bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intradural Extramedullary Pyogenic Abscess: Incidence, Management, and Clinical Outcomes in 45 Patients With a Mean Follow Up of 2 Years
Authors: Lenga Pavlina , Fedorko Stepan , Gülec Gelo , cand med  , Kiening Karl , Unterberg Andreas W. , Ishak Basem 
Published: January 2023

Study Design Retrospective review Objectives Spinal intradural extramedullary abscess (SIEA) is a rare disease with an unknown incidence. In this study, we systematically described the clinical course of SIEA in a large cohort with acute onset of neurological illness, assessed the morbidity and mortality rates, and determined the potential risk factors for mortality. Methods Electronic medical records of patients diagnosed with SIEA at a single institution for the period between September 2005 and December 2020 were retrieved. Results Over a period of 15 years, 881 patients with spinal infections were treated either conservatively or surgically at our center, of whom 45 patients (45/881, 5.1%) had SIEA. The overall mean age was 69.6 ± 5.6 years of patients diagnosed with SIEA and all of them underwent posterior decompression via laminectomy. The mean Charlson Comorbidity Index (CCI) was 6.9 ± 2.5, indicating a poor baseline reserve. Progressive neurological decline was observed in all patients (mean motor score, 88.6 ± 9.7). The in-hospital rate and 90-day mortality were 4.4% and 10%, respectively. Mortality was not surgery related. Most importantly, the patients’ motor deficits and blood infection parameters significantly improved after surgery. Risk factors for mortality were increased age, comorbidities as measured by CCI, and preoperative motor weakness (MS). Conclusions Immediate surgical decompression via laminectomy, with antiseptic irrigation and drainage of the subdural space, followed by antibiotic therapy, appears to be the key to ensuring beneficial clinical outcomes to treatment of rare diseases such as SIEA.
Hereditary platelet disorders associated with germ line variants in RUNX1, ETV6, and ANKRD26
Authors: Homan Claire C. , Scott Hamish S. , Brown Anna L. 
Published: January 2023

Abstract
Hereditary platelet disorders (HPDs) are a group of blood disorders with variable severity and clinical impact. Although phenotypically there is much overlap, known genetic causes are many, prompting the curation of multigene panels for clinical use, which are being deployed in increasingly large-scale populations to uncover missing heritability more efficiently. For some of these disorders, in particular RUNX1, ETV6, and ANKRD26, pathogenic germ line variants in these genes also come with a risk of developing hematological malignancy (HM). Although they may initially present as similarly mild-moderate thrombocytopenia, each of these 3 disorders have distinct penetrance of HM and a different range of somatic alterations associated with malignancy development. As our ability to diagnose HPDs has improved, we are now faced with the challenges of integrating these advances into routine clinical practice for patients and how to optimize management and surveillance of patients and carriers who have not developed malignancy. The volume of genetic information now being generated has created new challenges in how to accurately assess and report identified variants. The answers to all these questions involve international initiatives on rare diseases to better understand the biology of these disorders and design appropriate models and therapies for preclinical testing and clinical trials. Partnered with this are continued technological developments, including the rapid sharing of genetic variant information and automated integration with variant classification relevant data, such as high-throughput functional data. Collective progress in this area will drive timely diagnosis and, in time, leukemia preventive therapeutic interventions.
Migraine attacks are of peripheral origin: the debate goes on
Authors: Do Thien Phu , Hougaard Anders , Dussor Greg , Brennan K. C. , Amin Faisal Mohammad 
Published: January 2023

Abstract
Background
Despite the pervasiveness of migraine, the underlying pathophysiological mechanisms initiating migraine attacks are far from well understood and are matter of scientific debate.

Objective
In this narrative review, we discuss key evidence for that suggest a peripheral origin or central origin and provide directions for future studies that may provide further clarification.

Discussion
Migraine pathogenesis is considered to involve the trigeminovascular system, a term that encompasses the trigeminal nerve and its axonal projections to the intracranial blood vessels. Beyond any doubt both peripheral and central mechanisms are involved in migraine pathogenesis, but an unresolved question is the how the initial activation occurs in a migraine attack. Evidence favoring a peripheral origin of migraine attacks, i.e., initial events occur outside of the blood–brain barrier, include the importance of sensitization of perivascular sensory afferents early on in a migraine attack. Evidence favoring a central origin include the occurrence of prodromal symptoms, migraine aura, and activation of structures within the central nervous system early in and during a migraine attack.

Conclusions
Both peripheral and central mechanisms are likely involved in a migraine attack, e.g., peripheral nociceptive input is necessary for pain transmission and cortical activity is necessary for pain perception. Yet, the debate of whether migraine attacks are initiated a peripheral or central site remains unresolved. The increased focus on prodromal symptoms and on the development of a human model of migraine aura will possibly provide key arguments needed to answer this question in the near future. Until then, we cannot draw firm conclusions and the debate goes on.

Video link
Video recording of the debate held at the 1st International Conference on Advances in Migraine Sciences (ICAMS 2022, Copenhagen, Denmark) is available at: https://www.youtube.com/watch?v=NC0nlcKohz0.

Graphical Abstract
ROX index versus HACOR scale in predicting success and failure of high-flow nasal cannula in the emergency department for patients with acute hypoxemic respiratory failure: a prospective observational study
Authors: Praphruetkit Nattakarn , Boonchana Natyada , Monsomboon Apichaya , Ruangsomboon Onlak 
Published: January 2023

Abstract
Background
High-flow nasal cannula has been a promising initial respiratory support measure for patients with acute hypoxemic respiratory failure (AHRF) in the emergency department (ED). However, delayed detection of HFNC failure is associated with increased mortality. The ROX index is a tool that can help predict HFNC success. Nonetheless, its utility in ED patients is limited, and no studies have compared it with the HACOR scale, another tool that may be as accurate in predicting HFNC failure. Therefore, we aimed to compare the prognostic utility of the ROX index and the HACOR scale in emergency AHRF patients.

Methods
This prospective observational study was conducted at the ED of Siriraj Hospital, Thailand, between August 2018 and February 2020. Adult patients with AHRF requiring HFNC in the ED were included. The ROX index and the HACOR scale were measured at 1, 2, and 6 h after HFNC initiation. The primary outcome was HFNC success, defined as no intolerance or escalation towards mechanical ventilation or non-invasive ventilation within 48 h.

Results
A total of 75 patients were enrolled; 52 (69.3%) had a successful treatment. The ROX index was higher in the success group, while the HACOR scale was lower at all timepoints. The ROX index yielded generally higher discrimination capacity based on the area under the receiver operating characteristic curve (AUROC) than the HACOR scale [AUROC at 1, 2, and 6 h = 0.815, 0.784, 0.853 for ROX in predicting HFNC success and 0.733, 0.690, and 0.764 for HACOR in predicting HFNC failure]. The ROX index measured at 6 h at the cut-point of 4.88 had 92.98% sensitivity, 61.11% specificity, 88.33% positive predictive value, and 73.33% negative predictive value with a diagnostic accuracy of 85.33%.

Conclusion
The ROX index had superior prognostic utility in predicting HFNC outcome (success/failure) compared to the HACOR scale in patients with AHRF in the ED setting. Moreover, it is less complex and more efficient to be employed at bedside. Therefore, the ROX index is a more appropriate tool to guide further management and potential escalation therapy for AHRF patients with HFNC therapy initiated in the ED.
Melamine in the environment: a critical review of available information
Authors: Lütjens Laura H. , Pawlowski Sascha , Silvani Maurizio , Blumenstein Uwe , Richter Ingo 
Published: January 2023

AbstractLarge numbers of chemicals and products thereof are used in our daily routine to ensure a good quality of life. Substances may even serve as raw materials to produce daily life articles including electronic hardware, green houses, cars etc. Melamine is used for a great variety of products, such as wood panels, paints, coatings, foam seating’s and mattresses (as flame retardant), automotive brake tubes and hose. Based on the latest discussions, melamine has been concluded in the European Union to be classified as “carcinogenic to humans” (Carc. 2, H351) and “may cause damage to organs (urinary tract) through prolonged or repeated exposure” (STOT RE 2, H737). In addition, there is a self-classification of the European industry as suspect Repr. CAT2. Furthermore, the substance is considered a potential groundwater contaminant, due to a low log octanol carbon coefficient (Koc). However, the underlying data require further evaluation. Therefore, a review of available information related to the presence of melamine (M) and cyromazine (CM, of which M is a transformation product) in surface, ground and drinking water was conducted and the data were critically analysed for plausibility. Available monitoring data are scarce and investigated for the Netherlands and Germany mainly. Measurements in the catchment area of the river Rhine and Maas revealed, that both substances (M, CM) were not ubiquitously found in surface, ground and drinking water in these countries. All in all, it can be concluded that the available monitoring data are considered as conclusive, and thus requiring further investigation before a clear relationship between emission and occurrence of melamine in the environment can be drawn.
Evaluation and limitations of different approaches among COVID-19 fatal cases using whole-exome sequencing data
Authors: Forgacova Natalia , Holesova Zuzana , Hekel Rastislav , Sedlackova Tatiana , Pos Zuzana , Krivosikova Lucia , Janega Pavol , Kuracinova Kristina Mikus , Babal Pavel , Radvak Peter , Radvanszky Jan , Gazdarica Juraj , Budis Jaroslav , Szemes Tomas 
Published: January 2023

AbstractBackgroundCOVID-19 caused by the SARS-CoV-2 infection may result in various disease symptoms and severity, ranging from asymptomatic, through mildly symptomatic, up to very severe and even fatal cases. Although environmental, clinical, and social factors play important roles in both susceptibility to the SARS-CoV-2 infection and progress of COVID-19 disease, it is becoming evident that both pathogen and host genetic factors are important too. In this study, we report findings from whole-exome sequencing (WES) of 27 individuals who died due to COVID-19, especially focusing on frequencies of DNA variants in genes previously associated with the SARS-CoV-2 infection and the severity of COVID-19.ResultsWe selected the risk DNA variants/alleles or target genes using four different approaches: 1) aggregated GWAS results from the GWAS Catalog; 2) selected publications from PubMed; 3) the aggregated results of the Host Genetics Initiative database; and 4) a commercial DNA variant annotation/interpretation tool providing its own knowledgebase. We divided these variants/genes into those reported to influence the susceptibility to the SARS-CoV-2 infection and those influencing the severity of COVID-19. Based on the above, we compared the frequencies of alleles found in the fatal COVID-19 cases to the frequencies identified in two population control datasets (non-Finnish European population from the gnomAD database and genomic frequencies specific for the Slovak population from our own database). When compared to both control population datasets, our analyses indicated a trend of higher frequencies of severe COVID-19 associated risk alleles among fatal COVID-19 cases. This trend reached statistical significance specifically when using the HGI-derived variant list. We also analysed other approaches to WES data evaluation, demonstrating its utility as well as limitations.ConclusionsAlthough our results proved the likely involvement of host genetic factors pointed out by previous studies looking into severity of COVID-19 disease, careful considerations of the molecular-testing strategies and the evaluated genomic positions may have a strong impact on the utility of genomic testing.
Mobile APP-assisted family physician program for improving blood pressure outcome in hypertensive patients
Authors: Xing Fang , Guo Yijia , Xia Nan , Zhang Suolei , Yin Jinfeng , Qin Liyi , Zhu Chendi , Gao Qing , Jia Junnan , Zhao Yuesong , Qi Yousheng , Li Weimin 
Published: January 2023

Abstract
Background
This study was aimed to examine the effectiveness of App-assisted self-care in a Beijing community based on intelligent family physician-optimised collaborative model (IFOCM) program.

Methods
We conducted a survey of 12,050 hypertensive patients between Jan 2014 and Dec 2021. Generalized linear model was used to analyze the covariates that associated with blood pressure (BP) control. Decision tree and random forest algorithm was used to extract the important factors of BP outcome.

Results
The study included 5937 patients, mean age 66.2 ± 10.8, with hypertension in the baseline; 3108(52.4) were female. The community management resulted in mean systolic BP and diastolic BP reductions of 4.6 mmHg and 3.8 mmHg at follow-up. There were 3661 (61.6%) hypertension patients with BP control, increasing from 55.0% in 2014 to 75.0% in 2021. After adjusted for covariates, antihypertensive medication adherence, diabetes, and APP-assisted self-care were common predictors associated with BP control in GLM model and machine learning algorithm.

Conclusion
Community management based on IFOCM program significantly improved BP control in hypertensive patients. APP-assisted self-care would be beneficial for the management of chronic disease.
Peripheral blood lymphocyte subsets in children with nephrotic syndrome: a retrospective analysis
Authors: Deng Yan , Ou Ying-ying , Mo Cui-Ju , Huang Li , Qin Xue , Li Shan 
Published: January 2023

Abstract
Background
Nephrotic syndrome (NS) in children is widely believed to be associated with severe changes in the immune system. Based on lymphocyte subset analysis, we examined the pathogenesis of immune deficiencies in children with NS with varying steroid sensitivity.

Methods
Our study utilized flow cytometry to retrospectively analyze the ratios of lymphocyte subsets in 204 children with nephrotic syndrome and 19 healthy children.

Results
Compared with healthy children, the ratio of CD4 + /CD8 + in onset and remission was decreased in SRNS group (p < 0.05), and CD19 + B lymphocytes were increased in onset (p < 0.05). Compared with onset, the proportion of CD19 + B lymphocytes decreased in SRNS, while the proportion of CD19 + B lymphocytes increased in SDNS, p < (0.01). The ratio of CD8 + T/CD19 + B in onset in SDNS group was significantly higher than that in SSNS and SRNS groups (p < 0.01) and healthy control group (p < 0.05). Compared with onset, the ratio of CD8 + T/CD19 + B in SDNS group decreased significantly (p < 0.01), while the ratio of CD8 + T/CD19 + B in SRNS group increased significantly (p < 0.01). The proportion of CD56 + CD16 + NK cells was significantly reduced in children with INS (p < 0.01).

Conclusion
CD8 + T lymphocytes may be involved in the mechanism of lymphocyte subsets disorder during onset of SDNS, while CD19 + B lymphocytes may be involved in the mechanism of lymphocyte subsets disorder during relapse of SDNS. The CD8 + T/CD19 + B ratio may predict the degree of frequent recurrence. There is a certain degree of lymphoid subsets disorder in children with NS.
Awareness and knowledge of glaucoma among visitors of main public hospitals in Damascus, Syria: a cross-sectional study
Authors: Soqia Jameel , Ataya Jamal , Alhalabi Rawan , Alhomsi Rawan , Hamwy Romeo , Mardini Khaled , Hamzeh Ammar 
Published: January 2023

Abstract
Background
The main way to prevent blindness from Glaucoma is by early detection and diagnosis; and to do so the awareness must be raised among people where Glaucoma is defined as an acquired chronic optic neuropathy characterized by optic disk cupping and visual field loss. Lack of knowledge about this disease is one of the most important reasons that made it develop to advanced stages. Based on that, we conducted scientific research to assess peoples’ awareness and knowledge about Glaucoma.
After reviewing the literature, it was found that this study is the first in Syria.

Methods
We conducted a cross-sectional study in May 2022. The study included participants, who are above 20 years old, from visitors of Al-Mouwasat University Hospital in Damascus, Syria. During one week, Data was gathered according to the questionnaire, which was presented through face-to-face interviews with participants. We have allocated one point (1) to each question. Three levels of knowledge were adopted, namely; weak level from (0) to (3), average level from (4) to (7) and good level from (8) to (11). Associations between participants' demographic and other details were tested using Chi-square test and other tests, and a p-value of < 0.05 was considered significant.

Results
A total of 500 participants were interviewed. For awareness of Glaucoma, 33.6% of the participants (n = 168) had heard of Glaucoma, and 66.4% hadn’t (n = 332). Mean test results for the knowledge of Glaucoma was 1.62 out of 11, and only 8% of participants (n = 40) had a good knowledge of Glaucoma. Education Level, governorate, and department of hospital that the patient came for significantly affected the knowledge of Glaucoma. Moreover, hospital, Ophthalmologists' Clinics, and health staff (M = 5.45) were the better Resource for information than family, relatives, and friends (M = 3.16). Finally, social media and the Internet group had the lowest mean test results (M = 1.23). These test results were significant, with a p-value < 0.001.

Conclusion
The percentage of knowledge and awareness was significantly low. Organized community awareness methods must disseminate more ability to increase the general public's understanding to avoid injury and late diagnosis of Glaucoma.
Population health trends and disease profile in Somalia 1990–2019, and projection to 2030: will the country achieve sustainable development goals 2 and 3?
Authors: Morrison Joana , Malik Sk Md Mamunur Rahman 
Published: January 2023

Abstract
Objectives
This study aims to evaluate whether Somalia will reach Sustainable Development Goals 2 and 3 by 2030 and what the country requires to advance closer to these objectives.
Setting: Somalia.

Participants
We carried out analyses of secondary data obtained from the following open-access databases: Global Burden of Disease 2019 study; United Nations (UN) Department of Economic and Social Affairs Population Division; World Bank World Development Indicators; United Nations Children’s Fund (UNICEF); UNICEF/World Health Organisation (WHO)/World Bank Joint Child Malnutrition Estimates; and UN Interagency Group for Child Mortality Estimation (UN IGME), disaggregated by sex.
Primary outcome measures: stillbirth, neonatal, infant, under-five, maternal and child mortality; under-five malnutrition; life expectancy; health-adjusted life expectancy; age-standardised all-cause mortality; age-standardised cause-specific mortality for the leading causes of death; disability-adjusted life years. Secondary outcome measures: vitamin A coverage; stunting, overweight in children under 5; top risk factors contributing to cause-specific mortality.

Results
life expectancy in Somalia will increase to 65.42 years (95% UI 62.30–68.54) for females and 58.54 years (95% UI 54.89–62.19) for males in 2030. Stunting will continue to decline to 25.2% (90% UI 13.9–39.5%), and the under-five mortality rate will drop to 85.9 per 1000 live births (90% UI 22.0–228.1 per 1000 live births) for females and 96.4 per 1000 live births (90% UI 24.8–255.3 per 1000 live births) for males in 2030. This study’s analyses predict that the maternal mortality ratio in Somalia will decline to 696.42 deaths per 100,000 live births in 2030.

Conclusions
there has been progress towards SDG targets in Somalia since 1990. To achieve these, Somalia requires greater health improvements than observed between 1990 and 2019.
Self- and surrogate-seeking of information about mental health and illness in Germany
Authors: Freytag Anna , Baumann Eva , Angermeyer Matthias , Schomerus Georg 
Published: January 2023

Abstract
Background
Seeking information on mental health issues – both for oneself and on behalf of others (so-called surrogate-seeking) – is a critical early step in dealing with mental illness and known to impede stigmatizing attitudes and foster help-seeking. Yet, knowledge about mental health tends to be insufficient worldwide. Therefore, it is necessary to better understand the search for mental health information and examine the factors that are positively associated with information-seeking.

Method
In a face-to-face survey in Germany (N = 1,522), we investigated the factors related to mental health information-seeking. The data was analyzed by means of a logistic regression model, in which we distinguished those searching information for themselves from so-called surrogate seekers, i.e., people who seek information on behalf of someone else.

Results
Twenty-six percent of German adults in our sample have already searched for information on mental health, with the majority already having searched for information for others (73% of all seekers). Our findings indicate that individuals’ proximity to people with mental health issues, including their own mental health treatment experience (Cramer’s V = .429, p < .001), education (Cramer’s V = .184, p < .001), and desire for social distance from the affected people (F [1, 1516] = 73.580, p < .001, η2 = .046), play an important role in mental health information-seeking. The patterns of sociodemographic and proximity factors hereby differ between self-seekers and surrogate-seekers.

Conclusions
Our study provides insights into the public’s mental health information orientation. The findings may particularly guide strategies to improve mental health awareness and fill knowledge gaps in supporting informed decision-making and reducing stigma. Surrogate seekers appear to be an important and distinctive target group for mental health information provision. Depending on whether one wants to promote surrogate- or self-seeking seekers, different target groups and determinants should be addressed.