bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of regional heterogeneity and determinants of perinatal mortality in Ethiopia: review
Authors: Adebe Kebede L. , Wake Senahara K. , Mekebo Gizachew G. , Dessalegn Reta C. , DarajeYadata Sagni , Wolde Temesgen S. , Gondol Ketema B. , Galdassa Agassa , Amega Gora A. , Gefela Tizazu Y. 
Published: March 2023

Introduction:
The rate of mortality during the perinatal period is higher than at any other time in a person’s life, making it the most vulnerable. This study aimed to examine regional heterogeneity and the determinants of perinatal mortality in Ethiopia.

Methods:
The data for this study was obtained from the 2019 Ethiopia Demographic and Health Survey (2019 EMDHS) data. Logistic regression modeling and multilevel logistic modeling were used for data analysis.

Results:
A total of 5753 live birth children were included in this study. Of the total live births, 220 (3.8%) died in the first 7 days of life. Urban residence [adjusted odds ratio (AOR)=0.621; 95% CI: 0.453–0.850], residence in Addis Ababa (AOR=0.141; 95% CI: 0.090–0.220), family size of four or less (AOR=0.761; 95% CI: 0.608–0.952), age of mother at first birth of less than 20 years (AOR=0.728; 95% CI: 0.548–0.966), and using contraceptives (AOR=0.597; 95% CI: 0.438–0.814) were associated with lower risk of perinatal mortality compared to the respective reference categories whereas residence in Afar (AOR=2.259; 95% CI: 1.235–4.132), residence in Gambela (AOR=2.352; 95% CI: 1.328–4.167), no education (AOR=1.232; 95% CI: 1.065–1.572), poor wealth index (AOR=1.670; 95% CI: 1.172–2.380), and wealth index (AOR=1.648; 95% CI: 1.174–2.314) were associated with higher risk of perinatal mortality compared to the respective reference categories.

Conclusion:
In this study, the overall prenatal mortality rate was 38 (95% CI: 33–44) deaths per 1000 live births, which is high in magnitude. The study identified place of residence, region, wealth index, age of the mother at first birth, educational level of the mother, family size, and use of contraceptive methods as significant determinants of perinatal mortality in Ethiopia. Thus, mothers with no education should be given health education. Women should also be given awareness regarding the use of contraceptives. In addition, further research needs to be conducted in each region separately and information made available at the disaggregate level.
Association Between Baby Walker Use and Infant Functional Motor Development
Authors: Janusz Piotr , Pikulska Dagmara , Kapska Natalia , Kaniowska Marta , Darcz Marta , Bykowski Bartłomiej , Ekwińska Weronika , Stachowiak Emilia , Kotwicki Tomasz , Shadi Milud 
Published: March 2023

Purpose:
The aim of this study was to determine the association between baby walker use and infant motor development, quality of gait, and potential development of lower extremity deformities.

Methods:
An anonymous survey was conducted among 6874 parents and legal guardians regarding the use of baby walkers, their children's development, and the occurrence of lower extremity deformities and gait disorders. A total of 969 questionnaires were returned.

Results:
Baby walkers were used by 15.6% of children. A higher percentage of children who used baby walkers omitted crawling compared with the 10.7% of children who did not use baby walkers. Gait disorders occurred at a similar percentage in both groups.

Conclusions:
Use of baby walkers may be associated with infant motor development. Infants who used a baby walker were 3 times more likely to not have crawled for mobility than those who did not use a baby walker.
“Key Roles of Conjunctiva Fornix-Bulbar conjunctiva-Tenon's Capsule in Bulbar Conjunctival Prolapse after Conjoint Fascial Sheath Suspension.”
Authors: Hao Dong-Yue , Fan Xiao , Cao Jiao , Cang Zheng-Qiang , Cui Jiang-Bo , Chen Yong-Jun , Liu Chao-Hua , Song Bao-Qiang , Peng Pai 
Published: March 2023

Background
Bulbar conjunctival prolapse is one of the complications of conjoint fascial sheath (CFS) suspension and has a negative impact on surgical results. To explore the prevention methods of this complication, we compared the incidence of it between the below-conjunctiva fornix-bulbar conjunctiva- Tenon’s capsule (CBT) approach and the above-CBT approach to dissecting CFS in CFS suspension and shared our experience in the treatment of bulbar conjunctival prolapse.

Methods
From January 2020 to August 2021, 81 patients with severe congenital ptosis who underwent CFS suspension were enrolled and divided into 2 groups. Forty-five patients’ (Group A) CFS was dissected via the below-CBT approach and 36 patients’ (Group B) CFS was dissected via the above-CBT approach. The incidence and outcomes of bulbar conjunctival prolapse，and the postoperative condition were collected and analyzed.

Results
The incidence of bulbar conjunctival prolapse was 24.44% in Group A and 2.78% in Group B. Of the 12 bulbar conjunctival prolapse patients, 7 patients’ conditions improved after conservative treatment, while 5 did not. All of them underwent bulbar conjunctiva resection within 1 year and were cured. No recurrent prolapse was observed within 3 months post-operation. At the last follow-up, the mean MRD1 and PFH were 4.09±0.19mm and 9.85±0.62mm, respectively. There were no complications except lagophthalmos (16 eyelids), asymmetric eyelid contour (1 patient), and trichiasis (2 eyelids).

Conclusion
The incidence of bulbar conjunctival prolapse decreased significantly by dissecting CFS via the above-CBT approach. For patients with bulbar conjunctival prolapse after CFS suspension, bulbar conjunctiva resection could provide satisfactory results.

Level of Evidence IV
Adipose component transplantation – an advanced fat grafting strategy based on adipose tissue component selection for facial rejuvenation
Authors: Cai Junrong , He Yunfan , Liao Yunjun , Yao Yao , Feng Jingwei , Dong Ziqing , Lu Feng 
Published: March 2023

Background:
Autologous fat grafting is frequently used for volume augmentation and tissue regeneration. The uniform physical and biological characteristics of fat grafts, however, limit their optimal effects in various situations. Subjecting fat tissue to different mechanical processes results in adipose-derived products with distinct biological components and physical features. The present study describes a novel facial fat grafting strategy, adipose component transplantation (ACT), which yields different adipose products that can be applied to specific injection sites.

Methods:
All patients who underwent ACT were retrospectively evaluated. Fat tissue samples were fractionated into high density fat (HDF), adipose matrix complex (AMC), stromal vascular fraction (SVF)-gel, and adipose collagen fragment (ACF), as described. Each of these fractions was processed and injected into indicated recipient sites. Additional SVF-gel was cryopreserved and, if necessary, injected during the following 3 months. Patients were followed-up after 1, 2, 3, and 6 months, and annually thereafter.

Results:
From March 2020 to September 2021, 78 patients have undergone whole face fat grafting using the ACT strategy. All operations and secondary injections of cryopreserved SVF-gel were uneventful. There were no major complications, and final aesthetic results were satisfactory in 91% patients.

Conclusion:
The ACT strategy allows specific adipose products to be applied to specific injection sites, as warranted. AMC is indicated for sufficient rigid support, HDF when large volumes are required, SVF-gel for precise injection and cryopreservation, and ACF as mesotherapy for skin rejuvenation. The ACT strategy optimizes the biological functions and physical features of different adipose-derived products.
Psychosocial, sexual, reproductive and menopausal health in women with and without HIV in a high-income setting
Authors: Scofield Ditte , Weis Nina , Andersson Mikael , Storgaard Merete , Pedersen Gitte , Johansen Isik S. , Katzenstein Terese L. , Graugaard Christian , Frisch Morten , Moseholm Ellen 
Published: March 2023

Objectives:
To investigate psychosocial, sexual, reproductive and menopausal health in women with HIV (WWH) compared to women without HIV (WWOH) in Denmark.

Design:
A nationwide cross-sectional study.

Methods:
Data was retrieved from the SHARE study, a Danish nationwide cross-sectional survey examining psychosocial, sexual and reproductive health in people with HIV. Data from WWH, collected in 2021–2022, was matched 1:10 on age to a comparison group of WWOH from the nationally representative cohort study Project SEXUS. Associations between HIV status and psychosocial and sexual health outcomes were assessed by adjusted odds ratios (aOR) with 95% confidence intervals (95% CIs) obtained in logistic regression analyses controlling for potential confounding variables. The severity of menopausal symptoms in WWH was compared to published reference norms.

Results:
Among 144 WWH and 1440 WWOH, recurrent loneliness was significantly more common among WWH (aOR 2.22 [95% CI: 1.25–3.96]), and WWH had significantly fewer children and close friends (aOR 0.52 [95% CI: 0.28–0.96] for 3–9 vs. 0–2 close friends). Symptoms of anxiety and depression did not differ between groups. Lack of sexual desire (aOR 2.90 [95% CI: 1.29–6.50]), low FSFI-6 score indicating sexual dysfunction (aOR 3.40 [95% CI: 1.33–8.69]), lubrication dysfunction (aOR 8.24 [95% CI: 2.83–24.00]) and genital pain dysfunction (aOR 5.13 [95% CI: 1.26–20.86]) were significantly more common in WWH compared to WWOH. No differences were seen in menopausal characteristics.

Conclusions:
WWH in Denmark have fewer children and close friends, and more often report recurrent loneliness, lacking sexual desire and sexual dysfunction compared to WWOH. No differences were evident in menopausal characteristics.
Neuronal accumulation of hyperphosphorylated tau protein predicts stable memory impairment in people living with HIV
Authors: Gonzalez Jairo , Wilson Alyssa , Byrd Desiree , Cortes Etty P. , Crary John F. , Morgello Susan 
Published: March 2023

Objectives:
As lifespans increase in people with HIV (PWH), there is concern that age-related neurodegenerative disorders may contribute to cognitive decline. We asked whether brain accumulation of Alzheimer's disease (AD)-associated proteins amyloid-beta (Aβ) and hyperphosphorylated tau (p-tau) predicted cognitive performance in middle-aged PWH.

Methods:
In a prospectively followed, cognitively-characterized autopsy sample of 135 PWH, we used immunohistochemistry to assess Aβ plaques and neuronal p-tau in medial temporal and lateral frontal lobes. These pathologies were tested for associations with cognitive performance in seven domains: motor, speed of information processing, working memory, memory encoding, memory retrieval, verbal fluency, and abstraction/executive function. Univariate and multivariate analyses accounting for HIV-associated variables, reading level, and comorbidities were conducted. Longitudinal trajectories of memory functions were evaluated in 60 individuals with a median follow-up of 6.0 years.

Results:
In this population with mean age 51.4 ± 0.9 years, 58% displayed neuronal p-tau and 29% Aβ plaques. Neuronal p-tau, but not Aβ, predicted worse memory encoding and retrieval, but not other cognitive functions. With an ordinal hierarchy of neuronal p-tau locations (entorhinal, hippocampal, neocortical), decreased memory performance correlated with neocortical distribution. Memory function trajectories could not be distinguished between individuals with and without neuronal p-tau, and over 80% of the sample showed no change over time.

Conclusion:
In this middle-aged sample, neuronal p-tau accumulation contributes to memory deficits, but is not associated with accelerated decline in function over time. In the absence of AD-like deterioration, other etiologies for neuronal p-tau in cognitively impaired PWH must be considered.
Multiple systemic infections caused by Rhodococcus equi: case report.
Authors: Li Ning , Wu Changsheng , Cao Pengju , Chen Dongjie , Chen Falin , shen Xiuqing 
Published: March 2023

Abstract
Background: Rhodococcus equi, is one of the most important causes of zoonotic infections in grazing animals, especially in the patients who are immunosuppressed or long-term treatment with immunosuppressive drugs.
Case presentation: We report a case of Rhodococcus equi in a 65-year-old man with diabetes, hypertension and adultonset Still’s disease, on long term hormone therapy. This non-HIV infected man with blood, lung tissue and sputum infected by R. equi. Initially the patient failed to improve on multiple therapy including vancomycin and meropenem. Although the symptoms improved after adjusting the application of antibiotics according to the susceptibility, the patient had not healed upon discharge.
Conclusions: In recent years the number of Rhodococcus equi cases has been increasing. We describe herein the lethal case of R. equi infection in a non-HIV person.
Gut microbial features and dietary fiber intake predict gut microbiota response to resistant starch supplementation
Authors: Devarakonda Sri Lakshmi Sravani , Superdock Dorothy K. , Ren Jennifer , Johnson Lynn M. , Loinard-González Aura (Alex) P. , Poole Angela C. 
Published: March 2023

ABSTRACTResistant starch (RS) consumption can have beneficial effects on human health, but the response, in terms of effects on the gut microbiota and host physiology, varies between individuals. Factors predicting the response to RS are not yet established and would be useful for developing precision nutrition approaches that maximize the benefits of dietary fiber intake. We sought to identify predictors of gut microbiota response to RS supplementation. We enrolled 76 healthy adults into a seven-week crossover study. Participants consumed RS type 2 (RS2), RS type 4 (RS4), and a digestible starch, for ten days each with five-day washout periods in between. We collected fecal and saliva samples and food records before and during each treatment period. We performed 16S rRNA gene sequencing and measured fecal short-chain fatty acids (SCFAs), salivary amylase gene copy number, and salivary amylase activity (SAA). Dietary fiber intake was predictive of relative abundance of several amplicon sequence variants (ASVs) at the end of both RS treatments. Treatment order (the order of consumption of RS2 and RS4), alpha diversity, and a subset of ASVs were predictive of SCFA changes after RS supplementation. SAA was only predictive of the relative abundance of ASVs after digestible starch supplementation. Based on our findings, dietary fiber intake and gut microbiome composition would be informative if assessed prior to recommending RS supplementation. Using a precision nutrition approach to optimize the benefits of dietary fibers such as RS could be an effective strategy to compensate for the low consumption of dietary fiber nationwide.
Performance of ChatGPT on free-response, clinical reasoning exams
Authors: Strong Eric , DiGiammarino Alicia , Weng Yingjie , Basaviah Preetha , Hosamani Poonam , Kumar Andre , Nevins Andrew , Kugler John , Hom Jason , Chen Jonathan H 
Published: March 2023

AbstractImportanceStudies show that ChatGPT, a general purpose large language model chatbot, could pass the multiple-choice US Medical Licensing Exams, but the model’s performance on open-ended clinical reasoning is unknown.ObjectiveTo determine if ChatGPT is capable of consistently meeting the passing threshold on free-response, case-based clinical reasoning assessments.DesignFourteen multi-part cases were selected from clinical reasoning exams administered to pre-clerkship medical students between 2019 and 2022. For each case, the questions were run through ChatGPT twice and responses were recorded. Two clinician educators independently graded each run according to a standardized grading rubric. To further assess the degree of variation in ChatGPT’s performance, we repeated the analysis on a single high-complexity case 20 times.SettingA single US medical schoolParticipantsChatGPTMain Outcomes and MeasuresPassing rate of ChatGPT’s scored responses and the range in model performance across multiple run throughs of a single case.Results12 out of the 28 ChatGPT exam responses achieved a passing score (43%) with a mean score of 69% (95% CI: 65% to 73%) compared to the established passing threshold of 70%. When given the same case 20 separate times, ChatGPT’s performance on that case varied with scores ranging from 56% to 81%.Conclusions and RelevanceChatGPT’s ability to achieve a passing performance in nearly half of the cases analyzed demonstrates the need to revise clinical reasoning assessments and incorporate artificial intelligence (AI)-related topics into medical curricula and practice.
Comorbid hypertension and its associated factors among diabetic outpatients in West Shewa Zone public hospitals, Ethiopia: an institution based cross-sectional study
Authors: Hirpa Delessa , Abdissa Daba 
Published: March 2023

AbstractObjectivesHypertension (HTN) is the main contributor to the worldwide burden of disease and it is frequently coexists with diabetes and exacerbates its complications. The purpose of this study was to evaluate the prevalence and determinants of HTN among diabetic outpatients at West Shoa Zone public hospitals.MethodsFacility based cross-sectional study was conducted from June to December, 2020 among diabetic patients attending their follow up at West Shewa public hospitals, Ethiopia. Data were collected using interviewer administered pretested structured questionnaire. A variable having a p-value of <0.25 in the bivariable analysis were subjected to multivariable analysis to avoid confounding variable’s effect. Adjusted odds ratios were calculated at 95% confidence interval and considered significant with a p-value of ≤ 0.05.ResultsA total of 390 participants were included in the study. Their mean age was 46.45 years (±15.6) years. Our study found that there was high prevalence of hypertension among diabetic patients. Age ≥50 year, obesity, family history of hypertension and being single were associated with hypertension among participants. Hence, necessary actions are recommended by responsible bodies for identified problems.
Automated mood disorder symptoms monitoring from multivariate time-series sensory data: Getting the full picture beyond a single number
Authors: Corponi Filippo , Li Bryan M. , Anmella Gerard , Mas Ariadna , Sanabra Miriam , Vieta Eduard ,   INTREPIBD Group, Lawrie Stephen M. , Whalley Heather C. , Hidalgo-Mazzei Diego , Vergari Antonio 
Published: March 2023

AbstractMood disorders are among the leading causes of disease burden worldwide. They manifest with changes in mood, sleep, and motor-activity, observable with physiological data. Despite effective treatments being available, limited specialized care availability is a major bottleneck, hindering preemptive interventions. Nearcontinuous and passive collection of physiological data from wearables in daily life, analyzable with machine learning, could mitigate this problem, bringing mood disorders monitoring outside the doctor’s office. Previous works attempted predicting a single label, e.g. disease state or a psychometric scale total score. However, clinical practice suggests that the same label can underlie different symptom profiles, requiring personalized treatment. In this work we address this limitation by proposing a new task: inferring all items from the Hamilton Depression Rating Scale (HDRS) and the Young Mania Rating Scale (YMRS), the most-widely used standardized questionnaires for assessing depression and mania symptoms respectively, the two polarities of mood disorders. Using a naturalistic, single-center cohort of patients with a mood disorder (N=75), we develop an artificial neural network (ANN) that inputs physiological data from a wearable device and scores patients on HDRS and YMRS in moderate agreement (quadratic Cohen’sκ= 0.609) with assessments by a clinician. We also show that, when using as input physiological data recorded further away from when HDRS and YMRS were collected by the clinician, the ANN performance deteriorates, pointing to a distribution shift, likely across both psychometric scales and physiological data. This suggests the task is challenging and research into domain-adaptation should be prioritized towards real-world implementations.
Efficacy of Endovascular Thrombectomy in the Oldest Old (Stroke 90+ Study): A Community Center Experience
Authors: Brant-Zawadzki Michael , Mastrolia Deborah , Hara Junko , Baker Christopher , Mesipam Avinash , Peck Wallace , Brown David 
Published: March 2023

AbstractBackgroundWhile endovascular thrombectomy (EVT) is considered as the most effective treatment for a select group of patients with acute ischemic stroke and large vessel occlusion, its safety and efficacy in older patients are still debated especially in “read-world” settings. This study reports outcomes of EVT in acute ischemic stroke patients aged 90 and older in our community hospital setting.MethodsData between January 2018 and December 2022 were aggregated for all acute ischemic stroke patients with aged 90 and older at the time of EVT. Thirty-one patients met the criteria and were included in this report. The data valuables included, but are not limited to, demographics, stroke risk factors, thrombolysis in cerebral infarction (TICI), modified Rankin Scale (mRS), and NIH Stroke Scale (NIHSS).ResultsAll 31 patients had improvement in TICI scale. One had symptomatic intracranial hemorrhage after EVT not related to the procedure, but likely on the basis of reperfusion breakthrough. Three patients expired prior to their discharge from non-stroke related causes. Of remaining 28, four expired, six went into hospice care, and four lost to follow-up by 30-days post DC. Of six hospice cases, one expired by 90-day post DC, and additional three were lost to follow-up. Given this data, 20/27 (74%) survived to 30 days and 16/24 (67%) to 90 days. For their NIHSS symptomatic categories, 15/28 (54%) patients improved, 10/28 (36%) remained the same, and 3/28 (11%) declined. For mRS, at 30-days post DC, 7/24 (30%) patients showed improvement, 7/24 (30%) remained the same, and 10/24 (40%) declined. At 90-days post DC, 7/21 (33%) showed improvement from DC, 4/21 (19%) remained the same, and 10/21 (48%) declined.ConclusionsWhile a larger cohort study is necessary, our report supports the safety and efficacy of EVT in this patient aged 90 and older in a real-world setting.