bluuebunny/crossref_metadata_2025_split huggingface dataset:
T-HAD Score: A Novel Diagnostic Model for Advanced Fibrosis in Nonalcoholic Fatty Liver Disease (NAFLD)
Authors: Oommen Tharun Tom , Varghese Jijo , Devadas Krishnadas , Hareendran Atul , Nahaz Nibin , Giri Suprabhat 
Published: July 2023

Background and Aims. The NAFLD disease spectrum includes simple steatosis, nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. Progression from NASH, the forerunner of developing cirrhosis, portends a poor outcome as mortality is proportionately increased. This study sought to propose a new diagnostic model for advanced fibrosis in an Asian population cohort affected with NAFLD. Methods. Cross-sectional study conducted in the Department of Medical Gastroenterology, Medical College, Trivandrum. The study period was 2 years. After excluding secondary causes of hepatic steatosis, patients were subjected to vibration-controlled transient elastography or transient elastography (VCTE or TE) to assess hepatic fibrosis. Subjects were grouped into those with advanced fibrosis (

TE
>
10

Kpa) and those without (

TE
<
10

Kpa) based on the estimation of TE. A new scoring system was then developed. This was then validated in a cohort of 84 biopsy-proven patients.Results. 1617 NAFLD patients were included in the study. Independent predictors of advanced fibrosis in this cohort were hip circumference, triglycerides, aspartate aminotransferase (AST), and diabetes mellitus (duration more than 10 years). The coefficient of beta for these variables was calculated. T-HAD score was calculated using the following formula:

Hip

circumference
×
0.044
+
AST
×
0.028
+
diabetes

mellitus
×
3.7

−

0.03
×
triglycerides

. The AUROC of the T-HAD score was 0.929. The T-HAD score had a sensitivity of 90% and a specificity of 77% at a cut off of >2 for advanced fibrosis. We validated this score in another cohort of liver biopsy with advanced fibrosis. In the validation cohort, the T-HAD score had an AUROC of 0.926 in diagnosing advanced fibrosis (sensitivity of 89% and specificity of 71% at a cut off of >2). Conclusion. The T-HAD score based on data from the Asian population is a new diagnostic model which is beneficial in estimating the risk of advanced fibrosis. It is a simple yet effective tool that could be in-cooperated into day-to-day practice in a resource-limited setting.
The Macarian Homilies and Maximus the Confessor as Sources of al-Firdaws al-ʿaqlī (The Noetic Paradise)
Authors: Treiger Alexander 
Published: July 2023

Abstract
Al-Firdaws al-ʿaqlī (The Noetic Paradise) is an anonymous patristic treatise on spiritual life, which, as far as currently known, is lost in the original Greek and preserved only in Arabic. The purpose of the present contribution is to explore two of the principal sources of the Firdaws: the Macarian Homilies and the writings of St. Maximus the Confessor. This source-critical examination is a crucial preliminary step towards contextualizing the Firdaws and determining more precisely the location and time of its composition.
Projections of Large-Scale Atmospheric Circulation Patterns and Associated Temperature and Precipitation over the Pacific Northwest Using CMIP6 Models
Authors: Taylor Graham P. , Loikith Paul C. , Lee Hugo Kyo , Lintner Benjamin , Aragon Christina M. 
Published: July 2023

Abstract
Climate model projections of atmospheric circulation patterns, their frequency, and associated temperature and precipitation anomalies under a high-end global warming scenario are assessed over the Pacific Northwest of North America for the final three decades of the twenty-first century. Model simulations are from phase 6 of the Coupled Model Intercomparison Project (CMIP6) and circulation patterns are identified using the self-organizing maps (SOMs) approach, applied to 500-hPa geopotential height (Z500) anomalies. Overall, the range of projected circulation patterns is similar to that in the current climate, especially in winter, whereas in summer the models project a general reduction in the magnitude of Z500 anomalies. Significant changes in pattern frequencies are also projected in summer, with an overall decrease in the frequency of patterns with large Z500 anomalies. In winter, patterns historically associated with anomalously cold weather in northern latitudes are projected to warm the most, and in summer the largest temperature increases are projected over inland areas. Precipitation is found to increase across all seasons and most SOM patterns. However, some summer patterns that are associated with above-average precipitation in the current climate are projected to become significantly drier by the end of the century.

Significance Statement
This paper uses a novel method to analyze projections of large-scale atmospheric circulation over the Pacific Northwest of North America, reducing the uncertainty of changes to the circulation patterns over the region under a high-emissions scenario of global warming.
Pain Management Education for Rural Hospice Family Caregivers: A Pilot Study With Embedded Implementation Evaluation
Authors: Starr Lauren T. , Washington Karla T. , Jabbari JoAnn , Benson Jacquelyn J. , Oliver Debra Parker , Demiris George , Cagle John G. 
Published: July 2023

Background Assessing and managing hospice patients’ pain is a common source of anxiety among hospice family caregivers (HFCGs), especially caregivers in rural communities who face special challenges including distance, limited access, and concerns about opioid misuse. Objective To pilot test Ready2Care, a pain management education intervention for rural HFCGs. We sought to determine whether there was a signal of benefit for clinically-relevant outcomes and to identify contextual factors pertinent to conducting a future randomized clinical trial of Ready2Care. Methods We conducted a multi-method, single-arm study, enabling completion of paired t-tests comparing pre- and post-intervention measures of caregiver anxiety, pain management self-efficacy, barriers to pain management, and reports of patient pain intensity and corresponding patient and caregiver distress. We concurrently conducted an embedded implementation evaluation via calculation of descriptive statistics (recruitment and retention data) and directed content analysis of brief caregiver interviews. Results Twenty-seven (n = 27) HFCGs participated; 15 completed the study. Among completers, significant improvement was observed in patient pain intensity (average 1.4 points decrease on 0-10 scale) and in overall pain experience. No statistically significant changes were detected in caregiver anxiety, barriers to pain management, or pain management self-efficacy. Facilitators to successful conduct of a future clinical trial included high acceptability of Ready2Care, driven by its perceived clarity and relevance to caregivers’ concerns. Barriers included lower-than-anticipated accrual and an attrition rate of nearly 44%. Conclusion A multisite clinical trial of Ready2Care is warranted; however, its success may require more effective recruitment and retention strategies for rural caregiver participants.
The preventive effect of dexmedetomidine on anesthesia complications in strabismus surgery: a systematic review and meta-analysis
Authors: Chen Yiren , Li Mingjie , Zheng Yajing , Chen Ailuan , Li Chengjie 
Published: July 2023

Abstract
Objective
Dexmedetomidine is a medication that has analgesic, sedative, and anti-anxiety properties. In the clinical, it is often used to prevent common complications associated with strabismus surgery, including postoperative delirium, postoperative nausea and vomiting, postoperative pain, and oculocardiac reflex. However, its effectiveness and side effects of the present studies are different. The sample sizes of the present studies on the prevention of complications of dexmedetomidine are small. Therefore, this study evaluates the efficacy of dexmedetomidine in preventing anesthesia-related complications in strabismus surgery through a systematic review and meta-analysis.

Methods
Literature was retrieved from 10 commonly used databases and randomized controlled trials published up to May 2022 were sought. The included studies compared the intervention effects of dexmedetomidine versus placebo on anesthesia-related complications in surgery. The occurrence rates of postoperative delirium, postoperative nausea and vomiting, postoperative pain, and oculocardiac reflex in patients undergoing strabismus surgery were evaluated. Statistical analyses and forest plots were generated using Review Manager and STATA software. Binary outcomes were measured using relative risk (RR) with a 95% confidence interval for each outcome. The Cochrane risk of bias tool was used to assess the bias and risk in the studies that met the inclusion criteria.

Results
A total of 13 articles were ultimately included in the analysis, comprising 1,018 patients who underwent strabismus surgery. The dexmedetomidine group, compared to the placebo group, demonstrated significant reductions in the incidence of postoperative delirium (RR = 0.73, P = 0.001), severe postoperative delirium (RR = 0.45, P = 0.005), postoperative nausea and vomiting (RR = 0.48, P < 0.0001), and the need for supplemental analgesia postoperatively (RR = 0.60, P = 0.004). Additionally, subgroup analysis revealed that intravenous administration of dexmedetomidine significantly reduced the incidence of oculocardiac reflex (RR = 0.50, P = 0.001). In contrast, intranasal administration of dexmedetomidine did not have a significant effect on the incidence of oculocardiac reflex (RR = 1.22, P = 0.15). There was a significant difference between the subgroups (P = 0.0005, I2 = 91.7%).

Conclusion
Among patients undergoing strabismus surgery, the use of dexmedetomidine can alleviate postoperative delirium and reduce the incidence of postoperative nausea and vomiting, as well as postoperative pain. Moreover, intravenous administration of dexmedetomidine can lower the occurrence rate of the oculocardiac reflex.
A new classification of periampullary diverticulum: cannulation of papilla on the inner margins of the diverticulum (Type IIa) is more challenging
Authors: Shi He-xian , Ye Yong-qiang , Zhao Hai-wang , Kong De-cai , Huang Shan-zhou , Yan Qian , Chen Yu-bin , Zhang Ping , Chen Sheng , Hou Bao-hua , Zhang Chuan-zhao 
Published: July 2023

Abstract
Background
Periampullary diverticulum (PAD) may make the performance of endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis more difficult and may increase complication rates. The present study evaluated the effects of PAD on first-time ERCP in patients with choledocholithiasis.

Methods
Outcomes were compared in patients with and without PAD and in those with four types of PAD: papilla located completely inside the diverticulum (type I), papilla located in the inner (type II a) and outer (type II b) margins of the diverticulum; and papilla located outside the diverticulum (type III).
Parameters compared included cannulation time and rates of difficult cannulation, post-ERCP pancreatitis (PEP) and perforation.

Results
The median cannulation times in patients with types I, II a, II b, III PAD and in those without PAD were 2.0 min, 5.0 min, 0.67 min, 3.5 min, and 3.5 min, respectively, with difficult cannulation rates in these groups of 7.4%, 31.4%, 8.3%, 18.9%, and 23.2%, respectively. The rates of PEP in patients with and without PAD were 5.3% and 5.1%, respectively. Four patients with and one without PAD experienced perforation.

Conclusions
The division of PAD into four types may be more appropriate than the traditional division into three types. Cannulation of type I and II b PAD was easier than cannulation of patients without PAD, whereas cannulation of type II a PAD was more challenging. PAD may not increase the rates of PEP.
Systematic review and meta-analysis of knowledge on PMTCT of HIV/AIDS and Association factors among reproductive age women in Ethiopia, 2022
Authors: Kassie Sisay Yitayih , Chereka Alex Ayenew , Damtie Yitayish 
Published: July 2023

Abstract
Background
Despite increased interventions implemented for the prevention of mother-to-child transmission of HIV, There is still a vertical transmission. Hence, this study tried to assess the pooled prevalence of knowledge on PMTCT and factors associated with residence, ANC follow-up, and knowledge about HIV/AIDS among reproductive age women in Ethiopia.

Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed to review either published or unpublished studies in Ethiopia regarding knowledge on PMTCT. A comprehensive search of international databases, including Google Scholar, Cochrane Library, PubMed, HINARI, Embrace, Web of Science, Scopus, ProQuest, CINAHL, and Global Health, were searched. The data were analyzed using STATA/SE version 14. The random-effect model was used to estimate the effect size, and I-squared statistics and Egger’s test were used to assess the heterogeneity and publication bias, respectively.

Results
14 out of 14,091 assessed articles met inclusion criteria and were included in the analysis. The estimated pooled level of knowledge on PMTCT among reproductive-age groups was 62.15% [(95% CI: 43.63–80.66)]. Residence [(OR = 4.8, 95%CI: 2.99, 7.85)], ANC follow-up [(OR = 4.2, 95%CI: 2.21, 7.98)], and having sufficient knowledge about the diseases [(OR = 4.9, 95% CI: 3.6, 6.66)] were found to be significant predictors of knowledge on PMTCT among reproductive-age groups.

Conclusion
Strategies to improve the knowledge of PMTCT in Ethiopia should focus on rural women, improving knowledge about HIV/AIDS, and ANC follow-up. Efforts are also needed to involve husbands and related organization in the prevention of mother to child transmission of HIV.
Estimation of the relationship between meteorological factors and measles using spatiotemporal Bayesian model in Shandong Province, China
Authors: Jia Yan , Xu Qing , Zhu Yuchen , Li Chunyu , Qi Chang , She Kaili , Liu Tingxuan , Zhang Ying , Li Xiujun 
Published: July 2023

Abstract
Background
Measles-containing vaccine (MCV) has been effective in controlling the spread of measles. Some countries have declared measles elimination. But recently years, the number of cases worldwide has increased, posing a challenge to the global goal of measles eradication. This study estimated the relationship between meteorological factors and measles using spatiotemporal Bayesian model, aiming to provide scientific evidence for public health policy to eliminate measles.

Methods
Descriptive statistical analysis was performed on monthly data of measles and meteorological variables in 136 counties of Shandong Province from 2009 to 2017. Spatiotemporal Bayesian model was used to estimate the effects of meteorological factors on measles, and to evaluate measles risk areas at county level. Case population was divided into multiple subgroups according to gender, age and occupation. The effects of meteorological factors on measles in subgroups were compared.

Results
Specific meteorological conditions increased the risk of measles, including lower relative humidity, temperature, and atmospheric pressure; higher wind velocity, sunshine duration, and diurnal temperature variation. Taking lowest value (Q1) as reference, RR (95%CI) for higher temperatures (Q2–Q4) were 0.79 (0.69–0.91), 0.54 (0.44–0.65), and 0.48 (0.38–0.61), respectively; RR (95%CI) for higher relative humidity (Q2–Q4) were 0.76 (0.66–0.88), 0.56 (0.47–0.67), and 0.49 (0.38–0.63), respectively; RR (95%CI) for higher wind velocity (Q2–Q4) were 1.43 (1.25–1.64), 1.85 (1.57–2.18), 2.00 (1.59–2.52), respectively. 22 medium-to-high risk counties were identified, mainly in northwestern, southwestern and central Shandong Province. The trend was basically same in the effects of meteorological factors on measles in subgroups, but the magnitude of the effects was different.

Conclusions
Meteorological factors have an important impact on measles. It is crucial to integrate these factors into public health policies for measles prevention and control in China.
Migration and health research: past, present, and future
Authors: Goldenberg Shira M , Fischer Florian 
Published: July 2023

AbstractGlobal migration continues to rise at unprecedented rates. Migrants are an extremely heterogeneous group and face diverse health needs related to infectious diseases, sexual and reproductive health, non-communicable diseases, and healthcare access across the whole lifespan. In this editorial, we set the context and invite contributions for a collection on ‘Migration and health’ at BMC Public Health.
Biomechanical and clinical evaluation of minimal invasive plate osteosynthesis for two-part clavicle shaft fractures
Authors: Schlüßler Antonia , Fehrenbacher Manuel , Richter Richard Frank , Tille Eric , Biewener Achim , Nowotny Jörg 
Published: July 2023

Abstract
Background
Many surgical treatment methods exist for clavicle shaft fractures. A locking compression plate (LCP) fixation with three screws per fracture side is commonly used. For certain fractures a stabilization with 2 screws per side is potentially suitable, offering the advantage of reduced soft tissue approach, while avoiding the disadvantages of minimally-invasive nailing at the same time. This hypothesis was evaluated biomechanically and clinically.

Methods
Four treatment procedures were investigated biomechanically using composite human clavicle specimens. A load-to-failure test was performed using a three-point cantilever test. In group 1, a simple shaft fracture was simulated and stabilized with 2 screws per fracture side (5-hole LCP). In the second group 3 screws per side (7-hole LCP) were used. In group 3, a non-reduced fracture zone was simulated and treated with 3 screws per side (7-hole LCP). In group 4, an anatomically reduced fracture zone was simulated and treated with 3 screws per side (7-hole LCP). Furthermore 27 patients treated with a short plate and 2 screws per side (similar to group 1) were assessed after a minimum follow-up of 12 months (Constant and DASH Score).

Results
The maximum load-to-failure of group 1 was 367N. We observed the highest load-to-failure in group 2 with 497N and the lowest in group 3 with 90N. In group 4 a maximum load-to-failure of 298N could be evaluated. There was no significant difference in load-to-failure between the treatment of a simple clavicle fracture using 5- or 7-hole LCP (p = 0.121). However, we found a significant difference of load-to-failure between the simple and anatomically reduced fracture using a 7-hole plate (p = 0.014). The mean constant score of the surgically treated patients was 95 and the DASH score 3.0. Fracture consolidation was observed in 96.3%.

Conclusions
For certain non-fragmented and well interlocking 2-part fractures, a plate osteosynthesis fixed with only 2 screws per fracture side might offer sufficient biomechanical stability, better soft tissue preservation and comparable fusion rates compared to the operative treatment with 3 screws per side. However, the maximum load-to-failure of the 7-hole LCP was higher than of the 5-hole LCP, but this difference was not statistically significant.

Trial registration
Approval from the ethics committee of the Technical University of Dresden was retrospectively obtained (EK 588122019).
Water-soluble pristine C60 fullerenes attenuate isometric muscle force reduction in a rat acute inflammatory pain model
Authors: Zavodovskiy Danylo O. , Bulgakova Nataliya V. , Sokolowska Inna , Prylutskyy Yuriy I. , Ritter Uwe , Gonchar Olga O. , Kostyukov Alexander I. , Vlasenko Oleh V. , Butowska Kamila , Borowik Agnieszka , Piosik Jacek , Maznychenko Andriy 
Published: July 2023

Abstract
Background
Being a scavenger of free radicals, C60 fullerenes can influence on the physiological processes in skeletal muscles, however, the effect of such carbon nanoparticles on muscle contractility under acute muscle inflammation remains unclear. Thus, the aim of the study was to reveal the effect of the C60 fullerene aqueous solution (C60FAS) on the muscle contractile properties under acute inflammatory pain.

Methods
To induce inflammation a 2.5% formalin solution was injected into the rat triceps surae (TS) muscle. High-frequency electrical stimulation has been used to induce tetanic muscle contraction. A linear motor under servo-control with embedded semi-conductor strain gauge resistors was used to measure the muscle tension.

Results
In response to formalin administration, the strength of TS muscle contractions in untreated animals was recorded at 23% of control values, whereas the muscle tension in the C60FAS-treated rats reached 48%. Thus, the treated muscle could generate 2-fold more muscle strength than the muscle in untreated rats.

Conclusions
The attenuation of muscle contraction force reduction caused by preliminary injection of C60FAS is presumably associated with a decrease in the concentration of free radicals in the inflamed muscle tissue, which leads to a decrease in the intensity of nociceptive information transmission from the inflamed muscle to the CNS and thereby promotes the improvement of the functional state of the skeletal muscle.
Evaluation of mandibular trabecular and cortical bone by fractal analysis and radiomorphometric indices in bruxist and non-bruxist patients
Authors: Çitir Mesude , Karslioglu Hazal , Uzun Canan 
Published: July 2023

Abstract
Background
The aim of this study was to evaluate the effect of bruxism on the cortical and trabecular bone of the mandible using the radiomorphometric indexes and fractal analysis (FA) additionally to examine the efficiency of FA as diagnostic test for bruxism.

Methods
Evaluation was performed on panoramic radiographs of 94 bruxists and 94 non-bruxist individuals with the ImageJ program. Cortical bone was assessed with mandibular cortical index, mental index, and panoramic mental index. Trabecular bone in the condyle, gonial, and corpus region was evaluated by FA. An independent sample t and Mann-Whitney-U tests and Pearson and Spearman rank correlations were conducted for statistical analysis.

Results
A total of 188 participants, 112 female, and 76 male, were included in the study. The sample age ranged from 18 to 43, with a mean of 27.55 (± 7.022) years. FA values of the angulus were significantly higher than those of the condyle and corpus, and the mean of the sample for the angulus, condyle, and corpus, respectively, were; 1.36 (± 10), 1.10 (± 0.9), 1.13 (± 0.8). There was a positive correlation between FA of the mandibular corpus and age (r = .163, p = .025). Females’ values were smaller than males’ in the FAs of three regions, and significant differences were found in FA of the condyle and angulus of the mandible, MCI, and PMI according to gender. There was no statistically significant difference between bruxist and non-bruxist patients in term of FAs of three regions, MCI, MI, and PMI values (p > .05).

Conclusions
FA of the condyle and angulus of the mandible, MCI, and PMI are significantly affected by gender. However bruxism doesn’t cause a significant change in the fractal dimensions of the bone in the mandible and doesn’t change substantially MCI, MI, and PMI.