bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and post-operative outcomes of surgery for fistula-in-ano managed at a tertiary care hospital in Sri Lanka: a retrospective study
Authors: Shivakumar Vinoprasath , Jayarajah Umesh , Samarasekera Dharmabandhu Nandadeva 
Published: September 2023

Objectives Management of fistula-in-ano is associated with recurrence and, occasionally, with anal incontinence. We investigated the clinical characteristics and outcomes of fistula-in-ano. Methods We included patients with fistula-in-ano managed at a tertiary care center (2016–2021). We collected clinical characteristics and 1-year outcomes using questionnaires. The chi-square test was used in statistical analysis. Results In total, 284 patients (231 men, 81.3%; median age 39.5 [range: 7–73] years) were included. Most patients had simple fistulae (n = 191, 67.3%). Transphincteric (n = 110, 38.7%) fistulae were the most common type, followed by intersphinteric fistulae (n = 103, 36.6%). Fistulotomy (n = 157, 55.3%) was the most common procedure. Follow-up details were traceable in 157 (55.3%) patients. At 1 year, the overall healing rate was 88.5% (n = 136). There was no association between type of surgical procedure and incontinence. The mean Vaizey score, used to assess anal incontinence, was 0.84 (range: 0–14). Incontinence was observed in 32 patients (20.9%), and flatus incontinence was the most common type (n = 17, 53.1%). Complex fistulae were associated with higher recurrence rates than simple fistulae (32.6% vs. 2.8%). Conclusion The healing rate in surgical treatment of fistula-in-ano was 88.5%, with acceptable complication rates. There was no association between surgical procedure type and incontinence.
Probucol neuroprotection against manganese-induced damage in adult Wistar rat brain slices
Authors: Del Rio Naiz Sarah Camboim , Varela Karina Giacomini , de Carvalho Diego , Remor Aline Pertile 
Published: September 2023

Manganese (Mn) is an abundant element used for commercial purposes and is essential for the proper function of biological systems. Chronic exposure to high Mn concentrations causes Manganism, a Parkinson's-like neurological disorder. The pathophysiological mechanism of Manganism remains unknown; however, it involves mitochondrial dysfunction and oxidative stress. This study assessed the neuroprotective effect of probucol, a hypolipidemic agent with anti-inflammatory and antioxidant properties, on cell viability and oxidative stress in slices of the cerebral cortex and striatum from adult male Wistar rats. Brain structure slices were kept separately and incubated with manganese chloride (MnCl2) and probucol to evaluate the cell viability and oxidative parameters. Probucol prevented Mn toxicity in the cerebral cortex and striatum, as evidenced by the preservation of cell viability observed with probucol (10 and 30 μM) pre-treatment, as well as the prevention of mitochondrial complex I inhibition in the striatum (30 μM). These findings support the protective antioxidant action of probucol, attributed to its ability to prevent cell death and mitigate Mn-induced mitochondrial dysfunction.
Low disease activity state associated with fewer incident vertebral fractures in Mestizo women with systemic lupus erythematosus
Authors: Mendoza-Pinto Claudia , Etchegaray-Morales Ivet , Munguía-Realpozo Pamela , Osorio-Peña Ángel David , Méndez-Martínez Socorro , Ramírez-Lara Edith , Zárate-Arellano Diana , Solis-Poblano Juan Carlos , Ayón-Aguilar Jorge , García-Carrasco Mario 
Published: September 2023

Background Low disease activity state (LDAS) has been linked to a significant reduction in flares and damage accrual in patients with systemic lupus erythematosus (SLE); however, the effect of LDAS on the risk of vertebral fractures (VFs) in subjects with SLE is unknown, considering that low bone mineral density (BMD) and VF are frequent in SLE. Objective to evaluate whether achieving LDAS ≥50% of the observation time prevents new VF and BMD changes in Mestizo women. Methods We carried out a longitudinal, observational, and retrospective study. Mestizo women with SLE were included for a median of an 8-year follow-up. LDAS was described as Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score ≤4, prednisone ≤7.5 mg/day, and stable immunosuppressive therapies. BMD measurements and lateral thoracic and lumbar radiographs for a semiquantitative analysis for VF were assessed at baseline and during the follow-up. Uni- and multivariable interval-censored survival regression models were carried out. Results We included 110 patients: 35 (31.8%) had new VF. A total of 56 patients (50.1%) achieved LDAS ≥50% of the time during the follow-up and achieved a significantly lesser risk of incident VF (HR = 0.16; 95% CI, 0.06–0.49). After adjusting by age, BMI, menopause, prevalent VF, baseline BMD, cumulative glucocorticoid use, and anti-osteoporotic therapy, LDAS-50 was significantly related to a decrease in the risk of a new VF (HR = 0.39; 95% CI, 0.16–0.98). There was no association between LDAS and BMD measurement changes. When only patients on LDAS but not in remission ( n = 43) were evaluated for the risk of incident VF, both uni- and multivariate analyses were significant (HR = 0.12; 95 CI, 0.04–47; p = 0.001, and HR = 0.26; 95% CI, 0.7–0.88; p = 0.03). Conclusions LDAS ≥50% of the time was significantly associated with a diminished risk of new VF in Mestizo women with SLE, even in patients not in remission. However, LDAS did not help modify BMD changes over time.
Development and Validation of Oro-Motor Sensory Training Module for Feeding Problems in Children with Autism Spectrum Disorder
Authors: Nivetha S , Geetha Arya , Ulaghanathan Navitha 
Published: September 2023

Purpose: To develop and validate an oro-motor/sensory training module for addressing feeding challenges in preschool-aged children with autism spectrum disorder. Method: The present qualitative study was carried out in three phases: conceptualization, development, and validation of the oro-motor sensory training module. A total of 30 participants (15 speech language pathologists [SLPs] and 15 occupational therapists) treating children with autism spectrum disorders with a minimum of 5 years of experience validated the developed module. Descriptive and inferential statistics were done to see the reliability of the validation. Results: The overall rating of both groups of validators showed excellent reliability. Positive feedback was obtained for the module from the validators. Conclusion: The module can be a resource for SLPs and other professionals.
Telehealth access, willingness, and barriers during the COVID-19 pandemic among a nationally representative diverse sample of U.S. adults with and without chronic health conditions
Authors: Le Randy , Mendez Izabelle , Ponce Stephanie A , Green Alexis , El-Toukhy Sherine , Nápoles Anna M , Strassle Paula D 
Published: September 2023

Introduction During the COVID-19 pandemic, telehealth services represented a critical tool in maintaining continuity and access to care for adults in the USA. However, despite improvements in access and utilization during the pandemic, disparities in telehealth utilization have persisted. It is unclear what role access and willingness to use telehealth play in telehealth disparities. Methods We used data from the nationally representative COVID-19's Unequal Racial Burden (CURB) survey, an online survey conducted between December 2020 and February 2021, n = 5500. Multivariable Poisson regression was used to estimate the prevalence of perceived telehealth access and willingness to use telehealth services among adults with and without chronic conditions. Results Overall, 60.1% of adults with and 38.7% of adults without chronic conditions reported having access to telehealth. After adjustment, adults with chronic conditions were more likely to report telehealth access (adjusted prevalence ratio [aPR] = 1.35, 95% confidence interval [CI] = 1.21–1.50). Most adults with and without chronic conditions reported being willing to use telehealth services (85.1% and 79.8%, respectively), and no significant differences in willingness were observed across chronic condition status (aPR = 1.03, 95% CI = 0.95–1.13). Perceived telehealth access appeared to be a predictor of telehealth willingness in both groups (chronic conditions: aPR = 1.22, 95% CI = 0.97–1.54; no chronic conditions: aPR = 1.37, 95% CI = 1.22–1.54). The prevalence of perceived barriers to telehealth was low, with the majority reporting no barriers (chronic conditions = 51.4%; no chronic conditions = 61.4%). Discussion Perceived access to telehealth was associated with telehealth willingness. Investing in approaches that increase telehealth accessibility and awareness is needed to improve access to telehealth for adults with and without chronic conditions.
Evaluating the dynamic thermal sensitivities of human body with high-dense contacting thermal stimuli
Authors: Zhou Yijia , Luo Maohui , Yu Hang , Zhou Xiang 
Published: September 2023

Existing research have explored thermal sensitivity under steady thermal conditions while how it changes with time is unknown. In this study, the arm and face were taken as examples to study dynamic characteristics of thermal sensitivity. The test spots were stimulated under thermally neutral ambient conditions to obtain skin temperature and thermal sensation at three levels (e.g. the micro-scale (1.54 cm2) spot, local body part and whole body) at intervals of 4 s. Results showed that in the first 4 s of stimuli, skin temperature change would reach 52% of the final variation. The overshooting rate of the arm thermal sensitivity was 1.6 and 1.8 times over the stable state for cooling and heating stimuli, and that of the face was 1.9 and 2.0 times. 95% of subjects on the arm and 85% on the face were more sensitive to cooling stimuli. The warmth sensitivities of different genders and body parts were shown to be significantly different, while the cold sensitivity of different body parts produced small differences. When stimulating one test spot, the ratio of thermal sensation at three levels was 15:4:1 on the arm and 16:3:1 on the face. These results can help to understand how the body responds to spatially ununiform and temporally unsteady thermal exposures.
Risk of appendiceal malignancy in conservatively treated acute appendicitis
Authors: Ramadan Shaima , Buchwald Pamela , Olsson Åsa 
Published: September 2023

Background and aims: Appendectomy has historically been the standard treatment of acute appendicitis, but lately, conservative treatment of uncomplicated acute appendicitis with antibiotics has successfully been used in selected patients. Complicated acute appendicitis is often treated conservatively initially, but may benefit from interval appendectomy due to the higher risk of appendiceal malignancy and recurrence. Recommendations for follow-up after conservatively treated appendicitis vary. Furthermore, the risk of underlying malignancy and the necessity of routine interval appendectomy are unclear. This study aims to evaluate follow-up status, recurrence, and underlying appendiceal malignancy in conservatively treated uncomplicated and complicated acute appendicitis. Methods: This study included patients with conservatively treated acute appendicitis at Skåne University Hospital, Sweden during 2012–2019. Information on patient demographics at index admission and data on follow-up, recurrence, number of appendectomies after initial conservative treatment, and underlying malignancy were retrieved from medical charts. Results: The study cohort included 391 patients, 152 with uncomplicated and 239 with complicated acute appendicitis. Median time of study follow-up was 52 months. The recurrence risk was 23 (15.1%) after uncomplicated and 58 (24.3%) after complicated acute appendicitis ( p = 0.030). During follow-up, 55 (23%) patients with complicated acute appendicitis underwent appendectomy. Appendiceal malignancies were found in 12 (5%) patients with previous complicated acute appendicitis versus no appendiceal malignancies after uncomplicated acute appendicitis ( p = 0.002). Conclusion: The risk of appendiceal malignancy and recurrent appendicitis was significantly higher in patients with complicated acute appendicitis compared with uncomplicated acute appendicitis.
Accuracy of MRI in Assessment of High-Grade Partial Distal Biceps Tears
Authors: Schmidt Gregory J. , Fischer James P. , Hoyer Reed W. , Greenberg Jeffrey A. , Crosby Nicholas E. 
Published: September 2023

Background: Magnetic resonance imaging (MRI) is commonly used to diagnose and assess the extent of partial distal biceps injuries. The aim of this study was to report on the accuracy of MRI and the effect of injury history and study timing on its performance. Methods: A retrospective review of all patients who underwent surgical treatment of partial thickness distal biceps tears at a single center by multiple surgeons was performed. Inclusion criteria consisted of the performance of a preoperative MRI and documentation of the intraoperatively visualized extent of the tear, and 68 patients met the criteria for inclusion. A chart review was completed to evaluate the symptom duration, injury history, and tear extent. Results: All patients had distal biceps tears of greater than 50% intraoperatively. However, MRI did not indicate any tearing in 20 (29%) patients, and its sensitivity for high-grade tear was 44%. Magnetic resonance imaging was significantly less likely to be read as high-grade tears in patients with insidious onset of their symptoms in comparison with patients who reported a traumatic onset (27% vs 55%, P = .024). However, the time from symptom onset to MRI did not significantly correlate with diagnosis of a high-grade tear on MRI ( r = −0.15, P = .21). Conclusions: These results indicate that MRI can underreport partial distal biceps tear extent, and this more commonly occurs in patients with insidious onset of pain.
Anti-neutrophil cytoplasmic antibody associated vasculitis following rituximab: Outcomes of 50 patients in a tertiary single centre
Authors: Alenzi Fahidah , Sangle Shirish R , D’Cruz David P 
Published: September 2023

Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an uncommon condition with heterogeneous multisystem organ involvement and significant morbidity and mortality. This study aimed to characterize the clinical features and laboratory characteristics, including B cell depletion, the ability to reduce corticosteroid dosage, and outcomes, of patients with AAV following rituximab treatment. Methods: Retrospective clinical and laboratory data were collected from patients with AAV who visited our lupus unit, including 50 treated with rituximab. Numeric response variables (median and range) were collected, including age, follow-up duration, disease duration, and Birmingham Vasculitis Activity Score (version 3). Statistical analyses were conducted using the SPSS 25.0 software. Statistical significance was considered a p-value <.05. Results: Of the 50 patients, 40 (80%) had granulomatosis with polyangiitis, 30 (75%) achieved remission, and 10 (25%) had active disease. Fifteen patients (30%) had positive ANCA levels at their last ANCA level assessment follow-up. Thirty-seven patients (74%) had B cell depletion, and 30 (81.1%) were in remission. Their median immunoglobulin levels were 7.6 (2.7–21.2) g/L for IgG, 0.5 (0.07–1.71) g/L for IgM, and 1.83 (0.14–4.87) g/L for IgA. Forty-two patients (84%) were able to lower their steroid dose to <7.5 mg, with 36 (85.7%) in remission and six (14.3%) having active disease ( p = .003). Conclusion: Our data suggests that most patients experience clinical remission after rituximab maintenance treatment. Half the patients were in remission, with normal creatinine levels and inflammatory markers. In addition, our patients could reduce steroid use.
Warm-up exercises reduce music conservatoire students’ pain intensity when controlling for mood, sleep and physical activity: A pilot study
Authors: Austen Claire , Redman Drusilla , Martini Matteo 
Published: September 2023

Introduction Playing-related musculoskeletal pain is highly prevalent among classical music students, affecting them physically and psychologically. Unlike athletes or dancers, musicians’ pain often goes untreated due to stigma and lack of specialised healthcare. While warm-up exercises are common practice in sports and dance, there is a lack of empirical research regarding physical warm-ups for musicians’ pain. This study aimed to investigate the effects of a 2-week daily warm-up exercise intervention on conservatoire students’ pain intensity, interference and psychological distress, at day 0 and after 2 weeks. Methods Two groups were considered: an exercise ( n = 9) and a waitlist control ( n = 7) group. Data were collected using online Qualtrics surveys at three different stages. Results 2 × 2 mixed ANOVAs indicated no significant effects on any of the outcome variables. However, when controlling for sleep, anxiety, depression and physical activity, the analyses revealed a significantly greater decrease in pain intensity in the exercise group compared to the control. In addition, bivariate correlations indicated that pain interference, anxiety and depression delta scores were significantly correlated for the exercise but not the control group. Anxiety and pain intensity delta scores were significantly correlated in both groups. Conclusions These findings suggest that daily warm-up exercises have the potential to reduce musicians’ pain intensity but only if certain variables are factored in. This pilot study highlights the multifactorial nature of musicians’ pain and unveils the role that mood, sleep and physical activity level may have when assessing the efficacy of interventions based on warm-up exercises.
Interventions for malaria prevention in pregnancy; factors influencing uptake and their effect on pregnancy outcomes among post-natal women in a tertiary facility in the Volta Region of Ghana
Authors: Ampofo Gifty Dufie , Ahiakpa Abraham Kwadzo , Osarfo Joseph 
Published: September 2023

Objectives: Malaria in pregnancy is associated with adverse pregnancy outcomes including maternal anaemia and low birthweight. Uptake of preventive interventions is sub-optimal in sub-Saharan Africa including Ghana. Understanding local-level factors that influence uptake of these interventions can enhance control. The study assessed uptake of intermittent preventive treatment of malaria during pregnancy using sulphadoxine-pyrimethamine (IPTp-SP) and insecticide-treated net (ITN) use, their determinants and effects on pregnancy outcomes. Methods: A cross-sectional study involving 349 post-partum women was conducted from 25 August 2022 to 9 October 2022 at the Ho Teaching Hospital. A structured questionnaire was used to collect data on participant socio-demographics, ITN use, number of doses of sulphadoxine-pyrimethamine received, knowledge of malaria in pregnancy, haemoglobin levels and birth weight among others. Summary statistics were reported as frequencies, percentages and means. Associations between exposure and outcome variables were assessed using logistic regression methods and odds ratios reported with 95% confidence intervals. Statistical significance was concluded at p < 0.05. Results: More than 80% (291) of respondents received ⩾3 doses of intermittent preventive treatment using sulphadoxine-pyrimethamine and 64.8% (226) slept under ITNs the night before the survey. Age >25 years, employment, good knowledge of malaria in pregnancy, parity ⩾2 and initiating antenatal care visits in the first trimester facilitated the uptake of these interventions. Receiving ⩾3 doses of sulphadoxine-pyrimethamine was associated with having normal-weight babies (adjusted odds ratio 2.80, 95% CI: 1.07, 7.34; p = 0.036) while ITN use was associated with having term babies (adjusted odds ratio 2.72, 95% CI: 1.24, 5.90; p = 0.013) and normal maternal haemoglobin concentration at term (adjusted odds ratio 1.57, 95% CI: 1.01, 2.47; p = 0.044). Conclusions: The interventions were beneficial against low birthweight and preterm births which predispose to neonatal deaths and poor cognitive function in children. Malaria in pregnancy health campaigns should be intensified, especially among younger-aged primigravidae, to increase their knowledge of the condition as a way to further improve uptake of these preventive interventions.
Stand-Alone Anchored Spacer vs Anterior Plate Construct in the Management of Adjacent Segment Disease after Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis of Comparative Studies
Authors: Aldahamsheh Osama , Alhammoud Abduljabbar , Halayqeh Sereen , Jacobs W. Bradley , Thomas Kenneth C. , Nicholls Fred , Evaniew Nathan 
Published: September 2023

Study Design Systematic Review and Meta-Analysis. Objectives This study aimed to evaluate the clinical and radiological outcomes of surgically treated adjacent segment disease (ASDis) following ACDF with either anterior plate construct (APC) or stand-alone anchored spacers (SAAS). Method Multiple databases were searched until December 2022 for pertinent studies. The primary outcome was health-related quality of life outcomes [JOA, NDI, and VAS], whereas, the secondary outcomes included operative characteristics [estimated blood loss (EBL) and operative time (OT)], radiological outcomes [C2-C7 Cobb angle, disc height index (DHI) changes, fusion rate], and complications. Results A total of 5 studies were included, comprising 210 patients who had been surgically treated for cervical ASDis. Among them, 113 received APC, and 97 received SAAS. Postoperative dysphagia was significantly higher in the APC group [47% vs 11%, OR = 7.7, 95% CI = 3.1-18.9, P < .05]. Similarly, operative time and blood loss were higher in the APC group compared to the SAAS group; [MD = 16.96, 95% CI = 7.87-26.06, P < .05] and [MD = 5.22, 95% CI = .35 - 10.09, P < .05], respectively. However, there was no difference in the rate of prolonged dysphagia and clinical outcomes in terms of JOA, NDI, and VAS. Furthermore, there was no difference in the radiological parameters including the C2-7 Cobb angle and DHI as well as the fusion rate. Conclusion Our meta-analysis demonstrated that both surgical techniques (APC and SAAS) are effective in treating ASDis. However, with low certainty of the evidence, considering patients are at high risk of dysphagia following revision cervical spine surgery SAAS may be the preferred choice.
Splenic iron decreases without change in volume or liver parameters during luspatercept therapy
Authors: Denton Christopher C. , Vodala Sadanand , Veluswamy Saranya , Hofstra Thomas C. , Coates Thomas D. , Wood John C. 
Published: September 2023

Abstract
Splenic iron decreased whereas liver iron was stable during luspatercept therapy in some individuals with thalassemia. This suggests a reduction of ineffective erythropoiesis changes the organ distribution of iron and demonstrates that liver iron concentration alone may not accurately reflect total body iron content. This article describes data from subjects enrolled in BELIEVE (NCT02604433) and BEYOND (NCT03342404).