bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post−discharge mortality in the first wave of COVID−19 in Turkey
Authors: Fakili Fusun , Cetinkaya Pelin Duru , Baydar Oya , Baris Serap Argun , Kokturk Nurdan , Kul Seval , Karcioglu Oguz , Yildiz Pinar Aysert , Irmak Ilim , Sekibag Yonca , Azak Emel , Mulamahmutoglu Sait , Cuhadaroglu Caglar , Kerget Bugra , Ketencioglu Burcu Baran , Ozger Hasan Selcuk , Ozkan Gulcihan , Ture Zeynep , Ercelik Merve , Ciftci Tansu Ulukavak , Alici Ozlem , Temel Esra Nurlu , Ataoglu Ozlem , Kose Neslihan , Tor Muge Meltem , Gunluoglu Gulsah , Altin Sedat , Ozturk Onder , Gulhan Pinar Yildiz , Basyigit Ilknur , Boyaci Hasim , Oguzulgen I. Kivilcim , Borekci Sermin , Gemicioglu Bilun , Hanta Ismail , Okur Hacer Kuzu , Sagcan Gulseren , Akgun Metin , Kalyoncu Ali Fuat , Itil Oya , Bayram Hasan 
Published: November 2022

Objective:
To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish Thoracic Society (TTD)-TURCOVID study.

Methods:
In this retrospective cohort study, we analyzed the data of 18 of 26 centers included in the first TTD-TURCOVID study, and 1 112 cases diagnosed with COVID-19 between 11 March and 31 July 2020 participated in the study. All causes of death after COVID-19 discharge were recorded.

Results:
The mean age of the patients was (51.07±16.93) years, with 57.6% male patients. In the cohort group, 89.1% of COVID-19 treatment locations were hospital wards, 3.6% were intensive care units (ICUs), and 7.2% were community outpatients. In the longterm follow-up, the in-hospital mortality rate was 3.6% (95% CI 2.64.8), the post-discharge mortality rate was 2.8% (95% CI 1.9-3.9), and the total mortality was 6.3% (95% CI 5.0-7.8). After discharge, 63.3% of mortality overall occurred during the first six months. Mortality rates in post-discharge follow-ups were 12.7% (95% CI 8.0-30.6) in cancer patients, 10.8% (95% CI 6.3-22.9) in chronic obstructive pulmonary disease patients, 11.1% (95% CI 4.4-22.7) in heart failure patients, 7.8 (95% CI 3.8-14.3) in atherosclerotic heart disease patients, and 2.3% (95% CI 0.8-5.6) in diabetes mellitus patients. In smokers/ex-smokers, the all-mortality rates were higher than in non-smokers.

Conclusions:
This multicenter study showed that patients over 65 years of age, males, former/active smoker, ICU stay, lung, heart disease, and malignancy should be followed up for at least the first six months after discharge due to COVID-19.
EUS-guided coil placement and cyanoacrylate glue injection for gastric variceal bleeding with obvious spontaneous portosystemic shunts
Authors: Tang Li , Li Xu , Cui Jun , Huang Liu-Ye 
Published: November 2022

ABSTRACT

Background and Objective:
Ectopic embolism caused by cyanoacrylate glue for the treatment of gastric varices with obvious spontaneous portosystemic shunts is a serious complication of endoscopic therapy. This study was performed to investigate the safety and therapeutic effect of EUS-guided coil placement and cyanoacrylate glue injection for gastric varices with obvious spontaneous portosystemic shunts.

Materials and Methods:
Six patients with gastric variceal bleeding and obvious spontaneous portosystemic shunts were included in this study. We evaluated the success rate of variceal occlusion after intraoperative embolization, the postoperative rebleeding rate at 48 h and 2 weeks posttreatment, and the incidence of ectopic embolism and other adverse events. Gastroscopy and computed tomography portal venography (CTPV) were performed 7 months later.

Results:
All patients underwent successful coil placement and cyanoacrylate glue injection under EUS guidance. The blood flow was confirmed by Doppler examination, the target vessels were successfully blocked, and no rebleeding had occurred at 48 h or 2 weeks after endoscopic treatment. Gastroscopy was repeated 7 months after endoscopic treatment, revealing local ulcer formation. CTPV was also repeated 7 months after endoscopic treatment, showing that the coils were present in the target vessels with no displacement, the portosystemic shunt vessels were occluded, and no ectopic embolization had occurred.

Conclusion:
The coil placement combined with cyanoacrylate glue embolism is a safe and effective method for patients with gastric variceal bleeding and obvious spontaneous portosystemic shunts.
Comparison between EUS-guided fine-needle biopsy with or without rapid on-site evaluation for tissue sampling of solid pancreatic lesions: A systematic review and meta-analysis
Authors: Facciorusso Antonio , Gkolfakis Paraskevas , Tziatzios Georgios , Ramai Daryl , Papanikolaou Ioannis S. , Triantafyllou Konstantinos , Lisotti Andrea , Fusaroli Pietro , Mangiavillano Benedetto , Chandan Saurabh , Mohan Babu P , Crinò Stefano Francesco 
Published: November 2022

ABSTRACT
The benefit of rapid on-site evaluation (ROSE) on the diagnostic accuracy of EUS–guided fine-needle biopsy (EUS-FNB) in patients with pancreatic masses is still matter of debate. Aim of our meta-analysis is to compare the diagnostic outcomes of these two tissue acquisition strategies. Computerized bibliographic search on the main databases was performed through December 2021 and 8 studies were identified (2147 patients). The primary outcome was sample adequacy. Pooled effects were terms of odds ratio (OR) or mean difference and 95% confidence Interval (CI). There was no difference in terms of baseline variables between the two groups. Pooled sample adequacy was 95.5% (95% CI 93.2%–97.8%) and 88.9% (83.4%-94.5%) in the EUS-FNB + ROSE and EUS-FNB groups, respectively (OR = 2.05, 0.94–4.49; P = 0.07). Diagnostic accuracy resulted significantly superior in the EUS-FNB + ROSE group (OR = 2.49, 1.08–5.73; P = 0.03), particularly when the analysis was restricted to reverse bevel needle (OR = 3.24, 1.19–8.82, P = 0.02), whereas no statistical difference was observed when newer end-cutting needles were used (OR = 0.71, 0.29–3.61, P = 0.56). Diagnostic sensitivity was not significantly different between the two groups (OR = 1.94, 0.84–4.49; P = 0.12), whereas pooled specificity was 100% with both approaches. The number of needle passes needed to obtain diagnostic samples was not significantly different (mean difference 0.07,-0.22 to 0.37; P = 0.62). Our meta-analysis stands for a non-superiority of EUS-FNB + ROSE over EUS-FNB with newer end-cutting needles, whereas ROSE could have still a role when reverse bevel needles are used.
Small nonfunctional pancreatic neuroendocrine neoplasms: Time for a step-up treatment approach?
Authors: Rimbaş Mihai , Rizzatti Gianenerico , Tosoni Alberto , Impagnatiello Michele , Panzuto Francesco , Larghi Alberto 
Published: November 2022

ABSTRACT
Surgery has been regarded as the only curative treatment for patients with small nonfunctional pancreatic neuroendocrine neoplasms (NF-PNENs) less than 2 cm. Due to the significant adverse event rates of surgery, the European Neuroendocrine Tumor Society issued guidelines favoring surveillance for those patients lacking criteria suggestive of an aggressive disease. Despite the above recommendations, a significant proportion of small NF-PNEN patients still undergo surgery. Recently, several studies have reported the safety and effectiveness of EUS-guided radiofrequency ablation (RFA) for the treatment of small NF-PNENs. The experience with EUS-RFA is, however, limited, but published results indicate a potential role as a minimally invasive alternative treatment for these patients, in particular in those in whom further progression is more probable, before they reach the absolute need for surgery. A step-up approach with EUS-RFA followed by surgery for the failure cases can become a valid option to be validated in clinical studies.
The clinical efficacy and safety of TACE combined with apatinib for advanced hepatocellular carcinoma: A propensity score matching analysis
Authors: Chen Cheng , Duan Xiaoting , Shen Yanfeng , Li Guiying 
Published: November 2022

Background:
The combined treatment of transcatheter arterial chemoembolization (TACE) and apatinib had beneficial effects on the survival of patients with advanced hepatocellular carcinoma (HCC), but the efficacy of this regimen is still controversial and needs further investigation.

Materials and Methods:
The clinical records of advanced HCC patients between May 2015 and December 2016 were collected from our hospital. They were categorized into the TACE monotherapy group and the combination of TACE and apatinib group. After propensity score matching (PSM) analysis, the disease control rate (DCR), objective response rate (ORR), progression-free survival (PFS), and occurrence of adverse events were compared between the two treatments.

Results:
There were 115 HCC patients included in the study. Among them, 53 received TACE monotherapy and 62 were treated with TACE plus apatinib. After PSM analysis, 50 pairs of patients were compared. The DCR of the TACE group was significantly lower than that of the combination of TACE and apatinib group (35 [70%] versus 45 [90%], P < 0.05). The ORR of the TACE group was also significantly lower than that of the combination of TACE and apatinib group (22 [44%] versus 34 [68%], P < 0.05). Patients who received the combined treatment of TACE and apatinib had longer PFS compared with those in the TACE monotherapy group (P < 0.001). Moreover, hypertension, hand–foot syndrome, and albuminuria were more common in the combination of TACE and apatinib group (P < 0.05), although all adverse events were well tolerated.

Conclusions:
The combined treatment of TACE and apatinib showed beneficial effects on tumor response, survival outcomes, and tolerance to treatment, which may be used as a routine regimen for advanced HCC patients.
Molecular characterization of BK virus detected in renal transplant patients in Sri Lanka: a preliminary study
Authors: Ratnayake A.K.D. Varuni Yashodha , Fernando Narmada , Gajanayake Thusitha , Handunnetti Shiroma Mangalika , Jayamaha S. Chrishan Jude 
Published: November 2022

Background & objectives:
BK virus (BKV) is a polyomavirus and cause of a common infection after renal transplantation which could be preceded to BKV-associated nephropathy. It has four main subtypes (I–IV). BKV subtypes II and III are rare, whereas subtype I shows a ubiquitous distribution. The objective of the present study was to investigate the prevailing BKV subtypes and subgroups in renal transplant patients in Sri Lanka.

Methods:
The presence of BKV in urine was tested through virus load quantification by real-time PCR from 227 renal transplant patients who were suspected to have BKV infection. Of these patients only 41 were found to be BKV infected (>103copies/ml) and those were subjected to conventional PCR amplification of VP1 gene followed by BKV genotyping via phylogenetic analysis based on DNA sequencing data.

Results:
Persistent BK viral loads varied from 1×103 to 3×108 copies/ml. Of the 41 patient samples, 25 gave positive results for PCR amplification of subtyping region of VP1 gene of BKV. BKV genotyping resulted in detecting subtype I in 18 (72%) and subtype II in seven (28%) patients. BKV subgroups of Ia, Ib-1 and Ib-11, and Ic were identified with frequencies of 6/18 (33.3%), 6/18 (33.3%), 5/18 (27.8%), and 1/18 (5.6%), respectively.

Interpretation & conclusions:
Findings from this preliminary study showed a high occurrence of subtype I, while the presence of subtype II, which is rare and less prevalent, was a novel finding for this Asian region. This emphasizes the need for further molecular and serological studies to determine the prevalence of different BKV subtypes in Sri Lanka.
Effect of the Coronavirus Disease 2019 Pandemic on Suicide-Related Trauma Burden at a Level 1 Trauma Center
Authors: Eden Claire M. , Zhu Roger , Khedr Shahenda , Khariton Konstantin 
Published: November 2022

Introduction:
In March 2020, the first coronavirus disease 2019 (COVID-19) cases were reported in New York and a stay-at-home order was enacted soon after. Social isolation combined with pandemic-related stressors profoundly affected mental health. We hypothesize that there was an increase in violent suicide attempt during the COVID-19 pandemic lockdown compared to previous years.

Methods:
We queried our institutional trauma registry for total number of trauma activations and identified adult patients with International Classification of Diseases-10 diagnosis of intentional self-harm. We compared incidence during the lockdown to corresponding time periods from previous years. Demographic and injury characteristics were compared, as were outcomes such as mortality.

Results:
We observe a significant uptrend in patients requiring trauma intervention after suicide attempts from July 2019 through July 2020 (r = 0.8, P < 0.001) despite a significant downtrend in trauma volume at our institution during the same period (r = [FIGURE DASH]0.7, P = 0.003). Although not statistically significant, patients attempting violent suicide during lockdown were more likely to have preexisting psychiatric diagnoses, to live alone, to have injury severity score >9, and to require surgical intervention. Three COVID-period patients died in the emergency room compared to zero in the comparison group.

Conclusion:
Our data show a rise in violent suicide attempts during the pandemic lockdown despite an overall decrease in trauma volume. The ramifications of a stay-at-home order seem to have the most profound impact on individuals with preexisting mental health disease. Early establishment of mental health outreach programs may mitigate the reverberating psychosocial consequences of a pandemic.
Predictive Factors for Failure of Limb Salvage in Blunt Leg Trauma Associated with Vascular Injuries
Authors: Al-Zoubi Nabil A. , Shatnawi Nawaf J. , Khader Yousef , Heis Mowafeq , Aleshawi Abdelwahab J. 
Published: November 2022

Introduction:
Blunt leg trauma is common; however, it is rarely associated with significant vascular injury. This study was undertaken to determine the risk factors attributed to failure of limb salvage in acute postoperative period in blunt leg trauma with vascular injuries after revascularization.

Methods:
A retrospective analysis was conducted of all patients with blunt leg trauma involving bone and soft tissue associated with vascular injuries. They were studied in terms of demographic data, associated comorbidities, mechanism of trauma, associated extra leg injuries, type and nature of bone fractures, soft-tissue injuries, nerve injuries, time of ischemia, Injury Severity Score (ISS), Mangled Extremity Severity Score (MESS), injured vascular segments, modality of vascular repair, modality of bone fixation, thrombosis at the site of vascular repair, complications, limb salvage failure, and mortality.

Results:
Vascular injuries were identified in 45 arterial segments and 9 popliteal veins among 31 patients. The patients were 93% male, with a mean age of 31 years. The MESS ranged from 6 to 11, and the ISS ranged from 9 to 41. The main pathology of the injured vessels was contusion/thrombosis in 28 legs, which were repaired by interposition-reversed long saphenous vein graft. Seven patients developed postoperative thrombosis and underwent thrombectomy/embolectomy. Failure of limb salvage occurred in seven limbs with no mortality.

Conclusions:
Severe multi-segmental bone fractures, prolong ischemic time of >10 h, and MESS of ≥9 are significant predictors of limb loss in patients with blunt leg trauma in association with vascular injuries.
Knowledge and use of sunscreens among traders at an urban market in Lagos, Nigeria
Authors: Otrofanowei Erere , Anaba Ehiaghe Lonia , Akinkugbe Ayesha Omolara , Adeife-Cole Olufolakemi , Ayanlowo Olusola , Ikebudu Viola , Sarkar Rashmi 
Published: November 2022

Introduction:
Public health awareness on sun-protection practices especially sunscreen use is established in developed countries compared with some other tropical African countries. Open-market traders in Nigeria, who typically have black skin, spend up to 8 hours in daylight with unprotected sun exposure.

Aim:
To determine prevalence of the knowledge of sunscreen use and to discover if adequate and appropriate sunscreen use is practiced by market traders.

Methods:
Cross-sectional study on 307 consenting traders at Sandgrouse Market in Lagos, Nigeria. Demographic data and responses to questions on sun exposure and its effects, knowledge and use of sunscreen, source of knowledge, and frequency of application were documented with a predesigned study questionnaire. Data were analyzed with SPSS 22.

Results:
More females (207; 67.4%) were observed and the mean age was 42.7 ± 12.8 years, though most were within the 35- to 39-year age range. One-third (102; 33.2%) were unaware that sun exposure could damage the skin and only 30 (9.8%) were aware of or knew what sunscreen meant. Commercials or advertisements were the most common source of knowledge and females were significantly more aware of sunscreens (P = 0.018).

Conclusion:
There is poor knowledge and awareness of the use of sunscreen among urban market traders in Nigeria who have prolonged unprotected exposure during their daily activities. Females were significantly more aware of sunscreens than males but there was no significant difference in the use pattern.
Pityriasis alba
Authors: Ramteke Komal A. , Kar Sumit , Patrick Safa , Sawant Ajinkya , Ambhore Vivek 
Published: November 2022

Background:
Pityriasis alba (PA) is a common, benign skin disorder occurring predominantly in children and adolescents. It is characterized by the presence of multiple, ill-defined, hypopigmented patches with fine scaling particularly over the face.

Aims and objectives:
To study the clinical characteristics and epidemiologic parameters in the context of current scenario in a rural tertiary care hospital in central India.

Materials and methods:
We conducted a descriptive observational study over a period of 1 year. We studied 100 clinically diagnosed patients with PA of the age group 2 to 15 years during this study.

Results:
Most common age group of patients observed was 6 to 10 years. About 87% patients had Fitzpatrick skin type IV followed by type III (7%) and type V (6%). Male to female ratio was 1.17:1. Maximum patients belonged to class III (50%) followed by class IV (37%) and class V (10%) according to the modified Kuppuswamy socioeconomic status scale (2018). Maximum patients had age of onset ranging from 6 to 10 years. Clinical characteristics revealed that maximum patients had 0 to 5 patches, with a duration of 1 to 2 months most commonly over cheeks. Associated features such as itching, scaling, and erythema were present in 18%, 98%, and 1% of the patients, respectively. Pallor was observed in 28% patients. However, significant history of atopy was elucidated in only 21% of patients. Around 6% patients showed positive family history of having PA and 14% having a positive history of atopy in first-degree family members.

Conclusion:
Due to the easily visible hypopigmented patches most commonly over face, PA is a common cause of concern in pediatric age group. In recent times, possibility of multiple factors other than atopy should be kept in mind while thinking of the associating or implicating factors which will lead to proper management of this pigmentary disorder.
Validation of the health-related quality of life questionnaire for adult strabismus AS-20 in the Arabic language
Authors: Alamri Reem Saleh , Alyousef Mayar Abdulkarim , Bamardouf Noha Omar , Alharbi Badr Ali , Raffa Lina H. 
Published: November 2022

Background:
The impact of strabismus to the quality of life (QoL) in adult patients has not been assessed and explored in Arab countries.

Aims:
This study aims to assess the validity and reliability of the Arabic-translated adult strabismus-20 (AS-20) questionnaire in determining the impact of strabismus on health-related QoL (HRQoL) of patients.

Settings and Design:
A cross-sectional study on the psychosocial and functional scores collected from 161 adult patients with strabismus, diagnosed from 2011 to 2021 in King Abdulaziz University Hospital, Jeddah City. Population with no strabismus manifestation was used as the control group.

Subjects and Methods:
One hundred and sixty-one adult patients, with a minimum age of 18 years with manifest strabismus, were contacted via phone calls to answer the QoL questionnaire list using Arabic-translated AS-20 questionnaire.

Statistical Analysis Used:
A model of Alpha (Cronbach) was used to determine the reliability test of the Arabic-translated AS-20 questionnaire. A comparison of two mean scores was performed using an independent t-test or Welsch's t-test, which was only significant at < 0.05 level.

Results:
The overall AS-20 mean scores for male and female adults were 66.79 ± 28.2, with a total psychosocial and functional mean score of 65.70 ± 30.9 and 67.88 ± 30.8, respectively. In general, female patients have a higher mean score than male patients for all the subscale items, except item 6. The case group, involving strabismic patients, showed significantly lower AS-20 scale mean scores as compared to control (48.53 ± 25.8 vs. 83.48 ± 18.1), with mean scores of 43.85 ± 25.9 and 53.87 ± 24.8 for males and females, respectively. Moreover, excellent overall score was obtained in internal consistency (Cronbach's alpha = 0.918).

Conclusions:
With its excellent test-retest reliability results, the Arabic version of the AS-20 questionnaire was an applicable tool for assessing strabismus among Arabic-speaking patients. Prominent impact of strabismus on patient's HRQoL was determined by the significantly lower AS-20 scores of the patients than those of the control.
Assessment of awareness, experience, and attitude of Saudi women about oral health changes during the menstruation
Authors: Almutairi Abdullah Saleh 
Published: November 2022

Background:
One of the systemic conditions that lead to several changes in the oral cavity is hormonal changes which occur during puberty, menstruation, pregnancy, or menopause, so the awareness of women about these oral changes during the menstruation is important to motivate them toward maintaining good oral hygiene to prevent or reduce oral health changes during menstruation and to seek treatment if needed and not ignore them.

Aims:
This study aims to assess awareness, experience, and attitude of Saudi healthy menstruating women about oral health changes during menstruation.

Setting and Design:
This study was performed by distributing a questionnaire in the Arabic language to 401 healthy menstruating females between 18 and 45 years of age among the general population of Saudi Arabia.

Methodology:
A self-administered closed-end questionnaire was designed comprising 21 questions to assess the awareness, experience, and attitude of females about oral health changes during menstruation.

Statistical Analysis Used:
The frequency analysis and percentages for all answers were calculated. In addition, pairs of Chi-square analyses were conducted between the dependent and independent variables.

Results:
This study's results showed that halitosis was the oral change that the participants experienced most during their menstruation followed by a mouth burning sensation (36.4%), gingival bleeding (33.9%), alteration in taste sensation (31.2%), gingival swelling (30.2%), formation of oral ulcers (23.25), and increased tooth mobility (18.7%). 53.11% of the participants in this study were aware of the relationship between menstruation and oral health changes and 48.87% of them agreed that maintaining good oral hygiene can reduce these oral changes during menstruation.

Conclusion:
More than half of the participants in this study were aware of the relationship between menstruation and oral health changes and approximately half of them agreed that maintaining good oral hygiene can reduce these oral changes during menstruation.