bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term impact of pregnancy on renal function among Egyptian women with lupus nephritis: A case control study
Authors: Attia Doaa HS , Mokbel Abir , Mohamed Moataz Fatthy , Haggag Hisham Mamdouh 
Published: May 2023

Few studies tackled the long-term effect of pregnancy on lupus nephritis (LNs); thus, the study aimed to explore the long-term impact of pregnancy on renal outcomes in Egyptian patients with LN. Group I patients included females who had their first pregnancy after LN onset with ≥5 years elapsing after delivery; group II patients included females who had never got pregnant for ≥7 years after LN onset. Data were retrospectively collected at baseline (T0) and the last visit (Tlast). The study included 43 patients in group I and 39 patients in group II. The comparisons between the two groups regarding the characteristics at Tlast showed no significant difference regarding the serum creatinine, estimated glomerular filtration rate (eGFR), renal component of SLICC/ACR Damage Index (SDI) as well as the rate of renal flares, new-onset chronic kidney disease (CKD), progressed CKD and end-stage renal disease. Multivariate regression analysis revealed that systemic hypertension and renal flares were predictors of new-onset/progressed CKD ( p = 0.019, OR [95% CI] = 4 [1.3–13]; and 0.022, 13.8 [1.5–128.8], respectively) while pregnancy was not ( p = 0.363). Paired comparisons between T0 and Tlast characteristics within each group revealed significant increment of serum creatinine, renal SDI and CKD prevalence; as well as decrement of eGFR in group I ( p = 0.004, <0.001, 0.001 and <0.001, respectively) and group II ( p = 0.006, <0.001, 0.004 and 0.002, respectively). In conclusion, pregnancy, per se, does not affect the long-term renal outcome in LN patients; however, it is rather dependent on the existence of baseline renal damage and the development of renal flares.
Registered nurses’ exposure to high stress of conscience in long-term care
Authors: Munkeby Hilde , Bratberg Grete , Devik Siri Andreassen 
Published: May 2023

Background In long-term care, registered nurses and other care providers often experience tensions between ideals and realities in the delivery of services, which can result in stress of conscience. Burnout, low quality of care and a tendency to leave the profession are perceived as consequences. Objectives This study aimed to identify the socio-demographic and work-related factors associated with a high level of stress of conscience, particularly between nursing occupations. Research design A cross-sectional survey was conducted among care providers who worked in Norwegian nursing homes and home care services in the spring of 2021. The sample consisted of 950 registered nurses and 1143 other care providers. Data were collected online using the Stress of Conscience Questionnaire (SCQ). Ethical considerations Participation was voluntary and based on consent. The study was approved by the Norwegian Center for Research Data. Results Registered nurses were nearly twice as likely to report high levels of stress of conscience compared to other care providers in long-term care. In addition, being a female, living alone, caring for their own children, working in an institution (versus home based), working >75% time, working shifts, not having scheduled meetings for ethical reflection and working in municipalities with a higher population density were factors associated with a high level of SCQ score. Discussion Knowledge of factors that increase the risk of high SCQ scores in registered nurses provides opportunities for prevention. Managers in long-term care should pay more attention to how work is distributed between the occupational groups and should facilitate real opportunities for ethical reflection. Conclusions The results of this study show that registered nurses have particular exposure to high levels of stress of conscience compared to other care providers in long-term care. Particular attention should be paid to registered nurses working in nursing homes.
Risk Factors for the Recurrence of Instability After Lateral Ankle Ligament Repair
Authors: Luthfi Andi Praja Wira Yudha , Nakasa Tomoyuki , Ikuta Yasunari , Sumii Junichi , Nekomoto Akinori , Kawabata Shingo , Adachi Nobuo 
Published: May 2023

Background: Arthroscopic anterior talofibular ligament (ATFL) repair is widely performed for chronic lateral ankle instability (CLAI). Although many studies have reported excellent outcomes with this procedure, the recurrence of instability remains a common concern. Therefore, this study aimed to analyze the risk factors for the recurrence of instability after arthroscopic repair for CLAI. Methods: Fifty-six ankles of 53 patients with a mean age of 31.8 ± 14.7 years were retrospectively reviewed. All patients underwent arthroscopic ATFL repair. If instability remained immediately after ATFL repair, calcaneofibular ligament (CFL) repair was performed. The Ankle Activity Score (AAS) was assessed preoperatively, and clinical outcomes including the Japanese Society for Surgery of the Foot scale, Karlsson-Peterson scores, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) were evaluated preoperatively and at the final follow-up. Talar tilt angle (TTA) was assessed preoperatively and 1 year postoperatively. Ankles were divided into 2 groups—nonrecurrence (postoperative TTA, <6 degrees) and recurrence (postoperative TTA, ≥6 degrees)—and clinical outcomes were compared. Results: Sixteen ankles showed recurrent instability, whereas 40 did not. AAS, TTA, and social functioning in the SAFE-Q were significantly higher in the recurrence group than those in the nonrecurrence group preoperatively. In addition, the rate of poor ATFL remnant quality and the number of CFLs not repaired despite the preoperative injury diagnosis were significantly higher in the recurrence group than in the nonrecurrence group. Conclusion: Arthroscopic repair for ATFL and CFL deficiencies with preoperative high activity, poor remnant quality, and neglected CFL injury can result in the recurrence of instability. Appropriate surgical procedures to prevent the recurrence of instability should be selected for these ankles. Level of Evidence: Level IV, retrospective case series.
Bilateral acute iris transillumination (BAIT) syndrome: Differential diagnosis based on clinical, OCT and UBM findings
Authors: Cronemberger Sebastião , Vasconcelos-Santos Daniel Vítor , Correia de Carvalho Clóvis , Carvalho José Herculano , Calixto Júlia , Diniz-Filho Alberto 
Published: May 2023

Introduction Bilateral acute iris transillumination (BAIT) is a relatively new syndrome whose etiopathogenesis is still not fully understood. It is characterized by acute bilateral onset of intense pigment dispersion in the anterior chamber, iris depigmentation with severe transillumination defects, accentuated pigment deposition in the angle, and elevated intraocular pressure (IOP). In literature, the first case was of bilateral acute iris depigmentation (BADI) reported in 2004 in a 77-year-old woman. In 2019, Perone et al. published a review about BAIT syndrome. They reported a total of 79 cases have been published up that date, mainly in Europe and especially in Turkey and Belgium. The majority of reported cases were of bilateral acute iris depigmentation (BADI). BAIT syndrome might be mainly confused with acute iridocyclitis, acute primary angle-closure (APAC) and pigment dispersion syndrome (PDS). In relation to BAIT, controversies still exist regarding the etiology being the differential diagnosis of paramount importance for adequate treatment. Purpose To report a case of BAIT syndrome associated to refractory glaucoma and to discuss the differential diagnosis based on clinical, OCT and UBM findings. Methods We present a case of BAIT syndrome in which clinical, OCT and UBM findings have pointed out the similarities and, mainly the diagnosis differences with other ocular diseases. Conclusions BAIT syndrome with accentuated IOP rise must be differentiated of other ocular diseases. It requires urgent clinical therapy and/or surgical management as occurred in the present case for avoiding structural damage in OCT and visual field loss. OCT and UBM are critical for early recognition, differential diagnosis and management.
A scoping review of autism research conducted in Central Asia: Knowledge gaps and research priorities
Authors: Zakirova-Engstrand Rano , Yakubova Gulnoza 
Published: May 2023

Very little is known about the status of autism research in Central Asia. The purpose of this scoping review was to examine the scope and focus of the peer-reviewed research studies conducted with autistic people and their families in five Central Asian countries—Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. The electronic databases of EBSCO Host and Web of Science were used for systematic search of literature. Eleven articles that met eligibility criteria were included in the review and analyzed for topics and research areas outlined in the Interagency Autism Coordinating Committee Strategic Plan. Ten of these studies were conducted in Kazakhstan and one in Uzbekistan using qualitative, quantitative, and mixed-methods research designs. Five of the seven research areas—Diagnosis, Biology, Risk Factors, Services, and Treatment and Interventions—were represented in these studies, while there were no studies identified in the areas of Lifespan Issues or Infrastructure and Surveillance, highlighting a gap in research. None of the studies reported co-authorship of scientists from Central Asian countries. The review identified knowledge gaps and research needs to guide future research in autism in Central Asia to address the needs of autistic individuals and their families living in this region. Lay abstract Very little is known about the status of autism research in Central Asia. Through the library databases, we identified and reviewed 11 scientific studies conducted with autistic people and their families in five Central Asian countries—Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Of the 11 studies, 10 were conducted in Kazakhstan and 1 in Uzbekistan. Within these limited number of research studies, different topics such as diagnosis, risk factors of autism, biology, and various service and intervention areas were addressed. We identified several knowledge gaps and research priorities to address the needs of autistic people, their families, and professionals in Central Asia.
Impact of prehospital stroke triage implementation on patients with intracerebral hemorrhage
Authors: Almqvist Tove , Falk Delgado Anna , Sjöstrand Christina , Ahmed Niaz , Berglund Annika , Eriksson Einar , Mazya Michael V. 
Published: May 2023

Background: Little is known about how prehospital triage using large vessel occlusion (LVO) stroke prediction scales affects patients with intracerebral hemorrhage (ICH). Objectives: We aimed to investigate whether the Stockholm Stroke Triage System (SSTS) implemented in 2017 has affected timing and outcomes of acute ICH neurosurgery, and to assess system triage accuracy for ICH with a neurosurgical indication or LVO thrombectomy. Design: Observational cohort study. Methods: In the Stockholm Region, we compared surgical timing, functional outcome, and death at 3 months in patients transported by code-stroke ground ambulance who had ICH neurosurgery, 2 years before versus 2 years after SSTS implementation. We also calculated triage precision metrics for treatment with either ICH neurosurgery or thrombectomy. Results: A total of 36 patients undergoing ICH neurosurgery were included before SSTS implementation and 30 after. No significant difference was found in timing of neurosurgery [median 7.5 (4.9–20.7) versus 9.1 (6.1–12.5) h after onset], distribution of functional outcomes (median 4 versus 4), and death at 3 months [3/29 (9%) versus 5/35 (17%)] before versus after implementation, respectively. The SSTS routed a larger proportion of patients subsequently undergoing ICH neurosurgery directly to the comprehensive stroke center: 13/36 (36%) before versus 18/30 (60%) after implementation. Overall system triage accuracy for ICH neurosurgery or thrombectomy was high at 90%, with 92% specificity and 65% sensitivity. Conclusion: The SSTS, initially designed for prehospital LVO stroke triage, routed more patients with neurosurgical indication for ICH directly to the comprehensive stroke center. This did not significantly affect surgical timing or outcomes.
The Goudge Inquiry and Forensic Pathology in Canada
Authors: Milroy Christopher M. 
Published: May 2023

Aims: This article analyses the effects of The Inquiry into Pediatric Forensic Pathology in Ontario, commonly known as the Goudge Inquiry, and its effects upon forensic pathology in Canada. Methods: The Goudge Inquiry was a Government of Ontario public inquiry that examined the delivery of pediatric forensic pathology services to the Ontario Coroner’s Office and the Canadian criminal justice system. The inquiry was conducted by Mr. Justice Goudge, a court of Appeal Judge and made substantial recommendations of improving forensic pathology in a Coroner system and its role in delivering evidence to the criminal justice system. This article reviews the inquiry and discusses the effect of the inquiry on the development of forensic pathology in Canada and academic literature about the inquiry. Results: The Inquiry has had important effects on the role of all expert witnesses in the courts and is the most substantial examination of forensic pathology by any judicial inquiry. Conclusions: The Goudge Inquiry has been considered a significant success, being described as transformative.
Neuro-Sweet Syndrome: A Diagnostic Conundrum
Authors: Acurio Karlos , Chuquilin Miguel 
Published: May 2023

Sweet Syndrome presents as acute fever, leucocytosis and characteristic skin plaques. It can involve many organ systems but rarely affects the nervous system. We report the case of a 51-year-old female that presented with fever, rash, headache and encephalopathy. Brain magnetic resonance imaging showed extensive T2 hyperintensities involving cerebral hemispheres, cerebellum, and brainstem. A skin biopsy revealed dermal infiltration by neutrophils consistent with Sweet Syndrome. She started steroid treatment with a good clinical response. Further questioning revealed that she had a similar episode 10 years prior that had been diagnosed as acute disseminated encephalomyelitis. Neuro-Sweet Syndrome can present with a great array of symptoms and relapses over long periods of time making the diagnosis difficult without a high degree of suspicion. Clinicians should consider this syndrome in the setting of acute encephalitis with white matter lesions that are highly responsive to steroids particularly in the presence of previous similar symptoms.
Attitudes and associated factors of patients’ adoption of patient accessible electronic health records in China — A mixed methods study
Authors: Liu Jing , Gong Xiaoqian , Weal Mark , Dai Wei , Hou Shengchao , Ma Jingdong 
Published: May 2023

Background Although patient accessible electronic health records (PAEHRs) offer great potential in enhancing the provision of patient-centered care and improving satisfaction, the adoption rate is still low. Currently, few studies are there for researchers and health organization leaders to understand patients’ thoughts and related factors of PAEHRs adoption in developing countries. China adopted more limited practices of PAEHRs, among which we selected Yuebei People's Hospital as an example. Objective The study aimed to research patient attitudes toward PAEHRs use and the associated factors of patients’ adoption of PAEHRs in China, which is achieved by both qualitative and quantitative studies. Methods This study employed sequential mixed-methods. The DeLone & McLean information systems (D&M IS) success model, Unified Theory of Acceptance and Use of Technology (UTAUT) and task-technology fit (TTF) model were used to guide the research. Finally, we collected 28 valid in-depth interview responses, 51 valid semi-structured interview responses and 235 valid questionnaire responses. The research model was tested and validated using data collected. Results The findings of the qualitative study reveal that patients’ rate perceived task productivity and customer satisfaction as benefits, and poor-quality information as flaws. Results of the quantitative study show that the drivers of behavioral intention are performance expectance, effort expectancy and social influence; the predictors of use behavior are TTF and behavioral intention. Conclusion It is necessary to consider PAEHRs’ task-tool role in patients’ adoption behavior. Hospitalized patients value PAEHRs’ practical attributes and attach much importance to the information content and application design.
How do Specialists Address Contraceptive Care Compared to General Practitioners in a Federally Qualified Health Center in Maryland
Authors: Hart Leah , Beaudoin Jarett , Parsons Georgia , Alonge Olakunle 
Published: May 2023

Objectives: To determine associations between primary provider specialty and the contraceptive care that patients receive in a Federally Qualified Health Center setting in Maryland. Methods: A study of reproductive-age patients and their providers was performed from January 2018 to December 2021. A pooled crosssectional survey of electronic medical record data for 44 127 encounters of 22 828 patients was performed to calculate the odds of contraceptive care being addressed by patients who had General Practitioner, OB/GYN, pediatrician, or infectious disease (ID) specialists as their primary providers. Results: In 19 041 encounters (43%), contraception was addressed through either counseling alone, documentation of a contraceptive prescription, or long-acting reversible contraceptive (LARC) placement procedure. After adjusting for insurance status and race/ethnicity, the odds ratio (OR) of contraceptive care delivery was statistically significantly higher for OB/GYN providers compared to General Practitioners—OR 2.42 (CI 2.29-2.53) and statistically significantly lower for ID providers—OR 0.69 (CI 0.61-0.79). There was a non-statistically significant difference for Pediatricians—OR 0.88 (CI 0.77-1.01). Conclusion: The provision of contraceptive care, a critical aspect of comprehensive primary care delivered in an FQHC setting, varies by provider specialty, and may be negatively influenced by Ryan White funding related structures. There is a need to intentionally design robust referral and tracking systems to ensure contraceptive care is equitably accessible to all, regardless of assigned primary care provider specialty or HIV status.
Massive and Irreparable Rotator Cuff Tears: A Review of Current Definitions and Concepts
Authors: Sheth Mihir M. , Shah Anup A. 
Published: May 2023

Background: While massive and irreparable rotator cuff tears (MIRCTs) have been abundantly studied, inconsistent definitions in the literature and theories about pain and dysfunction related to them can be difficult to navigate when considering an individual patient. Purpose: To review the current literature for definitions and critical concepts that drive decision-making for MIRCTs. Study Design: Narrative review. Methods: A search of the PubMed database was performed to conduct a comprehensive literature review on MIRCTs. A total of 97 studies were included. Results: Recent literature reflects added attention to clarifying the definitions of “massive, “irreparable,” and “pseudoparalysis.” In addition, numerous recent studies have added to the understanding of what generates pain and dysfunction from this condition and have reported on new techniques for addressing them. Conclusion: The current literature provides a nuanced set of definitions and conceptual foundations on MIRCTs. These can be used to better define these complex conditions in patients when comparing current surgical techniques to address MIRCTs, as well as when interpreting the results of new techniques. While the number of effective treatment options has increased, high-quality and comparative evidence on treatments for MIRCTs is lacking.
Perspectives of lignite post-mining landscapes under changing environmental conditions: what can we learn from a comparison between the Rhenish and Lusatian region in Germany?
Authors: Gerwin Werner , Raab Thomas , Birkhofer Klaus , Hinz Christoph , Letmathe Peter , Leuchner Michael , Roß-Nickoll Martina , Rüde Thomas , Trachte Katja , Wätzold Frank , Lehmkuhl Frank 
Published: May 2023

Abstract
Background
The decision of the German federal government to cease lignite mining until 2038 or—if possible—already earlier until 2030, will cause manifold transition processes in the remaining lignite mining districts of Germany. The two largest districts are located in geographically opposite regions: The Rhineland in the western part and Lusatia in the east of Germany. As particularly these two mining districts will experience severe changes in their socioeconomic as well environmental conditions, the federal government has adopted comprehensive economic support measures. However, the environmental changes will also cause altered ecosystem functions and services to be provided by the future post-mining landscapes.

Results
In this paper, the two main lignite-producing regions of Germany are compared with regard to their natural and cultural settings. The economic situation and its history are reflected and differences are outlined. Part of the disparities in the cultural development can be explained by very different natural conditions, especially edaphic factors and climatic situation. Because of dissimilar geological settings, different mining technologies were developed and are in use in the two regions with distinct effects on the resulting post-mining landscapes.

Conclusion
The long-standing and manifold lignite mining activities have radically restructured the landscapes in Lusatia and the Rhineland. With the ongoing decline of the mining industry and its complete cessation, presumably within the next decade, both regions will alter their faces significantly. These changes offer both challenges but also opportunities with respect to the post-mining landscapes and their ecosystem services they are going to provide. The prerequisites for a positive socioeconomic development and for sustainable land-use concepts that also consider ecological aspects are different for both regions. However, or especially because of these differences, the knowledge exchange and experience transfer between both mining regions are pivotal for the success of this extensive transformation process.