bluuebunny/crossref_metadata_2025_split huggingface dataset:
Childhood Trauma and Self-harm in Youths with Bipolar Disorders
Authors: Janiri Delfina , Di Luzio Michelangelo , Montanari Silvia , Hirsch Daniele , Simonetti Alessio , Moccia Lorenzo , Conte Eliana , Contaldo Ilaria , Veredice Chiara , Mercuri Eugenio , Sani Gabriele 
Published: February 2023

Background:
Bipolar disorders (BD) in youth are associated with a high risk of self-harm
behaviors. Childhood trauma (CT) is a relevant environmental stressor that is related to both BD diagnosis
and self-harm in adulthood. It is not yet established whether CT may impact self-harm risk in
youth. Therefore, the aim of this study was to investigate the distribution patterns of CT in youth BD
with and without self-harm.

Methods:
We assessed 273 participants (aged 13-25 years), 96 youths with BD according to DSM-5
criteria and 177 healthy controls (HC). History of CT was obtained using the Childhood Trauma Questionnaire
(CTQ). The association between CT and self-harm was tested using multivariate statistical
models.

Results:
Over 45% of participants with BD reported lifetime self-harm. The BD Self-harm group reported
more emotional abuse, emotional neglect, sexual abuse, and physical abuse than HC. The BD
No-Self-harm group reported more emotional abuse than HC. The BD Self-harm group reported more
emotional abuse and neglect than the BD No-Self-harm group. The BD Self-harm group also reported
separated parents, hospitalizations, smoking, use of antiepileptics, antipsychotics and lithium. Emotional
abuse was an independent predictor of self-harm in youths with BD.

Conclusions:
Findings support the importance of assessing CT, in particular emotional abuse, in youth
with BD at risk for self-harm.
Antinuclear Antibody Seropositivity in Fibromyalgia Associated with Borrelia-specific T Lymphocytes
Authors: Puri Basant K. , Lee Gary S. , Schwarzbach Armin 
Published: February 2023

Background:
Our group have recently reported that there is no evidence of an associa-tion between fibromyalgia and Borrelia-specific T lymphocytes. However, a small number of case reports has suggested that infection by the bacterial genus Borrelia may be associated with the pres-ence of antinuclear antibodies (ANAs).

Objective:
To test the hypothesis that those fibromyalgia patients who are ANA seropositive are more likely to show evidence of Borrelia-specific T lymphocyte reactivity than those who are sero-negative.

Methods:
T lymphocyte reactivity to Borrelia burgdorferi sensu stricto (full antigen) was assessed using the enzyme-linked immunospot and serum ANA status was assessed using immunofluores-cence in 27 fibromyalgia patients fulfilling the revised diagnostic criteria of the American College of Rheumatology.

Results:
The ANA seropositive and seronegative groups were matched for age, sex and ethnicity; the T lymphocyte reactivity to Borrelia burgdorferi sensu stricto (full antigen) in the former group (mean 5.60) was significantly higher than that in the seronegative group (mean 1.77; p < 0.05).

Conclusion:
This novel study points to an association of ANA seropositivity in fibromyalgia with Borrelia-specific T lymphocytes.
Current Trends and Prospective Role of Flavonoids and Flavones as Anticancer
Agents: A Review
Authors: Sharma Rupali , Sapra Kavita , Samamadar Suman , Sapra Ashu , Kumar Virender 
Published: February 2023

Background:
Among the leading causes of death, cancer is second to heart disease as
a group of diseases. It has been found that several natural substances, including flavonoids, can
treat cancer in addition to several types of chemotherapy.

Objective:
Flavonoids are naturally occurring polyphenolic compounds with no or minimal toxicity,
and have been utilized by people since ancient times. They produce several special therapeutic
effects, such as anti-inflammatory, immune response modulating, and antioxidant effects,
thereby supporting normal cellular functions. Flavonoids can be classified into six major subtypes
or groups based on the degree of oxidation, chemical structure, and unsaturation in the
linking chain. Aside from flavonoids and flavanones, flavonols, flavonols, flavones, and anthocyanids
also fall into these categories.

Methods:
In order to find studies on flavonoids as anticancer agents, we searched Science Direct,
Google Scholar, PubMed, Wiley Online Library, Springer, and Medline databases.

Results:
The enhanced generation of reactive oxygen species (ROS) in the electron transport
chain due to oxidative stress leads to inflammation, the development of many degenerative diseases,
cancer, etc. Oxidative stress can be relieved by flavonoids because they regulate ROS homeostasis
(scavenging ROS), trigger apoptosis, and suppress prooxidant enzymes during oxidative
stress.

Conclusion:
Here we review the structure and classification of flavonoids and their mechanisms
of action as anticancer agents as well as the challenges involved in developing flavonoids to fight
cancer.
Predicting Severe COVID-19 Infection on Initial Diagnosis: Comparison
and Validation of CT Imaging Triage Tools
Authors: Kurban Lutfi Ali S , Abu Sa’a Maysam , Ahmed Farghal Aser Soliman , Aby Ali Hussain Ali , Syed Rizwan , Al Zwae Khaled 
Published: February 2023

Background:
Developing a reliable predictive tool of disease severity in COVID-19 infection
is important to help triage patients and ensure the appropriate utilization of health-care resources.

Objective:
To develop, validate, and compare three CT scoring systems (CTSS) to predict severe disease
on initial diagnosis of COVID-19 infection.

Methods:
One hundred and twenty and 80 symptomatic adults with confirmed COVID-19 infection
who presented to emergency department were evaluated retrospectively in the primary and validation
groups, respectively. All patients had non-contrast CT chest within 48 hours of admission. Three lobarbased
CTSS were assessed and compared. The simple lobar system was based on the extent of pulmonary
infiltration. Attenuation corrected lobar system (ACL) assigned further weighting factor based on
attenuation of pulmonary infiltrates. Attenuation and volume-corrected lobar system incorporated further
weighting factor based on proportional lobar volume. The total CT severity score (TSS) was calculated
by adding individual lobar scores. The disease severity assessment was based on Chinese National
Health Commission guidelines. Disease severity discrimination was assessed by the area under
the receiver operating characteristic curve (AUC).

Results:
The ACL CTSS demonstrated the best predictive and consistent accuracy of disease severity
with an AUC of 0.93(95%CI:0.88-0.97) in the primary cohort and 0.97 (95%CI:0.91.5-1) in the validation
group. Applying a TSS cut-off value of 9.25, the sensitivities were 96.4% and 100% and the specificities
were 75% and 91% in the primary and validation groups, respectively.

Conclusion:
The ACL CTSS showed the highest accuracy and consistency in predicting severe disease
on initial diagnosis of COVID-19. This scoring system may provide frontline physicians with a triage
tool to guide admission, discharge, and early detection of severe illness.
Common Bile Duct Obstructed by Lipiodol After Transcater Arterial
Chemoembolization for Hepatocellular Carcinoma: A Case Report
Authors: Zhang Fulong , Xu Jing , Zhu Yuandong , Shi Yan , Chen Shurong , Jin Zhiwang , Jiang Yuhong , Wang Hai 
Published: February 2023

Background:
Transcatheter arterial chemoembolization (TACE) is an effective treatment
for hepatocellular carcinoma (HCC), however, the complications of TACE have gradually become a
concern of clinicians. Injury to the bile duct has been the focus of many scholars.

Case Presentation:
HCC was diagnosed in a 51-year-old female patient, and the first TACE was performed
on April 10, 2020. The second TACE was performed on October 18, 2021. After the second
TACE, The patient suffered from nausea, jaundice, and body itching. Computed tomography (CT) of the
abdomen showed that the lower common bile duct was obviously blocked by the solidified lipiodol accompanied
by dilatation of intrahepatic and extrahepatic bile ducts on October 27, 2021. Endoscopic retrograde
cholangiopancretography (ERCP) and endoscopic nasobiliary drainage (ENBD) were performed
on October 29, 2021. The deposition of lipiodol in the common bile duct was significantly reduced.

Conclusion:
After the transcatheter arterial chemoembolization for hepatocellular carcinoma, we
should be on alert for damage to the bile duct, and pay attention to the deposition of lipiodol in the
common bile duct.
Aberrant Origin of the Distal Anterior Cerebral Artery from the Middle
Cerebral Artery Related to Obstruction of Bilateral Proximal Anterior
Cerebral Arteries: A Case Report
Authors: Kwak Hyo Sung , Chung Gyung Ho , Hwang Seungbae 
Published: February 2023

Background:
Aberrant origin of the distal anterior cerebral artery (ACA) arising from the
middle cerebral artery (MCA) is extremely rare.

Case Presentation:
A 74-year-old woman with a sudden onset of left-sided weakness was admitted to
the emergency department. Angiography revealed an unusual course of the distal ACA originating
from the MCA with bilateral obstruction of the proximal segment of the ACA and simultaneous occurrence
of infarction in the ACA and MCA territories.

Conclusion:
Knowledge of a rare vascular variation or anomaly could help understand brain imaging,
which has an unusual involvement of vascular territories, performed in patients with acute ischemic
stroke.
Diffuse Leptomeningeal Glioneuronal Tumors: A Case Series of Five Patients
with Parenchymal Forms and an Analysis of the Diagnostic Challenges,
Treatment Options and Outcomes
Authors: Demir Mustafa Kemal , Yapıcıer Ozlem , Kılıc Turker , Celik Serkan , Oven Bala Basak , Ozdamarlar Umut , Kundak Naz Ece , Kanan Duaa , Dincer Alp , Ertem Onder , Yakut Tahsin , Yılmaz Baran , Safi Sebnem 
Published: February 2023

Background:
Diffuse leptomeningeal glioneuronal tumors (DL-GNT) are rare glioneuronal
neoplasms with oligodendroglioma-like cells. These tumors can present as a dominant intracranial
mass or as a solitary spinal cord mass without leptomeningeal involvement. In this study, we aimed to
determine the magnetic resonance imaging and histopathological features, treatment modalities, and
clinical outcomes of the parenchymal forms of DL-GNTs.

Methods:
This is a retrospective three-center case series study of 5 patients with a confirmed parenchymal
form of DLGTs, out of which 4 patients were adults. Brain and spinal cord MR imaging were
performed in all patients at either 1.5 or 3T. The patients' age ranged from 5 years to 50 years with a
mean age of 27.6 years at presentation.

Results:
Four of the tumors were located in the frontal lobe, and one in the tectum. They were usually
solid-cystic enhancing tumors as the other mixed neuronal-glial tumors. All of the tumors had an extension
to the superficial surface of a cerebral hemisphere. One had systemic bone metastases. The
clinical signs and symptoms of the parenchymal form varied based on the location of the mass, in contrast
to the leptomeningeal form associated with hydrocephalus. In one case, the tumor’s initial grade
was defined as intermediate. The initial histopathology of the two cases was low-grade and no upgrade
occurred in the follow-up period. In two cases, although the tumors were low grade initially, they
progressed to an anaplastic form in the follow-up period.

Conclusion:
The parenchymal form of DL-GNTs is common in adults. Extension to the superficial
surface of a cerebral hemisphere is a distinctive imaging feature. Systemic osseous metastasis may
occur. Due to the presence of common histopathological features, including the biphasic composition
of glial and neuronal cell elements and oligodendroglioma-like cells, a proposed classification approach
might be more beneficial for the histopathological and imaging description, and management of
the glioneuronal tumors with oligodendroglioma-like features.
Recent Advances in Nasopharyngeal Cancer Management: From Diagnosis
to Theranostics
Authors: Benzeid Rajaa , Gihbid Amina , Benchekroun Nadia , Tawfiq Nezha , Benider Abdellatif , Attaleb Mohammed , Filali Maltouf Abdelkarim , El Mzibri Mohammed , Khyatti Meriem , Chaoui Imane 
Published: February 2023

Abstract:
Nasopharyngeal cancer (NPC) is one of the most common head and neck cancers.
NPC differs significantly from other cancers in its etiology, epidemiology, clinical behavior,
and treatment. Being highly radiosensitive, the standard treatment for NPC is radiotherapy.
However, radioresistance hampers the success of treatment and may cause local recurrence
and distant metastases in NPC patients. In this review, we discuss the updated protocols
for NPC diagnosis and treatment based on recent literature with an emphasis on the
mechanisms of radioresistance at the molecular level with a special focus on genetic and epigenetic
events, affecting genes involved in xenobiotic detoxification and DNA repair. We
also highlight the importance of some cellular and Epstein Barr viral miRNAs targeting
specific DNA repair factors and consequently promoting NPC radioresistance. These molecular
markers may serve as promising tools for diagnosis, prognosis, and radioresistance
prediction to guide theranostics of patients with NPC in the future.
Oxidative Chlorination: A Sustainable Alternative for the Preparation of
Chloroarenes
Authors: de Andrade Vitor S.C. , de Mattos Marcio C.S. 
Published: February 2023

Abstract:
Chloroarenes are important from both academic and industrial points of view. They are useful
intermediates and building blocks in manufacturing a range of bulk and fine aromatic chemicals, dyes,
flame retardants in electronic boards, disinfectants, and pharmaceutical drugs. In addition, diverse agrochemicals, synthetic drugs, and natural products are chloroarenes. Although conventional chlorination of
arenes is a well-established transformation that has been studied in detail in many textbooks, current challenges
have driven scientists to design new strategies that can address the need for efficiency and sustainability. The
oxidative chlorination reaction proceeds via an oxidation step of the chloride ion to generate the active
electrophilic chlorenium species in situ. In these regards, the present review focused on the main
achievementsof the oxidative chlorination of arenes, with special focus on their generality and green aspects. Therefore, the use of different oxidants (hydrogen peroxide, oxygen, iodine(III) reagents, enzymes)
and conditions of electrochemistry and photocatalysis are presented.
The Prevalence of Blood Borne Diseases in Blood Donors of Peshawar, Khyber Pakhtunkhwa, Pakistan
Authors: Khan Mudassir , Shah Hafsa , ur Rahman Zia , Zaman Fakhar , Badshah Shahid 
Published: February 2023

Background:The goal of the study was to investigate the burden of transfusion- transmitted infections (TTIs) hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), syphilis, and malarial parasite (MP) in ABO Blood Groups and Rh Type System among voluntarily blood donors in Khyber Pakhtunkhwa (KPK), Pakistan. It is a retrospective single center cross sectional study. This study was conducted from June 2020 to September 2021 (16 months) at the frontier foundation thalassemia center Peshawar KPK. Donors were physically healthy and fit for donation. Donors with physical disabilities and/or having co-morbid conditions were excluded from the report.Methods:All the samples were screened for anti-HIV, anti-HCV, HBsAg, Syphilis, and Malarial Parasite via ELISA kit and Immune Chromatographic Technique (ICT), respectively. A total of 6311 blood donations were evaluated. The majority of the donations (92%) were from (VNRBD) voluntary non-remunerated blood donation, while only 8% came from replacement donors.Results:Amongst 6311 blood donations, 1.50 % (n = 95) were infected at least with one pathogen, HBV positive cases were 0.855 % (n = 54), HCV positive cases were 0.316% (n = 20), syphilis positive were 0.30% (n = 19) and MP positive cases were only 0.031% (n = 2). HBV, HCV, syphilis and malaria infections rates were found to be low as compared to the previous data published, while no case was reported for HIV. The study also revealed the distribution pattern of the aforementioned pathogens in blood groups and the Rh type system of the reactive samples.Conclusion:The lower reported in our study indicates the awareness among the people of Peshawar about TTIs and their precautions. The prevalence rate that we are reporting is less than previously published articles in the same domain.
Dementia in patients with diabetes mellitus
Authors: Sitorus Lena Sovi E , Diniari Ni Ketut Sri , Kuswardhani R A Tuty 
Published: February 2023

The role of diabetes mellitus in neurodegeneration has been confirmed by neuroimaging and neuropathological studies. Apart from causing schizophrenia, chronic exposure to hyperglycemia may worsen cognitive function and cause significant cognitive disorders, such as Alzheimer’s and dementia. An 81-year-old woman was consulted to the Psychiatry department with fatigue and forgetfulness. She was found unconscious in her room. In the emergency room, her blood glucose level was 30 mg/dl with type 2 diabetes since 2012. She was able to pronounce her name correctly but forgot her age, said that she was in her home, the examinations were in the morning, and the name of her ex-employee who accompanied her and said that she already had breakfast, could repeat the names of 3 objects given. She was asked to repeat in 1 minute can only say 1 name of the object correctly, cannot count the subtraction several times. The patient correctly pronounced the name of the object shown to her, but cannot fold paper, write sentences, or draw. Psychiatrist give her Avram 1x5 mg and Aricept 1x5 mg also provided assistance, family education, and reminiscence therapy, and she had 8 units of Novorapid injection subcutaneously after a meal from the geriatrist.
Exoskeletons in the Digital Era: A Way to Improve the Level of Physical Activity Among Older Citizens
Authors: Madeleine Pascal , Christensen Daniel J R , Franch Jesper , Svendsen Lone , Hansen Ernst A , Hostrup Hanne , Pirscoveanu Cristina-Ioana 
Published: February 2023

Background
The COVID-19 pandemic has had a negative impact on the level of physical activity among older citizens.

Objective
The aim of this short paper is to set focus on the potential benefits of assistive walking devices for older citizens.

Methods
In this feasibility study, 24 older citizens aged >65 years participated in the study. The participants answered to the following questionnaires after fulfilling a consent form: Tilburg Frailty Indicator, International Physical Activity Questionnaire, and Quality of Life. Then, physiological and biomechanical assessments were made in a laboratory setting with and without wearing an exoskeleton (aLQ, IMASEN Electrical Industrial Co). The aLQ is a passive-assistive lower-limb walking exoskeleton activated by a cam spring system designed to improve gait. After the tests, the participants were asked to answer the following questions: “Do you feel the exoskeleton is helping you to walk?” and “What is your opinion on the device?”.

Results
The participants were community-dwelling older individuals, aged 72.6 (SD 4.5) years, and were characterized by an overall high level of physical activity of 3069 (SD 2847) metabolic equivalent–minutes per week. Their Tilburg Frailty Indicator indicated an overall frailty score of 3.5 (SD 2.5). The participants reported a Quality of Life score of 6.7 (SD 1.6) and an overall health score of 76.4 (SD 17.1). Moreover, of the 24 participants, 7 (29%) reported that carrying the tested exoskeleton did not induce any noticeable changes, and 3 (10%) reported that they walked better with the device than without.

Conclusions
These findings are of importance in our current digital era where the COVID-19 pandemic forced municipalities and hospitals to cancel or postpone the training and rehabilitation of older citizens, resulting in a degradation of the level of physical activity and health in general. The use of assistive walking devices can be a way to improve or maintain their level of physical activity. Future studies using a prospective design should confirm that.

Conflicts of Interest
None declared.
Implementation Challenges for Danish Hospitals in Digital Transformation
Authors: Kidholm Kristian 
Published: February 2023

Background
Increased digitalization of hospitals is a goal for national and regional health strategies. Since 2019, it has been an explicit goal to increase the use of virtual consultation with hospital patients. Two years after the start of the pandemic, virtual consultation for hospital patients has increased. At Odense University Hospital (OUH), we have seen a 30% and 337% increase in the annual number of telephone and video consultations with patients, respectively. However, the annual number of video consultations is still below 1% of the total number of outpatient visits.

Objective
This presentation describes challenges that may explain the slow implementation of telemedicine at OUH and how these challenges are handled in practice.

Methods
The description is based on 12 meetings with hospital managers and staff at OUH. Analysis of the content of the meetings has been condensed into the major themes specified in the results.

Results
Three main challenges have been found: (1) uncertainty regarding the quality of telemedicine interventions, (2) uncertainty regarding the technical and communicative skills needed to do video consultation, and (3) misunderstandings regarding the economic consequences of telemedicine. To address the uncertainty among our staff toward the clinical quality of telemedicine, a database including randomized trials of telemedicine interventions described in the PubMed database from 2010-2022 was produced. The database shows that more than 96% of interventions results in similar or improved clinical outcomes for selected patient groups. To ensure the skills needed by the hospital staff to do video consultation, we have offered courses in the technical and communicative aspects of video consultation to interested departments. Finally, some members of our staff believe that reducing the number of physical visits may reduce the hospital budget, which is contrary to the actual financial agreements with capitation payment. To address this misunderstanding, information about the true economic consequences of implementing telemedicine has been provided.

Conclusions
Successful implementation of telemedicine requires more than solid evidence; it also requires initiatives focusing on the challenges among the hospital staff.

Conflicts of Interest
None declared.