bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Scoping Review of Interventions and Experiences Increasing Medical Student Interest in Physical Medicine and Rehabilitation
Authors: Redepenning Drew H. , Chau Justin , Dorris C. Scott , Bliznak Victoria , Persson Daniel C. , Wilson Ethan , Pingenot Edward A. , Mayer R. Samuel 
Published: February 2023

Abstract
Increasing medical student exposure to Physical Medicine and Rehabilitation is an important factor for future growth of the field. Therefore, it is important to determine which types of interventions during medical school have the greatest impact on medical students’ decision to pursue a career in Physical Medicine and Rehabilitation. The purpose of this study is to perform a scoping review of the current literature that has analyzed how different interventions and experiences impact medical school students’ decision to pursue a career in Physical Medicine and Rehabilitation. A systematic and comprehensive search strategy was implemented across five different journal databases and yielded 18 articles meeting the inclusion criteria. A majority of studies analyzing specific interventions looked only at pre- and post-survey comparisons of the immediate impact of the intervention on interest in Physical Medicine and Rehabilitation and few looked at longitudinal outcomes such as match characteristics. The most frequently cited factor that was shown to positively impact interest in Physical Medicine and Rehabilitation was early exposure. Participating in clinical rotations also had a positive impact but was most effective when combined with early exposure. This review highlights the need for national recommendations for integrating Physical Medicine and Rehabilitation into all four years of medical education.
68Ga-FAPI-04 PET/CT in a Small Sarcomatoid Renal Cell Carcinoma With Widespread Metastases
Authors: Dong Aisheng , Yang Bo , Bai Yushu , Zuo Changjing 
Published: February 2023

Abstract
Sarcomatoid renal cell carcinoma is an uncommon high-grade malignancy with poor prognosis. We describe 68Ga-FAPI-04 PET/CT findings in a patient with a small (1.8 cm in the maximum diameter) sarcomatoid clear cell renal cell carcinoma with widespread metastatic disease. Both the primary renal tumor and its metastases in bones, lymph nodes, adrenals, and liver showed increased 68Ga-FAPI-04 uptake. The primary renal tumor showed hypovascularity on contrast-enhanced CT, mimicking papillary renal cell carcinoma. This case indicates FAPI PET/CT may be useful for detecting and staging of this unusual malignancy.
Blood Pressure Control From 2011 To 2019 In Patients 90 Days After Stroke
Authors: Levine Deborah A. , Morgenstern Lewis B. , Kwicklis Madeline , Shi Xu , Case Erin , Lisabeth Lynda D. 
Published: February 2023

AbstractBackground and AimsWhether and how much stroke survivors’ blood pressure (BP) control changed over the 2010s decade is unclear. We assessed whether 90-day BP control changed from 2011 to 2019, and whether temporal changes varied by ethnicity and sex.MethodsWe conducted a prospective cohort study of 1,755 first expert-adjudicated stroke cases ≥45 years in the Brain Attack Surveillance in Corpus Christi (BASIC) project with BP measurements from 2011-2019. We measured BP in patients’ residences at ∼90 days post-stroke using standardized procedures and validated oscillometric devices. The average of three BP measurements was used. Outcomes were BP control <130/80 mmHg (primary) and BP control<140/90 mmHg (secondary). We used inverse probability weights to account for attrition due to 90-day mortality and non-participation in study interviews. Using logistic regression, we examined the association between BP control and time (year) and demographic differences in trends through interactions with time adjusting for patient factors.ResultsMedian age was 66 years (interquartile range, 58-76 years), 59% were Mexican American, 49% were women. From 2011 to 2019, BP control <130/80 mmHg declined from 43.0% to 28.6% (P<0.001). Odds of BP control <130/80 mmHg decreased over time (odds ratio per one-year increase, 0.95; 95% CI, 0.91, 0.99) after adjustment for patient factors. BP control <140/90 mm Hg remained consistent at 59.3% in 2011 and 57.1% in 2019 (P=0.31). Odds of BP control <140/90 mm Hg appeared constant over time after adjustment for patient factors (odds ratio per one-year increase, 1.00; 95% CI, 0.96, 1.04). Trends in BP control <130/80 mmHg and <140/90 mmHg did not significantly differ by ethnicity or sex.ConclusionsFrom 2011 to 2019, BP control <130/80 mmHg decreased and BP control <140/90 mmHg did not improve in patients 90 days after stroke. Results suggest stroke survivors need effective, sustainable strategies to achieve BP control.AHA Journals Subject TermsCerebrovascular Disease/Stroke, Blood Pressure, Quality and Outcomes, Health Services
Prediction and prognosis of delayed cerebral ischemia via continuous monitoring of blood-brain barrier permeability
Authors: Zhang Chao , Tang Wenjuan , Cheng Liang , Yang Chen , Wang Ting , Wang Juan , Miao Zhuang , Zhao Xintong , Fang Xinggen , Zhou Yunfeng 
Published: February 2023

AbstractBackgroundBlood-brain barrier disruption is a prominent pathological characteristic of aneurysmal subarachnoid hemorrhage (aSAH), which can be measured as Ktransusing CT perfusion.PurposeTo monitor Ktranswithin 24 hours of aSAH and during the time window associated with a delayed cerebral ischemia (DCI) event (DCITW), and to explore its association with the trajectory of DCI, including outcome at three months.MethodsWe retrospectively assessed consecutive aSAH patients from a prospective database between July 2020 and September 2022. Patients were grouped according to the DCI occurrence and three months modified Rankin scale. Ktransat admission (admission Ktrans) and during DCITW (DCITW Ktrans) were compared between DCI and non-DCI groups, and between good outcome and poor outcome groups. The changes in Ktranswere also analyzed. Multivariate logistic regression analysis was performed to identify independent predictors of DCI and poor outcome.ResultsOne hundred and twenty-eight patients (mean age, 61±12 [SD]; 75 women) were included. Both admission Ktrans(0.58±0.18 vs 0.47±0.12,P=0.002) and DCITW Ktrans(0.54±0.19 vs 0.41±0.14,P<0.001) were significantly higher in the DCI group compared with the non-DCI group. Both of those were also higher in the poor outcome group compared with the good outcome group, but the difference was not statistically significant at admission (0.53±0.18 vs0.49±0.14,P=0.198). Ktransin the non-DCI group (0.47±0.12 vs 0.41±0.14,P=0.004) and good outcome group (0.49±0.14 vs 0.41±0.14,P<0.001) decreased significantly from admission to DCITW. Multivariate analysis identified DCITW Ktransand admission Ktransas independent predictors of poor outcome (OR=1.73, 95%CI: 1.24-2.43,P=0.001) and DCI (OR=1.75, 95%CI: 1.25-2.44,P=0.001), respectively.ConclusionElevated Ktransat admission is associated with the occurrence of DCI, but not with outcome at three months. Continuous monitoring of Ktransfrom admission to DCITW can accurately identify reversible and irreversible changes in Ktrans, and can predict outcome.
TheNR5A1/SF-1variant p.Gly146Ala cannot explain the phenotype of individuals with a difference of sex development
Authors: de Lapiscina Idoia Martinez , Kouri Chrysanthi , Aurrekoetxea Josu , Sanchez Mirian , Elzenaty Rawda Naamneh , Sauter Kay-Sara , Camats Núria , Grau Gema , Rica Itxaso , Rodriguez Amaia , Vela Amaia , Cortazar Alicia , Alonso-Cerezo M. Concepción , Bahillo Pilar , Berthod Laura , Esteva Isabel , Castaño Luis , Flück Christa E. 
Published: February 2023

AbstractSteroidogenic factor 1 (SF-1,NR5A1) plays an important role in human sex development. Variants ofNR5A1/SF-1 may cause mild to severe differences of sex development (DSD) or may be found in healthy carriers. So far, the broad DSD phenotypic variability associatedNR5A1/SF-1 variants remains a conundrum. TheNR5A1/SF-1 variant c.437G>C/p.Gly146Ala is common in individuals with a DSD and has been suggested to act as a susceptibility factor for adrenal disease or cryptorchidism. However, as the allele frequency in the general population is high, and as functional testing of the p.Gly146Ala variantin vitrorevealed inconclusive results, the disease-causing effect of this variant has been questioned. However, a role as a disease modifier in concert with other gene variants is still possible given that oligogenic inheritance has been described in patients withNR5A1/SF-1 gene variants. Therefore, we performed next generation sequencing in DSD individuals harboring theNR5A1/SF-1 p.Gly146Ala variant to search for other DSD-causing variants. Aim was to clarify the function of this variant for the phenotype of the carriers. We studied 14 pediatric DSD individuals who carried the p.Gly146Ala variant. Panel and whole-exome sequencing was performed, and data were analyzed with a specific data filtering algorithm for detecting variants inNR5A1- and DSD-related genes. The phenotype of the studied individuals ranged from scrotal hypospadias and ambiguous genitalia in 46,XY DSD to typical male external genitalia and ovotestes in 46,XX DSD patients. Patients were of African, Spanish, and Asian origin. Of the 14 studied subjects, five were homozygous and nine heterozygous for theNR5A1/SF-1 p.Gly146Ala variant. In ten subjects we identified either a clearly pathogenic DSD gene variant (e.g. inAR, LHCGR) or one to four potentially deleterious variants that likely explain the observed phenotype alone (e.g. inFGFR3, CHD7, ADAMTS16). Our study shows that most individuals carrying theNR5A1/SF-1 p.Gly146Ala variant, harbor at least one other deleterious gene variant which can explain the DSD phenotype. This finding confirms that the p.Gly146Ala variant ofNR5A1/SF-1may not contribute to the pathogenesis of DSD and qualifies as a benign polymorphism. Thus, individuals, in whom theNR5A1/SF-1 p.Gly146Ala gene variant has been identified as the underlying genetic cause for their DSD in the past, should be re-evaluated with a next-generation sequencing method to reveal the real genetic diagnosis.
Rett Syndrome in Ireland: A demographic study
Authors: Zade Komal , Campbell Ciara , Bach Snow , Fernandes Hazel , Tropea Daniela 
Published: February 2023

AbstractRett syndrome (RTT) is a rare neuropsychiatric condition associated to mutations in the gene coding for the methyl-CpG-binding protein 2 (MECP2). It is primarily observed in girls and affects individuals globally. The understanding of the neurobiology of RTT and patient management has been improved by studies that describe the demographic and clinical presentation of patients with RTT. However, in Ireland, there is a scarcity of data regarding patients with RTT, which impedes the ability to fully characterize the Irish RTT population. Together with the Rett Syndrome Association of Ireland (RSAI), we prepared a questionnaire to determine the characteristics of RTT patients in Ireland. Twenty families have participated in the study to date, providing information about demographics, genetics, familial history, clinical features, and regression. The main finding of this study is the limited number of genetic tests conducted to support the clinical diagnosis of RTT. The results shows that Irish patients with RTT have comparable presentation with respect to patients in other countries, however, they had a better response to anti-epileptic drugs and fewer skeletal deformities were reported. Nonetheless, seizures, involuntary movements and regression were more frequently observed in Irish patients. Despite the limited sample size, this study is the first to characterise the RTT population in Ireland and highlights the importance of genetic testing for patients with RTT in order to sharpen the characterization of the phenotype and increase the visibility of Irish patients in the international RTT community.
23-year trends indicate low rates of antimicrobial resistance inSalmonellaParatyphi A
Authors: Sajib Mohammad S. I. , Tanmoy Arif M. , Hooda Yogesh , Rahman Hafizur , Munira Sira J. , Sarkar Anik , Das Dipu , Rahman Md. Asadur , Islam Nazrul , Shahidullah Mohammod , Amin Md. Ruhul , Alam Md. Jahangir , Hanif Mohammed , Luby Stephen P. , Garrett Denise O. , Saha Samir K. , Saha Senjuti 
Published: February 2023

AbstractBackgroundTyphoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused bySalmonellaParatyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility ofSalmonellaTyphi, which causes typhoid. Hence, with rising drug resistance inSalmonellaTyphi, last-line antibiotics like ceftriaxone and azithromycin are prescribed for both typhoid and paratyphoid. Here, we report 23-year AMR trends ofSalmonellaParatyphi A in Bangladesh.MethodsFrom 1999 to 2021, we conducted enteric fever surveillance in two major pediatric hospitals and three clinics in Dhaka, Bangladesh. Blood cultures were performed at the discretion of the treating physicians; cases were confirmed by culture, serological and biochemical tests. Antimicrobial susceptibility was determined following CLSI guidelines.ResultsOver 23 years, we identified 2,725 blood culture-confirmed paratyphoid cases. Over 97% of the isolates were susceptible to ampicillin, chloramphenicol, and cotrimoxazole, and no isolate was resistant to all three. No resistance to ceftriaxone was recorded, and >99% of the isolates were sensitive to azithromycin. A slight increase in minimum inhibitory concentration (MIC) is noticed for ceftriaxone but current average MIC is 32-fold lower than the resistance cut-off. Over 99%, of the isolates exhibited decreased susceptibility to ciprofloxacin.ConclusionsSalmonellaParatyphi A has remained susceptible to most antibiotics, unlikeSalmonellaTyphi, despite widespread usage of many antibiotics in Bangladesh. The data can guide evidence-based policy decisions for empirical treatment of paratyphoid fever.
Analyzing the Influencing Factors on Quality of Life of Older People with Swallowing Dysfunction in Nursing Homes in China
Authors: Li Qianru , Li Laiyou , Sun Ning , Wang Hongyin , Chen Shuangqin , Li Hongyu , Yang Shuang 
Published: February 2023

AbstractObjectiveTo investigate the prevalence of dysphagia among the older adult population in nursing homes and unravel the relevant factors that precipitate quality of life of the older adults with swallowing dysfunction in nursing homes.MethodsBased on 102 individuals aged 50 years or older, with dysphagia, and who were admitted in community nursing home, we examined the demographic characteristic, the nutritional indices and the possible quality of life related variables through a cross-sectional study.ResultsThe reliability and validity of the C-DHI scale were proven high. The incidence of swallowing disorder risk in the older adult population of care institutions is 90.2%, and the incidence of nutrition risk and malnutrition is 67.64%. The general linear regression results show that the standard regression coefficient of FOIS is −2.75,P=0.007. The standard regression coefficient of nutritional methods is −3.84,P=0.000, and the difference was statistically significant, indicating that the C-DHI scale was negatively correlated with FOIS and nutrition methods.ConclusionsSwallowing disorders are also identified as a major problem amongst the older adult population in nursing homes, as there is a high prevalence of dysphagia among this population group. There are many factors related to the quality of life. The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. More attention to controllable influencing factors would improve the quality of life of older adults with swallowing dysfunction.
Hypertension among persons living with HIV — Zambia, 2021; A cross-sectional study of a national electronic health record system
Authors: Hines Jonas Z. , Prieto Jose Tomas , Itoh Megumi , Fwoloshi Sombo , Zyambo Khozya D. , Zachary Dalila , Chitambala Cecilia , Minchella Peter A. , Mulenga Lloyd B. , Agolory Simon 
Published: February 2023

AbstractBackgroundHypertension is a major risk factor for cardiovascular disease, which is a common cause of death in Zambia. Data on hypertension prevalence in Zambia are scarce and limited to specific geographic areas and/or populations. We measured hypertension prevalence among persons living with HIV (PLHIV) in Zambia using a national electronic health record (EHR) system.MethodsWe did a cross-sectional study of hypertension prevalence among PLHIV aged ≥18 years in Zambia during 2021. Data were extracted from the SmartCare EHR, which covers ∼90% of PLHIV on treatment in Zambia. PLHIV with ≥2 recorded blood pressure (BP) readings in 2021 were included. Hypertension was defined as ≥2 elevated BP readings (i.e., systolic BP of ≥140 mmHg or diastolic BP of ≥90 mmHg) during 2021 and/or on anti-hypertensive medication recorded in their EHR in the past five years. Multivariable logistic regression was used to assess associations between hypertension and independent variables.ResultsAmong 750,098 PLHIV aged ≥18 years with ≥2 visits in SmartCare during 2021, 101,363 (13.5%) had ≥2 blood pressure readings recorded in their EHR. Among these PLHIV, 14.7% (95% confidence interval [CI]: 14.5-14.9) had hypertension during 2021. Only 8.9% of PLHIV with hypertension had an anti-hypertensive medication recorded in their EHR. The odds of hypertension were greater in older age groups compared to PLHIV aged 18-29 years (adjusted odds ratio [aOR] for 30-44 years: 2.6 [95% CI: 2.4-2.9]; aOR for 45-49 years: 6.4 [95% CI: 5.8-7.0]; aOR for ≥60 years: 14.5 [95% CI: 13.1-16.1]), urban areas (aOR: 1.9 [95% CI: 1.8-2.1]), and persons prescribed ART for ≥6-month at a time (aOR: 1.1 [95% CI: 1.0-1.2]).DiscussionHypertension was common among a cohort of PLHIV in Zambia, with few having documentation of being on antihypertensive treatment. Most PLHIV were excluded from the analysis because of missing BP measurements in their EHR. Strengthening integrated management of non-communicable diseases in ART clinics might help to diagnose and treat hypertension in Zambia. Data completeness needs to be improved to routinely capture cardiovascular disease risk factors, including blood pressure readings consistently for PHLIV in their EHRs.
Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center run by Médecins sans Frontières in Herat, Afghanistan
Authors: Klein Ana , Bastard Mathieu , Hemat Hamayoun , Singh Saschveen , Muniz Bruno , Manangama Guyguy , Alayyan Amber , Tamanna Abdul Hakim , Barakzaie Bashir , Popal Nargis , Zmarial Kakar Mohammad Azeem , Poulet Elisabeth , Finger Flavio 
Published: February 2023

AbstractBackgroundThough many studies on COVID have been published to date, data on COVID-19 epidemiology, symptoms, risk factors and severity in low- and middle-income countries (LMICS), such as Afghanistan are sparse.ObjectiveTo describe clinical characteristics, severity, and outcomes of patients hospitalized in the MSF COVID-19 treatment center (CTC) in Herat, Afghanistan and to assess risk factors associated with severe outcomes.Methods1113 patients were included in this observational study between June 2020 and April 2022. Descriptive analysis was performed on clinical characteristics, complications, and outcomes of patients. Univariate description by Cox regression to identify risk factors for an adverse outcome was performed. Adverse outcome was defined as death or transfer to a level 3 intensive care located at another health facility. Finally, factors identified were included in a multivariate Cox survival analysis.ResultsA total of 165 patients (14.8%) suffered from a severe disease course, with a median time of 6 days (interquartile range: 2-11 days) from admission to adverse outcome. In our multivariate model, we identified male gender, age over 50, high O2 flow administered during admission, lymphopenia, anemia and O2 saturation <=93% during the first three days of admission as predictors for a severe disease course (p<0.05).ConclusionOur analysis concluded in a relatively low rate of adverse outcomes of 14.8%. This is possibly related to the fact, that the resources at an MSF-led facility are higher, in terms of human resources as well as supply of drugs and biomedical equipment, including oxygen therapy devices, compared to local hospitals. Predictors for severe disease outcomes were found to be comparable to other settings.
An Investigation into Discomfort and Fatigue Related to the Wearing of an EEG Neurofeedback Headset
Authors: Hanzal Simon , Tvrda Lucie , Harvey Monika 
Published: February 2023

AbstractSelf-regulating brain activity using electroencephalography (EEG) neurofeedback has the potential to improve cognitive functions, rehabilitate motor control and reduce chronic fatigue. Nonetheless, user experience and factors which may interfere with the beneficial effects of neurofeedback are still under researched. This preliminary study aimed to investigate whether wearing an EEG neurofeedback recommended headset for 1 hour induced significant physical discomfort and fatigue. Data were obtained from a standard visual analogue scale questionnaire and a newly developed EEG headset discomfort (EEGhd) questionnaire. 21 participants (12 in the experimental (headset) and 9 in the control (electrodes only) group) watched a nature documentary video while their brain signals were recorded. They completed the set of questionnaires before and after the video, while wearing the EEG headset (or electrodes). A two-sample t-test revealed that the experimental group experienced significantly higher EEGhd than the controls (p < .001). Participants reported the onset of discomfort after approximately 25 minutes. These results highlight the importance of assessing user experience and accounting for physical discomfort when designing an EEG neurofeedback study.
The phenomenology of auditory verbal hallucinations in schizophrenia assessed with the MiniVoiceQuestionnaire (MVQ)
Authors: Hugdahl Kenneth , Hjelmervik Helene , Weber Sarah , Sandøy Lydia Brunvoll , Bless Josef , Lilleskare Lin , Craven Alexander , Hirnstein Marco , Kazimierczak Katarzyna , Dwyer Gerard , Dumitru Magda L. , Sinceviciute Igne , Ersland Lars , Johnsen Erik 
Published: February 2023

AbstractWe used a 10-question self-report questionnaire, Mini Voice Questionnaire (MVQ), for mapping the phenomenology of auditory verbal hallucinations (AVH). The MVQ contains questions related to daily AVH frequency and duration, the events preceding AVH episode onset and offset, the very first AVH episode, emotional content, coping strategies, if the voice comes from the inside or outside of head, if it is one’s own voice heard, and whether the voice is present when filling out the questionnaire. Forty-one patients with a diagnosis of schizophrenia spectrum disorder participated in the study. The construction of the MVQ was originally driven by an interest in whether AVH-episode onsets and offsets, that is, the coming and going of the voice, are initiated by specific environmental events or mental states, or whether they occur spontaneously, which could have both theoretical and clinical implications. MVQ scores were correlated with PANSS and BAVQ questionnaire scores. The results showed that specific events do not precede onset or offset of AVH episodes except for the very first episode which was often associated with trauma or other negative events. This finding could have implications for neurobiological models of AVH, showing that AVH episodes are spontaneously initiated, pointing to a neuronal origin of AVH episode onsetsandoffsets. The P3 (hallucinatory behavior) item of the PANSS questionnaire correlated significantly with frequency and duration of AVH episodes: More frequent and longer AVH episodes were associated with higher P3 scores, implying more severe symptoms. The results are discussed in terms of recent AVH models.