bluuebunny/crossref_metadata_2025_split huggingface dataset:
The relationship between chronic PTSD, cortical volumetry and white matter microstructure among Australian combat veterans
Authors: Romaniuk Madeline , Xia Ying , Fisher Gina , Pannek Kerstin , Fripp Jurgen , Evans Justine , Rose Stephen 
Published: September 2022

Abstract
Background
Posttraumatic stress disorder (PTSD) has been associated with volumetric and white matter microstructural changes among general and veteran populations. However, regions implicated have greatly varied and often conflict between studies, potentially due to confounding comorbidities within samples. This study compared grey matter volume and white matter microstructure among Australian combat veterans with and without a lifetime diagnosis of PTSD, in a homogenous sample assessed for known confounding comorbidities.

Methods
Sixty-eight male trauma-exposed veterans (16 PTSD-diagnosed; mean age 69 years) completed a battery of psychometric assessments and underwent magnetic resonance and diffusion tensor imaging. Analyses included tract-based spatial statistics, voxel-wise analyses, diffusion connectome-based group-wise analysis, and volumetric analysis.

Results
Significantly smaller grey matter volumes were observed in the left prefrontal cortex (P = 0.026), bilateral middle frontal gyrus (P = 0.021), and left anterior insula (P = 0.048) in the PTSD group compared to controls. Significant negative correlations were found between PTSD symptom severity and fractional anisotropy values in the left corticospinal tract (R2 = 0.34, P = 0.024) and left inferior cerebellar peduncle (R2 = 0.62, P = 0.016). No connectome-based differences in white matter properties were observed.

Conclusions
Findings from this study reinforce reports of white matter alterations, as indicated by reduced fractional anisotropy values, in relation to PTSD symptom severity, as well as patterns of reduced volume in the prefrontal cortex. These results contribute to the developing profile of neuroanatomical differences uniquely attributable to veterans who suffer from chronic PTSD.
Translanguaging practices of Macau junior-one students in a remedial class
Authors: Chan Brian Hok-Shing , Chou Chris Ion-Pang 
Published: September 2022

AbstractThis qualitative study analyzes the use of translanguaging in co-learning activities involving four junior-one students in an English remedial class. The school advocates a policy of English immersion in the regular English class, although students may have difficulty understanding the teachers and interacting with them during the classes. In the remedial class, however, the policy is not strictly enforced, and, hence, students can leverage semiotic resources from their linguistic repertoires without restriction. All four learners constantly engage in translanguaging in interactive, co-learning activities, drawing upon semiotic resources from not only different languages (i.e., English, Cantonese, Japanese, Mandarin) but also non-academic registers (i.e., trendy expressions, internet slang) and non-verbal modes (e.g., body gestures, facial expression). In this particular context, the major purpose of translanguaging is to enable the subjects to take up multiple roles (i.e., as a peer and as a ‘little teacher’) and enact different relationships with classmates/groupmates (i.e., peer-peer and teacher-student) in the class (i.e., Excerpts 1 and 2). In the case of a low achiever, translanguaging allows him to actively seek help from the other ‘little teachers’; moreover, his use of Japanese, in which he takes pride, serves as a face-saving strategy. The preference for particular expressions (e.g., internet slang, trendy expressions, Japanese) reflects the students’ hobbies, personal experiences and cultural preferences, thus building their individual image and identity in relation to the teacher and other students.
Assessment of knowledge, attitude, and practice of ear care among Jazan general population, Saudi Arabia
Authors: Alharbi Fahd Ali , Sanguf Mohammed Ahmed , Mahzara Naif Khalid , Alhazmi Faris Abdu , Rajhi Abdulaziz Ahmed , Daak Lojain Ibrahim , Sharoufna Wejdan Ali 
Published: September 2022

Abstract
Objective
The present study aimed at determining the knowledge, attitude, and practice of ear care among Jazan population and its association with sociodemographic variables.

Methods
This is a cross-sectional study conducted between January and June 2022 in the Jazan region, Saudi Arabia. Data was collected using an Arabic electronically questionnaire and analyzed using SPSS software version 23.

Results
About 446 of the participants were included in the study. Two-hundred sixty-two (58.7%) of the participants were females. Most of the participants 200 (44.8%) were within the age group of 18–23 years old. Marital status of 315 (70.6%) of the participants was found to be single. Out of a total score of 5, regarding mean ± standard deviation for scores of respondents, knowledge score is 3.7 ± 0.88, 3.7 ± 0.94 for attitude score, and 3.6 ± 1.12 for practice score. About 91.9% of the respondents were found to be having good knowledge about ear care, whereas 8.1% of the participants were considered as having poor knowledge about ear care. In regards to attitude, about 90.4% was having good attitude regarding ear care, and 9.6% was with poor attitude. Considering practice, about 83.9% of the respondents were having good practice. Gender was found to be associated with good practice (p-value = 0.005) with males tend to have better practice compared to females. Educational level was found to be associated with good knowledge about ear care (p-value = 0.006) with university/postgraduate educational level having higher knowledge scores compared to other educational level.

Conclusion
Good knowledge, attitude, and practices among participants in regards to ear care were documented. Efforts should be directed towards raising the knowledge level, and this will result in improvements in attitudes and practices. This could be accomplished through health education campaigns, community events, and augmentation of the role of media.
Wide Arterial Sparing Encephalo-Duro-Synangiosis for Moyamoya: Surgical Technique and Outcomes
Authors: Dawkins Demi , Aagaard-Kienitz Beverly , Capel Kelly , Eisenmenger Laura , Samsonov Alexey , Li Yiping , Sandoval-Garcia Carolina , Iskandar Bermans 
Published: September 2022

BACKGROUND:
Moyamoya is managed by surgical revascularization, but no standardized method has yet been universally adopted.

OBJECTIVE:
To describe a new indirect bypass technique for pediatric moyamoya, wide arterial sparing encephalo-duro-synangiosis (WASEDS), which provides a much wider area of revascularization with minimal compromise to the middle meningeal arterial tree compared with traditional procedures. Initially used as a salvage technique after failed encephalo-duro-arterio-synangiosis, its success later motivated its use as a first-line procedure.

METHODS:
Clinical and radiographic records of patients who underwent WASEDS for moyamoya from 2009 to 2020 were reviewed. Brain perfusion relative cerebral blood volume on the side of the WASEDS procedure was calculated. Two-tailed paired t tests were performed to identify the statistically significant differences (P ≤ .05).

RESULTS:
WASEDS was successfully performed on 8 patients for a total of 14 cerebral hemispheres. Age ranged from 2 to 25 years. There were no mortalities. The average clinical and radiographic follow-up was 49.79 months (range 2-126 months), demonstrating improvement in neurological condition and no postoperative stroke and significant diminution or cessation of transient ischemic attacks in all patients. Relative cerebral blood volume increased 9.24% after the WASEDS procedure (P = .012). There were no neurological complications. There were 2 pseudomeningoceles related to the extensive dural openings.

CONCLUSION:
WASEDS is a safe and effective indirect revascularization technique for both primary and salvage techniques. It provides an extensive area of cortical revascularization with no compromise of the middle meningeal vasculature and subjective reports of early improvement in cognition and behavior. The main disadvantage is elevated risk of pseudomeningocele secondary to the large craniotomy.
Clinical characteristics and risk factors of lower extremity amputation in patients with diabetic foot
Authors: Wang Linru , Li Qiang , Chen Xiao , Wang Zhaowei 
Published: September 2022

Objectives: To investigate the risk factors of lower limb amputation, and help physicians better understand the clinical characteristics of patients with diabetic foot, and make treatment strategies for these patients correctly.
Methods: In this study, the inpatients with diabetic foot treated in our hospital form January 2013 to February 2021 were reviewed retrospectively. The patients were divided into amputation and conservative treatment groups. The variables of the patients, consisting of age, gender, smoking history, alcohol use, diabetes and ulcer duration, ulcer size, Wagner classification, ankle brachial index, previous amputation history, laboratory data, and medical comorbidities including hypertension, coronary artery disease, peripheral arterial disease, chronic renal insufficiency, retinopathy, and sequelae of cerebral infarction were selected for analysis to determine the risk factors of lower limb amputation.
Results: In this study, a total of 856 patients with diabetic foot were enrolled, in which 487 patients received amputation surgeries, and the amputation rate was 56.9%. There were significant differences between the two groups in gender (p=0.014), smoking history (p=0.011), ulcer duration (p=0.023), ulcer size (p=0.000), Wagner classification (p=0.000), ABI (p=0.031), peripheral arterial disease (p=0.000), HDL-C (p=0.013), osteomyelitis (p=0.000), and fibrinogen (p=0.001). A stepwise multiple logistic regression analysis revealed that male gender (p=0.003), larger ulcer size (p=0.001), higher Wagner classification grades (p=0.002), higher rate of peripheral arterial disease (p=0.02) and osteomyelitis (p=0.0001), and increased fibrinogen level (p=0.004) were independent risk factors of lower limb amputation in patients with diabetic foot.
Conclusion: The diabetic foot patients with male sex, larger ulcer size, higher grade of Wagner classification, peripheral arterial disease or higher fibrinogen level may face higher risk of lower limb amputation.
doi: https://doi.org/10.12669/pjms.38.8.5635
How to cite this:Wang L, Li Q, Chen X, Wang Z. Clinical characteristics and risk factors of lower extremity amputation in patients with diabetic foot. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5635
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cannabidiol in the treatment and prevention of Alzheimer’s disease – a comprehensive overview of in vitro and in vivo studies
Authors: Drożak Paulina , Skrobas Urszula , Drożak Martyna 
Published: September 2022

Introduction and purpose. Dementia is a major public health problem. Alzheimer’s disease (AD) accounts for 60% of dementia cases. However, AD is currently considered as an incurable disorder and the only few drugs available for its treatment are mostly symptomatic. In the quest for novel drugs for this devastating disease, cannabidiol (CBD) has been recently gaining attention due to its multiple properties, such as an ability to interact with various receptors, anti-inflammatory and antioxidative effects and many more. The aim of this review article was to summarize findings on the effect of CBD on AD with a focus on molecular mechanisms of CBD’s action and therapeutic effects which it exerts.
Description of the state of knowledge. In vitro studies, carried out on cell models of AD, showed anti-inflammatory and antioxidative properties of CBD through a suppression of pro-inflammatory genes and causing a reduction of production of, among others, nitric oxide. Moreover, CBD was proven to decrease amyloid β (Aβ) production, reduce formation and aggregation of tau fibrils, protect against microglial and Aβ-induced neurotoxicity and prevented the Aβ-induced deficit in long-term potentiation in hippocampus. In vivo studies, conducted mostly on mice models of AD, indicated that CBD improves memory and spatial learning, reverses deficit in social and object recognition, reduces anxiety-like behaviors and improves glucose metabolism. One study including humans demonstrated that CBD enhances cerebral blood flow in hippocampus. Currently there are two ongoing clinical trials on the use of CBD in AD-associated agitation.
Conclusions. Both in vitro and in vivo studies indicate that cannabidiol appears promising in the treatment and prevention of Alzheimer’s disease.
Treatment of diabetic foot ulcers: review of the literature with regard to the TIME clinical decision support tool
Authors: Patton Declan , Avsar Pinar , Wilson Pauline , Mairghani Maisoon , O'Connor Tom , Nugent Linda , Moore Zena 
Published: September 2022

Objective:The aim of this clinically orientated paper is to offer an overview of diabetic foot ulcer (DFU) dressings generally, and more specifically, their use in the treatment of DFUs.Method:The TIME clinical decision support tool (CDST) has been used as a clinical tool that can help clinicians bring together the different aspects of dressings for DFU treatment into a holistic approach to patient care.Results:DFUs are often difficult to heal, are painful and impact negatively on the individual's quality of life. Most DFU dressings are designed to support the healing of hard-to-heal wounds and represent one part of the management of DFUs. Apart from providing a moist environment, absorbing increased exudate, enhancing granulation and assisting in autolysis, the dressings need to be cost-effective. Wound dressing selection is based on clinical knowledge that ensures the dressing is most appropriate for the individual and the wound, taking into account the comorbidities that the individual may have.Conclusion:This paper has highlighted how the use of the TIME CDST model can enhance clinical care and is a further tool clinicians should consider when developing and executing DFU treatment plans. Future research needs to focus on large multicentre studies using robust methodologies, given the current gaps in the evidence, to determine the effectiveness of dressing products for DFUs.
The influence of adequate debridement and placental-derived allografts on diabetic foot ulcers
Authors: Tettelbach William H , Cazzell Shawn M , Hubbs Brandon , Jong Julie L De , Forsyth R Allyn , Reyzelman Alexander M 
Published: September 2022

Objective: To determine the role of debridement when patients are using placental-derived allografts (PDAs), data from two prospective, multicentre, randomised controlled trials (RCTs) were evaluated for the quality or adequacy of debridement on diabetic foot ulcers (DFUs) treated with PDAs. Results were compared with real-world findings via a retrospective analysis of 2015–2019 Medicare claims for DFUs. Method: Debridement adequacy in the prospective RCTs was adjudicated by three blinded wound care specialists. Treatments included two PDAs, dehydrated human amnion/chorion membrane (DHACM, n=54) or dehydrated human umbilical cord (DHUC, n=101), compared with standard of care (SOC, n=110). The key outcome was the influence of adequate debridement on rates of complete closure within 12 weeks. Additionally, a retrospective analysis of 2015–2019 Medicare claims for DFUs that received routine debridement at intervals ranging from every 1–7 days (18,900 total episodes), 8–14 days (35,728 total episodes), and every 15 days or greater (34,330 total episodes) was performed. Results: Within the RCTs, adequate debridement occurred in 202/265 (76%) of patients, 90/110 (82%) SOC ulcers, 45/54 (83%) of DHACM-treated ulcers, and in 67/101 (66%) of DHUC-treated ulcers. Complete closure occurred in 150/202 (74%) of adequately debrided ulcers, and in only 13/63 (21%) of ulcers without adequate debridement, p<0.0001. Debridement was the most significant factor for closure even when controlling for other clinical characteristics. Within the Medicare claims data 21% (18,900/88,958) of episodes treated with SOC only had debridement intervals of ≤7 days. Short debridement intervals in combination with the use of DHACM demonstrated statistically significant better outcomes than SOC including: 65% fewer major amputations (p<0.0001), higher DFU resolution rates (p=0.0125), 42% fewer emergency room visits (p<0.0001) and reduced usage of other hospital resources (admissions and readmissions). Conclusion: Prospectively collected data examining the quality of debridement and retrospectively analysed data examining the frequency of debridement supports routine adequate wound debridement, particularly at intervals of seven days, as an essential component of wound care. Optimal use of placental-derived allografts improves outcomes and lowers the use of healthcare resources.
Vitamin C and the management of diabetic foot ulcers: a literature review
Authors: Tong Khanh Phuong , Intine Robert , Wu Stephanie 
Published: September 2022

Objective:The lifetime risk of developing a diabetic foot ulcer (DFU) in people with diabetes is as high as 25%. A trio of factors constitute the diabetic foot syndrome that characterises DFUs, including neuropathy, vascular disease and infections. Vitamin C has important functions in the nervous, cardiovascular, and immune systems that are implicated in DFU development. Furthermore, vitamin C deficiency has been observed in individuals with DFUs, suggesting an important function of vitamin C in DFU management and treatment. Therefore, this literature review evaluates the role of vitamin C in the nervous, cardiovascular and immune systems in relation to wound healing and DFUs, as well as discussing vitamin C's lesser known role in depression, a condition that affects many individuals with a DFU.Method:A literature search was done using PubMed, Cochrane Library, Embase, Ovid, Computer Retrieval of Information on Scientific Projects, and NIH Clinical Center. Search terms included ‘diabetic foot ulcer,’ ‘diabetic foot,’ ‘vitamin C,’ and ‘ascorbic acid.’Results:Of the 71 studies initially identified, seven studies met the inclusion criteria, and only three were human clinical trials. Overall, the literature on this subject is limited, with mainly observational and animal studies, and few human clinical trials.Conclusion:There is a need for additional human clinical trials on vitamin C supplementation in individuals with a DFU to fill the knowledge gap and guide clinical practice.
COVID-19 in Africa: Underreporting, demographic effect, chaotic dynamics, and mitigation strategy impact
Authors: Thenon Nathan , Peyre Marisa , Huc Mireille , Touré Abdoulaye , Roger François , Mangiarotti Sylvain 
Published: September 2022

The epidemic of COVID-19 has shown different developments in Africa compared to the other continents. Three different approaches were used in this study to analyze this situation. In the first part, basic statistics were performed to estimate the contribution of the elderly people to the total numbers of cases and deaths in comparison to the other continents; Similarly, the health systems capacities were analysed to assess the level of underreporting. In the second part, differential equations were reconstructed from the epidemiological time series of cases and deaths (from theJohn Hopkins University) to analyse the dynamics of COVID-19 in seventeen countries. In the third part, the time evolution of the contact number was reconstructed since the beginning of the outbreak to investigate the effectiveness of the mitigation strategies. Results were compared to theOxford stringency indexand to the mobility indices of theGoogle Community Mobility Reports.Compared to Europe, the analyses show that the lower proportion of elderly people in Africa enables to explain the lower total numbers of cases and deaths by a factor of 5.1 on average (from 1.9 to 7.8). It corresponds to a genuine effect. Nevertheless, COVID-19 numbers are effectively largely underestimated in Africa by a factor of 8.5 on average (from 1.7 to 20. and more) due to the weakness of the health systems at country level. Geographically, the models obtained for the dynamics of cases and deaths reveal very diversified dynamics. The dynamics is chaotic in many contexts, including a situation of bistability rarely observed in dynamical systems. Finally, the contact number directly deduced from the epidemiological observations reveals an effective role of the mitigation strategies on the short term. On the long term, control measures have contributed to maintain the epidemic at a low level although the progressive release of the stringency did not produce a clear increase of the contact number. The arrival of the omicron variant is clearly detected and characterised by a quick increase of interpeople contact, for most of the African countries considered in the analysis.
Association between timing and type of postnatal care provided with neonatal mortality: A large scale study from India
Authors: Singh Lucky , Dubey Ritam , Singh Prashant Kumar , Nair Saritha , Rao M. Vishnu Vardhana , Singh Shalini 
Published: September 2022

Objectives
This study examines the association between quality Postnatal Care (PNC) considering timing and providers’ type on neonatal mortality. The aim extends to account for regional disparities in service delivery and mortality including high and non-high focus states.

Methods
Ever-married women aged 15–49 years (1,87,702) who had delivered at least one child in five years preceding the survey date surveyed in National Family Health Survey (2015–16) were included in the study. Neonatal deaths between day two and seven and neonatal deaths between day two and twenty-eight were considered dependent variables. Descriptive statistics and multivariate regression analysis were conducted.

Results
Chances of early neonatal mortality were 29% (OR = 0.71; 95%CI: 0.59–0.84) among newborns receiving PNC within a day compared to ones devoid of it while 40% (OR: 0.60; 95%CI: 0.51–0.71) likelihood for the same was noted if PNC was delivered within a week. Likelihood of neonatal mortality decreased by 24% (OR: 0.76; 95%CI: 0.65–0.88) when skilled PNC was delivered within 24 hours. Receiving quality PNC by skilled providers within a day in a non-high focus state decreased the chances of neonatal mortality by 26% (OR: 0.74; 95%CI: 0.59–0.92) compared to ones who did not receive any PNC.

Conclusions
Neonatal deaths were significantly associated with socioeconomic and contextual characteristics including age, education, household wealth, social group and region. Timing of PNC delivered and by a skilled healthcare provider was found significant in reducing neonatal mortality.