bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early distinction of Alagille syndrome and biliary atresia in infants: A Comparative Study
Authors: Zhou Shuyuan , Zhan Xue , Li Shuyuan 
Published: July 2024

Abstract

Background and aims: Alagille syndrome (ALGS) is a multisystem disorder that is often confused with biliary atresia (BA) shortly after birth. This study aimed to identify criteria for early distinction between these two diseases.
Methods: Patients with confirmed ALGS and BA were retrospectively enrolled in this study. Clinical data, biochemical results, ultrasound findings, and genetic testing results were analyzed.
Results: A total of 14 patients with ALGS under 3 months of age were included in this study, and compared with 28 age- and sex-matched patients with BA. (1) Clinical features: significant differences in cardiac structural abnormalities and distinctive facial features were observed. (2) Biochemical indicators: both groups showed increased lactate dehydrogenase (LDH) and gamma-glutamyl transferase (GGT) levels; the GGT level of the ALGS group (304.75 U/L) was lower than that of the BA group (515.00 U/L), while the LDH level was higher; Fibrinogen (FIB) and prothrombin time (PT), though normal, showed significant differences. (3) Ultrasonography: ALGS patients had a lower gallbladder abnormality rate (64.3%, 9/14) than BA patients (96.4%, 27/28) (p < 0.05); the incidence of hepatomegaly and splenomegaly in ALGS patients was significantly lower than that in BA (p < 0.05).
Conclusion: For infants less than three months of age with high GGT cholestasis, attention should be paid to whether there are facial features, hepatomegaly, splenomegaly, gallbladder abnormality, and skeletal and heart abnormalities, which combined with GGT, LDH, FIB, and PT, can serve as criteria for early distinction of the two diseases.
Effectiveness of Selective Antibiotics Use in Esbl-Related UTIs.
Authors: Aththanayaka Kasun Prabuddha , Weerasinghe Yasoda Hansani , Weerakkody Nimsha Sevwandika , Samarasinghe Gayani Geethika , Priyadarshana Upul 
Published: July 2024

Abstract

Background –
Urinary tract infections (UTIs) are the second most common infection, affecting 150 million people each year worldwide. Enterobacteriaceae species expressing extended-spectrum β-lactamases (ESBLs) are on the rise across the globe and are becoming a severe problem in the therapeutic management of clinical cases of urinary tract infection. Knowledge of the prevalence and antibiogram profile of such isolates is essential to develop an appropriate treatment methodology. This study aimed to investigate the prevalence of Enterobacteriaceae isolates exhibiting ESBL and their selective oral antibiogram profile at the district general hospital, Polonnaruwa.
Results -
A total of 4386 urine specimens received to the Microbiology Laboratory during the study period. Among them, 1081 (25%) showed positive results for urine culture while 200/1081 specimens showed ESBL isolates. Out of the selected 200 specimen’s majority (72%) of samples received from the In-Patient Department. There were 200 patients and reported that 115 (58%) were females and 85 (42%) were males. The majority (51%) of the patients belong to the age group of 55–74 years. Among the ESBLs positive specimens, the majority 74.5% (n = 149) identified organisms were E. coli followed by Klebsiella spp.17.5% (n = 35), Enterobacteriaceae 7% (n = 14) and only1% (n = 2) isolate of Proteus spp. Mecillinam (86.30%) and Nitrofurantoin (83.56%) showed higher effectiveness against E. coli. Nitrofurantoin showed the highest effectiveness against Klebsiella spp. (31.58%), other Enterobacteriaceae spp. (79%). Proteus spp. showed 100% effectiveness and resistance respectively against Ciprofloxacin, Cotrimoxazole and Nitrofurantoin.
Conclusion -
The most predominant ESBLs producing uro-pathogen was the E. coli in the study setting and E. coli had higher sensitivity rate against Mecillinam. Among currently used oral antibiotics Nitrofurantoin was the best choice for UTIs caused by ESBL producers.
The Impact of Selection Bias on Genetic Prediction Using the Bipolar Polygenic Risk Score in First-Admission Psychosis
Authors: Jonas Katherine , Asim Amna , Yang Yuan , Heilbronner Urs , Schulze Thomas , Lencz Todd , Vassos Evangelos , Clouston Sean , Kotov Roman 
Published: July 2024

Abstract

Polygenic risk scores (PRS) have potential utility as biomarkers of psychiatric disorders. However, while the schizophrenia (SZ) PRS has been consistently associated with case-control status and a more severe course of illness, the associations between the bipolar (BP) PRS and markers of bipolar disorder vary considerably between studies, with studies of population and case-control samples identifying many effects that cannot be replicated in case-only analyses. These analyses demonstrate that the heterogeneity in studies of the BP PRS is driven by selection bias. Specifically, selecting samples on the basis of diagnostic status or other phenotypes associated with genetic risk attenuates the correlation between the BP and SZ PRS. In such high-severity samples, while the SZ PRS predicts poor outcomes, the BP PRS predicts better outcomes. These findings highlight the importance of understanding the impact of selection bias in translational research evaluating PRS as biomarkers of psychiatric disorders, particularly when the intended application is populations enriched for high levels of genetic risk.
The Magnitude of Early Discontinuation of Intrauterine Contraceptive Device Use and Associated Factors among Clients at Marie Stopes Maternal and Child Health Center, Adama, Ethiopia
Authors: Girma Daniel , Aman Haji , Ejara Daba 
Published: July 2024

Abstract

Background
Intrauterine contraceptive devices are cost-effective, convenient, safe, and highly effective methods designed to be used for 10–12 years. However, the discontinuation of such long-acting reversible contraceptives is becoming a public health concern in Ethiopia. The practices may lead to program failures that cause significant health and economic impacts.
Objective
To assess the magnitude of early discontinuation of intrauterine contraceptive devices and associated factors among clients who received the method at Marie Stopes Maternal and Child Center in Adama town in Ethiopia, 2024.
Methods
Institutional-based cross-sectional study was conducted among 413 clients who received the service from January 1, 2017, to March 2022. A systematic random sampling technique was used to select the study participants. Data were collected from medical records and telephone interviews. The collected data were entered into Epi-Info version 7.1 and analyzed using SPSS version 25. The associations between dependent and independent variables were assessed by using binary logistic regression analysis. Adjusted odds ratio with its 95% CI was used to estimate the strength of associations. P –value < 0.05 was considered to declare statistical significance.
Result
The magnitude of early discontinuation of intrauterine contraceptive devices accounts for 20.6% (95% CI:16.7–24.9). In multivariate analysis, lack of formal education [AOR = 12.5, 95% CI: 4.97, 31.5)] and primary level of education [AOR = 3.5, 95% CI:1.6, 7.99)], giving birth to a male child in the last delivery[AOR = 0.317,95% CI:0.18, 0.55)], having two and lower number of children [AOR = 3.97,95% CI: 1.8, 8.95)], not counseled on methods [AOR = 16.5,95% CI;5.8,47.1)], having pelvic pain [AOR = 7.4, 95% CI:2.678,20.3)], pelvic infection[AOR = 8.67, 95% CI: 2.7,27.7)], heavy bleeding [AOR = 15.5,95% CI: 3.3,73.7)] and history of vaginal discharge[AOR = 5.9,95% CI: 2.1,16.88)] were associated with early discontinuation of intrauterine contraceptive devices.
Conclusion
The magnitude of early discontinuation of intrauterine contraceptive devices was high. Lack of counseling was the strongest factor associated with early discontinuation of intrauterine contraceptive devices. It is essential to provide counseling and early screening for clients to ensure that clients who choose intrauterine contraceptive devices have a lower risk of side effects and complications.
Robotic-Assisted Transcranial Doppler Monitoring in Acute Neurovascular Care: a Feasibility and Safety Study
Authors: Salimbeni Alvise Fattorello , Kulyk Caterina , Favruzzo Francesco , De Rosa Ludovica , Viaro Federica , Pieroni Alessio , Mozzetta Stefano , Vosko Milan R , Baracchini Claudio 
Published: July 2024

Abstract

Introduction: Transcranial Color Doppler (TCD) is currently the only non-invasive bedside tool capable of providing real-time information on cerebral hemodynamics. However, being operator dependent, TCD monitoring is not feasible in many institutions. Robotic assisted TCD (ra-TCD) was recently developed to overcome these constraints. The aim of this study was to evaluate the safety and feasibility of cerebral monitoring with a novel ra-TCD in acute neurovascular care.
Methods: This is a two-center prospective study conducted between August 2021 and February 2022 at Padua University Hospital (Padua, Italy) and Kepler University Hospital (Linz, Austria). Adult patients with conditions impacting on cerebral hemodynamics or undergoing invasive procedures affecting cerebral hemodynamics were recruited for prolonged monitoring (> 30 minutes) of the middle cerebral artery (MCA) with a novel ra-TCD (NovaGuideTM Intelligent Ultrasound, NeuraSignal, Los Angeles, CA, USA). Manual TCD was also performed for comparison by an experienced operator. Feasibility and safety rates were recorded.
Results: 92 patients [age: mean 68.5 years, range 36-91; gender: male 57 (62%)] were enrolled in the two centers: 54 in Padua, 38 in Linz. The exam was feasible in the majority of patients (85.9%); the head cradle design and its radiopacity hindered its use during carotid endarterectomy and mechanical thrombectomy. Regarding safety, only one patient (1.1%) reported a minor local edema due to prolonged probe pressure. Velocity values resulted similar between ra-TCD and manual TCD.
Discussion: This novel ra-TCD showed an excellent safety and feasibility, and proved to be as reliable as manual TCD in detecting blood flow velocities. These findings support its wider use for cerebral hemodynamics monitoring in acute neurovascular care. However, further technical improvements are needed to expand the range of applicable settings.
Predation of Two Species of Columbidae by the Burrowing Owl Athene Cunicularia (Strigiformes, Strigidae) in Urban Environment
Authors: Mendes Gabriela Carlos , Esclarski Priscilla , Zawadzki Cláudio Henrique 
Published: July 2024

Abstract

The burrowing owl Athene cunicularia is a species known for its adaptation to urban environments, being able to adjust their behaviors according to environmental conditions. This work reports the records of predation of two species of columbids by Athene cunicularia. 63 burrowing owl nests were monitored in the state of Paraná between June 2022 and July 2023. The identification of predated species occurred through direct observation at the time of predation and by comparison between wings and feathers found in the owls’ nests with pictures of the suspected species. Both Columba livia and Zenaida auriculata were registered, counting seven records. Six occurred in different points of the study area, while one occurred in the state of Roraima. The predation of these birds by Athene cunicularia should not be isolated cases, as they cohabit urban areas. Our data highlights the species' adjustment to the urban environment since the domestic pigeon is not part of its known diet and has about 146.1% of the owl’s body mass, reinforcing the importance of Athene cunicularia in urban environments as it controls the populations of species that can be harmful to humans.
Analysis of Msimbazi River Banks Erosion with Regards to Soil Erodibility
Authors: Alexander Augustina C. , Izdori Fides J. , Mulungu Deogratias M.M. , Mugisha Lucius R. 
Published: July 2024

Abstract

River bank erosion has become increasingly detrimental to most urban rivers around the world. One of the well-established factors influencing river bank failure especially during a rainy season is the soil erodibility. Msimbazi River is facing severe river banks erosion hazard at different section of the lower basin that have had significant impacts on the population along the Msimbazi River. The study analysed the river banks soil composition from three sections of lower Msimbazi River basin, Kinyerezi, Kigogo and Jangwani, to establish the risk of erosion with regards to soil erodibility. The Results indicated that river banks along the lower Msimbazi River basin are at risk of erosion hazard due insufficient clay content, which is crucial for soil strength against erosion. The ROslan and Mazidah (ROM) Erodibility Index (EIROM) painted that more than 80% of the river banks in the study area are at “high” to “critical” risk of erosion. The banks along Kinyerezi stretch were found to be more prone to erosion while Kigogo and Jangwani ones suffer from overburden deposit of sediment supplied from upstream. River banks characterization presented parameters that can exacerbate river banks erosion thus, aggregate of soil composition with other key parameters is important for effective banks protection.
The association between non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with serum uric acid levels and hyperuricemia risk
Authors: Huang Jingjing , Chen Chunyong 
Published: July 2024

Abstract

Background
The relationship between the non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR), serum uric acid levels, and hyperuricemia risk remains unclear. This study evaluated the association between NHHR with serum uric acid levels, and hyperuricemia risk in US adults.
Methods
The data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018 were analyzed cross-sectionally using weighted linear regression, weighted logistic regression, restricted cubic splines, and threshold effects analysis. Additionally, subgroup analyses were performed to investigate the relationships between NHHR, serum uric acid levels, and the risk of hyperuricemia.
Results
Among 9439 individuals (mean age: 48 ± 14 years), the mean NHHR was 2.56 ± 0.71, and the mean uric acid level was 5.40 ± 0.90. The overall prevalence of hyperuricemia was 21%, increasing significantly with NHHR quartiles (Q1: 13%, Q2: 17%, Q3: 24%, Q4: 31%, P < 0.01). Each unit increase in NHHR was associated with a 20% higher risk of hyperuricemia (95% confidence interval [CI]: 1.09–1.33, P < 0.01) and a 0.13 increase in uric acid levels (95% CI: 0.09–0.18, P < 0.001). Subgroup analyses confirmed these findings across various demographics. A non-linear relationship was found between NHHR and uric acid levels/hyperuricemia risk, with breakpoints at 4.33 and 3.91, respectively (P for nonlinear < 0.001).
Conclusions
Elevated NHHR is significantly correlated with higher uric acid levels and hyperuricemia risk in US adults. Early intervention and management of NHHR may help mitigate hyperuricemia.
Psychometric Properties of the Chinese Version of the Self-Injurious Thoughts and Behaviors Interview in Adolescent Outpatients
Authors: Huang Hui-Chun , Huang Yu-Hsin , Liu Hui-Ching , Huang Chiu-Rong , Sung Ming-Ru , Sun Fang-Ju , Liu Shen-Ing 
Published: July 2024

Abstract

Background:
The Self-Injurious Thoughts and Behavior Interview (SITBI) has been widely used in Western countries, but its use in Chinese culture is limited. Based on the scarcity of standardized Chinese interviews to assess self-injurious thoughts and behaviors, this study aimed to validate the SITBI Chinese version (SITBI-C).
Methods:
The psychometric properties of the SITBI-C were tested in 195 outpatient adolescents with various levels of suicidality. The test-retest, interrater and concurrent validity were investigated in this study.
Results:
The analysis of the SITBI-C showed perfect test-retest reliability within one week. The interrater agreement was also excellent, ranging across SITB-C items. The validity indices were good when comparing the responses to the SITBI-C and other interview-based and self-reported measures, suggesting strong convergent validity.
Conclusions:
Overall, the results of this research suggested that the SITBI-C demonstrated good psychometric properties. The SITBI-C is appropriate for assessing suicidality in the Chinese adolescent population and can be used to assess adolescent suicidality to determine the risk for suicidal behavior.
Can Virtual Reality Technology be Used for Empathy Education in Medical Students: A Randomized Case-control Study
Authors: Lin Huang-Li , Huang Man-Lin , Wang Yu-Ching , Yu Nan-Wen , Tang I , Hsu Yu-chen , Huang Yu-Shu 
Published: July 2024

Abstract

Background
Empathy is an important factor in the doctor-patient relationship, but mental illness is more difficult to understand than other diseases. Besides traditional skills, virtual reality (VR) has been identified as a promising tool in empathy education. This study aimed to investigate the ability of empathy enhancement, the feasibility of depression education, and the changes in thoughts and attitudes in medical students through a single VR experience.
Methods
We recruited medical students and randomly assigned them to two groups based on their completed Interpersonal Response Index scores. Two sets of VR systems were provided; the intervention group experienced the daily life of the depressed medical student, while the control group experienced the general medical student scenario. The improvement of empathy was assessed using the Jefferson Scale of Empathy-Health Professional Students (JSE-HPS), and the change of attitude was assessed through the Implicit Association Test. In addition, other questionnaires were used to evaluate the user experience of this VR system, and correlation analysis was conducted to examine the association between the use of VR and changes in the JSE and IAT scores.
Results
A total of 59 medical students were enrolled in this study. The intervention group showed a significant increase in the perspective-taking (pre: mean 5.817, SD 0.536; post: mean 5.947, SD 0.620; P = .03) and compassionate care (pre: mean 5.546, SD 0.581; post: mean 5.721, SD 0.629; P = .01) domains of the JSE score and a significant decrease in the empathy (SP) domain (pre: mean 3.583, SD 1.253; post: mean 2.967, SD 1.252; P = .002). The Pearson correlation analysis found a significant positive correlation between the JSE score with immersion aspect (r = 0.308, P = .049) and presence aspect (r = 0.415, P = .01), and we also found a significant negative correlation between the IAT score and presence aspect (r=-0.333, P = .04).
Conclusions
This study is the first randomized case-control study to investigate the effect of two different versions of VR on empathy development toward depression for medical students. Although the single VR experience was unable to induce a great improvement in empathy or attitude, the VR system could help medical students enhance their understanding of depressive disorders.
Trial Registration:
Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12624000297527; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386683&isReview=true
Normative Values for Heart Rate Variability Indices in Healthy Infants in the Emergency Department
Authors: Mathiprechakul Supranee , Guo Dagang , Chong Shu-Ling , Piragasam Rupini , Ong Marcus Eng Hock , Fook-Chong Stephanie , Ong Gene Yong-Kwang 
Published: July 2024

Abstract

Heart rate variability (HRV) has been used as a marker of cardiovascular health and a risk factor for mortality in the adult and paediatric populations, and as an indicator of neonatal sepsis. There has been an increasing interest in using short-term (5-minutes) HRV to identify infants <90 days of life with serious bacterial infections. However, there has not been any normative data range reported for short-term HRV indices in this infant population. We conducted a prospective observational study of short-term HRV analysis of well infants <90 days of life in the emergency department (ED) setting. 108 infants with complete data [51.9% male, median age 9 days (inter-quartile range 4-35 days)] were included. We found that heart rate (HR) is correlated with heart rate variability. Thus, normalisation of HRV parameters was done to remove their dependence on HR. We then provided a normative reference range of widely used short-term HRV time-domain, frequency-domain, and non-linear HRV metrics in our cohort. We produced a HRV calculator for evaluation of these short-term HRV variables in young infants in ED settings that can be used for future clinical research.
Postoperative Ascending Aortic Aneurysm in Pulmonary Atresia with Ventricular Septal Defect: Report of 3 Adult Cases
Authors: Zhang Zhengjie , Zhang Mingkui , Xue Hui , Fan Lixin 
Published: July 2024

Abstract

Background: Progressive dilation of the ascending aorta is prone to lead to aortic dissection in patients with pulmonary artery atresia and ventricular septal defect. However, reports of long-term complications such as aortic aneurysm or aortic dissection in adults with pulmonary artery atresia are relatively rare.
Case presentation: Case 1: A 38-year-old male patient diagnosed with "pulmonary artery atresia, ventricular septal defect, bicuspid aortic valve deformity" underwent ventricular septal defect repair, aortic valve replacement, and correction of pulmonary artery atresia at the age of 21. Seventeen years postoperatively, he developed aortic dissection and underwent Bentall surgery.
Case 2: A 33-year-old male patient diagnosed with "pulmonary artery atresia, ventricular septal defect" underwent Blalock-Taussig shunt surgery at the age of 17. Sixteen years postoperatively, he developed aortic root aneurysm and ascending aortic dilation.
Case 3: A 42-year-old female patient diagnosed with "pulmonary artery atresia, ventricular septal defect" underwent pulmonary artery atresia corrective surgery and ventricular septal defect repair at the age of 14. Twenty-eight years postoperatively, she developed aortic root aneurysm and ascending aortic dilation.
Conclusions: Following corrective surgery for pulmonary artery atresia with ventricular septal defect, long-term follow-up monitoring is necessary. Progressive dilation of the aorta should be promptly intervened to prevent the occurrence of aortic dissection.