bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current practices of follow-up programs for childhood cancer survivors in Italy
Authors: Terenziani Monica , Tozzi Alberto Eugenio , Diaco Laura , Biasin Eleonora , Cattoni Alessandro , Croci Ileana , Fraschini Donatella , Giorgiani Giovanna , Haupt Riccardo , Muraca Monica , Pillon Marta , Sironi Giovanna , Valsecchi Maria Grazia , Mastronuzzi Angela 
Published: July 2023

Introduction Quality of life in childhood cancer survivors is largely affected by survivorship care and transition from treatment to long-term follow-up (LTFU). Referring to evidence-based recommendations, we wanted to evaluate LTFU care for survivors through a survey among the Italian Association for Pediatric Hematology-Oncology (AIEOP) centers. The project aimed to evaluate the availability of services in Italy, investigate strengths and weaknesses, analyze improvements of awareness in the field, and identify the gaps that need to be addressed by different centers. Methods Together with the family representatives, on behalf of AIEOP’s Late Effects Working Group, we developed a questionnaire on assisting childhood cancer survivors. All AIEOP centers received one questionnaire including information on local health system organizations; LTFU for childhood cancer survivors; services for adult survivors of childhood cancer; information provided to survivors/caregivers and care plan delivery. Results Forty-eight AIEOP centers were contacted and 42 replied, with a response rate of 87.5%. The majority of respondents confirmed their interest in assisting patients with a survivorship care plan (95.2%), regardless of a clinic or dedicated staff. Discussion This is the first overview of LTFU in Italy, which provides detailed results at national levels, prompting consideration of improvements in the last decade. Although there is a high level of interest in survivorship care, many centers lack resources to implement such programs. The identification of these challenges is useful for planning future strategies.
Symptoms associated with headache in youth
Authors: Patterson Gentile Carlyn , Aguirre Geoffrey K. , Hershey Andrew D. , Szperka Christina L. 
Published: July 2023

Objective To determine the underlying relationships between a broad range of headache-associated symptoms and how they relate to headache burden. Background Symptoms associated with head pain inform classification of headache disorders. However, many headache-associated symptoms are not included in the diagnostic criteria, which is largely based on expert opinion. Large symptom databases can assess headache-associated symptoms irrespective of pre-existing diagnostic categories. Methods We conducted a large single-center cross-sectional study on youth (6–17 years old) assessing patient-reported outpatient headache questionnaires between June 2017 and February 2022. Multiple correspondence analysis, an exploratory factor analysis, was applied to 13 headache-associated symptoms. Results 6662 participants (64% female; median age 13.6 years) were included. Multiple correspondence analysis dimension 1 (25.4% of the variance) captured the absence or abundance of headache-associated symptoms. A greater number of headache-associated symptoms correlated with greater headache burden. Dimension 2 (11.0% of the variance) revealed three symptom clusters: (1) cardinal features of migraine (light, sound, and smell sensitivity, nausea, and vomiting), (2) nonspecific global neurologic dysfunction symptoms (lightheadedness, trouble thinking, blurry vision), (3) vestibular and brainstem dysfunction symptoms (vertigo, balance problems, ear ringing, double vision). Conclusion Assessing a broader range of headache-associated symptoms reveals clustering of symptomatology and a strong relationship with headache burden.
The Resolution of Kaplan Fiber Injuries Is Observed in a Majority of Cases at 9 Months After Acute Primary Anterior Cruciate Ligament Reconstruction: A Radiological Study
Authors: Lord Breck R. , Devitt Brian M. , Hookway Samuel R. , Klemm Haydn J. , Webster Kate E. , Whitehead Timothy S. , Feller Julian A. 
Published: July 2023

Background: The natural history of Kaplan fiber (KF) injuries after acute primary anterior cruciate ligament (ACL) reconstruction (ACLR) remains unknown. Purpose/Hypothesis: The purpose of this study was to evaluate the temporal change in the magnetic resonance imaging (MRI) appearance of the KF complex after acute primary ACLR. It was hypothesized that KF injuries would resolve with time. Study Design: Case series; Level of evidence, 4. Methods: A retrospective MRI analysis was conducted on 89 patients with ACL-injured knees to assess the change in the radiological appearance of KFs after primary ACLR. Patients who had undergone index MRI and ACLR within 90 days of the injury and further MRI at 9 months after surgery were included. Diagnostic criteria to identify radiological evidence of a KF injury and its subsequent resolution were applied, including the presence of high signal intensity on fluid-sensitive sequences, which is indicative of a pathological process radiologically. The proximity of KFs to the femoral cortical suspensory device (CSD) was noted on MRI scans and quantified in millimeters. Results: A KF injury was identified in 30.3% (27/89) of patients, with isolated high signal intensity observed in an additional 18.0% (16/89). At 9 months, MRI evidence of the reconstitution of the KF complex was found in 51.9% (14/27) of patients, with persistent discontinuity in the remaining patients (13/27). All patients (16/16) with isolated high signal intensity had complete resolution on repeat MRI scans. KF thickening was observed in 26.1% (12/46) of patients with previously healthy KFs and in 25.0% (4/16) with isolated high signal intensity. The CSD was positioned in close proximity (≤6 mm) to the center of the KF attachment in 61.8% (55/89) of patients, and this was associated with increased rates of KF thickening. Conclusion: The KF injury resolved radiologically in over half of the patients at 9 months after acute primary ACLR. High signal intensity in the region of the KFs on index MRI scans resolved in all cases, with evidence of residual KF thickening in only one-quarter of cases on repeat MRI scans, equivalent to the rate in those with healthy KFs. As such, it is not advisable to use high signal intensity on preoperative MRI scans as the sole criterion for the diagnosis of a KF injury. The position of the CSD after ACLR was intimately related to the KF attachment in the majority of patients, which was associated with KF thickening on postoperative MRI scans.
Defining the Borderline Dysplastic Hip: High Variability in Acetabular Coverage and Femoral Morphology on Low-Dose Computed Tomography
Authors: Graesser Elizabeth A. , Schwabe Maria T. , Clohisy John C. , Nepple Jeffrey J. 
Published: July 2023

Background: Borderline acetabular dysplasia is commonly radiographically defined as a lateral center-edge angle (LCEA) of 20° to 25°. While the variability of plain radiographic assessment of this population has been reported, an understanding of the variability of 3-dimensional (3D) hip morphology remains to be better defined. Purpose: To investigate the variability of 3D hip morphology present on low-dose computed tomography (CT) in the setting of symptomatic borderline acetabular dysplasia and to determine if plain radiographic parameters correlate with 3D coverage. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A total of 70 consecutive hips with borderline acetabular dysplasia undergoing hip preservation surgery were included in the current study. Plain radiographic evaluation included LCEA, acetabular inclination, anterior center-edge angle (ACEA), anterior wall index (AWI), posterior wall index (PWI), and alpha angles on anteroposterior, 45° Dunn, and frog-leg views. All patients underwent low-dose pelvic CT for preoperative planning, which allowed detailed characterization of 3D morphology relative to normative data. Acetabular morphology was assessed with radial acetabular coverage (RAC) calculated according to standardized clockface positions from 8:00 (posterior) to 4:00 (anterior). Coverages at 10:00, 12:00, and 2:00 were classified as normal, undercoverage, or overcoverage relative to 1 SD from the mean of normative RAC values. Femoral morphology was assessed with femoral version, alpha angle (measured at 1:00 increments), and maximum alpha angle. Correlation was assessed with the Pearson correlation coefficient ( r). Results: Lateral coverage (12:00 RAC) was deficient in 74.1% of hips with borderline dysplasia. Anterior coverage (2:00 RAC) was highly variable, with 17.1% undercoverage, 72.9% normal, and 10.0% overcoverage. Posterior coverage (10:00 RAC) was also highly variable, with 30.0% undercoverage, 62.9% normal, and 7.1% overcoverage. The 3 most common patterns of coverage were isolated lateral undercoverage (31.4%), normal coverage (18.6%), and combined lateral and posterior undercoverage (17.1%). The mean femoral version was 19.7°± 10.6° (range, −4° to 59°), with 47.1% of hips having increased femoral version (>20°). The mean maximum alpha angle was 57.2° (range, 43°-81°), with 48.6% of hips having an alpha angle ≥ 55°. The ACEA and AWI were poorly correlated with radial anterior coverage ( r = 0.059 and 0.311, respectively), while the PWI was strongly correlated with radial posterior coverage ( r = 0.774). Conclusion: Patients with borderline acetabular dysplasia demonstrate highly variable 3D deformities, including anterior, lateral, and posterior acetabular coverage; femoral version; and alpha angle. Plain radiographic assessments of anterior coverage are poorly correlated with anterior 3D coverage on low-dose CT.
Clastogenic, aneugenic, and tubulin polymerization properties of di-(2-ethylhexyl) phthalate and dibutyl phthalate
Authors: Javaji Kalpana , Mamilla Jhansi , Deshpande Shruti S , Kanaka Raju Y , Amanchy Ramars , Misra Sunil 
Published: July 2023

Phthalate compounds were found to disrupt the endocrine system and alter transcriptomes during human embryonic development. In our previous work, we have isolated and reported two such phthalates di-(2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP) from Brevibacterium mcbrellneri bacteria and evaluated their bioactive properties. Naturally derived phthalates might be less toxic compared with synthesized molecules. We have investigated biologically isolated phthalates to understand the possible genotoxic effects in mice and further investigated in silico binding and polymerization of β-tubulin. Three sub-lethal concentrations of DEHP (150 μM, 175 μM, and 200 μM) and DBP (10 μM, 15 μM, and 30 μM) were studied. The results showed that the phthalates were found to be highly genotoxic in nature. However, the pattern of genotoxic effects was not found to be dose-dependent in the induction of chromosome aberrations (CA), micronuclei (MN), and changes in the mitotic index (MI) in cells. In silico studies of phthalates on polymerization of β-tubulin suggested that both DBP and DEHP were able to interact with the hydrogen bonds and make strong van der Waals interactions with β-tubulin thereby possibly causing destabilization of microtubule network. Our study suggests that these phthalates might be playing an important role in normal cell division thereby showing highly genotoxic effects.
Juveniles Accessing Mental health Services: A Novel Approach to Enhance Mental Health Among Vulnerable Adolescents
Authors: Srinivasan Shiva Prakash , Behra Aloka Datta , Arumugam Chiranjeevi , Panda Protush , E. Rangeela , Nayak Smriti Smitha , Ramachandran Padmavati 
Published: July 2023

Background: As a signatory of the United Nations Commission on Child Rights, India has enacted laws and policies to protect the child’s interests. The Juvenile Justice Act of 2015 addresses the needs and well-being of the most vulnerable children, including those who do not have anyone to care for or have experienced a traumatic upbringing and those who are allegedly in conflict with the law. No research from India addresses these vulnerable children’s mental health and well-being. The current paper describes a pilot project to create mental health awareness and improve children’s care access in India’s Juvenile Justice System (JJS). Methods: Permission was obtained from appropriate governmental agencies in Odisha and Tamil Nadu and Child Care Institutions (CCIs) that consented to participate. A co-creation model was utilized to create youth-friendly spaces and methods to deliver mental health literacy for all stakeholders and access to care. Results: Seven CCIs and 278 children across two states participated in the implementation of the project. 37.8% of the children had resided for less than six months and 34.5% for more than two years in the current CCI. Of the various adverse childhood experiences, neglect was the highest at 76.3% followed by parental issues at 32%. Conclusions: Children in the JJS have many risk factors predisposing them to develop mental health issues. This unique pilot project describes implementing a codesigned and co-created model of delivery of mental health literacy and access to care to this vulnerable group of children.
Efficacy of combining intravenous and topical dexamethasone against postoperative pain and function recovery after total knee arthroplasty: A prospective, double-blind, randomized controlled trial
Authors: Wu Changjun , Luo Defa , Zhu Yu , Zhao Qingyuan , Wang Jian , Dai Yunlei 
Published: July 2023

Background Dexamethasone is a corticosteroid with powerful anti-inflammatory effects. This study aimed to explore whether combining intravenous and topical dexamethasone could improve postoperative pain, swelling, and function recovery after total knee arthroplasty (TKA). Methods In this prospective, double-blind, randomized controlled study, 90 patients undergoing primary unilateral TKA were randomized into a dexamethasone group, which received dexamethasone (10 mg) by periarticular infiltration during surgery, as well as intravenous dexamethasone (10 mg) before tourniquet release and at 12 h postoperatively; or a control group, which received equal volumes of isotonic saline instead of dexamethasone. The primary outcome was postoperative pain, as assessed on the visual analogue scale (VAS). Secondary outcomes were postoperative consumption of morphine hydrochloride for rescue analgesia, postoperative swelling ratio of the thigh, knee, and tibia; functional recovery in terms of total range of motion (ROM) of knee and daily ambulation distance; postoperative inflammation biomarkers levels of C-reactive protein and interleukin-6; and postoperative complications. Results Resting VAS scores at postoperative 6, 12, and 24 h, and VAS scores during motion at postoperative 2, 6, 12, and 24 h were significantly lower in the dexamethasone group. The dexamethasone group also showed significantly less morphine consumption during the first 24 h after surgery and cumulatively during hospitalization, milder limb swelling at 24 and 48 h postoperatively, greater flexion and total ROM on postoperative day 1, and longer ambulation distance on postoperative days 1 and 2, and lower levels of inflammatory biomarkers on postoperative days 1 and 2. The dexamethasone group had significantly lower incidence of postoperative nausea and vomiting. Conclusion Compared with placebo, the combination of intravenous and topical dexamethasone can reduce pain, swelling, and inflammation after TKA, it also can improve functional recovery and reduce the incidence of postoperative nausea and vomiting.
Expression of early growth responsive gene-1 in the lateral geniculate body of kittens with amblyopia caused by monocular form deprivation
Authors: Wang Ying , Fan Haobo , Zou Yunchun , Song Weiqi , Li Lan , Xie Juan , Chen Siyu 
Published: July 2023

Objective The expression of early growth responsive gene-1 (Egr-1) in the lateral geniculate body in the normal kittens and those affected with amblyopia caused by monocular visual deprivation was compared to explore the potential significance of Egr-1 in the pathogenesis of amblyopia. Methods A total of 30 healthy kittens were equally and randomly divided into the control ( n = 15) and the deprivation group ( n = 15). The kittens were raised in natural light and the right eyes of the deprived kittens were covered with a black opaque covering. Pattern visual evoked potential (PVEP) was measured before and 1, 3, and 5 weeks after covering. Five kittens from each group were randomly selected and euthanized with 2% sodium pentobarbital (100 mg/kg) during the 1st, 3rd and 5th week after covering. The expression of Egr-1 in the lateral geniculate body in the two groups was compared by performing immunohistochemistry and in situ hybridization. Results After three weeks of covering, PVEP detection indicated that the P100 wave latency in the deprivation group was significantly higher than that in the control group (P < 0.05), whereas the amplitude decreased markedly (P < 0.05). The number of the positive cells (P < 0.05) and mean optical density (P < 0.05) of Egr-1 protein expression in the lateral geniculate body of the deprivation group were found to be substantially lower in comparison to the normal group, as well as the number (P < 0.05) and mean optical density of Egr-1 mRNA-positive cells (P < 0.05). However, with increase of age, positive expression of Egr-1 in the control group showed an upward trend (P < 0.05), but this trend was not noted in the deprivation group (P > 0.05). Conclusions Monocular form deprivation can lead to substantially decreased expressions of Egr-1 protein and mRNA in the lateral geniculate body, which in turn can affect the normal expression of neuronal functions in the lateral geniculate body, thereby promoting the occurrence and development of amblyopia.
The selection of the suitable long peripheral catheter in DIVA patients: The significance of ultrasonography
Authors: Lisova Katerina , Pavelkova Katerina , Šimkova Petra , Mokra Dana , Palova Sabina , Charvat Jiri 
Published: July 2023

Background: There are several types of LPC (long peripheral catheters) that vary in length, size, insertion method, and cost. The aim of the study was to evaluate whether ultrasonography can be useful for the selection of the suitable LPC in DIVA (difficult intravenous access) patients. Methods: Based on the ultrasonographic examination, a long peripheral catheter was selected. A 6.4 cm LPC into a vein at a depth of up to 0.5 cm, a 8.5 cm LPC into a vein at a depth up to 1.5 cm, and a 9.8 cm catheter at a depth up to 2 cm using the cannula over needle method. A 12 cm catheter was inserted into the deeper veins using the direct Seldinger method. The catheter diameter was no more than 33% vein diameter. Dwell time and the number of complications of four vascular devices were recorded and compared. Results: One thousand one hundred fifty-six patients, average age 76 years (19–102), 501 men and 655 women, were included in the study. Average dwelling time was 10 days (1–30), there were 136 complications (11.7%). A catheter 6.4 cm long was inserted in 346 (29.8%), 8.5 cm in 140 (12.1%), 9.8 cm in 320 (27, 5%), and 12 cm in 356 (30.6%) patients. There were no significant differences in dwelling time, rate, and type of complications among the four catheters used. Conclusion: Our results confirm that ultrasound examination can be useful for the selection of the suitable long peripheral catheter in DIVA patients.
Social determinants of health and disparate disability accumulation in a cohort of Black, Hispanic, and White patients with multiple sclerosis
Authors: Orlando Christopher M , Pérez Carlos A , Agyei Paunel , Elsehety Marwah , Singh Sonia Kaur , Thomas Joseph , Alaina Omar , Lincoln John A 
Published: July 2023

Background: Black and Hispanic patients with multiple sclerosis (MS) have been shown to accumulate greater multiple sclerosis–associated disability (MSAD) than White patients. Disparities in social determinants of health (SDOH) among these groups have also been reported. Objective: To determine the extent to which associations of race and ethnicity with MSAD may be attributable to differences in SDOH. Methods: Retrospective chart analysis of patients at an academic MS center grouped by self-identified Black ( n = 95), Hispanic ( n = 93), and White ( n = 98) race/ethnicity. Individual patient addresses were geocoded and matched with neighborhood-level area deprivation index (ADI) and social vulnerability index (SVI). Results: Average Expanded Disability Status Scale (EDSS) scores at last-recorded evaluations of White patients (1.7 ± 2.0) were significantly lower than Black (2.8 ± 2.4, p = 0.001) and Hispanic (2.6 ± 2.6, p = 0.020) patients. Neither Black race nor Hispanic ethnicity was significantly associated with EDSS in multivariable linear regression models that included individual-level SDOH indicators and either ADI or SVI. Conclusion: Black race and Hispanic ethnicity are not significantly associated with EDSS in models that include individual and neighborhood-level SDOH indicators. Further research should elucidate mechanisms by which structural inequities affect MS disease course.
The familial risk and heritability of multiple sclerosis and its onset phenotypes: A case–control study
Authors: Boles Graysen Steele , Hillert Jan , Ramanujam Ryan , Westerlind Helga , Olsson Tomas , Kockum Ingrid , Manouchehrinia Ali 
Published: July 2023

Background: The two main phenotypes of multiple sclerosis (MS), primary progressive (PPMS) and relapsing Onset (ROMS), show clinical and demographic differences suggesting possible differential risk mechanisms. Understanding the heritable features of these phenotypes could provide aetiological insight. Objectives: To evaluate the magnitude of familial components in PPMS and ROMS and to estimate the heritability of disease phenotypes. Methods: We used data from 25,186 MS patients of Nordic ancestry from the Swedish MS Registry between 1987 and 2019 with known disease phenotype (1593 PPMS and 16,718 ROMS) and 251,881 matched population-based controls and 3,364,646 relatives of cases and controls. Heritability was calculated using threshold–liability models. For familial odds ratios (ORs), logistic regression with robust sandwich estimator was utilized. Results: The OR of MS diagnosis in those with a first-degree family member with ROMS was 7.00 and 8.06 in those with PPMS. The corresponding ORs for having a second-degree family member with ROMS was 2.16 and 2.18 in PPMS. The additive genetic effect in ROMS was 0.54 and 0.22 in PPMS. Conclusion: Risk of MS increases by several folds in those with a relative with MS. The likelihood of developing either disease phenotype appears independent of genetic predisposition.