bluuebunny/crossref_metadata_2025_split huggingface dataset:
System-level performance measures of access to rheumatology care: a population-based retrospective study of trends over time and the impact of regional rheumatologist supply in Ontario, Canada, 2002–2019
Authors: Barber Claire E. H. , Lacaille Diane , Croxford Ruth , Barnabe Cheryl , Marshall Deborah A. , Abrahamowicz Michal , Xie Hui , Avina-Zubieta J. Antonio , Esdaile John M. , Hazlewood Glen , Faris Peter , Katz Steven , MacMullan Paul , Mosher Dianne , Widdifield Jessica 
Published: December 2022

Abstract
Objective
To determine whether there were improvements in rheumatology care for rheumatoid arthritis (RA) between 2002 and 2019 in Ontario, Canada, and to evaluate the impact of rheumatologist regional supply on access.

Methods
We conducted a population-based retrospective study of all individuals diagnosed with RA between January 1, 2002 and December 31, 2019. Performance measures evaluated were: (i) percentage of RA patients seen by a rheumatologist within one year of diagnosis; and (ii) percentage of individuals with RA aged 66 years and older (whose prescription drugs are publicly funded) dispensed a disease modifying anti-rheumatic drug (DMARD) within 30 days after initial rheumatologist visit. Logistic regression was used to assess whether performance improved over time and whether the improvements differed by rheumatology supply, dichotomized as < 1 rheumatologist per 75,000 adults versus ≥1 per 75,000.

Results
Among 112,494 incident RA patients, 84% saw a rheumatologist within one year: The percentage increased over time (adjusted odds ratio (OR) 2019 vs. 2002 = 1.43, p < 0.0001) and was consistently higher in regions with higher rheumatologist supply (OR = 1.73, 95% CI 1.67–1.80). Among seniors who were seen by a rheumatologist within 1 year of their diagnosis the likelihood of timely DMARD treatment was lower among individuals residing in regions with higher rheumatologist supply (OR = 0.90 95% CI 0.83–0.97). These trends persisted after adjusting for other covariates.

Conclusion
While access to rheumatologists and treatment improved over time, shortcomings remain, particularly for DMARD use. Patients residing in regions with higher rheumatology supply were more likely to access care but less likely to receive timely treatment.
The impact of normal serum complement levels on the disease classification and clinical characteristics in systemic lupus erythematosus
Authors: Takamatsu Ryota , Shimojima Yasuhiro , Kishida Dai , Ichikawa Takanori , Sekijima Yoshiki 
Published: December 2022

Abstract
Background
Some patients have normal levels of complement during the diagnosis of systemic lupus erythematosus (SLE), although decreased serum levels of complement are a hallmark of the active phase of the disease. This study investigated the clinical characteristics, impact on the classification of SLE, and the prognosis of patients with SLE who had normal serum complement levels at initial diagnosis (N-com).

Methods
We evaluated 21 patients with N-com and 96 patients with hypocomplementemia at the initial diagnosis of SLE (H-com). The classification rates among the American College of Rheumatology (ACR) 1997, Systemic Lupus International Collaborating Clinics (SLICC) 2012, European League Against Rheumatism (EULAR)/ACR 2019 criteria, and clinical and immunological involvements were compared between SLE patients with N-com and H-com. Relapse and organ damage based on the SLICC/ACR damage index were also evaluated.

Results
The classification rates of SLE were not significantly different in the ACR, SLICC, and EULAR/ACR criteria between the N-com and H-com groups. Patients with N-com had no significant differences in the classification rates among the three criteria, whereas patients with H-com had lower classification rates in the ACR criteria than in the SLICC criteria. A lower incidence of renal manifestation, less positivity for anti-dsDNA antibody, and a higher incidence of fever were observed in patients with N-com than in those with H-com. The occurrence of relapse and organ damage was not significantly different between patients with N-com and H-com.

Conclusion
Patients with N-com were less involved in renal manifestation and anti-dsDNA antibody positivity but had a higher incidence of fever than those with H-com, while having no disadvantage in SLE classification processes. Serum complement levels at the initial diagnosis of SLE may not predict prognosis.
An estimation of the velocity profile for the laminar-turbulent transition in the plane jet on the basis of the theory of stochastic equations and equivalence of measures
Authors: Dmitrenko Artur V. , Selivanov A. S. 
Published: December 2022

AbstractThe theory of stochastic equations and the theory of equivalence of measures previously applied to flows in the boundary layer and in the pipe are considered to calculate the velocity profile of the flat jet. This theory previously made it possible to determine the critical Reynolds number and the critical point for the flow of the plane jet. Here based on these results the analytical dependence for the index of the velocity profile is derived. Velocity profiles are calculated for a laminar-turbulent transition in the jet. This formula reliably reflects an increase of the energy transferred from a deterministic state to a random one with an increase of the index of the velocity profile. Results show satisfactory agreement with the known experimental data for the velocity profile of the flat jet. Using obtained results it is possible to determine the location of technical devices for laminarization of the flow in the jet. This is important both for reducing friction in the flow around aerodynamic vehicles and for maintaining the jet profile if it is necessary to ensure the stability of the flow characteristics. Also the obtained relations can be useful for researching of the processes in combustion chambers, in the case of welding and in other technical devices.
Consanguinity and childhood acute lymphoblastic leukaemia: a case-control study
Authors: Kakaje Ameer , Alhalabi Mohammad Marwan , Ghareeb Ayham , Karam Bahjat , Mansour Bassam , Zahra Bayan , Hamdan Othman 
Published: December 2022

Abstract
Background
Consanguineous marriage is widely practised across the world. Its effect on acute lymphoblastic leukaemia (ALL) is controversial as both parents share some of the genes which might increase the incidence of sharing recessive genes. However, other theories suggest that consanguinity might have a protective factor as it does for other types of cancers. This study aims to study childhood ALL and consanguinity.

Methods
This is a case-control study, conducted in the major paediatric hospital in Damascus, Syria, using medical records. Case group included children with ALL, while control group included other patients and were matched by gender and age.

Results
This study comprised 386 patients, 193 of which were cases. Overall, 136 were of consanguineous marriages (36.8%), and there was no difference in consanguinity overall between cases and controls. However, when only comparing non-consanguineous parents and fourth-degree consanguinity, fourth degree was significantly higher among case group, suggesting a negative correlation OR = 0.387 (0.187–0.801) in contrast to third-degree consanguinity which was no significantly different when comparing the two groups (p > 0.05). We found no significant association between ALL and having a family history of cancer (p > 0.05) or between parents’ educational level and case-control groups (p > 0.05).

Conclusion
Our research suggests a negative association between fourth-degree consanguinity and childhood leukaemia. This was not observed with a third-degree consanguinity. Previous studies had contradicting data on consanguinity and ALL which demonstrates the need for further research.
Anesthetic management and the role of TEE in the entrapment of a paradoxical embolus by a patent foramen ovale
Authors: Davis Jevaughn S , Zvara Jessica , Parr K. Gage 
Published: December 2022

Abstract
Background
A paradoxical embolism arises when a venous thrombus passes through a cardiac right to left shunt and enters the arterial circulation. This can manifest as cardiovascular ischemia, cerebrovascular insults, increased right ventricular pressure, and/or volume overload leading to signs and symptoms of heart failure. While rare, paradoxical emboli carry high mortality and morbidity if diagnosis is missed and/or treatment is delayed. Transesophageal echocardiography can be diagnostic. Initial treatment revolves around anticoagulation and/or thrombolysis to prevent clot propagation. However, for clots in transit, emergent surgical removal is often necessary. Anesthetic induction can be tricky given the potential for rapid deterioration and the need to avoid increased right sided pressures and further clot migration.

Case presentation
In this report, we present a 72-year-old obese female with a history of hypertension, hyperlipidemia, gout, and diabetes found to have a paradoxical embolism caught in transit, trapped in a patent foramen ovale, and managed surgically. We describe the role of intraoperative transesophageal echocardiography in successfully treating this patient.

Conclusions
TEE plays an important role in the diagnosis and management of paradoxical PE. It can detect right and left heart thrombi and intracardiac shunts
, can help in the successful closure of intracardiac shunts, and can impact intraoperative surgical decision making.
A perfect storm: acute portal vein thrombosis in a patient with severe dengue and hemorrhagic manifestations—a case report
Authors: Gonzalez Carlos Eduardo Ruiz , Villamizar Juan Daniel Criado , León Yuderleys Masías , García Diego Fernando García , Hurtado Katherine Tatiana Centeno 
Published: December 2022

Abstract
Background
Dengue constitutes a public health problem in endemic regions. The clinical course can range from asymptomatic to severe expressions. Hemorrhagic manifestations are the most frequently reported complications; on the contrary, thrombotic complications are unusual.

Clinical case
We present the case of an adult patient who presented hemodynamic instability, severe thrombocytopenia, and positive serology for dengue, in whom acute portal vein thrombosis was documented. The possible pathophysiology of thrombocytopenia and thrombosis in dengue is discussed, as well as the dilemmas regarding the treatment of associated hemorrhagic and thrombotic manifestations.

Conclusions
The present case brings up the importance of considering the possibility of thrombotic events in patients with severe dengue. A high degree of suspicion, close assessment of hemostatic function, and quality supportive care are essential to improve outcomes. To our knowledge, this is the first report of dengue-associated portal vein thrombosis.
Evaluation of CEP55, SERPINE1 and SMPD3 genes and proteins as diagnostic and prognostic biomarkers in gastric carcinoma in Egyptian patients
Authors: Abdel-Tawab Marwa Sayed , Fouad Hanan , Yehia Ismaeel Ahmed , Tammam Ahmed Abd-Eltawab , Fahmy Alzhraa M. , Shaaban Saeed , Abdel-Salam Soha Mahmoud , Elazeem Naglaa Adly Abd 
Published: December 2022

Abstract
Background
Gastric carcinoma (GC) is a fatal disease. Detection of new biomarkers that can be utilized in the early diagnosis of GC is a pressing need. This present study assessed centrosomal protein-55 (CEP55)’ serpin family E member 1 (SERPINE1) and sphingomyelin phosphodiesterase 3 (SMPD3) genes and proteins in gastric adenocarcinoma with different tumor progression features. Thirty surgically resected gastric tissue samples from thirty patients suffered from gastric cancers were obtained. The gastric tissue samples were divided into tumorous (with different stages and grades) and adjacent non-tumorous samples. CEP55, SERPINE1 and SMPD3 genes were assessed by quantitative qRT-PCR, and their proteins were assessed by ELISA in the gastric tissue samples.

Results
As regards SERPINE1, CEP55 genes and proteins, results revealed significant elevations in the GC samples (p < 0.0001). On the contrary, SMPD3 gene and protein revealed significant decreases as compared to non-tumorous samples. The studied genes and proteins showed highly significant specificity and sensitivity in the early detection of GC. SERPINE1 gene and protein revealed highly significant increases and positive correlations, while SMPD3 gene and protein revealed highly significant decreases and negative correlations as the tumor progresses.

Conclusion
CEP55, SERPINE1 and SMPD3 genes and proteins could be used as useful biomarkers for the early detection of GC. SERPINE1 and SMPD3 genes and proteins might be used as risk and protective prognostic factors in GC, respectively.
Seismoelectric waves generated by a point source in horizontally stratified vertical transversely isotropic porous media
Authors: Cheng Qianli , Gao Yongxin , Zhou Guanqun , Chen Chieh-Hung , Wang Dongdong , Yao Cheng 
Published: December 2022

We study seismoelectric waves due to the electrokinetic effect in vertical transversely isotropic (VTI) media. An analytical method is presented for solving 3D seismoelectric waves generated by a point source and numerical simulations are conducted to investigate the characteristics of the seismoelectric waves. The results indicate that three types of seismoelectric signals can be observed, namely, a direct electromagnetic (EM) wave radiated by a seismic source, coseismic electric/magnetic fields accompanying seismic waves (including qP, qSV, and SH waves), and an EM wave converted at an interface from a seismic wave (i.e., the interface seismoelectric response). The seismoelectric signals in a VTI medium have some specific properties different from those in an isotropic medium. For example, a qP wave has a coseismic magnetic response, whereas in an isotropic medium a P wave cannot generate any coseismic magnetic field. All the qP, qSV, and SH waves have a direction dependent or anisotropic ability to generate coseismic electric and magnetic fields. The qP wave has the strongest ability to generate the electric field, 1–3 orders stronger than the qSV and SH waves. The qSV and SH waves have a comparable ability to generate the magnetic field, one order stronger than the qP wave. The results also indicate that the anisotropy in velocity, permeability, and conductivity has great impacts on the interface response. Simulations of an earthquake source demonstrate that the coseismic electric fields are dominated by the qP, qSV, and Rayleigh waves, whereas the coseismic magnetic fields are dominated by the SH and Love waves.
Contemporary Biological Insights and Clinical Management of Craniopharyngioma
Authors: Apps John Richard , Muller Hermann Lothar , Hankinson Todd Cameron , Yock Torunn Ingrid , Martinez-Barbera Juan Pedro 
Published: December 2022

Abstract
Craniopharyngiomas (CPs) are clinically aggressive tumors because of their invasive behavior and recalcitrant tendency to recur after therapy. There are 2 types based on their distinct histology and molecular features: the papillary craniopharyngioma (PCP), which is associated with BRAF-V600E mutations and the adamantinomatous craniopharyngioma (ACP), characterized by mutations in CTNNB1 (encoding β-catenin). Patients with craniopharyngioma show symptoms linked to the location of the tumor close to the optic pathways, hypothalamus, and pituitary gland, such as increased intracranial pressure, endocrine deficiencies, and visual defects. Treatment is not specific and mostly noncurative, and frequently includes surgery, which may achieve gross total or partial resection, followed by radiotherapy. In cystic tumors, frequent drainage is often required and intracystic instillation of drugs has been used to help manage cyst refilling. More recently targeted therapies have been used, particularly in PCP, but also now in ACP and clinical trials are underway or in development. Although patient survival is high, the consequences of the tumor and its treatment can lead to severe comorbidities resulting in poor quality of life, in particular for those patients who bear tumors with hypothalamic involvement. Accordingly, in these patients at risk for the development of a hypothalamic syndrome, hypothalamus-sparing treatment strategies such as limited resection followed by irradiation are recommended. In this review, we provide an update on various aspects of CP, with emphasis on recent advances in the understanding of tumor pathogenesis, clinical consequences, management, and therapies.
Longitudinal Sedentary Time and Symptoms in Breast Cancer Patients during Chemotherapy Using Ecological Momentary Assessment
Authors: WELCH WHITNEY A. , SOLK PAYTON , AUSTER-GUSSMAN LISA , WHITAKER MADELYN , SIDDIQUE JUNED , FANNING JASON , MISHORY ABBY , KHAN SEEMA , SANTA-MARIA CESAR , KULKARNI SWATI , PHILLIPS SIOBHAN M. 
Published: December 2022

ABSTRACT

Purpose
To examine the relationship between daily fluctuations in symptoms and sedentary behavior (SB) during chemotherapy (CT) for breast cancer.

Methods
Breast cancer patients (N = 68, Mage
= 48.5 ± 10.4 yr) undergoing CT wore an activity monitor on their hip to assess daily SB and completed prompts assessing symptoms (affect, anxiety, depression, fatigue, pain, and physical and cognitive functioning) for 10 consecutive days (3 d pre-CT, day of, and 6 d post-CT) at the beginning, middle and end cycles of CT. Mixed models assessed the bidirectional between-person (BP) and within-person (WP) associations of current day symptoms with minutes of SB measured on 1) the same day and 2) the next day, controlling for relevant covariates.

Results
Within person same-day results revealed a significant association between affect, anxiety, fatigue, physical functioning, pain, and cognitive functioning and same-day SB. Worse than average symptom ratings on a given day were associated with more SB that day. There was a significant WP relationship between previous-day anxiety, depression, and physical function and next-day SB (i.e., worse than average symptom ratings the previous day were associated with more SB the next day). Within person same-day results revealed a significant association between same-day SB and affect, anxiety, fatigue, pain, physical functioning, and cognitive functioning. The WP relationships were significant for previous-day SB and next-day affect and pain (i.e., higher than average SB associated with lower ratings). Relationships persisted when controlling for moderate-to-vigorous physical activity. There were no significant BP results.

Conclusions
Higher symptom ratings were associated with increased SB and higher SB was associated with worse symptoms. Future work should identify SB reduction intervention approaches tailoring to daily symptom burden during CT for breast cancer.
Using therapy outcome measures to identify the speech and language therapy needs of children and young people with severe acquired brain injury
Authors: Moll Deborah , Edwards Louise , Kelly Gemma , Hamilton Colin , Price Helen 
Published: December 2022

Background/Aims Children and young people often require speech and language therapy input following severe acquired brain injury. However, there is limited understanding of the impact of post-acute neurorehabilitation on children and young people's communication and swallowing, and how to measure this. The aim of this study was to evaluate the initial and ongoing speech and language therapy needs of children and young people in one specialist paediatric neurorehabilitation centre, and to determine the usefulness of therapy outcome measures for this population. Methods A retrospective review was performed of routinely collected data, including therapy outcome measures for children and young people admitted to the centre. Descriptive analysis was completed for all therapy outcome measures data, and statistical significance of change during rehabilitation was determined on those with sufficient data using Wilcoxon signed-rank tests. Results A total of 165 records of children and young people aged between 1 and 17 years were reviewed. The average length of stay at the centre was 19.7 weeks. The most prevalent therapy outcome measures were cognition and dysphagia. Highly significant differences were found between admission and discharge in all therapy outcome measures scores, including participation (Wilcoxon Z=-9.523, P<0.001) and wellbeing (Wilcoxon Z=-7.656, P<0.001). Median discharge scores did not exceed 4 (from a maximum of 5) for any scales. Conclusions Therapy outcome measures were able to capture the complex profiles of these children and young people and could measure changes during post-acute neurorehabilitation. Children and young people presented with a range of speech and language therapy needs following severe acquired brain injury. They made significant improvements in impairment, activity, participation and wellbeing scales during rehabilitation. Children and young people left with ongoing speech and language therapy needs in all areas, which require input from community services.
Comparison of shoulder muscle strength, shoulder range of motion and scapular motion in men with ankylosing spondylitis and healthy men: a case-controlled study
Authors: Mete Oguzhan , Oskay Deran , Haznedaroğlu Şeminur , Tufan Abdurrahman , Yildiz Taha Ibrahim 
Published: December 2022

Background/Aims Ankylosing spondylitis mainly affects the vertebral column, meaning that the assessment of the physical function of the upper extremity and scapulothoracic region in ankylosing spondylitis is often overlooked. Therefore, the aim of this study was to investigate shoulder muscle strength, shoulder active range of motion and three-dimensional scapular motion in patients with ankylosing spondylitis. Methods The study included 18 men with ankylosing spondylitis, and 16 age-matched typically healthy men as the control group. Muscle strength, active range of motion, and three-dimensional scapular motion were assessed with a digital hand-held dynamometer, an inclinometer, and an electromagnetic tracking device respectively. Results A decrease in shoulder flexion and abduction muscle strength on both the dominant side (P<0.001, P=0.001) and non-dominant side (P<0.001, P<0.001) was found in the ankylosing spondylitis group compared to the control group. A decrease in shoulder flexion, abduction, and external and internal rotation active range of motion on both the dominant side (P=0.001, P<0.001, P=0.015, P<0.001, respectively) and non-dominant side (P=0.001, P<0.001, P=0.017, P<0.001 respectively) was observed in the ankylosing spondylitis group. There was an increase in the upward rotation of the scapula on the non-dominant side at 30, 60, and 90° humeral elevations in the ankylosing spondylitis group compared to the control group (P=0.018, P=0.003, P=0.001 respectively). The other parameters of the scapular motion did not differ between groups (P>0.05). Conclusions This study showed that shoulder muscle strength and active range of motion were lower, and the upward rotation of the scapula was greater in men with ankylosing spondylitis compared to typically healthy men. The kinetics and kinematics parameters of the shoulder and scapula should be considered when assessing the physical function of patients with ankylosing spondylitis.