bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing matters: there are significant differences in short-term outcomes between two time points of status epilepticus
Authors: Pan Yiwen , Feng Yu , Peng Weifeng , Cai Yang , Ding Jing , Wang Xin 
Published: September 2022

Abstract
Background
In 2015, the International League Against Epilepsy proposed a new conceptual definition of status epilepticus (SE) with two operational dimensions (t1 and t2) to guide emergency treatment. The purpose of this study was to compare clinical characteristics and prognoses of patients at these two different time points.

Methods
We conducted a prospective observational cohort study of consecutive adults diagnosed with SE. In case of convulsive SE, t1 is 5 min and t2 is 30 min, whereas in case of focal SE with impaired consciousness, t1 is 10 min, t2 is 60 min. Data on clinical characteristics, including age, gender, history of prior seizures, neuroimaging, semiology, duration, and etiology of SE, were collected. The primary outcome was mortality, with seizure recurrence as a secondary measure, and functional status as tertiary outcome of enrolled patients at 3 months after SE onset.

Results
We screened one hundred patients with SE, with a median age of 66 years and 61% were male. Fifty-six (56.0%) patients reached t1 of SE, while 44 (44.0%) reached t2 of SE. Convulsive SE (52.0%, n = 52) was more common than focal SE with impaired consciousness (48.0%, n = 48). Status epilepticus secondary to an acute symptomatic process was the most common (50%, n = 50). Patients meeting t2 of SE demonstrated a remarkably increased risk of mortality (unadjusted analysis-RR 3.606, 95%CI 1.552–8.376, p = 0.003; adjusted analysis-RR 2.924, 95%CI 1.221–7.003, p = 0.016) and unfavorable functional status (unadjusted analysis-RR 1.803, 95%CI 1.280–2.539, p = 0.001; adjusted analysis-RR 1.664, 95%CI 1.184–2.340, p = 0.003) at 3 months compared to those who only reached t1 of SE. Patients reaching t2 of SE were more likely to experience seizure recurrence, however, there was no significant difference between the two cohorts.

Conclusions
Our study provides strong support for the new definition of SE. Patients meeting t2 of SE tend to have a remarkably increased risk of mortality and unfavorable functional outcomes compared to those who only reached t1 of SE. Furthermore, patients were likely to experience seizure recurrence after undergoing an episode of SE. Physicians must be educated about prompt recognition and appropriate management of SE.
Autistic children and adolescents with frequent restricted interest and repetitive behavior showed more difficulty in social cognition during mask-wearing during the COVID-19 pandemic: a multisite survey
Authors: Tamon Hiroki , Itahashi Takashi , Yamaguchi Sosei , Tachibana Yoshiyuki , Fujino Junya , Igarashi Miki , Kawashima Makiko , Takahashi Riina , Shinohara Nozomi A. , Noda Yoshihiro , Nakajima Shinichiro , Hirota Tomoya , Aoki Yuta Y. 
Published: September 2022

Abstract
Background
The public health measures enacted in order to control the coronavirus disease (COVID-19) pandemic have caused considerable changes to daily life. For autistic children and adolescents, adapting to the “new normal,” including mask-wearing, may be difficult because of their restricted interest and repetitive behavior (RRB) characteristics. We aimed to examine the relationships between RRB characteristics and the impact of mask-wearing on their social communications during the pandemic.

Methods
We recruited participants with a clinical diagnosis of autism spectrum disorder based on DSM-5 diagnostic criteria from two outpatient clinics in Tokyo, Japan, between November 2020 and April 2021 using a convenience sampling methodology. As a result, the participants consisted of 102 children and adolescents (mean (SD) age = 11.6 (5.3)). We collected data on RRB characteristics frequency before and during the pandemic using the CoRonavIruS Health Impact Survey (CRISIS) – Adapted for Autism and Related Neurodevelopmental conditions (AFAR). We then conducted factor analyses to compute the RRB severity composite scores, which are divided into lower- (e.g., sensory seeking), and higher-order (e.g., restricted interest). We also investigated mask-wearing culture using a bespoke questionnaire, and using Spearman’s rank correlation analyses, we examined the relationships between before pandemic RRB characteristics, and the impact of mask-wearing on social communications during the pandemic.

Results
We found that children and adolescents who exhibited lower-order RRB before the pandemic had difficulties in going-out with mask-wearing (rho = -0.25, q = .031), more challenges with mask-wearing (rho =  − 0.34, q = .0018), and difficulty in referring to others’ emotions while wearing masks (rho =  − 0.36, q = .0016). We also found an association between higher-order RRB before the pandemic and an uncomfortable sensation (rho =  − 0.42, q = .0002) and difficulties in referring to other’s emotions while wearing masks (rho =  − 0.25, q = .031).

Conclusions
We revealed that various behaviors, such as sensory seeking, repetitive motor mannerisms and movements, and rituals and routines, undertaken before the pandemic could be important predictors of difficulties with mask-wearing and social communication for autistic children and adolescents during the pandemic. Caregivers and teachers wearing masks may need to provide extra support for social communication to autistic children and adolescents showing RRB characteristics frequently.
Fistula between the rectal stump and left iliac artery
Authors: Alshammari Mariam , Fatani Jumana , Alotaibi Ohood , Alhajri Khalid , Terro Khalil 
Published: September 2022

Abstract
Background
Isolated iliac artery aneurysms are rare and difficult to diagnose. It is more common in males. It can be asymptomatic at diagnosis or can present with frank rupture, or symptoms caused by compression on nearby organs.

Case presentation
A 44 years old male was diagnosed with rectosigmoid adenocarcinoma and underwent low anterior resection. One year after the surgery, he presented with fistula between the rectal stump and left iliac artery that was managed by stenting.

Conclusion
A fistula between the rectal stump and the left iliac artery is very rare. There are several treatment options for ilio-rectal fistula but no conclusive specific treatment.
Association of sleep duration and insomnia with metabolic syndrome and its components in the Women’s Health Initiative
Authors: Peila Rita , Xue Xiaonan , Feliciano Elizabeth M. Cespedes , Allison Matthew , Sturgeon Susan , Zaslavsky Oleg , Stone Katie L. , Ochs-Balcom Heather M. , Mossavar-Rahmani Yasmin , Crane Tracy E. , Aggarwal Monica , Wassertheil-Smoller Sylvia , Rohan Thomas E. 
Published: September 2022

Abstract
Background
Epidemiological evidence suggests that inadequate sleep duration and insomnia may be associated with increased risk of metabolic syndrome (MetS). However, longitudinal data with repeated measures of sleep duration and insomnia and of MetS are limited. We examined the association of sleep duration and insomnia with MetS and its components using longitudinal data from the Women’s Health Initiative (WHI).

Methods
The study included postmenopausal women (ages 50–79 years) diabetes-free at enrollment in the WHI, with baseline data on sleep duration (n = 5,159), insomnia (n = 5,063), MetS, and its components. Repeated measures of self-reported sleep duration and insomnia were available from years 1 or 3 of follow-up and of the MetS components from years 3, 6 and 9. Associations were assessed using logistic regression and generalized estimating equations models, and odds ratios and 95% confidence intervals (CI) adjusted for major risk factors were calculated.

Results
In cross-sectional analysis, baseline sleep duration ≥ 9 h was positively associated with MetS (OR = 1.51; 95%CI 1.12–2.04), while sleep duration of 8- < 9 h was associated with waist circumference > 88 cm and triglycerides ≥ 150 mg/dL (OR = 1.18; 95%CI 1.01–1.40 and OR = 1.23; 95%CI 1.05–1.46, respectively). Insomnia had a borderline positive association with MetS (OR = 1.14; 95%CI 0.99–1.31), and significant positive associations with waist circumference > 88 cm and glucose ≥ 100 mg/dL (OR = 1.18; 95%CI 1.03–1.34 and OR = 1.17; 95%CI 1.02–1.35, respectively). In the longitudinal analysis, change from restful sleep to insomnia over time was associated with increased odds of developing MetS (OR = 1.40; 95%CI 1.01–1.94), and of a triglyceride level ≥ 150 mg/dL (OR = 1.48; 95%CI 1.08–2.03).

Conclusions
Among postmenopausal women in the WHI, sleep duration and insomnia were associated with current and future risk of MetS and some of its components.
Proton beam therapy for the isolated recurrence of endometrial cancer in para-aortic lymph nodes: a case report
Authors: Uno Kaname , Yoshihara Masato , Tano Sho , Takeda Takehiko , Kishigami Yasuyuki , Oguchi Hidenori 
Published: September 2022

Abstract
Background
Proton beam therapy penetrates tumor tissues with a highly concentrated dose. It is useful when normal structures are too proximate to the treatment target and, thus, may be damaged by surgery or conventional photon beam therapy. However, proton beam therapy has only been used to treat recurrent endometrial cancer in a few cases; therefore, its effectiveness remains unclear.

Case presentation
We herein report a case of the isolated recurrence of endometrial cancer in the para-aortic lymph nodes in a 59-year-old postmenopausal woman that was completely eradicated by proton beam therapy. The patient was diagnosed with stage IIIC2 endometrial cancer and treated with 6 courses of doxorubicin (45 mg/m2) and cisplatin (50 mg/m2) in adjuvant chemotherapy. Fifteen months after the initial therapy, the isolated recurrence of endometrial cancer was detected in the para-aortic lymph nodes. The site of recurrence was just under the left renal artery. Due to the potential risks associated with left kidney resection due to the limited surgical space between the tumor and left renal artery, proton beam therapy was administered instead of surgery or conventional photon beam therapy. Following proton beam therapy, the complete resolution of the recurrent lesion was confirmed. No serious complications occurred during or after treatment. There have been no signs of recurrence more than 7 years after treatment.

Conclusions
Proton beam therapy is a potentially effective modality for the treatment of recurrent endometrial cancer where the tumor site limits surgical interventions and the use of conventional photon beam therapy.
Measuring inequality in the distribution of health human resources using the Hirschman-Herfindahl index: a case study of Qazvin Province
Authors: Nasiri Asghar , Yusefzadeh Hasan , Amerzadeh Mohammad , Moosavi Saeideh , Kalhor Rohollah 
Published: September 2022

Abstract
Background
Achieving equity in the distribution of health services is one major goal in the health system. This study aimed to determine equality in distributing health human resources (physicians) in the Qazvin University of Medical Sciences before and after the Health Transformation Plan (HTP) based on the Hirschman-Herfindahl index (HHI).

Methods
In this descriptive-analytical study, the statistical population was general practitioners (GPs), specialists and subspecialists in the Qazvin University of Medical Sciences from 2011-to 2017. We extracted demographic statistics of the cities from the Statistical Center of Iran. Physicians’ statistics were obtained from the Curative Affairs Deputy at the Qazvin University of Medical Sciences. We assessed inequality using the HHI.

Results
The highest number of GPs was in 2014, and specialists and subspecialists were in 2017. The lowest number of GPs, specialists, and subspecialists were in 2016, 2011 and 2015. The HHI for GPs in 2011–2017 was between 4300 and 5200. The lowest concentration for specialists before the HTP plan was the cardiologist with 3300, and after the HTP, the internal specialist with 3900. Also, the numerical value of this index for all subspecialty physicians after the HTP was 10,000, the highest level of concentration.

Conclusion
The values obtained from the HHI index indicate the high concentration and disproportionate and inequitable distribution of human resources in the health sector in this province. The number of specialists in some cities is still much less than acceptable, and some cities even have shortcomings in the critical specialists.
Hierarchical clock-scale hand-drawn mapping as a simple method for bronchoscopic navigation in peripheral pulmonary nodule
Authors: Zhong Chang-Hao , Su Zhu-Quan , Luo Wei-Zhan , Rao Wan-Yuan , Feng Jia-Xin , Tang Chun-Li , Chen Yu , Chen Xiao-Bo , Fan Ming-Yue , Li Shi-Yue 
Published: September 2022

Abstract
Background
A feasible and economical bronchoscopic navigation method in guiding peripheral pulmonary nodule biopsy is lacking.

Objective
To investigate the utility of hierarchical clock-scale hand-drawn mapping for bronchoscopic navigation in peripheral pulmonary nodules.

Methods
We developed a hierarchical clock-scale hand-drawn mapping for bronchoscopic navigation in peripheral pulmonary nodules. Patients with peripheral pulmonary nodules were recruited and assigned to two groups in this retrospective study, subjects in VBN group received conventional bronchoscopy in conjunction with virtual bronchoscopic navigation (VBN) and radial probe endobronchial ultrasound (RP-EBUS) for biopsy (VBN group), while HBN group underwent ultrathin bronchoscopy and RP-EBUS under the guidance of hand-drawn bronchoscopic navigation (HBN). The demographic characteristics, procedural time, operating cost and diagnostic yield were compared between these two groups.

Results
Forty-eight patients with peripheral pulmonary nodule were enrolled in HBN group, while 42 in VBN group. There were no significant differences between VBN and HBN groups in terms of age, gender, lesion size, location and radiographic type. The time of planning pathway (1.32 vs. 9.79 min, P < 0.001) and total operation (23.63 vs. 28.02 min, P = 0.002), as well as operating cost (758.31 ± 125.21 vs.1327.70 ± 116.25 USD, P < 0.001) were markedly less in HBN group, compared with those in VBN group. The pathological diagnostic efficiency of benign and malignant disease in HBN group appeared similar with those in VBN group, irrespective of the size of pulmonary lesion (larger or smaller than 20 mm). The total diagnostic yield of HBN had no marked difference from that of VBN (75.00% vs. 61.90%, P = 0.25).

Conclusions
Hierarchical clock-scale hand-drawn mapping for bronchoscopic navigation could serve as a feasible and economical method for guiding peripheral pulmonary nodule biopsy, providing a comparable diagnostic yield in comparison with virtual bronchoscopic navigation.
Diagnosis of Apis dorsata venom allergy: use of recombinant allergens of Apis mellifera and a passive basophil activation test
Authors: Gunasekara Peshala , Handunnetti S. M. , Premawansa Sunil , Witharana E. W. R. A. , Ratnayake Indra P. , Kaluarachchi Pradeep , Karunatilake Chandima , Dias R. K. S. , Premakumara G. A. S. , Dasanayake W. M. D. K. , Seneviratne Suranjith L. , de Silva Rajiva 
Published: September 2022

AbstractBackgroundAllergy toApis dorsata(Giant Asian Honeybee) venom is the commonest insect allergy in Sri Lanka and South East Asia. However, laboratory diagnosis is difficult as the pure venom and diagnostic reagents are not commercially available.ObjectiveThis study assessed the use of four recombinant allergens ofA. melliferavenom and the passive basophil activation test in the diagnosis ofA. dorsatavenom anaphylaxis.MethodsSerum IgE levels to four recombinant allergens ofA. mellifera, rApi m 1, 2, 5 and 10 were assessed and compared with serum IgE to the crude venom ofA. melliferaorV. vulgarisby Phadia ImmunoCAP, in patients who developed anaphylaxis toA. dorsatastings. Basophil activation in response to venom ofA. dorsataorV. affiniswas assessed using a passive basophil activation test. Association of the severity of the reaction with basophil activation was compared.ResultsrApi m 1 and 10 combinedly had significant correlation (r = 0.722; p < 0.001) with the crude venom ofA. mellifera(Western honeybee) and a higher positivity rate of 90% (27/30). Whereas, IgE reactivity to rApi m 2 or 5 had significant correlation (p = 0.02 and p = 0.005 respectively) withV. vulgariscrude venom. All 30 (100%) were positive toA. dorsatavenom in passive BAT; 70% (21/30) had over 80% activation, 96.7% (29/30) had over 60% activation and 100% had over 50% activation. Percentage activation of basophils in patients who had mild or moderate reactions (n = 20) was significantly low (p = 0.02) from that of patients who had severe reactions (n = 10).ConclusionsrApi m 1 and 10 when combined was sensitive for the diagnosis ofA. dorsataallergy. This combination had the lowest cross-reactivity rate withVespula vulgaris. The passive BAT is highly sensitive inA. dorsataallergy. The basophil reactivity was significantly higher in severe anaphylaxis compared to mild/moderate anaphylaxis. This finding should be further explored in further studies.
The efficacy of a multi-strategy choice architecture intervention on improving the nutritional quality of high school students’ lunch purchases from online canteens (Click & Crunch High Schools): a cluster randomized controlled trial
Authors: Delaney Tessa , Yoong Sze Lin , Lamont Hannah , Lecathelinais Christophe , Wolfenden Luke , Clinton-McHarg Tara , Sutherland Rachel , Wyse Rebecca 
Published: September 2022

AbstractBackgroundHigh school canteens are an ideal setting for public health nutrition intervention, and choice architecture strategies that facilitate the purchase of healthier foods and beverages from school canteens are recommended by the World Health Organization. The rapid uptake of online lunch ordering within school canteens provides a unique opportunity to implement choice architecture strategies that support healthier food choices with high fidelity. Despite this, no trial has tested the efficacy of choice architecture strategies within an online lunch ordering system on improving the nutritional quality of high school student lunch purchases. The objective of this study was to assess the impact of embedding choice architecture strategies into an online lunch ordering system on the nutritional quality of the school canteen lunch purchases of high school students (aged 12–19 years).MethodsA cluster randomized controlled trial was conducted with nine high schools in one Australian state. Schools were randomized to receive either a 2-month choice architecture intervention (involving menu labelling, prompts, item positioning, and feedback), or usual online ordering. Nutrient quality of online canteen lunch purchases was assessed using routine data collected by the online ordering system. Primary outcomes were the proportion of ‘Everyday’, ‘Occasional’, and ‘Should not be sold’ items purchased, categorized using the state healthy canteen policy. Secondary outcomes were the mean energy, saturated fat, sugar, and sodium content of purchases and the mean weekly revenue from online lunch orders. Linear mixed models were analyzed to assess outcomes.ResultsAnalysis of the student cohort (Intervention: 4 schools, 656 students; Control:5 schools, 675 students) showed significant between group differences over time for the intervention group for the mean percentage of online lunch items per student that were ‘Everyday’ (+ 5.5%;P < 0.001) and ‘Should not be sold’ (− 4.4%;P < 0.001). There were no between group differences over time in the mean percentage of online lunch items that were ‘Occasional’; the average energy, saturated fat, sugar, or sodium content of lunch orders. There was also no difference in mean weekly revenue from high school student online lunch orders (P = 0.23).ConclusionsThese findings suggest that a low intensity, choice architecture intervention embedded within an online ordering system can increase the purchase of healthier food items for high school students in one Australian state without any adverse impact on canteen revenue.Trial registrationThis trial was prospectively registered on Open Science Framework on 23rd October 2020 as osf.io/h8zfr.
Effects of intervention combining transcranial direct current stimulation and foot core exercise on sensorimotor function in foot and static balance
Authors: Xiao Songlin , Wang Baofeng , Yu Changxiao , Shen Bin , Zhang Xini , Ye Dongqiang , Deng Liqin , Xu Yongxin , Zhou Junhong , Fu Weijie 
Published: September 2022

Abstract
Objective
This study aimed to examine the effects of combining transcranial direct current stimulation (tDCS) and foot core exercise (FCE) on the sensorimotor function of the foot (i.e., toe flexor strength and passive ankle kinesthesia) and static balance.

Methods
In this double-blinded and randomized study, 30 participants were randomly assigned into two groups: tDCS combined with FCE and sham combined with FCE (i.e., control group). The participants received 2 mA stimulation for 20 min concurrently with FCE over 4 weeks (i.e., three sessions per week). After the first two groups completed the intervention, a reference group (FCE-only group) was included to further explore the placebo effects of sham by comparing it with the control group. Foot muscle strength, passive ankle kinesthesia, and static balance were assessed at baseline and after the intervention.

Results
Compared with the control group and baseline, tDCS combined with FCE could increase toe flexor strength (p < 0.001) and decrease the passive kinesthesia threshold of ankle eversion (p = 0.002). No significant differences in static balance were observed between tDCS + FCE and control groups. The linear regression models showed an association towards significance between the percent changes in metatarsophalangeal joint flexor strength and the anteroposterior average sway velocity of the center of gravity in one-leg standing with eyes closed following tDCS + FCE (r2 = 0.286; p = 0.057). The exploratory analysis also showed that compared with FCE alone, the sham stimulation did not induce any placebo effects during FCE.

Conclusion
Participating in 4 weeks of intervention using tDCS in combination with FCE effectively enhances toe flexor strength and foot–ankle sensory function.