bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurosyphilis complicated by anti-γ-aminobutyric acid-B receptor encephalitis: A case report
Authors: Fang Ya-Xiu , Zhou Xiao-Ming , Zheng Dong , Liu Guang-Hui , Gao Peng-Bo , Huang Xiao-Zhen , Chen Zhi-Cheng , Zhang Hui , Chen Lin , Hu Ya-Fang 
Published: April 2024

BACKGROUND
Syphilis is an infectious disease caused by Treponema pallidum that can invade the central nervous system, causing encephalitis. Few cases of anti-N-methyl-D-aspartate receptor autoimmune encephalitis (AE) secondary to neurosyphilis have been reported. We report a neurosyphilis patient with anti-γ-aminobutyric acid-B receptor (GABABR) AE.
CASE SUMMARY
A young man in his 30s who presented with acute epileptic status was admitted to a local hospital. He was diagnosed with neurosyphilis, according to serum and cerebrospinal fluid (CSF) tests for syphilis. After 14 d of antiepileptic treatment and anti-Treponema pallidum therapy with penicillin, epilepsy was controlled but serious cognitive impairment, behavioral, and serious psychiatric symptoms were observed. He was then transferred to our hospital. The Mini-Mental State Examination (MMSE) crude test results showed only 2 points. Cranial magnetic resonance imaging revealed significant cerebral atrophy and multiple fluid-attenuated inversion recovery high signals in the white matter surrounding both lateral ventricles, left amygdala and bilateral thalami. Anti-GABABR antibodies were discovered in CSF (1:3.2) and serum (1:100). The patient was diagnosed with neurosyphilis complicated by anti-GABABR AE, and received methylprednisolone and penicillin. Following treatment, his mental symptoms were alleviated. Cognitive impairment was significantly improved, with a MMSE of 8 points. Serum anti-GABABR antibody titer decreased to 1:32. The patient received methylprednisolone and penicillin after discharge. Three months later, the patient’s condition was stable, but the serum anti-GABABR antibody titer was 1:100.
CONCLUSION
This patient with neurosyphilis combined with anti-GABABR encephalitis benefited from immunotherapy.
Comparison of two approaches to measuring clean faces as part of the facial cleanliness component of the SAFE trachoma elimination strategy
Authors: West Sheila K. , Munoz Beatriz , Mkocha Harran , Lynch Matthew C. , Gracewello Catherine , Kasubi Mabula , Wolle Meraf A. 
Published: April 2024

Background
The Alliance for the Global Elimination of Trachoma (GET) endorses the full SAFE strategy to eliminate trachoma; Surgery (for trichiasis), Antibiotics (to reduce the community pool of infection, Facial cleanliness, and Environmental improvement (to decrease transmission). There is no accepted measure of facial cleanliness. This study compared two possible metrics for facial cleanliness.

Method/Findings
Metric one: Clean face was defined as observed absence of ocular and nasal discharge on the face. Metric two: observing a grade of dirtiness (scale 10 = lightest to 0 = darkest) on a standard facial wipe. The reliability of grading a child’s face or grading a facial wipe was determined in children in Kongwa Tanzania. We also observed both measurements in a cohort of 202 children ages 1 to <7years prior to face cleaning, immediately afterwards, and 4 hours afterwards. Fifty of the children did not have face cleaning and were controls. Intra-and interobserver reliability was similar for both measures, the latter = 0.53 for observing a clean face and 0.52 for grading a facial wipe. There was no correlation between the two. Both measures detected facial cleaning, compared to control children who were not cleaned, immediately after cleaning; control children with 53% clean faces and wipe score of 6.7 compared to cleaned children with 88% clean faces and wipe score of 8 (p = .0001, p = < .0001, respectively). Both measures also detected face washing 4 hours previously compared to controls.

Conclusions
The two metrics were equally reliable, and both measured the behavior of face washing. They measure different aspects of a clean face; one measures the amount of dirt on wiped area and the other measures ocular and nasal discharge. Both measurements appear to capture the behavior of facial cleaning, and the choice of metric would appear to rest on the measurement that captures the stated objective of the behavior, consideration of costs, training, logistics, and implementation.
Determinants of adolescents’ depression, anxiety, and somatic symptoms in Northwest Ethiopia: A non-recursive structural equation modeling
Authors: Gebreegziabher Zenebe Abebe , Eristu Rediet , Molla Ayenew 
Published: April 2024

IntroductionIn low and middle-income countries, adolescent mental health is not only a major public health challenge but also a development concern. Depression and anxiety are the most common mental health disorders and somatic symptoms often co-exist with them. Adolescents with common mental health problems are associated with an increased risk of suicide, future unemployment, and poor quality of life. However, little is known about the mental health of adolescents in Ethiopia. Thus, this study aimed to assess the determinants of depression, anxiety, and somatic symptoms among adolescents in Northwest Ethiopia, in 2022.MethodsAn institution-based cross-sectional study was conducted from June 8 to 24, 2022. Two-stage stratified random sampling was used to select 1407 adolescents in Northwest Ethiopia. Structured and standardized self-administered questionnaires were used to collect the data. Non-recursive structural equation modeling was employed to assess the direct, indirect, and total effects of predictors. Adjusted regression coefficients and corresponding 95% confidence intervals were used to interpret the strength of the association.ResultsThe prevalence of depression, anxiety, and somatic symptoms were 28.21% (95% CI: 25.8, 31%), 25.05% (95%CI: 22.8, 27.5), and 25.24(95% CI: 23, 27.6%) respectively. Alcohol use had a significant positive effect on depression [β = 0.14, 95% CI: 0.073, 0.201], anxiety [β = 0.11, 95% CI: 0.041, 0.188], and somatic symptoms [β = 0.12, 95% CI: 0.062, 0.211]. Stress had a significant positive effect on depression [β = 0.76, 95% CI: 0.642, 0.900], anxiety [β = 1.10, 95% CI: 0.955, 1.264], and somatic symptoms [β = 086, 95% C: 0.700, 1.025]. Depression had a direct positive effect on anxiety [β = 0.74, 95% CI: 0.508, 1.010].ConclusionIn this study, the prevalence of depression, anxiety, and somatic symptoms was moderate. Alcohol use and stress were significantly related to depression, anxiety, and somatic symptoms. The bidirectional relationship between anxiety and depression was significant. Therefore, public health interventions should focus on the bidirectional relationship between depression and anxiety, as well as on identified factors to reduce the burden of mental illness in adolescents.
Effectiveness of trained religious leaders’ engagement in maternal health education on improving maternal health service utilizations: Protocol of cluster randomized controlled trial in Hadiya Zone, Southern Ethiopia
Authors: Arega Sadore Abinet , Kebede Yohannes , Birhanu Zewdie 
Published: April 2024

Background
Despite the many supply- and demand-side interventions aimed at increasing uptake of maternal health service utilizations, the maternal and new-born health service utilizations remains low. Religious leaders have the power to inhibit or facilitate effective adoption of maternal health service utilizations to promote maternal health. However, evidence on the roles of religious leaders in promoting maternal health in developing world is not fully known. Therefore this cluster-randomized trial is designed to evaluate the effects of trained religious leaders’ engagement in maternal health education in improving maternal health service utilization and knowledge of obstetric danger signs.

Methods
A community based cluster randomized control trial in which the study kebeles are randomly assigned into intervention and control groups will be conducted. The sample size is calculated using stata software. Three hundred six pregnant mothers will be enrolled in each group. A baseline study will be conducted before the intervention and post-intervention evaluation will be conducted after four months of intervention. Religious leaders will be selected and trained to lead participatory sessions on maternal health. Data on maternal health service utilizations, knowledge about obstetric danger signs, attitude towards skilled delivery service utilization and perception of pregnancy risk will be collected from a repeated cross sectional household survey. Effect of intervention will be assessed using multivariable logistic regression with generalized estimating equation model. Data will be analyzed using STATA software. For qualitative study, coded transcripts will be further analyzed and summarized in narratives for each theme and sub-themes.

Discussion
This is one of the first trials to evaluate the effectiveness of trained religious leaders’ engagement in maternal health education and will provide much needed evidence to policy makers about aspects of functionality and the religious leaders engagement required as they scale-up this programme in Ethiopia.
Development of insomnia in patients with stroke: A systematic review and meta-analysis
Authors: Yang Junwei , Lin Aitao , Tan Qingjing , Dou Weihua , Wu Jinyu , Zhang Yang , Lin Haohai , Wei Baoping , Huang Jiemin , Xie Juanjuan 
Published: April 2024

Background and aim
Stroke is a serious threat to human life and health, and post-stroke insomnia is one of the common complications severely impairing patients’ quality of life and delaying recovery. Early understanding of the relationship between stroke and post-stroke insomnia can provide clinical evidence for preventing and treating post-stroke insomnia. This study was to investigate the prevalence of insomnia in patients with stroke.

Methods
The Web of Science, PubMed, Embase, and Cochrane Library databases were used to obtain the eligible studies until June 2023. The quality assessment was performed to extract valid data for meta-analysis.
The prevalence rates were used a random-efect. I2 statistics were used to assess the heterogeneity of the studies.

Results

Twenty-six studies met the inclusion criteria for meta-analysis, with 1,193,659 participants, of which 497,124 were patients with stroke.
The meta-analysis indicated that 150,181 patients with stroke developed insomnia during follow-up [46.98%, 95% confidence interval (CI): 36.91–57.18] and 1806 patients with ischemic stroke (IS) or transient ischemic attack (TIA) developed insomnia (47.21%, 95% CI: 34.26–60.36). Notably, 41.51% of patients with the prevalence of nonclassified stroke developed insomnia (95% CI: 28.86–54.75). The incidence of insomnia was significantly higher in patients with acute strokes than in patients with nonacute strokes (59.16% vs 44.07%, P < 0.0001).
Similarly, the incidence of insomnia was significantly higher in the patients with stroke at a mean age of ≥65 than patients with stroke at a mean age of <65 years (47.18% vs 40.50%, P < 0.05). Fifteen studies reported the follow-up time. The incidence of insomnia was significantly higher in the follow-up for ≥3 years than follow-up for <3 years (58.06% vs 43.83%, P < 0.05). Twenty-one studies used the Insomnia Assessment Diagnostic Tool, and the rate of insomnia in patients with stroke was 49.31% (95% CI: 38.59–60.06). Five studies used self-reporting, that the rate of insomnia in patients with stroke was 37.58% (95% CI: 13.44–65.63).

Conclusions
Stroke may be a predisposing factor for insomnia. Insomnia is more likely to occur in acute-phase stroke, and the prevalence of insomnia increases with patient age and follow-up time. Further, the rate of insomnia is higher in patients with stroke who use the Insomnia Assessment Diagnostic Tool.
Prognostic nomogram for uncontrolled type 2 diabetes using Thailand nation-wide cross-sectional studies
Authors: Lertwanichwattana Teeraboon , Suwannahitatorn Picha , Mungthin Mathirut , Rangsin Ram 
Published: April 2024

Background
Uncontrolled type 2 diabetes (T2DM) and limited hemoglobin A1c (HbA1c) levels examination are a burden in community hospitals in Thailand. The nomogram from the patients’ information might be a practical solution to identify a high-risk group of diabetic complications. Thus, this study aimed to establish an effective prognostic nomogram for patients with uncontrolled T2DM.

Methods
Sequential nationwide cross-sectional studies of T2DM patients in 2018 and 2015 were utilized for development and validation groups, respectively, with this chronological order aiming to capture recent trends during development and assess the nomogram’s robustness across diverse timeframes. The predictive outcome was uncontrolled T2DM, defined as HbA1c ≥9%. The model was determined by multivariable regression analysis and established an effective prognostic nomogram. The receiver operating characteristic curve, Hosmer-Lemeshow goodness of fit test, and decision curve analysis (DCA) was applied to evaluate the performance of the nomogram.

Results
In 2018, 24% of the 38,568 participants in the development group had uncontrolled T2DM (defined as Hba1c ≥9%). The predictive nomogram of uncontrolled diabetes consisted of demographic characteristics, prescription medications, history of diabetic complications, and laboratory results (C-statistic of 0.77). The goodness of fit test and DCA showed good agreement between the result and clinical application for T2DM.

Conclusion
The predictive nomogram demonstrates simplicity, accuracy, and valuable prediction to enhance diabetic care in resource-limited countries, including Thailand.
An alternating-intervention pilot trial on the impact of an informational handout on patient-reported outcomes and follow-up after lung cancer screening
Authors: Triplette Matthew , Kross Erin K. , Snidarich Madison , Shahrir Shahida , Hippe Daniel S. , Crothers Kristina 
Published: April 2024

Introduction
Lung cancer screening (LCS) can reduce lung cancer mortality; however, poor understanding of results may impact patient experience and follow-up. We sought to determine whether an informational handout accompanying LCS results can improve patient-reported outcomes and adherence to follow-up.

Study design
This was a prospective alternating intervention pilot trial of a handout to accompany LCS results delivery.

Setting/Participants
Patients undergoing LCS in a multisite program over a 6-month period received a mailing containing either: 1) a standardized form letter of LCS results (control) or 2) the LCS results letter and the handout (intervention).

Intervention
A two-sided informational handout on commonly asked questions after LCS created through iterative mixed-methods evaluation with both LCS patients and providers.

Outcome measures
The primary outcomes of 1)patient understanding of LCS results, 2)correct identification of next steps in screening, and 3)patient distress were measured through survey. Adherence to recommended follow-up after LCS was determined through chart review. Outcomes were compared between the intervention and control group using generalized estimating equations.

Results
389 patients were eligible and enrolled with survey responses from 230 participants (59% response rate). We found no differences in understanding of results, identification of next steps in follow-up or distress but did find higher levels of knowledge and understanding on questions assessing individual components of LCS in the intervention group. Follow-up adherence was overall similar between the two arms, though was higher in the intervention group among those with positive findings (p = 0.007).

Conclusions
There were no differences in self-reported outcomes between the groups or overall follow-up adherence. Those receiving the intervention did report greater understanding and knowledge of key LCS components, and those with positive results had a higher rate of follow-up. This may represent a feasible component of a multi-level intervention to address knowledge and follow-up for LCS.

Trial registration
ClinicalTrials.gov NCT05265897.
News media coverage of LGBT identities over 10 years in a 400-million-word corpus
Authors: Ng Reuben , Chow Ting Yu Joanne , Yang Wenshu 
Published: April 2024

BackgroundThis study is the first to analyze LGBT portrayals in a news media dataset over a decade (2010–2020). We selected Singapore as a country of interest, emblematic of a nation grappling with state-encouraged heteronormativity and a remnant colonial law against homosexuality (377A), fraught with calls for its repeal that was only enacted in 2022. Our study is interested in this period bookended by challenge and change, particularly in newspaper portrayals of LGBT narratives. Newspapers are an important source of current information and have the power to shape societal perceptions. We lay the groundwork and provide a framework to analyze news media narratives of other Commonwealth nations with colonial pasts and inherited laws criminalizing LGBT communities.ObjectivesThis study analyzes LGBT portrayals in a 400-million-word news media dataset over a decade (2010–2020). First, we aimed to track the volume of LGBT media coverage over time and elucidate differences in coverage of different identity markers. Second, we aimed to track sentiments on LGBT portrayals. Third, we aimed to track salient narratives circulated about LGBT stories.MethodsThe study leveraged a 400-million-word corpus from news media in Singapore, identifying the following target keywords:LGBT,Lesbian,Gay,Bisexual,Transgender,Pink Dot(a local Pride event),377A. First, coverage volume was tracked using annual changes in keyword mentions per million, elucidating differences in coverage of different sub-groups. Second, sentiment analysis on a valence scale was conducted on LGBT collocates. Third, we distilled salient narratives about LGBT identities using thematic labelling of top-frequency collocates.ResultsFirst, overall coverage of LGBT steadily increased over the decade, though Gay identities evidenced asymmetrical coverage—outstripping ‘Bisexual’ keywords by seven times, ‘Lesbian’ by four, ‘Transgender’ by two. Second, sentiment scores forPink Dot (a local pride event)were most positive;Lesbian,Gay,LGBT,Transgenderwere neutral;Bisexualand377Adipped slightly negative. Third, topics differed across the four identities: uniquely, ‘Lesbian’ collocates related to sensationalized cinema; ‘Gay’ about hate crimes; ‘Bisexual’ about population surveys; ‘Transgender’ about challenges (transitioning, alienation, suicide).ConclusionsPractically, we presented a decade-long barometer of LGBT sentiments and themes on a national level, providing a framework to analyze media for more effective communication strategies—applicable to Commonwealth countries with similar inherited colonial laws. Salient repetition through media association may unwittingly frame certain issues negatively; caution is prudent in representing each sub-group adequately, rather than portraying the LGBT identity as monolithic.
Jacobian determinants for nonlinear gradient of planar ∞-harmonic functions and applications
Authors: Dong Hongjie , Peng Fa , Zhang Yi Ru-Ya , Zhou Yuan 
Published: April 2024

Abstract
We introduce a distributional Jacobian determinant

det

D
⁢

V
β

⁢

(

D
⁢
v

)

\det DV_{\beta}(Dv)

in dimension two for the nonlinear complex gradient

V
β

⁢

(

D
⁢
v

)

=

|

D
⁢
v

|

β

⁢

(

v

x
1

,

−

v

x
2

)

V_{\beta}(Dv)=\lvert Dv\rvert^{\beta}(v_{x_{1}},-v_{x_{2}})

for any

β
>

−
1

\beta>-1

, whenever

v
∈

W
loc

1
,
2

v\in W^{1\smash{,}2}_{\mathrm{loc}}

and

β
⁢

|

D
⁢
v

|

1
+
β

∈

W
loc

1
,
2

\beta\lvert Dv\rvert^{1+\beta}\in W^{1\smash{,}2}_{\mathrm{loc}}

.
This is new when

β
≠
0

\beta\neq 0

.
Given any planar ∞-harmonic function 𝑢, we show that such distributional Jacobian determinant

det

D
⁢

V
β

⁢

(

D
⁢
u

)

\det DV_{\beta}(Du)

is a nonnegative Radon measure with some quantitative local lower and upper bounds.
We also give the following two applications.

Applying this result with

β
=
0

\beta=0

, we develop an approach to build up a Liouville theorem, which improves that of Savin.
Precisely, if 𝑢 is an ∞-harmonic function in the whole

R
2

\mathbb{R}^{2}

with

lim inf

R
→
∞

inf

c
∈
R

1
R

⁢

⨍

B
⁢

(
0
,
R
)

|

u
⁢

(
x
)

−
c

|

⁢

d
x

<
∞

,

\liminf_{R\to\infty}\inf_{c\in\mathbb{R}}\frac{1}{R}\barint_{B(0,R)}\lvert u(x)-c\rvert\,dx<\infty,

then

u
=

b
+

a
⋅
x

u=b+a\cdot x

for some

b
∈
R

b\in\mathbb{R}

and

a
∈

R
2

a\in\mathbb{R}^{2}

.

Denoting by

u
p

u_{p}

the 𝑝-harmonic function having the same nonconstant boundary condition as 𝑢, we show that

det

D
⁢

V
β

⁢

(

D
⁢

u
p

)

→

det

D
⁢

V
β

⁢

(

D
⁢
u

)

\det DV_{\beta}(Du_{p})\to\det DV_{\beta}(Du)

as

p
→
∞

p\to\infty

in the weak-⋆ sense in the space of Radon measure.
Recall that

V
β

⁢

(

D
⁢

u
p

)

V_{\beta}(Du_{p})

is always quasiregular mappings, but

V
β

⁢

(

D
⁢
u

)

V_{\beta}(Du)

is not in general.
Optimization of process parameters in plasma arc cutting of commercial-grade aluminium plate
Authors: Choudhury Mridusmita Roy , Dutta Hrishikesh , Deka Utpal , Bhavani Basireddy , Saxena Kuldeep K. , Borah Anil 
Published: April 2024

Abstract
Plasma arc cutting (PAC) has emerged as a versatile and efficient method for the precision cutting of various materials, including commercial-grade aluminium plates. The optimization of process parameters is crucial for achieving high-quality cuts, minimizing material wastage, and enhancing overall productivity. This study aims to systematically investigate and optimize the key process parameters in PAC of commercial-grade aluminium plates. The experimental design involves the manipulation of parameters such as arc current, gas pressure, and workpiece thickness. A Design of Experiments approach, specifically Taguchi’s orthogonal array, is employed to efficiently explore the parameter space and identify the optimal combination of settings. The response variables considered for optimization include minimum surface roughness, minimum burr height, and maximum material removal rate (MRR). Analysis of variance is performed to get the percentage influence of each process parameter on the performance characteristic. The results obtained from the optimization process are expected to provide valuable insights into enhancing the efficiency and precision of PAC for commercial-grade aluminium plates. Arc current is found to be the most significant parameter in altering the surface roughness. The thickness of the material is the most significant parameter in altering burr height. None of the parameters is found to be significant in altering the MRR from Analysis of Variance analysis. From signal-to-noise ratio analysis and average performance graph, the optimum combination of processes in altering the bur height and MRR are found as arc current at 50 amp, the gas pressure at 5.4 bar, and the thickness of the workpiece at 6 mm.
El español de Loíza en el Debate de los Criollos del Español: Un análisis sociohistórico y lingüístico
Authors: Visconte Piero 
Published: April 2024

Resumen
Este estudio combina conocimientos sociohistóricos y lingüísticos para arrojar luz sobre la naturaleza y el origen del español de Loíza (EL), una variedad afrohispánica hablada en Loíza, Puerto Rico, por los descendientes de los africanos traídos a esta región para trabajar como esclavos durante el período colonial. El presente trabajo analiza la evolución de esta variedad y sus implicaciones para los estudios criollos. Al hacerlo, desafía la postura que presentaría ciertas características contemporáneas del EL y otras variedades afrohispánicas como las huellas de una etapa criolla anterior. Por lo tanto, este artículo contribuye al prolongado “Spanish Creole Debate” (Debate de los Criollos del Español) al proporcionar nueva información sobre una variedad afropuertorriqueña hasta ahora poco estudiada.