bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discontinuation of treatment and retreatment of neovascular age-related macular degeneration in the real-world: Bundang AMD cohort study report 5
Authors: Cho Soo Chang , Park Kyu Hyung , Park Sang Jun , Joo Kwangsic , Woo Se Joon 
Published: July 2023

IntroductionThis single-center retrospective cohort study investigated the incidence rate and risk factors for the discontinuation of anti-vascular endothelial growth factor (VEGF) injections and retreatment in typical neovascular age-related macular degeneration (tnAMD) and polypoidal choroidal vasculopathy (PCV) in the real-world setting.MethodsA total of 488 eyes with either tnAMD (n = 334) or PCV (n = 154) followed up for ≥3 years were analyzed. The discontinuation of treatment was defined as the cessation of anti-VEGF injections for 1 year or longer. Eyes with discontinuing treatment were subdivided into group A: eyes with stable responses (complete or incomplete resolution) and group B: those with no expectation of visual gain or poor response. The proportion and median time of discontinuation of treatment or retreatment were analyzed. The visual prognosis and the associated risk factors for the discontinuation of treatment or retreatment were also investigated.ResultsThe mean follow-up period was 8.1 ± 3.4 years. Of 488 eyes, discontinuation of the treatment occurred in 322 eyes (66.0%), and the median time to discontinuation was 1.5 years after the initial injection. Of 297 eyes with discontinuation of treatment excluding 25 eyes with vitrectomy or photodynamic therapy after the discontinuation of the injection, 277 eyes belonged to group A and the remaining 20 eyes belonged to group B. Of the 277 eyes discontinuing treatment with a stable response, 185 eyes (66.8%) were given retreatment. The median time to retreatment was 3.3 years after the discontinuation of the injections. PCV and the lower annual number of injections were the significant factors associated with discontinuation. Younger age, male gender, and PCV were the significant factors for the retreatment.ConclusionOur long-term real-world study showed that two-thirds of eyes with neovascular age-related macular degeneration (nAMD) had the discontinuation of the anti-VEGF injections and two-thirds of eyes discontinuing treatment with stable responses experienced retreatment. Long-term follow-up and regular monitoring are needed to detect the recurrence.
Automated detection of cerebral microbleeds on MR images using knowledge distillation framework
Authors: Sundaresan Vaanathi , Arthofer Christoph , Zamboni Giovanna , Murchison Andrew G. , Dineen Robert A. , Rothwell Peter M. , Auer Dorothee P. , Wang Chaoyue , Miller Karla L. , Tendler Benjamin C. , Alfaro-Almagro Fidel , Sotiropoulos Stamatios N. , Sprigg Nikola , Griffanti Ludovica , Jenkinson Mark 
Published: July 2023

IntroductionCerebral microbleeds (CMBs) are associated with white matter damage, and various neurodegenerative and cerebrovascular diseases. CMBs occur as small, circular hypointense lesions on T2*-weighted gradient recalled echo (GRE) and susceptibility-weighted imaging (SWI) images, and hyperintense on quantitative susceptibility mapping (QSM) images due to their paramagnetic nature. Accurate automated detection of CMBs would help to determine quantitative imaging biomarkers (e.g., CMB count) on large datasets. In this work, we propose a fully automated, deep learning-based, 3-step algorithm, using structural and anatomical properties of CMBs from any single input image modality (e.g., GRE/SWI/QSM) for their accurate detections.MethodsIn our method, the first step consists of an initial candidate detection step that detects CMBs with high sensitivity. In the second step, candidate discrimination step is performed using a knowledge distillation framework, with a multi-tasking teacher network that guides the student network to classify CMB and non-CMB instances in an offline manner. Finally, a morphological clean-up step further reduces false positives using anatomical constraints. We used four datasets consisting of different modalities specified above, acquired using various protocols and with a variety of pathological and demographic characteristics.ResultsOn cross-validation within datasets, our method achieved a cluster-wise true positive rate (TPR) of over 90% with an average of &lt;2 false positives per subject. The knowledge distillation framework improves the cluster-wise TPR of the student model by 15%. Our method is flexible in terms of the input modality and provides comparable cluster-wise TPR and better cluster-wise precision compared to existing state-of-the-art methods. When evaluating across different datasets, our method showed good generalizability with a cluster-wise TPR &gt;80 % with different modalities. The python implementation of the proposed method is openly available.
The impact of the COVID-19 pandemic era on children with primary headache: a questionnaire survey study and literature review
Authors: Yoon So Yeon , Kim Hye Min , Yi Yoon Young 
Published: July 2023

BackgroundThe coronavirus disease (COVID-19) pandemic has resulted in individual isolation and secondary problems, especially in children. Research on the effect of the social isolation on children with primary headache is limited. This study aimed at exploring the effects of environmental changes caused by COVID-19 on headache in children.MethodsThis cross-sectional survey study enrolled school-aged children (age, 8–16 years) with headache who were able to complete the questionnaire from a Pediatric Headache Clinic between January 2021 and December 2022. Headache diaries for all patients were in their medical records and two questionnaire responses were requested at a 3-month interval. The questionnaires included headache type, frequency, previous medical conditions, family history, Pediatric Migraine Disability Assessment scores (PedMIDAS) scores, changes in daily life after COVID-19, and factors that aggravated headaches associated with social distancing.ResultsWe identified 35 patients who were diagnosed with primary headache and continued to visit our outpatient clinic for at least 3 months. Among them, 33 (15 males and 18 females) patients responded to the first survey. The average age (±SD) of patients was 12.5 ± 1.9 years. PedMIDAS scores were not affected by the COVID-19 infection history. Prolonged use of masks and increased use of digital devices were reported as the most common factors that aggravated headache during the pandemic era.ConclusionCOVID-19 did not affect in worsening primary headache in children. However, the pandemic can introduce various changes in daily life, which in turn can affect the management of headache. By gathering feedback regarding the thoughts of the patients on the impact of the current pandemic environment, patient counseling on the precautions and management can be conducted in advance in the case of repeated lockdown in the future.
Case report: Foreign body aspiration requiring extracorporeal membrane oxygenation
Authors: Ginter Dylan , Johnson K. Taneille , Venettacci Oliver , Vanderlaan Rachel D. , Gilfoyle Elaine , Mtaweh Haifa 
Published: July 2023

IntroductionForeign body aspiration is a common cause of respiratory distress in pediatrics, but the diagnosis can be challenging given aspirated objects are mostly radiolucent on chest radiographs and there is often no witnessed choking event. We present a case of a patient who was initially managed as severe status asthmaticus, requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for refractory hypercarbia and hypoxemia, but was later found to have bilateral bronchial foreign body aspiration. This case is unique in its severity of illness, diagnostic dilemma with findings suggesting a more common diagnosis of asthma, and use of ECMO as a bridge to diagnosis and recovery.Patient caseA previously healthy 2-year-old boy presented during peak viral season with a 3-day history of fever, cough, coryza, and increased work of breathing over the prior 24 h. There was no reported history of choking or aspiration. He was diagnosed with asthma and treated with bronchodilator therapy. Physical examination revealed pulsus paradoxus, severe work of breathing with bilateral wheeze, and at times a silent chest. Chest radiographs showed bilateral lung hyperinflation. Following a brief period of stability on maximum bronchodilator therapies and bilevel positive pressure support, the patient had a rapid deterioration requiring endotracheal intubation, with subsequent cannulation to VA-ECMO. A diagnostic flexible bronchoscopy was performed and demonstrated bilateral foreign bodies, peanuts, in the right bronchus intermedius and the left mainstem bronchus. Removal of the foreign bodies was done by rigid bronchoscopy facilitating rapid wean from VA-ECMO and decannulation within 24 h of foreign body removal.ConclusionForeign body aspiration should be suspected in all patients presenting with atypical history and physical examination findings, or in patients with suspected common diagnoses who do not progress as expected or deteriorate after a period of stability. Extracorporeal life support can be used as a bridge to diagnosis and recovery in patients with hemodynamic or respiratory instability.
Etiology analysis and G6PD deficiency for term infants with jaundice in Yangjiang of western Guangdong
Authors: Yang Yi-Kang , Lin Chun-Fan , Lin Fen , Chen Zi-Kai , Liao Yu-Wei , Huang Yu-Chan , Xiao Bei-Ru , Huang Shan-Hua , Xu Yu-Mei , Chen Yue-E. , Cao Yan-Bin , Yang Li-Ye 
Published: July 2023

ObjectiveGlucose 6-phosphate dehydrogenase (G6PD) deficiency increases the risk of neonatal hyperbilirubinemia. The aim of this study is to evaluate the risk factors associated with hyperbilirubinemia in infants from the western part of Guangdong Province, and to assess the contribution of G6PD deficiency to neonatal jaundice.MethodsThe term infants with neonatal hyperbilirubinemia in People's Hospital of Yangjiang from June 2018 to July 2022 were recruited for the retrospective analysis. All the infants underwent quantitative detection of the G6PD enzyme. The etiology was determined through laboratory tests and clinical manifestations.ResultsOut of 1,119 term infants, 435 cases presented with jaundice. For the etiology analysis, infection was responsible for 16.09% (70/435), G6PD deficiency accounted for 9.66% (42/435), of which 3 were complicated with acute bilirubin encephalopathy), bleeding accounted for 8.05% (35/435), hemolytic diseases accounted for 3.45% (15/435), and breast milk jaundice accounted for 2.53% (11/435). One case (0.23%) was attributed to congenital hypothyroidism, multiple etiologies accounted for 22.3% (97/435), and 35.63% (155/435) were of unknown etiology. Of the jaundiced infants, 19.54% (85/435) had G6PD deficiency, while only 10.23% (70/684) of non-jaundiced infants had G6PD deficiency; this difference was found to be statistically significant (P &lt; 0.001). Furthermore, the hemoglobin levels in the jaundiced infants with G6PD deficiency (146.85 ± 24.88 g/L) were lower than those without G6PD deficiency (156.30 ± 22.07 g/L) (P = 0.001). 65 jaundiced infants with G6PD deficiency underwent G6PD mutation testing, and six different genotypes were identified, including c.95A &gt; G, c.392G &gt; T, c.1024C &gt; T, c.1311C &gt; T, c.1376G &gt; T, c.1388G &gt; A, c.871G &gt; A/c.1311C &gt; T, c.392G &gt; T/c.1388G &gt; A, and c.1376G &gt; T/c.1311C &gt; T.65iciencyConclusionIn newborns in Yangjiang, G6PD deficiency, infection, and neonatal hemolytic disease were identified as the main causes of hyperbilirubinemia and acute bilirubin encephalopathy. Specifically, Hemolytic factors in infants with G6PD deficiency may lead to reduced hemoglobin and increased bilirubin levels in jaundiced infants.
Neuropsychological measures of post-COVID-19 cognitive status
Authors: Lauria Alessandra , Carfì Angelo , Benvenuto Francesca , Bramato Giulia , Ciciarello Francesca , Rocchi Sara , Rota Elisabetta , Salerno Andrea , Stella Leonardo , Tritto Marcello , Di Paola Antonella , Pais Cristina , Tosato Matteo , Janiri Delfina , Sani Gabriele , Lo Monaco Rita , Pagano Francesco C. , Fantoni Massimo , Bernabei Roberto , Landi Francesco , Bizzarro Alessandra ,   Gemelli Against COVID-19 Post-acute Care Group
Published: July 2023

BackgroundCOVID-19 may result in persistent symptoms in the post-acute phase, including cognitive and neurological ones. The aim of this study is to investigate the cognitive and neurological features of patients with a confirmed diagnosis of COVID-19 evaluated in the post-acute phase through a direct neuropsychological evaluation.MethodsIndividuals recovering from COVID-19 were assessed in an out-patient practice with a complete neurological evaluation and neuropsychological tests (Mini-Mental State Examination; Rey Auditory Verbal Test, Multiple Feature Target Cancellation Test, Trial Making Test, Digit Span Forward and Backward, and Frontal Assessment Battery). Pre- and post-COVID-19 global and mental health status was assessed along with the history of the acute phase of infection. Post-COVID-19 cognitive status was modeled by combining persistent self-reported COVID-related cognitive symptoms and pathologic neuropsychological tests.ResultsA total of 406 individuals (average age 54.5 ± 15.1 years, 45.1% women) were assessed on average at 97.8 ± 48.0 days since symptom onset. Persistent self-reported neurological symptoms were found in the areas of sleep (32%), attention (31%), and memory (22%). The MMSE mean score was 28.6. In total, 84 subjects (20.7%) achieved pathologic neuropsychological test results. A high prevalence of failed tests was found in digit span backward (18.7%), trail making (26.6%), and frontal assessment battery (10.9%). Cognitive status was associated with a number of factors including cardiovascular disease history, persistent fatigue, female sex, age, anxiety, and mental health stress.ConclusionCOVID-19 is capable of eliciting persistent measurable neurocognitive alterations particularly relevant in the areas of attention and working memory. These neurocognitive disorders have been associated with some potentially treatable factors and others that may stratify risk at an early stage.
Women health providers: materials on cures, remedies and sexuality in inquisitorial processes (15th–18th century)
Authors: Espina-Jerez Blanca , Siles-González José , Solano-Ruiz M. Carmen , Gómez-Cantarino Sagrario 
Published: July 2023

BackgroundThe first inquisitorial trials were against Muslims and Jews. Later, they focused on women, especially caregivers. Progressively, they were linked to witchcraft and sorcery because of their great care, generational and empirical knowledge. The historiography of health in the 15th–18th centuries still has important bibliographical and interpretative gaps in the care provided by women.ObjectiveTo analyse the care provided by healers as health providers, accused by the Inquisition, justifying the importance of nursing in the diversity of community care in the 15th–18th centuries.MethodA scoping review was conducted following the Dialectical Structural Model of Care (DSMC). A database search was conducted for the period 2013–2022. Bibliographic and legislative resources were used. Cases and convictions from Castilla la Nueva were found in the National Historical Archive and the Diocesan Archive of Cuenca.ResultsThe concepts of healer, witch and sorceress envolved during the study period. They reflect and reveal the collective imaginary of the social structure. They had healing laboratories, practised psychological and sexual care. They used to accompany their therapeutic action with prayers and amulets. They shared their professional activity with their main denouncers, doctors, apothecaries and priests. They were usually women in socially vulnerable situations, who did not conform to social stereotypes.ConclusionsThey were predecessors of today’s nursing, they overcame socio-cultural difficulties, although they were condemned for it. Healers did not manage to regulate their profession, but they acted as agents of health in a society that demanded them while participating in the “witch-hunt”.
Potential biomarker of brain response to opioid antagonism in adolescents with eating disorders: a pilot study
Authors: Stancil Stephani L. , Yeh Hung-Wen , Brucks Morgan G. , Bruce Amanda S. , Voss Michaela , Abdel-Rahman Susan , Brooks William M. , Martin Laura E. 
Published: July 2023

BackgroundEating Disorders (ED) affect up to 5% of youth and are associated with reward system alterations and compulsive behaviors. Naltrexone, an opioid antagonist, is used to treat ED behaviors such as binge eating and/or purging. The presumed mechanism of action is blockade of reward activation; however, not all patients respond, and the optimal dose is unknown. Developing a tool to detect objective drug response in the brain will facilitate drug development and therapeutic optimization. This pilot study evaluated neuroimaging as a pharmacodynamic biomarker of opioid antagonism in adolescents with ED.MethodsYouth aged 13–21 with binge/purge ED completed functional magnetic resonance imaging (fMRI) pre- and post-oral naltrexone. fMRI detected blood oxygenation-level dependent (BOLD) signal at rest and during two reward probes (monetary incentive delay, MID, and passive food view, PFV) in predefined regions of interest associated with reward and inhibitory control. Effect sizes for Δ%BOLD (post-naltrexone vs. baseline) were estimated using linear mixed effects modeling.ResultsIn 12 youth (16–21 years, 92% female), BOLD signal changes were detected following naltrexone in the nucleus accumbens during PFV (Δ%BOLD −0.08 ± 0.03; Cohen’s d −1.06, p = 0.048) and anterior cingulate cortex during MID (Δ%BOLD 0.06 ± 0.03; Cohen’s d 1.25, p = 0.086).ConclusionfMRI detected acute reward pathway modulation in this small sample of adolescents with binge/purge ED. If validated in future, larger trials, task-based Δ%BOLD detected by fMRI may serve as a pharmacodynamic biomarker of opioid antagonism to facilitate the development of novel therapeutics targeting the reward pathway, enable quantitative pharmacology trials, and inform drug dosing.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04935931, NCT#04935931.
Case report: Impact of hyperthyroidism on psychotic symptoms in schizophrenia comorbid with Graves’ disease
Authors: Sumi Yukiyoshi , Kawahara Sanae , Fujii Kumiko , Yamaji Mayu , Nakajima Kou , Nakamura Tsubasa , Horikawa Osamu , Fujita Yukihiro , Ozeki Yuji 
Published: July 2023

IntroductionAuditory hallucinations are the most common type of hallucinations observed in schizophrenia; however, visual hallucinations are not uncommon. In Graves’ disease, depression, hypomania, and psychosis can occur. While the association between Graves’ disease and psychosis has been explored, understanding of the specific impact of thyroid dysfunction severity on psychiatric symptom severity is limited. Here, we present a case report of a patient with schizophrenia comorbid with Graves’ disease whose psychotic symptoms were impacted by hyperthyroidism.CaseThe patient was a 32-year-old Japanese woman who presented with auditory and visual hallucinations, agitation, and pressured speech. The patient was diagnosed with schizophrenia comorbid with Graves’ disease and thyroid storm. The patient’s psychotic symptoms were found to be associated with fluctuations in thyroid hormone levels, and visual hallucinations were observed only during thyroid storms. Treatment involved dexamethasone, potassium iodide, bisoprolol fumarate, and methimazole for thyrotoxicosis, and a blonanserin transdermal patch, paliperidone, and paliperidone palmitate for psychotic symptoms. The patient’s auditory and visual hallucinations improved with antipsychotic treatment and decreased thyroid hormone levels.ConclusionThis case highlights the importance of monitoring thyroid function in patients with schizophrenia, particularly those with comorbid Graves’ disease. The correlation between psychiatric symptoms and thyroid hormone levels was demonstrated on an individual level over time, with symptoms worsening as thyroid hormone levels increased. Additionally, our case suggests that abnormally high thyroid hormone levels may trigger visual hallucinations in individuals with schizophrenia. Further studies are needed to elucidate the underlying mechanisms and potential treatment implications of this association.
An ecological study on reinfection rates using a large dataset of RT-qPCR tests for SARS-CoV-2 in Santiago of Chile
Authors: Acuña-Castillo Claudio , Barrera-Avalos Carlos , Bachelet Vivienne C. , Milla Luis A. , Inostroza-Molina Ailén , Vidal Mabel , Luraschi Roberto , Vallejos-Vidal Eva , Mella-Torres Andrea , Valdés Daniel , Reyes-López Felipe E. , Imarai Mónica , Rojas Patricio , Sandino Ana María 
Published: July 2023

IntroductionAs the SARS-CoV-2 continues to evolve, new variants pose a significant threat by potentially overriding the immunity conferred by vaccination and natural infection. This scenario can lead to an upswing in reinfections, amplified baseline epidemic activity, and localized outbreaks. In various global regions, estimates of breakthrough cases associated with the currently circulating viral variants, such as Omicron, have been reported. Nonetheless, specific data on the reinfection rate in Chile still needs to be included.MethodsOur study has focused on estimating COVID-19 reinfections per wave based on a sample of 578,670 RT-qPCR tests conducted at the University of Santiago of Chile (USACH) from April 2020 to July 2022, encompassing 345,997 individuals.ResultsThe analysis reveals that the highest rate of reinfections transpired during the fourth and fifth COVID-19 waves, primarily driven by the Omicron variant. These findings hold despite 80% of the Chilean population receiving complete vaccination under the primary scheme and 60% receiving at least one booster dose. On average, the interval between initial infection and reinfection was found to be 372 days. Interestingly, reinfection incidence was higher in women aged between 30 and 55. Additionally, the viral load during the second infection episode was lower, likely attributed to Chile's high vaccination rate.DiscussionThis study demonstrates that the Omicron variant is behind Chile's highest number of reinfection cases, underscoring its potential for immune evasion. This vital epidemiological information contributes to developing and implementing effective public health policies.
Multi-beam X-ray optical system for high-speed tomography using a σ-polarization diffraction geometry
Authors: Voegeli Wolfgang , Liang Xiaoyu , Shirasawa Tetsuroh , Arakawa Etsuo , Hyodo Kazuyuki , Kudo Hiroyuki , Yashiro Wataru 
Published: July 2023

Abstract
A multi-beam X-ray optical system using a σ-polarization diffraction geometry is proposed and its potential for high-speed tomography using synchrotron radiation is experimentally evaluated. Projection images of a sample are obtained simultaneously from different directions with X-ray beams generated by diffraction of a white synchrotron radiation beam at silicon single crystals. This makes it possible to record a tomographic dataset without rotation of the sample or X-ray source. Data sets of two samples obtained in a proof-of-principle experiment with an exposure time of 1 ms were successfully reconstructed using an advanced compressed-sensing algorithm.