bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medial Flap Coblation Turbinoplasty Versus Submucous Resection: Outcomes
Authors: El-Sisi Hossam Elsayed , Etman Mohammed , Ebada Hisham Atef 
Published: July 2023

Background Variable surgical options are available for turbinate reduction. These options include total turbinectomy, partial turbinectomy, submucosal resection, laser surgery, cryosurgery, electrocautery, radiofrequency ablation, and turbinate out-fracture. However, there remains a lack of consensus for the preferred technique. Objectives The aim of this study was to describe the use of coblation for medial flap turbinoplasty procedure. Furthermore, the outcomes of this technique were compared to submucous resection in terms of improvement of patients’ symptoms, postoperative bleeding, crusting, and pain scores. Methods This prospective, randomized, comparative surgical trial was conducted on 90 patients. Patients were randomly allocated into 2 groups: medial flap coblation turbinoplasty group ( n = 45), and submucous resection group ( n = 45). The outcomes of both techniques were analyzed and compared. Results Both techniques were equally in alleviating patients’ symptoms of nasal obstruction. However, postoperative healing was significantly better in medial flap coblation turbinoplasty group. Additionally medial flap turbinoplasty showed a statistically significant better outcome in terms of postoperative bleeding, crusting and pain scores. Conclusion Both submucous resection and medial flap coblation turbinoplasty are effective in relieving nasal obstruction and enabling optimal volume reduction with preservation of function of the inferior turbinate. Coblation turbinoplasty has superior outcomes in terms of better healing and less postoperative pain and crusting.
Clinical Characteristics of 96 Patients Presenting With Hematogenous Spinal Osteomyelitis- a Retrospective Study
Authors: Truumees Eeric , Alexander Jeremiah , Chandler Calvin , Singh Devender , Geck Matthew , Stokes John 
Published: July 2023

Study Design: Retrospective study. Objective To report clinical characteristics and course of care for patients diagnosed with hematogenous spinal osteomyelitis (HVO). Methods Medical records of patients presenting to two tertiary care centers with HVO were reviewed. Results 96 consecutive patients with HVO were identified. Mean follow-up was 8.9 months. Most infections occurred in the lumbar region (50.0%). Of the cultures taken, MRSA accounted for 9%; MSSA, 26%; Streptococcus species, 12%; other gram-positive bacteria, 23%; gram-negative, 17%; fungal, 2.6%; and 11.5% of cultures returned no growth. 57 patients underwent surgery. Of these, 79% of the patients had undergone a trial of empiric antibiotics (cefepime and vancomycin) of the day prior to surgery. 44% underwent secondary surgeries, typically due to a heavy wound burden of necrotic tissue and pus. Postoperative antibiotics were prescribed to all patients. 51.6% of the patients were prescribed antibiotic therapy >6 months. Overall mortality rate was 3.8%. Major cause of all deaths was septic shock. Post-infection sequelae occurred in 47.4% of patients. The most common sequelae were persistent or new sites of infection, sepsis, and abscess. Conclusions Diabetes, hypertension, and renal failure appear to increase the risk of post-infection sequelae and death. While non-operative management was attempted in nearly 47%, ultimately 73% had surgery. This high rate may reflect our population of patients hospitalized in a tertiary care center. Available data suggests that patients presenting with hematogenous osteomyelitis be followed closely as failure of non-operative management, and resulting morbidity, was high.
Occupational Stress and Its Effects on Nurses at a Health Facility in Ho Municipality, Ghana
Authors: Dartey Anita Fafa , Tackie Vivian , Worna Lotse Comfort , Dziwornu Emmanuel , Affrim Derrick , Delanyo Akosua Dabi Rejoice 
Published: July 2023

Introduction The prevalence of occupational stress among nurses varies significantly around the globe. Nursing is often considered a stressful occupation and can have negative effects on the mental, physical, family relationships, and quality of care given to patients. The aim of this study was to explore the experiences, causes, effects, and coping strategies of occupational stress among nurses working at a health facility in Ho Municipality in Ghana. Methods The study employed a qualitative research approach with an exploratory design. Data saturation was reached with 18 participants. Purposive sampling was used to select participants, while semistructured interview guide with voice recorders were used in data collection. Data were manually transcribed and analyzed using thematic analysis. Results Overall, four main themes and ten subthemes were developed from this study. The main themes were nurses’ perception of occupational stress, sources of occupational stress, effects of occupational stress, and coping strategies adopted to cope with occupational stress. The subthemes were as follows: negative and positive stressful feeling, individual level, hospital level, general body pain and fatigue, mental health problems, ineffective relationships, low work output, diversional therapy, positive work outcomes, and psychological support from others (family and colleagues). Discussion There are more negative effects of occupational stress on nurses. However, most of the nurses adopted coping strategies to reduce stress with little or no support from the hospital. More support from the hospital will be required to totally manage occupational stress. Conclusion The study findings revealed how stress affects the daily life and work output of nurses. It is crucial to comprehend how work-related stress affects nurses and what aspects of their workplace are the most burdensome.
Incident pulmonary hypertension in 13 488 cases investigated with repeat echocardiography: a clinical cohort study
Authors: Stewart Simon , Chan Yih-Kai , Playford David , Harris Sarah , Strange Geoffrey A. 
Published: July 2023

BackgroundWe addressed the paucity of data describing the characteristics and natural history of incident pulmonary hypertension.MethodsAdults (n=13 448) undergoing routine echocardiography without initial evidence of pulmonary hypertension (estimated right ventricular systolic pressure, eRVSP <30.0 mmHg) or left heart disease were studied. Incident pulmonary hypertension (eRVSP ≥30.0 mmHg) was detected on repeat echocardiogram a median of 4.1 years apart. Mortality was examined according to increasing eRVSP levels (30.0–39.9, 40.0–49.9 and ≥50.0 mmHg) indicative of mild-to-severe pulmonary hypertension.ResultsA total of 6169 men (45.9%, aged 61.4±16.7 years) and 7279 women (60.8±16.9 years) without evidence of pulmonary hypertension were identified (first echocardiogram). Subsequently, 5412 (40.2%) developed evidence of pulmonary hypertension, comprising 4125 (30.7%), 928 (6.9%) and 359 (2.7%) cases with an eRVSP of 30.0–39.9 mmHg, 40.0–49.9 mmHg and ≥50.0 mmHg, respectively (incidence 94.0 and 90.9 cases per 1000 men and women, respectively, per year). Median (interquartile range) eRVSP increased by +0.0 (−2.27 to +2.67) mmHg and +30.68 (+26.03 to +37.31) mmHg among those with eRVSP <30.0 mmHgversus≥50.0 mmHg. During a median 8.1 years of follow-up, 2776 (20.6%) died from all causes. Compared to those with eRVSP <30.0 mmHg, the adjusted risk of all-cause mortality was 1.30-fold higher in 30.0–39.9 mmHg, 1.82-fold higher in 40.0–49.9 mmHg and 2.11-fold higher in ≥50.0 mmHg groups (all p<0.001).ConclusionsNew-onset pulmonary hypertension, as indicated by elevated eRVSP, is a common finding among older patients without left heart disease followed-up with echocardiography. This phenomenon is associated with an increased morality risk even among those with mildly elevated eRVSP.
Automated fundus ultrasound image classification based on siamese convolutional neural networks with multi-attention
Authors: Tan Jiachen , Dong Yongquan , Li Junchi 
Published: July 2023

AbstractFundus ultrasound image classification is a critical issue in the medical field. Vitreous opacity (VO) and posterior vitreous detachment (PVD) are two common eye diseases, Now, the diagnosis of these two diseases mainly relies on manual identification by doctors. This method has the disadvantages of time-consuming and manual investment, so it is very meaningful to use computer technology to assist doctors in diagnosis. This paper is the first to apply the deep learning model to VO and PVD classification tasks. Convolutional neural network (CNN) is widely used in image classification. Traditional CNN requires a large amount of training data to prevent overfitting, and it is difficult to learn the differences between two kinds of images well. In this paper, we propose an end-to-end siamese convolutional neural network with multi-attention (SVK_MA) for automatic classification of VO and PVD fundus ultrasound images. SVK_MA is a siamese-structure network in which each branch is mainly composed of pretrained VGG16 embedded with multiple attention models. Each image first is normalized, then is sent to SVK_MA to extract features from the normalized images, and finally gets the classification result. Our approach has been validated on the dataset provided by the cooperative hospital. The experimental results show that our approach achieves the accuracy of 0.940, precision of 0.941, recall of 0.940, F1 of 0.939 which are respectively increased by 2.5%, 1.9%, 3.4% and 2.5% compared with the second highest model.
Machine learning for predicting the risk stratification of 1–5 cm gastric gastrointestinal stromal tumors based on CT
Authors: Zhang Cui , Wang Jian , Yang Yang , Dai Bailing , Xu Zhihua , Zhu Fangmei , Yu Huajun 
Published: July 2023

Abstract
Backgroud
To predict the malignancy of 1–5 cm gastric gastrointestinal stromal tumors (GISTs) by machine learning (ML) on CT images using three models - Logistic Regression (LR), Decision Tree (DT) and Gradient Boosting Decision Tree (GBDT).

Methods
231 patients from Center 1 were randomly assigned into the training cohort (n = 161) and the internal validation cohort (n = 70) in a 7:3 ratio. The other 78 patients from Center 2 served as the external test cohort. Scikit-learn software was used to build three classifiers. The performance of the three models were evaluated by sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) and area under the curve (AUC). Diagnostic differences between ML models and radiologists were compared in the external test cohort. Important features of LR and GBDT were analyzed and compared.

Results
GBDT outperformed LR and DT with the largest AUC values (0.981 and 0.815) in the training and internal validation cohorts and the greatest accuracy (0.923, 0.833 and 0.844) across all three cohorts. However, LR was found to have the largest AUC value (0.910) in the external test cohort. DT yielded the worst accuracy (0.790 and 0.727) and AUC values (0.803 and 0.700) in both the internal validation cohort and the external test cohort. GBDT and LR performed better than radiologists. Long diameter was demonstrated to be the same and most important CT feature for GBDT and LR.

Conclusions
ML classifiers, especially GBDT and LR with high accuracy and strong robustness, were considered to be promising in risk classification of 1–5 cm gastric GISTs based on CT. Long diameter was found the most important feature for risk stratification.
Rapidly progressive interstitial lung disease combined with pneumocystis jiroveci pneumonia in a patient with single anti-TIF-1γ antibody positive dermatomyositis in the context of an underlying tumor
Authors: Zhang Hengzhe , Yue Jinfeng , Hou Xiaohui , Lu Hongjun , Bikdeli Arezou , Guo Haipeng , Li Hao , Li Daqing 
Published: July 2023

Abstract
Background
Interstitial lung disease (ILD) is a frequently observed comorbidity in autoimmune diseases such as dermatomyositis/polymyositis (DM/PM), and it is significantly associated with specific autoantibody types. One unique antibody type is the anti-transcription intermediate factor-1γ antibody (anti-TIF-1γ Ab), which has a positive rate of only 7%. It is often found in combination with malignancy and rarely with ILD, particularly rapidly progressive ILD (RPILD). In some cases, the presence of ILD in individuals with DM may indicate a paraneoplastic syndrome. Pneumocystis jiroveci pneumonia (PJP) typically occurs due to intensive immunosuppressive therapy, human immunodeficiency virus (HIV) infection, or malignancy, and rarely as an isolated condition.

Case presentation
A 52-year-old man with a history of rapid weight loss but non-HIV infected and not immunosuppressed who presented with fever, cough, dyspnea, weakness of the extremities, characteristic rash and mechanic's hand. Pathogenic tests suggested PJP, laboratory tests suggested a single anti-TIF-1γ Ab positive DM, imaging suggested ILD, and pathology revealed no malignancy. RPILD and acute respiratory distress syndrome (ARDS) developed after anti-infection and steroid hormone therapy. After mechanical support therapy such as Extracorporeal Membrane Oxygenation (ECMO), the patient developed late-onset cytomegalovirus pneumonia (CMVP), complicated bacterial infection, and ultimately death. Additionally, we discuss the potential causes of rapid weight loss, the mechanisms by which anti-TIF-1γ Ab may lead to ILD, and the possible connection between anti-TIF-1γ Ab positivity, rapid weight loss, immune abnormalities, and opportunistic infections.

Conclusions
This case emphasizes the importance of early recognition of malignant tumors and pulmonary lesions, assessment of the body's immune status, prompt initiation of immunosuppressive treatment, and prevention of opportunistic infections in individuals with single anti-TIF-1γ Ab positive DM presenting with rapid weight loss.
Surgical experience of extracorporeal membrane oxygenation for neonates with severe respiratory failure
Authors: Zhang Qi-Liang , Chen Xiu-Hua , Zhou Si-Jia , Cao Hua , Chen Qiang 
Published: July 2023

Abstract
Objective
Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. This paper summarizes our operation experience of neonatal ECMO via cannulation of the internal jugular vein and carotid artery.

Methods
The clinical data of 12 neonates with severe respiratory failure who underwent ECMO via the internal jugular vein and carotid artery in our hospital from January 2021 to October 2022 were collected.

Results
All neonates were successfully operated on. The size of arterial intubation was 8 F, and the size of venous intubation was 10 F. The operation time was 29 (22–40) minutes. ECMO was successfully removed in 8 neonates. Surgeons successfully reconstructed the internal jugular vein and carotid artery of these neonates. Arterial blood flow was unobstructed in 5 patients, mild stenosis was present in 2 patients, and moderate stenosis was present in 1 patient. Venous blood flow was unobstructed in 6 patients, mild stenosis was present in 1 patient, and moderate stenosis was present in 1 patient. The complications were as follows: 1 case had poor neck incision healing after ECMO removal. No complications, such as incisional bleeding, incisional infection, catheter-related blood infection, cannulation accidentally pulling away, vascular laceration, thrombosis, cerebral haemorrhage, cerebral infarction, or haemolysis, occurred in any of the patients.

Conclusion
Cannulation of the internal jugular vein and carotid artery can quickly establish effective ECMO access for neonates with severe respiratory failure. Careful, skilled and delicate operation was essential. In addition, during the cannulation process, we should pay special attention to the position of cannulation, firm fixation and strict aseptic operation.
Identification of Immune Infiltration in Odontogenic Keratocyst by Integrated Bioinformatics Analysis
Authors: Zhong Nian-Nian , Li Su-Ran , Man Qi-Wen , Liu Bing 
Published: July 2023

Abstract
Background
Odontogenic keratocyst (OKC) is a relatively common odontogenic lesion characterized by local invasion in the maxillary and mandibular bones. In the pathological tissue slices of OKC, immune cell infiltrations are frequently observed. However, the immune cell profile and the molecular mechanism for immune cell infiltration of OKC are still unclear. We aimed to explore the immune cell profile of OKC and to explore the potential pathogenesis for immune cell infiltration in OKC.

Methods
The microarray dataset GSE38494 including OKC and oral mucosa (OM) samples were obtained from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) in OKC were analyzed by R software. The hub genes of OKC were performed by protein-protein interaction (PPI) network. The differential immune cell infiltration and the potential relationship between immune cell infiltration and the hub genes were performed by single-sample gene set enrichment analysis (ssGSEA). The expression of COL1A1 and COL1A3 were confirmed by immunofluorescence and immunohistochemistry in 17 OKC and 8 OM samples.

Results
We detected a total of 402 differentially expressed genes (DEGs), of which 247 were upregulated and 155 were downregulated. DEGs were mainly involved in collagen-containing extracellular matrix pathways, external encapsulating structure organization, and extracellular structure organization. We identified ten hub genes, namely FN1, COL1A1, COL3A1, COL1A2, BGN, POSTN, SPARC, FBN1, COL5A1, and COL5A2. A significant difference was observed in the abundances of eight types of infiltrating immune cells between the OM and OKC groups. Both COL1A1 and COL3A1 exhibited a significant positive correlation with natural killer T cells and memory B cells. Simultaneously, they demonstrated a significant negative correlation with CD56dim natural killer cells, neutrophils, immature dendritic cells, and activated dendritic cells. Immunohistochemistry analysis showed that COL1A1 (P = 0.0131) and COL1A3 (P < 0.001) were significantly elevated in OKC compared with OM.

Conclusions
Our findings provide insights into the pathogenesis of OKC and illuminate the immune microenvironment within these lesions. The key genes, including COL1A1 and COL1A3, may significantly impact the biological processes associated with OKC.
Health literacy at work – individual and organizational health literacy, health supporting leadership and employee wellbeing
Authors: Lindert Lara , Choi Kyung-Eun , Pfaff Holger , Zeike Sabrina 
Published: July 2023

Abstract
Background
Against the backdrop of demographic change and the shortage of skilled workers, employees’ psychological wellbeing is of special interest for employers. In previous studies, individual health literacy has already been positively associated with psychological wellbeing. However, in order to improve health literacy, it is essential to take into account both the individual prerequisites and the demands and complexity of the system in which individuals operate. As current studies primarily focus on employees’ individual health literacy and as the concept of organizational health literacy, so far, is mainly used in the context of health care institutions, this study investigates on the impact of organizational health literacy and health supporting leadership on the relationship between individual health literacy and employees’ psychological wellbeing in a big German company based in the financial sector.

Methods
Data of an employee survey that was conducted in a big German company of the financial sector in October 2021 were analyzed by two mediation analyses using the PROCESS macro by Hayes for SPSS. A total of 2555 employees was included in analyses (51.4% male and 48.6% female).

Results
The relationship between individual health literacy and employees’ psychological wellbeing is partially mediated by organizational health literacy, indirect effect ab 0.268 – CI [0.170, 0.378] and by health supporting leadership, indirect effect ab 0.228 – CI [0.137, 0.329].

Conclusion
Study results provide new indications for planning and evaluating the health strategy of companies. Regarding the psychological wellbeing of employees, practitioners and researchers should focus not only on individual health literacy but also on organizational health literacy and health supporting leadership.
The evolution of COVID-19 vaccine hesitancy in Sub-Saharan Africa: evidence from panel survey data
Authors: Wollburg Philip , Markhof Yannick , Kanyanda Shelton , Zezza Alberto 
Published: July 2023

Abstract
Background
COVID-19 vaccination efforts are lagging in Sub-Saharan Africa, as just over 20 percent of the population has been fully vaccinated. COVID-19 vaccine hesitancy is considered important as a prerequisite for widespread vaccine take-up. Here, we study the dynamics of vaccine acceptance, its correlates, and reasons for hesitancy over time, drawing on two years of panel survey data.

Methods
In this observational study, we use multiple rounds of data from national High Frequency Phone Surveys (HFPS) in five countries in East and West Africa (Burkina Faso, Ethiopia, Malawi, Nigeria, and Uganda), covering a period between 2020 and 2022. The surveys are cross-country comparable and draw their samples from nationally representative sampling frames. Based on this data source, the study presents population-weighted means and performs multivariate regression analysis.

Results
COVID-19 vaccine acceptance was high throughout the study period (68% to 98%). However, acceptance levels were lower in 2022 than in 2020 in three countries (Burkina Faso, Malawi, Nigeria), and higher in one country (Uganda). Moreover, individuals are observed to change their stated vaccine attitudes between survey rounds, to a limited extent in some countries (Ethiopia) and more frequently in others (Burkina Faso, Malawi, Nigeria, Uganda). Vaccine hesitancy is higher in richer households, and those residing in urban areas; among women and those better educated. Hesitancy is lower in larger households and among heads of the household. The main reasons for hesitancy are concerns about side effects of the vaccine, its safety and efficacy, as well as assessments of COVID-19 risk, though these reasons fluctuate over time.

Conclusions
Reported COVID-19 vaccine acceptance levels remain far above vaccination rates in the study countries, suggesting that vaccine hesitancy is not the primary obstacle to reaching greater vaccine coverage, which may instead be related to access and delivery barriers as well as supply shortages. Nevertheless, vaccine attitudes appear malleable so that continued efforts are needed to retain high levels of vaccine acceptance.