bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral and macular polypoidal choroidal vasculopathy: A retrospective comparative case series
Authors: Venkatesh Ramesh , Mishra Pranjal , Nahata Harshita , Reddy Nikitha Gurram , Yadav Naresh Kumar , Chhablani Jay 
Published: May 2022

Purpose To compare clinical and imaging features and treatment outcomes between eyes having peripheral polypoidal choroidal vasculopathy (PCV) and macular PCV. Methods In this retrospective comparative case series, confirmed cases of peripheral and macular PCV cases on indocyanine green angiography (ICGA) were included. The various demographic features, imaging characteristics and clinical course between cases with peripheral and macular PCV were compared and analysed. Results Fifteen eyes of 12 patients and 22 eyes of 20 patients were diagnosed with peripheral PCV and macular PCV respectively based on polyps seen on ICGA. Mean age at presentation in peripheral and macular PCV groups were 76.3 ± 8.78 and 69.1 ± 8.64 years respectively (p = 0.038). Mean logMAR visual acuity in the peripheral and macular PCV group was 0.423 ± 0.568 and 0.535 ± 0.513 respectively (p = 0.595). Peripheral subretinal hemorrhage was noted commonly in the peripheral PCV group (n = 10, 66%) and hard exudates were common in the macular PCV (19, 86%) group. Subfoveal choroid was significantly thinner in peripheral PCV group compared to macular PCV group (215.2 ± 39.94 vs 283.3 ± 50.08; p = 0.001). At final follow-up visit, 50% eyes (n = 11) in macular PCV group were still active and 87% (n = 13) eyes in the peripheral PCV showed an inactive disease (p = 0.035). Conclusion Peripheral and macular PCV cases are two separate clinical entities having distinct pathogenesis, clinical and imaging features and treatment outcomes. Further studies are needed for understanding the pathomechanism in these distinct disease entities.
Management of coexisting bilateral ocular surface disease in xeroderma pigmentosum - sequence and outcomes
Authors: Rajagopal Rama , Srinivasan Bhaskar , Iyer Geetha , Agarwal Manokamna 
Published: May 2022

Purpose To report a rare presentation of bilateral, coexisting ocular surface disease in a case of Xeroderma pigmentosum and its successful management. Methods Case report. Results A 21-year-old male with Xeroderma pigmentosum presented with bilateral ocular surface squamous neoplasia (OSSN) along with central guttae in the right eye and corneal decompensation of the left eye. Subsequently, the patient developed dry eyes and lid margin keratinization in both eyes followed by perforation in the left eye. Sequential procedures both medical and surgical, including excision of the tumour, corneal transplantation and mucous membrane grafting addressing each of these ocular surface issues resulted in a successful outcome. There was no recurrence of the tumour over 3 years. Corneal transplantation is preferably done after a minimum of 6 months following excision. Mucous membrane grafting performed for progressive lid margin keratinization resulted in surface stabilization. Conclusions In Xeroderma Pigmentosum, multiple ocular surface features can rarely coexist and be bilateral. Periodic evaluation of the surface for tumours, progressive dry eyes and endothelial function is recommended as a part of routine evaluation in Xeroderma pigmentosum. Surface procedures should precede intraocular intervention. Sequential management can result in successful outcomes.
Artificial intelligence for the evaluation of peripheral artery disease using arterial Doppler waveforms to predict abnormal ankle-brachial index
Authors: McBane Robert D , Murphree Dennis H , Liedl David , Lopez-Jimenez Francisco , Attia Itzhak Zachi , Arruda-Olson Adelaide , Scott Christopher G , Prodduturi Naresh , Nowakowski Steve E , Rooke Thom W , Casanegra Ana I , Wysokinski Waldemar E , Swanson Keith E , Houghton Damon E , Bjarnason Haraldur , Wennberg Paul W 
Published: May 2022

Background: Patients with peripheral artery disease (PAD) are at increased risk for major adverse limb and cardiac events including mortality. Developing screening tools capable of accurate PAD identification is a necessary first step for strategies of adverse outcome prevention. This study aimed to determine whether machine analysis of a resting Doppler waveform using deep neural networks can accurately identify patients with PAD. Methods: Consecutive patients (4/8/2015 – 12/31/2020) undergoing rest and postexercise ankle–brachial index (ABI) testing were included. Patients were randomly allocated to training, validation, and testing subsets (70%/15%/15%). Deep neural networks were trained on resting posterior tibial arterial Doppler waveforms to predict normal (> 0.9) or PAD (⩽ 0.9) using rest and postexercise ABI. A separate dataset of 151 patients who underwent testing during a period after the model had been created and validated (1/1/2021 – 3/31/2021) was used for secondary validation. Area under the receiver operating characteristic curves (AUC) were constructed to evaluate test performance. Results: Among 11,748 total patients, 3432 patients met study criteria: 1941 with PAD (mean age 69 ± 12 years) and 1491 without PAD (64 ± 14 years). The predictive model with highest performance identified PAD with an AUC 0.94 (CI = 0.92–0.96), sensitivity 0.83, specificity 0.88, accuracy 0.85, and positive predictive value (PPV) 0.90. Results were similar for the validation dataset: AUC 0.94 (CI = 0.91–0.98), sensitivity 0.91, specificity 0.85, accuracy 0.89, and PPV 0.89 (postexercise ABI comparison). Conclusion: An artificial intelligence-enabled analysis of a resting Doppler arterial waveform permits identification of PAD at a clinically relevant performance level.
A Model to Explore how Communal Traits Affects Stay Intent Amongst Taiwanese Nurses
Authors: Chang WenYing , Lee YiHsuan 
Published: May 2022

Aims This study discusses the model built to explore low levels of communal traits’ influence on nurses’ stay intent. Background The high turnover rate and low stay intent amongst Taiwan's nurses is a serious issue. One reason for the low stay intent is nurse-to-nurse interpersonal conflict. Surface-level difference, such as low levels of communal traits, may be an important antecedent factor. Previous studies have found that this type of conflict can frequently arise in female-to-female relationships. Design This was quantitative, cross-sectional research using a questionnaire survey. Method 249 registered nurses participated in the survey, which employed convenience sampling. The data was collected from January 10th 2020 to February 10th 2020. Results/Findings: We found that nurses with low levels of communal traits become frustrated, creating psychological need thwarting and decreasing stay intention. Belonging perception appears to weaken this. In addition, autonomy and relatedness of need thwarting but not competence mediates the relationship between frustration experience and stay intent. Unlike in past studies, this was not found to be an exclusively female phenomenon. Conclusion Improving belonging perception may be the answer to overcoming negative outcomes caused by surface-level difference in the nursing profession. However, why surface-level difference has a negative influence remains a question that needs to be further explored. In addition, Taiwanese nursing managers in this low status and relationship-oriented nursing culture should also focus on improving frontline nurses’ confidence and self-conceptualizations.
The Effects of the COVID-19 Confinement on Screen Time, Headaches, Stress and Sleep Disorders among Adolescents: A Cross Sectional Study
Authors: Wehbe Andrew T. , Costa Tarek E. , Abbas Samar A. , Costa Jad E. , Costa George E. , Wehbe Tarek W. 
Published: May 2022

Background Headache is a common symptom affecting children and adolescents. The medical literature over the last three decades reveals a variable prevalence and triggers in different countries, regions, circumstances and times. This study aims to assess the prevalence, frequency and quality of headaches in the Lebanese adolescent population under the COVID-19 confinement and study its triggers and relationship to screen time, self-reported anxiety, and sleep. Methods A cross sectional design was used to collect two survey results by snowball distribution using social media targeting adolescents aged 15 to 17 years of age. The first survey included 13 questions with a single best answer about screen time, feeling anxious, sleep time, schedule and consistency, and headaches. The second survey included 3 questions about the quality of the headaches, anxiety and its triggers. Results Among 433 responders to the first survey, the prevalence of headaches, especially pressure points and band-like pressure was higher than any previously reported among adolescents in the literature, reaching 93.4%. Screen time was also higher than any previous reports with 95.6% spending 9 hours or more on screen while 64% of adolescents spending at least 12 hours a day on screen. In addition, the majority (82%) don't have consistent sleep habits and 41.8% consider themselves anxious. School was considered the main source of stress by 82.8% of the responders. The frequency of headache correlated significantly with increased screen time, self-reported anxiety and inconsistent sleep habits. Conclusions Headaches among adolescents are associated with increased screen use, sleep disorders, and self-reported anxiety. It is one of the primary somatization symptoms in this group expressing their extreme stress under the current economic, political, and health crisis. The present trends are likely to have major long term implications on adolescents’ health and academic achievements and should alarm educators and health officials to intervene in this situation.
Long-term archival of environmental samples empowers biodiversity monitoring and ecological research
Authors: Zizka Vera M. A. , Koschorreck Jan , Khan Collins C. , Astrin Jonas J. 
Published: May 2022

AbstractHuman-induced biodiversity loss and changes in community composition are major challenges of the present time, urgently calling for comprehensive biomonitoring approaches to understand system dynamics and to inform policy-making. In this regard, molecular methods are increasingly applied. They provide tools for fast and high-resolution biodiversity assessments and can also focus on population dynamics or functional diversity. If samples are stored under appropriate conditions, this will enable the analysis of DNA, but also RNA and proteins from tissue or from non-biological substrates such as soil, water, or sediments, so-called environmental DNA (eDNA) or eRNA. Until now, most biodiversity studies using molecular methods rely on recent sampling events, although the benefit of analyzing long-time series is obvious. In this context Environmental Specimen Banks (ESBs) can play a crucial role, supplying diverse and well-documented samples collected in periodically repeated sampling events, and following standardized protocols. Mainly assembled for integrative monitoring of chemical compounds, ESB collections are largely accessible to third parties and can in principle be used for molecular analysis. While ESBs hold great potential for the standardized long-time storage of environmental samples, the cooperation with Biodiversity Biobanks as scientific collections guarantees the long-time storage of nucleotide (DNA, RNA) extracts together with links to analytical results and metadata. The present contribution aims to raise the awareness of the biodiversity research community regarding the high-quality samples accessible through ESBs, encourages ESBs to collect and store samples in DNA-friendly ways, and points out the high potential of combining DNA-based approaches with monitoring chemicals and other environmental stressors.
Acute myocardial infarction with simultaneous total occlusion of the left anterior descending artery and right coronary artery successfully treated with percutaneous coronary intervention
Authors: Saito Ryuhei , Koyama Kohei , Kongoji Ken , Soejima Kyoko 
Published: May 2022

Abstract
Background
Simultaneous thrombosis in more than one coronary artery is an uncommon angiographic finding in patients with acute ST-segment elevation myocardial infarction. It is difficult to identify using 12-lead electrocardiography and usually leads to cardiogenic shock and fatal outcomes, including sudden cardiac death. Therefore, immediate revascularization and adequate mechanical circulatory support are required.

Case presentation
We report the case of a 58-year-old man who presented with vomiting and chest pain complicated by cardiogenic shock and complete atrioventricular block. Electrocardiography revealed ST-segment elevation in leads II, III, aVF, and V1–V6. Emergency coronary angiography revealed total occlusion of the proximal left anterior descending artery and right coronary artery. The patient successfully underwent primary percutaneous coronary intervention with ballooning and stenting for both arteries. An Impella CP was inserted during the procedure. Fifty-seven days after admission, he had New York Heart Association class II heart failure and was transferred to a rehabilitation hospital.

Conclusions
Acute double-vessel coronary thrombosis, a serious event with a high mortality rate, requires prompt diagnosis and management to prevent complications such as cardiogenic shock and ventricular arrhythmias. A combination of judicious medical treatment, efficient primary percutaneous coronary intervention, and early mechanical support device insertion is crucial to improve the survival rate of patients with this disease.
High burden of untreated syphilis, drug resistant Neisseria gonorrhoeae, and other sexually transmitted infections in men with urethral discharge syndrome in Kampala, Uganda
Authors: Hamill Matthew M. , Onzia Annet , Wang Tza-Huei , Kiragga Agnes N. , Hsieh Yu-Hsiang , Parkes-Ratanshi Rosalind , Gough Ethan , Kyambadde Peter , Melendez Johan H. , Manabe Yukari C. 
Published: May 2022

Abstract
Objectives
Prompt diagnosis and treatment of sexually transmitted infections (STIs) are essential to combat the STI epidemic in resource-limited settings. We characterized the burden of 5 curable STIs chlamydia, gonorrhea, trichomoniasis, Mycoplasma genitalium, syphilis, and HIV infection in Ugandan men with urethritis.

Methods
Participants were recruited from a gonococcal surveillance program in Kampala, Uganda. Questionnaires, penile swabs were collected and tested by nucleic acid amplification. Gonococcal isolates were tested for antimicrobial sensitivity. Sequential point-of-care tests on blood samples were used to screen for syphilis and HIV. Bivariable and multivariable multinomial logistic regression models were used to estimate odds ratios for preselected factors likely to be associated with STIs. Adherence to STI treatment guidelines were analyzed.

Results
From October 2019 to November 2020, positivity (95% CI) for gonorrhea, chlamydia, trichomoniasis, and Mycoplasma genitalium, were 66.4% (60.1%, 72.2%), 21.7% (16.8%, 27.4%), 2.0% (0.7%, 4.9%), and 12.4% (8.7%, 17.3%) respectively. All Neisseria gonorrhoeae isolates were resistant to ciprofloxacin, penicillin, and tetracycline, but susceptible to extended spectrum cephalosporins and azithromycin. HIV and syphilis prevalence was 20.0% (50/250) and 10.0% (25/250), and the proportion unaware of their infection was 4.0% and 80.0% respectively. Most participants were treated per national guidelines. Multivariable analysis demonstrated significant associations between curable STI coinfections and younger age, transactional sex, but not HIV status, nor condom or alcohol use.

Conclusions
STI coinfections including HIV their associated risk factors, and gonococcal AMR were common in this population. The majority with syphilis were unaware of their infection and were untreated. Transactional sex was associated with STI coinfections, and > 80% of participants received appropriate treatment.
The relationship between online courses and mental health among Chinese children
Authors: Zhou Shuang , Jin Chu-Yao , Guo Jing , Liu Zheng , Feng Qiang , Wang Jia , Xu Xiang-Rong , Wang Shi , Wan Zhong-Shang , Obel Carsten , Liu Hui , Wang Hai-Jun 
Published: May 2022

Abstract
Background
Previous studies on the association of online courses and mental health were mainly conducted in universities, and no study investigated the relationship between characteristics of online courses and children’s mental health in primary and secondary school. This study aimed to explore the association of online courses and children’s mental health in primary and secondary school.

Methods
A cross-sectional study was conducted through an online survey among 540 primary and secondary school students and their parents in the eastern, central and western region of China from April to May in 2020. Children’s mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Borderline mental health problems (SDQ total difficulties score ≥ 16) and mental health problems (SDQ total difficulties score ≥ 20) were defined according to Goodman’s standard. Multivariable linear and logistic regression models were used to examine the association between online courses and children’s mental health.

Results
Compared with those who did not have problems of online courses, children having the difficulty in understanding the content of online courses had a higher SDQ total difficulties score [β = 1.80, 95% confidence interval (CI): 0.89, 2.71] and a higher risk of borderline mental health problems [odds ratio (OR) = 1.93, 95%CI: 1.07, 3.49], while device or internet connection problems were not significantly associated with children’s mental health. Compared with children who had live courses, those having video-recorded courses had a higher SDQ total difficulties score (β = 0.90, 95%CI: 0.01, 1.80). Children who spent more than 4 h on online courses had a higher SDQ total difficulties score than those of less than or equal to 4 h (β = 0.95, 95%CI: 0.09, 1.81).

Conclusion
We found that online courses with inappropriate characteristics were associated with children’s mental health. The findings called for the efforts to optimize the online courses and improve children’s mental health.
The combined impact of LLINs, house screening, and pull-push technology for improved malaria control and livelihoods in rural Ethiopia: study protocol for household randomised controlled trial
Authors: Asale Abebe , Kassie Menale , Abro Zewdu , Enchalew Bayu , Belay Aklilu , Sangoro Peter O. , Tchouassi David P. , Mutero Clifford M. 
Published: May 2022

Abstract
Background
The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are commonly used malaria interventions that target indoor Anopheles vectors. Recent studies on the effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition, complementary interventions are needed to curb co-occurring pest populations which pose menace to agricultural crop productivity and food security. However, interventions that impact malaria mainly centre on public health strategies, overlooking subtle but important component of agricultural measures. Addressing the coexisting risks of malaria and crop pests could contribute to improved livelihood of communities.

Methods
A four-armed household, cluster-randomized, controlled study will be conducted to assess the combined impact of HS, LLINs and push-pull agricultural technology (PPT) against clinical malaria in children in Ethiopia. The unit of randomization will be the household, which includes a house and its occupants. A total of 838 households will be enrolled in this study. In this trial 246 households will receive LLINs and HS, 250 will receive LLINs, HS and PPT, 175 households will receive LLINs and PPT. The remaining 167 houses which receive LLINs only will be used as control. One child aged ≤14 years will be enrolled per household in each treatment and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons.

Discussion
Episodes of clinical malaria, density of indoor biting malaria vectors, sporozoite infection rate, improved crop infestation rate, crop yield gain, livestock productivity and cost effectiveness analysis will be the end points of this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and participatory methods to explore the acceptability of HS and PPT. Documenting the combined impact of LLINs, HS and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind.

Trial registration
Pan African Clinical Trials Registry, PACTR202006878245287. 24/06/2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=11101.
Beliefs and misperceptions about naloxone and overdose among U.S. laypersons: a cross-sectional study
Authors: Agley Jon , Xiao Yunyu , Eldridge Lori , Meyerson Beth , Golzarri-Arroyo Lilian 
Published: May 2022

AbstractBackgroundOverdose education and naloxone distribution (OEND) to laypersons are key approaches to reduce the incidence of opioid-involved overdoses. While some research has examined attitudes toward OEND, especially among pharmacists and first responders, our understanding of what laypersons believe about overdose and naloxone is surprisingly limited. Further, some scholars have expressed concerns about the prevalence of non-evidence-based beliefs about overdose and naloxone. We designed this study to analyze the prevalence, nature, and context of beliefs about naloxone and overdose among U.S. laypersons.MethodsWe conducted a cross-sectional study (n = 702) using Prolific.co (representative of the U.S. population by age, gender, and race). Primary outcomes were the believability of six statements about overdose/naloxone on a seven-point Likert-type scale. Five statements were unsupported, and one was supported, by current scientific evidence. We used latent profile analysis to classify participants into belief groups, then used regression to study correlates of profile classification.ResultsBelievability of the statements (7: extremely believable) ranged from m = 5.57 (SD = 1.38) for a scientifically supported idea (trained bystanders can reverse overdose with naloxone), to m = 3.33 (SD = 1.83) for a statement claiming opioid users can get high on naloxone. Participants were classified into three latent belief profiles: Profile 1 (most aligned with current evidence;n = 246), Profile 2 (moderately aligned;n = 351), and Profile 3 (least aligned,n = 105). Compared to Profile 1, several covariates were associated with categorization into Profiles 2 and 3, including lower trust in science (RRR = 0.36, 95%CI = 0.24–0.54; RRR = 0.21, 95%CI = 0.12–0.36, respectively), conservative political orientation (RRR = 1.41, 95%CI = 1.23–1.63; 3:RRR = 1.62, 95%CI = 1.35–1.95, respectively), and never being trained about naloxone (Profile 3: RRR = 3.37, 95%CI = 1.16–9.77).ConclusionsPreliminary evidence suggests some U.S. laypersons simultaneously believe that bystander overdose prevention with naloxone can prevent overdose and one or more scientifically unsupported claims about naloxone/overdose. Categorization into clusters displaying such belief patterns was associated with low trust in science, conservative political orientation, and not having been trained about naloxone.PreregistrationThis cross-sectional study was preregistered prior to any data collection using the Open Science Framework:https://osf.io/c6ufv