bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser photocoagulation of a hypofluorescent perifoveal exudative vascular anomalous complex/capillary macroaneurysm
Authors: Sagar Pradeep , Sahare Harshal , Shanmugam P Mahesh , Biswal Suchitra , Ravishankar H N 
Published: December 2022

Purpose To report successful treatment of a hypofluorescent perifoveal exudative vascular anomalous complex (PEVAC)/capillary macroaneurysm. Case description A 63 year old healthy gentleman had a perifoveal isolated aneurysmal lesion with white rim. Optical coherence tomography (OCT) showed cystoid macular edema (CME) with neurosensory detachment. The aneurysmal lesion was seen in the inner retina as a hyperreflective intraretinal structure with a heterogenous lumen suggestive of PEVAC/capillary macroaneurysm. OCT angiography showed a capillary loop and a slightly hyperreflective lesion at the tip of the loop in the superficial capillary plexus slab. Minimal reduction in edema was noted following one dose of intravitreal triamcinolone (2 mg). Fundus fluorescein angiography performed at 6 weeks demonstrated the capillary loop, but the aneurysmal lesion remained hypofluorescent with no definite leak in the late phase. Few perifoveal microaneurysms were seen in both the eyes. Six weeks later, focal laser photocoagulation of the aneurysmal lesion was performed, which resulted in complete resolution of macular edema at 1 month. There was no recurrence of macular edema till his recent follow up, which is 4 month post laser. Discussion PEVAC is typically described as unifocal lesion and is not associated with other retinal vascular abnormalities. But in this case, in addition to the lesion, perifoveal microaneurysms were seen in both the eyes. Despite the absence of leak on fundus fluorescein angiography, targeted focal laser photocoagulation resulted in complete resolution of macular edema at 1 month. Conclusion Laser photocoagulation would be helpful even in hypofluorescent PEVAC/capillary macroaneurysms.
Early return to activity of daily living after total hip arthroplasty: a systematic review and meta-analysis
Authors: Zampogna Biagio , Papalia Giuseppe Francesco , Parisi Francesco Rosario , Luciano Claudia , Gregori Pietro , Vorini Ferruccio , Marinozzi Andrea , Farsetti Pasquale , Papalia Rocco 
Published: December 2022

Background: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery. Aim: To evaluate the best approach for THA in terms of earlier return to activity. Method: Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients’ self-reported outcomes, ADL score and UCLA activity score with a short follow-up. Results: A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p  = 0.06 and p  = 0.10). The time to return to drive was similar among the 2 groups ( p  = 0.88). The return to work was faster with PA, but no statistical significance was reported ( p  = 0.47). Conclusions: Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA.
Vigabatrin-associated brain abnormalities on MRI in tuberous sclerosis complex patients with infantile spasms: are they preventable?
Authors: Wan Lin , He Wen , Wang Yang-Yang , Xu Yong , Lu Qian , Zhang Meng-Na , Wang Qiu-Hong , Dun Shuo , Liu Li-Ying , Shi Xiu-Yu , Wang Jing , Hu Lin-Yan , Zhang Bo , Yang Guang , Zou Li-Ping 
Published: December 2022

Background: Vigabatrin (VGB) is currently the most widely prescribed first-line medication for individuals with infantile spasms (IS) and especially for those with tuberous sclerosis complex (TSC), with demonstrated efficacy. Meanwhile, its adverse events, such as vigabatrin-associated brain abnormalities on magnetic resonance imaging (MRI; VABAM), have also been widely reported. Objectives: The objectives of this study were to observe the occurrences of VABAM in patients with IS caused by TSC (IST) and further explore the associated risk factors. Methods: Children with IS receiving VGB were recruited from our institution; clinical, imaging, and medication data were collected. Cerebral MRI was reviewed to determine the occurrence of VABAM. Group comparisons (IS caused by TSC and other etiologies) were performed; subgroup analyses on IST were also performed. Next, a retrospective cohort study of children taking VGB was conducted to explore risk/protective factors associated with VABAM. Results: The study enrolled 172 children with IS who received VGB. VABAM was observed in 38 patients (22.1%) with a peak dosage of 103.5 ± 26.7 mg/kg/day. Subsequent analysis found the incidence of VABAM was significantly lower in the 80 patients with IST than in the 92 patients with IS caused by other etiologies (10% versus 32.6%, p-value < 0.001). In subgroup analyses within the IST cohort, VABAM was significantly lower in children who received concomitant rapamycin therapy. Univariate and multivariate logistic regression analysis of the 172 IS children showed that treatment with rapamycin was the independent factor associated with a lower risk of VABAM; similar results were observed in the survival analysis. Conclusion: The incidence of VABAM was significantly lower in IST patients. Further research is needed to examine the mechanisms that underlie this phenomenon and to determine if treatment with rapamycin may reduce the risk of VABAM.
Predictive value of CAC score combined with clinical features for obstructive coronary heart disease on coronary computed tomography angiography: a machine learning method
Authors: Ren Yongkui , Li Yulin , Pan Weili , Yin Da , Du Jie 
Published: December 2022

Abstract
Objective
We investigated the predictive value of clinical factors combined with coronary artery calcium (CAC) score based on a machine learning method for obstructive coronary heart disease (CAD) on coronary computed tomography angiography (CCTA) in individuals with atypical chest pain.

Methods
The study included data from 1,906 individuals undergoing CCTA and CAC scanning because of atypical chest pain and without evidence for the previous CAD. A total of 63 variables including traditional cardiovascular risk factors, CAC score, laboratory results, and imaging parameters were used to build the Random forests (RF) model. Among all the participants, 70% were randomly selected to train the models on which fivefold cross-validation was done and the remaining 30% were regarded as a validation set. The prediction performance of the RF model was compared with two traditional logistic regression (LR) models.

Results
The incidence of obstructive CAD was 16.4%. The area under the receiver operator characteristic (ROC) for obstructive CAD of the RF model was 0.841 (95% CI 0.820–0.860), the CACS model was 0.746 (95% CI 0.722–0.769), and the clinical model was 0.810 (95% CI 0.788–0.831). The RF model was significantly superior to the other two models (p < 0.05). Furthermore, the calibration curve and Hosmer–Lemeshow test showed that the RF model had good classification performance (p = 0.556). CAC score, age, glucose, homocysteine, and neutrophil were the top five important variables in the RF model.

Conclusion
RF model was superior to the traditional models in the prediction of obstructive CAD. In clinical practice, the RF model may improve risk stratification and optimize individual management.
Amide proton transfer MRI differentiates between progressive multifocal leukoencephalopathy and malignant brain tumors: a pilot study
Authors: Koike Hirofumi , Morikawa Minoru , Ishimaru Hideki , Ideguchi Reiko , Uetani Masataka , Hiu Takeshi , Matsuo Takayuki , Miyoshi Mitsuharu 
Published: December 2022

Abstract
Background
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nerve system caused by the John Cunningham virus. On MRI, PML may sometimes appear similar to primary central nervous system lymphoma (PCNSL) and glioblastoma multiforme (GBM). The purpose of this pilot study was to evaluate the potential of amide proton transfer (APT) imaging for differentiating PML from PCNSL and GBM.

Methods
Patients with PML (n = 4; two men; mean age 52.3 ± 6.1 years), PCNSL (n = 7; four women; mean age 74.4 ± 5.8 years), or GBM (n = 11; 6 men; mean age 65.0 ± 15.2 years) who underwent APT-CEST MRI between January 2021 and September 2022 were retrospectively evaluated. Magnetization transfer ratio asymmetry (MTRasym) values were measured on APT imaging using a region of interest within the lesion. Receiver operating characteristics curve analysis was used to determine diagnostic cutoffs for MTRasym.

Results
The mean MTRasym values were 0.005 ± 0.005 in the PML group, 0.025 ± 0.005 in the PCNSL group, and 0.025 ± 0.009 in the GBM group. There were significant differences in MTRasym between PML and PCNSL (P = 0.023), and between PML and GBM (P = 0.015). For differentiating PML from PCNSL, an MTRasym threshold of 0.0165 gave diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of 100% (all). For differentiating PML from GBM, an MTRasym threshold of 0.015 gave diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 90.9%, 80.0%, and 100%, respectively.

Conclusion
MTRasym values obtained from APT imaging allowed patients with PML to be clearly discriminated from patients with PCNSL or GBM.
The impact of obesity on the accuracy of DXA BMD for DXA-equivalent BMD estimation
Authors: Kim Min-Woo , Lee Dong-Ha , Huh Jung-Wook , Bai Jang-Whan 
Published: December 2022

Abstract
Introduction
As the radiomics technique using texture features in CT is adopted for accessing DXA-equivalent bone mineral density (BMD), this study aims to compare BMD by DXA and predicted BMD to investigate the impact of obesity and central obesity in general patients.

Materials and methods
A total of 710 cases (621 patients) obtained from May 6, 2012, to June 30, 2021, were used in the study. We focused both their abdomen & pelvis CT’s first lumbar vertebrae axial cuts to predict estimated BMD and bone mineral content (BMC). In each patient’s CT, we extracted the largest trabecular region of the L1 vertebral body as a region of interest (ROI) using the gray-level co-occurrence matrices (GLCM) technique, and linear regression was applied to predict the indices. Cases were divided by central obesity/overall obesity and normal group by body mass index (BMI), waist circumference (WC), or index of central obesity (ICO) standard.

Results
The coefficients were all above 0.73, respectively. P-values from ICO were over 0.05 when the measures were Hip BMD and Hip BMC. In contrast, those from ICO were 0.0131 and 0.0351 when the measures were L1 BMD and L1 BMC, respectively, which show a difference between the two groups.

Conclusions
The CT HU texture analysis method was an effective and economical method for measuring estimated BMD and BMC and evaluating the impact of obesity. We found that central obesity especially exerted an effect on the disturbance of the clinical BMD measurements since groups were significantly different under the ICO standard.
Effect of predictors on incidence rate of pregnancy among reproductive age women on antiretroviral therapy at public hospitals of Jigjiga and Harar Towns, Eastern Ethiopia: a retrospective cohort study
Authors: Wariyo Abdi , Oljira Lemessa , Golicha Wako , Dirirsa Gebisa 
Published: December 2022

Abstract
Background
Globally, Human Immunodeficiency Virus (HIV) is the leading cause of death in women of reproductive age and accountable for a quarter of deaths during pregnancy in sub-Saharan Africa including Ethiopia. Introduction of antiretroviral therapy to women living with HIV highly improves lifestyle and the desire to have children. A comprehensive understanding of baseline predictors of pregnancy among women receiving ART essential to reduces unintended pregnancies, appropriate care, and preventing transmission from mother to child.

Objective
To determine the effect of baseline predictors on incidence rate of pregnancy among reproductive age women on antiretroviral therapy at public hospitals of Jigjiga and Harar town, Eastern Ethiopia from February 15 to march 15, 2020.

Methods
Retrospective cohort study was conducted on randomly selected 420 HIV-infected women using data recorded from September 11, 2014, to September 10, 2019 in Jigjiga and Harar town in Eastern Ethiopia. Simple random sampling was used to select study subjects from each hospital. Data were entered to Epi data version 3.2 and exported to Stata version 14.2 for analysis. Kaplan–Meier failure, and Cox proportional hazards model were used to estimate the incidence, and to identify predictors of pregnancy respectively. Variables which were significant (P value < 0.05) in the multivariate analysis were considered independent predictors of pregnancy.

Results
The overall incidence rate of pregnancy was 9.1 per 100 person-years (95% CI 7.19, 11.76). Being unadvanced HIV disease stage (AHR: 2.50; 95% CI 1.46, 4.19), having less than two children (AHR: 2.93; 95% CI 1.59, 5.40), and disclosed HIV status (AHR: 2.25; 95% CI 1.34, 3.79) were independent predictors of pregnancy.

Conclusion
The incidence rate of pregnancy among reproductive age women on ART was found to be considerable. Being unadvanced HIV disease stage, having less than two children, and disclosed HIV status were independent predictors of pregnancy. Thus, tailoring counseling have to be designed to enhance better pregnancy planning and consecutive health outcomes.
Cost-effectiveness analysis of dasatinib versus imatinib in pediatric philadelphia chromosome-positive acute lymphoblastic leukemia patients in China
Authors: Cao Wang , Yu Yuncui , Qiu Yingpeng , Liu Lu , Zhang Hao , Shi Liwei , Xiao Yue , Jia Lulu , Zhang Ruidong , Wang Xiaoling 
Published: December 2022

Abstract
Background
Dasatinib and imatinib are the recommended tyrosine kinase inhibitors (TKIs) for treating pediatric Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL), and the one which has been approved indication in China is imatinib. Recently, clinical demand for Ph + ALL treatment is becoming unmet gradually with the increasing resistance of imatinib. There are some studies reporting the better efficacy and comparative safety of dasatinib compared with imatinib, but no economic comparison has been published. This study aims to supplement economic evidence by comparing the cost-effectiveness between imatinib and dasatinib in treating pediatric patients with Ph+ ALL in China, and to help clinical rational drug use via multi-dimensional value assessment.

Methods
A decision tree model combined with a 10-year Markov model were established based on the disease progression. The parameters were collected from published literatures and our hospital’s electronic medical records. From the health system perspective, the incremental cost-effectiveness ratio (ICER) between the two treatment groups was calculated through cost-effectiveness analysis and then compared with the willingness-to-pay (WTP) threshold. The set WTP threshold in this study was 1 times per capita gross domestic product (GDP) of China, as recommended by the World Health Organization. Direct medical costs and quality-adjusted life years (QALYs) were calculated and discounted at 5%. The sensitivity analyses were conducted to assess the uncertainty and robustness of the results.

Results
The total costs were CNY 1,020,995.35 and CNY 1,035,788.50 in imatinib group and dasatinib group during the 10-year simulation, and the total QALYs were 2.59 and 4.84. Compared with the imatinib treatment group, the ICER was around CNY 6,575.78/ QALY, which was less than the set threshold CNY 70,892/ QALY. The sensitive analyses indicated the robustness of the results.

Conclusions
The cost-effectiveness analysis shows the potential cost-effective advantages of adding dasatinib comparing with adding imatinib for pediatric Ph + ALL patients in China under the set WTP threshold, which indicates that those patients could achieve more QALYs by paying acceptable fee.
Conceptualizing the effective mechanisms of a social needs case management program shown to reduce hospital use: a qualitative study
Authors: Fleming Mark D. , Safaeinili Nadia , Knox Margae , Hernandez Elizabeth , Esteban Emily E. , Sarkar Urmimala , Brewster Amanda L. 
Published: December 2022

Abstract
Background
Social needs case management programs are a strategy to coordinate social and medical care for high-risk patients. Despite widespread interest in social needs case management, not all interventions have shown effectiveness. A lack of evidence about the mechanisms through which these complex interventions benefit patients inhibits effective translation to new settings. The CommunityConnect social needs case management program in Contra Costa County, California recently demonstrated an ability to reduce inpatient hospital admissions by 11% in a randomized study. We sought to characterize the mechanisms through which the Community Connect social needs case management program was effective in helping patients access needed medical and social services and avoid hospitalization. An in-depth understanding of how this intervention worked can support effective replication elsewhere.

Methods
Using a case study design, we conducted semi-structured, qualitative interviews with case managers (n = 30) and patients enrolled in social needs case management (n = 31), along with field observations of patient visits (n = 31). Two researchers coded all interview transcripts and observation fieldnotes. Analysis focused on program elements identified by patients and staff as important to effectiveness.

Results
Our analyses uncovered three primary mechanisms through which case management impacted patient access to needed medical and social services: [1] Psychosocial work, defined as interpersonal and emotional support provided through the case manager-patient relationship, [2] System mediation work to navigate systems, coordinate resources, and communicate information and [3] Addressing social needs, or working to directly mitigate the impact of social conditions on patient health.

Conclusions
These findings highlight that the system mediation tasks which are the focus of many social needs assistance interventions offered by health care systems may be necessary but insufficient. Psychosocial support and direct assistance with social needs, enabled by a relationship-focused program, may also be necessary for effectiveness.
Ethanol tolerance of Clostridium thermocellum: the role of chaotropicity, temperature and pathway thermodynamics on growth and fermentative capacity
Authors: Kuil Teun , Yayo Johannes , Pechan Johanna , Küchler Jan , van Maris Antonius J. A. 
Published: December 2022

Abstract
Background
Clostridium thermocellum is a promising candidate for consolidated bioprocessing of lignocellulosic biomass to ethanol. The low ethanol tolerance of this microorganism is one of the remaining obstacles to industrial implementation. Ethanol inhibition can be caused by end-product inhibition and/or chaotropic-induced stress resulting in increased membrane fluidization and disruption of macromolecules. The highly reversible glycolysis of C. thermocellum might be especially sensitive to end-product inhibition. The chaotropic effect of ethanol is known to increase with temperature. This study explores the relative contributions of these two aspects to investigate and possibly mitigate ethanol-induced stress in growing and non-growing C. thermocellum cultures.

Results
To separate chaotropic from thermodynamic effects of ethanol toxicity, a non-ethanol producing strain AVM062 (Pclo1313_2638::ldh* ∆adhE) was constructed by deleting the bifunctional acetaldehyde/alcohol dehydrogenase gene, adhE, in a lactate-overproducing strain. Exogenously added ethanol lowered the growth rate of both wild-type and the non-ethanol producing mutant. The mutant strain grew quicker than the wild-type at 50 and 55 °C for ethanol concentrations ≥ 10 g L−1 and was able to reach higher maximum OD600 at all ethanol concentrations and temperatures. For the wild-type, the maximum OD600 and relative growth rates were higher at 45 and 50 °C, compared to 55 °C, for ethanol concentrations ≥ 15 g L−1. For the mutant strain, no positive effect on growth was observed at lower temperatures. Growth-arrested cells of the wild-type demonstrated improved fermentative capacity over time in the presence of ethanol concentrations up to 40 g L−1 at 45 and 50 °C compared to 55 °C.

Conclusion
Positive effects of temperature on ethanol tolerance were limited to wild-type C. thermocellum and are likely related to mechanisms involved in the ethanol-formation pathway and redox cofactor balancing. Lowering the cultivation temperature provides an attractive strategy to improve growth and fermentative capacity at high ethanol titres in high-cellulose loading batch cultivations. Finally, non-ethanol producing strains are useful platform strains to study the effects of chaotropicity and thermodynamics related to ethanol toxicity and allow for deeper understanding of growth and/or fermentation cessation under industrially relevant conditions.