bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceptions of Autism Spectrum Disorder among People in a Remote Area of Bangladesh
Authors: Sultana Nasrin , Mawla Md Rosaidul , Khan Nishat Farhana , Alam Mohammad Rashidul , Karim Md Ziaul , Haque Nadia 
Published: August 2023

Introduction: Autism is a neurodevelopmental disorder which are manifested within two years of life. It exhibits difficulties in social interaction, verbal and nonverbal communication, as well as repetitive or constrained interests and actions. Autism has already posed significant burden in health sector in Bangladesh. That’s why it is high time to address autism.
Objectives: To assess the factors affecting children with ASD and perception of rural people about it.
Methods: This cross sectional study was carried out from 01 January to 31 December, 2021 among 55 people of different unions of Bauphal Upazila of Patuakhali district.
Results: Majority of the autistic children are male (61.82%). In maximum cases, parents and family members were usually the first persons to identify (60%) the autistic symptoms. A good percentage (21.82%) respondents were ignorant about the cause of autism. Most (38.18%) of the children with autism were treated at government hospital. Maximum therapy received by the children is speech therapy (41.82%) and there is partial improvement (54.55%) of autism by applying therapy.
Conclusion: This study revealed that most of the parents of autistic child were unaware about its contributory factors and treatment. Even there is scarcity of trained or specialist health professionals. There are also false belief about autism that inhibit people to take proper treatment.
JAFMC Bangladesh. Vol 18, No 2 (December) 2022: 66-71
ANALISIS PENGGUNAAN KALIMAT IMPERATIF SEBAGAI KAJIAN PRAGMATIK DAN IMPLIKASI DALAM PEMBELAJARAN BAHASA INDONESIA
Authors: Dawolo Erikaryawati , Bawamenewi Arozatulo 
Published: August 2023

Pada penelitian ini yang menjadi permasalahan utama adalah bagaimanakah kalimat imperatif yang digunakan guru dalam pembelajaran bahasa Indonesia. Penelitian ini bertujuan untuk mendeskripsikan wujud dan isi kalimat imperatif yang digunakan guru dalam proses pembelajaran bahasa Indonesia. Penelitian ini menggunakan pendekatan kualitatif dengan jenis penelitian deskriptif, dan yang menjadi objek dalam penelitian ini dilakukan pada objek yang alamiah. Variabel penelitian ini adalah kalimat imperatif yang digunkan guru kepada siswa dalam pembelajaran bahasa Indonesia. Penelitian ini menggunakan jenis penelitian kualitatif dengan metode deskriptif. Metode analisis data yang digunakan pada penelitian ini adalah metode agih. Berdasarkan hasil penelitian peneliti menemukan 5 wujud kalimat imperatif yakni 1) perintah, 2) permintaan, 3) larangan, 4) ajakan, 5) pemberian izin.

Kata kunci: Kalimat Imperatif, Tindak Tutur, Pembelajaran Bahasa Indonesia
PENGEMBANGAN BUKU PANDUAN BERBASIS CONTEXTUAL TEACHING AND LEARNING PADA MATERI MENULIS SURAT PRIBADI DAN SURAT DINAS KELAS VII SMP
Authors: Gea Merry Artanti , Harefa Trisman 
Published: August 2023

Penelitian ini didasari dengan hasil observasi yang dilakukan peneliti di UPTD SMP Negeri 2 Gunungsitoli khususnya di kelas VII-B. Hasil observasi yang diperoleh adalah peserta didik cenderung bosan belajar karena menggunakan buku cetak. Penelitian ini dikembangkan dengan menggunakan model 4D yang terdiri dari empat tahapan yaitu pendefenisian, perencanaan, pengembangan, dan penyebaran. Tujuan penelitian ini adalah untuk (1) mengembangkan buku panduan menggunakan model Contextual Teaching and Learning pada materi menulis surat pribadi dan surat dinas, (2) mengetahui kelayakan buku panduan oleh ahli materi, ahli bahasa dan ahli desain, (3) mengetahui kepraktisan buku panduan melalui uji coba perorangan, uji coba kelompok kecil, dan uji coba lapangan, (4) mengetahui efektifitas buku panduan melalui hasil evaluasi belajar peserta didik. Berdasarkan hasil penelitian, maka dapat disimpulkan bahwa hasil validasi oleh ahli materi yaitu revisi I mencapai 75% dan revisi II mencapai 99,19%. Hasil validasi oleh ahli bahasa yaitu revisi I mencapai 82,14% dan revisi II mencapai 96,42%. Hasil validasi oleh ahli desain yaitu Revisi I mencapai 66,31% dan pemerolehan revisi II mencapai 93,68%. Hasil uji coba perorangan 86,66%, uji coba kelompok kecil 93,33%, dan uji coba lapangan 96,52%. Hasil kentuntasan belajar peserta didik mencapai 100% kentuntasan. Jadi, dapat disimpulkan bahwa media buku panduan yang telah dikembangkan oleh peneliti dapat dikatakan layak, praktis dan efektif dijadikan sebagai referensi belajar di sekolah.
Kata kunci: Bahan Ajar Buku Panduan, Model CTL, Surat Pribadi dan Surat Dinas
Outbreak of OXA-232-producing carbapenem-resistant Klebsiella pneumoniae ST15 in a Chinese teaching hospital: a molecular epidemiological study
Authors: Wu Xiaoyan , Li Xiangchen , Yu Junjie , Shen Mengli , Fan Chenliang , Lu Yewei , Gao Junshun , Li Xiaosi , Li Hongsheng 
Published: August 2023

Background and AimsThe incidence of OXA-232-producing carbapenem-resistant Klebsiella pneumoniae (CRKP) has been on the rise in China over the past five years, potentially leading to nosocomial epidemics. This study investigates the first outbreak of CRKP in the Second Affiliated Hospital of Jiaxing University.MethodsBetween February 2021 and March 2022, 21 clinical isolates of OXA-232-producing CRKP were recovered from 16 patients in the Second Affiliated Hospital of Jiaxing University. We conducted antimicrobial susceptibility tests, whole genome sequencing, and bioinformatics to determine the drug resistance profile of these clinical isolates.ResultsWhole-genome sequencing revealed that all 21 OXA-232-producing CRKP strains belonged to the sequence type 15 (ST15) and shared similar resistance, virulence genes, and plasmid types, suggesting clonal transmission between the environment and patients. Integrated genomic and epidemiological analysis traced the outbreak to two clonal transmission clusters, cluster 1 and cluster 2, including 14 and 2 patients. It was speculated that the CRKP transmission mainly occurred in the ICU, followed by brain surgery, neurosurgery, and rehabilitation department. Phylogenetic analysis indicated that the earliest outbreak might have started at least a year before the admission of the index patient, and these strains were closely related to those previously isolated from two major adjacent cities, Shanghai and Hangzhou. Comparative genomics showed that the IncFII-type and IncHI1B-type plasmids of cluster 2 had homologous recombination at the insertion sequence sites compared with the same type of plasmids in cluster 1, resulting in the insertion of 4 new drug resistance genes, including TEM-1, APH(6)-Id, APH(3’’)-Ib and sul2.ConclusionsOur study observed the clonal spread of ST15 OXA-232-producing between patients and the hospital environment. The integration of genomic and epidemiological data offers valuable insights and facilitate the control of nosocomial transmission.
Assessment of bleeding risk in cancer patients treated with anticoagulants for venous thromboembolic events
Authors: Poénou Géraldine , Tolédano Emmanuel , Helfer Hélène , Plaisance Ludovic , Happe Florent , Versini Edouard , Diab Nevine , Djennaoui Sadji , Mahé Isabelle 
Published: August 2023

IntroductionAnticoagulant is the cornerstone of the management of VTE at the cost of a non-negligible risk of bleeding. Reliable and validated clinical tools to predict thromboembolic and hemorrhagic events are crucial for individualized decision-making for the type and duration of anticoagulant treatment. We evaluate the available risk models in real life cancer patients with VTE. The objectives of the study were to describe the bleeding of cancer patients with VTE and to evaluate the performance of the different bleeding models to predict the risk of bleeding during a 6-month follow-up.Materials and MethodsVTE-diagnosed patient's demographic and clinical characteristics, treatment regimens and outcomes for up to 6 months were collected. The primary endpoint was the occurrence of a major bleeding (MB) or a clinically relevant non major bleeding (CRNMB) event, categorized according to the ISTH criteria.ResultsDuring the 6-months follow-up period, 26 out of 110 included patients (26.7%) experienced a bleeding event, with 3 recurrences of bleeding. Out of the 29 bleeding events, 19 events were CRNMB and 10 MB. One patient died because of a MB. Bleeding occurred in 27 % of the patients treated with DOACs and 22% of the patients treated with LMWH. Most of the bleedings were gastrointestinal (9 events, 31%); 26.9% of the bleedings occurred in patient with colorectal cancer and 19.6% in patients with lung cancer. In our cohort, none of the 10 RAMs used in our study were able to distinguish cancer patients with a low risk of bleeding, from all bleeding or non-bleeding patients. The Nieto et al. RAM had the best overall performance (C-statistic = 0.730, 95% CI (0.619–0.840)). However, it classified 1 out of 5 patients with major bleeding in the low risk of bleeding group. The rest of the RAMs showed a suboptimal result, with a range of C-statistic between 0.489, 95%CI (0.360–0.617)) and 0.532, 95%CI (0.406–0.658)).ConclusionsThe management of CAT patients is challenging due to a higher risk of both recurrent VTE and bleeding events, as compared with non-cancer patients with VTE. None of the existing RAMs was able to consistently identify patients with risk of anticoagulant associated bleeding events.
Drug-coated balloon: an effective alternative to stent strategy in small-vessel coronary artery disease—a meta-analysis
Authors: Felbel Dominik , Bozic Filip , Mayer Benjamin , Krohn-Grimberghe Marvin , Paukovitsch Michael , d’Almeida Sascha , Mörike Johannes , Gonska Birgid , Imhof Armin , Buckert Dominik , Rottbauer Wolfgang , Markovic Sinisa , Stephan Tilman 
Published: August 2023

BackgroundSmall-vessel coronary artery disease (CAD) is frequently observed in coronary angiography and linked to a higher risk of lesion failure and restenosis. Currently, treatment of small vessels is not standardized while having drug-eluting stents (DES) or drug-coated balloons (DCBs) as possible strategies. We aimed to conduct a meta-analytic approach to assess the effectiveness of treatment strategies and outcomes for small-vessel CAD.MethodsComprehensive literature search was conducted using PubMed, Embase, MEDLINE, and Cochrane Library databases to identify studies reporting treatment strategies of small-vessel CAD with a reference diameter of ≤3.0 mm. Target lesion revascularization (TLR), target lesion thrombosis, all-cause death, myocardial infarction (MI), and major adverse cardiac events (MACE) were defined as clinical outcomes. Outcomes from single-arm and randomized studies based on measures by means of their corresponding 95% confidence intervals (CI) were compared using a meta-analytic approach. Statistical significance was assumed if CIs did not overlap.ResultsThirty-seven eligible studies with a total of 31,835 patients with small-vessel CAD were included in the present analysis. Among those, 28,147 patients were treated with DES (24 studies) and 3,299 patients with DCB (18 studies). Common baseline characteristics were equally distributed in the different studies. TLR rate was 4% in both treatment strategies [0.04; 95% CI 0.03–0.05 (DES) vs. 0.03–0.07 (DCB)]. MI occurred in 3% of patients receiving DES and in 2% treated with DCB [0.03 (0.02–0.04) vs. 0.02 (0.01–0.03)]. All-cause mortality was 3% in the DES group [0.03 (0.02–0.05)] compared with 1% in the DCB group [0.01 (0.00–0.03)]. Approximately 9% of patients with DES developed MACE vs. 4% of patients with DCB [0.09 (0.07–0.10) vs. 0.04 (0.02–0.08)]. Meta-regression analysis did not show a significant impact of reference vessel diameter on outcomes.ConclusionThis large meta-analytic approach demonstrates similar clinical and angiographic results between treatment strategies with DES and DCB in small-vessel CAD. Therefore, DES may be waived in small coronary arteries when PCI is performed with DCB.
Association between visceral obesity and 10-year risk of first atherosclerotic cardiovascular diseases events among American adults: National Health and Nutrition Examination Survey
Authors: Zheng Liying , Sun Aochuan , Han Senfu , Qi Rongming , Wang Rumeng , Gong Xiao , Xue Mei 
Published: August 2023

BackgroundIn the United States, the relationship between visceral obesity and the risk of developing atherosclerosis cardiovascular disease (ASCVD) for the first time in 10 years is unclear.MethodsData for this cross-sectional study came from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2020. We collected variable information related to 10-year ASCVD risk and visceral obesity reliable indicators [Visceral obesity index (VAI) and Lipid accumulation product (LAP)]. And we used multiple logistic regression to analyze the correlation of visceral obesity indicators (VAI and LAP) with 10-year ASCVD risk. In addition, we assessed the linear relationship between VAI or LAP and 10-year ASCVD risk by smoothing curve fitting. Finally, we conducted subgroup analysis and sensitivity analysis after excluding participants with extreme VAI and LAP values to ensure that we obtained accurate and reliable results.ResultsOur study included a total of 1,547 participants (mean age: 56.5 ± 10.1, 60% of males). The results of the multiple logistic regression showed that compared with participants with the lowest VAI in the 1st Quartile (≤0.79), the adjusted OR values for VAI and elevated 10-year ASCVD risk in Q3 (1.30–2.14), and Q4 (≥2.15) were 2.58 (95% CI: 1.24–5.36, P = 0.011), 15.14 (95% CI: 6.93–33.05, P &lt; 0.001), respectively. Compared with participants with the lowest LAP in the 1st Quartile (≤28.29), the adjusted OR values for VAI and elevated 10-year ASCVD risk in Q3 (46.52–77.00), and Q4 (≥77.01) were 4.63 (95% CI: 2.18–9.82, P &lt; 0.001), 16.94 (95% CI: 6.74–42.57, P &lt; 0.001), respectively. Stratified analysis showed that the association between VAI or LAP and the first ASCVD event was more pronounced in males.ConclusionHigher VAI or LAP scores are significantly associated with elevated 10-year ASCVD risk in adults aged 40 to 79 in the USA, which suggested that monitoring visceral obesity is crucial to reduce the risk of a first ASCVD event.
Revealing the role of regulatory T cells in the tumor microenvironment of lung adenocarcinoma: a novel prognostic and immunotherapeutic signature
Authors: Zhang Pengpeng , Zhang Xiao , Cui Yanan , Gong Zetian , Wang Wei , Lin Shengrong 
Published: August 2023

BackgroundRegulatory T cells (Tregs), are a key class of cell types in the immune system. In the tumor microenvironment (TME), the presence of Tregs has important implications for immune response and tumor development. Relatively little is known about the role of Tregs in lung adenocarcinoma (LUAD).MethodsTregs were identified using but single-cell RNA sequencing (scRNA-seq) analysis and interactions between Tregs and other cells in the TME were investigated. Next, we used multiple bulk RNA-seq datasets to construct risk models based on marker genes of Tregs and explored differences in prognosis, mutational landscape, immune cell infiltration and immunotherapy between high- and low-risk groups, and finally, qRT-PCR and cell function experiments were performed to validate the model genes.ResultsThe cellchat analysis showed that MIF-(CD74+CXCR4) pairs play a key role in the interaction of Tregs with other cell subpopulations, and the Tregs-associated signatures (TRAS) could well classify multiple LUAD cohorts into high- and low-risk groups. Immunotherapy may offer greater potential benefits to the low-risk group, as indicated by their superior survival, increased infiltration of immune cells, and heightened expression of immune checkpoints. Finally, the experiment verified that the model genes LTB and PTTG1 were relatively highly expressed in cancer tissues, while PTPRC was relatively highly expressed in paracancerous tissues. Colony Formation assay confirmed that knockdown of PTTG1 reduced the proliferation ability of LUAD cellsConclusionTRAS were constructed using scRNA-seq and bulk RNA-seq to distinguish patient risk subgroups, which may provide assistance in the clinical management of LUAD patients.
Progressive high-fluence epithelium-on accelerated corneal crosslinking: a novel corneal photodynamic therapy for early progressive keratoconus
Authors: Mazzotta Cosimo , Pandolfi Anna , Ferrise Marco 
Published: August 2023

PurposeTo assess the preliminary clinical results of a new, progressively higher fluence-pulsed light Epi-On accelerated crosslinking nomogram (PFPL M Epi-On ACXL) in the treatment of progressive keratoconus (KC).SettingSiena Crosslinking Center, Siena, Italy.MethodsA prospective pilot open, non-randomized interventional study, including 32 eyes of 32 young-adult patients over 26 years old with Stages I-III progressive KC undergoing PFPL M Epi-On ACXL, was conducted. Riboflavin loading was performed by using Paracel I 0.25% for 4 min and Paracel II 0.22% for 6 min. The Avedro KXL System (Glaukos-Avedro, Burlington, USA) was used for pulsed-light accelerated crosslinking (ACXL) at air room 21% oxygenation and 13 min of UV-A irradiation. The treatment fluence was set at 7.2 J/cm2, 8.6 J/cm2, and 10.0 J/cm2 in corneas with baseline pachymetry &lt;420 μm (group 1: 8 eyes), ≥ 420 μm &lt;460 μm (group 2, 11 eyes), and ≥ 460 μm (group 3, 13 eyes), respectively. Uncorrected distance visual acuity (UDVA), best-spectacle corrected visual acuity (BSCVA), Scheimpflug corneal tomography, and anterior segment OCT (AS-OCT) data were collected at baseline and postoperatively at 1, 3, and 6 months.ResultsUDVA and BSCVA improved in all groups (P ≤ 0.05). Maximum keratometry values (K max) showed a significant decrease in the 10.0 J/cm2 group (Δ −1.68 D). The coma (HOAs) value improved significantly by the sixth month in all groups. OCT average demarcation lines were 211 ± 19 μm in group 1, 245 ± 23 μm in group 2, and 267 ± 21 μm in group 3.ConclusionsThe preliminary results show that pachymetry-based PFPL M Epi-On ACXL nomogram stabilizes ectasia progression. Higher fluence Epi-On ACXL increases CXL penetration, with better functional outcomes in the absence of complications.
Effective TME-related signature to predict prognosis of patients with head and neck squamous cell carcinoma
Authors: Wan Lingfei , Li Yuanshuai , Pan Wenting , Yong Yuting , Yang Chao , Li Chen , Zhao Xingxing , Li Ruihong , Yue Wen , Yan Xinlong 
Published: August 2023

Introduction: The tumor microenvironment (TME) is crucial for the development of head and neck squamous cell carcinoma (HNSCC). However, the correlation of the characteristics of the TME and the prognosis of patients with HNSCC remains less known.Methods: In this study, we calculated the immune and stromal cell scores using the “estimate” R package. Kaplan-Meier survival and CIBERSORT algorithm analyses were applied in this study.Results: We identified seven new markers: FCGR3B, IGHV3-64, AC023449.2, IGKV1D-8, FCGR2A, WDFY4, and HBQ1. Subsequently, a risk model was constructed and all HNSCC samples were grouped into low- and high-risk groups. The results of both the Kaplan-Meier survival and receiver operating characteristic curve (ROC) analyses showed that the prognosis indicated by the model was accurate (0.758, 0.756, and 0.666 for 1-, 3- and 5-year survival rates). In addition, we applied the CIBERSORT algorithm to reveal the significant differences in the infiltration levels of immune cells between the two risk groups.Discussion: Our study elucidated the roles of the TME and identified new prognostic biomarkers for patients with HNSCC.
Impact of a pyridazine derivative on tripartite synapse ultrastructure in hippocampus: a three-dimensional analysis
Authors: Xu Zan , Foster Joshua B. , Lashley Rashelle , Wang Xueqin , Benson Emily , Kidd Grahame , Lin Chien-liang Glenn 
Published: August 2023

IntroductionWe previously discovered a pyridazine derivative compound series that can improve cognitive functions in mouse models of Alzheimer’s disease. One of the advanced compounds from this series, LDN/OSU-0215111-M3, was selected as the preclinical development candidate. This compound activates local protein translation at the perisynaptic astrocytic process (PAP) and enhances synaptic plasticity sequentially. While biochemical evidence supports the hypothesis that the compound enhances the structural plasticity of the tripartite synapse, its direct structural impact has not been investigated.MethodsVolume electron microscopy was used to study the hippocampal tripartite synapse three-dimensional structure in 3-month-old wild-type FVB/NJ mice after LDN/OSU-0215111-M3 treatment.ResultsLDN/OSU-0215111-M3 increased the size of tertiary apical dendrites, the volume of mushroom spines, the proportion of mushroom spines containing spine apparatus, and alterations in the spine distribution across the surface area of tertiary dendrites. Compound also increased the number of the PAP interacting with the mushroom spines as well as the size of the PAP in contact with the spines. Furthermore, proteomic analysis of the isolated synaptic terminals indicated an increase in dendritic and synaptic proteins as well as suggested a possible involvement of the phospholipase D signaling pathway. To further validate that LDN/OSU-0215111-M3 altered synaptic function, electrophysiological studies showed increased long-term potentiation following compound treatment.DiscussionThis study provides direct evidence that pyridazine derivatives enhance the structural and functional plasticity of the tripartite synapse.
Which headache disorders can be diagnosed concurrently? An analysis of ICHD3 criteria using prime encoding system
Authors: Zhang Pengfei 
Published: August 2023

IntroductionReal-life headache presentations may fit more than one ICHD3 diagnosis. This project seeks to exhaustively list all logically consistent “co-diagnoses” according to the ICHD3 criteria. We limited our project to cases of two concurrent diagnoses.MethodsWe included the criteria for “Migraine” (1.1, 1.2, 1.3), “Tension-type headache” (2.1, 2.2, 2.3, 2.4), “Trigeminal autonomic cephalalgias” (3.1, 3.2, 3.3, 3.4, 3.5), and “Other primary headache disorders.” We also excluded “probable” diagnosis criteria. Each characteristic in the above criteria is assigned a unique prime number. We then encoded each ICHD3 criteria into integers through multiplication in a list format; we called these criteria representations. “Codiagnoses representations” were generated by multiplying all possible pairings of criteria representations. We then manually encoded a list of logically inconsistent characteristics through multiplication. All co-diagnoses representations divisible by any inconsistency representations were filtered out, generating a list of co-diagnoses representations that were logically consistent. This list was then translated back into ICHD3 diagnoses.ResultsWe used a total of 103 prime numbers to encode 578 ICHD3 criteria. Once illogical characteristics were excluded, we obtained 145 dual diagnoses. Of the dual diagnoses, two contained intersecting characteristics due to subset relationships, 14 contained intersecting characteristics without subset relationships, and 129 contained dual diagnoses as a result of non-intersecting characteristics.ConclusionAnalysis of dual diagnosis in headaches offers insight into “loopholes” in the ICHD3 as well as a potential explanation for the source of a number of controversies regarding headache disorders. The existence of dual diagnoses and their identification may carry implications for future developments and testing of machine-learning diagnostic algorithms for headaches.