bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sudden life-threatening laryngeal edema in pregnancy: a case report
Authors: Chrisnata Vincent , Sugiarto Adhrie , Erniody Erniody , Sethiono Aldy 
Published: April 2023

Abstract
Background
Severe laryngeal edema during pregnancy is uncommon but can be encountered, particularly in patients with preeclampsia accompanied by other comorbidities. Careful consideration must be given to balance the urgency of securing the airway with the safety of the fetus and the patient’s long-term health consequences.

Case presentation
A 37-year-old Indonesian woman was brought to the emergency department at 36 weeks gestation due to severe dyspnea. Her condition worsened a few hours later during intensive care unit admission, with tachypnea, decreased oxygen saturation, and inability to communicate, necessitating intubation. Due to the edematous larynx, we could only use 6.0-sized endotracheal tube. The use of a small-sized endotracheal tube was expected to be short-lived, so she was considered for tracheostomy. Nevertheless, we decided to perform a cesarean section first after lung maturation because it would be safer for the fetus, and laryngeal edema usually improves after delivery. Cesarean section was performed under spinal anesthesia for the safety of the fetus, and 48 hours after delivery, she underwent a leakage test with a positive result, so extubation was performed. Stridor was no longer audible, breathing pattern was within normal limits, and vital signs were stable. The patient and her baby both recovered well with no long-term health consequences.

Conclusion
This case demonstrates that unexpected life-threatening laryngeal edema can occur during pregnancy, in which upper respiratory tract infections may trigger it. The decision between conservative and aggressive immediate airway management should be made with careful consideration of securing the patient’s airway, the safety of the fetus, and the patient’s long-term health consequences.
A cross-country comparison of health-related quality of life in the United States, Sweden, and Norway during the first year of the COVID-19 pandemic
Authors: Chen Jiahe , Gong Cynthia L. , Persson Ulf , Gu Ning Yan 
Published: April 2023

Abstract
Background
Limited studies have directly compared health-related quality of life (HRQoL) in different countries during the COVID-19 global pandemic. The objective of this study was to evaluate the HRQoL outcomes in the US, Sweden, and Norway during the first year under the pandemic.

Methods
In April 2020, during early phase of the pandemic, separately in the US, Sweden, and Norway, we surveyed 2,734, 1,003 and 1,020 respondents, then again in January 2021, we collected 2,252, 1,013 and 1,011 respondents. The survey was first developed in English and translated into Swedish and Norwegian. Selected variables were used for the current study. We collected respondents’ HRQoL using the EQ-5D-5L. Respondents’ background information included their sociodemographic data, medical history, and COVID-19 status. We reported the EQ-5D-5L utility, EQ-VAS, and the proportion of problems with each of the EQ-5D-5L health subdomains. Population quality-adjusted life year (QALY) changes based on EQ-5D-5L utility scores were also calculated. Outcomes were stratified by age. One-way ANOVA test was used to detect significant differences between countries and Student’s t-tests were used to assess the differences between waves.

Results
Respectively for the US, Sweden, and Norway, mean EQ-5D-5L utilities were 0.822, 0.768, and 0.808 in April 2020 (p < 0.001); 0.823, 0.783, and 0.777 in January 2021 (p < 0.001); mean EQ-VAS scores were 0.746, 0.687, and 0.692 in April 2020 (p < 0.001), 0.764, 0.682, and 0.678 in January 2021 (p < 0.001). For both waves, EQ-5D-5L utilities and EQ-VAS scores in the US remained higher than both Sweden and Norway (p < 0.001). Norwegians reported considerably lowered HRQoL over time (p < 0.01). Self-reported problems with anxiety/depression were highest for the US and Sweden, while Norwegians reported most problems with pain/discomfort, followed by anxiety/depression. The population QALYs increased in the US and Sweden, but decreased in Norway.

Conclusions
In the first year of the pandemic, a rebound in HRQoL was observed in the US, but not in Sweden or Norway. Mental health issues during the pandemic warrant a major public health concern across all 3 countries.
Kernel-based genetic association analysis for microbiome phenotypes identifies host genetic drivers of beta-diversity
Authors: Liu Hongjiao , Ling Wodan , Hua Xing , Moon Jee-Young , Williams-Nguyen Jessica S. , Zhan Xiang , Plantinga Anna M. , Zhao Ni , Zhang Angela , Knight Rob , Qi Qibin , Burk Robert D. , Kaplan Robert C. , Wu Michael C. 
Published: April 2023

Abstract
Background
Understanding human genetic influences on the gut microbiota helps elucidate the mechanisms by which genetics may influence health outcomes. Typical microbiome genome-wide association studies (GWAS) marginally assess the association between individual genetic variants and individual microbial taxa. We propose a novel approach, the covariate-adjusted kernel RV (KRV) framework, to map genetic variants associated with microbiome beta-diversity, which focuses on overall shifts in the microbiota. The KRV framework evaluates the association between genetics and microbes by comparing similarity in genetic profiles, based on groups of variants at the gene level, to similarity in microbiome profiles, based on the overall microbiome composition, across all pairs of individuals. By reducing the multiple-testing burden and capturing intrinsic structure within the genetic and microbiome data, the KRV framework has the potential of improving statistical power in microbiome GWAS.

Results
We apply the covariate-adjusted KRV to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) in a two-stage (first gene-level, then variant-level) genome-wide association analysis for gut microbiome beta-diversity. We have identified an immunity-related gene, IL23R, reported in a previous microbiome genetic association study and discovered 3 other novel genes, 2 of which are involved in immune functions or autoimmune disorders. In addition, simulation studies show that the covariate-adjusted KRV has a greater power than other microbiome GWAS methods that rely on univariate microbiome phenotypes across a range of scenarios.

Conclusions
Our findings highlight the value of the covariate-adjusted KRV as a powerful microbiome GWAS approach and support an important role of immunity-related genes in shaping the gut microbiome composition.
The associations between screen time and mental health in adolescents: a systematic review
Authors: Santos Renata Maria Silva , Mendes Camila Guimarães , Sen Bressani Guilherme Yanq , de Alcantara Ventura Samara , de Almeida Nogueira Yago Jean , de Miranda Débora Marques , Romano-Silva Marco Aurélio 
Published: April 2023

Abstract
Background
Adolescents have extensive use of screens and, they have common complains related to mental health. Here a systematic review was done to understand the association between screen time and adolescent’s mental health.

Method
This review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses – PRISMA. An update search was performed in January 2023 with the following keywords: “screen time,“ “adolescent,“ and “mental health” on PubMed, PsycINFO and Scopus databases.

Results
50 articles were included, most have found associations between screen exposure and mental health in adolescents. The most used device by adolescents was the smartphone and the use on weekdays was associated with diminished mental well-being. Social media use was negatively associated with mental well-being and, in girls, associated at higher risk for depression.

Conclusion
Excessive screen time in adolescents seems associated with mental health problems. Given the profusion and disparity of the results, additional studies are needed to clarify elements such as the screen content or the interaction of adolescents with different screen devices.

Systematic review registration:
PROSPERO CRD42022302817.
Illusion of knowledge in statistics among clinicians: evaluating the alignment between objective accuracy and subjective confidence, an online survey
Authors: Lakhlifi Camille , Lejeune François-Xavier , Rouault Marion , Khamassi Mehdi , Rohaut Benjamin 
Published: April 2023

AbstractHealthcare professionals’ statistical illiteracy can impair medical decision quality and compromise patient safety. Previous studies have documented clinicians’ insufficient proficiency in statistics and a tendency in overconfidence. However, an underexplored aspect is clinicians’ awareness of their lack of statistical knowledge that precludes any corrective intervention attempt. Here, we investigated physicians’, residents’ and medical students’ alignment between subjective confidence judgments and objective accuracy in basic medical statistics. We also examined how gender, profile of experience and practice of research activity affect this alignment, and the influence of problem framing (conditional probabilities, CP vs. natural frequencies, NF). Eight hundred ninety-eight clinicians completed an online survey assessing skill and confidence on three topics: vaccine efficacy, p value and diagnostic test results interpretation. Results evidenced an overall consistent poor proficiency in statistics often combined with high confidence, even in incorrect answers. We also demonstrate that despite overconfidence bias, clinicians show a degree of metacognitive sensitivity, as their confidence judgments discriminate between their correct and incorrect answers. Finally, we confirm the positive impact of the more intuitive NF framing on accuracy. Together, our results pave the way for the development of teaching recommendations and pedagogical interventions such as promoting metacognition on basic knowledge and statistical reasoning as well as the use of NF to tackle statistical illiteracy in the medical context.
Fracking compared to conventional balloon angioplasty alone for calcified common femoral artery lesions using intravascular ultrasound analysis: 12-month results
Authors: Haraguchi Takuya , Fujita Tsutomu , Kashima Yoshifumi , Tsujimoto Masanaga , Otake Ryo , Kasai Yuhei , Sato Katsuhiko 
Published: April 2023

Abstract
Background
Fracking is a novel technique to crack calcified lesions by hydraulic pressure. This study aimed to compare the performance of fracking and conventional balloon angioplasty without stenting for calcified common femoral artery (CFA) lesions using intravascular ultrasound (IVUS) analysis.

Methods
This retrospective, single-center, comparative observational study included 59 patients (67 limbs) with calcified CFA lesions treated with either fracking (n = 30) or balloon angioplasty (n = 29) between January 2018 and December 2020. The primary endpoint was 1-year primary patency. The secondary endpoints included procedure success, freedom from target lesion revascularization (TLR), procedure-related complications, and freedom from major adverse limb events (MALE). Predictors of restenosis were identified using multivariate Cox proportional hazards analysis.

Results
The mean follow-up duration was 403 ± 236 days. The fracking group had significantly higher incidence of 1-year primary patency (89.8% versus 49.2%, P < 0.001), procedure success (96.9% versus 74.3%, P = 0.009), and freedom from TLR (93.5% versus 74.2%, P = 0.038) than the balloon group. The rate of freedom from MALE was significantly higher in the fracking group than in the balloon group (76.9% versus 48.6%, P = 0.033). The groups had no significant difference in procedure-related complications (6.2% versus 5.7%, P = 0.928). A larger postprocedural IVUS-estimated minimum lumen area (MLA) was associated with a lower risk of restenosis (hazard ratio, 0.78; 95% confidence interval, 0.67–0.91; P < 0.001), with a cut-off value of 16.0 mm2 determined using receiver operating characteristics curve analysis. The incidence of 1-year primary patency in patients with a postprocedural MLA ≥16.0 mm2 (n = 37) was significantly higher than that in those with a postprocedural MLA < 16.0 mm2 (n = 30) (87.8% versus 44.6%, P < 0.001).

Conclusion
This study demonstrated the superior procedural efficacy of fracking compared to balloon angioplasty in treating calcified CFA lesions. The safety outcomes after fracking were comparable to those after balloon angioplasty. Large postprocedural MLA was an independent positive predictor of patency.
HLA-B27 positivity in a large miscegenated population of 5,389,143 healthy blood marrow donors in Brazil
Authors: Resende Gustavo Gomes , Saad Carla Gonçalves Schahin , de Oliveira Danielli Cristina Muniz , de Sousa Bueno Filho Julio Silvio , Sampaio-Barros Percival Degrava , de Medeiros Pinheiro Marcelo 
Published: April 2023

AbstractBackgroundThe prevalence of HLA-B27 gene positivity in healthy Caucasian communities varies between 8 and 14%. However, there is a lack of information in countries with a high rate of miscegenation, such as Brazil.AimTo estimate the frequency of HLA-B27 in the Brazilian general population using a large national registry database.MethodsThis is a cross-sectional ecological study using the Brazilian Registry of Volunteer Bone Marrow Donors (REDOME) database on HLA-B27 allelic frequency and proportion of positives of healthy donors (18–60 years old). Data were analyzed according to sex, age, race(by self-reported skin color recommended by the Brazilian Institute of Geography and Statistics-IBGE), and geographic region of residence.ResultsFrom 1994 to 2022, a total of 5,389,143 healthy bone marrow donors were included. The overall positivity for HLA-B27 was 4.35% (CI 95% 4.32–4.37%), regardless of sex and age (57.2% were women, mean age was 41.7yo). However, there was a difference between races: 4.85% in Whites; 2.92% in Blacks; 3.76% inPardos(Browns i.e. mixed races); 3.95% inAmarelos(Yellows i.e. Asian Brazilians); and 3.18% in Indigenous. There was also a difference regarding geographic region of residence (North: 3.62%; Northeast: 3.63%; Southeast: 4.29%; Midwest: 4.5% and 5.25% in South). The homozygosity rate for the HLA-B27 was 1.32% of all the positives and only 0.06% in the general population.ConclusionsOur findings provide the first Brazilian national prevalence for HLA-B27 in 4.35%. There is a gradient gene positivity from North to South, suggesting that the genetic background related to the miscegenation due to colonization, slavery, and some later waves of immigration together with internal migratory flows, could explain our findings.
Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline
Authors: Sander Dirk , Bartsch Thorsten , Connolly Florian , Enzinger Christian , Fischer Urs , Nellessen Nils , Poppert Holger , Szabo Kristina , Topka Helge 
Published: April 2023

Abstract
Introduction
In 2022 the DGN (Deutsche Gesellschaft für Neurologie) published an updated Transient Global Amnesia (TGA) guideline. TGA is characterized by a sudden onset of retrograde and anterograde amnesia for a period of one to a maximum of 24 h (with an average of 6 to 8 h). The incidence is estimated between 3 and 8 per 100,000 population/year. TGA is a disorder that occurs predominantly between 50 and 70 years.

Recommendations
The diagnosis of TGA should be made clinically. In case of an atypical clinical presentation or suspicion of a possible differential diagnosis, further diagnostics should be performed immediately. The detection of typical unilateral or bilateral punctate DWI/T2 lesions in the hippocampus (especially the CA1 region) in a proportion of patients proves TGA. The sensitivity of MRI is considered higher when performed between 24 and 72 h after onset. If additional DWI changes occur outside the hippocampus, a vascular etiology should be considered, and prompt sonographic and cardiac diagnostics should be performed EEG may help to differentiate TGA from rare amnestic epileptic attacks, especially in recurrent amnestic attacks. TGA in patients < 50 years of age is a rarity, therefore it is mandatory to rapidly search for other causes in particular in younger patients. The cause of TGA is still unknown. Numerous findings in recent years point to a multifactorial genesis. Because the pathomechanism of TGA is not yet clearly known, no evidence-based therapeutic or prophylactic recommendations can be made.

Conclusions
There is no evidence for chronic sequelae of TGA with respect to cerebral ischemia, chronic memory impairment, or the onset of dementia-related syndromes.
Effusive-constrictive pericarditis as first manifestation of late-onset systemic lupus erythematosus: an atypical case with grave prognosis
Authors: Sumajaya I. Dewa Gde Dwi , Aryadi I. Putu Hendri , Eryana I. Made 
Published: April 2023

Abstract
Background
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that has a great diversity of clinical presentations and occurs mostly in young women. However, late-onset SLE does exist and seldom presents with an atypical case, including pericardial effusion (PE).

Case presentation
A 64 years old Asian woman presented with weakness all over the body and slight breathlessness for the past 2 days before the hospital admission. Her initial vital signs are 80/50 mmHg for blood pressure and a respiration rate of 24 breaths/min. Rhonchi were heard on the left lung and pitting edema on both legs. No evidence of any skin rash. Laboratory examination displayed anemia, hematocrit decrement, and azotemia. A 12-lead ECG demonstrated left-axis deviation with low voltage (Fig. 1). Chest X-ray showed left massive pleural effusion (Fig. 2). Transthoracic echocardiography revealed biatrial enlargement, normal EF 60%, diastolic dysfunction grade II, and thickening of the pericardium with mild circumferential PE corresponding with effusive-constrictive pericarditis (Fig. 3). The patient also brought CT angiography and cardiac MRI result, which confirmed pericarditis with PE. Treatment was initiated in ICU with fluid resuscitation of normal saline. The patient’s routine oral treatments, including furosemide, ramipril, colchicine, and bisoprolol, were carried on. An autoimmune workup was performed by a cardiologist and demonstrated an elevation in antinuclear antibody/ANA (IF) of 1:100, which finally unveiled a diagnosis of SLE. Pericardial effusion is one critical condition to consider, despite it being an uncommon presentation in late-onset SLE. Mild pericarditis in an SLE case can be treated with corticosteroid administration. Colchicine also has been found to reduce the risk of pericarditis recurrence. However, an atypical presentation from this case led to a slightly delayed treatment that escalated the morbidity and mortality risk. The patient had a sudden cardiac arrest and passed away 3 days after being treated.

Conclusions
Atypical presentation during late-onset SLE, mainly in the form of pericardial effusion even constrictive pericarditis, should be taken into a consideration since they are a scarce feature in SLE patients. Swift recognition and prompt treatment are important for the optimal outcome.
Exploring the life experiences of stroke survivors in Nigeria using the interpretive phenomenological analysis
Authors: Ogunlana Michael O. , Oyewole Olufemi O. , Nwosu Ifeoma Blessing , Govender Pragashnie 
Published: April 2023

AbstractBackgroundThe consequence of living as a stroke survivor has received significant attention in literature from different parts of the world. Enriching social relations and other factors are reported to influence the post-stroke experience. Differences in health systems, cultural factors and available resources have made it apt to explore the experience of life after a stroke in Nigerian stroke survivors. This study explored the lived experiences of Nigerian adult stroke survivors, with a focus on their concerns, hopes, dreams and daily routine experiences.MethodsThis qualitative study employed a phenomenological approach based on in-depth interviews with stroke survivors. Interpretative phenomenological analysis was used to analyse the in-depth exploration of the personal experiences of these stroke survivors and the meanings they attached to that experience.ResultsThe participants in this study described their experiences, emphasising both the visible loss of mobility and emotional issues related to their condition. Three superordinate themes were identified: (1) stroke presentation; (2) affect, coping, and adaptation; and (3) social supports.ConclusionThe study concluded that the experience of Nigerian stroke survivors is unique as it is a blend of supportive and non-supportive care scenarios, which is greatly associated with environmental and other intrinsic variables. Post-stroke mobility strongly influences the overall stroke experience.
Cooperative joint inversion of magnetotelluric and microseismic data for imaging The Geysers geothermal field, California, USA
Authors: Um Evan Schankee , Commer Michael , Gritto Roland , Peacock Jared R. , Alumbaugh David L. , Jarpe Steve P. , Hartline Craig 
Published: April 2023

The Geysers geothermal field located in northern California, USA, is the world’s largest electricity-generating geothermal facility. To delineate the spatio-temporal distribution of reservoir steam and recharge water, we have collected microseismic and magnetotelluric (MT) data using a dense array of stations in 2021. The microseismic and MT data have been inverted together using a 3D cooperative joint inversion workflow. The joint inversion exploits a cross-gradient structural constraint because electrical conductivity structures observed in the geothermal field are strongly correlated with [Formula: see text]/[Formula: see text] structures. To mitigate convergence issues associated with 3D large-scale joint inversion, the scheme is split into small manageable inversion subsets. By systematically performing the three inversion subsets and exchanging the structural information between velocity and conductivity models, the cooperative joint inversion mimics the full joint inversion. The 3D joint inversion results agree well with previous 3D microseismic and MT inversion studies. We find that the cooperative joint inversion improves overall MT images in terms of resolution and consistency with respect to the [Formula: see text]/[Formula: see text] model. The joint inversion also further reduces the MT data misfit. In contrast, the joint inversion does not significantly improve microseismic images because MT inversion produces low-resolution conductivity images with respect to microseismic images in depth of investigation (i.e., 1–5 km) and thus does not provide sufficient structural details that are required for improving microseismic images.