bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of treatment for 31 patients with seropositive autoimmune autonomic ganglionopathy in Japan
Authors: Hayashi Toshiyuki , Nakane Shunya , Mukaino Akihiro , Higuchi Osamu , Yamakawa Makoto , Matsuo Hidenori , Kimura Kazumi 
Published: August 2022

Background: Autoimmune autonomic ganglionopathy (AAG) is characterized by serum autoantibodies against the ganglionic acetylcholine receptor (gAChR). Immunomodulatory treatments may alleviate AAG symptoms, but the most appropriate treatment strategy is unclear. Objective: This study aimed to confirm the effectiveness of treatments, particularly immunotherapy, in patients with seropositive AAG in Japan, as well as to determine the most effective treatment and the best assessment method for clinical response to treatment. Methods: We collected data from a previous cohort study of patients with seropositive AAG. The clinical autonomic and extra-autonomic symptoms were objectively counted and subjectively assessed using the modified Composite Autonomic Symptom Score. Post-treatment changes in the gAChR antibody level were evaluated. Results: Thirty-one patients received immunotherapy. Among them, 19 patients received intravenous methylprednisolone; 27, intravenous immunoglobulin; 3, plasma exchange; 18, oral steroids; 2, tacrolimus; 1, cyclosporine; and 1, mycophenolate mofetil. Patients who received immunotherapy showed improvements in the total number of symptoms (from 6.2 ± 2.0 to 5.1 ± 2.0) and modified Composite Autonomic Symptom Score (from 37.4 ± 15.3 to 26.6 ± 12.8). Orthostatic intolerance, sicca, and gastrointestinal symptoms were ameliorated by immunotherapy. Immunotherapy decreased the antibody levels (gAChRα3 antibodies, from 2.2 ± 0.4 to 1.9 ± 0.4, p = 0.08; gAChRβ4 antibodies, from 1.6 ± 0.1 to 1.0 ± 0.2, p = 0.002), but antibody levels increased in 10 patients despite immunotherapy. The rate of improvement in the total number of symptoms was higher in patients with combined therapy than in patients with non-combined therapy (70.7% vs 28.6%). Conclusions: The scores in many items on the rating scale decreased after immunotherapy in patients with seropositive AAG, particularly in the combined immunotherapy group. However, more accurate assessment scales for clinical symptoms and multicenter randomized, placebo-controlled prospective studies are warranted to establish future treatment strategies.
Cost-effectiveness analysis of nivolumab plus ipilimumab versus chemotherapy as the first-line treatment for unresectable malignant pleural mesothelioma
Authors: Yang Liu , Cao Xueqiong , Li Na , Zheng Bin , Liu Maobai , Cai Hongfu 
Published: August 2022

Introduction: This study evaluated the cost-effectiveness of nivolumab plus ipilimumab (NI) versus pemetrexed plus cisplatin/carboplatin (C) as the first-line treatment for unresectable malignant pleural mesothelioma (MPM) from the perspective of US payers. Methods: A 10-year partitioned survival model was constructed using survival and safety data from the CheckMate 743 clinical trial. The output metrics of the model included the patient’s lifetime quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratio (ICER). Only direct medical costs were considered. One-way and probabilistic sensitivity analyses were conducted to assess the robustness of the results. Results: Among all randomized patients, group NI had an ICER of $475,677/QALY relative to group C. Among patients with epithelioid histology, group NI had an ICER of $760,955/QALY. Among patients with non-epithelioid histology, group NI had an ICER of $418,348/QALY. The ICERs of all three populations exceeded the willingness-to-pay threshold ($150,000). The results of one-way sensitivity analysis revealed that the cost of nivolumab had a great influence on the results. The results of probabilistic sensitivity analysis demonstrated that the possibility of NI being more economical in all randomized patients and in patients with non-epidemiology histology was 0. In patients with epithelioid histology, the probability that NI had an economic advantage was 0.6%. Conclusions: From the perspective of US payers, in patients with unresectable MPM, NI has no economic advantage over C.
Patient Preferences for Discussing and Acting on Health-Related Needs in Primary Care
Authors: O’Loughlin Kristen , Shadowen Hannah M. , Haley Amber D. , Gilbert Jennifer , Lail Kashiri Paulette , Webel Ben , Huebschmann Amy G. , Krist Alex H. 
Published: August 2022

Background: Addressing social needs, health behaviors, and mental health may help patients more than traditional medical care. However, these root causes of poor health are difficult to address and the role of primary care is unclear. This qualitative study assesses patient’s willingness and motivations to discuss and accept assistance for these needs from their primary care team. Methods: In July and August of 2020, semi-structured virtual interviews were conducted with family medicine patients (n = 6) and residents of low resource neighborhoods (n = 11) in Richmond, Virginia. Interviews were conducted over Zoom. We conducted a qualitative analysis of patient and resident interview transcripts. A rapid qualitative analysis approach and immersion-crystallization processes were used to identify themes and categories. Results: Interviewees reported varying degrees of comfort discussing topics with their health care team. They were less comfortable discussing needs they considered outside the realm of “traditional primary care” including finances, transportation, and housing, but interviewees expressed willingness to discuss these needs under certain conditions. Important factors were a strong patient-clinician relationship to create a trusted and safe space for discussion, adequate time for discussion during visits, communication of practices’ ability to provide resources to help patients, and ensuring appropriate high quality referrals. Conclusions: Primary care provides opportunity for identifying and addressing needs that adversely impact health. Some needs are more sensitive for patients to work with their care team on, though, there was willingness to work on any need when a strong provider relationship and clinic structure for providing support were in place. This study highlights critical care delivery factors which may be used to enhance patient comfort accepting support for their needs and ultimately improve clinical care and chronic disease management.
Mortality Rates in Femoral Neck Fractures Treated With Arthroplasty in South Africa
Authors: Jordaan Jacobus D. , Burger Marilize C , Jakoet Shafique , Manjra Muhammad Ahmed , Charilaou Johan 
Published: August 2022

Objectives To investigate the mortality rate for neck of femur fractures treated with arthroplasty at a tertiary level unit in South Africa and to evaluate the effect of known risk factors for mortality in neck of femur fractures treated with arthroplasty in the South African context. Design Retrospective cohort study. The main outcome was to determine mortality rates during in hospital stay, at 3 months, 6 months 1 year post surgery. The secondary outcome was to determine factors influencing mortality at 30 days, 6 months and 12 months post-surgery. Results Mortality rate was 3.3% in hospital, 5.6% at 30 days and 26.7% at 1 year. Age >79, ASA score >3, and cementing of the femur had statistically increased mortality risk ( P < .001). Average length of hospital stay was 12.3 ± 5.1 days (range 3.0-41.0 days) with 73% of patients discharged back to pre-hospital home. Conclusion Mortality rates after femur neck fracture arthroplasty in South Africa are slightly higher at 1 year compared to international data. However, the rates are comparably low during hospital stay, 30 day and at 6 months post-surgical intervals.
The Impact of Neonatal Mandibular Distraction on Long-Term Mandibular Growth and Morphology
Authors: Pfaff Miles J. , Beiriger Justin W. , Owoc Maryanna S. , Mittal Adi , Erpenbeck Sarah , Bruce Madeleine , Bradley James P. , Lee Justine C. , Losee Joseph E. , Goldstein Jesse A. 
Published: August 2022

Introduction: Mandibular distraction osteogenesis (MDO) is the gold standard treatment for upper airway obstruction associated with Robin Sequence (RS). The long-term effects of MDO on mandibular morphology approaching or at skeletal maturity remain unknown. The objective of this study was to morphologically characterize the mandibles of MDO and conservatively managed (CM) RS patients at or approaching skeletal maturity. Methods: Mandibular morphometric analysis was performed on MDO and CM patient mandibles via 3D-rendered computed tomographic (CT) images. Age- and sex-matched unaffected controls were used for comparison. Mean ± standard deviation was reported, Mann Whitney U Test was utilized, and a P-value of .05 or less was considered statistically significant. Results: RS patients (57.1% female, mean age 16.9 ± 2.6) treated with either CM (n = 5) or MDO (n = 7) were included. Age at latest CT was 17.3 ± 2.3 years for the CM group and 16.5 ± 2.9 for the MDO group. When compared to controls, CM patient mandibular body length was shorter, volumetrically smaller, and the anterior symphyseal angle was more obtuse ( P = .008, P = .06, and .008, respectively). When compared to controls, the MDO patient ramus height and body length were shorter ( P = .01 and <.001, respectively), the gonial angle and anterior symphyseal angle were more obtuse ( P = .02 and <.001, respectively), and mandibular volume was less ( P = .05). Conclusion: Neonatal MDO was associated with morphologic changes unique to the RS mandible at or approaching skeletal maturity. This study provides further insight into the long-term effects of MDO on mandibular morphology.
Research on Surface Roughness of Supersonic Vibration Auxiliary Side Milling for Titanium Alloy
Authors: Wei Xuetao , Yue Caixu , Hu Desheng , Liu Xianli , Ding Yunpeng , Liang Steven Y. 
Published: August 2022

AbstractThe processed surface contour shape is extracted with the finite element simulation software. The difference value of contour shape change is used as the parameters of balancing surface roughness to construct finite element model of supersonic vibration milling in cutting stability domain. The surface roughness trial scheme is designed in the orthogonal test design method to analyze the surface roughness test result in the response surface methodology. The surface roughness prediction model is established and optimized. Finally, the surface roughness finite element simulation prediction model is verified by experiments. The research results show that, compared with the experiment results, the error range of the finite element simulation model is 27.5%–30.9%, and the error range of the empirical model obtained by the response surface method is between 4.4% and 12.3%. So, the model in this paper is accurate and will provide the theoretical basis for the optimization study of the auxiliary milling process of supersonic vibration.
A framework for characterizing heterogeneity in neurodevelopmental data using latent profile analysis in a sample of children with ADHD
Authors: Arnett Anne B. , Flaherty Brian P. 
Published: August 2022

Abstract
Background
Heterogeneity in neurodevelopmental disorders, and attention deficit hyperactivity disorder (ADHD) in particular, is increasingly identified as a barrier to identifying biomarkers and developing standards for clinical care. Clustering analytic methods have previously been used across a variety of data types with the goal of identifying meaningful subgroups of individuals with ADHD. However, these analyses have often relied on algorithmic approaches which assume no error in group membership and have not made associations between patterns of behavioral, neurocognitive, and genetic indicators. More sophisticated latent classification models are often not utilized in neurodevelopmental research due to the difficulty of working with these models in small sample sizes.

Methods
In the current study, we propose a framework for evaluating mixture models in sample sizes typical of neurodevelopmental research. We describe a combination of qualitative and quantitative model fit evaluation procedures. We test our framework using latent profile analysis (LPA) in a case study of 120 children with and without ADHD, starting with well-understood neuropsychological indicators, and building toward integration of electroencephalogram (EEG) measures.

Results
We identified a stable five-class LPA model using seven neuropsychological indicators. Although we were not able to identify a stable multimethod indicator model, we did successfully extrapolate results of the neuropsychological model to identify distinct patterns of resting EEG power across five frequency bands.

Conclusions
Our approach, which emphasizes theoretical as well as empirical evaluation of mixture models, could make these models more accessible to clinical researchers and may be a useful approach to parsing heterogeneity in neurodevelopmental disorders.
Rice MPK17 Plays a Negative Role in the Xa21-Mediated Resistance Against Xanthomonas oryzae pv. oryzae
Authors: Zhu Zheng , Wang Tianxingzi , Lan Jinping , Ma Jinjiao , Xu Haiqing , Yang Zexi , Guo Yalu , Chen Yue , Zhang Jianshuo , Dou Shijuan , Yang Ming , Li Liyun , Liu Guozhen 
Published: August 2022

AbstractRice bacterial blight, caused by Xanthomonas oryzae pv. oryzae (Xoo), is one of the most serious diseases affecting rice production worldwide. Xa21 was the first disease resistance gene cloned in rice, which encodes a receptor kinase and confers broad resistance against Xoo stains. Dozens of components in the Xa21-mediated pathway have been identified in the past decades, however, the involvement of mitogen-activated protein kinase (MAPK) genes in the pathway has not been well described. To identify MAPK involved in Xa21-mediated resistance, the level of MAPK proteins was profiled using Western blot analysis. The abundance of OsMPK17 (MPK17) was found decreased during the rice-Xoo interaction in the background of Xa21. To investigate the function of MPK17, MPK17-RNAi and over-expression (OX) transgenic lines were generated. The RNAi lines showed an enhanced resistance, while OX lines had impaired resistance against Xoo, indicating that MPK17 plays negative role in Xa21-mediated resistance. Furthermore, the abundance of transcription factor WRKY62 and pathogenesis-related proteins PR1A were changed in the MPK17 transgenic lines when inoculated with Xoo. We also observed that the MPK17-RNAi and -OX rice plants showed altered agronomic traits, indicating that MPK17 also plays roles in the growth and development. On the basis of the current study and published results, we propose a “Xa21-MPK17-WRKY62-PR1A” signaling that functions in the Xa21-mediated disease resistance pathway. The identification of MPK17 advances our understanding of the mechanism underlying Xa21-mediated immunity, specifically in the mid- and late-stages.
Ultrasound biomicroscopy study of accommodative state in Smartphone abusers
Authors: Kashif Randa Farouk , Rashad Mohammad Ahmad , Said Azza Mohamed Ahmed , Rabie Menan Abd-El-Maksoud , Gomaa Wael Adel 
Published: August 2022

Abstract
Background
Addiction to Smartphone usage has psychological and physical impacts. However, the state of spasm of accommodation is unclear in Smartphone abusers.

Methods
We performed a cross-sectional study among adults aged 18–35 years between October 2016 and December 2018. Forty participants were Smartphone abusers according to the Smartphone addiction questionnaire, and 40 participants were non users. We measured auto refraction precycloplegia and postcycloplegia at far for all participants to evaluate the state of spasm of accommodation. We assessed the ultrasound biomicroscopy (UBM) parameters including anterior chamber angle (ACA).

Results
There was a significant difference in the odds of having spasm of accommodation between Smartphone abusers compared to non-users (OR = 6.64, 95% CI = 1.73–25.47; adjusted OR = 14.63, 95% CI = 2.99–71.62). The Smartphone abusers and non-users groups had a superior ACA median of 30.45° ± 8.3° vs. 26.75° ± 6.6° (P = 0.04) precycloplegia at far and 31.70° ± 11.8° vs. 31.45° ± 8.3° (P = 0.15) postcycloplegia at far, respectively, demonstrated by the Mann-Whitney U test. There was significant higher difference in the precycloplegic nasal ACA at far in the Smartphone abusers group than the non-users group (mean precycloplegic nasal ACA difference = 3.57°, 95% CI = 0.76° - 6.37°), demonstrated by the independent t test. Similarly, there was significant higher difference in the postcycloplegic nasal ACA at far (mean postcycloplegic nasal ACA difference = 4.26°, 95% CI = 1.33° - 7.19°).

Conclusions
Smartphone abusers are in a condition of accommodation spasm. As a result, cycloplegic refraction should be done for Smartphone abusers.
Governmental support for achieving “VISION 2020: the Right to Sight” in Iran: the cataract surgical rates
Authors: Hashemi Hassan , Rezvan Farhad , Yekta Abbasali , Khabazkhoob Mehdi 
Published: August 2022

Abstract
Purpose
The aim of this study was evaluate the effect of governmental support in the form of Health Transformation Plan (HTP) on increasing the cataract surgical rate.

Methods
The number of cataract surgeries was collected from Iranian cataract surgery clinics during 2019. HTP was implemented in 2014. Forty-seven major and forty-five minor surgery centers were selected from all provinces. In each center, sampling was done from 2012, 2013, 2015, and 2016.

Results
On average, 6202 and 7134 cataract surgery rate were performed before and after HTP, respectively. The cataract surgical rate rose by 15.03% after the HTP. After HTP, the proportion of cataract surgery increased by 21.32% in governmental centers and decreased by 17.56%, 24.45%, and 14.89% in private, insurance, and charity centers, respectively. The cataract surgical rate was 4093 and 6026 in the first economic quartile (the poorest), 3669 and 4595 in the second quartile, 5884 and 5928 in the third quartile, and 8427 and 9681 in the fourth quartile (the richest) before and after HTP, respectively. The highest growth in the cataract surgical rate was seen in the first quartile (47.24%) followed by the second (25.26%), fourth (14.88%), and third quartiles (0.74%).

Conclusion
The Health Transformation Plan has been successful in increasing the cataract surgical rate in the low-income group and identifying differences in the services as well as the economic groups within the population.
“I don’t hesitate to use the left-over antibiotics for my child” practices and experiences with antibiotic use among caregivers of paediatric patients at Zomba central hospital in Malawi
Authors: Machongo Redson Biswick , Mipando Alinane Linda Nyondo 
Published: August 2022

Abstract
Background
Inappropriate use of antibiotics is among the major causes of the global emergency of antibiotic resistance among children. The problem of inappropriate use of antibiotics among children is of special concern because they are still developing immunological systems, hence they are susceptible to many infectious diseases. As such, they receive a considerable disproportional amount of antibiotics which exposes them to antibiotic resistance. This study explored the lived experiences of caregivers of children under the age of five years on the use of antibiotics at Zomba central hospital.

Objective
The main aim of this study was to explore the lived experiences of caregivers of children under the age of five years on antibiotic usage at Zomba Central Hospital, Zomba-Malawi.

Methodology
This was a descriptive qualitative study with a phenomenological approach to explore the lived experience of caregivers of paediatric patients on antibiotic usage from May 2019 to July 2020. The study used interview guides to conduct in-depth interviews with 16 caregivers and purposive sampling was used to select the participants from the children’s ward. All interviews were audio-recorded and qualitative data was transcribed verbatim and thematically analysed manually to extract major themes and concepts on the subject matter.

Results
Caregivers had little knowledge about antibiotic use and its resistance. most caregivers use the antibiotics inappropriately through self-medication, use of left-over antibiotics, buying antibiotics without prescription, and sharing of antibiotics.

Conclusion
Based on the findings of this study, investment in public awareness and organising community-led interventions in antibiotic use related information is key to improve the quality use of antibiotics. The Government should focus on promoting interventions that lessen the indiscriminate use of antibiotics among the caregivers. Stringent laws need to be enforced by the government to restrict the access of antibiotics to parents without a prescription.
Effect of change in individual and household level characteristics on anemia prevalence among adolescent boys and girls in India
Authors: Srivastava Shobhit , Kumar Pradeep , Paul Ronak , Debnath Paramita 
Published: August 2022

Abstract
Background
Anemia is a significant public health challenge that affects the population of all nations. Anemia among adolescents emerged as an alarming public health issue as it harms an individual’s physical capacity and cognitive and work performance. The study aims to determine the effect of changes in individual and household level factors on the prevalence of anemia among adolescent boys and girls.

Method
The study utilized data from two waves of the “Understanding the lives of adolescent and young adults” (UDAYA) survey, conducted in Bihar and Uttar Pradesh during 2015–16 (wave-1) and 2018–19 (wave-2). The sample size for the present study was 4216 and 5974 unmarried adolescent boys and girls aged 10–19 years in both waves. We performed descriptive analysis to observe the characteristics of adolescents during 2015–16. Further, changes in selected independent variables from wave-1 to wave-2 were examined using the proportion test. Moreover, random-effect regression models were employed to examine the association of changes in individual and household level factors with anemia prevalence among adolescents.

Results
The prevalence of anemia decreased over time among adolescent boys (33 to 30%), whereas it increased among adolescent girls (59 to 63%). The results from the random-effect model show that adolescent boys who used shared toilets were more anemic than those who used a private restroom [β:0.05, 95% CI:(0.01, 0.08)]. Moreover, underweight [β:0.05, CI:(0.01, 0.09)] and thin [β:0.04, CI:(0.00, 0.07)] adolescent boys were more likely to be anemic compared to their normal counterparts. Additionally, boys who belonged to the poorest [β:0.08, CI:(0.02, 0.14)] households had a higher risk of anemia than the richest household.

Conclusion
The anemia prevalence was higher among adolescents aged 10–19 years in Uttar Pradesh and Bihar. This study has filled an information gap by providing state-level representative estimates indicating underweight status and thinness as the common factors behind the anemia prevalence among adolescent boys than in girls. Iron deficiency anemia is the most prevalent in certain age groups in India. Hence, Anemia prevention efforts and iron-folic acid (IFA) supplementation programs are currently being strengthened in India, targeting the high-risk population.