bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epileptic spasms related to neuronal differentiation factor 2 (NEUROD2) mutation respond to combined vigabatrin and high dose prednisolone therapy
Authors: Sakpichaisakul Kullasate , Boonkrongsak Rachata , Lertbutsayanukul Punjama , Iemwimangsa Nareenart , Klumsathian Sommon , Panthan Bhakbhoom , Trachoo Objoon 
Published: December 2022

Abstract
Background
Epileptic spasms are a devastating form of early infantile epileptic encephalopathy (EIEE) with various etiologies. Early diagnosis and a shorter lead time to treatment are crucial to stop the seizures and optimize the neurodevelopmental outcome. Genetic testing has become an integral part of epilepsy care that directly guides management and family planning and discovers new targeted treatments. Neuronal differentiation Factor 2 (NEUROD2) variants have recently been a cause of neurodevelopmental disorders (NDDs) and EIEEs with distinctive features. However, there is limited information about the clinical and electroencephalographic response of epileptic spasm treatment in NEUROD2-related NDD syndrome.

Case presentation
We report a female patient of Southeast Asian ethnicity with global developmental delay and epileptic spasms commencing in the first few months of life. A novel de novo heterozygous pathogenic NEUROD2 variant, p. E130Q, was subsequently identified by whole-exome sequencing. Electroencephalogram before treatment showed multifocal independent spikes predominantly in both posterior head regions and demonstrated marked improvement following combined vigabatrin and high-dose prednisolone treatment. However, multiple courses of relapse occurred after weaning off the antiseizure medication.

Conclusions
We propose that epileptic spasms related to de novo NEUROD2 pathogenic variant respond well to combined vigabatrin and high-dose prednisolone therapy. These findings may imply the benefit of using combination therapy to treat epileptic spasms in NEUROD2-related NDD syndrome.
Identification of CEACAM5 as a stemness-related inhibitory immune checkpoint in pancreatic cancer
Authors: Shi Haojun , Tsang Yiusing , Yang Yisi 
Published: December 2022

Abstract
Background
Immunotherapy has emerged as a new cancer treatment modality. However, tumour heterogeneity can diminish checkpoint blockade response and shorten patient survival. As a source of tumour heterogeneity, cancer stem cells act as an indispensable reservoir for local recurrence and distant metastasis. Thus, precision immunotherapy targeting tumour heterogeneity requires a comprehensive understanding of cancer stem cell immunology. Our study aimed to identify stemness-related inhibitory immune checkpoints and relevant regulatory pathways in pancreatic cancer.

Methods
Pancreatic cancer-specific datasets in The Cancer Genome Atlas and the Cancer Therapeutics Response Portal were collected for in-depth bioinformatic analysis. Differentially expressed genes between pancreatic cancers with high and low stemness index (mRNAsi) scores were compared to screen out inhibitory immune checkpoints. Survival analysis was used to predict the prognostic value of immune checkpoint plus immune infiltrate in patients with pancreatic cancer. The expression of stemness-related immune checkpoint across immune subtypes of pancreatic cancer was detected and gene set enrichment analysis was performed to figure out the relevant regulatory signallings.

Results
The abundance of cancer stemness predicted a low immunotherapy response to pancreatic cancer. The inhibitory immune checkpoint CEACAM5 that was enriched in pancreatic cancers with high mRNAsi scores also exhibited a strong correlation with invasive cell-enriched signature and Msi+ tumour-initiating cell-enriched signature. Levels of CEACAM5 expression were higher in the interferon-γ dominant immune subtype of pancreatic cancers that are characterized by high M1 macrophage infiltration. The patient group with high levels of CEACAM5 expression had a high risk of poor overall survival, even if accompanied by high infiltration of M1 macrophages. Furthermore, prostanoid and long-chain unsaturated fatty acid metabolic processes showed a significant association with cancer stemness and CEACAM5 expression.

Conclusions
Our findings suggest that CEACAM5 is a candidate stemness-related innate immune checkpoint in pancreatic cancer, and is potentially regulated by prostanoid and long-chain unsaturated fatty acid metabolic processes. Immune checkpoint blockade of CEACAM5, which synergizes with inhibition of those regulatory pathways, may improve the efficacy of precision immunotherapy targeting tumour heterogeneity caused by cancer stem cells.
Superficial capillary plexus vessel density/deep capillary plexus vessel density ratio in healthy eyes
Authors: Nam Ki-Yup , Lee Min-Woo , Lee Kook-Hyung , Kim Jung-Yeul 
Published: December 2022

Abstract
Background
To identify factors differently affecting the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in healthy eyes using their vessel density (VD) ratio.

Methods
Healthy eyes were enrolled. The ratio between the VD of SCP and DCP (SVD/DVD ratio) was calculated. Pearson correlation analyses were performed to identify the relationships between this ratio and other factors.

Results
The mean SVD and DVD were 36.2 ± 5.7 and 37.7 ± 4.9%, respectively, and the mean SVD/DVD ratio was 0.96 ± 0.15. The SVD was significantly correlated with the best-corrected visual acuity (BCVA) (r = − 0.368, P <  0.001), age (r = − 0.408, P <  0.001), and OCTA quality (r = 0.520, P <  0.001). The DVD was significantly correlated with the BCVA (r = − 0.150, P = 0.008), age (r = − 0.229, P <  0.001), and OCTA quality (r = 0.555, P <  0.001). Among various factors, age (r = − 0.296, P <  0.001), the BCVA (r = − 0.237, P <  0.001), axial length (r = 0.234, P <  0.001), and OCTA quality (r = 0.270, P < 0.001) were significantly correlated with the SVD/DVD ratio.

Conclusions
Age, BCVA, axial length, and OCTA image quality were significantly correlated with the SVD/DVD ratio. Age, the BCVA, and OCTA quality were more strongly correlated with the SCP, and the axial length was more strongly correlated with the DCP.
The impact of the COVID-19 pandemic on suicide rates in Hungary: an interrupted time-series analysis
Authors: Lantos Tamás , Nyári Tibor András 
Published: December 2022

Abstract
Background
From 2010 to 2019, suicide mortality fell steadily and substantially in Hungary: the declining trend remained stable, and the suicide rate decreased by more than one-third which was remarkable even from an international perspective. However, despite the declining trend, regional inequalities have always characterised the distribution of suicide mortality in Hungary. Following these favourable trends, COVID-19 appeared in Hungary on the 4th of March 2020 which might lead to an increase in suicides. We aimed to investigate this hypothesis in Hungary by gender, age, educational attainment, and region, as well.

Methods
To test whether the pandemic changed the declining trend of Hungarian suicide rates, the observed number of suicides during March–December 2020 (pre-vaccination period) was compared with the expected numbers (without the appearance of COVID-19). An interrupted time-series analysis was conducted by negative binomial regression using monthly data from January 2010 to February 2020 (pre-pandemic period).

Results
Suicide mortality increased significantly compared to the trend during the pre-pandemic period: overall (by 16.7%), among males (18.5%), in the age group 35–49 years (32.8%), and among vocational school graduates (26.1%). Additionally, significant growths in suicide rates were detected in the two regions (Central Hungary and Central Transdanubia) with the lowest COVID mortality rates (by 27.3% and 22.2%, respectively).

Conclusions
Our study revealed reversed trend in suicide mortality during the pre-vaccination period compared to the pre-pandemic period in Hungary. There were significant differences in the pattern of suicide rates by gender, age group, educational attainment, and region during the pre-vaccination period in Hungary, which might be attributed to the socio-economic effects of the COVID-19 pandemic. These findings could prove useful in preventive strategies as the identification of groups at higher risk may be important for suicide prevention; however, further investigations are needed to explore the reasons.
A case report involving the experience of pervasive pregnancy denial: detailed observation of the first 12 postpartum weeks
Authors: Chechko Natalia , Losse Elena , Stickel Susanne 
Published: December 2022

Abstract
Background
Pervasive pregnancy denial is a rare condition associated with distress and unassisted delivery.

Case presentation
The case involves a 38-year-old woman (NN), with two older children (ages 8 and 11), who was unaware, until delivery, that she had been pregnant. The case is discussed in the context of a 12-week observation of postpartum mood, stress, and mother-child attachment. NN and other 558 non-depressed women (mean age 32.41 years) were selected from the pool of participants in the RIPOD (risk of postpartum depression) study. All participants were recruited within 1–6 days of delivery. In addition to surveying depressed mood at childbirth, remote assessments of mood, mother-child attachment, and perceived stress were conducted at 3, 6, 9, and 12 weeks postpartum. Every other day, the participants also reported their current perceived stress levels based on a scale from 1 (low) to 10 (high). During the entire period of postpartum observation, NN reported no symptoms on the Edinburgh Postpartum Depression Scale, similar to only 1.6% of the sample, no stress as 0.7% of the sample, and above-average mother-infant bonding akin to only 4.6% of the sample. Her daily stress levels showed no disturbance, which was the case for only 3.32% of the total sample. On the day of delivery, NN reported a stress level of 1 (the minimum possible level), which was reported by only 4.2% of the total sample. However, NN reported the experience of delivery to be traumatic given that the child had fallen to the floor.

Conclusion
The experience of a denied pregnancy did not appear to disturb NN at any time point, not even on the day of delivery. Compared to NN, the other non-depressed participants reported wide fluctuations in stress levels during the observation period. NN did not report any risk factors for denied pregnancy. Thus, she belonged neither to any group of typical pregnancy deniers, as reported in the literature, nor to a typical postpartum group. We postulate, therefore, that the extent to which pregnancy denial can be deemed a normal variation, unrelated to a psychological or physiological condition, depends largely on personal traits.
Indoor bacterial and fungal aerosols as predictors of lower respiratory tract infections among under-five children in Ibadan, Nigeria
Authors: Fakunle Adekunle Gregory , Jafta Nkosana , Smit Lidwien A. M. , Naidoo Rajen N. 
Published: December 2022

Abstract
Background
This study aimed to investigate the association between exposure to diverse indoor microbial aerosols and lower respiratory tract infections (LRTI) among children aged 1 to 59 months in Ibadan, Nigeria.

Methods
One hundred and seventy-eight (178) hospital-based LRTI cases among under-five children were matched for age (± 3 months), sex and geographical location with 180 community-based controls (under-five children without LRTI). Following consent from caregivers of eligible participants, a child’s health questionnaire, clinical proforma and standardized home-walkthrough checklist were used to collect data. Participant homes were visited and sampled for indoor microbial exposures using active sampling approach by Anderson sampler. Indoor microbial count (IMC), total bacterial count (TBC), and total fungal count (TFC) were estimated and dichotomized into high (> median) and low (≤ median) exposures. Alpha diversity measures including richness (R), Shannon (H) and Simpson (D) indices were also estimated. Conditional logistic regression models were used to test association between exposure to indoor microbial aerosols and LRTI risk among under-five children.

Results
Significantly higher bacterial and fungal diversities were found in homes of cases (R = 3.00; H = 1.04; D = 2.67 and R = 2.56; H = 0.82; D = 2.33) than homes of controls (R = 2.00; H = 0.64; D = 1.80 and R = 1.89; H = 0.55; D = 1.88) p < 0.001, respectively. In the multivariate models, higher categories of exposure to IMC (aOR = 2.67, 95% CI 1.44–4.97), TBC (aOR = 2.51, 95% CI 1.36–4.65), TFC (aOR = 2.75, 95% CI 1.54–4.89), bacterial diversity (aOR = 1.87, 95% CI 1.08–3.24) and fungal diversity (aOR = 3.00, 95% CI 1.55–5.79) were independently associated with LRTI risk among under-five children.

Conclusions
This study suggests an increased risk of LRTI when children under the age of five years are exposed to high levels of indoor microbial aerosols.
The effects of different root canal irrigation protocols and artificial aging procedures on the bond strength between dentin and hybrid ceramic posts
Authors: Topbaş Celalettin , Çınar Şevki , Altan Bike , Şirin Dursun Ali , Fildişi Mehmet Ali 
Published: December 2022

AbstractThe purpose of this study is to investigate the effects of different root canal irrigation protocols applied to the dentin and artificial aging procedures on the micro pushout bond strength (mPBS) between dentin and hybrid ceramic posts. Seventy-five single-rooted mandibular premolar teeth were divided into 5 groups (Gr1-5). 50 of the teeth were used for the mPBS tests (n = 10), whereas 25 were used for the smear layer examinations (n = 5). Post space were prepared and irrigated with different irrigation-protocols in each group. (Gr1:[SS], Gr2:[NaOCl] + SS, Gr3:[EDTA] + NaOCl + SS, Gr4:[MA] + NaOCl + SS, Gr5:[Ch] + NaOCl + SS). Post and core pattern were fabricated with pattern resin and a fiber post, after scanning, the posts were milled with Vita Enamic resin ceramic block, and cemented. After 7 days the roots were sliced at thicknesses of 1 mm; half of them were subjected to mPBS test, while the other half were tested after undergoing mechanical cycling for artificial aging. For data analysis, the Shapiro-Wilk test was utilized to test normal distributions, 3-way analysis of variance was used to compare mPBS, and Tukey’s HSD test was conducted for multiple comparisons. SEM analysis was performed for examination of failure modes and smear layer removal. Different root canal irrigation protocols affected mPBS significantly. While Gr4 had the highest mPBS, Gr1 had the lowest. Regarding to different zones, the highest mPBS was in coronal zone, and the lowest one was in the apical zone. The aging procedure also led to a statistically-significant decrease in mPBS. Most frequent failure modes were cohesive failure in dentin and mixed failure. Irrigation with 7%MA (Gr4) showed better performance than 17% EDTA (Gr3) in smear layer removal, especially at the apical zone of the tooth. This is critical for the success of root canal treatment and increased the mPBS to a higher extent in all zones of the tooth.
Study protocol: understanding pain after dental procedures, an observational study within the National Dental PBRN
Authors: Kalenderian Elisabeth , White Joel , Yansane Alfa-Ibrahim , Urata Janelle , Holmes David , Funkhouser Kimberly , Mungia Rahma , Xiao Jin , Rauschenberger Cindy , Ibarra-Noriega Ana , Tran Duong , Rindal D. Brad , Spallek Heiko , Walji Muhammad 
Published: December 2022

Abstract
Background
Patient-reported outcome measures provide an essential perspective on the quality of health care provided. However, how data are collected, how providers value and make sense of the data, and, ultimately, use the data to create meaningful impact all influence the success of using patient-reported outcomes.

Objectives
The primary objective is to assess post-operative pain experiences by dental procedure type through 21 days post-procedure as reported by patients following dental procedures and assess patients’ satisfaction with pain management following dental surgical procedures. Secondary objectives are to: 1) assess post-operative pain management strategies 1 week following dental surgical procedures, as recommended by practitioners and reported by patients, and 2) evaluate practitioner and patient acceptance of the FollowApp.Care post visit patient monitoring technology (FollowApp.Care). We will evaluate FollowApp.Care usage, perceived usefulness, ease of use, and impact on clinical workload.

Design and methods
We describe the protocol for an observational study involving the use of the FollowApp.Care platform, an innovative mobile application that collects dental patients’ assessments of their post-operative symptoms (e.g., pain). The study will be conducted in collaboration with the National Dental Practice-based Research Network, a collective Network of dental practices that include private and group practices, public health clinics, community health centers and Federal Qualified Health Centers, academic institutional settings, and special patient populations. We will recruit a minimum of 150 and up to 215 dental providers and up to 3147 patients who will receive push notifications through text messages FollowApp.Care on their mobile phones at designated time intervals following dental procedures. This innovative approach of implementing an existing and tested mobile health system technology into the real-world dental office setting will actively track pain and other complications following dental procedures. Through patients’ use of their mobile phones, we expect to promptly and precisely identify specific pain levels and other issues after surgical dental procedures.
The study’s primary outcome will be the patients’ reported pain experiences. Secondary outcomes include pain management strategies and medications implemented by the patient and provider and perceptions of usefulness and ease of use by patients and providers.
Application of two level count regression modeling on the determinants of fertility among married women in Ethiopia
Authors: Hussen Nuru Mohammed 
Published: December 2022

Abstract
Background
Fertility is the element of population dynamics that has a vital contribution toward changing population size and structure over time. The global population showed a major increment from time to time due to fertility. This increment was higher in south Asia and sub-Saharan Africa including Ethiopia. So this study targeted the factors affecting fertility among married women in Ethiopia through the framework of multilevel count regression analysis using the 2016 Ethiopian Demographic and Health Survey data.

Methods
Secondary data set on the birth records were obtained from the 2016 Ethiopia Demographic and Health Survey. The survey was a population-based cross-sectional study with a two-stage stratified cluster sampling design, where stratification was achieved by separating every region into urban and rural areas except the Addis Ababa region because it is entirely urban. A two-level negative binomial regression model was fitted to spot out the determinants of fertility among married women in Ethiopia.

Results
Among the random sample of 6141 women in the country, 27,150 births were recorded based on the 2016 Ethiopian Demographic and Health Survey report. The histograms showed that the data has a positively skewed distribution not extremely picked at the beginning. Findings from the study revealed that the contraception method used, residence, educational level of women, women’s age at first birth, and proceeding birth interval were the major predictors of fertility among married women in Ethiopia. Moreover, the estimates from the random effect result revealed that there is more fertility variation between the enumeration areas than within the enumeration areas.

Conclusion
Unobserved enumeration area fertility differences that cannot be addressed by a single-level approach were determined using a two-level negative binomial regression modeling approach. So, the application of standard models by ignoring this variation ought to embrace spurious results, then for such hierarchical data, multilevel modeling is recommended.
Cancer prevention in females with and without obesity: Does perceived and internalised weight bias determine cancer prevention behaviour?
Authors: Bernard Marie , Löbner Magrit , Lordick Florian , Mehnert-Theuerkauf Anja , Riedel-Heller Steffi G. , Luck-Sikorski Claudia 
Published: December 2022

Abstract
Background
Women with obesity are not only at higher risk of developing cancer such as gynaecological malignancies but are also less likely to attend cancer prevention screenings (CPS). In this study, we aimed to obtain a better database for Germany and to investigate whether women with obesity are less likely to undergo CPS compared to women without obesity. Moreover, we aimed to identify factors that determine CPS behaviour.

Methods
A quantitative cross-sectional telephone survey was conducted that assessed data of 1003 females in the general public with obesity (BMI ≥ 30 kg/m2; n = 500) and without obesity (BMI < 30 kg/m2; n = 503). We assessed participants’ utilisation of cervical, breast, and colorectal CPS. Group differences were investigated by using Chi-Square tests, whereas influencing factors that might determine CPS behaviour were examined by multivariate logistic regression analyses. Therefore, logistic regression models for (a) the full sample and (b) the obese sample were conducted. Explanatory factors (i.e., cancer awareness, the internalisation of weight bias (WBIS) and perceived weight-based discrimination) were included. Confounding factors such as sociodemographic variables were included in the multivariate analysis.

Results
Women with obesity were less likely to undergo Pap smear (χ2(1) = 13.90, p < 0.001) and clinical breast examination (χ2(4) = 14.41, p < 0.01) compared to women without obesity. In contrast, the utilisation of all other CPS methods did not differ between women with and without obesity. Logistic regression analyses revealed neither an association between CPS behaviour and WBI nor perceived weight bias. Instead, previous cancer diagnoses and knowledge about CPS forms were found to reinforce CPS behaviour.

Conclusion
Although data did not suggest that internalised or perceived weight bias deter women with obesity from undergoing CPS, the role of weight bias has not yet been conclusively clarified. Future studies should address potential methodological limitations and evaluate the effectiveness of most recently established cancer prevention programs and in particular how they affect CPS behaviour in women with obesity.