bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation on the physicochemical properties of poly (ethylene-co-vinyl acetate)/mesoporous silica nanocomposites: Effects of content and surface functionalization
Authors: Lasmi Sofiane , Zoukrami Fouzia , A Marcos Fernández Ángel 
Published: January 2024

In this study, poly (ethylene-co-vinyl acetate)/mesoporous silica EVA/SBA-15 nanocomposites, containing 0.5, 1.5, and 2.5 wt% of unfunctionalized and functionalized SBA-15 were prepared by melt blending in an internal mixer. Mesoporous silica was synthesized through the sol-gel method and modified by hexadecyltrimethoxysilane (HDTMS). Several characterizations were performed; including Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), mechanical properties, dynamic mechanical analysis (DMA), and dielectric study to characterize the physicochemical properties of elaborated materials. The results revealed the successful synthesis and functionalization of mesoporous silica, as confirmed by the FTIR and SEM. The crystallinity of the nanocomposites decreased and the elastic modulus increased with the incorporation of the mesoporous silica. Measurement of tensile properties shows that the tensile strength of the nanocomposite content of 1.5 wt% F-SBA-15 is 17.2% is higher as compared to pure EVA. DMA analysis validates the improvement in mechanical properties of the EVA/SBA-15 samples. SEM images displayed well-dispersed F-SBA-15 nanoparticles and enhanced interfacial adhesion between the phases. TGA indicates the enhancement of the thermal stability of nanocomposites as compared with the pure EVA matrix. The surface functionalization presented an approach to preparing nanocomposites with enhanced thermal stability and a low dielectric constant.
Effect of the timing of antiretroviral treatment initiation on CD4 count in children and youths living with HIV in North India
Authors: Singh Mukesh Vir , Sharma Sukesh , Shrivastava Anubha , Shukla Santosh Kumar , Siddiqui Shahid Akhtar , Maurya Manisha , Mishra Nandita , Yadav Rajesh Kumar 
Published: January 2024

Background Immediate start of antiretroviral treatment (ART) among non-hospitalized outpatient children living with HIV may improve or worsen clinical outcomes due to immune reconstitution. Objective Role of immediate versus post-stabilization start of antiretroviral treatment in children and youths living with HIV on CD4 count and viral load suppression. Methods This was a single blinded, randomized controlled trial conducted on outpatients attending a tertiary care hospital associated HIV clinic in North India. We enrolled ART-naive children and youths living with HIV aged 18 months to 21 years in a 1:1 ratio. Block randomization was done using computerized software. Children and youths living with HIV were either started with ART on diagnosis immediately within 24 h (Group A) or post stabilization at 2 weeks (Group B) as per National AIDS Control Organization (NACO) India guidelines. Both groups were comparable for baseline characteristics. Results There was no significant difference seen in CD4 counts between two groups at 6 months follow up. CD4 count increased significantly in immediate group but not in post-stabilization group at 6 months. No significant changes/differences was seen in WHO clinical staging or anthropometry; one patient developed tuberculosis in both groups. Viral load at 6 months in both the groups did not differ significantly. Conclusion Immediate ART in children and youths living with HIV results in significant increase in CD4 count at 6 months follow up exemplifying immunological response to ART.
The potential causal association between systemic lupus erythematosus and endocrine and metabolic disorders in the East Asian population: A bidirectional two-sample Mendelian randomization study
Authors: Wang Tingliang , Zhang Yun , Chen Xuelan , Huang Zhenxing , Liang Xinghuan , Qin Yingfen , Luo Zuojie 
Published: January 2024

Objectives Observational studies indicate a significant correlation between systemic lupus erythematosus (SLE) and endocrine and metabolic disorders, but the causal association between SLE and endocrine and metabolic disorders remains unclear due to the reverse causality and confounding biases commonly presented in conventional observational research. This study endeavors to uncover the causal association between SLE and three common endocrine and metabolic disorders, including Graves’ disease (GD), type 2 diabetes mellitus (T2DM), and osteoporosis (OP). Methods We used genome-wide association study data for SLE and three endocrine and metabolic disorders in an East Asian population, employing bidirectional two-sample Mendelian randomization (MR) analysis and sensitivity analysis to ascertain the causal association between SLE and endocrine and metabolic disorders. Results A multiplicative random-effect inverse-variance weighted approach revealed a significant positive correlation between SLE and an elevated risk of GD with an odds ratio (OR) of 1.12 (95% CI: 1.04–1.22, p < .01), and inverse-variance weighted (IVW) analysis also indicated that SLE increased the risk of OP with an OR of 1.035 (95% CI: 1.003–1.068, p < .05). Additionally, GD causally affected SLE in an IVW analysis after Bonferroni correction, with an OR of 1.33 (95% CI: 1.19–1.49, p < .05/3), but the application of multivariable MR analysis resulted in the absence of a causal association of GD on SLE (OR 1.047, 95% CI: 0.952–1.151, p > .05). Lastly, the robustness and validity of the findings were verified through a sensitivity analysis. Conclusions We confirmed that SLE has a causal effect on GD as well as OP, but no evidence exists to substantiate a causal link between SLE and T2DM. Our study offers valuable contributions for uncovering the etiology of SLE and endocrine and metabolic disorders and furthering disease risk research while providing potential targets for disease monitoring and therapeutic intervention.
Estimating Tax Evasion in the Medical Sector in Comparison with Other Human-to-human (Η2Η) Life Services
Authors: Stasinopoulos D. , Goula A. , Kastanioti C. , Sarris M. , Soulis S. 
Published: January 2024

This paper attempts to measure and report the extent and magnitude of tax evasion in the medical sector and to be compared with other selected human-to-human (Η2Η) life services in the Greek economy. Specific household expenditures for human (Η2Η) services for the period 2011–2017 were analysed, using data from the annual ‘Household Budget Survey (HBS)’ of the Hellenic Statistical Authority (ELSTAT) and were compared with the financial administrative data from the ‘Statistical Business Register (SBR)’, which is updated on an annual basis with data provided by the tax authority, depending on the case-specific characteristics of each sector under study that have been taken into account in the calculations. The research showed that the participation of doctors in the phenomenon of tax evasion as a whole has been declining in recent years while other human economic activities are responsible many times over for the perpetuation and exacerbation of the phenomenon. The annual tax evasion on average for the period 2011–2017, for the medical sector, is estimated to amount to €565.6 million (0.31% of the Greek GDP – mean value of the same period), while for the ‘accommodation services (hotels)’ sector, it is estimated to €3.3 billion (1.84% of GDP), to €6.8 billion for the catering sector (3.76% of GDP), to €2.1 billion for the education sector (1.18% of GDP), to €87.3 million for the hairdressing/other beauty treatment services of the personal service sector and finally to €50.3 million for the funeral and related services sector.
Management of Velopharyngeal Dysfunction (VPD) Following Cleft Palate Repair: A Comprehensive Decision-Making Process Based on Severity and Structural Deficiencies
Authors: Hussain Syed Altaf , Vijayakumar Charanya , Balasubramanian Subramaniyan , Rahavi-Ezabadi Sara , Sundar Vishnu , Sybil Deborah , Hussain Zaid 
Published: January 2024

Objective To describe a comprehensive decision-making process for surgical correction of structural Velopharyngeal Dysfunction (VPD) following cleft palate repair and evaluate its efficacy. Design Retrospective study. Setting Tertiary care hospital. Patients 300 consecutive patients with unilateral or bilateral cleft lip and palate (CLP) or isolated cleft palate (CP) diagnosed with clinical VPD following cleft palate repair between 2009 and 2014. Of these 206 patients had structural VPD and underwent surgical correction. Interventions Surgical corrections were carried out according to the comprehensive two stage decision making process developed by the investigators. Step 1 of decision-making involved visualisation of the VP sphincter function by nasoendoscopy. This was followed by step 2 which involved per-operative identification of scarring, tissue loss, hypoplasia and other structural deficiencies in the soft palate and septal mucoperiosteum. The choice of operation was then made from a repertoire of interrelated and escalating surgical procedures consisting of palate revision and pharyngoplasties ranging from most anatomical to the least. Main outcome measures Evidence of postoperative restoration of VP function on nasoendoscopy, evaluation of speech for hypernasality, understandability, acceptability and symptoms of obstructive sleep apnea. Results Complete VP closure was demonstrated in 94% of patients treated using this algorithm. There was significant improvement in all speech parameters (p < 0.00001). Conclusion Our comprehensive decision-making process is designed to effectively correct structural VPD according to the severity of structural and functional deficiencies in the soft palate and avoid over treatment.
Prevalence of Diverse Genders and Sexualities in Australia and Associations With Five Forms of Child Maltreatment and Multi-type Maltreatment
Authors: Higgins Daryl J. , Lawrence David , Haslam Divna M. , Mathews Ben , Malacova Eva , Erskine Holly E. , Finkelhor David , Pacella Rosana , Meinck Franziska , Thomas Hannah J. , Scott James G. 
Published: January 2024

This study presents the most comprehensive national prevalence estimates of diverse gender and sexuality identities in Australians, and the associations with five separate types of child maltreatment and their overlap (multi-type maltreatment). Using Australian Child Maltreatment Study (ACMS) data ( N = 8503), 9.5% of participants identified with a diverse sexuality and .9% with a diverse gender. Diverse identities were more prevalent in the youth cohort, with 17.7% of 16–24 years olds identifying with a diverse sexuality and 2.3% with a diverse gender. Gender and sexuality diversity also intersect – for example, with women (aged 16–24 and 25–44) more likely than men to identify as bisexual. The prevalence of physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence was very high for those with diverse sexuality and/or gender identities. Maltreatment was most prevalent for participants in the youth cohort with diverse gender identities (90.5% experiencing some form of child maltreatment; 77% multi-type maltreatment) or diverse sexualities (85.3% reporting any child maltreatment; 64.3% multi-type maltreatment). The strong association found between child maltreatment and diverse sexuality and gender identities is critical for understanding the social and mental health vulnerabilities of these groups, and informing services needed to support them.
Criteria and Indicators for Centers of Clinical Excellence in Stroke Recovery and Rehabilitation: A Global Consensus Facilitated by ISRRA
Authors: Stockley Rachel C. , Walker Marion F. , Alt Murphy Margit , Azah Abd Aziz Noor , Amooba Philemon , Churliov Leonid , Farrin Amanda , Fini Natalie A. , Ghaziani Emma , Godecke Erin , Gutierrez-Panchana Tania , Jia Jie , Kandasamy Thoshenthri , Lindsay Patrice , Solomon John , Thijs Vincent , Tindall Tierney , Tippett Donna C. , Watkins Caroline , Lynch Elizabeth 
Published: January 2024

Background The aim of the International Stroke Recovery and Rehabilitation Alliance is to create a world where worldwide collaboration brings major breakthroughs for the millions of people living with stroke. A key pillar of this work is to define globally relevant criteria for centers that aspire to deliver excellent clinical rehabilitation and generate exceptional outcomes for patients. Objectives This paper presents consensus work conducted with an international group of expert stroke recovery and rehabilitation researchers, clinicians, and people living with stroke to identify and define criteria and measurable indicators for Centers of Clinical Excellence (CoCE) in stroke recovery and rehabilitation. These were intentionally developed to be ambitious and internationally relevant, regardless of a country’s development or income status, to drive global improvement in stroke services. Methods Criteria and specific measurable indicators for CoCE were collaboratively developed by an international panel of stroke recovery and rehabilitation experts from 10 countries and consumer groups from 5 countries. Results The criteria and associated indicators, ranked in order of importance, focused upon (i) optimal outcome, (ii) research culture, (iii) working collaboratively with people living with stroke, (iv) knowledge exchange, (v) leadership, (vi) education, and (vii) advocacy. Work is currently underway to user-test the criteria and indicators in 14 rehabilitation centers in 10 different countries. Conclusions We anticipate that use of the criteria and indicators could support individual organizations to further develop their services and, more widely, provide a mechanism by which clinical excellence can be articulated and shared to generate global improvements in stroke care.
The incidence, trends, and costs of treatment of femoral shaft fractures among Finnish children aged 2–12 years between 1998 and 2016
Authors: Laitakari Elina , Koukkula Topias , Huttunen Tuomas T , Mattila Ville M , Salonen Anne 
Published: January 2024

Purpose: The purpose of this study was to determine the incidence and trends of both hip spica casting and elastic stable intramedullary nailing in children aged 2–12 years who sustained femoral diaphyseal fracture between 1998 and 2016 in Finland. We also evaluated the actual hospital costs of both treatment methods as well as calculating the length of hospital stay. Methods: This study included all 2- to 12-year-old children with femoral diaphyseal fracture who were treated in Finland between 1998 and 2016. Data were collected from the National Hospital Discharge Register of Finland. Children were classified by age into five groups. The annual incidences per 100,000 persons were calculated using annual mid-year population census data obtained from Statistics Finland. Data on the annual actual daily hospital costs were collected from the Finnish Institute for Health and Welfare. Results: In total, 1064 patients aged 2–12 years who had sustained femoral diaphyseal fracture were treated with elastic stable intramedullary nailing or hip spica casting between 1998 and 2016. In children aged 4–5 years, the incidence of elastic stable intramedullary nailing increased during the study period from 5.4 per 100,000 persons in 1998 to 8.1 per 100,000 persons in 2016. Conclusions: The length of hospitalization in patients treated with elastic stable intramedullary nailing was shorter and, therefore, the total costs of hospital treatment were lower than in those children treated with hip spica cast. Level of evidence: level III.
Perception of In-Person Prerounding Amongst Neurology Residents Across Two Academic Centers
Authors: Chen Amalie , Prasad Sashank , Bowley Michael , Krupat Edward , Galetta Kristin 
Published: January 2024

Background and Purpose In-person prerounding has long been a routine practice for residents in the field of neurology. However, with the emergence of the COVID-19 pandemic, many institutions, including our two academic neurology centers, have shifted to computer rounding. This study aims to assess the effects of computer rounding alone compared to a combination of computer rounding and in-person prerounding from the perspective of neurology residents. Methods A mixed-methods approach was employed, including a survey administered to 79 neurology residents and a qualitative thematic analysis of their responses. Results The quantitative analysis revealed that residents who engaged in inperson prerounding spent significantly more time on prerounding and computer rounding compared to those who did not. The majority of residents reported a neutral effect of in-person prerounding on their relationship with patients and bedside time, but a significant impact on personal lives and other tasks. Qualitative analysis identified four key themes: accessibility to team members, learning opportunities gained and lost, inefficiency, and sleep disturbance. Conclusions Overall, residents perceived in-person prerounding as inefficient and causing sleep disruption for both patients and themselves. While some residents valued the face-to-face interaction and improved accessibility, others felt that computer rounding allowed for thorough review of patient data, improving preparedness and efficiency. The potential elimination of in-person prerounding from residents' routines may enhance their overall wellbeing. Further research is needed to assess the advantages and drawbacks of removing this classic approach to caring for patients from the perspective of residents, attendings and patients.
Computed Tomography Scans and Fixation Rates for Trimalleolar Ankle Fractures Over 10 Years at a Level 1 Trauma Center
Authors: Kocan Joseph , Joseph Elias , Mercado Paul , Haider Mohammad N. , Pavlesen Sonja , Rohrbacher Bernard 
Published: January 2024

Background: The posterior malleolus component of the trimalleolar ankle fracture has posed a controversial topic for diagnostic imaging and surgical management. Preoperative computed tomography (CT) scans are used to better appreciate fracture morphology and may affect management techniques. No prior study has investigated the trend in preoperative CT scan use and the rates of posterior and syndesmotic fixation for trimalleolar injuries. Methods: This retrospective cohort study evaluated the use of preoperative CT scans and the rates of posterior and syndesmotic fixation for trimalleolar ankle fractures over a 10-year period at an adult level 1 trauma center. Patients surgically managed for ankle fractures with OTA/AO classifications of 44B3, 44C3.3, 44C1.3, 44C2.3, and 44A3 were identified and included using Current Procedural Terminology codes and a prospectively collected fracture registry. Demographic information, comorbidities, fixation methods, and use of preoperative CT scan were recorded. Comparative analyses were performed to assess for yearly differences in demographic characteristics along with changes in trends of preoperative CT scans and posterior and syndesmotic fixation. Results: A total of 1191 patients were included in the analyses. OTA/AO 44B3.2 fractures were the most common injuries (yearly range of 59.4%-80.1%). The rate of posterior fixation did not significantly increase during the study interval (1.4% growth per year [95% CI −0.27, 3.07]). However, the rate of preoperative CT scan use significantly increased by 2.76% (95% CI 1.99, 3.52) per year and the rate of syndesmotic fixation increased by 2.58% (95% CI 1.17, 3.99) per year. Fixation methods for both the syndesmosis and posterior malleolus changed during the study timeline. Conclusion: Despite a relatively stable rate of posterior fixation, the frequency of preoperative CT scans and use of syndesmotic fixation increased significantly over a 10-year study period. Level of Evidence: Level IV, descriptive pilot study.
Unraveling cervical cancer screening dilemmas: histopathological insights from VIA and LEEP at bugando medical centre, Mwanza
Authors: Kaizilege Godfrey K. , Ndaboine Edgar , Chuma Clotilda , Mujuni Fridolin , Kiritta Richard , Matovelo Dismas , Ottoman Oscar , Elias Edrick , Masalu Nestory , Kidenya Benson R. , Mazigo Humphrey D. 
Published: January 2024

Abstract
Background
The single-visit strategy, also known as the “screen-and-treat” approach, is widely used to screen for cervical cancer in low- and middle-income countries. The screen-and-treat approach leads to unnecessary or inadequate treatment. Thus, a study was conducted to determine the histopathological patterns of aceto-white lesions on visual inspection with acetic acid (VIA) in patients who underwent a Loop Electrosurgical Excision Procedure (LEEP) at Bugando Medical Centre between January 2016 and December 2020.

Method
A 5-year retrospective cross-sectional case record review was conducted on 329 women who had LEEP at Bugando Medical Centre following a positive VIA cervical screening test. A standard data abstraction form was used to collect patient information. Missing client information records and LEEP without histopathological results were exclusion criteria. For statistical analysis, STATA version 15 was used; in descriptive statistics, frequency, mean, and standard deviation were used. The Chi2 and Fisher’s exact tests were used to investigate the relationship between patient characteristics and histopathological patterns, and a P-value of 0.05 was considered statistically significant in multinomial models.

Results
This study looked at 329 patients who had LEEP following a VIA positive but were not eligible for cryotherapy. Our study participants had a mean age of 40 ± 8.2 SD. There were 203 (61.7%) patients with benign lesions, including 4 with schistosomiasis and 2 with cervical tuberculosis. The precancerous lesions were discovered in 100 cases (30.4%), and 26 (7.9%) already had invasive cervical cancer. Out of 100 patients with precancerous lesions, 58 (17.6%) and 42 (12.8%) have high- and low-grade squamous intraepithelial (HSIL and LSIL) lesions, respectively. The presence of a precancerous lesion was found to be associated with age 31–40 years (P-value 0.042) and HIV positivity (P-value 0.004).

Conclusion
Most patients in this study had benign cervical lesions, which do not require LEEP treatment. Nonetheless, a considerable percentage of invasive cervical malignancies and rare benign diseases such as schistosomiasis and cervical tuberculosis were identified. A screen-and-treat approach within well-equipped tertiary hospitals like Bugando Medical Centre should explore alternative options instead of relying solely on straight LEEP.