bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hippocampal sclerosis in women with temporal lobe epilepsy: seizure and pregnancy outcomes
Authors: Chen Yujie , Hao Nanya , Xiong Weixi , Zhang Hesheng , Zhang Enhui , Ou Zhujing , Chen Lei , Wu Xintong , Zhou Dong 
Published: September 2024

Abstract
Background
Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is typically resistant to pharmacological interventions; however, achieving seizure freedom is possible through surgery. Our objective was to focus on the pregnancy and seizure outcomes during pregnancy of women with TLE-HS, and aim to identify predictors of seizure control.

Methods
The West China Registry of Pregnancy of Women with Epilepsy (WCPR_EPi) was a monocentric prospective cohort study of women with epilepsy (WWE). We screened women with TLE-HS in this database. Their clinical profile, anti-seizure medication (ASM) use, and pregnancy outcomes were extracted from the records of the registry (2010–2023).

Results
Out of 2320 WWE followed up, 47 pregnancies in women with TLE-HS were identified and analyzed. Seizure exacerbation occurred in 40.4% of pregnancies, and seizure freedom was present in 34.0% of these during pregnancy. Factors associated with seizure exacerbation during pregnancy was ASM non-adherence (odds ratio [OR] =7.00, 95% confidence interval [CI] 1.43–34.07, P=0.016). The surgery group showed a significantly higher seizure freedom rate (OR = 6.87, 95% CI 1.02–46.23, P=0.016) and lower rate of induced labor (0.0% vs 26.5%, P=0.047) compared to the medically-treated group alone. Caesarean section was chosen in 77.1% of cases due to seizure concerns, with comparable in epilepsy-related (n=20) and obstetric causes (n=24). No major congenital malformations were reported.

Conclusions
Surgical treatment before pregnancy appears to offer a higher chance of seizure freedom compared to medication alone. Most of women with TLE-HS can deliver healthy offspring regardless of suboptimal seizure control and unwarranted concerns.
Simultaneous beating-heart mitral valve replacement and aortic repair following Bentall procedure via double right mini-thoracotomies: a case report
Authors: Tanaka Toshimasa , Kinoshita Takeshi , Endo Daisuke , Tabata Minoru 
Published: September 2024

Abstract
Background
Redo mitral valve surgery by re-sternotomy approach has challenges such as bleeding and organ injury due to adhesion dissection, sternal bone infection, and poor field of view of mitral valve. On the other hand, redo mitral valve surgery via a right mini-thoracotomy approach appears to address these challenges. We successfully performed a double right mini-thoracotomies approach for mitral valve replacement and pseudoaneurysm repair under the beating-heart condition. Herein, we report the effectiveness and the safety of this technique and detailed procedure.
Case presentation.
The patient is a 71-year-old man with a history of Bentall procedure using a mechanical valve at another hospital 30 years ago. He developed acute heart failure due to severe mitral valve regurgitation. After medication, he was referred to our department for the purpose of surgery for mitral valve regurgitation. Preoperative transesophageal echocardiography showed extensive degenerative change of the both leaflets and chordae tendineae rupture at the P3 segment. Both left atrium and ventricle dilated, and left ventricle contractility reduced. Aortic mechanical valve had no problem. In addition, preoperative contrast enhanced computed tomography revealed a pseudoaneurysm at the distal anastomotic site of Bentall procedure. We performed mitral valve replacement by mechanical valve and repair of distal anastomotic cite under beating heart condition, utilizing a double right mini-thoracotomies approach for mitral valve and ascending aortic pseudoaneurysm respectively. The postoperative course was uneventful, the patient was discharged without complications.

Conclusion
The right mini-thoracotomies approach efficiently accessed mitral valve and ascending aorta in reoperations, reducing the adhesion dissection risks and ensuring clear exposure. Moreover, concomitant use of beating-heart technique minimized adhesion dissection for aortic cross-clamp, preserved cardiac function.
Partial Lipodystrophy Affecting the Extremities in a Young Woman With Autoimmune Polyglandular Syndrome 1
Authors: Agarwal Shubham , Bodansky Aaron , Xing Chao , Anderson Mark S , Garg Abhimanyu 
Published: September 2024

Abstract
Autoimmune polyglandular syndrome 1 (APS1) is an autosomal recessive disorder due to biallelic pathogenic variants in the autoimmune regulator (AIRE) gene that manifests with chronic mucocutaneous candidiasis, primary hypoparathyroidism, and adrenal insufficiency. We report a 39-year-old woman with APS1 who developed partial lipodystrophy during adulthood. She presented with diaper rashes, oral thrush, and tetany during infancy due to candidiasis and hypoparathyroidism. During childhood, she developed hypothyroidism, primary adrenal insufficiency, and ovarian insufficiency.
At age 14, she received a sibling-matched allogenic bone marrow transplant due to multiple antibiotic-refractory fungal infections. At age 35, her serum triglycerides were 914 mg/dL (10.32 mmol/L) and she had loss of subcutaneous fat from the upper and lower extremities and hips. A whole-body dual-energy x-ray absorptiometry revealed lower-extremity fat at less than the first percentile. Whole-exome sequencing on DNA extracted from saliva revealed pathogenic variants, p.Leu28Pro and p.Arg257* in AIRE but none in the known lipodystrophy genes. Phage-immunoprecipitation-sequencing revealed the presence of autoantibodies to MAGEB1, MAGEB4, and RFX6, which have been previously reported in APS1. Our case suggests that patients with APS1 may develop partial lipodystrophy due to autoantibodies against novel adipocyte-expressed proteins. A causal relationship of high levels of autoantibodies in our patient to adipose tissue–expressed ODC1, NUCKS1, or FNBP1L and lipodystrophy remains uncertain.
Surgery on the C3-4 Level and the Presence of Ligamentum Flavum Hypertrophy Increases the Risk of 30-Day Reoperation Rate After Anterior Cervical Discectomy and Fusion
Authors: Shin Hong Kyung , Jang Sun Woo , Park Jin Hoon 
Published: September 2024

BACKGROUND AND OBJECTIVES:
Cervical myelopathy caused by C3-4 level degeneration often exhibits different characteristics after anterior cervical discectomy and fusion (ACDF) than other cervical levels. This study compared the outcomes of C3-4 ACDF with surgeries at other levels and identified risk factors of 30-day reoperation after ACDF.

METHODS:
We retrospectively analyzed patients who underwent ACDF for degenerative cervical disease from 2018 to 2023. The patients were divided into 2 groups based on the level of surgery: C3-4 and non–C3-4 groups. Radiological outcomes, including cervical alignment and range of motion (ROM), were analyzed. Clinical outcomes were assessed with patient-reported outcomes and the rates of 30-day reoperation and complications after ACDF. Patient-reported outcomes included visual analog scale for neck pain, visual analog scale for arm pain, and modified Japanese Orthopedic Association scores. Risk factors of 30-day reoperation were assessed.

RESULTS:
Of 259 patients, 74 (28.6%) and 185 (71.4%) were in the C3-4 and non–C3-4 groups, respectively. The C3-4 group exhibited lower C2-7 ROM (P = .019), higher C3-4 ROM (P = .015), and greater C3-4 %ROM (P = .014). The C3-4 group demonstrated lower preoperative and 1-month postoperative modified Japanese Orthopedic Association scores (P < .001; P < .001, respectively). The rate of 30-day reoperation was significantly higher in the C3-4 group (9.5%) compared with the non–C3-4 group (2.2%) (P = .014). In addition, C3-4 surgical level (odds ratio = 4.99, P = .034) and ligament flavum hypertrophy (odds ratio = 5.84, P = .018) were identified as independent risk factors of 30-day reoperation after ACDF.

CONCLUSION:
Surgery on C3-4 level showed a higher risk of 30-day reoperation than other levels. It is likely due to C3-4 surgical level, and ligament flavum hypertrophy contributes to cord compression, particularly in the unstable early postoperative period.
Mid-term efficacy of the Cartiva synthetic cartilage implant in symptomatic hallux rigidus
Authors: Fletcher William R. , Collins Thomas , Fox Anna , Pillai Anand 
Published: September 2024

AimsThe Cartiva synthetic cartilage implant (SCI) entered mainstream use in the management of first metatarsophalangeal joint (MTPJ) arthritis following the positive results of large trials in 2016. Limited information is available on the longer-term outcomes of this implant within the literature, particularly when independent from the originator. This single-centre cohort study investigates the efficacy of the Cartiva SCI at up to five years.MethodsFirst MTPJ arthritis was radiologically graded according to the Hattrup and Johnson (HJ) classification. Preoperative and sequential postoperative patient-reported outcome measures (PROMs) were evaluated using the Manchester-Oxford Foot Questionnaire (MOXFQ), and the activities of daily living (ADL) sub-section of the Foot and Ankle Ability Measure (FAAM).ResultsPatients were followed up for a mean of 66 months (SD 7.1). Of an initial 66 cases, 16 did not return PROM questionnaires. A total of six failures were noted, with survival of 82%. Overall, significant improvement in both objective scores (MOXFQ and FAAM ADL) was maintained versus preoperatively: 18.2 versus 58.0 (p > 0.001) and 86.2 versus 41.1 (p > 0.001), respectively. The improvement was noted to be less pronounced in males. Subjective scores had deteriorated since early follow-up, with an interval decrease in patient satisfaction from 89% to 68%. Furthermore, a subset of cases demonstrated clinically important interval deterioration in objective scores. However, no specific patient factors were found to be associated with outcomes following analysis.ConclusionThis study represents the longest-term independent follow-up in the literature. It shows reassuring mid-term efficacy of the Cartiva SCI with better-than-expected survival. However, deterioration in scores for a subset of patients and lower satisfaction may predict ongoing failure in this group of patients. Additionally, males were noted to have a lower degree of improvement in scores than females. As such, ongoing observation of the SCI to assess durability and survivability, and identify predictive factors, is key to improving patient selection.Cite this article: Bone Jt Open 2024;5(9):799–805.
Equity in the geographical distribution of general practitioners in Iran
Authors: Khajehnasiri Farahnaz , Mosadeghrad Ali Mohammad , Alibeiginejad Mohammad Hossein 
Published: September 2024

Background
The equitable distribution of workforce is imperative for achieving public health goals. This study was conducted to evaluate the equity of the distribution of general practitioners (GPs) in Iran.

Methods
In this descriptive and cross-sectional study, data from the Information System of Benefits for Iranians and the Iranian Statistics Center were utilized. The study population encompasses all GPs operating in Iran in 2022. To assess equity in the geographical distribution of physicians, the Gini coefficient and Lorenz curve were calculated using Excel software. Additionally, ArcGIS software was used to create a distribution map.

Results
The population of Iran and active GPs in 2022 were 85,874,000 and 67,852 respectively, resulting in an average of 7.9 active GPs per 10,000 people. The provinces of Yazd, Tehran, Mazandaran, and Fars exhibited the highest concentration of active GPs per capita, collectively representing more than 28% of the population and 37% of the active GPs. Fifty percent of the active GPs were women. The Gini coefficients for the provincial and intercity distributions of GPs were 0.08 and 0.2, respectively.

Conclusion
The distribution of GPs among provinces and cities was deemed fair and relatively fair, respectively. Iran has a lower ratio of GPs per capita than the European nations. Policymakers should pay more attention to the implementation of appropriate policies with the aim of increasing equity in the geographical distribution of GPs in the country.
Mountain sickness in altitude inhabitants of Latin America: A systematic review and meta-analysis
Authors: Zila-Velasque J. Pierre , Grados-Espinoza Pamela , Goicochea-Romero P. Alejandra , Tapia-Sequeiros Gustavo , Pascual-Aguilar J. Enrique , Ruiz-Yaringaño Arturo J. , Barros-Sevillano Shamir , Ayca-Mendoza Jhon , Nieto-Gutierrez Wendy 
Published: September 2024

Objective
Chronic and acute mountain sickness is known worldwide, but most of the available information comes from the eastern continent (Himalayas) without taking into account the west which has the most recent group located at altitude, the Andes. The aim of this study was to synthesize the evidence on the prevalence of acute and chronic mountain sickness in Latin American countries (LATAM).

Methods
A systematic search of the variables of interest was performed until July 8, 2023 in the Web of Science, Scopus, PubMed and Embase databases. We included studies that assessed the prevalence of mountain sickness in high-altitude inhabitants (>1500 m.a.s.l) who lived in a place more than 12 months. These were analyzed by means of a meta-analysis of proportions. To assess sources of heterogeneity, subgroup analyses and sensitivity analyses were performed by including only studies with low risk of bias and excluding extreme values (0 or 10,000 ratio). PROSPERO (CRD42021286504).

Results
Thirty-nine cross-sectional studies (10,549 participants) met the inclusion criteria. We identified 5 334 and 2 945 events out of 10,000 with acute and chronic mountain sickness in LATAM countries. The most common physiological alteration was polycythemia (2,558 events), while cerebral edema was the less common (46 events). Clinical conditions were more prevalent at high altitudes for both types of MS.

Conclusion
Acute mountain sickness (AMS) occurs approximately in 5 out of 10 people at high altitude, while chronic mountain sickness (CMS) occurs in 3 out of 10. The most frequent physiological alteration was polycythemia and the least frequent was cerebral edema.
Why the Federal Breast Density Notification Law Marks a Turning Point for Women’s Health
Authors:   Volpara Health, Thomas Teri 
Published: September 2024

September 10, 2024, marked a historic shift in women’s healthcare when the first federal breast density notification and reporting mandate went into effect. This means that now, all women in the United States will be informed by their providers about whether they have dense breast tissue after a mammogram. While this law helps to inform women about their risks, it is just the beginning. We need to ensure that women can do something with this important information without facing financial or logistical roadblocks.
“The Jews’ Last March in Their Lives” – An Unknown Holocaust Photo from Dubno
Authors: Klacsmann Borbála 
Published: September 2024

Abstract
In this source publication I analyze a photograph taken by a Hungarian soldier serving in the Eastern front, which depicts the Jews of Dubno marching toward the Surmychi airfield where the Nazis massacred them. The image is an example of photos taken during the war and then stashed away, only to resurface again when the generation which survived the war, passed away. Today, several similar images are available in public collections and internet databases, and enrich our knowledge about the local events of the Holocaust.
Ökumenisches Kirchenrecht im Zerrbild historiographischer Erzählung
Authors: Esders Stefan 
Published: September 2024

Abstract

The Quinisext Council, assembled in Constantinople shortly after 690 to issue a series of more than 100 canons on practical issues and on clerical discipline, was designed as an Ecumenical council, but failed to gain ‘universal’ acceptance in the West. Moving beyond traditional interpretations which saw the conflict over the Quinisext Council largely as one between Emperor Justinian II in Constantinople and the papacy in Rome, the article asks how issues related to the Quinisext Council were received in the churches of the Exarchate of Ravenna and the Lombard, Visigothic, Frankish and Anglo-Saxon kingdoms. Drawing on accounts in Paulus Diaconus’ ‘History of the Lombards’, the ‘Chronicle of Alfons III’ ( of Asturia ) and Agnellus’ ‘Book of Pontiffs of the Church of Ravenna’, it is argued that there must have been a much wider debate about the Quinisext canons on celibacy and on chastity of clerics. As is shown by the analysis of these sources, some of the Quinisext canons on these topics were accepted in the exarchate of Ravenna, the Lombard kingdom of Italy and the Visigothic kingdom in Spain and Southern Gaul around 700; only when attitudes changed profoundly after the mid-eighth century, the acceptance of the council’s decisions by rulers and bishops became subject to polemical narratives in later historiography. By contrast, a case can be made on the basis of synodal decisions, canon law, hagiographical texts, theological treatises and chronicles that in the Frankish and Anglo-Saxon kingdoms, the Quinisext canons on clerical marriage were refuted by bishops, who confirmed older positions on the debated issues as transmitted through canon law tradition. Asking what may have caused both the acceptance and rejection of the Council’s decisions and revisiting the development of the papacy’s attitude to the Quinisext canons, it is argued here that juxtapositions and a priori-statements on religious culture in ‘East’ and ‘West’ are not helpful to understand the wide-ranging connectivity and communication that becomes visible from this debate. A Mediterranean perspective that fully embraces the world of the post-Roman ‘West’ including Britain does more justice to the openness of historical processes around 700.
Semi-generalized Bassian groups
Authors: Chekhlov Andrey R. , Danchev Peter V. , Keef Patrick W. 
Published: September 2024

Abstract
As a common non-trivial generalization of the concept of a (proper) generalized Bassian group, we introduce the notion of a semi-generalized Bassian group and initiate its comprehensive investigation.
Precisely, we give a satisfactory characterization of these groups by showing in the cases of 𝑝-torsion groups, torsion-free groups and splitting mixed groups their complete description.
Moreover, we classify the groups with the clearly related property that every subgroup is essential in a direct summand of the whole group.
Certa non certis... Sul testo della poetica tempestas nella redazione A dell’Historia Apollonii regis Tyri
Authors: Lubian Francesco 
Published: September 2024

Abstract
This contribution aims to present some reflections regarding the text of the poetica tempestas in the Historia Apollonii regis Tyri (§ 11), which has always posed significant challenges to editors and commentators of this Late Antique novel. The investigation focuses particularly on the version contained in the earliest surviving redaction (RA), highlighting the poem’s debts to the Latin poetic tradition and proposing three suggestions for the constitution of the text. The aim is to demonstrate that this poetic insert is the product of a versifier with solid scholastic training and considerable qualities, certainly not inferior to those exhibited by the redactor of RB.
Evaluation of the detector linearity response of the DR system in different x-ray bean filters
Authors: Daros K. A. C. , Murata C. H. , Policarpo E. M. , Ogawa K. J. , Miri C. , Fontoura O. S. , Farias T. M. B. 
Published: September 2024

In the recent past, at Brazilian radiology services, direct digital radiography (DR) systems are replacing Computed Radiography (CR). This situation provides several significant advantages such as improving digital image quality, patient effective dose reduction, and improved speed of examinations performed. To evaluate DR systems, various organizations have published protocols with guidelines concerning quality assurance and acceptance tests for DRs. In these protocols, there are methodologies for evaluating several parameters, such as the detector linearity response (DLR). To test the DLR, different methodologies are proposed by the organizations, such as the application of different additional filters on the X-ray beams spectrum to promote the X-ray doses suitable to produce the latent image in the DR. The objective of this work was to evaluate the results of different protocol methodologies for carrying out the DLR test of a DR flat panel. An analogic radiology equipment, a primary ionization chamber, a DR system and images unprocessed were used in this study. As indicated by the protocols, the spectra of the X-rays were modified by additional filters of copper (Cu) with aluminum (Al); Al; Cu; and polymethylmethacrylate (PMMA). The spectra of the X-rays were modified to achieve the exposure range of 0.1 to 7 mR. The results showed that the DLR curves adjustment were R²>0.99, for a logarithmic equation, type y=a.ln(x)+b. For the filters of 0.5 mmCu with 1.0 mmAl; 11.5 mmAl; 1.0 mmCu; 21 mmAl the mean pixel values showed 0.9% of the coefficient of variation (COV), while for 10 cm PMMA filters, the COV increased to 2.7%. The study showed that methodologies using Al, Cu and Al with Cu filters DLR have similar responses while using PMMA, the response was slightly different.
People Living With HIV Have More Intact HIV DNA in Circulating CD4+ T Cells if They Have History of Pulmonary Tuberculosis
Authors: Jean Juste Marc Antoine , Joseph Yvetot , Lespinasse Dominique , Apollon Alexandra , Jamshidi Parmida , Lee Myung Hee , Ward Maureen , Brill Esther , Duffus Yanique , Chukwukere Uche , Danesh Ali , Alberto Winiffer , Fitzgerald Daniel , Pape Jean , Jones R , Dupnik Kathryn 
Published: September 2024

Background: A primary barrier to curing HIV is the HIV reservoir. The leading infectious cause of death worldwide for people living with HIV is tuberculosis (TB), but we do not know how TB impacts the HIV reservoir.
Methods: Participants in identification and validation cohorts were selected from previously enrolled studies at Groupe Haïtien d’Étude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) in Port au Prince, Haiti. Intact and non-intact proviral DNA were quantified using droplet digital PCR of peripheral blood mononuclear cell (PBMC)-derived CD4+ T cells. Kruskal-Wallis tests were used to compare medians with tobit regression for censoring.
Results: In the identification cohort, we found that people living with HIV with a history of active pulmonary TB (n=19) had higher levels of intact provirus than people living with HIV without a history of active TB (n=47) (median 762; IQR, 183-1173 vs 117; IQR, 24-279 intact provirus per million CD4, respectively; P=0.0001). This difference also was seen in the validation cohort (n=31), (median 102; IQR, 0-737 vs 0; IQR, 0-24.5 intact provirus per million CD4, P=0.03) for TB vs no-TB history groups, respectively. The frequencies of CD4+ T cells with any detectable proviral fragment was directly proportional to the levels of interleukin-1 beta (r=0.524, P= 0.0025) and interleukin-2 (r=0.622, P=0.0002).
Conclusions: People living with HIV with a history of active pulmonary TB have more HIV provirus in their circulating CD4+ T cells, even years after TB cure. We need to characterize which CD4+ T cells are harboring intact provirus to consider the impact of T cell-targeting HIV cure interventions for people living in TB-endemic areas.