bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical features of acute generalized exanthematous pustulosis caused by hydroxychloroquine in rheumatology patients and exploration of CARD14 gene mutations
Authors: Luo Feng , Yuan Xue-mei , Xiong Hong , Yang Yu-zheng , Chen Chang-ming , Ma Wu-kai , Yao Xue-ming 
Published: April 2023

IntroductionAcute generalized exanthematous pustulosis (AGEP) is a rare condition characterized by superficial pustules following drug ingestion or infection. Currently, there is no clear link between rheumatism and AGEP. It has been described that hydroxychloroquine (HCQ) is a rare cause of acute generalized epidermal necrolysis (AGEP). Presently, there are limited studies on HCQ-induced AGEP. We aimed to explore the clinical features and associated gene expression of AGEP induced after HCQ treatment exposure in rheumatology patients.MethodsWe assessed patients with HCQ-induced AGEP diagnosed at the Second Affiliated Hospital of Guizhou University of Chinese Medicine between January 1, 2017, and May 1, 2022. We also reviewed similar cases reported in specific databases.ResultsThe study included five females (mean age, 40.2 years), and the mean time from initiation of HCQ treatment to symptom onset was 12.2 d. All patients received steroids and allergy medications after HCQ discontinuation, and the rash completely resolved within an average of 25.2 d. We performed whole exome sequencing and Sanger validation in our patient sample. CARD14 gene mutations were detected in three patients. Additionally, seven mutation sites were detected.DiscussionHCQ-induced AGEP may have a longer latency period and regression time than AGEP induced by other drugs. Our patients all experienced CARD14 gene mutations. AGEP often resolves with topical therapy and drug discontinuation, although some cases require systemic steroid therapy. In the future, patients with rheumatism should pay attention to the effectiveness of HCQ during treatment and be aware of the associated skin toxicity.
Dizziness in Saudi Arabia: An epidemiologic study
Authors: Alharbi Ahmad A. , Alshammari Maryam E. , Albalwi Abdulaziz A. , Ramadan Majed M. , Alsharif Doaa S. , Hafiz Ammar E. 
Published: April 2023

IntroductionDizziness is one of the most common and recurring complaints in adults presenting at the clinic. However, its prevalence in the population of the Kingdom of Saudi Arabia remains unclear. We aimed to examine the prevalence and correlates of dizziness in a large sample of the Saudi population.MethodsIn this is cross-sectional study, we used an electronic survey, which was completed by 1.478 respondents, with a response rate of 84% across five regions of Saudi Arabia. The online survey was launched on the Qualtrics website and distributed via social media channels to obtain heterogeneous responses. The study included adults aged ≥18 years who resided in Saudi Arabia during data collection. We used t-test and chi-square test for descriptive analysis and multiple logistic regression model to assess prevalence and predictors of dizziness.ResultsMore than half of the participants were aged between 26 years and 45 years (58.66%). Of the participants, 42.97% reported having dizziness at the time of taking the survey. Women were less likely than men to report dizziness (OR = 0.65; CI, 0.49, 0.87; p = 0.003). A description of the type of dizziness by age revealed that vertigo slightly decreased with age. Unclear vision with movement or blurry vision was common in young adults, whereas imbalance was common in older adults. A multiple regression model adjusted for demographic characteristics revealed a statistically significant association between dizziness and age group. Participants in the age group of 46–55 years were 1.83 times more likely to report dizziness compared to those aged &gt;65 years (odds ratio = 1.83; confidence interval, 0.62, 5.41; p = 0.0009).DiscussionDizziness is a common complaint in Saudi Arabia. Future studies should elucidate the risk factors for and mechanisms of dizziness to help prevent falls and reduced quality of life.
Neural oscillations during acupuncture imagery partially parallel that of real needling
Authors: Zhang Hao , Liu Qingxia , Yao Menglin , Zhang Zhiling , Chen Xiu , Luo Hua , Ruan Lili , Liu Tianpeng , Chen Yingshuang , Ruan Jianghai 
Published: April 2023

IntroductionTasks involving mental practice, relying on the cognitive rehearsal of physical motors or other activities, have been reported to have similar patterns of brain activity to overt execution. In this study, we introduced a novel imagination task called, acupuncture imagery and aimed to investigate the neural oscillations during acupuncture imagery.MethodsHealthy volunteers were guided to watch a video of real needling in the left and right KI3 (Taixi point). The subjects were then asked to perform tasks to keep their thoughts in three 1-min states alternately: resting state, needling imagery left KI3, and needling imagery right KI3. Another group experienced real needling in the right KI3. A 31-channel-electroencephalography was synchronously recorded for each subject. Microstate analyses were performed to depict the brain dynamics during these tasks.ResultsCompared to the resting state, both acupuncture needling imagination and real needling in KI3 could introduce significant changes in neural dynamic oscillations. Moreover, the parameters involving microstate A of needling imagery in the right KI3 showed similar changes as real needling in the right KI3.DiscussionThese results confirm that needling imagination and real needling have similar brain activation patterns. Needling imagery may change brain network activity and play a role in neural regulation. Further studies are needed to explore the effects of acupuncture imagery and the potential application of acupuncture imagery in disease recovery.
Validation of clinical acceptability of deep-learning-based automated segmentation of organs-at-risk for head-and-neck radiotherapy treatment planning
Authors: Lucido J. John , DeWees Todd A. , Leavitt Todd R. , Anand Aman , Beltran Chris J. , Brooke Mark D. , Buroker Justine R. , Foote Robert L. , Foss Olivia R. , Gleason Angela M. , Hodge Teresa L. , Hughes Cían O. , Hunzeker Ashley E. , Laack Nadia N. , Lenz Tamra K. , Livne Michelle , Morigami Megumi , Moseley Douglas J. , Undahl Lisa M. , Patel Yojan , Tryggestad Erik J. , Walker Megan Z. , Zverovitch Alexei , Patel Samir H. 
Published: April 2023

IntroductionOrgan-at-risk segmentation for head and neck cancer radiation therapy is a complex and time-consuming process (requiring up to 42 individual structure, and may delay start of treatment or even limit access to function-preserving care. Feasibility of using a deep learning (DL) based autosegmentation model to reduce contouring time without compromising contour accuracy is assessed through a blinded randomized trial of radiation oncologists (ROs) using retrospective, de-identified patient data.MethodsTwo head and neck expert ROs used dedicated time to create gold standard (GS) contours on computed tomography (CT) images. 445 CTs were used to train a custom 3D U-Net DL model covering 42 organs-at-risk, with an additional 20 CTs were held out for the randomized trial. For each held-out patient dataset, one of the eight participant ROs was randomly allocated to review and revise the contours produced by the DL model, while another reviewed contours produced by a medical dosimetry assistant (MDA), both blinded to their origin. Time required for MDAs and ROs to contour was recorded, and the unrevised DL contours, as well as the RO-revised contours by the MDAs and DL model were compared to the GS for that patient.ResultsMean time for initial MDA contouring was 2.3 hours (range 1.6-3.8 hours) and RO-revision took 1.1 hours (range, 0.4-4.4 hours), compared to 0.7 hours (range 0.1-2.0 hours) for the RO-revisions to DL contours. Total time reduced by 76% (95%-Confidence Interval: 65%-88%) and RO-revision time reduced by 35% (95%-CI,-39%-91%). All geometric and dosimetric metrics computed, agreement with GS was equivalent or significantly greater (p&lt;0.05) for RO-revised DL contours compared to the RO-revised MDA contours, including volumetric Dice similarity coefficient (VDSC), surface DSC, added path length, and the 95%-Hausdorff distance. 32 OARs (76%) had mean VDSC greater than 0.8 for the RO-revised DL contours, compared to 20 (48%) for RO-revised MDA contours, and 34 (81%) for the unrevised DL OARs.ConclusionDL autosegmentation demonstrated significant time-savings for organ-at-risk contouring while improving agreement with the institutional GS, indicating comparable accuracy of DL model. Integration into the clinical practice with a prospective evaluation is currently underway.
Transvaginal versus transabdominal specimen extraction surgery for right colon cancer: A propensity matching study
Authors: Yu Hongxin , Lu Weijie , Zhong Chonghan , Ju Houqiong , Wu Can , Xu Haocheng , Liu Dongning , Li Taiyuan 
Published: April 2023

BackgroundThe transvaginal route for specimen extraction is considered ideal for colorectal surgery, but its safety is still questioned. There has been little research on transvaginal natural orifice specimen extraction surgery (NOSES) in the right hemicolectomy. As a result, we conducted a study comparing transvaginal NOSES to traditional transabdominal specimen extraction surgery.Patients and methodsData on female patients who underwent radical right hemicolectomy at the First Affiliated Hospital of Nanchang University between January 2015 and December 2020 were collected retrospectively. A total of 847 patients were compliant, with 51 undergoing the transvaginal specimen extraction surgery (NOSES) group and 796 undergoing the transabdominal specimen extraction surgery (TISES) group. A propensity score matching method (1:2) was used to balance the clinicopathological characteristics of the two groups.ResultsFinally, 138 patients were enrolled in our study, with 46 in the NOSES group and 92 in the TISES group. Compared to the TISES group, the NOSES group had less intraoperative blood loss (p = 0.036), shorter time to first flatus (p &lt; 0.001), shorter time to first liquid diet (p &lt; 0.001), lower postoperative white blood cell counts (p = 0.026), lower C-reactive protein levels (p = 0.027), and lower visual analog scale (VAS) scores (p &lt; 0.001). Regarding the quality of life after surgery, the NOSES group had better role function (p &lt; 0.01), emotional function (p &lt; 0.001), and improved symptoms of postoperative pain (p &lt; 0.001) and diarrhea (p = 0.024). The scar satisfaction was significantly higher in the NOSES group than in the TISES group. Overall survival and disease-free survival in two groups were similar.ConclusionThe short-term results of transvaginal NOSES were superior to conventional transabdominal specimen extraction surgery. At the same time, transvaginal NOSES could improve the abdominal wall appearance and quality of life. The long-term survival was similar in the two surgical approaches. Therefore, transvaginal NOSES is worthy of our implementation and promotion.
Autonomic response to walk tests is useful for assessing outcome measures in people with multiple sclerosis
Authors: Kontaxis Spyridon , Laporta Estela , Garcia Esther , Guerrero Ana Isabel , Zabalza Ana , Matteo Martinis , Lucia Roselli , Simblett Sara , Weyer Janice , Hotopf Matthew , Narayan Vaibhav A. , Rashid Zulqarnain , Folarin Amos A. , Dobson Richard J. B. , Buron Mathias Due , Leocani Letizia , Cummins Nicholas , Vairavan Srinivasan , Costa Gloria Dalla , Magyari Melinda , Sørensen Per Soelberg , Nos Carlos , Bailón Raquel , Comi Giancarlo , the RADAR-CNS Consortium  
Published: April 2023

Objective: The aim of this study was to evaluate the association between changes in the autonomic control of cardiorespiratory system induced by walk tests and outcome measures in people with Multiple Sclerosis (pwMS).Methods: Electrocardiogram (ECG) recordings of 148 people with Relapsing-Remitting MS (RRMS) and 58 with Secondary Progressive MS (SPMS) were acquired using a wearable device before, during, and after walk test performance from a total of 386 periodical clinical visits. A subset of 90 participants repeated a walk test at home. Various MS-related symptoms, including fatigue, disability, and walking capacity were evaluated at each clinical visit, while heart rate variability (HRV) and ECG-derived respiration (EDR) were analyzed to assess autonomic nervous system (ANS) function. Statistical tests were conducted to assess differences in ANS control between pwMS grouped based on the phenotype or the severity of MS-related symptoms. Furthermore, correlation coefficients (r) were calculated to assess the association between the most significant ANS parameters and MS-outcome measures.Results: People with SPMS, compared to RRMS, reached higher mean heart rate (HRM) values during walk test, and larger sympathovagal balance after test performance. Furthermore, pwMS who were able to adjust their HRM and ventilatory values, such as respiratory rate and standard deviation of the ECG-derived respiration, were associated with better clinical outcomes. Correlation analyses showed weak associations between ANS parameters and clinical outcomes when the Multiple Sclerosis phenotype is not taken into account. Blunted autonomic response, in particular HRM reactivity, was related with worse walking capacity, yielding r = 0.36 r = 0.29 (RRMS) and r &gt; 0.5 (SPMS). A positive strong correlation r &gt; 0.7 r &gt; 0.65 between cardiorespiratory parameters derived at hospital and at home was also found.Conclusion: Autonomic function, as measured by HRV, differs according to MS phenotype. Autonomic response to walk tests may be useful for assessing clinical outcomes, mainly in the progressive stage of MS. Participants with larger changes in HRM are able to walk longer distance, while reduced ventilatory function during and after walk test performance is associated with higher fatigue and disability severity scores. Monitoring of disorder severity could also be feasible using ECG-derived cardiac and respiratory parameters recorded with a wearable device at home.
Psychosocial safety climate as a predictor of work engagement, creativity, innovation, and work performance: A case study of software engineers
Authors: Zadow Amy , Loh May Young , Dollard Maureen Frances , Mathisen Gro Ellen , Yantcheva Bella 
Published: April 2023

IntroductionCreativity is vital for competitive advantage within technological environments facing the fourth industrial revolution. However, existing research on creativity has rarely addressed how a climate beneficial for worker psychological health, a psychosocial safety climate (PSC), could additionally stimulate the growth of workplace creativity, innovation, and performance in digital environments.MethodTo examine how individually perceived PSC influences subsequent work engagement promoting higher levels of computer-based radical and incremental creativity, innovation, and work performance, employees in a software engineering firm (N= 29, 86 observations) completed a weekly questionnaire for 4 consecutive weeks.ResultsAt the between-person level PSC was positively related to average future weekly individual fluctuations of creativity (radical and incremental), work engagement, and job performance. Additionally weekly work engagement was related to future creativity (radical and incremental). Work engagement also mediated the between-person relationship between PSC and future creativity (both radical and incremental). PSC did not predict innovation.DiscussionThis study contributes to the theory on PSC, creativity, and work performance by elucidating the individual perceived PSC-creativity relationship and suggesting PSC systems as meaningful antecedents to digital work performance.
Simulation-based learning in teacher education: Using Maslow’s Hierarchy of needs to conceptualize instructors’ needs
Authors: Frei-Landau Rivi , Levin Orna 
Published: April 2023

IntroductionSimulation-based learning (SBL) has become an effective tool in the education field, and instructors play a significant role in leading it. Although much is known about participants’ needs, SBL instructors’ needs have yet to be addressed. The study’s goal was to explore SBL instructors’ needs while guiding an SBL workshop using the psychological framework of Maslow’s Hierarchy of Needs.MethodsWe employed a qualitative case-study design, consisting of 68 four-hour-long workshops, held at a teacher-education simulation center by the center’s professional instructors. Data collection comprised 211 statements derived from instructors’ open-ended reflections, the transcripts of two focus groups held with the instructors, and 98 interpersonal communication documents.ResultsData were analyzed using both deductive and inductive thematic analysis, which rendered 11 themes spanning Maslow’s five levels, and revealing two possible simulation-based learning paths: a complete process, in which all needs are met and an incomplete process, in which needs remain unmet.DiscussionTheoretical insights and practical implications are provided for attending to instructors’ needs (i.e., basic needs, security, belonging, self-esteem, self-actualization) to ensure optimal learning in teacher education when using SBL.
Associations of advanced age with comorbidity, stage and primary subsite as contributors to mortality from colorectal cancer
Authors: Gheybi Kazzem , Buckley Elizabeth , Vitry Agnes , Roder David 
Published: April 2023

BackgroundAlthough survival from colorectal cancer (CRC) has improved substantially in recent decades, people with advanced age still have a high likelihood of mortality from this disease. Nonetheless, few studies have investigated how cancer stage, subsite and comorbidities contribute collectively to poor prognosis of older people with CRC. Here, we decided to explore the association of age with mortality measures and how other variables influenced this association.MethodsUsing linkage of several administrative datasets, we investigated the risk of death among CRC cases during 2003–2014. Different models were used to explore the association of age with mortality measures and how other variables influenced this association.ResultsOur results indicated that people diagnosed at a young age and with lower comorbidity had a lower likelihood of all-cause and CRC-specific mortality. Aging had a greater association with mortality in early-stage CRC, and in rectal cancer, compared that seen with advanced-stage CRC and right colon cancer, respectively. Meanwhile, people with different levels of comorbidity were not significantly different in terms of their increased likelihood of mortality with advanced age. We also found that while most comorbidities were associated with all-cause mortality, only dementia [SHR = 1.43 (1.24–1.64)], Peptic ulcer disease [SHR = 1.12 (1.02–1.24)], kidney disease [SHR = 1.11 (1.04–1.20)] and liver disease [SHR = 1.65 (1.38–1.98)] were risk factors for CRC-specific mortality.ConclusionThis study showed that the positive association of advanced age with mortality in CRC depended on stage and subsite of the disease. We also found only a limited number of comorbidities to be associated with CRC-specific mortality. These novel findings implicate the need for more attention on factors that cause poor prognosis in older people.
Evaluation of the impact of the COVID-19 pandemic on health service utilization in China: A study using auto-regressive integrated moving average model
Authors: Xu Rixiang , Wu Lang , Liu Yulian , Ye Yaping , Mu Tingyu , Xu Caiming , Yuan Huiling 
Published: April 2023

BackgroundThe outbreak of COVID-19 in early 2020 presented a major challenge to the healthcare system in China. This study aimed to quantitatively evaluate the impact of COVID-19 on health services utilization in China in 2020.MethodsHealth service-related data for this study were extracted from the China Health Statistical Yearbook. The Auto-Regressive Integrated Moving Average model (ARIMA) was used to forecast the data for the year 2020 based on trends observed between 2010 and 2019. The differences between the actual 2020 values reported in the statistical yearbook and the forecast values from the ARIMA model were used to assess the impact of COVID-19 on health services utilization.ResultsIn 2020, the number of admissions and outpatient visits in China declined by 17.74 and 14.37%, respectively, compared to the ARIMA model’s forecast values. Notably, public hospitals experienced the largest decrease in outpatient visits and admissions, of 18.55 and 19.64%, respectively. Among all departments, the pediatrics department had the greatest decrease in outpatient visits (35.15%). Regarding geographical distribution, Beijing and Heilongjiang were the regions most affected by the decline in outpatient visits (29.96%) and admissions (43.20%) respectively.ConclusionThe study’s findings suggest that during the first year of the COVID-19 pandemic, one in seven outpatient services and one in six admissions were affected in China. Therefore, there is an urgent need to establish a green channel for seeking medical treatment without spatial and institutional barriers during epidemic prevention and control periods.
The relationship between irritability, depression and anxiety among Chinese college students during the COVID-19 pandemic: A network analysis
Authors: Li Ling , Ren Lei , Zhan Xiaoqing , Wang Lingzhi , Liu Chang , Zhao Mengxue , Luo Xi , Feng Zhengzhi , Li Kuiliang 
Published: April 2023

IntroductionIrritability, a common symptom included in the 5th Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is thought to be associated with multiple emotional disorders. It is commonly seen among college students in isolation during the COVID-19 pandemic. However, its relation with anxiety and depression remains unclear. We aim to study the relation of irritability, anxiety and depression in Chinese college students during the COVID-19 pandemic by using network analysis to understand the co-occurrence of these three disorders.MethodsDuring the COVID-19 pandemic, we recruited 1516 college students from five general universities in China to complete the Irritability, Depression and Anxiety Scale (IDA-S) to analyze the symptom network of irritability, depression and anxiety. Specifically, we assessed the indices of strength centrality and bridge strength for each node in the network.ResultsSome strongest linkages were found among anxiety symptoms “nervous” and “panic” (weight = 0.36), depression symptoms “sad mood” and “amused” (weight = 0.32), inward irritability items “self-hurt” and “self-harm” (weight = 0.32) and outward items “rough” and “aggressive” (weight = 0.28). The anxiety symptom “panic” had the highest strength value, followed by the inward irritability symptom “annoyed”. The nodes “ease” and “sleep” had the lowest strength value. In addition, the anxiety symptom “relax” had the highest bridge strength value, followed by inward irritability symptom “annoyed”.ConclusionThis study explored the characteristics of a network of irritability, depression and anxiety symptoms among Chinese college students during the COVID-19 pandemic. We found that anxiety and irritability symptoms played an important role in the network. The findings provide evidence for prevention and intervention for college students' mental health problems during the COVID-19 pandemic.