bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences in utilisation of extracorporeal membrane oxygenation support and outcomes in Taiwan
Authors: Chang Feng-Cheng , Chou An-Hsun , Huang Yu-Tung , Huang Jhen-Ling , Wu Victor Chien-Chia , Chang Chih-Hsiang , Hung Kuo-Chun , Chang Shang-Hung , Chu Pao-Hsien , Chen Shao-Wei 
Published: March 2023

Abstract
Background
The impact of sex-related differences in patients receiving extracorporeal membrane oxygenation support (ECMO) support is still inconclusive. This population-based study aimed to investigate sex differences in short- or long-term outcomes in order to improve clinical practice.

Methods
Patients who received ECMO between 2001 to 2017 were identified from the Taiwan National Health Insurance Research Database. Propensity score matching with a 1:1 ratio was conducted in female-to-male groups, to reduce confounding of baseline covariates. Outcomes included in-hospital mortality, all-cause mortality, all-cause readmission, and ECMO-related complications. Logistic regression analysis, Cox proportional hazard model, and join point regression were used to compare sex differences in both short- or long-term outcomes.

Results
In total, 7,010 matched patients from 11,734 ECMO receivers were included for analysis. The use of ECMO increased dramatically in past years, although the proportion of females was still lower than males. There was a decreasing trend of females undergoing ECMO over time. Female patients have lower risks of in-hospital mortality (64.08% in females vs 66.48% in males; P = 0.0352) and ECMO-related complications compared with males. Furthermore, females also had favorable long-term late outcomes such as all-cause mortality (73.35% in females vs 76.98% in males; P = 0.009) and readmission rate (6.99% in females vs 9.19% in males; P = 0.001).

Conclusions
Female patients had more favorable in-hospital and long-term survival outcomes. Despite improvement in modern ECMO technique and equipment, ECMO remains underutilized in eligible female patients. Thus, females should undergo ECMO treatment if available and indicated.

Trial registration
The institutional review board of Chang Gung Memorial Hospital approved all data usage and the study protocol (registration number: 202100151B0C502; date of registration: 23/08/2021).
Impact of dysautonomic symptom burden on the quality of life in Neuromyelitis optica spectrum disorder patients
Authors: Yang Lili , Li Wenjing , Xie Yan , Ma Shuai , Zhou Xiaobo , Huang Xinyue , Tan Song 
Published: March 2023

Abstract
Background
This study aimed to investigate the clinical risk factors of dysautonomic symptom burden in neuromyelitis optica spectrum disorder (NMOSD) and its impact on patients’ quality of life.

Methods
A total of 63 NMOSD patients and healthy controls were enrolled. All participants completed the Composite Autonomic Symptom Score 31 (COMPASS-31) to screen for symptoms of autonomic dysfunction. A comprehensive clinical evaluation was performed on NMOSD patients, such as disease characteristics and composite evaluations of life status, including quality of life, anxiety/depression, sleep, and fatigue. Correlated factors of dysautonomic symptoms and quality of life were analyzed.

Results
The score of COMPASS-31 in the NMOSD group was 17.2 ± 10.3, significantly higher than that in healthy controls (P = 0.002). In NMOSD patients, the higher COMPASS-31 score was correlated with more attacks (r = 0.49, P < 0.001), longer disease duration (r = 0.52, P < 0.001), severer disability (r = 0.50, P < 0.001), more thoracic cord lesions (r = 0.29, P = 0.02), more total spinal cord lesions (r = 0.35, P = 0.005), severer anxiety (r = 0.55, P < 0.001), severer depression (r = 0.48, P < 0.001), severer sleep disturbances (r = 0.59, P < 0.001), and severer fatigue (r = 0.56, P < 0.001). The disability, total spinal cord lesions, and fatigue were revealed to be independently associated factors. Further analysis revealed that the COMPASS-31 score was independently correlated with scores of all the domains of patients’ quality of life scale (P < 0.05).

Conclusions
Dysautonomic symptom burden is correlated with decreased quality of life and certain clinical characteristics such as disability, the burden of spinal cord lesions, and fatigue in NMOSD patients. Investigation and proper management of autonomic dysfunction may help to improve the quality of life in patients with NMOSD.
Association of smoking, alcohol, and coffee consumption with the risk of ovarian cancer and prognosis: a mendelian randomization study
Authors: Liu Sicong , Feng Songwei , Du Furong , Zhang Ke , Shen Yang 
Published: March 2023

Abstract
Objective
Currently, the association between smoking, alcohol, and coffee intake and the risk of ovarian cancer (OC) remains conflicting. In this study, we used a two-sample mendelian randomization (MR) method to evaluate the association of smoking, drinking and coffee consumption with the risk of OC and prognosis.

Methods
Five risk factors related to lifestyles (cigarettes per day, smoking initiation, smoking cessation, alcohol consumption and coffee consumption) were chosen from the Genome-Wide Association Study, and 28, 105, 10, 36 and 36 single-nucleotide polymorphisms (SNPs) were obtained as instrumental variables (IVs). Outcome variables were achieved from the Ovarian Cancer Association Consortium. Inverse-variance-weighted method was mainly used to compute odds ratios (OR) and 95% confidence intervals (Cl).

Results
The two-sample MR analysis supported the causal association of genetically predicted smoking initiation (OR: 1.15 per SD, 95%CI: 1.02–1.29, P = 0.027) and coffee consumption (OR: 1.40 per 50% increase, 95%CI: 1.02–1.93, P = 0.040) with the risk of OC, but not cigarettes per day, smoking cessation, and alcohol consumption. Subgroup analysis based on histological subtypes revealed a positive genetical predictive association between coffee consumption and endometrioid OC (OR: 3.01, 95%CI: 1.50–6.04, P = 0.002). Several smoking initiation-related SNPs (rs7585579, rs7929518, rs2378662, rs10001365, rs11078713, rs7929518, and rs62098013), and coffee consumption-related SNPs (rs4410790, and rs1057868) were all associated with overall survival and cancer-specific survival in OC.

Conclusion
Our findings provide the evidence for a favorable causal association of genetically predicted smoking initiation and coffee consumption with OC risk, and coffee consumption is linked to a greater risk of endometrioid OC.
The state of diabetes care and obstacles to better care in Aceh, Indonesia: a mixed-methods study
Authors: Sofyan Hizir , Diba Farah , Susanti Suryane S. , Marthoenis Marthoenis , Ichsan Ichsan , Sasmita Novi Reandy , Seuring Till , Vollmer Sebastian 
Published: March 2023

Abstract
Background
Cardio-metabolic diseases are a major cause of death worldwide, including in Indonesia, where diabetes is one of the most critical diseases for the health system to manage.

Methods
We describe the characteristics, levels of control, health behavior, and diabetes-related complications of diabetes patients in Aceh, Indonesia. We use baseline data and blood testing from a randomized-controlled trial. We conducted semi-structured interviews with eight health providers from Posbindu and Prolanis programs that target diabetes and other non-communicable diseases (NCDs). We also conducted three focus group discussions with 24 diabetes patients about their experiences of living with diabetes and the existing support programs.

Results
The blood tests revealed average HbA1c levels indicative of poor glycemic control in 75.8 percent of patients and only 20.3 percent were free from any symptoms. Our qualitative findings suggest that patients are diagnosed after diabetes-related symptoms manifest, and that they find it hard to comply with treatment recommendations and lifestyle advice. The existing programs related to NCDs are not tailored to their needs.

Conclusion
We identify the need to improve diabetes screening to enable earlier treatment and achieve better control of the disease. Among diagnosed patients, there are widespread beliefs about diabetes medication and alternative forms of treatment that need to be addressed in a respectful dialogue between healthcare professionals and patients. Current diabetes screening, treatment and management programs should be revised to meet the needs of the affected population and to better respond to the increasing burden of this disease.
Hemangioblastoma with late leptomeningeal metastasis: a case report
Authors: Poiset Spencer J. , Reddy Aneesh , Tucker Catherine M. , Kenyon Lawrence C. , Judy Kevin D. , Shi Wenyin 
Published: March 2023

Abstract
Background
Hemangioblastoma of the central nervous system is an uncommon benign neoplasm, with about 25% of cases in patients with von Hippel–Lindau disease. The incidence of metastasis is rare, particularly in patients without von Hippel–Lindau disease. We report a case of hemangioblastoma with leptomeningeal dissemination as a late recurrence.

Case presentation
A 65-year-old Caucasian man with a history of World Health Organization grade I hemangioblastoma of the cerebellar vermis underwent gross total resection in 1997. In early 2018, he developed intracranial recurrences with diffuse leptomeningeal disease of the entire spine. The patient underwent resection of intracranial recurrence, followed by palliative craniospinal irradiation. The disease progressed quickly, and he died 8 months after recurrence.

Conclusions
Despite a benign pathology, hemangioblastoma has a low risk of metastasis. The outcome for hemangioblastoma patients with metastasis is poor. Multidisciplinary care for patients with metastatic hemangioblastoma warrants further investigation, and an effective systemic option is urgently needed. Regular lifelong follow-up of at-risk patients is recommended.
Pulp-to-palm distance after plate fixation of a distal radius fracture corresponds to functional outcome
Authors: Jakobsson Hugo , Lundqvist Eva , Wretenberg Per , Sagerfors Marcus 
Published: March 2023

Abstract
Introduction
Several factors can influence the outcome after a distal radius fracture (DRF). The aim of this study was to assess whether postoperative pulp-to-palm (PTP) distance correlated with functional outcomes after plate fixation of DRF.

Materials & methods
This is a secondary analysis of a randomized controlled trial aimed to investigate the effects of plate fixation in patients with type-C fractures. Subjects (N = 135) were divided into 2 groups based on PTP distance (equal to or higher than 0 cm) at 4 weeks postoperatively. Outcome measures were collected prospectively at 3, 6 and 12 months and included Patient-Rated Wrist Evaluation (PRWE), Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) scores, wrist range of motion (ROM), Visual Analog Scale (VAS) pain scores, and hand grip strength.

Results
Overall, at 3 and 6 months patients with PTP > 0 cm had significantly worse outcomes (PRWE, QuickDASH, wrist ROM) than those with PTP =0 cm. At 12 months, QuickDASH and wrist ROM were still significantly worse. In the volar-plating subgroup, patients with PTP > 0 cm had significantly worse wrist ROM and grip strength at 3 months, but no significant differences were found in subsequent follow-ups. In the combined-plating group, patients with PTP > 0 cm had significantly worse QuickDASH, wrist ROM and grip strength at 3 months. At 6 and 12 months, wrist ROM was still significantly worse.

Conclusions
Measurement of PTP distance appears to be useful to identify patients likely to have worse outcome after plating of a DRF. This could be a tool to improve the allocation of hand rehabilitation resources.
Uptake of formal childcare among second generation and native mothers in Belgium: can increasing local childcare availability narrow migrant-native gaps?
Authors: Maes Julie , Neels Karel , Biegel Naomi , Wood Jonas 
Published: March 2023

AbstractResearch indicates that the uptake of formal childcare for children under age 3 is lower among migrant origin parents than among native parents in most European countries, and that these differentials extend to the second generation. Despite considerable investments in formal childcare availability in many European countries, it remains unclear whether and to what extent expanding local childcare availability effectively diminishes migrant-native uptake differentials due to the lack of longitudinal research. Therefore, this study assesses for Belgium to what extent expansions in childcare availability within municipalities in the period 2010–2014 has increased the uptake of formal childcare for children under age 3 among households where the mother has a second generation Southern European, Maghreb or Turkish background, versus no migration background. We use longitudinal census and register data for Belgium that were linked to longitudinal tax return data on childcare expenses and municipality-level data on childcare availability for children aged 0–3. Our results show that Southern European and Turkish origin mothers become more likely to use formal childcare when childcare places become more widely available within their municipalities, but also that the uptake gap with native mothers persists, since there is no differential effect of increasing local childcare availability. Since local childcare expansions entail a slightly stronger increase in formal childcare uptake among Maghreb origin mothers compared to native mothers, this results in slightly decreasing migrant-native uptake gaps, although considerable uptake gaps remain. To our knowledge, this is the first longitudinal study addressing the relationship between local childcare availability and uptake differentials by migration background. This study can inspire avenues for follow-up research which could provide additional insight into the possible mechanisms behind the varying effects of increasing local childcare availability by migration background and the persisting migrant-native uptake gaps.
Interactive effects of scaffolding digital game-based learning and cognitive style on adult learners’ emotion, cognitive load and learning performance
Authors: Chang Chi-Cheng , Yang Szu-Ting 
Published: March 2023

AbstractThere has been a little research on emotion, cognitive load, or learning performance for digital game-based learning (DGBL). However, there is still a dearth of research on investigating the interactive effects of scaffolding DGBL and cognitive style on the above three outcomes. Participants were 97 middle-aged and elder adults from a community college and randomly assigned into three groups. Taking prior knowledge as the covariate, 3 × 2 two-way MANCOVA was adopted to verify the interactive effects of scaffolding DGBL (hard scaffolding DGBL, soft scaffolding DGBL, and non-scaffolding DGBL) and cognitive style (Serialist and Holist). The findings presented that there exited significantly interactive effects of scaffolding DGBL and cognitive style on learning emotion, cognitive load, and learning performance. In hard scaffolding DGBL, learning emotion, cognitive load, and learning performance of Serialist learners were significantly better than those of Holist learners. Conversely, in soft scaffolding DGBL, learning emotion, cognitive load, and learning performance of Holist learners were significantly better than those of Serialist learners. Learning emotion, cognitive load, and learning performance of Serialist learners using hard scaffolding DGBL and Holist learners using soft scaffolding DGBL were significantly better than those of learners using non-scaffolding DGBL. The findings demonstrated concrete contributions and implications on practical promotion and theoretical development. This study ensures sufficiency of applying the cognitive-affective theory of learning with media (CATLM), cognitive load theory and cognitive style theory on DGBL, suggesting to extend the application of these theories to scaffolding.
Surgical management of idiopathic thoracal ventral spinal cord herniation: a case report
Authors: Sarigul Buse , Ogrenci Ahmet , Dalbayrak Sedat 
Published: March 2023

Abstract
Introduction
Idiopathic spinal cord herniation is a rare entity that is characterized by the displacement of the spinal cord through a defect in the dural layer and presents with symptoms of myelopathy. Surgical management usually results in good outcomes.

Case presentation
A 58-year-old female patient presented with weakness of both legs since four months. Her neurological examination showed paraplegia in the lower extremities, and ventral herniation was detected in the T9 vertebral level. The patient underwent surgery. Left T9 hemilaminectomy was followed by the reduction in the herniated spinal cord into its physiological location and the covering the anteriorly located dural defect via circumferentially covering the dural surface of the corresponding vertebral level. Postoperatively, the patient’s neurological status improved gradually and radiological scans showed a total reduction in the herniation.

Conclusion
Despite the rarity of the pathology, spinal cord herniation should be included in the differential diagnosis of the patients presenting with myelopathy or Brown–Séquard syndrome.
Pulmonary hemosiderosis secondary to mitral stenosis: a case report
Authors: Laudelino Jadson Soares , Aguiar Fernando Moreira Batista , Martins Filadélfia Passos Rodrigues , de Oliveira Rosineli Leopoldino , Cruz Glauberto Rolim Cartaxo Bezerra , Ramos Aline Lobo 
Published: March 2023

Abstract
Background
Pulmonary hemosiderosis is a rare disease that may be idiopathic or have a secondary etiology, such as mitral stenosis. The disease is a clinical and functional consequence of iron overload in the lungs in the form of hemosiderin. The diagnosis should be considered in patients with miliary nodules on chest tomography.

Case presentation
We report a case of a 30-year-old man with severe mitral stenosis who presented with chest pain and dyspnea. High-resolution chest tomography showed bilateral centrilobular micronodules. The diagnosis of pulmonary hemosiderosis secondary to mitral stenosis was suggested by transbronchial biopsy.

Conclusion
The diagnosis of idiopathic pulmonary hemosiderosis requires the exclusion of other etiologies of alveolar hemorrhage, including infections and vasculitis. One possible etiology is mitral stenosis.
Sustainability within interventional radiology: opportunities and hurdles
Authors: de Reeder Anouk , Hendriks Pim , Plug - van der Plas Helena , Zweers Dirk , van Overbeeke Philine S. M. , Gravendeel Joost , Kruimer Johan W. H. , van der Meer Rutger W. , Burgmans Mark C. 
Published: March 2023

Abstract
Background
Healthcare is a highly polluting industry and attention to the need for making this sector more sustainable is growing. The interventional radiology (IR) department is a relatively unique department in the hospital because of its synergetic use of both imaging equipment and medical instruments. As a result, the interventional radiology department causes a significant environmental burden in terms of energy usage, waste and water pollution. The aim of this study was to explore the current state of sustainability within IR by conducting a survey and interviews among IR specialists in the Netherlands.

Results
The main findings of this study were that there is a high awareness for the need of sustainability within IR, but that there is still limited action. Previous studies point towards the various opportunities in the field of energy, waste and water pollution, yet our study unveils these opportunities are often not implemented because of (1) sustainability not being a priority, (2) a dependency on employees, and (3) factors that simply cannot be changed by an individual IR department or hospital. Generally, our study indicates that there is a willingness to become more sustainable, but that the current system involves a wide range barriers that hinder true change. Furthermore, it seems that no one is currently taking the lead and a leading role from higher management, government, healthcare authorities or professional societies is lacking.

Conclusions
Despite the hurdles found in our study, IR departments can implement several improvements. An important factor is that sustainability should not lead to lower convenience for employees, which can be ensured by a sufficiently designed waste infrastructure and behavioral nudges. Furthermore, there lies an opportunity in more collaboration between IR departments in knowledge sharing and open innovation.
High seroprevalence and associated risk factors for hepatitis B virus infection among pregnant women living with HIV in Mtwara region, Tanzania
Authors: Shedura Vulstan James , Mchau Geofrey Joseph , Kamori Doreen 
Published: March 2023

Abstract
Background
Hepatitis B virus (HBV) infection continues to be a global public health problem. As of 2019, there were 296 million people chronically infected with HBV, resulting in nearly 1 million deaths from decompensated cirrhosis or hepatocellular carcinoma. The seroprevalence of HBV infection among pregnant women in Tanzania was reported to range between 3.8 and 8.03%. However, data on HBV infection in HIV-infected pregnant women is limited. We aimed to determine the seroprevalence and associated risk factors for HBV infection among HIV-infected pregnant women in selected health facilities in the Mtwara region. This was a health facility-based quantitative cross-sectional study conducted for three months (from February to April 2022). A structured questionnaire was used to collect information from the study participants. A total of 4 ml of blood was collected for HBV screening and confirmatory tests using rapid diagnostic tests and automated Enzyme-Linked Immunosorbent Assay (ELISA) tests, respectively. The logistic regression model was used to identify significant variables for HBV infection.

Results
Two hundred and twenty (n = 220) pregnant women living with HIV were enrolled in this study, with a median age of 32.7 years (Interquartile range (IQR) 27.6–37.6). The seroprevalence of HBV, chronic, and acute HBV infections were 10.5%, 10.0%, and 0.5%, respectively. We found that the multiparous women [aOR 11.99: 95% CI 1.11–129.01, p = 0.040], being infected with syphilis [aOR 27.65: 95% CI 9.07–84.30, p < 0.001], and having HIV viral load of 1000 copies/ml and above [aOR 16.00: 95% CI 1.70–150.63, p = 0.015], are factors independently associated with HBV infection.

Conclusions
The overall seroprevalence of HBV infection among pregnant women was 10.5%, which is high endemicity. Furthermore, the study revealed that having more than four children, a high HIV-1 viral load of ≥ 1000cp/ml, and being infected with syphilis are significant risk factors associated with HBV infection among pregnant women living with HIV in the Mtwara region.