bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric properties of the Caring Efficacy Scale among personal care attendants working in residential aged care settings
Authors: Shrestha Sumina , Wells Yvonne , While Christine , Rahman Muhammad Aziz 
Published: May 2023

AbstractObjectiveThis study assessed the psychometric properties of the Caring Efficacy Scale (CES) among personal care attendants providing care to older residents in residential aged care settings.MethodsThis cross‐sectional study was completed in Australia in 2020–2021. Confirmatory factor analysis (CFA) of the 30‐item original CES (Model 1) and 28‐item CES validated in registered nurses (Model 2) was conducted to assess the goodness of fit of these models in our study population. Due to unsatisfactory fit indices for both models, exploratory factor analysis (EFA) was conducted to examine the dimensionality and underlying structure of the original CES among personal care attendants. Internal consistency of the final scale and subscales identified was examined using item‐total correlations and Cronbach's alpha coefficients.ResultsTwo hundred and eighty personal care attendants participated in the study. The model fit indices such as Comparative Fit Index and Tucker Lewis Index of both models were less than 0.90, while the Standardised Root Mean Square Residual and Root Mean Square of Approximation values were greater than or equal to 0.08 and 0.06, respectively. The EFA identified a two‐factor structure, and 22 items of the 30 in the original scale were retained. Item‐total correlations amongst items retained in the scale and subscales were greater than 0.3. Cronbach's alpha for the abbreviated scale was 0.85, with 0.83 and 0.79, respectively, for the two subscales.ConclusionsThe modified CES can be used as a robust tool to assess the self‐efficacy of personal care attendants in providing care to older residents in residential aged care settings.
Acute generalized exanthematous pustulosis complicated by cutaneous small vessel vasculitis: A case report and literature review
Authors: Zhang Xingwei , Zhuang Kaiwen , Lyu Xiaoyan 
Published: May 2023

AbstractAcute generalized exanthematous pustulosis (AGEP) is a rare skin eruption characterized by widespread erythematous lesions covered with numerous pustules. Leukocytoclastic vasculitis is now considered an uncommon but possible histopathological feature within the clinical and pathological spectrum of AGEP. Our report describes a rare case of AGEP overlapping with cutaneous small vessel vasculitis, a condition that has only been reported once in the literature.
Combined or sequential DMEK in cases of cataract and Fuchs endothelial corneal dystrophy—A systematic review and meta‐analysis
Authors: Romano Vito , Passaro Maria Laura , Bachmann Bjoern , Baydoun Lamis , Ni Dhubhghaill Sorcha , Dickman Mor , Levis Hannah J. , Parekh Mohit , Rodriguez‐Calvo‐De‐Mora Marina , Costagliola Ciro , Virgili Gianni , Semeraro Francesco 
Published: May 2023

AbstractTo compare the outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed after phacoemulsification and intraocular lens (IOL) implantation (sequential DMEK) and DMEK combined with phacoemulsification and IOL implantation (combined DMEK) in patients with Fuchs endothelial corneal dystrophy (FECD) and cataract. Systematic literature review and meta‐analysis performed according to the PRISMA guidelines and registered in PROSPERO. Literature searches were conducted in Medline and Scopus. Comparative studies reporting sequential DMEK and combined DMEK in FECD patients were included. The main outcome measure of the study was the corrected distance visual acuity (CDVA) improvement. Secondary outcomes were postoperative endothelial cell density (ECD), rebubbling rate and primary graft failure rate. Bias risk was assessed and a quality appraisal of the body of evidence was completed using the Cochrane Robin‐I tool. A total of 667 eyes (5 studies) were included in this review, 292 eyes (43.77%) underwent a combined DMEK, while 375 (56.22%) eyes underwent a sequential DMEK surgery. We found no evidence of a difference between the two groups (mean difference, 95% CI) regarding: (1) CDVA improvement (−0.06; −0.14, 0.03 LogMAR; 3 studies, I2: 0%; p = 0.86); (2) postoperative ECD (−62; −190, 67 cells/mm2; 4 studies, I2: 67%; p = 0.35); (3) rebubbling (risks ratio: 1.04; 0.59, 1.85; 4 studies, I2: 48%; p = 0.89); and primary graft failure rate (risks ratio: 0.91; 0.32, 2.57; 3 studies, I2: 0%; p = 0.86). Of all the 5 non‐randomized studies, all (100%) were graded as low quality. The overall quality of the analysed studies was low. Randomized controlled trials are needed to confirm no difference or superiority of one approach in terms of CDVA, endothelial cell count and postoperative complication rate between the two arms.
Small‐for‐gestational‐age and predictors of HOMA indices, leptin and adiponectin in infancy
Authors: Huang Rong , He Hua , Nuyt Anne Monique , Julien Pierre , Marc Isabelle , Levy Emile , Fraser William D. , Luo Zhong‐Cheng 
Published: May 2023

AbstractAimTo assess whether small‐for‐gestational‐age (SGA) – an indicator of poor fetal growth, may affect metabolic health biomarkers in infancy and explore the predictors.MethodsThis was a nested matched (1:2) prospective observational study of 65 SGA (birth weight < 10th percentile) and 130 optimal‐for‐gestational‐age (OGA, birth weight 25th‐75th percentiles, control) infants in the 3D birth cohort with subjects recruited in Canada from 1 May 2010 to 31 August 2012. The outcomes included homeostasis model assessment of insulin resistance (HOMA‐IR) and beta‐cell function (HOMA‐β), circulating leptin and adiponectin concentrations at age 2 years.ResultsHOMA‐IR, HOMA‐β, leptin and adiponectin concentrations were similar in SGA versus OGA infants. Female sex and accelerated growth in length during mid‐infancy (3–12 months) were associated with higher HOMA‐IR. Caucasian ethnicity and decelerated growth in weight during late infancy (12–24 months) were associated with lower HOMA‐IR. Current BMI was positively associated with circulating adiponectin in SGA infants only (+13.4% [4.0%–23.7%] per BMI z score increment).ConclusionInsulin resistance and secretion, circulating leptin and adiponectin levels were normal in SGA subjects in infancy at age 2 years. The novel observation in SGA‐specific positive association between current BMI and circulating adiponectin suggests dysfunctional adiposity‐adiponectin negative feedback loop development during infancy in SGA subjects.
Robotic instruments outside the surgical field can cause problems: A case of critical bleeding during robotic distal pancreatectomy
Authors: Uchida Yuichiro , Takahara Takeshi , Mii Satoshi , Mizumoto Takuya , Iwama Hideaki , Kojima Masayuki , Kato Yutaro , Uyama Ichiro , Suda Koichi 
Published: May 2023

AbstractRobotic surgery has technical advantages including high optical magnification and articulation of forceps. However, the surgical field tends to be narrow due to the high magnification, and the forceps have no tactile sensation. A case of severe intraoperative bleeding from the splenic artery during robotic distal pancreatectomy is presented, with a video. A man in his 80s with a cystic tumor located at the pancreatic tail underwent robotic distal pancreatectomy. During mobilization of the pancreatic tail by an inferior approach, the root of the splenic artery was injured by the joints of the robotic instruments located outside the surgical field and the bleeding became uncontrollable under the robotic operation. It is important to always be aware of what the forceps are in contact with outside the surgical field. While dissecting the left subdiaphragmatic area in robotic distal pancreatectomy, the root area of splenic artery tends to be outside the surgical field. More attention should be paid to the positional relationship between the forceps trajectory and the major blood vessels by checking the surgical field from a distant view on a regular basis.
Mediation of self‐concept and moderation of teacher support between SES and reading achievement: Evidence from China and the United States
Authors: Ma Lihong , Xiao Leifeng , Li Qi 
Published: May 2023

AbstractBackgroundSocioeconomic status (SES) is important in students' reading development. The mechanism of how they are linked, however, is underexplored.AimsThis research aimed to explore whether reading self‐concept mediates the link between SES and reading achievement and whether teacher support moderates the direct and indirect link between SES and reading achievement.SamplesUsing PISA 2018 database, we selected 17,346 15‐year‐olds from 537 schools in B‐S‐J‐Z (China) and the United States (U.S.).MethodsMultilevel linear models were calculated to explore the potential mediation of self‐concept and the potential moderation of teacher support between SES and reading achievement.ResultsResults reveal that reading self‐concept mediated the link between SES and reading achievement at student level both in China and the United States, and teacher support moderated the link between SES and reading self‐concept both at student level and school level only in China, but not in the United States.ConclusionOur research highlights the importance of self‐concept and teacher support in improving students' reading achievement, especially for students of low SES, which has important theoretical significance and practical enlightenment for reading instruction.
Health and well‐being of sibling carers of adults with an intellectual disability in Ireland: Four waves of data
Authors: Brennan Damien , D'Eath Maureen , McCallion Philip , McCarron Mary 
Published: May 2023

AbstractBackgroundAs the life expectancy of people with intellectual disability increases, they may now outlive their parents or their parents' ability to continue to care. Siblings of adults with intellectual disability often succeed their parents as primary carers. Little is known about the health and well‐being of this important cohort of carers who will be both caring for and ageing alongside their brother or sister with intellectual disability. The Carer's Study within The Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA) provides a unique insight into the health and well‐being of family carers of older adults with intellectual disability including sibling carers in Ireland. This article reports on the findings from waves 1, 2, 3 and 4 of the IDS‐TILDA Carer's Study.MethodsThe IDS‐TILDA Carer's Study surveys family carers of older people (aged 40 years and older) with intellectual disability on a 3‐yearly cycle. The family carers complete a self‐administered, mixed‐methods questionnaire. The qualitative data are analysed thematically, and a descriptive analysis of the quantitative data is conducted using SPSS.FindingsIn each wave, sibling carers comprised a significant proportion of the Carer's Study participants: W1 58%; W2: 61.4%; W3: 76.7%; and W4: 45.8%. The siblings were predominantly female, not in paid employment and were caring without the support of a spouse or partner. Across the four waves, siblings reported good general health. However, a high prevalence of particular conditions including back pain, aching joints and stress was also reported, and in each wave, siblings reported feeling completely overwhelmed by their care responsibilities. Although sibling carers reported that they have considered the future, only a minority have progressed to action in this regard.ConclusionsThere is evidence of the strong relational and emotional commitment by the siblings to their brother or sister with intellectual disability. However, through the four waves of data, there was also evidence of physical, mental and financial toll. An urgent need exists to identify and engage with siblings to protect their well‐being as they provide care for an increasingly ageing sibling.
Association of Gestational Diabetes Mellitus and Perinatal Maternal Depression with Early Childhood Behavioral Problems: An Environmental Influences on Child Health Outcomes (ECHO) Study
Authors: Shuffrey Lauren C. , Morales Santiago , Jacobson Melanie H. , Bosquet Enlow Michelle , Ghassabian Akhgar , Margolis Amy E. , Lucchini Maristella , Carroll Kecia N. , Crum Rosa M. , Dabelea Dana , Deutsch Arielle , Fifer William P. , Goldson Brandon , Hockett Christine W. , Mason W. Alex , Jacobson Lisette T. , O'Connor Thomas G. , Pini Nicolò , Rayport Yael , Sania Ayesha , Trasande Leonardo , Wright Rosalind J. , Lee Seonjoo , Monk Catherine ,   program collaborators for Environmental influences on Child Health Outcomes
Published: May 2023

AbstractThis study examined the association of gestational diabetes mellitus (GDM), prenatal, and postnatal maternal depressive symptoms with externalizing, internalizing, and autism spectrum problems on the Preschool Child Behavior Checklist in 2379 children aged 4.12 ± 0.60 (48% female; 47% White, 32% Black, 15% Mixed Race, 4% Asian, <2% American Indian/Alaskan Native, <2% Native Hawaiian; 23% Hispanic). Data were collected from the NIH Environmental influences on Child Health Outcomes (ECHO) Program from 2009‐2021. GDM, prenatal, and postnatal maternal depressive symptoms were each associated with increased child externalizing and internalizing problems. GDM was associated with increased autism behaviors only among children exposed to perinatal maternal depressive symptoms above the median level. Stratified analyses revealed a relation between GDM and child outcomes in males only.
CB‐HRNet: A Class‐Balanced High‐Resolution Network for the evaluation of endoscopic activity in patients with ulcerative colitis
Authors: Wang Ge , Zhang Shujiao , Li Jie , Zhao Kai , Ding Qiang , Tian Dean , Li Ruixuan , Zou Fuhao , Yu Qin 
Published: May 2023

AbstractEndoscopic evaluation is the key to the management of ulcerative colitis (UC). However, there is interobserver variability in interpreting endoscopic images among gastroenterologists. Furthermore, it is time‐consuming. Convolutional neural networks (CNNs) can help overcome these obstacles and has yielded preliminary positive results. We aimed to develop a new CNN‐based algorithm to improve the performance for evaluation tasks of endoscopic images in patients with UC. A total of 12,163 endoscopic images from 308 patients with UC were collected from January 2014 to December 2021. The training set and test set images were randomly divided into 37,515 and 3191 after excluding possible interference and data augmentation. Mayo Endoscopic Subscores (MES) were predicted by different CNN‐based models with different loss functions. Their performances were evaluated by several metrics. After comparing the results of different CNN‐based models with different loss functions, High‐Resolution Network with Class‐Balanced Loss achieved the best performances in all MES classification subtasks. It was especially great at determining endoscopic remission in UC, which achieved a high accuracy of 95.07% and good performances in other evaluation metrics with sensitivity 92.87%, specificity 95.41%, kappa coefficient 0.8836, positive predictive value 93.44%, negative predictive value 95.00% and area value under the receiver operating characteristic curve 0.9834, respectively. In conclusion, we proposed a new CNN‐based algorithm, Class‐Balanced High‐Resolution Network (CB‐HRNet), to evaluate endoscopic activity of UC with excellent performance. Besides, we made an open‐source dataset and it can be a new benchmark in the task of MES classification.
Gene expression profiling and multiplex immunofluorescence analysis of bullous pemphigoid immune‐related adverse event reveal upregulation of toll‐like receptor 4/complement‐induced innate immune response and increased density of TH1 T‐cells
Authors: Marques‐Piubelli Mario L. , Seervai Riyad N. H. , Mudaliar Kumaran M. , Ma Wencai , Milton Denái R. , Wang Jing , Muhlbauer Aaron , Parra Edwin R. , Solis Luisa M. , Nagarajan Priyadharsini , Speiser Jodi , Hudgens Courtney , Cho Woo Cheal , Aung Phyu P. , Patel Anisha , Pacha Omar , Nelson Kelly C. , Tetzlaff Michael T. , Amaria Rodabe N. , Torres‐Cabala Carlos A. , Prieto Victor G. , Wistuba Ignacio I. , Curry Jonathan L. 
Published: May 2023

AbstractBackgroundImmune checkpoint inhibitor (ICI)‐based cancer therapies cause a variety of cutaneous immune‐related adverse events (irAEs) including immunobullous skin eruptions like bullous pemphigoid (BP). However, little is known about the underlying immunopathogenic drivers of these reactions, and understanding the unique gene expression profile and immune composition of BP‐irAE remains a critical knowledge gap in the field of oncodermatology/oncodermatopathology.MethodsBP‐irAE (n = 8) and de novo BP control (n = 8) biopsy samples were subjected to gene expression profiling using the NanoString® Technologies nCounter PanCancer Immune Profiling Panel. Multiplex immunofluorescence (mIF) studies using markers for T‐cells (CD3 and CD8), T helper 1 (TH1) cells (Tbet), TH2 cells (Gata3), TH17 cells (RORγT), and regulatory T‐cells (Tregs; FoxP3) were further evaluated using InForm® image analysis.ResultsCompared with de novo BP controls, BP‐irAE samples exhibited upregulation of 30 mRNA transcripts (p < 0.025), including toll‐like receptor 4 (TLR4) and genes associated with complement activation, and downregulation of 89 mRNA transcripts (p < 0.025), including genes associated with TH2, TH17, and B‐cell immune response. BP‐irAE demonstrated a greater density of Tbet+ (TH1) cells in the dermis (p = 0.004) and fewer Tregs in the blister floor (p = 0.028) when compared with that of de novo control BP samples.ConclusionsBP‐irAE exhibited activation of the TLR4/complement‐driven classical innate immune response pathway, with dermal TH1 immune cell polarization and decreased Tregs in the blister floor. TLR/complement signaling may underlie the immunopathogenesis of BP‐irAE.
Changes in continuous glucose monitoring metrics and predictors of improvement 12 months after conversion from Freestyle Libre to Freestyle Libre 2
Authors: Stimson Roland H. , Dover Anna R. , Strachan Mark W. J. , Wright Rohana J. , Forbes Shareen , Gibb Fraser W. 
Published: May 2023

AbstractAimsWe sought to assess whether conversion from Freestyle Libre to Freestyle Libre 2 (with low and high glucose alert functions) was associated with improved glucose metrics.Research Design and MethodsA prospective observational study to assess changes in CGM metrics in 672 adults with type 1 diabetes when converting to Freestyle Libre 2. Secondary outcomes included predictors of reduction in time below range (TBR) and increase in time in range (TIR).ResultsTBR fell by a median of 1.0% (IQR −2.7 to 0.3, p < 0.001) after 12 months and TIR decreased by 1.0% (−8.7 to 6.0, p = 0.004). TIR did not fall in people using high glucose alerts (p = 0.353). Average duration of low glucose events (<3.9 mmoL/L) fell by 10 min (−46 to 18, p < 0.001). Significant improvements in TIR (p = 0.029) and time above 13.9 mM (p = 0.002) were observed in those using high glucose alerts. Alert threshold settings were not associated with glycaemic response; however, low alert use was independently associated with a fall in TBR of ≥0.5% (HR 1.9 [95% CI 1.2–3.1], p = 0.009) and high alert use was independently associated with a rise in TIR of ≥5% (HR 1.6 [95% CI 1.0–2.5], p = 0.043) at 12 months.ConclusionsConversion to Freestyle Libre 2 was associated with significant improvements in low glucose metrics. Alert function users were more likely to see improvements across all CGM metrics. Challenges remain in encouraging alert use, helping users set optimal alert thresholds and optimizing response to alerts.
Antioxidant defense enzymes in multiple sclerosis: A 5‐year follow‐up study
Authors: Essenburg Carson , Browne Richard W. , Ghazal Diala , Tamaño‐Blanco Miriam , Jakimovski Dejan , Weinstock‐Guttman Bianca , Zivadinov Robert , Ramanathan Murali 
Published: May 2023

AbstractBackground and purposeOxidative stress biomarkers are increased in multiple sclerosis (MS) lesions. Antioxidant defense enzymes regulate reactive oxygen species that can cause tissue injury in MS.MethodsThe study of 91 subjects included 64 relapsing–remitting MS (RR‐MS; 72% female, baseline age ± SD = 44.6 ± 11 years, disease duration = 13.3 ± 8.8 years, median Expanded Disability Status Scale [EDSS] = 2.0, interquartile range = 1.8) and 27 healthy controls (HC) at baseline and 5‐year follow‐up (5YFU). Serum glutathione peroxidase (GPX), glutathione‐S‐transferase (GST), glutathione reductase (GSHR), superoxide dismutase, and paraoxonase‐1 (PON1) arylesterase and paraoxonase activities were measured using kinetic enzyme assays. Total cholesterol (TC), high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol (LDL‐C), and an apolipoprotein (Apo) panel with ApoA‐I, ApoA‐II, ApoB, ApoC‐II, and ApoE were obtained. Serum neurofilament (sNfL) was used to assess axonal injury. Disability was measured on the EDSS.ResultsGSHR activity was lower in HC compared to RR‐MS at baseline and 5YFU. GPX (p = 0.008) and PON1 arylesterase and paraoxonase activities (both p = 0.05) increased between baseline and 5YFU in HC but did not increase in RR‐MS. At baseline and 5YFU, GPX and GST were associated with TC, LDL‐C, and ApoA‐II; GSHR was associated with ApoA‐II and ApoC‐II. Antioxidant enzymes were not associated with sNfL or EDSS in RR‐MS.ConclusionsRR‐MS patients did not exhibit the changes in antioxidant enzyme activities over 5YFU found in HC; however, the differences were modest. Antioxidant enzyme activities are not associated with disability.
Immune checkpoint inhibitor‐associated central nervous system autoimmunity
Authors: Valencia‐Sanchez Cristina , Sechi Elia , Dubey Divyanshu , Flanagan Eoin P. , McKeon Andrew , Pittock Sean J. , Zekeridou Anastasia 
Published: May 2023

AbstractBackground and purposeOutcome and rechallenge data on central nervous system (CNS) autoimmunity triggered by immune checkpoint inhibitors (ICIs) are limited. We aim to describe a large series of patients with ICI‐triggered CNS autoimmunity, and to compare these patients with spontaneous paraneoplastic syndromes (PNS).MethodsWe retrospectively reviewed Mayo Clinic patients with ICI‐triggered CNS autoimmunity (February 2015–June 2021). Clinical characteristics were compared to spontaneous PNS patients (with antineuronal nuclear antibody [ANNA]‐1 or anti‐Hu neurological autoimmunity, and/or neuroendocrine tumors [NET]) evaluated within the same period.ResultsThirty‐one patients were included (55% female, median age = 63 years, range = 39–76). Median time from ICI initiation was 3.65 months (range = 0.8–44.5). The most common associated malignancies were melanoma and small cell lung cancer. CNS manifestations included encephalitis (n = 16), meningoencephalitis (n = 8), cerebellar ataxia (n = 4), demyelinating syndrome (n = 2), and myelopathy (n = 1). Magnetic resonance imaging was abnormal in 62%. Cerebrospinal fluid was inflammatory in 70%. Neural autoantibodies were identified in 47%, more frequently in patients with NET (p = 0.046). ICI was discontinued in 97%; 90% received immunosuppressive treatment. After median 6.8 months follow‐up (range = 0.7–46), 39% had unfavorable outcomes (grade ≥ 3). This was associated with higher severity degree at onset, shorter period from ICI to neurological symptom onset, and encephalitis. Four patients were rechallenged with ICI, and one relapsed. Patients with NET and with ANNA‐1 ICI‐triggered CNS autoimmunity had associated peripheral nervous system manifestations more frequently than their spontaneous counterparts (p = 0.007 and p = 0.028, respectively).ConclusionsOne third of ICI‐related CNS autoimmunity patients have unfavorable outcomes. Relapses may occur after ICI rechallenge. Neural autoantibodies are often present, more commonly in patients with NET.