bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in patient admission patterns at orthopedics and traumatology outpatient clinics before and after the earthquakes on 6 February 2023 in Turkey
Authors: Asfuroğlu Zeynel Mert , Gümüşoğlu Ender 
Published: July 2023

Abstract
Background
The increase in orthopedic injuries after earthquakes imposes a significant burden on the health system. However, the impact of earthquakes on outpatient admissions remains unclear. This study compared patient admissions to the orthopedics and traumatology outpatient clinics before and after earthquakes.

Methods
The study was conducted at a tertiary university hospital near the earthquake zone. In total, 8549 outpatient admissions were retrospectively analyzed. The study population was divided into pre-earthquake (pre-EQ) and post-earthquake (post-EQ) groups. Factors such as gender, age, city of origin, and diagnosis were compared between the groups. In addition, unnecessary outpatient utilization (UOU) was defined and analyzed.

Results
The pre-EQ and post-EQ groups included 4318 and 4231 patients, respectively. The two groups had no significant differences in age and sex distribution. However, the proportion of non-local patients increased after the earthquake (9.6% vs. 24.4%, p < 0.001). UOU was the most common reason for admission in both groups. The distribution of diagnoses differed significantly between the pre-EQ and post-EQ groups, with an increase in the number of trauma-related diagnoses (15.2% vs. 27.3%, p < 0.001) and a decrease in UOU (42.2% vs. 31.1%, p < 0.001) after the earthquake.

Conclusions
Patient admission patterns at orthopedics and traumatology outpatient clinics changed significantly after the earthquake. The number of non-local patients and trauma-related diagnoses increased, whereas the number of unnecessary outpatients decreased.
Level of evidence Observational study.
Pathophysiology and probable etiology of cerebral small vessel disease in vascular dementia and Alzheimer’s disease
Authors: Inoue Yasuteru , Shue Francis , Bu Guojun , Kanekiyo Takahisa 
Published: July 2023

AbstractVascular cognitive impairment and dementia (VCID) is commonly caused by vascular injuries in cerebral large and small vessels and is a key driver of age-related cognitive decline. Severe VCID includes post-stroke dementia, subcortical ischemic vascular dementia, multi-infarct dementia, and mixed dementia. While VCID is acknowledged as the second most common form of dementia after Alzheimer’s disease (AD) accounting for 20% of dementia cases, VCID and AD frequently coexist. In VCID, cerebral small vessel disease (cSVD) often affects arterioles, capillaries, and venules, where arteriolosclerosis and cerebral amyloid angiopathy (CAA) are major pathologies. White matter hyperintensities, recent small subcortical infarcts, lacunes of presumed vascular origin, enlarged perivascular space, microbleeds, and brain atrophy are neuroimaging hallmarks of cSVD. The current primary approach to cSVD treatment is to control vascular risk factors such as hypertension, dyslipidemia, diabetes, and smoking. However, causal therapeutic strategies have not been established partly due to the heterogeneous pathogenesis of cSVD. In this review, we summarize the pathophysiology of cSVD and discuss the probable etiological pathways by focusing on hypoperfusion/hypoxia, blood–brain barriers (BBB) dysregulation, brain fluid drainage disturbances, and vascular inflammation to define potential diagnostic and therapeutic targets for cSVD.
A self-guided Internet-based intervention for individuals with chronic pain and depressive symptoms: study protocol of a randomized controlled trial
Authors: Borsutzky Swantje , Moritz Steffen , Hottenrott Birgit , Gehlenborg Josefine 
Published: July 2023

Abstract

Background
Despite the existence of evidence-based therapy options for the treatment of chronic pain and comorbid depressive symptoms (e.g., CBT), many individuals remain untreated. Treatment gaps result from a lack of specialists, patient fear of stigmatization, or patient immobility. Internet-based self-help interventions could serve as an anonymous and flexible alternative treatment option. In a pilot study, chronic pain patients with comorbid depressive symptoms who used a generic Internet-based depression program showed a significant reduction in depressive symptoms (but not pain symptoms) compared to a waitlist control group. Based on these findings, we developed the low-threshold, anonymous, and cost-free Internet-based self-help intervention Lenio that is tailored to the specific needs of chronic pain patients with comorbid depressive symptoms. Lenio is accompanied by the smartphone application (app) COGITO designed to increase therapeutic success. With Lenio and COGITO addressing both chronic pain and depressive symptoms, the trial aims to increase treatment effects of online interventions for chronic pain patients by reducing both depressive symptoms and pain.

Methods
The effectiveness of the Internet-based self-help intervention and accompanying smartphone app will be evaluated in a randomized controlled trial (RCT). A total of 300 participants will be randomized into an intervention group (Lenio/COGITO), an active control group (depression-focused smartphone app), or a waitlist control group. Assessments will be done at baseline, after an 8-week intervention period (post), and after 16 weeks (follow-up). The primary outcome is the post-assessment reduction in “pain impairment” (mean value of impairment in daily life, free time, and work) as assessed by the DSF (German pain questionnaire).
Secondary outcomes will include the reduction in depressive symptoms as well as in the severity of pain.

Discussion
Lenio is one of the first Internet-based interventions to reduce chronic pain and depression that will be empirically evaluated. Internet-based interventions could offer a promising alternative to conventional face-to-face psychotherapy in the treatment of chronic pain patients. The primary objective of the current study is to add essential insight into the feasibility, effectiveness, and acceptance of Internet-based interventions for people with chronic pain and depressive symptoms.

Trial registration
DRKS-ID DRKS00026722, Registered on October 6th, 2021.
Minimax optimal control problems for an extensible beam equation with uncertain initial velocity
Authors: Hwang Jin-soo 
Published: July 2023

AbstractThis paper is devoted to the problem of minimax optimal control problems of an extensible beam equation with distributed controls and initial velocity disturbances (or noises). The existence of optimal solutions for distributed control with fixed disturbance, namely the $(P_{v})$
(

P
v

)
problem, and the existence of minimax optimal solutions to $(P)$
(
P
)
problem without restricting the initial disturbance are proved. We derive the necessary optimality conditions for optimal solutions of the $(P_{v})$
(

P
v

)
and $(P)$
(
P
)
problems in the form of Pontryagin’s maximum principle.
The association between deficiencies in paternal and maternal reflective functioning and anorexia nervosa symptomatology
Authors: Goshen Dor , Stein Daniel , Kurman Jenny , Farbstein Dan , Enoch-Levy Adi , Aival-Naveh Erez , Gur Eitan , Yoeli Neta , Bretler Tali , Koren Danny , Rothschild-Yakar Lily 
Published: July 2023

Abstract
Background
A large theoretical body of knowledge exists emphasizing the importance of parental mentalizing in the context of anorexia-nervosa (AN). However, the empirical support to these assumptions is still scarce. The aim of the present study was to examine whether parents of patients with AN are characterized by a lower mentalizing ability, and whether it is associated with impaired mentalizing, AN symptomatology and eating disorder (ED) related psychological traits in the daughters.

Methods
Thirty-two family triads (fathers, mothers, and daughters) of female adolescent and young adult inpatients with AN were compared with thirty-three non-clinical family triads (N = 195). The mentalizing ability of all the participants was assessed using semi-structured interviews and coded using the Reflective Functioning Scale (RFS). Self-report questionnaires were administered to the daughters to evaluate ED symptomatology and ED related psychological traits (e.g., low self-esteem, interpersonal insecurity, emotional dysregulation).

Results
Decreased reflective functioning (RF) levels were found among mothers and fathers of patients with AN compared to their control peers. Examining the entire sample, clinical and non-clinical groups together, showed that both paternal and maternal RF were associated with the daughters' RF and each were found to have a significant and distinct contribution to the daughters' RF. Significant associations were found between lower levels of maternal and paternal RF and increased ED symptoms and ED related psychological traits. The use of a mediation model suggested a serial relationship in which low maternal and paternal RF contributes to the daughters' low RF, which in turn is associated with higher levels of psychological maladjustment, and ultimately contributes to the increased severity of ED symptoms.

Conclusions
The present results provide strong empirical support for theoretical models that suggest that deficits in parental mentalizing may represent important correlates of the presence and severity of ED symptoms in AN. Furthermore, the results highlight the relevance of fathers' mentalizing ability in the context of AN. Finally, clinical and research implications are discussed.
Robust monitoring machine: a machine learning solution for out-of-sample R$$^2$$-hacking in return predictability monitoring
Authors: Yae James , Luo Yang 
Published: July 2023

AbstractThe out-of-sample $$R^2$$

R
2

is designed to measure forecasting performance without look-ahead bias. However, researchers can hack this performance metric even without multiple tests by constructing a prediction model using the intuition derived from empirical properties that appear only in the test sample. Using ensemble machine learning techniques, we create a virtual environment that prevents researchers from peeking into the intuition in advance when performing out-of-sample prediction simulations. We apply this approach to robust monitoring, exploiting a dynamic shrinkage effect by switching between a proposed forecast and a benchmark. Considering stock return forecasting as an example, we show that the resulting robust monitoring forecast improves the average performance of the proposed forecast by 15% (in terms of mean-squared-error) and reduces the variance of its relative performance by 46% while avoiding the out-of-sample $$R^2$$

R
2

-hacking problem. Our approach, as a final touch, can further enhance the performance and stability of forecasts from any models and methods.
A monthly leading indicator of Swiss GDP growth based on Okun’s law
Authors: Kugler Peter , Sheldon George 
Published: July 2023

AbstractWe propose a unique method of nowcasting and forecasting GDP growth based on a forward-looking measure of unemployment (FLUR) and Okun’s law that offers a number of advantages over current leading indicators of the Swiss business cycle. The following investigation, covering the period from 1991/1 to 2021/4, demonstrates that our approach outperforms an AR(1) model of GDP growth equally well as the popular Business Cycle Index of the Swiss National Bank and the KOF Barometer with respect to year-to-year growth, but less so in regard to quarter-to-quarter changes. Our findings suggest that our approach offers a reliable and useful indicator to policymakers seeking easily compiled information on the current and future course of the Swiss economy at monthly time intervals.
Advanced gynecologic malignancy identified after acute stroke case report
Authors: Jnani Jack 
Published: July 2023

Abstract
Background
Endometrial carcinosarcomas are rare and carry a very poor prognosis. They usually present with extensive lymphatic spread. An acute presentation of a stroke may reveal the underlying diagnosis.

Case presentation
A woman in her 50s with no reported medical history presented to the emergency department as a code stroke. She was found during the evening by her sister leaving the bathroom disheveled. At that time, she was found to be mute, not following commands, with left gaze deviation and right hemiparesis. Computed tomography (CT) imaging showed an acute infarct in the left middle cerebral artery M2 branch or frontoparietal territory consistent with acute stroke. Upon further review, the sister states that she has had significant vaginal bleeding and never had menopause. On admission, she had significant anemia. CT of the abdomen and pelvis showed a large right adnexal mass, endometrial thickening, diffuse lymphadenopathy, omental nodularity, and a pulmonary nodule concerning for gynecologic malignancy with metastasis. Surgical pathology showed high grade endometrial carcinosarcoma. She was outside of the tPA window, and neurology determined her not to be a candidate for thrombectomy. She was managed medically with antiplatelet agents, high dose atorvastatin, and blood transfusions.

Conclusions
Endometrial carcinosarcoma can present with severe anemia and irregular menstrual bleeding. In patients without routine gynecologic care, endometrial carcinosarcoma can go unnoticed and only be identified after workup for another condition such as acute stroke. Endometrial biopsy for diagnosis may be challenging in a patient with severe anemia. Alternatively, transvaginal ultrasonography with Doppler study and magnetic resonance imaging may be used to support the diagnosis. Furthermore, endometrial carcinosarcoma can complicate ischemic stroke management as it can present with bleeding and make it difficult to use anticoagulating agents.
Crystal structure of rice APIP6 reveals a new dimerization mode of RING-type E3 ligases that facilities the construction of its working model
Authors: Zheng Yangyang , Zhang Xin , Liu Yang , Zhu Tongtong , Wu Xuefeng , Ning Yuese , Liu Junfeng , Wang Dongli 
Published: July 2023

AbstractUbiquitination is an important modification process in eukaryotic organisms, and ubiquitin ligase (E3) is the most diversified component of this system. APIP6 (AvrPiz-t interacting protein 6) is one of the E3s of rice, and is involved in the recognition of AvrPiz-t, one effector from the pathogen Magnaporthe oryzae, for the initiation of host defense against M. oryzae. However, the structural detail of how APIP6 performs its function remains elusive. Here, we present crystal structure of the RING domain (i.e., the E2-interaction domain) of APIP6 (APIP6-RING). APIP6-RING exists as a homodimer in crystal packing, in solution and in vivo. APIP6-RING consists of one β hairpin and one α helix, and β hairpins of two APIP6-RING molecules interact with each other in a novel ‘shoulder-to-shoulder’ mode to form a β sheet, and also rendering APIP6-RING to form a homodimer. Hydrogen bonds play a major role in the dimer formation of APIP6-RING, while hydrophobic-intermolecular interactions are inconspicuous. Due to the interaction mode between RING-type E3 and E2 is generally conserved, we constructed and verified a model of APIP6-RING/E2 complex, and proposed a working model of APIP6 with E2, ubiquitin, and the substrate AvrPiz-t. Taken together, our research presents the first structure of plant simple RING-type E3 ligase that exists in an unreported dimerization manner, as well as a working model of APIP6.
Evaluation of the changes in incidence and patient age of knee arthroscopy along with changes in time between knee arthroscopy and arthroplasty between 1998 and 2018: a nationwide register study
Authors: Ponkilainen Ville T. , Uimonen Mikko , Sihvonen Raine , Partio Nikke , Paloneva Juha , Mattila Ville M. 
Published: July 2023

Abstract
Background
Recent evidence has led to guidelines to refrain from recommending knee arthroscopy for patients with an osteoarthritis diagnosis. The aim of this study was to evaluate the latest changes in the incidence of arthroscopic surgery for degenerative knee disease, changes in the ages of those patients and the delay between knee arthroscopy and arthroplasty, in Finland between 1998 and 2018.

Method
The data for were collected from the Finnish National Hospital Discharge Register (NHDR). All knee arthroplasties and arthroscopies performed due to osteoarthritis, degenerative meniscal tears, and traumatic meniscal tears were included. Incidence rates (per 100,000 person-years) as well as the median age of patients were calculated.

Results
The incidence of arthroscopy decreased 74% (413 to 106 per 100,000 person-years) and knee arthroplasty increased 179% (94 to 262 per 100,000 person-years) between 1998 and 2018. The incidence of all arthroscopies increased until 2006. Subsequently, the incidence of arthroscopy due to OA decreased by 91% and arthroscopic partial meniscectomy (APM) for degenerative meniscal tears decreased by 77% until 2018. The decrease of traumatic meniscal tears begun later, leading to decrease of 57% between 2011 and 2018. Conversely, the incidence of patients undergoing APM of traumatic meniscal tear increased 375%. The median age of patients who underwent knee arthroscopy decreased from 51 to 46 and from 71 to 69 in knee arthroplasty patients.

Conclusions
Increasing evidence that recommends refraining from knee arthroscopy in OA and degenerative meniscal tears has led to a dramatic decrease in the incidence of arthroscopies. Simultaneously, the median age of the patients who undergo these operations has continued to decrease.
Paroxysmal sympathetic hyperactivity in a child with stroke: a case report
Authors: Jomalkar Jay Bhagwat , Vijayan Vineetha , Saoji Avanti Rajendra , Vaidyanathan Abhinaya , Unki Praveen , Kondekar Santosh , Rathi Surbhi , Deshmukh Chandrahas T. 
Published: July 2023

Abstract

Background
Paroxysmal sympathetic hyperactivity (PSH) is the result of dysregulated autonomic function with sympathetic symptoms characterised by increased heart rate, respiratory rate, blood pressure and temperature with abnormal posture, which predominately occur periodically but can be persistent in severe cases. Common causes that present in similar fashion such as infectious process (bacteremia, meningitis, etc.); non-PSH neurological deterioration (increased intracranial pressure, intracranial haemorrhage, intracranial oedema, seizures, encephalitis); pulmonary embolism; thyrotoxicosis, alcohol or drug withdrawal; neuroleptic malignant syndrome; serotonin syndrome; and malignant hyperthermia need to be excluded before diagnosing PSH. The earlier the diagnosis made, the better the prognosis.

Case presentation
We report a case of a 3-year-old male child who was a diagnosed case of Tetralogy of Fallot presented with left focal seizure with secondary generalisation. Child also had respiratory complaints prior to convulsion. He had developed signs of raised intracranial pressure. Blood culture sent to rule out infective endocarditis was negative. CT brain showed bilateral diffuse cortical infarct. Child developed signs and symptoms of PSH such as fever, tachycardia, tachypnoea, hypertension, diaphoresis, dystonia and bilateral completely dilated pupils. Other common causes such as infective endocarditis, increased intracranial pressure, intracranial oedema, intracranial haemorrhage, seizure, encephalitis and infectious processes (bacteremia, meningitis and infective endocarditis) were ruled out. The diagnosis of PSH was made and started on propranolol along with clonidine. Child responded well to the treatment.

Conclusion
The complex pathophysiology of PSH warrants extensive work-up to rule out other common causes. The outcome of our patient shows the importance of early diagnosis and multidisciplinary treatment for better outcome.
A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis
Authors: Ramadan Haidi Karam-Allah , El-Raey Fathiya , Zaky Samy , Bakr Asmaa , Meghezel El-Zahraa M. , Bazeed Shamardan Ezzeldin S. , Badawi Rehab , Abd-Elsalam Sherief , Elbadry Mohamed , Hagag Mahmoud , Abu Rahma Mohamed Zakaria 
Published: July 2023

AbstractBackgroundChronic hepatitis C (HCV) and B viruses (HBV) represent the commonest global causes of liver cirrhosis. Other etiologies of non-viral cirrhosis such as autoimmune, metabolic, vascular, or biliary diseases are underestimated. The study aimed to identify causes, clinicoepidemiological characteristics, and outcome of non-B non-C liver cirrhosis. This Egyptian multicenter study recruited patients with liver cirrhosis excluding HCV and HBV. Clinical evaluation and the mortality were recorded. Laboratory, radiological, and histopathological assessment to diagnose the etiology was performed.ResultsOne hundred eighty-eight patients were included: 54.3% were males. Autoimmune hepatitis (AIH) was the most common cause of cirrhosis (28.2%), followed by Budd-Chiari syndrome (BCS) in 25%, and cryptogenic in 23.9%. Metabolic causes such as Wilson’s disease, non-alcoholic steatohepatitis (NASH), and hemochromatosis were reported in 7.4%, 3.2%, and 1.1%, respectively. Biliary and cardiac cirrhosis were less frequent. Older age was prevalent in hemochromatosis (67.5 ± 17.7 years) and NASH (60.7 ± 11), while young age in Wilson’s disease (29.5 ± 14.8) and secondary biliary cirrhosis (14.8 ± 4.8). Rural residence was common (60.6%). Mortality was reported in BCS (40.4%), cryptogenic (28.9%), cardiac (25%), Wilson’s disease (21.4%), AIH (17%), and NASH (16.7%). Hepatocellular carcinoma complicated 10.6% of cases. A significantly high percentage of patients had decompensated cirrhosis. Child–Pugh class and rural residence were significant predictors of mortality.ConclusionThis first report on non-B non-C cirrhosis in Egypt revealed a high prevalence of AIH, BCS, and cryptogenic cirrhosis. Advanced Child class and rural residence were the predictors of mortality.
Risk factors associated with Salmonella in dairy cattle farms in Henan and Hubei provinces, China
Authors: Wang Jie , Zhu Xiaojie , Zhao Yuxi , Xue Yongkang , Zhang Zhen , Yan Lei , Chen Yingyu , Robertson Ian D. , Guo Aizhen , Aleri Joshua W. 
Published: July 2023

AbstractA cross-sectional study was conducted to evaluate the risk factors associated with the Salmonella infection status of dairy herds in Henan and Hubei provinces, China. Herds were assigned a Salmonella status based on the isolation of Salmonella from fecal samples obtained from adult lactating dairy cows. Information on potential biosecurity risk factors was collected using a questionnaire template via a 15-min face-to-face interview with dairy cattle producers from May 2020 to March 2021. The questionnaire consisted of 23 questions across two broad categories of potential biosecurity risk factors: farm and biosecurity managemental factors. A total of 48 farms were surveyed. In all (100%, 48/48) of the surveyed farms, although sick animals were separated from healthy animals using fencing, there were no strict quarantine protocols for newly introduced animals. Mixed species rearing was practiced in 35.4% (17/48) of the farms. Feces were removed more than once a day in 45.8% (22/48) of the farms, whereas the remainder (54.2%, 26/48) only removed animal feces once a day. A total of 29.2% (14/48) of the farms were located < 2 km from other livestock farms. The use of personal protective equipment was consistently performed on all farms, with a majority of the workers on most farms (81.3%, 39/48) always disinfecting footwear before entering production areas. A significant association between Salmonella-positive status and the high frequency of the presence of wildlife (birds and rodents in sheds and feed storage places) was recorded (OR: 11.9, 95% CI: 1.7, 84.1, p = 0.013). Fortunately, no farms shared farm equipment with other farms. The study highlights the occurrence of wildlife as a risk factor for the presence of Salmonella in investigated dairy herds. There is a need to institute appropriate on-farm control measures for wild birds and rodents to control the potential spread of Salmonella in dairy production systems.