bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the canadian egg ladder in children with food protein-induced enterocolitis syndrome: a case series
Authors: Ye Linlei , Wong Tiffany , Lavine Elana , Cook Victoria E. , Erdle Stephanie C. 
Published: October 2023

Abstract
Background
Current management of food protein-induced enterocolitis syndrome (FPIES) involves strict avoidance of the offending food for 12–18 months, followed by oral food challenge (OFC) under physician supervision. OFCs are resource-intensive and there is a lack of a universal standardized protocol for FPIES. Prolonged avoidance may increase the risk of IgE-mediated allergy, particularly in atopic patients. Food ladders have shown success in promoting accelerated tolerance in patients with IgE-mediated allergy. Our case series evaluated the safety of use of the Canadian Egg Ladder in patients with mild-to-moderate FPIES to egg.

Methods
From May 2020 to November 2021, patients with mild-to-moderate FPIES to egg, defined as no history of lethargy or intravenous fluid administration, were started on the Canadian Egg Ladder. Instructions for advancing up the ladder were identical to using the Canadian Egg Ladder in patients with IgE-mediated allergy. Patients were followed every 3–6 months, at which time information was collected regarding progression up the ladder, symptoms while on treatment and interventions required. Treating allergists completed a survey to capture baseline demographic characteristics and prior tolerance to egg. Descriptive statistics were analyzed using MS Excel.

Results
Twenty-one patients with mild-to-moderate FPIES were started on the Canadian Egg Ladder. Median age at initiation of the ladder was 10 months (IQR, 9–11). Nineteen (90.5%) patients completed the ladder, tolerating a serving size amount of cooked egg, over a median duration of 7 month (IQR, 4–9 months). Four patients (19.0%) had mild symptoms including vomiting (9.5%), pallor (9.5%), belching (4.8%), irritability (4.8%) and small spit up (4.8%). In three of the four patients, symptoms were the result of accidental exposure to a higher step of the ladder. There were no reports of lethargy. No patients required health care presentation or intravenous fluid administration. No patients discontinued the ladder.

Conclusions
The Canadian Egg Ladder can safely guide the dietary advancement of egg-containing foods in patients with mild-to-moderate FPIES to egg, without the need for prolonged avoidance and resource-intensive OFCs.
Behçet's disease with intestinal involvement: a case report and review of the literature
Authors: Li Lin , Wang Jing , Li Huifang , He Chiyi , Niu Xiaoping 
Published: October 2023

Abstract
Background
Behçet’s disease (BD) is a chronic systemic disease characterized by vasculitis as the basic pathological change. BD is rare, and gastrointestinal involvement occurs in 3% to 25% of affected patients. This article describes a rare case of intestinal BD along with a literature review of intestinal involvement in BD.

Case presentation
A 50-year-old Han woman from China presented with a > 6-month history of distending pain in the right upper abdomen. Because of mechanical obstruction secondary to stricture formation from an ileocecal ulcer, she underwent radical right colon resection, and postoperative pathologic examination indicated an ileocecal ulcer. The patient was readmitted to the hospital 6 months postoperatively for recurrence of the same symptoms. Colonoscopy indicated obvious narrowing of the anastomosis with an oval-shaped deep ulcer that could not be passed by the endoscope. Pathologic examination showed acute and chronic inflammation of the anastomotic mucosa and granulation tissue. In addition, gastroscopy showed a 3.0- × 4.0-cm giant ulcer at the junction of the descending bulb along with a sinus tract. Moreover, total gastrointestinal computed tomography angiography showed significant thickening of the intestinal wall near the transverse colon, forming a sinus tract at the junction of the antrum and duodenum with a length of about 1.3 cm and width of about 0.2 cm. Further inquiry regarding the patient’s medical history revealed that she had developed repeated oral ulcers 3 years previously and repeated eye inflammation 5 years previously. Specimens of the right half of the colon removed 6 months previously were sent to Run Run Shaw Hospital Affiliated to Zhejiang University for consultation. The pathologic examination revealed vasculitis in the submucosa and subserosa, and the patient was finally diagnosed with BD. She began treatment with adalimumab, and repeat gastroenteroscopy revealed that the intestinal ulcer had significantly improved.

Conclusions
An oval-shaped deep intestinal ulcer is a characteristic lesion in patients with BD and may involve the intestinal muscle layer. This case emphasizes that BD is a vasculitis affecting multiple organs and can present with a single, deep, clean-edged intestinal ulcer that penetrates the bowel wall to form a sinus tract. Therefore, careful examination and differential diagnosis should be carried out to prevent a poor prognosis. Adalimumab is effective for patients with intestinal BD.
Exploring the impact of evaluation on learning and health innovation sustainability: protocol for a realist synthesis
Authors: Bird Marissa , Côté-Boileau Élizabeth , Wodchis Walter P. , Jeffs Lianne , MacPhee Maura , Shaw James , Austin Tujuanna , Bruno Frances , Bhalla Megan , Gray Carolyn Steele 
Published: October 2023

Abstract
Background
Within the Learning Health System (LHS) model, learning routines, including evaluation, allow for continuous incremental change to take place. Within these learning routines, evaluation assists in problem identification, data collection, and data transformation into contextualized information, which is then re-applied to the LHS environment. Evaluation that catalyzes learning and improvement may also contribute to health innovation sustainability. However, there is little consensus as to why certain evaluations seem to support learning and sustainability, while others impede it. This realist synthesis seeks to understand the contextual factors and underlying mechanisms or drivers that best support health systems learning and sustainable innovation.

Methods
This synthesis will be guided by Pawson and colleagues’ 2005 and Emmel and colleagues’ 2018 guidelines for conducting realist syntheses. The review process will encompass five steps: (1) scoping the review, (2) building theories, (3) identifying the evidence, (4) evidence selection and appraisal, and (5) data extraction and synthesis. An Expert Committee comprised of leaders in evaluation, innovation, sustainability, and realist methodology will guide this synthesis. Review findings will be reported using the RAMESES guidelines.

Discussion
The use of a realist review will allow for exploration and theorizing about the contextual factors and underlying mechanisms that make evaluations ‘work’ (or ‘not work’) to support learning and sustainability. Depending on results, we will attempt to synthesize findings into a series of recommendations for evaluations with the intention to support health systems learning and sustainability. Finalized results will be presented at national and international conferences, as well as disseminated via a peer-reviewed publication.

Systematic review registration
This realist synthesis protocol has been registered with PROSPERO (https://www.crd.york.ac.uk/prospero/ ID 382690).
Social connectedness and suicidal ideation: the roles of perceived burdensomeness and thwarted belongingness in the distress to suicidal ideation pathway
Authors: Gill Peter Richard , Arena Michael , Rainbow Christopher , Hosking Warwick , Shearson Kim M , Ivey Gavin , Sharples Jenny 
Published: October 2023

Abstract
Background
Suicide is a serious public health issue. Distress has been identified as a common risk factor, with research also suggesting that a lack of social connectedness is involved.

Methods
This quantitative, cross-sectional study investigated the role of perceived burdensomeness and thwarted belongingness in the psychological distress/suicidal ideation pathway in a community sample of 480 Australian adults.

Results
As expected, distress was found to be a strong predictor of suicidal ideation. Perceived burdensomeness and thwarted belongingness both moderated and mediated the relationship between distress and suicidal ideation. Specifically, distress was more strongly linked to suicide ideation when burdensomeness or thwarted belongingness were also high. This moderating effect was stronger for thwarted belongingness than it was for burdensomeness. These variables also mediated the pathway, in that higher distress related to higher burdensomeness and thwarted belonging, which in turn related to higher suicide ideation. This mediating effect was stronger for burdensomeness than for thwarted belonging.

Conclusions
Overall, the findings confirm the importance of our social relatedness in suicide. Increasing belongingness and reducing the perception of being a burden on others may be an important intervention strategy for weakening the link between distress and suicide ideation.
Developing and validation of COVID-19 media literacy scale among students during the COVID-19 pandemic
Authors: Jormand Hanieh , Barati Majid , Bashirian Saeed , Khazaei Salman , Jenabi Ensiyeh , Zareian Sepideh 
Published: October 2023

Abstract
Objective
This cross-sectional validation work evaluated the psychometric features of the COVID-19 Media Literacy Scale (C-19MLs) in Students.

Methods
The study was conducted on 530 students from a medical university in Hamadan, Iran, who were recruited through a stratified cluster random sampling process in June-July 2020. Intraclass Correlation Coefficient (ICC) and internal consistency were used to assess the reliability. Moreover, CFA (Confirmatory Factor Analyses) and EFA (Exploratory Factor Analyses) were carried out to examine construction validity. CVR (Content Validity Ratio) and CVI (Content Validity Index) were used to examine the content validity.

Results
According to the factor analysis, it was indicated that the C-19MLs included 21 items measuring five dimensions (constructedness of credible Covid-19 media messages, contractedness of fake media coronavirus messages, fake media coronavirus messages, audience, with three questions in each factor; format, represented lifestyles in fake media coronavirus messages with six questions in each factor) for an explanation of 58.4% of the prevalent variance. The average scores for the CVI and CVR were respectively 0.94 and 0.77. According to confirmatory factor analysis, the studied model had an appropriate fitting to the data; the relative chi-square (x2/df) = 2.706 < 3, RMSEA = 0.093 ≤ 0.1; CFI = 0.893 ≥ 0.9; TLI = 0.874 ≥ 0.9; GFI = 0.816 ≥ 0.9; and SRMR = 0.06 ≤ 0.08. Further analyses represented acceptable findings for internal consistency reliability values with 0.86 of Cronbach’s alpha.

Conclusions
The results proved that the C-19MLs is a reliable and valid tool, and it is suitable and acceptable now and can be utilized in forthcoming investigations. This highlights educators and stakeholders to realize the importance of participating individuals in the new media ecology and new ‘Infomedia’ ecosystems for enabling people in the current digital society.
Determinants of astrocytic pathology in stem cell models of primary tauopathies
Authors: Fiock Kimberly L. , Hook Jordan N. , Hefti Marco M. 
Published: October 2023

AbstractAstrocytic tau aggregates are seen in several primary and secondary tauopathies, including progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and chronic traumatic encephalopathy (CTE). In all of these diseases, astrocytic tau consists mostly of the longer (4R) tau isoform, even when adjacent neuronal aggregates consist of a mixture of 3- and 4R tau, as in CTE. Even the rare astrocytic tau aggregates seen in Pick’s disease appear to contain both 3R and 4R tau. The reasons for this, and the mechanisms by which astrocytic tau aggregates form, remain unclear. We used a combination of RNA in situ hybridization and immunofluorescence in post-mortem human brain tissue, as well as tau uptake studies in human stem cell-derived astrocytes, to determine the origins of astrocytic tau in 4R tauopathies. We found no differences in tau mRNA expression between diseases or between tau positive and negative astrocytes within PSP. We then found that stem cell-derived astrocytes preferentially take up long isoform (4R) recombinant tau and that this uptake is impaired by induction of reactivity with inflammatory stimuli or nutritional stress. Astrocytes exposed to either 3R or 4R tau also showed downregulation of genes related to astrocyte differentiation. Our findings suggest that astrocytes preferentially take up neuronal 4R tau from the extracellular space, potentially explaining why 4R tau is the predominant isoform in astrocytic tau aggregates.
3D-printing of the elbow in complex posttraumatic elbow-stiffness for preoperative planning, surgery-simulation and postoperative control
Authors: Grunert Ronny , Winkler Dirk , Frank Franziska , Moebius Robert , Kropla Fabian , Meixensberger Juergen , Hepp Pierre , Elze Maria 
Published: October 2023

Abstract
Background
Restoration of mobility of the elbow after post-traumatic elbow stiffening due to osteophytes is often a problem.

Methods
The anatomical structures were segmented within the CT-scan. Afterwards, the Multi Jet Fusion 3D-printing was applied to create the model made of biocompatible and steam-sterilizable plastic. Preoperative simulation of osteophyte resection at the 3D-model was performed as well as the direct comparison with the patient anatomy intraoperatively.

Results
The patient-specific was very helpful for the preoperative simulation of the resection of elbow osteophytes. The 3D anatomical representation improved the preoperative plan its implementation. A high degree of fidelity was found between the 3D Printed Anatomical representation and the actual joint pathology.

Conclusions
Arthrolysis of complex post-traumatic bony changes is an important indication for the use of 3D models for preoperative planning. Due to the use of 3D printing and software simulation, accurate resection planning is feasible and residual bony stiffening can be avoided. 3D printing models can lead to an improvement in surgical quality.
Climate change in Kazakhstan: implications to population health
Authors: Oladejo Toheeb Olalekan , Balogun Fatai Omeiza , Haruna Usman Abubakar , Alaka Hassan Olayemi , Almazan Joseph , Shuaibu Musa Saidu , Adedayo Ibrahim Sheu , Ermakhan Zhanerke , Sarria-Santamerra Antonio , Eliseo Don Lucero-Prisno 
Published: October 2023

Abstract
Background
Globally, climate change is one of the most pressing issues affecting the human race. The health of the Kazakh people is significantly impacted by climate change, which has made Kazakhstan one of the most vulnerable nations in Central Asia. This study reviews the impact of climate change on population health in Kazakhstan and provides recommendations to address these issues.

Main body of the abstract
This review paper evaluated available evidence and resources, which included journal articles, country reports, World Bank reports, United Nations Development Program reports, and other findings and reports relevant to the issues of climate change and the quality of life of the Kazakh people. The impact of climate change on the country is becoming more pronounced. Floods, deterioration of water quality, melting of glaciers, and extremes of temperature are some of the direct impacts of climate change observed in the country. These changes were shown to affect the health of the population.

Short conclusion
This review revealed mounting proof of how climate change is having an increasing impact on the lives of people in Kazakhstan. There is now an urgency to address the impact of climate change by implementing various mitigation and adaptation strategies.
Combining biosignals with RFID to develop a multimodal-shared control interface
Authors: Kumari Preeti , Mathew Lini , Kumar Neelesh 
Published: October 2023

AbstractThe paper presents an approach to develop assistive devices by combining multimodal biosignals and radio frequency identification (RFID). The brain and eye signals have been used as multimodal biosignals to control the movement of a robot in four directions and help reach near the object following a predefined path. RFID shared control over object identification, and the gripper arm connected at the end effector of the robot performs pick and place operations. Horizontal electrooculography (EOG) has been used forx-directional movement control and electroencephalography (EEG) signal obtained by visual stimulus, called steady-state visual-evoked potential (SSVEP) has been used fory-directional movement control of a robot. The SSVEP signal has also been used to ring an alarm in case of an emergency call by the user. Two parameters classification accuracy (CA) and information transfer rate (ITR) have been calculated for the performance evaluation of the proposed multimodal-shared control model and have shown improved results as compared to previous literature. The results also proved that the proposed model can be used for real-time mobility assistive applications.
Patritumab Deruxtecan (HER3-DXd), a Human Epidermal Growth Factor Receptor 3–Directed Antibody-Drug Conjugate, in Patients With Previously Treated Human Epidermal Growth Factor Receptor 3–Expressing Metastatic Breast Cancer: A Multicenter, Phase I/II Trial
Authors: Krop Ian E. , Masuda Norikazu , Mukohara Toru , Takahashi Shunji , Nakayama Takahiro , Inoue Kenichi , Iwata Hiroji , Yamamoto Yutaka , Alvarez Ricardo H. , Toyama Tatsuya , Takahashi Masato , Osaki Akihiko , Saji Shigehira , Sagara Yasuaki , O'Shaughnessy Joyce , Ohwada Shoichi , Koyama Kumiko , Inoue Tatsuya , Li Li , Patel Parul , Mostillo Joseph , Tanaka Yoshimi , Sternberg David W. , Sellami Dalila , Yonemori Kan 
Published: October 2023

PURPOSE Human epidermal growth factor receptor 3 (HER3) is broadly expressed in breast cancer; high expression is associated with an adverse prognosis. Patritumab deruxtecan (HER3-DXd) is an investigational HER3-targeted antibody-drug conjugate that is being evaluated as a novel treatment in HER3-expressing advanced breast cancer in the U31402-A-J101 study. METHODS Adults with disease progression on previous therapies were eligible. Patients in the dose-escalation, dose-finding, and dose-expansion parts received HER3-DXd 1.6-8.0 mg/kg intravenously once every 3 weeks or one of two alternative dosing regimens. In the dose-escalation part, the primary objectives were to determine the maximum tolerated dose and recommended dose for expansion (RDE). The safety and efficacy of the RDE were assessed during dose expansion. RESULTS One hundred eighty-two enrolled patients received ≥1 dose of HER3-DXd. Patients had a median of five previous therapies for advanced disease. Efficacy results are reported across clinical subtypes: hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2-negative) breast cancer (n = 113; objective response rate [ORR], 30.1%; median progression-free survival [mPFS], 7.4 months), triple-negative breast cancer (n = 53; ORR, 22.6%; mPFS, 5.5 months), and HER2-positive breast cancer (n = 14; ORR, 42.9%; mPFS, 11.0 months). Objective responses were observed in cancers with HER3-high and HER3-low membrane expression. Dose-limiting toxicities observed during dose selection were decreased platelet count and elevated aminotransferases. In dose expansion, GI and hematologic toxicities were the most common treatment-emergent adverse events (TEAEs) observed. Grade ≥3 TEAEs were observed in 71.4% of patients, and 9.9% discontinued treatment because of TEAEs. Three grade 3 and one grade 5 treatment-related interstitial lung disease events occurred. CONCLUSION HER3-DXd demonstrated a manageable safety profile and durable efficacy in heavily pretreated patients across clinical subtypes. These data warrant further evaluation of HER3-DXd in patients with HER3-expressing metastatic breast cancer.
FRI499 The Importance Of Identifying Atypical Presentation Of Thyroid Storm
Authors: Hernan Sacoto Daniel , Alejandra Villavicencio Camila , Franco-Akel Alberto , Belokovskaya Regina 
Published: October 2023

Abstract
Disclosure: D.H. Sacoto: None. C.A. Villavicencio: None. A. Franco-Akel, MD: None. R. Belokovskaya: None.
Thyroid storm is a rare and life-threatening syndrome. Despite treatment and supportive measures, it has an estimated mortality around 8–25%. Identifying atypical clinical presentation such as psychosis is crucial since prompt diagnosis and treatment is paramount for survival. We present an unusual case of psychosis as the manifesting symptom of thyroid storm.A 54-year-old female with a history of major depressive disorder, hypertension, and Graves’ disease presented to the ED with a 3-day history of bizarre behavior noted by the family. At the time of examination, the patient had pressured and circumferential speech, flight of ideas, labile mood, and paranoid ideations. On further questioning, patient reported palpitations and lack of sleep on days previous to presentation. Vital signs revealed hypertension (182/101 mmHg), tachycardia (176 beat per minute), tachypnea, and a temperature of 99.6 °F. Warm skin, fine tremors, and patellar hyperreflexia were noted on physical examination. Subsequent studies showed a suppressed TSH (&lt;0.01uIU/mL), an elevated T3 (227ng/dL) and free T4 (2.1ng/dL). TSH receptor antibody was found positive. Patient’s clinical presentation combined with a Burch-Wartovsky scale of 55 stablished the diagnosis. Further history was notable for non-adherence to methimazole. Iodine-131 was administered. Further treatment with prednisone, propranolol, and cholestyramine was started. Patient showed subsequent clinical improvement. Thyroid storm is a rare complication of hyperthyroidism. It is commonly precipitated by infection, surgery, or medication non-adherence. Atypical presentation of thyroid storm can be disguised as psychiatric condition or substance abuse disorder. These manifestations can be the result of a generalized hypermetabolism generated by an increase in NA+/K+ ATPAse activity, raising the basal metabolism, resulting in thermogenesis. In addition, upregulation of beta-adrenergic receptors lead to increased central nervous system sympathetic response. This results in a catecholamine surge which may manifest as psychosis, mania, or coma. Being aware of atypical presentation in thyroid storm such as active psychosis is key in early diagnosis and prompt management.
Presentation: Friday, June 16, 2023