bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiological Patterns and Geospatial Mapping of Cleft Lip/Palate in a Comprehensive Cleft Center in Northwestern Nigeria: Estimating Distribution Using Geographical Information Systems
Authors: Aborisade Adetayo , Oguchi Chika O. , Adeoye Joshua B. , Badamasi Murtala M. , Ibrahim Abdu N. , Adebola Rafael , Butali Azeez 
Published: January 2025

Objective This study aims to estimate the geospatial distribution of cleft lip/palate (CL/P) cases in northwestern Nigeria and to estimate the prevalence and patterns of CL/P across wards. Design This retrospective study utilized information from health records for inpatients with CL/P. These data were analyzed via descriptive statistics. Spatial mapping involves geocoding street addresses into map coordinate system before aggregation for subsequent spatial analyses. Setting The center used was a nongovernmental organization clinic that manages CL/P. Participants All patients managed during the study period under 15 years were selected for the study, while the spatial analysis included all patients with valid addresses. Results A total of 1556 cases were selected, while spatial analyses mapped 928 cases. The analysis indicated over half (54.4%, n = 505 patients) lived in Kano Metropolis, whereas 45.6% ( n = 423 patients) lived outside the Metropolis. CL/P prevalence correlated with the population density pattern in Kano. The prevalence of clefts was highest in Metropolis in 2008, and the Metropolis had the highest prevalence of clefts for children under 5 years of age. The significant patient and maternal factors were age ( P < .001), weight ( P < .001), socioeconomic status ( P < .003), positive family history of cleft ( P < .001), and maternal factors. Conclusion The GIS analysis revealed that most patients with CL/P who received treatment at the NGO lived nearby, with the greatest prevalence of clefts occurring in the Metropolis. The cost of travel may explain why those further afield do not come in for treatment or lack public awareness about the services provided at the cleft clinic.
A Comprehensive Weightbearing Computed Tomography Study on Patients With Hallux Valgus: Exploring Multiplanar Deformity Interrelationships
Authors: Wang Chien-Shun , Huánuco Casas Erik Jesús , Luo Emily J. , Acker Antoine S. , Easley Mark E. , de Cesar Netto Cesar 
Published: January 2025

Background Hallux valgus (HV) is a complex, multiplanar deformity. In this study, we examined the interrelationships between various components of this deformity using weightbearing computed tomography (WBCT). We hypothesized that the severity of traditional axial plane deformities would correlate with malpositioning of the metatarsosesamoid complex, first-ray coronal rotational deformity, and malalignment of the hindfoot and midfoot. The findings may offer valuable insights for guiding the correction of HV deformities. Methods Patients with an HV angle greater than 15 degrees who underwent WBCT were included. Traditional 2-dimensional parameters were semiautomatically assessed. Manual measurements included hindfoot and midfoot WBCT parameters, for example, foot and ankle offset, talar posterior and middle facet morphology, and forefoot arch angle. First-ray parameters, including first metatarsal rotation, sesamoid rotation angle, hallucal pronation angle, and sesamoid position, were measured using established methods. Patients were categorized by hindfoot moment arm values to evaluate hindfoot-forefoot relationships. Results Sixty-eight feet (53 patients) were included. Manual measurements exhibited excellent interobserver reliability, with ICCs of 0.845 to 0.987 and a kappa coefficient of 0.899 for the sesamoid position. The mean HV angle was 27.4 ± 7.8 degrees, whereas the mean IM angle was 15.8 ± 3.5 degrees. Significant correlations were observed between the HV and intermetatarsal (IM) angles, with all metatarsosesamoid complex parameters and first-ray coronal plane rotational parameters distal to the metatarsal head. The axial and sagittal talar–first metatarsal angles correlated with the HV angle but not with the IM angle. Significant differences in the HV angle, sagittal first tarsal–metatarsal joint angle, and first metatarsal head rotation were observed between the hindfoot moment arm groups, as confirmed by post hoc analysis. Conclusion The findings support our hypothesis, identifying significant correlations between metatarsosesamoid complex malposition, distal first-ray coronal pronation, and traditional axial plane deformities in HV. Some hindfoot–midfoot alignments correlated with the HV angle but not with the IM angle.
Patients With Chronic Lateral Ankle Instability and Small Osteochondral Lesions of the Talus Obtain Good Postoperative Results: A Minimum 10-Year Follow-up With Radiographic Evidence
Authors: Su Tong , Cheng Xiangyun , Zhu Yichuan , Xu Hao , Jiang Yanfang , Jiao Chen , Guo Qinwei , Jiang Dong 
Published: January 2025

Background: Few studies reported the long-term clinical outcomes and joint degeneration of patients with chronic lateral ankle instability (CLAI) and small osteochondral lesions of the talus (OLTs) following simultaneous open modified Broström-Gould (MBG) surgery and arthroscopic bone marrow stimulation (BMS). The purpose of this study was to study the long-term results of patients after BMS and BMG surgery, and to further evaluate the potential effect of OLT size on postoperative results. Methods: In this retrospective study, 110 CLAI patients were divided into 57 patients with OLTs (including 24 patients having combined small osteochondral lesions of the tibial plafond) receiving simultaneous BMS and MBG surgeries (BMS+MBG group), and 53 patients without OLTs receiving isolated open MBG surgery (MBG group). The OLT size and pre- and postoperative Kellgren-Lawrence grade were assessed. The subjective scores (visual analog scale pain score, Tegner activity, and Karlsson-Peterson scores), surgical complications, and return to sports were also compared pre- and postoperatively. Results: Patients were followed up at a mean of 144.2 ± 14.9 and 145.6 ± 11.4 months for the BMS+MBG and MBG groups, respectively. Subjective scores were significantly improved ( P < .001), and no difference was found in subjective scores or surgical complications between the 2 groups ( P > .05). Both groups showed progression of osteoarthritis grade ( P < .001), but with no significant difference of changes from the preoperative to the final follow-up (BMS+MBG group: 0.84 ± 0.75 to 1.32 ± 0.80; MBG group: 0.32 ± 0.48 to 0.86 ± 0.56, changes: 0.48 ± 0.59 vs 0.55 ± 0.51, P = .575). For sports function, both groups had similar results in Tegner scores (5.8 ± 1.3 vs 6.2 ± 1.3, P = .081). However, in a subgroup analysis, we found that in the BMS+MBG group, patients exceeding the mean size of OLTs (50 mm2) were associated with an average lower postoperative Karlsson-Peterson score ( P = .025) and higher postoperative osteoarthritis grade ( P = .037), with more changes ( P = .017) than those with OLTs <50 mm2. Conclusion: Patients with CLAI and small OLTs following simultaneous open MBG surgery and arthroscopic BMS showed good long-term outcomes and only mild progression of joint degeneration—overall similar to patients treated for CLAI with MBG surgery. Moreover, as OLT size increased, good outcomes were less predictable.
Avoidant Automatic Thoughts Are Associated With Task Avoidance and Inattention in the Moment: Replication in a Community Sample
Authors: Knouse Laura E. , Fan Yueyi , Narayanan Aditya , Ellison William D. 
Published: January 2025

Purpose: Avoidant automatic thoughts (AAT) are thoughts that precede or accompany a delay in the starting or ending of a task. In a prior study of college students using Ecological Momentary Assessment (EMA), AATs were frequent daily occurrences and participants with more severe ADHD symptoms at baseline reported more frequent AAT. Importantly, momentary presence of AAT was associated with greater task avoidance and inattentive symptoms. In the current study, we replicated and extended this study in a community sample of adults. Method: We measured AAT in the daily lives of 106 adults using EMA. Data were collected at baseline and up to five times per day for 6 days. Results: Using multilevel modeling, we found that baseline ADHD symptoms predicted more frequent AAT and more severe task avoidance and negative emotion in daily life. Recent presence of AAT was associated with inattention, task avoidance, and slightly elevated negative emotion in the moment. More severe baseline ADHD strengthened the relationship between AAT and both inattention and task avoidance. In exploratory analyses, we found that work tasks and household chores were the most avoided activities and that, instead, people were most likely to be doing other work tasks or engaging in screen time or self-care, respectively. Conclusions: This study replicates and extends our prior findings regarding AAT in daily life and their relationship to ADHD and supports continued research on this construct, which may have clinical utility for intervening in problematic avoidance behaviors.
Impact of load and movement on arteriovenous fistula flow
Authors: Antonio Adriana Marco , Vicente Thelma Cristina A , Diaz Thiago F , Sousa Eliane G X , Nakagawa Fernando T , Borges Cynthia M , Elias Rosilene M 
Published: January 2025

Introduction: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. Whether acute arm movement impacts arteriovenous fistula (AVF) blood flow is unknown. Methods: In this cross-sectional analysis, we evaluated AVF blood flow using an ultrasound device at resting and after three muscle movements for proximal (elbow flexion, shoulder adduction and abduction) or distal AVF (fist extension and flexion, fingers squeeze), without and with a 2 kg load. Results: We included 23 patients (14 men), 53 ± 13 years, 26.1% with diabetes, on dialysis for a median time of 5.2 months. At rest, blood flow in proximal and distal AVF were 4355 (2470, 7233) mL/min and 2286 (2063, 2442) mL/min, respectively. There was no significant difference between blood flow at resting and any movement before and after load in either proximal or distal AVF ( p > 0.05 for all comparisons). Conclusion: Acute arm movement with or without load does not significantly alter the blood flow of mature AVF. These results demystify the general belief that patients should avoid AVF arm movement.
The Prognostic Significance of TRs in Hepatocellular Carcinoma: Insights from TCGA and GEO Databases
Authors: Zhou Hao , Wang Weijie , Liang Ruopeng , Zhu Rongtao , Cao Jiahui , Sun Chenguang , Sun Yuling 
Published: January 2025

Background: Reduced expression of thyroid hormone receptors (TRs) has been observed in various human malignancies, though its predictive value in hepatocellular carcinoma (HCC) remains uncertain. Objective: To explore the predictive value of TRs in patients with hepatocellular carcinoma. Design: The design was bioinformatic analysis combined with experimental study. Methods: This study utilized Kaplan-Meier analysis of TR expression profiles from The Cancer Genome Atlas (TCGA). Expression levels of TRs in HCC and immune single cells were assessed using datasets from the Gene Expression Omnibus (GEO) and TCGA, analyzed with R software. Cox and logistic regression analyses were also conducted. Functional assays, including wound healing, CCK-8, and Transwell migration assays, were employed to investigate the role of the THRB gene. Results: Kaplan-Meier analysis revealed that low THRB expression was significantly associated with reduced overall survival (OS), 5-year OS and disease-specific survival (DSS) in HCC patients ( P < 0.05), while no significant association was found with THRA expression. Both Cox regression and logistic regression identified low THRB expression as an independent risk factor for HCC. THRB expression was significantly downregulated in tumor tissues compared to non-tumorous tissues in 3 GEO datasets and the TCGA profile. Functional assays confirmed that THRB inhibited HCC cell proliferation and migration. Additionally, single-cell RNA sequencing revealed that THRB was primarily expressed in CD16+ monocytes within tumor tissues and was associated with a poor OS rate. Conclusion: Reduced THRB expression, but not THRA, was correlated with decreased OS in HCC patients.
Microbial Safety of Sachet Water in Ghana: A Systematic Review
Authors: Ahiabor Wisdom K , Donkor Eric S 
Published: January 2025

Introduction: Access to safe drinking water is crucial for health and survival, yet many developing countries face significant challenges in this regard. In West Africa, rapid urbanisation has outpaced efforts to improve access to potable water, compelling households to rely on private vendors for solutions, particularly through the growing market for sachet water. Widely consumed in Ghana, sachet water has become a convenient and affordable option, with over 37% of the population depending on it. However, concerns about its microbial safety persist, as studies indicate that sachet water often fails to meet necessary safety standards. This review consolidated existing research on microbial contaminants in sachet water, aiming to provide a representative overview of the microbial quality of sachet water in Ghana. Method: The systematic review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A thorough literature search was conducted across multiple databases, including PubMed, Web of Science, ScienceDirect, Scopus and the search engine Google Scholar, using relevant search terms. Eligible studies were identified based on established criteria, and data were subsequently extracted and analysed. Results: A total of 28 studies published from 2003 to 2024 were selected for inclusion in this review. Notably, 96% of these studies reported bacteria from 17 different genera, while 11% examined parasites from 5 genera. Some studies (7%) investigated both types of contaminants. Overall, 2,276 sachet water samples were analysed, with 1,727 (76%) showing microbial contamination. Escherichia coli was the most identified bacteria, while Cyclospora cayetanensis and Cryptosporidium parvum were the most identified parasites. Conclusion: This study highlighted critical public health risks associated with sachet water in Ghana, particularly the presence of harmful bacteria and parasites. It is important to implement stricter manufacturing and sanitation standards and encourage safe handling practices to ensure the safety and quality of sachet water. Additionally, future research should focus on bridging existing gaps by investigating parasitic, viral, and fungal contaminants, to provide a holistic overview of the microbial contaminants in sachet water in Ghana.
Ascaris lumbricoides Emerging from a PleurX Draining Catheter: An Unexpected Diagnosis
Authors: Arafat Hasan , Abdul-Hafez Hamza A , Sabateen Ali 
Published: January 2025

Introduction: Ascaris lumbricoides is a common helminthic infection characterized by fecal-oral route of transmission. Commonly, it affects the gastrointestinal tract. However, in significantly rare cases, it can affect unexpected body regions, such as biliary tree, pancreas, and the lung. Case presentation: A 68-year-old female patient underwent PleurX tube insertion due to malignant pleural effusion. On the third week of insertion, she complained of itching and pain at the site of insertion, a grayish-white worm was visualized at the insertion site. Ascaris lumbricoides was identified by microbiological examination. She received 400 mg of albendazole. Conclusion: Our case describes a rare clinical situation of pleural ascariasis, emphasizing the importance of remaining aware of this rare complication of ascariasis.
Modifiable Risk Factors Including Self-Perceived Stress for Breast Cancer in Hong Kong: A Case-Control Study of 10 757 Subject
Authors: Yeo Winnie , Yuen Lok-Wa , Tsoi Kelvin Kam-Fai , Chan Emily Ying-Yang , Kwok Carol C , Soong Inda , Ng Ting-Ying , Chiu Joanne , Chan Miranda , Chan Sharon Wing-Wai , Wong Ting-Ting , Chan Yolanda Ho-Yan , Li Lawrence Pui-Ki , Yau Chun-Chung , Hung Wai-Ka , Cheung Polly Suk-Yee 
Published: January 2025

Background: In Hong Kong, breast cancer is the commonest female cancer. In addition to intrinsic risk factors that cannot be modified, other factors may be potentially modifiable. The objective of this report was to determine modifiable risk factors in association with breast cancer among Chinese women in our locality. Methods: This is a case-control study that enrolled breast cancer patients from the Hong Kong Breast Cancer Registry and healthy matched controls from the local community between 2014 and 2017. Potential risk factors were analyzed using multiple logistic regression. Results: In total, 5186 breast cancer patients and 5571 controls were recruited. Several modifiable risk factors were identified. Self-perceived high stress level (adjusted odd ratios [AOR]= 3.44; 95% confidence intervals [CI] = 3.13-3.78), dairy-rich diet (AOR = 3.33; 95% CI = 2.01-5.52), delayed child-bearing (AOR = 2.23; 95% CI = 1.79-2.79), meat-rich diet (AOR = 1.77; 95% CI = 1.54-2.04), ever use of oral contraceptives (AOR = 1.34; 95% CI = 1.22-1.47), nulliparity (AOR = 1.21; 95% CI = 1.08-1.35), and being overweight/obese (AOR = 1.21; 95% CI = 1.10-1.32) were found to be associated with an increased risk of breast cancer. On the other hand, breastfeeding (AOR = 0.76; 95% CI = 0.69-0.83) and exercise (odds ratio = 0.62; 95% CI = 0.56-0.68) were associated with decreased risk. Conclusions: In our locality, high-stress level, meat- and dairy-rich diet, reproductive history, use of oral contraceptives, and being overweight/obese were identified to be modifiable risk factors for breast cancer. Lifestyle modification may help reduce breast cancer incidence in the coming decades.
Transcriptomics profiling of Parkinson’s disease progression subtypes reveals distinctive patterns of gene expression
Authors: Fabrizio Carlo , Termine Andrea , Caltagirone Carlo 
Published: January 2025

Background Parkinson’s Disease (PD) varies widely among individuals, and Artificial Intelligence (AI) has recently helped to identify three disease progression subtypes. While their clinical features are already known, their gene expression profiles remain unexplored. Objectives The objectives of this study were (1) to describe the transcriptomics characteristics of three PD progression subtypes identified by AI, and (2) to evaluate if gene expression data can be used to predict disease subtype at baseline. Design This is a retrospective longitudinal cohort study utilizing the Parkinson’s Progression Markers Initiative (PPMI) database. Methods Whole blood RNA-Sequencing data underwent differential gene expression analysis, followed by multiple pathway analyses. A Machine Learning (ML) classifier, namely XGBoost, was trained using data from multiple modalities, including gene expression values. Results Our study identified differentially expressed genes (DEGs) that were uniquely associated with Parkinson’s disease (PD) progression subtypes. Importantly, these DEGs had not been previously linked to PD. Gene-pathway analysis revealed both distinct and shared characteristics between the subtypes. Notably, two subtypes displayed opposite expression patterns for pathways involved in immune response alterations. In contrast, the third subtype exhibited a more unique profile characterized by increased expression of genes related to detoxification processes. All three subtypes showed a significant modulation of pathways related to the regulation of gene expression, metabolism, and cell signaling. ML revealed that the progression subtype with the worst prognosis can be predicted at baseline with 0.877 AUROC, yet the contribution of gene expression was marginal for the prediction of the subtypes. Conclusion This study provides novel information regarding the transcriptomics profiles of PD progression subtypes, which may foster precision medicine with relevant indications for a finer-grained diagnosis and prognosis.
Comparing the Efficacy of Combined Intralesional Triamcinolone Acetonide With Topical Calcipotriol Versus Intralesional Triamcinolone Acetonide Monotherapy in Scalp and Beard Alopecia Areata: Results From a Randomized Single-Blinded Clinical Trial
Authors: Karat Thoyyib Parammal , Bains Anupama , Bhardwaj Abhishek , Singh Saurabh , Budania Anil , Patra Suman , Rajan M Bandhala 
Published: January 2025

Background: Intralesional (IL) steroids are the first-line treatment option for localized alopecia areata (AA). The present study aimed to compare the efficacy of topical calcipotriol with IL triamcinolone acetonide versus IL triamcinolone acetonide alone in AA. Methods: This randomized single-blinded clinical trial was conducted in a dermatology outpatient department. Both groups A and B received IL triamcinolone acetonide injections every 4 weeks for 12 weeks. Group A also received twice-daily topical calcipotriol. Follow-up was done every 4 weeks till 12 weeks. The primary outcome parameter was hair density assessment using a hair regrowth scale (RGS). Other parameters were the presence or absence of poor clinical response (less than 50% hair density), regrowth patterns, dermoscopy features, and adverse effects. Results: Seventy-three (179 patches) patients completed the study. RGS and patches with more than 50% terminal hair regrowth significantly improved in both the groups beginning in the fourth week and going forward ( P-value: .001, .001). The two treatment groups exhibited no statistically significant difference in terminal hair density ( P values: .930, .616, .178). However, subgroup analysis showed a statistically significant difference in scalp patches of group A compared to group B in the 12th week of the study ( P = .018) but not in beard patches ( P-value: .527). Group A exhibited more irritation with a reduced incidence of atrophy. Conclusion: The addition of topical calcipotriol to IL steroid showed increased efficacy in scalp patches of AA but not in beard patches. Also, the incidence of atrophy was lower in the combination group.
Survival disparities among Alzheimer's disease patients in Hawaii
Authors: Siriwardhana Chathura , Carrazana Enrique , Liow Kore 
Published: January 2025

Background Survival after an Alzheimer's disease (AD) diagnosis is vital for patients, their families, caregivers, and healthcare providers. Hawaii, known for its diverse ethnic population, exhibits significant racial health disparities. Objective This study examined racial/ethnic and socioeconomic disparities in AD survival in Hawaii and developed machine learning models to predict overall survival using Hawaii Medicare data. Methods Nine years of Hawaii Medicare data were utilized to gather information on AD development after age 65, following patients to capture all-cause survival or until censoring. The study examined the effects of race/ethnicity and socioeconomic status (SES) on mortality risk. Cox regression analysis was conducted on overall survival, accounting for covariates. A Survival Random Forest was employed to model survival, incorporating K years of longitudinal health profiles. Results The study included 9393 AD subjects. Analysis revealed that Asian Americans (AA) had a later age at AD diagnosis (p < 0.001), with an average age of 85.9, compared to 82.7 and 83.3 years for whites and Native Hawaiians and Pacific Islanders (NHPI), respectively. Low SES showed a marginal increase in hazard (Hazard Ratio [HR] = 1.36, p < 0.001). After covariate adjustment, compared to AAs with better SES, increased hazards were found for their white counterpart (HR = 1.18, p < 0.001) and groups with low SES: AA (HR = 1.28, p < 0.001), white (HR = 1.51, p < 0.001), and NHPI (HR = 1.39, p < 0.001). The predictive model had a Concordance-Index of 0.82, showing reasonable predictability. Conclusions Racial/ethnic and SES disparities significantly influence AD onset and survival. Combined with longitudinal health status data, machine learning demonstrates reasonable predictability of survival.