bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cortical thickness and diffusion tensor imaging in patients with neuropsychiatric systemic lupus erythematosus, with normal structure on brain MRI
Authors: Liang Shao-Yen , Wu Yi-Ying , Chang Ni-Jung , Lai Kuo-Lung , Chen Hsian-Min , Chen Hung-Chieh , Ouyang Yen-Chieh , Chen Yi-Ming , Chai Jyh-Wen 
Published: February 2023

Objectives Neuropsychiatric systemic lupus erythematosus (NPSLE) is associated with adverse outcomes; however, imaging abnormalities are only detectable by conventional brain magnetic resonance imaging (MRI) in up to 50% of patients. This study investigated the variability in cortical thickness and diffusion tensor imaging (DTI) parameters among patients with NPSLE whose brain morphology appeared normal on conventional MRI. Methods This retrospective study enrolled 27 female patients with NPSLE (median age: 41.0 years, range: 22–63 years) and 34 female healthy controls (median age: 37.0 years, range: 24–55 years). None exhibited evident abnormalities on conventional MRI. Regional volumes, cortical thickness, and DTI parameters, including fractional anisotropy (FA) and mean diffusivity (MD), were compared. Age-adjusted multivariable logistic regression analysis was conducted to detect significant NPSLE-associated differences. Results No significant differences in grey or white matter volume fractions were observed between the groups. However, the NPSLE group demonstrated significant cortical thinning in the right pars opercularis (2.45 vs 2.52 mm, p = 0.007), reduced FA values in the fornix (0.35 vs 0.40, p = 0.001) and left anterior limb of internal capsule (0.50 vs 0.52, p = 0.012), and increased MD in the fornix (1.71 vs 1.48, p = 0.009) and left posterior corona radiata (0.80 vs 0.76, p = 0.005) compared with those of healthy controls. Conclusions Cortical thickness measurements and DTI analyses can be used to detect differential variations in patients with NPSLE who exhibit an otherwise normal brain structure on conventional MRI, indicating the existence of subtle changes despite the absence of obvious macrostructural central nervous system involvement of lupus.
Early literacy experiences of two children during Covid-19 lockdown in South Africa: A semi- ethnographic study
Authors: Nkomo Sibhekinkosi Anna , Magxala Xoliswa Patience , Lebopa Nicholas 
Published: February 2023

As the world came to grips with the coronavirus diseases (COVID-19), educational institutions and the society at large faced the challenge of figuring out how to continue with teaching and learning in such a context. Many countries, including South Africa made efforts to help contain and suppress the spread of Covid-19. In the South African education sector, about 13 million learners and 440 000 teachers were released before the end of the first school term in March 2020. In addition, 30 000 Early Childhood Development (ECD) centres, about 100 000 teachers were also required to end their term before the official closing date. For many young learners, the lockdown period meant that they would be at home with (a) Limited access to age appropriate, fun and explicitly educational resources to play with as many shops considered resources that could be used to develop children’s sensory skills as not essential goods (b) They had limited exposure to structured learning and play as most caregivers are not qualified ECD practitioners (c) Children could not play outside, visit playgrounds and parks, yet, freedom of movement, activity and exercise is important for every child’s development and young children learn best through play and experimenting (d) Most of their curriculum content cannot be fully taught using online platforms. Given this background, through a semi-ethnographic study, the paper documents the early literacy experiences of two 3 year old children during the Covid-19 lockdown in South Africa. In addition, analysis of parents or caregivers’ feedback about their experiences in providing assistance to the young learners during the lockdown is presented. Findings of the study show that in both research contexts, literacy practices were different, but not lesser. Challenging as it was for the caregivers to support the development of literacy, the home environment provided many opportunities for learning.
Self-Efficacy and Readiness to Change Among Women with Recent Gestational Diabetes Engaging in a Web-Based Lifestyle Intervention: The Balance After Baby Intervention Trial
Authors: Saxon Cara E. , Seely Ellen W. , Bertin Kaitlyn B. , Suresh Krithika , Skurnik Geraldine , Roche Andrea T. , Schultz Claire , Blair Rachel A. , Nicklas Jacinda M. 
Published: February 2023

Few evidence-based programs exist to help women with a history of gestational diabetes reduce their risk of developing type 2 diabetes. In secondary analyses from a randomized clinical trial of a web-based lifestyle intervention program for postpartum women with recent gestational diabetes, we studied changes in self-efficacy for diet and physical activity and readiness to change health behaviors. Women were randomized at ∼6 weeks postpartum and completed questionnaires at 6 weeks and 6, 12, 18, and 24 months. Our study included 181 women (mean age 32.4 ± 5.2 years; 48% White, 19% Asian, 14% Black or African American, 17% other/mixed race; 34% Hispanic). In a linear mixed effects model, women in the intervention had significantly greater improvement in overall self-efficacy scores for physical activity compared with the control group at 24 months (difference in change scores between groups .35, 95% CI: .03 to .67, P = .03). The intervention group also demonstrated significantly greater improvement in self-efficacy scores for both physical activity subdomains, specifically “sticking to it” at 24 months and “making time” at 12 months. Participants in the intervention did not experience a significant difference in change in self-efficacy for diet or readiness to change compared with those in the control arm.
Infected popliteal pseudoaneurysm in a youth basketball player: A case report and brief review of the literature
Authors: Lavigne Alexandre , Ghali Rafik , Grimard Guy , Dubois Josée , Tapiero Bruce 
Published: February 2023

Introduction An infected popliteal pseudoaneurysm has never been described in the pediatric population. Physicians need to be aware of its presentation and management, in order to diagnose and treat this medical condition adequately. Methods We describe the case of a 14-year-old boy who developed myositis and cellulitis centered at the popliteal fossa after playing basketball. A treatment of intravenous cefazolin was started. 5 days later, he experienced a knee pain flare-up, which turned out to be a popliteal pyomyositis with a pseudoaneurysm of the popliteal artery. A saphenous vein graft bypass of the popliteal artery and an excision of the popliteal pseudoaneurysm were performed. Intravenous cefazolin was continued for 6 weeks and prophylactic acetylsalicylic acid for 6 months. Results and conclusion This case highlighted the importance of repeating radiologic investigations if a patient suffering from soft tissue infection has persistent pain after several days of appropriate antibiotics. A popliteal pseudoaneurysm can be diagnosed with ultrasound imaging and treated with a popliteal-popliteal bypass. Our patient needed a catheter-guided dilation of the anastomosis at the vein graft 6 months post-surgery, and then evolved favorably and went back to playing basketball 6 months post-dilation.
A rare case of bilateral isolated internal iliac artery aneurysms excluded with VBX covered stents
Authors: Ciofani Lorenzo , Massi Ilaria , Acciarri Pierfilippo 
Published: February 2023

Objective Isolated aneurysms of the internal iliac arteries (IIIAA) are a rare variant of aorto-iliac aneurysms, representing only 0.3–0.5% of intra-abdominal aneurysms. Bilateral isolated hypogastric artery aneurysms are even more rare. The rarity of IIIAA has determined the absence of a high level of evidence about its treatment. Method We present a case of bilateral isolated internal iliac artery aneurysms treated in two stages by positioning GORE VIABAHN VBX Balloon Expandable Endoprosthesis large, chosen for the possibility to adapt it to the anatomical diameter variations between the hypogastric artery and the posterior trunk, which was the distal landing zone chosen in both sides. Conclusion and results Total patency was detected 1 year after surgery in both sides. No buttock claudication, erectile dysfunction and/or signs of bowel ischaemia were referred. Preserving the hypogastric flow is an important goal in isolated hypogastric arteries aneurysms’ treatment and covered stenting surely represents a valid therapeutical choice.
A pilot study to validate AMTAS in a specialist outpatient clinic at a public restructured hospital in Singapore
Authors: Yeo Kai Hui Hazel , Chua Wei De Kenneth , Kamath Savitha Hosangadi , Lee Steven Lock Hey 
Published: February 2023

Background The prevalence of age-related hearing loss is expected to increase with the ageing population in Singapore resulting in increased demand for pure tone audiometry (PTA). One way of meeting the increased demand for PTA is the Automated Method of Testing Auditory Sensitivity (AMTAS). Nonetheless, before AMTAS may be implemented, it is important to validate its results by comparing them against those of conventional PTA for the diverse Singaporean population. Methods 100 participants were recruited from the Otorhinolaryngology clinic at a public hospital. PTA was conducted for participants via the conventional method and AMTAS. The hearing thresholds obtained via the two methods were then compared. A feedback questionnaire on the use of AMTAS was also completed by all participants. Results Air and bone conduction threshold results from 80 participants were analysed. The absolute mean difference in air conduction thresholds obtained via the two methods ranged from 3.30 to 9.62 dB. The absolute mean difference in bone conduction thresholds obtained via the two methods ranged from 8.16 to 9.38 dB. Most participants indicated that the machine was easy to use. Other feedback collected indicated that the AMTAS testing environment was noisy and that testing was fast. Conclusion This study finds that despite differences in hearing thresholds obtained via AMTAS and manual PTA, these differences are within the acceptable 10 dB test-retest variation. Nonetheless, existing issues related to the AMTAS software and noise levels in the testing environment will need to be addressed before it can be used in the clinic.
Association between adherence to the Mediterranean Diet and the Eatwell Guide and changes in weight and waist circumference in post-menopausal women in the UK Women’s Cohort Study
Authors: Best Nicola , Flannery Orla 
Published: February 2023

Objective This study investigated the associations between adherence to the Mediterranean Diet and the Eatwell Guide (EWG) and changes in weight and waist circumference in post-menopausal women. Study Design Post-hoc analysis of post-menopausal women from the UK Women’s Cohort Study. Main outcome measures Changes in weight, waist circumference and the risk of abdominal and general obesity. Results 4162 post-menopausal women were selected. Higher adherence to both the EWG and the Mediterranean Diet was associated with smaller increases in waist circumference over 4 years (EWG: β −0.47, CI −0.75, −0.20 per 1 tertile increase in score), (Mediterranean Diet: β −0.29, CI −0.58, −0.01 per 1 tertile increase in score); and lower risk of abdominal obesity (EWG: OR 0.55, CI 0.43, 0.70 third versus the first tertile), (Mediterranean Diet: OR 0.60, CI 0.46, 0.76 third versus the first tertile), but was not associated with weight changes (EWG: β 0.14, CI −0.07, 0.36 per 1 tertile increase in score), (Mediterranean Diet: β 0.03, CI −0.19, 0.25 per 1 tertile increase in score) or risk of becoming overweight or obese (EWG: OR 1.09, CI 0.77, 1.52 third versus the first tertile), (Mediterranean Diet: OR 0.91, CI 0.65, 1.27 third versus the first tertile). Conclusions The results suggest that adherence to either the Mediterranean Diet or the EWG can help to prevent abdominal obesity in post-menopausal women.
Effect of Velopharyngeal Insufficiency on Long-Term Patient-Reported Sleep-Related Impairment in Patients With Cleft Palate
Authors: Harshini Malapati Sri , Oberoi Michelle K. , Bertrand Anthony A. , Chin Patrick , Caprini Rachel M. , Chan Candace H. , Pfaff Miles J. , Wilson Libby F. , Lee Justine C. 
Published: February 2023

Objective: Velopharyngeal insufficiency (VPI) surgery in patients with cleft palate increases the risk for airway obstruction acutely. However, the long-term effects of VPI surgery on airway obstruction are unknown. In this work, we prospectively evaluated patient-reported sleep-related impairment scores as a screening tool for airway obstruction in patients with cleft palate (CP). Methods: Patients with CP > 14 years of age from 2 institutions were prospectively administered the Patient Reported Outcomes Measurement Information Systems sleep-related impairment short form. Patient characteristics, medical, and surgical histories were reviewed. Multivariable linear regression analyses were performed to assess the contribution of independent variables to sleep-related impairment scores. Results: Forty-four patients (mean age 20.5 ± 4.7 years) were included. Twenty-three patients (52.3%) were diagnosed with VPI. Seventeen patients (38.6%) underwent VPI surgery, of whom 14 patients (82.4%) were treated with sphincter pharyngoplasties at a mean age of 7.7 ± 4.1 years. Multivariable linear regression models to control for variables that could influence sleep-related impairment such as body mass index (BMI) ≥25 were developed to evaluate the contribution of VPI and VPI treatment. The diagnosis of VPI (β = .52, P = .004), VPI surgery (β = .48, P = .008), and sphincter pharyngoplasty (β = .47, P = .011) were found to independently predict sleep-related impairment in each of the respective regression models. Conclusions: A history of VPI, any type of VPI surgery, or sphincter pharyngoplasty were separately and independently predictive of patient-reported sleep-related impairment long-term. These data suggest that longitudinal airway obstruction screening in patients with cleft palate and VPI deserves consideration.
Pentafecta outcomes of robotic laparoscopically assisted radical prostatectomy during the initial experience in a university hospital
Authors: Cachoeira Eduardo Tosetto , de Oliveira Paludo Artur , Knijnik Pedro Glusman , Brum Pietro Waltrick , Burttet Lucas Medeiros , Berger Milton , Silva Neto Brasil 
Published: February 2023

Abstract
Background
Robotic laparoscopically assisted radical prostatectomy (RARP) is an option for the treatment of localized prostate cancer. The objective of the present study was to evaluate the pentafecta outcomes (biochemical recurrence, continence, potency, surgical complications and surgical margins) in patients undergoing RARP during the initial experience in a university hospital.

Methods
This is a retrospective study of patients who had RARP for localized prostate adenocarcinoma at a university hospital from August 2013 to October 2019 to evaluate pentafecta outcomes (biochemical recurrence, continence, potency, surgical complications and surgical margins). Data were collected and stored via Microsoft Office Excel program and analyzed using SPSS Software, version 20.0.

Results
One hundred and sixty-three RARP were performed, the mean age is 64.16 ± 6.54 years, PSA 6.20 (IQR = 4.91–8.95) ng/dl, BMI 27.14 (IQR = 24.22–29.26) kg/m2, D’Amico risk classification was 35 (22.3%) low risk, 81 (51.6%) intermediate risk and 41 (26.1%) high risk. One hundred and fifty-four patients entered the analysis of pentafecta with a rate of 38.3% reaching this outcome. Complications: Twenty-three (14.1%) patients had minor complications (Clavien I and II) and eight patients had major complications (Clavien IIIa, IIIb and IVa). Surgical margins were negative in 69.9% of patients. The biochemical recurrence-free rate was 89.5%. The overall continence rate was 93.5%, and the potency rate was 63.5%. Multivariate analysis showed that T2 patients are 2.7 times more likely to achieve pentafecta outcome than patients ≥ T3 (p < 0.05), while younger age and lower BMI data were found as a protective factor with RR of 0.95 and 0.94, respectively.

Conclusions
Preliminary pentafecta outcome of RARP in this university hospital is promising.
Low-dose pleiotropic radiosensitive nanoformulations for three-pronged radiochemotherapy of hypoxic brain glioblastoma under BOLD/DWI monitoring
Authors: Zhao Fangshi , Wang Xiaoyi , Zhu Wei , Zhao Dongju , Ye Caihua , Guo Yanyan , Dou Yan 
Published: February 2023

Abstract
Background
Hypoxia-mediated radioresistance is the main obstacle to the successful treatment of glioblastoma (GBM). Enhancing hypoxic radiosensitivity and alleviating tumor hypoxia are both effective means to improve therapeutic efficacy, and the combination of the two is highly desirable and meaningful.

Results
Herein, we construct a low-dose pleiotropic radiosensitive nanoformulation consisting of a high-Z atomic nanocrystal core and mesoporous silica shell, surface-modified with angiopep-2 (ANG) peptide and loaded with nitric oxide (NO) donor and hypoxia-activated prodrug (AQ4N). Benefiting from ANG-mediated transcytosis, this nanoformulation can efficiently cross the BBB and accumulate preferentially in the brain. Low-dose radiation triggers this nanoformulation to exert a three-pronged synergistic therapeutic effect through high-Z-atom-dependent dose deposition enhancement, NO-mediated hypoxia relief, and AQ4N-induced hypoxia-selective killing, thereby significantly inhibiting GBM in situ growth while prolonging survival and maintaining stable body weight in the glioma-bearing mice. Meanwhile, the proposed in vivo 9.4 T BOLD/DWI can realize real-time dynamic assessment of local oxygen supply and radiosensitivity to monitor the therapeutic response of GBM.

Conclusions
This work provides a promising alternative for hypoxia-specific GBM-targeted comprehensive therapy, noninvasive monitoring, and precise prognosis.

Graphical Abstract
Antibiotic resistance pattern, capsular types, and molecular characterization of invasive isolates of Streptococcus pneumoniae in the south of Tunisia from 2012 to 2018
Authors: Ktari Sonia , Ben Ayed Nourelhouda , Ben Rbeh Imen , Garbi Nourhène , Maalej Sonda , Mnif Basma , Rhimi Faouzia , Hammami Adnene 
Published: February 2023

Abstract
Background
Streptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide. In this study, we sought to analyze serotype distributions, antibiotic resistance, and genetic relationships of 106 clinical invasive pneumococcal isolates recovered in Tunisia between 2012 and 2018, prior to the routine use of pneumococcal conjugate vaccines (PCV).

Methods
We used multiplex PCR, the disk diffusion method and/or E-test, and multi-locus sequence typing (MLST).

Results
The most frequent serotypes were 14 (17%), 19F (14.2%), and 3 (11.3%). Of the 106 S. pneumoniae isolates, 67.9% were penicillin non-susceptible (29.4% were resistant), 45.3% were amoxicillin non-susceptible (17% were resistant), and 16% were cefotaxime non-susceptible. For antibiotics other than β-lactams, resistance rates to erythromycin, tetracycline, cotrimoxazole, and chloramphenicol were 62.3, 33, 22.6, and 4.7%, respectively. Two isolates were non-susceptible to levofloxacin. Among 66 erythromycin-resistant pneumococci, 77.3% exhibited the cMLSB phenotype, and 87.9% carried ermB gene. All tetracycline-resistant strains harbored the tetM gene. The potential coverage by 7-, 10-, and 13-valent pneumococcal conjugate vaccines were 55.7, 57.5, and 81.1%, respectively. A multilocus sequence typing analysis revealed great diversity. Fifty different sequence types (STs) were identified. These STs were assigned to 10 clonal complexes and 32 singletons. The most common STs were 179, 2918, 386, and 3772 – related mainly to 19F, 14, 6B/C, and 19A serotypes, respectively.

Conclusions
This study demonstrated that the majority of the serotypes of invasive pneumococci in the Tunisian population were 14, 19F, and 3. Moreover, we noted a high degree of genetic diversity among invasive S. pneumoniae isolates. The highest proportions of antibiotic non-susceptible isolates were for penicillin, erythromycin, and tetracycline. Further molecular characteristics are required to monitor the genetic variations and to follow the emergence of resistant pneumococci for the post-vaccination era in Tunisia.
Primary and secondary data in emergency medicine health services research – a comparative analysis in a regional research network on multimorbid patients
Authors: Schneider Anna , Wagenknecht Andreas , Sydow Hanna , Riedlinger Dorothee , Holzinger Felix , Figura Andrea , Deutschbein Johannes , Reinhold Thomas , Pigorsch Mareen , Stasun Ulrike , Schenk Liane , Möckel Martin 
Published: February 2023

Abstract
Background
This analysis addresses the characteristics of two emergency department (ED) patient populations defined by three model diseases (hip fractures, respiratory, and cardiac symptoms) making use of survey (primary) and routine (secondary) data from hospital information systems (HIS). Our aims were to identify potential systematic inconsistencies between both data samples and implications of their use for future ED-based health services research.

Methods
The research network EMANET prospectively collected primary data (n=1442) from 2017-2019 and routine data from 2016 (n=9329) of eight EDs in a major German city. Patient populations were characterized using socio-structural (age, gender) and health- and care-related variables (triage, transport to ED, case and discharge type, multi-morbidity). Statistical comparisons between descriptive results of primary and secondary data samples for each variable were conducted using binomial test, chi-square goodness-of-fit test, or one-sample t-test according to scale level.

Results
Differences in distributions of patient characteristics were found in nearly all variables in all three disease populations, especially with regard to transport to ED, discharge type and prevalence of multi-morbidity. Recruitment conditions (e.g., patient non-response), project-specific inclusion criteria (e.g., age and case type restrictions) as well as documentation routines and practices of data production (e.g., coding of diagnoses) affected the composition of primary patient samples. Time restrictions of recruitment procedures did not generate meaningful differences regarding the distribution of characteristics in primary and secondary data samples.

Conclusions
Primary and secondary data types maintain their advantages and shortcomings in the context of emergency medicine health services research. However, differences in the distribution of selected variables are rather small. The identification and classification of these effects for data interpretation as well as the establishment of monitoring systems in the data collection process are pivotal.

Trial registration
DRKS00011930 (EMACROSS), DRKS00014273 (EMAAGE), NCT03188861 (EMASPOT)