bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health insurance coverage and modern contraceptive use among sexually active women in Nigeria: Further analysis of 2018 Nigeria Demographic Health Survey
Authors: Bolarinwa Obasanjo Afolabi , Babalola Taiwo Oladapo , Adebayo Oladayo Abayomi , Ajayi Kobi V. 
Published: November 2022

Abstract
Background
Studies have shown that affordable health insurance can influence healthcare visits and increase the choice of medication uptake in sub-Saharan Africa. However, there is a need to document the influence of health insurance coverage and modern contraceptive use in order to encourage its uptake. Thus, this study examined the influence of health insurance coverage on modern contraceptive use among sexually active women in Nigeria.

Methods
The secondary dataset utilised in this study were derived from the 2018 Nigeria Demographic and Health Survey (NDHS). Data analyses were restricted to 24,280 women of reproductive age 15–49 years who were sexually active in the survey dataset. Weighted bivariate and multivariable logistic regression models were used to examine the influence of health insurance coverage on modern contraceptive use while controlling for possible confounders. A Significant level of alpha was determined at p < 0.05 using STATA 16.0.

Results
The prevalence of health insurance coverage and modern contraceptive use among sexually active women in Nigeria were 25.47% and 13.82%, respectively. About 1 out of every 4 sexually active women covered by health insurance were using a modern contraceptive, while 86.50% of the women not covered by health insurance were not using any modern contraceptive method. After adjusting for socio-demographic characteristics, the odds of using any modern contraceptive were significantly higher for sexually active women who were covered by any health insurance [aOR = 1.28; 95% (CI = 1.01–1.62)] compared to sexually active women not covered by health insurance in Nigeria.

Conclusion
The study demonstrated that health insurance coverage is a significant driver of health service utilization, including modern contraceptive use. Health insurance benefits are recommended to be expanded to cover a broader spectrum of family planning services in Nigeria. More research is required to understand the influence of different health insurance schemes and the use of modern family planning methods in Nigeria.
Geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia, 2016
Authors: Tareke Abiyu Abadi , Gashu Kassahun Dessie , Endehabtu Berhanu Fikadie 
Published: November 2022

Abstract
Background
Delayed antenatal care is when the first visit is carried out after 12 gestational weeks. Despite the fact that many studies have been conducted on antenatal care initiation, little attention has been paid to its spatial pattern. Therefore, this study examine geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia.

Objective
To assess geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia, 2016.

Methods
This study was grounded on the 2016 Ethiopian Demographic Health Survey. It incorporated extracted sample size of 4740 (weighted) reproductive-aged women. ArcGIS version 10.8 and SaTScan™ version 9.7 software were employed to investigate geographic information. To distinguish factors associated with hotspot areas, local and global models were fitted.

Result
the geographic pattern of Delayed antenatal care initiation was clustered (Moran’s I = 0.38, p < 0.001). Kuldorff’s spatial scan statistics discovered three significant clusters. The most likely cluster (LLR = 66.13, p < 0.001) was situated at the zones of SNNP and Oromia regions. In the local model, being uneducated, being poor wealth, having an unwanted pregnancy, and having higher birth order were factors associated with spatial variation of delayed antenatal care.

Conclusion
The spatial pattern of delayed antenatal care in Ethiopia is clustered. Maternal education, wealth status, pregnancy desirability, and birth order were predictor variables of spatial variation of delayed antenatal care. Therefore, designing a hotspot area-based interventional plan could help to improve early ANC initiation.
PET/MR: primary inferior vena cava leiomyosarcoma
Authors: Ronchi Brunela , Peña Gustavo Agustin , Sacchi Carlos 
Published: November 2022

AbstractPositron emission tomography (PET) combined with a magnetic resonance (MR) scanner (PET/MR) with 18F-fluorodeoxyglucose (FDG) tracer is being used in quite a few nuclear medicine centers. The aim of this study is to illustrate two uncommon cases of primary inferior vena cava leiomyosarcoma which were formerly evaluated with anatomical images such as computed tomography and ultrasound. These techniques were inferior in the definition of the tumor and its characteristics. F-18 FDG PET/MR was essential and provided all the necessary information: its origin, local extension, anatomo-metabolic behavior, form of presentation, and distant metastasis in one single diagnostic technique. PET/MR accurately contributed to the diagnosis in a shortened period of time and, therefore, in the prognosis of this disease with greater benefits.
SCN5A p.P1725L variant that showed ventricular fibrillation and recurrent pericarditis, and a family member with sick sinus syndrome
Authors: Yamamoto Hiroaki , Itamoto Chieko , Hayashi Minato , Kohno Tsunesuke , Yagihara Nobue 
Published: November 2022

Abstract
Background
In Brugada syndrome (BrS), the arrhythmogenic substrate is suggested to be located in the epicardial surface of the right ventricle outflow tract. Postmortem examinations of BrS described epicardial and interstitial fibrosis, the causes of which remain unclear.

Case presentation
We present a family in whom the proband is a case of aborted sudden cardiac death from ventricular fibrillation (VF) without spontaneous Brugada-type electrocardiogram, and his mother underwent pacemaker implantation due to sick sinus syndrome. The proband showed recurrent acute pericarditis two consecutive years before the VF episode. These events occurred twice in mid-spring, the same season when the lethal arrhythmia occurred.

Conclusions
This case suggests a possibility in the pathogenesis of epicardial fibrosis of BrS that the RVOT lesions induced by SCN5A mutations have not only fibrotic characteristics but also in some patients, inflammatory characteristics which may be manifested as repeated mild pericarditis or occult pericarditis.
Anti-NMDAR encephalitis with seizure-like activity and hemiplegia - a case report and literature review
Authors: Hu Junjie , Zhao Cailei , Zhao Xia , Fang Yu , Zhang Huiting , Cao Dezhi , Liao Jianxiang 
Published: November 2022

Abstract
Background
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis accounts for the vast majority of cases of autoimmune encephalitis. Its common clinical symptoms are psychiatric symptoms, behavioral dysfunction, seizures, speech impairment, cognitive impairment, movement disorders, decreased consciousness, and autonomic instability. This report was aimed to provide evidence for anti-NMDAR encephalitis with seizure-like activity, based on the clinical presentations, brain magnetic resonance imaging (MRI), and electroencephalogram (EEG) recordings.

Case presentation
We report a 11-year-old girl who suffered epigastric pain after vigorous physical activity. She felt weakness of the muscles. She had syncope only once and urinary incontinence on the way to the hospital and vomited at the arrival. The entire procedure lasted approximately 15 min. The next night she had recurrent headache attacks along with irritability, like someone “tapping” to the right occipital region. She experienced numbness in the left upper limbs and shallowing of the frontal lines on the left side. Holter monitoring showed normal findings, but brain MRI, EEG recording, and cerebrospinal fluid (CSF) antibody testing showed abnormal results. The patient was finally diagnosed with anti-NMDAR encephalitis. After treatment with glucocorticoids and acyclovir, she fully recovered and was discharged from the hospital.

Conclusions
Although the patient presented with pain and impaired limb movements, she did not have respiratory or (and) circulatory failure, and the symptoms entirely resolved. Early accurate diagnosis and timely treatment are essential for patients with anti-NMDAR encephalitis.
Analysis of prognostic factors in patients with brain metastases affecting survival
Authors: Gupta Sweety , Singh Sumit , Chophy Atokali , Nair Sharanya , Ahuja Rachit , Kusum K. , Joseph Deepa , Arora Rajnish , Gupta Amit , Gupta Manoj 
Published: November 2022

Abstract
Introduction
Brain metastases (BM) are associated with dismal prognosis as they cause significant morbidity and affect the quality of life of patients. Management of BM depends on the following factors: age, patient performance, size and the number of lesions, location of the tumor, comorbidities, primary tumor type, and extracranial disease burden. In the present study, the pattern of occurrence, clinical characteristics, treatment outcome of brain metastases, and factors, tumor characteristics, and treatment that may impact BM patients’ overall survival were analyzed.

Methods
Retrospective analysis of medical records of 116 patients with histologically proven primary site solid tumors with brain metastases was done in the present study. Clinicoradiological and pathological parameters were documented. The relationship between variables and outcome was assessed by univariate analysis using the Cox proportional regression model to reach a significance of p < 0.05, to determine independent predictors of overall survival.

Results
One hundred sixteen patients of BM from various solid malignancies were included. Age ranged from 18 to 81 years (median 53.5). One hundred four patients received WBRT with a dose range of 8–40Gy/1–15fr, 7 received SRS with a dose of 18–24Gy depending on the size of the metastatic lesion, and 2 received SRT 27–33Gy/3fr. At the time of final analysis, 47 patients with BM had expired, 60 were lost to follow-up, and 9 were alive. Median survival was 8.25 (0.5–32.5 months) months. Female gender (χ2 = 8.423; p = 0.015), RPA I (χ2 = 9.353; p = 0.05), and metachronous BM (χ2 = 3.793; p = 0.03) were associated with better survival. Patients with age 41–50 years, adenocarcinoma lung histology, and supratentorial location survived more than 2 years but did not show any statistical significance.

Conclusion
Brain metastases portend a very dismal prognosis. Certain clinicoradiological and pathologic factors have been identified to affect survival. More prospective multicentric trials, with a larger sample size, need to be conducted to assess the benefit of radiation in patients with limited life expectancy and identify prognostic and predictive factors for survival.
Unexpected septic pulmonary embolism imaging with 18-F FDG PET/CT in an infective endocarditis case: case report
Authors: Akgun Elife , Akyel Resit 
Published: November 2022

Abstract
Background
Infective endocarditis (IE) is a severe disease that is diagnosed using a combination of clinical, microbiologic, and imaging criteria (modified Duke criteria). The prognosis relies on the degree of valvular involvement and crucially the presence of systemic infectious embolism. We present an educational infective endocarditis case with images of 18-F fluoro-D-glucose positron emission tomography/computed tomography (18-F FDG PET/CT) showing hypermetabolic lesions on the prosthetic tricuspid valve and papillary muscle of right ventricle. Besides these lesions, PET/CT showed an unexpected hypermetabolic extra-cardiac focus.

Case presentation
A 36-year-old male patient with IE history was underwent 18-F FDG PET/CT imaging. FDG PET revealed hypermetabolic lesions on the prosthetic tricuspid valve and papillary muscle of right ventricle. Besides these lesions, PET/CT showed an unexpected hypermetabolic focus in the lower lobe of the right lung, which was consistent with septic pulmonary embolism.

Conclusions
18-F FDG PET/CT is a valuable, noninvasive imaging modality in diagnosis of prosthetic valve IE. It could change treatment planning since detecting extra-cardiac lesions.
Many different roads lead to Rome: equivalence of time-use for activity, sedentary and sleep behaviours and dietary intake profiles among adolescents
Authors: Dumuid Dorothea , Mellow Maddison L. , Stanford Tyman E. , Chong Kar Hau , Sawyer Susan M. , Smith Ashleigh E. , Lund Rasmussen Charlotte , Wade Alexandra , Olds Timothy 
Published: November 2022

Abstract
Background
How we spend our time and what we eat have important implications for our health. Evidence suggests that health-equivalent behaviour change options which result in the same benefit are available within both time use (physical activities, sedentary behaviours and sleep) and diet (e.g., fruit and vegetables, snack foods). However, it is not yet known if health-equivalent choices exist across both time-use and diet behaviours. This study aimed to explore if a variety of different time-use and dietary profiles were associated with equivalent physical functioning score among adolescents.

Methods
This study used cross-sectional data from 2123 adolescent participants from the Longitudinal Study of Australian Children (LSAC) (mean age = 14.4 ± 0.5 years), including time-use diaries (min/day of sleep, self-care, screen time, quiet time, physical activity, school-related and domestic/social), diet questionnaires (serves/day of fruit and vegetables, discretionary (snack) foods and sugar-sweetened beverages) and a measure of physical functioning (PedsQL™ 4.0 physical functioning scale for teens). Multiple linear regression models were used to find the association of 24-h time-use composition (expressed as isometric log ratios) and dietary variables with physical functioning score. The models were used to estimate which time-use and diet profiles (within a feasible range from the sample average) were associated with equivalent physical functioning scores. Finally, an interactive app was developed to make the results accessible to end users.

Results
Within 30 min and 1.5 servings of the average adolescent’s time-use and dietary behaviours, 45 equivalent options were associated with a ~ 0.2 SD improvement in physical functioning scale. All options associated with this improvement in physical function involved increasing physical activity and increasing fruit and vegetable intake, whilst also reducing discretionary food intake and sugar-sweetened beverages. Most behavioural options also increased sleep and reduced time spent in self-care, screen time and quiet time activities.

Conclusions
There are a range of time-use and diet profiles that may result in equivalent benefits in physical functioning among adolescents. Communicating these options using decision tools such as interactive apps may allow for tailored interventions across both time use and diet which are based on an individual’s needs, preferences and constraints.
Successful thoracic duct identification with patent blue V during thoracic duct ligation for chylothorax: a case report
Authors: Suzuki Yamato , Yamana Koji , Ishizawa Hisato , Kawai Hiroshi , Matsuda Yasushi , Kato Ryoichi , Takagi Yasushi , Hoshikawa Yasushi 
Published: November 2022

Abstract
Background
Chylothorax after thoracic surgery is a rare but severe complication. When thoracic duct ligation is performed for chylothorax, identification of the leakage site and the thoracic duct course is necessary. Administering milk orally or through a nasogastric tube and injecting indocyanine green into lymph nodes and lymphatic vessels can be performed to identify the leakage site and the thoracic duct course. However, the injection of patent blue V into the inguinal lymph nodes has not been reported.

Case presentation
A 69-year-old man underwent aortic replacement surgery for an aortic aneurysm of the distal arch. On postoperative day 3, after resuming oral intake, the patient was diagnosed with chylothorax. The patient was treated with fasting and total parenteral nutrition, but the chylous pleural effusion continued at 500–1000 ml daily. A plan for thoracic duct ligation was made. We injected patent blue V into the inguinal lymph node to identify the leakage site and the thoracic duct course. The blue-stained thoracic duct was identified and ligated, but the leakage site could not be identified because of the surrounding lung adhesions. The thoracic drain was removed on day 6 post-second operation, and the chylothorax did not recur.

Conclusion
Identifying the thoracic duct course using patent blue V is useful during thoracic duct ligation for chylothorax.
Comparisons Between Different Anti-osteoporosis Medications on Postfracture Mortality: A Population-Based Study
Authors: Wu Chih-Hsing , Li Chia-Chun , Hsu Yu-Hsuan , Liang Fu-Wen , Chang Yin-Fan , Hwang Jawl-Shan 
Published: November 2022

AbstractContextOsteoporosis is becoming a global epidemic in aging societies. Anti-osteoporotic medications can prevent fractures, and their pleiotropic effect on mortality is interesting but not well compared among each other.ObjectiveTo provide real-world evidence on the pleiotropic effect of different anti-osteoporotic medications on all-cause mortality, stratified by fracture site, sex, and age.MethodsThis longitudinal population-based postfracture cohort study, included mega-data from subjects ≥40 years of age with osteoporotic fracture who used anti-osteoporotic medications as recorded in Taiwan's National Health Insurance Research Database from 2009 to 2017 and followed until 2018. A multivariate Cox proportional hazards model with immortal time bias was used to assess the relationship between fracture sites and mortality stratified by anti-osteoporosis medication.ResultsA total of 46 729 subjects with an average age of 74.45 years (80.0% female) and a mean follow-up period of 4.73 years were enrolled. In the total fracture group, compared with raloxifene and bazedoxifene, we found that alendronate/risedronate (hazard ratio [HR] 0.83; 95% CI, 0.79-0.88), denosumab (HR 0.86; 95% CI, 0.81-0.91), and zoledronic acid (HR 0.78; 95% CI, 0.73-0.84) resulted in significantly lower mortality. Similar trends were observed in the hip, vertebral, or nonhip/nonvertebral fracture groups. Subjects receiving long-acting zoledronic acid showed the lowest mortality in the subanalysis according to sex or age over 65 years.ConclusionThis real-world mega-data study suggests that the usage of osteoporotic medication, especially a long-acting regimen, may lower postfracture mortality.
Inside the β Cell: Molecular Stress Response Pathways in Diabetes Pathogenesis
Authors: Kulkarni Abhishek , Muralidharan Charanya , May Sarah C , Tersey Sarah A , Mirmira Raghavendra G 
Published: November 2022

AbstractThe pathogeneses of the 2 major forms of diabetes, type 1 and type 2, differ with respect to their major molecular insults (loss of immune tolerance and onset of tissue insulin resistance, respectively). However, evidence suggests that dysfunction and/or death of insulin-producing β-cells is common to virtually all forms of diabetes. Although the mechanisms underlying β-cell dysfunction remain incompletely characterized, recent years have witnessed major advances in our understanding of the molecular pathways that contribute to the demise of the β-cell. Cellular and environmental factors contribute to β-cell dysfunction/loss through the activation of molecular pathways that exacerbate endoplasmic reticulum stress, the integrated stress response, oxidative stress, and impaired autophagy. Whereas many of these stress responsive pathways are interconnected, their individual contributions to glucose homeostasis and β-cell health have been elucidated through the development and interrogation of animal models. In these studies, genetic models and pharmacological compounds have enabled the identification of genes and proteins specifically involved in β-cell dysfunction during diabetes pathogenesis. Here, we review the critical stress response pathways that are activated in β cells in the context of the animal models.
LBSUN129 Adipose Tissue Analysis Toolkit (at-at): An Imagej Plugin For Automated Analysis Of Adipocyte Number, Size, And Pericellular Fibrosis In Histological Sections
Authors: Robino Jacob J , Bu Dawei , Field Bianca C , Scherer Philipp E , Roberts Charles T , Varlamov Oleg 
Published: November 2022

Abstract
Obesity-induced pathological expansion of white adipose tissue (WAT) involves adipocyte hypertrophy that occurs in tandem with the development of pericellular fibrosis. Other pathophysiological states, such as cancer and HIV, are also associated with fibrotic transformation of WAT depots. Aging, obesity, inactivity, and estrogen deficiency are also associated with an increase in bone marrow adiposity. Disease-associated changes in WAT morphology are typically assessed using histochemical analysis of WAT sections. However, manual analysis of large histological sections of WAT or bone marrow adipose tissue can be very time-consuming, while digital tools for the analysis of adipocyte size and pericellular fibrosis are limited. In response to this need, we have developed the Adipose Tissue Analysis Toolkit (AT-AT), a plugin for the open-source image analysis software ImageJ. AT-AT employs both local and global differentials in pixel intensity to threshold background apart from adipocyte-free tissue without user input. The AT-AT accurately captures adipocyte perimeter, maximum diameter, minimum diameter, and density per square millimeter of tissue in histological sections stained with common histological dyes, and performs automatic analysis of adipocyte cross-sectional area as well as pericellular fibrosis. AT-AT enables fully-automated analysis of batches of histological images using either default or user-defined adipocyte detection parameters including minimum circularity as well as minimum and maximum cross-sectional area. Likewise, users may set parameters for the thresholding algorithms, including the number of localized thresholds to be calculated in each image. AT-AT's thresholding techniques confer uniquely high resistances to both false-negative and false-positive detection events by comparison to other open-source adipocyte analysis software. They also enable superior measurement of adipocyte morphology, especially in the case of low-magnification images. AT-AT features several quality-of-life features, including automatic summarization of batch-collected data, the implementation of its thresholding algorithms as independent ImageJ commands, and an optional histogram builder. AT-AT can enhance the rigor and reproducibility of adipose tissue research. AT-AT will become available as a plugin for ImageJ in the fall of 2022.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.