bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tongue necrosis secondary to giant cell arteritis, successfully treated with tocilizumab: a case report
Authors: Cho Young Min , El Khoury Lara , Paramo Jonathan , Horowitz Diane Michelle , Li Jian Yi , Kello Nina 
Published: May 2023

Abstracts
Background
Giant Cell Arteritis (GCA) is a large vessel vasculitis that most commonly presents with headache, scalp tenderness, jaw claudication, and vision changes. Various other, less common, manifestations have been reported in the literature such as scalp and tongue necrosis. Though most patients respond to corticosteroids, some cases of GCA are refractory to the high doses of corticosteroids.

Case presentation
We present a 73-year-old female with GCA refractory to corticosteroids presenting with tongue necrosis. This patient significantly improved with a dose of tocilizumab, an IL-6 inhibitor.

Conclusion
To the best of our knowledge, this is the first case report of a patient with refractory GCA presenting with tongue necrosis that had rapid improvement with tocilizumab. Prompt diagnosis and treatment can prevent severe outcomes such as tongue amputation in GCA patients with tongue necrosis, and tocilizumab may be effective for corticosteroid-refractory cases.
Percutaneous versus open posterior stabilization and decompression in AOSpine-type A3 thoracolumbar fractures with neurological deficit
Authors: Song Xin , Ren Donglin , Zhang Feng , Han Shuai , Wu Desheng , Wang Jian 
Published: May 2023

Abstract
Background
This retrospective cohort study aimed to compare the clinical and radiological outcomes between two treatment strategies focusing on non-osteoporotic AOSpine-type A3 fractures of the thoracolumbar spine with neurological deficits at levels T11 to L2.

Methods
In total, 67 patients between 18 and 60 years of age who were treated operatively with either of the two treatment strategies were included. One treatment strategy included open posterior stabilization and decompression, whereas the other was based on percutaneous posterior stabilization and decompression via a tubular retraction system. Demographic data, surgical variables, and further parameters were assessed. Patient-reported outcomes (PROs), including the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), and the American Spinal Injury Association (ASIA) impairment score, were measured to assess functional outcomes. The regional Cobb angle (CA), the anterior height ratio of the fractured vertebrae (AHRV), and the degree of canal encroachment (DCE) were assessed. The ASIA score was used to assess neurological function recovery. The follow-up period was at least 12 months.

Results
Surgical time and postoperative hospital stay were significantly shorter in the minimally invasive surgery (MIS) group. Intraoperative blood loss was significantly less in the MIS group. Regarding radiological outcome, CA and AHRV at the time of follow-up did not show a significant difference. DCE at the time of follow-up was significantly improved in the MIS group. Lower VAS scores and better ODIs were observed in the MIS group at the 6-month follow-up, but similar outcomes were observed at the 12-month follow-up. The ASIA score was similar between both groups at the 12-month follow-up.

Conclusions
Both treatment strategies are safe and effective; however, MIS could provide earlier pain relief and better functional outcomes compared with OS.
Varying degrees of spontaneous osteogenesis of Masquelet’s induced membrane: experimental and clinical observations
Authors: Yin Qudong , Chen Xueming , Dai Beichen , Liu Jun , Yang Ying , Song Sheng , Ding Yanping 
Published: May 2023

Abstract
Background
Masquelet’s induced membrane (IM) has osteogenesis activity, but IM spontaneous osteogenesis (SO) has not been described previously.

Objectives
To report on varying degrees of IMSO and analyze its possible causes.

Methods
Twelve eight-week-old male Sprague-Dawley rats with 10 mm right femoral bone defects who received the first stage of IM technique (IMT) were used to observe the SO. In addition, clinical data from patients with bone defects who received the first stage of IMT with an interval of > 2 months post-operatively and exhibited SO between January 2012 and June 2020 were retrospectively analyzed. The SO was divided into four grades according to the amount and characteristics of the new bone formation.

Results
At twelve weeks, grade II SO was observed in all rats, and more new bone was formed in the IM near the bone end forming an uneven margin. Histology revealed bone and cartilage foci in the new bone. Four of the 98 patients treated with the first stage of IMT exhibited IMSO, including one female and three males with a median age of 40.5 years (range 29–52 years). The bone defects were caused by severe fractures and infection in two cases and by infection or tumor in one case each. Partial or segmental defects occurred in two cases. The time interval between inserting a cement spacer and diagnosis of SO ranged from six months to nine years. Two cases were grade I, and one case each of grades III and IV.

Conclusion
Varying degrees of SO confirm the existence of the IMSO phenomenon. Bioactive bone tissue or local inflammation and a long time interval are the primary reasons underlying enhancement of the osteogenic activity of IM and leading to SO, which tends to take place as endochondral osteogenesis.
Oral pathology and overweight among pupils in government primary schools in Cameroon: a cross-sectional study
Authors: Boukeng Lionel Berthold Keubou , Minkandi Claude Axel , Dapi Leonie Nzefa 
Published: May 2023

Abstract
Background
Tooth decay and periodontal diseases are the main oral pathologies in the world. The prevalence of overweight in children has increased worldwide. Overweight children have alterations in the composition of saliva and excessive consumption of saturated fatty acids tend to slow the metabolism of carbohydrates in the oral cavity leading to tooth decay, periodontal disease and others oral disorders. The aim of this study was to assess the relationship between oral pathologies and overweight in pupils of primary schools of Cameroon.

Methods
A cross-sectional study was carried out from June to August 2020 in four government primary schools selected through cluster sampling in Yaounde. 650 pupils aged between 6 and 11 years were enrolled. Data collected included anthropometric, oral pathologies, quality of oral hygiene and feeding habits. Data were analysed with the SPSS 26.0 statistical software and binary logistic regression was used to determine the risks of oral pathologies in overweight pupils. P-value of 0.05 was considered statistically significant.

Results
The prevalence of overweight was 27% (95% CI: 23.5—30.5). The main oral pathologies was tooth decay (60.3%). Binary logistic regression revealed that overweight pupils were significantly 1.5 times more likely to develop tooth decay than non-overweight pupils (95% CI: 1.1—2.4).

Conclusion
Overweight, tooth decay are prevalent among pupils. Overweight pupils have a higher risk of developing tooth decay compared to non-obese pupils. An integrated package of oral and nutritional health promotion activities is necessary in primary schools in Cameroon.
Effects of metaverse-based career mentoring for nursing students: a mixed methods study
Authors: Kim Yujeong , Kim Mi Young 
Published: May 2023

Abstract
Background
There is a lack of studies on metaverse-based career mentoring for college students in both quantitative and qualitative research. This study aimed to examine the effect of metaverse-based career mentoring among nursing students and explore the experiences of mentors and mentees.

Methods
This study used a mixed methods design using both a survey for collecting quantitative data and focus group interviews for a qualitative one. A total of 8 mentors and 43 mentees participated in the metaverse-based career mentoring program. The program covered eight career fields and was delivered across eight sessions of 60 min each, over six days. Career decision-making self-efficacy among mentees and platform and program satisfaction were measured before and after the program. Afterwards, 7 mentors and 12 mentees participated in the focus group interviews to investigate their experience of participating in the metaverse-based career mentoring program. Quantitative data were analyzed using descriptive statistics, paired t-test, Wilcoxon signed-rank test, and Mann-Whitney U test. The qualitative data underwent thematic analysis.

Results
After the metaverse-based career mentoring program, mentees’ career decision-making self-efficacy increased significantly compared to the baseline level. From the mentor–mentee focus group interviews, three key themes were derived: (i) communicating frankly and openly, (ii) being satisfied with realistic communication and program functions, and (iii) expecting an even more optimized program.

Conclusions
A metaverse-based career mentoring program for nursing students can have a positive effect on their career decision-making self-efficacy. In addition, in terms of education, it is helpful as a non-face-to-face medium and feeling a sense of reality, so it is expected that it will be beneficial in education by applying various contents in the future.
Symptoms and risk factors for long COVID in Tunisian population
Authors: Chelly Souhir , Rouis Sourour , Ezzi Olfa , Ammar Asma , Fitouri Sami , Soua Asma , Fathallah Ines , Njah Mansour , Mahjoub Mohamed 
Published: May 2023

Abstract
Background
The COVID-19 pandemic has presented various challenges, one of which is the discovery that after the acute episode, around 30% of patients experience persistent symptoms or develop new ones, now known as long COVID. This new disease has significant social and financial impacts. The objective is to determine the prevalence of long COVID in the Tunisian population and identify its predictive factors.

Methods
This was a cross-sectional study conducted among Tunisians who were infected with COVID-19 between March 2020 and February 2022. An online self-administered questionnaire was distributed through social media, radio, and television channels over the course of one month (February 2022). Long COVID was defined as the persistence of existing symptoms or the development of new symptoms within three months after onset, lasting for at least two months, and with no differential diagnosis. We performed univariate and multivariate analyses using binary stepwise logistic regression with a significance level set at 5%.

Results
A total of 1911 patients participated in our study, and the prevalence of long COVID was 46.5%. The two most frequent categories were general and neurological post-COVID syndrome, with a prevalence of 36.7% each. The most commonly observed symptoms were fatigue (63.7%) and memory problems (49.1%). In the multivariate analysis, the predictive factors for long COVID were female gender and age of 60 years or older, while complete anti-COVID vaccination was found to be a protective factor.

Conclusions
Our study found that complete vaccination was a protective factor against long COVID, while female gender and age of 60 years or older were identified as the main risk factors. These findings are consistent with studies conducted on other ethnic groups. However, many aspects of long COVID remain unclear, including its underlying mechanisms, the identification of which could guide the development of potential effective treatments.
Behavioral deviations: healthcare-seeking behavior of chronic disease patients with intention to visit primary health care institutions
Authors: Wu Shiyin , Du Shanshan , Feng Ruimei , Liu Wenbin , Ye Weimin 
Published: May 2023

Abstract
Background
Although primary health care (PHC) has been proven to be effective in preventing and treating chronic diseases, the visits rate of PHC institutions is still not ideal. Some patients initially express a willingness to visit PHC institutions but end up seeking health services at non-PHC institutions, and the reasons for this behavior remain unclear. Therefore, the objective of this study is to analyze the factors that contribute to behavioral deviations among chronic disease patients who originally intended to visit PHC institutions.

Methods
Data were collected from a cross-sectional survey among chronic disease patients with original intention to visit PHC institutions in Fuqing City, China. The analysis framework was guided by Andersen’s behavioral model. Logistic regression models were employed to analyze the factors affecting the behavioral deviations among chronic disease patients with a willingness to visit PHC institutions.

Results
A total of 1,048 individuals were finally included and about 40% of the participants with the original willingness to seek care from PHC institutions finally chose non-PHC institutions in their subsequent visits. The results of logistic regression analyses indicated that at the predisposition factor level, older participants (aOR60-69 = 0.602, P < 0.01; aOR70-75 = 0.475, P < 0.01) were less likely to have behavioral deviations. At the enabling factor level, compared to those covered by Urban Employee Basic Medical Insurance (UEBMI) and not reimbursed, those covered by Urban–Rural Resident Basic Medical Insurance (URRBMI) (aOR = 0.297, P < 0.01), and those answering that reimbursement from medical institutions was convenient (aOR = 0.501, P < 0.01) or very convenient (aOR = 0.358, P < 0.001) were less likely to have behavioral deviations. At the need factor level, participants who visited PHC institutions due to illness last year (aOR = 0.348, P < 0.001) and with polypharmacy (aOR = 0.546, P < 0.01) were less likely to have behavioral deviations compared to those without the visit of PHC institutions and not taking polypharmacy, respectively.

Conclusions
The deviations between the original willingness of PHC institution visits and subsequent behavior among chronic disease patients were associated with a number of predisposing, enabling, and need factors. Developing the health insurance system, strengthening the technical capacity of PHC institutions, and steadily developing a new concept of orderly healthcare-seeking behavior among chronic disease patients, will help promote their access to PHC institutions as well as improve the effectiveness of the tiered medical system for chronic disease care.
Retinoblastoma gene expression profiling based on bioinformatics analysis
Authors: Mao Jun , Lu Mingzhi , Lu Siduo , Xing Yiqiao , Xu Xuejiao , Chen Ying , Xu Huirong , Zuo Wei , Zhou Jingwen , Du Wei 
Published: May 2023

Abstract
Background
Retinoblastoma (RB) is frequently occurring malignant tumors that originate in the retina, and their exact cause and development mechanisms are yet to be fully comprehended. In this study, we identified possible biomarkers for RB and delved into the molecular mechanics linked with such markers.

Methods
In this study GSE110811 and GSE24673 were analyzed. Weighted gene co-expression network analysis (WGCNA) was applied to screen modules and genes associated with RB. By overlapping RB-related module genes with differentially expressed genes (DEGs) between RB and control samples, differentially expressed retinoblastoma genes (DERBGs) were acquired. A gene ontology (GO) enrichment analysis and a kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis were conducted to explore the functions of these DERBGs. To study the protein interactions of DERBGs, a protein–protein interaction (PPI) network was constructed. Hub DERBGs were screened using the least absolute shrinkage and selection operator (LASSO) regression analysis, as well as the random forest (RF) algorithm. Additionally, the diagnostic performance of RF and LASSO methods was evaluated using receiver operating characteristic (ROC) curves and single-gene gene set enrichment analysis (GSEA) was conducted to explore the potential molecular mechanisms involved with these Hub DERBGs. In addition, the competing endogenous RNA (ceRNA) regulatory network of Hub DERBGs was constructed.

Result
About 133 DERBGs were found to be associated with RB. GO and KEGG enrichment analyses revealed that the important pathways of these DERBGs. Furthermore, the PPI network revealed 82 DERBGs interacting with each other. By RF and LASSO methods, PDE8B, ESRRB, and SPRY2 were identified as Hub DERBGs in patients with RB. From the expression assessment of Hub DERBGs, it was found that the levels of expression of PDE8B, ESRRB, and SPRY2 were significantly decreased in the tissues of RB tumors. Secondly, single-gene GSEA revealed a connection between these 3 Hub DERBGs and oocyte meiosis, cell cycle, and spliceosome. Finally, the ceRNA regulatory network revealed that hsa-miR-342-3p, hsa-miR-146b-5p, hsa-miR-665, and hsa-miR-188-5p may play a central role in the disease.

Conclusion
Hub DERBGs may provide new insight into RB diagnosis and treatment based on the understanding of disease pathogenesis.
Gender differences in vision health-seeking behavior and vision health outcomes among rural Chinese schoolchildren by birth order and family size
Authors: Zhang Yunyun , Guan Hongyu , Ding Yuxiu , Xue Jing 
Published: May 2023

AbstractBackgroundThe gender gap remains a major impediment in the path toward equality, and it is especially wide in low-income countries. Gender differences in health-seeking behaviors may be a factor. Family size and childbirth order are two critical factors affecting family resource allocation. This study examines gender differences in healthcare-seeking behaviors among children with visual impairment in rural China across different family structures (birth order and family size).MethodsWe draw on a dataset containing 19,934 observations constructed by combining data from 252 different school-level surveys spanning two provinces. The surveys were all conducted in 2012 using uniform survey instruments and data collection protocols in randomly selected schools across western provinces in rural China. The sample children range in grades from 4 to 5. Our analysis compares rural girls with rural boys regarding vision health outcome and behavior (vision examination and correction).ResultsThe findings revealed that girls have worse vision than boys. Regarding vision health behaviors, girls have a lower overall vision examination rate than boys. There is no gender difference when the sample student is the only child or the youngest child in the family, but there is still a gender difference when the sample student is the oldest child in the family or the middle child in the birth order. When it comes to vision correction behavior, boys are more likely to own eyeglasses than girls are for groups of students with mild visual impairment, even when the sample student is the only child in the family. However, when the sample student has another brother or sister (the sample student is the youngest, the oldest child in the family, or the middle child in the birth order), the gender difference disappears.ConclusionsGender differences in vision health outcomes are correlated with gender differences in vision health-seeking behaviors among rural children. Depending on the birth order and family size, gender disparities in visual health practices vary. In the future, consideration should be given to providing medical subsidies to reduce the cost of vision health behaviors and to provide information interventions to change gender inequality in households and promote equality in children’s vision health behaviors.Trial registrationThe trial was approved by the Stanford University Institutional Review Board (Protocol No. ISRCTN03252665). Permission was received from local Boards of Education in each region and the principals of all schools. The principles of the Declaration of Helsinki were followed throughout. Written informed consent was obtained from at least one parent for all child participants.
Behavioral determinants of arsenic-safe water use among Great Plains Indian Nation private well users: results from the Community-Led Strong Heart Water Study Arsenic Mitigation Program
Authors: Endres Kelly , Zacher Tracy , Richards Francine , Bear Robe Lisa , Powers Martha , Yracheta Joseph , Harvey David , Best Lyle G. , Red Cloud Reno , Black Bear Annabelle , Ristau Steve , Aurand Dean , Skinner Leslie , Perin Jamie , Cuny Christa , Gross Marie , Thomas Elizabeth D. , Rule Ana , Schwab Kellogg , Moulton Lawrence H. , O’Leary Marcia , Navas-Acien Ana , George Christine Marie 
Published: May 2023

Abstract
Background
The objective of this study was to evaluate the behavioral determinants associated with exclusive use of arsenic-safe water in the community-led Strong Heart Water Study (SHWS) arsenic mitigation program.

Methods
The SHWS is a randomized controlled trial of a community-led arsenic mitigation program designed to reduce arsenic exposure among private well users in American Indian Great Plains communities. All households received point-of-use (POU) arsenic filters installed at baseline and were followed for 2 years. Behavioral determinants selected were those targeted during the development of the SHWS program, and were assessed at baseline and follow-up.

Results
Among participants, exclusive use of arsenic-safe water for drinking and cooking at follow-up was associated with higher self-efficacy for accessing local resources to learn about arsenic (OR: 5.19, 95% CI: 1.48–18.21) and higher self-efficacy to resolve challenges related to arsenic in water using local resources (OR: 3.11, 95% CI: 1.11–8.71). Higher commitment to use the POU arsenic filter faucet at baseline was also a significant predictor of exclusive arsenic-safe water use for drinking (OR: 32.57, 95% CI: 1.42–746.70) and cooking (OR: 15.90, 95% CI: 1.33–189.52) at follow-up. From baseline to follow-up, the SHWS program significantly increased perceived vulnerability to arsenic exposure, self-efficacy, descriptive norms, and injunctive norms. Changing one’s arsenic filter cartridge after installation was associated with higher self-efficacy to obtain arsenic-safe water for drinking (OR: 6.22, 95% CI: 1.33–29.07) and cooking (OR: 10.65, 95% CI: 2.48–45.68) and higher perceived vulnerability of personal health effects (OR: 7.79, 95% CI: 1.17–51.98) from drinking arsenic-unsafe water.

Conclusions
The community-led SHWS program conducted a theory-driven approach for intervention development and evaluation that allowed for behavioral determinants to be identified that were associated with the use of arsenic safe water and changing one’s arsenic filter cartridge. These results demonstrate that theory-driven, context-specific formative research can influence behavior change interventions to reduce water arsenic exposure. The SHWS can serve as a model for the design of theory-driven intervention approaches that engage communities to reduce arsenic exposure.

Trial registration
The SHWS is registered with ClinicalTrials.gov (Identifier: NCT03725592).