bluuebunny/crossref_metadata_2025_split huggingface dataset:
Common Mental Disorders and Their Correlates: A Community-based Survey Among Women in Southern Karnataka, India
Authors: Shenoy Rakshitha R , Prabhu Divya Arvind , Pandey Akhilesh Kumar , Praharaj Samir Kumar , Shetty Ranjitha S. 
Published: February 2024

Background: About 10% of Indians have common mental disorders (CMDs) which include depression and anxiety. These disorders are common in women, which not only impacts on their quality of life but also their family members. The objective of the study was to estimate the prevalence of CMDs, and factors associated with them among women residing in coastal Karnataka. Methods: A cross-sectional study was carried out among 980 women aged between 18 and 60 years from 2019 to 2021. Women were administered a baseline questionnaire along with Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder questionnaire-7 (GAD-7) and Cohen’s Perceived Stress Scale-4 (PSS-4). Data were collected using Epi-info and were analysed using SPSS version 15.0. Association between CMDs and socio-demographic, reproductive health and behavioural factors were expressed as crude and adjusted odds ratio (OR) with 95% confidence intervals (CI). Results: The prevalence of CMDs among women was 5.7%, with 4.6% having depression and 3.37% with anxiety disorders. Multivariate logistic regression analysis showed that residing in urban areas (OR = 2.15; 95% CI:1.10–4.17), having a chronic illness (OR = 2.38; 95% CI:1.14–4.97), history of recent bereavement in the family (OR = 2.20; 95% CI:1.02–4.75), early marriage (OR = 2.63; 95% CI:1.09–6.33), history of abortion (OR = 2.89; 95% CI:1.42–5.92), and exposure to domestic violence (OR = 3.08; 95% CI:1.14–8.33) were significantly correlated with CMDs in this sample. Conclusions: The study revealed that CMDs were prevalent among the surveyed women, which calls for routine screening of women for CMDs in primary care settings for early identification and appropriate interventions.
Clinical Assessment of the Correlation Between Tongue Pressure, Modified Mallampati Score, BMI, and Obstructive Sleep Apnea
Authors: Kolhe Shweta A. , Daokar Suchita S. 
Published: February 2024

Objective This study aimed to assess the connection between tongue pressure, Modified Mallampati Score (MMS), BMI, and their role in evaluating obstructive sleep apnea (OSA). Materials and Methods A total of 180 participants were categorized into four groups ( n = 45) based on the MMS. After securing informed consent, demographic data, including age, gender, body height, and weight (used to calculate BMI) were collected. A tongue pressure measurement system, patented as Innovative Australian Patent no. 2021106623 on 24 November 2021, was utilized. Results The one-way analysis of variance test was employed to compare variations in average BMI and tongue pressure across the groups. The post hoc Tukey test revealed significant differences at p ≤ .05. Tongue pressure significantly varied among the distinct MMS categories ( p = .001), notably with group 4 displaying significantly lower tongue pressure compared to the other three groups. Conclusion The findings suggest that both tongue pressure and MMS are interconnected factors contributing to OSA, while BMI and tongue pressure operate independently in determining OSA.
Rotator Cuff Repair With or Without Acromioplasty: A Systematic Review of Randomized Controlled Trials With Outcomes Based on Acromial Type
Authors: Maguire James A. , Dhillon Jaydeep , Scillia Anthony J. , Kraeutler Matthew J. 
Published: February 2024

Background: It is unclear whether the use of concomitant acromioplasty during rotator cuff repair (RCR) improves clinical outcomes and whether the outcomes are affected by acromial type. Purpose: To perform a systematic review of randomized controlled trials comparing clinical outcomes of RCR with and without acromioplasty, with a subanalysis of outcomes based on acromial type. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines by searching PubMed, the Cochrane Library, and Embase to identify randomized controlled trials that directly compared outcomes between RCR with versus without acromioplasty. A subanalysis was performed on the studies that provided outcomes based on acromial type. The search phrase used was rotator cuff repair (acromioplasty OR subacromial decompression) randomized. Patients were evaluated based on retear rate, reoperation rate, and patient-reported outcomes (PROs). Results: Application of inclusion criteria yielded 5 studies (2 studies were level 1, and 3 studies were level 2) including a total of 409 patients, with 211 patients undergoing RCR alone (group A) and 198 patients undergoing RCR with acromioplasty (group B). The mean patient age was 58.5 and 58.3 years in groups A and B, respectively. The mean follow-up time was 52.9 months, and the overall percentage of male patients was 54.1%. The rotator cuff tear size was 20.7 mm and 19.8 mm for groups A and B, respectively. No significant differences were found between groups for any of the PROs at final follow-up. Overall retear rates did not significantly differ between groups based on acromial type. Between 2 studies that measured reoperation rate, a significantly higher reoperation rate was found for the nonacromioplasty group (15%) versus the acromioplasty group (4.1%) ( P = .031). One of these studies found that 5 of 9 patients (56%) with a type III acromion in the nonacromioplasty group underwent reoperation compared with 0 of 4 patients with a type III acromion in the acromioplasty group. Conclusion: There is some evidence that acromioplasty during RCR reduces the risk for later reoperation. This may be particularly true for patients with type III acromions, although further studies with larger sample sizes are needed to corroborate these data.
Juvenile neuropsychiatric systemic lupus erythematosus: A specific clinical phenotype and proposal of a probability score
Authors: Labouret Mathilde , Trebossen Vincent , Ntorkou Alexandra , Bartoli Sophie , Aubart Mélodie , Auvin Stéphane , Bader-Meunier Brigitte , Baudouin Véronique , Corseri Olivier , Dingulu Glory , Ducrocq Camille , Dumaine Cécile , Elmaleh Monique , Fabien Nicole , Faye Albert , Hau Isabelle , Hentgen Véronique , Kwon Théresa , Meinzer Ulrich , Ouldali Naim , Parmentier Cyrielle , Pouletty Marie , Renaldo Florence , Savioz Isabelle , Benoist Jean-François , Le Roux Enora , Ellul Pierre , Melki Isabelle 
Published: February 2024

Objective Juvenile systemic lupus erythematosus (j-SLE) is a rare chronic auto-immune disease involving several organs. Neuropsychiatric (NP) SLE (NPSLE) is frequent in j-SLE and associated with increased morbidity/mortality. Although NPSLE classification criteria exist, attributing NP features to j-SLE remains a major challenge. The study objective is to thoroughly describe j-NPSLE patients and assist in their diagnosis. Methods This is a 4-year retrospective monocentric study of j-SLE patients. NP events were attributed to j-SLE using standardised diagnostic criteria and multidisciplinary paediatric clinical expertise. Clinical features, brain magnetic resonance imaging (MRI)s and samples analysis including cerebrospinal fluid were assessed. A risk of j-NPSLE score was developed based on multivariable logistic regression analysis. Results Of 39 patients included, 44% were identified as having j-NPSLE. J-NPSLE diagnosis was established at the onset of j-SLE in 59% of patients. In addition to frequent kidney involvement (76%) and chilblains (65%), all j-NPSLE patients displayed psychiatric features: cognitive symptoms (82%), hallucinations (76%), depressed mood (35%), acute confused state (18%) and catatonia (12%). Neurological involvement was often mild and nonspecific, with headache (53%) in about half of the patients. The main features reported on brain MRI were nonspecific T2/FLAIR white matter hyperintensities (65%), and cerebral atrophy (88%). Upon immunosuppressive treatment, clinical improvement of NP features was observed in all j-NPSLE patients. The score developed to attribute j-NPSLE probability, guide further investigations and appropriate treatments is based on hallucinations, memory, sleep and renal involvement (Sensitivity: 0.95 Specificity: 0.85). Cerebrospinal fluid (CSF) neopterin assessment increases the score sensitivity and specificity. Conclusion Physicians should carefully and systematically assess the presence of NP features at diagnosis and early stages of j-SLE. For j-NPSLE patients with predominant psychiatric features, a multidisciplinary collaboration, including psychiatrists, is essential for the diagnosis, management and follow-up.
Factors affecting different COVID-19 outcomes in patients with systemic lupus erythematosus during the second pandemic wave of COVID-19 in China
Authors: Liu Peng-Cheng , Zhang Min , Li Jian-Bin , Peng Yi-Lin , Yu Shu-Jiao , Wu Rui 
Published: February 2024

Objective To investigate characteristics associated with different COVID-19 outcomes of people with systemic lupus erythematosus (SLE) and COVID-19 during the second pandemic wave of COVID-19 in China. Methods In this retrospective study, people with SLE and COVID-19 who visited the First Affiliated Hospital of Nanchang University from December 2022 and February 2023 were subjected to this study. The three possible outcomes were listed in order of ordinal severity: (1) not hospitalized, (2) hospitalized but not receiving oxygenation, and (3) hospitalized with any ventilation or oxygenation. A multivariable ordinal logistic regression model was built to examine the association between COVID-19 severity and demographic traits, medications, comorbidities, and disease activity. Furthermore, among the 301 SLE patients included in our study, only two patients experienced mortality. In order to maintain statistical rigor, we have included these two deceased patients in the outcome measure of hospitalized with any ventilation or oxygenation. Results A total of 301 patients with SLE were enrolled in this study. The multivariate ordinal logistic regression analyses indicated that high SLE disease activity (vs remission; OR 39.04, 95% CI 3.08 to 494.44, p = .005) was associated with more severe outcomes. Three doses of COVID-19 vaccination (OR 0.19, 95% CI 0.07 to 0.51, p = .001), glucocorticoids dose (1–5 mg/day 0.14, 0.03 to 0.73, p = .020, and 6–9 mg/day 0.12, 0.02 to 0.61, p = .010), and more intensive immunosuppression drugs (0.34, 0.12 to 0.97, p = .044) were associated with better outcomes. In age-adjusted and sex-adjusted models, telitacicept (6.66, 1.35 to 32.86, p = .020) and rituximab (7.81, 1.87 to 32.66, p = .005) were associated with more severe outcomes. Hydroxychloroquine (0.47, 0.25 to 0.88, p = .018) was associated with favorable outcomes. Conclusion Different COVID-19 outcomes in people with SLE are mostly driven by COVID-19 vaccination, medications, and activity SLE. More importantly, three doses of COVID-19 vaccination may be associated with better outcomes.
Quality Improvement Project for Reducing Hypothermia on Admission in Neonates Admitted in A Tertiary Care (Level 3A) NICU in Ahmedabad, Western India
Authors: Shah Binoy , Mehta Ashish , Kamdar Jinal 
Published: February 2024

Title Quality Improvement project for reducing hypothermia on admission in newborns admitted to a neonatal care unit in a large academic tertiary (Level 3A) NICU in Ahmedabad, Western India. Background Neonatal hypothermia is a common and dangerous condition around the world. Moderate and severe hypothermia increase mortality and morbidity and predispose the fragile neonate to an increased risk of late-onset neonatal sepsis (LONS), intraventricular hemorrhage, and worsening of respiratory distress. Around 60% of neonates who are admitted to level 3 tertiary NICU in Ahmedabad, Gujarat, India, had a temperature below 36.5°C on admission. Method We conducted plan-do-study-act (PDSA) cycles to test and adapt solutions for decreasing hypothermia in neonates admitted to NICU. Identifying the root cause of hypothermia in terms of Manpower, Material, and Methods and enlisting them as fishbone diagrams. We adopted the strategy of using a transport incubator in the Ambulance and turning on the incubator before thirty minutes of delivery for preventing neonatal hypothermia. Results Within 8 months of starting our quality improvement project, the proportion of neonates who were hypothermic on admission decreased from 57% to 8%, Normothermic on admission increased from 23% to 53%, with an increase in mean admission temperature from 35.4°C during the pre-intervention phase to 36.6°C during post-intervention. There was also a reduction in the incidence of late-onset sepsis from 23% (pre-intervention phase) to 13% and subsequently 5% in the post-intervention period. Conclusion This study is a cost-effective approach to reducing admission hypothermia in NICU in a resource-limited setting with all outborn babies. Our study also emphasizes the importance of maintaining euthermia, not only in delivery rooms but also during transportation.
Gastric Perineurioma: A Rare Entity with Molecular Analysis and Literature Review
Authors: Vitale Alyssa M. , Alruwaii Fatima , Chitale Dhananjay A. , Ahsan Beena 
Published: February 2024

Background Perineuriomas of the gastrointestinal tract are benign neoplasms that commonly develop in the distal colon and are identified during screening colonoscopy; however, perineuriomas of the stomach are exceedingly rare and less frequently identified. Differentiating gastric perineuriomas from other more serious gastric neoplasms is critical to avoid unnecessarily aggressive treatments. Thus far, only six patients with gastric perineurioma have been described, and the molecular characterization of this entity is still lacking. Case Presentation We report a 52-year-old woman who presented with abdominal pain and gastric acid reflux and was found to have a 1.5 cm subepithelial gastric neoplasm composed of bland spindle cells displacing the gastric glands with no cytologic atypia or mitotic activity, suggesting a benign spindle cell neoplasm. Immunohistochemical analysis showed reactivity for perineurial markers glucose transporter-1 and epithelial membrane antigen, consistent with benign gastric perineurioma. DNA extracted from the tissue was used for a capture-based target sequence enrichment panel followed by Illumina next-generation sequencing and targeted bioinformatic analysis for oncogenic alterations within defined disease-associated target regions. No sequence variants in the BRAF gene were identified. Conclusions This rare case of gastric perineurioma helps solidify our understanding of how to discern various types of gastric neoplasms through traditional laboratory analysis alongside genetic sequencing approaches. Although extremely rare, gastric perineurioma should be kept in the differential diagnosis when assessing spindle cell gastric tumors to avoid unnecessary therapies, and physicians should understand the molecular characteristics of benign versus malignant tumors.
New insights in the pathogenic mechanism of multiple sclerosis: Is Epstein-Barr virus associated with optic nerve involvement?
Authors: Remolí-Sargues Lidia , Monferrer-Adsuara Clara , López-Salvador Belén , García-Villanueva Carolina , Gracia-García Alicia , Castro-Navarro Verónica , Cervera-Taulet Enrique 
Published: February 2024

Introduction There are no reports in the literature studying the possible relationship between Epstein-Barr virus (EBV) and optic nerve involvement in multiple sclerosis (MS). The aim of our study was to analyze the association between EBV antibodies titres and optical coherence tomography (OCT) and OCT angiography (OCTA) quantitative parameters Methods We conducted a retrospective study. The study included 98 eyes of 49 patients with MS. Years of MS duration, relapse count, history of optic neuritis (ON), and immunoglobulin (Ig) G antibodies to the EBV viral capsid antigen (VCA) were recorded from each patient. Also, OCT analysis (including retinal nerve fibre layer (RNFL) thickness and ganglion cell-inner plexiform layer (GCIPL) thickness) and OCTA analysis (including perfusion density (PD) and flux index (FI) of the radial peripapillary capillary plexus) were performed in each participant. Results No significant associations were observed between anti-EBV antibody levels and OCT or OCTA parameters ( p > 0,05). Correlation analysis between OCT and OCTA measurements showed a significant positive correlation between RNFL thickness and GCIPL thickness with peripapillary PD and FI ( p < 0,035). Subgroup analysis revealed a significant diminution of RNFL thickness, GCIPL thickness and peripapillary PD and FI ( p < 0,05) in the ON group. Conclusion We were unable to demonstrate a significant association between anti-EBV VCA IgG antibody titres and OCT or OCTA parameters. Nonetheless, further longitudinal studies are needed to explore the possible association of EBV with optic nerve involvement in MS.
Surgical complications: errors and adverse events
Authors: Giddins Grey 
Published: February 2024

Complications are a recognized hazard of surgery. The term is confusing; it has multiple meanings, including surgical error and adverse surgical outcomes. I propose the latter two terms are used. Grading of ‘complications’ is difficult but made easier by grading errors and outcomes separately, though they are not always linked. The exact grades are not established. Error avoidance requires efforts at a personal (surgeon) level, including training, learning and preparation, and at a systems level. Understanding human factors is important. The perspective of patients about adverse outcomes is not well understood. There is evidence that, unsurprisingly, patient perspectives may be different to surgeon perspectives. There are a range of surgeon responses to error and adverse outcomes; many are negative. These need to be understood better in order to protect patients and surgeons in the immediate aftermath and in the potentially prolonged ‘recovery time’, both for patients and surgeons. Level of evidence: V
Exploring Undergraduate Nursing Students’ Perceptions on Clinical Learning Environment in the UAE: A Focus on Perceived Benefits and Challenges
Authors: Maalouf Imad , El Zaatari Wafaa 
Published: February 2024

Introduction Establishing a supportive clinical environment is paramount for enhancing nursing students’ engagement in clinical practice, their clinical proficiencies, and satisfaction. The increase in nursing student enrollment at the Nursing College, driven by the collaborative efforts between Abu Dhabi Health Services Company (SEHA) and universities, has given rise to concerns regarding the quality of education and clinical instruction. These concerns are primarily due to the increased student-to-instructor ratio. Furthermore, the unsupportive clinical settings and learning tensions underscore the need to understand students’ learning experiences and address research gaps within the field of clinical learning in the United Arab Emirates (UAE). Objectives The purpose of this study is to investigate the undergraduate nursing students’ perceptions of their clinical learning environment, with a focus on perceived benefits and challenges. Methods This study used a cross-sectional survey design. The researchers administered a five-point Likert scale questionnaire, which had been adapted and contextualized, to a convenience sample of 217 third and fourth-year nursing students who willingly participated in this study. Results Despite the presence of positive aspects, such as diverse clinical experiences and strong support from both clinical instructors and peers, several challenges affect the students’ clinical learning. These challenges encompass disparate perceptions of supervision among staff nurses, learning tensions related to student academic workload, insufficient clinical supervision, and difficulties in finding assistance when needed. Conclusion There is a clear need to enhance the overall ward learning environment to optimize students’ academic motivation and clinical skills. Several measures can be taken to achieve this goal, including incentivizing and reducing the workload of staff nurses, investing in the professional development of clinical instructors, promoting peer interactions and group learning, and adopting a block pattern of education in years three and four for better clinical knowledge assimilation and reduced theoretical workload.
Biomarker analysis of the ASPEN study comparing zanubrutinib with ibrutinib for patients with Waldenström macroglobulinemia
Authors: Tam Constantine S. , Opat Stephen , D'Sa Shirley , Jurczak Wojciech , Lee Hui-Peng , Cull Gavin , Owen Roger G. , Marlton Paula , Wahlin Björn E. , García-Sanz Ramón , McCarthy Helen , Mulligan Stephen , Tedeschi Alessandra , Castillo Jorge J. , Czyż Jarosław , Fernández De Larrea Carlos , Belada David , Libby Edward , Matous Jeffrey , Motta Marina , Siddiqi Tanya , Tani Monica , Trněný Marek , Minnema Monique C. , Buske Christian , Leblond Véronique , Treon Steven P. , Trotman Judith , Wu Binghao , Yu Yiling , Shen Zhirong , Chan Wai Y. , Schneider Jingjing , Allewelt Heather , Cohen Aileen , Dimopoulos Meletios A. 
Published: February 2024

Abstract
The phase 3 ASPEN trial (NCT03053440) compared Bruton tyrosine kinase inhibitors (BTKis), zanubrutinib and ibrutinib, in patients with Waldenström macroglobulinemia (WM). Post-hoc biomarker analysis was performed using next-generation sequencing on pretreatment bone marrow samples from 98 patients treated with zanubrutinib and 92 patients treated with ibrutinib with mutated (MUT) MYD88 and 20 patients with wild-type (WT) MYD88 treated with zanubrutinib. Of 329 mutations in 52 genes, mutations in CXCR4 (25.7%), TP53 (24.8%), ARID1A (15.7%), and TERT (9.0%) were most common. TP53MUT, ARID1AMUT, and TERTMUT were associated with higher rates of CXCR4MUT (P &lt; .05). Patients with CXCR4MUT (frameshift or nonsense [NS] mutations) had lower very good partial response (VGPR) and complete response rates (CR; 17.0% vs 37.2%, P = .020) and longer time to response (11.1 vs 8.4 months) than patients with CXCR4WT treated with BTKis. CXCR4NS was associated with inferior progression-free survival (PFS; hazard ratio [HR], 3.39; P = .017) in patients treated with ibrutinib but not in those treated with zanubrutinib (HR, 0.67; P = .598), but VGPR + CR rates were similar between treatment groups (14.3% vs 15.4%). Compared with ibrutinib, patients with CXCR4NS treated with zanubrutinib had a favorable major response rate (MRR; 85.7% vs 53.8%; P = .09) and PFS (HR, 0.30; P = .093). In patients with TP53MUT, significantly lower MRRs were observed for patients treated with ibrutinib (63.6% vs 85.7%; P = .04) but not for those treated with zanubrutinib (80.8% vs 81.9%; P = .978). In TP53MUT, compared with ibrutinib, patients treated with zanubrutinib had higher VGPR and CR (34.6% vs 13.6%; P &lt; .05), numerically improved MRR (80.8% vs 63.6%; P = .11), and longer PFS (not reached vs 44.2 months; HR, 0.66; P = .37). Collectively, patients with WM with CXCR4MUT or TP53MUT had worse prognosis compared with patients with WT alleles, and zanubrutinib led to better clinical outcomes.