bluuebunny/crossref_metadata_2025_split huggingface dataset:
The interaction between circadian rhythm and epilepsy
Authors: Liu Mingsu , Ding Jing , Wang Xin 
Published: September 2022

AbstractEvidence about the interaction between circadian rhythms (CR) and epilepsy has been expanded with the application of advanced detection technology. An adequate understanding of how circadian system and epilepsy interact with each other could contribute to more accurate seizure prediction as well as rapid development of potential treatment timed to specific phases of CR. In this review, we present the reciprocal relationship between CR and epileptic activities from aspects of sleep effect, genetic modulation and brain biochemistry. It has been found that sleep-wake patterns, circadian timing systems and multidien rhythms have essential roles in seizure activities and interictal epileptiform discharge (IED). For instance, specific distribution patterns of seizures and IED have been reported, i.e., lighter non-rapid eye movement (NREM) sleep stage (stage 2) induces seizures while deeper NREM sleep stage (stage 3) activates IEDs. Furthermore, the epilepsy type, seizure type and seizure onset zone can significantly affect the rhythms of seizure occurrence. Apart from the common seizure types, several specific epilepsy syndromes also have a close correlation with sleep-wakefulness patterns. Sleep influences the epilepsy rhythm, and conversely, epilepsy alters the sleep rhythm through multiple pathways. Clock genes accompanied by two feedback loops of regulation have an important role in cortical excitability and seizure occurrence, which may be involved in the mTORopathy. The suprachiasmatic nuclei (SCN) has a rhythm of melatonin and cortisol secretion under the circadian pattern, and then these hormones can feed back into a central oscillator to affect the SCN-dependent rhythms, leading to variable but prominent influence on epilepsy. Furthermore, we discuss the precise predictive algorithms and chronotherapy strategies based on different temporal patterns of seizure occurrence for patients with epilepsy, which may offer a valuable indication for non-invasive closed-loop treatment system. Optimization of the time and dose of antiseizure medications, and resynchronization of disturbed CR (by hormone therapy, light exposure, ketogenic diet, novel small molecules) would be beneficial for epileptic patients in the future. Before formal clinical practice, future large-scale studies are urgently needed to assist prediction and treatment of circadian seizure activities and address unsolved restrictions.
Role of 18F FDG PET/CT in evaluation of post-operative ovarian carcinoma
Authors: Amer Marwa Ibrahim El-Sayed , Monib Ahmed Mohamed , Chalabi Nivine Abdel Moneim , Othman Amal Ibrahim Ahmed 
Published: September 2022

Abstract
Background
We evaluated the sensitivity, specificity and accuracy of fluorine-18-fluorodeoxyglucose with positron emission tomography/computed tomography (18F-FDG-PET/CT) in a group of patients with suspicion of ovarian cancer recurrence. It is considered a diagnostic dilemma, particularly in the 2 years following first-line therapy. CA125 serum levels computed tomography (CT) and other modalities are used during routine follow-up. These traditional modalities could provide a significant number of false-negative or equivocal results even in the presence of elevated CA125 levels. So the performance of 18F-FDG-PET/CT is essential for the optimal diagnosis of recurrence and treatment planning.

Results
Studying PET/CT behaviour in the detection of ovarian cancer recurrence, 18F-FDG-PET/CT had an accuracy of 98% with sensitivity and specificity of 98% and 100%, respectively. 18F-FDG-PET/CT had a PPV of 100% and NPV of 83%. While studying the CA125 level (> 35 U/ml) to detect the ovarian cancer recurrence during patient follow-up, the CA125 level had an accuracy of 50% with a sensitivity ratio and specificity ratio of 47% and 80%, respectively. CA-125 level had a PPV of 95% and NPV of 14%. In comparison between conventional CT and PET/CT studies, the PET/CT diagnosed local tumor recurrence in 16 patients (32%), while CT scan diagnosed local tumor recurrence in only 3 patients (6%), and PET/CT detected peritoneal recurrence in 34 patients (68%). CT scan found peritoneal deposits in 11 patients (22%), also the PET/CT showed suspicious abdominal LNS in 22 patients (44%) while, CT scan showed suspicious abdominal LNS in 4 patients (8%), and PET/CT showed suspicious pelvic LNS in 16 patients (32%). CT scan showed suspicious pelvic LNS in 7 patients (14%). PET/CT detected distant organ metastases in 18 patients (36%). CT scan detected distant organ metastasis in only 8 patients (16%). Comparison between CT and PET/CT in 32 follow-up cases for the detection of local tumor recurrence, peritoneal deposits, suspicious abdominal/pelvic LNs and distant organ metastasis. There was a statistically significant difference between CT and PET/CT the end results (p < 0.0001, p = 0.0047, p = 0.001, p = 0.03).

Conclusions
18F-FDG-PET/CT is more sensitive in detection and localization of ovarian cancer recurrence and more superior than the other imaging modalities.
Cross-sectional associations between 24-hour activity behaviours and motor competence in youth: a compositional data analysis
Authors: Tyler Richard , Atkin Andrew J. , Dainty Jack R. , Dumuid Dorothea , Fairclough Stuart J. 
Published: September 2022

Abstract
Background
The study aimed to examine the cross-sectional associations between 24-h activity compositions and motor competence in children and adolescents, while stratifying by sex and school type (primary or secondary school) and estimate differences in motor competence associated with reallocations of time between activity behaviours.

Methods
Data were collected from 359 participants (aged 11.5 ± 1.4 years; 49.3% boys; 96.9% White British). Seven-day 24-h activity behaviours [sleep, sedentary time, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA)] were assessed using wrist-worn accelerometers. Motor competence outcomes were obtained using the Dragon Challenge (process, product, time, and overall scores). Linear mixed models examined associations between activity behaviour compositions and motor competence outcomes for all participants and stratified by school type (primary or secondary) and sex. Post-hoc analyses modelled the associations of reallocating fixed durations of time between activity behaviours with the outcomes.

Results
In all participants, relative to other activity behaviours, MVPA had the strongest associations with motor competence outcomes. Time reallocations (5, 10, 15, 20 min) to MVPA from any of the other three behaviours were associated with higher overall, process, and time scores [effect sizes (ES) = 0.05–0.07 (5 min) and 0.19–0.27 (20 min)]. The stratified models displayed that MVPA had the strongest associations with outcomes in both sexes, irrespective of school type. The largest positive, and negative estimated differences occurred when MVPA hypothetically replaced LPA or sleep [ES = 0.04–0.10 (5 min) and 0.14–0.39 (20 min)], and when LPA or sleep hypothetically replaced MVPA [ES = − 0.03 to − 0.11 (5 min) and − 0.13 to − 0.54 (20 min)], respectively.

Conclusions
Relative to other activity behaviours, MVPA had the strongest association overall with motor competence outcomes. Hypothetical reallocations of time from LPA or sleep to MVPA (and vice versa) were associated with the largest positive estimated differences in motor competence outcomes. Therefore, our findings reinforce the key role of MVPA for children’s and adolescents’ motor competence.
Leveraging an Informatics Approach to Identify an Unmet Clinical Need for BRCA1/2 Testing Among Patients With Ovarian Cancer
Authors: Gray Stacy W. , Ottesen Rebecca A. , Currey Madeline , Cristea Mihaela , Nikowitz Janet , Shehayeb Susan , Lozano Vanessa , Hom Julie , Kilburn Julie , Lopez Lisa N. , Wing Sam , Sosa Ernesto , Shen Jenny , Morris Michael , Dilsizian Bedros , Joseph Thomas , Shen James , Adeimy Camille , Phillips Tanyanika , Bahadini Bahareh , Niland Joyce C. 
Published: September 2022

PURPOSE Although BRCA1/ 2 testing in ovarian cancer improves outcomes, it is vastly underutilized. Scalable approaches are urgently needed to improve genomically guided care. METHODS We developed a Natural Language Processing (NLP) pipeline to extract electronic medical record information to identify recipients of BRCA testing. We applied the NLP pipeline to assess testing status in 308 patients with ovarian cancer receiving care at a National Cancer Institute Comprehensive Cancer Center (main campus [MC] and five affiliated clinical network sites [CNS]) from 2017 to 2019. We compared characteristics between (1) patients who had/had not received testing and (2) testing utilization by site. RESULTS We found high uptake of BRCA testing (approximately 78%) from 2017 to 2019 with no significant differences between the MC and CNS. We observed an increase in testing over time (67%-85%), higher uptake of testing among younger patients (mean age tested = 61 years v untested = 65 years, P = .01), and higher testing among Hispanic (84%) compared with White, Non-Hispanic (78%), and Asian (75%) patients ( P = .006). Documentation of referral for an internal genetics consultation for BRCA pathogenic variant carriers was higher at the MC compared with the CNS (94% v 31%). CONCLUSION We were able to successfully use a novel NLP pipeline to assess use of BRCA testing among patients with ovarian cancer. Despite relatively high levels of BRCA testing at our institution, 22% of patients had no documentation of genetic testing and documentation of referral to genetics among BRCA carriers in the CNS was low. Given success of the NLP pipeline, such an informatics-based approach holds promise as a scalable solution to identify gaps in genetic testing to ensure optimal treatment interventions in a timely manner.
Cross-Sectional and Individual Relationships between Physical Activity and Glycemic Variability
Authors: Sparks Joshua R. , Sarzynski Mark A. , Davis J. Mark , Grandjean Peter W. , Wang Xuewen 
Published: September 2022

ABSTRACT

Introduction/Purpose
Overweight or obese adults spend more time sedentary and less time performing physical activity (PA) and are at an increased risk for developing impaired glycemic health. Free-living environments may provide insight into glycemic health in addition to clinical assessments. The purpose of this study was to examine the relationship between PA and glycemic health assessed by continuous glucose monitoring (CGM).

Methods
Twenty-eight overweight or obese adults each wore an accelerometer and CGM over the same 7 consecutive days. Average daily time (minutes and metabolic-equivalent minutes (MET-minutes)) and associated energy expenditure performing light (LPA), moderate-to-vigorous (MVPA), total PA, and standard deviation (SD) across days were calculated. Average daily 24-h and waking glycemia, mean glucose concentration, glycemic variability measured as the continuous overlapping net glycemic action, mean amplitude of glycemic excursions, and mean of daily difference were assessed.

Results
LPA MET-minutes per day was positively associated with 24-h and waking glycemia time-in-range and negatively associated with 24-h and waking time in hyperglycemia. Total PA time and the SD of MVPA and total PA time were negatively associated with 24-h mean glucose concentration. Individual-level analysis identified that most participants (50%–71%) expressed negative associations between LPA and MVPA time with 24-h mean glucose concentration, mean amplitude of glycemic excursion, and 4-h continuous overlapping net glycemic action.

Conclusions
Expectedly, greater total PA time and intensity-specific PA time were associated with lower 24-h and waking mean glucose concentration, greater glycemia time-in-range, and less time in hyperglycemia. The relationship between glucose concentrations and PA time SD was unexpected, whereas most participants expressed hypothesized relationships, which necessitates further exploration.
Promising COVID-19 therapies on examples of some antiviral, immunomodulatory and natural substances use - review
Authors: Bielewicz Krzysztof , Ryba Karolina , Karaś Anna , Kawałko Kinga , Pondel Kamil 
Published: September 2022

COVID-19 is one of the biggest challenges to medicine ever. Because of its dissemination in population effective drug to cure it was needed. There were some trials on antiviral drugs like lopiravir/ritonavir, remdesivir, darunavir/cobicistat, favipiravir, molnupiravir, discovered originally in order to treat other diseases. Only remdesivir and molnupiravir seem to be beneficial for patients with COVID-19, both of them are approved in therapy in a large number of countries allover the world. [2]
Another very important group of drugs used in trials against COVID-19 was immunomodulatory drugs. Some of them, like chloroquine/hydrochloroquine was very promising, but finally there were no evidences of its benefits found. [2] Corticosteroids used in moderate and severe COVID-19 caused general improvement of clinical status and decreased mortality. Interesting and quite promising may be use of interferons but for now lack of evidences does not allow to make clear statement about its benefits.
There are some argumentations for natural methods of COVID-19 treatment. Dietary recommendations, vitamin and microelements supplementation may be helpful in the therapy and in addition may not have any adverse effects. Also, herbal mixtures, developed centuries ago in China found usage during COVID-19 pandemic. After analysis of thousands of cases Traditional Chinese Medicine can be considered as one of the most successful attempt in combating COVID-19. [6]
Understanding autoimmune diseases: part 2
Authors: Perry Margaret 
Published: September 2022

In the second part of this series on autoimmune diseases, Margaret Perry gives an overview of systemic lupus erythematosus, coeliac disease and ulcerative colitis This article follows on from a previous one looking at some of the more widely seen autoimmune diseases. Autoimmune diseases are highly complex in their pathophysiology, and this together with the variety of signs and symptoms, and variable degrees of severity, often makes diagnosis difficult. This article aims to give a brief insight into the conditions discussed, giving general practice nurses and non-medical prescribers some knowledge and confidence in assessing and advising patients who present, with the aim of getting an earlier diagnosis and treatment, and, ultimately, improving quality of life of all those affected by any of these diseases.
FORMS OF PREVENTİNG HUNGER AND ENSURİNG FOOD SECURİTY İN TRADİTİONAL VİLLAGE LİFE
Authors: ŞAHİN Hayrettin 
Published: September 2022

People benefit from various animals and plants to meet their food needs and pass on their experiences in this direction from generation to generation. Villagers sometimes feed on animals and plants they grow, and sometimes on plants and animals that exist spontaneously in nature. The people living in the village have done various studies to prevent hunger and ensure food security by diversifying food and developing storage methods.
In this research, the food diversity situation between 1878-1960 in the villages of Oltu, Olur, Tortum, Uzundere, Narman and Şenkaya districts of Erzurum province was revealed. It focuses on the efforts to prevent hunger, which the villagers implement in their self-sufficient lives, away from the products produced in the city. The researcher determined the forms of preventing hunger and providing food security by making participant observations and in-depth interviews over a period of approximately five years (2016-2021).
As a result of the research, it has been determined that hunger is prevented and food security is ensured by raising various animals and products, storing them, expanding agricultural lands, making use of edible weeds and wild animals, using water effectively, assuming social responsibilities, providing food for the disadvantaged and getting rid of dependence on others. On the other hand, solidarity and sharing are very important for the village community.
The incidence and risk factors for stress fracture following periacetabular osteotomy
Authors: Morris William Z. , Justo Pedro G. S. , Williams Kathryn A. , Kim Young-Jo , Millis Michael B. , Novais Eduardo N. 
Published: September 2022

Aims The aims of this study were to characterize the incidence and risk factors associated with stress fractures following periacetabular osteotomy, and to determine their effect on osteotomy union. Methods We retrospectively reviewed all periacetabular osteotomies (PAOs) performed for developmental dysplasia of the hip (DDH) at one institution over a six-year period between 2012 and 2017. Perioperative factors were recorded, and included demographic and surgical data. Postoperatively, patients were followed for a minimum of one year with anteroposterior and false profile radiographs of the pelvis to monitor for evidence of stress fracture and union of osteotomies. We characterized the incidence and locations of stress fractures, and used univariate and multivariable analysis to identify factors predictive of stress fracture and the association of stress fracture on osteotomy union. Results A total of 331 patients underwent PAO during the study period with 56 (15.4%) stress fractures: 46 fractures of the retroacetabular posterior column, five cases of ischiopubic stress fracture, and five cases of concurrent ischiopubic and retroacetabular stress fractures. Overall, 86% (48/56) healed without intervention. Univariate analysis revealed that stress fractures occurred more frequently in females (p = 0.040), older patients (mean age 27.6 years (SD 8.4) vs 23.8 (SD 9.0); p = 0.003), and most often with the use of the broad Mast chisel (28.5%; p < 0.001). Multivariable analysis revealed that increasing age (odds ratio (OR) 1.04; 95% CI 1.01 to 1.07; p = 0.028) and use of the broad Mast chisel (OR 5.1 (95% CI 1.3 to 19.0) compared to narrow Ganz chisel; p = 0.038) and surgeon (p = 0.043) were associated with increased risk of stress fracture. Patients with stress fractures were less likely to have healed osteotomies after one-year follow-up (76% vs 96%; p < 0.001). Conclusion Stress fracture of the posterior column may be an under-recognized complication following PAO, and the rate may be influenced by surgical technique. Consideration should be given to using a narrow chisel during the ischial cut to reduce the risk of stress propagation through the posterior column. Cite this article: Bone Joint J 2022;104-B(9):1017–1024.
The Open-Fracture Patient Evaluation Nationwide (OPEN) study
Authors: Winstanley Robert J. H. , Hadfield James N. , Walker Reece , Bretherton Christopher P. , Ashwood Neil , Allison Keith , Trompeter Alex , Eardley William G. P. ,   on behalf of the Open-Fracture Patient Evaluation Nationwide (OPEN) collaborators
Published: September 2022

Aims The Open-Fracture Patient Evaluation Nationwide (OPEN) study was performed to provide clarity in open fracture management previously skewed by small, specialist centre studies and large, unfocused registry investigations. We report the current management metrics of open fractures across the UK. Method Patients admitted to hospital with an open fracture (excluding phalanges or isolated hand injuries) between 1 June 2021 and 30 September 2021 were included. Institutional information governance approval was obtained at the lead site and all data entered using Research Electronic Data Capture software. All domains of the British Orthopaedic Association Standard for Open Fracture Management were recorded. Results Across 51 centres, 1,175 patients were analyzed. Antibiotics were given to 754 (69.0%) in the emergency department, 240 (22.0%) pre-hospital, and 99 (9.1%) as inpatients. Wounds were photographed in 848 (72.7%) cases. Median time to first surgery was 16 hrs 14 mins (interquartile range (IQR) 8 hrs 29 mins to 23 hrs 19 mins). Complex injuries were operated on sooner (median 12 hrs 51 mins (IQR 4 hrs 36 mins to 21 hrs 14 mins)). Of initial procedures, 1,053 (90.3%) occurred between 8am and 8pm. A consultant orthopaedic surgeon was present at 1,039 (89.2%) first procedures. In orthoplastic centres, a consultant plastic surgeon was present at 465 (45.1%) first procedures. Overall, 706 (60.8%) patients required a single operation. At primary debridement, 798 (65.0%) fractures were definitively fixed, while 734 (59.8%) fractures had fixation and coverage in one operation through direct closure or soft-tissue coverage. Negative pressure wound therapy was used in 235 (67.7%) staged procedures. Following wound closure or soft-tissue cover, 509 (47.0%) patients received antibiotics for a median of three days (IQR 1 to 7). Conclusion OPEN provides an insight into care across the UK and different levels of hospital for open fractures. Patients are predominantly operated on promptly, in working hours, and at specialist centres. Areas for improvement include combined patient review and follow-up, scheduled operating, earlier definitive soft-tissue cover, and more robust antibiotic husbandry. Cite this article: Bone Joint J 2022;104-B(9):1073–1080.
Leveraging mHealth usage logs to inform health worker performance in a Resource-Limited setting: Case example of mUzima use for a chronic disease program in Western Kenya
Authors: Savai Simon , Kamano Jemimah , Misoi Lawrence , Wakholi Peter , Hasan Md Kamrul , Were Martin C. 
Published: September 2022

Background
Health systems in low- and middle-income countries (LMICs) can be strengthened when quality information on health worker performance is readily available. With increasing adoption of mobile health (mHealth) technologies in LMICs, there is an opportunity to improve work-performance and supportive supervision of workers. The objective of this study was to evaluate usefulness of mHealth usage logs (paradata) to inform health worker performance.

Methodology
This study was conducted at a chronic disease program in Kenya. It involved 23 health providers serving 89 facilities and 24 community-based groups. Study participants, who already used an mHealth application (mUzima) during clinical care, were consented and equipped with an enhanced version of the application that captured usage logs. Three months of log data were used to determine work performance metrics, including: (a) number of patients seen; (b) days worked; (c) work hours; and (d) length of patient encounters.

Principal findings
Pearson correlation coefficient for days worked per participant as derived from logs as well as from records in the Electronic Medical Record system showed a strong positive correlation between the two data sources (r(11) = .92, p < .0005), indicating mUzima logs could be relied upon for analyses. Over the study period, only 13 (56.3%) participants used mUzima in 2,497 clinical encounters. 563 (22.5%) of encounters were entered outside of regular work hours, with five health providers working on weekends. On average, 14.5 (range 1–53) patients were seen per day by providers.

Conclusions / Significance
mHealth-derived usage logs can reliably inform work patterns and augment supervision mechanisms made particularly challenging during the COVID-19 pandemic. Derived metrics highlight variabilities in work performance between providers. Log data also highlight areas of suboptimal use, of the application, such as for retrospective data entry for an application meant for use during the patient encounter to best leverage built-in clinical decision support functionality.