bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Sleep and Temperament of Preschool Children in Malaysia
Authors: Fujii Mai , Hayashi Masayuki , Teng Cheong Lieng 
Published: August 2022

Background: Unhealthy sleep patterns have been linked to a variety of adverse effects in children, and temperament could be an influencing factor in poor sleep quality. Aim: This study examined the association between temperament and sleep quality among preschoolers. Methods: The participants of the study were 35 children aged 3 years to 6 years in Northern Peninsular Malaysia. Observational sleep was recorded across 14 days. Further, a self-administered questionnaire was used to capture the children’s sleep-related issues. The Children’s Behavior Questionnaire-Very-Short-Form was used to measure the temperament of the children. The relationship between sleep patterns and sleep-related issues and temperament was assessed. Results: No significant differences were found between the 3 subscales of temperament sleep duration, and sleep and wake times, for both night sleep and naps. Concerning the association between temperament and children’s sleep issues, a negative weak correlation was found between negative affect and children’s difficulty falling asleep, as well as frequent night-time waking. Effortful control was found to have a weak positive correlation with “sufficient sleep” and “earliness of the sleep,” with a negative correlation for the topic “a child’s bad mood and crying through the day.” Conclusions: The results of this study did not show positive correlations between temperament and quality of sleep among preschool children in Malaysia, though some children’s sleep issue was correlated with temperament. Similar to other studies, these results might be an indication that a child’s difficult temperament could be a factor affecting sleep quality though further large-scale studies will be needed.
Posttraumatic Stress Disorder Among Adolescent Girls Infected with COVID-19: A Cross-Sectional Study
Authors: Suresh Anandu , Shivanna Sindhu Shankar , Satyanarayana Pradeep Tarikere 
Published: August 2022

Background: Pandemics are known to cause an increase in the prevalence of posttraumatic stress disorder (PTSD). The current COVID-19 pandemic has led to a surge in the same along with other problems such as anxiety and depression. Aim: To find out the prevalence of PTSD and other mental health abnormalities among adolescent girls who have contracted COVID-19 infection and the factors associated with it. Methods: This was a cross-sectional study carried out for 6 months at RL Jalappa Hospital and Research Center, Kolar. Adolescent girls infected with COVID-19 were included. A total of 100 girls took part in the study after matching inclusion and exclusion criteria. To assess for PTSD, the Mini International Neuropsychiatry Interview-KID (MINI-KID) and CPSS-5 Interviewer Version (CPSS 5-I) questionnaire were used. Data entered in Microsoft office excel were analyzed using SPSS v 22 (IBM Corp., Armonk, NY, USA). To check for the association between factors, chi-square test was applied. Results: The majority of girls were aged 18 years, belonged to nuclear families, and had a hospital stay for 7 days to14 days. About 15% of the girls had PTSD diagnosed using two tools. Panic disorder and separation anxiety were commonly seen. Duration of COVID symptoms adolescent girls had before being diagnosed with COVID-19 by RT-PCR and duration of the hospital stay along with symptoms like throat pain, headache, and diarrhea were a few clinical factors that had a statistically significant association with PTSD. Mental health screening seems to be disregarded in COVID-19 cases. COVID-19 can be a traumatic stressor event among adolescents which can elicit PTSD-like responses and also exacerbate mental health problems. Conclusions: Early screening for PTSD or other mental health abnormalities among adolescents post COVID-19 infection should be considered.
Televised Anti-Tobacco Media and Smoking Outcomes Among Heterosexual and Sexual Minority Adults in the United States
Authors: Titus Andrea R. , Thrasher James F. , Gamarel Kristi E. , Emery Sherry L. , Elliott Michael R. , Fleischer Nancy L. 
Published: August 2022

Background The prevalence of smoking is higher among sexual minority (SM) individuals compared with heterosexuals. The impact of televised anti-tobacco mass media campaigns on smoking outcomes among SMs is not known. Aims We examined whether televised anti-tobacco advertising was differentially associated with current smoking and smoking intensity for SM and heterosexual adults. Method We combined county-level anti-tobacco advertising data (gross rating points) with restricted, geocoded individual-level National Health Interview Survey data on smoking (2013–2015). We estimated associations between advertising and smoking outcomes, including potential effect modification by SM status. Results Greater anti-tobacco advertising exposure was associated with lower smoking prevalence (prevalence ratio [PR] = 0.97; 95% confidence interval [CI] = [0.94, 1.00]). Although the direction of the association differed for heterosexual and SM adults, differences were not statistically significant. No significant associations were observed with regard to smoking intensity. Conclusion Associations between anti-tobacco advertising and smoking were not significantly different for heterosexual and SM adults.
Relapsing antibody-negative patients with features of neuromyelitis optica spectrum disorders: Differences in N-acetylaspartate level in the cervical spinal cord indicate distinct underlying processes
Authors: Kossowski Bartosz , Kong Yazhuo , Klimiec-Moskal Elżbieta , Emir Uzay , Palace Jacqueline , Juryńczyk Maciej 
Published: August 2022

Background: Due to lack of biomarkers, antibody-negative patients with features of neuromyelitis optica spectrum disorders (NMOSD) are among the most challenging to diagnose and treat. Using unsupervised clustering, we recently identified ‘MS-like’, ‘spinal MS-like’, ‘classic NMOSD-like’ and ‘NMOSD-like with brain involvement’ subgroups in this cohort. Objective: We used magnetic resonance spectroscopy (MRS) to examine differences in the level of key metabolites in the spinal cord between the four identified subgroups. Methods: Twenty-five relapsing antibody-negative patients with NMOSD features classified by the unsupervised algorithm to one of the subgroups underwent a prospective cervical spinal cord MRS. Spectra from 16 patients fulfilled quality criteria and were included in the analysis. Results: Total N-acetylaspartate (tNAA), but not total choline (tCho) or myo-inositol (Ins), was significantly different between the four subgroups ( p = 0.03). In particular, tNAA was 47.8% lower in the ‘MS-like’ subgroup as compared with the ‘classic NMOSD-like’ subgroup ( p = 0.02). While we found a negative overall correlation between tNAA and disability score ( r = –0.514, p = 0.04) in the whole cohort, the disability score did not differ significantly between the subgroups to explain subgroup differences in tNAA level. Conclusions: Significant differences in the cervical spinal cord tNAA measurements confirm that the previously identified clinico-radiologic subgroups contain patients with distinct underlying disease processes.
Bilingual phonological awareness as a function of language proficiency
Authors: Oz-Vecht Einat , Degani Tamar 
Published: August 2022

Aims and objectives: The present study examined whether phonological awareness reflects a stable construct or whether it varies by the different languages of bilingual speakers. In particular, the study tests to what extent language proficiency determines phonological awareness above and beyond language structural characteristics. Methodology: Bilingual adult speakers were tested as they afford within-participant comparisons to address this issue. Specifically, 29 Hebrew (L1)-English (L2) bilinguals were compared to 33 English (L1)-Hebrew (L2) bilinguals on a timed auditory rhyme judgment task including 270 word-pairs (90 English pairs, 90 Hebrew pairs, and 90 pseudo-Hebrew pairs). Data and analysis: Reaction times and dʹ on the rhyme judgment task were compared between the two bilingual groups to examine the role of language proficiency in predicting phonological awareness performance. Furthermore, rhyme judgments on Hebrew pairs were correlated with those on English pairs to provide within-participant index of phonological awareness stability. Findings: Rhyme judgment performance on the same set of words was affected by the strength of linguistic representations, as determined by language proficiency profile. English-Hebrew bilinguals performed better on English pairs, whereas Hebrew-English bilinguals performed better on Hebrew pairs. Moreover, within-group comparisons revealed that performance in the more proficient language was not correlated with performance in the less proficient language. Originality: By testing two groups of bilinguals who differ in their language dominance profile using the same set of materials (including both L1 and L2 pairs), the results reveal differences in phonological awareness abilities as a function of language proficiency that cannot be reduced to structural differences between the examined languages. Significance: The findings underscore the dynamic nature of phonological awareness abilities and carry implications for clinical diagnosis of bilingual populations, in that rhyme judgment performance in one language should not be taken to index expected abilities in the other language of bilingual speakers.
Reduction in transfer of micro-organisms between patients and staff using short-sleeved gowns and hand/arm hygiene in intensive care during the COVID-19 pandemic: A simulation-based randomised trial
Authors: Vincent Laura , Ibrahim Mudathir , Kitchin Joanne , Pickering Claire , Wilson Jennie , Sorrentino Enrico , Salvagno Claudia , Earl Laurie , Ma Louise , Simpson Kathryn , Baker Rose , McCulloch Peter 
Published: August 2022

Background Current personal protective equipment (PPE) practices in UK intensive care units involve “sessional” use of long-sleeved gowns, risking nosocomial infection transmitted via gown sleeves. Data from the first wave of the COVID19 pandemic demonstrated that these changes in infection prevention and control protocols were associated with an increase in healthcare associated bloodstream infections. We therefore explored the use of a protocol using short-sleeved gowns with hand and arm hygiene to reduce this risk. Methods ICU staff were trained in wearing short-sleeved gowns and using a specific hand and arm washing technique between patients (experimental protocol). They then underwent simulation training, performing COVID-19 intubation and proning tasks using either experimental protocol or the standard (long-sleeved) control protocol. Fluorescent powder was used to simulate microbial contamination, detected using photographs under ultraviolet light. Teams were randomised to use control or experimental PPE first. During the simulation, staff were questioned on their feelings about personal safety, comfort and patient safety. Results Sixty-eight staff and 17 proning volunteers were studied. Experimental PPE completely prevented staff contamination during COVID-19 intubation, whereas this occurred in 30/67 staff wearing control PPE ( p = .003, McNemar). Proning volunteers were contaminated by staff in 15/17 control sessions and in 1/17 with experimental PPE ( p = .023 McNemar). Staff comfort was superior with experimental PPE ( p< .001, Wilcoxon). Their personal safety perception was initially higher with control PPE, but changed towards neutrality during sessions ( p < .001 start, 0.068 end). Their impressions of patient safety were initially similar ( p = .87), but finished strongly in favour of experimental PPE ( p < .001). Conclusions Short-sleeved gowns with hand and forearm cleansing appear superior to sessional long-sleeved gowns in preventing cross-contamination between staff and patients.
Death and Dialysis Following Discharge From Chronic Kidney Disease Clinic: A Retrospective Cohort Study
Authors: Che Michael , Iliescu Eduard , Thanabalasingam Susan , Day Andrew G , White Christine A 
Published: August 2022

Background: Multidisciplinary care is recommended for patients with advanced chronic kidney disease (CKD). A formalized, risk-based approach to CKD management is being adopted in some jurisdictions. In Ontario, Canada, the eligibility criteria for multidisciplinary CKD care funding were revised between 2016 and 2018 to a 2 year risk of kidney replacement therapy (KRT) greater than 10% calculated by the 4-variable Kidney Failure Risk Equation (KFRE). Implementation of the risk-based approach has led to the discharge of prevalent CKD patients. Objective: The primary objective of this study was to determine the frequency of occurrence of death and KRT initiation in patients discharged from CKD clinic. Design: Retrospective cohort study Setting: Single center multidisciplinary CKD clinic in Ontario, Canada Patients: Four hundred and twenty five patients seen at least once in 2013 at the multidisciplinary CKD clinic Measurements: Outcomes included discharge status, death, re-referral and KRT initiation. Reasons for discharge were recorded. Methods: Outcomes were extracted from available electronic medical records and the provincial death registry between the patient’s initial clinic visit in 2013 and January 1, 2020. KFRE-2 scores were calculated using the 4-variable KFRE equation. The hazard rates of death and KRT after discharge due to stable eGFR/low KFRE were compared to patients who remained in the clinic. Results: Of the 425 CKD patients, 69 (16%) and 19 (4%) were discharged to primary care and general nephrology, respectively. Of those discharged, 7 (8%) were re-referred to nephrology or CKD clinic, while only 2 (2%) discharged patients required subsequent KRT. The hazard of mortality was reduced after discharge from the clinic due to stable eGFR/low KFRE (adjusted HR = 0.45 [95% CI, 0.25-0.78, P = .005]). Limitations: Single center, observational retrospective study design and unknown kidney function over time post discharge for most patients Conclusions: Discharge of low risk patients from multidisciplinary CKD clinic appears feasible and safe, with fewer than 1 in 40 discharged patients subsequently initiated on KRT over the following 7 years.
Artificial intelligence–aided diagnosis model for acute respiratory distress syndrome combining clinical data and chest radiographs
Authors: Pai Kai-Chih , Chao Wen-Cheng , Huang Yu-Len , Sheu Ruey-Kai , Chen Lun-Chi , Wang Min-Shian , Lin Shau-Hung , Yu Yu-Yi , Wu Chieh-Liang , Chan Ming-Cheng 
Published: August 2022

Objective The aim of this study was to develop an artificial intelligence–based model to detect the presence of acute respiratory distress syndrome (ARDS) using clinical data and chest X-ray (CXR) data. Method The transfer learning method was used to train a convolutional neural network (CNN) model with an external image dataset to extract the image features. Then, the last layer of the model was fine-tuned to determine the probability of ARDS. The clinical data were trained using three machine learning algorithms—eXtreme Gradient Boosting (XGB), random forest (RF), and logistic regression (LR)—to estimate the probability of ARDS. Finally, ensemble-weighted methods were proposed that combined the image model and the clinical data model to estimate the probability of ARDS. An analysis of the importance of clinical features was performed to explore the most important features in detecting ARDS. A gradient-weighted class activation mapping (Grad-CAM) model was used to explain what our CNN sees and understands when making a decision. Results The proposed ensemble-weighted methods improved the performances of the ARDS classifiers (XGB + CNN, area under the curve [AUC] = 0.916; RF + CNN, AUC = 0.920; LR + CNN, AUC = 0.920; XGB + RF + LR + CNN, AUC = 0.925). In addition, the ML model using clinical data to present the top 15 important features to identify the risk factors of ARDS. Conclusion This study developed combined machine learning models with clinical data and CXR images to detect ARDS. According to the results of the Shapley Additive exPlanations values and the Grad-CAM techniques, an explicable ARDS diagnosis model is suitable for a real-life scenario.
Effectiveness of home care intervention on family ability to do caregiving at home and increase the independence among elderly with dementia
Authors: Sya’diyah Hidayatus , Nursalam  , Mahmudah  , Efendi Ferry 
Published: August 2022

Background: Dementia had effect on the dependence status of the elderly. Living in family can increase independence among elderly. The purpose of the study was to determine the effectiveness of home care intervention on the family’s ability to conduct caregiving at home as well as the independence of the elderly with dementia. Also, to determine the effect of family ability to conduct caregiving at home on the independence of the elderly with dementia. Design and Methods: This study used quasi-experimental with cross-sectional design. The sample size was 40 respondents into two groups and it was selected using simple random technique. Data were collected from January to June 2021. The intervention group received home care intervention, and the control group did not receive any treatment. The outcome was measured using questionnaire and analyzed using paired t-test and linear regression test. Results: This study showed that home care intervention is effective in improving the family’s ability to do home care ( p value <0.05) as well as the independence of the elderly with dementia ( p value <0.05). In addition, the ability of family to conduct caregiving at home had effect on the independence of the elderly with dementia ( p value <0.05). Conclusion: The home care intervention was effective in improving family ability and independence of elderly with dementia. This intervention was developed based on caregiver empowerment. It can be the guideline of family to conduct home care.
Micro Borrowing an Amalgam of Structure and Strategy: Evidence from India
Authors: Koride Padmavathi 
Published: August 2022

Micro borrowing was either an outcome of structure in the credit environment (termed the outreach stream), or a strategic response of the borrowers (termed the sustainability stream). Furthermore, borrower personal effects drove borrowing behaviour. This study draws variables from both the streams of literature and tests them against the amount borrowed and purposes loans are borrowed for. Results show how borrowing behaviour is neither an outcome of pure structure nor pure strategy, but rather, is an interplay of both, and further influenced by personal effects. The survey data (consisting of 839 rural borrower responses, from four districts of erstwhile Andhra Pradesh in South India) was subjected to a rigorous statistical analysis. Results show how a larger number of banks in the villages (a structural constraint), enabled the borrowers to receive larger loans, who defaulted more (a strategic response). Men borrowed larger sums (a personal effect). A similar amalgam of structure, strategy and personal effects drive borrowing behaviour even after controlling for loan purpose and district fixed effects. Yet, when district effects are introduced, amount borrowed is agnostic to personal effects, and is driven purely by structure and strategy. JEL Classifications: C25, C83, G51, Z13
A Unique Case of Syphilitic Hypopyon Panophthalmitis
Authors: Seely Mason , Deaner Jordan D. , Vajzovic Lejla 
Published: August 2022

Purpose: This work reports a unique case of syphilitic hypopyon panophthalmitis. Methods: A case report is presented. Results: A 25-year-old man with a history of HIV and intravenous (IV) drug use presented to an outside hospital with blurred vision and swelling of the right eye. Computed tomography was concerning for orbital cellulitis. On examination, he had limited extraocular motility, relative exophthalmos, periocular edema, 4+ anterior chamber cell, an irregular layering hypopyon, and no view of the fundus. Magnetic resonance imaging showed enhancement of the sclera, lateral rectus muscle, and lacrimal gland concerning for infectious or inflammatory panophthalmitis. The patient’s history and presentation were concerning for bacterial or fungal etiologies from an endogenous source. He began antimicrobial therapy. Diagnostic vitrectomy was unrevealing. Syphilis testing was positive. The patient showed improvement with IV antiluetic therapy. Conclusions: We present a case of syphilitic hypopyon panophthalmitis, a new constellation of findings in syphilitic ocular disease.
HMGB1 in the mPFC governs comorbid anxiety in neuropathic pain
Authors: Du Yu , Xu Ceng-Lin , Yu Jie , Liu Keyue , Lin Shi-Da , Hu Ting-Ting , Qu Feng-Hui , Guo Fang , Lou Guo-Dong , Nishibori Masahiro , Hu Wei-Wei , Chen Zhong , Zhang Shi-Hong 
Published: August 2022

Abstract
Background
Whether neuroinflammation causes comorbid mood disorders in neuropathic pain remains elusive. Here we investigated the role of high mobility group box 1 protein (HMGB1), a proinflammatory cytokine, in the medial prefrontal cortex (mPFC) in anxiety comorbidity of neuropathic pain.

Methods
Neuropathic pain was induced by partial transection of the infraorbital nerve (p-IONX) or partial sciatic nerve ligation (PSL) in mice and evaluated by measuring nociceptive thresholds to mechanical and heat stimulation. Anxiety-like behaviors were assessed by elevated plus maze, light dark box and open field tests. Aversive or anti-aversive effect was detected by conditioned place preference test. Neuronal activity was evaluated by single-unit and patch clamp recordings. The contribution of mPFC pyramidal neurons to anxiety was further examined by selectively inhibiting them by optogenetics. HMGB1 expression was measured by immunohistochemistry and western blotting. Antagonism of HMGB1 was achieved by injecting anti-HMGB1 monoclonal antibody (mAb) intracerebrally or intraperitoneally.

Results
Anxiety-like behaviors were presented earlier after p-IONX than after PSL. HMGB1 expression was upregulated in the mPFC temporally in parallel to anxiety onset, rather than in other regions associated with anxiety. The upregulation of HMGB1 expression and its translocation from the nucleus to cytoplasm in the mPFC occurred predominantly in neurons and were accompanied with activation of microglia and astrocytes. Infusion of anti-HMGB1 mAb into the mPFC during the early and late phases after either p-IONX or PSL alleviated anxiety-like behaviors and aversion without changing pain sensitization, while local infusion of exogenous ds-HMGB1, the proinflammatory form of HMGB1, into the mPFC induced anxiety and aversion but not pain sensitization in naïve mice. In addition to reversing established pain sensitization and anxiety simultaneously, intraperitoneal injection of anti-HMGB1 mAb reduced HMGB1 upregulation and suppressed the hyperexcitability of layer 2/3 pyramidal neurons in the mPFC after p-IONX. Moreover, optogenetic inhibition of mPFC pyramidal neurons alleviated anxiety in p-IONX mice.

Conclusion
These results demonstrate that HMGB1 in the mPFC drives and maintains anxiety comorbidity in neuropathic pain by increasing the excitability of layer 2/3 pyramidal neurons, and justify antagonism of HMGB1, e.g., neutralization by mAb, as a promising therapeutic strategy for neuropathic pain with anxiety comorbidity.