bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities in Vision Screening in Primary Care for Young Children With Autism Spectrum Disorder
Authors: Hoover Kimberly , Di Guglielmo Matthew D. , Perry Brittany 
Published: March 2023

OBJECTIVES
To determine the rate of vision screening among children with and without autism spectrum disorder (ASD), the rate of photoscreening compared with visual acuity screening, and the effect of demographic factors on vision screening for children with ASD.

METHODS
Data from well visits for 3- to 5-year-olds between January 2016 and December 2019 were collected via PEDSnet. Billing codes for vision screening were a proxy for the completion of vision screening. χ2 analysis examined the relationship of age, sex, race, ethnicity, region, and socioeconomic status to vision screening rate and rate of photoscreening versus visual acuity screening. Multivariate logistic regression assessed factors that impacted the odds of vision screening.

RESULTS
We analyzed 63 829 well-child visits. Children with ASD were less likely to have a vision screening (36.5%) compared with children without ASD (59.9%). The lowest rates of screening occurred during the 3-year visit. Of those with ASD, Black children had a lower screening rate (27.6%) than white (39.7%) and other/multiracial children (39.8%). The use of photoscreening was higher in Hispanic children, increasing the overall rate of vision screening greater than non-Hispanic children. Practice region influenced the rates of vision screening for children with ASD because of more photoscreening.

CONCLUSIONS
Children with ASD are less likely to receive vision screening at well visits compared with typically developing children. This disparity was greatest among younger children and Black children. One practice region used more photoscreening and had higher rates of screening. Photoscreening is a useful tool to decrease disparity, especially among high-risk patient groups.
Potential of machine learning methods in operational risk stratification in patients with coronary artery disease scheduled for coronary bypass surgery
Authors: Golukhova E. Z. , Keren M. A. , Zavalikhina T. V. , Bulaeva N. I. , Akatov D. S. , Sigaev I. Yu. , Yakhyaeva K. B. , Kolesnikov D. A. 
Published: March 2023

Aim. To develop and evaluate the effectiveness of models for predicting mortality after coronary bypass surgery, obtained using machine learning analysis of preoperative data.Material and methods. As part of a cohort study, a retrospective prediction of in-hospital mortality after coronary artery bypass grafting (CABG) was performed in 2182 patients with stable coronary artery disease. Patients were divided into 2 following samples: learning (80%, n=1745) and training (20%, n=437). The initial ratio of surviving (n=2153) and deceased (n=29) patients in the total sample indicated a pronounced class imbalance, and therefore the resampling method was used in the training sample. Five machine learning (ML) algorithms were used to build predictive risk models: Logistic regression, Random Forrest, CatBoost, LightGBM, XGBoost. For each of these algorithms, cross-validation and hyperparameter search were performed on the training sample. As a result, five predictive models with the best parameters were obtained. The resulting predictive models were applied to the learning sample, after which their performance was compared in order to determine the most effective model.Results. Predictive models implemented on ensemble classifiers (CatBoost, LightGBM, XGBoost) showed better results compared to models based on logistic regression and random forest. The best quality metrics were obtained for CatBoost and LightGBM based models (Precision — 0,667, Recall — 0,333, F1-score — 0,444, ROC AUC — 0,666 for both models). There were following common high-ranking parameters for deciding on the outcome for both models: creatinine and blood glucose levels, left ventricular ejection fraction, age, critical stenosis (>70%) of carotid arteries and main lower limb arteries.Conclusion. Ensemble machine learning methods demonstrate higher predictive power compared to traditional methods such as logistic regression. The prognostic models obtained in the study for preoperative prediction of in-hospital mortality in patients referred for CABG can serve as a basis for developing systems to support medical decision-making in patients with coronary artery disease.
Association of hypertriglyceridemia with risk factors for cardiovascular and renal complications in individuals with high cardiovascular risk
Authors: Murkamilov I. T. , Fomin V. V. , Murkamilova Zh. A. , Sabirov I. S. , Sabirova A. I. , Umurzakov Sh. E. , Yusupov F. A. , Maanaev T. I. , Gasanov K. A. 
Published: March 2023

Aim.To study clinical and functional manifestations of hypertriglyceridemia and its association with risk factors for cardiovascular and renal complications in individuals with high cardiovascular risk.Material and methods. The study included 272 patients (129 men and 143 women; mean age, 53,9±13,7 years) with a high cardiovascular risk, which was stratified using Systematic Coronary Risk Evaluation (SCORE) model by the presence of cardiovascular disease, and/or diabetes, and/or age ≥65 years, and/or blood pressure (BP) >180/110 mm Hg, and/or total cholesterol (TC) level >8,0 mmol/l. All study participants underwent clinical and paraclinical examination. Serum content of triglycerides (TGs) ≥1,7 mmol/L was considered hypertriglyceridemia (HTG). Depending on TG level, the entire sample was divided into 2 following subgroups: subgroup 1 (n=178) — serum triglycerides ≤1,6 mmol/l; subgroup 2 (n=94) — serum triglycerides ≥1,7 mmol/l, i.e. HTG.Results. We revealed significantly more persons with obesity (46,8%) and type 2 diabetes (28,7%) in HTG subgroup. There were 56,3% and 36,1% patients of HTG subgroup with hypertension (HTN) and coronary artery disease (CAD), respectively. A mid-high TG level (from 1,7 to 2,3 mmol/l) in the subgroup of patients with HTG was detected in 38,3% of cases. The serum content of TG from 2,3 to 5,6 mmol/l was detected in 54,2% of patients. TG level ≥5,6 mmol/l was detected in 7,5% of cases. In the subgroup of patients with HTG, high levels of systolic, diastolic and central (aortic) BP, body mass index, phosphorus, creatinine, cystatin C, estimated glomerular filtration rate (eGFR), and carotid intima-media thickness (IMT) were detected significantly more common. In the general sample, a significant direct relationship between TG concentration and cystatin C (r=0,168) and an inverse (negative) relationship with eGFR (r=-0,220) was obtained.Conclusion. Elevated serum TG levels are often observed in individuals with obesity, type 2 diabetes, hypertension and CAD. Patients with HTG had a pronounced cardiovascular and renal risk, including a significant increase in BP and carotid IMT, high levels of total cholesterol, low-density lipoprotein cholesterol, phosphorus, creatinine, cystatin C, and a decrease in eGFR. HTG was associated with an increase in serum cystatin C and a deterioration in renal nitrogen excretion.
Long-term survival of patients with cerebrovascular accident in different age groups in the REGION-M registry
Authors: Tolpygina S. N. , Zagrebelny A. V. , Chernysheva M. I. , Voronina V. P. , Kutishenko N. P. , Dmitrieva N. A. , Lerman O. V. , Lukina Yu. V. , Blagodatskikh S. V. , Lukyanov M. M. , Okshina E. Yu. , Parsadanyan N. E. , Martsevich S. Yu. , Drapkina O. M. 
Published: March 2023

Aim. To study the two-year survival rate of patients with cerebrovascular accident (CVA) in different age groups.Material and methods. The outpatient part of the REGION-M registry included 684 patients assigned to the City Polyclinic № 64 in Moscow, discharged from the F. I. Inozemtsev City Clinical Hospital (Moscow) in the period from January 1, 2012 to April 30, 2017 with a confirmed diagnosis of stroke or transient ischemic attack. All patients were divided into 5 age groups: group 1 — from 18 to 50 years old (n=72 (10,5%)), group 2 — from 51 to 60 years old (n=122 (17,8%)), group 3 — from 61 to 70 years old (n=156 (22,8%)), group 4 — from 71 to 80 years old (n=185 (27,0%)) and group 5 — 81 years and above (n=149 (21,8%)). Patient survival was assessed after 2 years of follow-up.Results. The mortality rate of patients during the follow-up period significantly increased with age as follows: in patients of 18-50 years old — 4%, 51-60 years old — 9,8%, 61-70 years old — 23,7%, 71-80 years old — 34%, 81-100 years old — 55% (p<0,0001). The relative death risk was 2,3 in group 2 (NA), 6,8 in group 3 (p<0,001), 9,8 in group 4 (p<0,0001) and 18,5 in group 5 (p<0,0001) compared with group 1. With increasing age in the study cohort, the proportion of women increased as follows: from 47,2% in group 1 to 77,9% in group 5 (p<0,0001). However, mortality among men and women in the groups did not differ. Patients in older age groups were more likely to have comorbidities and disability before the CVA. With increasing age, ischemic stroke was significantly more common and transient ischemic attack was less common (p<0,001).Conclusion. Mortality of patients who underwent stroke was significantly higher in older age groups and did not differ among men and women.
Possibilities of lipid clinics in identifying patients with familial hypercholesterolemia
Authors: Kim Z. F. , Galyavich A. S. , Sadykova D. I. , Nurieva L. M. 
Published: March 2023

Aim.To assess the detection rate of familial hypercholesterolemia among outpa­tients visiting a lipidologist.Material and methods.We analyzed the causes and nature of lipid metabolism disorders in patients of the Adult Lipidology Center as follows: 1233 people aged 18-84, including 777 women (63,02%) and 456 men (36,98%). Biomaterial samples from 421 patients with the phenotype of definite, possible or probable familial hypercholesterolemia were studied by massive parallel sequencing using a panel of 5 genes associated with familial hypercholesterolemia (LDLR, LDLRAP1, APOB, APOE, PCSK9). For statistical processing, descriptive statistics methods were used.Results.Working-age patients apply 1,56 times more often than patients of the older age group (60,91% vs 39,09%), and the vast majority of them were referred by a primary care physician based on data from periodic health examinations. The mean level of total cholesterol and low-density lipoprotein cholesterol in the lipidology center was 7,58 and 4,8, respectively. Out of 421 samples, 127 patients (10,3% of the total number of patients and 30,16% of the number of biosamples) had previously described variants of the LDLR, APOB and/or PCSK9 genes associated with familial hypercholesterolemia.Conclusion.The detection rate of definite familial hypercholesterolemia ranges from 5,51 to 8,43% of outpatients visiting a lipidologist, while the proportion of verified carriers of gene mutations related to familial hypercholesterolemia is 10,3%. The diagnosis should not be rejected with a formally low probability according to the S. Broom and DLCN criteria, as well as when identifying data suggestive of secondary lipid metabolism disorders.
Principles of healthcare management for patients with pulmonary hypertension: focus on continuity
Authors: Ryabkov V. A. , Vezikova N. N. , Goncharova N. S. , Simakova M. A. , Moiseeva O. M. 
Published: March 2023

In managing care for patients with rare, rapidly progressive pathologies such as pulmonary hypertension (PH) and chronic thromboembolic hypertension (CTEPH), early diagnosis and speed of routing are of particular importance. Reducing the time spent on patient routing reduces the risk of disease progression, the rate of hospitalizations, and thereby the socioeconomic burden of the disease.In the Republic of Karelia, an algorithm for routing patients with PH and CTEPH has been created, which is an example of a successful healthcare management.
Integrated solution for patients of a very high cardiovascular risk. Final results
Authors: Usova E. I. , Ionov M. V. , Alieva A. S. , Avdonina N. G. , Yakovlev A. N. , Zvartau N. E. 
Published: March 2023

Secondary prevention should be actively implemented at all stages of treatment and rehabilitation of patients after acute coronary syndrome (ACS). The integration of remote monitoring of patients with the transfer of vital and laboratory data into clinical practice seems promising.Aim.To evaluate the clinical and patient-centered effectiveness of the original 12-month combined face-to-face and telecare program in patients with recent ACS.Material and methods. For the present analysis the data from 84 (out of 100) patients (median age, 56 (50;61) years, 70 males) was used. These patients had to have hypertension and/or type 2 diabetes and an ACS with percutaneous revascularization within 12 months. Their low-density lipoprotein cholesterol (LDL-C) had to be above 2,4 mmol/L. Telehealth program supplemented routine care. A program contained electronic self-control diaries for blood pressure (BP) and lipid profile, and teleconsulting service (text chat). Mandatory face-to-face visits were carried out at 3 and 12 months after the enrollment. The primary end point was ∆LDL-C. Additional clinical and patient-specific endpoints were evaluated.Results.At the 12-month visit, there was a significant decrease in LDL-C by 1,6 (-2,3;-0,9) mmol/L. Besides the initial LDL-C value, the decrease in LDL-C was associated with the proper adherence to keeping diaries of BP and lipid profile (β=0,7), and the number of text messages sent by the doctor in the 1st month after the enrollment (β=0,04). In more adherent patients, the ∆LDL-C was greater by 0,49 mmol/L (95% CI (-1,2; -0,1)) after adjustment for abovementioned covariates. In 35 patients (42%), target LDL-C was achieved, in 60 patients (71%) — a decrease ≥1 mmol/l. Other lipids also have changed for the better. Moreover, adherent patients were twice as likely to achieve the target LDL-C (OR 2,2; 95% CI (0,6; 3,8)) than non-adherent ones. A decrease in office systolic BP by 5,8 mm Hg was shown (p=0,03). The number of physician-to-patient messages exceeded those from patients to physician (median 143 and 111 per patient for 12 months, respectively). The quality of life has improved, but only in terms of emotions. Satisfaction with the program remained high at all timepoints of the study.Conclusion.Our study showed the effectiveness of the integrated care in ACS patients with the telehealth tool included. Commitment to BP self-monitoring, as well as active consultative support at the first stages of rehabilitation, contributes to additional dynamic control of lipid profile, timely correction of lipid-lowering therapy with the achievement of the target LDL-C level. Most of the patients did not experience any difficulties in using the program and are ready to recommend integrated approach to other peers.
The cost effectiveness of the respiratory virus panel in childhood febrile neutropenia
Authors: KARA Buket , ALKAN Gülsüm , ERTAN Kübra , EMİROĞLU Melike , ARSLAN Prof. Dr. Uğur , VATANSEV Hüsamettin , KÖKSAL Yavuz 
Published: March 2023

ABSTRACT
Objective: The aim of this study is to analyze the clinical utility and cost of the respiratory virus panel test in the febrile neutropenia (FN) episode in children undergoing chemotherapy.
Material and Method: From 2014 to 2018, 180 episodes of FN in 93 children with cancer were retrospectively analyzed. The patients were divided into those with (Group A) and without respiratory virus panel (Group B). The demographic and clinical features and cost analysis of the groups A and B were noted.
Results: Of these FN episodes, 46 were in Group A (25.5%) and 134 were in Group B (74.5%). We found positivity in 45 (97.8%) of 46 episodes in Group A. While modification was required in 14 FN episodes (30.4%) in Group A, modification was required in 35 FN episodes (26.1%) in group B. The difference was not statistically significant (p=0.570). In Group A, only 5 (10.8%) were modified according to the respiratory virus panel. The respiratory virus panel prices were $72.43 (interquartile range, $38.8). The ratio of respiratory virus panel cost to the total cost was 9.67% (interquartile range 11.6). The median total cost of group A was $663.18 (interquartile range, 850.1), while that of group B was $596.24 (interquartile range, 723.81). The difference was not statistically significant (p=0.141).
Conclusion: The respiratory virus panel may contribute to the preference of antibiotics by giving rapid results in FN attacks. However, no effect on modification rates was observed, and only a small percentage of patients underwent antibiotic modification according to respiratory virus panel.
Gastrointestinal System Involvement of Multisystem Inflammatory Syndrome in Children (MIS-C): A Single Center Experience of 47 cases
Authors: YÜCEL Aylin , METİN Ozge 
Published: March 2023

Abstract
Backgraound/Aims: Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory syndrome which was newly described during the coronavirus disease 2019 (COVID-19) pandemic in children and characterized by fever, inflammation, multiorgan dysfunction. One of the major clinical presentation is gastrointestinal system involvement. The aim of the study is to evaluate the clinical course and outcome according to the severity of gastrointestinal presentation, focusing on MIS-C cases with gastrointestinal system involvement.
Methods: We performed a retrospective study of 47 MIS-C patients with gastrointestinal involvement in our clinic between October 2020 and March 2022. The patients were divided into two groups according to the severity of gastrointestinal involvement. The groups were compared in terms of demographic characteristics, gastrointestinal symptoms, laboratory parameters, other system involvement, length of hospital stay, treatment modalities, and clinical outcomes.
Results: According to the severity of gastrointestinal system involvement, 44.7% (n=21) of the cases were mild to moderate, 55.3% (n=26) were severe. The most common gastrointestinal symptoms at presentation were abdominal pain (78.7%), vomiting (59.6%), and nausea (55.3%). Transaminase elevation was present in 29.8% of the cases. The most common radiological findings were ascites (36.2%) and pancreatic edema (27.7%). In cases presenting with acute pancreatitis (n=9), intensive care unit admission rates (n=6) were statistically significantly higher. Brain natriuretic peptide (p=0.020) and d-dimer (p=0.032) were statistically significantly higher in the severe group than in the mild to moderate group.
Conclusions: In a significant part of the MIS-C cases with gastrointestinal involvement, severe findings is observed. Especially in cases presenting with pancreatitis, a more severe clinical course may be observed. Therefore, when managing patients presenting with gastrointestinal symptoms, the evaluation for pancreatitis is essential.
The change in disease severity and medication adherence of patients registered in community mental health center in the Covid-19 pandemic
Authors: YILMAZ Seda , KILIÇ Nülüfer 
Published: March 2023

Aim:
In this study, we aimed to investigate the changes in disease severity and medication adherence of patients who stayed away from Community Mental Health Center (CMHC) activities during the Covid-19 pandemic period although they participated more regularly in CMHC activities before the Covid-19 pandemic.
Materials and Methods:
54 patients who regularly attended CMHC were included in the study retrospectively. The first interview in this study was held in January 2020, and the second interview was held in June 2021.
Results:
The increase in the PANSS total 2 score compared to the PANSS total 1 score, the increase in the PANSS positive 2 score compared to the PANSS positive 1 score, the increase in the YMRS 2 score compared to the YMRS 1 score, and the decrease in the MMAS 2 score compared to the MMAS 1 score were found to be significant (p
Prognostic value of systemic immune-inflammation index in head and neck carcinoma patients undergoing definitive radio(chemo)therapy
Authors: GÜRDAL Necla , CERAN Yaren , KOTEK SEDEF Ayse 
Published: March 2023

ABSTRACT
Background:
The aim of this study is to investigate the prognostic effect of the systemic immune-inflammation index (SII) in non-surgically managed head and neck carcinoma patients who underwent definitive radio(chemo)therapy.
Methods:
Twenty four patients who were all treated with radio(chemo)terapy with curative intent for head and neck cancer (HNC) were included in the study. All patients were analyzed in terms of age at diagnosis, gender, body mass index, stage, radiotherapy dose/ fraction, chemotherapy (CT), pre-treatment complete blood count parameters, the pre-treatment systemic immune-inflammation index, local relapse, distant failure, overall survival (OS), and disease-free survival (DFS).
Results:
SII index was observed to be higher in locally advanced patients than in stage I/II patients (p=0.004). In addition, as a result of the evaluation made with ROC (receiver operating characteristic) analysis, it was observed that the SII index had a diagnostic value in predicting locally advanced disease (AUC:0.867, 95% CI :0.721-1.00, p=0.002). DFS and OS rates were 79% and 90% at a median follow-up of 9 months.
Conclusions:
The systemic immune-inflammation index predicts more advanced disease in non-surgically managed head and neck cancer patients. It can be considered as a biomarker that can contribute to the management of definitive radio(chemo)therapy.
New proteins in the differentiation of papillary renal cell carcinoma from clear cell renal cell carcinomas; Importance of DARS2, Reelin and Enkurin
Authors: BALTA Hilal , KOCAMAN Nevin , ÜÇER Özlem 
Published: March 2023

Purpose: The purpose of the present study was to examine the roles of new proteins DARS2, Reelin, and Encurin in the differentiation of Clear-Cell Renal Cell Carcinoma (RCC) and Papillary Renal Cell Carcinoma (RCC). Clear-cell RCC is the most common malignancy of the kidney, and papillary RCC is the second most common malignant malignancy in this respect. They are neoplasms and show similarity to each other, both histologically and morphologically, in some cases. Differential diagnosis is important because treatment approaches and prognoses are different. Although careful histopathological examination and specific immunohistochemical markers are important for diagnosis, there are no specific antibodies that can be used reliably and the search for biomarkers continues in this regard.
Materials and Methods: A total of 30 Clear-Cell RCC and 30 Papillary RCC cases were included in the present study. Patients were identified retrospectively by reviewing the hospital database and pathological reports. Pathological data were obtained from hospital medical archives and pathology reports.
Results: It was found that DARS2, Reelin, and Encurin proteins were significantly higher in papillary RCC when compared to clear-cell RCC.
Conclusion: It was concluded that DARS2, Reelin, and Encurin proteins may be potential biomarkers for the differentiation of Papillary RCC and Clear-Cell RCC.