries in the US Midwest
Authors: Anderson Sarah E , Schroedle Sarah , Stamper Taylor , Lundine Jennifer P , Patterson Emily S , DiGiovine Carmen P , Swearingen Scott , Wengerd Lauren R , Darragh Amy R 
Published: November 2024

ObjectiveAdolescents with acquired brain injuries are at risk for additional injuries after hospital discharge. We asked healthcare providers to identify and prioritise urgent hazards in the home setting for this population.MethodsWe used a convergent mixed methods approach. Healthcare providers who do discharge planning and community re-integration for adolescent patients with brain injury were recruited from hospitals in the US Midwest. Participants completed two structured surveys, semi-structured interviews and a Hazard Prioritisation Matrix Activity. We analysed quantitative data via descriptive statistics and qualitative data via inductive thematic analysis to identify hazards, urgency, interactive themes and generate a conceptual model.ResultsAll participants validated four preidentified hazards in the surveys and the interviews: slippery objects on the floor, large furniture/objects in the path of travel, unattended open flames and inappropriate use of cooking appliances. 59 hazards were self-identified during the Hazard Priority Matrix Activity and assigned an urgency rating, with 12 (20.3%) urgent, 20 (33.9%) major, 19 (32.2%) moderate and 8 (13.6%) minor risks. We identified seven interactive themes about hazard factors: hazardous activities, hazardous situations, hazardous objects, hazardous others, hazardous spaces, harms and client factors. A conceptual model for home safety concerns links hazards, risks and harms.ConclusionsAdolescents with acquired brain injuries need healthcare providers to recognise unique and complex hazards in their homes that could lead to harm. Mitigating home hazards may prevent additional unintentional injury for these adolescents. More research is needed to generalise this information for this population across clinical settings.Trial registration numberNCT04768946.
Spectrum of hereditary transthyretin amyloidosis due to T60A(p.Thr80Ala) variant in an Irish Amyloidosis Network
Authors: Hewitt Katie , Starr Neasa , Togher Zara , Sulong Saadah , Morris Joseph P , Alexander Michael , Coyne Mark , Murphy Katie , Giblin Gerard , Murphy Sinéad M , Joyce Emer 
Published: November 2024

BackgroundVariant transthyretin amyloidosis (ATTRv) is a hereditary multisystem disorder with clinical spectrum ranging from predominant cardiomyopathy to polyneuropathy. In the Irish population, the T60A mutation has been previously recognised as the most common genotype.ObjectivesThe aim of this study is to describe the diagnostic and phenotypic spectrum of patients with T60A ATTRv attending an Irish Expert Amyloidosis Network.MethodsIn this observational study design, the medical, laboratory and radiological records of patients enrolled in our amyloidosis registry with a confirmed genotype diagnosis of T60A ATTRv were reviewed.ResultsA cohort of 24 patients (12 female) met criteria for inclusion. The median age at diagnosis was 65 years (IQR 59.5–66.5) and median follow-up 44 months (IQR 31–58). Carpal tunnel syndrome was the initial manifestation in almost half (46%) of patients. Overall, a mixed cardioneuro phenotype was demonstrated including autonomic (75%), small (58%) and large fibre (46%) neuropathy largely predating a cardiac phenotype consisting of heart failure (63%), atrial arrhythmia (42%) and bradycardia (13%).ConclusionThe contemporary clinical spectrum of T60A ATTRv in Ireland is one of patients typically presenting in the seventh decade with an already manifest neuropathy phenotype, largely predating a cardiac phenotype dominated by heart failure.
Protocol of a Randomised Controlled Trial to Assess the Efficacy and Safety of a Oral Complementary Medicine Combination in People with Knee Osteoarthritis
Authors: Liu Xiaoqian , Shahid Arashi , Bracken Karen , Christensen Robin , Deveza Leticia , Collins Simone , Harnett Joanna , Hunter David , McLachlan Andrew , Robbins Sarah , Bowden Jocelyn 
Published: November 2024

Background Osteoarthritis (OA) is a leading cause of pain and disability in middle-aged or older adults worldwide. The prevalence of symptomatic knee OA has been increasing over the past several decades, indicating the need for the deployment of innovative prevention and treatment strategies for knee OA. The aim of this study is to investigate the efficacy and safety of an oral complementary medicine formulation in people with symptomatic knee OA. Methods This is a randomised, placebo-controlled, double-blinded (participants and investigators), two-arm, superiority, parallel, phase II trial. The study will recruit 82 ([Formula: see text]41 per arm) community-based participants with knee OA living in Australia. Participants aged [Formula: see text] 40 years with a clinical diagnosis of symptomatic knee OA and radiographic change on X-ray (Kellgren-Lawrence Grade [Formula: see text] 2) will be recruited. Participants will be randomly allocated to receive either a complementary medicine formulation containing a daily dose of Boswellia serrata extract (Boswellin[Formula: see text]Super, 250 mg/day), pine bark extract (Fenoprolic™70 Organic 100mg/day), curcumin (500mg/day), piperine (5mg/day), and methylsulfonylmethane (MSM, 1500mg/day), or placebo, for 12 weeks. The primary endpoint is change from baseline in average index knee pain at 12 weeks (visual analogue scale). Secondary endpoints include change in knee pain at other timepoints, the Knee Injury and Osteoarthritis Outcome Score (KOOS), global assessment of disease activity, global rating of change, health-related quality of life (AQoL-8D), and adverse events. Ethics, trial registration and dissemination: The study protocol has been approved by the University of Sydney Human Research Ethics Committee (#2021/877). The trial has been prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12623000380695, 14/04/2023). Dissemination will occur through lay summaries, scientific publications, conference abstracts, poster or oral presentations, infographics, and theses. Conclusion The outcomes of this study will provide high-quality evidence guiding the clinical use of the complementary medicine combination and will inform updates on international OA clinical practice standards on the use of complementary medicines.
Insights into Rheumatoid Arthritis in Kuwait: The Prevalence of Comorbidities
Authors: Khudadah Mohammad , Aldabie Ghaydaa , Albasri Anwar , Al-Herz Adeeba , Alsaber Ahmad , Saleh Khulood , Alawadhi Adel , Hasan Eman , Al-Kandari Waleed , Muhanna Aqeel , Ali Yaser , Alhadhood Naser , Tarakmeh Huda , Hayat Sawsan , Aldei Ali , Baroun Fatemah , kadi Amjad Al , Alhajeri Hebah , Abutiban Fatma , Alenzi Ahemd 
Published: November 2024

Introduction Rheumatoid Arthritis (RA) is a chronic autoimmune disease that causes joint inflammation and potential disability. (1). The relationship between comorbidities and RA is well-known and is associated with poor outcomes. (3,4, 5) Furthermore, patients with RA are at an increased risk of cardiovascular disease (CVD). (6) This study investigates the epidemiology of RA in Kuwait, focusing on the prevalence of comorbidities such as hypertension, type 2 diabetes, hyperlipidemia and obesity using the Kuwait Rheumatoid Arthritis registry. Methods This retrospective study analyzes data from 2239 RA patients in Kuwait, enrolled from February 2012 to May 2024 Results As shown in Table 1, (71.0%) are females with a mean age of 55.6 years and a mean disease duration of 11.1 years. The average body mass index (BMI) is 29.2, with 39.2%% having a BMIˆ3 of 30 and 11.3% are active smokers. Analysis of comorbidities in RA patients shows that hypertension (23%) and diabetes Type 2 (20%) are the most prevalent conditions, followed by thyroid disease and hyperlipidemia (13%), as demonstrated in Figure 1. Conclusion This study reveals a high prevalence of hypertension, diabetes, dyslipidemia and obesity, all of which are modifiable risk factors for CVD. This finding emphasizes the importance of pre-emptive screening for these comorbid conditions, establishing a comprehensive care plan, and optimizing treatment protocol to improve patient outcome.
Unravelling a Case of Coronary Vasculitis
Authors: Lafir Raahya , Atukorala Inoshi , Vidanapathirana Manudi 
Published: November 2024

Background Coronary vasculitis is a rare cause of myocardial infarction through varied mechanisms. We report the case of a 32-year-old female found to have diffuse coronary microaneurysms during treatment for an Inferior ST Elevation Myocardial Infarction (STEMI), with challenges in pinpointing the underlying aetiology. Results Our patient has been diagnosed with a seronegative arthritis and had been initiated on regular Golimumab 4 months prior. She presented with prolonged fever for 4 weeks and inflammatory oligoarthritis with left sacroiliac joint pain. During this admission, Antinuclear antibody was 1:2560 and anti ds DNA was 1:80. She had highly positive Rickettsia conorii IgG titres of 1:128, suggestive of acute infection with Orientia tsustsugamushi. Meropenem and doxycyclin for presumed typhus had no impact on her fever spikes. In the 10th week of the illness, she developed ischaemic chest pain with electrocardiographic changes of inferior STEMI and was thrombolysed. Invasive coronary angiography revealed numerous coronary microaneurysms affecting all major myocardial vessels, with minimal coronary artery disease. Following multidisciplinary discussion, she was treated with intravenous methylprednisolone, antiplatelets, a statin and warfarin for a diagnosis of coronary vasculitis. Repeat angiography showed complete resolution of the microaneurysms. She continues on anticoagulation and has since had no coronary events. Conclusion Typhus and medium vessel vasculitis such as Kawasaki and Polyarteritis Nodosa were potential diagnoses for this presentation. A diagnosis of SLE was established due to the highly specific immunological profile. As there are reports of high Rickettsial titres in autoimmune disease, which alongside the lack of response to doxycyclin makes Typhus unlikely. The possibility of golimumab induced SLE was briefly entertained due to similar reports, but the positivity of ds DNA and major organ involvement made this possibility unlikely. We highlight the cardiac involvement in this case due to its high morbidity on young patients, and the current paucity of knowledge on SLE-related endothelial dysfunction and immune-mediated vascular damage. The role of anticoagulation in this inflammatory milieu too, is controversial. This case highlights a rare presentation of SLE, with an emphasis on coronary vasculitis. It adds to the current knowledge on the complex cardiovascular risk in SLE and highlights ambiguous areas in current management strategies to prompt further research.
Development of Non-Genetic Risk Stratification Model of Severe Allopurinol Hypersensitivity (NoG-ALLOH Score): A Multicenter Study in Thailand
Authors: Towiwat Patapong , Lawanaskol Suppachai , Tassaneeyakul Wichittra , Sukasem Chonlaphat , Saksit Niwat , Nakkam Nontaya , Poolpun Duangkamon , Rerkpattanapipat Ticha , Klaewsongkram Jettanong , Rerknimitr Pawinee , Louthrenoo Worawit 
Published: November 2024

Background The side effect of allopurinol was severe allopurinol hypersensitivity (SAH). There are two major causes including genetic risk factor, HLA-B*58:01 and non-genetic risk factors including female, old age, renal impairment, inadequate starting dosage of allopurinol and received diuretic. Although HLA-B*58:01 testing is recommended in Thai, the several problems including cost, limitation of the testing and the delay of the result. Therefore, we aimed to use these non-genetic risk factors for developing the model to predict SAH. Method The study was a retrospective observational incidence density sampling. SAH cases were collected from tertiary care medical center which some cases were referred from primary care medical center; where most non-SAH cases were collected from primary care hospitals and tertiary care medical centers. The data of non-genetic factors particularly sex, age, renal function, co-diuresis, starting dosage of allopurinol and serum uric acid (SUA) of non-SAH cases selected the first description of allopurinol. The binary prevalence-weighted logistic regression statistical method was used to develop the prediction models. Three models were developed following general practice. Result Totally, there were 209 cases of SAH and 23,068 cases of non-SAH. Factors that were associated with the development of SAH within 90 days were female, old age (¿ 65 years old), renal impairment, inadequate starting dosage of allopurinol, co-medication(s) with diuretic and high SUA before prescription of allopurinol. Model 1a and model 1b were applied for patients who did not have and have SUA when starting allopurinol, respectively. Model 2 was applied for patients who had all non-genetic risk factors and started allopurinol within 60 days but have not SAH. The area under the receiver operating characteristic curve for model 1a, model 1b and model 2 were 0.72, 0.81 and 0.82, respectively (Figure 1). The performance for each predictions SAH were good. Conclusion Model 1a and model 1b predict SAH for the patients who had their first prescribed allopurinol, model 2 predicts SAH for the patients who had been taken allopurinol within 60 days but no SAH. The scoring system of each model helps clinician to prescribe allopurinol in real clinical practice before the patients develop SAH. The score of 0-1%, 1-2% and 2-100% indicates the low, moderate and high risk, respectively. The low-risk group can start allopurinol. The moderate-risk group considers to start allopurinol with closed monitoring of SAH. The high-risk group suggests to change to other urate lowering agents for preventing SAH (Table 1).
Optic Neuropathy AFG3L2 Related in a Patient Affected by Congenital Stationary Night Blindness
Authors: Cammarata Gabriella , Mihalich Alessandra , Manfredini Emanuela , Lamperti Costanza , Bianchi Marzoli Stefania , Di Blasio Anna Maria 
Published: November 2024

Objective: We describe a patient affected by congenital stationary night blindness (CSNB) secondary to CACNA1F and optic neuropathy associated with an AFG3L2 variant.Methods: We performed comprehensive neuro‐ophthalmologic examinations, retinal imaging, complete ocular electrophysiology, and brain and optic nerve MRI. Genomic DNA was extracted from the peripheral blood. The patient’s DNA was then investigated by next‐generation sequencing (NGS) with a panel including 32 genes associated with retinal dystrophy and therefore with a panel including seven genes associated with genetic forms of optic atrophy.Results: The genetic analysis identified a pathogenetic CACNA1F variant causing CSNB and a heterozygous variant in AFG3L2 that alters OPA1 processing and is known to be associated with OPA1‐like optic neuropathy.Conclusion: Optic disc atrophy has been previously described as an atypical feature in the phenotype of CSNB CACNA1F‐related. In this patient, we found a variant of the AFG3L2 gene that presumably explains the presence of optic atrophy in a subject affected by CSNB.Clinical Relevance: The clinical evidence of optic atrophy, which is atypical in CSNB, should raise the suspicion of concomitant hereditary optic neuropathy and emphasize the importance of broad genetic diagnostic testing to better define the genotype–phenotype correlation.
The Effect of the Nasal Structure on the Olfactory Cleft Airflow: A Systematic Review
Authors: Chen Lina , Liu Yuxing , Wu Dawei 
Published: November 2024

Objective Conductive olfactory losses mainly involve obstruction of the olfactory cleft (OC) and diminished OC airflow. This study investigated the association between abnormal nasal structure and OC airflow. Methods A systematic search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis to identify studies on the effect of the nasal structure on the OC airflow and olfaction. Results A total of 11 studies were included. Nasal vestibule morphological variabilities directly impact the transport of molecules in odorant-laden air to the OC. A greater airflow vortex and a narrower vestibule region intensified the airflow vortex toward the olfactory region. Middle turbinectomy significantly increased the average flux to the OC. The location of the major airflow and airflow velocity maxima shifted towards the OC in patients with septal deviation. The airflow has been redirected into the upper part of the nasal airway in patients with inferior turbinate hypertrophy. For patients with unilateral cleft lip, unilateral nasal airflow on the cleft side has a lower rate and flow. The mean velocity in the posterior OC correlated well with olfaction compared to that in the anterior OC. The nasal polyps (NP) within the middle meatus increased the olfactory airflow but did not enhance the olfaction. NP in the olfactory region or anterior to the olfactory region significantly decreased the olfactory airflow and olfaction. Furthermore, obstruction of the OC did not change the nasal patency. When the OC shape presented with a stenotic slit or lumen structure among patients with conductive olfactory dysfunction without NP, the inspiratory velocity and flow rate within OC were significantly lower than in the healthy control group. Conclusion Various nasal structural factors affect patterns of OC airflow and olfaction. Identifying the related airflow-limiting structures may promote the comprehensive evaluation of conductive olfactory losses in patients with olfactory dysfunction.
Mitigating excessive heat in Arabica coffee using nanosilicon and seaweed extract to enhance element homeostasis and photosynthetic recovery
Authors: Chandon Ekkachak , Nualkhao Patchawee , Vibulkeaw Metee , Tisarum Rujira , Samphumphuang Thapanee , Sun Jianqiang , Cha-um Suriyan , Yooyongwech Suravoot 
Published: November 2024

Abstract
Background
Global warming-related temperature increases have a substantial effect on plant and human health. The Arabica coffee plant is susceptible to growing in many places across the world where temperatures are rising. This study examines how nanosilicon and seaweed extracts can improve Arabica coffee plant resilience during heat stress treatment (49.0 ± 0.3 °C) by maintaining mineral homeostasis and photosynthetic ability upon recovery.

Results
The principal component analysis arrangement of four treatments, nanosilicon (Si), seaweed extract (SWE), Si + SWE, and control (CT), showed each element ratio of magnesium, phosphorus, chloride, potassium, manganese, iron, copper, and zinc per silicon in ambient temperature and heat stress that found influenced upper shoot rather than basal shoot and root within 74.4% of largest feasible variance as first principal component. Magnesium and iron were clustered within the silicon group, with magnesium dominating and leading to a significant increase (p ≤ 0.05) in magnesium-to-silicon ratio in the upper shoot under heat conditions, especially in Si and Si + SWE treated plants (1.11 and 1.29 fold over SWE treated plant, respectively). The SWE and Si + SWE treated plants preserved chlorophyll content (15.01% and 28.67% over Si-treated plant, respectively) under heat stress, while the Si and Si + SWE treated plants restored photosynthetic efficiency (Fv/Fm) better than the SWE treated plant.

Conclusions
The concomitant of the Si + SWE treatment synergistically protected photosynthetic pigments and Fv/Fm by adjusting the magnesium-silicon homeostasis perspective in Arabica coffee to protect real-world agricultural practices and coffee cultivation under climate change scenarios.
Prevalence and severity of pediatric cases in Stockholm’s physician-staffed prehospital units: a retrospective cohort study
Authors: Bäckström Denise , Jörnvall Henrik , Strandqvist Erik , Ahlerup Robert , Wahlin Rebecka Rubenson 
Published: November 2024

Abstract
Background
Ambulance missions involving pediatric patients are common in emergency medical services (EMS) globally, with variations in prevalence based on geographic location.
This retrospective cohort study analyzes the prehospital physician staffed units (p-EMS) in Stockholm, assignment dispatches and the prehospital characteristics and interventions involved, from January 1, 2021, to December 31, 2022.

Methods
Utilizing data from LogEze, a quality assurance system, we reviewed all Rapid Response Vehicle (RRV) operations in the Stockholm Region, which totaled 4,682 pediatric assignments. The analysis included dispatch types and interventions assessing the frequency and nature of pediatric prehospital missions.

Results
Pediatric cases constituted 20.0 % of RRV dispatches, with the majority involving respiratory distress, seizures, and blunt trauma. Despite high dispatch rates, advanced medical interventions were seldom required, indicating most pediatric cases were not severe. Stand-downs occurred in 30.1 % of cases, reflecting the cautious approach in pediatric dispatches. Furthermore, the study observed a significant reliance on p-EMS for complex pediatric cases, underscoring the value of specialized training and resources in managing such emergencies.

Conclusion
The study highlights the crucial role of p-EMS in enhancing pediatric emergency care in Stockholm. Despite frequent pediatric dispatches, the low incidence of severe cases underscores the need for precise triage and resource allocation. This analysis supports the need for continuous training and resource optimization in p-EMS to ensure high-quality care for pediatric patients across varied emergency scenarios.
Screen time and obesity prevalence in adolescents: an isotemporal substitution analysis
Authors: Byun Dohyun , Kim Yujin , Jang Hajin , Oh Hannah 
Published: November 2024

Abstract
Background
We examined the associations between screen time and adolescent obesity and the associations of reallocating screen time to other activities using isotemporal substitution models. Understanding the association between screen time and obesity may provide additional insights into effective obesity prevention strategies in adolescents.

Methods
We conducted a cross-sectional analysis of 5,180 adolescents (4th and 7th grade students) from the Korean Children and Youth Panel Survey 2018. Participants reported their height, weight, and average time spent watching television, using computer, using smartphone, and other after-school activities. Obesity was defined as BMI-for-age and -sex ≥ 95th percentile based on the 2017 Korean National Growth Charts. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between screen time and obesity prevalence, adjusting for potential confounders.

Results
Prolonged smartphone use (≥ 180 vs. <60 m/d: OR [95% CI] = 2.75 [2.06, 3.68]) was associated with a higher obesity prevalence. Television watching (≥ 120 vs. <60 min/d) was positively associated with obesity prevalence among 4th grade students (2.09 [1.51, 2.89]) but the association was not observed among 7th grade students (0.97 [0.63, 1.49]). One-hour increments of any non-screen time activities, with a simultaneous 1-hour decrease in combined screen time, were associated with a lower obesity prevalence (physical activity: 0.75 [0.65, 0.85]; sleeping: 0.69 [0.62, 0.78]; hanging out with friends: 0.80 [0.71, 0.89]; reading: 0.82 [0.69, 0.97]; studying: 0.84 [0.78, 0.90]; chatting with parents: 0.89 [0.88, 0.98]).

Conclusions
Our data suggest that public health strategies that reduce screen time and increase time for non-screen time activities, such as physical activity, may be effective in lowering adolescent obesity prevalence.