bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative outcomes of percutaneous transvenous mitral commissurotomy between low and high Wilkins score
Authors: Alidoosti Mohammad , Sattartabar Babak , Pourhoseini Hamidreza , Salarifar Mojtaba , Nematipour Ebrahim , Hajizeinali Alimohammad , Aghajani Hassan , Amirzadegan Alireza , Baharvand Fateme 
Published: July 2023

Background Percutaneous transvenous mitral commissurotomy (PTMC) is one of the non-surgical methods for patients with significant mitral stenosis. It is less invasive, less complicating with better outcomes compared to surgery. The Wilkins score ≤8 is used to select patients for PTMC, but the results of several studies suggest that PTMC can also be successful in a higher Wilkins score. The aim of this study is to compare the outcomes of PTMC between two groups. Methods In this retrospective study, patients who underwent PTMC between April 2011 and December 2019 were included. Patients were divided into two groups based on Wilkins score: 196 patients (57.64%) with a Wilkins score ≤8 (group I) and 134 patients (39.4%) with a Wilkins score >8 (group II). Results There was no difference in demographic characteristics between two groups except for age ( p = 0.04). Pre and post-interventional echocardiographic and catheterization measurements including left atrial pressure, pulmonary artery pressure, mitral valve area, mitral valve mean, and peak gradient were measured, and there was no difference between the two groups ( p > 0.05). The most common complication was mitral regurgitation (MR). Serious complications such as stroke and arrhythmias were rare in both groups (<1%). There was no difference between MR, ASD (atrial septal defect) and serious complications between the two groups. Conclusion This study shows that the Wilkins score with a cutoff value of 8 is not suitable for patient selection and novel criteria including both mitral valve features and other variables affecting the PTMC outcomes is needed.
Reasons for antiretroviral switching in Colombia: A retrospective cohort study
Authors: Valderrama-Beltrán Sandra Liliana , Martínez-Vernaza Samuel , Correa-Forero Shirley Vanessa , Jaimes-Reyes Maria Alejandra , Arévalo-Mora Leonardo , Martínez-Buitrago Ernesto , Franco Julieta , Beltrán-Rodríguez Claudia , Urrego-Reyes Juan , Leon Sebastian , García Garzon Martha , Gonzalez Claudia , Fonseca Norberto , Botero Monica , Andrade Javier , Alzamora Diana , Lenis William , Pardo José , Alzate-Ángel Juan , Mantilla Monica , Sussmann Otto , Montero-Riascos Leonardo , Álvarez-Moreno Carlos Arturo 
Published: July 2023

Introduction Long-term use of antiretroviral therapy (ART) for HIV infection might lead to the necessity of switching regimens. We aimed to analyze the reasons for the ART switch, the time-to-switch of ART, and its associated factors in a Colombian cohort. Methods We conducted a retrospective cohort in 20 HIV clinics, including participants ≥18 years old with confirmed HIV infection who underwent an ART switch from January 2017 to December 2019 with at least 6 months of follow-up. A time-to-event analysis and an exploratory Cox model were performed. Results 796 participants switched ART during the study period. The leading cause of ART switch was drug intolerance ( n = 449; 56.4%) with a median time-to-switch of 12.2 months. The longest median time-to-switch was due to regimen simplification (42.4 months). People ≥50 years old (HR = 0.6; 95% CI (0.5–0.7) and CDC stage 3 at diagnosis (HR = 0.8; 95% CI (0.6–0.9) had less hazard for switching ART over time. Conclusions In this Colombian cohort, drug intolerance was the main cause of the ART switch, and the time-to-switch is shorter than reports from other countries. In Colombia, it is crucial to apply current recommendations for ART initiation to choose regimens with a better tolerability profile.
Practical psychiatry: Providing temporary psychiatric cover
Authors: Looi Jeffrey CL , Allison Stephen , Woon Luke 
Published: July 2023

Objective Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors’ clinical experience and the existing research literature. Conclusions There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care. We suggest a framework for reviewing the potential hazards and benefits of a temporary post, and planning for the role, guided by consideration of the following: caring for patients, supporting staff, working with peers, and understanding local healthcare systems and the local regulatory environment. Application of this reflective framework is informed by the psychiatrist’s assessment of the temporary role, and consideration of the local service conditions.
Optimal and politically opportune language policies for the vitality of minority languages
Authors: Wickström Bengt-Arne 
Published: July 2023

Language policies for the purpose of (re)vitalizing a minority language are analyzed as a dynamic cost-effectiveness problem. We focus on policy measures with two types of cost structures: costs largely proportional to the number of beneficiaries (a rival measure) and costs independent of the number of beneficiaries (a non-rival measure). An example of the former is home nursing in the minority language and an example of the latter is street signs in the minority language. Both types of measures are assumed to contribute positively to the vitality of the minority language. We stylize the analysis, letting the rival measure have an immediate direct effect on the vitality and the non-rival one a protracted indirect effect on the language’s status. Two problems are addressed. Firstly, we study how the optimal combination of the two types of measure changes as the policy is implemented and the vitality of the minority language increases and show that a policy with fixed budget shares as a rule is sub-optimal. Secondly, we compare the opportune policy of a policy maker planning with a fixed time horizon with the optimal policy as the time horizon approaches infinity. The policy maker has incentives to plan for a sub-optimal policy with a reduction in the protracted measure for the whole planning period and making it equal to zero at the time horizon. All effects are illustrated in numeric examples.
Bevacizumab as adjunctive therapy in anterior persistent fetal vasculature
Authors: Elhusseiny Abdelrahman M , Hennein Lauren , VanderVeen Deborah K 
Published: July 2023

Purpose Surgical removal of a vascularized pupillary membrane may be challenging with the risk of intraoperative bleeding and postoperative recurrence. We present a case of a 4-week-old who presented with anterior persistent fetal vasculature (PFV) and dense vascularized pupillary membrane in which the use of intracameral and intravitreal bevacizumab may have contributed to successful treatment. Observation A 4-week-old-month-old otherwise healthy girl was referred to Boston Children's Hospital for evaluation of cataract. Ocular examination revealed right microcornea and vascularized pupillary membrane. The left eye exam was unremarkable. Only three weeks after surgical excision of the pupillary membrane and cataract extraction, recurrence of a vascular pupillary membrane was noted. Repeat membranectomy with pupilloplasty and use of intracameral bevacizumab was performed. The pupillary opening was further opened 5 months later, after repeat (intravitreal) bevacizumab, and the pupil has remained open and stable with >6 months’ follow-up. Conclusion and importance This case suggests a role for bevacizumab in the management of PFV, however, a cause-and-effect relationship cannot be proven. Further prospective comparative studies are needed to confirm our findings.
Multimodal imaging in early onset non-neovascular pigment epithelial detachments
Authors: Goudot Mathilde M , Rothschild Pierre-Raphael , Bauters Gautier , Vagge Aldo , Miere Alexandra , Souied Eric H , Behar-Cohen Francine , Bernabei Federico 
Published: July 2023

Purpose To describe multimodal imaging of two cases of bilateral non-vascularized pigment epithelial detachments (PED) in young patients with a long-term follow-up. Methods A complete ophthalmological examination was performed at each follow-up visit including best corrected visual acuity (BCVA), intraocular pressure, slit lamp examination, spectral domain optical coherence tomography (SD-OCT), fluorescein and indocyanine green angiography, OCT angiography. Results Multimodal imaging of two women presenting avascular PED, aged 43 and 57, respectively, was described. In both patients, SD-OCT revealed a high central macular hyporeflective elevation corresponding with PED. Both patients showed a choroidal layer thicker than 420 μm. Fluorescein and indocyanine green angiography didn’t show any choroidal neovascularization either at early or late frames. Cross-sectional and en face optical coherence tomography angiography (OCTA) didn’t show any flow beneath the PED. During the follow up period one eye showed a retinal pigment epithelium tear and all eyes showed the presence of apical sub-retinal fluid and hyperreflective material on the top of the PED. None of the two patients showed any sign of atrophy during the follow-up period. Conclusion The peculiar characteristics of the presented cases suggest that specific pathogenetic mechanisms, not necessarily related to age related macular degeneration, may play a key role in the development of these lesions. Whether early onset of such drusenoid PED is a specific entity resulting from a genetic deficit of lipid transporters in the RPE is unknown. Further genetic and metabolic studies should be conducted.
A Retrospective Analysis of Denosumab for the Treatment of Bone Metastases in Chinese Patients With Breast Cancer
Authors: Li Wei , Wu Xinyu , Yu Heng , Zhu Zekai , Li Wenjie , Huang Xiang 
Published: July 2023

Background: Denosumab entered the Chinese market for the first time in 2020. Since it is a short period of time, there is a lack of data on its effectiveness and safety in Chinese people. The objective of this study was to evaluate the effectiveness and safety of denosumab in delaying skeletal-related events (SREs) in patients with breast cancer metastatic to bone. Methods: The study retrospectively analyzed data from breast cancer patients with bone metastases (BM) who were treated with denosumab in the First Affiliated Hospital of Nanjing Medical University from September 2020 to January 2022. The primary endpoint was SRE incidence at 1 year after receiving denosumab treatment. The secondary endpoints included time to first on-study SRE and safety. Descriptive analysis was utilized to display clinicopathological features. The Kaplan-Meier method was used to estimate the median time to first on-study SRE in total population and subgroups. Logistic regression analysis and χ2 test were employed to determine the potential factors influencing the occurrence of SREs. Results: Fifty breast cancer patients with BM were enrolled in our study, and 54.0% of the patients had 5 or more metastatic bone lesions. After a median follow-up of 17.00 months, 24% of the patients developed SREs at 1 year after receiving denosumab treatment, and the median time to first on-study SREs was not reached. Five or more metastatic bone lesions were an independent risk factor for SRE occurrence (odds ratio = 6.06, 95% CI: 1.09-33.54, P = .039). The adverse events (AEs) associated with denosumab mainly included hypocalcemia (68.0%), periodontitis (28.0%), and myalgia (14.0%). Only 3 cases of grade III/IV AEs were reported, and no serious AEs occurred. Conclusion: Denosumab was effective and well tolerated in Chinese breast cancer patients with BM.
Ultrasound-guided closure of the femoral artery during venoarterial decannulation using a large-bore closure device
Authors: Rahman Tasnia , Herajärvi Johanna , Ahonen Henri , Jormalainen Mikko , Syrjälä Simo , Järvinen Tommi , Juvonen Tatu , Dahlbacka Sebastian 
Published: July 2023

Background: Peripheral femoro-femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is viable for fast hemodynamic assistance during cardiogenic shock. Ultrasound-guided closure with a large-bore device (MANTA®) is a feasible option potentially replacing surgical arteriotomy closure in peripheral VA-ECMO decannulation. Methods: This retrospective study included patients weaning from percutaneously inserted femoro-femoral VA-ECMO at the Helsinki University Hospital, Finland in 2012–2020. The primary endpoints were access-site complications, a composite of hematomas/seromas/surgical site infections (SSIs), and the safety endpoint of vascular complications (VCs). Results: A total of 100 consecutive percutaneously implanted and weaned VA-ECMO patients were stratified into two groups by decannulation strategy: percutaneous ultrasound-guided MANTA device ( n = 21, 21.0%) or surgical approach ( n = 79, 79.0%). The mean age of the cohort was 51 ± 13 years and females represented 25.0%. The technical success rate of the percutaneous ultrasound-guided MANTA technique was 95.2%. In multivariate analysis, surgical closure was associated with a higher incidence of combined access site hematomas/seromas/SSIs compared to percutaneous ultrasound-guided deployment of MANTA device (44.3% versus 9.5%, odds ratio (OR): 7.162, 95% confidence interval (CI): 1.544–33.222; p = 0.012). Similarly, access-site complications necessitating interventions were more frequent in the surgical closure group compared to US-MANTA (ultrasound-guided MANTA) group (26.6% versus 0.0%, p = 0.005). VCs were infrequent in both groups without any significant intergroup difference ( p > 0.99). Conclusions: Percutaneous ultrasound-guided MANTA closure of the femoral artery after VA-ECMO decannulation was associated with high technical success rate and low incidence of VCs. Compared to surgical closure, access-site complications were significantly less frequent, along with access-site complications necessitating interventions.
Postpartum Sciatic Neuropathy After Uncomplicated Vaginal Delivery
Authors: Boutros Nader , Saba Dina , Trikamji Bhavesh 
Published: July 2023

Postpartum neuropathies are common, including femoral neuropathy, peroneal neuropathy, lumbosacral trunk plexopathy, and lateral femoral cutaneous neuropathy. Sciatic mononeuropathy in the peripartum period is rare. Postpartum sciatic neuropathy (PSN) in the setting of cesarean section has been reported before. We present a case series of 2 sciatic mononeuropathies after vaginal delivery. Case 1 is a 25-year-old woman who presented with a left foot drop after normal vaginal delivery after being in labor for 3 hours. Case 2 is a 24-year-old woman who presented with a right foot drop after normal vaginal delivery and being in labor for 31 hours. Both cases noted foot drops in the immediate postpartum period. Neurologic examinations revealed flail foot, 4/5 hamstring muscle strength on MRC scale and intact hip abduction. They had paresthesia on the posterolateral aspect of the leg, dorsal and plantar aspect of the foot with absent ankle reflex. MRI did not show evidence of spinal cord, nerve root or plexus involvement. Electrodiagnostic studies revealed evidence of sciatic mononeuropathy proximal to the short head of biceps femoris. They were discharged home with an ankle brace and therapy. At 3 months follow up, they had complete resolution of weakness. There have been a few reported cases of PSN secondary to cesarean section. Sciatic involvement after vaginal delivery is extremely rare. We report 2 cases of PSN after vaginal delivery to highlight that sciatic mononeuropathy can occur not only after cesarean section, but also after uncomplicated vaginal delivery and should raise awareness of this risk to clinicians.
Cigarette Smoke Mediates Nasal Epithelial Barrier Dysfunction via TNF-α
Authors: Guo Ju , Meng Xuan , Zheng Yao-Ming , Zhao Shan-Kun , Qiang Chen , Zhou Li-Bo 
Published: July 2023

Background Extensive data suggest that exposure to cigarette smoke can induce pulmonary epithelial barrier dysfunction. However, the effects of cigarette smoke on the nasal epithelial barrier are still unclear. Here, we investigated the consequence and mechanism of cigarette smoke on the nasal epithelial barrier. Methods Sprague Dawley rats were exposed to cigarette smoke for 3 or 6 months, and changes in inflammatory markers and nasal barrier function were evaluated. Moreover, underlying mechanisms were explored. Finally, normal human bronchial epithelial cells were cultured with or without tumor necrosis factor-alpha (TNF-α) in vitro, and the levels of continuity and tight junction–associated proteins were measured. Results In vivo experiments showed that the nasal mucosal barrier function of rats exposed to cigarette smoke was disturbed. Indeed, proteins associated with tight junctions were decreased, and the levels of inflammatory factors, such as IL-8, IL-6, and TNF-α, were dramatically increased in comparison to those of control animals. In vitro, TNF-α was shown to disrupt the continuity of proteins associated with tight junctions and to downregulate the expression of these proteins in bronchial epithelial cells. Conclusions We found that cigarette smoke disrupted the nasal mucosal barrier, and the extent of the damage was correlated with the duration of cigarette smoke exposure. We showed that TNF-α can disrupt the continuity and attenuate the expression of tight junction proteins in human bronchial epithelial cells. Therefore, cigarette smoke may induce nasal epithelial barrier dysfunction through TNF-α.
The Effect of Transformational and Transactional Leadership Styles on Organizational Readiness for Change Among Health Professionals
Authors: Mekonnen Mathewos , Bayissa Zelalem 
Published: July 2023

Objective The purpose of this study was to determine the effect of transformational and transactional leadership styles on organizational readiness for change among health professionals in the case of selected public hospitals in the North Showa Zone, Oromia Region, Ethiopia. Methods The institutional-based cross-sectional study design was employed for one month in April 2021. The data were collected from a sample of 212 subordinate health professional staffs. Multi-factor leadership surveys and organizational readiness for change questionnaires were used for data collection. Data were analyzed using descriptive statistics and exploratory factor analysis, run on the SPSS 23 version. Pearson correlation and multiple regressions were used. Multiple regression results were expressed using the statistical values R2 and β-coefficient. Statistical significance was declared at a P-value of <.05. Result The Pearson product correlation of organizational readiness for change was found to be low positive and statistically significant for both transformational leadership behavior ( r = .49, P < .01) and transactional leadership behavior ( r = .39, P < .01). Both transformational leadership behavior ( t = 5.32, P = .00) and transactional leadership behavior ( t = 2.08, P = .034) were found to be significant contributors to the variance of organizational readiness for change among health professionals, according to the findings. However, transformational leadership behavior style appears to make a more significant contribution (β = 0.39) than transactional leadership style (β = 0.15) in predicting organizational readiness for change among health professionals. Conclusion The study revealed that whenever transformational and/or transactional leadership behaviors are exhibited by the administrative staff, readiness for organizational change (commitment and efficacy) increases among health professionals. The study also concluded that a quarter of the readiness for organizational change can be affected by the two leadership styles.
Health Promotion Behaviors and Psychosocial Factors Among Middle-Aged Women in Saudi Arabia
Authors: Ashgar Rnda I. , Krishnasamy Thilagavathi 
Published: July 2023

Introduction Middle-aged women experience several changes that can affect their biological and psychosocial health. A healthy lifestyle is a fundamental requirement for achieving optimal health. Objectives To examine the impact of psychosocial factors on health promotion behaviors among middle-aged women in Saudi Arabia. Methods A cross-sectional, descriptive, correlational study design was used. One hundred and eighteen middle-aged women completed the demographic questionnaire, Stunkard Figure Rating Scale, Perceived Stress Scale, and Health-Promoting Lifestyle Profile-II from September 2, 2020 to February 15, 2021. Multiple regression analysis was performed to estimate the impact of psychosocial factors on health promotion behaviors. Results Participants “sometimes” engaged in health promotion behaviors. Spiritual growth scored the highest, whereas physical exercise scored the lowest. Most of the participants were dissatisfied with their body image and reported moderate levels of perceived stress. The participants were more likely to report a preferred body image that was smaller than their perceived body image. Perceived stress and body image were significantly correlated with the total score for health promotion behaviors. Perceived stress level, age, and menopause status were significant predictors of health promotion behaviors. The model significantly predicted all the health promotion behavior subscales, excluding nutrition. Conclusion There were relationships between certain psychosocial predictors and health-promoting behaviors. This study can guide healthcare professionals in promoting middle adult women's adoption of health-promoting behaviors. More research can be conducted in Saudi Arabia to understand the health promotion behaviors of middle-aged women.
The 29-nucleotide deletion in SARS-CoV: truncated versions of ORF8 are under purifying selection
Authors: Bykova Anastassia , Saura Andreu , Glazko Galina V. , Roche-Lima Abiel , Yurchenko Vyacheslav , Rogozin Igor B. 
Published: July 2023

Abstract
Background
Accessory proteins have diverse roles in coronavirus pathobiology. One of them in SARS-CoV (the causative agent of the severe acute respiratory syndrome outbreak in 2002–2003) is encoded by the open reading frame 8 (ORF8). Among the most dramatic genomic changes observed in SARS-CoV isolated from patients during the peak of the pandemic in 2003 was the acquisition of a characteristic 29-nucleotide deletion in ORF8. This deletion cause splitting of ORF8 into two smaller ORFs, namely ORF8a and ORF8b. Functional consequences of this event are not entirely clear.

Results
Here, we performed evolutionary analyses of ORF8a and ORF8b genes and documented that in both cases the frequency of synonymous mutations was greater than that of nonsynonymous ones. These results suggest that ORF8a and ORF8b are under purifying selection, thus proteins translated from these ORFs are likely to be functionally important. Comparisons with several other SARS-CoV genes revealed that another accessory gene, ORF7a, has a similar ratio of nonsynonymous to synonymous mutations suggesting that ORF8a, ORF8b, and ORF7a are under similar selection pressure.

Conclusions
Our results for SARS-CoV echo the known excess of deletions in the ORF7a-ORF7b-ORF8 complex of accessory genes in SARS-CoV-2. A high frequency of deletions in this gene complex might reflect recurrent searches in “functional space” of various accessory protein combinations that may eventually produce more advantageous configurations of accessory proteins similar to the fixed deletion in the SARS-CoV ORF8 gene.