bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-60 LATE-ONSET THYROID EYE DISEASE IN A PATIENT WITH MULTIPLE COMORBIDITIES: A CASE REPORT
Authors: Abd Al Razq Zaid Qahtan , Khudhair Mahmood Shakir 
Published: January 2025

Abstract

Introduction
Thyroid eye disease (TED )is an autoimmune condition that affects the orbit around the eye, leading to inflammation and tissue remodeling. It is commonly associated with Graves’ disease but can also occur in other thyroid disorders. TED typically manifests within a few years of thyroid dysfunction, but late-onset cases, especially decades after thyroidectomy, is rare. This case report highlights a unique presentation of TED 34 years post-thyroidectomy in a patient with multiple comorbidities, including hypertension, type 2 diabetes mellitus, ischemic heart disease, and atrial fibrillation.

Clinical Case
A 75 years female with Hypertension, Type 2 Diabetes Mellitus, Ischemic Heart Disease & Atrial Fibrillation
Total Thyroidectomy: Performed in 1989 due to hyperthyroid disease, with no history of radioactive iodine ablation.
Presenting Symptoms:Red and gritty eyes, first presented in June 2023.
Clinical Findings:Orbital Examination: the patient was diagnosed with mild active thyroid eye disease.Neck Ultrasound: Showed very small residual thyroid tissue.TSH Receptor Antibody Test: Modestly elevated levels.Ophthalmologist consultation: prove the diagnosis of TED.
Laboratory Investigations:HbA1c: 9.1%Random Blood Glucose: 243 mg/dLTSH: 26 mIU/L
Medications:Thyroxine: 100 micrograms per daySitagliptin/metformin: 50/1000 mg twice dailyDigoxin: 0.25 mg dailyWarfarin: 3 mg dailyValsartan/HCT: 160/12.5 mg
Initial Management:Advised strict compliance with thyroxine therapy to normalize TSH levels.Added basal insulin and adjusted oral anti-diabetic therapy for tighter diabetes control.Recommended the use of artificial tears to keep eyes well-lubricated.Prescribed selenium supplementation.Referred to ophthalmologist for further evaluation.
Follow-Up:2 Months: HbA1c improved to 8.1%, TSH decreased to 8 mIU/L, and blood pressure and cardiac arrhythmia were well controlled. Bilateral orbital examination showed significant improvement.6 Months: The condition progressed to mild inactive thyroid-associated eye disease. TSH receptor antibodies were just above normal, and TSH normalized to 2.1 mIU/L.

Conclusion
This case illustrates the potential for TED to manifest many years after thyroidectomy, particularly in the presence of comorbid conditions. The patient’s non-compliance with thyroxine therapy and poorly controlled diabetes likely contributed to the exacerbation of her symptoms. The modestly elevated TSH receptor antibody levels and the presence of residual thyroid tissue further support the autoimmune activity.
This case underscores the importance of long-term monitoring and comprehensive management of thyroid and associated conditions.
While maintaining a euthyroid state is crucial for controlling thyroid eye disease, the impact of managing other comorbidities on TED control remains an area for further research.Figure 1:Thyroid Eye disease.
P-68 A CHALLENGING CASE OF HYPOTHYROIDISM
Authors: Omer Buzaid Najat 
Published: January 2025

Abstract

Introduction
Hypothyroidism is a common disease. L thyroxine once reached the stomach, undergoes disintegration and dissolution, and the active ingredient must reach the actual site of absorption. Disintegration is highly affected by the type of the formulation, the fasted or fed state, the gastric residence time, and the gastric motor function. The dissolution process consists of the release of solute molecules from the solid phase to the liquid one. Gastric juice pH. food, drugs and H pylori can affect L thyroxine absorption.

Clinical Case
IAA; A 54 y old female patient, known case of follicular thyroid carcinoma (FTC) since 2013, managed with total thyroidectomy, multiple radioactive iodine doses due to residual tissue. Post operative hypocalcemia that was resolved within a year. She was doing well on L- thyroxine suppressive dose of 200mcg/d. In 2018; she was operated for breast carcinoma, received chemotherapy and tamoxifen tablets. She was doing well on L thyroxine suppressive dose 250 mcg/d taken one hour before breakfast on an empty stomach, and was in complete remission regarding FTC. She lost to follow up for nearly one year. Her investigations: TSH= 39.7 mu/l, FT4= 6 (normal= 6.5-22 pmol/l), hemoglobin= 10.7 g/dl, calcium 8.7 mg/dl (normal= 8.4-10.5mg/dl not on calcium tab), celiac and H pylori serological screening were negative. TSH after 3 months =12.8 mu/l, She denied non compliance, Dose of L- thyroxine increased and gluten free diet was tried and did not work, dose increased to 400mcg/d. She was lost to follow up and came after one year,TSH =80 mu/l. L-thyroxine absorption test was performed; and L thyroxine mal-absorption was confirmed. She was advised to crush L-thyroxine 400 mcg/day and take it with water. TSH after two months was =13, free T4 =14 (normal=6.5-22 pmol/l). Gastroscopy showed pan moderate edematous gastritis and moderate erosive duodenitis. Duodenal biopsy showed chronic inflammation, negative celiac disease or malignancy.

Conclusion
Thyroid hormone is important for growth of intestinal mucosa. Selective L thyroxine malabsorption in the present case could be related to poor drug compliance and chronically uncontrolled thyroid status lead to intestinal edema and malabsorption. The other explanation was that gastritis caused inability of the stomach to properly dissolve tablet preparations to yield the active ingredient. The good response to crushed L thyroxine, which was a method of giving the drug to infants, suggested L thyroxine malabsorption problem started from the stomach.
Perceived Stress During Late Pregnancy and Infant Body Composition at 1 Month
Authors: Yang Xiaoran , Eckel Sandrah P , Maldonado Luis E , Yang Tingyu , Chen Xinci , Vigil Mario , Toledo-Corral Claudia M , Dunton Genevieve F , Grubbs Brendan H , Al-Marayati Laila , Lerner Deborah , Lurvey Nathana , Habre Rima , Farzan Shohreh F , Bastain Theresa M , Breton Carrie 
Published: January 2025

Abstract

Context
Worldwide, obesity remains one of the most challenging crises with children being one of the most susceptible populations. The effect of maternal stress during pregnancy on newborn body composition, measured by fat mass and lean mass has, not been extensively studied.

Objectives
We evaluated the association between perceived stress during late pregnancy and infant adiposity at 1 month and assessed effect modification by infant sex and preterm birth.

Methods
Mother-infant dyads (N = 138) were included from the ongoing MADRES cohort. Maternal perceived stress during late pregnancy was measured by the 10-item Perceived Stress Scale (PSS), as a cumulative score, during the third trimester. Infant adiposity measures, collected at 1 month by EchoMRI, included weight, fat mass (FM), and lean mass with FM-related ratios derived. Multivariable linear regression models with interaction terms were performed.

Results
Most mothers reported low to moderate stress (mean ± SD PSS: 13.2 ± 5.6) during late pregnancy. A 1-SD higher PSS was associated with higher FM% (FM (g)/weight (g): β = 0.78%; 95% CI, 0.13-1.44) but we did not find significant associations for the other adiposity measures. Statistically significant effects of perceived stress on FM-related measures were observed in male infants and preterm infants (both P for interaction &lt;.05) but were null among female infants or term infants.

Conclusion
In this predominately low-income Hispanic population, perceived stress during late pregnancy was associated with higher FM-related body composition measures during early infancy; this association was stronger among male and preterm infants compared to the overall population and other subgroups.
The Impact of Digitization on Print Book Sales: Analysis Using Genre Exposure Heterogeneity
Authors: Sharma Siddhartha , Telang Rahul , Zentner Alejandro 
Published: January 2025

Problem definition: The rise of digital channels has led to significant media market transformations. This paper studies whether and how digitization, sparked by the launch of Amazon Kindle in late 2007, affected print book sales. Methodology/results: To estimate the impact, we exploit the quasiexperimental variation in the popularity of digital books across different genres or subgenres. We employ difference-in-differences and other identification strategies, and we use print sales data on a large representative sample of book titles published in the United States from 2004 to 2015 across a variety of genres. Using various empirical specifications, we find that digitization significantly reduced print sales of adult fiction (the most popular genre in the e-book format) while having a much smaller impact on adult nonfiction and juvenile fiction. We further find that the effect for adult fiction is higher after the launch of the iPad (in 2010) and stronger for smaller publishers, the paperback version, and low-selling books. Managerial implications: Our findings provide book publishers with key inputs for optimal pricing and release strategies of different book formats. Our study also extends the vast yet growing academic literature on the impact of digital distribution channels on existing sales channels and can inform the policy debate concerning third-party digitization and its effect on physical sales. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0594 .
Use of a next-generation multilayered foam dressing in hard-to-heal wounds: a prospective, multicentre study
Authors: Ranire-Maguire Marisa , Caprioli Russell , Taylor Cristin , Rodger Rebecca , Thomas Andrew , Oropallo Alisha 
Published: January 2025

Objective: Hard-to-heal wounds present a significant healthcare challenge due to their complex aetiology, impact on quality of life (QoL) and consequent economic burden. The aim of this study was to assess the usability, safety and performance of a next-generation, multilayered foam dressing, ConvaFoam (Convatec Ltd., UK), in the management of indicated hard-to-heal wounds. Method: In this prospective, multicentre, interventional, non-comparator, open-label study, wounds included venous leg ulcers, arterial leg ulcers, diabetic foot ulcers and pressure injuries. The primary endpoint was percentage change in wound area at four weeks. Additional endpoints included percentage change in wound area at 12 weeks, satisfactory clinical progress (defined as ≥40% reduction in study wound area at four weeks), complete wound closure, adverse events, pain, QoL and health professional usability outcomes. Results: A total of 90 patients (109 wounds) were included in the full analysis set. The median percentage reduction in wound area from baseline was 47.88% (p<0.0001) at week 4 and 93.75% (p<0.0001) at week 12. Satisfactory clinical progress at four weeks was reported for 61 (55.96%) wounds. Complete wound closure by week 12 was observed in 43 (39.45%) wounds (p<0.0001). The median Wound Quality of Life-14 score improved from 55.36 at baseline, to 80.36 at week 12. Of the 2935 dressing applications, there were only two adverse events which were reported to be related to the study dressings. The majority of health professionals rated ease of application, exudate management, ease of removal and conformity as excellent. Conclusion: The ConvaFoam dressings were shown to be effective at reducing wound size and promoting healing in indicated hard-to-heal wounds, particularly diabetic foot and venous ulcers.
“Noisy Pleasures” and “Noisy Evil[s]”: The Political Dimensions of Sound in Jane Austen’s Mansfield Park
Authors: Bolger Elizabeth 
Published: January 2025

Abstract: In this essay, I demonstrate how Jane Austen uses sound (chatter, commotion, and silence) in Mansfield Park (1814) to create a conservative soundscape, one that associates reticence with the elite and noise with the lower classes. At the same time, I argue that Austen creates this soundscape only to break down its hierarchical assumptions about class. By considering her depiction of sound in relation to other eighteenth-century texts that discuss the politics of sound—Edmund Burke and Mary Wollstonecraft’s texts on the French Revolution, as well as Thomas Clarkson and Samuel Johnson’s texts on slavery—I delineate the implications of who and what makes noise in Mansfield Park . Following Wollstonecraft’s lead, Austen suggests that the supposedly silent elite may refrain from speech when they are confronted with humanitarian topics but that they are often noisy and loud in order to promote their own selfish desires and interests. This behavior points not only to a hypocrisy among the elite, who claim to appreciate silence when they in fact produce their own noise, but also to their immorality, as they willfully suppress others in pursuit of their own gain.
Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria
Authors: Salem-Bango Lindsay , OKeeffe Jennifer , Desjardins Michael R. , Lantagne Daniele , Altare Chiara , Kaur Gurpreet , Rangaiya Kanaganathan , Obroh Patricia Oke-Oghene , Audu Ahmadu , Solomon Chimda Emmanuel , Heath Thomas , Ihemezue Emmanuel Emeka , Aye Solomon , Lecuyot Baptiste , Sikder Mustafa , Doocy Shannon , Xiao Melody , Spiegel Paul B. 
Published: January 2025

Background
Cholera outbreaks are surging worldwide. Growing research supports case-area targeted interventions (CATIs), whereby teams provide a package of interventions to case and neighboring households, as an effective strategy in cholera outbreak control, particularly in humanitarian settings. While research exists on individual CATI interventions, research gaps exist on outcomes of integrated interventions during CATI responses.

Methodology/Principal findings
We conducted a prospective observational cohort study on CATIs during the 2021 cholera outbreak in Northeast Nigeria. During CATI response in Borno, Adamawa, and Yobe, research enumerators accompanied CATI teams to households and observed interventions (including provision of soap, Aquatabs, educational materials, and jerrycans; latrine and bedding disinfection; and hygiene promotion) and collected data on demographics, existing household water, sanitation, and hygiene, and household water free chlorine residual (FCR). Enumerators returned to households 10–14 days later to conduct follow-up surveys. We tested differences in reported delivery and receipt of interventions, and household drinking water FCR concentrations before and after CATIs. We also analyzed the associated relationship between CATI and environmental factors and odds of FCR <0.2 mg/L using quasi-Poisson multivariate logistic regression models with generalized estimating equations (GEE). We found household drinking water FCR significantly increased (p<0.001) post-CATI in Adamawa state. Self-reported receipt of Aquatabs and handwashing station availability were significantly associated with reduced odds of FCR <0.2 mg/L at follow-up. Self-reported receipt of hygiene promotion lacked significant associations with FCR in both Adamawa and Borno. These associations varied by type of water source.

Conclusions/Significance
These findings suggest that CATIs improved household drinking water FCR, a key protective measure against cholera, in Northeast Nigeria. Our research highlights factors associated with FCR concentrations <0.2 mg/L post-CATI in Adamawa and Borno, offering valuable insights for response planning, and overall supports the continued use of CATIs in humanitarian settings.
“I just felt that everything came tumbling down around me”—Barriers in cancer care for patients with severe mental illness: A qualitative study
Authors: Vendelsøe Astrid Næraa Høeg , Stie Mette , Hjorth Peter , Søndergaard Jens , Hansen Dorte Gilså , Jensen Lars Henrik 
Published: January 2025

Background
Patients with severe mental illness experience serious inequity when facing cancer treatment. They are less likely to be referred for cancer treatment following recommended guidelines and have poorer cancer survival than patients without mental illness. Relevant specialties such as psychiatry and general practice are rarely involved, and the patient perspective is rarely represented in research in the field. The present study investigated how patients with severe mental illness experience barriers to and facilitators of patient-centred cancer treatment and care.

Methods
In this qualitative case study, field observations, semi-structured interviews, and patient file analysis were performed with five patients with cancer in an adult psychiatric setting, included through purposeful sampling.

Results
Our analysis showed one major theme, “Complexity on many levels”, and four subthemes: “How the mental illness is affected by the cancer trajectory”, “The complexity of patient vulnerability”, “Fragmented healthcare system and lack of structure”, and “The role of the relationship between patient and health professional.” Barriers included the cancer trajectory leading to severe worsening of the mental illness, as well as fragmentation of the healthcare system and a lack of a systematic approach to the patient group. Facilitators included the health professionals acknowledging the patient’s own resources and approaching the patient as a person rather than a disease.

Conclusion
This study highlights critical focal points to improve care for patients with cancer who also struggle with severe mental illness. By addressing these target areas, healthcare providers can better tailor their approach to meet the unique needs of this population.
Genomic characteristics and molecular epidemiology of MRSA from medical centers in Mexico: Results from the Invifar network
Authors: Echaniz-Avilés Gabriela , Núñez-García Luis Ángel , Rodríguez-Noriega Eduardo , Velázquez-Acosta Consuelo , López-Jácome Luis Esaú , López-Gutiérrez Eduardo , Pérez-Vicelis Talia , Torres-Báez Cristina , Garza-Ramos Ulises , Rodríguez-Medina Nadia , Barajas-Magallón Juan Manuel , Vázquez-Larios Rosario , Silva-Gamiño Aldo Rafael , Franco-Cendejas Rafael , Gómez-Quiroz Adolfo , Garza-González Elvira 
Published: January 2025

Introduction
The methicillin-resistant Staphylococcus aureus (MRSA) genome varies by geographical location. This study aims to determine the genomic characteristics of MRSA using whole-genome sequencing (WGS) data from medical centers in Mexico and to explore the associations between antimicrobial resistance genes and virulence factors.

Methods
This study included 27 clinical isolates collected from sterile sites at eight centers in Mexico in 2022 and 2023. Antibiotic susceptibility testing was performed using VITEK 2. In addition, WGS was performed using a NovaSeq platform, and a bioinformatic analysis was conducted using several tools.

Results
In this study, 21 strains were CC5, five were CC8, and one was CC93. Moreover, six strains were identified as ST5(CC5)-MRSA-IIa- t895, four strains were found to be ST1011(CC5)-MRSA-IIa-t895, five strains were found to be ST1011(CC5)-MRSA-IIa-t9364, one strain was found to be ST1011(CC5)-MRSA-IIa-t8116, another was found to be ST1011(CC5)-MRSA-IIa-t62, three were found to be ST8(CC8)-MRSA-IVa-t8, one strain was ST5(CC5)-MRSA-IVa-t2, one strain was as ST93(CC93)-MRSA-IVa-t3949, two strains were ST9003(CC8)-MRSA-IVa-t18492, and three strains were ST9034(CC5)-MRSA-V-t2. All SCCmec IIa strains showed resistance to levofloxacin and ciprofloxacin, and all but two strains were resistant to clindamycin. Among the strains that harbored the type IIa cassette, most had the aadD, blaZ, and ermA_SDS genes and the erm A gene. Multiple genes for adhesion, enzymes, immune evasion, and secretion system were detected, regardless of SCCmec type. Of the SCCmec IVa strains, most harbored the Panton-Valentine leukocidin encoding genes.

Conclusion
In this study, the most frequently detected CC was CC5, followed by CC8, and CC93, and the most frequently detected MRSA ST was ST1011, followed by ST5. Most SCCmec elements were found to be type IIa, followed by type IVa. High MIC values were observed for ciprofloxacin, erythromycin, and clindamycin, particularly within SCCmec IIa. Of the SCCmec IVa strains, most harbored the lukS-PV and lukF-PV genes.
Extremizers of the Alexandrov–Fenchel inequality within a new class of convex bodies
Authors: Hug Daniel , Reichert Paul A. 
Published: January 2025

Abstract
Mixed volumes in n-dimensional Euclidean space are functionals of n-tuples consisting of convex bodies K, L, C
1, …, C

n–2. The Alexandrov–Fenchel inequalities are fundamental inequalities between mixed volumes of convex bodies, which cover as very special cases many important inequalities between basic geometric functionals. The problem of characterizing completely the equality cases in the Alexandrov–Fenchel inequality is wide open. Major recent progress was made by Yair Shenfeld and Ramon van Handel [25; 26], in particular they resolved the problem in the cases where K, L are general convex bodies and C
1, …, C

n–2 are polytopes, zonoids or smooth bodies (under some dimensional restriction).
We introduce the class of polyoids, which includes polytopes, zonoids and triangle bodies, and characterize polyoids by using generating measures. Based on this characterization and Shenfeld and van Handel's contribution, we extend their result to a class of convex bodies containing all polyoids and smooth bodies (under some dimensional restriction). Our result is stated in terms of the support of the mixed area measure of the unit ball B

n
and convex bodies C
1, …, C

n–2. A geometric description of this support is provided in the accompanying work [12].
Perturbation theory of asymptotic operators of contact instantons and pseudoholomorphic curves on symplectization
Authors: Kim Taesu , Oh Yong-Geun 
Published: January 2025

Abstract
In this paper, we first derive the covariant tensorial formula for the asymptotic operators of contact instantons w : Σ̇ → Q and of pseudoholomorphic curves u : (Σ̇, j) → (Q × ℝ, J͠) on the symplectization of a contact manifold (Q, λ). The formula is independent of the choice of connection on the nose and exhibits explicit dependence on the compatible pair (λ, J) of a given contact triad (Q, λ, J). Then based on this, we prove that all eigenvalues of the asymptotic operator are simple for a generic choice of compatible CR almost complex structure J for a given contact form λ. This perturbation theory has been missing in the study of pseudoholomorphic curves on symplectization.
Correlation of PM2.5 pollution and daily mortality rate of cardiovascular and cerebrovascular diseases in Northeast China through PM2.5 sources analysis
Authors: Hong Qianqi , Zhao Yang , Wang Jing , Sun Hongyan , Deng Lanxin , Cao Jingjing , Wang Cheng 
Published: January 2025

Abstract

Objective
This study aims to evaluate the relationship between PM2.5 concentration and daily mortality rate from cardiovascular and cerebrovascular diseases (CCVD) in cold regions of northern China, as well as to identify the primary sources of PM2.5.

Methods
A time series analysis model was used to calculate the exposure-response relationship between PM2.5 and CCVD mortality in Harbin. Positive matrix factorization (PMF) was employed to analyze the sources of PM2.5.

Results
After adjusting for multiple pollutant combinations, the maximum excess risk of cardio-cerebrovascular death on the day of PM2.5 exposure was 0.42% (95% CI: 0.15%-0.70%). Stratification by gender and age revealed that the elderly individuals and men were particularly susceptible to PM2.5 exposure. The source analysis identified seven major pollution sources contributing to PM2.5 in Harbin.

Conclusion
Our findings strengthen the evidence that PM2.5 is an independent risk factor for daily CCVD mortality, identify vulnerable populations that require special attention, and pinpoint the primary sources of PM2.5 in Harbin. These findings provide reference points for effectively reducing the health risks associated with PM2.5 exposure.