bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fatigue, Toll-Like Receptor 4, and Pro-Inflammatory Cytokines in Adults With Subarachnoid Hemorrhage: A 6-Month Longitudinal Study
Authors: Byun Eeeseung , McCurry Susan M. , Kwon Suyoung , Tsai Chi-shan , Jun Jeehye , Bammler Theo K. , Becker Kyra J. , Thompson Hilaire J. 
Published: October 2023

Background Fatigue is prevalent in subarachnoid hemorrhage (SAH) survivors. Biological mechanisms underlying fatigue post-SAH are not clear. Inflammation may contribute to the development of fatigue. This study aimed to examine the associations between inflammatory markers and fatigue during the first 6 months post-SAH. Specific biomarkers examined included both early and concurrent expression of Toll-Like Receptor 4 (TLR4) messenger RNA (mRNA) and plasma concentrations of pro-inflammatory cytokines, Tumor Necrosis Factor-alpha (TNF-α), Interleukin (IL)1β, and IL6. Methods We conducted a 6-month longitudinal study with a convenience sample of 43 SAH survivors. We collected blood samples on days 2, 3, and 7 and 2, 3, and 6 months post-SAH to assess biomarkers. Fatigue was assessed by the PROMIS Fatigue Scale at 2, 3, and 6 months. Linear mixed models were used to test the associations between early (days 2, 3, and 7) and concurrent (2, 3, and 6 months) TLR4 mRNA expression (TagMan gene expression assays) and TNF-α, IL1β, and IL6 plasma concentrations (multiplex assays) and concurrent fatigue. Results 28% of SAH survivors experienced fatigue during the first 6 months post-SAH. Fatigue levels in SAH survivors were higher than those of the U.S. population and consistent during the 6 months. Experience of fatigue during the 6 months post-SAH was associated with higher IL1β plasma concentrations on day 7 and IL1β, IL6, and TNF-α plasma concentrations during the 6 months post-SAH. Conclusion Inflammation appears to underlie the development of fatigue in SAH survivors.
The prevalence of autism among children with albinism
Authors: Gunz Stav , Rozen-Knisbacher Irit , Blumenfeld Anat , Hendler Karen , Yahalom Claudia 
Published: October 2023

Background The association between Autism spectrum disorders (ASD) and visual impairment has been mentioned in the literature. The aim of our study was to investigate the prevalence of autism among children with albinism compared to the prevalence of ASD in children with visual impairment secondary to other causes. Methods Retrospective study of children with albinism from January 2015 to December 2020. A control group was created with children with early onset visual impairment of similar visual range and age, secondary to diagnosis other than albinism. Patients with associated Autism were identified in both groups. Results Seven hundred and eight children aged 1–18 years with visual impairment were included in the study. 401 children had a diagnosis of albinism, of whom 14 were also diagnosed with ASD. In the control group, composed of 307 patients, only 3 had ASD (p: 0·03). Conclusions The prevalence of ASD in patients with albinism was 1 in 28, while in children with visual impairment from other causes was 1 in 102. We aim to raise awareness of the higher prevalence of autism in children diagnosed with albinism in order to reach earlier diagnosis and support.
The increasing complexity of femoral fragility fractures: incidence, fracture patterns and management over a 10-year period
Authors: Gibson Alexandria , Guest Megan , Taylor Trenton , Harrold Fraser , Gwynne Jones David 
Published: October 2023

Introduction: The purpose of this study was to determine whether there have been changes in the numbers and complexity of femoral fragility fractures presenting to our department over a period of 10 years. Methods: Patients >60 years presenting with femoral fragility fractures to our institution in 2018–2019 (397 fractures) were compared with respect to demographic data, incidence rates, fracture classification and surgical management with a historical cohort from 2009–2010 (335 fractures). Pathological and high velocity fractures were excluded. Results: The gender proportion and average age (83.1 vs. 82.7 years) was unchanged. The number of femoral fractures increased by 19% but the overall incidence in people >60 years fell by 6% ( p  = 0.41). The proportion of unstable trochanteric fractures (31A2 and A3) increased from 22% to 55% ( p  < 0.001). The proportion of displaced intracapsular fractures increased from 53% to 72% ( p  < 0.001). The incidence of stable trochanteric fractures fell from 12.4 to 7.3/10,000 patients>60 years ( p = 0.0006) while the incidence of unstable trochanteric fractures (31A2 and 31A3) increased from 3.5 to 8.9/10,000 patients >60 years ( p < 0.0001). The proportion of trochanteric fractures treated with an intramedullary (IM) nail increased from 9% to 35% ( p = 0.0001). The number of shaft and distal femoral fractures increased by 41% although the incidence did not change significantly. Periprosthetic fractures comprised 70% of femoral shaft fractures in both cohorts. Conclusions: The increasing number and complexity of femoral fragility fractures, especially unstable trochanteric fractures and periprosthetic fractures, is likely to have an impact on implant use, theatre time and cost.
To connect or not connect: long-term adoption of video consultations, and reasons for discontinuing use
Authors: Muli Irene , Hvitfeldt Helena , Cajander Åsa , Jäderlund Hagstedt Lovisa , Davoody Nadia , Taloyan Marina , Hägglund Maria 
Published: October 2023

Introduction This study investigates factors related to long-term and short-term adoption of video consultations (VCs) and reasons for discontinuing use among primary care patients. Methods A sample of primary care patients using VCs with healthcare providers were invited to take a survey in a cross-sectional study. Participants were asked about their intention to continue to have video consultations in the future, and those indicating no intention to use VCs in the future (short-term adopters) were asked about their reasons for this. Prevalence and statistical differences between long-term and short-term adopters were investigated. Results There were several statistically significant differences between long-term and short-term adopters (76% vs. 24%). Long-term adopters consisted of more middle-aged individuals (35–54 years) and the majority worked full-time (56%). They had more positive opinions of VCs and used VCs and video meetings for other purposes to a larger extent. They chose VCs because of the lack of time to go to the healthcare centre and because their provider offered them. The most common reason for discontinuing use was a preference for face-to-face consultations, with the youngest age group (16–34 years) reporting this to a larger extent. Discussion Younger and older age groups may be less likely to continue the use of VCs, potentially preserving the digital divide. Additionally, disparities in using similar technologies might contribute to the digital divide. Moreover, convenience, positive opinions of VCs, and experience with VCs were related to long-term adoption. Further studies are needed to explore non-use, age’s influence, and address usability issues.
Modeling, design, and optimization of a dielectric elastomer acoustic liner
Authors: Solano Chelsea , Cattafesta Louis 
Published: October 2023

The modeling, design, and optimization of an embedded dielectric elastomer (DE) membrane acoustic liner is considered. The acoustic impedance of the liner is modified when the DE is subjected to voltage, resulting in a reduction of the in-plane stress. A lumped element model of an embedded dielectric elastomer acoustic liner is derived and validated in a normal incidence impedance tube and is subsequently used to optimize its performance. The optimization cost functions include (1) maximization of the average absorption coefficient over a targeted frequency range, 400 – 1600 Hz and (2) maximization of the change in the liner fundamental resonance frequency when the membrane is activated. Good agreement between measured and predicted absorption is observed. Tuning of the resonant frequency requires a numerical solution for resonance using the imaginary part of the impedance, since a simple analytical expression for resonance cannot be derived due to the complex coupling between the acoustics of the liner and the electro-mechanics of the DE membrane. Nonetheless, resonant frequency shifts predicted with the lumped element model compare favorably to those measured with the activated liner sample, with a shift of 213 Hz.
Effect of tranexamic acid on intraoperative blood loss in pediatric osteotomies around the hip: Study protocol for a double-blind randomized placebo-controlled trial
Authors: van Kouswijk Hilde W , Tolk Jaap J , van Bommel Christian PE , Reijman Max , Kempink Dagmar RJ , de Witte Pieter B 
Published: October 2023

Background: Proximal femoral and/or pelvic osteotomies (PFPOs) can be indicated for a multitude of hip pathologies in (often asymptomatic) children, to prevent future hip problems. These procedures can result in significant blood loss. Tranexamic acid (TXA) is an antifibrinolytic agent routinely administered in adult trauma and joint reconstruction surgery to reduce blood loss. TXA is also registered for use in children and reported safe and beneficial for pediatric trauma, cardiac, and spinal surgery. However, for pediatric orthopedics, particularly for PFPOs, the available evidence is limited. Therefore, the current trial will investigate the potential reducing effect of preoperative TXA on intraoperative blood loss in pediatric PFPOs. Methods: In this single-center, double-blind, randomized placebo-controlled trial, we aim to include 180 participants aged from 1 to 18 years undergoing PFPOs for any indication at our institution. Participants will be randomized to receive either TXA or placebo (saline) during anesthetic induction. The primary outcome is intraoperative estimated blood loss (mL/kg), which is determined gravimetrically. Secondary outcomes include the percentage of patients with excessive blood loss (>20 mL/kg), procedure time and hospital stay, and postoperative hemoglobin level changes. Discussion: This will be the first prospective study investigating the effect of preoperative TXA on intraoperative blood loss in pediatric PFPOs. Its results will help to determine whether it would be advisable to adopt preoperative TXA as a standard medication to minimize blood loss and prevent complications in this vulnerable population. Trial registration: EudraCT: 2022-002384-30. Prospectively registered on September 26, 2022.
Personalized Prediction of Change in Fasting Blood Glucose Following Basal Insulin Adjustment in People With Type 2 Diabetes: A Proof-of-Concept Study
Authors: Thomsen Camilla Heisel Nyholm , Kronborg Thomas , Hangaard Stine , Vestergaard Peter , Hejlesen Ole , Jensen Morten Hasselstrøm 
Published: October 2023

Aims: For people with type 2 diabetes treated with basal insulin, suboptimal glycemic control due to clinical inertia is a common issue. Determining the optimal basal insulin dose can be difficult, as it varies between individuals. Thus, insulin titration can be slow and cautious which may lead to treatment fatigue and non-adherence. A model that predicts changes in fasting blood glucose (FBG) after adjusting basal insulin dose may lead to more optimal titration, reducing some of these challenges. Objective: To predict the change in FBG following adjustment of basal insulin in people with type 2 diabetes using a machine learning framework. Methods: A multiple linear regression model was developed based on 786 adults with type 2 diabetes. Data were divided into training (80%) and testing (20%) sets using a ranking approach. Forward feature selection and fivefold cross-validation were used to select features. Results: Participants had a mean age of approximately 59 years, a mean duration of diabetes of 12 years, and a mean HbA1c at screening of 65 mmol/mol (8.1%). Chosen features were FBG at week 2, basal insulin dose adjustment from week 2 to 7, trial site, hemoglobin level, and alkaline phosphatase level. The model achieved a relative absolute error of 0.67, a Pearson correlation coefficient of 0.74, and a coefficient of determination of 0.55. Conclusions: A model using FBG, insulin doses, and blood samples can predict a five-week change in FBG after adjusting the basal insulin dose in people with type 2 diabetes. Implementation of such a model can potentially help optimize titration and improve glycemic control.
Clinical remission of feline sino-nasal aspergillosis despite evidence of persistent infection
Authors: Fawsitt Jack , Russell Oliver , Alexander Akash , Peschard Anne-Lorraine , Wong Hannah , Kortum Andre 
Published: October 2023

Case summary Feline sino-nasal aspergillosis is a rare condition with only sparse heterogeneous reports in the literature regarding its treatment. This report describes the presentation, treatment and outcome of a cat with sino-nasal aspergillosis treated by meticulous debridement in combination with topical and systemic azole therapy. Diagnosis was based on MRI, in combination with rhinoscopic assessment and visualisation of fungal plaques, followed by histopathology, fungal culture and panfungal PCR. The cat was treated by debridement of fungal plaques via anterior rhinoscopy and frontal sinusotomy and local instillation of 1% clotrimazole solution, followed by a 4-week course of oral itraconazole. Histopathology confirmed fungal rhinitis and culture identified Aspergillus fumigatus and Aspergillus versicolor. Clinical remission was achieved after treatment; however, evidence of persistent infection was confirmed in the post-mortem examination 8 months after the cat was euthanased for unrelated reasons. Relevance and novel information Despite clinical remission, the persistence of fungal infection post mortem highlights the challenges of monitoring the response to treatment and illustrates that the resolution of clinical signs does not necessarily equate with a disease cure.
Leveraging digital technology for social connectedness among adults with chronic conditions: A systematic review
Authors: Wright Pamela J , Raynor Phyllis A , Bowers Dana , Combs Elizabeth M , Corbett Cynthia F , Hardy Hannah , Patel Khushi 
Published: October 2023

Purpose To review the evidence about the impact of digital technology on social connectedness among adults with one or more chronic health conditions. Methods PubMed, Embase, Social Sciences, CINAHL, and Compendex were systematically searched for full-text, peer-reviewed empirical evidence published between 2012 and 2023 and reported using the PRISMA flow diagram. Articles were critically appraised applying the Joanna Briggs Institute checklists. Specific data were extracted based on the framework for social identity and technology approaches for health outcomes and then analyzed and synthesized. Results Thirty-four studies met study criteria. Evidence showed heterogeneity among research methodology, chronic health conditions, digital technology, and health outcomes. Technology use was influenced by factors such as usability, anonymity, availability, and control. More advanced digital technologies require higher digital literacy and improved accessibility features/modifications. Social support was the most measured aspect of social connectedness. The emotional and informational forms of social support were most reported; instrumental support was the least likely to be delivered. Self-efficacy for using technology was considered in seven articles. Sixteen articles reported health outcomes: 31.2% ( n = 5) described mental health outcomes only, 18.8% ( n = 3) reported physical health outcomes only, 31.2% ( n = 5) detailed both physical and mental health outcomes, whereas 18.8% ( n = 3) denoted well-being or quality-of-life outcomes. Most often, health outcomes were positive, with negative outcomes for selected groups also noted. Conclusion Leveraging digital technology to promote social connectedness has the potential to affect positive health outcomes. Further research is needed to better understand the social integration of technology among populations with different contexts and chronic health conditions to enhance and tailor digital interventions.
Factors of regional variations in national cancer screening rates during the COVID-19 pandemic
Authors: Park Jong-Ho , Lim Jihye 
Published: October 2023

Objectives The objective of this study was to analyze factors of regional variation in national cancer screening rate in Korea using regional cancer screening rate data. In addition, during the COVID-19 pandemic in 2020, we tried to identify factors affecting cancer screening rate, including COVID-19 situation in the region. Methods Data provided by the National Health Insurance Service Center were used for the national cancer screening rate index data in 2020 in 229 regions. A correlation analysis was conducted to find correlation between national cancer screening rate and variation factors in the national cancer screening rate in the region to be analyzed. In addition, to confirm spatial dependence of the national cancer screening rate among regions, a global spatial autocorrelation (Global Moran's I) analysis was conducted. Results In the 2020 COVID-19 situation, variable factors affecting the national cancer screening rate among regions in Korea were the regional number of populations of cumulative COVID-19 confirmed cases, concern of damage caused by COVID-19 infection, income level, the proportion of the population graduating from middle school or lower, the average daily access time to general hospitals by car, and the average daily access time to hospitals and clinics by public transportation or walking. Conclusions Results of this study can be used to establish national digital health policies that reflect regional variation factors in situations such as the COVID-19 pandemic. It is believed that they can contribute to policies to promote community health in the future.
Tackling Health Inequities: A Unique, Asynchronous Course Designed Through Peer-to-Peer Methods
Authors: Burdzy Alexander , Dai Michelle , Nagubandi Veda , Nguyen My , Marten Carly , Paul-Quinn Jennifer 
Published: October 2023

OBJECTIVES This study investigates the efficacy and feasibility of an asynchronous, peer-to-peer health disparities enrichment course on postbaccalaureate prehealth students’ knowledge, behaviors, and reaction to course materials. INTRODUCTION Growing awareness of social inequities has prompted educators of prehealth and medical students to explore student education by addressing systemic healthcare issues. This cross-sectional study assessed reactions, learning, and self-reported behavior changes in students after taking the course “Social Determinants, Disparities, and Preparing for the Future of Healthcare” (SDDH). METHODS The curriculum was designed by prehealth postbaccalaureate students for their peers. Course goals were to educate participants on social determinants of health and to build cultural and structural competence in their roles as future healthcare professionals. SDDH is an asynchronous, noncredit-bearing, 5-h online course with 10 modules covering various topics. The Kirkpatrick Model was used to assess the effectiveness of the curriculum, alongside qualitative and quantitative analyses of student performance. RESULTS Out of the 102 active students in the prehealth program that accepted the invitation to join, 29 students successfully completed the course (rate of completion = 28%). On average, students expressed positive reactions and attitudes toward the course and experienced an observable increase in knowledge assessment scores upon curriculum completion ( P-value = .0002). Students’ self-reported observations demonstrated sustained behavioral change 3 months after course completion. CONCLUSION It is critical to educate prehealth students on health disparities, structural, and cultural competence. A course such as SDDH may help prehealth students build effective communication skills for advocacy and develop an empathetic, patient-centered approach earlier on in their career pursuit. Some barriers to students completing the entire course include its length, uncredited status, and voluntary self-enrollment.
Evaluation of extended depth-of-focus hydrophobic intraocular lens with an optic concept based on combination of high-order aberrations
Authors: Stodulka Pavel , Pracharova Zuzana 
Published: October 2023

Background: Extended depth-of-focus (EDOF) intraocular lenses (IOLs) provide a continuous range of uncorrected vision at different distances. Objective: To assess visual acuity, refractive outcomes, and patient satisfaction after cataract surgery using the LuxSmart EDOF IOL (Bausch+Lomb). Design: A two-center, prospective observational clinical study. Methods: This study includes patients who have undergone bilateral phacoemulsification with bilateral implantation of the LuxSmart EDOF IOL, with the aim of achieving emmetropia. Visual acuity (VA) and subjective refraction were obtained in all patients preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. Subjective measures were obtained using the Catquest-9SF questionnaire and the Patient-Reported Spectacle Independence Questionnaire (PRSIQ). Contrast sensitivity and a glare assessment were undertaken postoperatively. Safety outcomes were additionally assessed. Results: Sixty eyes from thirty patients were recruited for this study. The mean spherical equivalent was 1.04 ± 1.67 D preoperatively and −0.30 ± 0.46 D at 6 months. Monocular uncorrected distance VA was 0.57 ± 0.32 (logMAR) preoperatively and 0.09 ± 0.12 (logMAR) at 6 months. Mean 6-month monocular uncorrected VA was 0.11 ± 0.13, 0.12 ± 0.15, and 0.31 ± 0.15 (logMAR) at 80, 66, and 40 cm, respectively. More than 90% of patients were either fairly or very satisfied with their vision. There was one case of suspected vitreomacular traction postoperatively. Conclusion: The LuxSmart EDOF IOL offers good refractive, VA, and safety outcomes. The single elongated focal point designed to enhance the DOF shows good results for VA and patient satisfaction.
Use of point-of-care ultrasound in a low-resource setting to diagnose Achilles tendon rupture and avulsion fracture of the calcaneal bone
Authors: Habibullah Naheed , Dayo Jamil , Soomar Salman Muhammad , Ali Noman 
Published: October 2023

Abstract
Background
Point-of-care ultrasound (POCUS) is becoming more prevalent in recent years for evaluating patients presenting with musculoskeletal injuries in the emergency department (ED). This imaging modality has been utilized to diagnose soft tissue and bony injuries accurately, obtain appropriate consultation, and perform timely interventional procedures in the ED.

Case presentation
We present the case of a 55-year-old man who presented to the ED with significant left ankle pain following a ground-level fall. His physical examination showed swelling and tenderness around the ankle. POCUS examination aided the rapid and accurate detection of acute Achilles tendon rupture.

Conclusion
This case demonstrates that POCUS is a valuable diagnostic tool in evaluating patients with a suspected Achilles tendon rupture, especially in a resource-limited setting.