bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Workshops as an Effective and Engaging Policy Implementation Strategy: Lessons From the National Youth Sports Strategy
Authors: Vaux-Bjerke Alison , Polster Malorie , Swanson Lewissa , Armbruster Sonja , Piercy Katrina L. 
Published: October 2023

Background. Implementation is an important piece of effective policymaking, but connecting local organizations with federal policy can be challenging. A virtual workshop structure can help engage implementation partners, especially when in-person events are not possible. The workshops described here leveraged virtual outreach and facilitation methods to foster community engagement, forge connections, and build relationships at the regional, state, and local levels. Methods. This article focuses on five virtual workshops. The planning phase consisted of selecting the geographic scope of each workshop, developing outreach and facilitation materials, and supporting event logistics. The execution and summary phase included tailoring materials, hosting the events, and producing follow-up materials. Networking, resource sharing, collaboration, and active facilitation were employed to promote engagement. Results. Registration for the virtual workshops included 223 individuals representing organizations in 28 states. Participants shared 133 resources. In a post-event evaluation, 93% of respondents indicated they could identify at least one new resource to support their efforts to increase youth sports participation in their community, and 94% indicated they plan to follow up and explore potential partnerships/collaborations with others they met or heard from at the workshop. Networking and resource sharing were identified as the most useful aspects of the workshops. Conclusions. With careful planning and collaboration, virtual workshops represent a useful community engagement mechanism to bring policy into practice. Creating events focused on the participant experience supports health promotion professionals, engages communities, and takes a policy off the page and out to the people.
Development and Experimental Study of a Polytetrafluoroethylene-Tipped Microcatheter Poorly Adhesive to n-Butyl-2-Cyanoacrylate
Authors: Nakai Motoki , Saguchi Toru , Yunaiyama Daisuke , Takara Yuki , Tanaka Taro , Okada Yukinori , Saito Kazuhiro 
Published: October 2023

Purpose: We have developed a new microcatheter (designated “NSX”) with an outer layer of polytetrafluoroethylene (PTFE) at its tip. We compared the adhesion of the new NSX microcatheter and a conventional microcatheter with n-butyl-2-cyanoacrylate (NBCA) in vitro and in swine blood vessels. Materials and Methods: The 3 cm tip of the NSX microcatheter is composed of PTFE, which can be identified by double platinum markers. The tips of the NSX and conventional microcatheters were inserted into a vascular model filled with porcine blood with no flow, and NBCA mixed with lipiodol (1:2) was injected from the microcatheters. Two minutes after the injection of NBCA, the microcatheter was withdrawn and the degree of its adhesion to NBCA was evaluated by measuring the resistance value (N) during catheter removal with a digital force gauge. These measurements were repeated with 20 catheters of each type. Similarly, 5 injections were performed with both the NSX and conventional microcatheters in swine vessels. The degree of adhesion of the catheter and blood vessel was evaluated by 2 radiologists under X-ray fluoroscopy on a 3-point scale: 1, no adhesion; 2, mild adhesion; 3, strong adhesion. Results: The mean resistance values (N) for the NSX and conventional microcatheters were 0.503±0.186 and 1.051±0.367 (N), respectively (p<0.001). The NSX adhered negligibly to the NBCA and was easily removed, whereas the conventional microcatheter adhered strongly to the NBCA in the blood vessels and was difficult to remove from the swine vessels (p=0.008). Conclusions: The new NSX microcatheter with a PTFE tip exhibits poorer adhesion to NBCA than do conventional microcatheters and allows for safer injection of NBCA than conventional microcatheters, without requiring immediate catheter retrieval. Clinical Impact The NSX microcatheter with a PTFE tip adheres less strongly to NBCA than do conventional microcatheters and allows the safe injection of NBCA. The NSX microcatheter has double platinum markers on its tip, which make it easy to distinguish the PTFE-covered region. As the NSX does not adhere firmly to the arterial wall, it is less likely to cause vascular injury during removal of the catheter compared with conventional microcatheters, so there is no need to remove the NSX immediately after injecting NBCA. Even operators unfamiliar with NBCA can use NBCA safely with this new NSX microcatheter without requiring special training or skill.
Optimizing treatment persistence in epilepsy: a comparative analysis of combined antiseizure medications with different mechanisms of action
Authors: Chang Chun-Wei , Tseng Wei-En Johnny , Lin Wey-Ran , Ko Po-Chuan , Liu Chun-Jing , Lim Siew-Na 
Published: October 2023

Background: Combination therapy with antiseizure medications (ASMs) is a rational strategy if monotherapy cannot effectively control seizures, thereby aiming to improve tolerance and treatment persistence. Objectives: To compare the efficacy of different ASM combinations among patients. Design: Patients with epilepsy on monotherapy who had a second ASM added as concomitant two-drug therapy from January 2009 to May 2019 in the Chang Gung Research Database, Taiwan, were included in the analysis. Methods: ASM combinations were compared based on their primary mechanism of action (MoA) which are as follows: gamma-aminobutyric acid receptor (G), sodium channel blocker (SC), synaptic vesicle protein 2A (SV2), calcium channel blocker (C), and multiple mechanisms (M). Treatment persistence was compared, and the predictors of persistence were analyzed. Results: In total, 3033 patients were enrolled in this study. Combined ASMs with different MoAs had significantly longer treatment persistence than ASMs with similar MoAs, specifically SC and M combinations. Patients receiving combined ASMs with different MoAs were less likely to discontinue treatment [adjusted hazards ratio: 0.83 (95% CI: 0.75–0.93), p < 0.001]. Among all combinations, the SC + SV2 combination had the longest treatment persistence (mean ± SD: 912.7 ± 841.6 days). Meanwhile, patients receiving the G combination had a higher risk of treatment discontinuation than those receiving the SC + SV2 combination. Underlying malignancies were associated with an increased risk of treatment discontinuation across all MoA categories. Male patients receiving the SC, SV2, and M combinations were more likely to discontinue treatment than female patients. Moreover, patients with renal disease were more likely to discontinue treatment with the SV2 combinations. Conclusion: ASM combinations with different MoAs had superior efficacy and tolerability to ASM combinations with similar MoAs, particularly SC and M combinations. In our cohort, factors associated with treatment discontinuation included underlying malignancy, male sex, and renal disease. These findings may provide valuable insights into the use of ASM combinations if monotherapy cannot adequately control seizures.
De Novo Fibrinogen A Alpha Chain Amyloidosis in a Kidney Transplant Patient: Case Report and Literature Review
Authors: Khaja Taqui , Truong Luan , Nassar George 
Published: October 2023

Rationale: De Novo transplant amyloidosis denotes the condition when a patient develops amyloidosis after transplantation but had not been diagnosed with the disease prior to transplantation. The incidence of de novo amyloidosis in kidney transplants is rare, but few published case reports have described the occurrence of de novo Amyloid A protein (AA) and Light Chain (AL) amyloidosis. However, de novo hereditary fibrinogen A alpha chain (AFib) has not been previously reported. Patient Presentation: We present a 72-year-old man, a kidney transplant recipient, who developed progressive rise in his creatinine about 3 years after transplantation. He has long-standing diabetes mellitus type 2, obesity, and hypertension, so he did not have a kidney biopsy of his native kidneys prior to transplantation. Diagnosis: A kidney transplant biopsy was done that showed amyloidosis. Mass spectrophotometry confirmed it as AFib amyloidosis. Genetic testing of the patient revealed that he has fibrinogen A alpha gene (FGA) point mutation with a p.E545V variant. Interventions: Cardiac evaluation showed normal transthoracic echocardiogram. Cardiac magnetic resonance imaging (MRI) showed no involvement by amyloidosis. A peripheral nerve biopsy showed diabetic neuropathy. Thus, the kidney was the only organ involved by the disease. The kidney transplant was managed conservatively with blood pressure and diabetes control in addition to his usual immunosuppression regimen which was not altered. He is being treated with diuretics, angiotensin receptor inhibitors, and sodium glucose transport 2 inhibitors. Outcomes: Kidney transplant function exhibited only slow progression over 18 months since the diagnosis was confirmed. This slow progression is likely because the p.E545V point mutation variant is less aggressive than other gene deletion mutations and because our patient was judged to have been diagnosed early in the course of his disease. Teaching Points: In this case report, we illustrate the findings and testing that confirmed the diagnosis of AFib amyloidosis. We summarize the clinical aspects, outcomes of the disease, and treatment options. We believe this case report is interesting because it is the first reported case of AFib amyloidosis in a kidney transplant recipient who was not known to have the disease prior to kidney transplantation.
Sonographic Assessment of Intima-Media Thickness of Carotid Arteries in Hypertensive and Diabetic Volunteers
Authors: Kanwal Hafiza Iqra , Shahid Munaza , Bacha Raham 
Published: October 2023

Objective: Diabetes mellitus (DM) and hypertension are among the most common causes of arteriosclerotic diseases. Intima-media thickness is usually increased with arterial diseases and an increase in carotid intima-media thickness (cIMT) is associated with the presence and extent of coronary artery disease (CAD). This study was designed to sonographically compare the cIMT in hypertensive and DM patient volunteers. Materials and Methods: A case-control stratified study was conducted at Lahore imaging center. Patients were invited to the study had to more than 30 years of age, DM, and hypertension. Individuals from the same age group without hypertension and DM were invited as study controls. Patients with an endarterectomy, or other arterial interventional procedure, as well as a previous history of cardiovascular disease and stroke, were excluded. Results: The mean cIMT, within the right carotid artery was 0.53 mm for the control group, 0.69 mm for the DM group, 0.67 mm for the hypertensive group, and 0.98 mm for the DM and hypertensive patients. The mean cIMT of the left carotid artery was 0.56 mm for the control group, 0.7 mm for DM group, 0.68 mm for hypertensive group, and 1.01 mm for the DM and hypertensive patients. Conclusion: There was a significant difference between the mean cIMT among DM and non-DM individuals. The control group and the DM or hypertension group also differed significantly. However, a more significant difference was found in the mean cIMT within the common carotid artery of control group as well as those with both DM and hypertension.
Extensive systemic thrombo-embolism including intra-cardiac thrombosis mimicking an atrial myxoma in a patient with beta thalassaemia major – a case report
Authors: Welhenge Chiranthi , Ranasinghe Rumesh , Rajapakse Sanjeewa , Premawardhena Anuja 
Published: October 2023

Abstract
Background
Sepsis and thrombo-embolic disease are well known complications of thalassemia major. Intracardiac thrombi are however rare and can lead to diagnostic dilemmas.

Case presentation
We report the case of a 20-year-old female splenectomised thalassaemia major patient with severe iron overload, who presented with life threatening sepsis associated with a liver abscess. Discovery of a large oscillating intra cardiac lesion on 2D echocardiogram confirmed by Contrast Enhanced Computed Tomography (CECT) chest in the right atrium extending from the left hepatic vein through the inferior vena cava complicated the clinical course. After a prolonged Intensive Care Unit (ICU) stay supported with antibiotics and anticoagulation, she recovered with evidence of resolution of the intra cardiac thrombus.

Conclusions
Early recognition and prompt aggressive treatment of sepsis in patients with thalassemia is essential to prevent complications. Intracardiac thrombosis is a potentially treatable cause for an intra cardiac mass in patients with thalassemia major, which should not be missed.
A magnetic resonance imaging-based decision-making tool for predicting complex anal fistulas healing in the early postoperative period
Authors: Xu Hao , Xiao Guo-Zhong , Zheng Yi-Hui , Fu Yuan-Ji , Zhong Sheng-Lan , Ren Dong-Lin , Li Wen-Ru , Lin Hong-Cheng 
Published: October 2023

Abstract
Background
Magnetic resonance imaging (MRI) has excellent accuracy in diagnosing preoperative lesions before anal fistula surgery. However, MRI is not good in identifying early recurrent lesions and effective methods for quantitative assessment of fistula healing are still warranted. This retrospective study aimed to develop and validate a specific MRI-based nomogram model to predict fistula healing during the early postoperative period.

Methods
Patients with complex cryptoglandular anal fistulas who underwent surgery between January 2017 and October 2020 were included in this study. MRI features and clinical parameters were analyzed using univariate and multivariate logistic regression analysis. A nomogram for predicting fistula healing was constructed and validated.

Results
In total, 200 patients were included, of whom 186 (93%) were male, with a median age of 36 (18–65) years. Of the fistulas, 58.5% were classified as transsphincteric and 19.5% as suprasphincteric. The data were randomly divided into the training cohort and testing cohort at a ratio of 7:3. Logistic analysis revealed that CNR, ADC, alcohol intake history, and suprasphincteric fistula were significantly correlated with fistula healing. These four predictors were used to construct a predictive nomogram model in the training cohort. AUC was 0.880 and 0.847 for the training and testing cohorts, respectively. Moreover, the decision and calibration curves showed high coherence between the predicted and actual probabilities of fistula healing.

Conclusions
We developed a predictive model and constructed a nomogram to predict fistula healing during the early postoperative period. This model showed good performance and may be clinically utilized for the management of anal fistulas.
Comparison of the clinical characteristics of SARS-CoV-2 Delta (B.1.617.2) and Omicron (B.1.1.529) infected patients from a single hospitalist service
Authors: Radhakrishnan N. , Liu M. , Idowu B. , Bansari A. , Rathi K. , Magar S. , Mundhra L. , Sarmiento J. , Ghaffar U. , Kattan J. , Jones R. , George J. , Yang Y. , Southwick F. 
Published: October 2023

Abstract
Background
While existing evidence suggests less severe clinical manifestations and lower mortality are associated with the Omicron variant as compared to the Delta variant. However, these studies fail to control for differences in health systems facilities and providers. By comparing patients hospitalized on a single medical service during the Delta and Omicron surges we were able to conduct a more accurate comparison of the two varaints’ clinical manifestations and outcomes.

Methods
We conducted a prospective study of 364 Omicron (BA.1) infected patients on a single hospitalist service and compared these findings to a retrospective analysis of 241 Delta variant infected patients managed on the same service. We examined differences in symptoms, laboratory measures, and clinical severity between the two variants and assessed potential risk drivers for case mortality.

Findings
Patients infected with Omicron were older and had more underlying medical conditions increasing their risk of death. Although they were less severely ill and required less supplemental oxygen and dexamethasone, in-hospital mortality was similar to Delta cases, 7.14% vs. 4.98% for Delta (q-value = 0.38). Patients older than 60 years or with immunocompromised conditions had much higher risk of death during hospitalization, with estimated odds ratios of 17.46 (95% CI: 5.05, 110.51) and 2.80 (1.03, 7.08) respectively. Neither vaccine history nor variant type played a significant role in case fatality. The Rothman score, NEWS-2 score, level of neutrophils, level of care, age, and creatinine level at admission were highly predictive of in-hospital death.

Interpretation
In hospitalized patients, the Omicron variant is less virulent than the Delta variant but is associated with a comparable mortality. Clinical and laboratory features at admission are informative about the risk of death.
“A net for everyone”: fully personalized and unsupervised neural networks trained with longitudinal data from a single patient
Authors: Strack Christian , Pomykala Kelsey L. , Schlemmer Heinz-Peter , Egger Jan , Kleesiek Jens 
Published: October 2023

Abstract
Background
With the rise in importance of personalized medicine and deep learning, we combine the two to create personalized neural networks. The aim of the study is to show a proof of concept that data from just one patient can be used to train deep neural networks to detect tumor progression in longitudinal datasets.

Methods
Two datasets with 64 scans from 32 patients with glioblastoma multiforme (GBM) were evaluated in this study. The contrast-enhanced T1w sequences of brain magnetic resonance imaging (MRI) images were used. We trained a neural network for each patient using just two scans from different timepoints to map the difference between the images. The change in tumor volume can be calculated with this map. The neural networks were a form of a Wasserstein-GAN (generative adversarial network), an unsupervised learning architecture. The combination of data augmentation and the network architecture allowed us to skip the co-registration of the images. Furthermore, no additional training data, pre-training of the networks or any (manual) annotations are necessary.

Results
The model achieved an AUC-score of 0.87 for tumor change. We also introduced a modified RANO criteria, for which an accuracy of 66% can be achieved.

Conclusions
We show a novel approach to deep learning in using data from just one patient to train deep neural networks to monitor tumor change. Using two different datasets to evaluate the results shows the potential to generalize the method.
Estrogen-related genes for thyroid cancer prognosis, immune infiltration, staging, and drug sensitivity
Authors: Zhang Leiying , Zhou Man , Gao Xiaoni , Xie Yang , Xiao Junqi , Liu Tao , Zeng Xiangtai 
Published: October 2023

Abstract
Background
Thyroid cancer (THCA) has become increasingly common in recent decades, and women are three to four times more likely to develop it than men. Evidence shows that estrogen has a significant impact on THCA proliferation and growth. Nevertheless, the effects of estrogen-related genes (ERGs) on THCA stages, immunological infiltration, and treatment susceptibility have not been well explored.

Methods
Clinicopathological and transcriptome data of patients with THCA from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) were cleaned before consensus clustering. Differential expression analysis was performed on the genes expressed between THCA and paraneoplastic tissues in TCGA, and Wayne analysis was performed on the ERGs obtained from the Gene Set Enrichment Analysis MsigDB and differentially expressed genes (DEGs). Univariate Cox and least absolute shrinkage and selection operator (LASSO) analyses were used to identify the set of estrogen-related differentially expressed genes (ERDEGs) associated with progression-free intervals (PFI) and to establish a prediction model. Receiver operating characteristic curves were plotted to calculate the risk scores and PFI status to validate the predictive effect of the model. Enrichment analyses and immune infiltration analyses were performed to analyze DEGs between the high- and low-risk groups, and a nomogram plot was used in the risk model to predict the PFI of THCA.

Results
The expression of 120 ERDEGs differed significantly between the two groups (P < 0.05). Five (CD24, CAV1, TACC1, TIPARP, and HSD17B10) of the eight ERDEGs identified using univariate Cox and LASSO regression were validated via RT-qPCR and immunohistochemistry analysis of clinical tissue samples and were used for clinical staging and drug sensitivity analysis. Risk-DEGs were shown to be associated with immune modulation and tumor immune evasion, as well as defense systems, signal transduction, the tumor microenvironment, and immunoregulation. In 19 of the 28 immune cells, infiltration levels differed between the high- and low-risk groups. High-risk patients in the immunotherapy dataset had considerably shorter survival times than low-risk patients.

Conclusion
We identified and confirmed eight ERDEGs using a systematic analysis and screened sensitive drugs for ERDEGs. These results provide molecular evidence for the involvement of ERGs in controlling the immunological microenvironment and treatment response in THCA.
Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey
Authors: Lerdal Anners , Gay Caryl , Bonsaksen Tore , Ekeberg Øivind , Grimholt Trine , Heir Trond , Kottorp Anders , Lee Kathryn A. , Skogstad Laila , Schou-Bredal Inger 
Published: October 2023

Abstract
Background
Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population.

Methods
This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model.

Results
Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents’ fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items.

Conclusions
The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.