bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonclassic Congenital Adrenal Hyperplasia Metabolic Resolution Post Roux-en-Y Gastric Bypass and Associated Weight Loss
Authors: Romo Karina G , Shu Sharon W , Iqbal Qasim Z , Uwaifo Gabriel I 
Published: February 2024

Abstract
Nonclassic congenital adrenal hyperplasia (NCCAH) is characterized by mild cortisol deficiency, excess androgens and adrenocorticotropin (ACTH) production, and often with various features of dysmetabolic syndrome. Elective bariatric surgery is one of the most effective long-term management strategies for severe obesity. Our case presents a 34-year-old woman with symptomatic NCCAH and class III obesity who status post Roux-en-Y gastric bypass (RYGB) had significant weight loss with metabolic resolution of NCCAH, and no longer required glucocorticoid (GC) therapy. At 11 months post operation and off GC therapy, she had a weight deficit of approximately 160 pounds (72.57 kg) with continued metabolic resolution of NCCAH markers including ACTH, 17-hydroxyprogesterone, and androstenedione. Presently, GC therapy remains one of the few available treatments for symptomatic NCCAH; however, long-term GC therapy has the potential for various complications and side effects. Our case presents elective bariatric surgery as a potential and unique treatment option for patients with NCCAH with associated class III obesity. The exact pathophysiologic basis for this effect and its potential role in long-term management of appropriate NCCAH patients requires further study.
Severe Osteoporosis With Pathogenic LRP5 Variant
Authors: Stringer Felicity , Sims Natalie A , Sachithanandan Nirupa , Aleksova Jasna 
Published: February 2024

Abstract
A 24-year-old female patient was diagnosed with osteoporosis after presenting with numerous fractures throughout her childhood and adolescence. Risk factors included chronic constipation, severe vitamin D deficiency, and long-term high-dose steroid use for severe eczema. Metabolic bone disorder clinical exome screening (limited panel of metabolic bone disorders and gastrointestinal disorders) was undertaken and revealed a class 4 likely pathogenic variant in the LRP5 gene known to cause osteoporosis. Optimal treatment for patients with this variant is not well defined. A literature review of the condition and potential treatment options is discussed.
The Value of Regulators as Monitors: Evidence from Banking
Authors: Bisetti Emilio 
Published: February 2024

While conventional wisdom suggests that financial supervision is costly for bank shareholders, agency theory suggests that supervisors’ audits can reduce shareholder monitoring costs. I study this trade-off in the context of an unexpected decrease in off-site surveillance intensity by the U.S. Federal Reserve. Banks subject to reduced surveillance experience a 1% loss in bank Tobin’s q and a 7% loss in equity market-to-book. These banks engage in more earnings management, and appear to compensate lower regulatory surveillance with costly internal audits. My results document a novel substitution effect between public monitoring by regulators and private monitoring by shareholders. This paper was accepted by Victoria Ivashina, finance. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2021.03083 .
Technical Note—The Generalized Sethi Advertising Model
Authors: Kennedy Adrian P. , Sethi Suresh P. , Siu Chi Chung , Yam Sheung Chi Phillip 
Published: February 2024

New Flexible Advertising Model Unveiled: Enhancing Advertising Strategies Researchers have generalized the classical Sethi advertising model (1983) to provide a flexible yet tractable approach to optimizing advertising strategies. Unlike traditional methods, the generalized Sethi advertising model is designed to adapt to different market conditions in various media and markets, offering advertisers greater flexibility. By assuming a constant-returns-to-scale relationship between advertising expenditure and untapped market potential, the generalized Sethi advertising model provides advertisers with more options without sacrificing tractability. The research team has made important breakthroughs by developing practical formulas for determining the best advertising strategies for both individual companies and groups of companies. They have also conducted analyses to better understand how different factors influence these strategies. The generalized Sethi advertising model opens up new opportunities for advertisers to fine-tune their campaigns and reach more customers. This research marks a significant step forward in advertising optimization, giving businesses a valuable tool to achieve better results and make informed decisions in their advertising efforts.
Efficacy and safety comparison between silodosin and tamsulosin as medical expulsive therapy for distal ureteral stones
Authors: Rahman Farhan Haidar Fazlur , Leonardo Kevin , Ardaya Radhyaksa , Atmoko Widi , Parikesit Dyandra 
Published: February 2024

BACKGROUND Ureteral stones are a common urological condition causing significant discomfort and morbidity. Medical expulsive therapy (MET) is a noninvasive approach to facilitate the passage of stones. This study aimed to compare the efficacy and safety of silodosin and tamsulosin as MET in patients with distal ureteral stones (DUS).
METHODS We searched CINAHL, Cochrane Library, PubMed, and ScienceDirect for randomized controlled trials (RCTs) on the administration of silodosin and tamsulosin for DUS. The primary outcomes analyzed were stone expulsion rates and expulsion times, measured as risk ratio (RR) and mean difference (MD), respectively. Statistical analyses were performed using Review Manager 5.4 and STATA 17.
RESULTS 14 RCTs comprising 1,535 patients (770 received silodosin) met the inclusion criteria. The silodosin group had notably higher stone expulsion rates (RR 1.20, 95% confidence interval [CI] 1.13–1.27, p<0.00001, I² = 37%), shorter expulsion times (MD −2.98, 95% CI −4.35–−1.62, p<0.01, I² = 85%), and fewer colicky pain episodes (MD −0.35, 95% CI −0.59–−0.10, p<0.01, I² = 83%) than the tamsulosin group. Retrograde ejaculation was the only adverse event that had a significant difference between both groups, statistically favoring tamsulosin (RR 1.61, 95% CI 1.12–2.33, p = 0.01, I² = 0%).
CONCLUSIONS Silodosin should be preferred as the first-line MET agent for DUS owing to its better expulsion rate, shorter stone expulsion time, and fewer colicky pain episodes. However, tamsulosin may be used in selected cases where patients experience retrograde ejaculation after receiving silodosin.
Validation of artificial intelligence-based digital microscopy for automated detection of Schistosoma haematobium eggs in urine in Gabon
Authors: Meulah Brice , Oyibo Prosper , Hoekstra Pytsje T. , Moure Paul Alvyn Nguema , Maloum Moustapha Nzamba , Laclong-Lontchi Romeo Aime , Honkpehedji Yabo Josiane , Bengtson Michel , Hokke Cornelis , Corstjens Paul L. A. M. , Agbana Temitope , Diehl Jan Carel , Adegnika Ayola Akim , van Lieshout Lisette 
Published: February 2024

Introduction
Schistosomiasis is a significant public health concern, especially in Sub-Saharan Africa. Conventional microscopy is the standard diagnostic method in resource-limited settings, but with limitations, such as the need for expert microscopists. An automated digital microscope with artificial intelligence (Schistoscope), offers a potential solution. This field study aimed to validate the diagnostic performance of the Schistoscope for detecting and quantifying Schistosoma haematobium eggs in urine compared to conventional microscopy and to a composite reference standard (CRS) consisting of real-time PCR and the up-converting particle (UCP) lateral flow (LF) test for the detection of schistosome circulating anodic antigen (CAA).

Methods
Based on a non-inferiority concept, the Schistoscope was evaluated in two parts: study A, consisting of 339 freshly collected urine samples and study B, consisting of 798 fresh urine samples that were also banked as slides for analysis with the Schistoscope. In both studies, the Schistoscope, conventional microscopy, real-time PCR and UCP-LF CAA were performed and samples with all the diagnostic test results were included in the analysis. All diagnostic procedures were performed in a laboratory located in a rural area of Gabon, endemic for S. haematobium.

Results
In study A and B, the Schistoscope demonstrated a sensitivity of 83.1% and 96.3% compared to conventional microscopy, and 62.9% and 78.0% compared to the CRS. The sensitivity of conventional microscopy in study A and B compared to the CRS was 61.9% and 75.2%, respectively, comparable to the Schistoscope. The specificity of the Schistoscope in study A (78.8%) was significantly lower than that of conventional microscopy (96.4%) based on the CRS but comparable in study B (90.9% and 98.0%, respectively).

Conclusion
Overall, the performance of the Schistoscope was non-inferior to conventional microscopy with a comparable sensitivity, although the specificity varied. The Schistoscope shows promising diagnostic accuracy, particularly for samples with moderate to higher infection intensities as well as for banked sample slides, highlighting the potential for retrospective analysis in resource-limited settings.

Trial registration
NCT04505046 ClinicalTrials.gov.
Predictors of unplanned emergency hospital admissions among patients aged 65+ with multimorbidity and depression in Northwest London during and after the Covid-19 lockdown in England
Authors: Cicek Meryem , Greenfield Geva , Nicholls Dasha , Majeed Azeem , Hayhoe Benedict 
Published: February 2024

Introduction
Individuals with multimorbidity have an increased likelihood of using unplanned secondary care including emergency department visits and emergency hospitalisations. Those with mental health comorbidities are affected to a greater extent. The Covid-19 pandemic has negatively impacted on psychosocial wellbeing and multimorbidity care, especially among vulnerable older individuals.

Aim
To examine the risk of unplanned hospital admissions among patients aged 65+ with multimorbidity and depression in Northwest London, England, during- and post-Covid-19 lockdown.

Methods
Retrospective cross-sectional data analysis with the Discover-NOW database for Northwest London was conducted. The overall sample consisted of 20,165 registered patients aged 65+ with depression. Two time periods were compared to observe the impact of the Covid-19 lockdown on emergency hospital admissions between 23rd March 2020 to 21st June 2021 (period 1) and equivalent-length post-lockdown period from 22nd June 2021 to 19th September 2022 (period 2). Multivariate logistic regression was conducted on having at least one emergency hospital admission in each period against sociodemographic and multimorbidity-related characteristics.

Results
The odds of having an emergency hospitalisation were greater in men than women (OR = 1.19 (lockdown); OR = 1.29 (post-lockdown)), and significantly increased with age, higher deprivation, and greater number of comorbidities in both periods across the majority of categories. There was an inconclusive pattern with ethnicity; with a statistically significant protective effect among Asian (OR = 0.66) and Black ethnicities (OR = 0.67) compared to White patients during post-lockdown period only.

Conclusion
The likelihood of unplanned hospitalisation was higher in men than women, and significantly increased with age, higher deprivation, and comorbidities. Despite modest increases in magnitude of risk between lockdown and post-lockdown periods, there is evidence to support proactive case-review by multi-disciplinary teams to avoid unplanned admissions, particularly men with multimorbidity and comorbid depression, patients with higher number of comorbidities and greater deprivation. Further work is needed to determine admission reasons, multimorbidity patterns, and other clinical and lifestyle predictors.
Efficacy of BETTER transitional care intervention for diverse patients with traumatic brain injury and their families: Study protocol of a randomized controlled trial
Authors: Oyesanya Tolu O. , Ibemere Stephanie O. , You HyunBin , Emerson Maralis Mercado , Pan Wei , Palipana Anushka , Kandel Melissa , Ingram Darius , Soto Mayra , Pioppo Anne , Albert Brittany , Walker-Atwater Tamia , Hawes Jodi , Komisarow Jordan , Ramos Katherine , Byom Lindsey , Gonzalez-Guarda Rosa , Van Houtven Courtney H. , Agarwal Suresh , Prvu Bettger Janet 
Published: February 2024

ObjectiveThe purpose of this study is to examine the efficacy of BETTER (Brain Injury,Education,Training, andTherapy toEnhanceRecovery) vs. usual transitional care management among diverse adults with traumatic brain injury (TBI) discharged home from acute hospital care and families.MethodsThis will be a single-site, two-arm, randomized controlled trial (N = 436 people, 218 patient/family dyads, 109 dyads per arm) of BETTER, a culturally- and linguistically-tailored, patient- and family-centered, TBI transitional care intervention for adult patients with TBI and families. Skilled clinical interventionists will follow a manualized protocol to address patient/family needs. The interventionists will co-establish goals with participants; coordinate post-hospital care, services, and resources; and provide patient/family education and training on self- and family-management and coping skills for 16 weeks following hospital discharge. English- and Spanish-speaking adult patients with mild-to-severe TBI who are discharged directly home from the hospital without inpatient rehabilitation or transfer to other settings (community discharge) and associated family caregivers are eligible and will be randomized to treatment or usual transitional care management. We will use intention-to-treat analysis to determine if patients receiving BETTER have a higher quality of life (primary outcome, SF-36) at 16-weeks post-hospital discharge than those receiving usual transitional care management. We will conduct a descriptive, qualitative study with 45 dyads randomized to BETTER, using semi-structured interviews, to capture perspectives on barriers and facilitators to participation. Data will be analyzed using conventional content analysis. Finally, we will conduct a cost/budget impact analysis, evaluating differences in intervention costs and healthcare costs by arm.DiscussionFindings will guide our team in designing a future, multi-site trial to disseminate and implement BETTER into clinical practice to enhance the standard of care for adults with TBI and families. The new knowledge generated will drive advancements in health equity among diverse adults with TBI and families.Trial registrationNCT05929833.
The accuracy of 10 g monofilament use for clinical screening of diabetes peripheral neuropathy among Indian population
Authors: Hazari Animesh , Mishra Vinaytosh , Kumar Praveen , Maiya Arun 
Published: February 2024

Objective
The purpose of this study was to test the diagnostic accuracy of the 10g monofilament to screen for diabetic peripheral neuropathy (DPN) in India. The study further assessed the effect of physical activity, footwear use, and occupation on the outcome.

Methods
Non-probabilistic purposive sampling was used to recruit patients with T2DM to assess the diagnostic utility of the 10 g monofilament. 160 participants were recruited divided into 4 groups. Each group consisted of 40 participants with 20 under each category described as “Physical Worker Vs Non- physical worker” (n = 40), “Barefoot Vs Footwear” (n = 40), “Use of Slipper at Home Vs No-slippers use at home” (n = 40), “Agriculture Vs Non- agriculture” (n = 40). 10 g monofilament was used to detect the presence of protective sensation towards screening of DPN against biothesiometer (Vibration Pressure Threshold).

Results
The area under the ROC (receiver operating characteristic) curve was 0.6 for identifying DPN using the 10 g monofilament. Physical work (p = 0.04), footwear (p = 0.04), slipper use at home (p = 0.02) and occupation (p = 0.02) impacted on the diagnostic utility of the 10g monofilament.

Conclusions
This study shows that the 10 g monofilament has limited accuracy for detecting DPN in the Indian population and this is further affected by occupation, socioeconomic and religious practice.
Associations between Toxoplasma gondii seropositivity and psychopathological manifestations in schizophrenic patients: A single-center study from Ecuador
Authors: Rosado Diego , Intriago Belen , Loor Evelyn , Alcívar Flor , Avila Jorge , Sotomayor Mario , Villacres Larissa , Faytong-Haro Marco 
Published: February 2024

Background
Schizophrenia, a complex neuropsychiatric disorder, is believed to be influenced by various factors including environmental exposures. A potential environmental factor is the infection by the obligate intracellular parasitic protozoan, Toxoplasma gondii which affects neurotransmitter levels, which could potentially exacerbate, trigger symptoms of schizophrenia or make them worst.

Objective
To investigate the association between Toxoplasma gondii seropositivity and psychopathological presentation in persons with schizophrenia in Ecuador.

Methods
This study was conducted at the Neuroscience Institute of Guayaquil, Ecuador. Among 368 inpatients, 104 were selected based on specific inclusion and exclusion criteria. Descriptive statistics captured patient characteristics and mental health outcomes. Logistic regression models estimated the effect of toxoplasmosis on various mental health outcomes, controlling for demographic and health-related variables.

Results
86.5% of participants were seropositive for toxoplasmosis. Toxoplasma-seropositive schizophrenic patients had a lower risk of depression but a significantly higher risk of disorientation. The most prevalent mental health outcomes were Language Impairments (70.2%) and Bizarre Behavior (76.0%).

Conclusion
Our findings suggest that Toxoplasma gondii seropositivity may have specific effects on mental functions in schizophrenic patients, particularly reducing the risk of depression but increasing the risk of disorientation. Further studies are required to clarify these associations and the potential underlying mechanisms.
Health system’s availability and readiness of health facilities for chronic non-communicable diseases: Evidence from the Ethiopian national surveys
Authors: Defar Atkure , Zeleke Girum Taye , Berhanu Della , Lemango Ephrem Tekle , Bekele Abebe , Alemu Kassahun , Biadgilign Sibhatu 
Published: February 2024

Introduction
Non-communicable diseases (NCDs) currently cause more deaths than all other causes of deaths. Cardiovascular disease, diabetes, cancer, and chronic respiratory diseases-threaten the health and economies of individuals and populations worldwide. This study aimed to assess the availability and readiness of health facilities for chronic non-communicable diseases (NCDs) and describe the changes of service availability for common NCDs in Ethiopia.
Methods
We used data from the 2014 Ethiopia Service Provision Assessment Plus (ESPA +) and 2016 and 2018 Service Availability and Readiness Assessment (SARA) surveys, which were cross-sectional health facility-based studies. A total of 873 health facilities in 2014, 547 in 2016, 632 in 2018 were included in the analysis. (ESPA+) and SARA surveys are conducted as a census or a nationally/sub-nationally representative sample of health facilities. Proportion of facilities that offered the service for diabetes, cardiovascular disease, chronic respiratory disease, cancer diseases, mental illness, and chronic renal diseases was calculated to measure health service availability. The health facility service readiness was measured using the mean availably of tracer items that are required to offer the service. Thus, 13 tracer items for diabetes disease, 12 for cardiovascular disease, 11 for chronic respiratory disease and 11 cervical cancer services were used.

Results
The services available for diagnosis and management did not show improvement between 2014, 2016 and 2018 for diabetes (59%, 22% and 36%); for cardiovascular diseases (73%, 41% and 49%); chronic respiratory diseases (76%, 45% and 53%). Similarly, at the national level, the mean availability of tracer items between 2014, 2016 and 2018 for diabetes (37%, 53% and 48%); cardiovascular diseases (36%, 41% and 42%); chronic respiratory diseases (26%, 27% and 27%); and cancer diseases (6%, 72% and 51%). However, in 2014 survey year, the mean availability of tracer items was 7% each for mental illness and chronic renal diseases, respectively.

Conclusions
The majority of the health facilities have low and gradual decrement in the availability to provide NCDs services in Ethiopia. There is a need to increase NCD service availability and readiness at primary hospitals and health centers, and private and rural health facilities where majority of the population need the services.
Personal Protective Equipment Portraits Canada (PPC)–Humanization and surveying mask-wearing nationally
Authors: Rendon Laura , Taifour Tarek , Ventrella Cynthia R. , Seara Ana , Donovan Adamo A. 
Published: February 2024

Background
Personal Protective Equipment (PPE) Portraits is a hybridized art and medical intervention that lessens the alienating appearance of PPE through wearable, smiling headshot pictures. During the pandemic, the use of these portraits was expanded, but Canadian initiatives offered portraits only to immediate stakeholders. PPE Portraits Canada (PPC) aimed to provide PPE portraits to any Canadian healthcare institution and surveyed healthcare workers (HCW) regarding these portraits’ impact.

Methods
University student volunteers founded PPC via online platforms and coast-to-coast collaborations that allowed any HCW nationwide to request a free portrait via an accessible online form. PPC has gathered feedback from participating HCWs directly via an anonymous and bilingual survey.

Results
70% of HCWs wore their portraits “always” or “usually”, 69% of HCWs “definitely would” recommend their portrait, 89.5% of HCWs found that the PPE portraits made a difference in their experiences with patients and 74% found the same for their colleagues. The pre- and post-effect of the portraits, led to a 37.5% greater likelihood that HCWs felt “connected” or “very connected” to patients/residents. For the thematic analysis, 70% or more of the comments were rated as positive, with less than 5% of comments being rated as negative.

Conclusion
This model’s logistical framework can be expanded beyond PPE portraits to other initiatives with limited resources, allowing them to reach and positively impact diverse populations. HCW feedback was predominantly positive. The optimal design and impact of PPE portraits on patients and HCWs should be studied further to improve portrait adoption.