bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initial and mid-term results of LEO Baby stent-assisted coiling of intracranial aneurysms located in small arteries: A single-center experience with 131 consecutive patients
Authors: Shen Yunan , Ni Heng , Li Jingfeng , Jia Zhenyu , Cao Yuezhou , Shi Haibin , Zhao Linbo , Liu Sheng 
Published: September 2022

Background and purposeLow-profile intracranial stents such as the LEO Baby stents are considered to be advantageous for the treatment of intracranial aneurysms originating from small arteries. This study aimed to evaluate the initial and mid-term clinical and angiographic results of LEO Baby stents in stent-assisted coiling of intracranial aneurysms with small parent arteries (&lt;2.5 mm).MethodsWe performed a retrospective study to identify 131 patients with aneurysms arising from small parent arteries treated with Leo Baby stent-assisted coiling in a single institution between October 2018 and June 2021. We assessed the immediate and progressive aneurysm occlusion rates, procedure-related complications, and clinical outcomes.ResultsA total of 131 patients with 135 aneurysms were identified, including 65 (48.1%) cases of acutely ruptured aneurysms. Technical success was achieved in all cases (100%). The immediate angiography showed complete occlusion in 111 aneurysms (82.2%), neck remnants in 19 (14.1%), and residual sac in 5 (3.7%). Procedure-related complications occurred in 14 cases (10.3%), including 13 (9.6%) thromboembolic complications and 1 (0.7%) hemorrhagic complication. Six-month follow-up angiography was achieved in 106 (78.5%) aneurysms, which showed complete occlusion in 102 (96.2%) aneurysms, neck remnants in 2 (1.9%), and residual sac in 2 (1.9%). Clinical follow-up was available in all patients with a median duration of 6.8 months, and favorable clinical outcomes (modified Rankin Scale score: 0–2) reached 91.6%. The mortality rate was 4.6%.ConclusionOur results demonstrate that stent-assisted coiling of intracranial aneurysms located on small arteries using LEO Baby stents is technically feasible, highly effective, and has midterm durability in aneurysmal occlusion.
Identification of two novel variants of the BCL11B gene in two Chinese pedigrees associated with neurodevelopmental disorders
Authors: Che Fengyu , Tie Xiaoling , Lei Hong , Zhang Xi , Duan Mingyue , Zhang Liyu , Yang Ying 
Published: September 2022

ObjectiveAccording to a recent report, the mutation of transcription factor gene BCL11B is associated with the development of neurodevelopmental disorders and immune deficiency. By analyzing both clinical features and genetic variations, this study aims to reveal the genetic etiology of four patients with neurodevelopmental disorders from two unrelated Chinese pedigrees.MethodsFrom the 4 cases, the clinical data were collected. The potential pathogenic gene variations were analyzed by means of based-trio whole exome sequencing (Trio-WES) and then validated through Sanger sequencing in their respective pedigrees. Furthermore, both the in vitro minigene assay and the NMD assay were performed to evaluate the impact of splicing and frameshift variants.ResultsThe 4 patients displayed mild-to-severe intellectual developmental disorder, which was accompanied by speech delay, dysmorphic facies, and serious caries. In addition, the extended phenotype of developmental regression was observed in the proband from Family 1, which has been unreported previously. Molecular analysis was conducted to identify two novel heterozygous variants in the BCL11B gene: a maternal splicing variant c.427 + 1G &gt; A in Family 1 and a de novo frameshift variant c.2461_2462insGAGCCACACCGGCG (p.Glu821Glyfs*28) in Family 2. As revealed by the in vitro minigene assay, the c.427 + 1G &gt; A variant activated a new cryptic splice site. As confirmed by an overexpression assay, there was no significant difference in the level of mRNA and protein expression between the mutate-BCL11B (p.Glu821Glyfs*28) and the wild type. It confirms that p.Glu821Glyfs*28 variant could be an NMD escaping variant.ConclusionThe extended phenotype of BCL11B-related disorders is reported in this study to reveal the clinical and genetic heterogeneity of the disease. The study starts by identifying a splicing variant and a novel frameshift variant of the BCL11B gene, thus confirming its aberrant translation. The findings of this study expand the mutation spectrum of the genetic BCL11B gene, which not only improves the understanding of the associated neurodevelopmental disorders from a clinical perspective but also provides guidance on diagnosis and genetic counseling for patients.
Correlation between PD-L1 expression and radiomic features in early-stage lung adenocarcinomas manifesting as ground-glass nodules
Authors: Shi Wenjia , Yang Zhen , Zhu Minghui , Zou Chenxi , Li Jie , Liang Zhixin , Wang Miaoyu , Yu Hang , Yang Bo , Wang Yulin , Li Chunsun , Wang Zirui , Zhao Wei , Chen Liang’an 
Published: September 2022

BackgroundImmunotherapy might be a promising auxiliary or alternative systemic treatment for early-stage lung adenocarcinomas manifesting as ground-glass nodules (GGNs). This study intended to investigate the PD-L1 expression in these patients, and to explore the non-invasive prediction model of PD-L1 expression based on radiomics.MethodsWe retrospectively analyzed the PD-L1 expression of patients with postoperative pathological diagnosis of lung adenocarcinomas and with imaging manifestation of GGNs, and divided patients into positive group and negative group according to whether PD-L1 expression ≥1%. Then, CT-based radiomic features were extracted semi-automatically, and feature dimensions were reduced by univariate analysis and LASSO in the randomly selected training cohort (70%). Finally, we used logistic regression algorithm to establish the radiomic models and the clinical-radiomic combined models for PD-L1 expression prediction, and evaluated the prediction efficiency of the models with the receiver operating characteristic (ROC) curves.ResultsA total of 839 “GGN-like lung adenocarcinoma” patients were included, of which 226 (26.9%) showed positive PD-L1 expression. 779 radiomic features were extracted, and 9 of them were found to be highly corelated with PD-L1 expression. The area under the curve (AUC) values of the radiomic models were 0.653 and 0.583 in the training cohort and test cohort respectively. After adding clinically significant and statistically significant clinical features, the efficacy of the combined model was slightly improved, and the AUC values were 0.693 and 0.598 respectively.ConclusionsGGN-like lung adenocarcinoma had a fairly high positive PD-L1 expression rate. Radiomics was a hopeful noninvasive method for predicting PD-L1 expression, with better predictive efficacy in combination with clinical features.
Trigone ventricular glioblastoma multiforme with trapped temporal horn: A case report
Authors: Liu Lei , Wang Shaozhen , Dong Xuetao , Liu Yaodong , Wei Liudong , Kong Linghong , Zhang Qingjun , Zhang Kun 
Published: September 2022

BackgroundIntraventricular glioblastoma multiforme (GBM) is extremely rare, especially in the trigone region. This report presents a case of trigone ventricular GBM with trapped temporal horn (TTH).Case presentationA 59-year-old woman was admitted to our department with a 1-month history of rapidly progressive headache, nausea, and weakness in the right lower extremity. Head non-contrast computed tomography and enhanced magnetic resonance imaging (MRI) revealed a trigone ventricular mass lesion with TTH and heterogeneous enhancement. The lesion was found 18 months ago as a small asymptomatic tumor mimicking ependymoma. This neoplasm was removed subtotally through the right parieto-occipital approach guided by neuroendoscopy. A ventriculoperitoneal shunt was subsequently performed to relieve TTH. The final pathological diagnosis was GBM. Unfortunately, 36 days after the first surgery, the patient died due to her family’s decision to refuse therapy.ConclusionThis rare case shows that GBM should be considered in the differential diagnosis of trigonal tumors. In this case, the tumor possibly originated from the neural stem cells in the subventricular zone. Patients with intraventricular GBM have a worse prognosis, and careful follow-up and early surgery for small intraventricular tumors are necessary, even for those with ependymoma-like radiological findings.
The proper timing of virtual reality experience for reducing preoperative anxiety of pediatric patients: A randomized clinical trial
Authors: Ryu Jung-Hee , Ko Dayoung , Han Ji-Won , Park Jin-Woo , Shin Aesun , Han Sung-Hee , Kim Hyun-Young 
Published: September 2022

BackgroundThe virtual reality (VR) experience of an operation room (OR) prior to anesthesia and surgery has been known to reduce the anxiety and distress of pediatric patients. However, the proper timing needed for this is unknown. This randomized clinical study aimed to evaluate the proper timing of a VR tour of an OR (a few days before vs. immediately before anesthesia) to reduce the anxiety in a pediatric patient undergoing elective surgery.MethodsThe children from the ages of 4–10 years old were randomly divided into three groups. The control group received standard verbal information about the process of anesthesia and surgery 10 min before anesthesia. The VR A group experienced a VR tour at the outpatient clinic a few days before anesthesia, whereas the VR B group experienced the tour 10 min before anesthesia at the reception area of the OR. The 4-min VR video used in this study showed the experience of Pororo, an animation character, entering the OR and undergoing anesthesia. We evaluated the anxiety of children using the modified Yale preoperative anxiety scale (m-YPAS), the anxiety of caregivers using Beck anxiety inventory (BAI), and caregivers’ satisfaction.ResultsThe m-YPAS of the VR B group was significantly lower than that of the control and VR A groups (p = 0.001), whereas there was no statistically significant difference in BAI (p = 0.605) among the 3 groups. The score of caregivers’ satisfaction with the overall process of anesthesia and surgery was higher in VR A group than in the control and VR B groups (p = 0.054).ConclusionThe VR experience of an OR immediately before anesthesia was more effective than standard verbal information or a VR tour at the outpatient clinic a few days before anesthesia in reducing the anxiety and distress of children prior to surgery.Clinical trial registration[https://cris.nih.go.kr/cris/search/detailSearch.do/20773], identifier [KCT0006845].
Early care and support for young children with developmental disabilities and their caregivers in Uganda: The Baby Ubuntu feasibility trial
Authors: Nanyunja Carol , Sadoo Samantha , Kohli-Lynch Maya , Nalugya Ruth , Nyonyintono James , Muhumuza Anita , Katumba Kenneth R. , Trautner Emily , Magnusson Brooke , Kabugo Daniel , Cowan Frances M. , Zuurmond Maria , Morgan Catherine , Lester Deborah , Seeley Janet , Webb Emily L. , Otai Christine , Greco Giulia , Nampijja Margaret , Tann Cally J. 
Published: September 2022

BackgroundEarly care and support provision for young children with developmental disabilities is frequently lacking, yet has potential to improve child and family outcomes, and is crucial for promoting access to healthcare and early education. We evaluated the feasibility, acceptability, early evidence of impact and provider costs of the Baby Ubuntu participatory, peer-facilitated, group program for young children with developmental disabilities and their caregivers in Uganda.Materials and methodsA feasibility trial, with two parallel groups, compared Baby Ubuntu with standard care. Caregivers and children, aged 6–11 months with moderate-severe neurodevelopmental impairment, were recruited and followed for 12 months. Quantitative and qualitative methods captured information on feasibility (ability to recruit), acceptability (satisfactory attendance), preliminary evidence of impact (family quality of life) and provider costs.ResultsOne hundred twenty-six infants (median developmental quotient, 28.7) were recruited and randomized (63 per arm) over 9 months, demonstrating feasibility; 101 (80%) completed the 12-month follow-up assessment (9 died, 12 were lost to follow up, 4 withdrew). Of 63 randomized to the intervention, 59 survived (93%); of these, 51 (86%) attended ≥6 modules meeting acceptability criteria, and 49 (83%) completed the 12 month follow-up assessment. Qualitatively, Baby Ubuntu was feasible and acceptable to caregivers and facilitators. Enabling factors included community sensitization by local champions, positive and caring attitudes of facilitators toward children with disability, peer support, and the participatory approach to learning. Among 101 (86%) surviving children seen at 12 months, mixed methods evaluation provided qualitative evidence of impact on family knowledge, skills, and attitudes, however impact on a scored family quality of life tool was inconclusive. Barriers included stigma and exclusion, poverty, and the need to manage expectations around the child’s progress. Total provider cost for delivering the program per participant was USD 232.ConclusionA pilot feasibility trial of the Baby Ubuntu program found it to be feasible and acceptable to children, caregivers and healthcare workers in Uganda. A mixed methods evaluation provided rich programmatic learning including qualitative, but not quantitative, evidence of impact. The cost estimate represents a feasible intervention for this vulnerable group, encouraging financial sustainability at scale.Clinical trial registration[https://doi.org/10.1186/ISRCTN44380971], identifier [ISRCTN44380971].
Loneliness and lack of belonging as paramount theme in identity descriptions of Children Born of War
Authors: Mitreuter Saskia , Glaesmer Heide , Kuwert Philipp , Kaiser Marie 
Published: September 2022

ObjectiveChildren Born of War (CBOW) are an international and timeless phenomenon that exists in every country involved in war or armed conflict. Nevertheless, little is known on a systematic level about those children, who are typically fathered by a foreign or enemy soldier and born to a local mother. In particular, the identity issues that CBOW often report have remained largely uninvestigated. In the current qualitative study we began filling this gap in the scientific literature by asking how CBOW construct their identity in self-descriptions.MethodWe utilized thematic content analysis of N = 122 German CBOWs' answers to an open-ended questionnaire item asking how they see themselves and their identity in the context of being a CBOW.ResultsWe identified five key themes in CBOW' identity accounts. Loneliness and lack of belonging appeared as a paramount aspect of their self-descriptions next to narratives about belonging and positive relationship. On a less interpersonal basis, we found fighting and surviving and searching for truth and completion overarching aspects of their identities. There were also few accounts growing up unaffected by the fact of being born a CBOW. Although all themes portray different perspectives, they all (but the last one) clearly indicate the impeded circumstances under which CBOW had to grow up.ConclusionsIntegrating our findings with existing interdisciplinary literature regarding identity, we discuss implications for future research and clinical and political practice.
Transformative learning in the setting of religious healers: A case study of consultative mental health workshops with religious healers, Ethiopia
Authors: Baheretibeb Yonas , Soklaridis Sophie , Wondimagegn Dawit , Martimianakis Maria Athina (Tina) , Law Samuel 
Published: September 2022

ObjectivePsychiatric interventions that consider the socio-cultural and spiritual traditions of patients are needed to address stigma and improve access to mental health services. Productive collaboration between traditional healers and biomedical practitioners hold promise in such efforts, and applying tenets of transformative learning hold potential for mitigating an overemphasis on biomedical models in such collaboration. We present a framework for how to engage in health system reform to enhance mental health services in communities that are distrustful of, or unfamiliar with biomedical approaches. Our research question was how to bridge two seemingly opposing paradigms of mental health care, and we sought to understand how the theory of transformational learning (TLT) can be applied to learning among Religious healers and biomedical practitioners in culturally appropriate ways to improve collaboration.MethodsTLT informed the development, implementation, and evaluation of an educational intervention in Addis Ababa, Ethiopia that aimed to improve delivery of mental health services at two Holy water sites. The initiative involved both psychiatrists and religious healers with extensive experience providing care to mentally ill patients. Using a focused ethnographic approach that incorporates document analysis methodology, this qualitative study examined recordings and minutes of stakeholder meetings, workshops and informal interviews with participants, analyzed for evidence of Mezirow's 11 stages of transformative learning. A participatory action approach was used to encourage practice change.ResultsAll participants exhibited a high degree of engagement with the of the collaborative project and described experiencing “disorienting dilemmas” by Mezirow's classic description. Opportunities to reflect separately and in large groups encouraged a re-examination of attitudes previously contributing to siloed approaches to care and led to instrumental changes in mental health care delivery and a higher degree of coordination and collaboration between psychiatrists and traditional healers.ConclusionOur study demonstrates the utility of TLT in both the design and evaluation of initiatives aiming to bridge cross-cultural and cross-professional divides. The learning process was further enhanced by a collaborative participatory action model adjusted to accommodate Ethiopian socio-political and cultural relations.
The experiences of caregivers of children with epilepsy: A meta-synthesis of qualitative research studies
Authors: Yu Zhichao , Shao Qinwen , Hou Kunhua , Wang Yanjie , Sun Xianghong 
Published: September 2022

ObjectiveEpilepsy is one of the most common chronic neurological disorders in children. The caregivers of these children bear heavy burden of care in the process of taking care of them. The objective of this metasynthesis was to explore the experiences and needs of caregivers of children with epilepsy.Methods and data sourcesEight databases (PubMed, CINAHL, EMBASE, Web of Science, CNKI, Wanfang Data, VIP database, and CBM) were searched for qualitative studies from each database's inception to 31 June 2021. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized.Results13 studies were included, covering the data of 316 participants. 36 research results were extracted from these studies, which were combined into 11 categories, and finally formed 4 themes: (a) heavy burden of care; (b) emotional experience; (c) coping strategies; (d) care needs.ConclusionCaregivers beared a heavy burden of care and psychological burden. Despite the adoption of different coping strategies, their emotional distress was still very serious. Caregivers had unmet care needs. In order to improve caregivers' care capacity, the society and healthcare workers need to provide them with information support, psychological support, and take measures to create a friendly medical and living environment for them.ImpactUnderstanding the experiences of caregivers of children with epilepsy will inform future research and practice. Healthcare workers could develop interventions to reduce caregiver burden and improve the level of caregivers' mental health. On the other hand, effective programs should be designed to improve caregivers' knowledge of the disease and enhance their ability to care. Society needs to take steps to improve the medical environment and the social stigma that is not friendly to epilepsy.
Analysis of burnout and its influencing factors among prison police
Authors: Gao Jin , Du Xinyang , Gao Qing 
Published: September 2022

BackgroundBurnout among prison police is an occupational health issue in the field of public health. Although burnout has been a hot issue for decades, there has not been a focus on the specific group of prison police. This study explores the burnout status and its influencing factors among prison police.MethodsThe Maslach Burnout Questionnaire—General Survey (MBI-GS) was used to conduct a questionnaire survey among 1,024 prison police.ResultsIt indicates that emotional exhaustion, negative detachment, and self-efficacy were the most significant dimensions of the burnout among prison police officers. The results of multiple linear regression analysis showed that gender (−0.201, P = 8.8958E-11 &lt;0.05), workload (−0.441, P = 1.6287E-9 &lt;0.05), whether they have direct contact with supervisory subjects (−0.394, P = 2.1449E-39 &lt;0.05), and a sense of organizational support (−0.298, P = 3.7182E-7 &lt;0.05) were risk factors for burnout in prison police.ConclusionsBurnout among prison officers can be reduced through preferential treatment of prison police, sound organizational mechanisms, and self-improvement of prison police.
Confounder-adjusted MRI-based predictors of multiple sclerosis disability
Authors: Kim Yujin , Varosanec Mihael , Kosa Peter , Bielekova Bibiana 
Published: September 2022

IntroductionBoth aging and multiple sclerosis (MS) cause central nervous system (CNS) atrophy. Excess brain atrophy in MS has been interpreted as “accelerated aging.” Current paper tests an alternative hypothesis: MS causes CNS atrophy by mechanism(s) different from physiological aging. Thus, subtracting effects of physiological confounders on CNS structures would isolate MS-specific effects.MethodsStandardized brain MRI and neurological examination were acquired prospectively in 646 participants enrolled in ClinicalTrials.gov Identifier: NCT00794352 protocol. CNS volumes were measured retrospectively, by automated Lesion-TOADS algorithm and by Spinal Cord Toolbox, in a blinded fashion. Physiological confounders identified in 80 healthy volunteers were regressed out by stepwise multiple linear regression. MS specificity of confounder-adjusted MRI features was assessed in non-MS cohort (n = 158). MS patients were randomly split into training (n = 277) and validation (n = 131) cohorts. Gradient boosting machine (GBM) models were generated in MS training cohort from unadjusted and confounder-adjusted CNS volumes against four disability scales.ResultsConfounder adjustment highlighted MS-specific progressive loss of CNS white matter. GBM model performance decreased substantially from training to cross-validation, to independent validation cohorts, but all models predicted cognitive and physical disability with low p-values and effect sizes that outperform published literature based on recent meta-analysis. Models built from confounder-adjusted MRI predictors outperformed models from unadjusted predictors in the validation cohort.ConclusionGBM models from confounder-adjusted volumetric MRI features reflect MS-specific CNS injury, and due to stronger correlation with clinical outcomes compared to brain atrophy these models should be explored in future MS clinical trials.