bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time-dependent risk of COVID-19 death with overwhelmed health-care capacity in Japan, 2020–2022
Authors: Hayashi Katsuma , Nishiura Hiroshi 
Published: December 2022

Abstract
Background
It has been descriptively argued that the case fatality risk (CFR) of coronavirus disease (COVID-19) is elevated when medical services are overwhelmed. The relationship between CFR and pressure on health-care services should thus be epidemiologically explored to account for potential epidemiological biases. The purpose of the present study was to estimate the age-dependent CFR in Tokyo and Osaka over time, investigating the impact of caseload demand on the risk of death.

Methods
We estimated the time-dependent CFR, accounting for time delay from diagnosis to death. To this end, we first determined the time distribution from diagnosis to death, allowing variations in the delay over time. We then assessed the age-dependent CFR in Tokyo and Osaka. In Osaka, the risk of intensive care unit (ICU) admission was also estimated.

Results
The CFR was highest among individuals aged 80 years and older and during the first epidemic wave from February to June 2020, estimated as 25.4% (95% confidence interval [CI] 21.1 to 29.6) and 27.9% (95% CI 20.6 to 36.1) in Tokyo and Osaka, respectively. During the fourth wave of infection (caused by the Alpha variant) in Osaka the CFR among the 70s and ≥ 80s age groups was, respectively, 2.3 and 1.5 times greater than in Tokyo. Conversely, despite the surge in hospitalizations, the risk of ICU admission among those aged 80 and older in Osaka decreased. Such time-dependent variation in the CFR was not seen among younger patients < 70 years old. With the Omicron variant, the CFR among the 80s and older in Tokyo and Osaka was 3.2% (95% CI 3.0 to 3.5) and 2.9% (95% CI 2.7 to 3.1), respectively.

Conclusion
We found that without substantial control, the CFR can increase when a surge in cases occurs with an identifiable elevation in risk—especially among older people. Because active treatment options including admission to ICU cannot be offered to the elderly with an overwhelmed medical service, the CFR value can potentially double compared with that in other areas of health care under less pressure.
Detecting immunoglobulin G4-related intracranial arteriopathy with magnetic resonance vessel wall imaging: a preliminary experience in two cases
Authors: Mitani Koki , Funaki Takeshi , Tanji Masahiro , Onizawa Hideo , Yoshifuji Hajime , Fushimi Yasutaka , Torimaki Shinya , Yoshida Kazumichi , Miyamoto Susumu 
Published: December 2022

Abstract
Background
Detecting immunoglobulin G4 (IgG4)-related intracranial arteriopathy, a rare neurovascular complication of IgG4-related disease, is challenging. While magnetic resonance (MR) vessel wall imaging (VWI) can visualize various neurovascular pathologies, its application to this arteriopathy has not been reported as of this writing.

Case presentation
A 74-year-old male and a 65-year-old female manifested multiple cranial nerve palsy and neck pain, respectively. Both cases exhibited multiorgan masses with markedly elevated serum IgG4 levels and were clinically diagnosed with IgG4-related disease. Three-dimensional T1-weighted black blood VWI with and without contrast agent identified intracranial vascular lesions characterized as nearly-circumferential mural thickening with homogeneous contrast enhancement in the internal carotid and vertebral arteries; some of the lesions had been unrecognized with screening MR angiography due to expansive remodeling. The former patient underwent corticosteroid therapy, and VWI after treatment revealed decreased mural thickening and enhancement.

Conclusion
Further studies to elucidate characteristic findings of VWI might contribute to early detection of this treatable pathology.
Antenatal care utilization during the COVID-19 pandemic: an online cross-sectional survey among Filipino women
Authors: de Guzman Glaiza S. , Banal-Silao Maria Jesusa B. 
Published: December 2022

Abstract
Background
The COVID-19 pandemic resulted in unprecedented challenges to healthcare systems worldwide, including interruption of antenatal care services. The study aimed to determine the utilization of antenatal care services of Filipino women during the COVID-19 pandemic.

Methods
A cross-sectional study was conducted among postpartum women using an online self-administered survey in the Philippines from January 1 to March 31, 2022. The questionnaire used to assess health-seeking behavior was validated before the survey proper. Women aged 18 to 45 years who delivered in 2021 were recruited. The participants answered a structured questionnaire to assess their access, perceptions, and utilization of antenatal care. Utilization of antenatal care was evaluated using standard measures, including the timing of initiation of antenatal care, number of subsequent visits, and place of consults. The factors affecting the adequacy of antenatal care were determined for each variable through simple logistic regression.

Results
A total of 318 women were enrolled in the study. All the respondents agreed on the necessity of antenatal care. However, only 46.37% had six or more in-person antenatal visits, with the majority attended to by midwives at community health centers. Most respondents (71.38%) initiated antenatal care during the first trimester. Almost half reported deferrals of visits mainly due to lockdown restrictions, transportation problems, and financial issues. Positive predictors of adequate antenatal care were prior pregnancies (OR 1.80, 95% CI 1.11–9.20 for 2–3 prior pregnancies; OR 3.02, 95% CI 1.45–6.29 for 4 or more prior pregnancies), live births (OR 1.67, 95% CI 1.04–2.69 for 2–3 prior live births; OR 2.46, 95% CI 1.17–5.16 for 4 or more prior live births), having living children (OR 1.74, 95% CI 1.09–2.79), spousal support (OR 1.75, 95% CI 1.01–3.03 for married women; OR 1.89, 95% CI 1.09–3.28 for women with common-law partners), history of obstetric complications (OR 2.82, 95% CI 1.33–5.97), and use of private vehicles (OR 2.65, 95% CI 1.05–6.68). Negative predictors were employment (OR 0.37, 95% CI 0.22–0.63) and medical examination prior to pregnancy (OR 0.36, 95% CI 0.23–0.58).

Conclusion
Despite an overall positive perception of the necessity of antenatal care, utilization has been inadequate in more than half of the respondents. Various individual, facility, and policy-level factors affected the utilization of services during the pandemic. There is a need to augment antenatal care services in the country by mitigating barriers to access. The public health response should strengthen collaborative efforts with primary-level healthcare to increase service provision, especially to more vulnerable populations.
The incidence and risk factors of meconium amniotic fluid in singleton pregnancies: an experience of a tertiary hospital in Iran
Authors: Shekari Mitra , Jahromi Malihe Shirzadfard , Ranjbar Amene , Mehrnoush Vahid , Darsareh Fatemeh , Roozbeh Nasibeh 
Published: December 2022

Abstract
Background
Several common maternal or neonatal risk factors have been linked to meconium amniotic fluid (MAF) development; however, the results are contradictory, depending on the study. This study aimed to assess the prevalence and risk factors of MAF in singleton pregnancies.

Methods
This study is a retrospective cohort that assessed singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups: 1) those diagnosed with meconium amniotic fluid (MAF) and 2) those diagnosed with clear amniotic fluid. Mothers with bloody amniotic fluid were excluded. Demographic factors, obstetrical factors, and maternal comorbidities were extracted from the electronic data of each mother. The Chi-square test was used to compare differences between the groups for categorical variables. Logistic regression models were used to assess meconium amniotic fluid risk factors.

Results
Of 8888 singleton deliveries during the study period, 1085 (12.2%) were MAF. MAF was more common in adolescents, mothers with postterm pregnancy, and primiparous mothers, and it was less common in mothers with GDM and overt diabetes. The odds of having MAF in adolescents were three times higher than those in mothers 20–34 years old (aOR: 3.07, 95% CI: 1.87–4.98). Likewise, there were significantly increased odds of MAF in mothers with late-term pregnancy (aOR: 5.12, 95% CI: 2.76–8.94), and mothers with post-term pregnancy (aOR: 7.09, 95% CI: 3.92–9.80). Primiparous women were also more likely than multiparous mothers to have MAF (aOR: 3.41, 95% CI: 2.11–4.99).

Conclusions
Adolescents, primiparous mothers, and mothers with post-term pregnancies had a higher risk of MAF. Maternal comorbidities resulting in early termination of pregnancy can reduce the incidence of MAF.
Regular lung recruitment maneuvers during high-frequency oscillatory ventilation in extremely preterm infants: a randomized controlled trial
Authors: Werther Tobias , Kueng Erik , Aichhorn Lukas , Pummer Linda , Goeral Katharina , Berger Angelika , Hermon Michael , Klebermass-Schrehof Katrin 
Published: December 2022

Abstract
Background
Lung recruitment maneuvers (LRMs) improve lung volume at initiation of high-frequency oscillatory ventilation (HFOV), but it is unclear when to repeat LRMs. We evaluated the efficiency of scheduled LRMs.

Methods
In a randomized controlled trial, extremely preterm infants on HFOV received either LRMs at 12-hour intervals and when clinically indicated (intervention) or only when clinically indicated (control). The primary outcome was the cumulative oxygen saturation index (OSI) over HFOV time, limited to 7 days. Additionally, LRMs were analyzed with respect to OSI improvement.

Results
Fifteen infants were included in each group. The mean (SD) postmenstrual age and weight at HFOV start were 23 + 6 (0 + 5) weeks and 650 (115) g in the intervention group and 24 + 4 (0 + 6) weeks (p = 0.03) and 615 (95) g (p = 0.38) in the control group. The mean (SD) cumulative OSI amounted to 4.95 (1.72) in the intervention versus 5.30 (2.08) in the control group (p = 0.61). The mean (SD) number of LRMs in 12 h was 1.3 (0.2) in the intervention versus 1.1 (0.5) in the control group (p = 0.13). Performing LRM when FiO2 > 0.6 resulted in a mean OSI reduction of 3.6.

Conclusion
Regular versus clinically indicated LRMs were performed with equal frequency in preterm infants during HFOV, and consequently, no difference in lung volume was observed. LRMs seem to be most efficient at high FiO2.

Trial registration
ClinicalTrials.gov ID: NCT04289324 (28/02/2020).
The costs of interventions for type 2 diabetes mellitus, hypertension and cardiovascular disease in South Africa – a systematic literature review
Authors: Masuku Sithabiso D. , Lekodeba Nkgomeleng , Meyer-Rath Gesine 
Published: December 2022

Abstract
Background
In the context of a move to universal health coverage, three separate systematic reviews were conducted to summarise available evidence on the direct costs of interventions for type 2 diabetes mellitus, hypertension, and cardiovascular disease in South Africa.

Methods
PubMed® and Web of Science was searched for literature published between 01 and 1995 and 27 October 2022. Additionally, reference and citations lists of retrieved articles and experts were consulted. We also tracked reference lists of previous, related systematic reviews. Eligible publications were cost analyses of clinical interventions targeted at adults age 15 + reporting primary estimates of in- and out-of-hospital costs from a provider perspective. Costs were extracted and converted to 2021 US dollars, and article methodological and reporting quality was appraised using the 2013 CHEERS checklist.

Results
Of the 600, 1,172 and 1,466 identified publications for type 2 diabetes mellitus, hypertension, and cardiovascular disease, respectively, 10, 12, and 17 met full inclusion criteria. 60% of articles reported cardiovascular disease costs, 52% were of good reporting quality, and 10%, 50%, and 39% of type 2 diabetes mellitus, hypertension and cardiovascular disease papers reported private-sector costs only. Hypertension drug costs ranged from $2 to $85 per person-month, while type 2 diabetes mellitus drug costs ranged between $57 and $630 per person-year (ppy). Diabetes-related complication treatment costs ranged from $55 for retinopathy treatment to $25,193 ppy for haemodialysis, while cardiovascular disease treatment costs were between $160 and $37,491 ppy. Drugs and treatment of complications were major cost drivers for hypertension and type 2 diabetes mellitus, while hospitalisation drove cardiovascular disease costs.

Conclusion
The intervention costs of type 2 diabetes mellitus, hypertension and cardiovascular disease care have received more attention recently, particularly diabetes-related complications and cardiovascular disease. However, 39% of identified cardiovascular disease treatment costs used a private sector perspective, leaving significant research gaps in the public sector and the cheaper to treat hypertension and type 2 diabetes mellitus. This review fills an information gap regarding the intervention costs of these diseases in South Africa.
Impact of national COVID-19 restrictions on incidence of notifiable communicable diseases in England: an interrupted time series analysis
Authors: Nash Katrina , Lai Jo , Sandhu Karanbir , Chandan Joht Singh , Shantikumar Saran , Ogunlayi Fatai , Coleman Paul C. 
Published: December 2022

Abstract

Background
Non-pharmaceutical interventions (NPIs), such as travel restrictions, social distancing and isolation policies, aimed at controlling the spread of COVID-19 may have reduced transmission of other endemic communicable diseases, such as measles, mumps and meningitis in England.

Methods
An interrupted time series analysis was conducted to examine whether NPIs was associated with trends in endemic communicable diseases, using weekly reported cases of seven notifiable communicable diseases (food poisoning, measles, meningitis, mumps, scarlet fever and pertussis) between 02/01/2017 to 02/01/2021 for England.

Results
Following the introduction of COVID-19 restrictions, there was an 81.1% (95% CI; 77.2–84.4) adjusted percentage reduction in the total number of notifiable diseases recorded per week in England. The greatest decrease was observed for measles, with a 90.5% percentage reduction (95% CI; 86.8–93.1) from 42 to 5 cases per week. The smallest decrease was observed for food poisoning, with a 56.4% (95%CI; 42.5–54.2) decrease from 191 to 83 cases per week.

Conclusions
A total reduction in the incidence of endemic notifiable diseases was observed in England following the implementation of public health measures aimed at reducing transmission of SARS-COV-2 on March 23, 2020. The greatest reductions were observed in diseases most frequently observed during childhood that are transmitted via close human-to-human contact, such as measles and pertussis. A less substantive reduction was observed in reported cases of food poisoning, likely due to dining services (i.e., home deliveries and takeaways) remaining open and providing a potential route of transmission. This study provides further evidence of the effectiveness of non-pharmaceutical public health interventions in reducing the transmission of both respiratory and food-borne communicable diseases.
AO distractor and manual traction reduction techniques repair in distal tibial fractures: a comparative study
Authors: Wu Hao-Jun , He Yan-Xia , Hang Chen , Hao Lin , Lin Ting-Kui 
Published: December 2022

AbstractBackgroundMinimally invasive plate osteosynthesis (MIPO) via percutaneous plate placement on the distal medial tibia can be performed with minimizes soft tissue injury and produces good clinical results. However, the difficulty with MIPO lies in how to achieve satisfactory fracture reduction and maintain that reduction via indirect reduction techniques to facilitate internal fixation. The purpose of this study was to compare the effects of AO distractor and manual traction reduction techniques combined with MIPO in the treatment of distal tibia fractures.MethodsBetween January 2013 and December 2019, 58 patients with a distal tibia fracture were treated using MIPO. Patients were divided into two groups according to the indirect reduction method that was used: 26 patients were reduced with manual traction(group M), and 32 were reduced with an AO distractor (group A).Time until union and clinical outcomes including AOFAS ankle-rating score and ankle range of ankle motion at final follow-up were compared. Mean operative time, incision length, blood loss and postoperative complications were recorded via chart review. Radiographic results at final follow-up were assessed for tibial angulation and shortening by a blinded reader.ResultsMean operative time, incision length, and blood loss in group A were significantly lower than in group M(p = 0.019, 0.018 and 0.016, respectively).Radiographic evidence of bony union was seen in all cases, and mean time until union was equivalent between the two groups (p = 0.384).Skin irritation was noted in one case(3.1%) in group A and three cases(11.5%)in group M, but the symptoms were not severe and the plate was removed after bony union. There was no statistically significant difference in postoperative complications between the two groups(p = 0.461). Mean AOFAS score and range of ankle motion were equivalent between the two groups, as were varus deformity, valgus deformity, anterior angulation and posterior angulation. No patients had gross angular deformity. Mean tibial shortening was not significantly different between the two groups, and no patients had tibial shortening > 10 mm.ConclusionBoth an AO distractor and manual traction reduction techniques prior to MIPO in the treatment of distal tibial fractures permit a high fracture healing rate and satisfying functional outcomes with few wound healing complications. An AO distractor is an excellent indirect reduction method that may improve operative efficiency and reduce the risk of soft tissue injury.
OF spine classification of osteoporotic thoracolumbar vertebral body fractures by MRI and conventional radiographs only leads to high inter-observer agreement rates-an additional CT adds limited information for the of classification and the OF score
Authors: Spiegl Ulrich J. , Behr Lars , Osterhoff Georg , Rupprecht Gunnar , Scheyerer Max J. , Katscher Sebastian 
Published: December 2022

Abstract
Objectives
The purpose of this study was to investigate whether the addition of computed tomography (CT) to magnetic resonance imaging (MRI) improves the accuracy of classifying osteoporotic vertebral body fractures (OVBF).

Methods
A retrospective analysis of a prospective single-center database has been performed. All consecutive patients who had suffered an acute thoracolumbar OVBF in one level II spine center between 2017 and 2019 were analyzed. Thereby, fractures of type OF 1 and OF 5 were excluded. All fractures were initially classified by 5 board-certified orthopaedic surgeons based on MRI and conventional radiographs. Afterwards a reclassification including CT scans were performed. Differences in OF classification and OF score values between both measurements were analyzed.

Results
A total of 61 patients were analyzed with a mean age 75.8 years (SD: 8.8 years). In 82.9% of the cases, there was no difference in OF classification comparing classification based only on MRI versus MRI + CT. A difference of more than two OF types was observed in less than 1% of all ratings. The inter-rater reliabilities of the OF classification based on CT + MRI and MRI alone were 0.63 and 0.49, respectively. In 97.5% of the cases there was no therapy-relevant difference of the treatment recommendation with respect of a surgical or nonoperative treatment recommendation based on the OF score.

Conclusion
In terms of the OF classification and the OF score, the addition of CT add limited value compared to conventional radiographs and MRI only. Additionally, there is only a minor rate of disagreement in treatment recommendations when adding a CT.
Palliative care outpatients in a German comprehensive cancer center—identifying indicators for early and late referral
Authors: Müller S. , Fink M. , Hense J. , Comino M. R. Salvador , Schuler M. , Teufel M. , Tewes M. 
Published: December 2022

Abstract
Purpose
Despite that early integration of palliative care is recommended in advanced cancer patients, referrals to outpatient specialised palliative care (SPC) frequently occur late. Well-defined referral criteria are still missing. We analysed indicators associated with early (ER) and late referral (LR) to SPC of an high volume outpatient unit of a comprehensive cancer center.

Methods
Characteristics, laboratory parameters and symptom burden of 281 patients at first SPC referral were analysed. Timing of referral was categorized as early, intermediate and late (> 12, 3–12 and < 3 months before death). Ordinal logistic regression analysis was used to identify factors related to referral timing. Kruskal–Wallis test was used to determine symptom severity and laboratory parameter in each referral category.

Results
LRs (50.7%) had worse scores of weakness, loss of appetite, drowsiness, assistance of daily living (all p < 0.001) and organisation of care (p < 0.01) in contrast to ERs. The mean symptom sum score was significantly higher in LRs than ERs (13.03 vs. 16.08; p < 0.01). Parameters indicative of poor prognosis, such as elevated LDH, CRP and neutrophil-to-lymphocyte ratio (NLR) (p < 0.01) as well as the presence of ascites (p < 0.05), were significantly higher (all p < 0.001) in LRs. In univariable analyses, psychological distress (p < 0.05) and female gender (p < 0.05) were independently associated with an ER.

Conclusion
A symptom sum score and parameters of poor prognosis like NLR or LDH might be useful to integrate into palliative care screening tools.
Sexual dysfunction in women with genital warts: a systematic review
Authors: Adeli Mohadese , Moghaddam-Banaem Lida , Shahali Shadab 
Published: December 2022

Abstract
Purpose
To provide an understanding of the changes in sexual function in women with genital warts.

Methods
In this review study, databases searched included: PubMed, Science Direct, Scopus, Web of Science, Cochrane Library of Systematic Reviews, Google Scholar, ProQuest, Wiley, and Highwire Press. No study design limitations were applied to the initial search, and qualitative and quantitative studies published between 2005 and 2021 were included.

Results
19 articles were selected and analyzed narratively. The quality of the studies was almost good. The findings were classified into three groups: The prevalence of sexual dysfunction in women with genital warts (GWs) and Human Papillomavirus (HPV); Types of sexual dysfunction in women with genital warts, and associated factors; Psychosexual effects of genital warts.

Conclusion
This study provides up-to-date evidence of the changes in sexual function in women with genital warts. Although the results of most studies showed that women with genital warts experienced sexual dysfunction in almost all dimensions, differences in study design and study population made it difficult to determine the specific type of disorder such as libido, or arousal disorders in these women. Based on the findings of this review, more research in this field is recommended for the future.
Systematic review registration: (PROSPERO: CRD42020188584, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188584).