bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children
Authors: Hussain Azfira , Mohammad Arbaaz , Tharsis Asha , Badakere Akshay , Agarkar Sumita 
Published: February 2024

Background To explore the association of sleep timings, duration, consistency, and chronotype with premyopia and myopia among Indian children. Methods This hospital-based cross-sectional study included 453 children, aged 6–12 years. Two myopia participants were selected for each individual with the corresponding premyopia or emmetropia. All children underwent cycloplegic autorefraction and ocular biometric tests. The Children's Sleep Habits Questionnaire (CSHQ) and parental information on behavioral habits were used to assess the association of sleep parameters with myopia and premyopia using logistic regression models. Results Both myopia and premyopia exhibited significant late bedtime, short sleep duration, early wakeup time on only weekdays, and longer weekend catch-up sleep than emmetropia children (p < 0.05). In multivariate analysis, late bedtime (more than 24:00 a.m.) on weekdays (Odds ratio, OR = 3.63, 95% CI [0.74, 8.68]) as well as on free days (OR = 1.04, 95% CI [0.02, 8.08]); and early wake-up time only on weekdays (5:00–6:00 a.m., OR = 2.16, 95% CI [0.24, 6.76] and 06:00–07:00 a.m., OR = 2.42, 95% CI [0.51, 8.44]) were associated with increased risk of myopia (all p < 0.05) but not premyopia. After adjusting the confounding factors, when each of the eight CSHQ subscale components was analyzed, only bedtime resistance, night waking, and daytime sleepiness scores were significantly associated with a higher risk for premyopia and myopia (p < 0.05). Conclusions The sleep quality components, including bedtime resistance, night waking, and daytime sleepiness, equally involve a higher risk for myopia as well as premyopia.
Gene–environment interactions: Epstein–Barr virus infection and risk of pediatric-onset multiple sclerosis
Authors: Ziaei Amin , Solomon Olivia , Casper T Charles , Waltz Michael , Weinstock-Guttman Bianca , Aaen Greg , Wheeler Yolanda , Graves Jennifer , Benson Leslie , Gorman Mark , Rensel Mary , Mar Soe , Lotze Tim , Greenberg Benjamin , Chitnis Tanuja , Waldman Amy T , Krupp Lauren , James Judith A , Hart Janace , Barcellos Lisa F , Waubant Emmanuelle 
Published: February 2024

Background and Objective: Prior Epstein–Barr virus (EBV) infection is associated with an increased risk of pediatric-onset multiple sclerosis (POMS) and adult-onset multiple sclerosis (MS). It has been challenging to elucidate the biological mechanisms underlying this association. We examined the interactions between candidate human leukocyte antigen (HLA) and non-HLA variants and childhood EBV infection as it may provide mechanistic insights into EBV-associated MS. Methods: Cases and controls were enrolled in the Environmental and Genetic Risk Factors for Pediatric MS study of the US Network of Pediatric MS Centers. Participants were categorized as seropositive and seronegative for EBV-viral capsid antigen (VCA). The association between prior EBV infection and having POMS was estimated with logistic regression. Interactions between EBV serostatus, major HLA MS risk factors, and non-HLA POMS risk variants associated with response to EBV infection were also evaluated with logistic regression. Models were adjusted for sex, age, genetic ancestry, and the mother’s education. Additive interactions were calculated using relative risk due to interaction (RERI) and attributable proportions (APs). Results: A total of 473 POMS cases and 702 controls contributed to the analyses. Anti-VCA seropositivity was significantly higher in POMS cases compared to controls (94.6% vs 60.7%, p < 0.001). There was evidence for additive interaction between childhood EBV infection and the presence of the HLA-DRB1*15 allele (RERI = 10.25, 95% confidence interval (CI) = 3.78 to 16.72; AP = 0.61, 95% CI = 0.47 to 0.75). There was evidence for multiplicative interaction ( p < 0.05) between childhood EBV infection and the presence of DRB1*15 alleles (odds ratio (OR) = 3.43, 95% CI = 1.06 to 11.07). Among the pediatric MS variants also associated with EBV infection, we detected evidence for additive interaction ( p = 0.02) between prior EBV infection and the presence of the GG genotype in risk variant (rs2255214) within CD86 (AP = 0.30, 95% CI = 0.03 to 0.58). Conclusion: We report evidence for interactions between childhood EBV infection and DRB1*15 and the GG genotype of CD86 POMS risk variant. Our results suggest an important role of antigen-presenting cells (APCs) in EBV-associated POMS risk.
Capillaroscopic differences between primary Raynaud phenomenon and healthy controls indicate potential microangiopathic involvement in benign vasospasms
Authors: Brunner-Ziegler Sophie , Dassler Eva , Müller Markus , Pratscher Marco , Forstner Nikolaus Franz-Ferdinand Maria , Koppensteiner Renate , Schlager Oliver , Jilma Bernd 
Published: February 2024

Background: For primary Raynaud phenomenon (PRP), an otherwise unexplained vasospastic disposition is assumed. To test the hypothesis of an additional involvement of distinct ultrastructural microvascular alterations, we compared the nailfold capillary pattern of patients with PRP and healthy controls. Methods: A total of 120 patients with PRP (with a median duration of vasospastic symptoms of 60 [IQR: 3–120] months) were compared against 125 controls. In both groups, nailfold capillaroscopy was performed to record the presence of dilatations, capillary edema, tortuous capillaries, ramifications, hemorrhages, and reduced capillary density and to determine a semiquantitative rating score. Further, the capacity of finger skin rewarming was investigated by performing infrared thermography in combination with cold provocation. Results: Unspecific morphologic alterations were found in both, PRP, such as controls, whereby the risk for PRP was four times as high in the presence of capillary dilations (CI: 2.3–7.6) and five times as high if capillary density was reduced (CI: 1.9–13.5). Capillary density correlated with thermoregulatory capacity in both hands in the PRP group, but not in controls. In addition, a negative correlation between the microangiopathy score and the percentage degree of rewarming in both hands was found for patients with PRP only. Conclusion: We found specific differences within the microvascular architecture between patients with PRP and controls. As a conclusion, PRP may not be an entirely benign vasospastic phenomenon, but might be associated with subtle microcirculatory vasculopathy. In addition, we suggest that the implementation of a scoring system might serve as guidance in the diagnostic process at least of patients with long-standing PRP.
Discrete wavelet transform based processing of embroidered textile-electrode electromyography signal acquired with load and pressure effect
Authors: Etana Bulcha Belay , Dawud Ahmed Ali , Malengier Benny , Sitek Wojciech , Gemechu Wendimu Fanta , Krishnamoorthy Janarthanan , Langenhove Lieva Van 
Published: February 2024

The diagnosis of neuromuscular diseases is complicated by overlapping symptoms from other conditions. Textile-based surface electromyography (sEMG) of skeletal muscles, offer promising potential in diagnosis, treatment, and rehabilitation of various neuromuscular disorders. However, it is important to consider the impact of load and pressure on EMG signals, as this can significantly affect the signal’s accuracy. This study seeks to investigate the influence of load and pressure on EMG signals and establish a processing framework for these signals in the diagnosis of neuromuscular diseases. The sEMG data were collected from healthy subjects using a textile electrode developed from polyester multi-filament conductive hybrid thread (CleverTex). The textrode was embroidered directly on an elastic bandage (Velcro® strap) placed on volunteer’s muscles while different activities were performed with varying loads and pressure. The collected data were pre-processed using standard techniques of the discrete wavelet transform to remove noise and artifacts. The performance of the proposed denoising algorithm was evaluated using the signal-to-noise ratio (SNR), percentage root mean square difference (PRD), and root mean square error (RMSE). Various signal processing approaches (filters) were considered and the results were compared with the proposed EMG noise reduction algorithms. Based on the experimental results, the fourth level of decomposition for the sym5 wavelets with the Rigrsure threshold method achieved the highest signal-to-noise ratio (SNR) values of 16.69 and 21.91, for soft and hard thresholding functions, respectively. The SNR values of 22.11, 21.54, and 2.78 at three different pressure levels 5 mmHg, 10 mmHg, and 20 mmHg, respectively, indicate the superior performance of wavelet multiresolution filter in de-noising applications. The results of this study suggest that our methodology is effective, precise, and reliable for analysing sEMG data and provide insights into both physiological and pathological neuromuscular conditions.
Unsuspected Limitations of 3D Printed Model in Planning of Complex Aortic Aneurysm Endovascular Treatment
Authors: Bonvini Stefano , Raunig Igor , Demi Libertario , Spadoni Nicola , Tasselli Sebastiano 
Published: February 2024

Objective Static 3-dimensional (3D) printing became attractive for operative planning in cases that involve difficult anatomy. An interactive (low cost, fast) 3D print allowing deliberate surgical practice can be used to improve interventional simulation and planning. Background Endovascular treatment of complex aortic aneurysms is technically challenging, especially in case of narrow aortic lumen or significant aortic angulation (hostile anatomy). The risk of complications such as graft kinking and target vessel occlusion is difficult to assess based solely on traditional software measuring methods and remain highly dependent on surgeon skills and expertise. Methods A patient with juxtarenal AAA with hostile anatomy had a 3-dimensional printed model constructed preoperatively according to computed tomography images. Endovascular graft implantation in the 3D printed aorta with a standard T-Branch Cook (Cook® Medical, Bloomington, IN, USA) was performed preoperatively in the simulation laboratory enabling optimized feasibility, surgical planning and intraoperative decision making. Results The 3D printed aortic model proved to be radio-opaque and allowed simulation of branched endovascular aortic repair (BREVAR). The assessment of intervention feasibility, as well as optimal branch position and orientation was found to be useful for surgeon confidence and the actual intervention in the patient. There was a remarkable agreement between the 3D printed model and both CT and X-ray angiographic images. Although the technical success was achieved as planned, a previously deployed renal stent caused unexpected difficulty in advancing the renal stent, which was not observed in the 3D model simulation. Conclusion The 3D printed aortic models can be useful for determining feasibility, optimizing planning and intraoperative decision making in hostile anatomy improving the outcome. Despite already offering satisfying accuracy at present, further advancements could enhance the 3D model capability to replicate minor anatomical deformities and variations in tissue density.
Standardized approach to direct first pass aspiration technique for endovascular thrombectomy: Description and initial experience with CANADAPT
Authors: Macdonald I.R. , Linehan V. , Sneek B. , Volders David 
Published: February 2024

Background Endovascular thrombectomy (EVT) is standard of care for acute ischemic stroke. Stent assisted EVT with aspiration (SOLUMBRA) technique has remained a mainstay approach. There is growing evidence that A Direct Aspiration First Pass Technique (ADAPT) is a safe, efficient and effective approach for EVT, offering several advantages. This study describes and reports initial institutional experience in the use of a standardized scientific based aspiration only technique: CANADAPT. Methods Single center prospective cohort study was performed on consecutive patients treated for large/medium vessel ischemic stroke with CANADAPT. Intravenous thrombolytics were administered according to routine practice, independent of the decision to proceed with EVT. A sequential stepwise aspiration only technique was then applied, CANADAPT, consisting of three maneuvers, A, B and C. The reperfusion success rate, number of passes, use of rescue technique, complication rate and procedural cost were determined. Results Twenty-two patients were included in this case series representing M1 (17, 77%), M1/2 (2, 9%), carotid-T (2, 9%) and basilar (1, 5%) occlusions. First pass recanalization was achieved in 11 (50%) of patients. A further four patients had successful reperfusion with a second pass of CANADAPT (total 68% success rate). Only one patient had successful reperfusion with the aspiration catheter at the clot interface (CANADAPT A). All others required some withdrawal of the aspiration catheter for reperfusion (CANADAPT B and C). Seven patients had SOLUMBRA rescue. Of these, five patients (22% of total patients) had further successful reperfusion. Overall median procedural time was 23 min for first recanalization and 30 min for final recanalization. The cost per procedure was $6630 ± 1069 for CANADAPT, and $13,530 ± 2706 for SOLUMBRA techniques. Conclusions CANADAPT represents a standardized scientific-based approach to aspiration only thrombectomy intervention. This initial study demonstrates the safety, efficiency and efficacy of this technique for use in EVT.
Independent risk factors for in-hospital outcome of myasthenic crisis: a prospective cohort study
Authors: Wang Yuan , Huan Xiao , Zhu Xinfang , Song Jie , Yan Chong , Yang Lei , Xi Caihua , Xu Yafang , Xi Jianying , Zhao Chongbo , Xia Rong , Luo Sushan 
Published: February 2024

Background: Myasthenic crisis (MC) is a life-threatening condition for myasthenia gravis (MG). Therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIg) efficaciously treat patients with MC. However, not every MC responds well to rescue therapies, and the determinants for outcome with the evidence from prospective cohorts are still lacking. Objectives: To explore the risk factors for in-hospital outcomes in patients with MC. Methods: Using a national neuromuscular center-based cohort of MG with prospective follow-ups from the crisis to the post-crisis phase, we finally included 90 MC episodes from 76 independent patients who received a standard regimen of rescue therapies. Results: The mean admission age was 52.89 ± 15.72 years. With a female predominance of 63.16% (48/76) and a high proportion of thymoma-associated MG (TMG) of 63.16% (48/76), the overall in-hospital mortality was 2.63% (2/76) and the average duration for mechanical ventilation (MV) use was 17.09 ± 13.36 days (0–53 days). In contrast to the patients with anti-acetylcholine receptor (AChR) antibodies, muscle-specific tyrosine kinase (MuSK)-associated MC exhibited a shorter MV support (5.20 ± 5.07 versus 17.40 ± 13.24 days, p = 0.023), length of intensive care units (ICU) stay (6.00 ± 4.64 versus 19.16 ± 17.54 days, p = 0.046), and hospital stay (16.00 ± 4.12 versus 34.43 ± 20.48 days, p = 0.011). Thymoma [odds ratio (OR): 0.200, 95% confidence interval (CI): 0.058–0.687, p = 0.011], partial pressure of carbon dioxide (PCO2) in blood gas before MV (OR: 1.238, 95% CI: 1.015–1.510, p = 0.035), and pneumonia (OR: 0.204, 95% CI: 0.049–0.841, p = 0.028) were identified as independent risk factors for prolonged MV use. TMG patients with thymoma burden exhibited a notable longer MV use (22.08 ± 17.54 versus 8.88 ± 6.79 days, p = 0.001), a prolonged hospital stay (40.40 ± 26.13 versus 23.67 ± 13.83 days, p = 0.009) compared with non-TMG. Even with complete thymoma resection (R0), TMG exhibited an unfavorable outcome versus non-TMG. Conclusion: With timely rescue therapies and prospective follow-ups, the in-hospital outcome of MCs was substantially improved. Thymoma, PCO2 in blood gas before MV, and pneumonia were identified as independent risk factors for prolonged MV use.
Chronological improvement of survival in patients with advanced gastric cancer over 15 years
Authors: Ogata Takatsugu , Narita Yukiya , Oze Isao , Kumanishi Ryosuke , Nakazawa Taiko , Matsubara Yuki , Kodama Hiroyuki , Nakata Akinobu , Honda Kazunori , Masuishi Toshiki , Bando Hideaki , Taniguchi Hiroya , Kadowaki Shigenori , Ando Masashi , Ito Seiji , Tajika Masahiro , Muro Kei 
Published: February 2024

Background: Recent trials have reported a median overall survival (OS) of 11–17 months in patients with advanced gastric cancer (AGC). However, it is unclear how recently approved drugs contribute to patient prognosis. Objectives: We aimed to evaluate the characteristics and survival in patients with AGC over the past 15 years. Design: Retrospective study. Methods: We evaluated data of 1355 patients with AGC who received first-line chemotherapy between January 2005 and March 2019 at a single institution. We compared the characteristics and survival rates across four periods: January 2005–December 2007 (period A), January 2008–February 2011 (period B), March 2011–May 2015 (period C), and June 2015–March 2019 (period D). The median follow-up duration was 13.1 months, with 312, 333, 393, and 317 patients in periods A, B, C, and D, respectively. Results: There were no significant differences in patient characteristics between the four periods, except for the proportion of patients who underwent prior gastrectomy and human epidermal growth factor receptor 2 (HER2) testing. Patients in period D had significantly longer OS than those in period A [median: 15.7 versus 12.4 months; adjusted hazard ratio (aHR): 0.79; p = 0.02]. The mean OS in patients with liver metastasis (LM) in period D was remarkably longer than that in patients in period A (median: 19.3 versus 12.4 months; aHR: 0.61; p < 0.01), while that in patients with peritoneal metastasis showed limited improvement. Conclusion: Clinical strategy changes, including gastrectomy, HER2 testing, and approval of new drugs, may be associated with improved OS in patients with AGC. In the last 4 years, a remarkable improvement has been observed in patients with LM.
The effect of adult coloring (mandala pattern) on pain and anxiety associated with dressing changes in burn patients: A randomized controlled trial
Authors: Sadeqi Hamidreza , Rahzani Kobra , Hekmatpou Davood , Rakei Isfahani Siamak 
Published: February 2024

Introduction The study investigated the effect of mandala coloring on pain and anxiety associated with dressing changes in burn patients. Method This clinical trial was conducted on 60 patients in two groups. At the beginning of the study [baseline (T1)], anxiety and pain were assessed using the BSPAS and VAS. A mandala pattern with colored pencils was provided to the patients in the intervention group. Each patient was given 30 min to color. Anxiety was measured at the 35th minute (T2). A dressing change was performed and 15 min later, the variables were measured again (T3). The control group received no intervention. Results The mean anxiety at the baseline (T1), 35th minute (T2), and 15 min after dressing changes (T3) in the intervention and control groups were 38.73  ±  5.55, 26.20  ±  6.08 and 28  ±  8.53, and 39.17  ±  4.17, 41.27  ±  3.68 and 41.63  ±  2.97, respectively. Anxiety at T1 was at the same for both groups. The anxiety in the intervention group decreased (P < 0.001) at T2 and T3 and increased in the control group. The mean pain intensity at the baseline (T1) and 15 min after dressing changes (T2) in the intervention group was 8.47  ±  1.432 and 5.9  ±  1.9, respectively, and in the control group was 8.33  ±  0.802 and 8.77  ±  0.626. Pain intensity at T1 was at the same level for both groups. The pain in the intervention group decreased at T2 (P < 0.001), whilst it increased in the control group. Conclusion Mandala coloring can reduce pain and anxiety during dressing changes in burn patients. It can be used as adjuvant treatment. Lay Summary Wound dressing in burn patients is accompanied by pain. This painful experience can lead to wound dressing anxiety in these patients. For this purpose, a study was conducted to check whether coloring before wound dressing can reduce the pain and anxiety of dressing in adults. Two groups of patients were included in the study; before the dressing, one group received a pre-prepared image of mandela designs along with colored pencils and colored the design to their taste. The other group did not receive any intervention. The intensity of pain and the level of anxiety of the two groups were measured before and after the dressing. The results showed that the coloring of the mandela design before dressing reduced the pain and anxiety related to the proceedure.
Triple Gram-negative bacterial endophthalmitis following intravitreal injection
Authors: Zaher Samy , Rodriguez-Villalobos Hector 
Published: February 2024

Abstract
Purpose
To describe a puzzling case of endophthalmitis caused by three unusual bacteria after intravitreal injection, its outcome, and underlying questions.

Findings
A 70-year-old female patient was diagnosed with acute endophthalmitis following intravitreal aflibercept injection for age-related macular degeneration. A standard tap and inject procedure was performed. Microbiological analyses on the anterior chamber and vitreous samples yielded the presence of three non-fermenting Gram-negative rods: Pseudomonas stutzeri, Stenotrophomonas maltophilia, and Ochrobactrum anthropi. The outcome was favorable after intravitreal injections of vancomycin and ceftazidime, with an almost complete recovery of the visual acuity to its baseline level. No potential source of infection was identified.

Conclusion
Endophthalmitis following intravitreal injection can be caused by a wide variety of bacteria, including some rare Gram-negative species. They can sometimes co-exist in a single patient, but their virulence may vary greatly. Due to the variable antibiotic susceptibility and frequent multiresistance associated with non-fermenting Gram-negative rods, a prompt microbiological approach is required. Favorable outcome can be achieved with standard management.
A scoping review on the conceptualisation and impacts of new mobility services
Authors: Mubiru Ibrahim , Westerholt René 
Published: February 2024

AbstractIn the course of major societal developments such as digitalisation and increasing urbanisation, various forms of so-called new mobility services have emerged. Various disciplines are engaged in understanding these services. However, what is still missing is a comprehensive understanding of what the umbrella term new mobility services means beyond a loosely used catch-all term. This article provides an interdisciplinary overview of the concept of new mobility services and their respective impacts on mobility landscapes. These aspects are summarised using a scoping review approach by examining a total of 98 publications. Our results show that the term new mobility services is indeed an umbrella term for different mobility concepts that are conceptualised differently and whose impacts on mobility landscapes are manifold. However, by applying elements of formal concept analysis, we can identify several key characteristics that define the lowest common denominator for services to be classified as new mobility services.